DELAWARE STATE PLAN ON AGING October 1, 2008 to September 30, 2012 Department of Health and Social Services Division of Services for Aging and Adults with Physical Disabilities April, 2008 TABLE OF CONTENTS VERIFICATION OF INTENT ii INTRODUCTION 1 GOALS AND OBJECTIVES 6 RESOURCE ALLOCATION PLAN 12 DEMOGRAPHIC INFORMATION 15 STATE OF DELAWARE 18 ASSURANCES 20 STATE PLAN PROVISIONS AND INFORMATION REQUIREMENTS 33 APPENDICES 44 VERIFICATION OF INTENT The State Plan on Aging is hereby submitted for the State of Delaware for the period October 1, 2008, through September 30, 2012 by the Department of Health and Social Services, Division of Services for Aging and Adults with Physical Disabilities under provisions of the Older Americans Act, as amended during the period identified. The State Agency named above has been given the authority to develop and administer the State Plan on Aging in accordance with all requirements of the Act, and is primarily responsible for the coordination of all State activities related to the purposes of the Act, i.e., the delivery of supportive services, including multipurpose senior centers and nutrition services, and to serve as the effective and visible advocate for the elderly in the State. This Plan is hereby approved by the Governor and constitutes authorization to proceed with activities under the plan upon approval by the commissioner on Aging. The State Plan on Aging hereby submitted has been developed in accordance with all Federal statutory and regulatory requirements. __________________ (DATE) _______________________________ Guy Perrotti, Director Division of Services for Aging and Adults with Physical Disabilities __________________ (DATE) _______________________________ Vincent P. Meconi, Secretary Department of Health and Social Services I hereby approve this State Plan on Aging and submit it to the Assistant Secretary, DHHS, Administration on Aging for approval. __________________ (DATE) _______________________________ Ruth Ann Minner, Governor State of Delaware INTRODUCTION INTRODUCTION Purpose The State Plan on Aging serves as the contract between the State of Delaware and the Administration on Aging. This contract enables the State to receive funds under Title III and Title VII of the Older Americans Act in order to provide needed services to older Delawareans. The Plan includes all of the assurances, budgeting information, and demographic data required by the Older Americans Act and its regulations. In addition, the Plan will serve as one component of the Division of Services for Aging and Adults with Physical Disabilities’ (DSAAPD) strategic plan. The State Plan on Aging and a companion plan for adults with physical disabilities will be used to project and meet the needs of their respective target audiences over the next several years. Term of the Plan The Older Americans Act allows states to develop two-year, three-year, or four year plans. Delaware has elected to develop a four-year plan. Therefore, this State Plan covers the period beginning October 1, 2008 and ending September 30, 2012. Planning Process DSAAPD began the planning process by organizing focus groups on four topics. Three focus groups were held with representatives from organizations from throughout the senior network such as senior centers, service providers, nursing homes, hospitals, outreach programs, and other state agencies. Caregivers and seniors were also invited to participate. The three external focus group topics were: expanding long term care services and choices; prevention of elder abuse in home and community based settings; and prevention of elder abuse in long term care settings. One focus group was held on each topic in a centralized location that was easily accessible for all participants in the state. Each focus group had approximately ten participants. One focus group was held with DSAAPD staff only. The topics addressed were information, assistance and access. Representatives from all work units and management were invited to participate. The focus group had eleven participants. After the information from the focus groups was collected, an internal group of DSAAPD staff met and considered each topic. Through these meetings, objectives were discussed, drafted, and reviewed by a broader group of DSAAPD staff including representatives from the planning unit, the Public Health Educator, the State Long Term Care Ombudsman, the Joining Generations administrator, the administrator of caregiving programs, the Social Services Senior Administrator, a Management Analyst, the Chief Fiscal Officer, the Deputy Director, and the Director. As part of the planning process, DSSAPD reviewed the Administration on Aging’s (AoA) Strategic Action Plan for FY 2007-2012. (Please see www.aoa.gov/about/strategic/strategic.asp for further information.) The AoA serves as the Federal focal point and advocate agency for older persons and their concerns. It also administers funding provided to the States through the Older Americans Act and it’s amendments. In the Strategic Action Plan, AoA identifies five goals that will guide their activities over the next five years. They include: Goal 1: Empower older people, their families and other consumers to make informed decisions about, and to be able to easily access, existing health and long-term care options. Goal 2: Enable seniors to remain in their own homes with high quality of life for as long as possible through the provision of home and community-based services, including supports for family caregivers. Goal 3: Empower older people to stay active and healthy through Older Americans Act services and the new prevention benefit under Medicare. Goal 4: Ensure the rights of older people and prevent their abuse, neglect and exploitation. Goal 5: Maintain effective and responsive management. DSAAPD followed these goals while reviewing focus group responses and planning objectives. They are reflected in the main categories of our State Plan Objectives. Review of Draft Plan The draft plan will be posted on the Division’s website, www.dhss.delaware.gov/dsaapd, and a public hearing on the State Plan on Aging is scheduled. Advertisement for the public hearing will be posted in the legal classified section of the News Journal and the Delaware State News. All DSAAPD staff, focus group participants, and members of DSAAPD’s Governor’s Advisory Council will be notified of the public hearing. DSAAPD Functions The objectives presented in this plan address new initiatives for Title III and Title VII funds of the Older Americans’ Act which DSAAPD intends to pursue over the next four years. In addition, DSAAPD works on behalf of older persons and adults with physical disabilities in Delaware in a variety of other ways. The following is a summary of the major functions of the agency which may or may not be reflected in the objectives of the State Plan. DSAAPD: * issues and administers contracts for home and community based services for older persons and adults with physical disabilities; (Contracted services include adult day programs, adult foster care, Alzheimer's respite, assistive technology, attendant services, congregate meals, personal emergency response service, employment services, Hispanic outreach, home delivered meals, personal care services, home modification, legal services, respite care, and transportation); * advocates on behalf of older persons and adults with physical disabilities to create a broader awareness of the needs of these populations and to generate additional resources to meet these needs; * operates the Adult Protective Services Program which responds to cases of suspected abuse, neglect, or exploitation of impaired adults who are not living in a long term care facility like, a nursing home; * operates the Long Term Care Ombudsman Program which investigates and resolves complaints made by (or on behalf of) residents of long term care facilities such as, nursing homes; * operates the Community Services Program which offers a complete assessment of a person's physical, cognitive, social and emotional status in order to identify his/her needs. A care plan is developed with the individual and his/her family if possible, to provide a full range of appropriate services, utilizing all available funding sources; * operates the Delaware Medicare Fraud Patrol Program which provides public information to encourage people who have Medicare to carefully read their Medicare summary notices and ask questions if they do not think the information is correct. This program also trains people who are retired to help other Medicare beneficiaries get the information they need when they suspect fraud, waste, or abuse of the Medicare program; * operates the Delaware Money Management Program which offers money management service to help low-income seniors and adults with physical disabilities that have difficulty budgeting, paying routine bills and keeping track of financial matters; * manages the CARE (Caregiver Assistance-Respite-Education) Delaware Program to provide assistance for caregivers through needs assessment and care planning, organization of support groups and caregiver training, respite care, and community-based caregiver resource centers; * operates the Nursing Home Transition Program to assist nursing home residents, especially those who are Medicaid-eligible, to transition to the community; * encourages community service and mutual understanding between older and younger persons through the Joining Generations Program; * provides support to grandparent and relative caregivers through support groups; * develops and implements a variety of wellness and health promotion programs; * analyzes