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Governors Advisory Council on Aging

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					                        Governor’s Advisory Council on Aging
                      Minutes from the August 14, 2008 Meeting
              At the Continuing Education Building in Missoula, Montana


Vice-Chairman Gladys Considine, opened the meeting.

Attendance:
      Gladys Considine, Bob Maxson, Pat Ludwig, Toni Hagener, Mary Lou Miller,
Mary Mumby, Connie Bremner, Grace Bowman. Jessie James Hawley, Beverly Barnhart

Absent: Lauren Lynch

Staff: Kelly Williams, Brian LaMoure, Charlie Rehbein

Guests:
       Dannette Fadness, Sharon Alexander, Dan Doyle, Roger Millar, Eileen Sansom,
Bernie O’Connor

Minutes: Grace Bowman moved and Mary Mumby seconded the motion to approve the
minutes from the June 26th conference call meeting. Motion passed.

Old Business:
       We got approval from the Governor’s Office regarding the change to going to
three mini-conferences. Our sites are Glendive, Browning and Butte. In Glendive, May
5 and 6, 2009, we will use the Epic Center, which is the old Safeway. In Butte, May 7 and
8, 2009, we are planning on using the Copper King Inn and in Browning, the week of
May 11, we will use Connie’s new Center, but that date has not been set yet.

New Business:
        The Governor issued an executive order, number 35-2008, which Charlie handed
out. This executive order advances the use of technology to promote energy for Montana
Board, Council and Commission meetings. The intent of this executive order is to reduce
fuel consumption and to possibly increase public participation by using technology. In
the past we usually scheduled five meetings, four quarterly and one conference meeting.
This last year, fiscal year 2008, we have met more than that and had several conference
calls. If we utilize conference calls, we can do more meetings if we need to. It was
suggested that we consider two face-to-face council meetings and the rest conference
calls, with the possibility of having a third face-to-face at the annual conference.

The cost of having all of the Council members attend all three of the mini-conferences in
May of 2009 was discussed. Based on budget projections and utilizing a State van to
help reduce the cost of all Council members having to drive to each conference, the cost
would be $17,512.83. Charlie pointed out that this is about what we have in our budget
to fund the activities of the Council for the whole year. If only three or four Council
members attended only one of the mini-conferences, the cost would drop to



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approximately $7,150. One suggestion was that Council members only go to those
conferences which were closest to where they live. The cost as well as time commitment
is a factor that needs to be considered. To attend all three of the mini-conferences, we are
looking at a full week for Glendive and Butte plus another 2 or 3 days for Browning the
following week.

A question was asked if Council members could attend which ever mini-conference they
wanted to. Charlie and Kelly Williams both said that Council members could choose
which one they wanted to attend.

The discussion went back to the number of Council meetings to be held this year. Toni
Hagener moved and Bob Maxson seconded a motion to have two face-to-face meetings
each year and as many telephone conference calls as necessary to carry out our business.
The motion passed with only Jessie James Hawley opposing.

Kelly Williams clarified the Governor’s Executive order related to conserving energy and
stated that if the Council needs to have an additional face-to-face meeting during the year
to accomplish business, that could be requested and set up. The intent is not to limit the
meetings, but to do whatever we can to conserve energy while we carry out the business
of the Council.

Discussion returned to attending the mini-conferences and a motion was made by Toni
Hagener and seconded by Jessie James Hawley and Mary Mumby that Council members
be allowed to choose which mini-conference they wished to attend. Further discussion
followed related to Council members attending the mini-conferences closest to their
community, Council members being able to choose which conference they wanted to
attend with the possibility of them attending a second mini-conference if the member
paid their own way. It was suggested that we even consider a MetNet teleconference as a
way to get the information out to more people. MetNet teleconferences are ones where
people come to various locations and see and hear people in other communities on big
screen TVs. A question was asked about how much a MetNet teleconference would cost.
Kelly Williams explained that you have to have the conferences at sites that have
broadcasting abilities which are connect to the MetNet system. She also indicated that it
is approximately $150 per site set up and $52 per hour per site to have a MetNet
conference. The suggestion was made that we consider this at a later date and that maybe
a committee be formed to look into teleconferences and also taping of the information
presented from the conference sessions to be put out on the web or on computer disks.

Bob Maxson discussed the use of technology and how we can deliver the message we are
trying to get out. He made a suggestion that we set up a committee to look into
technology options.

