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Home My WebLink About20151922.tiff RESOLUTION RE: APPROVE FOUR-YEAR PLANNING AND SERVICE AREA AGING PLAN (TITLE III AND VII) FOR FEDERAL FISCAL YEARS 2016-2019 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 Planning and Service Area Aging Plan (Title III and VII) for Federal Fiscal Years 2016-2019 from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, Area Agency on Aging, to the Colorado Department of Human Services, Aging Services Unit, commencing July 1, 2015, and ending June 30, 2019, with further terms and conditions being as stated in said plan, and WHEREAS, after review, the Board deems it advisable to approve said plan, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Four-Year Planning and Service Area Aging Plan (Title III and VII) for Federal Fiscal Years 2015-2019 from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, Area Agency on Aging, to the Colorado Department of Human Services, Aging Services Unit, 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 1st day of July, A.D., 2015. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO d4trifed,OCam( “_z,___ jATTEST: c�• ..-140;4 / �h(� -�z� .{& 'Barbara Kirkmeyer, Chair Weld County Clerk to the Board -Tr- /1 n n _�� nn � Mike Freeman, Pro-Tern BY. l � (.Q1 W /I �• !��►� Cam_ De ur Clerk to the Bo:rd ' 1� I F. �z`, / ` - t� 4A,;;.• An P. Conway 1011 APPROV D AS TO Fey ; ' ' '' (2-)' t t(1:14 E„ :. . . Cozad / " nt •ttorney N% ( i �I /q J -)1 Steve Moreno iftle Date of signature: Li CC, 1-tSAttxn g1la 2015-1922 HR0086 /O //.,a_. MEMORANDUM [)A:[ : June 18.2015 TO: Board of County Commissioners - Pass-Around 1; r\ -, p1 FR: Judy A.Griego,Director,Human Services ,'n .rI :'_. .y O J N T Y RE: Weld County Department of I luman Services'Area Agency Ton Aging(AAA)Four Year Plan Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Departments'Area Agency on Aging(AAA)Four Year Plan— Attachment 1.The Weld County AAA Four Year Plan,State Fiscal years 2016-2019(July I,2015 to June 30.2019),will help guide the AAA staff and Advisory Board in the provision of services and support to the seniors of Weld County. The plan will he reviewed annually and adjustments will be made to reflect changes and new opportunities.All changes that may occur during the planning period will he vetted by AAA.the AAA Advisory Board.the Board of County Commissioners and the Colorado Department of Human Services.State Unit on Aging. The Plan includes:the public input process;programs that will be funded within the planning period;the use of volunteers by AAA and our service contractors;specific program and planning questions;outcome strategies and performance indicators for specific programs;and a form section.The planning document follows the template that was developed by the Colorado Department of Human Services,State(;nit on Aging. The public input process provided us with critical information we were able to use in our decision making process,along with the regulatory requirements of the Older Americans Act,when we defined the program areas that would be funded by the Older Americans Act and the Older Coloradoan funds over the next flour years. The question section of the plan touched on issues such as:the needs of the oldest segment of our aging population;increasing the number of seniors served:the scope of the Legal Program,and the role and expectations of the Long-Term erm Care Ombudsman Program.Each question was addressed thoughtfully. keeping in mind the requirements of the Older Americans Act.the scope of the programs and available resources. The final major section looked at outcomes.strategies and performance indicators of six key areas. They included those not served and underserved.caregiver,transportation.legal.ombudsman and nutrition programs. The outcomes and the performance indicators were predetermined by the State Unit on Aging.The strategies were either written by the State l nit on Aging or evaluated by AAA and/or additional strategies were developed and added by AAA. The performance indicators and outcomes pertaining to our contracted providers will be reflected in their contracts effective July I.2015. I do not recommend a Work Session. I recommend approval of this Plan. Approve Request ItO( ( .g nda<Anrk Session Sean Conway Steve Moreno Barbara Kirkmeycr 1,liLe 1 reeman Julie Coiad 2015-1922 Pass-Around Memorandum: tune 10. 2015 Page 1. AREA PLAN TITLE III and TITLE VII OLDER AMERICANS ACT Weld County Area Agency on Aging Region 2B STATE FISCAL YEARS 2016-2019 (July 1, 2015 to June 30, 2019) , , , i (-:. !,,,, , r - -- t;#{ 125 , : kiS* - r.' ' — t GrOver U#' ' 1 Nunn � r ;.a. .sign. 1N NN,__.),.. i 14 ' malt '.. :.j ,'7' *Thit le!, _ , . ,Severancegion `14,4 `.4c,.. Windsor' ' G 4 Greet et P)rt North Kersey North & East Weld County Central/West Weld County GI's, Up Evans South Weld County tvlilliken a. . • ' • • La Salle I jct n CV stofit 3/ r� ltr. t idcr'e t c R 9 !Mda e r ? ) ``Platteville �"'� M I71°1I ,f Fireston te'#i+ , , , , Afkete- .n. sessbill - l . : ' ' ' * 'F r1 Lupton , 04404444411•••• �_ y Docono File : UP Hudson a , 00 / 5. - / C) 02 , TABLE OF CONTENTS Section I: Executive Summary 4 Section II: Public Input 4 Section III: Current and Future Programs and Use of Volunteers . 6 Section IV: Questions 16 Section V: Demographics 23 Section VI: Title III /VI Coordination 23 Section VII: Outcomes, Strategies, and Performance Indicators 24 Section VIII: Forms 28 Attachment A: Direct Service Waiver Request 28 Attachment B: Meal Sites 30 Attachment C: Community Focal Points and Senior Centers 35 Attachment D: Regional Advisory Council Membership 38 Attachment E: Statement of Intent/Signature Page 39 Section IX: Area Plan Implementation . 40 Section X: Area Plan Checklist 42 SECTION I: EXECUTIVE SUMMARY The Weld County Area Agency on Aging Four Year Plan, STATE FISCAL YEARS 2016-2019 (July 1, 2015 to June 30, 2019) will help guide the Area Agency on Aging staff and Advisory Board in the provision of services and support to the seniors of Weld County. The plan will be reviewed annually and adjustments will be made to reflect changes and new opportunities. All changes that may occur during the planning period will be vetted by the Area Agency on Aging, the Area Agency on Aging Advisory Board, the Board of County Commissioners and the Colorado Department of Human Services, State Unit on Aging. The Plan includes: the public input process; programs that will be funded within the planning period; the use of volunteers by the Area Agency on Aging and our service contractors; specific program and planning questions; outcome strategies and performance indicators for specific programs; and a form section. The planning document follows the template that was developed by the Colorado Department of Human Services, State Unit on Aging. The public input process provided us with critical information we were able to use in our decision making process, along with the regulatory requirements of the Older Americans Act, when we defined the program areas that would be funded by the Older Americans Act and the Older Coloradoan funds over the next four years. The question section of the plan touched on issues such as: the needs of the oldest segment of our aging population; increasing the number of seniors served; the scope of the Legal Program, and the role and expectations of the Long-Term Care Ombudsman Program. Each question was addressed thoughtfully, keeping in mind the requirements of the Older Americans Act, the scope of the programs and available resources. The final major section looked at outcomes, strategies and performance indicators of six key areas. They included the unserved and underserved, caregiver, transportation, legal, ombudsman and nutrition programs. The outcomes and the performance indicators were predetermined by the State Unit on Aging. The strategies were either written by the State Unit on Aging or evaluated by the Area Agency on Aging and/or additional strategies were developed and added by the Area Agency on Aging. The performance indicators and outcomes pertaining to our contracted providers will be reflected in their contracts effective July 1, 2015. SECTION II: PUBLIC INPUT The Weld County Area Agency on Aging (AAA) offered multiple occasions for consumers to share the strengths and needs of seniors in Weld County. The Area Agency on Aging Advisory Board members and the Area Agency on Aging staff members played a significant role in gathering information through questionnaires and focus groups. Of the twenty-two (22) Weld County AAA congregate meal sites, board members and staff attended eleven (11) sites. Each of the visited seniors received a questionnaire and was provided an opportunity to share ideas and needs with the Area Agency on Aging. In addition, the remaining eleven (11) senior nutrition program sites received the same questionnaire that 4 was distributed in order to elicit their thoughts concerning not only senior service needs but also strengths that exist in their communities. These eleven (11) meal site visits occurred in 2014 on the following dates and locations: October 13 at the Fort Lupton Recreation Center; October 20 at the Greeley Manor; October 21 in Wattenberg; October 23 at the Broadview Apartments; October 27 at the Platteville Community Center; October 28 at the Evans Community Center; October 30 at the Carbon Valley Recreation Center; November 3 at the Milliken Community Center; November 6 at the Erie Recreation Center; November 7 at the Windsor Recreation Center; and November 18 at the Lochbuie Senior Center. Questionnaires were also given and collected at the 50+ Health and Job Fair on October 3, 2014; the Senior Nutrition Program volunteer trainings in October and November; churches and various Weld Aging Well workshops. Overall, the more than 700 consumers surveyed reported the positive activities occurring in their communities were the congregate meal programs (32%), the activities and programs offered through their local community or recreation center, and outings and exercise programs. Fellowship, volunteer opportunities, and health screenings were also reported as strengths the consumer utilizes. When inquired about improvements they would like to see, consumers stated transportation as the number one service. In centers that are unable to provide a structured and ongoing program (those that are only open for a limited time or are not run as a full community center), consumers are requesting an increase in program and activities offered. In addition, only seven percent of consumers stated an improvement was needed in the quality of the congregate meal