Ohio Department of Aging
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To: Members of the Ohio General Assembly
From: Director Merle Grace Kearns
"I'm on a fixed income and my washing machine just broke down. I can't afford to fix it or replace it. Can you help me?"
The Ohio District 5 Area Agency on Aging regularly receives this type of request. Until recently they have had little assistance to offer the caller. However, approximately seven years ago the Area Agency wrote a grant to the Richland County Foundation requesting funds to start a program that could purchase certain items for older adults who have no other means to meet their needs. Through the Helping Elderly Meet Essential Needs, or HEMEN, program, the Area Agency can purchase items such as mattress sets, lift chairs, glasses, washers, dryers and other household and personal health needs that they would otherwise be unable to afford.
Three out of five HEMEN consumers are at least 75 years old - the oldest is 93. The average monthly income for HEMEN consumers is $796. The average value of assistance provided per-incident by the HEMEN program is $270.
The program has been such a success that the Area Agency was able to apply for additional grants from the Shelby Foundation and Older Adult Consortium. Local dollars also enabled the Area Agency to utilize some Title III funds to support the HEMEN Program for all nine counties in their Planning and Service Area (Ashland, Crawford, Huron, Knox, Marion, Morrow, Richland, Seneca & Wyandot).
All consumers are surveyed about their satisfaction with the program and they report being extremely satisfied. The survey also asks the consumers how they would have met this need otherwise and most consumers stated they would "Just go without." Thanks to the HEMEN Program, none of those who call for help has to go without. For more information, please contact the Ohio District 5 Area Agency on Aging at (419) 524-4144.
All 11 of the countywide senior services property tax levies on the November 7 ballot passed in Athens, Belmont, Hancock, Lake, Morrow, Noble, Preble, Sandusky, Van Wert, Warren, and Wood counties. Additionally, the human services levy in Cuyahoga County that benefits older adults also passed. Six of the levies garnered over 60% of yes votes, as did the human services levy. There are 62 of Ohio's 88 counties (or 70%) with these type levies that generate over $100 million annually for services to older Ohioans.
Ohio Countywide Senior Services Property Tax Levies
*This health and human services levy also benefits older adults; the new levy will generate approximately $85.3 million in annual revenue
*Sources: Most senior services property tax levy voting results came from "Unofficial Election Results," Ohio News Network, OhioNewsNow.com, November 8, 2006. Sandusky's results came from that county's board of election, as did the human services levy in Cuyahoga. As of this writing, 1,424 of 1,434 Cuyahoga precincts had reported and absentee ballots had been counted. Athens' unofficial results came from The Athens News.
*Types of levies:
Replacement levies generate increased revenue.
Additional means that the current levy will be increased by the amount stated.
Renewal of a levy means that the same amount will be generated.
Open enrollment for Medicare prescription drug plan options begins November 15th. Seniors who are satisfied with their current Medicare prescription drug coverage will not have to take any action, but those who wish to make a change will find new options with lower costs and more comprehensive coverage for 2007.
Those whose plans are no longer being offered MUST re-enroll. These individuals should have received a letter notifying them if their plan has been discontinued. These beneficiaries will have a range of options available for comprehensive coverage. Those who qualify for the full subsidy will pay no premiums or deductibles in these plans.
People who are in the doughnut hole this year may want to look especially closely at some of the new plan offerings that provide coverage during the doughnut hole - some plans offer only coverage of generic drugs during the gap, but other more expensive plans may cover at least some brand name drugs.
It is important for seniors to understand that if they are satisfied with their coverage, they do NOT have to do anything during the open enrollment period.
In evaluating coverage, people should use the new internet tools provided by The Centers for Medicare and Medicaid (CMS) - you enter your drugs and the tool suggests the best plans for you.
The list of national plans can be found at www.medicare.gov/medicarereform/local-plans-2007.asp. Beneficiaries have access to help available 24/7 by calling 1-800-Medicare (1-800-633-4227).
There is now a new information service available for your constituents. The array of social services in Ohio is vast, as is the number of agencies and help-lines available. It can be hard to know where to turn for help. In many cases, people go without necessary services because they do not know where to start. Now, most Ohioans can dial 2-1-1 for information and referral services.
