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CUMBERLAND COUNTYAGING &COMMUNITYSERVICES DRAFT STRATEGICACTION PLAN FY2012-2016

1

TABLE OF CONTENTS

PART A

.................................................................................................................... 2

........................................................................................................................ 5

AGENCYMISSION........................................................................................................................................... 5

ORGANIZATIONAL STRUCTURE ................................................................................................................... 5

STRATEGIC PLAN DEVELOPMENT ............................................................................................................... 6

KEYDEMOGRAPHICS .................................................................................................................................... 7

CONSUMERS .................................................................................................................................................... 8

LOCAL POLITICAL &ECONOMIC CONDITIONS ......................................................................................... 9

NEEDSASSESSMENT PROCESS ................................................................................................................... 10

NEEDSASSESSMENT FINDINGS ................................................................................................................. 11

NATIONAL GOALS &INITIATIVES ............................................................................................................. 12

POSSIBLE RESOURCE DEVELOPMENT....................................................................................................... 12

............................................................................................ 13

GOAL 1:ACCESS SERVICES: ........................................................................................................................ 13

GOAL 2:HOME &COMMUNITYBASED SERVICES: ................................................................................. 13

GOAL 3:PROMOTE HEALTH &WELL-BEING:......................................................................................... 14

GOAL 4:ELDERRIGHTS &PROTECTION: ................................................................................................ 14

GOAL 5:MAINTAIN EFFECTIVE &RESPONSIVE MANAGEMENT: ......................................................... 15

...................................................................................................................... 15

..................................................................................................................................................... 17

SIGNATURE PAGE/STANDARDASSURANCES COMMONWEALTH OF PENNSYLVANIA ....................... 17

DOCUMENTATION OF PARTICIPATION BY THEAAAADVISORYCOUNCIL ........................................ 19

LISTING OF PLANASSURANCES AND REQUIREDACTIVITIES................................................................ 20

NARRATIVE SUMMARY OF THE PROCEEDINGS OF THEAAAAREA PLAN PUBLIC HEARING. ......... 23

.............................................................................................................................................. 24


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EXECUTIVE SUMMARY

The most livable communitywith the most efficient and effective

public services in Pennsylvania

Cumberland County Aging & Community Services is one of 655 Area Agencies on Aging across thenation which reach into every community and play a key role in delivering the services and care thatenable older adults to safely remain in their own homes and communities for as long as medicallypossible.

Every four years, all Area Agencies on Aging (AAA) across the nation are required to develop andsubmit a Plan that reflects future activities of the AAA to address the needs of older adults, adults

with disabilities, and caregivers in their designated Planning and Service Area (PSA).

In Cumberland County the strategic planning process is guided by an overall County Strategy setforth by the Board of Commissioners which identifies service priorities in tandem with an outcomeoriented financial management system. The Commissioners have developed a balanced scorecardwhich provides a framework used to align system-level and departmental strategies, goals, and targetoutcomes.

This 2012-2016 Four Year Strategic Action Plan has been developed using guidance issued by theAdministration on Aging and the Pennsylvania Department of Aging, and is designed to correlatewith the Strategic Directions of the Commissioners Balanced Scorecard for Cumberland County.

The changes in strategy with which A&CS approached the development of this Strategic Planinclude the following:

The Plan takes into account the constraints on fiscal resources experienced by todays local,state, and federal governments. The Plan is shaped by the aspiration of creating a livable community for all ages so that allages can benefit from strategies that support seniors. The Plan strives to align with the Strategic Plan of the County Commissioners and otherlocal strategic plans. In this way, organizational energies and resources can be maximized.

In the last 20 years, while Pennsylvania experienced a 10.9% growth rate in the population 60 yearsof age and older, Cumberland Countys 60+ population has grown at an astounding 44.5%. Withthe first wave of Boomers entering the older adult population a year ago, Cumberland County isbeginning to age rapidly.

In 2010 one of every 5 residents was 60 years of age or older and the Penn State Data Center hasprojected that by 2030 that ratio will be 1 in 4. These demographic changes occur within thecontext of concerns about growth in government spending and the ability to sustain promisesalready made.


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Indeed, the national economic downturn has caused decline in the agencys financial condition andis resulting in a weakened service system infrastructure. Not only has stagnant federal and statefunding not kept up with the growth in the older adult population, it hasnt even kept pace withinflation.

In addition to the flat funding of the Aging Block Grant for five of the last six years, rule changeshave eliminated an alternative source of revenue, creating a budget deficit of over $400,000 thatrequired a County General Fund Subsidy for the first time in over ten years.

