SFY 2019-2020 BUDGET PRESENTATIONpresented by Director Linda Miller
Governor’s Budget Hearing | December 10, 2018
IN TWO OR THREE COLUMNS
Information & Service Assistance
Nutrition & Health Promotion
Services to Promote Independence
THIS IS A SLIDE TITLEWhat We Do
2
“ The biggest challenge identified by Iowans when it comes to aging is overcoming obstacles that make it difficult to stay in their home as they age.
3Source: Joint AARP/OIL/IDA Website Survey, 2018
OUR PROCESS IS EASY
Return to Community
Family Caregiver Redesign
Aging and Disability
Resource Center
THIS IS A SLIDE TITLEDepartment Initiatives
4
Return to Community
15
Return to Community
6
Provides long-term care support planning to assist non-Medicaid eligible seniors who want to re turn to the ir community following a nursing facility or hospital stay.
Counties Served
7
MillsCassWoodburyPottawattamie
Family Caregiver Redesign
28
Family Caregiver Redesign
9
Iowa was awarded a John A. Hartford Foundation grant in 2018 to use evidence-based practices to strengthen Iowa’s Family Caregiver Program.
ADRC Revitalization
310
IN TWO OR THREE COLUMNS
New Website The Department is launching a new website for LifeLong Links this month.
Database ImprovementsIDA and the AAA Network are focusing on improving the referral database so that information is more accurate and accessible.
Call CenterNew geo-routing system.
Identifies calls by area code and routes directly to the local Area Agency on Aging.
THIS IS A SLIDE TITLEAging and Disability Resource Center (ADRC)
11
FY 2020 Status Quo Funding
Department on Aging & Area Agencies on Aging
$11,042,924
Long-Term Care Ombudsman Program
$1,149,82112
OFFICE OF THE STATE LONG-TERM CARE OMBUDSMANpresented by Cynthia Pederson, State Long-Term Care Ombudsman
Governor’s Budget Hearing | December 10, 2018
OUR PROCESS IS EASY
Local Long-Term Care
Ombudsman
Managed Care Ombudsman
Program
Volunteer Ombudsman
Program
THIS IS A SLIDE TITLEOSLTCO Structure
14
Local Long-Term Care Ombudsmen
15
▰Advocate for residents and tenants of long-term care facilities to protect resident and tenant rights, safety and welfare.
▰Aid in resolution of resident and tenant issues.
▰ Improve quality of life for residents and tenants of long-term care facilities.
Managed Care Ombudsman Program
16
Provides advocacy for the rights of Medicaid managed care members receiving care in a long-term care facility or enrolled in one of the HCBS waivers:▰ AIDS/HIV
▰ Brain Injury
▰ Children’s Mental Health
▰ Elde rly
▰ Health and Disability
▰ Inte llectual Disability
▰ Physical Disability
Volunteer Ombudsman Program
17
Volunteer Ombudsman make a difference in residents’ lives through regular visits to facilities.
They build relationships which foster trust and communication. Residents are encouraged to share information regarding their quality of life in the facility.
“ The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.
- William Arthur Ward
18
IN TWO OR THREE COLUMNS
TechnologyLLTCO participate in web-based meetings and conduct advocacy for residents/tenants via telephone and web technology
MCOP conducts the majority of advocacy via phone
Volunteer Ombudsmen attend statewide calls via the internet and phone
TravelCurrently leasing two vehicles from DAS
One for the east side and one for the west side of the state
LLTCO rotate cars every three months
Monthly mileage allotment for LLTCO when they do not have the DAS car
VolunteersRestructured training
29 volunteers in the pipeline
Self-guided computer training with intern experiences
Mentor Program: matching mentors to volunteers for first year of service
THIS IS A SLIDE TITLEReadjusting the Sails
19
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IOWA DEPARTMENT ON AGING TABLE OF ORGANIZATION (January 2019)
Iowa Commission on Aging
Linda Miller Office of the Director
Brian Majeski Assistant Director – PSM 2
Jennifer Donovan Administrator Office of Public Guardian
Ex Off 2
Tammy White Acct Tech 3
Dixie Daniels
Acct Tech 2
Jeff Batz Acct 3
Fiscal Unit
