Disclaimer

This material is based upon work supported by Marietta College. Any opinions, findings, conclusions, or recommendations are those of the author and do not reflect the views of Marietta College, its employees, or its administration.

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Executive Summary

The Area Agency on Aging 8’s (AAA8) Aging and Disability Resource Network program (ADRN) was setup as part of a nationwide effort to restructure support services for older adults, people with disabilities, family members, and care providers. AAA8 approached the team with the goal to reach key audiences with the ADRN information in the eight Southeastern Ohio Counties: Athens, Hocking, Meigs, Monroe, Morgan, Noble, Perry, and Washington. The key audiences to target are medical providers and caregivers. The ADRN has little funding, so the information must be provided on a strict budget. The team decided on three necessary tasks: selecting benchmark locations, developing effective marketing strategies and selecting grant opportunities.

The team’s first task was to benchmark other states to understand how they successfully implemented the ADRN program and how the target market was reached with the appropriate information. We selected seven states that had easily accessible sites with useful information about their ADRN programs and that had successfully reached the target markets using the five key components of the program: Information and Awareness, Options Counseling, Streamlined Access to Public Programs, Person-Centered Hospital Discharge Planning, and Quality Assurance and Evaluation. We determined the seven states that have best reached the target markets using these components are: Arkansas, Georgia, Indiana, New Hampshire, South Carolina, Texas, and Wisconsin. We also concluded that most of the states were able to utilize the 211 network through which the majority of their program information was dispersed. In addition, the states’ programs were able to communicate the information through networking and forming partnerships with community agencies and local businesses. We recommend that the client focuses on the five key components as the best way to reach the target markets. Also, the client should build strong relationships with businesses and the community.

The second task was developing effective marketing strategies to reach target markets within budget. Although most of the target markets can easily access the ADRN program’s website, it was important to keep in mind that the program deals with the aging and disabled and cannot rely on the notion that all individuals are technology savvy or have access to internet. Alternative strategies were needed to develop a market plan to reach both primary and secondary target markets through everyday encounters other than the web. We researched ideas, used benchmarks, and brainstormed to come up with other ways the program can get information out to the target markets. The final step was to formulate a list of health care providers and organizations that we wanted to reach with the ADRN program information. Then we decided the best ways to reach the target markets. Some examples include brochures, magnets, and waiting room advertising. All the pricing information was gathered for the suggestions. From the information we gathered, we recommend that the client provide a website that is easy to navigate, lobby county officials for a 211 system, employ market strategies such as magnets and brochures, and strive for strong partnerships.

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The team’s final task was researching grants that the program desperately needs in order to successfully expand and implement the ADRN program. The grants were selected by following recommendations from our client to research both government and local agencies that have available grant opportunities. We compiled a list of grants that we believe meet the eligibility of the client. Obtaining additional funding through grants will allow the ADRN staff to support projects that will keep the aging and disabled communities as well as their caregivers healthy and aware of the resources that are available. We recommend that the ADRN staff carefully review the grants that we outline in task three in order to expand the ADRN program.

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Table of ContentsThe Rational for ADRN.................................................................................................................................5

History.........................................................................................................................................................5

Older Americans Act................................................................................................................................6

The Business and Market Environment.......................................................................................................7

Demographics..........................................................................................................................................8

Trade Associations...................................................................................................................................9

Partners...................................................................................................................................................9

Funding....................................................................................................................................................9

Benchmarking............................................................................................................................................10

Task One: Selecting Benchmark Locations.................................................................................................14

Task Two: Developing Effective Marketing Strategies...............................................................................16

Task Three: Selecting Grant Opportunities................................................................................................20

Appendix A: Declaration of Objectives for Older Americans.....................................................................24

Appendix B: Contact Information for States that Have Successfully Implemented the ADRN Program....25

Appendix C: Disability by Type and Age Group..........................................................................................26

Appendix D: Median Household Income Distribution for Southeast Ohio................................................27

Appendix E: Outreach and Referral Facilities.............................................................................................28

Appendix F: Marketing Strategies..............................................................................................................29

Appendix G: Magnet Samples...................................................................................................................30

Work Cited.................................................................................................................................................32

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The Rational for ADRN

The Aging and Disability Resource Network (ADRN) is a collaborative effort of the Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS) designed to streamline access to long-term care. The ADRN initiative is part of a nationwide effort to serve as a single point of entry into the long-term support and service system for older adults, people with disabilities, and care providers. The overall goal of the ADRN program is to allow individuals to effectively navigate their health and other long-term support options by addressing the frustrations many individuals and their families experience when they need to obtain information and access support and services. 1

HistoryBuckeye Hills-Hocking Valley Regional Development District was established in 1968 as a regional planning and development center. On January 1, 1974 it was chosen as an Area Agency on Aging 8 (AAA8) by the Ohio Commission on Aging. Buckeye Hills-Hocking Valley Regional Development District is a government agency serving the following eight counties in Southeastern Ohio: Athens, Hocking, Meigs, Monroe, Morgan, Noble, Perry, and Washington. The funds for AAA8 service area come from the Older Americans Act. The purpose of the Older Americans Act is to create a comprehensive and coordinated system of services for seniors in the eight county region. 2

AAAs were established under the Older Americans Act (OAA) in 1973 to respond to the needs of Americans 60 and over in every local community across the country. AAAs provide a range of options that allow older adults to choose the home and community-based services and living arrangements that suit them best and make it possible for older adults to remain in their homes and communities as long as possible.3 The Area Agency on Aging also provides planning, advocacy, administrative, and organizational assistance to county commissioners, county councils on aging, and others who provide services to the elderly. The AAA was originally involved in developing and establishing senior centers, mainly focusing on transportation, information, and referral.

AAA8 experienced a year of transitions in 2001. Changes included the Caregiver Advocacy Program, which was created to allow the informal caregiver to receive case management services. Other improvements included the development of the Area on Agency Aging website and the AAA Newsletter, which was a form of community outreach. The website included an information and referral system and allowed anyone within the eight counties to access services.

