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HomeMy WebLinkAboutAgenda - 08-31-2004-2ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: August 31, 2004 Action Agenda Item No. SUBJECT: Budget Fallow Up -Proposed Realignment of OPT Driver Position as Eldercare Manaaer within the Department on Aging DEPARTMENT: Aging PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Position Impacts INFORMATION CONTACT: Jerry M, Passmore, Director Kate Barrett, Eldercare Program Manager TELEPHONE NUMBERS: Hillsborough 732-8181 Chapel Hill 968-4501 Durham 688-7331 Mebane 336-227-2031 PURPOSE: To consider approving the realignment of an existing permanent full time OPT Driver position to serve as permanent part time (35 hours) Eldercare Manager in the Department on Aging and the authorization of County funding for the portion of the position cost not offset by grant funds, using funds the Board reserved effective October 1, 2004 in the approved budget for 2004-05, BACKGROUND: The Manager's Recommended Budget for 2004-05 included a recommendation to realign an OPT Driver position to Eldercare Manager, to change the position from permanent full time to permanent part time (35 hours) and to provide County funding far the portion of the positicn cost not covered by grant funds. In the June BOCC work session discussions, the Board set aside the proposed funding for the position in a reserve and asked staff to bring the position request back for additicnal review. Needs Addressed The Orange County Master Aging Plan (M.A.P (Goal III-A) includes recognizing the needs of i efforts of caregivers in providing care to them. adopted an March 6, 2001 has 11 goals, one • Close to 20 percent of persons 65 and older require some assistance with activities of daily living (e.g, bathing, grooming, transferring, etc.). in 1999, 25.6 percent of Orange County residents age 65+ rated themselves to be in fair or poor physical health (PRC Community Health Assessment: Orange County). In addition, the dementia problem has been increasing with the population getting older, The National Alzheimer's Association reports almost 50 percent of the 85+ population has dementia or Alzheimer's disease. The issues of the impaired older adults become even mare demanding with the recent projection for Orange County's 65+ population to increase by 219 percent between 2000 and 2020. Maintaining the independence of impaired alder persons and their ability to live at home as long as possible is an important County responsibility that the Department on Aging attempts to carry out, To address this M.A.P, goal with additional supportive services, the Department on Aging sought and has received additional federal/state funds from the National Caregiver Support Program. The Department of Aging has used these funds over the past two years to hire a temporary eldercare social worker and most recently for a time limited appointment to help the permanent Eldercare staff with service delivery. Annually, this eldercare social worker has served over 70+ frail elderly clients and their caregivers, providing social work assessments of clients for all Department on Aging services. The eldercare social worker has created, implemented, and followed upon care plans; managed the eldercare information line one day per week; coordinated client care with contract home health agencies and maintained records and reports for in-home service delivery and federal/state reimbursements, This additional eldercare social worker staff support has proven its benefit to the overall success of the Eldercare Division, Attached is a mare specific list of the impacts of having this additional staff. Board of Commissioners' action to authorize the permanent staffing request will result in maintaining an additional qualified professional social worker to serve the elderly. Offsetting Funding For the Position The projected annual cost of the permanent part time Eldercare Manager position is $38.802 (salary and benefits), There are offsetting grant funds of 26 374. The net additional annual County cost is $12,428. OPT Driver Position Realigning the OPT Driver position to serve as Eldercare Manager would not have a negative impact on the Orange Public Transportation (OPT) program. In 2003-04 OPT was not able to renew its contract with the Head Start program for transportation of children. Head Start decided instead to provide the funds to individual families rather than using local transit services. With the loss of this contract, OPT had not filled the OPT Driver position, waiting for new or additional contracts to increase ridership and cover the cost of Driver position. The 2004-05 budget was prepared with the knowledge that the Head Start contract would not be reinstated and that there were no additional contracts requiring that the OPT Driver position be filled, Meanwhile, using the position in Eldercare Services would provide many positive outcomes for the elderly citizens in the County. FINANCIAL. IMPACT: Based on the proposed start