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Home My WebLink About982081.tiff RESOLUTION RE: APPROVE FOUR YEAR AREA PLAN FOR AREA AGENCY ON AGING AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Four Year Area Plan from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Human Services Department, Area Agency on Aging, to the Colorado Aging and Adult Services Division, with 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 from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Human Services Department, Area Agency on Aging, to the Colorado Aging and Adult Services Division be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair 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 26th day of October, A.D., 1998. BOARD OF COUNTY COMMISSIONERS W COUNTY, COLORAD ATTEST: f,' 'lo Constance L. Harb rt, Chair Weld County Clerk to the :o- . r ;4 i ' q ica _ CC�� Q) ' W. I-ItiLW bster, ro-Tem BY: Deputy Clerk to the : ;" UN V> rge . Baxter APP AS TO M: ale K. Hall Barbara J. Kirkmeyer • 982081 CC //.5 / c HR0069 I ill \(%; 1/4 r•II MEMORANDUM ' Constance L. Harbert, Chair TO: Board of County Commissioners DATE: October 23, 1998 C FROM: Walter J. Speckman, Executive Director, Human Services \j ) + COLORADO SUBJECT: Weld County Area Agency on Aging Four Year Plan Enclosed for Board approval is the Area Agency on Aging Four Year Plan for the years 1999 through 2002. This Plan is a required document for the state Aging and Adult Services Division and spells out the major needs, goals, and services to be addressed by the Area Agency on Aging during the designated planning period. The Plan includes results of a comprehensive needs survey completed on 360 Weld older adults in March 1998; major initiatives approved by the Area Agency on Aging Advisory Board in the areas of dental care for low-income elders, transportation for frail elders, in-home respite care, advocacy, high levels of loneliness reported by seniors; and finally an accounting of expected services to be provided. There are no funding requests as a part of this Plan. If you have questions, please call Linda Piper at 353-3800, extension 3320. • 982081 STATE OF COLORADO FOUR YEAR AREA PLAN TITLE III - OLDER AMERICANS ACT Calendar Fiscal Years 1999 - 2002 Due: November 16, 1998 Colorado Department of Human Services Division of Aging and Adult Services The Petroleum Building 110 16th Street, Suite 200 Denver, Colorado 80202 Grantee Organization Weld County Division of Human Resources Address 1551 North 17th Avenue . P.O. Box 1805 Greeley , Colorado 80632 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 1999) Grant Period From January 1, 1999 To December 31, 2002 (6/98) 91,O8/ Table of Contents Section I: Introduction Statement of Intent ii Advisory Council Review Statement of Assurances iv Audit Assurance v Section II: Executive Summary 2 Section III: Description of the Planning and Service Area 3 Section IV: Identification of Unmet Needs of the Elderly 5 Section V: Public Input 14 Section VI: Community Initiatives 15 Section VII: State/AAA Planning Initiatives: 18 Section VIII: Targeting 19 Section IX: Overview of Services: 1999-2002 19 Section X: Waivers 23 20 ATTACHMENT A 26 ATTACHMENT B ATTACHMENT C 27 ATTACHMENT D 28 ATTACHMENT E 29 ATTACHMENT F ATTACHMENT G 29 ATTACHMENT H 9.jos' STATEMENT OF INTENT The four-year area plan is hereby submitted for REGION I IB Planning and Service Area for the period January 1, 1999 through December 31, 2002 . It includes all assurances and plans to be followed by the Weld County Ares Aganry nn Aging 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, Division of Aging and Adult Services for review and approval. /c -/o -d (Signed) (Date) (Dir`�c tor, AT Agency on Aging) lC�-lG - ,r (Signed) �_— (Date) (Exe tive Director, Grantee Organization) The governing body of the Area Agency on Aging has reviewed and approved the 1999 — 2002 four-year area plan. t/ If!76/4R (Signed) g-.7.Zti-taea,L�, 0C f (Date) (Title) Conctanre I, Harbert (Chairperson of Governing Board, County Commissioners, etc.) ii (6/98) 952oS/ 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 transfers budgeted between Parts B, C-1, and C-2; 2. Statement of intent and justification for use of Part B funds for Advocacy, Coordination, and/or Program Development; 3. Application for waiver for the Area Agency on Aging to provide direct services; and 4. 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. /O- ZZ - 9r (Signed) A ma ce (Date) (Chas erson, Area Age y on Agirffi Advisory Council) (6/98) 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 AM 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. iv (6/98) 9i_27()Y' e. The MA 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 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 MA, 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 MA 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 AAA 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 9,1.2 as, by the area agency on aging to carry out a contract or commercial relationship that is not carried out to implement this title. 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 AM 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. 98908 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 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. /e) '/G (Signed) (Date) (Director, Area Agency on Aging) iv (6/98) 9$fi(9:5i AUDIT ASSURANCE Single Audit Clause All area agencies on aging and subgrantees shall comply with the requirements for audits as established by the U.S. Office of Management and Budget (OMB) Circular Number A-133, which establishes a uniform system of auditing for states, local governments and private non-profit organizations. A state, local government or private non-profit organization has an audit requirement for each fiscal year in which it expended Federal awards totaling $300,000 or more. For purposes of state and local governmental agencies, the term independent auditor means a state or local government auditor who meets the independence standards specified in Government Auditing Standards. Assurance of Compliance /(' -9er (Signed) h g (Date) (Director, Area Agency on Aging) SELF-ASSESSMENT ASSURANCE The last completed self-assessment instrument for Region-T-2 for CY 1997 was found to be in compliance with state regulations. I verify that relevant documentation is on file at the area agency on aging to indicate continued compliance. Assurance of Compliance /0 —lG -1� (Signed) -C1, (Date) (Director, Area Agency on Aging) v (6/98) 9t os' Section II: Executive Summary \Veld County is a large, mainly rural county situated in northeastern Colorado. The population of the county is 147,502 according to the 1995 population estimates from the Division of Local Affairs; classifying the county by census definition as a Standard Metropolitan Statistical area despite the rural nature of the county. Twenty—eight towns and villages are scattered throughout the county. Each of these communities has experienced population growth during the past four years. Some of this growth has been rapid and is regarded by nearly 29% of Weld's elders as \Veld County's most serious problem. Preparation for this Four Year Plan (1999 - 2002) has centered around the results of a 1998 Needs Assessment of Weld County Older Adults conducted by Dr. Robbyn R.Wacker and Dr. Carol A. Gosselink from the University of Northern Colorado. The goal of the needs survey was to collect sufficient data through telephone and mail surveys to assess the needs of Weld County residents age 60 and older. From interviews with 360 Weld County older adults we have learned that nearly 44% of them are living on incomes of$15,000 or less. We believe this information debunks the popular myth that most elders are living comfortably at the expense of the needs of younger generations. We also learned that a significant number of elders (22%) reported being lonely. Even with a wide range of programs and services for elders, there is still a need for communities to do a better job reaching out to lonely, isolated elders. Lack of access to affordable dental care also was reported as a high need. This study also emphasized the fact that Hispanic elders report higher needs in nearly every category. Utilizing an extensive analysis process with board members, board sub-committee members, staff, and a public hearing; the Area Agency on Aging has identified five (5) community initiatives which the Area Agency on Aging will focus on over the length of this planning period. Specifically, we will work to impact the incidence of reported loneliness among seniors; to increase resources for dental care for low-income elders; to increase transportation options for elders particularly Hispanic elders; to increase access to in-home respite care; and to alter our methods of impacting needs by concentrating on advocacy and resource development through educational and coordination efforts. Lack of sufficient statewide support for Older Americans Act Programs will be the number one state-wide priority issue of this Area Agency on Aging. Increased federal and state mandates without sufficient resources has seriously weakened the ability of Area Agencies on Aging to address even the most basic requirements of our agency. We will continue the educational and advocacy campaign begun in late 1997 to alert policy makers to the long neglected needs of Older Americans Act Programs. Other statewide issues that will be addressed by the Area Agency on Aging in the next four years is performance-based outcomes and care giving. Finally, the Area Agency on Aging will publicize the findings from the 1998 Needs Assessment of Older Adults in meetings and forums throughout Weld County. We intend to educate policy makers and the public about the needs of Weld's older adults and help communities to mobilize locally to address concerns identified from this first time comprehensive needs survey. 2 Section III: Description of the Planning and Service Area Population Profile The total population of Weld County, according to the 1995 population estimates of the Division of Local Affairs is 147,502. The projected estimate for 1999 is 160,578. By the year 2002, the total population for Weld County is expected to rise to 170,000. The number of elders age 60 and older living in Weld County in 1995 was 19,210. The 80 plus population in 1995 was 3,559. The projected estimate for 1999 is 20,558 for elders age 60 and older and 3,872 for elders 80 and older. These numbers are expected to rise to 21,880 for the 60 plus population and 4,097 for elders 80 and older by the year 2002. Weld County consists of twenty-eight small towns in addition to the City of Greeley. These communities vary in size from 108 for the town of New Raymer to 7,088 for the town of Evans; Greeley's estimated population is 67,410, according to the 1996 estimate update of the Colorado Division of Local Government. Several of the rural communities have high percentages of 60 plus residents. 