The Area Agency on Aging of Northwest Arkansas

1. The Area Agency on Agingof Northwest Arkansas

2. We are a non-profit organization serving 9 Counties in Northwest Arkansas • Baxter • Benton • Boone • Carroll • Madison • Marion • Newton • Searcy • Washington Our mission is to commit financial and human resources to enhance the lives of the Northwest senior community.

3. Agency Programs • Advocacy • Case Management • In-Home Services • Housing • Senior Center Services • Adult Day Care • Caregiver Programs • Non-durable Medical Supplies • Ombudsman • Personal Emergency Response • Family Caregiver • Community Support

4. The AAANWA has a put together a wide range of programs that helps to enhance the lives of those that want to remain in a home and community based setting. We care for the elderly, veterans, and Medicaid clients. • As an Area Agency on Aging we are responsible for advocating for the elderly and providing programs and services to them. • The success of our Agency depends upon our ability to market the programs and services we provide to our clients. • As a non-profit, we have programs and services that are available under program guidelines for the specific clients that are targeted by the grant. • We also have programs and services that are fee for service that we depend on to keep our agency solvent. • We have goals for both programs and services and unless we reach those goals, we are not fully successful at what we do in getting services to the clients. • In other words, we have a break even point and if we do not reach that point, we will not have sufficient funding to operate that program, service or even the agency.

5. AAANWA Network Senior Activity Centers Case Management In-Home Services AAANWA Housing

6. In-Home Services • 13 Registered Nurses • 9 Case Workers • 9 Support Staff • 477 In-Home Care Assistants • 856Clients

7. Personal Care - Medicaid • Performs medically necessary tasks pertaining to a client’s functional abilities which enable the client to be treated on an outpatient basis rather than an inpatient basis. Personal care services must be supervised by a registered nurse to assure that the services are completed accurately and appropriately. • Personal Care services are primarily based on the assessed physical dependency need for “hands-on” services with the following activities of daily living: eating, bathing, dressing, personal hygiene, toileting and ambulating. • Prior authorization is required for clients under the age of 21. • Maximum hours: 64 per month.

8. Personal Care – Private Pay • The Private Pay Program provides in home care to individuals who are not Medicaid/ElderChoice eligible and are willing to pay for the services. Private Pay services are available to persons 60 years of age or older, or disabled over the age of 21. • The client and the RN will determine what services will be provided and when. • An initial deposit equal to one month’s service is required. The actual billable rate is $16.76 per hour with a 2 hour minimum service limit. • When LTC insurance is present, the client pays the AAA and seeks reimbursement from the insurance company.

9. Personal Care – Veterans Administration • The VA program offers certain home and community based services as an alternative to nursing home placement. These services are available to the individuals determined eligible by the Veterans Administration • Number of hours/frequency is determined by the VA Social Worker • Services may include home health (personal care), homemaker and respite. • The VA care plan must be followed exactly for the AAA to be reimbursed for the services.

10. Case Management 20 Care Coordinators and Support Staff Programs • State Case Management • Targeted Case Management • Counseling Support Management • Intense Transition Management • Veteran-Directed Home & Community-Based Services • SHIP/MIPPA • Mental Health • Legal Services • Outreach and Community Education • Information and Assistance

11. Case Management (Care Coordination) • Since the Older Americans Act (OAA) was passed in 1965, the Administration on Aging (AoA) has provided services to elderly Americans, helping them maintain independence and remain in their own homes. Through its “Aging Services Network,” including State Units on Aging (SUAs), Area Agencies on Aging (AAAs), and tribal partners, AoA works to provide services designed to mitigate the effects of declining physical health and functioning experienced by frail older adults. • Case management or care coordination is an activity that assists individuals in gaining and coordinating access to necessary care and services appropriate to the needs of the individual. Care Coordinators assist in accessing all medical, social, educational and other services appropriate to the individual needs of the person served.

