NASUA’s Aging Information Management Systems Study

Jim Whaley, NASUA

Rob Ficke, Westat

Robin Ritter, Westat

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Overview/Background

Older Americans Act/NAPIS reporting• Accuracy• Burden• Capacity to meet reporting requirements

Use of data• Program operations• Quality Assurance• Accountability• Planning• Management

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Purpose of Study

Identify ways to:

1. Improve efficiency and effectiveness of reporting

2. Reduce burden of information collection across multiple funding streams

3. Eliminate the need for consumers and caregivers to repeatedly provide identifying information to multiple service providers

4. Reduce expense of reporting systems fragmentation by capitalizing on network economies of scale

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Process & Methodology

• Guided by Project Advisory Committee

• Conducted telephone survey of 49 SUAs

• Selected 15 states for follow-up survey

• Selected 5 states for case studies of best practices

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Content of Questionnaire

1. Capabilities & Functions

2. Technical Aspects

3. Policies

4. Computation of client counts Categories of data collected

5. Satisfaction with information system

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Capabilities & Functions

• Client tracking

• Case management

• Provider management

• Financial management

• Summary Reporting

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Technical Aspects

• Hardware

• Software

• Type of access ─ client server; web-based

• How AAAs & providers submit data to the state

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Categories of data collected

• Client vs. summary level

• Registered vs. non-registered services

• Demographics

• Health & functional status

• OAA Services

• Reason for leaving program

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Policy Implications

• How has SUA standardized collection and reporting of data

• How do state government information systems policies affect SUA

• Barriers vs. facilitators for information systems development

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Satisfaction with Information System

• Cost• Ease of use and modification• Flexibility• Report generation and ad hoc queries• Customer support• User Training• Documentation

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Degree of Program Integration

• OAA Title IIIB, C1, C2• OAA Title III D ─ Disease Prevention/Health Promotion• OAA Title III E ─ Family Caregiver Support• Long-Term Care Ombudsman (NORS)• Elder Rights• Senior Community Service Employment• State Health Insurance Programs (SHIP)• Medicaid Home & Community-Based Waiver• Social Service Block Grant• Nutrition Services Incentive Program• Aging & Disability Resource Center funds

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Criteria for Follow-Up/Best Practices

Vertical Integration: AAAs/providers using same system as SUA

Horizontal Integration: Same software used across multiple funding streams

Unduplicated client counts: Accuracy; based on individual clients

Technology innovations: Bar-coded IDs for client registration

Type of information systems: In-house vs. commercial systems

Diversity: Geographic, urban/rural, single state-PSA

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Preliminary Findings

• Use of information systems at SUA level is in flux

• Degrees of vertical & horizontal integration

• Use of technology for client registration is minimal

• Success with commercial software dependent on tailoring documentation and user training

NAPIS Information Management System DuringSurvey

Post-Survey

In-house custom-developed systems 24 18*

SAMS/Synergy 15 22

AIM/Saber Corporation 5 5

NAPIS Care/RTZ Associates 0 2

NAPIS Track/Mid-Iowa 1 1

In contract negotiations - commercial package 0 1

Contracted out data collection and processing 1 0

Manual/Excel spreadsheets 3 0

TOTAL 49 49*2 in RFP process; 3 more considering changing

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Facilitators Important to Information Systems Development

• Available funding

• Cooperation from AAAs/providers

• Leadership

• High costs

• Information systems development mandate

• Recommendations

• 79%

• 72%

• 67%

• 63%

• 31%

• 14%

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Barriers to Information Systems Development

SUA AAA Provider

Budgetary 56% 66% 69%

Administrative 56% 66% 69%

Technical 22% 39% 73%

Philosophical 6% 17% 42%

Political 8% 24% 40%

Procedural 3% 17% 37%

User 8% 24% 68%

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Special Use Software for Supporting Access to Services

• Most SUAs integrate client intake, assessment, and tracking

• Separate computer applications often support information & referral/assistance

• Only about 1/3 (32%) of SUAs integrate their I & R/A functions within their core MIS

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Reasons for Separate MIS Systems

• Wide selection of I & R/A software products

• Superiority of special use I & R/A software

• Existence of well-established I & R/A procedures that SUAs are reluctant to change

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Example of I & A/R Systems Integration

• Area Office on Aging of Northwestern Ohio (Toledo) uses Synergy’s SAMS Beacon software in conjunction with its existing web-based consumer information system (Synergy built the interface)

• Older persons, their families, and agency staff can use this system to identify community facilities and services to address their needs

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Implications for ADRCs

• Coordinating and integrating service system access software, such as I & R/A, with service delivery applications within state programs on aging is difficult and often does not occur

• ADRC information is not being integrated with information systems that support Title III of the Older Americans Act

• This suggests that identifying or developing I&R/A computer

applications that coordinate and integrate aging and disability program access may be problematic as well

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Next Steps NASUA Study

• Produce and disseminate written report

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Contact Information

NASUA:• Jim Whaley, Director, Center for the Advancement of

State Community Service Programs 202-898-2578, ext. 140 jwhaley@nasua.org

Westat:• Rob Ficke, Senior Study Director

301-294-2835 robertficke@westat.com

• Robin Ritter, Research Associate 240-314-5804 robinritter@westat.com

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Questions