In order to balance the agency budget, staff have been (and will be) furloughed and programs andservices are being reduced or eliminated. Home chore staff has been cut in half and Home Supportservices such as shopping and laundry services are being eliminated. A waiting list is in place for mostin-home services not funded by the Aging Waiver.

A comprehensive community needs assessment conducted in 2011 by the United Way of Carlisleand Cumberland County, consumer surveys, as well as input from the Aging Advisory Board, staff

and providers identified affordable housing, affordable medical care, and improved transportation askey needs.

It is imperative to note that the issues of income, housing, transportation and medical care are notwithin Aging & Community Services direct control. The agencys best strategy in these areas isbuilding new partnerships and continued advocacy on behalf of those issues.

Consumers also rated maintaining quality of life and the ability to remain in my home as important.Given that the bleak fiscal environment is expected to continue for the foreseeable future, theagencys ability to afford and deliver the critical services necessary to meet these goals is severelychallenged.

The Older Americans Act (OAA) requires that all services provided using OAA funds be targeted at

the most vulnerable older individuals. A brief summary of the Countys older adult population and

the mix of consumers served shows that the Agency has been successful in meeting those mandates:

2010 Population % Tot PopAge 60+

% Tot PopAge 65+

Live Alone65+

Rural65+

Poverty65+

Minority *65+

Pennsylvania 21.3% 15.4% 29.2% 15.4% 7.9% 8.3%Cumberland County 21.8% 15.6% 28.4% 18.0% 5.1% 2.8%Consumers Served ** 43.1% 23.6% 14.4% 4.5%

* Minority Data from 2009 since local 2010 data not available** In FY2010-11 the Agency provided services to 8.6 % of the 65+ population in the county;

of those receiving Agency services, 92.4% were 65 years of age and older; 50.1% were 80 and older.

In spite of the fiscal constraints, the agency expects to continue to meet the Older Americans Acttargets over the next four years for the Administration on Aging funded services.

Four of the PA Department of Agings focus areas as well as this plans objectives and strategies areorganized using the four core program goals and one management goal established previously:


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GOAL 1:ACCESS SERVICES:Enable all older individuals, adults with disabilities, their families and caregivers to makeinformed decisions about, and easily access, the Right Services at the Right Place at theRight Time.GOAL 2:HOME &COMMUNITYBASED SERVICES:Enable older individuals and persons with disabilities to live as independently as possible inthe residential setting of their choice, including supports for family caregivers.GOAL 3:PROMOTE HEALTH &WELL BEING:Enable individuals to make lifestyle changes which reduce their risk of disease, disability, andinjury.GOAL 4:ELDERRIGHTS &PROTECTION:Protect the rights of all older adults, and ensure that they are free from abuse, exploitation,neglect, and abandonment.GOAL 5:MAINTAIN EFFECTIVE &RESPONSIVE MANAGEMENT:Maintain and/or increase program performance and accountability through effective,efficient and responsive program management.

While many of the strategies outlined in this FY2012-2016 plan are designed to engage and educatethe public, the agency remains committed to its focus on providing high quality, efficient services tothe most vulnerable individuals with the resources available.

Over the past six years Aging & Community Services has established and refined local measuresconsistent with the Commissioners Strategic Planning Framework as well as existing guidance fromthe Administration on Aging (AoA).

As such, it maintains the three key performance measures outlined by the Administration on Agingwhich reach across all of the five strategic goals: Program Efficiency, Program Effectiveness, andConsumer Outcomes.

Additional local output measures which relate to the individual goals are tracked and reported

quarterly throughout the year. The following table lists the indicators currently being utilized:

While efficiency, effectiveness and quality client outcomes will always be measures to be monitored,program and service output indicators will need to be reviewed and modified as funding sources andprograms change over the next four years.

Measure 2009 Actuals 2010 Actuals 2011 Actuals 2012 Target

Estimated Long Term Living savings (HCBS vs. Nursing

Facility Care) 6,441,564$ 8,798,221$ 8,251,754$ 8,000,000$

Number of NFCE Consumers Served in HCBS 236 255 274 250

Positive HCBS consumer satisfaction rating of 90% or more 98% 98% 95% 90%

Number of consumers t ransitioned from Nursing facilities back

to the community 15 17 29 23

Number of I&A requests 13,938 16,879 16,783 16,500

Number of Consumers receiving rental/in home assistance 7,342 7 6,788 6,000

Number of assessments/reassessments 1,909 1,942 1,607 1,500

Number of people on the waiting list for service 0 0 13 48

Average number of days on waiting list 0 0 47 200Number of senior citizen trips 48,628 46,402 46,891 46,500

Number of adult day care days provided 4,765 4,945 4,436 4,000

Number of home meals delivered 6,855 5,780 4,480 4,000


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AGENCYOVERVIEW

Agency MissionTo enhance the quality of life for Cumberland County citizens byproviding a variety of Human Service programs, most of which aredesigned to assist low income seniors, adults, families, and adults withdisabilities to remain in their homes; and to assist community groupsand other public and private Human Service organizations to identifyand develop solutions to unmet Human Service needs.

