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Home My WebLink About941190.tiff RESOLUTION RE: APPROVE FOUR YEAR AREA PLAN FOR AREA AGENCY ON AGING TO COLORADO DEPARTMENT OF HUMAN SERVICES, AGING AND ADULT SERVICES, AND AUTHORIZE CHAIRMAN 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 Four Year Area Plan between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of Area Agency on Aging, and the Colorado Department of Human Services, Aging and Adult Services, commencing January 1, 1995, and ending December 31, 1998, with further terms and conditions being as stated in said plan, and WHEREAS, after review, the Board deems it advisable to approve said plan, 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 Four Year Area Plan between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of Area Agency on Aging, and the Colorado Department of Human Services, Aging and Adult Services, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is, authorized to sign said plan. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 5th day of December, A.D., 1994. nBOARD OF COUNTY COMMISSIONERS ATTEST:/A l y r/� /f, NQA WELD COUNTY, COLORADO Weld County ClerkClerk to the Board �, W. H. Webster, hairman BY: l `/t/i-'®-7/-1/lac-rric.� Deputy Clerk to the Board•_ Dale K. Hall, Pro- em APPROOD AS TO FORM: EXCUSED (/ % George E. Baxter . l2= � - —L—, EXCUSED County Attorn y ` Constance L. Harbert j /` 4 M S �.-/ //2 e' ' /Warbara J. Kirkmey r 941190 HRO06Q go ; his L�rvny) STATEMENT OF INTENT The Four Year Area Plan is hereby submitted for Region 2B Planning and Service Area for the period January 1 . 1995 through December 31. 1998 . It includes all assurances and plans to be followed by the Weld County AAA Name of Area Agency on Aging under provisions of the Older American's Act, as amended, during the period identified. The Area Agency on Aging identified will assume full responsibility to develop and administer the Four Year Area Plan in accordance with the requirements of the Act and related State Policy. In accepting this authority, the Area Agency on Aging assumes responsibility to promote the development of a comprehensive and coordinated system of community services and to serve as the advocate and focal point for older persons in the planning and service area. The Four Year Area Plan has been developed in accordance with the rules and regulations specified under the Older American's Act and Staff Manual Volume 10, and is hereby submitted to the Colorado Department of Human Services, Aging and Adult Services for review and approval. 11-10-94 (Signed) c y, c/c 8. 617 (Date) (Director Agency on Aging) 11-10-94 (Signed) (Date) (Execu 9 e Director, Grantee Organization) The governing body of the Ar Agency on Aging has reviewed and approved the Four Year Area Plan. /2��` /9 (Signed) bj14 (9.1) PG71 ) (Date) %f 7/q$$ (Title) Chairman. Weld County Board of Commissioners ii (7/94) 941190 ADVISORY COUNCIL REVIEW The Area Agency on Aging Advisory Council has had the opportunity to review and comment on the following items in the four year area plan. (Comments are attached.) 1 . Statement of intent and justification for use of Part B funds for Advocacy, Coordination, and/or Program Development; 2. Application for waiver for the Area Agency on Aging to provide direct services; and 3. Request for waiver of the requirement to award minimum percentage of funds for required support services (25% for access, 15% for in-home and 3% for legal services). The Area Agency on Aging Advisory Council has had the opportunity to review and comment on the four year area plan. (signed) r't -" � c , 'C c .vi �) (Date) (Chairperson, Area Agency on Aging Advisory Board) (7/94) 941190 • STATEMENT OF ASSURANCES The area agency on aging (AAA) will comply with the policies, procedures, and assurances contained in Colorado Department of Human Services Staff Manual, Vol. 10, Services to the Aging. The area agency on aging will have the ability to develop an area plan and to carry out, directly or through contractual or other arrangements, a program in accordance with the plan within the planning and service area. The area agency on aging will comply with the Older Americans Act as amended, the policies and procedures set forth in 45 CFR Parts 1321, 74 and 92 and any written amplification of these regulations issued by the U.S. Department of Health and Human Services. This assurance includes, but is not limited to, the statutory and/or regulatory requirements listed below: a. The AAA shall put 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). b. The AAA will set specific objectives for providing services to older individuals with greatest economic need and older individuals with greatest social need, include specific objectives for providing services to low-income minority individuals, and include proposed methods of carrying out the preference in the area plan. c. The AAA will develop and publish methods by which priority of services is determined, particularly with respect to the delivery of access, in-home, and legal assistance services. d. The AAA will enter into voluntary arrangements with nonprofit entities (including public and private housing authorities and organizations) that provide housing (such as housing under section 202 of the Housing Act of 1959 (12 U.S.C. 1701Q)) to older individuals, to provide— (i) leadership and coordination in the development, provision, and expansion of adequate housing, supportive services, referrals, and living arrangements for older individuals; and (ii) advance notification and nonfinancial assistance to older individuals who are subject to eviction from such housing. e. The AAA will list the telephone number of the agency in each telephone directory that is published, by the provider of local telephone service, for residents in any geographical area that lies in whole or in part in the service • 941190 and planning area served by the agency-- (i) under the name "Area Agency on Aging"; (ii) in the unclassified section of the directory; and (iii) to the extent possible, in the classified section of the directory, under a subject heading designated by the Commissioner by regulation. f. The MA will coordinate the planning and delivery of transportation services (including the purchase of vehicles) to assist older individuals, including those with special needs, in the area. The AAA will coordinate with Transportation Development Programs (TDPs) developed for their area, participate in the local planning process of transportation services, and act as an advocate for a coordinated transportation system in the PSA. g. The AM, in carrying out the State Long-Term Care Ombudsman program under section 307(a)(12), 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. h. The AAA may provide for an area volunteer services coordinator, who shall - (i) encourage, and enlist the services of, local volunteer groups to provide assistance and services appropriate to the unique needs of older.individuals within the planning and service area; (ii) encourage, organize, and promote the use of older individuals as volunteers to local communities within the area; and (iii) promote the recognition of the contribution made by volunteers to programs administered under the area plan. The AAA will provide an assurance that all its activities conform with-- (i) the responsibilities of the area agency on aging, as set forth in section 306 of the Older Americans Act; and (ii) the laws, regulations, and policies of the State served by the area agency on aging; j. The MA will provide assurances that funds received under this title will not be used to pay any part of a cost (including and 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. 941190 k. The AAA will provide assurances 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 of commercial relationship that is not carried out to implement this title. The AAA will, to the maximum extent practicable, coordinate the services it provides under this title with services provided under Title VI; m. The AAA 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 will specify the ways in which the area agency on aging intends to implement the activities. n. The AAA assures that case management services provided under this title through the area agency on aging will— (i) not duplicate case management services provided through other Federal and State programs; (ii) be coordinated with services described in subparagraph (A); and (iii) be provided by- 1) a public agency; or 2) a nonprofit private agency that— a) does not provide, and does not have a direct or indirect ownership or 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 b) is located in a rural area and obtains a waiver of the requirement described above. o. An area agency on aging may enter into agreement with agencies administrating programs under the Rehabilitation Act of 1973, and titles XIX and XX of the Social Security Act for the purpose of developing and implementing plans for meeting the common need for transportation services of individuals receiving benefits under such Acts and older individuals participating in programs authorized by this title. p. In accordance with an agreement entered into under paragraph (o), funds appropriated under this title may be used to purchase transportation services for older individuals and may be pooled with funds made available for the 94119n provision of transportation services under the Rehabilitation Act of 1973, and titles XIX and XX of the Social Security Act. q. The AAA assures that any expenditures for program development and coordination activities as a cost of supportive services will have a direct and positive impact on the enhancement of services for older individuals in the planning and service area. 11-10-94 (Signed) ge-7/Idet..X--- C� (Date) (D irector, Area Agency on Aging) iv (7/94) 941190 AUDIT ASSURANCE Single Audit Clause The audit requirements applicable to area agencies on aging and subgrantees are set forth in Section 10.480 of Volume 10. All area agencies on aging and subgrantees receiving more than 525,000 per fiscal year in federal funds shall comply with the requirements for audit as established by the U.S. Office of Management and Budget Circular Number A-128 and A-133 for obtaining financial and compliance audits. The standards to be followed may also be found in the Standards for Audit of Governmental Organizations, Programs, Activities and Functions issued by U.S. Generai Accounting Office. 1988 Revision, or the Guidelines for Audits of Federal Awards to Non-profit Organizations (April 1989) published by the Department of Health and Human Services. For purposes of state and local governmental agencies, the term independent auditor means a state or iocai government auditor who meets the independence standards specified in Government Auditing Standards. Assurance of Compliance // to 99 (SignedYd. 