U.S. Department of Health and Human Services

U.S. Administration on Aging 

Compendium of FY 2009 

Grant Awards 

Under Title IV of the Older Americans 

Act 

i 
i 

Explanatory Notes 

The Administration on Aging (AoA) Compendium of FY2009 Grants is the 30th edition of the 

annual compilation of project grant abstracts awarded under the Older Americans Act (OAA). 

It is in accordance with the OAA Section 432(6) which calls for the Assistant Secretary to 

submit a report to the U.S. Senate and House of Representatives which describe projects 

funded in the previous Fiscal year. 

Several changes have been made in this year’s edition: (a) Only new and continuation 

projects receiving FY2009 funds are included – previous editions included active projects 

which did not received new funding; (b) Project descriptions are organized by program area 

or topic by the AoA organizational unit responsible for conducting proposal competitions 

and/or monitoring projects with the exception of Congressional directed awards which are 

administered throughout the agency; (c) the index is by type of organization and arranged 

within categories by State; and (d) project descriptions include the name of the AoA project 

officer. 

Readers interested in learning about projects should first contact the grantee. Information 

about the program area can be found on the AoA website: http://www.aoa.gov and on 

websites of organizations serving as technical assistance resource centers that can be 

accessed through the AoA website. AoA may be contacted as follows: 

Telephone: (202) 619-0724 

Email: aoainfo@aoa.hhs.gov

Mailing Address: U.S. Administration on Aging 

 Washington, D.C. 20201 
ii 

Table of Contents 

Explanatory Notes ................................................................................................................... i

Center for Policy, Planning and Evaluation 

A. Office of Program Innovation and Demonstrations 

Aging and Disability Resource Centers......................................................................... 1

Alzheimer’s Disease Supportive Services – Innovation Projects ................................ 50

Alzheimer’s Disease Supportive Services – Evidence Based Projects....................... 59

Community Living Program......................................................................................... 67

Consumer-Directed Technical Support Project........................................................... 83

Evidence Based Health and Disease Prevention Program......................................... 84

Planning for a National Evaluation of Evidence-Based Programs ............................ 108

B. Office of Performance and Evaluation

Performance Outcomes Measurement Projects (POMP) ......................................... 109

Center for Program Operations 

A. Office of Home and Community Based Services

Community Innovations - Aging in Place Projects .................................................... 116

Community Innovations Technical Assistance and Training..................................... 130

Lifespan Respite Care Program................................................................................ 131

State and Area Agency Planning Projects ................................................................ 146

B. Office of Elder Rights 

Pension Information Counseling Program ................................................................ 150

National Center on Elder Abuse ............................................................................... 157

National Long-Term Care Ombudsman Resource Center........................................ 160

National Legal Assistance Resource Centers........................................................... 161

Senior Legal Services - Access Enhancement ......................................................... 166

Senior Medicare Patrol (SMP) Statewide Projects.................................................... 184

Senior Medicare Patrol (SMP) Integration Projects .................................................. 239

Senior Medicare Patrol (SMP) – Resource Center ................................................... 246

C. Office for American Indians, Alasken Native and Native Hawaiian Programs 

National Resource Centers on Older Indians, Alaska Natives and 

Native Hawaiians ...................................................................................................... 247

D. Office of Outreach and Consumer Information

Alzheimer's National Call Center .............................................................................. 250

Eldercare Locator ..................................................................................................... 251

Health Disparities among Minority Elders- Technical Assistance Centers................ 252

Multigenerational Civic Engagement Assistance Center........................................... 255

National Education and Resource Center on Women and Retirement ..................... 256

E. Headquarters and Regions 

Congressional Directed Awards................................................................................ 257
iii 

Organization Index..................................................................................................... iv

Academic Institutions 

American Indian, Alaskan Native and Native Hawaiian Organizations 

Area Agencies on Aging and State Associations 

Non-Profit State and Local Organizations 

State Government Agencies and Units on Aging 

National Organizations
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0041

Project Title: Alabama ADRC

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Alabama Department of Senior Services 

State Unit on Aging 

770 Washington Avenue, Suite 470 

 P.O. Box 301851 

Montgomery, AL 36130-1851 

Contact:

Julie Miller 

Tel. (334) 242-5743 

julie.miller@adss.alabama.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,056

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,056

Project Abstract: 

Alabama Department of Senior Services (ADSS) in partnership with Middle Alabama Area 

Agency on Aging are usiing this grant to pursue as the goal coordination of a personalized 

and consumer friendly approach to provide information and long-term care options, both 

public and private to meet the growing demands for long-term care services and supports for 

older individuals and those, disable or living with chronic illness for the Aging and Disability 

Resource Center (ADRC) grant to empower individuals to navigate their health and long-term 

support options. Objectives of the project include: 1) expansion of ADRCs to the M4A 

region; 2) Implement procedures; develop tools, and training to support hospital discharge 

planners and caregivers; 3) -expand and enhance services in collaboration with the 

Governor’s Office of Disability and Independent Living Resources of Greater Birmingham to 

serve all target populations; 4) prescreen clients for potential Medicaid spend down and 

counsel clients on importance of appropriate long-term care planning. By the end of the grant 

ADSS will increase Information technology (IT) capacity to implement system changes and 

track measure s that show effectiveness of program; ADSS and State ADRC Advisory 

Council will develop a 5 year plan and budget to implement statewide ADRCs in all AAA 

regions; and ADSS will coordinate with Medicaid working with other health and human 

service providers to increase awareness and funding for ADRCs and to develop a coherent 

system of access to modernize the long term care system in Alabama. 

Page 1 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0035

Project Title: Development and Expansion of a Fully Functional Aging and Disability

Resource Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Alaska Department of Health and Social Services 

Division of Senior and Disabilities Services 

550 W. 8th Ave. 

Anchorage, AK 99501 

Contact:

Kelda O. Barstad 

Tel. (907) 269-8164

Email: kelda.barstad@alaska.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

Alaska is currently undergoing a large systems change to restructure the Home and 

Community Based Medicaid Waiver (HCBMW) and Personal Care Assistance (PCA) 

programs. The Aging and Disability Resource Centers (ADRCs) have an opportunity to 

become an entry point into publicly funded long term support services, as part of a statewide 

system improvement project. There are three ADRCs and the goal of this grant is to develop 

three new ADRCs in areas of the state that currently don't have an ADRC. This infrastructure 

is necessary to achieve SDSs goal to utilize the ADRCs to streamline access to services 

statewide. The first 18 months will be used to develop and foster the growth of each new site 

with focus on awareness and assistance. This is fundamental to make the ADRCs visible 

and trusted places for seniors, caregivers and individuals with disabilities to access the full 

range of long term care support services regardless of their income. The second 18 months 

will focus on access. This will incorporate and implement activities of the current ADRC Pilot 

Project and SDS system changes to realign the process of the HCBM Waivers and the PCA 

Program. The Hospital Discharge Planning Tools, developed through the RCSC grant will 

also be implemented during the second 18 months of this grant into the new sites. At the end 

of the 36 months, Alaska will have six ADRC sites that meet the recommended metrics for a 

fully functioning ADRC. ADRCs will also develop and implement a five year plan and tools 

for program evaluation to create a sustainable ADRC program in Alaska. 

Page 2 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0008

Project Title: Arizona Aging and Disability Resource Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Arizona Department of Economic Security 

Division of Aging and Adult Services 

1789 W. Jefferson, Site Code 950A 

Phoenix, AZ 85007 

Contact: 

Melanie K Starns 

Tel. (602) 542-2591 

mstarns@azdes.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,622

Project Abstract: 

The Arizona Department of Economic Security, Division of Aging and Adult Services (ADESDAAS) in collaboration with the Area Agencies on Aging (AAAs), academic and community 

provider partners, will build upon the strengths of AZLinks, its Aging and Disability Resource 

Center (ADRC), to educate and develop formal linkages with federally supported Care 

Transition Programs by achieving the following goal and objectives: Goal: To assist 

individuals with chronic conditions who are being discharged from hospitals to avoid 

unnecessary nursing home placement or hospital re-admissions. Objectives are to: 1) 

increase ADRC resources to coordinate with local hospital discharge planners to incorporate 

the Care Transitions Program; 2)-Modify the statewide data management system to enable 

the Arizona ADRC to gather client information effectively; and 3) -Develop a five year 

operational plan with input from all key stakeholders. Expected outcomes include:more 

informed public and improved access to services; improved support for individuals and 

informal family caregivers; lower hospital re-admission rates, maintenance of current level of 

health functioning, improved capability to collect and process client data, increased self-care 

management, and effective integration with existing programs using a no wrong door 

approach. Anticipated products include: 1) annual data reports; 2) program materials for 

replication; 3) revised scopes of works and policies and procedures; 4) evaluation results; 

and 5) final report. 

Page 3 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0005

Project Title: Community Choices - Arkansas Care Transition Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Arkansas Department of Health and Human Services 

Division of Aging and Adult Services 

PO Box 1437 Slot S530 

Little Rock, AR 72203 

Contact: 

Kris Baldwin 

Tel. (501) 682-8509 

Email: kris.baldwin@arkansas.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,902

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,902

Project Abstract: 

The Choices in Living Aging and Disability Resource Center (ADRC), located in the Arkansas 

Division of Aging and Adult Services (DAAS), in collaboration with the University of Arkansas 

for Medical Sciences (UAMS) Medical Center and the St. Joseph's Mercy Health Center will 

adapt the model of the Colorado Care Transitions Intervention to implement the Community 

Choices project. The ADRC will develop and implement a replicable program that will target 

seniors and adults with disabilities who are at risk of nursing home admission. Hospital 

discharge planners will work with ADRC staff to identify consumers to ensure their needs are 

met as they transition from an acute care setting to the community. The overall goal of this 

project is to improve care transitions by providing consumers with the support and tools that 

promote self-knowledge and self-management as they move from one long term setting to 

another. Arkansas will partner with Area Agencies on Aging, Independent Living Centers, 

providers of community health and home and community based services to achieve the 

following objectives: 1) create community partnerships that will develop and implement a 

sustainable discharge planning process; 2) streamline access to home and community-based 

services(HCBS) that support consumers in transitioning from one long term setting to 

another; 3) implement a variety of training opportunities to community partners to increase 

consumer choices and better coordinate services in the community. Project outcomes 

include: 1) a replicable care transition program that can be expanded statewide; 2) 

community partners who are aware of services that increase consumer choices; 3) 

individuals at high risk of nursing home admission have quicker access to HCBS and 4) 

reduction in hospitalizations for program participants. 

Page 4 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0047

Project Title: Enhancing and Expanding California's ADRC

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

California State Independent Living Council 

1600 K Street, Suite 100 

Sacramento, CA 95814-4010 

Contact: 

Liz Pazdral

Tel. (916)445-0142 

liz@calsilc.org

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $199,365

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $199,365

Project Abstract: 

The grantee, the California State Independent Living Council (SILC), supports this three-year 

ADRC network enhancement in collaboration with the California Department of Aging, the 

Department of Rehabilitation, and the Health and Human Services Agency. The goal of the 

project is to enhance the California ADRC network, The objectives are: 1) expanding the 

network by one more site; 2) teaching and promoting practice of the Coleman Care 

Transitions Intervention model; 3) participation in the ADRC cross-agency Steering 

Committee work group activities; and 4) Strategic Planning to design a master plan to 

expand the ADRC Network throughout California. The expected outcomes of this project are 

increased consumer awareness of and information about long-term services and supports, as 

well as home and community-based service options; and increased consumer understanding 

regarding eligibility for long-term services and supports. The products from this project are a 

new ADRC location in California; data and lessons learned from promotion of the Coleman 

Transition Intervention; a final report, including evaluation results; a Website; and abstracts 

for national conferences. 

Page 5 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0028

Project Title: Expansion of Colorado's ADRC.

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Colorado Department of Human Services 

Office of Adult, Disability and Rehabiliation Services 

1575 Sherman St., 10th Floor 

Denver, CO 80203 

Contact: 

Todd Coffey 

Tel. (303) 866-2750 

todd.coffey@state.co.us

AoA Project Officer: Elizabeth 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,844

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,844

Project Abstract: 

The Colorado Department of Human Services (CDHS) and the Colorado Department of 

Health Care Policy and Financing (HCPF) will support a three-year expansion of the Aging 

and Disability Resource Center (ADRC) known as Adult Resources for Care and Help 

(ARCH) in Colorado. The Colorado ARCH utilizes the resources and knowledge base of 

existing agencies including: the Single Entry Point (SEPs) Agencies, the Area Agencies on 

Aging (AAAs), Centers for Independent Living (CILs), and Colorado 2-1-1. The goal of 

Colorado ARCH is to improve access to information and assistance for long-term care 

services for aging and disabled adults in Colorado. Colorado ARCH will coordinate with 

agencies to streamline access for both publicly and privately funded services. The objectives 

are: 1) expand and sustain a management information system (MIS); 2) enhance and expand 

the integration of evidence-based programs and education of hospital discharge planners; 3) 

expand Colorado ARCH Pilot sites to Eagle, Garfield, Grand, Jackson, Pitkin, Summit, Otero 

and Crowley Counties; 4) blend Denver and Boulder Counties into Colorado ARCH; 5) 

develop a plan to expand Colorado ARCH statewide; 5) expand Colorado ARCH to an 

additional three pilot sites; and 6) evaluate the impact of Colorado ARCH. Expected 

outcomes include: long-term care services, resources, and supports are made known to 

consumers in Colorado; long-term care services, resources, and supports are easily 

accessed; Resource Specialists improve the connections and collaboration to these services; 

and accessing the best fit for services expands the consumer's choice. 

Page 6 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0048

Project Title: Connecticut's Aging and Disability Resource Center Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Connecticut Department of Social Services 

Aging Services Division 

25 Sigourney Street 

Hartford, CT 06106 

Contact: 

Margaret Gerundo-Murkette 

Tel. (860)424-5322 

Margaret.Gerundo-Murkette@ct.gov

AoA Project Officer 

Fiscal 

Year 

Funding 

Amount

FY2009 $204,161

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $204,161

Project Abstract: 

The Connecticut Department of Social Services (DSS) and its State Unit on Aging (SUA), in 

partnership with the Agencies on Aging: of North Central (NCAAA), South Central (AASCC) 

and Western (WCAAA) Connecticut and the Centers for Independent Living (CIL): Center for 

Disability Rights (CDR), Independence Unlimited (IU), and Independence Northwest (IN), & 

Home and Community Based Services (HCBS) provider Connecticut Community Care, Inc. 

(CCCI), and the Hospital of Central CT (HCC) will partner to further expand Aging & Disability 

Resource Centers (ADRC) in Connecticut. The goal isf to provide consumers with a Single 

Entry Point (SEP) system to all long-term services and supports while providing streamlined 

access to all publicly funded long-term supports and services, including both HCBS and 

institutional care. Objectives are 1) to create new ADRC in the North Central Region (NCR) 

of Connecticut with core partners NCAAA, IU, and CCCI; 2) have the ADRC partner with 

HCC to pilot a new person-centered hospital discharge planning model ,the Care Transition 

Intervention (CTI), to reduce unnecessary hospital readmissions and replicate it in two 

remaining regions; 3) Incorporate new ideas for sustainability including use of Title III-B 

funds; 4) formally coordinate with the State Medicaid Agency (SMA) to provide expedited 

eligibility determinations (EED); and 5) develop a Statewide ADRC operational plan & budget. 

Expected project outcomes include: new ADRC; new committed partnerships; CTI model in 3 

regions; EED achieved; sustainable long term care (LTC) systems change. Expected 

products include: ADRC products in alternative formats; accommodations for consumers, and 

LTC Management. 

Page 7 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0020

Project Title: Delaware Aging and Disability Resource Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Delaware Department of Health and Social Services 

Division of Services for Aging and Adults with Physical Disabilities 

1901 N. DuPont Highway 

New Castle, DE 19720 

Contact: 

Guy Perrotti 

Tel. (302) 255-9390 

guy.perrotti@state.de.us

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,854

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,854

Project Abstract: 

The Delaware Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) 

proposes to use funds provided through this grant to establish a new, statewide Aging and 

Disability Resource Center (ADRC). The Delaware ADRC will provide a one-stop access 

point for long-term care services and supports for older persons and adults with physical 

disabilities in the State. The ADRC will be operated by DSAAPD staff in coordination with 

partner organizations, including the Division of Medicaid and Medical Assistance, the State's 

Health Insurance Counseling and Assistance Program (SHIP), the State's Centers for 

Independent Living (CILs), and the Delaware Aging Network (DAN). Functions to be carried 

out by the ADRC will include information & awareness; options counseling; streamlined 

access to public programs; person-centered hospital discharge planning; and quality 

assurance & evaluation. Because Delaware is a single planning and service area for 

purposes of administering funds under the Older Americans Act, DSAAPD currently serves 

as a focal point for information and assistance services statewide and performs as an access 

point for many public programs. The grant will allow DSAAPD to make the infrastructure 

improvements and systems changes needed for the successful implementation of an ADRC. 

Infrastructure improvements will include the installation of a state-of-the-art call center; the 

development of a web portal for real-time referrals; the creation of an ADRC web site with a 

searchable database; and the development of management information systems needed for 

client tracking. Other improvements will include expanded training, increased coordination 

among partner agencies, and formalized support of the hospital discharge planning process. 

Page 8 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0025

Project Title: Strengtheing D.C Office on Aging’s Aging and Disability Resource 

Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

District of Columbia Office on Aging 

441 Fourth Street, NW, Suite 900 South 

Washington, DC 20001 

Contact: 

Dr. Clarence Brown 

Tel. (202) 724-5622 

Email: clarence.brown@dc.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $225,899

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $225,899

Project Abstract: 

The goal of the District of Columbia Office on Aging and the Aging and Disability Resource 

Center (DCOA/ADRC) three year project, in collaboration with its Senior Service Network, 

collaborating partners and District hospitals, is to significantly strengthen its existing 

DCOA/ADRC program by developing and implementing a coordinated, person-centered 

hospital discharge planning component and streamlining access for family and informal 

caregivers support and services. The project's primary objectives are: 1) integrate hospital 

discharge planning component into the DCOA/ADRC starting with five pre-selected hospitals 

during the first eighteen months and all District hospitals in three years; 2) develop consumer 

cost model to accompany hospital discharge services and planning designed to show cost 

effective options that can save time and avoid frequent re-hospitalizations; 3) change the 

District's approach to and system for providing caregiving services among all service 

providers; 4) develop new informal caregiver support materials that are person centered, 

culturally competent, and targeted to low and moderate income groups for families post 

hospital discharge; and 5) increase access to information, services, sources of support and 

training for all District caregivers. The expected outcomes are: 1) the first DCOA/ADRC 

person-centered care coordination model in the District; 2) reduction in the District's rate of 

re-hospitalization and a consumer cost saving model; 3) real system change in providing 

streamlined access to caregiving services for consumers, family/informal caregivers of all 

ages; and 4) enhanced caregiving training and consumer information and support materials. 

The expected products are: consumer and family caregiver information and materials on 

hospital discharge planning; evaluation results of system changes; conference presentations; 

and reports. 

Page 9 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0006

Project Title: Florida Department of Elder Affairs 2009 Aging and Disability Resource 

Center Expansion Grant

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Florida Department of Elder Affairs 

4040 Esplanade Way, Suite 315 

Tallahassee, FL 32301 

Contact: 

Abbie Messer 

Tel. (850) 414-2105 

Email: messera@elderaffairs.org

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $238,842

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $238,842

Project Abstract: 

The Florida Department of Elder Affairs (DOEA) in collaboration with the Agency for Persons 

with Disabilities (APD) willexpand the disability population served by one of the existing Aging 

and Disability Resource Centers (ADRC) and to transition one of the current Aging Resource 

Centers (ARC) to a fully functioning Aging and Disability Resource Center. The goals of the 

grant are to strengthen current ADRC efforts by expanding the target population of people 

with disabilities served by the ADRC in Planning and Service Area (PSA) 5 to include 

persons with developmental disabilities, transition the Aging Resource Center in PSA 8 to a 

fully functioning ADRC by expanding services to include persons with developmental 

disabilities and establish a framework for statewide implementation of ADRCs. Its objectives 

include: 1) Develop a training curriculum on developmental disabilities including supports 

and services; 2) Educate ADRC staff, members of the service provider community, local 

coalition workgroup and other stakeholders regarding people with developmental disabilities; 

3) Enhance existing information and referral system by expanding resources that may be 

utilized for persons with developmental disabilities; 4) Streamline access to all publicly 

supported long-term care options including resources for persons age 50+ with 

developmental disabilities and their caregivers age 60+; 5) Develop a five-year plan to 

achieve statewide coverage of ADRCs; and, 6) Evaluate the project's effectiveness. 

Page 10 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0019

Project Title: Georgia's 2009 ADRC Expansion Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Georgia Department of Human Services 

Division of Aging Services 

2 Peachtree Street 

Atlanta, GA 30303 

Contact:

Cheryl Harris 

Tel. (404) 656-1705 

Email: chharris@dhr.state.ga.us

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

The broad goal of the application submitted by the Georgia Department of Human Services 

Division of Aging Services is to expand availability of Georgia¿s Aging and Disability 

Resource Connections (ADRCs) to all of the state's 159 counties and to strengthen the 

capacity of the ADRCs to serve all citizens needing long term care supports independent of 

age or disability type. The specific objectives of this proposal are: 1) add three new ADRCs in 

areas currently not served; 2) partner with the state's Quality Improvement Organization and 

the Center for Medicare and Medicaid Services pilot project, the Care Transitions Initiative, 

to establish a pilot discharge planning project linking the Northeast Georgia Area Agency on 

Aging ADRC, the Newton Medical Center and the two nursing homes located in Newton 

County, 3) add an additional ADRC website tool to integrate the Benefits Check up into eforms so that applying for multiple benefits is easier to manage; and 4) improve the quality 

assurance and reporting process to measure performance goals and indicators. The 

expected outcomes include: 1) increasing the number of ADRCs in Georgia from six to a total 

of nine raising the number of counties served by an ADRC from 70 to 119, which represents 

75% statewide coverage, 2) reducing readmission rates of Medicare beneficiaries discharged 

from hospitals in Newton county and avoiding unnecessary nursing home admissions; 3) 

increasing the number of contacts and individuals served by Georgia's ADRCs; and 4) 

developing and implementing a standardized customer satisfaction survey to improve 

ongoing quality of Georgia’s ADRC network. 

Page 11 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0002

Project Title: Expansion and Enhancement of Guam's Aging and Disability Resource 

Centers Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Guam Department of Integrated Services for Individuals with 

 Disabilities 

790 Gov. Camacho Road 

Tamuning, GU 96913 

Contact: 

Frank Reyes 

Tel. (671) 488-5623 

Email: dolphinguam@yahoo.com

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $225,862

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $225,862

Project Abstract: 

Guam has an operational no wrong door Aging and Disabilities Resource Center (ADRC) 

network. Consumers can access the information they need to make informed decisions about 

their long-term care. Project goals include: 1. Decreasing the amount of time between 

referral and intake; 2. Increasing diversions from institutional settings; 3. Increasing 

awareness about Medicare / Medicaid benefits (including Part D coverage); and 4. 

Decreasing rates of hospital readmissions within 30 days of discharge. Stakeholders have 

identified three areas for improvement: 1) Although consumers use the program to locate 

services, they often face a complicated enrollment process; 2) Although consumers use the 

program to learn about their options, there is no formal linkage to State Health Insurance 

Information Program (SHIP) counseling; and 3) Although discharge planners can use the 

program to make referrals, there is no coordinated process for transitioning consumers to a 

community setting. Accordingly, Guam will use new ADRC funds to: 1) streamline the 

enrollment process by working with providers to identify a common dataset for intake forms, 

and configuring Guam's ADRC information system to automatically populate these forms 

using existing community health records; 2). improve coordination with the SHIP program by 

co-locating SHIP counselors at ADRC community events, and cross-training ADRC / SHIP 

staff; and . 3) implement person-centered discharge planning. Improvements for discharge 

planners will include developing a consumer preference survey and a community living plan 

template; providing consumers, family caregivers, and discharge planners access to real time 

availability (waitlist) information; interfacing with medical records (to the extent possible) to 

eliminate duplication/compartmentalization of data; and expanding electronic community 

health records to include decision support tools that allow consumers to better manage 

chronic conditions while living in the community. 

Page 12 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0036

Project Title: Hawaii ADRC

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Hawaii Executive Office on Aging 

250 South Hotel Street, Suite 406 

Honolulu, HI 96813 

Contact: 

Caroline Cadirao 

Tel. (808) 586-7267 

Email: caroline.cadirao@doh.hawaii.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $244,328

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $244,328

Project Abstract: 

The State of Hawaii, Executive Office on Aging (EOA) in partnership with the four Area 

Agencies on Aging (AAA), proposes to expand the current Aging and Disability Resource 

Center (ADRC) statewide. The overall goals are to empower Hawaii's residents to make 

informed decisions about their options and to streamline access to the services and support 

that elders and their family caregivers need. 

EOA strives to fully integrate the disability community and partners by developing a 

seamless, single entry point with no wrong door approach. Through collaboration with the 

disability community and key health and social service providers, Hawaii's ADRC will move 

beyond the information and assistance component to incorporate more in-depth options 

counseling, streamline access to public and private long-term supports, and enhance personcentered hospital discharge planning to establish a fully functional ADRC. The objectives are 

to: 1) develop a 5-year operational plan and budget for achieving statewide coverage of 

Hawaii's ADRC; 2) expand and formalize linkages with key aging, disability and health care 

providers; 3) provide options counseling training to staff on specific aging and disability topics 

(e.g., private pay services, care home placement, disability services); 4) make enhancements 

to the Hawaii ADRC website to improve access to information and services; and 5) maintain 

an integrated data collection and reporting system for quality assurance and evaluation. The 

expected outcome is that the state will have a fully functional ADRC for Hawaii residents to 

make informed decisions about their long-term options and to access existing services and 

supports. 

Page 13 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0011

Project Title: Aging Disability Resource Center Grant

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Idaho Commission on Aging 

3380 Americana Terrace, Ste 120 

Boise, ID 83706 

Contact: 

Kim Toryanski 

Tel. (208) 334-3833 

Email: kim.toryanski@aging.idaho.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

The Idaho Commission on Aging (ICOA) is partnering with the Administration on Aging to 

work towards statewide reform of Long Term Services and Supports (LTSS). The ICOA 

Administrator, Kim Toryanski, is working to form partnerships at the state and local level that 

support modernization of service delivery. This grant will support the beginning of policy, 

procedure, and infrastructure change at the local and state levels to take the next steps to 

realizing reform. The goal of the grant will be to empower Idahoans to navigate their health 

and long term support options, with added supports for Medicare beneficiaries or individuals 

with chronic conditions during the critical event of hospital discharge, through statewide Aging 

and Disability Resource Center (ADRC) Implementation. The objectives are to: 1) amend 

and monitor AAA contracts to fully develop the local ADRC including nursing home diversion 

capacity; 2) develop a State Five Year Plan with all stakeholders involved; and 3) enhance 

management information systems supporting health and social service providers. The 

outcomes include access to a well-developed long term services and support system 

throughout Idaho that provides individuals in critical pathway settings, like hospitals and 

nursing homes, with consumer-centered assistance and planning to remain as independent 

as possible in the community. Products include required reports, evaluation results, and 

program materials for replication, and a Five Year Strategic Plan. 

Page 14 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0015

Project Title: Aging and Disability Research Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Illinois Department on Aging 

421 East Capitol 

Springfield, IL 62701 

Contact: 

Ross G Grove 

Tel. (217) 524-7627 

ross.grove@illinois.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $224,716

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $224,716

Project Abstract: 

The Illinois Department on Aging grant supports in partnership with the Illinois Department of 

Human Services, Healthcare and Family Services, and others.with this grant the project: 

Aging and Disability Resource Centers (ADRCs): Empowering Individuals to Navigate Their 

Health and Long Term Support Options. The goals of the project are to significantly 

strengthen and expand existing CPoE/ADRC programs, facilitate an integrated and/or fully 

coordinated access to Coordinated Points of Entry(CPoE) and ADRCs statewide, and to 

establish a plan for the implementation of a statewide CPoE/ADRC function. Our specific 

objectives are to: 1) expand the CPoE/ADRC network from 3 to 5 sites within the first year of 

the grant and an additional 2 sites in the second year; 2) increase by 250% the number of 

individuals who are served by CPoE/ADRC centers (from 37,150 contacts/year to 130,000 

contacts/year); 3) finalize and disseminate statewide standards for CPoE/ADRC to all ADRC 

centers in Illinois; 4) expand utilization of the web based Enhanced Services Program (ESP) 

resource data base; 5) develop a training curriculum to include disability issues and clientdirected care for all CPoE/ADRCs; 6) develop a comprehensive, universal intake form for all 

CPoE/ADRCs; 7) ensure that all CPoE/ADRC sites are providing high quality, personcentered long term care planning; 8) determine the feasibility of using ADRC tools 

established by other States into Illinois' service delivery model; and 9) establish a 5-year plan 

to implement CPoE/ADRC statewide, in partnership with DHS and HFS, and with input from 

key stakeholders. The products of the grant will be an expanded, standardized and high 

quality CPoE/ADRC system in Illinois, and a written plan to implement CPoE/ADRCs 

statewide. 

Page 15 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0007

Project Title: Indiana Aging and Disability Resource Centers: Empowering Individuals 

to Navigate Their Health and Long Term Support Options

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Indiana Family and Social Services Administration 

Division of Aging 

402 W. Washington St. Rm E442 

Indianapolis, IN 46204 

Contact: 

Andrea Vermeulen 

Tel. (317) 234-1749 

Email: andrea.vermeulen@fssa.in.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $162,031

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $162,031

Project Abstract: 

The State of Indiana, Family and Social Services Administration (FSSA), Division of Aging 

(DA), with support from stakeholders, will administer a 36 month grant to enhance the 

operations of Indiana's Aging and Disability Resource Centers (ADRCs) to include a robust 

person-centered hospital discharge planning function. The goals of this project are: 1) to 

integrate some of Indiana’s ADRC care managers into a hospital discharge planning process 

to provide timely, on-site access to comprehensive Options Counseling, care management 

and when appropriate, Preadmission Screening; 2) to more effectively coordinate 

hospital/ADRC planning process to support a more complete consumer/family discharge 

planning process; 3) to support, at the consumer's/family's option, access to high quality 

community-based long-term care supports with increased discharge to community-based 

settings and reduced reliance on nursing home care; and 4) to ensure when a consumer 

elects to reside in the community linkage with physicians and other health care supports with 

a goal of preventing hospital readmission or nursing home admission. Project objectives are 

to: (1) develop a structure for co-location of ADRC care managers at a hospital; (2) develop 

targeting criteria for consumer/family participation in the project; (3) develop and test 

procedures, protocols and other processes of care managers involved into the hospital 

discharge planning process to support the project and further accomplishment of project 

goals; (4) develop and implement an evaluation component for the project; and (5) develop a 

five year ADRC operational plan. 

Page 16 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0016

Project Title: Iowa Aging and Disability Resource Center Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Iowa Department on Aging 

510 East 12th Street - Suite #2 

Des Moines, IA 50319 

Contact: 

Mary Anderson 

Tel. (515) 725-3346 

Email: mary.anderson@iowa.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,212

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,212

Project Abstract: 

The State Unit on Aging (SUA), the Iowa Department on Aging (IDA), will use these funds to 

realize two goals: 1) establish Heritage Area Agency on Aging (AAA) planning and service 

area (PSA) as an Aging and Disability Rresource Center (ADRC) and 2) seek the input of key 

stakeholders to develop a five-year plan and budget for statewide ADRC coverage. The 

objectives of goal 1 are a) contract with Heritage AAA to support a no wrong door approach 

to initially continue ADRC services in Linn and Johnson Counties; b) require that, within 12 

months after receipt of funds, ADRC services as outlined in OAA II Section 202(b)7 will be 

available in all counties of Heritage AAA PSA; and c) implement a person-centered care 

coordination component for persons transitioning from institutional settings and those at risk 

for re-hospitalization, and d) adopt a private-pay fee-for-service model in the Heritage AAA 

ADRC service area. The objectives of goal 2 are a) convene a committee of key long-term 

services and supports stakeholders and b) develop a five-year plan and budget 

recommended by the SUA, State Medicaid Agency, and State Disability Agencies that 

describes how the state will realign and coordinate the existing information and access 

functions of the state and federal programs it administers and operationalize ADRCs 

statewide. 

Page 17 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0026

Project Title: Aging and Disability Resource Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Kansas State Department Of Aging 

503 S Kansas Ave 

Topeka, KS 66603-3404 

Contact: 

Tina Langley 

Tel. (785) 368-7331 

Email: tina.langley@aging.ks.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $413,594

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $413,594

Project Abstract: 

The Kansas Department on Aging (KDOA) Aging & Disability Resource Center (ADRC) will 

provide information, streamlined access, and assistance to all people seeking long-term care 

services in the state of Kansas. It will create bridges between existing service delivery 

systems and use an ADRC Online Resource Manual to create seamless access to 

information and resources for consumers. This grant will expand the ADRC project to include 

additional populations and systems. Project goals include to increase information and 

awareness of local resources; develop a method of providing consistent Options Counseling 

across agencies; streamline access to services by expediting eligibility determination; and 

improve evaluation of ADRC processes and procedures. The objectives are to identify local 

grass-roots, faith-based and volunteer programs to be added to the Online Resource Manual 

(ORM); create an Options Counseling Toolkit; provide Options Counseling training to Area 

Agency on Aging (AAA) and Center for Independent Living (CIL) staff; evaluate and revise 

the existing Expedited Service Delivery (ESD) process; develop a web-based ESD 

application; integrate the online ESD application with the current eligibility determination 

process; expand the ESD process to include all HCBS waivers; and develop a 

comprehensive evaluation process to use throughout the ADRC network. These activities 

will make the ADRC Online Resource Manual a more useful and user-friendly tool, increase 

the effectiveness of Options Counseling throughout the ADRC network, reduce the time 

consumers have to wait to start Home and Community Based Services, and improve our 

ability to evaluate the effectiveness of our program. 

Page 18 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0012

Project Title: Kentucky Aging and Disability Resource Center Grant

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Kentucky Cabinet for Health and Family Services 

Aging and Independent Living 

275 East Main Street, 3W-F 

Frankfort , KY 40621 

Contact:

Phyllis P Culp 

Tel. (502)564-6930 

Email: phyllis.culp@ky.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

Kentucky's Department for Aging and Independent Living (DAIL) grant supports the following 

proposed goals and corresponding objectives: Goal 1: Pilot both a new person-centered, 

hospital discharge planning model and a Universal Assessment and Plan of Care process. 

Objectives: 1) strengthen information and referral between the Green River Area Agency on 

Aging and Independent Living (GRAAIL) and local hospital; 2) provide on-site Medicaid 

eligibility; 3) implement the disease management, person centered care coordination model, 

Guided Care; 4) implement universal process in three regions; 5) evaluate impact of 

standardized processes; and, 6) disseminate project information. Goal 2: Strengthen 

existing ADRCs processes through the provision of Financial Planning and soft phone 

transfer. Objectives: 1) identify a financial expert; 2) develop a financial resource guide and, 

3) facilitate statewide training; 4) develop a relationship with the state-wide independent 

living council; and, 5) replicate Massachusetts soft phone transfer. Goal 3: Develop a five 

year plan. Objective: 1) facilitate discussion with key stakeholders. The expected outcomes 

of this project are: 1) prevention of nursing home admission; 2) individuals will have 

improved access to Medicaid eligibility; 3) prevent duplication of services; 4) ADRC callers 

will gain a better understanding of financial planning options. The products from this project 

are: a final report; ADRC processes for hospital discharge planning and seamless program 

entry, Financial Resource Guide, and a five year plan. 

Page 19 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0021

Project Title: Maine's Aging Disabilities and Resource Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Maine Department.of Health and Human Services 

Office of Elder Services, 

11 State House Station 32 Blossom Lane 

Augusta, ME 04333-0011 

Contact: 

Romaine Turyn 

Tel. (207) 287-9200 

Email: Romaine.Turyn@maine.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

Maine's Department of Health and Human Services (DHHS) will strengthen and expand 

Aging and Disability Resource Centers in Maine to help people of all ages, incomes, and 

disabilities, and their families, learn about, and access, the full range of long-term care 

services and supports available in their communities. The goal is to empower consumers to 

make informed decisions about long-term services and supports and to streamline access to 

existing services and supports through an integrated system. The objectives are to build 

effective local networks of providers and other stakeholders; minimize confusion for 

consumers and families; enhance individual choice and informed decisions by all consumers; 

develop a standard options counseling protocol to inform consumer decision-making, and 

expand ADRCs statewide by establishing ADRCs at Maine's two other AAAs. This project 

will integrate with the Older Americans Act programs, new funding opportunities from AoA, 

the Center on Medicare and Medicaid Service funded State Health Insturance Assistance 

IProgram, and Maine's eligibility determination process. Currently, the Area Agencies have 

robust relationships with the state Office of Integrated Access and Support (OIAS) which 

determines financial eligibility for Medicaid and 22 other programs; this grant will enable the 

Area Agencies to collaborate with OIAS to further streamline the application process by 

assisting and/or referring consumers to local touch screen kiosks in the community where 

consumers can electronically apply for Low-Income-Subsidy (LIS) and other programs. The 

Social Security Administration will share information from the LIS applications with the State, 

which will be accessible to ADRCs so their staff can provide additional assistance to 

consumers regarding other programs for which they may be eligible. 

Page 20 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0022

Project Title: Aging Disability Resource Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Maryland Department of Aging 

301 West Preston St Suite 1007 

Baltimore, MD 21201 

Contact: 

Donna Smith 

Tel. (410) 767-1271 

dms@ooa.state.md.us

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $271,459

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $271,459

Project Abstract: 

The Maryland Department of Aging (MDoA) will enhance its current ADRCs known as MAP 

(Maryland Access Point). Our goal is to make MAP a statewide program and vehicle for 

facilitating and coordinating State level long term care reform that cuts across agencies and 

programs by a) providing coordinated and streamline access to public programs and existing 

services and supports B) realigning funding streams C) develop a five year operational plan 

and budget with stakeholders. Our objectives include (a) streamlining access to MAPs by 

standardizing intake tools and (b) creating a unified application process that will be uniform 

(c) working with sites to integrate and restructure operations to be consistent with (MAP) 

workflow, staffing and communication and other infrastructure requirements. MAP is the 

vehicle through which other projects such as Money Follow the Person, Person Centered 

Hospital Discharge Planning Process and Nursing Home Diversion will build upon. All 

projects involve MAP sites (there are a total of eight MAPs in Maryland and if we are funded 

with this grant we will have ten) as single points of entry into the long-term care system for 

older adults and people with disabilities. 

Page 21 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0040

Project Title: Development of a Five year Strategic Action Plan to Enhance 

Massachusetts Aging and Disability Resource Center Service Delivery System

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Masschusetts Executive Office of Elder Affairs 

1 Ashburton Place, 5th Floor 

Boston, MA 02108 

Contact:

Ruth Polombo 

Tel. (617) 222-7512 

ruth.palombo@state.ma.us

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,056

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,056

Project Abstract: 

The Executive Office of Elder Affairs (Elder Affairs), in partnership with the Office of Medicaid 

(MassHealth), the Office of Disability Policies and Programs, and the Massachusetts 

Rehabilitation Commission (MRC) will use this grant to strengthen Aging and Disability 

Resource Consortia (ADRC) programs across all ages and disabilities and to develop a fiveyear operational plan and budget. Project objectives include: 1) develop a five-year 

statewide operational plan and budget for the ADRCs; 2) help people remain in their 

communities by enhancing ADRC and hospital and nursing home facility discharge planning 

relationships; 3) expand ADRC capacity to identify individuals at high risk of nursing home 

placement and Medicaid spend down, including the provision of a comprehensive long term 

care options program (Options); 4) integrate SHINE and other cross-disability 

counseling/benefit planning programs more fully with the ADRC network; and 5) develop 

evaluation tools and quality improvement activities for the ADRCs. Project outcomes include: 

1) a clear, articulate direction for ADRC activities; 2) improved options for consumers to 

remain in the community; 3) greater role and knowledge for consumers in choosing their own 

services; 4) enhanced capacity for ADRC networks to identify individuals at greatest risk of 

nursing home placement and Medicaid spend down; and 5) better ability of state and ADRC 

leadership to identify and replicate successes within ADRC networks. 

Page 22 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0043

Project Title: Michigan's 2009 Aging and Disabiity Resource Center Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Michigan Department of Community Health 

Office of Services to the Aging 

P.O. Box 30676 

Lansing, MI 48909-8176 

Contact:

Peggy J Brey 

Tel. (517) 241-0988 

breyp@michigan.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

Michigan's proposal supports Aging and Disability Resource Center (ADRC)-capacity by 

using local long term care (LTC) resources to develop a statewide No Wrong Door approach. 

This model recognizes all LTC stakeholders as equal partners, and builds on lessons learned 

from Michigan's Single Point of Entry (SPE) demonstration. Goals are 1) enhancement of 

individual choice and support informed decision-making through person-centered 

planning/thinking (PCP/PCT) and comprehensive information and awareness (I&A); 2) 

provision of seamless access to services for older adults/persons with disabilities; and 3) 

improvement in collaboration between Centers for Independent Living (CILs), Area Agencies 

on Aging (AAAs) and other stakeholders. Objectives include: 1) develop local ADRC 

partnerships using a No Wrong Door approach that will be fully functional within 5 years; 2) 

develop comprehensive mechanisms for unbiased, high quality I&A; 3) require ADRC 

partnerships to have Options Counseling services and practice the PCP/PCT approach; 3) 

develop/implement processes for streamlined access to services; 4) develop/implement a 

Quality Assurance/Evaluation plan; 5) collaborate with local hospital discharge planners to 

develop a PCP/PCT approach for responsive discharge planning; 6) support the 

establishment of an External Advocate for all LTC services; provide state-level support of 

local ADRC partnerships; and 7) embed culture change and PCP/PCT into ADRC operations. 

Outcomes include individuals having comprehensive LTC choices; individuals living in their 

preferred residential setting with services/supports in place; local communities having 

successful partnerships to address LTC planning/policies/services to meet individual needs; 

local partnerships developing relationships with hospitals to facilitate planning with individuals 

discharged to settings of choice; ADRC certifications associated with positive individual 

outcomes; duplication averted by tracking individuals in a shared database; and individuals 

having access to unbiased information on service providers. 

Page 23 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0045

Project Title: Minnesota's Return to the Community Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Minnesota. Department of Human Services 

Board on Aging 

PO Box 64976 540 Cedar Street 

St. Paul, MN 55164-0976 

Contact: 

Krista Boston 

Tel. (651)431-2605 

Email: krista.boston@state.mn.us

AoA Project Office: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $236,351

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $236,351

Project Abstract: 

Our Return to the Community project presents an assertive effort to change the mindset that 

nursing homes are a long-term living option for persons who could live successfully in the 

community. The project is developing referral protocols to: 1) support transitions; and 2) 

improve health care discharge planning. Return to the Community will target Minnesotans of 

any age who live with disabilities or chronic conditions, including those that are experiencing 

short term rehabilitative nursing home stays and those being discharged from hospitals. The 

project goal is that consumers and their families will access and receive long-term services 

and supports to successfully remain at home and avoid another institutional stay. Objectives 

are to: 1) develop referral protocols and partnerships to support nursing home transitions, 

focusing on people who have stayed beyond 90 days. 2) design and test a virtual system for 

streamlined discharge planning. 3) evaluate and report the impact of the project. 4)dDesign a 

sustainability model. Outcomes include a person-centered options counseling model will be 

implemented statewide; streamlined care transition partnerships will exist between hospitals 

and nursing homes; the ADRC will become the source for triage into effective options 

counseling; fewer low-need individuals will live long-term in nursing homes; a critical loop will 

be closed between assessment and care planning; and public long-term dollars will be welltargeted to support persons with highest needs, in the most integrated settings possible. 

Page 24 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0030

Project Title: Aging and Disabilities Resource Centers

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Montana Department of Public Health and Human Services 

Senior and Long Term Care Division 

111 Sanders P O Box 4210 

Helena, MT 59604 

Contact: 

Charles Rehbein 

Tel. (406) 444-7788 

Email: crehbein@mt.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $457,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $457,000

Project Abstract: 

The goal of the Project is to expand the current Montana Aging and Disability Resource 

Center (ADRC) model statewide and to enhance the relationships between ADRCs and 

Independent Living Programs by working cooperatively to establish a no wrong door 

approach to service delivery. The Project's four major objectives to be accomplished are to: 

(1) establish new ADRC programs in the six counties in Areas IV and in Area VIII; (2) in 

partnership with local Independent Living Programs (ILPs), develop and implement a no 

wrong door approach to service delivery that melds the strengths of both networks to 

streamline access to long term care services; (3) expand the care management capabilities 

of all ADRCs; and (4) develop a five year plan in conjunction with the Montana Association of 

Area Agencies on Aging (M4) and ADRC work group partners to implement the ADRC model 

statewide. The expected outcomes are: (1) the development of a no wrong door approach to 

service delivery that will further streamline access to long term care services for consumers; 

(2) increased ability to meet consumer demands for assistance through the increased 

capacity of the ADRC partnerships; (3) enhanced care management through ADRCs; and (4) 

statewide coverage for the ADRC model. The products of this Project are: improved 

screening and assessment tools; option counseling videos; Memorandums of Understanding 

(MOUs) with ILPs; new policies and procedures to deliver no wrong door services through 

ADRC/ILP partnerships; and a 5 year plan to take the ADRC model statewide. 

Page 25 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0009

Project Title: Connecting Nebraska: The Nebraska Aging and Disability Resource 

Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Nebraska Department of Health and Human Services 

State Unit on Aging 

P.O. Box 95026 

Lincoln, NE 68509-5026 

Contact: 

Sarah Briggs 

Tel. (402) 471-4623 

Email: sarah.briggs@nebraska.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $490,042

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $490,042

Project Abstract: 

Nebraska proposes to apply this Aging and Disability Resource Center (ADRC) grant to 

weave a rich array of existing resources into a fabric recognized and trusted by consumers, 

easily accessed at many points statewide. This fabric will connect consumers with a 

selection of services that is responsive to their unique needs regardless of where or how 

accessed. The statewide backbone of the ADRC is the existing Answers4Families web site, 

along with the many services for persons older than 60 coordinated through Area Agencies 

on Aging, and for persons with disabilities, through Independent Living Centers. Beginning 

with an eight-county pilot area, phased implementation will establish a self-sustaining 

statewide network with two interfaces (1) a user-friendly array of self-navigated interactive 

electronic subsystems along with telephone connections to persons trained to give 

information and assistance, and (2) a physical location to interface with a person who will 

help consumers access the combination of services they need. 

Page 26 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0039

Project Title: New Hampshire Aging and Disability Resource Center Enhancement 

Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

University of New Hampshire 

Institute on Health Policy & Practice 

Office of Sponsored Research 

 51 College Ave., Service Bldg. 

Durham, NH 03824 

Contact:

Susan Sosa 

Tel. (603) 862-4848 

Email: susan.sosa@unh.edu

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $245,801

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $245,801

Project Abstract: 

Based on the criteria set forth by the Administration on Aging and the Centers for Medicare 

and Medicaid Services, New Hampshire's ServiceLink Resource Center (SLRC) network is a 

fully functioning Aging and Disability Resource Center (ADRC). Despite this designation, the 

New Hampshire ADRC team recognizes that there are opportunities to expand and 

strengthen the SLRCs. This New Hampshire ADRC Enhancement project includes two major 

goals. The first goal is to strengthen the New Hampshire ADRC program, with the following 

objectives: (1) enhancing partnerships to facilitate the implementation of a No Wrong Door 

Model; (2) developing and implementing a Patient Centered Hospital Discharge Planning 

(PCHDP) Model; (3) expanding the current NH ADRC evaluation structure; and (4) enhancing 

information sharing capacity across SLRCs and partner agencies. The second goal 2 is to 

develop a five¿year operational plan for sustaining and strengthening the fully functioning 

ADRC model in NH. Part of goal two is the regular review of the operational plan to ensure 

the ADRC progress aligns to the plan. The outcomes are to implement a No Wrong Door 

Model and create a plan for continuing the model, implement a statewide PCHDP model; 

enhance the NH ADRC evaluation design with new metrics and reporting; improve 

communications systems across SLRCs and partner agencies, and create a five year 

operational plan. Products from this project are a final report, including evaluation results; 

implementation guides for No Wrong Door Model and PCHDP for SLRCs; a cost 

effectiveness methodology for ADRC; and the 5 year operational plan. 

Page 27 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0004

Project Title: New Jersey Aging and Disability Resource Connection

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

New Jersey Deptartment of Health and Senior Services 

240 West State Street 

Trenton, NJ 08625-0807 

Contact: 

Nancy E Day 

Tel. (606) 943-3429 

Email: nancy.day@doh.state.nj.us

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $444,549

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $444,549

Project Abstract: 

The New Jersey Department of Health and Senior Services in collaboration with the 

Department of Human Services continues to provide the leadership, executive authority and 

resources to strengthen the Aging and Disability Resource Center (ADRC). A no-wrong-door 

approach to accessing home and community-based services (HCBS), the ADRC serves as 

the catalyst for redesigning NJ's long-term support system. Since 2003, New Jersey has 

been building a model that focuses on a system-wide change and integration process, 

making it easier for older adults and persons with physical disabilities to access the full array 

of public and private Home and Community Based Service. With the ADRC model tested 

and partnerships in place, New Jersey is launching an aggressive strategy to institutionalize 

the business processes and tools statewide by December 31, 2010. Goal One, to build 

partnership with NJ's Care Transitional Teams and the ADRCs to avoid unnecessary hospital 

readmission or nursing home placement, has these objectives: (1) Establish a project team 

to design a coordinated, multidisciplinary approach between acute and community settings; 

(2) test and evaluate the model in Camden County (the Community Living Program pilot site) 

and then expand it statewide; (3) Use NJ's Pre-Admission Screening (PAS)/Pre-Admission 

Screening Resident Review (PASRR) hospital process to connect consumers to the ADRC. 

Goal Two, to support NJ's leadership to rebalance long-term supports through cost-effective 

strategies as thse objectives: (1) Expand the Global Budget Projection Process to 

incorporate the impact of expanded non-Medicaid HCBS options and ADRC interventions. 

Goal Three - ensure ADRCs are the visible and trusted no-wrong-door to long-term supports 

has these objectives: (1) Create a web-based community resource center through Harmony 

Information Systems; (2) Expand ADRC statewide by December 31, 2010. 

Page 28 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0044

Project Title: Aging Disability Resource Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

New Mexico State Aging And Long Term Services Deptartment 

2550 Cerrillos Road 

Santa Fe, NM 87505 

Contact: 

Carlos Moya 

Tel. (505) 476-4577 

Carlos.Moya@state.nm.us

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

The goal of this grant is to significantly strengthen the existing New Mexico Aging and 

Disabliity Resource Center (NMADRC). Support from this grant with allow expansion and 

enhancement of the key operational components of information and awareness, options 

counseling, streamlined access, person-centered hospital discharge planning, and quality 

assurance and evaluation. Information and awareness will continue to be provided by the 

existing partnership between the New Mexico ADRC and the New Mexico State Health 

Insurance Information Program (NMSHIP/Benefits Counseling). Benefits Counseling is 

provided by telephone via the NMADRC by NMSHIP certified staff; it is provided at the 

community level via local NMSHIP Coordinators and NMSHIP volunteers. Options 

counseling and person-centered hospital discharge planning are new components of the 

NMADRC. With this funding, the NMADRC will utilize paid Options Counselors to provide an 

in depth assessment of each identified client via a newly developed NMALTSD PersonCentered Planning Tool. The tool is designed to help a client determine what he or she may 

need to live a healthy, safe and fulfilling life. The geographic area for this service component 

will include the counties of Bernalillo, Valencia, Sandoval, Santa Fe, Rio Arriba, Taos, and 

Dona Ana. The client base in these counties will be derived from at risk Medicare 

beneficiaries discharged from local hospitals upon referral by their discharge planners to the 

NMADRC and at risk individuals on the Home and Community Based Medicaid Waiver 

registry of the Coordination of Long Term Services (COLTS) Program. Collaboration exists 

with hospitals in the identified counties incluing Lovelace Hospital; University of New Mexico 

Hospital in Albuqueque, Holy Cross Hospital in Taos, St. Vincent's Hospital in Rio Arriba, and 

Mesilla Valley Hospital in Dona Ana. 

Page 29 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0042

Project Title: Nevada Empowering Individuals through ADRC

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Nevada Department of Health and Human Services 

Aging and Disability Services Division 

3416 Goni Rd., Ste 132 

Carson City, NV 89706 

Contact: 

Jeff Doucet 

Tel. (702) 486-3545 

jsdoucet@adsd.nv.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $241,260

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $241,260

Project Abstract: 

The Nevada Aging and Disability Services Division (ADSD) and its network partners will build 

on their four years of collaborative experience to strengthen the competency and efficiency 

and to expand the availability of Aging and Disability Resource Centers (ADRC) in Nevada. 

The goals of the Empowering Individuals through ADRC project will be to 1) increase the 

number of ADRCs statewide; 2) improve knowledge about and the delivery of 

Options/Benefits Counseling to elders and individuals with disabilities both in institutions and 

the community; and 3) develop a five year operational plan that will sustain growth and 

quality. The objectives are to: 1) evaluate the Family Resource Center structure for 

compatibility; 2) recruit new ADRC sites in underserved areas of the state; 3) add three to six 

additional ADRC staff training modules; 4) Deploy an e-learning solution; 5) Improve use of 

Information and Assistance software for ADRC staff and the community at large; 6) Ensure 

both collaboration with aging network and public benefit organizations and service design 

review by an advisory group; 7) Develop or refine current tools for evaluation; 8) Collect and 

evaluate data sets consistently; and 9) Disseminate findings to support the operational plan. 

The expected outcomes are comparable performance by ADRCs in care planning and 

referral outcomes; improved access to training; adequate ADRC coverage and visibility 

statewide; and a collaborative funding plan and coordinated service choices within the 

partner network. The products are an improved website, an expanded training curriculum, an 

e-learning solution, enhanced I&A software, additional ADRC sites, and evaluation results to 

support the five year operational plan. 

Page 30 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0024

Project Title: New York State Office for the Aging: Aging and Disabilities Resource 

Center

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

New York State Office for the Aging 

2 Empire State Plaza 

Albany, NY 12223-1251 

Contact: 

Gail Koser 

Tel. (518) 474-4425 

Email: gail.koser@ofa.state.ny.us

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,056

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,056

Project Abstract: 

The project goal is to enhance the performance of Aging and Disability Resource Centers in 

New York by streamlining access to long term care services, empowering consumers to 

consider more informed choices using enhanced New York Connects options counseling, 

develop and implement a Consumer Navigator Program, and collaborate with key medical 

providers. Objectives include: (1) strengthen the promotion of New York Connects; (2) 

optimize choice through the availability of individualized options counseling; (3) increase 

consumer access to long term care services through service coordination; (4) facilitate 

person-centered transitions from hospitals, nursing homes and rehabilitation facilities; (5) 

establish performance goals that will ensure the satisfaction of consumers; and (6) advance 

systems change and streamline access to long term care services. This project builds upon 

the work of the Albany, Broome, and Tompkins Area Agencies on Aging (AAAs) and will 

share best practices and lessons learned with 25% of New York Connects programs 

statewide. Continuous quality improvement and evaluation will ensure effective and 

satisfactory service delivery. Measurable Outcomes are: (1) delivery of services to 100 

people through person-centered discharge planning and 40 consumers through the 

Consumer Navigator Program; (2) develop service delivery that results in consumers 

remaining safely at home; (3) develop present and future long term care plans that meet selfdirected criteria; (4) meet established quality performance indicators; and (5) share with 25% 

of New York Connects programs statewide. Products include a final report including 

evaluation results, tools, protocols, and training curricula. 

Page 31 of 281 
Program: Aging and Disability Resource Centers

Grant Number: 90DR0001

Project Title: State Planning for and Expansion of Aging and Disability Rresource 

Centers

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

North Carolina Department of Health and Human Services 

Division of Aging and Adult Services 

2001 Mail Service Center; Adams Bldg; 101 Blair Drive 

Raleigh, NC 27699-2001 

Contact: 

Sabrena Lea 

Tel. (919) 855-4428 

Email: Sabrena.Lea@dhhs.nc.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $226,772

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $226,772

Project Abstract: 

The North Carolina (NC) Department of Health and Human Services (DHHS) three-year 

Aging and Disability Resource Centers (ADRC) grant will empower individuals to navigate 

their health and long term support options. The project goals are to: 1) operate ADRCs in 50 

of 100 counties (30 counties currently covered) and plan for statewide ADRC coverage to 

serve adults with disabilities, older adults, their families, and others who support them; and 2) 

define equity and refine collaboration in the partnership between aging and disability 

programs. The approach will involve stakeholders representing disability and aging partners 

and consumers, and DHHS divisions in analyzing and planning for statewide ADRC 

implementation and building a framework for lasting partnerships. Objectives are to: 1) 

support development of multi-county programs to increase ADRC coverage by 20 counties 

and identify organizations to serve as connectors facilitating statewide expansion; 2) develop 

a plan for statewide infrastructure including authority, program management and standards; 

3) enhance collaboration between ADRCs and Community Care of North Carolina 4) identify 

and re-align existing, appropriate funding streams for ADRC program sustainability; and (5) 

create and implement protocols for aging and disability program collaboration. Project 

outcomes inclue: 1) consumers will find it easier to obtain information about and access to 

alternatives for informed service choices; 2) consumers will make fewer calls and repeat the 

same information less frequently; 3) individuals in transition will have access to options 

counseling; and 4) North Carolina will have a systems infrastructure that streamlines 

information and access processes and a means to financially sustain ADRCs. Project 

products are: 1) 5-year ADRC expansion plan; 2) revised ADRC operations manual. 

Page 32 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0046

Project Title: Development and implementation of an Aging and Disability Resource 

Center in North Dakota

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

North Dakota Department of Human Services 

Aging Services Division 

600 E Boulevard Avenue 

Bismarck, ND 58505-0250 

Contact: 

Heather Steffl 

Tel. (701) 328-4933 

Email: hsteffl@nd.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $202,771

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $202,771

Project Abstract: 

The North Dakota Department of Human Services (DHS), which includes the State Unit on 

Aging, State Medicaid and Disability Agencies, and home and community based long-term 

care services will develop an Aging and Disability Resource Center (ADRC) in North Dakota 

Region VII. The ADRC will empower older adults and adults with physical disabilities and 

their families to make informed choices about long-term support services, and will streamline 

access to services by realigning and optimizing infrastructure and resources. The ADRC will 

develop a no wrong door network with these state and community partners: State Unit on 

Aging, Medicaid, the Department of Human Services West Central Human Service Center 

(aging, disability, and mental health service provider); county social services; Older 

Americans Act providers (region/tribal); Centers for Independent Living, State Health 

Insurance Counseling Program, and others. Objectives include: 1) naming a program director 

to manage the day-to-day development of the ADRC No Wrong Door network, 2) establishing 

an Advisory Council to guide ADRC development, 3) implementing the ADRC network in 

Burleigh County in Year 1, 4) expanding the ADRC to three more counties in Year 2, 5) 

developing a 5-year operational plan, and 6) expanding the ADRC to the rest of Region VII in 

Year 3. At the grant's end, region residents will be aware of the ADRC and will contact the 

network for information about long-term supports and assistance accessing them. Products 

include: online options counseling tool, intake, information and options counseling protocols; 

seamless referrals and support; no wrong door model; evaluation results; a final report; and 

sustainability plan. 

Page 33 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0027

Project Title: Ohio's Front Door: Strengthening Access to the Long Term Care System

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Ohio Department of Aging 

50 W. Broad Street 9th Floor 

Columbus, OH 43215-3363 

Contact: 

Deanna Clifford 

Tel. (614) 644-5192 

Email: dclifford@age.state.oh.us

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $219,380

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $219,380

Project Abstract: 

Through this Aging and Disability Resource Center grant, the Ohio Department of Aging, in 

collaboration with Ohio's twelve Area Agencies on Aging, the Centers for Independent Living 

and other community-based partners, supports the development of a statewide front door to 

long-term care services, as envisioned by the state's Unified Long-term Care Budget 

recommendations. The goal of Ohio's ADRC project is to ensure that older adults and adults 

with physical disabilities are empowered to make informed decisions about publicly-funded 

and private pay long-term service and support options through a statewide, no wrong door 

Aging and Disability Resource Network enacted at the regional level. The objectives are: 1) to 

enhance information and awareness through shared resource information; 2) to provide 

person-centered, one-on-one assistance to consumers; 3) to develop consistent hospital 

discharge tools; 4) to improve access to benefits for individuals with physical disabilities; and 

5) to put in place consumer quality assurance and evaluation tools for ADRN activities. 

The expected outcomes are: collaboration among regional partners on shared information 

and resource materials as evidenced by Memoranda of Understanding; development of 

materials specific to individuals with disabilities; ADRN staff trained on person-centered 

thinking; person-centered thinking adopted in tools, materials and for one-on-one assistance; 

consistent, person-centered hospital discharge partnerships and tools; and, trained benefits 

analysts to assist persons with disabilities. Deliverables include required reports; resource 

materials for people with disabilities available in a variety of formats; person-centered tools 

for one-on-one assistance; and a person-centered hospital discharge planning toolkit. 

