west central nebraska area agency on aging updates to the ...dhhs.ne.gov/medicaid sua/wcnaaa...

West Central Nebraska Area Agency on Aging

Updates to the SFY 2020-2021 Area Plan

July 1, 2019 through June 30, 2023

Annual Budget

July 1, 2020 through June 30, 2021

Grantor: State Unit on Aging Division of Medicaid & Long-Term Care Department of Health & Human Services P.O. Box 95026 Lincoln, NE 68509

WCNAAA ADVISORY REVIEW STATEMENT FY 2020-21

1. This review was made at the Advisory Committee meeting on April 30, 2020 2. The Advisory Committee for the West Central Nebraska Area Agency on Aging, has

reviewed the Area Plan Application for this Area Agency on Aging and has the following attached comments.

Attach other comments on separate pages(s) as needed.

Would like to see increased funding for senior centers.

3. Specify groups and/or agencies which have been involved in the development of this plan.

Attach additional page(s) as needed.

Area J Advisory Committee, WCNAAA Governing Board,. WCNAAA staff, Meal Site, Satellite and Senior Center participants, Senior Center Directors and Boards, Nebraska State Unit on Aging.

The West Central Nebraska Area Agency on Aging Advisory Committee recommends that the DHHS State Unit on Aging approve the FY 2017-19 Area Plan.

[gl YES D NO

Signed:

Date: i./-/3o / c::<o I I

May 8, 2020

WCNAAA

FY 2020-2021

May 8, 2020

Cover Page Application Review Statement

Table of Contents

Section A Administrative

Agency Mission and History 1 Demographics 2 Agency Services 2-7 Description of WCNAAA Staff 8

Governing Board Members 9 Area “J” Advisory Council 10

WCNAAA Organizational Chart 11

Section B Program Goals, Objective, and Strategies Goal #1 Advocacy 1 Goal #2 Protect Rights and Prevent Abuse 2 Goal #3 Individual Self-Determination & Control 3 Goal #4 Long-Term Services and Supports 4 Goal #5 Effective and Responsive Management 5-6 Planning Process 7-12

Section C Service

Units of Service 1 Service Narrative 13 Contractor/Sub-awards 1-6

Section D One Year Budget Budget 1-14 Section E Centers (submitted Section F Disaster Plan Introduction 1 Situation and Assumptions 1 Concept of Operations 2-3 Organizational Roles and Responsibilities 3 Emergency Contacts 4 Agency Emergency Contact Numbers 5 Agency Emergency-Bad Weather 5 Identification of Vulnerable Clients 6

Disaster Intake Form 6-7 Client Check-Up List 8 Disaster Plans 9-17 Emergency Contacts 18-26 Senior Center Emergency Procedures 26-33 Pandemic Influenza Plan 34-38

WCNAAA

FY 2020-2021

May 8, 2020

Section G Direct Service Waiver Section H Care Management Section I Supplemental Documentation Legal Provider Contract and Pre-award Checklist

SECTION A

ADMINISTRATIVE

WCNAAA SECTION A SFY 2020-2021

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Description of West Central Nebraska

Area Agency on Aging

Agency Mission and History Mission West Central’s mission is to develop community focal points designed to provide comprehensive and coordinated delivery systems for supportive and nutritional services. The goal of the system is to assist older Nebraskans in: 1) attaining maximum independence in a home environment; 2) removing individual and social barriers to economic and personal independence; 3) maintaining and enhancing the quality of life; 4) eliminating premature institutionalization; and 5) providing for the at-risk older population. Organizational History The Older Americans Act of 1965 was the first comprehensive legislation for older people. The focus of this Act was on nursing homes and other institutionalized 24-hour care. In 1971, the White House Conference on Aging dealt with a broader range of services which allowed older people to stay in their own homes as long as possible. Subsequently, the Older Americans Act was revised emphasizing the need to provide the supportive services necessary to allow for older persons to live in their own homes with the greatest amount of dignity and independence possible. This change in emphasis was brought about because of the statistical awareness that an overwhelming percentage of older people in this country live independently. Only a small percentage of individuals live in a nursing or other group care facility. The revision of the Older Americans Act in 1973 provided for the establishment of state units on aging and the designation of area agencies on aging throughout the various states. The legal authority for the establishment of area agencies on aging all across the Nation derives from Title lll of the Older Americans Act Comprehensive Service Amendment. These grass root organizations helped establish needed aging services. The West Central Nebraska Area Agency on Aging was established in 1978 to develop and coordinate services for senior citizens in a seventeen county area of West Central Nebraska. The goal of the Agency is to improve quality of life of older Nebraskans, which in turn increases independence in their own homes. Programs are funded with the support of Federal, State and Local government funds and contributions made by older Nebraskans. In 1982, the Nebraska Legislature passed legislation providing State funding for aging services in Nebraska. Likewise in 1989, the Legislature passed LB-42 authorizing the provision of long-term care services. In 1998, West Central joined with the other area agencies on aging in the State and implemented the Senior Care Options program within the seventeen counties served. In 1998, West Central, in cooperation with the Nebraska Health and Human Services System, assumed the administration of the Aged and Disabled Medicaid Waiver program.


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Demographics West Central’s service area consists of seventeen counties located in the sand hills of Nebraska. The counties include: Arthur, Chase, Dawson, Dundy, Frontier, Grant, Gosper, Hayes, Hitchcock, Hooker, Keith, Logan, Lincoln, McPherson, Perkins, Red Willow and Thomas. All counties participate in the service area except: Hooker and Red Willow. However, the City of McCook participates in the program. Limited service is provided in the non-participating areas. The majority of PSA “J” is rural in nature and as with most rural areas; the senior population is growing, requiring additional services. 2010 Census Information According to the 2010 Census information the seventeen county PSA has experienced a total overall population decline of approximately 1% between 2000 and 2010. However, the over 60 population has experienced an approximate 3% overall population increase between 2000 and 2010. The seventeen county service area has 23% over 60 population. There has been a 45% increase of the minority 60+ population from 559 in 2000 to 1009 in 2010

Agency Services WCNAAA has designated nineteen full service Senior Centers, as community focal points along with three meal sites and five satellite sites. In order to be a full service Senior Center, a center must provide meals five days a week and provide a wide array of supportive services. Satellite sites and Meal sites alone are not counted as focal points. 1. Personal Care Assistance with Activities of Daily Living (ADLs) and/or health-related tasks provided in a person’s home and possibly other community settings. Personal care may include assistance with Instrumental Activities of Daily Living (IADLs). Contracted service provided in all seventeen counties in PSA “J”. 2. Homemaker Performance of light housekeeping tasks provided in a person’s home and possibly other community settings. Task may include preparing meals, shopping for personal items, managing money, or using the telephone, in addition to light housework. Contracted service provided in all seventeen counties in PSA “J”. 4. Home Delivered Meals A meal provided to an OAA qualified individual in his/her place of residence. The meal is served in a program administered by SUAs and/or AAAs and meets all the requirements of the Older Americans Act and all applicable laws. Meals provided to an individual through means-tested programs may be included. Caregivers (Older Relative or Family) can receive III-E funded Home Delivered Meals. If III-E is used to fund the meal, the meal should be counted under Caregiver Supplemental Services. Contracted services provided in Chase, Dawson, Dundy, Frontier, Gosper, Hayes, Hitchcock, Keith, Lincoln, Logan, Perkins and Red Willow counties.

7. Assisted Transportation Services or activities that provide or arrange for the travel, including travel costs, of individuals from one location to another. This service includes escort or other appropriate assistance for a person who has difficulties (physical or cognitive) using regular vehicular transportation. Does not include any other activity. Contracted service provided in all seventeen counties in PSA “J”.


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8. Congregate Meals A meal provided by a qualified nutrition project provider to a qualified individual in a congregate or group setting. The meal is served in a program that is administered by SUAs and/or AAAs and meets all the requirements of the Older Americans Act and State/Local laws. Meals provided to individual through means-tested programs may be included. Contracted services provided in Arthur, Chase, Dawson, Dundy, Frontier, Gosper, Grant, Hayes, Hitchcock, Keith, Lincoln, Logan, Perkins and Red Willow counties. 10. Transportation Services or activities that provide or arrange for the travel, including travel costs, of individuals from one location to another. Does not include any other activity. Contracted service provided in all seventeen counties in PSA “J”. 11. Nutrition Education A targeted program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information that is consistent with the current Dietary Guidelines for Americans and instruction to participants, caregivers, or participants and caregivers, overseen by a dietitian or individual of comparable expertise. Contract and Direct Service provided in Arthur, Chase, Dawson, Dundy, Frontier, Gosper, Grant, Hayes, Hitchcock, Keith, Lincoln, Logan, Perkins and Red Willow counties. 12. Information and Assistance Also known as Basic Information. A service that:

• provides the individuals with current information on opportunities and services available to the individuals within their communities, including information relating to assistive technology;

• assesses the problems and capacities of the individuals; • links the individuals to the opportunities and services that are available; and to the

maximum extent practicable, ensures that the individuals receive the services needed by the individuals, and are aware of the opportunities available to the individuals, by establishing adequate follow-up procedures. Contracted service provided in all seventeen counties in PSA “J”.

13. Health Promotion-Disease Prevention (Evidence Based) Activities related to the prevention and mitigation of the effects of chronic disease (including osteoporosis, hypertension, obesity, diabetes, and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, stress management, falls prevention, physical activity, and improved nutrition). Activities must meet ACL/AoA definition for an evidence-based program, as presented on ACL's website. Contracted and Direct service provided in Dawson, Keith, Lincoln, Perkins and Red Willow counties. 14. Health Promotion-Disease Prevention (Non Evidence Based) Health promotion and disease prevention activities that do not meet ACL/AoA definition for an evidence-based program as defined at ACL's website. Activities may include those defined in the OAA (Section 102(14). Contracted and Direct services provided in Chase, Dawson, Dundy, Frontier, Gosper, Hayes, Hitchcock, Keith, Lincoln, Perkins and Red Willow counties.


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16. Legal Assistance Legal advice and representation provided by an attorney to older individuals with economic or social need, and in the implementing regulation at 45 CFR Section 1321.71, and includes to the extent feasible, counseling or other appropriate assistance by a paralegal or law student under the direct supervision of an attorney. Contracted service provided in all seventeen counties in PSA “J”. 20. Care Management Assisting a client to identify and utilize services needed to assure that the client is receiving, when reasonably possible, the level of care that best matches his or her level of need. The Care Management Unit, through its Care Management Unit Supervisor and staff of care managers, assists clients with services as specified in the [Care Management] Act, including ongoing consultation, assessment, Long-Term Care Plan development, and referral for clients in need of long-term care; coordination of the Long-Term Care Plan; monitoring of the delivery of services for clients, and review of the client's Long-Term Care Plan. Provided in all seventeen counties in PSA “J”. 22. Senior Center Hours The hours of multipurpose senior centers are open to older individuals. Sites that only offer meals (also known as Nutrition Sites) should not be included. Contracted services provided in Chase, Dawson, Dundy, Frontier, Gosper, Hayes, Hitchcock, Keith, Lincoln, Perkins and Red Willow counties. 23. Material Distribution The provision of goods to an older individual at no cost or at a reduced cost which will directly support the health and independence of the individual with an assessed need. This can include: commodities, pantry items, clothing distribution, smoke detectors, eyeglasses, hearing aids, oral health, etc.

This also includes Emergency Response Systems (ERS, Personal Emergency Response System, PERS). An Emergency Response System is an electronic device and has portable buttons (including pendants and bracelets) worn by the customer. These units provide 24-hour on call support to the customer having a medical or emergency need that could become critical at any time. ERS can be landline or cell phone based services.

Previously counted in Durable Medical Equipment and Emergency Response System. This is no longer limited to medical equipment, adaptive devices, or assistive technology. Contracted and Contracted service provided in all seventeen counties in PSA “J”. 24. Social Activities Provision of activities which foster the social well-being of individuals through social interaction and the satisfying use of leisure time. Activities, such as performing arts, games, and crafts, either as an observer or as a participant, facilitated by a provider. This service covers activities at the provider’s location (i.e. senior center) or should be organized/planned by the provider (senior center). Contracted services provided in Chase, Dawson, Dundy, Frontier, Gosper, Hayes, Hitchcock, Keith, Lincoln, Perkins and Red Willow counties.


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25. Counseling The Senior Health Insurance Information Program (SHIIP) numbers are included in this service. Through a regional (SHIIP) representative and volunteers throughout the PSA counseling and assistance are provided for Medicare, private insurance and other financial issues. Most generally the SHIIP representative, assistant or trained volunteer meet one on one with clients to discuss signing up for Medicare, Social Security or any difficulties the client is having with these and other programs. Medicare Part D is a major program year round, but specifically during the annual open enrollment period. Clients are counseled on what options are most beneficial to them, but the client makes the decision as to what prescription plan they choose. Senior Medicare Patrol (SMP) units are also included in this service. The same representative and volunteers consult with clients concerning Medicare, Medicaid or private insurance fraud and scams. Contracted-provided in all seventeen counties in PSA “J”. 27. Outreach An interactive activity that conveys information about available services, aging, or the aging network. It includes in-person interactive presentations, booth/exhibit at a fair, conference, or other public event. This service includes Public Education and Presentations.

