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National Association of Area Agencies on Aging
Title VI Chat
Title VI Survey Results
October 21, 2015
National Association of Area Agencies on Aging
About n4a The National Association of Area Agencies on Aging (n4a) is a 501(c)(3) membership association representing America’s national network of 623 Area Agencies on Aging (AAAs) and providing a voice in the nation’s capital for the 256 Title VI Native American aging programs. n4a is dedicated to supporting the success of our members by:
• Advocating on behalf of the Aging Network,
• Raising the visibility of AAAs and Title VI programs nationwide,
• Offering training and educational events to build the capacity of our members, and
• Working to drive excellence in the fields of I&R/A, transportation, livable communities and volunteerism
www.n4a.org
National Association of Area Agencies on Aging
Survey Process
• Grant from ACL
• Partnership between n4a and Scripps Gerontology Center
• In the field from February 2014 to June 2014
• Launched online and completed almost exclusively through telephone interviews with Title VI administrators (via Shelly Zylstra)
• 88.7% response rate
National Association of Area Agencies on Aging
Survey Topics
• Connections to the larger tribal infrastructure;
• Key features and services of the Title VI programs;
• Innovative care delivery;
• Elder abuse prevention and intervention;
• Expanding services and sustainability; and
• Training and technical assistance needs.
National Association of Area Agencies on Aging
Grantees for the Title VI Program
74.9%
20.3%
4.8%
Individual Tribe
Tribal Consortium
Inter-tribal Council
National Association of Area Agencies on Aging
Who Do Elders Call When They Need Services?
54.0%
17.7%
10.6% 8.1%
6.1% 2.5% 1.0%
0%
10%
20%
30%
40%
50%
60%
National Association of Area Agencies on Aging
Areas Served by Title VI Program
Area
Percentage
of Title VI
programs
Number of
sites
(average)
Miles to
most distant
site
(average)
Miles to
most distant
elder
(average)
Predominantly
remote/frontier 3.3% 13 44 44
Predominantly rural 13.8% 4 254 166
Mix of suburban and rural 11.4% 2 51 48
Mix of urban, suburban, and
rural 9.0% 3 85 92
Mix of urban and suburban 59.0% 2 142 64
Predominantly urban* 2.4% 1 N/A 9
Predominantly suburban* 1.0% 1 N/A 26
*Programs have only one service site
National Association of Area Agencies on Aging
Most Common Funding Sources (in addition to Title VI) Used to Provide Title VI Services
10.9%
11.4%
15.3%
16.8%
18.3%
22.8%
22.8%
48.0%
64.4%
0% 10% 20% 30% 40% 50% 60% 70%
Tribal Transit transportation funding
Consumer donations for services
Grant funds
Revenue from gaming
Fundraising
Older Americans Act – Title III
Indian Health Service
Tribal council funding
Nutrition Services Incentive Program (NSIP)
National Association of Area Agencies on Aging
Services Offered to Elders in the Community (2011 & 2013)
84.1%
87.4%
88.9%
91.8%
88.4%
83.6%
91.8%
93.7%
97.1%
96.1%
85.9%
86.4%
87.3%
87.3%
90.1%
90.1%
93.0%
93.9%
94.8%
96.2%
75% 80% 85% 90% 95% 100%
Assessment for long-term services and supportseligibility
Medication management
Senior center
Transportation (medical)
Assistive devices
Health and wellness
Social activities
Information and referral/assistance
Home delivered meals
Congregate meals
2013
2011
National Association of Area Agencies on Aging
Health Promotion Services and Programs Available in Title VI Communities
58.0%
82.0%
88.5%
89.5%
90.0%
91.0%
94.5%
96.5%
97.5%
0% 20% 40% 60% 80% 100% 120%
Evidence-based programs
Disease-specific support program
Home injury prevention
Mental health screening or programming
Medication management
Caregiver support program
Diabetes management and prevention programs
Routine health screenings
General health promotion activities
National Association of Area Agencies on Aging
Evidence-based Health Promotion Services and Programs Offered by Title VI Programs*
19.8%
31.1%
33.0%
34.9%
34.9%
37.7%
37.9%
38.7%
41.5%
42.5%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Active Living Every Day
EnhanceWellness
Healthy Changes
Healthy Moves for Aging Well
Powerful Tools for Caregivers
EnhanceFitness
Chronic Disease Self-Management Program
Diabetes Self-Management Education Training (DSME-T)
Heart Healthy
Healthy Eating for Successful Living
(*of those Title VI Programs that offer evidence-based health promotion services and programs)
National Association of Area Agencies on Aging
Funding Changes Over Previous Two Years
58.8%
29.9%
11.3%
0%
10%
20%
30%
40%
50%
60%
70%
Decreased Remained flat Increased
National Association of Area Agencies on Aging
Specific Changes in Response to Financial Constraints
Action Taken Proportion of Title
VI Programs
Proactive and Strategic Reorganization Measures
Reorganized the program 34.9%
Explored new funding opportunities 30.2%
Explored new partnerships 16.1%
Increased program evaluations to determine time/money better spent 16.1%
Changes to Operations
Cut or eliminated business travel 42.3%
Cut or eliminated staff training 32.9%
Reduced total number of staff by not replacing those who left 26.8%
Increased caseloads 18.8%
Cut the budgets of at least some departments 14.8%
Changes Directly Affecting Staff and Clients
Reduced total staff hours by converting some positions from full-time to
part-time 30.9%
Froze staff salaries 28.9%
Eliminated or reduced staff salary increases 24.2%
Instituted waiting lists 13.4%
Restricted the number of clients served 12.8%
National Association of Area Agencies on Aging
Building Infrastructure to Expand Services and Sustainability
29.0%
29.1%
37.9%
63.9%
68.7%
74.2%
76.7%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Developing a data system to implementelectronic medical or health records
Developing technology to improve elder accessto services
Positioning our program as a point of entry forlong-term care in our area
Developing collaborations with our local Title IIIorganization
Providing a seamless intake, assessment, andeligibility determination process for the elder
Improving the way we maintain informationabout elders
Improving our information andreferral/assistance system
National Association of Area Agencies on Aging
Business Practices to Enhance Capacity
52.3%
52.5%
52.9%
53.0%
56.5%
61.9%
67.0%
73.2%
74.5%
78.7%
86.8%
0% 20% 40% 60% 80% 100%
Expanding the target groups we serve
Fiscally sustaining programs and services if no…
Writing grants for programs and services
Having enough staff
Expanding the types of programs and services we offer
Developing a system to provide supportive services to…
Acquiring Tribal Council support for providing…
Conducting outreach
Using information about elder outcomes
Conducting a needs assessment in our area
Having culturally competent staff
National Association of Area Agencies on Aging
Training and Technical Assistance Needs
27.7%
27.7%
28.2%
28.6%
29.6%
32.9%
33.3%
36.2%
38.0%
41.8%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Volunteer management
Learning more about Medicare
Partnerships
Understanding the long-term services and
supports system
Developing outcome measures
Grant writing
Resource development
Learning more about Medicaid
Strategic planning
Locating funding sources
National Association of Area Agencies on Aging
Mary Kaschak
Senior Program Manager
National Association of Area Agencies on Aging
www.n4a.org
Contact