Episode 113

How Aging and Disability Resource Centers help nursing home residents

 

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How Aging and Disability Resource Centers help nursing home residents

Aging and Disability Resource Centers (ADRCs) are system of partnered organizations available in every state dedicated to providing seniors with information on a host of programs and services.  In today’s episode, nursing home abuse lawyers Rob Schenk and Will Smith talk about ADRCs, including Georgia’s ADRC @adrcga with Melissa Sisneros, New Mexico Long Term Care Ombudsman.  

Schenk: Hey out there and welcome. I am Rob Schenk.

Smith: And I am William Smith.

Schenk: Are we are your hosts for this episode. We’re going to be talking about ADRCs which is short for Aging and Disability Resource Centers, which are nationwide programs and we’re not going to do this ourselves, because we are not experts on ADRCs. So we have a special guest all the way from New Mexico. Did you see several months ago, I don’t know if it was a Congressman from New Mexico or legislator from New Mexico where he was going to get married and he had to go to Washington, D.C., for some reason he was in Washington, D.C., and when he handed the driver’s license, his New Mexico driver’s license, they go, “You need a passport. Do you have a passport?” And he’s like, “No, here’s my driver’s license because I’m in the United States,” and she’s like, “Well we need your passport because you’re a foreigner.”

Smith: Because it was New Mexico?

Schenk: Yes. You didn’t see that?

Smith: No. That’s somebody who’s never left the city they were born in.

Schenk: And also what’s funny is that, and this is one of those things if you don’t live in that part of the country, you don’t know, or if you don’t live in that state, you don’t know, is that that’s not uncommon. According to the article, they’re like, “This is not the first time it’s happened to us,” and they talked to other New Mexicans who are like, “This happens as well.”

Smith: Holy… It reminds me of Mr. Burns on “The Simpsons” where he one time commented, “Ah, New Mexico.”

Schenk: Anyways, we have Melissa Sisneros from the New Mexico Long-Term Care Ombudsman Program who’s going to be educating us on ADRCs, and Will, can you tell us a little bit more about Melissa?

Smith: Yeah, sure. Ms. Sisneros, she even gave us a pronunciation on that and I’m still failing and I’m sorry, Melissa. Ms. Sisneros is currently the New Mexico State Long-Term Care Ombudsman. Prior to that, she ran the New Mexico State Health Insurance Assistance Program, or SHIP, and the New Mexico Senior Medicare Patrol, SMP, Program for the New Mexico Aging and Long-Term Care Services Department.

She is a CMS-certified nursing home surveyor and was a CMS-certified master trainer. She’s also worked for Adult Protective Services and the American Red Cross and Emergency Services.

We met her last year at the Consumer Voice Conference and got to know her and she has a breadth of knowledge and experience, so we are happy to have her on the show today.

Schenk: Melissa, welcome to the show. Check one. Oh, sorry about that. Technical difficulties. Melissa, now, welcome to the show.

Melissa: Thank you. Thank you for having me.

Schenk: Fantastic. Well Melissa, I think we should probably just dive right into this. Not a lot of people are familiar with ADRCs, so can you basically just tell us what an ADRC is, where it comes from and where someone can access it?

What is an Aging and Disability Resource Center?

Melissa: Sure. So an ADRC, or an Aging and Disability Resource Center, it’s a federal initiative that was established in the Older Americans Act. And what it is is it’s a network that’s established by each individual state as part of that state’s system of long-term care. And it’s purpose is to provide a coordinated system for older individuals, individuals with disabilities and their caregivers, a place where they can 1) get comprehensive information on the full range of available public and private long-term care programs, options and service providers and resources within their local community. And any federal or state programs that provide a long-term care service is in support through home and community-based service programs.

The second part is they provide person-centered counseling to assist individuals in assessing their existing or anticipated long-term care needs and goals and developing and implementing a person-centered care plan for long-term care that’s consistent with the desires of each individual and is designed to meet that individual’s specific needs, their goals and whatever circumstances they’re in.