Page 34 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0032

Project Title: Oklahoma's ADRC

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Oklahoma Department of Human Services 

Aging Services Division 

2401 NW 23rd Street Suite 40 

Oklahoma City, OK 73107 

Contact: 

Claire Dowers-Nichols 

Tel. (405) 522-4510 

Email: claire.dowers@okdhs.org

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,040

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,040

Project Abstract: 

The grantee, Oklahoma Aging Services Division, supports this three-year Aging and Disability 

Resource Center (ADRC) project. The goal of the program is to provide all Oklahoma 

citizens, regardless of income, a no wrong door system for information and options benefit 

counseling regarding long-term care decision-making and planning. The objectives are to: 1) 

develop a person-centered information system accessible to the public, professionals and 

target populations offered in alternate formats; 2) ensure that caregivers and care receivers 

are supported in a way that honors individual choice by providing training to I&A specialists; 

3) provide options counseling to individuals 60 and older and to people with disabilities; 4) 

streamline access to services by creating a standardized and efficient entry process for public 

and private pay services; and 5) further develop formal linkages between and among the 

public and private providers of long-term care supports by creating MOUs and other formal 

agreements. The expected outcomes are 1) a shared and comprehensive resource database 

and providing consistent information to people needing assistance; 2) options counseling will 

enable people to make informed, cost-effective decisions about long-term care services and 

plan for their future needs; 3) systematic training will ensure all entry points and partners 

provide I&A services that include public and private pay benefits; 4) reduction in the rate of 

institutional placement; 5) reduction in average length of time from first contact to eligibility 

determination. Products will include standardized intake instruments, training materials, 

Memoranda of Understanding (MOU), formal protocols, documentation of cost savings, and a 

best practices document. 

Page 35 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0031

Project Title: Expansion of the Aging and Disability Resource Center and Transitional 

Care Collaborative

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Oregon Deptment of Human Services 

Seniors and People with Disabiliites 

676 Church Street NE 

Salem, OR 97301 

Contact: 

Elaine Young 

Tel. (503) 373-1726 

Email: Elaine.Young@state.or.us

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,056

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,056

Project Abstract: 

The grantee, Oregon's Division of Seniors and People with Disabilities (SPD) supports this 

three year ADRC grant in partnership with Northwest Senior & Disability Services (NWSDS), 

Oregon Cascades West Council of Governments (OCWCOG), and other key organizations. 

The goals of this project are: 1) expand ADRC services to 30 percent of Oregonians, 2) 

complete a 5-year Strategic Plan to operationalize ADRCs statewide, and 3) support the 

implementation of best practices to improve transitions of Medicare beneficiaries across care 

settings and reduce unnecessary hospital readmissions. For Goal 1, the main objective is to 

strengthen the capacity of NWSDS and OCWCOG to meet the criteria for a fully functioning 

ADRC. For Goal 2, the main objective is to complete a gap analysis that prioritizes the work 

that must be completed at the local and state level to ensure a statewide ADRC system. For 

Goal 3, the main objective is to host a Transitional Care Collaborative that promotes 

strategies to address care transition issues for representative from hospitals, physician 

offices, home health agencies, AAA staff and others. Main outcomes include 3 AAAs that 

meet the criteria for a fully functioning ADRC, a comprehensive Strategic Plan for AoA and 

for use in the 2011 legislative session, and an increase in referrals from hospitals and 

physician offices to local Options Counseling and Transition Coaches. The products from this 

project are documented lessons learned while phasing in new technology, services, and 

staffing requirements to support a local ADRC, change packages for implementing 

Transitional Care Best Practices, abstracts for national conferences, and any final reports 

required by the Administration on Aging. 

Page 36 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0003

Project Title: Puerto Rico's Aging and Disability Rresource Centers 

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Puerto Rico Office of the Ombudsman for the Elderly 

P.O. Box 191179 

San Juan, PR 00919-1179 

Contact: 

Rossana Lopez 

Tel. (787) 721-6121 

Email: rlopez@ogave.gobierno.pr

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $50,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $50,000

Project Abstract: 

The Puerto Rico Office of the Ombudsman for the Elderly (PROOE), the State Unit on Aging 

in the Commonwealth, is developing Aging and Disability Resource Center Programs (ADRC 

with island-wide coverage. The specific objectives of this grant request are: 1) to establish an 

ADRC program that will offer information and one-on-one options counseling for the elderly 

and younger adults with physical disabilities in the Municipality of Carolina, within 12 months 

of program funding; 2): extend the ADRC program to initiate the provision of streamline 

access to all publicly funded long-term services and supports for the elderly and younger 

adults with physical disabilities in the Municipality of Carolina, within 18 months of program 

funding; 3) to develop a five year operational plan and budge, with input of all key 

stakeholders, for achieving statewide coverage of fully operational ADRCs, within 24 months 

of program funding; 4): Extend the scope of the established ADRC program in Carolina to 

begin person-centered hospital discharge planning and coordination, during the second year 

of program funding; 5) design and initiate implementation of quality assurance and evaluation 

procedures for all services provided by the ADRC program by end of first year of program 

funding; and 6) initiate program replication in North-eastern sector of Region I AAA. 

Proposed changes to existing Long Term Care/Home and Community Based Service 

(LTC/HCBS) programs include creating a Master Resources and Services Web-based 

Database, the installation of a streamlined access system to LTC/HCBS, to develop the 

position and role of LTC Options Counselor in the system, and to begin person-centered 

hospital discharge planning and coordination of LTC/HCBS. 

Page 37 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0014

Project Title: Rhode Island ADRC-THE POINT

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Rhode Island Department .of Elderly Affairs 

Hazard Building, 74 West Rd. 

Cranston, RI 02920 

Contact: 

Corinne C Russo 

Tel. (401) 462-0501 

Email: crusso@dea.ri.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

The grantee, the Rhode Island Department of Elderly Affairs (RIDEA), supports a three-year 

extension and expansion of its Aging and Disability Resource Center (ADRC), established in 

2005 and known locally as THE POINT. THE POINT's goal is to provide information about 

and referral to a statewide network of programs and services for seniors, adults with 

disabilities, and their caregivers. The expansion will create a partnership with the 

Department of Human Services (DHS/Medicaid), the lead State agency for the Rhode Island 

Global Medicaid Waiver, and build on formal linkages with government and community-based 

programs, as well as the state's Medicare Quality Improvement Organization (QIO), Quality 

Partners of Rhode Island. The project's objectives are to: (1) incorporate a patient coaching 

model into Options Counseling services and person-centered discharge planning; (2) with the 

QIO, develop and implement a Community Outreach Plan to increase formal linkages with 

the social services and healthcare communities; and (3) design and implement an Evaluation 

Plan that assesses service delivery (including customer satisfaction) and impact. The 

expected outcomes include achievement of the requirements to be designated as a fullyfunctional ADRC; increased penetration into the local healthcare community; improved 

customer service; and a measurable association with improved local trends in healthcare 

utilization and cost, specifically related to maximizing outcomes for those who wish to receive 

community-based health care. The products from this project will include a Final Report 

reflecting a formal program evaluation and an operational design for a well-coordinated 

system of information, referral, and client/patient coaching and support to ensure optimal 

health outcomes. 

Page 38 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0034

Project Title: Transitioning Area Agencies on Aging 's to Aging and Disability 

Rresource Centers

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

South Carolina Lieutenant Governor's Office on Aging 

1301 Gervais Street Suite 200 

Columbia, SC 29201 

Contact:

Denise W Rivers 

Tel. (803) 734-9939 

Email: riversd@aging.sc.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $218,530

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $218,530

Project Abstract: 

The South Carolina Lieutenant Governor's Office on Aging (LGOA) seeks expansion of the 

initiative to convert all Area Agencies on Aging to Aging and Disability Resource Centers 

(ADRCs) through this Aging and Disability Resource Centers grant proposal. This 

collaborative endeavor will be implemented in conjunction with the five Area Agencies on 

Aging that are not currently ADRCs as well as the South Carolina Department of Health and 

Human Services (the state Medicaid agency). The goal is to enable individuals with 

disabilities and/or in need of long-term care to make informed decisions regarding living 

environment, providers of services they receive, and acquisition of quality services consistent 

with their preferences and priorities through a statewide network. Objectives include: 

expansion of the ADRC initiative to serve as a visible single point of entry for older adults and 

adults with disabilities in every county in South Carolina; education to consumers on planning 

for future LTC needs; enhancement of South Carloina Access by adding new providers and 

additional topics and information to the statewide database; and modification to the IT system 

to streamline and simplify eligibility determination and service applications for long term care. 

Expected outcomes include increased awareness of the existence and functions of the 

ADRC; reduction in time and effort needed in applying for and obtaining services, thereby 

reducing frustration and confusion; greater success in finding appropriate services, 

culminating in greater consumer choice and greater utilization of home and community based 

services. Products will include a summary of lessons learned as well as a cost analysis. The 

most crucial product will be a one-stop shop for seniors and adults with disabilities. 

Page 39 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0050

Project Title: Development of ADRCs in South Dakota

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

South Dakota Department of Social Services 

Division of Adult Services and Aging 

700 Governors Drive 

Pierre, SD 57501 

Contact: 

Kim Malsam-Rysdon 

Tel. (605) 773-3165 

Email: kim.malsam-rysdon@state.sd.us

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $240,142

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $240,142

Project Abstract: 

South Dakota is at a crossroads in developing a sustainable system of long-term care 

services to meet the needs of its citizens in the near and long term. The state currently does 

not have any Aging and Disability Resource Centers, hindering access to services. The 

goals of the project are 1) the state Aging Unit will develop an Aging and Disability Resource 

Center (ADRC) in Sioux Falls, the largest community in the state, and 2) working with key 

stakeholders, develop a plan within eighteen months to implement ADRCs across South 

Dakota within three years. The target population of older adults and adults with physical 

disabilities will benefit from achieving the objectives of developing a Single Point of Entry 

system for long term care services and options counseling, integrating eligibility functions for 

public long term care services, and developing a quality assurance system. These objectives 

will be guided by statewide and local advisory workgroups comprised of key stakeholders 

including consumers, providers, and state agencies. Changes to the current system include 

revisions to current Aging Unit staff duties, development of person-centered intake, 

assessment and case planning processes and requisite staff training, incorporation of 

Medicaid financial eligibility determinations into the ADRC, and development of formal 

linkages between the long term care systems for elders and adults with physical disabilities. 

Outcomes include increased access to information about services and increased use of 

home and community based services by the target population. Products include outreach 

materials including a website, marketing plan, person-centered intake, assessment and case 

planning tools, staff training curriculum, statewide implementation plan and outcome data. 

Page 40 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0038

Project Title: Aging and Disability Resource Centers: Empowering Individuals to 

Navigate Their Health and Long Term Support Options

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Tennessee Commission on Aging and Disability 

500 Deaderick Street, 8th Floor, Suite 825 

Nashville, TN 37243 

Contact: 

Cynthia G Minnick 

Tel. (615) 741-205 6161 

Email: cynthia.minnick@tn.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,056

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,056

Project Abstract: 

The Tennessee Commission on Aging and Disability supports Aging and Disability Resource 

Centers (ADRCs): Empowering Individuals to Navigate Their Health and Long Term Support 

Options targeting older persons and adults with physical disabilities. The goal is to build on 

the existing Tennessee ADRC project to create fully functioning ADRCs in all nine regions of 

the state; and ensure ADRC concepts and functions are embedded in the state’s long term 

care system by coordinating staff, technology, partnerships, marketing, evaluation and 

accomplishing the project goals and objectives. Its objectives are: 1) iIncrease visibility and 

awareness of the existence and functions of the ADRC; 2) implement ADRCs that the public 

recognizes as a trusted, objective, reliable sources of information and assistance; 3) identify 

gaps or needs for training about responsiveness; 4) remove barriers that slow down ease of 

access to programs; 5) implement system changes that will streamline access and increase 

efficiency and effectiveness; 6) determine Tennessee's readiness for implementing personcentered hospital discharge planning; 7) monitor project goals, objectives and outcomes; 8) 

document development of nine fully functioning ADRCs; 9) Enhance technology at the 

ADRCs and TCAD; 10) Enhance functions of the state’s single point of entry system and 

ensure funding is embedded in the long term care system, and 11) Develop a 5-year 

operational plan and budget. Outcomes are:a coordinated and implemented marking system, 

healthcare professionals educated, ADRC staff trained in ADRC functions, barriers to access 

removed. Additional outcomes include the project embedded in the State's system, reports 

showing the project has accomplished its goals and objectives, and the 5-year operational 

plan and budget are completed. Products will include a 5-year operational plan and budget, 

marketing plan and materials, quality assurance, training and evaluation tools, technology 

improvements, and project reports. 

Page 41 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0013

Project Title: Texas Aging and Disability Resource Centers

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Texas Department of Aging and Disability Services 

701 W. 51st Street 

Austin, TX 78751 

Contact: 

Winnie Rutledge 

Tel. (512) 438-5891 

Email: winnie.rutledge@dads.state.tx.us

AoA Project Officer Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

The Texas Department of Aging and Disability Services (DADS) proposes to expand and 

enhance its current Aging and Disability Resource Center (ADRC) network by working with 

the ADRC State Advisory Council and its eight projects to standardize operations in support 

of fully functioning ADRCs. DADS proposes two goals: 1) to enhance the capacity of the 

current project sites options counseling and support services by collaborating with hospital 

discharge planning departments to reduce hospital readmissions and by providing additional 

structure to the operation of the ADRC project sites for more uniformity of services provided; 

and 2) to expand the number of ADRC project sites to at least one project in each region. 

Planned objectives include 1) adopting standards of operation using the lessons learned and 

the experience gained from the original sites three years of operation and other states' 

ADRCs; 2) increasing the capacity of ADRC projects to work with hospital discharge planning 

departments in at least one medical facility through increased funding and training 

opportunities because not all ADRC projects sites are actively involved with these 

departments; 3) increasing the capacity of Central Texas ADRC project to provide person 

centered care coordination through implementation of Guided Care model; 4) developing a 

five year state plan to expand ADRCs statewide with extensive stakeholder input; and 5) 

developing at least one new project during the first year of this grant. These activities will 

provide DADS, the project sites and the Administration on Aging several products: 1) policy 

and procedures manual for ADRC operations; 2) State Plan for statewide implementation of 

ADRCs; and 3) evaluation report of progress toward attainment of goals. 

Page 42 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0029

Project Title: Utah Aging and Disability Resource Center (ADRC)

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

The University of Utah 

Center on Aging/Geriatrics 

75 South 2000 East, RM 211 

Salt Lake City, UT 84112 

Contact: 

Somelea Neville 

Tel. (801) 585-6946 

Email: somelea.neville@osp.utah.edu

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

The Utah Commission on Aging will create a statewide Aging and Disability Resource Center 

in collaboration with the Utah Division of Aging and Adult Services, Division of Services for 

People with Disabilities, Medicaid Program, 211, Access Utah Network, Area Agencies on 

Aging, Centers for Independent Living, and Utah State University. Five goals are sought. 

The first goal is establish the organizational structure necessary to establish the ADRC. 

Objectives include employing staff, convening committees, developing ADRC model and 

evaluation/reporting plan. A second goal is to establish and maintain a state¿wide database 

of long term support options. Objectives include assessment of the current system, 

developing a plan, and evaluation. A third goal is to create a statewide awareness, 

information, and individualized counseling system. Objectives include assessment of the 

current system, development of a plan, identification and funding of pilot site, and evaluation. 

A fourth goal is to create a seamless single point of entry to publicly funded long term support 

programs. Objectives include assessment of the current system and development of plan. A 

fifth goal is to create a care transition system that provides individuals and caregivers with 

timely and accurate information about long term support options. Objectives include an 

assessment, consideration of models, and development of a plan. The target population is 

individuals aged 60 and older and disabled adults aged 18 and older, statewide. Identified 

products will be an operational ADRC, a statewide computerized database of information, a 5 

year state plan, and an online application for Medicaid long term support programs. 

Page 43 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0037

Project Title: Vermont Aging and Disability Resource Centerl: Empowering 

Individuals to Navigate Their Health and Long Term Support Options

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Vermont Department of Disabilities, Aging and Independent Living 

103 South Main Street Weeks Building 2nd Floor 

Waterbury, VT 05671-1601 

Contact: 

Merle Edwards-Orr 

Tel. (802)241-4496 

merle.edwards-orr@ahs.state.vt.us

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,582

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,582

Project Abstract: 

The Vermont Department of Disabilities, Aging and Independent Living (DAIL) strengthen the 

Vermont Aging and Disability Resource Connection (ADRC) statewide and develop a five

year operational plan and budget in collaboration with its ten core partner agencies. Project 

objectives include: 1) develop a five year operational plan and budget; 2) develop warm 

transfer capability among partner agencies to facilitate timely and efficient referrals; 3) build a 

marketing strategy to bring the ADRC statewide to the public and key stakeholders; 4) 

establish AIRS I/R/A professional staff capacity at each ADRC core partner agency; 5) 

improve person centered hospital discharge planning in collaboration with the Community 

Living Program (CLP) project efforts; 6) pilot a new model(s) of discharge planning in at least 

two regions of the state; 7) identify and develop effective partnership strategies with the State 

Medicaid Office re: eligibility determination processes; and 8) develop a quality improvement 

plan including vehicles for ongoing consumer involvement. Project outcomes include: 1) a 

statewide fully functional ADRC; 2) a sustainable five year operational plan and budget; 3) 

professionally staffed I/R/A service capacity in the ten partner agencies; 4) enhanced options 

counseling and decision support functions with the Vermont ADRC that incorporates the 

Community Living Program (CLP) goals and consumer preference to remain at home for as 

long as possible; 5) a collaborative, person centered discharge planning process in 

partnership with the CLP, local hospitals and nursing homes; and 6) a quality improvement 

plan supporting a five year ADRC operational plan. Project deliverables include a five year 

plan and budget, project reports, training materials, and conference presentation materials, 

such as abstracts. 

Page 44 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0018

Project Title: Aging and Disability Resource Centers: Empowering Individuals to 

Navigate Their Health and Long-Term Support Options

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Virginia Department for the Aging 

1610 Forest Avenue,Suite 100 

Richmond, VA 23229 

Contact: 

Katie Roeper 

Tel. (804) 662-7047 

katie.roeper@vda.virginia.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $246,056

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $246,056

Project Abstract: 

Virginia's No Wrong Door (NWD) initiative strives to streamline access to information and to 

public/private long-term services and supports for seniors and adults with disabilities - 

maximizing opportunities to live at home and engage in community life. The Virginia 

Department for the Aging will develop new NWD/Aging and Disability Research Center (ADR 

C) communities and significantly enhance existing ADRC operations in partnership with the 

Department of Medical Assistance Services, Department of Rehabilitative Services (DRS), 

Virginia Hospital/Healthcare Association, Area Agencies on Aging, Centers for Independent 

Living (CILS), and hospitals. The goals of this project are to: 1) Expand geographically 

growing closer to statewide coverage of Virginia's NWD/ADRC model of service delivery; 2) 

Expand functionally enhancing NWD/ADRC technology for optimal use by disability service 

providers; and 3) Expand collaboratively developing best practices in coordination of 

transition planning for NWD/ADRCs and hospital discharge planners. Objectives include: 

Establishing four new NWD/ADRC communities; enhancing technology to improve service 

coordination for people with disabilities; conducting feasibility studies to interface with hospital 

discharge planning information systems and the State Health Insurance Information Program 

(SHIP) reporting system; developing protocols for coordinating transition/service plans in five 

existing NWD/ADRC communities; cultivating a statewide approach to foster education about 

and support for person-centered care coordination; and developing a marketing plan for 

NWD/ADRC communities. Some of the expected outcomes include: four new ADRCs 

serving 23 additional localities; an increase in individuals served through ADRCs; the addition 

of five CILs and ten DRS case managers utilizing the ADRC technology; five ADRCs 

collaborating with discharge planners at 15 hospitals, resulting in a reduction in readmissions; 

increased consumer/caregiver understanding of options when leaving a hospital; and 

increased consumer satisfaction and provider efficiency. 

Page 45 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0017

Project Title: Aging and Disability Resource Center Expansion in Washington State

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Washington State Department of Social and Health Services 

Aging and Disability Services Administration 

640 Woodland Square Loop SE 

Lacey, WA 98503 

Contact: 

Susan L Shepherd 

Tel. (360) 725-2418 

Email: shephsl@dshs.wa.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $211,466

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $211,466

Project Abstract: 

Washington State Department of Social and Health Services-Aging and Disability Services 

Administration (DSHS-ADSA), supports this three year Aging and Disability Resource Center 

(ADRC) expansion project in collaboration with four Area Agencies on Aging (AAAs), 

interested stakeholders, and constituents. The goal of the project is to achieve significant 

progress toward statewide expansion of Washington State's ADRC program. The approach 

is to initiate and evaluate the expansion of ADRCs and demonstrate potential efficiencies and 

effectiveness ADRCs provide by employing person-centered principles in navigating longterm support options. The objectives are to: (1) achieve significant progress in establishing 

three new ADRC pilot sites; (2) convene a statewide ADRC planning and policy committee; 

(3) develop a five year operational plan and budget for achieving statewide coverage of fully 

functional ADRCs; (4) facilitate training and technical assistance for ADRC pilot site staff and 

partners; (5) enhance interagency relationships and partnerships with disability, long-term 

support option experts, and advocacy organizations; (6) evaluate the impact of the ADRC 

program; and (7) disseminate project information. The expected outcomes of this ADRC 

expansion project are: (1) four well functioning ADRC sites in Washington State; (2) an 

ADSA-approved operational plan and budget for statewide coverage of ADRCs; (3) 

methodology for determining cost savings related to ADRC catchment areas; (4) project 

evaluation reflecting project results; and (5) consumers more capable of making decisions 

about long term support options. The products from this project are: a final report, including 

evaluation results and lessons learned; a five-year operational plan and budget for statewide 

expansion; ADRC program standards; and established relationships and protocols with 

disability, long-term support option experts, and advocacy organizations. 

Page 46 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0033

Project Title: VITALS - Vital Aspects of Life Services

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

West Virginia Bureau of Senior Services 

1900 Kanawha Boulevard East 

Charleston, WV 25305 

Contact: 

Barbara S. Reynolds 

Tel. (304) 558-3317 

breynolds@wvseniorservices.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $228,856

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $228,856

Project Abstract: 

The West Virginia Bureau of Senior Services will partner with hospitals and Aging and 

Disability Centers (ADRCs) to develop a person-centered discharge planning process in a 

program named VITALS Vital Aspects of Life Services. The goal is to reduce the number of 

hospital readmissions for adults with a diagnosis of diabetes mellitus, chronic obstructive 

pulmonary disease, congestive heart failure, status post coronary bypass surgery, or hip 

fracture. There are five objectives: 1) develop a discharge planning kit that contains an 

assessment/service plan and information regarding long-term care options and multiple 

provider agencies to facilitate individual choice; 2) enhance existing partnerships between 

ADRCs and hospital discharge planners in order to arrange and ensure a person-centered 

discharge process; 3) develop a guided care model for follow-up after discharge that focuses 

on chronic disease and medication self-management, nutrition, and access to proper followup care; 4) evaluate the effectiveness of the project in deterring future hospital admissions; 

and 5 further strengthen the ADRCs and the long-term care system in West Virginia by 

recommending systems change based on evidence and lessons learned. There are four 

expected outcomes: 1) the pilot hospitals will see a decrease in readmissions; 2) patients 

involved will have greater input and choice in their discharge planning process; 3) both 

Medicare and Medicaid will experience a cost savings; and 4) ADRCs will be strengthened by 

VITALS to make them more fully functional and to optimize use of existing funding. 

Policymakers will subsequently be educated and systems change recommended. 

Page 47 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0023

Project Title: Improving Quality and Customer Satisfaction with Information and 

Assistance

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Wisconsin Department of Health Services 

Division of Long Term Care 

! West Wilson 

Madison, WI 53707 

Contact: 

Kristen Felten 

Tel. (608) 267-9719 

Email: Kristen.Felten@Wisconsin.gov

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $203,392

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $203,392

Project Abstract: 

The Wisconsin Department of Health Services has a plan in place to expand Aging and 

Disability Resource Centers (ADRC) statewide by 2012. This plan is supported by the 

Governor and the funding for the 09-11 phase has been approved in the current state 

biennial budget. The project goals are to a) significantly strengthen Wisconsin's ADRCs by 

building upon new and previous learning regarding the quality of, and customer satisfaction 

with, access to publicly funded long term care programs through the ADRC, and information 

and assistance and options counseling services, as well as b) achieving a reduction in 

unnecessary hospital readmissions. To achieve these goals, the objectives are: 1) to perform 

a quality evaluation and customer satisfaction survey regarding information and assistance 

and options counseling services with 16 new ADRCs not included in the 2008 study, and 

repeat the evaluation with the original 18 participating ADRCs to demonstrate improvement 

based upon the learning and identify areas needing additional support; 2) develop quality 

indicators of customer satisfaction with access to publicly funded long term care programs 

and to perform an evaluation of this service with all fully-functioning ADRCs; 3) to make 

funding available to individual ADRCs to strengthen and enhance their services based upon 

the results of each of the quality evaluations; 4) implement a specific plan with the Milwaukee 

County Aging Resource Center (the largest Wisconsin ADRC) to further streamline access 

and improve customer satisfaction; and 5) refine and strengthen existing connections 

between ADRCs, hospital discharge planning and home health agencies. 

Page 48 of 281 
Program: Aging and Disability Resource Centers 

Grant Number: 90DR0010

Project Title: The Wyoming ADRC Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Wyoming Department of Health 

6101 Yellowstone Rd. Suite 259B 

Cheyenne, WY 82002 

Contact:

Debbie Walter 

Tel. (307) 777-5048 

debbie.walter@health.wyo.gov

AoA Project Officer: Elizabeth Leef 

Fiscal 

Year 

Funding 

Amount

FY2009 $50,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $50,000

Project Abstract: 

The Wyoming Department of Health/Aging Division supports this three year project in 

collaboration with our local independent living organizations and other related state 

programs. The objectives are: 1.) serve as a visible and trusted source of information to our 

aging and/or developmentally disabled citizens including both institutional and home or 

community based care; 2) provide personalized and consumer friendly assistance to 

empower consumers to make informed decisions about their care options; 3) provide a 

streamlined and coordinated access to all care options so consumers can get the care they 

need through an single entry point (SEP) intake process;. 4) sssist individuals plan ahead for 

their future long-term care needs; and 5) sssist Medicare beneficiaries to understand and 

access the Prescription Drug Coverage and prevention benefits under the Medicare 

Modernization Act. The approach is to develop at least one and potentially two-three Aging 

and Disability Resource Center site(s) to provide statewide coverage through a toll-free 

number system within the first 12 months of the project. The expected outcomes include 1) 

simplified access to services and supports, eligibility determinations, and information for 

consumers who may find it difficult to navigate through the system on their own; 2) 

streamlined process of referral to other local, state and federal resources; and 3) access for 

every citizen to the services and supports they need. The products will be: 1) on-going 

reports to the Administration on Aging (AoA) regarding the number and type of consumers 

served; 2) survey evaluation results indicating consumer satisfaction with the process; 3) 

website detailing program services and providers; and abstracts for national conferences. 

Page 49 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0025

Project Title: Alzheimer's Disease Innovation

Project Period: 09/30/2009 - 03/31/2011

Grantee: 

Arizona Department of Economic Security 

Division of Aging and Adult Services 

1789 W. Jefferson St. Suite 950A 

Phoenix, AZ 85007 

Contact: 

Melanie K Starns 

Tel. (602) 542-2591 

Email: mstarns@azdes.gov

AoA Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $362,161

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $362,161

Project Abstract: 

The Arizona Department of Economic Security, Division of Aging and Adult Services (ADESDAAS), the State Unit on Aging, in collaboration with its partners, will achieve the following 

goal: to examine the feasibility, accessibility, and efficacy of Early-Stage Partners in Care 

(EPIC) intervention, a community-based group delivery program based on the dyadic 

intervention known as Early Diagnosis Dyadic Intervention (EDDI). The EPIC program will 

serve people diagnosed with early-stage dementia (EP) and their care partners (CP) 

throughout the state of Arizona. The objectives of the project are: 1) to adapt components of 

EDDI into EPIC; 2) to recruit and involve 80 EP/CP dyads into the EPIC program; 3) to 

deliver and ensure consistent implementation of the EPIC program; 4) to examine and test 

the feasibility and acceptability of EPIC; 5) to evaluate the efficacy of the EPIC program in 

terms of changes in EPs and CPs knowledge of dementia and early-stage issues and 

available services, communication and support with the dyad, and emotional well-being and 

quality of life for EPs and CPs; and 6) to develop and disseminate project information. 

Expected project outcomes include: 1) improved knowledge, communication, and support for 

EPs and CPs related to early-stage diagnosis, and increases in emotional well-being and 

quality of life for EPIC participants, and 2) positive feedback on the feasibility and 

acceptability assessments regarding the program and its challenges and opportunities. 

Project products include evaluation results and data related to the clients served; training and 

operator manuals; other materials need to replicate the project; and presentations and 

articles for publication. The priority area for this project is early-stage dementia. 

Page 50 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0026

Project Title: Alzheimer's Disease Innovation

Project Period: 09/30/2009 - 03/31/2011

Grantee: 

Kansas Department on Aging 

503 S. Kansas Ave. 

Topeka, KS 66603 

Contact: 

Tina Langley 

Tel. (785) 368-7331 

Email: Tina.Langley@aging.ks.gov

AoA Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $203,155

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $203,155

Project Abstract: 

The Kansas Department on Aging along with the Alzheimer's Association, Heart of America 

Chapter, the Area Agencies on Aging and the University of Kansas will implement an 

innovative project to expand dementia capacity through the State Aging organizations and 

Mental Health Centers. The goal of this project is to expand access and competency 

throughout the Aging Network and Mental Health Centers to recognize and assist families 

facing psychiatric complications of dementia. The objectives are: 1) to provide crisis support 

to individuals and families facing Alzheimer's disease; 2) to serve as a resource to state 

professionals and Mental Health Centers; 3) to provide dementia training to Mental Health 

Centers; and 4) to provide a model for dementia integration into state geriatric Mental Health 

Centers. Expected outcomes include: 1) reduced behavioral/affective challenges that 

negatively impact provision of care; 2) reduced transitional complications post hospital 

discharge; and 3) improved caregiver confidence in addressing warning signs of possible 

psychiatric complications. Project products will include: 1) a toolkit to improve assessment 

and intervention skills for psychiatric symptoms of dementia, to be dispersed to state Aging 

Network and Mental Health Centers; 2) a report and recommendations to be provided to the 

Kansas Secretary on Aging, Governor's Committee on Mental Health Planning and the 

Kansas House of Representatives Aging Committee; 3) a replication manual; 4) a cost 

analysis; and 5) an annual data report. This project addresses the Dementia Capable 

Network/Systems priority area. 

Page 51 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0028

Project Title: Alzheimer's Disease Innovation

Project Period: 09/01/2009 - 02/28/2011

Grantee: 

Maine Department of Health and Human Services 

Office of Elder Services 

32 Blossom Lane 11 State House Station 

Augusta, ME 04333-0011 

Contact: 

Romaine Turyn 

Tel. (207) 287-9214 

Email: Romaine.Turyn@maine.gov

AoA Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $470,620

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $470,620

Project Abstract: 

The Maine Department of Health and Human Services aims to provide individuals with 

dementia and their families with the maximum flexibility to choose and control their services 

and supports. The goal of this proposal is to improve the capability of consumer directed 

options within Maine's publicly funded proposals to serve the needs of people with dementia 

and their caregivers. The project objectives are: 1) to improve the awareness of, access to, 

and efficacy of the current consumer direction option, called the Family Provider Service 

Option (FPSO), for people with dementia and their families; 2) to increase utilization of the 

FPSO; 3) to assess primary caregiver needs and provide referral and linkage to community 

services and supports for families selecting the FPSO; 4) to expand, within state funded 

Home Based Care, the FPSO (which has an employer authority but only covers personal 

care services) to a more flexible budget option (with a menu of goods and services and an 

individualized budget); and 5) to use lessons learned to inform the expansion of the flexible 

budget option statewide and to other Medicaid programs. Expected project outcomes are 

increased awareness, utilization and satisfaction of consumers with dementia and their 

families with consumer directed options and caregiver support services. Policy makers will 

learn valuable lessons to inform the expansion of these options to other Medicaid programs. 

Products will include: a final report, an implementation manual, program cost analysis, a 

yearly data report and an evaluation report. This project falls under the dementia-capable 

network/systems policy area. 

Page 52 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0022

Project Title: Alzheimer's Disease Innovation

Project Period: 09/30/2009 - 03/31/2011

Grantee: 

Michigan Department of Community Health 

Office of Services to the Aging 

P.O. Box 30676 

Lansing, MI 48909 

Contact: 

Sally Steiner 

Tel. (517) 373-8810 

Email: Steiners@michigan.gov

Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $439,588

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $439,588

Project Abstract: 

The Michigan Office of Services to the Aging (OSA), in collaboration with Veterans Affairs 

(VA), Area Agencies on Aging (AAA), and community services providers, will develop a joint 

AAA-VA program for veterans. Creating Confident Caregivers-VA builds on two of Michigan's 

current projects: VA collaboration as a part of Community Living; and Savvy Caregiver 

Program (SCP) under the Alzheimer's program. The goal of the project is to develop an 

effective dementia caregiver support program for veterans through AAA-VA collaboration 

using a veteran-specific form of SCP. The SCP will be provided in a compressed four week 

format with one follow-up session. Carey Sherman, a SCP developer, will serve as trainer, 

fidelity and evaluation consultant. The project objectives are: 1) to expand collaboration with 

VA facilities to reach veterans with dementia or who are dementia caregivers; 2) to train staff 

from aging and VA facilities to provide a veterans' version of SCP over four weeks, with one 

refresher session; 3) to provide training and respite services to caregivers; 4) to assess 

effectiveness through data collection; and 5) to disseminate project information. The 

expected outcome of the project is to expand and strengthen Michigan's VA and aging 

networks' capacity to support veterans and dementia caregivers. AAA and VA staff in seven 

AAA regions will be trained in the program. Veterans and family caregivers will acquire 

enhanced knowledge, skills, and efficacy. Products will include a final report, a manual, a 

cost analysis, and an annual data report. This project falls under the dementia capable 

systems priority area. 

Page 53 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0021

Project Title: Alzheimer's Disease Innovation

Project Period: 09/30/2009 - 03/31/2011

Grantee: 

Minnesota Department of Human Services 

Board of Aging 

PO Box 64976 

 540 Cedar Street 

St. Paul, MN 55164-0976 

Contact: 

Rolf Hage 

Tel. (651) 431-2595 

Email: rolf.hage@state.mn.us

AoA Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $484,474

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $484,474

Project Abstract: 

The Minesota Board on Aging will expand the number of participating Early Memory Care 

sites and augment the state's infrastructure for supporting individuals with early stage 

dementia (ESD) and their caregivers, through embedding practices that build upon the 

medical home clinical model in both clinic and community agency practice. The goal is to give 

people in early stages of dementia and their caregivers optimal control over their lives to help 

sustain cognitive function, reduce premature decline and reduce the negative impacts on 

caregivers. The approach will be to integrate practices that support the health care home 

(HCH) (State of Minnesota's term for medical homes) into the state's framework for 

identification, diagnosis, joint medical/community care planning, and caregiver support, to 

increase MN's effectiveness in reaching people with early stage dementia. RE-AIM objectives 

include: 1. Reach - screen an additional 3,000 individuals for dementia; serve 150 additional 

hard to reach individuals; 2. Effectiveness - implement HCH Early Stage Dementia practice 

guidelines, resulting in reduction of premature cognitive decline and reduction in caregiver 

depression; 3. Adoption - health care and other organizations with natural connections to 

individuals with ESD adopt HCH Early Stage Dementia practice guidelines; 4. Implementation 

- Consistently implement HCH Early Stage Dementia practice guidelines across participating 

memory care sites; 5. Maintenance - Embed HCH Early Stage Dementia practice guidelines 

in MinnesotaHelp Network (ADRC), NHDP Live Well at Home, community medical clinics, 

MN Caregiver Coach practice, state policy and export to other states. Products: electronic 

assessment & care planning process, report of key lessons learned, a how-to manual and a 

cost analysis. 

Page 54 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0023

Project Title: Alzheimer's Disease Innovation

Project Period: 09/30/2009 - 03/31/2011

Grantee: 

New Hampshire Department of Health and Human Services 

Bureau of Elderly and Adult Services 

129 Pleasant St. 

Concord, NH 03301 

Contact: 

Kathleen Otte 

Tel. (603) 271-4680 

Email: kathleen.f.otte@dhhs.state.nh.us

AoA Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $484,459

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $484,459

Project Abstract: 

The New Hampshire Bureau of Elderly and Adult Services (BEAS) will enhance the existing 

network of community supports to better serve individuals in the early stages of Alzheimer's 

Disease and Related Disorders (ADRD) and their caregivers, in partnership with the New 

Hampshire Alzheimer's Association, the Dartmouth Center for Health and Aging (DCHA), the 

University of New Hampshire Institute on Disability (UNH/IOD), and five local Service Link 

Resource Centers (SLRCs). The goal of the project is to develop and implement a strategic 

plan to enhance the existing network of community supports to better identify and address 

the planning and service needs of individuals in the early stage of ADRD. The project 

objectives are: 1) to develop a state outreach plan; 2) to reach out to the medical community 

and integrate them into the network of community supports; 3) to develop, enhance and 

facilitate specific trainings for clinicians, care providers, individuals with ADRD and their 

family caregivers and embed these trainings within the SLRC network; 5) to provide 

consumer-directed caregiver supports; 6) to evaluate the impact of the trainings and services; 

and 7) to issues a final report. The expected outcomes of their project are: 1) the SLRC 

network and medical community will be better skilled to identify and meet the needs of 

persons with early-stage ADRD and, 2) caregivers of persons with ADRD will receive person 

centered, flexible caregiver supports. Products will include a manual including training 

materials specific to early stage ADRD, outreach materials, yearly data reports, final 

evaluation reports, and a cost analysis for replication. The project falls under the category of 

early-stage dementia projects. 

Page 55 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0024

Project Title: Alzheimer's Disease Innovation

Project Period: 09/30/2009 - 03/31/2011

Grantee: 

Oklahoma Department of Human Services 

Aging Services Division 

2400 North Lincoln Blvd State Capitol Complex - Sequoyah 

Building 

Oklahoma City, OK 73125 

Contact: 

Zachary Root 

Tel. (405) 522-3121 

Email: zachary.root@okdhs.org

AoA Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $484,470

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $484,470

Project Abstract: 

The Oklahoma Department of Human Services, Aging Services Division, will implement a 

project in collaboration with the Alzheimer's Association, Tulsa Area Agency on Aging, 

Areawide Aging Agency, OASIS Adult Day Services, Daily Living Centers, Sunbeam Family 

Services, Oklahoma Area Association of Community Health Representatives, LIFE Senior 

Services, Integris Medical Center, Catholic Charities, and the University of Oklahoma. The 

goal of the project is to reach Oklahomans with dementia (PWD) in early stages (ES) of 

Alzheimer's disease and related dementias (ADRD) and their families to equip and support 

them, mitigating later crises. The objectives are: 1) to establish the COMPASS II: Early Stage 

Directions Program; 2) to strengthen relationships among community agencies; 3) to expand 

community awareness, identity more ES families, and increase the number of Oklahomans 

with access to ES programs, particularly for underserved populations; 4) to evaluate the 

impact of added services; 5) to disseminate project information; 6) and to build upon existing 

research and demonstrate additional effective interventions for finding, educating, supporting 

and empowering ES persons with dementia and their families. Expected project outcomes 

include: increased knowledge of the disease and care options among persons with dementia 

and their caregivers; increased ability to cope and plan effectively for future needs; and 

project evaluations will reflect positive results. Project products will include a final report with 

evaluation results, a summary of lessons learned, a how-to manual allowing program 

replication, a cost analysis, abstracts for national and state conferences, and results from 

caregiver strain study. 

Page 56 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0020

Project Title: Alzheimer's Disease Innovation

Project Period: 09/30/2009 - 03/31/2011

Grantee: 

Utah State Department of Human Services 

Division of Aging and Adult Services 

120 N 200 W, #325 

Salt Lake City, UT 84103 

Contact: 

Sonnie Yudell 

Tel. (801) 538-3926 

Email syudell@utah.gov

AoA Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $277,245

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $277,245

Project Abstract: 

The Utah Division of Aging and Adult Services, the Alzheimer's Association Utah Chapter, 

and specific Area Agencies on Aging will support an evidence-informed, early stage dementia 

project for family caregivers of persons with dementia and implement the tools and strategies 

of the New York University Caregiver Intervention (NYUCI). The goal of the project is to 

employ this counseling and supportive intervention in a coordinated community-based 

culturally and continually isolated rural area. The project objectives are: 1) to achieve the 

original NYUCI participant outcomes; 2) to demonstrate an innovative strategy for 

communities newly challenges by diversity; and 3) to embed the intervention at sites across 

Utah for standardization. Expected outcomes include: lowered caregiver burden, reduced 

caregiver symptoms of depression, improved caregiver reaction to problem behaviors, 

strengthened caregiver social support network effectiveness, and delayed institutionalization. 

Project products will include a final report, a caregiver manual, a web-based provider support 

center, abstracts for national conferences, and a conference on multicultural counseling and 

dementia services to diverse communities. 

Page 57 of 281 
Program: Alzheimer’s Disease Supportive Services – Innovation Projects 

Grant Number: 90AI0027

Project Title: Alzheimer's Disease Innovation

Project Period: 09/30/2009 - 03/31/2011

Grantee: 

Wisconsin Department of Health Services 

Division of Long Term Care 

1 West Wilson Street 

Madison, WI 53703 

Contact: 

Sharon M Beall 

Tel. (608) 267-2439 

Email: Sharon.Beall@wisconsin.gov

AoA Project Officer: Theresa Arney 

Fiscal 

Year 

Funding 

Amount

FY2009 $418,298

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $418,298

Project Abstract: 

The Wisconsin State Unit on Aging, in collaboration with the Wisconsin Alzheimer's Institute 

and the Aging and Disability Resource Center (ADRC) of Portage County, will oversee the 

Dementia Capable Care in Wisconsin Project. The goal of the project is to create dementia 

capable systems with early diagnosis and referrals for people with dementia and family 

caregivers, to supportive services that delay or prevent institutionalization and reduce longterm care costs in Portage County. Project objectives are: 1) to improve detection of 

dementia; 2) to enhance physician capability to diagnose and treat dementia to increased 

numbers of consumers after positive cognitive screens; 3) to establish connections between 

health care providers and community care services; 4) to develop, administer, and connect 

consumers with direct services; and 5) to incorporate lessons learned into public policy and 

planning to affect a broader consumer base. Expected outcomes include increased numbers 

of people who: agree to cognitive screen and referral to physician for diagnosis; receive 

medical diagnosis and relevant treatment; accept health care referral to physician for 

diagnosis; and have access to dementia capable care. Three new initiatives to be developed 

include: in-home respite by volunteers, caregiver training in person care skills, and 

counseling services for young onset consumers. Project products will include: a yearly data 

report, implementation manual and how to manuals for two new direct service programs, cost 

analysis, article for publication, final report including evaluation results, and evidence that 

project is embedded into Family Care program. 

Page 58 of 281 
Program: Alzheimer’s Disease Supportive Services – Evidence Based Projects 

Grant Number: 90AE0335

Project Title: Care Partners Reaching Out (CarePRO)

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Arizona Department of Economic Security 

Division of Aging and Adult Services 

1789 W. Jefferson St. 950A 

Phoenix, AZ 85007 

Contact: 

Melanie K Starns 

Tel. (602) 542-2591 

Email: mstarns@azdes.gov

AoA Project Officer: Jane Tilly 

Fiscal 

Year 

Funding 

Amount

FY2009 $846,921

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $846,921

Project Abstract: 

The Arizona Department of Economic Security, Division of Aging and Adult Services, in 

partnership with the Arizona Area Agencies on Aging, the local Alzheimer Association, and 

Arizona State University, will translate Coping with Caregiving (CWC), a group intervention 

for family caregivers of persons with dementia, into a community-based program named Care 

Partners Reaching Out (CarePRO) for diverse populations of caregivers in Arizona. The 

project objectives are: 1) to expand the reach of empirically based caregiver interventions in 

Arizona by ensuring that CarePRO is accessible to diverse and underserved caregivers; 2) to 

ensure CarePRO's effectiveness by faithfully rendering the core elements of CWC trials to 

achieve expected caregiver outcomes, while making the intervention more accessible and 

practical; 3) to improve the delivery and adoption of CarePRO within the community by 

utilizing formative evaluation techniques to obtain ongoing feedback from caregiver 

participants and grant partners; 4) to assure the consistent delivery of the intervention 

through implementation of standardized training, focused workshop site selection, and 

supervised workshop delivery; and 5) to maintain and expand delivery of the CarePRO 

intervention to allow caregivers throughout Arizona an opportunity to learn the coping skills 

afforded. Expected outcomes for the project for caregivers include: 1) reduction of depressive 

symptoms; 2) increased use of positive, adaptive coping strategies; 3) reduction in use of 

negative coping strategies; and 4) reduction in negative interactions with others. Products 

from this project include: 1) a final report 2) evaluation results 3) training and operation 

manuals 4) materials required for replication; 5) cost analysis; 6) annual data reports; and 7) 

presentations and papers for publication. 

Page 59 of 281 
Program: Alzheimer’s Disease Supportive Services – Evidence Based Projects 

Grant Number: 90AE0337

Project Title: California's Evidence-Based Alzheimer's Disease Supportive Services 

Program to Better Service People with Alzheimer's an

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

California Department of Aging 

1300 National Drive 

Sacramento, CA 95834 

Contact: 

Janet Tedesco 

Tel. (916) 928-4641 

Email: jtedesco@aging.ca.gov

AoA Project Officer: Jane Tilly 

Fiscal 

Year 

Funding 

Amount

FY2009 $996,132

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $996,132

Project Abstract: 

The California Department of Aging (CDA), in collaboration the Alzheimer's Association 

California Southland Chapter, Dr. Mary Mittelman, Partners in Care Foundation and agencies 

within the aging network serving ethnic communities, proposes to implement the evidencedbased New York University Caregiver Intervention (NYUCI) to assist family caregivers of 

persons with dementia throughout California. The project's goal is to make the NYUCI 

available to the diverse California caregiver population and to demonstrate that this can be 

accomplished at a reasonable cost with outcomes similar to those achieved in earlier 

program research. Project objectives include: to develop capacity of California's dementia 

service providers to implement the NYUCI; to deliver the program and evaluate its impact on 

ethnically diverse caregivers; to develop products to assist with replication, including a 

lessons learned report, replication manual, cost analysis, and annual data report; and to 

disseminate findings through conference presentations and the preparation of an article for 

submission to a peer-reviewed journal. The program will be coordinated through Alzheimer's 

Association chapters in partnership with local Area Agencies on Aging and ethnic-focused 

agencies within the Aging Network. These partners will promote and facilitate the 

implementation of project activities at the community level and provide respite services. The 

expected caregiver outcomes from participating in this project participants will have 

decreased levels of depression, maintain better self-reported health, and have decreased 

stress reactions to problem behaviors; in addition, it is anticipated that the intervention will 

delay institutional placement of their spouse. The site-level outcome is that Alzheimer¿s 

Association chapters and community partners will adopt the program with intent of continuing 

to provide this intervention on an ongoing, sustainable basis. Products will include a cost 

analysis and annual report. 

Page 60 of 281 
Program: Alzheimer’s Disease Supportive Services – Evidence Based Projects 

Grant Number: 90AE0332

Project Title: The Georgia Support Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Georgia Southwestern State University 

800 GSW Drive 

Americus, GA 31709 

Contact: 

Richard C Birkel 

Tel. (229) 928-1234 

Email: rbirkel@canes.gsw.edu

Project Officer: Jane Tilly 

Fiscal 

Year 

Funding 

Amount

FY2009 $999,943

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $999,943

Project Abstract: 

The Rosalynn Carter Institute for Caregiving, in collaboration with the Georgia Department of 

Aging Services, the Alzheimer's Association, Southern Crescent and Northeast Georgia Area 

Agencies on Aging, will translate the New York University Caregiver Intervention (NYUCI) to 

serve a minimum of 150 spouse caregivers of individuals with Alzheimer's disease. Special 

efforts will be made to recruit rural and African American caregivers. The goal of the project 

is to support Georgia caregivers providing in-home care to spouses with Alzheimer's disease. 

The objectives of the project are: 1) to develop a steering committee to oversee project 

implementation; 2) to install NYUCI in two Area Agencies on Aging in Georgia; 3) to fully 

implement the NYUCI with fidelity to the motel and evaluate its impact on participants; 4) to 

adapt the program as necessary in light of evaluation results, real work experience, and in 

consultation with the Administration on Aging; 5) to assure the long-term maintenance and 

continued effectiveness of the project in Georgia; and 6) to support the adoption and 

implementation of the intervention by others. Anticipated outcomes for participating 

caregivers include: 1) reduced burden; 2) fewer depressive symptoms; 3) better health; 4) 

more satisfaction with their social support network; 5) being less troubled by spouses; 

memory and behavior problems; and 6) reduced likelihood of nursing home placement. 

Project products will include: 1) a how-to manual to support implementation of the program by 

others; 2) presentations at national conferences; 3) articles for publication; 4) yearly data 

reports; 5) a final report; and 6) an analysis of program startup and operating costs. 

Page 61 of 281 
Program: Alzheimer’s Disease Supportive Services – Evidence Based Projects 

Grant Number: 90AE0336

Project Title: Alzheimer's Disease Evidence Based

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Minnesota Department of Human Services 

Board on Aging 

PO Box 64976 

540 Cedar Street 

St. Paul, MN 55164-0976 

Contact: 

Rolf Hage 

Tel. (651) 431-2594 

Email: rolf.hage@state.mn.us

AoA Project Officer: Jane Tilly 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,000,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $1,000,000

Project Abstract: 

The Minnesota Board on Aging will expand the current Administration on Aging sponsored, 

evidence-based New York University Caregiver Intervention (NYUCI) in cooperation with the 

Alzheimer's Association Minnesota/North Dakota Chapter, three Area Agencies on Aging and 

four new health care and aging service agencies. These four new sites include an African 

American site, urban and rural Hispanic sites and an additional rural site. The goal of this 

project is to improve spousal caregiver well-being and social support systems which delayed 

nursing home placement an average of 18 months in the original research. Objectives of the 

project are: to serve an additional 200 families with the NYUCI; to meet original NYUCI 

participant outcomes; to demonstrate workability in ethnically diverse community settings; to 

maintain fidelity; and to embed the intervention into ongoing practice in Minnesota. Expected 

outcomes for caregivers include reductions in depression, burden, and the negative impacts 

of care receiver behavior. Expected products include a how-to manual, standardized 

assessment forms, cost analysis, marketing materials, articles/publications, a website 

section, and conference presentations. 

Page 62 of 281 
Program: Alzheimer’s Disease Supportive Services – Evidence Based Projects 

Grant Number: 90AE0333

Project Title: Nevada Care Alzheimer’s Disease Supportive Services Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Nevada Department of Health and Human Services 

Aging and Disability Services Division 

3416 Goni Rd., Suite 132 

Carson City, NV 89706 

Contact: 

Jeff Doucet 

Tel. (702) 486-3545 

jsdoucet@aging.nv.gov

Project Officer: Jane Tilly 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,000,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $1,000,000

Project Abstract: 

The State of Nevada Aging and Disability Services Division (ADSD), in partnership with the 

Cleveland Clinic Lou Ruvo Center for Brain Health (CCLRCBH), local Alzheimer’s 

Associations in Northern and Southern Nevada, and through a regional expansion program 

with the Arizona Department of Economic Security, Division of Aging and Adult Services 

(ADES-DAAS) and Arizona State University (ASU), will translate Coping with Caregiving 

(CWC), into a community-based program named NevadaCare, and make the intervention 

accessible throughout Nevada to diverse populations of family caregivers. The objectives of 

the project are: 1) to expand the reach of empirically-based caregiver interventions in 

Nevada, by ensuring that NevadaCare is available and accessible to eligible Nevada families 

suffering from the effects of Alzheimer's Disease and Related Disorders (ADRD), especially 

diverse, underserved populations; 2) to ensure NevadaCare effectiveness by faithfully 

rendering the core elements of CWC used in Resources for Enhancing Alzheimer's Caregiver 

Health (REACH) and other subsequent randomized controlled trials, while making the 

intervention more accessible and practical for both providers and family caregivers; 3) to 

improve the delivery and adoption of NevadaCare within the community by utilizing formative 

evaluation techniques to obtain ongoing feedback from caregiver participants and grant 

partners; 4) to assure the consistent delivery of the intervention through implementation of 

standardized training, focused workshop site selection, 5) and supervised workshop delivery 

in all service settings; to maintain and expand delivery of the NevadaCare intervention to 

allow Nevada caregivers an opportunity to learn the coping skills afforded. Expected 

products include intervention manuals, practical tools for implementation (including training 

materials), cost analyses, and the project reports to facilitate the replication and maintenance 

of the NevadaCare project. 

Page 63 of 281 
Program: Alzheimer’s Disease Supportive Services – Evidence Based Projects 

Grant Number: 90AE0334

Project Title: Alzheimer's Disease Evidence Based

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Oregon Department of Human Services 

Seniors and People with Disabilities 

676 Church Street 

Salem, OR 97301 

Contact: 

Elaine Young 

Tel. (503) 373-1726 

Email: elaine.young@state.or.us

AoA Project Officer: Jane Tilley 

Fiscal 

Year 

Funding 

Amount

FY2009 $880,759

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $880,759

Project Abstract: 

Oregon’s State Unit on Aging will implement STAR-C, family caregivers of people with 

dementia intervention. The State Unit on Aging will work with two Area Agencies on Aging, 

aging services providers in the Portland area, the Oregon Chapter of the Alzheimer¿s 

Association, and the University Washington School of Nursing Northwest Research Group on 

Aging to translate this evidence-based intervention in urban and rural areas of the state. The 

goal of the project is to effectively translate and sustain an evidence-based intervention to 

increase the ability of caregivers to care for family members with dementia. Project 

objectives are: 1) to develop partnerships and systems to translate and sustain the evidencebased STAR-C program in both a rural and urban area of Oregon; 2) to provide STAR-C 

intervention to at least 168 family caregivers and persons with dementia; and) to ensure 

program effectiveness, maintaining fidelity to the original research. Anticipated outcomes of 

the project include: 1) a decrease in the frequency and severity of behavior challenges 

among persons with dementia; 2) a decrease in depression and burden among caregivers; 

and 3) successful translation of the STAR-C program as a community-level intervention in 

both an urban and rural setting with fidelity to the core elements of the original research. 

Anticipate products of the project include a final report of key findings, a replication manual, a 

cost analysis estimating program start-up and per client costs, a yearly data report, and 

promotional materials. 

Page 64 of 281 
Program: Alzheimer’s Disease Supportive Services – Evidence Based Projects 

Grant Number: 90AE0338

Project Title: Tennessee Alzheimer's Disease Supportive Services Program: 

Evidence-Based Cooperative Agreements to Better Serve People

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Tennessee Commission on Aging and Disabiliity 

500 Deaderick Street, 8th Floor, Suite 825 

Nashville, TN 37243 

Contact: 

Cynthia G Minnick 

Tel. (615) 741-2056 

Email: cynthia.minnick@tn.gov

AoA Project Officer: Jane Tilly 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,000,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $1,000,000

Project Abstract: 

The Tennessee Commission on Aging and Disability, in collaboration with the Eastern 

Tennessee Chapter of the Alzheimer's Association, Covenant Health Systems and an 

Agency on Aging and Disability, support the Cleveland Alzheimer's Managed Care 

Demonstration. The goal is to coordinate health and community care to empower caregivers 

and persons with Alzheimer's disease to seek help, make appropriate decisions through care 

consultation, develop care plans, and receive needed community-based services based on 

the plan of care. The objectives include: to reach individuals with Alzheimer's disease and 

their families; to develop and implement a plan of care for the person with Alzheimer's and 

caregivers; to increase the family's use of support services; to decrease caregiver depression 

and stress; to enhance care coordination to reduce the use of crisis interventions; and to 

increase caregiver satisfaction with quality of care received from the programs. Outcomes 

include an increase in use of community supports; a decrease in utilization rates of crisis 

interventions; an increase in the utilization of community resources; greater caregiver 

satisfaction with the services provided; reduced caregiver depression and care-related stress; 

and more options for care for the person with early stage Alzheimer's disease. Products will 

include a final report of the project including key findings, unanticipated successes and 

barriers, and a summary of lessons learned; a how-to manual and materials; a cost analysis; 

and a yearly data report. 

Page 65 of 281 
Program: Alzheimer’s Disease Supportive Services – Evidence Based Projects 

Grant Number: 90AM2793

Project Title: Evidence-Based Prevention Programs-National Resource Center

Project Period: 09/30/2003 - 08/31/2010

Grantee: 

National Council on the Aging 

1901 L Street, NW 

Washington, DC 20036 

Contact: 

Bonita L Beattie 

Tel. (202) 479-6698 

Email: bonita.beattie@ncoa.org

Project Officer: Jane Tilly 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,300,000

FY2008 $925,000

FY2007 $725,000

FY2006 $687,500

FY2005 $685,000

FY2004 $600,000

FY2003 $600,000

Total $5,522,500

Project Abstract: 

The National Council on the Aging (NCOA)has established a National Resource Center to 

support prevention demonstration grantees to successfully implement evidence-based 

disability and disease prevention programs; engage the aging services network (and others) 

in evidence-based programs and facilitate their adoption; and assist the Administration on 

Aging (AoA) to further develop an evidence-based prevention program. The outcomes of this 

3-year project will be replicable programs that can positively affect the health and function of 

older adults, and increased support for the aging network's contributions in addressing 

prevention needs. The Center will leverage NCOA's experience in strengthening the capacity 

of aging service providers to offer evidence-based programming and provide multiple types of 

resources and technical assistance. Bringing complementary skills and knowledge are the 

Center's partners: the Aging Blueprint Office, the Healthy Aging Research Network of the 

Centers for Disease Control's Prevention Research Centers, University of California – Los 

Angeles' Geriatric Medicine and Gerontology Program, a leading communications and 

dissemination firm, and leading national aging organizations. 

Page 66 of 281 
Program: Community Living 

Grant Number: 90CD1199

Project Title: Alabama's Community Living Program

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Alabama Department of Senior Services 

770 Washington Avenue, Suite 470 

P.O. Box 301851 

Montgomery, AL 36130-1851 

Contact: 

Julie Miller 

Tel. (334) 353-9285 

Email: julie.miller@adss.alabama.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $304,020

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $304,020

Project Abstract: 

The Alabama Dept. of Senior Services in Partnership with South Alabama Regional Planning 

Commission with other stakeholders have as a project goal to implement program and 

infrastructure changes in methods which SUAs and AAAs use to serve and manage persons 

at high risk of Medicaid spend down and nursing home placement that improve quality for 

individuals and help transform AL’s LTC system. Objectives include: establish a fully 

functioning ADRC; develop polices for prioritization, provide a mix of flexible person centered 

services based on the cash and counseling model; and, serve a minimum of 50 people. 

Outcomes include: infrastructure in place to support consumer directed programs outside of 

Medicaid; strengthened capacity to provide streamlined information and counseling; and 

clients served based on their preferences with priority for those at greatest need. 

Page 67 of 281 
Program: Community Living 

Grant Number: 90CD1197

Project Title: Florida Department of Elderly Affairs Community Living Program Pilot 

Project

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Florida Department of Elder Affairs 

4040 Esplanade Way, Suite 315 

Tallahassee, FL 32399-7000 

Contact:

Jay Breeze 

Tel. (850) 414-2338 

Email: Breezej@elderaffairs.org

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $575,469

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $575,469

Project Abstract: 

The Florida Department of Elder Affairs (FDOEA) Community Living Program (CLP) project 

targets elders at high risk for nursing home placement and spend down to Medicaid. The 

project will operate in Broward, Marion and Miami-Dade counties in concert with the Planning 

and Service Area (PSA) 10 Aging and Disability Resource Center (ADRC), and PSAs 3 and 

11 Aging Resource Centers (ARCs), respectively. The goal of the project is to build on the 

current CLP Project and expand innovative service delivery options in the areas served by 

the existing ADRC/ARCs. This expansion will increase the capacity of the aging services 

network and minimize the number of elders placed in nursing homes, readmitted to hospitals, 

or spending down to Medicaid. Project objectives include: creating a self-sustaining 

administrative structure by developing a financial management system that supports 

consumer directed care (CDC) as a long-term alternative to traditional home and communitybased services (HCBS); identifying individuals not eligible for Medicaid but at high risk for 

nursing home placement and spend down to Medicaid utilizing and enhancing existing 

ADRC/ARC methods to improve targeting effectiveness in diverting clients; strengthening the 

aging network’s capacity to track client outcomes and document effectiveness of the 

program; and, rapidly authorizing and providing services by creating new and flexible service 

options using existing funding streams. 

