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HomeMy WebLinkAboutAgenda - 09-19-2006-7aORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: September 19, 2006 Action Agenda Item No. ~- q SUBJECT: Master Aging Plan Update and Preliminary Goals and Objectives Approval DEPARTMENT: Aging/ Advisory Board on Aging PUBLIC HEARING: (YIN) No MAP Task Force ATTACHMENT(S): 1) Steering Com. Minutes- May 11, 20Q6 2) MAP Approval of Outline and Theme 3) MAP Proposed Bill of Rights for Older Persons 4) Preliminary MAP Goals, Objectives and Strategies for 2007-11 INFORMATION CONTACT: Jerry M. Passmore, 245-2000 Pat Sprigg, Task Force Co-chair Florence Soltys, Task Force Co-chair PURPOSE: To update the Board of County Commissioners on the Master Aging Planning progress and to request approval of the report outline (including the report theme statement, and the development of a bill of rights for older persons) and the preliminary goals and objectives for 2007-11 for public comment. BACKGROUND: At the request of the Orange County Advisory Board on Aging, the Orange County Board of Commissioners approved on June 23, 2005 updating the Master Aging Plan (M,A,P.) for the Years 2006-2010, On October 18, 2005, the Board of County Commissioners approved the recommended M,A,P, Task Force charge, structure, membership and time frame -with Commissioners Barry Jacobs and Alice Gordon to serve on the Steering Committee.. The M,A,P. Steering Committee was formed and guided the activities of the three subcommittees charged with identifying specific issues of the elderly and developing goals, objectives and strategies to accomplish them, Since the last MAP update report to the BOCC on May 4, 2006, Pat Sprigg and Florence Soltys, co-chairs, held a M.A,P. Steering Committee on May 11"'to complete prioritization of subgroup issues and begin the development of goals, objectives and strategies. (Attachment #1) During the months of May through August, the three funcfional subcommittees - (1) Well/Fit Older Adult, (2) Disabled /Moderately Impaired Older Adult and (3) the Severely Impaired /Institutionalized Older Adult -and the four identified broad issues subgroups (Information/Access, Housing, Transportation and Transitional Care) met to finalize goals, objectives and strategies. The MAP Leadership team (consisting of the facilitators of all the subgroups) met to finalize goals, objectives and strategies for administration/planning and legislative/advocacy that would be included in the MAP report. The M.A,P. Steering Committee held its 5~" Meeting on August 24, 2006 and recommended the BOCC approve the MAP report outline, the MAP theme "Developing Aging-Friendly Communities in Orange", the development of a Orange County bill of rights for older persons, and preliminary goals, objectives and strategies (Attachments-#2, #3, and #4). After BOCC review and approval of MAP report outline (including theme, bill of rights) and the preliminary goals, objectives and strategies, the MAP Steering Committee (in partnership with the Aging Advisory Board) will hold public presentation meetings during September and October. At the end of the public comment period, the MAP Steering Committee will meet to review all public comments for MAP report changes. The final MAP report will be submitted to the BOCC on November 14 far approval. FINANCIAL IMPACT: There is no financial impact associated with receiving the MAP update and preliminary goals and objectives approval. RECOMMENDATION(S): The Manager recommends that the Board accept the update as information and consider approval of the proposed report outline, including the theme statement, the Bill of Rights for Older Persons and the preliminary goals, objectives and strategies for 2007-11 to receive public comment. ORANGE COUNTY MASTER AGING PLAN UPDATE: 2006-10 M.A.P. STEERING COMMITTEE MEETING #4 MAY I I, 2006 MINUTES The M.A.P. Steering Committee held a meeting on May 1 1, 2006 at the Southern Human Services Center, 2501 Homestead Road in Chapel Hill, North Carolina at 10:00 a.m. PRESENT: The list of those present is attached to these minutes. The list includes members, staff and visitors, MEETING OBJECTIVE: Complete prioritizing issues and begin Action Planning for 2006-10 Florence Soltys welcomed everyone to the meeting. She thanked Pat Sprigg for presenting an update to the Board of County Commissioners on May 4. This will be discussed later in the agenda. 1. Welcome and Introductions A. Recognition of Guests Everyone introduced themselves. Barry .Iacobs and Alice Gordon were congratulated on his re-election victory. B. Approve Minutes for Meeting #3, March 23 and Special Meeting April 20, 2006 It was suggested that a list of members present be attached to the minutes. A motion was made by Leo Allison, seconded by Connie Mullinix to approve the minutes for March 23 and April 20, 2006. This motion received a unanimous vote.. C. Other Items None 2. RCgort on Presentation to BOCC on MAP Update _ May ~ 2006 A. Follow up items Florence Soltys said that she mzderstands there was a ]ot of support for what was presented to the County Commissioners last week. There was a question about the tax issue which is on page 7 of the abstract. She emphasized that we need to find out what is happening in other places to help seniors with tax issues. Barry Jacobs said that the Commissioners were receptive and appreciative of al] the work that had been done. The County Commissioners did aslc for additional information for' possible future legislative priorities regarding different ways of dealing with taxes. Convnissioner Carey suggested that the senior community which is very active do some research on getting information from other states as well as North Carolina. Either this group or the Advisory Board on Aging could do this research in time for the long legislative session next year. Alice Gordon said that she is supportive of trying to find some tax relief for seniors and would be willing to help with the research not only for the seniors but for the lower income citizens. Jen-y Passmore said that he has talked about this issue with the Tax Collector and also about a person in transition who wants to stay in her trailer who they were able to help. There are four counties in North Carolina which are looking at the whole issue oftaxes. Ann .lohnson asked about the help this person received in paying her taxes and was told that she was given a loan from Senior Care of Orange County, hla which is a private non profit which receives private donations and provides a revolving fund that can be used for many reasons,. 4 Alice Gordon noted that there is Che issue of helping the seniors or others and then there is the issue of the impact on the County revenue system and figuring out something that will work. It needs to be seriously researched.. She feels there are various ways of helping seniors age in place or helping other low income citizens and balancing it with the County's revenue stream. Florence Soltys said that the Tax Collector worked with this person to pay her back taxes but there was no way to help her so she came to Senior Care of Orange Cowlty, Inc. and they had enough donations to pay the taxes. Also, this person is ill but has made a commitment that her property will pay back the money to the fund, This is a new way of helping people. Barry .Jacobs said that he talked with Commissioner Ward from Wake County who had a proposal of placing a lien on property and allowing the person to defer taxes while living there and then paying the taxes when the property is sold, Commissioner Ward needs to be contacted to find out how far this proposal went and see what the objectives may have been. Any tax proposal would need to go before the state legislators. They may let Orange County do a pilot program.. Nancy Coston said that Medicaid now takes liens on property. There may be something similar that Orange County can do. Also, Social Services tries to help the disabled as well as seniors and others. Ann Johnson said that there are major changes being proposed in the form of the Protective Services Act. The Department of Social Services has been promoting this change which calls for mandatory training and mentions elder adults as separate from the vulnerable, The proposal drops the word "disabled" and substitutes "vulnerable" and "elder adults" implying that all need protective services. There seems to be no support to consider that this might be erroneous in its interpretation. Nancy Coston said that she is on the task force. Ms. Hudson was the person who suggested they use this definition. Ann .lohnson has received a lot ofcalls from people about this issue and she is not happy about this, She will talk with John Saxton at the Institute of GovernmenC wlio is on the task force.. 3. Update Reports from Subcommittees -_ Priorities and Action Plans A. Well-Fit Functional Group -Myra Austin Myra Austin said that the Well-Fit Committee met and took their five top issues and assigned some tasks to those strategies and goals. Their top issue was home-based preventative community services which includes goals like aging in place through new housing development.. One idea is to provide incentives to built senior housing so that people from different backgrounds can live successfully in the same community. Their second goal is community assessment.. This would be a bi-annual community assessment to identify needs and issues of older adults. It was suggested that this project could be done with the help of UNC and other organizations. Another goal would be driver safety. They will look at developing an elder driver education course. They will write a safe driver brochure using programs like AARP and also work with the School of Occupational Therapy, Another strategy within this goal would be to mobilize the faith community in terms of helping with the education of older adults which will also involve the Department of Motor Vehicles. Another strategy within this goal is to develop a drivers screening project. This would utilize volunteers and use the DMV testing policies, The next objective is access to affordable health care. One piece of this is community education which goes back to hiring an additional staff member who would handle information and resource issues and also to manage volunteers. Another part of this particular goal is to work with the I-Iealth Department Co establish mobile clinics to include prevention screening