C. f)' TI~ llNC) ll'S lll)\ TISftllY .
( Jl) l) l" I'I~
I f) f) 1- f) II
GV 52.3: U 64/ 1997- 1998
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Dixie M. Jessen, Chairperson
(~() IJN(~ II. I ) 11~) 11I1~ 11S I fUUI
STATE DOCUMENTS
J )' I
GOVERNOR'S ADVISORY COUNCIL ON AGING
Conrad Berry Mary L. Walsh
Rio Rico, AZ Sierra Vista, AZ
JohnT. Boyer, M. D. Honorary Member
Tucson, AZ Gwen Bedford
A. Paul Blunt Phoenix, AZ
Scottsdale, AZ Ex- Officio Members
Dosia Carlson, Ph. D. Elvera Anselmo
Phoenix, AZ Office of the Attorney General
Kermit Clark, Sr. Henry Blanco
Tempe, AZ Aging and Adult Administration
Diane Daychild, M. S. W. Steve H. Gelbart
Scottsdale, AZ Arizona Dept. of Insurance
Arnold Jeffers Jane L. Lange
Tucson, AZ Arizona Dept. of Health Services
Dixie M. Jessen, R. N. Alan Schafer
Phoenix, AZ AHCCCS/ ALTCS
Gloria Moraga Staff
Mesa, AZ Anne Lindemann
Patrick Nugent Executive Director
Kingman, AZ Lupe Solis
Barbara O'Dell Program Specialist
Tucson, AZ
Maggie Dembowski
Dorothy Powell Program Specialist
Casa Grande, AZ
Helen Perez
Dorothy Staskey, Ph. D. Aministrative Secretary
Flagstaff, AZ B tt R d
eye er
John Templin, J. D. ARIZONA STATE LIBRARY _ Administrative Secretary
Sun City West ARCHIVES & PUBLIC RECORD~ .
FEB 1 1 2005
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Although keen to prepare for trends and challenges facing the aging community in
the near future, the Council constantly responds to crises in the aging field and to
day- to- day problems encountered by the elderly as they age.
Although many issues occupied the Council's time during this period, chief among
them were: elder abuse and exploitation, home and community- based services,
caregiver support, behavioral health funding for older adults, new trends in
grandparents roles and issues surrounding long term care needs, including end- oflife
issues.
To find better and more effective ways to promote the well- being and quality of life of
older adults in their later years, the Council undertakes the following activities:
advocacy, legislation development, information dissemination, promotion of public
understanding, interventions, fact finding and program development. The Council
conducts all of these activities keeping in mind its mandate as official advocate for
the elderly in this state.
• 1991- 2000 • A DECADE OF PREPARATION
GOVERNOR'S ADVISORY COUNCIL ON AGING
For nearly two decades, the
Council has strived to find
solutions to issues facing aging
constituents in Arizona. This
report covers Council activities
during 1997 and 1998.
l' s we approach the new millenium, awareness of the growing demographics
and the changing outlook in the world of " aging" pose new and exciting
challenges. Attitudes and perspectives prevalent in the 1960s, 70s and 80s,
changed considerably in the mid- 90s, as the first baby boomers reached their fifties.
The aging outlook will be markedly different as this cohort reaches their late fifties
and sixties. Their numbers alone demand innovative channels to meet new needs
and wants. To maximize its staff and resources, the Governor's Advisory Council on
Aging relies heavily on collaborations that help increase its reach and strengthen its
influence.
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Arizona continues to be one of the fastest growing states in the
nation. 1998 Census Bureau projections indicate that 643,754
people over the age of 65 live in Arizona.
The expected increase in numbers of elderly ( a doubling of the 55+
population by 2020) residing in the state causes continuous growth
in service demands. Throughout both the 1997 and the 1998
legislative sessions the Council led the charge to obtain additional
appropriations for programs experiencing insufficient funding.
In 1997, and again in 1998, the Council was instrumental in
obtaining the Governor's and the Legislature's support to forestall
deep cuts to the home and community- based services program
administered by the Area Agencies on Aging in Arizona. The
resulting appropriations forestalled service stoppages which would
have been necessary as a result of both federal cuts in Social
Services Block Grants, Title XX, and an increasing demand for
services.
Following a one- year pilot program of respite care for caregivers in
Maricopa County the Council spearheaded a legislative proposal to
institutionalize the program. In 1997, HB 2460 ( Chapter 162)
provided a $ 185,000 appropriation to expand the program statewide.