When the topic is Medicaid related, it may be MAC Eligible. See the Medicaid Administrative Claiming (MAC) section.

Previously the ACL defined this as a one-on-one intervention by the service provider. The ACL has removed Outreach as a federal service. The state has created a new service called Outreach. Contracted-service provided in all seventeen counties in PSA “J”. 28. Information Services A media activity that conveys information about available services, aging, or the aging network. It is a one way mode of communication. Examples include: Facebook posts, TV Ads/PSAs, radio ads/PSAs, website hits, brochures, newspaper ads, press releases. When counting brochures and other print media as Information Services, it should be counted when the cost is incurred (when the brochures are printed, when the newspaper ad is billed).

When the topic is Medicaid related, it may be MAC Eligible. See the Medicaid Administrative Claiming (MAC) section. Previously Information Services IIIB and/or Public Information. Contract and Direct Service- service provided in all seventeen counties in PSA “J”.

29. Legal Outreach An interactive activity that conveys information about legal issues, including but not limited to:

• Powers of Attorney • Wills • Health Care Directives • Reverse Mortgage • Social Security Benefits • Medicaid/Medicare

Legal Outreach includes in-person interactive community education presentations by an attorney or a staff supervised by an attorney at senior centers, conferences, or other public event. Legal Outreach does not include information provided by staff or an attorney at a booth/exhibit at a fair, or a conference or other public event. When the topic is Medicaid related, it may be MAC Eligible.


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See the Medicaid Administrative Claiming (MAC) section. Contracted service provided in all seventeen counties in PSA “J”. 32. Caregiver Respite Service which offer temporary, substitute supports or living arrangements for care recipients in order to provide a brief period of relief or rest for caregivers. Contracted service provided in all seventeen counties in PSA “J”. 33. Caregiver Supplemental Service Goods and services provided to complement the care provided by caregivers. If a Family Caregiver and Older Individual receive a Home Delivered Meal, the Family Caregiver Home Delivered Meal should be counted under Caregiver Supplemental Services. ERS services for the Care Recipient should be recorded under this service. The Client is the Caregiver. Contracted service provided in all seventeen counties in PSA “J”. 34. Caregiver Assistance Provided to a caregiver, at the direction of the caregiver:

• by an individual who is trained or experienced in the case management skills that are required to deliver the services and coordination described in subparagraph; and

• to assess the needs, and to arrange, coordinate, and monitor an optimum package of services to meet the needs, of the caregiver; and

Includes services and coordination such as— • comprehensive assessment of the caregiver (including the physical, psychological, and

social needs of the individual); • development and implementation of a service plan with the caregiver to mobilize the

formal and informal resources and services identified in the assessment to meet the needs of the caregiver, including coordination of the resources and services—

o with any other plans that exist for various formal services; and o with the information and assistance services provided under the Older Americans

Act; coordination and monitoring of formal and informal service delivery, including coordination and monitoring to ensure that services specified in the plan are being provided;

o periodic reassessment and revision of the status of the caregiver; and o in accordance with the wishes of the caregiver, advocacy on behalf of the

caregiver for needed services or resources. Contracted service provided in all seventeen counties in PSA “J”.

36. Caregiver Assistance-Information & Assistance • provides the individuals with current information on opportunities and services available to

the individuals within their communities, including information relating to assistive technology;

• assesses the problems and capacities of the individuals; • links the individuals to the opportunities and services that are available; and


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• to the maximum extent practicable, ensures that the individuals receive the services needed by the individuals, and are aware of the opportunities available to the individuals, by establishing adequate follow-up procedures. Contracted service provided in all seventeen counties in PSA “J”.

38. Caregiver Information A media activity that conveys information to caregivers about available services, aging, or the aging network. It is a one way mode of communication. Examples include: Facebook posts, TV Ads/PSAs, radio ads/PSAs, website hits, brochures, newspaper ads, press releases. When counting brochures and other print media as Information Services, it should be counted when the cost is incurred (when the brochures are printed, when the newspaper ad is billed). When the topic is Medicaid related, it may be MAC Eligible. See the Medicaid Administrative Claiming (MAC) section. Contracted and Direct Service-service provided in all seventeen counties in PSA “J”. SMP The Agency began participating in this program in 2010 through an SMP Expansion Grant. This program is also facilitated by the Agency’s Public Benefits Coordinator recruiting and training program specific volunteers and providing public awareness programs about Medicare fraud and waste. Provided in all seventeen counties in PSA “J”. Level of Care The Agency contracts with the Nebraska Department of Health and Human Services to provide this service. Medicaid and Medicaid eligible clients that have pending nursing facility admissions are screened by Agency staff to ensure they meet nursing facility level of care. The client is also provided information about alternatives to nursing facility care. Contracted-provided in all seventeen counties in PSA “J”. Medicaid Waiver The Agency contracts with the Nebraska Department of Health and Human Services to provide this service. Persons 65 years of age and older that meet nursing facility level of care and have pending nursing facility admissions and are eligible for Medicaid are provided information about alternatives to nursing facility admission. If they prefer a less restriction setting and choose to accept supportive services, participate in a needs assessment and can be safely placed in an assisted living facility or remain at home they can accepted into the program and are assigned a service coordinator. Contracted-provided in all seventeen counties in PSA “J”.


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Description of WCNAAA Staff

Full-Time Employees Executive Director Linda Foreman, CSW Fiscal Officer Sandra Matson Fiscal Specialist Cheyenne Shaner Fiscal Assistant/NAMIS Connie Childers Receptionist Ruth Van Horn Public Benefits Specialist/SHIIP/SMP Rep. Rhonda Godbey Choices Supervisor Torey Franzen, RN, BSN Aged & Disabled Medicaid Waiver/LOC Service Coordinator JerriAnne Snyder, BS Aged & Disabled Medicaid Waiver/LOC Service Coordinator Amy Young, RN Aged & Disabled Medicaid Waiver/LOC Service Coordinator Amanda Arensdorf, RN Aged & Disabled Medicaid Waiver/LOC Service Coordinator Nancy Peartree, BS Aged & Disabled Medicaid Waiver/LOC Service Coordinator Tanya Ruppert, BAAS Care Manager Connie Malone, RN Care Manager Shyenne Cooper, BA Assoc. Care Manager Teri Pokorny, LPN Resource Developer Billie Friehage Information & Referral Debra Dike Part-Time Employees SHIIP/SMP Shirley Lake

WCNAAA FY 2020-21

May 8, 2020 9

ARTHUR COUNTY RON JAEGLER DUNDY COUNTY RICHARD (Bart) BARTHOLOMEW GRANT COUNTY DAN VINTON KEITH COUNTY KIM ELDER MCPHERSON COUNTY BRETT NASON

Governing Board CHASE COUNTY JACCI BROWN FRONTIER COUNTY J.R. HOUSER HAYES COUNTY WAYNE CHRISTNER LINCOLN COUNTY WALT JOHNSON-TREASURER PERKINS COUNTY SID COLSON

DAWSON COUNTY P.J. JACOBSON GOSPER COUNTY GLEN MONTER –CHAIR

HITCHCOCK COUNTY PAUL NICHOLS

LOGAN COUNTY LEE WONCH-VICE CHAIR THOMAS COUNTY PAMELA MOODY

WCMAAA SECTION A FY2020-2021

May 8, 2021 10

AREA “J” ADVISORY COUNCIL Doug Hjelmstad Ruth Jurgens Dixie Dreher Dundy County Frontier County Gosper County Mary Nichelson Ruth Ann Hess Sandy Widholm Frontier County Dawson County Dawson County Virginia Deaver Bill Jividen Ken Niedan Perkins County Logan County Lincoln County Barbara Wegner David Yost Dawson County Keith County Earl Jones John Anderson Lincoln County Red Willow County

WCNAAA

Full-Time Employees Executive Director Fiscal Officer Fiscal Specialist Fiscal Assistant/NAMIS Receptionist

SECTION A

Description of WCNAAA Staff

Public Benefits Specialist/SHIIP/SMP Rep. Choices Supervisor Aged & Disabled Medicaid Waiver/LOC Service Coordinator Aged & Disabled Medicaid Waiver/LOC Service Coordinator Aged & Disabled Medicaid Waiver/LOC Service Coordinator Aged & Disabled Medicaid Waiver/LOC Service Coordinator Aged & Disabled Medicaid W aiver/LOC Service Coordinator Care·Manager Care Manager Assoc. Care Manager Resource Developer Information & Referral

Part-Time Employees SHIIP/SMP

APRIL 1, 2019

SPY 2020-2023

Linda Foreman, CSW Sandra Matson Cheyenne Shaner Coru1ie Childers Ruth Van Horn Rhonda Godbey Torey Franzen, RN, BSN JerriAnne Snyder, BS Amy Young, RN Amanda Arensdorf, RN Nancy Peartree, BS Tanya Ruppert, BAAS SusanAnclerson;CSW · · Shyenne Cooper, BA Teri Pokorny, LPN Billie Friehage Debrab1ke ·

Shirley Lake

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WCNAAA SECTION A FY2020-2021

May 8, 2020 11

WEST CENTRAL NEBRASKA AREA AGENCY ON AGING

ORGANIZATIONAL CHART

Medicaid

19 Senior Centers

4 Satellites Meal Sites 3 Meal Sites


Board of Directors


Area J Board

Executive Director Linda Foreman

Administrative Unit

Fiscal Officer Sandra Matson

Program Supervisor Torey Franzen, RN

Title III Unit

Public Benefits Specialist / SHIIP / SMP

Rhonda Godbey

SHIIP / SMP Shirley Lake

Legal Aid of

Nebraska

Resource Developer Billie Freihage

Program Coordinator

Vacant

Receptionist Vicki Gleason Information

& Referral Deb Dike

Independent Contractor Providers

Registered Dietician Consultant

Heidi Wietjes,MS,RD

Care Managers /Assoc. Care Managers

Teri Pokorny, LPN, Assoc CM Connie Malone, RN, CM

Shyenne Cooper, BA Medicaid Waiver

Service Coordinators Amanda Arensdorf, RN Nancy Peartree, BS Tanya Ruppert, BA JerriAnne Snyder Amy Young, RN

Medicaid Waiver/LOC

Program Unit

Care Management / Family Care

Giver Program Unit

Program Supervisor Torey Franzen, RN

Fiscal Specialist Angela Barkmeier

SECTIONB

PROGRAM GOALS, OBJECTIVE, AND STRATEGIES

WCNAAA SECTION B FY 20-21

1 May 8, 2020

Federal Goals


Federal Goals 2020-2021 Goal 1: Advocacy Advocate to ensure the interests of people with disabilities, older adults, and their families are reflected in the design and implementation of public policies and programs. Objective 1: Involvement in the process at the Federal, State and local level to ensure the needs of the public with disabilities, older adults and their families are known and addressed in the agencies services.

Strategy: Increase public awareness through public speaking and social media. Performance Measure: 1. Evidenced by promoting public awareness of the Agency annually through public

speaking and social media with a 1% increase public speaking events and social media followers. Baseline for public speaking: 10 Baseline for social media: 152 likes on Facebook FY 18-19 was the introduction of Facebook for WCNAAA so the 152 likes were a starting point. FY 19-20 the 1% was met with public speaking events and Facebook likes of 29,039

Objective 2: Engage Federal, State, and Local policy makers and other partners to ensure existing policies and programs optimally reflect the interest of people with disabilities, older adults, and their family members.

Strategy: Communicate and educate Federal, State, and Local policy members to influence public policy related to people with disabilities, older adults, and their family members.

Performance Measure: 1. Minimum of 1 contact with local State Senators per year.

Baseline for Senators: 1 Goal not met, met with Senator Groene one time

2. Increase number of NE4A annual meetings with the Director of Medicaid by 1%. Baseline for director of Medicaid: 3 Goal met, attended three NE4A meetings with the Director of Medicaid


2 May 8, 2020

Goal 2: Protect Rights and Prevent Abuse Protect and enhance the rights; and prevent the abuse, neglect, and exploitation of older adults and people with disabilities. Objective 1: Educate public and professionals on the rights and prevention of abuse, neglect, and exploitation of older adults and people with disabilities.

Strategies: 1. Provide public education presentations annually about protecting, detecting and reporting

fraud, abuse, financial exploitation and legal services. Senior Medicare Patrol Program volunteers network with events such as Shred-it Day and health fairs.

2. Distribute material and conduct educational programs for senior centers, service providers and civic group about the toll-free ElderAccess Line available throughout the state to provide legal service for the 60+ population.

