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Nevada Division for Aging Services

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Nevada Division for Aging Services Powered By Docstoc
					MICHAEL J. WILLDEN
Director

CAROL SALA
Administrator

JIM GIBBONS
Governor

State of Nevada Department of Health & Human Services

DIVISION FOR AGING SERVICES

Independent Living Grants Annual Report
FY 2007

Table of Contents
Introduction ..................................................................................................................................... 2 Grant Funding Priorities ................................................................................................................. 2 FY 07 Grant Dollars at Work.......................................................................................................... 3 Units of Service Provided ................................................................................................................4 Programs Funded in FY 07 ............................................................................................................. 4 2008 Grant Cycle Schedule ............................................................................................................ 6 Service Descriptions ....................................................................................................................... 7 Transportation ........................................................................................................................ 7 Respite Care ........................................................................................................................... 8 Supportive Services ............................................................................................................... 9 Adult Day Care ............................................................................................................. 9 Case Management ......................................................................................................... 9 Case Management – Elder Protective Services .......................................................... 10 Caregiver Support Services......................................................................................... 10 Information/Assistance/Advocacy .............................................................................. 11 Companion Services ................................................................................................... 11 Durable Medical Equipment and Health Care Products ............................................. 12 Geriatric Health and Wellness Services ...................................................................... 12 Homemaker Services .................................................................................................. 13 Home Services ............................................................................................................ 13 Legal Services ............................................................................................................. 13 Medical Nutrition Therapy ......................................................................................... 14 Volunteer Care ............................................................................................................ 14 Emergency Food Pantry.............................................................................................. 14 Personal Emergency Response System ...................................................................... 15 Protective Services ...................................................................................................... 15 Representative Payee .................................................................................................. 15 UNITS OF SERVICE DEFINITIONS ......................................................................................... 17

Division for Aging Services 2007 Independent Living Grants Report ~ Page 1

INDEPENDENT LIVING GRANTS
Introduction
The 1999 Nevada State Legislature created Independent Living Grants with Tobacco Settlement Funds received from the 1998 Master Settlement Agreement. Each year, 15 percent of Nevada’s share of settlement revenues is allocated to the Division for Aging Services. As a result, Independent Living Grants have been awarded every year since 2000; the most recent grant year was completed on September 30, 2007. The Division awards this funding in the form of Independent Living Grants (ILGs) to service providers in Nevada, most of which are community based. In light of flat and diminishing federal funding for aging services, and a skyrocketing senior population, ILGs have been essential for sustaining the Division’s mission: To develop, coordinate and deliver a comprehensive support service system in order for Nevada senior citizens to lead independent, meaningful and dignified lives. Census data and analysts’ projections clearly depict this unprecedented population growth of senior Nevadans and why the Independent Living Grants are so essential to meeting seniors’ needs. In the decade 1990 to 2000, the number of seniors in Nevada age 65 and older increased by 72 percent, while the increase nationwide was only 12 percent. In the same time period, the population of seniors age 85 and older increased 128 percent versus 38 percent nationwide. A number of reports suggest that this growth will continue to be significant for many years to come. USA Today analysts reviewed Census data, and in 2007 reported Nevada will have a 264 percent increase in persons age 65 and older between 2000 and 2030, the highest growth rate in the nation.

Grant Funding Priorities
NRS 439.630, Section 4 (d) states that the Division for Aging Services will allocate the available Independent Living Grants for:    Respite care for relief of informal caretakers. Transportation to new or existing services to assist senior citizens in living independently. Supportive Services, which allows senior citizens to remain at home instead of in institutional care.

These grants are awarded to organizations that promote self-sufficiency to individuals age 60 and older. For the FY 2007 grant year, October 1, 2006 through September 30, 2007, $5,136,306 was awarded by the Division through a number of grants covering an array of services. Of this, $684,049 was awarded for Respite Care, $3,819,962 was awarded for Supportive Services, and $632,295 was awarded for the provision of Transportation Services. As service needs increase in some areas and decrease in others, the Division adjusts allocations accordingly.

