2012 Area Plan Draft3a
Content
C b l d County, Pennsylvania Cumberland C ty P yl i
Stra gic A tion Pla S ateg Acti lan 201 -201 12- 16
AGI & COM ING MMUNIT SE TY ERVICE ES
110 CLARE 00 EMONT RO , CAR OAD RLISLE, PA 17015 A
Cellebrating 40 Ye of S g ears Service t Cumb to berland C County 197 72-2012
Pr repared by the Aging & Comm g munity Ser rvices Staff ff Terry L. Barley, D Director
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
TABLE OF CONTENTS
PART A EXECUTIVE SUMMARY .................................................................................................................... 2 AGENCY OVERVIEW ........................................................................................................................ 5 AGENCY MISSION........................................................................................................................................... 5 ORGANIZATIONAL STRUCTURE ................................................................................................................... 5 STRATEGIC PLAN DEVELOPMENT ............................................................................................................... 6 KEY DEMOGRAPHICS .................................................................................................................................... 7 CONSUMERS .................................................................................................................................................... 8 LOCAL POLITICAL & ECONOMIC CONDITIONS ......................................................................................... 9 NEEDS ASSESSMENT PROCESS ...................................................................................................................10 NEEDS ASSESSMENT FINDINGS .................................................................................................................11 NATIONAL GOALS & INITIATIVES .............................................................................................................12 POSSIBLE RESOURCE DEVELOPMENT .......................................................................................................12 GOALS, OBJECTIVES, & STRATEGIES............................................................................................ 13 GOAL 1: ACCESS SERVICES: ........................................................................................................................13 GOAL 2: HOME & COMMUNITY BASED SERVICES: .................................................................................13 GOAL 3: PROMOTE HEALTH & WELL-BEING:.........................................................................................14 GOAL 4: ELDER RIGHTS & PROTECTION: ................................................................................................14 GOAL 5: MAINTAIN EFFECTIVE & RESPONSIVE MANAGEMENT:.........................................................15 PERFORMANCE MEASURES ...................................................................................................................... 15 PART B ..................................................................................................................................................... 17 SIGNATURE PAGE/STANDARD ASSURANCES COMMONWEALTH OF PENNSYLVANIA .......................17 DOCUMENTATION OF PARTICIPATION BY THE AAA ADVISORY COUNCIL ........................................19 LISTING OF PLAN ASSURANCES AND REQUIRED ACTIVITIES................................................................20 NARRATIVE SUMMARY OF THE PROCEEDINGS OF THE AAA AREA PLAN PUBLIC HEARING. .........23 APPENDICES .............................................................................................................................................. 24
1
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
EXECUTIVE SUMMARY
Cumberland County’s Mission:
The most livable community with the most efficient and effective public services in Pennsylvania
Cumberland County Aging & Community Services is one of 655 Area Agencies on Aging across the nation which reach into every community and play a key role in delivering the services and care that enable older adults to safely remain in their own homes and communities for as long as medically possible. Every four years, all Area Agencies on Aging (AAA) across the nation are required to develop and submit a Plan that reflects future activities of the AAA to address the needs of older adults, adults with disabilities, and caregivers in their designated Planning and Service Area (PSA). In Cumberland County the strategic planning process is guided by an overall County Strategy set forth by the Board of Commissioners which identifies service priorities in tandem with an outcome oriented financial management system. The Commissioners have developed a balanced scorecard which provides a framework used to align system-level and departmental strategies, goals, and target outcomes. This 2012-2016 Four Year Strategic Action Plan has been developed using guidance issued by the Administration on Aging and the Pennsylvania Department of Aging, and is designed to correlate with the Strategic Directions of the Commissioners’ Balanced Scorecard for Cumberland County. The changes in strategy with which A&CS approached the development of this Strategic Plan include the following: 1. The Plan takes into account the constraints on fiscal resources experienced by today’s local, state, and federal governments. 2. The Plan is shaped by the aspiration of creating a “livable community for all ages” so that all ages can benefit from strategies that support seniors. 3. The Plan strives to align with the Strategic Plan of the County Commissioners and other local strategic plans. In this way, organizational energies and resources can be maximized. In the last 20 years, while Pennsylvania experienced a 10.9% growth rate in the population 60 years of age and older, Cumberland County’s 60+ population has grown at an astounding 44.5%. With the first wave of “Boomers” entering the older adult population a year ago, Cumberland County is beginning to age rapidly. In 2010 one of every 5 residents was 60 years of age or older and the Penn State Data Center has projected that by 2030 that ratio will be 1 in 4. These demographic changes occur within the context of concerns about growth in government spending and the ability to sustain promises already made.
2
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Indeed, the national economic downturn has caused decline in the agency’s financial condition and is resulting in a weakened service system infrastructure. Not only has stagnant federal and state funding not kept up with the growth in the older adult population, it hasn’t even kept pace with inflation. In addition to the flat funding of the Aging Block Grant for five of the last six years, rule changes have eliminated an alternative source of revenue, creating a budget deficit of over $400,000 that required a County General Fund Subsidy for the first time in over ten years. In order to balance the agency budget, staff have been (and will be) furloughed and programs and services are being reduced or eliminated. Home chore staff has been cut in half and Home Support services such as shopping and laundry services are being eliminated. A waiting list is in place for most in-home services not funded by the Aging Waiver. A comprehensive community needs assessment conducted in 2011 by the United Way of Carlisle and Cumberland County, consumer surveys, as well as input from the Aging Advisory Board, staff and providers identified affordable housing, affordable medical care, and improved transportation as key needs. It is imperative to note that the issues of income, housing, transportation and medical care are not within Aging & Community Services direct control. The agency’s best strategy in these areas is building new partnerships and continued advocacy on behalf of those issues. Consumers also rated maintaining quality of life and the ability to remain in my home as important. Given that the bleak fiscal environment is expected to continue for the foreseeable future, the agency’s ability to afford and deliver the critical services necessary to meet these goals is severely challenged. The Older Americans Act (OAA) requires that all services provided using OAA funds be targeted at the most vulnerable older individuals. A brief summary of the County’s older adult population and the mix of consumers served shows that the Agency has been successful in meeting those mandates:
2010 Population % Tot Pop % Tot Pop Live Alone Rural Poverty Minority * Age 60+ Age 65+ 65+ 65+ 65+ 65+ Pennsylvania 21.3% 15.4% 29.2% 15.4% 7.9% 8.3% Cumberland County 21.8% 15.6% 28.4% 18.0% 5.1% 2.8% Consumers Served ** 43.1% 23.6% 14.4% 4.5% * Minority Data from 2009 since local 2010 data not available ** In FY2010-11 the Agency provided services to 8.6 % of the 65+ population in the county; of those receiving Agency services, 92.4% were 65 years of age and older; 50.1% were 80 and older.
In spite of the fiscal constraints, the agency expects to continue to meet the Older Americans Act targets over the next four years for the Administration on Aging funded services. Four of the PA Department of Aging’s focus areas as well as this plan’s objectives and strategies are organized using the four core program goals and one management goal established previously:
3
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
GOAL 1: ACCESS SERVICES: Enable all older individuals, adults with disabilities, their families and caregivers to make informed decisions about, and easily access, the ‘Right Services at the Right Place at the Right Time’. GOAL 2: HOME & COMMUNITY BASED SERVICES: Enable older individuals and persons with disabilities to live as independently as possible in the residential setting of their choice, including supports for family caregivers. GOAL 3: PROMOTE HEALTH & WELL BEING: Enable individuals to make lifestyle changes which reduce their risk of disease, disability, and injury. GOAL 4: ELDER RIGHTS & PROTECTION: Protect the rights of all older adults, and ensure that they are free from abuse, exploitation, neglect, and abandonment. GOAL 5: MAINTAIN EFFECTIVE & RESPONSIVE MANAGEMENT: Maintain and/or increase program performance and accountability through effective, efficient and responsive program management. While many of the strategies outlined in this FY2012-2016 plan are designed to engage and educate the public, the agency remains committed to its focus on providing high quality, efficient services to the most vulnerable individuals with the resources available. Over the past six years Aging & Community Services has established and refined local measures consistent with the Commissioners Strategic Planning Framework as well as existing guidance from the Administration on Aging (AoA). As such, it maintains the three key performance measures outlined by the Administration on Aging which reach across all of the five strategic goals: Program Efficiency, Program Effectiveness, and Consumer Outcomes. Additional local output measures which relate to the individual goals are tracked and reported quarterly throughout the year. The following table lists the indicators currently being utilized:
Measure 2009 Actuals 2010 Actuals 2011 Actuals 2012 Target Estimated Long Term Living savings (HCBS vs. Nursing Facility Care) $ 6,441,564 $ 8,798,221 $ 8,251,754 $ 8,000,000 Number of NFCE Consumers Served in HCBS 236 255 274 250 Positive HCBS consumer satisfaction rating of 90% or more 98% 98% 95% 90% Number of consumers transitioned from Nursing facilities back to the community 15 17 29 23 Number of I&A requests 13,938 16,879 16,783 16,500 Number of Consumers receiving rental/in home assistance 7,342 7 6,788 6,000 Number of assessments/reassessments 1,909 1,942 1,607 1,500 Number of people on the waiting list for service 0 0 13 48 Average number of days on waiting list 0 0 47 200 Number of senior citizen trips 48,628 46,402 46,891 46,500 Number of adult day care days provided 4,765 4,945 4,436 4,000 Number of home meals delivered 6,855 5,780 4,480 4,000
While efficiency, effectiveness and quality client outcomes will always be measures to be monitored, program and service output indicators will need to be reviewed and modified as funding sources and programs change over the next four years.
4
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
AGENCY OVERVIEW
Agency Mission
To enhance the quality of life for Cumberland County citizens by providing a variety of Human Service programs, most of which are designed to assist low income seniors, adults, families, and adults with disabilities to remain in their homes; and to assist community groups and other public and private Human Service organizations to identify and develop solutions to unmet Human Service needs. Cumberland County Aging & Community Services is one of 655 Area Agencies on Aging across the nation which reach into every community and play a key role in delivering the services and care that enable older adults to safely remain in their own homes and communities for as long as medically possible. In addition to the Older Americans Act programs operated by the agency, Aging & Community Services currently administers the Homeless Assistance Program, Human Services Development Fund (HSDF), Food Assistance Programs, the Commonwealth’s Act 150 Attendant Care Program and the Attendant Care Waiver for Cumberland, Dauphin and Perry Counties. In the management of our programs and our strategic planning process, Aging & Community Services is guided by a set of core values in developing and carrying out its mission. These values include: • Listening to our consumers, their families & caregivers, and our partners who serve them; • Responding to the changing needs and preferences of our increasingly diverse and rapidly growing consumer population; • Producing measurable outcomes that significantly impact the well-being of our consumers and their family caregivers; and • Valuing and developing our staff. In 2012 Aging & Community Services marks its 40th year of serving Cumberland County’s older adults.
