New York State Plan on Aging 2019-2023 First Working Draft

1. New York State Plan on Aging 2019-2023 First Working Draft May 2, 2019

2. Welcome and Opening Remarks Greg Olsen, Acting Director New York State Office for the Aging

3. Goals of Webinar • Provide an overview of the first working draft of the New York State Plan on Aging 2019-2023 • Provide context for the Plan within Governor Cuomo’s vision and priorities • Provide brief overview of current trends • Provide brief overview of major content areas • Provide direction on how the public can provide input into the plan

4. NYSOFA Mission The mission of the New York State Office for the Aging is to help older New Yorkers be as independent as possible for as long as possible through advocacy, development and delivery of person-centered, consumer-oriented, and cost-effective policies, programs, and services that support and empower older adults and their families, in partnership with the network of public and private organizations that serve them.

5. State Plan on Aging 2019-2023 • The federal Older Americans Act (OAA) of 1965 requires that each state submit to the Administrator of the federal Administration for Community Living (ACL) a State Plan on Aging. • It requires a public input process to provide feedback and guidance to the state office.

6. State Plan on Aging 2019-2023 • Complies with Sections 305 and 307 of the OAA • Requirement to receive federal funding • Sets up state requirements regarding our role as a State Unit on Aging (SUA), including: • Evaluation of need for services • How funds will be distributed • The effectiveness of services provided to individuals with greatest economic need, greatest social need, or disabilities

7. State Plan on Aging 2019-2023 Sets up state requirements regarding our role as a SUA including: • Reporting • Fiscal controls and fund accounting procedures • Assurances that the state agency will carry out the Office of the State Long Term Care Ombudsman • Assurances in the provision of legal services • Assurances regarding the provision for services for the prevention of abuse of older individuals • Assurances for the provision of outreach and education, etc.

8. State Plan on Aging 2019-2023 • In New York State, under the Older American’s Act of 1965 (codified as 42 U.S.C. § 3001-3057(n)) and New York State Elder Law (Chapter 35-A of the Consolidated Laws), the New York State Office for the Aging (NYSOFA) is the designated State Unit on Aging. • NYSOFA is responsible for the development and administration of a State Plan that addresses federally prescribed goals and priorities as required by the Older American’s Act. The New York State Plan is organized to be consistent with the AoA/ACL four focus areas: • Older Americans Act (OAA) Core Programs; • AoA/ACL Discretionary Grants; • Person Centered Planning; and • Elder Justice.

9. The Governor’s Vision • Make New York State the healthiest state in the nation – address health disparities. • Advance a Health Across All Policies approach to incorporate health considerations into policies, programs, and initiatives led by non-health agencies. • Consider how all of our policies, programs and initiatives support us to further our goals as the first age friendly state. • Long term goal is to embed Health Across All Policies and Healthy Aging/Age Friendly into all aspects of our government work.

10. Prevention Agenda 2019-2024 • The Prevention Agenda is NYS’s public health improvement plan for improving health and reducing health disparities across the state through an increased emphasis on prevention • Since 2014, the Prevention Agenda has made substantial progress across 96 measures of public health and prevention – meeting and exceeding goals ahead of schedule in several areas. • To achieve our most challenging health goals, we need a broader approach.

11. Prevention Agenda 2019-2024 Vision: NYS will be the healthiest state for people of all ages Principles: To improve health outcomes, enable well-being and promote equity across the lifespan the Prevention Agenda will: • Focus on social determinants of health • Incorporate a Health Across All Policies approach • Emphasize healthy aging across the lifespan • Address health disparities Priorities: Prevent Chronic Disease, Promote a Healthy and Safe Environment, Promote Healthy Women, Infants and Children, Prevent Communicable Disease and Promote Well Being and Prevent Mental and Substance Use Disorders

12. What Determines Health?

13. Health Across All Policies is a Multi-Sectoral Approach to Improving Health The New York Academy of Medicine, 2016.

14. NYSOFA’s Priorities • Strengthening core OAA and state funded services to meet existing and future needs among older adults and their families • Expanding and strengthening the state’s No Wrong Door to serve all populations, regardless of age or payer source • Increasing the business acumen of the network to strengthen partnerships with health care systems and to develop models that reach new populations • Developing private pay models that serve middle and higher income older New Yorkers • Redefining and rebranding aging to demonstrate the enormous contributions older New Yorkers are to their families and to their communities – economically, socially and intellectually • Developing metrics to demonstrate the value of network services

15. Successful Aging – 3 Critical Components • Absence or avoidance of disease and the risk factors associated with disease • Maintenance of physical and cognitive function • Active engagement with life

16. New York Aging Network Structure • NYSOFA partners with 59 area agencies on aging (AAAs): 56 of are county based; one AAA is located on each of the St. Regis and Seneca reservations; and one AAA is run by the City of New York. • Combined, NYSOFA and the AAAs contract with almost 1,200 organizations to deliver cost-effective, non-clinical long-term services and supports in the homes and communities of at-risk older adults. • AAAs and partners afforded the opportunity to be innovative and flexible in meeting locally determined needs.