Division for Aging Services 2007 Independent Living Grants Report ~ Page 2

In keeping with Older Americans Act Amendments of 2006, the Division has established the following clients as priorities:       Low income older individuals Low income older minority individuals Older individuals with limited English proficiency Older individuals residing in rural areas Individuals at risk for institutional placement Older individuals with the greatest economic or social need

Grant Dollars at Work FY07 INDEPENDENT LIVING GRANT DOLLARS AT WORK
Services Provided October 1, 2006 through September 30, 2007
Transportation Respite Services Supportive Services Adult Day Care Caregiver Support Case Management Case Management - Elder Protective Services Companion Durable Medical Equipment Emergency Services Food Pantry Geriatric Health & Wellness* Home Services Homemaker Information Assistance & Advocacy Legal Services Lifeline Medical Nutrition Therapy / Special Meals Podiatry Protective Services Representative Payee Volunteer Care

Number Served Service Units
3,687 525 54 708 107 138 1,256 1,232 49 1,108 3,767 510 133 3,697 134 356 977 156 2,721 41 1,128 127,565 30,112 3,473 2,669 1,315 605 101,423 3,730 57 7,869 14,454 4,333 3,693 8,292 3,721 702 31,263 296 4,396 947 19,378

TOTAL

22,484

370,293

* Dental Services are included in Geriatric Health & Wellness, serving 838 clients with 4,358 procedures.

Division for Aging Services 2007 Independent Living Grants Report ~ Page 3

Units of Service Provided FY '07
Supportive Services 212,616

Transportation 127,565

Respite 30,112
Figures are extracted from quarterly reports submitted by all programs. The reporting covers a 12-month period (10-01-2005 through 09-30-2006).

In accordance with NRS 439.630 (e), the Division set aside $200,000 of the 2007 Independent Living Grant funds for assisted living facilities that satisfy the criteria set forth in NRS 319.147 and assisted living supportive services that are provided pursuant to the provisions of the Home and Community-Based Waiver Services, amended pursuant to NRS 422.2708.

Programs Funded in FY 07 with Independent Living Grants by County
County Churchill Clark County Program Churchill Area Regional Transportation Catholic Charities of Southern Nevada Catholic Charities of Southern Nevada Catholic Charities of Southern Nevada Overton Senior Center Clark County Social Services Clark County Health District Senior Citizens Law Project Blind Center of Nevada James Seastrand Helping Hands of North Helping Hands of Vegas Valley Las Vegas Helping Hands of Vegas Valley Helping Hands of Vegas Valley Rebuilding Together Jude 22 Service Transportation Transportation Nutrition Therapy Special Meals Transportation Protective Advocacy Legal CAT Tickets Home Services Respite Volunteer Transportation Home Services Emergency Food Pantry

Clark

Clark

Division for Aging Services 2007 Independent Living Grants Report ~ Page 4

Programs Funded in FY 07 with Independent Living Grants by County
County Program Service Transportation Adult Day Care Transportation Transportation Transportation Companion Lifeline Transportation Transportation Podiatry Transportation Transportation Transportation Information/Referral/Advocacy Information/Referral/Advocacy Transportation Transportation Information/Referral/Advocacy Transportation Geriatric Health & Wellness (Mental Geriatric Health) Health & Wellness (Visiting Representative Payee Nurse) Legal Services (Ward Representation) Volunteer Case Management Homemaker Transportation Lifeline Companion Geriatric Health & Wellness Transportation Taxi Coupons Caregiver Supportive Services Caregiver Supportive Services Transportation Home Services Geriatric Health & Wellness Companion Information/Referral/Advocacy Durable Medical Equipment Home Services Elder Protective Services Case Emergency Services Management Geriatric Health & Wellness - Dental Homemaker RTC of Southern Nevada Nevada Adult Day Healthcare Arturo Cambeiro Senior Center Martin Luther King Senior Center Douglas County Senior Center Douglas Douglas County Senior Center Douglas County Senior Center Tahoe-Douglas Senior Center Carlin Open Door Senior Center Elko Elko County Senior Center Esmeralda Nye County Senior Center Eureka Senior Center Eureka Humboldt Senior Citizens of Humboldt County Lyon County Senior Center Lyon County Mineral County Senior Center Mineral Mineral County Senior Center Pahrump Senior Center Nye Pershing County Senior Center Pershing Pershing County Senior Center County Washoe County Senior Center Washoe Washoe County Senior Center Washoe County Senior Center Washoe County Senior Center UNR Board of Regents Housing Authority of Reno Housing Authority of Reno CitiCare Rural RSVP MultiRural RSVP County Rural RSVP Rural RSVP Northern Nevada Transit Coalition Alzheimer’s Association of Northern Alzheimer’s Association of Southern Nevada Southern Nevada Nevada Transit Coalition Silver Independence Southern Nevada Adult Mental Health Elvirita Lewis Forum Services MultiHealth Insight County Care Chest The Continuum Maaverick Corporation Maaverick Corporation Miles for Smiles Nevada Urban Indians

