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HomeMy WebLinkAboutMINUTES - 11062001 - C.182 5 t' Contra TO: BOARD OF SUPERVISORS - ; Costan FROM: John Cullen, Director " z Employment & Human Services ment -___ County���K�C./gz DATE: September 17, 2001 SUBJECT: APPROVE and AUTHORIZE the SUBMITTAL of the Contra Costa County Area Agency on Aging Area Plan Year-End Report for FY 2000/2001 to the California Department on Aging and AUTHORIZE the Chair, Board of Supervisors to sign the Letter of Transmittal. SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDED ACTION* APPROVE and AUTHORIZE the SUBMITTAL of the Contra Costa County Area Agency on Aging Area Plan Year-End Report for FY 2000/2001 to the California Department on Aging and AUTHORIZE the Chair, Board of Supervisors to sign the Letter of Transmittal. FINANCIAL IMPACT- No fiscal impact. BACKGROUND- The ACKGRO JND-The Area Agency on Aging (AAA) provides services for older residents of the County under the Older American's Act (OAA) and Older Californian's Act (CAA). The 2000/2001 Area Plan Update proposed to continue to provide through contract Congregate Meals, Home-Delivered Meals, Legal Assistance, In-Home Services Registry, Friendly Visitor, Adult Day Care, Errand and Escort Services and Transportation under OAA. OCA funding has allowed AAA to provide through contract Alzheimer's Day Care Resource Center Services, Respite Registry, Brown Bag and Senior Companion Programs. In addition, AAA directly provides Information and Assistance, Disease Prevention and Health Promotion Services, Linkages, and Health Insurance Counseling Advocacy Program. The AAA continues to provide program development, coordination, administration, and planning. CONTINUED ON ATTACHMENT: ^ YES SIGNATURE: ` COMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER t SIGNATURE(S): ACTION OF BOAR N November 6, 2001 APPROVED AS RECOMMENDED XX OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE XX UNANIMOUS(ABSENT none ) 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 November 6, 2001 JOHN SWEETEN,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Conum ROBERT SESSLER 3-1605 ,r cc: JOHN CULLEN - EHSD Q / EHSD(CONTRACTS UNIT)- EB BY I W -,DEPUTY COUNTY ADMINISTRATOR SHARON JOHNSON/BARBARA MCNAIR,SUMMITT AREA AGENCY ON AGING s - .4Y�• tl�C .1 I3S 1001 TRANSMITTAL LETTER The 2000-2001 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 and individuals with functional impairments, their families and caregivers. 1. (Signed Chao erson, Gov ning Board Date 2. (Signed) ?& 7( 4/ 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 Pian. 3. (Signed)) Chairperson, Area Age y on Aging Date Advisory Council 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 2000-01 PSA-7 CONTRA COSTA COUNTY I ,y COUl� SUBMITTED BY.- SHARON TOHNSON DATE: August 30, 2001 H:Wrea Plan\END OF THE YEAR REPORT 00-01.doc rev.08/30/01 L NEEDS ASSESSMENT ACTIVITIES The AAA organized, coordinated, and implemented a day of data gathering by inviting local committees and commissions on Aging to participate in the planning process. The objective for bringing the local committees and commissions together was to discuss the obstacles and successes each local commission and committee has had in the last fiscal year. Bringing the local committees and commissions together was an empowering tool, because it promotes networking and assists the AAA in determining service needs in each city throughout the county. (Please see Attachment A.) AAA is continuing to participate in the planning collaborative to implement joint regional planning and program activities, including participation in the Contra Costa County United Way/Hospital Council Collaborative Community Assessment (Attachment B). The AAA Director and Planner participated in the Cabinet and Steering Committees of the United Way. AAA staff and the Housing Committee developed and implemented a survey and evaluated senior care facilities serving persons with dementia. (See Attachment C.) AAA staff participated in a Needs Assessment assessing seniors needs in West County by collaboration with the West County Coalition. HA.Ajea Plan\END OF TI4E YEAR REPORT 00-01.doc 1 08/30/01 Needs Assessment Activities Methodologies, Data, & Findings incorporated into Area Plan Priority Setting Analysis of Needs Assessment Data Community Needs Assessment Resources Staff Determine Needs Assessment Community Methodologies Demographics Economy 5-22-98 ap9899 needchrt.doc NEEDS ASSESSMENT METHODOLOGIES 1989-1993: • NINE PUBLIC FORUMS • THREE REGIONAL MEETINGS • KEYINFORMANT SURVEY FINDINGS: • TRANSPORTATION • HEALTH ISSUES • HOUSING • IN-HOME CARE • NUTRITION • ELDER AB USE/AD ULT PROTECTIVE SERVICES • COMMUNICATION, PUBLICITY, OUTREACH • VOL UNTEERS • PROGRAMDEVELOPMENT • FUNDING OF NEW SER VICES 1997-2001: • ANALYZED ALL OF THE SURVEYS AND ASSESSMENTS FOR THE LAST FO UR YEARS INCL UDING, WEST CO LINTY COALITION'S ASSESSMENT, DELTA 2000'S COMMUNITY FOR UM FINDINGS, UNITED WAY OF THE BAY AREA, AND ALLEN PARDINI'S DEMOGRAPHIC CENSUS DATA INFORMATION • PRETESTED CDA 'S SURVEY, UTILIZED CDA 'S SUR VE Y, AND UPDA TED THE KEY INFORMANT SURVEY FINDINGS: • TRANSPORTATION • MONEY TO LIVE ON = CDA SURVEY • HEALTH CARE • PROBLEMS DOING ACTIVITIES • PROBLEMS WITHPERSONAL ACTIVITIES • KEY INFORMANT SUR VEY.• • TRANSPORTATION • HOUSING • HEALTH RELATED ISSUES • ACCESS TO SER VICESICOMMUNICA TION • IN-HOME CARE • ISOLATIONAND LONELINESS • LONG TERM CARE 3 199 7-2001 STATE PLAN IDENTIFIED NEEDS THE 10 MOST IDENTIFIED AREAS OF NEED • ACCESSING SERVICES • CRIME PREVENTION • HEALTH CARE • HOUSING • INCOME • INFORMA TION AND ASSISTANCE • IN-HOME CARE • LONELINESS/SOCIALIZATION • NUTRITION • TRANSPORTATION s IL STATUS OF OBJECTIVES GOAL # 1: 1. Completed '98. C 2. Completed '98. C 3. Ongoing. 4. Completed '98. 5. Ongoing. C 6. Completed '97. 7. Completed '98. 8. Ongoing. C 9. Ongoing. C 10. Ongoing. C 11. Ongoing. 12. The Advisory Council recommended Adult Day Care (ADC) contracts be renewed for FY00-01. Networking to increase ADHC and ADC services is ongoing and becoming a stronger focus of the Advisory Council `01. P.D. 13. Ongoing. PD, 14. Completed '98. 15. Completed '99. C 16. Ongoing. C 17. Ongoing. C 18. Ongoing. C 19. Ongoing. C 20. Completed '98. HAArea Plan\END OF THE YEAR REPORT 00-01 Am 2 08/30/01 21. Caregiver Conference was held in East County in Oct. `99. PD 22. Ongoing. Scam Conferences were held in Concord (Oct. '99), Walnut Creek (March '00), San Ramon (July '00), Concord (Sept. '00), Oakland (May '01). All were well attended and provided information on a wide range of concerns and local and national resources. PD 22. Completed. The proposal was completed in July 1999; we were not funded. PD 23. Completed `99. PD 24. Completed `99. PD 25. Completed `99. C 26. Completed `99. 27. Completed-implementation ongoing `01. PD & C 28. Completed & group has discontinued `01. 29. Ongoing. C 30. Ongoing. C 31. Completed `00. Retreat held Sept '00 and another planned for Sept. '01. C 32. Ongoing. PD 33. Ongoing. PD 34. Ongoing. PD 35. Ongoing. PD 36. Ongoing. PD 37. Completed `00. 38. Ongoing. PD 39. Due to lack of staff and workload,we were unable to complete this objective. HAArea Plan\END OF THE YEAR REPORT 00-01.doc 3 08/30/01 40. AAA Staff worked with the U.C. Berkeley School of Social Welfare to enlist MSW Gerontology Majors, however, because CCC was unable to provide stipends, we were unsuccessful in our attempts to enlist interns. PD 41. Ongoing. C 42. Ongoing. PD 43. Completed `01. 44. Due to complex program issues and staff turnover, comprehensive program technical support and NAPIS data entry training were provided throughout `01. 45. Ongoing. PD 46. Ongoing. PD 47. Ongoing. PD 48. Completed `01. C GOAL #2: 1. Ongoing, as new facilities are built & data is revised. C 2. Ongoing. PD 3. Ongoing. PD 4. Ongoing. C 5. Ongoing. Committee is planning on do more in this area. C 6. Ongoing. PD 7. Ongoing. PD 8. Ongoing. PD 9. Not yet completed, though individual members have participated in other such forums around the County. PD HAArea Plan\END OF THE YEAR REPORT 00-01.doc 4 08/30/01 10. Ongoing. Currently working on a specific plan to approach the City Council and Board of Supervisors with a boilerplate of the Committee's position for policy development on Housing & Transportation, including how they are linked. C 11. Ongoing. Looking at each City's housing element. C 12. The Alzheimer's Subcommittee of the Health Committee has been working on the development and coordination of an Alzheimer's educational forum to be presented September 26, 2001. C 13. Ongoing. Looking at Alzheimer's training for staff of assisted living and SNF facilities. CCC California Senior Legislators introduced this bill and it is in process. C 14. Ongoing. Speakers from these entities come to Advisory Council meeting to present. C 15. Ongoing. Have been planning a concerted, written and personal outreach to all transportation entities and to entities making transportation decisions. C 16. Ongoing. Invited paratransit representatives to attend meetings and be on committee. They do attend occasionally. C 17. Committee's first Measure C Position Paper promoted increasing the percentage of Measure C funds designated for paratransit. C 18. Completed. Developed two measure C Position Papers: one on % of transit funding and one on creating enforceable language for the Housing Element `01. C 19. Ongoing. AAA staff will continue to meet with the Laotian population to develop programs. C 20. Ongoing. C 21. Ongoing. HAArea P1an\END OF THE YEAR REPORT 00-01.doc 5 08/30/01 22. Deleted — discontinued as a County Program. 23. Ongoing. 24. I & A was restructured to include intake responsibilities for several CCC Aging & Adult Services programs, therefore, AAA Outreach Staff has taken over primary responsible of disseminating information to low-income ethnic minorities. 25. Deleted - not realistic for I & A. 26. Ongoing. PD 27. Ongoing. PD 28. Ongoing. 29. Ongoing. 30. Ongoing. C 31. Ongoing. C 32. Ongoing. C 33. Ongoing. PD 34. Ongoing. C 35. Ongoing. 36. Initial effort completed-ongoing follow-up. C 37. Completed `01— ongoing follow-up. C 38. Ongoing. PD 39. Completed `01. 40. Completed `01. 41. Ongoing — Forum planned for September 2001. PD 42. Ongoing - Liaison Report on agenda at monthly meetings: hosting of speakers at committee and Advisory Council meetings `01. 43. Ongoing — Ombudsman attends Alzheimer's Subcommittee meetings V. HAArea PIan\END OF THE YEAR REPORT 00-0 Ldoc 6 08/30/01 44. Completed — follow-up will assist existing support workshops and classes. 45. Ongoing. 46. Ongoing. C 47. Ongoing. C 48. Ongoing. C 49. Completed '01. C 50. Ongoing. C 51. Ongoing. 52. Ongoing. C 53. Ongoing. PD 54. Ongoing. PD 55. Ongoing. PD 56. Ongoing. PD 57. Ongoing. PD GOAL #3: 1. Completed `98. 2. Ongoing. C 3. Ongoing (see Section III Targeting). C 4. Completed. All County Day planned and coordinated in both `00 & `01. PD & C 5. Ongoing (see Section III Targeting). C 6. Completed `01. C HAArea P1an\END OF THE YEAR REPORT 00-01.doc 7 08/30/01 7. Completed `01. Goal of increasing average daily attendence to 16 from 14 was surpassed to 18 at year-end. Will continue ongoing effort. C 8. Ongoing. 9. Ongoing. C 10. Ongoing. C GOAL #4: 1. Completed `99. 2. Ongoing. 3. Completed `98. 4. Ongoing. 5. Ongoing. 6. Ongoing. 7. Completed `99. 8. Completed `99. 9. Ongoing. 10. Completed `99. 11. Ongoing. P.D. 12. Completed `99. P.D. 13. Completed `99. P.D. 14. Completed `9. P.D. 15. Completed `01& Ongoing. Community Online Resource Database (CORD) is a collaboration between Contra Costa's Employment & Human Services, Health Services, and Community Services HAArea P1anNEND OF THE YEAR REPORT 00-01.doc 8 08/30/01 departments to provide staff, other professionals, clients and the public with referral and resource data via the Internet. C 16. Completed `01. PD 17. Ongoing. 18. Ongoing. PD 19. Ongoing. PD 20. Ongoing. PD 21. Ongoing. C GOAL #5: 1. Ongoing — Representatives of TACC and CSL are on the Legislative Committee. C 2. Ongoing —This year, staff started meeting regularly with the County Legislative Analyst for the California Welfare Director's Association, focusing on senior-related legislation. C 3. Ongoing — Actively supporting Prescription Drug coverage inclusion in Medicare and financial abuse protections. C 4. Ongoing. C 5. Ongoing —Focusing specifically on Olmstead and the energy crisis as it effects seniors. C 6. Completed `01. C 7. Completed `01. C 8. Ongoing. PD 9. Completed `01. PD 10. Ongoing. 11. Ongoing (see #3). PD HAArea Plan\END OF THE YEAR REPORT 00-01.doc 9 08/30/01 12. Ongoing. PD 13. Completed `01— however, is difficult to promote, due to the complexity of the issue. 14. Completed `01. C 15. Completed `01. C 16. Ongoing —Transportation & Housing Committees meeting jointly on this 17. Completed `01. C III. PROGRAM DEVELOPMENT AND COORDINATION Program Development and Coordination (PD & C) activities were included in Section II. Status of Objectives, indicated by a PD or C next to the correlating objectives. 