food such as spice, cooking methods and a reduction in the amount of waste due to the fact that participants are not allowed to take leftover food home. Several comments from the older adults also indicate they would like to see more attendance at their community events. When asked how consumers heard about senior services in their community, the majority relied on the senior or recreation center. That is closely followed by hearing information from friends, family and/or word of mouth; then the newspaper; newsletters; churches; internet; radio; and their physician, respectively. Professionals in the aging network, including Area Agency on Aging staff, were also given the opportunity through an emailed questionnaire to provide feedback on service strengths and gaps in the community. On August 14, 2014, the Centennial Area Health Education Center conducted an aging focus group that included various members of the community such as the Weld Food Bank, Area Agency on Aging, Lutheran Family Services, High Plains Library, North Range Behavioral Health Peer Counseling, Carbon Valley Recreation Center, North Colorado Medical Center, and the Weld County Department of Public Health and Environment. Again, overwhelmingly, transportation and housing were the main challenges facing older adults today according to the professionals working with seniors in Weld County. There is a gap in services for homemaker and personal care in the rural areas. This delay may be in response to an overall shortage of workers in this area as the job market strengthens due to the energy industry thriving in northern Colorado; or due to the sheer distance because of how large and vast Weld County is. 5 A number of methods have been used over the last eight months to determine not only the service or resource gaps in our community but also the strengths that lie within the community. The Area Agency on Aging will continue to partner with vital community agencies to increase funding for services for vulnerable and at risk seniors in our service area to close those resource gaps. The public hearing was held in the Weld County Department of Human Services during the Weld County Area Agency on Aging Advisory Board meeting on May 14, 2015 at 9:30 a.m. The hearing was made public through a press release to the Greeley Tribune Senior Life Page, the leading newspaper in Weld County. A total of twenty (20) individuals plus one community member representing Retired Senior Volunteer Program attended the meeting. SECTION III: CURRENT AND FUTURE PROGRAMS AND USE OF VOLUNTEERS Services and priority planning for the Weld County Area Agency on Aging (AAA) was guided by the information obtained from senior groups, individual seniors, volunteers, professionals, AAA staff, and the AAA Advisory Board, as well as, by the requirements under the Older Americans Act. The core and optional programs that we anticipate funding over this four year planning period will not be significantly different from the last Four Year Plan due to little change in the overall identified senior needs and service gaps. During the next four years we will explore increasing the use of voucher programs for services that are becoming harder to obtain through traditional providers. We will add a new service, Case Management, for at risk seniors to address the increasing need for case management services. Every four years the Weld County Area Agency on Aging releases a Request for Proposal (RFP) for all major program areas that are not provided directly by internal staff. For this bidding cycle, the RFP was released by the Weld County Department of Human Resources in February 2015. The bid proposal outlined the expectations, goals, and objectives of the specific programs the Area Agency on Aging was interested in funding. Once the proposals were received from interested bidders, they were reviewed by a subcommittee of the Weld County Area Agency on Aging Advisory Board. The subcommittee presented their findings and recommendations to the AAA Advisory Board. The Weld County Board of County Commissioners also reviewed the bids and gave the ultimate approval in May 2015. Below is a detailed outline of the service areas that will be funded during this four year planning period if the area continues to be a needed service and funding remains stable. Programs that are available through the Weld County Area Agency on Aging but are not funded by the Older Americans Act are also included in the plan, but are clearly identified as programs funded through other funding streams. Volunteers are used in several program areas listed below, in order to enhance or increase the volume of services provided. The AAA encourages the use of volunteers by contracted providers and the AAA internal programs if the volunteers are adequately supervised, trained, and meet the requirements of the program. 6 Information and Assistance (I & A) and Aging and Disability Resources for Colorado (ADRC) The Area Agency on Aging will ensure that all older persons within Weld County have reasonable and convenient access to information and assistance about services through the following means: • In order to meet the ever growing need for comprehensive information and assistance services (I &A) we have maintained an internal I & A position. This position is currently being funded primarily with non-federal funds (State funds). In addition to this position, all internal staff and contracted providers are required to stay current with community resources so they will be able to provide I & A services to the community. The staff will continue to work closely with our community partner, United Way 211, to insure that the 211 system has the most current AAA program information. • The AAA staff will continue to provide training and assistance to the senior coordinators (WELDCOs) who are located throughout Weld County. The senior coordinators are well known to seniors in their communities and are in a position to provide information and assistance to seniors in a cost effective and timely manner. The senior coordinators are either employees of the towns/cities they represent or are dedicated volunteers. • Based on the information obtained from the surveys completed in 2015, 2014 and 2010 the community remains in need of general and specific types of information related to older adults. Special attention will be paid to the needs of caregivers (including grandparents raising grandchildren) and seniors aged 75 and older over the next four years. • We will continue to disseminate information to the community at large through multiple forms of media including: the quarterly AAA newsletter, the 50+ Marketplace News, the Greeley Tribune (the Senior Life page), the Senior Nutrition quarterly newsletter, local rural weekly publications, local radio stations, agency service directories, agency program brochures, the Department of Human Services' website, Facebook, other potential social media, etc. • The AAA will support or form partnerships with other agencies to make workshops and trainings available to the general public on topics that address current senior issues or needs. • In 2011, the Weld County Aging and Disability Resources for Colorado (ADRC) was developed. The ADRC expands services to individuals with a disability from the age of 18 to 59 who are in need of community services and support verses the traditional I & A to the 60+ population. The state-wide challenge of the ADRC program is funding, specifically the services provided to individuals under the age of 60. In order to address this challenge the Colorado Association of Area Agencies on Aging (c4a) is partnering with the Colorado Health Foundation. We are in the second year of a two year grant period and we remain optimistic a one year extension will be approved. We have also partnered with the Colorado Department of Health Care Policy and Financing and the Colorado Department of Human Services to provide Options Counseling to residents of nursing home facilities who have indicated an interest in transitioning from the nursing home to a more independent setting within the community. The AAA network is also hopeful that additional federal funding will occur with the reauthorization of the Older Americans Act and other potential health care reforms on state and federal levels. 7 Outreach Services The Weld County 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: • Maintaining the Hispanic Elderly Outreach Program; a contracted service with Catholic Charities of Northern Colorado. The contractor's responsibility will be to continue to identify isolated and at risk Hispanic seniors (and other minority seniors) and provide information and assistance regarding community services to enable the seniors to remain independent in the community, with a specific focus on seniors residing in hard to reach and poverty areas in the southern region of Weld County. • Training the WELDCO coordinators on outreach techniques and providing 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/or impoverished. • Providing technical assistance on the services available to seniors in Weld County to a wide range of community leaders, including church leaders, service clubs, elected officials, and other volunteer organizations. Case Management Services for At Risk Older Adults The Area Agency on Aging will be funding case management services for the first time with state funds starting FY16 due to increasing numbers of at risk seniors in our community and the limited case management services that exist in Weld County. • The service provider will be Catholic Charities of Northern Colorado. This provider has been providing case management services to seniors for over 30 years but due to funding limitations and an increased aging population they will not be able to address the case management needs within the community without additional funding partners. The AAA will continue to encourage Catholic Charities Northern to seek additional funding partners in order to increase the numbers of seniors served. Transportation Services The 2010 Community Assessment Survey for Older Adults (CASOA) survey indicated that 8,694 (25%) seniors have experienced at least a minor problem accessing safe and affordable transportation. This compares with the 2004 Strengths and Needs survey that identified 1,532 (6%) seniors that stated they had difficulty (frequently or sometimes) arranging transportation for medical trips in the past year and five (5) percent reported difficulty arranging transportation for recreational or social trips. We anticipate as the senior population continues to increase (specifically the 85+), service needs will rise and there will be a need to increase transportation services. Currently the Weld County community receives transit services from a variety of entities: • The City of Greeley/Evans provides transportation services (fixed route and paratransit services) within the cities of Greeley and Evans. The Area Agency on Aging will explore partnership possibilities particularly around funding paratransit services to seniors who are unable to afford to access this service. 