Area Agencies on Aging: Designated Quasi-Governmental Instrumentalities of the State: 239 FTEs Elderbridge AAA – 37 FTEs | Northeast Iowa AAA – 61.25 FTEs | Aging Resources of Central IA – 14.8 FTEs | Heritage AAA – 20 FTEs | Milestones AAA – 53 FTEs | Connections AAA – 53.57 FTEs
Rosie Thierer Ex Off 2
Employment Programs
Denotes Lead Worker
Older American Act Programs
Julie Bergeson Prog Plan 3
Linda Hildreth Ex Off 2
Alex Curtis
Ex Off 2
Cynthia Pederson State Long Term Care Ombudsman – PSM 1
Pam Railsback LTCO
Stacia Timmer
LTCO
Kim Cooper LTCO
Tonya Amos LTCO
Kim Weaver LTCO
Julie Pollock LTCO
Jennifer Golle LTCO
Melanie Kempf LTCO
LTC Ombudsman
Vacant Prog Plan 3
Vacant Prog Plan 2
Vacant LTCO
Vacant Ex Off 1
Managed Care
Pamela Heagle LTCO
Administrative
Vacant Prog Plan 2
Janny Miller Admin Asst 2
Vacant Executive Sec
Angela Van Pelt Ex Off 3
Jane Erickson Mgt Anlst 3
Shan Sasser Mgt Anlst 3
Zachary Rhein Comp Off 2
Elder Rights
Ben Mulford Ex Off 2
Katie Mulford Admin Asst 2
Operations
Vacant Ex Off 2
Planning & Compliance
Office of
Public Guardian
Division of Planning, Programs & Administration
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Iowa Area Agencies on Aging | Page 1 of 3Revised 09/2018
Iowa Area Agencies on AgingLYON OSCEOLA DICKINSON EMMET
SIOUX O’BRIEN CLAY PALO ALTO
PLYMOUTH
WOODBURY
MONONA
CHEROKEE BUENAVISTA
IDA SAC
CRAWFORD CARROLL
HARRISON SHELBY AUDUBON
POCAHONTAS
CALHOUN
KOSSUTH
HUMBOLDT
WEBSTER HAMILTON HARDIN
WRIGHT FRANKLIN
HANCOCK
WINNEBAGO WORTH
CERROGORDO
GUTHRIE
POTTAWATTAMIE CASS ADAIR
MILLS
FREMONT
MONTGOMERY
PAGE
ADAMS UNION
TAYLOR RINGGOLD
GREENE BOONE STORY MARSHALL
DALLAS POLK JASPER POWESHIEK
MADISON WARREN MARION MAHASKA
CLARKE
DECATUR
LUCAS
WAYNE
MONROE
APPANOOSE
WAPELLO
DAVIS
TAMA BENTON LINN
IOWA JOHNSON
KEOKUK WASHINGTON
JEFFERSON
VAN BURENLEE
HENRYDES MOINES
LOUISA
MUSCATINE
CEDAR
JONESJACKSON
CLINTON
SCOTT
GRUNDY
BLACK HAWK
BUCHANAN DELAWARE DUBUQUE
BUTLERBREMER
FAYETTE CLAYTON
FLOYD CHICKASAW
MITCHELL HOWARD
WINNESHIEK ALLAMAKEE
PLANNING & SERVICE AREA 1: Elderbridge Agency on Aging
Counties Served: Audubon, Buena Vista, Calhoun, Carroll, Cerro Gordo, Clay, Crawford, Dickinson, Emmet, Floyd, Franklin, Greene, Guthrie, Hamilton, Hancock, Humboldt, Kossuth, Lyon, Mitchell, O’Brien, Osceola, Palo Alto, Pocahontas, Sac, Sioux, Webster, Winnebago, Worth and Wright
Director: Shelly Sindt
Contact Information: Mason City Office22 N Georgia, Ste. 216Mason City, IA 50401(641) 424-0678(800) 243-0678Fax: (641) 424-2927
Carroll Office603 N West St.Carroll, IA 51401(712) 792-3512(800) 243-0678Fax: (712) 792-3534
Fort Dodge Office308 Central Ave.Fort Dodge, IA 50501(515) 955-5244(800) 243-0678Fax: (515) 955-5245
Spencer Office714 10th Ave. E, Ste. 1Spencer, IA 51301(712) 262-1775(800) 243-0678Fax: (712) 262-7520
Website: www.elderbridge.org
1 2
3
4
5
6
510 E 12th Street, Ste. 2Des Moines, IA 50319515.725.3333 | 800.532.3213www.iowaaging.gov
Iowa Area Agencies on Aging | Page 2 of 3Revised 09/2018
PLANNING & SERVICE AREA 2: Northeast Iowa Area Agency on Aging (NEI3A)
Counties Served: Allamakee, Black Hawk, Bremer, Buchanan, Butler, Chickasaw, Clayton, Delaware, Dubuque, Fayette, Grundy, Hardin, Howard, Jackson, Marshall, Poweshiek, Tama and Winneshiek
Director: Donna Harvey
Contact Information: Waterloo Office2101 Kimball Ave., Ste. 320 PO Box 388Waterloo, IA 50702(319) 874-6840(800) 779-8707Fax: (319) 272-2455
Marshalltown OfficeNew site TBD(641) 753-4648
Email: [email protected]
Website: www.nei3a.org
PLANNING & SERVICE AREA 3: Aging Resources of Central Iowa
Counties Served: Boone, Dallas, Jasper, Madison, Marion, Polk, Story and Warren
Director: Joel Olah
Contact Information: 5835 Grand Ave., Ste. 106Des Moines, IA 50312-1444(515) 255-1310(800) 747-5352Fax: (515) 255-9442
Email: [email protected]
Website: www.agingresources.com
PLANNING & SERVICE AREA 4: The Heritage Area Agency on Aging
Counties Served: Benton, Cedar, Iowa, Johnson, Jones, Linn and Washington
Co-Directors: Kellie Elliott-Kapparos & Jill Sindt
Contact Information: 6301 Kirkwood Blvd. SWCedar Rapids, IA 52404(319) 398-5559 (800) 332-5934Fax: (319) 398-5533
Email: [email protected] [email protected]
Website: www.heritageaaa.org
