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HomeMy WebLinkAbout20051021.tiff RESOLUTION RE: APPROVE VALE GRANT APPLICATION FOR LONG TERM CARE OMBUDSMAN ADVOCATE/FRIENDLY VISITOR PROGRAM AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a VALE Grant Application for the Long Term Care Ombudsman Advocate/Friendly Visitor Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, Area Agency on Aging, and the Victims Assistance and Law Enforcement Board, commencing July 1, 2005, and ending June 30, 2006, with further terms and conditions being as stated in said application, and WHEREAS, after review, the Board deems it advisable to approve said application, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the VALE Grant Application for the Long Term Care Ombudsman Advocate/Friendly Visitor Program between the County of Weld,State of Colorado,by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services,Area Agency on Aging,and the Colorado Department of Human Services,be,and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 23rd day of March, A.D., 2005. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: 14.4,4/4/1 IL4 0. �William H. Je `-, Chair Weld County Clerk to the 4142 / Ria . J. eile, Pro-Tem Deputy Clerk to the Boa (1 1 EXCUSED David E. Long APP' a �' AS T.�T. • AEXCUSED Robert D. Masde my Attdrne CP/3 G nn Vaad Date of signature: 2005-1021 re H aOCaoC� au o°407os MEMORANDUM TO: Bill Jerke, Chair, Weld County Board of Commissioners FROM: Walter Speckman, Executive Director, W� C Department of Human Services J COLORADO DATE: Wednesday, March 23rd, 2005 SUBJECT: Weld County Area Agency on Aging's Long Term Care Ombudsman Advocate/Friendly Visitor Program VALE grant approval Enclosed for Board signature is the grant contract for VALE (Victims Assistance and Law Enforcement Board)assistance. The Ombudsman Program has received this grant for the last 7 years. The amount being awarded during the next grant cycle will be$8,500. The funding period will be from July 2005-June 2006. This grant will allow the Ombudsman program to provide elder abuse prevention programs to long term care staff;continue the long term care friendly visitor program;and maintain and strengthen the Volunteer Ombudsman program. If you have additional questions, please contact Eva Jewell at 353-3800, extension 3331. Li 2005-1021 VALE Grant Application Signature Page Applicant Agency: WELD COUNTY AREA AGENCY ON AGING Street Address: 1551 North 17th Avenue Mailing Address (if different): Post Office Box 1805 Phone: (970) 353-3800 ext 3324 Fax: (970) 304-6442 Email: rmaldonado@co.weld.co.us Project Title: Weld County Long Term Care Ombudsman Advocate/Friendly Visitor Grant Period: July 1, 2005 to June 30, 2006 The following signatories, understand and agree that any grant received as a result of this application shall incorporate and be subject to the statements made within the above described VALE Grant Application(The Application). Furthermore, the signatories certify that they have each read The Application and are fully cognizant of their duties and responsibilities for this project. (Original signatures of each party to this application(i.e., Project Director,Financial Officer and Authorized Official) are required. Please use BLUE INK to distinguish the original documents from copies). Project Director: Name: Eva Jewell Position/Title: Weld County Area Agency on Aging Director Agency(including Division or Unit): Weld County Area Agency on Aging,Division of Human Services Mailing Address: 1551 North 17th Avenue,Post Office Box 1805 Greeley, CO 80632 Phone: (970)353- 800 ext 3331 Fax: (970) 304-6442 E-Mail: ejewell@co.weld.co.us Signal re: a ..e)212_ Date: 3-/o - 4:-s Financial Officer: Name: Margee Johnson Position/Title: Interim Financial/Fiscal Director Agency(including Division or Unit): Division of Human Services Mailing Address: 1551 North 17th Avenue, Post Office Box 1805 Greeley, CO 80632 Phone: (970) 353-3800 Fax: (970) 304-6442 E-Mail: mjohnson@co.weld.co.us Signature: \C A {I a A ��[-\ S�rI� Date: 3-/p 6S Authorized Official Name: Bill Jerke Postion/Title: Chair Agency(including Division or Unit): Weld County Board of Commissioners Mailing Address: 915 10th Street, Greeley, CO 80631 Post Office Box 758, Greeley, CO 80632 Phone: (970) 356-4000 Fax: (970) 352-0242 E-Mail: bjerke@co.weld.co.us Signature: e./ v, Date: 3/23/2005 In accordance with the Colorado Revised Statutes 24-72-202.6,information supplied in this application is considered a public record. p(4los-/Da/ SECTION A-AGENCY INFORMATION 1. Applicant Agency (including Division or Unit): Weld County Area Agency on Aging Division of Human Services 2&3. Street/Mailing Address: 1551 North 17th Avenue Post Office Box 1805 Greeley, Colorado 80632 4. Phone: (970) 353-3800 extension 3324 Fax: (970) 304-6442 E-Mail: rmaldonado@co.weld.co.us 5. Project Director: Eva Jewell Title: Weld Area Agency on Aging Director 6. Project Title: Weld County Long Term Care Ombudsman Advocate/Friendly Visitor 7. Agency Status: Governmental 8. Grant Amount Requested: $8,500 • Section B: Summary The Weld County Long Term Care Ombudsman Program has been a consumer voice for the elderly residing in nursing homes and assisted living facilities (previously referred to as personal care boarding homes) for more than twenty(20) years. The authority of the local Ombudsman Program comes from the Older American's Act, Colorado Revised Statutes 25-11.5 and the Nursing Home Reform Law of 1987. The Weld County Ombudsman acts as a consumer voice for the concerns of the elderly living in institutions, who may have no one else to speak for them. The Ombudsman also receives and resolves questions, issues, problems and complaints made by, for, or on behalf of residents of long term care facilities. Weld County facilities have grown to include seven nursing homes and twenty assisted living facilities to respond to the increasing number of frail elders affected with chronic conditions which interfere with their ability to live independently in the community. This number does not include the additional seniors moving into the Weld community already requiring long term care, nor the people who will experience unanticipated changes in their general health status which will require long term care placement. In fact, the number of nursing home and assisted living homes are on the rise. Development plans have been submitted to build an additional nursing home in the Windsor area, and construction is anticipated. Construction has begun for an assisted living facility in the Greeley area, located by 47th Avenue and Highway 34. "Home Instead" is opening four small Personal Care Boarding Homes in Windsor. In addition, "The Bonell Good Samaritan Community," is adding two assisted living facilities in Windsor. The V.A.L.E. grant has allowed the Ombudsman Program to increase staff time to keep up with the increasing demand for advocacy on behalf of this very vulnerable population. The assistant position is currently working 16-20 hours per week in the field, visiting nursing homes and assisted living facilities. By maintaining a constant presence in these facilities, the Assistant Ombudsman has built trusting relationships with residents and staff The funds have also enabled the program to maintain an abuse prevention and awareness program aimed at educating Certified Nurse Assistants (C.N.A.'s). This has allowed the Assistant Ombudsman