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Home and Community Based Care services include:

• Adult Day Services
• In-home Respite Care
• Care Coordination
• Alzheimer’s Education and Caregiver Support–statewide

Barrow elder Amy Ohpeaha at a congregate meal. (Photo by North Slope Borough Senior Services Staff.)

The Alaska Commission on Aging awards grants to non-profit agencies to provide HCB services. These agencies also receive revenue through services rendered for Medicaid clients, grants funded through the Alaska Mental Health Trust Authority, and through active fundraising, client fees for services, local governments, civic organizations, and other sources.

In general, Home and Community Based programs provide services to physically frail/disabled persons age 60 and older and people of any age with Alzheimer's Disease and Related Disorders (ADRD). Agencies also target individuals with low incomes, people who live alone or with unpaid caregivers, members of ethnic minority populations, and people at risk for services to institutionalization.

Adult Day Services (ADS)

The Alaska Commission on Aging (ACOA) awards grants to support 12 Adult Day Programs located in 11 communities: Anchorage (two centers) Bethel, Chugiak, Fairbanks, Homer, Juneau, Kenai, Ketchikan, Kodiak, Nome, and Palmer.

ADS programs provide therapeutic and support services at a central location to functionally or cognitively impaired adults. Services may include exercise programs, reminiscing and memory activities, social and cultural gatherings, as well as assistance with health and personal care. All ACoA grant funded ADS programs provide services five days per week for a minimum of five hours per day. Individuals attend ADS programs on a planned basis determined by the individual’s needs and abilities. After a comprehensive assessment, the staff, client, and caregivers develop a mutually agreed upon plan of care to meet the physical, social, emotional, and cognitive needs of the client. Everyone then reviews the plan of care at least every six months and makes revisions as needed. The need for ADS services often exceeds what is available due to staffing and space limitations of the programs. In addition to direct services provided to individuals attending the programs, caregivers receive respite, information, and support services.

During FY01 a total of 507 individuals received 261,154 hours of adult day services in programs receiving funding from the ACoA and other funding sources. Of these individuals:

• 69% had Alzheimer's Disease and Related Disorders (ADRD)
• 30% were ethnic minorities
• 69% had incomes below the federal poverty level
• 42% lived in rural areas

Alois Kopun and Dan Skonberg learn to drum with the Kodiak Island Drummers who visited Island Cove Adult Day Program.
(Photo by Pat Branson.)

In-Home Respite Care Services

Respite Care Services are defined as planned care, assistance, and activities provided by a trained paraprofessional caregiver to a dependent adult in the client’s home for a scheduled period of time. Occasionally, the period of time may be extended to 24-hour care in either the client’s home or in another residence or facility. Respite care provides the full-time caregiver a crucial break from the relentless demands of caregiving. Respite also allows the dependent adult to benefit from a change of pace from their regular care provider.

The ACoA provides grants to support respite services in the following areas through four agencies:

Respite Care Client Profile

In FY01, ACoA grantees provided 77,160 hours of respite services to approximately 285 clients in approximately 64 communities throughout Alaska. (These figures represent services funded by the ACoA and MHTA grants, the Medicaid Waiver, and other funding sources.) Grantee quarterly programmatic reports on 285 client profiles indicate:

Care Coordination

Care coordination involves an in-depth assessment of a person’s needs and resources that leads to linking the client to a full range of appropriate services, utilizing all formal and informal resources, and monitoring the care provided over an extended period of time.

Care coordinators interview clients, their family, caregivers, and medical and social care providers to assess the client’s complex medical/social situation. Based on the assessment, a tailor-made plan of care that includes referrals for services is designed around the individual’s strengths, needs, and desires. The plan is implemented when accepted by the client, the client's family, and caregivers. The care plan is reevaluated at least once per year if needed. A revised plan of care is then designed to meet the client's changing needs.

As reported by ACoA grantees, 1,167 individuals received care coordination services in FY01 through funding from the ACoA, Medicaid Waiver program, and other sources. Quarterly programmatic reports on client services indicate:

• 39% had ADRD
• 38% were ethnic minorities
• 74% lived alone, with family members or other unpaid caregivers
• 39% lived in rural areas
• 71% had incomes below the federal poverty level

Statewide Alzheimer’s Disease Community Education and Caregiver Support

In FY01, through a statewide grant from the ACOA, the Alzheimer's Disease Resource Agency of Alaska (formerly the Alaska Chapter of the Alzheimer’s Association) provided the following:

• 6218 information and referral assistance calls to individuals seeking phone numbers, local contacts, and other brief information
• 205 individual and/or family consultations to individuals seeking extensive information and requests of a broad or indefinite nature (Requests are often multi-faceted in which information on a number of topics is provided. Providing resource materials, emotional support, and follow-up with the client are common activities.)
• 72 support group meetings for caregivers of Alaskans with Alzheimer’s Disease and Related Disorders (ADRD)
• 121 consultations to 105 service providers often involving an evaluation of a client situation and provision of information to paid service providers
• 84 public awareness activities of which examples include newspaper articles, public service announcements, newsletters, and public speaking engagements.

Other services include advocacy, education training, quarterly newsletter, caregiver information, and a multi-media lending library.

Santa Claus and Mrs. Claus bear a striking resemblance to Carl and Mary Mallett of the Sterling Area Senior Citizens.
(Photo by Judy Warren.)

SENIOR RESIDENTIAL SERVICES

Kotzebue and Tanana Residential Facilities were established by legislatively mandated funding. The funds are granted through the Commission on Aging to these two rural senior assisted living residences.

The residents, who are primarily Alaska Natives from rural communities in Alaska, are provided all meals and assistance with their housekeeping. Each resident has a semi-private room and receives services such as medication monitoring, skilled nursing care, assistance in transferring from wheel chair to bed, dressing, eating and bathing. These two programs served a total of 43 residents in FY01.

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