3. Provide information about rights and abuse to all Agency clients when initial assessment is completed.

Performance Measures: 1. Evidenced by the increase public presentations and social media awareness about

protecting, detecting, reporting fraud, abuse and financial exploitation by 1% annually. Baseline for presentations: 33 Goal was met, this would be included in the public speaking events and Facebook likes of 29,039

2. Evidenced by the increased number of units reported for the usage of the ElderAccess

Line from the PSA by 1% annually. Baseline for ElderAccess Line units: 278 Goal was met with 302 units being reported. Will continue to provide public awareness for program. Currently have improved Legal Outreach which should help awareness of the ElderAccess Line

3. Evidenced by maintaining client awareness by Care Managers providing Elder Abuse brochures and covering the material in the brochure with all new clients and with current clients at their annual review. Baseline for brochures to Care Management clients: 204 Goal has been met with materials provided to 266 Care Management clients. Care Managers provide a brochure and verbally cover the information with each new client and reassessment.


3 May 8, 2020

Goal 3: Individual Self-Determination & Control

Work with older adults and people with disabilities as they fully engage and participate in their communities, make informed decisions, and exercise self-determination and control about their independence, well-being, and health.

Objective 1: To provide education, information and support to enable consumer to make informed choices.

Strategies: 1. Provide older adults and people with disabilities, information, education, and counseling

on their options to live as independently as possible in the community. 2. Continue to provide grants to clients for consumer directed services through the Care

Management and Family Caregiver Programs. Using a mutually agreed upon authorized care plan, consumers are to determine such things as the Agency approved provider of their choice for services, client scheduling time of those services, and budget control over the hourly rate paid for authorized services.

3. Make available a variety of programs for consumers to choose participation, including evidenced based programs.

4. Work with Senior Centers and Meal Sites to identify ways to minimize annual decrease of meal numbers in both congregate and home delivered meal programs.

Performance Measures: 1. Evidenced by increasing number of Information and Assistance units provided to

potential clients annually by 1%. Baseline: 19,476 units Goal not met with 17,177 units. Will investigate how units are reported.

2. Evidenced by increasing Care Management clients annually by 1% Baseline: 204 Care Management clients Goal met with 266 clients Evidenced by increasing FCSP clients annually by 2%. Baseline: 225 FCSP clients. Goal met with 248 clients Evidenced by increasing the number of clients served by Health Promotion/Disease Prevention Evidence-Based programs offered annually by 1%. Baseline: 125 clients Goal not met with 121 clients, a couple of centers lost their group instructors Evidenced by increasing the number of Health Promotion/Disease Prevention (Non-Evidence-Based) units annually by 1%. Baseline: 475 clients Goal met with 533 clients

3. Evidenced by maintaining the number of Congregate meals served annually. Baseline: 159,656 Goal not met with 152,810 decline due to death, low attendance by younger seniors Evidenced by maintaining the number of Home Delivered meals served annually.

Baseline: 73,148 Goal not met with 69,557and more clients going to AL , LTC and living with family


4 May 8, 2020

Goal 4: Long-Term Services and Supports Enable people with disabilities and older adults to live in community through the availability of, and access to high-quality long-term services and supports, including supports for families and caregivers. Objective: Assist seniors in accessing home and community based services, which can delay entry into nursing homes and providing support for family caregivers.

Strategies: 1. Provide outreach, information & assistance, legal and case management through the Care

Management and Family Caregiver Support Programs and through community focal points...

2. Maintain a comprehensive directory of available public and private resources that includes formal and informal community based services for use in referral activities for consumers.

3. Work with state and community leaders towards the development of coordinated transportation systems within our PSA.

4. Provide continuing education for focal points on assisting seniors in accessing services. 5. Providing community focal points through multipurpose senior centers for nutritional

meals, health programs and socialization.

Performance Measures: 1. Evidence by increasing the number of units of Outreach by 1% annually.

Baseline: 1,980 activities Goal not met with 1,443 units, reporting is questionable as to the understanding of Outreach

2. Evidence by maintaining comprehensive directory annually. Comprehensive directory is maintained and available at the front desk

3. Evidenced by increasing the units of transportation provided for clients by 1% annually. Baseline: 14.500 one-way trips Goal met with 14,926 units Evidenced by increasing the units of assisted transportation provided for clients by 1% annually. Baseline: 244 one-way trips Goal not met with 231 units. Due to decrease requests for this service

4. Evidenced by holding 2 senior director educational meetings annually. Baseline: 2 meetings annually Goal met in August 2018, three sessions were held in Cozad, Sutherland and Stratton for education of directors for Medicaid Waiver program, by Waiver staff May 30, 2019 educational program for all directors in North Platte

5. Evidenced by maintaining the number of community focal points currently in operation annually. Baseline: 19 Goal met with 19 community focal points


5 May 8, 2020

Goal 5: Effective and Responsive Management Implement management and workforce practices that support the integrity and efficient operations of programs serving people with disabilities and older adults and ensure stewardship of taxpayers’ dollars.

Objective To ensure sound management and business practices that provide for good stewardship of both financial and human resources.

Strategies: 1. Routinely review and update policies and procedures as needed. 2. Continue in-depth assessments of Sub-Award recipients annually and require

corrections of deficiencies. 3. Update technology as needed to ensure staff have the tools available to do their job to

the best of their ability. 4. Consult with contracted professionals to ensure a clear understanding of audit and

legal guidelines are adhered to. 5. Participate in training for SUA new software. 6. Work for successful implementation of new system from SUA.

Performance Measures: 1. No annual findings from the APA and independent auditor concerning policies and

procedures. Baseline: 1 finding from APA Goal not met with 2 findings from APA, both have been corrected and approved by SUA and Agency auditor

Finding #1 Each month the WCNAAA prepares a journal entry to allocate mileage costs of their agency-owned vehicles to its various programs. The amount is determined by taking the miles driven in the agency’s vehicles and applying the GSA standard mileage rate of $.545 for each mile driven. This is not an allowable expense under the Uniform Grant Guidance because it does not represent an actual expense – there was no payment made for this expense. Applicable vehicle expenses would be for gasoline, maintenance, and depreciation. The total amount charged to the programs in July 2018 was $3,929.20. The WCNAAA should work with the SUA to reimburse for the unallowable cost. The charges was split between the programs as follows:

The APA tested a $4,983 payment for vehicle insurance. There are six vehicles, so each vehicle was assigned an equal share of the insurance cost, or $830.50 each. Four of the six vehicles were charged to local funds. However, one vehicle’s insurance expense was charged to IIIB and one vehicle’s insurance was charged to IIIE. The WCNAAA indicated that these two vehicles were purchased with IIIE and IIIB funds, so that is how they were advised to allocate the costs. However, the Uniform Grant Guidance requires that costs be allocated based on the relative benefits received and these two vehicles are used by various programs. The WCNAAA already tracks the miles driven in each of the vehicles by program, so the documentation is already available to allocate the costs to each program based on the mileage driven.

Mileage now charged per actual expenses


6 May 8, 2020

Finding #2 Community Action Partnership of Mid-Nebraska: This subrecipient included income from its Head Start Program in the amounts reported to WCNAAA. This income from another Federal program, was then included as Local Other Cash and reported to the SUA as income. For July 2018, the amount was $1,661.78.

The requirements set forth in the Uniform Grant Guidance at 2 CFR 200.306(b) states, in part, the following:

For all Federal awards, any shared costs or matching funds and all contributions, including cash and third party in-kind contributions, must be accepted as part of the non-Federal entity's cost sharing or matching when such contributions meet all of the following criteria:

Are not included as contributions for any other Federal award;

Are not paid by the Federal Government under another Federal award, except where the Federal statute authorizing a program specifically provides that Federal funds made available for such program can be applied to matching or cost sharing requirements of other Federal programs;

We recommend the WCNAAA work with the SUA to adjust its reports to remove the Head Start funding from its Local Other Cash matching amounts and ensure the appropriate level of match is obtained.

Head Start funding removed from Local Other Cash and all Local Other Cash reported by other sub-recipients corrected

2. Minimal findings annually in sub-award recipient assessments. Baseline: 2 findings or less per sub recipient assessment Goal met with two or less findings for sub-award recipients

3. Replace technology equipment as needed annually. Baseline: Upgrade 3 computers per year Purchase three new computers

4. Maintain open communications with SUA, APA and Agency auditor annually or as needed. Baseline: No findings for 2018-19 Agency audit or SUA monitoring visit Goal met 0 findings from Agency audit and SUA, open communication maintained

5. Attend training for SUA new software for replacement of NAMIS system. Baseline: Attend all trainings made available Agency has attended all trainings provided for PeerPlace and has successfully transferred to PeerPlace.

6. Implement use of new system as directed by SUA. Baseline: Successful implementation of new software system

Successful implemented PeerPlace

WCNAAA SECTION B FY2020-2021

Planning Process

West Central has a planning process which involves the general public, clients, client surveys, contractors, collaborating agencies and organizations, the PSA "J" Advisory Board and the Governing Board. The Agency program staff seeks input from all of the above mentioned resources in planning, developing and implementing programs. All input is evaluated in designing and implementing programs which are then approved by the PSA "J" Advisory Board and the Governing Board before being implemented into the Annual Area Plan and Budget. The agency as part of the Nebraska Associate of Agencies on Aging has participated in cooperative efforts with the National Association of Agencies on Aging, the State Unit on Aging, the gerontology department at UNO, AARP and Legal Aid of Nebraska to participate in needs assessments, surveys and focus groups to determine the needs across the state and specifically in the Area J PSA.

The Senior Centers have been identified as the focal points of their local communities and the surrounding area. Primary outreach starts at these focal points by providing brochures, current and pertinent information, newsletters, educational programs, local media advertising, community events, health fairs, senior information fairs as well as one on one contact. Programs from West Central are then organized and designed to reach and benefit the older individuals and their families. Several of the centers also provide services to satellite meal sites in nearby smaller communities. The Agency works to identify and encourage outreach and serves to those with low income, the greatest social and economic needs and minorities in the PSA.

Through the efforts of the Care Management and In-Home programs the Agency strives to assess, identity and meet the needs of those with self-care limitations as well as those with low income and the greatest social and economic need. The Agency does request a client contribution for its Care Management service and the In-Home services are provided on a sliding scale according to the client's ability to pay. An increased number of communities in the PSA "J" have an increased number of minority populations. To reach the minority population we have Spanish brochures available, work to provide information and educational programs to minority organizations such as NAP. If unable to meet the needs of a low-income and/or the minority individual, the Agency has developed collaborative relationships and partnerships with

I

other agencies to assist in meeting those unmet needs both socially and financially. In working with the rural population one of the greatest resources is the indigenous volunteers and community members who are relied on to identify and refer clients to the senior center and the Agency.

For the elder population in the PSA "J" the majority of programs offered by the Agency could be considered to assist in delaying institutionalization for those at risk. The LOC and Medicaid Waiver programs provide appropriate placement and offer the choice of a lesser level of care in assisted living or remaining independent at home with appropriate services. The Care Management and In-Home program provide services to maintain independence and delay institutionalization. The Family Caregiver Support Program provides respite for the caregiver to maintain their physical and emotional well-being so that they can continue to care for their loved ones at home. As well as providing lifelines so that at risk elders can continue to remain

May 8, 2020 7


independent. The Agency's congregate meal program not only meets nutritional needs, but also provides socialization for those folks at risk for social isolation. The Home-Delivered Meal program helps to enable clients that are at risk of institutionalization remain in their own homes with their nutritional needs being met. Most generally we find it is not just a single program, but a combination of several programs provided by the Agency that best meets the needs of the client.

The Agency has developed cooperative efforts with many area and community organizations. Within the Agency, much effort has been spent to bring together the central office and senior centers in the seventeen county PSA as one seamless organization. Care Managers and Service Coordinators visit centers to develop relationships and talk with potential clients. Senior center directors have been and will continue to be educated about Agency services and identifying potential referral clients within their community

Agency staff is involved and sit on the boards of; RSVP (community senior volunteer program) also hosting a volunteer permanently in-house and utilizing several volunteers for special projects; Home Health and Hospice services. Strong partnerships were developed and continue with Social Security, Extension offices and local community professionals in association with Medicare Part D. A close working relationship continues with local and area DHHS staff.

The Agency has developed a partnership with the area public health offices to offer flu and pneumonia immunizations to staff and seniors through clinics located at designated senior centers as well as providing health information programs at the senior centers.

Due to the Medicare Modernization Act through the Agency hosted SHIIP program many staff/volunteer hours and financial resources are devoted to the Medicare Part D Prescription Drug Program. The Agency has organized and leads a coalition in the Area "J" PSA with a goal to ensure that all qualified seniors, with a focus on low income individuals were provided and assisted with an opportunity to enroll in the program. Strong partnerships have been developed with the Social Security Administration, AARP, Senior Centers and area organizations to accomplish the goal. The Agency will continue this effort to the best of our ability with severely limited resources.