services for mental health, education and basic counseling. Another part of this is to improve access to availability of various treatments and facilities which will accept Medicaid and Medicare. The last goal is to increase budget allocations for older adult services and to solidify funding for Senior Times and provide funding for sustaining informational services. Connie Mullinix said that she applauds the effort to get into the plan to do a comnwnity survey.. She hopes that we will work very strongly with Healthy Orange and the Health Department and would propose that this be added to the report. Myra Austin accepted this change. Barry .Jacobs asked if we ever steer providers to senior communities in terms of health care.. He went to the opening of a new community called Asbury Crossing which is across from Mebane Lumber and they will have 140-160 owner occupied senior units and they have space within the community for a clinic.. Myra Austin said Chat we have never done anything like steer a doctor to a particular community. Florence Soltys said that this concept would need to be studied.. Perhaps someone like Piedmont Health would be interested in providing this service for a community. Comlie Mullinix mentioned that there may be a program at NC State which would provide funding for an on-site doctor. Ann .Johnson said that it seems to her that it would be worthwhile to include as a recommendation that a relationship with the County Planning Deparhnent needs to be developed so we would not be hearing about this new development after it has already been approved. The time to meet with them would have been when it was being planned.. .Jack Chestnut said that in a couple of cases the Advisory Board on Aging has been asked to review plans for new development and have offered comments. Barry .Jacobs agreed with Ann .Johnson and noted for the record that this development was approved by Mebane. The County will try to work with Mebane on Joint Planning sometime in the future. Jerry Passmore said that they approve of support services within the community. The issue is transportation for other services that will need to be reviewed and worked out, He would like to have a planning group look at these developments and look at several issues including human services and transportation.. .Janice Tyler clarified that they are asking for new positions for the new senior centers and Chese are noC included in the current budget so they will have to go back to Che County Commissioners as startup positions. .Jack Chestnut said that the Advisory Board on Aging has approved these new positions for the new Senior Center. B, Moderately Impaired Fwlctional Group -Kate Barrett Kate Barrett gave this report, The draft report dated April 12, 2006 is hereby made a part of these minutes by reference. The five top priority issues are (1) lack of mental health services, (2) isolation and loneliness, (.3) lack of case management services, (4) lack of collaboration with the faitJt communities and (5) dementia. Throughout all The group meetings they had, Che lack of information was mentioned -marketing and getting the word out. The f rst goal under isolation and loneliness is to establish a comprehensive database of county seniors, The ideas mentioned were centered on working with Emergency Management and the Department of Social Services to identify the seniors who need services. The second goal is to advertise the Dept. on Aging as a portal for all information and issues r°egarding seniors, The third goal deals with identifying nontraditional ways to seek out seniors,. The fourth goal is to establish formal relationships and encourage coordination between existing agencies. The fifth goal emphasizes the importance of making the new senior' centers welcoming and totally accessible to seniors with disabilities. Kate Barrett said that if we build the senior centers with accommodations which are inviting, the people will come. The sixth goal involves conducting a countywide campaign to get churches and other organizations to provide funding for frail seniors who cannot afford personal emergency response systems. The seventh goal is an extension of the current Friend to Friend program whereby trained volunteer seniors would call isolated seniors on a regular basis. The first goal under the Care Management subgroup involves getting county agencies to meet and share information and concerns regarding common clients and services. A lot more can be done by working together.. The second goal involves coordinating services among private, public and volunteer agencies. Kate Barrett said that she has a lot of questions about how this can be done. This seems to be something that people are interested in but the question of who would be responsible world need to be addressed. The third goal would be to develop a voluntary database of clients so that crucial information regarding clients will be available to professionals. The fourth goal would be to add Co the Orange County Resource Guide website state and national professional organizations and the last goal is to add professional staff capable of continuing physical rehabilitation interventions for seniors discharged from home health rehabilitation but who are still in need of follow-up in order to maintain optimal functioning. The Mental Health subgroup is proposing to have a partnership and implement a depression care system. She encouraged members of this Steering Committee to go to www.im~ct.ucla.orr? and check out this website., In the report that was distributed by Kate Barrett, there is additional information about A Primary Care Collaborative Model and Stepped Care. A depression care specialisC would be in the physician's offiice. There would be a geriatric psychiatrist who would serve in a consulting role. What you do is to remove the stigma of going to a Mental Health facility. This would also reduce the cost, It would take the Department on Aging working with UNC to make this work. The last subgroup working with dementia would include a massive outreach to minority churches. This would include information on how to get help. Ann .Johnson said that she feels it is important for people who are incontinence to realize that they don't have Co be incontinent, necessarily. Jerry Passmore said that he plans to meet with the architect for the new senior center and he will certainly make this point.. C. Institutionalized/Severely Impaired Functional Group- Jill Passmore .lilt Passmore said that they have identified Four (4) issues for the severely impaired/institutionalized older adults. They are listed below: • Quality of Life and Care issues •:• Caregiver Support/Work Force Issues • Education/Outreach •'• Person-directed Care They tools the previous Master Aging Plan and reviewed it and the priorities that were assigned and looked at all the objectives that were previously assigned to these priorities. They then decided to either keep as is or amend or delete them. The last meeting was spent on this project.. They will take this information back to the committee and look at where there are overlaps and holes in the plan. They will then set an action plan. They will divide these goals into legislation action, advocacy action or enforcement They will then make their recommendations, BREAK - (10 MINUTES) 4. Complete the Review, Clarification and RatinE of Issues in the four riori areas Housin Transpa•tation, Information/Access and transitional Care from the April 20"' Special Meetin TRANSPORTATION A. Review the Issue Priorities from Breakout Groups (See April 20`x' minutes) Al Terry reviewed the Transportation priority issues as listed on the handout, The first one is to expand Orange Public Transportation service level to equal the Chapel Hill/Carrboro L^-Z Rider,. He clarified this saying that Chapel Hill has geographical boundaries that Orange County does not have. This goal simply says that Orange County should have the funds that would provide the type ofservice that E-Z. Rider now provides. Orange County funds provide transportation for medical purposes only.. We do not have monies to enlarge the service tar other things. The second issue to expand transportation to senior centers, especially when the new centers open, refers not only to Orange Public Transportation but also includes Triangle Transit Authority. One way to do this is to offer the transportation services throughout the day, not,just one time a day, The third issue was to review fare structure/route costs in order to serve all seniors Currently, Orange County has not looked at their fare structure for about five years with the exception of the Hillsborough/Chapel Hill route that changed about six months ago. They need Yo look at the Medicaid reimbursement, the Triangle COG reimbursement and any kind of co-payments that are Chere and see if they need to be changed. We need to look at the most used routes and expand on those routes.. He said that unlike Durham and Wake counties, Orange County pays .35% of what Orange Transportation provides. The next issue is to consider combining E-Z Rider and OPT Service which would give us an opportunity to look at other sources of funding fiom businesses and other agencies in the County.. The last issue is to consider a separate Aging and Transportation Departments and this seems to be something that is looked at almost every year. It may be time to do this so that services can be expanded and we can get vehicles off the road. The second page of the handout is homework so that the members of this committee can rate the transportation issues and umnet objectives for MAP 2006-10.. .Jerry Passmore said that he would send out an electronic copy of this questionnaire to give committee members time to read through this material and answer online. He will mail the questionnaire to those who do not have email. He will also send out an electronic copy of the questionnaires for the transitional care priority issues, housing priority issues and information/access priority issues. AI Terry said that when purchasing a vehicle from the Federal contract through the State the regulations on the use of the vehicle are getting so strict that they are having to exclude certain populations in our County, There needs to be a decision about Counties purchasing vehicles on their own so they can be used for the general population. As an example, he said that they have been taking kids home from after school care. With