Currently, the PA Link uses Medicaid administrative funds matched by Pennsylvania Lottery funds to support its programs. Before 2015, person-centered counseling activities were reimbursed at a rate that was not attractive enough for many partners to invest the time in the paperwork needed to receive the reimbursement. The per-engagement rate for person-centered counseling was increased in 2015 in response to partner feedback. The PA Link will continue to research and pursue funding and reimbursement paths from both public and private resources.
Page 41 of 47 Streamlined Access to Public Programs
Pennsylvania has invested in efforts to streamline access to public programs and will continue to improve in this area. Through the Balancing Incentive Program, Pennsylvania has developed an online level one screening tool called the Information and Referral Tool (IRT). The IRT will allow consumers to perform a functional self-assessment that will point them to LTSS services that can assist them. The results of the level one assessment is in the form of links and contact information to program offices, the PA Link Web Resource Center and COMPASS.
The PA Link Web Resource Center is a public website that provides consumers with the ability to search for specific LTSS providers based on consumers’ location and functional needs. For example, consumers could search for respite services for an older Pennsylvanian in a specific county. It contains an electronic toolkit where consumers can find downloadable information on a variety of programs and services. The Web Resource Center also provides information and links to the IRT and COMPASS.
Currently the state COMPASS system allows consumers to determine their likely eligibility for public programs (Medicaid and Supplemental Nutrition Assistance Program) and apply online. Similar functionality will be added for HCBS/LTSS waiver programs by March 2016. This will not only enable consumers with Internet access to speed determinations, it will also provide a helpful tool for person- centered counselors to use with consumers in starting the process. PA Link partners are encouraged to participate in the COMPASS Community Partner program which allows them to assist individuals in completing applications and in monitoring the progress of applications, allowing partners to step in when needed to help consumers with the process and to explore private resources as a supplement.
The Information and Referral Tool, updated COMPASS site and PA Link Web Resource Center are scheduled to “go live” in March 2016.
Having the tools is not the end of the process. There also needs to be a coordinated, networked approach among local and regional agencies and organizations in the LTSS network. Local and regional staff must be educated about how to use these state-provided tools, how to work with consumers to get the most out of the tools and how to update their information and processes so that referrals are accurate, efficient and effective. Staff that interact with consumers will receive training on how to use the tools. Administrative staff will receive updates on how to update information and manage referrals. This training will be provided through current PA Link partner channels.
Online tools and an educated network will streamline access to Pennsylvania’s LTSS programs. Final functional eligibility analyses for public programs will continue to follow current
processes. Level of care determinations and intake assessments require specialized skills in different LTSS specialty areas. Person-centered counselors help to prepare consumers for these assessments as part of their normal engagements. Functional eligibility assessments will be
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further streamlined with Pennsylvania’s implementation of Managed Long Term Services and Supports scheduled to begin in 2017.
1. Goal
Pennsylvania will ensure that its NWD/PA Link partners are fully trained on all LTSS screening, education and referral tools.
2. Activities
Pennsylvania will provide documentation, trainings and updates on the use of the tools through its PA Link partner network. The timing will coincide with the “go live” dates of the COMPASS and Information and Referral Tool sites.
3. Group Responsible
The NWD project team is ultimately responsible for the training. PA Link staff will be the likely training agents to educate the PA Link partners in their regions. PA Link coordinators in local Service Areas will also provide updates through regular PA Link meetings.
4. Target Dates
The trainings dates will depend on the “go live” dates of the online tools. Training will likely occur one to three months after the initial date. This allows for piloting, testing and developing training materials and best practices/processes for PA Link partners.
5. Potential Barriers
Adopting new practices and systems requires effective training. Adoption depends on how well the system is marketed and made relevant to PA Link partners.
6. Outcome Measures
The success of the implementation of the IRT, Web Resource Center and COMPASS platforms will be measured by their accuracy and timely availability to the public. Over time, usage rates will reflect the effectiveness of marketing these resources.