A. The Agency focuses resources on the older individual who have the greatest economic need as follows:

• Increased outreach to those that might qualify for the Low Income Subsidy for the Medicare Part D Prescription Drug Plan and those identified through the client intake forms that identify poverty.

• Developing partnerships and offering education programs to minority groups to help identify the needs of that population and those with limited English proficiency. Developing and distributing Agency brochures in Spanish to reach the increasing minority population in the PSA. Contracting with translators as needed.

• Increased effort to reach the most frail and oldest of the old, the 85+ population through the local Senior Centers, the community focal point and public education.

• Senior Center directors are provided with educational programs to help them identify this population in their communities. They are encouraged to provide

May 8, 2020 8


one on one communication with potential clients to inform them of the services available. Care managers and Service Coordinators visit senior centers quarterly to provide outreach for any potential client that has been identified by the director or any potential client that might want to meet with them.

• Increased public awareness of Agency services through public presentations and events with an emphasis on the most rural areas.

• Potential clients are informed of Agency services that are available to them and other community and state resources. If needed, assistance is provided by the senior center director or Agency staff to enable the potential client to access whatever services they might need.

B. The Agency focuses resources on the older individual with the greatest social need as follows:

• Identifying potential clients living alone through the client intake forms. • Developing partnerships and offering education programs to minority groups to

help identify the needs of that population and those with limited English proficiency. Developing and distributing Agency brochures in Spanish to reach the increasing minority population in the PSA. Contracting with translators as needed.

• Increased effort to reach the most frail and oldest of the old, the 85+ population as they are at increased risk of isolation, through the local Senior Centers, the community focal point and public education.

• Special attention is given to those clients that receive Home Delivered meals that are homebound.

• Increased public awareness of Agency services through public presentations and events with an emphasis on the most rural areas. Local contacts in the rural area are many times the best resource for identifying those at risk of isolation and/or institutionalization.

• Potential clients are informed of Agency services that are available to them and other community and state resources. If needed, assistance is provided by the senior center director or Agency staff to enable the potential to access whatever services they might need.

• We currently have one client that is Native American and no additional funding is received. Services are provided through the Medicaid Waiver Program.

C. The Agency focuses resources on the older individuals with self-care limitations and those with Alzheimer's disease or related disorders as follows:

• Many of the above mentioned clients are identified through the Care Management or the Family Caregiver Support Program assessment once the client or caregiver has been referred to the program.

• Most clients in the FCSP are caring for a loved one with dementia, respite care is greatly encouraged, but seldom used.

• Referrals are received from a variety of sources; hospitals, DHHS, the community in general, self-referral, family, friends, law enforcement, senior directors, etc.

• Dementia can be a single qualifying factor on the assessment. • The client/family and care manager develop a care plan to meet the client's needs. • The client/family is provided with grant funding so they might purchase the

needed services.

May 8, 2020 9


• Potential clients are informed of Agency services that are available to them and other community and state resources. If needed, assistance is provided by the senior center director or Agency staff to enable the potential to access whatever services they might need.

• Through the HID Health Promotion and Disease Prevention Evidence Based program, a caregiver program "Powerful Tools for Caregivers" is offered annually to help caregiver cope with the stresses of caregiving.

D. Describing how the agency establishes priorities and when the need arises, how the shift of priorities would occur;

• Client priorities are establish by identifying those clients with the greatest economic and social need. If it is found that a potential client is in an immediate crisis situation financially or socially, they become a high priority and are scheduled for assessment as soon as possible. Program criteria has been developed for decreased resources resulting in decreased client services.

• The Agency establishes priorities for both limited funding and staff resource allocation in several ways. In relationship to the central office and staff resources, operational expenses are held to essential expenses. Staff travel and education is limited to within the state and only attendance of essential meetings. If the need would arise staffing, central office expenses and travel would be evaluated with providing client services taking priority.

• Care Management clients are becoming more frail and requiring additional funding and services as are Family Caregiver Support program clients. Care managers are educated on outside funding resources (Medicaid, Block grant, DPFS, etc.) and In-Home funds are the last to be accessed if outside funding is unsuccessful. This has resulted in a lower usage of funding dollars and an increase in the numbers of clients the Agency is able to provide services for. The Lifespan Respite program has become a mainstay funding resource for qualifying clients and preserves IIIE funding for expanded services for additional clients.

E. Describe how current service utilization is integrated into your agency's planning process.

• Program utilization is evaluated each year, for instance the Agency has seen a steady decline in the utilization of congregate meals over the past several years and over the past couple of years we have seen a steady increase in Home Delivered Meals. During the planning process these numbers are assessed, decrease or increase as needed. Also, with the continued decline of Congregate Meals the Agency has been able to increase the amount reimbursed to contractors for both Congregate and Home Delivered Meals.

• Programs are evaluated annually for utilization and are adjusted accordingly. F. Describe your Area Agency on Aging 's efforts regarding coordinating Title III programs

with Title VI Native American programs, including potential opportunities for coordination with the Indian Health Services.

• The Agency does not receive Title VI funding. The 2010 census for Nebraska shows 1.3% Native American population and the agency shows an average of .68% for the area, which would be statistically insignificant. The agency has one Native American client whose needs are being met, including cultural sensitivities. The agency will work with the State Unit on Aging and the

May 8, 2020 10


Department of Indian Affairs to ensure needed services and resources are available for any potential Native American clients.

G. Describe how your Area Agency on Aging is strengthening and/or expanding Title III and Title VII services.

• Increased reimbursement for Congregate and Home Delivered meals. • Provide additional annual grant funding in UIB, UICI and UIC2 to senior centers

and meals to help ensure they are able to continue to provide services. • Providing presentations on SHUP, SMP, Legal and Elder Rights annually in all

seventeen counties and requesting courthouses. • Participating in annual state Elder Rights Seminars. • Promoting the ElderAccess Line throughout the seventeen PSA. • Review taxonomy to ensure PeerPlace reporting is accurate. • Provided training and worked monthly with contractors to ensure they are

reporting their units of service correctly. • Reviewed taxonomy with staff and contractors to ensure accuracy in reporting.

H. Describe how your Area agency on Aging is integrating Title III and VII with the following AoA Discretionary Grant initiatives:

• Evidence Based Disease Prevention Programs-The Agency has made training for evidence based programs available to staff, senior center directors and volunteers, they have been trained in Powerful Tools for Caregivers, Tai Chi, Moving for Better Balance and Stepping On ..

• The Lifespan Respite coordinator provides routine staff education programs and provider lists are shared. Care managers help clients with the Lifespan Respite application if they feel they will qualify for increased funding.

I. Describe the strategies your Area Agency on Aging will use in planning for the population increase of older adults and the recommended action that will be needed to meet the needs of older persons living in your services area:

• As noted previously, while the general population of the PSA declined approximately 1 %; the 60 and older population has increased by approximately 6.5% according to the 2010 census.

• Senior Centers are evaluating their community needs; specifically the younger older adults offer needed services. While in the past years the Title IIIC Meal programs have been a mainstay of the Agency, in recent years the UICI Congregate meals have declined due to several factors; death of previous participants, increasing numbers of participants residing in assisted living facilities and a declining participation in general. Providers are working to make meal sites welcoming to a new generation of 60+ year olds, putting more focus on consumer choices, educational and health related programs. The IIICII Home Delivered meal program has grown as previous CI participants are now disabled and not attending the congregate program and there are younger 60+ year old participant in poor health required Home Delivered meals.

• Increasing public awareness of available services. • Promoting Health and Wellness programs to enable the growing older population

to remain independent. More resources are allocated to the educational and health related programs at the Senior Center level. Transportation continues to be a

May 8, 2020


major barrier to services in the rural area with an increasing older population requiring services.

• The Evidence Based Disease Prevention Programs are an ever growing part of Agency programming, supported by additional grant funding under IIID Health Prevention and Promotion.

• Developing strong partnerships with other community resources, such as hospitals, long-term care facilities and the VA for early identification of the older population needing services and intervening before institutionalization is needed and follow-up services upon discharge to prevent readmission to facilities.

• Continuation of SMP which has been a great success in reaching the older population concerning Medicare fraud and waste.

J. Describe planned efforts to support consumer control and choice in Title III programs, e.g., consumer choice in providers, and/or use of vouchers. In addition, outline planned activities to promote consumer control and choice in non-OAAA programs such as Veterans Directed Home and Community Based Services:

• The Agency will continue to support the consumer driven choices in the Care Management and IIIE Family Caregiver Support program that was implemented several years ago. Once services are determined by the care manager and the client, the client is given a grant to fund the needed services and list of approved providers who are independent contractors. The client contacts the providers, choose the provider, sets the hours of service, directs that service and the pay rate is determined by the client and provider. The provider is paid by the client. Consumer controlled choices are also strongly adhered to with Medicaid Waiver program.

• At the senior center level several of the centers have gone to open dining and provide an approximately two hour window of time for consumers to choose when they would like to eat the noon meal. The Agency will continue to encourage more centers to provide this option to consumers.

K. Describe changes in response to the Fair Labor Standards Act, as it relates to overtime. • The NE4A hired a legal consultant to review the exempt and nonexempt

designations for their individual agencies. As a result of the review all agency positions except for executive director, fiscal officer and Choices supervisor were given non-exempt status and were changed from salaried to hourly. A time clock was installed. Overtime is strongly discouraged and supervisor approval is needed to work any overtime. If overtime does occur it is paid or the employees is encouraged to take comp. time if possible.

• With the status of provider over-time unknown at this time the Agency will continue to look to DHHS for guidance and implement any future requirements.

May 8, 2020 12

SECTIONC

SERVICES

WCNAAA

I' Service Name

5 6 7 8

9 10 11 12

13

14

34

35

36

37 38

p lions Counselln Transitional 0 lions Counselin Benefits Assistance Mobility Training

Units of Service

Service Unit

Hour Hour Hour Meal Meal Hour Hour

One-Wa Tri Meal Meal

Person Hour Hour Hour

Actlvit Activlt Act iv it

Hour Hour Hour Unit

Hour

Session

Contact

Contact Hour Hour Hour Hour

SECTION C FFY 2020-23

Units of Service 07/01/18. 07/01/19. 12131/18 06/30/20 Change(%) Actual

501 0.00% 9,254 0.00%

0.00% 36 709 73,418 0.00% 26 738 55, 198 3.22%

0.00% 0.00%

244 0.00% 79,828 159,656 0.00% 67, 194 142,470 6.01%

0.00% 14 500 1.44%

44 0.00% 19,476 0.00%

125 0.00%

475 0.00%

0.00% 35,519 0.00%

2,112 0.00%• 47,828 0.00%

0.00% 0.00%

1,980 0.00% 2,198 0.00%

8 0.00%

0.00% 0.00%

781 0.00% 128 0.00%

225 0.00%

0,00%

2,335 0.00%

0.00% 275 0.00%

0.00% 0.00% 0.00% 0.00% 0.00%

1 April 1, 2019

WCNAAA

Taxono my#

Service Name

13 Health Promotion/Disease Prevention Evidence-Based

14 Health Promotion/Disease Prevention Non Evidence-Based

State Aging Services

20 Care Management

28 Information Services 29 Le al Outreach

Caregiver Services

34 Caregiver Assistance: Case Mana ement

35 Caregiver Support Groups Caregiver Assistance: Information &

36 Assistance 37 Care

ADRC Direct Services 40 Information & Referral 41 Options Counseling 42 Transitional Options Counseling 43 Benefits Assistance 44 Mobility Training

10% Variance

SECTION C FFY 2020-23

Change (%)

0.00% 0.00% 0.00% 0.00% 3.22% 0.00% 0.00% 0.00% 0.00% 6.01% 0.00% 1.44% 0.00% 0.00%

0.00%

0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

0.00% 0.00% 0.00% 0.00%

0.00%

0.00%

0.00%

0.00%

0.00% 0.00% 0.00% 0.00% 0.00%

Variance Reason yellow Indicates a variance explanation Is required for that service(here) & a new

service template Is needed (word document).

The Agency is working to improve ourtriage of clients to the lllE FCSP which in turn decreases the number of clients in Care Management. In the past clients have been identified in Care Management that could have benefited from the lllE FCSP

April 1, 2019

2

I t !

'

f i

WCNAAA

Definition:

SECTION C

Service Narrative: 1. Personal Care

FY 2020-2023

Assistance with Activities of Daily Living (ADLs) and/or health-related tasks provided in a person's home and possibly other community settings. Personal care may include assistance with Instrumental Activities of Daily Livinq (IADLs). Service Unit: Hour I Setting: One-on-One I Reqistered Service Eligibility: Individual must be 60 years old or older Client Details: 181 Collect ADLs D Client may be Anonymous

181 Collect IADLs 181 Client may Self-Direct this Service

D Collect NRA Score D Client may use Voucher Other Reporting Requirements: N/A Possible Funding Sources: D 111-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State)

181 111-B (Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other

D lll-C2 (Home Delivered Meal) D Care Management (State)

lo May be MAC Eligible Provider A background check is suggested. This is a private business matter Requirements: and outside the scope of SUNDHHS.

