Alameda County Aging Initiative

SSC must advance policy and innovations that establish community-based supportive services as key partners with healthcare, coordinate and bridge health and social services silos, and leverage new
and existing resources for better outcomes.
– SSC’s 2017 Policy Agenda

On June 27 2014, the Alameda County Board of Supervisors added a historic directive to its 2014/15 Budget, directing the county’s Social Services and Health Care Services Agencies to earmark emergency funding for senior services and to develop an integrated plan for providing long term, health and supportive services to seniors in Alameda County. Click here to read the memo that is now part of the County Budget.

Now the county is moving forward to develop a comprehensive plan that will address its rapidly aging population and the increasing demand for senior services that are already straining the healthcare and aging services network. This process will require the collaboration of both agencies, the aging services community and seniors themselves to accurately identify the needs, innovate the service network, and engage new resources.

Recent Developments

April 19, 2017 – On Monday April 24 the Board of Supervisors’ Joint Health & Human Services Committee will consider the proposed ordinance to create the Alameda County Council for Age Friendly Communities. (This item was originally on the February 27 calendar but rescheduled when that hearing went overtime.)

The Council, as currently proposed, will be a permanent public body charged with coordinating policy and systems change efforts in the county to improve health and social outcomes for older adults. If approved by the Committee, the Council ordinance will move on to the full Board for adoption.

The hearing will take place at 9:30am in the Board Chambers, 5th floor at 1221 Oak Street in Oakland.

March 22, 2017 – Those of you who didn’t attend the February 27 Board of Supervisors’ Joint Health & Human Services Committee – and who didn’t sit through to the end of the four-hour marathon – may not know that our agenda item was never heard. Because of the late hour, the proposed ordinance to create the Alameda County Council for Age Friendly Communities was bumped to April.

The Council, as currently proposed, will be a permanent public body charged with coordinating policy and systems change efforts in the county to improve health and social outcomes for older adults.

If approved by the Committee, the Council ordinance will move on to the full Board for adoption.

The next hearing date may be in April at the Health Committee, which usually meets on the second Monday of the month at 9:30am. Stay tuned.

February 20, 2017 – On Monday, February 27, the Board of Supervisors’ Joint Health & Human Services Committee will consider the proposed ordinance to create the Alameda County Council for Age Friendly Communities. Shaped by a participatory stakeholder process and representing multiple silos and sectors, the Council is charged with coordinating policy and systems change efforts to improve health and social outcomes for older adults.

The Council will be a permanent public body. So, not only will it draw on the bold goals and objectives of the recently completed County Plan for Older Adults; the Council will be in it for the long haul, building and adapting over time. Its major functions include facilitating communication between leaders, consumers and providers that identify key issues for healthy aging communities, conducting impact evaluations, making policy recommendations and advance initiatives that promote the health and social well-being of older adults. Click here to read the proposed Council Bylaws.

If approved by the Committee, the ordinance will move on to the full Board for adoption.

Monday’s Committee hearing will be from 12:30 to 2pm at the Board of Supervisors’ Chambers, 5th Floor, at 1221 Oak Street in downtown Oakland.

November 14, 2016 – On Friday November 18, Adult & Aging Services will hold the second in a series of stakeholder meetings on Alameda County’s Older Adult Plan. The purpose of these meetings is to hear from stakeholders and develop consensus around the name, scope, purpose, bylaws, and membership composition of a new Council that will be charged with advancing the Plan and its implementation. The goal is to pull all of this together within the next two months so that the details can be brought back to the Board of Supervisors’ Joint Health/Social Services Committee meeting on January 23 for the okay and referral to the full Board for adoption.

The meeting on the 18th will be held from 1:30 to 4:00pm in the Big Sur room at Adult and Aging Services. All are welcome, but RSVP to Delbert Walker at dwalker2@acgov.org. Click here for the meeting packet, including agenda, minutes from the October 14 meeting, first draft of proposed bylaws, and original bylaws of the moth-balled Long Term Care Planning Council. 

September 26, 2016 – Today the Alameda County Board of Supervisors’ Joint Health/Social Services Committee considered proposed next steps for advancing the bold mandate, goals and objectives of the County Plan for Older Adults.

Following the presentation, Board discussion and public comments, the Joint Committee instructed the Agencies to proceed with inclusive, consensus-based stakeholder meetings to develop a name, scope, purpose, bylaws, and membership composition for a new Council, and to bring those details back to the Joint Committee meeting in January for adoption and referral to the full Board.