Division for Aging Services 2007 Independent Living Grants Report ~ Page 5

Programs Funded in FY 07 with Independent Living Grants by County
County Program Elvirita Lewis Forum Elvirita Lewis Forum Service Durable Medical Equipment Geriatric Health & Wellness

2008 Grant Cycle Schedule
Programs funded as a result of the 2008 competitive application process are funded for two years, pending successful programming during the first year and available funding for the second year. Activity Dates for the 2008 Competitive Grant Process            RFP Issued Application Orientation Applications Due To RD and Outside Reviewers* Staff and Reviewers Orientation Staff and Reviewers Outcome Due Pre-Project Control Project Control NGA’s Sent to Grantees Grant Year Begins Grant Year Completed March 12 March 26, LV; March 27, Reno; March 28, Elko May 7 May 7 May 14 June 30 July 16 July 23 August 15 Oct. 1 Sept. 30, 2009

*Outside Reviewers are current and/or former Commissioners of the Nevada Commission on Aging, along with community members, who have an interest or experience in services for seniors.

Division for Aging Services 2007 Independent Living Grants Report ~ Page 6

Service Descriptions Transportation
Transportation services are vital to seniors. An Administration on Aging national study found that 21 percent of all clients using senior transportation services relied on those services for at least half of their transportation needs. Of those, more than 80 percent were either unable to drive or did not have a vehicle. Independent Living Grants (ILGs) have helped alleviate transportation problems for Nevada seniors by funding transportation programs throughout the state. Senior transportation programs funded with Independent Living Grants and other state and federal funds ensure that basic senior transportation services are provided in all seventeen counties. Rides were provided by senior center transportation programs, transit coalitions, volunteers and through taxi-bus voucher programs. Nevada seniors were transported to local senior centers for nutritious meals, to medical appointments, and to group outings that encompass social activities and shopping. Escorted Transportation, which is one volunteer escorting one frail senior to and from appointments, was provided by the Retired Senior Volunteer Programs (RSVP) statewide and by the Helping Hands programs in Las Vegas. The most vulnerable and frail seniors are able to get to and from medical appointments with the assistance of the many dedicated senior volunteers who donate their time and the use of their automobiles for helping Nevada’s elderly. To help ensure the well-being of Nevada seniors using this vital service, transportation programs funded by the Division for Aging Services are required to provide and document annual Elder Abuse Training for all drivers and program staff. Division grantees are required to report suspicion of elder abuse, neglect, exploitation and/or isolation pursuant to Nevada Revised Statutes (NRS) 200.5091 – 200.5099. Additionally, drivers are required to have driver safety training biannually. The Retired Senior Volunteer Program (RSVP) relays the following two client experiences regarding transportation: Despite cardiac problems, James was hitchhiking from the supermarket to his home, ten miles away, when one of RSVP’s Lyon County volunteers stopped to offer him a ride. This elderly gentleman had been hitchhiking to the supermarket for several months, because he doesn’t have a car. The RSVP volunteer gave him an information card for RSVP services, and since then RSVP has taken James to get his prescription medicine and for essential services. A senior writes about his transportation service: This letter is to let you know how very much I appreciate the services of C.A.R.T. In my six so called senior years, I seem to have accumulated many health problems and knew the time would come that I’d have to give up driving. This is the most difficult decision I have ever faced. Without the services of C.A.R.T., I wouldn’t have been able to face life.
Division for Aging Services 2007 Independent Living Grants Report ~ Page 7