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. By forming collaboratives, the AAA public and private partners are able to use in-kind resources to further expand, develop, and implement new services. Our collaboration have resulted in: new Senior Housing 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. 14AArea PIan\END OF THE YEAR REPORT 00-01.doc 10 08/30/01 IV. TARGETING The Area Agency on Aging (AAA) and programs funded through the AAA continue to target and serve minorities in Contra Costa County (CCC). Our County's ethnic demographic profile includes: Afro-American, Hispanic, Laotian, Vietnamese, Filipino, Russian, and Ukrainian, with a small percentage of Native American and Middle-Eastern elders. AAA requires its contractors to target and serve minorities and individuals with the greatest social and economic needs as part of their contractual obligation and compliance in accordance with the Older Americans Act and Older Californians Act. We continue to provide intensive outreach and targeting to our community. Our Community Liaison Staff seek out diverse and hard to reach seniors by forming collaborative working relationships with other organizations and groups, by making verbal presentations to a variety of audiences, and broadly distributing brochures, pamphlets, and other printed information about the available services. Translation services continue to be provided for both written and spoken information for the community at large and its contractors. The AAA Senior Information Newsletter was printed over the past year in four languages other than English: English, Spanish, Laotian and Vietnamese. We have almost doubled our circulation of the Newsletter this year throughout the County from approximately 2600 to 5000 by increasing our mailing list, the number of presentations made to various organizations and groups, and distribution while attending social events for outreach and rapport building. HAArea PIan\END OF THE YEAR REPORT 00-01.doc 11 08/30/01 During this past year, we held meetings with leaders from the Laotian, Vietnamese, Russian and Ukrainian populations in Contra Costa County to better understand there culture and needs. AAA Staff attended Conferences, which focused on planning for the needs of refugees in our County. We had meetings and discussions with the Director of the Resettlement and Immigration Services who represented the Jewish Family & Children's Services (JFCS). The purpose of this concerted effort was to increase understanding the functions of each agency (AAA and JFCS) and to determine how we can best work together to serve refugees living in the Bay Area. We continue to meet the needs of the Asian population in CCC through the Nutrition Program by continuing to provide meals targeted to he Laotian, Vietnamese and Filipino seniors. AAA staff and Nutrition staff 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 staff also participates in Cultural Awareness Day in East County annually. AAA continues to work with the United Laotian Community Development Inc., City of San Pablo, City of Richmond, West Contra Costa Senior Coalition and Lao Senior Association to assess the needs of it Laotian elders and develop strategies and programs to address the identified needs. The Collaboration's approach has been to engage service system administrators, community leaders and elders in a meaningful dialog. A grant proposal was submitted to and granted by the California Program to address the Multicultural Health objective by creating community driven, multicultural, HAArea Plan\END OF THE YEAR REPORT 00-01.doc 12 08/30/01 multilingual responses to the problem of health care access for the Southeast Asian elder communities in all of CCC. V. VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES AAA staff continues to participate, provide technical support, and assist in the coordination of the activities of the Contra Costa County's Fraud Fighters Coalition. The function of this committee is to support the newly formed Senior Fraud Fighter's Bureau by offering support, advice, technical assistance, planning and development of the bureau, advocacy, and Fraud Conferences presented Countywide. The Coalition is responsible for the successful development of the Senior Fraud Fighter's Bureau due to its diligent advocacy and hard work to involve the District Attorneys Office, County Supervisors, and other experts, while providing technical assistance to seek funding and develop of grant proposals. The Bureau provides Countywide services and is housed at the Elder Abuse Protection Agency in West County. The Coalition also provides advocacy and assistance by developing and promoting legislative activities for increasing law enforcement and protection for seniors who are/have been victims of fraud. The expansion of outreach efforts to protect vulnerable elders by fighting fraud have involved community collaboration and community education by inviting experts to Contra Costa County Television's local cable channel through the Senior Network show to get the word out about the latest scams. H:\Ajea PIan\END OF THE YEAR REPORT 00-01.doc 13 08/30/01 The Registry Program continues to include training on identifying potential abuse situations that are both physical and fiduciary for in-home workers. The augmentation to services to the vulnerable elders has allowed the addition of Legal staff to investigate elder abuse issues and to train the community in recognizing potential abuse problems. Ombudsman Services of Contra Costa provides mediation and conciliation services in the resolution of inquiries and complaints from older long term care residents and patients, to establish Family Councils for support of families of long term care residents, and to investigate reports of physical abuse of all dependent adult and elder residents of long term care facilities. The contract stipulates that they are to provide services to 3,750 unduplicated individual clients, 10,450 hours assisting in complaint investigation and resolution; and 140 hours of education and training provided to clients, family members, and facility care providers. This last Fiscal Year they surpassed their contract requirements with 10,505 hours provided to 4,351 seniors. HAArea PIan\END OF THE YEAR REPORT 00-01.doc 14 08/30/01 SERVICE UNIT PLAN — End of the Year Report 2000 = 2001 Note this Service Unit Plan utilizes the NAPIS (National Aging Program Information System) Categories Indicate the number of units of service to be provided with ALL funding sources, including federal, State, USDA, program income, and local funds (i.e., list all units of service reportable through the MIS). Other units of service cannot be added since only the units of service listed under each program are allowable. . Programs identified should be funded in the budget. The right-hand column titled Goals / Funds) provides the Area Agency with an opportunity to relate each Title III and Title VII funded service/program to goal statements and funding levels. Use of this column is optional. Area Agencies are encouraged to relate the listed source of funds to goals identified either by name or number. TITLE III Goals /Funds # Program (Optional) Projected Actual 1. Personal Care (In-Home)* Goal # Units of Service 2. Homemaker (In-Home)* Goal # Units of Service 3. Chore (In-Home)* Goal # Units of Service 4. Home Delivered Meals Goal # 1, 2, &4 Units of Service 180,000 217,074 $1,019,179 * Total funding is split between a) Nutrition Ed. b) Home Delivered Meals c) Congregate Meals 15 Projected Actual 5. Adult Day Care/Health Goal # 1 & 2 Units of Service 23 39 $87,331 6. Case Management (Access)* Goal # Units of Service 7. Congregate Meals Goal # 1, 2, 3, 4 Units of Service 173,395 192,265 $1,418,833 8. Nutrition Counseling Goal # Units of Service 9. Assisted Transportation (Access)* Goal # 1 & 2 Units of Service 360 408 $10,000 10. Transportation (Access)* Goal # Units of Service 65,000 63,243 29,000 11. Legal Assistance* Goal # Units of Service 3,500 6,879 $128,817 12. Nutrition Education Goal # Units of Service 150 201 28,990 13. Information and Assistance (Access)* Goal # 1,2,3,4 Units of Service 17,667 19,120 388,324 14. Outreach (Access)* Goal # Units of Service * Indicates Title III-B priority services 16 Projected Actual 15. Other Services Visiting (hrs) Goal # Units of Service 13,000 21,771 $22,800 Registry Goal # Units of Service 2,500 4,200 $35,762 Title VII Ombudsman Services $178,389 New Seniors 3,750 4,351 Compl/Inves/res hrs 10,450 10,505 17 ATTACHMENT A Partner in Planning Planning Today for Tomorrow Agenda 10:00 -10:20 Registration and get acquainted Review Resources and Displays 10:20 - 10:30 Welcome and Introduction of Participants 10:30 - 10:35 Introduction to Group sharing 10:35 - 11:05 Two 15 minute sharing segments First, segment. Sit by Committees or Commission or by Community. Share what's going on in your community that enhances the quality of life of seniors. Comment on independent seniors, the frail, the language isolated the disabled. Choose a scribe for sharing later. Second Segment. Discuss greatest obstacles and challenges in your communities for seniors, for families of elderly, neighborhoods, the city, or town. What would enhance the quality of life of seniors? Prioritize your lists. Choose a Scribe. 11:05- 11:50 Reports from the Groups Share and Respond 11:50- 12:05 Senior Information and Referral Up - Date 12:05 - 12:20 Break to Prepare for Lunch Minutes Partners in Planning Planning Today for Tomorrow Old I January 26, 2001 Sharon welcomed the group to the meeting at 10:00 a.m. At today's meeting,the discussion will be about what to do for the community in terms of providing support and how to best utilize resources. Sharon mentioned some of the things that have happened over the last ten years--Fraud Fighters, Care Givers conference. Sharon discussed the expansion of Adult Protective Services, MSSP and Linkages. She discussed the Central and West County Coalitions and local committees on Aging. Support of in home workers has been established through the development of the Public Authority. Today's meeting is to assist in identifying planning needs the AAA can assist with in the community. Sharon stated that Kitty Barnes and Barbara Morrow are working with east county seniors and grassroots organizations to develop a coalition in East County. The Advisory County has a Liaison committee of members who work with staff to the members of the Board of Supervisors. At this point Sharon introduced Margaret Schultz, who was the facilitator for the meeting. She stated that the meeting will be for the purpose of clarifying roles and relationships, develop networks and share resources. At this point everyone present introduced themselves, told where they are from and a secret about themselves. The first group activity was to address the relationship with Area Agency on Aging. What are key issues, priorities. Brainstorm ideas. Enhance communication, do networking. Ground Rules developed by the participants were as follows: 1. Allow equal air time 2. Withhold judgment 3. No side talk 4. Accept possible changes 5. Spokesperson 6. Use "I" experience 7. Don't give advice unless asked for 8. Stay focused 9. Have fun 10. Creative solutions Margaret asked the participants to think about their relationship with AAA. What works? What are the challenges? Sharon gave each participant a copy of the Area Agency on Aging brochure. The participants identified the following community issues: transportation, independent living, affordable assisted living, demographics, cost of prescription drugs, guidelines for senior housing, shared housing referral, homeless seniors, elder abuse prevention, caregivers—number and quality, adult children, affordable housing/SSL spirituality, appropriate medical care, alternative medical care. Other issues listed were assisted devices for disabled, mental health services, research based. Arnie Kasendorf stated that the Transportation Committee of the Advisory Council on Aging has just joined the Housing Committee. Earl stated that isolation and loneliness came up as top issues in a survey developed and implemented in Concord. Gil Shepard stated that spirituality and emotional issues are key to health. These link with transportation. Another key issue suggested was education and outreach. Top key issues were transportation, housing, isolation/loneliness, education/outreach, prescription drugs and mental health. Margaret asked each table to give solutions to each issue. New groups were formed to do the brainstorming. Sharon stated that the results will be incorporated into the four year Area Plan which goes to the California Department of Aging. Kitty Barnes will do a presentation of the information from today's meeting to the Advisory Council. Copies of today's material will go to each committee of the Advisory Council. The participants worked on housing, then worked on education/outreach. The participants next worked on transportation, mental health, isolation/loneliness, prescription drugs. There was a comment made that sometimes service providers and key leaders have assumptions around seniors needs. Bette Wilgus stated that there have been many surveys done around senior needs. Sharon stated that there is limited staff and volunteers to do surveys. The top ten priorities have not changed over the years California Department of.Aging,just shifted in priority. Sharon stated that she hopes AAA can do focus groups with student interns. Beverly Kalmbach stated that the survey she presented was not well received because of the time of the year. Could this be reconsidered? Leon Morphew discussed ads on TV for prescription drugs. Sometimes doctors prescribe drugs that are too expensive. 