HomeMy WebLinkAboutAging & Disability Advisory Committee - Agenda - 9/26/2023
(715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
FROM: Carrie Linder, Aging and Disability Services Manager
DATE: September 19, 2023
RE: Meeting Notice
The Bayfield County Department of Human Services Aging and Disability Services
Advisory Committee will meet on Tuesday, September 26, 2023, at 3:00 p.m.
In-person and Remote access to this meeting will originate from Conference Room A,
lower level of the Courthouse in Washburn. Public participation remote access is
available via phone, 715-318-2087, at the start of the meeting and entering participant
code 506693484 followed by the # sign. ADAC members will receive an invitation via
Microsoft Teams.
Notice is hereby given, in the event the standing committee does not have a quorum, the
County Board Chair or Vice Chair may act as an ex officio member (County ordinance,
Chapter 3, section 2-3-1(c)).
Any person wishing to attend who, because of a disability, requires special accommodations should contact the
Department of Human Services at 715-373-6144, at least 24 hours before the scheduled meeting time so appropriate
arrangements can be made.
1. The agenda includes: Call to Order and Introductions; Discussion and Possible Action-
Review of the June 27, 2023, Meeting Minutes; Discussion and Possible Action – 2024
GWAAR Budget; Other (Informational Items); Motion or Chair’s Announcement to
Adjourn
cc:
Post (bulletin board and website)
E-Mailed:
Dennis Pocernich, County Board Chair Mark Abeles-Allison, County Administrator
Lynn Divine, County Clerk Human Services Board
Elizabeth Skulan, BCDHS Director Management Staff
Sara Wartman, Health Dept. Director
Greater Wisconsin Agency on Aging Resources, Inc. (GWAAR)
DCS, Rhinelander
Daily Press
K:\Agends and Minutes\A&D Services Committee\Meeting Notices\A&D Meeting Notice-September 26, 2023
(715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
BAYFIELD COUNTY DEPARTMENT OF HUMAN SERVICES
AGING & DISABILITY SERVICES ADVISORY COMMITTEE
William (Bill) Bland – Chairperson Mary Dougherty Tracy Snyder
Lynette Benzschawel Vice-Chairman Karen Anderson The Brick Representative
RE: September 26, 2023, Aging & Disability Services Advisory Committee
Dear Committee Members:
Please be advised that the meeting of the Bayfield County Department of Human Services Aging & Disability
Services Advisory Committee and the Nutrition Program Advisory Council Committee will be held Tuesday,
September 26, 2023, at 3:00 p.m.
The meeting will originate from Conference Room A.
Participation via remote access is available by phone by calling +1 715-318-2087 at the start of the meeting
and entering participant code, 506693484 followed by the # sign. Committee members will receive an
invitation via Microsoft Teams.
Notice is hereby given, in the event the standing committee does not have a quorum, the County Board Chair
or Vice Chair may act as an ex officio member (County ordinance, Chapter 3, section 2-3-1 (c)).
Any person planning to attend who, because of a disability, requires special accommodations, should contact
the Department of Human Services at 715-373-6144, at least 24 hours before the scheduled meeting time, so
appropriate arrangements can be made.
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2
The agenda for the meeting is as follows:
AGENDA
1. Call to Order and Introductions
2. Discussion and Possible Action-Review of the June 27, 2023, Meeting Minutes
3. Discussion and Possible Action – 2024 GWAAR Budget
4. Other (Informational Items)
A. 2022-2024 Aging Plan Review
B. ADRC Workload and Scope of Practice
C. Regional Disability Benefits Specialist Vacancy
D. Social Connections Update
5. Motion or Chair’s Announcement to Adjourn
Thank you and stay safe and well!
Sincerely,
Carrie Linder
Aging and Disability Services Manager
Carolyn Novak
Aging Services Coordinator
c: Bayfield County DHS ADAC Committee Members
\\Bayco-FS6\DHS\Agendas and Minutes\A&D Advisory Committee\ADAC Minutes\2023 ADAC minutes\2023-06-27 ADAC Meeting
Minutes.doc 1
BAYFIELD COUNTY DEPARTMENT OF HUMAN SERVICES
AGING AND DISABILITY SERVICES ADVISORY COMMITTEE
Conf Room A and Remote via Teams
June 27, 2023
3:00 p.m.
Committee Members Present: Bill Bland, Karen Anderson, Tracy Snyder, Lynette
Benzschawel, Mary Dougherty, Alice Evenson BRICK
Representative, Dee Sweet arrived at 3:14
Committee Member Absent: Richard Kemmer
Others Present: Carrie Linder, Heather Gilbertson, Ellie Webb-Dementia Care
Specialist, Elizebeth Skulan arrived at 3:29
Call to Order and Introductions
Benzschawel called the meeting to order at 3:05 p.m. and introductions were made.
Discussion and Possible Action-Review of the February 28, 2023, Meeting Minutes
Motion by Bland, seconded by Snyder to approve the February 28, 2023, meeting minutes. Motion
passed.
Discussion and Possible Action-Election of Chairperson
Benzschawel called 3 times for nominations for Chairperson.
Dougherty nominated Bland as Chairperson, Snyder Seconded, Anderson Closed Nominations.
Motion by Dougherty, seconded by Snyder to approve Bland as the ADAC Chairperson. Motion passed.
Dementia Live Simulation and Empowerment Session – Ellie Webb, Dementia Care Specialist, Aging &
Disability Resource Center of the North
Webb is the Dementia Care Specialist for Ashland and Bayfield counties and works for the Aging
and Disability Resource Center of the North.
Webb gave a brief overview of what Dementia is, the symptoms of Dementia, the percentage of
residents in Bayfield County who have Dementia and ideas on how to make the community a
safe place to live for residents who have Dementia.
