0
Albany Guardian Society’s Educational Institute
Thursday, June 20, 2013
Laurie Bacheldor
Manager, Schenectady County Depar...
"For too long, too many Americans have faced the impossible choice
between moving to an institution or living at home with...
Aging Services Network
3
Office of Supportive
and Caregiver Services
Greg Case Director
Administration on Aging Kathy
Greenlee Assistant
Secretary ...
Older Americans Act:
The Centerpiece for Long-Term Services & Supports
Older Americans Act Structure at a Glance
Title I
D...
6Source: Prepared by the National Health Policy Forum, based on e-mail communications
with AoA staff and phone conversatio...
National Aging Network:
Helps 11 Million Seniors (and their Caregivers) Remain at
Home
Through Funding from the Older Amer...
Aging Network in New York State:
Helps 562,151 Seniors (and their Caregivers)
Remain At Home Through Low-Cost Community Ba...
Show me the money...
9
The Age Wave
10
Based on demographic projections,
New York State’s senior citizens will
increase dramatically:
The 60+ pop...
Through the Looking Glass
Demographics is Destiny:
Alice ponders what the world is like on the other side of a
mirror's re...
The 75+ population will to increase to 1,815,879 The 85+ population will increase to 566,423
70% increase from 2000 to 203...
Demographic Shifts in 20th
Congressional District
(Capital Region Counties)
13
Demographic Shifts in 19th Congressional
District
(Rensselaer & areas southwest of the Capital Region)
14
To the rescue:
Local Offices for the Aging
AAAs promote efficient and effective use of resources by incorporating these el...
To the rescue - continued
AAAs are effective and efficient. The Aging Network is a true network
in that it employs all ava...
OFAs serve frail, low-income, non-Medicaid
seniors most at risk of nursing home
placement
17
OFA Services are Cost Effective
Office for Aging Services vs. Nursing Home Average Cost
Annual cost of $10,000 vs. $100,00...
The Proof: Report #1
The Older Americans Act Impact on Diverting
Unnecessary Nursing Home Placement
2012 Report:
The Relat...
The Proof: Reports #2 & 3
Evaluation Reports on Nursing Home
Diversion• Nursing Home Diversion Modernization Program, Fina...
Livable Communities for Successful Aging
21
The Growing Contributions and Costs of
Family Caregiving
• Over 2.2 million informal caregivers – friends, family and neig...
Core AAA Programs to foster
independence
1 - NY Connects
Provides information and assistance for consumers of all ages see...
Core AAA Programs - continued
4 - Community Services for The Elderly (CSE)
CSE provides services such as case management, ...
1- NY Connects:
Choices for Long Term Care
Services
NY Connects is a statewide, locally based “no wrong door” entry
point”...
1 – NY Connects: ADRC Status has
generated $12+ million in grants in New
York State
26
GRANT PROGRAM TOTAL AWARD
Nursing H...
1 - NY Connects: Included in BIP
Application
Balancing Incentive Program (BIP) - provides grants to States to increase acc...
2 - Expanded In-Home Services for
the Elderly Program (EISEP)
A Foundation for Aging in Place
Many people want to age in p...
2 EISEP - continued
The Profile
The largest age group receiving EISEP personal care services is 85+ at
43%. The 75 – 84 ag...
2 EISEP - continued
Assessment & Multiple Services
The assessment process is a comprehensive review of a person’s needs an...
3 Wellness in Nutrition
(WIN)
(formerly Supplemental Nutrition Assistance Program)
Nutrition: A Foundation for Wellness
Ea...
3 WIN - continued
The Profile – Home Delivered Meals
The largest age group receiving home delivered meals is the 85+
year ...
4 - Community Services for the Elderly
Program (CSE)
Demographics of Persons Receiving CSE Services
During SFY 2011-12, ap...
4 CSE - continued
34
Economic Status
Limited income increases the risk for poor nutritional status in older persons.
Data ...
5 - Health Insurance Information
Counseling and Assistance Program
(HIICAP)
Information and Assistance
HIICAP provides inf...