the new regulations, they can no longer do this. They cannot provide a service that may be considered a "charter" service. .Terry Passmore said that there are also issues about taking people on outings or to the math The issue is that it is too far beyond our service area and that this is charter service. Right now, the buses cannot go beyond 50 miles from Orange County. Barry .Jacobs said that an issue last year was providing rides for seniors to go and vote. We were told that if we use Dept. of Transportation money that we could not take people to the poles. He asked if the new senior centers can also be polling places. It would make it easier For seniors to vote. Barry .Jacobs suggested asking the Board of Elections about this possibility for 2008. INFORMATION/ACCESS .Janice Tyler said that they identified five issues. The first is to improve website infornation to seniors. This would be used to promote the senior centers. They do a TV show each week and this would be linked to the website. Also, they want to expand the Senior Times to include a list serve for updated information.. The second item would be to increase outreach information meetings through the Roundtable of Senior Citizens Organizations (ROSCO). They had this many years ago in Orange Cowlty and would like to consider this again. The third issue is to increase newcomer infornation. There is a need to find out when a senior citizen moves to the area.. Maybe this can be done through the Chambers, Realtors, Visitors Bureau, eta The fourth 8 issue is the need for more specialized information access for,job seeking and vohmfeering. This is a continuing need for seniors. The Employment Security office does not separate out jobs suitable for seniors. The last priority issue is to increase marketing of aging services..Ianice Tyler said that she is working on a County connnittee looking at this entire area for human services. This includes looking at developing a logo, securing fw~ding for Senior Times, brochures and other items for advertising. Ann .lohnson mentioned that there are senior clubs in other counties and that Orange County does need to reach out to other clubs to give them information about senior services.. Yoko Crume said that at the State level they have a new initiative to coordinate State planning and local planning which hopefully will move toward a consumer directed approach to planning which will be outcome based. They would like to have guiding principles for seniors. They will work with other elected officials and the County Managers to try to coordinate State and County agencies.. Arm .Johnson said that one of the problems is that while it is clear who is responsible at the national level. At the State level, it is whoever the Governor appoints as the agency that is responsible and in North Carolina that agency is the Division of Aging and Adult Services. The area agencies are very clear also. What is not clear is who is responsible at the local level and that needs to be clarified. Kate Barrett asked if there is some way that our process can be used with this coordinating planning process.. Yoko Crume said that information from this committee can be fed into the state planning process and then worked into the national plan. Kate Barrett said that regarding marketing, there is a real need to market boomers and to prepare for the next generation and their needs. Barry .Jacobs asked if there is a list serve and was told that there is a database but not on a list serve.. He suggested a way to generate revenue for' the Senior' Tirnes might be to sell the list serve to advertisers who advertise in the Senior Times, He said that there is legislation in the State and Congress to change the way that cable is regulated which will end any opportunity to have a free television show. There will be no public access or local control. In answer to a question from .lack Chestnut about collaborating with the Recreation Department on publications, .Janice Tyler' said that what they are looking at is combining their request for bids that go out for each publication and hope that a savings can be realized by this process. HOUSING .tack Chestnut gave this report, His Steering Committee identified eighC (8) issues. The first is affordable housing for seniors both north and west of Hillsborough. The property tax breaks was addressed earlier in the agenda, The support services in planned senior communities was what Ann .Johnson and others were talking about. Barry Jacobs said that the County has asked the Planning Board to reconstitute the way land use plan updates will take place. The original Land Use Plan was written in 1981 and amended overtime and is in need of being updated. They want to create a process which will allow advisory boards that have an interest to make recommendations that will be incorporated into the Land Use Plan. Alice Gordon said that right now we have the Land Use Element of the Comprehensive Plan which is what is being sent back Co the Planning Board. We also have other elements and one of those has to do with affordable housing..Iack Chestnut said that what the Advisory Board on Aging hopes is that planning can be created for' "Senior Friendly Communities" like at Southern Village in Chapel Hill. There is a r°eal need to help people age in place. The next issue deals with education on how to age in place. They did have a Forum in Chapel Hill with 175 people attending. There is a need to have many more of these. The next initiative is to revise regulations and other restrictions to allow for innovative approaches to 9 allow aging in place,. This will come from Planning and the restrictive covenants and broadening these to include service providers, etc. Transportation for elders in rural areas has been talked about under transportation, The seventh issue is identify volunteers and others in the community who are able and willing to do repairs on homes and to upgrade structures to accommodate the increase in disability. He said that there will be baby boomers that will be looking for things to do and this could be one of those things that will help seniors who need repairs or upgrades to their existing residence. The last issue deals with a lack of incentives by and for developers..Iack said that we need to make it worth while for developers to provide senior housing which is affordable. Ann .lolmson asked .Jack to expand the third issue to include specifically the activity related to planning for Senior Friendly Communities. She feels that this is another thing that will be part of what the State will be doing across North Carolina, She would like this to be included in the State plan for areas which are already developed, TRANSITIONAL CARE Florence Soltys said that this is a new area because there are needs which are not being met. The first issue deals with creating a database for those people who are frail within the County. The second issue deals with the development ofa P.A.C.E. (Program of All-Inclusive Care of the Elderly) Program and support from the County to do it. There are no P,A.C.E. programs in North Carolina at this time and only 3.3 in the country.. It is a Medicaid and Medicare waiver and basically those people who qualify for this are at great risk for going into nursing homes. There would be a team of doctors that would be employed that would provide all the services for that elder person and they would have contracts with different agencies. There is one program like this being worked on in Wilmington at this time. They hope to have this program in this area within a couple of years. The next issue deals with the "blue and pink sheets". They, at one time, had a blue sheet for going into the hospital and a pink sheet for leaving for hospital and nursing home transitions.. These sheets help clarify the situation. This needs to be reimplemented. The next issue deals with information resources to improve transitions from hospital to nursing home or nursing home to hospital. Many times these people cannot speak for themselves and information is vague,. Someone who has a knowledge base of what is happening with a person needs to be available to help through the transition process.. The fifth issue is to implement the mental health reform recommendations which Kate Barrett previously discussed. We are seeing young chronically mentally ill people put in rest homes and nursing homes with people who are frail and don't understand what is going on and are terrified.. There are rest homes that only serve young chronically mentally ill males and it works very well. This is an area that really needs to be reviewed, The next issue deals with expanding adult day health as a transitional service. This would help people stay in their homes and is one way we can care for elders in this state.. The adult day health program will be the basis for the P.A.C.E. program as mentioned above. The other part of this would be to promote the alternative for the CAP/DA Program and V.A. The last issue deals with expanding assessment and care planning using home setting. Alice Gordon said that she feels the transitional process is fragmented, especially while a person is in the hospital. She feels that what a person really needs is an advocate. Nancy Coston said that the demands for in-home care services are more than CAP can handle and they are removing people off the program. She has concerns about this program. Florence Soltys said that she serves on the Aging Study Conunittee and ]snows that they have thousands of people across the State waiting for in-home care services.. No one is prioritizing these people and don't laiow where they are. The Aging Commission has asked for a review of this program. The available money needs to be matched with the needs.. Kate Barrett said that people are still calling for "Chore" services which is not available. We have a huge population that want to stay in their homes, to County Commissioner Alice Gordon was congratulated for winning another four years on the Board of County Commissioners, Florence Soltys said that on May 26 at Carol Woods from 10:00 a.m..-12 noon Rand Coble will announce a new study on aging for the State. They will be talking with many members of this Steering Committee. The meeting is open and everyone is invited, B. Rate the priority issues in Che four areas (handout) These will be sent to the members of this Steering Committee and the other professionals who are in attendance electronically by Jerry, Passmore for feedback. They will be mailed to those who do not have emaih 5. Rate the MAP Objectives for 2000-2005 in the four riori areas handout This will be sent electronically and mailed to those without email. 