Leah Rosenbaum, JVS Linda Blumberg, Jewish Federation Perry Ohren, Jewish Family Service

1. Collaboration in Action: Creating a Community Vision to Support the Growing Older Adult Population in Metro DetroitApril 16, 2007 …A Work in Progress Leah Rosenbaum, JVS Linda Blumberg, Jewish Federation Perry Ohren, Jewish Family Service AJFCA & IAJVS 2007 Annual Conference

2. Agenda • History of the COJES* Model Leah • COJES Today Perry • 2005 Detroit Population Study Linda • Eldercare Visioning Process Linda • Future of Eldercare Services Linda *Commission on Jewish Eldercare Services AJFCA & IAJVS 2007 ANNUAL CONFERENCE

3. Agency Execs Task Force on Aging • Jewish Family Service • Jewish Community Center • JVS • Jewish Apartments and Services • Jewish Home and Aging Services • Federation/COJES AJFCA & IAJVS 2007 ANNUAL CONFERENCE

4. Historical Perspective By the mid 1990s several challenges were facing the Jewish community with regard to services for older adults. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

5. Challenges: Jewish Nursing Home Borman Hall – a licensed Home for the Aged • No longer in the heart of the Jewish community • Poor state inspections • Fiscal drain on the Federation AJFCA & IAJVS 2007 ANNUAL CONFERENCE

6. Challenges: An Aging Population • In the mid 1980s, 1 in 100 Michigan residents was over 85. • 1990-2000 – more than a 30% increase in residents over 85 y.o. • Services would need to adapt to serve an older, frailer population. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

7. Eldercare Options Committee • Create a vision for caring for older adults • Develop a long-term strategy for the community’s delivery of eldercare services • Address the problems at Borman Hall and long term care institutional needs • Determine community-based care options with the goal of helping older Jewish adults to age in place AJFCA & IAJVS 2007 ANNUAL CONFERENCE

8. Gaps in Array of Service • Dementia specific Adult Day Care • In-home support services • Centralized information, referral and access to services • Affordable housing • Services for older adults with lifelong disabilities • Wellness, health prevention programs and access to primary health care • Transportation AJFCA & IAJVS 2007 ANNUAL CONFERENCE

9. Recommendation: Get out of the Nursing Home Business • Find a qualified operator to serve as a preferred provider • Transfer residents to facilities that served kosher food • Make Jewish Home and Aging Services responsible for ensuring that these homes operate “Jewishly” It was clear that Federation needed to convince the community that it was not turning its back on the Jewish frail elderly. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

10. Recommendation: Create Central Planning and Coordinating Authority • In the fall of 1996 COJES was formed as a consortium of the partner Federation agencies servicing older Jewish adults. • Organized as a function of the Federation, as part of the Planning Department • Comprised of lay leaders and professional staff of each Federation agency and community members at-large AJFCA & IAJVS 2007 ANNUAL CONFERENCE

11. Responsibilities of COJES • Serving as a central planning and coordinating authority for older adult services • Creating a continuum of care of quality services for Jewish older adults and their families • Developing a community-wide plan and budget for Jewish eldercare services AJFCA & IAJVS 2007 ANNUAL CONFERENCE

12. Meeting the Challenge • How to get five agency executives who were hired to protect and grow their own agencies to work together openly • How to develop collaborative rather than individualistic projects in order to maximize resources • How to avoid duplication of services AJFCA & IAJVS 2007 ANNUAL CONFERENCE

13. Meeting the Challenge:Getting Buy In • Build on the strengths and expertise of each of the partner agencies • Partner agencies were all active participants in the Eldercare Options Committee and the creation of COJES. • Partner agencies were part of the interviewing process to choose the director. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

14. Meeting the Challenge:Improve Collaboration COJES, along with the Agency Execs Task Force on Aging, has repeatedly looked for ways to enhance services and efficiency: • Examine the best use of existing resources • Examine if a program or service lends itself to collaboration • Not all services need to be provided by the Jewish community -- no need to duplicate what exists in the general community. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

15. Meeting the Challenge: Getting to Work How to best structure COJES for getting work done • Establishment of subcommittees composed of professionals and lay leaders to address gaps in services including: • Jewish Community Information Center • Adult Day Care • Chaplaincy • Community education • In-home Support Services • Budgeting • Housing and transportation • Falls prevention and wellness center AJFCA & IAJVS 2007 ANNUAL CONFERENCE

16. Initial Outcomes of COJES • There is a positive view in the community about Federation’s role in addressing the needs of older adults. • The preferred providers are offering good care at the nursing homes. • More older adults than ever before are being assisted by Federation agencies and receiving the supports needed to age in place. • There are expanded and new programs, many jointly operated. COJES agencies provide a variety of coordinated services offering a continuum of care for older adults. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