to educate residents and staff about the Ombudsman Program, abuse issues and resident rights, as well as investigation of complaints of abuse and neglect. The success and popularity for the abuse prevention program has escalated. As the market continues to grow, the demand for education for frontline staff also increases. Without the V.A.L.E. resource, the program will not be able to continue these imperative services. In addition, it would be impossible to continue and expand our Volunteer Ombudsman Program without the V.A.L.E. grant dollars. Long term care residents face both physical and psychological barriers when it comes to expressing and advocating for their needs. This makes residents more likely to be victimized by caregivers. The Ombudsman's role through observation and a frequent presence in the facilities; is to insure that resident rights are being respected, that quality care is administered, and that abuses do not occur. Continued funding of the Assistant Ombudsman will make it possible for the Weld County Area Agency on Aging Ombudsman Program to serve the increasing number of vulnerable long term care residents and their families. We are requesting a modest amount of V.A.L.E. Board Funds ($8,500) to continue to fund the Assistant Ombudsman position and to increase the expansion of elder abuse education to additional target populations. In 2005, the funds will allow the Assistant Ombudsman to continue her presence of 16-20 hours per week. This will continue the necessary involvement with the "Ensuring an Abuse Free Environment"program and aid in the recruitment and training of volunteers. We believe that our request for a continuation of funding relates to the 1 mandate of early crisis intervention and to provide assistance and support to victims and their families. Section C: Project Concept/Design Overall Issues Being Addressed: The purpose of the Weld County Long Term Care Ombudsman Program is to assist and empower consumers of long term care services by providing information about those services and furnish support in complaint resolution. These issues or complaints may include, but are not limited to access to long term care services, redress of neglectful or abusive care, and information and assistance with civil and human rights. The Long Term Care Ombudsman program is a resident/patient/consumer-centered advocacy program. Long Term Care Ombudsmen have statutory status under the Older Americans Act of 1965 as amended and are required by federal and state law to visit every nursing home monthly and every assisted living facility quarterly. They also receive, investigate and resolve complaints, identify needs of long term care residents and help establish programs to meet those needs. The Ombudsmen also document and report problems of long term care and help to stimulate and promote improvement of the system. Currently, Weld County has the capacity to occupy 889 nursing home residents and 462 assisted living residents, and the numbers are expected to continuously grow. The recent growth has resulted in an expansion of assisted living facilities. To meet the demand, the assisted living industry is expanding into the rural areas as well as continued expansions in the Greeley area. This additional growth will increase the Ombudsman responsibilities, including all education and technical assistance components, all required visitations, all complaint investigations, and all documentation and reporting. We hope to meet the need by continuing the Assistant Ombudsman position of.25 FTE, funded by this proposal. Due to the increased number of long term care residents Weld County has experienced in the last few years, the demand for Ombudsman services has also increased. Federal funds, through the Older Americans Act, are not keeping up with the growing need for long term care advocates. With limited current resources available to the Area Agency on Aging, it will be impossible to meet the minimum requirements for a visible presence in all of Weld's long term care facilities. In an effort to keep up with the visitations, the training and technical assistance to the facilities will be negatively influenced. Such training is the key to the prevention of practices that diminish the quality of life of residents and in many cases may border on abuse. There is continuing evidence from statements made by regulatory agencies that an informed, educated and empowered community presence in long term care facilities can help to maintain or improve the quality of the facility and thus the quality of the residents' lives. In short, the problem we are trying to resolve is the lack of Ombudsman resources to cover exceptional increases in the growth of long term care services in Weld County. In 2000, a federal commission concluded that nursing home and assisted living communities were severely understaffed and have made recommendations to enforce stricter and tougher staffing requirements and guidelines. As a result, Governor Bill Owens formed a Blue-Ribbon panel in June of 2000, to review these issues and make recommendations. In November of 2000, this panel developed a draft for assuring quality health care for Colorado, "A Partnership for Nursing Excellence." Unfortunately, the work to develop solutions is in the beginning stages and those of us who have the responsibility to oversee the care of the elderly must respond to this crisis now. 2 Some of the recommendations suggested have been to increase vocational and educational training, to expand and encourage people to enter the elder care health industry, empower current employees to enhance retention and give the patient-care professionals better tools to get their jobs done, and to reduce the numerous elder abuse and neglect incidents. Project Goals: Goal #1 (standard): The Weld County Long Term Care Ombudsman Program will provide direct services that assist crime victims with emotional and physical needs to stabilize their lives, provide a measure of safety and security, and/or enhance victims' experience with the criminal justice system. To provide elderly victims of crime with literature and guidance on how to report an abusive situation, and educate long term care facility staff on their responsibilities of reporting abuse. To assist elderly victims of crime with their rights as a victim, and referral to the Victim/Witness Program. To provide elderly victims of crime with information and assistance on how to apply for any financial assistance that may be available from Crime Victim Compensation. Inform elderly victims of crime and their families of their responsibilities as a victim. Goal #2: To enhance the ability of the Weld County Long Term Care Ombudsman Program to act as a consumer voice for the concerns of the elderly living in nursing homes and personal care boarding homes. By visiting nursing homes and personal care boarding homes, there is an ongoing process of building trust and rapport with the residents and staff so that instances of mistreatment and elder abuse can be identified and addressed promptly. ► To enhance the ability of the Weld County Long Term Care Ombudsman Program to receive and resolve questions, issues, problems and complaints on behalf of residents of long term care facilities. ► To enhance the ability of the Weld County Long Term Care Ombudsman Program to provide community education regarding issues of elder abuse and quality of life for residents in long term care facilities. ► To strengthen the ongoing elder abuse training program. The current training being used is a program developed by " CARTE," which stands for, " Coalition of Advocates for the Rights of the Infirm Elderly." This educational program is also known as, "Ensuring an Abuse Free Environment" training. CARTE consists of eight training modules that focus on various aspects of elder abuse. The training program will be used to assist with educating staff, residents, and family members regarding victimization. Training and education can be accomplished through CNA conferences or in-services at nursing homes or assisted living facilities. 