2 There was comment made that community needs to understand contributions older adults make in the community. Arnie Kasendorf talked about the survey the Laotian community did. A town hall meeting will be held February 23 to address the top issues. West County Coalition is hosting the meeting with Supervisor Gioia. Don Williams suggested that a list be made of the services seniors provide in the community(See Attachment A) Margaret suggested that a list could be created at the break of the services seniors provide in the community. Arnie Kasendorf discussed the recognition lunch that RSVP holds for its volunteers. There was a comment about Contact Care--seniors call seniors who live alone. Arnie Kasendorf stated that the county needs a publicity person to publicize what seniors do. Sharon stated that one of the ways to get information out to the community is through the Information and Assistance newsletter. Barbara Morrow stated that articles have already been printed in the newsletter about Friendly Visitor program, Care Management, Meals on Wheels, RSVP. Sharon stated that additional volunteer recruiting could be done from the private sector utilizing persons who are getting ready to retire. Birthe Kirsch asked how word could get to the isolated seniors? Sharon stated that often, seniors don't know about a service until the service is needed. Beverly Kalmbach stressed the importance of using Information and Assistance and publicizing their phone number-1-800-510-2020. Arnie Kasendorf stated that the number should be featured prominently on the front of the newsletter. Margaret asked the participants to go to the blue handout,the middle page, "Two Ways of Looking at the Same Problem". She asked that the participants take this back to those they work with. Margaret distributed handouts on strategic planning. "What is the final outcome"? Decide milestone, decide what steps need to be taken. What are resources needed? Margaret gave an example of planning a task. Communicate--get help. Margaret asked how networks are created in the room? How are networks created between their groups and AAA? She asked the participants to brainstorm ideas. At this point the groups reported out. 3 Jerry Sharrock's group reported the following: Enhance communication, three coalitions meet jointly at least once a year, address major county issues, encourage city commissions to attend coalitions, continue annual partnership meeting, have liaisons attend commission, coalition meetings, have liaisons meet with senior center directors, have members from today's meeting attend coalitions. Bette Wilgus'group reported: Add today's attendance list to SHARE mailing list. Have representatives from each group meet once or twice a year to share information. Teleconference from AAA website--1. Links 2. Page to list upcoming events. Hot line for new programs, developments, ideas. Arnie's group reported the following: Monthly meetings of coalition, yearly contact using a list from newsletter,E mail. Have regular meetings of representatives from other coalitions. Have mailings between coalitions to share what is happening in each area. Have quarterly joint coalition meetings. The Concord Commission on Aging table reported the following: Contribute to and read I&A newsletter. Commissions on Aging expand their newsletters. Check city websites where available. AAA staff share expertise in areas, such as planning. Exchange of information on specific topics. Have tour of I&A program to see what information is offered. Exchange ideas on fundraising, budgets. Work more closely with county supervisors. Leon Morphew's group reported the following: Include information from I&A newsletter with AARP, exchange ideas. Barbara Morrow stated that she and Sharon will review the notes from today's meeting. Margaret will make revisions. • The names and addresses from today's participants will be mailed out to those present. Sharon reminded those present that if the community and constituents they represent have any questions, please call the I&A toll-free number, 1-800-510-2020. 4 Key Issues • Transportation • Housing • Isolation/loneliness • Education & Outreach • Prescription drugs • Mental health • Community awareness of senior contributions Issues Transportation Independent living safety Affordable assisted living (subsidized) Demographics--where are seniors? Cost of prescription drugs Guidelines for senior housing--structural/facility, programs Isolation/loneliness Education & outreach Assisted devices for disabled Mental health services Shared housing referral Homeless seniors Elder abuse prevention Caregivers--paid (too few), quality Adult children Affordable housing/SSI Spirituality Continual education of services Appropriate medical care (alternative) Mental Health Use mental activities to stimulate a more healthy outlook. Encourage involvement with other people, groups and frequent activities. Offef seminars to senior groups regarding mental health issues regarding elder age groups. Work with EAP/Crisis centers/police & DA's regarding senior abuse problems. (Need better cooperation). Provide mental health clinicians in each area of county. Research on mental health needs in community. Discuss issue more frequently. Transportation to and from mental health centers and clinics. Education on what's available in community. Legal implications. Access (timely) to doctors. More stories-)�reduee stigma. (Reagan--Betty Ford) List of si ns--help families & caregivers recognize symptoms i.e. depression Suggestions of"what to do", first steps Outreach to places where seniors go Emphasize non medical dealing with issues instead of pills Support groups--patients & families Effects of medicines--"side" effects, overmedication, interactions between meds and alcohol Outreach to shut-ins TV series directed to shut-ins Use shows from commercial TV that highlight mental health issues. Dementia/Alzheimer's adoption by mental health or medical coverage. Recognize correlation between mental health &.physical activities. Housing Reverse mortgage education and options Co-op owned congregate living Transportation services nearby Built near business centers Shared housing--list of suggestions on how it would work Construction guidelines for senior housing via AAA to counties Need developer who will plan/build senior housing(provide funds) City planning & design review board to review guidelines Understand city position on true senior housing City councils--set aside percent for affordable senior housing Keep focus narrow--something that can be achieved More HUD type places County should give cities senior housing goals Resources for independent living Build more affordable housing ways to keep current affordable housing Goal of keeping seniors in own homes--aging in place Find out what resources are needed by "economic gap" people--above SSI but limited fixed income Define what affordable housing is Help create more subsidized housing--independent & assisted Education/Outreach Better spreading of already available information i. e. 911 (like), radio, TV/get message to community about older adults & what they provide Followup needed when seniors get information Education on how to deal with technology Advocate for seniors should be in every senior center Caring neighborhood program Ongoing (Poster keep at front desk) I&R training to refer to 800-510-2020 for focal points--all senior centers, churches, apartments, community centers, etc., police, NM's Magnets with phone # sent with PG&E bill Through Channel 25 (CCTV)/19/27 (city & county channels) Networking with health care providers Clarify Triple A terminology--glossary Outreach to assisted living facilities *Utilize senior centers/churches to spread information--organized, ongoing effort working with AAA *A job description Make this an "A1" priority for senior leaders--identify staff person to get job done senior groups More flyers Better use of Internet among service groups Expand outreach beyond usual suspects--Boy Scouts--Girl Scouts-- MacDonald's--Pacific Bell--Ser-vice Clubs--Barnes &Noble, Letter Carriers (knows a lot of residents) Road show to present&discuss infonnatio*n--ongoing/interactive Isolation/Loneliness Finding them--canvass neighborhoods Meals on Wheels Families--informing, surveying County records--who has lived in same home 30+ years Solutions 1) What's causing isolation? --alcoholism --depression 2) Community education--that this problem exists 3) Survey in tax bill Work with health care providers Promote volunteerism Outreach through churches/synagogues, etc., priests, rabbis, ministers Mobile book unit Senior centers outreach Meals on Wheels survey/take newsletter(report isolated senior) Transportation to programs, centers & churches Public relations Newsletter on activities Culturally sensitive assessment methods--tise what people will find (PG&E bills) Train gatekeepers--Meals on Wheels, police, fire, chaplains, emergency response teams, neighborhood watch, buddy systems Use interactive TV/radio/Intemet Apartment managers-program to help identify isolated Make community aware of needs Use neighborhood watch More support to Friendly Visitors, etc. Build community Prescription Drugs Caution regarding TV ads, prescription drugs Health care professionals talking at centers--pharmacists Health fairs at senior centers Individuals carry list of meds on person Health bracelets/drug allergies Take all drugs & vitamins to doctor appointments/herbals Layman terms to explain prescriptions Senior centers have drug information books available for members Doctor need to give complete drug information when prescribed Road show to share information Political action--lobby Advise doctors Educate consumer 8004 to get advice on drugs (pharmacists man) Contact by phone while senior takes drugs *Continue to advocate for federal Medicare coverage of drugs Education about discount opportunities Caution with supplements and self medication with herbal remedies Get help to obtain information about plans available Use part of state surplus to give vouchers Monitor what individuals take How see doctor who is not covered for Medi-Cal, Get information about simpified list of approved meds (approved by Medi-Cal) Patient guidelines for what to think about when acquire & use prescription drugs ss Alert about what kills--plain English Drug & alcohol interaction Help with administration of meds Alternatives to drugs--publicity, i.e. acupuncture, Chiropractor, homeopathy, massage Transportation Vouchers Better connections with county One transportation system Outreach & education Bus shelters Shopping center shuttles/other points Senior vans to work within designated area Voice opinions to county & state boards Short term transportation to appointments/same day Transportation specialist for seniors Education on bus schedules & how to use bus Affordable Central organization to "pool" vans during free hours--time share--institution State waivers on transportation "boundary" regulations Extend times--past 3:30-5:00 Move to facility that has a van Senior preference--survey Back packs to transport Connections between jurisdictions & systems Central planning Door to door--for frail (expand) Sunday transportation* Survey (mailed) for need Taxi vouchers Vans (buses) that go to supermarket doors Senior volunteer drivers (expand) Free transportation Build neighborhood mom/pop groceries Delivery for groceries, etc. Advocate for more federal subsidy Networking Enhance Communication • Three coalitions meet jointly yearly--address major county issues, share. functions/process • City commissions attend coalitions • Continue annual "partnership" meet • Liaisons to commissions/coalitions • Liaisons to senior center directors (is there a senior center organization?) • People here attend respective coalitions • Monthly meetings--coalition • Telephone contact using list from today & e mail (list serve) • Newsletter--each coalition to share • Regular meetings of representatives from other coalitions • Informational mailings between coalitions to share what