17. Current Status of the Network • The OAA pays states primarily for care and services for those over the age of 60; over time the network’s portfolio has expanded to assist other populations. • State and federal funding in the amount of $222 million leverages an additional $235 million in resources from municipal governments, private fundraising, participant contributions, and cost-sharing. • Network services are not entitlements; funds are capped, requiring counties to develop and sustain partnerships and leverage other community resources.

18. 2017-2018 Infrastructure • 59 AAAs • 1,176 contractors • 777 senior centers • 817 congregate meal sites • 324 central kitchens • 2,384 HDM routes • 40 EBIs implemented through AAAs, serving 20,077 • 1,191 HIICAP and LTCOP volunteers • 384 HIICAP counseling sites

19. 2017-2018 Network Service Provision Data reporting from the area agencies on aging to the state show that the network served more than 1.3 million people with $497 million invested (all sources) and includes: • 63,825 older New Yorkers who receive registered dietician (RD) certified home delivered meals • 196,547 older New Yorkers who receive RD certified meals in a congregate setting • 69,561 older New Yorkers who had case managers to help them maintain their independence and navigate various health and social service systems • 13,087 older New Yorkers who received personal care services in their homes • 108,044 older adults who receive transportation services to medical appointments, pharmacies, and other community outlets • 10,823 received legal assistance • 88,921 received nutrition counseling, and education • 293,633 received information and assistance • 109,144 received health promotion/prevention • 248,000 individuals who received Medicare plan and prescription counseling and assistance. • 13,109 older New Yorkers received caregiver support services and respite so they can continue to care for a frail loved one. • More than 250,000 contacts to NY Connects • 1.5 million page hits on the NY Connects Resource Directory

20. Network Strengths The strength of the network is the way it is organized, its partnerships, and its connection to the community. Network strengths include: • An established infrastructure/network with experience serving vulnerable populations for 40+ years • Extensive knowledge of community-based provider networks and how to access them • Experience with hospital transitions and evidence-based programs • Cultural and linguistic competence • Knowledge of the community they serve and their varied needs • Established relationships and trust across systems and among the public • Being nimble and able to provide services in the home • Serving clients for life; not episode focused • Serving individuals across all care settings • Serving as the eyes and ears of medical professionals in the home and community • Providing one door for information, services and supports • Extensive benefits and application assistance and screening • Low-cost, high-impact • Not insurance driven • Mission driven, but data informed

21. Aging in New York State • New York’s total population is over 19 million individuals, and the state ranks fourth in the nation in the number of adults age 60 and over – 4.3 million. • Demographic characteristics changing over time have important implications for the state plan on aging.

23. Minority Population Growth

24. Net In/Out Migration plus Immigration

25. Family Characteristics

26. Health and Impairment of Older Adults Chronic conditions are singled out as the major cause of illness, disability, and death in the United States. It is estimated that the cost of chronic conditions will reach $864 billion by 2040, with chronic conditions among older adults being more costly, disabling, and difficult to treat – and also the most preventable.

27. Other Trends in State Plan • Growth in long term care needs • Migration patterns • Income and poverty • Nutritional needs • Community Involvement

28. 2019–2023 State Plan on Aging Focus Areas Prescribed by AoA/ACL

29. Focus Areas Older Americans Act Core Programs • Strengthen or expand Title III and VII services • Increase the business acumen of aging network partners • Work towards the integration of health care and social services systems • Integrate core services with ACL discretionary grants

30. Focus Areas ACL Discretionary Grants • Develop measurable objectives that include integration of the grants within OAA core programs • Describe how the state will take advantage of ACA opportunities • Are there new activities as a result of this funding, new partnerships formed, etc.?

31. Focus Areas Person Centered Planning • Describe state’s efforts to make fundamental changes in state policies and programs that support consumer control and choice • Describe state’s efforts (measurable objectives) to support participant directed/person-centered planning for older adults and their caregivers across the spectrum of LTC services

32. Focus Areas Elder Justice • Describe the activities to prevent, detect, assess, intervene, and/or investigate elder abuse, neglect and financial exploitation • Describe planned efforts (measurable objectives) to support and enhance multi-disciplinary response to elder abuse involving APS, LTCOP, legal assistance programs, law enforcement, health care, financial institutions and other partners statewide.

33. State Plan Content • Draft Plan is a first working draft, it is continuously being worked on. • Contains background and summary information regarding the demographic make-up of the older population in the state. • Describes the programs and services administered by the Office. • Provides a course of action – Objectives, Strategies, and Expected Outcomes to meet the Overarching Goals. • While comprehensive – the State Plan is not intended to represent a detailed task oriented proposal. • The State Plan also follows guidelines provided by AoA regarding its structure. The Plan must be looked at in its entirety as an integrated approach to service, policy and program, not as individualized and isolated programs.

