2016-2018 County Plan on Aging OUTAGAMIE COUNTYcalcluster2.co.calumet.wi.us/calendar/ADRC...

County Plan on Aging: 2016-2018

2016-2018County Plan on Aging

OUTAGAMIE COUNTY

September 1, 2015

DRAFT


TABLE OF CONTENTS

1. Verification of Intent

2. Executive Summary

3. Organization and Structure of the Aging Unit

4. Context

5. Public Involvement in the Development of the County Plan on Aging

6. Goals for the Plan Period

7. Coordination Between Titles III and VI

8. Budget

9. Compliance With Federal and State Laws and Regulations

10. Assurances

11. Appendices



1. Executive SummaryThe Aging & Disability Resource Center (ADRC) Outagamie County Branch will encountercomplex challenges in coming years 2016-2018 based on the economy, demographics, status offederal, state and local funding plus available resources to meet the needs of Outagamie Countyolder people and family caregivers. These challenges will be compounded in the coming years,when Outagamie County will have to prepare and provide sustainment for the rising demographyof older people with attention to the 80-85 years and older population who need long term careand supports, which is projected to increase from 6 million in 2013 to 14.6 million in 2040; theshortage of and stress on family caregivers and other unpaid natural supports caring for olderloved ones with awareness and concern on care for persons with Alzheimer’s disease and relateddementias; older people in need of financial and benefit understanding and assistance; plus theincreasing need to prevent, delay and reduce chronic illness, disability and social isolationamong older people. To address these challenges, the ADRC Outagamie County Branch willeducate and empower older people and family caregivers in Outagamie County to become moreknowledgeable on local resources, Older Americans Act services, financial and benefit eligibilityopportunities and long term care electives. In addition, ADRC Outagamie County Branch staffwill inform, guide and advocate for older people and family caregivers to achieve and sustainperson-centered care and wellness, connections to natural supports and attain a desired quality oflife that maximizes independence.

The 2016-2018 Outagamie County Plan on Aging identifies the following objectives the ADRCOutagamie County Branch will pursue to support and advocate for older people and familycaregivers in their community: outreach, listen, educate and empower older people and familycaregivers to become engaged and profit from Aging & Disability Resource Center (ADRC)Outagamie Branch services; increase knowledge of community resources; promote, nurture andsupport a “healthy aging” lifestyle to improve and sustain good health and wellness; offerevidence based and other health promotion activities; provide individualized information andassistance offering unbiased benefit, options and long term care enrollment and disenrollmentcounseling; provide, coordinate and refer older people and family caregivers to home andcommunity-based support services; identify, assist, support and refer individuals and familycaregivers who are living with Alzheimer’s disease and related dementias; reduce isolation bybuilding social connections “people engaging with people” to support and assist each other; plusmonitor and improve the effectiveness and efficiency of local Older Americans Act fundedservices such as: transportation information, assistance and referral; Elderly Nutrition ProgramCongregate and Home Delivered meal service, nutrition counseling plus health and nutritioneducation; Elder Benefit Specialist Program; Home Handy Person Program; health clinic; homefoot care; respite care; shopping and errand service; home response systems; subsidized housingnurse advocate health checks, medication education and management; plus, family caregivereducation and support opportunities including Outagamie Caregiver Coalition promotional andeducational caregiver venues to empower and support family caregivers and other unpaid naturalsupports in caring for loved ones.

The 2016-2018 Outagamie County Plan on Aging fosters engagement, personal responsibility,ownership, education, support, advocacy and empowerment of Outagamie County older peopleand family caregivers consistent with the intent of the Older Americans Act and the mission ofthe Aging & Disability Resource Center (ADRC) Outagamie County Branch.


2. Organization and Structure of the County Aging Unit3-A Mission Statement and Description of the Aging Unit

Mission

It is the mission of the Aging & Disability Resource Center (ADRC) Outagamie County Branchto offer adults, families and the community a single point of contact for information andassistance plus individualized service planning to enhance self-sufficiency and quality of life.The ADRC helps people make the best decisions to prevent or postpone the need for long termcare services and preserve personal resources for as long as possible. The ADRC will inform,guide and advocate for older persons and family caregivers to achieve and sustain personalwellness and independence.

Branch Address

Aging & Disability Resource Center (ADRC) Outagamie County BranchHealth & Human Services Building - Level 2401 South Elm Street Entrance #3Appleton, WI 54911

Branch Hours of Operation

Monday through Friday 8:00 A.M. - 4:30 P.M.Office closed on holidays and when the Outagamie County Courthouse Complex is closed.

Branch Contact

Bonne Elias Planner, ADRC Outagamie County Branch Supervisor920-832-5718 866-739-2372 ADRC COW Regional Consortium Toll [email protected] or [email protected]

920-832-2113 ADRC Outagamie County Branch Fax

Websites

www.yourADRCresource.org ADRC COW Regional Consortium Website(Link to ADRC Outagamie County Branch Website)

www.outagamie.org ADRC Outagamie County Branch Website

mailto:[email protected]


http://www.youradrcresource.org/

http://www.outagamie.org/


3. Organization and Structure of the County Aging Unit3-B Organizational Chart of the Aging Unit


3. Organization and Structure of the County Aging Unit3-C Aging Unit Coordination With ADRCs

Outagamie County Aging Services is organizationally and physically integrated within the Outagamie CountyDepartment of Health & Human Services - Aging & Disability Resource Center (ADRC) Outagamie CountyBranch which is a branch office of the multi-county ADRC COW Regional Consortium serving Calumet,Outagamie and Waupaca counties. Outagamie County Aging Services and the ADRC Outagamie CountyBranch jointly collaborate on Outagamie County shared goals, staff trainings, initiatives and advocacy effortsserving Outagamie County older people and family caregivers.

The ADRC Outagamie County Branch Supervisor acts as a full-time Aging Director and oversees OutagamieCounty Older Americans Act funding. The ADRC Outagamie County Branch Supervisor directly administersand monitors the Elderly Nutrition Program, Elder Benefit Specialist Program and Home Handy PersonProgram plus external contracted Older Americans Act funded services utilizing federal Title III-B, Title III-Dand National Family Caregiver Support Program NFCSP/Title III-E funding.

The Outagamie County Department of Health & Human Services Aging & Long Term Support DivisionManager oversees and monitors the Outagamie County para transit system including Seniors and Individualswith Disabilities (state 85.21 Specialized Transportation) funding plus the state Alzheimer’s Family CaregiverSupport Program (AFCSP) funding related to the ADRC Outagamie County Branch.

The ADRC Outagamie County Branch Supervisor and Outagamie County Department of Health & HumanServices Aging & Long Term Support Division Manager share administrative responsibilities and work jointlyon the day to day operations and staffing of both the ADRC Outagamie County Branch and Outagamie CountyAging Services. The ADRC Outagamie County Branch Supervisor and Outagamie County Department ofHealth & Human Services Aging & Long Term Support Division Manager are accountable to the OutagamieCounty Executive, County Board and Outagamie County Department of Health & Human Services Director(Refer to 3. Organization and Structure of the County Aging Unit 3-B Organizational Chart of the Aging Unit).Both positions report to the Outagamie County Department of Health & Human Services Board, OutagamieCounty Aging & Long Term Support Advisory Committee and the ADRC COW Regional ConsortiumRegional Advisory Committee.


3. Organization and Structure of the County Aging Unit3-D Statutory Requirements for the Structure of the Aging Unit

Chapter 46.82 of the Wisconsin Statutes sets certain legal requirements for aging units.

Organization: The law permits one of three options. Which of the followingpermissible options has the county chosen?

CheckOne

1. An agency of county government with the primary purpose of administeringprograms for older individuals of the county.2. A unit, within a county department with the primary purpose of administeringprograms for older individuals of the county.

X

3. A private nonprofit corporation, as defined in s. 181.0103 (17).

Organization of the Commission on Aging: The law permits one of threeoptions. Which of the following permissible options has the county chosen? Check One

1. For an aging unit that is described in (1) or (2) above, organized as a committeeof the county board of supervisors, composed of supervisors and, advised by anadvisory committee, appointed by the county board. Older individuals shallconstitute at least 50% of the membership of the advisory committee andindividuals who are elected to any office may not constitute 50% or more of themembership of the advisory committee.

X

2. For an aging unit that is described in (1) or (2) above, composed of individualsof recognized ability and demonstrated interest in services for older individuals.Older individuals shall constitute at least 50% of the membership of thiscommission and individuals who are elected to any office may not constitute 50%or more of the membership of this commission.3. For an aging unit that is described in (3) above, the board of directors of theprivate, nonprofit corporation. Older individuals shall constitute at least 50% ofthe membership of this commission and individuals who are elected to any officemay not constitute 50% or more of the membership of this commission.Full-Time Aging Director: The law requires that the aging unit have a full-timedirector as described below. Does the county have a full-time aging director asrequired by law?

Yes


3. Organization and Structure of the County Aging Unit3-E Membership of the Policy-Making Body

Chapter 46.82 of the Wisconsin Statutes sets certain legal requirements for aging units.

“Members of a county commission on aging shall serve for terms of 3 years, so arranged that, as nearly aspracticable, the terms of one-third of the members shall expire each year, and no member may serve more than2 consecutive 3-year terms.“ In the case of county board council members, the requirement is 3 consecutive 2-year terms.

Outagamie County Department of Health & Human Services Board

NameAge 60 and

OlderElectedOfficial

Year FirstTerm Began

Chairperson: Jerry IversonX X 2012

Vice-Chairperson: Barney LemanskiX 2012

Secretary: Patrick MeyerX 2014

Cathy SpearsX 2014

Marcia TrentlageX X 2012

Kevin BehnkeX 2014

Keith SupriseX X 2014

Val DrierX 2011

Richard GosseX 2011

Barb ThielX 2011

Veronica Flower2014

@ 7/1/2015


3. Organization and Structure of the County Aging Unit3-F Membership of the Advisory Committee

If the aging unit has an advisory committee, listed below are the members of the advisory committee. Chapter46.82 of the Wisconsin Statutes requires that the membership of the aging advisory committee (whereapplicable) must consist of at least 50% older people, and individuals who are elected to office may notconstitute 50% or more of the membership.

