Four Year Plan

    SECTION I

Executive Summary

The Older Americans Act of 1965 established the Administration on Aging and acknowledged a governmental responsibility for meeting the basic needs of Older Americans.  Under this act, grants were provided to states to plan for and provide community services to older adults that would allow for “retirement in health, honor, dignity-after years of contribution to the economy”.   Reauthorized many times since the original passage, the Older Americans Act continues to provide a framework for state and local governments to develop individual plans to meet the needs of seniors.  The most recent re-authorization, in 2006, includes amendments that emphasize the importance of informed choice at all levels of decision-making regarding utilization of services.

The York County Area Agency on Aging celebrates more than thirty years of providing service and information to older adults.   Officially created in May 1975 by the York County Board of Commissioners, this non-profit organization has served as the core entity to plan and provide services to a growing population with changing needs.  As we move into the next cycle of service provision, we take seriously our responsibility to use the resources that are available to meet the needs identified by the local population. 

This Four Year Plan is the culmination of both an internal and external review of the issues the agency and the population we serve are facing.  It also incorporates the major trends found in the Strategic Action Plan for the U.S. Administration on Aging.  Initial strategizing for the plan began in August 2007 at a retreat for members of the Advisory Council Executive Committee and key staff members from the Agency on Aging.  The full advisory council was involved in a special planning session in September 2007, prior to the development of the survey tool and the questions for the focus groups.  More than 700 completed consumer surveys and diverse participation in four focus group sessions provided the input utilized to formulate the plan.  Final comments presented at the public hearing on April 14 provided closure to the plan as submitted to the Pennsylvania Department of Aging for approval. 

Minimal funding comes to the local agencies on aging from the federal government to partially support community services such as senior community centers and nutrition sites, transportation, education, and caregiver support.  In Pennsylvania, these funds are supplemented by state funding generated by the Pennsylvania Lottery to benefit Older Pennsylvanians.  A small amount of additional funding is provided from the County General Fund.  Combined funding has proved greatly insufficient to provide for even the basic needs of older adults struggling to maintain their independence in the community.  This plan makes no assumptions for increased funding at a level that would fill those gaps.  Instead, the focus is on partnerships and education, fostering a sense of community and neighbor responsiveness. 

Increasingly, the York County Area Agency on Aging relies on private, social, and faith based organizations to share a common mission to promote the continued independence of older adults in our community.   High utility bills, property taxes, and medical and insurance issues were cited as some of the greatest concerns our consumers are facing.  We find that providing information and resources to assist in making informed choices on these issues has become a much more important service over the last ten years.  It is our goal to enlist and train additional staff and volunteers from partner organizations to provide a front line of resources in the communities where older adults live and experience the greatest comfort level.  Our plan embraces intergenerational and peer support programs that are responsive to the diverse cultural and language needs of our consumer base. 

Another critical component of this four-year plan is the focus on Health and Wellness as they relate to healthy and independent living. It is far better for our society if we can empower older individuals to make healthy choices regarding their lifestyles that allow them to live active and quality lives.  We will utilize an array of resources and partnerships to educate, educate and educate.  An expansion of information resources available through additional and innovative mediums will greatly increase our ability to distribute timely and accurate information.  As an increasing number of older adults are comfortable accessing web sites, we will be utilizing more fully those resources to expand awareness of programs and services.  Blogging, You Tube, and e-mail alerts are quickly becoming accepted modes of communication among the Baby Boomer population we are serving as new and pre-retirees. 

While our agency will continue to provide the traditional hands on services such as assistance with personal care, respite, and home delivered meals, we find that funding does not keep pace with the increasing cost of such services.  The same pool of resources will be stretched to provide these services for an increasing group of older adults and there will be no choice but to tighten criteria so that we hold true to our mission statement and serve first those “with the greatest social or economic needs”.  More than eighty percent of Agencies on Aging across the state currently have waiting lists for Home and Community Based services, and without sufficient funding increases to balance population growth; there is little hope that we can avoid that same predicament.

Our plan has us refocusing and redirecting to touch as many lives as possible and connect individuals with the resources and information to make informed choices regarding services, health care and active living opportunities. We have the support of a community that will continue to work side by side to achieve the common goals that are a part of this plan.  None of the goals listed below are achievable without that support.