12. State Case Management (Client Representation) • Eligibility – This population consists of people age sixty (60) and older who have a need for coordination of multiple services and/or other resources and referrals. • Funding Source – State Aging Services • Purpose – An activity under which a client’s needs are assessed and services to meet those needs are either provided directly by the client representative (case manager) or arranged for in an organized and consistent manner. Client Representation includes, but is not limited to, such things as outreach, referral for legal assistance, providing information on and determining eligibility for public benefits such as QMB and SMB, assisting with completion of paperwork, attending meetings on behalf of clients, and information and assistance.

13. Targeted Case Management • Eligibility – People age 60 and older who are participating in ElderChoices, SSI or AR Seniors Medicaid • Purpose • To provide supportive care to medically needy individuals to enable them to remain independent in the community. • Our staff assists beneficiaries in accessing all medical, social, educational and other services appropriate to the beneficiary’s needs. • These clients typically have no reliable or available supports to assist them in gaining access to the necessary care and services they need. • Division – DAAS

14. Family Caregiver • Support Counseling • Caregiver Workshops • Respite Grants • Information and Education for Caregivers

15. Hospital to Home The Hospital to Home Transition Program is designed to help patients manage their healthcare with the support of a Health Coach. Participation in the program provides you with the necessary tools to better manage your healthcare, and reduces hospital readmissions and emergency room visits. Candidates in our nine county area must meet the following criteria: • Medicare and/or Medicaid beneficiary • Aged 60 or older And, diagnosis of one or more of the following illnesses: • Acute Myocardial Infarction (AMI) • Congestive Heart Failure • Chronic Obstructive Pulmonary Disease • Pneumonia and other Respiratory Illnesses • Urinary Tract Infection • Altered Mental Status but not Dementia/Alzheimer’s Primary

16. ElderChoices • About: ElderChoices is an Arkansas Medicaid home and community-based waiver program designed for the elderly population. ElderChoices, approved effective August 1, 1991, is designed for persons who due to physical, cognitive or medical reasons, require a level of assistance that would have to be provided in a nursing facility, if it were not for the services offered through this program. The major goal of this program is to provide services that assist eligible persons to remain in their homes or live with family in order to prevent or delay institutionalization

17. ElderChoices Services offered: Homemaker, Chore, Home Delivered Meals, Personal Emergency Response System (PERS), Adult Day Care, Adult Day Health Care, Respite, Adult Family Homes, Adult Companion • Criteria: To qualify for ElderChoices, you must • Be age 65 or older • Meet nursing home admission criteria at the intermediate level • Meet established financial criteria • Have a medical need for at least one of the ElderChoices services • Division: DAAS

18. Alternatives for Adults with Physical Disabilities • About: A Medicaid home and community-based program that provides attendant care and environmental modification services to individuals age 21 through 64 who meet the criteria for intermediate nursing home care. The individual’s income should be less than 300% of poverty and meet the resource limits for Medicaid. Persons who qualify may also receive regular Medicaid benefits. Individuals must be able to supervise their service providers whom they may choose from the list of eligible providers • Services offered: Attendant Care, Environmental Accessibility Adaptation, Case Management and Counseling Support • Criteria: Between ages 21 and 64 Declared physically disabled through SSA/SSI or medical review team Financially Eligible Meets Eligibility for Intermediate Level Nursing Home Placement • Division:DAAS

19. Counseling Support Management • Eligibility – People who are receiving the Alternatives for Adults with Physical Disabilities Program • Purpose • To provide supportive care to medically needy individuals to enable them to remain independent in the community. • Our staff assists beneficiaries in accessing all medical, social, educational and other services appropriate to the beneficiary’s needs. • These clients typically have no reliable or available supports to assist them in gaining access to the necessary care and services they need. • Division – DAAS