One number to call to get information about community services ensures that callers are directed to the appropriate agency and reduces the frustration of making multiple calls. 2-1-1 also reduces inappropriate 9-1-1 calls.
While it varies from community to community, 2-1-1 provides callers with information about, and referrals to, human services for everyday needs, as well as in times of crisis. Services commonly available through 2-1-1 include:
More than two-thirds of the state can dial 2-1-1 already and the Ohio Council of Information & Referral Providers, through the 2-1-1 Ohio Collaborative, is leading the effort to implement the service statewide. Nationwide, 2-1-1 serves approximately 190 million Americans - more than 65 percent of the US population. There are 206 active 2-1-1 systems covering all or part of 41 states (including 17 states with total coverage), plus Washington, DC and Puerto Rico.
A study commissioned by the United Way assessed the expected costs and anticipated benefits of a nationwide 2-1-1 system. The study concluded that 2-1-1 would ultimately provide American taxpayers up to $1.1 billion in net value over the next 10 years. It also found that when folks seek information or referral services for which they have little or no prior knowledge or experience, dialing 2-1-1 is much simpler than any other options.
2-1-1 is a free 24-hour service, so your constituents get the help they need when they need it. To learn if 2-1-1 is available in your district, log-on to www.211ohio.net. 2-1-1 helps people get and/or give help.
Congress recently passed H.R. 6197, a measure reflecting a bipartisan House-Senate agreement to reauthorize and strengthen services offered under the Older Americans Act, the chief federal law governing the organization and delivery of a number of social services for older Americans.
The legislation, which as first enacted in 1965, supports and protects seniors through a range of such social service programs as home-delivered nutrition, community service employment, long-term care coordination and elder abuse and neglect prevention.
Topping their priority list, the 2005 White House Conference on Aging called upon Congress to reauthorize the Older Americans Act during the 109th Congress.
Key Provisions of the Act are:
Assistant Secretary Josefina Carbonell from the U.S. Administration on Aging visited Ohio (Alliance Senior Center) to announce that ODA will receive a three year grant to implement evidence-based disease prevention programs in six regions of the State. Funding in year one is appropriated for $250,000 and $300,000 each for years two and three.
Our partners in this project include ODH, area agencies on aging (AAA), and community-based health care and aging service organizations. Our regional programs that are most effective and could be replicated statewide include Chronic Disease Self-Care Management, Physical Activity and Fall Prevention.
Six regional coalitions have joined ODA and ODH to implement these interventions, including Cleveland (PSA 10A), Akron (PSA 10B), Cincinnati (PSA 1), Columbus (PSA 6), Toledo (PSA 4) and Southeastern Appalachian Ohio (PSA 8).
Each year there is a state Senior Olympics competition, called Ohio Senior Olympics. Senior Olympics began in Ohio in 1979. The games have grown over the years, but the purpose remains the same-- to promote healthy lifestyles and physical activity for older Ohioans and to provide top quality athletic competition.
The state games are open to all athletes competing at the regional/local level. Ohio's state games are also open to athletes from outside of Ohio. This month, 1,039 older athletes from all over Ohio traveled to Youngstown to compete in the 2006 Ohio Senior Games. The games, held July 21 through August 26, hosted amateur athletic competitions for men and women ages 50 and older from around Ohio and throughout the nation.
Each year, regional Senior Olympics competitions are held in eight major Ohio cities. These events are hosted by parks and recreation departments, universities, municipalities, social service agencies and private companies, with a mission of promoting healthy lifestyles for older adults. The regional sites share the responsibility of hosting the state games on a rotating schedule. While it is not required that athletes participate in regional games to qualify for the state games, many do.
The 2006 Ohio Senior Games qualified athletes for the June 2007 Senior Olympics, to be held in Louisville, Kentucky. At the National Games, as many as 700 competitors from the Ohio games will join more than 11,000 senior athletes from around the country to compete in 18 sports and more than 800 events. The National Senior Games are held every two years and Ohio consistently sends one of the largest delegations of competitors to this event.
