No Wrong Door System

Description of Program

The Department of Elder Affairs (Department) received a 2014 grant award from the United States Department of Health and Human Services, Administration for Community Living (ACL) for “Transforming State Long Term Services and Supports (LTSS) Access Programs and Functions into a No Wrong Door (NWD) System for all Populations and all Payers.”  The grant period is September 30, 2014 through September 29, 2015. In this initiative, the Department is partnering with the Agency for Health Care Administration (AHCA), Department of Children and Families (DCF), Agency for Persons with Disabilities (APD), Department of Health (DOH), Department of Education (DOE), Department of Veterans Affairs (DVA), Developmental Disabilities Council, the Commission for the Transportation Disadvantaged, and the Florida Association of Area Agencies on Aging, to develop a comprehensive 3-year implementation plan for expanding Florida’s No Wrong Door System of access to long term services and supports for all populations and all payers. The goal is that Florida will develop a more integrated system that is easier for individuals to learn about and access the services and supports that they need, across care settings.

 

Key Goal and Deliverable of the No Wrong Door Planning Grant

GOAL:  To support a state-led 12-month planning process to identify the key actions the state will need to take to move forward with the development and implementation of a NWD System.

DELIVERABLE: A comprehensive 3-year implementation plan for creating a No Wrong Door System of access to long term services and supports for all populations and all payers.

 

NWD System Vision

The U.S. Administration for Community Living (ACL), the Centers for Medicare & Medicaid Services (CMS) and the Veterans Health Administration (VHA) have developed this Funding Opportunity Announcement (FOA) to assist states in the planning of a No Wrong Door (NWD) System to help individuals access long term services and supports (LTSS). The NWD System will make it easy for people of all ages, disabilities and income levels to learn about and access the services and supports they need. The NWD System will also provide states with a vehicle for better coordinating and integrating the multiple access functions associated with their various state administered programs that pay for LTSS.

 

NWD System Functions:

State Governance and Administration

The NWD System State Governing Body membership includes representatives from agencies that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, individuals with mental illness, and elders. Initial responsibilities for the governing body includes the following:

  • Setting up a process that will ensure key stakeholders have meaningful input into the ongoing development and implementation of the states’ NWD System.  Stakeholders should include consumers, their advocates, Area Agencies on Aging, Centers for Independent Living, local Medicaid agencies, local organizations that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, and individuals with mental/behavioral health needs, Veteran Service Organizations, as well as service providers, and other relevant public and private entities;
  • Developing criteria and/or process to determine what organizations at the state and local level should play a formal role in carrying out NWD system functions;
  • Developing criteria and/or process to determine what (if any) sub-state regions and/or substate entities would be used to support the state's administration and oversight of the local entities carrying out NWD System functions;
  • Designating and developing formal agreements and funding arrangements with the state and local organizations that are selected to carry out NWD System functions;
  • Developing a communications strategy and process that will facilitate on-going communication among the many different agencies and organizations playing formal roles in the NWD System; Identifying the existing public resources currently being used to support access functions across the multiple state administered programs that provide LTSS, and determining how these resources can best be coordinated and integrated to align their operation and performance with the NWD System functions outlined in this FOA; and,
  • Making recommendations to the Governor on key aspects of the NWD System’s design, development, financing, and on-going administration.

 

Public Outreach and Coordination with Key Referral Sources  

A NWD System must also have formal linkages (e.g., Formal Agreements and Protocols, etc.) with the key referral sources in a given community to ensure the staff in these entities know about the functions of the NWD System and have up-to-date information and tools for quickly identifying and referring individuals to the NWD System. Among the key sources of referral the NWD System must have formal linkages with all of the following entities:

  • Information and Referral Entities: This would include coordination with existing resources such as local Information, Referral and Assistance Programs, statewide 1-800 #’s and 211 systems  so staff working for these entities can appropriately and quickly refer individuals to NWD System person centered counselors.
  • Nursing Homes and other Institutions: A NWD System should be seen as a resource to discharge planners across the state to help facilitate the transition of residents back to the community. The State Medicaid Agency should designate the NWD System, or at least some of the organizations within the NWD System, to serve as a Local Contact Agency under the MDS Section Q guidance, as well as to serve as a vehicle for facilitating transitions under other grant programs like the Money Follows the Person Program.
  • Acute Care Systems: This would include working with hospitals to put in place protocols for NWD System person centered counselors to partner with hospital discharge planners with the common goal of supporting an individual through a transition that would help the person to successfully return to the community, even if a post-acute nursing home stay was necessary.
  • VA Medical Centers: This would include direct relationships between organizations within the NWD system doing Person-Centered Counseling and local VA Medical Centers on the implementation of the Veteran-Directed HCBS Program, and other programs the VA may choose to implement through the NWD System.

