U.S. Department of Health and Human Services

Administration on Aging

Compendium of

Active Grants

Under Title IV of the

Older Americans Act

Fiscal Year 2004
Compendium of Active Grants FY 2004

 Under Title IV of the Older Americans Act

 Arranged by AoA Priority Area

 

 Table of Contents

The Assistant Secretary for Aging, in support of the HHS Strategic Plan, has established five 

priorities to guide AoA’s activities over a 5 year period. For the FY 2004 Compendium Table 

of Contents, we have organized the discretionary programs under the corresponding AoA 

priority area. They are as follows:

Priority 1: Make it easier for older people to access an integrated array of health 

and social supports.

Program Page

 

Aging and Disability Resource Center 1

Aging Services Network Integrated Care Management Grants Program 16

Alzheimer's National Call Center 23

Alzheimer’s Disease Social Research Project 23

Eldercare Locator Program and the National Aging Information & Referral 24

Livable Communities Initiative 24

Retirement Planning and Assistance for Women 25

Bridging the Gap - Developing a Seamless Entry into Community-based Nutrition Services 25

Priority 2: Help older people stay active and healthy.

Program Page

 

Evidence Based Prevention Program 26

Health Disparities among Minority Elders -Technical Assistance Center 33

Nutrition, Physical Activity and Aging - National Resource Center 35

Older Indians National Resource Centers 35

Osteoporosis in Post-Menopausal Women 36

The Potential of Senior Centers to Improve the Health and Independence of 38

 Older Adults: A National Blueprint for the Future 

Priority 3: Support families in their efforts to care for their loved ones at home and 

in the community. 

Program Page

Alzheimer’s Disease Demonstration Grants to States (ADDGS) 38

Family Friends 70

National Family Caregivers Support Program 74
Educating State Legislators about Caregiver Support 98

Research on Young Caregivers 98

Priority 4: Ensure the rights of older people and prevent their abuse, neglect and 

exploitation. 

Program Page

Legal Assistance and Technical Projects 99

National Center on Elder Abuse 103

National Consumer Protection Technical Resource Center 104

National Long-term Ombudsman Program 105

National Legal Assistance and Elder Rights 106

Operation Restore Trust 108

Pension Information Counseling Projects 110

Pension Technical Assistance Project 116

Senior Legal Services - Enhancement of Access 116

Senior Medicare Patrol Program Integration 118

Senior Medicare Patrol Project 125

Priority 5: Promote effective and responsive management.

Program Page

Performance Outcomes Measures Project 154

Systems-building in State Family Caregiver Support and Promotion Programs 171

 

Congressional Mandates Page

Congressional directed funding of special projects for specific purposes. 172
Page 1 of 223 

Aging and Disability Resource Center

Baton Rouge, LA 70802

Contact: Mary Tonore (225)342-0171

Louisiana will establish a pilot Aging and Adult Disability Resource Center at the Cajun Area Agency on Aging (CAAA) 

with eight satellite locations in the parishes (counties). This pilot will test the design of the Resource Center in both urban 

and rural locations. The Resource Center will be combined with an interactive consumer-focused website; nationwide 

toll-free telephone number; and a single comprehensive assessment, eligibility determination, and care planning process 

to empower individuals to make informed choices and to streamline access to long-term care support. Based on the 

lessons learned from the implementation of the pilot Resource Center, Louisiana will issue an RFP to establish Aging and 

Adult Disability Resource Centers across the state.

 

Target Population: Year One - Persons 60 and older

 Year Two & Three - Persons 60 and older and adults.

Anticipated Outcomes: A convenient, accessible one-stop source of information, assistance, and streamlined access to 

services through a central location and satellite offices that provides consumers and their families information, assistance 

and referral resources, and comprehensive in-home assessments with the opportunity to self-divert from institutional care 

and receive appropriate services in the least restrictive community setting of their choosing; a "1-800" telephone and 

Internet access; enhanced comprehensiveness of center services by separating care management functions from service 

provision and cross training and certifying resource center staff; reduction in the number of intake, screening, and eligibility 

determination processes consumers must experience to receive services.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2005

375,999

48,000 412 North 4th Street, 3rd Floor 

Program: 

STATE OF LOUISIANA

Governor's Office Elderly Affairs

Aging and Disability Resource Center 101

90AM2753

WV Aging and Disability Resource Center

Charleston, WV 25305-5305

Contact: Julie Shelton (304)558-2241

West Virginia will establish two comprehensive pilot resource centers, one in an urban area and one in a rural area of the 

state, which will be implemented by local senior programs. The centers will integrate access to all long-term care 

programs - both public and private pay - and develop uniform and standardized processes to determine level of need, 

eligibility and care plans. Programs integrated into the resource centers include the WV SHINE (a health and wellness 

program), family caregiver support, and Alzheimer's disease caregiver support services, as well as the traditional 

long-term care services. The Bureau of Senior Services will partner with the West Virginia University. Center on Aging to 

evaluate the effectiveness of the two pilots to inform expansion to a statewide network of resource centers. 

Target Population: 

	Year One - Persons 60 and older and adults over age 18 with physical disabilities

	Year Two & Three - Persons 60 and older and adults over age 18 with physical disabilities

Anticipated Outcomes: Public understanding of the existence and functions of the resource centers; responsiveness to the 

unique needs of individuals and their long term care choices; a system of coordination for eligibility for publicly funded 

programs; provisions for pay private consumers; an informed state policy to promote a more balanced system of long 

term care based on consumer choice; protection for vulnerable individuals identified through the resource centers.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003 375,518

1900 Kanawha Blvd. East, Bldg. 10 

Program: 

WEST VIRGINIA BUREAU OF SENIOR SERVICES

Aging and Disability Resource Center 101

90AM2754
Page 2 of 223 

Aging and Disability Resource Center for Maryland

Baltimore, MD 21201

Contact: Ilene Rosenthal (301)767-1265

The Maryland Department of Aging (MDoA) will develop pilot Resource Centers in one urban/suburban county and one 

rural county which will serve the elderly and people with physical disabilities. The program will be designed to accomplish 

two primary goals: 1) to enhance existing infrastructure by creating a single point of entry at the local level capable of 

coordinating access to long term supports; and 2) to streamline the Medicaid financial and programmatic eligibility 

determination process to make it less cumbersome for consumers. MDoA will develop the project based on several key 

assumptions including: meaningful collaboration among partners; change processes require extensive education, 

follow-up and re-education; MIS linkages and redesigns must be cost-effective and adhere to HIIPAA; and state level 

policy changes will be required to effect local change. MDoA believes that introducing systems reform at the state level, 

along with establishing Resource Centers county by county, will create a foundation and groundswell that will assist them 

in achieving successful systems change statewide. 

Target Population: 

	Year One - Persons 50 and older

	Year Two and Three - Adults with physical disabilities

Anticipated Outcomes: An interagency advisory structure at the state and local levels; a visible, trustworthy, responsive, 

efficient and cost effective resource center that empowers consumers to exercise choice; standardized forms and training 

materials designed to be used across agencies; a streamlined Medicaid financial and programmatic eligibility 

determination process; a "fast track" financial eligibility screening process; improved programmatic eligibility determination 

by expanding and coordinating systems for case identification, intake, screening, and assessment.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2005

376,000

48,000 301 West Preston Street, Suite 1007 

Program: 

MARYLAND DEPARTMENT OF AGING

Aging and Disability Resource Center 101

90AM2755
Page 3 of 223 

SC Access Plus

Columbia, SC 29201

Contact: Barbara Kelly (803)734-9899

South Carolina proposes to pilot the Resource Center program by establishing centers in two counties - Aiken and 

Barnwell - located in the Lower Savannah AAA service area. Through these centers, consumers will receive information, 

assistance and counseling, assessment and short-term case management, eligibility screening, eligibility determination 

and the ability to apply for long term support services. Services, including Medicaid eligibility determination, will be 

co-located. Eligibility determination and application processes will be streamlined through an electronic data sharing 

methodology that will be developed in the pilot area. Building on an existing web-based information and assistance 

system, South Carolina Access, the management information system will be designed to link the resource center case 

management system with existing databases including the Medicaid Waiver Case Management system and the Bureau of 

Senior Services Family Caregiver system. Consumers will be able to apply for services on-line. Project staff will work 

with the University of South Carolina Research Foundation to conduct a program evaluation. 

Target Population: 

	Year One - Persons 60 and older

	First Quarter of Year Two & Year Three - Individuals with physical disabilities

Anticipated Outcomes: Resource centers in at least two locations providing information, counseling, eligibility screening 

and coordination with eligibility determination by Sept. 2005 and fully functional by Sept. 2006; a consumer tracking/case 

management system in operation by Sept. 2004; an on-line service application process in place by Sept. 2004; and an 

information management system - operational, and tracking referrals, utilization and costs in place by Sept. 2005.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2005

376,000

48,000 1301 Gervais Street, Suite 200 

Program: 

South Carolina Lieutenant Governor's Office on Aging

Aging and Disability Resource Center 101

90AM2756

MinnesotaHelp Information Network

St. Paul, MN 55155-5155

Contact: Mary Chilvers (651)431-7415

Minnesota will develop strong linkages between county long term care consultation and information, referral and 

assistance services. The state will: give consumers, their families and other caregivers and professionals access to more 

effective, consumer-friendly, robust decision support Internet tools to navigate long-term care information for planning and 

decision-making; provide standardized statewide professional screening, assessment and eligibility using XML data 

sharing protocols; and establish four Hennepin County (including Minneapolis) resource centers in easy to access 

locations to provide a full complement of personalized awareness and information, assistance and access functions. 

Minnesota plans to eventually replicate the resource center program throughout the state after the three-year project 

period. An evaluation consultant will be retained to work with project management and the advisory board to develop and 

implement an effective measure of the impact of the project on the quality of life of participant consumers. 

 

Target Population: 

	End of Year One - Persons 60 and older

	Year Two & Three - Persons 60 and older and individuals with disabilities of all types

Anticipated Outcomes: A resource center tailored to meet consumer's and professional's needs through tools connecting 

them to streamlined assess to long-term care services with a single, coordinated method of intake, assessment and 

eligibility, with quality monitored through a centralized data collection and evaluation; a decrease in consumer confusion 

and duplicative services and an increase in enhanced choice; an improved ability by State and local governments to 

connect consumers to needed services and supports from publicly and privately funded services.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003 347,394

444 Lafayette Road North 

Program: 

MINNESOTA BOARD ON AGING

Aging and Disability Resource Center 101

90AM2757
Page 4 of 223 

NJ EASE Aging & Disabilty Resource Center

Trenton, NJ 08625-0807

Contact: Nancy Day (609)943-3429

New Jersey will establish two to three Aging & Disability Resource Centers at the county level to test the development and 

implementation of models that will integrate information and assistance, assessment, eligibility determination, and access 

processes and staff across programs. New Jersey will build on its extensive information, assistance and referral system 

(NJ EASE) to provide information and assistance 24 hours a day, 7 days a week, and 365 days a year through its toll-free 

number and a new interactive website. A new management information system that supports client tracking, needs 

assessment, care plans, and utilization will be linked to a computerized universal application for services.

Target Population: 

Year One - Persons 60 and older

Year Two & Three - Persons 60 and older and individuals with physical disabilities

A special focus will be on hard-to-serve and underserved populations

Anticipated Outcomes: A visible, responsive, and trusted resource center, which will be the sole source for home and 

community-based services, connecting consumers to a full array of public and private supportive services to assist them 

in tailoring a care program that best meets their needs through a seamless process. The Resource Center will provide 

automated mechanisms for accurately tracking consumer utilization and service costs, which will aide in the development 

of needs assessments and care plan. It will also provide a comprehensive resource library to assist consumers with 

finding long-term care options and supports. 

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2005

375,079

48,000 240 West State Street 

Program: 

NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES

PO Box 807

Aging and Disability Resource Center 101

90AM2759

The Northeast Massachusetts Aging and Disability Resource Center Project

Boston, MA 02108-2108

Contact: Heather Johnson-LaMarche (802)879-1338

Massachusetts' Aging and Disability Resource Collaborative will be established in the Northeast Region of the state. In the 

first year, a uniform intake process will be developed and utilized by a team of intake workers from community partners 

who will provide comprehensive and coordinated information, referral and case management. Community service partners 

will be cross-trained to ensure timely and appropriate transfer of information and resources. In years two and three, the 

collaborative will expand to the rest of the Northeast region and will target hard-to-serve or underserved populations. 

Medicaid enrollment staff will be co-located at the resource center by year 3. A toll-free telephone number, interactive 

website of intake, referral and evaluation will provide the foundation for the collaborative's functions. The uniform 

screening and assessment tool and process developed under a Real Choice Systems Change grant will be launched 

through the collaborative.

Target Population: 

	Year One - Persons 60 and older and individuals with disabilities of all types

	Year Two & Three - Persons 60 and older and individuals with disabilities of all types

	A special focus will be on hard-to-serve and underserved populations

Anticipated Outcomes: A visible, trusted and accessible entry point into long-term care for consumers, including those 

from diverse populations; increased community communication and collaboration in the delivery of home and 

community-based services; and coordinated provision of long-term care services through an integrated case management 

function.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2005

352,500

48,000 One Ashburton Place, 5th Floor 

Program: 

Executive Office of Elder Affairs

Aging and Disability Resource Center 101

90AM2760
Page 5 of 223 

Rhode Island One Stop

Cranston, RI 02920-

Contact: Joan D'Agostino (401)462-0507

The Rhode Island Department of Elderly Affairs (DEA) proposes to create Elder and Adult Disabled Resource Centers that 

will provide services to the elderly and individuals with physical disabilities. DEA will develop an resource center in 

Cranston, Rhode Island, near Providence. A number of Older Americans Act, Medicaid and state funded programs will be 

co-located at the resource center site. Up to three satellite mini-centers will be established through an RFP process in 

additional locations throughout the state. Resource center infrastructure will include a toll-free line, a Web-based resource 

directory and benefits screening tool supported by a Real Choice Systems Change grant, and an integrated information 

management system. To facilitate systems coordination and collaboration, written agreements will be established with key 

partners. By Executive Order of the Governor, a long-term care Cabinet will be established to ensure a coordinated, 

consumer focused, cost effective system of long-term care. Rhode Island is in the process of consolidating services 

funded through state funds, Medicaid, and other federal programs into a new long-term care Support Program. The DEA 

project director for the Rhode Island Performance Outcomes Measurement Project will work with a contractor to conduct a 

project evaluation. 

Target Population: 

	Years 1 - 3 - persons 60 and older and people with physical disabilities

Anticipated Outcomes: Reduction in the level of consumer frustration and confusion and an increase in consumer 

satisfaction in Rhode Island's long-term support system, and a system that ensures eligible individuals receive more 

appropriate, less costly forms of support based on consumer preferences.

Project Period: 09/29/2003 - 09/30/2006

FY Grant Amount

FY 2003 352,030

Benjamin Rush Building #55 - 35 Howard Avenue 

Program: 

RHODE ISLAND DEPARTMENT OF ELDER AFFAIRS

Aging and Disability Resource Center 101

90AM2761

One-Stop Aging/Disability Resource Center

Helena, MT 59604

Contact: Doug Blakely (406)444-7787

Montana will establish a One-Stop Aging/Disability Resource Center in Yellowstone County. The Center, operated by the 

Area Agency on Aging, will be open 362 days a year with four counselors who will assist consumers in determining their 

eligibility for long-term care services, benefits and employment counseling and will provide referrals to federal, state, local 

and private agencies. A web-based eligibility and application process and a management information system that tracks 

client intake, needs assessment, care plan, utilization and costs will provide the infrastructure for the Resource Center 

functions. 

Target Population: 

 Year One - Persons 60 and older 

 Year Two & Three - Persons 60 and older and individuals with physical disabilities

Anticipated Outcomes: Informed, effective and empowered consumers who are members of Yellowstone County's 

continuum of care; a resource center as a place consumers recognize and utilize to resolve questions or problems and 

access a full array of long-term care services; and an effectively managed system that tracks long-term care services 

through client intake, needs assessments, care plans, utilization and costs.

Project Period: 09/29/2003 - 09/30/2006

FY Grant Amount

FY 2003

FY 2005

328,663

48,000 PO Box 4210 

Program: 

Department of Public Health & Human Services

Aging and Disability Resource Center 101

90AM2762
Page 6 of 223 

Aging and Disability Resource

Augusta, ME 04333-4333

Contact: John Baillargeon (207)287-9208

Building on the state's current statewide pre-admission assessment program and the recommendations of the Maine 

Olmstead Workgroup for Community-based Living, the Bureau of Elder and Adult Services will: work with three 

community coalitions to test methods to streamline consumer access to long term supports; establish, within the current 

long-term support assessment process for adults of all ages, the means to improve person-centered service planning for 

the targeted populations; implement referral and follow-up protocols to improve service coordination and ensure more 

effective service access; evaluate resource center results to inform the process of merging the two state departments 

responsible for the organization and delivery of long term support services; and replicate the process statewide. Resource 

Center funds will be used to enhance existing automated Medicaid eligibility tools and to assess the feasibility of a 

web-based Medicaid application process to improve "real time" interface.

Target Population: 

	Year One - Persons 60 and older

	Year Two and Three - adults with mental health and addiction disorders, brain injury, developmental 

disabilities, and cognitive impairments. 

Anticipated Outcomes: A cohesive network of local and state resources at the community level, that communicates 

effectively, to assist adults of all ages and incomes seeking long term support; enhanced management information 

systems and Medicaid level of care and financial application procedures to allow for more timely, user-friendly access; a 

revised pre-admission assessment tool to develop comprehensive service plans based on informed choice and consumer 

preference; a coordination and linkage of protocols at the state and local level to support ongoing service coordination for 

target populations.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003 360,586

35 Anthony Avenue - 11 State House Station 

Program: 

MAINE DEPARTMENT OF HUMAN SERVICES

Aging and Disability Resource Center 101

90AM2763

Aging and Disability Resource Center Project

Durham, NH 03824-3585

Contact: Amy Philbrick (603)862-5099

The goal of the New Hampshire Resource Center project is to integrate the current information and assistance program 

with the state Assessment and Counseling program and the eligibility determination and care plan authorization processes 

for nursing facility and home and community based waiver program. Resource Centers will establish a system of 

coordination with Medicaid financial eligibility determination. Four pilot Resource Centers will be developed initially to 

serve the elderly and all target populations of people with disabilities, with plans to establish resource centers statewide by 

the end of year three. The project advisory committee will guide the design and development of evaluation activities. A 

subcommittee of the advisory work group will guide consultants in selecting and implementing an automated information 

management system. 

Target Population: 

	Years 1 - 3: Persons 60+ and people with disabilities

Anticipated Outcomes: Consumers and their caregivers aware of the Resource Centers as a trusted place to get easy 

access to comprehensive and current information on long term support options; uniform clinical eligibility assessments of 

nursing facility applicants who have applied for Medicaid benefits; information, referral, counseling, and assessment 

services that are efficiently coordinated to eliminate duplication and burden on consumers.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003 376,000

Service Building, 51 College Road 

Program: 

University of New Hampshire

Aging and Disability Resource Center 101

90AM2764
Page 7 of 223 

Community Choice Aging and Disability Resource Center

Little Rock, AR 72203-1437

Contact: Gloria Powell (501)683-0966

Arkansas will develop a Community Choice Resource Center that serves older people, as well as people with physical or 

developmental disabilities, in a 12-county region of the state. The Area Agency on Aging of Southwest Arkansas will 

establish a physical Center co-located with partner agencies in an existing community center; provide out-stationed 

counselors to serve the 12-county region; and develop and implement an Internet-based consumer assessment, referral, 

enrollment and reporting tool that will serve as the project management information system. Arkansas will develop a 

procedures manual on how to operate a Resource Center, to encourage replication of the model across the state.

Target Population: 

	Year One - Persons 60 and older

	Year Two & Three - Persons 60 and older and individuals with physical or developmental disabilities

Anticipated Outcomes: The Community Choice Resource Center will: integrate programs; improve access; coordinate 

services; manage program information; and enhance choice.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

396,631

48,000 PO Box 1437, Slot S530 700 Main Street

Program: 

Arkansas Department of Human Services

Aging and Disability Resource Center 101

90AM2820

Iowa's Resource Center Initiative

Des Moines, IA 50309-3609

Contact: Mary Anderson (515)242-3346

Iowa will establish a Resource Center that will be accessible to every community by toll-free telephone service, web site 

access or through service delivery professionals. The state will integrate its Internet-based management information 

system with that of the developmental disabilities system. It will also create an interactive consumer-oriented website to 

expand to support this "no wrong door" approach to accessing the long-term care system. Information and counseling 

services will be made available to private-pay individuals. 

 

Target Population: 

	Year One - Persons 60 and older

	Year Two & Three - Persons 60 and older and individuals with developmental disabilities

Anticipated Outcomes: Empowered consumers who make informed choices about long-term care; streamlined access to 

long term supports; minimized consumer confusion; and limited use of unnecessary high-cost services.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004 400,000

Clemens Building, 3rd Floor 200 10th Street

Program: 

IOWA DEPARTMENT OF ELDER AFFAIRS

Aging and Disability Resource Center 101

90AM2821
Page 8 of 223 

Aging & Disability Resource Center

Saipan, MP 96950

Contact: Terry Castro (670)664-2598

The Commonwealth of the Northern Mariana Islands (CNMI) will establish an Aging and Disability Resource Center, 

where older people and people with disabilities in the island community can have access to clear and uniform information 

and counseling on all available long-term care services. The Center will also be a single point of entry to public short and 

long-term support programs and activities. It will reach out to underserved older people and people with disabilities in 

villages where people have limited access to information. CNMI will integrate access to long-term care programs and 

activities through co-location of personnel and an integrated database. Center staff will assist consumer in utilizing the 

Benefits Check-Up online tool to determine eligibility for public benefits.

Target Population: 

	Year One - All populations

	Year Two & Three - All populations

Anticipated Outcomes: simplified access to information and an eligibility screening process for a variety of long-term care 

supports and services in one location; educated consumers, professionals, and communities that know about the services, 

program resources, agencies and resource center; community-wide support for use of the resource center technology to 

provide clear, accurate and current information on available long-term care support; services that centralize screening of 

program applications to ensure clients are matched with appropriate programs that best meet their needs; and reduced 

waiting time for consumers who need screenings, program enrollments, and referrals.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004 100,000

Caller Box 10007 

Program: 

NORTHERN MARIANA ISLANDS DEPT OF COMM & CULTURAL AFFAIR

Northern Mariana Islands Dept. of Comm. & Cultural Affa

Aging and Disability Resource Center 101

90AM2822
Page 9 of 223 

Aging and Disability Resource Center

Santa Fe, NM 87505

Contact: Mary James (505)476-4758

New Mexico will realize the vision of the Resource Center by establishing the core capacity of information and assistance 

services statewide and phasing in a seamless public interface through a community-based resource center. New Mexico 

will develop a detailed provider database, strengthen the information and assistance capacity of 50 local sites across the 

state, standardize the needs assessment process, standardize and coordinate the eligibility determination process, and 

phase-in comprehensive resource centers to serve older people and individuals with physical disabilities across the state. 

The Interagency Long-term Care Committee, in it's capacity as project advisory committee, will set criteria for the selection 

of one or more resource center pilot sites. A consultant will be utilized to conduct a project evaluation based on project 

goals and objectives, and the advisory committee will use the results to make recommendations for operational and 

process modifications. 

 

Target Population: 

	Year One - Persons 60 and older

	Year Two & Three - Persons 60 and older and individuals with physical disabilities

Anticipated Outcomes: A statewide information system, counseling and assistance on public and private long-term care 

services; creation of a resource center with improved public awareness, information availability and assistance, and 

access to long term care services, case management and other related functions to promote personal choice, 

independence and cost-effective use of available services; and a system that enhances availability, assistance and 

access to long term care services to promote personal choice and independence of older people and adults with physical 

disabilities and to support their caregivers. 

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

399,450

48,000 2550 Cerrillos Road 

Program: 

STATE OF NEW MEXICO

New Mexico State Agency on Aging

Aging and Disability Resource Center 101

90AM2823
Page 10 of 223 

Aging and Disability Resource Center Administrative Supplement

Raleigh, NC 27699

Contact: Heather Burkhardt (919)733-8400

The North Carolina Resource Center program will construct a locally integrated, visible network of resources to provide 

uniform information and access for consumers in one urban and one rural county. The North Carolina Division of Aging 

will develop a Resource Center incorporating a new statewide Information and Assistance infrastructure, expanded use of 

volunteer benefits counselors, a modified version of NCOA's Benefits CheckUp, and the piloting of a uniform 

intake/screening tool. The Division of Medical Assistance (DMA) will develop a Chronic Care Management Project in a 

regional hospital to complement the Resource Center by providing essential functions targeted to the most complex 

long-term care populations reliant on public support. The DMA will also pilot a simplified adult Medicaid mail-in application 

through the Resource Centers. The foundations for an integrated, computerized tracking management system to facilitate 

seamless access to services and to aid in planning, development and evaluation will be developed. Research Triangle 

Institute will do the evaluation . 

Target Population: 

	Year One - Persons 60 and older 

	Year Two and Three - Second target population will be selected by the local communities from the target groups of 

people with physical disabilities, mental illness, and/or MR/DD. 

Anticipated Outcomes: Established Resource Center that is a visible and trusted source of assistance that conforms to 

standards necessary for statewide dissemination; disseminated information and assistance about long-term care needs 

that is relevant to seniors and younger persons with disabilities and their family caregivers; access to long-term care 

services with greater ease (less effort, less time) by Seniors and younger persons with disabilities; access to long-term 

care supports that enable seniors and younger persons with disabilities to remain in the community as long as possible. 

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

400,000

48,000 2101 Mail Service Center 

Program: 

NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

Aging and Disability Resource Center 101

90AM2824
Page 11 of 223 

Georgia's Aging and Disability Resource Center

Atlanta, GA 30303-3142

Contact: Lauren Burby (404)657-5331

Georgia will implement Aging and Disability Resource Centers in one urban (decentralized model) and one rural 

(centralized model) service area, to serve the elderly and people with developmental disabilities. The Centers will build 

upon the existing AAA based single point of entry system known as the Gateway system, which includes assessment and 

financial eligibility determination functions. Resource Centers will implement protocols for consistency in providing 

information and assistance services, build local coalitions, develop training and marketing strategies, and expand the 

service and resource database to include services for people with developmental disabilities, with the long term goal of 

moving Georgia toward the vision of a seamless consumer one-stop shop for all target populations in need of long-term 

care options statewide. Other regions across the state will be provided with the tools to replicate a centralized or 

decentralized resource center model for aging consumers and people with developmental disabilities. Evaluation will 

focus on the outcomes listed below and will draw on the client satisfaction surveys developed through the AoA 

Performance Outcome Measurement Project. 

Target Population: 

	Year One - Persons 60 and older 

	Year Two and Three - Individuals with developmental disabilities

Anticipated Outcomes: Resource Centers that are visible and trusted places where consumers get streamlined access to 

long-term care; a collaborative environment in which effective community coalitions between service networks occur; 

population specific protocols for information and assistance that will increase efficiency and effectiveness; an expanded 

resource database which includes resources for persons with developmental disabilities; and a staff cross-trained on 

issues and needs of the elderly and people with developmental disabilities.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

399,999

48,000 Two Peachtree Street, NW, Suite 9.398 

Program: 

Georgia Department of Human Resources

Aging and Disability Resource Center 101

90AM2825
Page 12 of 223 

Aging & Disabilty Resource Center Grants Program

Springfield, IL 62701-1789

Contact: Ross Grove (217)524-7627

Illinois will establish an Aging and Disability Resource Center in Rockford, to be administered by the Northwestern Illinois 

Area Agency on Aging, which will serve persons with developmental disabilities and older people. Illinois will establish a 

second Center in Decatur, to be administered by the East Central Illinois Area Agency on Aging, which will serve people 

with physical disabilities, older people and family caregivers. The Resource Centers will provide long-term care options, 

counseling and comprehensive needs assessments through a person-centered planning approach. The centers will 

expand caregiver support services to previously underserved populations, such as grandparents raising grandchildren. 

The Department of Disability & Human Development at the University of Illinois will evaluate the effectiveness of the 

Centers to determine feasibility of statewide expansion.

 

Target Population: 

	Year One - Persons 60 and older and individuals with physical and developmental disabilities

	Year Two & Three - Persons 60 and older and individuals with physical and developmental disabilities

Anticipated Outcomes: Established a Resource Center that maximizes the abilities of older people, persons with physical 

disabilities and persons with developmental disabilities to make informed choices and to meet their long term care needs; 

and a system of direct assistance to family caregivers who plan for the future needs of family members who have physical 

disabilities and/or developmental disabilities. 

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

400,000

48,000 421 East Capitol Avenue #100 

Program: 

ILLINOIS DEPARTMENT ON AGING

Office of The Director

Aging and Disability Resource Center 101

90AM2826

Lessons Learned: Redefining the Expansion of Wisconsin Resource Centers

Madison, WI 53707-7851

Contact: Anne Marie Ott (608)261-7809

The Wisconsin Department of Health and Family Services (DHFS) will expand geographic coverage of their full-service 

Aging and Disability Resource Centers, develop capacity for all target groups to be served resource centers, and develop 

infrastructure to support ultimate expansion to all parts of the state. Five local agencies will be selected through an RFP 

process to develop new full-service Resource Centers. DHFS will develop state-level infrastructure to support current and 

future development of a statewide system of full-service Resource Centers that serve elders and at least one other target 

population of individuals with disabilities. The state infrastructure will include: two toolkits, one to promote public 

awareness and one for long term care options counseling; identification of information management system solutions; 

ability to provide technical assistance in adding new target populations; technical assistance in identifying and accessing 

funding sources. Grant funds, together with state resources, will be used to identify and implement information 

management solutions capable of meeting the range of operational, administrative, and reporting needs of a Resource 

Center. DHFS will lead the project evaluation based on performance outcomes and indicators. 

Target Population: 

	Year One - Persons 60 and older 

	Year Two and Three - At least one other target population of people with disabilities

Anticipated Outcomes: A general public that is informed about the Resource Centers and using their services; Resource 

Centers that are visible and trusted places which provide objective, reliable and comprehensive one-stop shop 

information, assistance and access to long-term care and other community services, and eliminate duplication of services 

and multiple points of entry for mental health services.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004 400,000

1 West Wilson PO Box 7851, Room 450

Program: 

WISCONSIN DEPARTMENT OF HEALTH AND FAMILY SERVICES

Aging and Disability Resource Center 101

90AM2827
Page 13 of 223 

IN Aging and Disability Resource Centers

Indianapolis, IN 46207

Contact: Patty Matkovic (317)332-7132

Indiana will phase in the establishment of six Aging and Disability Resource Centers to coordinate information, referral 

and programmatic/financial eligibility determinations for older people and individuals with physical disabilities. The 

management information systems from the aging network and physical disabilities network will be integrated and 

Internet-based to provide the foundation for statewide expansion of the Resource Centers. Local Resource Centers will 

develop and implement an information marketing strategy that targets providers and community resources, as well as 

consumers.

 

Target Population: 

	Year One - Persons 60 and older

	Year Two & Three - Persons 60 and older and individuals with physical disabilities

Anticipated Outcomes: An expanded awareness of older people and individuals with physical disabilities to the full range 

of long term care services available to them; streamlined access to long-term care services for both public and private pay 

individuals; a management information system that will enable the state to promote a more balanced system of care that is 

based on consumer choice.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

389,405

48,000 402 West Washington St. - PO Box 7083, MS-21 

Program: 

INDIANA DIVISION OF DISABILITY, AGING AND

REHABILITATIVE SERVICES

Aging and Disability Resource Center 101

90AM2828

California Aging and Disability Resource Center Initiative

Sacramento, CA 95814-5814

Contact: Denise Crandall (916)419-7507

California will establish a Resource Center in Del Norte County and San Diego County, in partnership with the Area 

Agencies on Aging, to simplify access to long-term care services. The Resource Centers will identify systems 

improvements related to access, conduct public awareness activities, target outreach to underserved or hard-to reach 

populations, identify modifications to the Network of Care website, and partner with physicians who will link with social 

services. California will evaluate the effectiveness of the two Resource Centers based on geographic, cultural and 

socio-demographic differences. 

Target Population: 	Year One - Persons 60 and older; 

 Year Two and Three - All populations (San Diego), Persons 60 and older and individuals

 with physical disabilities (Del Norte)

Anticipated Outcomes: The establishment of Resource Centers which are non-stigmatizing public places, accessed for 

information and assistance by a diverse range of people, both private pay and public pay individuals referred by 

physicians and other professionals. Resource Centers refer clients to needed medical care, as well as social supports. 

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004 399,999

1600 K Street 

Program: 

STATE OF CALIFORNIA - DEPARTMENT OF AGING

Aging and Disability Resource Center 101

90AM2829
Page 14 of 223 

Florida Aging and Disability Resource Center (ADRC) Program

Tallahassee, FL 32399-7000

Contact: Sandi Smith (850)414-2000

Florida will develop and implement Resource Centers in two different service areas, offering information, counseling, 

referrals, assessment and eligibility functions for both publicly and privately funded services for the elderly and individuals 

with mental illness. To achieve this, Florida will co-locate information and referral, screening and assessment, access to 

crisis intervention, short-term case management, medical and financial eligibility determination, and long term care 

counseling. Florida will establish a single administrative structure accessible through multiple locations (senior centers, 

AAAs, housing authorities, mental health centers etc.) in each of the two resource center communities. The Department 

of Elderly Affairs, in conjunction with the Florida Office of Long-Term Care Policy, will develop and conduct the evaluation. 

The resource center program will benefit from an existing Florida project designed to merge existing program information 

management databases. The Florida legislature currently supports integrated long term care.

Target Population: 

	Year One - Persons aged 60 and older 

	Year Two and Three - individuals with mental illness

Anticipated Outcomes: visibility - demonstrated increase in the number of consumer requests; trust - eighty percent of 

respondents to a survey of ADRC customers express trust in Resource Center services; ease of access - eighty percent of 

respondents to a survey of ADRC customers express satisfaction with ease of accessing Resource Center services; 

responsiveness - eighty percent of respondents to a survey of ADRC customers express satisfaction with the 

responsiveness of Center services; efficiency and effectiveness - measured through: 1) a time study to determine savings 

as a result of Resource Centers, 2) customer interviews assessing value or services received, and 3) establishing 

baseline data in year one for each Resource Center.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

399,973

48,000 4040 Esplanade Way 

Program: 

FLORIDA DEPARTMENT OF ELDER AFFAIRS

Planning and Evaluation Unit

Aging and Disability Resource Center 101

90AM2830
Page 15 of 223 

Alaska's Aging and Disabilitites Resource Center

Anchorage, AK 99510-1020

Contact: Jim McCall (907)330-8436

Alaska will establish five regional Resource Centers operated by the State Centers for Independent Living (SILC) to 

provide citizen-centered "one-stop shopping" entry to long term support services for seniors and people with disabilities 

statewide. Two regional Centers will be established in the first year and three will be established in year two. The 

Resource Centers will offer information and referral services, eligibility screening, assistance in gaining access to long 

term support services for private pay consumers, comprehensive assessment for those seeking publicly funded services, 

programmatic eligibility determination for long term support services, and access to the Division of Public Assistance for 

Medicaid financial eligibility determination. The SILC will work with the Division of Senior and Disability Services and the 

Senior Housing Office to develop a management information system that tracks consumer intake, needs assessment, 

care plans, utilization, and costs. Formative and summative evaluations will be conducted by the center for Human 

Development.

Target Population: 

	Year One - Persons 60 and older and persons with disabilities of all types

	Year Two and Three - Persons 60 and older and persons with disabilities of all types

Anticipated Outcomes: Resource Centers with streamlined access to long term support services; outreach to underserved 

populations; Centers effectively empowering individuals in need, or planning for long term supports, to make informed 

choices; an emphasis on supporting consumer-driven, home and community based service options; and assistance with 

increasing the knowledge of health and long term support professionals and others providing services to the elderly and 

people with disabilities.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004 399,791

PO Box 101020 

Program: 

ALASKA HOUSING FINANCE CORPORATION

Aging and Disability Resource Center 101

90AM2831

Aging and Disability Resource Centers

Harrisburg, PA 17120-0001

Contact: Elaine S Smith (717)346-9713

Pennsylvania will plan and operate four demonstration Resource Centers located in diverse areas of the state to assist all 

consumers and family members who need information, counseling, assessment and assistance in applying for long-term 

care services. In two of the Centers, personnel from all relevant service agencies will be co-located at the Centers. In the 

remaining two Centers, relevant agencies will be connected via the Internet to each other and the co-located Centers to 

provide uniform delivery of information, assistance and access services. A single application for services will be 

developed, the eligibility process will be streamlined and a common assessment tool will be developed and utilized by all 

of the Centers. By the end of the project period, a plan will be established to expand the Resource Centers statewide, 

based on a comprehensive evaluation. 

Target Population: 

	Year One - All populations

	Year Two & Three - All populations

Anticipated Outcomes: Simplified and streamlined access to long-term care that ensures each individual's need for 

services is determined and addressed promptly; maximized consumer choice and service provisions in a consumer 

friendly manner, respecting and ensuring dignity of all served; a more balanced system of long- term care, which includes 

more home and community-based services.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2005 359,080

433 Forum Building 

Program: 

Pennsylvania Office of the Budget

PA Governor`s Office of Health Care Reform

Aging and Disability Resource Center 101

90AM2919
Page 16 of 223 

Partnership for the Integration of Community Supports with Managed Care

Southfield, MI 48034

Contact: Kathleen Kirschenheiter (248)357-2255

Area Agency on Aging 1-B (AAA 1B) will work in partnership with Health Alliance Plan's (HAP) Senior Plus Medicare 

Advantage Program to link 140 high risk HAP members and/or their caregivers to community supports utilizing AAA 1B's 

extensive resource database. The goal is to develop a model for a formal working partnership that benefits older adults 

through the integration of disease management and community support. The project will serve 140 high-risk HAP Senior 

Plus members with one or more chronic conditions in Oakland and Macomb counties. The project will target socially and 

economically disadvantaged members due to its focus on persons with chronic diseases, which exist in greater proportion 

among low-income and minority adult populations. Anticipated outcomes include: (1) 90% of AAA and HAP staff will 

increase knowledge of chronic disease management, prevention resources, and their knowledge about managing HIPAA 

compliant, inter-agency communications; (2) 80% of enrolled members will increase knowledge and confidence in their 

ability to self-manage their chronic condition; (3) 80% of enrolled members will demonstrate improvement in at least one 

clinical indicator for the disease management program; (4) 50% of enrolled members will show a reduced use of ER 

services and decreased hospital stays for at least a six-month period; (5) 80% of enrolled members will express 

increased satisfaction with HAP chronic disease management after involvement; (6) 90% of AAA staff working on project 

will increase knowledge of integrating Call Center technologies and care management with Managed Care Organization 

(MCO); and (7) 90% of staff involved will express confidence in the value of community supports in achieving positive 

health outcomes.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 49,516

29100 Northwestern Hwy. , Suite 400 

Program: 

Area Agency on Aging 1-B

Aging Services Network Integrated Care Management Grants Program 102

90AM2885

Baltimore Integrated Care Management

Baltimore, MD 21201

Contact: (410)396-4932

The Baltimore Commission on Aging and Retirement Education (CARE) proposes to create an integrated case 

management, medication monitoring, and benefit screening model to serve patients recently discharged from hospitals 

who are insured through a managed care organization (Elder Health). This project will enhance three separate activities 

currently conducted through CARE. The three hospitals selected as the source of the discharged patients, the University 

of Maryland Hospital, Union Memorial Hospital, and Sinai General Hospital, all serve urban, predominantly low-income 

neighborhoods in different sections of Baltimore. While the project will not impose income restrictions, the location of the 

hospitals assures that most of the patients will be near or below poverty level, and a substantial proportion will be dually 

eligible for Medicare and Medicaid. The project will have one major outcome: a reduction in re-hospitalizations of the 

project population by 10%, compared with the separate control group. The final product will be a sustainable model, 

which CARE and its partners will be able to cost-out and offer in the emerging marketplace of services for elderly persons 

with chronic illness.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 49,889

10 N. Calvert Street 

Program: 

Baltimore City Maryland

Commission on Aging and Retirement Education

Aging Services Network Integrated Care Management Grants Program 102

90AM2886
Page 17 of 223 

Culturally Competent Case Management for Non-English Seniors.

Boston, MA 02114

Contact: Rimma Zelfand (617)614-1939

Jewish Family and Children's Services will conduct a 12-month demonstration project that provides culturally competent 

case management and language access services for Russian-speaking seniors enrolled in a new managed care program 

serving dual eligible seniors in Eastern Massachusetts. The goal of the project is to develop a cost-effective case 

management model that addresses the clinical, financial, and logistical challenges associated with serving non-English 

speaking seniors in a managed care environment. The project will target low-income, Medicaid-eligible immigrants from 

the former Soviet Union, with limited English proficiency (LEP). The primary product will be a field-tested business plan 

for AAAs and Community Agency Service Providers (CASPs) seeking to contract with managed care entities to provide 

combined case management and language access services for seniors with limited English proficiency.

Project Period: 09/30/2004 - 03/30/2006

FY Grant Amount

FY 2004 49,683

31 New Chardon St. 

Program: 

Jewish Family and Children's Service

Senior Services

Aging Services Network Integrated Care Management Grants Program 102

90AM2887

AOA Integrated Care Management Grant - High Risk Screening Tool

Uniontown, OH 44685

Contact: Phyllis M Yoders (330)896-9172

Area Agency on Aging 10B (AAA 10B) will develop a High-Risk Screening Tool, designed to identify PASSPORT (Ohio's 

Medicare waiver program) enrollees at "high risk" for permanent nursing home placement. This is an enhancement to 

AAA 10B's existing High Risk Case Management System and established partnership with SummaCare, a Medicare 

HMO, in providing services for shared, dual-eligible clients. Both organizations will then implement appropriate 

interventions using a web-based care planning system to integrate our previously separate care plans. The target 

population includes 2,600 PASSPORT enrollees in a four county region in NE Ohio, of which two are urban and two are 

rural. AAA 10B serves low-income (Medicaid eligible), frail (nursing home level of care - LOC), older adults 60 and older 

who need assistance with at least two activities of daily living (ADL's) and three instrumental activities of daily living 

(IADL's). Anticipated outcomes include: (1) identify risk factors through the analysis of the most recent 3-year statewide 

data for discharged PASSPORT enrollees; (2) develop and validate a Risk Factor Scale; and, (3) develop and validate a 

High Risk Screening Tool. The expected outcome of the identification of "high risk" enrollees will be a significantly 

reduced PASSPORT program discharge rate (LTC placement).

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

1550 Corporate Woods Parkway 

Program: 

Area Agency on Aging 10B, Inc.