8 • Individual senior centers/recreation centers provide limited transit services either through their own vans or volunteer drivers. Also, Envision, the community center board, provides transit services to older adults with developmental disabilities. • For the last three years the AAA has contracted with a non-profit agency called Senior Resource Services, Inc. Senior Resource Services, Inc. provides rides to seniors using volunteer drivers. The challenge this agency faces is the increasing demands for services and the need for additional volunteers throughout Weld County. Over the last three years, Senior Resource Services, Inc. has expanded their volunteer team outside of the Greeley/Evans area. In-Home Services The Area Agency on Aging will provide in-home services (through provider contracts) to seniors in the community to help them remain in their own homes with a maximum degree of independence and choice by: • Maintaining funding for homemaker and personal care to frail seniors who have no other source of third party reimbursement for such services. Rehabilitation and Visiting Nurse Association (RVNA), a licensed home health care agency will continue to provide homemaker and personal care services. RVNA has had limited coverage in the southern region of Weld County. They will be actively exploring a variety of options that will increase services to this section of the county. The Area Agency on Aging will also be exploring future RFP options that will focus on the southern region of the county, including developing a voucher program. • Maintaining funding for in-home one-on-one peer counseling (seniors helping seniors) services to at risk seniors. Providing counseling in a home selling, versus office or mental health center, has been very successful with the senior population who often hesitate to access mental health services. This service addresses issues related to loneliness, isolation and loss, and other life changes that impact many seniors. This creative partnership with North Range Behavioral Health has been in place for over 28 years and continues to remain dynamic and relevant to seniors today. • Colorado Options for Long-Term Care Program or Single Entry Point(SEP) provides community-based long-term care options and case management services to persons qualifying for specific Medicaid waivers and state programs. Maintaining the Options for Long-Term Care Program within the Area Agency on Aging increases the likelihood that clients (many who are the most disabled, frail and low-income in the community) are referred correctly and quickly to the appropriate program or service. This program has seen a dramatic increase over the last five years and we do not foresee a slowing of growth in the near future. Legal Assistance Services The AAA Legal Services Program, after over 25 years of being housed within the Area Agency on Agency, was contracted out to a community provider, Colorado Legal Service (CLS). CLS will provide services that are aligned with the scope of services and priorities as described in the Request for Proposal. The priorities and scope of services will continue to be reviewed annually by internal staff, the provider, state staff during the program audit process, and formally every four years during the four year planning process. 9 The following are the priorities that guide the Legal Program: • Public Assistance Benefits: Provide legal assistance and advice in applying for and determination of eligibility for public assistance benefits, including but not limited to Long-Term Care Medicaid, Medicare Savings Plans, Old Age Pension, the Low-Income Energy Assistance Program (LEAP) and Supplement Nutrition Assistance Program (SNAP) . This will include providing advice and information on specifics of Medicaid Programs and payment of long-term care, including Medicaid Qualifications, Medicaid Coverage, Spousal Protection (Community Spouse Resource Allowance, Monthly Income Protection) and Medicaid Estate Recovery. Assistance will consist of advice and/or administrative representation for overpayments, reductions, termination or denial of Public Assistance Benefits. The Legal Services Provider will provide in-person representation before an administrative tribunal to appeal the reduction, termination or denial of a senior client's long-term care Medicaid. • Consumer Matters: Provide legal advice, negotiation and brief service regarding debt collections, breach of contract, garnishments, utility shut-offs and other contract disputes. Services may consist of assisting senior clients in preparing for self-representation, including, but not limited to: Small Claims Court, objections to garnishments, interrogatories, etc. • Housing Issues: Provide legal advice, negotiation and brief service on matters related to landlord-tenant- renting and subsidized housing. • Powers of Attorney and Living Wills: Provide assistance with document preparation of General Durable Power of Attorney, Medical Durable Power of Attorney and Living Wills. Additional services beyond the basic priorities include: • Community Education: Provide community legal education presentations as requested from Weld County senior centers, Weld County senior housing complexes, and long-term care facilities on topics of legal interest to senior clients such as preventative measures against consumer fraud, consumer debt issues, housing issues, advanced directives for healthcare, financial powers of attorney and related issues. • Community Outreach: Provide legal assistance and meet the needs of senior clients unable to travel. This will include visits to rural sites (e.g., senior centers, senior housing complexes, nutrition sites, etc.) and to institutionalized, isolated and homebound elderly residents of Weld County as needed, either by phone, e-mail, on-line resources, or in their homes. Assistance will include the capacity to reach minority senior clients by providing legal assistance in Spanish. • Administrative Duties: The legal services provider shall ensure service quality and maintain professional standards by providing the following: 1. Case management, including establishing a system of filing, record keeping, system for conflicts checks, docket control, and updating case activities; 2. Provide for the supervision of legal workers by an attorney; 3. Establish a system of review to evaluate the quality of legal work, determine what pertinent issues have been identified, to assure the timely handling of cases, to 10 ensure that clients are involved in establishing case objectives, and the client is kept informed of developments in the case; 4. Track unduplicated clients on a quarterly basis including units of services, types of cases and demographics; 5. Document those senior clients the legal service provider is unable to represent and the reason why they cannot be served; 6. Give appropriate resources and referrals; 7. Provide training for legal workers based on responsibilities and skills; and . 8. Ensure the confidences of clients are preserved from unauthorized disclosure. Ombudsman Services The Area Agency on Aging will continue to maintain the Ombudsman Program internally. The Lead Ombudsman reports to the Area Agency on Aging Division Manager 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 eight (8) Weld County nursing homes and twenty-four (24) assisted living facilities. The Lead Ombudsman will continue to supervise one full time ombudsman. The current level of staffing allows the ombudsman team to meet all the current requirements of the Ombudsman Program. The ombudsman staff will continue to participate in all required training sponsored by the State Ombudsman Program or other approved trainings that will help meet the annual training requirements for certification. The Ombudsman Program uses volunteers on a very limited basis due to the sensitive and confidential nature of the program and the high level of supervision required. Volunteers receive all required ombudsman training. In an effort to protect the rights of seniors in long-term care facilities, the Ombudsman Program will: • Maintain membership on the Weld County Adult Protection Networking Team; • Coordinate and provide elder abuse education activities for the community; • Train staff, the aging network and the general public on the referral procedures to adult protection; • Collaborate with Aims Community College's certified nurse aide classes; and • Participate in community victim advocacy groups. Disease Prevention and Health Promotion Services and Evidence-Based Programs The Weld County Area Agency on Aging currently offers six evidence-based programs under the name Weld Aging Well. The programs are: A Matter of Balance, Stanford's Chronic Disease Self-Management Program and Diabetes Self-Management Program, Powerful Tools for Caregivers, the Strong Women Program, and Tai Chi: Moving for Better Balance. The goal of the Weld Aging Well program is to promote a proactive and preventive approach for seniors to take towards their health while maintaining control of their health care needs. Future programs may include HomeMeds, Enhance Fitness, Enhance Wellness, and Healthy Moves for Aging Well as funding and capacity allows. The Weld Aging Well program currently utilizes 20 volunteers to lead the following evidence- based programs: A Matter of Balance, Stanford's Chronic Disease Self-Management Program and Diabetes Self-Management Program, Powerful Tools for Caregivers, the Strong Women 11 Program, and Tai Chi: Moving for Better Balance. Within capacity, the Weld County AAA strives to expand services. By the end of December 2015 we anticipate an increase of approximately three to five volunteers and several community partners. This is an annual calendar year goal. Nutrition Services Congregate Meal Program — The Friendly Fork The Weld County Area Agency on Aging, as mandated by the Older Americans Act, will assure the provision of the congregate and home delivered meal programs in Weld County. In order to meet both urban and rural senior needs, twenty-two (22) congregate sites have been developed throughout Weld County (as far north as Nunn and as far south as Erie). These sites are located in a variety of settings