 

GOAL I           EMPOWER OLDER YORK COUNTY RESIDENTS TO STAY ACTIVE AND HEALTHY THROUGH THE PROMOTION OF HEALTH AND WELLNESS

 

 

GOAL II          ENABLE OLDER YORK COUNTY RESIDENTS TO REMAIN IN THE SETTING OF THEIR CHOICE THROUGH THE PROVISION OF HOME AND COMMUNITY-BASED SERVICES

 

 

GOAL III         EMPOWER OLDER YORK COUNTY ADULTS TO MAKE INFORMED DECISIONS THROUGH AWARENESS AND EDUCATION

 

 

GOAL IV        EMPOWER OLDER YORK COUNTY ADULTS, THEIR FAMILIES, AND OTHERS TO ADVOCATE FOR RIGHTS AND BENEFITS FOR ALL SENIOR CITIZENS 

SECTION II

Agency  Overview

            The mission statement of the York County Area Agency on Aging continues to provide the framework for the agency as we look to the changing demographics and identified needs of our older population.

As we look to the next four years, it is increasingly important that we focus educational and advocacy efforts on the community as a whole if we are to successfully empower older individuals to better maintain their health and preserve maximum independence.  The goals and objectives in our plan are specific to this.  The investment of resources in low cost prevention programs has been proven to reduce the health care and placement costs that accompany advanced disease processes and functional impairment. 

Organization:

            The York County Area Agency on Aging is structured to provide staffs and resources to respond to the questions, problems and ongoing needs of a diverse older population.  We are a county-based non-profit organization, one of 52 Area Agencies on Aging located across the state.  We are governed by the York County Board of Commissioners, and the 65 staff members are employees of York County.  The department is one component of the County Human Services Department, operating under the direction of the Executive Director of Human Services.  Providing additional oversight and direction is the Advisory Council for the agency, whose members are appointed by the Board of Commissioners.

            The Pennsylvania Department of Aging has primary oversight for the administration of services directed and funded under the Older Americans Act.  This department also administrates an additional subset of services and programs unique to Pennsylvania. Primary funding for planning, programs and services comes to our local county entity under the terms of a cooperative agreement with this department.  This plan, which requires the approval of the Pennsylvania Department of Aging, is the local link in the chain of planning that is occurring at the state and federal level.

            The York County Area Agency on Aging is comprised of three departments, Administrative, Social Services and Program Development.  A five-member senior leadership team work together to provide oversight for the agency in general and administer the programs and services under our direction.  In addition to managing the human resource component of 65 staff persons, there are an additional more than 200 volunteers that provide service with varying degrees of time commitment, and a full complement of contracted service agencies that have daily contact as direct service providers.

            Our Program Development Department administers perhaps the greatest variety of services available on the local level.  Many of their activities are collaborative efforts involving numerous community partners and volunteers.  Staffs from this department answer questions on everything from housing options to complex insurance issues.  There were almost 20,000 information and referral contacts handled by the agency in 2007.  This department manages the local APPRISE program, which deals with the Medicare Part D Prescription Drug program as well as other insurance issues facing older adults.  The Medicare Part D program has required a complete shift in human resources to deal with the demand of education and one-on-one assistance to navigate increasingly complex programs.   In 2007 alone, more than 5000 Medicare Beneficiaries were assisted at 126 Medicare Drug Benefit counseling events.  Other programs and events managed by this department include publication of the bi-monthly New Horizon newspaper with a 29,000 subscription, organization of the annual Senior Games, distribution of Farmers Market Nutrition vouchers, administration of the annual local Flu Vaccine program along with other health promotion activities, and provision of countless educational seminars, benefit and health fairs, culturally diverse events, and organizational speeches. 

            The Administrative Department includes the Agency Director, Deputy Director, Director of Administrative Services, and supportive staff to administer the budgetary, contractual, and computer support functions of the agency, as well as provide advocacy and mediation services to residents of long term care facilities.  The agency currently administers an annual budget of 9.6 million dollars and contracts for direct service provision with 45 different vendors.  

            The Social Services Department represents the largest segment of staff resources.  Care Managers, Supervisors, and Support Staff are responsible for the intake, assessment, and individual care plan monitoring functions of the Agency.  Consumers of service are not limited to the older adult population.  Care Management Assessors conduct level of care assessments for any individual, aged 18 or older, to determine eligibility for long-term care services which may partially require public funding.   In addition to assessment responsibilities, Care Managers provide ongoing support and service management for more than 1300 older adults receiving in Home and Community Based Services on any given day, and investigate and resolve reports of older adults who may be in need of Protective Services.  In 2007, this department received 369 such reports.   

Our Community:

  York County is a mix of rural and urban neighborhoods, each with their own challenges and strengths.   Rural and urban seem to be meeting in the middle as an influx in population creates a demand for new housing developments in every area of the county.  The total county population currently exceeds 416,000.