Passport Division

Aging Services Network Integrated Care Management Grants Program 102

90AM2888
Page 18 of 223 

San Mateo County Integrated Information Project

San Mateo, CA 94403

Contact: Beccy M Ashton (650)573-3529

San Mateo County Aging & Adult Services will implement the Integrated Information Project, a critical component of the 

Long Term Supportive Services Project (LTSSP), San Mateo County's effort to achieve a fully capitated 

Medicaid/Medicare long-term care system. The goal of the Integrated Information Project is to implement a uniform 

assessment tool using a single automated case management system for all members of the target population entering 

home and community-based LTC services. The finished project will be utilized by all home and community-based service 

providers, which will include an ethnically & culturally diverse population. Anticipated outcomes include: (1) 

Implementation of a uniform assessment and automated case management system across Aging & Adult Services by 

12/05; (2) Implementation of the assessment tool within Senior Care Center and San Mateo Medical Center discharge 

planners by 12/05; (3) Implementation of the assessment tool with one Adult Day Care Center and eventually all OAA 

funded ADC providers; and (4) by 12/05, 80% of clients assessed by Aging and Adult Services will receive a single 

comprehensive assessment on entry into the system regardless of eligibility for categorical services.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

225 West 37TH Avenue 

Program: 

San Mateo County - Health Service Agency

Aging and Adult Services

Aging Services Network Integrated Care Management Grants Program 102

90AM2889

Access Care - Atlanta

Atlanta, GA 30303

Contact: 

The Atlanta Regional Commission (ARC) will partner with: (1) Evercare, a managed care organization implementing 

Evercare Assist, a new demonstration for end stage renal disease patients; (2) Visiting Nurse Health System (VNHS), a 

non-profit home health agency, to provide case management services; and (3) Project Open Hand/Atlanta, a non-profit, 

community provider of home-delivered meals. The partners propose to establish Access Care/Atlanta, a care 

management model integrating the medical care provided to persons with End-stage Renal Disease (ESRD) with 

services available through the aging network. The target population will include individuals with ESRD residing in two of 

the Atlanta region's two largest counties, Fulton and Dekalb, who are also enrolled in Evercare Assist and receiving 

dialysis. In Georgia, Fulton and DeKalb Counties house the highest concentration of older adults and low-income elderly, 

the highest minority populations age 60 and older, and the highest percentage of elders living alone. The proposed 

project will extend the monitoring of ESRD risk indicators into the home setting, improve nutrition for ESRD clients through 

a prescriptive meal program, and create an integrated system based on the strengths of partner agencies, maximizing the 

resources and involvement of the aging network.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

40 Courtland Street, NE 

Program: 

Atlanta Regional Commission

Community Services Department - Aging Services Division

Aging Services Network Integrated Care Management Grants Program 102

90AM2890
Page 19 of 223 

Partnership for Fall Prevention

Buffalo, NY 14202

Contact: 

This project represents a partnership between the Erie County AAA and the Independent Health Association (an Individual 

Practice Association-Health Maintenance Organization or "IPA/HMO") to reduce falls and fractures among the high risk 

elderly population. The goals of the project are: to demonstrate the effectiveness of combining health care and social 

model interventions, and to reduce the risk of falls and fractures among 200 older adults over a one-year period. 

Independent Health has identified 1,325 persons at high risk for incurring fractures. Senior Services will identify its current 

clients among that group and begin a falls prevention intervention. The primary outcome for this project is a reduction in 

the risk of falls. A secondary outcome is the potential cost savings to managed care organizations through reduction of 

high cost ER and inpatient hospital stays.

Project Period: 09/30/2004 - 12/31/2005

FY Grant Amount

FY 2004 33,165

95 Franklin Street 

Program: 

Eric County Department of Senior Services

Aging Services Network Integrated Care Management Grants Program 102

90AM2891

Pasco-Pinellas Long-term Care Partnership

Clearwater, FL 33760

Contact: Michael A Berstein (727)538-7460

The overall goal of this project is to help the aging network acquire the skills needed to assume or share risk in a 

managed care system and to partner with a for-profit managed care organization (MCO). Specifically, three state-funded 

local Lead Agencies, in partnership with the local AAA, propose to: (1) develop the framework for a legal partnership 

among the partners submitting this application; (2) use AoA funds to build the technical capacity of these agencies to 

assume risk; (3) develop a partnership strategy to negotiate with MCOs; and, (4) begin negotiations with one or more 

potential MCO partners. Planning activities also include developing a proposal to create an Aging and Disability Resource 

Center (ADRC) within the AAA. This project brings together an AAA and three community-based organizations that 

receive AoA funds in one of the regions with the highest concentration of elders in the nation. Ultimately, the intervention 

will benefit Medicaid-eligible low income and minority elders who are the target populations of the current agencies that 

currently serve 2,100 frail elders. Anticipated outcomes include: (1) a detailed plan and negotiating strategy for partnering 

with an MCO to provide case management services to Medicaid-eligible frail elders and other members of the MCOs LTC 

program; (2) a clearly delineated model contract that specifies the essential legal terms of the proposed partnership; (3) a 

business plan that identifies major costs and products associated with the operation of the partnership; and (4) a plan for 

the development of the ADRC that includes the partnership in the model.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

14041 Icot Blvd. 

Program: 

Gulf Coast Jewish Family Services, Inc.

Disabled and Elderly Services

Aging Services Network Integrated Care Management Grants Program 102

90AM2892
Page 20 of 223 

Integrated Care Management - Merging Aging Systems & Health Systems

Rochester, NY 14604

Contact: Mary Beer (585)244-8400 119

An ElderSource care manager will partner with the Lifetime Health geriatric-specialty team to provide in-home assessment 

and intensive, ongoing social care management for a maximum of 50 members of a Medicare Blue Choice MCO. At least 

50% of the patients will have a caregiver, and focus on outcomes for both the patient and caregiver will occur. Participants 

will have socially complex needs (defined as resistance, dementia, dysfunctional family dynamics, personal safety, mental 

health complications, need for substantial emotional support, etc). Anticipated outcomes include: (1) decreased ER 

and/or inpatient stays; (2) decreased caregiver stress (self report); (3) improved patient and/or caregiver functioning 

(based on OARS scores); and (4) improved patient and/or caregiver quality of life (self report).

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

87 N. Clinton Avenue 

Program: 

Catholic Charities of Diocese of Rochester

Eldersource

Aging Services Network Integrated Care Management Grants Program 102

90AM2893

Management Care Initative

Chicago, IL 60616

Contact: (312)791-0418

The Chinese American Service League (CASL) will enhance its current counseling efforts to increase the use of managed 

care within a community of low-income, monolingual ethnic Chinese elderly in the Chicago area by collaborating with 

Medicare and/or Medicaid managed care organizations (MCOs). Multicultural staff will be led by a CASL Managed Care 

Initiative worker, who will direct the project. The Managed Care Initiative (MCI) will try to reach two groups of people, 

those who have already joined an MCO and those who are ready to choose their plan. CASL estimates that more than 

500 seniors in the Chinatown, Armour Square, and Bridgeport areas of Chicago are already participating in a MCO, and 

approximately 100 more seniors are ready to join a program each year. The primary outcome for the MCI will be the 

increased knowledge of, accessibility to, and proper utilization of a Medicare MCO among Chinese residents in the 

Chicago area. Through this collaboration and assistance provided to MCOs, CASL believes that local MCOs will value 

CASL's important role and provide a portion of financial support for the continuity of the project.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

2141 S.Tan Court 

Program: 

Chinese American Service League

Elderly Services

Aging Services Network Integrated Care Management Grants Program 102

90AM2894
Page 21 of 223 

Health Enhancement Program

Seattle, WA 98121

Contact: (206)727-6297

Senior Services will streamline its evidence-based Health Enhancement Program (HEP) to reduce the program cost and 

make it more attractive to managed care organizations. The streamlined HEP will be piloted at the Burien Group Health 

Cooperative (GHC) primary care clinic and three senior centers in the clinic's service areas. The goal of the project is a 

streamlined HEP that maintains the fidelity to the theoretical model used in the efficacy trial and achieves the same or 

better participant outcomes. The selection of the GHC Burien Medical Center for this pilot ensures that lower-income 

older adults from ethnically diverse communities will be served. The Burien Medical Center serves 3,000 Medicare 

patients, many of whom have a significant chronic disease burden. The HEP nurses and social workers involved in this 

project are based at three locations in the community: West Seattle, Des Moines and Burien-Highline Senior Centers. 

Anticipated Outcomes: The outcome of the project will be a HEP model with a competitive capitation rate that manages 

twice the number of GHC referrals and has a graduation rate of 70%.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

2208 Second Ave, Suite 100 

Program: 

Senior Services of Seattle/King County

Senior Wellness Project

Aging Services Network Integrated Care Management Grants Program 102

90AM2895

Integrated Care Management

Cleveland, OH 44114

Contact: Sharen K Eckert (216)373-1608

The proposed project will test the feasibility and efficacy of a partnership among three service organizations in greater 

Cleveland . These are: Western Reserve AAA, MetroHealth Medical Center and its consumers who participate in the 

Anthem Senior Advantage Medicare managed care plan, and Benjamin Rose. Benjamin Rose will provide "care 

consultation," a telephone-based coordinating service that empowers seniors and their family members to find and use 

community services. The project will conduct a pilot study to test the efficacy of care consultation as an intervention to 

enhance the quality of lives for participants with chronic conditions. The desired study sample will include 70 Anthem 

patients and their primary family caregiver, if a caregiver exists. Patients will be generated from Anthem's managed care 

organization (MCO) patients who are frequent users of physician, hospital, and ER services. The 70 patients who agree 

to participate in the pilot study will be randomly assigned to either an intervention or control group. Some anticipated 

outcomes include a reduction in the likelihood of re-hospitalization and in the number of primary care visits, and an 

increase in the use of community services 

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

850 Euclid Avenue, Suite 1100 

Program: 

Benjamin Rose Institute

Advocacy and Public Policy Development

Aging Services Network Integrated Care Management Grants Program 102

90AM2896
Page 22 of 223 

Dementia Care Project Replication

Los Angeles, CA 90036

Contact: Debra Cherry (323)938-3379

The Alzheimer's Disease and Related Disorders Association (ADRDA) of Los Angeles will create a replication manual 

that will enable other Community Agency Service Providers (CASPs) and managed care organizations (MCOs) to put in 

place the Dementia Care Project, a replicable model that has proven effective in improving quality of care for older 

individuals with a chronic disease. The original Dementia Care Project served community dwelling people with a 

diagnosis of a dementing disease and an involved, non-paid caregiver. Participants were referred by their primary care 

physicians. Participants were ethnically diverse (55% African American, 21% Caucasian, 3% Latino, 1% Asian, and l9% 

non-specified). The model of collaboration has applicability to non-staff models of managed care and to other chronic 

diseases, as well. The Dementia Care Project demonstrated that it could improve quality of care in a managed care 

setting by providing physicians with innovative, evidence-based educational programs and materials and by putting in 

place care managers trained in dementia care. The lessons learned can be further replicated in other settings.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 27,335

5900 Wilshire Blvd, Suite 1100 

Program: 

Alzheimers Disease & Related Disorders

Association of Los Angeles

Aging Services Network Integrated Care Management Grants Program 102

90AM2897

Be Well

Inglewood, CA 90301

Contact: Skip W Halloran (310)412-4381

The City of Inglewood Senior Services Program will collaborate with the Food and Nutrition Management Services to 

expand the Be Well Program to seniors with high nutritional risk scores and/or chronic health conditions. Kaiser 

Permanente, a managed care organization (MCO), and the Los Angeles County Area Agency on Aging will participate 

with planning and evaluation. The target population will include senior citizens age 60 and older in the cities of Inglewood 

and Lennox in Los Angeles County. The targeted cities border South Los Angeles - the Watts community and the City of 

Compton. The population is 39% African American, 57% Latino, 1.5% Asian Pacific, and 4.3% Caucasian. Seniors that 

complete 4 months of the program will experience a 75% improvement in nutrition and physical health status and a 100% 

increase in their knowledge of health promoting behaviors. Seniors that complete 6 months will experience a 75% 

improvement in nutrition and physical status and 75% compliance with health promoting behaviors. A capitation rate and 

a written marketing plan for BE WELL will be developed.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 43,379

One Manchester Blvd. 

Program: 

City of Inglewood

Parks Recreation and Community Services

Aging Services Network Integrated Care Management Grants Program 102

90AM2898
Page 23 of 223 

National Alzheimer's Call Center

Chicago, IL 60601

Contact: Catherine Sewell (312)335-5191

The Alzheimer's Association will enter a cooperative agreement with the Administration on Aging to operate an 

Alzheimer's National Call Center to 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.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

993,500

1,001,177

979,104

225 N. Michigan Avenue, 17th Floor 

Program: 

ALZHEIMER'S DISEASE AND RELATED DISORDERS

ASSOCIATION, INC.

Alzheimer's National Call Center 103

90AZ2766

Alzheimer's Disease Social Research Project

New York, NY 10007

Contact: Ali Hodin Baier (212)442-1375

The Aging in New York Fund (ANYF), in collaboration with the New York City Department for the Aging (DFTA) and its 

partners at Zachary and Elizabeth M. Fisher Center for Alzheimer's Research Foundation (FCARF), New York University 

(NYU), and Rockefeller University (RU), will work to address the complex needs of New York City's diverse Alzheimer's 

community through education, technology, and research. These partnerships will address the needs of both patients and 

families via a variety of approaches, advancing research and service provision. The objectives and approach are: 1) to 

educate the multicultural community on Alzheimer's disease (AD), caregiving, and related long-term care issues 

(ANYF/DFTA); 2) to develop and strengthen AD knowledge in the aging workforce (ANYF/DFTA); 3) to measure the 

effectiveness of professional trainings through research and knowledge tests (ANYF/DFTA); 4) to conduct a national 

marketing and outreach campaign for the alzinfo.org website (FCARF); 5) to develop AD awareness programs for MDs 

and the general public (FCARF); 6) to explore the efficacy of individualized comprehensive, patient-centered care (NYU); 

and 7) to continue laboratory research to develop more effective treatment methods targeting agitation in AD (RU). 

Expected outcomes are: increased awareness in the multicultural community on AD, caregiving, and related long term 

care issues; growth in an AD educated aging workforce and community; increased access to information through 

technology and consumer and physician education; evidence of the efficacy of non-pharmacologic therapies to improve 

patient care; and advanced understanding of the brains' function and responses. Products from this project will include: 

reports; analyses of dementia workforce development and non-pharmacologic research; multilingual AD materials; articles 

for publication; and abstracts and presentations for conferences.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

2,943,530

2,937,312 2 Lafayette Street 15th Floor

Program: 

AGING IN NEW YORK FUND, INC.

Alzheimers Disease Social Research Project 104

90AZ2791
Page 24 of 223 

The Eldercare Locator Program & the National Aging Information & Referral Support 

Center

Washington, DC 20036

Contact: Share Mack (202)296-8130

The National Association of Area Agencies on Aging (N4A), in partnership with the National Association of State Units on 

Aging (NASUA), will execute a three-year program to provide older persons and their caregivers access to a premier 

national information and referral/assistance system capable of providing the information, assistance, decision-supports 

and advocacy needed to secure services. To achieve this goal, N4A will ensure the ongoing premier quality operation of 

the Eldercare Locator call center. In addition, N4A will increase public awareness of the service through strategic 

partnerships, and will implement a media/ marketing campaign emphasizing special target populations. NASUA will 

operate the National Aging Information & Referral Support Center to promote continued enhancement of aging I&R/A 

systems; facilitate ongoing quality improvements in I&R/A service delivery; and provide ongoing training and technical 

assistance. Products will include a call center procedures manual, new promotional material, marketing campaigns; I&R 

technical assistance products and website.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

1,174,979

1,374,937

1,174,937

1730 Rhode Island Avenue, NW, Suite 1200 

Program: 

NATIONAL ASSOCIATION OF AREA AGENCIES ON AGING

Eldercare Locator Program and the National Aging Information & Referral 105

90AM2746

Livable Communities for All Ages: Identifying Leading Models and Best Pratices

New York, NY 10021

Contact: Penny Feldman (212)609-1543 0

Building on five years of experience in developing measures of livable communities and working with diverse communities 

to plan and implement positive change, the Center for Home Care Policy and Research worked with AoA to identify 

leading models of livable communities for all ages and to disseminate information designed to help communities replicate 

promising models and practices. Specifically, the Center, along with two principal partners - the American Planning 

Association (APA) and the International City/County Management Association (ICMA), and others: (1) implemented a 

competitive process to identify the top eight models of livable communities for all ages; (2) developed a "case studies" 

document with descriptions of the winning model communities and related technical assistance materials, and (3) 

disseminated these materials to change agents in communities around the country. The purpose of this initiative was to 

raise awareness and motivate action among stakeholders to improve the livability of their communities for people of all 

ages and abilities. The long-term expected outcomes of this initiative are: (a) widespread awareness and acceptance of 

the livable communities concept; (b) large-scale replication of livable communities best practices, and as a result (c) 

improved communities where people of all ages and abilities have their needs and aspirations met equally well.

Project Period: 09/29/2004 - 12/31/2005

FY Grant Amount

FY 2004

FY 2006

124,770

15,000 107 East 70th Street 

Program: 

VISTING NURSE SERVICE OF NEW YORK

Center for Home Care Policy and Research

Livable Communities Initiative 106

90AM2903
Page 25 of 223 

Center to Educate Women About Retirement Security

Washington, DC 20006-1401

Contact: Cindy Hounsell (202)393-5452

WISER, with assistance from strategic public-private coalitions, is organizing a one stop gateway to information that can 

provide 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 ultimate goal of the 36 month project is to provide 

women with access to information that promotes their efforts to attain secure retirements. A state-of-the-art 

clearinghouse/lending library and satellite resource centers accessible to the Aging Network, FBOs, state and community 

agencies, financial institutions, 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 and 

other online resources. Major partnerships and coalitions have been formed with a range of private sector organizations to 

target low-income and minority women. Private sector organizations are as diverse as MANA, 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 FDIC, SSA, US DoL Women's Bureau, USDA Extension Service, and 

Comptroller General of the US. During year two, plans are to: continue strengthening public and private partnerships at the 

national and community levels; establish satellite resource centers accessible by CBOs, FBOs, non-profits, finance and 

business to encourage inclusion of women's financial security as an integral part of the agenda; initiate 2 new programs 

on a) financial planning for health care in retirement, and b) senior indebtedness; partner with insurance companies to 

develop materials about annuities for women; and continue outreach.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

248,376

248,376

248,376

1725 K Street, NW, Suite 201 

Program: 

WOMENS' INSTITUTE FOR A SECURE RETIREMENT

Retirement Planning and Assistance for Women 107

90AM2801

Bridging the Gap Developing a Seamless Entry into Community Based Nutrition Services

Alexandria, VA 22314

Contact: 

The importance of senior nutrition programs' integration into the long term continuum of care cannot be overstated. Delays 

in initiation of nutrition services following hospital discharge compromises the functional status of older adults. Meals On 

Wheels Association of America (MOWAA), a national organization representing both public and privately funded senior 

nutrition programs, is ideally positioned to facilitate such integration. By identifying best practices and barriers programs 

are facing, conducting a forum to identity solutions, and providing technical assistance and training, a prompt, seamless 

entry into community-based nutrition services can be achieved.

Project Period: 09/30/2003 - 12/31/2004

FY Grant Amount

FY 2003 145,000

1414 Prince Street, Suite 302 

Program: 

MEALS ON WHEELS ASSOCIATION OF AMERICA

Bridging the Gap Developing a Seamless Entry into Community Based Nutrition Services 199

90AM2808
Page 26 of 223 

Chronic Disease Self-Management with African-American Urban Elders

Philadelphia, PA 19130-3409

Contact: Bethea Eichwald (215)765-9000

Philadelphia Corporation for Aging, Center in the Park, Albert Einstein Healthcare Network, and the Community and 

Homecare Research Division, Jefferson College of Health Professions, will demonstrate an evidence-based disease 

prevention program (the Chronic Disease Self-Management Program, developed by Stanford Patient Education Research 

Center), with a target population of African American urban elders. Five hundred elders will participate over three years. 

The goal is to enable participants to assume a major role in managing their chronic health conditions. The objectives are: 

to increase lifestyle skills that assist in managing chronic conditions; to increase knowledge of personal risk factors 

associated with chronic disease; and to increase personal responsibility in the management of chronic disease. Expected 

outcomes are: improved health status, behavioral change, improved self-efficacy, and reduced health care utilization. A 

team approach to chronic disease self management, that can be replicated within the aging network, will be demonstrated. 

Results will be disseminated.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

180,000

180,000

180,000

642 North Broad Street 

Program: 

PHILADELPHIA CORPORATION FOR AGING

Evidence Based Prevention Program 201

90AM2773

Preventive Nutrition Education Cardiovascular Disease Program

Miami, FL 33130

Contact: Ramon Perez-Dorrbecker (305)858-0887

Little Havana Activities and Nutrition Centers of Dade County, Inc. (LHANC) is conducting an evidence-based nutrition 

and cardiovascular health program targeting Hispanic elders, a group at high risk for cardiovascular disease and obesity. 

Specifically, this program will target the 1,800+ Hispanic elderly participants of the 14 LHANC senior centers throughout 

Miami-Dade County, Florida. The goals of this project are: to increase knowledge of nutrition among Hispanic elders who 

are at risk for cardiovascular disease and obesity; to foster behavior change through group sessions and interactive 

activities; and to test whether the American Heart Association guidelines and materials can be utilized in a dietitian led 

model targeted to Hispanic elders. Participants will be screened for cholesterol and weight, and 100 to 125 seniors at risk 

for cardiovascular disease will be included in an intensive nutrition education and counseling program. Anticipated 

outcomes include: 1) a reduction in participants' dietary fat consumption, saturated fat and cholesterol, using the 

American Heart Association Eating Plan for Healthy Americans; 2) a reduction in participants' body weight by 5% and/or 

BMI to 27 or less; and 3) lowered participants' total cholesterol by 6%.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

200,000

200,000

200,000

700 SW 8th Street 

Program: 

LITTLE HAVANA ACTIVITIES & NUTRITION CENTERS OF DADE CO

Evidence Based Prevention Program 201

90AM2774
Page 27 of 223 

Activity Centers for Seniors - Evidence Based Prevention

Bellaire, TX 77401-1389

Contact: Chris Pollet (713)669-5260

Neighborhood Centers Inc. (NCI) will demonstrate the efficacy of evidenced-based preventive physical activity 

interventions within Senior Centers among elderly residents of low-income neighborhoods in Houston, Texas. The 

intervention selected for replication in Houston represents an integration of individual, group and community-wide 

participation. NCI's goal is to demonstrate, within impoverished, urban settings, that the Aging Services Network can 

efficiently improve the quality, effectiveness, availability, and convenience of evidence-based disability and disease 

prevention programs for the elderly.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

200,000

200,000

200,000

4500 Bissonnet, Suite 200 

Program: 

NEIGHBORHOOD CENTERS INC.

Evidence Based Prevention Program 201

90AM2776

 Evidence-Based Prevention Program: Nutrition

San Antonio, TX 78217

Contact: Al Notzon (210)362-5201

The Bexar Area Agency on Aging, in partnership with the City of San Antonio Department of Community Initiatives, the 

Texas Diabetes Institute, Our Lady of the Lake University, and OASIS proposes to provide culturally sensitive low 

glycemic meals and nutrition education, diabetes health screening and education, and physical activity education to 500 

low-income, poorly educated Hispanic seniors in the Title IIIC1 congregate meals program in churches and senior centers 

in San Antonio. The goal of this program is to prevent or delay the onset of type 2 diabetes among Hispanic elders. 

Participants will attempt to achieve a 7 percent weight loss and at least 150 minutes of physical activity per week during 

the first year and maintain these changes for 2 additional years. Outcomes will include an increase in participant 

knowledge of the relationship between nutrition, exercise and diabetes management, and increased adherence to lifestyle 

modifications that reduce risk factors for diabetes. Products will include a Spanish television documentary and a 

"Tex-mex" cookbook of taste-test approved, low-glycemic recipes and menus.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

200,000

200,000

200,000

8700 Tesoro Drive - Suite 700 

Program: 

ALAMO AREA COUNCIL OF GOVERNMENTS

Evidence Based Prevention Program 201

90AM2777
Page 28 of 223 

A Community-Based Medication Management Intervention

San Fernando, CA 91340

Contact: W. June Simmons (818)837-3775

Partners In Care Foundation will conduct a 3-year medication management project for seniors receiving a continuum of 

community-based social service programs in Los Angeles. The goal of the evidence-based Medication Management 

Intervention is to identify, prevent, and resolve medication errors among seniors identified at high-risk. The objectives are: 

to implement the intervention in at least 3 Senior Centers and at least 2 Medicaid-waiver programs; to evaluate the 

outcomes of the intervention that include assessment and recommendations and follow-up by a pharmacist; and to 

disseminate findings and lessons learned through a medication management website and other strategies. Products 

include a software screening tool, a comprehensive web-based Toolkit, evaluation tools, a final report, and manuscripts 

for publication. These products will be disseminated to direct service organizations and Area Agencies on Aging.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

200,000

200,000

200,000

732 Mott Street, Suite 150 

Program: 

PARTNERS IN CARE FOUNDATION, INC

Evidence Based Prevention Program 201

90AM2778

Active Start! Increasing Physical Activity Among Sedentary Older Adults in Los Angeles

Los Angeles, CA 90010

Contact: Laura Trejo (213)252-4023

The City of Los Angeles Department of Aging will implement a project to increase physical activity among sedentary older 

adults over three years. The project will recruit older adults in the West Adams/West Wilshire area of Los Angeles through 

OASIS centers, Jewish Family Services and Delta Sigma Theta Center for Life Development nutrition centers, and Tenet 

California's Brotman and Centinela Medical Centers. Health classes and activities will encourage them to incorporate 

physical activity into their lives. Expected outcomes include: an increased number of older adults indicating an intention to 

increase physical activity in order to help control and/or manage existing chronic health conditions; increased fitness levels 

in older adults participating in exercise classes; improved attitudes toward physical activity; and increased time (minutes) 

engaged in weekly physical activity. Products will include recruitment materials through a community-wide public 

awareness campaign, a refined project curriculum, evaluation tools and methodologies for practical application, web page 

information, and manuscripts for publication and professional conference presentations. These products will be made 

available throughout the aging services network.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

125,000

125,000

125,000

3580 Wilshire Boulevard, Suite 300 

Program: 

CITY OF LOS ANGELES DEPARTMENT OF AGING

Evidence Based Prevention Program 201

90AM2779
Page 29 of 223 

A Matter of Balance: A Volunteer Lay Leader Model

Scarborough, ME 04074

Contact: Laurence Gross (207)396-6501

Southern Maine Agency on Aging (SMAA) and its partners propose to address the issue of fall prevention using "A Matter 

of Balance" (MOB), the evidence-based intervention for fear of falling. SMAA and its collaborators propose translating the 

intervention, which currently uses health care professionals as facilitators, into a lay leader model facilitated by community 

based volunteers (MOBVLL). This will reduce the cost of the intervention, allowing MOBVLL to be offered more frequently, 

in a variety of settings, reaching a significantly higher number of older adults than would otherwise be possible. This 

proposal will: develop quality control mechanisms for the translation, monitor the consistency of this adaptation; measure 

the outcomes among participants; standardize the cost of establishing and offering the MOBVLL intervention; and detail 

the challenges and successes of disseminating this model to diverse socio-economic populations, diverse geographic 

areas, and in a variety of community settings. The outcomes of the MOBVLL intervention will be: reduced fear of falling; 

increased falls self-efficacy; and increased activity in community dwelling older adults. The MOBVLL will be disseminated 

throughout the aging network.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

125,000

125,000

125,000

136 U.S. Route 1 

Program: 

SOUTHERN MAINE AGENCY ON AGING

Evidence Based Prevention Program 201

90AM2780

"Women Take PRIDE in Managing Heart Diease"

Albany, NY 12210

Contact: Daniel Hogan (518)465-3322

Senior Services of the Albany Area, Inc., (dba Senior Services of Albany) will implement a research-based, 

self-management heart disease education program with four collaborating organizations. The "Women Take PRIDE" 

(WTP) intervention was developed and tested by researchers at the University of Michigan School of Public Health. The 

WTP targets women 60 years of age or older who have been diagnosed with heart disease. The project seeks to 

demonstrate the effectiveness of providing the intervention, and recruiting participants from a community setting, as well 

as from health care providers. WTP is a four-week education program focused on: (1) improving functional status, both 

physical and social; (2) improving the symptom experience and general health outcomes; and (3) improving the 

knowledge of and access to community resources. An extensive process evaluation will be conducted throughout the 

implementation period in order to evaluate the outcome measures and document lessons learned in the program 

implementation.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

192,000

125,000

125,000

25 Delaware Avenue 

Program: 

SENIOR SERVICE CENTERS OF THE ALBANY AREA, INC.

Evidence Based Prevention Program 201

90AM2781
Page 30 of 223 

Evidence-Based Fall Prevention Services in Senior Centers

Hartford, CT 06106-5129

Contact: Robin Harper-Gulley (860)724-6443

The goal of this 3-year project is to embed a sustainable evidence-based fall prevention strategy within greater Hartford 

senior centers by enhancing fall prevention-related knowledge and behavior and building or enhancing relationships 

between senior centers and relevant community and health care organizations. Project objectives are to develop, 

implement, evaluate, and disseminate a fall prevention program, based on Yale FICSIT ( Frailty and Injuries: Cooperative 

Studies of Intervention Techniques ) and other randomized controlled trials (RCTs). The fall prevention program will target 

balance, gait and vision impairments, postural hypotension, multiple medication use, and home hazards. The partners 

include North Central Area Agency on Aging (NCAAA), Connecticut Hospital Association/Connecticut Association for 

Home Care (CHA/CAHC), Hartford area senior centers, and the Center on Aging, University of Connecticut Health Center. 

Primary outcomes include reduced falls in senior center clients and increased fall prevention knowledge and behaviors in 

center staff and clients. Products include a replicable model of community-based fall prevention, print and web-based 

procedure manuals, peer-reviewed publications, and multidisciplinary expertise available to other community-based 

providers.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

220,000

220,000

220,000

2 Hartford Square West, Suite 101 

Program: 

NORTH CENTRAL AREA AGENCY ON AGING, INC

Evidence Based Prevention Program 201

90AM2782

Evidence-Based Prevention Programs for the Elderly-National Resource Center

Washington, DC 20024

Contact: Nancy Whitelaw (202)479-6625

The National Council on the Aging 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 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 CDC's Prevention Research Centers, UCLA's Geriatric Medicine and Gerontology Program, a leading 

communications and dissemination firm, and leading national aging organizations.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

600,000

600,000

685,000

300 D Street, SW, Suite 801 

Program: 

NATIONAL COUNCIL ON THE AGING

Evidence Based Prevention Program 201

90AM2793
Page 31 of 223 

Increasing Seniors' Access to Disease Self-management and Disability Prevention 

Services

Seattle, WA 98121

Contact: Susan Synder (206)727-6297

Senior Services of Seattle/King County proposes to offer a disease self-management and disability prevention program, 

the Health Enhancement Program, for a three-year period, to 2,037 older adults with chronic health conditions. The 

primary project objective is to increase participation at existing and new sites by seniors in King County, Washington. This 

will be done by working closely with a health care system to generate referrals and by increasing the number and type of 

program sites, especially those that have a track record of serving seniors of color or those who are limited English 

speaking. Project partners include a university, an Area Agency on Aging, a staff model health maintenance organization, 

a public hospital, and a county health department. New partnerships with revenue generating potential will also be 

established in order to increase the likelihood that this model program will be adopted on a national basis in the future. 

The participant outcome is that 80% of those enrolled for at least six months will improve or maintain at least one of the 

following: physical activity, depression, falls, and hospitalizations.

Project Period: 09/30/2003 - 03/31/2005

FY Grant Amount

FY 2003 100,000

2208 First Avenue, Suite 100 

Program: 

Senior Services of Seattle/King County

Evidence Based Prevention Program 201

90AM2809

Improving Self Management of Chronic Disease in the Elderly

Grand Rapids, MI 49503-9503

Contact: Nora Barkey (616)222-7012

The Area Agency on Aging of Western Michigan, partnering with a managed care plan, four community aging services 

providers, and a university evaluator will conduct a 3-year program using the Chronic Disease Self-Management Program 

(CDSMP) and enhanced outreach. The project seeks to show how the aging network, in partnership with a health care 

plan, can improve the health outcomes for older adults. Six hundred adults 60 and older with one of four common chronic 

conditions will be randomly assigned to receive standard care from managed care or aging services providers or to 

receive the CDSMP and enhanced outreach intervention, 200 per group. Measures of health outcomes will be taken at 3 

time intervals. Expected outcomes are: positive inter-system collaboration; increased chronic disease self management 

knowledge and skills for the community aging service provider (CASP) workers; positive health behaviors, self-efficacy, 

and health outcomes for participants compared to non-participants; and demonstrated cost and service benefits for older 

adults. Products will include the final report, manuscripts for publication, and presentations to both aging and health care 

audiences.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

150,000

125,000

125,000

1279 Cedar NE 

Program: 

AREA AGENCY ON AGING OF WESTERN MICHIGAN

Evidence Based Prevention Program 201

90AM2810
Page 32 of 223 

Healthy Changes: A Community-Based Diabetes Education and Support Program

Portland, OR 97204

Contact: Vicki Hersen (503)823-5269

Elders in Action, a community-based non-profit, and Providence Health System's Center on Aging will conduct a 3-year 

education and support program for older adults with diabetes. The goal is to increase the ability of program participants to 

self-manage, on a day-to-day basis, diet and physical activity aspects of their diabetes. Program elements include: weekly 

classes and support meetings held in a total of 16 community sites; community outreach and presentations provided by 

trained volunteer community educators; and one-to-one advocacy and problem solving assistance provided by trained 

volunteer Ombudsmen. Seniors age 55+ with diabetes will be served with services specially targeted to ethnically and 

geographically diverse, and low income seniors. Multnomah County Aging and Disability Services (AAA) will facilitate 

linkage of program elements with the greater senior network, and Oregon Research Institute will conduct the project 

evaluation. Products will include a curriculum manual, project publications and reports, evaluation tools and report, a final 

report, and web page information. These products will be disseminated to senior organizations, nationwide.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

150,000

125,000

125,000

501 SW Washington Street 

Program: 

ELDERS IN ACTION

Evidence Based Prevention Program 201

90AM2811

Healthy Ideas: Evidenced-based Disease Self-management for Depression

Houston, TX 77025

Contact: Jane Bavineau (713)685-6506

The overall goal of this 3 year initiative is to build on the Healthy IDEAS (Identifying Depression, Empowering Activities for 

Seniors) program developed by a regional team of professionals in aging services, geriatric care, mental health and health 

services research and introduced into the Houston community in 2002. This project targets community dwelling elders, 

with a special focus on underserved and minority subgroups. The specific goals of this proposal are: to prevent or detect 

depression through effective, evidence-based screening and health promotion education; to promote more effective 

treatment through appropriate mental health referrals; to decrease symptomatology and improve functioning in depressed 

elders who participate in the depression self-management program; to improve linkages between community aging 

service providers (CASPs) and community-based healthcare practitioners; and to prevent recurrence of the disease 

through regular depression screening. Expected outcomes include: more effective partnerships among community aging 

service providers, healthcare organizations, academic researchers and consumers; and refinement of the evidence-based 

depression self-management intervention to increase recognition, promote effective treatment, and prevent excessive 

functional disability due to depression. Evaluation outcomes, intervention materials and educational products will be 

disseminated among CASPs, community health providers, consumer advocacy/support groups.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

150,000

125,000

125,000

3838 Aberdeen Way 

Program: 

SHELTERING ARMS SENIOR SERVICES

Evidence Based Prevention Program 201

90AM2812
Page 33 of 223 

Preventing Diabetes: Healthy Living for American Indian Elders

Albuquerque, NM 87111-3851

Contact: Traci McClellan (505)292-2001

Under AoA's priority of eliminating health disparities among elderly individuals, the National Indian Council on Aging was 

funded to address preventing diabetes in American Indian elders. In partnership with American Indian Tribes and elder 

organizations throughout the country, this project will identify best practices and effective interventions for healthy living. 

New tools to prevent diabetes in American Indian/Alaska Native elders will be developed and disseminated based on the 

best practices identified.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

129,155

159,155

129,155

10501 Montgomery Blvd, NE, STE 210 

Program: 

NATIONAL INDIAN COUNCIL ON AGING, INC

Health Disparities among Minority Elders-Tech. Assistance Ctr. 202

90AM2772

The Healing Zone: Community Health Action & Advocacy Training Project

Washington, DC 20005

Contact: Linda Jackson (202)624-1137

The NCBA is conducting a 3-year faith-based community health leadership program to reduce obesity as a leading risk 

factor for chronic disease among African American seniors. Activities are being designed to increase knowledge about 

self-care strategies related to overweight and obesity, and include foci on cardiovascular disease, hypertension, kidney 

failure, and diabetes. Church-based aging and health advocacy committees are being established to disseminate health 

promotion information on weight reduction, and improved nutrition and increase physical activity. NCBA is collaborating 

with its network of chapters and field offices and with the National Aging Network. It is establishing linkages with 

community-based organizations, including Group Ministries of Baltimore and Group Ministries of Buffalo, NY, the Maryland 

Center of Bowie State University (an HBCU), the Area Agencies on Aging in Richmond, VA., Detroit, MI. and Jackson, MS, 

a rural site, as well as the American Kidney Fund. The project expects to reach 300 + seniors through 30 churches with six 

coalitions each. To date, community coalitions have developed and implemented action plans; four sites are established, 

each with 3 to 5 churches enlisted as participants; and 2 issues of the quarterly newsletter have been published. During 

year 2, links will be strengthened or established with evidence based projects, e.g. AARP and RWJ, et al and a Web site 

will be launched. Products include an Implementation Tool Kit, an Outcome Study, and established church-based aging 

and health advocacy committees at each project site. These committees will engage in grassroots health initiatives, public 

discourse, and policy-level discussions. The tool kit will include a participant work book, facilitator's guide, personal health 

journal, and fact sheets and will be available to participating churches, grassroots organizations, the aging network and 

members of local health coalitions.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

298,050

368,050

298,050

1220 L Street, N.W., Suite 800 

Program: 

NATIONAL CAUCUS & CENTER ON BLACK AGED, INC.

Health Disparities among Minority Elders-Tech. Assistance Ctr. 202

90AM2802
Page 34 of 223 

Addressing Health Disparities Among Asian and Pacific Islander Elders

Seattle, WA 98101

Contact: Ken Bostock (206)624-1221

The National Asian Pacific Center on Aging (NAPCA) is conducting a 3 year demonstration that targets health disparities 

among Asian American and Pacific Islander (AAPI) elders. NAPCA is identifying health promotion materials on Cancer, 

Diabetes and Cardiovascular disease, analyzing their cultural relevance and translating materials to appropriate 

languages for dissemination to 13 major urban communities with concentrations of AAPI elders. Using its network of 1000 

community-based organizations (CBOs) and Senior Community Service Employment Programs, NAPCA expects to reach 

target communities in CA, IL, MA, NY, PA, TX, Washington, DC and WA. A series of interventions, focused on health 

disparities experienced by AAPI elders, will be conducted. They will range from distribution of linguistically and culturally 

appropriate educational materials, to a healthy lifestyle program that incorporates disease specific seminars, lifestyle 

programs, screening for early detection and case referrals. Enactment of the Medicare Modernization Act significantly 

impacts low-income AAPI elders. Accordingly, the project is addressing the critical lack of useful, understandable and 

timely information on health promotion/disease prevention and affordable health care programs for vulnerable, 

underserved, multicultural AAPI elders with limited English proficiency. Ethnic-specific interventions include assessment 

and dissemination of linguistic and culturally appropriate materials for elders and their caregivers; strengthening effective 

health care advocacy efforts in AAPI communities; establishing collaborative partnerships among AAPI community-based 

organizations, community health centers and mainstream health information and assistance resources to assure access to 

accurate and reliable information; and enhanced AAPI involvement in, and sustained linkages among, AAPI CBOs, CHCs 

and HICAPs for ongoing access to health information, assistance and advocacy resources.

Project Period: 09/30/2003 - 09/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

356,365

436,365

356,365

1511 Third Avenue, Suite 914 

Program: 

NATIONAL ASIAN PACIFIC CENTER ON AGING

Melbourne Tower

Health Disparities among Minority Elders-Tech. Assistance Ctr. 202

90AM2803

Project Salud A La Vida

Pasadena, CA 91101

Contact: Carmela Lacayo (626)564-1988

ANPPM is designing health interventions for older Hispanic men and women that promote understanding and awareness 

of nutrition as it relates to the prevention of diabetes, cardiovascular disease, cancer and prostate cancer in older Hispanic 

men. ANPPM's public education campaign will educate older individuals on the importance of immunizations, and assist 

existing Medicare- Approved Drug Discount Card (MADDC) outreach programs to educate older Hispanic beneficiaries on 

obtaining Medicare Drug Discount Cards or accessing the transitional assistance program. Model health interventions that 

demonstrate multi-language, culturally- based approaches to health education and disease prevention are being designed 

in the Fotonovela format. Community health providers in Tucson, Kansas City, Philadelphia, and New Orleans are 

collaborating on package development to ensure information critical for promoting positive health practices & wellness 

among older Hispanic individuals. Health education modules are being designed specifically to assist older Hispanic 

adults make better decisions about personal health. Modules include written materials & audio cassettes on 

cardiovascular disease and prostate cancer, targeted to older persons with literacy problems. A community health 

education flip chart and manual for each health topic is being developed for community health clinics, migrant worker 

health centers and other CBO's. The immunization campaign directed at Hispanic elders includes Spanish/English 

30-second radio spots and plans for establishing community-based health alliances. Local Hispanic media and traditional 

Hispanic business, e.g. panaderias (Latino bakeries), tortilla factories, etc. are being enlisted to promote the immunization 

campaign. Target populations include monolingual older Hispanic immigrants who have recently arrived in the U.S., and 

migrated to areas of the country that are now seeing the arrival of large numbers of Hispanic immigrants.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

298,050

368,050

298,050

234 E. Colorado BIvd., Suite 300 

Program: 

Asociacion Nacional Pro Personas Mayores

Health Disparities among Minority Elders-Tech. Assistance Ctr. 202

90AM2804
Page 35 of 223 

Nutrition, Physical Activity and Aging-National Resource Center

Miami, FL 33199

Contact: Nancy Wellman (305)348-1517

The goal of the National Resource Center on Nutrition, Physical Activity and Aging (Center) is to expand and strengthen 

the knowledge and service delivery capability of Older Americans Act (OAA) Nutrition Programs and the Aging Network in 

nutrition and physical activity programs for older adults. The objectives are to provide training and technical assistance to 

enable mini-grant awardees to implement programs and document outcomes from nutrition and physical activity 

programs; disseminate information through the Center's website and build knowledge through publications and 

presentations; and provide training and technical assistance to the Aging Network on nutrition issues. Year 1 products 

include: (1) ten $10000 mini-grant projects with measurable outcomes; (2) annual report of Nutrition and Physical Activity 

Mini-Grant Projects; (3) National Mini-Grantee Workshop, Town Hall meetings at National Association of Nutrition and 

Aging Services Programs, Meals on Wheels Association of America, National Association of Area Agencies on Aging; (4) 

website that comprehensively covers nutrition, physical activity, aging; posting biweekly highlights to 3 Center-managed 

Listservs; 5) regularly updated Older Americans Nutrition ProgramToolkit, and (6) at least 2 journal, 4 newsletter, 2 Ask 

the Experts articles; 1 set of meeting backgrounders, proceedings; & 4 Aging Network presentations. In addition, the 

Center will provide technical assistance to the Aging Services Network through telephone calls, e-mails, as well as 

meeting consultations.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

460,369

460,369

460,369

11200 SW 8th Street, OE 200 

Program: 

THE FLORIDA INTERNATIONAL UNIVERSITY BOARD OF TRUSTEES

Nutrition, Physical Activity and Aging-Nat'l Resource Center 203

90AM2768

National Resource Center on Native American Aging - University of North Dakota

Grand Forks, ND 58201-9037

Contact: Alan Allery (701)777-3859

The goal of the National Resource Center on Native American Aging (NRCNAA), funded by AoA since 1994, is to raise 

American Indian elder life quality to the highest level thru research, technical assistance & training. Objectives: 1) 

monitoring native elder needs thru tribal and national assessments; 2) translating research into practice, promoting vitality 

for native elders thru health promotion training and technical assistance; 3) communication thru newsletters, fact sheets, 

and electronic media; 4) a health literacy project with published results. NRCNAA has been a leader in research & needs 

assessments with American Indians, Tribes, and older Americans for almost 10 years, & will continue the next 3 years of 

the proposed cooperative agreement. NRCNAA provides an array of training & technical assistance to various groups 

regionally and nationally. They collaborate with Title III & Title VI providers and will continue by connecting with AoA 

Regional Offices. to assist with regional and national training and technical assistance. NRCNAA will continue 

collaborating with federal & state recognized tribes; Alaskan Native corporations and villages; Native Hawaiians; urban 

Indian organizations; the National Indian Council on Aging, & other prominent aging groups. NRCNAA has the only 

national data base on American Indian elder needs & may be the only source for trend data on functional limitations, 

chronic disease, and health risks data for Native elders. 9,296 + elders at 88 sites represent 132 tribes in 22 states, & 11 

Indian Health Service areas. NRCNAA will help: 1) seniors access integrated array of health and long term care services; 

2) elders stay active and healthy; 3) support families caring for loved ones in their home and community; and 4) promote 

effective, responsive management/best practices, which will be disseminated to Native elders and Councils, & providers 

via e-mail, fact sheets, web, newsletter, articles, an 800 # and direct inquiry.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

345,000

345,000

345,000

501 N. Columbia Road, P.O. Box 9037 

Program: 

UNIVERSITY OF NORTH DAKOTA

National Resource Center on Native American Aging

Older Indians National Resource Centers 204

90AM2751
Page 36 of 223 

National Resource Center for American Indians, Alaska Natives and Native Hawaiians

Anchorage, AK 99508-4614

Contact: Cheryl Easley (907)486-6597

The National Resource Center for American Indian, Alaska Native and Native Hawaiian Elders at the University of Alaska 

Anchorage will report to an advisory board of native leaders on three goals: 1) empowering native communities to 

incorporate traditional ways of treating elders within community care systems, in keeping with community heritages; 2) 

providing technical information to promote culturally sensitive and appropriate services to maintain social well being within 

a spiritual elder-focused environment; and 3) increasing national visibility of native eldercare issues. Outcomes will 

include: 1) defined native elder values to better understand appropriate native eldercare standards; 2) defined clinical and 

behavioral needs; 3) assistance to native communities in conducting assessments of elder desires for their own care; and 

4) identification and research of "best or promising practices" of the current incorporation of culture-based native eldercare 

services.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

344,155

344,155

344,155

3211 Providence Drive 

Program: 

UNIVERSITY OF ALASKA ANCHORAGE

Older Indians National Resource Centers 204

90AM2752

Development of a Strategy and Action Plan to Raise Awareness about Osteoporosis in 

Post-Menopausal Women

Washington, DC 20037-0037

Contact: Judith A. A Cranford (202)223-2226

The goal of the National Osteoporosis Foundation project was to raise awareness about osteoporosis in post-menopausal 

women. The objectives of the project were: 1) to review relevant literature and existing awareness programs and 

materials; and 2) to sponsor a national survey that over sampled for minority women and stratified by older age groups, to 

determine current level of awareness about osteoporosis and to identify the most effective messaging strategies. 

