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HomeMy WebLinkAboutMINUTES - 06081993 - 1.69 1 -69 r To: BOARD OF SUPERVISORS Contra Perfecto Villarreal, Director Costa� FROM: Social Service Department County May 12, 1993 DATE: acou+� APPROVE AREA AGENCY ON AGING FOUR YEAR 1993-97 AREA PLAN NOTICE OF SUBJECT: GRANT AWARD, AND SUBGRANT AWARD CONDITIONS FOR FY 93-94 ; AND SIGN THE LETTER OF TRANSMITTAL (Ref. : 29-002- } SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION APPROVE Contra Costa County Area Agency on Aging Title III four (4) year Planning and Service Area Plan for FY 93-97 and EXECUTE the Letter of Transmittal to the California Department of Aging. Upon approval by County Counsel or the Social Service Contracts Administrator, AUTHORIZE the Director, Office on Aging to EXECUTE the FY 1993-94 Subgrant Award Conditions and the Notice of Grant Award. In addition, AUTHORIZE the Director, Office on Aging or his designee to EXECUTE and submit future Standard Agreement Amendments that only reflect an adjustment in line items or increased revenues when the amendments do not result in additional County cost or decrease in grant revenue. II. FINANCIAL IMPACT The FY 1993-94 Subgrant Award will provide $1,944,980 of Federal and State funds to conduct programs and activities on behalf .of county residents age 60+ under Title III of the Older Americans Act. The Area Plan Budget for FY 1993-94 provides for a required County match of $64,495. This County revenue has been included in the 1993-94 budget of the Social Service Department. CONTINUED ON ATTACHMENT: X YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMM EE APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE Oe§.UPfff RW93 9 7.dpc 1 HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT_ . 1 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. Contact Person: Sharon Johnson 313-1711 /% 9 cc: office on Aging ATTESTED County Administrator PHIL 110CHELOR,CLERK OF THE BOARD OF Auditor-Controller SUPERVISORS AND COUNTY ADMINISTRATOR Calif. State Dept. of Aging (6) _ BY DEPUTY M382 (10/88) -4 III. REASONS FOR RECOMMENDATION/BACKGROUND Since 1976 the office on Aging has been providing services for older residents of the county under Title III of the Older Americans Act. Under the 1993-97 four (4) year Plan and Subgrant Award the Office on Aging will continue to fund contractor agencies to provide congregate meals, home-delivered meals, legal assistance, case management, in home services for the frail, home visiting, in-home services registry, transportation, long term care ombudsman services, and elder abuse prevention. In addition, the office on Aging will provide information and referral services, establish a preventive health care and disease prevention program and perform the program development, coordination, administrative and planning responsibilities of an area agency on aging. cl plan9397 .doc -a*J TRANSMITTAL. LETTER The 1993-1997 Area Plan for PSA � is hereby submitted to the California Department of Aging for approval. The (Governing dy) 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 persons and persons with functional impairments, their families, and caregivers. 1. Si neA Chairperson, Governing Board Date 2. (Signed) Director, Area Agency on Aging Date The Area Agency Advisory Council has had the opportunity to participate in the planning process, and to review and comment on the Area Plan. 3.t (Signed) '7, HY3 Chairperson, Area Agency on Aging D to 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. 58 TABLE OF CONTENTS ° 1993 - 1997 FOUR YEAR AREA PLAN uRAFl PART ONE: AREA PLAN BACKGROUND SECTION A: Setting the Stage Description of the Planning and Service Area Description of the Area Agency on Aging Mission Statement Section B: Establishing Priorities Discussion of the Planning Process (Optional) Discussion of Needs Assessment,Targeting, and Identification of Priorities Needs Assessment 1. Survey Pretest 2. Survey 3. Isolated Homebound Frail Elderly Survey 4. Key Informant Survey 5. Focus Groups — Targeting Identification of Priorities PART TWO: AREA PLAN GOALS AND OBJECTIVES PART THREE: AREA PLAN ADMINISTRATIVE INFORMATION I l i Section A Description of the Planning and Service Area Physical Setting Situated northeast of San Francisco, Contra Costa County is bounded by San Francisco and San Pablo Bays, the Sacramento River Delta, and by Alameda County on the south. Ranges of hills effectively divide the county into three distinct regions. The western portion, with its access to water, contains much of the county's heavy industry. The central section is rapidly developing from a suburban area into a major commercial and financial headquarters center. The eastern part of the county is also undergoing substantial change, from a rural, agricultural area, to a suburban region. The county has extensive and varied transportation facilities--ports accessible to ocean-going vessels, railroads, freeways, and rapid transit lines connecting the area with Alameda County and San Francisco. Contra Costa County contains a very diverse social and physical environment, although it is often perceived to consist of a series of affluent suburbs. West County is made up of Contra Costa's developed coastline along the San Francisco and San Pablo Bays. The cities within this region include E1 Cerrito, Richmond, San Pablo, Pinole, and Hercules, along with the unincorporated areas of E1 Sobrante, Rodeo, Crockett, Port Costa and Kensington. The subarea is bordered on the east by the East Bay Hills. Central County is the most populous of the County's subareas and encompasses the communities lying in the valleys between the East Bay Hills and the Diablo Range to the east (north of Mt. Diablo) . Included among these communities are Lafayette, Moraga, Orinda, Walnut Creek, Concord, Clayton, Pleasant Hill and Martinez, as well as the unincorporated areas of Canyon, Clyde and Rheem. South County (also known as South Central County) is that area which lies south of Mt. Diablo. Because of its rapid growth and changing demographics the area of the San Ramon Valley has shown itself to be a distinct region of Contra Costa County and warrants special attention as a subarea. The South County subarea includes the cities of Alamo and Diablo, and the unincorporated communities of Danville and San Ramon. East County is the largest of the subareas in total land mass and the region stretches over much of the County's agricultural land to the Suisun Bay and the Sacramento River Delta. The East County subarea includes the cities of Antioch, Pittsburg, and Brentwood, and the unincorporated areas of Port Chicago, Oakley, Bethel Island, Knightsen and Byron/Discovery Bay. Also included ' in this region is the hilly terrain of the Diablo Range and the Tassajara along the Alameda County Border. ap 93-97 a.doc 1 Demographic Characteristics Contra Costa County currently has approximately 119, 145 older persons over 60. Between 1980-1990 the general population of the county rose 22%. The population over 60 over the past ten years rose 33 .52%. Central County has the largest proportion of seniors, although heavy concentrations are also in Pittsburg, Antioch, Richmond, San Pablo, and E1 Cerrito. The Area Agency on Aging works with 18 local Committees on Aging from the entire county who have representation on the Contra Costa Advisory Council on Aging. According to the 1990 Federal census Contra Costa County's total population was 803,732. The gender cohorts are 410,284 females 393,448 males with race cohorts as follows: 611, 033 White, 74,577 Black, 5, 336 American Indian, Eskimo, Aleut 77, 012 Asian Pacific Islander and other races 35,804, with an Hispanic cohort,' including all races 91,282 . Contra Costa County's 60+ total population is 119,145. The 60+ gender cohorts are 68,354 female and 50,791 male with race cohorts as follows 102, 305 White, 7,527 Black, 478 American Indian, Eskimo, Aleut, 7, 079 Asian Pacific Islander, other race cohort 1,756 with an Hispanic cohort which includes all races, 6, 657. Low Income Population According to the 1990 Federal census Contra Costa County has 10, 059 people 60+ with income levels at or below the poverty level--4, 126 are White, 1, 112 are Black, 89 are Asian, 456 Asian/Pacific Islander, 469 Hispanic origin, 148 other. Since the census ten years ago the 60+ population with income at or below poverty level has increased 9. 19%. There has been a significant increase in the 75+ with income at or below 100% poverty level. The 75+ low income has increased by 23 .76% in the last ten years. Resources and Constraints The resources available to the County are primarily through Federal and State allodations. Due to the funding formula adopted by the State of California it could mean either a reduction or an increase based on the factors in the formula. In general the County has realized a significant reduction in County staff available to serve adults due to severe Federal, State and local revenue cut backs. The loss of unemployment, the recession, realignment reduction due to less tax revenue generated has had a severe impact on how and to whom the County provides services. The Area Agency on Aging receives its revenue through Title III B, Cl, C2 , V, D, VII A & B of the Older Americans Act, State match, State overmatch and local County match. The Area Agency on Aging also receives revenue from the State for Health Insurance Advocacy and Counseling Program ' (HICAP) . The Area Agency on Aging also receives a small amount ap 93-97 a.doc 2 of revenue through Project CARE. The Title III Contractors have been successful in augmenting funding they receive from the Area Agency on Aging by accessing grants from United Way, Foundations, and cities. The last few years have proven to be a challenge to the private and public sectors. The reduction in revenue has definitely put constraints on the County. Description of the Service System The Area Agency on Aging Information and Assistance is the focal point into the Adult Services System. Calls for request for information go directly into AAA's countywide I&R and the person calling is linked to the appropriate service. I&R provides outreach to the community and has developed a working relationship with the following agencies: Hospitals Board .& Cares Skilled Nursing Facilities Ombudsman Legal Services for Seniors Adult Protective Services .In Home Support Services Case Management Geriatric Services Friendly Visitor West County Senior Services Y� East County Day Care Delta 2000 Opportunity West Transportation and Paratransit Services Discharge Planners Nutrition Services Homeless Shelters Geriatric Clinics Health Advocacy & Counseling Program Gateway/GateKeepers Educational Institutions Pharmacies Home Health Agencies Visiting Nurses Association Banks P.G. &E. Postal Service Law Enforcement Escort Services If the client is referred to another agency the information gathered by the Information and Referral (I&R) staff is passed on to that agency. Sharing of assessments is a way service providers ensure client satisfaction. AAA's referral system and the easy transfer of . clients, is due to the amount of time the I&R coordinator and aides spend in the field doing outreach and building on the existing working relationships. The Goals & ap 93-97 a.doc 3 Objectives of the Area Plan reflect what is happening in the community and also identifies the needs in the community. The AAA may not directly fund a needed service but does provide coordination and Program Development by AAA staff and AAA's Advisory Council participating in Social and Health Resources Exchange (SHARE) , Delta 2000, West County Senior Services Program, AAA's Contract agencies, Housing Committee, Health Committee, Transportation Committee, Legislation Committee, In Home Support Task Force, Project Care, and the Elder Care Committee, these are just a few examples of how the AAA staff and the Advisory Council interact with the community. Participation in the community and sharing AAA's Community Based System of Care Goals & Objectives is one of the key factors to communication in the community. The AAA has been at a disadvantage over the last year due to reduction in staff resulting in less visibility in the community--less visibility resulting in less communication. It's the AAA's goal to try and obtain additional revenue to increase staff or look at more creative approaches to delivering services within the adult services arena. In the past, the AAA has applied for Linkages funding and MSSP funds but was unsuccessful in obtaining these funds. The AAA in a collaborative effort with In Home Supportive Services, Adult Protective Services, Geriatric Services, West County Senior Services, and Family and Community Services is providing recruitment screening and training for the Social Service Department's IHSS workers. Part of the focus is to target San Pablo and Richmond because of their low income and minority population. This is an exciting example of the public private sector working together to serve a targeted population. ap 93-97 a.doc 4 Description of the Area Agency on Aging AREA AGENCY ON AGING Background Information The Contra Costa County Board of Supervisors was designated as the County Area Agency on Aging May 20, 1975. First funding of Title III federal funds (Older Americans Act) were granted by the State Department of Aging for the period Sept. 1, 1975 to June 30, 1976. The first contract period was for planning, setting up an Advisory Council, and other formulative steps to implement the Area Agency on Aging program. The County Office on Aging was established within the Social Service Department on February 24, 1976. The Contra Costa County Advisory Council on Aging has 36 members, appointed by the Board of Supervisors. It is Advisory to the Board of Supervisors (which is the Area Agency on Aging) and the County office on Aging. The Advisory Council as a whole, and particularly its Planning Committee, is actively involved in the Area Plan Needs Assessment objectives and setting priorities for the coming year, and reviewing the selection of services contracted out by the Area Agency on Aging. The Advisory Council holds three public hearings in East, West, and Central County on the draft of the Area Plan each -year. ap 93-97 a.doc 5 The Area Agency on Aging's purpose is to provide, through its Area Plan, a comprehensive and coordinated system of social services designed to meet the needs of the population aged 60 years and over. This system functions through the provision of the following countywide services: (1) Coordinating services, (2) pooling untapped resources, (3) providing information and referral service to seniors (Senior Information Network) , and (4) technical assistance to the community to develop or expand resources/services for older persons. In addition, the Area Agency on Aging has subcontracted out for services where there was a proven gap. Countywide projects have included such programs as Legal Services, In-Home Services Registry, Nursing Home Ombudsman, Case Management, Home Visiting In Home Services for the Frail Elderly, Preventive Health Care, and Prevention of Elder Abuse. Description of the Planning & Service Areas In the future, the vision for AAA is to integrate itself within Adult Services and to serve as a support and backup for IHSS and APS. IHSS & APS in turn, will integrate into AAA allowing maximum utilization of staff. The primary stake holders are the department heads, Assistant Director and division managers responsible for adult services. To take this a step further, integrate departments providing adult services i.e. geriatric Services Public Health Nursing, Conservatorship, etc. . Major stake holders are the County Administrator, Board of Supervisors, department heads and service providers-.'- Construct a service system that empowers adults rather than serves. Within this infrastructure focal points will be located in each region of the County East, West & Central County. Regionalizing government will enable the County to target specific populations and low income groups unique to its region. The AAA will take lead responsibility in developing and implementing Elder Care within the corporate structure. Providing Elder Care will generate additional revenues for the AAA allowing us to increase services and staff. ap 93-97 a.doc 6 Outcomes 1. Efficient and effective government 2. Promote Public/Private partnership 3 . Increase revenue 4. Increase services 5. Efficient coordination for adult service providers 6. Open ended communication on all levels 7. Empower rather than serve 8. Reduce dependency on government allocations Section A ap 93-97 a.doc 7 MISSION STATEMENT To provide leadership in addressing issues that relate to older Californians; to develop community based systems of care that provide services which support independence within California's interdependent society, and which protect the quality of life of older persons with functional impairments; and to promote citizen involvement in the planning and delivery of services. Addition to Mission Statement The mission of the Contra Costa County Area Agency on Aging (AAA) as specified in the Older Americans Act of 1965 as amended & the Older Californians Act is to seek to insure the delivery of an adequate level of social, health, and nutrition services to the elderly population targeting that segment of the elderly population that is the most vulnerable and in danger of losing their independence in Contra Costa County. The visible focal point of entry into the system for Senior Services is AAA Information and Referral (I&R) . AAA continues through its I&R to provide a wide range of community based systems of care which are readily accessible to all older persons in order for them to lead independent and dignified lives in their own homes for as long as possible. The AAA continues to involve collaborative decision making regarding Senior Services with subcontractors, Health, Housing, Transportation, Adult Day Health, Mental Health, and Legislative Review committees, seniors, senior centers, fraternal organizations such as Rotary and Soroptimist. AAA in collaboration with agencies providing senior services assists in developing Memorandums of Understanding (MOU) . The MOU's specify how the agencies will refer from agency to agency and work to achieve elements of a community based system of care. The AAA continues through its Title III D, Case Management and Title III B contracted out In-Home Services Registry, Ombudsman, Friendly Visitors and Legal Assistance for the Elderly Programs to target older persons who are most vulnerable. The AAA provides specific services not otherwise available in the community through subcontracts; directly delivers information and referral and case management services for which it- has been granted statutory authority; develops new programs and resources; provides technical assistance to strengthen existing programs; provides advocacy services to plead and/or support concerns common to many older persons; and coordinates programs, services, and organizations into community based systems of care serving older persons. The AAA advocates and supports legislation to secure additional funding for services to seniors in Contra Costa County. ap 93-97 a.doc 8 Section B: Establishing Priorities Discussion of the Planning Process Attached I have a step by step timeline for the Needs Assessment and Four Year Area Plan Development. The timeline for the focus groups and Updating the Key Informant Survey are further broken down in the next chart, Needs Assessment by Task. In addition, I have attached the Area Plan Implementation Chart. The Planning Committee and Planner chart out tasks by month every fiscal year. The Planning Committee agreed to pretest the California Department of Aging's survey. From the pretest results the planner identified problematic areas with the survey and modifications were made. Focus groups were conducted in each part of the County--East, Pittsburg Care Center; West, Vale Care Center; And Central, Elm Manor. The focus groups were ethnically diverse low income (medical) and included disabled persons. All focus groups were conducted in Skilled Nursing Facilities. Needs Assessment A needs assessment was conducted beginning in September, 1992 and ending in February, 1993. AAA used a convergent methodological approach because the AAA wanted multiple data points. AAA prepared a mission statement and identified tasks that needed to be completed (see charts) . The objective for two methodologies, i.e. the survey and focus groups, was to determine the services seniors need now or may need in the future to lead independent and productive lives living independently in their own homes or skilled nursing facility. AAA began the Needs Assessment process by analyzing all of the surveys the AAA could identify for the past four years. AAA analyzed West County Senior Services Needs Assessment and Findings, Delta 2000, United Way of the Bay Area, and the Senior Center Survey completed by the AAA. AAA looked for common trends, supportive information and opposing trends, and compared all of this with the Key Informant Survey completed four years ago and the new updated Key Informant Survey. Before AAA utilized the California Department of Aging's Survey on the target population, the survey instrument was pretested. The pretest group selected by the AAA consisted of the thirteen members of the Planning committee, a committee of the Advisory Council. A report is attached. Upon completion of the pretest and analysis of the data obtained, AAA identified a few problematic areas with the survey. AAA consulted with CDA and agreed to some minor modifications to the survey. The AAA used the State survey and surveyed the local committees on aging. AAA sent out one hundred surveys and 36 were returned. In addition for targeting purposes AAA conducted one on one interviews in skilled nursing facilities located in high density senior low income minority areas. AAA surveyed home bound frail isolated seniors on the home delivered meals route to allow for their input. AAA's planner wanted to assure they surveyed & interviewed both healthy, frail, and institutionalized seniors. A report is attached. The AAA updated the Key Informant Survey. AAA also utilized the focus group concept. The AAA conducted one focus group in each part of the County concentrating on those areas with the highest percentages of low income minority populations .in skilled nursing facilities. A report is attached. 9 Description of the sources data: 1990 census data Updated Key Informant. Survey State Survey Focus Groups Dr. Charlotte Perry (Gerontological Researcher) Dr. Beclee Wilson (gerontologist) Key Service Providers Clergy Consumers Public Health Nurse Nutritionist Key leaders in the community Needs Assessment Revisited Special Issues Report for Heart Land Center on Aging, Disability and Long Term Care Needs Assessments Volume I Needs Assessment in the Aging Network: Guidelines and Best Practices, Volume II Current Practices National Elder Care Institute on Transportation Focus Group Report Senior Center Survey United Way of the Bay Area West County Senior Services Network Delta 2000 Orinda Senior Study Report AP93-97 B. 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W mU � �CY) U � �D �co V j m � � pp 0 ca vii » %0 0� p Q- O U) 0 0 �c QW (n • • p L E Q \\ a yU U F� 0 C C C 0000 w � - E aE • • • cm cO C ca () ami m Y y C .r m Z 0 Coa\E � o Z (1) c o c4- .50) L (n .L %- L �+ �// coo WD O nc \ LCa a) O 0 Q C m CO v� m 0 0 X00 m 0) Y (31. � o a�� pc}, L N 'DV a. +,,, Q 99 cu c: FQ- .> O 0 -0 -> >s E �- o o m mo c E co A) � L . . 0 p aCO ^0U) • • VQEU n a T C Q) OO V) cn 0)_ 0 -0COp a Ez O '' C: O U a) ch �•I � Q Q t0 — aEo Contra Costa County Area Agency on Aging SURVEY PRETEST September, 1992 TABLE OF CONTENTS Page Introduction 1 Summary analysis of pretest data 2 Modifications made to survey 4 Pretest.data 5 Revised survey 11 INTRODUCTION The Objective The objective of the survey pretest was to determine whether the California Department of Aging's survey instrument was as sensitive to diversity as it could be, that it enabled repondents' to answer questions consistently, and that the categories within the survey were mutually exclusive and exhaustive. The Process In September 1992, Sharon Johnson, Planner for the Office on Aging, Beclee Wilson, PhD and Rosie Meddaugh, Graduate Student Intern from Sacramento State University reviewed the California Department of Aging's survey questionnaire. It was decided to pretest the survey instrument before sending it to the target population. The pretest group selected .consisted of the thirteen members of the Planning Committee, a committee of the Advisory Council on Aging. It was determined that the pretest group be treated as a control group in that they would receive no prior information or knowledge of the Needs Assessment or Survey. Each member was sent a survey including a cover letter and stamped self-addressed envelope. The deadline for the completion of the survey by Committee members was October 6, 1992. Of the thirteen surveys sent, eleven were returned. After identifying a few problem areas with the_ survey we contacted Edmond Long, Planner for the California Department of Aging, and it was decided that minor modifications could be made. The survey was modified and the revised version was then sent to eleven Local Committees/Commissions on Aging. The modifications made, the raw data and the revised survey are on pages 4-16. 