Loading...
HomeMy WebLinkAboutAgenda - 04-10-2007-2fORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: April 10, 2007 Action Agenda Item No. o~ ' -F SUBJECT: Presentation from Human Services Issues Forum 2006 DEPARTMENT: County Manager PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Forum 2006 Program Final Report on Forum 2006 INFORMATION CONTACT: Emily Adams, Co-Chair Human Services Advisory Commission Sharron Hinton, 245-2302 PURPOSE: To present the final report on the proceedings of the Human Services Issues Forum held on September 16, 2006 by the Human Services Advisory Commission (HSAC) of the Board of County Commissioners. BACKGROUND: Each fall, the HSAC convenes a forum on an issue of social significance to the community. Because the Master Aging Plan (MAP) Update was underway, the HSAC saw an opportunity to build greater awareness and broader community input on the County's desire to meet the needs of older persons. To that end, the HSAC partnered with the Orange County Advisory Board on Aging and the MAP Update Task Force to sponsor the 2006 Forum, "Communities Responding to an Aging Society: The Fabric of Our Lives". The format for Forum 2006 included a keynote presentation by State Representative Jennifer Weiss (35t" District), a leading champion for the elderly, as well as four discussion circles. The discussion circles were Housing and Transportation, followed by Information/Access to Services and Transitional Care. These topics emerged as major themes within the MAP Update. During each discussion, panelists provided a brief overview of current issues, which was followed by a question and answer period. Attached is a copy of the Final Report that depicts the activities and outcomes of the day. Copies will be forwarded to all presenters, participants, and interested partners. The Final Report can also serve as an appendix to the official MAP Update scheduled to be presented with recommendations to the BOCC later this spring. FINANCIAL IMPACT: There is no financial impact to receiving this report as information. RECOMMENDATION(S): The Manager recommends that the Board accept the Report from the Human Services Advisory Commission on Forum 2006. a :Q w a~ 3 O m ~~ mp _~ Zp = y- J ~ as L ~~ L ~ ~ Q. m= U= OI ._ ~' m to a~ ~ =U ~~ m N ~~ ~O ~~ ~ ~ `~ ~ ~® ~ ~ ~. .~ t^ ~nyC7{. ~ O ~i u `y ® ~ ~ ~ ~ 0 a'°a ~Q v a~i U .~ o~ U "r ~U 4~ o'~ ~y crs ~3 (' Q. M Q. ~ U ~ ~ r O r .~ ~t O~ -~., y, ~_~ ~~ ~ a~ ~U a~ ~' cp :~ O ~~ U L .~ a W w tOn vJ ~~ L 0 ~~ 0~ ~~ o~ ~~ ca ~ 4~ ~ .~ U O ~ ~ ~ ~ ~ ~ ~ t ~ ~ o ~ ~~ ~_ ~ ' ~ ~ ~ o ~ A ~ ~ .~ ~ ~ .~ - of N U Z U> ~ ~ O ~~ p 4. C~ VI ~ N .~ _ ~ `~ O p csi ~ u U 6 ~ „u ~ ~ ~ 41 m ~ O ~-Y~~cv 0 s cJ ~ is ~ _ V ~ m a, ~ > ~i--- yJ a, ~ ~ ~ ~ EN V ~ ~ ~ ~ ~' V i ~ ~ ~ c5 ® ZS o~,~ ~ ~j S .~ ~ 3 ~ ~ ~' a ,~, } co N t ll ~J~C~ cp F+ ~= N tU U .ice f0 ~ C ~ > ~ ,,,, ~ v ~ ~ = C (O ~ O n- N ~ ~~ ~~ ~~~~,v r = to .~ ; U C~ cn *'- ~ ~' ~ c , N O ~ ~ = O ~ N ~ a ~~ a ~ L ~ ,~ ~ ~ Q ~ to p Q O (A = N t~ ~' __ -Q ''"' ~ L ~ ~ _ . O ~ ~ ..C = - L tY] N ..C E E to L ~ QmW ~ ~ m~~W Q. Q ® . ,~ .1_r U N O L fit- N _ _ ~_ •~ ,_ ~ •L C G_ N_ ~ L U ~~ r cV w~~>U ~U °~ 0 C O .N N V L L v 0 U 0 r T I O M 0 U ~" ~ .~ ~.. O Q p ~ a p ~ a ~ d Uoo ~a ~O a~ L N (Lp ~ ~ O m ~ V - ~ U ~Q ~o ~~U ~ a ~ o°~ ~ ~ ~ ~ N ~ = p ~ ~ O ~ O' ~U'' 0pU U ~ _"'¢ a~c _ O ~ 7 0 c a©~ o ~~~w ~ i c~ ~ a~ o ~ Y-..~ ~ ~ ~ oO-,F-~ _® W Q c a' c o •~ a ~ ~ ;a O ° a a u- ~ a~ d •== ~ ~ d .~ ~.~ c~U W N 'p 'p ~ ~ ~U ~ ca Q Q ~ `~ c Z V N O` O ~ O "p ° .L ~ ~ (~ c~ -~ d ~ '`L'' O ~~ _~ ~ °' ~ O ¢ M ~ ~ a; V 0 s. c~ a i t~ O ~ O ,~,. D L" Q. ,~ ~, o~ ~ O cp ~ Q ~ ~ ~ ~~~=~p~na~~i O~ N t0 ao•~.c cuQ`~W ~UF-U ~~ ~~,. ~ ~~~i p ~ ~ 1- co ~~p~W c C[f ;+. -r ~' ~ 2 •~ O i ~ m~`'U ~ a~a F+ ~ 'C ,U tl'f a0 cv C-°`1°WU~C~ O y ~ ~ .~ ~ Di V .~ ~ p ~' p ~~m~~Co~o p ~N~ ~ ~,:5?-~ .~ V O O V J Q N'r to N ~ N'V © O ~+.. y„ Q O ~ j ~ ~ ~ ~ V ~E=m~U~Z~ p D O S •i ~~ O C N y- O F-, ~ „~ ?,,,, L. N ~ ~ ~ ~ = ~ ~ I Q°F~'•~o~~O°r c~a Qa~U~oi? U Rf ~ N G1 -O ~ ,~ U ~( ~'~~. O~ p ~~~°~a '' c c ,o ~ c[ p ., U ~ ~ cB oU ~CLQm ° 0 0~ ~o ; ~..; ~ y.,, L., N ~ o .~ QQ ~ d~~ Q,cV N~ ~Q L ~, 4.,, a~ •- O c o ~ ~ 0©0,~ o V V_o~o~~U„Cca c U oU ~~ caOcnOZ i ~ Q y C ~ F- ~,m ~ ~Q'°' N ~, .Q is ~ O C =ooc~~ ;~ ~ ~S O ~ O O >~C~~`1°u'_~C9 m '~c ~' ~ o a c ~a~a~o aiQ ~U = U a~i ~ o ~ ~ ~~aU -O O ., ~ O C p ~ -~ O L. cnL ~w o rn o N o~ °~ o >,° ~ i O ~ -_.. t- ~ o .