Maryland Department of Health and Mental Hygiene
“Community Options”
Development and Implementation of a Continuing
Education Seminar
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Introducing “Community Options:
a Discharge Planning Resource Seminar”
Created as a forum to bring
together discharge
planners, experts in public
and privately-funded home
and community-based
services, and HCBS service
providers.
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Maryland’s Real Choice Systems
Change Grant

Maryland Department of Health and Mental Hygiene was
awarded a 2001 Real Choice grant for an application entitled
“Increasing Access, Service Availability, and Quality in
Maryland’s Long-Term Care System.”
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Grant goals included:
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To increase the availability of attendant care services.
To provide nursing facility diversion through information and
assistance to consumers in acute care hospitals.
To assess the quality of waiver services and use that information to
focus on quality improvement efforts in the future.
To improve community-based service delivery to children with
serious emotional disturbances.
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Identifying a Need
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The need to educate discharge planners about HCBS
stemmed from experience with our “Hospital Outreach
Initiative”, the Real Choice nursing facility diversion
program.
The Hospital Outreach Initiative places local health
department nurses in acute care facilities to augment
discharge planning for persons at risk of nursing facility
admission.
Our nurses became an essential source of information
about HCBS for hospital discharge planning staff.
We saw a knowledge gap ranging from basic Medicaid
State Plan services to services for clients with more
complicated needs.
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Meeting the Need
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We developed a seminar that included
presentations and interactive case studies.
We offered Continuing Education Units
(CEU’s) to participants.
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The seminar was free.
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Social Workers received 6 CEU’s.
Certified Case Managers received 7 CEU’s.
To increase interest in the seminar, Real Choice
Grant funds were used so that admission and
CEU’s were free.
Opportunity for good public relations for
Medicaid.
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DHMH Goals
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To develop an effective model to educate
discharge planning personnel about HCBS in
Maryland.
To pilot the seminar two times.
To develop a model that could be sustained
after the grant ends with limited funds.
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The Target Audience
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Our target audience included discharge planning
professionals in acute care, long-term care, and
community-based settings.
We identified 2 diverse regions in Maryland:
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First seminar targeted case managers in Baltimore City
and parts of Western Maryland.
Second seminar targeted Central Maryland and counties
on the Upper Eastern Shore.
To reach the target audience, we advertised the
seminar through direct mailings, ListServs, and
word-of-mouth.
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Private Sector Partnership
Johns Hopkins Geriatric Education Center (GEC)
 Hopkins GEC has a special geriatric
education grant (Title IX grant) and provided
support on various levels.
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Administrative support, planning support,
assistance with identification of speakers.
Handled the CEU process via an agreement with
the Institute for Johns Hopkins Nursing.
Hopkins GEC has extensive experience with
holding CEU events for health care
professionals.
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Public Sector Partnerships
State and Local Entities
 Assistance with planning and/or speakers was
also gained through partnerships with the
following state and local agencies:
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Maryland Department of Disabilities
Maryland Department of Aging
Local Area Agencies on Aging
Local Health Departments
Mental Health Association of Maryland
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The Seminar Format
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Presentations about State-run programs directly from
administrators.
All presentations contained key information; including phone
numbers, points of contact, and program eligibility criteria.
Information about public and private programs from locallevel agencies.
Interactive case studies led by a panel of resourceful
discharge planners and program administrators from diverse
backgrounds.
Separate resource area with vendors and tables of paperbased resources.
Materials and handouts included copies of the presentations
with space for information from the vendor/resource area to
create a personalized “resource book.”
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Agenda – Seminar One
Guest Speaker – Spouse of a Medicaid Home and CommunityBased Waiver Recipient “Personal Experiences with
Discharge Planners and HCBS”
Session 1 Maryland Medicaid 101 and Medicaid HCBS Programs
HCBS Waiver Services
Session 2 Maryland Dept. of Disabilities Programs
Session 3 Maryland Dept. of Aging Programs
Session 4 Mental Health Assoc. of Maryland on Mental Health
Programs
Session 5 Keynote Speaker on “Strategies to Stay in the Home”
Session 6 Panel Discussion and Clinical Cases
*Time was included for lunch, breaks, and for participants to visit
the “Vendor / Resource Area.”