Total York County Population and Growth Rates, 1990 -- 2006
Age	Total Population 1990 Census	Total Population Census 2000	Total Population (July 1, 2006)	Growth Rate, 1990-2006	Growth Rate, 2000-2006
Total	339,574	381,751	416,322	22.6%	9.1%
Age 85 years or older	4,493	6,107	8,102	80.3%	32.7%
Age 65 years or older	44,443	51,492	56,154	26.4%	9.1%
Age 55 to 64 years	31,000	36,018	48,028	54.9%	33.3%
Source: 1990 Census; Census 2000; 2006 Population Estimates (July 1, 2006) ( U.S. Census Bureau Population Division)

We are located in one of the fastest growing areas of Pennsylvania, if not the nation, in terms of older adult population numbers.  We have seen a particular surge in the number of individuals aged 85 and older, who traditionally have the most intense needs for services and resources.  How do we cope with a 33 % increase in that population over the six-year period from 2000-2006 and prepare for the even larger surge in those currently aged 55-64? The services we currently have in place seem grossly inadequate to meet the challenges we face.  Our plan for the next four years and beyond must lead us outside of the traditional roles played by local Agencies on Aging.  We must strengthen existing relationships with partners in the community, creating new ones where appropriate, and embrace new technology that will allow us to more fully increase awareness of resources and choices.

Not only are we serving and preparing for huge increases in number of older adults, we are also well aware of the increased racial and cultural diversity present in this group. Total minority representation in York County approaches 10 % of the total population.  From 2000-2006, York County has seen a 1% increase in the number of individuals of Hispanic or Latino origin.  Those individuals are currently estimated at 3.9% of the total population.  Many of the goals in the current plan are dependent on our effectiveness in reaching and educating older adults. We are committed as an agency that language or cultural barriers should not compromise access to service.  We continue to increase our supply of informational resources for Limited English Proficient adults, secure translation services for the programs and services we provide, and strengthen our relationships with organizations with direct ties to diverse population groups.  Additionally, we strive to balance our workforce to be representative of the community and hope to increase the diversity of staff at all levels.

Residence:

            As is typical across Pennsylvania, older adults in York County prefer to engage in and receive services in their own homes and communities. Even though there are currently an additional 2,000 older adults in York County aged 85 and older as opposed to eight years ago, we have seen only a minimal increase in the number of skilled nursing home beds.  There are currently 2,173 beds available in 15 Skilled Nursing Facilities across the county, with five of those existing as part of a continuing care community.   While the number of beds has not grown significantly, the number of individuals entering and exiting these facilities for short-term stays has increased.   The agency focuses upon the population in need of some assistance to return home through our Nursing Home Transition Program, staffed by a Long Term Living Counselor who works directly with all Skilled Nursing Facilities in the county.  Administrators of local facilities describe admissions occurring with more of a “revolving door” practice as consumers increasingly seek rehabilitation services that will strengthen their ability to return to independent living.    For these individuals, Medicare pays for much of the short-term care they receive.  Those who experience long term stays in Skilled Nursing Facilities tend to be those aged 85 and older. The great majority of long-term residents in Skilled Nursing Facilities will at some point qualify for Medical Assistance payments that
exceed $5,000 per month.

Source: 2005 statistical abstract of the United States

            Assisted Living Facilities and Personal Care Boarding Homes have seen an increase in census over the past several years and many have expanded the scope of services available to residents.  Multi level services, including dementia care, are available with costs dependent on the level of services provided. Presently, in York County, 32 facilities exist to provide residential and personal assistance services to individuals determined to need support that is less than would be provided in a Skilled Nursing Facility.  New regulations are in place that governs the operations of Personal Care Boarding Homes, and new regulations are pending following the recent passage of Assisted Living legislation.  The goal of both is to improve the safety and well being of residents and enforce a consistent set of minimum standards. 

            There is a significant cost difference between Skilled Nursing Facilities and Assisted Living Facilities.  The average daily rate of the private room rate for York County Nursing Homes is $251.00. The average monthly rate for York County Assisted Living Facilities is $2678.00. The chart below shows a sampling of similar current cost comparisons in other areas of the state.

NURSING HOMES			ASSISTED LIVING FACILITIES
REGION	PRIVATE ROOM AVERAGE (PER DAY)		REGION	AVERAGE                    (PER MONTH)
Pittsburgh, PA	$234.00		Pittsburgh, PA	$2,578.00
Scranton, PA	$198.00		Scranton, PA	$2,133.00
Philadelphia, PA	$233.00		Philadelphia, PA	$3,419.00

Source:  The 2007 MetLife Market Survey of Nursing Home and Assisted Living Costs

There is an even wider disparity in payment between facilities that accept the Personal Care Boarding Home Supplement and those that do not.  The current reimbursement for a Personal Care Boarding Home provider if the resident has a total monthly income of less than $1,076.30 is $1016.30 month.  The resident retains $60.00 of their income for all other personal expenses.  Fewer and fewer homes in York County are willing to accept the state supplement as payment in full, which reduces the options that low income older adults as well as younger, functionally disabled adults have regarding shelter.  The increased monitoring by the Department of Public Welfare and the enforcement of the Personal Care Boarding Home Regulations is well intentioned, however the end result is that several homes no longer have a license to operate, and many more are operating with provisional licenses.  If a plan to increase reimbursement to providers does not materialize that is sufficient to cover the costs associated with providing minimum standards of quality care, our county will find itself in a crisis situation.  This issue surfaces as an objective for advocacy in the current plan.

