collaboration in action: creating a community vision to support the growing older adult population...

Collaboration in Action: Creating a Community Vision to Support the Growing Older Adult Population in Metro Detroit

April 16, 2007

Leah Rosenbaum, JVS

Linda Blumberg, Jewish Federation

Perry Ohren, Jewish Family Service

AJFCA & IAJVS 2007 Annual Conference

…A Work in Progress

AJFCA & IAJVS 2007 ANNUAL CONFERENCE

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Agenda

1. History of the COJES* Model Leah2. COJES Today Perry3. 2005 Detroit Population Study Linda4. Eldercare Visioning Process Linda5. Future of Eldercare Services Linda

*Commission on Jewish Eldercare Services


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Agency Execs Task Force on Aging

Jewish Family ServiceJewish Community Center JVSJewish Apartments and ServicesJewish Home and Aging Services Federation/COJES


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Historical Perspective

By the mid 1990s several challenges were facing the Jewish community with regard to services for older adults.


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Challenges: Jewish Nursing Home

Borman Hall – a licensed Home for the Aged No longer in the heart of the Jewish communityPoor state inspectionsFiscal drain on the Federation


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Challenges: An Aging Population

In the mid 1980s, 1 in 100 Michigan residents was over 85.1990-2000 – more than a 30% increase in residents over 85 y.o.Services would need to adapt to serve an older, frailer population.


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Eldercare Options Committee

Create a vision for caring for older adultsDevelop a long-term strategy for the community’s delivery of eldercare servicesAddress the problems at Borman Hall and long term care institutional needsDetermine community-based care options with the goal of helping older Jewish adults to age in place


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Gaps in Array of ServiceDementia specific Adult Day Care In-home support servicesCentralized information, referral and access to services Affordable housing Services for older adults with lifelong disabilities Wellness, health prevention programs and access to primary health careTransportation


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Recommendation: Get out of the Nursing Home Business

Find a qualified operator to serve as a preferred providerTransfer residents to facilities that served

kosher foodMake Jewish Home and Aging Services

responsible for ensuring that these homes operate “Jewishly”It was clear that Federation needed to convince the community that it was not turning its back on the Jewish frail elderly.


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Recommendation: Create Central Planning and Coordinating Authority

In the fall of 1996 COJES was formed as a consortium of the partner Federation agencies servicing older Jewish adults.Organized as a function of the Federation, as part of the Planning Department Comprised of lay leaders and professional staff of each Federation agency and community members at-large


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Responsibilities of COJESServing as a central planning and coordinating authority for older adult servicesCreating a continuum of care of quality services for Jewish older adults and their familiesDeveloping a community-wide plan and budget for Jewish eldercare services


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Meeting the ChallengeHow to get five agency executives who were hired to protect and grow their own agencies to work together openlyHow to develop collaborative rather than individualistic projects in order to maximize resourcesHow to avoid duplication of services


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Meeting the Challenge:Getting Buy In

Build on the strengths and expertise of each of the partner agenciesPartner agencies were all active participants in the Eldercare Options Committee and the creation of COJES.Partner agencies were part of the interviewing process to choose the director.


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Meeting the Challenge:Improve CollaborationCOJES, along with the Agency Execs Task Force on Aging, has repeatedly looked for ways to enhance services and efficiency:

Examine the best use of existing resources Examine if a program or service lends itself

to collaboration Not all services need to be provided by the

Jewish community -- no need to duplicate what exists in the general community.


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Meeting the Challenge: Getting to Work

How to best structure COJES for getting work done Establishment of subcommittees composed

of professionals and lay leaders to address gaps in services including: Jewish Community Information Center Adult Day Care Chaplaincy Community education In-home Support Services Budgeting Housing and transportation Falls prevention and wellness center


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Initial Outcomes of COJESThere is a positive view in the community about

Federation’s role in addressing the needs of older adults.The preferred providers are offering good care at the

nursing homes.More older adults than ever before are being assisted by

Federation agencies and receiving the supports needed to age in place. There are expanded and new programs, many jointly

operated.

COJES agencies provide a variety of coordinated services offering a continuum of care for older adults.


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Meeting the Challenge: Establishing a Cross Agency Budget

Shows how much money is actually being spent in the Jewish community on older adult services Shows how much governmental funding is helping to support servicesHelps provide information on duplication/ overlap of services among the agencies


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Meeting the Challenge: How to Fund ProgramsA commitment on the part of the Federation lay and professional leadership to raise money above and beyond the Campaign


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Allocation PlusRubin Jewish Community Trust for the ElderlyThe Jewish Fund


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Thanks to COJESCollaborative effortsReduction in duplication of servicesIncreased funding has been secured for older adult services.


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COJES Today

1. Merged/Joint Programs2. COJES Strategic Plan3. Eldercare Services Proposal


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Merged/Joint Programs

1. Coville Assisted Living2. Brown Adult Day Care3. Transportation4. Holocaust Survivor Services5. Assisted Meals6. NORC SSP

All as a result of the COJES process


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Coville Assisted Living

Transfer of endowed Assisted Living Program from Jewish Family Service to Jewish Apartments and Services

Why do it this way? It serves clients best.

JFS JFS & JAS JAS


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Brown Adult Day CareOne ProgramTwo Adult Day Care sitesOne Budget and One DirectorOperated Jointly by JVS and Jewish Home and Aging Services


JVS & JHAS


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Transportation

Centralized coordination and dispatching of transportation resourcesIncreased efficiencyShare Vehicles and Drivers


JFS & JAS


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Holocaust Survivor Services

Yad B’ Yad – collaboration between Jewish Family Service and Jewish Home and Aging Services to provide friendly visiting to Holocaust survivorsIt uses each agency’s expertise well.