Guidelines were set forth from the federal government stating that each state’s Area Agencies on Aging will transition to ADRC (or ADRN as it is referred to in Ohio). Ohio changed the name of the program to ADRN to sound more inclusive in order to improve partnerships. Between 2003-2005 AoA and CMS originally funded 43 states and territories to develop ADRN programs. Ohio received their grant in 2005, and immediately started implementing the program.4

1 “Area Agency on Aging 8.” Area Agency on Aging 8. Web. 19 Feb 2012. <http://www.areaagency8.org/>. 2 IBID3 “About N4A.” N4A: Advocacy. Action. Answers on Aging. 2011. Web. 19 Feb 2012.

<http://www.n4a.org/about-n4a/>.4 “Area Agency on Aging 8.” Area Agency on Aging 8. Web. 19 Feb 2012. <http://www.areaagency8.org/>.

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Older Americans Act In 1965, Congress enacted the Older Americans Act, which established the Administration on Aging (AoA) and state agencies on aging to address the welfare and needs of older Americans. The Act is considered the major resource for promoting the delivery of social services to the aging population. The mission was broad and merely stated that its goal was to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. 5

The Older Americans Act Amendments of 2006 reauthorized all programs under the Act through 2011. The amendment allowed for an active role to be taken by AoA, state and Area Agencies on

Aging in promoting home and community-based long-term care services. It also allowed funding for competitive grants in order for states to promote comprehensive elder justice systems. It required AoA to develop demonstration programs to help older people “age in place” and systems for mental health screening and treatment services.

The design of the ADRNs is to incorporate many vital end-user services that have long been part of the Older Americans Act network, because they are integral to what older people and people with disabilities need to maintain independence. See Appendix A for the Declarations of Objectives for Older Americans: Section. 101 for a clearer understanding of what exactly they wanted accomplished through the Act.6

5 “Older American Act.” Administration on Aging. Web. 19 Feb 2012. <http://www.aoa.gov/AoARoot/AoA_Programs/OAA/index.aspx>.6 "Older American Act Summary." Texas Department of Aging and Disability Services. Web.

<http://www.dads.state.tx.us/rules/oaa_summary.html>.

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The Business and Market EnvironmentWhen looking at the cost, time and planning that is involved in implementing a program such as ADRN, it is important to make sure that there is a real need for the services that are being provided.

To begin the research, we looked at the population of those living with a disability in Ohio and those who are 60+ in the eight counties. According the handouts from AAA8, in 2007, 309,000 Ohioans of all ages had a severe disability, and that group will grow to 328,000 by 2020 (13% increase),and four out of ten of those individuals with a severe disability receive assistance only from family or privately purchased care (see Appendix C). These statistics show an overbearing need for a service such as ADRN to help those who are disabled. We also researched the eight county area and the median household income distribution (see Appendix D). While these numbers reflect the population as a whole they showed that the median income was fairly low to that of the rest of the country and that these rural areas might be in more of a need to effectively navigate their health and other long-term support options.

The Dayton Daily News reported that The National Institute of Aging estimates around 7 million Americans are long-distance caregivers. This fact proves there is a real need for the aging, the disabled and their caregivers to receive the benefits of a program such as ADRN. Over the next four decades, it is expected that the share of people 65 and older will rapidly expand while the number of people under 20 will hold steady. This shows a need for a service that supports older adults, persons with disabilities, family members and caregivers in order to provide assistance and empower individuals to make informed decisions about their health. These statistics are startling. There is going to be a smaller share of people between 20 and 64, which is the age group that primarily is faced with the care giving for our primary markets.7

There are several key factors that reflect a state and national need for such a program. Many seniors and those who are disabled have difficulty identifying or recognizing their needs and are in denial of their self-care needs. This leads them to be reluctant or afraid to ask for help because they do not want to be a burden or are not sure of what questions to ask. Many of them may feel isolated and have a lack of transportation to access services that are available. Others are just simply unaware of the services offered and use media and technology less than the general public, so they are not able to easily research what is available. All of these are key factors that are addressed through the ADRN program, making it a valuable aspect to the community.

7 Sedensky, Matt. "Millions Now Manage Aging Parents' Care from Afar." Dayton Daily News. 26 Jan 2012. Web. <http://www.daytondailynews.com/lifestyle/ohio-health-news/millions-now-manage-aging-parents-care-from-afar-1319009.html>.

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DemographicsThe project area is located in Southeastern Ohio, near the Ohio River/West Virginia border. The table below shows one target audience. The following information was provided by the census and all numbers are approximate.

Table 1: Population of Elderly in the Eight County Region

County Total Population Population 60+ % 60+Athens 60,061 7,715 12.85Hocking 26,636 5,145 19.32Meigs 23,436 4,445 18.97Monroe 15,497 3,270 21.10Morgan 14,303 3,205 22.41Noble 11,631 2,460 22.15Perry 32,298 5,495 17.01Washington 64,000 12,290 19.20

2000 Ohio Census

Table 1 shows the need for the ADRN due to the high percentages of elderly population in all eight Southeastern Ohio counties.

Disability classification and qualifications can vary from state to state. The following chart displays the disabilities recognized in Ohio as well as the percent of citizens with that disability. Ohio estimated 328,000 people with a disability. This number only includes ages five and above. This represents approximately sixteen percent of Ohioans. See Figure 1 for a chart showing the distibution of disabilities in Ohio and the percent of the population with those disabilities five years of age and older.

Figure 1: Distribution of Disability Categories in Ohio

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Trade AssociationsThe Ohio Association of Area Agencies on Aging (O4A) is a nonprofit organization, which has a statewide network of agencies that provides services for the elderly, and advocates on behalf of older Ohioans. The Ohio Association addresses issues which have an impact on the aging network and provides services to those members, and serves as a collective voice for Ohio's Area Agencies on Aging (AAAs).The Association also initiates and is a backer for legislation and actions that are in support of Ohio's older adults, their families, and caregivers and the programs and services that affect them.8

The National Association of Area Agencies on Aging Primary (N4A) is the leading voice on aging issues for Area Agencies on Aging and supports that national network, which has 629 AAAs and 246 Title VI programs through advocacy, training and technical assistance. The N4A advocates on behalf of their member agencies for services and resources for older adults and persons with disabilities. They work with their members in achieving a collective mission of building a society that values and supports people as they age.9

PartnersCenters for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards.10

In addition to these programs, CMS handles the administrative standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the quality standards of long-term care facilities (commonly known as nursing homes).

