RD264 - Virginia's State Plan for Aging Services October 1, 2015 - September 30, 2019


Executive Summary:
MISSION:

The Virginia Department for Aging and Relhabilitative Services, in collaboration with comnumity partners, provides and advocates for resources and services to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families.

A restructuring of Virginia state government in 2012 created the Department for Aging and Rehabilitative Services (DARS), now responsible for planning and oversight of aging, employment, rehabilitative, and adult services and adult protective services. The new agency brought together the former Department of Rehabilitative Services, the Virginia Department for the Aging, Virginia's Long-Term Care Ombudsman Program, and the Adult Protective Services Division formerly housed within the Department of Social Services (DSS). Although these agencies and their local counterparts had a long history of collaboration, combining staff and systems has enhanced communication, streamlined access, and increased opportunities to coordinate home and community-based supports (HCBSs) for older adults and adults with disabilities.

In accordance with the Older Americans Act of 1965 (OAA), as amended, and pursuant to Virginia Code § 51.5-136, DARS, as the designated state unit on aging, is mandated to submit a state plan on aging services (State Plan) to the U.S. Administration on Community Living (ACL), the Governor and the General Assembly. DARS developed the State Plan in collaboration with the state's aging network, including the Commonwealth Council on Aging, the Area Agencies on Aging (AAAs), the Virginia Long-Term Care Ombudsman, and other state agencies, stakeholder organizations, and the older adults DARS serves. Virginia Code § 51.5-136 also requires that all state agencies submit reports on the impact of aging on their services, including unmet needs, and this was accomplished as part of this planning process. Further, state agencies designated staff in these reports who review agency policies and programs and identify opportunities to make those policies and programs more accommodating to older adults and persons with disabilities as required by Virginia Code § 2.2-604.1. The reports and agency staff can be found at: http://www.vda.virginia.gov/2015AgencyReports.asp. The State Plan reflects feedback from a public listening session held in Fishersville on February 13, 2015 before members of the Commonwealth Council on Aging with statewide input from videoconference sites in Roanoke, Abingdon, Fairfax, and Norfolk. DARS staff also worked with the Commonwealth Four-Year Plan Work Group (See Appendix G) to establish the State Plan goals and vision on March 6, 2015. The Work Group provided comment on a previously distributed exposure draft of the State Plan at its final meeting on April 17, 2015. The final draft State Plan was sent out to all members of three DARS advisory boards and interested parties and posted on the agency website for a public comment period. The State Plan describes the agency's goals and strategies to achieve its mission, emphasizing the common themes that will enhance the lives of older Virginians moving forward.

STATE PLAN VISION FOR VIRGINIA: Age-friendly livable comnumities that foster independence for all Virginians.

The 2010 census confirmed, nationally and statewide, the predicted yet unprecedented growth of the older population -- 1,419,306 Virginians over the age of 60, with the over 85 age group being the fastest growing segment of the population. Virginia's population, like that of the nation, is becoming older and more racially and ethnically diverse and with a growing number of individuals with limited English proficiency. Today, there are an estimated 1,484,173 adults in the Commonwealth who are over 60 years old, and this population will expand to more than 2 million by 2030 (U.S. Census, 2013 American Community Survey Estimate). By 2030, the entire baby boom generation will be between 66 and 84 years old. Just as older adults show big variations in their skills and abilities -- one 80-year old might play tennis, while another might live in a nursing home -- the internal process of aging differs in all of us. But it is a fact that the aging population will live longer due to advances in technology and medicine, and those older Virginians with chronic conditions may need more assistance for longer periods of time.

The critical need to provide supports to more older adults while resources are limited has reinforced a growing trend that emphasizes strategies to integrate long-term services and supports (LTSSs) into the community. HCBSs help older adults accomplish everyday tasks such as bathing, dressing, preparing a meal, or balancing a checkbook. Assistance with just a few of these tasks help frail elderly adults remain in their own homes independently. Therefore, these strategies not only reflect the cost-efficiency of HCBSs, but also reflect the predominant preference of older adults to age in place in their homes and communities. Research also supports this approach, documenting that supporting individuals at home can lead to better health outcomes. Agencies at the federal, state, and local levels should be identifying and addressing the need for the appropriate types and amounts of long-term care, emphasizing HCBSs.

