California RCSC Summary

<HR ALIGN=\"left\" ALT=\"Horizontal rule dividing sections\"> <A NAME=\"CARC\"></A> <P ALIGN=\"RIGHT\"><EM>Real Choice Systems Change</EM></P> <H2 ALIGN=\"CENTER\">CALIFORNIA</H2> <H3>Identified Problems with the State's Long-Term Care System</H3> <P> <UL> <LI>Shortage of personal assistance workers due to low wages and lack of benefits.</LI> <LI>Difficulty finding back up workers.</LI> <LI>Consumers with mental health problems have difficulty fulfilling employer responsibilities in the consumer-directed service option consistently over time.</LI> <LI>Mental health and acquired/traumatic brain injury assessment tools do not adequately evaluate consumer service needs.</LI> <LI>Lack of consumer training to assume employer responsibilities: recruitment, interviewing, training and supervising.</LI> </UL> </P> <H3>Perceived Strengths</H3> <P> <UL> <LI>Flexible, consumer-directed social services to assist persons with disabilities to remain independent in their communities.</LI> <LI>Family members may be hired to provide care, consistent with Medicaid regulations.</LI> <LI>County-level public authority mechanism addresses In-Home Supportive Service (IHSS) program limitations. For purposes of this grant, the program limitations potentially addressed by public authorities (PAs) and non-profit consortiums (NPCs) is the limitation on training. All PAs and NPCs are charged by statute with the responsibility of providing access to provider and recipient training. Almost all California counties have chosen to deliver individual IHSS provider services through the PAs and NPCs. This circumstance provides an excellent delivery vehicle for the tools that will be addressed under this grant, thus ameliorating one of the major existing program limitations.</LI> </UL> </P> <H3>Primary Focus of Grant Activities</H3> <P>Provide training resources to consumers and providers to improve the accessibility and quality of services.</P> <H3>Goals, Objectives, and Activities</H3> <P><STRONG>Overall Goal.</STRONG> Improve the IHSS consumers' ability to manage their own care and improve the quality of care delivered by IHSS caregivers through enhanced training tools to be developed during this project.</P> <P><STRONG>Goal.</STRONG> Develop training, educational materials and other methods of support to empower IHSS consumers to better understand the IHSS program and strengthen their skills to self-direct their own care.</P> <P><STRONG>Goal.</STRONG> Identify training and other support needs of IHSS caregivers and create materials, tools, and work aids that will enable those providers to improve the quality of care they render to consumers.</P> <P><STRONG><EM>Objectives/Activities (Activities span both grant goals)</EM></STRONG> <UL> <LI>Build a team that will develop the training tools as described above. The consultant team will review the IHSS program to ensure an adequate understanding of the program to effectively conduct the project activities.</LI> <LI>Conduct a needs assessment to identify key training and educational needs for IHSS consumers and caregivers.</LI> <LI>Inventory and acquire relevant training and educational materials.</LI> <LI>Prepare a cost-benefit report to describe the best ways of meeting previously unmet training needs.</LI> <LI>Design, modify and test new and existing training resources.</LI> <LI>Conduct statewide &quot;training for trainers&quot; sessions.</LI> </UL> </P> <H3>Key Activities and Products</H3> <P> <UL> <LI>Conduct IHSS program review and needs assessment to identify key training and educational needs.</LI> <LI>Inventory and acquire relevant existing training and educational materials and identify gaps.</LI> <LI>Design, modify, and test new and modified training resources and dissemination methods.</LI> <LI>Provide training for trainers.</LI> <LI>Develop a final report and issue new materials and curricula for trainer's manual.</LI> </UL> </P> <H3>Consumer Partners</H3> <P> <UL> <LI>Half of the Long-Term Care Council's membership are consumers with varying disabilities.</LI> <LI>The Real Choice Task Force consists of representatives of consumers, caregivers, and governmental agencies that participate in LTC services for elderly and disabled populations.</LI> </UL> </P> <H3>Consumer Partners and Consumer Involvement in Planning Activities</H3> <P>The Long-Term Care Council conducted four public forums in different parts of the state to solicit input from consumers, family caregivers, and advocates about their issues, concerns, and local innovative LTC strategies. Based on their input, the California Department of Social Services (CDSS) developed this grant application.</P> <H3>Consumer Partners and Consumer Involvement in Implementation Activities</H3> <P> <UL> <LI>The Real Choice Task Force will provide input to the CDSS and the project consultants during all phases of the grant program. The Task Force, or its established subcommittees, will also review and provide input on all work plans and deliverables. In addition, the consultant will provide information to the Task Force for feedback. This cooperative process is to be followed throughout the term of the project.