17. Meeting the Challenge: Establishing a Cross Agency Budget • Shows how much money is actually being spent in the Jewish community on older adult services • Shows how much governmental funding is helping to support services • Helps provide information on duplication/ overlap of services among the agencies AJFCA & IAJVS 2007 ANNUAL CONFERENCE

18. Meeting the Challenge: How to Fund Programs A commitment on the part of the Federation lay and professional leadership to raise money above and beyond the Campaign AJFCA & IAJVS 2007 ANNUAL CONFERENCE

19. Allocation Plus • Rubin Jewish Community Trust for the Elderly • The Jewish Fund AJFCA & IAJVS 2007 ANNUAL CONFERENCE

20. Thanks to COJES • Collaborative efforts • Reduction in duplication of services • Increased funding has been secured for older adult services. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

21. COJES Today • Merged/Joint Programs • COJES Strategic Plan • Eldercare Services Proposal AJFCA & IAJVS 2007 ANNUAL CONFERENCE

22. Merged/Joint Programs • Coville Assisted Living • Brown Adult Day Care • Transportation • Holocaust Survivor Services • Assisted Meals • NORC SSP All as a result of the COJES process AJFCA & IAJVS 2007 ANNUAL CONFERENCE

23. Coville Assisted Living Transfer of endowed Assisted Living Program from Jewish Family Service to Jewish Apartments and Services Why do it this way? • It serves clients best. JFS  JFS & JAS  JAS AJFCA & IAJVS 2007 ANNUAL CONFERENCE

24. Brown Adult Day Care • One Program • Two Adult Day Care sites • One Budget and One Director • Operated Jointly by JVS and Jewish Home and Aging Services Why do it this way? • It serves clients best. JVS & JHAS AJFCA & IAJVS 2007 ANNUAL CONFERENCE

25. Transportation • Centralized coordination and dispatching of transportation resources • Increased efficiency • Share Vehicles and Drivers Why do it this way?  It serves clients best. JFS & JAS AJFCA & IAJVS 2007 ANNUAL CONFERENCE

26. Holocaust Survivor Services • Yad B’ Yad – collaboration between Jewish Family Service and Jewish Home and Aging Services to provide friendly visiting to Holocaust survivors • It uses each agency’s expertise well. Why do it this way? • It serves clients best. JHAS & JFS AJFCA & IAJVS 2007 ANNUAL CONFERENCE

27. Assisted Meals • Serves Jewish Apartments and Services’ increasingly frail residents who cannot stand in cafeteria line • Employs JVS consumers (with DD and/or MI diagnoses) in an enclave setting to assist with meals Why do it this way? • It serves clients best. JAS & JVS AJFCA & IAJVS 2007 ANNUAL CONFERENCE

28. NORC SSP • JFMD Director • Housed at JFS • JFS and JVS staff • JCC as Venue Why do it this way? • It serves clients best. JFMD, JVS, JCC & JFS AJFCA & IAJVS 2007 ANNUAL CONFERENCE

29. COJES Strategic Plan SERVICES • Coordinating services • Jewish residential service package • Transportation • Care Management • In-Home Support Services • Affordable Housing • Day Programs • Caregiver Support Center • No Wrong Door • Applications for residential services • Life Planning for pending and current retirees • COJES Website • Art of Jewish Caregiving AJFCA & IAJVS 2007 ANNUAL CONFERENCE

30. COJES Strategic Plan RECOMMENDATIONS • Create packages of services/programs • Explore synergies • Develop a seamless transition process • Reduce wait time • Increase the number of care managers • Increase the number of subsidized slots • Increase the number of subsidized apartments • Develop a resource and support center for caregivers • Create a system whereby people can enter through many starting points • Develop one application for housing • Develop life planning workshops • Update current website • Create a caregivers training program in the Art of Jewish Caregiving AJFCA & IAJVS 2007 ANNUAL CONFERENCE

31. COJES Strategic Plan THEMES • Seamlessness • Baby boomers as caregivers and soon to be “older” consumers • Focus on “Welderly” as well as Frail Elderly • No Wrong Door • Campus(es) - Strengthening while Community-Focused • Charging for services, e.g, Concierge AJFCA & IAJVS 2007 ANNUAL CONFERENCE

32. Campus Connections Proposal • An accepted proposal to The Jewish Fund • A follow up study to further assess the wants and needs of older adults and their caregivers and the best methods for addressing these and delivering services • This has merged with the Eldercare Visioning Committee Process. Why do it this way? • It serves clients best. JAS, JCC, JFS, JHAS, JVS & JFMD AJFCA & IAJVS 2007 ANNUAL CONFERENCE