6. Next Steps _ Consider a Special Meetin in June before Summer Break The next meeting will be Wednesday, .July 19 from 10-12. 7. Adjournment The meeting was adjourned at 12:15 p.m. Respectfully submitted, Beverly Blythe, Recorder Jerry Passmore, Project Manager ~~- a~ Proposed Outline & Theme September 19, 2006 Orange County Master Aging Plan 2007-2011 Theme: "Developing Aging-Friendly Communities in Orange" EXECUTIVE SUMMARY II. ACKNOWLEDGEMENTS III. INTRODUCTION A. History and Need to Plan B. State of Orange County's Older Adults- Demographics C. Planning Process 1. Theme for 2007-11 Call to Action: Engage all departments of Orange County Government (and towns) 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. 2. Major Priority Areas and Functional Population Needs D. A Bill of Rights for Older Persons in Orange County IV. MASTER AGING PLAN GOALS FOCUS: ALL OLDER ADULTS _ OVERARCHING GOALS Goal A: Information/Access- Improve information & assistance options to all older persons and their families who need access to services , especially those most in need. Objectives Al - 5 and Strategies Goal B: Housing/Shelter -Promote an adequate supply of safe, affordable and suitable housing options for older residents to age in place. Objectives B1 - 5 and Strategies Goal C: Transit/Mobility- Enhance mobility options for all older persons regardless of functionality through a multi-modal vision that is acceptable, efficient, effective and affordable. Objectives C1 - 5 and Strategies Goal D: Transitional Care- Improve the transition and maintenance of older persons in the most appropriate care provider setting. Objectives D1 - 3 and Strategies Page 1 of 2 12 FOCUS: WELL-FIT OLDER ADULTS Goal E: Wetl-Fit Older Population -Improve and/or maintain the health and well-being of Orange County's Well-Fit Older Adults for as long as possible including future Older Persons. Objectives E1 - 5 and Strategies FOCUS: DISABLED/MODERATELY IMPAIRED OLDER ADULTS Goal F: DisabledlModerately Impaired Older Population -Maximize the safety, functional ability, and quality of life for impaired community-dwelling older persons and their family caregivers. Objectives F1 - 6 and Strategies FOCUS: INSTITUTIONALIZED/SEVERELY IMPAIRED OLDER ADULTS Goal G: Institutionalized/ Severely Impaired Older Population -Improve services, information access, and education, and outreach to long term care residents and families/caregivers that are affordable, accessible and promote quality of life through person-centered care. This also includes the retention, recognition, and training of paid facility staff, thereby improving quality and continuity of care for residents. Objectives G1 -11 and Strategies FOCUS: LEGISLATION/ADVOCACY Goal H: Legislation/Advocacy - Promote a legislative/advocacy Aging Agenda that supports Orange County's Bill of Rights for Older Persons. Objectives H1 -2 and Strategies FOCUS: COMMUNITY PLANNING AND ADMINISTRATION Goal I: Planning/Administration -Enhance the planning, administration, coordination and funding of a response system to the needs of older persons in Orange County. Objectives 11 - 3 and Strategies Page 2 of 2 1.3 Orange County, North Carolina A Bill of Rights for Older Persons Proposed -Sept 19, 2006 Prenurble: Orange Coarrty citizens of all ages /rove the ultimate responsibility to be or become self-reliant, to care for their fmuilies, m air! their neighbors and to plan prudent/y, for their old nge, Older persons have Nre responsibility to nrnke availnGle to t/1e coruunrrr/ty the Genefrts of dreir experience and knowledge. Society, be it through the institutions of the public or the private sector, lrns the responsibility to assist citizens to be prepared for t/reir Inter years, as wel! ns to assist direct/y other older persons rv/1o for one reason or another, cmnrot cope with the burden ojincrensing p/{ysicnl, nrentnl, social and environmerrtnl debilities. Therefore, tve, the Orange Cormty Board of Commissioners, subscribe to the following basic lnnunn r/ghts,for older persons /u Orange County, Nortlr Cnrolinn bused orr,founr/ing principles ojorrr state and nation. I. The Rixlu To Freedom, hrrlenerulerrce Anr/ The Free Exercise OfLuliv/dual Lritint/ve Ih T/ie Right To An Income In Retirerrrerrt W/rich Would Provide Arr Adequate Stnrulard O Livia III. The Right To Arr Opportunity For Enrploynrent Free Fro»r Discrinrinntory Practices Because OfAQe IV The Right To An Opnor&urity To Partic/pate Lr The Widest Range OfMemrinpful Civic Educational RecreationnlAnd CulturalActivit/es V, The Right To Suitable Horrsinx VL The Right To The Sest Level Of P/rysicn! And Mentn! Henltb Services Needed VII. The Right To Rendy Access To Effect/ve Socin! Services VIII. The Right To Annroprinte Lrst/tutiona/ Cnre When Reardred IX. The R/ght To A Life And Death Witlr Dixrrity We, Nte Board of County Connu/ssioners, pledge the resources of Orange County to advocate for these rights, for al( older persons regardless of race, color, creed, nge, ser, religion, sexrrn! or/entntion or rrationnl origin, with the cunt/orr that the conrplerit/es of orrr society Ge nrorritored, to assure t/rot the fn/fillnrerrt oJone right does not nrdl/fy the benefrts received as the resin! ojmrother entitlenrenG We firrther dedicate t/re technology and lrrunmr ski/! of Orange County so tJmt later life will Ge urnr/red in liberty with the realization of t/re prrrsnit of happiness. Proposed adoption- November, 2006 Adapted from the rederal Council on the Aging's Bicentennial Charter for Older Americans, January, 1976) 14 / ¢~ ~~/ ~~~ ~~ 0~' ®~\ \~ Orange County Master Aging Plan Proposed Preliminary Goals, Objectives, and Strategies For The Five-Year Period January 1, 2007 -December 31, 2011 For the The Orange County Board of Commissioners Prepared by The Master Aging Plan Task Force Pat Sprigg, Co-chair Florence Soltys, Co-chair September 19, 2006 Staffed by The Orange County Department on Aging Jerry M. Passmore, Director 14 IS Section IV. MASTER AGING PLAN GOALS FOCUS: ALL OLDER ADULTS -OVERARCHING GOALS Goal A: Information/Access- Improve information & assistance options to all older persons and their families who need access to services , especially those most in need. Objectives Al - 5 and Strategies Goal B: Housing/Shelter -Promote an adequate supply of safe, affordable and suitable housing options for older residents to age in place. Objectives B1 - 5 and Strategies Goal C: Transit/Mobility- Enhance mobility options for all older persons regardless of functionality through a multi-modal vision that is acceptable, efficient, effective and affordable. Objectives C1 - 5 and Strategies Goal D: Transitional Care- Improve the transition and maintenance of older persons in the most appropriate care provider setting. Objectives D1 - 3 and Strategies FOCUS: WELL-FIT OLDER ADULTS Goal E: Well-Fit Older Population -Improve and/or Maintain the Health and Well-being of Orange County's Well-Fit Older Adults for as long as Possible including future older persons. Objectives E1 - 5 and Strategies 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. Objectives F1 - 6 and Strategies 15 16 FOCUS: INSTITUTIONALIZED/SEVERELY IMPAIRED OLDER ADULTS Goal G: Institutionalized/ Severely Impaired Older Population -Improve services, information access, and education and outreach to long term care residents and families/caregivers that are affordable, accessible and promote quality of life through person-centered care. This also includes the retention, recognition and training of paid facility staff, thereby improving quality and continuity of care for residents. Objectives G1 -11 and Strategies FOCUS: LEGISLATION/ADVOCACY Goal H: Legislation/Advocacy - Promote a legislative/advocacy Aging Agenda that supports Orange County's Bill of Rights for Older Persons. Objectives H1 - 2 and Strategies FOCUS: COMMUNITY PLANNING AND ADMINISTRATION Goal I: Planning/Administration -Enhance the planning, administration, coordination and funding of a response system to the needs of older persons in Orange County. Objectives 11 - 3 and Strategies 16 17 FOCUS: ALL OLDER ADULTS- OVERARCHING GOALS 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. Objective A-1: Improve marketing and evaluation of existing Information and assistance services. Lead Organization Is): Dept. on Aging with Partners- United Way & Institute on Aging and others listed below. Strategies: A. Implement a community awareness campaign (esp, May- Older Americans Month each year) of the vital role of senior centers as information and services centers. B. Implement new ways of advertising telephone assistance-Local -DOA Elder Helpline; Region- United Way 211 and N.C. Care-Line and evaluate use for changes. C. Implement new ways to publicize specialized information, such as Seniors Health Insurance Information Program (SHIIP) and Medicare Part D to older adults. D, Administer a community survey to measure the impact of existing marketing strategies to reach older persons and families and make necessary changes,. Objective A-2: Improve access to printed and website information to older persons, families and service providers. Lead Organization (s): Dept. on Aging, BOCC with Partners- IT and others below. Strategies: Printed Materials Approach: A. Review and evaluate the Senior Times Newspaper (design, content, distribution) in informing older persons and make necessary changes, B, Review and evaluate the Orange County Eldercare Community Resource Guide in providing Information on resources and services for all older adults from the well-fit to the severely impaired/institutionalized and make necessary changes. 17 C. Increase the number of local newspapers that print monthly feature articles on older persons, their contributions and accomplishments. 