4 CSE – flexible to fit local communities
36
FUNDING
The flexible nature of CSE makes it the most effective vehicle to sup...
5 HIICAP - continued
Who does HIICAP Serve?
•Current Medicare beneficiaries
•People about to become eligible for Medicare ...
5 HIICAP - continued
Client Contacts
The HIICAP program began in New York State in the mid 1990’s. Between 2006 and 2012, ...
Challenges
• Aging Demographics affect everything: health
care, housing, transportation, quality of life
• Tough economy =...
Many Positive Aspects
• OFAs provide cost effective services to promote
independence in the community
• Plan and invest no...
Evidence-Based Definition
To see approved list or to suggest additional programs, go to: http://www.aoa.gov/A
41
Issues on the Horizon
• Olmstead Plan for New York: Roger Bearden, Special
Counsel to Governor Andrew Cuomo for Olmstead, ...
About Us
The New York State Association of Area Agencies on Aging represents the state’s local
offices for the aging estab...
June 20, 2013
A Conversation with our
Four Directors of Area Agencies on Aging:
Laurie Bacheldor
Manager, Schenectady Coun...
Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County
Round Table
A com...
Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County
Statistics & Unit...
Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County
Statistics & Unit...
Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County
New partnership w...
Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County
The Municipality ...
Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County
Aims to build upo...
Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County
Theater &
Activit...
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  1. 1. Albany Guardian Society’s Educational Institute Thursday, June 20, 2013 Laurie Bacheldor Manager, Schenectady County Department of Senior & Long Term Care Services Judy Coyne Commissioner, Albany County Department for Aging Sandra Cross Director, Saratoga County Office for the Aging Carol Rosbozom Director, Rensselaer County Unified Family Services, Department for the Aging An Overview of Area Agencies on Aging & the Aging Services Network Laura A. Cameron, Executive Director New York State Association of Area Agencies on Aging A Conversation with the Directors of our Four Area Agencies on Aging
  2. 2. "For too long, too many Americans have faced the impossible choice between moving to an institution or living at home without the long- term services and supports they need. The goal of the new Administration for Community Living will be to help people with disabilities and older Americans live productive, satisfying lives." Secretary Kathleen Sebelius April 16, 2012 2
  3. 3. Aging Services Network 3
  4. 4. Office of Supportive and Caregiver Services Greg Case Director Administration on Aging Kathy Greenlee Assistant Secretary Edwin Walker Deputy Assistant Secretary Office of Budget and Finance Steve Hagy Director Office of Grants Management Rimas Liogys Director Office of Information Resources Management Dan Berger Acting Director Office of Administration and Personnel Terry Nicolosi Director Office of Policy Analysis and Development Mimi Toomey Director Office of Nutrition and Health Promotion Programs Laura Lawrence Director Kathy Greenlee Administrator ACL Organizational Chart (Jan. 2013) Office of Long-Term Care Ombudsman Programs Becky Kurtz Director Office of Regional Operations Aviva Sufian Director Office of Innovation Ophelia McLain Director Office of Program Support Jennifer Johnson Director Office of Elder Rights Barbara Dieker Director Office of External Affairs Carol Crecy Director Center for Management and Budget Dan Berger Deputy Administrator Sharon Lewis Acting Principal Deputy Administrator Center for Disability and Aging Policy John Wren Deputy Administrator Office of American Indian, Alaskan Native and Native Hawaiian Programs Cynthia LaCounte Director Office of Performance and Evaluation Bob Hornyak Director Administration on Intellectual and Developmental Disabilities Sharon Lewis, Commissioner Jamie Kendall, Deputy Commissioner President’s Committee for People with Intellectual Disabilities VACANT Senior Advisor Region I Kathleen Otte Regional Administrator Office of Integrated Programs Lori Gerhard Director Region II Kathleen Otte Regional Administrator Region III Kathleen Otte Regional Administrator Region IV Costas Miskis Regional Administrator Region V Jim Varpness Regional Administrator Region VI Percy Devine Regional Administrator Region VII Jim Varpness Regional Administrator Region VIII Percy Devine Regional Administrator Region IX David Ishida Regional Administrator Region X David Ishida Regional Administrator 4
