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HomeMy WebLinkAboutNutrition Advisory Council - Agenda - 2/28/2023 (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: February 8, 2023 RE: Joint Meeting Notice The Bayfield County Department of Human Services Aging and Disability Services Advisory Committee and Nutrition Program Advisory Council Committee will meet on Tuesday, February 28, 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 878402658 followed by the # sign. ADAC & NAC 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. The agenda includes: Call to Order and Introductions; Discussion and Possible Action-Review of the December 5, 2022, Meeting Minutes (ADAC) and the September 28, 2022, Meeting Minutes (NAC); Discussion and Possible Action-Consideration to recommend appointment of Dee Sweet. (ADAC); Discussion and Possible Action-Consideration to recommend appointment of Alice Evenson. (ADAC); Social Isolation and Loneliness in Wisconsin Presentation- Carleigh Olson, MPH, CHES Office for Resource Center Development, Bureau of Aging and Disability Resources; Advocacy Update-Submitted on behalf of Janet Zander, GWAAR Advocacy & Public Policy Coordinator; Wisconsin Aging Advocacy Network (WAAN) Issues and Initiatives; Home Delivered Meal Assessment Pilot (NAC); Program Reports: B-3, CLTS/CCOP, ADRC, Aging; Adult Protective Services; Other (Informational Items); 2023 Meeting Dates; 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 Red Cliff-Tribal Chair Daily Press K:\Agends and Minutes\A&D Services Committee\Meeting Notices\A&D Meeting Notice-February 2023 – Joint Mtg with NAC above expectations ÿAÿFIELD (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 JOINT MEETING OF THE AGING & DISABILITY SERVICES ADVISORY COMMITTEE AND THE NUTRITION PROGRAM ADVISORY COUNCIL COMMITTEE Karen Anderson (ADAC & NAC) Red Cliff Elder Program Rep. (ADAC & NAC) Tracy Snyder (ADAC) Lynette Benzschawel (Vice-Chairman ADAC) (ADAC & NAC) Mary Dougherty (ADAC) The Brick Representative (ADAC) Richard Kemmer (ADAC & NAC) William (Bill) Bland (ADAC) Madelaine Rekemeyer (NAC) Francis Renn-Malcheski (NAC) Sue Aiken (NAC) RE: February 28, 2023, Joint Meeting of the Aging & Disability Services Advisory Committee Meeting and the Nutrition Program Advisory Council 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, February 28, 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, 878402658 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: 218 907 436 933 Passcode: ijGSHz Download Teams | Join on the web Or call in (audio only) +1 715-318-2087,,878402658# United States, Eau Claire Phone Conference ID: 878 402 658# Find a local number | Reset PIN Learn More | Meeting options above expectations PAÿFIELD 2 The agenda for the meeting is as follows: AGENDA 1. Call to Order and Introductions 2. Discussion and Possible Action-Review of the December 5, 2022, Meeting Minutes (ADAC) and the September 28, 2022, Meeting Minutes (NAC) 3. Discussion and Possible Action-Consideration to recommend appointment of Dee Sweet. (ADAC) 4. Discussion and Possible Action-Consideration to recommend appointment of Alice Evenson. (ADAC) 5. Social Isolation and Loneliness in Wisconsin Presentation- Carleigh Olson, MPH, CHES Office for Resource Center Development, Bureau of Aging and Disability Resources 6. Advocacy Update-Submitted on behalf of Janet Zander, GWAAR Advocacy & Public Policy Coordinator 7. Wisconsin Aging Advocacy Network (WAAN) Issues and Initiatives 8. Home Delivered Meal Assessment Pilot (NAC) 9. Program Reports: A. B-3 B. CLTS/CCOP C. ADRC D. Aging E. Adult Protective Services 10. Other (Informational Items) 11. 2023 Meeting Dates 12. 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 K:\Agendas and Minutes\A&D Advisory Committee\ADAC Minutes\2022 ADAC minutes\2022-12-05 ADAC Meeting minutes-draft.doc 1 BAYFIELD COUNTY DEPARTMENT OF HUMAN SERVICES AGING AND DISABILITY SERVICES ADVISORY COMMITTEE Conference Room A remote via Teams December 5, 2022 3:00 p.m. Committee Members Present: Richard Kemmer (In-Person), Bill Bland (In-Person), Karen Anderson (by phone at 3:20), Tracy Snyder (Teams), Lynette Benzschawel (Teams), Alice Evenson BRICK Representatives (Teams) Committee Member Absent: Red Cliff Elder Program Representative; Mary Dougherty Staff Present: Carrie Linder, Heather Gilbertson, Elizabeth Skulan (Teams) Call to Order and Introductions Kemmer called the meeting to order at 3:04 p.m. and introductions were made. Discussion and Possible Action-Review of the September 27, 2022, Meeting Minutes Motion by Lynette, seconded by Bland to approve the September 27, 2022, meeting minutes. Motion passed. Discussion and Possible Action-2023 Alzheimer’s Family Caregiver Support Program Application  Linder reviewed the application with committee members.  Highlighted budgeted items listed below: o Direct Services for caregivers of individuals with a dementia diagnosis. o Outreach activities and public awareness is included. o Support group development or assistance is included. Motion by Snyder, seconded Bland by to recommend approval of the 2023 Alzheimer’s Family Caregiver Support Program Application. Motion passed. Discussion and Possible Action-2023 Elder Abuse Application  Linder reviewed the application with committee members.  Highlighted budgeted items listed below: o Service Coordination o In-Home Services o Adaptive equipment o Personal emergency response system o Housing /moving/relocation o Residential Care Motion by Anderson, seconded by Benzschawel to recommend approval of the 2023 Elder Abuse Application. Motion passed. DRAFT: Subject to change at the next ADAC meeting K:\Agendas and Minutes\A&D Advisory Committee\ADAC Minutes\2022 ADAC minutes\2022-12-05 ADAC Meeting minutes-draft.doc 2 Discussion and Possible Action-TaiJi Expectations and Guidelines  Linder reviewed the Expectations and Guidelines with committee members.  The guidelines support both volunteers and participants.  It is a framework for respect of volunteers and participants and what is expected of both.  Provides a process / baseline if things are not going well. Motion by Bland, seconded by Benzschawel to adopt and approve the TaiJi Expectations and Guidelines. Motion passed. Program Reports – General Overview of A&D Programs  Birth to Three (B-3) o Staff is working on new training modules.  Children’s Long-Term Support/Children’s Community Options Program (CLTS/CCOP) o Forty-four children are receiving services between these two programs. o All children who were on the waiting list are now receiving services. o Changes to the parental payment limit will be taking place in 2023. o An updated the provider registry was rolled out by WIDHS.  Aging and Disabilities Resource Center (ADRC) o Assessments are being done to get clients enrolled into Long-term Care (LTC)  Aging Services o HDM drivers are doing a great job. Linder completed a ride along with drivers in October. o Linder stated it was refreshing being with the drivers and seeing the frontline and what the drivers encounter on a day-to-day basis. o Twenty to Twenty-five nutritionally at-risk participants also receive a frozen meal weekly through Core. o The Northwest Community Service Agency, provides boxes of food once a month to help supplement individual diets for individuals who meet the program guidelines. o Congregate meal sites are having a lower-than-expected turnout but are going well. o Linder and Support Staff will be working together to streamline the paperwork for volunteers and make it more uniform.  Adult Protective Services o Two APS staff are working with 47 clients. Other (Informational Items)  Staff evaluations due at end of year.  Linder is monitoring funding sources and making sure they are spent out by years end.  2023 contracts are being sent out to providers.  Grant applications are being completed and submitted for 2023 funds. 2023 Meeting Dates  February 28th  June 27th  September 26  November 28 K:\Agendas and Minutes\A&D Advisory Committee\ADAC Minutes\2022 ADAC minutes\2022-12-05 ADAC Meeting minutes-draft.doc 3 Social Isolation and Loneliness Work Group  Linder sent out a message to each member stating there was interest in taking this topic further as its own work group and that it is not inclusive to just the county committees or staff. Linder asked if there was any interest of members to also be on this work group.  Snyder and Dougherty will continue with this effort along with Linder.  State coalition has been working on social isolation and loneliness throughout the year and has a pilot program with a questionnaire.  A&D staff administered the survey with 25 home delivered, congregate and ADRC consumers. The purpose was to determine how easily a three-point survey could be integrated into these well-established programs.  Staff will continue to engage with clients that had a significant score of loneliness.  The work group needs to: o Identify who should be part of the task force. o Develop a Mission, Vision, and a Goal. o Tabled until 2nd week in January – Dougherty, Snyder, and Linder to spearhead the group. Kemmer adjourned the meeting at 4:18 pm Minutes respectfully submitted by Heather Gilbertson, Clerk III K:\Agendas and Minutes\A&D Nutrition Advisory Council\NAC minutes\NAC minutes 2022\2022-09-28 Nutrition Advisory Committee Mtg Minutes Approved by CN.doc 1 BAYFIELD COUNTY DEPARTMENT OF HUMAN SERVICES NUTRITION ADVISORY COUNCIL COMMITTEE Taking place at the Port Wing Meal Site at 11:00 September 28, 2022 Committee Members Present: Richard Kemmer- in person, Karen Anderson-in person, Lynette Benzschawel- in person, Francis Renn-Malcheski – in person, Sue Aiken- in person Committee Member Absent: Red Cliff Elder Program Representative, Madelaine Rekemeyer Staff Present: Carolyn Novak Call to Order and Introductions Kemmer called the meeting to order at 11:00 a.m. Introductions were made with new members present. Discussion and Possible Action-Review of August 30, 2022, Meeting Minutes Motion by Anderson second by Benzschawel to approve the August 30, 2022, meeting minutes as presented. Motion passed. Review Goals and Objectives within the Aging Plan for Bayfield County  Novak summarized the development, purpose, and scope of the current aging plan.  Besides the focus area Nutrition/Equity/Community Engagement, several other focus areas were identified and their purposes as they relate to the ENP were explained by Novak (Advocacy, Enhanced Transportation and Social Isolation and Loneliness).  Progress has been made according to the timeline outlined in the plan for the ENP. The Council agreed that creating pop up dining experiences in areas of the county next year that don’t have congregate meal sites will not only provide additional service to seniors, but also help determine where additional permanent sites may be needed.  The Social Isolation and Loneliness focus area was discussed at length by the Council. Meal sites were seen as important community gathering places for seniors for socialization and education. More discussion is expected at future NAC meetings. Program Reports: A. Congregate Meals o Barnes Meal Site Update – Novak summarized the recent listening session comments for the Council. The Council confirmed their decision to reduce the number of days open from 4 to 1 (will only be open on Thursdays). B. Home Delivered Meals – numbers of HDM participants are expected to increase as we go into winter. Staffing Updates - nothing to report. DRAFT: Subject to change at the next ADAC meeting K:\Agendas and Minutes\A&D Nutrition Advisory Council\NAC minutes\NAC minutes 2022\2022-09-28 Nutrition Advisory Committee Mtg Minutes Approved by CN.doc 2 Other (Informational Items) -nothing to report Future Meetings: A. October 21, 2022, at St. Louis Meal Site St. Louis School Gym, 713 Washington Ave, Washburn, WI 54891 Located right next to the St. Louis Church B. Discussion of 2023 Meetings – Council would like to have the first meeting of 2023 before the Aging and Disability Services Advisory Committee in the courthouse because of the potential for bad weather and because many of the members are on both committees. Second, third and fourth quarter meetings will be conducted at the meal sites (Iron River and Barnes for sure). Dates to be discussed and confirmed at the October 21, 2022, NAC meeting. Adjournment Motion by Anderson, second by Aiken to adjourn meeting. Meeting adjourned at 12:10 p.m. Minutes respectfully submitted by Carolyn Novak, Aging Services Coordinator Citizen Committee Member Application Citizens interested in serving on any county committee should complete and submit this form. First Name Dee Last Name Sweet Address1 239 So. 7th St. Address2 Field not completed. City Bayfield State WI Zip 54814 Are you a Bayfield County Resident? Yes Have you previously served on a county committe, board or commission? No If yes, which committee, board or commission? Field not completed. Home Phone Field not completed. Cell Phone 920-366-7636 Email Address dee@conservationvoters.org Date 12/16/2022 What City/Town/Village are you a Resident of? City of Bayfield Committee Aging/Elder Services List of Qualifications -- Tribal Elder -- UW Professor Emerita/Adjunct Faculty for Lac Courte Oreilles Ojibwe University -- Community Organizer (WI Native Vote) -- Published Writer -- Former WI Poet Laureate (2004-08) -- Bayfield Poet Laureate (2022-24) -- Advocate for Community Service/Volunteerism Citizen Committee Member Application Citizens interested in serving on any county committee should complete and submit this form. First Name Alice Last Name Evenson Address1 420 Ellis Avenue Address2 Field not completed. City Ashland State WI Zip 54806 Are you a Bayfield County Resident? No Have you previously served on a county committe, board or commission? No If yes, which committee, board or commission? Field not completed. Home Phone Field not completed. Cell Phone 715-209-4039 Email Address benevolencemanager@thebrickministries.org Date 10/13/2022 What City/Town/Village are you a Resident of? City of Washburn Committee Aging and Disability Advisory Committee List of Qualifications I am the new Benevolence Manager at The BRICK Ministries in Ashland. We provide services to individuals and families in both Ashland and Bayfield Counties. Several of the clients we serve are part of the aging and disabled community in Bayfield County. 