This program continues to provide much- needed relief for caregivers
who take care of their loved ones at home, and forestalls expensive,
premature institutionalization.
Arizona's retiree growth has been aided by the efforts of the
Department of Commerce Arizona Office of Senior Living ( now the
Arizona Office of Senior Industries Development), whose sole aim is
to attract wealthy retirees to the state. While recognizing and
applauding their efforts, the Governor's Council is concerned about
the consequent need to build up and reinforce the service
infrastructure to meet demand, especially in rural areas of the state.
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The recent boom in construction of upscale retirement communities
and assisted- living facilities in the state is a case in point. Their
presence testifies to the long- term vision of developers and others in
the housing industry. While the building boom illustrates their
outlook, the proliferation also highlights the fact that many Arizona
retirees are not able to afford high- priced accommodations and need
housing alternatives. Even those who retire with sufficient incomes
quickly expend their resources when faced with acute health crises
or long- term care costs, and end up requiring partial or full
governmental assistance and community services.
In 1997, the Council developed a request for an endowment fund for
aging services out of Tobacco Tax Funds. Although unsuccessful,
the Council's effort was aided by Rep. Susan Gerard's initiative to
include a $ 500,000 appropriation for aging services out of Tobacco
Tax Funds. By June 30, 1998 the program, which provides adaptive
equipment to seniors and other services not covered by other
programs, had served over 737 persons statewide. The Area
Agencies consider this appropriation one of the most cost- effective
and innovative means to assist seniors in need.
To better help Arizona prepare for the upcoming demographic
explosion, and to sensitize policy makers to the needs and wants of
current and future residents, the Council proposed to the Arizona
Town Hall Board that it host a meeting focused on aging issues.
In May 1998, the Town Hall hosted their first forum on aging issues,
" Meeting the Challenges and Opportunities of Arizona's Growing
Senior Population" in Prescott, Arizona. The Council's executive
director and many prominent Arizonans attended. Their deliberations
are encapsulated in the 72nd Arizona Town Hall Report dated
May 3- 6, 1998, and encompass long term care, financial security,
health care, Social Security, Medicare and other state and federal
issues and programs.
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• 2000
It is the Council's hope that their recommendations for state action
will serve as a guideline for future policy development in Arizona.
The consensus is that Arizona needs to move fast in order to ensure
an available, affordable, comprehensive array of aging services.
Forward action is necessary if we are to avoid the problems faced by
other retirement havens in the late 1980s and early 90s.
In celebration of the United Nations Proclamation of 1999 as
International Year of Older Persons, and in keeping with stated
goals of the National Institute of Aging to promote healthy aging, the
Council developed plans for a year- long fitness and physical activity
program for senior individuals. The program, " Arizona Senior Fitness
2000," is designed to promote daily physical activity for individuals at
whatever their level of capacity. To date, the program has 1400
participants, 80 facilities and over 75 coordinators
statewide. In collaboration with Senior Olympics,
the program will participate in their Parade of
Athletes. Arizona Senior Fitness 2000 will host
program awards at the Governor's Conference on
Aging in May 2000.
The Council works closely with the Governor's Office, the
Legislature, the aging services network ( including the Area Agencies
on Aging statewide) and the Aging and Adult Administration of the
Department of Economic Security. Other agencies with whom the
Council interacts on a regular basis include the Departments of
Health Services, Transportation, Insurance, and the Arizona Health
Care Cost Containment System ( AHCCCS). The Council often
develops or joins ad hoc coalitions in efforts to resolve mutual
issues.
Throughout 1997 and 1998, the Council concentrated in areas which
are fast becoming of paramount importance to older Arizonans.
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The Council's executive director and various Council members
actively participated in the Department of Health Services Task
Force charged with revising and enacting rules and regulations for a
consolidation of residential care facilities licenses into a universal
assisted- living license. The Task Force's efforts resulted in passage
of Senate Bill 1237 ( Chapter 178). The consolidation clarified
licensing requirements and has enabled facilities to offer appropriate
services for residents as they age in place.
The Council also provided input to the Governor's Blue Ribbon HMO
Task Force, which developed SB 1321 ( Chapter 251) instituting
insurance portability rights, and SB 1098 ( Chapter 100) which
instituted an appeals process for members of health maintenance
organizations.