Page 68 of 281 
Program: Community Living 

Grant Number: 90CD1201

Project Title: Expansion of Georgia's Community Living Program to the Northwest 

Georgia Planning and Service Area

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Georgia Department of Human Services 

Division of Aging Services 

2 Peachtree St., NW 9th Floor 

Atlanta, GA 30303 

Contact: 

Kim Grier 

Tel. (404) 520-2101 

Email: kagrier@dhr.ga.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $505,080

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $505,080

Project Abstract: 

Georgia’s Department of Human Services, Division of Aging Services (DAS) will implement 

this Community Living Program Project with the Northwest Georgia Area Agency on Aging 

(NWGA AAA) in the fifteen-county Northwest Georgia region. The goal of the project, 

Georgia’s Consumer Support Options (CSO), is to support the rebalancing of Georgia’s longterm care system. The objectives are: (1) to divert persons at risk of nursing home 

placement and Medicaid spend down; (2) to use established targeting criteria (established 

during the previous grant cycle) for the intake and screening process through the single-entry 

point Gateway system (3) to initiate the modernization of the Northwest Region’s aging 

services network by reallocating Title III and other non-Medicaid funds to support flexible 

spending pools; (4) to implement the DAS consumer-directed model of care, allowing 

consumers to tailor services to their individual needs; (5) to develop and maintain a Fiscal 

Management Service at the NWGA AAA; and (6) work with the Atlanta Veteran’s 

Administration Medical Center to provide the Veterans Directed Home and Community Based 

Service (VDHCBS) program, and, to implement the Tailored Caregiver Assessment and 

Referral (TCARE) protocol of caregiver assessment for the VDHCBS caregivers. Anticipated 

outcomes are a significant number of individuals at risk for nursing home placement, but not 

Medicaid eligible, will delay or avoid nursing home admission, and veterans will have the 

opportunity to enroll in a self-directed care program. The deliverables are: (1) a flexible 

spending fund pool to support CSO; (2) a fiscal management service operations manual; (3) 

the implementation of a VDHCBS program option; (4) marketing and promotional materials; 

and (5) interim and final reports. 

Page 69 of 281 
Program: Community Living 

Grant Number: 90CD1207

Project Title: Hawaii's Community Living Project

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Hawaii Executive Office on Aging 

250 South Hotel Street, Suite 406 

Honolulu, HI 96813 

Contact: 

Nancy Moser 

Tel. (808) 586-7309 

Email: nancy.moser@doh.hawaii.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $446,610

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $446,610

Project Abstract: 

The Hawaii Executive Office on Aging (EOA), which operates the Hawaii Aging and Disability 

Resource Center (ADRC), will conduct the Community Living Program (CLP) in collaboration 

with the Department of Human Services (the state Medicaid agency), State Council on 

Developmental Disabilities, Disability Communication Access Board, Area Agencies on 

Aging, and community service providers. The goal is to assist individuals who are not 

Medicaid eligible, but at imminent risk of nursing home placement, to remain in the 

community, avoiding institutionalization and spend-down to Medicaid. The objectives include: 

identifying at-risk individuals through ADRC and link them to home and community-based 

services (HCBS), including consumer directed options, to retain them in community living; 

coordinate ADRC’s intake and assessment protocol with Medicaid level-of-care and eligibility 

tools; identify those at risk of nursing home placement and not Medicaid eligible by adding 

CLP data elements to ADRC assessment protocols; using Financial Management Services to 

activate the option for consumer direction; and, to serve at least 90 individuals. Expected 

outcomes after two years include: 80 individuals will avoid institutionalization and spend 

down to Medicaid; ADRC sites will use a common intake form to assess individuals for 

service needs; and, individuals who need supports to remain living in the community have 

the option to elect consumer-directed services. 

Page 70 of 281 
Program: Community Living 

Grant Number: 90CD1200

Project Title: Building a Community Living Program for the State of Indiana

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Indiana Family and Social Services Administration 

Division on Aging 

402 W. Washington St. IGC-South Rm. E442 

Indianapolis, IN 46204 

Contact: 

Andrea Vermeulen 

Tel. (317) 234-1749 

Email: andrea.vermeulen@fssa.in.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $582,913

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $582,913

Project Abstract: 

The Indiana Family and Social Services Administration (FSSA) is collaborating with the 

state’s Area Agencies on Aging (AAAs) to develop a Community Living Program (CLP). The 

project goals are to establish mechanisms to ensure that individuals at greatest risk of 

nursing facility (NF) placement and Medicaid spend down receive services, and to build 

infrastructure necessary to support the growth of person-centered (PC) and participantdirected (PD) supports. Project objectives include: pilot and validate a research-based, 

objective, and standardized approach to targeting non-Medicaid funded home and 

community-based services (HCBS) to individuals most at risk of entering a NF and spending 

down to Medicaid eligibility; incorporate a PC approach into CLP operations; develop a datadriven quality management system for the CLP; increase the flexibility of PD options; and 

develop infrastructure that will provide counseling to accompany the PD services offered 

under the CLP. Outcomes include: a successful pilot of the MDS-HC, the adoption of 

targeting criteria and policies for assigning priority access to high-risk individuals, and a 

standardized approach for triaging assessments; and a process that results in 100% of the 

participants in the pilot sites having a PC experience. 

Page 71 of 281 
Program: Community Living 

Grant Number: 90CD1205

Project Title: Maine's Community Living Program

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Maine Department of Health and Human Services 

Office of Elder Services 

32 Blossom Lane 11 State House Station 

Augusta, ME 04333-0011 

Contact: 

Romaine Turyn 

Tel. (207) 287-9214 

Email: Romaine.Turyn@maine.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $293,329

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $293,329

Project Abstract: 

The goals of Maine’s Community Living Program are to: strengthen the capacity of Maine’s 

Aging Network to target individuals not eligible for Medicaid who are at highest risk of nursing 

home or residential care placement and spend-down and improve access to flexible and 

consumer-directed services for participants within 12 months. Objectives include: 

establishing the Area Agencies on Aging/Aging and Disability Resource Centers 

(AAA/ADRC) as Single Entry Points for individuals targeted in this proposal; 

developing/implementing options counseling protocols to inform consumer decision-making 

and spending; developing/using an assessment protocol for determining risk; creating more 

flexibility in Maine¿s consumer-directed Family Provider Service Option; educating the public, 

service providers and referral sources about the availability of options counseling; and 

establishing consumer monitoring and feedback mechanisms. Outcomes include: increasing 

private pay individuals who access options counseling; increasing consumers well-being and 

quality of life; improving communication and understanding among partner organizations 

about options counseling; improving AAA/ADRC ability to identify individuals at-risk for 

nursing home admission and spend-down; improving flexibility within the Family Provider 

Service Option Program; diverting at-risk elders from nursing homes and residential care and 

Medicaid spend-down; AAA/ADRC staff trained on and using new protocols; strengthening 

network of long-term services and supports. 

Page 72 of 281 
Program: Community Living 

Grant Number: 90CD1206

Project Title: Massachusetts Community Living Program

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Massachusetts Executive Office of Elder Affairs 

One Ashburton Place, 5th Floor 

Boston, MA 02108 

Contact: 

Ruth Palombo 

Tel. (617) 222-7512 

Email: Ruth.Palombo@state.ma.us

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $500,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $500,000

Project Abstract: 

The goal of this grant to the assachusetts Executive Office of Elder Affairs in partnership with 

the Massachusetts Rehabilitation Commission is to strengthen the capacity of the Aging and 

Disability Resource Consortia (ADRC) network to prevent people from unnecessary nursing 

home placement through implementation of the Community Living Program (CLP) grant. 

Adults and adults with disabilities in the state-funded Enhanced Community Options Program 

(ECOP) who are at greatest risk of nursing home admission will be referred to either Aging 

Service Access Points (ASAPs) or to Independent Living Centers (ILCs) for evaluation and 

access to home based services that include a consumer directed option. Services used, their 

cost and effectiveness in averting nursing home placement will be tracked for all participants. 

The program will build on successful diversion practices at Massachusetts’ eleven 

ADRCs,and address opportunities to develop their capacity to: provide the Senior Care 

Optoins Program (OPTIONS), information on consumer direction, and referral to communitybased services; use their information and referral services and field-based staff to identify the 

target population; track OPTIONS effectiveness in nursing home diversion; reach out to 

hospital, nursing and rehabilitation facility discharge staff to improve relationships; and, 

identify service gaps that may contribute to nursing facility admission. In addition, the 

program will increase capacity of ASAPs, who are key partners within the ADRCs, to offer 

ECOP consumers the opportunity to direct their own services, using individual budgeting. 

Page 73 of 281 
Program: Community Living 

Grant Number: 90CD1198

Project Title: Minnesota's Community Living Program 2009 - 2011

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Minnesota Department of Human Services 

Board on Aging 

PO Box 64976 

540 Cedar Street 

St. Paul, MN 55164-0976 

Contact: 

Jane Vujovich 

Tel. (651) 431-2573 

Email: jane.vujovich@state.mn.us

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $500,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $500,000

Project Abstract: 

The vision for Minnesota’s Community Living Program (MCLP) grant project is to reduce 

Medical Assistance (MA) spending by supporting pre-Medical Assistance (MA) high-risk older 

adults in self-managing their risk factors and maximizing their use of flexible service options. 

Minnesota’s Live Well at Home Program (LWAHP) (i.e., Nursing Home Diversion Program 

2007-2009) strategically identifies and helps high-risk persons proactively manage risk 

factors. The goals of MCLP are to: 1) Bolster the Aging Network’s capacity to target pre-MA 

eligible high-risk older adults and family caregivers through statewide implementation of the 

LWAHP; 2) Broaden statewide capacity to offer self-directed support options to at-risk 

persons; 3) Establish a system-wide approach to measure and report target group diversion 

from MA. Minnesota will partner with all Area Agencies on Aging (AAAs) to achieve the 

following objectives: 1) Broadly disseminate the Rapid Screen tool; 2) Integrate diversion 

support services and risk management protocols into the Minnesota Help Network; 3) Build 

capacity and sustainability for high quality diversion support services; and 4) Implement 

Veterans-Directed HCBS Option. The expected outcomes are: 1) Increased number of 

persons: a) using the Rapid Screen; b) taking action to manage their risks; c) buying selfdirected support; and, 2) Ultimately, evidence of MA savings. Core products are: risk 

management materials; consumer materials; a final report with evaluation results; an 

enhanced web-portal; and provider standards and training program. 

Page 74 of 281 
Program: Community Living 

Grant Number: 90CD1193

Project Title: Community Living Program Cooperative Agreements

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Montana Department of Public Health and Human Services 

Senior and Long Term Care Division 

111 Sanders P O Box 4210 

Helena, MT 59604 

Contact: 

Charles Rehbein 

Tel. (406) 444-7788 

Email: crehbein@mt.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $449,921

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $449,921

Project Abstract: 

The goal of Montana’s Community Living Program is to support the rebalancing of Montana’s 

long-term care system by assisting individuals, and their family and informal caregivers, who 

are at imminent risk of nursing home placement and not eligible for Medicaid, to use home 

and community based services to remain at home and in the community, and thus avoiding 

unnecessary nursing home placement. Major objectives are to: (1) expand ADRC model to 

one additional county in Area XI (Ravalli County); (2) design and implement targeting and 

assessment protocols to identify non-Medicaid older adults at imminent risk of nursing home 

placement and Medicaid spend-down; (3) develop a consumer directed option for Older 

Americans Act (OAA) funded services based on the Big Sky Bonanza program, allowing 

flexible spending options; and (4) maximize the number of persons served with OAA funds by 

introducing cost sharing for appropriate in-home services. The expected outcomes are: (1) 

serving at least 50 individuals who are identified at imminent risk of nursing home placement 

and Medicaid spend-down; (2) establishing a process to identify and target at-risk clients and 

offer them consumer directed services; (3) providing consumer direction for in-home services; 

(4) strengthening the capacity to provide information and services to help individuals remain 

in the community; and (5) expanding the cost sharing model to additional in-home services. 

Page 75 of 281 
Program: Community Living 

Grant Number: 90CD1202

Project Title: Statewide Expansion of a Consumer Directed Model Supporting Informal 

Caregivers

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

New Hampshire Department of Health and Human Services 

Bureau of Elderly and Adult Services 

129 Pleasant Street 

Concord, NH 03301 

Contact: 

Kathleen F Otte 

Tel. (603) 271-4680 

Email: Kathleen.F.Otte@dhhs.state.nh.us

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $474,374

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $474,374

Project Abstract: 

The New Hampshire Bureau of Elderly and Adult Services (BEAS), in partnership with the 

Institute on Disability at UNH (IOD), proposes to actualize the transformation of caregiver 

support services in New Hampshire, by expanding the Transitions in Caregiving Program 

statewide. Transitions in Caregiving (TIC) is a consumer-directed model that supports 

informal caregivers caring for older adults at risk of placement in a nursing facility and 

ultimately spend down to Medicaid. TIC is currently being implemented in 7 regions of the 

state through the ServiceLink Aging and Disability Resource Centers (SLRC’s) utilizing 

funding from previous NHDM grants and a Weinberg Foundation grant. The goal of this 

proposal is to actualize the transformation of the caregiver support program from a 

centralized, state-managed model into a flexible, consumer-directed model managed at the 

local level through the SLRC’s and implement it statewide. Objectives include: expand the 

infrastructure established under the initial NHDM project statewide; provide a comprehensive 

array of supports to family caregivers and train professional staff in the consumer directed 

model; pilot the model in one region with veterans at risk of nursing home placement; 

educate legislators and submit legislation to sustain the TIC program; and evaluate the 

efficacy of the program. Outcomes include: statewide implementation with secured funding; 

and services to veterans, under the Veteran’s Directed Home and Community Based Care 

(VD-HCBS) model. 

Page 76 of 281 
Program: Community Living 

Grant Number: 90CD1203

Project Title: New York State: Community Living Program

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

New York State Office for the Aging 

2 Empire State Plaza 

Albany, NY 12223-1251 

Contact: 

Gail Koser 

Tel. (518) 474-4425 

Email: gail.koser@ofa.state.ny.us

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $500,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $500,000

Project Abstract: 

New York State Office for the Aging, with its partners, will develop a peer mentoring learning 

community to expand and enhance self-directed capacity for nursing home diversion in aging 

network and VA consumers. The goal of the project is to build statewide capacity to offer 

seamless, flexible service delivery including self-directed options to divert participants from 

nursing home placement and Medicaid spend-down. This project builds upon work begun 

with Broome, Oneida and Onondaga Area Agencies on Aging (AAAs), expands to 7 

additional AAAs, serves over 200 persons (19% of eligible’s in those counties) at imminent 

risk for nursing home placement and Medicaid spend-down and prepares for statewide 

adoption of flexible service delivery including self-directed approaches. Objectives include: 

expand self-directed program capacity to serve 200 consumers in 7 AAAs and build the 

foundation to expand to 25% of State’s AAAs; implement continuous quality improvement 

strategies; set-aside Federal and State monies to support self-directed approaches to 

targeted populations; and amend the New York Expanded in Home Services for the Elderly 

Program (EHSEP) regulations to support self-directed delivery and implementation in 25% of 

State’s AAAs. Outcomes include: diversion of persons at-risk for nursing home placement 

and Medicaid spend-down; funding realignment; increased quality delivery; and, statewide 

replication/sustainability. 

Page 77 of 281 
Program: Community Living 

Grant Number: 90CD1204

Project Title: Oregon Community Living Project

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Oregon Department of Human Services 

Seniors and People with Disabilities 

676 Church Street 

Salem, OR 97301 

Contact: 

Elaine Young 

Tel. (503) 373-1726 

Email: elaine.young@state.or.us

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $322,165

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $322,165

Project Abstract: 

The State of Oregon Department of Human Services, Seniors and People with Disabilities 

Division (SPD), in collaboration with two Area Agencies on Aging’ Multnomah County Aging 

and Disability Services (ADSD) and Washington County Disability, Aging, & Veterans 

Services (DAVS) will use Community Living Program grant funding to enhance efforts at 

diverting individuals from nursing home placement and empowering them to be well-informed 

long-term care consumers. The goal of this project is to pilot key systemic changes at ADSD 

and DAVS that will enable those at risk of nursing facility placement and spend-down to 

Medicaid to remain in home and community-based settings. Project objectives include: 

revising the intake screening process to identify and respond quickly to those at imminent 

risk; implementing long-term care options counseling to help targeted individuals and their 

families make informed decisions about available services; expanding existing programs that 

promote self-directed care and developing new Web-based tools that enable consumers to 

research benefits and service options; increasing knowledge, skills, and abilities of case 

management staff and community partners to equip them to provide consumer-directed care; 

and, developing an evaluation process to track client outcomes and cost avoidance 

attributable to nursing facility diversion activities. Outcomes are: key indicators of imminent 

risk will be validated; consumer awareness and use of home and community-based services 

will increase as a result of long-term care options counseling; 100 at-risk individuals will delay 

or avoid nursing home placement and spend-down to Medicaid; and screening and case 

management staff wilI increase their knowledge, skills, and abilities to provide consumerdirected care. 

Page 78 of 281 
Program: Community Living 

Grant Number: 90CD1195

Project Title: Home And Community Based Services for Seniors, Adults With 

Disabilities and Veterans

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

South Carolina Lieutenant Governor's Office on Aging 

1301 Gervais Street Suite 200 

Columbia, SC 29201 

Contact: 

Denise W Rivers 

Tel. (803) 734-9939 

Email: riversd@aging.sc.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $425,536

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $425,536

Project Abstract: 

The South Carolina Lieutenant Governor’s Office on Aging’s (LGOA) Community Living 

Program: Supporting Independence and Choice in the Community, will be developed in 

collaboration with the VA Medical Center in Charleston (the Ralph H. Johnson VA Medical 

Center), the Trident Aging and Disability Resource Center. The goal of the program is to 

improve access to information and services, and increase options and consumer direction for 

non-Medicaid eligible Veterans/seniors who need nursing home level of care but who choose 

to remain in the community. Objectives include: development of a consumer directed 

Community Living Program through a unified coordination of care concept to ensure 

recognition of, and satisfaction with, individual preferences for community based services; 

identification and recruitment of service providers to assist the Veteran/senior; and 

development of enhancements to existing systems that promote information sharing across 

previously existing “silos”. Additional objectives include improvement of home and 

community based services for Veterans/seniors needing nursing home level of care by 

coordinating training and education for the Veteran/senior, family members, caregivers and 

ancillary participants; and utilization of information system enhancements to facilitate wellinformed consumer directed service plans as early as possible. Expected outcomes include: 

increased access to services and information; increased consumer control; increased 

independence through community based services; and greater likelihood of delayed 

relocation to a facility. Products will include a summary of lessons learned, a manual that will 

allow others to implement the demonstrated program, and a cost analysis providing an 

estimate of the cost of program start-up and operation. 

Page 79 of 281 
Program: Community Living 

Grant Number: 90CD1196

Project Title: Community Living Program of Tarrant County

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Texas Department of Aging and Disability Services 

Access and Intake 

701 W. 51st Street 

Austin, TX 78751 

Contact: 

Winnie Rutledge 

Tel. (512) 438-5891 

Email: winnie.rutledge@dads.state.tx.us

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $396,603

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $396,603

Project Abstract: 

Texas Department of Aging and Disability Services, collaborating with the Area Agency on 

Aging of Tarrant County (AAATC) and the Aging and Disabilitiy Resource Center (ADRC) of 

Tarrant County (ADRCTC), proposes a Community Living Program (CLP) for caregivers and 

older persons at imminent risk of nursing home placement and Medicaid spend down. Goals 

are to: 1) refine, expand and replicate CLP in a densely populated urban area, and 2) expand 

the scope and array of consumer-directed and evidence-based services to maximize 

consumer choice. The ADRC will refine screening of at-risk consumers, and provide 

intensive in-home services using agency-based and consumer directed services to delay 

nursing home placement. The objectives are: 1) effectively target consumers, including 

veterans, with needed community services and supports; 2) refine income screening, cost 

sharing and flexible Older Americans Act (OAA) funds to delay Medicaid spend down; 3) 

reduce time from first call to service initiation; 4) expand agency-based and voucher options 

to purchase services; 5) integrate person-centered evidence-based programs into service 

navigation functions; and 6) improve accountability of in-home service providers. The 

expected outcomes are: 1) blueprint for transformation of ADRC and AAA networks for more 

targeted allocations of resources and expanded arrays of consumer directed services to 

maintain consumers in the community and provide caregiver support; and 2) attaining targets 

of 80% of consumers living in the community six months after services begin and 70% at 9 

months. 

Page 80 of 281 
Program: Community Living 

Grant Number: 90CD1194

Project Title: Community Living Program: Choices for Independence

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Virginia Department for the Aging 

1610 Forest Avenue,Suite 100 

Richmond, VA 23229 

Contact: 

Kathy B Miller 

Tel. (804) 662-9341 

Email: kathy.miller@vda.virginia.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $259,880

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $259,880

Project Abstract: 

The Virginia Department for the Aging (VDA), in partnership with ten Area Agencies on Aging 

(AAA), will under this grant significantly enhance the modernization of Virginia’s system of 

long term care for seniors and veterans by expanding the Community Living Program (CLP) 

to over half of the Commonwealth. Project objectives include: diverting individuals at 

imminent risk of nursing home placement and spend-down to Medicaid; providing consumer 

directed options and a flexible array of community services to meet participant¿s individual 

needs; embedding a sustainable CLP model of service delivery into Virginia¿s network of 

aging services by building on the foundation established in Virginia’s 2008 CLP initiative and 

significantly expanding the program in both size and reach. Outcomes include: 100 eligible 

seniors diverted from nursing home placement and spend-down to Medicaid; 8 additional 

AAAs implementing CLP programs and offering consumer direction of services to both 

seniors and veterans; 65 Service Coordinators trained in all aspects of CLP; fiscal practices 

redesigned to allow flexible funding of an array of services from a choice of providers; 

demonstration of the efficacy of telemedicine to help rural seniors remain safely in their 

homes; improved speed and efficiency of client assessment and service initiation through 

Virtual Intake Centers; continued refinement and documentation of Virginia’s CLP model; 

comprehensive client and service tracking through specialized software; and evaluation of the 

CLP to document success in delaying or avoiding nursing home placement, cost 

effectiveness of the program and client satisfaction. 

Page 81 of 281 
Program: Community Living 

Grant Number: 90CD1192

Project Title: To Develop Wisconsin's Aging Network to Help Veterans and People 

Who Are Not Eligible for Medical Assistance

Project Period: 09/30/2009 - 09/29/2011

Grantee: 

Wisconsin Department of Health Services 

Division of Long Term Care 

1 W. Wilson St. PO Box 7850 

Madison, WI 53707-7850 

Contact: 

Wendy Fearnside 

Tel. (608) 266-5456 

Email: wendy.fearnside@wisconsin.gov

AoA Project Officer: Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $485,566

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $485,566

Project Abstract: 

The Wisconsin Department of Health Services will develop a Community Living Program 

(CLP) in partnership with the Greater Wisconsin Agency on Aging Resources and the Aging 

and Disability Resource Center (ADRC) of Kenosha County. There will also be a Veteran 

Directed Home and Community Based Services program, in cooperation with the Milwaukee 

VA Medical Center. The goal of Wisconsin’s CLP program is to develop the capacity of the 

State’s aging network to help people who are not eligible for Medicaid avoid unnecessary or 

premature nursing home placement and impoverishment. Objectives are: 1) to develop and 

pilot a CLP model that facilitates use of personal resources supplemented with public funding 

to secure individually-tailored services to help people through situations that put them at 

immediate risk of nursing home admission; and 2) to better understand the situations that 

lead to private pay nursing home admissions and spend down, the impact of options 

counseling and care management on admissions decisions, the types of services that will 

effectively help people avoid institutionalization and spend down; and the cost of providing 

those services. The expected outcomes are: 1) at risk individuals will live at home longer and 

maintain maximum control over their lives; and 2) the State will have documentation to 

support future policy and funding decisions regarding use of ADRC, Older Americans Act and 

other funding. 

Page 82 of 281 
Program: Consumer-Directed Technical Support 

Grant Number: 90OP0002

Project Title: Technical Support for Consumer-Directed Programs

Project Period: 09/30/2008 - 06/30/2011

Grantee: 

Boston College 

Graduate School of Social Work 

140 Commonwealth Avenue 

Chestnut Hill, MA 02467 

Contact: 

Diane Fabrizio 

Tel. (617) 552-6873 

Email: diane.fabrizio@bc.edu

Linda Velgouse 

Fiscal 

Year 

Funding 

Amount

FY2009 $399,444

FY2008 $200,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $599,444

Project Abstract: 

The grantee, the National Center for Consumer Direction (NCCD) at the Boston College 

Graduate School of Social Work, supports the goals enunciated in the Older Americans Act 

Amendments of 2006 and will provide valuable assistance to the Aging Network as it works to 

increase choices and consumer-directed options for high risk individuals that help to keep 

them in their homes and communities. The goal of the project is to help states and Area 

Agencies on Aging increase the consumer direction options available to their constituents. 

The objectives are: 1) to help programs identify consumer direction status, technical 

assistance needs and plans in their areas; 2) to provide states and Area Agencies on Aging 

with opportunities to participate in regular training sessions to increase their knowledge about 

and ability to provide consumer directed/flexible service options; 3) to identify leaders, both 

consumers and professionals, to help advance the development of consumer directed 

options; and 4) to develop linkages with and among Area Agencies on Aging and other 

programs working in the areas of consumer direction. The expected outcomes of this project 

are: that at least ten programs will develop basic support structures for consumer directed 

programming; at least eight programs will increase the degree to which consumer-directed 

options are available; and a network of consumer directed champions will be developed to 

advocate for and assist in the development of consumer direction. The products from this 

project will include: educational materials, including webinars and content for use at national 

conferences; a minimum of three Promising Practice Reports; and core performance 

indicators for consumer direction specific to the Aging Network. 

Page 83 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3134

Project Title: Arizona On The Move For Healthy Aging

Project Period: 06/01/2007 - 05/31/2010

Grantee: 

Arizona Department of Health Services 

150 North 18th Avenue, Suite 520 

Phoenix, AZ 85007 

Contact: 

Ramona L Rusinak 

Tel. (602) 364-0526 

Email: rusinar@azdhs.gov

Fiscal 

Year 

Funding 

Amount

FY2009 $250,000

FY2008 $200,000

FY2007 $250,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $700,000

Project Abstract: 

The Arizona Department of Health Services and its partner the Arizona Department of 

Economic Security, Division of Aging and Adult Services (ADES-DAAS) through the Arizona 

on the Move for Healthy Aging Project will implement the Chronic Disease Self-Management 

Program (CDSMP) and EnhanceFitness (EF) programs in Pima, Santa Cruz and Yavapai 

counties over three years. The goals are to: 1) implement evidence-based prevention 

programs targeting adults 60+; and 2) build and strengthen state and local healthy aging 

partnerships focused on prevention services targeting older adults. The objectives are to: 

develop a resource of CDSMP and EF trainers at the state and local levels, establish CDSMP 

and EF programs in three counties and integrate evidence-based prevention programs into 

planning and policy in state public health and aging networks. The outcomes of this project 

will be increased training and prevention program resources in two rural and one urban 

county, along with strong partnerships at local and state levels to increase capacity and 

infrastructure for prevention services targeting adults 60 years and older. An additional 

outcome will be the availability of data demonstrating the benefit to adults 60 years and older 

of participation in chronic disease self-management programs. The products from this project 

will include: a final report, evaluation results from the courses, data on health status and 

outcomes of participants to be used in fact sheets for policy and decision-makers, abstracts 

for national aging and public health conferences, and project information and resources 

available on the Healthy Aging Communication Network website and through the Arizona 

Aging and Disability Resource Center. 

Page 84 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3138

Project Title: Arkansas Empowering Older Adults Project

Project Period: 06/01/2007 - 05/31/2010

Grantee: 

Arkansas Department of Health and Human Services 

Division of Health 

P.O. Box 1437, H- 41 

Little Rock, AR 72203-1437 

Contact: 

Becky Adams 

Tel. (501) 661-2334 

Email: becky.adams2@arkansas.gov

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $250,000

FY2008 $200,000

FY2007 $250,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $700,000

Project Abstract: 

The Division of Health (DOH) of the Arkansas Department of Health and Human Services 

(ADHHS) proposes to initiate the Arkansas Empowering Older Adults Project. The DOH has 

the following partners: ADHHS/Division of Aging and Adult Services (DAAS), the University of 

Arkansas for Medical Sciences Reynolds Institute on Aging - Arkansas Aging Initiative, 

AAAs, the Aging and Disability Resource Center, aging service providers in each region, and 

local Hometown Health Improvement coalitions. The goal is to empower older Arkansans to 

take greater control of their health through lifestyle changes and to reduce their risk for 

chronic diseases and disability by delivering evidence-based prevention programs. The two 

proposed programs to be implemented are the Stanford Chronic Disease Self-Management 

Program in two regions and the Active Living Every Day, physical activity program statewide. 

The objectives are to develop program infrastructure; train facilitators and master trainers; 

implement the programs; provide opportunities for physical activity for older adults; maintain 

fidelity to the original design; assess the impact of programs; and disseminate project 

information. The expected outcomes are for participants to demonstrate positive lifestyle 

changes; increase their ability to cope with challenges and barriers to exercise; decrease 

chronic disease risk factors; and successfully collaborate and mobilize project partnerships. 

Page 85 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3122

Project Title: California Initiative to Empower Older Adults to Better Manage Their 

Health

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

California Department of Aging 

1300 National Drive, Suite 200 

Sacramento, CA 95834 

Contact: 

Janet Tedesco 

Tel. (916) 419-7500 

Email: jtedesco@aging.ca.gov

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $250,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $950,000

Project Abstract: 

The California State Departments of Aging and Health Services, local Area Agencies on 

Aging, public health and non-profits throughout the state, are implementing the Stanford 

Chronic Disease Self-Management Program (CDSMP) and/or Matter of Balance (MOB), a fall 

prevention program in five geographic areas and in several Multipurpose Senior Services 

Programs, introducing Medication Management and Healthy Moves. The goal is to create an 

effective infrastructure that includes both state and local partnerships to implement 

sustainable evidence-based prevention programs for older people within the state's aging

network.The objectives are to: implement the CDSMP and/or MOB in geographic areas that 

represent 40% of the state's seniors; disseminate two additional evidence-based programs 

for frail, dually eligible seniors in at least six communities; and provide technical assistance to 

the identified local partnerships as prototypes for further expansion. The anticipated 

outcomes are to create a sustainable network to provide community education and evidencebased programs for diverse older adults; integrate evidence-based programs into at least five 

geographic regions; and conduct outreach that will successfully recruit approximately 6,000 

high risk seniors to the initiative 

Page 86 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3130

Project Title: Empowering Older People to Take More Control of Their Health: 

Evidence-Based Prevention

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Colorado Department of Public Health and Environment 

PSD-COPAN-A5 4300 Cherry Creek Drive South 

Denver, CO 80246 

Contact: 

Normie M Voillequ 

Tel. (303) 692-2505 

Email: normie.morin@state.co.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

The Colorado State Unit on Aging (SUA) and the Dept. of Public Health and Environment 

(CDPHE) support this Healthy Aging Partnership Project in collaboration with the Consortium 

for Older Adult Wellness (COAW). The goal: expand the existing infrastructure of the 

partnership of the SUA, CDPHE, and COAW to implement and sustain the delivery of 

evidence-based (EB) prevention programs through community aging service providers. The 

objectivesare: 1) create a sustainable delivery system for Evidence-based (EB) program 

training and implementation, coordination, technical support & fidelity oversight of the Chronic 

Disease Self- Management Program (CDSMP) and A Matter of Balance (MOB) in three 

geographical areas of Colorado, and all 16 AAA regions by August '07; 2) modify significant 

factors caused by chronic diseases or conditions in a minimum of 68% of participants who 

enroll in CDSMP and/or MOB, by project's end; 3) expand the communication network of 

OAA community-based service providers that encourages the sharing of resources and 

increases the opportunity for collaboration; and 4) make this expanded system sustainable by 

and beyond August '09. Expected outcomes are: 1) expand accessibility for older adults to 

the CDSMP and other evidence-based programs; 2) embed an EBP service system into 

three regional health service providers that collaborate with regional communities for training, 

networking, and resource sharing; 3) train ten certified, regional, Master trainers in CDSMP 

and 50 paired community leaders per year, who will implement the program; 4) reach 3,500 

participants in CDSMP/Matter of Balance; 5) obtain AAA support to sustain EB programs by 

using Title III-D funds/private funding; 6) analyze data for evaluation on health indicators, 

participant reach, and program satisfaction through evidence-based disease prevention 

software; and 7) build upon existing networks with additional EB self-management 

interventions in physical activity, nutrition, and fall prevention. 

Page 87 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3141

Project Title: Connecticut Empowering Older People To Take Control of Their Health

Project Period: 06/01/2007 - 05/31/2010

Grantee: 

Connecticut Department of Social Services 

Aging Services Division 

25 Sigourney Street 

Hartford, CT 06106 

Contact:

Pamela Giannini 

Tel. (860) 424-5277 

Email: pamela.giannini@ct.gov

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $250,000

FY2008 $200,000

FY2007 $250,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $700,000

Project Abstract: 

The State of Connecticut Department of Social Services and the Department of Public Health 

is developing a collaborative and integrated network of state and local aging, health and nonprofit organizations with the goal of empowering older people to take more control over their 

own health through lifestyle changes that have proven effective in reducing the risk of 

disease and disability. Its approach is to translate research evidence into programs at the 

community level by imbedding low-cost prevention programs within existing state and local 

programs. The objectives are to expand these efforts by: 1) developing and enhancing 

linkages across state and local aging, health, and nonprofit organizations; 2) augmenting 

uptake of prevention efforts by training professionals and older adults in the Chronic Disease 

Self-Management Program (CDSMP); 3) training community-based professionals and seniors 

in fall prevention; 4) progressively implementing CDSMP in the designated geographic area; 

5) progressively implementing a fall prevention program in the designated geographic areas; 

6) conducting an impact evaluation; and 7) disseminating the results to Connecticut and to 

other states. Key organizations include three Area Agencies on Aging (AAAs), University of 

Connecticut, Yale University, and several local health, aging, and nonprofit organizations with 

Title III funding. The expected outcomes include increased knowledge and modified 

behaviors among professionals and seniors concerning chronic disease self-management 

and fall prevention. 

Page 88 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3174

Project Title: Evidence-Based Prevention Program

Project Period: 03/18/2008 - 05/31/2010

Grantee: 

Florida Department of Elder Affairs 

4040 Esplanade Way 

Tallahassee, FL 32399-7000 

Contact: 

Jay Breeze 

Tel. (850) 414-2338 

Email: breezej@elderaffairs.org

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $641,690

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $841,690

Project Abstract: 

The Florida Department of Health, in collaboration with the Florida Department of Elder 

Affairs, supports a three year project entitled "Empowering Older People to Take More 

Control of Their Health through Evidence-Based Prevention Programs". The goal of the 

project is to provide evidence-based interventions for arthritis and other chronic conditions to 

the maximum number of people age 60 years and older who are at risk and can benefit from 

the interventions. The objectives are: 1) to conduct master trainer and leader trainings for the 

Chronic Disease Self-Management Program (CDSMP) in three counties within three Planning 

Service Areas (PSA); 2) to conduct leader training for the Spanish Arthritis Self-Management 

Program (SASMP) in Miami-Dade and Palm Beach counties; 3) to conduct CDSMP and 

SASMP classes; 4) to evaluate the course through pre/post-tests and satisfaction surveys; 5) 

to ensure the fidelity of the implementation of the courses through direct observation of the 

classes and leader checklists; and 6) to disseminate project results. The expected outcomes 

of this project are: 1) for the CDSMP, positive changes in health care utilization, social/role 

activities limitations, disability, energy/fatigue, self-rated health, exercise behaviors, cognitive 

symptom management, communication with physicians, and health distress; 2) for the 

SASMP, positive changes in self-efficacy, health care utilization, depression, disability, pain, 

energy/fatigue, self-rated health, exercise, cognitive symptom management, and use of 

mental stress management/relaxation techniques. The intended products from this project 

are interim reports, a final report (including evaluation results), and abstracts for national 

conferences. 

Page 89 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3117

Project Title: Healthy Aging Partnership - Empowering Elders (HAP-EE)

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Hawaii Executive Office on Aging 

No. 1 Capitol District 250 S. Hotel Street, Suite 406 

Honolulu, HI 96813-2831 

Contact: 

Caroline Cadiroa 

Tel. (808) 586-0100 

caroline.cadiroa@doh.hawaii.gov

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $250,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $950,000

Project Abstract: 

Hawaii's Executive Office on Aging (EOA), in partnership with the Department of Health, 

three of Hawaii's four AAAs (Honolulu's Elderly Affairs Division, Hawaii County Office of 

Aging, Kauai's Agency on Elderly Affairs), and Older American Act-funded service providers 

and health and research partners in each of these three counties, propose to implement an 

Healthy Aging Partnership-Empowering Elders (HAP-EE) initiative. This project builds on 

Hawaii`s Healthy Aging Partnership (HAP), a broad partnership established in 2003 to 

improve older adult health by building aging network capacity to implement evidence-based 

(EB) prevention programs in Hawaii's multi-ethnic environment. Since its inception, HAP has 

trained 40 aging network partners in four counties (in needs assessment, EB programming, 

logic modeling, and evaluation), and three of four counties successfully piloted programs to 

enhance physical activity and healthy eating among meal site participants. Our current 

statewide goals are to: 1) continue building the aging network capacity in EB programming; 

and 2) effectively embed two EB programs: Stanford's Chronic Disease Self-Management 

Program (CDSMP) and the EnhanceFitness (EF) Program in our Aging Network. Over three 

years, we will: 1) expand the HAP Steering Committee and Evaluation Subcommittee; 2) 

enhance planning and evaluation skills of 40 Aging Network partners; 3) develop 30 leaders 

and/or master trainers for CDSMP and EF; 4) replicate with fidelity CDSMP by five OAAfunded providers in Honolulu County, and EF in eight nutrition sites in Hawaii County and six 

nutrition/recreation sites in Kauai County; and 5) engage 460 older adults in EB programs, 

180 in CDSMP and 280 in EF. 

Page 90 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3136

Project Title: Idaho Lifestyle Interventions for the Elderly

Project Period: 06/01/2007 - 05/31/2010

Grantee: 

Idaho Department of Health and Welfare 

Bureau of Community and Environmental Health 

450 West State Street, 6th Floor PO Box 83720 

Boise, ID 83720-0036 

Contact: 

Elke Shaw-Tulloch 

Tel. (208)334-5927 

Email: shawe@idhw.state.id.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $250,000

FY2008 $200,000

FY2007 $250,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $700,000

Project Abstract: 

The Idaho Department of Health and Welfare, in collaboration with the Idaho Commission on 

Aging, Area Agencies on Aging, and senior centers in Idaho, will implement health 

promotions programs for seniors on chronic disease self-management and nutrition 

education. The goal is to provide comprehensive programs in three health districts by 

incorporating evidence-based programs into an existing infrastructure that has successfully 

delivered physical activity/fall prevention classes for older people in rural and resource-poor 

areas. The objectives are to: 1) provide a Chronic Disease Self-Management Program 

(CDSMP); 2) contract with senior centers that are hosting other programs to add the CDSMP 

in their site and in other sites in their communities; and 3) train peer leaders for the Healthy 

Eating for Successful Living in Older Adults (HE) program. The outcomes will include: 1) 

CDSMP offered at nine senior centers in three local public health districts; 2) HE program 

introduced; 3) enhanced quality of life and greater control over health outcomes 

experienced by CDSMP participants; and 4) improved nutritional status of HE participants. 

Page 91 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3112

Project Title: Empowering Older People To Take More Control of Their Health

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Illinois Department of Public Health 

Office of Health Promotion 

535 West Jefferson 

Springfield, IL 62761 

Contact: 

Thomas J Schafer 

Tel. (217) 782-3300 

Tom.Schafer@illinois.gov

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

The Illinois Department of Public Health, in partnership with the Department on Aging, 

proposes to implement evidence-based disease prevention programs for older adults. The 

goal is to provide the Chronic Disease Self-Management Program (CDSMP) and the Strong 

for Life (SFL) exercise program to persons over age 60 through community-level, not-forprofit aging services provider organizations. The objectives are: 1) to begin implementing the 

CDSMP in three, and the SFL program in one, Planning and Service Area (PSA) as defined 

by the Older Americans Act, through AAAs; 2) to begin developing the infrastructure and 

partnerships necessary to effectively embed these programs for the elderly within statewide 

systems of health and long-term care; 3) to promote and refer to clinical preventive services 

through these programs; 4) to evaluate the efforts and monitor the fidelity of each program; 

and 5) to disseminate the results and findings. The expected long-term outcomes will be: 

potential improvement in the quality of life for older people; reduction of older people's risk of 

disease, disability and injury; positive lifestyle and behavioral changes for older persons; 

reduction in the use and cost of health care over time; and the increased availability and 

accessibility of evidence-based programs at the community-level for older persons. 

Page 92 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3123

Project Title: Iowa Healthy LINKS

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Iowa Department on Aging 

Parker Bldg., Suite 2 

510 East 12th Street Jessie 

Des Moines, IA 50319 

Contact: 

Kay Corriere 

Tel. (515) 725-3330 

Email: kay.corriere@iowa.gov

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $600,000

FY2008 $750,000

FY2007 $750,000

FY2006 $750,000

FY2005 $

FY2004 $

FY2003 $

Total $2,850,000

Project Abstract: 

The Iowa Department on Aging and Department of Public Health (IDPH) have partnered with 

the following three Planning Service Areas (PSA): Aging Resources of Central Iowa, 

Heritage Area Agency on Aging and Hawkeye Valley Area Agency on Aging to implement the 

Stanford Chronic Disease Self-Management Program (CDSMP) and EnhanceFitness. The 

initiative will be called the Iowa Healthy Links and its goal is improving the health of older 

Iowans with chronic diseases and increasing Iowa's capacity to provide evidence-based 

health promotion programs for older adults. All three areas will participate in program 

evaluation, creating the benchmarks and measuring the changes in participant's quality of 

life, health care utilization, chronic disease self-efficacy, fruit and vegetable consumption, 

physical activity and strength, along with program sustainability, dispersion, and capacity 

building. The Des Moines University will coordinate program evaluation. Anticipated 

outcomes include improvement in quality of life measures, health behaviors and a reduction 

in health care utilization, which will facilitate system development for sustainability. Results 

from the evaluation will be provided to the Iowa Department of Human Services (state 

Medicaid agency), Senior Living Coordinating Unit, State Board of Health, State Legislature 

and private organizations to impact polices and obtain funding for sustaining evidence-based 

preventive programs. The Iowa Healthy Links will provide a model for implementing 

evidence-based health promotion programs in other PSA's with other community partners. 

Page 93 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3120

Project Title: Empowering Older Mainers to Take More Control of Their Health

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Maine Department of Health and Human Services 

Office of Elder Services 

11 State House Station 442 Civic Center Drive 

Augusta, ME 04333 

Contact: 

Mary Walsh 

Tel. (207) 287-9207 

Email: mary.walsh@maine.gov

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $250,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $950,000

Project Abstract: 

The Office of Elder Services (Maine's State Unit on Aging) with the full commitment of the 

Maine Center of Disease Control and Prevention (the State Health Agency known as the 

Maine Chronic Disease Control Program (CDCP) is conducting this project with the goal of 

empowering older people to take more control of their health and reduce their risk of disease 

and disability. Objectives include: 1) expand access to and delivery of four evidence-based 

prevention programs; 2) expand and develop a network of volunteers trained to deliver the 

Matter of Balance/Volunteer Lay Leaders (MOB/VLL) program and the Chronic Disease Self 

Management Program (CDSMP); 3) develop four new EnhanceFitness sites; 4) expand 

EnhanceWellness to one new site; and 5) further develop the system of communication 

among health care providers, community service organizations, aging and disability resource 

centers, and the aging and long-term care system. It targets older people with chronic 

conditions, who could improve their health through participation in these programs. 

Significant Partners: the Maine CDCP; Area Agencies on Aging; MaineHealth's Partnership 

for Healthy Aging; Aging and Disability Resource Centers; and community organizations 

already participating in evidence-based wellness programs. Proposed activities are: 1) crosstrain existing MOB/VLL coaches to administer the CDSMP and develop a network of sites at 

which both programs are co-located and available; and 2) expand EnhanceFitness and 

EnhanceWellness programs at pilot sites. Outcomes anticipated include increased number of 

older Mainers who make healthy lifestyle changes; a network of people skilled and available 

to coach older Mainers in attaining and maintaining a healthy lifestyle; and increased 

communication and referrals among health care providers, community service organizations, 

and older adults. 

Page 94 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3125

Project Title: Living Well -Take Charge of Your Health

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Maryland Department of Aging 

301 West Preston Street, Suite 1007 

Baltimore , MD 21201-2374 

Contact: 

Sue Vaeth 

Tel. (410) 767-1090 

sjv@ooa.state.md.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

The Maryland Department of Aging and its partners, the Department of Health and Mental 

Hygiene, the Governor's Office of Community Initiatives, Office of Service and Volunteerism, 

Rural Maryland Council, Towson University, and two health insurance companies will 

implement this initiative. The goal is to encourage older people to take charge of their health 

through the Chronic Disease Self-Management Program (CDSMP) in six Planning Service 

Areas (PSAs), and the Active for Life program in one of those six. The approach is to develop 

state and local partnerships, including Area Agencies on Aging (AAAs), aging services 

provider organizations (ASPO), local health departments (LHD), health care providers, faithbased organizations, and other agencies in their jurisdictions to provide the CDSMP in many 

settings, promoting the program and making it widely available. The objectives are to: 1) 

enhance capacity to provide the CDSMP through licensing and training; 2) develop new and 

enhance existing partnerships for broad application of the CDSMP and for sustainability; 3) 

provide opportunities for 2,661 participants in CDSMP and 75 in Active for Life; 4) develop 

outreach and referral for potential leaders and participants; 5) evaluate the projects for quality 

and effectiveness; and 6) disseminate project information nationally and statewide. The 

expected outcomes include: 1) CDSMP will be available to participants in a variety of 

settings; 2) health care providers will make referrals to the evidence-based projects (EB); 3) 

participants will demonstrate outcomes as expected by the interventions; and 4) local 

partnerships, led by AAAs, ASPOs, and LHDs, will act as mentors to non-participating 

jurisdictions to enable them to develop EB projects in their areas. 

Page 95 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3137

Project Title: Massachusetts Empowering Older People to Take More Control of Their 

Health

Project Period: 06/01/2007 - 05/31/2010

Grantee: 

Massachusetts Executive Office of Elder Affairs 

Policy and Program Development 

One Ashburton Place 

Boston, MA 02108 

Contact: 

Sandra Tocman 

Tel. (617) 222-7512 

Email: Sandra.Tocman@state.ma.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $250,000

FY2008 $250,000

FY2007 $250,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $750,000

Project Abstract: 

The Massachusetts Executive Office of Elder Affairs (Elder Affairs) and its partner, the 

Department of Public Health Office of Healthy Aging/Health and Disability (MDPH) are 

implementing under this grant evidence-based prevention programs. The project goal is to 

develop a sustainable infrastructure within the Commonwealth to implement high-quality 

evidence-based disease prevention (EBDP) programs that provide the maximum number of 

at risk older adults and people with disabilities the tools to maintain healthy and active 

lifestyles. Elder Affairs and MDPH will partner with community-based organizations and 

provide leadership for the implementation and evaluation of the following EBDP programs in 

three geographic areas: 1) Stanford University's Chronic Disease Self-Management Program 

in the Northeast Area; 2) A Matter of Balance in Boston; and 3) Healthy Eating for Successful 

Living in Older Adults in the South Suburban area. The major objectives are to: 1) build and 

sustain private/public partnerships at the state and local levels to deliver EBDP programs; 2) 

create protocols and guidelines for implementation, evaluation, and reporting; 3) provide 

EBDP programs to reach older adults and people with disabilities; 4) monitor the project's 

progress, fidelity, and outcomes; and 5) effect statewide and local policy and systems to 

sustain the project. The expected outcomes are: existing public/private partnerships will 

expand their capacity to integrate EBDP programs into local and statewide systems; older 

adults and people with disabilities will report improvements in falls; better strategies for 

coping with diseases; better food choices; and increased levels of physical activity. 

Page 96 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3135

Project Title: Michigan's Older Adults: On the PATH to Better Health

Project Period: 06/01/2007 - 05/31/2010

Grantee: 

Michigan Department of Community Health 

Office of Services to the Aging 

PO Box 30676 

Lansing, MI 48909-8176 

Contact: 

Sherri C King 

Tel. (517) 373-4064 

Email: kings1@michigan.gov

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $250,000

FY2008 $200,000

FY2007 $250,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $700,000

Project Abstract: 

The Michigan Office of Services to the Aging (OSA) and the Michigan Department of 

Community Health (MDCH) support this grant. The goal is to create a sustainable statewide 

infrastructure that can facilitate the integration and embedding of evidence-based disease 

prevention programming into the local aging and public health networks. The objectives are 

to: expand and enhance the capacity of the existing statewide group, Partners on the PATH 

(Personal Action Toward Health); form community coalitions to oversee local provision of 

services; ensure these coalitions have a sustainable business plan; recruit and train program 

leaders; develop a universal system to use for evaluation and to monitor fidelity; provide 

follow-up and referral to participants; and disseminate project information and develop a 

template for other area agencies on aging to recreate. The expected outcomes of this project 

are: Partners on the PATH will become a line item in the state budget and will be 

instrumental in making recommendations on state policy concerning chronic disease; local 

coalitions will have a sustainable marketing plan and oversee classes offered; seniors who 

participate in classes will reduce their risk of developing chronic diseases; seniors with 

chronic diseases will adopt better health practices that will improve their quality of life; preand-post testing will reflect an increased knowledge in dealing with chronic diseases; and 

documented fidelity to the programs will be realized. 

Page 97 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3139

Project Title: Minnesota's Evidence-Based Health Promotion Initiative

Project Period: 06/01/2007 - 05/31/2010

Grantee: 

Minnesota Deptartment of Human Services 

Board on Aging 

PO Box 64976 

St. Paul, MN 55164-0976 

Contact: 

Jean Wood 

Tel. (651) 431-2563 

Email: jean.wood@state.mn.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $250,000

FY2008 $200,000

FY2007 $250,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $700,000

Project Abstract: 

The Minnesota Board on Aging in partnership with the Minnesota Department of Health will 

work with public and private partners at the state and community levels to build a sustainable, 

statewide-coordinated evidence-based health promotion initiative. The objectives are to: 1) 

implement three highly visible, evidence-based health promotion programs: The Chronic 

Disease Self-Management Program, Matter of Balance, a fall prevention program, and 

EnhanceFitness, a physical activity program; 2) collaborate with strategic partners who can 

ensure identification of at-risk individuals and consistent referrals to these programs and who 

have a stake in the outcomes; 3) refine and expand data and quality assurance systems that 

can be used by all aging services providers to track participation in these programs and 

assure fidelity of implementation; and 4) build a business case for these approaches to 

ensure their long-term sustainability. The expected outcomes of this initiative are: 1) older 

Minnesotans will have fewer falls and fall-related injuries, maximizing their independence and 

quality of life; and 2) more older Minnesotans will adopt self-management skills and work with 

their health care providers to more effectively manage their chronic conditions, contributing to 

improvement of health status, independence and quality of life. 

Page 98 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3116

Project Title: Empowering Older People To Take More Control of Their Health

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

New Jersey Department of Health and Senior Services 

PO Box 360 

Trenton, NJ 08625-0000 

Contact: 

Geraldine Mackenzie 

Tel. (609) 943-3499 

Email: geraldine.mackenzie@doh.state.nj.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $192,300

FY2008 $192,300

FY2007 $192,300

FY2006 $192,300

FY2005 $

FY2004 $

FY2003 $

Total $769,200

Project Abstract: 

The New Jersey Department of Health and Senior Services (DHSS) proposes to develop 

statewide capacity for local delivery of low-cost, evidence-based disease prevention 

programs (EBDPP). The grant will build upon New Jersey's model for healthy aging, which is 

based upon leadership and coordination within the Area Agency on Aging, program delivery 

through local community-based providers, and strategic partnerships with public health & 

other health care providers to assure the quality of health-related activities. Year 1 goal: 

empower seniors to reduce modifiable risk factors for disease and disability by establishing 

the infrastructure to effectively deliver the Chronic Disease Self-Management Program 

(CDSMP) in Atlantic, Cape May and Warren Counties, and the Healthy IDEAS (Identifying 

Depression, Empowering Activities for Seniors) Program in Essex and Union Counties. 

Objectives include: 1) establishing local partnerships for service delivery; 2) certifying master 

trainers and class leaders for CDSMP; 3) developing and delivering training for Healthy 

IDEAS; 4) implementing programs and integrating them into the counties' service delivery 

system; and 5) conducting a comprehensive evaluation. In addition, state level intra and interdepartmental partnerships will establish CDSMP in related networks, including Medicaid, 

Disabilities and Chronic Disease Services. Outcomes will be achieved on three levels: 1) 

participants will be empowered to better manage their chronic diseases through skill 

development and enhanced self-confidence; 2) the local service delivery system will have 

strengthened provider relationships and integrated delivery of EBDPP; and 3) the state will 

have a more fully developed model to support healthy aging statewide. Target audiences are 

underserved populations, including African-Americans, Latinos, frail individuals and those 

with access barriers. Products include: evaluated templates for model replication, reports 

detailing evaluation outcomes, & written materials distributed electronically via listservs and 

websites. 

Page 99 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3124

Project Title: Empowering Older New Yorkers To Take More Control of their Health

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

New York State Office for the Aging 

2 Empire State Plaza 

Albany, NY 12223-1251 

Contact: 

Marcus Harazin 

Tel. (518) 473-5705 

marcus.harazin@ofa.state.ny.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

The New York State Office for the Aging and its partner, the Department of Health, will 

implement evidence-based health promotion programs with the goal of building the capacity 

of local service delivery systems in New York State to incorporate and sustain 

implementation of the Chronic Disease Self- Management Program (CDSMP) and the Active 

Choices, physical activity program. Objectives are: (1) successfully implement CDSMP and 

Active Choices programs in three regions and reach 1,800 persons over age 60 over a three 

year period for CDSMP, and 3,300 persons for Active Choices; (2) ensure fidelity to program 

protocols, encourage on-going quality improvement and guide systems change at the state 

and local level, thereby increasing the likelihood of sustainability upon the completion of the 

project's funding; and (3) disseminate a model for implementation and sustainability of 

evidence-based programs. Anticipated Outcomes are: (1) improvement in health promotion 

participation and outcomes for residents over age 60; (2) integration of evidence-based 

programs into the health promotion offerings of the State and particularly in Point of Entry 

(POE) and Naturally Occurring Retirement Community Supportive Services Program 

Development; (3) greater integration of Area Agencies on Aging and County Health 

Department efforts; and (4) new public/private support for evidence-based health promotion 

programs. 

Page 100 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3140

Project Title: Empowering Older People to Take More Control of Their Health

Project Period: 06/01/2007 - 05/31/2010

Grantee: 

North Carolina Department of Health and Human Services 

Division of Aging and Adult Services 

2101 Mail Service Center 

Raleigh, NC 27699-2101 

Contact: 

Audrey Edmisten 

Tel. (919) 733-0440 

Email: audrey.edmisten@ncmail.net

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $149,380

FY2008 $149,380

FY2007 $149,380

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $448,140

Project Abstract: 

The North Carolina Division of Aging and Adult Services and the Division of Public Health are 

fully committed to the goal of mobilizing a statewide campaign to implement and sustain the 

Stanford University Chronic Disease Self-Management Program (CDSMP) to reduce the risk 

of disease and disability among seniors (outcome). The promised permanent full-time 

position to coordinate evidence-based health promotion symbolizes this strong commitment. 

The objectives are: to train 3564 participants in three geographic regions and to target lowincome, racial/ethnic minority, and/or rural older adults; (2) to work with at least 3 different 

target settings and delivery agents in each of the regions to deliver the CDSMP; (3) to assure 

that all sites deliver the program with fidelity; (4) to determine the extent to which participants 

benefit across race/ethnicity, poverty level, gender, age or geographic location; (5) to create a 

statewide infrastructure for ongoing sustainability and quality assurance; and (6) to evaluate 

the economic impact of the CDSMP. 

Page 101 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3119

Project Title: Ohio's Evidence-Based Prevention Program Initiatives

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Ohio Department of Aging 

50 W. Broad Street 9th Floor 

Columbus, OH 43215-3363 

Contact: 

Marcus J Molea 

Tel. (614)752-9167 

mmolea@age.state.oh.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

The Ohio Departments of Aging (ODA) and Health (ODH), AAAs and community-based 

health care and aging service organizations are working to build a collaborative infrastructure 

aimed at improving the health of older Ohioans by implementing evidence-based prevention 

programs at the local level. We are proposing to implement and evaluate three different 

interventions focusing on Chronic Disease Self-Care, Physical Activity, and Fall Prevention in 

multiple regions of the state. In Chronic Disease Self-Care, the Stanford Chronic Disease 

Self-management Program (CDSMP) will be extended to four regions of Ohio. Over the three 

year period, we will conduct 113 CDSMP courses, reaching 1165 older adults. Our Physical 

Activity intervention intends to sustain and expand the Active Living Every Day Program 

(a.k.a. Active for Life) in Southeastern Ohio. Over the three year period, we will conduct 15 

Active Living Every Day courses, reaching 225 older adults. The Fall Prevention intervention 

will offer A Matter of Balance/ Volunteer Lay Leader program in Cuyahoga County. Over the 

three year period we will conduct 56 Matter of Balance courses, reaching 420 older adults. 

Six regional coalitions have joined ODA and ODH to implement these interventions, including 

Cleveland (Planning and Service Area - PSA 10A), Akron (PSA 10B), Cincinnati (PSA 1), 

Columbus (PSA 6), Toledo (PSA 4) and Southeastern Appalachian Ohio (PSA 8). 

Page 102 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3113

Project Title: Living Longer, Living Stronger: The Oklahoma Project

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Oklahoma Department of Human Services 

Aging Services Division 

2400 North Lincoln Blvd. State Capitol Complex - Sequoyah 

Building 

Oklahoma City, OK 73125 

Contact: 

Zach Root 

Tel. (405) 521-2907 

zach.root@okdhs.org

AoA Project Officer: Leslies Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

The Oklahoma Department of Human Services Aging Services Division, in partnership with 

the State Department of Health, will develop and implement the Living Longer, Living 

Stronger project for persons 60 years and older in four rural regions. The partnership includes 

AAAs, aging services nonprofit providers, the Chickasaw Nation, and others within the 

collaborative network. The goal of the project is to increase the quality of life and decrease 

the complications of arthritis, heart disease, stroke, and obesity among persons residing in 

Oklahoma by providing the EnhanceFitness and Chronic Disease Self Management 

Programs. The project objectives are to: 1) develop and sustain quality implementation of 

two evidence-based health prevention programs for individuals 60 years of age and above; 

2) improve collaboration in providing services among health, public health, and aging 

services network agencies at the state and local level; and 3) evaluate the program, 

document activities, and disseminate the results. Project outcomes are to: 1) provide 

evidence-based health prevention programs to 2,800 individuals over 60; 2) develop over 100 

permanent program sites over three years; 3) improve health outcomes among 80% of 

participants; and 4) sustain the program once federal funding ends. The Oklahoma Project 

will produce an interagency advisory committee; a final report; marketing materials; articles 

for publication; data reflecting participants in Oklahoma; models for rural and tribal regions; 

and abstracts and workshops for national conferences. 

Page 103 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3115

Project Title: Evidence-Based Prevention Programs for Older Adults in Oregon

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Oregon Department of Human Services 

Seniors and People with Disabilities 

676 Church Street 

Salem, OR 97301-1076 

Contact:

Elaine Young 

Tel. (503) 373-1726 

elaine.young@state.or.us

Project Officer: Leslies Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $250,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $950,000

Project Abstract: 

The Oregon Department of Human Services offices of Seniors and People with Disabilities 

and Health Promotion, and Chronic Disease Prevention are implementing an evidence-based 

(EB) disease prevention initiative with the goal of promoting the health and independence of 

community-living older adults in four diverse areas in Oregon. The interventions: Tai Chi and 

the Chronic Disease Self-Management Program will promote active self-management of 

chronic conditions, promote physical activity, and reduce falls. The objectives are to: 1) reach 

at-risk seniors with EB programs through new and expanded partnerships between aging, 

health, private, and public agencies; 2) maintain fidelity to the design and research outcomes 

associated with the selected interventions; 3) increase awareness and use of EB health 

promotion programs focused on older adults; and 4) develop systems that can be used in 

sustaining, replicating, and expanding the use of such programs in Oregon. The anticipated 

outcomes are: new and expanded community partnering to offer EB to at risk older adults; 

increased participation by high risk older adults in EB programs to impact chronic disease 

self-management, physical activity, and falls prevention; and expansion of the three projects 

to additional counties, as a result of dissemination efforts. Products: final report, including 

data on participation & reach, and systems development; articles that may be written about 

the project; and logic models for implementation of each program, as well as abstracts for 

any conference presentations on the project. 