9,./„.4_,± (Date) (Director, Area Agency on Aging) V (7/94) 911190 TABLE OF CONTENTS FOUR YEAR PLAN: January 1, 1995 - December 31, 1998 DUE: November 15, 1994 I. INTRODUCTION: Page Number * Cover Page I * Statement of Intent ii * Advisory Council Review lil * Statement of Assurances iv * Audit Assurance v * Table of Contents vi II. EXFCUTIVE SUMMARY 1 M. DESCRIPTION OF THE PLANNING AND SERVICE AREA 2 * Population Profile 2 * Geographic Profile, Map 3 * Regional Trends 4 IV. IDENTIFICATION OF UNMET NEEDS OF THE ELDERLY 9 * Needs Assessment Methodology 8 * Needs Assessment Finding 9 * Integration of Needs Assessment Data 16 V. PUBLIC INPUT 16 * Overview of Public Input Initiatives 16 * Public Meeting(s) 16 * Program Development and Coordination Review (Not Applicable) VI. COMMUNITY INITIATIVES * Identify Community Initiatives 17 * Addressing the Community Initiatives 17 * County Priorities (Not Applicable) 941190 VII. TARGETING PROGRAM 21 * Identify Needs of Target Population 21 * Specific Objectives to Meet Need 22 * Methods to Accomplish Objectives 23 * Special Outreach Activities to Native American Elders (Not Applicable) VIII. FIRST YEAR OF THE FOUR YEAR PLAN: 1995 25 * Overview of Services in 1995 25 * Effectiveness of Targeting in 1993 22 IX. WAIVERS: 36 * Direct Service Provision Waiver 36 * Waiver of Minimum Percentages Required for Priority Services 37 X. ATTACHMENTS 38 * Meal Service Chart, AAS 260 * Regional Advisory Council Membership, AAS 270 * AAA Staffing Profile and Organizational Chart, AAS 280 * Community Focal Points and Senior Centers, AAS 290 * Senior Center Facilities Acquisition, Construction, or Alteration, AAS 293 * Cost Distribution Method * Proposed Purchase of Equipment * Needs Assessment Instruments CIA1Ion II EXECUTIVE SUMMARY Weld County is a large rural county situated in northeastern Colorado. The population of the county is at 131,821 classifying the county by census definition as a Standard Metropolitan Statistical area despite the rural nature of the county. Twenty- two towns and villages are scattered throughout the county. The locations and numbers of these communities presents a challenge to human service provision. During the past three years the Weld County Area Agency on Aging conducted five formal needs assessments. In addition, the agency analyzed census data and participant user requests and waiting lists from several key programs. On the basis of the needs assessment work, the Weld County Area Agency on Aging has chosen nine key initiatives to guide the work of the agency during the next four years. These initiatives will be Transportation, Information Dissemination, Housing, Long Term Care, Elder Abuse, Nutrition, Mental Health, Volunteerism, and Health Promotion. Transportation, Information Dissemination, Housing, and Volunteerism will be the four high priority initiatives and will receive the greatest emphasis during this planning period. Funding for Area Agencies during the next four years will be flat at best. Budget cuts are probable. The challenge will be how to better target existing resources and how to develop partnerships that will leverage new resources to address critical community needs. One such effort will begin in Fiscal Year 1995. The Area Agency will provide seed money to a new agency to develop a private respite care program. Promotion of client self sufficiency also will be a key theme for the remainder of the 1990's. Local control of congregate meal programs, cost sharing for transportation services, and increased use of volunteers are examples of ways the Area Agency intends to modify the delivery of existing services to help stretch existing resources. Finally, self sufficiency requires ready access to accurate information. A comprehensive plan for improving the dissemination of information to older adults and their families will be implemented during the first year of this plan and evaluated each subsequent year. 1 94119n III - DESCRIPTION OF PLANNING AND SERVICE AREA Population Profile The size, distribution, and characteristics of the population, along with growth trends are fundamental in planning for the county's future. General growth rates and population trends will impact the Area Agency on Aging's capacity to develop a well coordinated service delivery system for older adults. The growth and overall well being of older adults sixty years and older, particularly the 75 plus, frail, minority and seniors living in poverty will influence the specific initiatives of the Area Agency during the next four years. The total population of Weld County according to the 1990 census is 131,821. The 1990 census of persons 60 years of age and older (the target population of the Older Americans Act) is 18,016. This represents 3.99% of the state's 60 plus population and 13.6% percent of the total population of Weld County. (Table 1) Twenty - eight small towns and villages are scattered throughout Weld County. These communities vary is size from 96 for the Town of New Raymer in northeast Weld County to 5,000 plus for the communities of Evans, Fort Lupton, and Windsor. This large number of small communities makes Weld County unique compared to other Colorado counties. An analysis of the population of these communities shows that several of these rural communities have high percentages of 60 plus residents. Several of the highest percentages such as Grover at 27.4%, Keenesburg at 17.7%, and New Raymer at 16% are Weld's most isolated communities. (Table 2) Between 1980 and 1990 the 60 plus and 75 plus cohorts outgrew all other age cohorts in Weld County. (Table 3) A more long range view of population trends shows that between 1970 and 2010 the 60 plus cohort will have increased by 66.2% and the 85 plus cohort is projected to increase by 70.5% during this time frame. (Table 3A) Of particular interest is a comparison of the change in the 60 plus population for Weld County as compared to 15 other Area Agency planning and service areas throughout the state. According to an analysis prepared by the Aging and Adult Services Division, Weld County will experience a 28.6% increase in the 60 plus between 1980 and 2000. This places Weld 25th out of 63 Colorado counties in 60 plus 2 9` 1.190 Table 1 I s in N 1i ' a N u1 • CO • !t0 :n h N N E o> N • co C7 N 0 CO s In m T+ o+ I..I 90 : pwp 0 N Itl CJ N .Y N O' < O3 N OI N O a H M H a+ a el) l+ O Q U O c/a CO of % ui M : d h n m .> iO0 p O O: 1 IO Q M U C U N H a N >* co •i • N 'i •.Oi 'Cl En 0 O O m o •O U y O ea N M m • M d OND C C1 N On O O CO I H M 10 4-4 ro O N O O Iii O a, z P N TU3 F N r1 CO ^�OE N CO N I[1 iN1'1 E F al CL M ''I N M •N•1 M .01 N 0 A . d 4 • • N N Ir1 N m 0 y N h co `? M N O' EO I�-I M CO 0 S+'1 ••• n CI O w N N N O C e1 U U 01 yco 0 a 0 a $ 0 8 dC pO �1 r N D C n a0 u F g 0 N 041 10n Table 2 PERCENT OF 60+, 65+, 75+, 85+ POPULATIONS BY INDIVIDUAL WELD COUNTY TOWNS. Town 1990 pop 60+ pop 65+ pop 75+ pop 85+ pop AULT 1,107 236 (21.3%) 191 (17%) 89 (8%) 21 (2%) DACONO 2,228 374 (16.7%) 252 (11%) 86 (4%) 11 (>1%) EATON 1,959 407 (20.7%) 325 (17%) 156 (8%) 23 (1%) ERIE 1,244 143 (11.4%) 103 (8%) 61 (5%) 7 (1%) EVANS 5,877 620 (10.5%) 461 (8%) 205 (3%) 36 (1%) FIRESTONE 1,358 88 (6.4%) 68 (5%) 25 (2%) 3 (>1%) FORT LUPTON 5,159 560 (10.8%) 432 (8%) 175 (3%) 37 (1%) FREDERICK 988 126 (12.7%) 103 (10%) 48 (5%) 10 (1%) GARDEN CITY 199 24 (12%) 22 (11%) 6 (3%) 2 (1%) GILCREST 1,084 80 (7.3%) 54 (5%) 26 (2%) 3 (>1%) GREELEY 60,536 8,727 (14.4%) 6,765 (11%) 3,230 (5%) 929 (2%) GROVER . 135 37 (27.4%) 33 (24%) 15 (11%) 2 (1%) HUDSON 918 118 (12.8%) 88 (10%) 36 (4%) 9 (1%) JOHNSTOWN 1,597 273 (17%) 212 (13%) 99 (6%) 25 (2%) KEENESBURG 570 101 (17.7%) 76 (13%) 39 (7%) 10 (2%) KERSEY 980 139 (14.1%) 103 (11%) 44 (4%) 8 (1%) LA SALLE 1,783 235 (13.2%) 168 (9%) 71 (4%) 16 (1%) LOCHBUIE 1,168 172 (14.7%) 120 (10%) 45 (4%) 8 (1%) MEAD 456 40 (8.7%) 28 (6%) 15 (3%) - (0%) MILLIKEN 1,605 164 (10.2%) 113 (7%) 38 (2%) 9 (1%) NUNN 324 44 (13.5%) 33 (10%) 12 (4%) 4 (1%) PIERCE 823 102 (12.3%) 74 (9%) 26 (3%) 4 (>1%) PLATTEVILLE 1,515 181 (11.9%) 140 (9%) 58 (4%) 15 (1%) RATHER 96 22 (22.9%) 17 (18%) 8 (8%) 1 (1%) SEVERANCE 106 17 (16%) 12 (11%) 6 (6%) 2 (2%) WINDSOR 5,062 690 (13.6%) 543 (11%) 269 (5%) 54 (1%) 941190 Table 3 Q Sys : a99 � a . E)( 4 yalt-i }6 d� i Fd9 $ 1e� irekk (a 9 p (83P p 331 .-p 9gp�. 1,ism I a 1 -t' K] C A ii O[[.'. ry. 4-D Y/ °big ° N- P 6.O ,«ear. po � . . ° L y 0 Ft „moo ti a a 1 4-1 Ca a=s Oanl a 444 tk)50- Vaie#,tirt•friti Kt t D a 4 ill Cr— E3� es 0 Q$ ! U 'lie)" @a r t e 1 . -a s ` vT t th 83 •° . 3 � e�A ea4 be o... +' ' '2011. 3ae s A.z33,: §� i � 3 8 sae � �a a Sala" es6sa gP. ��a X8ro T, 1,11 lc s , Q„sd a is 1,�, ., A A . eh83 e ��yyc: la' "..4r,al� V,°,,I"S��f„„dSa . dR t d:j' .9A aae-. Q 0 O O is O .0 O O Q o M M N N tT O in O 941190 TABLE 3A w C.7 Pt Pt Pt Pt Pt Pt 1 V1 N N,-+ N. O CT O Ln O M N N'1 'C �O N. N Pt N C 14 4 J en m O 03 IN. ON O N co N N M ,y OJ 1 N ea N 1 O CO N as - o 1 ri M '� y n] DI ,-1 ,14 • O C! +-) U O O O ..i W L N r 1 O C4 . O 1 a a 1 O M F > O O `T 'p O U Q N to C,7 N d 1 N Ns N N C O to- CO UOO S M W O ^7 C U W W O M - `C CI O N t >4O O Nen a m N atO coO O 1 m CO N C en N. i•- CO ~ en it O N :4r.. C• O 0.• u z a O - U N co - N M rJ U O M O N.. N O 1 7tI .C O COM r l G OOn cil ~ M‘o 0n 1 ~ -N L+ m 4 o E i G 1 ro .. a C = N UI N 00N OQ t+ O N. in m 1 CO In 0% 0. E M mO H H CO a en ^ °` O W en n ..- CO N CI CC en O C •.-I N a.+ C U u O m- - O d 00 O 0 O yC ft b V 07. U CO Wi O 9 OS .. C C .-ECO D P n m ,O.+ u • O O O ti 941190 growth rate for this time period and 5th out of 16 Area Agency regions in 60 plus growth for this same time period. (Table 4) An examination of selected subgroups as a percent of the State total, prepared by Sue Bozinovski, Aging and Adult Services Division from Revised Population Estimates, CO Division of Local Government shows Weld County ranked 9th or greater in five subgroups when compared with 62 other Colorado counties. Weld County ranked 9th in percent of 75 plus population, 8th in percent of frail - disabled, 7th in percent of low income 60 plus population, 6th in percent of 60 plus minority population, and finally 1st in percent of rural 60 plus population. (Table 5) Geographic Profile Weld County is located on the eastern plains of Colorado, north and east of Denver. Greeley, the county seat and major city, is located in the east central portion of the county, approximately 60 miles northeast of Denver and 50 miles south of Cheyenne, Wyoming. (Map 1) Greeley, whose population is just over 60,000 serves as a regional hub for medical, educational, employment and retail needs for the most of Weld residents. However, residents of south Weld County tend to do business in Brighton, Longmont, Boulder, and the Denver suburbs. Twenty five small towns and villages ranging in population from 96 to 5,877 are situated primarily in the west and central portions of the county. There are no major geographical barriers between these communities other than distance. Often services are difficult to deliver to these communities because of the cost of transportation or the cost of stationing human services workers closer to the site of service delivery. The most isolated communities are located in the far northeastern sectors of the county. Here residents often transact business in towns across the border in Wyoming and Nebraska. Also, winter storms bring ground blizzards which are hazardous for residents living in small towns and ranches in northeast Weld County. It is in this section of Weld County that the highest percent of older persons reside compared to the total population of this area. (Map 2) 3 941190 Table 4 ) +7 ] \ / I { � | 7 | \ ) 0 § f CI 1,4— k ( . \ | } ) \ \ co 4.) ) § \ ] J ° ( \ J •§ 0.1 II B 44 c ) \ . . • / 0 O W M 0 x 41.1 4 ` § ii * s \ \ j( DO q 2 / ) i 4 in. / \ f a \ +4 7 - 2 k - • k a w •J k - ° ( \ I \ ) 1 2 / ! / k g Ow ; ° / \ ° i ) ) m § M o o j \ 9 ) ) 2 ; § i0 M Q ` / 2 § I ° § a X MIRK DIKKIK E. § ) N r Cl N N N N _ _ _ ^ -• • A 03 MCl , , 2 § NI . CI 4' - - - - - - - 941190 Table 5 y a a 0 H A! H H Ey 0" M .t Ot O ^ rN ^� N 0 H M W 47 O cn F a z aa a, c) O M `'0 y O 0. g I-i b0 G 0 i.w 00 d 6 41 C U )-40 F z O U U a a v C o0 a = p0 <4w o N 4 o M `a O 01 H o a 0 ,�-1 .o, C �� Z ~ C H N H N �O •rl li IA C 0 d 5F tl U W F? N 'd O ON N 01 0 03 C 01 O A+) 'd A R 1 J7 WF cf 'd W 0. 01 U 01 4.+ N N C a ,ti F y U VI W Oll O En Oct y - I U Dye - p P. .a U y IN U a 0 ,Op In Oct b N. mig r acv � o O � a F a PO. i F d U 4+ 0 O En 941190 WELD COUNTY MAP 1 (4004 Square Miles) V \Grover 171Parer National Grassfaads Nu m 3oa Puree 1 ' 131--.\. ............„ k 911- Ault New Renner- lassIt 104 e5 Eaton t09f Windsor- 9 C sas] riff raresat' 63190: f �_.T63 . f1P - 25 ersey \ Msa ' 6,aa I.09a �' —Teens-towns].6ss !a Salle- 3 \ '^a.r,.Ann Sat: 963 657 s Cilaest Mead Y,% 1061. as] �'' 1.904 te r17+ Firestone V]66 !lrtes6t/g \\ Fort Lupton 611 '•CHEYENNE s \1.161 SJp • _ i Erie Dacono Hudson m_ 1A01 ..N2 © 942 \ WYOMING 3 �� B ✓Lodtbue 984, 44 I, . COlOAAOO A el • FORT COLLI As * GREELEY S LOVE LAND LONGMONT A BOULDER ♦- -i.__...q...1.6-170 F Ca....41S1 DENVER w +•.w.. ♦ _ Sources Of Information: U.S.Census Bureau.Colorado Department of Employment and Training,Colorado Department of Local Affairs.Weld County.City of Greeley,Greeley Board of Realtors.Greeley/Evans School Dist.6.Weld ld Qn County Airport. Colorado Legislative Council. University of Northern Colorado Departme+a4l19V MAP 2 0 O U `e n N o to oi 0 0 — — — U a. r O ~ MI W �. • Jisi U L W o_ >-. z \ N Q, any c=.