ORGANIZATIONAL STRUCTURE
The County of Cumberland is the unit of general purpose local government designated as Planning and Service Area (PSA) 21 by the Commonwealth of Pennsylvania under Section 305(a) (l) (E) of the Older Americans Act of 1965, as amended. The Board of Commissioners is the governing body with the legal authority and responsibility for providing human services to older persons in the planning and service area. To carry out these responsibilities the Commissioners have established the office of Aging & Community Services to manage these programs, as well as an Aging Advisory Board to advise them on all matters relating to the planning, administration, and operation of programs and services for older adults.
5
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
AGENCY ORGANIZATIONAL CHART
CUMBERLAND COUNTY COMMISSIONERS CHIEF HUMAN SERVICES POLICY TEAM CLERK HUMAN SERVICES POLICY TEAM
DRUGS AND ALCOHOL
MENTAL HEALTH AND IDD
AGING & COMMUNITY SERVICES
CHILDREN AND YOUTH
COUNTY TRANSPORTATION
AGENCY DIRECTOR
DEPUTY DIRECTOR
CARE MANAGEMENT SUPERVISOR III/RN
COUNTY FINANCE OFFICE
AGING FISCAL OFFICER II
COMMUNITY SERVICES FISCAL OFFICER
CASE MGT SUPERVISOR HAP & CUMB CARES
CARE MGR SUPVR 1 APPRISE / I&A / OMBS
ADRC PROJECT MANAGER
FISCAL TECHNICIAN
FISCAL TECHNICIAN
CASE MGR / HOMELESS
SR CTR COORD (AO1)
CARE MGR II / I&A
FISCAL TECHNICIAN (V)
FISCAL TECHNICIAN
CASE MGR / CUMB CARES
DATA MANAGER
CARE MGR II / OMBS
HOME MOD COORD (V)
CLERK TYPIST II
ADM ASSISTANT II
CARE MGR II / OMBS
CLERK TYP II / RECEPT SKILLED LABORER SKILLED LABORER
ADM ASSISTANT I
CARE MGR II / I&A / APPR
CARE MGT SUPV I COMMUNITY TRANSITION
CARE MGT SUPV I AND ASSESSOR
CASE MGT SUPERVISOR ATT CARE / ACT 150
PART TIME CARE MGR II
PARE TIME CARE MGR II
CARE MGR II
CARE MGR II / FCSP
CARE MGR II / ASSESS
CARE MGR II / PC / DC
ATT CARE SVC COORD
PART TIME CARE MGR III
CARE MGR III
CARE MGR III
CARE MGR II / WAIVER
CARE MGR II / WAIVER
CARE MGR II / WAIVER
ATT CARE SVC COORD
COMM SOCIAL WORKER
Cumberland County has also developed various cross-system management teams to analyze issues, develop plans, and implement service strategies across the spectrum of County operations. These include a Senior Management Team, Human Services Policy Team, Claremont (Nursing and Rehab Center) Team, Emergency Management Team, and Criminal Justice Policy Team. These teams work to ensure the development of appropriate strategies, policies and programs that comprise a framework for delivering efficient and effective services for Cumberland County residents. Aging & Community Services is an active participant in the Human Services Policy Team and the Claremont Nursing & Rehabilitation Center Team. Cross-system working teams have also been established between Aging and Individuals with Developmental Disabilities, Aging and Mental Health, and Aging and Emergency Preparedness in order to address the needs of the growing older population.
STRATEGIC PLAN DEVELOPMENT
Every four years, all Area Agencies on Aging (AAA) across the nation are required to develop and submit a Plan that reflects future activities of the AAA to address the needs of older adults, adults with disabilities, and caregivers in their designated Planning and Service Area (PSA).
6
CUMBERLA COUNTY AGING & COMM AND MUNITY SERVIC CES
DRAFT STRAT ATEGIC ACTION PLAN FY 2012 N 2-2016
In Cum mberland Co ounty the str rategic plann ning process is guided b an s by overall County Stra ategy set fort by the Bo th oard of Com mmissioners w which es iorities in tan ndem with a outcome oriented fina an ancial identifie service pri manage ement system The Com m. mmissioners have devel loped a bala anced scorecar which pr rd rovides a fra amework used to align system-level and l departm mental strateg goals, an target out gies, nd tcomes.(see A Appendix A) 012-2016 Four Year St trategic Actio Plan has been developed on s This 20 using guidance issued by th Administration on Aging and the g he d Pennsyl lvania Depar rtment of A Aging, and th Strategic Directions o the he of Commi issioners’ Bal lanced Scorec card for Cum mberland County. The appr roach used by Aging & Community Services in d C developing th Strategic Plan include the his es following g: 1. The Plan take into accoun the constr T es nt raints on fisca resources e al experienced b today’s local, by st tate, and fede governm eral ments. 2. The Plan is sh T haped by the aspiration of creating a “livable comm f munity for al ages” so tha all ll at ag can benef from strat ges fit tegies that support seniors s. 3. The Plan reco T ognizes that Area Agencies on Aging a A alone cannot create the co ommunity th hat ol adults desire. lder 4. The Plan striv to align with the Strat T ves w tegic Plan of the County Commission and othe ners er lo strategic plans. In thi way, organ ocal is nizational ene ergies and res sources can b maximized be d.
KEY DEMOGRAPH E HICS
The majo ority of the demographic data that wa collected a analyzed is not presen here bu will d as and d nted ut be compi iled separate and made available on our websi www.ccpa.net/aging. The data w ely e o ite which follows fo ocuses on th hose factors that we believ will have a major infl ve fluence on ou service de ur elivery system in the next fou years. n ur
POPULA ATION TREN NDS
e decades the n number of p people In the last three d in Cu umberland C County age 6 and older grew 60 at 2½ times the ov verall county rate. With the first wav of “Boom ve mers” enterin the ng older adult popula ation a year ago, Cumbe erland Count is beginnin to age rap ty ng pidly. In 201 one of eve 5 residen was 60 ye of 10 ery nts ears age or older and th Penn State Data Cente has r he e er projec that by 2 cted 2030 that rat will be 1 i 4. tio in
7
CUMBERLA COUNTY AGING & COMM AND MUNITY SERVIC CES
DRAFT STRAT ATEGIC ACTION PLAN FY 2012 N 2-2016
While Pe ennsylvania experienced a 10.9% grow rate in p e wth people 60 yea of age and older durin the ars d ng last 20 years, Cumbe erland County’s growth rate has bee an astoun en nding 44.5% Notable in that %. n s d gration into the county since 2000. t growth is the role of domestic mig During the same t g time period the major u urban centers in the Com s mmonwealth have experie enced decline in this pop es pulation grou up. a s ase While Philadelphia realized its first increa in its tota populatio since the 1950 census, it al on e actually lost an ad y dditional 17 7.9% of its older residen nts. wanna Coun nty, home to Scranton lost n Lackaw 7.8%; Luzerne Co ounty, home to Wilkese -Barre lost 7 .4%; and A Allegheny C County, hom to me Pittsbu urgh lost 10.0 0%. For pla anning purpo oses, Cumbe erland Count has ty divided its 550.2 square miles of land into three d regions based on si s imilar charac cteristics and land d develop pment patter rns. In 201 51% of t county’s older adults lived 10, the on the 61.4 square miles of lan in the Ea e e nd astern region, 35% lived on the 210. square mi of , .1 iles land in the Centra region, an the rema n al nd aining 14% li on the 2 ive 278.6 square miles of lan in e nd the We estern region n.
EAST CENTRAL L WEST
60+ Pop Weste ern Central Eas stern Number 71 139 17982 26098 Percent 13.9% 51.0% 5 35.1%
CONSUM MERS
With the limited finan ncial resourc available, the agency se ces erved slightly more that 6 percent o the y 6.5 of county’s total older ad populati (those 60 years of age and older) i Fiscal Year 2010-2011. t dult ion 0 e in r Over h of those served were 80 years of a or half age older; 42.2% lived Alone; 24.0% lived in rural d areas; and 16.1% w below th poverty le were he evel. A com mparison of the ages of the county’s 60+ s popula ation and th hose of the consumers being served by Aging & Community Services c d clearly demon nstrates that the bulk of services are t s provid to the old and mos frail age gr ded dest st roups. The f following ta able contain key Nat ns tional Aging Pr rogram Infor rmation Syst tem (NAPIS data relate to the co S) ed onsumers ser rved by Agin & ng Commun Services during FY10 nity 0-11. (To co orrectly unde erstand the re elationships, first select h header
8
CUMBERLA COUNTY AGING & COMM AND MUNITY SERVIC CES
DRAFT STRAT ATEGIC ACTION PLAN FY 2012 N 2-2016
and read down the co olumn; i.e. of the rural population, 3 o p 31.4% live a alone; of thos who live a se alone, 17.9% ar rural). re
LOCAL POLITICAL & ECONOM CONDIT O MIC TIONS
rs eparing the agency’s last 4 year plan, little did we know that what a e Four year ago when we were pre appeared at the time to be just a minor eco e onomic slowd down was g going to turn into the biggest n recession since the Gr Depression. reat
Unemployment rat – Not Seasona Adjusted te ally
While Cumberla e and County has not been y immu to the ec une conomic pro oblems facin the ng nation and state since 200 its econ n e 08, nomic divers sity has ena abled it to fare better than . sity s loyers many. That divers includes major empl in th insurance healthcare manufactu he e, e, uring, and tr ransportation and wareho n ousing indust tries. The C County econ nomy also b benefits from the m region presence of federal, state and local nal e , govern nment oper rations. Cum mberland Co ounty ended 2010 with a Decembe unemploy d h er yment rate o 6.4 percen one of t lower rat in of nt, the tes Penns sylvania. The statewide ra was 8.1% e ate %. Overal growth co ll ontinues at a slower rate than before the recessio and it is anticipated that e on, s d there w be conti will inued decrea in the gr ases rowth of real estate in the next few years. l e Mortg gage foreclos sures have increased in the n recent months, bu only beca ut ause last yea was ar slow si ince legal qu uestions had to be resolve In ed. Februa 2012 th ary here were on 30 filin in nly ngs Cumb berland Coun a ratio o just 1 in 3 nty, of 3,333 housin units, ran ng nking 27th in the state, w n which had a ratio of 1 in 1,239. The nationwide ratio n e e was 1 in 637 home es.