including low-income housing, senior centers, recreation centers, town halls and community buildings. These sites have been carefully chosen over the years in an attempt to provide access to seniors throughout Weld County, paying special attention to where our most at risk seniors reside. The congregate meal program (The Friendly Fork) is internally managed by one full time staff member, an hourly registered dietitian, a warehouse manager, and administrative support staff. The Senior Nutrition Program has a multitude of volunteers that assist in the overall success of the program. All volunteers are covered by volunteer liability insurance. Volunteers who are age 55 and older are registered with our community partner, Retired Senior Volunteer Program. There are several different volunteer opportunities available such as; site coordinator, reception team, kitchen team, and greeter. All positions are extremely important to the nutrition program and all meal sites are very dependent on them. The site coordinator is responsible for assisting in managing the operation of the individual meal site. Their responsibilities range from: • Communicating with the Senior Nutrition Supervisor; • Recruiting, training, and supervising volunteers; • Familiarity with the regulations and Policy and Procedures of the program; • Keeping organized records for their individual site; • Providing an open, friendly atmosphere at the meal site; and • Attending annual volunteer trainings and encouraging volunteers to attend. The reception team manages the desk operations of the individual meal site. Their responsibilities range from: • Checking participants in for meals and following reservation policies; • Counting donations and documenting correctly; • Assisting with the Lunch Registration forms; • Assisting with ordering supplies both for kitchen and front desk volunteers; • Completing the monthly roster; • Recruiting volunteers; • Attending annual volunteer trainings; • Posting menus and handing out nutrition education flyers; and • Completing all needed paperwork for the AAA. 12 The kitchen team will complete duties relating to the delivery of meals to meal site consumers. They are expected to comply with the Colorado Department of Public Health and Environment regulations. Their responsibilities range from: • Having good personal hygiene during the volunteer service and be free of any communicable diseases; • Attending annual volunteer trainings; • Setting up/tearing down meal site equipment as assigned; • Cleaning and sanitizing all food contact surfaces; • Completing Food History Tracking Forms; • Following the portion guidelines from UNC and/or the AAA; • Using the correct methods for plating food; and • Recruiting volunteers. The greeter will 'greet' nutrition program participants to make them feel welcome at the congregate meal site and assist with any appropriate new participant paperwork. Their responsibilities range from: • Welcoming all participants, explaining how the program operates, and introducing the new participants to the group; • Completing appropriate paperwork for new participants; • Assisting the reception or kitchen team if they are short on volunteers; • Attending annual volunteer trainings; and • Recruiting volunteers. The Area Agency on Aging decided many years ago not to directly run a senior nutrition kitchen but rather contract with local providers. Over time it was determined that using one provider allowed us to control quality and overall cost of the program most effectively. The University of Northern Colorado is our meal provider. The actual delivery of food has always been provided by a professional transportation company (The Greeley Gopher), rather than by volunteers. In addition, it is important to note that due to our successful partnership with our local communities, all meal site locations are provided at no cost to the program. In the last ten years we, along with many nutrition programs across the country, have seen an overall decline in the numbers of seniors attending the congregate meal program. The decline is due in part to the increased frailty of the clients we serve. In Weld County, the majority of the seniors who attend the program are within the ages of 70-89 years; over 68 clients are between the ages of 90-99; and two clients are over 99 years old. The program is not seeing a large number of younger seniors entering the program. This may be because younger seniors are still in the workforce due to the economy or the younger senior may not see themselves in need of the meal program. It will be interesting to see if this younger cohort will seek out congregate services when they enter their later years. The outcome section of this plan provides insight to how we are reaching out to the senior community in order to increase the number of clients we believe would benefit from the meal program. The program is serving approximately 1,000 seniors throughout the county and providing over 42,000 meals throughout the year. Client satisfaction surveys indicate that the seniors who attend the program find it to be a positive experience and they believe it helps meet their nutritional and socialization needs. 13 In order to keep the program viable and relevant to seniors over the next four years the following items must occur: • Maintain a financial contract with the University of Northern Colorado or like provider to prepare hot meals for the congregate meal program; • Maintain a financial contract with a transit provider to deliver food from the meal provider to the designated meal sites; • Maintain and support the Area Agency on Aging staff who will continue to provide the required oversight needed to ensure that the program meets federal, state and local regulations and guidelines; • Maintain a positive relationship with the Weld County Department of Public Health and Environment; • Market the nutrition program across the county to attract new customers to the program; • Maintain nutrition education and counseling services to all congregate senior nutrition participants through educational presentations and written material and offer counseling services to all participants, targeting those participants who are nutritionally at risk. These services will be provided by a registered dietitian. See the outcome and strategy section for additional strategies. Home-Delivered Meals Program Nationally and locally the aging network is anticipating an increased need for home-delivered meals due to the growing number of adults 75 years and older. The Area Agency on Aging has historically provided the home-delivered program through the community provider, Meals on Wheels. Meals on Wheels is a cost effective and efficient agency, which uses its robust community connections, to recruit and retain a team of volunteers that deliver meals throughout Weld County. In order to maintain the program as it is currently structured, the following items must occur: • Maintain a financial contract with Meals on Wheels or like provider in order to provide home-delivered meals to Weld County seniors; and • Maintain nutrition education and counseling services to all home-delivered senior nutrition participants by providing participants with educational material and offer counseling services to all participants, targeting those participants who are nutritionally at risk. These services will be provided by a registered dietitian. National Family Caregiver Support Program The Weld County Area Agency on Aging (AAA) will continue to support the internal Family Caregiver position. The goal of the program will be to continue to provide information and assistance to caregivers, provide appropriate and needed caregiver training/workshops, and maintain the respite voucher program. According to the 2010 Community Assessment Survey for Older Adults (CASOA), twenty-nine (29) percent of seniors surveyed found that providing care for another person to be at least a minor problem. Based on current anecdotal information, as well as statistical information, the need for caregiver support and services will only grow over the next five years. There will be, in all likelihood, a need to increase the AAA administrative staff and dollars in order to meet the needs of caregivers. 14 Over the next four years the AAA will continue to work diligently to provide information and assistance for caregivers and the community at large by working closely with the aging network and our internal staff. We will also provide evidence-based workshops such as Powerful Tools for Caregivers. Internal staff members and community volunteers have been trained and have been providing workshops to Weld caregivers since 2008. The workshops have been held in a variety of settings in order to attract caregivers from around the county. Due to the number of grandparents raising grandchildren in Weld County the AAA staff will continue to work with other key agencies (such as Catholic Charities Northern, c.a.r.e, A Kid's Place, University of Northern Colorado, Weld County Department of Public Health and Environment and the Weld County Department of Human Services) in the community to provide educational opportunities such as legal clinics, resource fairs, support groups, newsletters, legal handbooks etc. Optional Support Services Adult Day Program The Weld County Area Agency on Aging will maintain funding of adult day care services (Eldergarden) for frail and at risk seniors who are trying to remain either in their own homes or in the homes of family members. Eldergarden has been successful in providing a safe, secure and stimulating environment for seniors while providing needed respite for caregivers and preventing or delaying nursing home and/or assisted living placement. Dental, Vision, and Hearing Program (DVH) The Dental, Vision, and Hearing Program (DVH) is a consumer directed, model of service delivery, voucher program which allows the older adult to select their provider of choice. The Visually Impaired Service Program is currently being funded through an appropriation of General Funds which started in State Fiscal Year 2015. The program was designed to be used for the purpose of providing services to older adults who are blind or visually impaired. The funds can be used to purchase assistive technology, visual aids and adaptive aids. It cannot be used to purchase eye glasses or cover the cost of eye examinations. These funds are managed by the program coordinator of the Dental, Vision, and Hearing Program. We will be working closely with clients and agencies such as the Curtis Strong Center, Ensight Skills Center, and Connections for Independent Living Vision After 55 Program. We will make referrals as appropriate to the Audio Information Network and the Greeley/Evans Lions Club, as well as, marketing to appropriate vision providers that may refer clients in need of assistive technology. Chore Program The Chore Service Program also functions as a voucher program that is consumer directed for seniors in need of chore services. These chore services are designed to increase the safety of the individual living at home in which they are unable to provide for themselves. Such tasks may include mowing the lawn, snow removal, fall or spring yard clean up, and heavy housework cleaning. 