</LI> <LI>Consumers will participate in the focus groups during the assessment phase.</LI> </UL> </P> <H3>Public Partners</H3> <P> <UL> <LI>County Welfare Director's Association representing county IHSS administrators and staff.</LI> <LI>Statewide Public Authority Council.</LI> <LI>California State Council on Developmental Disabilities.</LI> <LI>California State Senate Subcommittee on Aging and Long-Term Care.</LI> </UL> </P> <H3>Private Partners and Subcontractors</H3> <P> <UL> <LI>California Mental Health Planning Council.</LI> <LI>Family Caregiver Alliance.</LI> <LI>Independent Living Centers.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in the Planning Phase</H3> <P><STRONG>Public Partners</STRONG></P> <P>The grant application was written by state staff and public partners provided ideas for implementation.</P> <P><STRONG>Private Partners</STRONG> <UL> <LI>Private partners provided feedback during the grant application process and also provided ideas for implementation.</LI> <LI>Private partners also participated in the Task Force groups and provided technical assistance.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in Implementation</H3> <P>The key activity of the public and private partners is their participation on the Task Force. This role is generally established in the grant materials, but in the March 26, 2003 meeting of the Task Force, members were given the opportunity to further define ways in which the Task Force could participate in and contribute to the project.</P> <P><STRONG>Private</STRONG> <UL> <LI>The Family Caregiver Alliance will provide access to and technical advice on consumer education materials, and paraprofessional training materials.</LI> <LI>The California Caregiver Resource Centers are excellent local resources for training and dissemination efforts.</LI> </UL> </P> <P><STRONG>Existing Partnerships That Will Be Utilized to Leverage or Support Project Activities</STRONG> <UL> <LI>The Department has a strong working relationship with the California County Welfare Directors Association. The CDSS staff will provide the counties with status reports on this project at their regularly scheduled meetings. The CWDA is critical in the implementation of the IHSS program, since the county level is where the program is administered. All of the tools created or adopted in this project will be made available to the consumers and providers at the county level. The County Welfare Directors are instrumental in directing the local activities of program administration, and in negotiating the roles of the PAs and NPCs. Also, the PAs have a mandate to provide training; this project will provide the PAs with quality training materials.</LI> <LI>The most critical organizations, other than the counties themselves, are the PAs, NPCs and contracting providers. The state can interact with the PAs through the California Association of Public Authorities, and through the counties. The training requirement that exists for PAs and NPCs gives enormous leverage for the implementation of the training processes that utilize the tools developed through this grant.</LI> </UL> </P> <H3>Oversight/Advisory Committee</H3> <P>The Real Choice Task Force will serve in an oversight role for the grant. It will review all steps of the consultant team's activities, and will provide feedback on each component and phase of the process. This steering function is vital in keeping the activities of the project focused on the legitimate goals and objectives of the project. The Task Force will have scheduled meetings to discuss current work, review project timelines and discuss budget items, ensuring that the project stays on track.</P> <H3>Formative Learning and Evaluation Activities</H3> <P> <UL> <LI>Regular Project Task Force meetings will be held to discuss project development, implementation issues, and status reports; receive reports from subgroups; obtain feedback; and provide input from Task Force members.</LI> <LI>The contractor will submit monthly written status reports to CDSS.</LI> <LI>CDSS, the contractor, and appropriate subcontractors will participate in regular (at least bimonthly) conference calls/meetings to discuss current work, review priorities and timeframes, and discuss any budget issues.</LI> </UL> </P> <H3>Evidence of Enduring Change/Sustainability</H3> <P> <UL> <LI>The training activities will not be carried out until after the grant period. The purpose of the grant is not to provide training, but is to create the training tools that will be used to provide training beyond the grant period.</LI> <LI>The training will be carried out by the specific local organizations that have responsibility for the training. There are four entities that will be involved in providing that training, counties, PAs, NPCs, and contractors who provide contract mode services. As mentioned above, PAs have a mandate to provide access to training and the materials will be disseminated through this entity.</LI> </UL> </P> <H3>Geographic Focus</H3> <P>Statewide.</P>