9
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
The most serious and immediate issue facing the agency is the erosion of existing financial resources used to provide home and community based services for older adults, which is resulting in a weakened service delivery system infrastructure. Twenty-two years ago in the agency’s 1990 Strategic Plan for Aging Services we predicted: “A more vulnerable/frail population with increasing health related problems ... will result in a substantial increase in both the number of people needing service and the level of service required. Meeting this increase in demand will be extremely difficult, if not impossible, without additional funding.” While Cumberland County’s older adult population has grown by nearly 44.5% since 1990, funding from state and federal sources has been relatively stagnant. Not only has funding not kept up with the growth in the older adult population, it hasn’t even kept pace with inflation. In addition to the flat funding of the Aging Block Grant for five of the last six years, rule changes have eliminated an alternative source of revenue, creating a budget deficit of over $400,000 that required a County General Fund Subsidy for the first time in over ten years. In order to balance our budget, staff has been (and will be) furloughed and programs and services are being reduced or eliminated. Home chore staff has been cut in half and Home Support services such as shopping and laundry services are being eliminated. A waiting list is in place for most in-home services not funded by the Aging Waiver. As such, during this planning period the agency will obviously not be spending any time or money promoting and marketing those services. If this erosion continues unabated, the Cumberland County of tomorrow will have even less to offer vulnerable older persons in the way of supportive services.
NEEDS ASSESSMENT PROCESS
In October 2011, just as Aging & Community Services was preparing to develop this Strategic Plan, the local United Way of Carlisle and Cumberland County (UWCCC) released the final results of its strategic planning process. As part of that process, the UWCCC engaged Penn State Harrisburg’s Institute of State and Regional Affairs (ISRA) to conduct a comprehensive Community Needs Assessment. The Center for Survey Research (CSR), a unit within the Institute, then conducted a series of 10 indepth interviews and 4 focus group sessions with key community stakeholders. CSR also conducted a Listed Household Sample (LHH) telephone survey with 400 community members. The components of the UWCCC Community Needs Assessment that were completed included: • • • Holding Public Meetings (May 13 & August 25) Conducting In-depth Interviews of Community Stakeholders (June – July) Conducting Focus Groups of Community Stakeholders (June – July)
10
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
• •
Conducting a Community Survey of Residents (July – August) Conducting Demographic and Socioeconomic Background Research (July – August)
The UWCCC final report became the starting point upon which this plan was built. Other needs assessment activities conducted by Aging & Community Services included: • A review of the 2011 Regional Growth Management Plan (RGMP) compiled by Tri-County Regional Planning Commission. The RGMP is important since it is designed to encourage cooperation of ongoing planning for land use, transportation, economic and cultural development and to revise physical growth policies to the year 2035. A review of the Cumberland County Housing and Redevelopment Authorities (CCHRA) 2011 Strategic Plan A detailed analysis of the latest available Census data A detailed analysis of the agency’s service delivery data A survey of consumers Discussions with, and input from, the Aging Advisory Board and staff
• • • • •
NEEDS ASSESSMENT FINDINGS
Needs that were identified by UWCCC included: • Increased availability of affordable housing • Improved transportation system • Affordable medical care, especially for older adults • Improved access to Mental Health services Advisory Board identified: • High cost of everything (40%) • Housing (24%) • Transportation (20%) • Wellness/Prevention; stimulating mental and physical activities and socialization (12%) • Service information and availability (12%) • Other: food, medical, intergenerational programming Consumer Surveys identified the following as Important or Very Important: • Maintaining quality of life • Health insurance coverage • Ability to remain in my home; Prescription costs; and Knowing what services are available tied for third • Paying household expenses • Transportation It is imperative to note that the issues of income, housing, transportation and medical care are not directly within Aging & Community Services control. The agency’s best strategy in these areas is building new partnerships and continued advocacy on behalf of those issues.
11
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
NATIONAL GOALS & INITIATIVES
The Older Americans Act (OAA) requires that all services provided using OAA funds be targeted at the most vulnerable older individuals, specifically those: • with the greatest economic or social need • who are at risk for institutional placement • who are low income and minority • who are living in rural areas • who are limited in their English proficiency A brief summary of the County’s older adult population and the mix of consumers served shows that the Agency has been successful in meeting these mandates and goals:
2010 Population % Tot Pop % Tot Pop Live Alone Rural Poverty Minority * Age 60+ Age 65+ 65+ 65+ 65+ 65+ Pennsylvania 21.3% 15.4% 29.2% 15.4% 7.9% 8.3% Cumberland County 21.8% 15.6% 28.4% 18.0% 5.1% 2.8% Consumers Served ** 43.1% 23.6% 14.4% 4.5% * Minority Data from 2009 since local 2010 data not available ** In FY2010-11 the Agency provided services to 8.6 % of the 65+ population in the county; of those receiving Agency services, 92.4% were 65 years of age and older; 50.1% were 80 and older.
The agency will continue to meet or exceed the Older Americans Act requirements in the next four years.
POSSIBLE RESOURCE DEVELOPMENT
VOLUNTEERS: Dickinson College in Carlisle, Messiah College in Grantham, Central Penn College in Summerdale, and Shippensburg University in Shippensburg, all include community service as part of their graduation requirements or as a part of student life. INTERNSHIPS: Internships provide a venue for students to take their knowledge and apply it directly to the professional workplace, and successful internships often lead to permanent placements. Thus, Cumberland County has the opportunity to retain college graduates as taxpayers who live and work in the local community. INTERGENERATIONAL PROGRAMS: Penn State University, through its Cooperative Extension System develops new intergenerational initiatives and studies their impact on program participants and surrounding communities. The primary goal is to provide leadership and resource support for organizations interested in establishing intergenerational programs.
12
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
GOALS, O BJECTIVES, & STRATEGIES
GOAL 1: ACCESS SERVICES: Enable all older adults, adults with disabilities, their families and caregivers to make informed decisions about, and easily access the Right Services at the Right Place at the Right Time. OBJECTIVE 1.1: Streamline existing Information & Assistance services STRATEGY: Integrate the Cumberland Link ADRC into the agency’s I&A system. OBJECTIVE 1.2: Expand access to information about the array of long term living options. STRATEGY: Promote utilization of the new 211 system. OBJECTIVE 1.3: Continue to improve and modernize online customer service transactions through the use of the Internet and other emerging technologies as they become reliable and cost effective. STRATEGY: Continue to update and expand the information available on the agency website, Facebook, etc. GOAL 2: HOME & COMMUNITY BASED SERVICES: Enable older adults and adults with disabilities to live in the setting of their choice with a high quality of life for as long as possible through the provision of home and community-based services, including supports for family caregivers. OBJECTIVE 2.1: Promote Communities to Age & Live Well STRATEGY: Continue collaboration with Messiah Lifeways on their corporate initiated “Village Network” STRATEGY: Utilize GIS to identify Naturally Occurring Retirement Communities STRATEGY: Evaluate piloting a ‘Cluster Care’ model with the providers of Functional Assistance (including coordinating delivery between aging & disability aides) OBJECTIVE 2.2: Revitalize & Redesign Services STRATEGY: Improve ways to connect, communicate, and engage residents • Implement ‘Community Voice’, a Citizen Sourcing Module capability our website to allow residents to submit their ideas for improvements and changes they'd like to see implemented, and in turn allowing other residents to comment on ideas and vote ideas up or down. • Reconstitute the ‘County Council on Aging’, an organization with representatives from the various older adult groups in the county. STRATEGY: Develop and promote the vital role of Senior Centers. Re-focus and re-brand centers as a ‘Healthy Aging Centers’ Lower participation age to 50 Teach & utilize Web2 technology such as Skype
13
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Pursue collaboration and partnership with municipal Parks & Recreation Departments GOAL 3: PROMOTE HEALTH & WELL-BEING: Enable adults to make lifestyle changes that will reduce their risk of disease, disability, and injury. OBJECTIVE 3.1: Identify and address Health Disparities among Older Adults Health disparities are preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged groups. STRATEGY: Continue to work with the Foundation for Enhancing Communities to identify differences in health status and health behaviors and implement programs to reduce them. OBJECTIVE 3.2: Older adults learn to view falls and the fear of falling as controllable, set realistic goals to increase activity, change their environment to reduce fall risk factors, and exercise to increase strength and balance.. STRATEGY: Implement the ‘A Matter of Balance’ in partnership with the American Trauma Society – PA Division OBJECTIVE 3.3: Emphasize the individual’s role in managing his or her health and build their self-confidence, so they can be successful in adopting long-term healthy behaviors.. STRATEGY: Implement the Sanford University’s “Chronic Disease Self-Management Program” GOAL 4: ELDER RIGHTS & PROTECTION: Protect the rights of all older adults, and ensure that they are free from abuse, exploitation, neglect, and abandonment. OBJECTIVE 4.1: Continue to enhance and expand the Ombudsman program capability to identify and resolve long term living complaints STRATEGY: Continue to develop and implement the comprehensive volunteer recruitment and training program. OBJECTIVE 4.2: Continue to identify, investigate, and resolve instances of abuse, neglect, exploitation and abandonment under the Older Adult Protective Services Act STRATEGY: Ensure specially trained staff are available 24 hours a day, 7 days a week, to accept reports on behalf of an older adult whether the person lives in the community or in a care facility such as a nursing home, personal care home, hospital, etc. OBJECTIVE 4.3: Improve emergency preparedness and response capability supporting all functionally limited populations. STRATEGY: Implement a GIS based system to identify older adults and adults with disabilities who need assistance evacuating their homes during a disaster or emergency.
