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HomeMy WebLinkAboutMINUTES - 10172000 - C89 TO: 'v BOARD OF SUPERVISORS ., � Contra �J I Costa FROM: John Cullen, Director County Employment and Human §k L6p-`artment DATE: September 26, 2000 SUBJECT: APPROVE the Area Agency on Aging Fiscal Year 1999/2000 Area Plan'Year End Report. SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDED ACTION: APPROVE the Area Agency on Aging Fiscal Year 1999/2000 Area Plan Year End Report. FINANCIAL IMPACT: No Fiscal Impact. BACKGROUND: The Area Agency on Aging(AAA)provides services for older residents of the County under the Older Americans Act(OAA) and Older Californians Act(OCA). The 1999/2000 Area Plan Update proposed to continue to provide,through contract(s), congregate meals, home delivered meals, legal assistance, case management, in-home services for the frail case management clients, in-home services registry, friendly visitor, and transportation under OAA. OCA funding has allowed AAA to provide,through contract(s), Alzheimer's day care resource center services,respite registry, Brown Bag,and senior companion programs. In addition, AAA directly provides information and referral, disease prevention and health promotion services linkages, and health insurance counseling advocacy programs. AAA continues to provide program development, coordination, administration, and planning. CONTINUED ON ATTACHMENT:—X.---YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE ,ROVE OTHER SIGNATURE(S): ACTION OF BOAR October 17 , 2000 APPROVED AS RECOMMENDED_XX OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE ,UNANIMOUS(ABSENT _ - - - } AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT:_._—. __ ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED b c t o b€+r 1 7. 2 0 0 0 PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact: BOB SESSLER,3-160:5 cc: EHSD CONTRACTS UNIT(EB) COUNTY ADMINISTRATOR BY DEPUTY AUDITOR-CONTROLLER ' SHARON JOHNSON(SUMMIT) CONTRACTOR TRANSMITTAL LETTER The 1999-2000 End of the Year Report for PSA 7 is hereby submitted to the California Department of Aging for approval. The (Governing Body) supports the development of community based systems of care and recognizes the responsibility within each community to establish systems in order to address the care needs of older individuals andZha ls with functional impairments, their families and caregivers. 1. {Signed} /0////0 0 erso , erning Board Date z. {signed} A e 12,3 10C� Director, Area Agency on Aging Date The Area Agency Advisory Council has had the opportunity to participate in the planning process and to review and comment on the Area Plan. 1 3. (signed)} � � t t ► �F' �! � � �'� � � ,; , �-; � ,�� �� Chairperson, Ares Agency on Aging Date Advisory Council i I Please Note: The language used in this Transmittal Letter may also be used in local resolutions required for transmittal of the Area Plan. END OF THE YEAR REPORT . 999-0 PSA-7 CONTRA COSTA COUNTY r � r r r i ♦i�,a` - r, ♦S SU13M�TTLD BY SHARONC3�5C)1V DATE; SEPTEMBER 30, 2000 A:\ENL)OF THE YEAR RETORT 99-OO.doc rev. 09/28/00 J NEEDS ASSESSMENTACT1117TIES.- The Area Agency on Aging has been directly involved, and responsible for many needs assessments utilizing many different methodologies, including researching from a broad Bay Area wide perspective to specific population groups in Contra Costa County (CCC). All of our needs assessment activities have been collaborative with the AAA. as the lead or partnering with entities both public and private. Some of the assessments are still in progress. Through a collaborative effort by Employment and Human Services and Health Services a grant was secured from the State Office of Long Term Care that would research our Long Term Care needs for the Contra Costa.Our research has found that there are many excellent services available for the elderly and their families, however; there is not a coordinated method of linking and organizing those services to promote timely and effective use. Our research also indicates Medicare Managed Care plans have not invested in developing a geriatric approach to caring for seniors. Research has shown that geriatric medical practices, coupled with targeted case and disease management, can result in better outcomes for older people, especially frail seniors. The Long Term Care Task Force is a grass route group which AAA facilitates and maintains ongoing needs assessments including Service Delivery, Scope of Services, Dousing, Transportation, Consumer Input, and Resources, Allocation. The Consumer Input Design Team (a subcommittee of the Long Term Care Integration Pilot Project [LTCIPP]) hosted six (b) consumer input forums. The purpose of the forums was to solicit input from consumers and providers needing and providing Long Term Care (See Exhibit A) The Design Teams through monthly meetings, forums, surveys, focus groups, and research continue to make recommendations regarding Contra Costa County's Long 'Perm Care Strategic Plan. The Task Force and it's Design Teams include approximately 125 people representing the private and public sectors and consumers. One Design Team is dedicated to consumer input. This is an exciting challenge for CCC. AAEND OF THE YEAR REPORT 99-00.doc 1 09/28/00 IY. GOALS AND OBJECTIVES UPDATE: GOAL # 1. Objectives: 1. Completed 98/99. C 2. Completed 98/99. C 3. Ongoing. 