A ten-minute interactive simulation was given on how your mind would work if you had
Dementia. Most participants agreed that they felt frustrated, confused, and irritated from the
simulation.
Some takeaways from the presentation: Make eye contact with the individual when speaking,
keep conversations short and simple and never argue with the individual.
2024 Budget Guidance and DHS Priorities
The 2024 Budget focuses on two key factors: housing and youth and senior services.
How to leverage additional fees for services was recommended. No fees attached to any
programs Linder administers. There are contributions though.
DRAFT:
Subject to change at the
next ADAC meeting
\\Bayco-FS6\DHS\Agendas and Minutes\A&D Advisory Committee\ADAC Minutes\2023 ADAC minutes\2023-06-27 ADAC Meeting
Minutes.doc 2
Meal sites are the pipelines for aging residents to get out into the community and make
connections with Bayfield County Employees. Once that connection is made, residents are
more comfortable with asking for help at the county level.
The workload for Linder is continuing to grow with Bayfield County being one of the
counties with the highest age of residents. Also, the CLTS program is a complex program
and continues to increase with 40+ children receiving services at present. Hiring a Children
with Disability Manager and create an additional unit to oversee Birth to 3 and the CLTS
programs has been included in the DHS budget recommendations. Linder would continue
to oversee the ADRC, Aging and Adult Protective Services programs.
Other (Informational Items)
Talk to your elected officials about priorities that you would like to see funded.
Dementia Innovations: A grant was received to develop a workgroup to work with front line
workers and focus on training to help deescalate people with dementia experiencing disruptive
behaviors and stay living in their homes.
Nursing Home Study: Committee was convened to research innovative ways to help the nursing
home remain a viable resource.
2023 Meeting Dates
September 26, 2023
November 28, 2023
Benzschawel adjourned the meeting at 4:27 pm
Minutes respectfully submitted by Heather Gilbertson, Clerk III
2023 Aging Plan Assessment
FY 2022–2024
County Aging Plan Template and Required Documents 2022–2024
Goals for the Plan Period
IIIB: Advocacy
1. What are you trying to improve? What problem are you trying to solve?
Educate and empower older adults on the importance of completing POAs for
healthcare and finance.
Individuals are in control of their healthcare and financial decisions by having
their wishes and desires documented should they become incapacitated.
This will help reduce the need for court related actions of guardianships and
protective placements.
2. What is the current status of your problem or situation? Is it getting better or
worse?
The older adult population is rapidly growing in Bayfield County.
Older adults are being hospitalized and do not have a POA in place.
3. What factors are hindering your progress? (preventing you from succeeding)
Individual avoidance in accepting and addressing the need for end of life decision
making.
Time necessary to reach all individuals regarding the importance of completing
the forms.
Challenges in providing outreach for program materials due to lacking local
newspaper, radio stations and TV stations.
4. What factors are supporting your efforts?
Demographic data.
Strong partnerships.
Decent connection with community and older adults.
Support from leadership.
The current (2021) Scope of Services for Aging and Disability Resource Centers
(ADRCs) Grant Agreement requires ADRCs to “advocate on behalf of the
individuals and groups who comprise their target populations when needed
services are not being adequately provided within the service delivery system,”
including “…facilitation of a customer’s self-advocacy…”.
5. Who are your partners in helping you succeed? (who could you work with to
make this better)
Health care providers, court officials, attorneys, Hospice, and civic groups.
County Aging Plan Template and Required Documents 2022–2024
6. What are some strategies or steps that could help? (ideas to fix the problem)
Education and outreach, and assisting in completing the forms, including having
a Notary of Public onsite when hosting events.
7. What do you hope to see as an outcome or result?
A 15% increase in the number of individuals who have a POA of Health care
and/or Finance ready for activation as needed.
8. How will you measure your progress? How will you know that you have
achieved the results you wanted?
The overall number of cases referred for court appointed guardians and/or
protective placements for individuals without POA health care will decrease.
Focus area: Advocacy
Goal statement: Aging and Disability Services will act as a catalyst for county residents to
increase their own self advocacy by completing POA for healthcare and finance forms and
by providing educational opportunities to advocate for themselves and others.
Plan for measuring overall goal success – How will you know that you have achieved the results you want? Use
data.
By 2024, 10 population centers (minimum of 3 each year) in Bayfield County will have had a community event
providing education on and assistance with completing Power of Attorney Healthcare and Finance forms. Provide at
least one opportunity to learn more about advocacy.
Specific strategies and steps to meet your goal:
Measure (How will you know the
strategies and steps have been
completed?)
Due Date
Strategy 1: Host events in each community to assist older
adults to complete POA documents by providing direction
and assistance.
Action step: Identify and collaborate with host groups to
determine best time/day to hold outreach events
At least one group will be identified in
each community.
March
2022-
2024
Action step: Plan event details such as food, workers for event,
paperwork, presentation.
Event will be completed in each
community.
April
2022-
2024
Conduct outreach for each event including news media, local
groups, social media, etc. to promote event.
Documentation of outreach that took
place.
May
2022-
2024
Action step: Evaluate each event in each community to ensure
clear accurate information is being relayed to participants and
they were satisfied with what they received.
Evaluation will be completed, and
information used to better improve the
next event.
Oct.
2022-
2024
Strategy 2: Provide POA forms in public places so they may
act as a community resource for dissemination of
information.
County Aging Plan Template and Required Documents 2022–2024
Specific strategies and steps to meet your goal:
Measure (How will you know the
strategies and steps have been
completed?)