In 1998 the Council collaborated with the Alzheimer's Association
chapters and others in the state to obtain passage of a $ 1.2 million
appropriation for Alzheimer's disease research. The appropriation
included in HB 2354 ( Chapter 245) is a dollar for dollar match
through private grants. The bill established the Arizona Center for
Alzheimer's Research to bring together major research groups and
universities working this vital research area in the state.
1~ IJ) I~ llllIIIJSI~
Financial abuse and exploitation at the hands of unscrupulous
operators, who entice seniors to participate in mail order fraud
through deceptive advertisements and victimize them through
embezzlements and scams, continue to be of grave concern to the
Council. Arizona is one of the foremost states in the nation in
strategizing to eradicate financial exploitation and abuse of the
elderly.
During the 1998 legislative session, the elder abuse statutes were
strengthened in response to the Arizona Republic series, " Homes
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Without Hope," detailing abuses in care group homes. S8 1050
( Chapter 161) is an extensive vulnerable adult protection bill that
increased penalties and required fingerprinting and criminal record
checks for owners and employees of nursing care and residential
care institutions and home health agencies.
During the 1996 legislative session psychological and verbal abuse
of the elderly had been defined in H8 2053 ( Chapter 357), in order
to indict abusers and strengthen public response to elder abuse,
especially in care facilities.
In addition, S8 1050 established a Central Abuse registry under the
Office of the Attorney General. The bill also contained appropriations
for a centralized intake line for Adult Protective Services complaints
with extended hours of operation, and a 24- hour, seven- day a week,
elder resource referral line. The statewide toll- free phone line
became fully operational in January 1999. It is operated by the Area
Agencies on Aging.
Through collaborations with the Arizona Office of the Attorney
General, the Area Agencies on Aging, Adult Protective Services,
AARP, and many other organizations, the Council continues to
explore ways to deter and eradicate elder abuse of any kind. We are
active participants in the Maricopa County- based Maricopa Elder
Abuse Prevention Alliance ( MEAPA). Staff continues to support
MEAPA's efforts to develop temporary, emergency placements for
elder abuse victims, and effective, appropriate protocols for review of
elder abuse case handling and procedures.
To foster awareness statewide the Council supports development of
local elder abuse coalitions. Jointly with Arizona's Attorney General's
Office of Elder Affairs, the Council actively promoted the
development and met regularly with local task forces on elder abuse
in Santa Cruz and Pima counties.
With Council support the Pima County Task Force, staffed by the
Tucson Office of the Attorney General, staged a very successful
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training session for law enforcement officials in early 1998. The
Council presented a one- day Financial Abuse and Exploitation
Conference in October 1998 in Rio Rico. This conference was cosponsored
by the Santa Cruz Elder Abuse Task Force, staffed by
the Santa Cruz County Public Fiduciary Office. Over 100 field
professionals in the field of aging participated. The model for this
conference was piloted in Sierra Vista in late 1997. Requests for the
elder abuse presentations continue to come in, and the Council will
continue to sponsor these workshops as long as needed.
Financial Exploitation conferences with over 500 participants in
attendance continued to be held in late 1997 and in 1998 in Sierra
Vista, Payson, Flagstaff, and Rio Rico. These conferences were
planned in cooperation with local advocacy groups and with the
assistance of the local Area Agency on Aging.
During the 1997 legislative session the Council supported the
Supreme Court's efforts to create a private fiduciary fund from
monies collected through registration fees. HB 2023 ( Chapter 180)
appropriated $ 50,000 to the Supreme Court to investigate claims of
private fiduciary misconduct and to institute fiduciary training.
In 1998 the Legislature provided funding to the Supreme Court to reestablish
an elder law telephone hotline statewide. The $ 100,000
appropriation was contained in HB 2618 ( Chapter 207).
III~ Illl'TI0 Illll.. III~ lll.. l'II
Suicide among the elderly has been a serious concern in Arizona for
a long time. In 1994, the Council presented the first- ever public
discussion on the causes of elderly suicide and explored community
responsibility in a conference entitled, " Shadows in Life: Suicide
Among the Elderly." Shortly thereafter, the Office of Older Adult
Health at the Department of Health Services organized a Suicide
Prevention Task Force which was chaired by a Council staff
member.
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The Task Force developed a best practice curriculum for primary
care practitioners and health care professionals. The Task Force
also presented three continuing education workshops in Prescott,
Bullhead City and the Globe/ Miami area.
The Task Force curriculum became the basis for a " Depression in
the Elderly" workshop piloted by the Council in Sierra Vista in
December of 1997. Local health care professionals and planning
agencies, including local Area Health Education Centers
participated. An October 1998 conference in Flagstaff was geared to
a mainly Native American audience of professionals in the field of
aging.