Outagamie County Aging & Long Term Support Advisory Committee

Name Age 60 andOlder

ElectedOfficial

Year FirstTerm Began

Chairperson: Harriet RedmanX 2011

Vice-Chairperson: Beth BelmoreX 2013

Ken GrodeX 2010

Barb GermiatX 2010

John MuellerX 2010

Bonnie RadtkeX 2010

Richard SchamensX 2010

Marion WenzelX 2010

Jan GrignanoX 2013

Cheryl MuggenthalerX 2014

Dale Poliak2014

Bert WiegandX 2010

@ 7/1/2015

The Outagamie County Aging Advisory Committee and Aging & Long Term Support PlanningCommittee merged on May 25, 2010.


3. Organization and Structure of the County Aging Unit3-G ADRC Outagamie County Branch Staff

Name: Bonne Elias PlannerJob Title: Aging & Disability Resource Center (ADRC) Outagamie County Branch SupervisorTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Administers Outagamie County aging service programs in compliance with the Wisconsin EldersAct and Older Americans Act. Supervises ADRC Outagamie County Branch staff (ElderlyNutrition Program, Elder Benefit Specialist Program and Home Handy Person Program staff)and oversees daily Branch operations serving ADRC customers 17 ½ years and older plus familycaregivers.1 FTEName: Nanette PiersonJob Title: Elder Benefit SpecialistTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Provides benefit counseling and advocacy for Outagamie County persons 60 years and older.The Elder Benefit Specialist is an Outagamie County DHHS employee under the direction of theADRC Outagamie County Branch Supervisor and GWAAR Elder Law Supervising Attorney.1 FTEName: Sarah KorthJob Title: Elder Benefit SpecialistTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Provides benefit counseling and advocacy for Outagamie County persons 60 years and older.The Elder Benefit Specialist is an Outagamie County DHHS employee under the direction of theADRC Outagamie County Branch Supervisor and GWAAR Elder Law Supervising Attorney..5 PTEName: *****Job Title: Information and Assistance SpecialistsTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Provides information and assistance/referral, follow up, unbiased options and long term careenrollment/disenrollment counseling plus short term case management to ADRC customers 171/2 years and older. Also, perform Pre-Admission Consultations (PAC), Preadmission Screeningand Resident Reviews (PASARR), and attend Adults at Risk Interdisciplinary Team meetings.Information and Assistant Specialists are Outagamie County DHHS employees.7 FTEName: Sandra McBrideJob Title: Disability Benefit SpecialistTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected]

Brief Description of Duties:







Advocates and provides benefit counseling to ADRC COW Regional Consortium customers 18to 59 years with physical and developmental disabilities, mental illness and/or substance abusedisorders. The ADRC COW Regional Consortium contracts for 5 FTE Disability BenefitSpecialists through Valley Packaging Industries, Inc.Name: Xai ThaoJob Title: Disability Benefit SpecialistTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Advocates and provides benefit counseling to ADRC customers 18 to 59 years with physical anddevelopmental disabilities, mental illness and/or substance abuse disorders. The ADRC COWRegional Consortium contracts for 5 FTE Disability Benefit Specialists through ValleyPackaging Industries, Inc.Name: Sara RismeyerJob Title: Disability Benefit SpecialistTelephone Numbers: 920-832-5718 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Advocates and provides benefit counseling to ADRC customers 18 to 59 years with physical anddevelopmental disabilities, mental illness and/or substance abuse disorders. The ADRC COWRegional Consortium contracts for 5 FTE Disability Benefit Specialists through ValleyPackaging Industries, Inc.Name: Gale MaloneJob Title: ADRC AssistantTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Assists ADRC Outagamie County Branch customers 17 ½ years and older who are applying forpublic benefits and need help with preparing financial, medical and other related applicationdocuments. The ADRC COW Regional Consortium contracts for 2 ADRC Outagamie CountyBranch Assistants through Valley Packaging, Inc. .75 PTEName: Luann KripleanJob Title: ADRC AssistantTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Assists ADRC Outagamie County Branch customers 17 ½ years and older who are applying forpublic benefits and need help with preparing financial, medical and other related applicationdocuments. The ADRC COW Regional Consortium contracts for 2 ADRC Outagamie CountyBranch Assistants through Valley Packaging, Inc. .50 PTE

Name: Nicole SmithJob Title: Community Living SpecialistTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected] Description of Duties:Provides information and assistance/referral, follow up, unbiased options and long term careenrollment/disenrollment counseling plus short term case management to individuals currentlyresiding in nursing homes desiring to move back to their home, to the home of a family member







or to an alternative living arrangement. The ADRC COW Regional Consortium contracts for 1ADRC Outagamie County Branch Community Living Specialist through Valley Packaging, Inc.1 FTEName: ****Job Title: Support StaffTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected]

Brief Description of Duties:Provides receptionist and clerical duties for the ADRC Outagamie County Branch staff andOutagamie County Older Americans Act programs. Support Staff are Outagamie County DHHSemployees. 5 FTE

Name: Nancy KruegerJob Title: ADRC COW Regional Consortium Health and Wellness CoordinatorTelephone Numbers: 920-740-9572 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected]

Brief Description of Duties:Coordinates ADRC COW Regional Consortium health and wellness programming. The Healthand Wellness Coordinator is a Valley Packaging, Inc. contract employee serving ADRCCalumet, Outagamie and Waupaca counties. 1 FTE

Name: Tom StrattonJob Title: Outagamie County DHHS Aging & Long Term Support Division ManagerTelephone Numbers: 920-832-5178 866-739-2372 Toll Free 7-1-1 TTYEmail Address: [email protected]

Brief Description of Duties:Oversees and monitors the Outagamie County Para Transit system utilizing state 85.21Transportation funding. Oversees the state Alzheimer’s Family Caregiver Support Program(AFCSP) funding. Supervises the ADRC Outagamie County Branch Supervisor administeringOlder Americans Act programming in Outagamie County. .10 FTE on Aging Services activity.





4. ContextAccording to the U.S. Bureau of the Census, American Community Survey, 2008-2012 Five Year SurveyEstimates, 1,098,751 Wisconsin residents are 60+ years and older. This is a 7,642 increase from 1,091,139Census 2010. Wisconsin Department of Administration projections anticipate that Outagamie County residents60+ years and older will rise from 17.2% - 20% in 2015 to 20.1% - 25% in 2015. The federal Administrationon Aging cited between 2003 and 2013, the 60+ years and older population increased 30.7% from 48.1 millionto 62.8 million in the United States.

The U.S. Bureau of the Census, American Community Survey, 2008 -2012 Five Year Survey Estimates reflect783,662 Wisconsin residents are 65+ years and older in comparison to Census 2010, indicating 777,314, whichis an increase of 6,348 residents. The total Wisconsin population 65+ and older is projected to be 894,920 in2015 by UW-Madison Applied Population Laboratory. The federal Administration on Aging cited thepopulation 65+ years and older increased from 35.9 million in 2003 to 44.7 million in 2013 (24.7% increase)and is projected to more than double to 98 million in 2060.

The U.S. Bureau of the Census, American Community Survey, 2008 -2012 Five Year Survey Estimates reflectthat 116,549 Wisconsin residents are 85+ years and older compared to 118,505, which is a 1,966 decrease.However, the 85+ years and older population is projected to triple from 6 million in 2013 to 14.6 million in2040. The Applied Population Laboratory projected the 80+ years and older population to be 242,000 in 2015,growing to 256,705 in 2020 (6% increase) and to 295,635 in 2025 (15% increase). While this is an increase, it isnot the overwhelming statistics represented by looking at the 65+ years and older population who do not needlong term care in comparison with the 80+ years and older who do need long term care services and support.

U.S. Bureau of the Census, American Community Survey, 2008 - 2012 Five Year Estimates:

Age Groups Wisconsin Outagamie County

60+ years 1,098,751 19.3% 29,764 16.8%

65+ years 783,662 13.8% 21,022 11.9%

85+ years 116,549 2.0% 3,076 1.7%

Households with one or morepersons 60+ years

745,958 32.6% 20,077 28.9%

Households with one or morepersons 65+ years

547,441 23.9% 14,586 21%

Age 65+ Living Alone 232,135 29.6% 6,336 30.1%

Age 65+ in Poverty 57,530 7.6% 1,540 7.6%

Note: The U.S. Census Bureau’s American Community Survey is an ongoing, annual survey whose results offer the same level of detail previously collected everyonce every ten years by the decennial Census long form questionnaire, which was discontinued after the 2000 Census. This above data is collected from 3.5 millionhousing units sampled nationally (106,000 in Wisconsin) with a response rate of about 97%.

The statistics and projections above demonstrate a dramatic incline and impact in the coming decades asWisconsin residents grow older and live longer, with special attention to the “Baby Boomers” born 1943 to1964 and “Generation X” born 1965 to 1981. The “Baby Boomers" comprised 28.1% and “Generation X”28.4% of Outagamie County’s total 174,993 population in 2008, according to UW Extension demographics onOutagamie County population trends.

UW Extension demographics on 2000-2008 Outagamie County Growth of Race/Ethnic Groups cited a 53%increase in the Hispanic; 77% increase in the African American; 7% in American Indian; and 16% increase inAsian or Pacific Islander population. UW Extension and UW Applied Population Laboratory cited in their May2015 Hmong in Wisconsin: Statistical Overview that Wisconsin’s Hmong population increased from 33,791


4. Context - Page 2 Continuedin 2000 to 47,127 in 2010 (39% increase). Outagamie County is one of the counties in Wisconsin where theHmong population exceeded 2,000 people.

According to the Wisconsin Division of Long Term Care dementia population estimates, there areapproximately 100,000 Wisconsin persons with dementia residing in their homes, 22% living alone. AfricanAmericans and Latinos are at increased risk for dementia compared to the Caucasian population. Latinos are atone and a half times the risk and African Americans at twice the risk of developing dementia. Suggestedexplanations for this disparity are noted chronic health conditions including diabetes, obesity, heart disease andother cardiovascular illnesses known to increase risk for developing dementia. Native Americans are thought tobe at increased risk due to higher incidence of chronic health conditions. As the population in the U.S. growsolder, the number of individuals with Alzheimer’s disease and other dementias is expected to increase. Currentestimates predict those with dementia will double by 2040 and more than triple by 2050.

