Building Alliances For Safer Communities

“What’s Working” Webinar Multnomah County Aging & Disability

Services Gatekeeper Program

What we will be covering today: Overview of the Gatekeeper Program How to develop a program in your

community Key partners Identifying a “hub” and a lead agency Developing protocols Sharing of information with partners Engaging the business community Sustainability

Q & A

What is the Gatekeeper Program?

It is an outreach effort to identify, refer, and respond to at-risk older adults and people with disabilities living in our community.

Gatekeepers are trained: to identify warning signs to call a Gatekeeper Referral number

and report their concerns

Why does the Gatekeeper program exist?

Linking services with those most isolated in the community is often not successful

There are a number of reasons why high-risk older adults are unable, unwilling or resistant to seeking assistance.

Negative stigma associated with using “social services” Pride and stoicism Fear of losing control over their life. Shame, suspicion or fear Financial reasons Mental health issues such as paranoia, memory loss,

depression Lack of information about what services are available

or assistance they may qualify for

Who are Gatekeepers?Gatekeepers are nontraditional referral sources who come into contact with older adults or adults with disabilities through their everyday work or activities and who are trained: to recognize warning signs and red flags that

indicate an older adult/adult with disabilities may need some help/support

to report their concerns their local Gatekeeper Program

The Gatekeeper Model is a great fit with an Aging & Disability Resource Connection (ADRC)

Gatekeeper Structure Can Vary

Multnomah County Profile Housed in Type B Area Agency

on Aging (AAA) Part of 24/7 ADRC/Helpline Referrals assigned internally to

APS and case managers Referrals also assigned to

senior center case managers All referrals logged into new

ADRC call module and emailed to worker & supervisor

Program been operational for 25 years in Multnomah County

The Multnomah County Experience Ray Raschko develops the first Gatekeeper

Program in Spokane (1978) Human Solutions in Portland started a

Gatekeeper Program with three year grant, covering a geographic area of the County (1987)

Due to success of the program, absorbed by local AAA and expanded county-wide (1990)

Celebrated 25 Year Anniversary (2012) Received Award funding from The Aging

Network’s Volunteer Collaborative under the “What’s Working– Effective Practices” program (2012)

Gatekeeper Referrals in Multnomah County FY11/12395 daytime

Gatekeeper referrals received from the community: 66% of the Gatekeeper

calls were referred to Adult Protective Services

49% of the calls were for people who were NOT already receiving services

Gatekeeper Referrals By IndustryUtility Companies 30%Police/Fire/Rescue 15%Social Service Agencies 11%Anonymous 10%Banks/Credit Unions 7% The balance of referrals (27%) come

from letter carriers, faith communities, housing managers, transportation providers, concerned neighbors, etc.

Gatekeepers are trained to recognize warning signs, red flags and other

reasons to make a referral

Any change in normal routine is

critical.

Typical areas of potential warning signs are discussed during a training: Communication Financial Caregiver Stress Social Isolation Emotional Health Appearance of the

Person Physical

Limitations

Warning signs for people in the field are also covered Home needs repair and/or

is inaccessible Mail stacked up, old

newspapers laying around Strong odors on person

and/or in home Yard overgrown and

neglected Pets neglected and/or

too many pets

What information should Gatekeepers report?

 Customer’s name Date of birth or age, if known

or approximate  Address Telephone number A brief description of concerns,

observations, what the customer has self-reported or disclosed

Gatekeeper’s contact information

Anonymity and Confidentiality

This topic is covered during a training. It is an important protocol to address as you are developing your Gatekeeper Program. Anonymous: Gatekeeper’s name will not be

tied to the report or shared– total anonymity Confidentiality: Gatekeeper’s name will be

kept private to the client, alleged victim, alleged perpetrator, etc but will be on the report for follow up as needed

After the referral is made…what are some things we can do to help?It will be very important to

develop a simple and varied list of potential “next steps” and ways that your Gatekeeper Program will follow up once a Gatekeeper has called to make a referral.

Gatekeepers always want to know “now what?”

Client ChoiceGatekeepers become concerned when they

think that the person did not get help…we are not charged with “solving the problem”. It is important to cover the topic of Client Choice with Gatekeepers.

As an agency we value client choice We follow up on EVERY gatekeeper referral that

is made Does everyone gets help or gets their “issue”

resolved? --NO, they don’t Not everyone WANTS help.

What else Gatekeepers do to help?

•Donate money – we receive donations through United Way’s Employee Giving Campaign•Donate time – some Gatekeepers enjoy volunteering for a community agency•Donate resources – Gatekeeper organizations provide in-kind resources like printing or sponsor holiday gift drives

Key Elements of a Gatekeeper Program Identification of partners Establishing a lead agency and a hub Having memorandum of

understanding or a working agreement with partners

Development of protocols & triage techniques

Mechanisms for sharing information

Identification of partnersDiscuss with key leaders from community. Interested parties generally include:

•Utility Companies•Police/Fire/Rescue•Support Programs•Banks/Credit Unions •Letter Carriers•Housing •Transportation

Can you think of a group in your community?

Establishing a Lead Lead AgencyAgency & a HubHub Area Agency on Aging ADRC is a great a hub Law Enforcement Community Non Profit Older Adult Mental Health Agency A combined response

Lead Agency can partner with another agency for support like training

Memorandum of understanding or working agreement with partnersAdult Protective ServicesMedicaidSenior CentersAdvocacy GroupsSenior Corps RSVP ProgramMental HealthDevelopmental Disabilities

Protocols and triage techniques and sharing information It is important to know how calls will

be handled. Some considerations are: Will there be a home visit? What is response time? What do you do with after hours calls? How are calls documented and shared? What information is shared with Gatekeepers? How do your protocols fit with your agency’s

confidentiality protocols? How do you ensure consumers don’t “slip

through the cracks”?

Protocols and triage techniques Identify the client– are they already

being served? If so connect with their case manager

Where can new referrals (people who are not in the system and don’t have a case manager) be sent? Is this an APS issue? Is this a mental health crisis issue? Is this an urgent issue/imminent

danger? 911?

Consideration for sharing informationHow will the various groups share

information? Is email secure/confidential? Is there a call module with consistent

format? Are there back up procedures to

ensure that the recipient is not out of the office and the referral sits for several days until their return?

Mechanisms for sharing information Sharing with PARTNERS

Internal methodology for sharing Sharing with external partners Secure emails/HIPAA considerations Share with mental health call center Determine who you will need to

share info with and how it will occur with follow up loop

Mechanisms for sharing informationSharing with the Gatekeeper

What can you share back with the Gatekeeper?

When is it ok to share follow up information with the Gatekeeper?

Must consider client confidentiality

Why this program is important to the business community Helps customers achieve a better outcome Good public/partnership to support

consumer Business wants to help but goes beyond

their scope of work Peace of mind that consumer will get some

follow up Gatekeeper referrals are welcomed – not

seen as a “complaintant” Able to provide good customer support

while also managing business

Gatekeeper Program Sustainability Identify start up and on-going

funding; grants, reallocate existing resources,

business community support, etc. Important to have a designated coordinator for the program Regularly communicate your

successes Engage your local elected officials

Questions or Comments?