2017 – 2020 State Plan on Aging

TABLE OF CONTENTS LETTER TO CONSTANTINOS MISKIS ......................................................................... II VERIFICATION OF INTENT ......................................................................................... III HISTORICAL OVERVIEW ............................................................................................ IV EXECUTIVE SUMMARY ............................................................................................... V STATE PLAN ON AGING ............................................................................................................... 1 INTRODUCTION ............................................................................................................................. 1 MEDICAID SYSTEMS CHANGE ...................................................................................................... 2 DEMOGRAPHICS ............................................................................................................................ 4 MINORITY POPULATIONS ............................................................................................................. 5 OTHER TARGET POPULATIONS ..................................................................................................... 7 OLDER AMERICANS ACT PROGRAMS ........................................................................................... 9 DISCRETIONARY GRANTS ............................................................................................................. 9 ALABAMA’S PERSON CENTERED LONG-TERM CARE SUPPORT SYSTEMS ................................. 11 DOCUMENTATION OF NEEDS ...................................................................................................... 14 CHALLENGES AND OPPORTUNITIES ............................................................................................ 15 GOALS, OBJECTIVES STRATEGIES, AND OUTCOMES .................................................................. 18 CLOSING STATEMENT ................................................................................................................. 29 APPENDICES APPENDIX A: STATE PLAN ASSURANCES AND REQUIRED ACTIVITIES ........ 30 APPENDIX B: DOCUMENTATION OF ASSURANCES ............................................. 41 APPENDIX C: INTRA-STATE FUNDING FORMULA .............................................. 47 APPENDIX D: DEMOGRAPHICS ................................................................................. 55 APPENDIX E: DOCUMENTATION OF NEEDS ................................................................ 62 SUB-SECTION 1: TOWN HALL MEETINGS ................................................................................... 64 SUB-SECTION 2: CAREGIVER FOCUS GROUPS ........................................................................... 84 SUB-SECTION 3: ELDER JUSTICE ................................................................................................ 94 APPENDIX F: ADMINISTRATION ............................................................................. 102 SUB-SECTION 1: EMERGENCY PREPAREDNESS ........................................................................ 108 SUB-SECTION 2: PUBLIC HEARING ........................................................................................... 110 APPENDIX G: PROGRAMS ......................................................................................... 115 RSA Tower Suite 350 201 Monroe Street P.O. Box 301851 Montgomery, AL 36130-1851 NEAL G. MORRISON ROBERT J. BENTLEY COMMISSIONER GOVERNOR PHONE: (334) 242-5743 FAX: (334) 242-5594 www.alabamaageline.gov July 1, 2016 Mr. Constantinos Miskis, Regional Administrator U.S. Administration on Aging, Region IV Atlanta Federal Center 61 Forsyth Street, SW, Suite 5M69 Atlanta, GA 30303-8099 Dear Mr. Miskis: As the Commissioner of the Alabama Department of Senior Services, appointed by Governor Robert Bentley to be the Executive Officer for the State Unit on Aging, I hereby submit the State Plan on Aging for Alabama for the period of October 1, 2016, through September 30, 2020. The enclosed plan describes the goals, objectives, and strategies to provide advocacy, planning, and services in our state to address choice and independence for senior citizens and persons with disabilities. Included is the verification of intent, assurances, and other requirements as outlined under the provisions of the Older Americans Act of 1965, as amended. The Alabama Department of Senior Services and its various partners and stakeholders are committed to continuing progress to best meet the needs and preferences of our older population. If you have any questions regarding the 2017-2020 State Plan, you may contact me at 334-242- 4985 or Julie Miller at [email protected]. II Verification of Intent The state plan on aging for the period October 1, 2016 - September 30, 2020 is hereby submitted for the state of Alabama by the Alabama Department of Senior Services. The state agency named above was given the authority to develop and administer the state plan on aging in accordance with all requirements of the Older Americans Act, as amended, and is primarily responsible for the coordination of all state activities related to the purpose of the Act. This includes, but is not limited to, the development of comprehensive and coordinated systems for the delivery of supportive services, including multipurpose senior centers and nutrition services, and to serve as the effective and visible advocate for seniors in the state. This plan is hereby approved by the Governor and constitutes authorization to proceed with activities under the plan upon approval of the U.S. Assistant Secretary for Aging. The state plan hereby submitted was developed in accordance with all federal statutory and regulatory requirements. This plan is based upon projected receipts of federal, state and other funds and thus is subject to change depending upon actual receipts and/or changes in circumstances. Substantive changes to this plan will be incorporated through amendments to the plan. I hereby approve this state plan on aging and submit it to the U.S. Assistant Secretary for Aging. III Historical Overview The Alabama Department of Senior Services (ADSS) was created in 1957 as the single state agency for receiving and disbursing federal funds made available under the Older Americans Act (OAA) of 1965 and to serve as the lead agency on programs for the aging population. In 2008, Section 38-3-8 of the Code of Alabama was amended to provide that ADSS is to administer programs and funds that are not the specific responsibility of another state agency under federal or state statutes. ADSS has an Advisory Board of Directors composed of 16 members as follows: two members of the Senate appointed by the President of the Senate; two members of the House of Representatives appointed by the Speaker of the House; nine members appointed by the Governor; and three ex officio members: Commissioner of the Alabama Department of Labor, the State Health Officer, and the Commissioner of the Department of Human Resources. The Governor appoints the Commissioner of ADSS, who is a member of the Governor’s Cabinet. The Commissioner, subject to the merit system law, employs other personnel as may be necessary. ADSS provides guidance and monitoring to the 13 Area Agencies on Aging (AAAs), which act as grantee agencies serving their respective regions. The current Governor, Robert Bentley, is in his second term as Alabama’s Chief Executive. His term will end in January 2019 and this State Plan will be in effect the first year of a new administration. IV MISSION To promote the independence and dignity of those served through a comprehensive and coordinated system of quality services. VISION To help society and state government prepare for the aging demographics through effective leadership, advocacy, and stewardship. Executive Summary This plan was developed with information and research from current reports, feedback from citizens in local communities, taskforce groups and recommendations from AAAs, the Alabama Department of Senior Services (ADSS) staff, and the ADSS Advisory Board. The plan is being written during a time of historic change in Alabama’s healthcare system. ADSS is in a leadership role as an active participant and stakeholder in the planning and policy development for these proposed changes. ADSS is a freestanding planning, development, and advocacy State agency. The Department currently employs 44 individuals which include administrators, accountants, information technology specialists, registered dietitians, nurses, social workers, and clerical support personnel. ADSS administers the provisions of the OAA with the exceptions as provided in Ala. Code § 38-3-8, grants, other programs such as the Medicaid Home and Community-Based Waivers, and the state medication assistance program (SenioRx). The State aging network consists of nine Regional Planning Commissions, three independent AAAs, one county government, universities, non-profits, and over 700 service providers serving Alabamians age 60 and older. According to the U.S. Census Bureau Data, March 2015, Alabama’s population, age 65 and over, is 757,714 which represents 15.4 % of Alabama’s total population; many of these individuals reside in rural areas. Between 2015 and 2040, Alabama’s age 65 and over population is projected to increase by 82.6%, reaching over 1.2 million. This dramatic increase in the growing older population will require careful planning by the Governor’s

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