3 Currently the CARIE program is being offered to C.N.A.'s (Certified Nursing Assistants). The Weld County Ombudsman Program has discovered the benefits of offering the training to administrative and managerial long term care staff. The additional training for this program has been developed and is being offered to managerial staff on an ongoing basis. In addition, the Assistant Ombudsman has added a victims' rights and victims' assistance portion to the CARIE training program. Our goal is for each trainee to understand how to assist a victim with reporting a crime, and how to help them apply for victim assistance and compensation. However, due to the lack of adequate staffing, facilities had faced the challenge of enrolling their staff for an all-day training. The Weld County Ombudsman program has implemented an abbreviated version of the training to the students who attend the "Ensuring an Abuse Free Environment" training. In addition, the Assistant Ombudsman has been able to address the issues of elder abuse in the earlier stages of C.N.A. training, through the C.N.A. training center, which has been in existence since 1994. The C.N.A. training center provides the opportunity for individuals to become trained as Certified Nursing Assistants (C.N.A.'s). Upon completion of the training, many of the C.N.A.'s find positions within Weld County long term care facilities. This has allowed the Abuse Prevention training to be delivered to more students on a bi- monthly basis and has increased awareness and reporting standards to 30-50 students monthly. This has given the Ombudsman Program an opportunity to reach a wide variety of future nursing assistants, which will provide outreach services that are conducive with the Governor's Blue-Ribbon Committee goals. Project Objectives: Objective #1(standard): To provide services to the following estimated unduplicated number of crime victims during the 12-month grant period. (Note: Count each victim only once based upon predominant crime type). TYPE OF CRIME PROJECTED ACTUAL# ACTUAL# ACTUAL# ACTUAL# YEAR-TO- #VICTIMS VICTIMS VICTIMS VICTIMS VICTIMS DATE (grant year) 1ST QTR 2N°QTR 3a°QTR 4T"QTR TOTAL# (7/1-9/30) (10/1-12/31) (1/1-3/30) (4/1-6/30) VICTIMS 1.Child Physical Abuse 2.Child Sexual Abuse 3.Domestic Violence 4.Adult Sexual Assault 6 5.Adults Molested as Children 6.Other violent crimes:hate,bias 7.Survivors of Homicide Victims 8. Elder Abuse(including 54 economic exploitation and fraud crimes) 9.Assault 10. Robbery/Bank Robbery 11. Vehicular Assault& Homicide,DUI/DWI Crashes 12. Other, including Federal Crimes(specify) TOTAL 60 4 According the statutes listed in the State Long Term Care Ombudsman policies and procedures, the following definitions will be used for the above types of crime. • Sexual Abuse/Assault: Includes, but is not limited to, sexual harassment, sexual coercion, or sexual assault. Scenarios may include: resident to resident, staff to resident, and family to resident sexual abuse. • Elder Abuse: The term abuse means the willful (A) infliction of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical harm, pain or mental anguish; or (B) deprivation by a person, including a caregiver, of goods or services that are necessary to avoid physical harm, mental anguish or mental illness. (Older Americans Act, Section 102[13J) The term Elder Abuse will include: financial exploitation, physical abuse, verbal abuse, mental abuse, and involuntary seclusion. Objective #2 (standard): To provide the following types of services to the following estimated number of victims during the 12-month grant period. TYPE OF SERVICES PROJECTED ACTUAL# ACTUAL# ACTUAL# ACTUAL# YEAR-TO- PROVIDED #VICTIMS VICTIMS VICTIMS VICTIMS VICTIMS DATE (grant year) 15T QTR 2N°QTR 3RD QTR 4TH QTR TOTAL# (7/1-9/30) (10/1-12/31) (1/1-3/30) (4/1-6/30) VICTIMS 1. Crisis Counseling 2.Follow-up 50 3.Therapy 4.Group Treatment/Support 5. Shelter/Safehouse 6. Info/Referral in Person 40 7. Crim Just Support/Advocacy 8. Emergency Financial Assistance 9. Emergency Legal Advocacy 10. Victim Comp 30 Assistance(required) 11. Personal Advocacy 50 12. Telephone Contact 40 (Info/Referral) 13. Crisis Hotline Counseling 14. Other(specify): TOTAL 210 During this grant period we intend to: ► Continue the Assistant Ombudsman's presence of 16-20 per week in Weld County long term care facilities, for the purpose of providing a consumer voice for the concerns of elderly living in institutions and to be able to promptly address any instances of mistreatment or abuse. ► Continue and expand implementation of the "Ensuring an Abuse Free Environment" 5 training (CARTE), for C.N.A.'s, managerial staff and volunteer Ombudsmen. ► Maintain and distend the volunteer program to sustain the current 4 volunteers and to continue to recruit, and train an additional 6 volunteers. Volunteers assist the Ombudsman program for increased visibility with friendly visits. Volunteers are also involved in the CARTE training process. During the first three quarters of 2004, the Ombudsman Program successfully trained 7 volunteer Ombudsmen. From November 03-October 04, these volunteers contributed 543 hours to the Long Term Care Ombudsman Program. Although volunteer recruitment and retention is challenging, we have successfully retained 4 significant volunteers. The temporary volunteers have gained much insight regarding the Ombudsman Program and other services, such as victim assistance. Timetable: Visit 500 long term care residents and investigate 50 complaints by June 2006. This is a continuation request to proceed with the future CARTE training. The ongoing and enhanced Elder Abuse Prevention Program timetable will be as follows: ► Develop and implement Alzheimer's disease training for direct care staff who work with residents inflicted with Alzheimer's disease. The Ombudsman Program will continue to combine efforts with the Rocky Mountain Chapter Alzheimer's Association to educate individuals on older adults and Alzheimer's Disease. The Assistant Ombudsman and Alzheimer's Association Coordinator will provide Alzheimer's Disease trainings to direct care staff by December 31s`, 2005. ► Continue offering the Abuse Reporting section to our current Ensuring an Abuse Free Environment Evaluation. ► Continue to provide the Victims' Rights and Victims' Assistance portion to our Abuse Free Training. ► Continuous CARIE training to 125 direct line long term care staff along with 50 administrative and management staff by June 30th, 2006.. ► Provide condensed version of Elder Abuse Prevention Training to 230 C.N.A. students through the AIMS Community College Training Center by June 30th, 2006. Heighten volunteer program: • Recruitment and marketing to continue on a monthly basis from July 1s`, 2005-June 30`h, 2006. • Screening and orientation of new volunteers to proceed on a monthly or as needed basis from July Pt, 2005-June 30`h, 2006. • Training and support to continue on a monthly basis from July P`, 2005-June 30`h, 2006. • Expand role of one volunteer to assist with the instruction of the CARTE training, and additional Ombudsman presentations as needed by December 31 s`, 2005. Impact of Crime Program (formerly known as Victim Empathy for Offenders): The purpose of this program is to have offenders experience empathy for victims. 