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. Greeley, whose population is just over 60.000 serves as a regional hub for medical, educational, employment and retail needs for most of its residents. However, residents of south Weld County tend to conduct business in Brighton, Longmont, Boulder, and the Denver suburbs. Twenty-eight 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. Regional Trends: • The most significant regional trend impacting Weld County is growth. Housing starts, for example, increased during the first half of 1998 by 68.6% according to the Colorado 3 9g. csi Economic Chronicle. Most small rural Weld communities whose population has remained fairly stable for many, many years are growing—some quite significantly such as the community of Windsor. Plans are being made for major housing developments in the coming years for several of Weld's rural towns. The 1998 Needs Assessment of Weld County Older Adults indicated that 28.6% of respondents cited growth as the most pressing problem facing Weld County. Respondents' feelings centered around concerns that unbridled growth forces living expenses to rise and forces fixed-income persons into poverty. Many others were concerned about the loss of farm land to housing and industrial expansion. • The population growth has stimulated demand for housing. Status of the housing market in the Greeley/Weld market also is changing significantly. Housing costs have been increasing as well. The median home price in Weld County climbed from $68,118 in 1990 to $123,868 in 1996. The average rent increased 43% from 1990- 1996, from $357.00 to $511.00 per month. These trends have specific implications for aged individuals and couples living independently as renters and receiving SSI. For example, after paying FMR(Fair Market Rent) for a one-bedroom apartment, an individual would have $105 left to pay for all other living costs. • Job growth and the economy in Weld County has been positive. The current unemployment rate averages around 3.5%. Between 1990 and 1995 approximately 14,000 new jobs have been created. However, new jobs have been created primarily in the service and retail industry which are the two sectors with the lowest average wages. Due to the concentration of low paying jobs in the Greeley/Weld County region, findings show that 40% of renters cannot afford FMRs for a one bed-room apartment without paying more than 30% of their income for rent. For two-bedroom apartments 48% cannot afford FMRs without paying 30% of their income. These percentages are above the State median of 36% for one-bedroom and 44% for two-bedroom. • 'Assisted Living Facilities continue to be a growth industry in Weld County. Between 1997 and 1998 there was a 21% increase in assisted living beds in Weld County. One new skilled nursing facility also opened. Competition for residents among assisted living facilities is keen, a concern to the Area Agency on Aging in terms of appropriateness of placements and capacity to carry out ombudsman oversight and technical assistance. • Availability of resources specific to senior and care giver needs continues to grow, particularly services generated in the private sector. The increasing problem is funding support particularly for those just about poverty level. Supporting this phenomena is data from the 1998 Weld County Needs Assessment which shows that 44% of those responding to a question on income indicated that Weld County 60 plus seniors have incomes of$15,000 per year or less. 4 9s2oY/ Section IV: Identification of Unmet Needs of the Elderly Needs Assessment Methodology For the purpose of the four year plan, a comprehensive needs assessment survey was conducted for Weld County older adults, age 60 years of age and older. The Area Agency on Aging contracted with the University of Northern Colorado Department of Health and Human Sciences to develop and administer the survey. The needs survey directors used three types of data collection: telephone survey, mail survey, and focus groups. A total of 360 older adults, age 60 and over were contacted through these methodologies. Methods were used to ensure the over sampling of rural and minority respondents. The survey was intended to identify the needs and elicit the opinions of elders living independently or quasi—independently. The questionnaire included topics related to employment, volunteerism, care giving, transportation, housing, health and health care, financial concerns, attitudes toward life, and knowledge and use of services. The Area Agency on Aging also conducted an analysis of socioeconomic data, solicited input from staff. providers, advisory council members, rural senior coordinators, and the community at large. Needs Assessment Findings Socio-Deinographic Characteristics of Respondents Of the 360 respondents completing the survey, 66.4% were females and 33.1%were males. Six in 10 (59.7°0) respondents were 60-74 years of age, 33.6% were in the age group of 75 or older, and 24-four respondents (6.7%) did not provide their age. The mean age of respondents was 71.7. The vast majority of respondents (84.7%) were white; people of color represented 16.5% of the respondents. Six in ten were married (58.9%). Widowed respondents represented the next largest group (29.4%), followed by divorced/separated (8.9%), and never married (2.2%). The largest percentage (35.6%) of respondents reported their highest level of education as being high school graduates (or GED recipients). The rest reported their educational attainment (in descending frequency) as having some college (24.4%); 6th through 11th grade (21.4%); a graduate degree (8.6%); a bachelor's degree (6.9%); or less than 6th grade (2.2%). 5 One-half(53.3%) of respondents lived in a two-person household, one-third (33.9%) lived alone, and 11.8% lived in households with three or more persons. The average length of Weld County residency was 38.7 years, with a range of less than 12 months to 93 years. One-hundred-seventy respondents (47.2%) resided in urban locations and 188 respondents (52.2%), in rural locations. Thirty-eight respondents(10.6%)reported 1997 annual incomes of less than$8000; 11.4%,$8000- S10,499; 18.1%.$10,500-$14,999;41.7%,$15,000-$49,999,and 9.7%,$50,000 or more. Thirty-one respondents (8.6%) refused to divulge their annual household incomes. Fifty-eight of the 360 respondents. or 16.1%, reported an income below the poverty level, which in 1997 was $7,890 annually for one individual and $10,610 for a couple. Current Employment Nearly one in five (18.9%) of the respondents reported being employed. Males are twice as likely as females to be employed(28.6%vs. 14.2%,respectively). Among those 60-65 years of age,38.6% are employed compared with 3.6% of respondents age 81 and older. Respondents who worked outside the home for pay averaged 33 hours per week, with a range of two to 65 hours per week. Three-fourths of the employed respondents were satisfied with the hours they worked. When asked to identify the reasons they continued to work, the largest percent (64.7%) of the 68 employed respondents stated that they needed the income. All respondents who were not currently employed were asked"Have you been looking for work?" Only five respondents stated that they were seeking employment. The five respondents had been looking for employment an average of 18.4 weeks,with a range from two to 36 weeks. Volunteerism More than four in ten respondents volunteer in their community. Females are more likely that males to volunteer(45.2%vs.37.0%,respectively). Volunteering remains relatively high for those age 60- 75. At age 81 and older, about three in ten respondents volunteer. White elders are almost twice as likely as are elders of color to volunteer(45.2%vs. 25.5%). Respondents living below poverty level are significantly less likely than the rest of the respondents to volunteer: only about one in four (24.1%) volunteers. Volunteers averaged 17 hours a month. Primary Caregivers When asked, "Are you the main helper for someone who needs assistance with everyday activities, such as bathing,feeding,or helping someone to walk?"30 respondents said yes. The largest percent of care givers were providing assistance to a spouse/partner (60.0%). The rest were caring for a parent(16.7%),child(23.3%),other relative(6.7%),or a friend/neighbor(16.7%). About one-fourth of the care givers were providing care to more than one individual. The average number of hours spent each day as a primary care giver was 10.4 hours. Eight of the care givers stated that assistance with meal preparation would be helpful. Four care givers noted that two hour respite was desirable. Help with bathing and weekend respite were each cited by three care givers,and vacation respite was requested by two care giving seniors. 6 Transportation Forty-five individuals(12.5%)stated that they don't drive. When asked if they currently experienced times when they needed to go somewhere but had to stay home because they had no means of transportation, 16 (4.4%)of the respondents replied yes. While only 3.4%of those age 60-65 have had to stay home on occasion due to lack of transportation, three times that many seniors age 81+ have experienced this unmet transportation need. Elders of color are nearly twice as likely as white elders to have unmet transportation needs(7.3% for elders of color as compared with 3.9% for white seniors). Being below poverty level makes respondents nearly four times more likely than respondents above poverty level to encounter situations in which they cannot obtain the transportation they need (12.1% vs. 3.3%). Housing The majority of respondents (75.6%) currently lives in a free-standing home. The rest of the respondents live in apartments(9.7%),mobile homes(8.6%),townhouses/condos/duplexes(5.0%), rooms in private homes (0.3%), or some other type of housing (0.6%). Nearly all the participants own the dwelling in which they live (84.2%), 13.9% rent, and 1.4% live with others. Sixty-eight percent of the 303 current homeowners said maintaining the upkeep of their home was not very difficult at all; 26.4% stated that it was somewhat difficult, and 5.6% said it was very difficult. The most common repair needed was outside work, which was noted by 28.4% of the homeowners. When asked why they could not get the outside repairs completed, 29 respondents stated that the repairs were not a priority right now. About one-fourth of the 86 respondents needing home repairs reported that they just hadn't had time to get the repairs done. Cost was cited as an obstacle by 19 respondents, 12 stated that the people who were going to do the repairs hadn't finished the job yet, and two respondents stated that they didn't know whom to call for the repairs. The second most common repair needed, cited by 76 homeowners, was inside work. Plumbing repairs were needed by 14.2% of the 303 homeowners, heating repairs by 10.2%, electrical repairs by 9.9%, and other housing accommodations (e.g., bath rails, etc.) were needed by 5.6% homeowners. All respondents were asked whether they were experiencing a variety of housing problems. Having difficulty paying rent or mortgage most months was reported by 1.4% of the respondents. Living in a place where the space was not right, either too large or too small, was mentioned by 14.2% of the respondents. Sixteen respondents (4.4%) said they were having trouble moving around their home because of some physical condition(s). Worrying about crime in their neighborhood was an issue for 7.2%. Nine respondents(2.5%)stated that they were having trouble getting along with their neighbors. Snow removal was a problem for 6.7% of the respondents and getting yard work done was a concern for 10.6% of the respondents 7 2dOS/ Only 10.6%of the respondents anticipated moving in the next year. They said they might move into another house, four stated they would consider moving into an assisted living residence, 14 thought they could move into an apartment,five,into a condo,seven into senior apartments,and 10 into low- income apartments. Moving in with family and moving into a nursing home were each mentioned once by a respondent. Ten of the 38 respondents who expected to move would relocate due to health reasons, five said their current housing situation was too expensive, four noted that they needed an easier place to get around in, seven said their current home is too large and two said their current house was too small. Knowledge and Use of Services Respondents were read a list of 16 services that are available to seniors in Weld County. They were first asked whether they had ever heard of the service. If they had heard of the service, they were asked whether they had ever used the service. The service with which the greatest numbers of respondents were familiar was senior centers. Most respondents had heard of the senior center (91.1%); 31.4%had used the service, and 20.2% had gone to a senior center in the past six months. The second most recognized service was Meals on Wheels, which was identified by 85.3% of respondents. However, actual service use was low, with only 3.9% of the respondents ever having used the program,and only 0.6%having used Meals on Wheels in the last six months. The programs with the smallest amount of name recognition were the Brown Bag Program(recognized by 23.1% of respondents), the ombudsman program (known by 27.2%), and the senior companion program (recognized by 29.2%). For both the senior companion and ombudsman program,respondents had never used either program. Other Unmet Needs Next, respondents were queried,"In the last six months,have you experienced any of the following situations?" Thirteen percent had been discharged from the hospital.23.3%had an illness that lasted more than two weeks, 3.3% had experienced a problem with their Social Security or other type of income benefit, 5.8%had encountered a problem with Medicare or other health insurance, 8.6%felt as if they needed to talk to someone about a personal matter but had no one to turn to, 3.6% had trouble making a payment on a bill, 6.4% had been "ripped off' by a business or person, and 6.9% had experienced difficulty making meals or shopping. Attitudes about Service Use In an attempt to discover what some