HomeMy WebLinkAbout972302.tiffRESOLUTION
RE: APPROVE GRANT APPLICATION FORM TO THE VICTIM'S ASSISTANCE AND
LAW ENFORCEMENT BOARD 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 Grant Application Form between the
County of Weld, State of Colorado, by and through the Board of County Commissioners of
Weld County, on behalf of the Department of Human Services, and the Victim's Assistance and
Law Enforcement Board, commencing January 1, 1998, and ending December 31, 1998, with
further terms and conditions being as stated in said application, and
WHEREAS, after review, the Board deems it advisable to approve said application, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the Grant Application Form between the County of Weld, State of
Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the
Department of Human Services, and the Victim's Assistance and Law Enforcement Board be,
and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 22nd day of October, A.D., 1997.
ATTEST:
Weld County'
BY.
Deputy Clerk
AP "• EDAAST
/4
ounty Att
HS
FORM:
BOARD OF COUNTY COMMISSIONERS
WELD C LINTY, CODO
r
Baxter, Chair
arbara J. Kirkmey
W. H. Webster
972302
HR0068
Victim's Assistance & Law Enforcement Board
Nineteenth Judicial District
Fiscal Year 1998
GRANT APPLICATION FORM
I. Project Title Weld County Long Term Care OmbudsmanAdvocate/Friendly Visitor
Program
II. Lead Agency/Organization Weld County Area Agency on Aging
Contact Person Linda E. Piper. Director Phone 970-353-3800. Ext. 3320
Address 1551 North 17th Avenue. P.O. Box 1805. Greeley Colorado 80632
III. Amount Requested $7.271
IV. Non-profit Status X (Government) Yes
George E.
Chair, Bo
ATTEST:
Weld Co
By:
Deputy
(10/22/97)
mmi ssioners
Board
No In Process
Section A: Summary
The Weld County Long Term Care Ombudsman Program has been a consumer voice for the elderly residing in
nursing homes and personal care boarding homes (assisted living) for more than twenty (20) years. The authority of the
local ombudsman program comes from the Older American's Act, Colorado Revised Statutes 25-11.5 and the Nursing
Home Reform Law of 1987. The Weld County Ombudsman acts as a consumer voice for the concerns of the elderly
living in institutions who may have no one else to speak for them. The Ombudsman also receives and resolves questions,
issues, problems and complaints made by, for, or on behalf of residents of long term care facilities.
Currently 1,007 persons live in Weld County long term care facilities. This includes five nursing homes and 14
personal care boarding homes. By December of 1997 that number will rise to 1,273 (a 21% increase) with the opening
of one nursing home and five new personal care boarding homes. These new facilities are being built to respond to the
increasing number of frail elders age 75 and older with chronic conditions which interfere with their ability to live
independently in the community.
The V.A.L.E. grant has allowed the Area Agency on Aging Ombudsman Program to to increase staff time to
keep up with the increasing demand for advocacy on behalf of this very vulnerable population. With current resources,
the program will not be able to meet even the minimum requirements of the position.
We are requesting a modest amount of V.A.L.E. Board Funds ($7,271) to continue to fund the position of a part
time friendly visitor/Advocate to assist the lead Ombudsman. This position is working 10 hours per week in the field
visiting nursing homes and personal care boarding homes. By maintaining a constant presence in these facilities the
Assistant Ombudsman has built trusting relationships with residents and staff. This has allowed her to educate residents
and staff about the Ombudsman Program and resident rights as well as investigation of complaints of abuse and neglect.
Long term care residents face both physical and psychological barriers when it comes to expressing and
advocating for their needs. This makes residents more likely to be victimized by care givers. The ombudsman's role
through observation and a frequent presence in the facilities; is to insure that resident rights are being respected, that
quality care is administered, and that abuses do not occur. Continued funding of the ombudsman assistant will make it
possible for the Area Agency on Aging Ombudsman Program to serve all of the long term care residents and their
families including coverage for the proposed new facilities.
In 1998 the funds will be used to continue this valuable program and to expand its scope to include elder abuse
education using a tested program model. We believe that our request for a continuation of V.A.L.E. funding relates to
the mandate of early crisis intervention and to provide assistance to victims and their families.