The third is access for individuals to the full range of publicly supported long-term care services and supports for which they might be eligible and including any home and community-based service options. It serves as a single point of entry for people, and it also provides information and referrals available for individuals who are residing in institutional settings, such as a nursing home, or if they’re going to have to go into a nursing home, it provides them information to try to keep them in the community without having to go into that institutional setting, or the information for them to be able to turn back to the community safely.

Schenk: So – I keep turning my mic off, because there’s a leaf blower blowing in the background. I’m trying to minimize the background noise. But anyways, so Melissa, so where is this information access for the person looking for it? Is it the website? Do you have to write in and you get a pamphlet? How does that work?

Where can you find an Aging and Disability Resource Center?

Melissa: It’s going to depend on the ADRC and how each state has set it up, so with some ADCRs may go by a different name such as, for example in Georgia, their ADRC goes by the Aging and Disability Resource Connection as opposed to Resource Center. So they can most – most of the ADRCs will have a 1-800 number, a toll-free number, that anybody can call. Some ADRCs, if you access their website, they’ll have additional information where you can scroll through and maybe have like a resource directory to maybe say, “You know, I’m in this city and I’m looking for this type of service. Is there anything available?” And some may have even a webchat feature for people who necessarily maybe don’t want to call in or have issues with talking on the phone. They can go ahead and use a computer and do a webchat.

Schenk: Ah, wow. Okay. And so each state is different in terms of the level of resource that it is, so tell me about New Mexico, so somebody, say they wanted to know about any nursing home within a certain county that accepts Medicare or Medicaid, is that something that they can get help with from the ADRC, and if so, how would they do so in New Mexico?

Can an Aging and Disability Resource Center help find nursing homes that accept Medicare?

Melissa: Absolutely. So within New Mexico, New Mexico has all three features. They can either call in that 1-800 number. They can also – we have the webchat feature. We also have, if they go onto our website, we have a feature where they can just submit information or an email. And our telephone number in New Mexico for the Aging and Disability Resource Center is 1-800-432-2080. And so that’s the best option.

But from there, what’s nice about ADRC is they’re supposed to – when you’re trying to find resources, especially when something has happened, either a loved one has got sick or they need placement or you need to find something, it can be very overwhelming to try and find those resources in your area, especially for New Mexico. We’re a very rural and frontier state, so trying to find resources in those areas can be very daunting, and a lot of times they don’t know where to start. They don’t even know where to look. So if you call just that main number for any ADRC, no matter what state, it can help so it’s not that difficult to find those resources.

Schenk: In your experience, and this can be just in New Mexico, but in your experience, what are people using the ADRC for the most? What are a couple of the more common inquiries that are received to the ADRC?

What is an Aging and Disability Resource Center mostly used for?

Melissa: Some of the most common ones have to do with Medicare and Medicaid counseling, so it’s especially when someone is getting to the point where they’re turning 65 and they’re becoming eligible for Medicare, and Medicare can be very confusing of what all the parts mean and everything they have to sign up for, so it’s calling in to get that information of all that information and how to sign up for it. So we get that a lot as well.

We get a lot of information related to signing up for other benefits, such as Medicare savings programs, which are programs to help people who are lower income to help pay for the Medicare costs, or the Low-Income Subsidies, or the LIS Program, which helps pay for Medicare Part D or the prescription drug costs. People for the SNAP benefits, which are used to be called food stamps, to be able to apply for that information, to apply for Medicaid. So those are a lot of the questions that we get, is a lot of Medicare and Medicaid.

But it’s also finding out where can they get a home-delivered meal in their local community? Where can they sign up for or where can get a meal at a senior center? So it’s all – we get a range of information.

Schenk: Right. Right, right. So that makes sense that it’s a resource. So in your opinion then, what would be the difference between, say, an ADRC from whatever state and either CMS’s Nursing Home Compare website or the ombudsman programs of a particular state? Like what is the ADRC doing that’s different or what ground are they covering that others are not?

How is Aging and Disability Resource Center different from other programs?