18 D, Evaluate the need for amulti-lingual, culturally sensitive version of the Orange County Eldercare Community Resource Guide and make necessary changes. E. Partner with Emergency Response Organizations (EMS, DSS, Red Cross, Health Dept, RSVP) to improve dissemination of disaster preparation information to all older adults on multi-hazard situations such as natural disasters and man-made ones. F. Increase and monitor the availability of health and preventive information at all county health facilities, libraries, senior centers, and public facilities. G. Review all older adults services materials for developing culturally appropriate educational flyers for those most in need and make necessary changes. Website Approach: G, Redesign, maintain and evaluate (e.g. number of hits/ user comments on design and content) the County Aging web site for providing information and make necessary changes, H, Improve access to the internet for the public at county senior centers with wireless internet connection and on site checkout computers, Provide training (SeniorNet) at senior centers on internet access and use of key aging information websites such as Orange County's (www.co.orange.nc.us/aging), Triangle J.. Area Agency on Aging (www.tjaaa.org), The Full Circle of Care for family caregivers (fullcirclecare.org) and The National Eldercare Locator Services (Eldercare,gov) Objective A-3: Improve information outreach on preventive and community services to all older persons, those with specialized needs, aging service providers, community leaders, and public. Lead Organization (s1: Dept. on Aging with Partners listed below. Strategies: A, Place information at key locations used by older persons and families most in need such as pharmacies, physicians' offices, health clinics, places of worsip, Health Department, Cooperative Extension, libraries, Dept.. of Social Services and Senior Centers. B. Consider establishing a ROSCO (Roundtable of Senior Citizens Organizations) of key community elders who meet and disseminate a variety of information on services, opportunities and retirement educational matters. C. Partner with newcomer service organizations and publications such as Chambers of 18 Commerce, Visitors Bureau, Realtors Assn, Senior Living, Triangle Pointer with information distribution, 19 D. Partner with Faith Communities for information distribution to minorities who are less likely to seek out and know community services. E, Consider re-establishing networking meetings of service providers to the aging who serve older persons on agency information exchange and community issues. Partner with transit organizations (OPT, Chapel Hill Transit, TTA) in placing advertisement and information on buses for public information. G, Convene an annual "State of the Older Adult" breakfast in May (Older Americans Month) to keep the community informed and motivated about issues impacting older persons.. Obiective A-4: Increase educational and employment opportunities for older persons, service providers now and in the future (students). Lead Organization (s): Dept. on Aging with Partners-UNC Program on Aging And others listed below. Strategies: A. Partner with service providers and university faculty to offer an annual forum on key issues impacting on older persons such as caring for parents, moving or aging in place, sexuality in later life, spirituality and aging, dealing with dementia/depression, B. Investigate the implementation of a "senior jobs" program at the senior centers in partnership with businesses and N.C Employment Security Commission to educate and promote "semi- retirement" options. C. Develop increased opportunities for health professionals, university faculty and students to be exposed to aging issues through senior centers (student placements, UNC classes and special programs offered on site, etc.) Objective A-5: Expand information and outreach through electronic media such as public/private radio, television and cable, Lead Organization (s): Dept. on Aging with Partners listed below. Strategies: A. Expand and improve the local public access weekly television program"In Praise of Age" to reach a larger viewing audience throughout the county. B. Expand sponsorship funding of "In Praise of Age" show beyond the Dept, on Aging, Carol Woods and the Friends of the Senior Centers. 19 C Develop and seek funding fora new "Media and Aging" studio at the New Seymour Center that would provide on site show production with live audience participation, Zo D, Partner with radio and television to increase information and education programming on aging needs, services and issues. Goal B: HousinglShelter: Promote an adequate supply of safe, affordable, and suitable housing options for older residents to age in place. Objective B-1: Expand assistance in the retrofitting, repair and maintenance of existing older adults homes. Lead Organization (s): OC Dept. of Housing and Community Dev. with Partners- Aging Advisory Board and others. Strategies: A, Develop and distribute a listing of reliable/honest businesses who perform home repairs/renovations and maintenance.. (chamber of Commerce, Homebuilders Assn..) B. Encourage the development of volunteer groups (churches, clubs, youth, etc.) to provide low cost/no cost home maintenance (outside repair, yard work, etc.) to low income older adults. C. Monitor use and need to expand the County's Urgent Repair and Comprehensive Housing Rehabilitation Program for older adult home owners, D. Implement programs in vocational education classes at high schools and community colleges that provide credit far community service hours to older persons in Orange County. E. Establish a volunteer pool of retired trades people willing to provide home maintenance services on a sliding scale. Objective B-2: Expand tax assistance for older adults who have difficulty over time paying their property tax on their home. Lead Organization ~ BOCC and Manager's Office. Partners: County Attorney, Revenue Collector, Tax Assessor, Finance Director, Budget Director, Dept. on Aging/Aging Advisory Board, Senior Care of Orange County, Inc. and others. Strategies: A. Advocate legislatively to increase the coverage and allowance for the N.G. 20 Homestead Exemption Act, 21 B. Research property tax policies (state-wide and nationally) and recommend tax relief (city/county/state) measures for older adults with limited incomes to BOCC Objective B-3: Improve the provision of support services for all 55+ Communities and Senior Housing Projects in order for older adults to age in place. Lead Organization (s-: Dept. on Aging and Aging Advisory Board Strategies: A. Expand contracting with the Dept, on Aging for a Service Coordinator to non-profit housing for the elderly and for profit 55+ communities. B, Establish a courtesy review procedure (cities, county) of senior housing developers' proposals by the County Aging Advisory Board and County Affordable Housing Advisory Board before plans are approved, Objective B-4: Increase public education of older adults as well as developers to the desirability (need) to build, select, buy or rent senior housing that allow for easy retrofitting later for "Aging in Place" or disability modifications. Lead Organization (s): Planning Depts and OC Aging Advisory Board Strategies: A, Sponsor periodic forums on Senior Housing Options for older adults and families. B. Consider incentives for builders to construct Aging in Place homes, C. Sponsor periodic senior housing forums/workshops for developers/builders, realtors, and commercial rental property managers. Objective B-5: Increase the number of affordable multi-unit housing which are designed to support the needs of older persons, especially the low income. Lead Organization (s): BOCC with Partners - OC Housing and Community Dev. and OCIM. Strategies: A. Support the development of HUD 202 Senior Housing project for low income, especially in central/northern Orange County where none exist, 21 22 B. The County Affordable Housing Advisory Board consider county funding options to address the senior housing needs. C. Seek senior housing assistance from Orange County Housing and Land Trust, Empowerment, Inc., Habitat for Humanity, Women's Center, Weaver Community Housing Association, N.C. Land Trust and USDA Federal Housing Programs, Goal C: Transit/Mobility: Enhance mobility options for all older adults regardless of functionality through amulti-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): BOCC with Partners - NC Dept. on Transportation, RPO, O.P.T. ,Human Services Trans. Board, Planning Dept. Strategies: A, Encourage local merchants to financially support specific public routes or transit services, B. Solicit additional state and federal funds as well as private foundation grants. C. Consider local legislation to enact levies/taxes for transportation purposes. D. Review fare structures and donation programs to increase revenues. E, Partner with adult day care, assisted living, nursing home facilities to provide additional transit funding. F. Utilize Congestion Mitigation Air Quality (CMAC~) funds for bus shelters, bike racks, and park and ride lots Objective C-2: Improve Orange Public Transportation (OPT) transit services as requested by older adults in rural Orange County. Lead Organization (s): Orange Public Trans.(OPT), OC Trans. Services Board, OC Planning Dept. Strategies: A, Expand OPT's hours and route configurations for the new Orange County Senior Centers. 22 B, Develop new OPT routes to connect with existing North-South route (Hillsborough to Chapel Hill) to include Hillsborough in-town route and East- West public route, C. Expand OPT's scope and hours from medical to include other life sustaining and life enriching services. D. Require all future senior housing projects to have transit plans as a part of the approval process that is reviewed by the Transportation Services Board as well as the County Planning Board. Objective C-3: Improve coordination of all public transit routes and services within Orange County and the Triangle Region. Lead Organization (s): NC Dept. on Transportation and Trans. Services Board. Strateqies: A, Complete the Triangle Regional Development Plan (TRDP) study that will provide recommendations for consolidation/coordination of services within Wake, Durham, and Orange Counties. B. Complete Community Transportation Improvement Plan (CTIP) recommendations (after completioh of Regional Development Plan) for organizational placement of Orange Public Transportation (OPT) to stay within the Department on Aging or establish a new county transportation department or move OPT outside the county structure, Objective C-4: Expand mobility efforts through the use of volunteer staff (drivers and escorts) for frail/elderly who require door through door service. Lead Organization (s): Dept. Aging with Partners -O.P.T. RSVP and A Helping Hand Strateqies: A. Recruit volunteers to assist with preparing and transporting frail/elderly clients who require life sustaining transit issues through RSVP and other agencies. B. Provide volunteer staff training in assisting special populations (frail, elderly, mobility impaired) C. Educate older adults regarding the availability of volunteer staff to support transit needs. Objective C-5: Improve awareness of existing transit services and offering input for additional services. 