data, performs needs assessments, and develops and evaluates new services for older persons, adults with physical disabilities, and their families; * provides training to agency staff and staff in the aging and disabilities network on a range of topics related to the provision of services to older persons and adults with physical disabilities. These activities represent the core functions of the agency, and will continue to be carried out during the four years covered by this plan. GOALS AND OBJECTIVES GOALS AND OBJECTIVES Empower older people and their families to make informed decisions about, and be able to easily access, existing home and community-based options. * Establish an interagency task force to investigate and identify possible funding sources and to analyze various models to develop an Aging and Disability Resource Center for Delaware. * Develop a marketing plan to enhance public awareness of and access to DSAAPD services with specific emphasis on targeting populations most in need. * Develop guidelines for all DSAAPD public print, visual, audio and web- based media materials for customer usability, accessibility, cultural diversity and age and disability sensitivity. * Improve access to services through the establishment of a customer service unit within DSAAPD. * Develop training for DSAAPD staff and the aging network to improve cultural sensitivity. Enable seniors to remain in their own homes with high quality of life for as long as possible through the provision of home and community-based services, including supports for family caregivers. * Increase awareness in Delaware of “universal design” and other related options such as assistive technology that promote opportunities for aging in place. * Explore a streamlined approach to referral and assessment processes to ensure access to a comprehensive package of services. * Coordinate with Delaware employers to create working environments that support the needs of working caregivers. * Advocate for community based support and service coordination for older persons with mental illness and/or substance abuse problems. * Identify possible funding sources and community partnerships that will increase the number of individuals receiving home modification and assistive technology services. Empower older people to stay active and healthy through Older Americans Act services, including Evidence-Based Disease and Disability Prevention programs. * Coordinate with outside partners to develop a system to monitor, assess and report on the health status and key risk factors of older persons. * Participate in joint efforts with diverse organizations, stakeholders and consumers to identify priority areas and plan targeted strategies to improve the overall well-being of older Delawareans. * Work with state and community organizations to support plans and policies that ensure healthier, livable communities for all ages, particularly the elderly and those with disabilities. * Promote health literacy, prevention practices, and long-term care planning to improve health outcomes among older adults and empower them to make informed decisions about their health and long-term care options. Ensure the rights of older people and prevent their abuse, neglect and exploitation. * Coordinate with public and private advocacy and service organizations to encourage early estate planning among Delawareans to prevent financial exploitation later in life. * Establish partnerships with substance abuse agencies in Delaware to improve the state’s capacity for prevention and intervention of elder abuse cases in which substance abuse is a factor. * Expand materials available on the Division of Services for Aging and Adults with Physical Disabilities web site related to elder abuse, neglect and exploitation prevention and intervention. * Develop materials on elder abuse, neglect and exploitation detection and intervention strategies for use by physicians and other medical personnel in Delaware. * Coordinate with long term care facilities and advocacy groups in Delaware to incorporate staff training on respectful communication with residents. * Coordinate with the DHSS Public Information Officer and local media outlets to develop opportunities to highlight accomplishments of older persons in the State including those residing in long-term care facilities, as well as professionals who provide care. * Propose recommended changes to Delaware’s laws to strengthen the State’s response to cases of abuse, neglect or exploitation of vulnerable adults. Maintain effective and responsive management. * Conduct automated system planning initiatives to improve methods of data collection, storage and reporting; collect and track client data; manage caseload distribution; support program quality management; and track employee performance. * Develop an Emergency Preparedness Plan that supports safety and security for the elderly and ensures the continuity of DSAAPD’s operations during an emergency. * Oversee the development of baseline quality assurance measures for all DSAAPD programs and develop a quality assurance manual. * Research and make available information about the projected growth of the older population in Delaware. Participate in decision making and implementation efforts related to the Medicaid Long-Term Care reforms. * Strengthen a critical working relationship by meeting quarterly with the Division of Medicaid and Medical Assistance (DMMA) to discuss long-term care initiatives that impact Delaware’s older adults. * Continue to participate in the planning and implementation of Delaware’s Money Follows the Person Systems Change grant and the Medicaid Buy- In initiative. * Advocate for the needs of older Delawareans who choose to age in place and provide technical assistance to DMMA as Delaware develops additional home and community based services. Assist older Delawareans access information about the benefits available to them under the Medicare Modernization Act. * Maintain strong partnerships with Delaware’s Health Insurance Counseling Program, the Quality Improvement Organization, the Social Security Administration and the CMS regional office to educate Medicare beneficiaries about their benefits. * Expand the Senior Medicare Patrol Program, communicating updated Medicare information to beneficiaries by attending healthcares and community events, giving public presentations, disseminating a semi- annual newsletter, using print and broadcast media, and expanding the pool of volunteer participants. Improve the State’s capacity to respond to the needs of its older citizens in the event of an emergency. * Continue to coordinate with the Delaware Emergency Management Agency to exchange information related to emergency preparedness. * Develop plans to provide assistance to clients with special needs (for example, health and/or transportation needs) in the event of an emergency. * Update DSAAPD employee manual with information about emergency preparedness. * Develop protocols for alerting staff and clients of impending emergency situations. * Provide information to clients and staff about emergency preparedness. Serve as lead advocates for the needs of older persons in statewide transportation planning efforts. * Educate community partners about the correlation between access to transportation and independent community living. * Monitor projected growth of the older population in rural part of the state and communicate these data to transportation planning partners. Strengthen DSAAPD’s capacity for recruiting and retaining qualified volunteers. * Partner with sister agencies in expanding volunteer recruitment and retention efforts. * Streamline the process of volunteer recruitment, retention and recognition across the Division. * Expand efforts to recruit bilingual volunteers. * Develop a web-based volunteer application form for DSAAPD’s programs which utilize volunteers. * Provide volunteers with training on universal health precautions and other field safety issues. RESOURCE ALLOCATION PLAN STATE PROGRAM ALLOCATIONS BY PLANNING AND SERVICE AREA FOR FY'09 PLANNING AND SERVICE AREA TITLE III OTHER OAA NON-TITLE III TOTAL FUNDS SERVICE FUNDS FUNDS FUNDS AWARDED TITLE III-B 1,505,257 1,850,362 3,355,619 TITLE III-C-1 1,533,045 378,098 1,911,143 TITLE III-C-2 959,598 1,614,411 2,574,009 TITLE III-D 104,079 104,079 TITLE III-E 759,521 393,941 1,153,462 TITLE V 2,051,727 2,051,727 USDA 468,888 468,888 OMDUDSMAN ACTIVITY 77,106 77,106 ELDER ABUSE 25,028 25,028 STATE FUNDS RESPITE 130,305 130,305 PSA SUBTOTALS 4,861,500 OTHER TOTAL ALLOCATIONS 4,861,500 2,622,749 4,367,117 11,851,366 STATE AGENCY OPERATING BUDGET FOR FY'09 TOTAL RESOURCES TO BE USED FOR STATE AGENCY ADMINISTRATION TITLE III MATCH TO OTHER AGENCY TOTAL AGENCY TITLE III RESOURCES BUDGET TITLE III: STATE ADM. 500,000 500,000 TITLE III: (PART B) LONG-TERM CARE OMBUDSMAN 233,915 233,915 OTHER FEDERAL FUNDS 262,705 262,705 STATE 1,800,000 1,800,000 LOCAL PUBLIC OTHER TOTAL 733,915 1,800,000 262,705 2,796,620 DEMOGRAPHIC INFORMATION A PROFILE OF OLDER DELAWAREANS Selected Population Characteristics Year 2006 Estimates Number Percent Persons by Age 60-64 44,136 27.8% 65-74 60,623 38.2% 75-84 39,772 25.1% 85 and over 14,159 8.9% Total 60+ 158,690 100.0% Persons by Race (Age 65+) White 97,600 85.2% Black or African American 13,635 11.9% American Indian/Alaskan Native 368 .3% Asian 1,825 1.6% Hawaiian/Pacific Islander 17 .0% Other 461 .4% Two or More Races 798 .7% Persons of Hispanic or Latino Origin (Age 65+) Hispanic/Latino Origin 1,684 1.5% Poverty Status (Age 65+) At or Above Poverty Level 102,417 93.1% Below Poverty Level 7,607 6.9% Poverty Status