Livable communities bring together enhanced partnerships to provide aging services, housing, health care services, and transportation. All services have a significant educational component to ensure person-centered planning. The following are just a few exciting advancements toward livable communities that promote optimal aging and improve the lives of older Virginians.

• Eight Virginia communities have adopted age readiness plans, and the Greater Richmond Region was named the 2015 Metlife Foundation/Generations United Best Intergenerational Community.

• In December 2014, Virginia received a $2.6 million one-year grant from the Centers for Medicaid & Medicare Services (CMS) that includes funding for the Eastern Virginia Care Transitions Partnership to develop a plan to expand Care Transitions statewide through the AAA network with program enhancements including medication adherence, behavioral health screening, and advanced care planning.

• Under a one-year planning grant from the ACL, CMS, and the Veterans Health Administration, Virginia is developing a three-year plan to expand Virginia's Aging and Disability Resource Connection (ADRC) called No Wrong Door (NWD) to all populations and payers. The plan will focus on assessment of the current NWD system, common language, education and awareness, person-centered tools for assessments, quality, and sustainability.

• There are 14 Programs of All Inclusive Care for the Elderly (PACE) that help individuals who are 55 years of age or older remain in the community and address their health and social needs.

• In 2014, Virginia received an Alzheimer's Disease and Supportive Services Program (ADSSP) three-year grant to provide caregivers of persons with dementia counseling services and supports and referrals to community resources in the greater Charlottesville and Williamsburg areas.

• The 2015 Virginia Governor's Housing Conference will hold a competition to design a safe, affordable, energy-efficient home that allows for people to "age in place" in Virginia.

• DARS has partnered with the Virginia Department of Health to accept the 2015 President's Challenge on Healthy Aging by taking the Healthy Aging Pledge. This challenge aims to galvanize state and local health officials and the aging network to implement evidence-based strategies for increasing the number of older adults who are living well in the community.

Virginia not only recognizes the growing demand on services and supports that this aging demographic shift will produce, but also the increasing intellectual capital, time, and expertise that it will provide, generating unprecedented and as yet untapped levels of available skills, abilities, and diverse human resources. For example, the State Plan for Volunteerism and Services includes a goal to increase service opportunities for adults age 55 or older, including how to utilize their skills and experience to address community needs. DSS will collaborate with DARS, the Department of Labor and Industry, Virginia Employment Commission, AARP, local AAAs, local volunteer centers, institutions of higher education, the faith community, and other business and community organizations to increase service opportunities for older Virginians.

The mission of DARS has evolved to promote security and independence while providing the right care that empowers older adults and persons with disabilities to have and make choices about their lives. Moreover, older adult LTSSs that are rooted in the principles of the Culture Change or person-centered care movements have increasingly enhanced choice, dignity, respect, self-determination, and purposeful living. Utilizing demographic and service data, state agency reports on the impact of the aging population, and input from older adults and caregivers during listening sessions held by the Commonwealth Council on Aging and from aging network stakeholder meetings, DARS adopted the following service goals:

1. Assess and facilitate statewide community readiness for an aging population, recognizing both the untapped resources and the unmet needs of this population;

2. Empower older adults and their families to make person-centered and informed decisions about personal health and well-being, long-term services and supports, and end-of-life care options;

3. Enable people to live in the community as appropriate through the availability of formal and informal high-quality LTSSs, including supports for families and caregivers;

4. Strengthen statewide systems that protect the rights and prevent the abuse, neglect, or exploitation of older adults; and

5. Enhance effective and responsive management of programs serving older adults to ensure the fiscal and programmatic accountability of those programs.

These service goals support the overarching State Plan vision of creating livable communities that are age-friendly and foster independence, and they form the framework for the State Plan's strategic goals for 2015-2019.