Pat Ludwig discussed some technology that was used at a conference she was at and how
wonderful it was to be able to get all the information on a USB drive and maybe we could
do something like that and get some sponsors to help provide it. A question was asked
how we work with vendors on a mini-conference. Brian indicated that we have a number



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of groups interested in sponsoring the conferences. We will have to work with the local
conference planning committees regarding vendors. We don’t know what the charge will
be for the building or meals yet. When dealing with motels, we get charged for meeting
rooms and meals. We don’t know yet how that will work with the Epic Center in
Glendive. We will have to work with each community and see what needs to be done as
far as vendors.

The question was raised as to the motion on the floor and was briefly restated by Toni
that Council members could choose which mini-conference they wished to attend.

Beverly Barnhart moved to table Toni’s motion based on the discussion of having the
conference in three or four areas rather than one plus the possibility of using technology
and felt we need to think about this some more. Gladys called for those in favor of
tabling Toni’s motion to raise their hand; Beverly was the only one voting in support of
tabling. Then Gladys called for all those opposed to the tabling motion and in favor of
Toni’s motion to raise their hand. The tabling motion failed and motion to choose which
mini-conference council members wish to attend passed.

Pat Ludwig asked if we could have a discussion on the use of technology for other
conferences. Bob Maxson moved that we discuss later today some ideas about pursuing
technology alternatives. It was seconded by Mary Lou Miller and the motion passed.


Guest Speakers:
         Roger Millar, Director of City/County Office of Planning and Grants.
Mr. Millar talked to us about the Urban Fringe Development Area in Missoula and
Missoula County. He discussed their planning process and the recommendations they
developed related to the projected growth of Missoula and the fringe areas. They took
into consideration the aging of our society, traffic patterns, current open areas and other
factors such as police and fire protection. They held numerous meetings and leveraged a
lot of information from city, county, state and federal agencies, various organizations
both public and private, and neighborhoods to gather comments, ideas and concerns.
They are planning for 15,000 new households in the urban part of Missoula County over
the next 20 years. This is a less than 2% growth rate as compared to Boise Idaho which
has been growing at 6% per year for the past 30 years. They have 5,200 acres of
developable land, which includes underdeveloped land, inside our urban service area and
it is zoned for 27,000 homes which exceeds the projected need of 15,000.

In 1960 half of American house holds had children in them. By 2025, less than 30% will
have children in them. By 2025, 30% of our households will be just one person. In the
USA today, we have excess inventory of 22 million more large lots single family homes
than we will need in 2025. We currently have a need for 60 million smaller or attached
homes in the USA, due in part to the changing demographics. 75% of the people living
in Missoula could not afford to move to Missoula and buy the home they live in today.
So we will need to build more affordable housing, apartments or condominiums.




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Some other interesting statistics they looked at were for Montana. Between the years
2004 and 2030, the school age 0-17 stays about the same; the 18-33 age groups drops
40,000; 34-49 stays about the same; the 50-64 group stays about the same while the 65
and older age groups increases tremendously. Most of our growth will be in the 65 and
older group. Some of the things we need to look are who provides the services, who pays
them. The average age of Missoula county employees is 49. The Sheriffs department will
loose 2/3’s of their staff in the next ten years. As these people retire, who will take their
place, what kinds of wages will they need? What type of housing will they require?

   Dan Doyle, Professor of Sociology and University of Montana Intergenerational
   Gerontology Program and is also on the Area Agency on Aging Executive Board.
Professor Doyle informed us that they are trying to incorporate gerontology into various
programs and have established gerontology minor. There are four core classes and have
incorporated gerontology curriculum into several other programs such as social logy,
pharmacy, marketing, and business. We have developed evening and weekend classes to
help people attend classes as well as on-line classes. We are excited about the minor in
gerontology and have the support of the administration and getting some programs
excited about it also. It is an effort to get 18 to 25 year olds to look at how gerontology
fits into their majors, but are making headway. They have made it easy for students to
add a couple of classes to their disciplines to get a minor in gerontology. Jessie James-
Hawley suggested they encourage more participation by Native Americans.

      Eileen Sansom, the Chief Program Officer for Missoula Aging Services and
            Bernie O’Connor Programs Officer for Missoula Aging Services
Both presenters spoke to us about Missoula Aging Services. They handed out
information on the Missoula Aging Services, their goal, mission, and vision. They have
been planning for the future in developing services and their organization. The funds
they get from the county now exceed the amount of funds the state gives them. They
have 3 mill levies through the county and one from the city. They would like to see the
state a more active partner financially and will be working with the legislature to address
this issue. Also, the legislature capped 2 of the 3 mill levies. This means that only one of
our mill levies can grow while the other two are held at the level they were passed at.
They use volunteer drivers to deliver meals and are having trouble getting volunteers.
They have provided mileage for those who ask, and more are asking so they have to
provide mileage to more of them due to gas costs. The County Commissioners appoint
the Area Agency’s board and the city has one member on it in an ex-officio capacity.
Missoula has developed partnerships and provides a variety of services from nutrition and
farmers market to transportation and care management services to housing and caregiving
and in-home services. They try to match volunteers with the needs of the elderly and the
seniors with the needs of the volunteers.

