Description of Intended Single Source.doc

DESCRIPTION OF INTENDED

SINGLE SOURCE PURCHASE

(PUR 7776)

AGENCY: Department of Elder Affairs TITLE: Navigating Aging Needs, LLC (NAN), ElderCARE! program

Short description of the commodity or service desired:

The ElderCARE! program will offer high-level support to the Florida Alzheimer's Center of Excellence (FACE), a program of the Department of Elder Affairs. It will provide routine, supportive, and preventive care through NAN subscriptions to caregivers on the Alzheimer's Disease Initiative (ADI) waitlist and/or being supported by the FACE program. The ElderCare! program will serve as a clinical and expert level of support to Persons Living With Dementia (PLWD) and/or their family caregiver when the challenges experienced by the family are more complex than the FACE program is able to address. The service includes subscription-based support for Persons Living With Dementia and their caregivers through assessment and personalized development of care plans and access to supplemental personal and virtual support systems. Additionally, a caregiver registry will allow for further academic research and outcomes tracking. The NAN Caregiver Registry is unique in that it will track both FACE and Alzheimer’s disease patient data over one year - before, during, and after interventions are implemented. This registry creates a rich data source for analyzing the impact of specific interventions on Alzheimer patients and their FCEs. Additionally, it will provide valuable long-term insight into the most effective interventions to reduce the burden of care and prevent burnout.

A majority effort of this contract partnership will include a research program conducted with a distinct insurance provider. The provider will commit to a shared research project to assess health outcomes and associated health care costs and savings for the PLWD and their caregivers. The NANCares team will provide services to participants of this insurance plan and work with the insurance company's dedicated research team to develop, execute, and analyze outcomes.

Additionally, NANCares will agree to work with a Florida-based external care provider to launch a Care Navigation program within a clinic, health system, or similar care provider identified by the Department of Elder Affairs. The clinic and NANCares will commit to a partnership in which NANCares provides software and staff coaching to the clinic’s designated Care Navigator(s). This partnership is intended to introduce an element of scalability and shared investment of the program with the local community.

CONTACT

Name: Justin Taylor Address: 4040 Esplandade Way, Tallahassee, FL 32399 Telephone: 850-414-2153 Email: Taylorj@elderaffairs.org Internal tracking number, if any:

Date posted: 3/22/2024 Last day for receipt of information:

This description of commodities or contractual services intended for purchase from a single source is posted in accordance with Sections 120.57(3) and 287.057(3), Florida Statutes, and will remain posted for a period of at least 7 business days.

Commodity or Contractual Service Required (commodity or United National Standard Products and Services Code (UNSPSC), manufacturer, model, and description, as appropriate):

85121606 Geriatric services Quantity or Term (as appropriate):

1 year of subscription services Requestor (division, bureau, office, individual, as appropriate):

Department of Elder Affairs; Cari Eyre, Dementia Director Performance and/or Design Requirements (e.g. intended use, function or application, compatibility, requirements; reference to policy, rule, statute or other act of the Legislature, etc., as appropriate):

The ElderCARE! program will be offered for high-level support to the Florida Alzheimer's Center of Excellence (FACE), a program of the Department of Elder Affairs, will be able to provide routine, supportive, and preventive care through NAN subscriptions to Frail Caregivers of the Elderly (FCE) on the Alzheimer's Disease Initiative (ADI) waitlist, a detailed research project to examine health outcomes and health care cost savings, as well as a partnership with a local healthcare provider. The FACE team (employed at DOEA) have trained and received one year of coaching in this model of care.

NAN will support FACE as follows:

NAN Navigators will support FACE Care Consultants in increasing the number of Florida families impacted by Alzheimer’s disease reached by the programs of the DOEA including Memory Disorder Clinics (MDC), Dementia Care and Cure Initiative (DCCI), and Aging and Disability Resource Centers (ADRC) through regular coaching.

FACE Care Consultants will be given access to the NAN assessment and tracking tool used to assess risk and monitor the impact on persons living with dementia and their family caregivers – customize if needed to address specific needs of the FACE program.

NAN will track the impact of the FACE program on the medical, emotional, social, legal/financial outcomes through the NAN database, which already includes data on over 300 Floridians living with dementia and their caregivers.

FACE Care Consultants and all FACE participants will have access to the robust body of resources on the nanforcaregivers.com website, which are updated weekly.

Family caregivers of persons living with dementia who participate in FACE will receive a weekly newsletter designed to specifically address issues that family caregivers typically face in caring for their loved ones with Alzheimer’s disease – the newsletter will be co-branded

NAN will seek opportunities to analyze and report on the impact of this program and disseminate among national and international Alzheimer’s stakeholders.