Respite Care
Respite Service is an important priority of the Independent Living Grant legislation, because it provides caregivers with a small break from their around-the-clock responsibilities. This is important, because the non-stop demands of caretaking add considerable stress to the lives of women and men alike. Much has been written and said about caregivers. They remain the backbone of the long-term supportive services system in the United States, providing the majority of care for people who need help with activities of daily living – activities that include bathing, eating, paying bills and taking medication. Most of this caretaking is unpaid. However, the AARP research center has estimated its value may exceed $257 billion a year. Respite Service has an especially important role for employed caregivers, who contend with the challenge of working outside the home while caring for an elderly parent, and often children as well. Almost half of the “sandwich generation,” the cohort of Americans between age 45 and 55, have children less than age 21, as well as aging parents or aging in-laws. As depicted in a PBS production, Living Old, caretakers in their 40s, 50s and 60s are struggling to cope with what has happened to their parents and grandparents. Producers Navasky and O’Conner add that the elderly themselves are living lives that neither they nor their families ever prepared for or imagined. Millions are coping with chronic illnesses, increasing frailty and prolonged periods of dementia, which can last for years, even decades. They conclude: “For families, the emotional toll of caring for dependent family members can be overwhelming.” To assist Nevada’s caregivers, Independent Living Grants provide vital funding for respite voucher programs in Northern and Southern Nevada. Families are able to apply for up to $1,000 in respite vouchers to hire individuals who provide in-home respite, pay for adult day care hours or perhaps pay for a short stay in an assisted living or long-term care facility. Sometimes such a stay is necessary because the caregiver needs a vacation or may be faced with hospitalization. In addition, funds have been awarded to companion programs, where volunteer companions provide short periods of respite to a stay-at-home caregiver. Regarding respite care, a client writes: I used most of the respite care funds to attend our son’s wedding in Dallas. The airfare plus caregiver costs would have been too much to spend. I miss going to special family and other events. Physically, I’m in good health for being 74-yearsold, but mentally I need to get away. Thank you for the grant – I think of the June wedding often. My husband is still very patient, kind and gentle – I’m very lucky and thankful for that.

Division for Aging Services 2007 Independent Living Grants Report ~ Page 8

Supportive Services
Supportive services help eliminate or delay the need for seniors to enter assisted living or long term care facilities. These services described below are essential. For many seniors, what should be the best time of their lives is not. They are experiencing deteriorating health, illness and disability. Many are unable to remain in their own homes, and illness can challenge financial resources, causing some to become indigent. Seniors who live with a disability or chronic illness may have out-of-pocket expenses never before anticipated. Most seniors prefer to remain in their own homes. However, without supportive services, they are often forced to relocate – to move in with an adult child, move to an assisted living facility and ultimately to move to a nursing home. Providing seniors with Supportive Services makes it easier for them to remain independent in their homes. In considering the following service descriptions, it should be noted that many seniors use more than one Supportive Service within a year. The Division for Aging Services’ records are maintained service-by-service; thus, the actual aggregate, unduplicated number of seniors who benefited from Supportive Services is not yet available. However, the Division is currently implementing use of a software program that will enable the future provision of this data.

Adult Day Care
Adult Day Care is planned care in a supervised, protective, congregate setting during some portion of a day. Referencing Adult Day Care, a senior commented, “The staff is very caring. I’ve seen kindness and helpfulness given to those in need of special care.” Another senior’s daughter said, “The staff have made a tremendous difference with my mom and helping our family. We are so thankful.”

Case Management
Case Management identifies client needs and the services to meet those needs, which are then coordinated and monitored by a Licensed Social Worker. Clients must be functionally impaired to be eligible for this service. As an example of this service: John, age 62, was living alone, and received a pension and Social Security. He was diagnosed with polio as a child and struggles with the limitations it has caused his legs. The case manager received a call from a concerned neighbor, stating that he had seen John crawling to and from his mailbox, and while getting in and out of his car. The case manager visited and assessed John, finding that he needed assistive devices for ambulating safely, had very poor eye sight and was very lonely. The case manager discussed using a walker for ambulating, but John was reluctant to use it in public. After several visits and with rapport established, the case manager convinced John to accompany her to the senior center for lunch, using his walker. After lunch, John said he was very grateful and excited to make his next visit to the center. The
Division for Aging Services 2007 Independent Living Grants Report ~ Page 9