__ 941190 9 Regional Trends Public Transportation Transportation accessibility and choices are frequently expressed needs and one of the most challenging services to deliver. Just as the increasing numbers of very old and very frail elderly have increased needs for home delivered meals; the same demographics are increasing the need for handicapped accessible transportation. As a region, Weld County and the surrounding northeast area is heavily involved in regional and local transportation planning. This planning involves city and county elected officials and representatives from their transportation departments. Deliberations are focused on transportation consolidation possibilities, decreasing the use of personal automobiles, air quality, and increasing service to the transportation dependent. What the specific outcome of the consolidation planning will be is unknown. Housing Conditions and Shortages: Lack of affordable housing is a major issue for low income families and low income elderly. All subsidized senior housing projects have two and three year waiting lists. A community needs assessment was conducted in the Tri Town area of south Weld County with funding from the National Eldercare Coalition in April, 1993. Of the 168 seniors who were surveyed, 70% said that subsidized housing for seniors was a high need for this community. Much of the housing need is a result of the strong economy which is fueling demand for homes and rentals. According to the Weld County Housing Report (CHAS) the median rental was $219 in 1980 and $354 in 1990. Median cost to own a home in 1980 was $58,700 in 1980 and $70,000 in 1990. The same home in 1994 would cost slightly over $100,000. Interviews with the Weld County Housing Authority staff and local realtors confirm anecdotal information provided by seniors that rents are increasing from 50% to 300% over night. Also an on going and historical problem for Greeley is competition with college students for apartments. 4 941190 A Housing Task Force initiated by the Weld County Department of Social Services in conjunction with the City and County Housing Authorities and the United Way have mapped out a plan to address home ownership problems for low income families and other alternative housing options for the elderly and handicapped. A Housing Development Corporation was established to attract private interest in housing development for the low income. Another positive development is Housing and Urban Development (HUD) approval of a 40 unit Section 208 senior housing complex to be built in south Greeley. The North Colorado Medical Foundation is building a senior housing project for middle to upper middle income seniors who are seeking less care housing alternatives. In Weld County, the sentiment is that partnerships with the private sector will be key in solving the county's housing problems. Assisted Living Assisted living options in Weld County have significantly increased since 1980. To date, Weld County has 210 personal care beds and 735 nursing facility beds. Most of the personal care beds have been licensed in the last 5 to 8 years. Assisted living options must increase as the Weld population grows older. The "aging in place" phenomena that is occurring in senior independent living units is placing many additional responsibilities (often unwanted) on senior housing managers. Availability of Medical Care Greeley is the site of a major medical complex, North Colorado Medical Center (NCMC). Effective fall of 1994, the medical center became affiliated with Lutheran Health Services. Major services include a cardia vascular unit, oncology unit, level two trauma units, and level two nursery care. Other services include rehabilitation services through a progressive care unit and sub acute care through a transitional care unit. A new Diagnostic and Medical Arts Building is under construction and will open in the spring of 1995. Other medical centers in Brighton, Loveland, Fort Collins, Longmont, and North Denver provide a wide variety of choices for the latest in medical care and technology. 5 94119n Access to high quality medical care is not a problem for Weld seniors. Affordability, low numbers of family practice physicians located in small rural communities, and lack of access to home health care in south and northeast Weld County continue as negative trends affecting health care for some Weld seniors. Seniors also report difficulty finding doctors who will accept new Medicare patients. Availability of Mental Health Care Mental health services are available in Weld County through the Weld Mental Health Center and numerous private mental health professionals. The Coordinator for Geriatric Mental Health Services at the Weld Center reports that approximately 12% of Weld County older adults are depressed at one time or another. Mental health intervention, he reports, could benefit as many as one third of Weld's nursing home residents. These figures are lower than figures reported nationally. The number of referrals for peer counseling to the Weld Mental Health Center has remained steady for many years. Referrals from rural areas continue to be much less and reflect a continuing problem of informing rural Weld seniors and their families about this service. Since the passage of OBRA in 1989, the access to mental health services in Weld nursing homes has increased. The Mental Health Center now has an OBRA team of 3 full time FTE's providing mental health screening and intervention for nursing homes. The peer counseling program is an adjunct to this team and provides counseling when deemed appropriate. Changing Economic Patterns Weld County is first thought of as an agricultural county. The Economic Development Action Partnership (EDAP) estimates that 31%of the employment in Weld County is related to agriculture. Another 24% of the employment is in retail trade and educational services. In recent years oil and gas production have contributed significantly to the economy of the area. In 1994 alone, 1000 additional oil and gas wells are expected to be drilled. According to Ann J. Garrison, PhD, University of Northern Colorado (UNC) Economics Department, there is substantial new retail development in the local economy, employment is rising at rates greater than the State of Colorado, building 6 941199 permits and the value of building permits have increased in comparison to previous 12 month periods. Home sales and home values are up from previous years, as well. According to the Labor Area Unemployment Statistics (LAUS) for July, 1994 the Weld County and City of Greeley rates are holding at 4.7% as compared to a national average of 6.2%. At this current lower rate Weld is beginning to experience labor shortages particularly in low wage hourly jobs and part time jobs. Employers, unable to increase entry wages, are looking at other benefits to attract and retain workers. Flex time and employee assistance programs are options being discussed. This development could impact the employment status of older adults; causing companies to look more favorably toward older workers as an employment resource. Population Growth and Migration Patterns Population growth for Weld County is upward. Between 1980 and 1990 according to the U.S. Census Weld County population increased from 123,438 to 131,821 in 1990 or by 6.3%. Weld County is now ranked 8th in population as compared to all 63 Colorado counties. Another measure of growth is the increase in building permits issued. Data provided by the Weld County Planning Department shows that for unincorporated Weld County single family unit building permits increased from a total of 109 issued in 1993 to 136 issued in the first nine months of 1994. At this rate there will be a 40% increase in single family residences in unincorporated Weld County between 1993 and 1994. The same comparative data is not yet available for the towns and cities. However, there were 1,131 permits issued in this category in 1993. This trend has many Weld residents concerned about planning for growth. Growth South Weld County: South Weld County will continue to grow at a rate greater than the remainder of the county due to its proximity to the Denver Metropolitan area, proximity to the Boulder\Longmont area, and to Denver International Airport. For some seniors this could translate into a loss of community as towns become larger with more people leaving the community for work. On the other hand, the growth could strengthen the local economies allowing the communities and businesses to address community needs. 7 44114n Growth of the Community Center Concept: Community Centers rather than Senior Centers are becoming the predominate response to the educational and recreational needs of small rural communities. In 1980 67% of Weld's rural communities had no type of center, while 27% had senior centers and 9.1% had community centers. At present 41% of Weld's rural towns have community centers, 45.5% have senior centers, and 13.6% have no centers. (Table 6) At least two more Weld communities, Milliken and Evans, have future plans to build community centers which will be available for all ages. As one would expect, more communities anticipate hiring recreational coordinators rather than senior center coordinators. The community center is a practical approach that unites the community and utilizes tax dollars more efficiently. The Weld County Area Agency on Aging views this as a positive indicator that communities are moving toward a more comprehensive approach to community needs. Community centers also provide an excellent environment for intergenerational programming and can be a source for recruiting experienced older adults as community volunteers. Children and Youth in Crisis Weld census figures on child abuse, youth poverty, graduation rates, teen pregnancy, and youth unemployment all point to serious community problems that are of great concern to many Weld residents. Even as the growth of senior cohorts continue to outstrip the growth rates of children; the community is possibly more cognizant of the problems faced by children and youth. The challenge for advocates of the elderly is to engage older adults in utilizing their personal talents and resources to help the community improve the quality of life for the youth without neglecting the problems of the most needy and isolated elderly. 8 941190 Table 6 WELD COUNTY SENIOR CENTERS 1980 AND BEFORE No Centers 64° Community Centers 9% Senior Centers 27% SINCE 1990 Community No Centers Centers 14% 41% Senior Centers 46% 941190 IV - IDENTIFICATION OF UNMET NEEDS OF THE ELDERLY The Weld County Area Agency on Aging is responsible for assessing the needs of older persons in Weld County. In 1993 and 1994 data was collected from the following assessments: Key Informant Survey: An Assessment of the Services and the Problems and Needs of Older Adults. A key informant survey was conducted with 35 Weld agencies under the direction of Robbyn R. Wacker, Ph.D. of the University of Northern Colorado Gerontology Program. Agency key informants were asked to indicate the degree to which they felt various services or conditions were a problem for older adults in Weld County. The results indicated that: • Poverty, transportation, medical care and home health care were the top four issues that informants rated as a major problem. • Transportation, accidental injury in the home, crime against older adults, elder abuse, poverty, mental health issues, and home health care were rated by over 70% of the informants as a moderate or major problem. • There was a lack of consensus on the seriousness of employment, legal services, ethnic and racial discrimination, services for Hispanic older adults, services for frail older adults, and case management. When asked to indicate how serious they thought a variety of reasons were in acting as barriers to service use for older adults in their community; the following were seen as somewhat serious or very serious by a majority of the informants: • Reluctance to ask for help • Eligibility restrictions • Cost of services • Lack of information about services 9 941190 • Lack of transportation to services • Perception of cost as excessive • Reluctance to rely on non-family for services Tri-Town Senior Survey The Tri-Town Senior Survey was conducted in the summer and fall of 1993 to 168 individuals age 60 and over residing in the towns of Dacono, Frederick, and Firestone (known as Tri Town). These communities are located in the southwest sector of Weld County. This was a random sample telephone survey conducted by trained volunteers under the supervision of Ms Sue Tungate, MSW. Survey participants averaged 71 years, almost one-third were widowed. Major findings: • The Tri Town Senior Center is a well known resource for this community with over 90% having heard of the center. • Almost 2/3 of those who do