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Contact information:
Roxanne Rachlin, Project Manager 1545 Lilac Lane Lawrence, KS 66044
Voice: 785-864-5867
Fax: 785-864-5277
Email: roxanner@ku.edu
Aging and Social Work Education*Assisted LivingDiversion and Community Tenure*Hard-to-Reach Kansans*HospiceHospital Discharge Planning Project* Mental Health*Nursing Facility QuestionnaireOlder Adult Client Outcome IndicatorsPlanning for Long Term Care ServicesOther Projects* Indicates that a project is ongoing.
Aging and Social Work Education* Practicum Partnership Program The University of Kansas School of Social Welfare has received funding from the John A. Hartford Foundation to participate in a university-community partnership called, “The Practicum Partnership Program.” The program’s goal is to increase the number of graduate social work students with expertise in aging. In conjunction with local community agencies who specialize in serving older adults, Master’s level social work students in their foundation year will rotate through field agencies that provide exposure to a wide range of experiences with diverse groups of older adults, and participate in aging-related leadership activities. Students who complete their foundation practicum are eligible to apply for an internship stipend in their advanced year of the Master of Social Work Program. For more information contact Doreen Higgins, Project Coordinator, 785-864-3830
Institute for Geriatric Social Work GeroRich Training Initiative The purpose of GeroRich Training Initiative grant from the Institute for Geriatric Social Work at Boston University is to build on community partnerships and curriculum resources developed by the Hartford GeroRich sites. The goal is to provide quality and professional training to improve gerontological social work practice. As a result of the grant award the OALTC has expanded on the resources and partnerships produced from the Hartford GeroRich project. The OALTC has established three on-line training modules that cover three core areas of gerontological social work with an emphasis on the strengths perspective including: basic issues in aging; diversity and cross cultural competence in assessments and interventions; and legal and ethical issues. Presentation:Nelson-Becker, H., Landry, S., Dybicz, P., Chapin, R., Chandran, D., Gordon, T. (2006, February). Practice with Older Adults: Strengths-based Web Training for Social Workers. Paper presented at the Annual meeting of the Council of Social Work Education, Chicago, IL.
Hartford Gerontological Enrichment (GeroRich) in Social WorkThe Hartford Foundation has awarded the KU School of Social Welfare funds to develop a Hartford Gerontological Enrichment (GeroRich) in Social Work project. The purpose of this grant from the Council on Social Work Education with support from the John A. Hartford is to: 1) facilitate the development of curriculum resources designed to increase aging content in BSW and MSW foundation courses and in aging related placements, and 2) generate increased student interest in aging as a field of practice and in aging related placements. Our multi-level approach included interventions intended for faculty, students, and field. The interventions included 22 web-based learning resources, a website dedicated to the GeroRich project, Aging Tips of the month, a list serve for field instructors and students, mini-grants for students in conjunction with field instructors, and workshop presentations. Curriculum materials are available by clicking here. As part of the evaluation for this project, BSW and MSW foundation students were surveyed using the New York Academy of Medicine Aging Skill Competencies Scale to determine their perceived level of skill competency regarding work with older adults. Survey results have been collected and analyzed from the past two years. The University of Kansas School of Social Welfare awarded the OALTC internal funds to continue this evaluation in order to produce longitudinal results. Publication: Chapin, R., Nelson-Becker, H., Gordon, T., Landry, S., Chapin, W. (in press). Responding to the Hartford Geriatric Social Work Initiative: A multi-level community approach to building aging competency. Journal of Gerontological Social Work. Presentations: Chapin, R., Nelson-Becker, H., Gordon, T., Landry, S., Chandran, D., Macmillan, K. (2006, February). Sustaining the Hartford GeroRich Initiative: Evaluating Continued Effectiveness of a Multi-Level Intervention. Paper presented at the Annual meeting of the Council of Social Work Education, Chicago, IL. Gordon,T., Nelson-Becker, H., Chapin, R., & Landry, S. (2005,February).Impacting age-competency in social work students: Findings of a Hartford GeroRich Project. Paper presentation at Council on Social Work Education. New York, NY.