Section B: Project Concept/Design
2. Project Goals:
• To enhance the ability of the Weld County Long Term Care Ombudsman Program to act as a consumer voice for
the concerns of the elderly living in nursing homes and personal care boarding homes. By visiting nursing
homes and personal care boarding homes, there is an ongoing process of building trust with the residents so that
instances of mistreatment and elder abuse can be identified and addressed promptly.
• To enhance the ability of the Weld County Long Term Care Ombudsman Program to receive and resolve
questions, issues, problems and complaints on behalf of residents of long-term care facilities.
1
To enhance the ability of the Weld County Long Term Care Ombudsman Program to provide community
education regarding issues of elder abuse and quality of life for residents in long-term care facilities.
A program referred to as CARIE (see attachment B) which stands for Coalition of Advocates for the
Rights of the Infirmed Elderly will be used for training. CAME consists of eight training modules that
focus on various aspects of elder abuse. The training program will be used to assist with educating staff,
residents, and family member regarding victimization. Training and education can be accomplished
through CNA conferences or inservices at nursing homes or personal care boarding homes.
Project Objectives:.
Continue increased ombudsman presence of 10 hours per week in Weld County long term care facilities for the
purpose of providing a consumer voice for the concerns of elderly living in institutions and to be able to
promptly address any instances of mistreatment or abuse. Visitations to begin January 1, 1998.
Visit 500 long term care residents and investigate 50 complaints by December 31, 1998.
Implementation of the Elder Abuse Prevention Program which will train approximately 300 nursing home and
personal care boarding home staff on identification, causes and strategies for abuse prevention by December
1998.
3. Problem being addressed:
The purpose of the Weld County Long Term Care Ombudsman Program is to assist consumers of long-term
care services with information about those services and to resolve complaints related to the provision of the long term
care. These issues or complaints may include, but are not limited to: access to long-term care services, redress of
neglectful or abusive care, and information and assistance with civil and human rights. The long-term care ombudsman
program is a resident/patient/consumer-centered advocacy program.
Long term care ombudsmen have statutory status under the Older Americans Act of 1965 as amended and are
required by federal and state law to visit every nursing home monthly, every personal care boarding home quarterly, to
receive and resolve complaints, to identify needs of long term care residents and help establish programs to meet those
needs, and to document problems of long-term care and to stimulate improvement of the system.
As of December 1997 Weld County will have 852 nursing home beds and 421 personal care boarding home beds.
Ombudsman activities, including all education and technical assistance components, all required visitations, and all
complaint investigation will be handled by one .75 FTE qualified long term care ombudsman and the .25 FTE Assistant
Ombudsman funded by this proposal.
A trend analysis conducted by the Weld County Area Agency on Aging of projections of future long term care
facilities, both nursing homes and personal care boarding homes, to be built in Weld County by the end of 1997, shows a
21% increase in long term care beds. (See Attachment C) Federal funds, through the Older Americans Act, are not
keeping up with the need for long term care advocates. With current resources available to the Area Agency on Aging,
it will be impossible to meet the minimum requirements for a visible presence in long term care facilities. In an effort to
keep up with the visitations, we expect that both training and technical assistance to the facilities will also decrease.
Such training is key to the prevention of practices that diminish the quality of life of residents and in some cases may
border on abuse.
There is continuing evidence from statements made by regulatory agencies that an informed community presence
in long term care facilities can help to maintain or improve the quality of the facility and thus the quality of resident's
lives. In short, the problem we are trying to resolve is the lack of ombudsman resources to cover exceptional increases in
the growth of long term care services in Weld County in the next two years.
4. Timetable:
This is a continuation request. The hiring and training that were needed last year to get the program underway
will not be necessary as we plan to continue with the same employee in this position. Visitation and complaint
investigation will continue into 1998, beginning January I, 1998.
The implementation of the Elder Abuse Prevention Program timetable will be as follows:
Purchase of training materials by March 1, 1998.
Staff review and orientation to training materials by April 1, 1998.
Begin to train facility staff by May I, 1998.
Training of 300 nursing home and personal care boarding home staff by December 31, 1998.