happening in each area • Quarterly joint coalition meetings • Add today's attendee list to SHARE mailing list • Representatives (one or two) from each group meet once or twice a year, to share information • Teleconferencing--phone tree • AAA web site--1 . Links to coalitions 2. Page to list upcoming events • Hot line--for new programs and developments, ideas • Senior newsletter • News from other newsletters and announcements • AARP newsletters • Contribute networking ideas to and read Senior Information • COM exchange newsletters • Check city websites where available • AAA staff share expertise in areas such as planning • Share points from today within our own "home" groups • Exchange of visits to each other's meetings on a selective basis (i.e. on specific issues to be featured) • (Linda Anderson) Tour of Information and Assistance program could be offered to senior leaders • Exchange ideas on fundraising/budgets • County supervisor--work more closely with Summary of Evaluations EVALUATION PARTNERS IN PLANNING: PLANNING TODAY FOR TOMORROW Facilitator: Margaret Schultz Date: January 26, 2001 1. What did you like about today? Examples: --great organization& leader- realistic goals for today --everything—So many of us sharing learning. --remarkable —great job(ideas exchanged networking, facility, food --sharing- meeting people from different sections of the county —good ideas 2. Was enough time allowed for activities during the day? Yes 19 No 3 3. If you could change anything about the day what would it be? -our supervisors should attend —have one of AAA staff set the stage for continuing collaboration —more time to network —nothing- do more often —very informative & well planned —allow more time to put ideas on paper when in group —add more time for reports on what individuals are doing —not so much food —follow up meeting to discuss printed materials 4. Would you attend again? Yes 21 No 0_ Why or why not: --good networking and information --more sharing of information about our opportunities, priorities & solutions --let's have these workshops annually —it is ok - great --more mixing of participants from different groups ATTACHMENT B CONTRA COSTA COUNTY UNtTEDWAYINOSPITAL COUNCIL COLLABORATIVE COMMUNITY ASSESSMENT Cabinet&Steering Committee Members Janice Anderson Catherine Giacalone Etta Maitland Robert Sessler Program Coordinator Project Supervisor Executive Director Director Neighborhood Youth Corps,Contra CCC Office of Education Ombudsman Services of Contra Costa County Office on Aging Costa County Office of Education Contra Costa County Joe Goglio Cymdi Simpson Myrtle Ballard Community Services Director Ginger Marsh Director,Community Wellness& Office Manager Contra Costa County Central Labor Volunteer,Contra Costa County Prevention Program,Contra Costa California Employment Development Council Continuum of Care County Health Services Department Steve Graham Leila Marsh Belinda Smith Kitty Barnes Director,Community Health Community Health Specialist CDBG Program Manager Executive Director Partnerships Kaiser Permanente Community Development Dept. Delta Community Services Kaiser Permanente County of Contra Costa Jost Martin,LMFT Neil Barth Teddi Grant-Adel Administrative Programs Manager Isiah Turner President Director Contra Costa Mental Health Deputy City Manager/ Worldwide Educational John Muir/Mount Diablo Community Executive Director Services/Private Industry Council Health Institute Robert McEwan Private Industry Council of Richmond Central County Regional Office Executive Director Janet Harden Housing Authority of Ed Valladares Lynn Baskett West County Program Manager Contra Costa County Newcomer Coordinator Regional Vice President Regional Occupational Program Filipinos for Affirmative Action Hospital Council of Northern& Contra Costa County Office of Charlie McNeil Central California Education Executive Director Maria Teresa Viramontes Alcohol and Drug Council of Executive Director Rosemarie Bell Alana Hogan Contra Costa County East Bay Public Safety Deputy County Librarian Program Analyst Corridor Partnership Contra Costa County Library System Department of Social Services Ralph Murphy County of Contra Costa Managing Attomey John Wolfe Tom Berglund Contra Costa Legal Services Executive Vice President Director/Consultant Sharon Johnson Foundation Contra Costa County Taxpayers Mental Health Association of Assistant Director Association Contra Costa County Contra Costra County Office on Carol Newkirk Aging Executive Director Catherine Zaharko Linda Best YWCA of Marin,SF&San Mateo Director of Marketing/Corporate Executive Director Ginny Keenan Counties Development Contra Costa Economic Partnership Executive Director Doctors'Medical Center Alcohol&Drug Council of Kathleen Odne Brenda Blasingame Contra Costa County Executive Director Homeless Program Director Dean&Margaret Lesher Foundation Department of Health Services Julie Kelley Contra Costa County Assistant for Program&Policy Yung Ouyang Contra Costa County Health Services Researcher Linda Chandler Asian Pacific Environmental Network Deputy Director Jim Kennedy Private Industry Council of Contra Director,Redevelopment Agency Joseph Ovick Costa County Contra Costa County Community County Superintendent of Schools Development Department CCC Office of Education Linda Cherry Representative Carolyn Krantz Steve Peavler Contra Costa County Contractors' Pastoral Associate Program Manager,Children's Alliance St.Peter Martyr Church Services,Contra Costa County Social Services John Cullen Mark Lachman Director Associate Director of Development Deborah Pitts Contra Costa County Social Services Rubicon Programs,Inc. Community Affairs Alta Bates Medical Center Eileen DeMaria Yvette Leung Executive Director Food Security Project Coordinator Yvette Radford Child Abuse Prevention Council Contra Costa County Community Community/Gov't Relations Leader Wellness&Prevention Program Kaiser Permanente Wayne Ernstrom Chief,Social Work Services Christina Linville Rebecca Rozen Veteran's Outpatient Clinic Division Manager Representative U.S.Veteran's Administration Welfare Reform Planning Community&Government Relations Contra.Costa County Social Services Kaiser Permanente Kate Ertz-Berger Executive Director Darien Louic Bertha Ruiz Contra Costa Child Care Council East Bay Regional Director Program Manager United Way of the Bay Area East Bay Works Career Center- Brentwood ATTACHMENT C A Non-Medical Survey and Evaluation of Senior Care Facilities Serving Persons with Dementia in Contra Costa County The Purpose: Prepare and publish a survey of facilities located in Contra Costa County, California that offer residential care to older persons affected by dementia. The study would be limited to care facilities that provide a 24 hour per day program 365 days per year. The Need: The incidence of Alzheimer's Disease and other forms of dementia is on the increase. From age 65 to 74 about three percent of the people have Alzheimers. The incidence increases to nineteen percent for seniors 75 to 84 and to an estimated 47 percent for elders over 85 (Evans, D. A etal. "Estimated Prevalence of Alzheimer's Disease in the U. S."Millbank Quarterly(1990)68:267). For Contra Costa County this translates, in 1998, to over eleven thousand seniors afflicted with various forms of dementia. The Association of Bay Area Governments has published current . projections indicating the population of Contra Costa County will increase an additional seven percent by the year 2000 and over twenty percent by 2010. As the 85+age senior is increasing faster than the general population,the increase in seniors suffering from dementia will rise even more dramatically. At this time there is no governmental standard for a family to use as a guideline to determine the quality, much less the adequacy, of a facility to care for a loved one with dementia. To compound the matter, most family members are reeling from the impacts of the disease: trying to understand what the disease is; how to deal with it and what to expect for the future of all involved . Most / have little time or capacity to comparatively evaluate facilities that purport to serve the senior with dementia. Currently, they must rely almost entirely upon their own resources to find and evaluate facilities that may provide care and services they need. A precise, reliable and independently prepared comparative analysis of facilities would prove valuable to these families in their time of need. The State of California has volumes of regulations on the minimum levels of medical care necessary in Skilled Nursing Facilities (Nursing Homes and Convalescent Hospitals) and Residential care facilities for the Elderly (Assisted Living and Board and.Care). The families are often interested in the non-medical evaluation of the facility-those components that make a facility"home"instead of"a home"(for example:a hospital may meet all medical standards but most do not consider it a pleasant place to live.) The analysis would include objective information obtained from each facility. Each facility would also be reviewed on subjective issues to further define the living environment. It is anticipated that these subjective observations, when combined with the more statistical objective information will present a fuller picture of the environment for the potential resident and their family. The evaluations would be non-medical, that is, prepared by an informed and sensitized team of individuals who evaluate each facility on objective and subjective basis from the eyes of an informed buyer, but not a medical expert. The.Study The study would address the many aspects of concern of the families, including: Objective(Factual) General Size and type of facility. Care delivery structure(medical or social model, or other distinctive constructs). What level(s)of dementia does the facility provide care for? Licensure Safety Systems and design incorporated in the facility. Facilities to permit safe wandering. I Medical Size, composition and certification criteria of medical staff. Administrative and medical supervision of staff. Program Availability, frequency of activities programs. Is respite care available?At what cost? Is hospice care available? Nutrition What is the daily nutrition program? Are special diets accommodated? Financial What are the charges for facility? What is included in the quoted costs? Are various types of accommodations available?At what cost? Are unused pre-paid days refunded? What is the facilities discharge policies? i Subjective(Observations) General Is the facility clean, odor free? How"new"are the facilities? Is the facility appropriate for the frailty of the residents? What is the overall atmosphere of the facility? Safety Do the residents look well cared for? Are there apparent hazards that the residents must negotiate? Is the facility prepared for wandering residents? Medical Does the staff show"caring"? How does the staff communicate with the residents? Does staff allow resident privacy and choice? Program Are the residents active? What is the quality of activities programs? Are there other services provided that help families cope? Nutrition Is the food appetizing, tasty? Is there choice? Financial What is the likelihood of incurring "extra"charges on a regular basis? The Process 1. Define dementia(medical and as used by caregivers) 2. Determine issues to be evaluated. 3. Determine scale of evaluation for each issue. 4. Identify facilities operating in study area that meet study's facility definition. 5. Survey minimum of 3 facilities(site visit and phone surveys for each). 6. Review sample results and modify survey as necessary. 7. Determine channels for distribution of final report 8. Survey identified facilities(site visit and phone surveys for each). 9. Compile data. 10. Perform follow-up to fill voids in data. 11. Prepare final report. 