Lynn Kellogg, CEO Region IV Area Agency on Aging St. Joseph, Michigan February 24, 2009 – Boston, MA Setting the Stage for Veteran Directed Home and Community-Based Services Aging Network and ADRCs

Aging Network: The “Org” Chart U.S. Administration on Aging 56 State Units on Aging 655 Area Agencies on Aging 240 Tribes 29,000 Local Community Providers 500,000 Volunteers

Role of the Aging Network: Helping Older Adults Live Independently Based in Every Community in U.S. Focus on What Older Adults Need to Live Successfully at Home and In the Community Serve People of All Socio-Economic Status Recognize the Role and Support Caregivers Maximize Services Through Partnerships

Area Agency on Aging (AAA) Structure *Council of governments or Regional planning and development area

AAAs – Universal Core Functions To plan and develop comprehensive, coordinated systems of service to help people stay independent in their homes as long as possible To develop and fund certain core supports and service program such as meal service, home based support, transportation, caregiver support, legal services To help people access the supports and services they need To be an advocate

Area Agency on Aging Key Services Congregate Meals (99.8%) Information & Referral Services (99.4%) Home Delivered Meals (99%) Legal Assistance (98.4%) Family Caregiver Support (96.5%) Transportation (95.7%) Medication Management (87.3%) Case Management (83.6%) Personal Care (81.1%) Benefits Counseling (79.3%)

The Aging Network: Who We Serve 3 million people receive OAA-funded services such as home delivered meals and home care on a regular basis. 7 million people receive other services such as transportation and information and assistance on an occasional basis. Provide nutrition services to nearly 800,000 people at high nutritional risk. Data sources: O’Shaughnessy, C. The Aging Services Network: Accomplishments and Challenges in Serving a Growing Elderly Population, National Health Policy Forum. April 11, 2008 ; and AGID.

n4a/Scripps Project National survey of AAA’s involvement in the modernization of long-term care Grant from the Administration on Aging (AoA) to the National Association of Area Agencies on Aging (n4a) N4a contracted with Scripps Gerontology Center, Miami University, Oxford, Ohio

How AAAs “Graded”… Organizational Capacity - related to an organizational ability for comprehensive and efficient services (for example: electronic data systems, needs assessments, etc) Grade = 87.5 Consumer Direction – related to items that allow an organization to give consumers maximum choice and control over services they receive. Grade = 87.5 Private Pay – related to items that indicate whether an organization provides services to private pay, cost share and insurance clients. Grade = 65.8 Outreach & Business - related to items that reflect an organization’s orientation to do innovative planning and positioning. Grade 76.9

Involvement in Key Programs *2008 n4a AAA Survey

Funding Sources Proportion of agencies with funds from various sources (in addition to OAA)

Reauthorization of the OAA – “Modernization of the Act” Positive Trends Manifesting Across the Country… Shift from agency driven systems to consumer driven systems Growth of business partnerships and collaborations between AAAs and complementary interests [e.g. health sector, VA, 211 systems, corporate eldercare] Concept of Livable Communities for All Ages Civic Engagement – maintaining an active and involved citizenry Encouragement of the growth of a service industry that caters to the needs of a growing aged & disabled populous ADRCs Nursing Home Diversion

Core Elements: Flexible Services Self-Determination Targeting to those at high risk of institutionalization Supports designed to complement and support the individual, his/her family and caregivers

Other Initiatives 1) National Family Caregiver Support Program – provides expertise and a range of supports for caregivers. 2) AAA commitment to Evidence-Based Practice Multi-faceted topics – [e.g. fall prevention] Chronic disease self-management – consumer empowerment Project 2020 – national n4a/NASUA proposal

Challenges Not all AAAs… focus on the <60 population have self-directed care as a standard component of their operation use a flexible service structure in lieu of a service taxonomy have experience in forging business partnerships and contracts

Lynn Kellogg, CEO Region IV Area Agency on Aging 2900 Lakeview Ave. St. Joseph, MI National Association of Area Agencies on Aging (n4a)