not drive rely on family members for transportation. About one in eight people reported they face some sort of difficulty leaving home; most of these have difficulties with ambulation or use a wheel chair. • Overall, survey participants leave Weld County and travel to Longmont for primary appointments and shopping. • When asked what kind of help would be most useful to them, the most frequently given response was help with housekeeping or home maintenance. • More than 70% of the respondents felt that subsidized senior housing was needed. • Though 85% thought Tri Town was a good place to live; more than 1/3 of those responding expressed a wish to have more people to talk to. 10 941190 1994 Survey of Senior Center Coordinators The Weld County Senior Aide Coordinators, the principal outreach and service link to rural Weld communities were surveyed by the Area Agency on Aging with the assistance of Laurie Buys, Ph.D candidate from the University of Northern Colorado Department of Human Services. The survey instrument was developed to obtain basic demographic information on each of the Senior Coordinator programs to determine training needs of the Senior Coordinators, and to determine service gaps in rural Weld. The major findings included: • Community services that rural senior coordinators most often refer to are transportation, hearing aid testing, and volunteer opportunities. • The highest interest (82%) for future training on how to recognize and support volunteers. • Other training requests (50% or more responding) were for how to work with difficult people, how to manage time, how to market senior centers, how to recruit and train volunteers, and how to write small grants for funding. • The most frequently offered services at the rural senior centers (60% or more responding) were the Senior Nutrition Program (78%), health screening (67%), tax assistance (67%), nutrition education (72%), transportation (72%), information and referral (67%), bulletin boards (78%), home delivered meals (83%), personal follow up on referrals (61%), and volunteer opportunities (78%). Focus Groups In April, 1994 the Area Agency on Aging conducted four focus groups, three in rural Weld and one in Greeley. Fifteen persons were invited from each community to respond to ten (10) questions. Each focus group concentrated on a particular consumer group such as widows, care givers, and men. Focus groups discussed service needs, knowledge of services available, housing, intergenerational programs, volunteerism, care giving, and challenges of growing old. Several concern areas were mentioned consistently and are described as follows: 11 • Lack of information and understanding about services for seniors and their families was consistently mentioned. • Lack of information about how to access the Weld County Transportation Program was consistently expressed. • All four focus groups unanimously rejected the idea of "shared housing" programs as a way for seniors to have companionship and reduce living expenses. • All focus groups supported the idea of intergenerational programs. With the exception of the men's group; most felt that the schools should do more to utilize their talents and make them feel more welcome in the schools. (Men expressed fear of the risk and liability of volunteering in schools because of male sex perpetrators in our society.) • Many expressed concern and frustration with seniors who isolate themselves and do not participate in educational and recreational activities available to them. • Caregivers expressed a need for affordable respite care and more friendly visitors. Work and Family Needs Assessment A Work and Family Needs Assessment was conducted for a consortium of major Weld County employers in the fall of 1993 by the Work Options Groups, Inc. of Boulder, Colorado. North Colorado Medical Center, Flood and Peterson Insurance, Weld County Government, City of Greeley, Bank One, and The Greeley Medical Clinic agreed to participate in an employee survey to determine the extent of caregiver needs. The questionnaire was distributed to all employees of the participating employers. There were a total of 1,696 questionnaires received from the combined businesses resulting in a 49% return. Both child care and eldercare issues were addressed. The following findings regarding eldercare were published in the final report to the businesses in October, 1993: 12 941190 • 51% of the respondent population was between the ages of 26-40 years old. 14% were over the age of 50 years. 55% of the population had a total family income of less than $40,000 per year. • 11% of the total respondent population (185) employees indicated that they currently have elder care responsibilities. 11%of these caregivers assist their elders with daily care, 9% arrange for their care, 33% assist in emergencies, and 31% assist with a variety of other services. The result of the responsibilities was that 38% felt stress at home, 18% felt stress at work, 23% actually missed work, and 17% felt a financial strain. • 73% of the total respondent population indicated that their elderly dependents live locally which could have implications for additional stress and missed time at work as the needs of the dependents increase. 38% of those with elder care responsibilities indicated that they have had difficulty in locating adult care services. Approximately 200 full days and about 135 partial days were missed from work over the past year, by the combined responding employees, as a result of their elder care responsibilities. • 58% of the respondents indicated that they felt they would have some form of elder care responsibility in the future, resulting in nearly 2000 employees in the total group population dealing with elder care issues by the end of the century. 33% of the respondents indicated that it would happen within 2 years, and another 29% reporting that it would most likely occur within 3 - 5 years. 38% thought it would happen in 5 or more years. • Approximately 30% of the respondents indicated that their work schedules caused problems with their ability to "balance work and family" due to their work rotation schedule, working overtime, and working weekends. 69% of the respondents indicated that they were usually given less than 24 hours notice when expected to work overtime. Senior Nutrition Program Survey In 1992 a 40 question survey written under the direction of Dr. Robbyn Wacker of the UNC Gerontology Program was sent to a random sample of 250 senior nutrition participants. The purpose of the survey was to determine the level of satisfaction 13 941190 with this program and to determine the impact of the program on the lives of the participants. From the 250 surveys, 137 were returned representing a 65% response rate. Every nutrition site was represented in the survey except one. Some of the important findings from the survey are summarized below: • Health problems and lack of money were most often cited as reasons for not getting out of the house more • Almost all of the respondents were either satisfied or very satisfied with the meal program overall (90%). • Seventy-five percent indicated that they have changed their health habits (fat and salt) and 17% indicated that the information provided at the nutrition program helped influence this change. • Attending the meal program is seen as an important social activity for the participants (95%) and 75% indicated that the meal program was an important part of their diet. • The majority of the respondents disagreed when it was suggested that the donation amount was too high. Information and Referral Weld Information and Referral (WIRS) maintains a data base on all referrals that come into the agency during the course of a year. According to WIRS, 5,588 unduplicated I & R contacts were received in 1993. Of these contacts 531 or 9.5% were contacts from individuals 55 years of age and older (no age was given for 72 persons). Food, housing, assistance with prescription drugs, ramps, and eye and dental care needs were the predominate requests from the 55 plus calls. Food assistance was the most frequent request. 14 94119n Waiting Lists for Public Housing Waiting lists for senior public housing remain high. A September, 1994 telephone survey of senior housing managers confirms that seniors may expect to wait two to three years for apartments depending on priorities. Adult Protection Referrals The Weld County Department of Social Services keeps data on adult protection cases and referrals on a monthly basis. Monthly case load averages have increased from 17 cases per month in 1992, 20 cases per month in 1993, and 28 cases per month in 1994. Referrals (not necessarily cases opened) numbered 76 in 1992 and 117 in 1993. Single Entry Point Analysis of Service Gaps The Single Entry Point advisory committee, a committee of the Weld County Area Agency on Aging Advisory Board addressed resource gaps as reported by the case management staff. While not a scientific assessment of needs, the case managers are working with 250 clients on a monthly basis. The activities of care plan development for these essentially home bound clients presents many opportunities to evaluate the adequacy of resources needed to provide community based care. The following was determined by this committee to be some of the most significant resource gaps for case managers: • limited transportation options for clients who live in rural Weld and for all clients needing evening service • limited number of home health agencies that will provide unskilled care to HCBS clients • limited adult protection services • limited number of volunteers willing to assist clients with financial management and social interaction • limited number of people who are interested in providing 24 hour live in help for frail elderly and the young disabled 15 941190 • limited housing options for low income elderly and the young disabled • limited affordable respite services • limited access to dental and vision services for low income clients • limited services for head injured adults • limited adult foster care homes and alternative care facilities Summary Results of the assessments provided few surprises. Overall, respondents confirmed previously known information. Access to information, transportation, affordable home health care, lack of third party reimbursement for eye and dental care, housing and supportive housing options, and elder care are issues for Weld elderly and their families. For Weld County, except for transportation, these are not service gaps as much as they are access and affordability issues. The results of the needs assessments helped establish the community initiatives and specific actions that will be taken during the next Four Year Plan period. Area Agency Board members, rural Senior Aide Coordinators, Single Entry Point committee members, Senior Nutrition/Senior Center committee members, and participants in public hearings discussed and prioritized the initiatives. This input will direct time and resources where the most can be achieved in the next four years. V - PUBLIC INPUT Two public meetings were held for citizen input on the Weld County Four Year Plan. Windsor Community Center, Windsor Colorado, November 2, 1994 Twenty - six persons were in attendance. Participants were presented with an overview of the Weld County Area Agency on Aging and the Four Year Planning Process. Sections of the plan summarizing the Area Agency's Initiatives for the next four years and the programs recommended for funding in FY 1995 were made available to all participants. 