20. Money Follows the Person • A federal initiative to help states reduce their reliance on institutional care for people needing long-term care. • Expands options for elderly people and individuals with disabilities to receive care in the community • It requires 90 consecutive day institutional stay • 1 Day on Medicaid • Lasts 365 days per participant • Helps Adults with Physical Disabilities ( AAPD), DDS (ACS),Elderly (EC), Assisted Living (ALF) and • Mentally III (0)441S • Nursing home patients can self refer or others can refer • DAAS gives the referral to the AAANWA

21. Veteran-Directed Home &Community Based Services • Eligibility – Eligible participants are veterans with medical benefits and referred by the VA Medical Center Social Worker staff. • Funding Sources – Veterans Administration (VA) Fee For Service • Purpose –This person centered, client directed program is served by Care Managers who initiate care by conducting the Minimum Data Set – Home Care, Inter RAI (MDS-HC) assessment and translating that information into the hours of care determination tool. By assisting clients to develop a cash expenditure plan to determine their use of the monthly financial resource and general case management services, nursing home placement is delayed or avoided. The Community Living Coordinator and Care Managers work with AAA Payment Services, LLC, which is assisting with the fiscal management of the monthly financial award. The benefits of this program are twofold: participants who want to stay in their own homes are able to do so and the VA saves the expense of providing nursing home care.

22. Senior Health Insurance Information Program (SHIIP) • Eligibility – Any person seeking assistance with Medicaid and /or Medicare insurance benefits. • Funding Sources – Administration on Aging and Centers for Medicare and Medicaid Services • Purpose – Primarily Medicare Part D benefits counseling through individual sessions and group events. Case Management staff completed the training required to attain Certified Medicare Benefits Counselor’s status. The counseling provided includes clarification of Medicare, Medicaid, Medicare Savings Plans, Low Income Subsidy Programs, problem solving, eligibility for public benefits programs, military benefits, and long term care among other topics. • Division: AAANWA

23. Mental Health Referrals • Eligibility – This population consists of people age sixty (60) and older who have a need for coordination of multiple services and/or other resources and referrals. • Funding Sources – Not Applicable • Purpose – Encourage mental health awareness, diagnosis of problems, and treatment to improve the quality of life of older and disabled people. Mental Health Referrals also include encouragement to reduce isolation, combat lethargy and apathy, and engage older adults in socialization experiences.

24. Legal Assistance • Eligibility – This population consists of people age sixty (60) and older who have a need for coordination of multiple services and/or other resources and referrals. • Funding Sources – Title IIIB • Purpose – Legal advice, counseling and representation provided by an attorney, paralegal, or other person under the supervision of an attorney. Case Managers make the referrals to the contracted agency and follow through until the issue is resolved. Case Managers often assist with the required documentation and contacts to additional resources to facilitate efficient handling and a timely resolution.

25. Outreach • Eligibility – This population consists of people age sixty (60) and older who have a need for coordination of multiple services and/or other resources and referrals. • Funding Source – State Aging Services • Purpose – To reach uninformed segments of the target population within the service area to educate about the available services and resources that are designed to maintain beneficiaries at home and preclude or postpone institutionalization.

26. Information and Assistance • Eligibility – This population consists of people age sixty (60) and older who have a need for coordination of multiple services and/or other resources and referrals. • Funding Source – State Aging Services & Title IIIB • Purpose – To include providing information to a client about available public or voluntary services/resources and/or linkage to ensure the service will be delivered to the client. I&A may include advocacy or contact with the provider and/or family member on the client’s behalf. Referral involves a full assessment of the person and their informal support system in their own environment.

27. Community Support Program • This program provides assistance to senior center staff and local communities to implement health and wellness programs to area seniors. • Health Promotion Programs • Evidence Based Programs • Educational Programs • Fun and Active Events

28. Community Support Program Health Promotion Programs - These programs encourage and promote healthy life styles to reduce the risk for chronic and preventable conditions and to improve function among physically and /or mentally impaired older adults.

