HomeMy WebLinkAboutAgenda - 02-17-2009 - 6a ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: February 17, 2009
Action Agenda
Item No. (p -Q
SUBJECT: Acceptance of County Master Aging Report for 2007-2008 and Approve Priorities
for 2009
DEPARTMENT: Aging/Advisory Board on Aging PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): INFORMATION CONTACT:
MAP Work Plan Annual Report: 2007-08 Jerry M. Passmore, Aging Director and
and Priorities for Calendar Year 2009 MAP Project Manager, 245-2000
Steve Lackey, Chair, Adv. Board on Aging
PURPOSE: To review and accept the Orange County Master Aging Plan Annual Report covering
an eighteen-month period from July 2007 through 2008 and approve priorities for calendar year
2009.
BACKGROUND: On May 15, 2007 the Board of County Commissioners adopted the five-year
Master Aging Plan (MAP) covering the period 2007 through 2011. The MAP's overarching new
initiative was "Building Aging-Friendly Communities in Orange". The plan focused on three
functional population groups: the Well/Fit Older Adult, the Disabled /Moderately Impaired Older
Adult and the Severely Impaired /Institutionalized Older Adult. The MAP also identified and
addressed four broad issues: information/access, housing, transportation and transitional care.
The adopted Master Aging Plan directs the Department on Aging to implement the plan and the
Orange County Advisory Board on Aging to monitor the progress of the Plan and to submit annual
update reports to the County Commissioners on the accomplishments and recommended priority
changes (MAP Goal I: Planning/Administration., Objective 1). It was recommended periodic MAP
reports be submitted to town elected officials in Orange County (Town of Carrboro request).
The new priorities for 2009 listed below do not require any additional County funds. However, the
food service improvement priority will require the re-deployment of existing JOCCA County
nutrition funds to the Department on Aging for operating the nutrition program and operating the
Seymour Center kitchen beginning FY 2009-10.
1. Develop a local aging-friendly community assessment tool. (graduate student project)
2. Improve food service at Senior Centers in conjunction with supporting the local
economy and environment.
2
3. Consolidate Central/Northern Aging Services to the new Central Orange Senior Center (COSC)
adjoining the SportsPlex.
4. initiate program leadership and planning in geriatric mental health care.
5. Begin the three-year Community Resource Connection (CRC) project (2008-10) for improved
access to services for older adults and persons with disabilities.
The Orange County Advisory Board on Aging completed a thorough review of the first eighteen
months of the MAP accomplishments and new priorities for 2009 prepared by the Department on
Aging Director. On January 14, 2009, the Advisory Board on Aging approved the submission of
the attached MAP Annual Report.
FINANCIAL IMPACT: None at this time.
RECOMMENDATION(S): The Manager recommends the Board accept the Master Aging Plan
Annual Report (mid-2007 through 2008) and approve the priorities for calendar year 2009.
3
Orange County
Master Aging Plan
s
17 r . 52
J YE
(�rt eat°•k`fi
Work Plan Annual Report
Period: May, 2007 to June, 2008
and
Priorities for 2008-09
Monitored by
The Orange County Advisory Board on Aging
Staffed by
The Orange County Department on Aging
Jerry M. Passmore, Director
January 14, 2009
(Short Version)
0
4
I. Aging-Friendly Communities Initiative
A. Introduction to New MAP Initiatives
B. Call To Action
C. An Aging-Friendly Community Assessment Tool
II. MAP Work Plan for 2007-08
A. Introduction and Implementation Process
B. Work Plan Activities, Accomplishments and Recommendations
1. Focus: All Older Adults
2. Focus: Well-Fit Older Adults
3. Focus: Disabled/Moderately Impaired Older Adults
4. Focus: Institutional/Severely Impaired Older Adults
5. Focus: Legislation/Advocacy
6. Focus: Planning and Administration
III. New Priorities for 2008-09
1
5
I. Aging-Friendly communities Initiative
A. Introduction to New MAP Initiative
In the early planning stages, the Steering Committee, in conjunction with the subcommittees,
realized that the Master Aging Plan should be more than implementing needed services by a
group of agencies whose common mission is to serve older persons. The Master Aging Plan
should also promote and build aging-friendly communities that involve everyone, starting first
with all county departments and advisory boards of Orange County government and expanding
outward to towns and community groups. Thus, the Steering Committee approved and
recommended to the County Commissioners the MAP's New Initiative: "Building Aging-
Friendly Communities in Orange."