for Selected Groups (Age 65+) White At or Above Poverty Level 88,176 94.4% Below Poverty Level 5,252 5.6% Black or African American At or Above Poverty Level 11,334 85.0% Below Poverty Level 2,004 15.0% Asian At or Above Poverty Level 1,526 83.6% Below Poverty Level 299 16.4% Hispanic or Latino At or Above Poverty Level 1,501 91.6% Below Poverty Level 137 8.3% Number Percent Marital Status (Age 65+) Males Now married 35,592 73.2% Never married, separated, widowed, divorced 13,064 26.9% Females Now married 28,795 43.7% Never married, separated, widowed, divorced 37,107 56.3% Persons Living Alone (Age 65+) Males 7,974 26.0% Females 22,663 74.0% Persons by Disability Status (Non- institutionalized Persons Aged 65+) One or more types of disabilities 42,723 38.8% No disabilities 67,301 61.2% Persons by Language Spoken at Home (Age 65+) English only 107,353 93.7% Spanish Speak English very well 746 .7% Speak English less than very well 1,139 1.0% Other Indo-European Language Speak English very well 2,793 2.4% Speak English less than very well 1,106 1.0% Asian/Pacific Island Language Speak English very well 535 .5% Speak English less than very well 668 .6% Other Languages Speak English very well 214 .2% Speak English less than very well 0 0% Grandparents Living with Grandchildren Under Age 18 Grandparents responsible for care of children 5,607 33.1% Grandparents not responsible for care of children 10,933 66.1% Sources: U.S. Census Bureau, 2006 American Community Survey; Administration on Aging (compilation of Census 2006 Estimates) A PROFILE OF PERSONS SERVED THROUGH TITLE III PROGRAMS STATE OF DELAWARE FISCAL YEAR 2006 Number of Persons (Unduplicated Count Percent Total Persons Served 23,848 100.0 Persons by Race and Hispanic Origin African American 5,946 24.9 American Indian/Native Alaskan 13 .1 Asian 170 .7 White 9,983 41.9 Other 67 .3 Hispanic 464 1.9 Minority Persons 6,203 26.0 Persons Living in Rural Areas 7,519 31.5 Persons Below the Poverty Level 3,990 16.7 Population Projections for Selected Age Groups for State of Delaware and Counties 2000 2005 2008 2010 2015 2020 2025 2030 Delaware Persons aged 60+ 136,329 155,389 172,157 183,287 212,798 247,523 280,044 299,614 % change* NA 14.0% 26.3% 34.4% 56.1% 81.6% 105.4% 119.8% Persons aged 75+ 46,275 54,734 59,889 62,462 68,320 77,860 93,331 110,036 % change* NA 18.3% 29.4% 35.0% 47.6% 68.3% 101.7% 137.8% Persons aged 85+ 10,775 14,084 16,767 18,597 21,964 24,339 26,323 30,896 % change* NA 30.7% 55.6% 72.6% 103.8% 125.9% 144.3% 186.7% New Castle Co. Persons aged 60+ 77,233 84,812 92,877 98,498 114,340 133,137 150,778 162,805 % change* NA 9.8% 20.3% 27.5% 48.0% 72.4% 95.2% 110.8% Persons aged 75+ 27,605 30,719 32,270 33,037 34,964 39,942 48,749 58,727 % change* NA 11.3% 16.9% 19.7% 26.7% 44.7% 76.6% 112.7% Persons aged 85+ 6,591 8,320 9,700 10,576 11,886 12,649 13,504 16,385 % change* NA 26.2% 47.2% 60.5% 80.3% 91.9% 104.9% 148.6% Kent Co. Persons aged 60+ 20,037 23,495 26,513 28,215 32,437 37,988 43,296 46,156 % change* NA 17.3% 32.3% 40.8% 61.9% 89.6% 116.1% 130.4% Persons aged 75+ 6,465 7,679 8,669 9,188 10,127 11,332 13,306 15,322 % change* NA 18.8% 34.1% 42.1% 56.6% 75.3% 105.8% 137.0% Persons aged 85+ 1,557 1,940 2,282 2,505 2,892 3,304 3,553 3,999 % change* NA 24.6% 46.6% 60.9% 85.7% 112.2% 128.2% 156.8% Sussex Co. Persons aged 60+ 39,059 47,082 52,767 56,574 66,021 76,398 85,970 90,653 % change* NA 20.5% 35.1% 44.8% 69.0% 95.6% 120.1% 132.1% Persons aged 75+ 12,205 16,336 18,950 20,237 23,229 26,586 31,276 35,987 % change* NA 33.8% 55.3% 65.8% 90.3% 117.8% 156.3% 194.9% Persons aged 85+ 2,627 3,824 4,785 5,516 7,186 8,386 9,266 10,512 % change* NA 45.6% 82.1% 110.0% 173.5% 219.2% 252.7% 300.2% *Percent change from the year 2000 Source: Delaware Population Consortium Annual Population Projections, October 23, 2007, Version 2007.0 ASSURANCES Listing of State Plan Assurances and Required Activities Older Americans Act, As Amended in 2006 By signing this document, the authorized official commits the State Agency on Aging to performing all listed assurances and required activities. ASSURANCES Sec. 305(a) - (c), ORGANIZATION (a)(2)(A) The State agency shall, except as provided in subsection (b)(5), designate for each such area (planning and service area) after consideration of the views offered by the unit or units of general purpose local government in such area, a public or private nonprofit agency or organization as the area agency on aging for such area. (a)(2)(B) The State agency shall provide assurances, satisfactory to the Assistant Secretary, that the State agency will take into account, in connection with matters of general policy arising in the development and administration of the State plan for any fiscal year, the views of recipients of supportive services or nutrition services, or individuals using multipurpose senior centers provided under such plan. (a)(2)(E) The State agency shall provide assurance that preference will be given to providing services to older individuals with greatest economic need and older individuals with greatest social need, (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas) and include proposed methods of carrying out the preference in the State plan; (a)(2)(F) The State agency shall provide assurances that the State agency will require use of outreach efforts described in section 307(a)(16). (a)(2)(G)(ii) The State agency shall provide an assurance that the State agency will undertake specific program development, advocacy, and outreach efforts focused on the needs of low-income minority older individuals and older individuals residing in rural areas. (c)(5) In the case of a State specified in subsection (b)(5), the State agency and area agencies shall provide assurance, determined adequate by the State agency, that the area agency on aging will have the ability to develop an area plan and to carry out, directly or through contractual or other arrangements, a program in accordance with the plan within the planning and service area. States must assure that the following assurances (Section 306) will be met by its designated area agencies on agencies, or by the State in the case of single planning and service area states. Sec. 306(a), AREA PLANS (2) Each area agency on aging shall provide assurances that an adequate proportion, as required under section 307(a)(2), of the amount allotted for part B to the planning and service area will be expended for the delivery of each of the following categories of services- (A) services associated with access to services (transportation, health services (including mental health services), outreach, information and assistance (which may include information and assistance to consumers on availability of services under part B and how to receive benefits under and participate in publicly supported programs for which the consumer may be eligible), and case management services); (B) in-home services, including supportive services for families of older individuals who are victims of Alzheimer's disease and related disorders with neurological and organic brain dysfunction; and (C) legal assistance; and assurances that the area agency on aging will report annually to the State agency in detail the amount of funds expended for each such category during the fiscal year most recently concluded. (4)(A)(i)(I) provide assurances that the area agency on aging will— (aa) set specific objectives, consistent with State policy, for providing services to older individuals with greatest economic need, older individuals with greatest social need, and older individuals at risk for institutional placement; (bb) include specific objectives for providing services to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas; and (II) include proposed methods to achieve the objectives described in items (aa) and (bb) of subclause (I); (ii) provide assurances that the area agency on aging will include in each agreement made with a provider of any service under this title, a requirement that such provider will— (I) specify how the provider intends to satisfy the service needs of low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas in the area served by the provider; (II) to the maximum extent feasible, provide services to low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas in accordance with their need for such services; and (III) meet specific objectives established by the area agency on aging, for providing services to low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas within the planning and service area; and (4)(A)(iii) With respect to the fiscal year preceding the fiscal year for which such plan is prepared, each area agency on aging shall-- (I) identify the number of low-income minority older individuals and older individuals residing in rural areas in the planning and service area; (II) describe the methods used to satisfy the service needs of such minority older individuals; and (III) provide information on the extent to which the area agency on aging met the objectives described in clause (a)(4)(A)(i). (4)(B)(i) Each area agency on aging shall provide assurances that the area agency on aging will use outreach efforts that will identify individuals eligible for assistance under this Act, with special emphasis on-- (I) older individuals residing in rural areas; (II) older individuals with greatest economic need (with particular attention to low- income minority individuals and older individuals residing in rural areas); (III) older individuals with greatest social need (with particular attention to low- income minority individuals and older individuals residing in rural areas); (IV) older individuals with