PUR7776 Single Source Purchase - Eldercare!.pdf

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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 Frail Caregivers of the Elderly (FCE) 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. Subscriptions are for three months and can be renewed should the PLWD and their caregiver require additional assistance. When the family has reached stability within their careplan, they will be referred back to the FACE program for ongoing, non-clinical support. 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 FCE 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 FCE burnout.

CONTACT

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

Internal tracking number, if any: SS-2301

Date posted: 5/3/2023 Last day for receipt of information: 5/26/2023

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):

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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 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.

NAN will support FACE as follows:

• One-on-one virtual support will be provided to family caregivers of people living with dementia identified through FACE, who have acute or critical needs that will benefit from NAN’s navigators and team of experts that specialize in the medical, emotional, social, and legal/financial aspects of dementia and Alzheimer’s disease.

• A NAN Navigator will be assigned as a “partner” to each of the Care Consultants managing each of the FACE regions – each NAN Navigator will manage up to 200, 3-month subscriptions (see below for detailed description of the subscription) per region, per year

• 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).

• 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.

Blog information:

Each week the participants of NAN and FACE 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.

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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 FCE 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 FCE burnout.

We are not aware of any caregiver registries in Florida, although some examples exist around the country. However, their purpose is quite different from the NAN Caregiver Registry. Two examples include:

1. Family Caregiver Alliance Research Registry This registry provides a listing of publicly and privately supported surveys, studies, and clinical trials of interest to caregiving families dealing with chronic disabling health conditions.

2. University of Pittsburgh Regional Research Registry This registry enrolls family caregivers in research studies.

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:

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(Aging Insititute = Laird Model) 2010 2011 Aging Institute | All Other ADRD Pts | Aging Institute | All Other ADRD Pts # of Patients: 383 2,098 380 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 FCE (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 FCE

* 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

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

1. Monitor FCE 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 FCE 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 FCE 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 FCE 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

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Estimated Dollar Amount:

$682,000.00

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 FCE, thus allowing Florida taxpayer dollars to stretch farther and reduce the number of FCE 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.

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In addition to the exceptional level of expertise offered by NAN’s cofounders, NAN's model has four 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.

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

Justin Taylor, Buearu Chief of Contract Administration and 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

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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.