of the attitudinal barriers to service use might be, respondents were read a set of 10 attitudinal statements. After each statement, they were asked to indicate whether they strongly agreed, agreed, disagreed, or strongly disagreed with the statement. It appeared that respondents were somewhat divided in their views on the appropriateness of service use. The statement with which there was highest agreement was, "If I can't find a way to solve the problem on my own, I would consider seeking help from a program or service." About nine in ten respondents concurred with this statement. The statement over which respondents were most 8 9/. agl divided was, "1 would be reluctant to use a community program or service because I have been self- sufficient all my life." In response to this statement, 51.1% agreed while 42.0% disagreed. Social Contact The average number of children was 3.05, with a range of none to 11 children. The largest percent of respondents with children(44.8%)had contact with one or more of their children one to six times a week. The rest had contact once a day(37.3%), 1-3 times a month(12.7%),once a month(2.4%), 1-11 times a year(1.8%), or once a year or less (.3%). Only two respondents with living children claimed to never have contact with any of their offspring. The average number of living siblings reported by respondents was 2.7, with a range from zero to 14. The largest percent of respondents with siblings (27.8%) had contact with them one to three times a month. The rest had contact once a day (7.2%), one to six times a week (22.5%), once a month(16.3%), 1-11 times a year(16.7%),or once a year or less(5.2%). Thirteen respondents with living siblings (4.2%) claimed to never have contact with any of their brothers or sisters. The average number of grandchildren (including great grandchildren) was 6.3, with a range of none to 77 grandchildren/ great grandchildren. The largest percent of respondents with grandchildren (33.9%) had contact with them one to six times a week. The rest had contact once a day (14.2%), 1-3 times a month (24.8%), once a month(14.8%), 1-11 times a year(8.4%), or once a year or less (2.6%). Only four grandparents claimed to never have contact with any of their grandchildren. Respondents with grandchildren were queried, "Have you ever been denied visitation with your grandchildren by their parent(s)?" Of the 306 respondents with grandchildren,only nine(2.9%)said that visitation had been denied. About four in ten respondents (42.5%) had talked to a friend two to six times in the past week. About one-fourth (26.1%) had talked with friends by phone once a day or more, 15.0% had talked with friends once in the past week, but 16.4%of the respondents had not talked with any friends by phone in the past week. Forty percent of the respondents had spent time with a friend two to six times in the past week. Fifty respondents(14.0%)had spent time with friends once a day or more, and 23.3% had spent time with friends once in the past week. Seventy-nine (21.9%) of the respondents had not spent time with any friends in the past week. Health Needs When asked to rate their current health, 17.5% of respondents said their health is excellent, 47.5% said their health is good, 26.1% stated that their health is fair. and 8.6% rated their health as poor. Elders of color were twice as likely as whites to be in poor health. About one in seven elders of color indicated that their health was poor. In comparison, only about one in 13 whites were in poor 9 9aaati health. Individuals living in poverty were twice as likely as respondents living above poverty to classify their health as poor (15.5% vs. 7.2%). Of seven health conditions presented to respondents, the most common complaint was arthritis, affecting 60.8%of the respondents. The arthritis interfered with the activities of those with arthritis a great deal(17.8%), 50.2%of arthritis sufferers said it interfered a little,but 60(27.4%)respondents said the arthritis didn't interfere with their activities at all. Attitudes Towards Life In response to the statement. '`I feel I am useful and needed," 35.6% of the respondents strongly agreed, 54.7%agreed, 5.3% disagreed, and only .8% strongly agreed. In response to the statement, "I feel hopeful about the future," 26.4% of the respondents strongly agreed, 55.0% agreed, 10.3% disagreed, and only 1.7% strongly agreed. Only 13 respondents (3.6%) strongly agreed with the statement,"I often feel lonely." Sixty-five respondents(18.1%)agreed,52.8%disagreed,and 15.6% strongly disagreed. The statement, "I worry about becoming a burden to my family or friends," evoked a strongly agree response from 9.7%of the respondents,31.7%agreed,42.5%disagreed,and 8.6% strongly disagreed. The final statement was. "Older people are valued in my community," 19.4% strongly agreed, 60.3% agreed. 9.4% disagreed, and 1.4% strongly disagreed. Health Care The most common activity for which respondents needed assistance was housework,affecting 16.2% of the respondents. Of these respondents,only five stated that they sometimes had difficulty finding someone to help them. The second most frequent activity for which help was needed was shopping for groceries or other necessities. This affected 11.7% of the respondents. Of these, six stated that they sometimes experienced difficulty in locating assistance. When asked. "Do you have a family doctor that you see on a regular basis when you need health care?"nearly all respondents answered yes(89.4%). The 36 respondents(10.0%)who said no were queried about why they don't have a family doctor. Five of the 35 respondents (18.9%) said they couldn't afford a physician. Four respondents said they couldn't fmd a doctor that met their needs. One respondent said that finding a physician who would accept Medicaid was a deterrent. The 322 respondents with a regular family doctor were asked to evaluate their satisfaction with the health care they were receiving. Most respondents were either very satisfied (66.8%) or satisfied (26.4%),while 4.3%were somewhat or very(0.3%)dissatisfied. Among those who were somewhat or very dissatisfied, reasons for their dissatisfaction included that the doctor didn't spend enough time with them (nine respondents mentioned this) or that the doctor didn't seem to be able to help them (mentioned by four respondents). 10 • 91 eat/ Use of Medications When asked whether they ever use any medications, either prescription or over-the-counter drugs, 46 said no. The remaining 314 respondents were asked about their customary behaviors with respect to seven different situations dealing with medication. The behavior of most concern is that only 43.1% check whether there will be drug interactions, despite the fact that 26.1% have prescriptions from more than one doctor. Use of Other Health Services The most common health service for which 7.2%of the respondents had difficulty procuring service was dental care. The most common barrier to dental care, mentioned by 66.7% of the respondents having difficulty, was cost. Not knowing whom to see for dental care was the primary barrier for 20.0%of the respondents having difficulty procuring dental care. Transportation was the third most common reason, cited by 13.3% of the respondents having difficulty obtaining dental care. The second most common health service that respondents had difficulty obtaining was eye care,affecting 4.7% of the respondents. The most common reason noted by the respondents who had difficulty obtaining eye care was cost, mentioned by 70.6%, followed by transportation,cited by 17.6%of the respondents. Major Financial Concerns Respondents were asked, "Do you have any major financial concerns?" Ninety-five respondents (26.4%) answered yes and 255 (70.8%) answered no. The greatest single financial concerns were retirement (4.7%) and doctor/health care (4.2%). Needs of Weld County Respondents were read the following paragraph: "As you probably know, Weld County is currently in the process of growing and changing. What do you see as the most pressing problem facing Weld County?" The problem mentioned most was growth, cited by 28.6% of respondents. The second most common problem cited was that of transportation,traffic, and road maintenance(11.4%). The third highest response category, into which 10.0% of the respondents fell,was that Weld County is a great place to live and that no pressing problems are interfering with the quality of life of residents. The fourth highest category, mentioned by 9.7%, was concern about crime, teen drugs, gangs, juvenile delinquency, and the judicial/legal system. Focus Groups Although results from focus groups are not statistically representative, the following trends were noted during the participation of Hispanic seniors at a focus group in Greeley and another focus group in Fort Lupton. 11 9130i/ • Approximately half of the Hispanic seniors experience transportation difficulties. Many cannot drive or do not have a car and so rely almost totally on their adult children. • Housing was not a major issue for participating seniors except for one individual who could not afford the high rent and utility payments. • Getting appropriate eye care appears to be problematic for several Hispanic elders due to 'cost and eligibility barriers. • Loneliness affects some of the Hispanic seniors,especially those who have lost a loved one. • Many participants claim not to have been affected by racism and discrimination, although two individuals have had extremely difficult interactions with Anglos. Several individuals noted that the racism of Hispanic human service agency workers against other Hispanics is more of a problem. • Most participants did not have difficulties with legal issues. • Many participants feel that problems exist in the elder community of Hispanics and that such services as counseling, legal assistance, or relocation assistance are needed. Integration of Needs Assessment Data • The results of this assessment reflect the diversity of older adults who reside in Weld County. As is typical ofthe older adult population,the majority are relatively active,healthy,and are functioning independently. However, within the this group living in Weld County, there are pockets of individuals who do not have access to transportation, live with housing difficulties,have little social contact,have low levels of psychological well-being,struggle with daily activities and gaining access to health care services,and are unaware ofthe services and programs that exist to assist in improving their quality of life. Key Findings and Recommendations • Volunteering provides a way for respondents to feel useful, enjoy social contact and gain personal satisfaction. Of those who said they were not volunteering, 38% said they might volunteer if asked. Recruiting elders to volunteer within their communities can be psychologically beneficial to the volunteer and provide an important service to the ,community. Increase volunteer outreach efforts. • Elderly spouses between the ages of 71 and 75 are more likely to be caregivers than any other group. These caregivers are themselves elderly and at-risk of reduced physical and psychological well-being and might also be less likely to use adult day and respite services. 