Summary of 2007
Public Hearings
Western Illinois Area Agency on Aging (WIAAA) conducted two
Public Hearings. The first at Bridges Community Center, Ottawa, IL on May
3, 2007 and the second at the Mercer County Senior Center, Aledo, IL on May
4, 2007. These hearings are intended to give the public an
opportunity to comment on our Area Plan.
May 3, 2007 –
Bridges Community Center – Ottawa, IL
This public hearing was opened by Robert Gunberg, a
representative of the Advisory Council of Western Illinois Area Agency on Aging
(WIAAA). Robert explained the purpose of the hearing and what the procedure was
for testifying. WIAAA staff, Board of Directors members, Advisory Council
members, funded provider staff and all other participants introduced themselves.
Robert then introduced Jan Stille, Executive Director, who greeted those
attending the meeting.
Jan also explained that since issuing our Public
Information Document (PID), WIAAA has decided to make some changes in our Area
Plan for 2008-2010. For years we have funded Case Management through
Alternatives for the Older Adult (AFOA). These federal Older Americans Act funds
supplemented the Case Management services offered through the state Community
Care Program (CCP). There have now been some changes at the state level. 2007 is
the introductory year for a new case management concept called
"Comprehensive Care Coordination" (CCC). The comprehensive assessment,
which is a part of the program, is available to everyone sixty years of age or
older in Illinois. They are eligible to receive this assessment regardless of
income or assets. The state legislature made a commitment that the state of
Illinois will provide at least the assessment, for everyone who is in need of
it. AFOA will do these assessments and be reimbursed by the Illinois Department
on Aging. For this reason, it is the opinion of WIAAA that it is not necessary
for the case management dollars (Title III Older Americans Act case management
dollars) to go to Alternatives for the Older Adult.
Because of this change we have determined that perhaps
there are other services which we could fund which could provide additional help
to seniors which aid in keeping them in their homes. WIAAA has decided to put
those funds, for the time being, in the line item Community Focal Points (CFP).
However, this money at this time is not going to be allocated out to individual
agencies. CFP funding is used to provide Information and Assistance, Outreach
and Senior Center Services to seniors. CFPs also provide other services such as
Senior Health Assistance Program (SHAP), Circuit Breaker, Medicare D and many
other aging services.
During the fiscal year 2008 which begins on October 1,
2007, these funds will be used where they are needed. Some of the money may even
end up going back to Alternatives if it is in fact found that the payment from
the State for CCC does not cover the cost of the services or for some of the
other services they perform. WIAAA is also considering some additional training
for Information and Assistance and Outreach workers since these are much needed
services to helping seniors remain in their own homes. Also, a service which
seniors indicate is imperative to remain independent in their own homes is
"chore services" for tasks such as minor repair work, lawn mowing,
snow shoveling, etc. We feel there are most likely additional needs and this
could prove to be our opportunity to perhaps fund some of those needs.
Ultimately, we hope to get some additional senior
services funds into our ten county planning and service area. If the state funds
case management at a level that will allow them to provide all of the case
management services that the seniors need, then there will be some additional
funds coming into the area from the state money which will allow us to use our
federal money in other ways within our area.
Carol Kern - Director of Mendota Area Senior Services (MASS) – Mendota,
IL.
Carol testified that MASS was experiencing funding
difficulties in all areas, with the cost of providing transportation
skyrocketing. Her Information and Assistance Specialist and Outreach worker have
seen a tremendous increase in the amount of time spent working with Medicare D
and Illinois Cares Rx, stating they had provided service for 1,100 new persons
during 2006. In addition, they have seen an increase in office supply needs such
as inkjet cartridges, copier toner, and printer paper due to the increased work
load. Phone bills have risen due to the influx of calls from seniors with
pharmaceutical questions as well as increased calls made to insurance companies
on behalf of seniors.
Carol stated that MASS has one full time Information and
Assistance Specialist and one part time Outreach worker. Both are highly capable
individuals but MASS cannot even provide them with a reasonable wage or
benefits. Currently, 68% of their base funding is spent on Information and
Outreach services. In July, the new minimum wage increase will cause additional
problems with their already scarce funding at MASS. Six staff members will be
receiving a fifty cent hourly increase which brings with it the additional costs
in payroll taxes, etc. MASS has to raise an additional $54,000 to help meet its
FY 2007 budget. It is becoming more and more challenging to try to increase cash
match in order to maintain services.
