TOGETHER WE RISE MEALS ON WHEELS ANNUAL CONFERENCE & EXPO AUGUST 31 SEPTEMBER 2, 2016

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TOGETHER WE RISE MEALS ON WHEELS ANNUAL CONFERENCE & EXPO AUGUST 31 SEPTEMBER 2, 2016

NO HUNGRY SENIOR: AN INNOVATIVE PARTNERSHIP TUESDAY, AUGUST 30, 2016

SALLY JONES HEINZ MIFA PRESIDENT & CEO

SETTING THE STAGE: ABOUT MIFA MEALS ON WHEELS Began home-delivered meal service in 1976, added congregate sites in 1981 36 routes delivered primarily by volunteers As of 2014, served 900 meals each day Waiting list for meals at Aging Commission estimated at 2,000 names MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

SETTING THE STAGE: DEFINING THE NEED Poverty rate in Memphis is 29.8% - 14.5% among those age 65+ In 2015, there were 113,000 seniors in Shelby County - 18% growth since 2010 An estimated 3,700 Shelby County seniors are at the highest level of food insecurity MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

PROGRAM DESCRIPTION: NO HUNGRY SENIOR INITIATIVE No Hungry Senior (NHS) is an interdisciplinary partnership among nine agencies led by MIFA Funded through a $3.98M Plough Foundation grant NHS designed to reach seniors at greatest risk Collaboration partners: - MIFA (Metropolitan Inter-Faith Association), Aging Commission of the Mid-South, Baptist Memorial Health Care, Catholic Charities of West Tennessee, CoactionNet, Memphis Jewish Federation, Methodist Le Bonheur Healthcare, Mid-South Food Bank, University of Memphis School of Public Health MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

PROGRAM GOALS: NO HUNGRY SENIOR INITIATIVE NHS designed to reach seniors at greatest risk Explore a variety of delivery options NHS will add 2,300 clients over three years Increase volunteer engagement Increase community awareness of both senior hunger and our program MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

PROGRAM DESIGN: SCREENING PROCESS Referrals from Aging Commission of the Mid-South Referrals from Partner Hospitals In-Home Nutrition Assessments Hot Meals Delivered by MIFA M-F Kosher Frozen Meals Delivered by MJF biweekly Shelf-Stable Pantry Box Delivered by MIFA weekly 7 meals/7 snacks Grocery Box Delivered monthly MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

PROGRAM OUTCOMES 63% female 76% African American Mean age is 75-37% are 60-69 - 30% are 70-79 - 24% are 80-89 - 9% are 90+ 48% live alone; 45% report being lonely 37% less than high school education 51% income < $1,000/month MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

PROGRAM OUTCOMES 83% have high blood pressure 47% are diabetic Hospital stays in last 12 months: - 33% had 1-2 stays - 9% had 3-5 stays - 5% had >5 stays Emergency room visits in last 12 months: - 43% had 1-2 visits - 11% had 3-5 visits - 4% had >5 visits MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

PROGRAM OUTCOMES One-year client reassessments began in June 94 clients were visited in their homes Perceived health scores unchanged Improvements in three areas: - # of hospitalizations - # of falls (fewer for women) - Loneliness scores lower for overall group Biggest improvement: - 86% ate less than two meals before NHS - 18% ate less than two meals after one year MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

PROGRAM OUTCOMES N = 94 Yes No Don t Know Eat healthier foods 90% 8% 2% Achieve/maintain healthy weight 83% 10% 7% Improve your health 85% 7% 8% Feel better 87% 7% 6% Continue to live at home 50% 41% 9% Less hungry throughout the day 91% 6% 3% How would you rate the NHS program? Excellent Very Good Good Fair N = 94 46% 31% 20% 3% MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

KEY LEARNINGS: SUCCESSES Strong partnership with funder Built in time for project development, staffing Exceeded client enrollment goals Partners flexibility and trust allowed us to adapt - Removed grocery box, increased shelf-stable - Creative staffing adjustments to meet service growth Database creates process efficiencies, reporting and evaluation capabilities Increased volunteer opportunities MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