NAN will develop a research project as follows:

* NAN will develop and sign an Memorandum of Understanding and/or Buiness Associate Agreement (and other required documents) to outline and perform a research project with an insurance provider. The provider must provide an appropriate number of referrals and a dedicaed research team to suport the research component of this work.

NAN will work with a third-party clinic provider as follows:

* NAN will provide access to software (described above) and all digital resources contained wtihin the NANCare platform.

* NAN Navigators will support the local provider's designated Care Navigator through regular coaching.

The local provider's designated Care Navigator will be given access to the NAN assessment and tracking tool used to assess risk and monitor the impact on persons living with dementia and their family caregivers – customize if needed to address specific needs of the FACE program.

NAN will track the impact of the program on the medical, emotional, social, legal/financial outcomes through the NAN database, which already includes data on over 300 Floridians living with dementia and their caregivers.

The local provider's designated Care Navigator and all participants will have access to the robust body of resources on the nanforcaregivers.com website, which are updated weekly.

Family caregivers of persons living with dementia who participate in the program will receive a weekly newsletter designed to specifically address issues that family caregivers typically face in caring for their loved ones with Alzheimer’s disease – the newsletter will be co-branded.

Blog information:

Each week the participants the program will receive an email from Dr. Rosemary Laird. These email newsletters have an open-rate far higher than the industry standard (44% average compared to approximately 16%). The email will include a copy of her latest blog post. Blog topics address timely subjects (e.g., news on Alzheimer’s Disease, seasonal issues) and fall into the four foundational NAN topics of medical, emotional, social, legal/financial, and self-care for FCEs. An archive of blogs from Dr. Laird will be available in the NAN Resource section.

Videos and podcasts information:

NAN will present the educational content described above in video format and will plan to explore options for a podcast format to determine which format is preferred by subscribers.

The dashboard contents include updates in real-time (described in greater detail below).

During 2020, the educational programming offered in this format was presented to over 500 caregivers and consistently received five-star reviews by participants.

NAN receives support from a tech platform that includes a first-of-its-kind volunteer, HIPAA-compliant, family caregiver registry that allows further academic research and outcomes tracking. The NAN Caregiver Registry is unique in that it can aggregate both caregiver and Alzheimer’s patient data over 12 months - before, during, and after interventions are implemented. This registry will create a rich data source to analyze the impact of specific interventions on both Alzheimer's patients and their FCEs. It will provide valuable, long-term insight into the most effective interventions to reduce the burden of care and prevent caregiver burnout.

The Laird model of care received validation while Dr. Laird worked for Health First Aging Services (aka Aging Institute) in Brevard County. Two years of claims data were analyzed for patients under Dr. Laird’s care (Aging Institute) and compared against all other dementia patients. The results showed: reductions in Zarit Burden Scale (short format) scores among the supported family caregivers, fewer ER visits, and lower average costs of medical care for Alzheimer’s patients. Health First conducted this study internally, therefore we cannot share the report within this proposal; however, a summary of the key findings includes:

Patient Population: examined across 18 diagnostic codes included in the study

Intervention: the addition of social support to family caregivers (a dedicated social worker trained and supervised by Dr. Laird), one-on-one consultations with Dr. Laird’s network of aging experts [e.g., geriatrician, nurse practitioner]), access to a group and online caregiver resource materials, support, and training

Results:

(Aging Insititute = Laird Model) 2010 2011

Aging Institute | All Other ADRD Pts | Aging Institute | All Other ADRD Pts

# of Patients:

2,098 2,300

Avg# ER Visits/Pt:

1.82 1.94 1.78 2.07

Avg Med. $ to Plan $8,564 $12,176 $9,024 $10,710

The NAN model offered today contains the same fundamental components as Dr. Laird’s Health First model and is presented with enhanced technology that provides improved user experience, operational efficiency, and potential for scalability. The NAN tech platform continues to support NAN subscribers and the NAN team, specifically NAN Navigators.

Nanforcaregivers.com supports subscribers with:

- A personal dashboard

The dashboard includes the individual's NAN plan, a running count of time used and time remaining in their NAN subscription, each individual's Zarit score to track the burden of care.

- Scheduler

Easy-to-use scheduler for subscribers to schedule time with their NAN Navigator and NAN Experts

- Resources

This library of resources provides insight and support at every stage of the caregiver/patient experience.

- Marketplace

This feature includes products recommended by the NAN team for caregivers and patients, including books, products, and devices to make day-to-day living more comfortable and easy.

- Activities

This component includes fun and relaxing activities for caregivers to take a break or enjoy time with their loved ones.