Click here for the powerpoint slides that were presented by Chuck McKetney, Interim Assistant Agency Director at Health Care Services Agency and the head of the CAPE data unit, and Randy Morris, Adult and Aging Services Director. Click here for the public comments made by SSC Director Wendy Peterson.

September 23, 2016 – In April, the Alameda County Board of Supervisors’ Joint Health/Social Services Committee considered a draft of the Alameda County Plan for Older Adults and asked for the details on the “who, what and how” of implementation. Since then, the leadership at Health Care and Social Services Agencies have been in discussion with Planning Committee members and stakeholders to consider the best way to move the Plan’s bold mandate, goals and objectives forward. On Monday the Joint Committee will hear their proposal.

At the heart of the proposal is the creation of a Council that will report directly to the Board of Supervisors. This formal table’s first year charge will include instituting deep data analysis to aid the Council’s work, improving coordination of aging legislative advocacy across county departments, engaging the public hospitals and health care entities, and establishing communication channels with local Age-Friendly community efforts that are already underway in several parts of the county. To speed the process, the recommendation is to dust off an existing ordinance for the Long Term Care Planning Council (inactive for 10 years) and repurpose it with a new name, bylaws and membership.

To staff the Council, HCSA and SSA propose to hire a Management Analyst who would report to Randy Morris, Adult & Aging Services Director – an anchoring that would enable the Council to coordinate its work with the AAA and other aging services programs.

The proposals do a good job of addressing SSC’s requests – transparency, meaningful stakeholder participation in planning and implementation, and a central table that holds the big picture, allowing opportunities for collaboration and cross-sector work to be elevated and enabling CBOs and cities to align their planning with the county’s direction. If adopted by the Board of Supervisors, the proposed next steps will establish a long term, sustained process for advancing cross-silo, cross sector systems change. And this is the kind of change needed to address the current and future needs of older adults in Alameda County.

The Joint Committee Hearing on Monday, September 26, starts at noon. It will be held in the Board Chambers on the 5th floor of the County Administration Building, 1221 Oak Street in Oakland. Click here to go to the Committee’s Agenda. Sometime today the presentation should be posted on the committee agenda web site; you can find it by clicking here and selecting the attachment for the September 26 Joint Committee meeting.

July 13, 2016 – Just an update to our June 20 article below…The heads of the County’s Health and Social Services Agencies have asked to move the hearing date for the next draft of the plan to September. This will allow them more time to meet and to convene stakeholders. That probably means a Joint Committee hearing date of Monday, September 26. Save the date and be on the lookout for a stakeholder meeting announcement.

June 20, 2016 – “Back to the drawing board” was the message that the Board of Supervisors gave on April 25th when the Joint Health & Social Services Committee met to consider the draft of the Alameda County Plan for Older Adults. Supervisors asked the heads of Health and Social Services Agencies to bring a revised Plan back to the Committee in July.

Supervisors had multiple comments and questions about findings, resources, implementation and oversight. Of note: Supervisor Miley voiced his expectation that the Plan be structured as an ordinance, with implementation details, associated costs and explicit accountability so that County leaders can track progress and can plan for future funding needs. Supervisor Chan requested much greater specificity in the details of implementation, with goals and objectives more clearly connected to the needs, opportunities and gaps that were identified as priorities during the assessment and planning process.

At the hearing SSC voiced our concerns that the Plan’s next steps – action planning and implementation – will happen deep inside county agencies. We think this would be a mistake. It is essential that there be a “table” that holds the big picture, where feedback from stakeholders and multiple disciplines can inform the thinking, and opportunities for leveraging and collaboration will be recognized. We also know that a collaborative process will help stakeholders – including CBOs and cities – align their own planning and activities for greater impact.

To watch a video of the hearing go to http://www.acgov.org/board/broadcast.htm and scroll down to the “BOS Committee Meetings” section. You’ll see the May 25, 2016 Joint Health & Social Services Committee recording is available in several formats. Click here for the powerpoint that County staff used for their presentations.

Click here to link to the Alameda County Area Plan 2016-17 on the AAA web site; it is nearly identical to the draft submitted to the Joint Committee, and contains a wealth of assessment and research findings, plus current data gathered during the year-long planning process.