Page 104 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3118

Project Title: Implementation of Evidence-Based Intervention Programs Statewide

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

South Carolina Lieutenant Governor's Office on Aging 

1301 Main Street, Suite 200 

Columbia, SC 29201 

Contact: 

Terri Whirrett 

Tel. (803)734-9908 

Email: whirrett@aging.sc.gov

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

The South Carolina Lieutenant. Governor's Office on Aging and its partner, the Department 

of Health and Environmental Control will continue to provide proven prevention programs with 

the following goals and objectives: Goal 1) Increase the quality and years of life for older 

adults with chronic diseases or fear of falling. The objectives for goal one are to: 1) expand 

the Chronic Disease Self-Management Program (CDSMP) statewide; 2) implement A Matter 

of Balance fall prevention program (MOB) in two regions; 3) train additional Group Leaders 

and Master Trainers; and 4) expand health promotion strategies and materials to reach 

diverse groups, including underserved populations; and 5) continue to evaluate the reach, 

fidelity, and impact of the programs. Goal 2) Maintain and expand the infrastructure of 

partnerships to embed these programs in state health and long-term care systems. The 

objectives for goal two are to: 1) strengthen and expand the local partnership base; 2) 

provide leadership, consultation, and ongoing support to local partners; 3) sustain and 

expand the commitment of funds and resources from public and private sectors; and 4) 

strengthen and expand the SC Partnership for Healthy Aging. Participant Outcomes: 

CDSMP participants will report increased self-confidence, improved health status, and 

increased self-management behaviors. MOB participants will demonstrate a reduced fear of 

falling and increased mobility. System Outcomes: increased number and reach of evidencebased prevention programs for older adults in the state, and reductions in health care 

utilization and costs. 

Page 105 of 281 
105 -

Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3114

Project Title: Texas Healthy Lifestyles

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Texas Department of Aging and Disability Services 

Policy Analysis and Support- Mail Code W-578 

701 W. 51st St. 

Austin, TX 78751 

Contact: 

Jeffrey Kaufmann 

Tel. (512) 438-5471 

Email: jeffrey.kaufmann@dads.state.tx.us

AoA Project Officer: Leslies Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

The State of Texas, through the Department of Aging and Disability Services and the 

Department of State Health Services, under the umbrella of "Aging Texas Well," (ATW) and 

in cooperation with the Bexar Area Agency on Aging (AAA), the Brazos Valley AAA and 

Neighborhood Centers Inc., propose to expand regional public/private evidence-based health 

promotion to help seniors take control of their lives and reduce their risk of disease and 

disability. The goal is to create a focal point at the state level for evidence-based programs 

under the Aging Texas Well Initiative and expand the scope of these programs through the 

faith-based community, in rural areas, and non-traditional partnerships. The planned 

interventions are the Chronic Disease Self-Management Program, the Matter of Balance fall 

prevention program, and EnhanceFitness. The objectives are: (1) to develop a foundation of 

knowledge of the risks associated with chronic disease and the benefits of a healthier 

lifestyle; (2) to help older persons learn to take responsibility for day to-day self management 

of their disease; (3) to increase awareness of local resources for a healthier lifestyle; (4) to 

reduce the burden of chronic illness across the participating regions of Texas; (5) to 

incorporate a more comprehensive approach to chronic disease management as part of 

ATW; and (6) to disseminate project information at the conclusion of the grant term. The 

outcomes will be: improved self-efficacy (for chronic disease management), improved selfreported health status and symptom management, improved health behaviors, reduced 

utilization of healthcare resources, and stronger community resources to support non-medical 

chronic disease management. 

Page 106 of 281 
Program: Evidence Based Health and Disease Prevention 

Grant Number: 90AM3111

Project Title: Living Well in Wisconsin

Project Period: 09/30/2006 - 05/31/2010

Grantee: 

Wisconsin Department of Health Services 

Disabilty and Elder Services 

1 West Wilson Street PO Box 7850 

Madison, WI 53708-7850 

Contact: 

Gail Schwersenska 

Tel. (608) 266-7803 

Email: SchweGA@dhfs.state.wi.us

AoA Project Officer 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $250,000

FY2007 $250,000

FY2006 $250,000

FY2005 $

FY2004 $

FY2003 $

Total $950,000

Project Abstract: 

The Wisconsin Department of Health Service's Divisions of Disability and Elder Services and 

Public Health (Arthritis Program, Diabetes Prevention and Control Program, and Injury 

Prevention Program), in collaboration with four Area Agencies on Aging (AAAs), local 

county/tribal aging agencies, public health departments, health care providers, and the 

Wisconsin Medical Society, are collaborating to accomplish the following goals and 

objectives. The primary goal is to develop state infrastructure to support evidence-based 

prevention programs that feature the widespread availability of Chronic Disease SelfManagement (CDSMP) and Fall Prevention (Stepping On) workshops. These sessions will 

empower adults 60 years and older to carry out healthy behaviors that reduce the risk for 

chronic conditions, improve self-management of diseases and conditions, reduce risk and 

fear of falls, and increase quality of life. Objectives are to: 1) promote self-management of 

chronic conditions through the CDSMP by building and enhancing the existing infrastructure; 

2) develop and provide culturally competent CDSMP for Hispanic and Native American 

populations; 3) implement Stepping On in at least one planning service area; 4) evaluate 

program infrastructure, and monitor workshop fidelity; and 5) design a network to increase 

program awareness, and disseminate material. Expected outcomes are: 1) 116 additional 

active trainers, health professionals and lay leaders; and, 2) an additional 1,700 older 

persons will attend CDSMP sessions and 560 older persons will attend Stepping On 

sessions. 

Page 107 of 281 
Program: Planning for a National Evaluation of Evidence-Based Programs 

Grant Number: 90OP0001

Project Title: Planning for a Nationwide Evaluation of Evidence-Based Programs for 

Seniors

Project Period: 09/30/2008 - 06/30/2011

Grantee: 

The Texas A&M University System HSC Research Foundation 

Social and Behavioral Health 

400 Harvey Mitchell Parkway South, Suite 100 

College Station, TX 77845 

Contact: 

Marcia Ory 

Tel. (979) 458-1373 

Email: mory@srph.tamhsc.edu

AoA Project Officer: Jane Tilly 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,050,000

FY2008 $600,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $1,650,000

Project Abstract: 

 The Texas A&M Health Science Center School of Rural Public Health, with support from the 

Centers for Disease Control's Prevention Research Center-Healthy Aging Research Network, 

will develop a comprehensive plan for a nationwide evaluation of evidence-based programs 

(EBP) for seniors. The four major objectives are: 1) to assess the current state of knowledge 

about EBP practice and evaluation; 2) to identify strengths and gaps in reaching aging 

populations, delivering EBP services, and building training and evaluation capacity; 3) to 

recommend a nationwide evaluation plan, specifying design, measurement, desired 

outcomes, and other critical elements; and 4) to indicate key players/areas of expertise 

needed to conduct the proposed evaluation plan. The primary outcome will be a 

recommended plan to evaluate EBPs for older adults nationwide, in collaboration with the 

National Association of State Units on Aging, National Association of Area Agencies on 

Aging, and aging services provider organizations. Secondary outcomes are to improve the 

implementation and delivery of EBPs in terms of reach and adoption, treatment fidelity, costeffectiveness, and sustainability, ultimately leading to the enhancement of seniors' health and 

well-being. In addition to summary briefing reports and scholarly publications, specific 

products include a: research update, plan for online evaluator training modules, guidebook for 

applying cost-effectiveness methodology, and compendium of best practices. The intent of 

the project is to mobilize key stakeholders in synergistic partnership to help define and 

facilitate implementation of a nationwide evaluation effort developed with input from the aging 

services network, public health arena, and health care sector. 

Page 108 of 281 
Program: Performance Outcomes Measurement Projects (POMP) 

Grant Number: 90NG0007

Project Title: Arizona Next Generation: Performance Outcome Measurement Project

Project Period: 09/30/2008 - 07/31/2010

Grantee: 

Arizona Department of Economic Security 

Independent Living Support Unit 

1789 W. Jefferson, Site Code 950A 

Phoenix, AZ 85007 

Contact: 

Melanie Starns 

Tel. (602) 542-4446 

Email: mstarns@azdes.gov

AoA Project Officer: Cynthia Bauer 

Fiscal 

Year 

Funding 

Amount

FY2009 $57,904

FY2008 $52,224

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $110,128

Project Abstract: 

This project, the first phase of the Next Generation: Performance Outcome Measurement 

Project (POMP), is developmental and will encompass 1) the development of the "POMP TO 

GO" toolkit; 2) the development of longitudinal performance measurement surveys; 3) the 

development of a methodology to cross-validate the generic nursing home predictor model 

being developed under Advanced POMP; and 4) the development of a plan to assess the 

nursing home predictive value of key performance measure variables in earlier POMP 

surveys. Arizona is assuming a leadership role for the development of longitudinal surveys. 

The overall outcome for the Next Generation: POMP projects is enhanced performance 

measurement capacity throughout the Aging Network. The specific objectives for this project 

are noted above. 

Page 109 of 281 
Program: Performance Outcomes Measurement Projects (POMP) 

Grant Number: 90NG0001

Project Title: Florida Next Generation: Performance Outcome Measurement Project

Project Period: 09/30/2008 - 07/31/2010

Grantee: 

Florida Department of Elder Affairs 

4040 Esplanade Way, Suite 315 

Tallahassee, FL 32399-7000 

Contact: 

Jay Breeze 

Tel. (850) 414-2338 

Email: Breezej@elderaffairs.org

AoA Project Officer: Cynthia Bauer 

Fiscal 

Year 

Funding 

Amount

FY2009 $59,942

FY2008 $59,942

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $119,884

Project Abstract: 

This project, the first phase of the Next Generation: Performance Outcome Measurement 

Project (POMP), is developmental. Its objectives are: 1) the development of the "POMP TO 

GO" toolkit; 2) the development of longitudinal performance measurement surveys; 3) the 

development of a methodology to cross-validate the nursing home predictor model being 

developed under Advanced POMP; and 4) the development of a plan to assess the nursing 

home predictive value of performance measurement variables included in earlier POMP 

surveys. Florida will be assuming a leadership role in developing a plan to assess the 

predictive value of performance measures identified in earlier POMP surveys. The overall 

outcome for the Next Generation: POMP project is enhanced performance measurement 

capacity throughout the Aging Network. 

Page 110 of 281 
Program: Performance Outcomes Measurement Projects (POMP) 

Grant Number: 90NG0006

Project Title: Next Generation: Performance Outcome Measurement Project (POMP)

Project Period: 09/30/2008 - 07/31/2010

Grantee: 

Georgia Department of Human Resources 

Human Resources 

2 Peachtree Street, N.W., Suite 9-398 

Atlanta, GA 30303-3142 

Contact: 

Elaine Popham 

Tel. (912) 449-4996 

Email: mepopham@dhr.state.ga.us

AoA Project Officer: Cynthia Bauer 

Fiscal 

Year 

Funding 

Amount

FY2009 $27,651

FY2008 $27,651

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $55,302

Project Abstract: 

This project, the first phase of the Next Generation: Performance Outcome Measurement 

(POMP), is developmental. Its objectives include: 1) the development of the "POMP TO GO" 

toolkit; 2) the development of longitudinal performance measurement survey instruments; 3) 

the development of a methodology to cross-validate the nursing home predictor model under 

development in Advanced POMP; and 4) the development of a plan to identify nursing home 

predictive value of performance measurement variables included in earlier POMP surveys. 

Georgia is assuming a leadership role in the development of the "POMP TO GO" toolkit. The 

overall outcome for Next Generation POMP is enhanced Performance measurement capacity 

throughout the Aging Network. 

Page 111 of 281 
Program: Performance Outcomes Measurement Projects (POMP) 

Grant Number: 90NG0003

Project Title: Massachusetts Next Generation Performance Outcome Measurement 

Project (POMP)

Project Period: 09/30/2008 - 07/31/2010

Grantee: 

Massachusetts Executive Office of Elder Affairs 

One Ashburton Place, 5th Floor 

Boston, MA 02108 

Contact: 

Ruth Palombo 

Tel. (617) 222-7512 

Email: Ruth.Paolombo@state.ma.us

AoA Project Officer: Cynthia Bauer 

Fiscal 

Year 

Funding 

Amount

FY2009 $59,975

FY2008 $59,975

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $119,950

Project Abstract: 

This project, the first phase of the Next Generation: Performance Outcome Measurement 

Project (POMP), is developmental. Its objectives include: 1) the development of the "POMP 

TO GO" toolkit; 2) the development of longitudinal performance measurement survey 

instruments; 3) the development of a methodology to cross-validate the nursing home 

predictor model being developed under Advanced POMP; and 4) the development of a 

strategy to assess the nursing home predictive value of key performance measurement 

variables from earlier POMP surveys. Massachusetts has assumed a leadership role for the 

development of "POMP TO GO." The overall outcome for the Next Generation POMP project 

is enhanced performance measurement capacity throughout the Aging Network. 

Page 112 of 281 
Program: Performance Outcomes Measurement Projects (POMP) 

Grant Number: 90NG0004

Project Title: Next Generation: Performance Outcome Measurement Project

Project Period: 09/30/2008 - 07/31/2010

Grantee: 

New York State Office for the Aging 

2 Empire State Plaza 

Albany, NY 12223-1251 

Contact: 

I-Hsin Wu 

Tel. (518) 486-2730 

Email: i_wu@ofa.state.ny.us

AoA Project Officer: Cynthia Bauer 

Fiscal 

Year 

Funding 

Amount

FY2009 $60,000

FY2008 $60,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $120,000

Project Abstract: 

This project, the first phase of the Next Generation: Performance Outcome Measurement 

Project POMP), is developmental. Its objectives include: 1) the development of the "POMP 

TO GO" toolkit; 2) the development of longitudinal performance measurement survey 

instruments; 3) the development of a methodology to cross-validate the nursing home 

predictor model under development in Advanced POMP; and 4) the development of a 

strategy to assess the nursing home predictive value of key performance measurement 

variables of earlier POMP surveys. New York will be assuming a leadership role for 

developing a methodology to cross-validate the nursing home predictor model developed 

under Advanced POMP. The overall outcome for the Next Generation: POMP project is 

enhanced performance measurement capacity throughout the Aging Network. 

Page 113 of 281 
Program: Performance Outcomes Measurement Projects (POMP) 

Grant Number: 90NG0002

Project Title: Next Generation: Performance Outcome Measures (POMP)

Project Period: 09/30/2008 - 07/31/2010

Grantee: 

North Carolina Department of Health and Human Services 

Division of Aging and Adult Services 

2001 Mail Service Center 

Raleigh, NC 27699-2001 

Contact: 

Phyllis Bridgeman 

Tel. (919) 733-0440 

Email: phyllis.bridgeman@ncmail.net

AoA Project Officer: Cynthia Bauer 

Fiscal 

Year 

Funding 

Amount

FY2009 $60,000

FY2008 $60,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $120,000

Project Abstract: 

This project, the first phase of the Next Generation: Performance Outcome Measurement 

Project (POMP), is developmental. The objectives are: 1) the development of the "POMP TO 

GO" toolkit; 2) the development of longitudinal performance measurement survey 

instruments; 3) the development of a methodology to cross-validate the nursing home 

predictor model developed under Advanced POMP; and 4) the development of a plan to 

assess the nursing home predictive value of key performance measurement variables 

included in earlier POMP surveys. North Carolina is assuming a leadership role in the 

development of longitudinal performance measurement instruments. The overall outcome for 

the Next Generation POMP project is enhanced performance measurement capacity 

throughout the Aging Network. 

Page 114 of 281 
Program: Performance Outcomes Measurement Projects (POMP) 

Grant Number: 90NG0005

Project Title: Ohio's Next Generation POMP

Project Period: 09/30/2008 - 07/31/2010

Grantee: 

Ohio Department of Aging 

50 W. Broad Street 9th Floor 

Columbus , OH 43215 

Contact: 

Robert Lucas 

Tel. (614) 728-9133 

Email: rlucas@age.state.oh.us

AoA Project Officer: Cynthia Bauer 

Fiscal 

Year 

Funding 

Amount

FY2009 $60,000

FY2008 $60,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $120,000

Project Abstract: 

This project, the first phase of the Next Generation: Performance Outcome Measurement 

Project (POMP), is developmental. The objectives encompass: 1) the development of the 

"POMP TO GO" toolkit; 2) the development of longitudinal performance measurement 

surveys; 3) the development of a methodology to cross-validate the generic nursing home 

predictor model being developed under Advanced POMP; and 4) the development of a plan 

to assess the nursing home predictive value of key performance measure variables in earlier 

POMP surveys. The overall outcome for the Next Generation: POMP projects is enhanced 

performance measurement capacity throughout the Aging Network. 

Page 115 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2651

Project Title: Alaska Native Aging in Place Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Mt. Sanford Tribal Consortium 

P.O. Box 357 

Gakona, AK 99586 

Contact: 

Evelyn Beeter 

Tel. (907) 822-5399 x26 

Email: ebeeter@mstc.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $274,308

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $274,308

Project Abstract: 

In collaboration with the Alaska Native Tribal Health Consortium, University of Alaska and 

regional community college, State Senior and Disability Services and regional providers this 

project proposes the development of an Aging in Place program in two rural villages that will 

serve as a model for developing similar programs in other villages in Alaska. The goal of this 

three year demonstration project is to pilot an Aging in Place program in two rural Alaska 

Native villages to develop a cost effective, village based model that enables Native Elders to 

remain in their homes and villages during their remaining years of life. The objectives are: 1) 

Collaborate with strategic partners to develop a village based program, 2) Implement and 

evaluate services; 3) Disseminate process and outcome data and lessons learned to provide 

a model that can be adapted by other rural villages. The expected outcome is that the 

documentation of the project will provide an informative model and be of assistance to other 

Tribes in developing village based programs. Products include reports detailing evaluations of 

client services, and program development activities and outcomes and; a website that 

disseminates information and assistance to benefit rural Tribes in developing village based 

programs. 

Page 116 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2650

Project Title: Lesbian, Gay, Bi-Sexual and Transgender Aging in Place Initiative

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

The Los Angeles Gay and Lesbian Community Services Center 

Seniors Services 

1625 N Schrader Boulevard 

Los Angeles, CA 90028-6213 

Contact:

Karen O'Brien 

Tel. (323)993-7634 

Email: kobrien@lagaycenter.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $380,139

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $380,139

Project Abstract: 

The Los Angeles Gay & Lesbian Center's Seniors Services Department seeks funding for a 

three-year lesbian, gay, bisexual and transgender (LGBT) Aging in Place Initiative, a unique 

intervention providing LGBT seniors with targeted support services, as well as training for 

service providers that assist area seniors as they age in place. The overarching goal of the 

project is to ensure that LGBT older adults in Los Angeles are treated with dignity and 

respect as they access a comprehensive and coordinated continuum of aging-in-place 

support services that target LGBT seniors. The objectives are: 1) provide social/recreational 

programming, support services, and educational and intergenerational opportunities that 

assist LGBT older adults in building community and improving social networks, thereby 

decreasing isolation and invisibility; 2) provide short-term case management services, 

offering LGBT seniors individual support and assistance in times of need and crisis; and 3) 

train local health and human service agencies and providers to ensure LGBT older adults 

receive quality care in mainstream institutions. The expected outcomes of this pioneering 

intervention are: increase socialization among and between LGBT older adults and provide 

LGBT seniors with greater access to LGBT-targeted services; establish a central data bank 

for LGBT-friendly resources and become a resource clearinghouse; LGBT seniors will have 

greater access to resources that are LGBT-friendly; and increase the knowledge and 

awareness of LGBT senior issues and needs among mainstream social service providers. 

The products of this project are: evaluation data that will be useful for local efforts to better 

serve this population; a replicable model with project best practices for serving LGBT seniors, 

as well as a training curriculum, that will be useful to various programs throughout the state 

and country. 

Page 117 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2660

Project Title: Catholic Charities Older Adult Outreach and Engagement Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Catholic Charities Diocese of Stockton 

Mother Lode Senior Services 

1106 North El Dorado Street 

Stockton, CA 95202 

Contact:

Kathi Toepel 

Tel. (209) 532-8448 

Email: ktoepel@ccstockton.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $271,708

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $271,708

Project Abstract: 

Catholic Charities - Diocese of Stockton proposes a three-year Older Adult Outreach and 

Engagement Project in collaboration with Tuolumne and Calaveras County's social service 

agencies, the Area Agency on Aging, and community organizations supporting the needs of 

older adults. The approach is to expand the current Older Adult Outreach and Engagement 

Program by adding new services and strengthening existing ones. The primary goal of the 

project is to provide a comprehensive, community-coordinated case management system 

that is responsive and addresses the diverse needs of older adults residing in rural area, 

enabling more elderly residents to safely age in place, continue to live independently in their 

community while retaining the dignity and respect they have earned. Objectives include: 1) 

increase assessment and intervention services which address both physical and 

psychosocial needs; 2) establish a senior home sharing program; 3) improve both physical 

and mental activity levels among elderly clients by strengthening already existing senior 

volunteer programs and creating a partnership between teen/young adults and seniors. The 

expected outcomes are that senior citizens can maintain an important level of independence 

enabling self-determination and increasing the level dignity necessary for a higher quality of 

life. The Senior Home Sharing program will expand seniors' housing options well beyond 

placement in long-term care facilities. Pre- and post-evaluations will be conducted with 

participants to accurately document baseline needs, challenges and successes. Quarterly 

participant evaluations will reflect positive results from the expanded range of coordinated 

services. Deliverable products will include a final report with statistically supported findings. 

Recommendations which delineate methods for replicating successful project results will be 

included in a publishable report. 

Page 118 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2664

Project Title: Building A Lifelong Community in South Cobb County

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Atlanta Regional Commission 

Community Services Department 

40 Courtland Street, N.E. 

Atlanta, Ga 30303 

Contact: 

Cathie Berger 

Tel. (404) 463-3235 

Email: cberger@atlantaregional.com

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $265,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $265,000

Project Abstract: 

The Atlanta Regional Commission, the designated Area Agency on Aging for the ten county 

Atlanta region, proposes a community capacity building project for aging in place to be 

implemented with support from Cobb County Senior Services and in collaboration with the 

Jewish Federation of Greater Atlanta, Visiting Nurse Health System, and other community 

partners. The goal of Building Lifelong Communities in South Cobb County is to build the 

capacity of a local community in becoming a Lifelong Community where individuals of all 

ages can live throughout their lifetime through comprehensive planning, design, programming 

and community involvement. The objectives are: (1) to improve the design of the built 

environment to promote connectivity, retail and services, and housing stock needed to age in 

place. (2) to implement the NORC (Naturally Occurring Retirement Community) Model to 

enhance the system of long term services and supports that wrap around the built 

environment, and (3) to conduct outreach to involve and train residents to advocate for their 

own needs in the long range process of developing a Lifelong Community. Anticipated 

outcomes are: (1) increased awareness of Lifelong Community Principles among community 

leaders, (2) improved health outcomes for frail elders, (3) greater resident access to services 

and supports that facilitate aging in place, and (4) increased civic engagement among older 

adults in the community. The deliverables are: (1) increased connectivity, retail and services, 

and housing stock for older residents (2) cross-training and cross-referral protocols among 

local service providers; (3) the development of the South Cobb NORC, and (4) a model 

program that can be replicated regionally and statewide. 

Page 119 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2661

Project Title: Howard County Community Innovations for Aging in Place Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Coordinating Center for Home and Community Care, Inc. 

Corporate Development 

8258 Veterans Highway Suite 13 

Millersville, MD 21108 

Contact: 

Karen-Ann Lichtenstein 

Tel. (410) 987-1048 

kalichtenstein@coordinatingcenter.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $441,290

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $441,290

Project Abstract: 

The Coordinating Center for Home and Community Care proposes a three year Community 

Innovations for Aging in Place project in collaboration with the Howard County Aging and 

Disability Resource Center (ADRC). The approach integrates innovative case management 

expertise with existing community-based services to sustain independence of older 

individuals. Actualizing aging in place principles, the project goal is to establish a partnership 

between an experienced case management entity and a local ADRC creating a model for 

supporting elderly individuals with specialized health concerns to age in their own homes or 

sites of their choice and avoid costly re-hospitalizations and inappropriate facility placement. 

Objectives of the project are to: 1) Provide outreach to identify individuals living in a Naturally 

Occurring Retirement Community (NORC)/surrounding area and in danger of spending down 

to Medicaid and nursing home placement; 2) Work with Howard County General Hospital to 

implement a comprehensive discharge plan for participants that includes follow-up 

community-based case management; 3) Develop comprehensive community living plans 

that encompass the medical, social, educational and recreational supports individuals need to 

age in place, honoring the individual's strengths and choices; 4) Provide on-going case 

management ensuring that as the individual's needs change they have access to needed 

care and community supports including community housing alternatives; and 5) Establish a 

Community Development Council, comprised primarily of participants. Expected outcomes 

include: hospital readmissions will be significantly reduced; greater use of community-based 

services will be realized; individuals will remain in the community longer, and a replicable 

model of comprehensive care coordination will be implemented. Products include: a final 

report to include a case management replication model, a refined needs assessment, and a 

plan for sustainability. 

Page 120 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2654

Project Title: Services to Help At-Risk Elders Age in Place (SHARE)

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Boston Medical Center 

Elders Living at Home 

One Boston Medical Center Place 

Boston, MA 02118 

Contact: 

Eileen O’Brien 

Tel. (617) 638-6148 

Email: eileenm.obrien@bmc.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $288,131

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $288,131

Project Abstract: 

The Boston Medical Center's Elders Living at Home Program (ELAHP) proposes to provide 

and assess comprehensive services allowing a minimum of 40 low-income, formerly 

homeless older adults who are at risk of recurring homelessness to remain in public housing, 

with maximum independence, improved health and healthcare, and meaningful activities and 

relationships. The approach is to provide comprehensive, individualized, ongoing case 

management targeted to the specific needs of formerly homeless older adults. The goal of 

the project is to implement and evaluate an intervention to assist formerly homeless older 

adults to age in place. The objectives are: 1) to build a support network that is accessible 

and appropriate for formerly homeless older adults; 2) to help these older adults build on their 

individual abilities, interests, and living skills to achieve the highest possible level of selfdetermination; and 3) to document and disseminate findings from this intervention that can be 

used to advance services and policies for vulnerable, underserved older adults. The 

expected outcomes of this project are: 1) 95% of older adults will remain in their homes; 2) 

90% of older adults will increase independence, as measured by diminishing reliance on 

services; and 3) 80% of older adults will maintain or improve their health status; 80% will 

improve socialization. The products from this project are: data on intensive, individualized 

stabilization services; case studies on both successful and unsuccessful older adults; and a 

document on findings that will be shared with advocates for older adults and used to make 

public policy recommendations at the national, state, and local level. 

Page 121 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2655

Project Title: Caring Communities Resource Centers

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Catholic Charities of Kansas City-St. Joseph, Inc. 

Senior Care Services 

1112 Broadway 

Kansas City, MO 64105 

Contact: 

Michael W Halterman 

Tel. (816) 221-4377 x338 

Email: mhalterman@ccharities.com

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $317,631

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $317,631

Project Abstract: 

Catholic Charities of Kansas City-St. Joseph proposes implementing Caring Communities 

Resource Centers for three years in collaboration with senior centers and community 

partners of health and aging expertise. The approach takes health care assistance, social 

workers, chronic disease education and related health activities into senior neighborhood 

settings. The goal is to enhance older adults' ability to live independently and increase 

healthy behaviors through localized access to a continuum of health and social services 

focused on seniors and their caregivers supporting quality of life while aging in place. The 

objectives include: 1) services customized to needs of older adults in low-income, urban and 

rural neighborhoods; 2) outreach activities for awareness of the comprehensive scope of 

services; 3) intake and health screenings to determine health conditions and facilitate care 

plans for better management; 4)intervention, case management, and referrals to health 

providers; 5) chronic disease management workshops and health literacy; 6) mental health 

services; 7) assisting family caregivers to identify their own needs; 8) providing resources to 

address older adult/caregiver circumstances; and 9) respite services. The expected 

outcomes are: 1) older adults demonstrate improvement in healthy aging behaviors and 

ability to remain independent; 2) participants engage in health literacy and screenings; 3) 

older adults reduce reliance on emergency rooms and preventable hospitalization; 4) older 

adults demonstrate better disease self-management; 5) seniors report a greater sense of 

well-being; 6) caregivers demonstrate an increased ability to provide care; and 7)older adults 

report improvement when caregivers share in services. The products are evaluation reports, 

electronic and media articles for publication, and a new replicable model of service. 

Page 122 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2659

Project Title: Seniors Count Coordination Initiative

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Easter Seals New Hampshire, Inc. 

Seniors Count 

555 Auburn Street 

Manchester, NH 03103 

Contact:

Elin Treanor 

Tel. (603) 621-3462 

Email: etreanor@eastersealsnh.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $307,521

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $307,521

Project Abstract: 

Easter Seals New Hampshire and Seniors Count propose a three year Seniors Count 

Coordination Initiative in collaboration with the Catholic Medical Center, Elliot Senior Health 

Center, Dartmouth-Hitchcock, the Bureau of Elderly & Adult Services, Manchester 

Department of Public Health, and the Aging and Disability Resource Center. The overall goal 

of this initiative is to create and implement a replicable person-centered model that enhances 

coordination between medical services, community living/social services, and caregiver 

support for frail seniors in the Manchester service area. As part of this initiative, the Project 

Workgroup and Advisory Committee's objectives will be to 1. develop the infrastructure and 

tools needed to make the model successful; 2. hire and train staff; 3. implement the initiative; 

4. evaluate the effectiveness of the initiative; and 5. disseminate project information. The 

expected outcomes of the project are: seniors and caregivers will indicate satisfaction with 

the initiative; seniors and caregivers will agree that the program helped to prolong the senior's 

ability to age in place; seniors will experience a decrease in revolving-door hospitalization 

and emergency room visits; and caregivers will indicate that the initiative decreased their 

stress level and possibility of burnout. The products from this project are: a final report, 

including evaluation results; a website; articles for publication; an annual symposium; and 

presentations at national venues. 

Page 123 of 281 
Program: AP - Community Innovations - Aging in Place 

Grant Number: 90AP2658

Project Title: Jewish Family Service of New Mexico's CIAIP Aging In Place Project

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Jewish Family Service of Greater Albuquerque 

5520 Wyoming Blvd. NE Suite 200 

Albuquerque, NM 87109 

Contact: 

Michael Gemme 

Tel. (505) 348-4503 

Email: Michael@jfsnm.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $338,575

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $338,575

Project Abstract: 

Jewish Family Service New Mexico (JFS) proposes a three-year Community Innovations for 

Aging in Place (CIAIP) project in collaboration with the New Mexico Aging and Long Term 

Services Department, the Area Agency on Aging and Indian Area Agencies on Aging (AAAs), 

New Mexico Department of Health (DoH), Fort Sumner Community Development 

Corporation, and other service providers. The goal of the project is to implement a culturally 

diverse, innovative, and cost-effective aging in place program for the delivery and 

coordination of community-based health and social services in Native American, rural, urban, 

and suburban communities that supports seniors and their caregivers. The objectives are: 1) 

develop and maintain collaborative partnerships with housing facilities, for and not-for-profit 

organizations, and local, state, and tribal government agencies; 2) develop Partners Advisory 

Groups (PAGs); 3) empower participants to engage in volunteerism; 4) expand the project to 

include HUD-based housing and a Native American pueblo; 5) expand wellness interventions 

that support aging in place; 6) provide transportation activities; 7) promote Aging and 

Disability Resource Center resources and expand access to programs for participants and 

their caregivers; 8) promote long-term project sustainability; 9) evaluate impact of services; 

10) and disseminate project information. The expected outcomes of the project are: 1) a 

cost-effective, innovative, and culturally diverse program that increases emotional and 

physical wellbeing for seniors; 2) caregivers are supported through access to respite 

resources and programs; 3) multiple-design evaluations reflecting positive results due to 

participant-driven programming and integrated service provision. The products from the 

project are: a Brain Fitness program; culturally-based training CDs; a marketing toolkit; a final 

report and evaluation results. 

Page 124 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2657

Project Title: NORC Health Plus

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

New York City Department for the Aging 

Development 

2 Lafayette Street Room 729 

New York , NY 10007 

Contact: 

Ishrat Taleb 

Tel. (212) 442-0962 

italeb@aging.nyc.gov

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $338,575

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $338,575

Project Abstract: 

The New York City (NYC) Department for the Aging, in partnership with the United Hospital 

Fund, proposes to broaden the scope of existing Naturally Occurring Retirement 

Communities (NORC) in NYC to improve the health and mental health of residents and guide 

systems change for aging in place models. The goal of the NORC Health Plus program is to 

broaden the scope and guide systems changes to better meet the health and mental health 

needs of older NORC residents. The objectives are to: 1) Provide older NORC residents with 

the tools necessary to better manage their health by implementing the evidence-based 

Chronic Disease Self Management Program; 2) Empower older residents to better manage 

their mental health by offering Behavioral Activation Therapy; 3) Build the capacity of NORCs 

to support service and systems change and assume a broader community role; and 4) 

Increase the depth and breadth of NORC residents' participation in the governance and 

operation of the NORC services program. Anticipated outcomes: Seniors undergoing 

Behavioral Activation therapy will experience a reduction in depression, improved quality of 

life, increased socialization and participation in activities. For those clients with chronic 

illnesses one additional outcome will be their participation and follow through with the Chronic 

Disease Self Management Program requirements. Individual outcomes for seniors include 

improvement in health status and health behavior; greater self efficacy and better selfreported health; greater energy and reduced fatigue; fewer social role limitations; and better 

communication with physicians. There will be an increase in the number and type of 

meaningful volunteer opportunities available to NORC seniors. Additionally, formal 

mechanisms for volunteer recruitment, management, and retention will be in place and 

NORC services staff will significantly expand their knowledge base on community organizing, 

transformational leadership, volunteer management, and service programs. 

Page 125 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2662

Project Title: Community Innovations Aging In Place

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Supportive Older Women's Network 

4100 Main St., Suite 200 

Philadelphia , PA 19127 

Contact: 

June Siegel 

Tel. (215) 487-3000 x16 

Email: jsiegel@sown.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $269,804

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $269,804

Project Abstract: 

The Supportive Older Women's Network (SOWN) Growing Healthy Lives Together project is 

a comprehensive healthy living program for older adults, predominately women, who are 

aging in place in their homes. The project is targeted to serve a West Philadelphia 

neighborhood that has a very high percentage of minority, poor older adults living alone, with 

chronic multiple health conditions. A major challenge in the identified service area is the lack 

of in-home mental health services. The project is based on a prevention model that is 

inclusive, open to all older residents in the targeted community and accessible by being 

offered in the consumer's home/building/community. The Healthy Lives project provides an 

integrated approach to wellness coupling physical and emotional health; it is non-stigmatizing 

and normative and provides on-going support to sustain healthy lifestyle changes. The goal 

of the Healthy Lives project is to improve the physical and emotional well-being of older 

adults by providing a continuum of services to support healthy living. These services include: 

healthy living coaching, healthy living workshops, Healthy Diner lunches, a Fruit First healthy 

snacks program, traveling computer workshops to access health and social services, support 

groups, and volunteer ambassadors. The project looks at addressing barriers to information 

and knowledge, motivational-attitudinal based barriers, and resource-based barriers by 

creating a comprehensive healthy living program that includes education, motivation, 

socialization and resource access. The expected outcomes of this project are 1) increased 

knowledge of personal well-being and health, 2) improved confidence and self-mastery in 

managing health and well-being, 3) decreased depression, loneliness and social isolation, 

and 4) increased social connectedness. 

Page 126 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2663

Project Title: A Better Way to Live at Home: Education, Resources, and Supports for 

Older Adults

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Family Eldercare Housing & Community Services 

2210 Hancock Drive 

Austin, TX 78756 

Contact: 

Angela Atwood 

Tel. (512) 483-3589 

aatwood@familyeldercare.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $400,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $400,000

Project Abstract: 

Family Eldercare proposes a three year Community Innovations for Aging in Place project in 

collaboration with the Area Agency on Aging and five other agencies. The program will be 

provided in subsidized housing with high concentrations of low-income older adults in three 

Central Texas communities. The approach is to deliver services through a Service 

Coordinator at each site, provide case management to persons at risk of premature 

institutionalization and provide activities, including evidenced based practices, that impact 

aging in place. The goal of the project is to promote a community in which older adults are 

active and engaged and barriers to aging in place are proactively addressed. The objectives 

are: 1) establish an effective program for promoting aging in place, 2) develop a community 

culture for aging in place, 3) maintain or improve the physical and mental health of older 

adults, 4) increase opportunities for socialization and learning and 6) reduce the rate at which 

older adults move out. The expected outcomes are: 1) On-site staff and residents have 

increased understanding of the signs that older adults need additional support to remain 

aging in place, 2) Reduced fear of falling and improved activity levels among older adults, 3) 

Reduced medication problems, 3) Improved memory performance, 4) Increased older adult 

participation in on site activities and volunteerism, 5) Increased knowledge and skills among 

older adults and 6) Increased understanding of the relationship between program activities 

and older adult move out rates. The products are written reports with results and lessons 

learned, Internet posting of information, conference presentations and a toolkit for replicating 

the program. 

Page 127 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2653

Project Title: Houston Aging in Place Innovations

Project Period: 09/30/2009 - 09/30/2012

Grantee: 

Neighborhood Centers Inc. 

Senior Services 

4500 Bissonnet 

Bellaire, TX 77401 

Contact: 

Chris Pollet 

Tel. (713) 669-5260 

Email: cpollet@neighborhood-centers.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $500,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $500,000

Project Abstract: 

Neighborhood Centers, guided by the Aging Agenda for Houston and Harris County, will 

implement a three-year Houston Aging in Place Innovations project with the Houston Health 

Department and Area Agency on Aging, the Care for Elders partnership, the YWCA, Interfaith 

Ministries of Greater Houston and Gateway to Care. The project approach is a new role for 

Senior Centers serving naturally occurring retirement communities with a menu of evidencebased health promotion programs, case management teams that include certified community 

health workers and elder care field specialists, and neighborhood Elder-Care Action Teams. 

It will Serve concentrations of low-income, minority older adults in three neighborhoods. The 

goal is that older adults achieve optimal individual levels of functioning and support needed to 

age in place comfortably. The objectives are: (a) neighborhood aging in place assets and 

gaps related to the Aging Agenda are measured; (b) more older adults benefit from evidencebased programs and support services provided by Senior Centers, on-site and off-site; (c) 

older adults in case management achieve their individual service plans; and (d) neighborhood 

services to elders improve significantly through more frequent and stronger collaboration. 

Expected outcomes are: (a) older adults, both mobile and homebound, are better prepared 

and supported for a higher quality aging in place experience; (b) senior services providers are 

better connected and coordinated in leveraging resources and efficiently delivering quality 

services; and (c) Senior Centers are more integrated with other local service providers and 

community development entities, and capable of extending services to other neighborhood 

sites such as churches and senior apartment complexes. The products from this project are a 

final evaluation report and a complete replication report. 

Page 128 of 281 
Program: Community Innovations - Aging in Place 

Grant Number: 90AP2656

Project Title: Rural Elder Assistance for Care and Health (REACH)

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

City of Montpelier 

Department of Planning and Community Development. 

39 Main Street 

Montpelier, VT 05602 

Contact: 

Gwendolyn Hallsmith 

Tel. (802) 223-9506 

ghallsmith@montpelier-vt.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $334,670

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $334,670

Project Abstract: 

The City of Montpelier will lead a collaborative effort building on the success of the Onion 

River Exchange (ORE), an existing Time Bank, to promote coordination between agencies 

and emerging networks of community-based services. A new social enterprise called 

REACH -- Rural Elder Assistance for Care and Health -- will foster health, wellness, and 

resiliency for elders and caregivers, expand services to facilitate aging-in-place, and build 

livable communities for elders of all income levels. The goal is to create a community support 

system for elders in Central Vermont to provide innovative, reliable, and affordable personal, 

health, and social services. Objectives are to: 1) develop REACH social enterprise 

infrastructure enabling stakeholders, community members, elders, and caregivers to build 

networks of giving/receiving; 2) establish innovative REACH social insurance model to 

expand delivery of basic, assisted, and specialized services by rewarding community-based 

contributions; 3) integrate paid and community-based services; 4) create affordable access to 

preventive care for elders; 5) evaluate impacts of REACH; 6) disseminate results and lessons 

learned. The expected outcomes are to: a) increase vulnerable elders' ability to stay in their 

communities; b) expand services for elders, especially low-income rural elders, foster 

behaviors that sustain health and independence; c) increase ratios of community based and 

paid services; d) improve social, physical and mental wellbeing for elders and caregivers; e) 

improve community resilience, economic empowerment and livability; f) demonstrate viability 

of the REACH social insurance model for aging-in-place in rural settings. Products will 

include: 1) replicable social enterprise model to support aging-in-place and promote 

preventive elder care in rural settings; 2) community-based directories of REACH services; 3) 

customized Community Weaver software for rural settings. 

Page 129 of 281 
Program: Community Innovations Technical Assistance and Training 

Grant Number: 90AP2652

Project Title: Technical Assistance Provider and Evaluator for the Community 

Innovations in Aging in Place (CIAIP) Grantees

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Visiting Nurse Service of New York 

Center Home Care Policy Research 

1250 Broadway, 20th Floor Visiting Nurse Service of New York 

New York, NY 10001 

Contact: 

Mia Oberlink 

Tel. (212) 609-1537 

Email: mia.oberlink@vnsny.org

Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $485,648

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $485,648

Project Abstract: 

The Center for Home Care Policy and Research (CHCPR) of the Visiting Nurse Service of 

New York (VNSNY) proposes to provide a program of training and technical assistance 

through a collaborative Technical Assistance Grant (TAG) Team approach to the diverse 

community-based grantees of the Community Innovations for Aging in Place (CIAIP) initiative 

to assist them in their efforts to help older community residents age in place. CHCPR 

proposes to achieve the following goals: 1) assist CIAIP grantees in implementing initiatives 

to help older residents age in place; and 2) identify and disseminate "lessons learned" 

throughout the field and beyond. The major objectives include to: 1) implement a technical 

assistance package, including group work sessions, individual technical assistance, tools, 

and resources; 2) convene a National Advisory Committee to inform CHCPR activities; 3) 

conduct an evaluation by tracking key indicators critical to aging in place efforts and 

implement targeted evaluation studies resulting in in-depth analyses of promising 

approaches, programs, and services; and 4) Synthesize lessons learned and translate them 

into actionable steps to inform the field. Expected outcomes of the three-year technical 

assistance program: 1) Individualized technical assistance meets the needs of each grantee; 

2) Grantees advance toward objectives associated with successful aging in place initiatives; 

3) Lessons learned are translated into actionable steps that inform the field; and 4) Additional 

communities, and nontraditional service providers and networks, recognize the need for 

aging in place initiatives in their communities and use CHCPR-produced resources to support 

their efforts. Products from this program: 1) final report with evaluation results; 2) website; 3) 

CIAIP conference proceedings; 4) abstracts and teaching materials for presentations at 

national conferences; 5) tools and resources to support the development of aging in place 

initiatives; "how-to-manuals” for CIAIP grantees on specific issues related to their work. 

Page 130 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0010

Project Title: Alabama's Lifespan Respite Grant

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Alabama Department of Senior Services 

State Unit on Aging 

770 Washington Avenue, Suite 470 P.O. Box 301851 

Montgomery, AL 36130-1851 

Contact:

Julie Miller 

Tel. (334) 242-5743 

Julie.Miller@adss.alabama.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

The Alabama Department of Senior Services (ADSS), in partnership with Alabama Lifespan 

Respite Resource Network (Alabama Respite), the Alabama Respite Coalition (Coalition), 

and the Alabama Disability Resource Centers (ADRC), will expand lifespan respite in 

Alabama. The goal of this project is to provide a statewide, comprehensive, and coordinated 

approach to meet the respite care needs of caregivers of individuals with disabilities and 

chronic conditions regardless of age, income, race, ethnicity, special needs, or situation. The 

project will address the following objectives: 1) conduct a respite awareness campaign for 

caregivers, agencies, and the general public; 2) explore new local and state grant 

possibilities, grant collaboration between partners, and resource development for gap 

populations; 3) enhance the capacity of the Alabama Respite; 4) identify all agencies and 

resources currently providing respite funding; 5) identify caregiver training programs and link 

caregivers to them; 6) expand training and capacity of ADRC staff and the statewide virtual 

ADRC to include lifespan respite resources; and 7) work collaboratively with all Coalition 

partners to recruit and train respite care workers and volunteers. Outcomes: Coalition 

participation in the development of an Alabama strategic lifespan respite plan; establishment 

of a committee to investigate the structure of Alabama Respite; a public awareness and 

education campaign to foster better understanding of Alabama Respite’s mission and vision; 

increased respite options; increased volunteer, faith-based respite services, and “Sharing the 

Care” concept; and respite care will be provides to caregivers of all ages using a variety of 

existing funding sources. Products include lessons learned, development of marketing and 

respite training materials, and ADRC Lifespan Respite website collaboration. 

Page 131 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0004

Project Title: Arizona Lifespan Respite Care Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Arizona Department of Economic Security 

Division of Aging and Adult Services 

1789 W. Jefferson Street 950A 

Phoenix, AZ 85007 

Contact: 

Melanie K Starns 

Tel. (602) 542-2591 

Email: mstarns@azdes.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $199,128

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $199,128

Project Abstract: 

The Arizona Department of Economic Security, Division of Aging and Adult Services (ADESDAAS), in partnership with members of the aging network, the disability community, the 

Arizona Caregiver Coalition, and Arizona State University will work to achieve the following 

goal: Continue to develop the Arizona Lifespan Respite Care Program (LRCP) and provide 

public awareness related to the value and importance of respite care across the lifespan 

throughout Arizona, assuring culturally appropriate respite services are accessible to diverse 

populations of caregivers, including respite on short notice in emergency situations. The 

project will address the following objectives: 1) expand the reach of the LRCP to include all 

caregivers that could benefit from respite care, including caregivers of the elderly, disabled 

and children with special needs; 2) offer consumer-directed service delivery, making respite 

care more accessible, practical, and culturally acceptable; 3) improve public awareness of the 

LRCP and respite care through a social marketing campaign and establishing a toll-free 

respite hotline, operated by trained volunteers coordinated by the Arizona Caregiver 

Coalition; 4) assure consistent delivery of respite care statewide through implementation of a 

new caregiver assessment tool developed by Arizona State University; and 5) coordinate 

provision of emergency respite to caregivers identified by Arizona¿s Adult Protective 

Services. Anticipated outcomes of the Lifespan Respite Care Program include: 1) increased 

awareness of LRCP services; 2) improved access to respite care services; 3) enhanced 

ability to keep care recipients at home; and 4) improved ability to maintain independent 

activities. The products from this project will include a final report, evaluation results, cost 

analysis, annual data reports, and program materials for replication. 

Program: Lifespan Respite Care 

Grant Number: 90PG0004

Project Title: Special Programs for the Aging Title IV Discretionary Projects

Page 132 of 281 
Page 133 of 281 

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Family Caregiver Alliance 

180 Montgomery Street, Suite #1100 

San Francisco, CA 94104 

Contact: 

Kathleen A Kelly 

Tel. (415) 434-3388 

kkelly@caregiver.org

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,908,110

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $1,908,110

Project Abstract: 

The Family Caregiver Alliance in partnership with ARCH National Respite Network supports 

the three-year Strengthening Professional Networks: Technical Assistance for Caregiver 

Support and Lifespan Respite Programs with the goal of increasing capacity, efficiency and 

effectiveness of caregiver support and lifespan respite networks (Networks) at state and local 

levels. The project¿s objectives are: 1) To support Networks infrastructure development; 2) 

To develop and disseminate tools and resources for caregivers to the NFCSP and caregiver 

support programs; 3) To design and maintain a national respite care, technical assistance 

and information database; 4) To provide knowledge and competency tools and resources to 

Networks staff. Project outcomes include: increased efficiency of the Networks so the most 

benefit can be derived from the limited resources available; increased efficiency and 

effectiveness of the aging network through having the right tools and resources to address 

the changing needs of family caregivers; easy access to a database of respite resources so 

family caregivers can more effectively locate and use respite; increased competency of staff 

across the Networks through (1) receipt of high quality training aimed at increasing 

knowledge and skills and (2) dissemination of practice standards for knowledge and 

competencies related to family caregivers developed at the national levels. The products are: 

two websites offering national databases of respite programs and model caregiver support 

programs and materials; lifespan respite training materials; training modules; national and 

state conference workshops; monthly technical assistance emails; in-person and telephone 

technical assistance; practical tips for program developers; development of state children¿s 

respite programs listings; web casts; dissemination of practice guidelines; final report; and 

abstracts for national conferences. 
Program: Lifespan Respite Care 

Grant Number: 90LR0007

Project Title: Connecticut Lifespan Respite Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Connecticut Department of Social Services 

Aging Services Division 

25 Sigourney Street 

Hartford, CT 06106 

Contact: 

Margaret Gerundo-Murkette 

Tel. (860) 424-5322 

Email: Margaret.Gerundo-Murkette@ct.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $199,934

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $199,934

Project Abstract: 

The Connecticut Department of Social Services will implement the Lifespan Respite Care 

Program Grant in collaboration with the Connecticut Lifespan Respite Coalition (CLRC). The 

goal of the project is to expand the availability and accessibility of respite services. The 

approach is to promote the collaboration of providers, consumers and advocates to further 

develop the availability of respite services for caregivers of all persons across the lifespan. 

The objectives are: 1) to establish a database which will identify all respite services and 

funding sources in Connecticut; 2) to promote networking by establishing working 

relationships between CLRC and the Area Agencies on Aging and the Aging and Disability 

Resource Centers and with local service organizations in Connecticut; 3) to provide public 

awareness and resource information to caregivers and consumers; 4) to provide training 

options to caregivers and service organizations; and 5) to enable family caregivers to make 

informed decisions about respite care services. The expected outcomes of this project are: 

families and caregivers will have increased opportunity for choosing a respite provider; 

providers will demonstrate knowledgeable skills for providing specialized respite care for 

specific populations; and families will have more direct access to respite services. The 

products from this project will include a statewide regionalized database identifying respite 

provider agencies and organizations, eligibility requirements, and possible funding sources 

for persons requesting respite services; an expanded website; and a final report providing 

evaluation results and recommendations for continued implementation of the outcomes. 

Page 134 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0008

Project Title: DC Lifespan Respite Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

District of Columbia Office on Aging 

441 Fourth Street, NW, Suite 900 South 

Washington, DC 20001 

Contact: 

Clarence Brown 

Tel. (202)724-5622 

clarence.brown@dc.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $399,998

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $399,998

Project Abstract: 

The District of Columbia Office on Aging (DCOA) and the Aging and Disability Resource 

Center (ADRC) will establish a Lifespan Respite Care model in collaboration with several 

partners during the three year project period. The goal of the project is to establish and 

sustain the implementation and coordination of respite services for family caregivers of 

children and adults with disabilities. The District has two respite care programs that serve 

foster parents and nine programs that render respite services to caregivers of adults. The 

project's four primary objectives are: 1) enhance respite services available to families across 

age and disability spectrums by establishing the infrastructure for a lifespan respite system 

through recruitment and training; 2) improve coordination and dissemination of service 

delivery between different programs to optimize caregiver support; 3) promote awareness of 

respite care programs; and 4) conduct a needs assessment and advocate for services that 

are not currently available. The expected outcomes are: 1) to establish a quality Lifespan 

Respite Care Program infrastructure within DCOA/ADRC that will provide easily accessible 

and comprehensive delivery of respite services; 2) to increase family caregivers¿ awareness 

of and satisfaction from using respite services in the District; and 3) to create a sustainable 

Lifespan Respite Care Program infrastructure. DCOA/ADRC will produce the following 

products: 1) pre and post satisfaction questionnaire of informal caregivers; 2) a DC Lifespan 

Respite Care Web site; 3) caregiver survival and therapeutic engagement kits for caregivers; 

4) a plan for project sustainability; 5) project evaluation results; 6) a final report; 7) news 

articles; and 8) conference presentations and abstracts. 

Page 135 of 281 
Program: Lifespan Respite Care 

Grant Number: 90MA0011

Project Title: Broward County Family Caregiver Access Network Demonstration 

(FCAN)

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

United Jewish Community of Broward County, Inc. 

Community Relations/Planning 

5890 S. Pine Island Road 

Davie, FL 33328 

Contact: 

Pepi Dunay 

Tel. (954) 252-6949 

pdunay@jewishbroward.org

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $167,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $167,000

Project Abstract: 

United Jewish Community of Broward County, Inc. as the lead agency will support the 

Broward County Family Caregivers Access Network Demonstration Project (FCAN) in 

collaboration with Jewish Family Services of Broward County, local senior service agencies 

and United Jewish communities. The goal of the project is to foster improved well-being of 

family caregivers and increased ability to sustain caregiving. The project objectives are to 1) 

identify community services for family caregivers and understand their needs, strengths and 

interests; 2) increase community knowledge about family caregiving and promote increased 

caregiver self-identification; 3) increase the quality/quantity of caregiver assessments; and 4) 

increase service coordination for family caregivers. The overall approach will be to conduct a 

community assessment; implement multifaceted outreach; and conduct caregiver support 

groups, individual assessments, and service coordination. The target population is family 

caregivers of any age or ethnicity who are caring for older adults living in Broward County, 

Florida. The anticipated outcomes are: 1) 85% of participants will improve their knowledge of 

family caregiving; and 2) 80% of family caregivers who attend a support group or service 

coordination will report an improved sense of mental well-being and ability to continue 

caregiving. The products from the project include a brochure, flyer, web pages, resource list, 

an outreach presentation, and a final report with evaluation results. 

Page 136 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0002

Project Title: Illinois Lifespan Respite Care Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Illinois Department on Aging 

421 East Capitol 

Springfield, IL 62701 

Contact:

Ross G Grove 

Tel. (217)524-7627 

Email: ross.grove@illinois.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

The Illinois Department on Aging is implementing this three-year Lifespan Respite project in 

collaboration with the Illinois Respite coalition and other state and private organizations. The 

goal of the project is to improve respite care access to all populations by establishing a 

centralized, comprehensive statewide listing of respite services and coordinated referral 

process; and train respite providers and volunteers. To accomplish this goal, the project will 

address the following objectives: 1) create a respite website listing of all resources and 

training by geographic location; 2) provide respite services; 3) improve collaboration among 

state agencies that provide funding for respite services; 4) train caregivers and volunteers; 5) 

create a statewide respite task force; 6) create a statewide 800 respite number; 7) provide 

technical assistance and training materials for replication of the project; 8) create a public 

awareness campaign; and 9) evaluate the effectiveness of the project. Anticipated outcomes 

include: improved access to respite care programs for all populations; increased number of 

caregivers aware of respite services; increase collaboration between state respite programs; 

improved quality of life for caregivers; and improved coordination of services for respite care 

recipients. Products resulting from this project will include a report of evaluation results; a 

respite web site; a replicable training program; and printed materials listing statewide respite 

resources. 

Page 137 of 281 
Program: Lifespan Respite Care 

Grant Number: 90MA0010

Project Title: 2009 Congressional Mandates: Non-NORC

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Jewish Federation of Metropolitan Detroit 

6735 Telegraph Road 

Bloomfield Hills, MI 48301-3141 

Contact: 

Linda J Blumberg 

Tel. (248)203-1468 

Email: blumberg@jfmd.org

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $238,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $238,000

Project Abstract: 

The Family Caregiver Access Network (FCAN) will be a non-sectarian project of the Jewish 

Federation of Metropolitan Detroit (JFMD) and its constituent agencies. Jewish Family 

Service, a JFMD Constituent agency, will be the lead agency and will partner with the Brown 

Jewish Community Adult Dare Care Program and will collaborate with other organizations, to 

support family caregivers of older adults in their caregiving roles. The project¿s goal is to 

reduce caregiver burden, thereby improving the lives of caregivers and those for whom they 

are caring and reduce premature institutionalization. The objectives are to address barriers 

that lead to underutilization of caregiving support services, increase caregiver selfidentification, connect caregivers with needed resources and services, implement a more 

seamless and coordinated service delivery system of local agencies and supports, improve 

the lives of care recipients as their caregivers experience reduced stress and receive 

services and supports, diminish early or avoidable institutionalization of care recipients and 

develop a replicable model that can be shared with other eldercare agencies, thereby 

strengthening the nation¿s long-term care system. The expected outcomes of the project are 

that family caregivers will experience reduced burden and stress levels, feel healthier, feel 

more supported in their caregiving roles and feel that they are more able and more likely to 

continue in those roles. Pre and post tests will measure caregiver burden and statistics will 

be kept on institutionalization rates. The products from this project will be a final report, 

including evaluation results, a dissemination plan, and a web site. 

Page 138 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0009

Project Title: The New Hampshire Lifespan Respite Care Project includes a system 

wide competency based training program & registry for providers/f

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

New Hampshire Department of Health and Human Service 

Special Medical Services 

129 Pleasant Street 

Concord, NH 03301 

Contact: 

Elizabeth Collins 

Tel. (603) 271-8181 

ecollins@dhhs.state.nh.us

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $110,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $110,000

Project Abstract: 

The New Hampshire Department of Health and Human Services, Special Medical Services, 

supports the Lifespan Respite Care (LRC) project in collaboration with the Bureau of Elderly 

and Adult Services, Bureau of Developmental Disabilities, Bureau of Behavioral health, 

Division of Children and Youth, National Alliance on Mental Illness, New Hampshire, New 

Hampshire Family Voices, and the College of Direct Support. The goal of the project is to 

increase availability of trained LRC providers for New Hampshire residents. The objectives 

are: 1) choose direct support training modules appropriate to respite care providers, 

modifying them to meet the project needs, 2) develop training modules for the Severely 

Emotionally Disturbed (SED) and the Traumatic Brain Injured (TBI) populations, 3) develop a 

marketing campaign to recruit and train providers, 4) design and implement a coordinated 

registry providing access to fully trained respite care providers, 5) institute a pilot for the LRC 

targeting a specific population with SED based upon the model of New Hampshire Division of 

Children, Youth and Families (DCYF) Adoptive Care Respite Pilot, and 6) have the work plan 

and evaluation for sustainability of LRC overseen by the Planning Advisory Group. 

Outcomes of the Lifespan Respite Care Project include: 1) developed, expanded and 

marketed comprehensive respite training curriculum to meet the Lifespan Respite Care 

needs of NH residents, 2) established and coordinated registry of trained LRC providers, and 

3) a completed pilot utilizing the LRC trained providers, targeting children and youth with 

SED. The products from this project include a final report, evaluation results, marketing tools, 

and a LRC registry for New Hampshire. 

Page 139 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0012

Project Title: 2009 Nevada Lifespan Respite Care Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Nevada Health and Human Services 

Aging and Disability Services Division 

3416 Goni Rd., Ste 132 

Carson City, NV 89706 

Contact: 

Jeff Doucet 

Tel. (702) 486-3545 

jsdoucet@aging.nv.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

The Nevada Aging and Disability Services Division (ADSD), in collaboration with project 

partners - Cleveland Clinic Lou Ruvo Center for Brain Health (CCLRCBH); the Alzheimer¿s 

Association ‘ Northern Nevada/Northern California and Desert Southwest chapters; the local 

Aging and Disability Resource Centers (ADRC); and the Nevada Lifespan Respite Care 

Coalition - will work together to develop a coordinated, comprehensive system of information 

dissemination and service delivery called the Nevada Lifespan Respite Care Program. The 

goal of this project is to improve access to respite services and to develop a network of 

services, including training for caregivers and service providers through collaboration, 

outreach and volunteer utilization, particularly in rural areas for care recipients of all ages 

through training, volunteer recruitment and the development of quality standards. To 

accomplish this goal, the project will address the following objectives: 1) create a ¿Respite 

Care network¿ with project partners; 2) improve the quality of respite care services via the 

development of quality standards; 3) provide group and individual training to family 

caregivers, respite workers and volunteers via web resources, interactive video-conference 

technology, face-to-face sessions and DVDs; and 4) empower family caregivers to solicit, 

train and employ volunteers to provide needed respite in their communities. Project 

outcomes are focused on caregivers and care recipients that include: community outreach 

that builds on existing models and employs the train-the-trainer model; education to assist 

caregivers and train respite workers; access to services will be increased through network 

development; and improved quality of services. Products from the project will include training 

materials for program implementation, cost analysis, project report, newsletters, and 

conference presentations. 

Page 140 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0001

Project Title: Lifespan Respite Care Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

North Carolina Department of Health and Human Services 

Division of Aging and Adult Services 

2001 Mail Service Center 

Raleigh, NC 27699-2001 

Contact:

Alicia Blater 

Tel. (919) 733-8390 

alicia.blater@dhhs.nc.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $184,328

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $184,328

Project Abstract: 

The Division of Aging and Adult Services (DAAS) of the N.C. Department of Health and 

Human Services, in collaboration with the Division of Medical Assistance, the Office of LongTerm Services and Supports, the North Carolina Respite Care Coalition and other key 

partners, seeks to enhance and expand the quality and availability of lifespan respite services 

for all age groups throughout North Carolina via consumer and provider educational and 

informational activities, volunteer and provider training, and resource development. North 

Carolina will build upon and strengthen existing linkages to create a more coordinated system 

of respite services, improving access and reducing barriers to respite. The objectives are to: 

1) research, adapt and implement a model Lifespan Respite Care Program for NC; 2) 

improve statewide coordination of lifespan respite care and build leadership capacity across 

service delivery systems; 3) enhance infrastructure through new relationships with the faith 

and medical communities; and 4) develop and implement an innovative statewide respite 

education and public awareness initiative. Expected outcomes include: 1) better informed 

caregivers of adults and children about respite services and how to access them; 2) higher 

quality and more diverse and accessible respite options; 3) enhanced database systems to 

improve information dissemination about and coordination of respite services; and 4) stronger 

statewide respite care system. Project products include: a web-based guide to NC lifespan 

respite services; a model public relations plan for NC respite services; a web-based guide 

highlighting best practice respite care worker and volunteer recruitment and training 

programs in NC; and a series of web-based, print, and video segments to help family 

caregivers. 

Page 141 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0005

Project Title: Rhode Island Respite across the Lifespan

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Rhode Island Department of Elderly Affairs 

Hazard Building, 74 West Rd. 