Products produced included a comprehensive literature review, a national survey report, and a final report with 

recommendations on conducting osteoporosis education.

Project Period: 09/30/2002 - 03/31/2004

FY Grant Amount

FY 2002 99,955

1322 22nd Street, NW 

Program: 

National Osteoporosis Foundation

Osteoporosis in Post-Menopausal Women 205

90AM2684
Page 37 of 223 

A Whole Woman Strategy and Action Plan to Raise National Awareness About 

Osteoporosis

Orono, ME 04469-5717

Contact: Lenard Kaye (207)581-1446

The University of Maine Center on Aging was funded to develop a national osteoporosis awareness and action plan 

targeting postmenopausal women. The project: 1) conducted an extensive analysis of the experiences and lessons 

learned by osteoporosis prevention programs delivered by governmental and non-governmental agencies; 2) conducted a 

series of focus groups with ethnically and racially diverse older women around the country to determine where older 

women obtain their health information; and 3) tested mock brochures, graphics, and messages for an osteoporosis 

campaign as well as ideas about spokespeople and promotional items. Throughout the research project, the University of 

Maine Center on Aging received feedback and recommendations from two national expert blue ribbon panels in the areas 

of osteoporosis, aging, women, and minority populations. A final report with recommendations on implementing an 

osteoporosis awareness plan was produced.

Project Period: 09/30/2002 - 09/30/2004

FY Grant Amount

FY 2002 100,000

5717 Corbett Hall 

Program: 

University of Maine

Osteoporosis in Post-Menopausal Women 205

90AM2685

National Osteoporosis Awareness Project

Oakland, CA 94612-4612

Contact: 

The grantee, Foundation for Osteoporosis Research and Education (FORE), proposes convening a consensus 

development summit of experts, called the National Osteoporosis Council (NOC). The FORE's goal is to develop a 

strategy and action plan to implement a successful national osteoporosis awareness campaign. The objectives of this 

FORE project are: 1) to develop the NOC with representatives from statewide osteoporosis coalitions from around the 

country, such as the Arizona Osteoporosis Coalition, the Elder Floridian's Foundation, Michigan Osteoporosis Project, and 

the State of Texas; 2) to bring together groups that have already established relationships on the local level with 

community-based organizations; 3) to add representatives from government-based agencies, healthcare professionals, 

national consumer associations, and managed care organizations; 4) to form working groups at the summit around target 

audiences to discuss existing messages on diagnostics, prevention, and treatment; 5) to identify gaps; 6) to determine a 

strategy for developing a consensus on a message; 7) to develop a draft action plan; and 8) to convene a second summit 

to get consensus on the plan prior to submitting it. The expected outcomes are: a consensus of experts for strategy and 

action plan; an awareness campaign; a diverse coalition; a second summit. The product is a final report.

Project Period: 09/30/2002 - 03/31/2004

FY Grant Amount

FY 2002 100,000

300 27th Street 

Program: 

Foundation for Osteoporosis Research & Education

Osteoporosis in Post-Menopausal Women 205

90AM2686
Page 38 of 223 

The Potential of Senior Centers to Improve Health & Independence of Older Adults: A 

National Blueprint for the Future

Washington, DC 20024

Contact: Barbara Rayner 

The National Council on the Aging (NCOA) and the National Institute of Senior Centers (NISC) propose to develop a 

national blue print for maximizing the use of the country's senior centers to deliver proven and promising innovations that 

increase the health, independence and continuing contributions of older adults. We plan to identify 6-8 of the most 

promising innovations, assess the capacity of senior centers in 10 key states to implement these innovations, and develop 

national, state and local strategies for achieving widespread diffusion of these innovations through local and regional 

networks of senior centers. This 15 month-project will leverage NCOA's experience, current work and large network of 

national, state and local leaders and organizations to strengthen the capacity of senior centers to offer evidence-based 

and other promising programming in health promotion, disease and disability prevention, civic engagement, consumer 

direction and other community-based long-term care services. NCOA is engaging Barbara Rayner to direct this project. 

Barbara brings extensive experience successfully heading the Rhode Island State Unit on Aging and earlier experience 

directing senior centers and collaborating with NCOA in establishing and developing the National Institute of Senior 

Centers.

Project Period: 09/30/2003 - 05/31/2005

FY Grant Amount

FY 2003 125,000

300 D Street, SW, Suite 801 

Program: 

NATIONAL COUNCIL ON THE AGING

The Potential of Senior Centers to Improve Health & Independence of Older Adults: A National Blueprint for the Future 299

90AM2813

MICHIGAN MOVES FORWARD IN DEMENTIA CARE : TOWARDS STATEWIDE 

CAPACITY, QUALITY SVC PROGRAMS & IMPROVED DELIVERY OF PRIMA

Lansing, MI 48913-8913

Contact: (517)335-0252

This project is designed to integrate various systems to improve care for persons with dementia. Project goals are: to test 

models of support services; focus on care coordination between physicians, families, and voluntary health organizations; 

improve education, training and access to resources and information; and enhance the efficiency of statewide voluntary 

health organizations for Alzheimer's, Huntington's, and Parkinson's diseases.

Project Period: 07/01/1999 - 09/30/2004

FY Grant Amount

FY 1999

FY 2001

428,776

44,007 320 South Walnut Street 

Program: 

Michigan Department of Community Health

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2244
Page 39 of 223 

NEW MEXICO ALZHEIMER'S PROGRAM

Santa Fe, NM 87501-7501

Contact: Barbara Price 

This Alzheimer's Disease (AD) demonstration project goal is to expand personal care, adult day care, and in-home respite 

services in a culturally appropriate way, addressing the needs of Hispanic and Native American populations. It will also 

develop a culturally competent telemedicine approach for use in rural areas of the state. The targeted populations are 

Hispanic and Native American. The objectives of this AD project are: 1) to provide services to Native Americans and 

Hispanics, such as respite care, education, medical outreach; 2) to develop a caregiver education program; 3) to produce 

and test a respite music video for Hispanic and Native American; 4) to establish telemedicine sites; 5) to produce 

instructions in Spanish; 6) to produce an Adult Day Care Conference; 7) to launch a web site with county resources on 

web page; and 8) to expand physician outreach. The anticipated outcomes are: an evaluation of this AD project; two 

telemedicine sites; expanded (three) Native American Adult Day Care sites; increased awareness of day care as an option 

among Native Americans; Native American in-home respite program; increased rural and minority respite care; caregiver 

education; Alzheimer/dementia training for respite workers; and outreach materials for Native Americans and Hispanics. 

The products of this AD project are a final report, two telemedicine sites, and AD/dementia training materials.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

350,000

350,000

375,000

350,000

228 East Palace Avenue 

Program: 

New Mexico State Agency on Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2357

MODELS OF ASSISTANCE FOR NEVADA'S UNDERSERVED POPULATION WITH 

DEMENTIA

Las Vegas, NV 89102-9102

Contact: Phyllis Montavon 

The goal of this Dementia demonstration project is to target and serve the underserved Native Americans and Hispanic 

who suffer dementia, through the intervention of telemedicine, outreach, and caregiver and professional training, and a 

respite care voucher program. The objectives of this demonstration project are: 1) to provide consumer directed care for 

persons in the early stages of Alzheimer's Disease (AD) and for those under age 65 who do not qualify for other forms of 

assistance; 2) to establish local community networks; 3) to create and implement a Respite Care Voucher Program 

(RCVP) for 260 seniors; 4) to develop a Rural Caregiver's Training Project (RCTP); 5) to open a new AD Diagnostic and 

Treatment Center in Elko; 6) to test telemedicine (Telmed) opportunities for rural neurologists; 7) to develop a driver safety 

and education program; and 8) to establish more clinics to provide neurological services. The anticipated outcomes are: 

an increased number of Native American, Hispanic and rural populations who suffer dementia will be served through 

telemed., outreach, and caregiver and professional training; increased use of consumer directed care for persons in the 

early stages of AD; increased use of new local community networks; 260 seniors served with RCVP; a new computerized 

Program on AD behavioral issues for use by physicians; development of a Telemedicine Program to link rural AD families 

and rural neurologists with other specialists statewide; RCTP; and new tests and safety protocols for Driver Safety 

Program. The products include a final report; a Rural Telemedicine Program; an RCTP; an AD Diagnostic and Treatment 

Center in Elko; and a driver safety and education program.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

350,000

350,000

350,000

350,000

3100 W Sahara Avenue, Suite 103 

Program: 

State of Nevada Department of Human Resources

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2358
Page 40 of 223 

INTEGRATING DEMENTIA SERVICES WITH MAINE'S LONG TERM AND MANAGED 

CARE SYSTEMS

Augusta, ME 04333-4333

Contact: Romaine Turyn 

The goal of this project is to integrate the coordination of dementia-specific services for persons with Alzheimer's disease 

and their caregivers, and state mental health services, into the long-term care system. The objectives of this AD 

demonstration project are: 1) to develop models which will serve people with dementia who are enrolled in a rural 

Medicaid program coordinated/managed care demonstration program, while incorporating mental health services for 

people with dementia; 2) to identify undiagnosed persons with early on-set dementia; 3) to meet with doctors in the pilot 

sites to improve the identification and assessment of individuals with dementia; 4) to support the LTC needs of rural, 

low-income seniors; 5) to meet with providers and organizations of AD, mental health and aging services; and 6) to 

present Hands On Care Training sessions for 83 caregivers at 6 sites. The anticipated outcomes include: respite care 

provided for 260 families; care management and support provided to 113 families; meeting with Muskie school to monitor 

use and referral patterns of AD seniors; an early caregiver self-identification and educational intervention program; 

identification of caregivers with AD patients; Management Guidelines and training to physicians; and in-depth cross 

training on mental health, dementia and aging. The products are a final report; caregiver materials; dementia materials; 

physician training materials; and cross training materials.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

255,000

255,000

280,000

255,000

35 Anthony Avenue - 11 State House Station 

Program: 

Maine Department of Human Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2359

DEMENTIA CARE: BUILDING THE CAPACITY IN VERMONT

Waterbury, VT 05671-2301

Contact: 

The goal of this Dementia project is to improve the capacity of Vermont's adult day centers to deliver dementia-specific 

care. The objectives of this project are: 1) to develop support services for individuals with early-stage dementia; 2) to 

increase early detection of dementia; 3) to have a special focus on developing services in rural areas and for low-income 

individuals; 4) to develop public education and screening tools; 5) to develop state-wide public education; 6) to provide 

workshops for executives and managers, direct service providers, and nurses; 7) to make consumer-directed dementia 

respite grants to 274 caregivers; 8) to provide train-the-trainer programs for nursing home staff; and 9) to use 7 Minute 

Screen taught to medical students, 16 Eldercare Clinicians, and nurses. The anticipated outcomes are: increased 

dementia-specific care; increased support services for individuals with early-stage dementia; increased early detection of 

dementia through education and screening tool; a project evaluation by U. of Vermont; increased use of the Memory 

Clinic; special workshops for dementia specialist in the field; and train-the-trainer programs for nurses. The products are a 

final report, and Dementia and Adult Day Services workshops and training materials.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

350,000

350,000

375,001

350,001

103 South Main Street 

Program: 

Vermont Department of Aging and Disabilities

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2360
Page 41 of 223 

ALZHEIMER'S COMMUNITY OUTREACH, EDUCATION AND CAPACITY BUILDING 

PROJECT

St. Paul, MN 55155-5155

Contact: Jean Wood (651)296-2879

The goal of this Alzheimer's (AD) project is to develop model community-based service projects that specifically respond 

to the needs of ethnic minority families facing Alzheimer's disease. The objectives of this AD project are: 1) to develop five 

projects that are targeted to the needs of Native American, Hispanic, Hmong, and African Americans; 2) to train home and 

community-based agency managers and direct care workers in culturally appropriate approaches to dementia care; 3) to 

develop a community advocate resource point of contact in every county of Minnesota; 4) to develop culturally specific 

information, including a web site, for hard to reach AD populations; 5) to build assistance capacity of communities; 6) to 

develop a range of respite care models; 7) to develop a statewide Awareness and Support campaign; and 8) to expand 

day care and other home and community-based services in Native American communities. The anticipated outcomes are: 

fact sheets on Native Americans, African Americans, and Alzheimer's Disease; a Native American (Fond du Lac Tribe) 

mobile Respite Care Project; trained state ombudsmen staff regarding dementia; expanded project to three new 

communities; AD materials for Hispanic and Hmong populations; a web-based long distance caregiver education program; 

and a video training on "Keys to Dementia Capable Care". The products of this AD project are a final report; an evaluation; 

ethnic model projects; and a video training tool.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

270,061

270,061

295,061

270,061

444 Lafayette Road North 

Program: 

Minnesota Board on Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2361

ALASKA ALZHEIMER'S DEMONSTRATION PROJECT

Juneau, AK 99811-0209

Contact: Paula Recchia 

The goal of this four year Alzheimer's Demonstration (AD) project is to address local, regional and state needs of persons 

with Alzheimer's disease (AD), and caregivers living in isolated communities with high concentrations of low-income and 

Alaskan Native families. The objective is to develop flexible, culturally sensitive models of adult day care and group respite 

effective in minority and highly rural communities.The State Unit on Aging (SUA), which is the Alaska Commission on 

Aging (ACOA), has as its anticipated outcomes the following: a Memory Loss Clinic in four communities; an Adult Day 

Care Center; the design and implementation of wrap-around services to 18 senior natives and their families; provision of 

services-personal care, respite, chore, Adult Day Care, nursing, companionship, transportation, and long-term respite; 

designed a dementia workshop; an expanded Care Coordination; use of Medicaid eligibility and service coverage for 

ADRD Native Alaskans; flexible models of individuals in-home respite for ADRDs; flexible, culturally sensitive model of 

adult day services/group respite care to meet ADRD needs; a primary care initiative to enhance ADRD identification, 

assessment, and health care services; assessment of gaps in information and training needed by primary care staff for 

earlier identification of ADRD; and dementia protocols for care coordinators. The products of this AD project are a final 

report, a rural Native Alaskan dementia model (ADRD), and an Adult Day Care with Dementia workshop.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

222,973

298,556

375,000

350,000

PO Box 110209 

Program: 

Alaska Commission on Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2362
Page 42 of 223 

COMMUNITY ALZHEIMER'S RESOURCES AND EDUCATION (C.A.R.E.)

Austin, TX 78714-9030

Contact: Marc Gold 

This four year Alzheimer's Disease (AD) demonstration project will develop a culturally and linguistically appropriate 

assessment process and system of care for Hispanic families who are facing Alzheimer's disease (AD) and who live in the 

San Antonio and Rio Grande Valley areas of Texas. The AD project is based on the state's Community Alzheimer 

Resource and Education project, which emphasizes education, case management, and establishment of community 

resource and coordination groups. Direct care service gaps will be identified and addressed through the development of 

culturally competent respite and adult day care services. The objective is to coordinate with the larger Texas Dept. of 

Human Services AD program. The anticipated outcomes of this AD project are: a database; a handbook; an English and 

Spanish AD website; a Spanish caregiver guide; expanded Hispanic Helplines on AD; a Caregiver fair; delivery of direct 

home and community based services to 1000 Hispanic families; statewide project replication; 4 new communities for 

targeting of partnership-building; physicians trained on dementia and telemedicine; a telemedicine project for rural 

Hispanic AD families; and an updated Care Program Handbook. The products are: a final report; a database (website); a 

Handbook; a Spanish Caregiver Guide; an AD Hispanic Helpline; a Caregiver Fair (Hispanic); a cadre of trained 

physicians; and replicable project models.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

349,860

302,783

273,292

265,532

701 West 51st Street-Mail Code W-519 PO Box 149030

Program: 

The Texas Dept. of Human Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2363

PARTNERS IN CARE: ALTERNATIVE MODELS OF COMMUNITY-BASED CARE FOR 

ALZHEIMER'S FAMILIES

Cranston, RI 0292 -0

Contact: Kathleen McKeon 

The goals of this Alzheimer's Disease (AD) project are: to develop a model of consumer-directed respite care, with a focus 

on care provided by and for minority elders; to demonstrate a model of workforce development; and to develop an 

acuity-based assessment process for Alzheimer's-affected families. The objectives are to: 1) provide services for in-home 

respite care; 2) produce a policy and procedures manual; 3) provide minorities with home assessments, safety reviews, 

assessment of caregiver capacity, and information on services; 4) have 50 Certified Nursing Assistants (CNA) complete 

an Alzheimer's curriculum; 5) interview 30 families in the Partners in Care Program; and 6) provide Alzheimer's and 

dementia trainings. The anticipated outcomes are: a model of consumer-directed minority respite care; policies and 

procedures for Respite Program focused on rural areas; two semesters of training for CNAs in AD; and dementia training 

for licensure requirements. The products of this AD project are a final report; a model of consumer-directed respite care 

for minorities; and a model of acuity-based assessment process for AD affected families.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

231,000

303,000

308,000

283,000

Benjamin Rush Building #55 - 35 Howard Avenue 

Program: 

RHODE ISLAND DEPARTMENT OF ELDER AFFAIRS

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2364
Page 43 of 223 

ASIAN AND PACIFIC ISLANDER DEMENTIA CARE NETWORKS

Sacramento, CA 95814-5814

Contact: Sharon Watts 

The goal of this project is to develop a system of dementia care for Asian and Pacific Islanders in the Los Angeles and 

San Francisco Bay area. The objectives of this Dementia Project are: 1) to develop and provide culturally and linguistically 

competent educational, social, and supportive services for dementia-affected persons and their families; 2) to develop a 

collaborative model of assistance for Asian and Pacific Islander communities; 3) to promote access to home and 

community-based long-term care; 4) to develop training in culturally competent dementia care. The anticipated outcomes 

are: a consolidated care network system for Asian and Pacific Islanders; dementia and cultural sensitivity training; 

translated and tested Chinese materials; a new day care center in N. CA for Asian and Pacific Islander families; a 

Legal/respite Day Care Orientation Concept; a symposia on minorities concerning AD/Dementia; expanded use of 

statewide respite services; support groups for Chinese and Japanese speaking and Mandarin and Vietnamese groups; 

and dementia care training. The products are a final report; statewide system of dementia care materials; minorities 

dementia training materials; and a new day care center for minorities.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

350,000

350,000

350,000

350,000

1600 K. Street 

Program: 

STATE OF CALIFORNIA - DEPARTMENT OF AGING

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2365

BUILDING A SEAMLESS DEMENTIA SPECIFIC SERVICE DELIVERY SYSTEM FOR 

RURAL AGED

Des Moines, IA 50309-3609

Contact: Jayne Walke 

The Iowa Dementia project goal is to increase access to and use of community-based support services, using a nurse 

care managed (NCM) delivery system for persons with Alzheimer's disease and related dementias (ADRD). The 

objectives of this rural ADRD project are: 1) to improve the service delivery system; 2) to make the community-based long 

term care system more "dementia friendly"; 3) to develop a statewide dementia training for case management; to pilot a 

"Memory Loss Nurse Specialist" position; 4) to validate an instrument for guidance on when it is no longer safe to "live 

alone" ; and 5) to develop an Early Hospice Referral Project for late stage dementia. The anticipated outcomes are: rural 

ADRD programs in 8 counties; an evaluation; a modified nurse care management (NCM) for dementia senior rural clients; 

training on dementia recognition and early intervention; a community development dementia guide; a dementia training 

manual; local expert nurse case managers statewide serving as dementia resource persons; and an instrument for 

dementia placement and intervention. The products are a final report; dementia plans in 8 rural counties; an NCM system; 

dementia training manual and materials; and a community development guide.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

349,009

349,009

376,000

351,000

Clemens Building, 3rd Floor 200 10th Street

Program: 

Iowa Department of Elder Affairs

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2366
Page 44 of 223 

THE VIRGINIA ALZHEIMER'S DISEASE RESPONSE PROJECT: COLLABORATION, 

SERVICE MODELS, AND EDUCATION

Richmond, VA 23229

Contact: Bill Peterson 

The goal of this rural demonstration project is to develop new, holistic models of care for persons with Alzheimer's 

disease. These holistic demonstration models will address the service and health care needs of persons with Alzheimer's 

disease (AD), as well as their emotional and spiritual needs. The objective of this rural AD demonstration project is to 

provide education and training in effective methods of dementia care to certified nursing assistants (CNAs). The partners 

are Catholic Charities, St. Mary's Bon Secours Parish Nurse Program, AD Association, Virginia Department of Human 

Resource Management, Virginia Hospital Association, Senior Companion Program, Public Service Groups--fire 

departments, rescue squads, EMS, etc. The expected outcomes of this rural AD demonstration project are: a statewide 

AD Response Task Force; 13 subgrants to demonstrate a holistic approach to AD; a CNA dementia training program, 

manuals and mechanisms; dementia education for communities of faith; a curriculum to train parish nurses about AD, 

dementia, and Virginia's LTC system; an Older Adult Ministry Rural Workshop for Clergy; published article for physicians; 

an AD curriculum for physicians; and emergency room staff educated on AD. The products of this rural AD project are a 

final report; new holistic rural AD models; and education and training materials for CNAs.

Project Period: 07/01/2000 - 06/28/2005

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

350,000

350,000

375,000

350,000

1600 Forest Ave., Suite 102 

Program: 

Commonwealth of Virginia

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2367

ALZHEIMER'S DISEASE DEMONSTRATION GRANTS TO STATES PROJECT

Concord, NH 03301-3301

Contact: James Bretz 

The goal of this rural Alzheimer's Disease (AD) demonstration project is to expand and improve dementia-capable adult 

day and respite care services in rural communities. The objectives of this rural AD project are: 1) to improve access to 

services for rural, minority populations, and developmentally disabled (DD) through the development of culturally and 

linguistically competent services; 2) to expand the existing home and community based care system; and 3) to improve 

access to and use of community based services by persons with dementia. The community based organizations (CBO's) 

involved include: Easter Seals of New Hampshire; Life Coping, Inc; DD Council; local group homes; North County 

Alzheimer Partnership Program; community based aging organizations, Manadnock Developmental Services, and local 

community-based DD organizations. The expected outcomes are: a survey of needs of rural individuals and families; a 

Train the Trainer program for doctors and others; a program of prearranged "held beds" for ADRD patients; expansion of 

AD's Adult Day Programming and Respite Services; a comprehensive AD assessment clinic for minorities; family 

promotional and educational activities; alternative support programs; assessment team for in-home care for elders with 

DD; education materials on ADRD; and rural Adult Day Respite.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

250,315

250,315

250,315

250,315

State Office Part South-Brown Building 129 Pleasant Street

Program: 

New Hampshire Department of Health and Human Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2368
Page 45 of 223 

DEMONSTRATING A WISCONSIN DEMENTIA SERVICES NETWORK

Madison, WI 53707-7851

Contact: Sharon Bell 

The project's goal is to create a Dementia Service Network to improve access to diagnosis, treatment and services for 

minority and underserved families facing Dementia. The objectives of this Dementia demonstration are: 1) to expand a 

service credit bank for the provision of adult day care, respite, and other community based long-term care services; and 2) 

to address abuse of persons with Dementia through the development of Crisis Response Teams. The participating 

Community Based Organizations (CBO's) include AAAs, Housing Authority, St. Michael Hospital, AARP, Veteran 

Administration, University of Wisconsin Extension, St. Ann Center for Intergenerational Care, Milwaukee Community 

Service Bank, Wisconsin Alliance for Family Caregiving, and Alzheimer groups. The expected outcomes of this AD and 

Dementia demonstration project are: identification of early warning signs of AD and referral to memory assessment clinics; 

needed services to 115 individuals; outreach efforts to medical offices, pharmacies and churches; a caregiving curriculum 

for eight individuals; a Dementia and Aggressive/Abusive Behavior Summit; identification of Dementia specific outcomes 

and quality indicators; six Case Management for AD domains for use in home settings; a new caregiving model entitled 

"Changing Our Minds From Parent to Caregiver" for adult family home providers; protocols and training curriculum for the 

early treatment of AD; introduce Veterans Administration System to Dementia services; expand service delivery to 

underserved SE Wisconsin residents with AD; train assisted living providers to identify people with Dementia; and pilot 

Dementia Response Teams.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

350,000

350,000

350,000

350,000

1 West Wilson PO Box 7851, Room 450

Program: 

Wisconsin Department of Health and Family Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2369

ALZHEIMER'S DISEASE DEMONSTRATION GRANT

Little Rock, AR 72203-1437

Contact: Sandra Barrett 

This is a three year rural demonstration Alzheimer Disease (AD) project that will develop models of assistance for persons 

with Alzheimer's and their caregivers who live in rural areas of Arkansas. The objectives of the project are: 1) to develop 

facility-based respite; 2) to provide dementia training for adult day care staff; and 3) to increase the number of people who 

access adult day and respite services. The CBOs involved in this rural project include AAAs, Department of Health, 

University of Arkansas, local hospitals, adult day care centers, and AD groups. The anticipated outcomes are: training for 

respite care providers; train the trainer program; 138 clients (adult day care) served; overnight respite services; dementia 

care training (DCT); and dementia training to nursing facility aides. The products of this rural AD project are a final report; 

rural models of AD assistance; dementia training materials; family brochures; a curriculum; and dementia care training 

manuals.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

368,025

357,975

302,875

302,875

PO Box 1437, Slot S530 700 Main Street

Program: 

Arkansas Department of Human Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2370
Page 46 of 223 

CAREGIVERS ARE REALLY EXTRAORDINARY PROGRAM

Phoenix, AZ 85007-5007

Contact: Henry Blanco 

This is an Arizona, three year demonstration Alzheimer Disease (AD) project, whose goal is to design and increase the 

availability and utilization of respite care, especially among the Native American, Hispanic, and rural populations. A 

complementary goal is to expand and develop culturally sensitive and linguistically appropriate programs and materials for 

caregivers of persons with Dementia. The objectives of this rural project are: 1) to enroll 34 families in the CARE program, 

"Camino de Amistad"; 2) to train adult day care staff and in-home care workers on Dementia issues; 3) to use a new 

Training Curriculum and Resources Handbook on Dementia; 4) to develop three new service positions as a part of the 

Camino de Amistad model; 5) to create an Evaluation Scoring Committee; 6) to appoint minority and community members 

to the Committee to assess competent Dementia care services; and 7) to conduct a needs assessment. The 

community-based organizations (CBOs) involved in this project include AAAs, Sun Health, Grupo N, Az Telemedicine 

Program, Emergency Shelter for Wanderers Workgroup, American Indian tribes, local senior and community centers and 

Alzheimer groups. The anticipated outcomes are: 34 families enrolled in the CARE Program; 240 adult day staff and 

in-home care workers trained; 3 new service positions in the Camino de Amistad model; and replication of the Camino de 

Amistad in the off-reservation Native American population. The products are a final report; a needs assessment; interview 

questionnaires; and Dementia materials in Spanish.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

300,001

300,000

300,000

300,000

1789 West Jefferson - 905A 

Program: 

Arizona Department of Economic Security

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2372

ALZHEIMER'S RESPITE SERVICES DEMONSTRATION: REPLICATION THROUGH 

TRAINING, TECHNICAL ASSISTANCE AND CONSULTATION

Nashville, TN 37243

Contact: James Whaley 

The goal of this three year project, which serve African American, rural, and low income seniors, is to provide assistance 

to minority and low income Alzheimer's Disease (AD) patients and their caregivers. The objectives are: 1) to explore 

Internet uses in assisting AD families; 2) to adapt the experience of this demonstration and to replicate it throughout 

Tennessee; 3) to expand the use of the Senior Companion program (SCP); 4) to provide trained Senior Companions as 

providers of in-home services (IHS). The community-based organizations (CBOs) involved in this AD rural project are 

AAA, NASUA, individual physicians, ADRD groups, Mental Health Association, Corporation for National Service-Senior 

Companion Program, and local home and community based providers of home care and companion care services. The 

expected outcomes are: Internet assistance for AD families; trained Senior Companion providers of in-home respite (IHR), 

personal care, companion care; a replicable AD model; workshops on screening and assessment and rural service 

development; an Information and Assistance (I and A) system for ADRD community; a survey of caregivers' needs; and a 

survey of medical professionals on the incidence of ADRD. The products are: a final report; mental health screening tools; 

ADRD workshop materials; survey of caregivers' needs; and a survey of medical professionals.

Project Period: 07/01/2001 - 06/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

350,000

375,000

350,000

Andrew Jackson Bldg. 9th Floor 500 Deaderick Street

Program: 

Tennessee Commission on Aging & Disability

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2451
Page 47 of 223 

PROJECT CARE (CAREGIVER ALTERNATIVES TO RUNNING ON EMPTY)

Raleigh, NC 27699-8390

Contact: Jan Moxley 

This three year ADRD demonstration project's goal is to serve rural African Americans by implementing a family 

consultant service to: 1) improve access, choice, use and quality of respite services; and 2) to identify gaps and barriers 

in the existing North Carolina home and community-based care system. The objectives are: 1) to assess 166 client 

families; 2) to counsel and educate them on community-based services (CBS) and Alzheimer's disease; 3) to serve 132 

families with respite services; 4) to extend to 27 families telephone consultations and support; 5) to provide two community 

and caregiver trainings on rural ADRD; 6) to provide training at the State Information and Assistance Conference (I and 

A); 7) to provide services to rural families; and to develop ANGER TIP sheets for caregivers; 8) to conduct surveys. The 

anticipated outcomes are: ADRD client families assessed; respite services provided for 132 families; telephone 

consultation and support to 27 African American families; caregiver trainings on Alzheimer's Disease; training at State 

Information and Assistance Conference; respite and case management services to rural African American families; 

increased number of respite providers; and training of all Information and Assistance providers. The products are: a final 

report; new Anger Tip sheets for caregivers; and consumer satisfaction surveys.

Project Period: 07/01/2001 - 06/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

350,000

350,000

350,000

2101 Mail Service Center 

Program: 

NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2452

ALZHEIMER'S DISEASE INTERVENTION PROGRAM

Montgomery, AL 36130-1851

Contact: Derek Lee 

This three year Alzheimer Disease (AD) demonstration project's goal is to design to develop a system of care for persons 

with AD, including providing training to long-term care (LTC) providers, public education and community-based services. 

The project's objectives are: 1) to develop a Leadership Institute for long-term care - LILTC; 2) to develop volunteer care 

teams; 3) to expand affordable and accessible home and community-based (HCB) dementia care services (respite, adult 

day care, home health care, and personal care); 4) to conduct dementia trainings statewide for staff and caregivers; 5) to 

have a toll-free hotline provide TA and information to AAA staff and caregivers; 6) to develop a media awareness 

campaign; 7) to develop support groups for families and care teams; 8) to develop Care Teams with 45 volunteers serving 

12 families. The anticipated outcomes are: expanded HCB dementia care services; 35 dementia trainings statewide for 

1,084 direct care staff and caregivers; the development of an ongoing media awareness campaign ; AAA initiated support 

groups for families in the region and three care teams; AAA developed 8 Care Teams with 45 volunteers serving 12 

families; 16 Care Team Network (CTN) Discovery Events to recruit volunteers for Care Teams; and 2 CTN trainings for 33 

individuals; and AAA provision of HCB program information and assistance to 2,191 individuals. The products are a final 

report; dementia trainings materials; and a toll free hotline.

Project Period: 07/01/2001 - 06/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

350,000

350,000

350,000

770 Washington Avenue, Suite 470 

Program: 

Alabama Department of Senior Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2453
Page 48 of 223 

(STARS) SUPPORT THROUGH ALZHEIMER'S RELIEF SYSTEM

Tallahassee, FL 32399-7000

Contact: Gema Hernandez 

This three year Alzheimer's Disease (AD) demonstration project's goal is to design and develop the Support Through 

Alzheimer's Relief Systems (STARS) program . The objectives of this AD project are: 1) to coordinate the STARS program 

with partners; 2) to develop resources; 3) to target culturally under-served and rural Alzheimer's patients and caregivers; 

4) to conduct a culturally appropriate awareness campaign through faith-based institutions; 5) to develop a multi-cultural 

Alzheimer's volunteer resource network; 6) to establish a regional caregiver counseling hotline. The under-served 

populations are the rural, African Americans, and Hispanics. The expected outcomes are: improved current AD service 

delivery system; direct services to target ADRD patients and caregivers; outreach for rural ADRD; partner with faith-based 

institutions (FBIs); volunteers recruited from local churches; a caregiver counseling helpline; inter-agency agreements 

established; AD's awareness promoted; a volunteer resource network developed; Volunteer Recognition Day initiated; 

increased use of rural respite care and direct services; and project replication. The products are: a final report; AD 

Spanish brochures; an AD film; a caregiver self-help video; a caregiver counseling hotline; My Friend Initiative; and an 

in-home ADRD assistance model.

Project Period: 07/01/2001 - 06/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

350,000

350,000

350,000

4040 Esplanade Way 

Program: 

Florida Department of Elder Affairs

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2454

ILLINOIS RURAL AND LEP ALZHEIMER'S DISEASE DEMONSTRATION PROJECT

Springfield, IL 62761-0001

Contact: Connie Moody 

This is a three year Alzheimer's Disease (AD) demonstration project, whose goal is to target rural and limited English 

proficiency (LEP) elderly populations in order to expand and build on existing systems and coordinate and integrate 

services for persons with Alzheimer's Disease (AD) and their families. The objectives are: 1) to expand and coordinate 

outreach and service delivery efforts to individuals with AD and their caregivers; 2) to recruit 2 Korean physicians for the 

LEP elderly, and physicians in Russian and Hispanic communities, and meet with the President of the Polish American 

Medical Society; 3) to conduct caregiver trainings; 4) to conduct a support group leader training; and 5) to conduct 

caregiver trainings in rural areas. The Illinois Department of Public Health will partner with State funded regional AD 

assistance centers (ADAC), the Coalition of Limited English Speaking (LEP) Elderly, and an Alzheimer's Association 

chapter to collaborate on the project. The anticipated outcomes are: Southern Illinois University web-based continuing 

medical education project; referral of memory problems and memory loss clients to physicians, ADAC, and Primary 

Provider Network; outreach training; trainings on dementia and AD; translation of guide for LEP; support groups for LEP; 

meetings for rural and LEP teams; and assistance for Koreans, Russian, Polish and Hispanic communities. The products 

are: a final report; materials in Korean, Russian, Polish and Spanish; AD/Dementia Caregiver training materials; caregiver 

resource guide; and brochures.

Project Period: 07/01/2001 - 06/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

325,231

329,972

330,349

535 West Jefferson 

Program: 

Illinois Department of Public Health

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2455
Page 49 of 223 

MARYLAND ALZHEIMER'S DISEASE DEMONSTRATION PROJECT

Baltimore, MD 21201-2374

Contact: Jean Close (301)767-1100

This is a three year rural Alzheimer's Disease (AD) demonstration project, whose goal is to address long-term care (LTC) 

workforce shortages in Maryland (MD) by expanding the number of rural providers of dementia-competent care through 

developing microenterprises, or small businesses owned by low-income entrepreneurs. The objectives are: 1) to 

implement a consumer-directed respite care model; and 2) to improve the responsiveness, efficiency and quality of care 

for people with dementia and their families. The Community Based Organizations (CBO's) involved include AAAs, MD 

Respite Coalition, Caregiver Support Coordinating Council, AD Association, Women Entrepreneurs of Baltimore, MD 

Capital Enterprises, Lifestyles, Inc.. The expected outcomes are: 25 potential micro-enterprise providers trained; 6 training 

sessions on micro-enterprises; 12 dementia training sessions; 31 AAA case managers trained; develop, train, and launch 

25 micro-enterprise service providers; home and community based services to 60 AD families; and a total of 100 

entrepreneurs trained on dementia care. Products are: a final report; manuals; survey of LTC workforce shortages; 

dementia training materials; respite service program materials; and a consumer Handbook on Dementia Care Services.

Project Period: 07/01/2001 - 06/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

266,943

270,000

214,699

301 West Preston Street, Suite 1007 

Program: 

Maryland Department of Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2456

SPRINGFIELD MULTICULTURAL ALZHEIMER'S SERVICES PROJECT: 

PARTNERING OUTREACH, EDUCATION, AND SERVICES

Boston, MA 02108-2108

Contact: Eliza Lake 

The goal of this 3 year Alzheimer's Disease (AD) demonstration project is to provide access to appropriate information and 

services for Springfield's Latinos and African Americans with AD and their families and caregivers through multiple 

community and faith-based organizations. The objectives of this AD project are: 1) to develop outreach to Latinos and 

African Americans with AD; 2) to create a partnership between the Alzheimer Association (AA), the local AAA/ASAP, the 

local Visiting Nurses Association (VNA), and community organizations that will remove service barriers for those who are 

currently underserved; 3) to provide direct services through the Massachusetts Respite Care Program (MRCP); 4) to 

create new programs for Latinos and African Americans; 5) to provide education, training, support and respite to client 

families/caregivers; 6) to provide cultural competency training to all providers; and 7) to perform a project evaluation. The 

anticipated outcomes are: outreach to target populations; access for underserved; expanded respite and support AD 

services to Latinos and African Americans; direct services via MRCP and VNA; creation of new programs; cultural 

competency training; an evaluation; and removal of service barriers. The products of this AD project are a final report, and 

AD Spanish materials.

Project Period: 07/01/2001 - 06/30/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

350,000

350,000

350,000

One Ashburton Place 

Program: 

Commonwealth of Massachusetts

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2457
Page 50 of 223 

MISSOURI COALITION DEMONSTRATION PROJECT

Jefferson City, MO 65102-0570

Contact: Sandra Gifford 

The goal of this three year Alzheimer's Disease (AD) rural demonstration project is to deliver direct services to persons 

challenged by Alzheimer's Disease and Related Disorders (ADRD). The objectives of this ADRD project are: 1) to create 

and refine communication routes to extend services to diverse families; 2) to develop breakfast clubs and other family 

education and support services; 3) to conduct outreach to rural communities; 4) to develop service providers in rural 

communities; 5) to develop materials and resources for the Hispanic and Bosnian communities in Missouri. The 

partnership will involve the following community based organizations: MO Dept of Mental Health, AAAs, University of 

Washington at St. Louis, local community colleges, AD Assoc., local DD group workshops, respite and adult day care 

providers, and multi-ethnic and multi-faith aging advocacy organizations. The expected outcomes are: an In-home Respite 

Initiative; a public education campaign; a Train the Trainer program; the development of an Early Onset Diagnosis 

Program; Breakfast Club support groups for Hispanics; a clearinghouse; a first and second annual AD summit; training on 

Early On-Set Diagnosis of ADRD; a caregiver respite via A Day Out Program; home modification mini-grants; volunteer 

training via faith-based community groups; multi-cultural outreach via a bilingual website; a multi-cultural resource center; 

and ADRD training. The products are a final report; Spanish and Bosnian ADRD brochures; and an ADRD curricula.

Project Period: 07/01/2001 - 06/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

350,000

350,000

350,000

920 Wildwood Drive PO Box 570

Program: 

Missouri Department of Health and Senior Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2458

INDIANA ALZHEIMER'S DISEASE DEMONSTRATION GRANTS TO STATES

Indianapolis, IN 46207-7083

Contact: Bob Hornyak 

The goal of this three year Alzheimer's Disease (AD) rural demonstration project is to enhance attendance, provide 

educational resources and training for staff and program materials for consumers, especially the rural, low-income, and 

minority persons at Adult Day Services. The objectives of this AD project are: 1) to develop a voluntary electronic respite 

service; 2) to use in-home-video-monitoring of persons with Alzheimer Disease; 3) to assist the rural and low-income 

populations; and 4) to develop culturally sensitive educational materials for consumers. Involved partners include the 

following community-based organizations: Southwestern Indiana Regional Council on Aging, Inc.; Indiana Assoc. of AAAs; 

Governor's Task Force on ADRD; Vincennes University; Generations; AD Assoc.; and Mental Health Assoc.. The 

expected outcomes are: increased attendance of AD patients at adult day services centers; outreach educational 

sessions; in-home video monitoring of AD patients; persons educated on symptoms, diagnosis, and treatment of AD, and 

on services available; data collection; a dissemination plan; professionals trained for dementia/AD care; evaluation on 

in-home video; Pieces of the Puzzle caregiver training seminars; and a First Annual Conference on AD. The products are 

a final report, and training materials.

Project Period: 07/01/2001 - 06/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

300,000

300,000

300,000

402 N. Washington St. PO Box 7083

Program: 

Indiana Division of Disability, Aging and Rehab

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2459
Page 51 of 223 

Alzheimer's Arts, Education and Caregiver Initiative - A Kansas Strength-Based Respite 

Model

Topeka, KS 66603

Contact: Cindy Miller 

This is a three year Alzheimer's Disease (AD) demonstration project, whose goal is to develop a model day program to 

provide art and care for persons with AD in an effort to nurture their remaining strengths. The objectives are: 1) to create 

an environment that offers art and creativity through the development of an Arts and Inspiration Center; 2) to increase 

access through respite mini-grants program, a consumer-directed respite grant program which will target rural and 

Hispanic elders; 3) to develop a statewide education and information campaign, including Breakfast Clubs, a generally 

effective model of caregiver support groups in rural areas; 4) to educate and support family caregivers in venues where 

caregivers naturally congregate; 5) to pilot this program in several communities; 6) to evaluate this program; and 7) to 

replicate it statewide. The partners include: Kansas Dept. on Aging; Kansas Assoc. for AAAs; Health Care Assoc.; AD 

Assn. Chapters; Kansas Assn. of Homes and Services for the Aging. The anticipated outcomes are: Hispanic respite 

mini-grants; the Hispanic Arts and Inspiration Center; an AD Hispanic model day program; a Hispanic breakfast club 

model; arts-based respite opportunities for families coping with AD; availability and access to respite services for rural and 

low income elders and their caregivers; consumer directed respite care for rural Kansans; Hispanic support groups; and 

AD information and education. The products are a final report and a replication manual.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

225,000

225,000

225,000

503 S. Kansas Avenue 

Program: 

Kansas Department on Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2572

Pennsylvania Memory Loss Screening Program

Harrisburg, PA 17101-1919

Contact: Velma E Carter-Dryer 

This is a three year Dementia (D) demonstration project, whose goal is to develop the Pennsylvania Memory Loss 

Screening (MLS) Program. The MLS program is designed to create dementia screening (DS) and service delivery 

focusing on serving Latino/Hispanic American, Asian-American, African American and rural Pennsylvanians. The 

objectives of this MLS project are: 1) to develop models of community based service delivery; 2) to target the integration of 

medical and social support services; 3) to provide facility based, in-home and overnight respite and adult day care; 4) to 

serve people with early on-set dementia (before the age of 60) regardless of race; and 5) to provide direct services, e.g., 

facility based, in-home and overnight respite and adult day care. The Community Based Organizations involved in this 

MLS program include AAAs, PA Dept. of Health, PA Dept. of Public Welfare, Univ. of PA Health System (Memory 

Disorders Clinic), PA Intra-governmental Council on LTC, Hahnemann University, and Alzheimer's Assn. chapters of PA 

(AAC). The anticipated outcomes are: a cadre of volunteers; a dementia screening service for AD minorities and rural 

elders; improved client health; improved responsiveness of all agencies; greater access to services and community-based 

supports; improved referrals, screenings, and education forums; and partnership with corporate and private foundations. 