Due Date
Action step: Identify public spaces, such as libraries, churches,
and pharmacies, in each community agreeable to be a host site
forms to be accessed by individuals
List of sites is documented. Oct. 2022
Action step: Regular check ins will be scheduled and take place
to build and foster relationships with host sites and to
determine if there are any questions.
Schedule is documented. Nov.
2022-
2024
Action step: Act as a resource for community questions. Documentation of referrals received. Nov.
2022-
2024
Strategy 3: Provide advocacy training sessions.
Organize and provide education to the community related to
advocacy skill building.
Advocacy training sessions will be
tracked.
December
2024
Annual progress notes
8/15/22 notes:
Strategy 1: Hosted 8 listening sessions (Cable, Drummond, Red Cliff, Cornucopia, Port Wing, Iron
River, Bayfield and Washburn) and provided information to 73 individuals. In process of providing
part 2 which is providing notary services and witnesses to assist with the execution of the POAs.
Strategy 2: Currently in progress
Strategy 3: 2024
Strategy 1: A calendar of activities has been created for 2023 and beyond and includes both virtual
and in-person workshops for POA HC and F. Flyer has been attached.
Strategy 2: We decided we are not going to proceed with this strategy. To leave packets at libraries
and believe people are going to pick up and fill it out without help is unrealistic. Efforts are being
placed into Strategy #1 and in other public outreach events where conversations and one on one
with people can occur which are more meaningful and effective to get information out to the public
and get forms completed.
Strategy 3: 2024
IIIB: Enhanced Transportation
1. What are you trying to improve? What problem are you trying to solve?
There are older adults who do not have access to transportation because of
inability to drive, affordability and location.
Some options are available; additional transportation services are needed to
ensure access for all.
County Aging Plan Template and Required Documents 2022–2024
2. What is the status of your problem or situation? Is it getting better or
worse?
There are some transportation options available for older adults and people with
disabilities, but they are limited and not necessarily available throughout the
entire county.
The aging population is growing rapidly
The situation has worsened with the pandemic, as the volunteer driver program was
placed on hold.
Volunteer drivers are hesitant to transport people due to the ongoing nature of
the pandemic, vaccine hesitancy, etc.
The Volunteer Driver Program is the only program that has potential for county-
wide coverage but there are not enough drivers.
3. What factors are hindering your progress? (preventing you from
succeeding)
Bayfield County is a large geographical area with a sparse population density.
Silo transportation operations
Community members are not aware of the need for drivers.
Charitable rate vs. IRS mileage reimbursement rate is not the same, creating the
burden of issuing a 1099 tax form to drivers for income received.
4. What factors are supporting your efforts?
Active Transportation Coordinating Committee
Good relationships with many civic groups
Direct feedback and input from older adults
5. Who are your partners in helping you succeed? (who could you work with
to make this better)
Bay Area Rural Transit (BART)
NorthLakes Clinic
Independent Living Centers
GWAAR
Volunteer/civic organizations throughout the county (churches, CORE, local
Lions Clubs, etc.)
6. What are some strategies or steps that could help? (ideas to fix the
problem)
Research utilizing volunteer drivers from home delivered meals roster in Cable.
Work with Mobility Manager to explore other opportunities.
Seek grant opportunities, such as 5310 funds to supplement additional services.
Create Call to Action campaign to solicit new drivers
County Aging Plan Template and Required Documents 2022–2024
7. What do you hope to see as an outcome or result?
Expanded transportation service throughout the county.
Rivers will the right type of transportation to meet their personal goals.
Shared Ride Taxi program supporting the outlying areas of the county.
Volunteer Driver Program dedicated to older adults and people with disabilities.
8. How will you measure your progress? How will you know that you have
achieved the results you wanted?
Fully supported and comprehensive volunteer driver program for older adults.
Pre and post review of service area to note if expansion occurred.
Compare call-in request for transportation that were unfulfilled before and after
implementation of transportation enhancement efforts.
Call volume will increase
Focus area: Enhanced Transportation
Goal statement: Ensure older adults and people with disabilities within Bayfield County have the
transportation services needed to meet their daily needs.
Plan for measuring overall goal success – How will you know that you have achieved the results you
want? Use data.
Compare call-in request for transportation that were unfulfilled before and after implementation of
transportation enhancement efforts. Review of service coverage area pre and post enhancement
efforts.
Specific strategies and steps to meet your goal:
Measure (How will you
know the strategies and
steps have been
completed?) Du
e
D
a
t
e
Strategy 1: Work with Transportation Coordinating Committee
to determine suggested transportation enhancements and
additional transportation services.
Action step: Develop list of specific transportation projects to
implement and/or enhancements that need to occur.
List is created and used to
guide decisions.
Jan.
2022
Action step: Present recommendations to the various committees
and boards for review and approval.
Agendas and minutes will
document
recommendations and
progress.
Feb.
2022
Strategy 2: Create more awareness of the need for volunteer
drivers and transportation services.
Action step: Create and maintain an ongoing awareness campaign
for recruitment of new drivers.
Materials created and
places in which they are
distributed.
Jan.
2022
County Aging Plan Template and Required Documents 2022–2024
Action step: Collaborate with 6 different community partners (2 each
year) and provide information via short presentations on the scope of
the volunteer driver program and needs for more drivers.
Number of partners and
presentations provided.
June
2024
Action step: Implement initial and ongoing training and maintain
ongoing communication with volunteer drivers.
Agenda and sign in sheets June
2022
Strategy 3: Implement recommended and approved
transportation initiatives.
Action step: Design and/or enhance operational protocols.
Documents completed June
2023
Action step: Review policies and procedures with staff. Staff agenda and
attendance sheets
July
2023
Action step: Project implementation, including public awareness
campaign.