In addition, long-term measures of the time from initial application, assessment and eligibility determinations to service start dates will provide insight into how efficient and seamless the system has become. These kinds of metrics will be part of Pennsylvania’s Continuous Quality Improvement Plan.
7. Budget
The only budget implication for this goal would be if the PA Link opted to engage an outside vendor to develop training materials and facilitate train-the-trainer sessions for regional and local PA Link staff.
Page 43 of 47 8. Priority
This is a high priority goal. Tools are only as effective as the individuals using them and guiding others.
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Overall NWD Plan Performance
The NWD Governing Body will assess progress on the NWD goals by monitoring short and long-term performance metrics noted for each goal. Performance metrics for each goal include both LTSS system performance and consumer satisfaction measures.
1. Develop and implement a single IT solution for PA Link operations and program management including: person-centered planning, referrals, data gathering, outcome reporting and web resource center.
The project’s success will be measured by how well it met its objectives including design accuracy, zero defect programming, training effectiveness and user acceptance. (Deliver on time and within budget are measured as base requirements as well.) The after-action report will rate how well the IT support organization and the internal NWD project team met stakeholder expectations of the system and its implementation.
The application will be tested against the design specification developed in the business analysis phase. Users will rate ease-of-use, availability and the quality of the change management process. NWD project teams will measure how well the IT support organization met its requirements in terms of project management and communication. The long-term usefulness of the IT platform will be measured by “before and after”
survey scores measuring PA Link/NWD partner satisfaction with the system. Another measure will be the number of system change orders required to meet needs as PA Link partners use the product. The ultimate measure will be in terms of how efficiently and effectively consumers are served.
2. Develop a person-centered counseling certification process for PA Link partners.
The immediate success of the certification program goal will be measured by PA Link Partner compliance with the requirements and the percentage of counselors certified and recertified.
Longer-term measures involve how well counselors apply the skill and knowledge
attained. Metrics will include items such as: timeliness of consumer services, using a person-centered approach, consumers expressing that they are being heard, the time to connect consumers to services, consumer perceptions of the counselor and process and others related to the overall Continuous Quality Improvement plan. The person-centered counseling Quality Assurance Tool is already in development and will be used as a basis of the CQI plan.
3. Ensure that NWD/PA Link partners are fully trained on all LTSS screening, education and referral tools.
The success of the implementation of the IRT, Web Resource Center and COMPASS
platforms will be measured by their accuracy and timely availability to the public. Over time, usage rates will reflect the effectiveness of marketing these resources.
In addition, long-term measures of the time from initial application, assessment and eligibility determinations to service start dates will provide insight into how efficient and
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seamless the system has become. These kinds of metrics will be part of Pennsylvania’s Continuous Quality Improvement Plan.
4. Standardize Statewide Quality Assurance and Continuous Quality Improvement (CQI)
functions for the PA Link.
Success for the CQI program will be based on its comprehensiveness, consumer-focus and accuracy of metrics. The consumer-focus will be reflected in the final program’s inclusion of consumer recommendations for quality discovered in the stakeholder engagement process. The accuracy of metrics will be determined by management acceptance of the data elements. Comprehensiveness will be determined by the initial criteria identified in the project kickoff phase, but will include quality measures related to: consumer outcomes, consumer perceptions, provider competence, provider capacity, IT systems effectiveness and LTSS provider relations.
5. Implement an outreach and onboarding program for PA Link/NWD partners.
Short-term measures of the success of the onboarding package will include reviews of educational sessions and the clarity and usefulness of supporting documentation. Short- term measures will also include how much existing PA Link partners reengage with the network—as measured by attendance at functions, communication among partners and addition of person-centered planning services.
Long-term measure of the success of the onboarding and outreach packages will include a measure of new PA Link partners as well as any formalized linkages with affinity organizations.