2-03-23 janet.zander@gwaar.org Greater Wis. Agency on Aging Resources, Inc. Advocacy Update GWAAR Board Meeting February 10, 2023 • New State Legislature & New Congress The challenges facing older adults and people with disabilities, caregivers, and individuals living with dementia are non-partisan issues. It is important for us to get to know new legislators and to continue building relationships with all returning legislators and critical committee leaders and members as the new legislative session and next biennial budget process get underway. Jan. 3, 2023 was Inauguration Day for Wisconsin’s Governor, Lt. Governor, Attorney General, Secretary of State, State Treasurer, and many members of Wisconsin’s 106th State Legislature (including every state Assembly Representative, and half of the State Senators whose terms ran on even cycles). Retirements, resignations, and redistricting led to many of us having new state legislators. Getting to know your new legislators and beginning to build a relationship with them is an essential first step. To find out who your state legislators are for the 2023-2024 Legislative Session go to the Wisconsin State Legislature homepage and type in your home voting address in the white box underneath “Who Are My Legislators?”. To find contact information for all state legislators, as well as the names of their staff, biographies of the legislators, and other important information, go here for members of the Wisconsin Senate: 2023 Wis. State Senators and here for members of the Assembly: 2023 Wis. State Representatives. New legislative district maps are now available here: ❖ Statewide Assembly ❖ Statewide Senate ❖ Wisconsin Congressional Districts Members of the U.S. Congress were sworn into the 118th Congress earlier this month. Contact information for Wisconsin’s Members of Congress has been updated and is now available on the GWAAR website here. Contact information for Wis. U.S. Senators can also be found here. To find out who represents you in the U.S. House of Representatives, in the upper righthand corner of this page, enter your zip code in the white box to the left of the red “LOOK UP” box. Please use the contact information regarding your state and federal legislators to reach out to them and share how issues of importance to you are impacting you, your families, and the community members you serve. Greater Wisconsin Agency on Aging Resources,Inc. 2-03-23 janet.zander@gwaar.org Greater Wis. Agency on Aging Resources, Inc. State • 2023-2025 State Budget On Tues., Jan. 24, 2023, Governor Evers delivered his 5th State of the State address. In his address, he highlighted a number of initiatives he will be including in his 2023-25 biennial budget proposal. Included in the Governor’s budget priorities are several proposals the aging network might find of interest, including: Mental and Behavioral Health proposals • Declaring 2023 as the Year of Mental Health in Wisconsin • $500 million to expand access to mental and behavioral services across the state: o Crisis Urgent Care & Observation Center Grant Program - Provide $64,700 general purpose revenue (GPR) in fiscal year 2024 (FY24) and $10,038,500 GPR in fiscal year 2025 (FY25) for grants to establish up to two crisis urgent care and observation centers to offer a variety of behavioral health services, accept emergency detention cases, conduct medical clearances, and support up to 15 crisis stabilization beds. o Deaf, Hard of Hearing and Deaf-Blind Behavioral Health Treatment Program - Provide $1,936,000 GPR in FY25 for a grant to establish a state-wide behavioral health treatment program for individuals who are Deaf, Hard of Hearing or Deaf-Blind. o 988 Suicide & Crisis Lifeline Support - Provide $898,700 GPR in FY24 and $2,105,700 GPR in FY25 to cover operating costs of the state’s 988 Suicide & Crisis Lifeline call center. Child Care and Caregiving proposals • Create a $500 caregiver tax credit to help family caregivers pay for caregiving expenses • Expand the Child and Dependent Care Tax Credit • $340 million to permanently establish the Child Care Counts program to help providers • $22 million to support the “PartnerUp!” program which supports employer-child care provider partnerships and child care provider staff recruitment and retention Economy and Workforce • $50 million to bolster Wisconsin’s healthcare and long-term care workforce: o $22.5 million to establish an ongoing Innovation Grant program for healthcare employers to engage in improved recruitment and retention of long-term care providers o $8 million in support to the WisCaregiver Careers program to expand the long-term care workforce o $5 million over the biennium through the Worker Advancement Initiative for health care workforce programs. For more detail, see: o Governor Evers’ full budget address here o Mental Health Plan here o Child care/caregiving proposal here 2-03-23 janet.zander@gwaar.org Greater Wis. Agency on Aging Resources, Inc. o Workforce plan here The governor’s full 2023-25 executive budget proposal will be announced following his 2023-25 Biennial Budget Message to the Legislature on Wed., Feb. 15, 2023, at 7 p.m. The budget address can be viewed live at: https://wiseye.org/live/ or watched later at: https://wiseye.org/category/governor/ • Wisconsin Aging Advocacy Network (WAAN) State Issue Briefs 2022-2023 A new state Elder Justice issue brief has been completed and is posted on the WAAN webpage of GWAAR’s website. To view all the issue briefs currently posted to the WAAN webpage go here: https://gwaar.org/waan- issues-and-initiatives. Federal issue priorities will be posted at this same location in the coming months. • Upcoming Advocacy Days at the State Capitol ❖ Alzheimer’s Association – Wisconsin Chapter Wisconsin Advocacy Day Tues., March 7th, 9:00 A.M. – 3:00 P.M. Opening program at the Best Western Premier Park Hotel in Madison and meetings with your state lawmakers at the Wisconsin State Capitol in the afternoon. To register, click here ❖ Disability Advocacy Day of Action! Thursday, March 23, 2023 In -Person 10 A.M.– 3:00 P.M. Monona Terrace, One John Nolen Drive, Madison, WI & the Wisconsin State Capitol Register online Download Registration Form Download the flyer - here ❖ Aging Advocacy Day 2023 Tuesday, May 9, 2023 In-Person Event with virtual option for those unable to come to Madison. Best Western Premier Park Hotel, Madison & the Wisconsin State Capitol More information will be posted soon at https://gwaar.org/aging-advocacy-day-2023 Federal • COVID-19 National Public Health Emergency to End on May 11, 2023 The COVID-19 public health emergency (PHE) first declared in early 2020, is now set to end on May 11, 2023. The end of the PHE brings an end to the many Medicare and Medicaid flexibilities states were permitted to use in response to the pandemic. 2-03-23 janet.zander@gwaar.org Greater Wis. Agency on Aging Resources, Inc. The PHE end date is separate from the Medicaid continuous coverage protections expiration date, set by the Consolidated Appropriations Act (CAA) of 2023, for March 31, 2023. The CAA provides states with a timeline in which they must begin Medicaid eligibility redeterminations. To allow individuals no longer eligible for Medicaid to transition to Medicare (if eligible) or Marketplace plans, CMS announced Special Enrollment Periods (SEPs) outside of the standard enrollment periods. • Federal Government Ends Extra FoodShare Benefits in February 2023 In addition to ending the Medicaid continuous coverage protections, the CAA of 2023 passed in late Dec. 2022, also ends the emergency allotments that have been provided to households enrolled in the Supplemental Nutrition Assistance Program, or SNAP. In Wisconsin, the SNAP program is called FoodShare. February 2023 will be the last month families will receive the temporary increases in benefits put in place during the COVID-19 pandemic (households were receiving the maximum amount for their household size or $95, whichever was more). Regular FoodShare benefits will continue but rising food costs and the loss of extra benefits is anticipated to negatively impact individuals and families (affecting more than 700,000 individuals and about 400,000 households), as well as retailers and farmers who accept the benefits. Regional foodbanks and local distribution organizations are working to fill the gap. Older adults and people with disabilities are expected to be affected most, as they often receive the minimum benefits a month; when the emergency allotments end, they lose the extra $95/month and go back to receiving the monthly minimum benefit of $23/month. Making things even more challenging, households that receive FoodShare and Social Security benefits may see a further decrease in their FoodShare benefits due to the significant cost of living increase to Social Security benefits that took effect at the beginning of the year, some may be disqualified from receiving FoodShare benefits altogether. Benefits are determined by household size, income, and other factors. Those currently receiving FoodShare benefits should make sure their FoodShare information (address, income, expenses, and allowable deductibles) is up to date so they can receive all their possible benefits. Information can be updated by: 1. Using the MyACCESS mobile app (free in the Apple Store or Google Play Store) 2. Using your MyACCESS account at access.wisconsin.gov 3. Visiting your local agency to report changes in person. Look up your local agency at https://dhs.wisconsin.gov/forwardhealth/imagency/index.htm Older adults and people with disabilities needing help locating food pantries, other food support resources, or other local resources can contact their local Aging and Disability Resource Center or Tribal Aging and Disability Resource Specialist or call United Way's 211 help line. Anyone wishing to help is encouraged to consider donating to and/or volunteering at a local food pantry. New State Legislature & New Congress The challenges facing older adults and people with disabilities, caregivers, and individuals living with dementia are non-partisan issues. It is important for us to get to know new legislators and to continue building relationships with all returning legislators and critical committee leaders and members as the new legislative session and next biennial budget process get underway. Jan. 3, 2023 was Inauguration Day for Wisconsin’s Governor, Lt. Governor, Attorney General, Secretary of State, State Treasurer, and many members of Wisconsin’s 106th State Legislature (including every state Assembly Representative, and half of the State Senators whose terms ran on even cycles). Please use the contact information regarding your state and federal legislators to reach out to them and share how issues of importance to you are impacting you, your families, and the community members you serve. 74th Assembly District: Chanz Green Madison Office: Room 125 West State Capitol PO Box 8952 Madison, WI 53708 Telephone: (608) 237-9174 (888) 534-0074Fax: (608) 282-3674Email: Rep.Green@legis.wisconsin.gov Voting Address: 26595 Altamont Rd. Mason, WI 54856 Staff: Carson Lee Carson.Lee@legis.wisconsin.gov Current Committees  Committee on Criminal Justice and Public Safety  Committee on Forestry, Parks and Outdoor Recreation  Committee on Rural Development  Committee on Sporting Heritage  Committee on State Affairs (Vice-Chair) 25th Senate District: Romaine Quinn Madison Office: Room 123 South State Capitol PO Box 7882 Madison, WI 53707Telephone: (608) 266-3510 (800) 469-6562Email: Sen.Quinn@legis.wisconsin.gov Staff: Michael Luckey Michael.Luckey@legis.wisconsin.gov Ericka Braatz Ericka.Braatz@legis.wisconsin.gov Stacey Hessel Stacey.Hessel@legis.wisconsin.gov Jason Vick Jason.Vick@legis.wisconsin.gov Current Committees  Committee on Agriculture and Tourism  Committee on Education (Vice-Chair)  Committee on Housing, Rural Issues and Forestry (Chair)  Committee on Utilities and Technology  Joint Committee on Information Policy and Technology  Joint Legislative Council 7th Congressional District: Thomas Tiffany Offices: Washington, D.C. Office: 451 Cannon House Office Building Washington, DC 20515 Phone: (202) 225-3365 Wausau Office: 2620 Stewart Avenue, Suite 312 Wausau, WI 54401 Phone: (715) 298-9344 Committees: Judiciary • Courts, Intellectual Property, and the Internet • Crime, Terrorism and Homeland Security • Immigration and Citizenship Natural Resources • Energy and Mineral Resources • National Parks, Forests, and Public Lands (Vice Ranking Member) Wisconsin Aging |Advocacy |Network Core Member Organizations •Aging and Disability Professionals Association of Wisconsin (ADPAW) •Alzheimer's Association Wisconsin Chapter •Wisconsin Adult Day Services Association (WADSA) •Wisconsin Association of Area Agencies on Aging (W4A) •Wisconsin Association of Benefit Specialists (WABS) •Wisconsin Association of Nutrition Directors (WAND) •Wisconsin Association of Senior Centers (WASC) •Wisconsin Institute for HealthyAging (WIHA) •Wisconsin Senior Advocates •Wisconsin Senior Corps Association (WISCA) •Wisconsin Tribal Aging Unit Association The Wisconsin Aging Advocacy Network (WAAN)is a collaboration of organizations and individuals working with and for Wisconsin's older adults to shape public policy and improve the quality of life for older people.WAAN advocates for all older adults by educating the community and policy makers on particular issues impacting