HomeMy WebLinkAboutDecember 18, 2018Hawaii County Office of
Aging (HCOA)
Case Management (C
Wl'bat'S Best for Ku puna?
Draft 12/18
What is Case Management
RFP No. HCOA.2018.KCCMS.01
Case Management Services helps Ca
g .e s and Care
2
S 11
ervi
for Seni ors (SFS
,,
Brief History
Provided case management services since 1989-
0
Processes and protocols have changed over the years from
SFS accepting referrals directly and/or referrals coming
through P&R Coordinated Services
And since the creation of the _ D
Staffing has remained relatively the same and clients have
increased overt e years ('774-0 u:.ri. is 016.; 10,000 u:.rl_ is 01.) as the
need for services and funding increased. Orh, Urll === ()nc, I In
3
Key Point:
HCOA always encouraged SFS to
Ex-Dand their Contract Options .. .
Because of the RFP process...
there is i. thelir
Contract.
4
... SFS attempted in the past to seek out other
contracts... such as..
1991: Awarded Caregi'v'er :.. w �, �. rpt , m � � . ,. rt
.
Demonstration . r . w ct (CDSDP).
1992: Crisis Intervention and Respite and Renovation
Grant allowing the purchasinsr of ..� �, ..t for
• 1999-2006: Hawaii Community Foundation Person -in -
Need funds allowed another funding stream to help with
respite, u.t.111ty, bills, alertsystems.
2011: Elder Abuse funds to raise elder a'buse awareness.
19 2013-2015::. rti li ..t Directed Program. r ..
5
C
So,,,What is the County Paving For:
( -N "
".-J M- - -.A,.,.,c vliti C-1, sl Incti.1d, el. .
In -Take
The County Pays 56 per unit
Health Assessment (hour).
Care Planning
Care Coordination But at any given renewal, SFS
Discharge could increase this rate. And if
SFS is the only RFP respondent
then it puts the county is a very
weak negotiation position.
Client Demographics
Total Clients Y.6 ar: About SF PHN 1.00)
Average Age of Clients: 82yrs
Average Length of Service: 6 nionths
Pro's for Contracting OUT
V" Increasing privatization allows the local businesses to compete
for the best price and service quality. Cornpeb*,.tion rnakes
everybody better.,
0
Privatization stimulates th.e ecotionly' through jobs.
(,,, to negott
iae w.ifl-.ii, fl-.ii,e
ounty- does n,ot.1-.iiA,r ,tv,.
"U"t1i..0ti, should there be any disputes with the staff such
as poor work performance.
V"'Migl--a be rnore cost efft,-,'-,ct1*"ATe, given the increased
union raises over time.
But Really..
a�1 .ntake closer I a
I
C o e ti tl'*, o n?
2018 is the only time in almost 30 years that
another vendor (Catholic Charities) applied
for this contract.
#A #A if
N'ot a a a cot npetltlol,
..
10
job /Economy Growth?
0 If the in-house can help HCOA serve more clients
then
0 in-home providers can see more clients.
Whi.C11"Will. trigger an incratne the_ ork, f-.-(..)rce
capaci..-ty- f -or i.n.,-.h.,on.ae care wh_i.ch 'will. provide
more Jobs.
11
Civil. Service / "t.in.ion.?"
00
The County has a probad.on penod of 6 montl-is.,
which allows enough time to vet their employees.
The County also has a Job Perft)rm,ance ReV'iew
system that is comprehensive which includes
sijperv,.t.s.t.on.,, actions,
an.cl. tini..on.
et-nbraces the -[,-JNI.(" )N Processes
12
� � IIYI �h
I
Cu uuwm Ilw -. .- Iwu i ' Im
0
Lets l,00k, linto thi.s..
13
C
14
SR22
- ADS
III
SR22
- ADS
III
SR22
- ADS
III
SR20
- ADS
II
SR20
- ADS
II
$ 52,956.00
$ 52,956.00
$ 52,956.00
$ 48,948.00
$ 48,948.00
Current Contract
$ 22,771.17
$ 22,771.17
$ 22,771.17
$ 21,501.83
$ 21,501.83
10400 of CM
(10,000 hours)
Savinqs
$ 75,727.17
$ 75,727.17
$ 75,727.17
$ 70,449.83
$ 70,449.83
$ 368,081.16
$ 560,000.00
$ 191,918.84
Vehicles
2
$
46,000.00
Gas
500 mi./wk
$
5,200.00
Office Supplies
5 emp.
$
1,500.00
Computers
5 laptop
$
7,945.00
Possible Loss of Rent
$2100 x 12 Mo.
$
25,200.00
$ 85,845.00
Gas
500 mi./wk
$
5,200.00
Vehicle Maintenance
2 vehicles
$
1,000.00
Office Supplies
5 emp.