case manager arranged for the senior center to pick him up daily for lunch and activities at the center. John’s poor eyesight meant he couldn’t easily read and pay his bills, so the case manager began doing this for him. The case manager was also concerned about John driving with such poor eyesight, so she contacted the Department of Motor Vehicles, which terminated his license until an exam could be conducted. She then arranged for an appointment with an eye doctor. The doctor found that John had cataracts and performed surgery. Once the cataracts were removed, John was able to see and resumed driving. Due to his medical condition, the case manager helped him apply for Disability, and took him for an appointment at the Social Security Administration. He was awarded Social Security, which has increased his monthly income. John is now flourishing in his community and continues to attend the senior center daily.

Case Management – Elder Protective Services
DAS Elder Protective Services staff assesses victim needs and identifies appropriate services during an investigation. Then Case Management is provided to ensure that identified needs are managed and care is coordinated and monitored to promote client safety and well-being.

Caregiver Support Services
Caregiver Support Services provides education and supportive services for frail older adults, their families and professionals caring for elderly adults in their own homes. The Alzheimer’s Association of Northern Nevada provides this story: Adelaid was a patient of St. Mary’s Hospice and a resident at a local nursing home. Her care was fully covered by Medicaid. Her husband James was loving and devoted to her. He managed to visit her twice daily, even though he was without transportation, had little money and was confined to a wheelchair due to his own serious health problems. His devotion to Adelaid and desire to give her comfort and care during her final weeks of life led him to the decision that she should be at home with him during this time. James lived in a small room in a shelter, but advocated strongly for Adelaid to come home. This was a significant decision for him, as he would have to provide 24hour care for her, but James believed in his heart that was where she belonged. With Independent Living Grant funding, he was able to realize their dream of being together. He was able to pay for caregivers to help him with the more demanding activities of daily care that he couldn’t do alone. This allowed her to die with dignity, literally in his arms, in her bed at home.

Division for Aging Services 2007 Independent Living Grants Report ~ Page 10

Information/Assistance/Advocacy
Seniors often need assistance accessing services, and also knowing what services may be available to address their needs. Providers of this service help seniors access many needed services, medical appointments, errands, social activities, programs and benefits. The service advocates for clients and also provides transportation services necessary for seniors to reach services. The following describes experiences with Advocacy: Ms. D’s companion for 15 years had just passed away, when she came for an office intake. This left her emotionally and financially drained. Ms. D lives on a limited income and her social security only covered her rent, leaving little money for food, much less utilities. I was able to assist Ms. D in many ways. She had recently applied for lot rent subsidy, which was to start in the next two months. We applied for monies through Catholic Community Services, and the STARS program to assist with rent. She wanted to be active in the process and take her applications to the agencies. However, she had no transportation. I provided her with a seven-day ride pass. We had also applied for Lifeline and Low Income Heating and Energy Assistance (LIHEA), which reduced the cost of her utilities. Finally, before she left, I asked if she had food. She was able to count on her fingers that she had seven cans for today and the weekend. We were able to provide her with a pantry bag. Two weeks later, Ms. D called and thanked me for the services she received that day. She had enough money for rent, and reported that she is on a better path now.

Companion Services
Companion Services provides supportive companions to homebound seniors dependent on a caregiver for support. Companions also accompanied seniors to help them access services outside the home. As an example of Companion Services: Mr. C, age 66, is a Senior Outreach Volunteer who visits 73-year-old Ms. D weekly. Ms. D is a talented lady, who lives alone with macular degeneration. She loves to make clay pottery, but the situation with her vision limits her ability to obtain supplies. She often sat at home, very depressed. Because of Mr. C, she is now able to make pottery again. Mr. C takes her shopping for groceries and her pottery supplies. She says, “Life is good now; I am a much happier person.”