2.3 2.3 24 Lead Organization (s): Orange Public Trans. (OPT) with Partners - OC. Trans. Services Board, Orange Unified Trans. Board, and others. Strategies: A.. Expand and redesign customer service surveys with input from the older adults of Orange County. B. Hald public forums specific to older adults to educate residents of all transit options available in Orange County and surrounding areas. C. Enhance visibility of Orange Public Transportation with an easily identifiable transit system name, logo and website. D. Hold public forums to educate older adults on emergency evacuation procedures and transportation available (emergency shelter issues). Goal D: Transitional Care- Promote the transition and maintenance of older persons in the most appropriate health care provider setting. 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~sLDept. on Aging with Partners- Carol Woods Center of Excellence and others -Senior Care of Orange County, Piedmont Health Services, UNC Hospitals. Strategies: A. Community Day Health- Expand adult day health capacity and creative collaboration of services and resources between senior centers and day health centers. B. Health Maintenance Organization for the Poor -Support the development of P.A.C.E. (Program of All-Inclusive Care of the Elderly) which helps low-income elderly (medicaid/medicare eligible) to remain in their home as long as appropriate with community-based health care. D. Hospital Setting - Encourage a "senior friendly" space in hospital emergency rooms. E. Home Setting- Support expanding assessment and care planning using home setting (similar to Hubbard Program and mobile SHAC). 24 25 Objective D-2: Improve the coordination of care through increased contact and training of health care and community care providers that are key to the transitioning process. Lead Organization j~Dept. on Aging with Partners-Carol Woods Center of Excellence, and others. Strategies: A. Establish a Transitions Community Workgroup that meets regularly to discuss, create and implement strategies to improve transitions.. B.. Offer transitional care training of providers (and patients and their family members) to improve transitions. (Examples may include trainings and resource listings for discharge planners, including where to find nursing home survey reports, and a caregiver brochure outlining suggestions for a smooth transition.) Objective D-3: Improve the coordination of care through the development of uniform transitional care informational forms, materials and resources. Lead Organization (s): Triangle J Area Agency on Aging with Partners-Dept. on Aging, UNC Program on Aging and other regional aging providers. Strategies: A. Identify what health information is currently available, analyze haw to best use the information, and explore how to coordinate and share information to enhance the transitions and care of older persons, B. Consider reinstituting a "Transfer Informaticn Sheet" for hospital, nursing home and community transitions. 25 26 FOCUS: WF,LL-FIT OLDER ADIII,TS Goal E: Well-Fit Older Population - To Improve and/or Maintain the Health and Well-being of Orange County's Well-Fit Older Adults for as Long as Possible including Future Older Persons. (Prevention focus) Objective EE=1: Provide preventive home-based community services to help people maintain their health and age in place. Lead Organization Is): County and Towns- Planning and Housing Departments Partners-DOA Wellness Program. Strategies: A, Convene a committee to plan for "Senior and Liveable community designs" at town and county planning meetings that promote "Aging in Place" within new housing developments including: (1) Affordable housing, (2) Universal design features, (3) Walkable neighborhoods, and (4) caregiver housing on private properties, B. Plan strategies by Planning and Housing Departments that give builders incentives to build accessible housing, which encourage people from various socio-economic, ethnic, and racial backgrounds to live together in the same community.. C Plan strategies by Planning and Housing Departments that give developers monetary incentives to design communities that allow all residents easy accessibility to places of interest and need (shopping, banking, socializing, and leisure activities) by walking or biking.. D. Train a group of well-fit seniors by County/Town Depts. who would be peer models for healthy aging in their community by volunteering to develop and facilitate programs that may benefit all older adults (walking and exercise programs, hikes, games, community events, etc,) at existing community locations where they meet 26 i.e, senior centers, retirement communities, schools, churches). Objective E-2: Improve Access to Affordable Healthcare for all older persons. 27 Lead Organization (s): Dept. on Aging, Health Dept., Piedmont Health Services with other Partners. Strategies: A. Seek funding for additional DOA outreach staff (Information/assistance) who along with coordinating volunteers (including those from diverse ethnic backgrounds) will work to increase awareness and education of eligible older adults as to benefits of and enrollment process for Medicare Parts A, B, & D; and refer appropriate low-income older adults to Dept, of Social Services for Medicaid, In addition, provide awareness of available community medical, dental and mental health providers, Dept. on Aging (DOA) services, and other resources. B. Train a minimum of 5 volunteers by the Seniors Health Insurance Information Program (SHIIP) on Medicare information and coordinate availability for group/individual presentations to the community. C, Assess availability of current medical, dental, mental health providers in the Community as indicated by Medicare/Medicaid patients' acceptance and number of providers and develop an action plan by the DOA Wellness Program Council. D. Develop a plan to fund mobile medical, dental, and mental health services to older adults in accessible community settings that provides screening, education, basic counseling and care; and staff support (salary/benefits) for multicultural providers with an interest in geriatric services. (Staffing- Adult Health Nurse Practitioner, Nurse, Dentist, Dental Hygienist, Licensed Clinical Social Worker and Administrative Assistant.. Mobile Unite will travel to churches, community centers, senior centers, Objective E-3: Conduct community assessments bi-annually to track changes in senior needs and available resources in order to meet the needs. Lead Organization (s): Dept. on Aging's Wellness Program/Council with Partners- NC Institute on Aging, TJAAA, NC Division on Aging. Strategies: A. Convene a committee by the DOA Wellness Program to garner resources to fund and conduct the assessment and manage logistics of using these resources. 27 B Convene a committee of organizations by the DOA Wellness Program to collect and synthesize data that identifies needs and resources (including providers and need for additional providers) to support wellness and build an wellness action plan for the assessment. C, Conduct focus groups (by DOA Wellness Program Council) with a diverse range of older adults in a variety of community settings that investigate their needs and perceived resources or lack of resources to support their wellness. Make necessary program changes based on the findings.. D, Produce an executive summary (by DOA Wellness Program Council) of the needs and resources identified in the assessments, identifying both quantitative and qualitative data including priorities for program planning and further action steps. E. Evaluate the priorities, action steps, and results achieved (by DOA Wellness Program Council) from the previous bi-annual assessment and include in the 2010 bi-annual assessment report the priorities that were addressed, not addressed and the supports, barriers and problems to its achievements. Objective E-4: Improve Elder Adult Driver Safety for the protection of the individual and community. 28 Lead Organization (s): Dept. on Aging Wellness Program with Partners-UNC Program on Aging, UNC Occupational Dept., DMV, UNC Safety Research, State HARP. Strategies: A, Implement a campaign by DOA Wellness Program and RSVP to distribute transportation information/materials for safe driving and community mobility which includes: Identifying senior friendly car types, promoting AARP safe driving courses; encouraging transportation alternatives by health care professionals, (i,e. family, friends, public transportation, church volunteer drivers, emergency contact lists) B, Mobilize and train faith community by DOA Wellness Program to assist with safe driving campaign by providing transportation for elders and encourage acceptance if "no driving recommended" by health care professionals, friends, family, DMV, C. Implement a "Driver Screening Skills Project" by the DOA Wellness Council that utilizes volunteer testing options, DMV Testing Policy, UNC-CH Occupational Therapy Screening. D, Convene a group by UNC Program on Aging to develop a continuing education plan for appropriate health care professionals to address their role in driver safety for older adults.. Objective E-5: Increase information and education services that focus on the 28 personal health promotion, financial preparation and skills of Post World War II Generation (1946-64). Lead Organization (s): Dept. on Aging with Partners- public and private groups. Strategies: A. Plan and implement an annual pre-retirement (Life Span Planning) educational workshop(s) for Post World War II generation. 29 B, Expand opportunities for Past WWII generation to utilize a variety of wellness services in senior centers, offering evening and weekend programming, C. Research and implement creative models to utilize the Post WWII generation as a volunteer resource to serve older persons and other community needs. 