$
1,500.00
Possible Loss of Rent
$2100 x 12 Mo
$
25,200.00
$
32,900.00
With estimation of
Salary/Fringe increase.
Does
not
account increases/decreases
in outside vendor's
contract
amount.
Assumes 3% increase in Salaries
What does this
savings means for kupuna?
WE could get....
Year one savings = $106,073.84
4,080 Hours of Personal Care
4,420 Hours of Homemaker Services
3,315 Assisted Transportation Trips
7,072 Hours of Adult Day Care
' J
21,648 Home Delivered Meals
. m �sr tw w savings= $147,976.41
.
5,691 Hours of Personal Care
6,166 Hours of Homemaker
Services
4,624 Assisted Transportation
Tri s
9,865 Hours of Adult Dav Care
30,199 Home Delivered Meals
0
Lets l,00k, linto thi.s..
18
, Wi[th
F S e ■
CurrentAvverage
14 . to
e %. r : :Servies. . . . . . Initial
Intakeis a�. � � '^�` 'Months #
e
% - *
Nrid e # 'Not , , . , fault
more SFS
. . . , % 5
. the
. % .
§ `.. .
19
YJ rn,,,,4B L.J
c;aIII ls, car `vvallk-in cD,r `
,9% EDP R.,P re-. - I n to k.,A-- iSr n SIhn
^. R.,Ca nir mows kgns,<3r n S hA--,i--.t t.,cD- ^ EDPS
Ah E)PRip,,i--,cii,a list: Cia IF ba-ck. by p h,(D n,L-- CD r
11 n - PAE? FSAD-n iiimnn F%Jrilk--VV X04a ( Ul P t,CD- P4lC)tlJ--. S.
CD n -I p ll LjD,-g" Enry kvv,a IrFaA,twity
�AEM.,E SFS
S,chle�lcl Li IIS �, atlc--RE� n -t atnicl lc--,atreBiNre! r -
",C) n -I a. s sia s s rn ta n t
F LECi AA/ UP R 4C^ LU IbD� uc h,�,c k i n, vw i it h, uc I U� Wt
:SF" 5,'UPpf-t
AALE>S MI FeWi»eVVS, pUa n a FMICI ,a ppr4MWenS, S,�r-Vi4De'S.
.CSS Mi see, ndL-,, ,a p p rCVVa I t4D Ft �CO'A, A rn, i n t4D 4--r4--::,ata ,a rV i 4--4-= 4D r,L=: r.
A,
.St rvi,cia, J(D,rcle,.r --,L=,,nrt row S FS -tyu � a vv i-th -the,,
a,Lfft,ft4D"e"izl4acv ICD"n r"hta sL--/rviict-- ,tela i-,
V° ;hlcfcxr Rumml Rrcwwir sqzft4acful-s O/rhcj =amqifLmcr-/-,5i rtftJ,,r ,iron-�ft4mrni°
Pct DX a trkO a, rn ,r Iles. f, od I iicywFj trbg DX,. 5 F5 [prhovi a fod I iicvw,-,,Lq:D ca I I to 11 IIII -"Pjclte: PlHm
W`EBel.i.evc
In,., -l -louse
,, 4. ,,\ + # # #
e% .Tlime . Re . Services frolm.
lnl*,.tl*al,, ,..... �.' a../.
, . , be
31.1,,,,,1, 3 . . . . , .. ;)#
21
1A4C:4C30^-KC 'T'i ren wm L 1 invwm
L........................................................................ -------------------------- -
C,a c;a�l I s,, Kar vvallk-i n Kar 'Fam iDwjr,�g*--ts. r
. R.,C P ri--. - I n -ta k.,iS n SII n
R.,,amrn v.9% s -s kg n -s<3 nr n SII n xD- ^ EDS
.iN E>R.,pA--.,cia lls-t. Ca IF b�ck by p h,KD n,L--.,KD r
11 n- p*-- IFS,ICD-n in -t.14--. Fkf ilk --.'UV Nf Ea (LA P -t.,KD-
,,C) rin p llia.1t.,k--.,Ca IF LjD.O,, EnTry / i'va'a rea ,Cltlwmv
.IN E> R.,C' R.,4--. f 4--. F Ira 11! it.,4D- 4c M
A LA lljas� �at 14clilla n -t atnic]
"AD rn IL--, A s s'A--, s s rn It-- n
HAD n -I E--. 4% n -I I(-- "it C -7c) n,cl LA,c7t.,E--.,cj
'11.1.19ask.... it would be
But, some might
quicker if referrals go Go Directly to SFS
Prior tote ADRC,.. . allowed.�ref
to go directly to
0
SFS but it became a quaI-I*,-tY,,4,,isSItj.ran.ce issue.