KEY LEARNINGS: CHALLENGES Service capacity stretched at each agency More intensive levels of need than expected Complicated hospital referral process More need than resources can cover Shelf-stable clients lack daily volunteer engagement MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

WHAT S NEXT Client evaluations: One year of service Has health status improved? Have hospitalizations/ed visits decreased? Has isolation factor lessened? Level of meal satisfaction Sustainability: Finding resources and funding Healthcare market providers, payers, communitybased-organization model Public and private funders Growing volunteer network at all agencies MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

NO HUNGRY SENIOR: CLIENT IMPACT I hadn t had a good hot meal in years. I went to my doctor last week, and I gained six pounds. I can also walk to my mailbox and back, which I have not been able to do for months! - Mrs. M. MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

EXPANDING THE IN-HOME ASSESSMENT VISIT TO INCREASE OPPORTUNITIES FOR WRAP-AROUND SERVICES FRIDAY, SEPTEMBER 2, 1916

LI Z WEAVER, MS, LSW ALZHEIMER S DISEASE INITIATIVE PROJECT MANAGER

ABOUT SOUTHERN MAINE AGENCY ON AGING SMAA area: Population 65+: 86,713 (Maine: 1,319,192; oldest state by median age, mostly rural) MOW Program: 650 meals per day 11 community sites 15 site staff (most PT) 67 routes 300 volunteers (200 drivers) MEALS ON WHEELS ANNUAL CONFERENCE AND EXPO

HOW DID THE IDEA COME ABOUT? Long-held SMAA goals Maximize opportunity offered by the eligibility home visits Increase Assessor skill-set for identifying a broader range of needs Increase service utilization by MOW clients Increase MOW volunteer skills to identify and report special needs and red flags Increase collaboration between Nutrition and Community Services Improve Agency-wide dementia capability to meet growing need MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

ALZHEIMER S DISEASE INITIATIVE (ADI) GOAL: DEMENTIA CAPABLE NETWORK EXPANSION Funded by Administration for Community Living (ACL) Duration: 10/1/14 9/30/17 Target Audiences: people with dementia living alone; people with ID aging into dementia; family caregivers of people with dementia MOW goals perfectly aligned with ADI objectives MEALS ON WHEELS ANNUAL CONFERENCE AND EXPO

WHAT WE DID IN A NUTSHELL Developed a Community Support Assessment Tool Trained two MOW Assessors/Site Managers to pilot an expanded assessment tool during their initial and annual in-home visits Offered clients referral and linkage to services for identified needs Pilot period: July 2015 Present Referrals made through existing SMAA internal referral system Follow-up provided by appropriate Community Services staff MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

ADDED ASSESSMENT/REFERRAL CATEGORIES Financial ADL/IADL: Are needs being met and by whom? Memory Concerns Managing Chronic Conditions Falls History Health Insurance Prescription Medications Housing Isolation/Socialization Transportation Abuse/Neglect/Exploitation Home Safety Legal Issues Advanced Care Planning Caregiver Concerns Physical Activity Volunteer Interest/Need Other SMAA Resource Specialists link clients to available resources to address each of these needs MEALS ON WHEELS ANNUAL CONFERENCE AND EXPO

Referrals increased from 1 in 15 to 1 in 5

COLLATERAL BENEFITS Warm hand-off to help clients accept service providers Increased respect and collaboration between programs: - Monthly team meetings for planning and case review - Spontaneous collaboration between Assessor/Site Managers and Outreach social workers - Assessors invited to Community Service in-service training - Assessors serving on ADI Advisory Committee - Joint planning and delivery of staff and volunteer training Field staff involved in program design MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

CHALLENGES/ LESSONS LEARNED Doing this for the Grant thinking Determining which questions to include; which ones are most important Time challenges: How much extra time can we afford? Training non-social workers to ask sensitive questions Data entry issues and limitations Understanding the work flow of each department Breaking down silos requires patience and perseverance MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

WHAT IS NEXT FOR THIS PROJECT? In-depth analysis of pilot data Refining/shortening assessment tool Mapping and streamlining work flow processes to fit available resources Expanding pilot to all Assessors; all site managers to become assessors Restructuring of Nutrition program to allow more wrap-around services for neediest clients Dementia training for MOW volunteers MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