older adults;mobilizing people on priority issues;and advocating for change. WAANState IssueBrief October 2022 Invest in Aging and Disability Resource Centers Balance FundingAcross the State and Meet the Needs of Wisconsin's Growing Population of Older Adults and People with Disabilities WAAN's Position/BudgetRequest:Increasefunding to Aging and Disability Resource Centers (ADRCs)by $32.4 million to equalize historicalfunding disparities,fullyfundrequiredcontractedservicesfor a growing customer base,and provide an additional$25 million to addcriticalservices to all ADRC operations across the state. Wisconsin's Statewide network of ADRCs provide information about critical, cost saving services and programs related to aging or living with a disability. They serve individuals,family members,friends and professionals working with related issues.The state's 46 ADRCs and seven tribal Aging and Disability Resource Specialists (ADRS)that work at an ADRC serve the fastest growing demographic of our state's population.1 ADRCs across the state receive different levels of funding based on when they began operations. This method of funding has led to foundational funding inequities among ADRCs.2 In addition,the current funding formula does not consider health equity variables, changing demographics and rising expenses impacting operations. As a result,Wisconsin's network of ADRCs includes underfunded operations unable to provide equitable levels of service. Aging &Disability Resource Center Wisconsin Population 60 and Older 1,671.010 1,786,595 1,766.860 1,091,139 Projectionsdemonstrate a 64%increase in the number of Wisconsinites over sixtyfrom 2010 to 2040. Funding inequities among ADRCs contribute to an inconsistent approach to delivering required state- contracted services and the need to determine the amount of funding actually required to ensure every ADRC can provide all contractually-required services.In order to provide reliable,equitable and accurate funding to the state's ADRCs,factoring in the costs of ensuring health equity and addressing population growth and rising expenses,an increased investment of $32.4 million is needed. Wisconsin Aging |Advocacy |Network Contact WAAN Janet L.Zander,MPA,CSW Advocacy &Public Policy Coordinator Greater Wisconsin Agency on Aging Resources,Inc. 1414 MacArthur Rd.,Ste A Madison, Wl 53714 Office:(715)677-6723 Cell:(608)228-7253 janet.zander@gwaar.org Find this document and other WAAN issue briefsat: httns://awaar.ora/waan-issues-and- initiatives The base allocation for ADRCs has not increased since 2006.Since then,the population of older adults and people with disabilities has grown,as has the number of recommended services included in the ADRCs state contract.In addition to population growth,a number of underfunded ADRCs do not have the resources to provide these additional critical services/programs to their growing number of customers. To fully fund statewide expansion of critical services/programs known to preserve personal resources and improve quality of life an additional $25 million is needed.These critical services/programs include: •Full funding of the Elder Benefit Specialist (EBS)program.EBS funding has remained unchanged for over 20 years [§46.81(2)] •Expanding Caregiver Support and Programs •Expanding Health Promotion Services •Expanding Care Transition Services •Full funding of Aging and Disability Resources in Tribes •Full funding of Aging and Disability Resource Support Systems Fully funding ADRCs will deliver cost savings for individuals,families,and taxpayers.In 2021ADRCs served 223,139 individual customers (a 71 percent increase over 2016).3 One in four ADRC customers reported they were able to stay in their homes instead of going to a nursing home or assisted living facility directly because of the ADRC,saving tens of thousands of dollars per year for more than 35,000 customers.4 Based on 2021 data,it is estimated that ADRCs prevent 61hospital re- admissions,and 101emergency department (ED)visits per 1,000 customers served,for a 248%return on investment (ROI).5,6 Every dollar invested in Wisconsin ADRCs leads to a savings of $2.48 (actual ROI is even more significant as the 2021calculations relied on 2017 hospital and ED visits costs which are now substantially higher). With $32.4 million to address disparities and $25 million to provide critical services/programs,the state's ADRCs can effectively serve the increasing number of Wisconsinites who need them. 1.U.S.Census Bureau (2020,June 25).65 and Older population Grows Rapidly as Baby Boomers Age.Retrieved March 16,2021,from https://www.census.gov/newsroom/press- releases/2020/65-older-population-grows.html. 2.Aging Population Projections,www.dhs.wisconsin.gov/aging/demographics.htm. 3.ADRC statewide encounter data for CY2021 (as of May 4,2022) 4.Paul,Raul (2021).ACL No Wrong Door -Return on Investment (ROI).Metastar 5.The Agency for Healthcare Quality and Research report:https://www.hcup-us.ahrq.gov/ reports/statbriefs/sb248-Hospital-Readmissions-2010-2016.jsp?utm_source=ahrq&utm_ medium=en-13&utm_term=Safety_Program&utm_content=13&utm_campaign=ahrq_ en6_18_2019 6.Costs of Emergency Department Visits in the United States,2017:https://www.hcup- us.ahrq.gov/reports/statbriefs/sb268-ED-Costs-2017.jsp#:~:text=ln%202017%2C%20 aggregate%20ED%20visit,cost%20per%20visit%20of%20%24530 Wisconsin Aging |Advocacy |Network Core Member Organizations •Aging and Disability Professionals Association of Wisconsin (ADPAW) •Alzheimer's Association Wisconsin Chapter •Wisconsin Adult Day Services Association (WADSA) •Wisconsin Association of Area Agencies on Aging (W4A) •Wisconsin Association of Benefit Specialists (WABS) •Wisconsin Association of Nutrition Directors (WAND) •Wisconsin Association of Senior Centers (WASC) •Wisconsin Institutefor HealthyAging (WIHA) •Wisconsin Senior Advocates •Wisconsin Senior Corps Association (WISCA) •Wisconsin Tribal Aging Unit Association The Wisconsin Aging Advocacy Network (WAAN)is a collaboration of organizations and individuals working with and for Wisconsin's older adults to shape public policy and improve the quality of life for older people.WAAN advocates for all older adults by educating the community and policy makers on particular issues impacting older adults;mobilizing people on priority issues;and advocating for change. WAANState IssueBrief January 2023 Promoting Elder Justice Preventing abuse and promoting the rights and protection of older adults WAAN's Position:Wisconsin programs andservices dedicated to promoting elderjustice needincreasedfunding andstaff to address decades of stagnantfunding,population growth,andincreased needs. Evidence suggests that one in 10 people over the age of 60 is abused or mis¬ treated each year,with the percentage increasingfor people with dementia liv¬ ing at home.1Abuse involving victims aged 60 and older is referred to as elder abuse (§46.90),which comes in the form of abuse (physical,emotional sexual, treatment without consent,and unreasonable confinement or restraint),ne¬ glect,self-neglect,and/or financial exploitation (monetary impact to older Wis- consinites of at least $38 million dollars in 2021).2 Abuse and mistreatment of older adults can occur in the home,in care and residential facilities,and in the community.Chronic under-identification and reporting of elder abuse means the real number of older adults abused or mistreated is likely much higher.3 Elder mistreatment results in diminished well-being and quality of life and violates the rights of older adults to be safe and free from violence.A growing aging population,increased social isolation,shortage of paid and unpaid care¬ givers,and lack of resources to address ongoing long term care needs,as well as crisis and dementia care is placing increased stress on families and caregiv¬ ers and increased demands on elder justice programs and workers. Budget Requests 1.Double (at a minimum)the current program and service funding to meet growing service numbers and needs in the following programs: •Adult Protective Services (APS)Program -increase funding to counties from $5 million (the funding level set in 2009)to $12 million annually. APS reports have increased 85 percent from 2009-2021,leaving APS agencies under-resourced and under-staffed. •Domestic Violence in Later Life Program -increase funding from $75,000 (the funding level set when the program was implemented in 2010)to $150,000 annually.Funding is used by counties to provide awareness events and safety training and relocation assistance for vic¬ tims of abuse in later life aged 60 and older. •ElderAbuse Direct Service Program -increase funding from $2 mil¬ lion to $4 million annually.Under §46.90,each county in Wisconsin is required to administer an elder abuse response and reporting system. The Wisconsin Department of Health Services allocates state GPR funds annually to each county inthe state for the provision of direct services including temporary shelter,relocation assistance,housing,respite care, emergency funds for food and clothing and legal assistance.Approximate¬ ly 20 percent of Wisconsin counties regularly request additional funding. •Guardianship Support Center (GSC)-increase funding from $100,000 to $200,000 annually.The GSC has been flat funded at $100,000/year since 2005.Funds are used to provide training and technical assistance to consumers,families,and professionals statewide (§46.977(1));this includes issues related to protective placement,advance directives,and the roles (and limitations)of powers of attorney (POAs)and guardians. From 2014 to 2021,the GSC experienced a 78 percent increase in total calls and emails.Implementation of Guardian Training Requirements (§54.26)beginning in 2023 is expected to further increase the GSC workload,as potential new guardians will be directed to contact the GSC with further questions about guardianship and the online training content.In addition,the Wl Department of Health Service needs an estimated $65,000/year for ongoing management and maintenance of the new online guardian training program. Establish permanent funding to support the continuation of Wisconsin's Elder Abuse Hotline and Elder Justice Program ($59,500 for FY 2024 and $212,700 for FY 2025)-The statewide multi-disciplinary task force on elder abuse providingtechnical assistance and support related to crimi¬ nal investigations and prosecution and the elder abuse hotline providing centralized reporting and referral of crimes targeting the elderly have been funded by a series of federal grants which will lapse at the end of June 2024.Over the last two decades (2001-2021)county elder abuse reports have more than tripled. Change Wisconsin Statute §16.009 to comply with federal law (45 CFR §1324.11)requiring a full-time State Ombudsman in addition to an Ex¬ ecutive Director/agency head and fund the full-time State Ombudsman position and additional administrative support staff -1.0 FTE Communi¬ cations Specialist and 1.0 FTE Executive Assistant -($189,000 FY 2024 and $242,200 for FY 2025)to enhance the capacity of the Board on Aging and Long Term Care to serve clients and support staff responding to increas¬ ingly complex casework.Wisconsin is believed to be the only state in the nation without a full-time State Ombudsman position separate from the Executive Director's position. Expand infrastructure support -data reporting,case management, training coordination,oversight of a growing number of residential care facilities,and support for Wisconsin's tribal nations -by authorizing new positions within the state Department of Health Services ($12 million over the biennium). 1414 MacArthur Rd.,Ste A Madison, Wl 53714 ÿ IOM,National Research Council,Washington,D.C.,2014.Forum on global violence Office:(715)677-6723 prevention:Elder abuse and its prevention (pp.59-66). Cell:(608)228-7253 2.Wisconsin Department of Health Services,Adult Protective Services.Retrieved from https://www.dhs.wisconsin.gov/aps/index.htm on December 27,2022.janet.zander@gwaar.org 3.Birnstengel,G.(Ed.).