Division for Aging Services 2007 Independent Living Grants Report ~ Page 11

Durable Medical Equipment and Health Care Products
This service provides durable medical equipment, emergency prescriptions, diabetic supplies and liquid nutritional products. The value of this service is underscored by the following story: Ms. S, age 86, lived life to the fullest. She single-handedly raised seven children, while caring for her husband, a disabled veteran. She moved her family to Nevada from California in 1962, searching for a better quality of life. She worked a variety of jobs. Among them: a cocktail waitress in a casino, a dental assistant, a pulmonary rehabilitation assistant, a casino change person, a food server at the UNR cafeteria and a grocery store employee. Self-sufficiency and independence have been her strengths. However, she eventually began to suffer with osteoporosis, scoliosis and high blood pressure. C*A*R*E Chest provided bathroom safety equipment that helps her feel safer and more secure in the shower. She especially enjoys a walker with a seat that was also provided. It keeps her mobile and independent. She says “I can’t believe I can actually go Christmas shopping this year.”

Geriatric Health and Wellness Services
Geriatric Health and Wellness Services help ensure access to a comprehensive health/medical screening or assessment. Other services provided may include primary health care, dental care, mental health care, health education and wellness services, exercise, geriatric case management, medication management and Internet health services. Patients with suspected dementia may also undergo a comprehensive social evaluation. A Dental Services client writes: I hope I can find the words to express my extreme happiness with the magnificent treatment the Miles for Smiles program brought into my life. A dentist pulled all of my upper teeth out and made a plate. He also pulled some lower teeth and made a partial plate. Then the dentist discovered that Medicare and Medicaid would not cover the expenses, and all treatment stopped until I could pay full service charges. Since I live on Social Security, I had absolutely NO money to spend. The plates did not fit, so for four long and painful months I could not eat solid food, lost 30 lbs. and got very ill. I’m diabetic and was really worried and depressed. I searched and searched for an answer and finally an advocate for seniors suggested the Miles for Smiles Program. Yesterday was my appointment and last night, for the first time in four months, I ate a real meal! I have two more appointments and am actually looking forward to them. In a world that seems not to care about anyone, you and your people stand out like a shining star in the darkness. You have my heartfelt gratitude and I’m sending you the biggest THANK YOU I can find!!! God bless you all!!!

Division for Aging Services 2007 Independent Living Grants Report ~ Page 12

Homemaker Services
Homemaker Services provides seniors, unable to perform home and self care, with housekeeping and personal care assistance. Reno Housing Authority provides the following about Homemaker Services: Louise was an 83-year-old widow, who lived alone. She was very frail, and had a history of pulmonary disease and stomach cancer. She was on continuous oxygen and used a walker and the assistance of one person to ambulate. She had a niece with whom she was very close. In November, 2002, Louise was hospitalized for a ruptured ulcer. However, she was insistent on returning to her apartment and refused long term care placement. Homemaker Services began in December 2002 and continued until she was hospitalized again in December 2004. Her condition had deteriorated to the point where long term care was the only option. However, it is conservatively estimated that sustaining Louise with Homemaker and other needed services between 2002-04 saved almost $100,000 in long term care facility costs.

Home Services
Home Services provides home safety evaluations, home safety training, home accommodations and modifications, home maintenance, home repair assistance or home chore services and installation of home aides/equipment.

Legal Services
Legal Services provides consultation and/or representation in legal matters. Such services are critically important for seniors, as the following story illustrates: Mr. and Mrs. B lived in an upstairs apartment. After 12 years of residence there, the clients received a “no cause eviction.” They felt this was retaliation for pursuing an insurance claim against the landlord, because a tree fell on their car. The landlord advised Senior Law Practice staff that the eviction was due to his perception that the couple could no longer navigate the stairs. However, the landlord had previously refused to approve the tenants’ request to move to a downstairs apartment. Both of these are Fair Housing Act violations. Based on procedural issues, the court denied the landlord’s eviction request and filed a formal Fair Housing complaint with HUD. The transcripts of the eviction hearing contain the landlord’s admission to illegal housing discrimination motives.

Division for Aging Services 2007 Independent Living Grants Report ~ Page 13

Medical Nutrition Therapy
Medical nutrition therapists conduct nutritional assessments to screen seniors considered to be at risk, to determine if counseling/education, additional meals, nutrition supplements and/or case management may be needed. As an example: A client with a history of poorly controlled diabetes, heart disease and a cerebral vascular incident requested help from Catholic Charities of Southern Nevada, Meals on Wheels (MOW). His main problem was very serious skin ulceration due to being wheelchair bound, and his quality of life was poor. MOW registered dieticians and support staff began aggressive treatment that included education, diet adjustments and vitamin supplements to facilitate wound healing. Within two years, the client achieved an intended 47 pound weight loss, consistently average blood glucose readings and the ability to walk short distances. The client’s quality of life has significantly improved.