12 9Y)708/ Target adult day and respite services to elderly spousal caregivers and increase respite hours. • Another group of at-risk elders identified by this assessment are those who report they do not drive (13%). These individuals are dependent on others for access to the outside world. Although 4.4%of these elders indicated that they were unable to go somewhere due to a lack of transportation, all of these respondents must negotiate with others to obtain rides. Those at greater risk of having to stay home because of a lack transportation were elderly women, those over age 85 years, elders of color, those living in poverty and elders living in rural areas. Lack of transportation was a major concern voiced during the focus groups. Increase access to transportation to at-risk elders. The majority of respondents live in single family dwellings. For elderly homeowners,repairs to the inside and outside of the home are in most need. Those at greatest risk of having housing problems are those living below poverty and those over 70 years of age. Of those who anticipate moving, the housing type of choice is an apartment or low-income apartments. Housing needs include providing assistance with home repairs and increasing apartment living housing options. • Awareness of services is the critical first step in accessing the services when a problem or need arises. Awareness of programs ranged from 23%for the Brown Bag program to 1%for the senior center. Awareness levels increased when respondents had more contact with friends. Efforts should be made to increase awareness and understanding of the programs available in the County. Peers appear to be important in disseminating information about programs. Outreach efforts should he mindful of the attitudinal barriers to service use. • There is frequent social contact with children, siblings, and grandchildren among the respondents. Approximately 30% of respondents indicated they would like more contact with siblings and grandchildren. Increased social contact is related to improved psychological well-being. Intergenerational programs can be an indirect way to increase contact with "substitute grandchildren". Thirty-five percent of respondents indicated that their health was either fair or poor, with elders over 75, elders of color, and those living in poverty reporting lower levels of health status. Health interferes most often with housework, shopping for groceries and meal preparation, and taking a bath or shower. Hispanic elders, elders 75 and older, and those living below poverty have the most difficulty completing instrumental activities of daily living. Target in-home assistance to at-risk groups. Although most of the respondents reported good psychological well-being, 22% indicated that they were lonely. Those at greatest risk of poor psychological well-being are the oldest old (over 85 years of age), those with less frequent contact with friends and family, and elders living in 13 poverty. Devise a strategy for depression screening and increase the programmatic efforts of the friendly visiting and peer counseling programs. Low income elders are less likely to have access to health care services typically not covered by Medicare (e.g., dental care, eye care, hearing care). Respondents had the most difficulty accessing dental care. Work with the dental community to increase access to dental care (i.e., a pro bono or sliding fee scale program). Low income elders are also more likely to be in need of advocacy to help with solving income and consumer problems. Increase efforts of legal assistance to at-risk older adults. Of the top five financial concerns listed by respondents, three related to health care costs (e.g., health insurance, prescription drugs, and doctor and health care costs). Having enough income in retirement and property taxes were of concern to many. The biggest concerns were having enough income in retirement and paying for doctor and health care. Increase efforts to educate elders about property tax relief programs, home equity conversion programs, retirement planning, long term care insurance and other health care issues. As the Weld County adult population continues to age and grow in numbers, it becomes more important to ensure that all older adults and their families, regardless of race, income, age, and location have access to a continuum of health and social care services. Section V: Public Input A public hearing was held in the Weld County Centennial Building Public Meeting Room on August 13, 1998 at 1:30 p.m. The hearing was made public through an extensive invitation list along with a press release to the Greeley Tribune. Eighteen people were present to hear a one hour presentation on the Needs Survey. Charts and graphs depicting the results of the survey were presented using a Power Point projection method. The five community initiatives that the Area Agency on Aging proposes to address between 1999 and 2002 were presented. The entire presentation was followed by a question and answer period. There were some questions asking for clarification on the methodology of the study and on findings associated with Hispanic elders. The same presentation was also given to members of the Weld County Long Term Care Coordinating Committee, the Single Entry Point Advisory Committee, the Senior Nutrition Advisory Committee and Area Agency staff Other public presentations are planned for forums to be held in rural communities throughout Weld County in order to continue a strong educational presence regarding the results of the study and the Area Agency's initiatives. This activity will be particularly strong in the first year of the four year planning period. 14 9YdoSi Section VI: Community Initiatives The Weld County Area Agency on Aging has identified five community initiatives to focus on during the next four years: These initiatives are intended to address several significant findings from a county-wide needs assessment conducted on a representative sample of Weld County elders 60 years of age and older in April 1998. (1) Emphasize facilitator, leadership, coordination, advocacy and resource development role. Issue: Area Agencies on Aging do not have and will not have the financial resources to address many of the unmet needs of older adults in our planning and service areas. Area Agencies do, however, have over twenty (20) years of experience in planning and organizational activities to help organizations and communities improve the quality of life of older adults and respond to the most serious unmet needs of the most frail and isolated elder. How Issues will be addressed: This issue will be addressed by reordering the priorities of the Area Agency administrative team so that the team can concentrate more on community training, networking, grant writing, best model research, technical assistance, and partnering with other community organizations. Anticipated Accomplishments and their Impact: We anticipate that we will be able to leverage more interest by the community in elderly concerns and more resources to address those concerns. (2) Reduce the incidence of reported loneliness by seniors. Issues: The issue of loneliness was reported by 22 percent of older adults 60 plus as a significant problem. Despite the fact that most of Weld County's communities, including Greeley and 23 rural towns, support senior programs; there remain many (as many as 3.800 Weld seniors who are outside their community's social and helping network). Pervasive loneliness can be the root cause for depression and many physical health problems. How Issues will be addressed: The Area Agency will use a three pronged approach in the next four years to impact this finding. First, the Area Agency on Aging will conduct an extensive inventory of what both the formal and informal network offers in terms of outreach and on-going contact with isolated seniors. Second, a working group of representatives from the inventory list will be formed to begin a solution process. This may include research on best practice modes for reaching out to isolated and lonely seniors. Third, the Area Agency on Aging will allocate a modest amount of resources to pilot one to three specific projects designed to find creative approaches for increasing connections between communities and lonely seniors. 15 Anticipated Accomplishments and their Impact: The pilot(s) will be implemented with outcome based objectives to decrease the number of 60 plus persons reporting loneliness as a concern for them. The anticipated outcome will be that the pilot(s) could be replicated in other communities with the same results. (3) Increase and improve transportation resources for elders particularly low-income and minority. Issue: About 4.4% or potentially 850 to 900 seniors in Weld County experience times when they are unable to get transportation when they need it. This is three to four times more likely for 81 plus elders, elders of color, elderly widows 85 years and older and low-income elders. How Issues will be addressed: Overall marketing of transportation options must be increased county-wide. Increased funding will be sought from the Colorado Department of Transportation due to increased federal allocations to the Federal Transit Act to help support more demand- response transportation options for Weld seniors. Anticipated Accomplishments and their Impact: We expect transportation to be a needs issue for many, many years. However, we expect to to increase visibility of both the city and rural public bus service, increase volunteer transportation options, and improve the image of public transit. Our goal is to decrease numbers of older adults reporting that access to transportation for critical needs such as doctor's appointments and necessary shopping is a problem. (4) Increase dental resources for low-income seniors. Issues: Weld seniors (7.2%) reported in the 1998 Needs Assessment that the most common health service they had difficulty procuring was dental care. The most common barrier to dental care is cost. Unresolved dental problems decrease the quality of life of an older adult by decreasing food choices and overall nutritional intake, decreasing socialization particularly when associated with eating activities and by increasing exposure to discomfort and pain. How Issue will be addressed: The Area Agency on Aging will establish a task force to establish a plan for partnering Area Agency Title III, Part F monies with local resources to increase overall funding from the current dental program from $4,000 to at least $20,000 by 2002. Anticipated Accomplishments and their Impact: Additional funding will increase number of elders to be served in a given fiscal year from 14 to 60 by 2002. This initiative will increase overall public awareness of the access problems associated with dental care for older adults, increase numbers of low income elders receiving dental care, and provide a mechanism for local organizations and communities to participate in a well defined project for addressing the problem. 16 9101/ 5. Increase access to in-home respite care. Issue: According to the 1998 Needs Assessment about 8.5% or potentially 1,615 Weld seniors are the main helper for someone who needs assistance with everyday activities such as bathing, feeding, or helping someone to walk? Assistance requested was help with meal preparation, small blocks of respite care, help with bathing and weekend respite are needs most requested. How issue will be addressed: Without additional funding the Area Agency on Aging will not be able to directly support additional in-home respite care services. Therefore, the Area Agency will educate the community to the need, explore best practice in-home respite options and convene appropriate parties to generate ideas and plans for in-home respite services. Anticipated accomplishments and their Impact: Response to this need is one that will have to develop over time. The Area Agency will provide leadership on this issue. However, it would be difficult to predict what accomplishments could be realized by 2002. A minimum accomplishment will be that the Weld Community will have a better understanding of respite care in terms of the extent of the need and what services are most needed and who is currently capable of supplying in-home respite. 17 9Ya O8/ Section VII: State/AAA Planning Initiatives: Coordination with Statewide issues for the Older Americans Act Programs will strengthen the aging network's ability to impact unmet needs of the state's older adults. The Weld County Area Agency on Aging will concentrate coordination activities with the state in the following three areas: 1. First, and most important to the Weld County Area Agency on Aging is advocacy for increased state match. Twenty plus years of state support at a 5% level must be changed if Area Agencies are to have any impact on community-based needs for older adults. Approximately 18% of Weld's 60 plus seniors live below the poverty level. Some 40% live on incomes of$15,000 or less. Loneliness, lack of access to dental care, and caregiving needs are just a few of the areas that the Area Agency is unable to impact due to insufficient support and recognition from the State of community-based needs of seniors. Steps that will be taken will include: (A) Use needs assessment findings to inform elected officials and the general public of the unmet needs of Weld older adults. (B) Provide appropriate data to the State Aging Division to assist the division in writing a budget request for the Department that would list increased state match to OAA Programs as a priority. (C) Coordinate advocacy efforts with the Colorado Commission on Aging, Colorado Counties Inc., Colorado Municipal League, local communities and senior groups to build a support base for a match increase. (D) Educate state legislators at annual legislative breakfast sponsored by Weld County Human Services. 