4. Completed 98/99. S. Ongoing. C 6. Completed 97/98. 7. Completed 98/99. 8. Ongoing. C 9. Ongoing. C 10. Ongoing. C 11. Ongoing. 12. The Advisory Council recommended Funding be made available to provide Adult Day Care (ADC) services. AAA is now contracting with two Adult Day Health Care (ADHC) Centers to provide ADC services. Networking to increase ADHC and ADC services is ongoing. P.U. 13. Ongoing. 14. Completed 98/99. A:\END OF THE YEAR REPORT 99-OO.doc 2 09/28/00 15. Completed. C 1E. Ongoing. C 17. Ongoing. C 18. Ongoing. C 19. Ongoing. C 20. Completed 98/99. 21. Caregiver Conference was held in East County in Oct. 99. P.D. 22. Ongoing. Conferences were held in Concord (Oct. '99), Walnut Creep (March '00), and San Ramon (July '00). Each conference was well attended and provided information on a wide range of concerns and local and national resources. P. D. 23, Completed. The proposal was completed in July 1999; we were not funded. P.D. 24. Completed 98/99. P.O. 25. Completed 98/99. C 26. Completed 98/99. GOAL #2: Objectives: # 1. - 17. Ongoing. A;\END OF THE YEAR REPORT 99-00.doc 3 09/28/00 18. Ongoing: The Advisory Council developed a Liaison Committee, consisting of representatives of each District who meet individually with each County Supervisor and/or his staff representative. They address issues pertinent to seniors. Their first set of meetings addressed transportation needs. 19. Ongoing: The Advisory Council developed a position paper on this subject. This paper was sent to the Contra Costa Transit Authority with recommendations to apply to their updating of the current Measure C and the content of Future Measure C legislation. It was also hand-carried to the above referenced Liaison meetings with Supervisors. 20. Ongoing. 21. Ongoing. 22. Ongoing. 23. Deleted— discontinued as a County Program. 24. Ongoing. 25. Ongoing: This objective has been modified to reflect what AAA is actually doing. The I & A Program has been expanded adding 2.5 Social Workers and 1.5 AAA Outreach Workers: (Changes are italicized): Information & Assistance (I & A) will continue to provide staff ff to low-income ethnically diverse parts of the County to provide outreach and disseminate ethnically diverse A:\END OF THE YEAR REPORT 99-OO.doc 4 09/28/00 information on senior services available throughout CCC by June 30, 2401. 26. Deleted 97/98. (Not a realistic objective due to lack of participation.) 27. Ongoing. P.U. 28. Ongoing. GOAL #3 Objectives: 1. Completed 97/98. 2. Completed 98/99. C 3. Ongoing. 4. Completed 98/99. 5. Ongoing. 6. Ongoing. 7. Ongoing. 8. Completed 98/99. C 9. Completed 98/99. C 10. Ongoing. C 11. Completed 98/99. C 12. Ongoing. A:\END OF THE YEAR REPORT 99-OO.doc 5 09/28/00 13. Ongoing. GOAL #4 Objectives: 1. Completed 97/98. 2. Ongoing. 3. Completed 97/98. 4. Ongoing. 5. Ongoing. 6. Ongoing. 7. Completed 98/99. 8. Completed 97/98. 9. Completed 98/99. 10.Completed 98/99. 11.Completed 98/99. P.D. 12.Completed 98/99. P.O. 13.Completed 98/99. P.D. 14.Completed 98/99. P.D. GOAL #5 Objectives: # 1. 6- 9. Ongoing A:1END OF THE YEAR REPORT 99-00.doc 6 09/28/00 III, PROGRAM DEVELOPMENT ANIS COORDINATION. I have indicated on the update of the objectives which objectives were PD&C. The AAA is able to do millions of dollars worth of services, activities, and events because, the PD&C dollars are utilized to leverage other revenue sources. AAA and its public and private partners through collaborativns are able to use in-kind resources to further expand, develop, and implement new services. Our collaborations have resulted in: new Senior Dousing Projects, new services such as Errand and Escort, many special events, and less duplication of services through our ability to use funds for PD&C. IV. TARGETING.