6 • Continue a routine presentation schedule through the Probation office of Weld County. We continue to be the sole advocacy program that speaks to this group regarding victims of elder abuse. • Continue to speak on behalf of residents who reside in long term care facilities on a routine basis. Sexual assault intervention and reaction program: • Provide sexual assault education program for long term care facilities. • Coordinate guest speakers to present on sexual assault prevention and reaction tactics. • The Ombudsman Program will serve as a voice for residents in long term care settings by attending monthly Sexual Assault Resource Team (SART) meetings. Objective 3: To provide the following services to positively impact older adults in long term care facilities. TYPE OF SERVICE PROJECTED# ACTUAL# ACTUAL# ACTUAL# ACTUAL# YEAR-TO- (grant year) 1sT QTR 2ND QTR 3"D QTR 4T"ATR DATE TOTAL# (7/1-9/30) (10/1-12/31) (1/1-3/30) (4/1-6/30) I. Friendly/Educational Visits Total: 600 2.Complaint Investigations Total: 100 3.Abuse Free Training 175 Persons (C.A.R.I.E.) 4a. Resident Council Meetings 80 Nursing Homes 4b. Resident Council Meetings 60 Assisted Living Facilities 5.Volunteer Program/Training 6 Persons 6.Community Education 350 Persons 7. Certified Nursing Assistant 230 Persons Training 8. Attend SART Meetings 10 9. Attend CCVC Meetings 3 TOTAL 1614 How Goals and Objectives will be accomplished: Under the guidance of the Lead Ombudsman, the Assistant Ombudsman will continue to be assigned a specified number of long term care facilities to visit on a regular basis. Sixteen to twenty hours per week will be allotted for visitation and travel time. The average visit per facility will be one hour, however the visit could take longer if there is a need. During the four quarters of 2004, the Assistant Ombudsman and Ombudsman Volunteers made visits to 592 residents of long term care facilities and investigated 233 complaints. The Elder Abuse Prevention Program is based on a training module called the CARTE program also known as, "Ensuring an Abuse Free Environment" training. CARTE consists of eight training modules, each focusing on an important aspect of abuse issues including, identifying and recognizing abuse, the possible causes, understanding the complex issues surrounding care-giving, cultural and ethnic perspectives, resident/staff dynamics, ethical and legal issues, how to report abuse and intervention and prevention strategies. The Assistant Ombudsman will continue to utilize this curriculum to train staff and residents at long term care facilities, students attending Aims' Nurse and C.N.A. Training Center, 7 and others in the community. The Assistant Ombudsman has designed a condensed version of the CARIE training program, which will continue to be used to meet the changing needs of the long term care facilities in Weld county. Topics discussed include the following types of elderly abuse: physical, emotional, sexual, financial, abandonment, and neglect. Training individuals about elder abuse is very important for several reasons. First, the older adult population is the most vulnerable and frail. Many older adults rely on other people to take care of their activities of daily living and finances. Second, abuse of older adults is under reported. Many states including Colorado do not have mandatory reporting of elder abuse. However, Weld County has experienced an increase in reported incidences. This could be due to education, awareness, and empowerment on abuse issues, but also could indicate a heightened number of abuse occurrences. The Assistant Ombudsman will continue to track the reported number of abuse cases. Third, older adults (especially those 85+) are the fastest growing segment of the population. Anticipated problems in implementing goals and objectives: Currently, the program has four active volunteers, and the Assistant Ombudsman continues to progressively recruit potential dedicated volunteers. Unfortunately, the program has an ongoing challenge of recruiting appropriate and reliable volunteers. Staffing issues continue to be a major crisis in long term care facilities. For this reason, the Assistant Ombudsman continues to be flexible and open to requests from long term care facilities regarding training programs. If necessary, the developed programs can be modified to meet the needs and schedules of those working in long term care facilities. We do not anticipate any problems of reaching the new goals and objectives for July 2005-June 2006. The Assistant Ombudsman will be able to fulfill the original goals and objectives while enhancing the Volunteer, Sexual Assault training and CARTE programs. Effectiveness Evaluation: To evaluate the effectiveness of the CARTE program, the Assistant Ombudsman will continue to collect data from evaluations that are distributed at the end of the training session. This data continues to be utilized to determine if the goals and objectives of the program are being met. This information will also be used to enhance and modify the program if needed. The success of the Ombudsman Volunteer Program will be measured by monitoring the number of additional visits, educational sessions and volunteer satisfaction surveys will be evaluated. In addition to previous years, the results of this year's evaluations highlight how valuable the CARIE training is for staff working in long term care facilities. Program goals as related to the V.A.L.E. statute: This program continuation request most relates to 24-4.2-105, Section 2, part a and part b. Part a addresses provision of service for early crisis intervention. As mentioned earlier, there is evidence that when there is constant and continuing community presence in long term care facilities the potential to improve the quality of life and prevent abuse and exploitation is reduced for the residents. We intend to continue advocate contacts with long term care residents as a preventive move. We know that there may be many barriers to the elderly, particularly those in long term care facilities, to express their individual needs without assistance from others. Some of these barriers are physical due to loss of sight, speech, or hearing. Some barriers are psychological due to a sense of isolation, fear of retaliation, or disorientation. Barriers to self- 8 advocacy can also be related to the lack of information about rights, alternatives, and legal remedies. Part b addresses assistance programs for victims and their families. A key role of the long term care Ombudsman is complaint investigation and complaint resolution. Long term care residents must be assured that the Ombudsman will be able to follow up on their complaints in a timely and professional manner. With the continued increase in long term care beds, the ability of the present Ombudsman to respond appropriately to complaints will be jeopardized. The extension of the friendly visitor/advocate