In 2003 the North Carolina Division of Aging and Adult Services adopted a new initiative called
"Livable and Senior-Friendly Communities." Rather than follow the state's lead and focus solely
on the older population segment as implied in its initiative title, MAP chose the term "Aging-
Friendly Community," since aging is a process beginning at birth and ending with death. Thus,
Aging-Friendly Communities' designs should be livable for all ages. To promote healthy aging
for all, a preventive approach must be used. The central feature of aging-friendly communities
is the incorporation of active living features such as sidewalks, parks, and street lights, which
are close to essential services. (www.activelivingbydesion.orq). The new initiative provides an
over arching vision of where we want to be in the future that transcends the MAP's strategic
five-year plan.
B. Call to Action
Based on the county's demographic shift to a much older community and the rapid growth in
older persons living longer lives, the Master Aging Plan issued the following
Call to Action: Engage all departments of Orange County Government and towns, as
well as the broader public and private community, in the process of improving the
infrastructure and services to meet the needs of older adults who desire to age in place,
especially those with functional disabilities and impairments.
C. An Aging-Friendly Community Assessment Tool
While the new initiative was adopted by the County Commissioners on May 15, 2007 and
endorsed by towns as a principle, no formal workgroup structure has been formed to develop a
community assessment tool covering the major components of an aging-friendly community
that impact quality of life. Those components, identified by the N.C. Division of Aging and Adult
2
6
Services, are: Physical and Accessible Environment, Healthy Aging, Economic Security,
Technology, Safety and Security, Social and Cultural Opportunity, Access and Choice in
Services and Supports, and Public Accountability and Responsiveness In developing such a
local assessment tool the N.C. Division of Aging recommends the assessment of each
component on six dimensions: existence, adequacy, accessibility, efficiency/duplication, equity
and effectiveness/quality. (www.dhhs.state.nc.us/aginq).
Recommendation for 2008-09: The Aging Advisory Board recommends that we begin with the
development of such a community assessment tool, in consultation with the International
City/County Management Association (www.icma.org) and other professional organizations who
have identified health and livable communities as an important management strategy for older
adults. In subsequent years, the adopted assessment tool would be administered first by the
county and then expand participation to local town governments and community groups.
II. MAP Work Plan for 2007-08
A. Introduction and Implementation Process
The Master Aging Plan update for 2007-11 covers 9 overall goals, 45 specific objectives and
173 strategies recommended to accomplish those objectives. The MAP objectives have all
been prioritized under each goal with 1 being rated the highest. In order to have a manageable
plan, the updated MAP reduced the number of goal areas and objectives, but increased the list
of potential strategies for consideration during the five-year implementation period.
In reviewing the MAP goals and objectives, the following definitions have been used:
1. Goals These are broad vision statements in areas in which we want to
achieve something. Goals, described here, are open ended objectives
that are not directly measurable.
2. Objectives These are specific statements that focus on obtaining a result or
outcome, expected to be achieved by one or several strategies.
Objectives, described here, are result/outcome objectives not
process objectives.
Over the next four years, new objectives or modification of existing ones will be recommended
annually by the County Aging Advisory Board and County Department on Aging. MAP
workgroups would be formed to address, in priority order, the objectives beginning with 1
and/or 2 under the goal areas for 2007-09. A MAP annual progress report will be provided to
the BOCC, the Towns and other community groups. This MAP report covers the first year's
activities, accomplishments and recommendations for 2008-09.
3
7
B. Work Plan Activities and Accomplishments
1. Focus: All Older Adults
Goal A: Information/Access - Enhance information & assistance options for all older
persons and their families who need access to services, especially those most in need.
Obiective A-1: Improve marketing and evaluation of existing Information and
assistance services. (Broadly defined)
Lead Organization (s): Department on Aging with Triangle United Way 211
Activities. Accomplishments and Recommendations:
1. Orange County has worked in 2007-08 with NC CareLink in providing local resource/service
information for the creation of a statewide database for agency and individual citizen access.
2. Orange and Chatham Counties prepared a joint grant in 2007-08 to simplify access to
information and services for seniors and adults with disabilities. The three-year grant was funded
and is called Community Resource Connections (CRC). More CRC description is under Goal D:
Transitional Care.
Recommendation for 2008-09: To continue the database improvement project with NC CareLink
by promoting local agencies' participation and begin the CRC joint project with Chatham County.
Objective A-2: Improve access to printed and website information to older persons,
families, and service providers.
