Connecticut’s Veterans-Directed Care Program Outcomes Compared to HCBS Waiver Participants: HCBS CAHPS Results

Connecticut (CT) Veterans Directed Home and Community Based Services Program (VDC) is an innovative Veterans Administration (VA) services option providing veterans at risk of institutionalization with person-centered consumer-directed long-term services and supports at home. Funded by an Administration for Community Living grant, the CT Department of Aging and Disability Services partnered with the VA, the five CT Area Agencies on Aging, and UConn Health Center on Aging (UConn). UConn researchers conducted the Consumer Assessment of Healthcare Providers and Systems in Home and Community Based Services (HCBS CAHPS) survey with VDC participants (n=36) from October 2019 through March 2020. The standardized, validated HCBS CAHPS survey, which Connecticut administers to individuals in most CT Medicaid HCBS programs, is a universal, cross-disability tool to assess/improve the quality of HCBS programs. Analyses compared VDC participants’ program experiences to survey results from individuals in the Connecticut Home Care Program (CHCP) (for older adults) (n=629), Personal Care Assistance (PCA) (n=282), and Acquired Brain Injury (ABI) (n=327) waiver programs. Notably, more VDC participants (91%) knew who their support broker was, compared to CHCP, ABI, and PCA (82%, 79%, and 72%, respectively) who knew their case manager; 91% of VDC participants gave their support broker the highest rating, compared to 66% to 74% of participants in other programs who rated their case manager. This study provides strong evidence that the CT VDC program is positively impacting veterans and that the AAAs and support brokers are effectively helping them receive the HCBS they need in a consumer-directed way.

THE EFFECT OF AN ARTIST-IN-RESIDENCE PROGRAM ON SELF-REPORTED LONELINESS IN OLDER ADULTS

The study, funded by the Pennsylvania Council on the Arts and the Pennsylvania Department of Aging, measured the effect that an artist in residence program (conducted by state-vetted professional teaching artists) had on self-reported loneliness in older adult. All participants were aged sixty years or older and participated in programming in state-funded adult community centers located in fourteen sites throughout the Commonwealth of Pennsylvania. Artists offered 10 sessions in creating and critiquing art to older citizens in the artists’ respective art forms including performing arts, visual arts and multidisciplinary/interdisciplinary arts. Through pre and post-tests, changes in loneliness were measured using the Revised UCLA Loneliness Scale. The data revealed that there was a significant correlation between a self-reported decrease in feelings of loneliness and participation in a program conducted by professional artists. . It was proposed that findings from the study could influence the quality of programs provided by state-funded adult community centers in Pennsylvania and increase funding levels to adult community centers throughout the Commonwealth of Pennsylvania.

WE READ HIS PAL CARD AT THE FUNERAL: EVALUATING THE IMPLEMENTATION OF A PERSON-CENTERED COMMUNICATION TOOL

This symposium describes the development and implementation of an interdisciplinary and novel person-centered care (PCC) communication tool in nursing homes (NH). PCC is a philosophy that recognizes “knowing the person” and honoring individual preferences. The communication tool is based on an assessment of NH resident likes and dislikes via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In 2016, the Ohio Department of Medicaid (ODM) mandated NHs use the PELI as one of the factors that determine the quality portion of their daily Medicaid reimbursement rate. The Preferences for Activity and Leisure (PAL) Card was developed to communicate important resident preferences across care team members. In 2018, the PAL Card Project was approved by the Ohio Department of Aging as a Quality Improvement Project. The first presentation will describe the implementation of PAL Cards with n=43 NH providers. The second presentation will present data regarding the acceptability, feasibility, and appropriateness of the communication tool as rated by providers. The final presentation explores provider qualitative responses regarding the characteristics of the PAL Card communication tool related to effective implementation. The Discussant, Dr. Howard Degenholtz will discuss the implications of initiatives to address the quality of resident care.

Challenges Facing Case Management in a Changing Social Service Environment

Case management has been a difficult practice to track, particularly for the purposes of outcome measurements and accountability. As both policymakers and program administrators consider options for providing long-term care, the Data Analysis and Regulations Team of the California Department of Aging studied computerized client information for one of its case management programs to examine what we know about the people being served and the ability of the data collection system to meet the increasing demand for accountability. This article details the results of our study and discusses their implications within the dynamics of a changing social service environment.