2. The Weld County Area Agency on Aging recognizes that accountability is more important than ever due to limited resources. Every funded activity must be able to measure the impact of the activity on an identified problem or need. Accountability will also be closely tied to whether the State increases funding to Area Agencies on Aging. Therefore, we are committed to implementing performance-based outcomes where feasible. We will work with the State to: (A) Learn about performance-based outcomes and how to incorporate them in purchase of service agreements. (B) Provide training and technical assistance to service providers on performance-based outcomes. 18 Section VIII: Targeting Based on the Weld County 1998 Needs Assessment, Hispanic elders (Weld County's principal minority group) have the most difficulty obtaining transportation, completing instrumental activities of daily, and are consistently lower income than other groups. Weld County Hispanic elders represent about 12% of the 60 population. The greatest concentration of Hispanic elders are located in Greeley, Fort Lupton, Wattenburg, Milliken, Platteville, and Gilcrest. The Area Agency on Aging will target services to Hispanic elders using the following specific objectives: • Fund an Hispanic elderly outreach program capable of advocating for Hispanic elders through outreach, information and referral, and case intervention and establishing • Designate a part time FTE bilingual outreach and case coordination position within the AAA administrative office to provide bilingual support assistance to staff and direct case coordination services to Hispanic elders seeking assistance directly through the Area Agency on Agency. • Partner with Catholic Charities northern to find ways to better serve the transportation, and general isolation problems of Hispanic elders. Section IX: Overview of Services: 1999-2002 Information and Assistance The Area Agency on Aging will ensure that all older persons within Weld County have reasonable and convenient access to information about services through the following means: • trained AAA staff and rural senior coordinators who are capable of providing accurate and appropriate information to callers and walk-ins who access information through the Area Agency on Aging office and nineteen(19) rural senior aide stations throughout Weld County. • disperse information through all forms of media including The Senior Voice, the Senior Marketplace News, the Weld Monthly Times, the Greeley Tribune, local rural weekly publications, an updated I & R Directory widely distributed throughout the aging service network and the public at large, specialty articles and interviews on issues of public interest, workshops, and public speaking. • increase elder to elder contact by promoting creative friendly visiting contacts through the support and leadership of senior centers, church community, and other community volunteer organizations. (Specifically addressing needs assessment findings that the most informed seniors are those who have the most contact with friends.) 19 Outreach Services The Area Agency on Aging will ensure that outreach efforts are conducted throughout Weld County to identify older persons and to inform them of the availability of services by: • designating a minimum of one trained, bilingual Area Agency staff person for one on one outreach and for Spanish interpretation services as needed and appropriate. • contracting for specific Hispanic Elderly Outreach component whose responsibility will be to identify Hispanic elders and provide information and assistance to such elders in accessing needed services. • training rural senior coordinators on outreach techniques and provide incentives for local communities under the leadership of their rural senior programs to identify and maintain continuous contact with all seniors with particular emphasis on the oldest, most frail, and homebound. (Specifically to address needs assessment finding that 22% of 60 plus elders experience loneliness.) • providing technical assistance to wide range of community leaders including church leaders, service clubs, elected officials, and other volunteer organizations on the implications for health and well being of seniors who feel lonely and isolated. (Specifically to address needs assessment finding that 22%of 60 plus seniors experience loneliness.) Transportation Services According to the 1998 Needs Assessment of Weld County 60 plus, 4.4% indicated that they currently experience times when they need to go somewhere but stay home because they have no means of transportation. This is particularly true for females, elders of color, those below poverty and the 81 plus. The transportation barrier was reported to affect the ability to see a doctor, go shopping, attend religious activities, and attend other activities such as a senior center or library. The Area Agency does not provide specific funding for transportation but does coordinate the overall Weld County Transportation Program having responsibility for the funding and operation of the program utilizing other funding sources. The needs of the above named at risk groups will be served by: • Increasing finding from the Community Services Block Grant (CSBG), the Colorado Department of Transportation(CDOT), Medicaid, and fares to support the cost of rural transportation. • Increasing awareness of specific transportation options available to seniors and how to access the service—specifically demand-response service. 20 9.Poef • Coordinating more closely with other transportation systems, particularly the City of Greeley and Boulder County Transportation programs. In-Home Services The Area Agency on Aging will provide for the availability of services to older persons in their homes in order to help them remain in their own homes with a maximum degree of independence by: • Sponsoring the Colorado Options for Long Term Care Program or SEP (Single Point of Entry) which gives community based long term care options to persons qualifying for Medicaid and passing a medically needy screen. • providing financial support for homemaker and personal care to individuals who have no other source of third party reimbursement for such services and who cannot afford the full cost of the service. • providing financial support for in-home, one on one peer counseling services (specifically to address needs assessment findings that 22%of Weld 60 plus elders experience loneliness.) Legal Assistance Services The AAA will continue to maintain a part time paralegal on staff under the supervision (by contract) of a qualified attorney to provide advice and consultation to older adults with economic and social needs. Ombudsman Services The Area Agency on Aging will maintain on staff a 1.25 FTE ombudsman. The Ombudsman will report to the Single Entry Point Coordinator and will have all the authority vested by the Federal Older Americans Act and State of Colorado Statutes to carry out the activities of a long term care ombudsman. Oversight will include six (6) Weld County nursing homes and fifteen (15) assisted living facilities. A team of approximately six (6) volunteers will be trained and supervised to assist the ombudsman. The ombudsman program will be given high priority for additional funding should additional funding become available in order to respond to the 21% increase in assisted living beds in Weld County between 1997 and 1998 and the addition of one skilled nursing facility. Protective Services The Area Agency on Aging will assist the Weld County Department of Social Services to carry out Adult Protection services by: 21 9gaO5/ • maintaining membership on the Weld County Adult Protection Team • coordinating with TRIAD on elder abuse education activities • training staff and the aging network on referral procedures to adult protection • advocating for sufficient adult protection workers to respond in a timely manner to referrals Disease Prevention and Health Promotion Services The AAA will participate in community efforts to promote disease prevention by: • educating the community on expressed health issues of elders as per needs assessment results • coordinating with North Colorado Medical Center, Swing into Spring Health Fair and Health Hispanic Lifestyles Health Fair to develop a single annual health fair with screening, follow up, and educational components. • promoting, through technical assistance to Weld rural senior coordinators, health promotion activities as a central component of rural senior center programming. • partial funding of the Weld County Health Department Well Oldster Clinics. • funding directly from Older Americans Act Part F and by advocating for funding from other sources to increase support for access to dental care for low-income elders. (Specifically to address needs assessment findings that 7.2% of respondents have trouble accessing dental care due to cost) • advocating strongly with North Colorado Medical Center for a well defined and visible wellness program targeted to older adults. Nutrition Services The AAA will make awards for congregate and home delivered meal services that will have the capability of serving all of Weld County by: • Maintaining a financial contract with a home delivered meals provider to serve hot meals Monday through Friday and frozen meals for reheating on weekends - available in Greeley and through two satellite sites in South Weld County. • Maintaining a financial contract with the University of Northern Colorado Food Service to prepare hot meals for delivery throughout Weld County to 23 designated congregate meal sites. • Contracting with Weld County Transportation Program to deliver meals in bulk to congregate meal sites throughout Weld County. • Hiring a part time consultant to write menus and provide nutrition education and counseling to meal participants. • Supporting a part time AAA staff person to carry-out the contractual oversight needed to insure that the program meets the federal and state guidelines for an elderly meal program. 22 • Advocate with local communities to increase support of the congregate meals program. Advocacy, Coordination, and Program Development Traditionally the Weld County Area Agency on Aging has not requested a transfer of service dollars to support advocacy, coordination, and program development. For this Four Year Plan more emphasis will be placed on these activities with the clear intent of strengthening the AAA's leadership and technical assistance role to Weld communities. With limited federal and state funds and expanding needs, the AAA believes more time and resources must be directed to enabling and partnering activities that could result in creative community approaches for helping elders and their caregivers. Therefore the AAA will: • redirect resources as available and appropriate to give greater support to advocacy, coordination, and program development activities. Other Services case management, senior centers • The Area Agency will sponsor the Options for Long Term Care Program serving approximately 400 frail, low-income, at-risk seniors and disabled providing case management and in-home services. • The Area Agency will sponsor the federal Job Training Partnership Act employment and training program for older adults 55 years and older by continuing to apply for funding from the Colorado Department of Labor to support a .50 FTE older worker specialist. • The Area Agency on Aging will support a .50 FTE rural senior center technical advisor using Community Service Block Grant funds (CSBG). • The Area Agency on Aging will fund, with Title III, Part D a .30 FTE staff person to carry out case management and enhanced information and referral services for elders and their families who do not qualify for the Options for Long Term Care Program through Medicaid. Section X: Waivers No waivers are being sought. The Area Agency does not believe that it continues to be necessary to seek a waiver for the congregate meals program as a direct service. We carry a vendor grant with the University of Northern Colorado to prepare meals for the program ($150,000 approximate annually), we contract with the Weld County Transportation Program to transport the meals to local sites, and we have non financial agreements with each of the local sites who agree to provide a setting for the meals and the necessary resources to administer the program at the site. We have no paid nutrition site staff. Administrative staff include a part time nutrition consultant 23 9S;05/ to write the menus and monitor the sanitation at the sites and a part time FTE technical advisor to monitor the food service contract and the local site programs. We believe this does not constitute direct service provision under traditional definitions for direct service. See Area Agency on Aging Organizational Chart- Attachment C 24 7 �Ds/ ATTACHMENT A Regional Advisory Council Region II B FY 1998 Name Organizational Town Low 60+ Minority Disabled Affiliation Income Don Beierbach Retired Evans X (Business) John Cruz Retired Windsor X X X Mary Eastwood Insurance Greeley Mary Ellen Faules Insurance Greeley X Donald Feldhaus Retired Greeley (Education) Mary Fox Senior Center Kersey Dale Hall Commissioner Greeley Shirley Ianelli Denver Post Keenesburg Mary Jones Rancher Briggsdale Priscilla Kimboko Higher Education Greeley John Lee City of Greeley Windsor Mary Jane Lang Accounting Frederick X Bernie Olivas Retired (Social Ault X X Services) Jim Riesberg Food Bank Greeley Peg Scott Homemaker Fort Lupton X Judy Yamaguchi Hewlett Packard Platteville X 25 ATTACHMENT B Region II B FY 1998 Title III Meal Service Chart Site Name/Address 44%at$15,000 50%or more More than one Number days per week or less.