- AAA ARGETING:AAA staff has met with the Asian population in Contra Costa County and through the Nutrition Program are now providing Laotian, Vietnamese and Filipino meals and activities. Staff continues to serve other minorities (i.e.: Afro-American, Hispanic, and small numbers of middle eastern elders). AAA staff and Nutrition staff continue to meet with CDA and State staff to identify potential funding sources for new activities to be incorporated into Nutrition Cafes (sites) and Senior Centers. AAA requires its contractors to serve low-income minority individuals as part of their contractual obligation and compliance. AAA continues to develop and implement client satisfaction surveys. Surveys have been translated into Russian, Spanish and Tagalog. AAA continues to provide translation services for both written and spoken information for the community at large and its contractors. For the first time the Senior Information Newsletter is being printed in six(C) different languages besides English. AAA staff participates in Cultural Awareness Day in East County. The AAA staff has formed a Cultural Diversity Committee composed of Advisory Council members, community groups, and staff with the purpose of further identifying the needs of this population. The group plans to do outreach to the NAACP, professional organizations, Hispanic Chamber , churches, Junior Chamber of Commerces, ethnic studies, teachers, students, City web sites, local TV channels, housing projects, Senior Centers, Heritage Program (part of the YMCA in CCC) and Childcare Centers. A:\END OF THE YEAR REPORT 99-00.doc 7 09/28/00 This year AAA has two staff members who are providing intensive outreach and targeting to the community. They are seeking out the hard to reach seniors in CCC by forming working relationships with diverse ethnic organizations, making verbal presentations, distributing new brochures/pamphlets about AAA services, and contacting agencies/service providers, specifically targeting minorities. V: VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES. A.AA staff have participated in the continuing Fraud Fighters Coalition and continue to assist in bringing experts to Contra Costa County Television's local cable channel through the Senior Network show to get the word out about the latest scams. The Coalition is also working with the District Attorneys Office to develop a Senior Fraud Fighters Bureau. The Registry Program continues to include training on identifying potential abuse situations that are both physical and fiduciary for in-home workers. The most recent augmentation to services to the vulnerable elders has been the addition of Legal staff to investigate elder abuse issues and to train the community in recognizing potential abuse problems. A:\END OF THE YEAR REPORT 99-OO.doc 8 O9/28/OO Exhibit A. _,2 Contra Costa County LONG--TERM CARE INTEGRATION PLANNING PROJECT A Collaborative Effort of the Health Services & Employment& Human Services Departments CONSUMER INPUT FORUM REPORT (January - July z000) Six Consumer Input Forums were hosted throughout the county by the Consumer Input Design Team of the Long-Term Care Integration Pilot Project(LTCIPP)between the months of January and July of 2000. The purpose of the forums was to hear 'input from consumers and providers of long-term care services regarding what is working in the current system(s)and to solicit recommendations of how the system(s)could be improved. Two of the forums were hosted for residents of low-income housing complexes(Silver Oaks Apartments for Persons with Disabilities in Oakley(15 participants)and Nevin Plaza for senior residents(38 participants),one forum was at a Nutrition Site in Bethel Island(25 participants),one was at a community center in Pittsburg(11 participants)and one at a senior center in Pleasant Hill (4 participants). A sixth forum,for Care Managers, was held in Martinez(18 participants). A total of 111 persons participated in the forums. Most of the attendees were users of services (62%), while a smaller number were caregivers(38%). The ethnicity of the attendees was mixed;33%© African American,5%Asian Pacific Islanders,49%Caucasian,9% Hispanic and 1% Native American and 3%Other or unknown. A majority of the participants were women(78%). The ages varied with 23%of the participants under 60 years old, 14%60-65 years old,32%65-75 years old, 23%over 75,and 8% unknown. The users of services varied from being independent to quite frail and in need of assistance to participate in the forum. With the exception of the Bethel Island Nutrition Site participants(where all but one of the participants were not Medical eligible)and the Care Managers, most of the forum attendees fell into the category of Medical eligible-aged, blind or disabled. Each forum opened with brief self-introductions,a short overview of the LTCIPP and the purpose of the forum. A facilitator at each of the forums asked a series of 4 questions and answers were recorded. Often,there were questions asked by the participants regarding available services. Appropriate referrals were made whenever possible. Participants voiced appreciation of the opportunity to share their thoughts and opinions. August 2000 1 The following