In addition to the many facilities that offer choices for long term living, York County has a countywide distribution of subsidized housing options available to older adults who meet the financial eligibility criteria.  We have been fortunate in recent years to add several new buildings in various parts of the county dedicated to low/moderate income senior populations as the result of tax credit partnerships.  These complexes provide safe affordable housing and on site social service assistance, as well as foster a genuine sense of community among the residents.  The influx of new apartments has not, however, kept pace with the population surge in our county, nor has it addressed the increasing need for safe housing for the very low-income group.  There are long waiting lists for both income based rental units and Section Eight Rental Assistance.

The Demographics of Poverty:

            Addressing the need for low-income safe housing leads us to the next discussion on local poverty realities.  From first look at updated census numbers one might determine that poverty among older adults is less an issue than previously experienced.  The percentage of adults aged 65 and older at poverty level has decreased from 6.8% in 1999 to 5.6% in 2006.

Ratio of Income to York County Poverty Level for Individuals 65 +, 1999
	Number	Percent
Total 65+	48,753	100.0%
Under .50	1,155	2.4%
Under 1.00	3,332	6.8%
Under 1.25	5,480	11.2%
Under 1.50	8,472	17.4%
1.50 and over	40,281	82.6%
Source: Census 2000 SF3, Table PCT50

 

Ratio of Income to York County Poverty Level for Persons 65 +, 2006
	Number	Percent
Total 65+	53,666	100.0%
Under .50	931	1.7%
Under 1.00	3027	5.6%
Under 1.25	5646	10.5%
Under 1.50	7656	14.3%
1.50 and over	40821	76.1%
Source: ACS 2006, Table B17024

            The reality is that more than 10% of individuals aged 65 or older in our county live on an annual income of  $10,400 or less for a family of one and $14,000 or less for a couple.  It is no wonder that insurance and medication costs, property tax bills and high utility and household maintenance cost were the major concerns of those responding to our survey.   While the state of Pennsylvania has devoted additional lottery fund dollars to Property Tax rebates and PACE medication assistance, significant gaps in resources continue to exist for older adults.  While we continue our advocacy for services and programs to provide for basic needs, we will also expand efforts to increase the enrollment in and utilization of existing resources. 

            Home and Community Based Services are provided in York County with the full understanding of the financial limitations of the population we serve.  A small co-pay for shared ride transportation services, optional donations for congregate and home delivered meals, and a sliding scale cost share for other in home services are the only cost for services.  In terms of cost share, less than 20% of the consumers that receive cost shared services pay any part of the cost of their service. 

 

Challenges:

            As noted before, York County has experienced some of the largest older adult population growth in the state, almost 45% since 1990. Many other counties in the state have fewer older adults than they did in 1990.   It would be reasonable to assume that as population shifts, increased funds go to the areas seeing growth.  That is not the case in Pennsylvania.

In the early 1990’s, “Hold Harmless” legislation was passed to protect counties from suddenly losing state funds if the population decreased in their region.  Only “new” funding could be distributed to balance population shifts.  Some counties have as much as 19% fewer seniors than they did in1990, however they continue to receive the same level of funding from the state.  Counties with increased numbers get no additional compensation for the growth.   York County receives less funding for each older adult that lives here than almost any county in the state.  While the Pennsylvania Department of Aging has an updated funding formula in place to distribute funds, they cannot make any redistribution of historical funding.  A tremendous inequity in the distribution of Penn Care funding is the result, with York County continuing to be underfunded by more than 20% based on current demographics. 

The more than one (1) million dollars due to York County, if redistributed based on current population, would provide adequate funding to restore cuts to senior centers that occurred several years ago, and double the availability of in home assistance.  We will remain optimistic that a distribution of dollars from the Lottery Reserve may correct this injustice; however we are not so optimistic as to include those dollars in our plan. 

  Long-term care in Pennsylvania is at a critical point as the system strives to re-balance costly facility based skilled nursing care with home and community based services that represent maximum consumer choice.  Without an increase in the latter, we will not achieve this goal.  We have made every effort to listen and develop a plan that is innovative in its cost effectiveness but still responsive to the needs of our community.  The development of this plan was a true partnership with our community and the success of it is fully dependent upon strengthening that partnership.

 

SECTION III

Goals/Objectives

Where is the Agency going?

   

The following four goals have been identified as priority areas for the York County Area Agency on Aging for the 2008- 2012.  These goals follow the mission of a responsive and consumer-directed long-term care system that supports older adults in the community. 