Lead Organization (s): Department on Aging with County Information Systems
Activities, Accomplishments and Recommendations:
1. The Department on Aging printed the Community Resource Guide for 2007-08, a valuable
desk resource for agency personnel assisting older adults. The updated guide is available on the
County Department on Aging website. (www.co.orange.nc.us./aging)
2. Due to budget reductions, the Senior Times was reduced from a bi-monthly publication to a
quarterly one. The Senior Times was redesigned to make it more user-friendly and also an effort
to extend its shelve life. A new full-page column in the Herald Sun was negotiated and is printed
the months that the Senior Times does not print in order to keep the public better informed of
senior activities and services. A direct link from the Department on Aging Website to the Herald
Sun website has been established for easier public access to the current Senior Times on the
web.
4
8
Recommendation for 2008-09: Continue to print the Community,Resource Guide annually, with
updates available January 2009. Print the Senior Times quarterly under its new format. Both
publications will be made available on the County Department on Aging Website for easy
access.
Goal B: Housing/Shelter: Promote an adequate supply of safe, affordable, and suitable
housing options for older residents to age in place.
Obiective B-1: Expand assistance in the retrofitting, repair and maintenance of
existing older adult homes.
Lead Organization (s): Department on Aging with County Housing and Community
Development
Activities. Accomplishments and Recommendations:
1. The number of volunteer groups assisting older adults with home retrofitting, repair and
maintenance has increased. These include:
• Rebuilding Together of the Triangle: They have completed several projects in Orange
County and expect to increase their activity here.
• First Baptist Church of Hillsborough: This church has 2 weekends every year (spring
and fall) when several volunteer groups work on homes.
• Hillsborough Presbyterian Church: Small group of volunteers will build ramps and
railings. In the last year they completed 1 ramp and 1 railing.
This is just a partial list of the volunteer groups as faith communities frequently assist their
members in need of home repair/retrofitting.
2. Government programs include:
• Orange County Housing
• USDA grants and loans for homeowners in rural communities.
• OC Dept. on Aging has a small budget to install ramps and grab bars. 2 ramps were
completed last year.
During 2007-08 new senior housing in Hillsborough received local approval, specifically, Eno
Haven and Corbinton Commons. The BOCC awarded $1,000,000 in housing bond funds to
Eno Haven LLC to assist in construction of a 76-unit multi-family rental complex on US 70
West to provide much needed housing for low-income elderly and disabled individuals.
The Town of Hillsborough approved Corbinton Commons' request to develop on US 70 By-
Pass 47 single-family dwellings and a Continuing Retirement Community (CCRC) that would
include 193 independent living apartments, 12 independent living duplex units, 23 independent
living cottages, a 54 bed Healthcare center and a Wellness Center. Both project were reviewed
by the Orange County Advisory Board on Aging.
5
9
Recommendation for 2008-09: Retrofitting, repair and maintenance needs continue to exceed
resources. The livability of a home impacts the older adult's ability to remain safely in the home
and limited resources may have the unintended effect of increasing the number of older adults
seeking assisted living and nursing home care. Therefore, it is recommended that a workgroup
seek support from local businesses, faith communities, civic groups and others to increase
funds and volunteer manpower for this task.
Objective B-2: Expand tax assistance for older adults who have difficulty paying their
home property tax over time.
Lead Organization (s): County Board of Commissioners with supporting County
Departments
Activities, Accomplishments and Recommendations:
1. The Orange County Revenue Collector assists individuals with monthly payment plan options
and accepts credit card payments toward property tax.
2. The state Homestead Exemption program has been modified to provide tax reduction on
permanent home to elderly (65+) and disabled whose income does not exceed $25,600.
Qualified persons are excluded from tax that is greater of$25,000 or 50% of the appraised value
of their home. In addition, state has established a property tax Homestead Circuit Breaker
Deferment program for elderly and disabled whose income is less than $38,400.
3. The Orange County Tax Assessor allows for late applications for property exemption requests
completed through December rather than June, subject to BOCC approval.
Recommendations for 2008-09: Promote the availability of new expanded Homestead
Exemption and Deferment Programs for low-income elderly and disabled. Research further
tax assistance strategies for elderly"to aging in place.
Goal C: Transit/Mobility: Enhance mobility options for all older adults regardless of
functionality, through a multi-module vision that is acceptable, efficient, effective and
affordable.
Objective C-1: Increase funding sources for expansion and/or enhancements of
new or existing services to improve older adults transit services.