severe disabilities; (V) older individuals with limited English proficiency; (VI) older individuals with Alzheimer’s disease and related disorders with neurological and organic brain dysfunction (and the caretakers of such individuals); and (VII) older individuals at risk for institutional placement; and (4)(C) Each area agency on agency shall provide assurance that the area agency on aging will ensure that each activity undertaken by the agency, including planning, advocacy, and systems development, will include a focus on the needs of low-income minority older individuals and older individuals residing in rural areas. (5) Each area agency on aging shall provide assurances that the area agency on aging will coordinate planning, identification, assessment of needs, and provision of services for older individuals with disabilities, with particular attention to individuals with severe disabilities, and individuals at risk for institutional placement, with agencies that develop or provide services for individuals with disabilities. (6)(F) Each area agency will: in coordination with the State agency and with the State agency responsible for mental health services, increase public awareness of mental health disorders, remove barriers to diagnosis and treatment, and coordinate mental health services (including mental health screenings) provided with funds expended by the area agency on aging with mental health services provided by community health centers and by other public agencies and nonprofit private organizations; (9) Each area agency on aging shall provide assurances that the area agency on aging, in carrying out the State Long-Term Care Ombudsman program under section 307(a)(9), will expend not less than the total amount of funds appropriated under this Act and expended by the agency in fiscal year 2000 in carrying out such a program under this title. (11) Each area agency on aging shall provide information and assurances concerning services to older individuals who are Native Americans (referred to in this paragraph as "older Native Americans"), including- (A) information concerning whether there is a significant population of older Native Americans in the planning and service area and if so, an assurance that the area agency on aging will pursue activities, including outreach, to increase access of those older Native Americans to programs and benefits provided under this title; (B) an assurance that the area agency on aging will, to the maximum extent practicable, coordinate the services the agency provides under this title with services provided under title VI; and (C) an assurance that the area agency on aging will make services under the area plan available, to the same extent as such services are available to older individuals within the planning and service area, to older Native Americans. (13)(A) Each area agency on aging shall provide assurances that the area agency on aging will maintain the integrity and public purpose of services provided, and service providers, under this title in all contractual and commercial relationships. (13)(B) Each area agency on aging shall provide assurances that the area agency on aging will disclose to the Assistant Secretary and the State agency-- (i) the identity of each nongovernmental entity with which such agency has a contract or commercial relationship relating to providing any service to older individuals; and (ii) the nature of such contract or such relationship. (13)(C) Each area agency on aging shall provide assurances that the area agency will demonstrate that a loss or diminution in the quantity or quality of the services provided, or to be provided, under this title by such agency has not resulted and will not result from such non-governmental contracts or such commercial relationships. (13)(D) Each area agency on aging shall provide assurances that the area agency will demonstrate that the quantity or quality of the services to be provided under this title by such agency will be enhanced as a result of such non-governmental contracts or commercial relationships. (13)(E) Each area agency on aging shall provide assurances that the area agency will, on the request of the Assistant Secretary or the State, for the purpose of monitoring compliance with this Act (including conducting an audit), disclose all sources and expenditures of funds such agency receives or expends to provide services to older individuals. (14) Each area agency on aging shall provide assurances that funds received under this title will not be used to pay any part of a cost (including an administrative cost) incurred by the area agency on aging to carry out a contract or commercial relationship that is not carried out to implement this title. (15) provide assurances that funds received under this title will be used- (A) to provide benefits and services to older individuals, giving priority to older individuals identified in paragraph (4)(A)(i); and (B) in compliance with the assurances specified in paragraph (13) and the limitations specified in section 212; Sec. 307, STATE PLANS (7)(A) The plan shall provide satisfactory assurance that such fiscal control and fund accounting procedures will be adopted as may be necessary to assure proper disbursement of, and accounting for, Federal funds paid under this title to the State, including any such funds paid to the recipients of a grant or contract. (7)(B) The plan shall provide assurances that-- (i) no individual (appointed or otherwise) involved in the designation of the State agency or an area agency on aging, or in the designation of the head of any subdivision of the State agency or of an area agency on aging, is subject to a conflict of interest prohibited under this Act; (ii) no officer, employee, or other representative of the State agency or an area agency on aging is subject to a conflict of interest prohibited under this Act; and (iii) mechanisms are in place to identify and remove conflicts of interest prohibited under this Act. (9) The plan shall provide assurances that the State agency will carry out, through the Office of the State Long-Term Care Ombudsman, a State Long-Term Care Ombudsman program in accordance with section 712 and this title, and will expend for such purpose an amount that is not less than an amount expended by the State agency with funds received under this title for fiscal year 2000, and an amount that is not less than the amount expended by the State agency with funds received under title VII for fiscal year 2000. (10) The plan shall provide assurance that the special needs of older individuals residing in rural areas will be taken into consideration and shall describe how those needs have been met and describe how funds have been allocated to meet those needs. (11)(A) The plan shall provide assurances that area agencies on aging will-- (i) enter into contracts with providers of legal assistance which can demonstrate the experience or capacity to deliver legal assistance; (ii) include in any such contract provisions to assure that any recipient of funds under division (A) will be subject to specific restrictions and regulations promulgated under the Legal Services Corporation Act (other than restrictions and regulations governing eligibility for legal assistance under such Act and governing membership of local governing boards) as determined appropriate by the Assistant Secretary; and (iii) attempt to involve the private bar in legal assistance activities authorized under this title, including groups within the private bar furnishing services to older individuals on a pro bono and reduced fee basis. (11)(B) The plan contains assurances that no legal assistance will be furnished unless the grantee administers a program designed to provide legal assistance to older individuals with social or economic need and has agreed, if the grantee is not a Legal Services Corporation project grantee, to coordinate its services with existing Legal Services Corporation projects in the planning and service area in order to concentrate the use of funds provided under this title on individuals with the greatest such need; and the area agency on aging makes a finding, after assessment, pursuant to standards for service promulgated by the Assistant Secretary, that any grantee selected is the entity best able to provide the particular services. (11)(D) The plan contains assurances, to the extent practicable, that legal assistance furnished under the plan will be in addition to any legal assistance for older individuals being furnished with funds from sources other than this Act and that reasonable efforts will be made to maintain existing levels of legal assistance for older individuals; (11)(E) The plan contains assurances that area agencies on aging will give priority to legal assistance related to income, health care, long-term care, nutrition, housing, utilities, protective services, defense of guardianship, abuse, neglect, and age discrimination. (12) The plan shall provide, whenever the State desires to provide for a fiscal year for services for the prevention of abuse of older individuals, the plan contains assurances that any area agency on aging carrying out such services will conduct a program consistent with relevant State law and coordinated with existing State adult protective service activities for-- (A) public education to identify and prevent abuse of older individuals; (B) receipt of reports of abuse of older individuals; (C) active participation of older individuals participating in programs under this Act through outreach, conferences, and referral of such individuals to other social service agencies or sources of assistance where