34. Section A – OAA Core Programs • Access Services • Information and Assistance • NY Connects • Case Management • Transportation • Health Insurance Information, Counseling, and Assistance (HIICAP) • Private Pay Model • In-Home Contact and Support Services • Expanded In-home Services for the Elderly (EISEP) • Community Services for the Elderly (CSE)

35. Section A – OAA Core Programs • Supporting Aging in Place • Age-Friendly New York State • Naturally Occurring Retirement Communities (NORCs) • Activities for Health, Independence, and Longevity • Foster Grandparent Program • RSVP • Senior Community Services Employment Program (Title V – SCSEP) • Civic Engagement/Volunteering

36. Section A – OAA Core Programs • Nutrition Services • Nutrition Program for the Elderly • Supplemental Nutrition Assistance Program Education (SNAP-Ed) • Title IIID and Medicare Prevention Services • Disease Prevention and Health Promotion Services • Health Indicators Program • Sepsis Prevention • Supporting Caregivers • National Family Caregiver Support Program • Social Adult Day Services (SADS) • Respite Services • Caregiver Resource Centers • Emergency Preparedness

37. Section B – AoA/ACL Discretionary Grants • Lifespan Respite • No Wrong Door (NWD) Business Case Development • Medicare Improvements for Patients and Providers Act (MIPPA)

38. Section C – Participant Directed / Person Centered Planning • Accelerating Integrated, Evidence-Based, and Sustainable Service Participant-Directed Service Delivery • Embedding Person Centered Counseling within the NY Connects No Wrong Door System • Comprehensive System Transformation Statewide Training Initiative

39. Section D – Elder Justice • Legal Assistance Program • Legal Services Initiative / NYS Judicial Committee on Elder Justice • Long Term Care Ombudsman Program • Elder Abuse Education and Outreach • OVS/VOCA Elder Abuse Interventions and Enhanced Multi-disciplinary Team Initiative

40. State Plan on Aging Overarching Goals • Goal #1: Empower older New Yorkers, their families and the public to make informed decisions about, and be able to access, existing health, long term care and other service options. • Describes objectives, strategies and expected outcomes for: • Information and Assistance • NY Connects • Case Management • Transportation • HIICAP • Private Pay Model

41. State Plan on Aging Overarching Goals • Goal #2: Enable older New Yorkers to remain in their own homes with high quality of life for as long as possible through the provision of home and community-based services, including supports for family caregivers. • Describes objectives, strategies and expected outcomes for: • EISEP • CSE • Age Friendly State • NORCs • FGP • RSVP • SCSEP • Civic engagement/volunteering • Nutrition Program for the Elderly • Supplemental Nutrition Assistance Program Education (SNAP-Ed) • National Family Caregiver Support Program • Social Adult Day Services • Respite Services • Emergency Preparedness

42. State Plan on Aging Overarching Goals • Goal #3: Empower older New Yorkers to stay active and healthy through Older Americans Act services and those offered under Medicare. • Describes objectives, strategies, and expected outcomes for: • Disease Prevention and Health Promotion Services • Health Indicators Program • Sepsis Prevention

43. State Plan on Aging Overarching Goals • Goal #4: Embed ACL discretionary grants with OAA Title III core programs. • Describes objectives, strategies, and expected outcomes for: • Lifespan Respite • Medicare Improvements for Patients and Providers Act (MIPPA) • No Wrong Door (NWD) Business Case Development

44. State Plan on Aging Overarching Goals • Goal #5: Ensure the rights of older New Yorkers and prevent their abuse, neglect and exploitation. • Describes objectives, strategies and expected outcomes for: • Legal Assistance Program • Legal Services Initiative / NYS Judicial Committee on Elder Justice • Long Term Care Ombudsman Program • OVS/VOCA Elder Abuse Interventions and Enhanced Multi-disciplinary Team Initiative • Elder Abuse Education and Outreach

45. State Plan on Aging Overarching Goals • Goal #6: Ensure the network is prepared to respond in emergencies and disasters. • Describes objectives, strategies and expected outcomes for: • Emergency Preparedness

46. State Plan on Aging Overarching Goals • Goal #7: Enhance the capacity of the AAA network to develop business acumen strategies to engage with and integrate into emerging health care delivery system transformation activities that foster outcomes-driven population health approaches. • Describes objectives, strategies, and expected outcomes for • Business Acumen

47. How to Read Plan and Provide Input Go to NYSOFA website www.aging.ny.gov

48. How to Read Plan and Provide Input

49. How to Read Plan and Provide Inputhttps://aging.ny.gov/PlanonAging/index.cfm

50. Regional Meetings