29. Community Support Program • Evidence Based Programs • Peer Exercise Program Promotes Independence (PEPPI) • Be Well – Live Well (Chronic Disease Self Management Program) • A Matter of Balance (Fall Prevention) • Super Noggin (Brain Fitness) • Arthritis Foundation Walk with Ease, Tai Chi and Exercise Programs • Silver Sneakers • Diabetes Self-Management Education – Pilot Program in Boone County

30. Community Support Program • AAANWA is transitioning traditional senior activity centers into senior activity and wellness centers. In order to make the transition centers must offer a variety of programs in the 7 aspects or dimensions of wellness. • The 7 dimensions of wellness are: • Social • Physical • Intellectual • Emotional • Vocational • Spiritual • Environmental

31. Community Support Program • Educational Programs • Silver Haired Legislative Session • Nutrition Education • Mental Health Education • Many other Educational Programs

32. Community Support Program • Fun and Active Events • Northwest Arkansas Senior Games • Beanbag Baseball Tournaments • Wii Bowling Tournaments

33. Housing • 13 Senior Housing Apartment Complexes • 282 Apartments • 10 Different Communities

34. Housing • Eligibility • To qualify for housing, the head of the household must be 62 years of age or older (currently 55+ at Bull Shoals and Gravette) • The household must fall within the HUD Housing income guidelines for the county in which the apartment is located. • Located in the following counties: • Benton County • Dixieland Gardens Senior Housing in Rogers • Miller Place Senior Complex in Rogers • Osage Heights Senior Complex in Bentonville • Billy V. Hall Senior Complex in Gravette • North Arkansas Senior Housing of Gravette • Flint Creek Apartments in Gentry

35. Housing • Locations continued: • Baxter County • Willowbrook Senior Housing in Mountain Home • Carroll County • Oak Hills Senior Housing in Green Forest • Ozark Meadows Apartments in Berryville • Ozark Meadows II in Berryville • Marion County • Fallen Ash Senior Complex in Flippin • North Arkansas Senior Housing of Bull Shoals • Washington County • White River Senior Complex in Elkins

36. Senior Center Services • 9 Full-Time Senior Activity & Wellness Centers, • 10 Full-Time Senior Activity Centers, • 7 Part-Time Senior Activity Centers, • 2 Service Providers with 71 Staff • 242,962 Congregate Meals Served • 341,697 Home Delivered Meals Served • 341,239 Hours of Socialization • 62,611 One-way Trips of Transportation

37. Senior Center Services • Congregate Meal– A hot or other appropriate meal served to an eligible person in a group setting at a congregate meal site. Unit = 1 meal • Socialization – Facilitation of client’s involvement in activities to promote social interaction and reduce social isolation. This may be accomplished through activities, which provide personal enrichment; health, wellness and exercise programs; satisfying use of leisure time, and development of new skills and knowledge. Unit = at least one (1) hour with no maximum • Transportation – Transporting a client from one location to another by public or private vehicle so the client has access to needed services, care or assistance, supportive services or nutrition services. Unit = One, one-way trip • Home Delivered Meal – A hot or other appropriate meal delivered to the residence of a homebound individual who through a needs assessment has been determined eligible. Unit = 1 meal

38. Adult Day Centers Baxter House Adult Center Boone County Adult Day Care

39. Adult Day Centers • Adult Day Care facilities are licensed by the Office of Long-Term Care (OLTC) to provide care and supervision to meet the needs of four (4) or more functionally impaired adults for periods of less than twenty-four (24) hours, but more than two (2) hours, in a place other than the client’s own home. • The effects of dementia, Alzheimer’s, stroke, etc., may result in a senior adult no longer able to stay by oneself but not quite ready for a nursing home. • The Adult Day Care is a contracted service with the Northwest Arkansas Economic Development District, Inc., to provide the service in Boone and Baxter counties of Arkansas. The service first began in 1985 in Baxter County with the addition of Boone County in 1989 and continues to be rewarding for family caregivers and the communities. • Definition – To provide respite to caregivers for clients who cannot be left alone but who are not quite ready for institutionalization. • Purpose – To provide loving supervision, mental stimulation, mobility exercises, meals, transportation and care while the caregiver relaxes, runs errands or continues to work. Unit =One hour