2006 Ohio Senior Olympics
Total Number of Participants: 1064
Ohio Participants: 1039
Out of Ohio Participants: 25
Traveled the longest distance: Leslie Skillings, Haiku, HI
Largest Individual Event: Bowling Singles - 117
Largest Team Event: Volleyball - 151
The Kinship Care and Navigator Program was a result of Amended Substitute HB 282, during the 123rd General Assembly. Kinship Care and Kinship Navigator services provide information, referral and support services for relatives acting as caregivers, legal guardians or court-ordered legal custodians responsible for the day-to-day care of minor children residing with the caregivers. Services may include the identification of kinship caregivers, facilitated access to services and referrals for legal services, child care, support groups and financial assistance. Parenting education classes may also be provided.
The Ohio Department of Aging is a member of the Kinship Care Services Planning Council created to support services to kinship caregivers. Often times the caregivers are grandparents or other relatives. The Area Agency of Northwestern Ohio is a wonderful example of a sponsor supporting these services.
The Area Agency of Northwestern Ohio has created and distributed "Parenting Smarts: The Resource Guide for Grandparents & Other Relatives Raising Children". The purpose of Parenting Smarts is to provide information to kinship caregivers about the numerous services and organizations in the community which exist to help their families.
For more information about the Parenting Smarts Resource Guide visit www.areaofficeonaging.com or call the Kinship Navigator at 419-381-7060.
The Ohio Department of Aging strives to help citizens live active, healthy and independent lives and this month we have been educating them about the pandemic flu. Keeping our seniors safe and healthy during a pandemic starts with education. They must get informed and be prepared.
The best way to fight the flu is to avoid getting it. Good health habits can help keep your body healthy and fight off the flu. Eat a balanced diet that includes plenty of vegetables, fruits and whole grain products. Drink plenty of water and go easy on salt, sugar, alcohol and saturated fat. Exercise 30 minutes or more a day, at least three days a week. Get plenty of rest and avoid alcohol and tobacco use.
Symptoms of avian influenza in humans range from typical influenza-like symptoms (e.g., fever, cough, sore throat, muscle aches) to eye infections, acute respiratory distress, viral pneumonia and other severe, life-threatening complications. If someone show signs of these symptoms, they should see their doctor.
There currently is no commercially available vaccine to protect humans against the bird flu. The U.S. Department of Health and Human Services is developing pre-pandemic vaccines based on current lethal strains of the virus, collaborating with industry to increase the nation's vaccine production capacity and seeking ways to expand or extend the existing supply.
For more information on bird flu and how Ohio is preparing for a possible pandemic, visit www.ohiopandemicflu.gov.
The Ohio Department of Aging was a founding member and is an active participant in the Statewide Transportation Coordination Taskforce (STCTF). Formed in 1996, the STCTF currently includes the Ohio Departments of Aging, MRDD, MH, JFS and Transportation, the Rehabilitation Services Commission, the Developmental Disabilities Council and the Governor's Council on People with Disabilities. The sole mission of the STCTF is to work together to remove barriers that prevent successful coordination of programs and resources among providers, payers and other local partners. Ohio's STCTF has received national awards for their leadership and progress in transportation coordination, and two grants from United We Ride have enabled the STCTF to hold regional public forums around the state to develop and implement a strategic plan for Ohio.
The Ohio Department of Aging has crafted our administrative rules to be consistent and compatible with the rules of other payers. Together with other STCTF member agencies, Aging has developed, offered and funded driver training programs for providers statewide. We encourage area agencies on aging and their providers to coordinate locally, and keep them informed about resources and opportunities.
In July of 2006 the STCTF established a Transportation Coordination ListServ for its members and their local community partners. And Aging is leading a task force effort to develop an Ohio transportation coordination web page to provide resources, including information on coordinated driver training, how-to manuals for local coordination programs, best practices and funding opportunities.
New Federal Transit Administration (FTA) regulations released this summer require Metropolitan Planning Organizations and transit systems to implement local transportation coordination plans in FFY07 in order to remain eligible for federal funding for three programs (Specialized Transportation for Elderly & Disabled, Job Access & Reverse Commute, and New Freedom). Aging and other STCTF members are providing technical assistance to their partners and communities seeking to develop local plans.