~ o ~ ='c •U°~'~ ~ ~ Y 'a °'• w~°'° w aU~~U Rs •- =0cp ~ s~. ~ocUc~ ~ ~ ivc ~ Q 'o 00 ,~ ~ o ca 4- `t~ ° ~ o o w., m c ° •- c~ .o ~°m ° ° o'°o~ oo°~ 'QaQi= E °aa~a~ .~C .0 'i'' ,O G. O ~ ~ cti ;,_, O i ~ w ~ O Q to p ~ .~ ~~ .~? Oyu ~'~~ ~a~~ ~ooU 0='0 ch vvi-o ~~ oQ +~ U w oU ~ a ~Cj~ NU oCj O'''~%~~ 5QZ ~-~ Y °-o ~ t~~=' ~ ° ° ~ o -o `Q a~ 3d i .F+ O M ~ p ? 0. ~ ~ ~ ~ Q "Thy Fabric of Our Lives: Communities Responding to an Aging Society" Orange County Human Services Advisory Commission Forum Annual Report 2006 Prepared by Graduate Interns Helen Cole UNC School of Public Health Erin Stephens UNC School of Public Health Victoria Catoe NCCU Master of Public Administration Shonda Corbett NCCU Master of Public Administration Prepared for Orange County Human Services Advisory Commission in Partnership with The Orange County Advisory Board on Aging and the Master Aging Plan (MAP) Update Task Force 5 Introduction With the advancements in medicine and technology, we are seeing an explosion in the numbers of elderly in our nation. As of the year 2004, 9 percent of the Orange County population was 65 years and older.l With a projected increase for 2020 of 4 years to the median age in 2000 (30.4 years), it is becoming increasingly apparent that we must plan and address the needs of this growing segment of the population.2 In the age of multiple generations, there is a growing number of retirees who are contributing human resources. At the same time, there is an increase in the number of persons living to an advanced age in declining health and limited function. The Master Aging Plan (MAP) demonstrates the county's recognition of and desire to meet the needs of older persons. With the development of A Bill of Rights for older persons and attention being given to crucial issues, such as mobility, advocacy, transitional care, and security, it is exciting to imagine the possibilities for Orange County. May this report on the community forum assist the MAP steering committee in addressing the articulated needs and interests of the residents. Moreover, may it inspire the community to protect and promote the quality of life for older Orange County persons. 1U.5. Census Bureau. State and County Quick Facts. Orange County, North Carolinn. Retrieved November 4, 2006 from http://quickfacts.census.gov/qfd/states/37/37135.html. ZOrange County, North Carolina Economic Development Commission. Demographics. Retrieved November 4, 2006 from http://www.co.orange.nc.us/ecodev/stats/demogrph.htm Page 2 of 18 ~1' And the Day Begins.... Participants registered upon arrival and received agendas and information on resources for the aging in Orange County. After registration, the community forum began with the HSCAC Co-Chair, Robin Barnhill, welcoming participants and presenting the agenda. The forum was developed in coordination With a number of .Forum participants eager to start the day. groups to facilitate the gathering of policy makers, providers, consumers, and volunteers for a better community for the aging. Commissioner Valerie Foushee added welcoming remarks with greetings from the Orange County Board of Commissioners. Florence Soltys, introduced by Commissioner Barry Jacobs, updated the forum participants on the status for the Master Aging Plan (MAP). The MAP functions to promote a senior friendly community as part of a smart growth policy. It is a countywide plan that will involve both the public and private sectors. Soltys also shared some concerning statistics with the attendees. As of September, 2006, 18,000 people were aged 60 years and above in Orange County, surpassing the number of school-aged children in the county. The aging population is often referred to using the three "F's": fit, frail, and fragile. Within the older Orange Count population, 79% are considered fit, 16% as frail (disabled and in need of some assistance), and 5% as fragile (severely impaired and/or institutionalized). Given these statistics, the MAP will play a crucial role as the county continues to grow. Ann Johnson, a long time activist and community advocate, who serves as the Orange County Representative to Senior Legislator amongst other roles, introduced the forum's keynote speaker, the Honorable Representative Jennifer Weiss. The. North Carolina House Representative expressed her support of the increasing focus on the elderly community. She discussed the current legislation and legislative needs for the aging population, including housing, long-term care, and the impact of mental health reform. With the assertion of the value of