(2020,June 15).What is Elder Justice and Why Do We Need It?NextFindthisdocumentandAvenue. other WAAN issue briefs at: httas://awaar.ora/waan-is- sues-and-initiatives 2. Wisconsin Aging |Advocacy |Network Contact WAAN Janet L.Zander;MPA,CSl/l/4. Advocacy &Public Policy Coordinator Greater Wisconsin Agency on Aging Resources,Inc. mAZcgSQ Reducing Falls Among Older Adults in WisconsinWisconsinAging |Advocacy |Network Saving Lives,Preserving Independence,Reducing Costs Core Member Organizations •Aging and Disability Professionals Association of Wisconsin (ADPAW) •Alzheimer's Association Wisconsin Chapter •Wisconsin Adult Day Services Association (WADSA) •Wisconsin Association of Area Agencies on Aging (W4A) •Wisconsin Association of Benefit Specialists (WABS) •Wisconsin Association of Nutrition Directors (WAND) •Wisconsin Association of Senior Centers (WASC) •Wisconsin Institute for HealthyAging (WIHA) •Wisconsin Senior Advocates •Wisconsin Senior Corps Association (WISCA) •Wisconsin Tribal Aging Unit Association The Wisconsin Aging Advocacy Network (WAAN)is a collaboration of organizations and individuals working with and for Wisconsin's older adults to shape public policy and improve the quality of life for older people.WAAN advocates for all older adults by educating the community and policy makers on particular issues impacting older adults;mobilizing people on priority issues;and advocating for change. WAANState IssueBrief October 2022 WAAN's Position/Budget Request:Reduce the deaths,injuries,andpublic cost of Wisconsin's high rate offalls through a $378,000 annual budget appropriationfor the Falls Free Wisconsin Center—afalls prevention center of excellence that addresses the multiplefactors that influencefalls risk and delivers evidence-basedpreventionprograms and interventions across the state. The Scope and Cost of Older Adult Falls Nationally,one in four older adults experiences a fall each year,but Wiscon¬ sin has the nation's highest rate of deadly falls among older adults.1 Many assume Wisconsin's high death rate is due to the state's cold climate,but the majority of older adult falls occur in the home,and some states with similar climates have lower rates.From 2018-2020,there were 4,986 deaths due to falls among the 65+population in Wisconsin—nearly triple the number of people of all ages who died in motor vehicle accidents in the same period.2 Wisconsin's falls death rate rose 15 percent over that time period,exceeding the nationwide rate increase of 11percent.2 With the state's population aging, the problem is expected to grow. An estimated $1billion is spent annually on falls in Wisconsin which in¬ cludes both Medicaid and out-of-pocket expenses.3 Falls are a common cause of injury and disability.Ninety-five percent of hip fractures in older adults—a common cause of both long-term nursing home admissions and rehabilitation stays—are due to falls.1 In Wisconsin,the medi¬ an monthly cost for a semi-private room in a nursing home $9,022.4 Likewise, falls and their related injuries have a significant physical and financial impact on family caregivers.An AARP study revealed that family caregivers spend an average of $7,242 annually on out-of-pocket costs related to caregiving.5 Reducing Falls in Wisconsin The good news is we know how to save lives,preserve independence,and reduce costs by reducing the risk of falls.According to the Centers for Disease Control and Prevention (CDC),the rising number of deaths from falls among older adults can be addressed "by screening for fall risk and interveningto address risk fac¬ tors."The non-profit Wisconsin Institute for Healthy Aging,in partnership with Wiscon¬ sin's Department of Health Services (DHS) is poised to address the falls epidemic by launchingthe Falls Free Wisconsin Center. State funding will provide critically needed support for the center to lead a coordinated response to falls prevention that includes Wisconsin Has the highest rate of deadly falls among older people in the country. Wisconsin Aging |Advocacy |Network Contact WAAN Janet L.Zander,MPA,CSW Advocacy &Public Policy Coordinator Greater Wisconsin Agency on Aging Resources,Inc. 1414 MacArthur Rd.,Ste A Madison, Wl 53714 Office:(715)677-6723 Cell:(608)228-7253 janet.zander@gwaar.org Find this document and other WAAN issue briefs at: httos://awaar.ora/waan-is- sues-and-initiatives emergency services,health care and community-based interventions.WIHA is well-positioned to lead the coordinated effort and deliver evidence-based interventions that put falls prevention skills in the hands of older adults. WIHA's evidenced-based Stepping On program has been researched and proven to reduce falls by 31percent,with an average participant cost savings of $345.40.6 In another study,program participants experienced a 50 percent reduction in emergency department visits due to falls and a 50 percent reduc¬ tion in fall-related hospitalizations.7 WIHA partners with local aging offices and Aging and Disability Resource Centers (ADRCs),health care systems and the University of Wisconsin School of Medicine and Public Health providing statewide coordination,tools and training for outreach and delivery of proven,cost-effective programs. This funding will support the Falls Free Wisconsin Center to: •Enhance and maintain the infrastructure to support implementation of evi¬ dence-based falls-prevention programs and initiatives throughout the state; •Encourage uptake of evidence-based falls risk assessments and clinical and community-based interventions across Wisconsin; •Bring together and support the development of local falls-prevention coali¬ tions and initiatives as well as a statewide falls coalition; •Support ADRCs,county and tribal aging units,public health,and other local partners in developing and training falls prevention program leaders and recruiting participants; •Develop an online hub of falls prevention information and resources for consumers and community organizations; •Conduct a public education campaign to make older adults and their care¬ givers aware of the risk of falls and how they can prevent them; •Collect and analyze data to provide partners and the public with accurate information about the scope and impact of falls. 1.Centers for Disease Control and Prevention (CDC):https://www.cdc.gov/falls/data/fall- deaths.html 2.Wisconsin Department of Healthand Human Services (DHS)WIHS:https://www.dhs. Wisconsin.gov/wish/injury-mortality/icdlO-form.htm 3.Madison.com:https://madison.com/wsj/news/local/health-med-fit/wisconsin-still-has- nationshighest-rate-of-deadly-falls-among-older-adults/article b81e5663-0e29-5861-8e74- ca 7 409127138.html 4.Genworth:https://pro.genworth.com/riiproweb/productinfo/pdf/282102.pdf 5.AARP:https://www.aarp.org/caregiving/financial-legal/info-2021/high-out-of-pocket-costs. html#:~:text=According%20to%20a%20new%20AARP,and%20engagement%20officer%20 for%20AARP. 6.Clemson,Lindy,et al.,"The Effectivenessof a Community-Based Program for Reducing the Incidence of Falls inthe Elderly:A Randomized Trial,"Journal of American Geriatrics Society, 52:1487-1494,2004. 7.Bringing Healthy Aging to Scale:A Randomized Trial of a Quality Improvement Intervention to IncreaseAdoption of Evidence-Based Health Promotion Programs by Community Partners -ImplementationScience News,(https://news.consortiumforis.org/abstracts/bringing- healthy-aging-to-scale-a-randomizedtrial-of-a-guality-improvement-intervention-to- increase-adoption-of-evidencebased-health-promotion-programs-by-community-partners Wisconsin Aging |Advocacy |Network Core Member Organizations •Aging and Disability Professionals Association of Wisconsin (ADPAW) •Alzheimer's Association Wisconsin Chapter •Wisconsin Adult Day Services Association (WADSA) •Wisconsin Association of Area Agencies on Aging (W4A) •Wisconsin Association of Benefit Specialists (WABS) •Wisconsin Association of Nutrition Directors (WAND) •Wisconsin Association of Senior Centers (WASC) •Wisconsin Institute for HealthyAging (WIHA) •Wisconsin Senior Advocates •Wisconsin Senior Corps Association (WISCA) •Wisconsin Tribal Aging Unit Association The Wisconsin Aging Advocacy Network (WAAN)is a collaboration of organizations and individuals working with and for Wisconsin's older adults to shape public policy and improve the quality of life for older people.WAAN advocates for all older adults by educating the community and policy makers on particular issues impacting older adults;mobilizing people on priority issues;and advocating for change. WAANState IssueBrief November 2022 Caring for Wisconsin Family Caregivers The key to remaining independent,engaged and connected WAAN's Position:Caringfor Wisconsinfamily caregivers saves the state money,helps working caregivers remainin the workforce andprovides the supports needed to help sustain them in their caregiving roles. Budget Priorities 1.Create a Wisconsin state tax credit (up to $500)to ease the financial expenses of caregiving.A Wisconsin income tax credit reimburses family caregivers for expenses—like assistive technology,adult day services and other needed equipment and services purchased for their loved ones. 2.Expand Wisconsin Family and Medical Leave Policies.More Wisconsinites are filling the role of family caregiver and are struggling to maintain their outside employment.Many working caregivers are not covered by or able to access federal or state family and medical leave (FMLA)benefits including those who work for employers with fewer than 50 employees,workers caring for individuals outside their immediate family,and those who cannot afford to take unpaid leave.Expanding state leave polices to apply to employers with fewer than 50 employees and including grandparents,grandchildren,siblings and other extended family members or persons with close affinity relationship who are taking on increasing caregiving roles will save the state money,keep people working and provide the flexibility caregivers need to meet care responsibilities without fear of losing their job.Creating a paid family leave program would ensure those with access to family leave could afford to use it. 3.Increase Funding for Respite Service grants so more family caregivers can have access to respite opportunities and assistance to help pay for respite services. Legislative Requests 1.Keep flexibility in the Alzheimer's Family and Caregiver Support Program (AFCSP).The caregiver workforce shortage and growth in the aging population place increased demands on family caregivers.Waivers provided during the COVID-19 pandemic have allowed the AFCSP program to pay family members to provide respite care and lift the annual 112-hour cap on respite care.It is essential to continue these practices beyond 2023.Family caregivers are leaving the workforce or reducing their work hours to meet caregiving obligations.A family stipend for care is necessary for individuals to stay at home,in their community,for as long possible. 2.Update AFCSP—The program places a $4,000/year cap on payment for goods and services for each person with Alzheimer's disease in the household or facility (s.46.87 (6)(b)l.).This cap amount was set in 1985 and is very out of date.According to the CPI Inflation Calculator,the current amount if adjusted for inflation would be equivalent in purchasing power to about $11,000 today.1The annual cap needs to be increased to at least $11,000 and include annual adjustments for inflation. 3.Pass the CARE Act—The Caregiver Advise,Record,Enable (CARE)Act includes provisions to keep family caregivers informed about discharge plans for the patient and ensures caregivers receive explanation and training (as needed)for medical tasks they will need to perform at home. Approximately 80 percent of care at home is provided by unpaid caregivers who spend an average of 20 hours a week giving care.2 The majority (65 percent)of older adults with long-term care needs depend exclusively on family and friends,while nearly one-third (30 percent)supplement the care received from family with support provided by paid providers.Whether an older person can remain at home is often dependent on the availability of care provided by family and friends.3 Caregiving responsibilities include such tasks as grocery shopping,meal preparation,housekeeping,appointment scheduling and transportation,and often also include more intensive responsibilities like assisting with personal care (bathing,dressing,feeding), medication management and medical care (wound care,injections and other medical treatments). There are nearly 600,000 family caregivers in Wisconsin providing an estimated 490 million hours of care valued at $6.9 billion annually.4 According to a recent AARP report,over 60 percent of caregivers indicated they were also working full or part-time.5 The Wisconsin Employer and Family Caregiver Survey (2021)indicates 8 in 10 caregivers reported having their work life interrupted and more than half of working caregivers indicated their current situation is unsustainable.Nearly half (47 percent) of caregivers reported they have reduced their work hours 24 percent)or are considering leaving the workforce (23 percent).6 Individuals do not provide caregiving in isolation from the other roles and responsibilities in their lives.Family caregivers are also spouses/partners, parents,adult children,employees,community members and more.Each of these roles intersect with caregiving in different ways and at different times. According to recent AARP research,nearly 80 percent of people caring for an adult family member face regular out-of-pocket costs averaging annual spending of over $7,000 (an average of 26 percent of their income).Younger caregivers,those who are Hispanic/Latino or African American,and those caring for someone with Alzheimer's disease/dementia or mental health issues shoulder the highest financial burdens.7 As caregiving responsibilities grow in number and complexity,costs associated with caregiving roles become increasingly harder to finance,and caregiving can overwhelm and undermine other dimensions of one's life. initiatives AFCSP funding has helped to offset the cost of his participation in adult day services- Receiving no other financial assistance, ever little bit helps toward easing the financial burden of his care. —A Brown County caregiver who provides carefor her husband living with dementia Wisconsin Aging |Advocacy |Network Contact WAAN Janet L.Zander,MPA,CSl/l/ Advocacy &Public Policy Coordinator Greater Wisconsin Agency on Aging Resources,Inc. 1414 MacArthur Rd.,Ste A Madison, Wl 53714 Office:(715)677-6723 Cell:(608)228-7253 janet.zander@gwaar.org Find this document with complete references and other WAAN issue briefs at: httDs://awaar.ora/waan-issues-and- 1.CPI Inflation Calculator 2.Administration for Community Living-LongTermCare.gov.Who Will Provide Your Care? Feb.18,2020.Retrieved on July 29,2022 from https://acl.gov/ltc/basic-needs/who- will-provide-your-care#:~:text=About%2080%20percent%20of%20care,hours%20a%20 week%20giving%20care. 3.Family Caregiver Alliance,National Center on Caregiving.Women and Caregiving;Facts and Figures.May 2003.Retrieved on July 18,2022 from https://www.caregiver.org/ resource/women-and-caregiving-facts-and-figures/#. 4.AARP Public Policy Institute,Valuing the Invaluable 2019 Update:Charting a Path Forward,State Estimates.Washington,D.C.:AARP.Nov.2019.Retrieved on July 15,2022 from https://www.aarp.org/content/dam/aarp/ppi/2019/ll/family-caregivers-data-by- state.pdf. 5.AARP and NationalAlliance for Caregiving.Caregiving in the United States 2020. Washington,DC:AARP.May 2020.https://doi.org/10.26419/ppi.00103.001. 6.The Wisconsin Family and Caregiver Support Alliance.Wisconsin Employer and Working Caregiver Survey.May 2022.Retrieved on July 26,2022 from https://wisconsincaregiver. org/employer-engagement-workgroup. 