Elderly Services Program. Recent issues with the Butler County Elderly Se: Frequently Asked Questions Care Management Contract rs How will the decision to have just one care management agency affect se enrolled in the Elderly Services Program? Seniors will continue to receive meals on wheels, homemaking, and other in-home services if they are eligible. If they currently have a home health aide and remain eligible for the service, itis likely this aide will continue to serve them. Seniors may or may not have a new care manager. Their care manager - whether it's the one they have now, or someone new - will be employed by LifeSpan, Inc. The care manager is not the same person as the home care aide. The care manager assesses clients’ needs, arranges for services, solves any problems that arise, and phones and visits several times a year to make sure everything is going well. Shouldn't seniors receive care management from an organization in their own community rather than from one organization for the entire county? Care management should be consistent, regardless of where clients live in Butler County. That is not the case with four different care management agencies. For example, case loads per care manager have varied by as many as 60 clients from one agency to the next. Under the new contract, each care manager will have about 125, cases. This is in line with recommendations of the Scripps Gerontology Center (Miami University). That said, LifeSpan will ensure that care management continues to be performed in the community by having care managers operate out of existing LifeSpan offices in Hamilton, Middletown, Oxford, and West Chester. “Wilt having just one care management agency save the county money? ‘The purpose of assigning care management services to one agency was to deliver a more consistent level of service to disabled seniors of Butler County. As an additional benefit, he program will be more cost effective because overhead costs will go down. These costs currently range from 15.9% to 28.8% (based on 2008 budgets) across the four care management agencies. With one agency, the average administrative cost will be 11.7%. This is in line with administrative costs in Hamilton and Warren counties, which also have Elderly Services Programs with one care management agency. Does Council on Aging have something against senior centers? LifeSpan got the care management contract but it is not a senior center. And I've heard that without the care management contract, Butler County's senior centers will suffer financially and could even close. Couneil on Aging will continue to work closely with senior centers as we have for nearly 40 years. It has always been part of Council on Aging's mission to promote and support viable community-based services for seniors.The senior centers that have been providing care management services — Partners in Prime, Middletown Area Senior Citizens, Inc., and Oxford Senior Citizens, Inc. — will experience some financial loss without the Elderly Services Program care management contracts. But the program was not designed to fund senior center operations. Its purpose is to enable disabled seniors to receive care in their homes so that they can avoid an unnecessary or premature move to a nursing home. The senior centers also currently receive revenue as providers of home-delivered meals and related services. The new care management contract does not affect their current COA contract as direct, service providers. There is no intention to hurt senior centers, but we do need to make the Elderly Services Program as efficient and effective as possible. This is truer than ever before as the senior population grows and more people need help. LifeSpan may not have a senior center, but it does have a long and successful history of providing services for older adults in Butler County, including 30 years experience providing care management. Council on Aging is not located in Butler County. Why should this program be administered by an outside organization? Council on Aging is not an outside organization. We are a regional organization, designated by the Ohio Department of Aging to serve the older adults of five counties: Butler, Clermont, Clinton, Hamilton and Warren. Two years ago, we moved from downtown Cincinnati to northern Hamilton County in order to be more centrally located for the five counties we serve. We also have staff living in all five counties, many of whom are telecommuters who work out of their homes. We are southwestern Ohio's Area Agency on Aging. Area Agencies on Aging are the foundation of home and community-based services to our nation’s seniors, as authorized by the Older Americans Act. Around the nation, there are more than 600 regional organizations like Council on Aging that have a long history of service to seniors, their families, and caregivers. _Elderly Services Levy Fund Balance Why is there a fund balance (surplus) in the Elderly Services Levy? At the time of levy forecasting (spring, 2005), there were several issues impacting the millage recommendation including: a reported waiting list of nearly 900 people; a change in state tax law; and provider reports that rates should be higher due to rising costs. ‘The biggest factor was the waiting list. All signs pointed to pent-up demand and growing need for the program. We expected that most people on the list would enroll ifthe levy passed, but we had no way of knowing the actual number. We also projected that if the levy passed, the program would see a rapid influx of new clients within the first yeer. In fact, 536 people enrolled from the waiting list. Others did not enroll because their health had improved, they had moved to a nursing home, or they had died. In addition, we didn't see the rapid initial enrollment we had anticipated. Since that first year, however, enrollment has been gaining speed. Since the levy passed, client enrollment has increased by 46 percent.For the impact of change in state tax law, the levy committee relied on the expertise of | the county auditor. Around Ohio, there were different interpretations of what the law's impact might be. A conservative interpretation was used in Butler County and actual revenues have been higher. With regard to provider rates, a very unexpected thing happened. Providers reported it | ‘was costing them more to provide services. The levy amount was adjusted accordingly. However, increasing competition has driven prices down. That's a good thing, but it did add to the surplus. About $3.5 milion of the projected surplus resulted from Butler County's competitive marketplace. - It should be noted that in determining the size of the levy, Council on Aging joined with others including county officials; provider agencies (Partners in Prime, LifeSpan and others); and members of the community board. do not need this program anymore? ‘The need for these services is growing. Since the levy passed, client enrollment has increased by 46 percent. Also, like the rest of the country, Butler County is experiencing a growing population of adults ages 60+. Scripps Gerontology Center at Miami University expects a 74 percent increase in this group by 2020. As people age, they are more likely to be disabled and need help. If there Is extra money in the levy fund, does that mean seniors in Butler County What Is going to be done with the levy surplus? | ‘The levy surplus is in the county treasury, not at Council on Aging. COA and the community oversight board (Butler County Citizens for Elderly Services, inc.) will work with Butler County Commissioners to provide the information they need to make a decision they feel is right for the seniors and taxpayers. Whatever the outcome, COA and the community board want to ensure that seniors in | Butler County have a choice when it comes to where and how they will live as they age. The Elderly Services Program gives families another option when it comes to long-term care for their loved ones. The levy has a strong history of support and it is important that I've heard that senior centers are in danger of closii surplus in the county's levy fund? The levy does not fund senior centers. It funds the Elderly Services Program to help seniors in their homes. The program helps many seniors who are homebound, frail, and unable to use a senior center. Senior centers have other sources of funds, such as the federal Older Americans Act, and they existed long before the tax levy. | | \g. How can that be if there's a Could the surplus be used for something other than what I voted for? ‘The Butler County commissioners will decide the course of action for the surplus. If the | money is left in the Elderly Services fund, it will be used only to run the county's Elderly Services Program. The current levy expires in 2010. Financial projections show that if, the program continues to grow at its current pace and experiences no changes in | funding (ie. levy renewal in 2010), the levy surplus will be spent by 2015.