AL/RHC Facility Characteristics and Participation with the Medicaid HCBS/FE Waiver For the Fiscal Year 2000 Profile of Kansas Assisted Living and Residential Health Care Facilities project, the OALTC conducted a survey of all licensed assisted living and residential health care facilities (AL/RHCs) in Kansas. The survey collected data regarding the facility characteristics, e.g. profit status, average cost, level of service, professional staffing and whether they accepted Medicaid-HCBS/FE customers. Findings indicated that 70% of the facilities that participated in the survey accepted both private pay and Medicaid HCBS/FE residents, and the percentage of residents in AL/RHCs during the study time period that were Medicaid HCBS/FE recipients was 14.3%. During FY 2005, the OALTC re-surveyed all AL/RHCs in Kansas for the Assisted Living/Residential Health Care Facility Participation with the Medicaid HCBS/FE Waiver: A Five Year Follow-up project. The purpose of this study was to update the information collected in FY 2000 and identify changes in the availability and access of AL/RHCs for low-income older adults. This project was funded in part through a contract with KDOA and SRS. Reports available: Fiscal Year 2000 Profile of Kansas Assisted Living and Residential Health Care Facilities (2000). Publication: Chapin, R. & Dobbs-Kepper, D. (2001). Aging in Place in Assisted Living: Philosophy versus Policy. The Gerontologist, 41 (1): 43-50. Presentation: Higgins, D., Hickey, A., Rachlin, R., Nelson-Becker, H., Chapin, R. (2005, November). Access to Assisted Living for Low Income Elders: A Five Year Follow-up. Gerontological Society of America, Orlando, FL.
Mental Health Needs and Service Access in AL/RHCsIn 2002, the OALTC conducted a comprehensive statewide survey of AL/RHC administrators for the Meeting the Mental Health Needs of Elders in Assisted Living and Residential Health Care Facilities: Community and Facility Factors project. The purpose of this study was to gain a better understanding of the need for and awareness of mental health services in assisted livings and the characteristics that impede or facilitate access to mental health treatment. In addition, we conducted focus groups of community mental health center directors, assisted living providers, aging mental health specialists, and senior consumers to discuss strategies to increase access to mental health services for residents who reside in AL settings. This study was funded by the Retirement Research Foundation. During FY 2002, we expanded on our FY 2001 longitudinal study in the Barriers to Accessing Mental Health Services for Residents in Assisted Living and Residential Health Care Facilities from the Perspective of Residents and Community Mental Health Center Staff. In our FY 2001 study of AL/RHC facilities, it was found that 37% of the AL/RHC residents have some mental health diagnosis. In addition, it was suggested that residents in AL/RHCs with mental health needs might have difficulty accessing community mental health services. For the FY 2002 project, we interviewed a sample of residents in AL/RHCs about need, awareness, access and use of mental health services in the facility and community setting. We also interviewed community mental health center directors about these same issues. This project was funded in part through a contract with KDOA and SRS. Reports available: Barriers to Accessing Mental Health Services for Residents in Assisted Living and Residential Health Care Facilities from the Perspective of Residents and Community Mental Health Center Staff (2002). Presentations: Reynolds, K., McLendon, T., Lopez, A. (August, 2004). Mental Health Issues in Assisted Living Residents. Kansas Adult Care Executives Annual Convention, Wichita, KS. Chapin, R., Reed, C., Dobbs, D., & Hickey, A. (2003, January). Risk and Protective Factors Related to Depression: A Framework for Understanding the Mental Health Needs of Elders in Assisted Living. Society for Social Work and Research Seventh Annual Conference, Washington, DC, January 16-19, 2003.