Cumberland County Aging & Community Services is one of 655 Area Agencies on Aging across thenation which reach into every community and play a key role in delivering the services and care thatenable older adults to safely remain in their own homes and communities for as long as medicallypossible.

In addition to the Older Americans Act programs operated by the agency, Aging & CommunityServices currently administers the Homeless Assistance Program, Human Services DevelopmentFund (HSDF), Food Assistance Programs, the Commonwealths Act 150 Attendant Care Programand the Attendant Care Waiver for Cumberland, Dauphin and Perry Counties.

In the management of our programs and our strategic planning process, Aging & CommunityServices is guided by a set of core values in developing and carrying out its mission. These valuesinclude:

Listening to our consumers, their families & caregivers, and our partnerswho serve them;

Responding to the changing needs and preferences of our increasinglydiverse and rapidly growing consumer population;

Producing measurable outcomes that significantly impact the well-being ofour consumers and their family caregivers; and

Valuing and developing our staff.In 2012 Aging & Community Services marks its 40th year of serving Cumberland Countys olderadults.

ORGANIZATIONAL STRUCTURE

The County of Cumberland is the unit of general purpose local government designated as Planning

and Service Area (PSA) 21 by the Commonwealth of Pennsylvania under Section 305(a) (l) (E) ofthe Older Americans Act of 1965, as amended.

The Board of Commissioners is the governing body with the legal authority and responsibility forproviding human services to older persons in the planning and service area. To carry out theseresponsibilities the Commissioners have established the office of Aging & Community Services tomanage these programs, as well as an Aging Advisory Board to advise them on all matters relating to the planning, administration, and operation of programs and services for older adults.


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AGENCY ORGANIZATIONAL CHART

Cumberland County has also developed various cross-system management teams to analyze issues,develop plans, and implement service strategies across the spectrum of County operations. Theseinclude a Senior Management Team, Human Services Policy Team, Claremont (Nursing and Rehab

Center) Team, Emergency Management Team, and Criminal Justice Policy Team.These teams work to ensure the development of appropriate strategies, policies and programs thatcomprise a framework for delivering efficient and effective services for Cumberland Countyresidents.

Aging & Community Services is an active participant in the Human Services Policy Team and theClaremont Nursing & Rehabilitation Center Team. Cross-system working teams have also beenestablished between Aging and Individuals with Developmental Disabilities, Aging and MentalHealth, and Aging and Emergency Preparedness in order to address the needs of the growing olderpopulation.

STRATEGIC PLAN DEVELOPMENT

Every four years, all Area Agencies on Aging (AAA) across the nation are required to develop andsubmit a Plan that reflects future activities of the AAA to address the needs of older adults, adultswith disabilities, and caregivers in their designated Planning and Service Area (PSA).

CUMBERLAND COUNTY

COMMISSIONERS

CHIEF

CLERK

DRUGS AND MENTAL HEALTH AGING & COMMUNITY CHILDREN COUNTY

ALCOHOL AND IDD SERVICES AND YOUTH TRANSPORTATION

AGENCY DEPUTY

DIRECTOR DIRECTOR

CARE MANAGEMENT COUNTY FINANCE AGING ADRC

SUPERVISOR III/RN OFFICE FISCAL OFFICER II FISCAL OFFICER PROJECT MANAGER

FISCAL TECHNICIAN FISCAL TECHNICIAN

FISCAL TECHNICIAN ( V)

HOMEMOD COORD (V )

S KIL LED L AB ORER S KIL LED L AB ORER

CARE MGT SUPV I CASE MGT SUPERVISOR

AND ASSESSOR ATT CARE / ACT 150

PA RT TIME CA RE MGR II PA RE TIME CA RE MGR II CA RE MGR II CA RE MGR II / FCSP CA RE MGR II / A SSESS CA RE MGR II / PC / DC A TT CA RE SV C COORD

PA RT TIME CA RE MGR III CA RE MGR III CA RE MGR III CA RE MGR II / WA IV ER CA RE MGR II / WA IV ER CA RE MGR II / WA IV ER A TT CA RE SV C COORD COMM SOCIA L WORKER