Programs are implemented
and public awareness is
tracked
Dec
2023
Annual progress notes
8/15/22 notes:
Strategy 1: Educated the TCC on transportation funding sources and current available transportation
options. The public transit manager researched transportation options available in other counties and
brought the Door 2 Door option back to TCC. Modeled program after Door County’s project. County board
of supervisors allocated $25,000 of ARPA funds for each 2022 and 2023 to support service. Looking into
what it would take to utilize 85.21 funds to sustain service into the future. Conducted major marketing
outreach to advertise for Bayco Door-2-Door service.
Strategy 2: Transportation Assistance Program (TAP) – increased volunteer driver and rider participation
through advertising in newsletter (Living Well in Our Best Years), TAP driver flyer and TAP rider brochure
for volunteers. Newsletter: https://www.bayfieldcounty.wi.gov/421/Aging-Disability-Services
Strategy 3: 2023
Other notable accomplishments: Installed electric charging station, used 85.21 trust funds for local match to
purchase electric bus for BART.
Strategy 1: Door 2 Door is in the second year of ARPA funded service. Next step is to determine if 85.21
can become a funding source for the local match for 5311 funding. TCC recommended increasing the
number of service hours from 40 to 50 per week.
Strategy 2: Transportation Assistance Program (TAP) – a sustained outreach campaign has not been
implemented. Each Living Well newsletter includes information on this program and the need for
volunteers. Staff will work on this for the second half of 2023.
Strategy 3: We are going to research a voucher system to help address the lack of drivers and willingness
to drive to Duluth for medical appointments. Perhaps this will augment the TAP and Door 2 Door services
currently offered. Researching Find Your Own Driver model.
IIIC: Nutrition/Equity/Community Engagement
County Aging Plan Template and Required Documents 2022–2024
1. What are you trying to improve? What problem are you trying to solve?
Older adults are underrepresented in certain areas of the Bayfield County
Elder Nutrition Program service area. The nutrition will provide equitable
access to nutrition program services for outlying areas of Bayfield County.
Access to and availability of healthy food is challenging in many areas of the
county.
2. What is the status of your problem or situation? Is it getting better or
worse?
Lacking healthy food resources
Lacking transportation
Lacking access to social services
No broadband or computer access
Isolation in remote areas of the county
Rapidly growing aging population
Very rural, sparsely populated county
3. What factors are hindering your progress? (preventing you from
succeeding)
Challenges in providing outreach for program materials due to lacking local
newspaper, radio stations and TV stations.
Financial constraints for ongoing program support and/or additional
development
Last mile situation for access to grocery stores, meal sites, etc.
4. What factors are supporting your efforts?
Demographic data
Current successes in meal sites located in the county show that a consistent
presence provides participants with a higher comfort level with staff. This
provides for early intervention rather than reactive service delivery.
Direct feedback from older adults.
5. Who are your partners in helping you succeed? (who could you work with
to make this better)
Local community organizations interested in providing support for enhanced
or increased meal service.
Older adults who want access
GWAAR staff
ARPA funds
6. What are some strategies or steps that could help? (ideas to fix the
problem)
Meet with and explore the ability to contract with local vendors to provide
meals
County Aging Plan Template and Required Documents 2022–2024
Explore collaborations with community organizations to hire staff or recruit
volunteers who will facilitate local connections to the older adult population
Enhance transportation to include access to healthy food options
Utilize meal sites and community connections for ongoing dialogue and
community engagement
7. What do you hope to see as an outcome or result?
Equitable access to nutrition program services for older adults in outlying
areas of the county
Additional access to rural outlying areas of the county comes socialization,
education and empowerment.
Enhanced access to healthy food choices.
8. How will you measure your progress? How will you know that you have
achieved the results you wanted?
Increased program participation
Increased number of meal sites
Satisfaction surveys
Document community engagement activities
Focus area: Nutrition/Equity/Community Engagement
Goal statement: All older adults in Bayfield County will have access to healthy food including those in rural
and outlying areas of the county.
June
2022
Plan for measuring overall goal success – How will you know that you have achieved the results you
want? Use data.
Measurement of pre- and post-participation levels. Satisfaction surveys to new and existing participants
to determine whether new locations and programming meets their needs/desires. An addition of two meal
sites than what is currently available.
Specific strategies and steps to meet your goal:
Measure (How will you
know the strategies and
steps have been
completed?) Du
e
D
a
t
e
Strategy 1: Expand meal sites to two additional communities.
Action step: Locate potential vendors and sites. Discuss volume of
meals served; nutrition pattern, delivery requirements.
Documented number of
vendors, sample menus,
capacity to serve.
Jan.
2022
Action step: Determine rate per meal per vendor and develop budget. Rates are established and
budget is balanced.
Jan.
2022
Action step: Create Request for Proposal Actual RFP. Jan.
2022
County Aging Plan Template and Required Documents 2022–2024
Action step: Create detailed implementation plan, including which
communities will have meal site offering on what days.
Schedule of meals per day,
per community and at what
time.
Feb.
2022
Action step: Develop staffing/volunteer plan for each site including
roles and responsibilities to be carried out.
Meetings held, participants
noted; plan and training
documented.
Feb
2022
Action step: Create satisfaction survey to be used with new and
existing participants. Determine how and when to distribute.
Results from survey. Oct.
2022
Strategy 2: Integrate Enhanced Transportation for Nutrition
Access
Action step: Meet with older adults to understand their current needs
and what additional services and support they would like to see occur.
All comments and feedback
are tracked
March
2022
Action step: Map out what nutrition services are available through the
county (meal sites, food pantries, grocery stores, etc.)
Documented on map May
2022
Action Step: Work with TCC to ensure nutrition needs are met in any
enhancements made to transportation services.