The NWD System should be seen as a major resource for health care systems and providers; it will have the capacity to serve as a “front door” to the LTSS System that can quickly link their clientele to a full range of community services and supports. A fully operational NWD System will have formal linkages between and among all the major pathways that people travel while transitioning from one health care setting to another or from one public program payer to another. 


Person Centered Counseling

Person centered planning is an approach when working with individuals that is now being required in the LTSS System under multiple Medicaid regulations. The NWD System PCC function involves five basic steps: 1) conducting a personal interview; 2) developing a person-centered plan; 3) facilitating access to private services and supports; 4) facilitating streamlined assess to public programs; and 5) conducting ongoing follow-up. 

 

Meeting Information:

Notices of public meetings are published in the Florida Administrative Weekly and follow standards of the Florida Sunshine Law.

Kick-Off Meeting: The Department convened the No Wrong Door System State Governing Body (NWDSSGB) to review the project goals and objectives through a conference call meeting on Thursday, November 6, 2014 at 10:00 a.m. The NWDSSGB membership consists of the partnering agencies. The NWDSSGD meets monthly alternating by conference call and face-to-face meetings.

Planning Retreat:  On Thursday, January 8, 2015, the Department hosted a two-hour meeting retreat on the “No Wrong Door (NWD) System Planning Grant Project, ” with participation of the partnering agencies. The purpose of this retreat was to discuss the vision and mission statements of the NWD Project.

Public Meeting:  On January 21, 2015, the Department held a public meeting through a Webinar to inform the public about the planning grant and to review the vision and mission statements for Florida’s NWD system.

 

Stakeholder Input:

The Department plans to engage in constructive dialogue with stakeholders who use long-term services and supports (LTSS) and stakeholders who assist individuals in accessing LTSS, by listening to their concerns and learning from their experiences. The process for obtaining meaningful input from stakeholders includes public forums such as Webinars, face-to-face meetings, surveys, email correspondence, and roundtable discussions.  To share your experiences and offer suggestions regarding accessing long-term services and supports, please write to nowrongdoorplanningproject@elderaffairs.org.

 

January 21, 2015 No Wrong Door Planning Project Public Meeting



“If your browser does not support embedded video, please download the video here. Transcript of the video is available here.”

 

April 21, 2015 No Wrong Door Planning Project Public Meeting



“If your browser does not support embedded video, please download the video here. Transcript of the video is available here.”

April 21, 2015 No Wrong Door Planing Project Public Meeting - Document Presentation

 

Survey:

Florida Department of Elder Affairs is trying to make it easier for individuals, families, and caregivers in need of long-term care services and supports to learn about and access the help they need to remain in their homes and communities. We would appreciate it if you would give us some feedback on the call you made to get information or services for yourself or someone else. This will just take a few minutes, and your answers will help us to improve our services. Your answers are completely confidential and will not in any way affect the services that you are or will be receiving in any way.
Click here to take the survey

Please call the Florida Department of Elder Affairs at 850-414-2111 if you have problems taking the survey.

 

Planned Events:

On April 21, 2015, the Department plans to conduct a face to face meeting providing stakeholders an opportunity to review a draft of the three year implementation plan and provide input regarding the plan. The months of May and June, 2015 will provide an open comment period in which stakeholders may continue to share information that could inform the implementation plan development and to share information regarding the draft implementation plan.

On July 21, 2015, the Department plans to conduct a Webinar meeting providing stakeholders an opportunity to review and discuss the draft 3-year implementation plan with stakeholder input incorporated into the plan. August, 2015 will be a period that stakeholders may continue to share information regarding the final draft implementation plan.

The Department plans to conduct roundtable discussions and interviews in the eleven (11) planning and service areas (PSAs) across the state during the months of March, April, May, and June 2015.


Notice of Meeting/Workshop Hearing

DEPARTMENT OF ELDER AFFAIRS
The Department of Elder Affairs, No Wrong Door System Planning Project announces a public meeting to which all persons are invited.
DATE AND TIME: April 21, 2015, 10:00 a.m. – 11:00 a.m.
PLACE: Webinar: "https://meet.lync.com/fldoea/carlsonl/7U2T8P9T; Conference call: 1(888)670-3525, participant code: 2532858895
GENERAL SUBJECT MATTER TO BE CONSIDERED: Discussion of the No Wrong Door System Planning Project Initiatives.
A copy of the agenda may be obtained by contacting: Mary Hodges, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, Florida 32399-7000, telephone: (850) 414-2184, email:Hodgesm@elderaffairs.org.


Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 72 hours before the workshop/meeting by contacting: Mary Hodges, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, Florida 32399-7000, telephone: (850)414-2184, email:Hodgesm@elderaffairs.org. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

For more information, you may contact: Mary Hodges, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, Florida 32399-7000, telephone: (850) 414-2184, email: Hodgesm@elderaffairs.org.

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