COMMUNITY SERVICES

FISCAL TECHNICIAN

HUMAN SERVICES POLICY TEAM HUMAN SERVICES POLICY TEAM

CLERK TYPII / RECEPT

CASE MGT SUPERVISOR

HAP & CUMB CARES

CAREMGT SUPV I

COMMUNITY TRANSITION

CAREMGR II / OMBS

ADMA SSISTANT I

CLERK TYPIST II

CAREMGR II / I&A / APPR

ADM ASSISTANT II

CAREMGR II / I&A

CAREMGR II / OMBS

CARE MGR SUPVR 1

APPRISE/ I&A / OMBS

CASE MGR / HOMELESS

CASE MGR / CUMB CARES

SR CTR COORD (AO1)

DATA MANAGER


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The most serious and immediate issue facing the agency is the erosion of existing financial resourcesused to provide home and community based services for older adults, which is resulting in aweakened service delivery system infrastructure.

Twenty-two years ago in the agencys 1990 Strategic Plan for Aging Services we predicted:

A more vulnerable/frail population with increasing health related problems ...will result in a substantial increase in both the number of people needing serviceand the level of service required. Meeting this increase in demand will beextremely difficult, if not impossible, without additional funding.

While Cumberland Countys older adult population has grown by nearly 44.5% since 1990,funding from state and federal sources has been relatively stagnant. Not only has funding not keptup with the growth in the older adult population, it hasnt even kept pace with inflation.

In addition to the flat funding of the Aging Block Grant for five of the last six years, rule changes

have eliminated an alternative source of revenue, creating a budget deficit of over $400,000 thatrequired a County General Fund Subsidy for the first time in over ten years.

In order to balance our budget, staff has been (and will be) furloughed and programs and services arebeing reduced or eliminated. Home chore staff has been cut in half and Home Support services suchas shopping and laundry services are being eliminated. A waiting list is in place for most in-homeservices not funded by the Aging Waiver.

As such, during this planning period the agency will obviously not be spending any time or moneypromoting and marketing those services. If this erosion continues unabated, the CumberlandCounty of tomorrow will have even less to offer vulnerable older persons in the way of supportive

services.

NEEDSASSESSMENT PROCESS

In October 2011, just as Aging & Community Services was preparing to develop this Strategic Plan,the local United Way of Carlisle and Cumberland County(UWCCC) released the final results of itsstrategic planning process. As part of that process, the UWCCC engaged Penn State HarrisburgsInstitute of State and Regional Affairs (ISRA) to conduct a comprehensive Community NeedsAssessment.

The Center for Survey Research (CSR), a unit within the Institute, then conducted a series of 10 in-depth interviews and 4 focus group sessions with key community stakeholders. CSR also conducteda Listed Household Sample (LHH) telephone survey with 400 community members.

The components of the UWCCC Community Needs Assessment that were completed included:

Holding Public Meetings (May 13 & August 25) Conducting In-depth Interviews of Community Stakeholders (June July) Conducting Focus Groups of Community Stakeholders (June July)


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Conducting a Community Survey of Residents (July August) Conducting Demographic and Socioeconomic Background Research (July August)

The UWCCC final report became the starting point upon which this plan was built. Other needsassessment activities conducted by Aging & Community Services included:

A review of the 2011 Regional Growth Management Plan (RGMP) compiled by Tri-CountyRegional Planning Commission. The RGMP is important since it is designed to encouragecooperation of ongoing planning for land use, transportation, economic and culturaldevelopment and to revise physical growth policies to the year 2035.

A review of the Cumberland County Housing and Redevelopment Authorities (CCHRA)2011 Strategic Plan

A detailed analysis of the latest available Census data A detailed analysis of the agencys service delivery data A survey of consumers Discussions with, and input from, the Aging Advisory Board and staff

NEEDSASSESSMENT FINDINGS

Needs that were identified by UWCCC included:

Increased availability of affordable housing Improved transportation system Affordable medical care, especially for older adults Improved access to Mental Health services

Advisory Board identified:

High cost of everything (40%)

Housing (24%) Transportation (20%) Wellness/Prevention; stimulating mental and physical activities and socialization (12%) Service information and availability (12%) Other: food, medical, intergenerational programming

Consumer Surveys identified the following as Important or Very Important:

Maintaining quality of life Health insurance coverage Ability to remain in my home; Prescription costs; and Knowing what services are available

tied for third Paying household expenses Transportation

It is imperative to note that the issues of income, housing, transportation and medical careare not directly within Aging & Community Services control. The agencys best strategy inthese areas is building new partnerships and continued advocacy on behalf of those issues.