under this proposal will continue our Ombudsman hours insuring that the Lead Ombudsman and the Assistant Ombudsman will be able to respond to residents and their families in a timely and appropriate manner. Case Number 1: Sexual Assault The case that was presented in the 1999 VALE grant application concerning a Native American 80 year old female Alzheimer's/at-risk nursing home client has had further action in 2003. The Assistant Ombudsman became involved in this case initially in 1998. The Assistant Ombudsman was informed that the resident had been transported to the hospital with numerous injuries to her genitalia. Due to the nature of the client's injuries the Greeley Police Department and various other agencies became involved. Upon investigation it was determined that a sexual assault had occurred. The Greeley Police and the District Attorney's office actively worked on this case in 1999. In August, 2000 the case was brought to trial. The jury's verdict was first degree sexual assault on an at-risk adult, resulting in a sentencing of 16 years. The Ombudsman Program, as well as the 19th Judicial District Attorney's office continues to be involved in this case. A resentencing hearing is scheduled for October 16`h, 2003. The maximum sentencing for first degree sexual assault is life in prison. Therefore, the victim's D.D.A. is requesting that the defendant's sentencing be reviewed for an increase in sentence. The Assistant Ombudsman and Lead Ombudsman have been in frequent contact with the victim's family, and have advocated for them in numerous instances. In addition, the Ombudsman Program has voiced the family's request to speak at the resentencing hearing, and as a result, two of the resident's family members will address the court. The Ombudsman will attend this hearing with the resident's family, acting as a victims' rights advocate and consumer voice. Also, the Ombudsman Program reviewed information concerning the rights of Victims' of Crime and Victims' Compensation with the resident's family, as the resident is nonverbal and incompetent. Case Number 2: Sexual Assault Involvinz Spouses The Assistant Ombudsman investigated an allegation of sexual assault of an at-risk adult. Specifically, the resident resided on a secure Alzheimer's unit and had a diagnosis of advanced Alzheimer's disease. A staff member witnessed the resident's door open and the resident's husband having sexual intercourse with her. According to the staff member, it appeared that this was against the resident's wishes. The Assistant Ombudsman conducted an extensive investigation, including coordinating efforts with the facility staff to monitor the resident's behaviors before and after the husband's visits. In addition, the Assistant Ombudsman consulted with the Attorney General's Office and found that according to definition, this would be considered sexual assault if the resident was unwilling. Through much investigation, the Assistant Ombudsman was able to confirm that sexual relations with her husband were consensual. However, this case prompted the Ombudsman Program to explore the topic of residents who have a diagnosis of Alzheimer's disease and sexual relationships. Generally, residents who are inflicted with Alzheimer's disease have the right to have sexual relations, including intercourse. However, this only applies to those who can still make the decision to have 9 such relationships. The Assistant Ombudsman is concerned about when it is time for the facility staff to intervene, even in the cases regarding spousal involvement. The Assistant Ombudsman is currently coordinating efforts with the Alzheimer's Association and area facilities to address this issue. Some ideas include having an assessment upon admission, and educating family members about appropriateness of sexual relationships when the individual's disease progresses. Case Number 3:Illegal Physical Restraints This year the Assistant Ombudsman was contacted by the management team from an area nursing home, regarding a 61 year old developmentally disabled male resident. He has been described as having the cognitive ability of an 8 month old. The resident had been admitted to the facility 30 years ago, during a time when physical restraints were commonly used and accepted in such facilities. Although nursing home regulations have been improved to include sections regarding inappropriate physical restraints and the facility's obligation to use the least restrictive restraints possible, the family members' beliefs remained the same throughout the years. The resident's parents had been his legal guardians his entire life, and had a strong belief that several different restraints were necessary to ensure the resident's safety. Although the facility had made several attempts to reduce restraints, the guardians were very resistive and would make threats of lawsuits, which resulted in the facility choosing to postpone the reductions. The management team had contacted the Assistant Ombudsman to assist with pursuing restraint reduction, regardless of the consequences or family resistance. The Assistant Ombudsman felt that the resident's quality of life was greatly hindered by the restraints and chose to be an active participant in the restraint reduction planning for this resident. When the resident was awake, his parents insisted that he be tied to a glider chair that was tied to the wall hand rail, which was located right in front of the nurses' station. In addition, he had chest and arm restraints, which prohibited the resident from repositioning his body or having hand movement for most of the day. While using the restroom, the resident's arms were restrained and his body was tied to the toilet seat. His mother insisted that this take place, due to the possibility of the resident touching his private area. Also, when the resident was sleeping, his parents insisted that his legs, hands, and torso all be tied down with restraints, restricting him from repositioning during the night. The Assistant Ombudsman and the staff at the facility coordinated a meeting to discuss restraint reduction. Several entities attended this meeting: The Assistant Ombudsman; the facility staff; Adult Protective Services; Centennial Developmental Services Inc.; and the resident's guardians/parents. The facility informed the group of their intent to pursue restraint reduction for this resident, despite any consequences such as a lawsuit pursued by the family or deficiencies written by the State Health Department. Everyone was in support of restraint reduction except for the parents. The resident's parents contacted the Assistant Ombudsman after the meeting, wondering what rights they have as guardians in this situation. The Assistant Ombudsman explained that advocates are specifically concerned about the resident's rights and well being. The Assistant Ombudsman encouraged the parents to contact the State Health Department to activate an investigation from an outside agency. The resident's parents contacted the State Health Department and filed a formal complaint. An investigator visited the facility and observed the charting and the restraint reductions that were underway. The investigator was impressed with the facility's efforts and actually stated that it would be beneficial to speed up the reduction process. The Assistant Ombudsman and the facility staff coordinated an additional meeting after the survey findings were