ODA would like to remind you that we have expanded and re-designed our Web site to better serve you and your staff.
We have a special section called Advocacy and Legislation where you can locate information specifically for Policymakers and Legislators. This page includes:
You can also direct constituents to track legislation on our Legislation Watch page or participate in the public rules hearing process by accessing the Agency Rules section of the site.
Check out our new web site at aging.ohio.gov.
Assisted Living, a popular and cost-effective alternative for families, previously was not an option under Ohio's Medicaid program. However, the state budget bill passed last summer created and partially funded a new Medicaid waiver program which began July 1, 2006. The waiver was a priority of Governor Taft's Ohio Access initiative and was recommended by the Ohio Commission to Reform Medicaid.
The program projections allow for the enrollment of approximately 180 consumers in the first quarter of SFY 07. On the first day the waiver was open, with half the PASSPORT Administrative Agencies' reporting, more than 45 referrals were received from consumers interested in enrolling in the Assisted Living waiver.
One factor that will impact the success of the Assisted Living waiver is statewide provider capacity that matches consumer interest. The waiver opened with Assisted Living waiver providers located in nine counties that were designating approximately 135 living units for the Assisted Living waiver. A total of 25 Assisted Living waiver providers are expected to be certified by the end of the first month of the waiver.
You can support the development of this new cost-effective, consumer-oriented long-term care option by writing letters to the editor in support of the waiver; contacting Residential Care Facilities in your district to encourage provider participation and direct interested providers and consumers to the Area Agency on Aging or ODA for more information about participation in the waiver.
On May 2, all ten county senior services property tax levies on ballots across the state passed, bringing the total number of Ohio counties with current levies to 62. Levies generate more than $100 million each year to fund programs, services and facilities (not counting additional revenue from human services levies in two counties).
Only four other states, Kansas, Louisiana, Michigan and North Dakota use senior services levies. Ohio's levy success far outpaces that of these other states.
The Ohio Association of Gerontology and Education recently released "Locally Funded Services for Seniors: A Description of Levy Programs in Ohio." Researchers surveyed levy administrators in 56 counties to describe levy programs on a range of dimensions, from millage amounts to the total number of older citizens served. The survey also contained a section examining approaches to levy campaigns as well as a section looking at the various challenges involved in operating senior service levies. This report and information about levies by county is on the Department of Aging's Web site.
Funding is now available to assist qualified, low-income and elderly Ohioans manage the summer heat through the Home Energy Assistance Program (HEAP) Summer Crisis Program through August 31. This program provides assistance with summer cooling for low income seniors or those with qualifying medical conditions. Households must include a member who is at least 60 years old and meets the income qualifications for assistance in paying the current electric bill.
Households with a resident who has a documented medical condition and meets the income qualifications may also be eligible for an air conditioner and electric bill payment assistance. For more information, call the toll-free HEAP hotline at 1-800-686-1557. Information is also available on the HEAP Web site, www.odod.state.oh.us/cdd/ocs/heap.htm
Beginning July 1, 2006 the Assisted Living Program will be available statewide as an option for 1,800 Ohio seniors and adults with disabilities on Medicaid who are in need of long-term care under a Home and Community-Based Services Waiver.
Assisted living is a popular alternative for families as an intermediate form of care and previously was not an option under Ohio's Medicaid program. The assisted living services waiver program is one of the key priorities of Ohio Access, Governor Taft's blueprint to improve long-term services and support people with disabilities. In the January 2005 report, the Ohio Commission to reform Medicaid recommended that the state provide assisted living waivers as an alternative to costly nursing home care.
House Bill 66, the FY06-07 state budget bill, created and partially funded the assisted living waiver program, which will be administered by the Ohio Department of Aging. The Centers for Medicare and Medicaid Services, a division within the U.S. Department of Health and Human Services, approved the state's request to use Medicaid funds for this program on March 31.