Estimated and Projected Household Population 65 + years and older with Dementia

Year 2015 2020 2025 2030 2035 2040Wisconsin 101,489 114,126 135,477 162,295 190,657 213,238

Outagamie Co. 2,782 3,223 3,907 4,837 5,835 6,750Note: The Estimated and Projected Household Population 65+ years and older with Dementia in Wisconsin statistics were prepared by the Wisconsin Department ofHealth Services, Office on Aging.

According to the Estimated and Projected Household Population 65+ and older with Dementia statistics above,3% of Wisconsin residents 65+ years and older reside in Outagamie County with Alzheimer’s disease and otherdementias.

Caregiving in the U.S. 2015 Report (a joint research study report by AARP Public Policy Institute and NationalAlliance for Caregiving) revealed the following key findings on caregiving in America. An estimated 43.5million adults in the U.S. have provided care to an adult of a child in the prior 12 months. Approximately 18.2%interviewed in the study were reported to be caregivers. Estimated prevalence of caring for an adult is 16.6% or39.8 million Americans. Approximately 34.2 million Americans have provided unpaid care to an adult 50 yearsand older in the prior 12 months. 60% of caregivers are females; 40% are males. Eight in 10 are taking care ofone person. 85% provide care for a relative, with 49% caring for a parent or parent-in-law. One in 10 providescare for a spouse. Nearly one in 10 caregivers is 75 years and older. While the oldest caregivers are notexperiencing significantly more stress or strain than younger caregivers, they are more likely to be caregivingwithout unpaid help. On an average, caregivers have been in their role for 4 years. 24% have provided care for 5years or more. Other caregivers are twice as likely to have been in caregiving roles for 10 or more years. Thetypical care recipient is female (65%), averaging 69.4 years old. Nearly half of caregivers provide care tosomeone 75 years or older (47%). Approximately half of care is performed in the home (48%). On average,caregivers spend 24.4 hours a week providing care to their loved one. A majority of caregivers help their lovedone with at least one Activity of Daily Living (ADL; 59%), most commonly helping their loved one get in andout of bed and chairs. The most difficult ADLs involve personal care activities such as incontinence or diapers,toileting and bathing/showering assistance. On average, caregivers help with 4.2 out of 7 Instrumental Activitiesof Daily Living (IADLs) including transportation, grocery or other shopping and housework. All of theseactivities add up to a burden of care that varies widely for caregivers. 22% felt their health had gotten worse as aresult of caregiving. Caring for a close relative (spouse or parent) is more emotionally stressful for caregiversthat caring for another relative or non-relative. 38% reported high emotional stress from the demands ofcaregiving. One in 5 caregivers report experiencing financial strain. Caregivers who live more than one houraway report higher levels of financial strain. Six in 10 caregivers report being employed while caregiving.Among them, 56% worked full time, on an average of 34.7 hours per week. Six in 10 caregivers report


4. Context - Page 3 Continuedhaving to make a workplace accommodation as a result of caregiving such as cutting back on working hours,taking a leave of absence, receiving a warning about performance or attendance, etc. One in 4 caregivers state itis very difficult to get affordable services that would help with their loved one’s care.

According to the Pew Research Center Survey, more Americans are providing personal and financial care toaging parents, often in tandem with assisting adult children. The Pew Research Center Survey also revealed thatthree out of 10 Americans with an older parent said they helped out financially in the past year. 60% said theyassisted with personal care or daily tasks.

The Gerontological Society of America's "New Visions for Long Term Service and Supports" view the numberof Americans needing long term care will more than double in 2050, from 12 million in 2010 to 27 million in2050. 78% of older persons 65+ years and older have some limitation in self-care or household activity ability.Older people and caregivers need more support to handle the growing complexities of arranging for andproviding long term care and support and what can be frequent transitions. Family caregiving is the foundationfor support, however, this will become less available due to caregiver demographics. We have to improvesupport for family caregivers and keep them involved with caring for our aging and disability population.

The Draft 2013 Wisconsin County-Level Estimated Unpaid Eldercare Providers (family caregivers) by Age perthe U.S. Bureau of Labor Statistics’ National Ratios show the following number of caregivers by age group inWisconsin and in Outagamie County:

Age Groups 15-24 25-34 35-44 45-54 55-64 65 + TotalWisconsin 98,300 71,800 88,500 191,800 169,300 138,600 758,300Outagamie Co. 2,900 2,400 2,900 6,400 4,900 3,800 23,300

Wisconsin’s Aging Network integration into Aging & Disability Resource Centers (ADRC) delivering countyOlder Americans Act services has improved customer access to services in Outagamie County. This integrationhas provided a more holistic approach in identifying and meeting the needs of older residents and familycaregivers. In addition, the integration has offered health promotion and disease prevention opportunitiesthroughout the ADRC Calumet, Outagamie and Waupaca County (COW) Regional Consortium service area toolder people and family caregivers. Local ADRC Outagamie County Branch and ADRC COW RegionalConsortium data identify and support the need for ADRC services including Older Americans Act fundedprograms. The partnership of Aging Services with the ADRC has been successful in intervening withOutagamie County older residents and family caregivers earlier to prevent and delay the premature need forpublicly-funded long term care. This also enables individuals to use their own resources more efficiently,further delaying the need for public assistance.

ADRC Outagamie County Branch customer need for Older Americans Act and ADRC services is reflected inthe following 2014 statistics: 23% of the total 10,081 ADRC Outagamie County Branch customer contacts wereinquiries for Elder and Disability Benefit Specialist counseling services (Disability Benefit Specialist 987contacts and Elder Benefit Specialist 1,330 contacts); 8% were customers in need of financial assistance andsupport; 9% Family Care, Family Care Partnership and IRIS enrollments and disenrollments; 27% generalinformational inquiries; 4% Elderly Nutrition Program Home Delivered meal service; 3% housing assistance;4% home support; 2% home chore services and modifications; 3% medical and dental; and 2% transportationinformation, assistance or referral.

The 2014 State of Wisconsin Elder Benefit Specialist Program Summary Data identified that 34,091unduplicated participants statewide received Elder Benefit Specialist assistance. 17,959 (53%) participants were


4. Context - Page 4 Continued“new” to the Elder Benefit Specialist Program in 2014. 77% of the total statewide participant contacts were inneed of health insurance benefit counseling (i.e., Medicare). Of the total statewide participant contacts, 42% ofElder Benefit Specialist Program participants were between 60-69 years. The ADRC Outagamie County ElderBenefit Specialist Program is experiencing the same increasing trend in providing benefit counseling toOutagamie County residents. In 2014, 181 (66%) Outagamie County older residents were “new” to the ADRCOutagamie County Branch Elder Benefit Specialist Program. 12% of the total unduplicated participants werebetween 60-69 years, 8% 70-79 years and 4% 80-89 years. 12% were participants living alone. 7% were at orbelow 100% of the federal poverty level. 92 % of the ADRC Outagamie County Branch Elder Benefit SpecialistProgram total unduplicated participants in 2014 wanted to learn more about Medicare and their health insuranceoptions. Currently, the Social Security Administration does not provide individualized benefit counseling andrefers Social Security customers to area ADRC Benefit Specialist programs for information, guidance andadvocacy.

The Older Americans Act Elderly Nutrition Program purpose is to: reduce hunger and food insecurity; promotesocialization; and promote the health and well-being of people 60+ years by assisting them to gain access tonutrition and other disease prevention and health promotion services to delay the onset of adverse healthconditions resulting from nutritional health or sedentary behavior. Good nutrition is the foundation for healthyaging and can prevent disease or slow its progression. For many older people, this is their main (in the case ofHome Delivered meals, the only) meal of the day for reasons including lack of access to healthy food, financiallimitations or the inability to prepare a nutritional meal. Social interaction is vital for successful aging,providing mental stimulation, engagement in life and a sense of purpose. The Outagamie County NutritionProgram has been offering these benefits through Congregate and Home Delivered meal service since 1977,along with providing educational information and programming to support healthy living and independence forolder people.

The Wisconsin Elderly Nutrition Program has been experiencing a decline in the total number of meals servedstatewide and in Outagamie County. The Elderly Nutrition Program is also experiencing a shift fromCongregate to Home Delivered meal service reflected in the Greater Wisconsin Agency on Aging Resources,Inc. (GWAAR) and Outagamie County Nutrition Program 2010-2014 meal statistics below:

Elderly Nutrition Program Meals Served

Year 2010 2011 2012 2013 2014

Wisconsin3,924,050 TMS

1,885,086 C 48%2,038,964 HD 52%

3,853,635 TMS1,789,035 C 46%

2,064,600 HD 54%

3,892,475 TMS1,762,805 C 45%

2,129,670 HD 55%

3,783,557 TMS1,668,747 C 44%

2,114,810 HD 56%

3,701,283 TMS1,585,437 C 43%

2,115,846 HD 57%

Outagamie Co.

57,394 TMS22,902 C 40%

34,492 HD 60%

51,122 TMS20,575 C 40%

30,547 HD 60%

53,700 TMS21,733 C 40%

31,967 HD 60%

57,192 TMS22,285 C 39%

34,907 HD 61%

56,654 TMS21,922 C 39%

34,732 HD 61%TMS = Total Meals Served C= Congregate Meals HD = Home Delivered Meals

The Outagamie County Nutrition Program is currently facing the challenges of Congregate meal serviceparticipation declining; the need for more costly Home Delivered meal service especially in rural OutagamieCounty not in close proximity of a Congregate mealsite where Home Delivered meals may be disbursed safely;shortage of volunteers to not only transport Home Delivered meals but assist Congregate Mealsite Managers inpacking Home Delivered meals, serving Congregate meals and performing other essential mealsite operationaltasks; plus the need for substitute staff to provide regular staff coverage in their absence.


4. Context - Page 5 Continued

In 2016, the ADRC Outagamie County Branch will provide the following Older Americans Act fundedservices: Elderly Nutrition Program Congregate and Home Delivered meals plus nutrition education andcounseling services; Elder Benefit Specialist Program counseling and advocacy; home chore service; familycaregiver education and support; respite care (in-home and adult day care); in-home foot care; provide in-homeemergency response systems; health clinic screening and personal hygiene care; subsidized housing nurseadvocate service; plus transportation information and assistance. The ADRC will promote and provide aresource directory and circulate the quarterly The ADRC Connection newsletter to enhance the quality of lifefor older Outagamie County residents and family caregivers. Throughout the 2016-2018 County Plan on Agingcycle, the ADRC Outagamie County Branch will provide advocacy; empowerment; education; preventativehealth and wellness initiatives; individualized assessment; information, assistance and/or referral plus followup; unbiased options, benefit and publicly-funded long term care enrollment and disenrollment counseling; andshort term service coordination benefits to Outagamie County residents 60+ years and family caregivers.