older community members, she encouraged community members to purchase long-term Page 3 of 18 care insurance. Weiss called for increased home and community-based spending for elderly care and the increased awareness of business to the needs of elderly consumers. In response to an audience query, she advised that it is important to engage members of Chambers of Commerce in the planning for aging. Weiss applauded the community action in Orange County and encouraged the audience to keep their elected representatives accountable for addressing the needs of the population. Following the keynote address, forum attendees were divided into discussion circles such that each participant went to two discussions. The first concurrent circles were Housing and Transportation, followed by Information/Access to Services and Transitional Care. During each discussion, the invited panelists gave brief presentations on current issues, and then the floor was opened for question and answers. Page 4 of 18 Representative Jennifer Weiss speaks as community member and legislator Ann Johnson looks on Transportation Discussion Circle: The transportation session had five panelists representing different segments of public transport in the county: Orange County Public Transportation (OPT), Triangle Transit Authority (TTA), Chapel Hill Transit, Orange County Emergency Medical Services (EMS), and the HARP (American Association of Retired Persons) Driver Safety Program. Each panelist spoke briefly about the services provided by their respective organization or program. TTA currently offers bus and shuttle services to Wake, Durham, and Orange counties, as well as ride sharing, and is developing regional rail services. OPT provides bus and door-to-door transit services to within and beyond Chapel Hill and Carrboro to the rest of Orange County. The two programs coordinate to offer transportation through the Triangle region. One participant expressed concern about the extent and cost of TTA services for transportation to medical appointments. Other group members brought up similar concerns, revealing a need for improved communication to the public on the type of services offered besides the OPT bus system. An administrator from the UNC hospital expressed difficulty in arranging transportation for discharged elderly patients who are without family or caretakers, particularly during the evenings and weekend. Currently the hospital utilizes taxicabs for transportation, but there is a need for accessible hospital-to-door service in more appropriate vehicles. The EMS representative commented that public transport workers have body training but cannot be expected to act as a health monitor and perform their job. He mentioned experiences when drivers have transported discharged patients during the day without knowing if there would be anyone to help at the home. Another concern was the transportation of patients to outside the public services jurisdictions, specifically regarding OPT transporting hospital patients to beyond Orange County. It was evident that there was a need for communication from both sides to address this issue. Page 5 of 18 A staff member from Homestart, a residential program for homeless women, expressed concern that there is not any service to their residence after 5:30pm on the weekdays, and limited services on the weekends. Homestart encourages their residents to find jobs and women with evening jobs must make a lengthy walk after-hours that is off of the main road. Recently, the program has had a rise in disabled and older female residents and is concerned for their safety. Another forum participant added that the location of the new senior center is near the residential program, so there is a pressing need for extended service. Moreover, frustration was expressed with the lack of service to northern Orange County. The panelists referred all of the participants to a public forum the following evening to voice their concerns as the transportation system is in the process of reassessing service needs and is considering additional needs. They recognized that not all citizens could afford the shared ride service, thus other options would be considered. There were additional comments expressing confusion with specific services that the panel members responded to according to their expertise. The panelists were very. responsive to the comments of the participants, but did remind everyone of the barriers to service, such as financial