12. Publish report The Study Preparer Michael Dugan has been involved with senior issues for over twenty five years. He practiced architecture and was a principle of a multi-disciplined firm where he focused on housing, particularly senior housing and facilities for the developmentally disabled. He became sensitized to the special needs of people who have capabilities different than the general population. Working with non-profit developers he helped create housing for women with AIDS and senior housing for very frail seniors. He helped forge an alliance between affordable senior housing and i i I i affordable medical services,creating assisted living (of sorts)for a very frail, very poor population in inner city Oakland, California. Mr. Dugan is currently pursuing creation of modest cost assisted living in the Bay Area. He also is an active member of California Association of Housing and Services for the Aging, Contra Costa County Advisory Council on Aging and its Housing and Legislative subcommittees. He is a resident of Orinda,California and a member of the Orinda Design Review Board. . I I i I I I CONTRA COSTA COUNTY MINUTES ADVISORY COUNCIL ON AGING MARCH 17, 1999 MEE Muriel Clausen called the meeting to order at 9:35 am. Gerry Witucki led in the Pledge of Allegiance. Sally Shultz took the roll. PRESENT: Debbie Card,Reva Clark,Muriel Clausen,Cathy Demut,Margaret Dowling, Bonnie Eisenberg,Trevor Evans-Young,Dan Freudenthal, Cordelia Hardy,A. C. Hollister, Ora Jackson, Arnie Kasendorf,Bill Kendall,Alberto Lemos,Edith Loewenstein, Ilene Lubkin,"Leon Morphew, Norman Nelson,Nick Rodriguez,Phil Saxton, Gerald Sharrock,Sally Shultz, Paul Takayanagi, Ramon Taraya,Patsy Welty,Gerry Witucki.ABSENT/EXCUSED: Murray Bishop, Michael Dugan, Rudy Fernandez,Lou Ferrero,Andrew Newcomer,Gene Wolfe. GUESTS PRESENT: Janice Compton,Audrey Pite,Lupe Monterrosa,Barbara Lessegna, Christine Kolaites, Helen Hall, Joan Carpenter,M.C.Christi,Thongsoon Phutharme,Bounthong Karnsenvogi, Bonaypha Taminaly,Phanh Phongkia, Phanh Boutang, Dorothy Clinton,Maxine Concepcion,Kathryn Robertson,Natalie Zarchin,Dorothy Fowler, Gil Shepard,T. Gillen, Walter Bank, Laura Takovchi,Linda Rodini,Hakeim McGee,Deborah Janke,Gary Tatpaporn, Linda Thaxter,Georgia Stockton, Loren Cole. STAFF PRESENT: . Bob Sessler,Sharon Johnson,Judy Weitzner, Kathy Radke, Peter Koster, Barbara McNair,Karen Gregory, Ruth Goodin,Kitty Barnes, Linda Schaefer, Leah McIntosh,Bette Wilgus. Subject Discussion Action/Who Agenda The agenda was approved.. MSP (Evans- Young/Jackson) to approve the agenda as submitted. Minutes The minutes for the February meeting were approved MSP (EvansYoung/ as corrected. Freudenthal)to approve minutes following corrections. Show Maggie Dee as present. Mr. Kasendorf should be added to Housing committee on attendance list.. Correspondence Sally Shultz read the correspondence. Muriel stated that Trevor Evans-Young received a certificate of appreciation for his contribution to the Medicare education program. Inez Nichols resigned from the Advisory Council. On Friday,May 7 from 9 a.m. 3 p.m.a meeting on Immigration Rights will be held at the Plumbers& Steamfitters Hall in Concord. . _2_ i Subject Discussion ActionfWho Consent The consent calendar included a letter to Supervisor MSP(Evans-Young/ Calendar Uilkema inviting her to the roundtable discussion on Freudenthal)to approve April 21 at 1:00 p.m. The consent calendar also consent calendar. included the treasurer's report.. Committee .Muriel reported that the Silver Haired Congress met in e its Washington,D.C. Contra Costa County has a Legislative proposal that is#5 priority--requiring geriatric training Advocaa in medical schools. Alameda County has#3 priority. Health/Mental Dr.Loewenstein reported that the next Health Health committee meeting will be the second Thursday,next month with speakers on health-related topics.. . Housing The next Housing committee is Thursday,April 8 and will include a tour of the Concord Royale. Kitty Barnes reported that the Housing committee will start meeting on the first Thursday of the month, 1:30 p.m. beginning in May. Last month the committee toured Columbia Park Manor in Pittsburg. i Planning Leon Morphew reported that the Planning Committee received a report from Barbara Morrow on various contracts. Barbara Morrow will be monitoring federal contracts,and Barbara McNair will be monitoring state contracts. Ung Term Dr.Hollister reported that the Long Term Care Care Coordinating Committee Task Force had an item on the last Board of Supervisors consent calendar. The task force will develop a community based long term care plan. Social Service Department and Health Services will jointly apply for a planning grant from the State. Kitty Barnes reported that the Long Term Care committee is planning a caregivers conference in October. The committee is looking for volunteers to be on the committee to plan the conference. The subcommittee will meet Friday,April 2 at 9:30 a.m. Transportation Gerry Witucki stated that he is on the paratransit committee. The Pleasant Hill Senior Center is applying for a van. -3- Subject Discussion Action/Who utrition Ora Jackson stated that the waiting list for home delivered meals varies from month to month At the present time the following are on the waiting list: El Sobrante-7;Central County--101;Pittsburg-5. Nutrition will be celebrating its 25th anniversary on April 22. CoalitionsGerry Sharrock reported on the Central County Coalition. At the February meeting representatives from Elder Abuse Prevention reported on advance directive banking. Muriel Clausen reported that the West County Coalition is meeting today to hear the Public Hearing. Bob Sessler reported that the work of the In Home Supportive Services(IHSS)Implementation Team was completed on March 4. A report was presented to John Cullen,who will make a recommendation to the Board of Supervisors. The Board will take final action by the end of April. By July 1, staff and the registry will be up and running. The reauthorization of the Older Americans Act is looking more optimistic. Membership Patsy Welty reported that the Membership Committee interviewed two candidates. At that time the Council was full. Since then a resignation has been received. One of the candidate's names will be sent to the Board for approval. Kitty Barnes stated that in February the Housing committee had a joint meeting with the Long Term Care committee. Ombudsman Program representative met with the two committees. Kitty suggested that the Advisory Council invite Ombudsman Program representative Public Hod= Gerry Sharrock opened the public hearing. The 1999-2000 Area purpose of the public hearing is to allow public input Plan U ate on the information. During the question period,the . time limit for each speaker is two minutes. He introduced Bob Sessler,Director and Sharon Johnson, Planner. -4- Subject Discussion Action/Who Sharon Sharon went over the Older Americans Act contracted Johnson, services which include Ombudsman,Congregate anner Nutrition,Home Delivered Nutrition,Home Visiting, In Home Services Registry,Transportation,Legal Services,Adult Day Care,Brown Bag Program, Alzheimers Day Care Resource Center, Senior Companion,and Respite Registry. Office on Aging is going to bid for Alzheimer's Day Care, Brown Bag,Home Visiting,In Home Services Registry&Respite Registry,and Social Day Care. The services that the Office on Aging provide directly include Information and Referral, Health Insurance Counseling and Advocacy Program, Linkages and Respite Purchase of Services. Office on Aging other activities include Program Development,Coordination,Administration. Older Californian's Act services include Brown Bag Program,Alzheimer's Day Care Resource Center, Senior Companion and Respite Registry. Outreach/Targeting—A requirement is in the RFP that agencies providing service must adhere to. There are seven goals in the Area Plan. (see handout) Community Service Areas and Focal Points--including activities of such groups as West County Coalition, Central County SHARE group and others. Estimated Seniors to be Served and Estimated Units of Service to be Provided(attached to the 1999-2000 Area Plan Update)—Office on Aging will be going to bid for most services. Bob Sessler, Bob went over the budget for 1999-2000. There are 'rector two sources of funding: federal and state government. Title IIIB—$593,947;III administration—$223,390,IIIC Nutrition—$1,007,418; IIID In Home—$25,237;IIIF Health Promotion&Disease Prevention—$40,889;III Support for Ombudsman—$13,316;VIIB Elder Abuse Prevention—$12,828;USDA—$183,935. Total: $2,105,440. State Revenue: State Administration—$162,153; I-HCAP—$87,286; Older Californians Act—$387,612. Total: $639,051. -5- Subject Discussion Action/Who Bob went over the contracted services—Ombudsman— $89,606;Congregate Nutrition—$786,596;Home Delivered Nutrition—$487,238; Home Visiting— $22,800;In.Home Services Registry—$35,762; Nutrition Transportation—$26,000; Legal Assistance— $77,817;Social Day Care—$63,975;and$10,000 as yet to be determined. One of the programs that has been considered in an escort shopping service program. Office on Aging services: I&R—$298,642; Disease Prevention/Health Promotion—$40,889;Program Development—$29,842; Coordination--$36,991; AdministrativelAdvocacy—$223,390 and In Home Service for Frail at Risk Clients—$38,045. Federal government requires that 50%be spent on access services, 11%on legal services and a minimum of 8%on in home services. State funding includes programs under the Older Californian's Act: Senior Companion--$89,867; Brown Bag—$18,615;Alzheimers Day Care—$80,000; Respite Registry—$8,000. $900 goes to Napa/Solano to cover administrative costs for their Brown Bag program- Administration—$33,272; Linkages—$152,231; Respite Purchase of Services—$4,727 and HICAP—$87,286. Case management will be provided through MSSP program, Linkages Program,and APS program. Questions from Margaret Dowling asked if any.money from Title III or Audience state funds are going to IHSS Public Authority Registry? Bob stated that they are not. Bob stated that nothing would prohibit this. Maggie Dee also asked about HICAP brochures. Is there money to re-publish the brochures to include funding for younger disabled people? Bob stated that the office will come up with a plan to do this. Question was asked regarding the Bidders Conference— when does this occur? There are two bidders conferences on March 22. From 10:30 am. - 12:30 p.m. is for Older American Act programs,and 2:30 p.m. -4:30 p.m. is for Older Californians Act services. i -6- Subject Discussion Action/%o Walter Bank from Senior Legal Services asked if there is anything different with the service delivery? He also asked a question about the goals in the Area Plan. He said they are very broad. He asked if there are any --subgoals? He also asked if it would be possible for. Contra Costa Senior Legal Services to provide legal services to the other contractors? Bob stated that in answer to the first question,there are significant changes in the range of dollars for long term care case management which enables office on Aging to serve disabled and elderly clients. In answer to the second question about the Area Plan Goals, Specific ! Objectives are listed with each goal. Sharon stated that the objectives are very specific and time limited. Sharon does a year end report which is sent to the Board of Supervisors and California Department of Aging regarding outcomes of the goals and objectives. Bob stated that in answer to question#3,the only type of legal services are client centered services. Individual services could use the legal services. I A question was asked by Sandy Medvedoff from Diablo Valley Foundation—How long will it be until staff is hired for Multi Senior Services Program, Linkages,Adult Protective Services and the program is up and running? How long is the commitment for funding for the programs? Bob stated that the office is in the process of hiring case management staff. Four social workers,public health nurse and supervisor have been hired for MSSP. During the period April 1 -July 1,the program will obtain the 200 clients needed for the program. For the Linkages program—the office is in the process or hiring ' additional case worker. For the APS program, interviews will be scheduled soon. The level of funding right now is$700,000. The committed level won't be known until the state budget is adopted. -7- Subject Discussion Action/Who Trevor Evans-Young asked about the funds under Administration/Advocacy. Is it possible to adjust this? Bob stated that$2.1 million dollars is augmented by a million dollars in local matching resources. Also $300,0004400,000 in meal contributions is received. Bob stated that for administrative services, the county matches at 25%. For program development, coordination and supportive services,the county provides a 10%match. Trevor asked if any inkind funds or resources are included? Bob stated that for the current year$227,000 is received in cash match,and.an additional$158,000 in in-kind contributions from community agencies. The amount of grant related income is$669,000. Sharon stated that this goes back into the program. Question was asked regarding outreach to minorities and low income seniors. What kind of outreach is done in communities that can't access because of language barriers? Sharon stated that outreach is done to diverse populations. Also brochures are printed in different languages. Department has a contract with California Translation Services and Center for New Americans. Sary Tatpaporn of Asian Family Resource Center stated that Asian people from Laos and VietNam in North Richmond need help with English and becoming U. S.citizens. Dorothy Clinton read a paragraph of a letter from K. G. Dorosz. Ms. Dorosz spoke about the$70,000 previously awarded to provide case management services. Will any Older American Act funds be used for case management? Bob stated that no case management services will be provided directly by Older American Act funds because