ADRC COW Regional Consortium staff trainings and triage plus collaboration with other external and inter-county departments, regional ADRCs, service providers, coalitions (i.e., Outagamie Caregiver Coalition, FoxValley Advocacy Coalition and NeighborCARE), organizations (i.e., Fox Valley Memory Project), etc. viaelectronic and postal correspondence, meeting participation, telecommunication network, etc. will promote andsupport advocacy efforts to aid older people and family caregivers in Outagamie County. ADRC OutagamieCounty Branch staff will actively participate and advocate for older persons on the Outagamie County Adults atRisk Interdisciplinary Team (I-Team). The fundamental advocacy, technical assistance and education inaddition to the options, benefit and publicly-funded long term care enrollment counseling role of ADRC staffwill serve customers at no charge regardless of income and will not only benefit Outagamie County’s olderpopulation and family caregivers but also adults with disabilities. The Aging & Disability Resource Center(ADRC) Outagamie County Branch has created a vehicle and opportunity for the voice of older people to beheard in Outagamie County and within the ADRC COW Regional Consortium region. As ADRC COWRegional Consortium outreach and marketing efforts continue to create awareness about ADRC benefits andservices, Outagamie County older people and family caregivers will have improved access to resources inmeeting their needs.

The combination of static or insufficient funding, the rapidly aging population, increasing number of individualswith Alzheimer’s and other related dementias, shortage of family caregivers with complex needs, volunteershortage and sustainability, need for home and community based long term care, plus the need for customerpublic benefit comprehension and counseling driven by healthcare will create a strain and challenge for theADRC Outagamie County Branch throughout the 2016-2018 County Plan on Aging cycle to support and/ormaintain the service infrastructure in Outagamie County without crippling or dismantling programs and servicestargeted to serve older people and family caregivers.


5. Public Involvement in the Development of the County Aging Plan2016-2018 Outagamie County Plan on Aging development involved county-wide engagement and input fromOutagamie County Department of Health & Human Services Administrative, Aging & Disability ResourceCenter (ADRC) Outagamie County Branch and Aging Services staff (including Elderly Nutrition Program staffand volunteers); the Outagamie County Aging & Long Term Support Advisory Committee; OutagamieCaregiver Coalition (including advocate agencies and organizations serving older persons and familycaregivers); Outagamie County Public Officials; St. Joseph’s Food Pantry staff and volunteers; plus requesting2016-2018 Outagamie County Plan on Aging input and comment from the public at large via The ADRCConnection June 2015 newsletter readership. A two-sided survey form asking for the three (3) most importantissues facing older people and family caregivers (Appendix 11.1) plus the 2016-2018 County Plan on AgingRequired Focus Areas (Appendix 11.2) was mass distributed for feedback and comment. Survey participantscould respond by telephone, electronic mail or complete the survey form and mail directly to the ADRCOutagamie County Branch. Self-addressed, stamped return mailing envelopes were provided.

The ADRC Outagamie County Branch also made a sincere effort to elicit participation from older people andfamily caregivers by conducting Public Forum/Listening Sessions at the following events: 2016 ADRCVolunteer Recognition, Hortonville Senior Group and Kaukauna XYZ Senior Group social meetings. The two-sided survey form was reviewed and discussed. Survey participants were given the opportunity to voice theirinput and comments publicly and in person with the ADRC Outagamie County Branch Supervisor, fill out thesurvey form and give to the ADRC Outagamie County Branch Supervisor at the end of the PublicForum/Listening Session or take the survey form home, complete and mail to the ADRC Outagamie CountyBranch using a self-addressed, stamped return mailing envelope. All Public Forum/Listening Sessions wereappropriately publicized two weeks in advance and promoted locally “word of mouth”. Public Forum/ListeningSession dates, times, location and attendance are listed below. The ADRC Outagamie County Branch alsoregarded 2015 Nutrition Program Congregate and Home Delivered Meal Participant plus Volunteer DriverSatisfaction Survey feedback in the development of the 2016-2018 Outagamie County Plan on Aging.The ADRC Outagamie County Branch has Public Forum/Listening Sessions activity, outcome and surveysupporting documentation on file. Refer to Appendix 11.3 for 2016-2018 Outagamie County Plan on AgingLocal Priority Issues input and comments. The 2016-2018 County Plan was reviewed by the OutagamieCounty Aging & Long Term Support Advisory Committee 8/10/15 and Health & Human Services Board 8/11/15.

Local Priority Issues input was compiled from the following sources:Aging & Disability Resource Center (ADRC) Outagamie County Branch Staff (Information and Assistance Specialists,Community Living Specialist, Elder and Disability Benefit Specialists, ADRC Assistants, Support Staff, Supervisors)Outagamie County Elderly Nutrition Program Staff (Mealsite Managers, Food Transporters and Substitutes)Outagamie County Elderly Nutrition Program Congregate ParticipantsOutagamie County Aging & Long Term Support Advisory CommitteeOutagamie Caregiver Coalition MembershipOutagamie County Public OfficialsOutagamie County Department of Health & Human Services Administrative StaffSt. Joseph's Food Pantry Staff and 100 + VolunteersAging & Disability Resource Center (ADRC) Outagamie County Branch The ADRC Connection NewsletterJune 2015 Issue. Approximately 3,000+ readers.

Public Forum/Listening Sessions:Aging & Disability Resource Center (ADRC) Outagamie County Branch Volunteer Recognition - 5/6/15Thompson Community Center, Appleton 2:00 PM. 59 in attendance.Hortonville Senior Group - 6/25/15 Hortonville Municipal Building, Hortonville 1:00 PM16 in attendance.Kaukauna XYZ Senior Group - 5/20/15 Kaukauna Municipal Building, Kaukauna 1:00 PM35 in attendance.


6. Involvement of Older People in Aging-Related Program Development and PlanningGoal: The ADRC Outagamie County Branch will provide two (2) or more activities annually to enhancethe ability of older people and family caregivers to participate in the planning and oversight of agingservices in Outagamie County.

Major Activities/Completion Dates:

ADRC Outagamie County Branch Benefit Specialists will provide an educational training on public benefits(i.e., Medicare, Social Security, Veterans Benefits, etc.) to empower and improve benefit understanding anddecision making by older people and family caregivers. 2016-2018

ADRC Outagamie County Branch will create an opportunity for older people to speak for themselves, asserttheir interests, actively engage and render ownership in the NeighborCARE initiative. 2016-2018

ADRC Outagamie County Branch will collaborate with Lutheran Social Services Making the Ride Happenproviding an advocacy training to educate and inform older people, family caregivers and the public at large ontransportation options and opportunities in Outagamie County. 2017

ADRC Outagamie County Branch will hire a Volunteer Coordinator creating an opportunity for older people toactively participate, take ownership and help sustain community aging service programs through volunteerism.2016-2018

ADRC Outagamie County Branch will promote and empower Aging & Long Term Support AdvisoryCommittee members, interested Outagamie County older people and family caregivers to participate in theGreater Wisconsin Agency on Aging Resources, Inc. (GWAAR) Senior Statesmanship Program and engage inother related training and aging service planning opportunities. 2016-2018


6. Elderly Nutrition ProgramGoal: The ADRC Outagamie County Branch will provide three (3) or more activities annually to helpimprove and/or revitalize the Outagamie County Nutrition Program.


ADRC Outagamie County Branch will hire a PTE Volunteer Coordinator to recruit Outagamie CountyNutrition Program Congregate and Home Delivered meal service volunteers to transport homebound meals andassist with Congregate meal service operation. 2016

ADRC Outagamie County Branch will distribute and compile an annual Volunteer Survey to receive feedbackfrom volunteer drivers and coordinators in determining Outagamie County Nutrition Program Home Deliveredmeal service volunteer satisfaction and sustainability. 2016-2018

ADRC Outagamie County Branch will initiate and operate one (1) or more state approved senior diningrestaurant pilot(s) to increase Outagamie County Nutrition Program Congregate participation. 2016-2017

ADRC Outagamie Branch will evaluate, pursue and expand a cost-effective frozen meal service to eligibleOutagamie County Nutrition Program Home Delivered meal participants. 2016-2018

ADRC Outagamie Branch will partner with the Wisconsin Nutrition Education Program (WNEP), GreaterWisconsin Agency on Aging Resources, Inc. (GWAAR) and other nutrition related agencies to increase andimprove nutrition education to Outagamie County Nutrition Program Congregate and Home Delivered mealparticipants. 2016-2018

ADRC Outagamie Branch will annually calculate and evaluate the Wisconsin Bureau of Aging and DisabilityResources Standardized Cost Sheet for Nutrition Programs to increase and diversify Nutrition Program fundingopportunities. 2016-2018


6. Services in Support of CaregiversGoal: The ADRC Outagamie County Branch will provide five (5) or more activities annually to helpenhance services to support Outagamie County family caregivers.


