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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. Microsoft Teams meeting Join on your computer, mobile app or room device Click here to join the meeting Meeting ID: 282 965 834 759 Passcode: XoxjgM Download Teams | Join on the web Or call in (audio only) +1 715-318-2087,,506693484# United States, Eau Claire Phone Conference ID: 506 693 484# Find a local number | Reset PIN Learn More | Meeting options 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. Assisng 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 Exceponal 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 relang to access to publicly funded long-term care. Assistance with Medicaid applicaons not involving access to publicly funded long-term care will be provided as follows: i. ADRCs do not have the primary responsibility for assisng with Medicaid applicaons. The ADRC will provide customers who appear likely to be eligible or want to apply for Medicaid with basic informaon about how to apply for Medicaid and refer them to the appropriate agency for applicaon assistance, eligibility determinaon, and enrollment. ii. The ADRC will assist customers with the Medicaid applicaon 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 assisng with Medicaid applicaons for nursing home residents unless they are relocang 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.