16 4444on Participants were led through a prioritization process providing the Area Agency with additional information on which initiatives were priority concerns. The results of this work. Housing, transportation, and volunteerism were the top three priority initiatives for attenders at this meeting. The overall lack of rental housing for low and middle income seniors was frequently emphasized. Transportation was the next priority concern with the emphasis being on rural Weld County. Volunteerism was a third but high priority for this group as many of the participants direct or attend small rural senior centers throughout the county. The need for younger volunteers to assist at the centers and in the communities as large was widely discussed. Greeley Senior Activity Center, Greeley, Colorado, November 10, 1994 A public meeting was held in conjunction with the Area Agency on Aging Advisory Board meeting on November 10, 1994 at the Greeley Senior Activity Center. Thirteen board members and two interested citizens were in attendance. The Four Year Plan Community Initiatives and the funded programs for FY 1995 were reviewed. A concern was expressed regarding the Area Agency's Request For Proposal Process by Mary Orleans, Director, Catholic Community Services Northern (CCSN). Mary felt that the changes the Area Agency is requiring of the Spanish Elderly Outreach Program should have been more specifically outlined in the RFP. The change in emphasis, she expressed, was being required after the proposal had been written and submitted. A concern was expressed by Mr. Donald Cranson regarding the preparation of the Senior Nutrition congregate meals. Mr Cranson was concerned about the possible use of aluminum cook ware in the preparation of the meals and the potential harm of aluminum in light of research on the relationship of aluminum and Alzheimer's Disease. VI - COMMUNITY INITIATIVES Transportation Initiative (High Priority) Lack of transportation was expressed consistently and more often in needs assessments and focus groups than any other service. Providing demand response 17 941190 and modified demand response transportation service for residents of a county the size of the State of Connecticut is a massive challenge. The Area Agency on Aging is not prepared to predict the outcome of efforts to increase and improve transportation to elderly and disabled in rural Weld County four years from now. However, during the next four years the Area Agency will make transportation service improvement and expansion a major initiative. Specific actions steps that can reasonably be taken during the next four years are as follows: • Implement approved City and County transportation consolidation recommendations • Install transportation computer data base and routing software • Increased Urban Mass Transit, Section 18 funds • Install a 1-800 number for long distance service requests • Increase route schedule information to the general public • Implement fee for service • Increase contract service to private sector Information Dissemination Initiative (High Priority) Lack of information about available services was frequently mentioned as a problem for seniors and their families in needs assessments and focus groups. During the next four years the Area Agency will revise how information is disseminated to the public. A comprehensive action plan will be implemented to increase information to the Weld Community about senior issues and programs that will encompass every aspect of the network of services for the aging and involve private sector partnerships in the dissemination process. This plan will be developed with community input and will include but not be limited to the following actions: • Increase Legal presentations at Senior Aide Stations • Write Senior Services Column for weekly rural newspapers • Increase information for caregivers through work place contacts • Print a standardized outreach handout for rural Senior Coordinators 18 eaA44 Housing (High Priority) Population and economic growth is compounding an already difficult housing market for low income elderly. During the next four years the Area Agency on Aging will increase involvement with policy makers and housing specialists. Initiatives that could realistically become realities are: • a housing counseling service for seniors in conjunction with the Greeley Housing Development Corporation • Technical assistance to Town of Dacono to build a subsidized senior housing project • A pilot shared housing project (the Area Agency believes this is a viable option for some seniors and should be piloted despite the fact that the focus group participants rejected the concept) Volunteerism (High Priority) Older volunteers will continue to be a vital resource to the community and an integral and necessary part of Area Agency on Aging programs. • Increase intergenerational volunteering focusing on schools • Increase number of volunteers in the Senior Nutrition Program and the Ombudsman Program • Co sponsor with United Way an annual workshop on how to recruit and supervise older volunteers Long Term Care Home health care was listed by key informants as a major concern. Each year a greater percentage of calls to the Area Agency are about long term care questions. The needs of the most frail elders will continue to be a major focus of the Area Agency on Aging. Access to information about long term care must increase. Respite alternatives for caregivers will grow. For the next four years the Area Agency will: • Expand private case management • Increase home health care services for south Weld County 19 941190 • Seek private sector funding to build an assisted living facility • Improve methods of training personal care boarding home staff • Offer basic and enhanced elder care packages to local employers as a member of the United Way Family Support Network • Provide seed money to develop a private sector respite care business Elder Abuse Initiative The Weld community must be educated about elder abuse. Allocation of federal elder abuse monies to the local level is necessary to continue and expand this educational initiative during the next four years (allocation to local level not guaranteed.) With Title VII funding under the Older Americans Act the Area Agency proposes to carry out the following actions: • Work with Department of Social Services to establish an Adult Protection Team • Provide elder abuse educational seminars to a wide spectrum of community groups including, the University, service clubs, town boards, senior centers, and provider agencies. Nutrition Initiative Results from a client satisfaction survey of congregate nutrition participants proved that this program is widely appreciated and beneficial. Nutrition services will continue to be a vital part of the AAA's continuum of care - emphasis will be on increasing service to the frail and homebound. Major emphasis during the next four years will be to: • Increase capacity of rural communities to sponsor meal programs without government assistance • Expand home delivered meals service to all rural communities • Develop a volunteer recruitment plan to increase number of participants willing to help serve meals at congregate sites • Expand from three to eight the number of sites using reusable plates. • Revise reporting procedures to meet new federal reporting guidelines 2O 941190 Health Promotion Initiative Weld citizens increasingly are aware of the importance of taking responsibility for their health. During the next four years the Area Agency will fund creative health promotion programs emphasizing services to rural and minority populations. Initiatives will include but not be limited to: • Annual "Celebrating Healthy Lifestyles" symposium for Hispanic Elders • Pilot "Health Wise for Life" workshops at three rural senior centers with option to expand depending on evaluation of outcomes • Eye, dental, and hearing assistance programs for low income elderly VII - TARGETING PROGRAM The Weld County Area Agency on Aging must assure that services will be targeted to older individuals with greatest economic need and older individuals with greatest social need. Specific initiatives must address the needs of low income minority elders. According to the 1990 census as prepared by the Colorado Department of Local Affairs; low income elderly are numbered at 1,960 or 10 percent of the 18,813 60 plus seniors in Weld County. This ranks Weld County 7th out of 63 Colorado Counties in elderly poverty rates. An analysis completed by the UNC Geography Department for United Way in 1993 shows that the heaviest concentrations of older persons living in poverty primarily reside in northeast Weld and the north and east census tracts of Greeley. The principle minority population for Weld County as defined by the U.S. Census is Hispanics with Hispanic elders representing 11% of the 60 plus population. Poverty rates for Hispanic elders are much higher. According to the 1990 Census using the 65 plus cohort 30.5 % of Hispanic elders have poverty status as compared to a 10.9% poverty status for white 65 plus. The Weld County 65 plus poverty status rate for Hispanics is 7% higher than for Colorado. 21 941190 Another revealing statistic is that 3.8% of the 65 plus in Weld County are classified by the U.S. Census as linguistically isolated. For the City of Greeley this rate increases to 4.4%. Both percentage rates are higher that the Colorado rate of 2.7%. (Table 7) Effectiveness of Targeting Program in 1993 In 1993 the Area Agency provided the following services to low income minority (Hispanic Elders) in Weld County: • Outreach - 347 persons compared to goal of 280 persons • Respite - 5 persons compared to goal of 3 persons • Personal Care - 2 persons compared to goal of 3 persons • Day Care - 7 persons compared to goal of 5 persons • Counseling - 35 persons compared to goal of 37 persons • Legal Services - 11 persons compared to goal of 25 persons • Congregate Meals - 248 persons compared to goal of 250 persons • Home Delivered Meals - 20 persons compared to goal of 70 persons • Nutrition Outreach - 28 persons, no goal • LEAP Outreach - 34 persons, no goal • Elder Abuse Education - 73 persons, no goal • Chore Service - 1 person, no goal • Life Line - 1 person, no goal Legal services and home delivered meals were significantly deficient in terms of meeting goals. Goals were met in most other service areas; however, the goals need to be increased. Personal care, respite care, and day care are services where Hispanic elders are significantly under served. Using the above tabulation, 41% of the total 60 plus minority population may have received services (812 out of 1,960). This is an approximate percentage that does not take into consideration duplicated counts. The 812 minority elders served represents 16% of the 5,068 total persons receiving services in 1993, well above the percentage of 60 plus minority.elders (11%). 22 94114n Table 7 0 CV o 0 CV U') r 0 N Or CZ .C � N O a "CO Up Cn _.se O ziz CO ! . 4so o Cl) Cu LY L rgkii Va O (� d m co .., co stst c . '{ti't 1(gr sa co ol, �c3. s ue`:. N (fit: l'^^.F /YK b x Mn V) littalintlitMikt -D A a) Cu C u) 4-I co • z to 941190 Needs of the Low Income and Minority Population As far as the Area Agency on Aging is able to determine a client based needs assessment has never been conducted to determine needs from the perspective of the Hispanic elder. This will be a principle goal of the Area Agency during the period of this Four Year Plan and is detailed in the specific objective section below. However. from a historical and anecdotal perspective the needs of the Hispanic elder appear to result from: • isolation due to language and cultural barriers • greater numbers living in poverty • history of less access to health care • history of prejudicial treatment Specific Objectives to Meet Needs During the next four years the Area Agency on Aging proposes to make marked changes in outreach approaches to minority elders. For nearly twenty years the Area Agency has relied on the experience and expertise of the Catholic Community Services Hispanic Elderly Outreach Program to address the needs of Weld's Hispanic elders. We have determined that a different approach must be taken that will commit a greater number of agencies serving the elderly to learning the skills and techniques needed to work with Hispanic elders. The Area Agency will continue to support the Catholic Community Services Northern Hispanic Elderly Outreach Program, but at a lesser amount of funding. Outcome goals for the program will be changed focusing less on one on one outreach. Our intent is to better utilize the experience of this agency to provide training and technical assistance to a broad range of providers. Our goal is to expand the team of committed Hispanic elderly outreach efforts beyond CCSN and the Weld County Area Agency on Aging staff. We expect that this initiative will take time and patience; however the following specific objectives are proposed for the Four Year Plan: 23 9411 on • Conduct a comprehensive needs assessment of Hispanic elders living in north Greeley by December 31, 1996. • Provide technical assistance and training to rural Senior Aide Stations to help them develop a specific minority outreach program resulting in a 10% increase in Hispanic participation at rural sites. • Put in place a purchase of service agreement with Catholic Community Services Northern to plan and deliver a second annual "Hispanic Healthy Lifestyles Conference" for 100 Hispanic elders to be held May 5, 1995, agreement signed by January 1, 1995. • Provide LEAP outreach assistance to 50 low income seniors annually as a direct service of the Area Agency on Aging - September through March on an annual basis. • The Area Agency on Aging will seek cosponsors for a community workshop for service providers which will inform providers of the needs of Hispanic elders and train providers in the skills needed to conduct culturally sensitive outreach by December 31, 1997. To carry out these objectives the Area Agency will enter into partnerships with the following key organizations: • Catholic Community Services Northern • The rural Senior Aide Coordinators • The City of Greeley Planning Department • The City of Greeley Human Rights Commission • The Greeley/Weld Hispanic Chamber of Commerce • The Rodarte Community Center We believe that the overall result of refocusing our Hispanic elderly outreach program will be increased commitment from a broader base of providers to become involved in improving their service to Hispanic elders. We also believe that this methodology will increase the independence of Hispanic elders in terms of advocating for their own needs. 