7.Skufca,Laura,and Chuck Rainville.Caregiving Out-of-Pocket Costs Study 2021. Washington,DC:AARP Research,June 2021.https://doi.org/10.26419/res.00473.001. Wisconsin Aging |Advocacy |Network Core Member Organizations •Aging and Disability Professionals Association of Wisconsin (ADPAW) •Alzheimer's Association Wisconsin Chapter •Wisconsin Adult Day Services Association (WADSA) •Wisconsin Association of Area Agencies on Aging (W4A) •Wisconsin Association of Benefit Specialists (WABS) •Wisconsin Association of Nutrition Directors (WAND) •Wisconsin Association of Senior Centers (WASC) •Wisconsin Institute for HealthyAging (WIHA) •Wisconsin Senior Advocates •Wisconsin Senior Corps Association (WISCA) •Wisconsin Tribal Aging Unit Association The Wisconsin Aging Advocacy Network (WAAN)is a collaboration of organizations and individuals working with and for Wisconsin's older adults to shape public policy and improve the quality of life for older people.WAAN advocates for all older adults by educating the community and policy makers on particular issues impacting older adults;mobilizing people on priority issues;and advocating for change. WAANState IssueBrief November 2022 Reinforce Nutrition Services for Homebound Seniors Protect the Accessibility of Older Americans Act Nutrition Programs WAAN's Position:Senior hunger andisolation are growing criticalsocial issues effectively combatedby OlderAmericans Act Senior NutritionPrograms. These programs needsupport andfiscalbacking to maintainaccess to these crucialservicesfor the growing agingpopulation of Wisconsin. Budget Request •Protect vulnerable older adults by increasing the state contribution to Home-Delivered Meal (HDM)Services from the current level of $396,000 to $5.95 million.This increase would enable HDM programs across the state to meet rising needs.This also provides state funding for HDM services equal to the state funding for congregate nutrition services. Over their 50-year history,both programs have demonstrated positive impact on the health and well-being of the growing senior population. The Older Americans Act (OAA)HDM program has proven to be an effective way to address the growing crisis of hunger and isolation among seniors.The program's focus on nutritious food,social visits,safety checks and connection to other community services ensures that seniors receive the support they need to live more nourished and independent lives in their homes.The pro¬ gram saves taxpayer dollars by avoiding costly and preventable healthcare ex¬ penditures paid for through Medicaid,Medicare and/or personal resources. The state average cost to deliver a meal to a homebound senior is $11.93,1 comparatively the cost of one day in a nursing home is $286.00 and the cost of one day in the hospital is $2,558.00.2 When surveyed3 about their satisfaction with the senior nutrition program, HDM recipients said: "Meals are delicious, more than enough, nice variety and very healthy.For all of us who can't cook,thank you." "Having someone check on me means a lot.The program helps me to stay in my apartment." "I feel safe because my driver alerted police when I fell and waited until help arrived.There are some days when I have trouble moving around and it is hard to cook." Home-Delivered Meals have helped me because then I don't have to worry about cooking as I have shaky hands.I am also able to get a nutritious meal daily.The drivers are very nice and friendly,and I enjoy seeing them every day. —Beverly,89-year old Barron County resident Wisconsin Aging |Advocacy |Network Contact WAAN Janet L.Zander,MPA,CSW Advocacy &Public Policy Coordinator Greater Wisconsin Agency on Aging Resources,Inc. 1414 MacArthur Rd.,Ste A Madison, Wl 53714 Office:(715)677-6723 Cell:(608)228-7253 janet.zander@gwaar.org Find this document and other WAAN issue briefs at: httos://awaar.ora/waan-is- sues-and-initiatives •"The meals are healthy,well balanced.The volunteers are always kind- hearted and nice to talk to when they deliver." The HDM survey data for 2021 for Wisconsin (n=6,259),3 also indicates that for participants: •Program meals make up half or more of their total daily food intake—69 percent •Meal delivery provides: •Someone to talk to—47 percent •A sense of safety and security—45 percent •A link to get more support if needed—34 percent •Something to look forward to—66 percent The HDM services provided by the Elderly Nutrition Programs support a vulnerable population of older adults.Many HDM participants live alone (62 percent),are homebound and express that at least some of the time they lack companionship (51 percent)and feel left out (42 percent)and isolated (44 percent).3 The ability to access these crucial services in a timely and consistent manner is key to the program's successful intervention to support the health and independence of older adults.The program's accessibility is currently under threat statewide due to stagnant funding (no increase in funding since pro¬ gram implementation in the mid-80's),a growing aging population accom¬ panied by unprecedented levels of demand,and increased expenses driven by inflation and a lack of resources.The COVID-19 pandemic exposed critical levels of unmet need across the senior population in Wisconsin.This is evi¬ denced by the fact that collectively program allocations are being depleted at twice the rate of the annual budget revenues (some programs have spent the total year's allocation at the six-month mark)coupled with an increase of over 200,000 meals (6 percent increase)served annually when compared to pre-pandemic operations. The temporary operations flexibilities allowed during the public health emer¬ gency and the corresponding supplemental funding are currently propping up the operations of HDM services.Statewide,program leadership is prepar¬ ing for widespread budget insufficiencies when these flexibilities and supple¬ mental funding expire.According to the Wisconsin Association of Nutrition Directors,82 percent of programs surveyed statewide anticipate a need to prioritize meal services,reduce meal services and/or institute waiting lists if funding remains stagnant.4 We urge the state legislature to protect this criti¬ cal service for older adults by increasing the state contribution to the home delivered meals program. 1.Based on the 2022 average home-delivered meal cost submitted by 76%of the meal programs in Wisconsin 2.Wisconsin Fact Sheet.(2022,February).Facts &Resources.Retrieved November 1,2022, from https://www.mealsonwheelsamerica.org/learn-more/facts-resources 3.2021Wl Elder Nutrition Program Home Delivered Meal Satisfaction Survey 4.Wisconsin Association of Nutrition Directors 2022 Membership Nutrition Advocacy Survey Wisconsin Aging |Advocacy |Network Affordable,Accessible and Available Housing Honor older adults desire to age in place. Core Member Organizations •Aging and Disability Professionals Association of Wisconsin (ADPAW) •Alzheimer's Association Wisconsin Chapter •Wisconsin Adult Day Services Association (WADSA) •Wisconsin Association of Area Agencies on Aging (W4A) •Wisconsin Association of Benefit Specialists (WABS) •Wisconsin Association of Nutrition Directors (WAND) •Wisconsin Association of Senior Centers (WASC) •Wisconsin Institute for HealthyAging (WIHA) •Wisconsin Senior Advocates •Wisconsin Senior Corps Association (WISCA) •Wisconsin Tribal Aging Unit Association The Wisconsin Aging Advocacy Network (WAAN)is a collaboration of organizations and individuals working with and for Wisconsin's older adults to shape public policy and improve the quality of life for older people.WAAN advocates for all older adults by educating the community and policy makers on particular issues impacting older adults;mobilizing people on priority issues;and advocating for change. WAANState IssueBrief November 2022 WAAN's Position:Advance opportunities for housing that is affordable, accessible,andappropriate to the needs andexpectations of Wisconsin residents as they age.Create housingsecurity and quality supportive options available to all who needthem.Address socialinequities by creating opportunities to generate,preserve,andpass on wealth through housingfor older adults of color. Older adults overwhelmingly want to remain in their homes and communities,but major barriers persist such as unaffordability, inaccessibility,discrimination,and the lack of appropriate options,including available quality supportive housing that is affordable.The burden of housing affordability,as well as housing insecurity,has grown among homeowners and renters alike.Aging in the community within quality housing leads to better health outcomes,life satisfaction,and social engagement.To preserve the health and well-being of older adults,we must ensure more affordable, accessible,and high-quality housing is available for both renters and owners. Budget Priorities For Older Homeowners •Double the qualifying household income limit to $40,000 for the Wisconsin Housing and Economic Development Authority (WHEDA)property tax de¬ ferral loan program that provides loans to qualifying homeowners 65 years of age or older or a qualified veteran to pay up to $3,525 for property taxes. Such loans are recovered upon the sale of the property. Wisconsin Aging |Advocacy |Network Contact WAAN Janet L.Zander,MPA,CSW Advocacy &Public Policy Coordinator Greater Wisconsin Agency on Aging Resources,Inc. 1414 MacArthur Rd.,Ste A Madison, Wl 53714 Office:(715)677-6723 Cell:(608)228-7253 janet.zander@gwaar.org Find this document and other WAAN issue briefs at: httos://awaar.ora/waan-is- sues-and-initiatives •Establish a forgivable matching loan fund for low-income older homeown¬ ers to add assistive technology,home energy conservation measures,or accessibility modifications in urban areas modeled upon the United States Rural Development Section 504 Home Repair program. •Create a "Wisconsin Restorative Housing Program"to revitalize,preserve, stabilize,and increase homeownership for Wisconsinites of color through direct grants to homeowners for down payment/closing cost assistance, mortgage assistance,and home improvement assistance.1 For Older Renters •Create and provide $600,000 to fund a Housing Navigation Program to provide support to property owners and tenants by addressing housing responsibilities,reducing conflict,and avoiding unnecessary evictions,and to connect older adults with housing options that meet their needs.1 •Create and provide $2 million/annually to create a program to provide small grants to landlords to bring affordable housing units online.1 For Older Adults Who Are Homeless or Seeking More Affordable Housing •Increase the state Housing Tax Credit Program limit from $42 million/year to $100 million/year to pro¬ mote affordable housing development.An increase in state tax credits,paired with federal low-income housing tax credits,is projected to lead to the creation of ap¬ proximately 1,000 additional affordable housing units per year.1 •Increase Homelessness Prevention Program funding by $1 million/year to provide the additionally funding needed to make grants or loans to peo¬ ple or families of low or moderate income to defray housing costs (with priority given to individuals/families who are homeless).1 •Pursuant to 2019 Wisconsin Act 76,require the Department of Health Ser¬ vices to submit a Medicaid state plan amendment to allow Wisconsin Medic¬ aid to pay for housing supports for Medicaid and BadgerCare Plus members.1 Housing is one of the basic needs for healthy,safe and vibrant communities. Addressing affordability,accessibility,and supply issues,as well as discrimina¬ tion,will enable more older adults to remain in their homes and communities. Wisconsin has the second-highest rate of extreme cost burden for low-income homeowners in the Midwest —63.5%of low-income homeowners pay more than 50% of their incomes to housing.2 1.State of Wisconsin Interagency Council on Homelessness,2021-2023-Welcoming Wisconsin Home:A Statewide Action Plan for Homelessness,retrieved on Nov 11,2022 from 22.2.28 -2021Welcoming Wisconsin Home Report Final,https://doa.wi.gov/ Documents/WelcomingWisconsin Home.pdf 2.Office of the State Treasurer,HomeownershipTask Force Report,Published May of 2021. Retrieved on October 18,2022 from Office of the State Treasurer_Homeownership Task Force Report_FINAL (wi.gov) Wisconsin Aging |Advocacy |Network Reliable,Accessible and Affordable Transportation The key to remaining independent,engaged and connected Core Member Organizations •Aging and Disability Professionals Association of Wisconsin (ADPAW) •Alzheimer's Association Wisconsin Chapter •Wisconsin Adult Day Services Association (WADSA) •Wisconsin Association of Area Agencies on Aging (W4A) •Wisconsin Association of Benefit Specialists (WABS) •Wisconsin Association of Nutrition Directors (WAND) •Wisconsin Association of Senior Centers (WASC) •Wisconsin Institute for HealthyAging (WIHA) •Wisconsin Senior Advocates •Wisconsin Senior Corps Association (WISCA) •Wisconsin Tribal Aging Unit Association The Wisconsin Aging Advocacy Network (WAAN)is a collaboration of organizations and individuals working with and for Wisconsin's older adults to shape public policy and improve the quality of life for older people.WAAN advocates for all older adults by educating the community and policy makers on particular issues impacting older adults;mobilizing people on priority issues;and advocating for change. WAANState IssueBrief November 2022 WAAN's Position:Support increasedfundingfor public andspecialized transportation andsupport policies incentivizingcoordination of transportation services,encouraging volunteer driving,and authorizing localunits of government to raise revenuefor transportation services. Budget Requests 1.Increase the capital and operation assistance program funding for specialized transportation (s.85.22)by 20%($192,000)to assist with operations,replacement or acquisition of new transit vehicles and expand mobility management services needed to meet our needs as we age. Public transit and specialized transportation are critical infrastructure for the non-driving public,economic growth,and overall quality of life. 2.Restore transit funding for Milwaukee and Madison to 2019-2021levels, incorporate annual inflationary increases for mass transit assistance and specialized transportation assistance for counties and tribes (s.85.20,s.85.21,and s.85.215 respectively)to ensure we can maintain our existing system,and create and fund a dedicated specialized transportation fund to support voting related transportation needs (DMV,clerk's office,early voting locations,polling sites). 