  5. 5. Older Americans Act: The Centerpiece for Long-Term Services & Supports Older Americans Act Structure at a Glance Title I Declaration of Objectives. Sets out broad social policy objectives oriented toward improving the lives of all older people. Title II Administration on Aging (AoA). Establishes AoA within the Department of Health and Human Services (HHS) as the chief federal agency advocate for older persons and sets out the responsibilities of AoA and the Assistant Secretary for Aging. Establishes aging network support activities. Title III Grants for State and Community Programs on Aging. Authorizes activities of state and area agencies on aging and funds for supportive and nutrition services, family caregiver support, and disease prevention and health promotion activities. Title IV Activities for Health, Independence, and Longevity. Authorizes research, training, and demonstration projects in the field of aging. Title V Community Service Senior Opportunities Act. Authorizes grants to support part-time employment opportunities for unemployed low income people age 55 and older who have poor employment prospects. Title VI Grants for Native Americans. Authorizes grants for supportive and nutrition services to American Indians, Alaskan Natives, and Native Hawaiians. Title VII Vulnerable Elder Rights Protection Activities. Authorizes grants for the long-term care ombudsman program and services to prevent elder abuse, neglect, and exploitation. 5
  6. 6. 6Source: Prepared by the National Health Policy Forum, based on e-mail communications with AoA staff and phone conversations with DOL staff February 2012. Older Americans Act Federal Fiscal Year 2012 Funds for all States
  7. 7. National Aging Network: Helps 11 Million Seniors (and their Caregivers) Remain at Home Through Funding from the Older Americans Act AoA 56 State Units, 629 Area Agencies & 246 Tribal Organizations 20,000 Service Providers & 500,000 Volunteers Provide Services and Supports to 1 in 5 Seniors 26 Million Rides 26 Million Rides 35 Million Hours of Personal Care 35 Million Hours of Personal Care 240 Million Meals 240 Million Meals 135,000 Caregivers Trained 135,000 Caregivers Trained 4 Million Hours of Case Management 4 Million Hours of Case Management 792,000 Caregivers Assisted 792,000 Caregivers Assisted 6.4 Million Hours of Respite Care 6.4 Million Hours of Respite Care 7
  8. 8. Aging Network in New York State: Helps 562,151 Seniors (and their Caregivers) Remain At Home Through Low-Cost Community Based-Services NYS NY State Office for the Aging, 59 Area Agencies on Aging 1,900 Service Providers & 1,000 volunteers Provide Services and Supports to 1 in 7 Seniors 10.4 million Congregate Meals 10.4 million Congregate Meals 2.7 million hours of Personal Care 2.7 million hours of Personal Care 12.4 million Home Delivered Meals 12.4 million Home Delivered Meals 143,000 HIICAP client contacts 143,000 HIICAP client contacts 809,500 Hours of Case Management 809,500 Hours of Case Management Transportation 1.9 million rides Transportation 1.9 million rides 8
  9. 9. Show me the money... 9
  10. 10. The Age Wave 10 Based on demographic projections, New York State’s senior citizens will increase dramatically: The 60+ population is expected to reach 5,302,667 by the year 2030 68% increase from 2000 to 2030
  11. 11. Through the Looking Glass Demographics is Destiny: Alice ponders what the world is like on the other side of a mirror's reflection, and discovers that she is able to step through it to an alternative world – the Aging Services Network. 11 Age 75+ Age 85+
  12. 12. The 75+ population will to increase to 1,815,879 The 85+ population will increase to 566,423 70% increase from 2000 to 2030 73.5% increase from 2000 to 2030 12 Through the Looking Glass of the Aging Network, we can see the future
  13. 13. Demographic Shifts in 20th Congressional District (Capital Region Counties) 13
  14. 14. Demographic Shifts in 19th Congressional District (Rensselaer & areas southwest of the Capital Region) 14