15 SECTION IV: QUESTIONS The Area Plan covers State Fiscal Years 2016-2019 (July 1, 2015 through June 30, 2019.) The Plan shall respond specifically to each of the questions. 1. Describe the unserved and underserved clients in the PSA. Table 1 2013 Senior Population Estimates for Weld County Source: Colorado State Demographer, Department of Local Affairs 60+ 75+ 60+ 60+ 60+ 60+ 60+ Total Poverty Minority Minority 185% Rural Population and Poverty Poverty 42,986 11,682 3,484 6,085 871 10,746 12,865 269,643 16% of 27% of 8% of the 14% of 2% of the 25% of 30% of the total the Senior Senior the Senior Senior the Senior the Senior Population Population Population Population Population Population Population Table 2 Projected 60-90 year old Population Growth 2015-2020 Source: Colorado State Demographer, Department of Local Affairs Projected Weld County Population Percentage of Growth by Age 60-90 16.00 I 14.00 12.00 1 ■ . ■ 18.0C MI ■ MI ■ ■ 6.0C n $ N P s■ � tV■ n w ri■ a ° 11 ENE a e 1.4 ME al ll ri O.0C ■ ■ ■ . ■ Year2015 Year2016 Year2017 Year2018 Year2019 Year2020 60-69 ) � 70-79 g 80-90 16 Table 3 Projected Age 60-90 vs. Total Population Source: Colorado State Demographer, Department of Local Affairs Projected Age 60-90 v.s. Total Population (All Ages) 350300 3297749— 291,797 300.633 309,785 319,564 300000 2 250000 -- 200000 150300 � /, m + N ' CO 14�,0/0/ ' !'1 Q o N Ti in N Q Q 50000 0 . Year2015 Year 2016 Year2017 Year2018 Year2019 Year2020 ■60-90 ■Weld County All Ages As the three tables above indicate, Weld County's senior community is continuing to grow and change. Compared to our population estimates in our last four year plan we have seen an increase in the overall number of seniors 60+ (12% to 16% of the total senior population of Weld County). Interestingly, the percentages of seniors who fall within the poverty rate, minority, and/or rural silos have remained about the same in the last several years. However, when you look at seniors who currently fall within 185% of poverty, the number grows to 25% of the total senior population. In other words, one out of four seniors (single person) has a monthly income of$1,227.00 or less. We are also seeing an increase in the number of seniors who are 75+ years old and of that specific cohort, 32.3% are within 185% of poverty (3,773 people). When reviewing the demographic information of clients that received registered services in FY14 we found that 25% of the clients stated that they were living in poverty, 39% were living in rural Weld County, 15% stated they were a minority, and 60% were between the ages of 75-107. We are pleased that our outreach efforts have been successful in locating and serving clients that meet our targeting goals. We hope that with increased funding and continued outreach we will be able to increase the number of clients that meet our targeting goals in the next four years. 17 Table 4 Poverty by Age Ratio and Congregate Meal Site Locations Source : ACS 2008 -2012 : Census Track , US Census Percent of Individuals: Poverty by Age by Ratio From: Age 65 g Below 185% Poverty Source: Table B3-0q. ACS 2008-2012 5Y : Census Tracts To: No Limit iiti ,. . . _.... M, .... :<,".. ">,..:.eti>.,scf<aaia“a ..,:- :nt,.h.�.,..,,•_3gwk2.wad'.7eNc)rr.�kasx�wSl.,w.>wa"4a.YiM3-- ;ltna:^ .,nrt ;Y..- I.,` . .�,;�.". � .4-"'', 4.s4^. .'" y ' '' 1 Q 'Neld County. Colorado Unite 1 ± .1 Dm mg Dmg Centers 1 J r - Age 55' Comparative Dent L E G E N D i - .. IMO, ' " unn < 596 Of . . I-, 4 Population ti:._. ' -4\ t i ka396 t0 1096 er ce - 14-We IrJ'l::i tatty-Rd 90 r 1 El D _\ t 1096 tO 1596 f f '` 1 ill r - . 1396 t0 2096 ult=_ RY^ 20°6 of 25°6 0 ,, t!, 25% t0 30% n / 30°6t035% I 1 CD trik.f$a 3596 to 40°6 J £e ,, 11 ,' t 4096 t0 4596 4` Ili ' 50% ,'dfrf�., u Dom., silk . 7 =.flues( I t ! ! 4 fa, f f ' �.�.,....... i \., t * r t { atteville v ` y 1.�,. ' i r . it - y ts 7-- ---r---°- : r : 'Y' t 1f t :17 .-- .— 1, iF'J elflres6tril _ .t .: gaff lti s , -- Sa 4 `�� _ aEtf rtJ _rte T • DATA (XLSX) ~ t . ?. . I • ` ; Esri, HERE, DeLorme, USGS, NCA, USDA, EPA, NPS As shown in Table 4 , Weld County AAA' s 22 meal sites are situated within or nearby seniors who fall within 185 % poverty levels . The sites have been chosen over the years to give all seniors the greatest possible access to the senior nutrition program , keeping in mind our target population . As outlined in Section VII , the Senior Nutrition Program will continue exploring options to increase meal sites in housing locations and adding nutritious options , like a salad bar , to improve the client' s dining experience and access to fresh and nutritious food . In order to increase the number of clients we serve in the next four years several things must happen . First and foremost , funding must continue to increase if we are going to fund additional services so ongoing advocacy is necessary . Secondly , we will need to develop new and creative ways to provide core and optional services to our clients . Traditional means of service delivery may not always meet the needs of this changing and growing senior population . We are finding that the provider network is having capacity issues due to an increasingly limited work force . We , as so many of our fellow Area Agencies on Aging in Colorado , are also facing challenges reaching the most rural areas of service area . Thirdly , we must continue to seek alternative funding opportunities that can be used to either increase current services or add new services to our services options . Lastly , we would like to increase 18 our efforts in identifying seniors who are interested in participating in our evidence-based wellness programs. We hope that these types of prevention programs will help seniors avoid or at least delay the need for long-term care services and supports. 2. How will the following two demographic cohorts —those 75 years old to 84 years old and those 85 years and older— change in the PSA over the time of the Area Plan? What impacts does the AAA project to the budget and service provision because of these demographic change. Table 5 Weld County Population Forecast- 2015-2020 Source: Colorado State Demographer, Department of Local Affairs Age Total % 2015 2016 2017 2018 2019 2020 of Group change 75-84 9,048 9,447 9,994 10,675 11,422 12,094 30.1% 85-90 3,588 3,755 3,888 4,009 4,159 4,350 21.2% Weld County will be seeing a 30.1% growth in 75-84 year old individuals and a 21% growth in the 85-90+ year old group. We know that as we grow older we have a higher probability of needing community-based supportive services in order to live healthy, independent and productive lives. We anticipate an increase need in services such as: home-delivered meals, transportation, homemaker and personal care services, case management services, and chore services, to list just a few. One of the primary challenges will be to find viable providers and a work force that can provide the needed services. Local communities will also be challenged in the area of affordable senior housing and transportation (transit). There are many communities that have very limited or no low-income housing options or formal transit systems for their aging citizens. The concept of livable communities, not just for older adults but for people of all ages, must be taken seriously by community leaders, developers and civil servants if we hope to meet the needs of a growing population in Weld County. 3. How will the AAA increase the number of services provided and the number of unduplicated clients over the four years of the Area Plan? It is the goal of the Area Agency on Aging to provide services and support to the seniors of Weld County. Funding restrictions and capacity of our service providers prevent us from serving all Weld County seniors; therefore, we will continue our efforts to target our services to the most at risk senior, as defined by the Older Americans Act. As was noted earlier, Weld County is seeing an increasing number of seniors who are 75 and older who may need an increased number of community-based services and support. We will continue to provide Older Americans Act services either directly or through our contracted providers, as long as adequate funding is available. We are actively exploring different ways our programs can be provided to our target population. Over the last ten years, we have offered programs, such as the Caregiver, Chore and the Dental, Vision, and Hearing programs as voucher programs. The client can choose 19 either a formal or informal provider (depending on the service) and the Area Agency on Aging will reimburse approved costs. This approach increases the number of provider options a client has and in some cases reduces the cost of the service. We will explore using this approach with other service areas such as homemaker/personal care. We will also be working very closely with our community providers regarding their efforts to reach out effectively and efficiently to our target senior population. In addition, all of our providers, per contract, are required to provide comprehensive information and assistance to the clients and families they serve in order to increase the opportunity for clients to remain as independent in the community as feasible. Internally we will monitor the number of clients we are reaching monthly through our data system, SAMS. If we are not seeing the anticipated client counts we will address the issue with the provider and/or our internal program staff to determine the challenges that are occurring and explore solutions. 4. What evidence-based health promotion or disease prevention programs does the AAA currently provide and plan to provide during the period of the Area Plan? The Weld County Area Agency on Aging currently offers six evidence-based programs under the name Weld Aging Well. The programs are: A Matter of Balance, Stanford's Chronic Disease Self-Management Program and Diabetes Self-Management Program, Powerful Tools for Caregivers, the Strong Women Program, and Tai Chi: Moving for Better Balance. As mentioned previously, future programs may include HomeMeds, Enhance Fitness, Enhance Wellness, and Healthy Moves for Aging Well as funding and capacity allows. 