GOAL I      EMPOWER OLDER YORK COUNTY RESIDENTS TO STAY ACTIVE AND HEALTHY THROUGH THE PROMOTION OF HEALTH AND WELLNESS

GOAL II    ENABLE OLDER YORK COUNTY RESIDENTS TO REMAIN IN THE SETTING OF THEIR CHOICE THROUGH THE PROVISION OF HOME AND COMMUNITY-BASED SERVICES

GOAL III   EMPOWER OLDER YORK COUNTY ADULTS TO MAKE INFORMED DECISIONS THROUGH AWARENESS AND EDUCATION

GOAL IV  EMPOWER OLDER YORK COUNTY ADULTS, THEIR FAMILIES, AND OTHERS TO ADVOCATE FOR RIGHTS AND BENEFITS FOR ALL SENIOR CITIZENS   

 Goals/Objectives

Health and wellness of older adults has a major impact on the quality of life, as well as the need for community based and long term care services.  Older adults getting and staying healthier will reduce the demands on the aging system. 

The following target areas have been identified through the planning process as issues for our community’s older adults: nutrition, exercise, diseases, fall risk, medications, prevention, mental health, and health care.  Known statistics reflect that significant positive results can be reflected in overall health and wellness, with regular exercise, good nutrition, and on-going education on health issues. Falls are a significant cause of injuries to older adults and are often the origin of the domino effect of later medical problems.

As baby boomers age into the network they bring a different perspective to healthy living and wellness.  Compared with their parents, boomers are healthier and better educated.  They will be faced with the challenge of the cost of health care and the decreasing standard of retirement with employee health benefits.   Balancing the programming and provision of health promotion programs to this new generation while still serving the traditional consumer will bring challenges to the delivery of programs and services.  Volunteerism will play an important role for this new older adult, offering them the opportunity to remain active and involved while meeting the need for support and assistance with programming for other older adults.

Three areas have been identified and will be the focus of the objectives in the promotion of health and wellness goal.  The three objectives are as follows:

 

Objective 1     Strengthen and expand the community partnerships for the delivery of health programs to reach older adults in York County, including those in rural areas.

     

 

Objective 2     Reduce falls in the home.

 

 

Objective 3     Continue and expand the community education for pre-retiree and recent retirees.

 

Older adults want information regarding options for available care today.  They are also interested in directing their own care needs in a variety of settings of their choice.  While limited funding prevents the expansion of agency sponsored in-home services, the role of the agency will focus in the area of awareness, education, and developing community partnerships.  Priorities for available traditional in-home services will remain for at risk, low-income older adults, including those in rural areas and of diverse cultures.

Access to information on housing related issues is a key to the success of older adults remaining in the setting of their choice.  Information on housing options, utilities, alternative financing, taxes, home maintenance, and more will need to be available so that older adults can make informed decisions.

Collaboration and cooperation among the various community partners and across cultural diversity, is vital to the success of meeting the needs of all older adults and their caregivers.  Senior-related organizations will need to join together in partnerships to meet the needs of older adults.  The community in general- family members, faith community, neighbors and more- will need to take a stronger role in the lives of older adults. 

Caregivers are a valuable resource and are the key to caring for loved ones in the community. Specific attention and support is needed for caregivers, including those caring for older adults and those older adults caring for their grandchildren. 

Three areas have been identified and will be the focus of the objectives for this goal.  The three objectives are as follows:

 

Objective 1     Develop community partnerships to increase awareness of aging network services and programs.

 

     

Objective 2     Expand agency resources regarding available housing options in the community.

     

 

Objective 3     Assist caregivers to maintain older adults in the setting of their choice and assist caregivers of grandchildren in meeting their needs.

Awareness of services, programs and issues are the most important keys to successful aging. Objective information should be easily accessible to all older adults, across diverse cultures and incomes.  This will require literature and programming to be available in English and Spanish, and accessible to all individuals.

The health care and insurance system for older adults is complex and fragmented. Medicare, other health insurance issues, and prescription drug coverage have become a priority for older adults across all cultures. Ongoing education is vital to assure that older adults have appropriate insurance resulting in good health care.

Tools need to be available for the wide spectrum of older adults, those coming into the system now, as well as the 80+ year old seniors.  We will need to equip baby boomers with the knowledge “tools” to help themselves, which will also enable them to help older relatives. The range of tools must reach the new senior citizen, as well as the isolated older senior living in the community. 

Three areas have been identified and will be the focus of the objectives in the promotion of awareness and education.  The three objectives are as follows:

 

Objective 1     Expand the use of the Internet to increase education and awareness of programs and resources.

 

 

Objective 2     Reach out to older adults through a variety of mediums, resources, and across language barriers.