Darcia Ferrari - Director at Putnam County Achievement Services, Inc. (PCAS)
– Standard, IL.
Darcia indicated that PCAS staff is very concerned about
the financial future of the center. She implied that not only has the work load
increased on Information and Assistance Specialists and Outreach staff due to
Medicare D and Illinois Cares Rx, but so have the expenses for services
pertaining to these programs. I&A Specialsts provided assistance to 365
seniors while Outreach provided assistance to 526 seniors in 2006.
Transportation also saw an increase of 29% in the number of rides for seniors in
2006 and 2007 promises yet anther increase in rides provided to seniors.
Not only has staff time and transportation costs
increased but office supplies such as toner, paper and printer cartridges have
increased substantially, along with phone bills and mileage expenses for the
center. The PCAS Board of Directors has committed to giving staff small wage
increases each year but the minimum wage increases effective in July 2007 will
greatly challenge the center’s funding. The employees who currently staff the
center work part time without health and dental insurance or retirement
benefits. If these persons were to retire, there is no way the PCAS could fill
their positions at the wages they are able to offer.
PCAS has been able to keep many seniors living
independently in their own homes through the services it offers. Seniors can
enjoy a particular quality of life in their own home as opposed to an individual
who has no outside support system and must finally move into a care facility.
PCAS is grateful for the support of the seniors and the
local community but there is just so much they can do. PCAS would like to ask
WIAAA to filter more money into services such as Information and Assistance,
Outreach and transportation. Darcia states that they are grateful for the base
funding which they receive from WIAAA and said she would like WIAAA to know that
PCAS appreciates WIAAA efforts and all that they do for the center.
Michelle Jech - Program Director for Alternatives for the Older Adult, Inc.
(AFOA). (Serves all ten counties in the WIAAA Planning and Service Area)
Michelle stated that AFOA provides Case Management
services for ten counties in western Illinois. Funds through WIAAA are targeted
to the frailest seniors to provide comprehensive care management assessments,
care planning and monitoring.
Illinois has been progressive in developing the new
Comprehensive Care Coordination (CCC) program. WIAAA has been supportive of the
CCC and has worked together with Case Coordination Units (CCU), Area Agencies on
Aging, Illinois Department on Aging and other aging services partners. A
Comprehensive Care Management tool was developed over the years so that all CCUs
would provide seniors with a comprehensive assessment across all of Illinois.
This new assessment process is taking considerably
longer, as much as three hours per care manager, with the assessment tool itself
comprised of up to fifty pages. In addition, AFOA is experiencing a high level
of staff turn over at this time because of the additional work load and the
increased level of paperwork. AFOA is also experiencing an increased financial
strain and the Care Management Program is causing a deficit of $35,000 in the
AFOA budget.
Michelle expressed concern that WIAAA was pulling Case
Management funding for FY 2008. She is asking the WIAAA Board of Directors not
to transfer Title III Case Management funds from AFOA to another service. While
she agreed that Comprehensive Care Coordination is designed to be fully funded
by the state of Illinois, reimbursements received to date do not cover the cost
of the service. Michelle stated that "we do not know our revenues or costs
for this new initiative and may need your (WIAAA) support for this important
service to provide care management". She indicated that they have other
valuable services such as caregiver counseling (increase of 342% since 2002),
Money Management Program and the Ombudsman program (only two full-time employees
for ten counties) which are in need of additional funding as well.
May 4, 2007 –
Mercer County Senior Citizens’ Center – Aledo, IL
This public hearing was opened by Linda Eldridge, Vice
Chairperson of the Advisory Council of WIAAA. Linda explained the purpose of the
hearing and what the procedure was for testifying. WIAAA staff, Board of
Directors members, Advisory Council members, funded provider staff and all other
participants introduced themselves. Linda then introduced Jan Stille, Executive
Director, who greeted those attending the meeting and gave a brief explanation
of the decision of WIAAA to reallocate Case Management funding.
Michelle Jech, Program Director for Alternatives for the Older
Adults, testified to the same issues she had raised on May
3rd at the Ottawa public hearing.
Gloria Short - Director of Senior Services at Henderson County Health
Department – Gladstone, IL
Funds to provide Information and Assistance, Outreach and
Transportation are extremely important to us. There are only 8,200 people in
Henderson County but in 2006, Information and Assistance provided 1,013 units of
service and Outreach made 399 house calls to homebound seniors.
Transportation is a huge program in such a rural area.