29 30 FOCUS: DISABLED/MODERATELY IMPAIRED OLDER ADULTS Goal F: DisabledlModerately 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, and empowerment of family caregivers. Lead Organization (s-: Dept. on Aging's Eldercare Program with Triangle J AAA and Partners listed below. Strategies: A. Develop brochures on care giving to distribute in medical settings. Partners: National Family Caregiver Support Program, OCDaA, UNC Program on Aging, Eastern NC Alzheimer's Association. B. Create a "Community Caregivers Alliance" in which caregivers can communicate with each other to share information, ideas, bartered services, social interaction, and emotional support., This group will be the voice of caregivers to county human services. Partners: Existing OCDOA support group members, OCDOA, OCDSS, OCHD, Caring Family Network, faith communities, UNC Program on Aging. C. Create a group respite program at senior centers for impaired family members who are unable to navigate the senior centers independently but are too independent to accept adult day care programs. Partners: OCDoA, OCDSS, OCHD, UNC Program on Aging, .IOCCA, Charles House D. Develop issue-specific support groups as the need is identified by caregivers. Partners: Care giving clients, physicians, and local mental health providers, OCDOA, OCDSS, OCHD, Caring Family Network (formerly OPC). E. Work with community partners to learn the cultural factors which affect care giving in minority communities. Partners: Institute on Aging, African Community Outreach Program at Duke, Eastern NC Alzheimer's Association, JOCCA, OCDOA, OCDSS, OCDH, NC Extension Services, A Helping Hand. F. Offer culturally specific classes/presentations to church pastors, informal community leaders, and church members to enable them to recognize that dementia is much more than memory lass so church members can begin to comprehend the stresses experienced by caregivers and mobilize support for them,. Partners: OCDSS, OCHD, African-American Community Outreach Program at Duke, NC Extension Services, Eastern NC Alzheimer's Association, A Helping Hand, IFC, OCIM, .I000A, local churches, primary care physicians, Piedmont Health Systems, 30 Caring Family Network (formerly OPC) G. Hire professional staff to function as liaison with faith communities and county human services to enable families to reduce their stress level while postponing institutional placements. Partners: OC Government, Triangle J, faith communities. 31 H. Create a regular newspaper column devoted to O and A about care giving issues. Partners: OCDOA interdisciplinary staff, local newspapers, UNC Program on Aging, Piedmont Health Systems, and National Family Caregiver Support Program. Objective F-2: Offer best practices in mental health care for older persons in affordable, stigma-free, non-psychiatric settings. Lead Organization Is): Dept. on Aging's Eldercare Program, UNC Geropsychiatry with Partners- public and private groups listed below. Strategies: A. Implement the IMPACT program for geriatric depression in primary care physician offices through partnerships with primary care physician practices, UNC Geriatric Psychiatry, and OCDOA. B. Provide Medicare-reimbursable mental health therapy for seniors and their caregivers by clinical staff at senior centers. C. Provide therapy groups for seniors with mental health issues at senior centers as the need arises, based on input from seniors, families, physicians, and human service personnel. Partners: UNC Geriatric Psychiatry, UNC Program on Aging, Primary physician practices, OCDOA, licensed clinicians, OCDSS, Caring Family Network (formerly OPC). Objective F-3: Increase the utilization, safety, and comfort of the new senior centers by/for individuals with functional impairments in mobility, vision, hearing, continence, and memory. Lead Organization (s): Dept. on Aging with Partners-North Carolina Division of the Blind; Center for Universal Design, OCDOA, North Carolina Services for the Deaf and Hard of Hearing, DSS, OC Disability Awareness Council, Eastern NC Alzheimer's Association, and architects. Strategies: A. Design workshops for seniors on "How to be a Friend to a Person with Memory Loss.." B. Create apost-rehabilitation program in each senior center, in which impaired seniors can continue to increase or maintain functional ability after Medicare rehabilitation services have been discontinued. 31 32 C. Design spaces visually to meet the needs of individuals with an array of low vision problems.. D Design the floor to assist people with low vision to walk safely from one area to another. E. Provide equipment to assist low vision readers, F. Make the facility as acoustically favorable as possible.. G. Provide equipment to enable hearing impaired people to participate in lectures, activities, and support groups, H, Design bathrooms with floor to ceiling doors to maximize privacy, I. Make incontinence supplies and disposal clearly visible while enabling their use in a private and dignified manner, J. Purchase chairs that make sitting for 2+ hours comfortable and facilitate easy sit- stand transfers. K. Make all furniture easy to clean in case of spills or incontinence. L. Consider wheelchair placement in all rooms. M. Have wheelchairs available for emergency use. N. Use name tags to reduce anxiety associated with memory loss. Objective F-4_: Increase supportive services to home-bound older persons through partnerships between agencies, churches, and volunteers to increase safety and enhance socialization. Lead Organization (s): Dept. on Aging with Partners, public and private groups, listed below. Strategies: A. Expand the Dept. on Aging's Frail Elderly Fund through a campaign of private donations to provide funding to help meet the safety and care needs of at-risk seniors,. Partners: OGDOA, OCDSS, Friends of Senior Centers, AARP, local businesses, civic groups. Junior League of Orange and Durham, Advisory Board on Aging, local long-term care facilities, local media, churches, and local residents B. Work with local community members to help identify home-bound, isolated seniors to offer a home visit/assessmentfvom Department on Aging to offer telephone reassurance, emergency list inclusion, and other appropriate services.. G, Work with local police, sheriffs department and community watch groups to develop Orange County Community Cares Networks to establish check- ins on homebound, at-risk seniors with a spirit of neighborliness and friendliness rather than an investigative approach. Partners: Police departments, sheriff departments, OCDSS, OCDOA, utility meter readers, Postal Service, OPT, Chapel Hill-Carrboro Transit, neighborhood watch programs, Meals on Wheels volunteers, local churches. D. Work with churches to identify practical ways that they can assist isolated seniors with chronic illnesses, such as paying for emergency response systems (e.g. Health Watch.) and providing transportation and escort service to physician appointments to augment the involvement of social service agencies. 32 Partners: OCDOA, OCDSS, OCHD, local churches, OCIM, retired health professionals.. Objective F-5: Increase community awareness of care management services. Lead Organization (s): Dept. on Aging's Eldercare Program, DSS Adult Services Unit, and Health Dept. 3.3 Strategies: A. Create a public awareness campaign about the Community Alternative Program (CAP-DA). B, Create a public awareness campaign about private care managers in the community. C, Create interest in making care management available to individuals who do not qualify for CAP-DA and cannot afford in home services to help support the OCDOA Frail Elderly Fund and in-kind contributions from private care managers. D, Support and increase church care teams with an emphasis on chronic care, Objective F-6: Increase collaboration on evaluation, care planning, and on-going intervention by Orange County agencies offering case management. Lead Organization (s): Dept. on Aging's Eldercare Program, DSS Adult Services Unit, and Health Dept. Strategies: A, The Department on Aging, Department of Social Services Adult Services, and OCHD Chronic Care Nurse Educator staff will have a method of sharing a client database to maximize synergy and decrease duplication of effort without violating HIIPA, B. The Department on Aging, OCDSS, OCHD Chronic care nurse educator will meet regularly to discuss difficult cases before they are candidates far guardianship. 3.3 34 FOCUS: INSTITUTIONALIZED/SEVERELY IMPAIRED OLDER ADULTS Goal G: Institutionalized! Severely Impaired Older Population-Improve services, information access, and education and outreach to long term care residents and familieslcaregivers that are affordable, accessible and promote quality of life through person-centered care. This also 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): TJAAA Long Term Care Ombudsman Program, Nursing Home and Adult Care Home Community Advisory Committees with staff support from the Dept. on Aging. Strategies: A. Refer development to Nursing Home and Adult Care Home Community Advisory Committees to report annually to BOGG. Work to change structure; perhaps make members BOCC appointees,. B. Find ways for non-participants to participate. C. Secure more staff resources to function and define other resources needed. Objective 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. (Comments: Delayed because of funding. Procured grant monies to obtain/operate a dental access mobile unit in Orange County. A van and equipment have been obtained. A dentist has been found. The program will hopefully begin in 2007. Lead Organization (s): Access Dental Regional Coalition with partners -TJAAA Long Term Care Ombudsman Program, OC Health Dept., Dept. on Aging Wellness Program, Carol Woods, OC Aging Advisory Board and Chatham Council on Aging. with staff support from the Dept. on Aging. 34 35 Strategies: A Monitor progress of funding and operation for necessary changes. B. Assist Access Dental and identifying participants for the program. Objective G-3: Provide in-service instruction in oral hygiene procedures to long term care facility personnel. Lead Organization (s): UNC Center for Public Service partner with TJAAA Long Term Care Ombudsman Program, Nursing Home and Adult Care Home Community Advisory Committees Strategies: A. Request the Center for Public Service to identify resources such as Access Dental, Durham Technical Community College, dental hygiene techs, and the UNC Dental School Objective G-4: Increase the number of adult care homes that accept special assistance monies in order for residents not to be placed in out-of county facilities. Lead Organization (s): OC Long Term Care Facility Roundtable and the Adult Care Home Community Advisory Committee with staff support from the Dept. on Aging. Strategies: A. Develop creative incentives approved by County Commissioners. Objective G-5: Investigate the potential for developing a hospital affiliated long-term care teaching nursing home facility. Lead Organization (s); ? Strategies: A. Redefine and clarify model and pursue issue with UNC and Duke. B. Encourage a partnership between UNC and LTC agencies to define quality of care and training.. C. Approach individuals and private foundations for interest and funding. 