14
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
STRATEGY: Utilize and promote the ‘South Central Alert System’. GOAL 5: MAINTAIN EFFECTIVE & RESPONSIVE MANAGEMENT: A critical factor in the Agency’s ability to ensure continual achievement of its mission and goals is its ability to continuously review and refine organizational structure and management practices to effectively and efficiently support its employees, programs and services. OBJECTIVE 5.1: Align agency budget expenditures with available funding levels STRATEGY: Continue waiting lists for underfunded mandated services STRATEGY: Continue to reduce or eliminate underfunded non-mandated services STRATEGY: Adjust staffing patterns to available funding and service levels OBJECTIVE 5.2: Utilize Return-on-Investment for decision making. STRATEGY: Focus on activities with low-cost (information, education, etc.) STRATEGY: Build partnerships with non-traditional organizations STRATEGY: Implement Senior Center Performance Based Funding Formula OBJECTIVE 5.3: Leverage existing technology investment. STRATEGY: Implement Electronic Record and Document Management STRATEGY: Use GIS for Care Management assignments and scheduling
PERFORMANCE MEASURES
Over the past six years Aging & Community Services has established and refined local measures consistent with the Commissioners Strategic Planning Framework as well as existing guidance from the Administration on Aging (AoA). While many of the strategies outlined in this FY2012-2016 plan are designed to engage and educate the public, the agency remains committed to its focus on providing high quality, efficient services to the most vulnerable individuals with the resources available. As such, it maintains the three key performance measures outlined by the Administration on Aging which reach across all of the five strategic goals. Measure 1: Program Efficiency Indicator 1.1: Estimated Savings of HCBS vs. Intuitional Care Measure 2: Program Effectiveness Indicator 2.1: Ratio of target populations served vs. ratio of total target populations Measure 3: Client Outcomes Indicator 3.1: 90% or more of consumers surveyed rate services Good to Excellent Additional output measures which relate to the individual goals are tracked and reported quarterly
15
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
throughout the year. The following table lists the indicators currently being utilized:
Measure 2009 Actuals 2010 Actuals 2011 Actuals 2012 Target Estimated Long Term Living savings (HCBS vs. Nursing Facility Care) $ 6,441,564 $ 8,798,221 $ 8,251,754 $ 8,000,000 Number of NFCE Consumers Served in HCBS 236 255 274 250 Positive HCBS consumer satisfaction rating of 90% or more 98% 98% 95% 90% Number of consumers transitioned from Nursing facilities back to the community 15 17 29 23 Number of I&A requests 13,938 16,879 16,783 16,500 Number of Consumers receiving rental/in home assistance 7,342 7 6,788 6,000 Number of assessments/reassessments 1,909 1,942 1,607 1,500 Number of people on the waiting list for service 0 0 13 48 Average number of days on waiting list 0 0 47 200 Number of senior citizen trips 48,628 46,402 46,891 46,500 Number of adult day care days provided 4,765 4,945 4,436 4,000 Number of home meals delivered 6,855 5,780 4,480 4,000
While efficiency, effectiveness and quality client outcomes will always be measures to be monitored, program and service output indicators will need to be reviewed and modified as funding sources and programs change over the next four years.
16
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
PART B Section 1. Signature Page/Standard Assurances Commonwealth of Pennsylvania Department of Aging FY 2012-16 Area Agency on Aging Four-Year Area Plan on Aging Signature Page Area Agency on Aging Name and Address:
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES 1100 CLAREMONT ROAD, CARLISLE, PA 17015
I/we certify that I/we are authorized to submit this Plan on behalf of the designated Area Agency on Aging and agree to abide by regulations issued by the Pennsylvania Department of Aging, the U.S. Department of Health and Human Services, and the U.S. Department of Labor. I/we further certify that the general public has had the opportunity to review and comment on this Plan through the public hearing process and that written policies, procedures or agreements, as appropriate, have been developed in accordance with Part B, Section 3, and are on file for review and approval, as appropriate, by Department of Aging officials. I/we assure that services and programs of the Area Agency on Aging will be managed and delivered in accordance with the Plan submitted herewith. Any substantial changes to the Plan will be submitted to the Department of Aging for prior approval. I/we hereby expressly, as a condition precedent to the receipt of State and Federal funds, assure: That in compliance with Title VI of the Civil Rights Act of 1964; Section 504 of the Federal Rehabilitation Act of 1973; the Age Discrimination Act of 1975; The Americans With Disabilities Act of 1990; The Pennsylvania Human Relations Act of 1955, as amended; and 16 PA Code, Chapter 49 (Contract Compliance regulations): 1) I/we do not and will not discriminate against any person because of race, color, religious creed, ancestry, national origin, age, sex, or handicap; a) In providing services or employment, or in its relationship with other providers; b) In providing access to services and employment for handicapped individuals. 2) I/we will comply with all regulations promulgated to enforce the statutory provisions against discrimination. I/we further hereby agree that all contracts for the provision of services addressed herein will require contractors to comply with these same provisions. I/we certify that the advisory council of the Area Agency on Aging has participated in the development of this Plan and has reviewed the Plan as herewith submitted.
17
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Signature(s) of Governing Authority Official(s), e.g., Chairman of County Commissioners or President, Board of Directors. Title Chairman Vice Chairman Secretary Date
(Signature of the Area Agency on Aging Director)
Director (Title)
(Date)
Name of Person to Contact Regarding the Contents of This Plan: _________________________________ (Name) _______________________ (Area Code and Telephone)
18
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Part B. Section 2 Documentation of Participation by the AAA Advisory Council
PSA NO. _________ NAME OF AAA: ________________________________________________ PLAN PERIOD FROM ____________ TO____________ In accordance with 6 PA Code, Section 35.23, a.(1) and (2) and the Older Americans Act of 1965, as amended, I certify that the Area Agency on Aging Advisory Council has had the opportunity to assist in the development of this Plan. I further certify that the Area Agency on Aging Advisory Council has participated in at least one Public Hearing held on this Plan. The Area Agency on Aging Advisory Council ______ does ______ does not recommend approval of this Plan. ____________________________________________ Signature of the Chief Officer of the Area Agency on Aging Advisory Council ____________________________________________ Typed Name and Title ________________________ Date
19
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Part B. Section 3 Listing of Plan Assurances and Required Activities Older Americans Act, As Amended in 2006 ASSURANCES The Older Americans Act of 1965, as amended, requires each Area Agency on Aging to provide assurances that it will develop a Plan and carry out a program in accordance with the Plan. Each Area Agency on Aging must comply with the following provisions of the Act and written policies, procedures or agreements, as appropriate, must be on file in the Area Agency on Aging office and available for review and approval by Department of Aging officials. Area Plans • Assurances that an adequate portion, as required under section 307(a)(2) of the amount allotted for part B to the planning and service area will be expended for the delivery of the following categories of service: access to service -- transportation, health service, outreach, information assistance, and case management; in-home services -- supportive services for families of older individuals who are victims of Alzheimer's disease and related disorders with neurological and organic brain dysfunctions; and legal assistance. Assurances that the AAAs will report annually to the State agency in detail the amount of funds expended for each such category during the fiscal year most recently concluded. Assurances that the AAAs will a) set specific objectives, consistent with state policy, for providing services to older individuals with greatest economic need, older individuals with greatest social need, an older individuals at risk for institutional placement; b) include specific objectives for providing services to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas and include proposed methods to achieve these specific objectives. Assurance that AAAs will include in each agreement made with a provider of any service under this title, a requirement that such provider will: a) specify how they intend to satisfy the service needs of low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas in accordance with their need for such services; and, to maximum extent feasible, provide services to low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas in accordance with their need of such services; and meet specific objectives established by the AAA for providing services to low income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas within the planning and service area. Each area agency shall: identify the number of low-income minority older individuals and older individuals residing in rural areas in the planning and service area; describe the methods used to satisfy the service needs of such minority older individuals, and provide information on the ext two which the AAA met the objectives described in clause (a)(4)(A)(i).
• •
•
•
20
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
•
Assurances that the AAAs will use outreach efforts that will identify individuals eligible for assistance under this Act with special emphasis on: older individuals residing in rural areas; older individuals with the greatest economic need (focus on minority and rural populations); older individuals with the greatest social need (focus on minority and rural populations); older individuals with severe disabilities; limited English proficiency; Older individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction (and their caretakers); older individuals at risk for institutional placement; and assurances that each activity including planning, advocacy, and systems development will focus on the needs of low-income minority older individuals an older individuals living in rural areas. Assurances that AAAs will coordinate planning, identification, assessment of needs, and provision of services for older individuals with disabilities, with particular attention to individuals with severe disabilities and individuals at risk for institutional placement, and with agencies that develop or provide services for individuals with disabilities. In coordination with the State agency and the State agency responsible for mental health services, increase public awareness of mental health disorders, remove barriers to diagnosis and treatment, and coordinate mental health services provided with funds expended by the AAA with mental health services provided by community health centers and by other public agencies and non-provide private organizations. Assurances that the AAAs, in carrying out the State Long-Term Care Ombudsman program under section 307(a)(9), will expend not less than the total amount of funds appropriated under this Act and expended by the agency in fiscal year 2000 in carryout out such a program under the title. Information and assurances concerning older individuals who are Native American including a) information concerning whether there is a significant population of older native Americans in the planning and service area and, if so, an assurance that the AAA will pursue activities, including outreach, to increase access of those Native Americans to programs and benefits under this title; coordinate the services the AAA provides under this title with services provided under Title VI; and make services under the area plan available to the same extent such services are available to older individuals within the planning and service area, to older Native Americans. Assurances that the AAA will maintain the integrity and public purpose of services provided, and service providers under this title in all contractual and commercial relationships. Assurances that the AAAs will disclose to the State Agency and the Assistant Secretary to identify of each nongovernmental entity with which such agency has a contract or commercial relationship to providing any service to older individuals and the nature of such relationship. Assurances that the AAAs will demonstrate that a loss or diminution in the quality or quantity of the services provided, or to be provided, under this title by such agency has not resulted and will not result from such non-governmental contracts or such commercial relationships. Assurances that the AAAs will demonstrate the quality and quantity of the services to be provided under this Title by such agency will be enhanced as a result of such non-governmental contracts or commercial relationships. Assurances that the AAAs will, on the request of the Assistant Secretary or the State agency, for the purposes of monitoring compliance with this Act -- including an audit -- disclose all sources and expenditures of funds such agency receives or expends to provide services to older individuals.
21
•
•
•
•
• •
•
•
•
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
•
Assurances that funds received under this title will be used to provide benefits and services to older individuals, giving priority to older individuals identified in paragraph 4(A)(i) and in compliance with the assurances specified in paragraph 13 and the limitations specified in paragraph 1 and the limitations in section 212.
22
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Part B. Section 4 Narrative Summary of the Proceedings of the AAA Area Plan Public Hearing. Attach a written narrative (no more than five pages) summarizing the proceedings of the AAA Area Plan Public Hearing. The Public Hearing is scheduled for June 15, 2012 at the Aging & Community Services building conference room.