3.Create a dedicated transportation funding source within Home and Community-Based Services (HCBS)Medicaid waiver programs for older adults and adults with disabilities.Increasingtargeted transportation funding for HCBS programs would ensure access to contracted transportation services for Manage Care Organizations (MCOs),improving Wisconsin Aging |Advocacy |Network Contact WAAN Janet L.Zander,MPA,CSW Advocacy &Public Policy Coordinator Greater Wisconsin Agency on Aging Resources,Inc. 1414 MacArthur Rd.,Ste A Madison, Wl 53714 Office:(715)677-6723 Cell:(608)228-7253 janet.zander@gwaar.org Find this document and other WAAN issue briefs at: httos://awaar.ora/waan-issues-and- initiatives MCOs capacity to supply participants (including those living in residential care facilities)with transportation services that meet their full needs as active and independent members of their communities. Legislative Requests 1.Create a state-level Transportation Coordination Council with representation from all state agencies operating,supporting,or usingtransportation services,as well as representatives from the aging,Veteran,provider,and disability communities.Coordination of transportation resources expands access and stretches needed resources.WAAN supports incentivizing coordination among state and local transportation systems,including the creation of a statutory Transportation Coordination Council. 2.Develop and pass legislation to modify state law to prohibit an insurer from increasingthe rating,or denying,nonrenewing,or cancelling an insured solely for acting as a volunteer driver or for reimbursement of actual expenses,includingmileage reimbursement.Volunteer driver programs are an effective use of private resources for the public good. Some volunteer drivers find it difficult to obtain liability insurance because they are transporting others or being reimbursed for travel related expenses.Some insurance agencies classify any mileage reimbursement as compensation as a for-profit Transportation Network Company. 3.Develop statutory authority allowing local units of government the ability to raise revenue for transportation service needs.Local units of government are in dire need of transportation funding to be able to provide sustainable public and specialized transportation.Statutory authority is needed to permit local units of governments,collaboratively, to raise sustainable funds to provide reliable,affordable,and accessible transportation options to all. Transportation services support the health,well-being,financial security, independence,and community engagement of Wisconsinites who do not drive,as well as advances economic development,employment,and financial security for all Wisconsinites.Specialized transportation funding and coordination: supports family caregivers by enabling them to remain employed and reducing lost productivity. drives economic growth by increasing livability through infrastructure investment. keeps us healthy by providing access to preventive and routine healthcare. reduces household costs by providing alternatives to buying and maintaining a personal vehicle. promotes independence by increasing access to community resources. increases socialization by providing opportunities to engage in the community. Wisconsin Aging |Advocacy |Network Core Member Organizations •Aging and Disability Professionals Association of Wisconsin (ADPAW) •Alzheimer's Association Wisconsin Chapter •Wisconsin Adult Day Services Association (WADSA) •Wisconsin Association of Area Agencies on Aging (W4A) •Wisconsin Association of Benefit Specialists (WABS) •Wisconsin Association of Nutrition Directors (WAND) •Wisconsin Association of Senior Centers (WASC) •Wisconsin Institute for HealthyAging (WIHA) •Wisconsin Senior Advocates •Wisconsin Senior Corps Association (WISCA) •Wisconsin Tribal Aging Unit Association The Wisconsin Aging Advocacy Network (WAAN)is a collaboration of organizations and individuals working with and for Wisconsin's older adults to shape public policy and improve the quality of life for older people.WAAN advocates for all older adults by educating the community and policy makers on particular issues impacting older adults;mobilizing people on priority issues;and advocating for change. WAANState IssueBrief November 2022 Protect the Right to Vote Support Safe,Secure,and Accessible Voting for All WAAN's Position:Support improvements to the voting process to ensure every eligible older adult (andadult with disabilities)who wants to vote, can vote,no matter where they live. Over the past several years,voting in Wisconsin has become increasingly more difficult,if not impossible for many people,especially for older voters and peo¬ ple with disabilities.These folks need "enhanced access"which allows them to vote with the necessary support and assistance.Many older adults and people with disabilities experience barriers to voting in person and rely on absentee voting.Maintaining access to voting by mail (including permanently for indefinitely confined voters)is critical. It is unclear and sometimes confusing,as to who can provide assistance to individuals residing in facilities (nursing homes,assisted living facilities,group homes)and whether those assistors are trained to provide all the support individuals may need to vote. Budget Requests 1.Increase DMV access by: •Expanding service hours at existing DMV locations to include expand¬ ed weekday hours and Saturday hours in the four weeks preceding a statewide election,and •Co-locating DMV state identification (ID)operations at locations currently accessed by non-drivers and people with disabilities such as Aging and Disability Resource Centers,income maintenance offices, and human service departments. 2.Allocate additional funding for specialized transportation programs (Wis.Stat.§85.21 and §85.215)to fund transportation for voting relat¬ ed activities includingtransportation to the DMV,municipal clerks,early voting locations,and to polling sites on election day. 3.Allocate additional funding to the Wisconsin Elections Commission for expansion of the Polling Place Accessibility Audits program (to fund an increased number of audits conducted on Election days)and the Acces¬ sibility Supply Program providing cost effective and simple solutions to address accessibility issues at polling places. Legislative Requests 1.Enhance Election Inspector (aka poll worker)/Special Voting Deputy (SVD)training—There is wide variation in the content and amount of training election inspectors and SVDs (who conduct absentee voting in person inside residential care facilities and qualified retirement homes) receive.Wis.Stat.§7.315(l)(b)requires all election inspectors and SVDs receive training at least once every two years.To ensure election inspectors have up-to-date information of voting regulations and voter rights,change the state statute to require new election inspectors and SVDs to complete training on core competencies (including disability ÿ ÿÿÿÿ VOTE ÿ ÿÿÿÿ Wisconsin Aging |Advocacy |Network Contact WAAN Janet L.Zander,MPA,CSW Advocacy &Public Policy Coordinator Greater Wisconsin Agency on Aging Resources,Inc. 1414 MacArthur Rd.,Ste A Madison, Wl 53714 Office:(715)677-6723 Cell:(608)228-7253 janet.zander@gwaar.org Find this document and other WAAN issue briefs at: httns://awaar.ora/waan-is- sues-and-initiatives related content)before serving and a minimum of one training pro¬ gram annually,thereafter. 2.Improve access to obtaining a photo ID for voting by: •Expanding acceptable photo ID options for voting to be inclusive of non-drivers.Options for consideration include:any photo ID card issued by the Federal Government,the state of Wisconsin,or a Wis¬ consin county,municipal government,or other governmental entity; college and university ID cards from all Wisconsin colleges and techni¬ cal schools;Wisconsin high school photo ID cards;and an affidavit of affirmation for voters who have reasonable impediments to obtaining a photo ID;and •Expanding online services at the DMV by makingthe forms (MV3004 and MV3012)used to apply for a Wisconsin ID or paper receipt for voting (when the voter does not have certain documenta¬ tion)available online. 3.Improve access to secure,equitable and private absentee voting by: •Providingaccess to absentee voting by creating a screen reader acces¬ sible,Americans with Disabilities (ADA)compliant,absentee ballot for voters with blindness,vision or other disabilities that restrict them from physically markingan absentee ballot and who rely on assistive technology to vote privately and independently,and •Changing Wis.Stat.§6.87(4)(b)l to include ADA accessible and secure drop boxes as an allowable method for returningan absentee ballot. Drop boxes have long been available in some Wisconsin communities and around the country.A recent review,conducted by the Associated Press,of the use of the boxes across the country determined that no state reported "any instances in which the boxes were connected to voter fraud or stolen ballots,"nor were there incidents of vandalism that might have affected election results by destroying ballots." 4.Improve access to voting for care facility residents by: •Developing a protocolto ensure all eligible facilities offer SVD services; •Changing Wisconsin law (§6.875(2)(a))to allow all SVDs (as an extension of the municipal clerk's office)to assist residents with vot¬ er registration (as needed)and voting absentee in person; •Modifying the timeline for conducting SVD visits ((§6.875(6)(a))to expand the amount of time SVD visits overlap with open registra¬ tion timelines and to allow adequate time for care facility residents who were unable to vote during the SVD visits to receive,complete and return their absentee ballots by mail;and •Ensuring the processfor allowing relatives of residents to be noti¬ fied of and/or observe the voting process (Wis.Stat.§6.875(6)(c)2) complies with federal Residents'Rights Requirements related to Nursing Home Residents'Right to Vote (https://www.cms.gov/files/ document/qso-21-02-nh.pdf). Older adults and people with disabilities contribute to our state's high partic¬ ipation rate.Wisconsin must take the necessary steps to ensure secure and accessible voting are available to all eligible voters. Rev. 02-09-2023 GWAAR Nutriton Team PLEASE SEE THE OTHER SIDE Privacy Statement: “The information you are being asked to provide is needed to determine if you are eligible to receive Older Americans Act Services and to comply with federal reporting requirements. This information will be stored in a secure electronic database and will not be used for any other purpose. Your information will not be shared with another agency without your permission. This information will not be sold to anyone. You have the right to review your electronic record and request changes to assure accuracy. You will not be denied most services if you refuse to provide this information. If you have questions regarding this, please ask the aging unit staff.” HOME DELIVERED MEAL REGISTRATION ENHANCED DETERMINE (2023) Person/Agency Making Referral: ___________________________________ Date of Referral:Click or tap to enter a date. Name (First, MI, Last): Click or tap here to enter text. Date of Registration: Click or tap to enter a date. Residential Address (Fire No. & Street): Click or tap here to enter text. Date of Birth (month/day/year): XX/XX/XXXX City/State/Zip: Click or tap here to enter text. Phone Number (with area code): Click or tap here to enter text. Gender Identity: ☐ Male ☐ Female ☐ Transgender Male ☐ Transgender Female ☐ Self-Describe (specify): ________________________ ----------------------------------------------- Preferred Language: ☐ English ☐ Spanish ☐ Hmong ☐ Other: ___________________ Race: ☐ American Indian or Alaska Native ☐ Asian or Asian American ☐ Black or African American ☐ Native Hawaiian or Pacific Islander ☐ White ☐ Other: _____________________ ------------------------------------- Ethnicity: ☐ Hispanic or Latino ☐ Not Hispanic or Latino Household: ☐ I live alone. ☐ I live with others. --------------------------------------------------------- Income Status: Is your income at or below the following guidelines based on the number in your home? ☐ Yes ☐ No # in Home Month / Year 1 $1,215 $14,580 2 $1,643 $19,720 3 $2,072 $24,860 4 $2,500 $30,000 Activities of Daily Living (ADLs) Check Yes for each ADL that you/the client need substantial assistance to complete (including verbal reminding, physical cuing, or supervision). Check No for each ADL you can complete without substantial assistance. No Help Needed Yes, Needs Help Bathing: Gets in and out of the bath or shower, uses faucets, washes, and dries oneself safely. Dressing: Dresses and undresses safely. Toileting: Uses toilet and cleans oneself. Transferring: Moves in and out of bed or chair. Feeding: Gets food or drink from plate, bowl, or cup into mouth and uses utensils. Continence: Exercises complete self-control. TOTAL Number of Yes ADLs _________ Instrumental Activities of Daily Living (IADLs) Check Yes for each IADL that you/the client need substantial assistance to complete (including verbal reminding, physical cuing, or supervision). Check No for each IADL you can complete without substantial assistance. No Help Needed Yes, Needs Help Food Preparation: Plans, prepares, and serves adequate meals independently. Shopping: Takes care of all shopping needs independently. Medication Management: Takes medication in correct dosages at correct time. Ability to Manage Finances: Handles financial matters and/or day-to-day purchases. Housekeeping: Participates in housekeeping tasks. Laundry: Launders some items independently. Mode of Transportation: Travels unassisted via personal vehicle, public transportation, or taxi. Ability to Use Telephone: Dials and/or answers the telephone. TOTAL Number of Yes IADLs _________ Rev. 02-09-2023 GWAAR Nutriton Team For each of the following statements, please tell me which one is “often true,” “sometimes true” or “never true” for the past 12 months. Often True Sometimes True Never True 1. We (I) worried whether our food would run out before we (I) got money to buy more.  