Positioning the Aging Network for the

Future of Long Term Care

John Wren4th State Units on Aging Nutritionists & Administrators

Conference August 2006

Choices for Independence

A Strategy for:

• Giving Seniors More Choices, Control and Independence in the Community

• Positioning the Aging Network

Policy Environment

• Growing Elderly Population

• Increasing Numbers of Impaired Elderly

• Growing Cost of LTC

• Dissatisfaction with Current System

Challenges with Current System

• Not Responsive to Consumers

• Institutional Bias

• Fragmented and Inefficient

• Very Expensive

Growth in LTC Expenditures

0

20

40

60

80

100

120

140

Medicaid Medicare LTCI Other Public Family

2030

0

20

40

60

80

100

120

140

Medicaid Medicare LTCI Other Public Family

20052005 2030

Aging Network’s Unique Assets

• Consumer Focus

• Advocacy / System Development Role

• Nationwide Infrastructure for HCBS

• Capacity to Reach People Early

• Trusted Source of Information and Assistance

Key Elements of Choices

• Empowering People to Make Informed Decision and to Access Needed Care

• Helping High Risk Individuals Avoid Nursing Home Placement

• Keeping People Healthy

Key Program Components

• Aging & Disability Resource Centers

• Evidence-Based Prevention Programs

• Community Living Incentives

Aging Network’s Unique Assets

• Consumer Focus• Advocacy / System Development Role

• Nation-wide Infrastructure for HCBS

• Capacity to Reach People Early

Choices for Independence

• Current Status

– Reauthorization

– FY 2007 Budget

Strategies We’re Using to Achieve our Strategic Goals

Goals

Advocacy

Consumer Informationand Public Education

Knowledge Development,Research Translation and Community Implementation

Grants to States,Territories and Tribes

Technical Assistance

Effective and ResponsiveManagement

AoA’s Overall Strategy

“Strengthen the capacity of the Aging Services Network to play a leadership role in health and long-term care

through initiatives that involve partnerships with

other key stakeholders.”

Better nutrition and increased physical activity is well within reach.

http://www.aoa.gov/youcan

•A partnership approach

•Outreach and mobilization to community organizations

•Partners encourage older Americans to eat better and move more

Strengthening National ProgramsAlzheimer’s Disease

• Alzheimer’s Disease Demonstration GrantsAlzheimer’s Disease Demonstration Grants– Vehicle for advancing changes to a state’s overall system of

home and community-based care – Require grantees to use evidence-based research from NIA

and other sources in developing their plans

• Program Evaluation and TA Resource Center Program Evaluation and TA Resource Center ContractContract– Gather Best Practice Case Studies– TA – Replicating best practices & community-based

alternatives– Link to federal and state long term care systems

development initiatives

Strengthening National ProgramsReturn Focus of Nutrition Programs as Wellness Programs

• “You Can! Steps to Healthier Aging” Mini-GrantsMini-Grants– Fund 8-10 nutrition programs; announce April 30 at Secretary’s

“Steps to Healthier US” Summit

• $1.5 Million Earmark – “Bridges to Health and Wellness”– Provide high risk older adults, short term home delivered meals,

nutrition education/counseling, referral to physical activity programs, and links to community wellness programs

– Change the culture of home delivered "meal" providers – nutrition as a wellness program and a link to other community services

Health Promotion in Native American Communities

• National Resource Center on Native American Aging– Reducing LTC Needs

through HP/DP– Counseling Healthy

Behavior

Eliminating Health Disparities AmongMinority Elder Individuals

Target Population: Older Persons of Hispanic Descent

• Project Title: Project Salud A La Vida• Grantee: Asociacion Nacional Pro Personas Mayores• Goal: Increase awareness of—

– cardiovascular disease in older Hispanic women– prostate cancer in older Hispanic men– need for annual influenza and pneumococcal vaccine

• Strategies: Multilanguage, culturally based, Fotonovela format• Focus: Reach monolingual Hispanic immigrant elders in 4 cities

Eliminating Health Disparities AmongMinority Elder Individuals

Target Population: African American Elders

• Project Title: Obesity: A Leading Risk Factor for Healthy Living• Grantee: National Caucus and Center on the Black Aged, Inc. • Goal: Reduce obesity, a leading risk factor for chronic disease among African American seniors, including:

– Cardiovascular disease; hypertension; kidney failure, & diabetes• Strategies: Establish church-based aging and health advocacy committees that will disseminate health promotion information designed to:

– promote weight reduction– improve nutrition– increase physical activity

• Focus: Reach African American elders through faith-based collaborations

Evidence-Based Prevention Grants Program

• Goal– Demonstrate efficacy of delivering proven risk

reduction interventions through our providers • Key Design Elements

– $6+million over 3 years– 12 projects & National TA Center– Public/Private Partnership

• Anticipated Outcomes

Older Americans ActTitle III D Evaluation

• Involvement of AoA and the Network in Heath Promotion/Disease Prevention

• Evaluation of III-D underway through RTI International

• Literature Review and Expert Panel Observations Suggest Program Effectiveness

• AoA Seeks Observations and Information of Value for Health-Related Program Development at Federal, State and Community Levels

Making It Happen: The CM Enablers

Getting the Resources

Making and Overseeing the Grants/Contracts

Providing IT Service and Support

Keeping AoA Staff Healthy and Safe

CCCS

OE

CPPD

CWCBS

ASA

OCBS

OAIN

OCCP

ES

RSC

CM