Iowa Area Agencies on Aging | Page 3 of 3Revised 09/2018
PLANNING & SERVICE AREA 5: Milestones Area Agency on Aging
Counties Served: Appanoose, Clinton, Davis, Des Moines, Henry, Jefferson, Keokuk, Lee, Louisa, Lucas, Mahaska, Monroe, Muscatine, Scott, Van Buren, Wapello and Wayne
Director: Becky Passman
Contact Information: Davenport Office935 E 53rd St.Davenport, IA 52807-2664(563) 324-9085(855) 410-6222Fax: (563) 324-9384
Ottumwa Office623 Pennsylvania Ave.Ottumwa, IA 52501(641) 682-2270(855) 410-6222Fax: (641) 682-2445
Burlington Office509 Jefferson St.Burlington, IA 52601-5427(319) 752-5433(855) 410-6222Fax: (319) 754-7030
Email: [email protected]
Website: www.milestonesaaa.org
PLANNING & SERVICE AREA 6: Connections Area Agency on Aging
Counties Served: Adair, Adams, Cass, Cherokee, Clarke, Decatur, Fremont, Harrison, Ida, Mills, Monona, Montgomery, Page, Plymouth, Pottawattamie, Ringgold, Shelby, Taylor, Union and Woodbury
Director: Kelly Butts-Elston
Contact Information: Council Bluffs Office300 W Broadway, Ste. 240Council Bluffs, IA 51503(712) 328-2540(800) 432-9209Fax: (712) 328-6899
Creston Office109 N Elm St. Creston, IA 50801(641) 782-4040(800) 432-9209Fax: (641) 782-4519
Sioux City Office2301 Pierce St.Sioux City, IA 51104(712) 279-6900(800) 432-9209Fax: (712) 233-3415
Email: [email protected]
Website: www.connectionsaaa.org
Older Americans Act Services and Funding Sources Draft – January 15, 2019
Services
Allowable IDA Funding Source
Mandatory or Optional
Elderly Services
LifeLong Links
18 - 59 EAPA
T3B
T3C1
T3C2
T3D
T3E
NSIP
Other
Adult Day Care / Health X X X Optional Assisted Transportation X X X Optional Behavioral Health Supports X X X Optional Case Management
FC & ORC Case Management - ORC is Optional EAPA Assessment & Intervention
X X X X
X Mandatory
Chore X X X Optional Congregate Nutrition
CN - FC & ORC – Both Optional X X X X X Mandatory
FC & ORC Counseling ORC is Optional X X X Mandatory Emergency Response System (ERS)
FC & ORC Emergency Response System X X X X Optional
Health Promotion: Evidence-Based X X X X Mandatory Health Promotion: Non Evidence-Based X X X Optional Home Delivered Nutrition
FC & ORC Home Delivered Nutrition – Both Optional
X X X X X Mandatory
Homemaker X X X Optional Information & Assistance
FC & ORC I & A - ORC is Optional EAPA Consultation
X X X X X
X Mandatory
Information Services – FC & ORC X X X Optional Legal Assistance X X X Mandatory Material Aid
FC & ORC Supplemental Services X X X X X Optional
Nutrition Counseling X X X X X Mandatory Nutrition Education X X X X X Mandatory Options Counseling
FC & ORC Options Counseling – ORC is Optional X X X X X Mandatory
Outreach X X X Optional Personal Care X X X Optional FC & ORC Respite Care: (In Home, Out of Home/Day, Out of Home/Night, Other)
X X X Optional
Support Group FC & ORC X X X Optional Training & Education
FC & ORC Training X X X X Optional
Transportation X X X Optional
Information & Service Assistance (Mandatory)
Nutrition & Health Promotion (Mandatory)
Services to Promote Independence (Optional)
• Case Management FC & ORC Case Management EAPA Assessment & Intervention
• Counseling (FC) • Information & Assistance
FC & ORC Information & Assistance EAPA Consultation
• Legal Assistance • Options Counseling
FC Options Counseling ORC Options Counseling - Optional
• Congregate Nutrition FC & ORC Congregate Nutrition - Optional
• Health Promotion: Evidence-Based
• Health Promotion: Non Evidence-Based
(Optional) • Home Delivered Nutrition
FC & ORC Home Delivered Nutrition- Optional
• Nutrition Counseling • Nutrition Education
• Adult Day Care / Health • Assisted Transportation • Behavioral Health Supports • Chore • Emergency Response System
FC & ORC Emergency Response System
• Homemaker • FC & ORC Information
Services
• Material Aid FC & ORC Supplemental Services
• Outreach • Personal Care • FC & ORC Respite Care • FC & ORC Support
Groups • Training & Education
FC & ORC Training • Transportation
Note: Older Relative Caregiver (ORC) services align with Family Caregiver (FC) services. Older Relative Caregiver services are all optional.
