Long-Term Care and Financial Services

• As part of the intake process for individuals seeking nursing home care, S&DS’ pre-nursing home admission screening staff completed 995 assessments. Seventy-nine of those assessed were diverted to other less-restrictive and less-expensive care settings.
• An average of 3,080 persons per month received S&DS-administered long-term care services, such as Medicaid and Oregon Project Independence. Each long-term care client received ongoing service coordination assistance from an S&DS Case Manager.
• S&DS’ weekly Medicaid long-term care caseload grew from 2,804 cases at the beginning of July 2001 to 2,833 cases at the end of June 2001. As in most prior years, all of this growth occurred in care settings other than nursing homes. S&DS’ nursing home weekly caseload dropped by 56 cases during the year, from 617 to 561 cases. Contributing to this 9 percent decline in the nursing home caseload was the completion by S&DS staff of 483 relocations of clients from nursing homes to less-restrictive care settings. At year-end, 80.2 percent of S&DS’ Medicaid long-term care clients either were receiving services in their own homes or in licensed community care settings other than nursing homes. Comparable percentages from prior years are 78.0 percent (2000-01), 76.4 percent (1999-2000), and 73.5 percent (1998-99).
• A major contributor to the growth of S&DS’ in-home care caseload was the growth of the Client-Employed Provider (CEP) program. S&DS staff who administer this program are responsible for the recruitment, screening, and orientation of individuals who work for S&DS’ in-home care clients. Staff also process timesheets and payment documents for these workers. In 2001-02, S&DS CEP Specialists recruited, screened, and oriented 729 new CEPs county-wide. During the course of the year, an average of 1,157 CEPs provided services to 1,445 clients each month. The average monthly payroll for this program in Lane County was $766,601. Between July 1, 2001 and June 30, 2002, S&DS’ CEP Specialists processed $9,199,206 in payments to CEPs.
• During the year, S&DS Case Managers assisted 362 older individuals to secure in-home services funded by Oregon Project Independence (OPI). Staff assessed clients’ needs, developed plans of care, and authorized and arranged for the following OPI-funded services: Home Care, Personal Care, Meals on Wheels, and Money Management.
• S&DS continued to work closely with the Oregon Department of Human Services’ Vocational Rehabilitation Division (VRD) on the Disability Employment Initiative (EI). In addition to collaborating closely with VRD, S&DS’ staff continued to facilitate the Work Readiness Alternatives Workshop (WRAW) program, which helps people with disabilities explore issues and services relating to gainful employment. WRAW workshops were held at VRD’s Springfield office, and two S&DS EI Specialists worked out of that office two days each week.

• Financial Services is S&DS’ largest program constellation. Staff determines eligibility for Medical Assistance, Food Stamps, and General Assistance (GA), and carries caseloads of eligible clients. S&DS’ average weekly Financial Services caseload during the year was 7,520—670 more than the prior year. Over the course of the year, the number of individuals assisted on a weekly basis grew by 9.2 percent, or 654 persons. At year-end, 7,798 seniors and persons with disabilities were being served.
• Accuracy in the administration of the federal Food Stamps program is a continuing problem for DHS. When eligibility and benefit determination errors exceed a certain level, the State of Oregon is penalized by the federal government. S&DS staff has worked over the past two years to reduce errors in this program. During the first seven months of the federal fiscal year, S&DS had no cited Food Stamp Program Quality Control issuance errors.
• Oregon’s GA program provides temporary cash assistance to severely disabled, poor people while they apply for federal benefits—SSDI and SSI—administered by the Social Security Administration. An important part of this program is aiding these individuals in the SSI application and appeal processes. During 2001-02, 182 local GA recipients were approved for SSI benefits. As a result, the State of Oregon recovered $628,914 from the federal SSI program for the cash grants provided to these individuals while their applications for SSI benefits were pending.
• Applicants for and recipients of services have administrative hearing rights if they are aggrieved by decisions by S&DS staff to deny, terminate, or reduce benefits. During the year, 238 hearing requests were filed, with the vast majority (191) contesting GA disability decisions. S&DS’ original decisions were affirmed in approximately 70 percent of these cases.