       Sharon Alexander, Dean of the U of M Continuing Education Department
and Dannette Fadness, U of M Life Long Learning Institute (MOLLI)
Dean Alexander welcomed us on behalf of the Provost. She explained that the MOLLIL
Program started in 2005 as the Montana Life Long Learning Institute, an educational
program for people over the age of 55, intellectually based utilizing University



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professors, both active and retired professors, and community members who are experts
in their field. These are short courses are offered 3 times a year, fall, winter and spring.
The courses are 6 weeks in duration for an hour and a half in length. They are designed
to let us as older adults to keep our minds alive. There is a direct connection between
keeping our minds active and a healthy old age.

Studies have shown that the brain learns and grows by interacting with the world through
perception and action. Mental stimulation like life long learning strengthens the
connection between brain cells and protects against cognitive decline. Neuroscience
research tells us that challenging activities lead to the formation of new brain cells and
new connections among these cells, a process called neurogenesis.

As our population ages, it is important that we continue to provide educational activities.
The MOLLI program is so engaging that we need to take it to other locations because it is
so important. Being able to take it statewide would be so advantageous to the elderly, but
cost is a problem. In 2006, the Bernard Osher Foundation, located in San Francisco,
provided some funding for three years for this program. Osher Life Long Learning
Institute provides funding based on membership. At the end of three years, if they have
500 members, they get $1 million which will help fund this program. Currently, they
have 736 members and had 1,274 enrolled in classes through 52 courses at four locations
in Missoula. Membership annual fee is $20 for July 1, 2008 through June 30, 2009 and it
needs to be noted that membership is required to enroll in MOLLI courses. Course fees
are generally $50 and it was noted that scholarships are available for those on fixed
incomes. To learn more about memberships and registration you may call 406-243-2905
or e-mail molli@umontana.edu.

Pat Ludwig’s suggestion that MOLLI consider doing one to two week sessions in the
summer when retired people could participate will be considered.

We broke for lunch.

Town Listening Session
Gladys Considine opened the Town Listening Session at 1:15PM with 35 people in
attendance. She welcomed everyone and explained the roll of the council. The council
members introduced themselves and where they were from. She also introduced the state
staff. She discussed the survey sheets which had been handed out and asked people to
take time to fill them out. She noted that this is an informal session with no set speakers.
We do have people from different services and asked that they talk a little about their
programs.

Professor Dan Doyle talked about the ability of getting a minor in gerontology at the
University of Montana.

Dannette Fadness gave an overview of the MOLLI program.




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Nancy Heyer, a nurse for a private pay senior home health care program, talked about
their target being to provide the highest quality caregiver services. Their experience is
that people 60 years of age or younger are buying services for their elderly family
members. Caregiving and health care are extremely important to us, our workers and
people in general. One of the problems is when you provide health insurance for those
staff who serve Medicaid clients and can’t for those who don’t have Medicaid clients.
She also noted that on October 1, 2008 Medicaid (this should be Medicare) will not pay
Hospice services any longer. While it may not be eliminated totally, it will be reduced or
stripped down. Based on this, their legislative priorities are health care for health care
workers and the hospice benefits being cut. The other thing is wage reduction by setting
a reimbursement rate for Hospice services. This option will reduce Hospice services and
eliminate it in some areas. All three of our congressmen are against this.

Connie Bremner noted that August 20, 2000 the Commissioner from Washington DC and
the Regional Social Security Director will be coming to the Blackfeet Reservation in
Browning to meet with the seniors and Tribal Council. They will have a listening session
in the afternoon. If any one had comments they want to send because they are not able to
attend, they can send them to respite@3rivers.net.

Traci, the care manager from Missoula Aging Services talked about the need for in-home
services is growing and that they have a waiting list for services in Missoula and there are
at least 400 people on the waiting list statewide. She also noted that under the Home and
Community Based Waiver program, the state is only proposing increasing services for 58
people over the biennium, which is about 29 slots per year. As we age, the number is only
going to grow. We have found that you can serve three people with the same amount of
funds you serve one person in a nursing home. She talked about AARP’s meetings
regarding rebalancing the Medicaid budget. She also talked about quality of life versus
cost per person and needing to balance the two.