The Administration on Aging (AoA) is a federal agency responsible for serving and advancing the concerns of a growing senior population by developing a comprehensive, coordinated and cost-effective system of home and community-based services that helps elderly individuals maintain their health and independence in their homes and communities.11

AoA works with and through the Aging Services Network and is part of the Department of Health and Human Services and is headed by the Assistant Secretary for Aging, who reports directly to the Secretary.

FundingBeginning in 2003, AoA and CMS offered grants to states to develop Aging and Disability Resource Center (ADRCs) Programs. The grant opportunity provides for the implementation of the ADRC program, which allows each state to assist its target market in order to make informed decisions about long-term service and support options and to streamline access to existing services and support.

8 "About." Ohio Association of Area Agencies on Aging. Web. 5 Mar 2012. <http://www.ohioaging.org/Pages/About>.

9 “About N4A.” N4A: Advocacy. Action. Answers on Aging. 2011. Web. 19 Feb 2012. <http://www.n4a.org/about-n4a/>.

10 “Centers for Medicare & Medicaid Services.” Centers for Medicare & Medicaid Services.Web. 19 Feb 2012. <http://cms.gov/>.

11 "Aging & Disability Resource Centers ." Administration on Aging. Web. 19 Feb. 2012. <http://aoa.gov/AoARoot/AoA_Programs>.

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Currently, all 50 states have received ADRC grants. Ohio received its federal grant to implement what they refer to as the ADRN program in 2005. This grant was piloted in Cuyahoga County through the Western Reserve Area Agency on Aging. Ohio’s program wants to avoid creating a single point of entry for the system. Rather, it wants to create a Resource Network. This is why they refer to their ADRC program as ADRN.

Ohio received a second grant from the AoA to expand the ADRN program in 2009. The purpose of this grant is to further the statewide reach and to develop the tools and processes that will streamline access to services for its target market. According to the Administration on Aging (AOA), The Ohio Department of Aging received $219,380 from the federal government and $14,468 from the state government making the combined total grant for 2009 $233,848.

Over the next three years, Ohio will receive $3 million to give older adults, people with disabilities and their caregivers.

Benchmarking

Through our research we have found numerous states that have successfully reached their target audience by utilizing the appropriate channels. Each has followed the key components of the ADRC program which include:

1. Information and Awareness2. Options Counseling3. Streamlined Access4. Person-Centered Hospital Discharge Planning5. Quality Assurance and Evaluation

1. Information and Awareness: Through the Information and Awareness components the ADRC’S ability to serve as a trusted network allows individuals to receive objective information on a range of long-term support options. A key feature of the Information and Awareness component is to help people understand their health and to provide benefits and programs that will assist them with daily and long-term living. This will also allow for the ability to link their target markets with needed support by referring them to the appropriate agency that handles the program best suited to their needs. A number of states have been able to successfully integrate their Information and Awareness components with other ADRC functions as well as with their overall statewide systems of care.

Some of those leading examples consist of:

South Carolina was able to develop and maintain a comprehensive and easily accessible web database that allows their target audience to be able to find the information, resources and services that best suits their needs. This web-based program also allows the staff at the ADRC program as well as their associates in the medical profession to have secure access to the web-based client tracking system. They use what is known as I&R/A (Information, Referral and Assistance) software which allows them to maintain the electronic resource databases and client tracking system, which in turn can be shared.12

12 "Learn About." SC Access: Aging and Disability Information. 2012. Web. 19 Feb 2012. <https://scaccess.communityos.org/cms/>.

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Arkansas has implemented a call center which includes a state-wide toll-free number that is run by state employees. The call center can provide some early Options Counseling, I&R/A, and can assist callers in filling out medical related forms. If callers need more in-depth help not provided by the call center, then the staff can link them to local ADRC partners that will be able to assist them further. We were able to find that there are other states that use a call center model similar to Arkansas, including Minnesota, West Virginia, New Mexico and Rhode Island.13

2. Options Counseling: This component is defined as a cooperative decision-support process whereby the target audience can receive “one-on-one” counseling on an as-needed basis. The main goal of Options Counseling is to help the target audience recognize and understand what their needs may be and to provide them with the resources to help them make informed decisions about the long-term service and support choices that are available to them.

Examples of states that have successfully implemented the Options Counseling include:

New Hampshire utilizes I&R/A specialists to help determine if the caller will benefit from the Options Counseling being offered. If not, then the caller will be referred to the LTS Counselor on staff. The position of LTS Counselor (Long Term Substitute Counselor) is able to provide both pre-screening for eligibility and a wide-range of options counseling to the individuals that are looking for long-term support.14

Indiana works in collaboration with the State Health Insurance Counseling Program (SHIP).Some of the SHIP counselors that are co-located with ADRCs are also Options Counselors. When individuals contact the ADRCs and have questions about health insurance, the ADRC representatives are able to schedule appointments for the SHIP counselors, providing a single point of entry for support and services to the target audience. Indiana is unique because it has managed this co-location with SHIP even though it is located within the state-level insurance department instead of the aging department.15

3. Streamlined Access to Public Programs: The Streamlined Access to Public Programs is used so that ADRCs have a single point of entry to publicly funded long-term support. This requires ADRC programs to have protocols and procedures in place necessary to facilitate unified access (i.e., needs assessment, eligibility determination, care planning) to both community-based and institutional long-term support services. The goal is to ensure consumers get the information they need regardless of which service they use.

Some states that have been noticeably successful in establishing operational models for the Access component include:

In New Hampshire, ADRCs were established by the Department of Health and Human Services for the purpose of being a solitary unit responsible for conducting individuals’ intake, assessments, and eligibility determination for all long-term care programs. To ensure this

13 "Choices in Living Resource Center - Arkansas." Choices in Living Resource Center - Arkansas. Web. 19 Feb. 2012. <http://www.choicesinliving.ar.gov>.

14 "ServiceLink: Yesterday, Today, and Tomorrow." Service Link: Resource Center. New Hampshire Government, 2012. Web. 19 Feb 2012. <http://www.nh.gov/servicelink/aboutus.html>.

15 "FSSA: Area Agencies on Aging/ADRC." IN.gov: Home. Web. 3 Apr. 2012. <http://www.in.gov/fssa/da/3478.htm>.