• Highlights of S&DS’ adult foster care Licensing and Monitoring Unit include:
  • The number of adult foster care homes of all types grew slightly during the year; there were 295 licensed homes in June 2002, up nine homes from July 2001.
  • A trend identified two years ago continued in 2001-02—commercial foster homes are caring for more medically involved and fragile clients.
  • In addition to its licensing and monitoring work, staff endeavored to improve the quality of services delivered by providing 12 hours of classroom training to owners, operators, and staff each month, and giving many hours of technical assistance to new and existing providers.
• S&DS’ Criminal Records Specialist completed 3,609 criminal records checks on CEPs and on owners, operators, and staff in adult foster care homes. The number of record checks completed in 2001-02 was 19 percent greater than in the prior year. To complete these reviews, the Specialist queried three on-line databases: the Area Information Records System (AIRS), the Oregon Law Enforcement Data System (LEDS), and the Oregon Judicial Information Network (OJIN). She also prepared for and participated in 1,324 informal hearings of individuals who wished to dispute the findings of their criminal records check. To her credit, none of these informal hearings proceeded to a formal hearing.

• S&DS received 1,423 complaints of abuse, neglect, or exploitation of seniors or people with disabilities in 2001-02. Of these, 922 of these complaints resulted in formal investigations. Of the balance, most were referred for follow-up, while others did not meet the criteria for an investigation.
• Of the investigations completed, 627 (68 percent) involved individuals living in community settings outside of licensed facilities; the remaining 295 complaints involved licensed care facilities, such as nursing homes, foster homes, and the various types of residential and assisted living facilities. Compared to 2000-01, the number of community complaints stayed substantially the same, while the number of facility-related complaints declined by one-third.
• Although the decline in investigations involving licensed facilities is noteworthy, some of this is due to the March 2002 implementation by DHS of a new system for the investigation of complaints in nursing homes.
• S&DS continues to work to educate the agencies, businesses, and the public about elder abuse, and promote the reporting of suspected abuse to the Adult Protective Services Unit. In this vein, staff conducted three training sessions for employees of banking institutions; increased referrals concerning financial exploitation have resulted from this outreach.

• In June 2001, S&DS implemented a new telephone answering and call routing system—a telephone tree—for its Information and Referral line. During 2001-02, S&DS fine-tuned this system to avoid confusion for callers and increase the productivity of division staff. After a trial period of several months, the system was adopted as a permanent business practice by S&DS’ Advisory Councils and management.
  
• On an ongoing basis, S&DS’ support personnel provide invaluable assistance to customers and staff. Approximately half of these staff have specialized duties, such as medical transportation scheduling, while the other half provide general office support. As S&DS’ caseloads increase, the burden on support personnel increases proportionally. Examples of responsibilities include:
  • Phone and walk-in reception;
  • Medical transportation scheduling, which included 74,754 rides in 2001-02, up 7 percent from 2000-01;
  • Client file management, including creation, storage, and retrieval, and the transfer of files among offices;
  • Issuance of Electronic Benefits Cards, for Food Stamp benefits, and bus passes;
  • Word processing and mail-outs;
  • Medical supply ordering for Medicaid clients; and
  • The collection and receipting of clients’ contributions for services.

Senior Outreach

• The Senior Outreach Program provided 56,342 Information and Referral service contacts to older clients and members of their families, and delivered Case Management services to 825 frail, homebound older persons who needed assistance in order to remain independent in their own homes or apartments.
• Outreach staff screened and certified 614 applicants to receive benefits from the federal Low Income Energy Assistance Program, screened and authorized Meals on Wheels for 469 persons, and screened and authorized Escorted Transportation for 507 new clients.
• In 2001-02, Outreach staff also coordinated the work of 171 volunteers: ElderHelp, Senior Companions, and community volunteers. These volunteers contributed 35,958 hours of service to Outreach Program clients.

Group Meals and Meals on Wheels

• 84,807 meals were provided to 1,010 participants in the program’s 13 Group Dining Rooms. Nearly half of the participants in the Group Dining program had incomes at or near the federal poverty level.
• 83,984 Meals on Wheels were delivered to 767 homebound seniors by program volunteers and staff. Comparing service to last year, 2,626 fewer meals were provided in 2001-02. As with the Group component of the program, over 43 percent of the recipients of these meals had incomes at or near the federal poverty level.