ADRC Outagamie County Branch will publish and distribute The ADRC Connection newsletter providingcurrent information on available programs and services to support and assist family caregivers. 2016-2018

ADRC Outagamie County Branch Supervisor will attend monthly Outagamie Caregiver Coalition meetings toshare ADRC and Older Americans Act knowledge of family caregiver resources in Outagamie County with theCoalition membership and report to ADRC staff and the Aging & Long Term Support Advisory Committee onOutagamie Caregiver Coalition activity. 2016-2018

ADRC Outagamie County Branch will fund, promote, monitor and support Lutheran Social Services Makingthe Ride Happen transportation information and assistance, Right-at-Home Foot Care plus family caregiversupport and education activities (including Alzheimer’s Family Caregiver Support Group, Share the Care,Caregiver Cafes, etc.) and other Lutheran Social Services family caregiver educational programming. 2016

ADRC Outagamie County Branch will fund, promote, monitor and support ResCare In Home Respite Care plusShopping and Errand services. 2016

ADRC Outagamie County Branch will fund, promote, monitor and support St. Paul Elder Services, Inc. AdultDay Respite Care and provision of Home Emergency Response Systems. 2016

ADRC Outagamie County Branch will provide a caregiver informational, resource folder (with input from theOutagamie Caregiver Coalition) to distribute to family caregivers. 2016-2018

ADRC Outagamie County Branch staff will provide unbiased information, assistance/referral and follow up;options, benefit and publicly-funded long term care enrollment and disenrollment counseling; plus short termservice coordination to family caregivers and ADRC customers at large. 2016-2018

ADRC Outagamie County Branch will screen and administer the state Alzheimer's Family Caregiver SupportProgram (AFCSP) funding in response to the stress and service needs of families caring for someone withirreversible dementia at home. 2016-2018

ADRC Outagamie County Branch staff will demonstrate ADRC Assistive Technology Tool Kit devices, audioand visual enhancements plus other adaptive resources to enhance customer independence and provide supportto family caregivers. 2016-2018


6. Services to People with DementiaGoal: The ADRC Outagamie County Branch will provide four (4) or more activities annually to enhancethe support of family caregivers and individuals who are living with Alzheimer's disease and otherrelated dementias in Outagamie County.


ADRC Outagamie County Branch will fund, promote, monitor and support Lutheran Social ServicesAlzheimer's Family Caregiver Support Group, Share the Care, Caregiver Cafes and other caregiver educationalprogramming. 2016

ADRC Outagamie County Branch will fund, promote and support ResCare In Home Respite Care and otherrespite opportunities for family caregivers and individuals who are living with Alzheimer’s disease and otherrelated dementias. 2016

ADRC Outagamie County Branch will fund, promote and support St. Paul Elder Services, Inc. Adult DayRespite Care and provision of Home Emergency Response Systems. 2016

ADRC Outagamie County Branch will screen and administer the state Alzheimer's Family Caregiver SupportProgram (AFCSP) funding in response to the stress and service needs of families caring for someone withirreversible dementia at home. 2016-2018

ADRC COW Regional Consortium will support and promote Fox Valley Memory Project activities andservices (i.e., Memory Loss Resource Center, Memory Cafes, social and comprehensive community educationalevents, Purple Angel Program, REACH initiative, Music and Memory Program, employer outreach initiative,person-centered cognitive assessments, on-going local research, etc.) and will be represented on the Fox ValleyMemory Project Executive Coordinating Committee. 2016-2018

ADRC Outagamie County Branch will provide information, assistance/referral and follow up plus offer anADRC Dementia Tool Kit to family caregivers and ADRC customers at large. 2016-2018

ADRC Outagamie County Branch will collaborate with Mosiac Family Health to create an In Home ResponseTeam in assessing and providing information and assistance to family caregivers and individuals who are livingwith Alzheimer's disease and other related dementias. 2017-2018


6. Healthy AgingGoal: ADRC Outagamie County Branch will enhance, outreach and expand evidence based healthpromotion and disease prevention programming by offering one (1) or more healthy aging activitiesannually in Outagamie County to increase county wide program participation.


ADRC COW Regional Consortium will hire a PTE Health and Wellness Coordinator Assistant for the ADRCOutagamie County Branch to oversee evidence based health promotion and disease prevention programming inOutagamie County. 2016

ADRC COW Regional Consortium will increase health promotion and disease prevention program capacity inOutagamie County by recruiting four (4) new volunteer leaders. 2016

ADRC COW Regional Consortium will outreach and improve the health of older people and persons withdisabilities in rural Outagamie County (outside of Appleton) with two (2) evidence based programs (SteppingOn: Falls Prevention, Living Well with Chronic Disease: Self Management or Healthy Living with Diabetes).2017

ADRC COW Regional Consortium will increase visibility and knowledge of evidence based programs inOutagamie County and attract referral sources by offering four (4) presentations to rural healthcare providersand/or senior groups. 2018


6. Local PriorityGoal: ADRC Outagamie County Branch will implement one (1) annual quality improvement activity thatwill impact and improve services to older people and family caregivers in Outagamie County.


ADRC Outagamie County Branch will operate one (1) or more state approved senior dining restaurant pilot(s)to increase Outagamie County Nutrition Program Congregate participation. 2016

ADRC Outagamie County Branch will collaborate with Lutheran Social Services Making the Ride Happenproviding an advocacy training to educate and inform older people, family caregivers and the public at large ontransportation options and opportunities in Outagamie County. 2017

ADRC COW Regional Consortium will provide an advocacy or empowerment training and discussion withprominence on addressing and improving services to older people. ADRC staff and advisory committees, localpolicy-making boards, public officials, coalitions, medical community, civic organizations, service providers,etc. serving older people will be invited to participate in the training and discussion. 2018


7. Coordination Between Titles III and VI

Goal: ADRC Outagamie County Branch will initiate and coordinate two (2) or more informationaland/or educational commitments with Oneida Tribe Elder Services to ensure the provision of services toOneida Nation Elders.


ADRC Outagamie County Branch will provide Oneida Tribe Elder Services with current resource informationon ADRC Outagamie County Branch services. 2016-2018

ADRC Outagamie County Branch Supervisor will meet with the Oneida Tribe Elder Services Program Directorannually to discuss service delivery and resource options for Oneida Nation Elders. 2016-2018

Oneida Tribe Elder Services staff will be invited to attend ADRC Outagamie County Branch and ADRC COWRegional Consortium staff development trainings. 2016-2018

ADRC Outagamie County Branch will collaborate and coordinate the most effective options and enrollmentcounseling with Oneida Tribe Elder Services staff (including the Oneida Tribe Elder Services Aging &Disability Resource Specialist) in serving Oneida Nation Elders. 2016-2018

ADRC Outagamie County Branch will support Oneida Tribe Elder Services and Oneida Nation Elders duringOneida Tribe waiver transition. 2016-2018

ADRC Outagamie County Branch will collaborate and fund Oneida Elderly Transportation utilizing stateSeniors and Individuals with Disabilities funding. 2016

Oneida Tribe Elder Services staff will be invited to attend Outagamie County Adults-at-Risk InterdisciplinaryTeam meetings. 2016-2018

Oneida Tribe Elder Services will be invited to become a representative member on the ADRC COW RegionalConsortium Advisory Committee. 2016-2018


8. Budget

To be completed by DHHS Fiscal.


2016 ADRC Outagamie County Branch AGING FUNDING REQUESTS

Lutheran Social Services of Wisconsin and Upper Michigan (LSS) $88,420 2015 - $86,449:

Health Clinic $31,188 (Title III-B) 2015 - $30,280Registered nurse provides health checks (blood pressure and sugar), medication review and monitoring,nutrition education, foot care and will refer and/or advocate for participants with health care providers whennecessary. Monthly specialized health screenings and educational presentations include hearing, vision,diabetes, skin and prostate cancer, mental health, supplements and other current health topics. The HealthClinic provides wellness checks to in-home foot care participants. Participants will be referred to their physicianif symptoms of ill health are observed. The Health Clinic is located at the Thompson Community Center and isavailable on Tuesday, Wednesday and Thursday 9:00 -10:00 A.M and 11:30 A.M. -12:30 P.M. A voluntarydonation is accepted.

In-Home Foot Care $14,561 (Title III-B) Personal Care Service 2015 - $14,137Registered nurse provides in-home foot care to participants (including diabetics) who are unable to attend areafoot care clinics. Foot care is available on Tuesday and Wednesday 12:30 - 4:30 P.M. by appointment.Participants will be referred to their physician if infection, sores or other symptoms of ill health are observed. Avoluntary donation is accepted.

Transportation Information and Assistance $ 19,000 (Title III-B) Access Service 2015 - $12,850“Making the Ride Happen” (MRH) provides comprehensive information and assistance in connectingOutagamie County older residents to local transportation options. MRH certifies senior riders for the “urban”Valley Transit II para-transit system. A voluntary donation is accepted.

Family Caregiver Support and Education $23,671 (Title III-E) 2015 - $22,982Family Support Specialist offers family caregivers education, training, one-to-one and/or support groupopportunities and respite. LSS partners with the Outagamie Caregiver Coalition and allocates $3,500 forOutagamie Caregiver Coalition marketing and caregiver education. LSS provides support staff to attendmonthly Caregiver Coalition meetings to transcribe meeting minutes and maintain the Outagamie CaregiverCoalition membership list. LSS is the Outagamie County “Share the Care” host station to support individualswho are chronically ill and/or aging and are in need of a support network (friends, family, etc.). LSS offers a“Thriving Caregiver” series that meets 6 times/year providing education and support to family caregivers. LSSprovides one-to-one case management and/or offers a monthly support group for caregivers affected bydementia. LSS collaborates with the Fox Valley Memory Project to provide no cost respite care for familycaregivers to attend support group meetings. Caregiver Café opportunities are being pursued to engagecaregivers in meaningful conversation. A voluntary donation is accepted.

ADRC Outagamie County Branch Prevention $7,737 2015 - $1,500:

ADRC Health and Prevention Programs $7,737 (Title III-D Evidence-Based) 2015 - $1,500Provide ADRC Outagamie County Branch Health and Prevention “Stepping On: Falls Prevention” ankleweights and “Living Well with Chronic Disease: Self-Management” educational books and compact discs(CDs).

Continued ►


2016 AGING FUNDING PROPOSALS - Page 2 Continued

ADRC Home Handy Person Program $791 2015 - $443:

ADRC Home Handy Person Program $791 (Title III-B) Chore Service 2015 - $443Provide minor home repairs (i.e., leaking faucets, running toilets, installing grab bars, etc.) to OutagamieCounty residents 60 years and older on a donation basis. A voluntary donation is accepted.

ResCare $43,016 2015 - $18,973 + $32,262 one-time funding supplement = $51,235:

Respite Care $22,268 (Title III-E) Respite Service 2015 - $12,029 + $16,701 = $28,730ResCare staff provide temporary in-home respite (i.e., personal care, homemaker and/or chore services) torelieve primary family caregivers. Respite is available 24/7 including holidays and may not exceed 112 hoursper year per participant according to Older Americans Act Title III-E funding guidelines. A voluntary donationis accepted.