date of October 1, 2004, the Manager's Recommended Budget requested a net amount of $9,322 to fund the position for 2004-2005. With the adoption of the approved budget for 2004-2005, the Board of Commissioners set aside a reserve pending its fuurther consideration of the position request. RECOMMENDATION(S): The Manager recommends that the Board effective October 1, 2004: • Approve the realignment of the OPT Driver position to serve as Eldercare Manager. • Approve changing the position from permanent full time to permanent part time (35 houurs per week), and Authorize the release of funds from the budgeted reserve to fund the position for 2004-05. Attachment Position Impacts Summary of the Eldercare Manager Position Impacts on the Department on Aging's Eldercare Division Direct client involvement: ^ 30 clients on in-home aide services under HCCBG. Formal quarterly reassessment during home visits as mandated by AAA. Care plans modified as appropriate. ^ 65 case assistance clients, involvement dependent on need/desire for services. ^ Planned and facilitated 8 week widowed persons support group, ^ Initial in-home assessments of approximately 6 new clients per month. ^ Manage the information and helpline and office walk-ins one day per week. Some examples of client services provided (Case Assistance) 100+ year old client living alone with inadequate care: Helped family understand the shortcomings of the client's situation. Facilitated medical intervention. Outcome: Worked with family and client to find placement, accept the diagnosis, and begin Hospice services. 80+ year old client with uninformed family: Had been prescribed 15 medicines but was not taking any because the client had not been to the doctor for several years, Outcome: Facilitated medical appointments; educated family about the importance of medication compliance and follow up doctor visits. Helped family understand and apply for Medicaid. 80+ year old client living in a chaotic situation without an identified caregiver: Educated family regarding client's needs and recommended care options. Outcome: Client moved in with family; improved client health and quality of life. 70+ and 60+ year old couple with multiple health problems and stress about custodial grandchildren: Working with both clients over a death in the family and the circumstances of the death. Worked with psychiatry to get in home counseling services for one grandchild. Worked with another grandchild to begin substance abuse counseling, Helped clients understand and prioritize overdue bills; connected them with DSS for financial help. Outcome: Two grandchildren receiving treatment. Tension on seniors reduced, Utility services have been maintained, Clients are making progress in processing death of their child. 80+ year old client with vision and dental problems: Educated client about UNC Dental School Program and free glaucoma screening. Outcome: Abscesses gone from mouth, pain free: Under the care of an eye doctor for the first time in 15 years. 80+ year old client with urgent home repair need. Worked with family to comply with Urgent Home Repair's requests and ended stalemate between family and agency, Educated family about Medicaid application process, Outcome: Home repair is scheduled; family has agreed to make Medicaid application, Administrative tasks: ^ 30 clients with contracted in-home services: All documentation, communication with clients and home care agencies, and billing as per AAA mandates, ^ 26 clients receive respite services under the NFCGSP: Coordinate services, track billing, and input data into computer program for NFCGSP. Export data to Triangle J CQG. ^ 14 clients attending adult day care: Track attendance and payment ^ Create and implement dementia screen in local physician offices to facilitate early diagnosis of dementia, ^ Create an easy system of referrals from physician's office to community resources. ^ Collaborate with Alzheimer's Association and Long-term Care Roundtable to plan 2 half-day interactive training workshops for family and professional caregivers. ^ Facilitate 2 support groups far caregivers of individuals with dementia. ^ Provide caregiver counseling and education to families. Examples of counseling topics include, but are not limited to: o Understanding community resources appropriate for different functional levels o Accessing community services, including specialized medical consultations, o Understanding dementia-induced behaviors. o Learning caregiver skills to enhance in-home care (managing wandering, responding to delusions, dealing with repetitive questioning), o Problem solving around stressful care giving situations. o Long-distance care giving problem solving. o Asking for help from children and/or siblings in caring for a loved one, o Dealing with anger, guilt, and sadness that can accompany care giving o Creating a caregiver's emergency plan, in case the sole caregiver becomes incapacitated, o Supporting the caregiver in finding respite and taking care of her/himself.