23
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
APPENDICES
24
CUMBERLA COUNTY AGING & COMM AND MUNITY SERVIC CES
DRAFT STRAT ATEGIC ACTION PLAN FY 2012-2016 N 2
APPENDIX A: COUNTY STRATEGY P :
25
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
26
Stra gic A tion Pla S ateg Acti lan 201 -201 12- 16
AGI & COM ING MMUNIT SE TY ERVICE ES
110 CLARE 00 EMONT RO , CAR OAD RLISLE, PA 17015 A
Cellebrating 40 Ye of S g ears Service t Cumb to berland C County 197 72-2012
Pr repared by the Aging & Comm g munity Ser rvices Staff ff Terry L. Barley, D Director
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
TABLE OF CONTENTS
PART A EXECUTIVE SUMMARY .................................................................................................................... 2 AGENCY OVERVIEW ........................................................................................................................ 5 AGENCY MISSION........................................................................................................................................... 5 ORGANIZATIONAL STRUCTURE ................................................................................................................... 5 STRATEGIC PLAN DEVELOPMENT ............................................................................................................... 6 KEY DEMOGRAPHICS .................................................................................................................................... 7 CONSUMERS .................................................................................................................................................... 8 LOCAL POLITICAL & ECONOMIC CONDITIONS ......................................................................................... 9 NEEDS ASSESSMENT PROCESS ...................................................................................................................10 NEEDS ASSESSMENT FINDINGS .................................................................................................................11 NATIONAL GOALS & INITIATIVES .............................................................................................................12 POSSIBLE RESOURCE DEVELOPMENT .......................................................................................................12 GOALS, OBJECTIVES, & STRATEGIES............................................................................................ 13 GOAL 1: ACCESS SERVICES: ........................................................................................................................13 GOAL 2: HOME & COMMUNITY BASED SERVICES: .................................................................................13 GOAL 3: PROMOTE HEALTH & WELL-BEING:.........................................................................................14 GOAL 4: ELDER RIGHTS & PROTECTION: ................................................................................................14 GOAL 5: MAINTAIN EFFECTIVE & RESPONSIVE MANAGEMENT:.........................................................15 PERFORMANCE MEASURES ...................................................................................................................... 15 PART B ..................................................................................................................................................... 17 SIGNATURE PAGE/STANDARD ASSURANCES COMMONWEALTH OF PENNSYLVANIA .......................17 DOCUMENTATION OF PARTICIPATION BY THE AAA ADVISORY COUNCIL ........................................19 LISTING OF PLAN ASSURANCES AND REQUIRED ACTIVITIES................................................................20 NARRATIVE SUMMARY OF THE PROCEEDINGS OF THE AAA AREA PLAN PUBLIC HEARING. .........23 APPENDICES .............................................................................................................................................. 24
1
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
EXECUTIVE SUMMARY
Cumberland County’s Mission:
The most livable community with the most efficient and effective public services in Pennsylvania
Cumberland County Aging & Community Services is one of 655 Area Agencies on Aging across the nation which reach into every community and play a key role in delivering the services and care that enable older adults to safely remain in their own homes and communities for as long as medically possible. Every four years, all Area Agencies on Aging (AAA) across the nation are required to develop and submit a Plan that reflects future activities of the AAA to address the needs of older adults, adults with disabilities, and caregivers in their designated Planning and Service Area (PSA). In Cumberland County the strategic planning process is guided by an overall County Strategy set forth by the Board of Commissioners which identifies service priorities in tandem with an outcome oriented financial management system. The Commissioners have developed a balanced scorecard which provides a framework used to align system-level and departmental strategies, goals, and target outcomes. This 2012-2016 Four Year Strategic Action Plan has been developed using guidance issued by the Administration on Aging and the Pennsylvania Department of Aging, and is designed to correlate with the Strategic Directions of the Commissioners’ Balanced Scorecard for Cumberland County. The changes in strategy with which A&CS approached the development of this Strategic Plan include the following: 1. The Plan takes into account the constraints on fiscal resources experienced by today’s local, state, and federal governments. 2. The Plan is shaped by the aspiration of creating a “livable community for all ages” so that all ages can benefit from strategies that support seniors. 3. The Plan strives to align with the Strategic Plan of the County Commissioners and other local strategic plans. In this way, organizational energies and resources can be maximized. In the last 20 years, while Pennsylvania experienced a 10.9% growth rate in the population 60 years of age and older, Cumberland County’s 60+ population has grown at an astounding 44.5%. With the first wave of “Boomers” entering the older adult population a year ago, Cumberland County is beginning to age rapidly. In 2010 one of every 5 residents was 60 years of age or older and the Penn State Data Center has projected that by 2030 that ratio will be 1 in 4. These demographic changes occur within the context of concerns about growth in government spending and the ability to sustain promises already made.
2
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Indeed, the national economic downturn has caused decline in the agency’s financial condition and is resulting in a weakened service system infrastructure. Not only has stagnant federal and state funding not kept up with the growth in the older adult population, it hasn’t even kept pace with inflation. In addition to the flat funding of the Aging Block Grant for five of the last six years, rule changes have eliminated an alternative source of revenue, creating a budget deficit of over $400,000 that required a County General Fund Subsidy for the first time in over ten years. In order to balance the agency budget, staff have been (and will be) furloughed and programs and services are being reduced or eliminated. Home chore staff has been cut in half and Home Support services such as shopping and laundry services are being eliminated. A waiting list is in place for most in-home services not funded by the Aging Waiver. A comprehensive community needs assessment conducted in 2011 by the United Way of Carlisle and Cumberland County, consumer surveys, as well as input from the Aging Advisory Board, staff and providers identified affordable housing, affordable medical care, and improved transportation as key needs. It is imperative to note that the issues of income, housing, transportation and medical care are not within Aging & Community Services direct control. The agency’s best strategy in these areas is building new partnerships and continued advocacy on behalf of those issues. Consumers also rated maintaining quality of life and the ability to remain in my home as important. Given that the bleak fiscal environment is expected to continue for the foreseeable future, the agency’s ability to afford and deliver the critical services necessary to meet these goals is severely challenged. The Older Americans Act (OAA) requires that all services provided using OAA funds be targeted at the most vulnerable older individuals. A brief summary of the County’s older adult population and the mix of consumers served shows that the Agency has been successful in meeting those mandates:
2010 Population % Tot Pop % Tot Pop Live Alone Rural Poverty Minority * Age 60+ Age 65+ 65+ 65+ 65+ 65+ Pennsylvania 21.3% 15.4% 29.2% 15.4% 7.9% 8.3% Cumberland County 21.8% 15.6% 28.4% 18.0% 5.1% 2.8% Consumers Served ** 43.1% 23.6% 14.4% 4.5% * Minority Data from 2009 since local 2010 data not available ** In FY2010-11 the Agency provided services to 8.6 % of the 65+ population in the county; of those receiving Agency services, 92.4% were 65 years of age and older; 50.1% were 80 and older.
In spite of the fiscal constraints, the agency expects to continue to meet the Older Americans Act targets over the next four years for the Administration on Aging funded services. Four of the PA Department of Aging’s focus areas as well as this plan’s objectives and strategies are organized using the four core program goals and one management goal established previously:
3
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
GOAL 1: ACCESS SERVICES: Enable all older individuals, adults with disabilities, their families and caregivers to make informed decisions about, and easily access, the ‘Right Services at the Right Place at the Right Time’. GOAL 2: HOME & COMMUNITY BASED SERVICES: Enable older individuals and persons with disabilities to live as independently as possible in the residential setting of their choice, including supports for family caregivers. GOAL 3: PROMOTE HEALTH & WELL BEING: Enable individuals to make lifestyle changes which reduce their risk of disease, disability, and injury. GOAL 4: ELDER RIGHTS & PROTECTION: Protect the rights of all older adults, and ensure that they are free from abuse, exploitation, neglect, and abandonment. GOAL 5: MAINTAIN EFFECTIVE & RESPONSIVE MANAGEMENT: Maintain and/or increase program performance and accountability through effective, efficient and responsive program management. While many of the strategies outlined in this FY2012-2016 plan are designed to engage and educate the public, the agency remains committed to its focus on providing high quality, efficient services to the most vulnerable individuals with the resources available. Over the past six years Aging & Community Services has established and refined local measures consistent with the Commissioners Strategic Planning Framework as well as existing guidance from the Administration on Aging (AoA). As such, it maintains the three key performance measures outlined by the Administration on Aging which reach across all of the five strategic goals: Program Efficiency, Program Effectiveness, and Consumer Outcomes. Additional local output measures which relate to the individual goals are tracked and reported quarterly throughout the year. The following table lists the indicators currently being utilized:
Measure 2009 Actuals 2010 Actuals 2011 Actuals 2012 Target Estimated Long Term Living savings (HCBS vs. Nursing Facility Care) $ 6,441,564 $ 8,798,221 $ 8,251,754 $ 8,000,000 Number of NFCE Consumers Served in HCBS 236 255 274 250 Positive HCBS consumer satisfaction rating of 90% or more 98% 98% 95% 90% Number of consumers transitioned from Nursing facilities back to the community 15 17 29 23 Number of I&A requests 13,938 16,879 16,783 16,500 Number of Consumers receiving rental/in home assistance 7,342 7 6,788 6,000 Number of assessments/reassessments 1,909 1,942 1,607 1,500 Number of people on the waiting list for service 0 0 13 48 Average number of days on waiting list 0 0 47 200 Number of senior citizen trips 48,628 46,402 46,891 46,500 Number of adult day care days provided 4,765 4,945 4,436 4,000 Number of home meals delivered 6,855 5,780 4,480 4,000
While efficiency, effectiveness and quality client outcomes will always be measures to be monitored, program and service output indicators will need to be reviewed and modified as funding sources and programs change over the next four years.
4
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
AGENCY OVERVIEW
Agency Mission
To enhance the quality of life for Cumberland County citizens by providing a variety of Human Service programs, most of which are designed to assist low income seniors, adults, families, and adults with disabilities to remain in their homes; and to assist community groups and other public and private Human Service organizations to identify and develop solutions to unmet Human Service needs. Cumberland County Aging & Community Services is one of 655 Area Agencies on Aging across the nation which reach into every community and play a key role in delivering the services and care that enable older adults to safely remain in their own homes and communities for as long as medically possible. In addition to the Older Americans Act programs operated by the agency, Aging & Community Services currently administers the Homeless Assistance Program, Human Services Development Fund (HSDF), Food Assistance Programs, the Commonwealth’s Act 150 Attendant Care Program and the Attendant Care Waiver for Cumberland, Dauphin and Perry Counties. In the management of our programs and our strategic planning process, Aging & Community Services is guided by a set of core values in developing and carrying out its mission. These values include: • Listening to our consumers, their families & caregivers, and our partners who serve them; • Responding to the changing needs and preferences of our increasingly diverse and rapidly growing consumer population; • Producing measurable outcomes that significantly impact the well-being of our consumers and their family caregivers; and • Valuing and developing our staff. In 2012 Aging & Community Services marks its 40th year of serving Cumberland County’s older adults.