Melissa: Well when it comes to ombudsmen, ombudsmen are specific to long-term care facilities. So if we’re an ombudsman, we’re an advocate in a long-term care facility, which means that’s the population that we work with is residents in those facilities and/or their family members or alternative decision makers. So if they ask us questions on some of this information, we can give them referrals and a lot of times we’re referring to the ADRC. If they’re asking – because a lot of times, we’re dealing with actual residents, but now you have a resident who’s now in a nursing home, but their spouse is still living in the community and maybe they’re living alone because now their spouse is living in the nursing home. So they’re asking questions like, “You know what? I don’t have enough food,” or “I don’t have enough money to buy prescriptions. What can I do with that? How can I find information for that?” So a lot of times we’re referring to the ADRC.

When it comes to something such as Medicare.gov, Nursing Home Compare or CMS, the Centers for Medicare/Medicaid Services, a lot of those you can go to their website, but to actually speak to one of their persons is very difficult. When you go to their website and let them know what you’re looking for, it can be very daunting to find what you’re looking for. ADRC can handle all of that. So you can call just that one number and say you have a question related to something you’re trying to find on Medicare.gov or Nursing Home Compare, they can walk you through the steps and help you. They can even contact, say, someone with Social Security if you’re having issues with Social Security, because it can be,  again, very confusing not understanding, not even knowing what the right questions are to ask. Someone with the ADRC can help with that.

So it’s that no wrong door model, just that one place where you can try to get almost all of your questions answered or get referrals to the correct resources without trying to find it all on your own.

Schenk: So it sounds like, I mean the potential consumer of the ADRC could be anybody from thinking about – a family member thinking about their loved one going into long-term care, it could be somebody who’s already in long-term care. I mean it runs the gamut. There are resources for pretty much everybody all along the…

Smith: Individuals not wanting to go to long-term care that want to know where they can get a hot meal or get some home resources.

Schenk: Yeah, it really runs the spectrum of services.

Melissa: It does. It tries to help people to remain in their communities as much as possible, to keep them as independent as possible.

Schenk: Yeah, it seems like that is the overwhelming – I don’t know how you would say it – it’s like the theme of a lot of these organizations is that the number one thing we want to do is to make sure people stay in their home for as long as possible because that seems, from a health standpoint, from a psychological standpoint, the best thing for each person.

Aging and Disability Resource Centers are designed to be as user friendly as possible

Melissa: Yes, the whole point is not only to improve their quality of care but also their quality of life. And that is correct. It’s to try to keep people – and us as ombudsmen, our whole purpose is to ensure that for residents in long-term care facilities that they continue to have those residents’ rights, the same rights you have when you’re at home. You don’t lose them when you go into a facility. When it comes to ADRC, it’s the same thing. It’s to help keep them in their homes, keeping them in there but also safely, and helping them keep their dignity and that good quality of life.

Smith: Melissa, and I don’t want to put you on the spot here because this is not something we’ve talked about necessarily, but can you think of some obstacles that you guys are facing or some hurdles that you guys are trying to overcome, what the biggest problems are? It could be getting the word out there? It could be something as simple as logistics, I don’t know. Can you talk about that, though, what obstacles you’re facing in getting this program running or in running the program itself?

What are some obstacles facing Aging and Disability Resource Centers?

Melissa: Well I mean one of the obstacles that we always face for one is getting information out there, so we have a huge outreach program where we go out and we do presentations in the community and in nursing homes and assisted living at senior centers, anywhere that people can be referring to us. Another obstacle for a lot of places is resources, having enough resources to meet the demand of the kind of calls that we’re getting in so that people aren’t having to wait a long time to speak to someone.

Another obstacle sometimes is family members. For us as ombudsmen, we’re resident advocates, so we advocate on behalf of what the resident wants. A lot of times that can be difficult, and even when a resident is calling the ADRC can be difficult because family members or maybe children want something different than what the resident wants or what the consumer wants. They’re wanting to make decisions for Mom and Dad because they’re getting older and they don’t think they’re making the right decisions. Well our job is to advocate for what the resident wants whether we agree with them or not or what the consumer wants. It’s not what the family member wants. So it’s sometimes dealing with those family dynamics, which can be very difficult.