40. Ombudsman • 1 Full-time Ombudsman • 3 Certified Back-up Ombudsman • 1 Part-time Certified Volunteer Coordinator • 17 Certified Volunteer Ombudsman • 2000 individuals served • 78 facilities with 5500 certified beds • Laraine Lamb, Regional Ombudsman

41. Ombudsman Advocacy and Resident Rights • The Ombudsman Program of Area Agency on Aging of Northwest Arkansas serves individuals residing in 78 long-term care facilities in the counties of Baxter, Benton, Boone, Carroll, Madison, Marion, Newton, Searcy and Washington . The Ombudsman investigates concerns and complaints voiced and always advocates for the rights of people residing in nursing homes, assisted living and residential care communities. • Resident Rights and advocacy for these rights is the primary focus of the program. Many people do not have family or friends who visit them and they are fearful to voice concerns…the Ombudsman can step up and do this for them. • The Ombudsman also makes routine visits to the facilities, attends resident council meetings, encourages development of family councils at facilities, provides in-service trainings to facility staff and educates the public on the Ombudsman program.

42. Volunteer Ombudsman Program • Volunteerism is important to the success of the program. Currently we have 17 volunteers in our 9 county region that visit facilities just 2-4 hours per week. When a resident informs a volunteer of a problem, the volunteer reports this to the Regional Ombudsman who then investigates and resolves. • Volunteers are certified by the state of Arkansas as Certified Volunteer Ombudsmen who receive quarterly training, education and sharing with other volunteers and the Regional Ombudsman and the Volunteer Coordinator. • Area Agency on Aging of Northwest Arkansas piloted the first Certified Volunteer Ombudsman program in the state of Arkansas in 2001. • To learn how to become a Volunteer Ombudsman, please contact 870-741-1144 at AAA’s Harrison office or 479-273-9424 at AAA’s Bentonville office.

43. Ombudsman Volunteers • Our Certified Volunteer Ombudsmen are a very important element of the Ombudsman program.

44. Non-Durable Medical Supplies We offer a variety of incontinence products and non-durable medical equipment. The Area Agency on Aging of Northwest Arkansas bills Medicaid for allowable items and is Medicare Accredited to bill Medicare for commodes, canes, crutches and walkers.

45. Personal Emergency Response Systems Utilizes state of the art equipment to access needed assistance or emergency help to an individual at the push of a button. The equipment connects the individual to a call center that is monitored 24 hours a day, 7 days a week. The operators in the call center assess the clients situation and either call the individuals designated responder or appropriate emergency personnel.

46. The Area Agency on Aging of Northwest Arkansas andThe Aging FoundationA Vital Part of the Community

47. Area Agency on Aging of Northwest Arkansas is a solid leader in the aging industry. • 576 employees (area wide) • Over $7,000,000 in annual wages • Over $15,000,000 annual budget

48. The Area Agency on Aging of Northwest Arkansas andThe Aging Foundation Do all of the good you can, by all the means you can, in all the ways you can, in all the places you can, at all the times you can, to all the people you can, as long as you can. John Wesley

49. Area Agency on Aging Foundation • Private Non-Profit Foundation 501 (C)3 • Gifts for the Future • Wills • Bequests

50. What Can You Do To Help? • Make a Contribution to the Aging Foundation • Designate it for/to the local senior center, home delivered meals, the emergency fund for local seniors • Organize a fund raising event and donate funds to aging services • Contact your Senator and Representatives and ask them to support funding for senior services • Offer to volunteer your time to help deliver meals to the frail elderly • Teach a class at the senior center • Make “in-kind” contributions • Refer seniors/families to the senior centers and adult day care.