ORGANIZATIONAL STRUCTURE
The County of Cumberland is the unit of general purpose local government designated as Planning and Service Area (PSA) 21 by the Commonwealth of Pennsylvania under Section 305(a) (l) (E) of the Older Americans Act of 1965, as amended. The Board of Commissioners is the governing body with the legal authority and responsibility for providing human services to older persons in the planning and service area. To carry out these responsibilities the Commissioners have established the office of Aging & Community Services to manage these programs, as well as an Aging Advisory Board to advise them on all matters relating to the planning, administration, and operation of programs and services for older adults.
5
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
AGENCY ORGANIZATIONAL CHART
CUMBERLAND COUNTY COMMISSIONERS CHIEF HUMAN SERVICES POLICY TEAM CLERK HUMAN SERVICES POLICY TEAM
DRUGS AND ALCOHOL
MENTAL HEALTH AND IDD
AGING & COMMUNITY SERVICES
CHILDREN AND YOUTH
COUNTY TRANSPORTATION
AGENCY DIRECTOR
DEPUTY DIRECTOR
CARE MANAGEMENT SUPERVISOR III/RN
COUNTY FINANCE OFFICE
AGING FISCAL OFFICER II
COMMUNITY SERVICES FISCAL OFFICER
CASE MGT SUPERVISOR HAP & CUMB CARES
CARE MGR SUPVR 1 APPRISE / I&A / OMBS
ADRC PROJECT MANAGER
FISCAL TECHNICIAN
FISCAL TECHNICIAN
CASE MGR / HOMELESS
SR CTR COORD (AO1)
CARE MGR II / I&A
FISCAL TECHNICIAN (V)
FISCAL TECHNICIAN
CASE MGR / CUMB CARES
DATA MANAGER
CARE MGR II / OMBS
HOME MOD COORD (V)
CLERK TYPIST II
ADM ASSISTANT II
CARE MGR II / OMBS
CLERK TYP II / RECEPT SKILLED LABORER SKILLED LABORER
ADM ASSISTANT I
CARE MGR II / I&A / APPR
CARE MGT SUPV I COMMUNITY TRANSITION
CARE MGT SUPV I AND ASSESSOR
CASE MGT SUPERVISOR ATT CARE / ACT 150
PART TIME CARE MGR II
PARE TIME CARE MGR II
CARE MGR II
CARE MGR II / FCSP
CARE MGR II / ASSESS
CARE MGR II / PC / DC
ATT CARE SVC COORD
PART TIME CARE MGR III
CARE MGR III
CARE MGR III
CARE MGR II / WAIVER
CARE MGR II / WAIVER
CARE MGR II / WAIVER
ATT CARE SVC COORD
COMM SOCIAL WORKER
Cumberland County has also developed various cross-system management teams to analyze issues, develop plans, and implement service strategies across the spectrum of County operations. These include a Senior Management Team, Human Services Policy Team, Claremont (Nursing and Rehab Center) Team, Emergency Management Team, and Criminal Justice Policy Team. These teams work to ensure the development of appropriate strategies, policies and programs that comprise a framework for delivering efficient and effective services for Cumberland County residents. Aging & Community Services is an active participant in the Human Services Policy Team and the Claremont Nursing & Rehabilitation Center Team. Cross-system working teams have also been established between Aging and Individuals with Developmental Disabilities, Aging and Mental Health, and Aging and Emergency Preparedness in order to address the needs of the growing older population.
STRATEGIC PLAN DEVELOPMENT
Every four years, all Area Agencies on Aging (AAA) across the nation are required to develop and submit a Plan that reflects future activities of the AAA to address the needs of older adults, adults with disabilities, and caregivers in their designated Planning and Service Area (PSA).
6
CUMBERLA COUNTY AGING & COMM AND MUNITY SERVIC CES
DRAFT STRAT ATEGIC ACTION PLAN FY 2012 N 2-2016
In Cum mberland Co ounty the str rategic plann ning process is guided b an s by overall County Stra ategy set fort by the Bo th oard of Com mmissioners w which es iorities in tan ndem with a outcome oriented fina an ancial identifie service pri manage ement system The Com m. mmissioners have devel loped a bala anced scorecar which pr rd rovides a fra amework used to align system-level and l departm mental strateg goals, an target out gies, nd tcomes.(see A Appendix A) 012-2016 Four Year St trategic Actio Plan has been developed on s This 20 using guidance issued by th Administration on Aging and the g he d Pennsyl lvania Depar rtment of A Aging, and th Strategic Directions o the he of Commi issioners’ Bal lanced Scorec card for Cum mberland County. The appr roach used by Aging & Community Services in d C developing th Strategic Plan include the his es following g: 1. The Plan take into accoun the constr T es nt raints on fisca resources e al experienced b today’s local, by st tate, and fede governm eral ments. 2. The Plan is sh T haped by the aspiration of creating a “livable comm f munity for al ages” so tha all ll at ag can benef from strat ges fit tegies that support seniors s. 3. The Plan reco T ognizes that Area Agencies on Aging a A alone cannot create the co ommunity th hat ol adults desire. lder 4. The Plan striv to align with the Strat T ves w tegic Plan of the County Commission and othe ners er lo strategic plans. In thi way, organ ocal is nizational ene ergies and res sources can b maximized be d.
KEY DEMOGRAPH E HICS
The majo ority of the demographic data that wa collected a analyzed is not presen here bu will d as and d nted ut be compi iled separate and made available on our websi www.ccpa.net/aging. The data w ely e o ite which follows fo ocuses on th hose factors that we believ will have a major infl ve fluence on ou service de ur elivery system in the next fou years. n ur
POPULA ATION TREN NDS
e decades the n number of p people In the last three d in Cu umberland C County age 6 and older grew 60 at 2½ times the ov verall county rate. With the first wav of “Boom ve mers” enterin the ng older adult popula ation a year ago, Cumbe erland Count is beginnin to age rap ty ng pidly. In 201 one of eve 5 residen was 60 ye of 10 ery nts ears age or older and th Penn State Data Cente has r he e er projec that by 2 cted 2030 that rat will be 1 i 4. tio in
7
CUMBERLA COUNTY AGING & COMM AND MUNITY SERVIC CES
DRAFT STRAT ATEGIC ACTION PLAN FY 2012 N 2-2016
While Pe ennsylvania experienced a 10.9% grow rate in p e wth people 60 yea of age and older durin the ars d ng last 20 years, Cumbe erland County’s growth rate has bee an astoun en nding 44.5% Notable in that %. n s d gration into the county since 2000. t growth is the role of domestic mig During the same t g time period the major u urban centers in the Com s mmonwealth have experie enced decline in this pop es pulation grou up. a s ase While Philadelphia realized its first increa in its tota populatio since the 1950 census, it al on e actually lost an ad y dditional 17 7.9% of its older residen nts. wanna Coun nty, home to Scranton lost n Lackaw 7.8%; Luzerne Co ounty, home to Wilkese -Barre lost 7 .4%; and A Allegheny C County, hom to me Pittsbu urgh lost 10.0 0%. For pla anning purpo oses, Cumbe erland Count has ty divided its 550.2 square miles of land into three d regions based on si s imilar charac cteristics and land d develop pment patter rns. In 201 51% of t county’s older adults lived 10, the on the 61.4 square miles of lan in the Ea e e nd astern region, 35% lived on the 210. square mi of , .1 iles land in the Centra region, an the rema n al nd aining 14% li on the 2 ive 278.6 square miles of lan in e nd the We estern region n.
EAST CENTRAL L WEST
60+ Pop Weste ern Central Eas stern Number 71 139 17982 26098 Percent 13.9% 51.0% 5 35.1%
CONSUM MERS
With the limited finan ncial resourc available, the agency se ces erved slightly more that 6 percent o the y 6.5 of county’s total older ad populati (those 60 years of age and older) i Fiscal Year 2010-2011. t dult ion 0 e in r Over h of those served were 80 years of a or half age older; 42.2% lived Alone; 24.0% lived in rural d areas; and 16.1% w below th poverty le were he evel. A com mparison of the ages of the county’s 60+ s popula ation and th hose of the consumers being served by Aging & Community Services c d clearly demon nstrates that the bulk of services are t s provid to the old and mos frail age gr ded dest st roups. The f following ta able contain key Nat ns tional Aging Pr rogram Infor rmation Syst tem (NAPIS data relate to the co S) ed onsumers ser rved by Agin & ng Commun Services during FY10 nity 0-11. (To co orrectly unde erstand the re elationships, first select h header
8
CUMBERLA COUNTY AGING & COMM AND MUNITY SERVIC CES
DRAFT STRAT ATEGIC ACTION PLAN FY 2012 N 2-2016
and read down the co olumn; i.e. of the rural population, 3 o p 31.4% live a alone; of thos who live a se alone, 17.9% ar rural). re
LOCAL POLITICAL & ECONOM CONDIT O MIC TIONS
rs eparing the agency’s last 4 year plan, little did we know that what a e Four year ago when we were pre appeared at the time to be just a minor eco e onomic slowd down was g going to turn into the biggest n recession since the Gr Depression. reat
Unemployment rat – Not Seasona Adjusted te ally
While Cumberla e and County has not been y immu to the ec une conomic pro oblems facin the ng nation and state since 200 its econ n e 08, nomic divers sity has ena abled it to fare better than . sity s loyers many. That divers includes major empl in th insurance healthcare manufactu he e, e, uring, and tr ransportation and wareho n ousing indust tries. The C County econ nomy also b benefits from the m region presence of federal, state and local nal e , govern nment oper rations. Cum mberland Co ounty ended 2010 with a Decembe unemploy d h er yment rate o 6.4 percen one of t lower rat in of nt, the tes Penns sylvania. The statewide ra was 8.1% e ate %. Overal growth co ll ontinues at a slower rate than before the recessio and it is anticipated that e on, s d there w be conti will inued decrea in the gr ases rowth of real estate in the next few years. l e Mortg gage foreclos sures have increased in the n recent months, bu only beca ut ause last yea was ar slow si ince legal qu uestions had to be resolve In ed. Februa 2012 th ary here were on 30 filin in nly ngs Cumb berland Coun a ratio o just 1 in 3 nty, of 3,333 housin units, ran ng nking 27th in the state, w n which had a ratio of 1 in 1,239. The nationwide ratio n e e was 1 in 637 home es.