* minority complete meal per meals are served day served C-1 C-2 C-I C-2 C-1 C-2 Birchwood Apartments X X 3 5 Broadview Apartments X X 2 5 Eldergarden Adult Day X X 5 0 Erie X X 1 5 Evans X X 1 5 Gilcrest X X 1 0 Greeley Manor X X 3 5 Greeley Senior Center X X 2 0 Greeley Senior Housing X X 2 5 Hill N'Park X X I 1 Johnstown X X 1 5 Kersey X X 2 5 LaSalle X X 1 5 Lochbuie X X 1 1 Mead X X 1 1 Milliken X X 2 1 Nunn X X 1 1 Pierce X X 1 1 Platteville X X 1 1 Rodarte Center X X X 1 1 University Plaza X X 2 5 Wattenburg X X X 1 0 Windsor X X 2 5 TOTAL 23 23 2 N/A * Based on income data from Weld County Needs Assessment- 1998 26 r — , § 2 a r tea (a co �A3 a t � ( w > 2 ; z k �O CA \ I r / k $ § k 2 () I d # c § k2tk § IC o § •co 0 2 c I ` TJ \ � � � o & tk al c k \ � � kf { .2 S - ' 2G mit ° k c e U .R U. ] | � � 0 0 e , as ■ z c @Q • 2 0 ' CU co V) k � q « a a) E ca k § O k . _ > \ Cn Z1 •- ` C k ° m C 0 2 % ti) -J c & 0) 0 2k CZ Q3 ° @ ( « O f § co s13 C < 0 ■ 2 % � . E a 03 O. co t § § G � 03 0 s .%E 15 tu t k 2 « , • E CU I a) • a \ ;CI � ] ) ) )t se- f- 11(:)- t $ : )a � . , &To » � _ e7° 22 S § b. t k % v � k ) 2 ( N. \ 0 OCo aos \ t § '0 o § wE 0 ) E- ca (Oct � Q CL 2 z 2 0,20g/ ATTACHMENT D Community Focal Points and Senior Centers A B C B E F List all focal point and senior centers Focal Senior III-B funded High High including nutrition sites Point Center Low Income Minority Ault Senior Citizens Center % X 204 1St Street Ault C0 80611 Phone: 970-834-1325 Tri Town Senior Center X X X X 106 5th Street Dacono,CO 80514 Phone: 970-833-4300 Eaton Senior Center 223 1st Street Eaton,CO 80615 Phone: 970-454-2937 Erie Senior Center X x Erie Town Hall 645 Holbrook Erie,c0 Phone: 303-665-3555 Evans Senior Center X X X 3700 Golden Evans,CO 80620 Phone: 970- 339-5344 Fort Lupton Senior Center X X X X 515 4th Street Ft.Lupton,CO 80621 Phone: 303-857-4080 Greeley Senior Activity Center X X % 1010 6th Street Greeley, CO 00631 Phone: 970-350-9435 Grover Senior Center % X Prairie Village Senior Housing 211 Larimie Ave. Grover.CO Phone: 970-895-2346 Johnstown Senior Center % X % 101 Charlotte Street Johnstown, CO 80534 Phone:970- 587-5251 Hill N'Park Senior Center X X Yosemite Drive & Yellowstone Greeley.CO 80634 Phone: 970-330-8619 Kersey Senior Center X X X X 415 1st Street Kersey. CO 80644 Phone: 303-352-8394 Lochbuie Senior Center X X X % 0501 Willow Drive Brighton, CO Phone: 303-659-8262 Mead Community Center X X 441 3rd Street Mead, CO 80542 Phone: 970-535-4477 Milliken Senior Center X X X X 105 Harriet Avenue Milliken, CO 80543 Phone:970-587-2484 Nunn Nutrition Site X X % 755 3rd Street Minn, C0 80648 Phone: 970-834-2655 Windsor Senior Center X X X 301 Walnut Windsor, CO 80550 Phone: 970-686-7476 Pierce Senior Center X X X X X 221 Main Avenue Pierce, CO 80650 Phone: 970-834-2655 Platteville Community Center X X X X 508 Reynolds Platteville, CO Phone: 970-705-6274 p 28 9$,20 v ATTACHMENT E - Senior Center Facilities Acquisition. Construction or Alteration The Weld County Area Agency on Aging does not propose to utilize Title III funds under the Older Americans Act to acquire, construct or alter any senior centers in the next four years. ATTACHMENT F - See Weld County Division of Human Services Cost Allocation Plan ATTACHMENT G - Proposed Purchase of Equipment The Weld County Area Agency on Aging does not plan any major purchases of equipment withing the next Four Year Planning Period. 29 , ATTACHMENT F ` •� DIVISION' OP HINM ,`. SERVICES COST aLOC. lON PLAN BY MARILYN CARLINO FISCAL OFFICER REVISED MAY 1998 CERFII_ICATION OF COST ALLOCATION PLAN This is to certify that I have reviewed the cost allocation plan submitted herewith and to the best of my knowledge and belief 1. All costs included in this proposal revised May 1998, to establish the cost allocation method for calendar year 1998 are allowable in accordance with the requirements of OMB Circular A-87 and the requirements of the Federal award(s) to which they apply. 2. All costs included in this proposal are properly allocable to the Federal awards on the basis of a beneficial or causal relationship between the expenses incurred and the awards to which they are allocated in accordance with applicable requirements. Further, similar types of costs have been accounted for consistently. I declare that the foregoing is true and correct. State of Colorado County of Weld Division fHgman Services ,Walter J. Speckman "Executive Director / . v 9S sI WELD COUNTY DIVISION OF HUMAN SERVICES ORGANIZATIONAL CHART WELD COUNTY COMMISSIONERS • Various Administration and Advisory minittees Other County Departments - Weld County Private Industry Council •- Social Services - Human Services Committee - Finance - Area Agency on Aging Committee - Computer Services - Head Start Parent Policy Council - Health Division of Human Resources Executive Director Walter J. Speckman Administrative Unit 353-3800 - Fiscal/Contracts and Grants Management - Marilyn Cer_in: - Personnel/Office Management. Commodity Supplemental Fccd Susan Talmadge SENIOR CITIZENS YOUTH AND ADULT CHILDREN PROGRAMS PROGRAMS EMPLOYMENT PROGRAMS - Head Start (12 Centers) - Area Agency on Aging - Job Service - Migrant Head Start - Senior Nutrition (23 Sites) - Job Training Partnership (State-Wide) - Senior Coordinator Act - State Funded Pre-School (20 Centers) - Job Opportunities & Basic Program (4 School Dists.) - Transportation Skills (JOBS) - Day Care (40 Vehicles) - Food Stamp Employment - Case Management Program - Senior Employment - Dislocated Workers Ombudsman - Senior Legal Services Tere Keller-Amaya Janet Luna-Flaugher Linda Piper Linda L. Perez 303-3800 353-3800 353-3800 PURCHASE OF SERVICES COORDINATION AGENCIES - Larimer County Care-A-Van - Meals on Wheels - Greeley and Weld Housing - University of Northern - Latimer County Human Authority Colorado Development - Colorado Rehabilitation - Plan de Salud Health Clinic - Home Health Care Services - Sunrise Health Clinic - Adult Day Care - Weld Information and - Colorado Migrant Health (Eldergarden) Referral Services Department — Peer Counseling (Weld) - Colorado State University - Weld Mental Health - Catholic Community - Dream Team - Weld Food Bank Services - Colorado Child & Adult Can - Private Dentists - Adams County Mental Health Food Program - Trinity Housing - Island Grove Treatment - Northern Colorado Center on - BOCES Center Deafness - Restitution Center - Aims Community College - Centennial Development - 12 School Districts Services, Inc. • 9flo8/ ea ..c. i \ L: a \ § 6. \ } } f \ * 5 / ) ! \ } t tI = \ ! ; 2 \ ® ) \ / .g , 5 = • - _\ \ \\ • � \ }j • E. g 2 : = a �j Lc Co C.: Li { � \ , } - \ / . s - \ } \ \ - @Lip } \ \ . /\ . >24 } \ \ / � • 7 L- r , . - - V7 7 %& » . 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WELD COUNTY DIVISION OF HUMAN RESOURCES COST ALLOCATION PLAN PURPOSE The purpose of this cost allocation plan is to outline, in writing, the methods and procedures that Weld County Division of Human Services will use to allocate costs to its various programs, contracts and grants. BACKGROUND Weld County Division of Human Services (DHS) operates as an umbrella agency of Weld County Government. DHS is the administrative entity for various federal and state programs, grants and contracts. These programs are grouped into four areas; Employment Services, Family Educational Network, Area Agency on Aging and Other Human Service. Employment Services includes the following grants and contracts; Job Training Partnership Act Grant programs, Job Service, Summer Job Hunt, Summer of Service, Employment First Food Stamp/Job Search Program, Workfare, TANF, Family Support Program, Americorps, Youth Crime Prevention Initiative, Educational Computer Lab, and One Stop Programs. Family Educational Network consists of the following revenue sources and programs; Head Start, Migrant Head Start, Child Care Food Program, Family Support Program, Neighbor to Neighbor and Preschool. Area Agency on Aging incorporates Older American Act funds into several Senior programs. It also relies on USDA funds for Senior nutrition programs, Community Service Block Grant Funds for coordinating the Senior volunteer program, Federal Transit Funds for Senior Minibus transportation, and Single Entry Point Funds and Private Contracts for Senior Case management and JTPA funds for Older Worker. Other Human Service programs and funding include; Community Service Block grant, Commodity Supplemental Food Program, and LeHeap These grants require that DHS complies with OMB Circular A-102, Uniform Administrative Requirements for State and Local Governments and OMB Circular A- 87, Cost Principles for State and Local Governments. This Cost Allocation Plan is based on the definitions and requirements spelled out in OMB Circular A-87. GENERAL APPROACH The general approach of DHS in allocating costs to particular programs, grants and contract is as follows; A) All costs identifiable with a specific program, grants or contracts are charged directly to the benefiting program. B) Unassigned direct costs are assigned to cost pools and are allocated monthly based on monthly time sheet distribution percentages of the personnel assigned to each particular cost pool. For example, the percentages taken against the Employment Services cost pool only come from Employment Services staff. 969°3/ ALLOCATION METHODOLOGY DHS uses five cost pools; 1) Transportation Cost Pool---This pool is used to accumulate all the joint costs associated with running DHS's Transportation Department which provides minibus transportation for several of our programs. This pool includes transportation staff salaries, fringe benefits, and all transportation operational costs. 2) Employment Services Cost Pool---This pool is used to accumulate all the joint costs associated with the operations of Employment Services including; Employment Services staff salaries, fringe benefits, and other costs which cannot be directly identified to a program. 3) Area Agency on Aging Cost Pool---This pool is used to accumulate all salary and fringe costs and joint costs associated with Area Agency on Aging employees and programs. 4) Administrative Cost Pool---This pool includes all administrative salaries, fringe, overhead and other joint costs associated with administering all DHS programs that cannot be directly identified to a grant or contract. 