1 Summary Analysis of Pretest data Demographics Of the thirteen surveys sent, eleven were returned. The surveys returned indicated that the sample was almost evenly divided by gender. Five respondents indicated they were male and six indicated they were female. Respondents median age was seventy-four. . Responses to the catagory of Marital Status was mixed. Six indicated that they were now married, three stated they were widowed, one indicated that they were divorced and one respondent indicated that they had never married. The ethnic make-up of the sample was predominently white. Ten respondents indicated that they were white and one respondent indicated that they were black. The majority of the respondents indicated that they lived in a house and that they did not live alone. Eight lived in a house and three indicated that they lived in apartments. Seven answered "no" to living alone, while three indicated that they did live alone and one participant left this catagory blank. Five respondents indicated that they were not presently married and that their income level was $1,156 or above per month. Of the eight who were married, three respondents indicated their income level as $1,476 per month. While the remaining two, stated_ their income levels as $1,191 and $736-925. Nine responded "no" to receiving SSI/SSP, two responded "yes". Problems for the elderly: (Crime, Employment, Energy/utilities, Getting Information About Services/Benefits, Getting Servicesibenefits, health Care, Housing, Legal Affairs, Loneliness, Money to Live On, Nutrition/Food, Taking Care of Another Person, Transportation) Of the items listed, taking care of another person was a serious problem for three of the eleven respondents. Crime, getting information about services/benefits, and health care were minor problems. However, four respondents indicated that crime, energy/utilities, health care, and money to live on were serious problems. No one indicated that they had difficulty going outside .their homes alone. Problems doing activities: (Doing housework, Doing laundry, Shopping/errands, Preparing meals/cleaning up, Grooming, Taking medicaions, Using public transportation, Driving a car, Using the telephone, Handling money) Overall most respondents had little difficulty performing the activities listed. One respondent indicated an inability to do housework. Two indicated that they had serious problems doing housework and using public transportation. If the respondent had difficulty performing an activity, either a spouse or a paid worker would help them. Problems with personal activities: (Eating, Bathing, Dressing/undressing, Walking Climbing stairs, Getting in and out of bed in time, Getting to the bathroom on time) Most respondents indicated having no difficulty or minor difficulty performing each activity. Very few indicated that they were unable to do a particular activity. Walking and climbing stairs, were indicated as an activity that respondent's were unable to do (each item was marked once) and some indicated serious difficulty with getting to the bathroom in time (this item was marked twice). Of those who indicated difficulty performing an activity, stated a spouse helped them or no one helped them. 3 Modifications The pretest indicated that we needed to make slight modifications to the State survey instrument. 1. Items changed or added to: Question 3. "Marital Status" was changed to "relationship status". "Long time companion" was added to this category. Question 6. "Congregate living facilities" was added. Question 8. SSI and SSP were separated and spelled out. Questions 12, 13, 18 and 19. An additional response category of 'other" was added. 2. Two new questions were added to the questionnaire. 1. Have you ever heard of the Contra Costa County Area Agency on Aging. `2. Have you ever called the Contra Costa County Area Agency on Aging for assistance and information? 3. Directions were modified to several questions in the survey. Y Pretest data Survey's sent 13 Survey's returned 11 Percent returned so far 85%. 1. Sex: 5 M 6F 45% of respondents are male 55% of respondents are female AGE 2. Year of Birth: 1910 82 1911 81 1911 81 1917 75 1917 75 1918 74 1918 74 1919 73 1919 73 1920 72 - 1921 71 Median Age: 74 3. Marital Status: 3 widowed 6 now married 1 divorced 1 never married 54% responded they were now married. 27% responded they were widowed. 9% responded they were divorced 9% responded they were never married. (rounding) 4. Ethnic Group: 10 white 1 black 90610 of the respondents indicated tlhe\ were white. 10% of the respondents indicated the\ were black. 5. Living Arrangements living alone: Yes 3 No 7 1 blank 27% indicated they lived alone 63% indicated that they did not. 10% left the item blank. 6. Living Quarters: 8 house 3 apartment 93% indicated they lived in a house. 27% indicated they lived in an apartment. 7. Income--not married now. 5 $1,156 or above per month Income--are married now. 3 $1,476 or above per mo. 1 1,191-1,475 per mo. 1 736-925 per mo. *One respondent darkened both income categories (not married now and are married now 45% of the respondents indicated that they were not married now and that their income was $1,156 or above per month. 27% of the respondents indicated that they were married now and that their income was $1,476 or above per mo. 9% of the respondents indicated that they were married now and that their income was between $1,191 and 1,475 per mo. 9% of the respondents indicated that they were married now and that their income was between $736 and 925 per mo. 8. Do you get SSI/SSP Yes 2 No 9 18% of the respondents indicated that they received SSI/SSP. 8290 of the respondents indicated that they did not receive SSI/SSP. 6 9. Below is a list of problems which keep some people from being independent. Respondents had to indicate which was a problem to them. PROBLEM IS IT A PROBLEM TO YOU? No Minor Serious Problem Problem Problem Crime 6 4 1 Employment 9 2 Energy/utilities 10 1 Getting Information About Services/benefits 6 4 Getting Services/benefits 7 3 Health Care 5 4 1 Housing 11 Legal Affairs 9 2 Loneliness 9 2 Money to Live On -9 1 1 Nutrition/Food 10 1 Taking Care of Another Person 6 2 3 Transportation 11 * 1 respondent left "getting info about servicesibenefits" and "getting services" blank. 1 respondent left health care blank. 10. Two problems that affect you the most. From Question #9 1 None of the problems affect her. Additional problems, Political careers-anxiety for others in my age bracket who suffer financially and/or health problems, transportation, etc. 1 Employment-would like to work, one or two days a week. Additional problems, loneliness-feel isolated and often alone though am surrounded by family and friends am looking ahead down the "golden road". 1 Health care--sees three Drs. at various intervals, states that's a problem. Taking care of another is a problem when the caregiver has had a stroke. I Wife has health problems, can't do housework, cooking or walling. 7 1 She is the caregiver for her husband who is 90--financial concerns. utility bills Congress should do something about "Notchyear babies". 2 blank 1 Cut in interest rate causes a shortage of money. 1 taking care of another person: Reason for move from Orinda to the Waterford at Rossmoor where meals, housekeeping, nursing personnel, home health aides, and security are available. 1 Crime. I drive through war zones in Richmond. 1 Health-would have physical exam more often but too expensive. So go only when I have a problem. 11. Because of health conditions, you have difficulty going outside the home alone. Shop, visit Dr. Yes No 10 1 respondent did not continue filling out survey--stopped here. 100% of respondents replied that they did not have difficulty going outside the home alone. 12. How much difficulty do you have with each activity? ACTIVITY DO YOU HAVE DIFFICULTY? No Minor Serious Unable to Problem Problem Problem Do Doing Housework 5 3 1 1 Doing Laundry 9 1 Shopping /Errands 7 3 Preparing Meals/Leaning Up 5 5 Grooming 7 3 Taking Medications 9 Using Public Transportation 7 1 Driving a Car 7 3 Using the Telephone 9 1 Handling Money 10 * 1 respondent indicated that she did not use public transportatioal. * I respondent crossed out public transportation activity. * 1 respondent indicated that they did not take medications. * 1 respondent left 10-16 blank. 13. For each activity with which you have difficulty, who helps you to do activity. ACTIVITY WHO HELPS YOU? Spouse other Friend Agency Paid No Relative Volunteer Worker One Doing Housework 1 4 1 Doing Laundry 1 2 1 Shopping /Errands 1 1 3 Preparing Meals/Cleaning Up 2 3 2 Grooming 1 4 Taking Medications 1 3 Using Public Transportation 4 Driving a Car 1 1 3 Using the Telephone 1 3 Handling Money 1 5 *5 left 13 blank Overall, it would appear that if respondents had difficulty doing a task that they did the activity themselves with the help of "no one". 14. Because of a health condition, do you have any difficulty taking care of your own personal needs such as bathing, dressing, or getting around inside the home? Yes 3 If yes, ans. # 15& 16 No 5 *1 respondent didn't answer *1 respondent left this blank. ' 15. How much difficulty do you have with each activity ACTIVITY WHO HELPS YOU? Minor Unable to No ulty Serious do Eating 1 Bathing 2 2 Dressing/Undressing 2 2 Walking 1 1 1 1 Climbing Stairs 3 1 Getting In and Out of Bed 2 2 Getting to the Bathroom in Time 1 1 2 * one respondent answered NO, but continued with 15&16. 16. For each activity with which you have difficulty, show who helps you to do activity. ACTIVITY WHO HELPS YOU? Other Agency Paid_ No —Spouse Relative Volunteer Worker One Eating 3 Bathing 1 3 Dressing/Undressing 1 3 Walking 1 3 Climbing Stairs 1 3 Getting In and Out of Bed 1 3 Getting to the Bathroom in Time 1 3 ---T * one respondent answered "no one" to all categories. This is the same individual that responded "No" then continued on. =S capretes.chp 1�� SURVEY OF OLDER CALIFORNIANS This survey will provide the Contra Costa County Office on Aging (Area Agency on Aging)with information about the needs of older persons. It will help the Contra Costa County Office on Aging to plan services in the future. Please take a few moments to fill out this survey by darkening the appropriate spaces and filling in the blanks. Your responses will remain confidential. Please call the Contra Costa County Office on Aging at 313-1711 if you have questions. Thank you for your help. 1.Sex 4. Ethnic Group 5.Living Arrangements am: I am: I live alone: ❑ Male ❑ White ❑ Yes ❑ Female ❑ Black ❑ No ❑ Hispanic 2.Year of Birth Asian/Pacific Islander 6. Living Quarters was born in: ❑ Asian Indian I live in a: Year: El House El Cambodian ❑ Chinese ❑ Apartment 3.Relationship Status ❑ Filipino ❑ Mobile Home/Trailer I am: ❑ Guamanian ❑ Hotel ❑ Now Married El Hawaiian El Congregate Living ElWidow/Widower facilities El Japanese El Separated ❑ Boarding ❑ Korean House/Board and ❑ Divorced El Laotian Laotian ❑ Never Married ❑ Board and ❑ Samoan Care/Residential El Long time Care Home companion ❑ Vietnamese El Other Asian El Nursing Home ❑ American ❑ No Residence Indian/Eskimo/Aleut 01 Other ❑ Other Please specify 11 7. Income Complete only if you are NOT MARRIED NOW. ❑ $0 - $575 per month ❑ $576- - 645 per month ❑ $646 - $725 per month ❑ $726 - $1,155 per month ❑ $1,156 or above per month Complete only if you ARE MARRIED NOW. Which one of the categories below describes your total COMBINED MONTHLY INCOME before taxes in 1991? ❑ $0 - $735 per month ❑ $736 - $925 per month ❑ $926 - $1,190 per month ❑ $1,191 - $1,475 per month ❑ $1,476 or above per month 8. Do you get Supplemental Security Income.) ❑ Yes ❑ No 9. Do you get Supplemental Security Payment (Gold Check)? ❑ Yes ❑ No 10. Have you ever heard of the Contra Costa County Office on Aging (Area Agency on Aging)? ❑ Yes ❑ No 12 11. Have you ever called the Contra Costa County Office on Aging (AAA) for assistance and information? ❑ Yes ❑ No 12. Below is a list of problems. Please show how much each one is a problem to YOU. (PLEASE DARKEN THE APPROPRIATE NUMBER FOR EACH PROBLEM) PROBLEM IS IT A PROBLEM TO YOU? No Minor Serious Problem Problem Problem Crime ❑ 2❑ 0 Employment ❑ ] Energy/utilities2❑ 3❑ Getting Information About ❑ _ Services/benefits Getting Services/benefits1❑ 0 3❑ Health Care ❑ 0 3❑ Housing1❑ 2❑ 3❑ Legal Affairs1❑ 2❑ 3❑ Loneliness 1❑' 2❑ I 3❑ i Money to Live On 1❑ 2❑ 3❑ Nutrition/Food ❑ ❑ 3❑ Taking Care of Another Person ❑ ❑ Transportation 1 2 0 13 13. Please choose from Question #12 the TWO problems that affect YOU the most. Please write about why they are problems for you on the lines below. First Problem: : (FOR EXAMPLE: Employment) Second Problem: Are there any problems that are not on the list that are important to YOU? If so, please write about them on the spaces below. 14. Because of a HEALTH CONDITION, do you have any difficulty going outside the home alone, for example, to shop or visit the doctor's office? ❑ Yes ❑ No Please go on to questions #15 and #16. 14 15. Below is a list of activities. How much difficulty do YOU have with each activity? (PLEASE DARKEN THE APPROPRIATE NUMBER FOR EACH ACTIVITY) ACTIVITY DO YOU HAVE DIFFICULTY? No Minor Serious Unable to Other Problem Problem Problem D Doing Housework 1 2 3 4 5 Doing Laundry 1❑ ❑ 30 a a Shopping /Errands a a a ® D Preparing Meals/Cleaning Up 2❑ 3❑ Grooming 1❑ a a a a Taking Medications 0 20 3❑ a a Using Public Transportation 1❑ 0 a a o Driving a Car Q 3❑ ® 0 Using the Telephone 0 a ® 0 Handling Money 0 a 16. For each activity with which you have difficulty, please show who helps you to do that activity. (PLEASE DARKEN ALL NUMBERS THAT APPLY) ACTIVITY WHO HELPS YOU? Other Friend Agency Paid No Other Spouse Relative Volunteer Worker One Doing Housework 0 ® 51 © Q Doing Laundry a 0 Shopping /Errands 1❑ 3a ® 5❑ Preparing Meals/Cleaning Up 0 ® © a Grooming 0 0 F 0 © 0 Taking Medications0 ❑2 [3 ® 0 © 0 Using Public Transportation M a 3❑ Driving a Car 0 a o a o © a' Using the Telephone [j] l 2 1 0 ® a Handling Money 1❑ C 30 ® f © ❑7 15 17. Because of a HEALTH CONDITION, do you have any difficulty taking care of your own personal needs such as bathing, dressing, or getting around inside the home? ❑ Yes If "YES" please answer questions #18 and #19. ❑ No If "NO" you have finished. Thank you. 18. Below is a list of activities. How much difficulty do YOU have with each activity? (PLEASE DARKEN THE APPROPRIATE NUMBER FOR EACH ACTIVITY) ACTIVITY DO YOU HAVE DIFFICULTY? No Minor Serious Unable to Other DifficullyDiffiQuU Difficully D Eating Bathing � 0 Dressing/Undressing o a a a o Walking 1❑ a a a a Climbing Stairs 1❑ a a ® 5❑ Getting in and Out of Bed a a D ® D Getting to the Bathroom in Time 0 ® 5❑ 19. For each activity with which you have difficulty, please show who helps you to do that activity. (PLEASE DARKEN ALL NUMBERS THAT APPLY) [—ACTIVITY WHO HELPS YOU? Other Friend Agency Paid No Other Spouse Relative I Volunteer Worker One Eating I Q ® a © a Bathing1❑ a a Dressing/Undressing 3❑ Walking1❑ 2❑ 3❑ a a © a Climbing Stairs a ® 0 © 0 Getting In and Out of Bed' 1❑ a al ® 0 © 0 Getting to the Bathroom in Time a ® © 0 END THANK YOU FOR YOUR HELP. 16 Contra Costa County Area Agency on Aging KEY INFORMANT SURVEY Noven, her, 1992 Table of Contents Page Introduction 1 Summary of Responses Introduction 2 Key Informant Survey Mailing List 12 Questionnaire 17 INTRODUCTION The Objective The objective of the Key Informant survey was to increase the knowledge of the needs of the elderly and the systems providing them with programs and services. The process was first utilized in the Area Agency's planning of 1988. The 1992 survey therefore, offers an opportunity of comparison between the two surveys. The information obtained will be used initially by the planning committee of the Contra Costa Area Agency on Aging to assist it in setting priorities for the Area Plan. The Process In November 1992, it was decided to engage the assistance of Dr. Beclee Wilson in order to repeat the Key Informant Survey she had helped to develop and implement for the 1988-89 Area Plan. Sharon Johnson, Planner for the Office on Aging, Rosie Meddaugh, Graduate Student Intern from Sacramento State University, and Beclee Wilson reviewed the process and revised the initial mailing list. Letters inviting participation and a questionnaire were sent to over 50 people who were a cross-section of key service providers and key community leaders who are advocates for the elderly. Included were hospital administrators, clergy, representatives-from minority communities within the county and providers of services and programs to the county's elderly. Responses to the questions were obtained through telephone conversations between Dr. Wilson and the key persons. The six-question questionnaire was designed to focus on discovering what are the major problems facing the elderly in the county and what changes need to be made in the various services and programs, advocacy and legislative concerns, unmet needs, and what people felt was working really well for the elderly in the county. The questions were formed around the goals established in the Older American Acts and specific objectives of the Area Plan. People were asked to give several responses to each question and these were not prioritized. Telephone enterviews were conducted by Beclee Wilson over a six-week period and some responses were received by mail. 27 responses were received out of 43 potential respondents. There were some persons who received the initial mailing who no longer qualified because of job change or other circumstances. Copy of the n tiling list is on page 4-8. 1 Questionnaire 1992 Key Informant Survey Summary of Responses 1. In your local community or in the county as a whole, what are the most serious problems facing the elderly population? Transportation - 18 Housing - moderate and low income - 14 Health care and medical expenses - 11 In-home support services - 9 Awareness of how to access services - 5 Skilled nursing facilities/quantity, quality, affordable - 5 Affordable services of all sorts - 4 Too few services dealing with isolation/loneliness - 3 Income maintenance/financial management - 3 Cut-backs in services - 3 Case management - 2 Access to Alzheimer's units in nursing homes - 1 Day care facilities - 1 Lack of awareness of legal problems - 1 Problems of minority elderly (social and economic) - 1 Fragmented services - 1 Rural area seniors - 1 Elder abuse - 1 Stress - 1 Treatment for alcohol - 1 Physicians with geriatric training - 1 Respite care - 1 Neighborhood crime that keeps elderly homebound - 1 Culturally sensitive services - 1 2 Question 1 - Descriptions Transportation 1. More door-to-door transportation 2. Rules for obtaining LINKS too stringent 3. Needs to be safe, reliable, consistent 4. Inadequate linkage between areas of the county 5. E&H busses were easier to get 6. Weekend/night service Housing Issues 1. More moderate and low cost housing needed 2. Inadequate supply of affordable/subsidized housing 3. Waiting lists too long 4. Needs of low income just above qualifying 5. Affordable Health Issues 1. Hospitals and nursing homes that don't impoverish 2. .Preventative health care 3. Concern of cost for persons with medicare only portion 4. Dental needs 5. Strugle of the just above MediCal persons 6. Lack of MediCal beds (SNF) 7. Rise in concern over nursing home quality past 5 years 8. Trend toward private nursing homes with no MediCal beds 9. Access to quality medical care 10. Available convalescent and custodial care 11. Non-profit convalescent hospital 12. Access to quality affordable home care In-Home Support Services 1. Services for low income elderly 2. Affordability 3. Assistance in locating services 4. Fragmentation 5. Handiperson maintenance services 6. Good in-home care and support services 7. Concern about cut-backs IHSS S. Can't be replaced by all-volunteer workers 9. So little, now less 10. Lick of low-cost or volunteer assistance with housekcel)ing transportation, meal preparation ] I. funding for support seri ices Awareness of How to Access Services 1. Rules too complicated 2. Helps for locating services 3. Fragmentation of services 4. Getting services a hassel 5. Without knowledge, one illness and life can fall apart 6. Not enough outreach 7. Lack of culturally sensitive services Skilled Nursing Facilities Access/Quality 1. Long term medical care that doesn't impoverish 2. Access' to Alzheimer's units in nursing homes for MediCal patients 3. Good/affordable SNF 4. Lack of Medical beds 5. Growing concern in Antioch area over quality 6. Newest nursing homes private, no MediCal beds. 7. Non-profit convalescent hospital 2. Of the services and programs currently provided to elderly in your local community, or in the county as a whole, what changes or improvements are needed? Transportation - 8 better recognized, more flexible (LINKS) - 3 Sunday transportation -2 intercity difficult, look at area-wide needs expand hours and better service by LINK IHSS need major changes - 3 mechanisms for recruitment, wages, training improved more assistance in funding, keeping workers caseload burdensome Home visiting, Friendly Visitor program increase - 2 Affordable in-home services «loth the senior in mind - 2 Lack of adequate funding of services - 2 More outreach on availablicv of services - 2 More case management, - Information on stow seniors can use talents and skills - 1 Wider information on ser,\,ices to stop redundancy - t Increase Brown Bag food distribution times - 1 Shopping services - I In-1lonie care provider program (S111) - 1 Nlediral eligibilit\r, roc°ed: tai he I73t�rc user friendly, - 1 l:n�crG�enrN, housing �acr.- in<3deyuatc - 1 2. Continued Strengthen existing programs - 1 Need program leaders at senior centers - 1 More case management - 1 in community centers - 1 Less fragmentation and more coordination among services Targeting the neediest - 1 Technical assistance to present service providers for targeting the neediest - 1 Home Care registry needs staff for improved services - 1 Difficulty in getting to senior center programs (Brentwood) Less emphasis on recreation at senior centers -, 1 Assistance in locating isolated seniors - 1 Everything needs to be expanded in rural areas - 1 Expand senior day care (East County) - 1 Nutrition programs better utilized - 1 lunch increased to 5 days (Hercules) - 1 Affordable health care - 1 home health care accessibility and affordability - 1 Enhance representative payee program - 1 Alcohol counseling - 1 Need for better and earlier discharge planning from acute hospital and SNFs - 1 Better SNF care for Alzheimer's patients - 1 Housing units increased - 2 rental units city gov't give incentives All services over extended - 2 Family visitor program increased - 1 Respite care - 1 Fragmentation, lack of coordination of services - 1 Need for technical assistance to agencies - 1 Cultural diversity awareness services/communication - 1 Rodeo Community Center closed - hardship - 1 Reduced IHSS caseload - 3. The Area Agency on Aging seeks to develop a coordinated community based system of services for the elderly. What areas/issues of coordination or cooperation. among the different agencies serving the elderly would you like the AAA to address? More education and outreach sharing information between agencies and to citizens - 14 Programs telling public and private institutions what services are available - 1 Targeted education for special groups, i.e.,clergy - 1 Greater marketing/advertising of services 1 Case management outreach - 1 Educational information about senior needs and services - 1 Better information on home health care workers and agencies - 1 Transportation - 7 more pay as you go, coordination between para/reg - 1 weekend-2 Service provider needs - 6 Bi-monthly conferences agency representatives share info and prioritize and deal with unmet needs - 2 2-day retreat of all providers to get better acquainted, network and share common concerns - 1 Need to know bigger picture (state, national) - 1 Need coordinated fund raising - 1 Like telephone conferencing approach - 1 Need to centralize services where transportation is accessible - 2 Advisory. Council and various providers need a better handle on what's going on. - 1 In-home support services public/non-profit coordination to developa system of services for low income elders, publicrivate partnerships -1 Long-term care Concern about AAA role as provider as well as coordinator of services Need to work on provider targeting, fragmentation - <• Survey to target the location of elderly in communities - 1 Localize case management programs - 1 Coordination for new immigrant population (Hercules/San Pablo - 1 Assistance with contracts (RSVP) - 1 Encourage Delta 2000 coordinated, umbrella approach - 1 Casew-orkers at each senior center - 1 Need more coordination in discharge planner nursing borne placement of elderly - 1 Target East County for coordination efforts - 1 Ahility to svnthesize statistical and demographic. data - 1 Reduce (onr��etition and.enhance cooperation between service l)roV icier l.tluitahlc (listrihution of funds - ] t; 4. What do you consider the greatest unmet need for the elderly in the county? Health care issues - 6 Adequate medical care by properly trained/educated physicians - 1 Lack of beds for MediCal patients - 1 More trained personnel for home health care - 1 Dental, vision - 1 Affordable housing - 5 Community independent living situation low income - 1 Congregate living with personal care at low cost - 1 Local housing needed in Hercules - 1 Homeless - 1 Transportation - 4 education in use of public transportation - 1 inexpensive simple to access - 1 weekend - 2 Outreach - 3 on case-management - 1 to the home-bound elderly - 1 In-home services and access - 2 Access to services - 2 Education for utilization of services - 1 Alternative care between board and care and nursing - 2 Low cost case management - 2 Need for more elderly day care - 1 Care services in centralized places - 1 Opportunity for continuing education for elderly - 1 Lack of adequate income - 1 Continuing ageism in community - 1 Volunteer programs where seniors could get credit for services rendered to draw down when needed - 1 Programs with concern for safety of elderly - 1 More gatekeeper type programs in communities - 1 More information to Hispanic immigrant population - 1 Better senior center (Hercules) - 1 Conaregate meals center with socialization (Orinda) - 1 More programs oriented toward men (Orinda) - 1 Planning for old age programs (baby boomer) - 1 Process to begin to anticipate future demand - 1 .Vlore programs for elderly to nei ork form support systems for themselves - 1 More home delivered meals available - 1 Effective taraetinj to meet needs of neediest - I Good sen�iccs, just need more - l Eocus 1-1nrups to ;Iui in progr,rn: design - 1 4. Continued Facility for long term care - 1 Resources for low income to remain at home - 1 Lost without community center in Rodeo - 1 Low income & minority elders do not have access to services- 1 5. What advocacy efforts should be undertaken at the local, state, or federal level on behalf of the elderly? What issues should be addressed and/or what legislation would you like to see adopted? Health related issues - 13 Universal health care - 4 Medical insurance Prescription costs Preventive health care Affordable health care - 2 Cost containment Legislation forcing SNFs to acce t certain % of Medical patients, whether for or non profit. - 2 Long term care benefits - 3 More coalition advocacy similar to that between Kaiser and groups concerned about transportation access for medical appointments (Antioch) Federal and state laws limiting charges for medicare - hospitals, nursing homes etc. Funding for programs related to the elderly - 8 We know what is needed now. What we need are dollars. Need to speak out at local level about state budget cuts that deplete SSI coverage, free medical coverage. Need price control Look at fundingpattern at state level. So many little programs and each year something new. We need programs to meet basic needs on an On Loc model Local level we need Board of Su ervisors to put money back in social services. . We neefocalpoint idea, not all senior center based. AAA needs to pursue new formula for funding. Our community is stagnated. Need to increase funding for present funding. Housing issues - 4 Legislation for low cost housing Affordable housing to meet the need - 2 Housing with support services and safety like EI Cerrito Royale S 5. continued. Transportation concerns - 5 Transportation in the more rural areas Coordination of transportation and housing Concerned about the impact of ADA on funding for transportation for the elderly. Legislation needs to come up with funding formula of its own or modify the legislation Weekend transportation Revisit the Older Americans Act at the Federal level looking especially at the emphasis on nutrition, and the mandate of service to all older persons. More local involvement by district attorney in investigating and prosecuting feduciary abuse cases regardless of dementia of the elderly person Need to deal with 'over monitoring" of programs funded by a variety of sources into one agency. Targeting - recognizing the diversity of the population. More_responsiveness to the needs of the under represented minority elderly. Funding to go the the focal point model, local service center. Have information and referral services all in one place. Threatened with cut-off from general fund, it`simportant for the AAA to advocate for support of local services. Training for people to help enact legislation Stop treating underclass as second class citizens Nutrition - funding and programming Need a White House and State House conference on aging In-home services covered by insurance - 2 Le islation to create very long term capital gain exclusions for elderly. Study to look at impact of low interest periods on elderly. Elder abuse Look at rises in medicare that take awaains in Social Security increases, particularly those on U' Concern about cuts in in-home care - SSI - Adult protective services need to be addressed Women's issues, particularly women of color Research to investigate the reality of the lives of present day elderly. 