35 36 Objective G-ti: Offer sufficient and affordable continuing education unit programs, certificate training and placement program for certified nursing assistants (CNAs) and personal care aides (PCAs), administrators, nursing directors, resident care coordinators medical assistants and others throughout the community (e.g., internships, co-op programs). Lead Organization Is): OC Long Term Care Facility Roundtable with staff support from the Dept. on Aging. Strategies: A, Pursue training partnership with Durham Technical Community College, local facilities, and other health professionals as identified. B, Provide food and Continuing Education Units (CEU) to invite attendance at training programs. C.. Partner with Roundtable, Community Advisory, Committees, Ombudsman Program, Department an Aging, Department of Social Services, D, Study the needs of local facilities and work to address these needs, Objective G-7: Develop and implement recognition programs for long term care personnel endorsed by the BOCC. Lead Organization Is): OC Long Term Care Facility Roundtable with staff support from the Dept. on Aging. Strategies: A, Refer to Roundtable to develop guidelines and criteria for recognition, B. Partner with facilities, Community Advisory Committees, Advisory Board on Aging, Ombudsman Program, Department of Social Services, and Friends of Residents in Long Term Care in implementation of approved BOCC program. Objective G-8: Improve the training for long term care facility activity directors. Lead Organization (s): OC Long Term Care Facility Roundtable with support from Durham Tech Community College. Strategies: A. Work with statewide activity professional associations 36 37 B. Offer semi-annual training through with Durham Tech Community College ,the UNC Schools of Education, Recreation, & Occupational Sciences, Regional Ombudsman, and OC Dept. of Social Services. Objective G-9: Ensure inclusion of current long term care resources in the updating and printing of the Orange County Resource Guide.. Lead Organization Is): Dept. on Aging Strategies: A. Request the Department on Aging staff submit to the Roundtable leadership the updated draft guide for review before publication. Objective G-10: Ensure inclusion of current long term care resources in the updating of the county web site. Lead Organization (s): Dept. on Aging and County Commissioners Clerks Office Strategies: A. Request the county webmaster to submit notifications to the Roundtable leadership and LTC Ombudsman when the Community Advisory Committee reports are posted and facility data is current. Objective G-11: Support the development and operation of resident and family councils in long term care facilities. Lead Organization (s): TJAAA Long Term Care Ombudsman Program, Nursing Home and Adult Care Home Community Advisory Committees with staff support from the_Dept. on Aging. Strategies: A. Provide technical assistance to residents and family councils by the TJAAA LTC Ombudsman Program, Community Advisory Committees, the Roundtable and long term care facilities. B. Collaborate with Friends of Residents in Long Term Care for technical assistance and public policy issues. 37 38 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 alegislative/advocacy mechanism to involve older persons, local county boards, officials and public in improving the lives of older persons. Lead Organization Is): Aging Advisory Board with Dept. on Aging and partners listed below. Strategies: A. Partner with Aging Advocacy groups to offer training at senior centers for older adults on the legislative process and procedures to impact legislation, including the Internet to key information websites such as legislators, advocacy groups, and monitoring bills, B. Enhance participation in the N.C Senior Tar Heel Legislature by Orange County with county representatives reporting back to the County Aging Advisory Board and BOCG, C, Prepared an annual Orange County Aging legislative/advocacy agenda updated by the Aging Advisory Board for BOCC approval. This to be done in partnership with other county committees with special areas of concern such as the Human Services Transportation, Affordable Housing Committee, Nursing Home Community Advisory Committee, Adult Care Home Community Advisory Committee, Retired Senior Volunteer Council, DSS and Health Department boards. D. Participate as a member of the N,C Coalition on Aging, the TJCOG Advisory Council on Aging and the Coalition for Continuity of Care for the Geriatric Community by the County Aging Advisory Board and reporting back to the BOCC, E. Establish legislative monitors on key aging issues by the Dept. on Aging in order to keep the County Advisory Board on Aging and BOCC informed on a timely manner. Objective H-2: Increase educational opportunities for older persons, local officials, legislators and general public to be exposed to legislative issues related to aging. Lead Organization (s): Advisory Board on Aging with the Dept. on Aging and partners listed below. Strategies: A Partner with aging advocacy groups to hold regular meetings to discuss, review and 38 update organizations and individuals on current and proposed legislation. 39 B, Hold an annual legislative public meeting (such as a breakfast) by the County Advisory Board on Aging that highlights aging legislative issues at the local, state and national levels. C, Increase the use of the local public access weekly television program"In Praise of Age" to inform alder persons and the community on legislative issues. D. Partner with radio and television to increase information about legislative aging matters, E. Maintain a list serve by the Dept.. on Aging to mobilize older adults/advocates as to legislation and advocacy issues that need their timely support. (ex, Homestead Exemption Act changes, UNC Aging research cuts) 39 40 FOCUS: PLANNING AND ADMINISTRATION Goal 1: PlanninglAdministration -Enhance the planning, administration, coordination and funding of a response system to the needs of older persons in Orange County. Objective I-1: PlanninglCoordination -Improve the County's planning and coordination efforts for the growing aging population. Lead Organization (s):_Aging Advisory Board with support from the Dept. on Aging and partners listed below. Strategies: A. Monitor the progress of the five year Master Aging Plan by the Advisory Board on Aging far the Board of County Commissioners, providing an annual update on accomplishments and recommend priority changes.. B. Continue holding joint meetings between the Advisory Board on Aging and the United Way Senior Issues Team for improved public-private service coordination, planning and funding. C. Increase staff support for existing planning and advocacy bodies, specifically, the Advisory Board on Aging, the Long Term Care Facility Roundtable, the Nursing Home Community Advisory Committee, the Adult Care Home Advisory Committee. D. Create a Technical Advisory Committee to the Dept. on Aging Director, consisting of staff representatives from public arid private agencies whose purpose is joint planning. The committee's mandate would be contract /agreement negotiation for cooperative service provision and joint pursuit of funds. Objective I-2: Administration- Improve the service delivery of the Department on Aging's services as well as other county departments that serve older persons. Lead Organization (s): Aging Advisory Board with the Dept. on Aging and partners listed below. Strategies: A. Conduct community surveys (developed by Federal Adm. on Aging) to measure performance of county aging services in the areas of information/assistance, case management, senior centers, congregate nutrition, home-delivered nutrition, and transportation and recommend necessary changes. 40 41 B. Review the organizational staffing patterns of the Dept. on Aging and other county departments for the appropriate placement of aging services and recommend necessary changes. C, Provide increased staff and volunteer leadership training to consistently improve their performance levels, (i, e. N,C. Division on Aging conferences/workshops, and National Aging conferences) D. Enhance the operations of Orange County Senior Centers as recognized state funded "centers of Excellence" by pursuing and maintaining national certification from the National Council on Aging's National Institute for Senior Centers. Objective I-3: Funding- Increase appropriate public and private funding for aging services that are affected by a growing older population. Lead Organization (s): Aging Advisory Board with the Dept. on Aging, County Managers Office and partners listed below. Strategies: 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. B, Review the process for allocating and administering the community Block Grant Funds from the State Division of Aging far various aging programs within the county and recommend necessary changes. c, Investigate the feasibility of establishing a Dept, on Aging public information/ development officer to expand the marketing and community awareness of county aging services as well as seek more private funds D. Expand county funding for DOA Wellness program staffing that includes Wellness Program Goordinatar, Wellness Program Tech I and Office Assistant/Clerical. E. Expand county funding over time for staff support (receptionist and staff) to extended operational hours at the new senior Centers as needed, F. Expand county funding for Dept. on Aging information services and program evaluation such as a database, listserves, evaluation surveys, uniform software coordination with other county agencies. G. Request increased subsidy from the Friends of the Senior Centers and Triangle United Way for wellness/health promotion classes in order for low income older persons' participation. 41