5. How Objectives will be accomplished:
Under the guidance of the lead ombudsman the advocate will continue to be assigned a specified number of long
term care facilities to visit on a regular basis. Ten hours per week will be allotted for visitation and travel time. The
average visit per facility will be one hour; however the visit could take longer if there is a need. During 1997 the
Assistant Ombudsman made visits to 492 residents of long term care facilities and investigated 42 complaints.
The Elder Abuse Prevention Program is based on a training module called the CARTE program. CAME consists
of eight training modules. The first module is an overview of abuse in nursing homes. The second module identifies and
recognizes abuse. The third module explains possible cause of abuse. The fourth module focuses on understanding
feelings of the care giver. The fifth module identifies cultural and ethnical perspectives and implication for resident/staff
dynamics. The sixth module focuses on abuse of staff by residents (understanding the abuse instead of personalizing).
The seventh module explains ethical and legal issues of reporting abuse. The eighth module provides intervention
strategies for abuse prevention.
The Assistant Ombudsman will train staff at long term care facilities and residents regarding victimization.
Abuse issues include physical, emotional, sexual, financial, abandonment, and neglect. Training individuals about elder
abuse is very important for several reasons. First, the older adult population is the most vulnerable and frail. Many older
adults rely on other people to take care of their activities of daily living and finances. Second, abuse of older adults is
under reported. Many states including Colorado do not have mandatory reporting of elder abuse. Third, older adults
(especially those 85+) are the fastest growing segment of the population. Fourth, the study of gerontology has been
limited which affects professionals in their ability to address the problems of elder abuse effectively.
3
6. Anticipated problems in implementing goals and objectives:
Implementing the extension of our current ombudsman program in 1997 did not pose any problems. The
Assistant Ombudsman position met the goals and objectives within the appropriate time lines. We do not anticipate any
problems of reaching the new goals and objectives for 1998. The Assistant Ombudsman will be able to fulfill the
original goals and objectives while implementing the Elder Abuse Prevention Program.
7. Program goals as related to the V.A.L.E. statute:
This program continuation request most relates to 24-4.2-105, Section 2, part a and part b. Part a addresses
provision of service for early crisis intervention. As mentioned earlier, there is evidence that when there is constant and
continuing community presence in long term care facilities the potential to improve the quality of life and prevent abuse
and exploitation is reduced for the residents. We propose to continue advocate contacts with long term care residents as
a preventive move. We know that there may be many barriers to the elderly, particularly those in long term care
facilities, to express their particular needs without assistance from others. Some of these barriers are physical due to loss
of sight, speech, or hearing. Some barriers are psychological due to a sense of isolation, fear of retaliation, or
disorientation. Barriers to self advocacy can also be because of the lack of information about rights, alternatives, and
legal remedies.
Part b addresses assistance programs for victims and their families. A key role of the long term care ombudsman
is complaint investigation and complaint resolution. Long term care residents must be assured that the ombudsman will
be able to follow up on their complaints in a timely and professional manner. With the continued increase in long term
care beds, the ability of the present ombudsman to respond appropriately to complaints will be jeopardized. The
proposed friendly visitor/advocate to be hired under this proposal will extend our ombudsman hours insuring that the
lead ombudsman will be able to respond to residents and their families in a timely and appropriate manner.
This year the Assistant Ombudsman was contacted by a relative who was concerned about her mother who
resides in a nursing homes. The resident had received bruising on two occasions, and deep second degree burns. The
relative suspected abuse or neglect by nursing home staff. The Assistant Ombudsman attended a meeting with the family
member to discuss issues with the Director of Nursing, a staff member from Medical Records, a Charge Nurse, and the
Administrator. The Assistant Ombudsman also spoke with the resident's doctor. The doctor was not as concerned with
the bruising because of the resident's physical condition. However, the doctor did express concern about the deep
second degree burns on the residents heels. The burns were a result of heating pads being left on for to long. The
nursing home took proper measures to insure that it would not happen again.
Section C: Service Information
8. Population and geographic area targeted:
Population targeted are 60 plus elderly residing in nursing homes and personal care boarding home located in
Weld County.