6. From your perspective in your local community or in the county as a whole, what do you feel is. being done well for the elderly population? I bear from people like Sunny McPeak and others, major interest and concern for the elderly. Family Counseling and Community Service. Meal on Wheels, Friendly Visitor, Helping Hands Information for Social Services Development of Senior Centers - 9 Good centers Good classes and entertainment Special event luncheons Men's group emphasis (San Ramon) Nutrition meals at centers Central location of centers Access to services With limited budgets senior centers doing very well. Senior Center in Brentwood doing an excellent job HICAP counseling excellent - 3 Information' and 'Referral - 3 Delta 2000 - 3 Elder service committee Great unbrella organization - need more New Geriatric Clinic (East County) Good network of services working very hard cutbacks causing stress Ombudsman/ Adult Protective Service - 3 New senior housing in Antioch Committees on Aging (Antioch and Pittsburg) Working on low income housing needs Day care for the handicapped Respite for caregivers The transportation we do have AAA Advisory Council, especially mental health and health committee Health department Geriatric services Conservators Services that are being provided Transportation Nutrition - 2 Teleconferencing (Key Informant Survey) a good way to communicate w len people are so busy. Qualm, Service providers most not competitive, but \(ork to,-Ietlie' r to coordinate services. I-ft,ort to look at ways to determine unmet needs. delivered meals 6. continued Day Care Alzheimer's care and education Cancer support (wellness community) Geriatric service outreach good, except the disinclination to deal with alcohol related problems Really impressed with Muir Senior Services - 2 Muir 65 new programs library Lions Club Blind Center West County Senior Services Network- real boost to everyone Service providers really work well together Transportation monies moving more toward cooperation Would like to see AAA give us an update on how they are implementing action on the concerns raised by the Key Informant survey. Paralegal services There is concern about senior problems AAA really connected Advisory Council with programs Really identified core needs of the elderly well, full wheel of services - 2 Good relationship of AAA to providers, good collegial relationship. I depend on them at grant time. We have a successful focal point model (El Cerrito) Think AAA does an excellent job advocating, staying on top of issues. The name recognition of Meals on Wheels - need it for every senior related program Health care, although it's not up to level of expectations AAA is assessible Social Security - one out of every 6 get a check In-home care in west county through West County Senior Services Network. Efforts to get community aware of minority concerns Representative payee program, done well, we really use it. Encouraging Comissions on Aging to be more recognized in cities. .s­v} t92 11 Key Informant Survey Mailing List Code L=Local Committee Chair K=Key Person 937-3-311 Ms Linda Anderson FAMILY COUNSELING & COMM SERV. code: K 1300 Civic Drive WALNUT CREEK, CA. 94596 933-5397 Rabbi Raphael Asher Congregation B'Nai Tikvak code: K 25 Hillcraft hay Walnut Creek, CA. 94596 432-2200 Ms Beverly Benson LOS MEDANOS HOSPITAL code: K 2311 LOVERIDGE RD PITTSBURG, CA. 94565 235-1199 Ms Magdalena Cantu code: K 5500 Barrett E1 Cerrito, CA. 94530 232-0500 Ms Heidi Cartan West County Senior Services Networ code: K 402 Harbour Way Richmond, CA. 94801 634-0184 Rev Robert Clark Delta Comm. Presbyterian Church code: K 2400 Discovery Bay Byron, CA. 94514 Ms Betty Conner Antioch Social Services code-: K 4545 Delta Faire Blvd. Antioch, CA. 94509 . 646-2080 Ms Nancy C. Fanden Countra Costa County, Supervisor code: K 805 Las Juntas Street Martinez, CA. 94553 779-1404 Ms Ruth Goodin Delta 2000 code: K 2400 Sycamore Drive, #16 Antioch, ' CA. 94509 439-2061 Ms Frances Green Pre School Coordinating Council code: K 1760 Chester Dr. Pittsburg, CA. 94565 646-6511 Ms Arnell Hinkle Prevention Program code: K 75 Santa Barbara Rd. Pleasant Hill , CA. 94523 222-0396 Ms Debbie Janke GRIP (Greater' Richmond Interfaith code: K 2709 Macdonald Ave Richmond, CA. 94SO4 Reverend Johnson code: K 127 Schooner Cou_-t Rikchmond, CA. 94804 x 21 Ms Rosemarie Kennedy CC County Library code: K 1750 Oak Park Bl,,-d. Pleasant Hill , Com. 94523 937-1530 Ms Judy Kent Mt. Diablo Adult School code: K 3100 Oak Park Blvd.. Pleasant Hill, CA. 94523 X -)712 Ms Betsy Keyes LEGAL SERVICES FOR THE ELDERLY code: K 1305 MACDONALD AVE RICHMOND, CA. 94804 933-6030 Rev Stan Klop Council of Churches code: K 64 Sandy Lane Walnut Creek, CA. 94596 945-8695 Ms Peg Kovar DIABLO VALLEY FOUNDATION code: K 1963 TICE VALLEY BLVD WALNUT CREEK, CA. 94596 646-2596 Mr Paul Kraintz CCC Health Services code: K 597 Center Ave. Martinez, CA. 94553 283-8722 Rev Andrew Kurth Lafayette/Orinda Presbyterian code: K 49 Knox Dr. Lafayette, CA. 94549 798-1078 Ms Mary Lou Laubscher Cambridge Community Center code: K 1135 Lacey Lane Concord, CA. 94520 5- --6740 Ms Katie Lewis EL CERRITO "OPEN HOUSE" code: K 6500 STOCKTON EL CERRITO, CA. 94530 233-4464 Ms Varsie Lometti code: K 602 Cypress Pt. Road Richmond, CA. 94801 229-2210 Mr Richard Lujan UCSSO code: K 516 MAIN ST MARTINEZ, CA. 94553 939-3000 Ms Eileen Lynette JOHN MUIR HOSPITAL code: K 1601 YGNACIO VALLEY RD WALNUT CREEK, CA. 94596 833-2444 Ms Lucille Maffei code: K 221 Tangerine Court San Ramon, CA. 94583 939-1211 Ms Jean Marana ROSSMOOR OFFICE OF SPECIAL SRV code: K 1001 GOLDEN RAIN RD WALNUT CREEK, C-.. 94596 235-7C: 682-15-50 Atty. John Milgate code: K 101 Gregory Lane Pleasant Hill, Ca. 94523 754-1156 Ms Diane Papanu-Houpt ANTIOCH SENIOR CENTER code: K P.O. BOX 739 ANTIOCH, CA. 94509 X 4380 Ms Julie Peck CCC GERIATRIC SERVICES code: K 2500 ALHAMBRA A%'E MARTINEZ, CA. 94553 799-5817 Mr Jose Poblete Hercules Sen Citizens Club code: K 190 Turquise (Ohlone Comm Ctr) Hercules, CA. 94547 374-3231 Mr. Tom Powers Contra Costa County, Supervisor code: K 100 37th Street, Room 270 Richmond, CA. 94805 939-7913 Sr Joan Prohaska St. John Vianney Church code: K 1650 Ygnacio Valley Rd Walnut Creek, CA. 94598 234-4013 Mr Al Rodriguez San Pablo Social- Security Office code: K 2101 Van Ness Ave. San Pablo, CA. 94806 9- ' -7059 Ms Dorothy Sargent ChurchWomen United code: K 50 Forest Hill Drive Walnut Creek, CA. 94596 Ms Marta Saucedo League of United Latin Am. Citizen code: K 131 Harbor Way Richmond, CA. 94801 820-8683 Mr. Robert I. Schroder Contra Costa County, Supervisor code: K 510 La Gonda Way Danville, CA. 94526 235-4900 Ms Tomi Skinner SENIOR CITIZENS CENTER code: K 1943 CHURCH LANE SAN PABLO, CA. 94806 372-3590 Ms Margo Spaulding MARTINEZ COMMUNITY CENTER code: K 1111 FERRY ST MARTINEZ, CA. 94553 233-9954 Mr Nancy Strohl CC LEGAL SERVICES FOUNDATION code: K 1017 MACDONALD AVE RICHMOND, CA. 94804 235-4226 Rev Ron Swisher Easter Hill Methodist Church code: K 3911 Cutting Blvd. Richmond, CA. 94806 Reverend Timmons coder K P.O. Box 82135 Pittsburgh, CA. 94565 427-8138 Mr. Tom Torlakson Contra Costa County, Supervisor code: K 300 E. Leland Avenue, Ste 100 Pittsburg, CA. 94563 640-2706 Mr Charles Underwood CCC DEPT OF SOCIAL SERVICES code: K 30 Muir Road Martinez, CA. 94553 525-7086 Mr Bill Waki code: K 614 Everett E1 Cerrito, CA. 94530 757-4094 Rev Ron Weber 1st Congregational Church code: K 620 E. Tregallas Rd. Antioch, CA. 94509 254-0200 Ms Isabelle Weissman JFKU Orinda code: K 12 Altarinda Orinda, CA. 94563 685-1230- -Ms Ruth Mary Whelan DVC code: K 321 Golf Club Rd Pleasant Hill, CA. 94523 646-5763 Ms Sunne Wright McPeak Contra Costa County, Supervisor code: K 2301 Stanwell Dr. Concord, CA. 94520 6r--8358 Ms Mildred Beck Concord Comm. on Aging code: L 4656 Benbow Ct. _. Concord, CA. 94521 223-2331 Mr Cliff Berg E1 Sobrante Comm. on Aging code: L 4615 Santa Rita E1 Sobrante, CA. 94803 376-3539 Mr Walter Blumst Orinda Sr. Services Comm. code: L 265 Ivy Place Orinda, CA. 94563 Chair Alamo-Danville Comm. on Aging code: L 120 S. Hartz Ave Danville, CA. 94526 376-3015 Ms Lynda Cole Moraga Comm. on.Aging code: L 2 Merrill Drive Moraga, CA. 94556 937-8321 Mr Ralph Cooperman Pleasant Hill Commission on Aginc_ code: L 3 Penrith Walk Pleasant Hill , CA. 94523 Ms Helen Derby Richmond Commission on Aging code: L 2400 Nevin ,''x'425 Richmond, CA. 94SO4 799-2201 Ms Grace Fowler Rodeo Ctte. on Aging code: L 144 John Street Rodeo, CA. 94572 526-5421 Mr Dan Freudenthal E1. Cerrito Comm on Aging code: L 6500 Stockton El Cerrito, CA. 94530 724-8236 Mr. Steve Henderson Pittsburg Ctte on Aging code: L 3024 Railroad Ave. Pittsburg, CA. 94565 228-2350 Ms Mary Lynn Hornbeck Martinez Comm. on Aging code: L 4807 John Muir Road Martinez, CA. 94553 237-7896 Ms Gloria Humer San Pablo Ctte. on Aging code: L 1943 Church Lane San Pablo, CA. 94806 930-8980 Ms Mary Shockley Walnut Creek Comm. on Aging code: L 201 San Antonio Way Walnut Creek, CA. 94598 283-6194 Ms Sandra Smith Lafayette Sr. Svcs. Commission code: L 3238 Driftwood Dr. Lafayette, CA. 94549 526-6744 Mr Bruce Watkins E1 Cerrito Comm. on AGing code: L 6500 Stockton E1 Cerrito, CA. 94530 7r--4108 Ms Ada Wristen Antioch Comm on Aging code: L P.O. Box 846 Antioch, CA. 94509 1 i> F ! QUESTIONNAIRE Please review these questions in preparation for the interview session. We would appreciate 3 to 5 responses to each one. 1. In your local community (specify) or in the county as a whole, what are the most serious problems facing the elderly population? 3-5 problems 2. Of the services and programs currently provided to elderly in your local community (specify) or in the county as a whole, what changes or improvements are needed? 3-5 services/programs 3. The Area Agency on Aging seeks to develop a coordinated community based system of services for the elderly. What areas/issues of coordination or cooperation among the different agencies serving the elderly would like the AAA to address? - 3-5 coordination issues 1.7 What do you consider the greatest unmet need for the elderly in, the county? 5. What advocacy efforts should be undertaken at the local, state, or federal level on behalf of the elderly? What issues should be addressed and/or what legislation would you like to see adopted? 6. From your perspective in your local community or in the county as a whole, what do you feel is being done well for the elderly population? Bob APSI . DOC2 l.c 69 Contra Costa County Area Agency on Aging Survey California Department of Aging survey November 1992 Table of Contents Pace Introduction 1 Summary Analysis 2 Target Population 4 Survey data 5 INTRODUCTION The Process In November, 1992 it was determined to target the Local Committees/Commissions on Aging throughout Contra Costa County as the recipients of the revised California Department of Aging Survey instrument. Eleven Local Committees/Commissions agreed to participate in the survey. The Committees/Commissions are diverse in that they vary in size from 1 to 19 members and are largely comprised of seniors with an express interest in serving the elderly population in their cities and the surrounding community. The criteria utilized by AAA in determining the target population was threefold: first that they be geographically dispersed throughout the County, that they play some form of advocacy role for elders, and that the target group's response rate of return for the survey be high. The process began with an initial contact made by phone to the Committee/Commission chairs. This was followed by letters inviting them to participate and questionnaires that they could distribute to their members. Follow=up reminders to complete and return the survey were sent to the Committee/Commission chairs. In all, 100 survey instruments were sent out with a final response rate of return of 36%. It should be emphasized that although our response rate of 36% is sufficient as a total return for the survey, our overall sample was small and nonrandom. Our sample, an intact group (i.e. local committees/commissions on Aging) consisted of individuals who are "active" and 'Well". Active and well are defined as, persons who are healthy and have the ability to perform daily activities. ps /finalrpt/survey.chp i Summary Analysis Demographics Of the 36 or 36% that responded to the survey 27 or 75%, stated that they did not live alone. Twenty-two or 62% were female, while fourteen or 38% were male. The median year of birth was 1920. Thirty-two or 88% indicated they were white. Twenty-four or 67% indicated that they were married. Twenty-eight or 77% indicated that they lived in a "house". Eleven or 31% indicated that they were not married now, with income ranges of $646-1,156 or above per month. Twenty-five or 69% indicated that they were married with income ranges of $1,191-1,476 or above per month. There were no responses to the lower income categories. Problems for the elderly The main concern or issue for the elderly was "crime". Ten or 28% of the respondents stated that crime was "no problem", fourteen or 38% indicated that it was a "minor problem" and ten or 28% stated that it was a "serious" one. The open-ended questions, whereby respondents had to indicate wj= problem affected them the most, "crime" or the "fear of crime" was the major concern. and was indicated as the "first problem" seven times and twice as the "second problem". Regarding this issue, Respondent's explanations varied from outright "fear", to perceptions i.e. the possibility of a potential criminal act to their person, to taking preventative measures to minimize the possibility of a crime i.e. "keeping doors locked" or being "actively involved in police work". The issue of Health care followed crime as the next major concern. Three or 8% of the respondents indicated Health Care as a "first problem" and two or 6% indicated Health Care as the "second problem". Again, explanations given by respondents on Health Care, were varied. Some indicated that Health Care was "too complicated, deductible unpredictable". Respondents indicated financial concerns surrounding "24 hour care", as well as "confusion about medi-gap policies and concern over cost of medical insurance." Care of another person ranked third in our findings. Four or 11% of respondents indicated this to be a problem to them. Three of the four stated that they were presently taking care of another person. Additional comments were, "Mother-in-law lives with us so we can't have a life of our own", "I manage the household, tend to my wife and I am involved in' the community. and in my profession", "caring for elderly mother". ps /finalrpt/survey.chp 2 Problems doing activities Overall, the participants in the survey were well seniors who indicated having no difficulty going outside the home alone, to shop or visit the doctor, etc.. Generally, respondents indicated having "no problem" doing a specific activity such as "doing housework, doing laundry", etc. If a respondent did indicate having a problem doing an activity, it was usually a "spouse or "paid worker" who helped them. Problems with personal activities Twenty-eight or 77% of participants indicated having no difficulty taking care of their own personal needs such as bathing, or getting around inside the home due to a health condition. Two or 5% of participants indicated having difficulty. Although only two indicated that they had difficulty, several respondents chose to continue to answer questions 18 and 19. Those who continued, stated they had "minor difficulty" eating (one or 2%), walking (two or 5%), climbing stairs (four or 11%), getting in and out of bed (two or 5%), and getting to the bathroom in time (four or 11%). Some indicated having "Serious difficulty" eating (one or 2%) and bathing (one or 2%). Some were "unable to do" an activity such as walking (one or 2%), climbing stairs (one or 2%), getting in and out of bed (one or 2%) and getting to the bathroom in time (one or 2%). In this case, if respondents had difficulty, they indicated that "no one" helped or they indicated 'other" as an alternative response. It was no surprise to the AAA that all of the respondents indicated that they had heard of the Agency.__However, 14 participants indicated that they had never called the Office for assistance and information. * Due to rounding and "no answer" responses percentages will not total 100%. ps /finalrpt/survey.chp 3 Target Population Survey instruments were sent to the following Local CommitteesCommissions on Aging: Mildred Beck, President Lou Ferrero, Chair Antioch Ctte. on Aging Concord Commission on Aging 415 W. 2nd St. 1312 Kentucky Drive Antioch, CA 94509 Concord, CA 94521 754-0337 672-7539 15 surveys sent 11 Surveys sent Edith Drott Sandra Smith, Chair EI Cerrito Ctte. on Aging Lafayette Sr. Serv. Commission 10890 San Pablo Ave. 3238 Driftwood Dr. EI Cerrito, CA 94530 Lafayette, CA 94549 526-4770 283-6194 19 surveys sent 9 surveys sent Sylvia Clark, Chair Orval Grigsby, Chair Martinez Ctte. on Aging Orinda Senior Serv. Commission 130 Farm Lane 82 Scenic Drive Martinez, CA 94553 Orinda, CA 94563 229-4199 254-3662 M 1 survey sent 6 surveys sent Marge Doty, Chair Steve Henderson Pinole Adv. Comm. on Aging 3024 Railroad Ave. 2500 Charles Ave. Richmond, CA 94565 Pinole, CA 94565 427-1772 758-4082 7 surveys sent 7 surveys sent Gloria Alsheimer, Chair Dora Gonsalves Pleasant Hill Comm. on Aging 100 Arlene Lane 713 Stonebridge Way Walnut Creek, CA Pleasant Hill, CA 933-7434 682-8127 6 surveys sent 9 surveys sent Mary Ellen Patrick 1380 Contra Costa Ave. San Pablo, CA 94806 234-8928 10 surveys sent Total number of surveys distrih�Ied: 100 ps /finalrpt/survey.chp 4 RESULTS OF SURVEY OF OLDER CALIFORNIANS DECEMBER, 1992 1.Sex 3.Relationship Status 5. Living Arrangements Fl-41 Male I am: I live alone: 22 Female 24 Now Married ® Yes 50 Widow/Widower r 27 No 2.Year of Birth ® Divorced 10 No Answer 1 1907 1] Never Married 1 1910 0 MARKED BOTH Widow/Widower & 6. LivingQuarters 2 1911 Divorced 2 1912 1 live in a: 2 1913 28 House 1 1914 4. Ethnic Group F5—] Apartment 2 1916 1 am: 1� Nursing Home 1 1917 32 White 2� Other- Condo 1 19181� Black 2 191917 White/Hispanic 4 1920 median 10 Japanese 3 19221� No Answer 1 1923 1 1924 3 1928 2 1929 1 1931 1 1932 1 1938 1 1939 1 1942 1 1957 1 no year given ps /finalrpt/survey.chp 5 7. Income Complete only if you are NOT MARRIED NOW. $646 - $725 per month $726 - $1,155 per month $1,156 or above per month Complete only if you ARE MARRIED NOW. Which one of the categories below describes your total COMBINED MONTHLY INCOME before taxes in 1991? 0 $1,191 - $1,475 per month 2 $$1,476 or above per month 8. Do you get Supplemental Security Income? 0 Yes 34 No 9. Do you get Supplemental Security Payment (Gold Check)? 34 No 0 No Answer 10. Have you ever heard of the Contra Costa County Office on Aging (Area Agency on Aging)? 361 Yes 11. Have you ever called the Contra Costa County Office on Aging (AAA) for assistance and information? F20 Yes F-1- I No 27 No Answer ps / li4rpt/survey.chp 6 12. Below is a list of problems. Please show how much each one is a problem to YOU: (PLEASE DARKEN THE APPROPRIATE NUMBER FOR EACH PROBLEM) PROBLEM IS IT A PROBLEM TO YOU? No Minor Serious Did Not Problem Problem Problem Answer Crime 10 14 10 2 Employment 21 7 5 3 Energy/utilities 21 10 3 2 Getting Information About 21 9 3 3 Services/benefits Getting Services/benefits 20 9 3 4 Health Care 16 8 9 3 Housing 25 4 3 4 Legal Affairs 20 11 2 - 3 Loneliness 22 8 2 4 I Money to Live On 25 5 4 2 Nutrition/Food 27 5 2 2 Taking Care of Another Person 24 5 4 3 I j Transportation 21 ' 10 ! 2 3 i ps /finalrpt/survey-chp 7 13. Please choose from Question #12 the TWO problems that affect YOU the most. Please write about why they are problems for you on the lines below. First Problem: (FOR EXAMPLE: Employment) Second Problem: Are there any problems that are not on the list that are important to YOU? If so, please write about them on the spaces below. 14. Because of a HEALTH CONDITION, do you have any difficulty going outside the home alone, for example, to shop or visit the doctor's office? - 117 Yes 32 No 37 No Answer Please go on to questions #15 and #16. ps /finalrpt/survey.chp 8 15. Below is a list of activities. How much difficulty do YOU have with each activity? (PLEASE DARKEN THE APPROPRIATE NUMBER FOR EACH ACTIVITY) ACTIVITY DO YOU HAVE DIFFICULTY? No Minor Serious Unable Other Did Not Problem Problem Problem to Do Answer Doing Housework 21 9 1 5 Doing Laundry 29 2 5 Shopping /Errands 28 4 4 Preparing Meals/Cleaning Up 25 6 5 Grooming 29 2 5 Taking Medications 27 4 5 Using Public Transportation 22 3 2 2 7 Driving a Car 23 5 1 1 6 Using the Telephone 31 1 4 Handling Money 32 4 16. For each activity with which you have difficulty, please show who helps you to do that activity. PLEASE DARKEN ALL NUMBERS THAT APPL ACTIVITY WHO HELPS YOU? Other Friend Agency Paid No Other No Spouse Relative Volunteer Worker One Answer Doing Housework 9 5 4 1 17 1 Doing Laundry 4 2 7 1 . 22 Shopping /Errands 5 1 7 23 i a Preparing Meals/Cleaning Up 7 2 1 5 21 Grooming 2 I 1 1 23 Taking Medications 2 j 1 13 1 19 Using Public Transportation i 12 24 Driving a Car 3 1 2 11 19 Using the Telephone 1 14 21 Handling Money 2 1 11 22 ps /finlrpt/survey.chp 9 17. Because of a HEALTH CONDITION, do you have any difficulty taking care of your own personal needs such as bathing, dressing, or getting around inside the home? Yes If "YES" please answer questions #18 and #19. 