OKDHS Aging Services Division Going Beyond Just Core Services

1. OKDHS Aging Services DivisionGoing Beyond Just Core Services OKDHS Commission Retreat Wednesday, September 29, 2010 Lance Robertson State Aging Director Oklahoma Department of Human Services Aging Services Division

2. Presentation Agenda • General Overview • Demographics, Network Structure, Service Demand • Innovativeness • Program Highlight: Senior Farmers’ Market Nutrition Project (SFMNP) • Program Update: ADvantage • Program Update: Title III Senior Meals Existing Challenges • The Perfect Storm • Oklahoma: 2015

3. Current State Demographics • 694,024 Oklahomans 60+ (20th in US) • 19.3% of population • By 2030, 24.45% of population (954,795) • 70,555 age 85+ (rank of 25th in US) • 99,559 by 2030 • Raw number has increased twelve times since 1900 • Life expectancy of 65+ is now 19.1 years • 19.3% are minorities • Baby Boomers • Entitlements and state/federal programs

4. Number of Older Americans - Line

5. Number of Older Americans - Density

6. Life Expectancy

7. Aging Services in OK “…a unifying force at the state level through which the broad policy objectives of the Older Americans Act ultimately come to pass. An agency designated by the Governor as the focal point on all matters relating to the needs of older adults.”

8. Aging Services Network • 17 Major Programs • Major (OAA Core) Services: • Access to Services • Nutrition • Home & Community Based LTC • Disease Prevention & Health Promotion • Vulnerable Elder Rights Protection • 66.7% of OAA funding goes to Title III • Meals, transportation, legal services, homemaker services, respite • Family Caregiver Support = 13% • High ratio of caregivers • Services provided (5 core services) • Recipients: reaching 2-7%

9. Program Snapshot • All 17 major programs are fully tapped • Network reaches 400,000 of the 635,000 in some manner • Programmatic examples: • Adult Day Health – 18,000 care days delivered annually • 11,000 caregivers served through voucher program • 2,000,000 passenger trips - 82 new vehicles • 2-1-1 program fielded 232,067 calls • 40,300 volunteers, 2.7 million hours, $45 million in economic value • Legal Aid served 4,000 individuals • Ombudsman investigated 6,400 complaints • The cumulative number of meals served tops 6 million

10. Innovativeness • Going beyond Core Services • Innovative Programming: • OK Aging Advocacy Leadership Academy • OK Court Appointed Advocates for Vulnerable Adults • Grand-parenting Initiative • Minority Aging Initiative • Prisoner Reentry Program • Aging & Disability Resource Consortium • Unique partnerships • National recognition • Grant Funding

11. Grants

12. SFMNP • Promotes nutritionally healthier lifestyles for low-income senior participants and their families by supplementing their household food purchases with fresh produce available through local farmers’ markets.  • Uses an efficient Electronic Benefits Transfer (EBT) system • Also promotes the growing of fruits and vegetables to sell through farmers’ markets by local, typically smaller, farmers. • Annual program budget = $75,000 • SFY09 = 450 served • Projections for SFY10 = 2300 served • Many partners, including: USDA, select Area Agencies on Aging, Oklahoma farmers, Regional Food Bank, The Kerr Center, OK Dept of Agriculture, etc.

13. The ADvantage Program • State’s HCBS option • Cost may not exceed what Medicaid would have paid for nursing facility care • Because each consumer care plan must be less than NF costs, the program saves OK millions in Medicaid dollars • Each person who elects ADvantage could elect NF care • 24,164 different individuals served over the year • Straightforward eligibility: level of care, financial, support at home, 21 & older • Savings to the state: $300,000,000

18. ADvantage Update • SFY10(P): 18,864 members • 5,314 left • 4,263 entered • Technology Rollouts • ELDERS fully launched • Integrated Voice Response system • Provider portal • Factors impacting program • Fewer applicants • Proper administration • Recertification process

20. Title III Senior Meals • Update on the $5 million funds (HB2367) • Preliminary Statewide Summary • November ’09 & July ’10 cut: $7,400,000 • SFY2011 HB2367 funds: $5,000,000 • AAA Admin restoration: $373,588 (8%) • Meal restoration: $4,626,412 (92%) • # of nutrition sites reopened: 7 • # of sites restored to 5 days: 74 • # of nutrition site staff restored to full: 141 • Total meals projected: 757,501 • Congregate: 455,383 • Home Delivered: 302,118

21. “Flow” of Care Home & Comm Based Services Acute Nursing Home Older Americans Act

22. Existing Challenges Within population: • High poverty rate (19th in US) – 10.5% of 65+ • Larger number of rural dwellers • Very poor health indicators • High disability ratio (8th in US) • High Old-Age Dependency Ratio (14th in US) • Leading state for Grandparents Raising Grandchildren (6th in US) – 44,000 • Reliance on public programs • Income/Lack of savings • Poor LTC planning

23. Chronic Health Conditions

24. Physical Activity

25. Obesity

26. Use of Leisure Time

27. Existing Challenges Within service delivery system: • Budget Fragility • Politics • Competition for resources • Creating a brand • Present capacity of network • Ability to expand network on a dime • General awareness

28. The Perfect Storm Budget Problems Demographic changes Service Demand State Challenges

29. Making It Work Four (4) critical puzzle pieces

30. Making It Work Federal Government State Government Personal Accountability Support Within Community

31. OK Dept. of Human Services OK Dept. of Mental Health & Substance Abuse Services OK Insurance Dept. OK Dept. of Commerce OK Dept. of Health OK Health Care Authority OK Dept. of Rehab OK State Board of Examiners for LTC Administrators Web Portal ADRC Telephone 2-1-1 Senior Info Line Oklahoma’s Aging Services Aging Population and Caregivers Points of Entry Lead Agency for Aging Services Partners OKDHS Aging Svcs Division Program/Service Information Flow & Synergetic Partnership Area Agencies on Aging Disability Community Providers Corporate Partners Higher Education Advocate Groups Connecting all the pieces….

32. Oklahoma 2015 – A state where we: • Are less reliant on state/federal dollars • Deliver services as efficiently as possible • Serve those in our system with the most dire needs • Have effectively created an identity and brand • Ensure the full array of information needed is readily accessible to seniors and their caregivers • Have strong, effective advocacy groups with a “plan” • Collect and use meaningful data • Empower consumers

33. Oklahoma 2015 – A state where we: • Have successfully merged aging and disability • Are known for many models of excellence • Have successfully defragmented services and increased information access • Focus on preventing premature or inappropriate nursing home placement • Boast creativity, innovativeness and resiliency in offering a robust number of services • Support many dynamic partnerships • Assure socialization abounds and independence reigns

34. Lance Robertson OKDHS Aging Services Division Lance.robertson@okdhs.org 405-521-2281 www.okdhs.org THANK YOU FOR YOUR TIME & ATTENTION!