Cranston, RI 02920 

Contact: 

Corinne C Russo 

Tel. (401) 462-0501 

Email: crusso@dea.ri.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

The Rhode Island Department of Elderly Affairs (RI DEA) will implement a model of respite 

services across the lifespan and create the infrastructure across existing respite systems to 

enable greater awareness and access. Directed by DEA, The Point (RI¿s Adult and 

Disability Resource Center), the Parent Support Network of Rhode Island, the Roman 

Catholic Diocese of Providence and the RI Lifespan Respite Coalition, including RI¿s Health 

and Human Services Agencies will join to develop the respite services designated for the 

Global Medicaid Waiver, and make respite an integral part of the TimeBanks program for 

family caregivers of persons of all ages with special needs. The goal of the project is for 

caregivers to have knowledge of available resources and access to services. Rhode 

Island¿s approach will expand the TimeBanks program to include respite and to develop a 

system across populations for referral and access to traditional and emergency respite care 

services. Project objectives include, 1) coordinate and expand traditional planned emergency 

lifespan respite under the Global Medicaid Waiver; 2) expand statewide TimeBanks program 

to effectively serve as a volunteer lifespan respite program; and 3) disseminate project 

information to increase public awareness of available respite care. Outcomes include a 

volunteer respite program for caregivers across the lifespan is active and that recommended 

policies and procedures for the respite benefit in the Global Waiver will be complete. Key 

project indicators to be measured include: 1) number of persons using Medicaid respite; 2) 

numbers of persons accessing respite through TimeBanks by project¿s end; 3) number of 

incidents annually; and 4) satisfaction with new respite services. 

Page 142 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0011

Project Title: Lifespan Respite in South Carolina

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

South Carolina Lieutenant Governor's Office on Aging 

1301 Gervais Street, Suite 200 

Columbia, SC 29201 

Contact: 

Denise W Rivers 

Tel. (803) 734-9939 

riversd@aging.sc.gov

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $199,989

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $199,989

Project Abstract: 

The Lieutenant Governor’s Office on Aging, in partnership with the South Carolina Respite 

Coalition and Family Connection of SC, and key stakeholders will establish a Lifespan 

Respite System building on current infrastructure. The goal of this project is to improve 

access to respite services’in South Carolina for all family caregivers of people of any age with 

any special need. The objectives are to: establish a state and local coordinated Lifespan 

Respite system that expands and enhances respite services statewide for all family 

caregivers of people with disabilities and special needs; establish a State Advisory Council to 

guide the development of the coordinated Lifespan Respite System; build local networks and 

capacity to recruit and train volunteers to fill gaps in respite services; provide outreach, 

information and screening for respite services through the Aging and Disability Resource 

Centers (ADRC) and the Family to Family Health Care Information and Education Center; 

and, disseminate information to family caregivers across the state and provide information 

and training materials to help them mobilize social supports for respite and to encourage 

earlier and increased use of respite. Outcomes include: greater collaboration across public 

and private organizations that increases access to respite services; increased family 

caregiver knowledge, skills and ability to use respite services thoughout their caregiving 

years; and contribution of new knowledge to the field for how Lifespan Respite Programs can 

harness volunteerism to expand respite options for families through partnerships with two of 

the largest volunteer efforts in the country: the Corporation for National and Community 

Services (CNCS) and faith-based communities. 

Page 143 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0006

Project Title: Lifespan Respite Care Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Tennessee Commission on Aging and Disability 

500 Deaderick Street, 8th Floor, Suite 825 

Nashville, TN 37243 

Contact: 

Cynthia G Minnick 

Tel. (615) 741-2056 

Email: cynthia.minnick@tn.gov

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

The Tennessee Commission on Aging and Disability (TCAD), the Tennessee Respite 

Coalition (TRC), and the Area Agencies on Aging and Disability (AAADs) and the Aging and 

Disability Resource Centers (ADRC) support this Lifespan Respite Care Program. The goal 

of the project is to expand, enhance, and formalize a system to improve the statewide 

dissemination and coordination of respite and improve access and quality of respite to 

families. Project objectives include: 1) facilitate coordination among respite programs and 

providers and ensure an inclusive coalition for respite services; 2) increase access to respite 

through a “no wrong door” approach; 3) develop a plan to collect and analyze data about the 

respite needs of families and the provision of respite services statewide; 4) enhance abilities 

of the TRC to respond to respite needs through a Respite Specialist; 5) increase 

opportunities for provider and caregiver training; and 6) increase respite volunteer training. 

Outcomes include: 1) increased awareness of the Lifespan Respite System; 2) coordinate 

and expand the number of respite care providers; 3) increase the capability of TRC to 

respond to the needs of caregivers; 4) increase access to services; 5) partner the 

colleges/universities to expand the volunteer respite program model and increase respite 

volunteers; 6) update the current TRC computer database to provide a tracking system and 

data on respite referral results across age and disability, on access to respite, and track the 

success of referrals across the system; and 7) develop a plan for sustainability of the system 

through fundraising and grants. Products include a “how-to” manual, reproducible materials, 

and a cost assessment methodology. 

Page 144 of 281 
Program: Lifespan Respite Care 

Grant Number: 90LR0003

Project Title: Texas Lifespan Respite Care Program

Project Period: 09/30/2009 - 09/29/2012

Grantee: 

Texas Department of Aging and Disability Services 

Access and Intake 

701 West 51st Street 

Austin, TX 78751 

Contact:

Christy Fair 

Tel. (512) 438-3257 

christy.fair@dads.state.tx.us

AoA Project Officer: Greg Link 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

The Texas Department of Aging and Disability Services (DADS) will implement a statewide 

respite program to enhance and expand the coordination and availability of respite services in 

the state. Objectives include: (1) the creation of the Texas Respite Coordination Center 

(TRCC); (2) increasing the availability of respite services; (3) implementing a caregiver 

awareness campaign; and, (4) developing best practices, materials and tools for respite care 

providers. DADS will administer the contract for the TRCC, as well as the contracts for 

expanding services under a newly enacted Texas House Bill 802. DADS will also carry out 

several activities related to the statewide awareness campaign. The TRCC will: (1) support 

the respite coordination and outreach efforts of the Texas Respite Coalition, Aging and 

Disability Resource Centers and contractors of respite under House.Bill 802; (2) compile and 

annually update a Texas Inventory of Respite Services, (3) conduct respite forums across the 

state; (4) develop media kits and outreach materials aimed at caregivers; and, (5) develop 

training and best practice tools for providers of respite services. Working with the Texas 

Respite Coalition and other partners, Texas will work toward two outcomes: (1) caregivers 

will have a greater knowledge about and access to, a wider array of respite care options; and, 

(2) Texas will have a respite care system that has greater capacity and is more coordinated 

across service systems. The Texas Health and Human Services Commission will conduct 

ongoing evaluation activities to assess the program’s effectiveness, using a comparison 

analysis of the Inventory, as well as provider interviews and a caregiver survey. 

Page 145 of 281 
Program: State and Area Agency Planning Projects 

Grant Number: 90PG0003

Project Title: Project to increase capacity of AAA/Title VI aging programs by providing 

tools and resources that enhance their ability

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

National Association of Area Agencies on Aging 

1730 Rhode Island Avenue, NW Suite 1200 

Washington, DC 20036 

Contact:

Helen Eltzeroth 

Tel. (202) 872-0888 

heltzeroth@n4a.org

Project Officer: Bob Hornyak 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,257,681

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $1,257,681

Project Abstract: 

The National Association of Area Agencies on Aging (N4A) will partner with Scripps 

Gerontology Center to increase the management and leadership capacities of Area Agencies 

on Aging (AAAs) and Title VI aging programs and broaden their role in the delivery of 

community-based services and supports to better address the needs of older adults and their 

caregivers. The goal of the project is to increase the capacity of AAAs and Title VI Native 

American aging programs to enhance management practices and methodologies; leadership; 

and their role in the delivery of community-based services and supports. Project objectives 

include: expand the knowledge base of AAA and Title VI programs regarding operations and 

trends, management, program development and services that promote continuous quality 

improvement; provide training and technical assistance to AAA and Title VI staff on trends, 

tools, strategies and techniques to expand and enhance their operations; and enhance and 

support the knowledge base and leadership of AAA and Title VI governance boards on the 

roles and responsibilities of the Aging Network to respond strategically to the needs of older 

adults and caregivers. AAA and Title VI programs will provide state-of-the-art management 

and performance-based programs and systems that enable older adults to age successfully 

at home and in the community for as long as possible. The project will disseminate findings 

and reports to the AAA and Title VI community, as well as to the aging field. N4A will market 

the dissemination of the project materials through promotion to AAAs, Title VI programs, AoA, 

State Units on Aging and the broader aging field. 

Page 146 of 281 
Program: State and Area Agency Planning Projects 

Grant Number: 90PG0005

Project Title: Aging Network Long-Term Strategic Planning

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

National Association of State Units on Aging 

1201 15th Street, NW, Suite 350 

Washington, D.C., 20005 

Contact:

Eric Risteen 

Tel. (202) 898-2578 

Email: eristeen@nasua.org

AoA Project Officer: Deborah Burns 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,000,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $1,000,000

Project Abstract: 

The National Association of State Units on Aging (NASUA) is implementing this project to 

ensure that the state planning model continues to be fully available for use by all State Units 

on Aging (SUAs) and Area Agencies on Aging (AAAs). This project will work to not only 

enhance the state planning model, but to continue to expand comprehensive planning to the 

Aging Services Network. The overall goal of this project is to enhance the capacity of SUAs 

and AAAs to develop strategic planning processes and to continue to expand comprehensive 

planning in the on-going activities of all SUAs and AAAs. NASUA will achieve the following 

objectives: promote use of the Comprehensive Planning Model by SUAs, AAAs, and Title VI 

Organizations; provide technical assistance for comprehensive planning for aging services; 

develop and integrate GIS mapping technology for SUAs and AAAs; monitor and analyze 

states¿ development of information exchanges and electronic health records in support of 

their planning efforts to rebalance the long term care system; and support conference 

planning (HCBS Conference and National Aging and Disability I & R Symposium). Project 

outcomes: more State Units on Aging, AAAs and Title VI Organizations will use consistent, 

comprehensive planning processes and models in moving their state forward in reforming the 

long term care system; update, maintain, and make modifications to the planning model for 

use by the Aging Services Network; SUAs and AAAs will have expanded capacities for 

collecting and analyzing information and data to use in planning and measuring desired 

outcomes; best practices and successful models will be shared among states and AAAs. 

Page 147 of 281 
Program: State and Area Agency Planning Projects 

Grant Number: 90AM3142

Project Title: Aging Strategic Alignment Project for the Aging Network

Project Period: 07/01/2007 - 06/30/2010

Grantee: 

Benjamin Rose Institute 

11900 Fairhill Rd., Suite 300 

Cleveland, OH 44120 

Contact: 

Linda S. Noelker

Tel. (216) 373-1603 

Email: lnoelker@benrose.org

AoA Project Officer: Robert Hornyak 

Fiscal 

Year 

Funding 

Amount

FY2009 $600,000

FY2008 $900,000

FY2007 $1,199,745

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $2,699,745

Project Abstract: 

Benjamin Rose Institute Aging Strategic Alignment Project will address key issues in the 

provisions of the The 2006 Amendments to the Older Americans Act, including provisions 

related to long-term care that underscore the national role of the Aging Services Network in 

home and community-based services. Through a cooperative agreement, the Benjamin 

Rose project will establish a roadmap that will help the Aging Network understand the 

significance and long-range vision inherent in the new long-term care provisions, and identify 

strategies and tactics that the various components of the Network can use to advance a 

coordinated approach to implementing the new provisions. The Benjamin Rose project 

identifies systematic work with the National Association for State Units on Aging Planning 

Grants, National Association of State and Area Agencies’ readiness assessments, Lewin 

Group ADRC technical assistance, Cash & Counseling, evidence-based disease and 

disability prevention, and the nursing home diversion grants, as critical components to a 

successful roadmap. Major objectives: 1) develop a communication strategy for AoA and the 

Aging Services Network for the implementation of the new OAA long-term care provisions; 2) 

complete an aging network readiness review, working with the Aging Services Network, 

applicable National Associations and AoA grantees/contractors; 3) finalize and commence 

roll-out of the Roadmap for the Aging Services Network's role in long-term care; 4) provide 

technical assistance to the Network; 5) conduct information/training sessions with AoA 

headquarters staff and regional office staff to ensure consistent communication messaging to 

the Network (on-going). Benjamin Rose will work with AoA headquarters staff and select 

regional administrators to ensure successful project management. 

Page 148 of 281 
Program: State and Area Planning Projects 

Grant Number: 90OP0003

Project Title: Moving Forward Together: Promoting State-of-the-Art Business Planning 

in the Aging Network

Project Period: 09/30/2008 - 09/29/2010

Grantee: 

Miami University of Ohio 

Scripps Gerontology Center 

500 E. High Street 

Oxford, OH 45056 

Contact:

Tricia Callahan 

Tel. (513) 529-1795 

Email: tricia.callahan@muohio.edu

AoA Project Officer: Deborah Burns 

Fiscal 

Year 

Funding 

Amount

FY2009 $47,000

FY2008 $200,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $247,000

Project Abstract: 

Scripps Gerontology Center (Scripps) is assisting in the planning of the National Listening 

Forums on the Reauthorization of the Older Americans Act Three Regional Forums to be 

held in Dallas, Alexandria, and San Francisco in the months of February and March of 2010. 

These sessions will provide an opportunity for all levels of the network to provide information 

to the Administration on Aging about what works as well as where changes in the law will 

strengthen their ability to serve older adults, caregivers and persons with disabilities in a 

changing environment. Scripts Gerontology Center will provide technical support for the 

forums, locate the hotels and meeting room space, pay the travel costs for expert witnesses, 

state unit on aging directors, an area agency on aging representative from states, and some 

Title VI participants. Scripps will also be responsible for recording the sessions and providing 

AoA with a summary report by the end of April 2010. 

Page 149 of 281 
Program: Pension Information Counseling Program 

Grant Number: 90AM3150

Project Title: New England Pension Assistance Project - Pension Counseling and 

Information Program

Project Period: 09/30/2007 - 07/31/2010

Grantee: 

University of Massachusetts Boston 

Gerontology Institute 

100 Morrissey Blvd. 

Boston, MA 02125-3393 

Contact: 

Paula Noonan 

Tel. (617) 287-5371 

paula.noonan@umb.edu

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $157,500

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $557,500

Project Abstract: 

The Gerontology Institute of the University of Massachusetts Boston continues its operation 

of the New England Pension Assistance Project, which provides free assistance to individuals 

from all six New England states (Connecticut, Maine, Massachusetts, New Hampshire, 

Rhode Island, and Vermont) who have questions or problems with their pensions. The goal 

of the project is to increase workers' and retirees' knowledge of, and access to, retirement 

benefits. The objectives of the project are: 1) to maximize individuals' retirement standard of 

living; 2) to educate older workers, retirees, and the community about pensions and 

retirement income, as well as issues affecting eligibility; 3) to identify recurring problems 

faced by workers in obtaining adequate pensions; and 4) to target outreach to women, lowincome and minority workers and retirees, and elders with limited English proficiency. The 

project will accomplish its goal through a program of individual counseling and referrals, case 

investigation, legal research, community education, and outreach. The expected outcomes 

are to help clients secure the benefits to which they are entitled and to increase awareness of 

pension rights, issues and problems among clients and the general population. The 

expected products are: a final report, including evaluation results; semi-annual newsletters; 

published press articles; and an enhanced website. 

Page 150 of 281 
Program: Pension Information Counseling Program 

Grant Number: 90AM3149

Project Title: The Mid-Atlantic Pension Counseling Project

Project Period: 09/30/2007 - 07/31/2010

Grantee: 

South Brooklyn Legal Services 

105 Court Street 

Brooklyn, NY 11201- 

Contact: 

Deborah Alexander 

Tel: (646) 442-3302 

Email: DeborahA@sbls.org 

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $157,500

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $557,500

Project Abstract: 

Legal Services for the Elderly, the grantee, continues its operation of the Mid-Atlantic Pension 

Counseling Project. The goal of the project is to provide pension counseling and information 

for the New York and New Jersey region. The objectives are: 1) to resolve the caller's 

pension problem by providing specialized services, ranging from information to direct 

counseling and assistance; 2) to reach people throughout the region; 3) to collect information 

about the services rendered; and 4) to share the experiences of the project. The expected 

outcomes are: 1) increases in clients' financial stability; 2) increases in clients' informed 

decision-making; and 3) provision to clients of specialized, expert assistance. The products 

from this project will be periodic and final reports, three years of data concerning clients and 

the services they need, and a dramatically improved website. This model will target retired 

workers and pension claimants with focused outreach and services. Isolated and 

homebound clients will be targeted for outreach through telephone access and through the 

use of radio and newspapers for outreach concerning pension services. Non-English 

speaking clients will also be targeted through the use of bi-lingual staff and on-demand 

translators. 

Page 151 of 281 
Program: Pension Information Counseling Program 

Grant Number: 90PC0002

Project Title: Upper Midwest Pension Rights Project

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Iowa Legal Aid 

1111 9th Street Suite 230 

Des Moines, Ia 50314 

Contact: 

Bill Nassif 

Tel. (515) 282-8161

Email: bnassif@iowalaw.org

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

 

Iowa Legal Aid, a key partner in the Upper Midwest Pension Rights Project since the initial 

award of the grant in 2007, continues its position of lead grantee during this third and final 

year of the project. The Upper Midwest Pension Rights Project will continue its goal of 

providing quality, comprehensive pension counseling, information, and referral through a 

coordinated, regional service model to the states of Iowa, Minnesota, North Dakota, South 

Dakota, and Wisconsin. The collaborative partnership involving Iowa Legal Aid, the 

Metropolitan Area Agency on Aging (Minneapolis, Minnesota), Legal Services of North 

Dakota, and the University of South Dakota Elder Law Forum, will focus on the following 

objectives and activities: 1) to deliver pension counseling services, including detailed legal 

analysis of claim viability, assist with survivor benefit and former spouse pension issues, draft 

claims and appeals, conduct lost pension searches and refer to employee benefits 

professionals, legal aid, and law school clinics; 2) to conduct outreach activities that will 

include intake and referral through partnerships with the Aging and Disability Resource 

Centers, Area Agencies on Aging, Legal Services, and Social Security field offices, as well as 

a targeted initiative to labor, rural, and immigrant communities; and 3) to increase operational 

efficiency by identifying, sharing and implementing effective pension counseling practices, 

and to collect and report on project and client outcome data, consistent with the overall 

Administration on Aging Pension Counseling Program. Expected project outcomes and 

products include an increase in overall economic self-sufficiency of retirees served, 

heightened consumer awareness of pension counseling, information and referral services, 

increased efficiency and improved project outcome data, semester and final reports, and a 

restoration of legal rights. 

Page 152 of 281 
Program: Pension Information Counseling Program 

Grant Number: 90AM3148

Project Title: Mid-America Pension Rights Project

Project Period: 09/30/2007 - 07/31/2010

Grantee: 

Elder Law of Michigan, Inc. 

3815 W. St. Joseph St., Suite C-200 

Lansing, MI 48917 

Contact:

Christa Schofield 

Tel. (517) 485-9164 

Email: cschofield@elderlawofmi.org

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $157,500

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $557,500

Project Abstract: 

The Mid-America Pension Rights Project, led by Elder Law of Michigan, Inc., expands on the 

success of the Great Lakes Pension Rights Project and remodel the project into a centralized 

regional pension counseling project. The approach utilizes specialized toll-free telephone 

service with "quick call" responses from attorneys who are pension specialists, a project 

website, and pension-specific/exclusive outreach. Objectives are: 1) to establish a regional 

approach to the five-state area using a centralized toll-free number, a common website and 

joint marketing materials; 2) to implement creative outreach strategies to reach all 

pensioners, including those who have limited English proficiency, cognitive impairments and 

profound health problems; and 3) to provide intensive and consistent pension counseling 

services to Michigan and Ohio, with expansion into Pennsylvania and Kentucky and, in year 

3, Tennessee. The main goal is to provide equitably distributed pension counseling and 

information services to individuals in Michigan, Ohio, Pennsylvania, Kentucky and 

Tennessee. Expected outcomes include: 1) improvement of the financial situation & security 

of retirees and their spouses; 2) enhancements in the understanding of pension benefits, 

rights, and options; and 3) increases in the availability of, and access to, high-quality pension 

counseling and information in Kentucky, Pennsylvania, and Tennessee. Telephonic 

outcome-based client and stakeholder surveys will reflect the positive results from the 

planned intervention. Products will include: scripts for telephone system recordings for basic 

information for limited English proficiency clients, posters and flyers for outreach to Social 

Security offices and literacy coalitions, and new substantive pension materials for hospice 

patients and rural retirees. 

Page 153 of 281 
Program: Pension Information Counseling Program 

Grant Number: 90PC0001

Project Title: South Central Pension Rights Project

Project Period: 09/30/2008 - 07/31/2010

Grantee: 

Texas Legal Services Center 

815 Brazos, Suite 1100 

Austin, TX 78701 

Contact: 

Paula Pierce 

Tel. (512) 477-6000 x128 

Email: ppierce@tlsc.org

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $400,000

Project Abstract: 

Texas Legal Services Center provides pension counseling, information, and advocacy 

services in Texas, Oklahoma, Louisiana, Arkansas, and Missouri as the South Central 

Pension Rights Project. The goal is to establish a regional pension counseling and 

information project to serve the South Central region in an effort to protect financial security 

and foster independence in retirement. The project's objectives are to provide regional 

pension counseling and information services, and outreach, in a manner programmatically 

consistent with other projects funded by the Administration on Aging (AoA) through: 1) 

individual counseling; 2) case investigation and non-litigation client advocacy; 3) regional 

intake and referral services; 4) specialized outreach; 5) dissemination of specialized 

publications; 6) staff development; 7) use of volunteers and law students; 8) data collection, 

analysis and reporting; and 9) shared learning across the AoA-funded pension projects. 

Expected outcomes include increased: 1) access to regional pension counseling services; 2) 

access to pension counseling by low-income, non-English speaking, Native American, 

minority, rural and females workers, retirees, and beneficiaries; 3) financial well-being of 

retirees; 4) awareness of project services among potential referral sources; 5) and awareness 

of pension rights among workers and retirees in the service region. Products will include 

brochures, posters, and publications informing individuals about their legal rights regarding 

retirement income, a website, operations manual, regular reports, and a final report. 

Page 154 of 281 
Program: Pension Information Counseling Program 

Grant Number: 90AM3153

Project Title: Senior Legal Hotline Pension Counseling and Information Project

Project Period: 09/30/2007 - 07/31/2010

Grantee: 

Legal Services of Northern California 

Senior Legal Hotline 

517 12th Street 

Sacramento, CA 95814 

Contact: 

David Mandel 

Tel. (916) 551-2142 

Email: dmandel@lsnc.net

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $200,000

FY2008 $200,000

FY2007 $157,500

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $557,500

Project Abstract: 

Legal Services of Northern California provides comprehensive regional pension information, 

counseling, casework and referrals, initially in California, then expanding to include Nevada, 

Arizona and Hawaii. The new service will be jump-started through efficient co-location with 

the grantee's existing statewide senior legal hotline, adding a module to the hotline's hightech phone system, sharing administrative and support functions, but creating a distinct 

identity with separate outreach, specialized principal staff and volunteers. Project outcomes 

will be the creation of an efficient new avenue by which individuals in the region can obtain 

the information they need to discover, understand and obtain pension rights and benefits; and 

greater consumer awareness about common pension problems and where to find assistance. 

These, in turn, will contribute to greater financial security and effective planning among 

beneficiaries, helping to maintain optimal health and independence among a vulnerable 

population. Products will include outreach and educational materials, as well as activity, 

outcome and evaluation reports detailing findings, lessons and recommendations to others 

undertaking similar work. 

Page 155 of 281 
Program: Pension Information Counseling Program 

Grant Number: 90AM3147

Project Title: National Pension Assistance Resource Center: Supporting the Pension 

Counseling and Information Program

Project Period: 09/30/2007 - 07/31/2010

Grantee: 

Pension Rights Center 

1350 Connecticut Avenue, NW, Suite 206 

Washington, DC 20036 

Contact: 

John Hotz 

Tel. (202) 296-3776 

jhotz@pensionrights.org

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $852,914

FY2008 $720,000

FY2007 $588,920

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $2,161,834

Project Abstract: 

The Pension Rights Center with this grant continues its operation of the National Pension 

Assistance Resource Center, which has two primary goals: to enhance the capabilities of the 

Administration on Aging's (AoA's) Pension Counseling and Information Projects, and to 

advance AoA's vision of a nationwide pension assistance network. Objectives of the project 

will be to: 1) deliver legal training and technical assistance to AoA's pension counseling 

projects and an extended community of legal services providers; 2) conduct nationwide 

outreach for the Pension Counseling Program through coordinated media relations and a 

web-based information and referral application; and 3) manage the sharing and 

implementation of identified best practices across the AoA pension counseling projects, and 

track overall program outcomes through field-based data-collection tools and methods. 

Outcomes will include increased competency and effectiveness for those projects that 

receive training and technical assistance; increased consumer and advocacy community 

awareness of, and access to, pension information and assistance services nationwide; and 

improved operational efficiencies, data collection and reporting practices across the pension 

counseling projects. Products will include: customized field-based training events and 

annual training conferences; training materials; case consultations and legal backup services; 

web-based resources for advocates, including fact sheets, press releases, project brochures 

and other outreach materials, a nationwide pension information and referral resource for 

consumers; newspaper and magazine articles, and radio and television appearances; an 

online pension counseling data-collection and reporting tool; and a pension counseling 

listserv and other shared-learning resources. 

Page 156 of 281 
Program: National Center on Elder Abuse 

Grant Number: 90AM3144

Project Title: National Center on Elder Abuse

Project Period: 09/01/2007 - 06/30/2010

Grantee: 

National Adult Protective Services Foundation 

920 Spring St., Suite 1200 

Springfield, IL 62704 

Contact: 

Kathleen Quinn 

Tel. (217) 523-4431 

Email: kathleen.quinn@apsnetwork.org

AoA Project Officer: Stephanie Whittier Eliason 

Fiscal 

Year 

Funding 

Amount

FY2009 $398,950

FY2008 $398,950

FY2007 $398,950

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $1,196,850

Project Abstract: 

National Center on Elder Abuse (NCEA) is an equal partner, multi-disciplinary consortium 

with expertise in elder abuse, neglect, and exploitation. Goals are to: develop and 

disseminate information for professionals to increase elder abuse, neglect, and exploitation 

identification and reporting and guide programs that protect older people; provide tools to 

increase professional ability of those with daily access to seniors to identify, address, and 

prevent elder abuse, neglect, and exploitation; and promote systems change through 

development of programs, models, and initiatives that measurably decrease elder abuse, 

neglect, and exploitation incidence. The National Adult Protective Services Association will 

execute a 3-year program as a collaborator in the NCEA, and undertake the following 

activities to promote the above goals: (1) conduct a national needs assessment to identify 

both the elder abuse training needs of, and currently available training for, targeted 

professionals; (2) develop a feasible, long range strategic plan to address gaps identified in 

the needs assessment; (3) continue to maintain and expand the national elder abuse/APS 

training library; (4) continue to develop and disseminate training materials for personnel 

engaged in preventing, identifying, and treating elder abuse, neglect, and exploitation; (5) 

conduct 4 annual, national webcasts on elder abuse/APS to disseminate information for 

targeted professions; and (6) annually prepare and distribute an annotated bibliography of 

recent elder abuse research. Expected outcomes are: (1) timely, high quality information to 

support state & local capacity building and innovation; (2) increased professionalization of 

adult protection & elder abuse service networks; and (3) increased knowledge of the extent 

and causes of elder abuse and skills & practices for prevention. 

Page 157 of 281 
Program: National Center on Elder Abuse 

Grant Number: 90AM3145

Project Title: Empowering Elder Abuse Organizations through Local, State, and 

National Collaborations

Project Period: 09/01/2007 - 06/30/2010

Grantee: 

National Committee for the Prevention of Elder Abuse 

1612 K Street NW Ste 400 

Washington, DC 20006 

Contact: 

Megan Wiley 

Tel. (202) 682-4140 

Email: mwiley@matzblancato.com

AoA Project Officer: Stephanie Whittier Eliason 

Fiscal 

Year 

Funding 

Amount

FY2009 $300,000

FY2008 $300,000

FY2007 $300,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

National Center on Elder Abuse (NCEA) is an equal partner, multi-disciplinary consortium 

with expertise in elder abuse, neglect, and exploitation. Goals: develop and disseminate 

information for professionals to increase elder abuse, neglect, and exploitation identification 

and reporting and guide programs that protect older people; provide tools to increase 

professional ability of those with daily access to seniors to identify, address, and prevent 

elder abuse, neglect, and exploitation; and promote systems change through development of 

programs, models, and initiatives that measurably decrease elder abuse, neglect, and 

exploitation incidence. In support of the NCEA goals, the National Committee for the 

Prevention of Elder Abuse will execute a 3-year program as a collaborator in the NCEA and 

undertake the following activities to encourage and enhance development of comprehensive 

elder justice systems: (1) award mini-grants of approximately $10,000 each year to support 

the creation and promote the sustainability of multidisciplinary local and state elder abuse 

networks; (2) provide technical assistance to states and AAAs to promote the widespread 

development, implementation, and sustainability of new or existing local and state elder 

abuse networks; (3) maintain and augment the Promising Practices Clearinghouse; and (4) 

develop analyses of state statutory issues and track federal laws that impact elder abuse 

detection, intervention, and prevention & disseminate that information. The expected 

outcomes are: (1) timely, high quality information to support state and local capacity building 

and innovation; (2) increased professionalization of adult protection and elder abuse service 

networks; and (3) increased knowledge of the extent and causes of elder abuse & skills and 

practices for prevention. 

Page 158 of 281 
Program: National Center on Elder Abuse 

Grant Number: 90AM3146

Project Title: NCEA Co-Manager

Project Period: 09/01/2007 - 06/30/2011

Grantee: 

University of Delaware 

Ctr Comm Research & Service 

210 Hullihen Hall 

Newark, DE 19716 

Contact: 

Judith Trefsger 

Tel. (302) 831-2629 

Email: trefsger@udel.edu

AoA Project Officer: Stephanie Whittier Eliason 

Fiscal 

Year 

Funding 

Amount

FY2009 $174,996

FY2008 $264,998

FY2007 $264,998

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $704,992

Project Abstract: 

National Center on Elder Abuse (NCEA) is an equal partner, multi-disciplinary consortium 

with expertise in elder abuse, neglect, and exploitation. Goals: develop and disseminate 

information for professionals to increase elder abuse, neglect, and exploitation identification 

and reporting and guide programs that protect older people; provide tools to increase 

professional ability of those with daily access to seniors to identify, address, and prevent 

elder abuse, neglect, and exploitation; and promote systems change through development of 

programs, models, and initiatives that measurably decrease elder abuse, neglect, and 

exploitation incidence. As a 4 year NCEA program collaborator, The University of Denver will 

support these goals and increase national awareness of elder abuse and NCEA resources 

and services, and: 1) promote public awareness materials; 2) create a strategic social 

marketing plan and implement select elements; 3) develop and disseminate products to 

enhance public and professional response to elder mistreatment; 4) foster 

coordination/communication among entities addressing elder mistreatment; 5) provide 

effective managerial support to NCEA. Products: online user- searchable, public awareness 

resource inventory; strategic social marketing blueprint; customizable fact sheets, issue 

briefs, and educational/outreach materials; elder abuse listserv maintenance; monthly enewsletters; self-service article/research database. Anticipated outcomes: 1) increased 

national awareness of elder abuse as a social problem requiring action; 2) enhanced 

awareness/use of NCEA resources/ services; 3) improved prevention and intervention 

strategies by practitioner use of NCEA resources/services; and 4) expanded capacity to 

respond to needs of stakeholders through efficient and effectively managed NCEA. 

Page 159 of 281 
Program: National Long-Term Care Ombudsman Resource Center 

Grant Number: 90AM2690

Project Title: National Long-Term Care Ombudsman Resource Center

Project Period: 06/01/2003 - 05/31/2010

Grantee: 

NCCNHR (formerly National Citizen's Coalition for 

 Nursing Home Reform) 

1828 L Street, NW, Suite 801 

Washington, DC 20036 

Contact: 

Sarah Wells 

Tel. (202) 332-2275 

Email: swells@nccnhr.org

AoA Project Officer: Barbara Dieker 

Fiscal 

Year 

Funding 

Amount

FY2009 $547,000

FY2008 $537,444

FY2007 $550,000

FY2006 $550,000

FY2005 $550,000

FY2004 $550,000

FY2003 $550,000

Total $3,834,444

Project Abstract: 

This is a three year cooperative agreement between AoA and the MCCNHR (formerly 

National Citizens' Coalition for Nursing Home Reform). The project goal is to equip the longterm care ombudsmen to carry out their responsibilities under the Older Americans Act as the 

ombudsman. Responsibilities are to: 1) address the problems and complaints of residents of 

long-term care facilities; and 2) represent residents needs and interests. To attain these 

goals, the Center will provide support, training and technical assistance to the ombudsman 

network that daily responds to requests for assistance from facility residents, their families 

and the public. The five objectives are: 1) to direct training and training materials to enhance 

ombudsman skills; 2) to develop specific products and dialogue forums; 3) to conduct daily 

technical assistance, and provide information and referral services on program management, 

program promotion, training, and pertinent national and state long-term care issues; 4) to 

promote the ombudsman program; and 5) to collaborate on efforts to strengthen ombudsman 

involvement in state and national initiatives. The anticipated outcomes include: transmittal of 

current and accurate information to ombudsmen and State Agencies on Aging directors, to 

improve their state training, management, program promotion and advocacy functions; and 

full utilization of the Center's technical assistance and products. Products include a final 

report; training materials; data base enhancements; and conference materials. 

Page 160 of 281 
Program: National Legal Assistance Resource Centers 

Grant Number: 90LA0001

Project Title: National Legal Resource Center 

Project Period: 09/30/2008 - 07/31/2011

Grantee: 

American Bar Association Fund for Justice and Education 

740 15th Street, NW 

Washington, DC 20005 

Contact: 

Holly Robinson 

Tel. (202) 662-8694 

Email: robinsoh@staff.abanet.org

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $185,000

FY2008 $150,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $335,000

Project Abstract: 

The American Bar Association (ABA) Fund for Justice and Education, through the ABA 

Commission on Law and Aging, will develop and disseminate a wide range of information and 

resources on law and aging as the primary activity under funding Option IV: Information and 

Resource Development and Dissemination. The ABA will make informational materials and 

other resources available to professionals and advocates in law and aging including Legal 

Service Corporation, Legal Assistance Developer, pro bono, elder law and consumer law 

attorneys in the public and private sectors; members of the judiciary, law enforcement, aging 

services staff of area agencies on aging and Aging and Disability Resource Centers 

(ADRCs), employees and volunteers of organizations providing legal and aging services to 

older persons (including low income minorities and Native Americans), older consumers, and 

other professionals and advocates within organizations serving older persons. The 

informational materials and other resources on law and aging to be developed and/or 

disseminated will include: research and findings on cutting edge issues of elder law; 

newsletters; fact sheets; issue briefs; self-help manuals; educational and outreach materials; 

results of demonstration projects impacting aging and legal systems; and models of 

innovation in legal and aging service delivery. The project will include administration of a 

professional listserve and the development of content for the National Legal Resource 

Centers website. Anticipated Outcomes are support of the leadership, knowledge, and 

systems capacity of states, legal services providers, area agencies on aging, ADRCs, and 

other organizations serving older persons and enhance the quality, cost effectiveness, and 

accessibility of legal assistance and elder rights programs provided to older persons. 

Page 161 of 281 
Program: National Legal Assistance Resource Centers 

Grant Number: 90LA0002

Project Title: National Elder Rights Training Project

Project Period: 09/30/2008 - 07/31/2011

Grantee: 

National Consumer Law Center, Inc. 

77 Summer Street, 10th Floor 

Boston, MA 02110-1006 

Contact: 

Odette Williamson 

Tel. (617) 542-8010 

Email: owilliamson@nclc.org 

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $156,000

FY2008 $150,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $306,000

Project Abstract: 

National Consumer Law Center will train aging and legal service providers and advocacy 

networks as its primary activity under this grant.. Training and education will be available to 

advocates and professionals in law and aging, including Legal Assistance Developers (LADs) 

Legal Services Corporation attorneys, pro bono attorneys, elder law & consumer law 

attorneys, judiciary members, law enforcement, Area Agencies on Aging and Aging and 

Disability Resource Centers (ADRCs), employees and volunteers of organization.'s providing 

legal or aging services to older persons (including low income minorities and Native 

Americans), older consumers, and other professionals and advocates serving older persons. 

Partnering with the National Senior Citizen's Law Center, training topics include: 1) 

application of laws on long term care in institutional and community-based settings; financing 

health care through Medicare/Medicaid; financing health care through appropriate private pay 

options; guardian/conservator and surrogate decision-making; housing and public benefits; 

Older Americans Act services; predatory mortgage lending; home foreclosure; and vulnerable 

older adult abuse, neglect, self-neglect, and exploitation; 2) application of laws on fraud, 

targeting older consumers, including identity theft, investment fraud, and other financial 

crimes; 3) proper identification/referral of legal and elder abuse issues by aging and legal 

service providers; 4) coordination/integration of legal and aging service delivery systems, inc. 

enhanced linkage of legal services with ADRC's; 5) target and enhance access to legal 

services for older persons in most social & economic need; 6) development of measurable 

outcomes for legal service delivery systems that quantify beneficial impact of legal services 

on older persons; and 7) collaborations to enhance access to quality legal and aging services 

for older persons most in need. Anticipated Outcomes include: enriched quality, and 

improved cost effectiveness and accessibility of legal assistance and elder rights programs 

for older persons. 

Page 162 of 281 
Program: National Legal Assistance Resource Centers 

Grant Number: 90LA0003

Project Title: Building the Legal Capacity of the Aging Network through Case 

Consultations

Project Period: 09/30/2008 - 07/31/2011

Grantee: 

National Senior Citizens Law Center 

1444 Eye Street NW, Suite 1100 

Washington, DC 20005 

Contact: 

Lynda Martin-McCormick 

Tel. (202) 289-6976 x207 

Email: lmm@nsclc.org

Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $206,000

FY2008 $200,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $406,000

Project Abstract: 

The National Senior Citizens Law Center (NSCLC) will provide case consultation as its 

primary activity under this grant. NSCLC will make case consultation available to 

professionals and advocates in law and aging, including: Title III-B legal assistance providers, 

Legal Services Corporation (LSC) providers, Legal Assistance Developmers, elder law and 

consumer law attorneys in the public and private sectors, members of the judiciary, aging 

services staff of area agencies on aging and Aging and Disability Resource Centers 

(ADRCs), and other professionals and advocates within organizations serving older persons. 

NSCLC will provide intensive and tailored advice in the following legal subject matter areas 

(in partnership with the National Consumer Law Center): healthcare benefits, long term care 

in institutional or home and community based settings; Older Americans Act services’ Social 

Security (including SSI and SSDI); Medicare (including Medicare Part D), Medicaid (including 

the financing of home and community based care); housing (including defense against 

foreclosures or evictions); pension benefits; abuse, neglect, and financial exploitation of 

vulnerable elders; consumer fraud/scams; guardianship (including the defense of 

guardianship); Insurance benefits; eebt collection harassment; mortgage fraud and predatory 

lending; and credit repair and counseling. Anticipated Outcomes are that the project will 

support the leadership, knowledge, and systems capacity of states, legal services providers, 

Area Agencies on Aging, ADRCs, and other organizations serving older persons, and 

enhance the quality, cost effectiveness, and accessibility of legal assistance and elder rights 

programs provided to older persons. 

Page 163 of 281 
Program: National Legal Assistance Resource Centers 

Grant Number: 90LA0004

Project Title: National Legal Resource Center: Technical Assistance (TA) for Legal 

and Aging Systems Development

Project Period: 09/30/2008 - 07/31/2011

Grantee: 

Center for Social Gerontology Inc, The 

2307 Shelby Ave 

Ann Arbor, MI 48103-3803 

Contact: 

Penelope A Hommel 

Tel. (734) 665-1126 

Email: phommel@tcsg.org

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $386,554

FY2008 $300,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $686,554

Project Abstract: 

The Center for Social Gerontology (TCSG) provides technical assistance in the design, 

implementation, administration, and evaluation of legal assistance delivery and elder rights 

advocacy systems. The grantee works with states, Area Agencies on Aging, Aging and 

Disability Resource Centers (ADRCs), and legal services providers to improve the delivery of 

legal assistance and elder rights programs, with an emphasis on the implementation of wellintegrated and cost effective legal service delivery systems. TCSG provides technical 

assistance in the following areas: (1) technical assistance to states, Area Agencies on Aging, 

ADRCs, and legal providers involved in the Model Approaches demonstration projects; (2) 

technical assistance to state and local organizations in the development of intake and 

assessment tools; (3) technical assistance to state and local organizations in the 

development of needs assessment tools; (4) technical assistance to state and local 

organizations in the development of systems capacity assessment tools; (5) technical 

assistance to state and local organizations in the development of outreach strategies; (6) 

technical assistance to state and local organizations in the development of outcomes 

measures and reporting/data collection systems; (7) technical assistance to state and local 

organizations in the development of legal service delivery strategic plans; (8) technical 

assistance to state and local organizations in the development of legal service delivery 

standards; (9) technical assistance to AAAs, ADRCs, and local legal service providers, in the 

integration of legal assistance programs into community based service delivery systems; (10) 

technical assistance to state and local agencies and organizations on guardianship issues; 

and (11) technical assistance to state and local organizations on innovative funding sources 

for legal assistance and elder rights programs. 

Page 164 of 281 
Program: National Legal Assistance Resource Centers 

Grant Number: 90LA0006

Project Title: Center for Elder Rights Advocacy (C.E.R.A.)

Project Period: 09/30/2008 - 07/31/2011

Grantee: 

Elder Law of Michigan, Inc. 

3815 W. St. Joseph St., Suite C-200 

Lansing, MI 48917 

Contact: 

Katherine B White 

Tel. (517) 853-2375 

Email: kwhite@elderlawofmi.org

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $295,956

FY2008 $200,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $495,956

Project Abstract: 

The Center for Elder Rights Advocates (CERA) will provide direct technical assistance to 

state and local organizations in the design, implementation, administration, and evaluation of 

senior legal helplines.The Center will work with states, area agencies on aging, Aging and 

Disabilities Resource Centers (ADRCs), and legal services providers to expand and improve 

well integrated and cost effective legal service delivery systems that involve legal helplines 

and interface seamlessly with the aging services network. The project will support the 

leadership, knowledge, and systems capacity of states, legal services providers, area 

agencies on aging, ADRCs, and other organizations serving older persons and enhance the 

quality, cost effectiveness, and accessibility of legal assistance and elder rights programs 

provided to older persons. 

Page 165 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0007

Project Title: Model Approaches to Statewide legal Assistance

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Legal Services Of Northern California 

517 12th Street 

Sacramento, CA 95814 

Contact: 

David Mandel 

Tel. (916) 551-2142 

Email: dmandel@lsnc.net

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $100,000

Project Abstract: 

California's Senior Legal Hotline (SLH), the Department of Aging (CDA), and the Legal Aid 

Association of California (LAAC) will undertake a three-year partnership to better meet the 

legal needs of many more seniors, targeting the most needy among the state's huge, diverse 

population and reducing serious disparities in the existing availability of legal help. The 

project goal is to increase the availability of low-cost, high-quality legal assistance to seniors 

through improved coordination among the hotline, local senior legal services providers, the 

Dept. of Aging, and others. Objectives include conducting assessments of seniors¿ legal 

needs and gaps in the existing delivery system; setting policies that will improve efficiency 

through service coordination and reduced duplication; increasing volunteer participation, 

focusing especially on the State Bar’s Pro Bono Practice Program; harnessing the aging and 

legal services networks and media for targeted outreach; establishing a permanent body of 

stakeholders to provide feedback and advocate for expansion of senior legal services; and 

striving to increase support for sustainability and growth of the hotline and senior legal 

services providers. Proposed project outcomes include better access to senior legal 

services; more pro bono volunteers; and greater efficiency and better results through 

increased coordination and collaboration. Products will include reports from the needs and 

gap assessments, updated standards and reporting protocols, agreements on provider 

coordination, client self-help materials, advocate resources, and outreach plan and materials. 

Page 166 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90AM3171

Project Title: Model Approaches to Statewide Legal Assistance

Project Period: 09/30/2007 - 05/31/2010

Grantee: 

Connecticut Department of Social Services 

Aging Services Division 

25 Sigourney Street 

Hartford, CT 06106 

Contact: 

Marie Peck-Llewellyn 

Tel. (860) 424-5244

Email: marie.peck.llewellyn@ct.gov 

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $100,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $300,000

Project Abstract: 

Connecticut's (CT) Model Approaches project is a collaboration between the State Unit on 

Aging and CT's legal service Consumer Law Project (CLPE). The goal is to create a 

comprehensive legal assistance delivery system for seniors by fully integrating CT's legal 

helpline with all the components of the State's Title III-B (Older Americans Act) and other 

legal and aging service providers. Its objectives are to develop a comprehensive statewide 

system of low cost legal services, focusing on seniors with consumer problems; 2) to 

strengthen CT's system for protecting senior's rights and financial security; and 3) to increase 

access to services for underserved populations. Project outcomes are: 1) a developed, 

statewide system of low cost legal services focusing on seniors with consumer problems; 2) a 

strengthened CT system for protecting senior rights and financial security; 3) increased 

access to services, particularly for seniors traditionally underserved due to geographic, 

cultural, language, and/or physical isolation; and 4) increased legal assistance and 

information resources. 

Page 167 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90AM3172

Project Title: Model Approaches to Statewide Legal Assistance

Project Period: 09/30/2007 - 05/31/2010

Grantee: 

Florida Department of Elder Affairs 

4040 Esplanade Way, Suite 315 

Tallahassee, FL 32399-7000 

Contact: 

Jay Breeze 

Tel. (850) 414-2338 

Email: Breezej@elderaffairs.org

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $100,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $300,000

Project Abstract: 

The goal of Florida's AoA Model Approaches project is to develop a coordinated system of 

high quality, accessible, and targeted legal services for Florida's seniors. Project objectives 

are: 1) ensure the ability of the Florida Senior Legal Helpline (Helpline) and statewide system 

of Aging Resource Centers (ADRCs) to provide a convenient point of access to a coordinated 

legal services delivery system; 2) improve the quality of referrals to legal services providers 

through development of a follow-up system; 3) promote and enhance the Helpline and Title 

IIIB legal services programs by coordinating with a broader aging services delivery system; 

4) integrate the Helpline and Title IIIB legal services with the pro bono legal services 

network; 5) integrate the Helpline and the Title IIIB legal services with various self-help 

resources; 6) develop statewide standards to ensure consistent levels of quality among & 

between legal services providers; 7) establish a meaningful statewide reporting system to 

capture data needed to improve efficiency & maximize resources; and 8) target services 

appropriately to those most in need. Anticipated outcomes are improved access to, and 

quality of legal services for elders achieved by the following measurable results: 1) a 10 

percent increase in the number of elderly served through the Helpline and Title IIIB legal 

services; 2) a 25 percent increase in the number of elderly clients who felt they were 

appropriately referred and served through the legal services delivery system, including the 

pro bono network; 3) a 15 percent increase in the number of FL elders who use self-help 

resources to take independent action to advocate for themselves, thereby reducing need for 

direct legal services; and 4) consistent levels of satisfaction and levels of service ensured 

among seniors in need of legal services; and legal services that will certainly reach those 

most in need or otherwise disadvantaged. 

Page 168 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90AM3169

Project Title: Project Senior Connect: Linking Legal Resources for Older Kentuckians

Project Period: 09/30/2007 - 05/31/2010

Grantee: 

Kentucky Cabinet for Health and Family Services 

Department for Aging and Independent Living 

275 East Main Street, 3 W-F 

Frankfort, KY 40621 

Contact: 

Phyllis Culp 

Tel. (502) 564-6930 

Email: phyllis.culp@ky.gov

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $100,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $300,000

Project Abstract: 

The goal of Kentucky's (KT) Model Approaches project is to strengthen the relationship 

between the legal services provider and older Kentuckians, enabling older Kentuckians in 

underserved areas of the state to better receive needed legal services. Objectives: 1) to 

improve the collaborations between legal service providers, AAAs, and Aging and Disability 

Resource Markets (ADRM); 2) to develop a blueprint for mapping what the consumers need 

and what the providers can offer; 3) to enhance consumer awareness, through education, 

training, list serve, and website information, of legal assistance available through both public 

and private attorneys willing to provide low cost or pro bono services; and 4) complete a 

survey of existing legal assistance sources in both the public and private sector, with the 

information included in the ADRM web directory of services. Outcomes are: 1) KT seniors 

will have access to a wider array of comprehensive and integrated services and face fewer 

barriers to obtaining legal services; 2) KT seniors will receive high quality legal assistance 

based on the results of the data collected from surveys of both consumers and providers; 3) 

more KT seniors will have access to pro bono legal services by private attorneys referred by 

AAAs, ADRMs or a legal aid office; 4) KT seniors in isolated rural areas will have greater 

access to legal assistance; and 5) more KT seniors will receive high quality legal services 

based on the results of empirical data. 

Page 169 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0009

Project Title: Model Approaches to Statewide Legal Assistance Systems

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Lousiana Governor's Office of Elderly Affairs 

412 North 4th Street, 3rd Floor 

Baton Rouge, LA 70802 

Contact: 

Jane A Thomas 

Tel. (225) 342-7100 

Email: janeathomas@msn.com

AoA Project Director: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $99,654

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $99,654

Project Abstract: 

The goal of Louisiana's Model Approaches project is to increase access to legal services for 

seniors with the greatest social and economic need, utilizing the helpline and other legal 

services. The Legal Assistance Developer (Governor's Office of Elderly Affairs) will 

collaborate with the Louisiana Civil Justice Center (the helpline) and the legal service 

providers in Louisiana to develop a coordinated system of legal services to the 60 and older 

population. Project objectives include conducting a statewide legal needs assessment of 

seniors; providing a statewide toll-free helpline to seniors; developing packets and 

downloadable forms such as healthcare powers of attorney and living wills; referring seniors 

who need direct representation to legal service providers; completing a statewide reporting 

form for III-B providers to report quarterly; and completing development of standards for 

targeting Louisiana's most vulnerable seniors. The expected outcomes are a statewide fully 

integrated and coordinated legal delivery system targeted to those seniors in greatest need 

and providing increased access to legal services' a statewide senior legal helpline and a 

finalized reporting form for III-B providers; and a meaningful reporting form for helpline data. 

The products expected are a completed needs assessment, a Title III-B reporting form, 

establishment of standards, senior-friendly packets, and Aging Disability and Resource 

Centers linkages to websites and toll free phone numbers. 

Page 170 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0006

Project Title: Model Approaches to Statewide Legal Assistance Systems

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Legal Services for the Elderly Inc. 

5 Wabon Street 

Augusta, ME 04330 

Contact: 

Jaye Martin

Tel. (207) 620-3103 

Email: jmartin@mainelse.org

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $102,058

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $102,058

Project Abstract: 

The goal of Maine’s Model Approaches project is to increase the number of elders in Maine 

who seek and obtain ready access to high-quality legal assistance when their basic human 

needs are at stake, through the implementation of sustainable, low-cost delivery methods. 

Collaborative partners include Maine’s Office of Elder Services, Legal Services for the 

Elderly, Inc., five Area Agencies on Aging, the Long Term Care Ombudsman, Attorney 

General, private bar, and the University of Maine’s Law School, Dept. of Social Work, and 

Center on Aging. The objectives are to establish a collaborative leadership structure for elder 

legal service in Maine; increase the capacity of the system through use of collaborative pro 

bono mechanisms; and increase access to legal services by underserved groups of elders. 

The expected outcomes are participation by key agencies in a new leadership structure; 

enhanced coordination of services; adoption of a cooperative statewide outreach plan 

targeting hard-to-reach groups; and an increase in the number of socially or economically 

disadvantaged elders receiving services, particularly minorities and non-English speakers. 

The products include a needs assessment with a focus on hard-to-reach groups, a replicable 

interdisciplinary elder rights leadership structure, and collaborative low-cost approaches for 

expanding the capacity of a statewide legal services delivery system. 

Page 171 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90AM3173

Project Title: Coordinated Legal Assistance in Michigan for Seniors (CLAIMS)

Project Period: 09/30/2007 - 05/31/2010

Grantee: 

Michigan Department of Community Health 

Office of Services to the Aging 

Chandler Building Plaza 

300 E. Michigan Avenue 

Lansing, MI 48933 

Contact: 

Lynne W McCollum 

Tel. (517) 373-7692 

Email: weinsteinl@mich.gov

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $115,043

FY2008 $115,043

FY2007 $115,043

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $345,129

Project Abstract: 

The Michigan Office of Services to the Aging (OSA) proposes the Coordinated Legal 

Assistance in Michigan for Seniors (CLAIMS) Project. The overall goal is to coordinate and 

integrate current programs and services into a seamless web of legal and aging services to 

keep older adults economically secure and independent. The cornerstone of the service 

delivery model will be an updated Legal Hotline for Michigan Seniors (LHMS), augmented 

with resources from the private bar, local law schools, and lay advocates. Objectives are: 1) 

convene an Elder Rights Coalition (ERC) to coordinate services between aging, legal & 

private bar resources, prioritizing legal services around elder abuse, financial exploitation, 

predatory lending, tax foreclosure, bankruptcy, identity theft, consumer fraud, unclaimed 

public benefits and other identified needs. The Elder Rights Coalition partners, led by OSA, 

include: the LHMS, Title IIIB and LSC legal services, Area Agencies on Aging, the Long Term 

Care Ombudsman Program, Adult Protective Services, the State Health Insurance 

Counseling Program (aka MMAP), Michigan Poverty Law Program, Legal Services 

Association of Michigan, Michigan State Bar Foundation, and other key legal & aging 

advocates; 2) conduct a senior citizen legal needs assessment; 3) modify Title IIIB service 

delivery standards and the reporting system to promote outcomes-based service delivery; 4) 

craft and implement an integrated service delivery plan; and 5) reshape the LHMS from a 

call-back to a direct answer system. Products include: 1) a comprehensive state plan for 

integrated legal and aging services; 2) a senior citizen legal needs survey; and 3) a 

statewide outcome-based reporting. Anticipated Outcomes are: 1) improvements in the 

financial well-being of clients; 2) increased access to legal information and services for older 

adults; and 3) implementation of an integrated and accountable delivery system that serves 

an additional 4,000 older adults, a 33% increase. 

Page 172 of 281 
Program: Senior Legal Services-Access Enhancement

Grant Number: 90SL0004

Project Title: Model Approaches to Statewide Legal Assistance Systems

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Missouri Department of Health and Senior Services 

920 Wildwood Drive, P.O. Box 570 

Jefferson City, MO 65102 

Contact: 

Marta J Fontaine 

Tel. (573) 526-3246 

marta.fontaine@dhss.mo.gov

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $97,914

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $97,914

Project Abstract: 

The Missouri Department of Health and Senior Services is coordinating and enhancing 

existing limited and fragmented senior legal services by instituting a statewide toll-free phone 

line in conjunction with an online helpline. The goal is an integrated system of senior legal 

services that any consumer, senior or caregiver -- urban or rural, English or non-English 

speaking -- can access for information on legal issues and referrals to Title III-B and Legal 

Services Corporation funded services, or private attorneys providing pro bono or low-cost 

services involving critical needs. The target population includes rural and minority seniors, 

foreign-language speaking immigrants (primarily Spanish, Bosnian and Vietnamese), inhome service recipient populations assessed by Adult Protective Services and/or served by 

Medicaid waiver programs, and nursing facility residents. Objectives include conduct of a 

needs assessment to guide establishment of a toll free number paired with an online helpline 

to link seniors and their caregivers to legal information and services specific to their local 

area; an increase in the amount of pro bono and low-cost hours of private attorneys for senior 

legal services; and increased access to computers at community agencies, including senior 

centers and meal sites. Expected outcomes include increased awareness of senior legal 

issues and services and the integration of existing and additional services, resulting in better 

informed decisions on legal issues for Missouri seniors. The final products are to be a 

statewide senior legal phone helpline and companion online helpline, standard reporting and 

measurement tools, and additional legal service hours provided by Missouri Bar Association 

members. 

Page 173 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0001

Project Title: Model Approaches to Statewide - Legal Assistance System

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Legal Aid of Nebraska 

1904 Farnam Street, Suite 500 

Omaha, NE 68102 

Contact: 

Selina Perry 

Tel. (402) 348-1069 

Email: sperry@legalaidofnebraska.com

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $100,000

Project Abstract: 

The project goal is to ensure that elders with greatest social or economic need have access 

to quality legal assistance through an integrated service delivery system. The “Nebraska 

Model” proposes to benefit the aging and legal services field of knowledge by developing a 

model addressing the unique needs of a large, predominantly rural state, with the rapidly 

increasing number of elders confronting geographic isolation as a chief barrier to access to 

legal services. Objectives are to foster linkages between Area Agencies on Aging and Legal 

Aid, and among legal aid providers, and the broader aging services system; establish a 

statewide system to serve the most vulnerable, underserved elders; integrate low-cost 

service delivery mechanisms with Title III-B legal services and the broader aging services 

delivery system; promote awareness of legal services available; and develop a statewide 

accountability system. Expected outcomes include continued provision of legal services via 

ElderAccessLine (helpine) to 1200 clients; satisfaction ratings of at least 85%; legal services 

for minority elder populations that are over 50% low-income, over 1/3 geographically isolated, 

ESL or LEP, 15% Native Americans, African Americans, Hispanic or other minorities; 

measurable increase in calls from elders to the ElderAccessLine, with a measurable 

decrease in cost per person. Products will include a legal services inventory, culturally 

competent toolkit, marketing plan, outcomes-based service standards, and sustainability 

plan. 

Page 174 of 281 
Program: Senior Legal Services-Access Enhancement 

Grant Number: 90AM3164

Project Title: Center Legal Assistance Services for Seniors

Project Period: 09/30/2007 - 05/31/2010

Grantee: 

Nevada Department of Health and Human Services 

Division for Aging Services 

445 Apple Street, #104 

Reno, NV 89502 

Contact: 

Sally Ramm 

Tel. (775) 688-2964 253 

Email: sramm@aging.nv.gov

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $100,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $300,000

Project Abstract: 

Nevada Division for Aging Services (DAS) will partner with Nevada Legal Services, Inc. 

(NLS) and Washoe County Senior Law Project (WCSLP) to pilot a project aimed at 

increasing the access of seniors to civil legal services throughout Nevada (including the city 

of Las Vegas in year two). The innovation of this model is to use Central Legal Assistance 

System for Seniors (CLASS), a statewide telephone system, as a "single point of entry" for 

the senior population through: 1) direct legal advice to callers while on the phone; 2) intake 

and immediate connection for further legal representation by NLS, WCSLP, other legal 

services, State Bar Lawyers Referral and Information Services; 3) referral to other resources; 

and 4) cooperation with senior centers statewide, providing their clients with legal assistance 

using Project NEON (Nevada Elders on the Net) computers. The intended outcome of the 

project is increased quantity and quality of civil legal services for seniors to improve the 

independence and security of their lives. Measures to be tracked are: 1) the number of 

callers; 2) the level of services provided; 3) the breadth of legal information on 

NevadaLawHelp.org addressing those problems identified in the needs assessment; and 4) 

personal feedback from callers and senior service providers. 

Page 175 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90AM3168

Project Title: New Hampshire Senior Legal Access Network

Project Period: 09/30/2007 - 05/31/2010

Grantee: 

New Hampshire Department of Health and Human Services 

Bureau of Elderly and Adult Services 

129 Pleasant Street 

Concord, NH 03301-3857 

Contact: 

Mary J McGuire 

Tel. (603) 271-4725 

Email: mmcguire@dhhs.state.nh.us

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $97,582

FY2008 $97,582

FY2007 $97,582

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $292,746

Project Abstract: 

The goal of the New Hampshire Model Approaches project is to increase access to low-cost 

legal services for seniors by developing a fully integrated, coordinated system that 

incorporates pro bono and reduced fee legal services with the services offered by Title III-B 

legal services and senior legal helpline providers to ensure that socially and economically 

disadvantaged seniors in NH receive the legal help they need. Project objectives: 1) to 

increase access to the helpline and to increase the number of cases handled for extended 

representation by Title IIIB and pro bono programs; 2) to meet the legal needs of seniors 

subject to financial exploitation; 3) to enhance the presence and integration of the helpline 

and Pro Bono program in aging and disability resource centers; 4) to conduct needs 

assessment and develop a statewide legal service delivery plan; 5) to evaluate the impact of 

proposed interventions; 6) to disseminate project and evaluation information. Outcomes: 1) 

Increased number of referrals to SCLP Advice Line by ServiceLink Resource Center 2) 

Increased number of referrals to Pro Bono referral program by SCLP Advice Line and a 

broad range of legal issues 3) Increased access to affordable legal services for seniors 

subject to financial exploitation 4) Greater awareness of seniors’ legal needs and most 

effective outreach methods. Product: 1) Financial exploitation and other pamphlets 2) 

question and answer manual 3) articles for publication 4) Needs assessment report and, 5) 

statewide legal service delivery plan. 