Shopping and Errand $20,748 (Title III-B) 2015 - $6,944 + $15,561 = $22,505ResCare staff grocery shop, pick up prescriptions and render personal errands to meet the needs of eligible,homebound older Outagamie County residents. ResCare staff may escort participants to the bank but will nothandle cash or checks. Shopping and Errand service is available Monday through Friday 8:00 AM - 4:00 PM.A $5.00 suggested donation is welcomed.

Non Profit Affordable Housing Based Rental Services (NAHBRS) $43,120 2015 - $37,496:

Nurse Advocate Program $43,120 (Title III-B) 2015 - $37,496Registered nurse provides health checks (blood pressure and weight), medication education and management,performs home assessments on new participants evaluating medical conditions to prevent future healthproblems plus educates and supports Outagamie County Housing Authority subsidized apartment residentsliving at Randall Court- Appleton, Crescentview - Kimberly, Pinewood - Hortonville and Hillside - Seymour tolead a healthy and independent lifestyle. Participants will be referred to their physician if symptoms of illhealth are observed and/or to the ADRC for community resources, if applicable. A voluntary donation isaccepted.

St. Paul Elder Services, Inc. Care Partner Support Services $17,496 2015 - $17,496:

Respite Care $12,096 (Title III-E) Respite Service 2015 - $12,096Provide temporary respite at St. Paul Elder Services’ Club Gabriel Adult Day Program. Respite may not exceed112 hours per year per participant according to Older Americans Act Title III-E funding guidelines.

In-Home Response Systems $5,400 (Title III-E) 2015 - $5,400Provide in-home Critical Signal Technology’s BOB response systems which include fire and carbon monoxidedetector, blood pressure cuff, alert and motion sensor accessories. BOB features a pendant or watch and timedreminders in a caregiver’s voice.

A voluntary donation is accepted for temporary respite and response system use.


9. Compliance with Federal and State Laws and Regulations


10. Assurances

The applicant certifies compliance with the following regulations:

1. Legal Authority of the Applicant

• The applicant must possess legal authority to apply for the grant.• A resolution, motion or similar action must be duly adopted or passed as an official act of the

applicant's governing body, authorizing the filing of the application, including all understandingsand assurances contained therein.

• This resolution, motion or similar action must direct and authorize the person identified as theofficial representative of the applicant to act in connection with the application and to providesuch additional information as may be required.

2. Outreach, Training, Coordination, & Public Information

• The applicant must assure that outreach activities are conducted to ensure the participation ofeligible older persons in all funded services as required by the Bureau of Aging and DisabilityResources designated area agency on aging.

• The applicant must assure that each service provider trains and uses elderly persons and othervolunteers and paid personnel as required by the Bureau of Aging and Disability Resourcesdesignated area agency on aging.

• The applicant must assure that each service provider coordinates with other service providers,including senior centers and the nutrition program, in the planning and service area as requiredby the Bureau of Aging and Disability Resources designated area agency on aging.

• The applicant must assure that public information activities are conducted to ensure theparticipation of eligible older persons in all funded services as required by the Bureau of Agingand Disability Resources designated area agency on aging.

3. Preference for Older People With Greatest Social and Economic Need

The applicant must assure that all service providers follow priorities set by the Bureau of Aging andDisability Resources designated area agency on aging for serving older people with greatest social andeconomic need.

4. Advisory Role to Service Providers of Older Persons

The applicant must assure that each service provider utilizes procedures for obtaining the views ofparticipants about the services they receive.

5. Contributions for Services

• The applicant shall assure that agencies providing services supported with Older Americans Actand state aging funds shall give older adults a free and voluntary opportunity to contribute to thecosts of services consistent with the Older Americans Act regulations.

• Each older recipient shall determine what he/she is able to contribute toward the cost of theservice. No older adult shall be denied a service because he/she will not or cannot contribute tothe cost of such service.


• The applicant shall provide that the methods of receiving contributions from individuals by theagencies providing services under the county/tribal plan shall be handled in a manner that assuresthe confidentially of the individual's contributions.

• The applicant must assure that each service provider establishes appropriate procedures tosafeguard and account for all contributions.

• The applicant must assure that each service provider considers and reports the contributionsmade by older people as program income. All program income must be used to expand the sizeor scope of the funded program that generated the income. Nutrition service providers must useall contributions to expand the nutrition services. Program income must be spent within thecontract period that it is generated.

6. Confidentiality

• The applicant shall ensure that no information about, or obtained from an individual and inpossession of an agency providing services to such individual under the county/tribal or areaplan, shall be disclosed in a form identifiable with the individual, unless the individual provideshis/her written informed consent to such disclosure.

• Lists of older adults compiled in establishing and maintaining information and referral sourcesshall be used solely for the purpose of providing social services and only with the informedconsent of each person on the list.

• In order that the privacy of each participant in aging programs is in no way abridged, theconfidentiality of all participant data gathered and maintained by the State Agency, the AreaAgency, the county or tribal aging agency, and any other agency, organization, or individualproviding services under the State, area, county, or tribal plan, shall be safeguarded by specificpolicies.

• Each participant from whom personal information is obtained shall be made aware of his or herrights to:

(a) Have full access to any information about one’s self which is being kept on file;(b) Be informed about the uses made of the information about him or her, including the identityof all persons and agencies involved and any known consequences for providing such data; and,(c) Be able to contest the accuracy, completeness, pertinence, and necessity of information beingretained about one’s self and be assured that such information, when incorrect, will be correctedor amended on request.

• All information gathered and maintained on participants under the area, county or tribal planshall be accurate, complete, and timely and shall be legitimately necessary for determining anindividual’s need and/or eligibility for services and other benefits.

• No information about, or obtained from, an individual participant shall be disclosed in any formidentifiable with the individual to any person outside the agency or program involved without theinformed consent of the participant or his/her legal representative, except:

(a) By court order; or,(b) When securing client-requested services, benefits, or rights.

• The lists of older persons receiving services under any programs funded through the StateAgency shall be used solely for the purpose of providing said services, and can only be releasedwith the informed consent of each individual on the list.


• All paid and volunteer staff members providing services or conducting other activities under thearea plan shall be informed of and agree to:

(a) Their responsibility to maintain the confidentiality of any client-related information learnedthrough the execution of their duties. Such information shall not be discussed except in aprofessional setting as required for the delivery of service or the conduct of other essentialactivities under the area plan; and,(b) All policies and procedures adopted by the State and Area Agency to safeguard

confidentiality of participant information, including those delineated in these rules.

• Appropriate precautions shall be taken to protect the safety of all files, microfiche, computertapes and records in any location which contain sensitive information on individuals receivingservices under the State or area plan. This includes but is not limited to assuring registrationforms containing personal information are stored in a secure, locked drawer when not in use.

7. Records and Reports

• The applicant shall keep records and make reports in such form and requiring such informationas may be required by the Bureau of Aging and Disability Resources and in accordance withguidelines issued solely by the Bureau of Aging and Disability Resources and the Administrationon Aging.

• The applicant shall maintain accounts and documents which will enable an accurate review to bemade at any time of the status of all funds which it has been granted by the Bureau of Aging andDisability Resources through its designated area agency on aging. This includes both thedisposition of all monies received and the nature of all charges claimed against such funds.

8. Licensure and Standards Requirements

• The applicant shall assure that where state or local public jurisdiction requires licensure for theprovision of services, agencies providing services under the county or area plan shall be licensedor shall meet the requirements for licensure.

• The applicant is cognizant of and must agree to operate the program fully in conformance withall applicable state and local standards, including the fire, health, safety and sanitation standards,prescribed in law or regulation.

9. Civil Rights

• The applicant shall comply with Title VI of the Civil Rights Act of 1964 (P.L. 88-352) and inaccordance with that act, no person shall on the basis of race, color, or national origin, beexcluded from participation in, be denied benefits of, or be otherwise subjected to discriminationunder any program or activity under this plan.

• All grants, sub-grants, contracts or other agents receiving funds under this plan are subject tocompliance with the regulation stated in 9 above.

• The applicant shall develop and continue to maintain written procedures which specify how theagency will conduct the activities under its plan to assure compliance with Title VI of the CivilRights Act.


• The applicant shall comply with Title VI of the Civil Rights Act (42 USC 2000d) prohibitingemployment discrimination where (1) the primary purpose of a grant is to provide employmentor (2) discriminatory employment practices will result in unequal treatment of persons who areor should be benefiting from the service funded by the grant.

• All recipients of funds through the county/tribal or area plan shall operate each program oractivity so that, when viewed in its entirety, the program or activity is accessible to and usable byhandicapped adults as required in the Architectural Barriers Act of 1968.

10. Uniform Relocation Assistance and Real Property Acquisition Act of 1970

The applicant shall comply with requirements of the provisions of the Uniform Relocation and Real PropertyAcquisitions Act of 1970 (P.L. 91-646) which provides for fair and equitable treatment of federal and federallyassisted programs.

11. Political Activity of Employees

The applicant shall comply with the provisions of the Hatch Act (5 U.S.C. Sections 7321-7326), which limit thepolitical activity of employees who work in federally funded programs. [Information about the Hatch Act isavailable from the U.S. Office of Special Counsel at http://www.osc.gov/]

12. Fair Labor Standards Act

The applicant shall comply with the minimum wage and maximum hours provisions of the Federal Fair LaborStandards Act (Title 29, United States Code, Section 201-219), as they apply to hospital and educationalinstitution employees of state and local governments.

13. Private Gain

The applicant shall establish safeguards to prohibit employees from using their positions for a purpose that is orappears to be motivated by a desire for private gain for themselves or others (particularly those with whom theyhave family, business or other ties).

14. Assessment and Examination of Records

• The applicant shall give the Federal agencies, State agencies and the Bureau of Aging andDisability Resources authorized Area Agencies on Aging access to and the right to examine allrecords, books, papers or documents related to the grant.

• The applicant must agree to cooperate and assist in any efforts undertaken by the grantor agency,or the Administration on aging, to evaluate the effectiveness, feasibility, and costs of the project.

• The applicant must agree to conduct regular on-site assessments of each service providerreceiving funds through a contract with the applicant under the county or tribal plan.

15. Maintenance of Non-Federal Funding

• The applicant assures that the aging unit, and each service provider, shall not use OlderAmericans Act or state aging funds to supplant other federal, state or local funds.


