1. Nutrition Data Webinar January 14, 2014 Kim W. La Croix MPH, RD State Unit on Aging Oregon Public Health Division Rhonda Buedefeldt OAA NAPIS Program Analyst State Unit on Aging

2.  Improve data reporting to accurately capture nutrition risk and maximize program effectiveness and funding opportunities  Understand federal reporting requirements for OAA Nutrition programs Objective:

3.  Importance of reporting nutrition data  Review of current numbers  How to report and pull nutrition data  Tips to improve reporting Agenda

4. OAA Nutrition Program Purpose: Section 330  Reduce hunger & food insecurity  Promote socialization of older individuals  Promote the health & well-being of older individuals

5. Important for SUA Nutrition & Health Health Functionality Independence Quality of life

6.  Increased aging population  More older people living longer  More women than men  More “healthy” older people  Baby boomers, diverse expectations  Managing chronic conditions  More home and community based services, less facility-based care Demographics

7.  Grant reporting requirements  Maximize funding  Reach those most in need  Tailor nutrition interventions  Leverage funds/marketing promotion Why report nutrition data?

8. STATISTICAL DATA –Hunger/Obesity/Chronic Disease –National –Oregon

9. Older Oregonians and Hunger Show symptoms of dementia More prone to falling injuries More likely to be Diabetic Far less likely to be in excellent or very good health 5x more likely to suffer from depression Twice as likely to have at least 1 ADL limitation. 5% of OR seniors are food insecure (29 th ) Ziliak, J., & Gundersen, C. (2009, Sept.) Senior hunger in the United States: Differences across states and rural and urban areas. University of Kentucky Center for Poverty Research Special Reports. http://www.ukcpr.org/Publications/seniorhungerfollowup.http://www.ukcpr.org/Publications/seniorhungerfollowup 11% of 50- 59 years in OR are food insecure (8 th ) 89% of food-insecure older adults receive neither HDM nor congregate meals GAO 2011. Nutrition Assistance: Additional Efficienceis Could Improve Services to Older Adults. Washington, DC: GAO. http: ww.gao.gov/new.items/d11782t.pdf.

10. 2000 Obesity Trends* Among U.S. Adults BRFSS, 1990, 2000, 2010 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 2010 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Source: Behavioral Risk Factor Surveillance System, CDC

11. Obesity Prevalence by County, ages 55+ PUBLIC HEALTH DIVISION Health Promotion & Chronic Disease Prevention Source: 2006-2009 Oregon BRFSS

12. Prevalence of Selected Chronic Conditions Among Older Oregonians

15. OAA Meals in Oregon FY 2011 & 2012 FY 2011 Congregate: 983, 439 HDM: 1, 705, 483 ----------------- Total: 2, 688, 922 63.4% 36.5% FY 2012 Congregate: 945, 861 HDM: 1, 705, 010 ----------------- Total: 2, 650, 871 total meals: -38, 051 /-1.5% congregate meals -37, 578/4% 64.3% FY 2011

16. Data can leverage funding opportunities CCOs: communicate, coordinate and partner with nutrition programs for services –Better nourished patients mean improved performance outcomes –Focus intervention on those with the highest need

17. Funding/Resource Streams Decreasing public funding Competition for limited public funding Trend towards social entrepreneurism Need to develop efficiency, community partnership, alternative funding, more volunteer efforts Public/private sources demanding performance data State Program Reports http://www.aoa.gov/AOARoot/Program_Results/SPR/index.aspx

18.  Gather required NAPIS (National Aging Program Information System) information  Ensure confidentiality  Framing the message, “peer pressure” to encourage people to register  Process and Systems Improvements Tips to improve reporting

19. Let’s look at important nutritional service data Oregon is required to report annually to the federal government STATE PROGRAM REPORT (SPR)

20. Q: Why is the client’s answers on the NAPIS registration important? Q: What does the AAA do with the NAPIS information? Q: What happens to the information? Oregon’s Performance Report

21. The Older Americans Act funds are to be targeted to “…older individuals who have the greatest economic need, with particular attention to low-income older individuals, including low-income minority, older individuals with limited English proficiency, those at risk for institutional placement, and older individuals residing in rural areas” OAA 306 (a)(1) Federal Requirements

22. The following demographics reported in the annual State Program Report (SPR) is our evidence that the TARGET population is being served:  Age  Gender  Rural (Zipcode)  Poverty  Live alone (# in Household)  Race and Ethnicity Evidencing TARGET population

23. Nutritional Risk/ADLs/IADLs Why are those “nutrition data questions” from NAPIS registration so darn important? Let’s take a CLOSER look at Oregon’s 2013 SPR

24. Total Clients Served – FYE 2013

25. Section IIA - Number of Clients, At-Risk Clients and Meals provided – Congregate

26. Congregate Client Demographics

27. Data Flow 1) AAA and Nutrition Site aids client in completion of NAPIS form 2) Collected NAPIS Registration information in input into OACCESS – The State’s data collection application 3) OACCESS uploads data to RAIN at midnight 4) RAIN uploads to the federal State Program Report

28. NAPIS Registration Form

29. Important OACCESS Screens Person Details – Gender, Age, Race/Ethnicity

30. Important OACCESS Screens Rural determination

31. Important OACCESS Screens # in Household and Poverty

32. Now let’s look at 2013’s Home- Delivered Meal (HDM) data

33. Section IIA - Number of Clients, At-Risk Clients and Meals provided – Home-delivered

34. Assessing Nutritional Risk

35. Client demographics for a Home- Delivered Meal (HDM) include the level of impairment. Meal Preparation Shopping Rx Management Managing $ Housework (light or heavy) Transportation EatingDressing BathingToileting Transferring (in/out of bed/chair) Walking Instrumental Activities of Daily LivingActivities of Daily Living

36. ADL/IADLs

37. HDM Client IADL levels – 2013 report

38. HDM Client ADL levels – 2013 report

39. Other nutrition service data

40. Special Diets

41. Helpful REPORTS

42. Nutritional Risk Report

44. Service & Unit report

47. Service & Billing Report

48. Reflection The Data you report substantiate’s the V A L U E of your program and service trends

49. Need Technical Assistance? http://www.oregon.gov/dhs/spwpd/pages/sua/info-aaa.aspx

50. Contact information: Kim La Croix kimberly.w.lacroix@state.or.us 971.673.0606 (desk) 971.212.1110 (cell) Rhonda Buedefeldt rhonda.buedefeldt@state.or.us 503.373.1854 Questions?