of additional new funds in APS,Linkages and MSSP. Bob stated that the Office on Aging is still committed to the national priority of 50%for these access services. Mrs. Clinton asked if there will only be 200 people served under the program? Bob stated that the 200 is for MSSP only. i Subject Discussion Action/Who Arnie Kasendorf asked question about mandate for minorities and low income. He stated that he doesn't see outreach in his community. Sharon stated service providers are encouraged o utilize county translators to have brochures translated into different languages. AAA has coordinated with other agencies and provided bilingual family conferences. AAA staff also participates on cultural diversity task forces. Question was asked by Laura Takeuchi from Japanese American Services of East Bay—She asked what languages the brochures are printed in? Sharon stated that service providers have been hired. All service providers are mandated to serve minorities and those of low income. Languages that brochures are printed in include Spanish,Tagalog, Laotian, Vietnamese and Farsi. i A member of the audience stated that outreach includes more than printing information in different languages. There is a missing link between the community and the services. Sharon stated that she will take the information to the Planning Committee and the Advisory Council. i Judy Weitzner stated that I&R can make presentations on different topics. I&R can be'reached at 1-800-510- 2020. Public Gerry Sharrock reminded audience members of the two Comment minute time limit. Mr. Tatpaporn stated that most younger families are working and fewer parents stay home with older parents. Most of the older Asian people do not speak English. He recommended that these issues be integrated into the Plan. Question was asked regarding Asian/American Islander seniors--there needs to be a method of providing services for transportation to the entire county. It is difficult for ethnic providers to provide services with Older American Act dollars. Language barrier for seniors isn't only problem,there is a cultural difference. Loren Cole,Executive Director,Senior Outreach Services distributed a two page handout. Dr. Cole stated that he feels the case management program provided by Senior Outreach Services is more dollar effective than the programs operated by the county. Subject Discussion Action/Who Walter Bank, Senior Legal Services requested the $10,000 in the"as yet to be determined"category be allocated for Senior Legal Services. Deborah Janke, West County Adult Day Care—She commended the Advisory Council on their recommendation to provide$63,975 for Social Day Care. Dorothy Clinton backed up what Walter Bank said about Senior Legal Services needing more funding. Audrey Pite spoke in support of Senior Outreach Services. She spoke regarding the impact of losing the Geriatric Unit. Georgia Stockton from Senior Outreach Services stated that she is glad that MSSP has the component with Linkages. 20%of SOS clients are not eligible for MSSP and 30%are not eligible for Linkages. That leaves 49%that will fall through the cracks. She suggested that volunteers could go to senior centers. Leah McIntosh from I&R stated that her major concern is that MSSP and Linkages are located in central county. There is a psychological barrier to keep people in east and west county from accessing services. Dr. Hollister spoke about demographics in Contra Costa County. The population,especially of older people,is increasing. The population of those over the age of 65 is at risk of needing services. Ruth Goodin asked about the timeline for finalization of the plan? Bob stated that the plan is reviewed by staff and put together for the Planning committee for its meeting the first Tuesday in April. The final recommendations go to the Advisory Council in April and on to the Board of Supervisors in late May or early June. Sharon stated that the Area Plan is a living document, always changing. Sharon stated that she will put her business cards on the table for anyone interested in contacting her regarding the Plan Gerry Sharrock thanked everyone for coming,and the . meeting was adjourned at 12:00 noon.. - I t I Subject Discussion ActionlWho i Submitted by, { Sally Shultz, Advisory Council Secretary f II 4 - !4 1 I I I i ' I II I i .� • 4 • ' � ,� � � � \� � � \. u � � ,s� • � �! \ , ., t � � 1 J �• .; • � � . � 1 ,. �� � 1 � • � � � �, �� � '1 �� y �• �, • t � �'� �` „ '` � !►. �, ,` 1 \ - , `\ , � . �, � �� � ` \\V � c'���� .r � � � � �.` � � .� 1 • � • • all IN • 11 � Y , 1 • • 11 11 ,, •� •• � 1\ �/ • 11 � .. ,, � �� `� � � •� r •� � � � � `1 � 7 I �y \� 1 11 \ � • `� . • ' � i � � • � ` �� • �� �� 1 � \' � 1 ` �1 �, ,� � . �1 ' � 11 \� � �,� � ��� 11 . ' � � • _• 1' 1 � � 11 � \ ,\ 1 1 � `, I ` 0 1 • 1 R Advisa-i-Couricil on Aging C.....JL_-_ OFFICE ON AG:NG 2530 Arnold Drive, Suite 300 Aging Martinez, 94553-4359 Office on Ag� Marti ez, CaliforniaCa00 Sharon Johnson 2530 Arnold Drive, Suite 300 Martinez, CA s V_ April 13 1999 P TO: Planning Committee Members FROM: Leon Morphew,Chair SUBJECT: Monthly Meeting WHAT: April Planning Committee Meeting WHEN: Friday,April 23, 1999 - 1:30 p.m.* WHERE: 2530 Arnold, Suite 300, Martinez Diablo Room *Note different day & time this meeting only. AGENDA: ctivi : Time: I. Public Comment 1:30 11. Review Public Hearing Information 1:35 -2:00 III. Maggie Dee-Grocery Escort Shopping 2:00-2:15 IV. Make Funding Recommendations Re: 2:15 - 3:00 a. Contra Costa Senior Legal Services b. Grocery/Escort Services C. Social Day Care V. Public Comment THE CONTRA COSTA COUNTY ADVISORY COUNCIL ON AGING IS APPOINTED BY THE BOARD OF SUPERVISORS TO ADVISE THE AREA AGENCY ON AGING ON ALL MATTERS RELATED TO THE DEVELOPMENT AND ADMINISTRATION OF THE ANNUAL AREA AGENCY PLAN AND OPERATIONS CONDUCTED THEREUNDER,IN ACCORDANCE WITH MANDATES FROM THE OLDER AMERICANS ACT. ANY COMMENTS OR RECOMMENDATIONS MADE BY THE COUNCIL OR ITS INDIVIDUAL MEMBERS DO NOT REPRESENT THE OFFICIAL POSITION OF THE COUNTY OR ANY OF ITS OFFICERS. PLANNING COMMITTEE CONTRA COSTA COUNTY MINUTES ADVISORY COUNCIL ON AGING APRIL 6, 1999 MEETING Leon Morphew called the meeting to order at 9:35 a.m. Present: Rosemary Shepard,Norman Nelson, Sally Shultz,A. C. Hollister, Ora Jackson, Reva Clark,Leon Morphew,Ramon Taraya,Gerard Witucki. Excused: Gerald Sharrock, Lou Ferrero.Staff Present: Sharon Johnson, Barbara McNair, Karen Gregory. Guests resent: Loren Cole, K. G. Dorosz. Clear the Air/Information Sharing I� i Reva Clark stated that she attended a meeting at Supervisor Gioia's home. She also attended the ribbon cutting of the North Richmond Center for Health. i Reva shared with the group that she has a new grandson. Sharon introduced Barbara McNair,who will be monitoring the Older Californian's Act programs as well as other duties. i Rosemary Shepard announced that Betty.Fielding has a new book published on memory. i - I Minutes I Rosemary Shepard moved and Reva Clark seconded to approve the March minutes as submitted. The motion passed. Report on April 2, 1999 Meeting,with Boupha Toomalay&Louise Gonsalez I Sharon stated that she received a call from Father McKinney,who is representing the Asian population. The meeting with Boupha Toomalay and Louise Gonsalez did not take place,because of Good Friday. The Laotian population would like to have a senior center building for their population. Sharon discussed some of the other alternatives: the seniors could meet at Richmond Senior Center,have some cultural meals and participate in arts and crafts. Father McKinney will be invited to a Planning Committee meeting. Report on Results of RFI for Respite Registry Sharon stated that a legal notice was put in the newspaper for$3,333 in start-up funds for Respite Registry. Independent Living Resource will be providing the service. Independent Living Resource is located at 3200 Clayton Road in Concord. -2- Maggie Dee Proposal for Grocery Escort Shopping Maggie Dee has proposed that Office on Aging fund grocery escort shopping in— the-amount of$10,000 in hopes that a grocery store will match this amount. Sharon stated that the Planning Committee needs to make a decision on the$10,000-- whether to use it for the grocery escort service or augment legal services. Leon Morphew—Evaluate Planning Committee Leon Morphew discussed some of the duties of the Planning Committee. The Planning Committee is governed by the federal and state goverment and is a policy making body. Mr. Morphew's question: would Sharon be more effective without the Planning Committee? Sally stated that the Planning Committee is not a policy making body. It makes referrals to the Advisory Council. The Board of Supervisors is the Area Agency on Aging and is the policy making body. The director of the Office on Aging has the authority to support the Advisory Council with its recommendations. The committee brainstormed the following: Planning Committee: 1. How beneficial is the Planning Committee/or is it? a. Budget process b. Contract monitoring C. Population diversity Contractors come in to the Planning Committee meeting, and the members ask questions. Barbara Morrow reports to the Planning Committee quarterly. Sharon stated that the item that needs to be addressed is population diversity. Leon Morphew stated that he feels the services that are offered to seniors are too fragmented. Sharon stated that Aging and Adult Services is in the process of being redesigned. Mr. Cullen's philosophy is to focus on the client. Make the process friendly for the client. Leon Morphew stated that he would like to have a segment of each Planning Committee devoted to how effective the committee is. Public Hearin Items tems A. Asian Family Resource Center-Sary Tatapaporn Sharon stated that according to the letter received from the Asian Family -3- Resource Center,the older members of the Asian families feel that younger family members are losing their culture. Sharon stated that she would like to ask Mr. Tatpapom to speak to the Planning Committee. Dr. Hollister stated that a proposal is needed from Asian Family Resource Center. Sharon stated that possibly Information and Referral could make a presentation to the Asian group. Sally Shultz stated that El Cerrito has phone books in many languages. She also suggested that Ellen McDonald be contacted. Senior Outreach Services--Dr. Loren Cole Dr. Loren Cole,executive director of Senior Outreach Services, stated that he is concerned about Office on Aging moving to providing case management services through MSSP and Linkages. Dr. Cole stated that he feels that gaps in services won't be filled by the Linkages program. Dr. Cole stated that care management is at the heart of the services that Senior Outreach Services provides. Dr. Cole stated that their agency needs time to make the change, to realign the way funds are raised. i Gerry Witucki stated that there are concerns about the fiscal solvency of the agency. ;I Dr. Cole stated that he has worked with nonprofits for 35 years. He has been a business manager for 21 years..In the cost saving measures for the agency, Dr. Cole stated that overhead was cut and two line staff were laid off. Three new meals on wheels routes were opened, and three more will be opened. Over$50,000 was raised for meals on wheels since September. Dr. Cole stated that half of the current care management program is being taken away. About 125 people will not be served under the MSSP program. Dr. Cole stated that the clients of MSSP must be skilled nursing facility certifiable. The clients of Linkages must meet at least one Activity of Daily Living. Sharon stated that the Office on Aging is also receiving the Adult Protective Services augmentation. Self neglect is one criteria for APS augmentation. Ramon Taraya asked how effective their program is in outreach to the Asian/Laotian community? Dr. Cole stated that Senior Outreach Services has over 1600 volunteers. Ramon Taraya asked about the reduction in services at the agency. Dr. Cole stated that there has not been a reduction in service. Sharon stated that the units of service for the agency continues to be over what is required. -4- Dr. Cole stated that the agency is looking to develop more fee for service programs. Dr. Cole stated that their agency is asking the Office on Aging for$75,000. This will provide staffing to continue the services. K. G.Dorosz K.G. Dorosz is the executive director of the Elder Abuse Prevention Consortium. She stated that she is present in two capacities: 1. Advocacy for services for seniors. 2. As chair of West County Senior Coalition. Kagey stated that many of the clients do not meet the criteria for MSSP or APS. Kagey stated that the APS standard level of cases is 10. Kagey stated that she feels that agencies should be supported when they.go through tough times. She asked that the$75,000 be set aside until the situation is studied. Kagey stated that the Office on Aging is required to give at least 50%of their federal allocation to access. Dr. Cole suggested looking at how Information and Referral is funded. The following is the brainstorming the committee did on case management issue. Case Management Loren Cole,K. G. Dorosz $75,000 in Title IIIB Older American Act funds. 