28 No If "NO" you have finished. Thank you. 18. Below is a list of activities. How much difficulty do YOU have with each activity? (PLEASE DARKEN THE APPROPRIATE NUMBER FOR EACH ACTIVITY) ACTIVITY DO YOU HAVE DIFFICULTY? No Minor Serious Unable to Other Did Not Difficulty Difficulty Difficulty Do Answer Eating 8 1 1 26 Bathing 9 1 26 Dressing/Undressing 26 Walking 7 2 1 Climbing Stairs 6 4 1 25 Getting in and Out of Bed 8 2 1 25 Getting to the Bathroom in Time 7 4 1 24 19. For each activity with which you have difficulty, please show who helps you to do that activity. (PLEASE DARKEN ALL NUMBERS THAT APPLY) ACTIVITY WHO HELPS YOU? Other Friend Agency Paid No Other Did Not Spouse Relative Volunteer Worker One I Answer i Eating 2 1 33 Bathing 2 1 33 Dressing/Undressing Walking 4 32 Climbing Stairs i 5 31 Getting In and Out of Bed ; 3 1 32 i Getting to the Bathroom in Time I I 3 1 32 i ps /finslrpt/survey.chp 10 Contra Costa County Area Agency on Aging FOCUS GROUPS December, 1992 TABLE OF CONTENTS Page Focus Group Summary & Findings 1 -Warm-Up 5 Questions 6 Focus Group Summary & Findings Objective The objective of the focus group was to determine the services seniors need now or may need in the future to lead independent and productive lives whether living independently in their own homes or skilled nursing facilities. The Process The Contra Costa County Area Agency on Aging held three focus groups in East and Central county. The first focus group, held in East county was conducted in Pittsburg at the Pittsburg Care Center on December 9, 1992, at 10:30 a.m. and the second focus group was held in Walnut Creek at the Elm Manor on December 9 at 1:30 p.m. The third focus group, conducted in West county was held at the Vale Care Center in San Pablo on December 31, 1992 at 10:30 a.m.. The process was to target and concentrate on low income minority sections (individuals) of the county. It must be stated at the outset that the process and results of our inquiry are by no means scientific i.e. the target sample was selected on a nonrandom--voluntary basis with assistance from the Contra Costa County Ombudsman program. Each focus group produced insightful information that might otherwise have been lost if AAA relied solely on information gathered through a survey instrument alone. In addition, the process had to be modified in order to accommodate an individual's-capabilities to participate fully. Modifications were: utilization of the entire survey instrument as the primary information gathering tool, and the activity of ranking services and listing services. However, the survey's demographic page (page one of the California Department of Aging survey) was utilized to gather demographic data AAA needed. In place of the survey, open-ended questions were used. They are listed on page 5. The Analysis Generally the major issues of concern or need for those individuals in Skilled Nursing Facilities(SNF's) are as follows: 1. Isolation. Although surrounded by cohorts, many feel isolated from the world at large. The discussion in all three focus group sessions revealed that there was a strong need by the clients to have visitors from the outside come into the facility to read to them or help them write letters. Their sense of isolation could be lessened, they indicated, if they could go outside the facility more often. The San Pablo group, for example, vividly remembered a picnic that they had been able to go on a year ago. Such a need could be filled by organizations taking clients out on small excursions. i 2. Activities and intellectual stimulation. In order to keep from getting "dull", as one client stated, it was important to have intellectual stimulation and an increase in activities. One client suggested the possibility of having student interns in all disciplines visit the nursing facilities and give presentations i.e. current events or on other issues. 3. 'Twenty-four hour care. Generally, the residents in the SNFs stated their needs were being met. When asked, "what would they have needed in order to live at home, if they had wanted to" the reply was, twenty-four hour care. Many did not feel that their children would want to care for them -or could financially do so. Some members of the group indicated that they might be lonely if they were to be at home twenty-four hours a day. Participants indicated that, at least, in the facility they had activities and others around them. The undertaking of the focus group process, a new method for the AAA, was in many respects a learning experience. The facilitator and-cofacilitator were not trained in focus group dynamics; however, by the time the San Pablo group met we felt more accomplished and had better results. In addition, each group in and of itself was very different in their ability to understand and participate in the discussion. Having said this, it was still a worthwhile endeavor with regard to the insights gained by both the residents and the AAA staff. It must also be mentioned that since our sample was very small, these results may not be applicable to the overall SNF population, thus the temptation to generalize to the larger population should be held to-a minimum, if done at all. A. Demographics A total of 20 participated in the focus group. The facilitator and cofacilitator collected the self reported demographic data. Although not all of the responses were reported. Of those who provided demographic data 17 were women, 3 were men, 9 were widowed, 4 divorced, 5 never married, 1 married, 1 separated. The ethnicity of the groups were 16 white, three black, and one didn't answer. the educational level varied greatly. Except for one person waiting for hip surgery they were all residents of a skilled nursing facility and they were all medi-cal recipients. Attached are the group characteristics. This focus group was held December 9, 1992 at Pittsburg Care Center in Pittsburg. Group Characteristics AGE Participants ranged in age from 75 to 92 with the average age being 73 GENDER There were seven women and two men MARITAL STATUS Three were widowed, one married, one single, and three had never married and one indicated two relationship status RESIDENCE Skilled Nursing Facility EDUCATION Varied MOBILITY Three could walk, five needed aides such as wheel chairs or walkers. One was mobile RACE/ETHNICITY Seven participants indicate they were white and one Black and one did not indicate INCOME All Medi-Cal This focus group was held December 9, 1992 at Elm Manor in Walnut Creek. Group Characteristics AGE Participants ranged in age from 48 to 88 with the average age being 74 GENDER Six Females MARITAL STATUS Three were widowed, two never married and one individual was divorced RESIDENCE Skilled Nursing Facility EDUCATION Varied MOBILITY Needed aides like wheel chairs or walkers RACE/ETHNICITY Six participants indicated they were white INCOME All Medi-Cal This focus group was held December 31, 1992 at Vale Care Center in San Pablo. Group Characteristics AGE Participants ranged in age from 59 to 82 with the average age being 79 GENDER There were four women and one man MARITAL STATUS Three were widowed, two divorced RESIDENCE Skilled Nursing Facility EDUCATION Varied MOBILITY All five in wheel chairs RACEIETHNICITY Three participants indicate they were white and two African American INCOME All Medi-Cal 4 Warm-up - 10 Minutes If everyone would take their seats/finish their meal, we can get started. Good morning/afternoon. My name is and I want to thank you on behalf of the Office on Aging for taking time out to speak with Rosie and me. Would you please introduce yourselves.. Today, we will be filling out a survey Rosie will assist three of you and I'll assist the other three. Before we get started, I want to share with you -- first the process--how I intend to conduct this session and second, ground-rules for participating. I'd like to discuss the process. We will take about 20-30 minutes to fill out the survey and about 30 minutes in discussing if there were adequate funding for services for the elderly what would you like to see provided in Contra Costa County? You will notice the microphone in the center of the table - yes we will be recording for the second half of the session. The purpose for recording this session is because my memory isn't perfect and what you have to say is very important to me and if I'm taking notes I won't be able to concentrate on your comments. Your comments will be kept anonymous but not confidential. By this I mean, we will use your comments in the final report but we will not identify you personally. Let me hand out the survey. Rosie will hand out pencils. Rosie will assist the three of you and I'll assist the other. Now that the survey has been completed. I'd like to move into the next 2nd phase of the Interview. Ground-rules - There are not right, wrong, or unimportant responses. So feel free to be open and honest. If you have a different opinion than someone else in the room we want to hear it. We want.to hear from each of you. I ask that one person speak at a time and that you speak loudly and clearly. Please no side conversations. I will remind you to speak up during the meeting if I think you are not talking loud enough. I also reserve the right to move the discussion forward if we seem to get stuck on one topic. So please do not take my efforts personally, I just want to assure that we discuss all of the issues we need to cover. And finally, I will be asking you to jot down a couple of notes during the session to help you think about certain issues. We would like to keep these notes to help us in reviewing the tapes. If this presents a problem for anyone, feel free to take your notes with you. Does every one understand the ground rules? Are there any issues of concern? Let's get started. General Discussion Take a blank sheet of paper and list those services NOT provided for seniors in this community. Focus Reveal For the Services you have identified list which is the Most Important, Next ,sr«usgrp.chp1/27/93 Inlportatlt. and Least Iniportant. Open-ended Questions L Please introduce yourself and share with the group what you did and where you lived prior to coming here? 2. If you could have any service you wanted here what would it be 3. If you were able to remain in your own home, what kinds of services would you need? 4. What kinds of activities do you participate in? 5. Do you have outside visitors come to visit you? 6. What kinds of activities does the SNF's provide? 7. If you would please share with me a point of wisdom to live the rest of my life by. 8. Would you like to be in your home? If you were at home would isolation be a problem? 9. Do you have roommates? Is it difficult to have a roommate? * These are the core questions that were posed to the group. Discussion prompted additional questions during the process. Focus group tape transcription 1/29/93 Pittsburg Introduction If you had a million dollars what services would you like funded? Make me get younger. (2) Own my own home. If you could stay in your own home what would you need? Buy medication. Food. Is there anything that you don't have now, that you would like to have? Somebody to help write letter. Opposite sex to socialize. Like to be home. Where «:ere you all from before coming to live here? h (3) Nursing homes Broken hips Stroke Physical problems brought them here. Do you get physical therapy here? Yes Joe gave his wife a bad time, coughed a good deal. Do family members come to visit you? yes, grandchildren--live in the area that's why she came here. Joe, children, two boys. other respondents impossible to hear. Is there someone you can go to if you have a problem? Have you ever heard of the Ombudsman? Family helps Most didn't answer question. One respondent was concerned about the mail, in that she hadn't received any in a while. Walnut Creek . Introduction We handed out our list of activities that they were suppose to look at and indicate which activities might be needed. Virginia--Kept house mostly. Wanted to know why we were here. We have most all activities. Barb--difficulty speaking. Lived in LA-went to UCLA, studied medicine, computers. Family--mother, down South. Clara-- Lived in San Francisco and Walnut Creek (33 yrs). Likes it here, close to church, Kaiser and home. Resident for 6 yrs. 6 mo. They have interesting activities. Would like a friendly visitor. Interested in transportation on our list. Uses county connection once a month to go to St. Marys parish. Educational stimulation? . Classes-they have that. Not in the teaching sense. Activities--most important--Friendly visitor--writing or reading. Misses being able to write. Can't handle paperbacks, small books. Helen--Seattle WA. Worked in Zoo. Docent and Volunteer. 6 yrs in CA. Sister lives here, in Berkeley. Gets to see her. Needs hip surgery. Thelma--Never did anything exciting. LVN--20 years--Michigan and Kansas. Has a daughter and grandson. Anyone married--NO If you could go on a trip, anywhere you wanted to go, where would it be? Hawaii Paris John Muir--Clara--hard for her to travel--too much pain. Would love to go to Hawaii. Europe Travel--can't anymore Virginia--likes to sit in the sun. Do each of you have your own room? No, have roommates. Virginia--she pees all night but she's nice. Is having a roommate problem? No. Loneliness, is it a problem? yes, would like someone to come visit. we play cards watch TV and exercise, Sit and BE Fit. What other kinds of entertainment, social interaction or crafts do you have here? Crafts, make christmas things christmas party--dessert only now, it used to be a pot luck. Celebrate birthdays, no one is forgotten. Where did you live before you came here? Virginia--Kensington--owned home, husband got ill with cancer and passed away. Moved to apt. then to convalescent home in Pleasant Hill. Kids thought she should come to WC. Helen--Seattle, WA. Had arthritis so bad she couldn't even tie her shoes. Needs hip surgery. After surgery she'll live by herself, close to her sister in Berkeley. Thelma--Michigan, Kansas--apartment, lived in a senior apt. Clara--SF and WC. Owned her own home. Had been to other care centers. Goes home once in a while. Uses County Connection with sons help. If you had as much money as you could possibly need, what would you do with it? Still stay here Keep it in the bank Give to charity Would you stay here? Clara--I guess I would have to unless I had 24 hr. help. I don't know if I'd do that, my needs are taken care of very nicely. I'm around people all the time, at home that wouldn't be. Would miss companions don't have activities, have nurse on hand. S Helen--I'll stay here till I have my operation then go to a Sr. Complex or apt. What would have enabled you to stay home? 24 Hr. care. Is that an insurance problem? No not necessarily 24 hour care What kind of advise would you give to someone, words of wisdom? Treat people like you would like to be treated. Sometimes your kids can do more of that than in a place like this. My kids are good to me. I love them too much to live with them. They have their own lives to live. Kids today don't care for their elders the way we used to care for ours. Be yourself, enjoy, appreciate, use time wisely. San Pablo Introduction Leslie-- two children, one son in Hayward and one daughter, a nurse and granddaughter in medical school. She lived in San Francisco. She had a stroke. Nine months in this nursing home. Nice place but doesn't like to be confined. Could be doing other things. Surgery on leg goes to therapy. Allen--Went around the world this year, plans to go again next year. Visited 30 countries. Involved in theater, as an actor, director and university professor. Stated he led a very exciting life. Has children in Portland, Albuquerque, and Maryland. Divorced. Played eccentric characters. Divorced. How do you feel about being here? Allen--8th hospital this year. Enjoy this one best. Stated people his age can do what ever they really want if they want it badly enough. Ruth--Not interesting life--seven children, had a great life with them. Husband past away. here 2 yrs this month. Stroke. Rehab every day. couldn't speak. Enjoys people her age, likes where she is, has great life now. Thelma--raised on farm. Texas. one child, widow and son died. One grandchild and a wonderful daughter-in-law. Making the best of it. No serious illnesses. Daughter-in-law lives in Richmond. Ida--five children--life «•as beautiful when I was well. Stroke What service or activity would you like to see provided? Nurses take more pain with patient:. 9 Do you have visitors from outside? No--would like some. Nurses want them to do more on their own. What kinds of activities? Chess, News, Around the World (TV). Any speakers? No Read newspapers to them--enjoy that. Family brings in things they need. Painting Do you share rooms? Problem? Yes, No Isolated? confined sometimes can't cope--would like to get out more. Erma takes them out. Picnic-last summer, church. Allen wants intellectual stimulation-graduate student from University to talk about current events. If you were to remain in your own home, what kinds of services would you need? Need someone to do most things someone to clean, can't walk. I have a good son, but he wouldn't want to care for his mother. Personal grooming? could do that. Wouldn't want to be alone in case something happens. Could care for herself. Give advise to live by. Make it the happiest, get people to participate in anything, participate in the arts. Nice to be active live a clean life read as widely as you can keep mind active What do you do here to keep your minds active? Sometimes I get kind of dull, can't think. I go to church and pray. To do right, not hurt anybody, don't take anything that doesn't belong to you. Is there anything that you could add to make your life here more fulfilling-richer? Yes, the nurses should be trained differently and better. In what way? How to take care of the patients Don't care about anything but the money. (Consensus Ida and Leslie both black). Are there enough nurses to care for you? Yes--if they do their duty, have a certain responsibility. I don't complain--doesn't do any good. Should be more professional. Il 61 Contra Costa County Area Agency on Aging Homebound Isolated Frail Elderly Survey California Department of Aging survey January 1993 Table of Contents Pace Introduction 1 Summary of data 2 Appendix 4 East County data West County data Central County data Introduction The Objective The objective of the survey was to determine the needs of the isolated, home bound frail elderly. The Process In January 1993, it was decided that the California Department of Aging's survey instrument would be utilized to survey the isolated, home bound frail elderly. With the assistance of the Senior Nutrition Program's Nutritionist, Liz Vargas and Nutrition Coordinators, located in West, Central and East County, twelve participants in the home delivered-meal program (four from each part of the county) were asked to volunteer for the survey. Telephone interviews were conducted by the Nutrition Coordinators with each participant. 1 Summary Analysis Demographics Our sample consisted of nine females and three males. Year of birth ranged from 1902 to 1931. The Relationship Status of our respondents varied: seven respondents indicated being widowed, one stated widower, two indicated being divorced, one stated never married and one indicated presently married. Our sample's ethnic makeup was predominantly white; with ten respondents stating they were white and two indicating that they were black. Most of our respondents indicated that they lived in an apartment or a house, one respondent stated their living quarters to be a mobil home/trailer. The majority of the respondents lived alone. The income question responses were mixed. In West County, all respondents indicated that they were not married now with income ranges from $576-645 per month, $646-725 per month, and $726-1,155 per month. Four respondents indicated that they did not receive Supplemental Security Income, three of the four also indicated that they did not ,receive the Supplemental Security Payment (one left question number nine blank). In Central County, all participants responded as not being married now to the income question. The four respondents were evenly divided among the four income choices. To the questions of whether they received any Supplemental Security Income, one respondent stated "yes" and three stated "no". All participants indicated that they did not receive the Supplemental Security Payment. In East County, one respondent stated that they_were married now with an income level range of $736-925 per month. Three participants indicated that they were not married now with income level ranges of $0-575 per month, $576-645 per month, and $726-1,155 per month. All respondents indicated that they did not receive Supplemental Security Income and/or Supplemental Security Payment. It appears some participants may not be aware that they are eligible to receive supplemental income. The AAA will address this issue through the Senior Nutrition Program. Generally, the participants were aware that the AAA existed, however the majority indicated that they had not called the AAA for assistance. 2 Problems for the Elderly The main concerns that participants had in East County were as follows: crime, healthcare and not having enough money to live on. Comments by respondents from East County with relation to crime were, "I am afraid to leave the door open in the day time." "It's not safe in my own home". Healthcare, "It's too expensive, I can't afford it.", "Unable to afford good healthcare", "Have to wait too long for healthcare services and appointments". In West County, respondents main concerns were: Healthcare, transportation, and crime. Comments by respondents were as follows: Healthcare, "Appointments are hard to get", "Co-payments are high so I don't go unless it is absolutely necessary". Transportation, "Getting to the doctor is very bad as I must be taken by ambulance". Crime, "I live in an area with high crime and am fearful of going to the bus stop or neighborhood grocery". In Central County, participants' responses to the open-ended questions revealed that transportation was the major concerti Comments were: "Cannot use public transportation, must be accompanied by relative, friend, or hired helper". "I don't have a car". "County Connection is not dependable, I am eighty years old and have been stuck for hours waiting". "No transportation on Sunday to go to church". Problems doing Activities Generally, those participating in this survey stated that they had difficulty going outside the home alone. Participants from East County generally had difficulty performing activities. These included activities such as, "driving a car", "doing housework" and "laundry". Most of the respondents indicated having "no one" to help them. If someone did help them, a relative other than a spouse helped. Responses from West County indicated that they were unable or had serious problems with daily activities. These respondents either had a "paid worker', "friend" or a "relative" other than a spouse help them. Those in Central County seemed a bit "healthier" in that their responses to the range of difficulty concentrated more in the areas of having "minor' or "no" difficulty doing an activity. Their helpers were primarily "paid workers", "agency volunteers", and "relatives" other than a spouse. Problems with personal activities It could be said that the twelve participants in this survey had some range of difficulty taking care of their personal needs. Overall, they indicated having "no" to "minor' difficulty. Those who indicated that they had some range of difficulty stated that an "agency volunteer' or "no one" helped them. Appendix 0 Survey data of home bound isolated frail elderly in Central Contra Costa County Central County 4N 1. Sex 3 Female 1 Male 2. Year of Birth 1912 1913 1915 1922 3 . Relationship Status 1 Never Married 2 Widow 1 Divorced 4. Ethnic Group 4 White 5. Living Arrangements I live alone: 4 yes 0 No 6. Living Quarters I live in: 4 Apartment 7. Income--Not married 1 $576-645 per mo. 1 646-725 per mo. 1 726-1, 155 per mo. 1 1, 156 or above. 8. Do you get Supplemental Security Income? 1 Yes, 3 No 9. Do you get Supplemental Security Payment (Gold Check) ? 4 No 10. Have you ever heard of the Contra Costa County Office on Aging (Area Agency on Aging) ? 3 Yes, 1 No 11. Have you ever called the Contra Costa County Office on Aging(AAA) for assistance and information? 1 Yes, 3 No 12 . Below is a list of problems. Respondents had to indicate which was a problem to them: No Minor Serious .Crime 3 1 Employment 3 1 Energy/utilities 3 1 Getting information 4 Getting services 3 1 Health care 3 1 Housing 4 Legal affairs 4 Loneliness 3 1 Money to live on 3 1 Nutrition/food 3 1 Taking care of another person 4 Transportation 1 2 1 13 . Please choose from Question #12 the two problems that affect you the most. First problem: 3 Transportation. --Cannot use public transportation, must be accompanied by relative, friend, or hired helper. --I don't have a car. --County Connection is not dependable-client has been stuck for hours waiting and is. 80 yrs old. No transportation on Sunday to go to church. Second Problem: 1 Nutrition. HDM only provides part of food requirements. Must depend on others to do shopping for her. 1 Loneliness. I hate sleeping by myself. Parkinsons Disease-No cure-fractured hip-slowly getting worse. 1 Cost of medications. Medical doesn't cover my medications. In order to pay for medicine she has to cut food and clothing allowance. 1 Respondent left #13 Blank. 14 . Because of a health condition, do you have any difficulty going outside the home alone? 3 Yes, 1 No. 15. Activity list. How much difficulty do you have with each activity? Range of difficulty Activity No Minor Serious Unable Other Doing housework 3 1 Doing Laundry 2 1 1 Shopping/Errands 2 2 Preparing meals/cleaning up 1 3 Grooming 4 Taking Medications 4 Using Public Transportation 1 1 2 Driving a Car 1 3 Using the telephone 4 Handling Money 2 2 16. For each activity with which you have difficulty, who helps you? Other Friend Agency Paid No Other Spouse Relative Volunteer worker one Doing housework 3 1 Doing laundry 2 1 Shopping/errands 2 1 2 .Preparing meals/cleaningup 4 Grooming 2 Taking medications 2 Using Public Transportation 1 2 1 Driving a Car 2 1 2 Using the telephone - 2 Handling Money 1 1 1 1 respondent left doing laundry blank. 1 respondent answered that 2 helpers helped--Shopping/Errands. 2 respondents left Grooming blank. 2 respondents left Taking medications blank. 1 respondent indicated 3 helpers--Other relative, friend, - paid worker. 2 respondents left using phone blank. 1 respondent left handling money blank. 17. Because of a health condition, do you have any difficulty taking care of your own personal needs? 1 Yes, 3 No 18 . Range of difficulty No Minor Serious Unable other Eating 1 1 Bathing 2 Dressing/Undressing Walking 1 1 Climbing stairs 1 1 Getting in and out of bed 1 1 Getting to the bathroom in time 2 Although 3 answered "No" to #17 , one of the 3 responded to questions #18 and 19 . 19. Who helps you do activities? Other Friend Agency Paid No Other Spouse Relative Volunteer Worker One Eating 2 Bathing 1 1 Dressing/Undressing Walking 1 1 climbing stairs 1 1 Getting in and out of bed 1 1 Getting to the bathroom 1 1 in time survey . data for home bound isolated frail elderly in East Contra Costa County East County 4N 1. Sex 3 Female 1 Male 2. Year of Birth 1917 1919 1925 1931 3 . Relationship Status 1 Married 2 Widow 1 Divorced 4. Ethnic Group 3 White 1 Black 5. Living Arrangements I live alone: 2 yes 2 No 6. Living Quarters I live in: 2 House 1 Apartment 1 Mobil Home/trailer 7. Income Not married 1 $0-575 per mo. 1 576-645 per mo. 1 726-1, 155 per mo. Married 1 $736-925 per mo. 8. Do you get Supplemental Security Income? 