  15. 15. To the rescue: Local Offices for the Aging AAAs promote efficient and effective use of resources by incorporating these elements into their service delivery system: AAAs promote early identification and intervention. Early identification and intervention has long been proven to promote cost containment. This is especially relevant in the long term care arena when late stage intervention often means nursing home placement. AAAs promote independence of the individual . Seniors living independently in their own homes is both cost effective to the state and beneficial to the individual. AAAs focus on family. Family and other informal caregivers remain the primary source of care for clients served by the Aging Network. AAAs not only acknowledge caregivers in a client’s care plan, but also provide a vital support network to caregivers to help them cope with their increasing responsibilities. AAAs employ a non-medical model. In a medical model, the emphasis is on illness and treatment, whereas in the non-medical model, the focus is on issues related to strengths and wellness. An underlying principle is the emphasis on respecting individual differences and promoting individual choices. AAAs promote flexibility. AAAs provide a care plan to suit each senior’s individual needs, reassessing and adjusting services over time. Seniors are provided with only those services that are deemed appropriate for their current needs. 15
  16. 16. To the rescue - continued AAAs are effective and efficient. The Aging Network is a true network in that it employs all available community services. As situations change, AAAs have found creative ways to tap community and government resources. AAAs are challenged to utilize every resource available, making it the number one goal to keep families together and as independent as possible, for as long as possible. AAAs are positioned to impact Long Term Care Reform. Through the local NY Connects programs, AAAs have brought together over 1,600 consumers, providers and other stakeholders involved in the care of seniors and the disabled. They have formed local long-term care councils to analyze the gaps in the long term care services provided in their communities, and are developing plans and implementing strategies to address the identified issues. The systems change work the councils are doing is critically important in utilizing existing resources and bringing together a wide spectrum of stakeholders. 16
  17. 17. OFAs serve frail, low-income, non-Medicaid seniors most at risk of nursing home placement 17
  18. 18. OFA Services are Cost Effective Office for Aging Services vs. Nursing Home Average Cost Annual cost of $10,000 vs. $100,000 18
  19. 19. The Proof: Report #1 The Older Americans Act Impact on Diverting Unnecessary Nursing Home Placement 2012 Report: The Relationship between Older Americans Act Title III State Expenditures and Prevalence of Low-Care Nursing Home Residents •Objective. To test the relationship between older Americans Act (OAA) program expenditures and the prevalence of low-care residents in nursing homes (NHs). •Principal Findings. Results indicate that increased spending on home- delivered meals was associated with fewer residents in NHs with low-care needs. •Conclusions. States that have invested in their community-based service networks, particularly home-delivered meal programs, have proportionally fewer low-care NH residents. •Closing paragraph: “This article reveals that despite efforts to rebalance LTC, there are still many NH residents who have the functional capacity to live in a less restrictive environment. The challenge for states and CMS will be to build and invest in systems and programs that divert unnecessary NH placement for individuals who can be sustained in the community.” Source: Thomas, Kali A. and Vincent Mor. Health Research and Educational Trust. Published online December 3, 2012. Health Services Research, Volume 48, Issue 3, pages 1215-1226, June 2013 19
  20. 20. The Proof: Reports #2 & 3 Evaluation Reports on Nursing Home Diversion• Nursing Home Diversion Modernization Program, Final Evaluation Report. January 18, 2011. Broome, Oneida and Onondaga (Sept. 2008 – Sept. 2010) • Community Living Program, Final Evaluation Report. December 16, 2012. Albany, Cayuga, Dutchess, Orange, Otsego, Tompkins, Washington (Sept. 2009 – Sept. 2012) Both reports prepared by: Center for Excellence in Aging & Community Wellness, Univ. at Albany Outcomes Data • All 93 of the program participants were at high risk for nursing home placement and of spending down their income and assets to the Medicaid level. (NHDM, 2011) • All 114 of the program participants were at high risk for nursing home placement and of spending down their incomes and assets to the Medicaid level. (CLP, 2012) Nursing Home Placement • 81% of the 93 participants in the program did NOT enter a nursing home during the program period. (NHDM, 2011) • 89% of 114 participants did NOT enter a nursing home during the program period. (CLP, 2012) Medicaid Spend-Down • 83% of 93 participants did NOT spend down to Medicaid. (NHDM, 2011) • Only 1 of 114 participants entered Medicaid supported home care. Note, however, that 9 20