4
9. Numbers of persons in need of these services:
By December 1997 1,273 Weld County residents will live in long term care facilities. All of these residents
receive services through the ombudsman program either directly with visitations and complaint resolution or indirectly
through training and technical assistance provided to staff to improve the quality of care. By extension, the Program also
may represent the concerns of relatives and/or friends of long term care residents as long as the concern reflects the
concerns of the resident.
This project will make it possible for the Area Agency on Aging Ombudsman Program to continue to serve all of
the long term care residents and their families when appropriate including the proposed new residents with the same type
and degree of services that we currently are providing.
10. Management Plan
The Director of the Weld County Area Agency on Aging will be accountable for the administration of this
project. The part time ombudsman advocate will be trained and supervised on a daily basis by the lead ombudsman
under the supervision of the Long Term Care Coordinator who reports to the Area Agency on Aging Director.
11. and 12. Duplication of Services
There is no other program which provides services equivalent to the ombudsman program.
13. Cost Savings
When an advocate visits a long term care facility and discovers that a patient has an open sore which is not being
properly cared for, the advocate can work with the facility to help staff learn procedures that prevent pressure points
which irritate the skin in the first place. There is considerable medical savings to the taxpayer (most nursing home
residents are on Medicaid) when extreme medical procedures can be avoided.
When long term care patients are restrained, not only is it a violation of individual rights, but an opportunity is
missed to administer therapies which can help the patient become more independent. The ombudsman, again, can
identify these situations and work with the staff to develop plans of care which will respect individual rights and give the
patient care that may increase his/her potential to be independent. Dependence costs society.
Section D: Efficiency
14, Evaluation of project
The Ombudsman Program maintains files which generate monthly, quarterly, and annual reports. Data is kept on
numbers of visits, complaints, and technical assistance contacts. Data is broken down further to reflect types of
interventions, types of complaints, types of facilities, and actions taken.
5
Section E: Budget
15. Future funding needs
Future funding needs will correlate with how much growth occurs in long term care beds in Weld County. The
current growth spurt is statewide and is reflective of the rapid increase in numbers of elderly 75 years of age and older
who are frail and in need of some type of long term care. Assisted living continues to be a fast growing industry in all
areas of Colorado and the nation. Area Agencies on Aging nation—wide are working to bring this to the attention of
federal and state governments emphasizing the need for support of the ombudsman program.
16. See attached budget
17. Budget Narrative
We are requesting $6,771 dollars for a .25 FTE advocate/friendly visitor at $7.50 per hour for 10 hours PER
week — $3,915 for hourly salary and $392 for FICA. Travel reimbursement will be at .27 cents per mile for 5,256 mile
or $1,314 dollars. Mileage records will be kept by the advocate for documentation. Overhead is at 10 percent or ($650)
for supplies and general administration. Training is ($500) and includes cost to attend ombudsman training sessions in
Denver and other local and state training required by the Area Agency on Aging. This year we are requesting an
additional ($500) for the Elder Abuse Prevention Training Module.
VICTIM ASSISTANCE AND LAW ENFORCEMENT BOARD
DETAILED AGENCY BUDGET
16. DETAILED PROJECT BUDGET: Include the estimated cost of all resources needed to undertake the project.
round off figures to the nearest dollar. This budget page must include all monies available. In -kind
services need to be listed only In the budget narrative. not on this page.
a. Personnel (Employees)
(1)
(2)
TOTAL
Salaries (list each position with salary rate and
Percentage of time devoted,
Eva Jewell
' 32,679/YR I
5 %
1.634. •
Mindy Rickard
j6,270/YR i
99 '
16,107
Tia J.
3,9l5/YR
100'
3.915
/YR I
t
/YR
k
Subtotal of Personnel - .
S
I CA, Retirement, Fringe Benefits
etc. ,
2,382
Total Personnel Costs
b. Su
c.
PP
lies and Other Operating Expenses
I S
Icommunications. reproduction)
Supplies/operating/overhead/admin
Training
Total Supplies and Operating Expenses
Travel (itemize transportation and subsistence
Mileage/out of town travel/meals
I S
2.218
1,000
3.943
CATEGORY
TOTAL
e 24,038
I
Total Travel Costs
d. Equipment (itemize)
Total Equipment Costs
e. Professional Services (itemize individuals and organizations
I S
I S
Is
IS
Total Professional Services Costs
f. TOTAL PROJECT COST
g.