• The applicant must assure that each service provider must continue or initiate efforts to obtainfunds from private sources and other public organizations for each service funded under thecounty or tribal plan.

16. Regulations of Grantor Agency

The applicant shall comply with all requirements imposed by the Department of Health and Family Services,Division of Supportive Living, Bureau of Aging and Disability Resources concerning special requirements offederal and state law, program and fiscal requirements, and other administrative requirements.

17. Older Americans Act

The applicant shall comply with all requirements of the Older Americans Act (PL 89-73).

18. Federal Regulations

The applicant shall comply with all federal regulations (45 CFR 1321) governing Older Americans Act fundsand programs.

19. Wisconsin Elders Act

The aging unit must comply with the provisions of the Wisconsin Elders Act.

Wisconsin Statutes Chapter 46.82 Aging unit.

“Aging unit” means an aging unit director and necessary personnel, directed by a county or tribal commissionon aging and organized as one of the following:

(1) An agency of county or tribal government with the primary purpose of administering programs ofservices for older individuals of the county or tribe.

(2) A unit, within a county department under s. 46.215, 46.22(3) or 46.23, with the primary purpose of administering programs of

and services for older individuals of the county(4) A private corporation that is organized under ch. 181 and(5) that is a nonprofit corporation, as defined in s. 181.0103 (17).

Aging Unit; Creation. A county board of supervisors of a county, the county boards of supervisors of 2 or morecontiguous counties or an elected tribal governing body of a federally recognized American Indian tribe or bandin this state may choose to administer, at the county or tribal level, programs for older individuals that arefunded under 42 USC 3001 to 3057n, 42 USC 5001 and 42 USC 5011 (b). If this is done, the county board orboards of supervisors or tribal governing body shall establish by resolution a county or tribal aging unit toprovide the services required under this section. If a county board of supervisors or a tribal governing bodychooses, or the county boards of supervisors of 2 or more contiguous counties choose, not to administer theprograms for older individuals, the department shall direct the area agency on aging that serves the relevant areato contract with a private, nonprofit corporation to provide for the county, tribe or counties the services requiredunder this section.


Aging Unit; Powers and Duties. In accordance with state statutes, rules promulgated by the department andrelevant provisions of 42 USC 3001 to 3057n and as directed by the county or tribal commission on aging, anaging unit:

(a) Duties. Shall do all of the following:

1. Work to ensure that all older individuals, regardless of income, have access to information, services andopportunities available through the county or tribal aging unit and have the opportunity to contribute to the costof services and that the services and resources of the county or tribal aging unit are designed to reach those ingreatest social and economic need.2. Plan for, receive and administer federal, state and county, city, town or village funds allocated under the stateand area plan on aging to the county or tribal aging unit and any gifts, grants or payments received by thecounty or tribal aging unit, for the purposes for which allocated or made.3. Provide a visible and accessible point of contact for individuals to obtain accurate and comprehensiveinformation about public and private resources available in the community which can meet the needs of olderindividuals.4. As specified under s. 46.81, provide older individuals with services of benefit specialists or appropriatereferrals for assistance.5. Organize and administer congregate programs, which shall include a nutrition program and may include oneor more senior centers or adult day care or respite care programs, that enable older individuals and their familiesto secure a variety of services, including nutrition, daytime care, educational or volunteer opportunities, jobskills preparation and information on health promotion, consumer affairs and civic participation.6. Work to secure a countywide or tribal transportation system that makes community programs andopportunities accessible to, and meets the basic needs of, older individuals.7. Work to ensure that programs and services for older individuals are available to homebound, disabled andnon-English speaking persons, and to racial, ethnic and religious minorities.8. Identify and publicize gaps in services needed by older individuals and provide leadership in developingservices and programs, including recruitment and training of volunteers, that address those needs.9. Work cooperatively with other organizations to enable their services to function effectively for olderindividuals.10. Actively incorporate and promote the participation of older individuals in the preparation of a county ortribal comprehensive plan for aging resources that identifies needs, goals, activities and county or tribalresources for older individuals.11. Provide information to the public about the aging experience and about resources for and within the agingpopulation.12. Assist in representing needs, views and concerns of older individuals in local decision making and assistolder individuals in expressing their views to elected officials and providers of services.13. If designated under s. 46.27 (3) (b) 6., administer the long-term support community options program.14. If the department is so requested by the county board of supervisors, administer the pilot projects for homeand community-based long-term support services under s. 46.271.15. If designated under s. 46.90 (2), administer the elder abuse reporting system under s. 46.90.16. If designated under s. 46.87 (3) (c), administer the Alzheimer’s disease family and caregiver supportprogram under s.46.87.17. If designated by the county or in accordance with a contract with the department, operate the specializedtransportation assistance program for a county under s. 85.21.18. Advocate on behalf of older individuals to assist in enabling them to meet their basic needs.


19. If an aging unit under sub. (1) (a) 1. or 2. and if authorized under s. 46.283 (1) (a) 1., apply to thedepartment to operate a resource center under s. 46.283 and, if the department contracts with the county under s.46.283 (2), operate the resource center.20. If an aging unit under sub. (1) (a) 1. or 2. and if authorized under s. 46.284 (1) (a) 1., apply to thedepartment to operate a care management organization under s. 46.284 and, if the department contracts with thecounty under s. 46.284 (2), operate the care management organization and, if appropriate, place funds in a riskreserve.

(b) Powers. May perform any other general functions necessary to administer services for older individuals.

(4) Commission On Aging.

(a) Appointment.1. Except as provided under sub. 2., the county board of supervisors in a county that has established a single-county aging unit, the county boards of supervisors in counties that have established a multicounty aging unit orthe elected tribal governing body of a federally recognized American Indian tribe or band that has established atribal aging unit shall, before qualification under this section, appoint a governing and policy-making body to beknown as the commission on aging.

2. In any county that has a county executive or county administrator and that has established a single-countyaging unit, the county executive or county administrator shall appoint, subject to confirmation by the countyboard of supervisors, the commission on aging. A member of a commission on aging appointed under thissubdivision may be removed by the county executive or county administrator for cause.

(b) Composition.

A commission on aging, appointed under par. (a) shall be one of the following:

1. For an aging unit that is described in sub. (1) (a) 1. or 2., organized as a committee of the county board ofsupervisors, composed of supervisors and, beginning January 1, 1993, advised by an advisory committee,appointed by the county board. Older individuals shall constitute at least 50% of the membership of theadvisory committee and individuals who are elected to any office may not constitute 50% or more of themembership of the advisory committee.2. For an aging unit that is described in sub. (1) (a) 1. or 2., composed of individuals of recognized ability anddemonstrated interest in services for older individuals. Older individuals shall constitute at least 50% of themembership of this commission and individuals who are elected to any office may not constitute 50% or moreof the membership of this commission.3. For an aging unit that is described in sub. (1) (a) 3., the board of directors of the private, nonprofitcorporation. Older individuals shall constitute at least 50% of the membership of this commission andindividuals who are elected to any office may not constitute 50% or more of the membership of thiscommission.

(c) Terms.Members of a county or tribal commission on aging shall serve for terms of 3 years, so arranged that, as nearlyas practicable, the terms of one-third of the members shall expire each year, and no member may serve morethan 2 consecutive 3-year terms. Vacancies shall be filled in the same manner as the original appointments. Acounty or tribal commission on aging member appointed under par. (a) 1. may be removed from office for causeby a two-thirds vote of each county board of supervisors or tribal governing body participating in theappointment, on due notice in writing and hearing of the charges against the member.


(c) Powers and duties.A county or tribal commission on aging appointed under sub. (4) (a) shall, in addition to any other powers orduties established by state law, plan and develop administrative and program policies, in accordance with statelaw and within limits established by the department of health and family services, if any, for programs in thecounty or for the tribe or band that are funded by the federal or state government for administration by the agingunit. Policy decisions not reserved by statute for the department of health and family services may be delegatedby the secretary to the county or tribal commission on aging. The county or tribal commission on aging shalldirect the aging unit with respect to the powers and duties of the aging unit under sub. (3).

(5) Aging Unit Director; Appointment. A full-time aging unit director shall be appointed on the basis ofrecognized and demonstrated interest in and knowledge of problems of older individuals, with due regard totraining, experience, executive and administrative ability and general qualification and fitness for theperformance of his or her duties, by one of the following:

(a) 1. For an aging unit that is described in sub. (1) (a) 1., except as provided in subd. 2., a county or tribalcommission on aging shall make the appointment, subject to the approval of and to the personnel policies andprocedures established by each county board of supervisors or the tribal governing body that participated in theappointment of the county or tribal commission on aging. 2. In any county that has a county executive or countyadministrator and that has established a single-county aging unit, the county executive or county administratorshall make the appointment, subject to the approval of and to the personnel policies and procedures establishedby each county board of supervisors that participated in the appointment of the county commission on aging.(b) For an aging unit that is described in sub. (1) (a) 2., the director of the county department under s. 46.215,46.22 or 46.23 of which the aging unit is a part shall make the appointment, subject to the personnel policiesand procedures established by the county board of supervisors.(d) For an aging unit that is described in sub. (1) (a) 3., the commission on aging under sub. (4) (b) 3. shallmake the appointment, subject to ch. 181.


11. Appendices

Appendix 11.1

Are you an older adult? Are you a family caregiver?Let your voice be heard! Your opinion counts.

The Aging & Disability Resource Center (ADRC) Outagamie County Branch has begun the process ofcapturing views, concerns and issues facing Outagamie County residents 60 years and older plus familycaregivers in preparation of drafting the 2016-2018 County Plan on Aging for Outagamie County. The CountyPlan on Aging depicts how Outagamie County will spend federal and state Older Americans Act funding foraging programs. To fulfill our mission in drafting the County Plan on Aging, we ask for input from olderpeople and family caregivers.

Please list what you feel are the three (3) most important issues you are facing?1)2)3)

Are there programs or services you wish were available in your community?

Other additional thoughts or comments?

Name (Optional)____________________________________________________Telephone _____________________ Email______________________________

We appreciate your time in assisting us and value your input to serve older people and family caregivers. Yourvoice can make a difference. Thank you.