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NATIONAL GOALS &INITIATIVES

The Older Americans Act (OAA) requires that all services provided using OAA funds be

targeted at the most vulnerable older individuals, specifically those: with the greatest economic or social need who are at risk for institutional placement who are low income and minority who are living in rural areas who are limited in their English proficiency

A brief summary of the Countys older adult population and the mix of consumers served shows that

the Agency has been successful in meeting these mandates and goals:

2010 Population % Tot PopAge 60+

% Tot PopAge 65+

Live Alone65+

Rural65+

Poverty65+

Minority *65+

Pennsylvania 21.3% 15.4% 29.2% 15.4% 7.9% 8.3%Cumberland County 21.8% 15.6% 28.4% 18.0% 5.1% 2.8%Consumers Served ** 43.1% 23.6% 14.4% 4.5%

* Minority Data from 2009 since local 2010 data not available** In FY2010-11 the Agency provided services to 8.6 % of the 65+ population in the county;

of those receiving Agency services, 92.4% were 65 years of age and older; 50.1% were 80 and older.

The agency will continue to meet or exceed the Older Americans Act requirements in the next fouryears.

POSSIBLE RESOURCE DEVELOPMENT

VOLUNTEERS:

Dickinson College in Carlisle, Messiah College in Grantham, Central Penn College in Summerdale,and Shippensburg University in Shippensburg, all include community service as part of theirgraduation requirements or as a part of student life.

INTERNSHIPS:

Internships provide a venue for students to take their knowledge and apply it directly to theprofessional workplace, and successful internships often lead to permanent placements. Thus,Cumberland County has the opportunity to retain college graduates as taxpayers who live and work

in the local community.

INTERGENERATIONAL PROGRAMS:

Penn State University, through its Cooperative Extension System develops new intergenerationalinitiatives and studies their impact on program participants and surrounding communities. Theprimary goal is to provide leadership and resource support for organizations interested in establishingintergenerational programs.


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GOAL 1:ACCESS SERVICES:

Enable all older adults, adults with disabilities, their families and caregivers to make informeddecisions about, and easily access the Right Services at the Right Place at the Right Time.

OBJECTIVE 1.1: Streamline existing Information & Assistance services

STRATEGY: Integrate the Cumberland Link ADRC into the agencys I&A system.

OBJECTIVE 1.2: Expand access to information about the array of long term living options.

STRATEGY: Promote utilization of the new 211 system.

OBJECTIVE 1.3: Continue to improve and modernize online customer service transactionsthrough the use of the Internet and other emerging technologies as they become reliable andcost effective.

STRATEGY: Continue to update and expand the information available on the agencywebsite, Facebook, etc.

GOAL 2:HOME &COMMUNITYBASED SERVICES:

Enable older adults and adults with disabilities to live in the setting of their choice with a highquality of life for as long as possible through the provision of home and community-based services,including supports for family caregivers.

OBJECTIVE 2.1: Promote Communities to Age & Live Well

STRATEGY: Continue collaboration with Messiah Lifeways on their corporateinitiated Village Network

STRATEGY:Utilize GIS to identify Naturally Occurring Retirement Communities

STRATEGY: Evaluate piloting a Cluster Care model with the providers of FunctionalAssistance (including coordinating delivery between aging & disability aides)

OBJECTIVE 2.2: Revitalize & Redesign Services

STRATEGY:Improve ways to connect, communicate, and engage residents

Implement Community Voice, a Citizen Sourcing Module capability ourwebsite to allow residents to submit their ideas for improvements andchanges they'd like to see implemented, and in turn allowing other residentsto comment on ideas and vote ideas up or down.

Reconstitute the County Council on Aging, an organization withrepresentatives from the various older adult groups in the county.

STRATEGY:Develop and promote the vital role of Senior Centers.

Re-focus and re-brand centers as a Healthy Aging Centers Lower participation age to 50 Teach & utilize Web2 technology such as Skype


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Pursue collaboration and partnership with municipal Parks & RecreationDepartments

GOAL 3:PROMOTE HEALTH &WELL-BEING:

Enable adults to make lifestyle changes that will reduce their risk of disease, disability, and injury.

OBJECTIVE 3.1: Identify and address Health Disparities among Older Adults

Health disparities are preventable differences in the burden of disease, injury, violence, or inopportunities to achieve optimal health experienced by socially disadvantaged groups.

STRATEGY:Continue to work with the Foundation for Enhancing Communities toidentify differences in health status and health behaviors and implement programs toreduce them.