Lead Organization (s): Department on Aging- Public Transportation Div. with Board of
County Commissioners
Activities, Accomplishments and Recommendations:
1. A Cross Town Senior Shuttle application by Chapel Hill Transit and OPT for New Freedom
Funds was prepared, submitted, and funded in 2008. The proposed shuttle would pickup
6
10
seniors in high density areas and transport them directly to high demand service areas such as
the senior center, library, shopping centers, etc. This would be a third tier between bus
stop/transfer service which some seniors find difficult and the specialized, expensive EZ Rider
door-to-door pickup for certified handicapped seniors.
2. During 2008 a TTA and OPT partnership promoted the use of the existing Hillsborough to
Chapel Hill 420 route with much success in increased ridership.
Recommendation for 2008-09:
1. Begin implementation of the Chapel Hill/Carrboro Cross Town Senior Shuttle by the Chapel
Hill Transit, in partnership with Orange Public Transportation.
2. Improve route 420 (Hillsborough to Chapel Hill public route) by coordinating with Chapel Hill
transit to operate a larger capacity bus during the route peak hours. OPT would continue to
operate route 420 during mid-day service. Since the public Hillsborough to Chapel Hill hourly
route would leave from the two Senior Centers between 9:00 a.m. —3:00 p.m. each day,
citizens would be able to ride to hospital clinics and travel between senior centers for different
activities, and to the new Orange County Durham Tech campus for classes.
3. All rural transportation for senior trips would be merged with the two new Senior Centers
which will serve as connector hubs for transporting out to other necessary services such as
weekly shopping, banking, etc., and periodic medical trips when possible. In January, 2009,
OPT would begin senior transportation from the Efland and Cedar Grove community centers to
the new Central Orange Senior Center.
Obiective C-2: Improve Orange Public Transportation (OPT) transit services and
the county's emergency disaster transit provision for older adults.
Lead Organization (s): Department on Aging- Public Transportation Div. with Emergency
Services
Activities. Accomplishments and Recommendations:
North Carolina Department of Transportation has implemented a state wide evacuation plan for all
transit systems. Orange County Emergency Services and Orange Public Transportation have
arrangements to provide essential transportation during inclement weather conditions. Orange
Public Transportation has also arranged to assist with Animal Control to move pets to shelters as
needed.
Recommendation for 2008-09: Review multi-hazard transit plan and arrangements with
institutional facilities for patient transport in advance.
Goal D: Transitional Care - Promote the transition and maintenance of older persons in
the most appropriate health care provider setting.
7
11
Objective D-1: Maintain older persons in the most appropriate setting through the
development or expansion of innovative models of aging-friendly community
programs.
Lead Organization (s): Department on Aging-Aging Transitions Div. with Board of
County Commissioners and the Carol Woods-Community Connections for Seniors Project
Activities, Accomplishments and Recommendations:
1. Orange and Chatham Counties prepared and received a grant to create Community
Resource Connections (CRC) formerly called ADRC (Aging and Disabilities Resource
Connections) to simplify the access to a variety information and services for seniors and adults
with disabilities within both counties. This model is designed to break down individual service
silos, which create fragmentation of services and frustration with the system. The CRC should
result in information sharing among agencies within the CRC. As a result, the consumer should
receive access to a full array of services with reduced paperwork and reduced wait time.
2. Carol Woods has awarded the CRC a $10,000 award for its first implementation year from
its Community Connections for Seniors' Duke Endowment.
3. The CRC (Orange County and Chatham County) agreed to participate in a Nursing Home
Modernization Grant submitted by the N.C. Division of Aging and Adult Services to the federal
government. If funded, the grant would create an Orange County pilot program in which
persons who exceed poverty level can be granted limited federal funds to create an
individualized in-home long-term care plan. The goal is to design programs that cost less than
placement in a nursing home while providing greater personal freedom and satisfaction.
4. A group respite demonstration program called "Caregivers Day Out", which provides a one
day per week break for caregivers, continues to be held at the Seymour Center. The goal is to
have local faith groups visit the program and consider replicating in their faith communities.
Recommendation for 2008-09: Begin the three-year CRC project and continue the group
respite program as a demonstration expansion project.
Objective D-2: Improve the coordination of transitional care through increased
contact and training of health care and community care providers.
Lead Organization (s): Department on Aging-Aging Transitions Div. with Carol Woods-
Community Connections for Seniors Project.
Activities, Accomplishments and Recommendations:
1. The CRC project will significantly improve the communication and cross training of health care
providers in the aging and disability fields.
2. Volunteers in the group respite demonstration program are being trained to re-create this
weekly caregiver respite program in their churches.