 

 

Objective 3     Continue to be an educator, advocate and counselor in the area of

                         Medicare and other health insurance matters.

 

Advocacy of senior issues is an important role for everyone, including older adults themselves.  On-going community-wide advocacy efforts are needed in support of senior issues.  According to the community survey completed during the planning process the highest areas of concern by older adults is regarding taxes, health care and medications. Advocacy at the local, state and national level is one of the vital steps that can be taken on these issues.   

Older adults themselves need to be activated to speak up on behalf of their own issues. This can be accomplished if the proper tools are made available to them.  There are many issues for older adults that are beyond the authority and/or financial control of the agency.    The agency can serve as the facilitator and educator to enable and empower others to do appropriate advocacy.  

A specific advocacy issue of concern is access to affordable licensed Personal Care Home facilities in York County.  This is a current concern and is expected to grow in future years. This advocacy needs to come in the form of support from other professionals in the community who are involved in placement and care of those individuals in need of the personal care home option, along with older adults and their families.

Three areas have been identified and will be the focus of the objectives in the promotion of advocacy for older adult issues.  The three objectives are as follows:

 

Objective 1     Enable seniors to advocate for senior issues including, taxes, Medicare, utilities, home maintenance expenses, health insurance/cost of medications, and assistance with caregiving issues.

 

 

Objective 2     Mobilize a Network of provider/advocates.

  

 

Objective 3     Advocate for access to affordable licensed Personal Care Home facilities. 

SECTION IV

Strategies

Strategies and Outcomes & Performance Measures

 

Objective 1     Strengthen and expand the community partnerships for the delivery of health programs to reach older adults in York County. 

      Strategies:

Ø      Bring programming to the consumer, including low-income adults and those living in rural areas, by partnering with community resources.

Ø      Collaborate with senior centers on programming and activities.

Ø      Facilitate intergenerational opportunities through partnerships with schools.

Ø      Partner with the medical community to promote regular doctor visits.

Ø      Partner with the faith community to promote health awareness.

Ø      Create a clearinghouse of health and wellness information and resources.

Ø      Offer community-based programming to include peer support and mentoring.

Ø      Offer programming for diverse cultures and languages.

The eight strategies shown will be initiated through the continuation and strengthening of the efforts that have already been started with the partners in the senior centers, schools, faith and medical communities. This effort will be strengthened in the first year of the plan and will continue during the duration of the plan. Staff of the Program Development Department, will have leadership responsibility in this area; although it is expected that staff from all divisions of the agency will play a role in the effort.  It is also expected that the community partners will assume responsibility for various aspects as their roles and commitment are defined.  Measurement of this objective will occur by evaluating new partnerships developed, along with continuation of long-term partnerships. It is projected that two (2) new partners will be identified each year of the plan.  A true measure will also occur as activities and programs are developed with outcome-based tools included in the design and planning.   The clearinghouse of health and wellness information will be initiated in the second portion of the planning time frame. Community resources will be used as collaboration sources and potential leaders. These will include the already established community resource, the FIRST information and referral system.

 

Objective 2     Reduce falls in the home.

 

      Strategies:

Ø      Identify funding to activate a community fall risk program.

Ø      Partner with professionals and businesses in the community for the development and promotion of a fall risk program.

Ø      Expand the Prime Time Health Healthy Steps Program in senior centers and other community locations.

The first two strategies in the reduction of falls objective will require additional time and effort. These will be projected for initiation after year two of the plan with completion by the end of the four years.  These strategies will require involvement from agency managers, along with staff from the Program Development Department. This will also require the development of strong partners for funding and development of the program. A search for partners will begin in the initial years of the plan. The outcome measures will be developed along with the actual program, so the successes can be measured. The third strategy will be initiated by the Prime Time Health Coordinator in year one of the plan with expansion of the Healthy Steps Program from the current participation of four (4) senior centers to an additional two (2) senior centers and two (2) other community locations. Gradual expansion of the program will continue in the following years. The Healthy Steps Program has outcome measures within it as it tracks participants through completion of the program. 

 

Objective 3     Continue and expand the community education for pre-retiree and recent retirees.

 

      Strategies:

Ø      Continue new retiree seminars in conjunction with health partnerships.

Ø      Develop programs targeting the baby boomer population.

Ø      Continue and expand facilitation of community activities to include health fairs, senior games, and other programs.

Ø      Promote volunteerism and recruit for agency programs, including diverse cultures.