Yes*  Yes*  Yes 2. The food that we (I) bought just didn't last and we (I) didn't have money to get more.  Yes*  Yes*  Yes *= Food Insecure ☐ Yes ☐ No Have you recently lost weight without trying? ☐ No (0) ☐ Unsure (2) ☐ Yes If yes, how much weight have you lost? ☐ 2-13 pounds (1) ☐ 14-23 pounds (2) ☐ 24-33 pounds (3) ☐ 34 pounds or more (4) ☐ Unsure (2) 2. Have you been eating poorly because of a decreased appetite? ☐ No (0) ☐ Yes (1) Weight loss score: ___ Appetite Score: ___ = Total Score: ___ ☐ At high nutrition risk if all 3 are True ☐ DETERMINE Score (6+) ☐ Weight/Appetite Score (2+) ☐ Food Insecure Reason(s) home-delivered meals are needed (check all that apply): ☐ Individual is frail and essentially homebound by reason of illness, disability, or isolation. ☐ Spouse or domestic partner of a person eligible for a HDM and participation is in the best interest of the homebound older individual. ☐ Adult under age 60 with a disability and resides at home with an eligible older individual participating in the program. ☐ Individual is unable to leave home under normal circumstances. ☐ Individual is unable to participate in the congregate meals program because of physical or emotional problems. ☐ No spouse, domestic partner, or other adult living in same household who is both willing and able to prepare meals. ☐ Individual is unable, either physically or emotionally, to obtain food and prepare adequate meals. ☐ Other: ________________________________________________________ \ Program Contributions ☐ Participant would like a contribution letter mailed to home. ☐ Participant will make contributions directly. Do NOT mail a contribution letter. ☐ IRIS/Family Care will be paying for the meals. ☐ Someone else who will be contributing on behalf for meals. PLEASE COMPLETE THE SUMMARY SHEET Send contribution letter to: Name: ___________________________________ Address: _________________________________ _________________________________________ _________________________________________ Phone: ________ Email: ____________________ DETERMINE Questions No Yes I have an illness or condition that made me change the kind and/or amount of food I eat. 0 2 I eat fewer than 2 meals per day. 0 3 I eat few fruits or vegetables or milk products. 0 2 I have 3 or more drinks of beer, liquor or wine almost every day. 0 2 I have tooth or mouth problems that make it hard for me to eat. 0 2 I don't always have enough money to buy the food I need. 0 4 I eat alone most of the time. 0 1 I take 3 or more different prescribed or over-the-counter drugs a day. 0 1 Without wanting to, I have lost or gained 10 pounds in the last 6 months. 0 2 I am not always physically able to shop, cook, and or feed myself. 0 2 Risk Level: ___ 0-2 Low ___3-5 Moderate ___6 + High TOTAL _________ Emergency Contact: _________________________________ Relationship: ____________________ Phone: _________________________ Email: _____________________________________________ DRAFT GWAAR Nutrition Team Updated 2-9-23 3 Home Delivered Meals Summary Page HDM Assessors to Complete ☐ Initial Assessment ☐ Reassessment Recipient Name: _________________________________ Phone: _________________________________ Address: _________________________________ DOB: _________________________________ HDM Start or Reassessment Date: select date Please complete the following assessment information to verify eligibility. Is the person on My Choice Family Care, iCare, or IRIS? ☐ Yes ☐ No If yes, refer the client to their Partnership or Family Care Case or Care Manager to authorize home-delivered meals. ☐ Authorization Received Date: Click or tap to enter a date. DO NOT CONTINUE BELOW BASIC ELIGIBILITY REQUIREMENTS: Must Check ONLY One. ☐ Age 60+: Is frail and/or currently essentially homebound by reason of illness, disability or isolation. Homebound is defined as “does not leave home under normal circumstances.” ☐ Relational Exception: A spouse of a person eligible for HDM’s regardless of age or condition, if assessment concludes it is in the best interest of the homebound older individual. ☐ Relational Exception: A disabled individual who resides at home with an eligible older individual participating in the program. ☐ Eligible to receive meals for ☐ 3 months ☐ 6 months ☐ 1 year ☐ Other _____________ ☐ Not eligible to receive meals (please indicate reason) Click or tap here to enter text. Approval for Number of Meals per week: Check the box that corresponds with the Prioritization Tier ☐ Tier 3 = 5 days per week ☐ Tier 3 = Weekend meals ☐ Breakfast Meals ☐ 2 Meals a Day ☐ Tier 3 = _____ Liquid Nutritional Supplements ☐ With Meals ☐ Bulk Pick Up ☐ Tier 2= ___ days per week ☐ Tier 1= ___ days per week ☐ Case Manager overriding Nutrition Risk Score and approving _______ # of meals each week (please indicate reason) Click or tap here to enter text. Concerns to Follow-Up On: Click or tap here to enter text. ☐ Referral Form Completed Assessor Name: Click or tap here to enter text. Date of Assessment: Click or tap to enter a date. DRAFT GWAAR Nutrition Team Updated 2-9-23 4 Referral Summary Form (Optional) Participant’s Name:_____________________________________ Date: Click or tap to enter a date. Make Referral to/for: Notes Make Referral to/for: Notes Person Filling out Form: Insert Name ☐ Home Repair/House Keeping/Yard work/Appliance Concerns ☐ Activities and Socialization ☐ Honor Flight Information ☐ Adaptive Equipment ☐ Independent Living Center ☐ Adult Protective Services ☐ Library ☐ Alcohol Abuse & Addiction Resources ☐ Malnutrition Resource List ☐ Appliance Repair/Concerns ☐ Medically Tailored Meal/Special Diet ☐ Caregiver Support ☐ Medication Review ☐ Pill Box ☐ Case Manager ☐ Memory Screen ☐ Cooking for 1 or 2 Ideas and Recipes ☐ Music Therapy ☐ Craft/Color Pages/Kits ☐ Non-Dairy Milk Option ☐ Dementia Care Specialist (DCS) ☐ Options Counselor ☐ Dentist ☐ Pet Support ☐ Dietitian ☐ Pharmacist ☐ Eat-10 Screen (Swallow concerns) ☐ Pill Box ☐ Eating Disorder Resources ☐ Resource Directory ☐ Elderly Benefit Specialist (EBS) ☐ Senior Center List ☐ Energy Assistance ☐ Senior Dining/Grab-N-Go Location List ☐ Evidence-Based HP or Wellness/Nutrition Class ☐ Senior Farmers Market Vouchers ☐ Food on a Budget Ideas ☐ Support Group or Additional Resources (Specify) ☐ Food Pantry/Mail Order Meals List ☐ Technology Assistance ☐ Foodshare ☐ Transportation ☐ Friendly Visitor/Caller Program ☐ UW Extension ☐ Grandparents Support ☐ Veterans Officer ☐ Grocery Delivery ☐ Volunteer Opportunities ☐ Healthcare Provider ☐ Weekend or additional meals/liquid supplements or snacks: ☐ Hearing and/or vision resources ☐ Other: Click or tap here to enter text. DRAFT GWAAR Nutrition Team Updated 2-9-23 5 Meal Prioritization Worksheet (Option 1) DATA POINTS FOR MEAL PRIORITIZATION 1. DETERMINE Nutrition Risk Level: ☐ Low Risk (0-2) ☐ Moderate Risk (3-5) ☐ High Risk (6 to 21) 2. MST Malnutrition Screen Score: ☐ Not at Risk (0 to 1) ☐ At Risk (2 to 5) 3. Food Insecure? ☐ Yes ☐ No 4. Poverty Income at or below the following guidelines? ☐ Yes ☐ No ☐ Unknown 5. Lives Alone ☐ Yes ☐ No but alone during the day- no support ☐ No and has supports 6. ADL/IADL: 3 + of the following ADLs/IADLs: ☐ Transferring ☐ Feeding ☐ Food Prep ☐ Shopping ☐ Transportation ☐ Ability to use phone ☐ Yes 3 or more ☐ No ADDITIONAL NOTATIONS: ☐ Case Manager overriding Nutrition Risk Score and approving _______ # of meals each week (please indicate reason) ☐ Eligible to receive meals for ☐ 3 months ☐ 6 months ☐ 1 year ☐ Not eligible to receive meals Click or tap here to enter text. Priority Level and Nutrition Supports: ☐ Tier 3 (5 or more of the following): ☐ At high nutrition risk (Has all three of the following): ☐ DETERMINE Score (6+) ☐ Appetite/Weight Score (2+) ☐ Food Insecure ☐ Poverty level ☐ 3+ ADL/IADL ☐ Alone during day with no supports Eligible for: ☐ 5 Hot Meals/week ☐ Weekend Meals ☐ Nutrition Counseling ☐ Nutrition Education ☐ Oral Liquid Nutrition Supplement ☐ Tier 2 (5 or more of the following): ☐ DETERMINE Moderate Risk ☐ Appetite/Weight Score Low Risk ☐ Food insecure ☐ Poverty level ☐ 3+ ADL/IADL ☐ Has supports during the day Eligible for: ☐ 3-5 Meals/week (as funding and capacity allows) ☐ Tier 1 ☐ DETERMINE Low/Moderate & Appetite/Weight Not at Risk, Food Insecure = Eligible for 3-5 Meals per week (can be hot/frozen or combined delivery) ☐ Ambulatory, unable to leave home due to one or more of the following: ☐ Caregiver role ☐ Cannot drive in the winter ☐ Transportation unavailable ☐ Other: Click or tap here to enter text. ☐Meals are in the best interest of the eligible individual. Additional Services/Resources/Referrals ☐ Frozen/Weekend Meals ☐ Senior Dining Meals ☐ Carry Out Meals ☐ Liquid Nutritional Supplements ☐ Nutrition Counseling/Dietitian Follow-Up ☐ Malnutrition Resource List ☐ Complete Enhanced DETERMINE Questions ☐ Food Share Application Assistance ☐ Transportation to ☐ Grocery ☐ Food Pantry ☐ Senior Dining Site ☐ Other ☐ Adaptive Equipment/Independent Living Center Referral ☐ Nutrition Education ☐ NOURISH Steps Website ☐ Nutrition/Socialization/Health & Wellness Resource List ☐ Commodity Food Box ☐ Other Food Box Click or tap here to enter text. ☐ Nutrition Class ( ☐Stepping Up Your Nutrition, ☐ Eat Better, Move More, Weigh Less ☐ Caregiver Support ☐ Senior Farmers Market Vouchers ☐ Other type here DRAFT GWAAR Nutrition Team Updated 2-9-23 6 Meal Prioritization Worksheet (Option 2) Prioritization of (Agency) Elder Nutrition Program Assessment/Reassessment Participant Name: _______________________ Phone: _________________________ Address: ________________________________________ ________________________________________ DOB: ___________________ HDM Start Date: select date Please complete the following assessment information to verify eligibility. Is the person on My Choice Family Care, iCare, or IRIS? If yes, refer the client to their Partnership or Family Care Case or Care Manager to authorize home-delivered meals. DO NOT CONTINUE BELOW. ☐ Yes ☐ No Authorization Received BASIC ELIGIBILITY REQUIREMENTS: Must Check ONLY One. ☐ Age 60+: Is frail and/or currently essentially homebound by reason of illness, disability or isolation. Homebound is defined as “does not leave home under normal circumstances.” ☐ Relational Exception: A spouse of a person eligible for HDM’s regardless of age or condition, if assessment concludes it is in the best interest of the homebound older individual. ☐ Relational Exception: A disabled individual who resides at home with an eligible older individual participating in the program. ☐ Eligible to receive meals for ☐ 3 months ☐ 6 months ☐ 1 year ☐ Not eligible to receive meals (please indicate reason below) Click or tap here to enter text. Approval for Meals per week: Check all that apply: ☐ Tier 3 = 5 days per week ☐ Tier 3 = Weekend meals ☐ Tier 3 Breakfast Meals ☐ 2 Meals a Day ☐ Tier 3 =Liquid Nutritional Supplements ☐ With Meals ☐ Bulk Pick Up ☐ Tier 2= _3__ days per week ☐ Tier 1= __2_ days per week ☐ Case Manager overriding Nutrition Risk Score and approving _______ # of meals each week (please indicate reason below) Date of Assessment: _____________ Assessor Name: ________________________ Tier 3: (Minimum of 5 meals per week) Individuals with 1 or more of the following risk factors. ☐ Frail & essentially homebound under normal circumstances with no support and cannot obtain food and prepare adequate meals due to illness, emotional, intellectual, or physical disability. ☐ Have a live-in partner, spouse, or caregiver who is unable to prepare adequate meals for themselves and the eligible participant, if meals are not provided will result in negative outcomes. ☐ Confused or self-endangered when left alone (Live with someone who is not present during the day to assist them.) ☐ Unable to participate in the congregate meals program because of physical or emotional condition. ☐ Recently discharged (from the hospital, LTC) with no paid or unpaid support. ☐ At high risk due to confusion, memory loss, dementia, severe cognitive or mental health impairment. ☐ Resides in geographically isolated rural areas with no or limited support. (No easy access to shopping, restaurants, transportation, or care workers to ensure a consistent source of nutrition.) ☐ 3 + of the following ADLs/IADLs: ☐ Transferring ☐ Feeding ☐ Food Prep ☐ Shopping ☐ Transportation ☐ Ability to use phone ☐ other reason ☐ At high nutrition risk (Has all three of the following): ☐ DETERMINE Score (6+) ☐Appetite/Weight Score (2+) ☐ Food Insecure ☐ Tier 2 -Up to 5 Meals a Week (If capacity allows) Individuals who have 1 or more of the following: ☐ Ambulatory, unable to leave home without assistance but can prepare meals and eat without assistance, but unable to obtain groceries and are economically food insecure. ☐ Lives with another person who is unable to prepare meals/lacks paid or unpaid support. ☐ Short-term needs, temporary health limitations. ☐ Adult under 60 with a disability that lives