5. Describe any federal Discretionary Grant Programs in AAA. These may include: Alzheimer's Disease Support Services Program (ADSSP); Evidence-based Disease and Disability Prevention Programs such as Chronic Disease Self- Management Program (CDSMP); Senior Medicare Patrol (SMP); and programs that support community living. The Weld County Area Agency on Aging is currently participating in the federal Discretionary Grant "Empowering Older Adults and Adults with Disabilities through Chronic Disease Self- Management Education Programs". It is a grant funded through the U.S. Department of Health and Human Services, Administration on Aging, Administration for Community Living. 6. Describe how the AAA takes advantage of opportunities through the Affordable Care Act (e.g. Colorado Choice Transitions (Money Follows the Person Program), Community- Based Care Transition Program, etc.) The Weld County Area Agency on Aging manages the Options for Long-Term Care (OLTC) entity for Weld County. The OLTC is currently participating in the Colorado Choice Transition (CCT) grant by providing intensive case management for clients who have requested and have met the CCT grant requirements to transition from a nursing home to a less restrictive environment in the community. In addition, the AAA's Aging and Disability Resources for Colorado (ADRC) has entered into a contract with the Colorado Department of Human Services and the Colorado Department of 20 Health Care Policy and Financing in order to provide options counseling to residents who either request to leave the facility through the Section Q process or have indicated a desire to leave the facility by contacting the nursing home staff or the ADRC directly. This grant currently only goes through June 30, 2015 but we anticipate the grant will be renewed in the next fiscal year. 7. Specifically, what legal issues are given priority for receiving representation from the Legal Assistance Program during the next four years? How will the AAA ensure that the local Legal Assistance provider is able and willing to provide representation for these issues? Weld County Area Agency on Aging will be contracting the Legal Assistance Program. The contract scope of work will consist of providing legal information, advice, counseling, assistance, document preparation and administrative representation by an attorney, who is a member of the Colorado State Bar, to ensure the rights and entitlement of older persons by providing or securing legal assistance. The program will serve adults aged 60 years and above with special attention given to those individuals who have the greatest economic and social need, particularly low-income minority individuals. The legal issues that will be given priority may include, but are not limited to: applying for and determination of eligibility for public assistance benefits, such as Long-Term Care Medicaid, Medicare Savings Plans, Old Age Pension, the Low-Income Energy Assistance Program (LEAP) and Supplement Nutrition Assistance Program (SNAP). This will include providing advice and information on Medicaid program specifics and payment of long-term care, including Medicaid Qualifications, Medicaid Coverage, Spousal Protection (Community Spouse Resource Allowance, Monthly Income Protection) and Medicaid Estate Recovery. Assistance will consist of advice and/or administrative representation for overpayments, reductions, termination or denial of Public Assistance Benefits. The legal services provider will provide in-person representation before an administrative tribunal to appeal the reduction, termination or denial of a senior client's long-term care Medicaid. The provider shall deliver legal advice, negotiation and brief service regarding debt collections, breach of contract, garnishments, utility shut-offs and other contract disputes. Services may consist of assisting senior clients in preparing for self-representation, including, but not limited to, Small Claims Court, objections to garnishments, interrogatories, etc. Other services shall include legal advice, negotiation and brief service on matters related to landlord-tenant-renting and subsidized housing. As well as, assistance with document preparation of General Durable Power of Attorney, Medical Durable Power of Attorney and Living Wills. The scope of other services will include community education and community outreach. 21 8. How will the AAA ensure that legal advice from the local Legal Assistance Provider is able to provide representation for these issues? The AAA has entered into a contract with Colorado Legal Services. This agency has the appropriate staff, skill set and a history of service provision in Colorado. Since this is a new provider for the AAA we will be meeting with the provider regularly to make sure any issues or concerns that may arise are resolved quickly. We are also requiring the provider to survey clients regularly to determine client satisfaction. 9. What long-term care issues with the local Ombudsman Program give priority to as a systems advocate during the next four years? The Ombudsman Program has seen an increased number of residents in nursing homes and assisted living facilities that are impacted by mental health issues and traumatic brain injury. These residents frequently are a challenge for staff. There is a need for appropriate training and support for staff and family, as well as, mental health services and other related services for residents. Also, residents who display difficult or high risk behaviors, regardless of diagnosis in facilities, frequently are faced with transfers and/or discharge issues. The Ombudsman Program advocates for these residents, but when their behaviors are extreme and are a threat to other residents, the Ombudsman Program is placed in a precarious position. Limited residential options for the resident, places a burden on nursing homes, assisted livings as well as the hospital systems. The Ombudsman will work closely with facility staff, the State Long-Term Care Ombudsman's office, the Ombudsman network, Adult Protective Services and local community providers to address this issue. 10. In addition to resident council meetings, family council meetings, and trainings to facility staff, what other activities will the local Ombudsman participate in during the next four years to educate the community regarding ombudsman services? The local Ombudsmen will be involved with networking and working committees, such as the Weld County Coordinating Committee for Victims of Crime (CCVC), ADRC, Options Counseling Committee, the Weld County Bio-Ethics Committee, the Weld Senior Services, and other future appropriate committees. The program staff will also provide information and assistance regarding the program by doing presentations to the University of Northern Colorado and Aims Community College classes, participating on panels, workshops, and attending other appropriate community and agency events. 11. What will be the duties of the local lead Ombudsman during the next four years? Will the lead Ombudsman conduct routine facility visits and respond to resident complaints? The Area Agency on Aging will maintain the Ombudsman Program internally. The Lead Ombudsman will report to the Area Agency on Aging Division Manager 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 such as conducting routine facility visits and responding appropriately to resident complaints. Oversight will include eight (8) Weld County nursing homes and twenty-four (24) assisted living facilities. The Lead Ombudsman will continue to supervise one full time ombudsman. The current level of staffing allows the ombudsman team to meet all the current requirements of the Ombudsman Program. 22 In an effort to protect the rights of seniors in long-term care facilities, the Ombudsman Program works closely with the Colorado Department of Human Services Adult Protection team and other community groups by: • Maintaining membership on the Weld County Adult Protection Networking Team; • Coordinating and providing elder abuse education activities for the community; • Training staff, the aging network and the general public on the referral procedures to adult protection. Also educating nurse aides in training prior to beginning employment as a C.N.A. staff in long-term care facilities; • Participating in community victim advocacy groups; and • Seeking to maintain funding from the Victims Assistance and Law Enforcement (VALE) grant, or other possible funding sources. SECTION V: DEMOGRAPHICS Area Agencies on Aging are required to review the changes in population over the four years of the Area Plan for only two cohorts of older adults. These are (1) the population between the ages of 75 and 84 years old and (2) the population of older adults age 85 and up (85+). Using the State Demographer's Website to the Population by Age and Gender, identify how the population in these two groups will change in the PSA in the next four years. Total % Age 2015 2016 2017 2018 2019 2020 of Group change 75-84 9,048 9,447 9,994 10,675 11,422 12,094 30.1% 85-90 3,588 3,755 3,888 4,009 4,159 4,350 21.2% See answer in Section IV Question 2 SECTION VI: TITLE III / VI COORDINATION This does not apply to Weld County Region 2 B 23 SECTION VII: OUTCOMES, STRATEGIES, AND PERFORMANCE INDICATORS The outcomes and performance indicators listed below are a required component of the Area Plan with no change in language. Suggested strategies for achieving the designated goals are listed. AAAs may include additional outcomes, strategies, and/or performance indicators. The others, not listed as required, include suggestions from the AAAs during the strategy planning sessions. In areas that identify survey language as a component of the indicator, the SUA will provide the language to be incorporated into the survey. 1. UNSERVED AND UNDERSERVED Unserved and Underserved Outcome Increase the number of people served and number of quality services provided through the Older Americans Act and State Funding for Senior Services. Unserved and Underserved Strategies • Targeting, outreach, and provision of service to low-income and low-income minorities as well as individuals with greatest social need (e.g. living alone). • Performance-based contracting. • Increase efficiencies. Unserved and Underserved Performance Indicators Performance Indicator 1: Increased number of unduplicated clients statewide. Performance Indicator 2: 80% of consumers identify the services received through OAA/SFSS maintains or improves their independence. 