appropriate and consented to by the parties to be referred; and (D) referral of complaints to law enforcement or public protective service agencies where appropriate. (13) The plan shall provide assurances that each State will assign personnel (one of whom shall be known as a legal assistance developer) to provide State leadership in developing legal assistance programs for older individuals throughout the State. (14) The plan shall, with respect to the fiscal year preceding the fiscal year for which such plan is prepared— (A) identify the number of low-income minority older individuals in the State, including the number of low income minority older individuals with limited English proficiency; and (B) describe the methods used to satisfy the service needs of the low-income minority older individuals described in subparagraph (A), including the plan to meet the needs of low-income minority older individuals with limited English proficiency. (15) The plan shall provide assurances that, if a substantial number of the older individuals residing in any planning and service area in the State are of limited English-speaking ability, then the State will require the area agency on aging for each such planning and service area— (A) to utilize in the delivery of outreach services under section 306(a)(2)(A), the services of workers who are fluent in the language spoken by a predominant number of such older individuals who are of limited English-speaking ability; and (B) to designate an individual employed by the area agency on aging, or available to such area agency on aging on a full-time basis, whose responsibilities will include-- (i) taking such action as may be appropriate to assure that counseling assistance is made available to such older individuals who are of limited English-speaking ability in order to assist such older individuals in participating in programs and receiving assistance under this Act; and (ii) providing guidance to individuals engaged in the delivery of supportive services under the area plan involved to enable such individuals to be aware of cultural sensitivities and to take into account effectively linguistic and cultural differences. (16) The plan shall provide assurances that the State agency will require outreach efforts that will— (A) identify individuals eligible for assistance under this Act, with special emphasis on— (i) older individuals residing in rural areas; (ii) older individuals with greatest economic need (with particular attention to low- income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas; (iii) older individuals with greatest social need (with particular attention to low- income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas; (iv) older individuals with severe disabilities; (v) older individuals with limited English-speaking ability; and (vi) older individuals with Alzheimer’s disease and related disorders with neurological and organic brain dysfunction (and the caretakers of such individuals); and (B) inform the older individuals referred to in clauses (i) through (vi) of subparagraph (A), and the caretakers of such individuals, of the availability of such assistance. (17) The plan shall provide, with respect to the needs of older individuals with severe disabilities, assurances that the State will coordinate planning, identification, assessment of needs, and service for older individuals with disabilities with particular attention to individuals with severe disabilities with the State agencies with primary responsibility for individuals with disabilities, including severe disabilities, to enhance services and develop collaborative programs, where appropriate, to meet the needs of older individuals with disabilities. (18) The plan shall provide assurances that area agencies on aging will conduct efforts to facilitate the coordination of community-based, long-term care services, pursuant to section 306(a)(7), for older individuals who-- (A) reside at home and are at risk of institutionalization because of limitations on their ability to function independently; (B) are patients in hospitals and are at risk of prolonged institutionalization; or (C) are patients in long-term care facilities, but who can return to their homes if community-based services are provided to them. (19) The plan shall include the assurances and description required by section 705(a). (20) The plan shall provide assurances that special efforts will be made to provide technical assistance to minority providers of services. (21) The plan shall (A) provide an assurance that the State agency will coordinate programs under this title and programs under title VI, if applicable; and (B) provide an assurance that the State agency will pursue activities to increase access by older individuals who are Native Americans to all aging programs and benefits provided by the agency, including programs and benefits provided under this title, if applicable, and specify the ways in which the State agency intends to implement the activities. (22) If case management services are offered to provide access to supportive services, the plan shall provide that the State agency shall ensure compliance with the requirements specified in section 306(a)(8). (23) The plan shall provide assurances that demonstrable efforts will be made-- (A) to coordinate services provided under this Act with other State services that benefit older individuals; and (B) to provide multigenerational activities, such as opportunities for older individuals to serve as mentors or advisers in child care, youth day care, educational assistance, at-risk youth intervention, juvenile delinquency treatment, and family support programs. (24) The plan shall provide assurances that the State will coordinate public services within the State to assist older individuals to obtain transportation services associated with access to services provided under this title, to services under title VI, to comprehensive counseling services, and to legal assistance. (25) The plan shall include assurances that the State has in effect a mechanism to provide for quality in the provision of in-home services under this title. (26) The plan shall provide assurances that funds received under this title will not be used to pay any part of a cost (including an administrative cost) incurred by the State agency or an area agency on aging to carry out a contract or commercial relationship that is not carried out to implement this title. (27) The plan shall provide assurances that area agencies on aging will provide, to the extent feasible, for the furnishing of services under this Act, consistent with self-directed care. Sec. 308, PLANNING, COORDINATION, EVALUATION, AND ADMINISTRATION OF STATE PLANS (b)(3)(E) No application by a State under subparagraph (b)(3)(A) shall be approved unless it contains assurances that no amounts received by the State under this paragraph will be used to hire any individual to fill a job opening created by the action of the State in laying off or terminating the employment of any regular employee not supported under this Act in anticipation of filling the vacancy so created by hiring an employee to be supported through use of amounts received under this paragraph. Sec. 705, ADDITIONAL STATE PLAN REQUIREMENTS (as numbered in statute) (1) The State plan shall provide an assurance that the State, in carrying out any chapter of this subtitle for which the State receives funding under this subtitle, will establish programs in accordance with the requirements of the chapter and this chapter. (2) The State plan shall provide an assurance that the State will hold public hearings, and use other means, to obtain the views of older individuals, area agencies on aging, recipients of grants under title VI, and other interested persons and entities regarding programs carried out under this subtitle. (3) The State plan shall provide an assurance that the State, in consultation with area agencies on aging, will identify and prioritize statewide activities aimed at ensuring that older individuals have access to, and assistance in securing and maintaining, benefits and rights. (4) The State plan shall provide an assurance that the State will use funds made available under this subtitle for a chapter in addition to, and will not supplant, any funds that are expended under any Federal or State law in existence on the day before the date of the enactment of this subtitle, to carry out each of the vulnerable elder rights protection activities described in the chapter. (5) The State plan shall provide an assurance that the State will place no restrictions, other than the requirements referred to in clauses (i) through (iv) of section 712(a)(5)(C), on the eligibility of entities for designation as local Ombudsman entities under section 712(a)(5). (6) The State plan shall provide an assurance that, with respect to programs for the prevention of elder abuse, neglect, and exploitation under chapter 3— (A) in carrying out such programs the State agency will conduct a program of services consistent with relevant State law and coordinated with existing State adult protective service activities for-- (i) public education to identify and prevent elder abuse; (ii) receipt of reports of elder abuse; (iii) active participation of older individuals participating in programs under this Act through outreach, conferences, and referral of such individuals to other social service agencies or sources of assistance if appropriate and if the individuals to be referred consent; and (iv) referral of complaints to law enforcement or public protective service agencies if appropriate; (B) the State will not