questions were asked: 1. What services do you (or the person(s)you care for)currently have/use to assist you to live independently or to improve the quality of your life? 2. What services do you(or the person(s)you care for)not have(but would like to have)to assist you in living independently or to improve the quality of your life? 3. What could make it easier for you(or the person(s)you care for)to receive the services that you want/need? 4. What is your(or the person(s)you care for) main unmet transportation need? What changes would you like to see in the transportation system? The Consumer Input Design Team recognizes that many consumers of the long-term care target population are unable to attend forums due to physical limitations. The Team knows that input from this homebound population is critical. To accommodate this need Consumer Input Design Team members are in process of interviewing hornzbound consumers through individual referrals from several community agencies. Thirty-five interviews are currently in process. Additional interviews are expected. Input gleaned from these interviews will be added to the input outlined in this report. Can the following pages you will find each of the questions and an overview of the answers to date. It is interesting to note that many of the themes were similar in each of the focus groups. Areas of particular concern to a geographic area are noted. August 2000 2 1. WHAT SERVICES DO YOUURRENTLY HAVE/USE TO ASSIST YOU TO LI'C'E INDEPENDENTLY OR TO IMPROVE THE QUALITY OF YOUR LIFE? "I don't know what services there are!" "I gave up trying to get services. First they told me that I cold get Medical. Then they told me I couldn't. Aand they kept asking me questions. It became too complicated." Most forum participants reported using the following services: • Medicare • MediCal • IHSS • Paratransit • Special rates for utilities • Lew-income housing(independent living) Other Services used by participants included: • Adult Day Health • Assisted Living • Board and Care • Support Groups • HMOs • Congregate Meals • Independent Living Resource • Veterans Services • Brown Bag(food program.) • Senior Legal Services • Case Management August 2000 3 WHAT SERVICES DO YOU (or your clients) NOT HAVE (BUT WOULD LIKE TO HAVE T ASSIST YO IN LIVING INDEPENDENTLY OR TO IMPROVE THE QUALITY OF YOUR LIFE? "I don't understand the forms. I couldn't find anyone to help me. I just gave up." "I can't afford the medications that 1 need." "They sent me a walker. It was in a box and it needed to be put together. I couldn't open the box. A neighbor helped me, but he didn't know how to put it together. It's still in the box." "I couldn't find anyone to pay for the pillow that 1 needed for my wheelchair, but Medical paid my hospital bill when I was hospitalized with sores that I got from not having the pillow." "Sometimes, two hours a month is not enough. I want to have enough time with a client to get the job done...!" "No one comes to the consumer...Everyone expects the consumer to come to them...and the consumer just can't do it!" Themes that we heard repeated in ALL of the forums_included: • Assistance with Navigating the System more information better referral services more case/care management more intensive care management communication between agencies serving the same consumer specialized care management for persons with Alzheimer's and other farms of dementia nurses/social workers in the home => assistance with understanding eligibility and application procedures consumers need an educated advocate to assist in accessing the appropriate resources assistance with advocacy and legal needs • Transportation =:> more affordable,accessible and reliable transportation errand and escort services/Shopping services reliable • Pharmaceuticals additional assistance with pharmaceutical costs assistance with medication management • Medical ==> better monitoring of medical needs => better communication with medical staff August 2000 4 Additional Themes that repeatedly heard in all forums (exce©t for Bethel Island): • In-Home Care additional IHSS hours(to allow people to stay at home and not have to go into a nursing facility) task oriented assignment of hours based upon reasonable time to perform the job in a quality manner => back-up care-givers =*, assistance with hiring caregivers • Home Visits bring services,including medical care,into the home more nurses in the community for seniors and disabled persons => more "Friendly Visitors" • Health Care Services more geriatricians more mental health services need for at-home substance abuse intervention programs dentists who accept Medical • Housing more affordable and appropriate housing care managers in housing facilities and residential facilities need for emergency