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program is carried out, New Hampshire co-locates the ADRC with the state-employed nurses who conduct the assessments and determine individuals’ eligibility. One major benefit of having co-located staff is that they have access to Medicaid information on-site at the ADRC. The staff at the ADRC are employed by multiple organizations, but they all work together to determine the eligibility of individuals. 16

Wisconsin has a standardized process for accessing all adult long-term care programs through the ADRC. ADRC staff uses this process to perform a level of care assessment, determine the functional eligibility of an individual for Medicaid HCBS waiver programs, and assist the individual through the financial eligibility process. If the ADRC does not hear back from someone regarding a particular eligibility termination, they use a tickler file system to follow up with the Economic Support Unit. If someone is not eligible, there are protocols set for the ADRC to follow up with that individual and provide information about alternative private pay options. Local ADRCs are required to have an enrollment plan that outlines how the ADRC and Economic Support Unit collaborate to help consumers access public benefits. 17

4. Person-Centered Hospital Discharge Planning: ADRCs are used to create networks among the major services for long-term care. These include physician services, hospital discharge planning, pre-admission screening programs for nursing homes, as well as the various community organizations that reach out to the ADRC’s target population. These pathways make sure people are given the correct information and are aware of all their options so they can make well-informed decisions when it comes to their care as they transition through health care programs into long-term support systems.

Some leading examples of the outreach with hospital discharge planning programs are:

In Texas, ADRC and hospital discharge organizers are able to work together in order to identify individuals and their caregivers who are at risk of being hospitalized and provide information and services to them. ADRC Care Transition Specialists are able to coach their target audience to ensure that their needs are met in the transition from acute care to a community setting. A unique feature with how Texas has successfully implemented their ADRC program is that they provide training to the staff and to other health professionals about the ADRC program.

In order to make the relationship possible between ADRC and hospital discharge workers, the ADRC has partnered with Scott & White HealthCare's Department on Aging and Care to implement the Colorado Care Transitions Intervention.18

Georgia is also able to maintain a relationship between ADRC and hospital planners, due to the collaboration with the Georgia Hospital Association. Together, through strong channels of communication, the ADRC staff and hospital discharge planners are able to distribute educational information and resources to their target markets. Similar to Texas, ADRC staff in Georgia is able to provide educational training sessions for the discharge planners and social

16 IBID17 “WI Aging and Disability Resource Centers Customer Home Page." Wisconsin Department of Health Services.

Web. 19 Feb. 2012. <http://www.dhs.wisconsin.gov/ltcare/adrc>.18 "Help for Texans: Aging and Disability Resource Centers." DADS: The Texas Department of Aging and Disability

Services. Web. 19 Feb. 2012. <http://www.dads.state.tx.us/services/adrc>.

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workers about the ADRC program and the Transition coordinators who work with nursing facilities are co-located with ADRC staff. 19

5. Quality Assurance and Evaluation: Every ADRN/ADRC Program should have an on-going system for assuring the quality of the ADRN/ADRC and evaluating its impact on consumers, system efficiencies and costs. The ADRC/ADRN programs must establish a way to measure performance goals for their programs, along with indicators that can be used to track progress on the performance goals. It is important to establish ways to measure the performance goals and indicators in order to understand if the information being supplied is easily accessible. It is also significant to reduce the amount of time and level of frustration and confusion individuals and their families may experience in trying to access long-term support that is offered. 20

Following is an example of a way to successfully implement the Quality Assurance and Evaluation function:

The Wisconsin ADRC conducted an evaluation of consumer satisfaction with the information and assistance and options counseling provided by the ADRCs through a statewide telephone survey of 1,673 individuals, as well as focus groups and interviews with staff and program managers at 18 local sites. The evaluation assessed several aspects of consumer satisfaction from staff and consumer perspectives and identified program strengths as well as areas for improvement. The state uses the findings to assist its ADRCs to achieve and maintain high quality services for the state’s aging and disability populations by providing ADRCs with constructive feedback.21

For a list of the contact information for all seven states that have successfully implemented the program see Appendix B.

Many of the states that we have researched are able to utilize the 211 network in their area, which benefits their ADRC program. A majority of the states are able to communicate and reach their target markets by relaying their ideas and information through partnerships with other businesses and community agencies as well as through community events and through their ADRC website.

Task One: Selecting Benchmark Locations

Introduction The ADRN is part of a new program rolled out from the federal government to serve as a single point of entry into long-term support and services for the aging, disabled, and their care providers. The purpose

19 "Georgia ADRC - Home." Georgia ADRC - Home. Web. 19 Feb. 2012. <http://www.georgiaadrc.com>.

20 "Aging & Disability Resource Centers ." Administration on Aging. Web. 19 Feb. 2012. <http://aoa.gov/AoARoot/AoA_Programs>.

21 “WI Aging and Disability Resource Centers Customer Home Page." Wisconsin Department of Health Services. Web. 19 Feb. 2012. <http://www.dhs.wisconsin.gov/ltcare/adrc>.

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of benchmarking other states is to gain and utilize the information that has helped them successfully implement the ADRC program and reach the target markets with the appropriate information.

Methodology To analyze the other states, we researched each state’s ADRC website and selected 11 states that had easily accessible sites with beneficial information on their programs. We then began to call each of the 11 state’s ADRC point of contact to gather additional information on its program. Doing this allowed us to determine if these states had successfully reached the target markets with one of the five key components of the program. The five key components are: Information and Awareness, Options Counseling, Streamlined Access to Public Programs, Person-Centered Hospital Discharge Planning, and Quality Assurance and Evaluation. The list was narrowed to seven states that had been able to successfully reach their target markets with the key components of the ADRC program. These seven states were selected because we were able to get the most information about their success. We were not able to gather much information from the four that we eliminated. In order to give our client a variety of useful information to apply to each of the five key component areas, we made sure to research at least two states with solid, successful ADRN programs. See Table 2 below for the states and points of contact from which we were able to gain valuable information for our research

Table 2: Contact information for states that have successfully implemented ADRN.