OBJECTIVE 3.2: Older adults learn to view falls and the fear of falling as controllable, setrealistic goals to increase activity, change their environment to reduce fall risk factors, andexercise to increase strength and balance..

STRATEGY: Implement the A Matter of Balance in partnership with the AmericanTrauma Society PA Division

OBJECTIVE 3.3: Emphasize the individuals role in managing his or her health and build theirself-confidence, so they can be successful in adopting long-term healthy behaviors..

STRATEGY:Implement the Sanford Universitys Chronic Disease Self-ManagementProgram

GOAL 4:ELDERRIGHTS &PROTECTION:

Protect the rights of all older adults, and ensure that they are free from abuse, exploitation, neglect,

and abandonment.

OBJECTIVE 4.1: Continue to enhance and expand the Ombudsman program capability toidentify and resolve long term living complaints

STRATEGY: Continue to develop and implement the comprehensive volunteerrecruitment and training program.

OBJECTIVE 4.2: Continue to identify, investigate, and resolve instances of abuse, neglect,exploitation and abandonment under the Older Adult Protective Services Act

STRATEGY: Ensure specially trained staff are available 24 hours a day, 7 days a week,to accept reports on behalf of an older adult whether the person lives in the

community or in a care facility such as a nursing home, personal care home, hospital,etc.

OBJECTIVE 4.3: Improve emergency preparedness and response capability supporting allfunctionally limited populations.

STRATEGY: Implement a GIS based system to identify older adults and adults withdisabilities who need assistance evacuating their homes during a disaster oremergency.


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STRATEGY: Utilize and promote the South Central Alert System.

GOAL 5:MAINTAIN EFFECTIVE &RESPONSIVE MANAGEMENT:

A critical factor in the Agencys ability to ensure continual achievement of its mission and goals is its

ability to continuously review and refine organizational structure and management practices toeffectively and efficiently support its employees, programs and services.

OBJECTIVE 5.1: Align agency budget expenditures with available funding levels

STRATEGY: Continue waiting lists for underfunded mandated services

STRATEGY: Continue to reduce or eliminate underfunded non-mandated services

STRATEGY: Adjust staffing patterns to available funding and service levels

OBJECTIVE 5.2: Utilize Return-on-Investment for decision making.

STRATEGY: Focus on activities with low-cost (information, education, etc.)

STRATEGY: Build partnerships with non-traditional organizations

STRATEGY: Implement Senior Center Performance Based Funding Formula

OBJECTIVE 5.3: Leverage existing technology investment.

STRATEGY: Implement Electronic Record and Document Management

STRATEGY: Use GIS for Care Management assignments and scheduling

Over the past six years Aging & Community Services has established and refined local measuresconsistent with the Commissioners Strategic Planning Framework as well as existing guidance fromthe Administration on Aging (AoA).

While many of the strategies outlined in this FY2012-2016 plan are designed to engage and educatethe public, the agency remains committed to its focus on providing high quality, efficient services tothe most vulnerable individuals with the resources available.

As such, it maintains the three key performance measures outlined by the Administration on Agingwhich reach across all of the five strategic goals.

Measure 1: Program Efficiency

Indicator 1.1: Estimated Savings of HCBS vs. Intuitional CareMeasure 2: Program Effectiveness

Indicator 2.1: Ratio of target populations served vs. ratio of total target populations

Measure 3: Client Outcomes

Indicator 3.1: 90% or more of consumers surveyed rate services Good to Excellent

Additional output measures which relate to the individual goals are tracked and reported quarterly


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throughout the year. The following table lists the indicators currently being utilized:

While efficiency, effectiveness and quality client outcomes will always be measures to be monitored,program and service output indicators will need to be reviewed and modified as funding sources and

programs change over the next four years.

Measure 2009 Actuals 2010 Actuals 2011 Actuals 2012 Target

Estimated Long Term Living savings (HCBS vs. Nursing

Facility Care) 6,441,564$ 8,798,221$ 8,251,754$ 8,000,000$

Number of NFCE Consumers Served in HCBS 236 255 274 250

Positive HCBS consumer satisfaction rating of 90% or more 98% 98% 95% 90%

Number of consumers t ransitioned from Nursing facilities backto the community 15 17 29 23

Number of I&A requests 13,938 16,879 16,783 16,500

Number of Consumers receiving rental/in home assistance 7,342 7 6,788 6,000

Number of assessments/reassessments 1,909 1,942 1,607 1,500

Number of people on the waiting list for service 0 0 13 48

Average number of days on waiting list 0 0 47 200

Number of senior citizen trips 48,628 46,402 46,891 46,500

Number of adult day care days provided 4,765 4,945 4,436 4,000

Number of home meals delivered 6,855 5,780 4,480 4,000


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PART B

Section 1. Signature Page/Standard Assurances Commonwealth of PennsylvaniaDepartment of Aging