8
12
3. Three MSW students and one Johnston Intern are working at the Seymour Center this year.
The three MSW students are all participating in a program designed to create practitioners in
the field of aging.
4. The Mood, Memory, and Mobility Clinic, (3M clinic) a model project funded under the UNC
Hospitals Futures Grant, is a joint Department on Aging and UNC program that provides a
multi-disciplinary screening clinic that includes: medicine, pharmacy, occupational Therapy,
physical therapy, and social work. This "3M Clinic", offered at the Seymour Center, provides a
user-friendly approach in dealing with inter-related aging issues for older adults and cutting-
edge training for future aging practitioners.
Recommendation for 2008-09: Assist Carol Woods in sponsoring a Transitional Care
Community meeting at the Central Orange Senior Center with the purpose of identifying critical
transitional care issues and recruiting agencies and consumers willing to work on them.
2. Focus: Well-Fit Older Adults
Goal E: Well-Fit Older Population - To Improve and/or Maintain the Health and Well-
being of Orange County's Present and Future Well-Fit Older Adults. (Prevention focus)
Obiective E-1: Provide preventive community-based services which assist older
adults in maintaining good health and to age in place.
Lead Organization (s): Department on Aging with the Senior Centers' Wellness
Program Div.
Activities. Accomplishments and Recommendations:
1. New Facility for Wellness: The new 15, 000 sq. ft. Central Orange Senior Center is in
construction and scheduled to open in early January 2009. It will be co-located with the
county-owned SportsPlex and a partnership will be developed to expand wellness services
with the use of the pool, fitness studio, classes, ice rink for seniors. The announcement of
special senior fees will be in the Dec-Feb issue of Senior Times.
2. Wellness Activities: A large number of services are provided in the community for citizens
to help maintain health and contribute to aging in place. 62-health education
programs/lectures were offered throughout the county, at different sites in 2007-08. Examples
include: "Ask the ...Health Care Professionals", 7 new exercise classes, hearing workshops,
healthy cooking demos, Feldenkrais workshops, Aging 101 Series.
3. Fitness Activities: In 2007-08, 2629 individuals participated in fitness and exercise classes in
the past year (50% increase from 2006), provided by 17 contracted providers who provided an
array of services that appealed to a wide variety of client interests and functional levels.
Examples of new classes are:, Inspired Movement, Boomer Yoga, Pilates, NIA, Balance Class,
Fit & Fun, Stretch &Tone, and Qi-Gong.
9
13
4. Walking for Health: The University Mall walking group has continued to grow, averaging 28
walkers per monthly event and added an outdoor walking club at the Seymour Center in 2007.
The Central Orange Senior Center has promoted a walkers group with weekly program led by
volunteers.
5. Functional Screening: More than 350 participants completed a free required physical
assessment functional screen to use the new fitness room at the Seymour Center in 2007-08.
Before beginning a fitness program, the screen provides valuable personal information for
health and safety on key functional elements-flexibility, balance, agility, strength and
endurance. Since the screen is part of a national study, each participant receives comparable
fitness data to other persons of the same age and gender. Part-time personal trainers have
been added to assist clients in the Fitness Studio at selected hours.
6. Heath Immunizations and Screenings: In 2007-08, 2882 older adults participated (duplicate)
in immunizations/screening programs. In addition, blood pressure screenings occurred weekly
at both Senior Centers, and bimonthly at 2 Community Centers. Volunteer nurses monitored
an average 10-15 people per week per site. Examples of screening areas include: Vision,
Hearing, Glucose/Cholesterol, Flu Shots, Fit Feet clinics, and massage therapy. "Ask the
Pharmacist or Nutritionist", dental hygienist services are also provided at nominal charge or no
charge to clients. 720 Flu shots were administered on 9 different clinical dates at four different
locations. (150 more shots were administered than 2006). Monthly Foot Care Clinics served
an average of 547 clients in 2007-08. (That's 5,470 toes ® - up by 40 clients over 2006).
Recommendation for 2008-09:
1. Complete negotiation with the SportsPlex management for a special Central Orange Senior
Center fee for use of their fitness studio, pool and classes by older adults. Goal is to have fees
comparable to those offered at the Seymour Center Fitness Center.
2. Offer additional Chronic Disease self-management classes such as diabetic prevention, but
in other areas like arthritis.
3. Continue to utilize and expand use of university health care staff and post-graduate student
providers for health education and screening programs. Disciplines include: Physical Therapy,
Medical Students, Nursing, Pharmacy, Dental Hygiene and Public Health.
Objective E-2: Improve access to affordable healthcare for all older persons.