The products are: a final report; an MLS model of community-based service delivery to minorities; a replication manual; 

and multi-language materials.

Project Period: 07/01/2002 - 06/30/2006

FY Grant Amount

FY 2002

FY 2003

FY 2004

349,012

349,012

349,012

555 Walnut Street, 5th Floor 

Program: 

PENNSYLVANIA DEPARTMENT OF AGING

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2573
Page 52 of 223 

Implementing Changes to Improve Dementia Care in Home, Community and Health 

Service Organizations

Lansing, MI 48913-8913

Contact: Irene Kazieczko (517)335-0252

This is a three year demonstration project that will focus on rural populations and will help the State of Michigan to take a 

systems integration approach to improving care for Alzheimer (AD) families. The four goals of this AD project are: 1) to 

replicate a model program of assistance designed to improve access and coordination of care between physicians, people 

with dementing illnesses, their families, and voluntary health organizations (VHO); 2) to implement two models of 

assistance in home and community-based service organizations that improve their responsiveness to the needs of people 

with dementing illnesses and their families; 3) to implement the current statewide capacity of VHOs for Alzheimer, 

Huntington and Parkinson diseases to follow-up on inquiry calls, provide care consultation and link callers with other 

supportive services ; and 4) to identify components of each model of assistance that have potential for replication or 

integration by other similar organizations and disseminate key results, lessons, protocols and service methodologies to 

units of state government, AAAs, VHOs and interested health care providers. The anticipated results of this AD program 

are: a state model; better understanding of Alzheimer patients' illness; increased level of knowledge and confidence in 

caring for the patients; and use of new protocols. A product of this AD program is a final report.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

282,373

272,355

257,224

320 South Walnut Street 

Program: 

MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2574

Coordinated Care Alzheimer's Demonstration Project

Albany, NY 12223-1251

Contact: Marcus Harazin (518)474-5478

This three year Developmental Disabilities (DD) and Alzheimer's Disease (AD) project goal is to develop direct services to 

persons with DD/AD in rural areas and to low income. It is designed to help them remain in family homes and group 

homes in their communities. The community-based organizations (CBOs) involved are the State Office on Aging; Health 

Dept., Office on Mental Retardation and DD; AAAs, Alzheimer's Assn. Chapters; chapters of the Assn. of Retarded 

Citizens (ARC), Univ. of NY at Albany and local DD service providers. The objectives of this DD/AD project are: 1) to find 

and identify individuals with DD/AD; 2) to provide current information, education, training; 3) to develop support group 

services to family caregivers; 4) to develop comprehensive professional training programs; 5) to create an DD/AD 

competent workforce for DD service providers, AAAs and chapters of the Alzheimer's Assn.; 6) to disseminate the models 

of services and training to other regions in NY state; and 7) to plan for long-term funding development. The anticipated 

outcomes are: 40 persons with DD/AD identified and served; in one year, support groups formed in 10 group homes and 3 

regions, and 15 groups established in year two; 150 home care staff and family caregivers trained; and a review of 

Medicaid waivers and other funding mechanisms to help with DD/AD persons. The products are a final report, a family 

resource directory, and training materials.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

305,000

266,883

224,676

3 Empire State Plaza 

Program: 

NEW YORK STATE OFFICE FOR THE AGING

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2575
Page 53 of 223 

West Virginia Alzheimer's Disease Demonstration Project

Charleston, WV 25305-5305

Contact: Jan Bowen (304)558-3317

This is a 3 year Alzheimer's Disease (AD) demonstration project whose goal is to identify and address needs of rural and 

low-income West Virginia Appalachian and other WV families struggling with AD. The Community Based Organizations 

(CBO) involved are: the Alzheimer's Disease Association; Office of Health Facilities Licensure and Certification; local 

scouts; 4-H programs and faith-based youth groups; and local senior centers. The objectives are: 1) to issue start-up 

grants to senior centers that will work with community coalitions; 2) to establish or enhance local adult day care 

centers/facilities; 3) to issue grants to county senior centers and local service organizations to provide in-home respite 

care; 4) to develop a consumer directed respite care approach by issuing respite care grants directly to families; 5) to 

create a statewide toll-free help- line; 6) to update the CNA training curriculums to include dementia training; 7) to change 

CNA licensure requirements to require education and experience in assisting persons with dementia; and 8) to develop 

merit badges in AD, dementia and the aging process in collaboration with local civic, community and faith-based groups. 

The anticipated outcomes are: a sustainable collaborative process to help rural AD persons; increased access to and 

availability of rural respite care and rural adult day care services; 24 CNA training programs state-wide and reduction in 

CNA turnover in LTC settings; dementia training for licensure; an AD Merit Badge program; and a statewide centralized 

toll-free help line.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

250,000

250,000

250,000

1900 Kanawha Blvd. East, Bldg. 10 

Program: 

West Virginia Bureau of Senior Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2576

Helping Rural Colorado Families Access Supportive Services for Alzheimer's Disease

Fort Collins, CO 80523-0523

Contact: Paul Bell (970)491-7215

Acting through Colorado State University, the goal of this 3 year Alzheimer's Disease (AD) rural and Hispanic 

demonstration project is to increase the availability of home health care, companion services, personal care, respite care, 

adult day care, support groups, and related services to individuals and families with dementia and their families in rural 

Colorado. The objectives of this AD project are: 1) to demonstrate various models of respite care provided by faith-based 

groups, civic organizations; 2) to develop a cadre of volunteers as respite providers; 3) to develop and provide family and 

professional training in the Savvy Caregiver Program; 4) to recruit and coordinate with the Cooperative Extension Service 

(CES) Gerontology team, AAAs, AD Association, and service providers; and 5) to create a Coordination Task Force that 

will assimilate feedback from the project, and monitor the project's progress. The anticipated outcomes are: 500+ families 

trained to use supportive services to prevent caregiver burnout; an expanded 24/7 English/Spanish AD Helpline; stigma 

of AD's in rural areas eliminated; private sector funding of support services developed; caregiver screening tools 

developed; caregiver burden reduced; a community coalition developed; and access to home and community-based care 

services improved.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

350,000

350,000

350,000

202 Johnson Hall 

Program: 

STATE BRD OF AGRICULTURE ACTING BY & THRU CO STATE UNIV

State Board of Agriculture, acting by and through

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2577
Page 54 of 223 

Oklahoma Alzheimer's Coalition Project

Oklahoma City, OK 73105-3105

Contact: Norma Goff (405)522-4510

This three year Alzheimer's Disease (AD) demonstration project goal is to develop an in-home respite and companion 

visitation recruitment and support program using mentors and volunteers, working in teams, to provide direct home and 

community based (HCB) services targeted to African American, Native American and rurally isolated populations. The 

Community Based Organizations involved in this project are the Methodist Church, the Presbyterian Church; Tulsa AAA; 

Osage County Nutritional sites and Day Care and home health; and others. The objectives are: 1) to train students to 

deliver specialized dementia care; 2) to support their on-the-job training program; 3) to prepare ten mentors and on-site 

front line workers (nurses, aides, etc.) for adult day care (ADC) and respite programs; and, 4) to replicate the program in 

faith-based and community/civic groups. The anticipated outcomes are: a multi-level health profession career ladder for 

front-line community based care staff; increased staff retention; increased access to direct services for African American 

and Native American AD persons; increased supply of LTC home and community based care workers; increased supply 

of volunteer workers; and a replication volunteer model. The product is a final report.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

338,363

338,363

338,363

312 NE 28th Street - LC #150 

Program: 

OKLAHOMA DEPARTMENT OF HUMAN SERVICES

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2578

The Alzheimer's Disease Project of Mississippi

Jackson, MS 39201-9201

Contact: Jennie Hillman (601)359-1288

This is a 3 year Alzheimer's Disease (AD) African American demonstration project. The goal is to develop 

volunteer-staffed day respite programs with targeted outreach and service delivery to African Americans. The involved 

CBOs include MS Dept of Mental Health, AD Assn., AAA, Baptist Health System, RSVP, First Friends Adult Day Care 

Center, MS Senior Companion program, and others. The objectives are: 1) to expand the capacities of existing in-home 

and group respite, homemakers, and personal care services; 2) to improve the long-term care workforce by providing 

educational training programs; 3) to develop and improve the use of Senior Companions Program; 4) to improve the 

retention of the workforce through training programs for direct care workers (CNAs, home health aides, sitters, 

companions); 5) special training for staff on ways to work with and support the independence of AD clients who live alone; 

and, 6) to strengthen a volunteer program. The anticipated outcomes are: expanded service availability for AD persons; an 

increased volunteer workforce; an increased capacity of the care system; increased AD /Dementia trainings; and 

integration of mental health and aging network services. The products are a final report and AD brochures.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

252,000

239,223

239,223

1101 Robert E. Lee Building 

Program: 

Mississippi Department of Mental Health

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2579
Page 55 of 223 

ConsumerDirected Services for Families of Persons with Alzheimer's Disease

Lincoln, NE 68509-5044

Contact: Janice Price 

This project will use a consumer-directed approach (CDA) to serve persons with mild to moderate forms of Alzheimer's 

Disease (AD), and their caregivers. The first goal of the project will be to enable consumers to make effective decisions 

about care for their relatives and allow them to remain at home as long as possible. The second goal of this project is to 

offer caregivers a mentor who will provide information and support, mental health support, if needed, and expanded 

education/training opportunities. Partnerships will be formed with existing community services and religious and rural 

coalitions to coordinate and enhance services for caregivers and to reach the currently under-served population of 

caregivers in five county area. The anticipated outcomes are: consumer-directed approach for AD patients; caregivers for 

AD patients; family and relative integration; increased support for AD persons to stay at home and in their community; a 

mentor assigned for each AD person; and mental health support for each AD person. The product is a final report.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

326,000

278,300

150,000

PO Box 95044 

Program: 

Nebraska Department of Health and Human Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2692

Dementia Outreach Lexington: Diagnosis/Treatment and Services for African-Americans

Frankfort, KY 40621

Contact: Phyllis E. Culp 

Kentucky's Office of Aging Services, in collaboration with the Sanders Brown Center on Aging and the Greater Kentucky 

and Southern Indiana Chapter of the Alzheimer's Association, will conduct a three-year program to increase awareness of 

dementia and utilization of dementia care services by the African-American community. The objectives of the project are: 

(1) to increase awareness of dementia in the Lexington/Fayette County African-American population; (2) to provide 

dementia diagnostic services for African-Americans in their community setting; and (3) to offer two separate services 

through churches, e.g., support groups and a Best Friends care program - to complement programs already in place. 

Expected outcomes are: increased use of diagnostic and treatment services already in place in an African-American 

neighborhood, and an increase in sense of satisfaction with caregiving efforts. Products are: a final report; informational 

materials on dementia and available services; training materials for coaching caregivers and patients; evaluation tools; 

and manuscripts for publication.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

212,970

189,029

189,029

275 E. Main Street, 3W-F 

Program: 

KENTUCKY CABINET FOR HEALTH SERVICES

Division of Aging Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2693
Page 56 of 223 

Rural Respite Program - Group Socialization and In-Home Respite

Salt Lake City, UT 84103

Contact: Michael Bednarek 

This project plans to expand access to community-based respite services and to develop a system of in-home respite care 

that is volunteer driven, for persons with Alzheimer's disease and related dementias and their caregivers within rural areas 

of the state and/or minority communities where no such program exists. The goal is to develop relationships with diverse 

organizations and faith based programs to mobilize and train volunteer respite companions. Culturally sensitive volunteer 

training materials will be developed to reach a wide range of volunteers and clients. The objectives are: 1) to train 

volunteer companions who will provide respite care supplemented by home health care; 2) to prepare professionals to 

teach basic dementia care to participating families; 3) to develop a model for a two-pronged program with parallel 

development of a plan for community awareness and educational presentations and a program for recruiting and training 

volunteers and clients; 4) to provide respite for caregivers, while providing care and socialization for their family member 

with Alzheimer's. The expected outcomes are: increased access to community-based and in-home respite services; 

increased use of volunteers for AD persons; increased number of rural caregivers; trainings for AD volunteers and 

caregivers; and improved access to dementia care services for families with AD persons. The product is a final report.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

300,000

300,000

300,000

120 North 200 West, Room 319 

Program: 

Utah Department of Human Services

Aging and Adult Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2694

Early Intervention and Continuous Supportive Services Project

Boise, ID 83720-0007

Contact: Lois Bauer 

Idaho's Alzheimer's (AD) Project creates a collaborative model, the "Stand By You Program". The goal is to provide a 

network of services and a single point of entry for people with Alzheimer'sDisease (AD) and their families. The objectives 

are: 1) to offer, through a family advisor, an array of community services; 2) to offer monthly orientations to Alzheimer's 

Disease and nine-week in-depth training courses; 3) to offer individual, couple and family counseling; and, 4) to offer 

access to responsive paid and informal respite and companion services. The anticipated outcomes are: dementia-specific 

training for the network of providers and a peer group; shared best practices; quality improvement processes explored; 

sustainability and capacity building methods implemented; and purpose and values of the "Stand By You Program" 

articulated by a professional, community Advisory group, to the professional communities they represent. The products 

are: a final report, and training materials on AD.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

320,348

305,298

293,217

PO Box 83720 

Program: 

IDAHO COMMISSION ON AGING

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2695
Page 57 of 223 

Home And Community Based Support Services for Hispanic Cultured Persons with 

Alzheimer's Disease and their Caregivers

San Juan, PR 00919-1179

Contact: Rossana Lopez-Leon (787)721-4560

The Office for Elderly Affairs for the Commonwealth of Puerto Rico will conduct a 3-year demonstration project with two 

primary goals: 1) to develop and provide a comprehensive home-based support model for Hispanic Persons with 

Alzheimer's Disease (AD) and their Caregivers, and 2) to improve receptiveness of existing Senior Centers and the Long 

Term Care (LTC) service networks toward persons with AD and dementia related disorders (ADDRD). The objectives are: 

1) to provide a variety of respite services, home health care, companionship, homemaker services and case management; 

2) to provide information and training to strengthen their skills and well being; 3) to provide both community service 

networks with "know-how" information and training, which will result in increased knowledge, sensitivity and receptiveness 

of persons with AD; and 4) to incorporate community organizations and government agencies as part of its Advisory 

Council, which will play an active role in planning, implementation and evaluation activities. The expected outcomes are: 

increased family home support for Hispanics with AD in Puerto Rico; and increased sensitivity towards Hispanics with 

ADDRD. The products are a final report, and AD Hispanic training materials.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

300,000

300,000

300,000

P. O. Box 19179 Old San Juan Station

Program: 

Puerto Rico Ombudsman for the Elderly

Education and Training Division

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2696

Comprehensive Alzheimer's Care Program

Baton Rouge, LA 70802

Contact: Mary Tonore 

The Louisiana's Governor's Office of Elderly Affairs, in collaboration with Our Lady of Lake Regional Medical Center's 

Division of Elderly Services and the Alzheimer's Services of the Capital Area, proposes a Comprehensive Alzheimer's 

Care Program to provide adult care services to persons with Alzheimer's Disease and related dementia. The program will 

be comprehensive in nature, providing a safe stimulating environment for an individual with Alzheimer's Disease or related 

dementias. This program will provide an option for caregivers who must work evenings during the week, but do not wish to 

place their loved ones in a nursing facility. The program will expand current respite services to include the hours of 

6pm-7am, M-F, thus offering respite care for overnight stays. Services will include social interaction, exercise, meals, 

recreational activities, and caregiver support groups.

Project Period: 07/01/2003 - 06/30/2004

FY Grant Amount

FY 2003 210,000

412 North 4th Street 

Program: 

State of Louisiana

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2722
Page 58 of 223 

Reaching and Empowering Alzheimer's Clients Together (REACT)

Hartford, CT 06106-5033

Contact: Kathy Bruni (860)424-5058

The Connecticut Department of Social Services (CDSS) is developing this Alzheimer's Disease (AD) project, a 3 year 

partnership with the Connecticut AD Assn., AAA, and the Capitol Region Conference of Churches. The goal of this AD 

project is to conduct community outreach, awareness, and clinical supportive services for AD persons and their families. 

The objectives are: 1) to provide community based and in-home clinical assessment/counseling/treatment; 2) to develop 

materials and treatment strategies; 3) to conduct outreach and increase participation of underserved populations; 4) to 

conduct program and service integration; and 5) to expand current services/support systems. The projected outcomes are: 

increased participation of underserved seniors; creation and dissemination of outreach and educational materials; access 

and availability to families to resources and services; expanded service/care/support network; increased services and 

treatments; fewer barriers in accessing care and services; and connected to services for isolated self-neglecting AD 

persons. The program products are web accessible and include final report; brochures; evaluation/assessment tools; 

training manuals; and treatment manual.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

250,000

250,000

250,000

25 Sigourney Street 

Program: 

CONNECTICUT DEPARTMENT OF SOCIAL SERVICES

Social Work and Prevention Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2723

North Dakota Alzheimer's Demonstration Project: Working Together

Bismarck, ND 58505-0250

Contact: Sheryl R.H. Pillger 

The goal of the North Dakota Working Together project is to build an alliance between the medical community, parish 

nurses, OAA and community services to increase dementia identification, treatment and caregiver respite with a special 

focus on rural areas and American Indian reservations. A University of ND dementia curriculum will train a pool of 

Qualified Service Providers (QSPs) with expertise in dementia care. Two medical systems will provide protocols, tools 

and training to the medical community to facilitate assessment, treatment and referral for enhanced respite services.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

261,150

261,150 600 East Blvd. Ave., Dept. 325 

Program: 

ND ST DEPT OF HUMAN SERVICES

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2767
Page 59 of 223 

Staying the Course in Alzheimer's Care

Waterbury, VT 05671-2301

Contact: Maria Mireault (802)241-3738

The Vermont Department of Aging and Independent Living (DAIL) will develop and implement a three-year project that 

provides supportive, educational and/or direct service interventions for caregivers of people with Alzheimer's Disease and 

Related Disorders (ADRD), helping those with ADRD remain in their homes and communities. The project will serve 450 

households, targeting family caregivers with low incomes, caregivers residing in rural, underserved areas of the state, and 

supportive services teams caring for people with ADRD and developmental disabilities. Vermont's DAIL will link project 

activities to Vermont's community-based long-term system, enhancing existing services and developing new resources, 

such as case management and eldercare mental health within primary care practices; dementia care capable 

developmental service teams; and caregiver wellness and supportive services projects.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 103 South Main Street Ladd Hall 3rd Floor

Program: 

Vermont Department of Aging and Independent Living

Division of Advocacy and Independence

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2768

Alzheimer's Demonstration Program: Coordinating Care in Wyoming

Cheyenne, WY 82002

Contact: Beverly J Morrow 

The Aging Division will engage in a one-year pilot project to greatly improve the coordination of outreach to, and services 

for, people with Alzheimer's Disease/dementia and their caregivers. The goals are: to better understand the need of AD 

families in Wyoming; increase knowledge bases regarding AD; raise awareness of available resources; and create a 

more effective, responsive network of services that strengthen community-based in-home care recipients and support the 

needs of caregivers. Expected outcomes include: increased support and stress reduction for caregivers; coordinated 

services that improve care and effectiveness, leading to prolonged avoidance of premature institutionalization; and 

increased awareness and knowledge among professionals and the public. Products will include dementia resource 

manuals, a reliable needs assessment, a Web resource and final report.

Project Period: 07/01/2004 - 06/30/2006

FY Grant Amount

FY 2004 150,000

6101 Yellowstone Road Room 259B 

Program: 

WY ST DEPARTMENT OF HEALTH

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2769
Page 60 of 223 

Alzheimer's Disease Demonstration Grant

Pierre, SD 57501

Contact: Pat Miller 

Through this one-year grant, the South Dakota Office of Adult Services and Aging will identify the needs of individuals with 

Alzheimer's Disease and related dementia and their paid and unpaid family caregivers. Once the needs have been 

identified, a coordinated system of care and training to meet these needs will be developed. First, a meeting will be held 

to identify partner agencies and organizations that work with individuals with Alzheimer's Disease. These partner 

agencies will form the planning committee. A main focus of the planning committee will be the identification of the number 

of people with this disease who live in South Dakota and their location, as well as measurements of the effectiveness of 

the current support system. Training for paid and unpaid caregivers will be developed and a program that offers direct 

supportive services for caregivers will be a priority.

Project Period: 07/01/2004 - 06/30/2006

FY Grant Amount

FY 2004 225,000

State Office Bldg. 700 Governors Drive

Program: 

SD ST DEPARTMENT OF SOCIAL SERVICES

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2770

AoA Alzheimer's Demonstration Grant

Richmond, VA 23229

Contact: Janet L Honeycutt 

Based upon the feedback that the Virginia Department for the Aging (VDA) received during its first Alzheimer's Disease 

Demonstration Grants to States Program (ADDGS), VDA will initiate three new projects (objectives) to improve services to 

the 107,403 older Virginians and their families impacted by Alzheimer's disease and related disorders (AD), and to better 

integrate Alzheimer's disease programs into the long-term care services system. The first project (objective) will award 

grants to the four Alzheimer's Association chapters in Virginia to provide respite care to families caring for persons with 

AD. The second project (objective) will demonstrate the viability of the systems changes that will result from the 

development of a Comprehensive Virtual Center on Alzheimer's Disease. The third and final project (objective) will initiate 

the development of affordable driver assessment and rehabilitation programs in Virginia targeted to drivers in the very 

early stages of AD. VDA will also reactivate the state-level Alzheimer's Disease Response Task Force (ADRTF), created 

under the department's first ADDGS grant, to provide ongoing guidance during the implementation and evaluation of the 

three objectives.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 1610 Forest Ave., Suite 100 

Program: 

Commonwealth of Virginia

Virginia Department for the Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2771
Page 61 of 223 

Alzheimer's Community Outreach, Education and Capacity-building Project

St. Paul, MN 55155-3483

Contact: Jean Wood (651)296-1531

The goal of the Minnesota Working Together project is to engage in a three-year systems change effort to connect the 

medical and community care systems to create an integrated service system for caregivers and individuals with dementia, 

in order to increase dementia identification, assessment, treatment and caregiver respite.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 444 Lafayette Road 

Program: 

Minnesota Board on Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2772

Alzheimer's Demonstration Grant

East Baton Rouge, LA 70802

Contact: Mary Tonore 

The Governor's Office of Elderly Affairs and community partners, the Alzheimer's Association and Alzheimer's Service of 

the Capital Area, will improve the responsiveness of Louisiana's overall system of home and community-based care to the 

needs and preferences of persons with Alzheimer's Disease and their caregivers. The major objectives of the partnership 

are: to streamline access to information and services that support persons with Alzheimer's Disease and their caregivers; 

increase consumer control in service options; empower individuals and their caregivers with increased skills and tools to 

self-advocate and manage needs; and increase services to the underserved through outreach to rural and minority 

residents. The expected outcome is that persons with Alzheimer's Disease and their caregivers will have increased 

access to information and services that are culturally appropriate and geographically/physically convenient. The proposed 

activities to achieve these objectives include: more availability and consumer direction for National Family Caregiver 

Support Program participants; increased respite services and caregiver education; diversity outreach efforts for minority 

and rural caregivers; and mobile day services to offer innovative respite options.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 412 North 4th St - 3rd Floor 

Program: 

State of Louisana Governor's Office of Elderly Affairs

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2773
Page 62 of 223 

Expanding Culturally Appropiate Adult Day Care to Minorities and Mid-Late Stage 

Clients.

Des Moines, IA 50309

Contact: Jayne Walke (515)725-3309

The Iowa Department of Elder Affairs (IDEA) will conduct a three-year program to increase the capacity of Adult Day 

Health and Respite (ADR) providers to deliver culturally appropriate service to persons with dementia and to emerging 

minority populations in rural settings. Goals include: 1) convene statewide committee to evaluate and develop ADR 

training; 2) increase use of direct services for ADR care; 3) assessment and intervention services and staff education to 

ADR provided by a Memory Loss Nurse Specialist (MLNS); and 4) evaluate and develop culturally sensitive education, 

training materials, classes, and services. Expected outcomes include: increased numbers of higher level dementia clients 

receiving adult day/respite services from trained staff; expertise of a MLNS for assessment and education; dementia 

specific adult day/respite centers meeting new state rules and regulations; and increased client/family satisfaction with 

services. Products will include a web site, culturally specific training manual, educational and evaluation tools, and 

research manuscripts. These will be disseminated to community colleges, direct service organizations and area agencies 

and introduced at state, local and national conferences.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 510 East 12th Street, Suite 2 

Program: 

State of Iowa

Iowa Department of Elders Affairs

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2774

Focus on Families

Little Rock, AR 72203

Contact: Kris Baldwin (501)682-2441

The Arkansas Division of Aging and Adult Services' project is called Focus on Families. The project combines models of 

direct care for underserved populations, use of faith-based and other volunteer organizations, plus innovative methods for 

improving access to services, information, and supports. The goals are: to focus services/support at the home and 

community level for people with Alzheimer's Disease (AD)/related disorders and their family caregivers; develop additional 

services; and make access to services easier and resource information more readily available. Major objectives include: 

developing and implementing a bridge fund to make home and community-based waiver services available pending 

eligibility determination; developing a Web-based information system; implementing two models of direct care; providing 

faith-based volunteer services; televising family caregiver training; holding annual symposiums for AD caregivers; and 

exploring the needs of people who have both AD and developmental disability through a stakeholders' committee. The 

overall approach includes enhancement of current systems change initiatives, focus on minority and rural populations, and 

collaboration with key partners and community organizations. Products from the project include broadcast-based training 

materials, Web-based information, direct care and volunteer service models, bridge fund procedures/outcomes, 

symposiums, and reports.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

281,150

275,754 PO Box 1437, Slot S530 

Program: 

ARKANSAS DEPARTMENT OF HUMAN SERVICES

Division of Aging and Adult Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2775
Page 63 of 223 

Walk of Friendship Program

Phoenix, AZ 85007

Contact: Henry Blanco (602)542-4446

The Arizona Department of Economic Security, Aging and Adult Administration will build upon its Walk of Friendship 

model of assistance to address the need for care systems that are dementia-capable and culturally sensitive for 

individuals with dementia, their families, and their caregivers. The goals of the program are to expand culturally sensitive 

and linguistically appropriate services and materials for persons with dementia and their caregivers and to improve 

coordination and service delivery of home and community-based services at the state and local level. Expected outcomes 

are: underserved populations with the disease and their caregivers will have increased assess to dementia-capable 

services; family caregivers will have an increased awareness and knowledge of Alzheimer's disease and available 

resources; individuals and families will better cope with and plan for disease progression and memory loss; persons with 

the disease and their family caregiver will have enhanced quality of life and better social supports; and community 

engagement in dementia capable delivery of services will be improved. Products will include an evaluation report, final 

report, and web page information.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

276,059

276,059 1789 West Jefferson Street (950A) 

Program: 

AZ ST DEPT OF ECONOMIC SECURITY

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2776

DE Memory Loss Screening Demonstration Project

New Castle, DE 19720

Contact: Carol Barnett 

The Alzheimer's Association Delaware Valley Chapter, Delaware Regional Office, has planned and will implement the 

Delaware Memory Loss Screening Demonstration Project. The memory loss screening tool was developed by the 

University of Pennsylvania Memory Loss Clinic and is a proven instrument to identify possible neurological problems. The 

project will target populations that are confronted with substantial barriers to accessing memory loss screening and 

support services. This is a community-based, education and service program that will bring memory loss screenings and 

dementia-related services directly to people in their communities.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

161,150

161,150 1901 N Dupont Highway, Main Annex 

Program: 

DE DEPARTMENT OF HEALTH & SOCIAL SERVICES

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2777
Page 64 of 223 

D.C. Awareness and Care Program (DC AACP)

Washington, DC 20001

Contact: Sherlyn Taylor (202)727-8367

The District of Columbia Office on Aging (DC OoA) plans to conduct a three-year program mobilizing the African American 

faith community to create community coalitions that elevate awareness of Alzheimer's Disease and related disorders 

(ADRD) and increase utilization of services by African Americans. Goals include: reaching African Americans who are not 

linked to services; testing an approach to link caregivers to direct services; and providing Montessori-based Activities for 

Persons with Dementia (MBAP) at adult day care centers. Expected outcomes are: amplified awareness of ADRD; 

increased number of caregivers linked to services; and improved level of functioning in ADRD elders. Products include 

educational videos, culturally sensitive training manual, assessment/evaluation tools, and web page information that are 

disseminated to public and private service organizations. Key partners include Home Care Partners, Alzheimer's 

Association, and DC OoA lead agencies and day care programs.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

263,768

263,768 441 4th Street, NW, Suite 900 South 

Program: 

District of Columbia Office on Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2778

Alzheimer's Demonstration Project

Jefferson City, MO 65109

Contact: Diane Brown (573)751-6014

This initiative will focus on promoting the climate for a systems change. Efforts will be directed to improving the quality of 

life for persons in Missouri, through expansion of real options to individuals, as they make choices about their lives. It will 

embark on the following three components:

-- "Empowerment Groups" - An innovative community respite model for individuals in the earlier stages of Alzheimer's, 

based on their capacity to self-direct care and supporting a sense of purpose and value for the individual.

-- A security support program addressing difficulties with wandering behavior.

-- "Staying Home" grant funding to expand care support options for those individuals in the later stages of a dementia.

Contracting with the four chapters of the Alzheimer's Association, Missouri will strengthen the mounting movement 

towards strength-based care, responsiveness to individual philosophy of life and bolstering opportunities to remain in the 

home longer.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

230,523

230,523 920 Wildwood Drive - P.O. Box 570 

Program: 

State of Missouri

Missouri Dept of Health and Senior Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2779
Page 65 of 223 

(STARS and Beyond) Support through Alzheimer's Relief Systems and Beyond

Tallahassee, FL 32399-7000

Contact: Teressa Franklin (850)414-2039

The goal of the Florida Department of Elder Affairs proposed Alzheimer's Demonstration Project, "Support through 

Alzheimer's Relief Systems (STARS) and Beyond," is to increase access to services for individuals with dementia, their 

caregivers and families residing in traditionally underserved rural, minority and culturally diverse communities. Project 

objectives are: providing direct services, wanderer registration and related services for dementia clients and their 

caregivers; developing a prioritization system for improving services to dementia clients and caregivers; recruiting 

faith-based organizations to conduct community-outreach activities; conducting community outreach activities through 

faith-based organization volunteers; conducting community education presentations; establishing a task force of 

professionals and agencies serving dementia clients; and expanding 24/7 crisis-intervention, information and referral 

telephone services. The project approach will emphasize collaborative partnerships among service agencies to minority, 

elderly and culturally diverse dementia clients and their caregivers in rural areas, found in the nine service counties. Major 

products will include culturally sensitive dementia awareness and services brochures, and an Alzheimer's Disease 

"caregiver sensitive" service prioritization form.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 4040 Esplande Way, Suite 280D 

Program: 

State of Florida Department of Elder Affairs

Division of Volunteer & Community Based Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2780

Alzheimer's Disease in Rural Maine.

Augusta, ME 04333

Contact: Romaine Turyn (207)287-9200

The Bureau of Elder and Adult Services proposes to increase access to an array of services provided to caregivers of 

people with Alzheimer's Disease in rural Maine through a collaboration between providers within Maine's Home and 

Community Based Care System (HBCS), the Aging Network, and Real Choice System Change Initiatives. The project will 

expand the pilot caregiver companion program to rural counties and add mental health, end of life care and hospice 

referral services for clients/families affected by AD, served by the HBCS and AAAs. The project will expand the focus of 

the ADRC's to include family caregivers. Priority will be on increasing end of life care and hospice services in aging 

programs. Finally, the project will recognize direct care workers trained in dementia care, in collaboration with the Direct 

Care Workforce Demonstration. Outcomes include: an increase in the numbers of caregivers receiving companion 

services, mental health counseling and hospice services; and a reduction in the degree of caregiver burden, stress and 

depression. Products include screening tools, training materials, Web site information and intervention strategies that 

reduce stress.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

297,121

297,121 442 Civic Center Drive, 11 State House Station

Program: 

Bureau of Elder and Adult Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2781
Page 66 of 223 

Project Care ( Caregivers Running on Empty)

Raleigh, NC 27699-2101

Contact: Karisa Derence 

The North Carolina Division of Aging and Adult Services will implement a new three-year program of consumer-directed 

respite for dementia caregivers in ten counties, building upon prior successes. The program goal is to improve the 

quality, access, choice, and use of respite services. The aging service delivery system will be bolstered by the integration 

of dementia-capable resources into the Family Caregiver Support Program, the new Aging and Disability Resource 

Centers, and the State long-term care plan. Expected outcomes include: 1) expanded availability of dementia-specific 

training, education, and resources; 2) increased family awareness of the value and availability of respite; 3) greater family 

control over services; and 4) increased use of dementia-specific respite care services by low-income rural and minority 

families. Products to be disseminated include: dementia-specific materials on family decision-making and 

consumer-directed service use; guidelines on how to respond to caregiver anger; materials on rural and minority family 

care topics; visiting tips for faith-based volunteers; and a policy paper based on the grant experience and literature 

review. Project staff will report findings to local evaluation and planning committees.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 2101 Mail Service Center 

Program: 

North Carolina Department of Health and Human Services

Aging and Adult Services Division

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2782

Alzheimer's Disease Demonstration Grants to States.

Montgomery, AL 36130

Contact: Lori Frazier 

The State of Alabama, Department of Senior Services will conduct a three-year program to: (1) improve direct services 

available to family caregivers by incorporating Resources for Enhancing Alzheimer's Caregiver's Health (REACH) 

evidence-based, in-home social and behavioral interventions, which promote skill building; and (2) improve Alabama's 

overall system of care by a) incorporating the needs and preferences of persons with dementia into the State's long term 

care system, b) by expanding volunteer services, to include "Caring Teams" that partner with faith-based communities to 

provide in-home and supportive services to families, and c) through Leadership Institutes for Older Adults, which provide 

systems advocacy and volunteer service. Expected outcomes are: a decrease in caregiver burden, as measured by 

feeling of self-efficacy, anxiety and depression; and an increase in access to and knowledge about available services. 

Products will include training manuals on REACH interventions, Alzheimer's Caring Teams, and Leadership Institutes. 

Other products include evaluation tools, Web page information, a final report, and published reports on the impact of the 

Leadership Institute. These products will be disseminated through state and national conferences, to direct service 

organizations and to the Area Agencies on Aging (AAAs).

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 770 Washington Ave, Suite 470 

Program: 

Alabama Department of Senior Services

State Unit on Aging

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2783
Page 67 of 223 

ADDGS Project Expansion and Integration in Nevada

Las Vegas, NV 89102

Contact: Melvin L Phillips (702)486-3545

Nevada's Division of Aging Services will fund and coordinate four dementia-related service providers. These providers 

will target Nevada's rural residents, those with early state dementia, and both urban and rural underserved minorities. 

These and all other dementia-related services will be integrated into all home and community-based services (HCBS) 

networks through the Division's computerized Single Point of Entry (SPE) system. SPE is based on a robust software 

platform ("SYNERGY") that integrates databases, including those providing resources and referral options.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 3100 W. Sahara Avenue, Suite 103 

Program: 

NEVADA DEPT OF HUMAN RESOURCES

Division of Aging Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2784

Memory Care Connections

Madison, WI 53707-7850

Contact: Gail Schwersenka 

This Wisconsin Department of Health and Family Services (DHFS) seeks funding for four demonstrations of Memory Care 

Connections, a model of local collaboration aligning dementia services provided by diagnostic clinics, Aging/Disability 

Resource Centers, Alzheimer's Association Chapters and service providers. The goal is to provide individuals and 

families affected by Alzheimer's disease with the information, medical diagnosis and management, caregiver support and 

services needed to achieve improved quality of life through closely connected local dementia services networks. Local 

sites will be funded to deploy nurses/social workers to link consumers with the dementia service network.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 1 West Wilson Street - PO Box 7850 

Program: 

WISCONSIN DEPARTMENT OF HEALTH AND FAMILY SERVICES

Disability and Elder Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2785
Page 68 of 223 

Tennessee Alzheimer's Demonstration: System Building through Adaption of Best 

Practices

Nashville, TN 37243-0860

Contact: Tabitha Satterfield (615)741-2056

The Tennessee Commission on Aging and Disability will provide respite services for about 300 persons with Alzheimer's 

Disease and their caregivers in five (5) counties. Also, this demonstration brings about the following system level 

outcomes: implementation of the coping with caregiving REACH model in Tennessee; health promotion/disease 

prevention provided to Alzheimer's caregivers in collaboration with the National Family Caregiving Support Program; a 

media campaign to assist the project; implementation of family-directed care in the Tennessee Aging Services; and 

exploration of potential program enhancements for Tennessee in-home services, making them more responsive to the 

needs of caregivers. Project evaluation will be the responsibility of the Tennessee Commission on Aging and Disability.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 500 Deaderick St., Suite 825 

Program: 

Tennessee Commission on Aging and Disability

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2786

Asian and Pacific Islander Dementia Care Networks

Sacramento, CA 95814-4020

Contact: Denise Crandall (916)322-5290

The California Department of Aging (CDA), in coordination with the California Department of Health Services (CDHS) and 

a coalition of community organizations, proposes to develop and expand culturally and linguistically competent services 

for Asian-American, dementia-affected families in Northern and Southern California. The project's goal is to enhance the 

capacity of local health and social service providers to serve Vietnamese, Korean and Chinese dementia-affected 

families. The project's strategy is to build community capacity through coordination of community-based collaboratives; 

training for ethnically diverse professional providers; and service coordination for caregiving families via bi-cultural, 

paraprofessional Care Advocates. Products will include linguistically appropriate educational materials, an updated 

replication manual, tip-sheets for working with the target populations derived from focus group findings, and a manuscript 

on culturally competent dementia services for Asian-Americans.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 1600 K Street 

Program: 

State of California Department of Aging

Director's Office

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2787
Page 69 of 223 

Continuing Partners in Care

Cranston, RI 02920

Contact: Joan D'Agostino (401)462-0500

The Rhode Island Department of Elderly Affairs (DEA), in partnership with three community-based services organizations, 

will support RI's Systems Change Initiatives, particularly the new ADRC, by developing and strengthening statewide 

resources for AD families, especially minority families and those at or near the poverty line. Changes in RI's overall home 

and community-based system of long-term care will result from streamlining access to services and family caregiver 

support services for AD families. An interagency Project Advisory Group, comprised of advocates and consumers, as well 

as AD and aging professionals, will guide and oversee this three-year effort. Process and outcome evaluation will be 

performed; best practices models will be developed; and results will be disseminated locally and nationally.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

294,050

294,050 35 Howard Avenue 

Program: 

Rhode Island Department of Ederly Affairs

John O. Pastore Center

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2788

(INDIANA) Alzheimer's Disease Demonstration Grant to States

Indianapolis, IN 46207-7083

Contact: Jacqueline Bouyea (317)232-7123

Indiana's Bureau of Aging and In-Home Services will enhance support to the Alzheimer's Disease caregivers in Indiana. 

The objectives of this project involve the expansion of the video monitoring technology that allows caregivers to monitor 

persons with Alzheimer's Disease through video cameras and computer software from an off-site location. Indiana will 

seek funding approval through the In-Home Services network, including Medicaid Waivers for these technological 

services that will assist with long-term viability of these services. The Powerful Tools Training that "trains the trainer" will 

be offered statewide to Area Agency on Aging and state staff. Caregivers will learn how to take care of themselves, and to 

access help and community services. Development of a Volunteer Respite Program that targets Alzheimer's caregivers 

will further increase the support tools available. A volunteer coordinator will recruit community help to provide respite 

care. The availability of these support programs will enhance the support statewide for the caregiver.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 402 West Washington Street - PO Box 7083, MS-21 

Program: 

DIVISION OF DISABILITY, AGING & REHABILITATIVE SERVICES

 Indiana Bureau of Aging and In-Home Services

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2789
Page 70 of 223 

New Mexico Alzheimer's Program

Santa Fe, NM 87505

Contact: Lynne Anker-Unnever 

The State of New Mexico Aging and Long-Term Services Department (ALTSD) proposes to develop and implement 

respite care services, particularly community-based adult day care, targeting underserved communities and tribes in rural 

New Mexico. ALTSD will provide regional caregiver support services to be coordinated by Area Agencies on Aging (AAA) 

throughout New Mexico. AAAs will employ regional care coordinators who will provide individual client services, training 

and advocacy. Care coordinators will receive many of their referrals from the ALTSD Aging and Disability Resource 

Center.

Project Period: 07/01/2004 - 06/30/2007

FY Grant Amount

FY 2004

FY 2005

311,150

311,150 2550 Cerrillos Road 

Program: 

New Mexico Aging & Long-Term Services Department

Aging Network Division

Alzheimers Disease Demonstration Grants to States (ADDGS) 301

90AZ2790

BUILDING A FAMILY FRIENDS NETWORK IN WISCONSIN: 

MILWAUKEE/WAUSKESHA PILOT

Madison, WI 53718-6751

Contact: Leslie McAllister (608)224-0606

The Coalition of Wisconsin Aging Groups, Inc., (CWAG), in partnership with United Cerebral Palsy of Southeastern 

Wisconsin and the Respite Care Association, developed a statewide network of Family Friends projects (FFP). The 

project's goal is to link older persons with families who have children with disabilities. The objectives of this FFP project 

are: 1) to pilot the FFP in Milwaukee and Waukesha counties for the first two years of the project; 2) to expand to other 

counties in the third year; 3) to convene a FFP Advisory Council to guide the program; 4) to develop an evaluation protocol 

for the Milwaukee area pilot program, which will require the participation of families, senior volunteers, and representatives 

of community stakeholder groups; 5) to develop best practice standards for developing and maintaining a Family Friends 

program around Wisconsin; and 6) to provide for the training and technical assistance that will be provided for partners 

interested in developing Family Friends projects in their communities. The anticipated outcomes are: a strong partnership 

with Cerebral Palsy and Respite Care Association; a statewide network of FFP; a pilot FFP; a strong Advisory Council; an 

evaluation; a cadre of senior volunteers; best practice standards; trainings; and technical assistance. The products of this 

FFP project are: a final report; pilot projects; a strong coalition for FFP; an evaluation protocol.

Project Period: 09/30/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

80,000

80,000

80,000

2850 Dairy Drive Suite 100

Program: 

Coalition of Wisconsin Aging Groups

Family Friends 302

90AM2404
Page 71 of 223 

FAMILY FRIENDS/VOLUNTEER SENIOR AIDES

New York, NY 10029-6574

Contact: Danielle Laraque (212)241-5866

The goal of the Mount Sinai School of Medicine, Division of General Pediatrics project is to operate a Family Friends 

(FFP) intergenerational program to address the needs of children with special health care needs and their families who 

reside in East Harlem. Children targeted are those in stressful situations who are at risk for, or have been abused or 

neglected infants and children of women who are substance users; children who have a critically ill or dying parent; 

children of women in domestic violence situations; or children who have been abused. FFP project objectives are: 1) to 

establish a Family Friends Program; 2) to utilize the creativity, resources and strength of elders to provide emotional 

support and mentorship to children with disabilities and families under stress; and 3) to support elders in achieving 

fulfillment through networking with other seniors and involvement with children and families in need. The anticipated 

outcomes are: an intergenerational program of young and elderly; services to children with special health needs and to 

their families; a cadre of senior volunteers; and an evaluation. The products of this FFP project are a final report, an 

evaluation, and a strong FFP program.