24 941190 VIII - FIRST YEAR OF THE FOUR YEAR PLAN: 1995 Over the past eighteen years the Weld County Human Services Department, the umbrella agency for the Area Agency on Aging; has initiated a number of resource development efforts. The service pattern for aging services has evolved to a delivery system comprised of many partnerships with local, state, federal, and private sector entities. When viewed in total, Older Americans Act (OAA) funds are only one half of the total funding available to the Area Agency on Aging. The following description of services is divided into three major categories which delineate general sources of funding and whether it is a service provided directly or through purchase of services agreements. Even with these divisions, the intricacies of the partnerships are not completely explained. We believe this to be an indicator of how successfully the Area Agency on Aging has integrated services to develop a continuum of care for Weld older adults. SERVICES PROVIDED DIRECTLY BY THE AAA - NOT WITH OAA FUNDS General Outreach Services: Outreach is an integral activity of every program. It is an activity that is never ending and must be continually evaluated to determine effectiveness. The Area Agency on Aging relies heavily on the rural senior aide coordinators to conduct outreach from 21 rural senior stations county wide. Incorporated as the WELD COS, INC. , the rural coordinators and their centers are generally supported by their local towns. The role of the Area Agency is to provide technical assistance. This is provided through a half time advisor, a member of the AAA staff, who is funded from the federal Community Service Block Grant (CSBG). In 1995, the WELDCOS will rerpive the same level of AAA staffing support. A general fund grant from the Board of Commissioners in the amount of $11,500 will help defray senior center expenses and another allocation of approximately $10,000 of CSBG funds will be available to reimburse senior coordinator mileage conducted in the course of their duties. Since 1993 the Area Agency on Aging has received a Low Income Energy Assistance (LEAP) grant specifically for outreach to isolated seniors. The LEAP grant supports a bilingual outreach worker and member of the AAA staff to make contact with 50 25 naI a nn seniors each year who have not been recipients of other services. Assistance with transportation, housing, eye glasses, dental, medications and the Ensure Food Supplement Program are also arranged when needed. The LEAP outreach funds for 1995 are secured, but the final amount is not known. Multipurpose Senior Centers: Weld County has 21 senior activity centers including the Greeley Senior Activity Center. The Greeley center is supported by the City of Greeley and membership fees. The rural centers are supported by the individual towns in which they are located and with Community Service Block Grant funds which support technical assistance provided by Area Agency staff. Another source of local support comes from the Weld County General Fund. A small annual allocation from the Board of County Commissioners is divided among the rural centers to help pay for operating expenses or provide special services to the memberships. (Same as explained under outreach above.) Community support for the rural centers continues to grow. A survey conducted in March, 1994 evaluated training needs for the senior coordinators (WELDCOS). More than 60% percent requested training in How to recognize and support volunteers, How to work with difficult people, How to market the senior center, and How to recruit and train volunteers. In 1995, AAA technical assistance to the WELDCOS will concentrate on the training needs expressed in this survey. Employment and Training: The Senior Employment Program is funded under the Job Training Partnership Act Older Worker Discretionary monies. Funded since 1985, this program provides employment and training for approximately 20 older adults 55 years of age and older annually. Funding for 1995 has not been secured; however it is projected to continue at the same rate of $28,125 annually. In 1995, the Senior Older Worker Program will coordinate with the North Colorado Medical Center Respite Care Program (a new service funded by AAA MB funds) to recruit and train respite workers. The Job 26 9411g() Training Partnership Act monies of the Older Worker Program will be tapped to support recruitment and training. The combining of JTPA, Title III B, and NCMC Foundation monies will, we believe, strengthen the potential for success of this new program. Transportation Services: The management and supervision of the Weld Transportation System is a responsibility of the Area Agency Director. The Area Agency, therefore, has a direct and integral role in the development of transportation resources. Needs assessments conducted by the Area Agency in 1994 showed in every instance that transportation is one of three consistently expressed needs for rural Weld residents. City of Greeley residents are served by "The Bus" which is funded and operated by the City of Greeley Transportation Program. This system provides both fixed route and door to door service. The Weld County Transportation System provides most rural Weld towns with weekly or bi weekly transportation to larger commercial areas for shopping and medical appointments. The combined financial support for these two E & D services is approximately $635,000 annually. Even so, there are many unmet needs. Many elderly and disabled express, at transportation hearings the need for more handicapped accessible service, need for less notification time to receive service, and in the case of rural communities, the need for more frequent service. Transportation is not an Older Americans Act funded service even though it is continually expressed as a high priority need. Due to the relatively small amount of Title III B funds awarded to Weld County and the enormous amount of money it would take to have a positive impact on this service; the Area Agency believes Title III B funds are better spent on other needed services. In 1995, a comprehensive transportation software package will be brought on line giving the Weld County Transportation System a faster and more efficient means of routing, billing, and tracking clients. Also in 1995 it is expected that city and county elected officials will provide further direction on consolidation of some aspects of the city and county transportation systems with the goal of focusing on the needs of the elderly and the disabled. 27 nil 4OA Case Management: In 1995, the Area Agency on Aging will continue to be the state designated Single Point of Entry (SEP) for Long Term Care. This program, funded entirely by Medicaid, supports four case managers and a Single Entry Point Coordinator to provide community based long term care services to all ages and disabilities. Approximately two thirds of the SEP cases are older adults. A new long term care initiative for 1995 will be a Corporate Eldercare Service which will be offered through a consortium initiated by United Way of Weld County. This consortium, called the Family Support Network, has a Monfort Foundation grant to address work and family caregiving issues in the work place. A package of eldercare services, extending from information to full blown case management, will be offered for purchase by the AAA/SEP and marketed by the Consortium to local employers. Information and Assistance: Information and Assistance is one of the most vital services an Area Agency on Aging can provide. The Weld County Area Agency on Aging historically has regarded I & A services as an integral component of all AAA related activities. Specific I & A funding from the Older Americans Act is not allocated for this service. There is no lack of qualified agencies and personnel to provide information and assistance. The United Way funds a county wide Information and Referral Agency (WIRS). The Area Agency gives training and technical assistance monthly to a network of rural senior aide coordinators whose principle responsibility is I & A. As many as 30 provider agencies meet bi monthly to keep current on programs and services. Despite these resources, lack of information continues to be a frequently expressed need in studies and focus groups conducted by the Area Agency on Aging. To address this concern the Area Agency will develop a plan of action to increase consumer knowledge about where to call for information. This plan will be ready to put into effect beginning January 30, 1995. 28 41111 can SERVICES PROVIDED THROUGH PURCHASE OF SERVICE AGREEMENTS Legal Assistance Services: Legal services for older adults is available in Weld County through the private sector, Colorado Rural Legal Services, Weld County Legal Services, Inc. and the Area Agency Senior Legal Aide Program. The Area Agency contracts with a private attorney for case consultation and court time. In turn, the contract attorney provides legal supervision to a paralegal who is a member of the Area Agency staff. For many years there had been a waiting list for AAA senior legal services. An analysis of legal service requests showed that common wills were taking over the service capacity of the program. In response, the AAA recruited private attorneys to accept will referrals at a reduced rate. A priority service list excluding wills was developed with the approval of the AAA Advisory Board. By focusing legal assistance on the priority areas of life threatening situations, assistance and advice in applying for public assistance, personal rights issues, and education and information the Area Agency Senior Legal Aide Program is able to respond to all legal requests in a timely manner. Unless homebound or terminally ill, all other will requests are referred to private attorneys. In 1995, the Area Agency Senior Legal Aide Program funding will remain stable. However, the paralegal will increase the number of informational sessions at rural senior centers throughout the county. The goal is to help older adults become more knowledgeable and proactive on senior legal issues. With the same resources, it is our goal to balance individual case consultation and information provision to citizens in community settings. The increase of access to information is consistent with needs assessment results. In Home Health Care: One of the most frequently requested services from tabulations of I & R rails to the Area Agency is for home health care. The availability of home health care services is extensive in Weld County, particularly in the Greeley and areas surrounding Greeley. Still, for many seniors this is not an affordable service and too frequently not supported by third party insurers. The Area Agency believes that home health 29 941190 care should be a long term care service that is funded by private insurers and by Medicaid and Medicare at an adequate level to meet most in home health needs. In the meantime, the Area Agency on Aging will continue to provide limited