complete to discuss further steps for restraint reduction. to Throughout this case, the Assistant Ombudsman worked closely with a variety of individual to ensure that the resident's rights as an individual and a resident were honored. In several instances the Assistant Ombudsman advocated for the resident who was unable to speak for himself. The resident continues to excel with each restraint reduction and has not suffered any injuries. His overall quality of life has vastly improved and as a result he can be seen smiling, crossing his legs, and humming along with music, which are new occurrences. Section D: Service Information Population and geographic are targeted: Populations targeted are 60 plus elderly residing in nursing homes and personal care boarding homes located in Weld County. Numbers of persons in need of these services/Presently being served: Approximately, 1,400 Weld County residents live in long term care facilities. All of these residents receive services through the Ombudsman program, either directly with visitations and complaint resolution or indirectly through training and technical assistance provided to staff to improve the quality of care. By extension, the program also may represent the concerns of relatives and/or friends of long term care residents as long as the concern reflects the concerns of the resident. Continuation of support will make it possible for the Area Agency on Aging Ombudsman Program to continue to serve all of the long term care residents and their families with the same type and degree of services that we currently are providing. Duplication of Services: There is no other program which provides services equivalent to the Ombudsman Program. Community Support, Coordination and Networking: (a) The Weld County Area Agency on Aging's primary goal is to help maintain an individual's independence and dignity in their homes and community by identifying and advocating for their special needs. In order to accomplish this goal our agency works closely with community providers to facilitate a means to obtain needed services quickly and efficiently to the seniors in our community. We have formal agreements with agencies that we fund directly to provide a variety of services to seniors such as: Elder Garden Adult Day Program, Senior Peer Counseling through North Range Behavior Health and in home personal care through RVNA. We have established coordination agreements with a number or other agencies such as: Greeley Police Department, Sheriffs Office, Adult Protective Services, Weld County Victims Assistance, the Probation Department, Social Services of Weld County, the District Attorney's office, the Alzheimer's Association, local nursing facilities, and local assisted living facilities. (b) The Weld County Area Agency on Aging is an active participant in Weld County's Coordinating Committee for Victims of Crime (CCVC), and also a participant in the CCVC Coordination Agreement. Currently, the active member is Raegan L. Maldonado, Lead Long Term Care Ombudsman. The Lead Long Term Care Ombudsman anticipates further involvement with future subcommittees, as assigned and needed in the CCVC meetings. It is pertinent for Assistant Ombudsman to be involved in this committee and she has been attending CCVC meetings. The Assistant Ombudsman will offer to share information from our"Ensuring an 11 Abuse Free Environment"training with the members of CCVC. In addition, the Lead Ombudsman routinely presents information to the CCVC committee about the Weld County Long Term Care Committee. For many years, the Long Term Care Committee has been open to all interested community agencies and individuals that provide services to older adults in Weld County. Unfortunately, attendance at this committee has been scarce, possibly due the increasing responsibilities of those working in long term care. As a result, the Lead Ombudsman and Assistant Ombudsman will coordinate a yearly event to provide community support, education, and networking for the Weld County senior population. c) The Weld County Area Agency on Aging has been actively involved in TRIAD since its formation in Weld County. Currently, Pete Archuleta, Weld Area Agency on Aging Legal Services Coordination, attends the TRIAD meetings and provides pertinent information from TRIAD to the rest of the Area Agency on Aging staff. The Lead Ombudsman also attends the "SART" Sexual Assault Resource Team meetings. Crime Victim Compensation Program: (a) The Weld County Area Agency on Aging regularly informs victims about Victim Compensation. For example, during the sexual assault case involving an at-risk adult in 1998, the Ombudsman's office assisted the victim's family in applying for services. The victim's family and the Ombudsman used resources available through Victim Compensation during the time of the trial. Such resources include the Victim Assistance area set up for victims and families at the Weld County courthouse. (b) The Weld County Area Agency on Aging and the Ombudsman program do not foresee any issues that would prevent informing crime victims of the Victim Compensation eligibility requirements and information regarding victims' rights. We would also be able to provide assistance to those individuals who are unable to apply for assistance independently. (c) Our agency receives Victim Compensation training for direct services staff and volunteers on a regular basis. The last training was provided by Karol Patch from the District Attorney's office on September 24th, 2003. The training took place at the Weld County Area Agency on Aging. Staff and Volunteer Training: The Weld County Area Agency on Aging continues to take the steps necessary to assure that pertinent staff and volunteers have read and understand the rights afforded to crime victims. (a) Our agency notifies victims about their rights under VRA. (b) To assure that pertinent staff and volunteers are trained on VRA, our agency coordinates training seminars with the Colorado Organization for Victim Assistance (COVA), and with the District Attorney's Office. (c) The last COVA VRA training took place on September 16, 2002 at the Weld County Area Agency on Aging. Other agencies were invited to attend this training. Kerry Johnson provided the training, and COVA indicated that future training would be possible. In addition, the Lead Ombudsman attended a COVA training during a quarterly CCVC meeting on September 10`h, 2003. Terri Livermore provided this training. The last VRA training provided by the District Attorney's office took place on September 24, 2003 and was conducted by Karol Patch. (d) When appropriate, the Area Agency on Aging notifies victims of their rights under VRA by referring individuals to the District Attorney's Office Victim Assistance Program. As mentioned above, the Area Agency on Aging referred the victim of the sexual assault case and her 12 family to the District Attorney's Office. (e) Ombudsman brochures, English and Spanish . Cost Savings: When an advocate visits a long term care facility and discovers issues that affect the direct health of a resident, the advocate can facilitate and coordinate care with the facility to enhance the resident's plan of care to help reduce the problem from escalating. There are considerable medical savings to the taxpayer(most nursing home residents are on Medicaid) when extreme medical procedures can be avoided. When long term care patients are