  21. 21. Livable Communities for Successful Aging 21
  22. 22. The Growing Contributions and Costs of Family Caregiving • Over 2.2 million informal caregivers – friends, family and neighbors – provide direct care to people of all ages with disabilities. • If the work of these caregivers had to be replaced by paid home care workers, the cost would be $32 billion annually in New York State (Valuing the Invaluable: 2011 Update - The Growing Contributions and Costs of Family Caregiving, AARP, page 27, Table B1). • 2009 NYSOFA report, Sustaining Informal Caregivers: Caregiver Support Programs Participants Survey: • Caregiver support services and community resources help caregivers to provide care longer and may also help delay or prevent nursing home placement. Caregivers spend 62.6 hours a week providing care. • 36% reported their receivers of care cannot be left alone at home. • 42% reported that their receivers of care can only be left alone for short periods of time or need to be checked on in person several times a day. 22
  23. 23. Core AAA Programs to foster independence 1 - NY Connects Provides information and assistance for consumers of all ages seeking long term services and supports, helping them remain independent. Predominantly operated by AAAs 2 - Expanded In Home Services for the Elderly Program (EISEP) EISEP is designed to provide non-medical services including personal care or housekeeping services. Case managers determine need through an assessment. 3 - Wellness in Nutrition (WIN) (previously Supplemental Nutrition Assistance Program, SNAP) Provides meals for qualifying seniors either in a congregate setting or as a home delivered meal. Each meal provides at least one-third recommended daily allowance (RDA) for nutrition. Nutrition education and counseling are also offered. 23
  24. 24. Core AAA Programs - continued 4 - Community Services for The Elderly (CSE) CSE provides services such as case management, meals, adult day services, home care, transportation, health promotion and information and assistance. 5 - Health Insurance Information Counseling & Assistance Program (HIICAP) HIICAP provides information to seniors on Medicare, Medicaid, managed care, EPIC, and other health insurance options and issues, and also assists Medicare beneficiaries to access needed health care and to apply for programs such as the Medicare Savings Program. 24
  25. 25. 1- NY Connects: Choices for Long Term Care Services NY Connects is a statewide, locally based “no wrong door” entry point” into the long term care system and provides one stop access to free, objective and comprehensive Information and Assistance on long term services and supports (LTSS). A locally- based community resource, NY Connects links individuals of all ages (and their caregivers) with the most appropriate services and supports, regardless of payment source. 25
  26. 26. 1 – NY Connects: ADRC Status has generated $12+ million in grants in New York State 26 GRANT PROGRAM TOTAL AWARD Nursing Home Diversion Modernization (2008): 3 counties $ 927,710 Veteran Directed Home and Community Based Services Program1 (2008): 4 counties Up to $1,000,000 (estimated) Community Living Program (2009): 10 counties $ 959,284 Aging and Disability Resource Center Grant (2009): 2 counties $ 680,171 Chronic Disease Self-Management Program (2009): Statewide ARRA Funding $ 1,190,610 Lifespan Respite Care Program (2010): Statewide $ 188,950 Medicare Improvement for Patients and Providers Act (MIPPA) for Beneficiary Outreach and Assistance (2010): Statewide Affordable Care Act funds $ 2,567,032 ADRC Evidenced-Based Care Transitions Program (2010): 1 county Affordable Care Act funds $ 430,000 ADRC Nursing Home Transition and Diversion Program (2010): 1 region (DOH) Affordable Care Act funds $ 399,600 Accelerating Integrated, Evidence-Based, and Sustainable Service Systems for Older Adults, Individuals with Disabilities_Part A (2011): 51 counties $ 2,616,900 Accelerating Integrated, Evidence-Based, and Sustainable Service Systems for Older Adults, Individuals with Disabilities_Part B (2011): 6 Alzheimer’s Association Chapters $ 686,000 Chronic Disease Self-Management Education Programs (2012): Statewide 2012 Prevention and Public Health Funds $ 575,000 (for Year 1) Estimated Total: $12,221,257 1 Payment for services provided to Veterans in participating counties goes directly to AAAs.
