2015-2016 Aging Services Area Plan Budget Public Hearing County Government Center 150 North Queen Street Planning Commission Conference Room #104 Lancaster, PA February 1, 2016 12 Noon AGENDA 1. Call to Order and Pledge of Allegiance Bob Sauders Advisory Council Chair 2. Introductions / Purpose / Function of Advisory Council Bob Sauders 3. Presentation and Overview of 2015-2016 Aging Services Area Plan Budget Jacqueline Burch Executive Director 4. Public Comment / Questions 5. Adjournment
AREA PLAN PREFACE AND SERVICE HIGHLIGHT SUMMARY FISCAL YEAR 2015-2016 This Area Plan Summary has been prepared to present in general terms the program and fiscal trends of the Lancaster County Office of Aging. It includes a proposed cost center budget reflecting anticipated resources and expenditures, and a brief description of agency services. It should be noted that funding allocated to the programs mentioned herein is primarily derived from two major state and federal funding agreements -- the Aging Services Block Grant (via the Pennsylvania Department of Aging), and Title XIX Medicaid Waiver Grant. These respective allocations represent a planning or placeholder budget for each fiscal year, subject to subsequent amendment based on actual reported expenses, availability of funds, and other regulatory or budgetary considerations. As is well known by now, this fiscal year and budget cycle was one entirely unprecedented in the history of our Commonwealth. After a six-months-long impasse between the Governor and State Assembly, a partial appropriations bill was ultimately approved last month, providing full Lottery and Medicaid home-and-community-based care funding to the Board of County Commissioners on our behalf. Regrettably this extensive delay forced providers to go without payment for services rendered from July 1, 2016. As a result new referrals for care were unable to be staffed during this time, providers struggled to stay afloat financially, and the waiting list grew to nearly 300 individuals. Further, the County instituted a hiring freeze which having just been lifted, continues to severely impact agency staffing and mandated operations as we now work to backfill a dozen vacancies.
Despite the lengthy delay, the allocation received for FY15-16 again includes more than $1 million for waiting list reduction and enables us to maintain services to consumers from the prior fiscal year. A state-established minimum spending parameter for in-home services -- which includes cost centers such as Personal Care, Home Delivered Meals, Adult Day Care, Assessments, Care Management, Medical Equipment/Supplies, Protective Services, Guardianship, and Consumer Reimbursement among others will require spending at least $4,528,199 (or 60%) of our total Aging Block Grant in these areas. Programmatically, we continue to experience steady growth in reports of need for Older Adult Protective Services (age 60+), and for those age 18-59 as well. We anticipate the development and roll-out of Community Health Choices Pennsylvania s Managed Long Term Services and Supports (MLTSS) initiative, which will likely involve AAA s playing a key role in the area of assessment. We are employing new tools, strategies and partnerships to achieve full compliance with mandated timeframes for completing Level of Care Determinations (LCDs), and expect a revised version of the LCD with the advent of Community Health Choices. Lastly, in the midst of the budget impasse we were able to expand our provider network via a lengthy RFP (Request For Proposal) process required by the state and County, adding a new and much-needed city-based Adult Daily Living Center. ******************* Persons interested in a more extensive explanation of the 2015-2016 Aging Services Block Grant Budget / Area Plan may contact the Lancaster County Office of Aging at 150 North Queen Street, Suite #415, Lancaster PA 17603 or call (717) 299-7979 or 1-800-801-3070; Fax (717) 295-2070 or email: aging@co.lancaster.pa.us. Copies of the Aging Block Grant as well as the agency s 2012-2016 Four Year Area Plan are available for public s review at said location during normal business hours, or on the agency website at www.lancoaging.org.
2015-2016 ANTICIPATED BUDGETED RESOURCES A. AGING SERVICES BLOCK GRANT AGREEMENT 1. Regular Block Grant $5,609,386 2. Family Caregiver Support Program (State) $198,436 3. Family Caregiver Support Program (Federal) $164,965 4. Nutrition Services Incentive Program $60,962 5. APPRISE (Insurance Counseling Program) $33,008 6. Health Promotion $30,859 7. Options Services Funds $1,371,817 8. Block Grant Supplement $116,160 9. Ombudsman Volunteer $7,010 10. Waiting List Initiative $0 11. APPRISE - Addl Base, MIPPA-AAA, ADRC $24,258 B. TITLE XIX AGREEMENT Total Block Grant $7,616,861 1. Aging & Disability Resource Center (ADRC) $107,888 2. Medicaid Assessment $850,664 3. Information & Referral $115,340 4. Nursing Home Transition Reimbursement $112,000 5. Aging Waiver Reimbursement (Service Coordination/Enrollment) $592,657 6. Aging Waiver Reimbursement (Meals) $48,000 Total Title XIX $1,826,549
C. OTHERS 1. Program Income (Local) $124,576 2. Program Income (Federal) $5,544 4. County Cash (2015) $111,235 5. Senior Community Services Employment (Title V) $150,786 6. Options State Cost Sharing $24,254 7. Human Services Block Grant $18,557 Total Others $434,952 D. IN-KIND 1. Cost Allocation $608,000 2. Volunteer Services $230,000 Total In- Kind $838,000 SUMMARY OF TOTAL RESOURCES (A+B+C+D) A. Aging Services Block Grant Agreement $7,616,861 B. Title XIX Agreement $1,826,549 C. Others $434,952 D. In-Kind $838,000 Grand Total Resources (A+B+C+D) $10,716,362
2015-2016 ANTICIPATED BUDGETED EXPENDITURES I. ADMINISTRATION 1. Administrative Expenses $473,096 2. Cost Allocation $636,830 Subtotal $1,109,926 II. ACCESS SERVICES 1. Information and Referral $616,325 (includes APPRISE) 2. Outreach $107,900 3. Transportation $200,700 4. Nursing Home Transition $137,015 Subtotal $1,061,940 III. IN-HOME SERVICES 1. Personal Care $772,302 2. Home Support $228,000 3. Home Health $9,600 4. Care Management $1,013,073 5. Assessment $1,182,350 6. Home Delivered Meals $408,000 7. Adult Daily Living $300,000 8. Med Equip/Supplies/Devices $144,000 9. Personal Assistance Services $396,000
10. Consumer Reimbursement $472,809 11. Protective Service $683,209 Subtotal $5,609,343 IV. LEGAL SERVICES $51,500 V. COMMUNITY SUPPORT 1. Employment/Job Bank $74,855 2. Senior Community Services Employment (Title V) $150,579 3. Volunteer $35,850 Subtotal $261,284 VI. CONGREGATE MEALS $294,268 VII. SENIOR COMMUNITY CENTER SERVICES $613,887 VIII. OMBUDSMAN $118,047 IX. GUARDIANSHIP $477,687 X. DOMICILIARY CARE $12,786 XI. PA DEPT OF AGING WAIVER PROGRAM $318,000 XII. VALUE OF IN-KIND (VOLUNTEER) $230,000 XIII. VALUE OF IN-KIND (EMPLOYMENT) $16,731. Subtotal $2,081,406