FY 2012-16 Area Agency on Aging

Four-Year Area Plan on Aging

Signature PageArea Agency on Aging Name and Address:

CUMBERLAND COUNTYAGING &COMMUNITYSERVICES1100CLAREMONT ROAD,CARLISLE,PA 17015

I/we certify that I/we are authorized to submit this Plan on behalf of the designated Area Agency on Agingand agree to abide by regulations issued by the Pennsylvania Department of Aging, the U.S. Department ofHealth and Human Services, and the U.S. Department of Labor. I/we further certify that the general public

has had the opportunity to review and comment on this Plan through the public hearing process and thatwritten policies, procedures or agreements, as appropriate, have been developed in accordance with Part B,Section 3, and are on file for review and approval, as appropriate, by Department of Aging officials.

I/we assure that services and programs of the Area Agency on Aging will be managed and delivered inaccordance with the Plan submitted herewith. Any substantial changes to the Plan will be submitted to theDepartment of Aging for prior approval.

I/we hereby expressly, as a condition precedent to the receipt of State and Federal funds, assure:

That in compliance with Title VI of the Civil Rights Act of 1964; Section 504 of the Federal RehabilitationAct of 1973; the Age Discrimination Act of 1975; The Americans With Disabilities Act of 1990; ThePennsylvania Human Relations Act of 1955, as amended; and 16 PA Code, Chapter 49 (Contract Complianceregulations):

1) I/we do not and will not discriminate against any person because of race, color, religious creed, ancestry,national origin, age, sex, or handicap;

a) In providing services or employment, or in its relationship with other providers;b) In providing access to services and employment for handicapped individuals.

2) I/we will comply with all regulations promulgated to enforce the statutory provisions againstdiscrimination.

I/we further hereby agree that all contracts for the provision of services addressed herein will requirecontractors to comply with these same provisions.

I/we certify that the advisory council of the Area Agency on Aging has participated in the development ofthis Plan and has reviewed the Plan as herewith submitted.


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Signature(s) of Governing AuthorityOfficial(s), e.g., Chairman of CountyCommissioners or President, Board of Directors.

Title Date

Chairman

Vice Chairman

Secretary

Director(Signature of the Area Agency on (Title) (Date)Aging Director)

Name of Person to Contact Regarding the Contents of This Plan:

_________________________________ _______________________(Name) (Area Code and Telephone)


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Part B. Section 2

Documentation of Participation by the AAA Advisory Council

PSA NO. _________

NAME OF AAA: ________________________________________________

PLAN PERIOD FROM ____________ TO____________

In accordance with 6 PA Code, Section 35.23, a.(1) and (2) and the Older Americans Act of 1965, asamended, I certify that the Area Agency on Aging Advisory Council has had the opportunity to assist in thedevelopment of this Plan. I further certify that the Area Agency on Aging Advisory Council has participatedin at least one Public Hearing held on this Plan.

The Area Agency on Aging Advisory Council ______ does ______ does not recommend approval of this

Plan.

____________________________________________Signature of the Chief Officer of the Area

Agency on Aging Advisory Council

____________________________________________Typed Name and Title

________________________Date


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Part B. Section 3

Listing of Plan Assurances and Required Activities

Older Americans Act, As Amended in 2006

ASSURANCES

The Older Americans Act of 1965, as amended, requires each Area Agency on Aging to provide assurancesthat it will develop a Plan and carry out a program in accordance with the Plan. Each Area Agency on Agingmust comply with the following provisions of the Act and written policies, procedures or agreements, asappropriate, must be on file in the Area Agency on Aging office and available for review and approval byDepartment of Aging officials.

Area Plans

Assurances that an adequate portion, as required under section 307(a)(2) of the amount allotted forpart B to the planning and service area will be expended for the delivery of the following categories

of service: access to service -- transportation, health service, outreach, information assistance, andcase management; in-home services -- supportive services for families of older individuals who arevictims of Alzheimer's disease and related disorders with neurological and organic brain dysfunctions;and legal assistance.

Assurances that the AAAs will report annually to the State agency in detail the amount of fundsexpended for each such category during the fiscal year most recently concluded.