  27. 27. 1 - NY Connects: Included in BIP Application Balancing Incentive Program (BIP) - provides grants to States to increase access to non-institutional long-term services and supports (LTSS) and transform LTC systems. •$600 million grant awarded to New York State by the federal government in March 2013 in order to continue to rebalance the system. Provides New York State an additional 2% in FMAP (Federal Matching Assistance Percentage, essentially Medicaid funding) to continue to rebalance its long term services and supports system. •Three primary deliverables (from page 1 of New York’s BIP application): • No Wrong Door/Single Entry Point: Enhance the existing NY Connects Network, which is currently operational in 54 counties and serves as an information and assistance system for long term care services. • Core Standardized Assessment Instrument: Continue implementation of the Uniform Assessment System (UAS-NY) and align with other agencies to ensure compliance with the core data set. • Conflict-Free Case Management Services: Remediate any case management arrangements that do not align with the principles of BIP. The Balancing Incentive Program also provides new ways to serve more people in home and community-based settings, in keeping with the integration mandate of the Americans with Disabilities Act (ADA), as required by the Olmstead decision. The Balancing Incentive Program was created by the Affordable Care Act of 2010 (Section 10202). 27
  28. 28. 2 - Expanded In-Home Services for the Elderly Program (EISEP) A Foundation for Aging in Place Many people want to age in place at home and not in a nursing home. But, with advanced age comes illness and disabilities, nonmedical in nature, nevertheless limiting. EISEP provides services that allow older New Yorkers the opportunity to age in place with dignity and respect. Services Provided Under EISEP Non-medical in-home services, case management, non- institutional respite and ancillary services are provided under EISEP 28
  29. 29. 2 EISEP - continued The Profile The largest age group receiving EISEP personal care services is 85+ at 43%. The 75 – 84 age bracket not far behind at 33%. The oldest old (85+), is the fastest-growing segment of America's senior population. As life spans increase, so too will those who need EISEP services in order to remain at home in their communities. 29
  30. 30. 2 EISEP - continued Assessment & Multiple Services The assessment process is a comprehensive review of a person’s needs and circumstances. Often, a package of services is needed to address the unique circumstances of an individual. Seniors receiving personal care services through EISEP have multiple needs: more than 55% receive three to five services, and an additional 15.4% receive six or more services. 30 1 Service 2 services 3 – 5 services 6 or more
  31. 31. 3 Wellness in Nutrition (WIN) (formerly Supplemental Nutrition Assistance Program) Nutrition: A Foundation for Wellness Eating well is important at any age. Numerous benefits of a healthy diet and proper nutrition include: increased mental acuteness; resistance to illness and disease; higher energy levels; a more robust immune system; faster recuperation times; and better management of chronic health problems. Receiving a home delivered meal (HDM) provides a solid basis upon which to achieve good nutrition. HDMs are provided by Area Agencies on Aging (AAA) directly or through subcontractors. Since many seniors aren’t eating as much as they should, the food they do eat must be as nutritious as possible. 31
  32. 32. 3 WIN - continued The Profile – Home Delivered Meals The largest age group receiving home delivered meals is the 85+ year old at 41.5%. The 75 – 84 age bracket not far behind at 32.6%. The 85+ population is the fastest-growing segment of America's senior population. As life spans increase, so too will the numbers needing meals in this age bracket. 32
  33. 33. 4 - Community Services for the Elderly Program (CSE) Demographics of Persons Receiving CSE Services During SFY 2011-12, approximately 60,877 older New Yorkers benefited from Community Services for the Elderly (CSE) funded services. A count of CSE customers indicates that 30% are low- income, 48% are frail and disabled, 62% are over the age of 75 and 51% live alone. Many of those receiving CSE services fall into more than one of these categories. These characteristics represent a high risk for reduced independence, isolation and the likelihood of needing community supports. 33
  34. 34. 4 CSE - continued 34 Economic Status Limited income increases the risk for poor nutritional status in older persons. Data shows that of those receiving home delivered meals, nearly 40% fall below 150% of the poverty level standard. Lacking money to pay for adequate foods can result in a host of nutrition problems. The meals received though the HDM program provide the nutritional balance that many seniors cannot afford to buy with the financial resources they have.