funding for elders who need homemaker/home health care and cannot afford the full cost of the service or who have no other means of third party reimbursement. In 1995, this funding will be increased from$21,390 to$22,390. This small increase will have little impact on this service gap. Counseling Services - Mental Health Peer Counseling has been an Area Agency supported service through Title III of the Older Americans Act since 1976. This program counsels over 200 elders throughout the county each year. A trained peer counselor is sent to the home of an older adult who is experiencing problems such as depression, loneliness, separation from family, difficulty coping, anxiety or other mental health problems. The Area Agency on Aging believes that in home counseling is a vital link in the development of a long term care continuum in Weld County. Peer counselors are instrumental in helping an older person cope with the day to day stresses associated with growing old and frail. The peer counselor also is a link between the elder and other services. In 1995, the Area Agency on Aging will fund this program at the same level of$23,737. A new initiative of this program will be to start a day treatment program 2 days per week for the chronically mentally ill elderly. Area Agency funding only represents about 25% of the resources available to this program, making this a valuable partnership for the Area Agency on Aging. Adult Day Care Eldergarden Adult Day Program, Inc. has received funding through a purchase of services agreement with the Area Agency on Aging since 1985. Adult day care began as a little known and rarely utilized. Several years ago this program almost closed. Now, the average weekly attendance in Greeley is 35 participants. At the satellite site in Fort Lupton (South Weld) attendance is at 12 participants. Needs surveys and anecdotal information support the fact that respite care is an often expressed community need. Eldergarden is one way for families to have time apart. In 1995, Eldergarden will extend hours of service in Greeley to include 7:30 30 941190 a.m. to 8:30 a.m. and 3:30 p.m. to 5:30 p.m. Saturdays will be added with service available from 9:00 a.m. to 3:00 p.m. The Area Agency on Aging will increase funding to Eldergarden in 1995 by $500.00. Also in 1995 planning is underway for Eldergarden to apply for Community Development Block Grant monies through Weld County Government to design and build a free standing adult day center in Greeley. It is highly possible that another compatible agency serving elders would co locate with the program maximizing opportunities to share administrative overhead. Home Delivered Meals Meals on Wheels, Inc. of Weld County has received Older Americans Act C2 funding since 1977. The increasing number of very old, very frail elderly in Weld County matches national trends and is a strong indicator for increased home delivered meals options. Should federal funding increase, home delivered meals would be a priority for increased funding. Areas where increased service would be given consideration are: subsidies for more older persons who qualify for the meal, but cannot afford the full cost of the meal, an added breakfast meal for very frail clients currently enrolled in the program, and expansion of service to all rural areas of Weld County. Congregate Meals Approximately 2,800 seniors participate annually in the congregate meal program. Unlike many regions nationwide; the congregate meal program in Weld County continues to be very successful in most of the 22 rural communities where this service is provided. In 1995 the Area Agency on Aging will fund congregate and home delivered meals at a level commensurate with 1994 levels of funding. Also in 1995, the Weld County Senior Nutrition Program will conduct a voluntPor recruitment effort to increase volunteers. In Weld County all meal site activities are handled by volunteers. As participants become older and more frail; it is more difficult to retain enough volunteers. Younger participants must be educated about how critical volunteers are to the program. 31 941190 In 1995 the number of sites converting from paper to plastic plates will increase by two bringing the total to five sites using plastic ware over paper. Cost and environmental concerns are primary to this initiative. In 1995 the Area Agency will begin an examination of the potential of current designated meal sites to become self sufficient resulting in less reliance on the OAA congregate meals program for support. Hispanic Elderly Outreach The Catholic Community Services Northern Hispanic Elderly Outreach Program has been funded by the AAA since 1978. Bilingual staff contact approximately 400 Hispanic elderly each year. In 1995, Title III B funding for this program will be decreased from the current $25,653 to $21,000. Another $2,500 in Part F Health Promotion funds will be awarded the program to conduct an Hispanic Elders Health Promotion Conference as an extension of their outreach work. A summary of the rationale for this new focus is described in the Section VII, Targeting Program. Disease Prevention and Health Promotion Services: Two health promotion projects were funded through a Request for Proposal process in 1994. The Hispanic Elderly Conference, "Promoting Healthy Lifestyles", was very surrnssful and will be refunded for 1995. A diabetic outreach and education program for Hispanic elders of south Weld County was funded and is progressing slowly. The Area Agency proposes to RFP the remaining Health Promotion Part F funds in January, 1995. Respite Care A volunteer respite care program has been an Older Americans Act funded service since 1990. Both demographics and needs assessments indicate this service to be a high need for Weld families in 1995 and many years beyond. Because of waiting lists and many indicators pointing to the need for greater arrPss for respite care; the Area Agency will support a new approach to the delivery of respite services in 1995. A proposal by Seniors Are Special a program of the North Colorado Medical Foundation to provide respite care using paid respite workers will be funded by the Area Agency for the first time in 1995. 32 941190 The Area Agency rationale for funding this model over a volunteer respite model is the belief that the demand for respite care is sufficient to market the service at a cost. The Area Agency will target Older Americans Act funds for start up costs. In the long run, the Area Agency hopes that the program will become self sufficient thereby freeing up the $10,000 award for another initiative. SERVICES PROVIDED DIRECTLY BY AAA WITH OLDER AMERICANS ACT FUNDS Advocacy, Coordination, and Program Development These activities are a critical responsibility of the Area Agency on Aging. However, the cost for carrying out these activities is a component of the AAA administrative budget. In 1995, the Area Agency Director will devote considerable time to the development of resources in the primary need areas of transportation, respite care, corporate elder care, and housing. Ombudsman Services: The designated local long term care ombudsman for Weld County is Mindy Rickard of the Area Agency on Aging. This position is supervised by the Area Agency Single Entry Point Coordinator. (See Table 8) Nine months ago this position was increased from a half time to three quarter time FTE. The ombudsman is assisted by two volunteers who visit nursing home and Personal Care Boarding Home residents. In 1995, the number of Ombudsman volunteers available for visitation and monitoring will increase from two to five. Weld County has 735 nursing home beds and 5 facilities. There are 210 Personal Care Boarding Home beds and 18 facilities operational on the average at any given time. Persons living in nursing homes and personal care boarding homes are among the most frail and vulnerable of older adults in Weld County. The priority issues that our region faced in the last year centered around staffing problems. The lack of CNAs and their level of training continues to impact the quality of care the residents are receiving in long term care facilities. CNA turn over is precipitated by low wages, poor benefits, and low regard for their work. In 1994, through a funding initiative led by the University of Northern Colorado, a consortium of nursing homes and home health agencies, are participating in a CNA 33 9411.99 \ — g Table _ § % m o ) { 0 a - q a 0 z c., , , SEo 4 ) ) § W27 a % 2xx � » . 2 b L S \ � � � & / ■ f% ) s $ w 2. ) 227 J ) § | k ° . / \\\\ 2 � � \ RI � 0 0 • a - 0 _ @ o % - ' • k § ; ■ f § § 4a ■ CCx CO 0 @ • c an kk 7k ' § a & p O L. E EL' 0 Ca' c � � e 2 . © , . O) Q z . _ at d b / C 4?.... ok � I §2 & § lin 2 ke O1 E � � ) f ■ m � z Et 0 � t e ' x ) � 0ut § c) 5 § % k k a \ § k .0Q % } 2v 2 ' © � ` () .5 - ° 1 ° i. 0 0 e as 3 L. $ If7§ . ) 2 . k #t k � 4 ° J ] ti \ \ k \/ to § ) 2 ictI _ al c -0. � v @k 4 _ % k =j a _ mt a • ; c § � � 5 c § \ kk lb C. o � $ \ \ L. Z � ti2 , 01 \ E -o 413 0. % E � k A. aA § tact Ce- aG � k ee .0m a3 2 2 L5 ) to k E C' U ) § § To • ik / E R Mfa O t . • o it t. § & k \ kEk k \ o Z • . co ■ Z , ft. to O 0.• 5m 941110 Training Program. The program is directed and advised by the consortium. The quality of the training is high and the consortium concept is very positive for the community. However, there is no indication at this time that CNA turnover has decreased. The isolation of residents in Personal Care Boarding Homes is the most serious problem, we believe, for residents. This leads to lack of social and recreational activities. In 1995, the ombudsman will develop a one on one training program for PCBH operators using video tapes and individual discussion sessions. The goal is to address training needs without providing group workshops which historically have been poorly attended by PCBH operators. Also in 1995, a cooperative program with the Eldergarden Adult Day Program will continue. Eldergarden staff provide recreation and social services on site at selected personal care boarding homes. This creative partnership is proving surressful. Elder Abuse Education: In 1993 the Area Agency on Aging initiated a major elder abuse education campaign. Using Part G Elder Abuse funds under the Older Americans Act, a total of 39 presentations were made to various groups around the county. These groups included nursing homes, town boards, university classes, senior centers, local civic groups, police departments, health providers, and radio stations. The second phase of the Weld County Elder Abuse Education Campaign, to begin in January of 1995 will focus on a major elder abuse conference. It is anticipated that this will be a joint venture with the Greeley/Weld Interfaith organization. The continued allocation of Title VII monies for elder abuse education to the local level is critical to the success of the initiative. Also in 1995, the Weld County Department of Social Services will increase by one FTE adult protection worker. A adult protection team will be formed with the Area Agency on Aging having an active membership on this team. 34 941190 Ensure Food Supplement Program The Area Agency initiated an Ensure Food Supplement Program in conjunction with the Weld Food Bank in 1992. Certification is handled by the AAA and distribution occurs at the food bank. At last count 72 cases of Ensure and Ensure Plus are being distributed monthly to 20 seniors who have a doctor's prescription for the food supplement. This budget neutral program continues to grow. In 1995, it is expected that this program will be discontinued due to the inability of Ross Laboratories to continue this contract with the Colorado Nutrition Program. SUMMARY OF RATIONALE FOR SUPPORTING THE ABOVE SERVICES From a historical perspective, the Weld County Area Agency on Aging has supported and promoted services that address needs of rural elders (rural senior centers and transportation; frail elders (in home health care, adult day care, respite care, home delivered meals); and services that maintain independence (congregate meals, peer counseling, legal aide, and employment). In 1995, the Area Agency will continue to maintain a balance of support in these areas. However, as demographics change and as the needs of elders become more focused on long term care; small but appropriate changes in resource development and support are evident from the program listing above. • The Area