permit involuntary or coerced participation in the program of services described in subparagraph (A) by alleged victims, abusers, or their households; and (C) all information gathered in the course of receiving reports and making referrals shall remain confidential except-- (i) if all parties to such complaint consent in writing to the release of such information; (ii) if the release of such information is to a law enforcement agency, public protective service agency, licensing or certification agency, ombudsman program, or protection or advocacy system; or (iii) upon court order. REQUIRED ACTIVITIES Sec. 307(a) STATE PLANS (1)(A)The State Agency requires each area agency on aging designated under section 305(a)(2)(A) to develop and submit to the State agency for approval, in accordance with a uniform format developed by the State agency, an area plan meeting the requirements of section 306; and (B) The State plan is based on such area plans. Note: THIS SUBSECTION OF STATUTE DOES NOT REQUIRE THAT AREA PLANS BE DEVELOPED PRIOR TO STATE PLANS AND/OR THAT STATE PLANS DEVELOP AS A COMPILATION OF AREA PLANS. (2) The State agency: (A) evaluates, using uniform procedures described in section 202(a)(26), the need for supportive services (including legal assistance pursuant to 307(a)(11), information and assistance, and transportation services), nutrition services, and multipurpose senior centers within the State; (B) has developed a standardized process to determine the extent to which public or private programs and resources (including Department of Labor Senior Community Service Employment Program participants, and programs and services of voluntary organizations) have the capacity and actually meet such need; (4) The plan shall provide that the State agency will conduct periodic evaluations of, and public hearings on, activities and projects carried out in the State under this title and title VII, including evaluations of the effectiveness of services provided to individuals with greatest economic need, greatest social need, or disabilities (with particular attention to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas). Note: “Periodic” (defined in 45CFR Part 1321.3) means, at a minimum, once each fiscal year. (5) The State agency: (A) affords an opportunity for a public hearing upon request, in accordance with published procedures, to any area agency on aging submitting a plan under this title, to any provider of (or applicant to provide) services; (B) issues guidelines applicable to grievance procedures required by section 306(a)(10); and (C) affords an opportunity for a public hearing, upon request, by an area agency on aging, by a provider of (or applicant to provide) services, or by any recipient of services under this title regarding any waiver request, including those under Section 316. (6) The State agency will make such reports, in such form, and containing such information, as the Assistant Secretary may require, and comply with such requirements as the Assistant Secretary may impose to insure the correctness of such reports. (8)(A) No supportive services, nutrition services, or in-home services are directly provided by the State agency or an area agency on aging in the State, unless, in the judgment of the State agency-- (i) provision of such services by the State agency or the area agency on aging is necessary to assure an adequate supply of such services; (ii) such services are directly related to such State agency's or area agency on aging's administrative functions; or (iii) such services can be provided more economically, and with comparable quality, by such State agency or area agency on aging. _________________________________________ ____________________ Signature and Title of Authorized Official Date STATE PLAN PROVISIONS AND INFORMATION REQUIREMENTS STATE PLAN PROVISIONS AND INFORMATION REQUIREMENTS 102(30)(G) – formerly 102(19)g The term “in-home services” includes other in-home services as defined by the State agency in the State plan submitted in accordance with Sec. 307. Delaware funds the following in-home services with Title III funds: Housekeeping; Personal Care; Respite Care; and Personal Emergency Response System. Each of these services is described briefly below: Housekeeping: Housekeeping is an in-home service for frail older persons. The service allows them to live in their own homes as long as possible. Specific housekeeping services include assistance with shopping, meal preparation, light housekeeping, and laundry. All services are provided by trained housekeepers. Personal Care: Personal care services are provided for persons who need help at home because of illness or disability. The services are designed to help a person maintain his or her household and continue living independently. Specific activities may include assistance with personal hygiene (for example, bathing or shaving), meal preparation, shopping, light housekeeping, and other services. Respite Care: Respite care is a program that provides relief to primary caregivers, such as family members, who give care to someone in need. Respite care can be regularly scheduled (for example, once a week) or can be given from time-to-time, as needed by the family. Respite care can be provided at home or in a state-approved long-term care facility. Personal Emergency Response System: A personal emergency response system is a device that allows a person at high risk (for example an older person who lives alone and has a health problem) to get immediate help in the event of an emergency. The person who is using the system wears a button that he or she can push if needed. The button connects electronically to the person's phone, which is programmed to send a signal to a response center. Trained professionals in the response center then carry out a series of actions to help the person in need. Section 305(a)(2)(E) The State agency shall provide assurance that preference will be given to providing services to older individuals with greatest economic need and older individuals with greatest social need (with particular attention to low- income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas) and include proposed methods of carrying out the preference in the State plan; The Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) assures that such preference will be given, as required. Efforts to carry out this provision are as follows: * Efforts will be made to maintain Spanish-speaking staff for statewide bilingual service coverage. * Spanish language publications will be developed and made available in print and on the internet * Relationships with national and state minority organizations will be maintained. * Outreach activities will target communities and populations in greatest need. * Services, such as congregate meals, will continue to be made available in areas which are accessible to persons in greatest need. * DSAAPD will continue to provide a full range of services through the agency office in Southern Delaware, as well as through contractors located in rural areas of the State. Section 306(a)(17) Area plans shall include information detailing how the area agency on aging will coordinate activities, and develop long-range emergency preparedness plans, with local and State emergency response agencies, relief organizations, local and State governments, and any other institutions that have responsibility for disaster relief service delivery. Delaware is a single planning and service area. State agency plans for emergency preparedness are described in section 307(a)29 below. Section 307(a) (2) The plan shall provide that the State agency will: (C) Specify a minimum proportion of the funds received by each area agency on aging in the State to carry out part B that will be expended (in the absence of a waiver under sections 306(b) or 316) by such area agency on aging to provide each of the categories of services specified in section 306(a)(2) (Note: those categories are access, in-home, and legal assistance). Delaware is a Single Planning and Service Area (PSA), and therefore, does not allocate funds to area agencies on aging. Section 307(a)(3) The plan shall: (A) include (and may not be approved unless the Assistant Secretary approves) the statement and demonstration required by paragraphs (2) and (4) of section 305(d) (concerning distribution of funds); (Note: the “statement and demonstration” are the numerical statement of the intrastate funding formula, and a demonstration of the allocation of funds to each planning and service area) Delaware is a Single PSA and does not allocate funds to area agencies on aging. (B) with respect to services for older individuals residing in rural areas: (i) provide assurances the State agency will spend for each fiscal year of the plan, not less than the amount expended for such services for fiscal year 2000. (ii) identify, for each fiscal year to which the plan applies, the projected costs of providing such services (including the cost of providing access to such services). (iii) describe the methods used to meet the needs for such services in the fiscal year preceding the first year to which such plan applies. Funds expended to serve older persons in rural areas in each fiscal year in this plan will not be less than those expended for fiscal year 2000. There are no actual or projected additional costs of providing services under this title to older persons in rural Delaware. Because of the very small geographic size of the State, contract rates generally do not differ by region, and differences in urban/rural travel costs are minimal. For the fiscal year preceding the ones in which this plan applies, many