States ContactSouth Carolina Denise Rivers

(803) 734-9939Arkansas Charles Thompson

(501) 682-2441New Hampshire Wendi Aultman

(603) 271-9068Indiana Justin Phillips

317-232-7110Wisconsin Carrie Molke

(608) 267-5267Texas Jennie Costilow

(512) 438-5163Georgia Cheryl Harris

(404) 656-1705

From our data we determined that it is essential to incorporate the five key components into the ADRN program overview. It is important to incorporate the Information and Awareness component because it provides objective information about health, benefits, and programs that will assist them. We were able to determine that South Carolina and Arkansas have successfully implemented this program. The Options Counseling component is important as it provides “one-on-one” counseling to the target audience. It also helps individuals recognize and understand their needs and gives them information about the resources available to them. New Hampshire and Indiana are examples of successful programs that have implemented this component. Streamlined Access to Public Programs provides a

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unified access point of entry to receive information regarding aspects of health. When looking at this component we saw that New Hampshire and Wisconsin were able to effectively apply this program. Person-Centered Hospital Discharge Planning creates a relationship that allows information and services to those at risk of being re-hospitalized. Texas and Georgia were able to work together with their hospital planners to execute a productive program. Quality Assurance and Evaluation allows the ADRN program to have an on-going system to guarantee the quality of the ADRN and evaluate the impact it has on consumers, system efficiencies, and costs. Wisconsin is an example of a state that has been very successful implementing this component.

Task Two: Developing Effective Marketing Strategies

Introduction The main challenge the ADRN program faces is reaching the target markets with the funds available. Many of the target markets can easily access the web in order to gain the information needed. However, it is also important to keep in mind that the program deals with an aging and disabled population and cannot rely on the fact that individuals in the target markets will be savvy to this

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technology. A market strategy is needed to reach the primary and secondary markets through everyday encounters, as well as through the web. We were given the target markets that needed to be reached by our client for the ADRN program; these are shown below.

Target MarketsThe primary target markets are those who are 60 years and older, as well as individuals 18 years and older who have physical disabilities. The secondary target markets are: service providers, caregivers, the business community, and the general public. These target markets are the individuals that need to be reached with the ADRN information.

RecommendationsOur recommendations for the Information and Awareness component are similar to what we learned from South Carolina and Arkansas. We realize that while not everyone is able to access the web, it is still a very important aspect of the ADRN that needs to be addressed. Not only is it important that the ADRN has a fully functioning website, but it is crucial that the program provides a website that is easy to navigate. A site that is easy to navigate makes an effective tool in order to better reach the target markets. If viewers have to look hard, then they will quickly lose focus, become frustrated and will leave the site without gaining any valuable information. Outlined below are tips for an easily accessible website for the aging and the disabled.

Key Tips for Making Your Website Senior Friendly

Break information into short sections Give instructions clearly and number each step Minimize the use of jargon and technical terms Use single mouse clicks Allow additional space around clickable targets Use 12- or 14-point type size, and make it easy for users to enlarge text Use high-contrast color combinations, such as black type against a white background Provide a speech function to hear text read aloud Provide text-only versions of multimedia content Minimize scrolling Choose a search engine that uses keywords and does not require special characters or

knowledge of book value terms22

Also, with regards to the Information and Awareness component, all the successful states that we have benchmarked have incorporated a 211 network. In five of the eight county areas, 211 networks are not available. However, we did contact Stephen Wertheim, Director of 211 in NE Ohio and Chair of the Ohio State 211 Association. We learned that the Federal Communications Commission set aside 211 as the Health and Human Services information and referral line for the country in 2000. Unlike 911, it did not set aside a tariff for funding. 411 is able to sustain a network based on a per call fee. Unfortunately, 211s have no direct income stream. Ohio’s 211 is funded through the Health and Human Services on a county by county basis with a mixture of state, federal and local taxes. Each county decides how it will spend its dollars, and each county must decide whether it will have a 211. Therefore, 211s are individually run, have their own database of community services and most counties maintain their own

22 "Health and Aging." The National Institute on Aging. U.S Department of Health and Human Services, 2012. Web. 24 Mar 2012. <http://www.nia.nih.gov/health/publication/making-your-website-senior-friendly>.

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website. Even though close to 90% of the population is covered by 211, rural and smaller counties are often not covered. It is recommended that the ADRN staff lobby the county officials in Hocking, Meigs, Monroe, Noble, and Washington Counties. United Ways also fund 211s partially, so we would also recommend contacting the organization to acquire provisions for funding 211.

The key component areas of Options Counseling, Streamlined Access to Public Programs and Person-Centered Hospital Discharge Planning are essential to the ADRN program. The components ensure people are given the correct information and provide options for decision making. In order to accomplish those goals partnerships with health care professionals, other businesses and community agencies are crucial. It is also important to be involved in community events. Texas worked with other agencies and professionals in order to provide information and services. They also provided training to the staff and other health professionals about the ADRC program. It is vital to form strong, trusting relationships with health care providers and other organizations in order to maximize the spread of information regarding the ADRN program. Once those relationships have been built the ADRN staff should provide training to those individuals dealing with the target markets. We have formed a list of outreach and referral facilities that the ADRN should partner with to establish crucial partnerships that will expand the information and awareness. The outreach and referral facilities list can be seen in Appendix E.

The final key component of the ADRN program is Quality Assurance and Evaluation. The quality of the ADRN needs to be evaluated in order to determine its impact on consumers, system efficiencies and costs. Wisconsin was able to assess the overall effectiveness of their program. Wisconsin conducted an evaluation of consumer satisfaction through a statewide telephone survey of individuals, as well as focus groups and interviews with staff and program managers at 18 local sites. In order to evaluate AAA8 ADRN program’s effectiveness, the staff should take advantage of a consumer satisfaction survey and conduct interviews with key stakeholders. Every ADRN Program should have an on-going system for assuring the quality of the ADRN and evaluating its impact on consumers, system efficiencies and costs. In order to gain the results, the consumer satisfaction surveys can be mailed to the individuals who had accessed the ADRNs for information or services. Also, a link can be provided on the ADRN website for individuals to take the survey. To heighten the chances of the individuals completing and returning the survey, include a postage-paid business reply envelope. The purpose of the survey will reinforce the Quality Assurance and Evaluation section of the ADRN program. Also, it will allow the staff to evaluate consumer satisfaction with service and information received from the ADRN. The survey will also indicate any changes that need to be made. Table 3 below shows an example of survey questions that could be used in the survey and interviews.