Beverly Barnhart noted that we need nursing homes also. She told us of a person who
had no family in Bozeman, but has money and chose to live in the Gallatin County
nursing home because it met her needs. There was further discussion with several people
commenting that there are some amazing nursing homes and we don’t want to eliminate
nursing homes. We want people to have the choice so we want to promote expansion of
choice and allow people options based on entitlement.

Judy Munson, Summit Independent Living Center, talked about working with people
with visible and invisible disabilities. People with disabilities have been advocating for
some of the same things the elderly are beginning to advocate for now. We don’t want to
duplicate nor eliminate services. Housing is an issue for both the elderly and disabled.
On August 26th, they will be having a presentation on housing alternatives both public
and private at the University Theater. Housing is also a choice and we want people to
think about universal design so they may not have to move if they need to make changes
to meet their needs. Also, transportation is also a big issue for both the elderly and
disabled. Health care for health care workers is extremely import, and we need to keep




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working with the state and other stakeholders to keep moving forward on health care in
Montana. Our intent needs to be the same, doing what is best for Montana.

Eileen Sansom, talked about the wide variety of services offered through Missoula Aging
Services. She noted that they have a list serve for senior issues during the legislature and
if people are interested in that they can get on the list by sending an e-mail to
senior@missoulaagingservices.org. It is a good way to keep up on issues during the
legislative session.

Renee Labrie talked about the importance of and need for Information and Assistance as
well as SHIP and Ombudsman services. Having the professionals available to help people
is critical to choice. She gave several examples of how staff have helped and advocated
for people who need assistance in order to get services. They have provided assistance in
getting someone in the Reverse Annuity Mortgage program due to a tax problem in
which they were about to lose their home; to helping someone get services because their
family members refused to provide adequate financial payment for a home they received
from the senior citizen; to helping a man return to his home in the community from the
nursing home because it is what he wanted and he has lived at home now for 2 years with
no problems; to helping people with Medicare Part D. When someone calls the agency
requesting a home delivered meal, they do an assessment of a client’s needs to determine
if they need more than just the meal in order to stay in their home. The issues they get
are not always easy and some take days or weeks to resolve but they are there to help
them, to advocate for them.

Barbra Morgan, with the Montana Geriatric Education Center with the University of
Montana, talked to us about the center which is part a consortium of University of
Montana, Montana Tech in Butte and the Northwest Research and Education Institute in
Billings. They provide geriatric education for health care professionals and health
professionals students and higher education facility. Most of the disciplines served are
nursing and pharmacy and social workers. They are federally grant funded by HERSA
and we are in our second grant. One of the things they are charged with is improving
health literacy. One way they accomplish this is by hosting an annual conference. This
year’s conference is in Billings at the Mansfield Health Education Center on October 14,
2008 on Improving Geriatric Care Transitions: Medication Safety and Health Literacy.
The conference will be broadcast to interactive videoconferencing sites around Montana.
For more information about the Center or the conference or a videoconferencing site near
you, contact barbra.morgan@umontana.edu or call (406)243-2453. If there is a
videoconferencing services available that is not currently one of the sites which is part of
the conference and if there are enough interested participants, the Center will try and get
it set up, just contact Barbra.

Patti Holcum, with the University, talked about elder abuse and prevention. They have
gone to various communities talking about this issue. What they have found is that there
is a need for an adult protective service worker on each of the reservations. It was noted
that there is a need for more APS workers state wide. Kelly Williams explained that we
have to go through the legislative process to get additional APS staff.



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Connie Bremner talked about the need for APS workers on the Reservations to be hired
from Tribal members due to the sensitivity of the elders and their concerns about opening
up to or dealing with strangers, it was suggest that any adult protective social workers on
Reservations should be Native American. It was also noted that there is a need for APS
workers to be culturally sensitive.


Gladys opened it up for general comments by asking, “Are you getting old in Missoula
and do you have any concerns about getting old in Missoula?” Bob Maxson commented
that when you walk across the street in Missoula, cars stop and let you cross, that just
does not happen were he is from. If it can happen in Missoula, we have hope it can
happen in Montana.

All the entertainment and educational opportunities in Missoula make it a great place to
grow older in. A lot of places don’t have what we have here and meeting the unmet
needs in rural Montana is going to be the challenge. Can we get the services people need
and can we recognize what those unmet needs are and help provide them. One thing that
is needed and has been for about 25 years is transportation.

It was noted that Montana does not have retirement communities like they have in other
states, like Sun City in Arizona. There was some discussion about senior housing and the
need for it, for smaller apartments and homes designed for people as they age.