Smith: You know, this is something that we just talked about with another podcast guest, Bethany Brown who works with Human Rights Watch on behalf of the elderly. And it’s this issue of family members can be a problem sometimes. They really can. You get in a position where you have to take care of your mom or your dad or your loved one, and all of a sudden, you become, you somehow regress them to a childish position and you put yourself in an authoritarian one. And I see this all the time. We have family members, on simple things like, “Well, I don’t want Mama smoking anymore.” Well she’s an adult. She has rights.

Melissa: Exactly.

Smith: She’s clearly over the age of 18 and has been since Truman was in office, so if she wants to smoke, she can smoke.

Melissa: Exactly.

Smith: But yeah, it’s a difficult battle and I think a lot of people don’t realize family members, you hit the nail on the head with that, can be part of the problem.

Melissa: You know, another thing we run into a lot too is, you know, POAs, people who have been designated as a POA.

Smith: And just for our listeners, we’re talking about power of attorney.

Melissa: Correct, yes, I’m sorry. Power of attorney. And so people a lot of times will say, “Well I’m her POA.” Yes, but she can still make her own decisions. So as far as we’re concerned, that POA doesn’t mean anything to us.

Smith: It’s not a guardianship.

Melissa: Exactly.

Smith: Although even guardianships are a huge problem because the guardianship is what the person with a POA thinks that they have, the POA thinks that they have. A guardianship gives them absolute power over somebody.

Schenk: At least in the state of Georgia.

Smith: Yeah, well definitely in the state of Georgia, but I think it’s also a national problem.

Melissa: It definitely is.

Smith: Yeah, and it’s a shame. It’s just another way that rights get chipped away by the elderly, and actually, Bethany and I were talking about this as well, just the mere act of going into a facility starts to chip away at your rights because, you know, you’re a grown woman who’s been independent all of her life and you’re 85 years old, and now you have somebody who’s telling you, “This is what time we get up. This is what you’ll have for breakfast.” So it’s always more ideal to help people stay in the homes, and I know that part of what the multitude of things that the ADRC can do is offer those alternatives or at least give a direction on where to go to find that support.

Melissa: Yes, and that’s definitely what ADRCs can do. They can help people stay as independent as possible and let them know what resources are available.

Smith: Yeah, which are always the ultimate desire is if you can stay at home or avoid a facility, do so.

Melissa: Yes. And so what it also helps is it helps to keep people or to teach people how to be their own advocate, how to speak for themselves. So they’re not going to rely on someone else. They can get the information, and that’s even with our program. As an ombudsman, our first goal is to empower residents to be their own advocate. And I think that’s what a lot of the ADRC, it’s empowering people to be able to be independent.

Schenk: Is there anything else that you would want to say about ADRCs?

Smith: That you wanted to bring up?

Schenk: That you might want to bring up?

Smith: Yeah.

Melissa: No, I think we covered everything. I think everyone should know that ADRCs are not just for the elderly. They’re also for people of disabilities of all ages. And they’re about also caregivers, not just in New Mexico, but nationally, you have a lot of people, we call them unpaid caregivers – they’re usually family members that are not only working full time a lot of times but also having to care for a family member, which can be very overwhelming, very frustrating. And so that they know there are resources out there that can help them, that they can contact them on behalf of the family member or whoever they’re maybe caring for, whether it be through an Alzheimer’s association to help them get into a support group if they need resources related to that or maybe resources, some Alzheimer’s associations or groups can help with training. There are a lot of resources out there. It’s not just for the elderly and it’s not just for people who are disabled, but also for their support system for them.

So instead of trying to sit there and – I know most places don’t have a phone book anymore – but say, “Okay, I need home health,” then having to sit there and try and find information, or “I need a hospice” or “How do I apply for Medicaid?” or “How do I get food stamps?” Instead of trying to figure it out on their own, which again, can be very overwhelming, very daunting and very frustrating, they can contact an ADRC, and that ADRC is that no wrong door model. From there, they can find out, “Okay, I want to know how to report someone to Adult Protective Services.” They can give them that information. “I want to talk to an ombudsman because my mom’s in a nursing home.” They can tell them, refer them to us. So if there’s only going to be one number, one place that they find it, it should be an ADRC because from that ADRC, they can refer them and get the information to them instead of them trying to find it on their own.