AL/RHC Resident Length of StayThe Statewide Study of Assisted Living and Residential Health Facilities and Resident Capacity to Age in Place study surveyed a random sample of facilities and tracked resident length of stay to determine factors associated with varying lengths of stay. The study examined potential relationships between length-of-stay variables such as staffing patterns, resident payer status (public or self-pay), resident functional and cognitive status, and facility characteristics. The OALTC also surveyed states to identify aging-in-place strategies that have worked elsewhere. Report available:
Diversion and Community Tenure*The Longitudinal Study of Customers Diverted Through the CARE Program*, or Diversion Study, tracked four cohorts of older adults who had applied for nursing facility admission and were living in a community setting thirty days later. The purpose was to measure how long these diverted older adults were able to maintain community tenure, to explore the level at which they use community-based services, and to identify the differences and similarities between diverted and non-diverted older adults. The OALTC has continued to track the original cohort of diverted customers for five years (Report forthcoming). Continued tracking allows the OALTC to establish a complete and accurate measure of the average length of community tenure. The Examination of the Relationship of the Use of Medicare Home Health Services and Informal Caregiving to Successful Community Tenure project built on the analysis of factors related to long-term community tenure. The purpose of this study was to examine the relationship of the use of Medicare home health services and informal caregiving to community tenure of older adults who were diverted from nursing facility placement.The Expanded Examination of Factors Related to Diversion and Successful Community Tenure for Medicaid Customers: The Role of Diagnoses and Prescription Drug Use* project also builds on the Diversion Study by examining the affect of different diagnoses and medication use on the likelihood of being diverted and on the length of community tenure. This study will also provide a cost-benefit analysis of HCBS/FE compared to nursing facility care (Report forthcoming). These projects were funded in part through a contract with KDOA and SRS.Reports Available:Longitudinal Study of Customers Diverted through the Care Program Report: Fiscal Year 2000;Longitudinal Study of Customers Diverted through the CARE Program: Fiscal Year 2001 Report, and Appendices; Longitudinal Study of Customers Diverted through the CARE Program Report: Fiscal Year 2002: Summary of Key Policy Findings, Technical Report, and Appendices;Examination of the Use of Medicare Home Health Services and Informal Caregiving and Their Relationship to Successful Community Tenure and Appendices (2003);The Diversion Study Update: Community Tenure Status of Diverted CARE Assessment Customers at 36 months (2005).Presentations: Macmillan, K., Chapin, R., Rachlin, R., Zimmerman, M., & Baca, B. (2005, November). Community Tenure of Older Adults 36 Months After NF Diversion: Challenging Assumptions with Facts. Gerontological Society of America, Orlando, FL. Macmillan, K., Chapin, R., Rachlin, R., & Zimmerman, M. (January 2005). Length of community tenure following application for nursing facility placement: A prospective study. Paper presented at the annual meeting of the Society for Social Work and Research, Miami, FL. Publication: HoardingThe Community Tenure of Older Adult Hoarders: Identifying Risks and Enhancing Opportunities is funded by the Borchard Foundation on Law and Aging. The purpose of this project is to provide baseline information for service providers and state and local policy makers on hoarding problems among older adults in Kansas, and to identify code enforcement regulations and related policies that may affect their community tenure. Project objectives are to: identify innovative practices and policies in responding to hoarding cases nationally; develop a profile of older adult Kansans who hoard; identify current interventions and outcomes of hoarding cases in Kansas; identify code enforcement regulations and related policies in Kansas that impact older adult hoarders’ community tenure; and report recommendations for changes in Kansas that can help communities to build on pre-existing service networks to address hoarding problems. Report available: Community Tenure of Older Adults Who Hoard: Identifying Risks and Enhancing Opportunities (2007) Title page Full report Recent Presentations: Chapin, R., Koenig, T., McKenzie, S., Landry, S., Reynolds, K., & Rachlin, R. (2007, November). The Community Tenure of Older Adult Hoarders: Identifying Risks and Enhancing Opportunities. 60th Annual Meeting of the Gerontological Society of America. San Francisco, CA. Reynolds, K. (2007, October). Hoarding in Older Kansans: Results from an Exploratory Study. The Aging and Mental Health Coalition of Kansas City North. Kansas City, MO. Reynolds, K., & Landry, S. (2007, May). Hoarding in Older Kansans: Results from an Exploratory Study. Kansas Governor's Conference on Aging. Topeka, KS. Reynolds, K., Landry, S. (2007, April). The Community Tenure of Older Adult Hoarders: Identifying Risks and Enhancing Opportunities. Understand Hoarding Conference. Wichita, KS HospiceFindings from the Diversion Study indicated that within six months of the CARE assessment, 23% of diverted customers had died and 28% of non-diverted customers had died. The OALTC conducted an exploratory study of end of life care, specifically hospice use, in FY 2004 called, Hospice Component of the Longitudinal Diversion Study: Explanation of Hospice Use by Medicaid and Medicare Consumers in Kansas. A survey of CARE assessors was completed and indicated that lack of knowledge of palliative care was a barrier to hospice utilization. During FY 2005, the OALTC focused on barriers to discussing end-of-life concerns*. Four focus groups of the CARE assessors were completed that allowed us to explore their depth of knowledge about end of life care and their attitudes towards palliative care (Report forthcoming). This project was funded in part through a contract with KDOA and SRS. Report available:Hospice Component of the Longitudinal Diversion Study: Exploration of Hospice Use by Medicaid and Medicare Consumers in Kansas (2005).Area Agency on Aging End-of-life Resources Tool Kit for Professionals Presentations: Gordon, T., Landry, S., Chapin, R., Zimmerman, M., Rachlin, R., Hickey, A. (2005, November). Examining Hospice Utilization Among Older Adults Applying for NF placement. Gerontological Society of America, Orlando, FL. Gordon, T., Macmillan, K., Chapin, R., & Landry, S. (2005, August). Exploring hospice utilization by Medicaid and Non-Medicaid customers: A secondary analysis of a longitudinal study of frail older Kansans. Paper presented at the 1st National Conference on Access to Hospice And Palliative Care, St. Louis, MO. Publications:Chapin, R., Gordon, T., Landry, S., Rachlin, R. (in press). Hospice Use by Older Adults Knocking on the Door of the Nursing Facility: Implications for Social Work Practice. Journal of Social Work in End-of-life and Palliative Care.