Agenda and minutes from
meetings
May
2022
Understand satisfaction levels and additional needs Results from survey. 2022-
2024
Strategy 3: Create Pop Up Meal Sites in Communities without
Congregate Meal Sites
Action step:
Create schedule of listening sessions and map out communities with
and without meal sites.
Schedule of sessions had
been created and carried out
throughout the county.
May
2023/
2024
Action step: Plan event details such as food, workers for event,
paperwork, presentation.
Work plan provides
documentation
June
2023/
2024
Action Step: Conduct outreach for each event including news media,
local groups, social media, etc. to promote event.
All outreach activities are
tracked
Action step: Meet with older adults to understand their current
satisfaction and what additional services and support they would like
to see occur.
All comments and feedback
are tracked
June
2024
Action step: Document the interest per community via number of
participants who attended, and comments received.
Number of participants and
comments received per
community are documented.
July
2023/
2024
Understand satisfaction levels and additional needs Results from survey. Sept.
2024
Annual Progress Notes
8/15/22 notes:
Strategy 1: 2021 hosted (9) out-door listening sessions in May of
2021to gain input on opening new and previous congregate meal
sites. Opened Barnes with some covid restrictions in July 2021. Used
County ARPA (2022 and 2023) to hiring nutrition coordinator to
oversee the elder nutrition program. This individual has worked on
opening 5 congregate sites throughout the county this spring.
County Aging Plan Template and Required Documents 2022–2024
Elder nutrition program volunteer hours – for 2022 (January thru July)
HDM (Cable Area) – 255.75 total hours
Congregate Meal Sites (Cornucopia, Port Wing and Washburn) –
744.25 total hours
Volunteer – 1000 total hours
Total Financial Impact = $29,950.00
* The 2022 Federal Volunteer Rate is $29.95
Next steps involve outreach/surveys to determine who is not being
served, who is still in isolation. There are still individuals out there that
need help and are alone.
Strategy 2: Need to investigate what can be done when it comes to
integrated enhanced transportation for nutrition access
Strategy 3: 2023/2024
Strategy #1:
Completed. Five meal sites are currently open for business. The
Barnes site has been temporarily closed due to the lack of staff and
will reopen September 7.
The Iron River community would like one additional day per month.
This has been analyzed and determined feasible. In October, meals
will be served the 2nd and 4th Thursday of the month.
Strategy 2: Door2Door has been marketed to the general public as
has the volunteer driver program.
Strategy 3:
Work is underway to host the first pop-up site along the HWY 63
corridor at the Drummond Community Center. Tentative date is
September 21. It will be modeled after a recent event hosted to bring
attention to World Elder Abuse Awareness Day.
With the current staffing levels, it is unlikely we will be able to do more
than one pop-up per year.
Title III D: Social Isolation and Loneliness and Community
Engagement
1. What are you trying to improve? What problem are you trying to solve?
County Aging Plan Template and Required Documents 2022–2024
Reduce the health effects of social isolation and loneliness among older adults
by engaging with and understanding what older adults need to remain
connected.
2. What is the current status of your problem or situation? Is it getting better
or worse?
Loneliness and social isolation in older adults are serious public health risks
affecting a significant number of people in the United States and putting them at
risk for serious medical conditions.
Current research suggests that victims of elder abuse experience loneliness
more often than other groups. (CDC, Loneliness and Social Isolation Linked to
Serious Health Conditions (November 4, 2020)
40% of older adults experience loneliness, while 7-17% report being socially
isolated (McMaster University Feb. 2019)
Social Isolation is linked with increased death (1;4), dementia (1;5), depression,
and risk of elder abuse; while loneliness is associated with increased blood
pressure (3;7), cognitive decline (3;8), and reducing the body’s ability to protect
itself from infections (3;9). (McMaster, 2019)
Social isolation is an important public health issue that has gained recognition
during COVID-19 pandemic because of the risks posed to older adults based on
physical distancing (Front. Public Health, 21 July 2020
https://doi.org/10.3389/fpubh.2020.00403
3. What factors are hindering your progress? (preventing you from
succeeding)
It’s difficult to measure social isolation and loneliness
Throughout COVID-19 traditional service delivery practices have be altered and
translated to serve and engage older adults in a safe manner, which has further
isolated many individuals.
Many older adults do not have access to technology or Wi-Fi or do not know to
effectively use it.
4. What factors are supporting your efforts?
Increased awareness among policy makers and community leaders is occurring
Health Care Systems are an important, yet underused, partner in identifying
loneliness and preventing medical conditions associated with loneliness. Nearly
all adults aged 50 and older interact with the health care system in some way.
For those without social connections, a doctor’s appointment or visit from a home
health nurse may be one of the few face-to-face encounters they have. (CDC,
Nov 2020)
One purpose of the OAA Nutrition Program is to promote socialization of older
adults.
Title III-B, Title III-C , Title III-D and Title III-E OAA dollars may be used to
implement interventions.
County Aging Plan Template and Required Documents 2022–2024
5. Who are your partners in helping you succeed? (who could you work with
to make this better)
WI State-Wide Coalition to End Social Isolation and Loneliness
WITC Gerontology Program
Local non-profits such as SeeMyART and Core Community Resources
6. What are some strategies or steps that could help? (ideas to fix the
problem)
Bring together and coordinate a task force comprised of clinical and community-
based organizations to develop a public awareness campaign and to engage and
support older adults.
Utilize Program to Encourage Active, Rewarding Lives (PEARLS). This program
addresses late life depression symptoms, which are risk factors and
consequences of social isolation and loneliness.
Focus on older adults’ lack of social connectedness to more accurately pinpoint
the root issues faced by the older adult and more appropriately introduce
interventions and solutions to mitigate the program.