There was also concern about the work force. Who is going to provide the services as
people age? The issue turned to money and the need to find a funding source for the
Older Montanan’s Trust Fund in order to have resources for the future. Pat Ludwig noted
that the Trust fund was passed and funded with one time only funds of about $7 million,
which is a good start, but it needs to be increased so there are monies available in the
future to meet the needs.

Gladys concluded the Listening Session by thanking people for coming and reminded
them if they have any concerns, to contact the Council and the Senior and Long Term
Care Division or Missoula Aging Services.

Council meeting reconvened
Chainman Beverly Barnhart called the Council meeting back to order.

There was discussion regarding the listening session. Several thought it was one of the
most informative but disappointed in not having more people participate in the session.
It was noted that we have held these sessions at Senior Centers and have a captive
audience. Some thought that since they have more services available in Missoula that
maybe they don’t get as good a turn out as in other more rural parts of the state. We still
need to get more individuals to these meetings.




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There was some discussion regarding how the senior center in Missoula functions.
Charlie and Gladys gave us a history lesson on how the Missoula Senior Center became a
stand alone organization that does not take Federal or State funds from Area XI Agency
on Aging-Missoula Aging Services. They discussed how Missoula Aging Services
coordinates their meals programs through contracts with restaurants for their congregate
meals and the hospital for home delivered meals. They have criteria that they follow for
home delivered meals.

Charlie explained how Missoula Aging Services became an area agency and how they get
county funds. He talked about how they build partnerships and how they have used
some of the grant funds they have received from the State to build these relationships.
Missoula has done some good things in developing resources and partnerships in order to
assist people in getting the services they need. A question was asked about Ravalli
County and its relationship to Missoula Aging Services. Missoula and Ravalli counties
make up Area XI Agency on Aging.

Reports by Council Members
Grace reported that she always goes to the Area II Agency on Aging’s quarterly reports.
There are 11 counties in Area II and you find out what problems and successes these little
counties are having. She reported that John McCrea’s legal presentations are wonderful
and well received. Also that Karen Erdie does a great job and her meetings are very
informative.

Pat reported that she is the secretary and goes to all of the Area III Agency meetings. She
also always gives a report on the Council. They have quarterly meetings and usually run
from 8:30 to noon. She talked about RSPV program and that Deb Pate is the Area
Director. She stated it was a good way to keep everyone informed. She also talked about
the transportation expansion in Area III giving people rides for medical needs to Great
Falls and Kalispell.

Mary Mumby talked about the meetings in Area IX in Kalispell. She talked about the
Farmers Market program for seniors and that Area IX opted out of the program and
raised their own funds due to limitations the Federal government was putting on them.
She also talked about the success of the community gardens program and that they need
more space. It was noted that Area IX in Kalispell is a single county Area Agency.

Toni talked about the need for transportation, especially medical and dental care
transportation to services outside of Hill County, Area X Agency on Aging. People who
transport commodities are reducing the amount they are getting because of increased
costs due to fuel costs.

Jessie reported that Fort Belknap has put in for an assessment, planning and development
grant to look at developing long term care service center. This will allow for more
services.




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Beverly reported that she had attended the Area IV board meeting in Livingston at the
new senior center there, which is very nice. She noted that the governing board and the
advisory board for Area IV meet together so she felt it was a little hard to follow
sometimes what was going on, but it was good. Their program was very good, we
learned about Veteran’s services and issues plus the food was excellent.

The discussion returned to the use of technology as a conference option or in helping to
get our message out and get more people involved. Chairman Barnhart appointed a
committee to look into the possible use of technology for meetings and conferences.
Appointed to the committee were: Bob Maxon, Pat Ludwig, Gladys Considine, and Brian
LaMoure of the state office staff.

Bob Maxson asked how the Council information and decisions get to the Governor. Kelly
Williams responded that the minutes of the meetings were regularly reviewed by the
Department Director and taken to the Governor.
Charlie passed out the information from the surveys we did at the Helena and Butte
Listening Sessions.

Brian asked for Chairman Barnhart to appoint committees to work with him on
developing each of the mini-conferences for 2009. Connie Bremner, Mary Mumby,
Gladys Considine and Jessie James Hawley were appointed to assist with the Browning
conference. Bob Maxson, Grace Bowman and Mary Lou Miller were appointed to help
with the Glendive conference. Lauren Lynch, Pat Ludwig and Toni Hagener were
appointed to help with the Butte conference. Brian indicated that he would be calling
every very soon to begin the planning process.

Beverly Barnhart closed the meeting.




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