Appendix 11.2

2016 - 2018 Outagamie County Plan on AgingThe 2016-2018 County Plan on Aging addresses the current and future service and support needs of OutagamieCounty residents 60 years and older plus family caregivers. The County Plan will define issues, challenges andopportunities facing the ADRC Outagamie County Branch in meeting the needs of older people and familycaregivers. Listed below are the 2016-2018 County Plan on Aging Required Focus Areas:

Involvement of Older People in Aging-Related Program Development and PlanningThe Older Americans Act is founded on a principle of American democracy that people affected by programsand policies should have ownership of those programs and policies, including an integral role in their planningand development. The active participation of older people in the design, development and implementation ofpolicies and programs gives them ownership of and responsibility. For each year of the 2016-2018 CountyPlan, the ADRC Outagamie County Branch must delineate activities that the ADRC will undertake to helpenhance the ability of older people fully participate in the planning and oversight of community aging services.

Elderly Nutrition ProgramThe Elderly Nutrition Program is the largest program operated by the national and state aging networks. TheElderly Nutrition Program consists of two meal services: 1) Congregate Meal Service providing meals in acommunity environment that promotes socialization and healthy aging; 2) Home Delivered Meal Serviceproviding meals and daily social contact to those who are homebound. Other services such as nutritionscreening, assessment, education and counseling are available to help older people meet their health andnutrition needs. For each year of the 2016-2018 County Plan, the ADRC Outagamie County Branch mustdelineate activities the ADRC will undertake to improve the Outagamie County Nutrition Program.

Caregivers Support ServicesCaregiver support focuses on the tremendous demands placed on family caregivers and other informalcaregivers who help older people remain living at home or in the community. The purpose of caregiver supportservices is to help caregivers as they provide care to their older family members, friends, neighbors and tominor children who are under the care of an older resident. For each year of the 2016-2018 County Plan, theADRC Outagamie County Branch must delineate activities the ADRC will undertake to enhance caregiversupport.

Services to People with DementiaDementia is a term for deterioration in cognitive function, severe enough to interfere with daily life. Symptomsusually develop slowly and get worse over time, although strokes and other brain events can cause sudden onsetor worsening of the condition. For each year of the 2016-2018 County Plan, the ADRC Outagamie CountyBranch must delineate activities the ADRC will undertake to help enhance services in support of familycaregivers.

Healthy AgingHealthy aging “evidence based” programs have been tested through scientific studies and have been shown tobe effective at preventing disease, injury or improving health. The results of the studies have been published inprofessional journals. The term ‘‘disease prevention and health promotion’’ means evidence-based programsrelated to the prevention of chronic disease (osteoporosis, hypertension, obesity, diabetes and cardiovasculardisease), alcohol and substance abuse reduction, smoking cessation, weight loss, stress management, fallsprevention, physical activity and improved nutrition. For each year of the 2016-2018 County Plan, the ADRCOutagamie County Branch must delineate activities the ADRC will undertake to develop healthy agingprogramming.

Local PrioritiesThe ADRC Outagamie County Branch must include a goal based on a local priority for each year of the 2016-2018 County Plan. Input from older people and family caregivers will identify goals.

Oneida Tribe CoordinationThe ADRC Outagamie County Branch must define how the ADRC and Oneida Tribe Elder Services willcollaborate to ensure the provision of services to tribal elders for each year of the 2016-2018 County Plan.


Appendix 11.3

2016 - 2018 Outagamie County Plan on Aging Local Priority Issues

What are the three (3) most important issues facing older people and family caregivers?

#1 Local Priority Issues Affordable and accessible transportation (10) Affordable health care (dental and medical) (8) Dementia care (3) Affordable home repair and maintenance (2) Affordable housing (2) Affordable Medications Failing health (2) Finances (2) Respite care (2) End of life care Family Care Housekeeping Elderly isolation Medication checks Nutrition Recreation Shopping and errand services Social Security Stress and burnout

#2 Local Priority Issues Affordable in-home support services (8) Caregiver support and respite (5) Better education on aging. How it applies to family relationships and what to expect when a

family member is aging (3) Health insurance (3) Loneliness and isolation (3) Shopping and errand services (3) Affordable home repair and maintenance (2) Affordable housing (2) Affordable healthcare (dental and vision) (3) Nutrition (2) Transportation (2) Healthy aging (2) Fear of falling Financial Legal


Appendix 11.3 - Page 2 Continued

#3 Local Priority Issues Affordable home repair and maintenance (5) Transportation (4) Caregiver Support (3) Affordable in-home support services (3) Nutrition (2) Socialization (2) Volunteer opportunities (2) Affordable housing (2) Affordable prescription medications Dementia-focused activities Experiencing loss Food Share issues Guardianship support Health insurance Health issues Affordable respite care (2) Shopping and errand services

Are there programs or services you wish were available in your community?

Financial help services On demand transportation In-home stabilization for individuals with dementia. Caregiver support. Affordable and flexible respite care Public Health to go into homes and do medication set-ups/checks and blood pressure screenings. Updating the Thompson Center Free Clinics (flu, pneumonia and shingles vaccinations) County Supportive Home Care Program is only available for residents 65+. Would be helpful if they

could serve people between 60 and 64 years too. In-home volunteer service for socialization when recuperating from accident. More entertainment and educational programs to keep low income housing residents together (exercise

programs, etc.) Small bus tours leaving from the community center (Timber Rattler games, PAC, etc.) Affordable rural transportation (2) Bus or van to take participants to mealsites to eat and socialize. Weekend transportation 6 day food home delivery or a community food site. Low cost housing when additional levels of care are needed. Legal help Protection for the programs that are in place to help seniors and some type of pact between agencies,

facilities and providers which will not limit the number of beds or services that these agencies orfacilities will provide to those who run out of dollars. (2)



Other additional thoughts or comments?

I think that it is very scary that programs for the elderly and disabled seem to end up on the choppingblock the minute our legislators want to save a buck. Yet, we will add tax upon tax for a stadium,convention center or other less than necessary items thereby throwing fragile people under the bus.About 20 years ago, there were number of stories highlighting the fact that elderly were having to eatdog food in order to pay for medications. It sounds as though we may wish to start stocking up.

More respite caregivers for in-home caregiver relief. Cheaper rates. Cable TV is far too expensive Older people are taken advantage of Minimizing the gaps of care from independent living to assisted living to nursing home Programs to assist people with End of Life care (hospice). Education, POA-HC, etc. How to take care of my own health issues especially stress. Keeping services affordable Need ADRC’s! Don’t even think about replacing them with contracted services outside the communities

where services take place. The biggest issue will be funding. Additional resources and services will be needed but there will not be

enough elder employment position and supportive programs available to assist them. Wait lists will startagain. Dementia is already becoming more prevalent and there will need to be more housing optionsavailable (nursing homes, CBRFs, etc.)

I really believe if everyone understood the ramifications of being a full code or even pursuing treatmentat all, more would choose comfort measures alone thus saving tons of money. Eighty percent of allhealth care costs are spent in the last few years of your life.

Lacking a Power of Attorney. People may have partial POAs or a living will but they are not specificenough to avoid guardianship.

Financial struggles. Social Security is encouraging folks to wait until 70 years old to retire to receivemaximum benefits. Many elderly can’t physically make it that long. Some just don’t want to. Medicarecontinues with large donut holes with deductibles many can’t afford with the increase in cost of living.

How will people be able to remain in their home as they age? Two-story homes may be out of thequestion. Homes may have to be modified to allow wheelchairs to get through entry ways. Assistedliving/CBRFs/RCACs are lovely. It’s the cost that is tough and we already see that these places wantprivate pay folks. That is just the beginning of the problem. Who will care for them at home?

With the push by the federal government for unpaid, natural supports coming on the heels of ageneration (our children) who have put off childbearing until their 30’s and sometimes 40’s, I’mconcerned about those kids being able to help out Mom and Dad when they still have children at home.Having a family (especially with multiple children) takes 110% focus and commitment, so it could beincredibly difficult for our adult children to take on any significant role in caregiving for their parents.Of course, there may be other relatives or close friends who could help out but adult children usuallybear the brunt of the burden even if it’s just coordination and oversight of the care.

Dementia care availability and expertise for these individuals Dealing with changing state and federal requirements of programming for seniors that are at this time

unknown. This will require flexibility of staff to insure that seniors can access the services. It will alsorequire handicapped accessible buildings, with centralized services, that are on a bus route.

Need to develop safe housing for individuals with Alzheimer’s and behaviors. We are getting more andmore calls from family members who have nowhere to go.



Will the array of services needed by seniors be available in the future? This includes resources for out-of-home placements, in-home care, home delivered meals, therapy services, etc. The questionsassociated with this is how do we fund the need based on number of seniors with fewer young to supportthe growing elderly population and will there be adequate numbers of staff available to provide theservice they need?

Dramatically shifting demographics. The biggest challenge will be its size relative to the balance of thepopulation.

Housing – with the "Silver Tsunami" and the number of people calling about housing, I am going toguess there will be shortage of housing for people.

Lack of natural supports. Adult children are not staying in their home towns long term. Neighbors arenot helping neighbors.

Who will take care of our elderly? Improvements to wages and benefits will be a big factor to ensurethere are enough qualified people to provide direct care services to our elderly population.

Local Priority Issues input was compiled from the following public forums and sources:

Aging & Disability Resource Center (ADRC) Outagamie County Branch Staff (Information and AssistanceSpecialists, Community Living Specialist, Elder and Disability Benefit Specialists, ADRC Assistants, SupportStaff, Supervisors)Outagamie County Elderly Nutrition Program Staff (Mealsite Managers, Food Transporters and Substitutes)Outagamie County Elderly Nutrition Program Congregate ParticipantsOutagamie County Aging & Long Term Support Advisory CommitteeOutagamie Caregiver Coalition MembershipOutagamie County Public OfficialsOutagamie County Department of Health & Human Services Administrative StaffAging & Disability Resource Center (ADRC) Outagamie County Branch Volunteer Recognition -Public Forum/Listening Session 5/6/15 59 in attendance.St. Joseph's Food Pantry Staff and 100 + VolunteersHortonville Senior Group - Public Forum/Listening Session 6/25/15 16 in attendance.Kaukauna Senior Group - Public Forum/Listening Session 5/20/15 35 in attendance.Aging & Disability Resource Center (ADRC) Outagamie County Branch The ADRC Connection NewsletterJune 2015 Issue. Approximately 3,000+ readers.

July 1, 2015

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