Page 176 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0008

Project Title: Model Approaches to Statewide Legal Services

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Legal Aid of North Carolina 

224 South Dawson Street 

Raleigh, NC 27601 

Contact: 

Angeleigh Dorsey 

Tel. 828-236-1080 x3106 

Email: angied@legalaidnc.org

AoA Project Officer: Valerie Soroka 

FY2009 $93,954

Fiscal 

Year 

Funding 

Amount

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $93,954

Project Abstract: 

Legal Aid of North Carolina (LANC), in partnership with the North Carolina Division of Aging 

and Adult Services (DAAS), and Campbell University School of Law (Campbell), proposes 

development of an integrated, coordinated statewide legal assistance delivery system for lowincome seniors, with particular emphasis upon isolated, underserved, rural and minority 

seniors. Objectives are evaluation of the current legal assistance delivery system; increased 

access to low-cost, quality legal assistance to seniors in the greatest need through expansion 

of the pilot LANC Senior Helpline into a statewide helpline serving all 100 counties; and 

establishment by Campbell of a senior law clinic and statewide conference for stakeholders 

to develop pro se materials and pro bono services as determined by a senior legal needs 

survey. The outcome will be sustainable, integrated, and coordinated access to low-cost 

legal assistance. The expected products from this project are: the first North Carolina legal 

needs assessment, a new senior law clinic in the state capital, a statewide senior legal 

helpline, and a final report for the Administration on Aging. 

Page 177 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0003

Project Title: Model Approaches to Statewide Legal Assistance Systems

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Pro Seniors, Inc. 

7162 Reading Road Suite 1150 

Cincinnati, OH 45237 

Contact: 

Rhonda Y Moore 

Tel. (513) 458-5506 

Email: rmoore@proseniors.org

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $100,000

Project Abstract: 

Pro Seniors, Inc., which has housed the Ohio Senior Legal Hotline since 1990, is supporting 

a project with the Ohio Attorney General, Department of Aging, Area Agencies on Aging 

(AAAs), and legal services programs, to develop a more integrated and coordinated senior 

legal services delivery system in Ohio to better meet the legal needs of the state’s large, 

growing, and in many cases, disabled and vulnerable senor population. Project objectives 

include: 1) enhancing and promoting access to legal services for Ohio seniors by 

strengthening the capacity of the helpline; 2) conducting an analysis of the current senior 

legal service delivery system; 3) fostering increased collaboration and coordination between 

legal services providers, including Title III-B providers, the helpline, pro bono providers, and 

the broader aging service delivery network, including AAAs; and 4) increasing legal services 

to underserved populations. Outcomes include 1) increasing helpline clients by 10%; 2) 

increasing by 10% each, the number of low-income, minority and rural helpline clients; 3) 

increasing effective helpline referrals to legal aid programs by 20%; and 4) increasing by 5% 

each, the percentage of low-income, minority and rural Title III-B clients. Products will 

include a quarterly elder law newsletter, a statewide elder law task force, an Ohio elder law 

resource website and listserv, and a matrix for helpline referrals to Title III-B programs and 

data on stakeholder participation, including survey results. 

Page 178 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90AM3170

Project Title: Model Approach to Pennsylvania's Legal Assistance System for Seniors

Project Period: 09/30/2007 - 05/31/2010

Grantee: 

Pennsylvania Department of Aging 

555 Walnut Street 

Harrisburg, PA 17101-1919 

Contact: 

Anne Kapoor 

Tel. (717) 783-0509 

Email: akapoor@state.pa.us

AoA Project Officer: Omar Valverde 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $100,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $300,000

Project Abstract: 

The Pennsylvania Department of Aging (PDA), in partnership with SeniorLAW Center and its 

Pennsylvania HelpLine, with this grant will improve the quality and quantity of legal services 

for Pennsylvania seniors. The goal of the three-year project is to create an integrated 

delivery system of legal services for seniors that will reduce the disparity in services 

statewide and strive to ensure that older Pennsylvanians, particularly underserved language, 

racial and ethnic minorities, the homebound, persons with disabilities and rural and lowincome populations, receive the legal assistance they need. The objectives are: 1) to 

strengthen Pennsylvania's current system of legal services for seniors by enhancing the 

continuity of services offered by Pennsylvania's Area Agencies on Aging and identifying 

unmet legal needs; 2) to develop a plan to maximize existing resources and develop new 

cost-effective legal service mechanisms to meet those needs; 3) to expand the SeniorLAW 

HelpLine to provide legal counseling, referrals and limited advocacy to increased numbers of 

seniors and their families; 4) to educate seniors, their caregivers, and aging services 

providers on seniors' legal rights, proactive protection, and accessing resources; and 5) to 

maximize resources and reach more seniors by creating pro bono and other legal resources. 

Expected outcomes include: 1) improved access for seniors, particularly underserved 

populations; 2) expanded legal services and resources; 3) strengthened and newly-created 

relationships with community, faith-based, cultural and other organizations that serve 

vulnerable senior populations; and 4) increased awareness by seniors, their families and 

service providers of seniors' legal rights and protections, and where they can turn for help. 

Page 179 of 281 
Program: Senior Legal Services-Access Enhancement 

Grant Number: 90SL0011

Project Title: Model Approaches to Statewide - Assistance Systems

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Rhode Island Legal Services, Inc. 

56 Pine Street, Suite 400 

Providence, RI 02903 

Contact: 

Robert M Barge 

Tel. (401) 274-2652 121 

Email: rbarge@rils.org

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $100,000

Project Abstract: 

Rhode Island Legal Services, Inc. proposes to plan and implement a three-year program to 

increase access to legal assistance for seniors in Rhode Island. The plan seeks to develop a 

fully integrated, coordinated, low-cost state legal assistance network: the Rhode Island 

Senior Legal Assistance Network (RISLAN). RISLAN will incorporate legal services 

providers, and the services of Rhode Island's Title III-B legal services provider, with Rhode 

Island's Aging and Disability Resource Center (the POINT), to ensure that all socially and 

economically disadvantaged seniors obtain the legal help they need. Objectives include 

conducting a legal needs assessment of senior Rhode Islanders; collaborating with all 

stakeholders to build a network of legal services providers and pro bono programs; and 

increasing coordinated access and availability of legal assistance at senior centers. 

Outcomes include greater numbers of seniors experiencing increased security from eviction, 

foreclosure, or financial exploitation, and seniors' lives improved by elimination of legal 

problems. Expected products are a statewide senior legal assistance plan, consumer, tax, 

and financial exploitation pamphlets, an electronic desk manual listing "frequently asked 

questions" of a legal nature, and an evaluation report. 

Page 180 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0005

Project Title: Model Approaches to statewide Legal Assistance Systems

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

South Carolina Lieutenant Governor's Office on Aging 

1301 Gervais St., Suite 200 

Richland, SC 29201 

Contact: 

Catherine S Angus 

Tel. (803) 734-9983 

Email: cangus@aging.sc.gov

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $100,000

Project Abstract: 

The Lieutenant Governor’s Office on Aging will partner with South Carolina Legal Services 

(SCLS) and ten Area Agencies on Aging (AAAs) and Aging and Disability Resource Centers 

(ADRCs), to increase, improve, and enhance seniors’ access to legal services throughout 

South Carolina. Project goals are to increase visibility and accessibility of legal services for 

seniors, as well as the number of seniors receiving legal services; conduct a needs 

assessment to identify specific populations and services needed; develop and implement 

educational initiatives for the target population (including rural and low-income seniors and 

immigrant populations); and support and expand SCLS’s intake line to provide telephone 

assistance or appropriate referral for Title III-B assistance. Planned outcomes include 

improved access to expanded legal services; improved quality of life and independence for 

seniors; development of a sustainable system for access to those services with ongoing 

collaboration and participation by stakeholders after the project’s end; and a system of 

ongoing data collection and assessment. Products will include an updated Guide to Laws 

and Programs Affecting Seniors, a DVD for mass distribution on futures planning/estates and 

the probate process, a referral system to legal assistance with data collection, and final grant 

reporting on outcomes including lessons learned. 

Page 181 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0010

Project Title: Model Approaches to Senior Legal Services

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Utah Legal Services Inc 

205 North 400 West 

Salt Lake City, Ut 84103 

Contact: 

Tanta Lisa Clayton 

Tel. 801-924-3390 

Email: tclayton@utahlegalservices.org

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $100,000

Project Abstract: 

The goal of Utah's project is to develop a well coordinated and integrated system of efficient, 

accessible, and targeted legal services for Utah seniors. The objectives are to: 1) create a 

statewide senior legal helpline; 2) conduct a legal needs assessment; 3) convene a Utah 

Elder Law Coalition to develop a comprehensive and integrated statewide legal service 

delivery plan; 4) target services appropriately to those most in need; and 5) expand, enhance 

and coordinate self-help delivery mechanisms. Measurable project outcomes include: 1) 

increase by 20% the number of seniors receiving services for high priority cases; 2) increase 

by 30% the number of Utah's targeted senior population (low-income, homebound, rural, 

minority, and limited English-speaking) that will have access to legal services; and 3) 

increase by 15% the awareness of available legal services and ability to identify legal issues, 

by the broader community-based aging network. The proposed products include a legal 

needs assessment, comprehensive and integrated statewide delivery plan, written self-help 

materials, video files, podcast audio files, Spanish language presentation materials, a "How 

to Manual," summary journal articles, and project methodology and lessons learned 

presentations. 

Page 182 of 281 
Program: Senior Legal Services - Access Enhancement 

Grant Number: 90SL0002

Project Title: Model Approaches to Statewide Legal Assistance Systems

Project Period: 09/01/2009 - 08/31/2012

Grantee: 

Vermont Legal Aid, Inc. 

PO Box 1367 

264 North Winooski Avenue 

Burlington, VT 05402 

Contact: 

Michael Benvenuto 

Tel. (802) 863-5620 

mbenvenuto@vtlegalaid.org

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $100,000

Project Abstract: 

Vermont Legal Aid, Inc. is evaluating, coordinating and expanding the delivery of legal 

services to seniors throughout the State of Vermont. The goal of the project is to improve the 

lives of Vermont seniors by providing greater access to comprehensive and coordinated legal 

services in all areas of the State. This will be accomplished by establishing a coordinated 

service delivery system for seniors statewide, including the piloting of a helpline for seniors 

focused on consumer laws problems. Target populations will include rural seniors 

(comprising approximately 82% of the senior population), with particular emphasis upon 

homebound seniors, immigrant, and limited-English-speaking seniors. he expected outcome 

of this project is a coordinated system for the intake, referral, and delivery of legal services 

that increases access to services for seniors statewide. The expected products from this 

project are: 1) a legal needs study for the State of Vermont; 2) a comprehensive and 

integrated intake and referral system for seniors; and 3) a pilot project of a statewide helpline 

focused on consumer law issues for seniors, which can serve as a template for integrating 

helpline services into a full-service organization. 

Page 183 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0027

Project Title: Senior Medicare Patrol Program Grant

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Alabama Department of Senior Services 

770 Washington Ave., Suite 470 

Montgomery, AL 36130 

Contact: 

Robyn James 

Tel. (334) 242-5743 

Email: Robyn.James@ADSS.Alabama.gov

AoA Project Officer: Dorothy Smith 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year of a three-year Senior Medicare Patrol (SMP) project grant to the 

Alabama Deptment of Senior Services (ADSS) to support an SMP program, in collaboration 

with the 13 Area Agencies on Aging. The goal of the project is to educate beneficiaries and 

providers to identify errors in Medicare billing to combat healthcare waste, fraud and abuse. 

The objectives are to: educate beneficiaries and providers on how to identify errors in 

Medicare billing; provide publications to educate beneficiaries on identifying potential fraud 

and abuse; publicize a statewide 1-800 number for assistance; establish an effective 

reporting mechanism to track outreach events, as well as potential fraud and abuse cases; 

build partnerships with healthcare providers, Medicare carriers and fiscal intermediaries; and 

recruit & train volunteers. Expected outcomes: more rural, low-income, and non-English 

speaking aging consumers educated and aware of Medicare waste, fraud and abuse, with 

contacts/assistance should they suspect a problem; measurable outcomes with postevaluations at seminars will show a marked increase in the awareness and detection of fraud 

and abuse positively affecting target areas; increased publicity on waste, fraud and abuse will 

be available statewide; volunteers will be recruited and trained in rural and underserved 

areas; and healthcare providers will begin to be trained to identify healthcare waste, fraud 

and abuse. Products will include: website with statewide resources; reference materials on 

waste, fraud and abuse; and community-based educational programs designed to provide 

tips on preventing and identifying waste, fraud and abuse, emphasizing the importance of 

protecting one's personal information; and required reports, including evaluation results. 

Page 184 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2955

Project Title: Senior Medicare Patrol

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Alaska Department of Health and Social Services 

Division of Senior and Disability Services 

 3601 C Street, Suite 310 

Anchorage, AK 99503 

Contact:

Jeanne M Larson 

Tel. (907) 269-3669 

Email: jeanne.larson@alaska.gov

AoA Project Officer: Terry Duffin 

Fiscal 

Year 

Funding 

Amount

FY2009 $149,996

FY2008 $149,996

FY2007 $149,482

FY2006 $149,482

FY2005 $149,482

FY2004 $

FY2003 $

Total $748,438

Project Abstract: 

This is a continuation of the Alaska SMP Project to recruit and train local senior citizens in 

each group of communities, to educate Medicare beneficiaries and their families about the 

importance of recognizing and reporting Medicare and Medicaid fraud, error and abuse. The 

goal of the project is to implement a statewide plan that empowers senior volunteers to assist 

older persons to become educated about their health care expenditures under Medicare in 

order to prevent error, fraud, abuse and waste. The objective is to reach vulnerable, isolated 

and limited English speaking Medicare beneficiaries through partnership with the American 

Association of Retired Persons (AARP), Older Persons Action Group (OPAG), Alaska 

Native Tribal Health Consortium (ANTHC), and the Anchorage Senior Center and other local 

senior centers throughout the State of Alaska. Expected outcomes are: increased number of 

volunteer counselors; increased awareness regarding healthcare error, fraud, abuse and 

waste; increased number of complaints by beneficiaries or partner agencies; and increased 

savings attributable to the project. Products will include voice enhanced CD-ROMs; 

PowerPoint training materials; video teleconferences; brochures; and reports, as required. 

Page 185 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2931

Project Title: Senior Medicare Patrol Projects

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Arkansas Department of Health and Human Services 

Aging and Adult Services 

P.O. Box 1437, Slot S530 

Little Rock, AR 72203-1437 

Contact: 

Herb Sanderson 

Tel. (501) 682-2441 

herb.sanderson@arkansas.gov

AoA Project Officer: Lisa Theirl 

FY2009 $180,000

Fiscal 

Year 

Funding 

Amount

FY2008 $180,000

FY2007 $179,530

FY2006 $179,530

FY2005 $179,533

FY2004 $

FY2003 $

Total $898,593

Project Abstract: 

This is a continuation of the Arkansas Division of Aging and Adult Services to administer the 

Senior Medicare Patrol (SMP) project in collaboration with regional partners committed to 

consumer education and the protection of the aging and disabled populations of the state. 

The goal of the project is to empower senior beneficiaries to identify, prevent, and report 

healthcare fraud, waste and abuse. The target populations are the vulnerable and 

underserved, such as those impacted by low literacy, low income, cultural barriers and 

geographic isolation. The objectives are to: train partners and volunteers to present the 

Arkansas SMP (ASMP) message; educate and empower seniors to prevent healthcare fraud; 

collaborate with the aging, minority and disability communities to reach underserved 

populations regarding healthcare fraud and health literacy; package the ASMP healthcare 

fraud and abuse message and health literacy message together with information the public 

wants and needs; and share all educational materials developed with seniors across the state 

and with other SMPs. The expected outcomes are: increased beneficiary awareness of 

healthcare fraud and abuse, as indicated in surveys returned after group sessions; increased 

effectiveness of activities to reach minority, rural, low-literate and non-English speaking 

populations; increased effectiveness of ASMP volunteers to educate beneficiaries in the 

areas of Medicare Basics (Parts A, B, C, & D); healthcare fraud, efforts, and abuse; volunteer 

reporting; low-income subsidies; and Medicare Rights. Products will include brochures, 

training modules, "tip sheets", and reports as required. 

Page 186 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2954

Project Title: Ferret Out Fraud - Senior Medicare Patrol Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Arizona Department of Economic Security 

Aging and Adult Administration 

1789 West Jefferson, 950A 

Phoenix, AZ 85007 

Contact: 

Melanie Starns 

Tel. (602) 542-6572 

Email: mstarns@azdes.gov

AoA Project Officer: Dennis Dudley 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $159,943

FY2006 $159,943

FY2005 $159,943

FY2004 $

FY2003 $

Total $839,829

Project Abstract: 

This is a continuation of the Arizona Department of Economic Security, Aging & Adult 

Administration, Arizona Senior Medicare Patrol Project (ASMPP) to address the need to 

educate and disseminate information about Medicare/Medicaid error, fraud, and abuse in the 

health care system. The goals of the program are to build the capacity of the ASMPP to 

reach beneficiaries with special emphasis on expanding culturally sensitive and linguistically 

appropriate materials for beneficiaries and developing processes that will result in program 

improvement. The expected outcomes are: beneficiaries, including those who are culturally 

diverse, will have increased awareness and knowledge in order to detect and prevent 

Medicare/Medicaid error, fraud and abuse; Area Agency on Aging (AAA) staff and volunteers 

will have increased knowledge to educate beneficiaries, their families and other professionals 

on Medicare/Medicaid error, fraud and abuse; AAA staff will have an increased 

understanding of tools to improve the ASMPP; and Arizona Beneficiaries Coalition and 

Arizona Fraud Prevention Coalition members and other organizations will have increased 

opportunities to partner in efforts to educate and prevent Medicare/Medicaid error, fraud, and 

abuse. Products of this project include: required reports, evaluation materials, and Spanish 

brochures. 

Page 187 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0020

Project Title: California Senior Medicare Patrol (SMP)

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

California Health Advocates 

5380 Elvas Ave., Suite 104 

Sacramento, CA 95819 

Contact: 

Julie R Schoen 

Tel. (714) 560-0309 

Email: jschoen@cahealthadvocates.org

AoA Project Officer: Sau Wo Lam 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to the California Health Advocates 

(CHA). The CHA Senior Medicare Patrol (SMP) has statewide coverage and a national 

presence. The goals are to: collaborate with already established creditable organizations; 

utilize a statewide 800 number in partnership with the State Health Insurance nformation 

Program (SHIP); refine relationships with other agencies to improve case tracking, 

communication and recoupment outcomes; participate in state/regional organizations; partner 

with California Medicare Coalition, Latino Health Access, Asian Pacific Islander Coalition, and 

other aging groups; provide necessary reporting forms and training materials via Internet; 

identify high profile cases that will substantiate credibility and value of the SMPs nationwide; 

maintain and improve our cohesive case tracking system; improve the efficiency of the SMP 

program, while increasing results for both operational and quality measures; reach 

underserved populations by hiring staff with bi-lingual capabilities and proven track records in 

outreach and service; and be recognized collectively as a national program with the other 

Administration on Aging (AoA) SMPs and the National Technical Resource Center. Expected 

measurable outcomes: provide a minimum of 12 training sessions per year; ensure a 

volunteer base of 800 statewide; provide yearly conferences on fraud & abuse issues for 

managers; report a minimum of 24 cases of fraud annually; increase savings to Medicare 

from $1.5 million to $3.0 million; increase numbers of elderly educated from current average 

of 10,000 to 12,000 per year; and target training and education to isolated and hard-to-reach 

populations. Products will include: a newsletter; fact sheets; placemats; website; brochures; 

flyer for hard-to-reach populations; and a final report. 

Page 188 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2951

Project Title: Anti-Fraud Education Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

State of Colorado 

Department of Regulatory Agencies 

1560 Broadway Street, Suite 850 

Denver, CO 80202 

Contact: 

Liz Tredennick 

Tel. (303) 894-7552 

liz.tredennick@dora.state.co.us

AoA Project Officer: Courtney Hoskins 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $167,591

FY2006 $167,591

FY2005 $167,591

FY2004 $

FY2003 $

Total $862,773

Project Abstract: 

This is a continuation of the Colorado Division of Insurance project, through its Senior Health 

Insurance Information Program (SHIP), to support the Senior Medicare Patrol (SMP) project, 

in collaboration with 16 SHIP affiliates and Colorado Access to Benefits Coalition (ABC) 

members. The goals are to: promote an understanding of Medicare/Medicaid fraud and 

abuse among consumers/caregivers; increase reporting when fraud and abuse occurs; and 

decrease the incidence of Medicare and Medicaid fraud and abuse in Colorado. The 

objectives are to: provide consumer education on anti-fraud messages; assist consumers 

with fraud/abuse complaints; and continue development of network of organizations and 

individuals delivering the message and assisting those who suspect fraud and/or abuse, with 

an emphasis on reaching out to rural and minority populations. The expected outcomes are: 

increased placement of effective messages in applicable consumer publications; expanded 

network (individuals, agencies, media) for dissemination of anti-fraud messages; increased 

awareness of potential Medicare fraud among Colorado consumers; a decrease in the 

incidence of undetected cases of Medicare fraud/abuse in the State; and an increase in the 

resolution of reported cases of suspected fraud and/or abuse. The products from this project 

are SMP brochures, Personal Healthcare Journals, fraud alerts, consumer presentations, 

fraud messages in partner consumer-oriented materials, semi-annual narrative reports with 

evaluation data and financial reports, as required. 

Page 189 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0013

Project Title: Connecticut Choices SMP Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Connecticut Department of Social Services 

25 Sigourney Street 

Hartford, CT 06106 

Contact: 

Marie Peck-Llewellyn 

Tel. (860) 424-5244 

Email: marie.peck.llewellyn@ct.gov

AoA Project Officer: Gene Brown 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant awarded to the Connecticut 

Department of Social Services. The goal is to enable beneficiaries to become better health 

care consumers by increasing their awareness of Medicare, Medicaid, and other potential 

incidents of health care fraud, errors, abuse and scams in order to detect and reduce 

improper payments and prevent victimization of themselves and others by ferreting out 

fraudulent scams and practices. The objectives are to: enhance/create partnerships utilizing 

volunteers; improve program visibility through an awareness campaign; provide education to 

beneficiaries and professionals, specifically targeting homebound and other isolated and/or 

hard to reach populations; and improve project efficiency, while increasing both operational 

and quality measures. Targeted areas include seniors in urban and rural areas with a high 

concentration of underserved seniors, but which have produced a disproportionately low 

number of clients; African American and Hispanic seniors; and isolated homebound seniors. 

Expected outcomes include: increased awareness among consumers of health care fraud, 

abuse and related scams; increased accessibility, quantity and effectiveness of information 

available to help targeted populations from being victimized; increased awareness of fraud 

and abuse issues of those professionals involved with homebound/homecare clients; 

expanded programming for and participation of volunteers in community initiatives; increased 

beneficiary inquiries and reports of suspected fraud, waste or abuse that result in action and 

savings attributable to the project. Products from the project include a web-based training 

program, power point presentations, and outreach materials. 

Page 190 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2936

Project Title: Delaware Medicare Patrol Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Delaware Department Of Health And Social Services 

Division of Services for Aging and Adults with Physical Disabilities 

1901 N. DuPont Highway, Main Annex 

New Castle, DE 19720 

Contact: 

Carol Barnett 

Tel. (302) 255-9390 

Email: carol.barnett@state.de.us

AoA Project Officer: Carmen Sanchez 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $163,538

FY2007 $170,000

FY2006 $170,000

FY2005 $170,000

FY2004 $

FY2003 $

Total $853,538

Project Abstract: 

This is a continuation of the Division of Services for Aging and Adults with Physical 

Disabilities (DSAAPD) support of the Senior Medicare Patrol (SMP) project, in collaboration 

with State of Delaware Department of Health and Social Services, ElderInfo (State Health 

Insurance Information Program), Medicaid Fraud, and related fraud or Medicare groups. The 

goal of the project is continue to reach vulnerable and hard to reach Medicare and Medicaid 

beneficiaries through trained volunteers by providing education, developing reading materials 

at a low reading level and maintaining federal, state, and local partnerships. The objectives 

are to: continue to recruit and train culturally aware, bilingual, retired professionals with 

experience in health care, communication and education to teach Medicare and Medicaid 

beneficiaries and their families throughout Delaware; continue or to develop partnerships with 

Federal, State and local agencies with new and creative strategies for reaching out to the 

culturally diverse, low income, low literate, and isolated Medicare and Medicaid beneficiaries; 

develop and implement a marketing outreach plan, using research conducted to effectively 

reach and educate vulnerable and hard to reach diverse seniors. The expected outcome is 

an increased number of contacts to the 800 number, by email, or other communication, due 

to our outreach efforts. The products from this project are a Smart Facts generated OIG 

report with data assessment reports; a website; press releases and articles for publications; 

newsletters and flyers; and in-house training, and reports as required. 

Page 191 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM3204

Project Title: National Hispanic SMP Project

Project Period: 09/30/2008 - 05/31/2011

Grantee: 

The National Hispanic Council on Aging 

734 15th Street NW, Suite 1050 

Washington, DC 20005 

Contact: 

Maria E Hernandez-Lane 

Tel. (202) 347-9733 

Email: mlane@nhcoa.org

AoA Project Officer: Derek Lee 

Fiscal 

Year 

Funding 

Amount

FY2009 $450,000

FY2008 $360,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $810,000

Project Abstract: 

The National Hispanic Council on Aging (NHCOA) supports this three-year project focusing 

on outreach and education in areas with high Hispanic populations. The goal for the project 

is to educate Hispanic older adults of Mexican, Cuban, Central American, South American, 

Caribbean, and other Latino origins about Medicare, Medicaid and home healthcare fraud 

and abuse prevention and reporting, by crafting comprehensive programs tailored to the 

specific characteristics and needs of all the different Hispanic groups in the country. The 

objectives are to: 1) concentrate on outreach and education in areas with high Hispanic 

populations; 2) expand the education focus to include Medicaid and home health care; 3) lay 

groundwork for a nationwide social marketing campaign to promote behaviors that lead to the 

prevention and reporting of Medicare fraud; and 4) develop a web-based cultural competency 

course targeting healthcare providers and pharmacies. Expected outcomes: 1) increased 

understanding of the Medicare, Medicaid and home healthcare systems, fraud and abuse 

and ways to report fraud; 2) increased avenues for reporting fraud and abuse among 

beneficiaries and their families; and 3) increased awareness of culturally-competent practices 

in relation to Medicare for Hispanic older adults. Products will include educational materials 

specific to each Hispanic population. 

Page 192 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2940

Project Title: Senior Medicare Patrol Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Legal Counsel for the Elderly 

601 E Street, NW 

Washington, DC 20049 

Contact: 

Jan May 

Tel. (202) 434-2164 

Email: JMay@AARP.org

AoA Project Officer: Barry Klitzsberg 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $160,000

FY2006 $160,000

FY2005 $160,000

FY2004 $

FY2003 $

Total $840,000

Project Abstract: 

This is a continuation of the Senior Medicare Error Patrol Project (SMEPP), a cooperative 

agreement project administered by the Legal Counsel for the Elderly, Inc. (LCE). Per the 

new program specifications of the Administration on Aging (AoA), LCE will expand the SMP 

District-wide. The goal of the SMEPP is to teach District of Columbia Medicare and Medicaid 

beneficiaries how to detect and prevent healthcare fraud and waste. The objectives are to: 

reach out to all 8 wards in the District of Columbia, particularly hard to reach segments of 

African American, Hispanic, and Asian Pacific American populations & institutions; 

collaborate with DCOA and its Senior Service Network to realize healthcare system savings; 

recruit and train diverse volunteers to enhance culturally-effective outreach; improve data 

collection via a SMARTFACTS database and through updates and trainings from the National 

Consumer Protection Resource Center; and increase SMP visibility through radio, television, 

print and online media, highlighting its successes. Expected outcomes are: increased 

awareness of healthcare fraud and abuse within hard-to-reach populations throughout the 

District; increased participation in multilingual & multicultural educational seminars; increased 

promotion of the SMP Hotline to ensure complaints were referred to proper authorities in a 

timely manner; increased dissemination of SMP materials through radio, television, print, and 

online media outlets; increased project effectiveness via SMARTFACTS; and increased 

documentation cost savings to the Medicare and Medicaid programs and beneficiaries. 

Products are: brochures, pamphlets, and a final report. 

Page 193 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2939

Project Title: Senior Medicare and Medicaid Patrol of Florida.

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Area Agency on Aging of Pasco-Pinellas, Inc. 

9887 4th Street North, Suite 100 

St Petersburg, FL 33702 

Contact: 

Sally Gronda 

Tel. (727) 570-9696 x266 

Email: grondas@elderaffairs.org

AoA Project Officer: Ronald Taylor 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of the Area Agency on Aging of Pasco-Pinellas, Inc. (AAAPP) Senior 

Medicare Patrol (SMP) program. The goal is to build upon past experiences and expand 

outreach statewide through strategic partnerships representing a variety of programs whose 

missions coincide with the SMP. The objectives are to: expand the Steering Committee 

statewide; establish new partnerships/collaborations to assist in expanding the program 

statewide and reaching underserved populations; develop and implement a marketing and 

outreach plan that is culturally competent; develop and implement innovative strategies to 

expand outreach and education statewide; expand volunteer recruitment efforts in the current 

project areas of Pasco and Pinellas counties; expand volunteer training to incorporate the 

new Medicare Modernization Act; and expand volunteer recognition efforts statewide. 

Expected outcomes include: an increase in the number of complaints to the statewide SMP 

fraud hotline as a result of an expanded marketing and outreach campaign; an increase in 

the involvement of retired professionals, particularly older minority individuals, in 

Medicare/Medicaid education and training; and increased awareness/knowledge among 

seniors about fraudulent practices and Medicare Part D. Products will include a webpage; 

brochures and posters; data/results of community education; articles and interviews for 

publication; and a final report, including evaluation results. 

Page 194 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2933

Project Title: Senior Medicare Patrol (SMP)

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Georgia Department of Human Resources 

Division on Aging 

2 Peachtree Street, NW 

Atlanta, GA 30303 

Contact: 

Erika Lawson 

Tel. (404) 651-6314 

Email: edlawson@dhr.state.ga.us

AoA Project Officer: Ronald Taylor 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of the Georgia Department of Human Resources (DHR), GeorgiaCares 

Senior Medicare Patrol (SMP) project. The goal of this project is to empower Georgians to 

become better informed healthcare consumers, who are able to recognize quality healthcare, 

fraud, error, abuse and waste. The project objectives are to: increase awareness of fraud 

and the SMP among Georgia's citizens; increase capacity of outreach through the expansion 

and development of partnerships; increase the number of active recruited volunteers; 

increase opportunities to provide new training methods to local, certified coordinators for 

program and volunteer management; increase capacity to reach target populations. 

Expected outcomes: 100% of all persons completing beneficiary surveys and training 

evaluations after attending SMP trainings and/or community education sessions will 

demonstrate an increase in awareness of Medicare and Medicaid error, fraud and abuse; 

increased number of active, recruited volunteers entered into the Aging Information 

Management System (AIMS); increased program outcomes entered into SmartFacts, AoA's 

web-based data management system; increased outreach activities; and increased capacity 

to reach target populations. Products will consist of: completion of the upgrade to the Aging 

Information Management System (AIMS) database to better capture and utilize client date; a 

final report, including evaluation results, client demographics, program monitoring, successes 

and areas needing improvement; shared website utilization with GeorgiaCares SHIP program 

to promote utilization of socially isolated populations to obtain needed and relevant 

information on Medicare/Medicaid fraud, error, abuse and waste reporting and resources. 

Page 195 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0021

Project Title: 2009 Guam Senior Medicare Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Guam Department of Public Health and Social Services 

123 Chalan Kareta 

Mangilao, GU 96913-6304 

Contact:

J. Peter Roberto, ACSW 

Tel. (671) 735-7102 

Email: caring.communities@yahoo.com

AoA Project Officer: Anna Cwirko-Godycki 

Fiscal 

Year 

Funding 

Amount

FY2009 $75,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $75,000

Project Abstract: 

This is the first year continuation of a three-year SMP project. The goal of the Guam SMP 

Project is to continue expanding and further enhancing the project for the purpose of 

educating Medicare and Medicaid beneficiaries, family members, and caregivers to actively 

protect themselves against fraudulent, wasteful and abusive health care practices and to 

report suspected errors. Guam SMP project objectives are to: train members of the 

American Association of Retired Persons, local chapter, to serve as Guam SMP project 

volunteer resources and educators; educate and provide community awareness of 

Medicare/Medicaid waste, fraud and abuse; disseminate, in various formats, project 

information on Medicare/Medicaid waste, fraud and abuse; foster current and establish new 

partnerships; and evaluate project activities and communicate project outcomes. Expected 

measurable outcomes are: an increased number of proficiently trained volunteers; increased 

numbers of education beneficiaries, families and caregivers; increased tracking of inquiries 

and the rate of inquiry resolution; and increased Medicare/Medicaid savings. Products will 

include consumer driven, culturally appropriate informational materials; volunteer training 

items, e.g. training manual, volunteer incentives and certificates of appreciation; evaluation 

tools, and required reports. 

Page 196 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0024

Project Title: Senior Medicare Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Hawaii Executive Office on Aging 

250 South Hotel Street 

Honolulu, HI 96813-2831 

Contact: 

Noemi Pendleton 

Tel. (808) 586-0100 

Email: noemi.pendleton@doh.hawaii.gov

AoA Project Officer: Anna Cwirko-Godycki 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year of a three-year grant to continue a SMP in the State of Hawaii's 

Executive Office on Aging. SMP Hawaii works closely with partners in the aging network, law 

enforcement, and various community advocacy organizations. The goal of the project is to 

encourage seniors to become self-advocates, protecting themselves, their families and their 

communities from financial, consumer and healthcare fraud. Program objectives are to: 

establish working partnerships and multi-agency projects with local, state, and federal law 

enforcement agencies; reach out to isolated, underserved, and non-English populations, i.e., 

Native Hawaiians, Southeast Asian, homebound; develop and replicate innovative outreach 

tools; and develop volunteer recruitment, retention, and training strategies. Expected project 

outcomes: conduct four advisory council meetings with representatives from law 

enforcement, regulatory, consumer advocacy, and aging network organizations; conduct 

fraud prevention and resource fairs on Oahu and neighbor islands (Oahu, Hawaii, Maui, and 

Kauai); develop and replicate a DVD to highlight various healthcare fraud schemes, i.e., 

durable medical equipment, home healthcare, HMO, Part D; recruit and train 10 volunteers in 

both Native Hawaiian and Southeast Asian communities; and develop and distribute a fraud 

prevention and awareness booklet. Products will include: a DVD; potholders with program 

information; brochures; fraud awareness and prevention booklet; and project reports, 

including evaluation results. 

Page 197 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2949

Project Title: Idaho Medicare Education Partnership

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Idaho Commission on Aging 

3380 Americana Terrace, Suite 120 

Boise, ID 83706 

Contact: 

Kim Toryanski 

Tel. (208) 344-3833 

Email: ktoryanski@aging.idaho.gov

AoA Project Officer: Terry Duffin 

FY2009 $180,000

Fiscal 

Year 

Funding 

Amount

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of a cooperative agreement awarded to the Idaho Commission on 

Aging (ICOA). The Idaho Senior Medicare Patrol Project works with Senior Health Insurance 

Benefit Advisors (SHIBA), the Pocatello Area Agency on Aging, and the Hispanic Outreach 

Division of Canyon County Office on Aging, to use trained volunteers to educate beneficiaries 

in understanding and analyzing their Medicare billing information. The goal is further 

penetration into the senior community to expand consumer awareness of fraud by utilizing 

trained volunteers to educate and empower beneficiaries to scrutinize their Medicare billing 

information and flag unusual entries or charges, and to forewarn seniors on identity theft, 

consumer fraud and other health care scams. The objectives are to: foster a statewide 

education program for Idaho beneficiaries and their caregivers in analysis of the Medicare 

Billing Summary Notices; carry forward this prevention approach in the context of other types 

of health care fraud, by partnering with other entities, such as the Idaho Health Care 

Association and Idaho private insurance carries; extend the programs' visibility through the 

Aging and Disability Resource Center in Northern Idaho; improve efficiency by training staff 

and volunteers to fully utilize the SMARTFACTS System; and forge relationships with harder 

to reach populations, such as Idaho's Native Americans and Hispanics. Expected outcomes 

are: increased frequency of reports by seniors in detecting instances of suspected fraud; and 

reduced numbers of seniors falling prey to scams and fraudulent business practices. 

Products will include: a final report, including evaluation results; updates on the ICOA 

website; articles in the ICOA Newsletter and press releases; and regular program information 

disseminated through presentations at Senior Centers and during town hall events hosted by 

the Governor. 

Page 198 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0026

Project Title: Statewide Illinois SMP Program

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

AgeOptions 

Benefits, Information, and Education 

1048 Lake St. 

 Suite 300 

Oak Park, IL 60301 

Contact: 

Anne Posner 

Tel. (708) 383-0258 

Email: anne.posner@ageoptions.org

AoA Project Officer: Amelia Wiatr 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year of a three-year continuation grant to the Suburban Area Agency on 

Aging-AgeOptions, for the Senior Medicare Patrol (SMP) program for the state of Illinois. The 

goal of the program is to recruit and train volunteers to conduct health care fraud control, 

outreach and education. The objectives are to: foster national and statewide program 

coverage; improve beneficiary education and inquiry resolution for other areas of health care 

fraud; foster national program visibility and consistency; improve the efficiency of the SMP 

program, while increasing results for both operational and quality measures; and target 

training and education to isolated and hard-to-reach populations. The expected outcomes: 

statewide coverage through collaborations with all the Area Agencies in Illinois; a centralized 

intake system to report health care fraud; a statewide media campaign; expansion of the 

SMP message to people with disabilities through partnership with the Illinois Network for 

Centers for Independent Living (INCIL); improved targeting to ethnic and limited English 

speaking seniors through partnership with the Coalition for Limited English Speaking Elderly 

(CLESE); increased awareness about Medicare Part D and Durable Medical Equipment 

(DME) fraud; consistent branding of the program with the national SMP effort; an increased 

number of people reached with the SMP message; and suggested best practices for reaching 

and educating isolated and hard-to-reach populations. The products from this project are: 

project reports, as required, including evaluation results; a website; newsletters; SMP power 

point presentation; SMP posters; playing cards; a fraud prevention toolkit; and an SMP 

brochure. 

Page 199 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0006

Project Title: SMPP - Senior Medicare Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Indiana Association of Area Agencies on Aging Education Institute 

9302 N. Meridian Street Suite 200 

Indianapolis, IN 46260 

Contact:

Kristen S LaEace 

Tel.(317) 818-0702 

Email: klaeace@iaaaa.org

AoA Project Officer: Amelia Wiatr 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year of a three-year continuation grant to the Indiana Association of Area 

Agencies on Aging (IAAAA) Education Institute, Inc. to continue an education and training 

model, the Indiana Senior Medicare Patrol (SMP) project. The goal is to create an education 

and training model on Medicare fraud prevention, including Part D, for elder volunteers and 

others who work with underserved Medicare populations including rural, low income and 

African American groups. The objectives are to: continue working with established partners 

to foster national and statewide program coverage; improve beneficiary education and inquiry 

resolution for other areas of health care fraud; foster national program visibility and 

consistency; improve the efficiency of the SMP program, while increasing results for both 

operational and quality measures; and target training and education to isolated and hard-toreach populations. The expected outcomes are an increase in the beneficiary knowledge of 

Medicare fraud and abuse, and a 10% increase in the number of complaints 

reported/received over the life of the project. Products will include brochures, personal health 

care journals, Medicare Summary Notice (MSN) guides and informational sheets, project 

reports as required, including evaluation results. 

Page 200 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0001

Project Title: Empowering Seniors to Prevent Healthcare Fraud

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Hawkeye Valley Area Agency on Aging Inc 

2101 Kimball Ave, Suite 320 

 P O Box 388 

Waterloo, IA 50704-0388 

Contact: 

Shirley Merner 

Tel. (319) 272-2244 

Email: smerner@hvaaa.org

AoA Project Officer: Amelia Wiatr 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

The Hawkeye Valley Area Agency on Aging (HVAAA) is in its first year of a three-year Senior 

Medicare Patrol Project (SMP) grant application. The SMP's major partners include Iowa's 

Area Agencies on Aging (AAA), and Iowa EXPORT Center of Excellence on Health 

Disparities (Project EXPORT) located at the University of Northern Iowa. Through these 

partnerships, the SMP continues to achieve statewide coverage, expert knowledge of 

underserved populations, expertise in design of culturally-sensitive marketing and 

educational materials, and previously established community relationships. The project's goal 

is to recruit, train, and empower retired professionals to create responsible beneficiaries of 

healthcare statewide. The focus of this project is to increase outreach and education to 

include Iowa's isolated and hard-to-reach, underserved populations including African 

American, Asian, Hispanic, Native American, rural Iowans and other emerging populations. 

The objectives: improve program efficiency statewide; foster and nurture statewide coverage 

and increase outreach to target populations; increase public awareness to underserved 

populations; improve beneficiary healthcare education by focusing on underserved 

populations; and foster national SMP visibility and recognition for Iowa SMP's outreach 

project. The expected outcomes are: targeted elderly population will be equipped to be good 

stewards of healthcare dollars; recovery of misspent healthcare dollars will increase; and an 

increase in the number of reports of healthcare concerns for resolution or investigation. The 

products from this continuation project include folders; informational handouts that are 

culturally sensitive; an updated ID theft brochure; give-away items for use at health fairs and 

presentations; and reports as required, including evaluation results. Project lessons learned 

will be provided to the AoA National Consumer Protection Technical Resource Center 

(NCPTRC). 

Page 201 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2956

Project Title: Senior Medicare Patrol Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Kansas Department on Aging 

503 S. Kansas Ave. 

Topeka, KS 66603 

Contact: 

Tina Langley 

Tel. (785) 368-7331 

TinaLangley@aging.state.ks.us

AoA Project Officer: Amelia Wiatr 

Fiscal 

Year 

Funding 

Amount

FY2009 $78,241

FY2008 $78,241

FY2007 $63,930

FY2006 $63,930

FY2005 $63,930

FY2004 $

FY2003 $

Total $348,272

Project Abstract: 

This is a continuation grant for the Kansas Department on Aging. The goal of the Kansas 

Senior Medicare Patrol Project is to increase understanding of fraud issues and increase the 

detection and reporting of errors, fraud, and abuse by beneficiaries. The objectives are to: 

foster statewide program coverage through partnerships with volunteer networks and use of a 

toll-free number and interactive website; improve beneficiary education and inquiry resolution 

for health care fraud in the Medicaid system; foster national program visibility by working with 

the State Health Insturance Information Program (SHIP) and Aging and Disability Resource 

)ADRC) programs and by utilizing a web-based data collection system; improve the efficiency 

of data tracking and demonstrate an increase in program measures by utilizing 

SMARTFACTS; and target education to low-income populations, residents in nursing 

facilities, and Spanish-speaking beneficiaries. Expected outcomes are: an increase in the 

number of counties having trained SMP volunteers; an increase in the number of volunteers 

conducting education activities; an increase in the number of beneficiaries receiving 

education; an increase in the number of "simple inquiries" received; and an increase in the 

number of "complex issues" received. The products will include: Of the Inspector General 

(OIG) reports generated through SMARTFACTS; program materials developed for our target 

populations; narrative reports detailing strategies and results; and other reports, as required. 

Page 202 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM3133

Project Title: SMP- Kentucky

Project Period: 01/01/2007 - 05/31/2011

Grantee: 

Louisville/Jefferson County Metro Government 

810 Barrett Ave, 3rd Floor 

Louisville, KY 40204 

Contact: 

Eileen Goggin 

Tel. (502) 574-7304 

Eileen.Goggin@louisvilleky.gov

AoA Project Officer: Ronald Taylor 

Fiscal 

Year 

Funding 

Amount

FY2009 $170,000

FY2008 $170,000

FY2007 $272,610

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $612,610

Project Abstract: 

This is a continuation of a grant to the Louisville Metro Government Community Action 

Partnership (LMCAP) to continue to operate the statewide Senior Medicare Patrol program, 

the Kentucky Senior Medicare Patrol (KY SMP), through seven regional existing Retired 

Senior Volunteer Programs (RSVPs). The goal is to maintain a pool of volunteers (a target of 

335 people age 55 and older) to act as Medicare educators throughout the state. The 

objectives are to: 1) broaden educational services to Medicare and Medicaid beneficiaries in 

all 120 Kentucky counties; 2) recruit and train 50 new senior volunteers; 3) integrate KYSMP 

services into 10 statewide Community Action Partnerships (CAPs) and 2 Legal Aid Offices in 

the eastern and northeastern counties of the state; 4) update training manual inserts; 5) 

identify new statewide partnerships for collaboration on community outreach events that 

focus on educating the general retiring public; and 6) research and develop strategies to 

reach English as a Second Language populations. Expected outcomes are: 1) an increase in 

the number of educational services to beneficiaries; 2) more established partnerships to 

preserve integrity of Medicare/Medicaid programs; and 3) an increase in the number of 

knowledgeable beneficiaries of healthcare fraud in the Medicare and Medicaid programs. 

Products will include: project reports, including evaluation results, as required; educational 

materials for volunteers and beneficiaries; group session post survey results; personal 

healthcare journals; and data tracking reports. 

Page 203 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0018

Project Title: Louisiana Senior Medicare Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Louisiana Health Care Review, Inc. 

Quality Improvement 

8591 United Plaza Blvd, Suite 270 

Baton Rouge, LA 70809 

Contact: 

Tricia S Canella 

Tel. (225) 248-7064 

Email: tcanella@lhcr.org

AoA Project Officer: Derek Lee 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to the Louisiana Health Care Review, 

Inc. (LHCR) which is the Medicare Quality Improvement Organization (QIO) for Medicare in 

Louisiana under contract with the Centers for Medicare and Medicaid Services. Working in 

partnership with the LHCR, Office of Elderly Affairs (OEA), Senior Health Insurance 

Information Program (SHIIP) and other aging related organizations such as the Louisiana 

Medicaid Fraud Control Unit and the USDA Rural Assistance Program and will be supported 

by LHCR. The goal is to create a network of volunteers recruited from the Louisiana Retired 

Teachers' Association that work through the state's Aging and Disability Resource Centers 

(ADRC) and the Area Agencies on Aging (AAA) to train beneficiaries to detect, report, and 

prevent healthcare fraud. The LaSMP will be a statewide effort, with an additional focus on 

the elderly homebound living in rural and hard-to-reach areas of the state, mainly in Medically 

Underserved and Healthcare Professional Shortage areas. The objectives are to: recruit and 

support volunteers statewide; increase fraud education among Medicaid beneficiaries; 

implement a web-based seamless data collection system; improve the efficiency of LaSMP 

by increasing both operational and quality measures; and achieve sustainability for future 

efforts by coordinating all of the state's agencies that investigate fraud and elderly abuse. 

Expected outcomes: to improve dialogue between patients and their health care provider, to 

reduce the number of coding errors, improve health outcomes by insuring that services 

ordered by the physician are delivered; develop an interactive fraud prevention web site; and 

create a unified state agency fraud initiative. Products will include: a survey, fraud 

prevention website, and reports as required.. 

Page 204 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2948

Project Title: Senior Medicare Patrol Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Maine Department of Health and Human Services 

Office of Elder Services 

442 Civic Center Drive, 11 State House Station 

Augusta, ME 04333 

Contact: 

Mary Walsh 

Tel. (207) 287-9207 

Email: mary.walsh@maine.gov

AoA Project Officer: Gene Brown 

FY2009 $180,000

Fiscal 

Year 

Funding 

Amount

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of the Maine Senior Medicare Patrol (SMP) Project, Maine Department 

of Health and Human Services. The goal is to educate beneficiaries, MaineCare (Medicaid) 

participants, their families and caregivers about Medicare benefits and empower them to 

identify and report health care errors, fraud and abuse. The objectives are to: train State 

Health Insurance Information Program (SHIP)/SMP volunteers and staff: provide statewide 

outreach and education through expanded collaboration with the Maine SHIP and statewide, 

regional and community organizations; and increase the number of health care fraud 

complaints referred to Medicare and MaineCare. The expected outcome is an increased 

number of educated Medicare beneficiaries, MaineCare participants, their families, and 

caregivers who are knowledgeable, responsible consumers who will detect and report health 

care fraud. Products will include flyers, presentations, brochures, information cards, health 

journals, posters, a Community Medicare Advocate's Handbook, a new on-line SHI/SMP 

training tool, training materials, and Medicare Bingo. A final report and presentations will be 

developed to share information with the AoA, the Centers for Medicare and Medicaid 

Services (CMS), the National Consumer Technical Resource Center, other SMPs and SHIPs. 

Page 205 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0028 

Project Title: Maryland SMP- Senior Medicare Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Maryland Department of Aging 

301 W. Preston Street- Suite 1007 

Baltimore, MD 21201 

Contact: 

A. Cassaundra Brown 

Tel. (410) 767-1278 

Email: acb@ooa.state.md.us

AoA Project Officer: Barry Klitsberg 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year Senior Medicare Patrol (SMP) project 

operated by he Maryland Department of Aging (MDoA). The goals are to: increase senior

awareness of health care fraud, waste, abuse and error; to mobilize state and community 

resources to work together in resolving and publicizing health care fraud concerns; and to 

support the goals of the AoA Senior Medicare Patrol. The objectives are to: develop 

partnerships and collaborations to ensure statewide program coverage; improve beneficiary 

education and inquiry resolution for other areas of health care fraud; increase awareness for 

beneficiaries about the problem of healthcare, fraud waste and abuse; identify and test best 

practices to reach the hard-to-reach population; target training and education to isolated and 

hard-to-reach populations; recruit and train volunteers with a variety of skills and education; 

foster program visibility and consistency; incorporate the new SMP logo and tagline in all 

MDoA and AAA SMP materials; and incorporate the use of the Smartfacts reporting system 

in Maryland's Senior Medicare Patrol Program. Expected outcomes are to: provide 

statewide outreach to Medicare and Medicaid beneficiaries and their families; receive 

inquiries of suspected incidences of fraud, waste, error or abuse; document estimated 

savings attributable to the project; develop new partnerships; assist individuals; and recruit, 

educate and train a volunteer corps of retired professionals. The products from the project 

will include: an assessment survey for Medicare beneficiaries; a paper on building 

partnerships with non-English communities; an updated training curriculum; a new SMP 

brochure; and an enhanced web site. 

Page 206 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2930

Project Title: Massachusetts Medicare and Medicaid Outreach and Education Program 

"Senior Medicare Patrol Project"

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Elder Services of the Merrimack Valley, Inc. 

360 Merrimack Street, Building #5 

Lawrence, MA 01843 

Contact: 

Lucilia Prates 

Tel. (978) 946-1368 

Email: lprates@esmv.org

AoA Project Officer: Barry Michaels 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of the Elder Services of the Merrimack Valley, Inc. grant to support the 

Massachusetts Senior Medicare Patrol (MA SMP) project. The goal is to continue to broaden 

and increase its outreach and education efforts throughout the state to reach low income, 

vulnerable, isolated, and limited English-speaking (LEP) populations about their health 

benefits eligibility, and how to identify Medicare and Medicaid errors, fraud and abuse. The 

objectives are: to foster national and statewide program coverage; to improve beneficiary 

education and inquiry resolution for other areas of health care fraud; to foster national 

program visibility and consistency; to improve the efficiency of the SMP Program whole, 

increasing the results for both operational and quality measures; and to target training and 

education to isolated and hard-to-reach populations. The expected outcomes are: an 

increased linguistic capacity of the Massachusetts Serving Health Insurance Needs of Elders 

(SHINE) Program in the 13 regional SHINE programs; an increased number of SHINE 

counselors in the 13 regional programs; increased outreach, education services, and benefits 

counseling to at least 250,000 beneficiaries across the state; and LEP populations reached 

throughout Massachusetts through a multi-pronged, multi-ethnic media campaign. Products 

include: website; training materials in different languages; and reports, as required. 

Page 207 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM3143

Project Title: Senior Medicare Patrol Program

Project Period: 06/01/2007 - 05/31/2011

Grantee: 

Michigan Medicare\Medicaid Assistance Program 

6105 West St. Joseph Hwy Suite 204 

Lansing, MI 48917 

Contact: 

Stacey Platte 

Tel. (517) 886-1242 

Email: StaceyP@MyMMAP.org

AoA Project Officer 

Fiscal 

Year 

Funding 

Amount

FY2009 $160,000

FY2008 $160,000

FY2007 $160,000

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $480,000

Project Abstract: 

The Michigan Medicare/Medicaid Assistance Program (MMAP) picked up the third year of a 

three-year grant, originally awarded to the Area Agencies on Aging Association of Michigan. 

MMAP will achieve the project goal to increase prevention, detection, and reporting of 

Medicare and Medicaid fraud, errors, and abuse by Michigan's 1.5 million Medicare 

beneficiaries through statewide education, outreach, and prevention efforts. The objectives 

are: 1) to foster national and statewide program coverage; 2) to improve beneficiary 

education and inquiry resolution for other areas of heath care fraud; 3) to foster national 

program visibility and consistency; 4) to improve the efficiency of the SMP program while 

increasing results for both operational and quality measures; and 5) to target training and 

education to isolated and hard-to-reach populations. Expected outcome sare: 1) increased 

savings to Medicare, Medicaid, and individual beneficiaries; 2) increased number of active 

volunteers who counsel beneficiaries and conduct outreach about Medicare fraud, errors, and 

abuse; 3) increased number of beneficiaries who know how to prevent, detect, and report 

Medicare fraud, errors, and abuse; 4) increased referrals from state and local partners; and 

5) increased and improved SMP services. Products will include: summary of innovative best 

practices in reaching traditionally underserved populations; press releases, flyers, and 

outreach presentations; SMP brochures; training materials; Internet-based SMP training and 

certification module. 

Page 208 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0005

Project Title: Minnesota's SMP 2009-2012

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Minnesota Department of Human Services 

Board on Aging 

PO Box 64976 

 540 Cedar Street 

St. Paul, MN 55164-0976 

Contact: 

Krista K Boston 

Tel. (651) 431-2605 

krista.boston@state.mn.us

AoA Project Officer: Kathleen Votava 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year health care anti-fraud demonstration project 

in partnership with the seven Minnesota Area Agencies on Aging and related organizations 

serving hard-to-reach populations. The goal of the project is to empower individuals to 

identify and report instances of error, fraud and abuse in the health care system with 

emphasis placed on Medicare and Medicaid programs. Objectives of the project are to: 

foster national and statewide Senior Medicaid Patrol (SMP) coverage; improve beneficiary 

education and inquiry resolution for other areas of health care fraud; foster national program 

visibility and consistency; improve the efficiency of SMP, while increasing results for 

operational and quality measures; and target training and education for hard-to-reach 

populations. Expected outcomes are: an increased number of Minnesotans who receive 

services from the Senior LinkAge Line who are aware of fraud, abuse and error issues and 

know how to identify and report them; increased number of consumers and professionals 

from helping agencies who know where to go for objective help with questions regarding 

health care fraud, errors and abuse; a decreased number of individuals who experience 

confusion and frustration when trying to report and resolve fraud, abuse and errors; and 

increased knowledge, skills and confidence of Senior LinkAge Line staff/volunteers to provide 

comprehensive health insurance counseling, as it pertains to health care fraud, abuse and 

error. Products will include: a new interactive Web site; secure instant message software and 

voiceover IP capability; automated statewide tracking of health care fraud, abuse and error 

grievances; virtual volunteer coordinator reference handbook; a cookbook; and a report, as 

required. 

Page 209 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0015

Project Title: Senior Medicare Patrol

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Mississippi Department of Human Services 

750 North State Street 

Jackson, MS 39202 

Contact:

Marion Dunn Tutor 

Tel. (601) 359-4925 

Email: marion.tutor@mdhs.ms.gov

AoA Project Officer: Joyce Robinson-Wright 

Fiscal 

Year 

Funding 

Amount

FY2009 $175,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $175,000

Project Abstract: 

This is the first year continuation of a three-year Senior Medicare Patrol (SMP) grant to the 

Mississippi Department of Human Services (MDHS), Division of Aging and Adult Services 

(DAAS), to establish a statewide network of trained volunteers serving in their communities to 

educate and assist seniors in identifying and combating health care fraud, error and abuse. 

As the State Unit on Aging, DAAS will use oversight and coordination to provide services to 

Mississippi's older population through a system of Area Agencies on Aging (AAAs). The 

three-year project will incorporate statewide partnerships and sub-grants to serve seniors in 

Mississippi's 82 counties. The project goal is to educate Mississippi's population to 

recognize, report and reduce fraud and abuse of Medicare recipients. The objectives are to: 

foster national and statewide program coverage; improve beneficiary education and inquiry 

resolution for other areas of health care fraud; foster national program visibility and 

consistency; improve efficiency of the SMP program, while increasing results for both 

operational and quality measures; and target training and education to isolated and hard-toreach populations. The expected outcomes are: increased number of trained volunteers; 

increased number of volunteer presentations; increased number of Mississippians educated 

in fraud and abuse awareness; increased number of Medicare abuse/error complaint calls; 

and increased amount of dollars saved to Medicare, Medicaid or beneficiaries. Products will 

include: required reports, including evaluation results; low-literacy literature; and a volunteer 

training manual. 

Page 210 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0004

Project Title: The Missouri SMP

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

District III Area Agency on Aging 

PO Box 1078 

Warrrensburg, MO 64093 

Contact: 

Diana Hoemann 

Tel. (660) 747-3107 

Email: dhoemann@goaging.org

AoA Project Officer: Kathleen Votava 

Fiscal 

Year 

Funding 

Amount

FY2009 $179,978

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $179,978

Project Abstract: 

This is the first year continuation of a three-year grant to the District III Area Agency on Aging 

(AAA) for support of the Missouri Senior Medicare Patrol project (SMP). The goal of the 

Missouri SMP is to increase the awareness of Medicare and Medicaid error, fraud, and abuse 

among beneficiaries, their caregivers, home health and in-home workers, and hard-to-reach 

populations in the state of Missouri. The objectives are to: conduct a statewide media 

campaign that semi-annually will focus on a topic of interest to Medicare/Medicaid recipients; 

refine and consolidate the training materials needed to train SMP volunteers; contract with 

each Missouri AAA and the Missouri state prescription assistance program to provide 

volunteer support and training; utilize the SMP Coalition's expertise to provide direction and 

support for the project; develop an educational series focused on home health care and inhome care workers that will increase the ability of these professionals to recognize and report 

potential fraud and abuse to the appropriate agency, as well as distribute fraud and abuse 

information to their clients; and collaborate with AAA's, local community groups and the state 

Office on Minority Health to reach targeted hard-to-reach populations. Expected outcomes 

are: two retired senior volunteers will conduct activities to educate beneficiaries about 

potential fraud and abuse in each county in Missouri; every county in the state will conduct a 

minimum of one group presentation and one media event; and beneficiary inquiries about 

health care error, fraud and abuse will increase by 25% in areas targeted for minority 

outreach. Products will include: educational toolkits, articles for publication, and a final report. 

Page 211 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2937

Project Title: Montana Medicare Waste Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Missoula Aging Services 

337 Stephens Avenue 

Missoula, MT 59801 

Contact: 

Susan Kohler 

Tel. (406) 728-7682 

skohler@missoulaagingservices.org

AoA Project Officer: Susan Raymond 

FY2009 $180,000

Fiscal 

Year 

Funding 

Amount

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of the Medicare Waste Project of the Missoula Aging Services, which 

will build on its nine years of experience in outreach and education to Medicare beneficiaries 

on the issues of waste, fraud and abuse and general consumer healthcare fraud through the 

Senior Medicare Patrol (SMP). The goals are to identify, report and reduce errors, fraud & 

abuse within the Medicare and Medicaid systems and focus on home health care, Medicaid 

and Medicare. The objectives are to: inform and educate Medicare beneficiaries statewide 

by May 31, 2011 to identify potential healthcare error, fraud and abuse; maintain 100 older 

adults as educators, counselors and advocates for Medicare beneficiaries, their families and 

the public; enhance & expand relationships and collaborations with relevant state agencies 

and organizations on the issues of consumer healthcare fraud and Medicare/Medicaid; and 

produce a library of self-training CD's for volunteers as well as beneficiaries. Expected 

outcomes are: a higher level of beneficiary understanding, empowering them to identify and 

report healthcare waste, fraud and abuse, as demonstrated by survey returns; an increased 

number of professional outreach partnerships statewide, including SMP, resulting in a more 

recognizable message; and a greater number of volunteers receiving consistent and timely 

training. Products will include: project reports, as required; abstracts for state and national 

conferences; Montana- specific SMP brochures, healthcare journals and a website; a library 

of self-training CD's; ads and articles for publication; and training manuals for partners and 

volunteers. 