6. Assess current capacity of PA Link/NWD system.
Success for the current LTSS system’s unmet need and capacity assessment will be based on its thoroughness as measured by acceptance of the methodology, scope of data
collected and effectiveness of the analysis and its presentation. If executed well, the assessment and its findings will be accepted by executive leadership.
Longer term monitoring will involve how effectively Pennsylvania ensures that individuals receive the services they need in the setting of their choice. Baseline information in the capacity survey will be used in the CQI program surveys to assess improvements in access to services, the quality of care and preferences of location. 7. Expand and develop state level executive oversight of the PA Link/NWD system.
Currently, executive leadership of PA Link/NWD is in the PA Department of Aging.
However, because the PA Link serves consumers in specialty areas whose executive oversight is in different agencies (Department of Humans Services and Department of Military and Veterans Affairs) the PA Link reports to and receives input from multiple agencies. This will continue with overall oversight being a function of all three agencies. Specific success on the legislative goal above will be measured by passage of the bill and
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Intermediate success will be measured by how well the NWD project team and its partners prepare materials and deliver support related to passage of the bill.
8. Develop more formal communication strategies with NWD/LTSS stakeholders.
The communications platform project success will be measured by its adoption and use by NWD partners. A longer-term measure will be used via a survey. During the NWD planning process, PA Link partners were asked to rate communication effectiveness. A follow-up survey one-year after the implementation of the communications platform will measure its usefulness and effectiveness for PA Link partners.
9. Standardize and promote the PA Link brand across the Commonwealth.
Short-term measures of the success of the branding project include evaluations of the branding sessions, consumer acceptance of branded materials and timeliness of project completion.
Long-term measures will include brand-recognition and brand-understanding metrics. As part of the NWD Planning Grant Project, potential partners were surveyed about their understanding of the PA Link message and mission. Follow-up surveys after brand implementation can measure how effectively new materials and communication have increased overall understanding of the PA Link and its lead role in facilitating a NWD system in Pennsylvania.
NWD Communication and Marketing Plan
The NWD Communication Plan has two key elements: communicating plan performance to key constituents and stakeholders and communication with the general public.
Constituent and Stakeholder Communication
The NWD Planning Project used multiple methods to communicate with stakeholder groups. These methods worked well and will be refined moving forward.
Agency leadership communication included bi-weekly briefings in the Rebalancing Initiatives Leadership Team. Project leadership communication included bi-weekly conference calls and emails.
Workgroup teams met bi-monthly (and more often as needed) by webinar to discuss
strategies and develop plans.
Stakeholder communication occurred on several fronts including: bureau updates from agency leadership, stakeholder outreach sessions and stakeholder project e-updates. These forms of communication will be used as plan elements are implemented. Each plan objective is a discrete project that includes a project sponsor (agency leadership), project manager (agency staff) and a workgroup team (stakeholders.) Each objective/project team will develop and implement a specific project communication plan based on the practices developed in the NWD Planning Project. In addition to project communication, executive reports and
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briefing papers will be developed for agency leadership, legislative staff and key leadership in affinity organizations in the LTSS network.
Communication with the General Public
When Pennsylvania has finalized its portfolio of projects and timelines to move to a NWD approach, the project team will produce branded reports and briefing papers for the general public. These will mirror the executive reports prepared for agency leadership and legislators. Key milestones will be published on the PA Link website and project updates will be available for interested individuals.
Mass marketing to the general public will occur in a managed, graduated fashion. Key goals in the plan include updating partner responsibilities, refining governance and developing a NWD brand.
In addition, Pennsylvania intends to measure system capacity based on likely person-centered counseling needs and to build capacity in the network to meet the needs. When the updated mission, goals, measures, brand, capacity and infrastructure are in place the PA Link/NWD approach can be marketing more broadly to the general public.
Outreach and marketing would focus on where consumers in need would be found: hospitals, schools, corporations, associations, houses of worship, clubs, grocery stores and others. Materials would include brochures, video, fact sheets, presentations and press releases.