5) FENWC Cost Pool---This pool is used to accumulate all the joint costs associated with the operations of Family Educational Network of Weld County including; FENWC staff salaries and fringe, as well as other costs which cannot be directly identified to a specific program. TRANSPORTATION COST POOL The Transportation Department system tracks client miles and trips associated with each program served. These figures are accumulated into a monthly report. Monthly, percentages of miles per program are calculated for the period. The percentages are taken against the total transportation department costs for the month. The amounts are allocated from the pool to the program (fund) receiving benefit. EMPLOYMENT SERVICES COST POOL Monthly time sheets are kept by all Employment Services employees noting their time per month per program served. Monthly, the time worked per program is entered into a spreadsheet which calculates total time (weighted by rates of pay) percentages per program. The time/rate percentages are taken against this pool of costs and are allocated to grants served accordingly. Cne;10a/ AREA AGENCY ON AGING SERVICES COST POOL Monthly time sheets are kept by all Area Agency on Aging employees noting their time per month per program served. Monthly, the time worked per program is entered into a spreadsheet which calculates total time percentages per programs weighted by rates of pay. The time/rate percentages are taken against this pool of costs and are allocated to grants served accordingly. ADMINISTRATIVE COST POOL Monthly time sheets are kept by all Administrative staff noting their time per month per program served. Monthly, the time worked per program is entered into a spreadsheet which calculates total time percentages per program weighted by rates of pay. The time/rate percentages are taken against this pool of costs and are allocated to grants served accordingly. FENWC COST POOL Monthly time sheets are kept by all FENWC staff noting their time per program served. The classroom staff allocates by percentage of children per program. Monthly, the percentages are calculated and taken against this pool of costs and allocated to grants and programs served accordingly. GENERAL LEDGER ACCOUNTING Weld County uses a uniform classification of accounts for all general ledger departments. Each grant or program is its own general ledger department (fund) . All direct costs are charged directly to the particular department it served. All allocated costs are entered into the ledger by journal entry--from the pools to the grant departments. Each allocated line item is coded so it can be identified as to cost pool source. Each expense, whether direct or allocated, is also coded with a program code to charge it against the cost category defined by the grant. REPORTING Most grant programs are on quarterly reporting. Each general ledger department is printed for the time period to report. The department carries the calendar year-to-date totals for each cost category of expenses. From the total for the grant cost category is subtracted what has been reported in prior periods of the same calendar year. The balance for the cost category is transferred to the report for the current period. The ledger report, is the documentation of costs and backup to reported expenditures. 9Yi0n / WELD COUNTY ALLOCATION PLAN The next three pages come from the Weld County Cost Allocation Plan. The first page is a copy of the cover, the second page is the signed certification that the plan conforms to OMB requirements and the third page is the summary sheet that notes the cost charged to Human Services by the County. The total cost charged to Human Services for 1998 is $316,077 . The County posts one-fourth of this expense into Human Services Administrative cost pool quarterly and Human Services allocates the cost out as per the method defined under administrative cost pool. On the fourth page, is an estimated budget allocation for 1998 of what amount of the $316, 077 will hit each of the Human Service programs. 9a08/08/ ° • • Cij c� a.' Ca Z F" O 1 Z O F" t' g O U . O F U � �N .7 < < n O ` - o O U c x v U �yy — .. J .^ N < Z• < v �--' O In a F • ec F O o z < , � L� U O • = > " GC c• x A Uu < N r ^ 96 W 8-J Ct.414 ::IH • E AND DEPARTMENT OF FINANCE ADMINISTRATION PHONE (970) 356-4000, EXT.4218 FAX: (970) 352-0242 P.O. BOX 758 COLORADO GREELEY, COLORADO 80632 CERTIFICATION OF COST ALLOCATION PLAN This is to certify that I have reviewed the cost allocation plan submitted herewith and to the best of my knowledge and belief: (1) All costs included in this proposal dated July 20, 1997, to establish cost allocations or billings for calendar year 1996 are allowable in accordance with the requirements of OMB Circular A-87, "Cost Principles for State and Local Governments," and the Federal award(s) to which they apply. Unallowable costs have been adjusted for in allocating costs as indicated in the cost allocation plan. (2) All costs included in this proposal are properly allocable to Federal awards on the basis of a beneficial or causal relationship between the expenses incurred and the awards to which they are allocated in accordance with applicable requirements. Further, the same costs that have been treated as indirect costs have not been claimed as direct costs. Similar types of costs have been accounted for consistently. I declare that the foregoing is true and correct. STATE OF COLORADO COU OF W DA/ „p1 — Donald D. Warden, Director Finance and Administration DDW/ch DATED: July 20, 1997 99;0s' - try a 6 Y N O r y 4• L u in 74 J 4 C J ` a. < Y T 7 :J J J 2 J G in co .4 m /1 ' N V P.N N V C'. .4I{` < Nin uco co r . '1 a V I, C. leO N • • N • n r f N V =O C V O 01N N N P f N .4 V N - N N V N - n LO N N . V O ! P V { O N N • b y. „] V N %.0 00 N N N 0 O I'1 O N N W { Cl NN O q • f. 4 - ^ ti - • • • - O• II N 4 o N N N 0 U V N U = 0 n n t - N m N P1 N a ile ••• V M P O = /V1 O N N (q N N O N N m • E N O e .4 r N - t• r- p1 C. b N N • N U 0 0 N D 4e1 f1 Y S G q qr, a zd O1a 4 a 'L a { 5 3 5 u a G rJ D3 pp < {o. y O O h a 00 V Z .a < ¢ I. y i O .Or 41 ry y u i y „ o u e > g u - f i e. n fi > > C. _V o u 9 M1 Vtgl i VI �sjlt 5pQs + a ,p tau u r I O 0 0 m fi. •C Si. 6 U V S 6 s U F ESTIMATED ALLOCATION OF WELD COUNTY COST ALLOCATION PLAN COSTS TO HUMAN SERVICES PROGRAMS FOR 1998 TOTAL ALLOCATION 316,077 JTPA IIA 8,364 JTPA IIC 1,394 EDWAA 7,435 JTPA IIB 11,617 JTPA PI 558 JOB SERV 11,617 AMCORP 5,576 YCPI 2,323 TANF 9,294 EMP 1ST 6,041 LAB 5,576 SOS 2,323 FENWC 162,639 AAA 37,175 TRANS 37,175 CSBG 6.970 TOTAL 316,077 9,g,PoSi ATT:ACHAIEiNT H What Do You Think? 9 `� lI7 A Community Survey of Older Adults in Weld County Conducted by the University of Northern Colorado - Gerontology Program Sponsored by the Weld County Area Agency on Aging 9&208/ 'Section I. In this first section. we would like to ask you some questions about your work and volunteer status. Please circle the letter that best represents your answer. 1. Are you currently working for pay? a: Yes D. About how many hours a week do you work? b. No (SKIP TO QUESTION 4) Hours 2. Are you satisfied with the number of hours you are working? a. Yes, I am satisfied b. No, I would like to work more hours c. No, I would like to work less hours 3. What are the reasons you continue to work? (Circle all that apply) a. I need the income b. Working keeps me mentally active c. It gets me out of the house — keeps me from being bored d. I feel I am contributing to society e. I enjoy the social contact with others f. The health insurance benefits g. Other - Please specify: (SKIP TO QUESTION 7) 4. Have you been looking for work? a. Yes b. No (SKIP TO QUESTION 7) 5. How long have you been looking for work? Weeks or Months 6. What do you think is the main reason you cannot find a job? (Select one) a. I don't have the right training or education requirements b. Poor job market c. I am convinced that employers think I am too old d. I lack the transportation I need to get to work or look for work e. I lack job seeking skills f. Other — Please specify: 7. Do you currently volunteer through an organization (like a church or hospital) or is there V meone you help on your own, individually? a. No (SKIP TO QUESTION 11) b. Yes i) I volunteer with an organization ii) I volunteer individually iii) I volunteer with an organization and individually 8. During a typical month, about how many hours do you volunteer? _Hours 3 9. Regarding the amount of time you volunteer, would you say that in the past year you: a. Would have liked to volunteered more time b. Would have liked to volunteered less time c. Volunteered just the right amount 10. What would you say are the reasons you volunteer? (Circle all that apply to you) a. I enjoy the contact with others b. I feel useful when I help others c. We have a moral or social responsibility to help others d. Volunteering keeps me from feeling lonely e. It's a way for me to use my skills f Volunteering is a way for me to use my time g. I feel personal satisfaction when I help others h. If I help people now, they will help me when I need help i. It's a way to help the organization j. Other — Please specify: (SKIP TO QUESTION 13) 11. In the last year. have you ever been asked to be a volunteer? a. Yes b. No If you were asked to volunteer, would you be willing to do so? 1. Yes 2. No 3. Maybe 12. People choose not to volunteer or are unable to volunteer for a variety of reasons. What are the reasons you do not currently volunteer? (Circle all that apply) a. I don't know where to volunteer b. No time, too busy c. Lack of transportation d. My health e. I am a caregiver of a family member f. No interest or desire g. Other — Please specify: 13.Are you the main helper for someone who needs assistance with everyday activities, such as bathing, feeding, or helping someone to walk? a. Yes b. No (SKIP TO QUESTION 17) 9Baosi 4 14. For whom do you provide care? (Circle all that apply) a. Spouse/Partner b. Parent c. , Child d. Other relative e. Friend or neighbor 15.How many hours do you spend each day caring for this person? Hours per day 16.What type of assistance or service would be most helpful to you in caring for this person? (Circle all that apply) a. Transferring the person (for example, moving them from the bed to the chair) b. Bathing and grooming c. Meal preparation or grocery shopping d. A place that could provide overnight care e. A place that could help with care over the weekend f. A place that could provide assistance while I went away for a week or so g. Someone to help a couple of hours a day so I could run errands h. Other — Please specify: Section II. In this next section, we would like to ask you about transportation and housing concerns. Please circle the letter that best represents your answer. 17.Which of the following driving situations best describes you? a. My spouse/significant other or I drive (SKIP TO QUESTION 21) b. I do not drive 18: Have there been times in the past month when you needed to go somewhere but had to stay home due to lack of transportation? a. Yes b. No (SKIP TO QUESTION 21) • 91,.;265/ • 5 icate how often in the last month you were 19. activities dbecause of a lack of unable Please transp rt tion. Please placea participatefollowing in the box that best represents your answer. Activity None ' 1-2 times 3-5 times 6+times I don't do this activity Visiting family or friends Going to the doctor Going grocery shopping Going to other stores Going to church Dining out Going to the senior center Library Volunteering Other entertainment 20.When you have trouble getting the transportation you need, what would you say is the main reason? a. Can't afford to pay for transportation b. Have to rely on others' availability c. I ave o gschedule too far ahead nd witf time hout someone to help me d. I have trouble getting e. If I don't call far enough in advance, there aren't any seats available f. Riding on public transportation takes too long g. Uncertain how to arrange for rides on public transportation h. Can't get from my house where the bus up i. Other — Please specify: 21.Have you ever used public transportation to get around in your community? a. Yes b. No (SKIP TO QUESTION 23) 9V° 6 22. What. if any, problems have you experienced? (Circle all that apply) a. I have not experienced any problems OR b. I have trouble getting to the bus stop c. The bus drivers are not helpful or courteous d. I have trouble getting in and out of the bus e. The bus doesn't go to the places I need to go f. The bus doesn't run during the evenings and weekends g. It is too confusing to have to make transfers between buses h. I worry about my safety while on the bus i. Inconvenient hours of operation j. Trips take too long k. Other — Please specify: • Now we would like you to tell us about your housing situation. 23.What type of home do you live in? a. House b. Townhouse/condominium/duplex c. Mobile home d. Apartment e. Room in a private home f. Other — Please specify: 24. Do you currently rent or own your home? a. Rent (SKIP TO QUESTION 27) b. Own c. I live in someone else's home (SKIP TO QUESTION 28) 25.How difficult is it for you to maintain the upkeep of your home? a. very difficult b. somewhat difficult c. not very difficult at all • 91,908/ • 26. Please tell us what kinds of repairs in your home needs and for the repairs you need what keeps you from making those repairs. Place a V in the box that best represents your answer. If you need repairs, what keeps you from making those repairs? Repairs Can't Don't Haven.t had I have contacted Repairs Not afford know the time to someone, but are not Needed the cost whom to do the repairs they haven't important call or call completed the right now someone work Plumbing Electrical Heating Outside (such as the roof, gutters. siding, painting) Inside (such things as ceiling, floors. windows, painting) House not set up to accommodate the physical conditions I have (e.g., need a ramp, bath rail, etc). 