Live Long, Live Well: Area Agency on Aging Area Plan 2012–2016
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Live Long, Live Well: Area Agency on Aging Area Plan 2012–2016 Fiscal Year 2013-2014 Update Division of Social Services Aging and Adult Services 10 North San Pedro Road, Suite 1023 San Rafael, CA 94903 415-473-7118 www.marincounty.org/aging 1 TABLE OF CONTENTS Page Number Transmittal Letter 3 Executive Summary 4 Planning Process / Establishing Priorities 5-7 Major Changes in the PSA 8-9 FY 13/14 Priorities 10-14 Public Hearings 15-17 Area Plan Narrative Goals and Objectives 18-24 Service Unit Plan (SUP) Objectives 25-52 Priority Services 53-54 Notice of Intent to Provide Direct Services 55-56 Request for Approval to Provide Direct Services 57-59 Governing Board 60 Advisory Council 61-63 Legal Assistance 64-67 Organization Chart 68 Assurances 69-75 2 TRANSMITTAL LETTER Area Plan Update Fiscal Year 2013-2014 AAA Name: Marin County Division of Aging and Adult Services PSA Number 5 This Area Plan is hereby submitted to the California Department of Aging for approval. The Governing Board and the Advisory Council have each had the opportunity to participate in the planning process and to review and comment on the Area Plan. The Governing Board, Advisory Council, and Area Agency Director actively support the planning and development of community-based systems of care and will ensure compliance with the assurances set forth in this Area Plan. The undersigned recognize the responsibility within each community to establish systems in order to address the care needs of older individuals and their family caregivers in this planning and service area. 1. Judy Arnold ___________________________________ _______________ President, Marin County Board of Supervisors Date 2. Marjorie Belknap, M.D. ___________________________________ ________________ Chair, Marin County Commission on Aging Date 3. Annette Balter ___________________________________ ________________ Program Manager, Division of Aging and Adult Services Date 3 LIVE LONG, LIVE WELL: MARIN COUNTY AREA PLAN FOR AGING 2012-2016, FISCAL YEAR 2013–2014 UPDATE EXECUTIVE SUMMARY Every four years, the Older Americans Act requires Area Agencies on Aging (AAA) to submit an Area Plan that reflects strategies and activities to best serve the needs of older adults and family caregivers in their designated Planning and Service Area (PSA). The Marin County, Division of Aging and Adult Services (DAAS), designated as PSA 5, is one of 33 PSAs in California. The Division is responsible for the planning, coordination, administration, and monitoring of programs and services for older adults in Marin County. The Live Long, Live Well: Marin County Area Plan for Aging 2012–2016, Fiscal Year 2013–14 Update is the first update of the current four-year planning cycle. It presents strategies that will be carried out by the AAA, to effectively address and respond to the needs of a rapidly aging community in Marin. The planning process undertaken to develop the Area Plan identified critical priority areas for the AAA and the Marin County Commission on Aging (COA), its advisory council. Key areas of concern included: health promotion and prevention services; services to isolated elders; nutrition and food security; activities for older adults; volunteer and civic engagement; special needs of the LGBT older adult population; improvements in accessing information and resources; and the need for an expanded and well-coordinated service delivery system. New local data reflecting health indicators and cultural/language needs are presented in this update. Improvements in the service system achieved through collaboration with community partners and continued integration of the Division of Aging and Adult Services are also described. Information presented in this update will inform funders, service providers, and members of the community about the needs and opportunities to improve the quality of life, and sustain the independence, of older persons in Marin County. PLANNING PROCESS/ ESTABLISHING PRIORITIES Each year, the AAA works with the Commission’s Planning Committee to develop an Annual Area Plan Update. Analysis of any new local data related to older adults is completed, a review of the previous year’s objectives is undertaken, and strategic objectives for the coming year are developed. NEW DEMOGRAPHIC DATA Marin County has seen a significant growth in the number of older adults, between 2000 and 2010 the number of persons over 60 increased by 38%, from 44,647 to 61,454. In 2010, people over the age of 60 made up almost 25% of the Marin population, and that number is expected to grow.1 According to the American Community Survey (ACS), approximately 5% of all Marin residents over the age of 65 (2,046 residents) were at 100% of the Federal Poverty Level in 20112, a mere $10,890 for a single person that year. Perhaps a better indicator of economic insecurity is the “elder economic index.” The Elder Economic Planning Act of 2011, mandated AAAs to use the “Elder Economic Security Standard Index” in planning efforts, a measure of costs to older adults that takes into account local variations between California’s counties. In Marin, about 7,000 older adults have incomes above the federal poverty level, but below the elder economic index ($27,334 a year in Marin3); taken together, about a quarter of Marin’s seniors are considered ‘poor.’ In 2012, the Healthy Marin Partnership issued, “Pathways to Progress 2013: Assessing the Health care Needs of Marin County,” an extensive local survey, looking at a variety of indicators to assess community health, wellness, and equity. This report frames priorities for the County and community partners. For instance, while heart disease, cancer and stroke are the leading causes of death in Marin, Marin has higher death rates due to Alzheimer’s disease than California or the nation, and Marin’s binge drinking rates are also higher than the rest of the state. The report also highlighted the issue of falls for Marin’s older adults, discussed below. Falls Fall incidents and associated costs are increasing as the older population in America increases. The CDC estimates that the associated costs for falls was $19 billion in 2000 and this number will grow to $55 1 U.S. Census Bureau. (2010). State & County Quickfacts: Marin County, CA. Retrieved from http://quickfacts.census.gov/qfd/states/06/06041.html. 2 U.S. Census Bureau, 2007-2011 American Community Survey. 3 UCLA Center for Health Policy Research and the Insight Center for Community Economic Development, http://www.insightcced.org/uploads/eesi/2010%20county%20pages/Marin/marin_es.pdf 5 billion in 2020.4 Healthy Marin Partnership analyzed Emergency Medical Services (EMS) calls across the county, revealing that falls were the primary reason for all calls. EMS calls are a way to measure acute and traumatic injuries. Fall rates averaged over three years, from 2009 to 2011, showed that countywide, the overall fall rate for all ages was 7.1 per 1,000. For those over age 65, it was 25.8 falls per 1,000. Novato has one of the highest percentages of older adults in Marin County and subsequently one of the highest numbers of falls.5 In Fiscal Year 12/13, the Fall Prevention Task Force examined intrinsic and extrinsic factors leading to falls in the senior community, focusing on Novato. The Task Force is also looking at how to develop follow-up protocols for seniors who are assisted by EMS after a fall, but do not go to the hospital. Dominican University staff and study consultants are analyzing coded narrative responses from Patient Care Reports as well as conducting focus groups and follow-up surveys regarding depression and other mitigating factors, such as poly-pharmaceutical use and dementia, and how these might affect fall rates. This report will be completed by the close of 12/13 and will inform interventions and best practices in the future. Alzheimer’s and Dementia Alzheimer’s is the fifth leading cause of death in California, claiming the lives over 10,000 people in 2010. Approximately one third of all seniors who die each year have Alzheimer’s or another dementia. In America today, over 5 million people are living with Alzheimer’s and that number is expected to triple by 2050. According to the Alzheimer’s Association, the cost of caring for those with Alzheimer’s and other dementia in the United States is estimated to total $203 billion in 2013 and to climb to $1.2 trillion by 2050. Caregivers are providing even more unpaid care and there will be higher costs associated in the next 20 years.6 In Marin, Alzheimer’s is the third leading cause of death, accounting for 35 deaths per year, higher than the state or national rate.7 Marin is ranked 46 out of 58 counties, with a death rate of 34.6 compared to California at 30.5.8 Applying national prevalence rates for Alzheimer’s disease to the population of Marin results in an estimate of almost 2,000 cases, of which 1,100 would be moderate or severe. The total number of cases is expected to double by 2030. It is a disease with significant costs and extensive 9 effects on families and the community. 4 Centers for Disease Control. Costs of Falls Among Older Adults. Retrieved from: http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html 5 Healthy Marin Partnership, Pathways to Progress 2013, Assessing the Health Care Needs of Marin County. 6 Alzheimer’s Association. “California Alzheimer’s Statistics.” Retrieved from : http://www.alz.org/alzheimers_disease_facts_and_figures.asp#quickFacts 7 County of Marin, Vital Statistics. 8 Health Status Profiles on Alzheimer’s. 9 Strategic Plan Data Focus Report, Marin County Division of Aging and Adult Services, 2007. 6 CalFresh Data from the 2012 California Food Policy Advocates Report10 revealed that only 14% of households with elderly adults that are eligible for CalFresh are utilizing benefits.