Engage older adults as volunteers.
Facilitate social interaction with peers.
Utilize resources created by ACL and NCOA to assist in providing services
virtually (toolkits, webinars, factsheets, etc.)
7. What do you hope to see as an outcome or result?
Increased meaningful connections among older adults thus reducing the health
effects of loneliness.
8. How will you measure your progress? How will you know that you have
achieved the results you wanted?
Loneliness scale - baseline in year 1 compared to end of goal period
number of partnerships developed, and task force meeting held
number of events or programs developed, and participants attended
County Aging Plan Template and Required Documents 2022–2024
Focus area: Title III D: Social Isolation and Loneliness and
Community Engagement
Goal statement: Reduce the health effects of social isolation and loneliness by developing an
awareness campaign, developing partnerships, identifying older adults most vulnerable,
implementing interventions, and evaluating outcomes.
Plan for measuring overall goal success – How will you know that you have achieved the results you
want? Use data.
Implement loneliness scale as a baseline in year 1; track partnerships developed, track public awareness
materials used, track evidence-based workshops in new communities, track number of participants creation
and distribution of Beyond Blue booklet.
Specific strategies and steps to meet your goal:
Measure (How will you
know the strategies and steps
have been completed?) Du
e
Da
t
e
Strategy 1: Raise public awareness of loneliness as a public health
issue and share strategies to improve connections and create a
feeling of purpose.
Action step: Identify partners invested in working on this issue;
develop task force, host meetings, and create action plan.
Number of partners engaged,
number of meetings held
Jun
e
202
2 3
Action step: Develop awareness materials and conduct a social
isolation and loneliness campaign using social media, print and radio
and local outlets.
Materials developed and used Mar
202
2 4
5
Action step: Create and implement action plan. Action plan developed Dec
202
2 3
Strategy 2: Task force will identify loneliness in older adults in
communities throughout Bayfield County and provide access to
meaningful and culturally relevant resources and services.
Action step: Task force host community gatherings in at least three
communities to gain input and insight on social isolation and
loneliness.
Number of gatherings and
participants attended
May
202
3
202
4
Action step: Advocate to create space for older adults in 3
communities for purposes of gathering together.
Communities are identified;
community engagement is
identified.
July
202
4
Strategy 3: Task Force will implement interventions to create
meaningful connections.
Action step: Expand Tai Chi classes to 2 additional communities. Number of Tai Chi classes
held in two new communities
and number of participants
attending.
Mar
202
2
Action step: Develop Beyond Blue booklet and distribute widely to
normalize the need for social support.
Booklet is created and
distribution is tracked.
Jun
e
202
4
County Aging Plan Template and Required Documents 2022–2024
Annual progress notes
8/15/22 notes:
Strategy 1: Planning on working on in 2023.
Strategy 2: 2023
Strategy 3: Have 4 Tai Chi leaders trained and committed to provide classes. Two have been held thus far
and in the process of setting up 3 additional classes starting in September. Five classes in 4 communities.
Strategy 1: A Social Connections Workgroup has been formed. The initial group was comprised of
volunteers form the Nutrition Advisory Council, Aging and Disability Advisory Committee and Human
Services Board. Six members of that group brainstormed next steps. It was decided to focus on creative
and connected leaders within the communities of Cornucopia, Washburn, and Cable for this pilot
project. The initial thought is to focus on individuals who are 55 and older and going through major life
transitions, which might have the feeling of being disconnected from themselves or their
community. Twelve people from 6 different communities attended the first meeting to provide their insights
around this topic. Next meeting will entail development of an action plan.
Strategy 2:
Strategy 3: Spring and fall Tai Chi classes have been/are being hosted in Herbster, Barnes, and
Drummond by volunteers. Several communities have also began hosting other wellness activities; we are
striving to work with and not compete with what is taking place. I recently connected a few community
representatives with how to add their events to the county calendar to provide additional outreach.
Strategy 3: 2024
Title IIIE: Caregiver Support/Person-Centered Services
1. What are you trying to improve? What problem are you trying to solve?
There are not enough respite providers and caregivers still need support. We
need to figure out a different way to support family caregivers.
2. What is the current status of your problem or situation? Is it getting better
or worse?
Caregivers cannot find home care workers or other types of in-home support.
This has gotten worse since the pandemic.
3. What factors are hindering your progress? (preventing you from
succeeding)
Lack of home care agencies and workers
For those home care agencies/workers in existence, many will not travel to remote
parts of the county.
Limited support services in general in very rural areas
County Aging Plan Template and Required Documents 2022–2024
Medicaid reimbursement rate is low so rate of pay for workers tends to be low.
4. What factors are supporting your efforts?
Everyone has access to a phone
Making phone calls is cost effective
Caregivers consistently say that having someone to talk to is helpful
Caregiver say information and education is important
There are some new programs and resources for rural caregivers that people may
not know about
5. Who are your partners in helping you succeed? (who could you work with
to make this better)
Little Brothers, Friends of the Elderly (Phone Companions Program)
2-1-1 Caregiver Outreach Program
Rural Caregiver Project
Trualta
Aging and Disability Services staff
Other non profits and agencies with volunteers and/or professional staff
interested in partnering.
6. What are some strategies or steps that could help? (ideas to fix the
problem)
Utilize unique, new caregiver support programs.
Create outreach materials.
Teach caregivers how to find “non-traditional” respite (asking family/friends,
adaptive equipment, etc.)
Develop call schedule to call caregivers in need – or the people they care for.
Train callers to identify mental health emergencies and to triage needs.
Use Trualta materials as a basis for phone calls – discuss training modules.
Create policy to allow for payment of non-professional caregiver support.