They have 7 vehicles on the road all the time and must maintain and service
those vehicles. It’s tough for their seniors to get to appointments due to the
long distances they must travel in such a rural area. There are just two doctors
and no hospital in this county so seniors must seek a lot of their healthcare
elsewhere, often needing transportation assistance to get there.
Two other programs which are extremely important are the
Home Delivered and Congregate Meal programs. In 2006, Gloria’s department
actually served 16,586 meals between those two programs.
Margaret Bent - Director of VNA Senior Services in Knox County –
Galesburg, IL (as read by Pam Russell, Director of Mercer County Senior
Citizens’ Center)
Margaret testified that it is becoming harder and harder
to serve the seniors in her area due to lack of funding increases. She must pay
her Information and Assistance Specialists and Outreach workers, rent office
space, purchase increased amounts of office supplies, pay mileage and maintain
current equipment such as printers and copiers. With the increase in clients
they have seen over the past two years, VNA could use 3 fulltime workers but as
it stands now, they have 1 part time I&A Specialist and 1 part time Outreach
worker. In addition, there is never enough money to be able to offer health and
dental insurance, retirement or other benefits to these workers.
The transportation program continues to eat up their
resources with the staggering increase in vehicle insurance, maintenance and
fuel costs. They have had to increase their suggested donation for rides and
while that amount is intended as a "suggested donation" many seniors
want to help by making the full donation, putting a strain on their own budgets.
Margaret indicated that it was either this or cut back on the amount of
transportation services VNA could offer.
She also stated "It is imperative that the State and
Federal Governments realize agencies must have increases in funding in order to
meet the needs of seniors who have built this country".
Carol McCrery – Director of Strom Senior Center – Monmouth, IL
Carol testified that the level of Information and
Assistance and Outreach services has greatly increased. She indicated that these
services are "maxed out" with all the changes that have occurred with
Medicare D and Illinois Cares Rx. There is no such thing as "down
time" any more, with barely enough time to get the essentials attended to.
Carol intimated that some days it feels like "we can’t see the light at
the end of the tunnel". The eight hour day no longer exists as more and
more seniors request more and more help. Information and Assistance and Outreach
need additional funds in order to continue to meet the needs of the growing
senior population.
Marilyn Woelke – Caregiver Program – Alternatives for the Older Adults,
Inc (Serves all ten counties in the WIAAA Planning and Service Area)
Marilyn indicated that the Caregiver services such as
respite, supplemental assistance, individual counseling, trainings and support
groups remain a high priority for Alternatives. Marilyn spoke of the
overwhelming need for more funds to expand these services. She introduced Eva (a
caregiver) who told us "her story" about how the Caregiver services
assisted her while trying to care for her husband. Eva also spoke of the
importance of the Caregiver programs and how they helped her come to grips with
understanding her husband’s dementia. These services enabled her to keep him
out of a long term care facility and attend to his needs in her own home. The
support groups and counseling helped her cope with the responsibility and stress
of such an overwhelming task.
Bre Theim – Director of the Rock Island County Senior Center – Rock
Island, IL
Bre talked of the increase of her transportation costs,
mainly fuel and maintenance as a critical issue for the senior center. The costs
of operation are getting higher and the waiting list for rides is getting
longer. They provide transportation in three counties: Rock Island, Mercer and
Henry. This puts a real strain on vehicles that are already quite old and
needing constant repair.
Bre also spoke to the issue of increased staff time
needed to counsel seniors on programs such as Medicare D and Illinois Cares Rx.
Seniors state that they are confused by all the changes and Bre stated it used
to take 20-30 minutes to assist with Circuit Breaker appointments when now it
can take up to an hour or more per senior.
Chris Clemens – Alzheimer’s Association – Peoria Chapter
Chris addressed the funding which Alzheimer’s receives
from WIAAA, stating she was very grateful for this funding. They use the funding
for training which deals with lessons on stress management, empowering caregiver
support, empowering the caregiver to manage the care of their loved in the home,
etc. She feels there is always a need for additional funding to provide more
caregiver training classes.
AREA PLAN ISSUES:
- Information and Assistance and Outreach
All providers who presented testimony at the two Public Hearings
seemed to agree that Information and Assistance and Outreach services are a
critical need for seniors who wish to remain independent in their own homes. The
most common concern of those who provide these services was that they are sorely
under funded and over worked. Ever since the inception of Medicare D and the new
Illinois Cares Rx program I&A and Outreach workers have been swamped. They
have seen their case loads and length of appointment times triple. Most of the
providers stated they do not have enough funds with which to pay reasonable
salaries or give health insurance or additional benefits to their Information
and Assistance and Outreach staff.