The first strategy of this objective will be initiated in year one of the plan by the APPRISE Coordinator and volunteers. The retiree events started in late 2007 will be expanded to meet the increasing demand. The program will be improved to address the issues of the targeted population and be offered more frequently in two locations in the county.  The quality of the retiree seminars is measured through surveys completed by participants at every event. The number of participants attending the events will also measure the success. The current annual participation of 400 attendees will be expanded by 50% over the first two years of the plan. The agency’s Information Specialists will spearhead the second and third strategies, developing programs to target the baby boomers and expansion of community outreach activities. These will begin in year one of the plan and will continue through the duration of the four years. This strategy will include agency sponsored activities, as well as participation in a wide range of community sponsored events. The current participation of an estimated ten (10) events annually will be targeted to increase an additional 20% each year of the plan. The fourth strategy will be the responsibility of the Volunteer Coordinator and will also be an on-going effort throughout the next four years. Promotion of volunteer programs, including recruitment of new volunteers will continue in an aggressive manner. A prime target will include the retirees who attend the seminars outlined in the first strategy. This strategy will be measured by surveys of all volunteers and other informal tools, including the number of active and new volunteers recruited and retained in the program.

 

Objective 1     Develop community partnerships to increase awareness of aging network services and programs.

 

      Strategies:

Ø      Develop and facilitate neighborhood networking to foster a sense of community, including rural areas.

Ø      Encourage community leaders, including those from diverse cultures to mobilize their community as a resource for older adults

Ø      Partner with townships/municipalities for education and resources

Ø      Partner with faith organizations.

Ø      Partner with the medical community.

Ø      Partner with private industry and community foundations to expand resources.

Agency staff, advisory council members, members of the Multi-Cultural Coalition, and other community resources will facilitate the strategies in this objective.  Development of partnerships with the medical, faith, and municipalities will be initiated in the first year of the plan; however the efforts will be an on-going process. The current partnerships in each of these areas will be expanded to include 2 new partners each year of the plan. The outcome measures will reflect in the number and strength of the partnerships. The community and neighborhood networking will be impacted by the success of the partnerships, along with outreach and education efforts that will occur in Goal III. The final strategy will require researching, education, relationship building, and more. The focus of this strategy will occur in the later years of the plan. Performance measures will include the development and formation of partnerships and sustaining such.

 

 

Objective 2     Expand agency resources regarding available housing options in the community.

 

      Strategies:

Ø      Partner with local housing organizations, and other housing sources.

Ø      Develop a means to make housing resource database available to the general community.

Ø      Develop resource booklet/tool for linking to clearinghouse.

The strategies under this objective will be initiated in year two of the plan. The partnerships will be initiated first and the two other strategies will be initiated in cooperation with the new partners.  Staff from across agency departments will have a role in facilitating this goal.  It is expected that the community partners will spearhead some of this effort in cooperation with the agency.

 

Objective 3     Assist caregivers to maintain older adults in the setting of their choice and assist caregivers of grandchildren in meeting their needs.

 

      Strategies:

Ø      Develop resource information/tools on programs and services available.

Ø      Partner with faith and business community to facilitate services and support for older adults to remain in their homes.

Ø      Promote and expand the Rent-a-Kid Program.

The second strategy will have already been initiated in prior objectives through partner building. This strategy will interface with the strategy efforts in Goal II, when the partnership is initially developed.   The agency’s Information Specialists will take leadership responsibility for strategy one. This effort will include working with the FIRST (Free Information and Referral Service – countywide service sponsored by York County United Way) staff, where a portion of this information is already compiled. The final strategy under this objective will be a joint effort of several staff and volunteers of the Program Development Department and will be initiated in year one. The Rent-A-Kid Program will be measured in number of senior/youth match’s and also via the survey completed by the older adult participant.  The current Rent-a-Kid Program annual matching of 125 people will be increased 10% during each year of the plan.

 

Objective 1     Expand the use of the Internet to increase education and awareness of programs and resources.    

              

      Strategies:

Ø      Promote use of agency web site.

Ø      Develop partnerships to enable older adults to have access to computers.

Ø      Promote use of other web sites, including Medicare, Social Security, and others.

Ø      Develop and promote new Internet resources, including You Tube, email alerts, and blogging.

Strategies one and three will be an on-going effort, facilitated by the agency’s Information Specialist. It will be initiated in year one and continued throughout the duration of the plan. The success of this effort will be measured by the traffic counter set on the web site.  The ‘hits’ on the web site will increase by 10% each year of the plan. The second and fourth strategies will be initiated in later years of the plan, through the facilitation of the agency’s Information Specialist and supported by community resources.  These resources may include local colleges, technical schools, businesses and others that were identified through partnerships in Goal I and II.  

Objective 2     Reach out to older adults through a variety of mediums, resources, and across language barriers.

 

      Strategies:

Ø      Encourage the development of free television programming targeted at older adults,

 Ø      Continue Multi-Cultural Coalition efforts to reach diverse older adults and families.

 Ø      Educate the children/families of older adults.

 Ø      Educate the first point of contact.

 Ø      Continue participation in community senior fairs and events.