1. Received$700,000 in start-up funds for MSSP to carry 200 cases. MSSP is for Medi-Cal clients and the clients must be skilled nursing facility certifiable. 2. Received$152,000 for Linkages,which serves the 18+population. There is no income requirement. The clients must meet at least one Activity of Daily Living. The caseload is 75. 3. Adult Protective Service Augmentation-16 to 22 staff. 10 cases per worker? Sharon suggested that Linda Anderson talk to the Planning Committee next month. Sharon stated that it will be necessary to have another Planning Committee meeting this month. Dr. Hollister stated that he would like to have a pie chart that would show the disposition of Title III services. I ' -5- The special Planning Committee meeting will be Friday,April 23 at 1:30 p.m. Reva Clark announced that the Concord Royale will hold an open house from 1 P.M. to 4 p.m. on Thursday,April 8. The Housing Committee will have a private tour that day. I Sally Shultz stated that Gerry Sharrock will be honored for his work on scams at a dinner in Oakland. Submitted by,, I II Karen Gregory Advisory Council Secretary I t ; i i I I II I it . II At this point Sharon went over the pie charts with the committee. One pie chart shows how Older Californian's Act funds are spent; another shows how Older American's Act funds are spent. Contra Costa Senior Legal Services Walter Bank from Contra Costa Senior Legal Services has requested $30,000. PI anning Estimates At this point Sharon went over the planning estimates, which compare 1998/99 planning estimates with 1999/2000 planning estimates. The meeting was adjourned at 3:10 p.m. Submitted by, Karen Gregory Staff Secretary ATTACHMENT C A Non-Medical Survey and Evaluation of Senior Care Facilities Serving Persons with Dementia in Contra Costa County The Purpose: Prepare and publish a survey of facilities located in Contra Costa County, California that offer residential care to older persons affected by dementia. The study would be limited to care facilities that provide a 24 hour per day program 365 days per year. The Need: The incidence of Alzheimer's Disease and other forms of dementia is on the increase. From age 65 to 74 about three percent of the people have Alzheimers. The incidence increases to nineteen percent for seniors 75 to 84 and to an estimated 47 percent for elders over 85 (Evans, D. A. etal. "Estimated Prevalence of Alzheimer's Disease in the U. S." Millbank Quarterly(1990)68:267). For Contra Costa County this translates, in 1998,to over eleven thousand seniors afflicted with various forms of dementia. The Association of Bay Area Governments has published current projections indicating the population of Contra Costa County will increase an additional seven percent by the year 2000 and over twenty percent by 2010. As the 85+age senior is increasing faster than the general population,the increase in seniors suffering from dementia will rise even more dramatically. At this time there is no governmental standard for a family to use as a guideline to determine the quality, much less the adequacy, of a facility to care for a loved one with dementia. To compound the matter, most family members are reeling from the impacts of the disease: trying to understand what the disease is; how to deal with it and what to expect for the future of all involved . Most / have little time or capacity to comparatively evaluate facilities that purport to serve the senior with dementia. Currently, they must rely almost entirely upon their own resources to find and evaluate facilities that may provide care and services they need. A precise, reliable and independently prepared comparative analysis of facilities would prove valuable to these families in their time of need. The State of California has volumes of regulations on the minimum levels of medical care necessary in Skilled Nursing Facilities (Nursing Homes and Convalescent Hospitals)and Residential care facilities for the Elderly (Assisted Living and Board and.Care). The families are often interested in the non-medical evaluation of the facility-those components that make a facility"home"instead of"a home"(for example: a hospital may meet all medical standards but most do not consider it a pleasant place to live.) The analysis would include objective information obtained from each facility. Each facility would also be reviewed on subjective issues to further define the living environment. It is anticipated that these subjective observations, when combined with the more statistical objective information will present a fuller picture of the environment for the potential resident and their family. The evaluations would be non-medical, that is, prepared by an informed and sensitized team of individuals who evaluate each facility on objective and subjective basis from the eyes of an informed buyer, but not a medical expert. The Study i i The study would address the many aspects of concern of the families, including: i Objective(Factual) i General Size and type of facility. �. Care delivery structure(medical or social model, or other distinctive constructs). - What level(s)of dementia does the facility provide care for? Licensure Safety Systems and design incorporated in the facility. Facilities to permit safe wandering. i Medical ! Size, composition and certification criteria of medical staff. ! Administrative and medical supervision of staff. Program Availability, frequency of activities programs. Is respite care available?At what cost? Is hospice care available? ! ! Nutrition What is the daily nutrition program? Are special diets accommodated? Financial ! What are the charges for facility? What is included in the quoted costs? Are various types of accommodations available?At what cost? Are unused pre-paid days refunded? What is the facilities discharge policies? i ! ! ! ! ! Subjective(Observations) General Is the facility clean, odor free? How"new"are the facilities? Is the facility appropriate for the frailty of the residents? What is the overall atmosphere of the facility? Safety Do the residents look well cared for? Are there apparent hazards that the residents must negotiate? Is the facility prepared for wandering residents? Medical Does the staff show"caring"? How does the staff communicate with the residents? Does staff allow resident privacy and choice? Program Are the residents active? What is the quality of activities programs? Are there other services provided that help families cope? Nutrition Is the food appetizing, tasty? Is there choice? Financial What is the likelihood of incurring"extra"charges on a regular basis? The Process 1. Define dementia(medical and as used by caregivers) 2. Determine issues to be evaluated. 3. Determine scale of evaluation for each issue. 4. Identify facilities operating in study area that meet study's facility definition. 5. Survey minimum of 3 facilities(site visit and phone surveys for each). 6. Review sample results and modify survey as necessary. 7. Determine channels for distribution of final report 8. Survey identified facilities(site visit and phone surveys for each). 9. Compile data. 10. Perform follow-up to fill voids in data. 11. Prepare final report. 12. Publish report The Study Preparer Michael Dugan has been involved with senior issues for over twenty five years. He practiced architecture and was a principle of a multi-disciplined firm where he focused on housing, particularly senior housing and facilities for the developmentally disabled. He became sensitized to the special needs of people who have capabilities different than the general population. Working with non-profit developers he helped create housing for women with AIDS and senior housing for very frail seniors. He helped forge an alliance between affordable senior housing and affordable medical services,creating assisted living(of sorts)for a very frail,very poor population in inner city Oakland, California. Mr. Dugan is currently pursuing creation of modest cost assisted! living in the Bay Area. He also is an active member of California Association of Housing and Services for the Aging, Contra Costa County Advisory Council on Aging and its Housing and Legislative sub-committees. He is a resident of Orinda, California and a member of the Orinda Design Review Board. I I ! _ I I I I I I i I I i i it . v CONTRA COSTA COUNTY MINUTES ADVISORY COUNCIL ON AGING MARCH 17 1999 MEETING Muriel Clausen called the meeting to order at 9:35 a.m. Gerry Witucki led in the Pledge of Allegiance. Sally Shultz took the roll. PRESENT: Debbie Card,Reva Clark,Muriel Clausen,Cathy Demut,Margaret Dowling, Bonnie Eisenberg,Trevor Evans-Young,Dan Freudenthal, Cordelia Hardy,A.C. Hollister, Ora Jackson, Arnie Kasendorf,Bill Kendall,Alberto Lemos,Edith Loewenstein,Ilene Lubkin,-Leon Morphew, Norman Nelson,Nick Rodriguez,Phil Saxton, Gerald Sharrock,Sally Shultz,Paul Takayanagi, Ramon Taraya,Patsy Welty,Gerry Witucki. ABSENT/EXCUSED: Murray Bishop, Michael Dugan,Rudy Fernandez,Lou Ferrero,Andrew Newcomer,Gene Wolfe. GUESTS PRESENT': Janice Compton,Audrey Pite, Lupe Monterrosa,Barbara Lessegna,Christine Kolaites,Helen Hall, Joan Carpenter, M. C. Christi,Thongsoon Phutharme,Bounthong Karnsenvogi, Bonaypha Taminaly,Phanh Phongkia,Phanh Boutang, Dorothy Clinton,Maxine Concepcion, Kathryn Robertson,Natalie Zarchin,Dorothy Fowler,Gil Shepard, T. Gillen, Walter Bank,Laura Takovchi, Linda Rodini,Hakeim McGee,Deborah Janke,Gary Tatpaporn,Linda Thaxter,Georgia Stockton, Loren Cole. STAFF PRESENT: .Bob Sessler,Sharon Johnson,Judy Weitzner, Kathy Radke, Peter Koster,Barbara McNair,Karen Gregory,Ruth Goodin,Kitty Barnes, Linda Schaefer, Leah McIntosh, Bette Wilgus. Subject Discussion Action/Who Aeg nda The agenda was approved.. MSP (Evans- Young/Jackson) to approve the agenda as submitted. Minutes The minutes for the February meeting were approved MSP (EvansYoung/ as corrected. Freudenthal)to approve minutes following - corrections. Show Maggie Dee as present. Mr. Kasendorf should be added to Housing committee on attendance list.. Correspondence Sally Shultz read the correspondence. Muriel stated that Trevor Evans-Young received a certificate of appreciation for his contribution to the Medicare education program. Inez Nichols resigned from the Advisory Council. On Friday,May 7 from 9 a.m.:3 p.m.a meeting on Immigration Rights will be held at the Plumbers & Steamfitters Hall in Concord. . -2- Subject Discussion Action/Who i Consent The consent calendar included a letter to Supervisor MSP(Evans-Young/ Calendar Uilkema inviting her to the roundtable discussion on Freudenthal)to approve April 21 at 1:00 p.m. The consent calendar also consent calendar. included the treasurer's report.. I Committee .Muriel reported that the Silver Haired Congress met in e its Washington,D. C. Contra Costa County has a L&gislative proposal that is#5 priority--requiring geriatric training Advocacy in medical schools. Alameda County has#3 priority. Health/Mental Dr.Loewenstein reported that the next Health Health committeemeeting will be the second Thursday,next month with speakers on health-related topics.. . i Housing The next Housing committee is Thursday,April 8 and will include a tour of the Concord Royale. Kitty Barnes reported that the Housing committee will start meeting on the first Thursday of the month, 1:30 p.m. beginning in May. Last month the committee toured Columbia Park Manor in Pittsburg. Planning Leon Morphew reported that the Planning Committee received a report from Barbara Morrow on various i contracts. Barbara Morrow will be monitoring federal contracts,and Barbara McNair will be monitoring state contracts. Ung Term Dr. Hollister reported that the Long Term Care Care Coordinating Committee Task Force had an item on the last Board of Supervisors consent calendar. The task force will develop a community based long term care plan. Social Service Department and Health Services will jointly apply for a planning grant from the State. Kitty Barnes reported that the Long Term Care committee is planning a caregivers conference in October. The committee is looking for volunteers to be on the committee to plan the conference. The subcommittee will meet Friday,April 2 at 9:30 a.m. Transportation Gerry Witucki stated that he is on the paratransit committee. The Pleasant Hill Senior Center is applying for a van. -3- Subject Discussion Action/Who utrition Ora Jackson stated that the waiting list for home delivered meals varies from month to month. At the present time the following are on the waiting list: El Sobrante--7;Central County--101; Pittsburg--5. Nutrition will be celebrating its 25th anniversary on April 22. CoalitionsGerry Sharrock reported on the Central County Coalition. At the February meeting representatives