Page 212 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0011

Project Title: Nebraska SMP Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Nebraska Department of Health and Human Services 

State Unit on Aging 

PO Box 95026 

Lincoln, NE 68509 

Contact: 

Patty Pierson 

Tel. (402) 471-9345 

Email: patty.pierson@nebraska.gov

AoA Project Officer: Kathleen Votava 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to the Nebraska Office of Long Term 

Care (LTC) Ombudsman to support the Senior Medicare Patrol (SMP) program, Nebraska 

ECHO Project (Educating and Empowering Consumers of Healthcare Organizations). The 

goal of the ECHO Project is to increase awareness among Nebraska's beneficiaries on how 

to identify, report and prevent Medicare and Medicaid fraud, error and waste and to empower 

and assist them in protecting their rights. This includes the right to be billed accurately for 

services received and to not be victimized by fraud schemes. The objectives of the Nebraska 

SMP are to: disseminate project information to beneficiaries, their caregivers, and the 

general public; recruit, train and support qualified volunteers and enlist their efforts on behalf 

of beneficiaries; develop and maintain a network of partnerships that will work together to 

eliminate healthcare fraud, error and waste; provide outreach and advocacy to the most 

vulnerable of beneficiaries; and provide targeted education to hard-to-reach populations. The 

expected outcomes of this project are: beneficiaries will have an increased awareness of 

healthcare fraud, error and waste, and initiate positive changes in their behavior; additional 

volunteers will be recruited and trained; and an increased number of inquiries and complaints 

will be resolved or result in some action, including the savings or recoupment of healthcare 

dollars. The products from this project will include: educational and promotional materials; a 

consumer website; and a summary of project data and accomplishments. 

Page 213 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0019

Project Title: Senior Medicare Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Office of the Nevada Attorney General 

Health and Human Services 

555 East Washington Ave. #3900 

Las Vegas, NV 89101 

Contact: 

Jo Anne C Embry 

Tel. (702) 486-3154 

Email: jembry@ag.nv.gov

AoA Project Officer: Dennis Dudley 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to the Nevada Office of the Attorney 

General. The goal is to increase awareness of Medicare, Part D and Medicaid fraud, waste, 

and abuse. The objectives of the Nevada Senior Medicare Patrol (SMP) project are to: 

create training manuals and develop new materials with the new logo and tag line, and 

culturally competent materials for non-English speaking and Nevada's rural populations; 

maximize partner collaborations in order to improve outreach to Hispanic and rural 

populations; increase complaints to the program through the increased outreach; and 

incorporate the SmartFacts system to maximize program progress reporting. Expected 

outcomes are: increased complaints to our state-wide hotline and increased awareness of 

issues involving Medicare, Medicare, Part D, and instances that may point to fraud, error or 

abuse. The products will include: brochures; training modules; placemats, key chains, pens, 

pencils, jar openers, notepads, refrigerator magnets, and required reports. 

Page 214 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0022

Project Title: Senior Medicare Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

New Hamphire Department of Health and Human Services 

Bureau of Elderly and Adult Services 

129 Pleasant Street 

Concord, NH 03301 

Contact: 

Karol Dermon 

Tel. (603) 271-4925 

kdermon@dhhs.state.nh.us

AoA Project Officer: Barry Michaels 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is a first year continuation of a three-year grant to the New Hampshire Department of 

Health and Human Services, Bureau of Elderly and Adult Services (BEAS) for support of a 

Senior Medicare Patrol (SMP) project. The goal of the project is to recruit, train and manage 

a network of volunteers and counselors statewide to educate Medicare beneficiaries and their 

families about health care error, fraud and abuse. The objectives are to: foster statewide 

and local SMP program awareness; provide outreach and education on health care fraud and 

abuse; conduct targeted outreach and assistance to people who are hard to reach; and 

improve operational efficiencies and ensure consistent quality of reporting systems. 

Expected outcomes are: increased statewide awareness of the Senior Medicare Patrol 

project; increased number of Medicare beneficiaries reached who are homebound, living in 

isolated or rural areas, who have low literacy, limited income and/or living with disabilities or 

chronic illnesses; more improved operationally efficient program; and an increase in the 

number of knowledgeable beneficiaries on matters of health care fraud, error and abuse and 

other scams. Products will include: brochures; newsletters; PowerPoint presentations; and 

project reports and evaluation, as required. 

Page 215 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2935

Project Title: Senior Medidare Patrol of New Jersey

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Jewish Family and Vocational Service of Middlesex County 

32 Ford Ave 2nd Floor 

Milltown, NJ 08850 

Contact: 

Marci Fineman 

Tel. (732) 777-1940 

Email: m.fineman@jfvs.org

AoA Project Officer: Barry Klitsberg 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of the Jewish Family and Vocational Services of Middlesex County 

grant to support a Senior Medicare Patrol (SMP) project designed to improve the quality of 

healthcare for senior citizens in New Jersey. The goal is to reach out and to provide 

information so that seniors (with an emphasis on African- Americans and the homebound 

population) can take the appropriate steps to protect themselves from becoming victims of 

fraud. The objectives are to: utilize staff and volunteers in order to reach as many seniors of 

the State as possible; partner with aging services professionals, law enforcement personnel 

and others to promote awareness of Medicare/Medicaid fraud; develop and disseminate 

consumer educational materials about and to prevent Medicare/Medicaid fraud; provide 

counseling and serve as consumer advocates in resolving billing disputes and errors; and 

receive and resolve complaints of suspected fraud and to make referrals to appropriate 

agencies. The expected outcomes are: seniors in New Jersey will become aware of the 

extent of fraud in the Medicare and Medicaid programs; seniors will review their Medicare 

Summary Notices to ensure that they are receiving the services for which Medicare is paying; 

seniors will take the necessary steps to call their providers to correct any billing disputes and 

errors; and seniors will report suspected cases of fraud to JFVS-SMP and to other agencies. 

The products will include: semiannual and final reports; Group Session Post Survey; press 

releases & articles for publication; television interviews; public service announcements on 

radio and television; and brochures, flyers, and tip sheets. 

Page 216 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2929

Project Title: Senior Medicare Patrol-New Mexico Seniors Saving Medicare/Medicaid

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

New Mexico Aging and Long-term Services Department 

2550 Cerrillos Road 

Santa Fe, NM 87505 

Contact: 

Deborah Armstrong 

Tel. (505) 476-4755 

Email: debbie.armstrong@state.nm.us

AoA Project Officer: Lisa Theirl 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation grant to the New Mexico Aging and Long Term Services Department to 

support a Senior Medicare Patrol (SMP) project. The goal of the New Mexico Aging and 

Long-Term Services Department Senior Medicare Patrol (SMP) program is to strengthen 

client self-advocacy by increasing beneficiaries' knowledge of their rights and their ability to 

recognize and react to Medicare and Medicaid (M/M) error, fraud, and under/over utilization. 

The objectives are to: continue to foster national and statewide program coverage; improve 

beneficiary education and inquiry resolution for many areas of health care fraud, with special 

focus in New Mexico on Medicaid waste, fraud and abuse and Medicaid long-term care 

initiatives; continue to foster national program visibility and consistency; increase operation 

and quality measures to improve the efficiency of the SMP program; and target training and 

education to isolated and hard-to-reach populations. Expected outcomes: an established 

presence and an active volunteer base in the greater Albuquerque, Santa Fe and Las Cruces 

areas and in some smaller communities in the state; recruitment of Spanish and Navajo 

speaking volunteers; a toll-free help line accessible throughout the state; expanded 

knowledge of Medicare/ Medicaid waste, fraud and abuse through most of the state; an 

increase in the number of volunteers proficient in M/M issues; a high-percentage of seniors 

informed about Part D Medicare program enrollment procedures; and the recovery of 

thousands of dollars. Products will include a new Medicare/Medicaid packet; an updated 

volunteer training manual; an on-line volunteer training module; and on-line fraud alerts 

specific to the basics of Medicare, Medicaid, home health care, and Medicare prescription 

drug coverage and Medicare health plans. All products will be bilingual. 

Page 217 of 281 
Program: MP - Senior Medicare Patrol (SMP) 

Grant Number: 90MP0012

Project Title: New York State Senior Medicare Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

New York State Office for the Aging 

Health Benefits and Economic Section 

2 Empire State Plaza 

Albany, NY 12223-1251 

Contact:

Deana Prest 

Tel. (518) 474-2401 

Email: deana.prest@ofa.state.ny.us

AoA Project Officer: Barry Klitsberg 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to New York State Office for the Aging 

to support a Senior Medicare Patrol (SMP) program. The goal of this project is to ensure 

health care fraud control outreach and education in aging, social, health and law 

enforcement networks. The objectives are to: expand already established programs; expand 

the number of certified long-term care ombudsman and health insurance information 

counselors who are trained SMP volunteers; renew the contract with National Government 

Services, Inc. (NGS) to continue its role of maintaining a statewide toll-free hotline; work 

cooperatively with the NY Connects Program, which is an ADRC-type model with regard to 

staff development and community presentations; continue work with New York State Office of 

Medicaid Inspector General and the New York State Attorney General Medicaid Fraud Unit to 

increase enforcement and prosecution of fraud, error and abuse cases; work with long 

standing and new partners who are committed to reaching those in most economic and social 

need, who are particularly vulnerable to health care fraud, error and abuse due to social 

isolation; and develop multiple ways to disseminate SMP through a variety of conferences 

and symposiums. Expected outcomes are to: expand the network of SMP volunteers to 

include providers and seniors across residential and community-based systems; increase the 

awareness of isolated seniors; and reactivate the state workgroup. Products include: a final 

report consisting of a model for replication; a legislative proposal for whistleblower protection; 

data collection; a hotline number for general information; and updated outreach materials. 

Page 218 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0014

Project Title: North Carolina SMP Program

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

North Carolina Department of Insurance 

11 South Boylan Avenue 

Raleigh, NC 27603 

Contact: 

Carla S Obiol 

Tel. (919) 807-6900 

carla.obiol@ncdoi.gov

AoA Project Officer: Dorothy Smith 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to the Seniors' Health Insurance 

Information Program (SHIIP) to continue the North Carolina Senior Medicare Patrol (NCSMP) 

program. The goal of this program is to reduce Medicare/Medicaid error, fraud and abuse 

through statewide coordinated efforts of educational and promotional activities and to 

encourage reporting by Medicare/Medicaid beneficiaries and caregivers. The objectives are 

to: provide and expand education/promotional activities to Medicare/Medicaid beneficiaries, 

caregivers, and traditionally underserved populations; recruit, train and retain volunteers; 

received and resolve complaints of error, fraud and abuse; network with statewide partners to 

serve as advisors, trainers and to provide counseling assistance with resolving error, fraud 

and abuse issues; develop and disseminate educational materials to the SMP Resource 

Center and projects; participate in the SMP complaints management system and integration 

strategies; and evaluate program outcomes. The expected outcomes are: increased number 

of reported and resolved complaints; increased number of educational materials and 

strategies that will serve as examples for other SMP projects. The products from the project 

are written reports and evaluations; educational, promotional and training materials; and 

education and outreach activities. 

Page 219 of 281 
Program: Senior Medicare Patrol Program 

Grant Number: 90MP0010

Project Title: North Dakota Senior Medicare Patrol (II) Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Minot State University 

North Dakota Center for Persons with Disabilities 

500 University Ave W. 

Minot, ND 58707 

Contact: 

Linda Madsen 

Tel. (701) 858-3424 

Email: linda.madsen@minotstateu.edu

AoA Project Officer: Susan Raymond 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to Minot State University (MSU). The 

MSU Community Outreach Services of the North Dakota Center for Persons with Disabilities 

(NDCPD) will collaborate with AARP, North Dakota Disability Advocacy Consortium 

(NDDAC), Retired Senior Volunteer Program (RSVP), and the North Dakota Senior Health 

Insurance Counseling (SHIC) program to help rural seniors identify and report Medicare 

errors, fraud & abuse through a Senior Medicare Patrol (SMP) program. The goal of North 

Dakota SMP is to help all seniors, including those in the most rural counties and those with 

disabilities, review their Medicare bills to assure that no errors, fraudulent charges or abuse 

have occurred. Local volunteers, regional volunteer coordinators and disability adapted 

curricula will be utilized to educate underserved Medicare beneficiaries, including seniors in 

frontier counties, and individuals with disabilities on Medicare and Medicaid. Objectives are 

to: increase steering committee membership for comprehensive state input; sustain 8 

regional volunteer coordinators and at least 80 volunteers statewide; continue training 

regional coordinators and volunteers to provide beneficiary assistance; implement SMP 

activities for at least 400 beneficiaries, including information dissemination, group training, 

and one-on-one beneficiary education and inquiry processes; provide ongoing guidance and 

technical assistance to meet individual needs; and evaluate the impact of the ND SMP 

project. Expected outcomes include: greater public awareness of potential Medicare errors, 

fraud or abuse; increased skills in examining Medicare charges; and increased inquiries and 

resolution of errors, fraud & abuse. Products will include a final report with evaluation results; 

an accessible website; web-based training materials with CD-ROM; adaptable and disability 

accessible volunteer and constituent training materials; paper and electronic presentations; 

and professional articles. 

Page 220 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2947

Project Title: Ohio Seniors Fight Fraud

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Pro Seniors, Inc. 

7162 Reading Road, Suite 1150 

Cincinnati, OH 45237 

Contact: 

Rhonda Y Moore 

Tel. (513) 458-5506 

Email: rmoore@proseniors.org

AoA Project Officer: Kathleen Votava 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $129,280

FY2006 $129,280

FY2005 $129,280

FY2004 $

FY2003 $

Total $747,840

Project Abstract: 

This is a continuation of a grant to Pro Seniors to continue its Senior Medicare Patrol (SMP) 

Project, Ohio Seniors Fight Fraud (OSFF), in Southwestern Ohio. The goal of this project is 

to empower beneficiaries and consumers to prevent health care fraud through outreach and 

education. The objectives are to: establish SMP program coverage in all counties through 

strategic partnerships; increase beneficiary education and inquiry resolution regarding 

Medicaid fraud; foster national program visibility and consistency by enhancing the capability 

of the Aging and Disability Resource Centers and other community-based organizations to 

identify and refer health care fraud to Ohio SMP (OSMP); improve the efficiency of Ohio SMP 

through effective use of SMARTFACTS; and use creative outreach strategies to reach 

isolated and hard-to-reach populations, including low-income, rural and limited Englishspeaking individuals. The anticipated outcomes for the coming year include: recruiting and 

training 15 additional volunteers and educating at least 5,000 Medicare beneficiaries and 

caregivers, including 800 rural and 300 limited English-speaking populations, about health 

care fraud and inquiry resolution. The products of this project are: required reports, post 

surveys, volunteer newsletters, the health care fraud presentation, educational handouts, 

Personal Health Care Journals, and radio public service announcements. 

Page 221 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2952

Project Title: SUMMIT Medicare/Medicaid Fraud, Abuse and Waste Reduction

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Oklahoma Insurance Department 

2401 NW 23, Suite 28 

Oklahoma City, OK 73107 

Contact: 

Cindy A Brown 

Tel. (405) 521-6632 

Email: cindybrown@insurance.state.ok.us

AoA Project Officer: Lisa Theirl 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $160,000

FY2006 $160,000

FY2005 $160,000

FY2004 $

FY2003 $

Total $840,000

Project Abstract: 

This is a continuation of a grant for the Senior Medicare Patrol (SMP) program, Summit 

Medicare/Medicaid Fraud, Abuse and Waste Reduction Program (SUMMIT). The goal is to 

reduce Medicare/Medicaid fraud, abuse and waste in Oklahoma. Objectives are to: provide 

fraud information to Oklahomans using catalysts: general public (beneficiaries, family 

members, caregivers) through community presentations, public education, SMP training, with 

emphasis on geographically isolated rural/frontier elders; provide Temporary Assistance to 

Needy Families (TANF) recipients through the Literacy Resource Office's Life Skills module; 

assist isolated elders through home delivered meals by utilizing the Oklahoma Senior Center 

Association, and SUMMIT, SHICP, and AARP volunteers; educate college/university 

students through Oklahoma Campus Compact Service Learning; inform Hispanic elders 

through Hispanic Chambers of Commerce; and educate American Indians through Oklahoma 

Indian Council on Aging. The expected outcomes are: TANF recipients learn civic 

responsibility in reducing Medicaid fraud; more college/university students realize the urgency 

to preserve Medicare/Medicaid for future generations; and all Oklahomans, including 

Hispanics, American Indians, isolated rural/frontier and homebound beneficiaries learn selfprotection against healthcare fraud. Products: training/resource manual; brochures and 

resource flyers; lesson plan for Oklahoma Literacy Council Life Skills in audio & visual; fraud 

booklet written at 4th - 6th grade reading levels; a presentation for college/university Service 

Learning Coordinators; handouts in Spanish; and required reports, including evaluation 

results. 

Page 222 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2938

Project Title: Oregon Senior Medicare Patrol

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Oregon Department of Human Services 

Seniors and People with Disabilities 

676 Church Street, NE - 2nd Floor 

Salem, OR 97301-1076 

Contact: 

Elaine Young 

Tel. (503) 947-1199 

Email: elaine.young@state.or.us

Project Officer: Terry Duffin 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation grant to the Oregon Department of Human Services to support the 

Senior Medicare Patrol (SMP) project, in collaboration with the Oregon Senior Health 

Benefits Assistance Program (SHIBA), the Oregon Home Care Commission, the Governor's 

Commission on Senior Services, AARP, and the Oregon Department of Justice. The goals 

are to: continue to provide information, outreach, education, resources and advocacy through 

utilization of retired professionals as volunteers to combat Medicare/Medicaid (M/M) errors, 

fraud, and abuse; educate hard-to-reach M/M beneficiaries and those most vulnerable to 

elder rights violations by training in-home caregivers; and enhance outreach to tribal and 

minority communities. The objectives are to: improve SMP coverage area by gaining 

volunteers in Oregon's more rural areas through existing partnerships and new partnerships 

with retiree organizations and hospitals; conduct targeted outreach to dual-eligible clients to 

more fully educate them regarding their benefits, fraud and abuse; increase the SMP 

presence at the beneficiary level through direct beneficiary contacts, including distribution of 

the Oregon SMP newsletter; and improve efficiencies in the program by bringing the program 

into a larger Medicare unit in the Senior and People with Disabilities Division. The expected 

outcomes of the project are an increase in the number of volunteers and volunteer 

sponsoring organizations and an increased number of clients educated about fraud, waste 

and abuse. The products will include a training product that can be downloaded from the 

web for volunteers and others to access at their convenience, and required reports. 

Page 223 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0023

Project Title: Pennsylvania SMP

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

AgeOptions 

100 S. Broad Street, Suite 1500 

Philadelphia, PA 19110 

Contact: 

Diane Menio 

Tel. (267) 546-3434 

Email: menio@carie.org

AoA Project Officer: Carmen Sanchez 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to the Center for Advocacy for the 

Rights and Interests of the Elderly (CARIE) to support a Senior Medicare Patrol project for 

the state of Pennsylvania (PA-SMP). The goal is to detect, combat, and increase public 

awareness of health care fraud and abuse throughout the state of Pennsylvania, thereby 

reducing the incidence of such practices. The objectives are to: increase program visibility 

and awareness in Pennsylvania through onsite outreach activities; achieve comprehensive 

statewide coverage through a partnership with the State Health Insurance Information 

Program (SHIP); recruit and train retired beneficiaries to provide outreach and education to 

their peers; provide consultation and complaint resolution to consumers; provide measurable 

outcomes and demonstrate the project's effectiveness; and utilize partners and an advisory 

committee to build a strong program. The expected outcomes include: several thousand 

individuals reached at health fairs and presentations leading to increased awareness of fraud 

and its prevention; a presence in each of Pennsylvania's 67 counties through newsletter 

articles, consumer education materials and giveaways, and direct contact with consumers; 

new volunteers who will be trained on health care fraud detection and prevention; increased 

numbers of consumers assisted with complaint resolution; and an increase in reporting and 

savings to the Medicare program. Products will include: a semiannual and final reports, as 

required; consumer education materials, including flyers, bookmarks, promotional items, and 

health care calendars; consumer materials targeted to non-English speakers, i.e., flyers in 

Spanish, Chinese, etc.; volunteer newsletters and alerts; and a comprehensive website. 

Page 224 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2941

Project Title: Puerto Rico Alert to Fraud Project-Senior Medicare Patrol Project (SMPP)

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Puerto Rico Office of The Ombudsman For The Elderly 

Governors Office for Elderly Affairs 

P.O. Box 191179 

San Juan, PR 00919-1179 

Contact: 

Rossana Lopez-Leon 

Tel. (787) 721-6121 

Email: rlopez@ogave.gobierno.pr

AoA Project Officer: Carmen Sanchez 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of a grant to the Puerto Rico Office of the Ombudsman for the Elderly 

to support a Senior Medicare Patrol (SMP) project. The goal of the Puerto Rico Alert to 

Fraud is to enhance the capacity of the Puerto Rico SMP Alert to Fraud project (PR-Alf/SMP) 

to recruit and train volunteers to educate Medicare and Medicaid beneficiaries, caregivers 

and their families to detect and report health care fraud. The objectives are to: foster the 

national and program coverage; improve beneficiary education and inquiry resolution for 

other areas of health care fraud; foster program visibility to enhance its capacity to identify 

and refer suspected fraud; improve consistency and accuracy in collecting and reporting 

program performance date; improve the efficiency while increasing results for both 

operational and quality measures; and ensure the training and education of targeted isolated 

and hard-to-reach populations. The expected outcomes are: one major initiative per quarter 

in collaboration with Consortium members to produce anti-health care fraud strategies and 

activities; volunteers and staff demonstrate at least 90% proficiency in knowledge relevant to 

prevention, detection, and reporting health care fraud; at least 90% average on participants' 

evaluations during outreach educational activities; 90% rate of compliance with performance 

objectives; and less than 5% error rate in collecting and reporting program data in the 

SMARTFACTS system. Products from the project will include a final report; educational 

materials in Spanish; and outcome assessments of all strategies for outreach and education 

and web access to program information. 

Page 225 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0002

Project Title: Senior Medicare Patrol Projects - Providing education, information, and 

Counseling to Seniors Regarding Medicare Fraud 

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Rhode Island Department of Elderly Affairs 

74 West Road 

Cranston, RI 02920 

Contact: 

Maria N Sansiveri 

Tel. (401) 462-0560 

Email: maria@dea.state.ri.us

AoA Project Officer: Gene Brown 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year Senior Medicare Patrol Project (SMP). The 

goals are to recruit and train volunteers to provide a comprehensive, coordinated statewide 

information and referral system to educate groups of Medicare/Medicaid beneficiaries, their 

families and professionals about Medicare/Medicaid fraud, error and abuse. The objectives 

are to: use the Rhode Island Adult and Disability Resource Center (ADRC) known as "The 

Point" as the central Information and Referral access for persons concerned about SMP 

issues; contract with six regional agencies to help coordinate SMP activities; partner with the 

State Health Insurance Information Program (SHIP) program by conducting a variety of cosponsored educational community outreach events; recruit more counselors than expected; 

improve program visibility and impact (particularly in Providence); provide counseling to nonEnglish speakers (especially Spanish); professionalize the training process of SMP 

counselors through structured certification; and access Department. of Elderly Affairs' 

contacts and public awareness mechanisms in communicating the SMP message to the 

network and relevant community members. As with the successful activities of the past year, 

the expected outcome will be increased program centralization to assure that achievable and 

measurable activities occur every week. Products from this project are: a final report, 

including evaluation results; a resource guide; press releases; newspaper articles; brochures; 

and abstracts for national conferences. 

Page 226 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0009

Project Title: Senior Fraud Counseling

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

South Carolina Lieutenant Governor's Office on Aging 

Senior Medicare Patrol 

1301 Gervais Street, Suite 200 

Columbia, SC 29201 

Contact: 

Gloria McDonald 

Tel. (803) 734-9902 

mcdong@aging.sc.gov

Ronald Taylor 

Fiscal 

Year 

Funding 

Amount

FY2009 $175,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $175,000

Project Abstract: 

This is the first year continuation of a three-year grant for the Senior Medicare Patrol (SMP) 

program administered by the Lieutenant Governor's Office on Aging-Division of Aging 

Services. The SMP program provides services that address fraud in Medicare/Medicaid 

through a statewide aging network with Area Agencies on Aging (AAAs) as service providers 

in each of the ten regions of the state. The goal of the Senior Medicare Patrol project is to 

provide statewide fraud education and seminars to individuals and groups about Medicare 

and Medicaid fraud, error and abuse. The objectives are to: conduct ongoing seminars, 

submit fraud alerts to the media, make home visits and telephone contacts to inform 

beneficiaries and the public at large about Medicare health care fraud; establish a system for 

individuals to report suspected fraud/abuse and errors; recruit, train, and retain counselors to 

help individuals review and understand health care summary notices; collaborate with aging 

network, PalmettoGBA Benefits Integrity Unit and the Attorney General's Office to train 

counselors and to serve as a clearinghouse for suspected fraud; and disseminate project 

information, literature and promotional items. The outcomes of the project are to reach 

diverse beneficiary population with awareness of fraudulent tactics and increase reading of or 

have caregivers review Medicare Summary Notices for fraud and errors. Products include: 

semi-annual reports; final report, including evaluation results; and educational and 

promotional materials. 

Page 227 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0007

Project Title: South Dakota SMP Program

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

East River Legal Services Corporation 

335 N. Main Ave., #300 

Sioux Falls, SD 57104 

Contact:

Candise H. Gregory 

Tel. (605) 336-2475 

Email: gregory.candise@att.net

AoA Project Officer: Courtney Hoskins 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

The East River Legal Services (ERLS) supports this first year continuation grant of the threeyear South Dakota Senior Medicare Patrol (SMP) project in collaboration with the South 

Dakota State Health Insurance Information Program (SHIPP), Cooperative Extension 

Services, South Dakota Division of Insurance and South Dakota Attorney General's Office. 

The goal of the project is to provide education and information relating to Medicare fraud, as 

well as other types of health care and consumer fraud. The objectives are to: recruit and 

train volunteers from the network; educate seniors about Medicare benefits and how to 

recognize and report suspected fraud, error, waste and abuse; expand outreach to seniors in 

all 66 counties of the state; keep seniors advised in a timely manner of issues affecting their 

health and well-being; and increase inquiry resolution for seniors. The expected outcome is 

an increase in client contacts and households reached through media events. Products will 

include a final report of project results and statistical information; an interactive website; the 

Medicare Advantage handout; scam alerts; and a targeted newspaper column and additional 

self-help and information publications and tools to assist seniors with health care matters. 

Page 228 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2944

Project Title: Tennessee Senior Medicare Patrol Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Upper Cumberland Development District 

1225 South Willow Ave. 

Cookeville, TN 38506 

Contact: 

Holly Williams 

Tel. (931) 432-4111 

Email: hwilliams@ucdd.org

AoA Project Officer: Joyce Robinson-Wright 

FY2009 $180,000

Fiscal 

Year 

Funding 

Amount

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of a grant to the Upper Cumberland Development District/Area Agency 

on Aging and Disability (AAAD) to administer a three-year Senior Medicare Patrol (SMP) 

program focusing on fraud, waste, and abuse monitoring in the Medicare and Medicaid 

systems. The goal is to enhance and expand the existing Tennessee Senior Medicare Patrol 

Project by focusing on recruitment of qualified volunteers, strengthening our community 

partnerships and expanding our joint Senior Medicare Patrol project (SMP) and State Health 

Insurance Information Program (SHIP) Advisory Board. The objectives are to: expand and 

enhance the joint SMP/SHIP Advisory Board; hold statewide volunteer trainings to increase 

the volunteer base; develop new outcome measurement tools; produce a quarterly 

newsletter; enhance the SMP website; enhance media exposure; disseminate project 

information; and provide semi-annual reports to AoA. The expected outcome is increased 

awareness of the Tennessee SMP program. Products from this project are: required reports, 

including evaluation results; and magnifying glasses, fraud playing cards, and other volunteer 

recognition items. 

Page 229 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2946

Project Title: Senior Medicare Patrol Project - MOD Squad

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Better Business Bureau Educational Foundation 

1333 West Loop South, Suite 1200 

Houston, TX 77027 

Contact:

Candice Twyman 

Tel. (713)341-6141 

ctwyman@bbbhou.org

AoA Project Officer: Derek Lee 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $125,000

FY2006 $125,000

FY2005 $125,000

FY2004 $

FY2003 $

Total $735,000

Project Abstract: 

This is a continuation of a grant to the Better Business Bureau Education Foundation to 

accomplish and continue to implement a collaborative effort utilizing volunteers and 

community stakeholders educating Medicare and Medicaid beneficiaries to detect and report 

healthcare fraud, waste and abuse. The goal for the project is to combat Medicare fraud and 

waste by recruiting and training retired professionals as volunteer educators to reach other 

older adults throughout the Greater Houston area and empower them to become partners in 

the effort to end Medicare fraud, waste and abuse. The objectives are to: develop and 

maintain collaborative efforts with eldercare agencies and service organizations; engage 

older adults to actively participate in protecting themselves from consumer fraud; recruit and 

train volunteers to provide education; expand outreach to limited English-speaking 

populations; and increase awareness and engage agencies and professionals in promoting 

the prevention of healthcare fraud. Expected outcomes are: increased understanding of 

Medicare benefits and fraud; increased detection and reporting of healthcare fraud; and 

increased awareness of consumer fraud. Products will include: educational materials for 

limited English-speaking populations; tools to reach low-literate beneficiaries; and training 

tools for professionals. 

Page 230 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0008

Project Title: The Utah SMP Program 

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Utah Department of Human Services 

Division of Aging and Adult Services 

Human Services 

120 N 200 W, #325 

Salt Lake City, UT 84103 

Contact: 

Darren Hotton 

Tel. (801) 538-4412 

Email: dhotton@utah.gov

 

AoA Project Officer: Susan Raymond 

Fiscal 

Year 

Funding 

Amount

FY2009 $158,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $158,000

Project Abstract: 

This is the first year continuation of a three-year grant to Utah Legal Services to support a 

Senior Medicare Patrol (SMP) project. The goal of the three-year project is to educate and 

empower Utah seniors and caregivers to prevent and report health care fraud by recruiting 

and training volunteers to conduct outreach and education and to interact with law 

enforcement. The objectives are to: increase outreach to the Native American population 

through our sub-grantee, Utah State Ombudsman Program; increase the quality and scope 

of community education events and one-on-one sessions; increase the number of inquiries 

and rate of resolution of reported health care fraud; gather data for grant reporting; and 

increase statewide travel. The expected outcomes are: an increased awareness of health 

care fraud following educational presentations and one-on-one sessions; and an increased 

number of beneficiaries who read notices, report errors and seek assistance from this project. 

Products will include: project reports, as required; training materials; evaluation results; 

website; brochures; and a monthly newsletter. 

Page 231 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2953

Project Title: Senior Medicare Patrol Program

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

Virginia Association of Area Agencies on Aging 

24 E. Cary Street, Suite 100 

Richmond, VA 23219 

Contact: 

Susan Johnson 

Tel. (804) 644-5628 

sjohnson@theV4A.org

AoA Project Officer: Carmen Sanchez 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $160,000

FY2006 $160,000

FY2005 $160,000

FY2004 $

FY2003 $

Total $840,000

Project Abstract: 

This is a continuation of a grant to the Virginia Association of Area Agencies on Aging (V4A) 

to manage a statewide Senior Medicare Patrol Project (SMP) to reduce public funds lost in 

Virginia due to Medicare/Medicaid error, fraud, and abuse. The goal of V4A is to provide 

education about health care fraud, error and abuse, and prevention tools to beneficiaries, 

family members and providers. The approach will expand use of a toll-free hotline for 

questions, referrals, and the reporting of Medicare/Medicaid fraud; subcontract with local 

Area Agencies on Aging (AAA) and Aging and Disability Resource Center (ADRC) programs 

for older volunteers to assist with public education and outreach activities; and collaborate 

with statewide organizations that reach target populations. Objectives are to: disseminate 

80,000 Medicare Medicaid Protection Toolkits through AAAS with State Health Insurance 

Assistance Program/Virginia Insurance Counseling Assistance Program Activities, TRIAD 

chapters, Senior Navigator Centers, local Social Services, and other partners; train staff and 

volunteers statewide; establish systematic outreach plans to reach beneficiaries, caregivers, 

and residents in long term care facilities, and rural, low-income, and Hispanic populations; 

collaborate with statewide organizations/agencies to enhance their participation in SMPrelated activities; and enhance responses to callers' inquiries and complaints. The expected 

outcomes are: increased number of beneficiaries, caregivers, and family members will learn 

about health care fraud, preventing fraud, and reporting Medicare or Medicaid fraud; and 

increased number of referrals to SMP by way of statewide partners. Products from this 

project will include: a Medicare/Medicaid fraud prevention toolkit; articles for media 

publication throughout the state; an updated website for public use; and a quarterly SMP 

communique for communication among AAA partners, and aging, health and consumer 

partners. 

Page 232 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0017

Project Title: Senior Medicare Patrol Project - Cooperative Agreement

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Virgin Islands Department of Human Services 

Senior Citizen Affairs Administration 

Knud Hansen Complex Building A 

Charlotte Amalie, VI 00802 

Contact:

Michal Rhymer-Charles 

Tel. (340) 774-1166 

Email: mrhymercharles@dhs.gov.vi

AoA Project Officer: Carmen Sanchez 

Fiscal 

Year 

Funding 

Amount

FY2009 $75,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $75,000

Project Abstract: 

This is the first year continuation of a three-year grant to the Virgin Islands Department of 

Human Services. The grant will support a Senior Medicare Patrol (SMP) program which will 

recruit and train senior citizens, including retired professionals as volunteers, to educate 

Medicare and Medicaid beneficiaries and/or their caregivers on how to protect themselves 

from fraud and abusive health care practices. The primary goal of the SMP program is to 

continue to expand the program territory wide, through recruitment, outreach, referral, and 

follow-up. The objectives of the project are to: identify target populations, such as seniors in 

isolated and hard-to-reach areas; develop educational materials to serve the bilingual and 

culturally diverse and visually impaired, as well as those with limited literacy skills; develop a 

reporting system to report and follow up on any suspected fraud or abuse; implement 

program coverage strategies, such as web-based applications, media and outreach events; 

enhance beneficiaries' education through various collaborative efforts and group training 

sessions with statewide partners; and establish outreach outcomes for seniors at eight senior 

citizen centers territory wide, caregiver support groups, senior independent living 

communities, and assisted living facilities. The expected outcomes are an increased number 

of: volunteers recruited, training sessions, beneficiaries reached, and educational activities. 

Products will include: required reports, including evaluation results; brochures; and 

educational materials. 

Page 233 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0003

Project Title: Vermont Senior Medicare Patrol (SMP): Helping Medicare eneficiaries 

Become Active Partners in Health Care

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Community of Vermont Elders 

P.O. Box 1276 

Montpelier, VT 05641 

Contact:

Dolly Fleming 

Tel. (802) 229-4731 

Email: dolly@vermontelders.org

AoA Project Officer: Barry Michaels 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to provide a Senior Medicare Patrol 

(SMP) project, Community of Vermont Elders. The goals of the project are to: build upon the 

current structure of collaborative efforts with professionals in Vermont's elder network who 

can assist with public education, identification of Medicare error and waste and referral; 

continue to utilize the media as a primary educational strategy, which effectively provides 

useful resource information to isolated and homebound beneficiaries; continue to identify 

opportunities to educate Vermonters about Medicare program benefits, rights and 

protections; and develop an outreach and education strategy to reach people with disabilities. 

The objectives are to: continue collaborative agreement with AAAs; collaborate with the 

State Health Insurance Information Program (SHIP) to form an educational strategy for 

people with disabilities; continue collaboration with the National Senior Service Corps; 

continue expansion of referral and reporting services; identify/train and incorporate an intern 

as a designated program outreach assistant; and strengthen/broaden representation and 

expertise on the Vermont SMP Advisory Council. The expected outcomes are: a reduction in 

Medicare/Medicaid error, fraud and abuse; increased number of referrals received; an 

increase in the number of volunteers engaged in education; an increase in the number of 

beneficiaries and providers educated; addition of key stakeholders in Advisory Council; 

increased reporting; and increased public awareness about Vermont SMP and Medicare 

error, fraud and abuse. Products from this project will include: a final report, including 

evaluation results; public service announcements; and educational materials. 

Page 234 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90AM2942

Project Title: 2008-2009 Senior Medicare Patrol Project Consortium

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

State of Washington 

Office of the Insurance Commissioner 

P.O. Box 40256 

Olympia, WA 98504 

Contact:

Tobi Johnson 

Tel. (360) 725-7218 

Email: tobij@oic.wa.gov

AoA Project Officer: Terry Duffin 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation grant to the Washington State Office of the Insurance Commissioner's 

(OIC) Statewide Health Insurance Benefits Advisors (SHIBA) HelpLine Statewide Health

Insurance Benefits Advisors (SHIBA) HelpLine to support a Washington State Senior 

Medicare Patrol (SMP) project. The goal of the project is to prevent Medicare and Medicaid 

fraud, abuse, and waste by educating consumers on how to better monitor what these 

programs pay for on their behalf, and to identify and report potential discrepancies. The 

objectives are to: recruit, train, and place retired professional people to provide service; 

provide public education, counseling and outreach to seniors and their caregivers and those 

enrolled in Medicaid; develop and distribute, via volunteers who specialize in fraud education 

and consumer protection, information statewide to the public targeting rural, diverse, and 

limited-English speaking populations; develop effective fraud training curricula that supports 

high-quality service; address the information gap by recruiting technologically-savvy 

volunteers and ensuring appropriate resources are available to enter information directly into 

the SMARTFACTS system; and develop and maintain community partnerships that increase 

program capacity and sustainability. The expected outcomes are: Medicare and Medicaid 

beneficiaries and caregivers are better informed and educated on how to prevent, monitor, 

and report potential fraud and abuse; more efficient tracking of fraud and abuse incidences 

and trends by partnerships; and more trusted and competent volunteer networks to support 

rural, diverse, and limited-English speaking communities. Products will include: semiannual performance measures and financial reports; social marketing and public education 

materials, and specific fraud volunteer training materials. 

Page 235 of 281 
Program: MP - Senior Medicare Patrol Project 

Grant Number: 90AM2943

Project Title: West Virginia Senior Medicare Patrol Project

Project Period: 07/01/2005 - 05/31/2011

Grantee: 

AARP Foundation 

601 E Street, N.W. 

Washington, DC 20049 

Contact:

Julia Stephens 

Tel. (202) 434-2051 

Email: jstephens@aarp.org

AoA Project Officer: Barry Klitsberg 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $180,000

FY2007 $180,000

FY2006 $180,000

FY2005 $180,000

FY2004 $

FY2003 $

Total $900,000

Project Abstract: 

This is a continuation of a grant to the AARP Foundation, for support of the West Virginia 

Senior Medicare Patrol Project. The goal is to further reduce public funds lost to Medicare 

and Medicaid through error, waste, fraud and abuse by continuing to expand the efforts 

implemented in previous years. The project objectives are to: recruit, train and support 

volunteer leaders and educators to provide education, training, and consultation about health 

care fraud and abuse to their peers in rural counties; conduct a media campaign to promote 

the project and toll-free hotline using newspaper, radio, and television; provide education to 

Medicare and Medicaid beneficiaries; and provide assistance through complaint resolution to 

those reporting suspected health care fraud and abuse. Expected outcomes are: reduction 

in error, waste, fraud, and abuse in the delivery of health care services within Medicare and 

Medicaid; increased number of volunteer led workshops, beneficiaries educated, complaints 

received, providers trained, and savings to the Medicare and Medicaid programs; and an 

increase in the number of people reached through public relations and marketing activities. 

Products will include a training film aired on cable access television, and required project 

reports. 

Page 236 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0016

Project Title: Wisconsin SMP Coalition Of Wisconsin Aging Groups Senior Medicare 

Patrol Project

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Coalition of Wisconsin Aging Groups 

Legal Services 

2850 Dairy Drive, Suite 100 

Madison, WI 53718-6742 

Contact:

Bridget M Erstad 

Tel. (608) 224-0606 

Email: bridgete@cwag.org

AoA Project Officer: Sam Gabuzzi 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to the Coalition of Wisconsin Aging 

Groups' (CWAG) Elder Law Center to build on the successful volunteer and partnering 

programs of its nine-year Senior Medicare Patrol Grant ("the project") and Integration Grant 

by expanding the project's scope to address healthcare integrity broadly. The goal is to train 

seniors to be better healthcare consumers and to increase the reports of healthcare error, 

fraud, waste, and abuse. The objectives are to: enhance its statewide coverage by 

continuing to revise its volunteer structure by expanding the current regional system aligned 

with the CWAG nine districts to a county-based lead volunteer representative system and 

redesign the project's volunteer positions to reflect four distinct levels of involvement; 

improve beneficiary education and problem resolution by continuing to create training 

materials and publications for use by volunteers and project partners that teach seniors to be 

better healthcare consumers by identifying and reporting healthcare integrity problems; foster 

national visibility by continuing to share materials and experiences with the National 

Consumer Protection Technical Resource Center; improve the efficiency and effectiveness of 

the project through increased complaint referrals by encouraging Wisconsin seniors to report 

suspected cases of healthcare fraud more broadly; and continue to focus educational and 

training opportunities for isolated and hard-to-reach populations. Expected outcomes 

include: an increase in the number of elderly individuals educated; an increase in the number 

of inquiries to the project and rate of inquiry resolution; and an increase in Medicare, 

Medicaid, and other healthcare savings. Products will include: project reports, as required; 

evaluation results; two websites, written articles for publication; data on performance 

outcomes; and presentations at national conferences. 

Page 237 of 281 
Program: Senior Medicare Patrol (SMP) 

Grant Number: 90MP0025

Project Title: Senior Medicare Patrol for Wyoming

Project Period: 06/01/2009 - 05/31/2012

Grantee: 

Wyoming Senior Citizens, Inc 

PO Box BD 106 West Adams Avenue 

Riverton, WY 82501 

Contact:

Charlie Simineo 

Tel. (307) 856-6880 

Email: execdir@wyoming.com

AoA Project Officer: Courtney Hoskins 

Fiscal 

Year 

Funding 

Amount

FY2009 $180,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $180,000

Project Abstract: 

This is the first year continuation of a three-year grant to the Wyoming Senior Citizens, Inc. to 

conduct a Senior Medicare Patrol (SMP) project to serve isolated and rural, low income, 

disabled, and Native Americans on the Wind River Indian Reservation. The goal of this 

project is to educate those persons who will benefit from Medicare fraud and abuse 

information, Medicare Modernization Act and Medicare Part D changes. The objectives are 

to: train SMP volunteers; educate beneficiaries and general public about Medicare fraud; 

test beneficiaries' knowledge through feedback survey to determine if information presented 

was beneficial; track data on number, types and results of referrals; recruit and maintain 

retired professionals, as well as one bilingual volunteer; educate seniors who do not visit 

senior centers; establish at least one coalition partner in each county; and update educational 

materials. Expected outcomes are: increased volunteer knowledge; increased awareness of 

the SMP program in the general population; increased identification of problems on health 

care bills and explanation of benefits; increased efficiency in tracking data; and increased 

savings of dollars in the Medicare program. Products from the project will include: 

brochures, posters, bookmarks, health care journals, playing cards, hand sanitizers, band-aid 

kits and other educational materials and reports as required, including evaluation results. 

Page 238 of 281 
Program: Senior Medicare Patrol (SMP) Integration Projects 

Grant Number: 90SM0007

Project Title: Integration with Current SMP Project to Empower Seniors to Prevent 

Healthcare Fraud.

Project Period: 09/30/2008 - 06/30/2010

Grantee: 

Arkansas Department of Health and Human Services 

Divison of Aging and Adult Service 

700 Main Street 

P.O. Box 1437, Slot S530, AR 72203 

Contact: 

John Pollett 

Tel. (501) 682-8504 

Email: john.pollett@arkansas.gov

AoA Project Officer: Doris Summey 

Fiscal 

Year 

Funding 

Amount

FY2009 $285,194

FY2008 $114,806

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $400,000

Project Abstract: 

This is the final year of a two-year project. The Arkansas Department of Human Services, 

Division of Aging and Adult Services and the University of Arkansas at Little Rock (UALR) 

Integration project will focus on expanding and integrating program coverage within one of 

the poorest, most rural areas in the nation, the Arkansas Delta, via an innovative community 

outreach, education and research model that can be successfully replicated by other SMPs 

across the country. Partnerships with organizations in the Arkansas Delta, the Tri-County 

Rural Health Network, and the one-of-a-kind Senior Justice Center will facilitate this initiative. 

The objectives are to: determine what underserved Medicare beneficiaries want and need to 

know, and to educate them about Medicare benefits and the potential for healthcare fraud 

associated with those benefits; and conduct a research study to determine the best 

method(s) for reaching out to rural seniors, either through personal inquiry in their homes or 

in focus groups. Expected outcomes: a better understanding of how rural seniors prefer to 

receive health-related information; increased beneficiary awareness of the need to prevent 

healthcare fraud and abuse; changes in beneficiary behavior as they apply what they have 

learned about preventing healthcare fraud, avoiding becoming the victim of healthcare scams 

prevalent in the Delta, and accessing benefits to which they are entitled. Products will 

include the results of data collection and analyses shared with AoA, other SMPs, the Aging 

and Disability Resource Network, and the nationwide aging network via a study report to be 

published in a scientific journal dedicated to aging issues. 

Page 239 of 281 
Program: Senior Medicare Patrol (SMP) Integration Projects 

Grant Number: 90SM0005

Project Title: Delaware Senior Medicare Patrol Integration Project

Project Period: 09/17/2008 - 06/30/2010

Grantee: 

Delaware Department of Health and Social Services 

Division of Services for Aging and Adults with Physical Disabilities 

1901 N. DuPont Highway 

New Castle, DE 19720 

Contact: 

Cynthia Allen 

Tel. (302) 255-9390 

Email: cynthia.allen@state.de.us

AoA Project Officer: Doris Summey 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

This is the final year of a two-year project. The grantee and state unit on aging, Division of 

Services for Aging and Adults with Disabilities, supports this two-year SMP integration project 

in collaboration with the State of Delaware Department of Health and Social Services, 

Delaware Aging, Network, Latin American Community Center, and Retired Senior Volunteer 

Program. The goal is to expand coverage of the existing projects through partners and 

volunteers by using innovative techniques, in providing education and developing responsible 

healthcare advocates in the prevention of healthcare fraud. The objectives are to: foster 

national and statewide program coverage; foster national program visibility and consistency; 

target training and education to isolated and hard-to-reach populations. Expected outcomes: 

an increased number of beneficiaries educated in rural, isolated, and hard-to-reach areas; an 

increased number of volunteers recruited and trained; and an increase in the number of 

inquiries and complaints of potential fraud, error, and abuse received. Products include: a 

divisional website; state plan; three display panel brochures for general outreach to seniors, 

volunteers, and baby boomers; an outreach kit developed from a Medicare/Medicaid 

Assistance Rolling Councilor (MARC) pilot project; and reports that include evaluation results, 

as required. 

Page 240 of 281 
Program: Senior Medicare Patrol (SMP) Integration Projects 

Grant Number: 90SM0003

Project Title: SMP Integration Grant

Project Period: 09/30/2008 - 06/30/2010

Grantee: 

Maryland Department of Aging 

301 West Preston Street, Room 1007 

Baltimore, MD 21201 

Contact: 

Donna Smith 

Tel. (410) 767-1271 

Email: dms@ooa.state.md.us

AoA Project Officer: Doris Summey 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

This is the final year of a two-year project. The goals of the Maryland Senior Medicare Patrol 

(SMP) Integration Grant are to expand the reach of the SMP program, using the SMP fraud 

prevention message, to educate rural, isolated senior Marylanders and tribal elders who are 

Medicare beneficiaries; and to strategically partner with Area Agencies on Aging (AAAs), and 

Aging and Disability Resource Centers (ADRCs) in outreach initiatives. The objectives are 

to: identify isolated populations in rural and tribal areas; ensure that the SMP fraud message 

reaches rural isolated senior Marylanders and tribal elders; provide necessary skills, 

knowledge and tools to help prevent fraud, error or abuse in healthcare, and empower 

seniors to take action to report instances of suspected fraud, error or abuse; develop regional 

outreach in counties that do not have the SMP program (Calvert, Charles, Cecil, Allegany, 

Garrett, Washington); ensure coordination in targeted counties where there is an ADRC 

already partnered with an AAA; develop and implement a rural outreach plan with the Rural 

Maryland Health Council; develop new partnerships with Native American organizations in 

Southern Maryland; identify and test best practices to reach the isolated populations in rural 

and tribal areas; provide customized training and education in rural and tribal areas; recruit 

and train volunteers in rural and tribal areas; and foster program visibility and consistency. 

Expected outcomes: two regional SMPs established in coordination with the existing ADRCs 

in rural western Maryland and the lower Eastern Shore; an outreach sub-committee created 

to assist and advise the creation and implementation of an outreach plan targeted to rural, 

isolated senior Marylanders and tribal elders; and a SMARTFACTS data system in use. 

Products will include: a targeted outreach plan; customized SMP educational materials; 

media samples; and a final report, as required. 

Page 241 of 281 
Program: Senior Medicare Patrol (SMP) Integration Projects 

Grant Number: 90SM0004

Project Title: Senior Medicare Patrol Integration

Project Period: 09/17/2008 - 06/30/2010

Grantee: 

Massachusetts Executive Office of Elder Affairs 

1 Ashburton Place, 5th floor 

Boston, MA 02108-1518 

Contact: 

Richard Miranda 

Tel. (617)222-7439 

Email: richard.miranda@state.ma.us

AoA Project Officer: Doris Summey 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,898

FY2008 $100,898

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $201,796

Project Abstract: 

In its final year of a two-year project, the goal of the Senior Medicare Patrol (SMP) Integration 

Project, in collaboration with the Executive Office of Elder Affairs (EOEA), is to develop 

innovative strategies to expand the SMP program message to reach and educate isolated 

elders in rural areas and in counties with high American Indian/Native American presence. 

The objectives are to: foster national and statewide program coverage by developing 

strategic approaches in collaboration with the Massachusetts' aging network; foster national 

program visibility and consistency in the dissemination of the SMP program message of 

preventing healthcare errors, fraud and abuse; and target training and education about the 

SMP program message to isolated and hard-to-reach populations, such as rural elders and 

American Indians/Native Americans, in order to facilitate ongoing outreach and education of 

geographically isolated populations in Massachusetts. Expected outcomes: program 

message integrated into four statewide programs administered by EOEA--Protective 

Services, Money Management, Family Caregiver Support Program and Long-term Care 

Ombudsman Program; MP outreach broadened and education efforts expanded to rural, 

insular and American Indian/Native American populations across Massachusetts, through 

community presentations, public forums, and targeted local media; increased awareness of 

the SMP program message and imminent changes in Medicare/Medicaid reimbursement 

policy reforms; and an increase in the number of inquiries, complaint and referrals made to 

the MA SMP program. Products include: culturally appropriate PSAs; articles for 

newsletters; a survey; culturally sensitive training modules; and required reports. 

Page 242 of 281 
Program: Senior Medicare Patrol (SMP) Integration Projects 

Grant Number: 90SM0006

Project Title: Ohio SMP Integration Project

Project Period: 09/30/2008 - 06/30/2010

Grantee: 

Ohio Department of Aging 

50 W. Broad Street 9th Floor 

Columbus , OH 43215 

Contact: 

Erin Pettegrew 

Tel. (614) 995-0882 

Email: epettegrew@age.state.oh.us

AoA Project Officer: Doris Summey 

Fiscal 

Year 

Funding 

Amount

FY2009 $99,551

FY2008 $99,551

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $199,102

Project Abstract: 

This is the final year of a two-year project. The goal of the Ohio Department of Aging (ODA) 

and the Senior Medicare Patrol (SMP) Integration Project is to develop a cooperative network 

of state and local partnerships that informs and trains senior volunteers, aging network 

personnel, health care providers, and others in contact with seniors, their families and 

caregivers to prevent Medicare and Medicaid fraud, error, and abuse. The objectives are to: 

expand the capacity of local partners who assist rural, elderly consumers to recognize 

potential Medicare fraud; develop effective outreach strategies that overcome regional 

barriers to communication with consumers; create and disseminate educational materials to 

elderly consumers and their representatives; and utilize lessons learned as models for 

expanding the project statewide. Expected outcomes: increased number of aging network 

professionals trained to work with consumers on how to identify potential Medicare waste, 

fraud or abuse; increased number of consumers reporting Medicare concerns to the Ohio 

SMP; increased knowledge base of local partners; and an expanded number of cable 

television stations airing a training segment. Products include: a training video; pre-and 

post-surveys; and educational materials. 

Page 243 of 281 
Program: Senior Medicare Patrol (SMP) Integration Projects 

Grant Number: 90SM0001

Project Title: Puerto Rico SMP Integration Project

Project Period: 09/30/2008 - 06/30/2010

Grantee: 

Puerto Rico Office of the Ombudsman for the Elderly 

PO Box 191179 

San Juan, PR 00919-1179 

Contact: 

Rossana Lopez-Leon 

Tel. (787)721-6121 

Email: rlopez@ogave.gobierno.pr

AoA Project Officer: Doris Summey 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

This is the final year of a two-year project. The goal of the Puerto Rico Office of the 

Ombudsman for the Elderly (PROOE) and the Senior Medicare Patrol (SMP) Integration 

Project is to enhance the capacity of its SMP, Alert to Fraud Project (PR-ALF/SMP), to deliver 

its fraud awareness message to Medicare/Medicaid beneficiaries, caregivers and their 

families residing in isolated and hard-to-reach rural areas. Objectives are to: extend the PR 

SMP program's network of collaborative partners to include programs serving hard-to-reach 

rural communities; develop a cadre of 15 local volunteers geared toward conducting outreach 

activities in select hard-to-reach rural communities in their municipalities; establish 

distribution links through AAAs to disseminate fraud awareness and prevention materials to 

participants in programs serving beneficiaries in rural areas; establish distribution links 

through senior centers for Medicare/Medicaid fraud awareness and prevention material to 

reach participants residing in rural areas; and develop and deliver media outreach activities 

aimed at reaching isolated, hard-to-reach residents in rural communities. Expected 

outcomes are: an increase in the number of one-on-one counseling sessions and group 

educational sessions offered to beneficiaries residing in rural areas; an increase in the 

number of Medicare/Medicaid beneficiaries residing in rural areas who show awareness 

regarding healthcare error, fraud, and abuse; and an increase in the number of inquiries and 

complaints received by the SMP project originating from beneficiaries from rural communities 

that result in some action. Products include: educational materials in Spanish; radio 

presentations; newspaper articles; and reports as required. 

Page 244 of 281 
Program: Senior Medicare Patrol (SMP) Integration Projects 

Grant Number: 90SM0002

Project Title: Wisconsin Senior Medicare Patrol Rural and Tribal Outreach Project

Project Period: 09/30/2008 - 06/30/2010

Grantee: 

Wisconsin Department of Health Services 

Division of Disabiity and Elder Services 

1 West Wilson Street 

P.O. Box 7850 

Madison, WI 53707-7850 

Contact: 

James Schmidlkofer 

Tel. (608) 266-5364 

Email: james.schmidlkofer@wisconsin.gov

AoA Project Officer: Doris Summey 

Fiscal 

Year 

Funding 

Amount

FY2009 $100,000

FY2008 $100,000

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $200,000

Project Abstract: 

This is the final year of a two-year project. The goal of the Wisconsin Rural and Tribal 

Outreach Program is to raise awareness of the Senior Medicare Patrol (SMP) fraud message 

among Wisconsin's rural and tribal elderly population, and serve as a conduit for persons 

interested in volunteering for the program. The objectives are to: foster national and 

statewide program coverage by utilizing components of the aging network and non-aging 

partners, such as the University Extension Agents, Farm Bureau Rural Electric Cooperatives 

and other organizations in contact with rural hard-to-reach elderly; foster national program 

visibility and consistency; and target training and education to isolated and hard-to-reach 

populations. Expected outcomes are: an increased number of rural and tribal elders who are 

educated about healthcare fraud, waste, error and abuse; an increased number of partner 

organizations willing to work on educating consumers; an increased number of consumers 

reporting healthcare fraud concerns to the SMP; and a greater involvement of the aging 

network and Aging and Disability Resource Centers (ADRCs) in conducting outreach and 

public education. Products include: educational materials; materials suited for Tribal elders; 

and reports as required. 

Page 245 of 281 
Program: Senior Medicare Patrol (SMP) – Resource Center 

Grant Number: 90AM2807

Project Title: National Consumer Protection Technical Resource Center

Project Period: 09/30/2003 - 08/31/2010

Grantee: 

Hawkeye Valley Area Agency On Aging 

2101 Kimball Avenue, Suite 320 

Waterloo, IA 50702 

Contact: 

Shirley Merner 

Tel. (319) 358-9402 

smerner@hvaaa.org

AoA Project Officer: Barbara Lewis 

Fiscal 

Year 

Funding 

Amount

FY2009 $1,293,546

FY2008 $1,819,994

FY2007 $1,290,000

FY2006 $600,000

FY2005 $600,000

FY2004 $600,000

FY2003 $600,000

Total $6,803,540

Project Abstract: 

Hawkeye Valley Area Agency on Aging, is operating in the 5th and final year of a grant for the 

National Consumer Protection Technical Resource Center project, in collaboration with 

Health Benefits ABCs, and related governmental and consumer protection groups. The goals 

of the project are to: provide training and technical assistance to Senior Medicare Patrol 

(SMP) projects to increase their knowledge and ability to meet their mission, and increase 

national visibility and integration of the SMP Projects into the aging and fraud prevention 

network. The objectives are to: advance the Administration on Aging's strategic priorities for 

the SMP Program; improve beneficiary education and inquiry resolution for health care fraud; 

improve the efficiency and quality of the SMP program; help SMPs target training and 

education to hard-to-reach populations; increase SMP program visibility; and enhance SMP 

program consistency. The expected outcomes of this project are to: achieve mastery of 

SMART FACTS as a reporting and program management tool; increase the number and 

appropriateness of SMP referrals to resolution entities; standardize volunteer certification 

program implementation plan and curriculum development; increase the number of 

nationwide entities who are familiar with the SMP program; increase training and education 

tools available to SMPs for reaching hard-to-reach populations; increase tools available to 

SMPs to promote a unified fraud prevention, detection, and reporting message; increase 

SMP satisfaction with and utilization of such tools; increase SMP staff knowledge of health 

care fraud and consumer protection issues; and the project evaluation using Re-AIM will 

reflect positive results in SMP ability to achieve their program mission consistently and with 

quality. The products of this project are: a web-site, newsletters, e-digest, updated 

operations manuals, volunteer certification implementation plan and curriculum, needs 

assessment, fact sheets, and Public Servoce Announcements. 

Page 246 of 281 
Program: National Resource Centers on Older Indians, 

Alaska Natives and Native Hawaiians 

Grant Number: 90OI0001

Project Title: National Resource Centers on Older Indians, Alaska Natives and Native 

Hawaiians

Project Period: 07/01/2009 - 06/30/2012

Grantee: 

University of Alaska Anchorage 

3211 Providence Drive 

Anchorage, AK 99508 

Contact: 

Robert White 

Tel. (907) 786-1065 

Email: ayosp@uaa.alaska.edu

AoA Project Officer: Meg Graves 

Fiscal 

Year 

Funding 

Amount

FY2009 $486,332

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $486,332

Project Abstract: 

The National Resource Center on Older Indians, Alaska Natives and Native Hawaiians 

(Center) will be focusing on Alaska Native elder issues. The goal is to increase elder mental 

health through collaboration by: 1) decreasing the absence of respect; 2) safety and wellness 

(elder mistratment); 3) coordinating organizational service delivery; and 4) expanding elder 

knowledge of availale services/programs for Alaska Native elders. The Center’s will focus on 

building core tools to eliminate fractionalization of elders' services, including the creation of a 

network of providers. The Center will coordinate services of all organizations in the state of 

Alaska providing services to Native Alaska elders, compile information into a directory, and 

facilitate cross organizational meetings. Partnerships will be maintained via audio 

conferencing,information dissemination, two partner meetings and one statewide meeting. 

Information will be provided to the elders, their councils and organizations via meeting 

presentations and Blackboard dialogs. Products developed will be educational tools (basic 

health education materials such as health literacy, over/under/conflicting/of medication), 

demonstrative implementation models (best promising and emerging practices to be 

replicated with cultural adjustments), and continued program implementation into future 

years. Products will also help prevent various geriatric medical maladies to decrease health 

disparity of elders. 

Page 247 of 281 
Program: National Resource Centers on Older Indians, 

Alaska Natives and Native Hawaiians 

Grant Number: 90OI0002

Project Title: Ha Kupuna: National Resource Center for Native Hawaiian Elders

Project Period: 07/01/2009 - 06/30/2012

Grantee: 

University of Hawaii 

School of Social Work 

2530 Dole Street Sakamaki Hall D-200 

Honolulu, HI 96822 

Contact: 

Sue Larson 

Tel. (808) 956-6058 

Email: vlarson@hawaii.edu

AoA Project Officer: Meg Graves 

Fiscal 

Year 

Funding 

Amount

FY2009 $484,974

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $484,974

Project Abstract: 

The Ha Kupuna, a Resource Center for Native Hawaiian Elders, was established in 2006. 

The goal of this Center is to develop and disseminate knowledge on health and long-term 

care in order to increase and improve the delivery of services to Native Hawaiian elders and 

their caregivers. In building upon thier work, their objectives are to: 1) sustain their core 

organizational structure; 2) develop a national knowledge base; 3) provide technical 

assistance and training to Title VI organizations; 4) improve the capability of organizaitons in 

using a qualitative methodology; 5) record the stories of elders; and 6) broadly disseminate 

information. Over the course of the project this Center's activities will include: 1) six 

completed reports; 2) two completed manuscripts; 3) six presentations at national and local 

meetings/conventions; 4) two meetings for advisory council members; 5) coordination with 

the two other funded Native American Resource Centers; 6) updated Website; 7) focus 

groups with caregivers caring for Native Hawaiian elders; 8) focus groups with memebers of 

the Association of Hawaiin Civic Clubs (representing Native Hawaiian elders); and 9) expand 

to Native Hawaiian elders in California. The Center's outcome measures will include 

increases in knowledge, skills, and/or capacity among members of their Advisory Council, 

Title VI service providers, and other providers working with Native Hawaiian elders within the 

state of Hawaii and the California aging network. 