Volunteer Care
Volunteer Care involves the provision of services to seniors, who are typically alone and frail, chronically ill, homebound and/or dependent on a primary caregiver. Volunteers provide a wide array of services, such as: transportation to and from medical appointments; companion services; personal emergency response system equipment installation and instruction in its use; resistance training exercises; work at local and state agencies to augment existing personnel; staff the Farmer’s Market; grocery shopping and putting groceries away in seniors’ homes; chores, such as meal preparation; assistance with reading mail and bill paying; prescription pick-up; book reading to seniors and assistance with correspondence. Retired Senior Volunteer Program (RSVP) provides this story: Kathie, a Dayton volunteer, has taken on the assignment of visiting with two sistersin-law in Stagecoach. She has helped one of them with managing her records, as this woman has macular degeneration. Kathie has helped the other sister with repairing her house by providing a weatherization survey for both clients. This has helped them feel more secure and comfortable this winter. Both women have come to depend upon Kathie’s visitations as a major source of comfort.

Emergency Food Pantry
The Emergency Food Pantry service provides emergency food supplies, and purchased and donated non-perishable food items to assist seniors in meeting their nutritional needs. Jude 22 provides the following information: We had an extraordinary Christmas party on December 15, 2006, hosting 320 seniors who use our services. Every senior who attended the party received Christmas gifts and a hen, courtesy of the Nevada Division for Aging Services. Mayor Oscar Goodman made a short Christmas speech and Councilman Gary Reese also spoke. The Las Vegas Academy sang old fashioned Christmas Carols, and there was plenty
Division for Aging Services 2007 Independent Living Grants Report ~ Page 14

of food to eat. Many of the seniors cried; they said these were the only gifts they will receive for the holidays. All who attended had a wonderful time.

Personal Emergency Response System
The Personal Emergency Response System service (PERS) helps homebound seniors living alone, to feel more secure at home. Program volunteers or staff assess each client’s need for a PERS, and when the need is determined, ensures that installation is completed in a timely manner and that the client understands how to use the system. In an emergency, this program summons assistance in response to the senior pressing an alert button on a personal transmitter that is worn on the wrist or around the neck. The transmitter alerts a monitoring station that assistance is needed. The following illustrates the value of a PERS: Mary, a recent widow, is suffering with osteoporosis and had fractured three vertebrae while lifting her husband in and out of bed during the last few months of his life. Now bent over and afraid of falling, she needed to have a sense of security restored. RSVP helped her obtain a PERS for her home. Through a combination of Division for Aging Services funds and RSVP’s Lyon County Adopt a Senior Program, RSVP was able to give this system to her for one-third the cost. Now Mary knows she will have care immediately in case of her emergency, making her feel more secure in her own home.

Protective Services
Protective Services assist seniors at imminent risk to self or others and/or suspected of being victims of abuse, neglect (including self-neglect), exploitation or isolation. Services include, but are not limited to, investigations, assessments, referrals, advocacy and emergency transportation, plus the application of the full spectrum of social work and crisis management skills. When investigations are completed, clients may be referred to Case Management – Elder Protective Services, for ongoing assistance.

Representative Payee
The Representative Payee service provides money management and supportive community case management. Seniors eligible for this service are unable to receive and manage their own funds and have no other suitable person to act on their behalf. Services include managing the monthly income of qualifying seniors who need assistance in paying bills and maintaining a personal budget based on comprehensive client assessment and regular monitoring of his or her status, plus case coordination with case managers from other agencies. Representative payee services are provided by a Social Worker, including client assessment, development of service plans and coordination of services with other agencies.

Division for Aging Services 2007 Independent Living Grants Report ~ Page 15

A Social Worker writes the following about Representative Payee: During a routine home visit to complete an assessment for services, I noted that the client was in debt to Paycheck Loan, had overdrawn her bank account by more than her monthly SSA amount, was in danger of being evicted due to inability to pay rent, and she had minimal food. Because she had asked for assistance, I was able to stop overdraft from taking all of her SSA funds, making it possible to pay her monthly rent, utilities and food. With the assistance of budgeting her money with payee services, the client has been able to pay off her loans, become current on all utilities, purchase food on a regular basis and be assured that her rent will be paid in a timely manner. The client has since built up a small savings account in case of emergency needs and for a trip to visit her son, whom she hasn’t seen in eight years.