feasibility and personnel limitations. The OPT is currently working on two development plans, one of which focuses on metropolitan planning and the other a regional plan to develop community transit services. The organization is in the process of considering how to combine services in Durham, Orange, and Wake counties, specifically looking at the .costs and impacts. Chapel Hill Transit is considering more environmentally friendly technology such as buses that run on more efficient fuel. Both session panelists and attendees were very engaged during the first panel session. Upon ending, participants continued to engage with the panelists before moving on to the next session. Page6of18 ~o Housing Discussion Circle: Housing discussion session participants included Karen Daniels of Carol Woods Retirement Center, Laura Martin of Alters Wynwood & Clare Bridge of Chapel Hill, Betty Stevens of Brookshire Nursing Center, Jack Chestnut of the Orange County Advisory Board on Aging, Tara Fikes of Orange County Housing and Community Development and Lane Sarver. Moderator Jan Wassel, Director of the Gerontology graduate program at UNC- Greensboro, started the discussion by introducing the topic at hand: the transition from independent to nursing care. She began by asking the representatives from different levels of care and consultants to introduce themselves. Laura Martin of Alters Wynwood and Clare Bridge, an assisted living and memory care living facility, described the meaning of the term "assisted living." According to Ms. Martin, assisted living has many meanings. Alters Wynwood and Clare Bridge offers a variety of services for people who are unsafe living alone. Their services include medication assistance, assistance with dressing, and Panelists and forum participants discuss the incontinence care. Their services are housing issues faced by the elderly citizens of not one-on-one, instead they are one- Orange County. on-ten to one-on-twenty. When a resident moves to the facility, an assessment is conducted to determine which services they will need. Betty Stevens of Brookshire Nursing Center in Hillsborough described services at her organization as "skilled nursing." They provide long-term care or short-term rehabilitation care. The level of care can be at any level and may include restorative nursing, dietary services, and more depending on the need of the resident. Most of their residents are not very high functioning. Karen Daniels of Carol Woods Retirement Community described the level of care provided by her organization as independent care through skilled nursing. They operate four individual retirement centers in Chapel Hill. Residents pay an entry Page 7 of 18 fee or a purchase fee upon moving to the retirement community and move in with a life-time contract. A range of services are provided including meals, house-keeping services, and maintenance services. Although the residents in the community are in their retirement years, there are lots of residents that take on second careers. The organization provides a safety net of assisted living and skilled nursing. Jack Chestnut tied in information presented by other panelists to the County's Master Aging Plan (M.A.P.). Mr. Chestnut said that many older adults do not want to move from their homes at all. He discussed a 55+ community in Mebane, which is intergenerational. They would like to make it easier for people to stay in their own homes, providing transportation and amenities near home. Mr. Chestnut says that they do not have a 55+ community in Northern Orange County but they are building a new senior center in Hillsborough. Panelist Lane Sarver brought up that a lot of people who can't afford moving to assisted living or 55+ communities. He discussed the need to help folks afford independent apartments and the need to build low-income housing and to provide assistance for rent and bills. Mr. Sarver says that all programs have long waiting lists because the need is great. He would like to bring such programs to Northern Orange County. Tara Fikes of Orange County Housing and Community Development discussed Section 8 Housing and a rent voucher program using federal and state funding. She also discussed a local program, the Urgent Repair Program, which provides assistance for home repair. This program is for the elderly and the disabled and is for people who live in owner-occupied homes. After the panelists introduced themselves, Ms. Wassel opened the discussion up