Growing Older in North Carolina: Helping Seniors Navigate Transitions

1,120 views

Published on

The 2010 Census showed that every day for the ensuing five years, 8,000 people would turn 65. How are counties in North Carolina preparing for this “Silver Tsunami?” Orange County and its aging services providers have embarked on a unique partnership to develop coordinated community support for older adults and adults with disabilities. The program is having a remarkable impact by helping citizens age successfully and reducing re-hospitalizations for those with complex hospital transitions. What is your county doing to prepare? This workshop, held during the NCACC's 2012 Annual Conference, highlighted a successful public-private partnership of community support designed to teach attendees how to approach their county’s Silver Tsunami with a spirit of discovery.

Published in: News & Politics
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,120
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
4
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Growing Older in North Carolina: Helping Seniors Navigate Transitions

  1. 1. GROWING OLDER IN NORTH CAROLINA: Helping Seniors Navigate Transitions North Carolina Association ofCounty Commissioners Annual Conference August 17, 2012
  2. 2. The Silver TsunamiEvery day for the next five years, 2
  3. 3. Percent of Population 65 and Over in NC 2010 Pasquotank Currituck Camden Alleghany Ashe Surry Stokes Warren Northampton Rockingham Caswell Person Gates Vance Watauga Wilkes Halifax Hertford Granville Perquimans Yadkin Forsyth Mitchell Avery Guilford Franklin Chowan AlamanceOrange Bertie Caldwell Alexander Davie Durham Nash Yancey Madison Edgecombe Iredell Davidson Wake Martin Washington Burke Randolph Chatham Catawba Wilson Tyrrell Dare Buncombe McDowell Rowan Haywood Pitt Beaufort Johnston Swain Rutherford Lincoln Lee Greene Hyde Graham Henderson Cabarrus Harnett Moore Wayne Jackson Polk Cleveland Gaston Stanly Montgomery Mecklenburg Lenoir Cherokee Macon Transylvania Craven Clay Cumberland Pamlico Richmond Hoke Jones Union Sampson Anson Duplin Scotland Onslow Carteret Robeson Bladen Pender Columbus New Hanover Brunswick 10% or less 11% to 20% 21% to 30% North Carolina – 13%Source: US Census 2010
  4. 4. Percent of Population 65 and Over in NC 2030 Pasquotank Currituck Camden Alleghany Ashe Surry Stokes Warren Northampton Rockingham Caswell Person Gates Vance Watauga Wilkes Halifax Hertford Granville Perquimans Yadkin Forsyth Mitchell Avery Guilford Franklin Chowan AlamanceOrange Bertie Caldwell Alexander Davie Durham Nash Yancey Madison Edgecombe Iredell Davidson Wake Martin Washington Burke Randolph Chatham Catawba Wilson Tyrrell Dare Buncombe McDowell Rowan Haywood Pitt Beaufort Johnston Swain Rutherford Lincoln Lee Greene Hyde Graham Henderson Cabarrus Harnett Moore Wayne Jackson Polk Cleveland Gaston Stanly Montgomery Mecklenburg Lenoir Cherokee Macon Transylvania Craven Clay Cumberland Pamlico Richmond Hoke Jones Union Sampson Anson Duplin Scotland Onslow Carteret Robeson Bladen Pender Columbus New Hanover Brunswick 10% or less 11% to 20% North Carolina – 19% 21% to 30% 31% or moreSource: NC State Data Center, April 2012
  5. 5. The Graying of North Carolina• NC in the midst of significant demographic change• The state’s 2.4 million baby boomers are entering retirement age• NC has the highest percentage of older adults living in rural areas among Pasquotank Currituck the most populous states Camden Alleghany Ashe Surry Stokes Warren Northampton Rockingham Caswell Person Gates Vance Watauga Wilkes Halifax Hertford Granville Perquimans Yadkin Forsyth Mitchell Avery Guilford Franklin Chowan AlamanceOrange Bertie Caldwell Alexander Davie Durham Nash Yancey Madison Edgecombe Iredell Davidson Wake Martin Washington Burke Randolph Chatham Catawba Wilson Tyrrell Dare Buncombe McDowell Rowan Haywood Pitt Beaufort Johnston Swain Rutherford Lincoln Lee Greene Hyde Graham Henderson Cabarrus Harnett Moore Wayne Jackson Polk Cleveland Gaston Stanly Montgomery Mecklenburg LenoirCherokee Macon Transylvania Craven Clay Cumberland Pamlico Richmond Hoke Jones Union Sampson Anson Duplin Scotland Onslow Carteret Robeson Bladen Pender Columbus New Hanover 2010 Brunswick Counties with more 60+ than 0-17 (43) Counties with more 0-17 than 60+ (57)Source: US Census 2010