Lead Organization (s): Health Department with the Department on Aging's Aging
Transitions and Senior Centers' Wellness Program Divisions
Activities, Accomplishments and Recommendations:
1. The Department on Aging in cooperation with the UNC Medical School Program on Aging
established in 2007 at the Seymour Center the "Mood, Memory and Mobility Clinic", a free of
charge health service funded by the UNC Hospitals Futures grant.
2. The Aging Transitions division of the Department on Aging collaborated in 2007-08 with
Piedmont Health Services on increasing the senior use of Piedmont Health whose mission is to
serve individuals with limited incomes.
10
14
Recommendation for 2008-09: Continue these strategies on affordable healthcare access and
develop other partnerships.
3. Focus: Disabled/Moderately Impaired Older Adults
Goal F: Disabled/Moderately Impaired Older Population — Maximize the safety,
functional ability, and quality of life for impaired, community-dwelling older persons and
their family caregivers.
Objective F-1-: Increase community recognition, support, education and
empowerment of family caregivers.
Lead Organization (s): Department on Aging-Aging Transitions Div.
Activities, Accomplishments and Recommendations:
1. An initial meeting of the Community Caregiver Alliance was held. Caregivers have been
incorporated into the community engagement task force.
2. Support Groups: The Aging Transitions staff has promoted the value of self-help and group
support by offering several support groups, such as weekly group respite at the Seymour
Center, a Parkinson's Support Group in Central Orange Senior Center, three supports groups
for Caregivers of people with dementia, and a weekly group for individuals with mild dementia.
3. Dementia Outreach: A part time coordinator of African American caregiver outreach
conducted research of the literature and met with many minority community leaders to prepare
culturally sensitive presentations for use in minority communities. Over 25 formal
presentations in 2007-08 were delivered in minority churches, to increase awareness of
dementia symptoms and management.
4. Caregiver Class/Workshops: "The Powerful Tools for Caregivers" class was presented in
early 2008 and will be replicated in fall 2008. The workshops are a joint endeavor between the
NC Cooperative Extension Service and the Department on Aging. Three new community
workshops were designed and implemented in 2008 for family caregivers by the Department
on Aging's Transitions/Eldercare Division.
Recommendation for 2008-09: To continue the support groups, classes, and dementia
outreach, involve other community groups and to establish a new column in the News of
Orange to educate the community and empower family caregivers.
Objective F-2: Offer best practices in mental health care for older persons in
affordable, stigma-free, non-psychiatric settings.
Lead Organization (s): Department on Aging-Aging Transitions Div.
11
15
Activities, Accomplishments and Recommendations:
1. Mental Health Planning: Meetings were held with OPC Mental Health, a UNC geriatric
Psychiatrist, a representative from the N.C. Division of Aging and Adult Services, and the
Department on Aging to create a plan to implement the IMPACT program at local physicians'
offices. The program focuses/treats clients with depression. Based on national research in the
difficulty of gathering primary care physicians' support, a decision was made to implement
IMPACT in a user-friendly senior center setting. To explore this new approach, the UNC Program
on Aging paid for Kate Barrett, Aging Transitions Administrator, and Jan Gerard, MSW at the
Seymour Center to attend Effective Programs to Treat Depression in Older Adults:
Implementation Strategies for community Agencies on May 19-20, 2008.
This conference was sponsored by the Centers for Disease Control (CDC), the Healthy Aging
Research Network, Preventions Research Centers Program, the University of Washington, and
the Carter Center for Mental Health. A local coalition attended including: 2 social workers from
OCDOA; Lea Watson, MD, geriatric psychiatrist; Rebecca Hunter, MPH, UNC Geriatric Education
Center and Mary Edwards, NC Division of Aging and Adult Services. The University of
Washington presenters have researched and written extensively about the IMPACT depression
management program and other evidence-based programs for depression in older adults. This
community coalition of OCDOA, UNC, and the NC Division of Aging and Adult Services returned
from the conference with a plan to implement a geriatric depression treatment program at the
Seymour Center. The Department on Aging's Transitions staff attended a follow-up IMPACT
training in Seattle, funded by the Robert Woods Johnson Foundation and UNC.
2. Community Mental Health Education: The Aging Transitions Staff presented best practices in
mental health for the NC Healthy Aging Network in September 2008, conducted a workshop for
Piedmont Health Services social workers on diagnosing and treating geriatric depression and
taught UNC medical students on a) recognizing geriatric depression and b) evidence based best
practices for geriatric depression.