Table3: Example of Possible Key Indicators to Ask in the Survey

Survey Questions Yes No Unsure

Person listened carefully?

Person was knowledgeable?

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Person was courteous and respectful?

Information was clear?

Information was helpful?Were you directed to another person?(If the staff member couldn’t assist you.)Was this service helpful?

Did you have any problems with this service?

Would you refer others?

Additional RecommendationsThe communication strategy should be used to create customized messages through the use of pamphlets, magnets, waiting room advertisements and partnerships with local health care professionals that will allow information to be distributed through the appropriate channel, in order to reach our target markets. The goal of distributing information is to convey to each target audience how ADRN impacts them. Buckeye Hills Area Agency on Aging 8 is currently partnering with two subcontractors, AAA6 and AAA7; five hospitals and twenty eight providers including hospitals and primary care providers. More networking is encouraged to expand and form more partnerships around the eight county areas. With this, AAA8 will be better suited to disperse information and grow awareness about ADRN and AAA8. With a limited budget, the pricing information is very important for our client. We provided what we believe are the best methods to reach the target markets. Even if the pricing of a particular suggestion exceeded the budget, we still decided to make the recommendation we felt strongly about.

One of our more significant recommendations is that the ADRN partake in waiting room advertisement. An example of where ADRN can participate in this form of advertisement can be seen firsthand at First Settlement Orthopedics. It has two locations; one is located in Marietta and the other in Belpre. First Settlement currently offers an opportunity to advertise in their waiting rooms. Each waiting room displays a forty two inch flat screen television that is viewed by approximately twelve hundred people per week. Over the course of a year that totals over sixty thousand potential viewers. Each thirty second commercial will show every twenty minutes, the commercial also becomes permanent property for AAA8. The cost for advertising is two hundred and fifty dollars per month. This opportunity provides advertising reach by capitalizing on a setting in which no activity takes place and waiting room patients become a captive audience. Advertising in this format also builds credibility for AAA8 since the ads are displayed in a medical office. ADRN staff should branch out and find other facilities such as First Settlement that participate in this type of advertising in the other eight county areas.

Other forms such as magnets, commercials and flyers are display methods to increase awareness of ADRN when a representative is not present. We recommend that the ADRN program disperse these types of materials at the locations mentioned in Appendix F to increase awareness of the program. The prices of the material we recommend to disperse are shown in Table 4. Also the sample magnet advertising, which is recommended, can be viewed at Appendix G.

Table 4: Recommendations and Pricing for Materials to be Dispersed

Uprinting Vistaprint

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Magnets 500 ct. 3”x4”6 Shipping Days

$101

500 ct. 3.5”x 2”3 Shipping Days

$99.99Flyers 500 ct. Gloss Paper 5.5”x 8.5”

3 Shipping Days$98.41

100 ct. 5.5”x8.5”3 Shipping Days

$39.99Poster 500 ct. 18’x24” Gloss Paper

3 Shipping Days$352.54

High Gloss Paper3 Shipping Days

$12.99 Each

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Task Three: Selecting Grant Opportunities

ProblemIt is essential that the ADRN staff receives funds in order to fulfill the requirements of the program. Grants are one way to provide the crucial funds needed to successfully expand and implement the ADRN program. If approved for a grant, the funds that AAA8 would receive would go directly to continue existing projects for the ADRN program. Obtaining additional funding through grants will allow the ADRN staff to support projects that will benefit and keep our aging and disabled communities and their caregivers healthy and aware of the resources available to them. MethodologyThe client suggested researching government and local agencies, in order to find grants that were compatible with their program. We ran a basic search on all of the government grant sites as well as a Google search to compile a list of possible grant opportunities. The list was narrowed to the grants that we believe met the client’s eligibility. Potential GrantsHealth Promotion for People with DisabilitiesFunding Opportunity Number: CDC-RFA-DD07-7020501SUPP12

Posted Date: Feb 29, 2012 Current Closing Date for Applications: Mar 30, 2012

Expected Number of Awards: 16Estimated Total Program Funding: $1,000,000

DescriptionThe purpose of the program is to provide financial assistance to allow completion of objectives related to improving the health and quality of life for people with disabilities.

Building Integrated & Sustainable Lifespan Respite ProgramsFunding Opportunity Number: HHS-2012-AOA-LI-1205

Creation Date: Mar 15, 2012Current Closing Date for Applications: May 14, 2012

Expected Number of Awards: 5 Estimated Total Program Funding: $2,495,000

DescriptionThe U.S. Administration on Aging (AoA) is providing this competitive grants opportunity to assist eligible state agencies with implementation of the requirements of the Lifespan Respite Care Act of 2006 (P.L. 109-442). Eligible state agencies receiving funding under this announcement will work through Aging and Disability Resource Centers and in collaboration with state respite

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coalitions or other state respite organizations to enhance and expand the availability of Lifespan respite services in the state.

Telehealth Network Grant ProgramFunding Opportunity Number: HRSA-12-092

Creation Date: Mar 05, 2012Current Closing Date for Applications: Apr 13, 2012

Expected Number of Awards: 14 Estimated Total Program Funding: $3,500,000

DescriptionThis announcement solicits applications for the Telehealth Network Grant Program (TNGP). The primary objective of the TNGP is to demonstrate how telehealth programs and networks can improve access to quality health care services in rural and underserved communities TNGP networks are used to: (a) expand access to, coordinate, and improve the quality of health care services; (b) improve and expand the training of health care providers; and/or (c) expand and improve the quality of health information available to health care providers, and patients and their families, for decision making. However, as noted below, because of legislative restrictions, grants will be limited to programs that serve rural communities, although grantees may be located in urban or rural areas.