from Elder Abuse Prevention reported on advance directive banking. Muriel Clausen reported that the West County Coalition is meeting today to hear the Public Hearing. Bob Sessler reported that the work of the In Home Supportive Services(IHSS)Implementation Team was completed on March 4. A report was presented to John Cullen,who will make a recommendation to the Board of Supervisors. The Board will take final action by the end of April. By July 1, staff and the registry will be up and running. The reauthorization of the Older Americans Act is looking more optimistic. Membership Patsy Welty reported that the Membership Committee interviewed two candidates. At that time the Council was full. Since then a resignation has been received. One of the candidate's names will be sent to the Board for approval. Kitty Barnes stated that in February the Housing committee had a joint meeting with the Long Term Care committee. Ombudsman Program representative met with the two committees. Kitty suggested that the Advisory Council invite Ombudsman Program representative Public Hearing Gerry Sharrock opened the public hearing. The 1999-2000 Area purpose of the public hearing is to allow public input Plan U ate on the information. During the question period,the time limit for each speaker is two minutes. He introduced Bob Sessler, Director and Sharon Johnson, Planner. -4- Subject Discussion Action/Who ' Sharon Sharon went over the Older Americans Act contracted Johnson, services which include Ombudsman,Congregate Planner Nutrition,Home Delivered Nutrition,Home Visiting, In Home Services Registry,Transportation,Legal Services,Adult Day Care,Brown Bag Program, Alzheimers Day Care Resource Center, Senior Companion,and Respite Registry. i Office on Aging is going to bid for Alzheimer's Day Care, Brown Bag,Home Visiting,In Home Services Registry&Respite Registry,and Social Day Care. The services that the Office on Aging provide directly include Information and Referral, Health Insurance Counseling and Advocacy Program, Linkages and Respite Purchase of Services. Office on Aging other activities include Program Development, Coordination,Administration. i Older Californian's Act services include Brown Bag Program,Alzheimer's Day Care Resource Center, Senior Companion and Respite Registry. Outreach/Targeting--A requirement is in the RFP that agencies providing service must adhere to. There are seven goals in the Area Plan. (see handout) . Community Service Areas and Focal Points--including activities of such groups as West County Coalition, Central County SHARE group and others.. Estimated Seniors to be Served and Estimated Units of Service to be Provided(attached to the 1999-2000 Area Plan Update)—Office on Aging will be going to bid for most services. Bob Sessler, Bob went over the budget for 1999-2000. There are 'rector two sources of funding: federal and state government. Title IIIB—$593,947; III administration—$223,390,IIIC Nutrition—$1,007,418;IIID In Home--$25,237; IIIF Health Promotion&Disease Prevention—$40,889;III Support for Ombudsman—$13,316;VIIB Elder Abuse Prevention—$12,828;USDA—$183,935. Total: $2,105,440. State Revenues State Administration—$162,153; I-RCAP—$87,286;Older Californians Act—$387,612. Total: $639,051. -5- Subject Discussion Action/Who Bob went over the contracted services—Ombudsman— $89,606;Congregate Nutrition—$786,596;Home Delivered Nutrition—$487,238; Home Visiting— $22,800; In.Home Services Registry—$35,762; Nutrition Transportation—$26,000; Legal Assistance— $77,817; Social Day Care—$63,975;and$10,000 as yet to be determined. One of the programs that has been considered in an escort shopping service program. Office on Aging services: I&R—$298,642;Disease Prevention/Health Promotion—$40,889; Program Development—$29,842; Coordination—$36,991; Administrative/Advocacy—$223,390 and In Home Service for Frail at Risk Clients—$38,045. Federal government requires that 50%be spent on access services, 11%on legal services and a minimum of 8%on in home services. State funding includes programs under the Older Californian's Act: Senior Companion—$89,867; Brown Bag—$18,615;Alzheimers Day Care—$80,000; Respite Registry—$8,000. $900 goes to Napa/Solano to cover administrative costs for their Brown Bag program. Administration—$33,272; Linkages—$152,231; Respite Purchase of Services—$4,727 and HICAP—$87,286. Case management will be provided through MSSP program, Linkages Program,and APS program. Questions from Margaret Dowling asked if any.money from Title III or Audience state funds are going to IHSS Public Authority Registry? Bob stated that they are not. Bob stated that nothing would prohibit this. Maggie Dee also asked about HICAP brochures. Is there money to re-publish the brochures to include funding for younger disabled people? Bob stated that the office will come up with a plan to do this. Question was asked regarding the Bidders Conference— when does this occur? There are two bidders conferences on March 22. From 10:30 am. - 12:30 p.m. is for Older American Act programs,and 2:30- p.m. -4:30 p.m.is for Older Californians Act services. i -6- i ! Subject Discussion Action/Who ' Walter Bank from Senior Legal Services asked if there is anything different with the service delivery? He also asked a question about the goals in the Area Plan. He said they are very broad. He asked if there are any subgoals? He also asked if it would be possible for Contra Costa Senior Legal Services to provide legal services to the other contractors? Bob stated that in answer to the first question,there are significant changes in the range of dollars for long term care case management which enables office on Aging ' to serve disabled and elderly clients. In answer to the second question about the Area Plan Goals,Specific Objectives are listed with each goal. Sharon stated that the objectives are very specific and time limited. Sharon does a year end report which is sent to the Board of Supervisors and California Department of Aging regarding outcomes of the goals and objectives. i Bob stated that in answer to'question#3,the only type of legal services are client centered services. Individual services could use the legal services. ' A question was asked by Sandy Medvedoff from Diablo Valley Foundation—How long will it be until ! staff is hired for Multi Senior Services Program, Linkages,Adult Protective Services and the program is up and running? How long is the commitment for funding for the programs? Bob stated that the office is in the process of hiring case management staff. Four social workers,public health nurse and supervisor have been hired for MSSP. During the period April 1 -July 1,the program will obtain the 200 clients needed for the program. For the Linkages program—the office is in the process or hiring additional case worker. For the APS program, interviews will be scheduled soon. The level of funding right now is$700,000. The committed level won't be known until the state budget is adopted. -7- Subject Discussion Action/Who Trevor Evans-Young asked about the funds under Administration/Advocacy. Is it possible to adjust this? Bob stated that$2.1 million dollars is augmented by a million dollars in local matching resources. Also $300,0004400,000 in meal contributions is received. Bob stated that for administrative services,the county matches at 25%. For program development, coordination and supportive services,the county provides a 10%match. Trevor asked if any inkind funds or resources are included? Bob stated that for the current year$227,000 is received in cash match,and an additional$158,000 in in-kind contributions from'community agencies. The amount of grant related income is$669,000. Sharon stated that this goes back into the program. Question was asked regarding outreach to minorities and low income seniors. What kind of outreach is done in communities that can't access because of language barriers?. Sharon stated that outreach is done to diverse populations. Also brochures are printed in different languages. Department has a contract with California Translation Services and Center for New Americans. Sary Tatpaporn of Asian Family Resource Center stated that Asian people from Laos and VietNam in North Richmond need help with English and becoming U. S.citizens. Dorothy Clinton read a paragraph of a letter from K. G. Dorosz. Ms. Dorosz spoke about the$70,000 previously awarded to provide case management services. Will any Older American Act funds be used for case management? Bob stated that no case management services will be provided directly by Older American Act funds because of additional new funds in APS,Linkages and MSSP. Bob stated that the Office on Aging is still committed to the national priority of 50%for these access services. Mrs.Clinton asked if there will only be 200 people served under the program? Bob stated that.the 200 is for MSSP only. i Subject Discussion Action/Who Arnie Kasendorf asked question about mandate for minorities and low income. He stated that he doesn't see outreach in his community. Sharon stated service providers are encouraged o utilize county translators to have brochures translated into different languages. AAA has coordinated with other agencies and provided bilingual family conferences. AAA staff also participates on cultural diversity task forces. Question was asked by Laura Takeuchi from Japanese i American Services of East Bay—She asked what languages the brochures are printed in? Sharon stated that service providers have been hired. All service providers are mandated to serve minorities and diose of low income. Languages that brochures are printed in include Spanish,Tagalog,Laotian, Vietnamese and Farsi. A member of the audience stated that outreach includes more than printing information in different languages. There is a missing link between the community and the services. Sharon stated that she will take the information to the Planning Committee and the Advisory Council. Judy Weitzner stated that I&R can make presentations on different topics. I&R can be reached at 1-800-510- 2020. ublic Geny Sharrock reminded audience members of the two Comment minute time limit. Mr.Tatpaporn stated that most younger families are working and fewer parents stay home with older i parents. Most of the older Asian people do not speak English. He recommended that these issues be integrated into the Plan. Question was asked regarding Asian/American Islander seniors—there needs to be a method of providing services for transportation to the entire county. It is difficult for ethnic providers to provide services with Older American Act dollars. Language barrier for seniors isn't only problem,there is a cultural difference. Loren Cole,Executive Director,Senior Outreach Services distributed a two page handout. Dr. Cole stated that he feels the case management program provided by Senior Outreach Services is more dollar effective than the programs operated by the county. -9- Subject Discussion Action/Who Walter Bank,Senior Legal Services requested the $10,000 in the"as yet to be determined"category be allocated for Senior Legal Services. Deborah Janke, West County Adult Day Care—She commended the Advisory Council on their recommendation to provide$63,975 for Social Day Care. Dorothy Clinton backed up what Walter Bank said about Senior Legal Services needing more funding. Audrey Pite spoke in support of Senior Outreach Services. She spoke regarding the impact of losing the Geriatric Unit . Georgia Stockton from Senior Outreach Services stated that she is glad that MSSP has the component with Linkages. 20%of SOS clients are not eligible for MSSP and 30%are not eligible for Linkages. That leaves 49%that will fall through the cracks. She suggested that volunteers could go to senior centers. Leah McIntosh from I&R stated that her major concern is that MSSP and Linkages are located in central county. There is a psychological barrier to keep people in east and west county from accessing services. Dr. Hollister spoke about demographics in Contra Costa County. The.population,especially of older people, is increasing. The population of those over the age of 65 is at risk of needing services. Ruth Goodin asked about the timeline for finalization of the plan? Bob stated that the plan is reviewed by staff and put together for the Planning committee for its meeting the first Tuesday in April. The final recommendations go to the Advisory Council in April and on to the Board of Supervisors in late May or early June. Sharon stated that the Area Plan is a living document, always changing. Sharon stated that she will put her business cards on the table for anyone interested in contacting her regarding the Plan Gerry Sharrock thanked everyone for coming, and the meeting was adjourned at 12:00 noon.. n Subject Discussion Action/Who Submitted by, i i Sally Shultz, Advisory Council Secretary i i i .i i i i i i i I it i i i CIO 0 co IOD 10 IaD C: 46. 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