  35. 35. 5 - Health Insurance Information Counseling and Assistance Program (HIICAP) Information and Assistance HIICAP provides information and assistance on health care coverage options directly or through subcontractors via telephone and face-to-face interactive sessions, public education presentations and programs, and media activities. HIICAP counselors and volunteers must have knowledge of and be able to provide unbiased information and assistance on health insurance programs. 35
  36. 36. 4 CSE – flexible to fit local communities 36 FUNDING The flexible nature of CSE makes it the most effective vehicle to support programs for the growing senior population. Funds are spread across a variety of programs supported by State and Federal Funding. Note: NYC reallocated expenditures under CSE resulting in funding adjustments in four categories: Home Delivered Meals, Homemaking/Personal Care, Senior Center Recreation & Education and Congregate Meals, according to the New York State Office for the Aging. Therefore CSE expenditures for this fiscal period vary significantly as compared to previous years.
  37. 37. 5 HIICAP - continued Who does HIICAP Serve? •Current Medicare beneficiaries •People about to become eligible for Medicare or planning for retirement •People younger than 65 years old who are eligible for Medicare due to a disability •People needing information on long-term care insurance •People who are eligible for both Medicare and Medicaid When to contact a HIICAP counselor •Counselors are available year round to help: •Individuals as they turn 65 or otherwise become eligible for Medicare •During open enrollment periods •Understand which options are best suited to the individual’s needs •Resolve problems during the year 37
  38. 38. 5 HIICAP - continued Client Contacts The HIICAP program began in New York State in the mid 1990’s. Between 2006 and 2012, client contacts more than doubled. By the close of SFY 2011-12, there were 142,744 client contacts through the HIICAP program, compared to only 66,667 in 2006, a huge increase. 38
  39. 39. Challenges • Aging Demographics affect everything: health care, housing, transportation, quality of life • Tough economy = tough choices • OFAs in a good position to help stem the tide of Medicaid spend-down, but limited funding has resulted in waiting lists for services 39
  40. 40. Many Positive Aspects • OFAs provide cost effective services to promote independence in the community • Plan and invest now in OFA services to curtail future escalating costs (remember the Looking Glass) • Carving out a role in managed care • Aging network expanding its role in evidence-based programs such as CDSMP, Care Transitions 40
  41. 41. Evidence-Based Definition To see approved list or to suggest additional programs, go to: http://www.aoa.gov/A 41
  42. 42. Issues on the Horizon • Olmstead Plan for New York: Roger Bearden, Special Counsel to Governor Andrew Cuomo for Olmstead, is preparing an Olmstead Plan for the State, to ensure that individuals with disabilities can live in the community in the least restrictive setting • Reauthorization of the Older Americans Act (OAA) by Congress. OAA was due to be reauthorized in 2011 (every 5 years). Senator Sanders (VT) introduced S. 1028 on May 23, 2013. Waiting for a bill in the House of Representatives. • Medicaid Redesign efforts will continue to affect the service delivery system and the Aging Services Network: • Implementation of Medicaid Managed Long Term Care • Expansion of Social Model Adult Day Services - now a covered service under Medicaid. See legislation to ensure that all SADS programs are subject to the same oversight by NYSOFA: S. 5397-A (Savino)/A. 7736 (Millman) • Balanced Incentive Payments (BIP) – includes NY Connects 42
