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n4a 2007 Aging Network Survey. Preliminary Title VI Survey Results March 2008. Background. National Association of Area Agencies on Aging ( n4a ) with a grant from Administration on Aging contracted with Scripps Gerontology Center , Miami University, Oxford, Ohio to:

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n4a 2007 Aging Network Survey

Preliminary Title VI Survey Results

March 2008


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Background

  • National Association of Area Agencies on Aging (n4a)

  • with a grant from Administration on Aging

  • contracted with Scripps Gerontology Center, Miami University, Oxford, Ohio to:

    • Create a self-assessment survey for Title VI and AAA organizations about key components of Choices for Independence; provide timely and useful reports.

    • Develop training and technical assistance for the aging network for moving forward with long-term care* programming.

      * home and community based long-term care


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Major components of the project

Annual web-based self-assessment survey and mini-surveys

Feasibility analysis of a national integrated provider data base

Workshops on business planning for Title VI and Title III (AAA) directors

Web accessible up-to-date and comprehensive training materials for AAA board members


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Survey

  • Web-based survey: designed using SNAP software

  • Mailed option

  • AAA survey-launched June 25, 2007

  • Title VI survey-launched August 31, 2007

  • Average completion time: 30-45 minutes

  • Toll free number available for all concerns


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Survey Development

  • Goals

    • User-friendly

    • Useful

    • Thorough

  • Input

    • Listening sessions

    • Focus groups

    • Advisory Council

    • Key Informant and cognitive interviews


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Title VI Participation

  • Scripps Title VI Coordinator

  • Support from National Resource Center on Native American Aging

  • Ongoing support from Yvonne Jackson (AoA)

  • Conducted focus group with 5 Title VI program directors (first phase of Title VI Advisory Group)

  • Contracted with Cynthia LaCounte as an independent consultant


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Different Timelines

  • AAA and Title VI surveys on different timelines due to:

    • Concerns about timing of survey, conflicts with other required reporting

    • Feedback from Title VI Directors

    • Feedback from Tribal Consultants


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Response Rates

  • AAA survey launched June 25, 2007

    81.8% response rate

  • Title VI survey launched August 31, 2007

    83% response rate


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Current Efforts

Ended survey completions mid-March, 2008

Data analysis and meaningful conceptualization

Report writing and dissemination

Continuing work with Title VI and AAA Advisory Groups

Develop and launch mini-surveys


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In this session…..

  • We present basic and preliminary findings

  • We seek your comments

  • We seek a conversation


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Organizing Principles(Choices for Independence)

Enable elders to remain in their own homes through the provision of home and community-based long-term care

Empower consumers to stay active and healthy through disease prevention and health promotion services

Streamline access to home and community-based services through single point of entry and strategic partnerships

Enhance organizational capacity of the aging network for the area-wide development and implementation of home and community-based long-term care systems.


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DRAFTPreliminary Findings and Issues

  • These findings are in draft form and should not be duplicated or shared.

  • These findings are based on an earlier, 72% response rate, not the final 83% response rate.

  • Final analysis will be reported at a later date.


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Organizational Capacity

  • Average (mean) # of Clients Served: 278

    • 25th Percentile: 85

    • 50th Percentile: 150 (median)

    • 75th Percentile: 374

  • Average (mean) # of Employed Staff:

    • Full Time: 3.9

    • Part Time: 3.2

  • Average Length of Current Director (years): 7.0

  • Average Length of Previous Director (years): 3.7


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Services

  • Participants were asked to identify which home and community-based services (out of a list of 28) they provide and whether those services were provided with OAA funding and/or other funding.

  • They were also asked to identify if select services were provided with a consumer directed option.


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Assistive devices

Case management

Chore

Native American Family Caregiver Support Program

Home delivered meals

Home health

Homemaker

Home modification

Home repair and maintenance

Official eligibility determinations for public programs

Congregate meals

Food pantry

Information and referral/assistance

Legal assistance

Outreach

Ombudsman

Paperwork and money management

Translator/interpreter assistance

Services

  • Medication Management

  • Personal Care

  • Respite Care

  • Transportation

  • Adult day service

  • Adult Protective Services

  • Assessment for care planning

  • Assessment for long-term care service eligibility

  • Benefits counseling


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Services(Proportion of programs who offer select services)


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OAA Funding

Congregate Meals 95.4%

Home delivered meals 90.8%

IR/A 88.4%

Outreach 82.1%

NAFCSP 71.7%

Transportation 71.7%

Other Funding

Home repair and maintenance 66.7%

Transportation 66.7%

Assistive devices 60.5%

Home modification 59.3%

Medication management 55.6%

Home health 49.4%

IR/A 49.4%

Benefits Counseling 49.4%

Services(Proportion of programs who offer selected services with OAA funding and with funding other than OAA)


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Consumer Directed ServicesAnalysis issue: How did respondents interpret “consumer directed services?

  • 22.5% of programs stated that their program provides consumer/self-directed services.

  • Most common consumer directed services include:

    • Respite care 82.1%

    • NAFCSP 30.8%

    • Chore 30.8%

    • Personal care 23.1%


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Funding Sources

Percent of respondents providing home and community-based services with funds other than OAA funds:

  • Medicare 5.6

  • Medicaid 12.5

  • Medicaid waiver 16.3

  • Indian Health Service 70.6

  • American Indian Relief Council 4.4

  • Revenue from gaming 20.6

  • Other tribal funding 73.1

  • Title III funding 41.3

  • Other state funding 28.8

  • SSBG 13.1

  • Grant funds 15.6

  • Private pay clients 3.1

  • Other 16.9


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Funding SourcesPercent of programs that use at least some funding from each of the following sources.


