Aging & Disability Resource Centers Program
The Purpose of the Program and How it Works
The Aging and Disability Resource Center Program (ADRC), a collaborative effort of ACL (formerly Administration on Aging), the Centers for Medicare & Medicaid Services (CMS), and now the Veterans Health Administration (VHA), supports state efforts to streamline access to long-term services and support (LTSS) options for older adults and individuals with disabilities. ADRCs simplify access to LTSS, and are a key component to long-term care systems reform.
ADRCs are known to be “No Wrong Door (NWD)” or “Single Entry Point (SEP)” , and are designed to serve as highly visible and trusted places available in every community across the country where people of all ages, incomes and disabilities go to get information and one-on-one counseling on the full range of LTSS options. Nationally, ADRC programs have taken important steps towards meeting AoA and CMS’s vision by:
- Creating a person-centered, community-based environment that promotes independence and dignity for individuals
- Providing easy access to information and one-on-one counseling to assist consumers in exploring a full range of long-term support options
- Providing resources and services that support the needs of family caregivers.
Finding the right services can be a daunting task for individuals and their family members. The current LTSS system involves numerous funding streams, and is administered by multiple federal, state and local agencies using complex, fragmented, and often duplicative intake, assessment and eligibility processes. There are more and more options for services and supports, in home, residential, and institutional settings. Individuals trying to access the multitude of new LTSS frequently find themselves confronted with a maze of agencies, organizations and bureaucratic requirements at a time when they may be vulnerable or in crisis. These issues frequently lead to use of the most expensive forms of care, including institutional care such as nursing homes or extended hospitalization, and can cause a person to quickly exhaust their own resources.
ADRC programs provide information and assistance not only to individuals needing either public or private resources, but also to professionals seeking assistance on behalf of their clients and to individuals planning for their future long-term care needs. ADRC programs also serve as the entry point to publicly administered long-term supports, including those funded under
Medicaid, the
Older Americans Act, Veterans Health Administration, and state revenue programs.
To date, ACL has funded 54 out of 56 states and territories to implement ADRC activities. Nationwide 467 ADRC systems are in place actively serving older adults and persons with disabilities. Close to 70% of the U.S. population lives in an ADRC service area. Since the inception of the program, ADRCs have responded to over 17 million contacts helping answer questions related to health and long-term services and supports.
For a downloadable / printer-friendly fact sheet about ADRCs, download the
ADRC Fact Sheet (PDF, 0.1MB).
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Recent Initiatives
In 2012, the Veteran Health Administration (VHA) partnered with ACL and Centers for Medicare & Medicaid Services (CMS) to fund an opportunity specifically designed to help support states in pursuing and developing sustainability strategies for a statewide ADRC Options Counseling Program in conjunction with their health systems transformation. Under the Aging and Disability Center Program grant, states were eligible to apply for The Enhanced ADRC Options Counseling Program (Part A) or ADRC Sustainability Program Expansion Supplemental (Part B).
The Enhanced ADRC Options Counseling Program (Part A)
The Enhanced ADRC Options Counseling Program funded states will serve as high-performing national models for providing LTSS options counseling to all state residents with LTSS needs.
A high performing ADRC Options Counseling Program is designed specifically to help individuals and their family caregivers access the right services at the right time in the right setting. It will have capacity to serve people of all ages, disabilities and income levels, including individuals interested in planning for or able to pay for their LTSS needs. It will also streamline eligibility determinations for people appropriate for public LTSS programs and increase access to lower cost community-based alternatives that can help avoid institutional care and preserve personal resources. States will use their ADRC Options Counseling Programs as a key tool for rebalancing their LTSS systems and for making their systems more person-centered, more efficient, and more supportive of community living.
Coordination with Balancing Incentive Program
Additionally, this funding opportunity aligns with states pursuing other health system transformation efforts such as Medicaid Balancing Incentive Program and demonstrations under the Center for Medicare & Medicaid Innovation. Under this funding opportunity, ADRC Options Counseling Programs will meet national performance standards and training and certification requirements. ACL will establish these standards and training requirements in collaboration with CMS, VHA and the funded states. The funded states also must adopt the standards established by CMS for the Balancing Incentive Program NWD/SEP structural change.
Goals and Outcomes
The long-term outcome for Part A awarded states will be documented by increases in community-living and quality of life for state residents as well as a more effective use of public resources, especially as people access lower cost alternatives to institutional care. This will be accomplished by the states over a three year project period by:
- Strengthening the capacity of the ADRC Options Counseling Program to serve people of all ages, income levels and disabilities by adopting a “No Wrong Door” approach that operationally involves a wide array of community agencies and organizations in the ADRC so it can effectively serve a broad range of populations, including at a minimum, older adults, people with disabilities of all ages, people with physical, intellectual and developmental disabilities (ID/DD), and family caregivers.