 Ø      Continue and expand educational seminars to retirees and pre-retirees.

 Strategy two will be facilitated by the members of the Multi-Cultural Coalition members in year one of the plan and will continue for the duration of the plan. Their efforts will be measured by participation at events and activities and through survey tools designed for feedback available in English and Spanish. Participation of an estimated 100 people per event in the agency sponsored diversity events will increase 10% each year of the four years of the plan.  The agency’s Information Specialists and other appropriate agency staff will initiate the other five strategies during the initial two years of the plan.  These efforts will be measured by surveys offered at all seminars, by participation attendance, and the number of events/seminars held per year. Participation in the agency-sponsored events will increase 20% each year of the plan.

  

Objective 3      Continue to be an educator, advocate and counselor in the area of  

                          Medicare and other health insurance matters.

 

       Strategies:

Ø      Develop community partnerships to expand awareness of programs and increase community resources.

 Ø      Recruit additional volunteers; and enrich and support current volunteers.

 Ø      Continue and expand opportunities for one-to-one assistance and general education seminars for all Medicare beneficiaries.

 Ø      Continue and expand educational seminars to retirees and pre-retirees.

 All four strategies in this objective will be facilitated by the APPRISE staff and volunteers, and the other staff in the Program Development Department, who work in these areas.  These are also on-going strategies that will be initiated in year one and continued throughout the plan timeframe. These efforts will be measured by surveys used at targeted events and by the number of requests/counseling opportunities.  The current estimated 20 partnerships will be increased 10% each year of the plan.  The current 12 volunteers will be increased to 20 active volunteers by the end of the plan period.

Objective 1     Enable seniors to advocate for senior issues including, taxes, Medicare, utilities, home maintenance expenses, health insurance/cost of medications, and assistance with caregiving issues.

       Strategies:

Ø      Develop a tool kit for advocacy.

 Ø      Utilize the agency web site to link advocates to resources and information on aging issues.

 Ø      Develop computer tools (webinars, etc) regarding senior issues to utilize along with the agency’s web site.

 Ø      Create an electronic network of providers/advocates.

 The agency’s Advocacy Committee will initiate the tool kit for advocacy, the first strategy, during the initial year of the plan.  The tool kit will include legislative points of contact, sample support letters, and list of legislative contact information. The outcome measures will include the number of requests for the information and other measurable successes from this activity. It is projected that the tool kit will be shared with 200 people during the initial year of the plan, with an expected increase of 20% each of the other three years of the plan. Awareness of the agency web site and using it as a source to other links will be an on-going effort of staff and volunteers, as identified in Goal III.  The development of computer tools will involve accessing progressive electronic tools, such as webinars, to reach a wider target of older adults and partners. The electronic network will involve establishing an electronic mailing group of health care professionals and other partners to share input on common issues facing the aging network. The outcome will be measured by the number of participants and the number of activities. During the initial year of the plan, 25 provider/advocates will be identified. This network will increase 20% each of the other three years of the plan. The last two strategies will be initiated after the second year of the plan under the leadership of the Advocacy Committee, Management staff, while utilizing the skills and resources of the Information Specialist staff.

 

Objective 2     Mobilize a Network of provider/advocates

 

     Strategies:

Ø      Establish relationship/regular meetings with legislators regarding senior issues.

 Ø      Senior centers utilized to promote advocacy.

 Ø      Opportunity for regular meetings with providers.

 Ø      Use agency advisory council to promote advocacy.

 This strategy follows closely with the work under Objective 1. The electronic network developed in Objective 1 will be the catalyst to move this objective forward.  The establishment of regular meetings with legislators will include protocols such as legislative breakfasts and other activities. All four strategies under this objective will be initiated in year one of the plan under the direction of the agency’s Advocacy Committee, Management Staff, and Advisory Council. These efforts will continue throughout the duration of the plan.  The outcome will be measured by the number of advocates who participate, the number of contacts with the legislative offices, and the positive outcome of issues on behalf of older adults. 

Objective 3     Advocate for access to affordable licensed Personal Care Home facilities.

 

     Strategies:

Ø      Inform and educate community partners on the issues so they can participate in the advocacy.

 Ø      Keep open communication with local legislators and the licensing agency on current and future issues.

 Professionals and others who assist in the placement of older adults in personal care home settings will be provided access to issues related to the industry through electronic tools, already referenced in Objectives 1 and 2. Also, as part of Objective 2, open communication will be encouraged with legislative staff, on issues including access to affordable licensed personal care homes. The two strategies will be initiated in year one under the direction of the agency’s Deputy Director and the Advocacy Committee. This will be an on going effort during the four years of the plan.

 The agency’s senior managers ongoing throughout the year will review this plan. The full plan will be officially reviewed on an annual basis by the Advisory Council.