Detailed description of how service is provided. • Is it a subaward, contract, direct service? • What counties are served this way? • What is the same? What's different about the service?

Contract-Centers/Counties: All seventeen counties in PSA "J"

This service was previously included in Self-Directed Care and has now been broken into an individual service.

Grants are provided to Care Management clients encouraging client-directed services in the client hiring independent contractors to provide personal care. Referrals are received from various sources such as hospitals, home health agencies, friends/families and potential clients themselves. Clients are contacted by the Care Management staff, a meeting is arranged, and assessment completed and client needs determined by the care manager and the client. The care manager authorizes, coordinates and monitors the services. Grants are provided to clients and the client then hires an independent contractor of their choice, sets the pay rate and hours of service. The Agency does provide a list of providers that have been signed up and had background checks done, but it is ultimately the client's choice as whom to hire. A monthly calendar is kept by the client and signed by both the client and provider and sent to the Agency and grant funds are provided to the client' to pay the provider. If the cost is higher than the amount provided by the grant, the client is the responsible to pay the difference. Most generally this service assists with a client's Activities of Daily Living which could include bathing, showering, dressing, getting in and out of bed or a chair (transfer), walking, using the toilet, and eating.

April 1, 2019

3

)

)

WCNAAA

Definition:

SECTION C

Service Narrative: 2. Homemaker

FY 2020-2023

Performance of light housekeeping tasks provided in a person's home and possibly other community settings. Task may include preparing meals, shopping for personal items, managinq money, or using the telephone, in addition to light housework. Service Unit: Hour I Settin~: One-on-One I Registered Service Eligibility: Individual must be 60 years old or older Client Details: 181 Collect ADLs ~ Client may be Anonymous

181 Collect IADLs 181 Client may Self-Direct this Service D Collect NRA Score D Client may use Voucher Other Reporting Requirements: N/A Possible Funding Sources: D 111-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State)

181 111-B (Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other D lll-C2 (Home Delivered Meal) D Care Management (State)

D May be MAC Eligible Provider A background check is suggested. This is a private business matter Requirements: and outside the scope of SUA/DHHS.

Detailed description of how service is provided. • Is it a subaward, contract., direct service? • What counties are served this way? • What is the same? What's different about the service?



Grants are provided to Care Management clients encouraging client-directed services in the hiring of independent contractors to provide homemaker services. Referral are received from various sources such as hospitals, home health agencies, friends/families and potential clients themselves. Clients are contacted by the Care Management staff, a meeting is arranged, and assessment completed and client needs determined by the care manager and the client. The care manager authorizes, coordinates and monitors the services. Grants are provided to clients and the client then hires and independent contractor of their choice, sets the pay rate and hours of service. The Agency does provide a list of providers that have been signed up and had background checks done, but it is ultimately the client's choice as whom to hire. A monthly calendar is kept by the client and signed by both the client and provider and sent to the Agency and grant funds are provided to the client to pay the provider. It the cost is higher than the amount provided by the grant, the client is the responsible to pay the difference. It mainly includes the Instrumental Activities of Daily Living which are related to living independently: light housework, preparing meals, managing money and shopping.

April 1, 2019

4

SECTION C

WCNAAA Service Narrative: FY 2020-2023 4. Home Delivered Meals

Definition: A meal provided to an OAA qualified individual in his/her place of residence. The meal is served in a program administered by SUAs and/or AAAs and meets all the requirements of the Older Americans Act and all applicable laws. Meals provided to an individual through means-tested programs may be included.

Caregivers (Older Relative or Family) can receive 111-E funded Home Delivered Meals. If 111-E is used to fund the meal, the meal should be counted under CareQiver Supplemental Services .. Service Unit: Meal I Setting: One-on-One I Registered Service Eligibility:

• Individual must be 60 years old or older & unable to attend a Congregate Meal, OR

• Spouse of an Eligible Individual (60 years or older that is unable to attend a Congregate Meal), OR

• Dependent Individual with Disability that lives with an Individual an Eligible Individual (60 years or older that is unable to attend a Congregate Meal)

Note: Each AAA determines how "unable to attend a Congregate Meal" is defined. This can include, but is not limited to: being homebound or having 2+ ADLs. Each AAA should have a policy to determine eliQibility. Client Details: 181 Collect ADLs D Client may be Anonymous

181 Collect IADLs D Client may Self-Direct this Service

181 ·Collect NRA Score 181 Client may use Voucher Other Reporting Requirements: Meals that are funded with other funding sources (Med-waiver or Title XX) must be marked. Possible Funding Sources: 181 111-A (NSIP Raw Food) d 111-D (Health Pro) D ADRC (State)

D 111-B (Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other 181 lll-C2 (Home Delivered Meal) D Care Management (State)

lo May be MAC Eligible Provider A background check is suggested. This is a private business matter and Requirements: outside the scope of SUA/DHHS. Detailed description of how service is provided.

• Is it a subaward, contract, direct service? • What counties are served this way? • What is the same? What's different about the service?

Subaward-Centers/Counties: Chase, Dawson, Dundy, Frontier, Gosper, Hayes, Hitchcock, Keith, Lincoln, Logan, Perkins, the City of Lexington and the City of McCook. No changes to this service. Also includes means tested meals. A Home-Delivered Meal assessment is completed during a face to face meeting. Considered is the limited physical mobility, the inability to safely prepare meals, psychological and/or mental Impairment, or lack of knowledge and/or skills to prepare the meal. The provision of meals to homebound eligible individuals is a vital service which in many cases facilitates the individual's ability to remain independent and in their own home. This prevents premature institutionalization and its associated costs. West Central makes low cost, nutritionally sound home delivered meals available five days a week to eligible participants. All home delivered meals in the PSA "J" are provided by volunteers. During the face to face assessment. It is hoped that any other unmet needs the client may have can be identified and addressed if the client chooses to do so.

April 1, 2019 5

SECTION C

WCNAAA Service Narrative: FY 2020-2023 7. Assisted Transportation

Definition: Services or activities that provide or arrange for the travel, including travel costs, of individuals from one location to another. This service includes escort or other appropriate assistance for a person who has difficulties (physlcal or cognitive) using regular vehicular transportation. Does not include any other activity.

Service Unit: One-Way Trip I Setting: One-on-One or Group I R . t d S . SettinQ eg1s ere erv1ce

Eligibility: Individual must be 60 years old or older Client Details: 181 Collect ADLs D Client may be Anonymous

181 Collect IADLs 181 Client may Self-Direct this Service

D Collect NRA Score D Client may use Voucher Other Reporting Requirements: N/A Possible Funding Sources: D 111-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State) 181 111-B (Supportive Service) D 111-E (Caregiver) 181 Local

D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other


lo May be MAC Eligible Provider

This is a private business matter and outside the scope of SUA/DHHS. Requirements:

Detailed description of how service is provided. • Is it a subaward, contract, direct service? • What counties are served this way? • What Is the same? What's different about the service?



Grants are provided to Care Management clients encouraging client-directed services in the hiring of independent contractors to provide assisted transportation services. Referral are received from various sources such as hospitals, home health agencies, friends/families and potential clients themselves. Clients are contacted by the Care Management staff, a meeting is arranged, and assessment completed and client needs determined by the care manager and the client. The care manager authorizes, coordinates and monitors the services. Grants are provided to clients and the client then hires and independent contractor of their choice, sets the pay rate and hours of service. The Agency does provide a list of providers that have been signed up and had background checks done, but it is ultimately the client's choice as whom to hire. A monthly calendar is kept by the client and signed by both the client and provider and sent to the Agency and grant funds are provided to the client to pay the provider. It the cost is higher than the amount provided by the grant, the client is the responsible to pay the difference. This service includes escort or other appropriate assistance for a person has difficulties using regular vehicular transportation.

April 1, 2019 6

SECTION C

WCNAAA Service Narrative: FY 2020-2023 8. Congregate Meals

Definition: A meal provided by a qualified nutrition project provider to a qualified individual in a congregate or group setting. The meal is served in a program that is administered by SUAs and/or AAAs and meets all the requirements of the Older Americans Act and State/Local laws. Meals provided to individual through means-tested proqrams may be included. Service Unit: Meal I Setting: Group Settinq I Reqistered Service Eligibility:

• Individual must be 60 years old or older, OR

• Spouse accompanying Individual 60 years or older, OR

• Volunteer serving the meal, OR

• Individual with a Disability, living with a parent 60 years or older & accompanying the parent, OR

• If the meal is served at senior housinq, Individual with a Disability, livinq in senior housinq Client Details: D Collect ADLs D Client may be Anonymous

D Collect IADLs D Client may Self-Direct this Service

181 Collect NRA Score 181 Client may use Voucher Other Reporting Requirements: Meals that are funded with other funding sources (Med-waiver or Title XX) must be marked. Possible Funding Sources: 181 111-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State)

D 111-B (Supportive Service) D 111-E (Caregiver) 18] Local 181 111-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other


lo May be MAC Eligible Provider A background check is suggested. This is a private business matter Requirements: and outside the scope of SUA/DHHS.


Subaward- Centers/Counties: Arthur, Chase, Dawson, Dundy, Frontier, Gosper, Grant, Hayes, Hitchcock, Keith, Lincoln, Logan, Perkins, the City of Lexington and the City of McCook in Red Willow County.

There has been closure of 1 meal site and 2 satellite centers. Means test meals are included in this service. Congregate meals19 senior centers, 3 satellite sites and 3 meal sites to provide noon meals five days a week. Not only do the centers and sites provide a meal that meets all of the established requirements with meal pattern and dietary Guidelines for Americans and provide a minimum of 33 1/3% of the current Daily Recommended Dietary Intake, they also provide an opportunity for socialization for seniors. The nineteen senior centers most generally prepare the meal on site, the satellite site meals are most generally prepared at a senior center and transported to the satellite location. The meal sites are restaurants the counties have contracted with to provide the noon meal.

April 1, 2019 7

)

WCNAAA

Definition:

SECTION C

Service Narrative: 10. Transportation

FY 2020-2023

Services or activities that provide or arrange for the travel, including travel costs, of individuals from one location to another. Does not include any other activity.

Service Unit: One-Way Trip I Setting: One-on-One or I Non-Registered Service Group SettinQ

Eligibility: Individual must be 60 years old or older Client Details: D Collect ADLs 181 Client may be Anonymous D Collect IADLs 181 Client may Self-Direct this Service D Collect NRA Score D Client may use Voucher Other Reporting Requirements: NIA Possible Funding Sources: D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State)

181 111-8 (Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other

D lll-C2 (Home Delivered

D Care Management (State) Meal)

lo May be MAC Eligible Provider This is a private business matter and outside the scope of Requirements: SUA/DHHS.


Subaward- Centers/Counties: Benkelman, Cozad, Gothenburg, Grant, Lemoyne, McCook and Ogallala in PSA "J"


Seven of the centers have center, city or county transportation programs. Lemoyne transportation is provided by volunteers in private vehicles. The agency had also provided this service for Care Management clients., but have found that the service has actually been clarified as Assisted Transportation and the units of service are now recorded under that service and no Transportation is logged for Care Management, only for Senior Center transportation.

April 1, 2019 8

)

SECTION C

WCNAAA Service Narrative: FY 2020-2023 11. Nutrition Education

Definition: A targeted program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information that is consistent with the current Dietary Guidelines for Americans and instruction to participants, caregivers, or participants arid careqivers, overseen by a dietitian or individual of comparable expertise.

Service Unit: Session I Setting: One-on-One or I Non-Registered Service Group Settinq

Eligibility: Individual must be 60 years old or older Client Details: D Collect ADLs 181 Client may be Anonymous D Collect IADLs D Client may Self-Direct this Service D Collect NRA Score D Client may use Voucher Other Reporting Requirements:

• Program Topic (i.e. Heart Healthy or Drink Enough Water) • Estimated Audience Size

Possible Funding Sources: D 111-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State) 181 111..:B (Supportive Service) D 111-E (Caregiver) 181 local 181 lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other

181 111-C2 (Home Delivered


lo May be MAC Eligible A background check is suggested. The provider must be a

Provider Registered Dietitian or have comparable experience. "Comparable Requirements: experience" is a private business matter and outside the scope of

SUA/DHHS.


Subaward- Centers/Counties: Arthur, Chase, Dawson, Dundy, Frontier, Gosper, ·Grant, Hayes, Hitchcock, Keith, Lincoln, Logan, McPherson, Perkins, City of Lexington and City of McCook, Red Willow.

Contract-Dietician Direct Service by Agency staff.

The Agency provides approved nutrition informational materials to be distributed to clients of congregate and home delivered meal programs at all senior centers, satellites and meal sites. The Registered Dietician provides annual nutrition programs for dietary managers. Center and site directors are encouraged to bring in local dietary professionals for information and presentations.