The current multiyear study, Meeting the Mental Health Needs of Older Adults Through Civic Engagement will complete the analysis of the Kansas Community Mental Health Center (CMHC) and the PASRR Level II datasets by comparing characteristics of older adults utilizing community-based services and those considering nursing facility level of care. An additional two years of data from the Universal Assessment Instrument (UAI) dataset will be collected and analyzed, in order to identify trends. In FY 09, Area Agency on Aging (AAA) staff will be interviewed to provide input with regard to findings. Another component of this project is a three year study to develop and pilot a peer support program within Central Plains AAA, in Wichita. At the end of the first year, we will provide initial data on applicability of this model for AAAs in Kansas. At the end of the second year, we will provide an in depth analysis of pilot data and establish protocols for implementation. At the end of the third year, a manual and related materials will be produced that will enable other AAAs and other aging service providers with the tools necessary to implement their own peer support program. This project is funded in part through a contract with the KDOA and SRS. The study, Meeting the Mental Health Needs of Older Adults in the Community involved continuing to gather data in order to further identify trends about both older adults who used the Kansas Community Mental Health Centers (CMHCs), and older adults with serious mental illness considering nursing facility placement. In addition, data from the KDOA Universal Assessment Instrument (UAI) dataset (an instrument used by the AAAs) was analyzed in order to develop a profile of clients with low and high scores. In addition, in response to a request from the Governor's Mental Health Services Planning Council to modify the mental health training that had been developed for aging service providers so that it could be offered to CMHC case managers, a revised training was provided in both the western and eastern regions of the state. This project was funded in part through a contract with KDOA and SRS (report forthcoming). The Older Adult Mental Health Service Access project continued the analysis of the Kansas Community Mental Health Center (CMHC) dataset in order to identify trends in utilization by older adults. Another activity was to analyze two years of data from the PASRR Level II dataset in order to provide a profile of older adults with serious mental illness considering nursing facility placement. A third activity was to survey all other states to identify innovative mental health services for older adults and strategies for funding those services. Finally, the OALTC built on the Planning for Long Term Care Before the Boom project to determine the impact that Medicaid eligible older adults with mental health problems will have on the mental health system in Kansas (report forthcoming). This project was funded in part through a contract with KDOA and SRS. The three year project, Connecting Older Kansans with Community Mental Health Resources involved the development, evaluation, and implementation of training and a screening tool to enhance the ability of Kansas service providers to identify older adults who may be experiencing mental health problems and to refer them for appropriate resources. Data was also collected to develop a profile of older adults who accessed Kansas Community Mental Health Centers (CMHCs). This project was funded in part through a contract with KDOA and SRS. Reports available: Recent Presentations: Reynolds, K. (2007, November). Peer Support Programs for Older Adults. Older Adults and Life Transitions: Addictions. Mental Wellness, Ethics. Wichita, KS. Reynolds, K., Etzel-Wise, D., Graham, A., Troutt, N., Luber, N., & Holthaus, J. (2006, April). Advanced Training: Case Management with Older Adults. Great Bend, KS. Reynolds, K., Chapin, R., Rachlin, R., Lopez, A., Roberts, C. (2005, November). Do Older Adults Access Community Mental Health Centers? Paper presented at the 58th annual meeting of the Gerontological Society of America, Orlando, FL. Trout, N., Reynolds, K. (September, 2004). The Aging SPMI Individual. Kansas Health Care Association Convention. Kansas City, KS. Mental Health Needs and Service Access in AL/RHCsIn 2002, the OALTC conducted a comprehensive statewide survey of AL/RHC administrators for the Meeting the Mental Health Needs of Elders in Assisted Living and Residential Health Care Facilities: Community and Facility Factors project. The purpose of this study was to gain a better understanding of the need for and awareness of mental health services in assisted livings and the characteristics that impede or facilitate access to mental health treatment. In addition, we conducted focus groups of community mental health center directors, assisted living providers, aging mental health specialists, and senior consumers to discuss strategies to increase access to mental health services for residents who reside in AL settings. This study was funded by the Retirement Research Foundation. During FY 2002, we expanded on our FY 2001 longitudinal study in the Barriers to Accessing Mental Health