The inception of the ARRC was a Lyame changer!
23
Why did HCOADefend. this
I ..............
"Contract -Out" Model for So Long?
We think because...
When the Office cost it out, they u.sedt 7.1e
. . e l (nurses, etc), and found it way too
x . ti .. " ...e. But the model has changed to a sod al.
a
Cont.. 0
bring the ADRC into the aging network. Aga.itl, we d-idn't
fully, embrace fl -1e .A.DR.0 ]*..ni't's totality..
XNTC'
We d-l"dnit.l-.i,'t' . t tii,e arn,ount of A, 1,. staff and I&A
expertise we have now. Went from 1 ADRC staff to
25
Sowliat ehaveHow would it look like if we add
CM in-house?
26
What does the ADR C,--ADS-s
. v c
"s .,rew, do?
n ormation sslstance e erra
Follow-ups Nverage v e r IN4orali.
Brief Assessment (2.1) 1,200 contacts
Employment Verification (1-,-,CCG)9001 to ADRC / 30 Aging
Option Counseling 0 95 options counseling
Legal Assessment and Referral (average 40 minutes)
Refer about 30 to SFS
Screen Hospital and other Medicaid or PHNs
Referrals
27
o . 0 0
A,.n ,,
ADRC (Nic and his crew) was
suunosed to be Half of the
S oluti on. 0 0
The other Half
(Jo and her Staff) was
cc"'
In-Hou,se" Case Mnagernenll
28
And.. The State Office has
Mandated an "In-house" Model
Since 2011
And.. HCOA Agreed, signed
in agreeance (p 43), but.: later
recerid.ed.
29
2011 Hawaii Systems Change Initiative
5 -Yr. Plan for Implementing
11 Page 22 "A,spa. rt,()f't]2eAl.)RC..I*t'77P.1cl,n7enta-tl'().tz
plap, th e AAA5 will b uild s atff ca -pa City' to bfitlg
,@ Page 43 ".f---ff.`,'OA. tnust rn,ake selTeral. rn,ajor
stru.ctural- cl--i,anges to nwet ff-ii,e fully-function,1419
c.r.1 t e.r.1 a .1 ICOA. Plans on bringing case
ni,anagernent functi oil's .1* 11,-1-.ii,ou.se...
30
III )(S) ili. G,.-)ntna,ct
Sc(2p(� Serv',.wes
use the funds received under this Contract to
31
Pro's for County Provided Services
It's 1,,.n our CONTRACT
and. we are
technically
Out,of compliance.
32
:3
13
11
Sa
11
11
:1
13
But if you Need more Pro's...
We, are no longer Just a plkanning office..AI)RC �is In th.e fed-eral
language
F".,,cxse of collaboration — Same Office.
National Case tiriam,,igement Accreditation.
Internship and training :iis
More,,rimely
Not at the whini of the"vend-or
More flexibility in. services those not Eliggible fi.�)r KC services
.5
0
Cost savin.t.psl allow forServing More SeniorS at.i. d. tti. eir
W.1-13
("areprivers
33
A couple more...
'0 Increased quallity, ass urance witl,i Venolo. r -S,
0 1 � er because of
nsitionswou-Id be sm,00tl
lo'spltal tra
I "' 71 e x 1i b i 11t..
.
We can, it,n,projTe -issues in rv,at-traae, rat.t.i,er t-I-ii,an wait
one y,ear.
We would fulfill M.'ayor.1-1-arry's Kitn,'s visiotl of being the
best ADRC in the nation where services are provided in a
timely, and effective manner.. And if we fail it's on
HCOA.- Nobodv else to blame! 34
Plus we have a history of
St,wcessfu-1 nINNIMb.ause" Model.s
Jawan. ..OL
...
11 Home Delivered Meals
Congregate Meals
,@ Coordinated Servii.ces for thi,e Elderly
Senior Transportation Services
S E .. 35
HCOA Would Continue to Work Directi
KTA - Home Modification
' a � �1Ny�uryiyiu�t
Oo
With
Coun
Partners Would Continue
Community Paramedicine
Police/ Prosecutor
Elderly Activities -CSE
Transportation/Paratransit
Busing
Elderly Activities -Nutrition
Elderly Activities -Senior
Centers/Meal Sites
0
Mayors Office County Housing
Elderly Activities-RSVP/STEP
F,lom.e
/ ,
,
It'sin U , CONTR.Acr and. - .
.� + ,
. � . . . . ,� , out ~ � w 3 .
w % .]. */ * ... . 1.,. \. * we
< / i y 9 / results.
Ve Think .....
in-house Case Management
IS.Best.fog1V)una
Draft 12/18