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OKDHS Aging Services OKDHS Aging Services DivisionDivision

Going Beyond Just Core ServicesGoing Beyond Just Core Services

OKDHS Commission RetreatOKDHS Commission RetreatWednesday, September 29, 2010Wednesday, September 29, 2010

Lance RobertsonLance RobertsonState Aging DirectorState Aging Director

Oklahoma Department of Human ServicesOklahoma Department of Human ServicesAging Services DivisionAging Services Division

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Presentation AgendaPresentation Agenda General OverviewGeneral Overview

• Demographics, Network Structure, Service DemandDemographics, Network Structure, Service Demand InnovativenessInnovativeness

• Program Highlight: Senior Farmers’ Market Nutrition Program Highlight: Senior Farmers’ Market Nutrition Project (SFMNP)Project (SFMNP)

Program Update: ADvantageProgram Update: ADvantage Program Update: Title III Senior Meals Existing Program Update: Title III Senior Meals Existing

ChallengesChallenges The Perfect StormThe Perfect Storm Oklahoma: 2015Oklahoma: 2015

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Current State DemographicsCurrent State Demographics 694,024 Oklahomans 60+ (20th in US)694,024 Oklahomans 60+ (20th in US)

• 19.3% of population19.3% of population• By 2030, 24.45% of population (954,795)By 2030, 24.45% of population (954,795)

70,555 age 85+ (rank of 25th in US)70,555 age 85+ (rank of 25th in US)• 99,559 by 203099,559 by 2030

Raw number has increased twelve times Raw number has increased twelve times since 1900since 1900

Life expectancy of 65+ is now 19.1 yearsLife expectancy of 65+ is now 19.1 years 19.3% are minorities19.3% are minorities Baby BoomersBaby Boomers Entitlements and state/federal programsEntitlements and state/federal programs

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Number of Older Americans - Line

55

Number of Older Americans - Density

66

Life Expectancy

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Aging Services in OKAging Services in OK

Administration on Aging &State of Oklahoma

Area Agencies on Aging (11)

Program Partners

Network of Providers

State Unit on Aging =OKDHS Aging Services Division

“…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.”

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Aging Services NetworkAging Services Network 17 Major Programs17 Major Programs Major (OAA Core) Services:Major (OAA Core) Services:

• Access to ServicesAccess to Services• NutritionNutrition• Home & Community Based LTCHome & Community Based LTC• Disease Prevention & Health PromotionDisease Prevention & Health Promotion• Vulnerable Elder Rights ProtectionVulnerable Elder Rights Protection

66.7% of OAA funding goes to Title III66.7% of OAA funding goes to Title III• Meals, transportation, legal services, Meals, transportation, legal services,

homemaker services, respitehomemaker services, respite• Family Caregiver Support = 13%Family Caregiver Support = 13%

High ratio of caregiversHigh ratio of caregivers Services provided (5 core services)Services provided (5 core services) Recipients: reaching 2-7%Recipients: reaching 2-7%

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Program SnapshotProgram Snapshot All 17 major programs are fully tappedAll 17 major programs are fully tapped Network reaches 400,000 of the 635,000 in some Network reaches 400,000 of the 635,000 in some

mannermanner Programmatic examples:Programmatic examples:

• Adult Day Health – 18,000 care days delivered annuallyAdult Day Health – 18,000 care days delivered annually• 11,000 caregivers served through voucher program11,000 caregivers served through voucher program• 2,000,000 passenger trips - 82 new vehicles2,000,000 passenger trips - 82 new vehicles• 2-1-1 program fielded 232,067 calls2-1-1 program fielded 232,067 calls• 40,300 volunteers, 2.7 million hours, $45 million in 40,300 volunteers, 2.7 million hours, $45 million in

economic valueeconomic value• Legal Aid served 4,000 individualsLegal Aid served 4,000 individuals• Ombudsman investigated 6,400 complaintsOmbudsman investigated 6,400 complaints• The cumulative number of meals served tops 6 millionThe cumulative number of meals served tops 6 million

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InnovativenessInnovativeness

Going beyond Core ServicesGoing beyond Core Services• Innovative Programming: Innovative Programming:

OK Aging Advocacy Leadership AcademyOK Aging Advocacy Leadership Academy OK Court Appointed Advocates for Vulnerable AdultsOK Court Appointed Advocates for Vulnerable Adults Grand-parenting InitiativeGrand-parenting Initiative Minority Aging InitiativeMinority Aging Initiative Prisoner Reentry ProgramPrisoner Reentry Program

Aging & Disability Resource ConsortiumAging & Disability Resource Consortium Unique partnershipsUnique partnerships National recognitionNational recognition Grant FundingGrant Funding

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GrantsGrants

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SFMNPSFMNP Promotes nutritionally healthier lifestyles for low-Promotes nutritionally healthier lifestyles for low-

income senior participants and their families by income senior participants and their families by supplementing their household food purchases supplementing their household food purchases with fresh produce available through local with fresh produce available through local farmers’ markets.  farmers’ markets. 

Uses an efficient Electronic Benefits Transfer Uses an efficient Electronic Benefits Transfer (EBT) system (EBT) system

Also promotes the growing of fruits and Also promotes the growing of fruits and vegetables to sell through farmers’ markets by vegetables to sell through farmers’ markets by local, typically smaller, farmers.local, typically smaller, farmers.

Annual program budget = $75,000Annual program budget = $75,000 SFY09 = 450 servedSFY09 = 450 served Projections for SFY10 = 2300 servedProjections for SFY10 = 2300 served Many partners, including: USDA, select Area Many partners, including: USDA, select Area

Agencies on Aging, Oklahoma farmers, Regional Agencies on Aging, Oklahoma farmers, Regional Food Bank, The Kerr Center, OK Dept of Food Bank, The Kerr Center, OK Dept of Agriculture, etc.Agriculture, etc.

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The ADvantage ProgramThe 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

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1515

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1717

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ADvantage UpdateADvantage Update SFY10(P): 18,864 membersSFY10(P): 18,864 members

• 5,314 left5,314 left• 4,263 entered4,263 entered

Technology RolloutsTechnology Rollouts• ELDERS fully launchedELDERS fully launched• Integrated Voice Response systemIntegrated Voice Response system• Provider portalProvider portal

Factors impacting programFactors impacting program• Fewer applicantsFewer applicants• Proper administrationProper administration• Recertification processRecertification process

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Over 6 million Senior Meals Provided in 2010

2420423 2345894 2259309 2161419 2151752 2083247 1821353

1873255 1918850 1858371 1876742 1853495 1819750 1401105

874251 1174954 1693945 2250071 2666500 30746092954531

0

2000000

4000000

6000000

8000000

Congregate Home-Delivered ADvantage

ADvantage 874251 1174954 1693945 2250071 2666500 3074609 2954531

Home-Delivered 1873255 1918850 1858371 1876742 1853495 1819750 1401105

Congregate 2420423 2345894 2259309 2161419 2151752 2083247 1821353

2004 2005 2006 2007 2008 2009 2010

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Title III Senior MealsTitle III Senior Meals Update on the $5 million funds (HB2367)Update on the $5 million funds (HB2367)

• Preliminary Statewide SummaryPreliminary Statewide Summary• November ’09 & July ’10 cut: $7,400,000November ’09 & July ’10 cut: $7,400,000• SFY2011 HB2367 funds: $5,000,000SFY2011 HB2367 funds: $5,000,000• AAA Admin restoration: $373,588 (8%)AAA Admin restoration: $373,588 (8%)• Meal restoration: $4,626,412 (92%)Meal restoration: $4,626,412 (92%)• # of nutrition sites reopened: 7# of nutrition sites reopened: 7• # of sites restored to 5 days: 74# of sites restored to 5 days: 74• # of nutrition site staff restored to full: 141# of nutrition site staff restored to full: 141• Total meals projected: 757,501Total meals projected: 757,501

Congregate: 455,383Congregate: 455,383 Home Delivered: 302,118Home Delivered: 302,118

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““Flow” of CareFlow” of Care

OlderOlderAmericansAmericans

ActAct

AcuteAcuteNursingNursingHomeHome

HomeHome&&

CommCommBasedBased

ServicesServices

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Existing ChallengesExisting ChallengesWithin population:Within population: High poverty rate (19High poverty rate (19thth in US) – 10.5% of in US) – 10.5% of

65+65+ Larger number of rural dwellersLarger number of rural dwellers Very poor health indicatorsVery poor health indicators High disability ratio (8High disability ratio (8thth in US) in US) High Old-Age Dependency Ratio (14High Old-Age Dependency Ratio (14thth in in