The waiver program will pay only for two services; assisted living services and community transition services. The Community Transition service is a one-time payment of up to $1500 for costs associated with establishing a residence for individuals transitioning from a nursing home facility.
Participant eligibility and enrollment is managed by the Area Agency on Aging. Participation is limited to nursing facility residents and existing Medicaid waiver consumers (PASSPORT, Ohio Home Care, or Choices participants) would otherwise permanently remain/enter a nursing facility. Participants must be 21 years of age and be financially eligible for Medicaid and determined to need a "nursing facility level of care." For more information contact us.
At the request of the General Assembly, ODA has contracted for an independent evaluation of the PASSPORT program through a competitive process. The Scripps Gerontology Center at Miami University has been selected as the evaluator. Scripps will release a series of five topical reports on: Consumer eligibility; Cost neutrality (compared to nursing home costs); Quality Assurance; Assessment and Service Planning and Fiscal Accountability. Below is an update on the progress of each of these reports to date.
Consumer eligibility and Cost Neutrality studies:
Scripps has supplied information on 24,000 PASSPORT clients and a sampling of 6000 nursing facility residents for a comparison group to ODJFS to obtain information on other Medicaid and non-Medicaid benefits that these beneficiaries may be receiving. ODJFS has a target date of June 5 for response. Housing subsidy information on an individual basis is not in any centralized database. ODA has agreed that our case managers will collect this information on a sample of PASSPORT consumers. If necessary, Scripps may have to use average cost data for this one element.
Quality Assurance:
Scripps has begun conducting provider focus groups. The plan is to use the focus groups to develop a survey questionnaire that will be mailed to current and former PASSPORT providers. The rationale for surveying former providers is to find out why they ceased providing services to PASSPORT consumers. Internal Review Board (IRB) approval - required by research protocols when any entity is conducting research on human subjects - has been obtained as of mid-May. A meeting scheduled at Scripps with ODA staff on June 7 to discuss the current CMS approach to their "quality framework."
Assessment and service planning:
All 13 PASSPORT Administrative Agencies (PAA) will be visited by Scripps researchers. First visit to test protocols for this study has been completed at Area Agency on Aging 6 and this has resulted in a modified methodology that can be employed in all thirteen visits.
Fiscal Accountability:
Sample PASSPORT Information Management System (PIMS) screens have been generated by ODA for Scripps because it is not feasible to give them real time access to PIMS. Scripps has obtained all PASSPORT operations manuals from ODA. The fiscal group will join the quality group for the June 7 meeting since ODA requires the PAAs to employ some shared quality assurance/fiscal accountability measures. One example is unit of service verification where PAA Quality Assurance staff review a sample of provider records to ensure that paid units of service were actually delivered to consumers. ODA requires this measure because routine single audits required by federal law do not test for this.
These reports will become available during February and March, 2007 with a final report due to the General Assembly by June 1, 2007.
The Central Ohio Area Agency on Aging has a long established history of using Title III D funds to provide Disease Prevention and Health Promotion education to Central Ohio older adults and their families.
Over the past 16 years, COAAA has provided this valuable education to over 80,000 participants. These sessions occur in either 60 or 90 minute presentations within the community, and cover a wide variety of topics. Topics include "Caring for a Loved One in a Nursing Home", "Oh My Aching….." on pain management, "Savvy Senior Safety", "60 + Rules for the Road". In addition, COAAA offers workshops on Caregiving, Diabetes Information, Incontinence, Eye Health, Oral Health for Seniors, Alzheimer's Disease, Maximizing You Memory, Sensitivity to Aging, Women's Health Issues, and Men's Health.
They also provide a great deal of education on Medicare benefits, and most recently, Medicare Part D. Over the past 16 years, COAAA have researched and developed over 35 different topics related to health education. COAAA also have provided training to over 10,000 paraprofessionals on these topics as well. Other AAAs in Ohio are replicating the COAAA model of DP/HP education.
America's aging population reached a turning point in 2006. One of the nation's largest generations, the baby boomers, started turning 60. As many as 78 million people constitute the baby boom generation, and they stand to make an enormous contribution to the rich character and wisdom older adults offer to all of us.