April 12, 2016 – On April 25 a joint meeting of the Alameda County Board of Supervisors’ Health and Social Services Committees will consider a draft of the county Plan for Older Adults. The draft is the result of a year-long effort to develop a comprehensive plan that will address the County’s rapidly aging population and emerging needs that are already straining the healthcare and aging services network. Click here for a copy of the most recent Plan Draft (this one is formatted for the California Department of Aging; a draft with a simpler format will be presented to the BOS). Click here for a copy of the Plan Vision and Goals Statement.

Please plan to attend this important meeting. We expect that Supervisors will weigh in on what structure or entity will have the responsibility of moving this comprehensive plan forward into implementation – a fundamental question that is not addressed in the current draft of the plan except for those elements that are under the prevue of the Area Agency on Aging. Supervisors’ feedback that will shape the final draft of the plan that is expected to go to the full Board in May.

March 28, 2016 – The Planning Committee working on the Alameda County Plan for Older Adults will meet on Wednesday, March 30 from 1:30pm to 4pm on the 1st floor of the Eastmont Town Center, Suite 137.

This week’s meeting is an important one. The Committee will be looking at a draft of the County Planfor Older Adults for the first time, providing feedback to inform and adjust the Plan as it nears completion. On April 25 the Plan will be brought to the Board of Supervisors’ Joint Health and Social Services Committee for their feedback. The Plan is expected to be brought to the full Board for approval sometime in May.

So far the Committee has crafted a Vision and First Year Goals statement that provides a good outline of the scope and intent that will be embodied in the Plan. Click here for the draft of the statement which the Committee considered at its February 17 meeting.

February 23, 2016 – An older adult’s ability to access health and supportive services is directly tied to the cost of the services and the options covered by her/his health insurance. This is a key take-away from a report heard at last week’s meeting of the Planning Committee working on Alameda County’s Plan for Older Adults.

Members of the Data Subcommittee focused on access to health care, “aging well” community supports and in-home care. Their report looked at data and research on income insecurity, coverage and the cost of care for elders with complex needs, as well as several local assessments that point to eligibility, coordination and geographic gaps in key services. Click here for a copy of the powerpoint presentation.

The report provided powerful evidence that economically insecure older adults in Alameda County do not have the resources or coverage to meet the challenges of aging. A robust network of community-based supportive services can help address the gaps in resources and coverage. The report highlighted local assessments that point to eligibility, coordination and geographic gaps in three of the key services that are critical pieces of the service network – case management, fall prevention and adult day care/ADHC.

February 2, 2016 – On Monday, January 25 a joint meeting of the Alameda County Board of Supervisors Health and Social Services Committees heard a progress report on the County’s developing Plan for Older Adults.

Randy Morris, Adult and Aging Services Director, began by noting that leaders at all levels of government are struggling with the issue of how to address the titanic growth of the older adult population. He quoted from Senator Carol Liu’s Select Committee report A Shattered System: Reforming Long Term Care in California about the cost of inaction (click here for a copy of the report). Describing the internal leadership team of SSA, HCSA, Public Health, BHCS, and AAA that has been working in parallel to the public Planning Committee effort, Randy stated that this ongoing cross-silo team effort “has to be the new normal.” He also confirmed that SSA’s $980,000 augmentation of older adult services administered through the AAA will continue as a regular fixture of the Social Services Agency’s annual budget.

Rebecca Gebhart, acting Health Care Services Agency Director, expressed a sense of celebration at the work that has been achieved, highlighting the BOS’s decision to fund an Older Adult Priority Area within Measure AA (click here for Rebecca’s 2 page 2015 Year End Update). She spoke of the work ahead, including refining the inventory of older adult services in the county and identifying gaps and opportunities.

Tracy Murray, Area Agency on Aging Director, presented an update on the planning process, including highlights from the countywide survey of older adults and the Planning Committee’s draft Vision and First Year Goals Statement. The Vision and Goals include committing to an Age-Friendly County (with dedicated funding for the effort), supporting pervasive involvement of all county departments, and supporting and finding resources for a build out of key services). Click here for the presentation that includes details of the Draft Statement.

The hearing was a positive step towards aligning the BOS with the major elements of the plan moving forward. The Supervisors – Carson, Chan, Miley and Valle – displayed a high level of engagement, asking both clarifying and directive questions. It is clear that there is not agreement about the right vehicle for moving the work forward – creating a new separate agency versus a team-based, integrated approach – and we’ll be looking for opportunities for discussion around this key issue.