to questions from the other attendees of the discussion group. The first question was for Ms. Fikes to clarify some things about the program she was announcing. She said that money for ramps and such often comes from congregations and is only for privately owned property. Another discussion participant inquired about the financial level necessary to be eligible for home repairs. Ms. Fikes responded that the program provides services for individuals with an income of $18,750 or below (approximately 50% of the median income and less). Another discussion participant asked whether the home repair program used volunteer laborers for home repairs. Ms. Fikes replied that Page 8 of 18 !a they only use contractors that have insurance. In response to a later question, Ms. Fikes stated that the program has a limit of $5,000 per house and can only respond to the most urgent needs. Another member of discussion asked if there had been any thoughts of using co- housing systems that are used in other places such as in Scandinavia. Mr. Sarver replied that some elderly people in Carrboro and Chapel Hill were starting to put together a co-housing project but this is for people who can afford full mortgages, not those with low incomes. center. Someone else asked if there were any group home facilitation available. Ms. Kate Barrett of the Aging Transitions Program, a discussion participant, replied that Charles ,House is thinking about opening a new facility. More information on this can be found at www.second journey.org. Mr. Sarver added that coordinated housing is often able to assist with nutrition services and perhaps a good place for a new facility would be near a senior Ms. Wassel, the moderator, asked how we could help people who can not afford to stay in their own homes. Mr. Chestnut replied that helping people with taxes helps people stay in their own homes. He also stated that education needs to be placed on builders to encourage them to build close to services (for example the Glen Lennox area and areas near Timberlyne Shopping Center). He said that we need to get the word out to increase affordable units. Ms. Wassel then asked how we are going to make sure that when we encourage development, we will be able to provide services. Mr. Chestnut replied that Southern Village represented a good example of services located near housing but that homes in Southern Village are expensive. It is important to develop new housing around an anchor store where residents would be able to shop. He said that he hopes to educate developers on these topics. Another participant in the discussion asked what happened to the sharer home that used to exist in Chapel Hill. The home consisted of a group of people who were Page 9 of 18 i3 sharing a home that was operated by a manager. The moderator said that it would be a great idea to place a graduate student in a sharer home to integrate the home. Ms. Karen Daniels said that the assisted living program at the Carol Woods Retirement Center uses the concept of sharer housing. In their program up to 12 individuals share a house. Ms. Daniels said that this concept will probably become very popular. She also mentioned that there will be lots of different kinds of consumers in the boomer generation. Ms. Daniels also mentioned a new initiative to get young people interested in the aging population. Following this comment, a graduate student from the Urban and Regional Planning department at the University of North Carolina at Chapel Hill, introduced herself to the group and said that she became interested in the aging population while working in a retirement facility as ahigh-school student. After another participant asked what had happened to the sharer home that used to be in Chapel Hill, someone replied that the home had been ,purchased by an individual. The new owner could not find enough residents to keep the home up. In closing the session, Mr. Chestnut asked that participants, look at the housing sections in the Master Plan on Aging and that if any one had any ideas, they would try to incorporate them. The moderator then thanked everyone for coming and pointed out the future opportunities for discussion, which were listed in the forum information packets. Page 10 of 18 i ~- Information/Access to Services biscussion Circle: Accessibility is recognized as an essential component when it comes to accommodating the needs of those who are in need of services. If you ignore the needs of a large section