7. What do you hope to see as an outcome or result?
Caregivers feel connected to resources.
Caregivers have increased sense of belonging.
Caregivers can reach out to family, friends, neighbors with an ability to pay for
their services
Caregiver experience decreased stress and burnout – something to look forward
to
8. How will you measure your progress? How will you know that you have
achieved the results you wanted?
Pre and post surveys
Policy to pay non-professional caregivers is created. Caregivers have additional
ways in which to receive support.
County Aging Plan Template and Required Documents 2022–2024
Focus area: Title IIIE: Caregiver Support/Person-Centered Services
Goal statement: Family caregivers will have increased choices in how to feel more supported in
their caregiving role by having access to regular support calls, caregiver classes, Trualta, and respite.
Plan for measuring overall goal success – How will you know that you have achieved the results you
want? Use data.
Pre- post- surveys. An increase of caregiver support options from 2022 to 2024, as evidenced by a
creation of a resource list with 3 additional options of what is currently available.
Specific strategies and steps to meet your goal:
Measure (How will you
know the strategies and steps
have been completed?) Du
e
Da
t
e
Strategy 1: Utilize the Rural Caregiving Project – 6 week class
done on caregiver’s own schedule which includes connection
with other caregivers
Action step: Get information to caregivers about the program.
Outreach materials are
created and outreach is
conducted
Jan
202
2
Action step: Explain the program to potential participants. Contact with caregivers is
documented.
Feb
202
2
Strategy 2: Find individuals who can designate time each week
to make phone calls to caregivers
Action step: Research who can make calls, such as paid staff,
volunteers, etc.
Roster of callers is
developed.
May
202
3
Action step: Train people using Mental Health First Aid, UW
Oshkosh Dementia Specialist trainings, thorough review of local
resources, Trualta resources, etc.
Training agendas and
participant sign in sheets are
documented
Aug
202
3
Action step: Inform caregivers of opportunity to receive a regular call
from staff.
Contact with caregivers is
documented.
Oct
202
3
Action step: Schedule phone calls. Call roster is developed Nov
202
3
Strategy 3: Create policy to allow non-professionals to be
reimbursed for providing respite.
Action step: Educate policy makers about the importance of respite
and lack of professional respite providers.
Emails, letters, presentations Jan
202
4
Action step: Recommend policy to allow reimbursement for non-
professional providers (family, friends, neighbors, etc.)
Policy is developed Jun
e
202
4
Annual progress notes
8/15/22 notes:
Strategy 1: Offered the Rural Caregiving Project a 6-week class done on caregiver’s own schedule which
includes connection with other caregivers. Three caregivers expressed interest in participating.
County Aging Plan Template and Required Documents 2022–2024
Strategy 2: There are 8 caregivers that staff checks in regularly and supports. Staff also informally checks
in on those individuals that need a little extra attention. The current staffing in place does not allow for
more to be done with this goal at this time.
Strategy 3: 2024
Strategy 1: Ongoing and as needed. Powerful Tools for Caregivers appears to be the most popular
educational opportunity for caregivers. The Dementia Care Specialist has provided it a few times in the
past year and is planning to lead it again this year. There is also interest in a caregiver support group in
Washburn. Because the one established in Iron River has had two consistent participants (one from
Washburn and one from Herbster) we will likely move it to Washburn.
Strategy 2: Staff continue to reach out to caregivers identified as needing additional support. Some
discussions have occurred with CORE to develop a calling tree, but that has not been developed to date.
Strategy 3: 2024
Coordination Between Title III and Title VI
Within Bayfield County geopolitical boundary is the federally recognized Red Cliff Band
of Lake Superior Chippewa. Red Cliff is notable for being the band closest to the
spiritual center of the Ojibwe nation, Madeline Island. The reservation is located in the
Town of Russell and the Town of Bayfield, north and northwest of the city of Bayfield.
As of July 2018, there are 5,312 enrolled members, with about half living on the
reservation and the rest living in the city of Bayfield or the Belanger Settlement.
Historically, both the county and tribal aging programs have worked together to best
serve Tribal elders both within and outside of tribal boundaries, with dignity and
respect. With the development of the ADRC of the North, the Red Cliff Elder Program
has had the opportunity to hire a Tribal Aging Resource Specialist. Staff from both
agencies has held meetings to review current policy and procedure and to acquaint
with one another.
To help ensure that Red Cliff Tribal members are knowledgeable of information and
services available through the Aging & Disability Resource Center, and the county, the
Aging and Disability Services Manager and key staff will continue to work with Elder
Program staff and tribal representatives to ensure effective outreach and education
continues to take place. Specifically, a tribal representative holds a seat on the county
Aging and Disability Advisory Committee, the ADRC of the North governing board, and
the tribal transportation director holds a seat on the county Transportation Coordinating
Committee. Tribal staff are invited to participate in the planning of the annual caregiver
conference
8/15/22 notes:
County Aging Plan Template and Required Documents 2022–2024
Bayfield County has a good working relationship with the tribe. Unfortunately, Anna
Hanson the tribal nutrition director is resigning who has been with the tribe for many
years. Bayfield County will continue to coordinate and communicate with Red Cliff to
ensure a positive relationship continues.
Bayfield County continues to have a good working relationship with the Red Cliff tribe.
The new director, Sarah Tourdot has been very busy and often must step in and work in
the kitchen. We have not had much opportunity to collaborate on activities yet.