  6. 6. • Our 65 and older population will double in the next 20 years from 1.2 to 2.4 million.• While NC is 10th nationally in size of total population, we are 9th in those 60 +.• By 2025, 85 of NC 100 counties are projected to have more people over age 60 than under age 17 and one in four NC citizens will be 60 and older. Pasquotank Currituck Camden Alleghany Ashe Surry Stokes Warren Northampton Rockingham Caswell Person Gates Vance Watauga Wilkes Halifax Hertford Granville Perquimans Yadkin Forsyth Mitchell Avery Guilford Franklin Chowan AlamanceOrange Bertie Caldwell Alexander Davie Durham Nash Yancey Madison Edgecombe Iredell Davidson Wake Martin Washington Burke Randolph Chatham Catawba Wilson Tyrrell Dare Buncombe McDowell Rowan Haywood Pitt Beaufort Johnston Swain Rutherford Lincoln Lee Greene Hyde Graham Henderson Cabarrus Harnett Moore Wayne Jackson Polk Cleveland Gaston Stanly Montgomery Mecklenburg Lenoir Cherokee Macon Transylvania Craven Clay Cumberland Pamlico Richmond Hoke Jones Union Sampson Anson Duplin Scotland Onslow Carteret Robeson Bladen Pender 2025 Columbus New Hanover Brunswick Counties with more 60+ than 0-17 (85) Counties with more 0-17 than 60+ (15) Source: NC State Data Center
  7. 7. The Long-TermServices and Supports LandscapeIn North Carolina long-term services andsupports are funded by numerous sources,administered by multiple agencies, and havecomplex, fragmented, and often duplicativeintake, assessment, and eligibility functions. 7
  8. 8. Determining how to obtainservices is difficult both forpersons who qualify for publiclyfunded support and for those whocan pay privately.A uniform, coordinated system ofinformation and access for allpersons seeking long-term supportwill minimize confusion, enhanceindividual choice, be cost efficient,and support informed decision-making. 8
  9. 9. Recent Milestones For American Health Care• Medicare Modernization Act (2003)• Deficit Reduction Act (2005)• Medicare Improvement for Patients and Providers Act (2008)• Affordable Care Act (2010)
  10. 10. http://www.kff.org/medicare 10
  11. 11. 11
  12. 12. • In 2003, the US Administration on Aging (AoA) launched the federal Aging and Disability Resource Center (ADRC) initiative, which began with three core functions – Awareness, Assistance, and Access• The set of core expectations has grown over time – Information, referral, and awareness – Options counseling, advice, and assistance – Streamlined eligibility determinations for public programs – Person-centered transitions – Quality assurance and continuous improvement• Since 2009 AoA and CMS are viewing ADRCs as the platform to: – Intervene during care transitions – Promote consumer direction – Implement new initiatives (e.g., Veteran Directed Home and Community Based Services) – Catalyze broader systems change 12
  13. 13. North Carolina Community Resource Connections (CRCs) Alleghany Northampton Cu Gates Pa rrituck Vance Warren sq Granville Stokes Surry Rockingham Caswell uo Ashe Person Pe Ca t an Hertford rq m k de ui n Watauga Halifax m an Ch Wilkes Alamance s Orange o Durham Avery Yadkin Forsyth wa Guilford Bertie Franklin n Edg r Caldwell de Nash e Yancey an Davie co m ex Iredell n Madison Al Martin hin gto be Davidson Wake Was Tyrrell Chatham Wilson Dare Burke Randolph McDowell Ha Buncombe Catawba Rowan yw Pitt Beaufort oo d Lincoln Johnston Hyde Swain Greene Lee Rutherford Cabarrus Clev Mecklenbu Harnett Graham Henderson Jack Stanly Moore elan s on Gaston Wayne Lenoir ia Polk Montgomery Craven van d Pa Cherokee Macon n syl rg ml T ra Cumber ic o Clay Richmond Hoke -land Jones Union Anson Sampson Duplin Scot- land Onslow Carteret RobesonCabarrus CRC (Cabarrus ) BladenChatham-Orange CRC [Chatham and Orange] PenderEastern Carolina CRC -Developing [Carteret, Craven, Duplin, Greene, Jones, New Hanove rLenoir, Onslow, Pamlico, Wayne] ColumbusForsyth CRC [Forsyth] BrunswickGreat Smokies CRC [Haywood, Jackson, Macon]High Country CRC [Ashe, Alleghany, Avery, Watauga, Wilkes]Isothermal CRC - Developing [Cleveland, McDowell, Polk, Rutherford]Land of Sky CRC [Buncombe, Henderson, Madison, Transylvania]Lumber River CRC - Developing [Bladen, Hoke, Richmond, Robeson, Scotland]Mecklenburg CRC [Mecklenburg]Northwest Piedmont CRC [Davie, Stokes, Surry, Yadkin]Piedmont Triad CRC [Alamance, Caswell, Davidson, Guilford, Montgomery,Randolph, Rockingham]Pitt-Beaufort CRC [Pitt, Beaufort]Wake CRC [Wake]Western CRC [Cherokee, Clay, Graham, Swain] March 2012
  14. 14. In 2009 NC was one of 9 states to be awarded a CMS Person-Centered Hospital Discharge Model Grant (PCHDM) • The over arching goal for this grant was to provide states the opportunity to develop effective care transitions models that integrated community-based services with hospital discharge planning as a means for preventing avoidable hospital re-admissions. • Projected Outcomes- • Improve quality of care for Medicare beneficiaries through a comprehensive community effort • Reduce preventable hospital re-admissions • Increase discharge from Hospital to Home for target populations