April 1, 2019 9

SECTION C

WCNAAA Service Narrative: FY 2020-2023 12. Information and Assistance

Definition: Also known as Basic Information. A service that:

• provides the individuals with current information on opportunities and services available to the individuals within their communities, including information relating to assistive technology;

• assesses the problems and capacities of the individuals; • links the individuals to the opportunities and services that are available; and • to the maximum extent practicable, ensures that the individuals receive the services

needed by the individuals, and are aware of the opportunities available to the individuals, by establishinq adequate follow-up procedures.

Service Unit: Contact I Setting: One-on-One I Non-Registered Service Eligibility: N/A Client Details: D Collect ADLs 181 Client may be Anonymous

D Collect IADLs D Client may Self-Direct this Service

D Collect NRA Score D Client may use Voucher Other Reporting Requirements: N/A Possible Funding Sources: D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State)

181 111-B (Supportive Service) D 111-E (Caregiver) 181 Local


D lll-C2 {Home Delivered


I 181 May be MAC Eligible Provider A background check is suggested. This is a private business matter Requirements: and outside the scope of SUA/DHHS.


Subaward- Centers/Counties: All seventeen counties in PSA "J"

SHllP was formerly counted underthis service and has been moved to 1118 Counseling.

The service is a combination of services provided by the Agency and the senior centers. All Agency staff provide information and assistance, however many fail to document. It is primarily the designated Information and Assistance staff member that takes telephone calls, meets with potential clients, make telephone calls for information, provides clients with referral information if needed and mails out information packets. Senior center directors also fulfill this same role at the local level as well referring potential clients on to the Agency or another appropriate resource. Follow-up is provided if requested, needed or required.

April 1, 2019 10

+

'

WCNAAA

Definition:

SECTION C

Service Narrative: 13. Health Promotion/ Disease Prevention (Evidence-Based)

FY 2020-2023

Activities related to the prevention and mitigation of the effects of chronic disease (including osteoporosis, hypertension, obesity, diabetes, and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, stress management, falls prevention, physical activity, and improved nutrition). Activities must meet ACL/AoA definition for an evidence-based program, as presented on ACL's website. Service Unit: N/A I Setting: One-on-One or Group Setting I Sign-In Service Eligibility: Individual must be 60 years old or older Client Details: D Collect ADLs 181 Client may be Anonymous D Collect IADLs D Client may Self-Direct this Service D Collect NRA Score D Client may use Voucher Other Reporting Requirements:

• Name

• Birth Year

• ZIP Code Possible Funding Sources: D Ill-A (NSIP Raw Food) 181 111-D (Health Pro) D ADRC (State) 181 111-8 (Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other D lll-C2 (Home Delivered Meal) D Care Management (State)

ID May be MAC Eligible Provider

Trained and/or certified to meet program requirements. Requirements:


Contact- Centers/Counties: City of Lexington, City of McCook, Perkins County Senior Center, Lemoyne Senior Center, Gothenburg Senor Center, Grand Generation Center Cozad and North Platte Senior Center.

Direct Service by Agency staff-Powerful Tool for Caregivers

The Agency contracts with Senior Centers annually to provide Evidence Based programs. Tai Chi "Moving for Better Balance" is facilitated at six centers; Stepping On is provided at two centers and the Powerful Tools for Caregivers is facilitated annually by Agency staff and a senior center director. The Tai Chi, Stepping On and Powerful Tools for Caregivers are Evidence-based programs facilitated by trained leaders. The current programs are facilitated by Agency staff, senior center staff and volunteers. The Agency pays for senior center directors, volunteers and agency staff to attending training to become leaders for these programs and to increase availability of the programs in PSA

April 1, 2019 11

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WCNAAA

Definition:

SECTION C

Service Narrative: 14. Health Promotion/ Disease Prevention (Non Evidence-Based)

FY 2020-2023

Health promotion and disease prevention activities that do not meet ACL/AoA definition for an evidence-based program as defined at ACL's website. Activities may include those defined in the OAA (Section 102(14)). For example:

health risk assessments routine health screening - home injury control - - services

- health education - medication management - gerontological counseling age-related diseases and chronic disabling conditions information -

- counseling regarding social services and follow-up health services - educational services for individuals and their primary caregivers - physical fitness, group exercise, and music therapy, art therapy, and dance-movement

therapy Service Unit: NIA I Setting: One-on-One or Group Setting I Sign-In Service Eliaibilitv: Individual must be 60 years old or older Client Details: D Collect ADLs 181 Client may be Anonymous D Collect IADLs D Client may Self-Direct this Service D Collect NRA Score D Client may use Voucher Other Reporting Requirements:

• Name

• Birth Year •. ZIP Code

Possible Fundina Sources: D Ill-A (NSIP Raw Food) 0 111-D (Health Pro) D ADRC (State) 181 lll-8 (Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other D lll-C2 (Home Delivered Meal) D Care Management (State)

lo May be MAC Eligible Providers must administer services within the scope of their own

Provider professional practice that they are deemed competent to perform. Requirements: These practices must be permitted in terms of what their own

professional licensure aooroves and allows. Detailed description of how service is provided.


Subaward-Centers/Counties: Arthur, Chase, Dawson, Dundy, Gosper, Grant, Hayes, Logan, Frontier, Hitchcock, Keith, Lincoln, Perkins and Red Willow. Contract-Foot clinics: Cozad, Gothenburg, Grant, Hayes Center, Hershey, Lemoyne, City of Lexington, City of McCook, North Platte and Ogallala Direct Service by Agency staff. The Agency provides health education information materials to all senior center, satellite and meal sites to be distributed to congregate and home delivered meal clients. Senior Centers also provide health education materials and speakers at their local centers. The Agency provides grants for foot clinics at ten centers. Centers provide a variety of health screenings. Most multipurpose center offer a variety of services which include; physical fitness, group exercise, and music therapy, art therapy, and dance-movement therapy.

April 11 2019

12

SECTION C

WCNAAA Service Narrative: 16. Legal Assistance

FY 2020-2023

May 8, 2020 Page 13

Definition: Legal advice and representation provided by an attorney to older individuals with economic or social need, and in the implementing regulation at 45 CFR Section 1321.71, and includes to the extent feasible, counseling or other appropriate assistance by a paralegal or law student under the direct supervision of an attorney. Service Unit: Hour Setting: One-on-One Restricted Service Eligibility: Individual must be 60 years old or older Client Details: ☐ Collect ADLs ☒ Client may be Anonymous ☐ Collect IADLs ☐ Client may Self-Direct this Service ☐ Collect NRA Score ☐ Client may use Voucher Other Reporting Requirements: Legal Assistance Providers will also need to record: • III- B Restricted Demographics (new) • Number of Open Cases • Number of Closed Cases by:

o Advice o Limited Representation o Representation

Number of Cases about: • Abuse/Neglect • Age

Discrimination • Health Care • Housing • Income

• Long-Term Care • Nutrition • Utilities • Other

• Defense of Guardianship/ Protective Services

This grey section will be implemented 10/1/2020 Possible Funding Sources: ☐ III-A (NSIP Raw Food) ☐ III-D (Health Pro) ☒ Local ☒ III-B (Supportive Service) ☐ III-E (Caregiver) ☒ Other ☐ III-C1 (Congregate Meal) ☒ CASA (State Aging) ☒ Title IV ☐ III-C2 (Home Delivered Meal) ☐ ADRC (State) ☒ Title VII ☐ May be MAC Eligible Provider Requirements:

• Attorney, OR • Law student under direct supervision of an attorney, OR • Paralegal under direct supervision of an attorney

Detailed description of how service is provided.

• Is it a subaward, contract, direct service? • What counties are served this way? • What is the same? What’s different about the service?

Contract Centers/Counties: All seventeen counties in PSA "J" The Agency contracts with Legal Aid of Nebraska to support the ElderAccess Line toll-free number to make legal services available in the seventeen county PSA. Per the ElderAccess Line, an attorney provides brief legal consultation free of charge and refers on to the local office if more in-depth services are required. Legal Aid provides monthly and annual reports on the number of people accessing the service and the hours of service provided. Law clinics are being provided annually by law students to answer questions and prepare simple legal documents such as wills, POA and Living Wills

WCNAAA

Definition:

SECTION C

Service Narrative: 20. Care Management

FY 2020-2023

Assisting a client to identify and utilize services needed to assure that the client is receiving, when reasonably possible, the level of care that best matches his or her level of need. The Care Management Unit, through its Care Management Unit Supervisor and staff of care managers, assists clients with services as specified in the [Care Management] Act, including ongoing consultation, assessment, Long-Term Care Plan development, and referral for clients in need of long-term care; coordination of the Long-Term Care Plan; monitoring of the delivery of services for clients, and review of the client's Long-Term Care Plan. Service Unit: Hour I Setting: One-on-One I Registered Service Eligibility: Individuals 60 years or older are eligible. Those under 60 may also be served, subject to service prioritization. Client Details: 181 Collect ADLs D Client may be Anonymous

181 Collect IADLs ~ Client may Self-Direct this Service 181 Collect NRA Score D Client may use Voucher Other Reporting Requirements: See Care Management reporting requirements. Possible Funding Sources: D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State) D 111-B (Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other D lll-C2 (Home Delivered Meal) 181 Care Management (State)

I j2g May be MAC Eligible The Care Management Unit Supervisor and care managers shall have the following minimum qualifications:

• A current Nebraska license as a registered nurse, or baccalaureate Provider or graduate degree in the human services field, or certification Requirements: under the Nebraska Social Work Law; and

• At least two years of experience in long-term care, gerontology or community health.

• In addition, a Care Management Unit Supervisor shall have at least two years of supervisory or management experience.


SubAward- Centers/Counties: All seventeen counties in PSA "J" Case Management is funded by CASA, LB-42, and local funds. The program assesses 60+ individuals who are less fragile than those requiring nursing home care. Upon receiving a referral, a care manager contacts the client, arranges a meeting, completes an assessment, determines eligibility of client for program, determines needs and with the client develops a care plan and in-home services to meet those needs to remain in their home. Services are funded through 1118 services: Once services are established, the care manager monitors the client on a routine basis and assesses the effectiveness of the service. Clients remain on the program until they no longer need or want the service, their needs cannot be met and/or safety becomes an issue. Previously suggested contribution requests were sent to clients with over 149% of poverty. Currently clients that at over 149% of poverty Income are sent invoices at a percentage determined by the $54 Care Management rated and the NAMIS program. If clients do not pay the required amount, Agency funds are used to off-set the amount.

April 1, 2019 14

l I

__ ,::

SECTION C

WCNAAA[ Service Narrative: 22. Senior Center Hours

Definition: The hours of multipurpose senior centers are open to older individuals.

Sites that onl offer meals Service Unit:

Other Reporting Requirements: N/A Possible Fundin Sources: D Ill-A {NSIP Raw Food) D 181 111-B (Supportive Service) D 181 lll-C1 (Congregate Meal) 181 181 111-C2 (Home Delivered Meal) D

111-D (Health Pro) 111-E (Caregiver) CASA (State Aging) Care Management (State)

FY 2020-2023

D ADRC (State) 181 Local 181 Other

D May be MAC Eligible Provider Re uirements: Must be multipurpose senior center.


Subaward- Centers/Counties: Chase, Dawson, Dundy, Frontier, Gosper, Hayes, Hitchcock, Keith, Lincoln, Perkins, the City of Lexington and the City of McCook.

The hours nineteen multipurpose senior centers are open to the public are recorded monthly The Senior Center provide the Agency with the number of hours they are opened daily and if unscheduled closings occur. Routinely the number of operational days per month are counted and the daily hours are multiplied times the operational days. The Agency requires the multipurpose centers to provide one hour of supportive service for every three meals that are served, these units usually meet the supportive service requirement.

April 1, 2019 15

SECTION C

WCNAAA Service Narrative: FY 2020-2023 23. Material Distribution

Definition: The provision of goods to an older individual at no cost or at a reduced cost which will directly support the health and independence of the individual with an assessed need. This can include: commodities, pantry items, clothing distribution, smoke detectors, eyeglasses, hearing aids, oral health, etc. This also includes Emergency Response Systems (ERS, Personal Emergency Response System, PERS). An Emergency Response System is an electronic device and has portable buttons (including pendants and bracelets) worn by the customer. These units provide 24-hour on call support to the customer having a medical or emergency need that could become critical at any time. ERS can be landline or cell phone based services. Previously counted in Durable Medical Equipment and Emergency Response System. This is no lonqer limited to medical equipment, adaptive devices, or assistive technoloQv. Service Unit: Unit I Setting: One-on-One I Registered Service Eligibility: Individual must be 60 years old or older Client Details: D Collect ADLs D Client may be Anonymous D Collect IADLs 181 Client may Self-Direct this Service D Collect NRA Score D Client may use Voucher Other Reporting Requirements: N/A Possible Funding Sources: D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State)

181 111-B {Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other D 111-C2 (Home Delivered Meal) D Care Management (State)

lo May be MAC Eligible Provider This is a private business matter and outside the scope of Requirements: SUA/DHHS. Detailed description of how service is provided.