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Disease Prevention and Health Promotion Services or Programs (proportion of programs that provide disease prevention and health promotion services or programs-regardless of funding source)


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Funding Sources (Disease Prevention and Health Promotion)

Percent of respondents providing disease prevention and health promotion services and programs with funds other than OAA funds, from the following sources:

  • Medicare 3.8

  • Medicaid 9.6

  • Medicaid waiver 9.0

  • Indian Health Service 78.8

  • American Indian Relief Council 3.8

  • Revenue from gaming 10.3

  • Other tribal funding 49.4

  • Title III funding 28.8

  • Other state funding 15.4

  • SSBG 5.1

  • Grant funds 15.4

  • Private pay clients 2.6

  • Other 10.3


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Involvement in Key Programs

  • ADRC: How did respondents define ADRCs?

  • Evidence-Based Programming: How did respondents define ADRCs?

  • Transition Programming: How did respondents define transitioning elders from nursing home back to community?

  • Targeting: How did respondents define targeting?


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Single Point of Entry

  • How did respondents define single point of entry?


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Partnerships

  • Participants were asked to identify which partnerships (out of a list of 20) they maintain with federal, state and local organization or affiliations.

  • They were also asked to identify if the partnership was formal (formalized with a contract, compact or memorandum of agreement) or informal (non-contractual)


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Federal agencies

Medicaid

Indian Health Service

Tribal organization or consortium

Department of Health

MR/DD organizations

Disability service orgs.

Mental/Behavioral health

Adult Protective Services

Public housing authority or other housing programs

Partnerships

  • Health care providers and maintenance

  • Managed care/HMO network

  • Businesses

  • Advocacy organizations

  • Charitable organizations

  • Educational institutions

  • Research institutions

  • Religious organizations

  • Other social service orgs.

  • Other


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Partnerships-Formal and Informal (5 most common and 5 least common partnerships)


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Formal Partnerships

Tribal organization or consortium 44.4%

Indian Health Service 42.6%

Health care providers 38.0%

Federal agencies 27.8%

Department of Health 25.9%

Informal Partnerships

Health care providers 83.7%

Indian Health Service 80.7%

Public housing authority or other housing programs 74.7%

Adult Protective Services 71.7%

Department of Health 70.5%

Partnerships(Most common formal and informal)


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Progress Questions

  • Sets of questions related to Choices principles

  • Response Options:

    • Do not plan to work on this.

    • Would like to work on this but cannot.

    • Plan to work on this but have not begun.

    • Have made progress.

    • Have this in place.


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Helping Elders to Remain in their Own Homes: Most progress

  • Asking elders about their service preferences.

  • Assessing elder satisfaction with their services.

  • Assisting elders in planning in advance for long-term care.

    (Discuss)


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Helping Elders to Remain in their Own Homes: Least progress

  • Providing vouchers or cash to elders so they may purchase services.

  • Providing services to elders who pay for their own services.

  • Building billing systems for private pay elders.

  • Developing policies and procedures to serve private pay/insurance elders.

  • Developing policies and procedures for elders who pay for a part of their services.


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Helping Elders Get Home and Community-Based Services: Most progress

  • Developing collaborations with our local Area Agency on Aging (Title III)

  • Improving our Information and Referral/Assistance System.


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Helping Elders Get Home and Community-Based Services: Least progress

  • Electronically maintaining a billing system.

  • Developing innovative technology to improve elder access.


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Helping Elders Get Home and Community-Based Services: Mixed progress

  • Positioning our organization as the single point of entry for long-term care in our area.

  • Coordinating a single assessment and eligibility determination process.

  • Electronically maintaining information about elders and their services.

  • Electronically maintaining health information about elders (ADLs, IADLs, diagnoses).

  • Electronically maintaining provider information.


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Building Home and Community-Based Long-Term Care Systems:Most progress

  • Developing a system to provide home and community-based services to older adults.

  • Acquiring board/governance support for home and community-based service provision.

    • (Discuss: Did respondents mean tribal government support as opposed to organization board?)

  • Acquiring Tribal Council support for providing home and community-based services.

  • Having culturally competent staff.


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Building Home and Community-Based Long-Term Care Systems: Least progress

  • Developing a system to provide home and community-based services to persons of all ages.

    Building a tribal nursing home.


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Building Home and Community-Based Long-Term Care Systems: Mixed progress

  • Having enough staff to move forward with new programs.

  • Case managing long-term care services.

  • Having financial resources to move forward with new programs.

  • Seeking grants for programs.

  • Obtaining grants for programs.

  • Fund-raising and development.

  • Developing relationships with universities or research centers to evaluate our programs and activities. (Discuss)

  • Marketing to attract elders to our services.

  • Building a tribal assisted living facility.

  • Expanding the types of services we offer.


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Training and TA Needs

Percent of respondents who identified the following training and technical assistance needs as most useful to their organization:

  • Understanding the LTC system 69.3

  • Resource development 60.8

  • Strategic planning 60.8

  • Learning more about Medicare 46.4

  • Learning more about Medicaid 44.6

  • Strategic alliances 27.1

  • Choices for Independence as a strategic framework 26.5


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In memory of

Alan Allery

And in honor of his important contribution to this effort.


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For further information:

[email protected]

[email protected]

[email protected]

Scripps Gerontology Center

Miami University

Oxford, OH 45056

513-529-2914


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