27.Are you having any of the following housing problems? (Circle all that apply) a. I have difficulty paying rent or mortgage most months b. Amount of space — too large or too small c. I have trouble moving around my home because of some physical conditions I have d. I worry about the crime in my neighborhood e. I don't get along with my neighbors f I have problems getting my yard work done g. I have problems getting my snow shoveled h. Other — Please specify: i. I have none of these problems 28.Do you anticipate moving in the next year? a. Yes 0 b. No (SKIP TO QUESTION 30) Why do you expect to move? a. Because of health reasons b. My current living arrangement is too costly c. I need a place that is easier to get around in d. My home is too big to keep up e. My home is too small for my needs f: Don't like the neighborhood g. Want to be closer to family or friends h. Other— Please specify: • 29. What type of living arrangement would you consider moving into? (Circle all that apply) I. Another house 2. Assisted living (where someone provides meals and helps with everyday activities) 3. Shared home with one or more persons not related to you 4. Apartment 5. Townhome or condo 6. Senior apartments with services (e.g., meals and housekeeping) 7. Low-income senior apartments 8. Live with family 9. Nursing home 10.Other — Please specify: Section III. In this next section, we would like to about your awareness of some programs and services in Weld County. 30. Please let us know if you have heard of these programs, if you have ever used these programs, and about how many times you used the program. Place a ✓ in the box that best represents your answer. Have you ever Have you ever About how many times in the last six heard of this used this months did you use the program?` program? program? PROGRAM OR SERVICE No Yes No Yes None 1-3 4-6 7-9 10+ Senior center Senior legal aid Home-health program Well adult clinics Homemaker services Adult day care services Peer counseling Senior group meals Meals on Wheels Long Term Care Ombudsman Senior Companions Senior Employment Programs Elderhostel Brown Bag Program Lifetime Wellness Clinic RSVP 9fa oar/ 9 31.In the last six months. have you experienced any of the following situations? (Circle all that apply) a. Been discharged from the hospital b. Had an illness that lasted more than two weeks c. Had a problem with your Social Security or other type of income benefit d. Had a problem with Medicare or other health insurance e. Felt like you needed to talk to someone about a personal matter f. Had trouble making a payment on a bill you owe g. Got "ripped off" by a business or person h. Had difficulty making meals or shopping 32.Please indicate whether you strongly agree, agree. disagree or strongly disagree with the following statements. Please place a ✓ in the box that best represents your answer. Strongly Agree Disagree Strongly Agree Disagree I would not be inclined to use a community program or service because I don't want people to talk about my personal situation I would be embarrassed to ask for help from a community program or service Programs and services that are available for older adults are for people who are worse off than I am Personal troubles should be resolved within our family without help from a community program or service Sometimes people can't always solve a problem on their own without help from a program or service I would be reluctant to use a community program or service because I have been self-sufficient ail my life Families should take care of each other and not ask for help from a community program or service I would be reluctant to use a program or service because I don't want to be dependent on others for assistance If I can't find a way to solve the problem on my own, I would consider seeking help from a program or service Sometimes it is alright to receive help without giving something in return Section IV. Next, we would like to ask about your interactions with friends and family members. 33.How many children do you have? _ (If you do not have any children, put a 0 in the blank and skip to question 36) 99,20s/ 10 34. On average, how often do you have contact (by phone or in person) with one or more of your children? a. Everyday b. 1-6 times a week c. 1-3 times a month d. Once a month e. 1-5 times a year f. About once a year or less g. Never 35.How would you rate the amount of contact you have with your children? a. The contact I have with them is less than I would like b. It's about right c. The contact I have with them is more than I would like 36. How many brothers or sisters do you have? (If you don't have any brothers or sisters. place a 0 in the blank and skip to question 39) 37.On average, how often do you have contact (by phone or in person) with one or more of your brothers and sisters? a. Everyday b. 1-6 times a week c. 1-3 times a month d. Once a month e. 1-3 times a year f. About once a year or less g. Never 38. How would you rate the amount of contact you have with your brothers and sisters? a. The contact I have with them is less than I would like b. The contact I have with them is about right c. The contact I have with them is more than I would like • 39.How many grandchildren do you have? (If you don't have any grandchildren, place a 0 in the blank and skip to question 43) 40.On average, how often do you have contact (by phone or in person) with one or more of your grandchildren? a. Everyday b. 1-6 times a week c. 1-3 times a month d. Once a month e. 1-3 times a year f. About once a year or less g. Never W:2705-/ 11 41.How would you rate the amount of contact you have with your grandchildren? a. The contact I have with them is less than I would like b. The contact I have with them is about right c. The contact I have with them is more than I would like 42.Have you ever been denied visitation with your grandchildren by their parent(s)? a. Yes b. No 43.About how many times did you talk to friends on the telephone in the past week (either you called them or they called you)? a. Once a day or more b. 2-6 times in the past week c. Once in the past week d. Not at all in the past week 44. How many times during the past week did you spend time with friends? a. Once a day or more in the past week b. 2-6 times in the past week c. Once in the past week d. Not at all in the past week Section V. This next section will ask you some questions about your health and health care services. 45.How would you rate your current health? a. excellent b. good c. fair d. poor 46. Listed below are some health conditions people often have. Please place a ✓ in the box to indicate if you have any of the following health conditions and how much these health conditions interfere with your activities. If yes, about how much does the condition interfere with your activities? Health Condition No Yes A great deal A little Not at all Osteoporosis Arthritis Glaucoma or other vision/eye problems High blood pressure Heart trouble Diabetes Stomach trouble Emphysema, chronic bronchitis, asthma Other— Please specify: , 9,sf,2o-/ 12 47.Next. we would like to ask you some questions about how you feel about life. Please indicate how much you agree or disagree with the following statements. Strongly Strongly Agree Agree Disagree Disagree I feel I am useful and needed I I feel hopeful about the future I often feel lonely I worry about becoming a burden to my family or friends Older people are valued in my community I 48.Below is a list of activities that we all need to do as part of our daily lives. For each activity, please tell us if you can do the activity without any help, if you need some help, or if you can't do it at all. If you do need some help with an activity, please tell us if there are times when you have difficulty fording someone to help you with that activity. Place a ✓ in the box that best represents your answer. If you need assistance, are there times when you have difficulty finding someone to help you with this? I can do this I need Unable ACTIVITY without some to do Yes No assistance assistance alone Shop for groceries or other necessities Prepare your own meals I I Walk or move about Manage and take your own medications Do your own housework Get in and out of chairs or your bed Dress and undress yourself _ Take a bath or shower Manage your own money and financial affairs 9, .A0 Sl/ 13 49.Do you have a family doctor that you see on a regular basis when you need health care? a. Yes (SKIP TO QUESTION 51) b. No 50.Could you tell us why you don't have a family doctor? a. I can't afford the cost of seeing a doctor b. I can't find a doctor I like c. I can't find a doctor that accepts Medicare d. I can't fmd a doctor that accepts Medicaid e. Other - Please specify: (SKIP TO QUESTION 53) 51.How satisfied are you with the health care you are receiving from your.doctor? Are you.. a. very satisfied, b. somewhat satisfied. D' If you are satisfied_ skip to Question 53 c. somewhat dissatisfied. or d. very dissatisfied? 52.If you are dissatisfied, what is the main reason you feel that way? a. Doctor doesn't spend enough time with me b. The doctor doesn't help me with my problems c. I have to wait too long to get an appointment d. The doctor doesn't seem to be able to help me my problems e. Other — Please specify: 53.How often do you do the following? Please place a ✓ in the blank that best represents your response. Most of Frequently Occasionally Never the time Take medication prescribed for someone other than you because it worked well for them Check to see if there will be any interactions with your prescribed drugs before taking non- prescription medication (such as aspirin or cold medicine) Throw away out of date prescriptions Feel knowledgeable about all of the medications you are taking Worry that you are addicted to your medications Take prescriptions from more than one doctor Take less than what is prescribed in order to make the prescription last a longer amount of time 14 54.Now we would like to ask you about some other health services. Please tell us if you had difficulty getting these services in the last year and what was the reason you experienced difficulty. Place a ✓ in the boxes that best represents your answer. Experienced If yes, what is the primary reason you difficulty in experienced difficulty in getting this getting this service? service last year? Didn't Don't Health Service need this No Yes Cost Transportation know service whom to see Eye care Hearing care Dental care Home health care I L Rehabilitation services Other health care - specify: Section VI. Now, we just have to ask you a few questions about yourself This information helps us classify the surveys. Just remember, though, that all your responses are completely confidential. 55.What gender are you? a. Female b. Male 56.What is the highest level of education you have completed? a. Less than 6th grade b. 6th to 11th grade c. High school or GED d. Some College e. Bachelor's degree f. Graduate degree 57.What do you consider your race to be? a. Hispanic b. White (Non-Hispanic) c. African American d. Asian American e. American Indian 1. Mixed race - Please specify: • 15 58.What is your martial status? a. Married/Partner b. Widowed c.. Divorced or separated d. Never married 58a. What is your age? 59.Not counting yourself, how many people live with you? 60.How long have you lived in Weld County? Months or Years 61. For the purpose of our survey, we need to have a routh idea about your income. This information will not be shared with anyone. Into which of the following categories did your total family income from all sources fall last year before taxes? a. Less than $8000 b. $8000-$10,499 c. $10,500-$14,999 d. $15,000-$49,999 e. $50,000+ 62.Do you have any major financial concerns? a. Yes b. No (SKIP TO QUESTION 65) 63.What would you say are your financial concerns? (Circle all that apply) a. Doctor and other health care costs b. Prescription medication costs c. Transportation costs d. Home repair costs e. Bills in general f. Health insurance costs g. Property taxes h. Having enough money for my retirement years i. Utility and phone costs j. Paying for nursing home care or long term care k. Other—Please specify: 64.Of those you selected in Question 63, which would you say is your biggest concern? Place the letter in the blank below. • 16 Section VII. Needs of Weld County 65.When you think about Weld County as a whole, what do you see as the most pressing problem facing Weld County? are there any other comments that you would like to make? • giurnA Watt/ If you would like a summary of the results of this study, please ✓ this box O %5a0, / Hello