About a year ago, in February 2010, the Chicago Bridge hosted a monthly event about aging services and long-term care. The vast world of long-term care was explored and Bridge members were inundated with acronyms for programs, services, and departments. In this post, I will add another long-term care acronym or two to your lexicon as I describe the Aging and Disability Resource Center Program (ADRC), a joint effort of the Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS).
ADRC’s are currently a federal grant funded, single-point of entry to the long-term supports and services system for both older adults and persons with disabilities. ADRCs aim to integrate and coordinate long-term supports and services, a system that is quite complex and thus difficult to navigate. The main goals of ADRCs are to make the diverse range of long-term care options easier to understand, assist consumers to make informed decisions on what kind of services and supports they may need, and help people to gain access to long-term supports and services. The definition, functions, and vision for ADRCs can be found in the Older Americans Act.
ADRCs in Illinois
Illinois currently has 3 operating ADRCs. The ADRCs are located in already existing community-based locations. The Northwestern Illinois Area Agency on Aging hosts an ADRC in north-west Illinois and serves 9 counties. The Macon County Mental Health Department hosts another ADRC in mid-Illinois and serves 5 counties. Lastly, AgeOptions, the suburban Cook County Area Agency on Aging, hosts an ADRC in collaboration with the Progress Center for Independent Living.
Recently, in September 2010, the Department of Health and Human Services announced the funding of $60 million dollars of Affordable Care Act funds to help individuals and their caregivers better understand and navigate their health and long-term care options through ADRCs. Illinois received funding through the Affordable Care Act for three out of the four available grant categories:
- Medicare Outreach and Assistance in Low Income Programs and Prevention Grants: $1,499,253.
- ADRC Options Counseling Grants: $457,160
- Evidence Based Care Transition Grants: $197,656
- The Evidence Based Care Transitions Grant in Illinois was awarded to the Illinois Department on Aging, AgeOptions, and the Illinois Transitional Care Consortium. The Care Transitions model is the Bridge Model.
ADRCs and Care Transitions
The Program Announcement for the ADRC Evidence Based Care Transition Program explains the issue of rehospitalization after discharge from a hospital. According to a research study*, 1 out 5 Medicare beneficiaries is rehospitalized within 30-days of hospital discharge, and 1 out 3 within 90-days. In 2004, these readmissions are estimated to have cost $17.4 billion to Medicare! Many of these readmissions are potentially avoidable, and care coordination and transitions in care have become a way to address the high rate of hospital readmissions. Accordingly, policy makers, federal and state governments, and aging service providers have made care coordination and care transitions a priority.
Care transitions have become a focal point in health reform discussions as a way to provide better care and bend the cost curve. In conjunction with ADRCs, it is now being demonstrated through this AoA funded project that care transitions offer an opportunity to reach older adults and persons with disabilities. Through care transitions programs, consumers are introduced to the long-term care system, the Aging Network, and the disability network of programs and services.
In Illinois, our Aging Network is unique: we have a Case Coordination Unit (CCU) system. The Illinois funded Evidence Based Care Transition Program capitalizes on the CCU system: the Bridge Model was developed by the Illinois Transitional Care Consortium to build off of the strengths of the CCU system, connecting older adults being discharged home from the hospital with long-term supports and services through the Aging Network. For readers interested in transitions in care, stay tuned to the Chicago Bridge blog—I will be covering this topic in greater detail for a future post.
The Future of ADRCs
ADRCs are a relatively new venture for the United States, having started in 2003. With the current ADRC demonstration projects on care transitions and other ADRC grant funded projects for options counseling, ADRCs are in a time of expansion. ADRCs are making long-term supports and services accessible, easier to understand, and consumer-centered. The United States is notorious for its ‘patchwork’ of health and long-term care services. Although I would argue that the only answer to coordinating all of these programs, supports and services is a single-payer healthcare system, I will admit that ADRCs are a step in the right direction.
*Jencks, S., Williams, M., Coleman, E. (2009). Re-hospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine; 360: 1418-28.
Special thanks to Bridget Murtha, Chicago Bridge Blog Editor.