4 No 9. Do you get Supplemental Security Payment (Gold Check) ? 4 No 1.0. Have you ever heard of the Contra Costa County Office on Aging (Area Agency on Aging) ? 2 Yes, 2 No 11 . Have you ever called the Contra Costa County Office on Aging(AAA) for assistance and information? 1 yes, 3 No ti t 12 . Below is a list of problems. Respondents had to indicate which was a problem to them. No Minor Serious Crime 1 1 2 Employment 2 2 Energy/utilities 2 2 getting info 1 3 getting services 1 1 2 Health care 1 1 2 Housing 4 Legal affairs 3 1 Loneliness 2 1 1 Money to live on 1 3 Nutrition/food 3 1 Taking care of another person 4 Transportation 3 1 13 . Please choose from Question #12 the two problems that affect you the most. First problem: * 2 Crime. Afraid to leave door open in the day time. It's not safe in own home. 1 Energy/utilities. Utility bills are too high for people living on fixed income. 1 Money to live on. Mortgage too high, had to borrow money to put new roof on house this takes away most of living expense money. _- Second Problem: * 3 Healthcare. It's too expensive, can't afford it. Unable to afford good healthcare. Have to wait too long for health care services and appointments. 1 Nutrition/food. Doesn't get enough food. Food is very expensive, can't afford some foods that are needed for proper nutrition. 14 . Because of a health condition, do you have any difficulty going outside the home alone? 2 Yes, 2 No. 1 15. Activity list. How much difficulty do you have with each activity? Range of. difficulty Activity No Minor Serious Unable Other Doing housework 2 2 . Doing Laundry 1 1 2 Shopping/Errands 2 1 1 Preparing meals/cleaning up 2 1 1 Grooming 1 2 2 Taking Medications 3 1 Using Public Transportation 2 1 1 Driving a Car 1 3 Using the telephone 3 1 Handling Money 1 2 1 16. For each activity with which you have difficulty, who helps you? Other Friend Agency Paid No Other Spouse Relative Volunteer worker one Doing housework 1 1 2 Doing Laundry 1 1 2 Shopping/Errands 2 1 1 Preparing meals/cleaningup 2 2 Grooming 1 1 2 Taking Medications 1 3 Using Public Transportation 1 2 Driving a Car 1 3 Using the telephone _ 4 Handling Money 4 17. Because of a health condition, do you have any difficulty taking care of your own personal needs? 1 Yes, 3 No 18. Range of difficulty No Minor Serious Unable other Eating Bathing 1 1 Dressing/Undressing Walking 1 Climbing stairs 1 1 Getting in and out of bed 1 1 Getting to the bathroom in time 1 1 19 . Who helps you do activities? Other Friend Agency Paid No Other Spouse Relative Volunteer Worker One Eating 2 Bathing 1 1 Dressing/Undressing Walking 1 1 Climbing stairs 1 1 Getting in and out of bed 1 1 Getting to the bathroom in time 1 1 Survey data of home bound isolated frail elderly in Central Contra costa County West County 4N 1. Sex 3 Female 1 Male 2. Year of Birth 1902 1913 1914 1919 3. Relationship Status 3 Widow 1 Widower 4. Ethnic Group 3 White 1 Black a. Living Arrangements I live .alone: 3 yes 1 No 6. Living Quarters I live in: 3 House 1 Apartment 7. Income--Not married 1 $576-645 per mo. 2� 646-725 per mo. 1 726-1, 155 per mo. 8. Do you get Supplemental Security Income? 4 No 9. Do you get Supplemental Security Payment (Gold Check) ? 3 No 1 Blank 10. .Have you ever heard of the Contra Costa County Office on Aging (Area Agency on Aging) ? 3 Yes, 1 No 11. Have you ever called the Contra Costa County Office on Aging(AAA) for assistance and information? 2 yes, 2 No 12 . Below is a list of problems. Respondents had to indicate which was a problem to them. No Minor Serious Crime 2 2 Employment 4 Energy/utilities 2 2 Getting information 4 Getting services 3 * 1 Health care 1 3 Housing 3 Legal affairs 1 2 Loneliness 1 2 1 Money to live on 3 * 1 Nutrition/food 1 3 Taking care of another person 4 Transportation 1 3 1 respondent left Legal affairs blank. 13 . Please choose from Question #12 the two problems that affect you the most. First problem: 1 Health Care. Appts are hard to get, doctors no longer take time to explain why they are giving you a certain medicine; the Co-payments are high so I don't go unless it is absolutely necessary. 1 Transportation. Getting to doctor very bad as she must be taken by ambulance. 1 Crime. Lives in area with high crime/potential or real. Very fearful of going to bus stop or neighborhood grocery. This fear makes client almost as home bound as physical limitations do. 1 Loneliness. Depression is major problem. Is on medication-has in home help also. Second Problem: 2 Transportation. Taxis are too expensive; with all the stories one hears on TV and sees in the paper client is fearful to ride the bus very often. Family helps when they can but work days and client doesn't want to impose on them. --Can no longer drive-knows what is available to her but their is nuisance factor. 1 Health care. Basically difficult because of transportation. Bedfast-sister cares for and lives with her. 1 Housing. This is a problem due to limited income. feels he is forced to live in more dangerous areas-also feels landlord doesn't take very good care of property. 14 . Because of a health condition, do you have any difficulty going outside the home alone? 4 Yes, 0 No. 15. Activity list. How much difficulty do you have with each activity? Range of difficulty Activity No Minor Serious Unable Other Doing housework 1 1 2 Doing Laundry 2 2 Shopping/Errands 3 1 Preparing meals/cleaning up 2 2 Grooming 1 3 Taking Medications 4 Using Public Transportation 2 1 Driving a Car 4 Using the telephone 2 1 Handling Money 1 3 1 respondent left Using phone blank. 16. For each activity with which you have difficulty, who helps you? Other Friend Agency Paid No Other Spouse Relative Volunteer worker one Doing housework 1 2 1 Doing Laundry 1 2 1 Shopping/Errands 2 2 1 Prepare meals/clean up 2 1_. 4: 1 Grooming 1 1 1 Taking ,Medications 1 1 Use Public Transport 1 1 1 Driving a Car 1 1 1 Handling Money 3 2 respondents checked more than one helper who helps; Shopping/Errands, Preparing Meals/Cleaning up, and Grooming. 2 respondents left grooming blank. 2 respondents left taking medication blank. 1 respondent left using transportation blank. 1 respondent left driving car blank. 1 respondent left using phone blank. 17. Because of a health condition, do you have any difficulty taking care of your own personal needs? 2 Yes, 2 No 18 . Range of difficulty No Minor Serious Unable other Eating 3 Bathing 3 Walking 2 1 Climbing stairs 1 1 1 Getting in and out of bed 1 2 Getting to the bathroom in time 2 1 19. Who helps you do activities? Other Friend Agency Paid No Other Spouse Relative Volunteer Worker One Eating 1 Bathing 1 1 1 Walking 1 2 Climbing stairs 1 Getting in and out of bed 1 1 Getting to bathroom 1 in time 2 respondents left eating blank. 2 respondents left climbing stairs blank. 1 -respondent left getting in and out of bed blank. 2 respondents left getting to the bathroom on time blank. Section B Targeting Description of Area Agency Targeting Priorities As They Relate to Those Discussed in the Older Americans Act The Area Agency on Aging through its Request for Proposals (R.F.P.$) requires bidders to include a plan for community outreach to assure that low income individuals, minorities, limited English-speaking individuals and persons identified as being of greatest economic or social need aged 60 years or older are being served. If an outreach plan is not included in the proposal, it may not be accepted. The Area Agency on Aging assures that low income minority individuals are served through a contractual requirement that requires the Contractor to serve a certain percentage of low income individuals. Information and Referral (I&R) outstations Senior Aides in various parts of the county to disseminate information on senior services available throughout Contra Costa County. I & R staff also develops referral agreements with companies to assist targeted populations facing financial and service difficulties. AP93-97 B. DOC 20 Section B Targeting TARGETING Section 306 (5) (A) (i) of the Older Americans Act states the following: Need (with particular attention -to low-income minority individuals) residing in such area, and the number of older Indians residing in such area, and the efforts of voluntary organizations in the community) , evaluating the effectiveness of the use of resources in meeting such need, and entering into agreements with providers of supportive services, nutrition services, or multipurpose senior centers in such area, for the provision of such services or centers to meet such need; (2) provide assurances that an adequate proportion, as required under section 307 (a) (22) , of the amount allotted for part B to the planning and service area will be expended for the delivery of each of the following categories of services-- (A) services associated with access to services (transportation, outreach, and information and referral) ; (B) in-home services (homemaker and home health aides, visiting and telephone reassurance, chore maintenance, and supportive services for families of elderly victims of Alzheimer's disease and related disorders with neurological and organic brain dysfunction; and (C) legal assistance; and specify annually in such plan, as submitted or as amended, in detail the amount of funds expended for each such category during the fiscal year most recently concluded; (3) designate, where feasible, a focal point for comprehensive service delivery in each community, giving special consideration to designating multipurpose senior centers as such focal point; (4) provide for the establishment and maintenance of information and referral services in sufficient numbers to assure that all older individuals within the planning and service area covered by the plan will have reasonably convenient access to such services; (5) (A) (i) provide assurances that preference will be given to providing services to older individuals with the greatest economic or social needs, with particular attention to low-income minority individuals, and include proposed methods of carrying out the preference in the area plan; (ii) provide assurances that the area agency will include in each agreement made with a provider of any service under this title, a requirement that such provider will-- (I) specify how the provider intends to satisfy the service needs of low-income minority individuals in the area served by the provider; and (II) attempt to provide services to low-income minority individuals in at least the same proportion as the population of low-income minority older individuals bears to the population of older individuals of the area served by such provider; and AP93-97 B. DOC 21 Section B Targeting (iii) with respect to the fiscal year preceding the fiscal year for which such plan is prepared-- (I) identify the number of low-income minority older individuals in the planning of service area; and (II) describe the methods used to satisfy the service needs of such minority older individuals; and (B) assure the use of outreach efforts that will identify individuals eligible for assistance under this Act, with special emphasis' on rural elderly, older individuals who have greatest economic need (with particular attention to low-income minority individuals) , older individuals who have greatest social need (with particular attention to low-income minority individuals) , and older individuals with severe disabilities, and inform such individuals of the availability of such assistance. AP93-97 B.DOC 22 Section B Targeting Section B A description of the methods used to identify the target population. Demographics of each city and unincorporated area of Contra Costa clearly demonstrates where there are pockets of low income minority seniors. The methods used in the needs assessment process to identify and focus on the low income minority were as follows: 1. AAA Planner and AAA's student intern held focus groups in each region of the County East, West and Central. Within each region we conducted a focus group located in a high density minority, low income, skilled nursing facility. 2. The State survey was also utilized in each region of the county and targeted those low income minority seniors who were homebound and isolated. 3. AAA's HICAP coordinator in conjunction with West County Senior Services Network is providing Ombudsman services to low income minority in Richmond and San Pablo through the CARE project. 4. East Contra Costa County has a large Hispanic population. A method Delta 2000 and AAA have utilized is to have conferences that are bilingual. 5. Delta 2000 in collaboration with AAA, and other service organizations, i. e. clergy, nonprofits, N.A.A.C.P. , Filipino Association, Black Families Association participate in a cultural sensitivity task force to raise awareness and sensitivity to different ethnic groups, by engaging speakers, having conferences, and networking with each other. 6. The AAA Planner and cultural sensitivity task force are planning a Hate/Crime conference for East County residents. AP93-97 B. DOC 23 Section B Targeting Section B A description of target populations within the P.S.A. , their characteristics, needs and locations. The attached charts give very specific ethnic data by city by the 60+ population. As shown on the chart East Richmond, E1 Cerrito, Pinole and Hercules as a Asian Pacific Islander population. The cities of Richmond, Pittsburg, and San Pablo have a higher ratio of the Black population than other parts of the County. West Pittsburg (Bay Point) , City of Brentwood, City of Antioch, Bayview-Montalvin, Oakley, City of Pittsburg have a high concentration of the Hispanic population. Contra Costa County has pockets of low income minority population in E1 Pueblo, Pittsburg, Oakley, Brentwood, South Concord, Richmond, and in San Pablo, a majority of the population is in the greatest social and economic need. Contra Costa County is providing English as a second language, bilingual conferences, resource material in various languages, some home delivered ethnic meals and some ethnic meals at congregate sites. Contra Costa County provides translators for people with language barriers. In Contra Costa the frailest of the frail are the white and hispanic ethnic groups. The very frail have the opportunity, if Medi-cal eligible to reside in a Board and Care or skilled Nursing Facility that accepts Medi-Cal. In Contra Costa County the Hispanic population tends to care for the elderly within the family unit. Delta 2000 provides a cultural diversity task force to sensitize and address racial, ethnic, gender, and sexuality concerns. This model is anticipated to be replicated in Central and West County. Contra Costa County provides physical therapy and support group at John Muir Delta Memorial, Mt. Diablo and Kaiser hospitals for those individuals with neurological disorders. Mt. Diablo Rehabilitation, East County Day Care, and West County Day Care provides care for those individuals. The Private Industry n Council and AAA's Title V are collaborating to maximize funding of both agencies to provide work experience, job placement and training for low income seniors. AP93-97 B. DOC 24 i I1 , m m m O O ("7 n n W W W W D Y O ID �d( J N N J O 3 m tD m < ro 0 O 7C O r• O O n p I O C r 7 `f n 0 a 7C N 3 '9 OJ n. .- O n t O v •c c v x n no < � o to pppp P ; N A • p r .O • • N ; O r t • N r A r VI W N N O W r P r O • P -4 4 • t T r r r t 1 r r wvl ; VVt r to r o O. 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Cy 0 N A:: N M N cn cn y N O iW A O ?' W m.� — D Co w �' w � 0D � � w � cD a� 3° ° ' ° C °. A a° a° a° a° co 0 - -. O W b (D . (O p sv A M N . go b) N• m o O = c w 0 �_ N n ',3 r. A� 0 CA) 0w i 7o p c Lit cc/) n N C7� A !�/� S C:) n 3e o O N -C ) 0 g co m D CD 0 a 00 O 0 cD m O 1 n F .I 'b A 00 0 a D m '0 oe N cn N CD Z N pi O D < CD C C Section B Targeting Section B Identification of Priorities A description of adequate proportion considerations Contra Costa County AAA's adequate proportion's percentages are as follows: 65.00% Access 14.19% In Home Services 10. 67% Legal Access is Case Management, transportation, and I&R. AAA chooses to spend 65% of the Federal funding on Access. The, Key Informant Survey lists the top five areas of concern as transportation, housing , health, access to services, and In home support services. The AAA allocates some of its funding for transportation, however the transportation problem in Contra Costa County especially in Central and East County is an enormous problem and if AAA directed all of its funding to transportation it wouldn't begin to address the problem. West County provides escort services for seniors. The Advisory Council 's transportation committee is advocating for a better transportation system -in Contra Costa County. The AAA funds In Home Services Registry, Friendly Visitors and In Home Support Services for the frail. These are all priority services. In addition the Social Service Department provides limited In Home Support Services. The AAA also contracts with Family and Community services for training of IHSS providers and In Home Services Registry for the Social service Department's IHSS clients. United Way funds the Helping Hands Project in East County which provides a volunteer pool to do some volunteer In Home services. The C.D.A. survey shows that crime was the most serious problem for seniors. The AAA allocates limited funding for legal services; however further investigation into what seniors mean by crime is needed. The AAA's adequate proportion percentages are the same as the previous fiscal year. The Advisory Council 's Housing Committee will continue its advocating and support for affordable housing for seniors. AAA staff will continue its coordination efforts with various housing committees in Contra Costa county to realize additional senior housing. The AAA will study the percentages as it relates, to the focus groups, the survey, and the Key Informant Survey and make adjustments next year if needed. AP93-97 B.DOC 25 Section B Targeting Section B A description of targeting mandates This section has been described in the Targeting Section. A description of other considerations which influence prioritization. The percentages in adequate proportion may change based on the final grant allocation. AAA has made significant reductions in County overmatch which has resulted in a reduction of staffing. AAA is in the process of redesigning the I&R and HICAP service to include Preventive Health Care. AAA may be required to go to public hearing again. An identification of priorities for the planning cycle as they relate to needs assessment, funding and the considerations listed above. The AAA staff and the Advisory Council on Aging will determine methods for expanding, developing, and coordinating those areas of concern identified in the needs assessment. Changes in the four year plan may be forthcoming in the next four years. If the AAA would receive additional funding the AAA contractors would receive an across the board increase if appropriate. The AAA may consider funding additional home delivered meals. The AAA would utilize its Needs Assessment to determine service priorities. If AAA receives a decrease in revenue AAA and the Advisory Council will entertain across the board cuts. It is the Planner's intention in the next four years to develop an elder care component with for profits and large corporations to bring additional revenue into Contra Costa County. AP93-97 B. DOC 26 DRAFT 3/18/93 GOAL #1 The AAA staff is committed to enhancing Contra Costa County's community based system of care and will provide AAA Staff Assistance for program development,coordination and technical assistance to Coalitions, nonprofits serving the senior population and to expand existing resources and develop new programs, based on identified service need. RATIONALE As part of the needs assessment, the Key Informant Survey, and focus groups requested AAA to maintain a high level of visibility and leadership. OBJECTIVES YEAR 1 1. AAA planner will attend the Antioch Committee on Aging Multipurpose Task Force to find a land site by June 30, 1994 to build a multipurpose health care facility. 2. AAA staff will attend the Elder Care Committee to expand day care for Seniors by applying for funding for East County by June 30, 1994. 3. AAA planner will remain on the Executive Board of Delta 2000 to coordinate, develop, and expand services for seniors through June 30, 1994 by continuing to advocate for seniors. - 4. AAA planner will attend local committees on Aging Senior Centers and Service Provider meetings to form a Coalition that will coordinate all senior services in Central County by June 30, 1994. 5. AAA staff will assist Delta 2000 and West County Senior Services Network with grant writing by providing demographic data to bring additional senior resources to Contra Costa County by June 30, 1994. 6. AAA staff will coordinate with CASH (Citizens for Affordable Senior Housing) in Oakley to locate a land site for affordable Senior Housing by June 30, 1994. 7. AAA staff will work with the Antioch Chamber of Commerce, Antioch Human Relations Commission and Delta 2000 to apply for CDBG funds to renovate the old Antioch Police Station to eventually provide a one stop shopping for services for seniors by June 30, 1997. 8. AAA planner will attend and be a member of the United Way Leadership Board to inform the Board of Senior Needs on a Countywide basis in an effort to fill needs for seniors with United Way funds by June 30, 1994. 9. AAA planner and Delta 2000 are applying for a grant to the AARP Andrus Foundation for an action Demonstration Project in the amount of$150,000 over the next three years by June 30, 1994 AP93-97 GOALS.CHP 10. AAA staff will train bank tellers, PG&E workers on how to be a gatekeeper by June 30, 1994. 11. AAA staff will collaborate.with Delta 2000's Elder Care committee to provide an aging in place conference for East County Seniors by June 30. 1994. 12. AAA staff will coordinate with West County Senior Services Network to apply for a demonstration project in the amount of$150,000 over the next three (3)years by June 30, 1994. 13. AAA staff will coordinate with West County to provide a Senior Information day by June 30, 1994. AP93-97 GOALS.CHP 2 GOAL #2 AAA will maintain an active leadership role by collaborating with the community groups elected officials, service providers, and coalitions in order to continue to provide all health, social and nutrition needs and protect older persons who are in danger of abuse or neglect. RATIONALE Expanding and providing new services and more coordinated services with AAA staff input is being requested. In addition provide protection to those seniors at risk of being abused or neglected. OBJECTIVES YEAR 1 1. The Advisory Council's health committee in conjunction with AAA staff will study the three main insurance based, employer based, and single payer to determine which is the most cost effective and best serves over all needs of the population by June 30, 1994 2. The Health Committee with the assistance of AAA staff will determine which.._- universal health care they will support and then advocate for it through a letter writing campaign by June 30, 1994. 3. The Health Committee and AAA staff will educate the community through speakers presenting information on health access issues by June 30, 1994. 4. The Legislative Review Committee and AAA staff will analyze legislation with special emphasis on Prevention of Elder Abuse and inform the Advisory Council on which legislation they should support and advocate for by June 30, 1994. 5. The Advisory Council and AAA staff will write letters of support for legislation that will assist in bringing in additional revenue for expanding or developing new services for seniors that are needed in Contra Costa County,by June 30, 1994. 6. The Housing Committee and AAA staff will implement a housing survey in the city of Pleasant Hill to determine the housing needs of seniors 60+ by June 30, 1994. 7. The Housing Committee and AAA staff will establish linkages with local committees on aging in order to review the city's general plan to determine if they are providing adequate housing for seniors on an ongoing basis. 8. The Housing Committee will continue to engage speakers that are experts in senior housing to continue to educate the housing committee on housing issues on an ongoing basis. AP93-97 GOALS.CHP 3 9. The Transportation Committee and AAA staff will work with the Transit Authority to ensure ADA doesn't reduce paratransit transportation for the elderly by attending transportation meetings and advocating for seniors on an ongoing basis. 10. The Adult Day Health Committee is supporting groups who want to expand adult day health care by putting them in contact with appropriate parties, referring them to other adult day health care facilities throughout the Bay Area, putting them in touch with resources and supporting their applications on an ongoing basis. AP93-97 GOALS.CHP 4 GOAL #3 AAA will provide public information and community education regarding the aging process, demographics and needs of the elderly,funding availability, and training opportunities to seniors and their families,the general community, and service provider agencies. " RATIONALE This came up as an issue in the Key Informant Survey as part of the needs assessment. OBJECTIVES YEAR 1 1. AAA Planner will provide each city with demographics by age, sex, race, and income cohorts by formatting the demographics in chart form by June 30, 1994. 2. I&R coordinator will assist Central and East County senior service providers in preparation of an all County Day,where providers will be given the opportunity to share what their agency does with other agencies by June 30, 1994. 3. AAA Planner will on a continuing basis FAX funding resources to appropriate agencies on an ongoing basis. 4. AAA staff will provide the public with_preventive health care and disease control information on a continuing basis by telephone and community presentations by June 30, 1994. 5. HICAP Coordinator and volunteers will provide preventive health care and disease control at counseling sites, public presentations, and written information by June 30, 1994. 