The goal is to sensitize professionals working with the elderly to
recognize behavioral changes and symptoms of depression, and to
utilize appropriate responses and interventions. To date, over 700
people statewide have attended these workshops.
PIIO( JllllI) 111~ VII~' f
Throughout late Spring and early Summer 1997 the Council
reviewed and made program recommendations on the formulation of
the three- year State Plan on Aging by the Department of Economic
Security Aging and Adult Administration ( our state's Unit on Aging).
Over the summer Council members presided over statewide public
hearings to gather community input in Yuma, Bisbee, Casa Grande,
Sun City, Phoenix, and Window Rock.
This document is updated and renewed in three- year planning
cycles and the process will be repeated in Spring 2000. The Council
renewed a reporting format to review the progress of activities
detailed in the Plan in late 1998 and early 1999.
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In June 1997 Governor Symington issued Executive Order 97- 8,
creating the Commission on Aging and End- of- Life issues. This
action was in response to a United States Supreme Court decision
which made the question of physician- assisted suicide a matter for
each state to decide. The Commission, although independent of the
Council, is chaired by Anne Lindeman, Executive Director, and
staffed by her executive secretary.
During a six- month review process, the Commission heard testimony
from numerous health care professionals, affected patients and
community advocates. Recommendations developed as a result of
their deliberations are presented in a full report dated December 31,
1997.
The Commission's recommendations, centered around promotion of
programs such as hospice, and the development of protocols which
will ensure quality of care at the end of life and preservation of the
individual's right to make decisions. Other areas of review included
the education and training of physicians in geriatric care and pain
management, promotion of advance directives, and exploration of
finance options to provide both needed education and training of
health care professions, and to uphold the needs of the dying
patient.
Given the importance of their task, the Commission's life was
extended to implement the recommendations. Their first task was
the development of a grant request to the Robert Woods Johnson
Foundation for their End- of- Life initiatives.
Although unsuccessful in this effort, the Commission continues to
pursue other funding resources and alternatives to implement the
proposal. The Commission continues to meet bimonthly throughout
1998 and early 1999. The Council upholds the Commission's work
and supports its mission.
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In every generation, grandparents have been taking care of
grandchildren. In the late 1980s and the 90s a new trend has been
emerging. More and more grandparents are becoming primary
caregivers for their grandchildren. Nationally over 4 million people
are solely responsible for their grandchildren. The reasons are
many: death, illness, drug abuse, or economic hardship. Whatever
the reason, these older adults are facing an unexpected situation at
a time when most were looking forward to their " golden years."
Grandparents often live in one person households. Thus, when they
assume additional responsibility, many face undue physical and
mental stress and financial constraints. They list legal, economic,
health care, training and education, and communication problems as
primary concerns. In response to the growing incidence of these
situations the Council created a Task Force on Grandparent
Concerns. The Task Force is a joint effort with Center DOAR, a local
social services agency which has been a leader in focusing attention
to these situations and developing networking support groups for
grandparents. The Task Force is made up of professionals in the
field and grandparents who faithfully attend meetings from as far
away as Kingman, Arizona.
The Task Force recommendations were presented to the Council in
a report dated September 1998. In response, the Council developed
a bill to make it easier for grandparents to register their
grandchildren in school, when in process of obtaining legal custody.
HB 2614, School Residence; Non- Parents ( now Chapter 46),
introduced by Representative Lou Ann Preble, passed in the 1999
legislative session.
At the request of the Task Force, the Council also supported HB
2417 ( now Chapter 251), to create a subsidized permanent
guardianship program in the Department of Economic Security for
children in the foster care system. This bill was successful. In 1997,
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the Council supported S8 1294 ( Chapter 45), which granted
visitation rights to grandparents.
In March 1998 the Task Force hosted a conference in Phoenix,
" Grandparents Raising Grandchildren: Surviving and Thriving,"
spotlighting legal and other concerns affecting grandparent
caregivers. Over 80 people attended and gave high marks to the
information received.
The Council also co- sponsored two sites for a national satellite video
conference with the University of Wisconsin and Purdue University,
held in January 1999. The two sites, one in Phoenix and one in
Tucson, hosted over 75 participants.
The collaboration with the University of Arizona Cooperative
Extension Service continues to produce results. Following a
successful grant application, the Extension Service is developing
audio information tapes, which will be updated regularly with
advocacy and information messages composed by Task Force
members. The messages will be available to the public by calling the
Extension Service.