  15. 15. Resources and Milestones• CRC Care Transition Projects – Forsyth County – Chatham-Orange Counties – Rockingham County – Land of Sky• PASSPORT• Area Agencies on Aging• NC Alliance for Care Transition (NC ACT) – NC Hospital Association Quality Center – Community Care of NC – Carolinas Center for Medical Excellence
  16. 16. Transitions of Care• Definition: The movement of persons from one health care practitioner or setting to another as their condition and care needs change• Poor Transitions… – Compromise clients safety & quality of care – Burden clients and their families – Increase costs to clients, payers, providers & employers
  17. 17. Readmissions: By the Numbers 20% Medicare Beneficiaries readmitted within 30 Days 33% readmitted within 90 Days Hospitalizations account for 33% of total Medicare $ Readmissions result in $17.4 Billion annually 76% of Medicare readmissions potentially avoidable Estimated $12 Billion Preventable Expenditures
  18. 18. The Challenge“If re-hospitalizations are frequent, costly, and able to be reduced, why haven’t they been?” Hospital-level barriers Community-level barriers State-level barriers
  19. 19. New Models of CareThere are a number of proven & promising modelsto improve outcomes during transitions:Common Elements: Interdisciplinary Communication/Collaboration Transitional Care Staff Patient Activation Enhanced Follow-up (by phone / home visit) For more resources: www.cfmc.org/integratingcare
  20. 20. NCMJ: Care Transitions www.ncmedicaljournal.com
  21. 21. How does our community navigate this transition? Area Agency on County Aging Social Home Services Assisted Living Cooperative Extension Nursing ? Home Mental Health Home Health Provider Care Continuing Care Rehabilitation Retirement Community Community Resource Connection Faith Adult Day Services Community Senior County Council/ Center Department on Aging
  22. 22. Community Engagement Event • Plan WITH Not FOR Community • Power of Consumers • Map Current Reality • Assess Beliefs • Build Common Vision • Set Priorities • Define Action Steps
  23. 23. Local Core Collaborators Consumers Aging Services Agencies Disability Services Agencies In-Home services Senior Centers Community Organizations Dept. of Social Services Area Agencies on Aging Community Health Centers Hospitals
  24. 24. Community-Based Approach“Communities across the US are beginning toconsider transitions of care as a community–basedchallenge that requires shared ownership and closecollaboration across settings.” (Institute for Healthcare Improvement)
  25. 25. Local Level Planning • How to get started? • What has been done?
  26. 26. Orange County Is Now In It’s Third Master Aging Plan (MAP)•Objectives for Developing MAP•Input•Process•Plan
  27. 27. Objectives For Developing MAP• Citizen Engagement• A plan for the whole county• Sustainability• Accountability
  28. 28. Citizen Engagement• Focus Groups• Community Forums• Work Groups – Housing – Navigation and Transportation – Health and Wellness – Community Engagement – Aging in Place
  29. 29. Integrated Countywide Plan• Government Readiness Survey • Personal Interviews with County Dept. Heads.
  30. 30. • Steering Committee – Key County Department Heads, citizen representation, community organizations, BOCC Representatives – Increased buy-in and commitment agencies across the county – Personal interviews
  31. 31. Sustainability and Accountability• Economic context requires creativity• Public Private Partnerships• Built-in indicators of success• MAP Evaluation Committee
  32. 32. How Can You Begin In Your Community?• Contact your local Dept. or Council on Aging• Find out if they have a strategic plan• Is it time to update the plan and you like what you have heard today visit us at www.orangecountync.gov/aging• We have created an on-line MAP toolkit
  33. 33. Most Important Role For You• Get involved and stay involved!• If your community does not have an Aging Plan, advocate that they get started planning.• The Silver Tsunami is going to have a dramatic impact on you and your community.
  34. 34. Our Contact InformationBernadette PelissierOrange County Board of Commissionersbpelissier@orangecountync.govHeather AltmanCarol Woods Retirement Communityhaltman@carolwoods.orgSabrena LeaNorth Carolina Division of Aging & Adult ServicesSabrena.Lea@dhhs.nc.govJanice TylerOrange County Department on Agingjtyler@orangecountync.gov

×