2. CAREGIVER PROGRAMS Caregiver Program Outcome Because of support received through the OAA/SFSS Caregiver Services, caregivers will feel supported, exhibit greater self-efficacy, and have improved access to information and services. Caregiver Program Strategies • Explore expanding locations or number of caregiver conferences. • Increase information available through newsletters and other forms of media. • Increase access to evidence-based groups for caregivers, for example, Powerful Tools for Caregivers. • Increase number of respite vouchers for available for caregivers. • Arrange respite so caregivers can participate in events, support groups, etc. • Explore the development of a caregiver mentor program. Caregiver Program Performance Indicators Performance Indicator 3: Number of caregivers served. Performance Indicator 4: 80% of NFCSP clients report in annual surveys that they feel supported by the NFCSP and express feelings of greater self- efficacy. 24 3. TRANSPORTATION PROGRAMS Transportation Program Outcome Older adults have transportation available to access health care, maintain social interaction, and reach community and social services. Transportation Program Strategies • Initiate or expand volunteer transportation services. • Expand types of rides available to consumers beyond nutrition and medical. Transportation Program Performance Indicators Performance Indicator 5: 90% of transportation clients indicate transportation was available to access necessary services in the community when needed. Performance Indicator 6: Number of registered transportation clients and rides provided. 4. LEGAL ASSISTANCE PROGRAMS Legal Assistance Outcome Resources are effectively expended on legal issues faced by those most in need and for which other legal assistance is not available. Legal Assistance Strategies • Services rendered are dictated by client needs, as articulated in the Priority Services in the Older Americans Act. • Utilize mechanisms available to resolve the client's problem, including willingness to negotiate or to bring to court or to an AU Hearing. • Promote adherence to Statewide Standards for Title 1118 Legal Assistance in Colorado. Legal Assistance Performance Indicators Performance Indicator 7: Number of persons who receive legal assistance through Title III and SFSS. Performance Indicator 8: Number of service units provided through Title III and SFSS. Performance Indicator 9: Number of unduplicated clients that legal assistance could not serve. Performance Indicator 10: Number of clients referred to other appropriate agencies or resources. 5. OMBUDSMAN PROGRAMS Ombudsman Program Outcome Resources are effectively expended on issues faced by those most in need and for which other assistance is not available. Ombudsman Strategy • Ombudsmen receive the information and training sufficient to allow them to perform the responsibilities and duties of the position. 25 Ombudsman Performance Indicators Performance Indicator 11: Number of training sessions attended by certified Ombudsman each year. Performance Indicator 12: Number of certified ombudsman in region each year. Performance Indicator 13: Number of facilities regularly visited not in response to a complaint. Performance Indicator 14: Number of complaints handled and resolved per year. Performance Indicator 15: Number of Ombudsman consultations. 6. NUTRITION PROGRAMS Nutrition Program Outcome Older adults will access nutrition services, socialization, and community resources to promote independence. Nutrition Program Strategies • The Senior Nutrition Program (The Friendly Fork) will continue to provide nutrition education to all participants through the menus/nutritional analysis, monthly nutrition hand-outs, Friendly Fork Flash (quarterly newsletter), Senior Life Page, resource fairs and community events and mailings. • The Friendly Fork may expand the number of meals per week at the sites that are only serving a meal one day a week. (Fort Lupton, LaSalle, Platteville, Wattenberg) • The Friendly Fork will examine the practicality of having a meal site in the Keenesburg/Hudson area 1 - 2 days a week. The Friendly Fork will also look into the possibility of adding a meal site at other senior housing facilities located in Greeley such as Meeker Commons Communities, Joe P Martinez Senior Housing, and Fox Hill. • The Friendly Fork will increase the amount of salad bars offered at meal sites. Currently there are three salad bars (Carbon Valley, Johnstown, and Windsor). • The Friendly Fork will continue to offer three annual volunteer trainings throughout the year to increase food safety, sanitation, and program knowledge. We will also educate volunteers on proper customer service and ways to increase customer satisfaction. • The Registered Dietitian (RD) for the Friendly Fork will make Nutrition Counseling more appealing and available to all participants which will in turn increase our counseling numbers. The RD will experiment with different advertising techniques in order to provide the service. • The Friendly Fork will research working with a local restaurant or current food vendor to offer breakfast at some of our meal sites, preferably our senior housing facilities. • The Friendly Fork will explore a partnership with the Weld Food Bank to provide produce before/after meals and include nutrition education about the produce provided. • The Friendly Fork will explore the feasibility of bringing Meals on Wheels' frozen meals in line with the nutritional requirements of Volume X in order to reimburse services and increase service units in South County. Nutrition Program Performance Indicators Performance Indicator 16: Number of persons who receive congregate and home delivered services per year. Performance Indicator 17: 90% of congregate nutrition program meal clients state obtaining transportation to the meal site was very easy or somewhat easy. 26 Performance Indicator 18: 90% of congregate nutrition program meal clients report that during the past year someone from the Nutrition Program provided information or referred them to places to learn about financial, social, or health services that are available to them or told them how to get the help. Performance Indicator 20: 90% of home delivered meal clients report that during the past year someone from the Nutrition Program provided information or referred them to places to learn about financial, social, or health services that are available to them or told them how to get the help. Performance Indicator 21: 90% of congregate nutrition program meal clients report they are very satisfied or somewhat satisfied with opportunities to spend time with other people at the meal site. Performance Indicator 22: 90% of congregate nutrition program meal clients report that the nutrition program has helped them to live independently and stay in their own home. Performance Indicator 23: 90% of home delivered meal program clients report that the nutrition program has helped them to live independently and stay in their own home. 27 SECTION VIII: FORMS Attachment A Region 2B DIRECT SERVICE WAIVER REQUEST We hereby request approval of a Waiver to provide the direct services listed below. 1. Chore Program 2. Congregate Meal Program 3. Evidence-Based Wellness Programs 4. Information and Assistance 5. Material Aid 6. National Family Caregiver Program Direct Service Waiver Request: Program Information Direct Service Program: Chore Program Organizational Structure and Delivery System: The Chore Program has been housed within the Weld County Area Agency on Aging since its inception. The Chore Program is managed by the Caregiver Coordinator, who also manages the National Family Caregiver Program. The Chore Program is a voucher program that allows the client to use the vendor of their choice. Direct Service Program: Congregate Meal Program Organizational Structure and Delivery System: The Congregate Meal Program has been housed in part within the Area Agency on Aging since 1980. The manager of the program, registered dietitian, and additional administrative staff are used to coordinate the program. The Weld County Area Agency on Aging purchases all prepared meals from the University of Northern Colorado and the meal transportation service is provided another contractor, The Greeley Gopher. There are twenty-two (22) meal sites located throughout Weld County in a variety of community settings. A team of volunteers facilitate the meal service at each meal site. See full description of the program within the Four Year Plan document. Direct Service Program: Evidence-Based Wellness Programs Organizational Structure and Delivery System: The Evidence-Based Wellness Program has been managed internally since the designation of Part D of the Older Americans Act. The program is managed by the Wellness Coordinator who 28 oversees the program and volunteers. The Weld County Area Agency on Aging currently offers six evidence-based programs under the name Weld Aging Well. The programs are: A Matter of Balance, Stanford's Chronic Disease Self-Management Program and Diabetes Self- Management Program, Powerful Tools for Caregivers, the Strong Women Program, and Tai Chi: Moving for Better Balance. Future programs may include HomeMeds, Enhance Fitness, Enhance Wellness, and Healthy Moves for Aging Well as funding and capacity allows. Direct Service Program: Information and Assistance Organizational Structure and Delivery System: The Information and Assistance Program has been managed internally since its inception over six years ago. This position is funded by Older Coloradoan Funds. The Information and Assistance Coordinator is a full time position and is supervised by the Community Outreach Supervisor. In addition to Information and Assistance this staff member also manages the Aging and Disability Resources for Colorado (ADRC), as well as, the Grandparents Raising Grandchildren Program under Part E. Direct Service Program: Material Aid(Dental, Vision and Hearing Program) and Visually Impaired Program Organizational Structure and Delivery System: The Wellness Coordinator manages the Dental, Vision, and Hearing Program and the Visually Impaired Program. Both programs are run as a voucher program, which allows the client to use a vendor of their choice. The Dental, Vision, and Hearing Program has been an internal program for over ten years. The Visually Impaired Program was added in FY 15 and for efficiency was added to the duties of the Wellness Coordinator. The Wellness Coordinator also manages the Weld Aging Well program, as noted above. Direct Service Program: National Family Caregiver Organizational Structure and Delivery System: The National Family Caregiver Program has been managed internally since the initial funding of Part E of the Older Americans Act. The Caregiver Coordinator manages the voucher respite program and provides information and assistance to caregivers. 