outreach activities were used to reach older persons in rural areas. Such outreach activities included the presentation of information in local broadcast media, community newspapers, etc., as well as the distribution of information through local gatherings (e.g., health fairs and other senior events). DSAAPD maintained a statewide toll-free phone number for information and access to services, as well as a web site and e-mail address. In addition, DSAAPD maintained an office in southern Delaware, a predominantly rural area of the State. Section 307(a)(8) (B) Regarding case management services, if the State agency or area agency on aging is already providing case management services (as of the date of submission of the plan) under a State program, the plan may specify that such agency is allowed to continue to provide case management services. DSAAPD, as a State agency, provides case management services on an ongoing basis as part of its Community Services Program as well as Adult Protective Services Program. This service provision will continue during the State Plan period. (C) The plan may specify that an area agency on aging is allowed to directly provide information and assistance services and outreach. Delaware is a Single PSA. Information & assistance activities as well as outreach activities are carried out by the State agency. Section 307(a)(10) The plan shall provide assurance that the special needs of older individuals residing in rural areas are taken into consideration and shall describe how those needs have been met and describe how funds have been allocated to meet those needs. Delaware assures that the special needs of older individuals residing in rural areas are taken into consideration in the planning and provision of services. DSAAPD allocates resources such that services are provided throughout the state, in rural as well as urban areas. Agency staff who provide services are located in both rural and urban areas. Contractor selection also ensures that provision of service covers all geographic areas of the State. As noted above, because of the size of the state, resources can be distributed to all geographic areas without additional cost. Section 307(a)(14) The plan shall, with respect to the fiscal year preceding the fiscal year for which such plan is prepared-- (A) identify the number of low-income minority older individuals in the State, including the number of low income minority older individuals with limited English proficiency; and Please refer to population figures presented in the demographic section of this plan for data on race, Hispanic origin, poverty status, and language proficiency. Additionally note that in 2006, an estimated 10.7% of all Delawareans lived below the poverty level. Poverty rates were significantly higher for those persons who spoke a language other than English at home (16.3%) and especially for those persons who spoke Spanish (23.7%). (B) describe the methods used to satisfy the service needs of the low- income minority older individuals described in subparagraph (A), including the plan to meet the needs of low-income minority older individuals with limited English proficiency. * DSAAPD has maintained a Spanish language section in its agency web site (www.dhss.delaware.gov/dsaapd) and has made many of its publications, including the Guide to Services for Older Delawareans, available in Spanish. * DSAAPD has contracted with the Latin American Community Center to provide Hispanic Outreach services and to provide congregate meals which feature Spanish cooking. * Many outreach activities were used to reach low-income minority older individuals. Such outreach activities included the presentation of information on billboards, local broadcast media, and community newspapers, etc., as well as the distribution of information through local gatherings (e.g., health fairs and other senior events). Section 307(a)(21) The plan shall: (B) provide an assurance that the State agency will pursue activities to increase access by older individuals who are Native Americans to all aging programs and benefits provided by the agency, including programs and benefits provided under this title (title III), if applicable, and specify the ways in which the State agency intends to implement the activities . The 2000 Census indicates that .3 % of all Delawareans reported themselves to be Native American. Approximately half of Delaware’s Native Americans live in Sussex County. The Division of Services for Aging and Adults with Physical Disabilities assures that it will continue to outreach to Native Americans through local programs (e.g., senior centers and nutrition sites) and will include Native Americans in minority targeting initiatives. Section 307(a)(28) (A) The plan shall include, at the election of the State, an assessment of how prepared the State is, under the State’s statewide service delivery model, for any anticipated change in the number of older individuals during the 10 year period following the fiscal year for which the plan is submitted. (B) Such assessment may include- (i) the projected change in the number of older individuals in the State; (ii) an analysis of how such change may affect such individuals, including individuals with low incomes, individuals with greatest economic need, minority older individuals, older individuals residing in rural areas, and older individuals with limited English proficiency. (ii) an analysis of how the programs, policies, and services provided by the State can be improved, including coordinating with area agencies on aging, and how resource levels can be adjusted to meet the needs of the changing population of older individuals in the State; and (iv) an analysis of how the change in the number of individuals age 85 and older in the State is expected to affect the need for supportive services. DSAAPD conducts ongoing assessments of projected increases in the number of older individuals in Delaware based on demographic data provided by the Delaware Population Consortium and other sources. These data indicate that the in-migration of retirees from other states, especially in Delaware’s southernmost county, magnifies the anticipated expansion in the older population associated with the aging of the baby boom generation. Of special concern is the expected increase in the number of persons age 85 and older. The exponential growth in this population sub-group, sometimes referred to as the “oldest old” is expected to significantly impact the amount, type and range of services needed over the next decade. A summary of the current population projections for the older population in Delaware is presented in the demographic section of this plan. Over the next several years, DSAAPD expects to carry out comprehensive strategic planning initiatives to address how the State can best use its resources to meet the needs of the growing population of older persons. Section 307(a)(29) The plan shall include information detailing how the State will coordinate activities, and develop long range emergency preparedness plans, with area agencies on aging, local emergency response agencies, relief organizations, local governments, State agencies responsible for emergency preparedness, and any other institutions that have responsibility for disaster relief service delivery. DSAAPD works closely with other State agencies on emergency planning activities, including the Delaware Emergency Management Agency, which is charged with developing comprehensive emergency preparedness plans. As described in the objectives section of this plan, DSAAPD will carry out a number of specific activities, including: coordinating with the Delaware Emergency Management Agency to exchange information related to emergency preparedness; providing information to clients and staff about emergency preparedness; developing plans to provide assistance to clients with special needs (for example, health and/or transportation needs) in the event of an emergency; develop protocols for alerting staff and clients of impending emergency situations; and updating the DSAAPD employee manual with information about emergency preparedness. In addition, DSAAPD will continue to register all new clients in the State’s 911 emergency system to assure that their special needs will be known to emergency personnel when responding to an emergency. Section (a) (30) The plan shall include information describing the involvement of the head of the State agency in the development, revision, and implementation of emergency preparedness plans, including the State Public Health Emergency Preparedness and Response Plan DSAAPD’s Director is closely involved with the State’s emergency preparedness planning and has attended Continuity of Operations (COOP) training with several designated agency staff. The Director will continue to play an active role in the planning process, receiving regular updates on planning activities. The Director will also review and comment on all emergency preparedness and/or response plans and implementation strategies as they relate to the older population in Delaware. Section 705(a)(7) In order to be eligible to receive an allotment under this subtitle, a State shall include in the State plan submitted under section 307: (7) a description of the manner in which the State agency will carry out this title in accordance with the assurances described in paragraphs (1) through (6). (Note: Paragraphs (1) of through (6) of this section are listed below) In order to be eligible to receive an allotment under this subtitle, a State shall include in the State plan submitted under section 307: (1) an assurance that the State, in