3. A Model Mental Health Clinic: The UNC Mood Memory and Mobility Screening clinic that
began in 2007 is being staffed by a UNC geriatrician, physical therapist, and a pharmacist. The
Department on Aging provides an occupational therapist and a social worker. If appropriate,
when a patient is screened in for depression limited follow-up sessions are scheduled with a
clinical social worker.
Recommendation 2008-09:
1. Cognitive Impairment Support Group-To begin at the Seymour Center in January 2009 a
support group for individuals who are newly diagnosed with mild cognitive impairment or early
stage dementia. This group generally experiences significant depression and anxiety. The
group's purpose will be educational, supportive, and activity based, facilitated by two second year
MSW students from UNC-Chapel Hill.
2. Continue the planning to implement the IMPACT Program in the user-friendly senior center
setting.
12
16
4. Focus: Institituionalized Severely Impaired Older Adults
Goal G: Institutionalized/Severely Impaired Older Population - Improve services,
information access, education and outreach to long term care residents and
families/caregivers that are affordable, accessible and that promote quality of life
through person- centered care. This includes the retention, recognition and training of
paid facility staff, thereby improving quality and continuity of care for residents.
Objective G-1: Continue a Long Term Care Facility Roundtable (OCLTCFR)
comprised of service providers, consumers, advocates, and regulators, who will
work to define, address, and resolve current priority issues related to the quality of
care and quality of life of the long term care facility population.
Lead Organization (s): Department on Aging with TJAAA Ombudsman Program,
Nursing Home and Adult Care Home Community Advisory Committees
Activities. Accomplishments and Recommendations: None during this report period.
Recommendation for 2008-09: The Department on Aging would re-establish regular meetings
of the Long term Care Facility Roundtable.
Obiective G-2: Begin operation of mobile Dental Access Unit for senior residents
in Orange, Chatham and Durham counties, with priority given to long term care
facilities, the homebound and senior centers.
Lead Organization (s): TJAAA Ombudsman Program and Access Dental Coalition with the
Department on Aging.
Activities. Accomplishments and Recommendations:
1. Dental Activities: This objective is a continuation of the previous MAP in 2001-06 designed
to develop a mobile access dental unit for severely impaired and institutionalized older
adults/disabled in long term care facilities and the homebound in Orange County, as well as
Chatham and Durham counties.
The Regional Access Dental Coalition, chaired by Jill Passmore, Lead Regional LTC
Ombudsman, last met on Oct 18, 2007 at the Seymour Center with Access Dental, a non-profit
organization that operates mobile dental units out of Greensboro. With a recent
$200,000 allocation of state funds to expand access dental services, the Coalition confirmed
its interest with Access Dental to expand service in Orange, Durham and Chatham
counties. The Coalition is comprised of representatives from the three counties. Orange
County representatives included Jack Chestnut (Carol Woods), the late Florence Soltys
13
17
(Aging Board), Angela Cooke (Health Dept.), Laura Deloye (Adult Care Home Community
Adv. Corn.), Gwen Phillips (DSS), Myra Austin (Dept. on Aging Wellness Program), Mary Ann
Peter(Nursing Home Community Adv. Corn.), and Betty Stevens (Brookshire Nursing Center).
Bill Milner, Dentist and Director of Access Dental, supported expansion in to Orange County,
and applied necessary state funds. Plans are to operate the mobile dental van out of
Greensboro, with a possible need for storage space in Orange County for dental supplies.
Accomplishment: Funding was secured in January, 2008 and program operations
began in May, 2008.
5. Focus: Legislation/Advocacy
Goal H: Legislation/Advocacy - Promote a legislative/advocacy Aging Agenda that
supports Orange County's Bill of Rights for Older Persons.
Objective H-1: Establish a legislative/advocacy mechanism to involve older persons,
local county boards, officials and the public in improving the lives of older persons.
Lead Organization (s): Orange County Advisory Board on Aging and Board of County
Commissioners with the Department on Aging
Activities, Accomplishments and Recommendations:
1. To date no activities or accomplishments have occurred due to a "short session" of the N.C.
General Assembly in 2008.
Recommendation for 2008-09: Convene a local O.C. Aging Legislative Workgroup, headed by
the Orange County Senior Tar Heel Delegate and Alternate, to identify, prioritize and
recommend legislation action (studies, bills, implementation, enforcement) to address aging
issues and submit to the BOCC for consideration. This should occur by January 2009 when the
N.C. General Assembly convenes.
Objective H-2: Increase the educational opportunities for older persons, local
officials, legislators and general public to be exposed to legislative issues related
to aging.