WHAT IS THE SUSTAINABILITY PLAN? Normalization of best practices Include Nutrition Program under Community Services Department Restructure Nutrition community sites to allow additional support for MOW clients: - Warming Crew - Telephone check-in Seek additional funding MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

SPEAKER CONTACT INFORMATION Liz Weaver, MS, LSW Project Manager Alzheimer s Disease Initiative Southern Maine Agency on Aging 136 U. S. Route One Scarborough, Maine 04074 207-396-6578 lweaver@smaaa.org MEALS MEALS ON ON WHEELS ANNUAL CONFERENCE AND AND EXPO EXPO

IT S ABOUT MORE MAGNIFYING IMPACT THROUGH SOCIAL INNOVATION

MATTHEW PIEPER EXECUTIVE DIRECTOR OPEN HAND ATLANTA

It s About EMPOWERMENT SOLUTIONS Good Measure Meals offers calorie-controlled, gourmet Meal Plans for individuals looking to manage their weight, eat a healthy balanced diet, and/or help manage or prevent chronic diseases associated with obesity. Additionally, Good Measure Meals supports the healthy meal program with an array of Nutrition Education options designed to assist customers in achieving their health and wellness goals.

+ It s About SOLUTIONS SOLUTIONS As the social enterprise of Open Hand, Good Measure Meals not only expands our mission across the entire socioeconomic spectrum but also contributes 100% of all net proceeds to support the programs and services of Open Hand. =

It s About SOLUTIONS SOLUTIONS GOALS: Triple Bottom Line Impact 1. Generate Additional Revenue to Support Open Hand s Mission 2. Improve the Health and Quality of Life for our Customer 3. Help Create a Healthier Community

Our community-based approach relies on collaboration with like-minded partners who are looking for opportunities to make a serious impact on the health of our community. Partners Become Pick-up Locations, Customers or Referral Sources It s About PARTNERSHIPS SOLUTIONS Expanding Access to Healthy Meals and Nutrition Support Which in Turn Supports Subsidized Meals and Education for our Neighbors in Greatest Need

Pickup Locations include: Health Clubs Wellness Centers YMCAs Corporations Clinics Hospitals Physicians Offices It s About PARTNERSHIPS SOLUTIONS

Good Measure Meals Provides Open Hand Atlanta with: Financial Sustainability Steady Weekly Cash Flow It s About INNOVATION SOLUTIONS Mission Attainment: A Healthier Community Increased Buying Power/ Economies of Scale Driving Quality Deeper Stakeholder Engagement Scope of Impact

Financial Outcomes 2014 OH Revenue GMM It s About SUCCESS SUCCESS Comprises 27% of Open Hand s Revenue Serves over 2000 Customers Annually Adds six-figure dollars to the bottom line Partners with over 100 Community/Corporate Partners

Health Outcomes Access to Food and Nutrition Services Improves Health Outcomes and Lowers Cost of Care* It s About SUCCESS SUCCESS *Numerous nutrition studies validate that nutritionally balanced diets and nutrition education help people achieve better health outcomes and quality of life.

Key Learnings MISION It s About MISSION Creating the Right Business Model Fit Non Profit For Profit (B Corp) Hybrid Mission Alignment (Mission Vs Revenue) Mission Drift Securing Funding Where Does the Start Up Capital Come From? Investors/Grant/Philanthropic/Social Impact Bonds Where do you search for funding?

Key Learnings MISION It s About IMPACT Measuring Social Impact Do others care (stakeholders, funders, community?) What are the inherent challenges with measuring outcomes that you face? How do you share these outcomes? Do these outcomes influence your messaging, financials and innovation? Growing Impact vs Growing Revenue Did you look to grow revenue or impact first? Do you have a model that could be replicated in other geographies? Would social franchising be an option for your model? Are their like organizations that are doing the same thing?

Key Learnings MISION It s About MESSAGING How to Market a Social Enterprise Messaging the Social Value Objectively Conscious Consumer Spending Index