In addition, grandparents' concerns and support groups are being
formed throughout the state with local sponsorship and the
assistance of Grandparents United, an Arizona organization
dedicated to giving legal and other assistance to grandparent
caregivers.
The Aging and Adult Administration has shown interest in
developing responses to the needs of these grandparents through
grant proposals and proposed activities statewide. The Task Force
fosters program development and provides information as it
continues to meet on a regular basis.
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In anticipation of the unveiling of Medicare Health Plan Choices
Program by the Health Care Finance Administration ( HCFA), and to
reduce elderly beneficiaries' anxiety over the proposed changes, the
Council hosted seven information workshops statewide over a threeday
period in November 1998. The sessions were planned and
developed in collaboration with HCFA's Region X Office of Public
Information, and the Aging and Adult Administration's Benefits
Counseling Program, which provided speakers and materials for
dissemination at the information forums. Over 300 people attended
statewide.
In addition, the Council's executive director has actively participated
in the planning and development of Arizona's Medicare " Ferret Out
Fraud" campaign since its inception. This campaign is an off- shoot of
HCFA's Medicare fraud prevention efforts.
Proposed changes to the Medicare program continue to hold the
Council's close attention and involvement. HCFA requested the
participation of the Council's executive director in the local advisory
committee for HCFA's Medicare Competitive Pricing Demonstration
Project. Required by the Balanced Budget Act of 1997, this pilot
project will test a new methodology for paying Medicare+ Choice
managed health care plans in the state. Naturally, this proposal has
aroused grave concern among aging advocates and Medicare
beneficiaries. The Council continues to closely monitor
developments and will make its voice heard as needed.
If) f) 7 SI~ NIOlll) llY ll1' rl'III~ 1.. 1~(. ISI. Jl1' IJlll~
Senior Day at the Legislature is held every other year, in those years
when the Council does not host a Governor's Conference. Senior
Day 1997 was overshadowed by concerns over the future of home
and community based services ( HCBS) in the state. Newspaper
headlines announced cutbacks in HCBS, on March 7, 1997- the
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day Senior Day was held. With over 900 people in attendance, the
aging network, including the area agencies on aging, the Aging and
Adult Administration, aging service agencies and other
organizations, were understandably nervous about expected service
interruptions to hundreds of elderly receiving HCBS services.
Maricopa County would have been hardest hit by the service
curtailments.
With Governor Symington and legislative leaders in attendance, help
was on the way. The Governor ordered the redirection of $ 250,000
in Social Services Block grants to augment aging coffers and
forestall services closures. As always, the issues of the day focused
on issues vital to elderly people's well- being. Respite, Hospice, and
the Ombudsman program were highlighted and the Legislators
responded by approving funds for respite care and additional
funding for HCBS.
I fnUI f, O'TI~ IINf) ll'S f~ ONI~ I~ 111~ N(~ I~ () N iIf, INf,
The 1998 Governor's Conference on Aging, " A Compass for the
Future: Dynamic Directions," was held in Flagstaff, Arizona during
two snowy days in May 1998. It was the tenth bi- annual conference
hosted by the Council. Over 500 people from throughout the state
attended the conference on the beautiful campus of Northern
Arizona University. Although the conference was smaller than
previous years due to facility size, participants rated the conference
highly.
The conference contained more than 40 workshops on various
subjects, focused in four tracks. One keynote session on the
challenges of the new aging demographics, two policy sessions, and
one plenary session for each of four tracks were conducted. Topics
covered everything from active aging, spirituality, trends and
challenges, options and problem areas.
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Prominent advocacy issues included respite care for caregivers, the
augmentation of the ombudsman program and additional funding for
home and community- based services. The 1998 Legislative session
produced over $ 500,000 additional funds for these programs.
The next Governor's Conference will be held in May, 2000 in
Phoenix.
I.. OOIlIN(, l'HI~ l'l)
A comprehensive, affordable, and accessible array of aging services
statewide is the guiding focus as the Council continues to promote
and develop programs, foster discussions, and present conferences
and workshops. The Council's constant goal is both to sensitize
policy makers to the current needs and wants of the aging
population, and to assist the aging network to develop affordable
options and realistic solutions.
With the dedication of Council members, volunteers, the aging
network, and the commitment of the staff, the Council feels confident
it can continue to find and implement solutions to the challenges
ahead.
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