Congregate Meal Program in Bisbee
Three years ago, because a congregate meals program no longer existed in Bisbee, the AAA piloted a voucher program that allowed seniors at or below 150 percent of poverty to use a SEAGO voucher to purchase a 7-day meals coupon. This coupon allowed these seniors to have a meal at the Copper Queen Hospital cafeteria.
This has been such a successful pilot that because of capacity issues at the cafeteria, the hospital has limited the number of vouchers to 45 per month and as of May 1, 2010 to SEAGO coupons being limited to dinner and not lunch. The dinner is going to be enhanced with presentations on health and nutrition, and possibly some music.
Health Promotion and Disease Prevention
The AAA has conducted four A Matter of Balance classes to date, by using existing staff. Since this staff has very limited time to conduct these classes, they have not been systematic, or available throughout the region. In order to avoid this spotty coverage, SEAGO plans to contract with a consultant, who is a master trainer in a variety of evidence based programs. This individual will be charged with finding out what programs exist and developing a plan for providing
A Matter of Balance and Chronic Disease Self Management throughout the region. The total Title III-D funding plus state match will be used to cover the consultant’s time and travel. The consultant will seek additional funding from DES/DAAS or ADHS to actually implement the evidenced based programs.
Cochise Health Systems has applied to ADHS to have a member of their staff plus a member of the Cochise County Health Department be trained as master trainers for CDSMP. These two new trainees plan to work with the SEAGO consultant to conduct the two classes that each must conduct in order to complete their certification as master trainers.
By partnering with other agencies there should be sufficient master trainers to provide classes and develop a corps of lay coaches.
New Willcox Senior Center
Through Congresswoman Gabrielle Gifford’s budget, has earmarked the City of Willcox to receive funding to construct a senior center. The City decided to award this funding to the Northern Cochise Community Hospital (NCCH). A 3,000 square foot modular building is being erected on the NCCH campus.
It will have a manager’s office, two class rooms, a large open community area, and an area to be used as a sleep lab at night. There will probably be a naming contest, and “senior center” is not likely to be part of the name. Careful planning is underway to make this a center for lifelong learning, offering health education, classes on arts, travel, genealogy, and avoiding activities like bingo.
The SEAGO AAA has a contract with NCCH to provide transportation in the Willcox area, and has a short-term contract with NCCH to provide A Matter of Balance classes in Willcox and Sunsites. The hospital has selected the same individual to manage this new facility, as will likely be chosen by SEAGO as the consultant to develop the health promotion activities described above.
Benson Transportation
In April 2009, Catholic Community Services (CCS) in Southeastern Arizona announced that they would no longer provide transportation services in the Willcox and Benson areas. When no other provider was found in the Benson area, CCS agreed to extend its contract with SEAGO AAA for another year.
The City of Benson decided to work with ADOT and SEAGO’s transportation planner to explore other options, and applied to operate a public transportation system under Section 5311. This new funding will begin October 1, 2010, and the AAA has issued a Request for Proposal (RFP) for a new transportation provider as of July 1, 2010.
Since the City of Benson is the only agency that has requested an RFP, it is likely that the City will take over the operation of the senior transportation program in July, and then integrate it with the public transit system as the 5311 program is implemented.
The AAA has contracts where its funding is integrated with 5311 programs in Bisbee and in Douglas. Because the Arizona Legislature has eliminated the Local Transportation Assistance Fund II (LTAF II) program that had been funded by the Power Ball, financing transportation is going to be a huge challenge throughout the SEAGO region. Therefore, AAA staff will be working very closely with the transportation planner and contractor to preserve the existing transportation systems.
State Health Insurance Assistance Program (SHIP)
In the summer of 2007, an insurance coordinator was hired at the AAA, instead of subcontracting this service. This has enhanced the information and benefits counseling that the AAA has traditionally provided.
It has also increased the AAA’s visibility throughout the region, because the insurance counselor circuit rides throughout the region, meeting with Medicare beneficiaries at libraries, wellness centers, community buildings, and even at times in individuals’ homes.
This service will be continued during the term of this Area Plan, and efforts will be made to strengthen this program.
Aging and Disability Resource Centers (ADRC)
The SEAGO AAA is very interested in the concept of an ADRC, but cannot afford to dedicate staff to this effort. Instead the AAA has focused on having case managers throughout the region be knowledgeable of benefit programs, and toward that end periodically updates a benefit chart.
The AAA has focused on keeping the Cochise, Graham-Greenlee, and Santa Cruz Resource Directories up to date, and has been training community groups to use them. The ACOA has decided to embrace the Ambassador Program and help make this a region wide program.
The AAA also is known as a source of information on how ALTCS works and on advanced directives. Case managers frequently refer individuals who need information about ALTCS to SEAGO. The provision of health insurance counseling with SHIP funding is another building block toward an ADRC some day in the future.
Management Information Systems and Case Management
Much as the AAA would like to see AIMS replaced, the financial reality is that SEAGO will continue to work with DAAS to maintain this system and work with case mangers to have client intake, needs assessment, care plans and service utilization that are appropriate and cost effective.
SEAGO does not intend to provide case management services directly, and will continue to contract with a case management provider in each of the four counties. The financial support provided by Cochise, Greenlee, and Santa Cruz Counties to the case management program in their respective counties ensure the viability of these programs.
Without this financial support the number of case managers in these three counties would be reduced from eight to four.
Maintenance of Independence and Elder Abuse Prevention
Home and community based programs help many to remain independent, and despite budget cuts, SEAGO is committed to continue to fund these programs. As described above, SEAGO is planning to develop implement evidence based health promotion programs and continue to partner with NCCH and with the Cochise College Center for Life Long Learning to promote well-being.
SEAGO will continue to facilitate the Cochise Elder Abuse Task Force, assist with the semi-annual Elder Abuse Conference in Santa Cruz County and assist with the annual Break the Silence conference in Graham County. These efforts promote awareness of the scams that exist and how to avoid them.
Self-Directed Care
As the comments from the ACOA reflect, this is an area that will require study for successful models elsewhere, before any plan for local implementation is seriously considered.
Coordination with Health Care Systems
As the comments from the ACOA reflect, there is real interest in working more closely with hospitals, clinics, and emergency responders. The SEAGO health insurance counselor has been working closely with the hospitals in Safford and Sierra Vista, and AAA director has been working closely with the ones in Bisbee and Willcox to establish partnerships. Home care providers are required to identify any services that could be changed to Medicare or insurance, and SEAGO is to be the payer of last resort.
Case managers and Medicare certified home health agencies work closely together when clients qualify for services through their insurance. Hospitals will likely be partners in the implementation of evidence based prevention programs. Having Cochise Health Systems, which is the ALTCS program contractor for Cochise, Graham, and Greenlee Counties, partner in the implementation of CDSMP should help maximize resources for this effort.
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