of your target audience, they will not know about services or use services. As the aging population grows and their needs for particular services cultivate, any and everything should be made available to ensure them a healthy lifestyle. The Orange County's information/access to services discussion was held to discover how to keep people, especially the elderly, informed about needed services. The discussion began with the panel members stating their names and which agency they were representing. Next the moderator had the audience members taking part in the forum introduce themselves, what agency they were representing, and what they would like to gain from the discussion. When questioned why she had participants introduce themselves, Gwen Harvey, the moderator stated that she wanted everyone to know the wants and needs of each other and to be able to network. The participants of the forum included budget analysts, students, librarians and individuals representing their respected agencies, area schools, transportation departments, health and human services, and local government. The panel discussion started off with l.ula Ann Johnson of Triangle United Way. She talked about the services of 2-1-1. The phone number 2-1-1, started back in 2001 for area counties and provides directory assistance for finding community health and human service resources. ~ This number, that now houses information for 16 different counties throughout the state of North Carolina, has information for nearly 20,000 nonprofits throughout the state. The Triangle United Way is now trying to receive funding from Z. Smith Reynolds, a North Carolina based organization that helps fund programs that improve the quality of life of the people of North Carolina, to expand its services statewide. 2-1-1 is a free service with multilingual representatives and is available 24 hours a day, 365 days a year providing a link to vital services in the community. For Internet users, information cnn be obtained via web at www.nc211.org . The same information that can be obtained by calling the telephone number may also be obtained on the website. There are several options available to make the online searches easier, either by city, county, zip code or agency. Johnson would like each agency to be added to the Triangle United Wny's online database and Page 11 of 18 15 add/edit their agencies' current information. She is also asking for suggestions on system improvement. The audience participants had a few concerns regarding 2-1-1. One of their main concerns was that they were unaware of the service. Participants would also like for the service to house information for different services so that it can help citizens find help or a community service for themselves or someone in need. It was affirmed that the 2-1-1 service is being advertised through the local area television station, WRAL, television networks, and radio. The next panel member was Linda Grimm of Triangle J Area Agency on Aging. Triangle J Area Agency on Aging, which covers seven of the surrounding counties, is an organization that provides information and direct services for older adults and their caregivers. Full Circle of Care is another organization that is affiliated with Triangle J that is geared toward the aging population. More information regarding the two different agencies can be accessed through their websites www.tjaaa.org and www.fullcirclecare.org. Katherine Leith of Orange County Department on Aging writes a column geared towards senior citizens that can be found in the Chapel Hill Herald Sun newspaper. At the Orange County Department on Aging, individuals and their families can obtain information, counseling, and services to help them navigate the medical, personal, and social transitions that may accompany aging. The department also has a Community Resource Guide available for senior citizens to help them obtain needed information. Kim Sholar from the Orange County Public Library, spoke .briefly on reading materials and computer access at the library. She noted that if anyone needs help accessing the Internet or finding needing resources, she as well as her colleagues, will be more than happy to assist. The panel gave various suggestions . on the best way to relay and receive information. One panel member said that the best way to distribute information is either through the Internet or a-mail. Therefore, she declared that an organization can advance its cause through informational