Total Percent by Source
(1) Federal Funds
(2) VALE Funds •
(3) Other Funds
TOTAL
$
$ 7,271 23
24,528 77
$ 31,799
k
100 t
Please explain the source of "Other Funds' in the budget narrative.
17. BUDGET NARRATIVE: Explain and justify th4 project budget and relate the item budgeted to project activities
(use continuation sheets). -
OR VAPPL. VW
Is
3,818
3,943
I $ 31,799
0
0
ATTACHMENT A
REGION: 28
NOTIFICATION OF GRANT AWARD TO AREA AGENCY ON AGING
FOR OLDER AMERICANS ACT TITLE III FUNDS
Type of Grant or Action
■ Initial Award
Revision of Earlier Grant issued
Grant Award Period
Beginning: 1/1197 and Ending 12/31/97
COMPUTATION OF AWARDS:
ADMINISTRATION OF THE AREA PLAN
Total Approved Budget
Local Share of Cost
Federal Share of Cost
SERVICES UNDER THE AREA PLAN
Total Part B, D & F Budget
Less B, 0, & F Program Income
Net Part B, D, & F Budget
Total C-1 and C-2 Budget
Less C-1 8 C-2 Program Income
Net Part C-1 &O-2 Budget
Total Services Budget
Local Share of Cost
Fed/State Share of Cost
45,155
$ 12,351
S 32,804
E 403,105
S 79,000
$ 324,105
$ 365,715
$ 166,951
S 198,764
S 522,869
E 197,275
S 325,594
Grant Award No.
02B - 88 (FY 1997)
Region 28
Name and Address of Grantee
Weld County Department of Human Resources
PO Box 1805
Greeley, Colorado 80632
PART B SUPPORTIVE SERVICES
Fed/State Carryover
Fed/State New Allocation
Total Part B F/S Award
PART C-1 CONGREGATE MEALS
Fed/State Carryover
Fed/State New Allocation
Total Part C-1 F/S Award
PART C-2 HOME DELIVERED MEALS
Fed/State Carryover
Fed/State New Allocation
Total Part C-2 F/S Award
PART D IN -HOME SERVICES
Fed/State Carryover
Fed/State New Allocation
Total Part D F/S Award
S 148,811
PART F HEALTH PROMOTION SERVICES
Fed/State Carryover
Fed/State New Allocation
Total Part F F/S Award
TOTAL AWARD FOR SERVICES
Except where it is in conflict with this Notification of Grant Award in which case the Notification of Grant Award governs,
the area plan upon which this award is based is an integral part of this grant.
APPROVALS:
by
Barbara cDonnell, Executive Director
Colorado Department of Human Services
1575 Sherman Street
Denver, CO 80203
148,811
S 31,353
$
4,837
4,837
S
8,158
S 8,158
375 594
Author¢e/of Grant Recipient
Title Date
ATTAC H.',iENT B
QUALITY OF CARE PROJECT
"ENSURING AN ABUSE FREE ENVIRONMENT'
Module 1 An Overview nt Abuse in Nursing Hnmac
In this meeuwe an overview of abuse in nursing homes is presented. Topics include general characteristics of
nursing home residents and the events that usually precipitate placement; societal perceptions of nursing
homes; organization of the nursing homes; and nursing home legislation, including residents' rights.
Module 2 jdentifratin i and Renagnifian j/Ihus,
The curriculum uses six categories of abuse: physical, psychological, sexual, financial exploitation, and active
and passive neglect. Examples are provided of each type, as are indicators of abuse.
Module 3 Possible Causes of Ahn5y
Topics include understanding factors that place residents at risk of abuse. This module presents behavioral
problems and communication deficits In residents that can precipitate abuse. Problems that affect nursing
aides, such as lack of training, inadequate supervision, work stress, and the facility environment are discussed
Module 4 Understanding Faalingc Ahn,d Caregiving
A stress indicators exercise Is used to assist staff in identifying their own areas and levels of stress within and
outside the workplace. This is followed by a discussion about different causes of stress, systems of stress, and
the need to use self control when faced with a difficult situation. The danger signs of stress and the
relationship between stress and the potential for abuse are covered. Staff then explore methods and ideas
about developing more healthy responses to stress.