- Rapidly diffusing trained and certified ADRC Options Counselors throughout the funded states, and building stronger partnerships between health and LTSS systems to reduce unnecessary readmissions and promote improved health, better care and lower costs. This includes placing ADRC Options Counselors on interdisciplinary care teams and linking individuals discharged from institutional settings to community based LTSS.
- Developing financially sustainable ADRC models that includes revenue from multiple public programs (including Medicaid, Medicare, the Older Americans Act, the VHA and other programs) to cover expenses associated with such tasks as:
- Outreach
- Screening/assessing individuals’ need for LTSS
- Working with individuals and their families to develop service plans
- Linking individuals to needed services, helping individuals to use self-directed service models
- Assisting individuals in determining their eligibility for public programs
- Adopting national performance and outcome standards and aligning data collection and reporting methods across LTSS payers within a state to minimize administrative burden and support continuous quality improvement. The funded states will participate in a six month collaborative process with ACL, CMS, and VHA to develop a nationally directed evaluation. This National Evaluation Framework will document the impact of ADRC Options Counseling Programs on the quality of life and well-being of individuals and families, and the utilization and cost of LTSS and health care services.
Part A State Awards
| STATE |
FEDERAL AWARD |
| Connecticut |
$694,000 |
| Maryland |
$700,000 |
| Massachusetts |
$700,000 |
| New Hampshire |
$700,000 |
| Oregon |
$700,000 |
| Vermont |
$700,000 |
| Washington |
$700,000 |
| Wisconsin |
$699,757 |
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ADRC Sustainability Program Expansion Supplemental Program (Part B)
ACL designed this funding opportunity to help support states in pursuing and developing sustainability strategies for ADRC Options Counseling Program in conjunction with their health systems transformation and funding from the Center for Medicare and Medicaid (CMS) and Veteran Health Administration (VHA). Under this opportunity, states will continue to work toward developing a high performing statewide ADRC Options Counseling Program as outlined in their own statewide ADRC development/expansion plans and as described in the 2012 ACL, CMS, VHA Funding Opportunity.
Goals and Outcomes
States receiving awards will seek to achieve the following two key sustainability goals as part of this funding opportunity:
- Strengthening the capacity of the ADRC Options Counseling Program to serve people of all ages, income levels and disabilities by adopting a “No Wrong Door” approach that operationally involves a wide array of community agencies and organizations in the ADRC so it can effectively serve a broad range of populations; and
- Developing financially sustainable ADRC models that includes revenue from multiple public programs (including Medicaid, Medicare, the Older Americans Act, and the Veterans Health Administration and other programs)
Based on the experience to-date with ADRCs across the nation, and the importance of having an ADRC infrastructure that can effectively reach and serve different populations with unique LTSS needs as well as different ethnic and cultural groups, ACL is encouraging funded states to adopt a “No Wrong Door” (NWD) approach to implementing their ADRC Options Counseling Programs. The NWD approach operationally involves a wide array of agencies and organizations in the ADRC Program so it can effectively reach and serve a broad range of populations, including older adults, individuals with physical disabilities of all ages, individuals with intellectual and developmental disabilities, as well as individuals who can pay for their own services.
Part B State Awards
| STATE |
FEDERAL AWARD |
| Alabama |
$199,758 |
| Alaska |
$199,757 |
| Arizona | $199,460 |
| Arkansas | $182,772 |
| California | $202,443 |
| Colorado | $199,496 |
| Delaware | $199,741 |
| Georgia | $197,759 |
| Florida | $183,545 |
| Hawaii | $181,021 |
| Idaho | $199,759 |
| Illinois | $202,443 |
| Indiana | $202,443 |
| Iowa | $199,758 |
| Kentucky | $177,758 |
| Maine | $199,758 |
| Michigan | $199,500 |
| Minnesota | $199,750 |
| Montana | $195,958 |
| Nebraska | $194,000 |
| Nevada | $199,150 |
| New Jersey | $118,295 |
| New Mexico | $199,758 |
| North Carolina | $174,995 |
| Ohio | $194,724 |
| Oklahoma | $199,745 |
| Rhode Island | $199,759 |
| South Carolina | $193,508 |
| South Dakota | $173,419 |
| Tennessee | $194,306 |
| Texas | $198,161 |
| Utah | $199,758 |
| Virginia | $199,776 |
| West Virginia | $174,000 |
| Washington DC | $202,443 |
| Guam | $194,745 |
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ADRC Program Resources and Useful Links
- ADRC Technical Assistance Exchange (TAE) (www.adrc-tae.org):
Sponsored by ACL, the ADRC TAE website provides training and technical assistance to states working on ADRC/NWD/SEP programs. The ADRC TAE website includes summary information on state efforts, a variety of resources related to the development and implementation of ADRC/NWD/SEP programs, and provides a forum for peer-to-peer information exchange on policy and program issues. In partnership with ACL, the ADRC TAE provides direct technical assistance to states and communities as they develop, implement and evaluate their ADRC/NWD/SEP projects.
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