9
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
The most serious and immediate issue facing the agency is the erosion of existing financial resources used to provide home and community based services for older adults, which is resulting in a weakened service delivery system infrastructure. Twenty-two years ago in the agency’s 1990 Strategic Plan for Aging Services we predicted: “A more vulnerable/frail population with increasing health related problems ... will result in a substantial increase in both the number of people needing service and the level of service required. Meeting this increase in demand will be extremely difficult, if not impossible, without additional funding.” While Cumberland County’s older adult population has grown by nearly 44.5% since 1990, funding from state and federal sources has been relatively stagnant. Not only has funding not kept up with the growth in the older adult population, it hasn’t even kept pace with inflation. In addition to the flat funding of the Aging Block Grant for five of the last six years, rule changes have eliminated an alternative source of revenue, creating a budget deficit of over $400,000 that required a County General Fund Subsidy for the first time in over ten years. In order to balance our budget, staff has been (and will be) furloughed and programs and services are being reduced or eliminated. Home chore staff has been cut in half and Home Support services such as shopping and laundry services are being eliminated. A waiting list is in place for most in-home services not funded by the Aging Waiver. As such, during this planning period the agency will obviously not be spending any time or money promoting and marketing those services. If this erosion continues unabated, the Cumberland County of tomorrow will have even less to offer vulnerable older persons in the way of supportive services.
NEEDS ASSESSMENT PROCESS
In October 2011, just as Aging & Community Services was preparing to develop this Strategic Plan, the local United Way of Carlisle and Cumberland County (UWCCC) released the final results of its strategic planning process. As part of that process, the UWCCC engaged Penn State Harrisburg’s Institute of State and Regional Affairs (ISRA) to conduct a comprehensive Community Needs Assessment. The Center for Survey Research (CSR), a unit within the Institute, then conducted a series of 10 indepth interviews and 4 focus group sessions with key community stakeholders. CSR also conducted a Listed Household Sample (LHH) telephone survey with 400 community members. The components of the UWCCC Community Needs Assessment that were completed included: • • • Holding Public Meetings (May 13 & August 25) Conducting In-depth Interviews of Community Stakeholders (June – July) Conducting Focus Groups of Community Stakeholders (June – July)
10
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
• •
Conducting a Community Survey of Residents (July – August) Conducting Demographic and Socioeconomic Background Research (July – August)
The UWCCC final report became the starting point upon which this plan was built. Other needs assessment activities conducted by Aging & Community Services included: • A review of the 2011 Regional Growth Management Plan (RGMP) compiled by Tri-County Regional Planning Commission. The RGMP is important since it is designed to encourage cooperation of ongoing planning for land use, transportation, economic and cultural development and to revise physical growth policies to the year 2035. A review of the Cumberland County Housing and Redevelopment Authorities (CCHRA) 2011 Strategic Plan A detailed analysis of the latest available Census data A detailed analysis of the agency’s service delivery data A survey of consumers Discussions with, and input from, the Aging Advisory Board and staff
• • • • •
NEEDS ASSESSMENT FINDINGS
Needs that were identified by UWCCC included: • Increased availability of affordable housing • Improved transportation system • Affordable medical care, especially for older adults • Improved access to Mental Health services Advisory Board identified: • High cost of everything (40%) • Housing (24%) • Transportation (20%) • Wellness/Prevention; stimulating mental and physical activities and socialization (12%) • Service information and availability (12%) • Other: food, medical, intergenerational programming Consumer Surveys identified the following as Important or Very Important: • Maintaining quality of life • Health insurance coverage • Ability to remain in my home; Prescription costs; and Knowing what services are available tied for third • Paying household expenses • Transportation It is imperative to note that the issues of income, housing, transportation and medical care are not directly within Aging & Community Services control. The agency’s best strategy in these areas is building new partnerships and continued advocacy on behalf of those issues.
11
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
NATIONAL GOALS & INITIATIVES
The Older Americans Act (OAA) requires that all services provided using OAA funds be targeted at the most vulnerable older individuals, specifically those: • with the greatest economic or social need • who are at risk for institutional placement • who are low income and minority • who are living in rural areas • who are limited in their English proficiency A brief summary of the County’s older adult population and the mix of consumers served shows that the Agency has been successful in meeting these mandates and goals:
2010 Population % Tot Pop % Tot Pop Live Alone Rural Poverty Minority * Age 60+ Age 65+ 65+ 65+ 65+ 65+ Pennsylvania 21.3% 15.4% 29.2% 15.4% 7.9% 8.3% Cumberland County 21.8% 15.6% 28.4% 18.0% 5.1% 2.8% Consumers Served ** 43.1% 23.6% 14.4% 4.5% * Minority Data from 2009 since local 2010 data not available ** In FY2010-11 the Agency provided services to 8.6 % of the 65+ population in the county; of those receiving Agency services, 92.4% were 65 years of age and older; 50.1% were 80 and older.
The agency will continue to meet or exceed the Older Americans Act requirements in the next four years.
POSSIBLE RESOURCE DEVELOPMENT
VOLUNTEERS: Dickinson College in Carlisle, Messiah College in Grantham, Central Penn College in Summerdale, and Shippensburg University in Shippensburg, all include community service as part of their graduation requirements or as a part of student life. INTERNSHIPS: Internships provide a venue for students to take their knowledge and apply it directly to the professional workplace, and successful internships often lead to permanent placements. Thus, Cumberland County has the opportunity to retain college graduates as taxpayers who live and work in the local community. INTERGENERATIONAL PROGRAMS: Penn State University, through its Cooperative Extension System develops new intergenerational initiatives and studies their impact on program participants and surrounding communities. The primary goal is to provide leadership and resource support for organizations interested in establishing intergenerational programs.
12
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
GOALS, O BJECTIVES, & STRATEGIES
GOAL 1: ACCESS SERVICES: Enable all older adults, adults with disabilities, their families and caregivers to make informed decisions about, and easily access the Right Services at the Right Place at the Right Time. OBJECTIVE 1.1: Streamline existing Information & Assistance services STRATEGY: Integrate the Cumberland Link ADRC into the agency’s I&A system. OBJECTIVE 1.2: Expand access to information about the array of long term living options. STRATEGY: Promote utilization of the new 211 system. OBJECTIVE 1.3: Continue to improve and modernize online customer service transactions through the use of the Internet and other emerging technologies as they become reliable and cost effective. STRATEGY: Continue to update and expand the information available on the agency website, Facebook, etc. GOAL 2: HOME & COMMUNITY BASED SERVICES: Enable older adults and adults with disabilities to live in the setting of their choice with a high quality of life for as long as possible through the provision of home and community-based services, including supports for family caregivers. OBJECTIVE 2.1: Promote Communities to Age & Live Well STRATEGY: Continue collaboration with Messiah Lifeways on their corporate initiated “Village Network” STRATEGY: Utilize GIS to identify Naturally Occurring Retirement Communities STRATEGY: Evaluate piloting a ‘Cluster Care’ model with the providers of Functional Assistance (including coordinating delivery between aging & disability aides) OBJECTIVE 2.2: Revitalize & Redesign Services STRATEGY: Improve ways to connect, communicate, and engage residents • Implement ‘Community Voice’, a Citizen Sourcing Module capability our website to allow residents to submit their ideas for improvements and changes they'd like to see implemented, and in turn allowing other residents to comment on ideas and vote ideas up or down. • Reconstitute the ‘County Council on Aging’, an organization with representatives from the various older adult groups in the county. STRATEGY: Develop and promote the vital role of Senior Centers. Re-focus and re-brand centers as a ‘Healthy Aging Centers’ Lower participation age to 50 Teach & utilize Web2 technology such as Skype
13
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Pursue collaboration and partnership with municipal Parks & Recreation Departments GOAL 3: PROMOTE HEALTH & WELL-BEING: Enable adults to make lifestyle changes that will reduce their risk of disease, disability, and injury. OBJECTIVE 3.1: Identify and address Health Disparities among Older Adults Health disparities are preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged groups. STRATEGY: Continue to work with the Foundation for Enhancing Communities to identify differences in health status and health behaviors and implement programs to reduce them. OBJECTIVE 3.2: Older adults learn to view falls and the fear of falling as controllable, set realistic goals to increase activity, change their environment to reduce fall risk factors, and exercise to increase strength and balance.. STRATEGY: Implement the ‘A Matter of Balance’ in partnership with the American Trauma Society – PA Division OBJECTIVE 3.3: Emphasize the individual’s role in managing his or her health and build their self-confidence, so they can be successful in adopting long-term healthy behaviors.. STRATEGY: Implement the Sanford University’s “Chronic Disease Self-Management Program” GOAL 4: ELDER RIGHTS & PROTECTION: Protect the rights of all older adults, and ensure that they are free from abuse, exploitation, neglect, and abandonment. OBJECTIVE 4.1: Continue to enhance and expand the Ombudsman program capability to identify and resolve long term living complaints STRATEGY: Continue to develop and implement the comprehensive volunteer recruitment and training program. OBJECTIVE 4.2: Continue to identify, investigate, and resolve instances of abuse, neglect, exploitation and abandonment under the Older Adult Protective Services Act STRATEGY: Ensure specially trained staff are available 24 hours a day, 7 days a week, to accept reports on behalf of an older adult whether the person lives in the community or in a care facility such as a nursing home, personal care home, hospital, etc. OBJECTIVE 4.3: Improve emergency preparedness and response capability supporting all functionally limited populations. STRATEGY: Implement a GIS based system to identify older adults and adults with disabilities who need assistance evacuating their homes during a disaster or emergency.
