ANCOR Pushes for Change
ANCOR Urges Providers and Legislators to Adapt Care and Funding Models to Include Technology
At this year’s Technology Summit & Showcase, ANCOR (American Network of Community Options and Resources) issued a stirring declaration of the need for change in service and funding models in a press release, “Bringing Long-Term Supports & Services into the 21st Century. [Read the PDF version of the ANCOR Statement here.]
ANCOR’s statement marks a pivotal moment for providers seeking to keep up with changing resources and for states that face long waiting lists.
SimplyHome's Jason Ray explains why this is such a big moment for ANCOR: “ANCOR is not merely saying that incorporating technology is important -- they’re saying it is a requirement for providers to remain sustainable in the future and to meet the requirements of the HCBS final rule and the Olmstead Act. And ANCOR is also saying that technology must be included as a form of support just like staff support -- while many still see technology and staff support as being mutually exclusive.”
Perhaps the most striking part of ANCOR’s statement was the assertion that current service models actually deter innovation and hinder providers from meeting the expectations of Olmstead and the Final Rule:
The methods, standards, funding, and accountability of today’s service system for people with disabilities and seniors were established when the only tool available to supervise and support individuals was the physical presence of a caregiver [...]
These outdated tools and way of thinking deter innovation, self-determination, quality outcomes and the most effective use of resources.
Employing technology to support individuals and their families can not only be resource-efficient, but, it can offer a powerful tool to enable community integration and person-centered supports by extending the reach of support persons.
While previous service models that do not incorporate technology as a form of support are certainly understandable, they are no longer sufficient. Providers can no longer ignore the great potential of technology in caring for their clients. The CMS final rule defines outcome-oriented services not by the safety of the individual, but by the nature and quality of the individual’s experiences (including, but not limited to, the individual’s safety).
Many barriers -- primarily, regulatory and payment methodologies -- can limit an individual's access to technological resources. CMS must identify and remove these barriers in order to provide for greater independence, privacy, and community integration of individuals with disabilities.
SimplyHome at Work to Transform Models of Care
At SimplyHome, we focus on these questions: What goals does the individual have for himself or herself? How can technology increase or improve this person’s independence? How can we enable this person to navigate daily life with greater dignity, to take reasonable risks with appropriate safety nets of support, and to learn life skills that will empower the independence desired by the individual?
Supported by technology, many individuals can move into more independent living settings. Here, Vicki and Laura get ready to wash apples and other produce as they prepare a meal together.
SimplyHome’s custom solutions seek to empower individuals to meet their own goals, whether that means cooking independently, living in their own homes, being responsible for their own daily medications and activities, or transitioning to a more independent residential setting.
As ANCOR asserts in the position paper, “If supports are to be truly person-centered, individuals should, with the assistance of their selected circle of support, make decisions on critical quality of life matters and how to best achieve them including through the use of technology.”
What Does This Mean for Providers?
The incorporation of technology not only enables care that is more person-centered, but can provide cost-effective alternatives to care based on 24/7 staffing.
Providers who have worked with SimplyHome technology have been able to widen the scope and depth of their services to many more individuals, and empower their staff to attend to the most urgent care needs. Individuals who need less in-person care and who are capable of learning independent living skills are empowered to work towards their own goals.
Providers do face hurdles as they explore new models of care. Many existing care models are tied to existing assets already owned by the providers, and the individuals providing services are comfortable with how these supports are currently delivered. Supports are also built around “doing for” the individual and minimizing risk to the organization. This usually results in too much oversight and way too little opportunity for the individual with disabilities. This requires providers to shift their culture away from “doing for” to training, supporting, and engaging with individuals to enable them to have the dignity of risk in a new way of living.
Individuals supported by technology can set goals for their daily routines -- and meet them using that technology. Sophia (pictured here) uses technology to remind her of daily routines such as going to play basketball, and making sure to lock the door when she leaves. Read more about Sophia here.
What Does This Mean for States?
By opening new avenues for services to be provided, and by making such services more cost-effective, the states can begin to impact their current waiting list populations without increasing the funds required to provide such supports.
Many states (including PA and NC, who both released new supported living waivers to include the use of technology) are moving towards the inclusion of technology supports in supported living environments. This will allow individuals to be properly supported without staff or family in-person support when it isn’t necessary, and it will allow for much more cost-effective outcomes.
Many states currently have waiting lists for residential supports, so even if you are eligible for services, you may not be able to receive services. For example, there are over 10,000 people on the NC waiting list, over 9,000 in SC, and over 13,000 in PA. In New Mexico, the waiting list time is 11-12 years once a person becomes eligible and enrolls in services.
How Does This Look in Real Life? The Charles Lea Story
Since 2008, the Charles Lea Center (CLC) in Spartanburg, SC, has utilized SimplyHome technology to provide support to individuals in settings that range from traditional staff-based care to independent apartments.
During a six-year period of gradually incorporating more technology into their support services, CLC was able to start seven new programs, generating enough savings to enable CLC to support six new individuals, without using any additional state dollars.
In 2014, CLC created a transition program that helps individuals make the move into their own homes and gain the skills they need to live independently. The unique program offers training and assistance as necessary from a centralized office, and over time the individuals become comfortable enough with our technology that they are ready to move into their own apartments or homes.
Today, 93% of the transition program’s residents use SimplyHome technology in their independent living settings, while 37% of all CLC programs use technology to support individuals. By integrating technology into their support services, CLC is able to provide support for their clients for less than $100 per day per individual. Without technology, this cost would be approximately $200 per day.
Most telling is how the individuals feel in their technology-supported living settings: in a recent survey, when CLC residents were asked if they felt safe in their homes, 100% said yes. Two individuals who have fully taken advantage of the transition program are Laura and Vicki, who now live in their own apartment together:
How Does This Look in Real Life? The Imagine! Story
Imagine!, a Colorado non-profit that helps people with developmental disabilities, is also demonstrating how technology can be a tool for independence.
“We’re looking at new ways to keep people in the community in a safe and secure setting that also supports independence,” said Greg Wellems, the Chief Operating Officer at Imagine!
He continues, “The idea is to use technology in a community-based setting that will allow people to be monitored remotely and will allow their loved ones or caregivers to know when they are home, what area of the apartment or living space they are accessing, remotely lock doors, remotely let people know what facilities they are using, and support them with medication adherence.”
One individual who uses technology supports through Imagine! is Sophia Hicks, who uses SimplyHome solutions to promote safety, to live in her own place with a roommate, and to receive verbal prompts about completing her daily routine. Read (and watch) Sophia’s story here.