Smith: It really is a one-stop shop, and I’m very glad that you pointed out, and we tend to focus on the elderly because that’s the majority of our clients, but as somebody with a disabled mother, disability is a huge issue as well. I mean these ADRCs are also for those with disabilities.

Melissa: Correct.

Smith: And those who support them. So yeah, I appreciate you pointing that out. But it really is a one-stop shop. It is a centralized location for people to go. And we’re going to try help the word out there about the one we have here in Georgia.

Schenk: Yeah, and Melissa, can you give us that 1-800 number for the New Mexico ADRC again?

Melissa: Absolutely. So it’s 1-800-432-2080.

Schenk: And we’re going to have that up on the screen. And for anybody interested in the Georgia ADRC, the ADRC here in Georgia, the phone number for that is 404-656-1705, or you can email the rep here, Karen Nelson, at karen.nelson@dhs.ga.gov. And I think… Go ahead.

Melissa: I also have the toll-free number for the Georgia ADRC.

Smith: Oh, please.

Schenk: There’s a toll-free one. Yeah, go ahead.

Melissa: Yeah, so that number is 1-866-552-4464, and online, you can always just go to georgiaadrc.com.

Smith: Excellent.

Schenk: Excellent.

Smith: Well we, Melissa, we really appreciate you coming on here. It was great meeting you and getting to know you at the conference. Is that something that you go to every year?

Melissa: Yes, we do. And it was such a pleasure meeting you guys.

Smith: Okay, well we will definitely see you next year. Hopefully it’s in another good location. It was the year before that in Arlington, and then it’s been now in Alexandria. I don’t know if they’re going down the alphabet of Virginia. I guess we’ll see.

Schenk: Yeah, we’ll see.

Melissa: Yeah, we’ll have to see.

Smith: All right.

Schenk: Awesome, well thank you so much, Melissa.

Smith: Thank you.

Melissa: Thank you. You guys have a great day.

Schenk: Bye.

Smith: All right, bye-bye.

Melissa: Bye-bye.

Schenk: ADRCs. Enough said.

Smith: I’m so happy to learn more about these programs because this really is a catch-all place to send a lot of people who call us and have issues that we can’t help them with.

Schenk: That’s right.

Smith: It sounds like they can literally point them in the right direction on any issue that they may have.

Schenk: That’s right. Their no wrong door policy is pretty cool.

Smith: Yeah.

Schenk: So they won’t be refused.

Smith: Yeah.

Schenk: You know, today as this goes to air, it’s April 8th. And as we all know, it’s National Draw a Picture of a Bird Day. So I was actually thinking about us both drawing one very quickly in 10 seconds, drawing one and then having Gene put it up on the screen and people can vote on who drew the best bird. All right, here we go.

Smith: Okay.

Schenk: All right. All right, here we go. Dude, you got to wait for this. We’re timing this.

Smith: I’m sorry.

Schenk: Okay, so we’re going to do 10 seconds. We’re going to do 10 seconds. So let me get my timer. Ready?

Smith: Yep.

Schenk: Go. Five seconds. Time.

Smith: Okay.

Schenk: So this is – put your name on it.

Smith: Okay, and what I want people to notice about this is that I attempted to draw the eagle, symbol of the United States.

Schenk: That is definitely some type of Harry Potter bat.

Smith: And all you have drawn is some cutesy, funny, little duck.

Schenk: Duck. A duck is a bird.

Smith: So one of us cares about this country and the other one is a jokester.

Schenk: Is a jokester. But at any rate, we’ll have Gene flash it up on the screen.

Smith: Yeah, it’s super important.

Schenk: With that artistic endeavor out of the way, that’s going to conclude this episode of the Nursing Home Abuse Podcast. There are two ways to consumer each and every episode. The first way is to listen to it. You can listen to us by downloading the podcast on wherever you get your podcast from, whether it be iTunes, Stitcher, Spotify, Google Play, Pod Puppies, wherever, or you can watch, and in this instance, you can see the different bird drawings here, but you can watch us on our website, which is NursingHomeAbusePodcast.com, or you can check us out on YouTube. And with that, we will see you next time.

Smith: See you next time.


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