At an unprecedented pace, federal and state leaders, community based organizations, and all avenues of the health care system are expending their time and resources to respond to the COVID-19 pandemic. As a result of this crisis, there is an urgent need to support the capacity of the aging and disability network and increase all efforts to coordinate services to overcome these new challenges. Aging and Disability Resource Centers (ADRCs), through a coordinated No Wrong Door System (NWD) infrastructure, provide the foundation to support the most vulnerable populations during such crises. ADRCs provide essential services related to application assistance, assessments, person-centered planning, care coordination and follow-up for all populations including older adults, persons with disabilities and caregivers. The ADRCs are local NWD partners or organizations that offer community living services and supports to advance the health, well-being, independence, and community participation of people with disabilities and older adults. ADRCs are well positioned to address and support COVID-19 related efforts as they can provide coordinated assessments, person-centered care plans, evidence based care transitions, social isolation assessments, eligibility determination, data collection, reporting, and more.
The purpose of this emergency FOA is to support capacity and resource allocation at the state, local and territorial level to ensure coordination across agencies and support immediate response to urgent needs resulting from COVID-19. Funding will enable states and territories to support ADRCs in providing critical access functions to those populations most at risk of COVID-19 and mitigate adverse effects resulting from this national pandemic such as social isolation, limited access to nutritional supports and personal care services, etc. Additionally, funds would enable ADRCs to enhance and increase virtual access to services such as utilizing telehealth technologies to engage with health care practitioners and case managers.
Use of Funds
Funding may be used by states and territories with designated ADRCs to increase and enhance specific services/functions such as:
E-initial assessment for social determinants of health, personal care, social isolation, and/or other health needs (e.g. standardized screenings or intake processes specific to tracking COVID-19 related information);
State or local information and referral capacity (e.g., staffing, training, infrastructure);
Virtual short and long-term care coordination;
Tele-functional clinical assessments;
Care transitions (hospital-to-home and nursing home-to-home) follow-up, including tele-care transition;
Person-centered plan development; and
Staff training and infrastructure specific to virtual and/or e-service assessments and delivery.
Expected activities to be performed under this FoA include:
Rapid assessment of workforce, population and services
Conduct rapid assessment of workforce responsible for conducting application assistance, assessments, person-centered planning, care coordination, transitional services and follow-up to ensure the safety of workforce and continuity of services.
Conduct rapid assessment of emerging workforces, including but not limited to volunteers, FEMA personnel/crises counselors, specialized taskforces, etc., assisting with COVID-19 in order to leverage state resources.
Conduct rapid assessment of populations most at risk of COVID-19 who are seeking transitional support from hospital-to-home and nursing home-to- home to release additional pressure on hospitals and nursing homes.
Conduct rapid assessment of services provided that are at or above capacity and at risk of being stopped due to increased demand of COVID-19 emergency.
Virtual management of ADRC access functions
Enhancement of access functions, e-services to overcome access challenges resulting from COVID-19.
Deployment of targeted care transition services
Targeted populations most at risk of COVID-19 who are seeking transitional support from hospital-to-home and nursing home-to-home.
Mitigating social isolation through proactive Information and Referral (I&R) follow-up
Increase state and local I&R processes by supporting phone and web-based capacity to respond to increased demands as a result of COVID-19;
Initiate follow-up protocols with all ADRCs and I&R to ensure that services are activated and are responsive throughout COVID-19 crises;
Develop and implement social isolation screenings and protocols.
Develop and/or enhance innovative services or service structures
Utilize I&R workforce to provide engagement of volunteers to conduct social calls, text messaging or video chat to homebound individual;
Ensure statewide I&R access system is able to collaborate with local restaurants and/or online/mobile food order and delivery services (e.g., Peapod, Instacart, Grubhub, DoorDash) to provide delivered meals;
Ensure statewide I&R access system is able to collaborate with local transportation services (e.g., paratransit, volunteer transportation services, non-emergency medical transportation services funded by CMS, etc.) to engage in reserve transportation services to deliver meals, food and medications to older adults, people with disabilities and their caregivers.
Partner with state Assistive Technology Act program to develop and provide assistive technology assessments, technology devices, and training for older adults, people with disabilities, caregivers and clinicians to understand how to use telehealth technologies to provide and receive services and participate in technology strategies to increase social engagement and social connectedness while reducing social isolation.
Key requirements for grantees under this emergency FOA will include:
ACL will be required to identify the state’s NWD System Lead Agency responsible for ADRC oversight and distribution of funding to ADRCs and provide the state agency contact (name, title, organization, contact information). State agencies may jointly administer ADRC activities, however, ACL will only review one application and only fund one agency per state.
Applicants will be required to identify and/or attach a list of NWD/ADRC organizations in your state.
At the state level, applicants will be strongly encouraged to work with key stakeholders responsible for coordinating the on-going development, implementation, financing, evaluation and continual improvement of the state's NWD System. This includes representatives from the State Medicaid Agency, the State Unit on Aging, state authorities administering mental health services, state agencies that serve or represent the interests of all people with disabilities, and other ACL-funded organizations, including the State Protection and Advocacy System, University Centers for Excellence in Developmental Disabilities, State Council on Developmental Disabilities, State Independent Living Council and the State Assistive Technology Program. The NWD System Key Elements provides more information on the NWD System infrastructure and the need for such partnerships.
At the local ADRC level, coordination with Centers for Independent Living and Area Agencies on Aging will also be required to the extent that they are separate organizations from the local ADRC.
As described in the FOA description section, applicant will be required to conduct a rapid assessment of the existing and emerging workforce relevant to ADRC functions.