Page 248 of 281 
Program National Resource Centers on Older Indians, 

Alaska Natives and Native Hawaiians 

Grant Number: 90OI0003

Project Title: University of North Dakota National Resource Center on Native American 

Aging

Project Period: 07/01/2009 - 06/30/2012

Grantee: 

University of North Dakota 

Center for Rural Health 

School of Medicine and Health Sciences 

 501 North Columbia Road 

Grand Forks, ND 58202-9037 

Contact: 

Twyla B Baker-Demaray 

Tel. (800) 896-7628 

Email: tbakerdemaray@medicine.nodak.edu

AoA Project Officer: Meg Graves 

Fiscal 

Year 

Funding 

Amount

FY2009 $922,236

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $922,236

Project Abstract: 

The goal of the National Resource Center on Native American Aging is to provide culturally 

sensitive community training and technical assistance to Native elder providers and 

information and resources for elders and Native elder-focused organizations. The major 

objectives are to: 1) pilot test the WELL-Balanced senior exercise curriculum developed in 

2008-2009; 2) advance Native elder caregiving resources; 3) provide research training; 4) 

research elder abuse codes; 5) offer training seminars based on the national data file; and 6) 

continue current dissemination efforts. The anticipated measurable outcomes for the project 

include: 1) improved means of communication and resources for Native American elders; 2) 

provision of a culturally sensitive program to help older Native people stay active and healthy; 

3) identication of health and social status for future long-term planning; 4) increased 

knowledge of resources for Native American elders; 5) increased awareness of elder abuse, 

codes, and resources; 6) provision of training and updates on Center programs and needs 

assessment data; and 7) improvement and dissemnination of Center resources, including 

presentations, journal articles, fact sheets, curriculums, and toolkits. The products from this 

project will include: 1) a family/community care toolkit; 2) updated wellness curricula; 3) report 

of the pilot testing of the WELL-Balanced project; 3) summaries, briefs, training sessions and 

presentations on the website; 4) journal submissions and articles; and 5) newsletters and fact 

sheets to improve understanding of the Native aging process. 

Page 249 of 281 
Program: Alzheimer's National Call Center 

Grant Number: 90AZ2766

Project Title: National Alzheimer's Call Center

Project Period: 08/01/2003 - 07/31/2010

Grantee: 

Alzheimer's Disease and Related Disorders Assoc., Inc 

225 N. Michigan Avenue, Suite 1700 

Chicago, IL 60601 

Contact: 

Catherine Sewell 

Tel. (312) 335-5191 

Email: Cathy.Sewell@alz.org

AoA Project Officer: Amelia Wiatr 

Fiscal 

Year 

Funding 

Amount

FY2009 $963,500

FY2008 $963,500

FY2007 $963,500

FY2006 $977,130

FY2005 $979,104

FY2004 $1,001,177

FY2003 $993,500

Total $6,841,411

Project Abstract: 

The Alzheimer's Association has a cooperative agreement with the Administration on Aging 

to operate an Alzheimer's National Call Center for individuals with Alzheimer's disease and 

their families, delivering personalized, timely information, care consultation, crisis 

intervention, and referral to local services, 24 hours a day, 7 days a week. A single 1-800 

line, web site, and e-mail address will link callers seamlessly to information experts and care 

consultants in local Association chapters nationwide, with default to the national Center 

when local responders are unavailable. All national and local Center personnel will receive 

uniform training and retraining and utilize a common computer-based repository of 

information, care protocols, and materials. The Center's goal is to improve the quality of life 

of persons with Alzheimer's and their caregivers. Callers will have an increased 

understanding of and ability to deal with Alzheimer's, and success in finding local services. 

Center performance will exceed industry standards. The Center will expand its reach to 

consumers, particularly in minority and limited English-speaking populations. 

Page 250 of 281 
Program: Eldercare Locator 

Grant Number: 90AM2746

Project Title: The Eldercare Locator

Project Period: 09/30/2003 - 07/31/2010

Grantee: 

National Association Of Area Agencies On Aging 

1730 Rhode Island Avenue, NW, Suite 1200 

Washington, DC 20036 

Contact: 

Helen M Eltzeroth 

Tel (202) 872-0888 

heltzeroth@n4a.org

AoA Project Officer: Sherri Clark 

Fiscal 

Year 

Funding 

Amount

FY2009 $812,176

FY2008 $812,176

FY2007 $812,176

FY2006 $1,201,230

FY2005 $1,174,937

FY2004 $1,374,937

FY2003 $1,174,979

Total $7,362,611

Project Abstract: 

The National Association of Area Agencies on Aging's (n4a) goal is to redesign and 

reposition the Eldercare Locator so that current and future older adults and caregivers have

the information they need about the choices they have in order to maintain their 

independence and quality of life. To achieve this goal, the objectives for the Eldercare 

Locator are to: 1) implement seamless connections to resources at the national, regional and 

local level for callers; and 2) maintain and develop strategic partnerships, both public and 

private, to promote and market the new direction of the Eldercare Locator; and 3) develop 

and implement a comprehensive marketing plan that focuses on the new direction of the 

Eldercare Locator. The outcome of this program will be that callers and web site users will 

have the information they need about aging services in order to make informed decisions. 

Page 251 of 281 
Program: Health Disparities among Minority EldersTechnical Assistance Centers 

Grant Number: 90HD0001

Project Title: Project Bienestar – Well Being

Project Period: 08/01/2009 - 07/31/2012

Grantee: 

Asociacion Nacional Pro Personas Mayores 

234 E. Colorado Blvd, Suite 300 

Pasadena, CA 91101 

Contact: 

Carmela G Lacayo 

Tel. (626) 564-1988 

Email: anppm@aol.com

AoA Project Officer: Diane Freeman 

Fiscal 

Year 

Funding 

Amount

FY2009 $217,226

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $217,226

Project Abstract: 

The goal of the Asociacion Nacional Pro Personas Mayores (AAPPM) Project Bienestar 

(Well-Being):is to assist limited English proficient Hispanic elders and their families to access 

community-based health interventions. ANPPM has a track record of developing innovative, 

culturally competent, bilingual materials for older people, their families and providers. 

ANPPM will focus on approaches to Cronic Disease Self Management (CDSM) that can 

enable Hispanic elders to develop the confidence and motivation needed to manage the 

challenges of living with a chronic disease. Staff are scheduled for training in CDSM at 

Stanford during Spring 2010. ANPPM has over 400 Title V Senior Community Services 

Employment Program (SCSEP) sites in four States and the District of Columbia. Using the 

train-the-trainer approach, Title V enrollees will be enlisted to promote the nationwide use of 

CDSM skills by older Hispanics. 

Page 252 of 281 
Program: Health Disparities among Minority Elders-Technical Assistance Centers 

Grant Number: 90HD0002

Project Title: Technical Assistance Center for Asian Pacific Islander Seniors

Project Period: 08/01/2009 - 07/31/2012

Grantee: 

National Asian Pacific Center on Aging 

1511 Third Avenue Suite 914 

Seattle, WA 98101 

Contact: 

Kenneth J Bostock 

Tel. (206) 838-8166 

Email: kjb@napca.org

AoA Project Officer: Dianne Freeman 

Fiscal 

Year 

Funding 

Amount

FY2009 $352,273

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $352,273

Project Abstract: 

The goal of the National Asian Pacific Center on Aging (NAPCA) Technical Assistance 

Center is to improve the health care outcomes and quality of life and to reduce health care 

costs for Asian-Pacific Islander (API) seniors. NAPCA reaches the 26 API subgroups across 

the Nation through its health, employment and advocacy programs. NAPCA’s Title V Senior 

Community Service Employment Program has sites in nine cities, including Boston, Chicago, 

Houston, Los Angeles, Orange County (CA), New York, Philadelphia, San Francisco and 

Seattle. With this network as a foundation NAPCA is in a unique position to reach API seniors 

through the interagency, collaborative effort on expanding the availability of diabetes selfmanagement training programs. Training in Chronic Disease Self Management (CDSM) skills 

will be taken by staff in order to promote the use of these skills in a culturally competent way 

among older Asian American and Pcific Islanders. Additionally, NAPCA maintains a toll free 

multilingual hotline. 

Page 253 of 281 
Program: Health Disparities among Minority Elders-Technical Assistance Centers 

Grant Number: 90HD0003

Project Title: National Minority Aging Organizations Technical Assistance Centers

Project Period: 08/01/2009 - 07/31/2012

Grantee: 

National Caucus and Center on Black Aged, Inc. 

1220 L. Street, NW Suite 800 

Washington, DC 20005 

Contact: 

Karyne D Jones 

Tel. (202) 637-8400 

kjones@ncba-aged.org

AoA Project Officer: Diane Freeman 

Fiscal 

Year 

Funding 

Amount

FY2009 $217,226

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $217,226

Project Abstract: 

The Administration on Aging entered into a cooperative agreement with the National Caucus 

and Center on the Black Aged, Inc. (NCBA) to operate Seniors Unite with Resources to Get 

Empowered: A Community Health Action and Advocacy Training Program (Project SURGE). 

The goal is to advance knowledge and increase the effectiveness of future efforts to eliminate 

health disparities among African American elders. NCBA staff participated in Chronic 

Disease Self Management (CDSM) training at Stanford University during early fall 2009. 

Volunteers will help older African Americans adopt healthier lifestyles using a trusted, 

decentralized, community-based approach through a network which includes senior housing 

communities, churches and senior centers. Volunteers will be trained as master trainers to 

promote the use of CDSM skills among older people. The project will initially be conducted in 

Baltimore, MD; Buffalo, NY; Oklahoma City, OK and with the Medical University at South 

Carolina in Charleston, SC. 

Page 254 of 281 
Program: Multigenerational Civic Engagement Assistance Center 

Grant Number: 90AM3152

Project Title: National Technical Assistance Center for Multi-Generational and Civic 

Engagement Projects

Project Period: 09/30/2007 - 05/31/2010

Grantee: 

National Council on Aging, Inc. 

Civic Engagement 

1901 L Street, NW, 4th Floor 

Washington, DC 20036 

Contact: 

Thomas Endres 

Tel. (202) 479-6621 

Email: Thomas.Endres@ncoa.org

AoA Project Officer: Marla Bush 

Fiscal 

Year 

Funding 

Amount

FY2009 $969,234

FY2008 $952,301

FY2007 $980,584

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $2,902,119

Project Abstract: 

The National Council on Aged, in partnership with the National Association of Area Agencies 

on Aging, Temple University's Center for Intergenerational Learning, the National Assembly 

and Easter Seals, and in collaboration with the Corporation for National and Community 

Service and Atlantic Philanthropies, will develop a national technical assistance center to 

foster the development of effective multigenerational and civic engagement models. The 

Center objectives include: 1) soliciting and awarding up to 19 competitive grants for 

replicable, innovative, local, multigenerational and civic engagement projects; 2) providing 

Vista volunteers to the grants; 3) providing grantees with training and technical assistance, to 

include the use of web based tools; 3) developing a baseline on best practices for mobilizing 

older volunteers; and 4) assisting AoA to develop a civic engagement page for its website. 

Project site visits will be conducted, training and technical assistance provided, and an 

annual conference arranged. Products include program and best practices materials, and 

other publications. 

Page 255 of 281 
Program: National Education and Resource Center on 

Women and Retirement Planning 

Grant Number: 90AM2801

Project Title: National Education and Resource Center on Women and Retirement 

Planning

Project Period: 09/30/2003 - 07/31/2010

Grantee: 

Womens' Institute for a Secure Retirement 

1146 19th Street, NW Suite 700 

Washington, DC 20036 

Contact:

Cindy Hounsell 

Tel. (202) 393-5452 

Email: wiserwomen@aol.com

Fiscal 

Year 

Funding 

Amount

FY2009 $245,520

FY2008 $241,470

FY2007 $245,520

FY2006 $248,376

FY2005 $248,376

FY2004 $248,376

FY2003 $248,376

Total $1,726,014

Project Abstract: 

The Womens’ Institution for a Secture Retirement (WISER) with assistance from strategic 

public-private coalitions, is organizing a one stop information gateway providing access for 

traditionally hard to reach women (i.e. average and low income women, women of color and 

women with limited English proficiency) "user friendly" financial management tools. The 

project goal is to provide women with access to information that promotes their efforts to 

attain secure retirements. A clearinghouse/lending library and satellite resource centers 

accessible to the Aging Network, faith-based organizations (FBO), state amd community 

agencies, financial institutions, and business and government agencies are being 

established. Staff conduct training sessions and information panels nationwide; and provide 

access to a variety of financial planning tools, including fact sheets & other online resources. 

Partnerships and coalitions have been formed with a range of private sector organizations to 

target low-income and minority women. Diverse private sector organizations include: MANA 

(formerly Mexican American National Association), National Latina Women's Organization, 

Mother's Voices/Multi-Ethnic Community Retirement Project, Coalition of 100 Black Women, 

General Federation of Women's Clubs, Profit Sharing Council of America, MetLife, MFS 

Investment Management, and the Society of Actuaries. Public sector partners include the 

Federal Deposit Insurance Commission, Social Security Administration, U.S/ Department of 

Labor’ Women's Bureau, U. S. Department of Agriculture Extension Service, and Comptroller 

General of the U.S. Year two plans are to continue strengthening public and private 

partnerships at the national and community levels; establish satellite resource centers 

accessible by community-based organizations (CBO), FBOs, non-profits, finance and 

business to encourage inclusion of women's financial security as an integral part of the 

agenda; initiate two new programs on financial planning for health care in retirement and 

senior indebtedness and partnership with insurance companies to develop materials about 

annuities for women. 

Page 256 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0007

Project Title: The Healthy Body, Healthy Mind (Cuerpo Sano, Mente Sana) Program

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Alzheimers Disease And Related Disorders 

Association Inc 

5900 Wilshire Blvd., Suite 1100 

Los Angeles, CA 90036 

Contact: 

Debra Cherry 

Tel. (323) 930-6225 

Email: debra.cherry@alz.org

AoA Project Officer: Theresa Arney 

Fiscal Funding 

Year Amount

FY2009 $190,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $190,000

Project Abstract: 

The Healthy Body, Healthy Mind (Cuerpo Sano, Mente Sana) Program addresses underrecognition of Alzheimer’s disease and related dementias (ADRD) in minority communities 

and seeks to remedy their lack of access to accurate information and services through a 

comprehensive outreach and education program targeting east and southeast Los Angeles, 

west Central and South Los Angeles. The goal of the caregiver education and outreach 

project is to ensure that families of African American and Latino seniors living with ADRD are 

identified, educated about the disease, and provided with culturally & linguistically appropriate 

information and support services through the Association and community partners. 

Objectives: (1) conduct 80 outreach activities; (2) coordinate and implement 40 community 

education events, including sessions promoting healthy lifestyles (Healthy Body, Healthy 

Mind/Cuerpo Sano, Mente Sana); (3) coordinate and implement 20 caregiver education 

sessions (English & Spanish); (4) disseminate 5,000 pieces of literature on risk reduction for 

brain disease, Alzheimer’s disease and/or caregiving; and (5) hold two media events, one for 

a Spanish language audience. Outcomes: The Alzheimer’s Association hopes to achieve: 1) 

increased awareness of risk factors for Alzheimer’s disease and related disorders in the 

African American and Latino communities targeted by this project; 2) increased knowledge of 

Alzheimer’s disease and caregiving among family caregivers who attend educational 

programs; and 3) increased access by Latinos and African American caregivers to 

appropriate health and social services to help afflicted families obtain support and medical 

care. Products: Lessons learned will be summarized in a report to be shared with Alzheimer’s 

Association chapters through regional meetings, and with other aging services providers as 

requested. 

Page 257 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0008

Project Title: California Senior Legal Hotline

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Legal Services of Northern California 

Senior Legal Hotline 

517 12th Street 

Sacramento, CA 95814 

Contact: 

David Mandel 

Tel. (916) 551-2142 

Email: dmandel@lsnc.net

AoA Project Officer: Valerie Soroka 

Fiscal 

Year 

Funding 

Amount

FY2009 $238,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $238,000

Project Abstract: 

Legal Services of Northern California will increase the capacity of California’s Senior Legal 

Hotline to provide legal assistance to the state’s elders. In particular, the hotline will focus on 

targeting, reaching, and helping those most in need – those who face daunting challenges 

due to limited means, isolation, disability, discrimination, lack of English proficiency, or other 

disadvantages. The overall goal is improved delivery of legal assistance to California seniors 

through increased hotline capacity and better coordination. The major objectives are to: 1) 

handle significantly more cases than would be possible otherwise; 2) advance development 

of the hotline’s technological capacity and content management for a) better sharing of 

resources online among California’s senior legal services network, and b) enabling volunteer 

retired attorneys to perform hotline work from remote locations; and 3) work with the 

California Department of Aging and others on strategic planning for better statewide 

coordination. The expected outcome is that more California seniors will receive crucial, 

timely, legal help, more coherently delivered, to help them resolve disputes, achieve planning 

goals, prevent exploitation and maintain maximum independence. Products will include 

shared print and online resources for providers and informational material for clients, in 

addition to improved technology for sharing, protecting, and disseminating the information, 

and reports or presentations to hotlines in other states that are seeking models of efficiency 

and innovation. 

Page 258 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0002

Project Title: Culturally and Linguistically Appropriate Fall Prevention Program for 

Monolingual Seniors (Spanish and Korean)

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

St. Barnabas Senior Center of Los Angeles 

St. Barnabas Senior Services 

675 S. Carondelet Street 

Los Angeles, CA 90057 

Contact: 

Rebecca Benard 

Tel. (805) 649-8722 

Email: rbenard@sbssla.org

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $133,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $133,000

Project Abstract: 

St. Barnabas Senior Services (St.Barnabas) recently piloted a two-year InSTEP (Increasing 

Stability Through Evaluation & Practice) program with the Archstone Foundation, the 

University of Southern California, and the West Los Angeles Veterans Administration 

Geriatric Resarch Education and Clinical Center. Building on success from this program and 

these collaborative relationships, St. Barnabas will offer a year-long program with the goal of 

enabling culturally and linguistically isolated Korean- and Spanish-speaking seniors to 

experience healthy aging and independent living by increasing their physical stability and 

reducing their risk of falling. The objectives are to: 1) provide a culturally and linguistically 

appropriate fall prevention program for Korean- and Spanish-speaking seniors in the greater 

Los Angeles area that incudes a five-pronged approach: community outreach, medical and 

psychosocial assessment, home risk assessment, home modifications, and a 12-week 

exercise class; 2) evaluate the effectiveness of this program; and 3) desseminate the results 

of the evaluation to policy, peer and public organizations that would benefit from this 

information. The expected outcomes are increased public awareness in the Korean- and 

Spanish-speaking communities concerned with falls. Pre and post program participant 

evaluation will reflect positive results in self-confidence, independence, and reduction in falls 

or risk of falls; home fall-prevention meausres will be identified and implemented; and through 

the dissemination of program findings with key constituents, wellness and healthy aging will 

be promoted. 

Page 259 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0012

Project Title: 2009 Congressional Mandates: Non-NORC

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Miami Jewish Home and Hospital for the Aged 

5200 NE 2nd Avenue 

Miami, FL 33137 

Contact: 

Daniel T. Brady 

Tel. (305) 762-1380 

dbrady@mjhha.org

AoA Project Officer: Joseph Lugo 

Fiscal 

Year 

Funding 

Amount

FY2009 $476,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $476,000

Project Abstract: 

The Miami Jewish Home and Hospital, through its affiliate, Florida Program of All Inclusive 

Care for the Elderly (PACE) Centers is developing a PACE adult day care center in the City 

of Hialeah. The adult day care center is designed to provide a supportive environment for 

individuals over the age of 55 who reside in the PACE service area. The project goals are: 1. 

to develop and open a PACE day care center in the City of Hialeah; 2.) to develop a network 

of services providers necessary to establish a full range of services to the individuals being 

served in the PACE day center. Objectives include 1) to identify, screen and select a 

professional and para-professional staff for the adult day center; 2). To Identify, assess and 

admit to the adult day center no less than 100 individuals in the first year of operation.; 3). to 

provide transportation to and from the adult day care site for no less than 75 individuals on a 

weekly basis by the end of first year of operation.; and 4) provide a program of activities 

(recreational and social) and nutritious meals to ndividuals admitted to the adult day program. 

Page 260 of 281 
Program: Congressional Directed Awards 

 

Grant Number: 90MA0004

Project Title: Financial Scam and Fraud Elder Awareness Project

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Stetson University 

Center for Excellence in Elder Law 

1401 - 61st Street South 

Gulfport, FL 33707 

Contact: 

Rebecca C Morgan 

(727) 562-7872 

morgan@law.stetson.edu

AoA Project Officer: Doris Summey 

Fiscal 

Year 

Funding 

Amount

FY2009 $95,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $95,000

Project Abstract: 

Stetson University and the Center for Excellence in Elder Law, are conducting a one-year 

pilot project designed to inform and educate elder individuals about financial scams and 

frauds. The goal is to develop a project designed to inform and educate elder individuals 

about financial scams and frauds. The objectives are to decrease the occurrence of and 

minimize the potential for financial scam and fraud victimization among elder individuals and 

to produce a sustainable and replicable project that can be duplicated and implemented 

throughout the State of Florida, as well as in other individual states nationwide. The 

measurable outcome will be an increased awareness among elderly individuals about 

financial scams and frauds. Products produced by the project will include informational and 

educational materials and services about financial scams and frauds, including speeches and 

presentations, brochures and handouts, webpage platforms and interfaces, non-legal 

technical assistance advice, reference databases and resource guides, as well as a 

replication handbook to assist with project duplication and implementation throughout the 

State of Florida, as well as in other indvidual states nationwide. 

Page 261 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MI0001

Project Title: Medicare Improvements for Patients and Providers Act Resource Center

Project Period: 05/01/2009 - 04/30/2012

Grantee: 

National Council on the Aging, Inc. 

1901 L Street, NW - 4th floor 

Washington, DC 20036 

Contact:

Marisa Scala-Foley 

Tel. (202) 479-6976 

Email: marisa.scala-foley@ncoa.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $5,000,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $5,000,000

Project Abstract: 

The National Council on Aging will administer a National Resource Center on Senior Benefits 

Outreach and Enrollment (the Center) that will: promote the use of cost-effective benefits 

outreach and enrollment strategies; increase the use of web-based decision support tools 

among the aging and disability services networks, and consumers; increase the usability of 

current benefits screening and enrollment systems; provide training and technical assistance; 

develop an online information clearinghouse on promising benefits outreach and enrollment 

practices; analyze and provide data to Medicare Improvements for Patients and Providers 

(MIPPA) funded agencies; and work with the Centers for Medicare and Medicaid Services 

and the Administration on Aging to analyze and report on outcome measures. The Center’s 

goals are to: be the nationally recognized source of timely, useful information and assistance 

on benefits outreach and enrollment for the aging and disability networks and a leader in 

helping to improve benefits outreach and enrollment practices; and to increase participation 

of seniors and adults with disabilities in public benefits programs through its own work and 

that of the agencies receiving MIPPA outreach and enrollment funding. The expected 

outcomes are: the development of a national network of enrollment centers; increased 

numbers of consumers and their families receiving information, counseling and enrollment 

assistance with public benefits; increased use of web-based benefits screening and 

enrollment tools; and increased numbers of professionals receiving training and technical 

assistance about benefits outreach, enrollment, and follow-up strategies, as well as other 

issues related to public benefits. 

Page 262 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0015

Project Title: "Safe at Home" Elders Fall Prevention

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Rebuilding Together, Inc. 

Safe at Home 

1899 L Street, NW Suite 1000 

Washington, DC 20036 

Contact: 

Gregory C. Secord 

Tel. (202) 384-6781 

Email: gsecord@rebuildingtogether.org

AoA Project Officer: Irma Tetzloff 

Fiscal 

Year 

Funding 

Amount

FY2009 $285,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $285,000

Project Abstract: 

Rebuilding Together, Inc., under its "Safe at Home" project is a collaborative partnership with 

the National Association of Area Agencies on Aging (n4a); the American Occupational 

Therapy Association (OTA) and the National Association of Home Builders (NAHB) to enable 

more elderly remain in their own homes throughout their lives. A 2005 study found that 

15,800 people age 65+ died from injuries related to unintentional falls; 1.8 million 65+ needed 

emergency room care and 433,000 were hospitalized (CDC 2008). Safe at Home addresses 

falls prevention through community projects that improve accessibility and safety for lowincome elderly by drawing upon community resources and volunteers. Rebuilding Together 

collaborates with the Aging Network, health care providers, home builders and remodellers, 

the private sector and volunteers to improve the accessibility and safety of the living 

environment. These modifications, based upon the principles of universal design, will enable 

a number of elderly to have greater functional ability to care for themselves. Participation by 

community members in these home modification efforts, generate a greater appreciation and 

understanding of some of the best ways to plan and prepare for growing older through 

¿hands-on¿ experiential training provided by qualified staff. Products include a web-based 

volunteer training video, completion of 23 home modification projects, and increased national 

awareness through various articles and presentations at national conferences, trade shows. 

Rebuilding Together is targeting three cities: Baltimore, Maryland, Minneapolis, Minnesota 

and Hartford, Connecticut for the development of a sustainable falls prevention coalition. 

Page 263 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0019

Project Title: Georgia Naturally Occurring Retirement Communities (NORC) Initiative

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Jewish Federation of Greater Atlanta 

1440 Spring Street, NW 

Atlanta, GA 30309 

Contact:

Deborah A Kahan 

Tel. (404) 870-1624 

dkahan@jfga.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $95,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $95,000

Project Abstract: 

The goal of this project is to continue to support development of the NORC Initiative in 

Georgia which is to help older adults live in their homes as long as possible with true quality 

of life, to prevent hospitalization, to build the capacity of the community to age in place, and 

to replicate the model in different communities with different populations and foci. Six NORC 

locations are currently supported in Savannah, the City of Atlanta, the greater metropolitan 

area of Atlanta, and a rural county. The objectives include: developing and addressing 

unmet needs of older adults in each community; increasing neighborhood awareness of 

senior issues; greater coordination of services between agencies; enlisting additional partner 

agencies, particularly non-traditional partners; disseminating information about the Georgia 

NORC initiative; building sustainability, and evaluating impact factors affecting seniors¿ 

ability to age in place. Expected outcomes are: reducing social isolation; increasing home 

safety; increasing knowledge of and access to community resources; and improving senor's 

ability to maintain a healthy life style and manage chronic disease and/or health challenges. 

Page 264 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0026

Project Title: 

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Intergenerational Resource Center, Inc. 

444 Edgewood Ave. S.E. 

Atlanta, GA 30312 

Contact: 

Brenda Sanford 

Tel. (404) 524-1023 

Email: irc_daycare@msn.com

AoA Project Officer: Danielle Nelson 

Fiscal 

Year 

Funding 

Amount

FY2009 $56,947

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $56,947

Project Abstract: 

The Intergenerational Resource Center will help older adults and veterans participating in its 

adult day health program to address the factors that lead to dementia and other mental health 

conditions such as borderline personality disorder. The goal of this project is to create a 

model program that provides "novel" tasks to enhance cognitive functioning for participants. 

The program will offer one-on-one and group meetings to assess problems and establish 

goals for care plan development. It will also collaborate with public and private agencies to 

offer case management services that address participant goals and foster continuity care. 

Expected participant outcomes include the decrease in impulsive and disruptive behaviors 

and improved interpersonal relationships. Other expected outcomes include a model 

intensity scale instrument, psychosocial definitions for use with each level of care, a staff 

training module; and an evaluation instruments for use in determining behavioral changes. 

Page 265 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0016

Project Title: 2009 Congressional Mandates: Non-NORC

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

SOWEGA Council on Aging, Inc. 

1105 Palmyra Road 

Albany, GA 31701 

Contact: 

Kay H Hind 

Tel. (229) 432-1124 

khhind@dhr.state.ga.us

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $95,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $95,000

Project Abstract: 

The grantee, SOWEGA Council on Aging, supports this educational project in collaboration 

with other local organizations. The goal of this project is to provide extensive education and 

monitoring of health conditions that affect the senior citizens in the 14-county Southwest 

Georgia area served by the grantee. The objectives of this grant are to 1) promote better 

lifestyles through education about diseases and conditions prevalent in our area; 2) monitor 

health conditions among senior center participants; 3) develop linkages to local and national 

resources; 4) expand assessment and intervention services; 5) evaluate the impact of the 

added services; and 6) disseminate project information. The expected outcome of this 

project is clients will increase their ability to make positive changes in their health conditions. 

Measurable outcomes will be reflected in pre- and post-tests results. The products from this 

project will be a final report, and information will be shared on local, state, and national levels. 

Page 266 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0025

Project Title: Congressional Mandate

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

St. Clair County 

201 North Church Street 

Belleville, IL 62220 

Contact: 

Alice Jackson 

Tel. (618) 234-4410 7044 

stclaireaging@yahoo.com

AoA Project Officer: Leslie Swann 

Fiscal 

Year 

Funding 

Amount

FY2009 $143,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $143,000

Project Abstract: 

St. Clair County Office on Aging will establish a senior wellness center demonstration project 

in collaboration with the St. Clair County Health Department, St. Clair County Mental Health 

Board and local senior center. The goal of the project is to promote optimal mental, medical, 

and physical well-being of seniors throughout St. Clair County. The objectives are to (1) 

expand preventive physical, medical, and mental health services for individuals 55 years of 

age and older; (2) provide seniors easy access to health care; and (3) improve health 

outcomes for seniors through preventive programs. The expected outcomes will minimize 

illnesses and decrease hospitalizations and premature nursing home admission, thereby 

reducing the use of Medicare and Medicaid. 

Page 267 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0022

Project Title: Indianapolis NORC

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Jewish Federation of Greater Indianapolis 

6705 Hoover Road 

Indianapolis, IN 46260 

Contact: 

Lori Moss 

Tel. (317) 259-6822 

Email: lmoss@jfgi.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $438,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $438,000

Project Abstract: 

The Jewish Federation of Greater Indianapolis through its affiliate ElderSource organization

will enhance the Elder-Friendly Communities program which organizes existing and new 

services and activities assisting residents over the age of 60 to safely age in place. This 

project will allow the program to expand beyond its initial 1.5 square mile geographic 

boundary in northwest Indianapolis and a nearby apartment building with over 100 low 

income residents. The goal of this demonstration project is to enhance the ability of seniors 

in the targeted areas to continue living safely and independently within the community. 

Objectives include increasing access to supportive services and involving seniors in 

strengthening the community as a whole. The anticipated outcome is that older adults will be 

better prepared and supported for aging in place and have improved physical and emotional 

health. This goal and expected outcomes will be achieved by collaborating with leaders in 

the areas of planning and service delivery and through the integration of customized direct 

services, specialized resources, and educational and volunteer opportunities responsive to 

their needs. In addition to outcomes for older adults, the project will develop usable tools for 

evaluation, replication along with community and individual assessments, an effective internet 

presence and a final report. 

Page 268 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0014

Project Title: A Community Nursing Program and Exploratory Research Project 

Examining the Effects of Traumatic Stress on the Elderly

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Jewish Family Service 

3330 West Esplanade Ave S ST600 

Metairie, LA 70002-3454 

Contact: 

Paul Groch 

Tel. (504) 831-8475 

Email: pgroch@jfsneworleans.org

AoA Project Officer: Irma Tetzloff 

Fiscal 

Year 

Funding 

Amount

FY2009 $238,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $238,000

Project Abstract: 

The Jewish Family Service (JFS) is engaged in a one-year Community Nursing Project 

(JFSCNP) in collaboration with Tulane School of Social Work. The goal of the project is to 

provide greater understanding of how traumatic events, such as hurricanes, impact the at-risk 

elderly. This project is designed to stimulate further research that will enable health and 

social service agencies to modify existing or create new programs to mitigate the long-term 

debilitating affects of traumatic stress in the elderly. The objectives are to provide an inhome, multidimensional nursing assessments and provide a referral service to appropriate 

community resources. The goals include increased understanding by participants of their 

health needs and more efficient doctor visits to provide greater accessibility to needed social 

services. Student nurses will perform in-depth interviews of selected clients, conduct focus 

groups, and evaluate elderly assessments and appropriate referrals to community resources. 

Participants are selected from the elderly who coped with the impact of hurricanes Katrina 

and Rita. Project results will be shared through a final report and evaluation, published 

articles, abstracts at national conferences and web-based data. 

Page 269 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0018

Project Title: Supportive Services in Naturally Occurring Retirement Communities

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Jewish Family and Child Services of Waltham, Massachusetts 

Senior Services 

1430 Main Street 

Waltham, MA 02451 

Contact: 

Kathy Burnes 

Tel. (781) 693-5573 

kburnes@jfcsboston.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $95,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $95,000

Project Abstract: 

This project continues development of three NORC programs for frail older residents in senior 

housing developments in Malden, Brookline and Framingham, Massachusetts. The goal is to 

enable residents to live with dignity in their own homes for a long as possible. Major 

objectives are: to increase physical activity, social connection , and improve awareness of 

healthy, low cost nutrition through existing and new activities; to encourage participation of 

residents in planning, embracing and sustaining activities that maintain or improve their 

health and wellness and address current economic challenges to make the most out of scant 

resources; and to cross train NORC sites in best practices such as cost effective program 

development and implementation and evaluation tools and techniques. Cost effective 

preventive health and social services will be brought to each site through collaborative 

relationships with community partners and volunteer resources. Outcomes will be: increased 

awareness of healthy and cost-effective nutrition; improved health indicators; increased social 

connection; increased satisfaction of resident advisory group members and staff with their 

leadership roles; and new knowledge regarding the experience of cross-training and 

implementing an evidence based walking program at three NORC sites. 

Page 270 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0017

Project Title: Highland/West Seventh NORC “Home For a Lifetime!”

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Jewish Family Services of St. Paul 

1633 West 7th Street 

Saint Paul, MN 55102-4227 

Contact: 

Rena Waxman 

Tel. (651) 698-0767 

rwaxman@jfssp.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $238,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $238,000

Project Abstract: 

The goal of this project is to assist older adults living in the Highland/West 7th neighborhood 

of St. Paul to age in place through targeted and coordinated services, enhanced 

independence, improved socialization, empowerment, community building and increased 

quality of Life. Objectives include: Identifying, cataloging and publicizing the 

resources/services available for seniors; engaging seniors and caregivers as well as 

professionals in analyzing current resources and determining unmet needs and addressing 

plans to meet them; providing volunteer opportunities for seniors to apply their knowledge 

and experience to address community needs; improving availability of mental health 

counseling for seniors; and providing health education programs and consultations for 

seniors and caregiver; create sustainability for the project. Expected outcomes are: Seniors 

and caregivers will have increased knowledge about resources and services; seniors will 

have increased engagement in the community; and service providers will improve their ability 

to provide a seamless experience for community-based seniors by means of improved interorganizational communication. 

Page 271 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0005

Project Title: Home Companion Programs to Help Keep Low-Income Seniors 

Independenti

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Nevada Rural Counties RSVP Program, Inc. 

3303 Butti Way - Building 1 Building 1 

Carson City, NV 89701 

Contact: 

Janice Ayres 

Tel. (775) 687-4494 

Email: branded@rsvp.carson-city.nv.us

AoA Project Officer: Richard Nicholls 

Fiscal 

Year 

Funding 

Amount

FY2009 $95,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $95,000

Project Abstract: 

The RSVP Home Companion Program is an innovative volunteer program to deliver a 

comprehensive support system, whose goal is to assist low-income and homebound seniors 

so that they can remain independent and in their own homes, preventing premature 

institutionalization. The objectives are to 1) provide basic everyday needs services such as 

social companionship, help with correspondence, transportation to medical, dental and vision 

appointments, to pick up prescriptions, go grocery shopping, etc., provide respite care to fulltime caregivers, and help with monitoring any assistive technology to which the senior has 

access such as Lifeline, an RSVP program that provides security for seniors living alone with 

an emergency telephone system; 2) to recruit and train volunteers to provide these services; 

3) to inform the communities in which we serve that this free program is available and explain 

how it benefits low-income seniors and the community as a whole; and 4) to collaborate with 

local senior centers, city and county social service agencies, other area non-profit agencies, 

the regional United Way organizations and the Nevada Division for Aging Services to help 

maximize all services for seniors in need. The anticipated outcomes are that these seniors 

will remain independent in their own homes where they are happiest and thus healthier, to 

continue as productive members of their communities, while living out their lives with dignity. 

The products from this program will be RSVP Field Representative volunteer evaluation 

reports of client service, Home Companion volunteer training session summaries, website 

assistance for clients and volunteers alike, volunteer recruitment advertising, and 

participation in community service fairs. 

Page 272 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0020

Project Title: Secure@Home NORCs Program

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Jewish Family and Children Services of Greater Mercer County 

Senior Services 

707 Alexander Rd, Suite 102 

Princeton, NJ 08540 

Contact:

Jill Jaclin 

Tel. (609) 987-8100 

Email: jillj@jfcsonline.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $190,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $190,000

Project Abstract: 

This project will support low and moderate income older adults living in Ewing, Lawrenceville, 

Princeton and West Windsor, New Jersey, to continue aging in place through a membershipbased, non-sectarian program that delivers critical services tailored to participants needs and 

fills identified service gaps. The goal is to increase resiliency and reduce/eliminate risk 

factors that lead to frailty, loss of independence, and premature institutionalization. 

Objectives are to: to serve 250 elderly persons in the four residential areas; provide a 

comprehensive range of coordinated health and social services; engage in partnerships with 

community agencies; promote independence and health aging; empower members through 

volunteerism and involvement in project administration; fill service gaps in Medicare, 

Medicaid, or Older Americans Act resources; and disseminate results. Outcomes will be that 

75% of members: demonstrate improved resiliency and quality of life by accessing 

transportation, increasing home safety and accessibility, engaging in emergency 

preparedness, demonstrating emotional wellbeing, healthcare and medication management, 

increasing social connections, and using support and respite for caregivers while continuing 

to age at home. 

Page 273 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0003

Project Title: Alzheimer's Social Research Project: Keeping Your Mind Sharp

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Aging in New York Fund, Inc. 

New York City Department for the Aging 

2 Lafayette Street, 21st Floor 

New York, NY 10007 

Contact: 

Ali Hodin Baier 

Tel. (212) 442-1375 

Email: ali@anyf.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $285,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $285,000

Project Abstract: 

The Aging in New York Fund/New York City Department for the Aging (ANYF/DFTA) and its 

partner the Zachary and Elizabeth M. Fisher Center for Alzheimer's Research Foundation 

(FCARF) collaboratively support this one-year Administration on Aging grant. The goal of the 

project is to educate community-dwelling seniors about memory loss through education and 

multimedia information. The objectives are five-fold: (1) to reduce stress of seniors with agerelated memory loss to understand normal changes in information processing and ways to 

enhance mental performance; (2) to enable participants to distinguish between normal agerelated cognitive changes and potential Alzheimer's disease (AD); (3) to inform participants 

what to do if they suspect AD; (4) to educate participants about lifestyle changes to reduce 

risk or delay AD onset; (5) to educate seniors and social service providers about the nature 

and progression of AD, disease management, and community options. The expected 

outcomes are: (1) an improvement in participants' knowledge and awareness of the 

differences between normal age-related cognitive change and AD or other dementias and; (2) 

an increase in the degree to which participants understand the nature and progression of AD, 

appropriate disease management approaches, and community options. Products from this 

project are: English and Spanish training manuals; CD product; abstracts for professional 

conferences, a nationally distributed magazine, and semi-annual and final reports. 

Page 274 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0021

Project Title: Project Independence/North Hempstead

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Town of North Hempstead 

220 Plandome Road 

Manhasset, NY 11030 

Contact: 

April Brown-Lake 

Tel. (516) 627-4062 

Email: browna@northhempstead.com

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $333,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $333,000

Project Abstract: 

The Project Independence/North Hempstead project goal is to support and empower aging 

residents of the town to remain in their own homes and familiar intergenerational 

communities as they grown older and age in place in order to avoid unwanted and costly 

residential alternatives. Its objectives are: to expand services currently in two areas of the 

township to the entire township, particularly community nursing and social work services; to 

research and catalog all existing services available throughout the town ; to survey the 

transportation needs of older residents and successful strategies used by similar 

municipalities; to assist and support grandparents who are caregivers for their young 

grandchildren; to assist older residents to make minor household repairs; to offer basic dental 

services to older residents without dental insurance; to provide memory screening and early 

memory loss programming; to strengthen existing and building new partnerships with 

community organizations, to develop outreach strategies to inform the community; and to 

evaluate the effectiveness of the program. Expected outcomes are that the town's aging 

residents will access the range of services, educational, recreational and volunteer 

opportunities; improve their health, vitality, and sense of emotional well-being and connection 

to their community; and be able to remain in their own homes. 

Page 275 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0001

Project Title: Enhanced Service Programs at the Yorktown Senior Center

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Town of Yorktown, NY 

363 Underhill Avenue 

Yorktown Heights, NY 10598 

Contact:

Lorraine DeSisto 

Tel. (914) 962-6565 327 

Email: ldesisto@yorktownny.org

AoA Project Officer: Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $666,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $666,000

Project Abstract: 

The project goal is to provide comprehensive programs and services to enhance the dignity 

and promote the independence of adults 50 years and older. Services at the Yorktown 

Senior Center will be expanded and enhanced to serve existing clients as well as "new" older 

adults. The enhanced center will provide an environment conducive to the development of a 

social support system that will reduce loneliness and depression and enhance life 

satisfaction. Outreach specialist will deliver information and programs for individuals that will 

enable them to explore new possibilities, connect with peers, and discover pathways to 

significant service. A health promotion program will help older adults to cultivate healthy 

attitudes and behaviors. The objectives of this project are as follows: 1) to respond to the 

needs and interests of a diverse community, 2) to increase older adults' opportunities for 

socialization and education, and 3) to promote healthier lifestyles. Program participants will 

complete pre and post tests to measure the impact of expanded and integrated services. 

Page 276 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0023

Project Title: Jewish Family and Child Services NORC Project

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Jewish Familiy and Child Services of Portland 

Lifeline Program 

1130 SW Morrison, Suite 316 

Portland, OR 97205 

Contact:

Marian Fenimore 

Tel. (503) 226-7079 

Email: marian@jfcs-portland.org

AoA Project Officer Greg Case 

Fiscal 

Year 

Funding 

Amount

FY2009 $95,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $95,000

Project Abstract: 

This project will support and enable isolated seniors in the North Portland area to 

successfully age in place by providing a comprehensive system of innovations to participating 

seniors. Objectives are: to decrease isolation among participating seniors; to increase 

senior service coordination, resource development and dissemination; and to support the 

independence and ability of seniors to age in place. The intended outcomes include: that 

seniors will report increased participation of activities outside the home, increase 

friendships/relationships, less isolation, and an increase in quality of life; that participating 

seniors will report an awareness of and access to senior resources and services, and 

increase in the number of services available to seniors to help them age in place, and 

increase in opportunities for seniors to improve their overall health and well being, and 

improved communication and collaboration among service providers; and seniors will report 

an increase in their successful utilization of resources and services and increase in overall 

independence, health and well being. 

Page 277 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0009

Project Title: Gatekeeper Expansion Project

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Multnomah County Oregon 

County Human Services 

421 SW Oak St Ste 510 

Portland, OR 97204 

Contact: 

Paul Iarrobino 

Tel. (503) 988-3620 x24030 

Email: paul.iarrobino@co.multnomah.or.us

AoA Project Officer: Barbara Lewis 

Fiscal 

Year 

Funding 

Amount

FY2009 $48,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $48,000

Project Abstract: 

Multnomah County Aging and Disability Services (ADS) supports this one-year projec to 

expand our outreach efforts using the Gatekeeper model, a national best practice. The goal 

of the project is to provide outreach and training to the business community and other 

community groups, primarily non-mandatory reporters, to identify at-risk older adults and 

people with disabilities living in the community, and link them to critical social and health 

services. Gatekeepers are trained to identify signs and symptoms that may indicate 

vulnerable adults needing assistance. Some of these signs include confusion, depression, 

poor health, functional disability, financial exploitation or homes in disrepair. ADS intends to 

expand the Gatekeeper program by recruiting and training Volunteer Gatekeeper Trainers to 

be ambassadors to the businesses and other community groups, to extend the capacity and 

reach of the program. The objectives are to: provide trainings to the business community and 

other community organizations that come in to regular contact with seniors and people with 

disabilities; establish and expand linkages to professional associations through the use of 

Volunteer Gatekeeper Trainers, create training modules that reflect general course content 

and customization for type of business, evaluate impact of added training and outreach, and 

disseminate project information. The expected outcomes of this project are: identification of 

isolated (remote, hard-to-find, un/under served) seniors and people with disabilities at risk of 

depression, poor health, financial exploitation, neglect, abuse and/or unsafe living 

environments by recruiting and training volunteer (non mandatory, non-traditional) 

businesses and other community partners and increase linkages to critical social and health 

services for Multnomah County¿s seniors and people with disabilities who may be 

experiencing depression, poor heath, financial exploitation, neglect, abuse, and/or living in 

unsa 

Page 278 of 281 
Program: Congressional Directed Project Award 

Grant Number: 90MA0013

Project Title: Reducing the Risk of Serious Falls Among the Nation's Elderly

Project Period: 08/01/2009 - 07/31/2010

Grantee: 

Cedar Crest College 

Nursing 

100 College Drive 

Allentown, PA 18104 

Contact:

Marcie F Walker 

Tel. (610) 606-4666 3385 

mfwalker@cedarcrest.edu

AoA Project Officer: Sherri Clark 

Fiscal 

Year 

Funding 

Amount

FY2009 $95,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $95,000

Project Abstract: 

Cedar Crest College will develop, implement, and evaluate this one-year project, entitled 

“Reducing the Risk of Serious Falls among the Nation’s Elderly.” The goal of this 

assessment and intervention project is to reduce the risk of serious falls and, thus, the 

number of hospitalizations that result from them across the nation. The proposed approach 

will utilize baccalaureate and master’s level nursing students to conduct the program, under 

the supervision of nursing faculty. The objectives are to: 1) conduct individualized client and 

environmental risk assessments of senior citizens who live in independent, senior housing; 2) 

implement both individualized and exercise interventions designed to prevent falls; 3) 

evaluate and measure the results; and 4) incorporate the study into the Cedar Crest College 

baccalaureate and master’s in nursing curricula to sustain the project. The expected 

outcomes of this project are: participants will remain in independent housing for longer 

periods of time as a result of reduced falls and injuries; Medicaid costs for hospitalizations 

related to falls will be reduced; and future nurses will be educated to recognize risk factors 

and design appropriate interventions. The products from this project are: a final report, 

including evaluation results; a redesigned baccalaureate and master’s in nursing geriatric 

curriculum; and articles for publication and presentation at local and national nursing 

conferences. 

Page 279 of 281 
Program: Congressional Directed Awards 

Grant Number: 90MA0024

Project Title: Non-NORC Congressional Mandate

Project Period: 08/01/2009 - 08/01/2010

Grantee: 

Utah Department of Human Services 

Division of Aging and Adult Services 

120 North 200 West, # 325 

Salt Lake City, UT 84103 

Contact: 

Darren Hotton 

Tel. (801) 538-3910 

Email: dhotton@utah.gov

AoA Project Officer: Richard Nicholls 

Fiscal 

Year 

Funding 

Amount

FY2009 $95,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $95,000

Project Abstract: 

The Utah Division of Aging and Adult Services (DAAS) are requesting funding to enhance 

and expand the State’s State Health Insurance Information Program (SHIP). DAAS has been 

the host to SHIP for the last sixteen years. Utah SHIP program is a national program that 

offers one-on-one counseling and assistance to people with Medicare, caregivers and their 

families and provides free counseling and assistance via telephone and face-to-face 

interactive sessions, public education presentations and programs, and media activities. 

Objectives of this porject are to: 1)provide Temporary trained staff to local AAA SHIP staff; 

2)provide statewide ethnic outreach and education through expanded collaborations with 

statewide, regional and community organizations; 3)increase the number of computers 

available to seniors in rural senior centers; and 4) Opportunity for local AAA SHIP 

coordinators to receive expanded training. Outcome:include: 1) Educate Medicare 

beneficiaries, their families and caregivers to become knowledgeable, responsible 

consumers; 2) empower Medicare beneficiaries, their families and caregivers to take an 

active role in their healthcare; and 3) empower local AAA SHIP contracts to be the Medicare 

experts in their area (SHIP services branding). The grant will support temporary staff for our 

local SHIP contracts Annual Election Period and Medicare Advantage Open Enrollment time 

frames; Grass roots activities in several Ethnic communities; several new computers placed 

in rural Utah senior centers. A final report and presentations will be developed to share 

information with the Administration on Aging, the Centers for Medicare and Medicaid 

Services, and other SHIPs. 

Page 280 of 281 
Page 281 of 281 

Program: Congressional Directed Awards 

Grant Number: 90MA0006

Project Title: Caregiver Training on Elder Abuse and Neglect Prevention

Project Period: 08/01/2009 - 12/31/2010

Grantee: 

University of Wisconsin Oshkosh 

Center for Career Development and Employability 

800 Algoma Blvd. 

Oshkosh, WI 54901-3551 

Contact: 

Pat Nichols 

Tel. (920) 424-0981 

Email: nichols@uwosh.edu

AoA Project Officer: Stephanie Whittier Eliason 

Fiscal 

Year 

Funding 

Amount

FY2009 $333,000

FY2008 $

FY2007 $

FY2006 $

FY2005 $

FY2004 $

FY2003 $

Total $333,000

Project Abstract: 

The University of Wisconsin Oshkosh, Center for Career Development and Employability 

Training (C.C.D.E.T.), in collaboration with the Wisconsin Department of Health Services, will 

refine and present a series of train-the-trainer workshops with the overarching aim of 

reducing the incidence of caregiver abuse and neglect both in Wisconsin and throughout the 

country. The grantee will expand the availability of caregiver training and training materials to 

both regional and national audiences. Workshops will be offered to health care facility staff 

who, in turn, will train their own caregivers, thus maximizing potential outreach. The two 

primary project objectives are as follows: 1) provide direct caregivers with the interpersonal 

skills and strategies necessary to positively address challenging situations with those in their 

care and 2) increase awareness of the potential for abuse and neglect in long-term care 

settings. The expected outcomes of this training project are that at least 80% of participants 

in train-the-trainer events will report the following: a) the training increased their awareness of 

potential abuse and neglect; b) the training improved their professional interpersonal skills in 

at least one of the following the areas: communication, observing professional boundaries, or 

maintaining professional demeanor; and c) the training gave them tools that enhanced their 

ability to interact positively in challenging situations with residents or clients. The product from 

this project is a final report, including evaluation results. 
iv 

Organization Index 

Academic Institutions 

American Indian, Alaskan Native and Native Hawaiian Organizations 

Area Agencies on Aging and State Associations 

Non-Profit State and Local Organizations 

State Government Agencies and Units on Aging 

National Organizations 

 Page

Academic Institutions 

Benjamin Rose Institute 148 

Boston College 83 

Cedar Crest College (Pennsylvania) 279 

Georgia Southwestern State University 61 

Miami of Ohio University 149 

Minot State University 220 

Stetson University 261 

Texas A&M University 108 

University of Alaska-Anchorage 247 

University of Delaware 159 

University of Hawaii 248 

University of Massachusetts Boston 150 

University of New Hampshire 27 

University of North Dakota 249 

The University of Utah 43 

University of Wisconsin Oshkosh 281 

American Indian, Alaskan Native and Native Hawaiian Organizations 

Mt. Sanford Tribal Consortium (Alaska) 116 

Area Agencies on Aging and State Associations 

Area Agency on Aging of Pasco-Pinellas, Inc (Florida) . 194 

Atlanta Regional Commission (Georgia) 

SOWEGA Council on Aging, Inc. (Georgia) 266 

Indiana Association of Area Agencies on Aging Education Institute 200 

Hawkeye Valley Area Agency On Aging (Iowa) 201, 246 

District III Area Agency on Aging (Missouri) 211 

New York City Department for the Aging (New York) 126, 274 

Upper Cumberland Development District (Tennessee) 229 

Virginia Association of Area Agencies on Aging (Virginia) 232 
v 

Non Profit State and Local Organizations 

California: 

Alzheimers Disease and Related Disorders Association Inc 257 

Catholic Carities of Stockton 118 

California Health Advocates 188 

 Legal Services of Northern California 153, 166, 258 

Los Angeles Gay and Lesbian Community Services Center 117 

St. Barnabas Senior Center of Los Angeles 259 

District of Columbia 

 Legal Counsel for the Elderly 193 

Florida 

 Miami Jewish Home and Hospital for the Aged 260 

 United Jewish Community of Broward County, Inc . 136 

Georgia 

 Intergenerational Resource Center 265 

Jewish Federation of Greater Atlanta 119, 264 

Guam 

 Department of Mental Health and Substance Abuse 

Illinois 

 AgeOptions 199 

St. Clair County 267 

Indiana 

 Jewish Federation of Greater Indianapolis 268 

Iowa 

Iowa Legal Aid 152 

Kentucky 

 Louisville/Jefferson County Metro Government 203 

Louisiana 

 Jewish Family Service 269 

Louisiana Health Care Review, Inc. 204 

Maine 

 Legal Services for the Elderly Inc. 171 

Maryland 

 Coordinating Center for Home and Community Care, Inc. 121 

Massachusetts 

 Boston Medical Center 122 

Elder Services of the Merrimack Valley, Inc. 207 

 Jewish Family and Child Services of Waltham 270 

Michigan 

Center for Social Gerontology Inc. 164 

Elder Law of Michigan, Inc. 152, 165 

Center for Social Gerontology Inc. 164 

Michigan Medicare\Medicaid Assistance Program 208 

Jewish Federation of Metropolitan Detroit 138 
vi 

Minnesota 

 Jewish Family Services of St. Paul 271 

Missouri 

Catholic Charities of Kansas City-St. Joseph, Inc 122 

Montana 

 Missoula Aging Services 212 

Nebraska 

 Legal Aid of Nebraska 174 

Nevada 

Nevada Rural Counties RSVP Program, Inc. 272 

New Hampshire 

Easter Seals New Hampshire, Inc. 123 

New Jersey 

 Jewish Family and Children Services of 

Greater Mercer County 273 

Jewish Family and Vocational Service of Middlesex County 216 

New Mexico 

 Jewish Family Service of Greater Albuquerque 124 

New York 

South Brooklyn Legal Services 151 

Town of North Hempstead 275 

Town of Yorktown 276 

Visiting Nurse Service of New York 

North Carolina 

 Legal Aid of North Carolina 177 

North Dakota 

East River Legal Services Corporation 228 

Ohio 

 Pro Seniors, Inc. 178, 221 

Oregon 

 Jewish Family and Child Services of Portland 277 

 Multnomah County County Human Services 278 

Pennsylvania 

 AgeOptions 224 

Supportive Older Women's Network 126 

Rhode Island 

 Rhode Island Legal Services, Inc. 180 

South Dakota 

 East River Legal Services Corporation 228 

Texas 

 Better Business Bureau Educational Foundation 230 

Family Eldercare Housing & Community Services 127 

 Neighborhood Centers Inc. 128 

Texas Legal Services Center 154 

Utah 

 Utah Legal Services Inc. 182 

Vermont 

City of Montpelier 129 

Community of Vermont Elders 234 
vii 

Vermont Legal Aid, Inc. 183 

Wisconsin 

 Coalition of Wisconsin Aging Groups 237 

Wyoming 

 Wyoming Senior Citizens, Inc 238 

State Government Agencies and Units on Aging 

Alabama Department of Senior Services 

 State Unit on Aging 1, 67, 131, 184 

Alaska Department of Health and Social Services 

 Division of Senior and Disability Services 2, 185 

Arkansas Department of Health and Human Services 

 Division of Health 85 

Arkansas Department of Health and Human Services 

 Division of Aging and Adult Services 4, 186, 239 

Arizona Department of Economic Security 

 Division of Aging and Adult Services 3, 50, 59. 109, 132, 187 

Arizona Department of Health Services 84 

California Department of Aging 60, 86 

California State Independent Living Council 5 

Colorado Department of Human Services 

 Office of Adult, Disability and Rehabiliation Services 6 

Colorado Department of Regulatory Agencies 189 

Colorado Department of Public Health and Environment 87 

Connecticut Department of Social Services 

 Aging Services Division 7, 88, 134, 167, 190 

Delaware Department of Health and Social Services 

 Division of Services for Aging and 

Adults with Physical Disabilities 8, 191, 240 

District of Columbia Office on Aging 9, 135 

Florida Department of Elder Affairs 10, 68, 89, 168 

Georgia Department of Human Services 

 Division on Aging 11, 69, 111, 195 

Guam Department of Integrated Services for 

Individuals with Disabilities 12 

Guam Department of Public Health and Social Services 196 

Hawaii Executive Office on Aging 13, 70, 90, 197 

Idaho Commission on Aging 14, 198 

Idaho Department of Health and Welfare 

 Bureau of Community and Environmental Health 91 

Illinois Department on Aging 15, 137 

Illinois Department of Public Health 

 Office of Health Promotion 92 

Indiana Family and Social Services Administration 

 Division of Aging 16, 71 

Iowa Department on Aging 17, 93 

Kansas Department on Aging 18, 51, 202 
viii 

Kentucky Cabinet for Health and Family Services 

Department for Aging and Independent Living 19, 169 

Louiana Governor's Office of Elderly Affairs 170 

Maine Department.of Health and Human Services 

 Office of Elder Services 20, 52, 72, 94, 205 

Maryland Department of Aging 21, 95, 206, 241 

Massachusetts Executive Office of Elder Affairs 22, 73, 96, 112, 242 

Nevada Department of Health and Human Services 

 Division for Aging Services 175 

Michigan Department of Community Health 

Office of Services to the Aging 23, 53 97, 172 

Minnesota Department of Human Services 

 Board of Aging 24, 54, 62, 74, 98, 209 

Mississippi Department of Human Services 

 Division of Aging and Adult Services 211 

Missouri Department of Health and Senior Services 173 

Montana Department of Public Health and Human Services 

 Senior and Long Term Care Division 25, 75 

Nebraska Department of Health and Human Services 

 State Unit on Aging 26, 213 

Nevada Department of Health and Human Services 

Aging and Disability Services Division 30, 63, 140 176 

Nevada Office of the Attorney General 214 

New Hampshire Department of Health and Human Services 

Bureau of Elderly and Adult Services 55, 76, 176, 215 

New Hampshire Department of Health and Human Services 

Special Medical Services 139 

New Jersey Department of Health and Senior Services 28, 99 

New Mexico Aging And Long Term Services Department 29, 217 

New York State Office for the Aging 31, 77, 100, 113. 217 

North Carolina Department of Health and Human Services 

 Division of Aging and Adult Services 32, 101, 114, 141 

North Carolina Department of Insurance 219 

North Dakota Department of Human Services 

 Aging Services Division 33 

Ohio Department of Aging 34, 102, 115, 243 

Oklahoma Department of Human Services 

 Aging Services Division 56, 103 

Oklahoma Insurance Department 222 

Oregon Department of Human Services 

Seniors and People with Disabilities Division 36, 64, 78,104, 223 

Pennsylvania Department of Aging 179 

Puerto Rico Office of the Ombudsman for the Elderly 37, 225, 244 

Rhode Island Department of Elderly Affairs 38, 142, 226 

South Carolina Lieutenant Governor's 

 Office on Aging 39, 79, 105, 143, 181, 227 

South Dakota Department of Social Services 

 Division of Adult Services and Aging 40 

Tennessee Commission on Aging and Disability 41, 65, 144 
ix 

Texas Department of Aging and Disability Services 42, 80, 106, 145 

Utah Department of Human Services 

Division of Aging and Adult Services 280 

Vermont Department of Disabilities, Aging 

and Independent Living 44 

Virginia Department for the Aging 45, 81 

Virgin Islands Department of Human Services 

 Senior Citizen Affairs Administration 233 

Washington Office of the Insurance Commissioner 235 

Washington State Department of Social and Health Services 

 Aging and Disability Services 46 

West Virginia Bureau of Senior Services 47 

Wisconsin Department of Health Services 

 Division of Long Term Care 48, 58, 82 

Wisconsin Department of Health Services 

 Division of Disability and Elder Services 107,245 

Wyoming Department of Health 49 

National Organizations 

AARP Foundation 236 

Alzheimer's Disease and Related Disorders Assoc., Inc. 250 

American Bar Association Fund for Justice and Education 161 

Asociacion Nacional Pro Personas Mayores 252 

Family Caregiver Alliance 133 

National Consumer Law Center, Inc. 162 

National Hispanic Council on Aging 192 

National Asian Pacific Center on Aging 253 

National Adult Protective Services Foundation 157 

National Association Of Area Agencies On Aging 146, 251 

National Association of State Units on Aging 147 

National Caucus and Center on Black Aged, Inc 254 

NCCNHR (National Citizen's Coalition For Nursing Home Reform) 160 

National Committee for the Prevention of Elder Abuse 158 

National Council on the Aging, Inc. 66, 253, 262 

National Senior Citizens Law Center 163 

Pension Rights Center 156 

Rebuilding Together, Inc. 263 

Women’s Institute for a Secure Retirement (WISER) 256