Project Period: 09/30/2000 - 09/29/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

79,001

79,001

79,001

1 Gustave L. Levy Place, Box 1075 

Program: 

Mount Sinai School of Medicine

Family Friends 302

90AM2405

FAMILY FRIENDS/VOLUNTEER SERVICE AIDE PROJECT

Knoxville, TN 37950-1650

Contact: Barbara H. H Monty (865)524-2786

The goal of the Knoxville-Knox County Community Action Program (KCAP) Office on Aging is to establish a Family 

Friends (FFP)/Volunteer Senior Aides (VSA) program. The objectives of this FFP project are: 1) to select and train 40 

volunteers to provide mentoring, educational and recreational activities, stability, and friendship to 40 families and to 80 

disadvantaged children; 2) to identify families as seeking self-sufficiency through a partnership with a newly developed 

Bridges program, funded to provide intensive case management, job search assistance and training to individuals in the 

nineteen census tracts of the inner city Empowerment Zone; 3) to provide basic computer training for twenty of the Family 

Friends/VSA volunteers; and, 4) to prepare volunteers to better assist the family with educational assignments, and 

increase the potential for recreational activities. The expected outcomes of this FFP project are: a strong FFP; a cadre of 

Volunteer Senior Aides; training for 40 volunteers; a match to 40 families and to 80 children; a Bridges program; intensive 

case management; and job search assistance and training to individuals. The products of this FFP project are a final 

report; a strong FFP project; a cadre of senior volunteers; computer training for 20 volunteers.

Project Period: 09/30/2000 - 03/31/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

79,273

79,273

79,273

2247 Western Avenue, PO Box 51650 

Program: 

Knoxville-Knox County Community Action Committee

Family Friends 302

90AM2406
Page 72 of 223 

FAMILY FRIENDS PROGRAM

Portland, ME 04101-4101

Contact: Susan Lavigne (207)773-0202

The goal of the People's Regional Opportunity Program through its Foster Grandparent Program is to start a Family 

Friends program (FFP) that will use trained older volunteers to reduce the number of neglected and abused children in 

at-risk families. A significant number of families have special parenting challenges (stressors), including: 1) having 

children with special medical needs; 2) parents with special medical needs; 3) families parenting in isolation; and, 4) very 

low income families with children ages zero to three. Learning how to manage these stressors is the project's immediate 

goal. The FFP's objectives are: 1) to match 20 older volunteers with 37 families; 2) to recruit volunteers through existing 

Foster Grandparent recruitment channels, which include the RSVP program, Big Brothers/Big Sisters and through the 

National Senior Service Corps of Maine; 3) to apply a family functioning scale annually; 4) to report enrolled families as 

Outcomes and to report as measures of impact the following reductions in family stress: increased family bonding, 

improvement in family functioning, and overall satisfaction with the FFP. The outcomes of this newly designed FFP are: a 

cadre of trained older volunteers; matched families with a volunteer; a reduction of children at-risk; respite program for 

families and caregivers; reduction in stressors; and increased family bonding.

Project Period: 09/30/2000 - 03/31/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

74,942

74,942

74,942

510 Cumberland Avenue 

Program: 

People's Regional Opportunity Program

Family Friends 302

90AM2407

FAIRBANKS NATIVE ASSOCIATION'S FAMILY FRIENDS PROJECT

Fairbanks, AK 99701-4848

Contact: Clarice Dickess (909)452-1648

The goal of the Fairbanks Native Association (FNA) Family Friends project (FFP) is to start up and implement a culturally 

relevant Family Friends project for the Native population. The grantee (FNA) will do this in partnership with the local Foster 

Grandparent Program and with the National Senior Services Corps (NSSC). The FNA programs, i.e. Head Start, Early 

Start, Life Givers, and the Women and Children's Center for Inner Healing, daily serve the population at highest risk for 

substance abuse and its related problems. The objectives of this FFP program are: 1) to recruit families and children from 

these programs; 2) to support the two other FNA programs, Elders and Forget-Me-Not Assisted Living, with outreach and 

recruitment of appropriate Elder volunteers; and 3) to make fifteen matches in the first year, 20 in the second and 25 in the 

third. The outcomes of this FFP project are: a new FFP; strengthened partnerships; substance abuse care for families 

at-risk; a cadre of volunteers.

Project Period: 09/30/2000 - 09/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

73,446

73,446

73,466

201 First Avenue, Suite 200 

Program: 

Fairbanks Native Association

Family Friends 302

90AM2408
Page 73 of 223 

PEOPLE INC.

Williamsville, NY 14231-4231

Contact: Ilene Simon (716)634-8132

The People, Inc., situated in Williamsville, western New York, designed the Speak Up ! project. The goal is to create a 

model Family Friends program (FFP) for children with developmental delays/disabilities (DD), ages 2-5. This program will 

operate in the western counties of Erie, Niagara, Genesee, Orleans, Allegany, Cattaragus, Chautauga, and Wyoming. The 

objectives of this FFP project are: 1) to use six senior volunteers to provide speech and language development programs 

to 24 children; 2) to select the children from predominantly low-income families in the Buffalo, New York area; 3) to 

improve the children's speech, educate the families in parenting and boost emotional well-being for both volunteers and 

families; 4) to produce a replication manual on how to use this FF/VSA program. The outcomes of this project are: a 

model FFP; support and care for children with DD; a cadre of volunteers; and a speech and language development 

programl. The products of this project are a final report; a replication manual; and training.

Project Period: 09/30/2000 - 03/31/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

40,450

40,450

40,450

1219 North Forest Rd., PO Box 9033 

Program: 

People, Inc.

Family Friends 302

90AM2409

The National Center for Family and Friends

Washington, DC 20024

Contact: Susan Lutz 

The National Council on the Aging, Inc., in partnership with Temple University Center for Intergenerational Learning, 

proposes to enhance the Family Friends program through the development, operation, and management of the National 

Center for Family Friends. In brief, Center objectives are: 1) to establish 6 or 7 new model Family Friends projects; 2) 

facilitate viable Family Friends projects through effective, training, technical assistance and guidance; 3) design and test 

an expansion of the Family Friends model that uses senior volunteers to assist at-risk youth; and 4) improve the 

well-being of older volunteers, parents, children/youth participating in Family Friends sites and to increase the 

understanding of the impact of the program on Family Friends participants. Anticipated outcomes include: 1) expansion of 

a national network of viable Family Friends projects; 2) more effective strategies of older volunteers helping at-risk 

children and youth, improved NCFF and project performance; 3) a positive impact on program volunteers, families and 

children. Products include an improved web and e-group sites, a lessons learned manual, a program evaluation, annual 

conferences, orientations for program directors, site visits to projects, training/technical assistance, and such publications 

as Newsline and E-/FaxNews.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

980,584

980,584

980,584

300 D Street, SW, Suite 801 

Program: 

THE NATIONAL COUNCIL ON THE AGING

Family Friends 302

90AM2770
Page 74 of 223 

Taking Care of Each Other in the Blackfeet Community Focusing on Elders

Browning, MT 59417-9417

Contact: Connie Bremner (406)338-7257

The Blackfeet Nation was awarded a Native American Caregiver Support Program (NACSP) demonstration grant to focus 

on building networks and assisting grandparents caring for grandchildren. Core values to be used in developing the 

Blackfeet Nation NACSP will include: 1) restoring the Blackfeet traditional family values; 2) rebuilding the Blackfeet 

tradition of respect, love, and honor; and 3) taking care of each other in the Blackfeet community. A cornerstone of the 

program will be the development of a network of community service providers to: 1) share expertise across the network; 2) 

support family caregivers, including grandparents taking care of grandchildren; and 3) provide assistance to caregivers to 

improve the quality of care for elders. A Caregiver Training Manual and a Grandparents Raising Grandchildren Support 

Group Training Manual, incorporating Blackfeet traditional and cultural values, will be developed and used to train both 

family caregivers and grandparents caring for their grandchildren. Each manual will contain training sessions, activities for 

each session, and an evaluation form.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

100,000

100,000

P.O. Box 76 

Program: 

BLACKFEET TRIBAL BUSINESS COUNCIL

National Family Caregivers Support Program 303

90CG2509

NATIVE AMERICAN CAREGIVER SUPPORT PROGRAM - DISCRETIONARY GRANT

Oneida, WI 54155-4155

Contact: Tina Pospychala (920)869-2448

This project envisions a team approach for creating an alliance with all twelve Indian Tribes in Wisconsin. This alliance 

will develop a better understanding of caregiver needs in order to work together to leverage additional funding at the 

Tribal, county, state and Federal levels to better serve American Indian caregivers throughout Wisconsin. The goals of 

this project include: 1) creating a solid caregiver network of American Indian aging service professionals, organizations, 

and programs; 2) coordinating and creating an American Indian specific resource manual to include Tribal, non-Tribal, 

local, county, and state resources; 3) reducing barriers to caregivers by providing appropriate information on access to 

resources; and 4) advocating and leveraging funding for Tribal communities. To achieve these goals the program will: 1) 

develop a resource manual and video to target the tribal population; 2) develop a website and LISTSERV for caregivers to 

get information and access resources and services; 3) review and support a training curriculum on caregiving; and 4) 

determine future needs of family caregivers and generate ideas to help smaller Tribes meet their needs today and prepare 

for the future.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

100,000

100,000

P.O. Box 365 

Program: 

ONEIDA TRIBE OF INDIANS OF WISCONSIN

National Family Caregivers Support Program 303

90CG2510
Page 75 of 223 

ALASKA

Juneau, AK 99801-9983

Contact: FRANCINE JONES (907)586-1432

The goal of this project is to increase the level of access to caregiver support services for the Native elderly and their 

caregivers within Southeast Alaska. This program has the following objectives: 1) assess the current status of caregiver 

support within the region, including cultural, financial and geographical barriers; 2) inventory resources that are currently 

available to provide respite care and training to caregivers; 3) develop a program model for caregiver support that reflects 

the unique needs and circumstances and cultural values of the Native elders within the region in need of care; and 4) 

share information with others facing similar challenges in the area of caregiver support. A resource manual will be 

available at the end of the project.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

100,000

100,000

320 W. Willoughby S 300

Program: 

CENTRAL COUNCIL TLINGIT AND HAIDA INDIAN TRIBES

National Family Caregivers Support Program 303

90CG2511

Native American Caregiver Support Program

Pablo, MT 59855-9855

Contact: Jand Clairmont (406)675-2700

The goal of this project is to develop a comprehensive, consumer friendly delivery system to provide services for 

caregivers. The project will provide culturally sensitive services and systems to sustain the efforts of family and other 

informal caregivers. The project has the following goals: 1) bring together all existing in-home service providers to 

brainstorm how they can work together; 2) plan ways to work together as a team; 3) revise current services to meet the 

needs of the caregiver; 4) develop a one-stop service delivery system; and 5) develop policies and procedures and a 

Home Care Attendant Handbook Manual to share with others.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

100,000

100,000

P.O. Box 278 

Program: 

CONFEDERATED SALISH AND KOOTENAI TRIBES

National Family Caregivers Support Program 303

90CG2512
Page 76 of 223 

CHEHALIS AND NISQUALLY TRIBAL CAREGIVER SUPPORT PROGRAM

Shelton, WA 98584-8584

Contact: Amadeo Tiam (360)426-3990

This is a Caregivers' coalition, which includes the Confederated Tribes of the Chehalis Reservation and the Nisqually 

Indian Tribe, working with the South Puget Intertribal Planning Agency. The goal of this project is to increase the level of 

coordination and leverage of resources for caregiver support services for the tribal elderly population within the tribal 

service areas of Thurston, Pierce, and Grays Harbor counties in southwest Washington State. The objectives are: 1) to 

assess the current status of caregiver support within the area, both through tribal and non-tribal programs; 2) to identify 

barriers to accessing these resources, including cultural, financial and geographical barriers; 3) to develop an inventory of 

resources that are currently available to provide caregiver support; 4) to develop and demonstrate a program model for 

maximizing the coordination and leveraging of caregiver support resources; 5) to address the unique needs, 

circumstances and cultural values of the tribal elders within the area in need of care; and 6) to disseminate the project 

model and findings to other tribal groups and organizations facing similar challenges.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

100,000

100,000

2970 SE Old Olympic Hwy 

Program: 

South Puget Intertribal Planning Agency

National Family Caregivers Support Program 303

90CG2513

CAREGIVERS SUPPORT PROGRAM - DISCRETIONARY FUNDS

Honolulu, HI 96813-5125

Contact: Tara McKenzie (808)535-6705

Alu Like, Inc. plans to develop quality standards and mechanisms of accountability for their Caregiver program. The goal 

of this Caregiver project is to establish a multifaceted Native American Caregiver Support Pilot Program consisting of a 

workshop, user friendly/culturally appropriate manuals, direct services, satisfaction surveys and utilization surveys. The 

objectives of this Caregiver project are: 1) to examine the effects of direct services; 2) to provide direct services to support 

family caregivers; 3) to provide financial incentives and compensation in the form of compensations for respite care; 4) to 

conduct pre and post surveys; 5) to conduct periodic surveys to determine the extent of implementation in the homes; and 

6) to conduct assessments of the effectiveness and levels of satisfaction. The expected outcomes of this caregiver project 

are: caregiver quality standards and mechanisms of accountability; a caregiver pilot program; educational workshop; 

caregiver direct services; respite care; and assessments.

Project Period: 09/30/2001 - 09/29/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

100,000

100,000

458 Keawe Street 

Program: 

ALU LIKE, INC.

National Family Caregivers Support Program 303

90CG2514
Page 77 of 223 

ROSEBUD SIOUX TRIBE MULTI-FACETED NATIVE AMERICAN CAREGIVER 

SUPPORT PROGRAM

Rosebud, SD 57570-7570

Contact: Connie Bodeaux (605)747-2960

The goal of this Rosebud Sioux Tribe's American Caregivers Support Services Program (FCSSP) project is to provide 

access to services for caregivers to include counseling services, support groups, caregiver training, information, 

transportation and respite care. The objectives of the FCSSP are: 1) to provide assistance to the caregiver in making 

decisions and problem solving relative to their caregiver roles; 2) to develop an effective and efficient data collection 

system to measure outcomes; 3) to develop a uniform reservation-wide assessment and information system to ensure 

quality of care and policy to support and strengthen family caregiving; 4) to provide 405 caregiver assessments; and 5) to 

have an individual Management By Objectives (MBO) annual plan of action steps summary.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

100,000

100,000

PO Box 430 

Program: 

Rosebud Sioux Tribe Native American Caregiver

National Family Caregivers Support Program 303

90CG2515

KAPUNA CAREGIVER SUPPORT PROGRAM

Hana, HI 96713-6713

Contact: Cheryl Vasconcellos (808)248-7515

The goal of this project is to increase access to available support services and develop additional support services needed 

by caregivers. This will be accomplished by: 1) supporting and enhancing the capability of caregivers to meet the 

functional and health care needs of elders by developing caregiver skills; 2) providing periods of respite for family 

members caring for frail elders; 3) improving the health and quality of life for caregivers; and 4) enabling elders to safely 

remain in their homes and community for the duration of their lives by caring for the caregiver. The Kupuna Caregiver 

Support Program will develop an intensive training curriculum for family caregivers. To participate in the training, family 

caregivers will have to make a commitment to the program by participating in 40 hours of training; attend monthly support 

group meetings; complete evaluations and other surveys; provide care to family members and request assistance from 

the program as needed. The program, in turn, will offer hands-on training experience; monthly support group meetings; 

case management services; assistance to support family caregivers and a monthly stipend to assist family caregivers in 

their role as caregivers.

Project Period: 09/30/2001 - 09/29/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

99,918

100,000

P.O. Box 807 

Program: 

HANA COMMUNITY HEALTH CENTER, INC.

National Family Caregivers Support Program 303

90CG2516
Page 78 of 223 

REDEFINING THE FAMILY GROUP CONFERENCING MODEL FOR ELDERS AND 

CAREGIVERS, THEIR FAMILIES, AND TRIBAL COMMUNITIES

Sequim, WA 98382-8382

Contact: Elizabeth Mueller (360)683-1109

The purpose of the "Empowering Caregivers of Elders" is to provide caregiver support services to families, while 

maintaining the highest degree of elder self-determination. Jamestown S'Klallam will develop a support program for 

caregivers by adapting Family Group Conferencing and matching the approach with the best of family support practices 

for on-going services. The conference allows the development of a plan for the caregiver and the leader that is agreed on 

and supported by the entire family, by creating a "talking circle". Family Group Conferencing empowers those who 

participate by bringing families together and giving them the credit for being able to make good decisions for those who 

are vulnerable. A training manual, "Empowering Caregivers of Elders" will be available at the end of the project. The 

manual will introduce you to the steps in the model and walk you through the process. It will include forms, checklists, 

tips, vignettes and other useful information.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

100,000

100,000

100,000

1033 Old Blyn Hwy 

Program: 

THE JAMESTOWN S'KLALLAM TRIBE

National Family Caregivers Support Program 303

90CG2517

A COLLABORATION BETWEEN BUSINESSES FOR PROFIT AND NON-PROFIT 

THAT ADDRESSES WORKPLACE CAREGIVERS ISSUES

St. Louis, MO 63130-3130

Contact: Ann R. R Barnes (314)726-5766

The grantee manages this three year National Family Caregivers Support Program (NFCSP) entitled "A Collaboration 

Between Businesses for Profit and Non-Profit that Addresses Workplace Caregivers Issues." The target populations are 

the caregivers and their employers. The goal is to address the challenges that employed caregivers and their employers 

face and to create a cost-effective model to allow caregivers to provide quality care while remaining productive on the job. 

The objectives of the project are: 1) to identify employer's awareness of the issues and barriers to their participation; 2) to 

quantify the costs of employee caregiving; 3) to collaborate with organizations to design cost-effective eldercare 

management approaches; 4) to improve access to services and support; 5) to educate employers on caregiver burden 

issues and its impact on them. The outcomes are: employer/caregiver surveys and analyzed data; 1000 employed 

caregivers will have access to a menu of approaches to comprehensive workplace-delivered eldercare management 

services; employers will be more aware of and receptive to workplace eldercare management programs; a model/pilot 

program for employers of all sizes called "The Caring Workplace"; cost-effective eldercare management approaches; a 

business advisory council; a general business education campaign; and a more employer-friendly workplace. The 

products of this project are a final report; and a pilot project with 10 employers.

Project Period: 09/30/2001 - 11/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

178,800

178,800

178,800

6633 Delmar Blvd. 

Program: 

ST. ANDREWS RESOURCES FOR SENIORS

National Family Caregivers Support Program 303

90CG2529
Page 79 of 223 

SUPPORTING OLDER AFRICAN AMERICAN CAREGIVERS: ASSESSING NEEDS, 

BUILDING SKILLS, AND MAINTAINING HEALTH

Philadelphia, PA 19130-3409

Contact: Rodney D. D Williams (215)765-9000

This is a three year demonstration project managed by PCA. The goal of this Caregiver project (FCSP) is to demonstrate 

an innovative model of supplemental services and interventions for older African American female caregivers 65 years 

and older that are caring for a spouse. The objectives of the project are: 1) to improve the caregiver's physical health, 

functional, and emotional health; 2) to disseminate information; 3) to develop an evaluation; 4) to decrease caregiver 

stress; and 5) to implement a telemedicine program. The anticipated outcomes are: maintain and improve caregiver 

health; enhance performance of caregiving tasks, decrease caregiver stress; increase quality of life; a telemedicine 

intervention using in-home telecommunication technology; a demonstration with a short-term nursing intervention; a 

racial/ethnic flexible protocol; an outcome evaluation; prevention of premature institutionalization; training on "Cultural 

Implications of Assessment"; and 200 caregivers served by year three. The products of this Older African American 

Caregiver project are a final report; an evaluation; and "Supporting Older African American Caregivers."

Project Period: 09/30/2001 - 09/30/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

141,097

153,087

120,439

624 N. Broad Street 

Program: 

PHILADELPHIA CORPORATION FOR AGING

National Family Caregivers Support Program 303

90CG2530

CAREGIVER RESOURCE CENTER FOR DEAF AND LATE DEAFENED ELDERS: A 

DEMONSTRATION PROJECT

Boston, MA 02108-2108

Contact: Eliza Lake (617)222-7477

The State Unit on Aging (SUA), i.e., the Executive Office of Elder Affairs, will manage the three year demonstration 

National Family Caregiver Support Program (NFCSP) project. The goal of the Caregivers for the Deaf project is to train 

caregivers in serving the Deaf and Late-Deafened Elders (DALDE), and Hard of Hearing Elders (HOHE). The objectives 

are: 1) to establish a Caregiver Resource Center for Deaf and Late Deafened Elders (CRC-DLDE); 2) to implement this 

project in Pilot Site #1; 3) to develop a public information plan; 4) to conduct a survey; and 5) to replicate the project in two 

other sites. The anticipated outcomes are: outreach; contracts between state and community partners; training programs 

(curricula) that reduce family and caregiver stress; a CRC Daycare Program; a project web site; program evaluation; data 

collection tools; annual report on the findings of pilot site; an ADC-DLDE. The products are: a final report; a Caregiver 

Resource Center for DALDE; an evaluation; articles; brochure; press releases; and training resources.

Project Period: 09/30/2001 - 09/29/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

157,604

157,604

157,604

One Ashburton Place 

Program: 

COMMONWEALTH OF MASSACHUSETTS

National Family Caregivers Support Program 303

90CG2531
Page 80 of 223 

KINSHIP CARE RESOURCE NETWORK

Rochester, NY 14604-1407

Contact: Irene Conveny (585)262-7153

The Catholic Family Center of the Catholic Diocese of Rochester (CCDR) is managing this three year Kinship Care 

Resource Network (KCRN) demonstration project. The goal of this project is to create an accessible, comprehensive 

continuum of services to Kinship Care Families (KCF). The objectives are: 1) to improve access to information and 

services; 2) to extend and coordinate case management services; 3) to improve knowledge and skills of kinship 

caregivers; and 4) to improve knowledge and skills of the professionals who work with the kinship caregivers and their 

families. The anticipated outcomes are: a single entry point; the Provider Resource Network; increased use of case 

management services; free legal clinic and legal consultations; support groups; seminars and workshops; to serve Kinship 

caregivers; increased knowledge as kinship caregivers; professionals work with KCRN; professionals have increased 

knowledge; improved family stability; collaboration with the Salvation Army; and an Intergenerational Kinship Care Camp. 

The products are: a final report; Kinship Care conference materials; a new computer system; training materials for elder 

law attorneys; and fact sheets.

Project Period: 09/30/2001 - 11/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

200,000

200,000

200,000

87 North Clinton Avenue 

Program: 

CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER

National Family Caregivers Support Program 303

90CG2532

MAINE PRIMARY PARTNERS IN CAREGIVING FAMILY CAREGIVER SUPPORT 

PROGRAM

Bangor, ME 04401-4401

Contact: Roberta Downey (207)941-2865

The Eastern AAA, the grantee, directs and manages this 3 year Caregiving demonstration project. The goal of this 

Partners Caregiver project (PCP) is to demonstrate that primary health care can develop an effective and efficient 

caregiver intervention in a rural setting. The objectives are: 1) to demonstrate the effectiveness of a rural PCP as a point 

of early intervention; 2) to show that caregivers will accept and utilize Maine Primary Partners in Caregiving (MPPC) 

interventions; 3) to demonstrate that MPPC interventions will be successful in ameliorating multiple risks of caregiving; 4) 

to show that MPPC community service partnership was established and sustainable; 5) to identify caregivers and refer 

them to the National Family Caregiver Support Program (NFCSP) for services. The outcomes of the Rural Partners 

Caregiver project are: data collection; interviews; model curricula;15 primary care practices; 883 caregivers assessed in 

physician practices; increase in physician referrals from 7 to 137; high level of satisfaction; training and education 

sessions on Penobscot Nation and Pleasant Point reservations; assistance to other AAAs; and an evaluation. The 

products of the Rural project are a final report; data collection; interviews; model curricula; caregiver handbook; tip sheets; 

caregiver workshop curriculum materials; training materials; a Rural Caregiver Best Practice Manual; a rural hotline; 

brochures; and posters.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

200,000

200,000

200,000

450 Essex Street 

Program: 

Eastern Area Agency on Aging

National Family Caregivers Support Program 303

90CG2533
Page 81 of 223 

CUIDANDO CON CONFIANZA (CARING WITH CONFIDENCE)

Tuscon, AZ 85711-5711

Contact: Marian Lupu (520)790-7262

This is a three year National Family Caregiver Support Program (NFCSP). The project partners include the residents and 

the City of South Tucson and COPE Behavioral Services, Inc. The goal of this Caregiver project is to develop, test and 

implement an effective, culturally appropriate and acceptable model of family caregiver support (FCS) designed by 

caregivers in South Tucson, AZ. The objectives of the project are: 1) to identify the demographic characteristics of 

Mexican-American caregivers and elders in South Tucson; 2) to reduce the stress of primary family caregivers; and 3) to 

create a replicable model employed by community caregivers to establish a culturally and linguistically appropriate, 

sustainable model of caregiver support services. The anticipated outcomes are: cooperative agreements with Safe 

Havens, police, and fire departments; trained personnel; established, community focus groups; the development of project 

materials; outreach programs; establishment of Safe Havens; recruitment of caregivers; behavioral health workshops; 

referral services and support groups; data collection; dissemination of results; and an evaluation. The products are a final 

report; a tested family caregiver support model; methods to alleviate the stress and burden experienced by primary 

caregivers; literature on the characteristics of Hispanic caregivers; and a replication manual.

Project Period: 09/30/2001 - 09/29/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

170,540

170,540

170,540

5055 East Broadway Blvd., Suite C104 

Program: 

PIMA COUNCIL ON AGING

National Family Caregivers Support Program 303

90CG2534

SERVING SENIOR CAREGIVERS AND THEIR ADULT CHILDREN WITH 

DEVELOPMENTAL DISABILITIES

Springfield, IL 62701-1789

Contact: Jean Blaser (217)785-2870

The three year National Family Caregiver Support Project (NFCSP) will work with elderly family caregivers of adult 

children with developmental disabilities (DD). The goal of this National Caregiver project is to provide services and support 

to frail elderly caregivers and their adult children with DD to maximize independence. The objectives of the Caregiver 

project are: 1) to identify currently needed services and referrals for both the caregiver (s) and the individual with DD; 2) to 

work with DHS to improve coordination between the service programs for the aged and for DD; 3) to assist caregivers in 

planning for the future needs of the family member with DD; and 4) to expand this project to one area and then to another 

area in Northern Illinois and in Central Illinois. The anticipated outcomes are: outreach to 50 families (DD); identification of 

needed services and referrals; support group; service coordination; identification of barriers to caregiving ; assistance to 

caregivers(DD); workshops; improved policy, practice, theory and research; evaluation; and dissemination. The products 

of this Family Caregiver project are: a final report; data collection; workshop materials; newsletters; and conference 

materials.

Project Period: 09/30/2001 - 12/31/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

174,684

197,226

197,226

421 East Capitol Avenue #100 

Program: 

Illinois Department on Aging

National Family Caregivers Support Program 303

90CG2535
Page 82 of 223 

ELDER CAREGIVERS OF ADULTS WITH DISABILITIES

Harrisburg, PA 17101-1919

Contact: Joan Dougherty (717)783-6207

The three year Innovation Grants (total 28 grants) Program of the National Family Caregiver Support Project (NFCSP) is 

managed by the grantee, the Pennsylvania Department of Aging (PDOA), the State Unit on Aging. The target population is 

elderly primary caregivers of adult children with MR/DD, especially those who are isolated and who struggle in silence 

without community resources. PDOA will partner with two AAAs and local MR/DD advocacy agencies. The goals of the 

project are: to reduce caregiver stress and burden; to reimburse consumers for expenditures out of pocket related to 

caregiving; and to provide resources for all caregiving needs. The objectives of this Caregiver project are: 1) to establish 

an MR/DD service program tailored to individual needs; 2) to allow the consumer to decide how to use the reimbursement; 

3) to develop a comprehensive intake form; 4) to produce an assessment form; 5) to disseminate project information. The 

outcomes of this Caregiver project are AAAs participation; MR/DD referrals; needs and resources of the MR/DD 

community identified; trainings for AAAs and MR/DD staff; evaluation protocols; and reimbursement to caregivers families. 

The products of the project are a final report; fact sheets; and a comprehensive referral form.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

200,000

200,000

200,000

555 Walnut Street, 5th Floor 

Program: 

Pennsylvania Department of Aging

National Family Caregivers Support Program 303

90CG2536

LIFELONG LEARNING AND WELLNESS PROGRAM AT ASIAN COMMUNITY 

CENTER

Sacramento, CA 95831-5831

Contact: Donna Yee (916)393-9026

This is a three year National Family Caregivers Support Program (NFCSP) for elderly Asian families. The goal of this 

Asian Caregivers Project is to address particular, rather than generic, cultural, language, and service system challenges. 

The three objectives are: 1) to build capacity in a multi-cultural community through multi-faceted small group interventions 

and community level events that foster involvement in service oriented activities; 2) to support Asian American and Pacific 

Islanders (AAPI) caregivers to develop culturally appropriate caregiver support resources (products and activities); and 3) 

to incorporate feedback mechanisms. The anticipated outcomes are: programs and services that support the efforts of 

family caregivers (older adults); an exercise/nutrition wellness program; self-help products and activities; concerted 

assistance to improve the accessibility and linkage of services that sustain and provide for caregiver respite; bi-annual 

identification and assessment of targeted community caregiver needs; a survey of 5000 households and findings; a small 

group of caregivers (intervention) recruited; and an AAPI corp of instructors and advisors. The products are: a final report; 

an AAPI Cookbook; and Health Education and Information Presentation (s) with materials.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

163,767

163,767

163,767

7801 Rush River Drive 

Program: 

ASIAN COMMUNITY CENTER

National Family Caregivers Support Program 303

90CG2537
Page 83 of 223 

Aging Caregivers and the Exceptional Child - ACE Project

Tucson, AZ 85411-5411

Contact: Ellie Ward (520)795-3108

This is a three year National Family Caregiver Support Program (NFCSP). The goal of this ACE project is to build a 

multi-faceted Family Caregiver Program that will increase services to grandparents and aging primary caregivers who are 

raising children with Mental Retardation and/or Developmental Disabilities (MR/DD). The objectives of this ACE project 

are 1) to establish the ACE administrative structure; 2) to identify barriers to access and utilization of support services by 

aging caregivers; 3) to design and implement a replicable, six-stage social marketing plan; 4) to establish a pilot voucher 

system; 5) to implement an evaluation component that will monitor project outcomes. The anticipated outcomes are 

findings related to caregivers of children with MR/DD; a consumer-determined replicable model of access to services; 

increased awareness level and attitudinal shift in OAR/DD in the home; increase the body of knowledge regarding aging 

caregivers and children with MR/DD; provision of replicable printed materials for MR/DD; national dissemination; focus 

group's results. The products of this ACE program are a final report; Spanish project materials; printed materials.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

136,537

136,537

136,537

3941 East 29th Street, Suite 603 

Program: 

UNITED CEREBRAL PALSY OF SOUTHERN ARIZONA

National Family Caregivers Support Program 303

90CG2538

ESTABLISHING COMMUNITY CAREGIVING NETWORKS (CARE-NET's) AND 

DEVELOPING A COMMUNITY CAREGIVING CAPACITY INDEX

Americus, GA 31709-1709

Contact: Ronda C. C Talley 

The goal of this Community Caregiving Networks Project is to support community caregiving leaders who will develop 

more coordinated, integrated systems of care in local and regional communities. The objectives of this Caregiver project 

are: 1) to focus on establishing a network of caregiving communities (CARE-NET) within and among 6 Georgia AAA 

districts; 2) to develop a new metric, i.e., the Community Caregiving Capacity Index (CCCI), which will allow communities 

to assess their caregiving strengths and needs; 3) to develop action plans for a coordinated, community-wide response to 

improve caregiving services. The anticipated outcomes of this Caregiver program are: a Community Caregiving Program; 

Community Caregiving Leaders; a caregiving network; 6 active Georgia AAA districts; a new metric CCCI; and improved 

caregiving services. The products of this caregiving program are:: a final report; a CARE-NET start- up and 

implementation guide; an instrument to assess community caregiving capacity; and a community action planning guide.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

150,000

150,000

150,000

800 Wheatley Street 

Program: 

Georgia Southwestern State University

National Family Caregivers Support Program 303

90CG2539
Page 84 of 223 

NJ EASE FOR CAREGIVERS: BUILDING A MULTI-FACETED CAREGIVER SUPPORT 

SYSTEM

Trenton, NJ 08625-0807

Contact: Christine Grant (609)943-3463

The goal of this project, NJ Ease for Caregivers Building a Multi-Faceted Caregiver Support System, is to develop a 

multifaceted support system concerned with the needs of caregivers, broadening the focus of the existing NJ EASE single 

entry system for senior services. The objectives of this Caregiver project are: 1) to develop and implement a uniform 

caregiver assessment; 2) to develop care planning tools; 3) to pilot a staff caregiver training; 4) to modify and create state 

policies to integrate federal and state funded caregiver services; 5) to develop critical pathways for caregiver decision 

making; 6) to develop service coordination protocols to guide worker action; 7) to set caregiver service standards. The 

anticipated outcomes of this caregivers program are: a single entry system for caregiver senior services; a multifaceted 

caregiver support system; a uniform caregiver assessment; care planning tools; caregiver training; state caregiver policies; 

caregiver protocols; and caregiver service standards. The products of this caregiver program are a final report; caregiver 

planning tools; caregiver training materials; caregivers protocols; and caregiver standards.

Project Period: 09/30/2001 - 06/30/2006

FY Grant Amount

FY 2001

FY 2002

FY 2003

250,000

250,000

250,000

P.O. Box 807 

Program: 

New Jersey Department of Health and Senior Services

National Family Caregivers Support Program 303

90CG2540

SELF-DIRECTED CARE VOUCHER PROJECT

Atlanta, GA 30303-3142

Contact: (404)657-5336

This project is being administered by the Georgia Department of Human Resources. The goal of this project, Self-Directed 

Care Voucher (SDCV) project, is to demonstrate a self-directed care model for family caregivers of elderly people. The 

objectives of this SDCV caregiver project are: 1) to increase service options by developing 5 self-directed voucher projects 

in rural areas that can be replicated in other states; 2) to evaluate the effects of self-directed care; 2) to adapt and 

administer a Caregiver Support and Satisfaction Survey to caregivers participating in voucher programs. The expected 

outcomes of this SDCV Caregiver program are: a self-directed care voucher; a self directed care model; increased 

services; 5 rural SDCV projects; replication of SDCV model; an evaluation; and, a SDCV survey. The products of this 

SDCV Caregiver program include a final report, a replication manual, and a professional evaluation of caregiver support 

and satisfaction.

Project Period: 09/30/2001 - 11/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

228,499

228,499

228,499

Two Peachtree Street, NW, Suite 9.398 

Program: 

Georgia Department of Human Resources

National Family Caregivers Support Program 303

90CG2541
Page 85 of 223 

CAREGIVER MARKETING AND INFORMATION CAMPAIGN

Arkansas, KS 67005-7005

Contact: Stacey Boothe (316)681-2144

The goal of this Caregiver project is to develop a marketing and information campaign for Caregivers. The objectives of 

this Caregiver project are: 1) to increase public awareness of caregiving; and 2) to generate referrals to caregiver 

supportive services. The approach consists of a statewide paid media campaign, providing caregiver tips and resources 

utilizing TV, radio, and billboards. A 1-800 Caregiver line is available. Print media are accessed through monthly 

statewide press releases. The outcomes of this Caregiver campaign are: increased earlier self-identification by caregivers; 

greater utilization of caregiver resources; and an increase in public awareness of caregiving. The products of this 

Caregiver Campaign include: a final report; videos of the caregiver shows; reports on effective marketing tools to reach 

caregivers; and copies of the caregiver shows for other states to broadcast.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

200,000

200,000

200,000

P.O. Box 1122 

Program: 

Ten County Aging Board

National Family Caregivers Support Program 303

90CG2542

HEALTHCARE CONSORTIUM OF ILLINOIS

Dolton, IL 60419-0419

Contact: (877)227-3771

The goal of this project, Healthcare Consortium of Illinois, is to establish a Caregivers Assistance Registry and Enhanced 

Support System (CARESS). The objectives of this Caregiver project are: 1) to expand the support system for caregivers; 

2) to enhance coordination and collaboration among service providers; 3) to service 4 predominantly African American 

communities on Chicago's south side; 4) to train case managers on how to assist caregivers; and 5) to recruit a volunteer 

respite corps through local area churches. The expected outcomes of this Caregiver program are: a Healthcare 

consortium; trained case managers; a Caregivers Assistance registry; an expanded caregivers support system; 

coordination and collaboration of service providers; services to 4 African American communities; trained case managers; 

a cadre of respite corps volunteers; and involvement of local area churches. The products of this Caregiver program are: a 

final report; a consortium; a Caregivers Assistance Registry; caregiver training materials.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

249,435

249,435

249,435

1350 E. Sibley Blvd. 

Program: 

Healthcare Consortium of Illinois

National Family Caregivers Support Program 303

90CG2543
Page 86 of 223 

CARE TEAM MODEL: A PROJECT OFFERING CAREGIVER-FOCUSED SERVICES, 

INC. CAREGIVER TRAINING, RESPITE AND RESOURCE COUNSELING

Edina, MN 55436-5436

Contact: Jean Sigford (952)929-1697

The goal of the project, Care Team Model - A Project Offering Caregiver-Focused Services, managed by the grantee, 

Normandale Ministry for Healing and Wholeness, is to offer caregiver-focused services. The objectives of the Caregiver 

program are: 1) to conduct caregiver training, respite and resource counseling; 2) to match each caregiver with a care 

team of volunteers; 3) to offer one on one counseling designed to assist caregivers in navigating the system of resources; 

4) to arrange for community services; 5) to provide training for 30 caregivers as provided through the Red Cross; 6) to 

seek partnership with government; and 7) to seek replication of the model in the greater metropolitan communities of St. 

Paul and Minneapolis. The expected outcomes of the Caregiver program are: increased caregiver services; caregiver 

training; respite training; resource counseling; caregivers matched with a volunteer; one on one counseling; Red Cross 

collaboration; and replication of the model. The products of this Caregiver program include: a final report; new assessment 

protocols; measurement of caregiver stress; Care Team Model Manual; caregiver resource and education materials; and 

videotapes.

Project Period: 09/30/2001 - 11/30/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

77,000

77,000

77,000

6100 Normandale Way 

Program: 

NORMANDALE MINISTRY FOR HEALING AND WHOLENESS

National Family Caregivers Support Program 303

90CG2544

STRENGTHENING THE CAREGIVING PROCESS: A CARE-RECEIVER EFFICACY 

INTERVENTION

Denver, CO 80208-0208

Contact: Enid Cox (303)871-4018

The goal of this project is to examine the knowledge, attitudes, and behaviors of care receivers. The objectives of this 

Caregiver project are: 1) to apply both medical and social science research affirmations of the importance of a sense of 

efficacy and an active role by patients/clients in their care, to positive health and mental health outcomes; 2) to establish 

the central importance of the caregiver/care-receiver relationship in the care process, as noted in caregiver research 

targeting eldercare. (limited focus has been given to interventions that assist older individuals in defining and developing 

competencies in their care receiving role); 3) to demonstrate an empowerment-oriented intervention that increases the 

efficacy of older care receivers in self-care, use of services and support networks, communication skills, and other aspects 

of care receiving; and 4) to assist their caregivers and improve the quality of the overall care process. The expected 

intervention outcomes include increased competency of elders and reduced caregiver stress. The deliverable products of 

this Caregiver program include: a final report; an intervention manual; a training outline for intervention workers; and a 

comprehensive program evaluation report.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

138,666

138,666

138,666

2199 So. University Blvd. 

Program: 

University of Denver (Colorado Seminary)

National Family Caregivers Support Program 303

90CG2545
Page 87 of 223 

INTEGRATING CAREGIVING ACTIONS, RESOURCES AND EDUCATION

Evanston, IL 60201-0201

Contact: David Lindeman (847)492-6810

The goal of this Caregiver project is to implement and evaluate a regional family caregiver education project (RFCEP). 

The objectives of the project, entitled "Integrating Caregiving Actions, Resources and Education" (I -Care), are to: 1) 

improve career outcomes; 2) develop a cadre of experienced trainers; 3) use a "train the trainer" (TTT) approach to 

prepare 120 class trainers and 20 master trainers over 3 years; 4) reach 2,490 Illinois caregivers with an emphasis on 

reaching underserved, minority caregivers across a broad service area, including community-based and residential 

settings; 5) place the evaluation of the caregiver education program and teaching effectiveness of trainers under the 

direction of 2 experienced researchers; and 6) employ comprehensive dissemination strategies, including web-based 

resources, professional and community presentations, and publications. The anticipated outcomes of this caregiver 

program are: a new RFCEP (I-Care); improved careers; a cadre of trainers; a train the trainer (TTT) program; 120 classes 

for TTT; 20 master trainers; outreach to 2,490 caregivers; an evaluation; and a dissemination plan. The products of the 

caregiver program are a final report and TTT materials.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

199,904

199,904

199,904

1603 Orrington Avenue, Suite 1080 

Program: 

Mather Lifeways

National Family Caregivers Support Program 303

90CG2546

OUTREACH AND SUPPORT FOR MALE CAREGIVERS

Richmond, VA 23229

Contact: Bill Peterson (804)662-9325

The goal of this Caregivers project is to demonstrate the results of using special caregiver ombudsmen to reach out to and 

initiate one-on-one contact with male caregivers in 3 regions of Virginia, and to develop outreach strategies targeted to 

male caregivers. This grant is focused on male caregivers, particularly retired military personnel and men living in rural 

farming communities. The objectives of this caregiver project are: 1) to have the ombudsmen work with male caregivers to 

help them share their concerns about their role as a care provider; 2) to utilize services that will help them to continue in 

their role as an effective caregiver; 3) to disseminate an evaluation report to AAAs in Virginia; 4) to make national 

dissemination through the N4A and NASUA; and 5) to make a special effort to have the report available to veterans 

organizations and farm groups. The expected outcomes of this male caregiver program include: a trained caregiver 

ombudsmen for male caregivers; one-on-one contacts in 3 regions of Virginia; outreach strategies to serve male 

caregivers; strengthened caregiver services by retired military males; and trainings in the male role as caregiver. The 

products of this male caregiver program are: a final report; a cadre of male care providers; and an evaluation report.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

200,000

100,000

200,000

1600 Forest Ave., Suite 102 

Program: 

Commonwealth of Virginia

National Family Caregivers Support Program 303

90CG2547
Page 88 of 223 

END OF LIFE PLANNING FOR MULTIETHNIC CAREGIVERS

Honolulu, HI 96822-2319

Contact: Kathryn Braun (808)956-5768

The goal of this project, administered by the University of Hawaii at Manoa (UHM), entitled "End of Life (EOL) Planning for 

Multiethnic Caregiver", is to explore the impact of group targeted messages and individually tailored support on EOL 

planning by multiethnic caregivers receiving Long-Term Care services. The objectives of this Caregiver End of Life 

program are: 1) to identify the caregiving "stage" of participants; 2) to provide 600 caregivers with appropriate message 

booklets and their choice of supplemental support; 3) to track changes in End Of Life knowledge, attitudes, and behaviors 

(KAB); 4) to document culturally linked barriers to End Of Life planning and strategies to address them; 5) to compare the 

costs of each approach; 6) to disseminate information to State Units on Aging (SUA). The anticipated outcomes of the 

program include support and information to multiethnic caregivers; caregiving "stages" of EOL caregivers; assistance to 

600 caregivers; changes in EOL KABs; known culture barriers to EOL planning; and strategies to overcome identified 

cultural barriers. The products of the project include: a final report; booklets on death and dying; and a description of the 

intervention.