6. The Advisory Council committees will inform the general community of special educational presentations through special invitations, newspaper articles, and information in Newsletters on an ongoing basis. 7. I&R staff will make educational presentations on services available to seniors by speaking engagements,written materials, and participation in conferences, on an ongoing basis. 8. AAA staff will collaborate with West County Senior Service Providers to provide Senior Information Day for Seniors in N'�est County by June 30, 1994. AP93-97 GOALS.CHP 5 GOAL #4 AAA will target low-income minority seniors in its delivery of services and identify, develop and expand service availability to this targeted population. Rationale Mandate under the Older Americans Act and was an issue in the Key Informant Survey. OBJECTIVES YEAR 1 1. AAA Planner will continue to meet and confer with the multicultural task force to identify service needs by June 30, 1994. 2. AAA Planner will participate on the multicultural task force to enhance her sensitivity to other cultures and how services should be delivered in a culturally sensitive nature on a continuing basis. 3. AAA staff through project CARE will identify high risk seniors with In-Home Supportive Service needs in Richmond and San Pablo by June 30, 1994. 4. Area Agency on Aging through its Request For Proposals (R.F.P.$)will continue to require bidders to include a plan for community outreach to assure that low income individuals, minorities, limited English-speaking individuals and persons identified as being of greatest economic or social need aged 60 years or older are being served. 5. AAA will continue to be in compliance with the County's Affirmative Action policy regarding Minority and Women Business Enterprise which is incorporated as part of the Request for Proposal. 6. AAA will require that their contracts specify the percentage or number of clients that must be targeted on anongoing basis. 7. Information & Referral (I&R) will continue to outstation Senior Aides in low income minority parts of the county to disseminate information on Senior Services available throughout Contra Costa County by June 30, 1994.. 8. I&R staff will develop referral agreements with companies to assist targeted populations facing financial and service difficulties on an ongoing basis. AP93-97 GOALS.CHP 6 GOAL #5 AAA will serve as the advocate for all persons age 60+ in Contra Costa County by monitoring, evaluating, and commenting upon policies,programs, hearings, levies, and community actions which.affect the elderly population of the county. RATIONALE: This Goal is necessary to be in compliance with CDA's requirements and the Older Americans Act.. OBJECTIVES: YEAR 1 1. The Advisory Council's Housing Committee will continue to advocate for the expansion of low income housing for Seniors throughout Contra Costa County by writing letters of support, speaking before city councils and the Board of Supervisors on an ongoing basis. 2. The Advisory Council's transportation committee will continue to support expansion of paratransit services throughout Contra Costa County by advocating for additional transportation funds directed toward paratransit on an ongoing basis. 3. The Advisory Council's Health/Mental Health Committee will advocate for quality health care for all and improvement in Long Term Health Care by testifying at public hearings, commenting on policies at Public forums on an ongoing basis. 4. The Advisory Council's Adult Day Health Care Committee will advocate for expansion of Day Care by writing letters of support, apply for funding, and develop community action on an ongoing basis. 5. The Contra Costa County Advisory Council on Aging will advocate for seniors by serving as a communications line that brings information to the AAA and by providing information on local programs and services on an ongoing basis. 6. The Advisory Council's Legislative Review Committee will continue to support legislation that will benefit seniors by advocating the Board of Supervisors, local representatives, and Washington, D.C. on an ongoing basis. AP93-97 GOALS.CHP 7 GOAL #6 The AAA will enhance the administrative efficiency of its contracting and service delivery operations for the purpose of improving the responsiveness of the community based system of care for the elderly in Contra Costa County to the changing needs of the older population. RATIONALE: This is an internal goal based on self evaluation. OBJECTIVES: YEAR 1 1. AAA Contracts monitor will improve the contract monitoring system by including examination of case records at random to ensure each contract agency is in compliance with their contract by June 1997. AP93-97 GOALS.CHP 8 GOAL #7 AAA will establish a preventive health care program that will provide health care insurance counseling and health promotion information to the older population of Contra Costa County by means of community outreach activities. RATIONALE: This service must be provided in order to be in compliance with the Older Americans Act. OBJECTIVES: YEAR 1 1. AAA staff as part of its I&R outreach efforts will provide prevention of health care programs for seniors, service providers, and senior center participants, etc.by June 30, 1994. 2. HICAP staff will provide health care insurance counseling and health care promotion information through its staff and volunteer base at designated counseling sites and through community presentations by June 30, 1994. AP93-97 GOALS.CHP 9 SERVICE UNIT PLAN Indicate the number of units of service to be provided with all funding sources, including federal funds, State funds, USDA, program income, and all local funds (i.e., 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 column titled "Goals/Funds" provides the Area Agency with an opportunity to relate Title III and Title VII funded services/programs 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 IIIB SUPPORTIVE SERVICES (Required units of service are marked by an"R") MIS# MIS Program Units of Service by Activity Goals/Funds (Optional) 1 Information & Assistance 1,550 Follow-up (R) Goal(s) 12,800 Information(R) 3,487 Outreach 17,860 Referral (R) 534 Comprehensive Assessment $ 2 Ombudsman 10,683 Complaint/Abuse Investigation Goal(s) and Facility Monitoring (R) 160.2 Community Education/Advocacy (Please Report Title 1118 and Title VII Ombudsman Units Here) 3 Case Management Outreach Goal(s) q1 ? Comprehensive Assessment (R) r;,Ad Care Planning (R) 692 Service Authorization or Arrangement (R) 1,088 Supervision Conservatorship Assessment $ Case Monitoring 4 Housing Follow-up (R)* Goal(s) Outreach Placement (R)* Referral (R)* Repairs/Renovation (R)* Community Education/Advocacy $ 5 Adult Day Care Transportation (R)* Goal(s) Equipment (R)* Day of Attendance (R)* Repairs/Renovation (R)* Staffing Costs (R)* S * At least one of these required units must be funded. TITLE 11113 SUPPORTIVE SERVICES MIS# MIS Program Units of Service by Activity Goals/Funds (Optional) 6 Alzheimer's Day Care Community Education/ Goal(s) Advocacy (R)* Information(R)* Transportation Equipment Family Support (R)* Day of Attendance (R)* Repairs/Renovation $ 7 Security/Crime Community Education/ Goals) Advocacy (R)* Escort (R)* Follow-up (R)* Outreach Referral (R)* Home Security (R)* $ 8 In-Home Services Chore (R)* Goal(s) Housekeeping/Homemaking (R)* Outreach Personal Care (R)* Telephoning (R)* 12,720 Visiting (R)* 3,768 In-Home- Services Registry (R)* Shopping Assistance $ 9 Health Community Education/ Goal(s) Advocacy (R)* Health Screening (R)* Outreach Physical Fitness Therapy Comprehensive Assessment (R)* Hospice (R)* $ 10 Mental Health Community Education/ Goal(s) Advocacy (R)* Follow-up (R)* Outreach Referral (R)* Therapy (R)* Comprehensive Assessment (R)* S * At least one of these required units must be funded. - TITLE 11113 SUPPORTIVE SERVICES (Required units of service are marked by an "R") MIS# .MIS Program Units of Service by Activity Goals/Funds (Optional) 11 Adurlt Day Transportation (R)* Goal(s) Support Center Equipment (R)* Day of Attendance (R)* Repairs/Renovation (R)* Staffing Costs (R)* $ 12 Transportation Escort (R)* Goal(s) Income Support/Material Aid (R)* Outreach _Transportation (R)* Shopping Assistance $ 13 Community Services Income Support/Material Aid (R)* Goal(s) and Senior Center Outreach (R)* Support Activity Scheduling (R)* Volunteer Opportunities (R)* Senior Center Staffing (R)* Translation Volunteer Recruitment Visiting $ 14 Legal Assistance 161 Community Education/ Goal(s) Advocacy 1o,683 Legal Assistance (R) $ 15 Employment/ Counseling Goal(s) Second Career Community Education/ Advocacy Outreach Placement (R) $ 16 Consumer Services Discount (R)* Goal(s) Community Education/ Advocacy (R)* Forms Completion/ Letter Writing (R)* Outreach $ 17 Adult Day Health Care Staffing Costs Goal(s) Dav of Attendance (R)* Transportation (R)* Repairs/Renovation Equipment (R)* $ ' * At least one of these required units must be funded. TITLE IIIB SUPPORTIVE SERVICES MIS# MIS Program Units of Service by Activity Goals/Funds (O tional) 18 Respite Care Respite Registry (R)* Goal(s) Counseling Community Education/ Advocacy (R)* Follow-up (R)* Information (R)* Caregiver Support Group Outreach Referral (R)* Volunteer Recruitment Service Authorization or Arrangement $ TITLE IIIC NUTRITION SERVICES MIS# MIS Program Units of Service by Activity Goals/Funds (O tional) 20 Congregate Nutrition Outreach Goal(s) Transportation 202,654 Meals (R) 135 Nutrition Education (R) $ 21 Home Delivered Outreach Goal(s) Nutrition Meals (R) ice?Nutrition Counseling $ Nutrition -Education (R) TITLE IIID IN-HOME SERVICES FOR FRAIL OLDER INDIVIDUALS MIS# MIS Program Units of Service by Activity Goals/Funds (Optional) 19 Title IIID 12 Minor Home Modifications (R)* Goal(s) Home Health Aides (R)* Chore (R)* 1, 227 Housekeeping/Homemaking (R)* 17 Telephoning (R)* Visiting (R)* Respite (including Adult Day Care) (R)* $ * At least one of these required units must be funded. TITLE (IIF DISEASE PREVENTION AND HEALTH PROMOTION SERVICES MIS# MIS Program Units of Service by Activity Goals/Funds (Optional) 23 Title IIIF Counseling Goal(s) Community Education/ Advocacy (R)* Health Screening Information (R)* Outreach (R)* Physical Fitness Therapy Comprehensive Assessment Home Security Equipment Family Support Nutrition Education Nutrition Counseling Nutrition Screening $ TITLE VII VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES MIS# MIS Program Units of Service by Activity Goals/Funds (Optional) Ombudsman Complaint/Abuse Investigation Goal(s) and Facility Monitoring (R) Community Education/Advocacy (Please report Title VII Ombudsman Units under MIS Program #2.) 22 Title VII Complaint/Abuse Investigation Goal(s) Elder Abuse 21 and Facility Monitoring Community Education/ Advocacy (R) Follow-up Outreach Referral $ }; I 3. �. t _ . _ ,l, t`.: . ,: _.. :�__._ - _ .. �:� _ __..-_. F .S ` yi '+`' �l t' i'� _} \i 7 �.� ttt � � F .�,,, '-� t,•' �. I i .� ti ' ` �/ l i� ASSURANCES A The area agency on aging assures that it shall: 1. Develop an area plan and carry .out, directly or through contractual or other arrangements, a program in accordance with the plan within the planning and service area. (305{c)) 2. Submit for approval by the State agency a plan which meets all requirements specified in Section 306(a)(1) and (2). (306{a)) 3. Specify annually in the area plan, as submitted or as amended, in detail the amount of funds expended for each such category of services [i.e., services associated with access to services, in-home services, and leal assistance] during the fiscal year most recently concluded. (306{a){2W 4. Designate, where feasible, a focal point for comprehensive service delivery in each community, giving special consideration to deisgnating as such focal points multipurpose senior centers operated by organizations that have a proven record of providing services to older individuals that: a. Were officially designated as community action agencies or community action programs under section 210 of the Economic Opportunity Act of 1964 (42 USC 2790) for fiscal year 1981, and did not lose the designation as a result of failure to comply with such Act; or b. Came into existence during fiscal year 1982 as direct successors in interest to such community action agencies or community action programs; and that meet the requirements under section 675 (3)06) of th {E})Community Services Block Grant Act (42 USC 9904(c)(3)). 5. Provide for the establishment and maintenance of sufficient numbers of information and assistance services to assure that all older individuals within the planning and service area covered by the plan will have reasonably convenient access to such services, with particular emphasis on linking services available to isolated older individuals and older individuals with Alzheimer's disease or related disorders with neurological and organic brain dysfunction (and the caretakers of individuals with such disease or disorders). (306{a){4)) 6. Set specific objectives for providing services to older individuals with the greatest economic needs and greatest social needs, including specific objectives for providing services to low-income minority individuals, and include proposed methods of carrying out the preference in the .area plan. (306(a)(5){A){i)) 36 7. Include in each agreement made with a provider of any service under this title, a requirement that such provider will-- (1) specify how the provider intends to satisfy the service needs of low-income minority individuals in the area served by the provider; (ll) to the maximum extent feasible, provide services to low-income minority individuals in accordance with their need for such services; and (III) meet specific objectives established by the area agency on aging, for providing services to low-income minori individuals within the planning and services areas. (306{a}(5){A} ii}) 8. Use outreach efforts that will - (i) identify individuals eligible for assistance under this Act, with special emphasis on - (1) older individuals residing in rural areas; (11) older individuals with greatest economic need (with particular attention to low-income minority individuals); (111) older individuals with greatest social need (with particular attention to low-income minority individuals); (IV) older individuals with severe disabilities; (V) older individuals with limited English-speaking ability; and (VI) older individuals with Alzheimer's disease or related disorders with neurological and organic brain dysfunction (and the caretakers of such individuals); and (ii) inform the older individuals referred to in subclauses (1) through (VI) of clause (i),- : and the caretakers of such individuals, of the availability of such assistance. (306{a){5}{13)) 9. Ensure that each activity undertaken by the agency including planning, advocacy, and systems development, will includea focus on the needs of low-income minority older individuals. (306{a){5){c)) 10. Perform for the planning and service area all of the activities specified in Sec. 306(a)(6)(A) through (S). (306 {a){6){A)-{S)) 11. Provide assurances that any amount received under Part D will be expended in accordance with such part. (306 (a){7}) 12. Provide assurances that any amount received under Part E will be expended in accordance with such part. (306 {a}{81) 13. Provide assurances that any amount received under Part F will be expended in accordance with such part. (306 (a){91) 14. Assure that the area agency on aging, in carrying out the State Long Term Care Ombudsman program under section 307(a)(12) and 712, will expend not less than the total amount of funds. appropriated under this Act and expended by the agency in fiscal year 1991 in carrying out such a program under this title. (306(a){11) and 307 {a}{12}) -15. Assure that the activities conform with - (i) the responsibilities of the area agency on aging, as set forth in this subsection; and (ii) the laws, regulations, and policies of the State served by the area agency on aging. (306(a){13}{13}) 37 16. Assure that it will - (A) maintain the integrity and public purpose of services provided, and service providers, under this title in all contractual and commercial relationships; (B) disclose to the Commissioner and the State agency- (i) the identity of each nongovernmental entity with which such agency has a contract or commercial relationship relating to providing any service to older individuals; and (ii) the nature of such contract or such relationship; (C) demonstrate that a loss or diminution in the quantity or quality of the services provided, or to be provided, under this title by such agency has not resulted and will. not result from such contract or such relationship; (D) demonstrate that the quantity or quality of the services to be provided under this title by such agency will be enhanced as a result of such contract or such relationship; and (E) on the request of the Commissioner or the State for the purpose of monitoring compliance with this Act (including conducting an audit), disclose all sources and expenditures of funds such agency receives or expends to provide services to older individuals. (306 {a){14)(A) through (E)) 17. Assure that funds received under this title will not be used to pay any part of a cost (including an administrative cost) incurred by the area agency on aging to carry out a contract or commercial relationship that is not carried out to implement this title. (306 {a){15)) 18. Assure that preference in receiving services under this title will not be given by the area agency on aging to particular older individuals as a result of a contract or commercial relationship that is not carried out to implement this title. (306 {a){16)) 19. Assure that projects in the planning and service areas will reasonably accommodate participants as described in section 307(a)(1 3)(G). (306{a){17)) 20. Assure that the area agency on aging will, to the maximum extent practicabie, coordinate the services itrovides under this title with services provided under title VI. (306{a){18)) 21. Assure that (A) the area agency on aging will pursue activities to increase access by older individuals who are Native Americans to all aging programs and benefits provided by the agency, including programs and benefits under this title, if applicable; and (B) specify the wars in which the area agency on aging intends to implement the activities. (306{a){19)) 22. Assure that case management services provided under this title through the area agency on aging will - (A) not duplicate case management services provided through other.Federal and State programs; (B) .be coordinated with services described in subparagraph (A); and (C) be provided by - (i) a public agency; or (ii) a nonprofit private agency that - (1) does not provide, and does not have a direct or indirect ownership or 38 controlling interest in, or a direct or indirect affiliation or relationship with, an entity that provides, services other than case management services under this title; or (II) is located in a rural area and obtains a waiver of the requirement described in subclause (1). (306{a){20)) 23. Be [a] the leader relative to all aging issues on behalf of all older persons in the planning and service area. This means that the area agency shall proactively carry out, under the leadership and direction of the.State agency, a wide range of functions related to advocacy, planning, coordination, inter-agency linkages, information sharing,brokering, monitoring and evaluation, designed to lead to the development or enhancement of comprehensive and coordinated community based systems in, or serving, each community in the planning and service area. These systems shall be designed to assist older persons in leading independent, meaningful and dignified lives in their own homes and communities as long as possible. [b] A comprehensive and coordinated community based system described in paragraph (a) of this section shall: {1} Have a visible focal point of contact where anyone can go or call forUp, information or referral on any aging issue; (2) Provide a range of options; {3 Assure that these options are readily accessible to all older persons: The independent, semi-dependent and totally dependent, no matter what their income; {4) Include a commitment of public, private, voluntary and personal resources committed to supporting the system; {5) Involve collaborative decision-making among public, pnvate, voluntary, . religious, and fratemal organizations and older people in the community; {6) Offer special help or targeted resources for the most vulnerable older persons, those in danger of losing their independence; (7) Provide effective referral from agency to agency to assure that information or assistance is received, no matter how or where contact is made in the community; (8) Evidence sufficient flexibility to respond with appropriate inddividualized assistance, especially for the vulnerable older person; (9) Have a unique character which is tailored to the specific nature of the community; {10) Be directed by leaders in the community who have the respect, capacity and authority necessary to convene all interested persons, assess needs, design solutions, track overall success, stimulate change and plan community responses for the present and for the future. (1321.53{a),{b)) 24. Use the resources made available to the Area Agency on Aging under the Older Americans Act to finance those activities necessary to achieve elements of a community based system set forth in paragraph (b) [of Section 1321 .53]. (1321 .53{c)) 25. Work with elected community officials in�the planning and service area to designate one or more focal points on aging in each.community, as appropriate. (1321 .53(c)) 26. Assure access from designated focal points to services financed under the Older Americans Acta (1321 .53(c)) 9 27. Work with, or work to assure that community leadership works with, other applicable agencies and institutions in the community to achieve maximum collocation at, coordination with or access to other services sand opportunities for the elderly from the designated community focal points. (1321.63(c)) 28. Consult with and support the State's Long Term Care Ombudsman Program. (1321.61{b){4)) 29. [Not deem any] requirement in Section 1321 .61 to supersede a prohibition contained in the Federal appropriation on the use of Federal funds to lobby the Congress; or the lobbying provision applicable to private nonprofit agencies and organizations contained in OMB Circular A-122. (1321.61(d)) 30. Assure that persons age 60 and over who are frail, homebound by reason of illness or incapacitating disability, or otherwise isolated, shall be given priority in the delivery of services under this part. (1321.69(a)) B. The State agency, the California Department of Aging is assuring in the State Plan on Aging that the following requirements will be met. The State's assurance is based on area agency on aging compliance with certain federal statutes and regulations and State statutes including those identified below. Any area agency on aging which has a need for technical assistance in regard to such compliance should contact its assigned Community Services Analyst. The area agency on aging assures that: 1. Such fiscal control and fund accounting procedures will be adopted as may be necessary to assure proper disbursement of, and accounting for, Federal funds paid under this title to the area agency on aging including any such funds paid to the recipients of a grant or contract. (307{a){7){A)) 2. (i) No individual (appointed or otherwise) involved in the designation of the head of any subdivision of an area agencyon aging, is subject to a conflict of interest prohibited under this Act; i) no officer, employee, or other representative of an area agency on aging is subject to a conflict of interest prohibited under this Act; and (iii) mechanisms are in place to identify and remove conflicts of interest prohibited under this Act. (307{a){7){13)) 3. (i) (It will) maintain the integrity and public purpose of services provided, and service providers, in all contractual and commercial relationships; (ii) Demonstrate that a loss or diminution in the quantity or quality of the services provided, or to be provided, under this Act by such agency has 0 not resulted and will not result from such contract or such relationship; (iii) Demonstrate that the quantity or quality of the services to be provided under the Ian will be enhanced as a result of such contract or such relationship. �3071a)(71[Cj) 4. It will give consideration where feasible, in the furnishing of home delivered meals, to the use of organizations which (i) have demonstrated an ability to provide home delivered meals efficiently and reasonably; and (ii) fumish assurances to the area agency on aging that such organizations will maintain efforts to solicit voluntary support and that the funds made available under this title to such organizations will not be used to supplant funds from non-federal sources. (307{a)(13)(H)) 5. It shall establish procedures that will allow nutrition project administrators the option to offer a meal, on the same basis as meals are provided to elderly participants, to individuals providing volunteer services during the meal hours, and to individuals with disabilities who reside at home with and accompanyto meal sites older individuals who are eligible under this Act. (307(a)(1 31{1)) 6. In the case of purchase or construction, there are no existing facilities in the community suitable for leasing as a multipurpose senior center,[and that the] plans and specifications for the facility are in accordance with regulations relating to minimum standards of construction, promulgated with particular emphasis on securing compliance with the requirements of the Act of August 12, 1968,-commonly known as the Architectural Barriers Act of 1968. (307{a)(1 4){B) and {C)) 7. Any laborer or mechanic employed by any contractor or subcontractor in the performance of work on the facility [multipurpose senior center] will be paid wages at rates not less than those prevailing for similar work in the locality as determined b the Secretary of Labor in accordance with the Act of March 3, 