Mori l..,5, J uil!nrars^pd Ethnic Pwenar•tives and L
A review of the meaning of culture and ethnicity is followed by a dscussion of the various cultural backgrounds
and the ethnic diversity of the residents and staff in the facility. Staff then discuss how understanding of these
differences can enrich both staff and resident relationships.
Module R Abuse of StaHhv Rem ri n!s f Indarstand pg versr c Peraen.eft iin�e
This module covers causes of resident anger and verbal and physical aggression. Nonviolent approaches to
defusing anger and minimizing resident aggression are presentee through group discussion and role play.
Modulo T fthiral and I anal Rains of Reporting Rusnenpd Anima
This module encourages staff discussion of what they perceive their ethical responsibility to be regarding the
reporting of abuse. Pressures against reporting are discussed. Trainers are encouraged to review reporting
procedures for their facilities and the Colorado laws. A review of the possible consequences of not reporting
suspected abuse is included.
Module R Insarvention Strategies /nr Abuss Prevention
This module provides a review of topics covered throughout the curriculum, and gives participants the
opportunity to practice intervention strategies through role-playing. Content includes the appreciation of
challenging residents, expectations of staff and residents, accepting Individual differences, understanding
versus personalizing resident aggression, and the use of creative intervention strategies to manage challenging
behavior.
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ATTACHMENT C
WELD COUNTY
Long Term Care Beds -Current and Projected Analysis
Current Long Term Care Beds Status:
Nursing Home Beds 732
Personal Care Boarding Home Beds (assisted living) 275
Projections for Future Facilities:
Life Care Center- Opening Dec. 1997
Living Centers- Opening Dec. 1997
Alladin- Opening Oct. 1997
Windsor -Opening Oct. 1997
Beehive -Opening Nov. 1997
New nursing home beds total: 120
New assisted living beds total: 146
120 nursing home beds
64 assisted living beds
52 assisted living beds
16 assisted living beds
4 assisted living beds
10 assisted living beds
Total beds by 1998: 1,273 ( this is a 21% increase from August of 1996)
updated Oct. 1997
ATTACHMENT 13
AREA AGENCY ON AGING ADVISORY BOARD MEMBERSHIP
Gale Heiman
Greeley
01-31-99
Beverly McConnico
Greeley
01-31-1999
John Espinosa
Milliken
1-31-1999
Mary Ellen Faules
Bonell
1-31-2000
Mary Fox
Kersey
WELDCOS
1-31-2000
Barbara Kirkmeyer
County Commissioner
Revolving Position
Priscilla Kimboko
Greeley/UNC
1-31-99
John Lee
City of Greeley
Undetermined
Suzanne Gray Listenann
Eaton/Church
1-31-98
open position
1-31-2000
Jim Riesberg
Greeley
1-31-98
Margaret (Peg) Scott
Fort Lupton
1-31-99
Wilbert Wiedeman
Evans
1-31-98
Shirley Ianelli
Hudson/Keenesburg
1-31-99
Judy Yamaguchi
Platteville
1-31-2000
MEMO
To: George E. Baxter, Chair, Board of County Commissioners 1
From: Walter J. Speckman, Executive Director Human Services V
Subject: Contract with Victim Assistance and Law Enforcement Board
Date: October 20, 1997
(0
Enclosed for Board approval is a grant proposal to the Victim's Assistance and Law
Enforcement Board (VALE) for $7,271 to support additional staff time to expand ombudsman
visitations to Weld County nursing homes and personal care boarding homes. The request is a
$500 increase over the 1997 grant. The increase will be used to fund and elder abuse training
program with nursing home and assisted living staff.
The proposal, if funded, would begin January 1, 1998 and extend through December 31, 1998.
Please address any additional questions to Linda Piper, Director, Weld County Area Agency on
Aging, extension 3320.
972302
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