JHAS & JFS


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Assisted Meals

Serves Jewish Apartments and Services’ increasingly frail residents who cannot stand in cafeteria lineEmploys JVS consumers (with DD and/or MI

diagnoses) in an enclave setting to assist with meals


JAS & JVS


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NORC SSP

JFMD DirectorHoused at JFSJFS and JVS staffJCC as Venue


JFMD, JVS, JCC & JFS


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COJES Strategic Plan

Coordinating services Jewish residential service

packageTransportationCare Management In-Home Support ServicesAffordable HousingDay Programs

Caregiver Support Center

No Wrong Door Applications for

residential services Life Planning for

pending and current retirees

COJES Website Art of Jewish Caregiving

SERVICES


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COJES Strategic PlanRECOMMENDATIONS

Create packages of services/programsExplore synergiesDevelop a seamless transition processReduce wait timeIncrease the number of care managersIncrease the number of subsidized slotsIncrease the number of subsidized apartmentsDevelop a resource and support center for caregiversCreate a system whereby people can enter through many

starting pointsDevelop one application for housingDevelop life planning workshopsUpdate current websiteCreate a caregivers training program in the Art of Jewish

Caregiving


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COJES Strategic PlanTHEMES

SeamlessnessBaby boomers as caregivers and soon to be “older” consumersFocus on “Welderly” as well as Frail ElderlyNo Wrong DoorCampus(es) - Strengthening while Community-FocusedCharging for services, e.g, Concierge


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Campus Connections Proposal

An accepted proposal to The Jewish FundA follow up study to further assess the wants and needs of older adults and their caregivers and the best methods for addressing these and delivering servicesThis has merged with the Eldercare Visioning Committee Process.


JAS, JCC, JFS, JHAS, JVS & JFMD


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2005 Detroit Jewish Population Study

78,000 persons live in 30,000 Jewish households plus 500 Jews in institutions for a total of 78,500 persons in the Jewish community; 72,000 are Jews.*24% (18,486) are 65+ (compared to 17% - 17,850 in 1989).14% (10,920) are 75+ (compared to 6% - 6360 in 1989).4.4% (3432) are 85+ (compared to 1% - 1000 in 1989).47 – median age, 1989 – 41, NJPS 2000 – 3988% of Jews have lived in Detroit 20+ years – 97% for those 65+.

*More on the ‘05DJPS available at www.jfmd.org/


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2005 Detroit Jewish Population Study

59% of households have an adult child in the area.Median income: $85,000; $41,000 - age 65+; $86,000 - elderly couples; $24,000 - elderly singles17% of households have health-limited member; 33% for elderly households.In-home care and transportation most needed services among older adultsAssociation with Jewish community (memberships, practice and/or philanthropic giving) highest among elderly couples – 79%; drops to 45% among elderly single households


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Eldercare Visioning Committee: Role

Examine the current package of services to older adults and service delivery systemExplore local and national models of eldercare service deliveryDevelop recommendations re: best way to deliver servicesDevelop recommendations for funding older adult services


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Eldercare Visioning Committee: Basic Premises

The number of people who will need services in the future and the cost of providing services will increase.The primary focus of services is community, not institutional based.The current system is not broken, but needed to decide if current system is best for the future, needs modification or there needs to be a new system.The process is to be approached with no preconceived ideas and from a communal rather than individual agency perspective. Committee members are encouraged to share, participate, be creative and brainstorm.There are no bad ideas.Committee has the ability to have a major impact now and in the future.


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Eldercare Visioning Committee: Roadmap

Educating Committee membersCreating a common knowledge baseLearning about other local and national models of eldercare service deliveryExamining specific service areasSharing information gatheredMaking recommendationsPresenting recommendations to Federation leadership


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Eldercare Visioning Committee: Lay-Professional Intersection

Committee staffed by Planning Director/COJES DirectorOther Federation staff include: Chief Administrative Officer, Endowment Specialist and Jewish Fund DirectorAgency Executives Task Force on Aging presents to the Committee vision for older adult services, identified gaps and recommendations for futureTask Force joins Committee for presentations on other local and national modelsConsultant includes meetings with Task Force members in report to Visioning CommitteeTask Force to give input into Committee’s recommendations prior to finalization


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Eldercare Visioning Committee: Benefits

Creates greater visibility for needs of older adultsReaffirms Federation’s commitment to addressing needs of older adultsGets more people at the tableEngenders significant funding for older adult services


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Eldercare Visioning Committee: Challenges

Delay in implementation of COJES Strategic PlanAltered professional-lay partnership that is core tenet of COJESPotential lengthy implementation time for Visioning process recommendationsWays to create dialogue between Committee and COJES Agency Executives Task Force on Aging


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Eldercare Visioning Committee: Possible Outcomes

Creation of a central agency

Modification of current COJES model


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The diagram above refers to services that could perhaps be consolidated. In addition, there still needs to be a discussion of other services that could potentially be consolidated such as food services and Holocaust survivor services. A decision was made to continue to coordinate volunteer services, but not to consolidate them into one agency due to the nature of volunteerism and the agency/volunteer relationship.

Eldercare Services Structure

Stay Tuned!

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Questions, Answers & Dialogue


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Contact InformationLeah Rosenbaum, Executive Vice President and Chief Operating

OfficerJVS 29699 Southfield Road, Southfield, MI 48076 (248) 233-4220 • [email protected]

Linda Blumberg, Director, Planning & Agency Relations Jewish Federation of Metropolitan Detroit6735 Telegraph Road, Bloomfield Hills, MI 48301(248) 203-1468 • [email protected] Perry Ohren, Chief Program OfficerJewish Family Service of Metropolitan Detroit6555 West Maple Road West Bloomfield, MI 48322(248) 592-2302 • [email protected]

collaboration in action: creating a community vision to support the growing older adult population...

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