technology. This same panel member said that the phone book or word of mouth is another good method. Another panel member said that information should be placed in as many places as possible to guarantee that it is where it should be. Also, a neighborhood advisory program is a good source to receive information. Page 12 of 18 1 ~o The audience commented on what the panel had to say about accessing information. Some of them agreed with a panel member's comment on putting information in as many places as possible. Others said that it does not matter how much information you put out, because people will not look for it or pay it any attention until they actually need it. There was consensus from the audience that the best methods to relay information was either through flyers or word-of-mouth. Page 13 of 18 1`7 Transitional Care Discussion Circle Following the. introductions of the panel members, the discussion began with a question regarding the provision end-of-life care at nursing homes as it is done in hospice care. In response, panelist Betty Stevens of Brookshire Nursing Home described the home's commitment to quality care for their residents. Their facility includes the best and most comfortable care possible at the end of life for patients by notifying the hospice, family members, and /or local churches. However, she also recognized the limitations of serving primarily Medicare recipients. As Medicare does not fully cover the cost of service for each patient, the facility loses money by taking in Medicare patients. She recommended an increase in the Medicare allowance in order to cover more of the patients' cost nt each facility. Diane Kapel and Janet Hadar, both employees of UNC Hospital, indicated that the Hospital would not turn away anyone without healthcare insurance because it is a state hospital. They expressed the need for the state to increase the benefits to cover more of the cost of patient care. Kapel shared that her staff meets with each patient and makes the necessary arrangements for patients who live alone and for those who may need transportation or in- home services. Unfortunately, the hospital is seeing a growing number of patients that do not have additional support outside of the immediate services of the hospital. Some patients may be allowed to stay a day longer in the hospital in order to be able to care for themselves independently once being discharged from the hospital. Hadar, a discharge planner, indicated that there is a need for the patients to have some type of transitional care from the hospital to their home as there is a lapse in care for many patients once they leave the hospital. Vibeke Talley, an occupational therapist and member of the Orange County Department on Aging (OCDOA), visits patients' homes to assess the patient's needs in order to provide quality in-home care. Once patients have contacted the department and requested assistance with at-home rehabilitation, OCDOA uses a Page 14 of 18 i~, referral system to link patients with the appropriate services. This is a service more easily accessed by Orange County residents discharged from UNC hospitals, rather than those from other hospital systems. However, a resident or family member can call the OCDOA anytime and get a home assessment and begin the referral process for services. Kate Barrett of the OCDOA presented a directory of services for county residents. The directory includes contact names and numbers, services that are provided and can be offered in the home. Free to all residents, the directory is supported by donations. Barrett recommended the book as a resource .for those needing assistance, and also recommended calling the OCDOA in times of need. The duty of Gwen Phillips of the Orange County Department of Social Services is to monitor the local nursing homes. If a resident can not stay in their private homes then they are placed in a facility that can provide them with care. Also a person in a facility can still get help from the county in a nursing home. Phillips complimented the local nursing homes as being outstanding places to live if someone can not live independently. The state regulates how the facility should be operated. Orange County is lucky to have some of the best facilities in the country. for their residents and more people are moving here because the quality of care that is offered. If a resident is active and would like an outlet then Laura Deloye of Senior Care of Orange County addresses the need for daycare for adults. The center has various hours and the rates are for single persons or married couples. Senior Care of Orange County has a sliding fee scale and charges up to $70.00 per day. The center has activities planned and is a very good social outlet. The center serves functioning adults that can take care of themselves. There are no medical services provided at the center. Carol Taylor of Piedmont Health System supports the development. of P.A.C.E .