510 E 12th Street, Ste. 2 Des Moines, IA 50319 515.725.3333 | 800.532.3213 www.iowaaging.gov
RETURN TO COMMUNITY
PURPOSE: Using evidence-informed interventions, this initiative provides long-term care support planning to assist
non-Medicaid eligible seniors who want to return to their community following a nursing facility or hospital stay. This will achieve cost savings for the consumer, the State, and the Medicaid program by delaying or avoiding enrollment in the Medicaid program.
COUNTIES TARGETED: Cass, Mills, Pottawattamie and Woodbury GOALS:
• Help seniors to maintain their independence by keeping them in their homes with a comprehensive set of wrap around services and supports.
• Achieve person-centered planning by enabling seniors to have the information and assistance they need to stay in their homes if they so choose.
• Integrate services through care coordination and management. • Increase access to primary and preventative care. • Reduce unnecessary facility placement, unnecessary hospital admissions and readmission, emergency
department use.
OBJECTIVES: • Implement evidence informed interventions for older Iowans who are transitioning from hospitals or nursing
facilities by formalizing key referral sources and increasing access to person-centered counseling. • Connect to other programs and resources such as family caregiver program to fully optimize available
resources. • Develop and implement a consumer satisfaction survey to document the quantitative and qualitative benefits
and outcomes.
PERFROMANCE METRICS: • Total Number of Referrals • Total Number of Successful Transitions • Total Number of Transitions to the Community • Average Length of Time in the IRTC Program • Results From Customer Satisfaction Surveys
OUTCOMES:
• Ensure consumer choice in a care setting by assisting in transitioning consumers to a community setting. • Increase access to person-centered planning. • Achieve cost savings for the consumer and the Medicaid program by delaying or avoiding enrollment in the
Medicaid Program.
Consumers
* Individuals age 60 or older* Medicare and/or Private Pay* Desire to return to their community
Connect to Other Resources Within
ADRC Like:
Case Management
Service
Assisted Transportation Service
Chore Service
Congregate Nutrition
Health Promotion: Evidence Based
Health Promotion: Non Evidence Based
Home Delivered Nutrition)
Homemaker Service
Material Aid Service
Nutrition Counseling Service
Nutrition
Personal Care Service
Transportation Service
Legal Assistance
Return To Community Initiative ProcessJanuary 2019
Disability Resources
Mental Health Assistance
Financial Management Counseling
Veteran Assistance
Housing
Food Assistance
Other Supports & Services
Goals
*Facilitate consumer choice in a care setting*Achieve cost savings for the consumer and Iowa’s Medicaid program
Adult Day Services
Discharge Referral
Received From Hospital Case Manager and
AAA is Contacted
Assessment Completed Including
Level of Risk
Hospital Staff Huddle Update on Consumer
Enter Information into TAV and
Wellsky
Hos
pita
lA
rea
Age
ncy
o
n A
gin
gP
rovi
der
P
artn
ers Referrals Made
To Other Agencies
According to Need
Enter Early Identified
Barriers and Comments into
TAV and Wellsky
Options Counselor Meets With Consumer &
Completes Intake
Contact Consumer within 2 Days. Coordinate/
Prioritize with Consumer
Initial Home Visit To Identify Needs,
Barriers and Develop Care Plan
Follow Up After
Discharge For
Performance Evaluation
Provide RTC Options
Counseling & Services up to
90 days
If Assistance is Needed after 90
Days, Refer to Case Mgmt
OAA Programs & Services
Consumer Discharged To
Facility?
LTC
Faci
lity
Consumer is Transferred to
Facility
Consumer Appears on TAV Dashboard /
Information Faxed To AAA
No
Yes
Receive Referral of
Pending Discharge
Options Counselor
Meets With Senior to
Introduce RTC
Person Center
Planning With Senior
Begins
Make Referral
Make Referral
Process Stages
Referral
Admitted
Discharge
Discharge With
Appropriate Services in
Place
Consumer Information & Needs Entered
into TAV
Emergency Response System