2012 Lifespan Respite Care Program Competing Program Expansion SupplementsFunding Opportunity Number: HHS-2012-AOA-LR-1206

Posted Date: Mar 15, 2012 Current Closing Date for Applications: May 14, 2012

Estimated Total Program Funding: $2,495,000

DescriptionThe U.S. Administration on Aging (AoA) is providing these competitive grant opportunity to current grantees of the Lifespan Respite Care Program to further implement the requirements of the Lifespan Respite Care Act of 2006 (P.L. 109-442). Lifespan Respite Care programs are coordinated systems of accessible, community-based respite care services for family caregivers of children or adults of all ages with special needs. Based on an FY 2012 appropriation of approximately $2.5 million, it is anticipated that this opportunity could provide funding for as few as zero (0) and up to as many as nine (9) grants, with a federal funding level of up to $150,000 per award for a 12 month project period. The number of awards and the amount of each award will depend on several key factors, including the total FY 2012 appropriation for the Lifespan Respite Care Program and the amount of funds remaining after new grant awards are made to states under Funding Opportunity Numbers HHS-2012-AoA-LR-1203 and HHS-2012-AoA-LI-1205. The primary focus of these one-year Competitive Expansion Supplement grants is the provision of respite services to eligible populations. In addition to using the funds to provide respite services, successful applicants may also use funds to further enhance the volunteer recruitment, training and retention activities begun during years one and/or two of their existing

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grants and further enhancement of outreach and dissemination activities, provided those activities can be demonstrated to produce a measurable increase in the provision of respite services. This is a limited grant competition. Awards will only be made to eligible state agencies as defined in Statute (P.L. 109-442) and who received funding under this program in FY 2010 or FY 2011.

Telehealth Resource Center Grant ProgramFunding Opportunity Number: HRSA-12-097

Posted Date: Feb 24, 2012Current Closing Date for Applications: Apr 20, 2012

Expected Number of Awards: 5 Estimated Total Program Funding: $1,625,000

DescriptionThis announcement solicits applications for the Telehealth Resource Center Grant Program (TRCGP). The purpose of the TRCGP is to support the establishment and development of Telehealth Resource Centers (TRCs). The TRCGP expects to create centers of excellence that expedite and customize the provision of telehealth technical assistance across the country, while at the same time working together to make available a wide range of expertise that might not be available in any one region. The TRCs provide technical assistance to health care organizations, health care networks, and health care providers in the implementation of cost-effective telehealth programs to serve rural and medically underserved areas and populations. The program seeks entities with proven successful records in providing technical assistance in the development of sustainable telehealth programs.

In this funding cycle, states that will not have coverage, and OAT seeks applicants for, include Alabama, Alaska, Arizona, California, Colorado, Idaho, Indiana, Illinois, Iowa, Louisiana, Michigan, Minnesota, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York (Western, Central, and Southern), North Dakota, Ohio, Oregon, Pennsylvania, South Dakota, Texas, Utah, Washington, Wisconsin, and Wyoming.

Translational Research to Help Older Adults Maintain their Health and Independence in the Community (R01)Funding Opportunity Announcement Number: PA-11-123

Creation Date: May 05, 2012Current Closing Date for Applications: May 08, 2014

Expected Number of Awards: The number of awards is contingent Estimated Total Program Funding: Application budgets are not limited, but need to

reflect actual needs of the proposed project.

DescriptionThe National Institute on Aging (NIA) and the Administration on Aging (AoA) invite applications using the R01 award mechanism for translational research that moves evidence-based research findings towards

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the development of new interventions, programs, policies, practices, and tools that can be used by community-based organizations to help elderly individuals remain healthy and independent, and living in their own homes and communities. The goal of this FOA is to support translational research involving collaborations between academic research centers and community-based organizations with expertise serving the elderly (such as city and state health departments, city/town leadership councils, and Area Agencies on Aging) that will enhance our understanding of practical tools, techniques, programs and policies that communities across the nation can use to more effectively respond to needs of their aging populations.

ConclusionIt is important to apply for grants, because the amount of funds that each ADRN program receives from the federal and state government is not enough to cover the cost associated with having a successfully implemented program. The main purpose of applying for a grant is to receive the money, but more importantly it is for the positive changes that the ADRN program will be able to make in the lives of the aging, disabled and their caregivers. It will also allow the staff to accomplish goals that they might otherwise not be able to reach with the initial funding from the state and federal government, such as purchasing magnets and brochures to get the word out about the ADRN program. These grants are essential in order to expand the ADRN program. Extensive research was conducted on many sites in order to find grants for which the staff may apply.

RecommendationsOur grant recommendation is essential as the ADRN program would not be possible without continuous funds from outside sources. We recommend that the ADRN staff carefully review the six grants in order to expand the ADRN program. We believe that ADRN meets the eligibility requirements of the grants. We encourage them to research the grants in more depth and apply for them, if they do in fact meet all requirements. The funds that AAA8 would receive if approved for a grant would go directly to continue existing projects for the ADRN program. Obtaining additional funding through grants will allow the ADRN staff to strive to support projects that will benefit and keep our aging and disabled community and their caregivers healthy and aware of the resources available to them.

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Appendix A: Declaration of Objectives for Older Americans

Section. 101

The Congress hereby finds and declares that, in keeping with the traditional American concept of the inherent dignity of the individual in our democratic society, the older people of our Nation are entitled to, and it is the joint and several duty and responsibility of the governments of the United States, of the several States and their political subdivisions, and of Indian tribes to assist our older people to secure equal opportunity to the full and free enjoyment of the following objectives

1. An adequate income in retirement in accordance with the American standard of living.

2. The best possible physical and mental health which science can make available and without regard to economic status.

3. Obtaining and maintaining suitable housing, independently selected, designed and located with reference to special needs and available at costs which older citizens can afford.

4. Full restorative services for those who require institutional care, and a comprehensive array of community-based, long-term care services adequate to appropriately sustain older people in their communities and in their homes, including support to family members and other persons providing voluntary care to older individuals needing long-term care services.

5. Opportunity for employment with no discriminatory personnel practices because of age.

6. Retirement in health, honor, dignity—after years of contribution to the economy.

7. Participating in and contributing to meaningful activity within the widest range of civic, cultural, educational and training and recreational opportunities.

8. Efficient community services, including access to low cost transportation, which provide a choice in supported living arrangements and social assistance in a coordinated manner and which are readily available when needed, with emphasis on maintaining a continuum of care for vulnerable older individuals.