- Transportation
Providers of transportation presented testimony addressing the
high cost of insuring, fueling and maintaining their vehicles with no additional
funding available. They stated that transportation is a vital service for
seniors who are no longer able to drive. It remains the critical link for
seniors to the outside world, to doctor and therapy appointments, grocery
shopping and so much more. If seniors cannot leave their homes without
assistance, transportation services play a major role in keeping those seniors
from becoming isolated, depressed and immobilized.
- Case Management
Alternatives for the Older Adult, Inc. testified to the
importance of case management as a vital tool which keeps seniors in their
homes. The new program, Comprehensive Care Coordination (CCC), has created
additional work for case managers, with the intake process consisting of
approximately 50 forms and taking up to three hours to perform the assessment.
Alternatives for the Older Adult has expressed concern that WIAAA is pulling the
Case Management funding for FY 2008. While they agreed that CCC is designed to
be fully funded by the state of Illinois, reimbursements received to date do not
cover the cost of the service.
- Caregiver Services
Alternatives for the Older Adult requested additional funds
for caregiver services such as respite, individual counseling, support groups,
training and supplemental services. They are reaching more and more caregivers
who need assistance and feel this is a need that will only continue to grow as
more people identify themselves as caregivers.
WIAAA RECOMMENDATIONS:
- Information and Assistance and Outreach
Recommendation:
- WIAAA recognizes the need to transfer additional funds to Information and
Assistance and Outreach services in order to continue to meet the increase
in demand by seniors who need this assistance. WIAAA will take into
consideration the transfer of Case Management dollars to Information and
Assistance and Outreach services. Funds could also be used for training as
we believe that Information and Assistance Specialists and Outreach workers
would greatly benefit from additional training and certification such as
Alliance of Information and Referral Systems (AIRS) offers.
Rationale:
Each provider of Information and Assistance and Outreach services spoke of
the need for increased funding for these services and have done so at
Community Input meetings and Public Hearings for the past several years.
These services have not seen additional funding for a long time. WIAAA
believes the problem of increased need for these services will only continue
to grow with the baby boomers on the verge of retirement. WIAAA feels it may
be time to place additional funds in these and other services.
- Transportation
Recommendation:
- Each provider of transportation testified to the critical need for
increase for funding for these services due to increased costs such as
vehicle insurance, fuel and maintenance. WIAAA plans to actively
participate in the Human Service Transportation Committees and work to get
additional Department of Transportation support for our transportation
providers.
Rationale:
WIAAA is aware that transportation is a vital link in keeping seniors
independent while remaining in their own homes. The State of Illinois is
embarking on a new initiative to approach transit planning and coordination
for rural and small-urbanized Downstate areas from a regional perspective.
WIAAA has become an active participant on the Human Service Transportation
Plan committees and continues to seek workable solutions to transportation
problems. WIAAA urges transportation providers to become involved with
regional transit planning committees to see what alternatives are available.
- Case Management
Recommendation:
- WIAAA has recommended that the Case Management funds be pulled from
Alternatives for the Older Adults, Inc. The decision to remove case
management dollars from Alternatives was not made lightly by the WIAAA
Board of Directors. Discussion centered on what action would be in the
best interest of the majority of the seniors in our area.
Rationale:
Because case management is now funded through the State through the new
Comprehensive Care Coordination program, WIAAA believes that seniors will
still receive the case management services they need. WIAAA also feels it is
time to reallocate these dollars to other services which seniors need. Some
of those services may include Information and Assistance and Outreach
services, training for Information and Assistance Specialists and Outreach
workers, Chore Services, etc.
- Caregiver Services
Recommendation:
- Caregiver services are crucial to keeping seniors out of nursing homes
so that the caregivers can keep their loved ones at home as long as
possible. These services also help caregivers cope with the stress of
caregiving and avoid caregiver "burn out". WIAAA will continue
to evaluate the funded caregiver services to determine which services are
most utilized and needed by caregivers. We also will continue to advocate
for additional Caregiver funding.
Rationale:
Only funds allocated to Caregiver Services can be used for those services.
It is the responsibility of WIAAA to evaluate the need for each service and
redistribute the funding among the Caregiver Services in the way that best
meets the needs of the caregivers and care recipients in our area. We also
take into account how many caregivers would benefit from each type of
service.
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