Project Period: 09/30/2001 - 12/31/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

128,246

128,246

128,246

2530 Dole Street, SAG D200 

Program: 

UNIVERSITY OF HAWAII AT MANOA

National Family Caregivers Support Program 303

90CG2548

TELEPHONE SUPPORT GROUPS FOR CAREGIVERS

Albany, NY 12210-2210

Contact: Ann Disarro (518)465-3322

The goal of this project, entitled Telephone Support Groups for Caregivers, is to assess the effectiveness of telephone 

support groups (TSG) for caregivers of frail elderly care recipients. The grantee, Senior Service centers of the Albany 

Area, Inc., will administer this grant. The objectives of this TSG program are: 1) to establish a multi-component group 

program that includes emotion-focused coping strategies and support; 2) to implement eight weekly, one and a half-hour 

telephone group sessions; 3) to assess Caregivers about health status; emotional well-being; social support burden; 

pressing problems associated with caregiving; and knowledge and use of community resources for caregiving. The 

anticipated outcomes of this TSG project are: Telephone Support Groups; a cadre of caregivers for frail elderly care 

recipients; emotion-focused coping strategies; 8 weekly one and a half-hour TSG sessions; a caregiver assessment; and 

dissemination of this model. The products include a final report, a manual, and an assessment.

Project Period: 09/30/2001 - 01/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

193,381

199,277

199,277

25 Delaware Avenue 

Program: 

SENIOR SERVICE CENTERS OF THE ALBANY AREA, INC.

National Family Caregivers Support Program 303

90CG2549
Page 89 of 223 

AN OUTCOME BASED SYSTEM FOR ENHANCING THE QUALITY OF CAREGIVER 

SUPPORT SERVICES

Columbus, OH 43215-5928

Contact: Richard LeBlanc (614)644-7967

The Ohio Department of Aging (SUA) is charged with the administration of the "Outcome Based System for Enhancing the 

Quality of Caregiver Support Services" (CS). The goal of this CS project is to design and test an outcome-focused quality 

monitoring system for the range of OAA services that benefit caregivers. The objectives of this CS project are: 1) to 

develop a quality monitoring system (QMS) with input from caregivers, older consumers, the aging network, and service 

providers; 2) to design it with primary emphasis on caregiver needs; 3) to base the principles and standards for quality of 

service on outcomes identified by all the stakeholders; 4) to evaluate a quality assessment system for effectiveness and 

feasibility; 5) to develop recommendations based on caregiver and stakeholder input and the results of the evaluation; and 

6) to use these recommendations to develop a guide for states, area agencies, and providers interested in improving the 

quality of caregiver support services delivered through the aging network. The expected outcomes include: an 

outcome-focused quality monitoring system(QMS); outcomes identified by the stakeholders; an evaluation; 

recommendations; a State, AAA's guide. The products of this CS program are a final report; an evaluation; an 

assessment; and a guide.

Project Period: 09/30/2001 - 03/29/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

198,173

198,173

198,173

50 West Broad Street, 9TH Floor 

Program: 

Ohio Department of Aging

National Family Caregivers Support Program 303

90CG2550

ADULT DAY SERVICES PLUS: A MODEL FOR CARE MANAGEMENT WITH FAMILY 

CAREGIVERS USING ADULT DAY SERVICE

Newton Square, PA 19073-9073

Contact: Karen Reever (610)353-6642

This project, entitled Adult Day Services Plus: A Model for Care Management with Family Caregivers, is administered by 

Mid County Senior Services. The goal of this Caregivers project is to evaluate the addition of caregiver care to adult day 

services. The objectives of this project are: 1) to develop and test care management tools that facilitate targeting where 

caregiver support is needed; 2) to design plans of care for the caregiver that are integrated with the care plan of the care 

receiver; 3) to deliver support in ways to which the caregiver is receptive; 4) to produce a replication manual; and 5) to 

help disseminate the model through professional presentations at conferences and articles in journals and newsletters. 

The expected outcomes of this Caregiver program are: an Adult Day Services-Plus Caregiver model; a program 

evaluation; care management tools; caregiver and care receiver plans; a replication manual; dissemination of the 

Caregiver model; conferences materials; and articles in journals and newsletters. The products of this caregiver project 

are: a final report; care management tools; a replication manual; and conference materials.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

109,935

109,935

109,935

22 Media Line Road 

Program: 

Mid County Senior Services

National Family Caregivers Support Program 303

90CG2557
Page 90 of 223 

TRANSFORMING THE CAREGIVER EXPERIENCE AT THE END OF LIFE: THE 

NATIONAL TRAIN-THE-TRAINER PROGRAM

Largo, FL 33770-3770

Contact: Kathleen Egan (727)586-4434

The goal of this Train the Trainer (TTT) Caregiver project is to provide specialized training for family caregivers providing 

care for persons at the end of life (EOL). The objectives of this TTT Caregiver project are: 1) to assess family caregiver 

needs; 2) to design the Caregiver program; 3) to implement this Caregiver program; 4) to evaluate the program ; 5) to 

provide in-depth training so that hospice and palliative care professionals and family caregivers nationwide can have the 

necessary information regarding caregiving issues particularly at the end of life; 6) to produce a toolkit for all participants in 

the train the trainer program; and 7) to provide the training directly to 210 hospice and palliative care professionals and 

reach approximately 10,000 family caregivers. The expected outcomes of this Caregiver program are: a TTT program 

specialized training for family caregivers who serve EOL persons; and trained 210 professionals and 10,000 family 

caregivers. The products include: a final report; train-the-trainer materials; an assessment; an evaluation; and a toolkit.

Project Period: 09/30/2001 - 03/30/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

199,998

199,965

197,545

300 East Bay Drive 

Program: 

THE HOSPICE INSTITUTE OF FLORIDA SUNCOAST

National Family Caregivers Support Program 303

90CG2560

NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM

Miami, FL 33156-3156

Contact: Steven Weisberg (305)670-6500

The National Family Caregiver Support Program ( NFCSP) is administered by the Alliance for Aging, of Miami Florida. The 

goal of this project is to demonstrate a 24 hour crisis respite and referral program for caregivers of elders and disabled 

adults in Miami-Dade County, Florida. The objectives of the National Family Caregiver Support program are: 1) to 

establish a demonstration Caregiver model program; 2) to provide 24 hour crisis, respite services and referral services for 

caregivers; 3) to provide training for caregivers of elders and disabled adults; 4) to provide access to unscheduled crisis 

respite services; and 5) to conduct an evaluation. The expected outcomes of this NFCSP project are a 24 hour crisis 

respite and referral program for caregivers, and training for caregivers. The major products of this NFCSP program 

include: a replicable model for unscheduled crisis, for respite services; training materials; caregiver policies; and 

caregiver procedures; an evaluation; a caregiver model; and a guide. The evaluation component will produce data 

regarding system effectiveness and the degree to which the model program meets stated goals and objectives.

Project Period: 09/30/2001 - 12/31/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

190,000

190,000

190,000

9500 S, Dadeland Boulevard, Suite 400 

Program: 

ALLIANCE FOR AGING

National Family Caregivers Support Program 303

90CG2563
Page 91 of 223 

PROVIDING ASSISTANCE TO CAREGIVERS IN TRANSITION (PACT)

Martinez, CA 94553-4553

Contact: (925)335-8727

This project, entitled Providing Assistance to Caregivers in Transition (PACT), is administered by the grantee, Contra 

Costa County Employment and Human Services. The goal of this Caregiver project is to support, educate, and empower 

family caregivers who have family members aged 60+, who have recently been placed in a skilled nursing facility (SNF). 

The objectives are: 1) to provide various levels of care coordination for caregivers whose care recipient chooses to 

transition back to the community, as well as to those who remain in the SNF; 2) to evaluate the PACT program; 3) to 

distribute the evaluation report to the aging network. The anticipated outcomes of this program are: empowered family 

caregivers; educated family caregivers to serve family members recently placed in an SNF; care coordination for 

caregivers whose care recipient chooses to transition back to the community and for those who remain in the SNF; an 

evaluation; and dissemination of reports to the aging network. The products of this PACT program are a final report, a 

program evaluation report, and training materials.

Project Period: 09/30/2001 - 06/30/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

203,409

203,409

203,409

49 Douglas Drive 

Program: 

CONTRA COSTA COUNTY EMPLOYMENT AND HUMAN SERVICES

National Family Caregivers Support Program 303

90CG2564

A Multi-State Family Caregiver Mediation Project

Ann Arbor, MI 48103-8103

Contact: Penelope Hommel (734)665-1126

The goal is to effectively manage A Multi-State Family Caregiver Mediation project. The objectives of this Multi-State 

Family Caregiver project are: 1) to use mediation to assist frail older persons and their family caregivers; 2) to address 

and resolve problems and disputes, which all too frequently arise when families face physical, emotional, and financial 

demands of providing long term care to an older family member; 3) to develop a replication manual; 4) to develop and 

disseminate the model during year three; 5) to provide technical assistance and training to state (SUA) and area 

agencies (AAAs) in other states on how to replicate the caregiver mediation projects; 6) to replicate this caregiver 

mediation model; and 7) to evaluate this model program. The expected outcomes of this Family Caregiver program are: 

mediation as an effective caregiver tool that will assist frail elderly and their family caregivers; resolution of family 

problems and disputes; a replication manual; a Family Caregiver Mediation model; technical assistance and trainings to 

SUAs and AAAs. The products of this program are a final report; caregiver mediation as a planning tool; a replication 

manual; a mediation model; an evaluation report; and technical assistance and training materials.

Project Period: 09/30/2001 - 03/31/2006

FY Grant Amount

FY 2001

FY 2002

FY 2003

215,664

215,664

215,664

2307 Shelby Avenue 

Program: 

THE CENTER FOR SOCIAL GERONTOLOGY, INC.

National Family Caregivers Support Program 303

90CG2565
Page 92 of 223 

EARLY DIAGNOSIS OF DEMENTIA: DYADIC COUNSELING FOR FAMILY 

CAREGIVERS AND PARENTS

University Park, PA 16802-6802

Contact: (814)863-9980

The goal of the Pennsylvania State University Dementia project is to provide a structured, time-limited program of dyadic 

counseling to family caregivers and care recipients who are in the early stages of dementia. The objectives of this 

Dementia project are: 1) to develop positive communication patterns between the care giver and the care recipient; 2) to 

increase knowledge and understanding about available services, preferences for care, care values; 3) to increase the care 

recipients active participation in his/her care plan; 4) to disseminate the products to direct service organizations and the 

AAAs. The expected outcomes of this program are: a structured, time-limited Dyadic Counseling; assistance to caregivers 

who work with dementia cases; positive communications between the caregiver and the dementia patient; care for those 

in the early stages of dementia; increased knowledge; and the increased participation in their care plan. The products 

include: a final report; the EDDI treatment manual; care preferences assessment tools; the evaluation tools; manuscripts 

for publication in appropriate journals; and web page information of the results.

Project Period: 09/30/2001 - 03/31/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

150,000

181,000

181,000

110 Technology Center Building 

Program: 

THE PENNSYLVANIA STATE UNIVERSITY

National Family Caregivers Support Program 303

90CG2566

Promoting Systemic Development of State Family Caregiver Support Programs

Washington, DC 20005-0005

Contact: Viginia Dize (202)898-2578

This 3 year cooperative agreement SFCSP project will assist State Units on Aging (SUA) in the systemic development of 

their Family Caregiver Support Programs (FCSP). The goal of this project is to develop a step-by-step method designed to 

bring the system components, i.e. service package, coordination, continuity, quality and effectiveness, into a coherent 

whole. The objectives of this project are: 1) to integrate the state FCSP with home and community-based services 

programs; 2) to provide caregivers with customized services and supports; 3) to use a knowledge development process 

involving experts representing policy, research, administration and advocacy. The anticipated outcomes include a cadre of 

experts and a Project Advisory committee (PAC). The products of this project are: a final report; TA materials; a guide; 

State Experience Reports; power point presentations; fact sheets; symposia materials; executive summaries; a 

self-assessment tool; research briefs.

Project Period: 09/30/2002 - 12/31/2004

FY Grant Amount

FY 2002

FY 2003

185,000

185,000 1201 15th Street, NW, Suite 350 

Program: 

National Association of State Units on Aging (NASUA)

National Family Caregivers Support Program 303

90CG2626
Page 93 of 223 

Caregiver Coalitions Research Project

Washington, DC 20049-0049

Contact: Ellen Lebowitz (202)434-2787

The grantee, the AARP Foundation, is managing this 2 year cooperative agreement entitled Caregiver Coalitions 

Research Project (CCRP). The goal of this CCRP project is to support the implementation of the National Family 

Caregiver Support Program (NFCSP) by fostering the development of caregiver coalitions at the state and community 

levels. The objectives of this project are: 1) to research the benefits of caregiver coalitions; 2) to promote expansion of the 

program; 3) to conduct outreach; 4) to perform an evaluation of caregiver services; 5) to collaborate with AoA; 6) to 

present trainings at local, state, regional and national aging conferences; and 7) to develop and disseminate publications 

and technical assistance tools. The expected outcomes of this AARP project are: a literature review; research; caregiving 

coalitions; an inventory of program materials; six focus groups; a TA Log; and an expanded website. The products of this 

project are: a final report; results of research; a compendium; an inventory of program materials; training materials; a 

guide; and conference materials.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

150,000

150,000 601 E Street NW 

Program: 

AARP FOUNDATION

National Family Caregivers Support Program 303

90CG2627

Caregiver Adaptations To Reduce Environmental Stress (CARES)

Los Angeles, CA 90089--114

Contact: George-Ann Cleary (213)740-6062

The two-year cooperative agreement between AoA and the University of Southern California (USC) provides for 

substantial involvement and collaboration with AoA. The goal of this Caregivers project is to create and stimulate 

improved systems of supportive services that increase caregiver utilization of environmental coping strategies (ECS) to 

reduce physical burden and strain. The objectives of this project are: 1) to assess caregiver awareness, as well as aging 

network knowledge, strategies and activities designed to assist caregivers in utilizing ECS in their own homes or in the 

homes of care recipients; 2) to educate aging network service providers on how to effect systems change in delivering 

special services; 3) to stimulate aging network activities that address physical caregiver burdens and stresses, including 

collaborating with other key entities such as Centers for Independent Living; and 4) to test and evaluate strategies by 

service providers to enhance caregiver ECS for dissemination and replication by others. The expected outcomes are: 4 

focus groups of caregivers; new knowledge to AAAs; caregiver workshops; on-line training; reduced caregivers burden 

and strain; ECS To Caregivers; and fact sheets. The products of this project are: a final report; all relevant products and 

documents on website; workshop materials; fact sheets and a "Best Practices" booklet; teleconference materials; and a 

literature review.

Project Period: 09/30/2002 - 12/31/2004

FY Grant Amount

FY 2002

FY 2003

150,000

148,991 Department of Contracts and Grants University Park, Mail Code 1147

Program: 

UNIVERSITY OF SOUTHERN CALIFORNIA

National Family Caregivers Support Program 303

90CG2628
Page 94 of 223 

Educating, Training and Supporting Informal Caregivers in Their Homes

Cincinnati, OH 45203-5203

Contact: Arlene de Silva (513)345-8611

This is a two-year cooperative agreement between AoA and the Council on Aging of Southwestern Ohio (COA). The AAA 

No.7 is a subcontractor to the grantee, the COA. A second sub-contract is with Scripps Gerontology Center at Miami 

University, who will do the evaluation. The goal of the project is to reduce caregiver stress, burden, and injuries, and 

increase caregiver knowledge of appropriate care strategies, thereby allowing caregivers to continue in the role and to 

improve the quality of the care they provide. The target group for this program will be the referrals from discharge planning 

social workers at hospitals and nursing homes, adult day centers, senior centers and social service agencies. The 

objectives of this Caregivers project are: 1) to support the National Family Caregiver Support Program (NFCSP); 2) to 

design programs for family caregivers; 3) to implement programs for family caregivers; 4) to evaluate an in-home training 

program for family caregivers; 5) to conduct trainings at aging conferences; and 6) to provide skills to family caregivers. 

The expected outcomes are: identification of caregivers at community sites; 150 caregivers trained in their home; 

evaluation on the reduction of stress, depression and reduced injuries; an increase in knowledge, skills and confidence 

(KSC) in their caregiving skills; and all relevant products and documents on website. The products of this project are a 

final report; training materials; an evaluation; a caregiver training manual; and a TA log.

Project Period: 09/30/2002 - 03/31/2005

FY Grant Amount

FY 2002

FY 2003

150,000

150,000 644 Linn Street Suite 1100 

Program: 

COUNCIL ON AGING OF SOUTHWESTERN OHIO

National Family Caregivers Support Program 303

90CG2629

Caregiver Awareness through Resources and Education for Professionals

San Francisco, CA 94103-4103

Contact: Jim Emerman (415)974-9628

The cooperative agreement between AoA and the American Society on Aging (ASA) is a three-year project. The goal is to 

increase the ability of healthcare professionals, specifically social workers, occupational therapists and nurses, to identify 

the needs of family caregivers they encounter in daily practice; and to link these family caregivers to needed services, 

including those provided through the NFCSP program and the aging network. The objectives of this Caregiver project are: 

1) to develop and disseminate a CD-ROM and web-based self study program; 2) to provide training at national and 

regional conferences; 3) to provide training through 12 phone/Web live e-seminars; 4) to survey social workers, nurses 

and OTs to access awareness of NFCSP and family caregiving issues. The expected outcomes of this project are 10,000 

professionals trained; assess the training needs of nurses, social workers and OTs; survey data; 7 Module curriculum on 

family caregiving; training materials; continuing education credits (CEC) for nurses and others; series of 3-5 e-learning 

programs on website; TA Log; all relevant products and documents on website; recognition of Family Caregivers as a 

group with distinct needs; Continuing Education Credits; and an evaluation. The products of this project are: a final report; 

16,000 copies of the CD-ROM program; dissemination; training workshops materials; CECs; a 7 Module curriculum; and 

3-5 e-learning programs on website.

Project Period: 09/30/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

184,846

234,346

25,000

833 Market St, Suite 511 

Program: 

AMERICAN SOCIETY ON AGING

National Family Caregivers Support Program 303

90CG2630
Page 95 of 223 

The State of the States in Family Caregiver Support

San Francisco, CA 94104-4104

Contact: Lynn Friss Feinberg (415)434-3388

This project, entitled The State of the States in Family Caregiver Support, is a three-year cooperative agreement between 

AoA and the Family Caregiver Alliance (FCA). The goal of this FCA Caregiver project is to stimulate development of 

public policies and programs that support family and informal caregivers of the elderly and persons with disabilities. The 

objectives of the project are: 1) to increase understanding of the range and scope of federal and state funded caregivers 

support programs in each of the 50 states; 2) to assist the aging network in program development and identification of 

best practices; and 3) to collect data on caregiver services under the NFCSP, Medicaid waivers, State General Funds, 

System Change grants, and other State funding streams. The anticipated outcomes are: a three year state legislative 

trend analysis; a state-specific database; an updated FCA website; an FCA TA Log; and all relevant products and 

documents on its website. The products of this project are a final report; 50 State survey; and briefing materials.

Project Period: 09/30/2002 - 11/30/2004

FY Grant Amount

FY 2002

FY 2003

191,400

191,400 690 Market Street, Suite 600 

Program: 

FAMILY CAREGIVER ALLIANCE

National Family Caregivers Support Program 303

90CG2631

Communicating Effectively with Healthcare Professionals Project

Kensington, MD 20895-0895

Contact: Andrew T. T Zovko (301)942-6430

The goal of this two-year Caregiver project is to train family caregivers to advocate on behalf of their loved ones with 

health care professionals, and to deliver a continuity of care and access to the health care resources needed by both the 

caregiver and the care recipient. The objectives of this project are: 1) to provide caregivers with specific communication 

skills; 2) to allow family caregivers to function as a member of the health care team; 3) to conduct regional 

train-the-trainer (TTT) workshops; and 4) to establish a national cadre of experts who can train caregivers. The expected 

outcomes of this project are: a trained network of 500 workshop leaders; 250 persons trained each year; trainers to train 

15,000 family caregivers in two years; one workshop leader training conference in each of AoA's 10 regions; feedback 

from trainers and caregivers; trainer and caregiver evaluations; quarterly AoA project teleconference calls; and an updated 

website. The products of this Caregiver project are a final report; a national cadre of experts; a curriculum; training 

materials; and a TA Log.

Project Period: 09/30/2002 - 02/28/2005

FY Grant Amount

FY 2002

FY 2003

150,000

150,000 10400 Connecticut Avenue, Suite 500 

Program: 

NATIONAL FAMILY CAREGIVERS ASSOCIATION

National Family Caregivers Support Program 303

90CG2632
Page 96 of 223 

National Center on Grandparents and Other Relatives Raising Children

Washington, DC 20001-0001

Contact: Ana Beltran (202)638-0259

The goal of this three-year cooperative agreement between AoA and the grantee is to implement the National Family 

Caregivers Support Program (NFCSP) by establishing a National Center on Grandparent and other Relatives Raising 

Children. The objectives of this project are: 1) to recruit a national network of experts; 2) to provide training and technical 

assistance to the aging network; 3) to collaborate with AoA; 4) to present trainings at local, state, regional and national 

aging conferences; 5) to develop and disseminate publications and TA Tools; and 6) to provide skills to the aging network 

to more appropriately respond to the needs of these caregivers. The expected outcomes of this project are a survey; 

increased network of expert trainers; provision of TA to 350 individuals request by year two; dissemination of fact sheets; 

and an updated website. The products of this Caregiver project are a final report; a technical assistance log; conferences 

materials; training materials; publications; TA tools; a literature review; fact sheets; a manual; a tool kit; and products and 

documents on the website.

Project Period: 09/30/2002 - 12/31/2004

FY Grant Amount

FY 2002

FY 2003

185,000

185,000 122 C Street, NW, Suite 820 

Program: 

GENERATIONS UNITED

National Family Caregivers Support Program 303

90CG2633

Applying the NFCSP to Caregivers of Persons with Developmental Disabilities

Silver Spring, MD 20910-0910

Contact: Sharon Davis (301)565-5456

The goals of this three-year cooperative agreement, a Developmental Disabilities (DD) Caregiver project, are: to assist the 

State Units on Aging (SUA) with the implementation of the NFCSP project and to integrate these services into the existing 

aging and home and community-based service system. This project will enhance awareness and abilities of SUAs, AAAs, 

and local provider agencies to provide these services to grandparents and related caregivers of children and adults with 

DD. The objectives of this DD Caregiver project are: 1) to provide a collaborative training program for the aging network; 

2) to provide TA to SUAs, AAAs and service provider organizations; 3) to work for the adoption of culturally and ethnically 

sensitive outreach and service delivery; 4) to identify best practice approaches to service delivery for family caregivers; 

and 5) to disseminate project resource materials to additional audiences. The expected outcomes are: TA and training; 

training workshops at 2-3 national meetings; Internet materials and resources; an aging family caregiver model; state's 

best practices; and an updated ARC website. The products of this Caregiver project are: a final report; training materials; 

TA materials; and best practices in service delivery to Caregivers.

Project Period: 09/30/2002 - 03/31/2005

FY Grant Amount

FY 2002

FY 2003

184,997

184,997 1010 Wayne Ave. Suite 650

Program: 

THE ARC OF THE UNITED STATES

National Family Caregivers Support Program 303

90CG2648
Page 97 of 223 

Transportation Solutions for Caregivers

Chicago, IL 60606-0606

Contact: Lisa Peters (312)551-7189

This is a three-year Caregiver cooperative agreement whose goal is to enhance the aging network's capacity to address 

transportation issues of caregivers and their loved ones. The objectives of this project are: 1) to provide specialized 

services that address the fears of elders and their caregivers; 2) to plan for transportation alternatives; 3) to provide 

community planning to serve transportation-dependent individuals; 4) to provide volunteer-based, low-fare services; 5) to 

provide education for caregivers on mobility alternatives; 6) to enhance the networks expertise through tools, training and 

technical assistance; and 7) to recommend policy changes that encourage coordination and flexibility. The expected 

outcomes include: 15 national partners in the National Advisory Council; five train-the-trainer workshops; trainings for 200 

Faith-in-Action organizations; TA and Peer Mentoring for all Trainers; and workshops at four national conferences. The 

products of this Caregiver project are a final report; a Transportation Tool Kit for Caregivers in Spanish; a Transportation 

Solutions package for Practitioners; Train-the-Trainer Workshop materials; and TA and Peer Mentoring materials.

Project Period: 09/30/2002 - 12/31/2004

FY Grant Amount

FY 2002

FY 2003

184,997

199,983 230 West Monroe Street, Suite 1800 

Program: 

EASTER SEALS, INC.

National Family Caregivers Support Program 303

90CG2649

Making the Link: Connecting Caregivers with Services through Physicians

Washington, DC 20036

Contact: Adrienne Dern (202)296-8130

The goal of this Caregiver two-year cooperative agreement between the Administration on Aging (AoA) and the National 

Association of Area Agencies on Aging (NAAAA) is to strengthen the ability of Area Agencies on Aging (AAAs) and Title 

VI's (OAA) Native American aging programs to serve family caregivers via a campaign to involve physicians in identifying 

caregivers and then referring them to National Family Caregivers Support Program (NFCSP) services. The objectives of 

this project are: 1) to create the strategies and tools AAA and Title VI (OAA) need to collaborate with local physicians; 2) to 

promote within the medical community the concept that caregiving is a public health issue; 3) to increase awareness 

among physicians of the important health care role of family caregivers; and 4) to enhance the ability of physicians to 

connect caregivers with NFSCP services. The expected outcomes are linkages between AAA and Title VI programs and 

local physicians; linkages between physicians and family caregivers to connect caregivers with services; an Advisory 

Board; and a team of 120 AAAs and Title VI programs. The products are: a final report; TA materials; training materials; 

Caregiver Resource Packets for Physicians; a questionnaire; a strategy kit; and conference materials.

Project Period: 09/30/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

149,950

149,950 1730 Rhode Island Avenue, NW, Suite 1200 

Program: 

NATIONAL ASSOCIATION OF AREA AGENCIES ON AGING

National Family Caregivers Support Program 303

90CG2650
Page 98 of 223 

Educating State Legislators about Caregiver Support

Washington , DC 20005

Contact: Virigina L Dize (202)898-2578

The National Association of State Units on Aging (NASUA) and the National Conference of State Legislatures (NCSL) 

submitted an unsolicited proposal to train state legislators and staff on caregiving issues. This one year grant will have the 

following outcomes:

1. Conduct focus groups of state legislators.

2. Prepare state specific profiles for state legislators on caregiving statistics, and place on NASUA and NCSL websites 

with other caregiving materials

3. NCSL will have a session on caregiving at their annual conference and AoA will be invited to exhibit.

4. NCSL will incorporate articles on caregiving in their State Health News.

5. Information will be made available to legislators for inclusion in speeches, newsletters, and bulletins.

Project Period: 09/30/2004 - 12/31/2005

FY Grant Amount

FY 2004 100,000

1201 15th Street N.W. Suite 350

Program: 

NATIONAL ASSOCIATION OF STATE UNITS ON AGING

Center for the Advancement of State Community Service

Educating State Legislators about Caregiver Support 398

90AM2834

Research on Young Caregivers

Bethesda, MD 20814

Contact: Gail Gibson Hune (301)718-8444

The National Alliance for Caregiving (NAC), in collaboration with the United Hospital Fund (UHF), will conduct research to: 

1) determine the nationwide prevalence of children ages 8-18 who are caregivers; 2) learn what role children play in 

giving care and; 3) learn how the caregiving role impacts the life of a child. Nearly all studies of U.S. caregivers have 

focused on adults who provide care. Very little is known about the prevalence of children serving as caregivers in this 

country. This research will be a starting point for determining the impact of caregiving on young people and developing 

policy solutions to meet their needs. After collecting the data, the project partners will prepare a report that will be released 

at a conference in Washington. DC., for professionals with an interest in family caregiving, members of the press, and 

Congressional staff. The final report will also be disseminated to NAC members, UHF's mailing lists, AoA's aging network, 

and Congressional offices. The report will also be made available on the NAC, UH, and AoA web sites. The anticipated 

outcome of this project will be to increase awareness of the issues facing young caregivers, with the goal of adapting or 

creating services to accommodate their special needs.

Project Period: 09/30/2003 - 12/31/2004

FY Grant Amount

FY 2003 124,970

4720 Montgomery Lane, 5th Floor 

Program: 

National Alliance for Caregiving

Research on Young Caregivers 399

90AM2805
Page 99 of 223 

TECHNICAL ASSISTANCE PROJECT FOR STATEWIDE LEGAL HOTLINES

Washington, DC 20049-0049

Contact: (202)434-2787

The goal of the AARP Foundation project is to provide training, capacity building and technical assistance to the Senior 

Legal Hotlines (SLH ) network, as well as to programs planning the development of legal hotlines to maintain the quality 

and integrity of the legal hotline service delivery model. The Foundation proposes to combine new and proven techniques 

to achieve its purpose. The objectives of this SLH program are: 1) to build program capacity; 2) to maintain the integrity of 

the legal hotline model; 3) to provide training and technical assistance (T and TA) to the newly funded grantees from their 

development and operation phases through their transitional phase; 4) to guarantee to become self-supporting at the 

conclusion of Administration on Aging funding; 5) to support existing statewide senior hotlines via site visits, on-call 

technical support, teleconferences, web sites, interactive web board, and newsletters; 6) to promote knowledge and 

support of legal hotlines through expansion of the Legal Hotline Technical Assistance Library, Web boards, newsletters, 

and conference presentations; 7) to promote the adoption of the American Bar Association's (ABA) proposed standards 

governing legal hotlines; and 8) to use these standards as a quality assurance tool. The outcomes are: a stronger SLH 

network; a SLH service delivery model; and training and TA. The products are a final report and website materials.

Project Period: 08/01/2001 - 09/29/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

FY 2004

100,000

100,000

100,000

100,000

601 E Street NW 

Program: 

AARP FOUNDATION

Legal Assistance and Technical Projects 401

90AM2467

Legal Helpline for Elder Kentuckians

Lexington, KY 40508

Contact: Jamie Odle Hamon (859)255-9913

The grantee for this three-year Legal Hotlines project will target low-income seniors in remote, rural Kentucky, seniors with 

low-literacy levels and the disabled. The Legal Hotline project will partner with the State library system, senior center staff, 

nursing home ombudsman program staff and other senior services staff. The goal of this Legal Hotline project is to 

provide legal and non-legal advice and referral, while expanding and strengthening the existing hotline to low-income rural 

seniors. The objectives of this Legal Hotline project are: 1) to expand and strengthen the HelpLine's services by 

emphasizing the use of technology; 2) to design a Pilot Rural Outreach Project; and 3) to establish a program to assist 

seniors, and provide training to volunteer attorneys. The anticipated outcomes are: legal assistance provided to 13,100 

seniors over three years; statistical data provided by the Pilot Rural Outreach Project; methodology and data 

disseminated to other senior legal hotlines, the Administration on Aging, AARP, and other stakeholders in the senior 

hotline community; educational materials for seniors provided; service providers and volunteer attorneys consulted on 

consumer law issues; and a legal assistance hotline will be established and helpline services will be available. The 

products are a final report; dissemination materials; and training materials on predatory lending.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

100,000

100,000

100,000

535 West Second Street, Suite 101 

Program: 

ACCESS TO JUSTICE FOUNDATION

Legal Assistance and Technical Projects 401

90AM2668
Page 100 of 223 

Senior Hotline Innovation Project

Washington, DC 20049-0049

Contact: Wayne Moore (202)434-2149

This is a three year Statewide Legal Hotline Innovation Project that will serve Washington DC's ethnic and racial minority 

seniors, especially African Americans and persons with low-incomes. The Legal Counsel for the Elderly has opened an 

outreach office in a multi-service community agency serving seniors. The agency also works closely with the DC Office on 

Aging, the Legal Aid Society, Catholic Charities and the Washington Legal Clinic for the Homeless. The goal of this Legal 

Hotline project is to provide and deliver legal assistance to elderly African-Americans who want and need legal advice and 

referral. The objectives are: 1) to double the productivity of Hotline staff; 2) to use staff-supervised non-attorney volunteers 

to resolve brief services cases; and 3) to use staff-supervised non-attorney volunteers to provide legal services to African 

American and other minority seniors at community agencies and faith-based organizations; 4) to evaluate in-house and 

disseminate to legal/aging network. The anticipated outcomes are: increased productivity and decreased the cost per case 

of hotlines; a new way of handling brief services; develop a low-cost method of targeting hotline services for 

disadvantaged populations by using non-legal volunteers to assist seniors via a website; three legal innovations; and a 

volunteer corp of non-attorneys. The products are a final report and an evaluation. .

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

110,000

110,000

110,000

601 E Street, NW 

Program: 

Legal Counsel for the Elderly

Legal Assistance and Technical Projects 401

90AM2669

Legal Hotline for Michigan Seniors Coordinated Economic Assistance Project

Lansing, MI 48933-8933

Contact: Kate White (517)485-9164

This three year project has close ties with local legal services providers, Area Agencies on Aging, insurance counseling 

programs, AARP, senior centers, law schools, veterans programs, and the state and local ombudsman programs. 

Targeted populations are Seniors over 60, disadvantaged elders, elders with limited English proficiency, and low income 

and rural elders. The goal of this Legal Hotline project is to increase the number of seniors served and educated on how to 

protect themselves from debt and steps to resolve indebtedness. The objectives of the project are: 1) to serve seniors with 

an expanded traditional hotline; 2) to provide opportunities for seniors to find new resources for health care; 3) to improve 

their economic well being; 4) to use a new comprehensive Coordinated Economic Assistance Screening Tool; 5) to focus 

on Veterans benefits, unclaimed pensions, Medicare/Medicaid, state tax credits, and other benefits; 6) to provide brief 

services for bankruptcy and debt protections; and 7) to use retired social workers. The anticipated outcomes are: a list of 

seniors out of debt; an increased awareness in seniors on how to protect themselves from debt and steps to reduce 

indebtedness; opportunities for seniors to find new resources for health care and other benefits; increased legal services 

to a significant number of seniors; and trained law students, retired social workers and legislative staff. The product is a 

final report.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

149,711

149,711

149,711

221 N. Pine Street 

Program: 

ELDER LAW OF MICHIGAN, INC.

Legal Assistance and Technical Projects 401

90AM2670
Page 101 of 223 

Maryland Senior Legal Hotline

Baltimore, MD 21202-1202

Contact: William Stokes (410)539-5340

This three year, well-established Maryland Senior Legal Hotline project will serve socially and economically disadvantaged 

seniors over age 60, with special emphasis on Asian Americans, Spanish-speaking seniors and seniors with low literacy 

levels.The Legal Aid Bureau will partner with various Asian American and Spanish advocacy and community groups. The 

goal of this Legal Hotline project is to provide accessible, high-quality legal information and assistance to seniors. The 

objectives of the project are: 1) to improve services to non-English seniors; 2) to provide callers at intake/access points 

with up-to-date legal information; 3) to educate seniors in debt collection and garnishment cases. The anticipated 

outcomes are: improved legal services; provision of the most accurate, up-to-date elder law information; 600 seniors 

receiving advice on debt collection issues each year; updated law outlines; products dissemination; and an expanded 

hotline. The products of this project are a final report, an evaluation, and a website.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

125,000

125,000

125,000

500 East Lexington Street 

Program: 

Legal Aid Bureau, Inc.

Legal Assistance and Technical Projects 401

90AM2671

Statewide Senior Legal Helpline

Augusta, ME 04338-2723

Contact: Jennifer Minkowitz (207)621-0087

This is a three year project targeted to rural, low literacy and limited English language elders, victims of elder abuse and 

legally challenged seniors. The Legal Services for the Elderly will work with Area Agencies on Aging and community 

health centers, the Elder Abuse Task force of Mid-Coast Maine, Adult Protective Services, AARP, Family Crisis Service, 

Volunteers of America, local law enforcement agencies, and clergy. The goal is to improve access to legal assistance. The 

objectives of the project are: 1) to improve client service delivery system; 2) to use an outcomes-based model; 3) to create 

new legal resources; 4) to expand access in rural areas; 5) to build a coalition of community and law enforcement 

organizations; 6) to conduct elder abuse outreach and education; 7) to implement a pilot program to reduce barriers 

towards uses of telephone services. The outcomes of this project are: positive outcomes for seniors using Hotline 

services; seniors knowledgeable about legal issues; identification and prevention of legal problems; local legal community 

resources for seniors; available community organizations; more knowledgeable caregivers; seniors for whom telephone 

service presents barriers have greater access to legal services; rural community health center kiosks; new legal 

resources; a coalition of partners; a pilot program on telephone service. The product is a final report.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

110,000

110,000

110,000

9 Green Street, P.O. Box 2723 

Program: 

LEGAL SERVICES FOR THE ELDERLY

Legal Assistance and Technical Projects 401

90AM2672
Page 102 of 223 

Connecticut Legal Services Consumer Law Project for Elders

Middletown, CT 06457-6457

Contact: Kevin Brophy (203)756-8074

This three year Statewide Legal Hotlines project serves seniors who have consumer law problems, with a focus on 

Hispanic, African American, rural elderly, and members of faith-based organizations. Partners in planning and 

implementing this project include Area Agencies on Aging (AAAs), sister legal services organizations and the Episcopal 

Diocese. The goal of this project is develop a hotline that will provide telephone access and high quality legal services to 

seniors who have legal consumer problems. The objectives are: 1) to make the system easy for clients to access hotline 

staff through direct calls or referrals; 2) to train AAAs to spot issues; 3) to make cross referral of clients; 4) to develop 

extensive outreach to minorities and rural elderly clients, and to faith based organizations; and 5) to provide a full service 

response to hotline clients. The anticipated outcomes are: enhanced collaboration and synergy among senior consumer 

law providers; increased capacities and capabilities of AAAs and other non-legal service partners to identify consumer law 

issues and make appropriate referrals; improved quality and accessibility; and friendly telephone access. The products of 

this project are a final report, an evaluation, and training materials.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

125,000

125,000

125,000

62 Washington Street 

Program: 

CONNECTICUT LEGAL SERVICES, INC.

Legal Assistance and Technical Projects 401

90AM2673

Serve Our Seniors Legal Telephone Hotline

Columbia, SC 29202

Contact: Teresa Cosby (864)679-3232

This is a three year Statewide Senior Hotline project to serve seniors over 60, low-income, isolated rural poor, 

limited-English speaking, seniors victimized by crime, and seniors with disabilities. This grantee has a Memorandum of 

Partnership signed by over 50 aging service providers including Area Agencies on Aging, every Council on Aging, 

numerous senior centers, housing programs, Adult Protective Services programs, United Way, YWCA and other non-legal 

agencies. The goal of this project is to enhance access to and improve the current legal services intake system. The 

objectives are: 1) to place the hotline in the Legal Aid Telephone Intake Service; 2) to provide counsel and advice and 

extended service for those senior callers with legal needs; 3) to refer callers to senior service organizations with non-legal 

needs; and 4) to produce an employee and volunteer training manual, a senior resource guide for callers. The anticipated 

outcomes are: resolved senior's legal issues; 12 seniors to have called the hotline equaling 1152 per year; 875 seniors will 

have received counsel and advice; 277 seniors will have received extended services through Serve Our Seniors; and the 

outreach component of the hotline will have reached 3000 seniors. The products are a final report; a training manual; a 

resource guide; and public relations materials.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

104,040

104,040

104,040

2109 Bull Street 

Program: 

THE SOUTH CAROLINA CENTERS FOR EQUAL JUSTICE

Legal Assistance and Technical Projects 401

90AM2674
Page 103 of 223 

Establish and Operate a Statewide Senior Hotline in Idaho, the Third Most Rural State in 

the Nation

Boise, ID 83702-3702

Contact: Kelly Miller (208)336-8980

This is a three year statewide Legal Hotline project that will serve the rural elderly, with an emphasis on those in the 

greatest social and economic need, Hispanic and Native American seniors, and seniors with disabilities. The collaborators 

will include the six Area Agencies on Aging in the state, Idaho Hispanic Commission, Idaho State Library system, state 

and local nursing home ombudsmen, AARP Senior Programs, Meals on Wheels, over 100 senior centers and meal 

providers, senior housing and Home Health Care agencies and tribal governments. The goal of the project is to establish 

a Legal Hotline to include non-legal referrals for those seniors in need. The objectives of this project are: 1) to support a 

vigorous outreach via a Hotline Community Advisory Team; 2) to develop a legal interactive electronic website; 3) to 

advertise access to senior computers via local libraries; 4) to develop legal materials via a Senior Law Advisory Team; 

and 5) to use the hotline as a feedback source. The anticipated outcomes are: increased access; outreach; results of Title 

III-B (OAA) costs; a combined website and hotline; double the number of senior citizens receiving legal assistance; and 

increased collaboration via the Idaho Senior Hotline Community Advisory Committee. The products are a final report; an 

evaluation; a legal hotline and joint website; an Advisory Team report; electronic brochures; surveys (3); and a 

dissemination plan.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

110,000

110,000

110,000

310 North 5th Street 

Program: 

IDAHO LEGAL AID SERVICES, INC.

Legal Assistance and Technical Projects 401

90AM2675

National Center on Elder Abuse

Washington, DC 20005-2842

Contact: Theresa Lambert (202)898-2578

The National Association of State Units on Aging, in partnership with an alliance of four nationally recognized and 

respected collaborating organizations representing the many disciplines in elder abuse prevention, will execute a 3-year 

program to continue the work of the National Center on Elder Abuse. The continuing goal is to provide information, 

training, and technical assistance about elder abuse trends, policy and legislative developments, research that impacts on 

prevention, promising practices, and key issues for the field - in a variety of formats, to all segments of the population. 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 and skills and practices for prevention. Products include: a comprehensive web site, 

monthly newsletter, listserve for professional dialogue and exchange, a web-based clearinghouse, a searchable database 

of promising practices, a training lending library, specialized workshops and best practice exchange, state statutory 

analysis, issue briefs on local and state network development and outreach to rural and minority communities, a brochure 

and PowerPoint module for faith-based communities, and other support materials.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

815,250

815,250

815,250

1201 15th Street, NW, Suite 350 

Program: 

NATIONAL ASSOCIATION OF STATE UNITS ON AGING

National Center on Elder Abuse 402

90AM2792
Page 104 of 223 

National Consumer Protection Technical Resource Center

Washington, DC 20036

Contact: David Schulke 

This is the second year of a three year grant to the American Health Quality Foundation, in partnership with the Hawkeye 

Valley Area Agency on Aging to support and maximize the effectiveness of Senior Medicare Patrols (SMPs) through 

operation of the Resource Center. The "Center" objectives are to: assess SMP needs/capabilities; inform SMPs about 

top Medicare/Medicaid fraud and abuse issues; ensure SMPs can effectively reach special target populations; and support 

SMPs in addressing volunteer and program management issues. Deliverables include: a written profile of SMP needs and 

capabilities; a written summary of top error, fraud and abuse issues; a national Online Resource Center with a Best 

Practices and FAQ database; project Toolkits; and materials translated for special populations. The Center has been in 

the forefront of informing SMPs about the provisions of the 2003 Medicare Modernization Act and the new prescription 

drug benefit. The Center has also introduced a mentoring program, which matches new project directors with more 

experienced directors to provide a forum for lessons learned.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

300,000

300,000

368,750

1155 21st Street, NW, Suite 202 

Program: 

AMERICAN HEALTH QUALITY FOUNDATION

National Consumer Protection Technical Resource Center 403

90AM2806

National Consumer Protection Technical Resource Center

Waterloo, IA 50702

Contact: Donna Harvey 

This is the second year of a three year grant to staff the National Consumer Protection Technical Resource Center. The 

grantee will work in partnership with the American Health Quality Foundation to provide technical assistance to Senior 

Medicare Patrol projects (SMPs) nationwide. There is at least one project in each state, the District of Columbia and 

Puerto Rico. These projects recruit and train professional to work in their communities to educate Medicare/Medicaid 

recipients and their families regarding health care fraud, error and abuse. The goals of the "Center" are: 1) to provide 

advice, guidance, and technical assistance which enhances SMP project's abilities to conduct outreach to beneficiaries 

and their families and caregivers - particularly those with limited English proficiency, disabilities, or who reside in rural 

areas - to reduce or recoup improper payments; and 2) insure that best-practices are shared in a wide variety of platforms, 

such as National Conferences, WEB based seminars, or other online or offline resources.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

300,000

300,000

300,000

2101 Kimball Avenue, Suite 320 

Program: 

HAWKEYE VALLEY AREA AGENCY ON AGING

National Consumer Protection Technical Resource Center 403

90AM2807
Page 105 of 223 

CONSUMER PROTECTION TECHNICAL ASSISTANCE RESOURCE CENTER

Albany, NY 12223-1251

Contact: Faith Fish (518)474-5478

This is one of four "National Consumer Protection Technical Assistance Resource Centers" (NCPTARC) that was 

consolidated into one Center in 2003. This center focused on partnership strategies to involve health care provider, 

family caregivers, and state and local government agencies in outreach and education activities related to Medicare and 

Medicaid fraud (MMF), waste and abuse. The goal is to give advice, guidance and technical assistance (TA) to Senior 

Medicare Projects (SMP) Nationwide, and to raise consumer awareness about Medicare/Medicaid Fraud (MMF), waste 

and abuse. The objectives are: 1) to support these four NCPTARC projects regarding MMF issues; 2) to disseminate 

educational materials; 3) to replicate best practice strategies for promoting consumer awareness regarding waste, fraud, 

and abuse in Medicare and Medicaid (MMF); 4) to provide outreach to minority and non-English speaking individuals 

(MNESI); and 5) to provide education to MNESI. The anticipated outcomes of this MMF program are: an increased 

awareness of beneficiaries regarding the detection and reporting of MMF, error, and abuse; advice, guidance and TA to 

elderly consumers; a Consumer Protection Resource Center (CPRC); and partnership strategies. The products of this 

MMF project are a final report; a CPRC; SMP and MMF materials; educational materials and a national SMP conference 

call to discuss the partnership training manual.