This May, we will once again celebrate Older Americans Month. The Department of Aging supports the desire of older adults to live in their own homes and communities for as long as possible. We work knowing that the combination of independence and choice are essential to the pursuit of healthy aging.
ODA is proud to honor our aging population by celebrating two very special events: This year Senior Citizens Day is May 16 and the theme is "Be Healthy… Be Vibrant!" Communities throughout the state will hold events that range from luncheons; awards ceremonies and outings do intergenerational activities and much more.
We are also very excited to host the annual Ohio Senior Citizens Hall of Fame and Elder Caregiving Award Ceremony which will take place on May 17, 2006 at the Statehouse Atrium here in Columbus. Since 1977, more than 300 individuals have been inducted into the Ohio Senior Citizens Hall of Fame for extraordinary achievements and contributions to others. Similarly, thousands of Ohioans of all ages selflessly give their time, their energy and themselves to care for aging family and friends. By honoring some of these amazing citizens, we symbolically salute all those who help keep Ohio great.
As a former legislator, I know these events are well attended by our seniors and they appreciate a chance to meet their elected officials. I encourage you to "Be Healthy… Be Vibrant" this May!
The Connections Dementia Training is the first comprehensive training made available to all long-term care facilities in Ohio. The Department of Aging supports the movement to transform long-term care environments into places where people live and work with meaning and purpose. The dementia training focuses on each resident's personhood and what they can do, what they want, and what they need. Representatives of the Office of the State Long-Term Care Ombudsman and supervisors from the Ohio Department of Health participated in the first session. Ombudsmen found it to be very practical and inclusive of the attitudes and methods that should be found in nursing homes, but often are not. We look forward to seeing the positive outcomes that can result from nursing home staff participating in the Connections training. If you would like more information, please visit www.alztraining.org.
Area Agency on Aging District 7, Inc., which serves 10 counties in Appalachian Ohio, provides Title III Part D funds to the OSU Geriatric Dental Program to provide dental service throughout their region on a twice-monthly basis. Senior year dental students under the close practicing of dentists perform a wide range of dental services, including oral examinations, cleaning, filling, extractions, and denture relining and repair. Over five hundred older adults have been served through December 2004. The clinic is set up in a location convenient to older adults and meeting all accessibility criteria. The location is often in the local senior center, senior housing complex or congregate nutrition sites. Mobile dental equipment is transported from OSU by van. The latest in portable dental equipment and processes are used. The AAA has received numerous letters and comments from satisfied customers who would not otherwise have access to dental care due a lack of dentists in their respective areas and/or the cost of needed dental work. This program has received numerous awards, including the 2001 Ohio Association of Area Agency on Aging (O4A) Partnership Award. Additional funding includes a grant from the J. Floyd Dixon Foundation that provides dental services to grandparents over the age of 50 who are currently raising their grandchildren.
The SFY 2006 and 2007 budget included a provision that allows individuals in a nursing facility the option to go into the PASSPORT program, regardless of slot availability, provided they are on the PASSPORT waiting list. This provision is referred to as Home First.
The Ohio Department of Aging has been tracking the use of Home First provision starting in July through manual reports submitted by the PASSPORT Administrative Agencies. In October we began tracking how many days an individual was in a nursing facility prior to using the Home First provision. This data is collected through the assessment process by asking the individual to self report.
Statewide summary of Home First activity:
Governor Bob Taft announced that that the deadline to apply for the Emergency Home Energy Assistance Program (EHEAP) has been extended to April 28 from March 31.
The deadline extension is a result of additional funding for the Low Income Home Energy Assistance Program (LIHEAP), which was recently approved by the United States Congress. Information about HEAP, EHEAP or other energy assistance programs that are available for low-income individuals is available at a toll free hotline, 1-800-282-0880, or online.
Know an Ohioan about to turn 90 or older? Honor him or her with an official certificate signed by Governor Bob Taft and Merle Grace Kearns, Director of the Ohio Department of Aging. Click here to order one at no cost for someone you know. Ohio residents only, please. Allow 4-6 weeks for delivery.
Ohio Department of Aging