carrying out any chapter of this subtitle for which the State receives funding under this subtitle, will establish programs in accordance with the requirements of the chapter and this chapter; The State of Delaware has established programs and services in accordance with this chapter. Some of the services are provided under contract by vendor agencies and others are operated directly by DSAAPD. A full list of services provided within Delaware, including program description, eligibility criteria, and contact information can be found on the agency’s web site, www.dhss.delaware.gov/dsaapd. (2) an assurance that the State will hold public hearings, and use other means, to obtain the views of older individuals, area agencies on aging, recipients of grants under title VI, and other interested persons and entities regarding programs carried out under this subtitle; In developing this plan, and for other planning purposes, DSAAPD gathers information from outside entities to gauge opinions, measure need, and explore service options. As described in the introduction of this plan, a series of focus groups on a variety of topics was held to gather input in preparation for the development of State Plan goals and objectives. (3) an assurance that the State, in consultation with area agencies on aging, will identify and prioritize statewide activities aimed at ensuring that older individuals have access to, and assistance in securing and maintaining, benefits and rights; The State assures that it will identify and prioritize statewide activities related to securing and maintaining benefits and rights, as described above. Specific activities include: * The provision of information and assistance services statewide * The provision of case management services, both through the Adult Protective Services Program and the Community Services Program * The operation of the Long Term Care Ombudsman Program * Coordination with outside agencies, such as the Attorney General’s office and the Insurance Department to ensure the protection of rights * Coordination with organizations such as the Division of Social Services and the Social Security Administration to maintain current information on available benefits (4) an assurance that the State will use funds made available under this subtitle for a chapter in addition to, and will not supplant, any funds that are expended under any Federal or State law in existence on the day before the date of the enactment of this subtitle, to carry out each of the vulnerable elder rights protection activities described in the chapter; Delaware assures that it will continue to use funds, as described above, to carry out elder rights protection activities. Each of these elder rights protection activities is described briefly below: * The Long-Term Care Ombudsman Program is operated directly by the DSAAPD. The Ombudsman Program responds to complaints; advocates for residents; and provides training in long-term care facilities. * Adult Protective Services (APS) assists impaired adults who are subject to abuse, neglect and/or exploitation. APS workers receive and investigate reports of abuse and neglect and provide social service intervention as necessary. * The Community Services Program (CSP) provides a range of services including information and assistance; advocacy; service authorization; and case coordination * DSAAPD contracts with Community Legal Aid Society, Inc. to operate the Elder Law Program. * DSAAPD coordinates with other organizations (such as the Division of Long Term Care Residents Protection, police organizations, the Department of Justice, and others) to promote elder rights protection. (5) an assurance that the State will place no restrictions, other than the requirements referred to in clauses (i) through (iv) of section 712(a)(5)(C), on the eligibility of entities for designation as local Ombudsman entities under section 712(a)(5); Delaware assures that it will operate within the guidelines outlined above with regard to the designation of local Ombudsman entities. Delaware has a single, statewide Ombudsman entity. (6) an assurance that, with respect to programs for the prevention of elder abuse, neglect, and exploitation under chapter 3— (A) in carrying out such programs the State agency will conduct a program of services consistent with relevant State law and coordinated with existing State adult protective service activities for: (i) public education to identify and prevent elder abuse; (ii) receipt of reports of elder abuse; (iii) active participation of older individuals participating in programs under this Act through outreach, conferences, and referral of such individuals to other social service agencies or sources of assistance if appropriate and if the individuals to be referred consent; and (iv) referral of complaints to law enforcement or public protective service agencies if appropriate; (B) the State will not permit involuntary or coerced participation in the program of services described in subparagraph (A) by alleged victims, abusers, or their households; and (C) all information gathered in the course of receiving reports and making referrals shall remain confidential except-- (i) if all parties to such complaint consent in writing to the release of such information; (ii) if the release of such information is to a law enforcement agency, public protective service agency, licensing or certification agency, ombudsman program, or protection or advocacy system; or (iii) upon court order. Delaware assures that it will continue to operate the Adult Protective Services (APS) Program in accordance with all of the provisions detailed above. The APS program in Delaware is operated directly by DSAAPD staff. The program complies with all provisions of the Older Americans Act with regard to elder abuse prevention as well as relevant State laws and regulations. Appropriate outreach, information, and referral activities occur as part of the ongoing operation of the program. APS staff work in close coordination with outside agencies (e.g., law enforcement agencies) in carrying out elder abuse protection activities. Client information collected in the process of complaint investigation remains confidential, and is shared with outside entities, such as law enforcement entities, only as required and only in keeping with professional guidelines, as described above. APPENDICES MISSION STATEMENTS DEPARTMENT OF HEALTH AND SOCIAL SERVICES To improve the quality of life for Delaware's citizens by promoting health and well-being, fostering self- sufficiency, and protecting vulnerable populations. DIVISION OF SERVICES FOR AGING AND ADULTS WITH PHYSICAL DISABILITIES To improve or maintain the quality of life for Delawareans who are at least 18 years of age with physical disabilities or who are elderly. The Division is committed to the development and delivery of consumer-driven services which maximize independence through individual choice, enable individuals to continue living active and productive lives and protect those who may be vulnerable and at risk. DELAWARE HEALTH AND SOCIAL SERVICES Division of Services for Aging and Adults with Physical Disabilities VISION STATEMENTS DEPARTMENT OF HEALTH AND SOCIAL SERVICES Together we provide quality services as we create a better future for the people of Delaware. DIVISION OF SERVICES FOR AGING AND ADULTS WITH PHYSICAL DISABILITIES As we move into the future, Delaware Health and Social Services' Division of Services for Aging and Adults with Physical Disabilities will continue to focus on our core mission, and at the same time, plan for meeting the challenges that lie ahead. We must prepare to serve succeeding generations of diverse populations, whose needs may require uniquely different strategies and resources. We will focus on innovative approaches to advocacy, education, partnering, service delivery and technology. These approaches will enhance our capacity to: support customers and their caregivers; encourage healthy lifestyles; teach skills necessary for making informed life choices; facilitate greater community integration and participation; promote self-determination; and foster independence. DELAWARE HEALTH AND SOCIAL SERVICES Division of Services for Aging and Adults with Physical Disabilities Governor’s Advisory Council on Services for Aging and Adults with Physical Disabilities Esther Brennan Azalia Briggs Bobby Brown C. Regina Byers (Chair) Katherine Cowperthwait Julia Gause Elsie Hawthorne Evelyn Hayes Bonnie Hitch Edward Larrivee Karen Lloyd (Co-Chair) LaVaida Owens-White Patricia Painter William Payne Lelia Perkins Gloria Price Mary Ann Teller DIVISION OF SERVICES FOR AGING AND ADULTS WITH PHYSICAL DISBILITIES (DSAAPD) CONTACT INFORMATION General Contact Information Division of Services for Aging and Adults with Physical Disabilities Herman M. Holloway, Sr. Campus Main Administration Building 1901 N. DuPont Highway New Castle, DE 19720 Phone: 1-800-223-9074 TTY: (302) 453-3837 FAX (302) 255-4445 E-mail: DSAAPDinfo@state.de.us Web: www.dhss.delaware.gov/dsaapd New Castle County: New Castle Office Herman M. Holloway, Sr. Campus Main Administration Building, First Floor Annex 1901 N. DuPont Highway New Castle, DE 19720 Phone: (302) 255-9390 or 1-800-223-9074 Fax: (302) 255-4445 New Castle County: Newark Office University Plaza 256 Chapman Road Oxford Building, Suite 200 Newark, DE 19702 Phone: (302) 453-3820 or 1-800-223-9074 Fax: (302) 453-3836 TTY: (302) 453-3837 Kent/Sussex Counties: Milford Office Milford State Service Center 18 N. Walnut St., First Floor Milford, DE 19963 Phone: (302) 424-7310 or 1-800-223-9074 Fax: (302) 422-1346 TTY: (302) 422-1415