restrained, not only is it a violation of individual rights, but an opportunity is missed to administer therapies, which can help the patient become more independent. The ombudsman, again, can identify these situations and work with the staff to develop alternate interventions which will respect individual rights and give the patient care that may increase his/her potential to be independent. Dependence costs society. Elder abuse education is invaluable to reduce incidences that occur. When a resident is exposed to an abusive situation the experience can cause not only physical, but also emotional, psychological, and social damage. The resources used to investigate and monitor these incidences are costly and limited, the Ombudsmen become a valuable resource to assist and prevent abuse in long term care facilities. Repercussions from abuse result in expensive and time consuming therapies and utilize valuable resources allocated for the community. The abuse education provided by the funds from this grant help to raise awareness and allow intervention before abuse situations occur. Management Plan: The Director of the Weld County Area Agency on Aging will be accountable for the administration of this project. The part time Ombudsman advocate will continue to be trained and supervised on a daily basis by the Lead Ombudsman under the supervision of the Weld County Area Agency on Aging Director. Service Providers: Lead and Assistant Ombudsmen along with volunteers will provide the proposed services. Interestingly 19.7 of the current volunteers indicated they would be interested in increasing the number of hours currently volunteering. The respondents stated one of the primary reasons for volunteerism is they feel useful when helping others. In order for the Ombudsman program to continue to meet the needs of the ever-growing long term care population, we must expand the use of volunteers in the program. The Assistant Ombudsman has taken the lead in regard to volunteer recruitment, training and supervising. The increase of Ombudsman presence in all of the long term care facilities may allow intervention to transpire before abuse situations occur. Section E: Efficiency Evaluation of project: The Ombudsman Program maintains files that generate monthly, quarterly, and annual reports. Data is kept on numbers of visits, complaints, referrals and technical assistance contacts. Data is broken down further to reflect types of interventions, types of complaints, types of facilities, and actions taken. This data is analyzed by the state Ombudsman office to assist in determining the efficiency of the program. 13 In addition, the Ombudsman Program has developed a client satisfaction survey, and is in the process of revising the survey. It is anticipated that these questions will assist with measuring the quality of Ombudsman services provided to residents, families and community individuals. Overall, the 2004 survey response was positive. At the conclusion of the current grant period, the Ombudsman Program will have provided CARTE training for CNA staff representing all nursing homes and the majority of PCBHs in Weld County. This is evidenced by the number of contacts made by the end of 2004, 592 residents visited and 233 complaints investigated by the Assistant Ombudsman. This would not have been possible without the funds from the V.A.L.E. grant. Cost / benefit ratio: Due to the complexity and uniqueness of the program, the current cost benefit ratio is difficult to determine as we provide a combination of training, technical assistance and direct service to an unlimited number of residents and family members. However, we do know that early intervention by the Ombudsman can prevent costly medical costs that may have resulted due to poor quality of care. Section F: Budget Future funding needs: Future funding needs will correlate with how much growth occurs in long term care beds in Weld County. The current growth spurt is statewide and is reflective of the rapid increase in numbers of elderly 75 years of age and older who are frail and in need of some type of long term care. Assisted living continues to be a fast growing industry in all areas of Colorado and the nation. Area Agencies on Aging nationwide are working to bring this to the attention of federal and state governments emphasizing the need for support of the Ombudsman Program. Budget Narrative: We are requesting $8,500 dollars for a .25 FTE advocate/friendly visitor for 16-20 hours PER week and supervisory oversight for a total of$7,700 for salary. Travel reimbursement will be at .385 cents per mile for approximately 2077 miles equaling $800. Mileage records will be kept by the assistant ombudsman for documentation. See attached budget See attached list of Board of Directors See attached letter of support See attached Grant Application Memorandum See attached 1 copy of our agency's most recent audit report (booklet) 14 DETAILED PROJECT BUDGET DETAILED PROJECT BUDGET: Include the estimated cost of all resources needed to undertake the project(round off figures to the nearest dollar). This budget page must include all monies available. In-kind services need to be listed only in the budget narrative,not on this page. a. Personnel(Employees) (1) Salaries(list each position with salary rate and percentage of time devoted) PERSONNEL(Employees) TOTAL VALE VALE COST % TOTAL Eva Jewell $720 0% $0 Raegan Maldonado $34,028 0% $0 Kathleen Alvarado $20,285 .91% $7,700 Marcia Jorgensen $20,285 0% $0 Subtotal of Personnel $75,318 .91% $7,700 (2)Total FICA,Retirement,Fringe Benefits, $18,072 0% $0 etc. Total Personnel Costs $93,390 .91% $7,700 b. Supplies and Other Operating Expenses(communications,reproduction) Supplies/overhead $5,000 0% $0 Total Supplies and Operating Expenses $5,000 0% $0 c. Travel(itemize transportation and subsistence) Mileage $6,500 .09% $800.00 Total Travel Costs $6,500 .09% $800.00 d. Equipment(itemize) Total Equipment Costs $0 $0 e. Professional Services(Itemize individuals and organizations) Total Professional Services Costs TOTAL PROJECT COSTS $104,890 100% 58,500 g. Total Project Funding Breakdown (I)VALE Funds $8,500 8% (2)Federal Funds $74,390 71% (3)Other Funds $22.000 21% TOTAL $104,890 100% Please explain the source of "Other Funds"in the budget narrative. Area Agency on Aging Board Membership List Michelle Adler Don Beierbach Betty Jones 3412 Trinidad Street 4292 W 14th St Dr. 1959 26 Ave Evans, CO 80620 Greeley CO 80634 Greeley, CO 80634 H:970-506-1242 H: 970 352-5952 H: 970-353-7295 W:970-395-6415 E-mail: E-mail: E-mail: dndbeierbach@juno.com wmrch22(c aol.com Michelle.Adler.iayz@ statefarm.com Ruth Gartrell Mary Jones 20076 Southgate Ave. 30887 Road 88 Adella Andrijeski LaSalle, CO 80645 Ault, CO 80610 26416 Range View Drive H: 970-737-2942 H: 970-656-3652 Kersey, CO 80644 E-mail: trellra@aol.com E-mail: None H:970-350-0447 E-mail: Mike Geile Pam Shaddock ade126416@netzero.net Commissioner City of Greeley Centennial Complex 1000 10`h Street Al Arriessecq Greeley, CO 80631 Greeley, CO 80631 504 N. 71st Ave W: 356-4000 ext 4209 H: 970- 5180 Greeley, CO 80634 Email: O: 970- 350-9770 H-351-7414 mgeile@co.weld.co.s E-mail: E-mail: pjshaddock@comcast.net albert.arriessecq@northran Patricia Graham ge.org 1638 27th Avenue Phil Shovar Greeley, CO 80634 1805 19th Ave Germaine (Geri) Arndt W: 970-351-1559 Greeley, CO 80631 505 2' St. H: 970-356-1124 H: 304- 9819 Ft. Lupton CO 80621 E-mail: E- mail: H: (303) 857-0832 patricia.graham@unco.edu phil415(a�msn.com Email: geriarndt@earthlink.net Nancy Meek 4267 W 15th Street Lane Susan Bromley Greeley, CO 80634 1621 13`h Ave H-353-2850 Greeley, CO 80631 C-3963657 Revised 2-05 H: 352-8750 E-mail: W: 353-3373 cobuilder@comcast.net E-mail: susanbromley(2 earthlink.n Elmer Montoya et 2077 35th Ave Ct. Greeley, CO 80634 Bev Daniel H-339-9094 2244 WCR 12 E-mail: Erie, CO- 80516-8919 eandbmont@netzero.com H: (303) 828-9497 E-mail: None www.aIzrockymtn.org Colorado Chapter,Inc. 970 392 9202 phone 3001 Eighth Ave.,#100 910 346 9025 facsimile Evans,CO 80620 800 864 4404 HELPLINE Thursday, March 10th, 2005 Raegan L. Maldonado alzheimer's Qs association Lead Ombudsman Weld County Area Agency on Aging 1551 North 17`h Avenue PO Box 1805 Greeley, CO 80632 RE: Ensuring an Abuse Free Environment Training, "CARTE" Dear Ms. Maldonado: I am writing this letter in support of the"Ensuring an Abuse Free Environment Training," also known as the "C.A.R.I.E."training program. This program is vital in Weld County and continues to have a direct impact on the reduction of abuse and neglect of at-risk adults. This is the second year that the Alzheimer's Association has combined efforts with the Weld County Ombudsman Program to provide education to Certified Nursing Assistants. Older adults inflicted with Alzheimer's disease are an extremely vulnerable group, many of which reside in area long term care facilities. In addition, individuals with Alzheimer's disease may exhibit behaviors related to the disease process, which can be very challenging for direct care staff and add to stress in their work environment. The 2003-2005 training evaluations indicate that direct care staff are requesting and need ongoing training regarding residents who exhibit behaviors. The curriculum used to educate direct care staff, involves strategies on how to effectively deal with stress related to residents' behaviors. Our goal for this combined training is to contribute to the reduction of abusive situations that take place in secure Alzheimer's environments. Overall, this training gives the direct care provider the ability to identify signs and symptoms of elder abuse, to prevent abusive situations, and to alleviate stress. It is my recommendation that this program be continued, and if possible, offered to additional employees, such as managerial staff members. Sincerely, i2 Bonnie L. Wacker Alzheimer's Association Regional Director Colorado Chapter the compassion to care,the leadership to conquer ■ Community College Friday,March 11, 2005 Ombudsman To Whom It May Concern: I am writing this letter in support of the Ombudsman Friendly Visitor/Advocate Program. There is no other service of this kind offered in Weld County. The Ombudsman Program offers a very important training to direct care staff. In addition, the Weld County Ombudsmen present information to the AIMS C.N.A. classes, which are held on a monthly basis. The Assistant and Lead Ombudsman educate students on how to identify signs and symptoms of elder abuse, and ultimately how to prevent abusive situations. This is very important, as the shortage of staff in nursing homes and assisted living facilities increases the stress experienced by these frontline staff members. Many of the students who attend the Community Certified Nurse Aide Training Program become employees at long term care facilities in Weld County. Early intervention is crucial in preventing elder abuse in such long term care settings. In addition to providing information to our students, the Ombudsman Program routinely participates in the AIMS Nursing Advisory Board Meetings. During these meetings we discuss such topics as staffing needs in long term care environments. This includes the need to have trained nurses and direct care staff in such buildings. I would like to recommend that this program be continued, and if possible, expanded to reach more individuals who are directly involved in the care of frail elders. If you have questions or would like to request further information, please contact me at your convenience. Sincerely, /W 4n n mac ) Carmen Fisher Program Coordinator Friday, March 11, 2005 Raegan L. Maldonado Weld County Area Agency on Aging 1551 North 17th Avenue PO Box 1805 Greeley, CO 80631 RE: The Continuation of Ensuring an Abuse Free Environment Training, "CARIB" Dear Ms. Maldonado: I am writing in support of the training provided by the Weld County Long Term Care Ombudsman Program. As a registered nurse at North Colorado Medical Center, I continue to work closely with Certified Nursing Assistants. The Certified Nursing Assistants often provide direct care to patients who have resided in long term care facilities and who will most likely'return to such a setting. It is vital for direct care staff to have training on how to identify abuse and neglect. Some of the Certified Nursing Assistants that I supervise have obtained their certification through AIMS Community College Nurse Aide Training Program. Through this program, the Lead Ombudsman and Assistant Ombudsman provide unique elder abuse training and intervention strategies to Certified Nursing Assistant Students. It is important for these students to receive this training because hospital direct care staff must have the skills necessary to identify signs and symptoms of elder abuse. Overall, I believe that the "C.A.R.I.E."training program assists with improving care for both nursing home residents and patients in hospital settings. It is my recommendation that this program be continued, as it is an excellent way for direct care staff to learn how they can participate in the prevention of elder abuse in hospitals and long term care facilities. The training also provides them with skills to recognize abusive situations when individuals are admitted from the community. Sincerely, • Tina Huston, RN ; North Colorado Medical Center • - VICTIM ASSISTANCE AND LAW ENFORCEMENT BOARD GRANT APPLICANT MEMORANDUM OF UNDERSTANDING CONCERNING THE RIGHTS AFFORDED TO CRIME VICTIMS As provided in C.R.S. 24-4.2-105, (4.7), Colorado law requires the following: A REQUESTING AGENCY OR PERSON SHALL ACKNOWLEDGE IN WRITING THAT SUCH AGENCY OR PERSON HAS READ AND UNDERSTANDS THE RIGHTS AFFORDED TO CRIME VICTIMS PURSUANT TO SECTION 24-4.1-302.5 AND THE SERVICES DELINEATED PURSUANT TO SECTION 24-4.1-303 AND 24- 4.1-304. SUCH WRITTEN ACKNOWLEDGMENT SHALL BE ATTACHED TO SUCH REQUESTING AGENCY'S OR PERSON'S APPLICATION FOR MONEYS PURSUANT TO THIS SECTION. THE BOARD SHALL NOT ACCEPT FOR EVALUATION ANY APPLICATION FOR A GRANT OF MONEYS PURSUANT TO THIS SECTION UNTIL THE REQUESTING AGENCY OR PERSON PROVIDES THE BOARD WITH SUCH WRITTEN ACKNOWLEDGMENT. The prospective grantee certifies to the VALE Board, by submission of this completed Grant Applicant Memorandum of Understanding Concerning the Rights Afforded to the Crime Victims, that the agency or person described herein has read and understands the rights afforded to crime victims as required by C.R.S. 24-4.2-105, (4.7). • PROJECT DIRECTOR: EVA JEWELL TITLE: WELD AAA DIRECTOR PROJECT: WELD COUNTY LONG TERM CARE OMBUDSMAN ADVOCATE/FRIENDLY VISITOR AGENCY: WELD COUNTY AREA AGENCY ON AGING ADDRESS: 1551 NO TH 17TH AVENUE, POST OFFICE BOX 1805 GREELEY, CO 80632 SIGNAXURE: I/0 DATE: 3 - /o - O� (NOTE: COPIES OF THE STATUTES DESCRIBED ABOVE WILL BE PROVIDED TO PROSPECTIVE GRANT RECIPIENTS UPON REQUEST). GRVRA.VAL Hello