Contract Centers/Counties: All seventeen counties in PSA "J" Emergency Personal Response system were a component of the 1118 In-Home service program and are utilized through the Care Management program. Referrals are received from various sources such as hospitals, home health agencies, friends, families and potential clients themselves. A care manager contacts the client, arranges a meeting, assesses the client, coordinates and implements service to meet the client's needs with the client's agreement. When a client meets criteria (dementia, deficit in two AD Ls and/risk for falling) this program is provided on a sliding scale fee system which ranges from clients' paying privately to the Agency paying the entire monthly amount. This program provides reassurance the client may remain at home with the ability to summon assistance in an emergency. Other products such as briefs, nutritional supplements, etc. are provided when a need is identified .. Subaward-Centers/Counties: Dawson, Dundy, Frontier, Gosper, City of McCook, Keith, City of Lexington, Lincoln in the PSA Formerly Durable Medical Equipment. This service is facilitated at the Senior Center level with the centers receiving inquiries from participants, participants' families and other families in the community who are unable to afford to purchase medical equipment or would be using the equipment for a short period of time. Families frequently donate medical equipment to the centers. The equipment is loaned out for no charge or a donation can be made.

April 1, 2019 16

WC NAM

Definition:

SECTION C

Service Narrative: 24. Social Activities

FY 2020-2023

Provision of activities which foster the social well-being of individuals through social interaction and the satisfying use of leisure time. Activities, such as performing arts, games, and crafts, either as an observer or as a participant, facilitated by a provider.

This service covers activities at the provider's location (i.e. senior center) or should be organized/planned by the provider (senior center). Service Unit: Person Hour I Setting: Group Setting I Non-Registered Service Eligibility: Individual must be 60 years old or older Client Details: NIA D Collect ADLs !8l Client may be Anonymous D Collect IADLs D Client may Self-Direct this Service D Collect NRA Score D Client may use Voucher Other Reporting Requirements: NIA Possible Funding Sources: D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State) !8l 111-8 (Supportive Service) D 111-E (Caregiver) !8l Local D lll-C1 (Congregate Meal) !8l CASA (State Aging) !8l Other

D lll-C2 (Home Delivered




Subaward- Centers/Counties: Chase, Dawson, Dundy, Frontier, Gosper, Hayes, Hitchcock, Keith, Lincoln, Perkins, the City of Lexington and the City of McCook.

This service was formerly included in Supportive Services would include those activities that are common to the centers, such as; quilting, playing pool, playing cards, socializing, exercise programs not counted under 1110, parties, dances, speakers, holiday celebrations, television, computer utilization, video games, etc. The center should be staffed by either a director or volunteers during the hours it is open to the public. Trips to another center for lunch and entertainment. Escorted trips for several days through travel agencies have become popular at several of the centers.

April 1, 2019 17

WCNAAA

Definition:

SECTION C

Service Narrative: 25.Counseling

FY 2020-2023

Services that assist older adults to address issues, concerns, or make decisions. This can include counseling on specific topics like financial issues, SHllPi(Senior Health Insurance Information Program, managed through a federal grant to the N braska Department of Insurance), housing, health insurance, taxes, etc.

Does not include Nutrition Counseling, Caregiver Counseling, Options Counseling, or Transitional Options Counseling. Service Unit: Hour I Setting: One-on-One I Registered Service Eligibility: Individual must be 60 years old or older Client Details: D Collect ADLs D Client may be Anonymous D Collect IADLs D Client may Self-Direct this Service D Collect NRA Score D Client may use Voucher Other Reporting Requirements: N/A Possible Funding Sources: D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State) 181 111-B (Supportive Service) D 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other D lll-C2 (Home Delivered Meal) D Care Management (State)

lo May be MAC Eligible Provider Must meet topic specific credentialing, training, or expertise (i.e.: Requirements: SHllP counselors must be a certified SHllP counselor).


Contract Centers/Counties: All seventeen counties in PSA "J"

The Senior Health Insurance Information Program (SHllP) numbers are included in this service. Through a regional (SHllP) representative and volunteers throughout the PSA counseling and assistance are provided for Medicare, private insurance and other financial issues. Most generally the SHllP representative, assistant or trained volunteer meet one on one with clients to discuss signing up for Medicare, Social Security or any difficulties the client is having with these and other programs. Medicare Part D is a major program year round, but specifically during the annual open enrollment period. Clients are counseled on what options are most beneficial to them, but the client makes the decision as to what prescription plan they choose. Senior Medicare Patrol (SMP) units are also included in this service. The same representative and volunteers consult with clients concerning Medicare, Medicaid or private insurance fraud and scams.

April 1, 2019 18

)

WCNAAA

Definition:

SECTION C

Service Narrative: 27. Outreach

FY 2020-2023

An interactive activity that conveys information about available services, aging, or the aging network. It includes in-person interactive presentations, booth/exhibit at a fair, conference, or other public event. This service includes Public Education and Presentations.


Previously the ACL defined this as a one-on-one intervention by the service provider. The ACL has removed Outreach as a federal service. The state has created a new service called Outreach.

Eli ibilit : Information about available services, a Client Details:

Other Reporting Requirements: • Estimated Audience Size

Possible Funding Sources: D .ill-A (NSIP Raw Food) 181 111~8 (Supportive Service) D lll-C1 (Congregate Meal) D lll-C2 (Home Delivered Meal)

D 111-D (Health Pro) · D 111-E (Caregiver) 181 CASA (State Aging) D Care Management (State)

D ADRC (State) Local Other

181 May be MAC Eligible Provider Requirements:

This is a private business matter and outside the scope of SUA/DHHS.



This service is provided by the Agency and Senior Centers. Outreach is primarily providing information about available Agency and Senior Center services to potential clients and connecting clients with services to meet their needs with particular attention being paid to those who have the greatest social-economic need, poverty and minorities. The Agency and Senior centers participate in several health and information fairs annually. Public education and presentations are provided by Agency on services and resources.

April 1, 2019

J.

19

SECTION C

WCNAAA Service Narrative: FY 2020-2023 28. Information Services

Definition: A media activity that conveys information about available services, aging, or the aging network. It is a one way mode of communication. Examples include: Facebook posts, TV Ads/PSAs, radio ads/PSAs, website hits, brochures, newspaper ads, press releases.

When counting brochures and other print media as Information Services, it should be counted when the cost is incurred (when the brochures are printed, when the newspaper ad is billed).


Other Reporting Requirements: • Topic (if the system allows) • Estimated Audience Size

Possible Fundhf Sources: D Ill-A (NSIP Raw Food) 181 111-B (Supportive Service) D Ill-C1 (Congregate Meal) D lll-C2 (Home Delivered Meal)

D 111-D (Health Pro) D 111-E (Caregiver) IZI CASA (State Aging) D Care Management (State)

D ADRC (State) 181 Local 181 Other

181 May be MAC Eligible Provider Re uirements:

This is a private business matter and outside the scope of SUA/DHHS.


Subaward- Centers/Counties: All seventeen counties in PSA "J" Direct Service by Agency: All seventeen counties in PSA "J"

Information is provided in several different mediums such as; newspaper, television and radio advertising, brochures disseminated to community partners and senior centers and mass mailings. Individual packets are sent out when a potential client is identified or requested by the public The Agency has a website which is currently being updated and will provide links to numerous other programs and Agencies. Over the past two years the Agency has developed a Facebook page and routinely posts information of interest to clients and professionals. Senior Centers also advertise special events and post their menus in their local newspapers and radio stations. Most Center have websites and are quite active on Facebook.

April 1, 2019 20

WCNAAA

SECTION C

Service Narrative: 29. Legal Outreach

FY 2020-2023

An interactive activity that conveys information about legal issues, including but not limited to: • Powers of Attorney • Wills • Health Care Directives • Reverse Mortgage • Social Security Benefits • Medicaid/Medicare

Legal Outreach includes in-person interactive community education presentations by an attorney or a staff supervised by an attorney at senior centers, conferences, or other public event.

Legal Outreach does not include information provided by staff or an attorney at a booth/exhibit at a fair, or a conference or other public event.

When the topic is Medicaid related, it may be MAC Eligible. See the Medicaid Administrative Claimin MAC section. Service Unit:' Activit Settin : Grou Settin istered Service Eli ibilit : Information about available services, a Client Details:

Other Reporting Requirements: • Estimated Audience Size ·

Possible Fundin Sources: D Ill-A {NSIP Raw Food) 181 111-B (Supportive Service) D lll-C1 (Congregate Meal)

lll-C2 (Home Delivered .D Meal)

D D 181

D

111-D (Health Pro) 111-E (Caregiver) CASA (State Aging)

Care Management (State)

D ADRC {State) 181 Local 181 Other

181 May be MAC Eligible

Provider Requirements:

• Attorney, OR • Law student under direct supervision of an attorney, OR • Parale al under direct su ervision of an attorne



The supervising staff attorney at the North Platte Legal Aid office provides several public presentations at senior centers annually. ·

April 1, 2019 21

WCNAAA

Definition:

SECTION C

Service Narrative: 32. Caregiver Respite

FY 2020-2023

Service which offer temporary, substitute supports or living arrangements for care recipients in order to provide a brief period of relief or rest for careQivers. Service Unit: Hour Setting: One-on-One or Group Setting I Registered Service Eligibility: • Family CareQiver OR • Older Relative CareQiver

Care Recipient Caregiver (Client) Details: l8l Must have 2 ADLs l8l Collect Demographics D May be Anonymous

or a cognitive l8l Collect Eligibility 181

May Self-Direct this deficit Service

181 May do Caregiver

181 May use Voucher Assessment

Other Reporting Requirements: Where Respite was Provided:

• In-Home • Out-of-Home (day) • Out-of-Home (overnight)

• other Respite Possible Funding Sources: D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State) D 111-B (Supportive Service) 181 111-E (Caregiver) l8l Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) l8l Other D lll-C2 (Home Delivered Meal) D Care Management (State)

lo May be MAC Eligible Provider A background check is suggested. This is a private business matter Requirements: and outside the scope of SUA/DHHS. Detailed description of how service is provided.


Contract-Centers/Counties: All seventeen counties in PSA "J" Grants are given to the Caregiver to encourage self-directed care. The clients are identified in the same way care management client are, but with the focus on the caregiver as a client. When a referral is received, a care manager schedules a home visit with the caregiver and care receiver to perform an assessment of their situation and needs. The care manager and caregiver identify the needs and agree upon a care plan to address the needs and relieve stress for the caregiver. The care manager monitors the progress of the caregiver and if the services have helped to improve their situation and relieved their stress. The program provides assistance to primary caregivers to allow them the opportunity to care for themselves. The program provides relief and assistance for those caregivers so that the potential for burnout by the caregivers can be decreased or avoided. This allows the caregiver and care receiver to remain at home as long as possible. Providers may go into the home to provide respite or the care receiver may be admitted to a long-term care facility for a short period of to allow the caregiver a break from caregiving. If the provider is in-home, the Caregiver hires an independent contractor of their choice, sets the pay rate and hours of service. The Agency does provide a list of providers that have been signed up and had background checks done. A monthly calendar is kept by the Caregiver and signed by both the Caregiver and provider and sent to the Agency and grant funds are provided to the Caregiver to pay the provider. If the cost is higher than the amount provided by the qrant, the client is the responsible to pay the difference

April 1, 2019 22

SECTION C

WCNAAA Service Narrative: 33. Caregiver Supplemental

Services

FY 2020-2023

Effective 7-01-2019 Submitted 9-26-2019 Page 23

Definition: Goods and services provided to complement the care provided by caregivers. If a Family Caregiver and Older Individual receive a Home Delivered Meal, the Family Caregiver Home Delivered Meal should be counted under Caregiver Supplemental Services. ERS services for the Care Recipient should be recorded under this service. The Client is the Caregiver. Service Unit: Unit Setting: One-on-One Registered Service Eligibility: • Family Caregiver OR • Older Relative Caregiver

Care Recipient Caregiver (Client) Details: ☒ Must have 2 ADLs

or a cognitive deficit

☒ Collect Demographics ☐ May be Anonymous

☒ Collect Eligibility ☐ May Self-Direct this Service

☒ May do Caregiver Assessment ☐ May use Voucher

Other Reporting Requirements: N/A Possible Funding Sources: ☐ III-A (NSIP Raw Food) ☐ III-D (Health Pro) ☐ ADRC (State) ☐ III-B (Supportive Service) ☒ III-E (Caregiver) ☒ Local ☐ III-C1 (Congregate Meal) ☒ CASA (State Aging) ☒ Other ☐ III-C2 (Home Delivered Meal) ☐ Care Management (State) ☐ May be MAC Eligible Provider Requirements: N/A

Detailed description of how service is provided.