14
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
STRATEGY: Utilize and promote the ‘South Central Alert System’. GOAL 5: MAINTAIN EFFECTIVE & RESPONSIVE MANAGEMENT: A critical factor in the Agency’s ability to ensure continual achievement of its mission and goals is its ability to continuously review and refine organizational structure and management practices to effectively and efficiently support its employees, programs and services. OBJECTIVE 5.1: Align agency budget expenditures with available funding levels STRATEGY: Continue waiting lists for underfunded mandated services STRATEGY: Continue to reduce or eliminate underfunded non-mandated services STRATEGY: Adjust staffing patterns to available funding and service levels OBJECTIVE 5.2: Utilize Return-on-Investment for decision making. STRATEGY: Focus on activities with low-cost (information, education, etc.) STRATEGY: Build partnerships with non-traditional organizations STRATEGY: Implement Senior Center Performance Based Funding Formula OBJECTIVE 5.3: Leverage existing technology investment. STRATEGY: Implement Electronic Record and Document Management STRATEGY: Use GIS for Care Management assignments and scheduling
PERFORMANCE MEASURES
Over the past six years Aging & Community Services has established and refined local measures consistent with the Commissioners Strategic Planning Framework as well as existing guidance from the Administration on Aging (AoA). While many of the strategies outlined in this FY2012-2016 plan are designed to engage and educate the public, the agency remains committed to its focus on providing high quality, efficient services to the most vulnerable individuals with the resources available. As such, it maintains the three key performance measures outlined by the Administration on Aging which reach across all of the five strategic goals. Measure 1: Program Efficiency Indicator 1.1: Estimated Savings of HCBS vs. Intuitional Care Measure 2: Program Effectiveness Indicator 2.1: Ratio of target populations served vs. ratio of total target populations Measure 3: Client Outcomes Indicator 3.1: 90% or more of consumers surveyed rate services Good to Excellent Additional output measures which relate to the individual goals are tracked and reported quarterly
15
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
throughout the year. The following table lists the indicators currently being utilized:
Measure 2009 Actuals 2010 Actuals 2011 Actuals 2012 Target Estimated Long Term Living savings (HCBS vs. Nursing Facility Care) $ 6,441,564 $ 8,798,221 $ 8,251,754 $ 8,000,000 Number of NFCE Consumers Served in HCBS 236 255 274 250 Positive HCBS consumer satisfaction rating of 90% or more 98% 98% 95% 90% Number of consumers transitioned from Nursing facilities back to the community 15 17 29 23 Number of I&A requests 13,938 16,879 16,783 16,500 Number of Consumers receiving rental/in home assistance 7,342 7 6,788 6,000 Number of assessments/reassessments 1,909 1,942 1,607 1,500 Number of people on the waiting list for service 0 0 13 48 Average number of days on waiting list 0 0 47 200 Number of senior citizen trips 48,628 46,402 46,891 46,500 Number of adult day care days provided 4,765 4,945 4,436 4,000 Number of home meals delivered 6,855 5,780 4,480 4,000
While efficiency, effectiveness and quality client outcomes will always be measures to be monitored, program and service output indicators will need to be reviewed and modified as funding sources and programs change over the next four years.
16
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
PART B Section 1. Signature Page/Standard Assurances Commonwealth of Pennsylvania Department of Aging FY 2012-16 Area Agency on Aging Four-Year Area Plan on Aging Signature Page Area Agency on Aging Name and Address:
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES 1100 CLAREMONT ROAD, CARLISLE, PA 17015
I/we certify that I/we are authorized to submit this Plan on behalf of the designated Area Agency on Aging and agree to abide by regulations issued by the Pennsylvania Department of Aging, the U.S. Department of Health and Human Services, and the U.S. Department of Labor. I/we further certify that the general public has had the opportunity to review and comment on this Plan through the public hearing process and that written policies, procedures or agreements, as appropriate, have been developed in accordance with Part B, Section 3, and are on file for review and approval, as appropriate, by Department of Aging officials. I/we assure that services and programs of the Area Agency on Aging will be managed and delivered in accordance with the Plan submitted herewith. Any substantial changes to the Plan will be submitted to the Department of Aging for prior approval. I/we hereby expressly, as a condition precedent to the receipt of State and Federal funds, assure: That in compliance with Title VI of the Civil Rights Act of 1964; Section 504 of the Federal Rehabilitation Act of 1973; the Age Discrimination Act of 1975; The Americans With Disabilities Act of 1990; The Pennsylvania Human Relations Act of 1955, as amended; and 16 PA Code, Chapter 49 (Contract Compliance regulations): 1) I/we do not and will not discriminate against any person because of race, color, religious creed, ancestry, national origin, age, sex, or handicap; a) In providing services or employment, or in its relationship with other providers; b) In providing access to services and employment for handicapped individuals. 2) I/we will comply with all regulations promulgated to enforce the statutory provisions against discrimination. I/we further hereby agree that all contracts for the provision of services addressed herein will require contractors to comply with these same provisions. I/we certify that the advisory council of the Area Agency on Aging has participated in the development of this Plan and has reviewed the Plan as herewith submitted.
17
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Signature(s) of Governing Authority Official(s), e.g., Chairman of County Commissioners or President, Board of Directors. Title Chairman Vice Chairman Secretary Date
(Signature of the Area Agency on Aging Director)
Director (Title)
(Date)
Name of Person to Contact Regarding the Contents of This Plan: _________________________________ (Name) _______________________ (Area Code and Telephone)
18
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Part B. Section 2 Documentation of Participation by the AAA Advisory Council
PSA NO. _________ NAME OF AAA: ________________________________________________ PLAN PERIOD FROM ____________ TO____________ In accordance with 6 PA Code, Section 35.23, a.(1) and (2) and the Older Americans Act of 1965, as amended, I certify that the Area Agency on Aging Advisory Council has had the opportunity to assist in the development of this Plan. I further certify that the Area Agency on Aging Advisory Council has participated in at least one Public Hearing held on this Plan. The Area Agency on Aging Advisory Council ______ does ______ does not recommend approval of this Plan. ____________________________________________ Signature of the Chief Officer of the Area Agency on Aging Advisory Council ____________________________________________ Typed Name and Title ________________________ Date
19
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Part B. Section 3 Listing of Plan Assurances and Required Activities Older Americans Act, As Amended in 2006 ASSURANCES The Older Americans Act of 1965, as amended, requires each Area Agency on Aging to provide assurances that it will develop a Plan and carry out a program in accordance with the Plan. Each Area Agency on Aging must comply with the following provisions of the Act and written policies, procedures or agreements, as appropriate, must be on file in the Area Agency on Aging office and available for review and approval by Department of Aging officials. Area Plans • Assurances that an adequate portion, as required under section 307(a)(2) of the amount allotted for part B to the planning and service area will be expended for the delivery of the following categories of service: access to service -- transportation, health service, outreach, information assistance, and case management; in-home services -- supportive services for families of older individuals who are victims of Alzheimer's disease and related disorders with neurological and organic brain dysfunctions; and legal assistance. Assurances that the AAAs will report annually to the State agency in detail the amount of funds expended for each such category during the fiscal year most recently concluded. Assurances that the AAAs will a) set specific objectives, consistent with state policy, for providing services to older individuals with greatest economic need, older individuals with greatest social need, an older individuals at risk for institutional placement; b) include specific objectives for providing services to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas and include proposed methods to achieve these specific objectives. Assurance that AAAs will include in each agreement made with a provider of any service under this title, a requirement that such provider will: a) specify how they intend to satisfy the service needs of low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas in accordance with their need for such services; and, to maximum extent feasible, provide services to low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas in accordance with their need of such services; and meet specific objectives established by the AAA for providing services to low income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas within the planning and service area. Each area agency shall: identify the number of low-income minority older individuals and older individuals residing in rural areas in the planning and service area; describe the methods used to satisfy the service needs of such minority older individuals, and provide information on the ext two which the AAA met the objectives described in clause (a)(4)(A)(i).
• •
•
•
20
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
•
Assurances that the AAAs will use outreach efforts that will identify individuals eligible for assistance under this Act with special emphasis on: older individuals residing in rural areas; older individuals with the greatest economic need (focus on minority and rural populations); older individuals with the greatest social need (focus on minority and rural populations); older individuals with severe disabilities; limited English proficiency; Older individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction (and their caretakers); older individuals at risk for institutional placement; and assurances that each activity including planning, advocacy, and systems development will focus on the needs of low-income minority older individuals an older individuals living in rural areas. Assurances that AAAs will coordinate planning, identification, assessment of needs, and provision of services for older individuals with disabilities, with particular attention to individuals with severe disabilities and individuals at risk for institutional placement, and with agencies that develop or provide services for individuals with disabilities. In coordination with the State agency and the State agency responsible for mental health services, increase public awareness of mental health disorders, remove barriers to diagnosis and treatment, and coordinate mental health services provided with funds expended by the AAA with mental health services provided by community health centers and by other public agencies and non-provide private organizations. Assurances that the AAAs, in carrying out the State Long-Term Care Ombudsman program under section 307(a)(9), will expend not less than the total amount of funds appropriated under this Act and expended by the agency in fiscal year 2000 in carryout out such a program under the title. Information and assurances concerning older individuals who are Native American including a) information concerning whether there is a significant population of older native Americans in the planning and service area and, if so, an assurance that the AAA will pursue activities, including outreach, to increase access of those Native Americans to programs and benefits under this title; coordinate the services the AAA provides under this title with services provided under Title VI; and make services under the area plan available to the same extent such services are available to older individuals within the planning and service area, to older Native Americans. Assurances that the AAA will maintain the integrity and public purpose of services provided, and service providers under this title in all contractual and commercial relationships. Assurances that the AAAs will disclose to the State Agency and the Assistant Secretary to identify of each nongovernmental entity with which such agency has a contract or commercial relationship to providing any service to older individuals and the nature of such relationship. Assurances that the AAAs will demonstrate that a loss or diminution in the quality or quantity of the services provided, or to be provided, under this title by such agency has not resulted and will not result from such non-governmental contracts or such commercial relationships. Assurances that the AAAs will demonstrate the quality and quantity of the services to be provided under this Title by such agency will be enhanced as a result of such non-governmental contracts or commercial relationships. Assurances that the AAAs will, on the request of the Assistant Secretary or the State agency, for the purposes of monitoring compliance with this Act -- including an audit -- disclose all sources and expenditures of funds such agency receives or expends to provide services to older individuals.
21
•
•
•
•
• •
•
•
•
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
•
Assurances that funds received under this title will be used to provide benefits and services to older individuals, giving priority to older individuals identified in paragraph 4(A)(i) and in compliance with the assurances specified in paragraph 13 and the limitations specified in paragraph 1 and the limitations in section 212.
22
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
Part B. Section 4 Narrative Summary of the Proceedings of the AAA Area Plan Public Hearing. Attach a written narrative (no more than five pages) summarizing the proceedings of the AAA Area Plan Public Hearing. The Public Hearing is scheduled for June 15, 2012 at the Aging & Community Services building conference room.
23
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
APPENDICES
24
CUMBERLA COUNTY AGING & COMM AND MUNITY SERVIC CES
DRAFT STRAT ATEGIC ACTION PLAN FY 2012-2016 N 2
APPENDIX A: COUNTY STRATEGY P :
25
CUMBERLAND COUNTY AGING & COMMUNITY SERVICES
DRAFT STRATEGIC ACTION PLAN FY 2012-2016
26