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U O7 X N C J an X 0 2 N w° .a) 0 o Z 5 a) 2 a) a) w v Z Z w d N O J N E - O d J j N N o 2 U V u0 co r a0 L H H X X X X U O 0 0 Z Z Z z D D D D X X X X cr en X X X X X X X X oo _ 2' c '&5E E d o O _ v r o o c u7 o co > 5 co r E o > 10 O co co N- O co m N O N O O Ln coO co 1.O — O V) O a' r Cr OW O (0 O > 00 N O) V U T O co p N l0 (0 "O CO -O X N N c 00 C M (0 C Q V (O 0 �' O M CO = CO CO C - N 'O @ N O M O C 0 o O O o v c L o ' 0 ' in CI d Q aD SrC C E O O C v co co E r On Y v (o c U �\ d N13 in co o �` .- co co v D 2' (l N O2 Lo r O. N o >. y el x co U O O C co O V O Z O Lu p Or a33`` (6j a O L.L _w _ '> W Q7 © 'O O) U O N O) N.r O. L on co U U p N co o O) V I� '� O L V O N O O on N LO -O f0 N- (0 co E N 'n U X N O w d) J ' M 3 N N C M O N DT m o 4o 12 O c r co w - L a@ d rn c m r o c 0 a o U U O) O r N r N N N Attachment C Region 2B COMMUNITY FOCAL POINTS AND SENIOR CENTERS LIST ALL FOCAL POINTS AND SENIOR CENTERS INCLUDING NUTRITION SITES IF IT IS A FOCAL POINT CHECK IF FACILITY IS: CHECK IF LOCATION SERVES: CENTER NAME PREDOMINANTLY ADDRESS, CITY,ZIP CODE A A FUNDED PREDOMINANTLY LOW-INCOME PHONE NUMBER FOCAL SENIOR THROUGH LOW INCOME MINORITY CONTACT POINT CENTER TITLE III-B ELDERLY ELDERLY EMAIL 1. Ault Senior Center x PO Box 1338 Ault, CO 80610 970-834-1325 Pat Farmer no email 2. Carbon Valley Recreation Center x x 701 5th St Frederick, CO 80550 303-833-3660 Lee Athmann athmannlivahoo.com 3. Erie Community Center x x 4450 Powers Street Erie, CO 80516 303-926-2795 Cindy Hickman chickmanerieco.qov 4. Evans Community Center x x 1100 37th Street Evans, CO 80620 970-339-5344 x 132 Dorothy Hoff bqraubercierAci.evans.co.us 5. Ft. Lupton Community Center x x 203 S Harrison Avenue Ft. Lupton, CO 80621 303-857-4200 x 112 Courtney Ciciotti cci ci otti Afortl u pto n.o rq 6. Greeley Senior Activity Center x x 1010 6th Street _ Greeley, CO 80631 970-350-9440 Sheri Lobmeyer Sheri.LobmeyerrahGreelevgov.com 35 7. Hill N Park x 4205 Yosemite Place Greeley, CO 80634 970-330-8619 Sharon Strausser seniors2222agmail.com 8. Johnstown Community Center x 101 W Charolette Johnsontown, CO 80534 970-587-5251 Shirley Newsom-Gamez sgamezabaiabb.com 9. Kersey Senior Center x 415 1st Street Kersey, CO 80644 970-352-8394 Adella Andrijeski recreationaci.kersey.co.us 10. LaSalle Community Center x 101 Todd Avenue LaSalle, CO 80645 970-284-0900 Jennifer James recreation.lasalle(cilcomcast.net 11. Lochbuie Senior Center x 501 Willow Drive Lochbuie, CO 80603 303-659-8262 Nancy Kaufroath afterglows501askybeam.com 12. Mead Community Center x 441 34rd Street Mead, CO 80542 970-535-4477 Barbara Currie curriecaboose(cilgmail.com 13. Milliken Community Center x 1101 Broad Street Milliken, CO 80543 970-587-0671 Crystal Lucarelli clucarelliCilmillikenco.gov 36 14. Nunn Senior Center x 775 3rd Street Nunn CO 80648 970-897-2459 JoAnn Ortega 987av8ezlink.com 15 Pierce Senior Center x 221 Main Avenue Pierce, CO 80651 970-834-2655 Denise Miller denmile@hotmail.com 16. Platteville Community Center x 508 Reynolds Platteville, CO 80651 970-785-2245 x 1106 Christy Landry clandry(a�plattevillegov.org 17. Windsor Community Center x 250 N 11th Street Windsor, CO 80550 970-674-3515 Jay Eckhardt jeckhardtAwindsorgov.com 37 Attachment D Region 2B REGIONAL ADVISORY COUNCIL MEMBERSHIP List all persons presently serving as members of your Regional Advisory Council. NAME ORGANIZATION AFFILIATION Linda Banghart Community Alice Boyle Community Susan Collins University of Northern Colorado Gerontology Professor Julie Cozad Weld County Commissioner Nancy Culbreath Community Bruce Fitzgerald Community George Heath Community Kenneth Humphrey Community Mary Jones Community Willis Kulp Community Sandy Magnuson Community Shirley Medbery Community Ken Norem Community William Pike Community James Riesberg Community Roberta Speyer Community Katherine Swafford Community Wayne Wagner Community Judy Yamaguchi Community Please indicate on the chart below how many members are low income, minority, or over 60 LOW-INCOME MINORITY 60 + 0 1 18 38 Attachment E Region 2B STATEMENT OF INTENT The Area Plan Is hereby submitted for Weld County Area Agency on Aging 2B Region For the period July 1,2015 through June 30,2019 This Area Plan includes all assurances plans under provisions of the Older Americans Act during the period identified. The Area Agency on Aging identified above shall assume full responsibility to develop and administer the Area Plan in accordance with the requirements of the Older Americans Act and related State regulations and 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. SIGNATURES: ELIO, BOARD OF COUNTY COMMISSIONERS ATTEST{�j„ddet) '' ,J T.• W LD COUNTY, OLOARDO Weld County Clerk t•the Bo ; ..w. te6t t�� ©" By: �I r arbara Kirkmey r,Chair .R1L—1 201 De•ut Clerk to the Board T_ y s' �` � APPROVED AS TO SUB ANCE: APPROVED AS TO FUNDING: c./ ‘,./A.,‘6,9-d;0 �� Ele ted Officiator Depa ent H d Controller (((,(/,(/ —f`1 A — Director of General Services APPROVED AS TO FORM: WELD COUNTY AREA AGENCY ON r; G ADVISORY BOARD County Attorney /R erta Speyer,Chaj WELD COUNT REA AGENCY ON AGING Eva M.Jewell,D' isi n Head 39 ao 15�IRaa G) SECTION IX: AREA PLAN IMPLEMENTATION SUMMARY OF OUTCOMES PERFORMANCE INDICATORS 9/30/16 19/30/17 19/30/18 19/30/19 OUTCOME ONE UNSERVED AND UNDERSERVED: Increase the number of people served and number of quality services provided through the Older Americans Act and State Funding for Senior Services. Performance Indicator 1: Increased number of unduplicated clients statewide. Performance Indicator 2: 80% of consumers identify the services received through OAA/SFSS maintain or improve their independence. OUTCOME TWO CAREGIVERS: Because of support received through the OAA/SFSS Caregiver Services, caregivers will feel supported, exhibit greater self-efficacy, and have improved access to information and services. Performance Indicator 3: Number of caregivers served. Performance Indicator 4: 80% of NFCSP clients report in annual surveys that they feel supported by the NFCSP and express feelings of greater self-efficacy. Performance Indicator 5: 90% of transportation clients indicate transportation was available to access necessary services in the community when needed. OUTCOME THREE TRANSPORTATION: Older adults have transportation available to access health care, maintain social interaction, and reach community and social services. Performance Indicator 5: 90% of transportation clients indicate transportation was available to access necessary services in the community when needed. Performance Indicator 6: Number of registered transportation clients and number of rides provided. OUTCOME FOUR LEGAL ASSISTANCE PROGRAMS: Resources are effectively expended on legal issues faced by those most in need and for which other legal assistance is not available. PERFORMANCE INDICATOR 7: Number of persons who receive legal assistance through Older Americans Act and State Funding for Senior Services. PERFORMANCE INDICATOR 8: Number of service units provided. PERFORMANCE INDICATOR 9: Number of clients referred to other appropriate agencies or resources. OUTCOME FIVE OMBUDSMAN PROGRAM: Resources are effectively expended on issues faced by those most in need and for which other assistance is not available. PERFORMANCE INDICATOR 10: Number of training sessions attended by certified ombudsmen each year. 40 9/30/16 9/30/17 9/30/18 9/30/19 PERFORMANCE INDICATOR 11: Number of certified ombudsmen in state. PERFORMANCE INDICATOR 12: Number of facilities regularly visited not in response to a complaint. PERFORMANCE INDICATOR 13: Number of complaints handled and resolved per year. PERFORMANCE INDICATOR 14: Number of ombudsman consultations. OUTCOME SIX NUTRITION: Older adults will access nutrition services, socialization, and community resources to promote independence. PERFORMANCE INDICATOR 16: Number of persons who receive congregate and home delivered meal services. Performance Indicator 17: 90% of congregate nutrition program meal clients state obtaining transportation to the meal site was very easy or somewhat easy. Performance Indicator 18: 90% of congregate nutrition program meal clients report that during the past year someone from the Nutrition Program provided information or referred them to places to learn about financial, social, or health services that are available to them or told them how to get the help. Performance Indicator 19: 90% of home delivered meal clients report that during the past year someone from the Nutrition Program provided information or referred them to places to learn about financial, social, or health services that are available to them or told them how to get the help. Performance Indicator 20: 90% of congregate nutrition program meal clients report they are very satisfied or somewhat satisfied with opportunities to spend time with other people at the meal site. Performance Indicator 21: 90% of congregate nutrition program meal clients report that the nutrition program has helped them to live independently and stay in their own home. Performance Indicator 22: 90% of home delivered meal program clients report that the nutrition program has helped them to live independently and stay in their own home. 41 SECTION X: AREA PLAN CHECKLIST Section Section Contains Information Y/N Page Section to and Approved Numbers be Revised Where Information is Located._ Executive Incorporate essential points. Summary Describe outcomes and Yes 4 strategies. Public Input Describe number, dates, and locations of the Public Input Meetings. Yes 4-6 Discuss how public input informed Area Plan. Volunteers, List programs in place as of July Current/Future 1, 2015. Programs List additional programs the Yes 6-15 AAA is considering implementing. Nine Questions Each question answered? Yes 16-23 Demographics Review the changes in population for two cohorts: of 75 and 84 years old and age 85 and up. Yes 19 Comment on how increases in these two cohorts may affect budgeting and planning of services. Title III/VI Regions that provide both Title Coordination III and Title VI nutrition programs n/a n/a shall describe the coordination of the programs. Forms Attachment A? Only AAAs requesting waivers will submit this form. Attachment B? Yes 28-39 Attachment C? Attachment D? Attachment E? Area Plan Implementation form properly Implementation filled out. (Please remember, implementation of the Area n/a n/a Plan will be reviewed during program evaluations by SUA staff.) 42 Hello