with an eligible individual actively participating in the program. ☐ Limited capacity to perform ADLs/IADLs (2 of the following) ☐ Transferring ☐ Feeding ☐ Food Prep ☐ Shopping, ☐ Transportation ☐ Ability to use the phone ☐ other reason ☐ At moderate nutrition risk: ☐ DETERMINE Score (4+) ☐ Appetite/Weight Score (2+) ☐ Food Insecure ☐ Tier 1 (If capacity allows; provide Up to 5 meals per week, bulk delivery acceptable. I.e., a combo of hot, cold, frozen, shelf-stable meals). ☐ Ambulatory, unable to leave home due to one or more of the following: ☐ Caregiver role ☐ Cannot drive in the winter ☐ Transportation unavailable ☐ Other: Click or tap here to enter text. ☐Meals are in the best interest of the eligible individual. Additional Services/Resources/Referrals ☐ Frozen/Weekend Meals ☐ Senior Dining Meals ☐ Carry Out Meals ☐ Liquid Nutritional Supplements ☐ Nutrition Counseling/Dietitian Follow-Up ☐ Malnutrition Resource List ☐ Complete Enhanced DETERMINE Questions ☐ Food Share Application Assistance ☐ Transportation to ☐ Grocery ☐ Food Pantry ☐ Senior Dining Site ☐ Other ☐ Adaptive Equipment/Independent Living Center Referral ☐ Nutrition Education ☐ NOURISH Steps Website ☐ Nutrition/Socialization/Health & Wellness Resource List ☐ Commodity Food Box ☐ Other Food Box Click or tap here to enter text. ☐ Nutrition Class ( ☐Stepping Up Your Nutrition, ☐ Eat Better, Move More, Weigh Less ☐ Caregiver Support ☐ Senior Farmers Market Vouchers ☐ Other type here DRAFT GWAAR Nutrition Team Updated 2-9-23 7 Enhanced DETERMINE Questions Pathways For HDM Assessor (Optional) DETERMINE Question (Screen) If yes, ask Follow Up Questions (Assess) Referral/Intervention Options (Person-Centered Plan) I have an illness or condition that made me change the kind and/or amount of food I eat. ☐ Yes (2) ☐ No (0) ☐ Do they follow a special diet? If yes, include more details (type of diet and/or why they avoid various foods). Click or tap here to enter text. ☐ Do they struggle with knowing what to cook, plan meals, menus, understanding their diet? ☐ Recent fall(s) ☐ Recent Surgery OR Planned Surgery Upcoming ☐ Incontinence? Ask: “Have you experienced any urinary incontinence/leakage, even a small amount, in the past 30 days? ☐ Yes ☐ No ☐ Don’t Remember ☐ On Oxygen ☐ On Dialysis ☐ Feeling excessively tired and fatigued Physical Impairment? ☐ Hearing ☐ Vision ☐ Severe arthritis or other physical limitation ☐ Other ☐ Refer to Case Manager ☐ Refer to Independent Living Center/Adaptive Equipment ☐ Follow up with Hearing and/or vision resources ☐ Refer to Registered Dietitian ☐ Refer to Options Counselor ☐ Refer to Stepping Up Your Nutrition Class ☐ Refer to Health Promotion class(es) Click or tap here to enter text. ☐ Refer to a Healthcare Provider ☐ Provide Therapeutic or Medically Tailored meal Click or tap here to enter text. I eat fewer than 2 meals a day. ☐ Yes (3) ☐ No (0) (If Yes, ask What do you typically eat during the day? Who do you eat with, what time of day do you eat, where do you eat, why do you eat?) Click or tap here to enter text. ☐ No appetite ☐ Unable to prepare food. ☐ Unable to shop for food. ☐ Cannot afford food. ☐ I sometimes forget to eat. ☐ Dementia/Cognitive Concerns Click or tap here to enter text. ☐ Can they open the food packaging? ☐ Do they need adaptive equipment to open, prepare, cook or eat food? Click or tap here to enter text. ☐ Do they have working equipment to cook or reheat food or to store it properly, i.e. working fridge/microwave/stove/freezer? Click or tap here to enter text. ☐ If they have a pet, do they have enough food for their pet? ☐ Are they raising grandchildren? Do they share food/their meal with their grandchildren? Click or tap here to enter text. ☐ Ask about culture and religious beliefs to see if this is one of the reasons. Click or tap here to enter text. ☐ Refer to Dietitian ☐ Eating Disorder Screen ☐ Refer to EBS to complete Food Share Application ☐ Provide list Food and Meal Options/ Senior Dining Sites. ☐ Pet Food Assistance ☐ Appliance Concerns ☐Activities for socialization ☐ Arrange for transportation to the grocery store/food pantry. ☐ Arrange for a proxy food pantry shopper. ☐ Grocery delivery options ☐ Explore adaptive equipment. ☐ Refer to support group ☐ Refer to Dementia Care Specialist ☐ Weekend/Additional Meals ☐ Work with Caregiver Specialist to provide Grandchild meals under Caregiver funding I eat few fruits, vegetables or milk products. ☐ Yes (2) ☐ No (0) ☐ Cannot chew fresh F/V. ☐ No access to fresh fruits and veggies. ☐ Cannot peel or cut fresh produce. ☐ Do not know how to prepare F/V. ☐ Lactose Intolerant ☐ Ask what fruits & veggies and dairy products they typically eat and list below OR why they don’t eat them. Click or tap here to enter text. ☐ Medications limit what they are able to eat. Click or tap here to enter text. ☐ Cannot have leafy green veggies ☐ Refer to Dietitian ☐ Swallow Screen (EAT-10) ☐ Adaptive Equipment Referral ☐ EBS Foodshare Application. ☐ Offer transportation ☐ Lactose Free Dairy Option ☐ Offer Senior Farmers Market Vouchers DRAFT GWAAR Nutrition Team Updated 2-9-23 8 I have 3 or more drinks of beer, liquor, or wine almost every day. ☐ Yes (2) ☐ No (0) ☐ Are they a widow/widower or live alone? Click or tap here to enter text. ☐ Ask about their appetite. (Poor/Fair/Good) Other Details: Click or tap here to enter text. ☐ Encourage to discuss with healthcare provider ☐ Offer Support Group ☐ Provide Alcohol Abuse and Addiction resources I have tooth or mouth problems that makes it hard for me to eat. ☐ Yes (2) ☐ No (0) ☐ Dentures? Full or partial. Do they fit? ☐ Have their own teeth. ☐ Edentulous (No teeth) ☐ Broken or Missing Teeth ☐ Dry mouth? ☐ Swallowing problems? ☐ They have visited the dentist in the past year. If no, why? ________________ ☐ Ask about brushing/flossing habits. ☐ If they have a caregiver, ask if any challenges with feeding and oral health care. ☐ They smoke or chew tobacco ☐ Complete Swallow Screen (EAT-10) and make referral ☐ Rec. healthcare provider review meds to see if they are causing dry mouth. ☐ Refer to Dentist ☐ Ask if a Veteran? If yes, refer to VA Officer ☐ Provide a list of free or no cost dentists. ☐ Refer to ADRC for adaptive equipment/ easy-grip toothbrush. ☐ Provide information about good oral hygiene for older adults. ☐ Ask if interested in quitting tobacco use and make an appropriate referral. ☐ EBS to review insurance plans that include dental care during open enrollment. ☐ Caregiver Support I don’t always have enough money to buy the food I need. ☐ Yes (4) ☐ No (0) ☐ Ask if they get food from the food pantry, family, neighbors, etc.to make ends meet. Click or tap here to enter text. ☐ Do they know the meals are offered on a contribution basis? ☐ Provide Resources and Tips on how to make meals on a budget. ☐ Food Wise UW Extension ☐ EBS Foodshare Application. ☐ Provide a list of food pantries and community meals. I eat alone most of the time. ☐ Yes (1) ☐ No (0) ☐ Concerned about social isolation or loneliness. ☐ Seems depressed. Why? Click or tap here to enter text. ☐ Do they have a pet(s)? Click or tap here to enter text. ☐ What do they feed the pet? Click or tap here to enter text. ☐ Do they have a smartphone, tablet, or computer? ☐ Interested in learning how to Skype, Zoom, Facetime, etc.? If yes, specify. Click or tap here to enter text. ☐ Do they have internet access? If no, why not? Click or tap here to enter text. ☐ Are they a Veteran? If yes, are they interested in the Honor Flight or other programs and services from the VA? Click or tap here to enter text. ☐ Arrange transport to Senior Dining Site if able and interested on _________ days of the week. ☐ Offer Friendly Visit, phone call. ☐ Provide list of community meals and senior dining locations. ☐ Provide Technology Training and Connectivity Resources ☐ Library Book Delivery ☐ Provide information about local Senior Center ☐ Provide Craft/Coloring Kits/pages ☐ Interested in Volunteer Opportunities ☐ Refer to Veterans Office for Honor Flight DRAFT GWAAR Nutrition Team Updated 2-9-23 9 I take 3 or more different prescribed or over-the-counter drugs a day. ☐ Yes (1) ☐ No (0) ☐ Ask what herbs, supplements, vitamins, and other OTC medicines they take. (List below) Click or tap here to enter text. ☐ Are they taking their meds as prescribed? If not, why? Click or tap here to enter text. ☐Do they understand the instructions of how and when to take meds? Click or tap here to enter text. ☐ Refer to Dietitian ☐ Recommend a. medication review ☐ Suggest or provide a pillbox to help them manage their meds. ☐ Encourage to tell their MD all the over-the-counter supplements/vitamins they take. ☐ EBS to review insurance options for prescription drug coverage Without wanting to, I have lost or gained 10 pounds in the last 6 months. ☐ Yes (2) ☐ No (0) ☐ Any change in health condition or life event change to help determine the root cause. ☐How do their clothes fit, do they seem lose or tight? (10 lbs is about a clothing size). Click or tap here to enter text. ☐ Ask about their sleep habits. ☐ Ask about their energy level and strength. ☐ Are they able to shop, carry groceries, open food packaging ☐Do they need transportation? ☐ Refer to dietitian ☐ Weekend or Additional Meals ☐ Liquid Supplement ☐ Transportation ☐ Other: Click or tap here to enter text. I am not always physically able to shop, cook, and/or feed myself. ☐ Yes (2) ☐ No (0) ☐ Does someone else prepare meals for them? Who? Click or tap here to enter text. ☐ Do they use a lot of convenience foods? What types? Click or tap here to enter text. ☐ Do they have any adaptive equipment? Know how to use it? Or are interested in learning about it? Click or tap here to enter text. ☐ Able to open boxes, packages, cans? ☐ Able to prepare food? ☐ Ask if they get any physical activity? If yes, what type and how often and for what duration. Click or tap here to enter text. ☐ Refer to dietitian. ☐ Refer to health promotion classes as appropriate. Click or tap here to enter text. ☐ Refer to ADRC or Independent Living Center for adaptive equipment. ☐ Provide Resource list of physical activity or movement classes/programs Notes: Click or tap here to enter text. DRAFT GWAAR Nutrition Team Updated 2-9-23 10 Enhanced DETERMINE Person-Centered Action Plan (Optional) Date:Click or tap to enter a date. Offer the participant the opportunity to create a person-centered Action Plan. Example 1: 1. This week I will drink water (what) 2. An X ounce container (how much) 3. Before lunch (when) 4. 3 days a week (M, W, F) (how many) 5. Confidence level of 8 Example 2: 1. This week I will go to the senior dining site (what) 2. For1 meal a day (how much) 3. for lunch (when) 4. 2 days a week (T, TH) (how many) 5. Confidence level of 9 The Action Plan should answer these questions: (Record their plan at the bottom of this page so you have a record for follow-up). 1. What are you going to do? 2. How much are you going to do? 3. When are you going to do it? 4. How many days a week you are going to do it for? 5. What is their confidence level on a scale of 1 to 10 of how likely they are to complete this plan? Note: If the score is less than 7, ask what adjustment(s) they could make that would increase their confidence level to a 7 or higher. Notes and Follow-Up Plan: Click or tap here to enter text. Click or tap here to enter text. (Cut and give to the participant. You can help them write in the spaces if they need assistance.) ----------------------------------------------------------------------------------------------------------------------------------------------- The NOURISH Step I want to Take is… This week I will: 1. What you are going to do: _________________________________________________________ 2. How much are you going to do: _____________________________________________________ 3. When are you going to do it?_______________________________________________________ 4. How many days a week?: _________________________________________________________ What is your confidence level? (1 to 10) ______________________________________________ (If your confidence level is less than 7, what can you modify to make if more achievable?) Not Confident at all Unsure Very Confident 10 1 3 4 5 6 7 8 9 2 DRAFT GWAAR Nutrition Team Updated 2-9-23 11 The NOURISH Step I want to Take is… This week I will: 5. What you are going to do: _________________________________________________________ 6. How much are you going to do: _____________________________________________________ 7. When are you going to do it?_______________________________________________________ 8. How many days a week?: _________________________________________________________ 9. What is your confidence level? (1 to 10) ______________________________________________ (If your confidence level is less than 7, what can you modify to make if more achievable?) Not Confident at all Unsure Very Confident Progress Notes/thoughts during the week. (Successes and Barriers). Noting these things during the week can help us work through barriers and celebrate successes next time we meet. The NOURISH Step I want to Take is… This week I will: 1. What you are going to do: _________________________________________________________ 2. How much are you going to do: _____________________________________________________ 3. When are you going to do it?_______________________________________________________ 4. How many days a week?: _________________________________________________________ 5. What is your confidence level? (1 to 10) ______________________________________________ (If your confidence level is less than 7, what can you modify to make if more achievable?) Not Confident at all Unsure Very Confident Progress Notes/thoughts during the week. (Successes and Barriers). Noting these things during the week can help us work through barriers and celebrate successes next time we meet. 10 1 3 4 5 6 7 8 9 2 10 1 3 4 5 6 7 8 9 2