Division for Aging Services 2007 Independent Living Grants Report ~ Page 16

UNITS OF SERVICE DEFINITIONS
Service Adult Day Care Alzheimer’s Diagnostic Service Caregiver Supportive Services Case Management Case Management – Elder Protective Services Companion One hour One diagnostic or follow-up visit. One contact with or on behalf of a caregiver and/or client or One hour of training/educational meeting in a group setting One hour One hour One hour of service Unit of Service

Durable Medical Equipment and One adaptive device or one health care product Health Care Products Emergency Services Food Pantry Foster Grandparent Program One payment of an essential service One food bag per person One hour of service by a Foster Grandparent

Geriatric Health and Wellness (contains several categories) One health-screening visit or self-assessment or One wellness service or One Internet visit One primary care visit, case management, follow-up, or reassessment visit or One health screening or testing or One person-to-person consultation and/or referral or One dental procedure One person-to-person consultation and/or referral or One mental health screening or testing or One session of direct care, case management, follow-up, or reassessment or One session of group counseling for the client or caregiver

Health Screening

Direct Patient Care for Medical and Dental Program

Mental Health Programs

Division for Aging Services 2007 Independent Living Grants Report ~ Page 17

Service Geriatric Health and Wellness, continued Alzheimer’s Diagnosis Geriatric Assessment and Care Management

Unit of Service

One diagnostic or follow-up visit One hour of assessment, planning and/or care management service One hour of training/educational meeting in a group setting or One face-to-face session or One Internet session or One written communication to a medical professional One documented, structured, exercise session in an individual or group setting or One Resistance Training presentation to a Senior Center, assisted living facility, nursing home or senior group activity One reminder to take a medication or One evaluation from a doctor or pharmacist comparing any number of medications, herbal remedy, or vitamin/mineral supplements with appropriate education for the usage of medications or One visit to organize medication(s) for a daily, weekly, or monthly duration of time, with appropriate education for the usage of medications or A contact with a client for medication management consultation, education, or follow-up purposes One hour of Home Attendant or Personal Care One unit equals completion of a home accommodation/ modification, a home aid or equipment, a home maintenance or a home repair and or any other intervention that is part of the home service plan or One unit equals completion of one hour of home safety evaluation, home safety training or home chore service or One unit equals completion of one modification to a vehicle One hour of homemaker/chore service One contact by telephone, in person, or on behalf of an older individual One hour of Legal Assistance

Health Education

Exercise Programs

Medication Management

Home Care Services

Home Services and Vehicle Modifications

Homemaker Service Information, Assistance and Advocacy Legal Assistance

Division for Aging Services 2007 Independent Living Grants Report ~ Page 18

Service Personal Emergency Response System Medical Nutrition Therapy

Unit of Service One Personal Emergency Response System installation Completion of one client contact to screen, assess, intervene, counsel and/or provide education

National Family Caregiver Support-Title III-E (contains several categories) Counseling/ Support Groups/ Caregiver Training Respite Access Assistance Information Services Nutrition Podiatry Screening Protective Service Representative Payee Respite and Supportive Services Retired & Senior Volunteer Program (RSVP) Telephone Reassurance Transitional Housing Transportation Volunteer Care One session One hour One contact One activity One congregate or home-delivered meal One foot screening visit One hour One hour of representative payee service on behalf of a client One hour of service One hour of volunteer service One telephone contact, or one contact with, or on behalf of, a client One hour or One placement One trip (one-way ride) One hour of service

Voucher Services (contains several categories) Taxi Voucher Program Transportation Tokens Respite Voucher Program One coupon book (20 vouchers) One token One hour of respite care regardless of the cost to provide that unit

Full information on these service specifications can be found at http://www.nvaging.net/grants/serv_specs/service_specifications.htm

Division for Aging Services 2007 Independent Living Grants Report ~ Page 19


				
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