US)US) Leading state for Grandparents Raising Leading state for Grandparents Raising

Grandchildren (6Grandchildren (6thth in US) – 44,000 in US) – 44,000 Reliance on public programsReliance on public programs Income/Lack of savingsIncome/Lack of savings Poor LTC planningPoor LTC planning

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Chronic Health Conditions

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Physical Activity

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Obesity

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Use of Leisure Time

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Existing ChallengesExisting Challenges

Within service delivery system:Within service delivery system:• Budget FragilityBudget Fragility• PoliticsPolitics• Competition for resourcesCompetition for resources• Creating a brandCreating a brand• Present capacity of networkPresent capacity of network• Ability to expand network on a dimeAbility to expand network on a dime• General awarenessGeneral awareness

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The Perfect StormThe Perfect Storm

BudgetBudgetProblemsProblems

ServiceServiceDemandDemand

DemographicDemographicchangeschanges

StateStateChallengesChallenges

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Making It WorkMaking It Work

Four (4) critical puzzle piecesFour (4) critical puzzle pieces

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Making It WorkMaking It Work

FederalFederalGovernmentGovernment

SupportSupportWithinWithin

CommunityCommunity

PersonalPersonalAccountabilityAccountability

StateStateGovernmentGovernment

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Oklahoma’s Aging ServicesOklahoma’s Aging Services

OK Dept. of Human OK Dept. of Human ServicesServices

OK Dept. of Mental OK Dept. of Mental Health &Health &

Substance Abuse Substance Abuse ServicesServices

OK Insurance Dept.OK Insurance Dept.OK Dept. of CommerceOK Dept. of CommerceOK Dept. of HealthOK Dept. of HealthOK Health Care OK Health Care

AuthorityAuthorityOK Dept. of RehabOK Dept. of RehabOK State Board of OK State Board of

Examiners Examiners for LTC Administratorsfor LTC Administrators

WebWebPortalPortal

ADRCADRC

TelephonTelephonee

2-1-12-1-1Senior Info LineSenior Info Line

Area Agencies on Aging Area Agencies on Aging

Disability CommunityDisability Community

ProvidersProviders

Corporate PartnersCorporate Partners

Higher EducationHigher Education

Advocate GroupsAdvocate Groups

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and Caregiversand CaregiversPoints ofPoints of

EntryEntryPartnersPartnersLead Agency forLead Agency for

Aging ServicesAging Services

Connecting all the pieces….Connecting all the pieces….

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Oklahoma 2015 – Oklahoma 2015 – A state where we:A state where we:

Are less reliant on state/federal dollarsAre less reliant on state/federal dollars Deliver services as efficiently as possibleDeliver services as efficiently as possible Serve those in our system with the most Serve those in our system with the most

dire needsdire needs Have effectively created an identity and Have effectively created an identity and

brandbrand Ensure the full array of information needed Ensure the full array of information needed

is readily accessible to seniors and their is readily accessible to seniors and their caregiverscaregivers

Have strong, effective advocacy groups with Have strong, effective advocacy groups with a “plan”a “plan”

Collect and use meaningful dataCollect and use meaningful data Empower consumersEmpower consumers

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Oklahoma 2015 – Oklahoma 2015 – A state where we:A state where we:

Have successfully merged aging and disabilityHave successfully merged aging and disability Are known for many models of excellenceAre known for many models of excellence Have successfully defragmented services and Have successfully defragmented services and

increased information accessincreased information access Focus on preventing premature or Focus on preventing premature or

inappropriate nursing home placementinappropriate nursing home placement Boast creativity, innovativeness and resiliency Boast creativity, innovativeness and resiliency

in offering a robust number of servicesin offering a robust number of services Support many dynamic partnershipsSupport many dynamic partnerships Assure socialization abounds and Assure socialization abounds and

independence reignsindependence reigns

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Lance RobertsonLance RobertsonOKDHS Aging Services DivisionOKDHS Aging Services DivisionLance.robertson@okdhs.orgLance.robertson@okdhs.org405-521-2281405-521-2281www.okdhs.orgwww.okdhs.org

THANK YOU FOR YOUR TIME & THANK YOU FOR YOUR TIME & ATTENTION!ATTENTION!