shelters(hotel vouchers not appropriate for many of the persons in this target population) • Equipment accessibility to needed assistative equipment and repair of such equipment instruction and assistance on use of durable medical equipment changes in the regulations about how wheelchairs are issued home modifications • Basic Needs =o- assistance with nutritional needs/food =*. financial assistance for emergency needs • import support groups for users of services and caregivers August 2000 5 4/ • Abuse Prevention programs to assist consumers to rid themselves of abusive caregivers in their home or in residential or nursing facilities more oversight of caregivers at nursing facilities • Social =::- affordable and accessible social events • Difficulty accessing all services participants from Bethel Island stressed the difficulty of accessing services due to the remoteness of the island. 3. WHAT COULD MAKE IT EASIER FOR YOU TO RECEIVE THE SERVICES THAT YOU WANT 1 NEED? "lam always waiting. Waiting for a call back, waiting f©r my ride, waiting for my case worker-always waiting." "I wish that l had someone to talk to about what choices to make." "Sometimes I am afraid far my safety." • Respect from the"system" being treated as equal to, rather than "less-than" need for client centered system providers need to understand that this population has a difficult time getting out and about return phone calls having more of a voice in decisions affecting "me" => more appropriate discharge from hospital (currently discharge is often made prematurely with no caregiver in place) need for more service providers increased attention to cultural and ethnic diversity increased multi-lingual services • Information more accessible information to consumers at all levels(including those in nursing facilities). better understanding of services/ more understandable information better understanding of eligibility requirements August 2000 6 /6 • Mental Health Services system designed to listen to client with mental health needs advocates for mental health clients more staffing for mental health services =i:�- add therapist to IHSS team to assess and refer to mental health resources • Easier eligibility simpler eligibility procedures less stringent policies less paperwork assistance with filling out forms • Better communication systems => less phone numbers the opportunity to talk to a real person • Caregivers better training for caregivers train caregivers to understand the needs of the consumers ("continuum of caregiving) better pay for caregivers => medical benefits for caregivers emergency respite services for caregivers 4. 'WHAT IS YOUR MAIN PROBLEM WITH THE TRANSPORTATION SYSTEM? WHAT CHANGES WOULD YOU LIKE TO SEE? `7 gat to the doctor's office too late to see the doctor and I had to wait.2 hours before being picked up to go home." "I can't afford the ride to BART. I try to walk, but my oxygen doesn't always hold out" "I get on the van. Get dropped at the BART station and wait for another van. It takes me all day." • Main Problems Lack of clear information Accessibility to service is difficult =t- Too expensive =i Waiting periods too long Rides often too long and out of the way => Reservation limitations August 2000 7 => Unreliable pick-up and drop-off times Lift equipment often not working Limited wheelchair accessibility Geographic restrictions Safety issues/feelings of vulnerability Inequities from one service to another BART elevators often not working Suggested Changes • Expanded Services expanded hours guaranteed ride home, if appointment is running late express bus service more accessible services => more door-to-door service expanded escort services more taxi vouchers => choice of sedans instead of only vans more bus stops/covered bus stops less geographic restrictions => better coordination between systems => more group trips • Information easily accessible and understandable information easier eligibility large print schedules • Reservations more same day services =::�, short service request availability • Drivers =:> provide sensitivity trainings to drivers provide trainings to drivers re: geographic areas =:> provide better pay for drivers August 2000 8 s i.J CONSUMER INPUT DESIGN TEAM 1999- 2000 Dennis Greenberg Peggy Nichols—Co-chair Benefits Specialist Executive Director Independent Living Resource Lions Blind Center Jeanne Greenberg E.R. Riggall,M.D. Caregiver Alameda/Contra Costa Medical Association Task Farce Member Helen Fall Consumer Advocate Task Force Member Gordon Shasky Chair IHSS Public Authority Leah McIntosh Health Insurance Counseling &Advocacy Program Doreen (Pam) Steneberg—Co-Chair Consumer Advocate Task Farce Member Hilda Newall Executive Director Bedford Center Ellie Strauss Task Farce Member Elder Abuse Prevention