Project Period: 08/01/2000 - 07/31/2005

FY Grant Amount

FY 2000

FY 2001

FY 2002

159,000

155,000

135,000

3 Empire State Plaza 

Program: 

NEW YORK STATE OFFICE FOR THE AGING

National Consumer Protection Technical Resource Center 403

90AP2375

National Long Term Care Ombudsman Resource Center

Washington, DC 20036

Contact: Alice H H Hedt 

This is a three year cooperative agreement between AoA and the National Citizens' Coalition for Nursing Home Reform. 

The project goal is to equip the long-term 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 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 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.

Project Period: 06/01/2003 - 05/31/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

550,000

550,000

550,000

1828 L Street, NW, Suite 801 

Program: 

NATIONAL CITIZEN'S COALITION FOR NURSING HOME REFORM

National Long-Term Ombudsman Program 404

90AM2690
Page 106 of 223 

National Legal Resource Initiative for Financially Distressed Elders

Boston, MA 02110-1006

Contact: Nancy M. M Coleman (617)542-8010

This three year project is managed by the National Consumer Law Center (NCLC), which will partner with private bar 

associations, volunteer attorneys, and others. The goal of this National Legal Assistance and Elder Rights project is to 

help older Americans avoid or remedy economic exploitation, understand their financial options, and make reasoned, 

informed consumer decisions to prolong their independence. The objectives of this NLAER program are: 1) to increase 

the number of qualified local providers; 2) to share NCLC's consumer law expertise with legal assistance providers 

representing elderly clients; 3) to disseminate legal and consumer education materials (designed to empower elders) to 

attorneys and advocates regarding the pressing consumer law needs of older Americans; 4) to improve communication 

and coordination on consumer law topics; 5) to expand NCLC expertise; 6) to evaluate NCLC effectiveness in meeting the 

consumer law needs of older Americans. The expected outcomes are: specialized legal training; advice and 

co-counseling; an improvement in the quality and accessibility of legal assistance for older Americans; a decreased 

number of elders who fall prey to consumer scams and abuses in the marketplace; and intensive, substantive workshops. 

The products are a final report, an evaluation, detailed practice manuals with legal pleadings, a report on Lessons 

Learned, and other publications, and brochures.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

150,000

149,025

149,025

77 Summer Street, 10th Floor 

Program: 

NATIONAL CONSUMER LAW CENTER

National Legal Assistance and Elder Rights 405

90AP2640

Strengthening Leadership and Quality and Accessibility of Legal Assistance and Elder 

Rights Activities

Ann Arbor, MI 48103-8103

Contact: Penelope Hommel (734)665-1126

The goal of this National Legal Assistance and Elder Rights Project (NLAER) project is to enhance legal assistance and 

elder rights advocacy programs to ensure seniors' access to essential services and benefits. The objectives are: 1) to 

enhance the leadership capacity of state and area agencies on aging to support elder rights activities; 2) to improve the 

quality and accessibility of the legal assistance provided to older people; and 3) to coordinate and collaborate with AoA, 

the Legal Services Corporation (LSC), other NLAERPs, and other non-legal organizations. The anticipated outcomes are: 

enhanced leadership of state Legal Assistance Developers; increased focus/resources by the LSC; outcome measures for 

legal assistance programs; critical guidance to state and local legal programs through an expanded/updated 

Comprehensive Guide to the Delivery of Legal Services; and enhanced coordination of legal assistance and 

community-based long-term care programs.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

150,000

149,025

149,025

2307 Shelby Avenue 

Program: 

THE CENTER FOR SOCIAL GERONTOLOGY, INC.

National Legal Assistance and Elder Rights 405

90AP2641
Page 107 of 223 

Legal Assistance in a Time of Change

Washington, DC 20005

Contact: 

The ABA Fund for Justice and Education is the grantee for this three year National Legal Assistance and Elder Rights 

(NLAER) Project. The goal is to enhance state (SUA) and area agencies on aging (AAA) capacity to support elder rights 

and improve the quality and accessibility of legal assistance for vulnerable elders and limited-English speakers. The 

objectives are: 1) to identify issues and resources and provide a forum for consultations; 2) to enhance elder rights using 

education and training; 3) to provide assistance on substantive legal and ethical issues; 4) to support legal assistance and 

elder rights advocacy systems. The anticipated outcomes of this NLAER project are: 1) state and area agencies, Title IIIB 

(Older American Act) attorneys, private attorneys and state bar associates will have improved their knowledge and 

awareness of legal issues and resources affecting older persons; 2) Legal Assistance Developers, State Long-Term Care 

Ombudsmen, and bar section and committee chairs will have received legal publications; 3) consumers will have 

benefited from materials and technical assistance to advocates by retaining housing, preserving health or financial 

decision-making authority, receiving benefits to which they are entitled, and avoiding scams. The products of this NLAER 

program are a final report, bulletins, publications, fact sheets, consumer's tool kits, brochures (Spanish), and articles.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

150,000

149,025

149,025

740 15th Street, NW 

Program: 

AMERICAN BAR ASSOCIATION FUND FOR JUSTICE AND EDUCATION

National Legal Assistance and Elder Rights 405

90AP2642

National Legal Assistance and Elder Rights Project

Washington, DC 20049

Contact: Ellen Lebowitz (202)434-2787

The AARP Foundation is managing this three year National Legal Assistance and Elder Rights (NLAER) Project. The goal 

of the National Training Project (NTP) is to enhance the leadership capacity of state and area agencies on aging in order 

to support vulnerable elder rights and to improve the quality and accessibility of legal assistance and information provided 

to elders. This will be accomplished by offering training and materials to advocates and elders, and by coordinating 

National Conferences on Law and Aging. The objectives are: 1) to conduct 15 trainings annually on issues of law, 

advocacy skills, and strategic planning; 2) to train 2,460 and 3,360 advocates during the three year grant period; 3) to 

conduct 2 coalition building events each year; 4) to update modules on nine areas of the law; 5) to update modules on 

three advocacy skills; and 6) to publish 51 state-specific planning for incapacity booklets. The anticipated outcome is an 

increase in the number of individuals with enhanced knowledge of elder law and advocacy issues. The products are a final 

report, on-line modules, overhead presentations, enhanced website, newsletters and booklets, conference materials, and 

materials in Spanish.

Project Period: 09/30/2002 - 09/29/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

150,000

149,025

149,025

601 E Street NW 

Program: 

AARP FOUNDATION

Foundation Programs

National Legal Assistance and Elder Rights 405

90AP2643
Page 108 of 223 

National Support for Legal Assistance and Elder Rights

Washington, DC 20005-0005

Contact: Edward C. C King (202)289-6976

This a three year National Legal Assistance and Elder Rights Project. The goal is to increase the well-being of older 

persons by enhancing the quality and accessibility of legal assistance and advocacy available to them, especially the most 

vulnerable, including minorities and limited-English speaking populations. The objectives are: 1) publicize the availability 

of substantive assistance; 2) provide effective case consultations; 3) produce and disseminate written information to the 

aging network; 4) offer training workshops; 5) facilitate, review, assess, and work to improve this system; 6) conduct a 

two-year Pilot Project in a state, convening interested parties; and 7) produce a report of the Pilot Project. The target 

populations are Hispanics, Native Americans and African Americans. The project outcomes are: providing reliable 

information; supporting training and assistance to aging network advocates; and assessing and enhancing legal delivery 

systems. The products of the NLAER program are manuals and guides, specialized mailings, enhanced website, reports, 

and analyses.

Project Period: 09/01/2002 - 08/31/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

150,000

149,025

149,025

1101 14th Street, NW - Suite 400 

Program: 

NATIONAL SENIOR CITIZENS LAW CENTER

National Legal Assistance and Elder Rights 405

90AP2644

SAGEWATCH - A COLLABORATION EDUCATING HAWAII'S SENIORS TO REDUCE 

MEDICARE FRAUD AND ABUSE

Honolulu, HI 96813

Contact: Deborah Hanson (808)586-7273

This project, entitled SageWatch, is a collaboration educating Hawaii seniors to reduce Medicare fraud (MMF) and abuse. 

This is a collaborative three year cooperative agreement effort with AARP, AAAs, health care provider associations, 

Medicare contractors, senior health care organizations, law enforcement, immigrant and Native Hawaiian organizations, 

consumer advocates, SAGE PLUS, and the Long-Term Care Ombudsman (LTCO). The goal of this project is to bring 

awareness to Hawaiians about Medicare/Medicaid (MMF) Fraud, waste, error and abuse (FWEA). The objective of this 

project is to improve the quality of healthcare for seniors by addressing MMF and other health insurance discrepancies, 

not limited to waste, fraud and abuse. The expected outcomes are: improved healthcare of Hawaiian seniors; more 

awareness of fraud; increased reported cases of FWEA; trained senior Hawaiian volunteers; and identified fraud cases. 

The products of the MMF project are a final report; MMF education materials; and training materials.

Project Period: 07/01/2000 - 11/30/2003

FY Grant Amount

FY 2000

FY 2001

FY 2002

193,046

153,048

153,046

250 South Hotel St., Suite 109

Program: 

Executive Office on Aging

Operation Restore Trust 406

90AM2341
Page 109 of 223 

HEALTH CARE WASTE, FRAUD AND ABUSE SENIOR MEDICARE PATROL 

PROJECT

Concord, NH 03301-3301

Contact: Lloyd Farnham 

A collaborative effort with the Community Services Council of New Hampshire, the New Hampshire Association of Senior 

Centers, and the University of New Hampshire Cooperative Extension Service.

Project Period: 07/01/2000 - 11/30/2003

FY Grant Amount

FY 2000

FY 2001

FY 2002

248,416

231,416

250,416

State Office Part South-Brown Building 129 Pleasant Street

Program: 

New Hampshire Department of Health and Human Services

Operation Restore Trust 406

90AM2345

FOR SENIOR MEDICARE VOLUNTEER RECRUITMENT/TRAINING PATROL 

PROJECT

Albany, NY 12223-1251

Contact: Faith Fish (518)474-5478

This three-year cooperative agreement, entitled For Senior Medicare Volunteer Recruitment/Training Patrol (SMP) 

Project, is a collaborative effort between the grantee, the New York State Office for the Aging, and the New York State 

Attorney General's Office, 11 metropolitan Area Agencies on Aging AAA), and the New York State Association of Senior 

Centers. The target population is Medicare beneficiaries. The goal of this SMP project is to develop and strengthen the 

Senior Medicare Patrol (SMP) who will combat Medicare/Medicaid (MMF) program fraud, waste, error and abuse (FWEA). 

The objective of the project is to recruit and train retired senior Medicare volunteers to serve as volunteer community 

experts and resources in combating health care FWEA. The expected outcomes are: improved healthcare for seniors; 

increased cadre of volunteers trained; a new SMP project; satisfied Medicare beneficiaries; increased awareness of 

FWEA; and increased number of reported cased of FWEA. In the six month reporting period ending December 31, 2003, 

thirteen training sessions were held, which were attended by 306 beneficiaries and information assistants. The product is 

a final report.

Project Period: 07/01/2000 - 06/30/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

290,000

273,000

295,000

3 Empire State Plaza 

Program: 

New York State Office for the Aging

Operation Restore Trust 406

90AM2349
Page 110 of 223 

TECHNICAL ASSISTANCE PROJECT PENSION INFORMATION AND COUNSELING 

DEMONSTRATION PROGRAM

Washington, DC 20036-6608

Contact: John P. P Hotz (202)296-3776

The goal of the Pension Rights Center (PRC) is to provide technical assistance and training to the pension counseling 

demonstration projects. The PRC will focus on six major objectives: 1) to enhance the legal competency and advocacy 

skills among project staff through continued training and technical assistance; 2) to improve coordination between the 

demonstration projects and other related government agencies; 3) to maximize the use of technology and coordinate 

information between AoA, TAP and the pension counseling demonstration projects; 4) to implement a comprehensive 

data collection system; 5) to strengthen the capacity of the pension demonstration projects through the continuing 

development of local and national support networks, including developing and expanding lists of low-cost or pro bono 

attorneys and actuaries; and 6) to increase local and national visibility of the pension counseling demonstration projects. 

The anticipated outcomes are expansion of technical assistance; training for all pension counseling projects; increased 

legal competency; increased coordination through networking; a data collection system; increased volunteers or pro bono 

attorneys and actuaries; increased national visibility; and new networks. The products of this project include a final report, 

and data collection.

Project Period: 01/03/2000 - 12/31/2003

FY Grant Amount

FY 2000

FY 2001

FY 2002

FY 2003

187,500

187,500

208,610

46,875

1140 19th Street, N.W., Suite 602 

Program: 

Pension Rights Center

Pension Information Counseling Projects 407

90AM2329

PENSION INFO. & COUNSELING PROJECT INFO. & PROBLEM SOLVING 

TECHNIQUES WHICH HAVE ASSISTED INDIVIDUALS TO OBTAIN PENSION

Tuscon, AZ 85711-5711

Contact: Marian Lupu 

The goal of this Pension Information and Counseling Project is to provide information, services and problem-solving to 

older individuals in Arizona, particularly low and moderate income and minority seniors, including Native Americans. The 

project objectives are: 1) to continue its pension counseling services; 2) to continue conducting seminars with the Arizona 

Aging and Adult Administration to raise pension consciousness among community service system case workers; 3) to 

identify and protect pension funds to which low and moderate income clients of the State may be entitled; 4) to build on 

the project's successful pension seminar with the Tohono O'odham Indian Tribe, and plan and conduct three seminars for 

other Indian tribes of Arizona, including the Navajos, Zunis, and Apaches; 5) to strengthen and extend the working 

relationship with the regional office of the Department of Labor and other federal agencies as a means of increasing the 

pension assistance resources available to low-income and minority older persons; and 6) to continue the on-going 

successful use of the media for outreach to the public. The anticipated outcomes are: new pension information; increased 

services; new problem solving methods; new pension counseling seminars to Navajos, Zunis and Apaches; increased 

pension funds protected; and increased pension counseling resources. The products of this project are a final report, and 

pension counseling seminar materials.

Project Period: 03/01/2000 - 12/31/2003

FY Grant Amount

FY 2000

FY 2001

FY 2002

75,000

75,000

75,000

5055 East Broadway Blvd., Suite C104 

Program: 

PIMA Council on Aging

Pension Information Counseling Projects 407

90AM2330
Page 111 of 223 

PENSION INFORMATION EFFORT (PIE)

Chicago, IL 60602-0602

Contact: Ann Rich 

The goals of the Chicago Pension Information Effort (PIE) are to assist seniors by providing and disseminating pension 

information about their retirement and their life course planning. Three objectives for this PIE project are: (1) to increase 

community awareness of retirement issues including an emphasis on life course planning; (2) to serve a greater number 

of seniors with hands-on pension counseling; and (3) to strengthen relationships with faith-based organizations and labor 

unions. The anticipated outcomes are: an increased number of seniors who will benefit from retirement and other 

long-term planning; an increased number of community forums; outreach activities to address PIE issues; recruitment of 

law student volunteers to assist in the actual pension counseling; work with faith-based organizations; training of 

volunteers; benefits of life course planning; initial pre-screening for clients; and pension questions answered. The 

products of the project are: a final report; fact sheets; faith-based organization and labor unions reports; forum materials; 

and a cadre of volunteers.

Project Period: 09/30/2000 - 12/31/2003

FY Grant Amount

FY 2000

FY 2001

FY 2002

74,353

74,960

74,926

30 North LaSalle, Suite 2320 

Program: 

City of Chicago

Pension Information Counseling Projects 407

90AM2429

PENSION COUNSELING THROUGH LAW SCHOOL CLINICS

Tuscaloosa, AL 35487-0104

Contact: Norman Stein 

The University of Alabama, the grantee, will manage this Pension Counseling project. The new Law School Clinic project 

will employ volunteer students. The project director will be responsible for the day-to-day operation of the clinic and serve 

as a resource to the students on some of the less complex cases. The goal of the project is to assist seniors and provide 

them with pension counseling and information about life course planning and legal questions on retirement. The objectives 

of the project are: 1) to provide information to seniors on pensions; 2) to use student volunteers to counsel seniors on less 

complex legal cases; 3) to provide technical assistance to other pension projects; 4) to provide on-site training to law 

students who help seniors; 5) to provide supervision for the more complicated cases; and 6) to conduct research on 

pension counseling. The anticipated outcomes are: outreach activities; a cadre of Law School Clinic volunteers; Pension 

Rights Center activities in DC; training for all of the pension projects staff; and research into gaps in the law and utilization 

of Pension Counseling Clinics. The products are a final report, Law School clinic materials, and volunteer student reports.

Project Period: 09/30/2000 - 12/31/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

74,928

74,989

73,408

Box 870104 

Program: 

THE UNIVERSITY OF ALABAMA

Pension Information Counseling Projects 407

90AM2435
Page 112 of 223 

Legal Hotline for Michigan Seniors Coordinated Economic Assistance Project

Lansing, MI 48933-8933

Contact: Kate White (517)485-9164

This is a two-year Pension Counseling Project which will serve older women, people with limited English proficiency, low 

income seniors and seniors in rural areas. Both Michigan and Ohio Legal Services organizations (the grantee and the 

sub-grantee) will perform outreach by working with local legal services providers (Title IIIB [Older Americans Act] and the 

Legal Services Corporation). The goal of this project is to enhance the outreach for the current pension counseling 

project. The project's activities will include intake, advice and information on benefits to pensioners and will change its 

name to the "Great Lakes Pension Rights Project." The objectives of this project are: 1) to continue the pension 

information and counseling services in Michigan and Ohio; 2) to expand the Michigan and Ohio project by beginning to 

screen pension callers for eligibility for Veterans benefits; 3) to use targeted media outreach and Internet research to 

reach residents with unclaimed pensions; 4) to work with the Michigan Office of Services for the Aging, the Michigan 

Department of the Treasury, and the Pension Benefit Guaranty Corporation to locate pensioners with unclaimed pensions. 

The outcomes are: increased financial/retirement knowledge; improved financial well-being of seniors; and increased 

benefits to Veterans and surviving spouses. Products are a final report, and interventions.

Project Period: 09/30/2002 - 09/29/2004

FY Grant Amount

FY 2002

FY 2003

150,000

150,000 221 N. Pine Street 

Program: 

Elder Law of Michigan, Inc.

Pension Information Counseling Projects 407

90AM2677

Pension Rights Project

St. Paul, MN 55104-5104

Contact: Dennis Gerhardstein (651)645-0261

This two-year project will target older workers and retirees in Minnesota and Wisconsin, and expand to Iowa, North Dakota 

and South Dakota in year two. The goal of this project is to expand to neighboring states and to deliver pension 

counseling services. The six objectives are: 1) to extend the project outreach to cover Minnesota and Wisconsin through 

the creative use of PensionNet (a comprehensive web of state and regional service networks serving the needs of aging, 

women, and minorities); 2) to enhance the PensionNet with a comprehensive media plan and training program; 3) to 

develop a single point of entry; 4) to expand to Iowa and Dakotas in Year 2 and Year 3; 5) to combine comprehensive 

services for workers and retirees with both private and government plans and include innovative initiatives to meet the 

needs of participants in 401(k), multi-employer (union) and state public employee plans. The anticipated outcomes are: 

increased # of seniors served from 500 to 700 by year 3; an increase in overall cost efficiency of the delivery of pension 

information and counseling services; increased clients' understanding of 401(k) plans; an increase in the number of 

attorneys; and increased understanding of pension services. The products are: a final report; a report on 401(k) plans; an 

improved PensionNet; and training materials.

Project Period: 09/30/2002 - 09/29/2004

FY Grant Amount

FY 2002

FY 2003

150,000

150,000 1885 University Ave #190 

Program: 

MINNESOTA SENIOR FEDERATION

Metropolitan Region

Pension Information Counseling Projects 407

90AM2678
Page 113 of 223 

Midwest Pension Rights Project

St. Louis, MO 63139

Contact: Suzanne Lagomarcino (314)725-5862

The Gateway Chapter (St. Louis, MO) of the Older Women's League will create the regional Midwest Pension Rights 

Project by combining the experience and resources of the Pension Benefits Project (Missouri) and the Chicago Pension 

Information Effort Project, along with new partners. The transition will be seamless for persons currently being served by 

the Projects, while expanding services to the region. The goal is to provide workers and retirees with a full range of 

pension counseling services concerning private and government plans. The objectives are: 1) offer comprehensive 

counseling, advocacy and referral services to individuals, 2) conduct outreach targeting low-income women, minorities 

and non-English speaking populations, 3) build on the experience of the Missouri and Chicago projects, incorporating 

"best practices" in casework and coalition building; and 4) educate workers about the value of saving for retirement. 

Outcomes will be: improved economic security and peace of mind for clients; increased awareness of pension rights; and 

workers saving for retirement. Successful strategies and educational materials will be shared at the Washington DC 

Conference and on the PensionHelp America Web site. Products include a final report, educational materials, website 

resources.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

149,614

149,902

149,972

2165 Hampton Avenue 

Program: 

OWL, THE VOICE OF MIDLIFE AND OLDER WOMEN

Gateway Chapter

Pension Information Counseling Projects 407

90AM2799

Mid-Atlantic Pension Counseling Project

New York, NY 10036

Contact: Ann Biddle (212)391-0120

Legal Services for the Elderly of New York City (LSE) will establish the Mid-Atlantic Pension Counseling Project to deliver 

pension counseling and advocacy to the States of New York and New Jersey. In the first year, LSE will serve New York, 

with special emphasis on rural counties, and in the second year LSE will expand to serve all of New Jersey. In addition, 

LSE will serve pensioners who no longer reside in New York or New Jersey, but whose employers were headquartered in 

these states. The major objective will be resolution of clients' pension problems. Outcomes will include development of 

powerful, state-of-the-art technology for high-quality, low-cost voice, fax, data transfer, video teleconferencing, and 

broadband Internet access. The low cost will permit LSE to invest substantial resources immediately in experienced staff. 

The sophisticated network will allow staff to perform many tasks quickly and efficiently; will allow staff to train advocates in 

remote locations in real-time video sessions; and will allow LSE to add services in New Jersey seamlessly. In sum, the 

technology will enable LSE to bring pension counseling to more people. LSE will partner with The Rural Law Center of 

New York (RLC) to expand outreach in New York's rural counties. Products will include a replicable protocol to investigate 

"lost pensions" for distribution to all legal services providers in the region, as well as to other pension counseling projects, 

and non-English products for the New York markets, to be refined for release in New Jersey.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

149,974

149,974

149,974

130 West 42nd Street, 17th Floor 

Program: 

LEGAL SERVICES FOR THE ELDERLY

Pension Information Counseling Projects 407

90AM2800
Page 114 of 223 

New England Pension Assistance Project (NEPAP)

Boston, MA 02125

Contact: Ellen A Bruce (617)287-7300

The New England Pension Assistance Project proposes to increase workers' and retirees' knowledge of and access to 

retirement benefits in the six New England states (Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, 

and Vermont). The applicant's objectives are: 1) to maximize individuals' retirement standard of living; 2) to educate older 

workers, retirees, and the community about different types of 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, low-income and minority workers and retirees, and elders with limited English proficiency. The project proposes 

to accomplish its goal through a program of individual counseling and referrals, case investigation, legal research, 

community education, and outreach. Products will include a final report.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

137,000

159,064 100 Morrissey Boulevard 

Program: 

UNIVERSITY OF MASSACHUSETTS BOSTON

Pension Information Counseling Projects 407

90AM2899

Great Lakes Pension Rights Project

Lansing, MI 48917

Contact: Katherine B White (517)485-9164

Elder Law of Michigan proposes to continue the services currently rendered by the regional Great Lakes Pension Rights 

Project. The primary goal is to maintain and expand pension counseling services in Michigan and Ohio by increasing 

expertise in public pension plans. The secondary goal is to expand service to additional states by using referral partners, 

primarily Senior Law Center of Pennsylvania and the Access to Justice Foundation (Kentucky), to identify pension-related 

cases through their senior legal helplines for referral to Michigan and Ohio. Products for development include flyers for 

national dissemination, web-based information on state and local pension issues, and a training outline to help other 

projects train and support law student volunteers in pension work. 

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

137,000

150,000 3815 W. St. Joseph St., Suite C-200 

Program: 

ELDER LAW OF MICHIGAN, INC

Pension Information Counseling Projects 407

90AM2900
Page 115 of 223 

Upper Midwest Pension Rights Project

St. Paul, MN 55104

Contact: Mary Browning (651)645-0261 121

The Upper Midwest Pension Rights Project proposes to serve workers and retirees with high-quality, comprehensive and 

cost-effective pension information, counseling, advocacy and referral services through a coordinated, multi-state, regional 

service delivery model. The five-state region to be served will include Minnesota, Wisconsin, Iowa, North Dakota and 

South Dakota. Outreach through the creative use of PensionNet, a comprehensive web of state and regional service 

networks serving the needs of seniors, women and minorities, will be enhanced by comprehensive media plans and 

training programs. National initiatives will be supported through the sharing of information and lessons learned with other 

pension counseling projects nationwide. Products will include a final report and a comprehensive website with links to fact 

sheets, resources, and information regarding public plans for the five-state region.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

137,000

150,000 1885 University Avenue, Suite 171 

Program: 

Minnesota Senior Federation

State Office

Pension Information Counseling Projects 407

90AM2901

Pension Information Counseling and Assistance Program of the Southwest

Austin, TX 78701

Contact: Roger W Curme (512)477-3977

Texas Legal Services Center will implement the Pension Information, Counseling & Assistance Program of the Southwest 

(PICAPS). PICAPS will provide assistance to individuals with pension problems and questions in Texas and surrounding 

southwestern states. Under PICAPS, the benefits counseling partnership between Texas Legal Services Center and the 

Area Agencies on Aging will be expanded to include pension counseling. PICAPS' goal is to assist workers, retirees, and 

beneficiaries in their ability to secure enforcement of legal rights under pension and retirement savings plans. Through 

targeted outreach, PICAPS' efforts will be focused on reaching low-income individuals, minorities, Native Americans, 

women, and non-English speaking individuals. Products will include statistical reports (outreach, referral source, benefits, 

demographics, plan and sponsor type, recoveries, etc.); a final report; and data collection regarding cash benefits 

recovered.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

50,000

65,000 815 Brazos, Suite 1100 

Program: 

Texas Legal Services Center, Inc.

Legal Hotline for Texans

Pension Information Counseling Projects 407

90AM2902
Page 116 of 223 

National Pension Assistance Resource Center

Washington, DC 20036

Contact: John Hotz (202)296-3776

The Pension Rights Center is in the process of expanding its Technical Assistance Project into a National Pension 

Assistance Resource Center, supporting not only AoA's Pension Counseling and Information Program, but a nationwide 

pension information and assistance network as well. Goals of the applicant are to: 1) strengthen pension counseling skills 

and capacities of AoA's Pension Counseling Projects, State and Area Agencies on Aging, and legal service providers for 

older Americans; and 2) design and implement PensionHelp America, the first nationwide network of pension information 

and assistance resources, accessible through the Internet. Objectives are: to provide technical support services through 

training events, onsite consultations, telephone, and e-mail communications to develop a nationwide dataset of pension 

assistance resources; and to produce a basic set of recommendations and strategies for advancing pension assistance on 

a national level. Products will include training manuals and videos, e-newsletters, and a national pension assistance 

database.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

400,000

400,000

346,000

1350 Connecticut Avene, N.W, Suite 206 

Program: 

PENSION RIGHTS CENTER

Pension Technical Assistance Project 408

90AM2798

Consumer Law Project for Seniors

Manchester, NH 03101

Contact: John/Cheryl Tobin/Driscoll (603)644-5393

New Hampshire Legal Assistance (NHLA), in collaboration with key legal, community, and faith-based organizations, will 

develop a 3-year project titled The Consumer Law Project for Seniors (CLPS), to improve and expand the delivery of legal 

services to New Hampshire seniors victimized by consumer-related abuses and financial exploitation. The project will 

train service providers, police, and judges; outreach to minority and rural elderly and legislators; create a pilot consumer 

law clinic and self-help office; and recruit and train private attorneys to handle pro bono and reduced fee consumer cases. 

NHLA anticipates the following outcomes: 1) increased availability of affordable legal services to seniors in consumer 

areas; 2) increased referrals to the Advice Line/CLPS by service providers, police, and judges; and 3) increased 

prevention and remediation of consumer abuses and financial exploitation of seniors in New Hampshire. NHLA target 

audiences will include rural, isolated elderly; non-English speaking elderly; elder care providers; social workers; police and 

other law enforcement officials; district court judges; private attorneys; Health Insurance Counseling, Education 

Assistance Services network; and the Division of Adult and Elderly Services. Products will include a final report.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

90,000

90,000

90,000

1361 Elm Street, Suite 307 

Program: 

NEW HAMPSHIRE LEGAL ASSISTANCE

Senior Legal Services-Enhancement of Access 409

90AM2794
Page 117 of 223 

Statewide Senior Legal Hotline

Seattle, WA 98104

Contact: Joan Kleinberg (206)464-1519

Northwest Justice Project (NJP) proposes a 3-year project to pilot an "enhanced" statewide legal service delivery system 

that offers broad telephonic access to legal assistance, exploring the most effective and efficient ways to act on the 

findings of the 2002 Hotline Outcomes study and the 2003 Senior Statewide Legal Hotlines Client Outcomes Study. NJP's 

test of these study recommendations will provide the legal community with information about the extent to which such 

measures actually improve client outcomes, and NJP will also develop tools to assist programs in implementing such an 

"enhanced" hotline model. NJP anticipates the following outcomes: 1) preservation of tenancy in rental housing; 2) 

eligibility for coverage of medical care through Medicaid or Medicare; 3) ending collection activity on alleged indebtedness; 

and 4) preservation of income. Target audiences include: seniors of limited literacy; seniors with mental or physical 

disabilities; geographically isolated seniors; limited-English speaking seniors, especially Spanish and Vietnamese 

speaking; seniors of the lowest education levels; and social service providers. It is anticipated that there will be a 20% 

increase in the number of seniors who favorably resolve legal problems affecting housing, income and benefits 

preservation, safety and independence, and consumer protection. Products will include a final report.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

100,000

100,000

100,000

401 Second Avenue South - Suite 407 

Program: 

NORTHWEST JUSTICE PROJECT

Senior Legal Services-Enhancement of Access 409

90AM2795

Senior Legal Hotline

Sacramento, CA 95814

Contact: David Mandel (916)551-2142

Legal Services of Northern California proposes to expand to a statewide senior legal services program over the next 3 

years. In collaboration with various legal service providers, area ombudsmen, Area Agencies on Aging, the State Bar, law 

schools, and local community and faith-based organizations, the Senior Legal Hotline Plus (SLH) will reach out to needy 

seniors throughout California, especially those who are low income, disabled, isolated, or non-English speaking. Legal 

Services of Northern California anticipates the following measurable outcomes as a result of statewide expansion: 1) an 

increase in the number of seniors who receive income from all sources for which they are eligible and in the number who 

avoid home loss, consumer rip-offs, scams, and other financial abuse; 2) an increase in the number of seniors able to plan 

their estates as they wish, including the maintenance of maximum independence; 3) more seniors who are raising 

grandchildren able to navigate the legal system; and 4) improved services for seniors from other legal call centers as a 

result of SLH activities and dissemination of information. Products will include a final report.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

135,000

135,000

135,000

444 North 12th St. Suite 312 

Program: 

LEGAL SERVICES OF NORTHERN CALIFORNIA

Senior Legal Services-Enhancement of Access 409

90AM2796
Page 118 of 223 

Predatory Lending

Hammond, LA 70404-0404

Contact: Brian Lenard (985)345-2130

Southeast Louisiana Legal Services Corp. (SLLS) proposes a three year project to prevent Louisiana seniors from losing 

their homes to predatory mortgage companies. The objectives are: 1) to provide representation to owners of homes in 

foreclosure; 2) to educate the elderly to the dangers that can arise in mortgaging their homes; and 3) to train public 

interest and pro bono attorneys to challenge foreclosures. These objectives will be pursued by a consortium of programs, 

both governmental and community-based, and the target audiences will include rural seniors; monolingual Spanish, 

Vietnamese, and French-speaking seniors; and state and local attorneys. The core providers of service will be one intake 

paralegal and two attorneys. They will provide representation in these cases, and expertise/assistance to others 

throughout the state handling these cases. Expected outcomes are that 400 homes will be saved from foreclosure and, in 

another 100 cases some other material benefit to the client will be achieved. Products include training materials, form 

pleadings, annual reports, publications and outreach/educational materials addressing this critical problem. These will be 

distributed locally and nationally to direct service providers.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

95,000

95,000

95,000

PO Drawer 2867 

Program: 

Southeast LA Legal Services Corp.

Senior Legal Services-Enhancement of Access 409

90AM2797

Senior Medicare Patrol Program Integration Grant (TierII)

Madison, WI 53718-6751

Contact: Helen M Dicks (608)224-0606

This is the second year of a two year grant to integrate the state Senior Medicare Patrol program into the fabric of the 

aging services network. The goal of the project is to complete development of a comprehensive training and compliance 

program for allied health care professionals. Self study and lecture-based material will instruct social workers, 

pharmacists, nurses and physicians on the public benefits and resources for assisting patients with benefits, and for 

protecting these benefits from error, fraud, and abuse. Interest in Medicare part D has provided opportunities to partner 

with other community groups, volunteer programs and professional associations. Target population: Medicare 

beneficiaries. Collaborators: WI SHIP, WI Multi- Agency Response to Part D, various community organizations, 

professional associations and the law enforcement community. FY 2004 Anticipated Outcomes: Developed and 

disseminated Agents and Deceptive Practices booklet about reporting and detection procedures; and coordinated roll-out 

of Wisconsin specific Medicare Modernization Act (MMA) media campaign, including press releases, talk shows etc. The 

results of this project will be disseminated to all Senior Medicare Patrol projects through AoA's SMP resource center.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 2850 Dairy Drive, Suite 100 

Program: 

Coalition of Wisconsin Aging Groups

Senior Medicare Patrol Program Integration 410

90AM2905
Page 119 of 223 

Senior Medicare Patrol Integration Project For Rural Hispanic Communities (SM-PIP)

Washington, DC 20036

Contact: Charles Mendoza Ph.D.,J.D. (202)265-1228

This is a two year project to increase knowledge and provide the skills necessary for Hispanic senior participants to 

understand and utilize the new Medicare Modernization Act (MMA) benefits and to avoid fraudulent schemes that may be 

associated with discount drug cards or preventive services. The project has promoted MMA and prevention efforts through 

the training of peer advocates, launching a community-based education campaign, establishing new partnerships with 

organizations that serve the Hispanic community and disseminating lessons learned and outcomes through a network of 

organizations, consumers and service providers. In addition, NHCOA recognizes the role of the family in getting their 

message to seniors, who are often very close to and involved with family members.

Collaborators: University of TX- Pan American, RSVP, City of La Joya, KLJS TV 17, Our Lady Queen of Angels Parish, La 

Voz Del Anciano, and Senior Companion program

Anticipated activities/outcomes: Provide bilingual peer volunteers, project staff and advisory committee members for 

media MMA events; enhance web site to include links to local and national resources related to benefits and fraud 

control; develop new partnerships with health and social service providers, representatives of local area aging network, 

senior center staff and community leaders and participate in one media event quarterly using materials adapted to local 

language and culture.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

95,509

95,509 1341 Connecticut Avenue, N.W., Suite 4.2 

Program: 

The National Hispanic Council on Aging

Senior Medicare Patrol Program Integration 410

90AM2906

Operation Restore Trust of Iowa SMP Integration Grant

Des Moines, IA 50309

Contact: Shirley Merner (515)242-3333

This is a two year project to create and disseminate curriculum focused on increasing the number of fraud referrals made 

to the Iowa Medicaid Fraud Control Unit (MFCU) and the number of dollars recouped in Medicaid fraud due to divestiture 

(arrangement of assets to become Medicaid eligible). Hamilton College, the Iowa MFCU and the grantee have united to 

achieve this goal. The intervention will consist of a public education campaign to help identify people in their communities 

who may be using Medicaid as an inheritance protection plan. Target Population: Iowa's Medicaid beneficiaries will be 

reached through outreach and education at AAA sites. Products and Project Outcomes: Increased Medicaid recoupments 

as awareness of divestiture increases; Iowa Law Enforcement Needs Assessment Survey developed; Medicaid 

divestiture fraud (MDF) case curriculum & training package developed. Dissemination: A statewide television campaign 

will be conducted to reach those unable to attend community education events. The results of divestiture education will be 

provided to AoA in the final report.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 200 Tenth Street 

Program: 

Iowa Department of Elder Affairs

Senior Medicare Patrol Program Integration 410

90AM2907
Page 120 of 223 

Senior Medicare Patrol Integration Continuation Project

Sacramento, CA 95819

Contact: Julie Schoen (714)560-0309

This is a two year project to develop a partnership with the California Department of Justice (DOJ) that will expand the 

Senior Medicare Projects capacity and begin to educate consumers regarding Medi-Cal (Medicaid). This project has not 

previously dealt with Medicaid fraud, which accounts for more than $29 billion in annual expenditures - nearly one-quarter 

of the State's entire budget. Currently, beneficiaries get their information about MMA from their local pharmacy. A 

secondary goal will be to establish a private sector fraud-based education program on MMA by establishing a relationship 

with a nationwide pharmacy chain. The project has contacted Walgreen's corporate headquarters to promote fraud 

education outreach using a private-sector partner. Special Populations and Organizations: The project has strong 

relationships with Latino Health Access, The National Association of Pacific Islanders, and State and Federal agencies 

serving these populations, including the CA Dept of Aging and CMS. CHA established and hosts the CA Medicare 

coalition, which meets 6 times per year in regional meeting. Collaborators: California Department of Justice Bureau of 

Medi-Cal fraud and Elder Abuse, Orange County Council on Aging. FY 2004 Anticipated Outcomes: Changed observable 

behavior of Medi-Cal recipients to detect and report fraud and abuse complaints, and established links between the DOJ 

and the CHA/Scams websites to coordinate "Fraud Alerts"; also, provided consumer education and increased awareness 

of related issues to 2,500 English speaking pharmacy partner customers.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 5380 Elvas Ave., Suite 104 

Program: 

California Health Advocates

Senior Medicare Patrol Program Integration 410

90AM2908

Senior Medicare Patrol Project Integration

Philadelphia, PA 19103

Contact: Rebecca Nurick (215)545-5728

This is a two year project to develop and implement a curriculum targeting home health care fraud in Medicare. The 

project has reached out to: homebound older Pennsylvanians through "meals on wheels" providers; Russian-speaking 

dual eligible clients through the Family Caregiver support program; and visually impaired individuals from Associated 

Services for the Blind. Volunteers have completed pre and post test training to evaluate their knowledge of the material 

and ability to conduct the presentation. Evaluations collected to date, after/at "Healthy at Home" presentations, indicate 

participants learned something new about Medicare home health benefits, and 98% agreed that they will use the fraud 

prevention tips. Distribution of the presentation was conducted with the Delaware Valley Access to Benefits Coalition and 

the Coalition of Philadelphia APPRISE counselors to promote discount drug card information. A summary of all lessons 

learned will be reported to AoA in the final 2006 report. Partners and community based organizations: CMS-Region III; 

OIG-Region III; Pennsylvania Dept. of Aging; AARP PA; Philadelphia Corp. for Aging; Community Legal Services; 

Pharmacia & Upjohn; Podiatrist and professor emeritus at Temple University; Albert Einstein Medical Center-APPRISE 

program (PA's SHIP program); APPRISE of Schuylkill County; RSVP of Chester, Montgomery, Bucks, Capital Region, 

Lehigh Region, Somerset and Schuylkill County, Philadelphia East and RSVP. FY 2004 Outcomes: Based on the results 

of beneficiaries surveyed, the project expects that as a result of the curriculum developed there will be an increased 

awareness of home health care fraud and will be increased reporting of potential fraud in home health, as well as MMA in 

the long term.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 100 North 17th Street, Suite 600 

Program: 

Center for Advocacy for the Rights and Interests

of the Elderly

Senior Medicare Patrol Program Integration 410

90AM2909
Page 121 of 223 

The Great Lakes Inter-Tribal Council Senior Medicare Patrol Integration

Lac Du Flambeau, WI 54538

Contact: Wendell Holt (715)588-3324

This is a 2 year project to fully integrate State Medicaid and Indian Health Service (IHS) partners into the fabric of 

Wisconsin's American Indian communities for education, outreach and reporting of health care fraud. Tribal, Federal/State 

partners will work cooperatively to diminish fraud in those American Indian Communities. Specifically integrated training 

on home health and other areas under Medicaid will be offered to tribal aging unit staff, who will then train elders and 

program recipients in their community. A manual documenting this model will be disseminated to other tribal communities 

to replicate this model project. The manual will also be distributed to the SMP resource center. Tribal elders and Benefit 

Specialists will work with the American tribes within their communities to teach them about health care fraud. For instance, 

the Great Lakes Native American Elders Association serving WI and MN tribes will be participating in this project. FY 

2004 Outcomes: established collaborative relationships with Federal and State for a Medicare Part D tribal workgroup; 

and increased awareness of the issues through the Tribal benefits network, a key element of which is a vehicle to 

communicate CMS findings.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 2932 Highway 47 North 

Program: 

Great Lakes Inter-Tribal Council, Inc.

Senior Medicare Patrol Program Integration 410

90AM2910

Puerto Rico ALF Network Integration Initiative

San Juan, PR 00919-1179

Contact: Rossana Lopez-Leon (787)721-6121

This is a two year project to enhance the capability of the current Senior Medicare Project (SMP) in Puerto Rico (PR) to 

integrate its Medicare fraud awareness prevention and reporting activities into the fabric of the aging service network at 

the community level and within the fraud prevention network island-wide. The project is focused on Non-English speaking 

Hispanic senior Medicare beneficiaries. Process and outcome oriented evaluation procedures will continue as proposed 

for year one of the project. All training materials were developed in Spanish and were distributed to Center Directors. 