9. Immediate benefit from proven research knowledge which can sustain and improve health and happiness.

10. Freedom, independence, and the free exercise of individual initiative in planning and managing their own lives, full participation in the planning and operation of community based services and programs provided for their benefit, and protection against abuse, neglect, and exploitation. (42 U.S.C. 3001)

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Appendix B: Contact Information for States that Have Successfully Implemented the ADRN Program

States Website ContactSouth Carolina http://www.scaccesshelp.org Denise Rivers

Deputy DirectorLt. Governor

(803) 734-9939riversd@aging.sc.gov

Arkansas www.choicesinliving.ar.gov Charles ThompsonDirector

(501) 682-2441charles.thompson@arkansas.gov

New Hampshire

www.servicelink.org Wendi AultmanProgram Manager

(603) 271-9068waultman@dhhs.state.nh.us

Indiana http://www.in.gov/fssa/da/3478.htmq Justin PhillipsProgram Director

317-232-7110justin.phillips@fssa.IN.gov

Wisconsin http://www.dhs.wisconsin.gov/ltcare/adrc/ Carrie MolkeQuality Unit Supervisor

(608) 267-5267Carrie.Molke@wisconsin.gov

Texas http://www.dads.state.tx.us/services/adrc/index.html

Jennie CostilowGrants Coordinator

(512) 438-5163jennie.costilow@dads.state.tx.us

Georgia www.georgiaadrc.com Cheryl HarrisADRC Director(404) 656-1705

chharris@dhr.state.ga.us

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Appendix C: Disability by Type and Age Group

Appendix D: Median Household Income Distribution for Southeast Ohio

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Appendix E: Outreach and Referral Facilities

• Home and Community Based Programs (adult day care, senior centers)

• Civic Groups (VFW’s, Lion’s Clubs, Rotary)

• Health Care/LTC Facilities (discharge planners)

• Special Care Facilities/Programs (hospice)

• Faith-Based Groups (churches)

• Government (Federal, State, County, VA, Dept. of Health)

• Foundations

• Department of Human Services

• Trade Associations (HealthCare Association, Unions)

• Housing (Condominium Association, Public Housing, Property Managers)

• Insurance Companies (Cigna, Humana, United Health Care, Anthem BCBS)

• Businesses (banks, hotels)

• Advocates Resources (Legal Aid Society)

• Public Safety (fire department, police)

• Transportation (taxis, public buses)

• Caregivers’ Support Groups (Alzheimer’s Association, Caregivers Coalition)

• Disability Network

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Appendix F: Marketing Strategies

Target Markets ChannelSenior Market (60 years old and above) Magnets

Service ProvidersCommunity centers

One on One interactionWaiting room advertisements

Disabled Individuals(18 years old and above)

MagnetsWebsites

Support GroupsService Providers

Electronic newslettersWaiting room advertisements

Caregivers Media,Workplace

Support GroupsFaith-Based Groups

Service Providers PresentationsCollateral Materials

(brochures, handouts)Trade Newsletters

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Appendix G: Magnet Samples

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Work Cited

"About." Ohio Association of Area Agencies on Aging. Web. 5 Mar 2012. <http://www.ohioaging.org/Pages/About>.

About N4A." N4A:Advocacy. Action. Answers on Aging. 2011. Web. 19 Feb 2012. <http://www.n4a.org/about-n4a/>.

"Aging & Disability Resource Centers ." Administration on Aging. Web. 19 Feb. 2012. <http://aoa.gov/AoARoot/AoA_Programs

“Aging and Disability Resource Center: Technical Assistance Exchange." Welcome to the Technical Assistance Exchange. Web. 19 Feb. 2012. <http://www.adrc-tae.org/tiki-index.php?page=HomePage>.

"Aging Statistics." Administration on Aging. Web. 19 Feb. 2012. <http://www.aoa.gov/aoaroot/aging_statistics>

"Area Agency on Aging 8." Area Agency on Aging 8. Web. 19 Feb. 2012. <http://www.areaagency8.org/>.

Centers for Medicare & Medicaid Services." Centers for Medicare & Medicaid Services. Web. 19 Feb. 2012. <http://www.cms.gov/>.

"Choices in Living Resource Center - Arkansas." Choices in Living Resource Center - Arkansas. Web. 19 Feb. 2012. <http://www.choicesinliving.ar.gov>.

"FSSA: Area Agencies on Aging/ADRC." IN.gov: Home. Web. 3 Apr. 2012. <http://www.in.gov/fssa/da/3478.htm>.

"Georgia ADRC - Home." Georgia ADRC - Home. Web. 19 Feb. 2012. <http://www.georgiaadrc.com>.

"Find Grant Opportunities." Grants.gov. U.S. Dept. of Health and Human Services, 2012. Web. 5 Mar 2012. <http://grants.gov/>.

"Health and Aging." The National Institute on Aging. U.S Department of Health and Human Services, 2012. Web. 24 Mar 2012. <http://www.nia.nih.gov/health/publication/making-your-website-senior-friendly>.

"Help for Texans: Aging and Disability Resource Centers." DADS: The Texas Department of Aging and Disability Services. Web. 19 Feb. 2012. <http://www.dads.state.tx.us/services/adrc>.

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“Older American Act.” Administration on Aging. Web. 19 Feb 2012. <http://www.aoa.gov/AoARoot/AoA_Programs/OAA/index.aspx>.

"Older American Act Summary." Texas Department of Aging and Disability Services. Web. <http://www.dads.state.tx.us/rules/oaa_summary.html>.

"Learn About." SC Access: Aging and Disability Information. 2012. Web. 19 Feb 2012. <https://scaccess.communityos.org/cms/>.

Sedensky, Matt. "Millions Now Manage Aging Parents' Care from Afar." Dayton Daily News. 26 Jan 2012. Web. <http://www.daytondailynews.com/lifestyle/ohio-health-news/millions-now-manage-aging-parents-care-from-afar-1319009.html>.

"ServiceLink: Yesterday, Today, and Tomorrow." Service Link: Resource Center. New Hampshire Government , 2012. Web. 19 Feb 2012. <http://www.nh.gov/servicelink/aboutus.html>.

“WI Aging and Disability Resource Centers Customer Home Page." Wisconsin Department of Health Services. Web. 19 Feb. 2012. <http://www.dhs.wisconsin.gov/ltcare/adrc>.

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