Lead Organization (s): Orange County Advisory Board on Aging with the Department on
Aging.
Activities, Accomplishments and Recommendations:
1. An Aging Legislative Update Forum was held June 16, 2008 which was sponsored by the
Orange County Advisory Board on Aging, the Triangle J Area Agency on Aging, the TJAAA
14
18
Ombudsman Program, AARP's Chapel Hill Chapter, and the Orange County Nursing Home
and Adult Care Home CACs. Arrangements were made by the Department on Aging with over
50 participants. The purpose was to educate the public to advocacy issues, organizations, and
specific legislation.
2. The Legislative Forum was taped, edited and broadcast on the In Praise of Aging TV Show
in a two part series —Advocacy, Sept. 13, 2008 and Bills and Issues, Sept.20, 2008.
Recommendation for 2008-09: To hold an annual public Aging Legislative Forum by February
2009 to present advocacy issues and any recommended legislative priorities per the BOCC and
other aging advocacy groups.
ctli jjaL,uv - Enhance the planning, administration, coordination
and funding of a response system to the changing needs of Orange County's older
persons.
Objective I-1: Planning/Coordination - Improve the County's planning and
coordination efforts for the growing aging population.
Lead Organization (s): Orange County Department on Aging with the Advisory Board on
Aging and the Triangle United Way.
Activities, Accomplishments and Recommendations:
1. Several Planning initiatives occurred in 2007-08. The United Way established a Orange
County Profile Committee to identify issues to fund through a new funding plan. Carol Woods
received a three-year Community Connections for Seniors Project grant that focuses on aging
transition issues and the County Comprehensive Planning was undertaken. All of these major
planning initiatives impact older adults. The Department on Aging Director and staff
participated on various committees in an effort to coordinate them with the MAP.
Recommendation for 2008-09: To continue planning efforts with various groups.
Objective 1-2: Administration- Improve the service delivery of the Department
on Aging's services as well as other county departments and other non-profit
agencies that serve older persons.
Lead Organization (s): Orange County Department on Aging and the Orange County
Advisory Board on Aging with the County Manager's Office
Activities, Accomplishments and Recommendations:
1. In 2007-08, a catered food model project of a soup/salad option began at Seymour Center,
underwritten by the Friends. This led to further discussion of food service improvement and the
Dept. on Aging taking leadership in a major food service initiative.
15
19
2. In 2007-08, construction of the new Central Orange Senior Center including the Day Health
Program was begun, providing over 19,000 sq. ft. of service space, adjoining the SportsPlex.
Recommendation for 2008-09:
1. To consolidate central and northern Orange aging services at the new Central Orange
Senior Center when completed in January, 2009.
2. To improve the overall food service for seniors, beginning with the development of a meal
service luncheon plan for FY2009-10.
Objective 1-3: Funding- Increase appropriate public and private funding for aging
services that are affected by a growing older population.
Lead Organization (s): Orange County Department on Aging and the Orange County
Advisory Board on Aging with the County Manager's Office
Strategies for 2007-08:
A. Analyze the past and current funding of aging services by the county, towns and
Triangle United Way, comparing it with the projected growth of the older population
and recommend necessary funding changes based on service needs.
Activities, Accomplishments and Recommendations:
1. In 2007-08, no work was done on this strategic objective.
Recommendation for 2008-09: The Department on Aging Director and Aging Advisory Board
would establish a workgroup to begin the analysis of senior service funding by various sources
and prepare a report for local funding agencies.
III. New Priorities for 2008-09
In addition to the recommendations identified throughout the MAP Interim report for FY2008-
09, the following are new priorities to be incorporated in the five-year MAP Plan which will
require the Department on Aging and Advisory Board on Aging attention. The overall purpose
of the new priorities is to improve the efficiency and effectiveness of aging services in Orange
County with a holistic and preventive approach to meeting the needs of older adults. The
following new priorities will not require any additional county funds. However, the food service
improvement priority will require the re-deployment of existing JOCCA county funds to the
Department on Aging's operation of the nutrition program through the Seymour Center kitchen.
1. Develop a local aging-friendly community assessment tool.
2. Improve food service at Senior Centers in conjunction with supporting the local
economy and environment.
3. Consolidate Central/Northern Aging Services to the new Central Orange Senior
Center (COSC) adjoining the SportsPlex.
4. Initiate program leadership and planning in geriatric mental health care.
5. Begin the three-year Community Resource Connection (CRC) project for improved
access to services for older adults and persons with disabilities.
16