2023 ADRC Scope of Services***
***Excerpt from page 12, II. Core Services
I. Access to Other Public and Private Programs and Benefits
1. Assis ng Customers in Accessing Programs and Benefits
When an individual contacts, or is referred to, the ADRC and appears to be eligible for or interested in
receiving public program services or benefits, the ADRC will refer the customer to the appropriate
benefit specialist or the local, state, or federal agency responsible for determining the customer’s
eligibility. Programs and benefits to which customers will be referred include, but are not limited to,
Medicaid, Medicare, Social Security, Supplemental Security Income (SSI), Social Security Disability
Insurance (SSDI), SSI Excep onal Expense Supplement (SSI-E), FoodShare, veteran’s benefits, mental
health services, and other public programs and benefits.
When an individual contacts, or is referred to, the ADRC and appears to be eligible for or interested in
receiving private program services or benefits, the ADRC will refer the customer to the appropriate
benefit specialist or the private agency responsible for determining the customer’s eligibility.
The ADRC will assist customers applying for home and community based long-term care Medicaid
consistent with the requirements rela ng to access to publicly funded long-term care.
Assistance with Medicaid applica ons not involving access to publicly funded long-term care will be
provided as follows:
i. ADRCs do not have the primary responsibility for assis ng with Medicaid applica ons. The
ADRC will provide customers who appear likely to be eligible or want to apply for Medicaid with
basic informa on about how to apply for Medicaid and refer them to the appropriate agency for
applica on assistance, eligibility determina on, and enrollment.
ii. The ADRC will assist customers with the Medicaid applica on when it determines that the
assistance that is available from the local or regional income maintenance agency or other
sources is not mely or sufficient to ensure access.
iii. The ADRC is not responsible for assis ng with Medicaid applica ons for nursing home
residents unless they are reloca ng to the community.
IV. Vacancies, Absences, and Transitions
A. Introduction
Agencies are responsible for serving benefit specialist customers by performing benefit specialist functions and
responsibilities during a benefit specialist absence caused by vacancy, vacation, or leave of absence.
The agency supervisor notifies the DHS EBS or DBS program manager and program attorney as soon as possible after
learning of a benefit specialist's departure or vacancy. The agency may also wish to contact community partners and
agencies that work closely with the benefit specialist.
In the case of short-term absences such as vacation, family medical leave, or parental leave, the agency can adopt the
portions of this policy that are appropriate based on the length of the leave. For example, a short-term absence would not
automatically require the revocation of an appointment of representation or written notice to customers. To the extent
possible, the benefit specialist should discuss open cases with the supervisor, the staff person providing interim coverage,
and/or the program attorney prior to taking their leave.
B. Caseload Management During a Vacancy
i. Caseload Management Plan
The agency supervisor chooses how to manage the benefit specialist's caseload during a vacancy or absence.
Some permissible ways to do so include:
Distributing workload to other staff within the agency.
Enlisting the help of a benefit specialist in another county.
Referring customers to the local Social Security field office, income maintenance
consortium, or other appropriate entity to apply for benefits. See the Caseload Management
Guidelines for details.
Working with the DHS EBS or DBS program manager and the program attorney, using
the Caseload Management Guidelines, to develop a workload management plan if the remaining
caseload is unmanageable given existing resources.
ii. Interim Benefit Specialist
The agency supervisor designates an interim benefit specialist. The interim benefit specialist can be another
benefit specialist within the agency, a benefit specialist from a nearby agency, or (for DBS vacancies) the local
supervisor. It is preferable that the interim benefit specialist is another benefit specialist rather than the local
supervisor. The interim benefit specialist:
Assumes the benefit specialist functions and responsibilities or oversees these
responsibilities if responsibilities are delegated to more than one employee.
Receives technical assistance from the program attorney. These services are only provided
to the interim benefit specialist.
Accesses and utilizes the client-tracking data system, the program's SharePoint site, and
other systems necessary to perform benefit specialist services. If the interim benefit
specialist does not have access, contact the DHS EBS or DBS program manager to discuss
the possibility of receiving temporary access to the client-tracking system.
Adheres to program confidentiality standards, as outlined in the Operations Manual.
Adheres to the limitations of combined activities governed by the prohibited activities
policy, as outlined in the Operations Manual.
iii. Existing Cases
The benefit specialist takes the following actions prior to vacating the position or starting a planned long-term
absence, as time allows:
Reviews and updates all files, including the client-tracking system, paper, and electronic
files.
Files or documents customer communications, case status, customer documents, decisions,
and actions for each case.
Withdraws authorized representative status on all applicable cases.
o The departing benefit specialist discontinues the representation with written notice
to the customer.
o If authorized representation needs to continue, the interim benefit specialist should
work with the customer to complete and submit a new appointment of
representation. The newly appointed representative must understand the associated
responsibilities of taking on the role of authorized representative.
o The program attorney is available to assist the agency supervisor and/or interim
benefit specialist in these decisions and to provide information to them about the
process of becoming an authorized representative.
Reviews all open cases to take one of the following actions, as appropriate, on each case:
o Closes the case.
o Refers the customer to a private attorney.
o Refers the customer to the program attorney for representation.
o Transitions the customer to the interim benefit specialist.
o Sends a letter to each customer with an open case informing them of the benefit
specialist's departure and what to expect regarding continued assistance on their
case. The written notice requirement does not preclude contacting the customer
verbally in addition to sending a written notice.
If the benefit specialist's departure is too sudden or unexpected to complete the above tasks,
the local supervisor should confer with the program attorney to discuss how to handle open
cases.
If the interim benefit specialist is located at a different agency, then the local supervisor
must decide whether:
o Open cases will be closed in the client-tracking system and customers are referred to
the interim benefit specialist's agency.
o The interim benefit specialist will be given temporary access to the agency's client-
tracking system. The DHS EBS or DBS program manager must approve this
arrangement.
iv. New/Prospective Cases
See the Caseload Management Guidelines for guidance on how to handle new or prospective cases.