• Is it a subaward, contract, direct service? • What counties are served this way? • What is the same? What’s different about the service?

Contract-Centers/Counties: All seventeen counties in PSA "J" This program is administered much the same as the IIIB Materials program, but the client is the Caregiver. Referrals are received from various sources such as hospitals, home health agencies, friends, families and potential clients themselves. A care manager contacts the Caregiver, arranges a meeting, assesses the Caregivers stress, coordinates and implements service to meet the Caregiver and Care receiver’s needs with their agreement. This program provides reassurance the care receiver may remain at home with the ability to summon assistance in an emergency with an ERS which in turn relieves stress for the Caregiver. Other products such as briefs, nutritional supplements and durable medical equip., etc. are provided when a need is identified. This service also includes, homemaker, personal care, and assisted transportation. On rare occasion the Agency has provided minimal funding for home improvements needed so that the care receiver can become more independent or that care is less stressful for the caregiver.

SECTION C

WCNAAA Service Narrative: FY 2020-2023 34. Caregiver Assistance:

Case Management

Definition: Provided to a caregiver, at the direction of the caregiver:

• by an individual who is trained or experienced in the case management skills that are required to deliver the services and coordination described in subparagraph; and

• to assess the needs, and to arrange, coordinate, and monitor an optimum package of services to meet the needs, of the caregiver; and

Includes services and coordination such as-

• comprehensive assessment of the caregiver (including the physical, psychological, and social needs of the individual);

• · development and Implementation of a service plan with the caregiver to mobilize the formal and informal resources and services identified in the assessment to meet the needs of the caregiver, including coordination of the resources and services-

0 with any other plans that exist for various formal services; and 0 with the information and assistance services provided under the Older Americans Act;

coordination and monitoring of formal and informal service delivery, including coordination and monitoring to ensure that services specified in the plan are being provided;

0 periodic reassessment and revision of the status of the caregiver; and 0 in accordance with the wishes of the caregiver, advocacy on behalf of the caregiver for

needed services or resources. Service Unit: Hour I Setting: One-on-One I ReQistered Service Eligibility: • Family Caregiver OR • Older Relative Caregiver Possible Funding Sources:

Care Recipient Caregiver (Client) Details: 181 Must have 2 AD Ls 181 Collect Demographics D May be Anonymous

or a cognitive 181 Collect Eligibility D May Self-Direct this Service deficit May do Caregiver

181 Assessment D May use Voucher

Other Reporting Requirements: N/A D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC (State)

D 111-B (Supportive Service) 181 111-E (Caregiver) 181 Local



I 181 May be MAC Eligible Provider A background check is suggested. This is a private business matter and Requirements: outside the scope of SUA/DHHS. Detailed description of how service is provided.


Subaward- Centers/Counties: All seventeen counties in PSA "J" This program is administered much the same as the Care Management program, but the client is the Caregiver. Upon receiving a referral, a care manager contacts the Caregiver, arranges a meeting, completes a stress assessment of the Caregiver and assesses the care receiver, determines eligibility for program, determines needs and with the Caregiver develops a care plan and in-home services to meet those needs. Once services are established, the care manager monitors the Caregiver on a routine basis and assesses the effectiveness of the service on their stress level. Clients remain on the program until they no longer need or want the service, their needs cannot be met and/or safety becomes an issue. Serves could be respite, materials or In-home care.

April 1, 2019 24

SECTION C

WCNAAA Service Narrative: FY 2020-2023 36. Caregiver Assistance: Information & Assistance

Definition: • provides the individuals with current information on opportunities and services available to

the individuals within their communities, including information relating to assistive technology;

• assesses the problems and capacities of the individuals;

• links the individuals to the opportunities and services that are available; and

• to the maximum extent practicable, ensures that the individuals receive the services needed by the individuals., and are aware of the opportunities available to the individuals, by establishing adequate follow-up procedures.

Service Unit: Contact I Setting: One-on-One I Non-Registered Service Eligibility: • Family Caregiver OR • Older Relative Caregiver

Care Recipient Caregiver (Client) Details: D D Collect Demographics 181 May be Anonymous

May collect 181 Collect Eligibility D

May Self-Direct this demographics if Service OAA eligible.

181 May do Caregiver

D May use Voucher Assessment

Other Reporting Requirements: N/A Possible Funding Sources: D Ill-A (NSIP Raw Food) D 111-D (Health Pro) D ADRC {State) D lll;;B {Supportive Service) 181 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other D lll-C2 {Home Delivered Meal) D Gare Management (State)




The service is a combination of services provided by the Agency and the senior centers. All Agency staff provide information and assistance, however many fail to document. It is primarily the designated Information and Assistance staff member that takes telephone calls, meets with potential clients, make telephone calls for information, provides clients with referral information if needed and mails out information packets. Senior center directors also fulfill this same role at the local level as well referring potential clients on to the Agency or appropriate other resources. Follow-up is provided if requested, needed or required.

April 1, 2019 25

1·

. /

WCNAAA

Definition:

SECTION C

Service Narrative: 38. Caregiver Information

Services

FY 2020-2023

A media activity that conveys information to caregivers .about available services, aging, or the aging network. It is a one way mode of communication. Examples include: Facebook posts, TV Ads/PSAs, radio ads/PSAs, website hits, brochures, newspaper ads, press releases.

When counting brochures and other print media as Information Services, it should be counted when the cost is incurred (when the brochures are printed, when the newspaper ad is billed).

When the topic is Medicaid related, it may be MAC Eligible. See the Medicaid Administrative Claimin MAC section.

Activity

Other Reporting Requirements: • Topics (if system allows) • Estimated Audience Size

Possible Fundin Sources: D Ill-A {NSIP Raw Food) D 111-D (Health Pro) D ADRC (State) D 111-B (Supportive Service) 181 111-E (Caregiver) 181 Local D lll-C1 (Congregate Meal) 181 CASA (State Aging) 181 Other D lll-C2 (Home Delivered Meal) D Care Management (State)

181 May be MAC Eligible Provider Re uirements: N/A


Subaward- Centers/Counties: All seventeen counties in PSA "J" Direct Service by Agency: All seventeen counties in PSA "J" Information is provided in several different mediums such as; newspaper, television and radio advertising, brochures disseminated to community partners and senior centers and mass mailings. Individual packets are sent out when a potential client is identified or requested by the public The Agency has a website which is currently being updated and will provide links to numerous other programs and Agencies. Over the past two years the Agency has developed a Facebook page and routinely posts information of interest to clients and professionals. Senior Centers also advertise special events and post their menus in their local newspapers and radio stations. Most Center have websites and are quite active on Facebook .

April 1, 2019 26

WCNAAA SECTION C

Contractor-Subaward DetailsFY 2020-2021

May 8, 2020

Provider Name Service Provided Relationship Total Provider Cost Receives OAA Funds

Nebraska Legal Aid 16. Legal Assistance Contract 3,000$ Yes29. Legal Outreach

Heidi Wietjes 8. Congregate Meals Contract 2,500$ YesUniversity of Nebraska-Law Clinic 16. Legal Assistance Contract 3,339$ No

Arthur County 8. Congregate Meals 8,131$ Yes4. Home Delivered Meals Contract

Chase County-Imperial Senior Center 4. Home Delivered Meals Contract 20,622$ Yes8. Congregate Meals12. Information & Assistance22. Senior Center Hours24. Social Activties28. Information Services

Cozad-Haymaker Grand Generation Cenet 4. Home Delivered Meals Contract 42,474$ Yes

8. Congregate Meals10. Transportation11. Nutrition Education12. Information & Assistance13. HP/DP (Evidence-Based)14. HP/DP (Non Evidence-Based)22. Senior Center Hours23. Material Distribution24. Social Activties28. Information Services

Curtis-Area Senior Citizens Center 4. Home Delivered Meals Contract 16,538$ Yes8. Congregate Meals12. Information & Assistance22. Senior Center Hours24. Social Activties

WCNAAA SECTION C


May 8, 2020

Dundy County Senior Center-Benkelman 4. Home Delivered Meals Contract 21,118$ Yes

8. Congregate Meals10. Transportation12. Information & Assistance22. Senior Center Hours23. Material Distribution24. Social Activties28. Information Services

Eustis Senior Center 4. Home Delivered Meals Contract 14,355$ Yes8. Congregate Meals12. Information & Assistance14. HP/DP (Non Evidence-Based)22. Senior Center Hours24. Social Activties27. Outreach28. Information Services

Farnam Senior Center 4. Home Delivered Meals Contract 17,337$ Yes8. Congregate Meals12. Information & Assistance22. Senior Center Hours23. Material Distribution24. Social Activties28. Information Services

Gosper County Senior Center-Elwood 4. Home Delivered Meals Contract 21,355$ Yes8. Congregate Meals12. Information & Assistance14. HP/DP (Non Evidence-Based)22. Senior Center Hours23. Material Distribution24. Social Activties28. Information Services

WCNAAA SECTION C


May 8, 2020

Gothenburg Senior Cenior-Brady Satellite 4. Home Delivered Meals Contract 67,492$ Yes

8. Congregate Meals10. Transportation11. Nutrition Education12. Information & Assistance13. HP/DP (Evidence-Based)14. HP/DP (Non Evidence-Based)22. Senior Center Hours23. Material Distribution24. Social Activties27. Outreach28. Information Services

Grant County Meal Site-Hyannis 8. Congregate Meals Contract 4,173$ Yes4. Home Delivered Meals

Hayes County Senior Center-Hayes Center 4. Home Delivered Meals Contract 9,078$ Yes

8. Congregate Meals12. Information & Assistance14. HP/DP (Non Evidence-Based)22. Senior Center Hours24. Social Activties

Hershey Senior Center 4. Home Delivered Meals Contract 12,667$ Yes8. Congregate Meals12. Information & Assistance14. HP/DP (Non Evidence-Based)22. Senior Center Hours24. Social Activties

WCNAAA SECTION C


May 8, 2020

Heritage Senior Center-Mccook 4. Home Delivered Meals Contract 102,811$ Yes8. Congregate Meals10. Transportation12. Information & Assistance13. HP/DP (Evidence-Based)14. HP/DP (Non Evidence-Based)22. Senior Center Hours23. Material Distribution27. Outreach28. Information Services

Keith County Senior Center-Ogallala 4. Home Delivered Meals Contract 45,148$ Yes8. Congregate Meals10. Transportation12. Information & Assistance14. HP/DP (Non Evidence-Based)22. Senior Center Hours23. Material Distribution24. Social Activties27. Outreach28. Information Services

Lemoyne Senior Center 4. Home Delivered Meals Contract 15,605$ Yes8. Congregate Meals10. Transportation12. Information & Assistance13. HP/DP (Evidence-Based)14. HP/DP (Non Evidence-Based)22. Senior Center Hours23. Material Distribution24. Social Activties28. Information Services

McPherson County 4. Home Delivered Meals Contract 6,930$ Yes8. Congregate Meals

WCNAAA SECTION C


May 8, 2020

Grand Genration Center-Lexington 4. Home Delivered Meals Contract 55,762$ Yes8. Congregate Meals10. Transportation12. Information & Assistance13. HP/DP (Evidence-Based)14. HP/DP (Non Evidence-Based)22. Senior Center Hours23. Material Distribution24. Social Activties28. Information Services

North Platte Senior Center 4. Home Delivered Meals Contract 99,503$ Yes8. Congregate Meals11. Nutrition Education12. Information & Assistance13. HP/DP (Evidence-Based)14. HP/DP (Non Evidence-Based)22. Senior Center Hours23. Material Distribution24. Social Activties27. Outreach28. Information Services

Perkins County Senior Center-Grant Venango Meal Site and Madrid Satellite Site 4. Home Delivered Meals Contract 21,466$ Yes

8. Congregate Meals10. Transportation11. Nutrition Education12. Information & Assistance13. HP/DP (Evidence-Based)14. HP/DP (Non Evidence-Based)22. Senior Center Hours24. Social Activties28. Information Services

WCNAAA SECTION C


May 8, 2020

Stapeleton Meal Site 4. Home Delivered Meals Contract 21,436$ Yes8. Congregate Meals

Hitchcock County Senior Center 4. Home Delivered Meals Contract 8,747$ Yes8. Congregate Meals11. Nutrition Education12. Information & Assistance14. HP/DP (Non Evidence-Based)22. Senior Center Hours24. Social Activties

Sutherland Senior Center 4. Home Delivered Meals Contract 10,095$ Yes8. Congregate Meals12. Information & Assistance22. Senior Center Hours24. Social Activties

Wauneta Senior Center 4. Home Delivered Meals Contract 20,489$ Yes8. Congregate Meals12. Information & Assistance22. Senior Center Hours24. Social Activties

WCNAAA SECTION C


May 8, 2020

west central nebraska area agency on aging updates to the ...dhhs.ne.gov/medicaid sua/wcnaaa...

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