  43. 43. About Us The New York State Association of Area Agencies on Aging represents the state’s local offices for the aging established under the federal Older Americans Act to respond to the needs of Americans age 60 and over. The Association provides professional development and education that includes the annual Aging Concerns Unite Us (ACUU) conference, webinars, regional caregiver forums and a fall Leadership Institute. The Association works to strengthen and expand long term services and supports to individuals so they may age in place in the community. A core philosophy is to work in collaboration with other agencies, which is accomplished through the Aging Alliance, a coalition of organizations representing Older New Yorkers. Looking to the future, the Board of Directors has approved a new name, the Association on Aging in New York, to create a more cohesive and inclusive network to address the diverse needs of an aging population, as well as individuals of all ages needing long term services and supports. www.agingny.org New York State Association of Area Agencies on Aging 272 Broadway, Albany, NY 12204 Phone (518) 449-7080 Fax (518) 449-7055 Laura A. Cameron, Executive Director laura@agingny.org Cell (518) 424-2556 43
  44. 44. June 20, 2013 A Conversation with our Four Directors of Area Agencies on Aging: Laurie Bacheldor Manager, Schenectady County Department of Senior & Long Term Care Services 107 Nott Terrace, Suite 202, Schenectady , NY 12308 Phone (518) 382-8481 x1236 Judy Coyne Commissioner, Albany County Department for Aging 162 Washington Ave., 6th Floor, Albany, NY 12210 Phone (518) 447-7177 Sandra Cross Director, Saratoga County Office for the Aging 162 High Street, Ballston Spa, NY 12020 Phone (518) 884-4100 Carol Rosbozom Director, Rensselaer County Unified Family Services, Department for the Aging Pattison Rensselaer County Government Center 1600 7th Avenue, Troy, NY 12180 Phone (518) 270-2730 Moderator: Laura Cameron Executive Director, NYS Association of Area Agencies on Aging, 272 Broadway, Albany, NY 12205 Phone (518) 449-7080 • www.agingny.org 44
  45. 45. Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County Round Table A committee of community stakeholders who are reviewing the Medicaid program changes in NYS and how it will impact long term care. Reviewing such issues as: Transitioning from County LTC to Managed Long Term Care providers such as Fidelis, PACE and VNA NY Choice County’s role with Medicaid eligibility Relationship of transition and New York Connects (I&A)
  46. 46. Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County Statistics & Units of Service TRANSPORTATION Medical Transportation: 15,400; 577 unduplicated 60+ Congregate Meal Transportation: 13,836/145 consumers Total w/other sites : 29,447/746 consumers ConMal
  47. 47. Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County Statistics & Units of Service Congregate Meals & HDM Programs Total Meals: 27,500, 1,075 unduplicated 60+ Home Delivered Meals: 85,550/565 consumers Health Promotion & Education Presentations, clinics, counseling: 950 unduplicated Health PrConMal
  48. 48. Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County New partnership with Public Health and Center for Excellence in Aging & Community Wellness Living Healthy Workshop– practical ways to live better and healthier Living Healthy with Diabetes A Matter of Balance
  49. 49. Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County The Municipality Senior Centers – New Collaborative Rotterdam, Niskayuna, Scotia Glenville and SLTC •Meeting quarterly to review: Site Services Trips Shared Services – such as Healthy Educational Programs Trends and Gaps in Services
  50. 50. Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County Aims to build upon the strength of the city of Schenectady’s emerging arts district to offer arts programming; complementary to that already presented by Proctors, Schenectady Light Opera company , and other arts entertainment and education organizations.
  51. 51. Senior & Long Term Care Services, Schenectady CountySenior & Long Term Care Services, Schenectady County Theater & Activities Educational Workshops Outside court yard art activities Theater/art productions Job Training Skills
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