No Wrong Door: Promising Practices for Accessing Long-Term Services and Supports

No Wrong Door: Promising Practices for Accessing Long-Term Services and Supports


Photo courtesy of Sullivan County New Hampshire ServiceLink

Most of us will need long-term services and supports (LTSS), either for ourselves or our family members. However, most of us do not know about our options and how to pay for these services. That is why the LTSS State Scorecard—created by the AARP Public Policy Institute and funded by The Scan Foundation and The Commonwealth Fund—ranks states on their Aging and Disability Resource Centers. These Centers are an important feature of a high performing LTSS system.

Aging and Disability Resource Centers can serve as the gateway for helping individuals and their families find and access LTSS, including light housekeeping, transportation, and respite care to give family caregivers a break, just to name a few. States have these “one-stop-shopping” models to help people receive public and private services regardless of which organization they contact. Therefore, they are sometimes called “no wrong door.” If people contact an organization within this system, they can be connected with information, referrals, and supports, resulting in “no wrong door” to services irrespective of their age, income, or disability. Area Agencies on Aging, Centers for Independent Living, and state agencies such as Medicaid agencies and state units on aging work together to make up this no wrong door system. While the states have these centers, the operations and functions of each center vary greatly, which is why the Scorecard ranks them.

Although the previous two Scorecards included an indicator on these Centers, the upcoming third edition contains an updated indicator to reflect published guidance on key elements of no wrong door systems from the federal government. AARP, in collaboration with the U.S. Administration for Community Living and The Lewin Group, collected information for this indicator from a survey of state administrators. Then, they followed up by interviewing administrators from states that had scored well or demonstrated innovation to produce a newly released promising practices and toolkit paper on person- and family-centered practices.

This first in a series of promising practices and toolkit papers provides concrete examples of how six states—Connecticut, Michigan, New Hampshire, Virginia, Washington, and Wisconsin—plus the District of Columbia promote person- and family-centered practices in their no wrong door systems. These Centers are using an interactive process directed by individuals and family members to support decision making. They also help to develop a plan of support that reflects an individual’s and family’s strengths, preferences, needs, and values. It affirms the core principle that each person is the expert in his or her own life rather than simply plugging people into programs based on their eligibility.

The promising practices are:

 

  • Ensuring leadership support for these practices (with examples from the District of Columbia’s mayor-led cross-population task force, Michigan’s broad support for change, and Virginia’s state legislation on this practice);
  • Creating standards for these practices (with examples from Washington’s statewide standards of practice, Virginia’s co-employment model between aging and disability organizations, the District of Columbia’s intake to better listen to people and families, and Wisconsin’s follow-up);
  • Training the “no wrong door” workforce (with examples from New Hampshire’s training and certification, the District of Columbia’s training for all, New Hampshire’s peer support model, Virginia’s person-centered advocates, and Connecticut’s essay exam); and
  • Helping people maximize use of private resources (with an example from Wisconsin that has been a leader in serving private pay clients).

 

This promising practices and toolkit paper includes resources and contacts for state and federal administrators, providers, and advocates to learn about—and even replicate—these practices. This paper also provides a checklist of what is needed to move toward more person- and family-centered practices.

NOTE: The third edition of the Scorecard will be released soon … on June 14th. Promising practices and toolkits are a new feature of the Scorecard project. More papers—such as promising practices in preventing long-term nursing home stays—will be forthcoming. For the new Scorecard, the promising practices and toolkit papers, and more, please go to the LTSS State Scorecard interactive website at www.longtermscorecard.org.

 

Wendy Fox-Grage is a Senior Strategic Policy Advisor for the AARP Public Policy Institute. She works on state long-term services and supports issues, including Medicaid and home- and community-based services.

 

 

 

 

 



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Virginia County Explores How Technology Can Help Aging Population

Virginia County Explores How Technology Can Help Aging Population


It’s clear that a majority of people want to remain independent as they age and now technology can help them do so. As a Northern Virginia resident and an employee of AARP, I was drawn to a recent local event titled “Can Technology Help Older Arlingtonians Age Independently?”

The event was the fourth installment of Arlington County’s Digital Destiny campaign which seeks to explore the impact of the Digital Revolution on defined aspects of life for the county and its residents.

This session featured Arlington county employees, local residents and aging experts discussing tech trends likely to have the greatest impact on older Americans.

Speakers included:

  • Amy Doherty, Chief Information Officer and AARP
  • Brittany Weinberg, Director of Community Engagement,Aging2.0

 

Doherty discussed three emerging trends and how they can apply to aging independently:

  1. Leveraging virtual reality to make the aging experience real to people of all ages.
  2. Investigating ways that robotics can aid in caregiving and social isolation.
  3. How artificial intelligence could strengthen programs like the Fraud Watch Network that provide citizens with information on how to avoid scams.

 

Brittany Weinberg, the Director of Community Engagement, Aging2.0. explained how people-centered-design, including voice recognition and gesture controls, is improving the technology experience for people of a variety of ages and is helping to solve issues related to caregiving and social isolation. She also noted that the prevalence of sensors within the home helps enable people to age independently and live in their homes for as long as possible.

After each speaker presented, the audience was charged to brainstorm ways they thought technology could make their lives easier.

The ideas presented included:

  • Programs that enable schools to give back to the 50+ community by allowing children to tutor older adults
  • Programs like Cyber Seniors and AARP TEK were mentioned as existing resources to help educate adults about technology.
  • Libraries were mentioned as good resources and as go-to sites for downloading digital books, taking classes and accessing educational videos via Lynda.
  • The group also encouraged tech companies to design for all ages and accessibility



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