September 22, 2015 – Last month, the Planning Committee working on the County’s Plan for Older Adults heard a compelling presentation by Lillian Schaechner, who directs the Alameda County Behavioral Health Care Services’ Older Adult System of Care. Lillian began by asking us to imagine a society where we challenge assumptions about health and ability among older adults, value their contributions and see them as capable of growth, change and learning.  

Even though mental health problems are more common than heart disease, lung disease and cancer combined, stigma and misunderstanding complicate efforts to effectively address this health priority. This is especially true in the case of older adults. Nearly 20% of Americans age 55+ experience depression and anxiety disorders (the most common mental health diagnoses for older adults), and the suicide rate is about 50% higher among older adults compared to the nation as a whole. Yet the general public and even many healthcare professionals believe the myth that depression is a normal part of aging, and societal assumptions lead us to conclude that dementia is the root of an older adult’s mood and behavior changes.

ACBHCS’s Older Adult System of Care currently provides services – via contracts and county programs – to 2,427 older adults age 60+ per year. This is only 7% of the total clients served by BHCS. In order to really begin to address the need for mental health services and supports for older adults in the county, Lillian recommends a collaborative approach that includes educating ourselves (health/social service providers and stakeholders), investing in programs and practices that work, and tapping into multiple funding streams so individuals can get the support they need.

To learn more about the programs and services that the Older Adult System of Care currently provides, click here for Lillian’s powerpoint presentation. If you would like information on BHCS’s Mental Health First Aid Training (Older Adult Module), contact Paul Takayanagi at TrainingUnit@acbhcs.org.

Click here for a fact sheet on Alameda County Behavioral Health Care Services’ ACCESS program, a system wide point of contact for information, screening and referral for mental health and substance use disorder services and treatment.

July 7, 2015 – Click here to go to SSC’s Survey Toolkit, where you’ll find suggestions for distribution and .pdfs of surveys in seven languages.

February 12, 2015 – The Planning Committee charged with shepherding the development of the Alameda County Plan for Older Adults met for the first time on February 3. The meeting focused on developing key elements and structure in preparation for the kick-off meeting on March 18. Meeting minutes and a narrative will be posted soon.

January 7, 2015 – Last June’s Board of Supervisors directive envisioned a comprehensive, integrated and sustainable plan of service delivery to older adults – spanning and, ideally, connecting the silos of agencies and departments. As the funding elements of the County Aging Initiative have moved forward, a lot has been happening behind the scenes to design the planning process. Here’s the summary:

The initiative coincides with the county’s obligation to conduct a county-wide needs assessment and develop an Area Plan for the Older Americans Act services administered through the AAA. So the Area Plan process will form the backbone of the “bigger” agency-spanning plan, and the planning process will be public and engage the entire community of stakeholders – seniors, caregivers, and CBOs included. To guide the process of assessment and planning an ad hoc committee will be formed, attached to the County Commission on Aging, with seats representing a range of stakeholders and expertise. Expect this committee to be formally launched at the Commission’s January 12 meeting, with recruitment underway soon after.

During the design phase of the last few months, the staff and leadership at HCSA and SSA (including the AAA, Public Health and Behavioral Health) have been both accessible and open to ideas. Their actions convey a clear recognition that the County Aging Initiative is a high priority; both agencies have put resources in place for the staffing, facilitation and activities needed for a robust and participatory planning process.

Have questions? Feel free to email wendy@seniorservicescoalition.org.

November 14, 2014 – On October 27, a joint hearing of the Alameda County Supervisors’ Health and Social Services Committees heard an update from Social Services Agency Director Lori Cox and Health Care Services Agency Director Alex Briscoe on the progress of the county’s new aging services initiative. This was the first chance for Supervisors outside of the Social Services Committee to be exposed to the elements of the initiative and to ask questions. I recommend watching the video.

Click here for the powerpoint presentation that accompanied Lori Cox’s report. Click here to go to the county web page where you can view the recorded hearing (scroll down to the “BOS Committee Meetings” and select one of the viewing options for the October 27 “Special Meeting and Joint Health & Social Services Committee”).

Opportunities to Engage

None at this time.

Resources

Click here for the County Older Adult Planning Committee’s archive of agendas, minutes and materials.

 

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