Services for Residents in Assisted Living and Residential Health Care Facilities from the Perspective of Residents and Community Mental Health Center Staff. In our FY 2001 study of AL/RHC facilities, it was found that 37% of the AL/RHC residents have some mental health diagnosis. In addition, it was suggested that residents in AL/RHCs with mental health needs might have difficulty accessing community mental health services. For the FY 2002 project, we interviewed a sample of residents in AL/RHCs about need, awareness, access and use of mental health services in the facility and community setting. We also interviewed community mental health center directors about these same issues. This project was funded in part through a contract with KDOA and SRS. Reports available: Barriers to Accessing Mental Health Services for Residents in Assisted Living and Residential Health Care Facilities from the Perspective of Residents and Community Mental Health Center Staff (2002). Presentations: Reynolds, K., McLendon, T., Lopez, A. (August, 2004). Mental Health Issues in Assisted Living Residents. Kansas Adult Care Executives Annual Convention, Wichita, KS. Chapin, R., Reed, C., Dobbs, D., & Hickey, A. (2003, January). Risk and Protective Factors Related to Depression: A Framework for Understanding the Mental Health Needs of Elders in Assisted Living. Society for Social Work and Research Seventh Annual Conference, Washington, DC, January 16-19, 2003. Nursing Facility Questionnaire
Analysis and Reporting Findings of the Nursing
Facility Evaluation of Older Adult Client Outcome IndicatorsThe purpose of the Older Adult Client Outcome Indicators Project is to monitor specific outcomes for adults age 65 and over who are receiving long term care services and are the mandated responsibility of KDOA, SRS, and KDHE. For seven consecutive years (1995-2002), we examined independence and protection indicators at the state, county and Area Agency on Aging Planning and Service Area levels to discern regional variations and longitudinal patterns. Independence indicators relate to rates at which Kansans age 65 and over use nursing facilities and home- and community-based services, discharge from nursing facilities to the community, and are diverted from placement through community-based alternatives. Protection indicators track older Kansans’ rates of abuse, neglect, and exploitation in community and institutional settings. Data for indicators are broken down by age group, allowing more precise tracking of the most vulnerable groups. The annual reports summarize findings, examine trends for previous years, and offer policy strategies for improving home- and community-based service delivery. This project was funded in part through a contract with KDOA and SRS. Reports available: Older Adult Client Outcome Indicator Project Report Fiscal Year 2002. Older Adult Client Outcome Indicator Project Report Fiscal Year 2000.
Planning for Long Term Care Services The Planning for Long Term Care Services Before the Boom project focused on the increasing attention being paid to the aging baby boomers. In 2031, the oldest baby boomers will turn age 85. By 2025, 1 in 5 Kansans will be aged 65 and older. The current trends in long-term care services and the specific demographics of the baby boomers will influence the timing and intensity of the impact of these changes on long-term care services in Kansas. According to a report published by AARP (2002), national trends in long-term care are changing. These trends in long-term care and demographics are important factors that will influence future provision of long-term care services to older adults. Through this project OALTC examined the demographic trends identified in the AARP report that will effect the national baby boomer generation and applied them to Kansas in order to determine how conditions in Kansas may differ from what is expected nationally. This project was funded in part through a contract with KDOA and SRS. Report available: Planning for Long-Term Care Services in Kansas Before the Boom (2006).
Hospital Discharge Planning Project* Report Available: Real Choice Final Report (2007) Other ProjectsExpedited Service DeliveryExpedited Service Delivery (ESD) is a process for providing in-home services to Medicaid HCBS/FE applicants while their financial determination is being made. Through ESD, customers can receive in-home services during the Medicaid financial eligibility process. The ESD process is comprised of two components: completion of the ESD worksheet; and getting services delivered in a timely manner. The purpose of the project was to develop and test the ESD financial screening worksheet and the ESD process. This project was funded in part through a contract with KDOA and SRS.Report available: Expedited Service Delivery Pilot Evaluation Report (1999). Kansas Nursing Facility Project Evaluation, Kansas Department on AgingForbes-Thompson, S., Dunton, N., Gajewski, B., Wrona, M., Becker, A., Chapin, R., Rachlin, R., Lee, R., & Zimmerman, M. (2003). Kansas Nursing Facility Project Evaluation. Kansas Department on Aging. For more information, visit http://www.nursingoutcomes.org/knfp.htm.
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