Assurances that the AAAs will a) set specific objectives, consistent with state policy, for providingservices to older individuals with greatest economic need, older individuals with greatest social need,an older individuals at risk for institutional placement; b) include specific objectives for providingservices to low-income minority older individuals, older individuals with limited English proficiency,

and older individuals residing in rural areas and include proposed methods to achieve these specificobjectives.

Assurance that AAAs will include in each agreement made with a provider of any service under thistitle, a requirement that such provider will: a) specify how they intend to satisfy the service needs oflow-income minority individuals, older individuals with limited English proficiency, and olderindividuals residing in rural areas in accordance with their need for such services; and, to maximumextent feasible, provide services to low-income minority individuals, older individuals with limitedEnglish proficiency, and older individuals residing in rural areas in accordance with their need ofsuch services; and meet specific objectives established by the AAA for providing services to lowincome minority individuals, older individuals with limited English proficiency, and older individualsresiding in rural areas within the planning and service area.

Each area agency shall: identify the number of low-income minority older individuals and olderindividuals residing in rural areas in the planning and service area; describe the methods used tosatisfy the service needs of such minority older individuals, and provide information on the ext twowhich the AAA met the objectives described in clause (a)(4)(A)(i).


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Assurances that the AAAs will use outreach efforts that will identify individuals eligible for assistanceunder this Act with special emphasis on: older individuals residing in rural areas; older individualswith the greatest economic need (focus on minority and rural populations); older individuals with thegreatest social need (focus on minority and rural populations); older individuals with severedisabilities; limited English proficiency; Older individuals with Alzheimer's disease and relateddisorders with neurological and organic brain dysfunction (and their caretakers); older individuals at

risk for institutional placement; and assurances that each activity including planning, advocacy, andsystems development will focus on the needs of low-income minority older individuals an olderindividuals living in rural areas.

Assurances that AAAs will coordinate planning, identification, assessment of needs, and provision ofservices for older individuals with disabilities, with particular attention to individuals with severedisabilities and individuals at risk for institutional placement, and with agencies that develop orprovide services for individuals with disabilities.

In coordination with the State agency and the State agency responsible for mental health services,increase public awareness of mental health disorders, remove barriers to diagnosis and treatment, andcoordinate mental health services provided with funds expended by the AAA with mental health

services provided by community health centers and by other public agencies and non-provide privateorganizations.

Assurances that the AAAs, in carrying out the State Long-Term Care Ombudsman program undersection 307(a)(9), will expend not less than the total amount of funds appropriated under this Actand expended by the agency in fiscal year 2000 in carryout out such a program under the title.

Information and assurances concerning older individuals who are Native American including a)information concerning whether there is a significant population of older native Americans in theplanning and service area and, if so, an assurance that the AAA will pursue activities, includingoutreach, to increase access of those Native Americans to programs and benefits under this title;coordinate the services the AAA provides under this title with services provided under Title VI; and

make services under the area plan available to the same extent such services are available to olderindividuals within the planning and service area, to older Native Americans.

Assurances that the AAA will maintain the integrity and public purpose of services provided, andservice providers under this title in all contractual and commercial relationships.

Assurances that the AAAs will disclose to the State Agency and the Assistant Secretary to identify ofeach nongovernmental entity with which such agency has a contract or commercial relationship toproviding any service to older individuals and the nature of such relationship.

Assurances that the AAAs will demonstrate that a loss or diminution in the quality or quantity of theservices 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.

Assurances that the AAAs will demonstrate the quality and quantity of the services to be providedunder this Title by such agency will be enhanced as a result of such non-governmental contracts orcommercial relationships.

Assurances that the AAAs will, on the request of the Assistant Secretary or the State agency, for thepurposes of monitoring compliance with this Act -- including an audit -- disclose all sources andexpenditures of funds such agency receives or expends to provide services to older individuals.


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Assurances that funds received under this title will be used to provide benefits and services to olderindividuals, giving priority to older individuals identified in paragraph 4(A)(i) and in compliance withthe assurances specified in paragraph 13 and the limitations specified in paragraph 1 and thelimitations in section 212.


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Part B. Section 4

Narrative Summary of the Proceedings of the AAA Area Plan Public Hearing.

Attach a written narrative (no more than five pages) summarizing the proceedings of the AAA Area Plan

Public Hearing.

The Public Hearing is scheduled for June 15, 2012 at the Aging & Community Services building conference

room.


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APPENDICES


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CUMBERLA

ND COUNTY GING &COM

AP

UNITYSERVIC

PENDIXA:

ES

25

COUNTY

DRAFT STRA

TRATEGY

TEGICACTION PLAN FY201 -2016


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2012 Area Plan Draft3a

Documents

Transcript of 2012 Area Plan Draft3a