1. Supporting older texans an overview of Area agencies on aging

2. Area agencies on aging (AAAs): authority and role • Created by Older Americans Act of 1965 • Funded by Administration for Community Living and State Units on Aging (Texas Department of Aging and Disability Services) • Plan, administer, coordinate, and provide services

3. AAA organizational structure (1 of 2) • Form nationwide network, comprised of 618 AAAs • Texas served by 28 AAAs(24 sponsored by Councils of Governments) • Access AAAs by calling 1-800-252-9240

4. AAA eligibility criteria (1 of 3) • Persons age 60 and over • Informal caregivers of persons age 60 and over • Medicare beneficiaries of any age • Nursing home residents of any age • Grandparents at least 55 years of age who are primary caregivers for grandchildren under the age of 18 years

5. AAA eligibility criteria (2 of 3) • Eligibility age-based, rather than income-based • However, AAAs required to target high-risk persons • Greatest economic need • Greatest social need • Greatest risk of institutionalization

6. Aaa eligibility criteria (3 of 3) • Targeting criteria (cont.) • Primary language other than English • Rural-dwelling • Alzheimer’s or related dementias

7. Aaa fee structure • All services provided without charge to eligible persons • Voluntary contributions welcomed

8. AAA Required Services (1 OF 3) • Information, referral and assistance • Benefits counseling • Legal Awareness • Legal Assistance • Care coordination • Caregiver support

9. AAA REQUIRED Services (2 OF 2) • Long-term care ombudsman • Nutrition • 3,633,468 congregate meals served during FY12 • 4,886,825 home-delivered meals served during FY12

10. AaA Optional SERVICES Services to support independent living (e.g., demand-response transportation, evidence-based disease prevention, respite, emergency response, homemaker, chore maintenance, and residential repair)

11. AAAs improving health outcomes Evidence-based programs • Care Transitions • HomeMeds • Stanford Chronic Disease Self Management • Diabetes Self-Management • Arthritis Self-Management

12. Care transitions • Target older persons at high risk of readmission • Provide in-home and telephonic coaching services • Understanding medical condition • Following up with primary care physician • Complying with treatment plan • Reconciling medications

13. homemeds • Home-based intervention that identifies and resolves potential drug-drug interactions • Nearly half (46.7%) of participants at risk of medication-related injury, with average of 2-3 potential problems per participant

14. Stanford chronic disease self-management (1 of 2) • Series of six workshops, serving small groups of people with chronic disease • Uses lay leader model to help participants manage symptoms, deal with stress, communicate with family and health care providers, and evaluate treatments

15. Stanford chronic disease self-management (2 of 2) • Outcomes include reduced hospital lengths of stay, outpatient visits, and hospitalizations • Cost to savings ratio of 1:4, with results persisting for up to three years

16. AAAs decreasing risk of premature institutionalization • Evidence-based programs • A Matter of Balance • Stress Busting for Family Caregivers

17. A Matter of balance • Series of eight workshops, serving small groups of 6-15 participants who are concerned about falling • Uses lay leader model to counteract negative self-talk and learn strategies for reducing incidence of falls • Outcomes include increased activity levels, mobility control, and social function

18. Stress busting for family caregivers • Education and support for small groups of family caregivers • Outcomes include decreased caregiver stress, depression, and anxiety, in addition to decreased rates of nursing home placement

19. aaas decreasing risk of premature institutionalization • Case management/in-home services • Personal assistance/homemaker • Residential repair, emergency response, DME, nutritional supplements, etc.

20. Aaas advocating for nursing home residents • Long-Term Care Ombudsman • Advocates for residents’ rights (e.g., to pursue relocation) • Helps prospective residents choose facilities • Provides training to facility staff • Supports resident/family councils • Appeals involuntary discharge

21. AAAs increasing economic security (1 of 2) • Options counseling/benefits counseling • Medicare • Medicare Savings Programs: help with Parts A, B premiums, deductibles, co-pays • Low-Income Subsidies: help with Part D co-pays

22. AAAs increasing economic security (2 of 2) • Medicaid • Pharmaceutical companies’ patient assistance programs • Food stamps • Veterans benefits • Emergency financial assistance

23. AAAs decreasing caregiver burden • Caregiver education and training • Support groups • Seminars • One-on-one education • Caregiver respite

24. Accessing AAA services 1-800-252-9240 http://www.dads.state.tx.us/contact/aaa.cfm

25. Aging and disability resource centers (ADRCs) • Interagency collaborations that serve people of all ages, with all types of disabilities, their family caregivers, and Texans who want to plan in advance of need for long-term services and supports • Provide information, referral, and case management without charge, through funding from Texas Department of Aging and Disability Services

26. ADRC expansion • ADRCs currently operational in 15 communities • Will go statewide in early 2014 • Will serve as “front door” to Medicaid long-term services and supports • Will provide options counseling as core service

27. Accessing ADRC services http://www.dads.state.tx.us/services/adrc/

28. Questions? Jennifer Scott Director, Capitol Area Agency on Aging jscott@capcog.org 512-916-6053 Doni Green Manager, North Central Texas Area Agency on Aging dgreen@nctcog.org 817-695-9193