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Seminar One
Outcomes and Evaluations
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100 participants were registered.
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64 people attended with a no show rate of 36%.
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Wait list established.
20% of attendees were RN’s, 72% were social workers.
All presentations scored 3.6 or higher on a scale of 1-5 (1 = lowest
score, 5 = highest score). State-level administrators received some of
the lowest scores.
Most negative comments suggested that the information presented by
State-level administrators was too technical and overwhelming.
Interactive case study session was well-received.
6 vendors participated in the vendor/resource area and roughly 100
paper-based resources were available on unmanned tables. Participants
stated they really appreciated this area and the ability to build their
own resource reference book.
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Lessons Learned:
Planning the Second Seminar
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Due to the high no-show rate, we “overbooked” the second seminar.
Charging a nominal fee to secure attendance was considered, but was too
difficult administratively.
We decreased the amount of technical information from State-level
administrators.
We increased the number of local-level speakers.
We changed the seminar to a more interactive format.
We included more vendors in the resource area.
A web-based database will be created with Hopkins that lists resources
presented and suggested resources from participants. Participants of the
next seminar were encouraged to share resources to contribute to an
online database.
Participants’ knowledge bases ranged from novice to seasoned
professional, but most participants really needed basic information about
Medicaid.
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Agenda – Seminar Two
Session 1 Department of Health and Mental Hygiene
Medicaid 101, Medicaid Home and Community-Based Waivers
Session 2 Maryland Department of Disabilities (MDoD)
State Plan, MDoD services
Session 3 Medicare Part D
Session 4 Panel A “Access to Information”
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Experts in identifying resources presented information about HCBS and worked through
case studies with audience participation.
Session 5 Panel B “Community Supports”
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Included representatives from mental health and case management agencies. Presentations
included various core services. Panelists and audience worked through case studies
Session 6 Panel C “Community Living – Affordable and Accessible”
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Housing and environmental modification experts, including a home energy assistance
program representative, gave presentations worked through case studies.
*Time was included for lunch, breaks, and for participants to visit the
“Vendor / Resource Area.”
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Seminar Two
Outcomes and Evaluations
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115 participants were registered.
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78 people attended with a no show rate of 32%.
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Wait list established.
11% of attendees were RN’s, 74% were social workers
All presentations scored 4 or higher on a scale of 1-5 (1 = lowest score, 5
= highest score).
86% of participants felt the information would help them in their practice.
87% stated they learned new information, but again, there were many
comments about participants feeling “overwhelmed.”
73% stated they would attend the seminar again next year, 20% stated
they were unsure.
91% stated they would pay $25 to attend, 59% stated they would pay $50.
13 vendors participated and over 100 paper-based resources were
available.
The resource binders were again well-received.
One vendor offered to provide some funding for future seminars.
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Next Steps…
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Examine future funding options:
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Registration fee
Vendor funding
State funds
Partnership with Hopkins GEC
Restructure the seminar to decrease breadth of
information presented or have a two day event.
Continue to assess the needs of the discharge
planning community and modify the seminar
accordingly.
Plan and host future events.
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Contact Information
Lisa Kelemen, RN, MSN
Maryland Department of Health and Mental Hygiene
Room 122 F
201 West Preston Street
Baltimore, MD 21201
(410) 767-5095
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This document was developed under Grant No. 18-P-91593/3-01 from the U.S.
Department of Health and Human Services, Centers for Medicare and Medicaid
Services. However, the contents herein do not necessarily represent the policy of the
U.S. Department of Health and Human Services, and you should not infer endorsement
by the Federal government.
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