Agency is funding a new and different respite care proposal that will be a partnership with the North Colorado Medical Foundation to develop a pay for service respite service. AAA funds will be start up in nature with the goal of developing a self supporting program. • New dollars for nutrition programs will be targeted to the frail (home delivered meals), the isolated (rural Weld), and toward developing local operating congregate meal sites. • Community Development Block Grant monies will be tapped through Weld County Government to build a stand alone day care facility allowing for expansion of hours and days of service. • Coordination and consolidation efforts between City of Greeley and Weld County Transportation Systems will continue to maximize limited resources 35 941190 • Corporate eldercare services will grow through membership in the Family Support Network Consortium sponsored by United Way. • An information dissemination plan will be written to improve the availability of information to elders and their families. • The Area Agency will support the Single Entry Point case management service by expanding availability of this service to private citizens in the work place, agreements with national family support insurers, and through fee for service. • The Hispanic Elderly Outreach Program will be funded, but with a new emphasis-increasing technical assistance to agencies in how to serve Hispanic elders. • An additional $1000 will be targeted to home maker/home health care despite the fact that this service should be supported by governmental (Medicare & Medicaid) and private health insurers. IX - WAIVERS Direct Service Provision Waivers An Area Agency must request a waiver from the state agency in order to directly provide any services not directly related to an area agency's administration functions. The Weld County Area Agency on Aging has determined that there are no services beyond those permitted under the regulations that are being provided directly by the Area Agency. Waiver of Minimum Percentages Required for Priority Services The $19,550 appropriated on the average annually for senior legal aide represents 15% percent of the Title III B allocation for legal services and exceeds the 3% minimum. 36 411 1 on The $45,127 appropriated on the average annually for in home services (homemaker/home health care and peer counseling) represents 33% percent of the Title III B allocation for in home services and exceeds the 15% minimum. The $21,000 allocated for Hispanic Elderly outreach represents 15.4% of the Title III B allocation for access services and falls short of the required 25% minimum for access. The Area Agency is seeking a waiver for the following reasons: • Two public hearings were held on the Area Plan. Access services were specifically addressed. See Section V for a summary of the public hearing and review process. • The Area Agency has successfully obtained other sources of funding for access services. CSBG and UMTA grants for transportation, CSBG and local town grants for outreach and information and referral, and a LEAP Outreach grant total $158,850 annually for these services. 37 ci.:11 on I X — ATTACHMENTS * Meal Service Chart, AAS 260 * Regional Advisory Council Membership, AAS 270 * AAA Staffing Profile and Organizational Chart, AAS 280 * Community Focal Points and Senior Centers, AAS 290 * Senior Center Facilities Acquisition, Construction, or Alteration, AAS 293 (not applicable) * Cost Distribution Method * Proposed Purchase of Equipment (not applicable) * Needs Assessment Instruments 38 941190 In Cr) a) T N >- av too N LL' m a 0 n n N r r N- N r N- N N N N r N N- , O N O d m .0 la E N cc E W y o d i- 3 0 CO N r r r CO N r r N r r r N r r r r N r N )O a) a) _ O. a) a) N C L C E C o L ct a) O 3 .. m N w a) Ca: 0 a) o Eo m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O 0 0E8 -8 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 z z o co O O N Lo C L) O O O O O O O 0 O O O O O O O O O 2 O 2 O CD a) 222222222222 2 2 2 2 2 )- Z } Z N N U L c) O 3 E m O N O r Ca F. o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O �' 5E c) z z z z z z z z z z z z z z z z z } x } z N n. + 0 c O a) N 0 ..- .- 0 2 G X X X X X X X X X X X X X X X X X X X X XN m .= N27.4 _ — O m NQ1 C CO NU CD c N O O a7 LT CD L - d V d C >a) U) 0. 0.0 X X X X X X X X X X X X X X X X X X X X X N I— CC a I w o c a) — y ^ 3 r r = ` N = _ _ .ai 0 0 c '0`o c ,c a> c 2 0 c a) c U U `o_ c 0 ¢ o o iA o •`o z' d m 0 d c d a) `? r c 'c o y. COCn a d 110C 'c c .Z 0 0 c d 0 c `m = a 0 E c Q ro o o m z' m ¢ U ci 0`0 • U 0 U E � N a E cLll a) �) N `O z c c o con (n 4 c . E c `0 ° U a0) al rn o fn 'O .Q (n (n 3 0 (n o o y d al N C CC P al O J ca 8 > N d N _ = a d 0 c N a N N a) a) V Q �+ O C fJJ d O a) Z C N O L o Y CO = "O ≥ = = F J 2 o > d v d d = o d m 8 d = o m m 0 c m O I— m m w in C7 0 0 x v Y J J E z d 1 cc D 3 1- H 941190 REGIONAL ADVISORY COUNCIL Region FY List name of all persons presently serving as members of your Regional Advisory Council. Name Organizational County Low Minority 60+ Dis- Affiliation or Income abled Town Mary Ellen Faules Insurance Greeley No No Y No Dr. Richard Foe Retired Greeley No No Y No Mary Fox WELDCOS Kersey No No N No Renee Gonzales Housing Lupton No Yes N No Priscilla Kimboko University Greeley No No N No Grace LeBlanc Retired Greeley No No Y No John Lee Transportation Greeley No No N No Suzanne Listemann Religious Eaton No No N No Chic Renfro Retired Lupton No No Y No Jim Riesberg Consultant Greeley No No N No Pedro Rucobo Retired Greeley No Yes Y No Donn Shedd Senior Ctr Greeley No No N No Wilbert Wiedeman Retired Evans No No Y No • AAS 270 (7/94) Page 941190 AREA AGENCY ON AGING STAFFING PROFILE Region FY AAA Personnel Number # Of # Of Categories Of Minority FTEs FTEs FTEs Paid With OAA Funds 1. Agency Executive/ 3 0 .50 Management Staff 2. Other Paid Professional Staff B Functional Responsibili A. Planning .20 0 .10 B. Development 1.20 0 .70 C. Administration 4.20 0 .55 D. Service Delive 19.75 0 1.85 E. Access/Care Coordination 5 0 .10 F. Other 1 0 .50 3. Clerical/Sus sort Staff 1 1 .25 nc 4. Volunteers 60 15 ••; 5. Total AAA Staff 95.35 16 4.55 FUNCTIONAL RESPONSIBILITIES A. Planning--Includes needs assessment, plan development, budgeting/resource analysis, service inventories, standards development and policy analysis. B. Development--Includes public education, resource development, training and education, research and development and legislative activities. C. Administration--Includes bidding, contract negotiation, reporting, reimbursement, accounting, auditing, monitoring and quality assurance. D. Access/Care Coordination--Includes outreach, screening, assessment, case management and I&R. E. Service Delivery--Includes those activities associated with the direct provision of 2 service which meets the needs of an individual older person and/or caregiver. Page AAS 280 (7/94) 941190 V 0 r O 2t U :. % o r -� O U a in tOn o y Ta mZ '> H E - d r E ,`o Cy C y o tot aci Q c 8 y = = Qy o Y ea r V I t t en y n t LTJ y c 3rr ` U o v - - '� I W `�° :O m m a CO m0 c .21:: o h:El.. CO � U O Ai y R a O i u) 0O a • Qag � = 03 mc a � N C) E 03 cf) N U c lb a`� n Ca U D i � �gd P C Z. = *O ooyo' c Al e � O w `oa � � v y E y Q O dchi Y cull O (5C y- E °1 'ov . v .n`°oci a coO � yO. ` ciYyo, a, '1 jo C O O L U d ¢ �_ ¢ 1 2 a CD m N 3 'cv ' sc CD ,S3 Q � •� m ≤ �a C0 If co v» OY G a= W E :E CCI I m m y 1. coc 'c Q 0a R 'E I ae Q 6- 'e n L w .fin 0 W a c y y 's F.P. N y 'c c c " c c it n .9. 8g ‘. 'ii O V h. I- U o c En Z al . U o d d a y E a • vi a " : U -'l = E a, d • e " E T C y •e . 'o Q 901 a o o C v = ocn H o f d a o S. to: R c U 'o c u v v .: cU ial m 03 b. E c �(to d W oy n e o > c o d o a It _ °1 Q o C E ` O IL v cc co y c o .d a a 1�0 0 O U . cn mZ . atu O a - . Qm 941190 Community Focal Points and Senior Centers A 8 C D E F List all focal point and senior Focal Senior III-8 high low High centers including nutrition sites Point Center funded income minority Greeley Senior Activity Center X X X X 1010 6th Street Greeley, Colorado 80631 Phone: 350-9435 Ault Senior Citizens Center X X 204 1st Street Ault, CO 80611 Phone: 834-1325 Tri Town Senior Center X X X 106 5th Street Dacono, CO 80514 Phone: 833-4300 Eaton Senior Center X 223 1st Street Eaton, CO 80615 Phone: 454-2937 Evans Senior Center X X X 3700 Golden Evans, CO 80620 Phone: 339-5344 Fort Lupton Senior Center X X X X 515 4th Street Fort Lupton, CO 80621 Phone: 857-4080 Johnstown Senior Center X X X 101 Charlotte Street Johnstown, CO 80534 Phone: 587-5251 Kersey Senior Center X X X 415 1st Street Kersey, CO 80644 Phone: 352-8394 Milliken Senior Center X X X X 105 Harriet Avenue Milliken, CO 80543 Phone: 587-2484 Pierce Senior Center X X X X 221 Main Avenue Pierce, CO 80650 Phone: 834-2655 Windsor Senior Center X X X X 301 Walnut Windsor, CO 80550 Phone: 686-7476 941190 Community Focal Points and Senior Centers Continued: A B C D E £ List all focal points and senior Focal Point Senior III-B High Low High centers including nutrition sites Center funded Income minority Hill and Park Senior Center X X 4225 Yosemite Drive Greeley, CO 80631 Phone: 330-8619 After Glows Senior Center X X X 0501 Willow Drive Brighton, CO 80601 (Lochbuie) Phone: 659-8262 Nunn Senior Center X 755 3rd Street Nunn, CO 80648 Phone: 897-2459 9411.Q') Region 2B FY 95 SENIOR CENTER FACILITIES Total Federal/ Local Local Other Budget State Cash In-Kind Resources 1. Acquisition 2. Construction 3. Renovation/ Alteration 4. Grand Total 5. Name and Address of the Grantee: NA 6. Name and Address of the Sr. Center: (if different from the grantee) 7. Date of Award (or anticipated date): 8. Area Agency Assurance of no suitable alternatives. In the case of acquisition or construction of a facility to serve as a Senior Center, provide a summary of efforts made to locate or lease a facility. 9. Grants in excess of $2,000 must comply with the requirements of the Davis-Bacon Act. Attach an explanation of how this requirement will be met. 10. Provide a demographic profile of the center participants (e.g., percent low-income minority). NOT APPLICABLE Authorized Signature AAS 293 (7/94) 941199 STATE OF COLORADO FOUR YEAR AREA PLAN TITLE III - OLDER AMERICANS ACT Fiscal Years 1995 - 1998 Due: November 15, 1994 Colorado Department of Human Services Aging and Adult Services 1575 Sherman Street, 4th Floor Denver, Colorado 80203-1714 Grantee Organization Weld County Board of Commissioners Address Centennial Building Greeley, Colorado 80631 Area Agency Name Weld County Area Agency on Aging Address 1551 North 17th Avenue. P.O. Box 1805 Greeley, Colorado 80632 Grant Award Number (FY 1995) (7/94) 941190 r � MEfrlORAf DUfn W. H. Webster, Chairman Weld County Board of Commissioners November 30, 1994 t Illik TO Date ` 1 �I Walter J. Speckman, Executive Director Human Services COLORADO From Area Agency on Aging Four Year Plan Subject. Enclosed for Board Approval is the Weld County Area Agency on Aging Four Year Plan for the years 1995 through 1998. This plan is a requirement of the Older Americans Act and is written to guide the activities of the Area Agency for the next four years. The results of several formal needs assessments, analysis of census data, evaluation of program waiting lists, information from focus groups, and advice and input from the Area Agency on Aging Advisory Board have determined the principle initiatives for this planning period. High priority initiatives will be transportation, information dissemination, housing, and volunteerism. These four concerns were most consistently expressed as problems or issues to be promoted in Weld County. Also, the plan outlines the funding proposals for the first year of the plan, calendar year 1995: Proposed funding is for the following agencies and programs: Weld County Senior Nutrition - $134,332 • Meals on Wheels home delivered meals - $28,400 • RVNA Home Health Care - $22,290 (increase of $1000) • Seniors are Special Respite Care - $10,000 (new program) • Eldergarden Adult Day Care - $14,950 ($500 increase) • Charles Connell, Attorney Senior Legal Program - $5000 • Catholic Services Hispanic Outreach - $21,000 ($4,653 less) • Catholic Community Services Health Promotion - $2,500 • Weld Mental Health Peer Counseling - $23,737 WELDCOS, Inc. training and staff development - $500 Please call Linda Piper, Director Weld County Area Agency on Aging if you have questions at extension 3320 941190 Hello