33. 2005 Detroit Jewish Population Study • 78,000 persons live in 30,000 Jewish households plus 500 Jews in institutions for a total of 78,500 persons in the Jewish community; 72,000 are Jews.* • 24% (18,486) are 65+ (compared to 17% - 17,850 in 1989). • 14% (10,920) are 75+ (compared to 6% - 6360 in 1989). • 4.4% (3432) are 85+ (compared to 1% - 1000 in 1989). • 47 – median age, 1989 – 41, NJPS 2000 – 39 • 88% of Jews have lived in Detroit 20+ years – 97% for those 65+. *More on the ‘05DJPS available at www.jfmd.org/ AJFCA & IAJVS 2007 ANNUAL CONFERENCE

34. 2005 Detroit Jewish Population Study • 59% of households have an adult child in the area. • Median income: $85,000; $41,000 - age 65+; $86,000 - elderly couples; $24,000 - elderly singles • 17% of households have health-limited member; 33% for elderly households. • In-home care and transportation most needed services among older adults • Association with Jewish community (memberships, practice and/or philanthropic giving) highest among elderly couples – 79%; drops to 45% among elderly single households AJFCA & IAJVS 2007 ANNUAL CONFERENCE

35. Eldercare Visioning Committee: Role • Examine the current package of services to older adults and service delivery system • Explore local and national models of eldercare service delivery • Develop recommendations re: best way to deliver services • Develop recommendations for funding older adult services AJFCA & IAJVS 2007 ANNUAL CONFERENCE

36. Eldercare Visioning Committee: Basic Premises • The number of people who will need services in the future and the cost of providing services will increase. • The primary focus of services is community, not institutional based. • The current system is not broken, but needed to decide if current system is best for the future, needs modification or there needs to be a new system. • The process is to be approached with no preconceived ideas and from a communal rather than individual agency perspective. • Committee members are encouraged to share, participate, be creative and brainstorm. • There are no bad ideas. • Committee has the ability to have a major impact now and in the future. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

37. Eldercare Visioning Committee: Roadmap • Educating Committee members • Creating a common knowledge base • Learning about other local and national models of eldercare service delivery • Examining specific service areas • Sharing information gathered • Making recommendations • Presenting recommendations to Federation leadership AJFCA & IAJVS 2007 ANNUAL CONFERENCE

38. Eldercare Visioning Committee: Lay-Professional Intersection • Committee staffed by Planning Director/COJES Director • Other Federation staff include: Chief Administrative Officer, Endowment Specialist and Jewish Fund Director • Agency Executives Task Force on Aging presents to the Committee vision for older adult services, identified gaps and recommendations for future • Task Force joins Committee for presentations on other local and national models • Consultant includes meetings with Task Force members in report to Visioning Committee • Task Force to give input into Committee’s recommendations prior to finalization AJFCA & IAJVS 2007 ANNUAL CONFERENCE

39. Eldercare Visioning Committee: Benefits • Creates greater visibility for needs of older adults • Reaffirms Federation’s commitment to addressing needs of older adults • Gets more people at the table • Engenders significant funding for older adult services AJFCA & IAJVS 2007 ANNUAL CONFERENCE

40. Eldercare Visioning Committee: Challenges • Delay in implementation of COJES Strategic Plan • Altered professional-lay partnership that is core tenet of COJES • Potential lengthy implementation time for Visioning process recommendations • Ways to create dialogue between Committee and COJES Agency Executives Task Force on Aging AJFCA & IAJVS 2007 ANNUAL CONFERENCE

41. Eldercare Visioning Committee: Possible Outcomes Creation of a central agency Modification of current COJES model AJFCA & IAJVS 2007 ANNUAL CONFERENCE

42. Eldercare Services Structure The diagram above refers to services that could perhaps be consolidated. In addition, there still needs to be a discussion of other services that could potentially be consolidated such as food services and Holocaust survivor services. A decision was made to continue to coordinate volunteer services, but not to consolidate them into one agency due to the nature of volunteerism and the agency/volunteer relationship. AJFCA & IAJVS 2007 ANNUAL CONFERENCE

43. Stay Tuned! 43

44. Questions, Answers & Dialogue AJFCA & IAJVS 2007 ANNUAL CONFERENCE

45. Contact Information Leah Rosenbaum, Executive Vice President and Chief Operating Officer JVS 29699 Southfield Road, Southfield, MI 48076 (248) 233-4220 • lrosenbaum@jvsdet.org Linda Blumberg, Director, Planning & Agency Relations Jewish Federation of Metropolitan Detroit 6735 Telegraph Road, Bloomfield Hills, MI 48301 (248) 203-1468 • blumberg@jfmd.org Perry Ohren, Chief Program Officer Jewish Family Service of Metropolitan Detroit 6555 West Maple Road West Bloomfield, MI 48322 (248) 592-2302 • pohren@jfsdetroit.org AJFCA & IAJVS 2007 ANNUAL CONFERENCE