(Program of All-Inclusive Care of the Elderly) which helps low-income elderly(Medicaid /Medicnre eligible) to remain in their home as long as possible with community-based health care. They are currently waiting on a grant award. Florence Soltys of the Orange County Advisor Board on Aging mentioned that UNC Hospital needs to include in their emergence entrance an admission area for the aging adults. She used the example of the pediatrics entrance. They should have Page 15 of 18 i~ the same sort of entrance for the elderly and frail adult waiting in a crisis environment. This would allow for them. to be seen faster by a doctor. There is a growing need in the health care field for services provided to the aging adult. Included are shortages of doctors and nurses specializing in geriatrics. Gerontology is the medical specialty for aging adults and fewer students are finding this an interesting field of study. These specialists need to be paid better and the adult population is getting larger for a demand for these specialists to be available. The elderly can have appointments at the School of Medicine~as a walk-in by calling a nurse at the school. The School of Medicine has clinic on Mondays and has mobile SHAC. The Hubbbard program is 10 years old and Ms. Soltys is the Medicare Part B expert. There was some discussion about the State Health Plan. The issues were: pre- approve plans, lack of skilled people knowing the difference between Medicare and Medicaid, "homebound" needs to be defined, and wages need to be increased to afford the plan. The group also discussed a 10 year plan to end "Aging in Poverty" which would include providing affordable housing, securing jobs for older adults to continue to work past 65 years of age and on-going adult training so adults can get access to information and transportation services. Page 16 of 18 acs Building Senior Centers for the 21~ Century- An Update: After lunch, the forum participants heard about the two new senior centers which will replace the current facilities in Chapel Hill and Carrboro. Pam Jones, Director of the Orange County Purchasing and Central Services Department, began by describing the Robert and Pearl .Seymour Center. The center is being planned by a committee of commissioners and seniors and will open on May 1, 2007. Ms. Jones also described the Central Orange Senior Center which will be an addition to the Sports-Plex. The Central Orange Senior Community member Ann Johnson with forum Center will be reviewed by county resenters. commissioners in early November. It will feature a separate entrance and identity from the Sports-Plex and will house an adult day health center. The center is scheduled to open in early 2008. Janice Tyler, Administrator at the Senior Centers (Orange County Department on Aging), discussed the development of new programs which would be made possible by combining North Side Senior Center and Elliot Road Senior Center. New programs, which will be offered in the new facility, will be announced in the biweekly Senior Times. The center is entering a relationship with UNC Geriatrics which would provide assessments at the new Senior Center. Jerry Passmore, Director of the Orange County Department on Aging, described the new senior center as "one-stop shopping" for seniors. It will be available for new programming for all departments. Everyone will be able to use the facilities for programming for seniors. Mr. Passmore also discussed the importance of riding the bus to the new senior center as transportation is critical for the success of the center. Page 17 of 18 a~ Closing Remarks Robin Barnhill, HSAC Co-Chair, closed Forum 2006 with acknowledgements and appreciation for the over 120 participants who attended the forum. She encouraged them to continue and contribute to plans and preparations underway to assist all persons in their desire to age successfully within the greater community. 5 ecicrl Thanks to the Contributin Photo r4 her, Jerr Possmor Page 18 of 18