The NAN technical platform is HIPAA compliant and supports the NAN team as follows:

* The scheduling function tracks time spent with each subscriber.

* A proprietary algorithm that generates a NAN Plan based on inputs from caregiver (subscriber) and used by the NAN Navigator to:

> Assess and track critical indicators for Alzheimer’s Disease patients in key domains; medical, emotional, social, legal/financial

> Assess and track Zarit Burden Scale based on quarterly inputs provided by caregiver

* HIPAA-compliant database that tracks 80+ factors on individuals with Alzheimer’s and their family caregivers that can track improvements in the health and wellness of the Person with Living Dementia (PLWD) or caregiver that results from the NAN Plan

* Track changes in the PLWD or caregiver's health and wellness due to the progression of the disease

In addition to the program offerings described in the program summary, two strategies to monitor and evaluate the Florida ElderCARE! service include:

1. Monitor caregiver use and engagement with NAN products and services and continually upgrade products based on ongoing consumer feedback

2. Administer the Zarit Burden Interview (ZBI) with caregiver enrolled in NANCare every six months to monitor the impact of the program on the burden of care

Evaluation and outcome reports will be issued every six months and captured in the NAN Family Caregiver Registry.

NANforCaregivers.com has support from a robust, HIPAA-compliant cloud-based SaaS platform that leverages the best of breed, off-the-shelf software. It will collect, track, and analyze user data to ensure that caregiver and their frail loved one's problems are identified and resolved and report on measurable outcomes for the program. The NAN tech platform includes a scheduling module to provide an electronic means of verifying when and where service occurs and the actual amount of time the provider spends with an FCE. It will also support ongoing communication with the caregiver providing a real-time dashboard on the status of their frail elder and pushing out updates on the NAN community, educational and self-care resources. NAN's software as service (SaaS) model ensures ease of integration with DOEA and the 11 AAA existing systems. The tech platform optimizes the user experience and extends the suite of values arising from NAN's core capabilities as an electronic tool that enhances the user's health and wellness.

The platform is accessible for users on all major browsers (Edge, Chrome, Firefox, and Safari) and all devices (desktop, tablet, and mobile) utilizing HTML5 responsive website design and development best practices. The website is secure via SHA-256 RSA encrypted SSL using Transport Layer Security (TLS) 1.3 and boasts bot and DDoS protection via industry-leading Cloudflare CDN services.

Dr. Rosemary Laird will additionally offer one academic journal publication to review program progress and Florida Governmenr's role in improving outcomes for its residents.

Intended Single Source:

Navigating Aging Needs LLC

721 Palmer Way

Melbourne, FL 32940 https://nanforcaregivers.com Patricia Allman, NAN Chief Executive Officer (main point of contact)

301-213-7006 pallman@nanforcaregivers.com

Rosemary Laird, MD, NAN Chief Medical Officer 321-261-1314 rlaird@nanforcaregivers.com

Estimated Dollar Amount:

$1,000,000 Justification for single source acquisition (what is necessary and unique about the product, service or source; steps taken to confirm unavailability of competition, as appropriate):

NAN is necessary because Florida state resources are currently unable to meet the demand for caregiver support services. In addition, demographic projections indicate that approximately one-quarter of Florida’s current population are baby boomers who will age into retirement in the next 10 years and will significantly increase the demand for AAA services [Florida State Plan on Aging 2017-2020]. NAN will help address these unmet needs with direct care support to the most vulnerable caregivers, thus allowing Florida taxpayer dollars to stretch farther and reduce the number of caregivers in Florida on the ADI waitlist and at risk of burnout.

The ElderCare/NAN program is a proprietary care model developed with demonstrated success by Dr. Rosemary Laird and owned by NANCare, LLC. The extremely high level of expertise offered and extensive reach by its directors is unmatched in the senior care industry.

The extraordinary accomplishments of co-founder Dr. Rosemary Laird have been recognized by her peers nationally, public health officials in Florida, and her patients’ families. In 2013, Dr. Laird received the Clinician of the Year award from the American Geriatrics Society, which recognizes one exceptional health professional per year who delivers outstanding care to older adults. In 2019, Dr. Laird was selected to Chair the Florida Alzheimer’s Disease Advisory Committee, which advises on state policy in Florida. In 2021, Dr. Laird was awarded the Suzanne R. Plakon Humanitarian Award for leadership in Alzheimer’s Advocacy. This is what her patients’ family caregivers have to say:

“What sets Dr. Laird apart is her team approach in helping our family of caregivers navigate through the challenges of dealing with our mom’s declining cognitive abilities. Dr. Laird’s team efforts included addressing the needs of her patients’ caregivers. Her social workers met with us on a regular basis, and they were always just a phone call away from providing any assistance we may have asked of them. This team approach offered to both patients and caregivers assures that the best in consistent and caring medical care is provided to all of those dealing with team Dr. Laird!!!” – Mark Hendelson, family caregiver of a patient with Alzheimer’s Disease.