1931 (Y40 U.S.C. 276a - 276a-5, commonly known as the Davis-Bacon Act), and the Secretary of Labor shall have, with respect to the labor standards specified in this clause, the authority and functions set forth in reorganization plan numbered 14 of 1950 (15 F.R. 3176; 64 Stat. 1267), and Section 2 of the Act of June 13, 1934 (40 U.S.C. 276c). (307{a)(14)(D)) 8. It shall (i) enter into contracts with providers of legal assistance which can demonstrate the experience or capacity to deliver legal assistance; (ii) inlcude in any such contract provisions to assure that any recipient of funds under division (i) will be subject to specific restrictions and regulations promulgated under the Legal Services Corporation Act (other than restrictions and regulations governing eligibility for legal assistance under such Act and governing membership of local governing boards) as determined appropriate by the Commissioner; and (iii) attempt to involve the private bar in legal assistance activities 41 authorized under this title, including groups within the private bar furnishing services to older individuals on a pro bono and reduced fee basis. (307 (a)(15){A)) 9. No legal assistance will be furnished unless the grantee adminsters a program designed to provide legal assistance.to older individuals with social or economic need and has agreed, if the grantee is not a Legal Services Corporation project grantee, to coordinate its services with existing Legal Services Corporation protects in the planning and service area in order to concentrate the use of funds providd under this title on individuals with.the greatest such need; and the area agency on aging makes a finding, after assessment, pursuant to standards for service promulgated by the Commissioner, that any grantee selected is the entity best able to provide the particular services. (307{A){15){B)) 10. It shall, to the extent practicable, require that legal assistance furnished under the area plan will be in addition to any legal assistance for older individuals being furnished with funds from sources other than this Act and that reasonable efforts will be made to maintain existing levels of legal assistance for older individuals. (307(a)(15){D)) 11. It will give priority to legal assistance related to income, health care, long-term care, nutrition, housing, utilities, protective services, defense of guardianship,-abuse, neglect, and age discrimination. (307{a)(1 51{E)) 12. [in carrying out services for the prevention of abuse of older individuals], it will conduct a program [other than such a program funded under Section 303(8)], consistent with relevant State law and coordinated with existing State adult protective service activities for: (i) public education to identify and prevent abuse of older individuals; u) receipt of reports of elder abuse; iii) active participation of older individuals participating in programs under this Act through outreach, conferences, and referral of such individuals to other social services agencies or sources of assistance where appropriate and consented to by the parties to be referred; and (iv) referral of complaints to law enforcement or public protective service agencies where appropriate. (307{a){16)(A), p.36-37) 13. If a substantial number of the older individuals residing in the planning and service area are of limited English-speaking ability, then the area agency on aging shall (A) utilize in the delivery of outreach services under.Section 306(a)(2)(A), the services of workers who are fluent in the language spoken by a predominant number of such older individuals who are of limited English-speaking ability; and (B) designate an individual employed by the area agency on aging, or available to such area agency on aging on a full-time basis, whose responsibilities will 42 include (i) taking such action as may be appropriate to assure that counseling assistance is made available to such older individuals who are of limited English-speaking ability in order to assist such older individuals in participating in Programs and receiving assistance under this Act; and (ii) providing guidance to individuals engaged in the delivery of supportive services under the area plan involved to enable such individuals to be aware of cultural sensitivities and to take into account effectively linguistic and cultural differences. (307(a){20)) 14. Its area plan shall, with respect to the fiscal year preceding the fiscal year for which the plan is prepared: (a) identify the number of low income minority older individuals in the planning and service area; and (b) describe the methods used to satisfy the service needs of such minority older individuals. (307 {a){231) 15. It shall conduct efforts to facilitate the coordination of community based, long term care services, pursuant to Sec. 306(a)(6)(1), for older individuals who: (a) reside at home and are at risk of institutionalization because of limitations on their ability to function independently; (b) are patients in hospitals and are at risk of prolonged institutionalization; or (c) are patients in long term care facilities, but who can return to their homes if community-based services are provided to them. (307{a)(26)) 16. It shall consult and coordinate in the planning and provision of in-home services under Section 341 of the Older Americans Act, with State and local agencies and private nonprofit organizations which administer and provide services relating to health, social services, rehabilitation, and mental health services. (307{a){27)) 17. Its area plan shall, with respect to the fiscal year preceding the fiscal year for which the plan is prepared, describe the methods used to satisfy the service needs of older individuals who reside in rural areas. (307(a){29)) 18. Special efforts will be made torovide technical assistance to minority providers of services. (307{a)�32)) 19. Funds received under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by the area agency on aging to carry out a contract or commercial relationship that is not carried out to implement this title. (307{a){38)) 43 20. Preference in receiving services under this Title III will not be given by the area agency on aging to particular older individuals as a result of a contract or commercial relationship that is not carried out to implement this title. (307{a){39)) 21. If the area agency on aging receives funds appropriated under section 303 (g) (for supportive services for caregivers) the area agency on aging will expend such funds to cant' out part G. (307{a){40)) 22. Demonstrable efforts will be made: (A) to coordinate services provided under this Act with other State services that benefit older individuals; and (B) to provide multigenerational activities, such as opportunities for older individuals to serve as mentors or advisers in child care, youth intervention, juvenile delinquency treatment, and family support programs. (307{a){41)) 23. It shall prepare and submit to the Stateagency a report of the activities conducted with funds provided under this paragraph and the evaluation of such activities. (705{a)7){B){iii)) 24. All services provided under Title III meet any existing State and local licensing, health and safety requirements for the provision of those services. (1321 .17{f){4)) 25. It shall not fund program development and coordination activities as a cost of supportive services for the administration of area plans until it has first spent ten percent of the total of its combined allotments under Title III on the administration of area plans. (1321.17{f){14)(i)) 26. It shall, consistent with budgeting cycles, submit the details of proposals to pay for program development and coordination as a cost of supportive services to the general public for review and comment. (1321 .17{f){14){ii)) 27. It shall provide the State agency an explanation of how proposed expenditures for program development and coordination will have a direct and positive impact on the enhancement of services for older persons in the planning and service area. (1321 .17 (f)){14)){iii)) 28. Any amount received for a program under Title VII will be expended in accordance with the provisions of Title VII for that program. (Title VII) 44 C. The area agency on aging may not: 1. Require a provider of legal assistance under this part to reveal any information that is protected by attorney-client privilege. (1321 .51{c)) 2. Engage in any activity which is inconsistent with its statutory mission under the Act or policies prescribed by the State agency. (1321.53{c)) SERVICES/PROGRAMS FUNDED BY NON-TITLE III SOURCES (OPTIONAL) Area Agencies are encouraged to list other services/programs which they fund in the PSA. Doing so could enable Area Agencies to provide a more comprehensive description of the PSA's service delivery system. The following is one example of a format that may be used for this purpose. PROGRAM UNITS OF UNDUPLICATED GOALS/FUNDS SERVICE PERSONS SERVED Title V Senior Community Services Employment Program is federally allocated to serve 25. enrollees, but with turnover it serves approximately 28-30. The Program's goal is to place 20 percent of enrollees into unsubsidized jobs. The funding the program receives approximately $142, 000 per year. There : is a required match of 10 percent of total funds. HICAP In 1992 the HICAP program provided free counseling and education to 5,536 Contra Costa seniors. Highly trained volunteers provided individual help with Medicare concerns, insurance claims and the selection of supplemental insurance to 1,498 county seniors. Volunteers contributed 4, 543 hours of service in 1992. Funding for HICAP in FY 1992-93 is as follows: (Figures are best estimate) CDA: $62, 682 Title III Coordination 13 , 828 AOA (Project Care) : Administered by CDA - 10, 638 Title IIF: 14, 000 HCFA: Administered by CDA 8, 350 Total $109,498 Project CARE is considered a function of the HICAP program. The HICAP Program Manager facilitates and staffs the Health Services Task Force in West County, oversees the subcontract with West County Senior Services Network, administers the program and provides technical assistance to the community. ' ap93-97 part3 APPENDIX IA NOTICE OF INTENT FOR AREA AGENCY ON AGING TO PROVIDE SPECIFIED OLDER AMERICANS ACT SERVICES The Department has determined that provision of the following specific Title III and Title VII services are considered part of an Area Agency on Aging's functions: Information and Assistance (formerly information and referral); Case Management; Program Development and Coordination; Disease Prevention and Health Promotion; and Prevention of Elder Abuse, Neglect, and Exploitation. These services can be provided by the Area Agency because it has the leadership and mandated responsibility to meet the service needs of the targeted populations in the Planning and Service Area. Area Agencies will receive authorization (through the Area Plan approval process) to provide these services for the four year plan period on the basis of completion of this Appendix IA. Check ap licable Fiscal Year if this Check all applicable Notice of Intent is not for all four types of service Fiscal Years of the Plan Period X Title III B Information and Assistance X FY 93-94 X FY94-95 X FY95-96 X FY96-97 Title III B Case Management FY93-94 FY94-95 FY95-96 FY96-97 X Title III B Program Development and Coordination X FY93-94 X FY94-95 X FY95-96 X FY96-97 X Title III F Disease Prevention and x FY93-94 FY94-95 FY95-96 FY96-91 Health Promotion Title VII Prevention of Elde , Abuse, FY93-94 FY94-95 FY95-96 FY965-97 Neglect, and Exploitation Please describe meth%,­1s that will be used to assure that target populations throughout the Plannirrand Service Area will be served. 46 APPENDIX II PUBLIC HEARINGS Complete this section regarding public hearings conducted for the 1993-97 PSA Plan, For Planning and Service Areas which are multi-county, public hearings must be conducted in each county. Place an asterisk beside the hearings at which the PSA Plan was provided in a language other than English and/or at which a translator was used during the hearing. Indicate any hearing held at a long term care facility by entering (LTC) after the appropriate location: Location Date Number Attending walnut Creek 3/10/93 30 Pittsburg 3/12/93 11 Richmond 3/19/93 42 Discuss outreach efforts used in seeking out the institutionalized or homebound/disabled older persons' input into the PSA Plan: The hearing impaired were reached through an interpreter. The notice specifically asked if anyone needed a translator to notify our office. The institutionalized were reached through AAA's needs assessment: Were proposed expenditures for program development and coordination discussed at the hearing? x Yes No Not Applicable Were all interested parties notified of the public hearing and provided the opportunity at a public hearing to testify regarding the establishment of minimum percentages for adequate proportion in the PSA . x Yes No Not Applicable 4S Summarize the comments received concerning the establishment of minimum percentages for adequate proportion. The percentages were not an issue. The Director went over the percentages and the general public didn't express an opinion. Summarize other major issues discussed or raised at the public hearings: 1. Concern over home delivered meal program. 2. Give Service Providers a raise or COLA. 3. Lack of meal service on a North Richmond route. 4. Focal Point as elder services was discussed as well as funding. 5. Would the AAA consider directing its funding to -specific region who work with special population groups. List major changes in the PSA Plan as a result of input from attendees at the hearings: 1. If the AAA receives -addition&l Title III funding the first priority will be to give current contractors a COLA. 2. Consider R.F.P. funding options. 49 Public Hearing Walnut Creek March 10, 1993 Gene Wolfe welcomed everyone to the hearing. The purpose of the hearing is to allow the public input on information being presented. There will be two presentations: one from Sharon Johnson, Assistant Director and Planner and presentation on the budget by Bob Sessler, Director. There will be time for questions after each presentation. The second part of the hearing will be for public comment. Mr. Wolfe asked everyone present to introduce themselves. At this point Sharon Johnson did her presentation. She stated that she has had assistance from Rosie Meddaugh, student intern from Sacramento State, in doing a needs assessment. Dr. Beclee Wilson, a former student intern, has assisted in updating the key informant survey. The top five issues that came out of the key informant survey were transportation, housing, health care, in home support services, and awareness of how to access services. The issues will be addressed through Advisory Council committees or objectives in the Area Plan. The members of the Planning Committee were . used as "guinea pigs" on CDA's survey. Minor _. modifications were made to the survey. It was sent to local committees on aging. Liz Vargas and Paul Kraintz from the Nutrition Project helped with the survey also. Isolated homebound seniors were interviewed also. The main concern was crime. The seniors stated that health care was too complicated and too expensive. There are confusions about Medicare policies. The next problem was daily activities. Next, Sharon listed the contracted services: nursing home ombudsman, case management, congregate nutrition, home delivered nutrition, home visiting, in home services registry, transportation, legal services, in home services for frail, and y prevention of abuse, neglect and exploitation of older adults. The services provided directly. include information and referral and disease prevention and health promotion services. Other activities provided by the Office on Aging include program development, coordination, and administration. Another service offered by the Office on Aging is outreach/targeting. The Area Agency on Aging. through its Request for Proposals (R.F.P. 's) requires bidders to include a plan for community outreach to assure that low-income individuals and persons identified as being of greatest economic or social need aged 60 years or older are being served. Sharon went over the seven goals in the Area Plan. The Area Agency on Aging has established three community service areas--East, Central and West County. Included in the 4 year Area Plan are new seniors to be served and the number of . units of services to be provided during fiscal year 1993-94 . Also included are a projection of congregate meals during fiscal ,year 1993-94 and projection of home delivered meals to be served during 1993-94 . Sharon asked fo_ questions. -2- Paul Kraintz expressed concern over the survey that revealed crime as the biggest issue. Sharon stated she will look into this. Question was asked what is available for seniors who are middle class? Sharon stated that contracted services are available to anyone over the age of 60. Bob stated that the Older Americans Act requires low income and minority seniors to be targeted. The services, however, are available to seniors over the age of 60. Question was asked do the projected dollars include cuts that will have to be made because of the state cuts? Bob stated that this will be covered during his presentation. Walter Blumst stated that the total number of meals (215,000) in congregate meals seems low. Bob stated that this is based on the current service level. Liz Vargas stated that congregate meals have gone down or stabilized statewide and nationwide. Walter Blumst asked how the unduplicated account is arrived at? Sharon stated that the number of new seniors served over the last six months are added up and divided by 12. Bob stated that all programs except information and referral are required to keep track of each client by name. Next, Bob Sessler started his presentation. Bob stated that he will do an overview of where the-funding comes from. Federal Funds OAA IIIB supportive services IIIC1 congregate meals IIIC2 home delivered meals IIID home services for frail IIIF preventive health VIIA Ombudsman VIIB elder abuse prevention U. S. Department of Agriculture meal reimbursement State Funds LTC Ombudsman Supportive services Congregate meals Home delivered meals In Home Services for Frail Elder Abuse Prevention Local Funds Required match--Contra Costa County Local contractors Non match - local contractors Local agencies -3- Grant related income — client contributions Bob stated that the amount being received from the state is the bare minimum. Bob discussed the Intra State Funding Formula. A federal court ruled October 1 that the state had to come up with a new formula. The new formula was to go into effect sometime after October 1. However, the new formula did not go into effect until February 24. The California Department of Aging redistributed the state dollars. Office on Aging will wind up with total amount of dollars that it had previously. The county is facing a potential shortfall in home delivered meal program. Almost all the state dollars were lost. Monday, March 8 a letter was received listing the amount of money the Office on Aging will receive next year. The amount is about $4,000 less than' the current Grant Allocation Plan. Another public hearing may have to be held after July 1. Next, Bob went over some items that cause restrictions in the way funds are spent. Funding Requirements LTC Ombudsman Shift federal and state dollar allocations supportive services Adequate proportion for priority services--Access--65%, Legal--14%, In Home--11% Meal Programs Up to 30% of federal funds allocated may be transferred between congregate and home delivered Shift. allocation of state dollars Program Development & Coordination Up to 10% of IIIB funds may be spent Administration & Advocacy Shift allocation of federal funds State funding In Home Services for Frail Shift allocation of federal and state dollars Preventive Health Shift allocation of federal and sate dollars --- Elder Abuse Prevention Shift allocation of federal and state dollars Dora Gonsalves asked how much federal money will be lost because of loss of state money? Bob stated that he has prepared a budget. If County Administrator accepts the recommendation will not lose any federal funds. Statement was made that Congress is considering eliminating Commission on Aging along with three other commissions. The Gray Panthers are concerned that the elimination of the Commission on Aging would jeopardize funding of the older Americans Act. It would also mean no access to elder issues at the federal level. Bob stated that there is a federal Council on Aging. Congress has a Select Committee on Aging. That committee's fate is questionable. There is a Senate Subcommittee on Aging. That committee has been approved. At the state level there have been various recommendations to eliminate boards and commissions. Walter stated that under the older Americans Act federal money comes by titles. Does state money come in a similar fashion? Bob stated that the California Department of Aging did reallocation. All state money is in one pot. All state funding is specific for the service it is intended for. Question was asked if state does- not send necessary matching funds will that mean losing federal funds? Bob stated that the state is not recommending cutting any of aging funds necessary to maintain funding. Gene Wolfe stated that the Governor is cutting back money from counties and cities which is having an impact locally. Lafayette will have to eliminate its congregate meal site. It also may close down all senior services. Linda Anderson asked if it is known how many home delivered meals are needed? She stated if it was known the total needed it would help in terms of obtaining funding from foundations. Public Comment Linda Anderson with Family and Community Services stated that she is concerned about next year for home delivered meals and meals on wheels. She is concerned about losing city and county funding. Walter Blumst asked where the money would be spent if additional funds are. received? Sharon Johnson stated that the Planning Committee's priorities would be looked at. All comments from .the public hearings will go back to the Planning Committee. Bob stated that the Area Plan will list priorities. -5- Ish Mendonsa with Family and Community Services stated that the county has access to obtaining funds that nonprofit agencies don't. She proposes that the county and Family and Community Services work together to obtain funding. Sharon stated that this sums up what the coalitions in the three parts of the county are trying to do. Linda Anderson stated that no one at Family and Community Services has ever received a raise. She stated that if additional funding is received, she hopes this will be considered. Dora Gonsalves asked what is going on with elder abuse prevention? Bob stated that the Office on Aging has had funding for elder abuse prevention for 1 1/2 years. A workshop was done on elder abuse prevention for law enforcement agencies. The police officers met with providers of social services. This workshop was done by the East Bay Elder Abuse Prevention Consortium. A training curriculum was developed for police officers. Richmond police officers were trained to recognize elder abuse. Family and Community Service is holding a training for their in home service providers.. This is focusing on abuse prevention issues. There is a new program--personal care option. Sylvia Clark spoke of conference she attended in San Francisco. She stated that at the conference it was stated that a film on Elder Abuse will be distributed to senior centers. Gene Wolfe thanked everyone for attending. A10 PUBHRGWC.doc Public Hearing Pittsburg March 12 , 1993 Dr. Loewenstein stated that the public hearing is being sponsored by the Contra Costa County Office on Aging and the Contra Costa County Advisory Council on Aging. The purpose of the hearing is to present the program for the next four years and get public input. She asked everyone present to introduce themselves. After Sharon Johnson's and Bob Sessler's presentations, questions will be taken. After that will be the public comment portion of the hearing. Dr. Loewenstein introduced Bob Sessler, director of the Office on Aging, and Sharon Johnson, assistant director and planner of the Office on Aging. Sharon welcomed everyone and thanked everyone who participated in the planning process. The comprehensive needs assessment consisted of four different steps. one of these steps involved the updating of key informant survey. Sharon acknowledged Dr. Beclee Wilson's contribution in updating the key informant survey. Sharon also acknowledged Rosie Meddaugh's assistance. Ms. Meddaugh is a student intern. A pretest of the survey was done with Planning Committee members. Minor modifications were made to the survey. Focus groups were done in all three parts of the county. A 36% response was received from the key informant survey. The top five issues from the respondents were as follows: transportation, housing, health care, in home supportive services and awareness of how to access services. There was a 36% response from the California Department of Aging survey. This was sent to local committees on aging. The Nutrition Project identified frail , isolated homebound elderly and surveyed them. One of the top issues that came out of this was crime. Focus groups were held in all three parts of the county. Residents from skilled nursing facilities were interviewed. Sharon stated that the residents stated that they were basically satisfied at the skilled nursing facility; however, they would like a friendly visitor and more education activities. The residents stated that they would like to have better trained nurses. Sharon stated that the Advisory Council Health, Transportation and Housing committees will be utilized to assist in dealing with issues that came from the comprehensive needs assessment. Sharon stated that the contracted services of the Office on Aging include Nursing Home Ombudsman , Case Management, Congregate Nutrition, Home Delivered Nutrition , Home Visiting, In Home Services Registry, Transportation , Legal Services , In Home Services for Frail , and Prevention of Abuse , Neglect , and Exploitation of Older Adults . The Office on Aging direct services include Information and Referral. and Disease Prevention, r.d Heal.th Pr.omot_on Services. Office on Aging other activities include Program Development, Coordination, and Administration. Another required area is outreach/Targeting. The Area Agency on Aging through its Request for Proposals requires bidders to include a plan for community outreach to assure that low-income individuals, minorities, limited English-speaking individuals and persons identified as being of greatest economic or social need aged 60 years or over are being served. Sharon listed the seven goals of the Area Plan. The three community service areas are East, West, and. Central county. Included are new seniors to be served and the number of units of services to be provided during fiscal year 1993-94. Also included are projection of congregate meals program for FY 1993-94 and projection of home delivered meals program for FY 1993-94. Next, Bob started his presentation on the budget and adequate proportion. Bob stated that the budget is uncertain at the present time. He listed the origins of the funds. Federal Funds OAA IIIB supportive services IIIC1 congregate meals IIIC2 home delivered meals IIID home services for frail IIIF preventive health VIIA Ombudsman VIIIB elder abuse prevention U. S. Department of Agriculture meal reimbursement State Funds LTC Ombudsman Supportive services Congregate meals Home delivered meals In home services for frail Elder abuse prevention Local Funds Required match--Contra Costa County Local contractors Non match - local contractors Local agencies The state has changed the way it distributes funds . The result is that there will be less funds going to home del %-ered meals . When the new funding formula we-it into effect , the _: te took the state dollars and reallocated them so that no area agency would lose funds. Next, Bob went over the funding requirements. Funding Requirements LTC Ombudsman Shift federal and state dollar allocations Supportive Services Adequate proportion for priority services--Access--65$, Legal--14%, In Home--11% Meal Programs Up to 30% of federal funds allocated may be transferred between congregate and home delivered Shift allocation of state dollars Program Development & Coordination Up to 10% of IIIB funds may be spent Administration & Advocacy Shift allocation of federal funds State funding In Home Services for. Frail Shift allocation of federal and state dollars Preventive Health Shift allocation of federal and state dollars The budget is a repetition of the current funding level. A letter with the actual allocation was received, and the actual allocation will be $4 ,000 less than listed in the Grant Allocation Plan. The amount received for Disease Prevention and Health Promotion will be between $30,000-$40 ,000 . One of the Advisory council meetings will be used as a public hearing to publicize the final budget. There is uncertainty of what will happen with the state budget. Also, cities and nonprofit agencies may not be able to put in financial support as in the past. Bob asked for questions on t :e budget. There were no questions . Public Comment Question was asked what impact will the shortfall in funds for home delivered meals have? Bob stated that the numbers are changing day by day. The meal cost is about $4.50 a meal. The total budget for home delivered meals is about $650,000. The shortfall will be about 10%. Dr. Loewenstein asked what percentage of the 10% could be met by the clients themselves. Bob stated that the contributions average $1.25-$1.30 for each person. Question was asked will evaluation be done to see if more congregate sites need to be closed? Bob stated that funds may have to be transferred out of congregate program. Question was asked are the people who receive home delivered meals asked to donate? Dr. Loewenstein stated that she did not designate whether the additional funds would come from home delivered meals or congregate meals. The donations are strictly voluntary, and no one is refused a meal because of inability to pay- Question was asked, what is done for meals for people on weekends? Two frozen meals are given to the senior on Friday. Ish Mendonsa stated that if more money does come in she would like to see increase go to programs already operating. Question was asked, in the In Home Supportive Service program, how many hours of care is a person allowed? Bob stated that this is up to individual case managers. Sharon gave example of some of the ways the funds in In Home services for Frail are used. Ish Mendonsa stated that Family and Community services is now operating the Retired" senior volunteer Program. This program has over 600 volunteers. Their advisory council will hold their first meeting this week. Awards luncheons are planned for May. Bernice Russ is the new director. Sharon discussed the Helping Hands project, which was started through United Way. Dr. Loewenstein thanked everyone for attending. All) 1�flPl`I'I'.doc Public Hearing Richmond March 19, 1993 Mr. Witucki welcomed everyone to the hearing. He asked everyone present to introduce themselves. The purpose of the hearing is to allow the public a chance to have input on the information being presented. Comments will be recorded for further consideration by the Advisory Council on Aging. The ground rules are as follows: Sharon Johnson, assistant director and planner will do her presentation and take questions, then Bob Sessler, director, will do his presentation and take questions. Following these presentations, there will be time for public comment. Mr. Witucki introduced Bob Sessler. and Sharon Johnson. Sharon stated that she, Rosie Meddaugh, who is a student intern working with Sharon; and Dr. Beclee Wilson, a former student intern, have been working on the comprehensive needs assessment. Dr. Wilson updated key informant survey. Sharon highlighted some of the responses from the survey. The top five issues that came out of the survey are transportation, housing, health care, in home support services and information on how to access services. Another survey that was utilized was the California Department of Aging survey. It was sent to local committees on aging. The Nutrition Project helped with this survey by identifying frail homebound seniors to survey in each part of the county. The top issue that came out of this survey was crime. The next most important issue was health care. The seniors stated that health care is too expensive and too complicated. Residents of skilled nursing facilities were part of focus groups held in each region of the county. The residents stated that isolation was a major problem. The residents wanted more activities and intellectual stimulation. The residents stated that they were relatively satisfied with where they were. Contracted services of the Office on Aging include Nursing Home Ombudsman, Case Management, Congregate Nutrition, Home Delivered Nutrition, Home Visiting, In Home Services Registry, Transportation, Legal Services, In Home Services for Frail, and Prevention of Abuse, Neglect and Exploitation of Older Adults. Office on Aging Direct Services include Information and Referral and Disease Prevention and Health Promotion Services. Office on Aging other activities include Program Development, Coordination, and Administration. .Outreach/Targeting refers to the fact that Area Agency on Aging requires bidders to include a plan for community outreach to assure that low-income individuals, minorities, limited English-speaking individuals and persons identified as being of greatest economic or social need aged 60 years or older are being served. -2- Sharon went over the seven Area Plan Goals. Bob will go over Adequate Proportion when he does the budget presentation. The Community Service Areas are East, Central and West county. Listed are new seniors to be served and the number of units of services to be provided during fiscal year 1993-94. Also listed are projection of Congregate Meals Program for FY 1993-94 and projection of Home Delivered Meals Program for FY 1993-94. Sharon asked for questions. Bea Hill stated that she has had problem reaching the proper county number for a problem she has with her basement. Sharon gave Mrs. Hill a West County Mini Guide. These mini guides listed many numbers for various services. K. G. Dorosz asked Sharon to describe what elder care is. Sharon stated that it means elder services. K. G. Dorosz asked if the plan was to build new elder care coalitions or build on existing coalitions? Sharon stated that the plan was to build on West County Senior Services. K. G. Dorosz asked what the Office on Aging's involvement will be with West County Senior Services .Network? Sharon stated that it will stay the same. Sharon stated that in east and central county the coalitions are modeling after West County Senior Services Network, using inter agency approach. The coalitions plan to apply for various funding. Ahmadi Thomas asked question about home delivered meals in North Richmond. There has been a problem in getting drivers. Paul Kraintz stated that services have never been terminated in North Richmond. Mrs. Thomas stated that there was a meeting to try to - get people that live in the area to be drivers. Joanne Routzahn stated that there is a driver on the North Richmond route now. Heidi Cartan stated that they were also told that the Meals on Wheels route was stopped in North Richmond. Sharon stated that she would like to have the name and telephone number of the person who brought up this problem. Sharon will check on the problem. Question was asked about the difference between Meals on Wheels and Home Delivered Meals. Meals on Wheels is through a private contractor, and Home Delivered Meals is through the county. Ahmadi Thomas stated that she would like to get home delivered meals for her husband. She has a person who comes in to help take care of her husband, but the person only comes three hours a day. b —3— The statement was made that if North Richmond is not being served with home delivered meals, the figures shown on the handout should be different. Bob Sessler stated that there needs to be a federal home delivered meals route in North Richmond. Bob stated that he will investigate what the relationship is between the Meals on Wheels route and home delivered meals route. Bob stated that the figures on the handout are based on the first six months of the year. Ava McAlister stated that she is concerned that outreach be continued in west county. She stated that outreach in one community is not the same as outreach in another community. Sharon stated that through Project Care Richmond and San Pablo areas are being targeted. K. G. Dorosz asked what Disease Prevention and Health Promotion includes? Also does this include money? Bob stated that the exact funding is not known yet. There is a tentative plan to use the funds to add health promotion component within I&R and expand the Health Insurance Counseling program. Judy Weitzner is busy developing a plan for putting health promotion services in touch with services providers, hospitals, etc. K. G. Dorosz asked if mental health is included in, the Disease Prevention program? Bob stated that it does. Heidi Cartan stated that she is happy that Ava discussed advocacy program. She stated that she has a question about goal statement #5. She asked about the Office on Aging's role in case of future cuts. Bob stated that specific objectives will fall on volunteers of the Advisory Council and its committees. Staff support is provided to the Advisory Council and its committees. The Advisory Council is focusing its advocacy at the state level. Sharon gave an example of work Advisory Council committees are doing. The Housing Committee is looking at general plans of cities to make sure there are adequate low income housing for seniors. Joe Palmeri asked how legal services are provided? Sharon stated that Contra Costa Legal Assistance for the Elderly has a contract with the Office on Aging. This organization receives funding from the Office on Aging as well as from State Bar Trust Fund, United Way and others. Question was asked how are services broken down by the three regions of the county? Also are there figures on how these are broken down? (Person stated this should be included when another public hearing is held:) •- . Joanne Routzahn. asked how outreach/targeting for low income minorities. What are percentage of ethnic served? Bob stated -4- that the figures for each provider of services is well above what they should be for minorities served. K. G. Dorosz stated that she has concerns on the developing of coalitions. What kind of services will the coalitions that are formed be providing? Bob stated that it will be up to the coalitions as to what services they will provide. The Office on Aging is working with coalition to go after funding and improve working relationship. K. G. Dorosz stated that she was talking about allocation of staff time. She asked what West County Senior Services Network could expect in regards to amount of staff time. Bob stated that there is a small amount of staff time involved. Bea Hill stated that she has a non profit license to operate adult day care. Her open is open for seniors. The city put a computer and word processor in her home. Next, Sharon asked Bob Sessler, director of the Office on Aging to speak about the budget and Adequate Proportion. Bob stated that the figures listed on page nine of the handout are the current Grant Allocation Plan. The goal is to maintain the current federal and state funding level. Federal Funds OAA IIIB supportive services IIIC1 congregate meals IIIC2 home delivered meals IIID home services for frail IIIF preventive health VIIA Ombudsman VIIB elder abuse prevention U. S. Department of Agriculture meal reimbursement State Funds LTC Ombudsman Supportive services Congregate meals Home delivered meals In home services for frail Elder abuse prevention Local Funds Required match--Contra Costa County Local contractors Non match - local contractors Local agencies Grant related income - client contributions -5- Next, Bob went over some items that cause restrictions in the way funds are spent. Funding Requirements LTC Ombudsman Shift federal and state dollar allocations Supportive Services Adequate proportion for priority services--Access--65%, Legal--14%, In Home--11% Meal Programs Up to 30% of federal funds allocated may be transferred between congregate and home delivered Shift allocation of state dollars Program Development & Coordination Up to 10% of IIIB funds may be spent Administration & Advocacy Shift allocation of federal funds State funding In Home Services for Frail Shift allocation of federal and state dollars Preventive Health Shift allocation of federal and state dollars Elder Abuse Prevention Shift allocation of federal and state dollars Bob stated that the actual allocation will be about $4 , 000 less than listed on the Grant Allocation Plan. There will be another public hearing when the actual budget is known. At this point, Bob asked for questions on the budget. Question was asked if reduction in administrative figure will mean a reduction in staff. Bob stated that a loss of funds in this area has resulted in the county pulling out additional funds in this area. Two administrative positions were lost from the Office on Aging. A $6, 000 increase was received in the administrative area. -6- Question 6-Question was asked when RFP's are sent out, is weight given to new programs? Bob stated that RFP' s are done every four years for the contracted services. Question was asked are there programs that are continuously funded? Bob stated that each private agency that has a contract over $10,000 has to go through RFP process every four years. Question was asked will the county contract with an agency that does not serve the entire county? Heidi stated that there is some clarification needed with agencies that are providing services that are not .county wide. Some agencies specialize in certain population group: Would the Office on Aging consider funding an agency that did not provide its services countywide? Bob stated that that is an option within the .agency. Question was asked would the Office on Aging continue to fund an agency that is not providing services to all the areas that are in need? Bob stated that that is not the intention of the Office on Aging. Lillie Mae Jones asked how she could file a federal complaint. Bob stated that she would need to file a complaint with Region IX office of Administration on Aging in San Francisco. Question was asked about I&R budget. How is this money spent? Bob stated that the I&R budget pays -for 3 1/2 full time staff and administrative support. Question was asked about Preventive Health. What will be the amount for this and what is the definition? Bob stated that the amount will be between $30-40,000. The definition is very broad. Question was asked who mails out--the 9 page handout that was available at today' s meeting? How is word spread about the public hearings? Sharon stated that the Advisory Council members are asked to spread the word. Press releases are done. Information about the public hearings is also published in the Office on Aging newsletter. The statement was made that the public hearings should be accessible to seniors that don't drive. Question was asked if mini-guides are available for the Fresno area? Sharon stated that there is now an elder care locator. This will be publicized in the newsletter. Information about services in other areas is available by calling Senior Information. Ava McAlister stated that she is concerned that outreach office needs to be kept in West County. Public Comment Lillie Mae Jones stated that it is important to keep up outreach in West County. Heidi Cartan stated that she would encourage the Office on Aging to review their policy regarding RFPs. She would like to see the Office on Aging accept RFP's from agencies that may not provide services countywide. Amos Adams, Jr. made a comment that young people when looking at seniors are looking at their future. Nancy Masters stated that she feels it is important for the Office on Aging to continue to support West County Senior Services Network in terms of staff and other resources. Ahmadi Thomas stated that she has not been able to locate a support group in her area for families of head injury patients. Mrs. Koasse with East Bay Consortium for Elder Abuse Prevention stated that she would like to be informed when any RFP's are sent out. Joe Palmeri asked how it is possible to get the medical profession to take an older person's illnesses seriously? Bob stated that some very important ideas for the new Health Promotion/Disease Prevention program came out of today's hearing. Nancy Masters stated that Brookside Hospital has programs for older people. Antioch has a geriatric clinic. Lillie Mae Jones asked if notification is sent out about various grants that come in to the Office on Aging. bob stated that he and Sharon are responsible for this. They make every effort to publicize these grants. Mr. Witucki thanked everyone for attending. A10 PHRICH.doc APPENDIX III GOVERNING BOARD Name/Title of Officers Term Expires Tom Powers Supervisor District I 1995 Jeff Smith Supervisor District 2 1997 Gayle Bishop Supervisor District 3 1997 Sunne Wright McPeak Chair, Board of Supervisors 1995 Supervisor District 4 Tom Torlakson Supervisor District 5 1997 Number of Members of the Board f;vP (5 APPENDIX IV ADVISORY COUNCIL Older Americans Act Regulation § 1321 .57 Name/Title of Officers Term Expires Eugene Wolfe, President 9-30-94 Ralph Copperman, lst Vice President 9-30-93 Edith Loewenstein, 2nd Vice Prt�s.ti:zent 9-30-93 Rosemary Generaf MembershipCharacteristics: Ora Jackson,'Treas. 9-30-94 Number Council Members (Total, including vacancies) 40 Members 60+ 29 %--of PSA's 60+ % on population advisory council Race/Ethnic Composition White 76 6 Hispanic 6 . 0 3 .3 Black 6. 0 Asian/Pacific Islander 6, 0 3. 3 Native American/Alaskan Native ^� o Other 9 Low Income Representative X Yes No Disabled Representative x Yes No Supportive Services Provider Representative X Yes No Health Care Provider Representative x Yes No Veteran Health Care Provider Representative Yes x No (If appropriate) Local Elected Officials X Yes No Persons With Leadership Experience X Yes No In The Private And Voluntary Sectors Explain any "No" answers: Briefly describe the process designated by the local governing bodies to appoint advisory council members: APPENDIX V ACCESS, IN-HOME SERVICES, AND LEGAL ASSISTANCE Based on analyses by the Area Agency of needs assessment findings and resources available within the Planning and Service Area and discussions at public hearings on the Area Plan, the following minimum percentages of applicable Title III B funds have been identified for annual expenditure throughout the four year plan period. Category of Service Percentage of Title IIIB* Funds To Be Expended 1993-97 Access: 65 % (Outreach, Transportation, Information and Assistance, and Case Management) In-Home Services: 14.19 % Legal Assistance: 10.67 In order to provide details about the amount of funds expended in 1991-92 for Access, In-Home Services and Legal Assistance, attach a copy of page 4 from your close-out document for 1991-92. t Title III expenditure for Access Services, In-Home Services, and Legal Assistance are calculated based on the Title IIIB baseline allocation less Title IIIB administration and less Ombudsman. 52 TABLE 1 MINIMUM TITLE III B EXPENDITURE REQUIREMENTS FOR ACCESS SERVICES, IN-HOME SERVICES, AND LEGAL FOR FY 1993-94 Category of Service Percentage of Title III B Fund to be Expended 1993-94 Access 65% In-Home Services 14.19% Legal Assistance 10.67% 33 II O Or .O II O O W 11 , f` • \ . !� II N .Z.. 11 \ , ^ OIL fY x • 11 0 N ' r A II _r L W Q 11 r P i • P 11 M , M , 0 11 O • v 0= 11 f� f� 11 N < 11 2 • W N 11 . 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II as Vf S 2«. S J J d >S W . O r 7 ' W Z � II 1- I I A IC O ' J II CC 1-Q Q N J 0 7 a , U r N , H 6 11 Z 11 Y- , W A 0 K Q 11 1'- , O�W In D J!- Z Q J N II fY , CCN A O O r 1-' 11 K . W fLN�U r Q2UQ t7[12 N , •- , •- , < Z Q 11 Q ' A W. O • O 11 Q . Z Q W Z W W O w W Z O S . O . O ' P- O 11 0 , II Q , od Q N •� U 11 U , II d , -+U r A d U , •-- 11 CL . USN--S S N 1- J W U- , H I APPENDIX VI COMMUNITY FOCAL POINTS LIST Provide an updated list of designated community focal points and their addresses: The Planning Committee of the'Contra Costa County Advisory Council on Aging seconded and unanimously passed a motion for focal points in East, West, and Central Contra Costa County. The focal points are a coalition of seniors,clergy,corporate CEO's,service providers, city, county, and United Way persons. A coalition exists in East County and is referred to as Delta 2000's Elder Care Committee. In West County there are several coalitions serving the older population. Presently, Central County is in the process of applying to United Way for funding for a staff person to staff the coalition. The Central County coalition is comprised of local committee on aging members, service providers, city and county. The Central County coalition is currently advocating for corporate representation. The coalition's purpose is to provide ongoing needs assessments, demographics, additional revenue for services to the elderly, and as the coordinator for the system of services. For example,the coalition will provide a forum for senior center directors to come together to share information. Case managers and discharge planners will work on better methods for transitioning a person from the hospital to home. Nutrition providers will get together to share information. The coalition will enhance the Community Based System of Care. Contra Costa County service system for seniors is scattered throughout the County, and each service system for each part of the County looks different. The coalition will pull these service systems together for a more coordinated and unified way of delivering services. AP93-97 Appendix.chp APPENDIX VII Title III-B Multipurpose Senior Center(MPSC) Acquisition and Construction'Compliance Review- 1980 to 6/30/93 PSA#-2— (\/�No Title III-B funds have been used for MPSC Acquisition or Construction. Recapture Period Title III Grantee And/Or Senior Center Type III-B Funds %Of MM/ DD/YY Compliance Ac JConsL Awarded Total Costs Begins Ends Verification Nor= Address Nw= Address Nane: Address: Naoe: Address - Naos Address NW= Add":= NW= Address Construction is defined as building a new facility,including the costs of land acquisition,architectural and engineering fees,or making modifications to,or in connection with,an existing facility which more than doubles the square footage of that original facility and all physical improvements. ' Acquisitidn is defined as obtaining ownership of an existing facility(in fee simple or by lease for 10 years or more) for use as an MPSC. 56 APPENDIX Vlll CORPORATE ELDERCARE Is the Area Agency currently involved in corporate eldercare? Yes No If yes, please describe your activities. Is the Area Agency planning to become or to continue to be involved in corporate eldercare? Yes X No If yes, please describe your activities. The AAA planner will explore the feasibility of the AAA involving itself in the: corporate sector. The Area Agency shall adhere to all the corporate eldercare requirements of the California Department of Aging. The Department is currently in the process of regulation development. Until regulations are finalized, all corporate eldercare activities should be consistent with Program Memos 90-57 and 91-38. Area Agencies planning to initiate contracts should draft proposals as soon as possible to allow the Department to work with the Area Agency to expedite the review and approval process. Ln < �.. M X40, ,n ai N RS H 4.3 i ° a� • y 0 V C7 � a a �= M o TA �o U" .� a, ,;�% c v's' p 0 40 0.0 A j W 0 cu cc 10 '� U cd W ❑ 00o , CA M p � o Jcc o � Q �A c- Ott;�� •.'..`;_j: :';5: .,�'•`,::;fir •i?^::::'i: Ol a+ P .ti'fes'. ••},.r{{::::.•.'•..�. il. to Ir• -\ � \ E : �� �f�•r;:n:.r: .i� to � a. 41 c3 o 4- U { O to GO IA M �::12;::t:... 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