Co-founder Patricia Allman has 25+ years of success building public-private partnerships that improve public health in the US and around the world. In 1999, Patricia founded Dillon Allman & Partners, which creates public-private partnerships between government health agencies (e.g., National Institutes of Health) and leaders in the health industry (e.g., Johnson & Johnson) to improve public health. In 2011, Patricia founded Knighten Health, a medical education and communications company that creates multi-platform programs for physicians and patients to improve public health through medical education and patient education. Patricia has been an advocate for healthy aging through her volunteer work on boards including the Robert Wood Johnson Foundation and HelpAge. This is what her collaborators have to say:

“It was a pleasure working with Patricia Allman and her team in creating a digital tool that has made the National Institute of Aging’s Short Physical Performance Battery accessible to clinicians around the world.” – Jack Guralnik, MD, PhD, former Chief of Epidemiology and Biometrics at the National Institute of Aging/NIH.

In addition to the exceptional level of expertise offered by NAN’s cofounders, NAN's model has five additional key differentiators that make it unique:

1.

NAN focuses exclusively on family caregivers of older adults with Alzheimer’s Disease, who face a unique set of challenges that are continually changing as the disease advances. Caring for an aging loved one with Alzheimer’s is especially challenging due to the broad range of domains that are impacted (memory, speech, activities of daily living) and the progressive decline. Led by Dr. Rosemary Laird, Florida’s leading expert on Alzheimer’s Disease, everyone on the NAN care team specializes in the unique set of challenges associated with this challenging condition.

2.

NAN has a care model that combines high touch with high tech:

a.

High Touch – family caregivers receive ongoing support from a personal NAN Navigator (social worker) and a multidisciplinary team of local experts (e.g., geriatrician, pharmacists, dietician) with years of experience responding to the broad range of continually changing issues faced by Alzheimer’s patients and their caregivers. The NAN team assesses and continually monitors the individual needs of each subscriber and connects them to the care they need when they need it. Each subscriber has an “account” of time that they can draw from as needed over the life of the subscription: 12 hours with a NAN Navigator and 24 hours with a NAN expert. The care model was developed by Dr. Rosemary Laird, a recognized leader in Alzheimer’s Disease in Florida, and has been designed to be flexible and adaptable to the unique needs of each individual subscriber.

b.

High Tech – the NAN tech platform has been specifically designed to support NAN’s subscribers and the NAN team. It includes a proprietary algorithm that assesses and tracks the wellbeing of patients and their family caregivers, and that provides a personalized plan of action.

3.

NAN holds itself accountable by tracking 80+ factors including the loved one’s medical, emotional, social, legal/financial wellbeing and the caregiver burden. All changes in the loved one’s and subscriber’s wellbeing are captured in the NAN database and reflected in each subscriber’s personal dashboard. The NAN Navigator uses this data to continually adjust each subscriber’s NAN Plan. For subscribers that agree to participate, the database will be used for long-term analysis on interventions to reduce the burden on family caregivers of patients with Alzheimer’s Disease.

4. NAN established its efficacy through a pilot project offered within Broward County (PSA 10) throughout March 2022 to May 2023. The pilot supported 235 family caregivers in Broward County with subscription-based virtual support. The users reported improvements in all four foundational domains of NAN serive: medical, emotional, social, and legal/financial.

5. NANCares is made even more distinct through its efforts to assess outcomes. This program's success has been recognized through findings chosen for the Alzheiemer's Association's Innternational Conference in Amsterdam 2023. An economic impact assessment was performed by the Associate Department Chair of an unaffiliated university. The researcher is an expert in econometric methodology, applied microeconomics, and demography. The current plans to enter a research program with an insurance company further demonstrate NANCares' unique position to ensure the best possible outcomes for seniors at the best possible price point.

Approved By (names & titles, as appropriate, e.g., requestor, requestor management, information systems, budget, purchasing):

Prospective vendors are requested to provide information regarding their ability to supply the commodities or contractual services described. If it is determined in writing by the agency, after reviewing any information received from prospective vendors, that the commodities or contractual services are available only from a single source, the agency shall: provide notice of its intended decision to enter a single-source purchase contract in the manner specified in Section 120.57(3), F.S.

PUR 7776 (01/16)

60A-1.045, F.A.C.