Collaborators and community-based organizations (CBOs) include: the Centers for Medicare & Medicaid Services (CMS) 

PR field office, and PR Health Assistance Program (IMEDICAID), PR Quality Improvement Organization (QIO), Catholic 

Social Services, Alzheimer's Assoc., PR Diabetes Assoc., and Asociacion De Pensionasos. 100 volunteers from 

various Senior Centers will be trained to serve as center-based coordinators. FY 2004 outcomes: Developed strategic 

plan for the project; conducted monthly workshops for members of the fraud taskforce; and registered 2,000 senior center 

beneficiaries as Medicare Fraud Prevention team members.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 P.O. Box 191179 

Program: 

Puerto Rico Office of the Ombudsman for the Elderly

Senior Medicare Patrol Program Integration 410

90AM2911
Page 122 of 223 

Senior Medicare Patrol Program Integration

Little Rock, AR 72203-1437

Contact: Herb Sanderson (501)682-2441

This is a two year project of the Arkansas Senior Medicare Patrol (SMP) to work with their regional partners to expand 

awareness of SMP activities and make fraud prevention strategies and activities an integral part of the state government. 

Specific goals have been set for each region, i.e., number of individuals in each targeted population to be reached by our 

intervention. To evaluate the effectiveness of this approach the project will track each of the Health and Human Services 

(HHS) Office of the Inspector General (OIG) performance measures by county and or zip code. Part of the OIG data 

collected is on beneficiaries educated and complaints received based on project outreach. The results will be 

disseminated quarterly in a report to all partners. Material has also been developed for outreach to nursing home 

residents and distribution of this material is under way. Collaborators are the University of Arkansas, local senior centers, 

and libraries. FY 2004 Outcomes: Contracted with the University of AR to use their GIS application to accurately track and 

target project efforts. 	

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

93,867

93,868 PO Box 1437, Slot S530 

Program: 

Department of Human Services

Senior Medicare Patrol Program Integration 410

90AM2912

MOD Squad

Houston, TX 77027

Contact: Candice Twyman (713)341-6141

This is a two year project to assist the Texas State Senior Medicare Patrol project MOD Squad provide education and 

information about the Medicare Modernization Act ( MMA ) to help older adults and their caregivers understand the impact 

of the changes and increase awareness and reporting of suspected fraud. Efforts include going to outlying counties and 

bringing together service providers and beneficiaries to make group presentations. Limited English speaking populations 

will be targeted with translated materials. Key personnel in communities will be trained about health care fraud in order to 

share the message within the community outlets. Community Based organizations' Ombudsmen are used to evaluate 

training methods and track potential abuse in their communities. FY 2004 Outcomes: MOD Squad has reached over 

22,000 older adults on 91 occasions with information about the changes in MMA, making those individuals less 

susceptible to fraud or errors. Five training sessions were conducted to increase the awareness of 137 professionals; 

training materials have been disseminated in English and Spanish to increase awareness of the Medicare changes; and a 

checklist has been developed for use by providers to point out clues that may indicate fraud.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

55,000

55,000 1333 West Loop South, Suite 1200 

Program: 

Better Business Bureau Education Foundation

Senior Medicare Patrol Program Integration 410

90AM2913
Page 123 of 223 

Indiana Senior Medicare Patrol Integration Project - Senior ESP

Indianapolis, IN 46205

Contact: Melissa A Durr (317)202-0500

This is a two year project to develop an innovative model of health care fraud education, with emphasis on Medicare Part 

D, that will be embedded by the Senior Medicare Patrol (SMP) into the Indiana aging network . Partnering with the SHIIP, 

the Medicaid Fraud Unit and a pharmacy chain, the project will develop a training module which will include a message 

for the public regarding fraud. This module will be fully integrated into training for AAA case managers, I& E staff, SHIIP 

counselors and project volunteers. The target population will include rural and low income seniors. Collaborators include 

the Senior Health Insurance Information program, Hoosier RX and the IN Medicaid Fraud Control Unit (MFCU). 

Anticipated activities/outcomes: A fully integrated training module for AAA case managers; and a decision tree tool to help 

project volunteers and others to determine if fraud exists. Dissemination activities will include: brochures and other 

messages in English and Spanish developed at the fourth grade reading level, with a consistent and accessible message; 

and an Email communications network to discuss outreach and other project activities. The MFCU will provide guidance 

on the accuracy of messages developed. The results of this project will be provided to AoA, our partners and other 

interested organizations.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 2506 Willowbrook Pkwy., Suite 250 

Program: 

IAAAA Education Institute, Inc.

Senior Medicare Patrol Program Integration 410

90AM2914

SMP Integration of Medicare and Medicaid

Edsion, NJ 08817-2598

Contact: Charles Clarkson (732)777-1940

This is a two year project to integrate the Senior Medicare Patrol project into the state aging services network. The grantee 

will develop new statewide collaborations, coalitions and other integration efforts, emulating successful practices of 

established programs and developing new approaches designed to meet the unique needs of the state's older population. 

It will specifically integrate Medicaid and Medicare fraud messages regarding the Medicare Modernization Act of 2003 

targeting MEDICAID recipients. Collaborators include: NJ Housing and Mortgage Finance Agency SVCS., Healthcare 

QIO, NJ DHHS, AARP, Rutgers Coop Extension, NJ Traid, and NJ Medicaid Fraud Control Unit. Anticipated 

activities/outcomes: 200 beneficiaries and providers and conference attendees will report that 80% found it worthwhile; 25 

additional potential cases of fraud will be identified; and 8,000 seniors will attend community based education. 

Dissemination activities will reach 650,000 beneficiaries through a media campaign. Products will be translated into 

Spanish, Korean, one Indian dialect, as well as printed in Braille or large print. The results of this effort will be reported to 

AoA, the SMP resource center and others.

.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 515 Plainfield Ave., Suite 201 

Program: 

Jewish Family & Vocational Service of Middlesex County,

Inc.

Senior Medicare Patrol Program Integration 410

90AM2915
Page 124 of 223 

Illinois Senior Medicare Patrol Integration Program

Oak Park, IL 60301

Contact: Kim B Blechschmidt (708)383-0258

This is a two year project to integrate the Illinois Senior Medicare Patrol Project into the Aging Services Network. The 

overall project design will be to develop an innovative model of health care fraud education, with emphasis on Medicare 

Part D, that will be embedded in the aging network across the state of Indiana. Partnering with SHIIP, the Medicaid Fraud 

Unit and a pharmacy chain, the project will develop a training module which will include a message for the public 

regarding fraud. This module will be fully integrated into training for AAA case managers, I& E staff, SHIIP counselors and 

project volunteers. The project will schedule presentations and displays for senior groups, professional groups, senior 

advocate, conferences and seminars. The target population is rural and low income seniors. The project coordinator will 

evaluate and improve training materials as necessary. Collaborators: Senior Health Insurance Information program, 

Hoosier RX and MFCU. The project will involve community-based organizations (CBOs) which serve senior groups for 

educational presentations. FY 2004 Outcomes: A model for health care fraud education, developed and embedded within 

the aging network; and standardized training materials created for use by AAAs and SHIIP counselors to insure consistent 

group presentations.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

100,000

100,000 1048 Lake Street, Suite 300 

Program: 

Suburban Area Agency on Aging

Senior Medicare Patrol Program Integration 410

90AM2916

SORT Integration Tier I Project

Warrensburg, MO 64093

Contact: Rona J McNally (660)747-5447

This is a two year project award for the Missouri Senior Medicare Patrol Project to develop new statewide collaborations, 

coalitions and other integration efforts, emulating successful practices of established Senior Medicare Patrol 

programs.This integration project will develop a comprehensive statewide approach to increase awareness and detection 

of MEDICAID fraud among providers, recipients and caregivers.The target population is rural and low income individuals. 

Collaborators include: MO Div. Medical Svcs., Dept. Health & Senior Svcs., CLAIM (CMS), LTC Ombudsman program, 

Alliance of AAA, Attorney General, and David Pearce, State Representative. Anticipated activities/outcomes: The grantee 

anticipates that 95% of education seminar attendees surveyed will indicate a willingness to report concerns. The results of 

this project will be reported to AoA and the National Consumer Protection Technical Resource Center.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

99,857

99,784 106 W. Young Street 

Program: 

District III Area Agency on Aging

dba Care Connection for Aging Services

Senior Medicare Patrol Program Integration 410

90AM2917
Page 125 of 223 

Senior Medicare Patrol Integration, Tier II

Boise, ID 83706

Contact: Lois S Bauer 

This is a two year project to integrate Medicare error and fraud awareness and prevention knowledge within two rural, 

underserved regions in Idaho, and hire Fraud Education specialists to assist beneficiaries understand the Medicare 

Modernization Act of 2004 ( MMA), cultivate new partnerships and help resolve billing errors/fraud complaints. The target 

populations in rural communities will be Hispanic and Native American people. Collaborators will include: WA Ofc. 

Insurance Commissioner, Eastern Idaho Special Services Agency, Inc., Area II Agency on Aging. Anticipated activities 

and outcomes: Medicare beneficiaries and their families and advocates will scrutinize Medicare bills and report fraud, error 

and abuse; and trained volunteers will be used to assist with one-to-one assistance with beneficiaries. A local contact list 

and reporting process will be developed to evaluate the progress of this project. The results will be reported to AoA and 

other interested parties.

.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004

FY 2005

96,508

96,508 3380 Americana Terrace, Suite 120 

Program: 

Idaho Commission on Aging

Senior Medicare Patrol Program Integration 410

90AM2918

SENIOR MEDICARE PATROL PROJECT

Edison, NJ 08817-8817

Contact: Irene Stolzenberg (732)777-1940

The Senior Medicare Patrol, NJ Healthcare Advocacy Volunteer Effort (NJHAVE), is in the third year of a three year 

cooperative agreement project administered by the Jewish Family and Vocational Service of Middlesex County, Inc. The 

goal of NJHAVE is to improve the quality of health care for senior citizens provided in New Jersey by addressing 

Medicare, Medicaid and other health insurance discrepancies, including but not limited to waste, fraud and abuse, through 

the use of trained retired persons as volunteers. The objectives of this project are: 1) to continue and expand working 

relationships with local aging and community service agencies; 2) train new Training Associate Agencies; 3) recruit and 

train volunteers; 4) increase awareness of Medicare and Medicaid beneficiaries and their caregivers through community 

and media events; 5) identify and report new potential cases of health insurance discrepancies; 6) evaluate effectiveness 

of the project; and 7) work in collaboration with the NJ State Health Insurance Assistance Program (NJ SHIP) on Medicare 

issues. To achieve the objectives of this project, NJHAVE will collaborate with NJ SHIP, Retired Senior Volunteer 

Programs, NJ Triad Association, NJ Association of Area Agencies on Aging, NJ Housing and Mortgage Finance Agency, 

and Empire Medicare Services. The target populations of the project are Medicare and Medicaid beneficiaries, with 

special outreach to the visually and hearing impaired senior populations. The expected outcomes are: increased 

awareness of fraud; and an increase of reported cases and continued increase of informed health care consumers 

throughout the state. The major products of the project are new and/or revised educational and training materials, and 

outreach and educational materials available in various languages, Braille and large print for the visually impaired.

Project Period: 07/01/2001 - 06/30/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

FY 2004

180,000

180,000

202,000

180,000

515 Plainfield Avenue 

Program: 

JEWISH FAMILY & VOCATIONAL SERVICE OF MIDDLESEX COUNTY

Senior Medicare Patrol Project 411

90AM2447
Page 126 of 223 

KENTUCKY ASSOCIATION OF SENIOR SERVICE CORPS SENIOR MEDICARE 

PATROL PROJECT

Frankfort, KY 40601

Contact: Judy Cederholm 

This three-year cooperative agreement is a Senior Medicare Patrol (SMP) project managed by the grantee. The Kentucky 

Association of Senior Service Corps collaborated with the local AAAs, State Medicaid Fraud Unit, LTC Ombudsman and 

the Project Advisory Councils. The target population of this SMP project is Kentucky seniors in 40 counties. The goal of 

this project is to develop and strengthen the SMP program by making seniors aware of Medicare/Medicaid (MMF) waste, 

fraud, error and abuse and educating seniors on the detection and reporting of fraud and abuse, relative to the Medicare 

statement and services received. The objective of the program is to establish a state SMP through the existing Retired 

Senior Volunteer Program (RSVP). The expected outcomes of this MMF program are: an SMP Plan; RSVP Programs; 

and an RSVP evaluation. The products of this project are a final report and training materials.

Project Period: 07/01/2001 - 06/30/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

FY 2004

187,176

164,176

186,176

164,176

3445 Versailles Road #A 

Program: 

KENTUCKY ASSOCIATION OF SENIOR SERVICE CORPS

Senior Medicare Patrol Project 411

90AM2448

SENIOR MEDICARE PATROL PROJECT

Cookeville, TN 38506-8506

Contact: Nancy C. C Peace 

The Senior Medicare Patrol (SMP) Project is a three-year cooperative agreement managed by the grantee, the Upper 

Cumberland Development District/AAA. The collaborators of this SMP project are the Area Agency on Aging (AAA), the 

AAA Senior Centers, AARP, Tennessee (TN) Aging and Disability Network, CIGNA, and LTC Ombudsman. The target 

population is the senior centers' individuals. The goal of this project is to develop and support an SMP which will prepare 

and make seniors aware of the Medicare/Medicaid waste, fraud, error and abuse. The objective of this program is to 

recruit and train retired persons who will serve as volunteer community experts and develop resources in combating 

health care fraud, waste and abuse. The anticipated outcomes of this project are: recruitment of a cadre of volunteers; 

educational workshops, inc. Agricultural Extension Services workshops; FBI (TBI-Tennessee Bureau of Investigation) 

trainers. The products of this project are a final report, educational materials, and training materials.

Project Period: 07/01/2001 - 06/30/2005

FY Grant Amount

FY 2001

FY 2002

FY 2003

FY 2004

201,000

180,000

202,000

180,000

1225 South Willow Avenue 

Program: 

UPPER CUMBERLAND DEVELOPMENT DISTRICT/AAA

Senior Medicare Patrol Project 411

90AM2449
Page 127 of 223 

Senior Medicare Patrol Project

Montgomery, AL 36130-1851

Contact: Judy Meeks 

The Senior Medicare Patrol (SMP) Project is in its third year of a cooperative agreement sponsored by the grantee, 

Alabama Department of Senior Services. The grantee collaborated with Blue Cross Blue Shield (BCBS), NAACP, AARP, 

RSVP, Alabama Nursing Home Association, Association of Home Health Agencies, and the Medicaid Fraud Unit of the 

Attorney General. The goal of this SMP project is to educate seniors about detecting and reporting health care error, fraud 

and abuse. The objective of this SMP program is to work with all 67 counties in the state in order to train minorities, the 

disabled and rural seniors, with the support of the 13 Area Agencies on Aging (AAA), to be aware of, detect, and report 

cases, complaints of error, fraud and abuse in their Medicare/Medicaid billings. The major outcomes are: a regional 

advisory committee of three volunteers each to serve as educators; the results of peer counseling to seniors; a reporting 

system to collect data on program evaluation; referrals of cases to the Medicaid Fraud Unit; the results of the collaboration 

by the 13 AAAs; the results of the regional advisory committee; and results of peer counseling to seniors. The products of 

this SMP project are a final report; findings of the 67 counties; a volunteer recruitment kit; and a reporting system to collect 

data on evaluation.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

160,000

160,000

770 Washington Avenue, Suite 470 

Program: 

Alabama Department of Senior Services

Senior Medicare Patrol Project 411

90AM2580

Senior Medicare Patrol Project: Volunteer Program

Columbus, OH 43215-3215

Contact: Lisa Durham (614)645-3382

This Senior Medicare Error Patrol (SMP) project is the third year of a three year cooperative agreement project. The 

collaborators are the Ohio Department of Aging workgroup, the Attorney General Office (Victim Assistance, Senior 

Protection Initiative, and Senior Protection Initiative and Senior Pro Bono project), Council on Aging of Southwestern Ohio, 

Adult Protective Services, and others. The goal of this SMP project is to develop the Senior Medicare Error Patrol by 

enabling Medicare/Medicaid (M/M) beneficiaries to detect and report fraud, error and abuse. The objective of this SMP 

project is to train and support eligible M/M senior in SW Ohio. The major expected outcomes are: a Senior Medicare 

Patrol established; data collection and reporting forms developed; 30 senior volunteers assisting M/M beneficiaries, 

recruited and trained; and 5000 seniors reached. The products of this SMP program are a final report; a Senior Medicare 

Patrol; and project data forms.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

123,128

145,128

123,128

174 E Long Street 

Program: 

Central Ohio Area Agency on Aging

Senior Medicare Patrol Project 411

90AM2581
Page 128 of 223 

Collaborative SW OH Volunteer Training & Support for Public Education, Counseling & 

Referral for Medicare/Medicaid Fraud

Cincinnati, OH 45237-3838

Contact: Rhonda Y. Y Moore (513)458-5506

This is a three year, co-operative agreement, Senior Medicare Patrol Project (SMP) supported by the grantee, Pro 

Seniors, Inc., in collaboration with the National Council for the Prevention of Elder Abuse, Council on Aging of 

Southwestern Ohio, Adult Protective Services, Office of the Attorney General, Coalition for Nursing Home Reform and 

many others. The target population is eligible Medicare/Medicaid (M/M) persons in SW Ohio. The goal of this SMP project 

is to develop and strengthen the Senior Medicare Error Patrol, who will make seniors aware of and educated about 

combating M/M waste, fraud, error and abuse. The objective of this SMP program is to train and educate senior volunteers 

on M/M fraud. The expected and major outcomes of this SMP program are: a Senior Medicare Patrol Project established; 

project forms developed; data collected; 30 volunteers trained to help others; and 5000 individuals contacted through 

outreach. The products of this project are: a final report; training materials; project forms; and a data bank of fraud cases.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

124,863

124,863

124,863

7162 Reading Road Suite 1150

Program: 

PRO SENIORS, INC.

Senior Medicare Patrol Project 411

90AM2582

Senior Medicare Error Patrol Projects

Richmond, VA 23219-3219

Contact: E. Harris Spindle (804)644-2804

This Senior Medicare Patrol Project, known as the Senior Medicare Error Patrol Project, is managed by the Virginia 

Association of Area Agencies on Aging (V4a). The collaborators in this project are the 25 Area Agencies on Aging. The 

goal of the project is to develop the Senior Medicare Error Patrol Project by educating beneficiaries through senior 

volunteers about Medicare and Medicaid fraud, error and abuse. The objectives are: to recruit and train retired 

professional volunteers to educate the elderly population about Medicare and Medicaid and how to detect and report 

fraud, error and abuse; and to provide outreach and education to the minority, rural, disabled and non English speaking 

elderly population. The expected outcomes are: increased consumer awareness of fraud and how to report it; and 

decreased Medicare and Medicaid fraud. The products from this project are: a final report, training packages, and data 

collection instruments.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

182,000

160,000

24 E. Cary Street - 1st Floor 

Program: 

VIRGINIA ASSOCIATION OF AREA AGENCIES ON AGING

Senior Medicare Patrol Project 411

90AM2583
Page 129 of 223 

Arkansas Senior Medicare/Medicaid Fraud Patrol

Little Rock, AR 72203-1437

Contact: John V. V Diaz 

This three year cooperative agreement, Arkansas Senior Medicare/Medicaid Fraud Patrol (ASMP) project, is managed by 

the grantee. Collaborating with the State Unit on Aging are the local regional partners, including AAAs, RSVPs, and 

Community Action Program agencies; the UA Cooperative Extension Service; Governor's Commission on People with 

Disabilities; Attorney General's Medicaid Fraud Control Unit; the Arkansas Advocates for Nursing Home Residents 

(AANHR); the Developmental Disability Council and the DDS; Arkansas Foundation for Medical Care (the QIO); the SHIIP; 

and AARP. The goals of this SMP project are: to recruit and train retired Medicare beneficiaries, who in turn educate and 

inform other beneficiaries and local communities about the nature and extent of errors, fraud, and abuse in the Medicare 

and Medicaid programs; and to help identify and report suspected errors, fraud and abuse. The objectives of this project 

are to combat Medicare/Medicaid fraud and to educate beneficiaries, caregivers and the general community. The 

expected outcomes are: a statewide network of trained and active volunteers who reach out to local communities through 

group presentations, community education events, one-on-one counseling and mass media; an Advisory Council that will 

provide input and advice regarding various aspects of the project and assist the project in accomplishing its goals; nursing 

home fraud targeted via the state Ombudsmen, the nursing home Family Councils, and publication of a Consumer 

Handbook for Nursing Homes; a 24-hour toll-free hotline in operation to receive complaints; complaints 

documented,verified/ resolved/referred; and statewide expansion. The products are: interim and final reports; training 

curricula and materials; web page; materials for use by the volunteers in community outreach; best practices developed 

and published; and performance measures documents.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

165,000

160,000

PO Box 1437, Slot S530 700 Main Street

Program: 

ARKANSAS DEPARTMENT OF HUMAN SERVICES

Division of Aging and Adult Services

Senior Medicare Patrol Project 411

90AM2584

Senior Medicare Error Patrol

Juneau, AK 99811-0209

Contact: Teresa Clark 

This is a three year cooperative agreement of an Alaska based Senior Medicare Error Patrol (SMP) project, targeted for 

Alaskan Native Medicare beneficiaries and providers. The goal of this SMP project is to save Medicare/Medicaid (M/M) 

and private dollars by providing beneficiaries education programs that will assist senior Alaskan Natives to detect and 

report error, fraud and abuse. The collaborators with this grantee are Alaskan Native Tribal Health Consortium, AARP, 

RSVP, Alaska Commission on Aging, Older Persons Action Group. The objectives of the SMP project are to assist 

Alaskan Natives in reviewing their medical billings, and to assist providers in solving difficult billings before they enter the 

system. The expected outcomes are: a corp of 60-75 volunteers; medical billing students assisting providers; behavior 

change in seniors so they review their bills; fraud and abuse cases detected, reported and solved; findings of dollars 

saved; increased number of Alaskan Native beneficiaries assisted; increased number of providers assisted. The products 

of this SMP program are a final report; lessons learned; classroom curriculum.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

149,482

149,482

149,482

PO Box 110209 

Program: 

ALASKA COMMISSION ON AGING

Senior Medicare Patrol Project 411

90AM2585
Page 130 of 223 

Medicare Overpayment Detectives or the MOD Squad Volunteers Will Educate Other 

Older Adults about Medicare Fraud & Abuse

Houston, TX 77027

Contact: Candice Twyman (713)341-6141

This Texas project is a three year cooperative agreement Senior Medicare Patrol (SMP) project that is managed by the 

grantee, the Better Business Bureau Education Foundation (BBBEF). The collaborators in this SMP project are 

TeleMundo (Spanish television), Hispanic Chamber of Commerce, Houston AAA, AARP, Asian American Family 

Counseling Center, and the Indochinese Cultural Center (Vietnamese). The goal of this SMP project is to train minority 

seniors to detect and report Medicare/Medicaid (M/M) fraud, error and abuse. The objective of this MMF project is to 

recruit and train diverse retired professional volunteers to educate groups of Medicare beneficiaries how to detect and 

report M/M fraud (MMF), error and abuse. The anticipated outcomes of this MMF project are: education and information to 

change behavior; train the trainer materials; corp of volunteers; continuing education for volunteers; develop a reporting 

system; a self-defense kit. The products of this MMF program are a final report; materials in Spanish; pre and post 

presentation quizzes; train the trainer materials; planned presentations; a reporting system for data; and a self-defense kit.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

101,165

108,665

101,165

1333 West Loop South Suite 1200

Program: 

Better Business Bureau Education Foundation

Senior Medicare Patrol Project 411

90AM2586

Combating Health Care Waste, Fraud and Abuse

Lansing, MI 48917-4850

Contact: Mary M Ablan (517)886-1029

The Area Agencies on Aging (AAA) Association of Michigan is the grantee for this three year, cooperative agreement 

Senior Medicare Patrol (SMP) project, in collaboration with the Centers for Medicare and Medicaid Services, the Michigan 

Office of Services to the Aging and the Michigan Peer Review Organization (PRO). The target populations of this project 

are the Medicare/Medicaid (M/M) beneficiaries and their caregivers in the state of Michigan. The goal of this SMP project 

is to combat Health Care Waste, Fraud (MMF) and Abuse. The objective of this SMP project is to train a statewide 

network of volunteers in M/M waste, fraud and abuse and receive support from volunteer coordinators. The anticipated 

outcomes of this MMF project are: enhanced awareness of detecting and reporting health care waste, fraud and abuse; 

enhanced reporting by volunteers; increased # of toll-free hotline calls; and increased skills of beneficiaries in detecting 

and reporting. The products of this SMP project are a final report, and project data collection.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

202,000

160,000

160,000

6105 West St. Joseph, Suite 209 

Program: 

AREA AGENCIES ON AGING ASSOCIATION OF MICHIGAN

Senior Medicare Patrol Project 411

90AM2587
Page 131 of 223 

Massachusetts Medicare, Outreach and Education Project

Lawrence, MA 01843-3740

Contact: Carolyn Hubers (978)683-7747

This is the third year of a three year cooperative agreement for a Massachusetts based Senior Medicare Patrol (SMP) 

project managed by the grantee, Elder Services of the Merrimack Valley, Inc., an Area Agency on Aging (AAA). The AAA 

will collaborate with the Executive Office of Elder Affairs, the State Unit on Aging (SUA) and MA SHIP program, the Mystic 

Valley Elder Services, Minuteman Elder Services, Minuteman Home Care and Danvers Council on Aging. The goal is to 

build the capacity of the 12 MA SHIP programs and to educate and bring awareness to the Medicare/Medicaid fraud 

(MMF), error and abuse to the vulnerable Medicare beneficiaries. The objective is to recruit and train retired professional 

volunteers to educate groups of M/M beneficiaries about detecting and reporting M/M fraud, error and abuse. The major 

outcomes are: self assured and less intimidated consumers when interacting with M/M programs; a survey of consumers 

counseled to identify error, fraud or abuse; a mini-grant process to build the capacity of AHIP sites to provide outreach and 

education; a media campaign; results of meetings with minority organizations; results of outreach and education; results of 

mini-grant process; results of survey; number of cases of error, fraud or abuse. The products are a final report, Public 

Service Announcements, and newsletters.

Project Period: 07/01/2002 - 12/31/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

218,152

198,152

176,152

360 Merrimack Street, Building #5 

Program: 

ELDER SERVICES OF THE MERRIMACK VALLEY, INC.

Senior Medicare Patrol Project 411

90AM2588

SUMMIT Medicare/Medicaid Fraud, Abuse and Waste Reduction Program

Oklahoma City, OK 73152-3408

Contact: Cindy A Brown (405)521-6632

This three year cooperative agreement, Senior Medicare Patrol (SMP) project, is sponsored by the grantee, the Oklahoma 

Insurance Department (OID). The collaborators with the grantee are the State/Federal Fraud Investigators, AARP 

Oklahoma, Oklahoma Indian Council on Aging, Long-Term Care Ombudsman Program, Oklahoma Association for Senior 

Centers, Oklahoma Area Aging Agencies, and the Oklahoma Senior Health Insurance Counseling Program. The goal of 

this MMF project is to reduce Medicare/Medicaid fraud (MMF), abuse and errors for Oklahoma Hispanic, American 

Indians, rural and isolated senior populations. The objective of the MMF program is to recruit and train retired 

professionals, family caregivers, and people who work in the aging field to educate groups of Medicare beneficiaries about 

detecting and reporting MMF, error and abuse. The expected outcomes are: MMF information for homebound Oklahoma 

seniors; rural public service announcements; print ads for rural newspapers, for professional and organizational 

newsletters, for the Oklahoma Viet Times, and for Viva Oklahoma Hispanic news; a video in Creek Nation language; a 

program evaluation; trained volunteers; M/M education programs; and minority participants. The products of this SMP 

project are: a final report; MMF findings by the State/Federal Fraud Investigators; rural PSAs; ads in newsletters; a video 

in Creek for Creek Nation Indians; and an evaluation.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

182,000

212,523

PO Box 53408 

Program: 

STATE OF OKLAHOMA INSURANCE DEPARTMENT

Senior Medicare Patrol Project 411

90AM2589
Page 132 of 223 

A MEDICARE FRAUD PATROL PROJECT IN RURAL LATINO COMMUNITIES

Washington, DC 20036

Contact: Jose L Velasco (202)265-1288

This is the third year of a co-operative agreement Senior Medicare Fraud Patrol (SMP) project managed by the grantee, 

the National Hispanic Council on Aging (NHCoA), located in Washington, D.C. The project was carried out in El Paso, TX; 

Dallas, TX; La Joya, TX; and Brownsville, TX. The goal of this project was to develop the Senior Medicare Waste Patrol 

in the Latino Communities by reporting waste in the Medicare/Medicaid (M/M) health programs. The objective of the 

project was to recruit and train peer advocates (Voceros-Voices) toward the success of the Medicare Waste patrol project. 

The project targeted the population of rural persons with very low income, resources and educational level. The major 

outcomes of this project are established study circles; and established partnerships and linkages. The products of this 

program are a final report; and education materials for 25,000 seniors.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

191,497

191,497

191,462

1341 Connecticut Ave., NW Suite 4-A

Program: 

NATIONAL HISPANIC COUNCIL ON AGING

Senior Medicare Patrol Project 411

90AM2590

Colorado Anti-Fraud Education Project

Denver, CO 80202-0202

Contact: Robert Pierce (303)894-7552

This is the third year of a three year cooperative agreement to establish a Colorado based Senior Medicare Patrol (SMP) 

Grant project, managed by the Colorado Division of Insurance, in collaboration with the State Long-Term Care 

Ombudsman program, Colorado Coalition for Elder Right and Adult Protection, and the Colorado SHIP program. The goal 

of this project is to continue public education about Medicare and Medicaid fraud. The objectives of this program are to: 

ensure consumer awareness of Medicare and Medicaid error, fraud and abuse; educate on suspected fraud detection and 

reporting; provide individual counseling evaluation of fraud reports; measure the understanding of Medicare fraud; and 

address literacy, language, and disability access barriers. Providers and consumers who are Spanish speaking, 

vulnerable or geographically isolated will be targeted for this program. The major outcomes are: a new publication to 

inform consumers about health billing processes and avoiding overpayment; a video entitled 'Paying your Bills Right'; 

measures of pre and post improved understanding of what constitutes fraud; identification of methods for removing rural 

access barriers; a reduction in literacy, language and disability access barriers; number of Medicare and Medicaid fraud 

cases; and an evaluation. Products are: a final report; a new publication; a video 'Paying your Bills Right'; and twelve 

educational presentations.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

189,279

211,417

189,417

1560 Broadway #850 

Program: 

COLORADO DIVISION OF INSURANCE, DORA

Senior Medicare Patrol Project 411

90AM2591
Page 133 of 223 

Statewide Health Insurance Benefits Advisors (SHIBA) Helpline

Seattle, WA 98104-8104

Contact: Joan . R Lewis (206)389-2752

This is a three year cooperative agreement to operate a Washington State based Senior Medicare Patrol Project, 

managed by the Washington Office on the Insurance Commissioner (WOIC). The collaboration will be with Statewide 

Health Insurance Benefits Advisors (SHIBA) statewide sponsors. The target populations are the non-English speaking and 

the minority communities. The goal of this project is to develop and support a Senior Medicare Patrol, which will prepare 

seniors to combat Medicare/Medicaid (M/M) fraud, error and abuse. The objective of this program is to train retired senior 

professional volunteers to handle complex Medicare fraud cases and to report them. The major outcomes are: a data 

collection and retrieval system; a SHIBA Helpline in the Asian-Pacific Islander community; and a fraud web page. The 

products are a final report; training workshops; a data retrieval system; a Helpline; and a web page.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

205,000

182,000

160,000

810 Third Avenue, Suite 650 

Program: 

Washington State Office of the Insurance Commissioner

Senior Medicare Patrol Project 411

90AM2592

Senior Medicare Error Patrol Project

Santa Fe, NM 87501-7501

Contact: Debbie Armstrong 

The grantee, the New Mexico Aging and Long Term Services Department (SUA), will support this three-year cooperative 

agreement Senior Medicare Patrol (SMP) project in collaboration with the Medicaid Fraud Unit, New Mexico Medical 

Review Association (Peer Review Organization) PRO, Senior Citizens Law Office, New Mexico State Bar, Attorney 

General, AARP, Ombudsman, RSVP, and many other partners on the federal and state level. The target population 

includes Medicare and Medicaid (M/M) recipients in New Mexico and their caregivers. The goal of this project is to 

educate the senior and disabled M/M beneficiaries on how to detect and report M/M error, waste, fraud and abuse. The 

objective of this project is to recruit and train retired senior professional volunteers to assist the vulnerable senior/disabled 

individual on how to detect and report M/M fraud, error and abuse; a consortia. The major outcomes are: an enhanced 

Consortium, empowered self-advocacy, and a positive impact on all of the six (6) Planning and Services Areas (PSAs) of 

New Mexico. The product is a final report, and evaluation.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

242,000

222,000

200,000

228 East Palace Avenue 

Program: 

NEW MEXICO STATE AGENCY ON AGING

Senior Medicare Patrol Project 411

90AM2593
Page 134 of 223 

Idaho Medicare Education Partnership

Boise, ID 83720-0007

Contact: Donna Denney 

The Idaho Medicare Education Partnership is a three year cooperative agreement Senior Medicare Patrol (SMP) grant 

supported by the grantee, the Idaho Commission on Aging. The Collaborators are four Native American Tribal Councils; 

Migratory Council; Cigna Senior Health Insurance Advisors, and RSVP. The goal of this project is to establish a corp of 

elderly volunteers who will prepare senior Medicare/Medicaid (M/M) beneficiaries to detect and report error, fraud and 

abuse in these health programs. The objective of the project is to produce a statewide volunteer corp of retired rural 

seniors to teach M/M beneficiaries to understand and analyze their billing and detect and report error, fraud and abuse. 

This project will target rural Idahoans who are frail and low income. Major outcomes in this SMP project are: increased 

outreach efforts; evaluation of program; volunteer stations in rural communities; work with migrant councils to solicit 

volunteers; and recruitment of Native American volunteers through Tribal Councils. Products of this SMP program are: a 

final report; a list of Native American statewide corp of retired volunteers; a report on savings from combating M/M waste; 

and a report on number of cases of fraud and abuse, error and waste.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

205,000

160,000

160,000

PO Box 83720 

Program: 

Idaho Commission on Aging

Senior Medicare Patrol Project 411

90AM2594

Maine Medicare Education Partnership

Augusta, ME 04333-4333

Contact: Betty Balderston 

This is a three year cooperative agreement entitled Maine Medicare Education Partnership sponsored by the grantee. The 

goal of this project is to prepare the at-risk vulnerable elderly to be responsible consumers and to encourage them to 

report suspected Medicare and Medicaid health care fraud (MMF), error and abuse. The project population is the rural and 

French speaking elderly. The objective of the program is to train and educate rural and French speaking older volunteers 

to help Maine Medicare and Medicaid (MMF) beneficiaries to report error, fraud and abuse in these two health programs. 

The collaborators are five (5) AAAs in Maine and the Legal Services for the Elderly (LSE) and the LTC Ombudsman 

program. The anticipated outcomes and products of this MMF program are: 1) seniors educated on how to reduce costs 

attributed to health care errors, fraud and abuse; 2) improved presentation skills of the volunteers; 3) new posters; 4) a 

Community Medicare Advocate Handbook; a 45-minute training video; a statewide conference abstract.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

182,000

160,000

35 Anthony Avenue - 11 State House Station 

Program: 

MAINE DEPARTMENT OF HUMAN SERVICES

Senior Medicare Patrol Project 411

90AM2595
Page 135 of 223 

Senior Medicare Patrol Project

Salem, OR 97301-7301

Contact: GayLynn Pack (503)947-5042

This Oregon based Senior Medicare Patrol (SMP) Project is a three year cooperative agreement sponsored by the 

grantee, in collaboration with the Oregon Association on Area Agencies on Aging, OR Department of Consumer and 

Business Services, AARP, and the Oregon Library System. The goal of this project is to recruit and train seniors to 

combat Medicare and Medicaid (MMF) billings errors, fraud and abuse. The objective of this MMF project is to recruit and 

train retired professional volunteers to educate groups of Medicare beneficiaries about the importance of recognizing and 

reporting M/M fraud (MMF), error and abuse. The major outcomes of this MMF project are: ensured diversity; increased 

outreach; a publicized, toll-free telephone number for the Oregon Fraud Reporting Line; an increase by 5,000 in the 

number of seniors' awareness; and 75% of seniors will have reported greater understanding of Medicare. The products of 

this MMF program are a final report; a toll-free telephone; brochures, flyers, health care journals; a data collection 

instrument; and CREEK tribal presentation materials.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

182,000

160,000

500 Summer Street NE E-95 

Program: 

Seniors and People with Disabilities

Senior Medicare Patrol Project 411

90AM2596

Atlanta Senior Medicare Patrol Project

Atlanta, GA 30303-0303

Contact: Victoria Shanahan (404)463-3220

This project, entitled the Atlanta Senior Medicare Patrol (SMP) Project, is the third year of a three year cooperative 

agreement for a Senior Medicare Patrol Project sponsored by the grantee, the Atlanta Regional Commission (ARC). The 

collaborators that will work with ARC are AARP; Jewish Family and Career Services; Christian Methodist Episcopal 

Church; Center for Pan Asian Community Services; DeKalb County; Center for Positive Aging; and the Council on Aging . 

The goal of this project is to use volunteers to help beneficiaries of Medicare and Medicaid (MMF) identify and report error, 

fraud and abuse. The objective of the MMF project is to use 22 trained volunteers to help low income and minority elderly 

and disabled adults to identify and report error, fraud and abuse. Major outcomes of this program are: changes in behavior 

of M/M beneficiaries by taking responsibility to assess their Medicare bills and take action; increased confidence among 

the eight partner agencies; education of 31,520 persons on M/M uses; 3,250 presentations; a program manual describing 

the "Pass it on Campaign"; and Area Agencies on Aging (AAA) replication strategies. The products of this MMF program 

are: a final report with findings; a report on the error, fraud and abuse cases uncovered; Georgia Generations magazine; 

and "Aging Connection", a program manual.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

182,000

160,000

40 Courtland Street 

Program: 

ATLANTA REGIONAL COMMISSION

Senior Medicare Patrol Project 411

90AM2597
Page 136 of 223 

Senior Medicare Error Patrol Project

Washington, DC 20049-0049

Contact: Brian Bullock (202)434-2153

The Senior Medicare Error Patrol Project (SMEPP) is in the third year of a three year cooperative agreement project 

administered by the Legal Counsel for the Elderly, Inc. (LCE). The goal of the SMEPP is to enhance its current model of 

utilizing retired persons as volunteer resources and educators of Medicare and Medicaid beneficiaries to combat health 

care error, fraud and abuse throughout the District of Columbia. Since 1975, LCE has been an integral partner in the 

District's coalition of community organizations serving the elderly and the aging network of the DC Office on Aging. LCE 

will build on its presence in the community and partner with the aging network, George Washington University - Health 

Insurance Counseling Project, the American Association of Retired Persons and other community organizations to 

achieve the goal of the SMEPP. The objectives of the project are: 1) to recruit and train new volunteers to inform and 

educate beneficiaries on detecting and reporting error, fraud and abuse; 2) design and update health care fraud materials; 

3) serve as liaison to the health care and aging networks to establish linkages with additional public and private agencies 

to address systemic issues; 4) expand outreach to beneficiaries and the aging and other service provider networks; and 5) 

expand and refine the current intake and reporting system. The target populations of the SMEPP are Medicare and 

Medicaid beneficiaries, with special outreach to the non-English speaking Spanish and Chinese communities and 

low-income elderly. The major outcome of the project will be an increase in the knowledge of beneficiaries and the public, 

to enable them to prevent and/or report health care fraud and errors, evaluated through a three tier approach. The 

products of the project are: new and/or updated training and educational materials; bi-lingual outreach and educational 

materials; quarterly newsletters; and a Medicaid consumer handbook.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

182,000

160,000

601 E Street, NW 

Program: 

Legal Counsel for the Elderly

Senior Medicare Patrol Project 411

90AM2598

Ferret Out Fraud - Senior Patrol Project

Phoenix, AZ 85007-5007

Contact: Martha Taylor 

The grantee, the Arizona Department of Economic Security, is the State Unit on Aging that manages this third year of a 

three year cooperative agreement for the Senior Medicare Patrol (SMP) Project. The collaborators are the Inter-tribal 

Council of Arizona, Navajo Nation, AZ Office of Attorney General, Better Business Bureau(BBB), and the AZ Department 

of Insurance. The goal of this MMF project is to assist Hispanic seniors to detect and report Medicare/Medicaid (MMF) 

fraud, error and abuse. The objective of this MMF project is to investigate and prosecute M/M fraud. The major outcomes 

of this MMF project are: M/M Hispanic beneficiaries educated on ways to detect and report billings fraud; a list of identified 

complaints; increased knowledge and skills; an expanded fraud coalition through work with fraud partners and 

identification of new partners; an advisory committee of beneficiaries; volunteers matched with mentors; a large technical 

assistance and support group; continuing education units (CEU) for beneficiaries; resolution of cases of fraud, error and 

abuse identified by this project. The products of the MMF program are: a final report; materials in Spanish; results of 

collaborators efforts; a trainers program; list of the fraud coalition; list of new partners in outreach; list of new volunteers 

with mentors.

Project Period: 07/01/2002 - 06/30/2006

FY Grant Amount

FY 2002

FY 2003

FY 2004

159,931

181,943

159,943

1789 West Jefferson - 905A 

Program: 

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

Senior Medicare Patrol Project 411

90AM2599
Page 137 of 223 

Senior Medicare & Medicaid Patrol Project

Tallahassee, FL 32399-7000

Contact: Don Holmes 

This Senior Medicare Patrol (SMP) Project is a three year cooperative agreement supported by the grantee, the Florida 

State Unit on Aging (SUA). The collaborators for this program are Area Agencies on Aging (AAA) in Fort Myers, Tarpon 

Springs, St. Petersburg, Pinellas Park and Gulfport. The goal of this project is to develop and implement a Senior 

Medicare and Medicaid Fraud (MMF) Patrol project for low-income elders and minorities. The objective of the MMF project 

is to reduce Medicare losses due to errors, fraud and abuse using retired professionals. The major outcomes are: data 

collection on losses to 36,000 elderly attendees annually; recruitment and training of 60 retired professionals with diverse 

backgrounds to serve as volunteers; establishment and maintenance of a database and tracking system for reporting; 

development of an SMP cable television presentation; a seniors' survey; and results of SMP cable T.V. The products of 

this MMF program are: a final report, including the number of Medicare losses due to errors; findings from a group of 60 

retired Hispanic professionals; results of survey of 80% of at-risk attendees; an impact survey; multi-lingual (Hispanic) 

promotional materials; and a database tracking system.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

202,000

158,500

158,500

4040 Esplanade Way 

Program: 

FLORIDA DEPARTMENT OF ELDER AFFAIRS

Senior Medicare Patrol Project 411

90AM2600

Senior Medicare Patrol Project

Atlanta, GA 30303-0303

Contact: Erika Lawson (404)657-5253

This is a three year Senior Medicare Patrol (SMP) Project sponsored by the grantee, the Georgia Department of Elder 

Affairs, the State Unit on Aging (SUA). The goal of this project is to educate and inform three million elders, their families, 

caregivers, friends and professionals in Georgia about Medicare/Medicaid (MMF) fraud, error and abuse. The objective of 

the MMF project is to enhance and expand this effort thoughout the state and local areas using volunteers from retired 

professionals groups, targeting rural populations and limited English speaking persons. Collaborators with the grantee, the 

Georgia Department of Elder Affairs, are: Cigna Health Care Medicare Administration; the LTC Ombudsman; the 

University of Georgia; and 12 Area Agencies on Aging (AAA). The major outcomes of this MMF project are: lowered costs 

for Medicare/Medicaid use after error, fraud and abuse cases are uncovered; project cost savings through the use of 

volunteers; better records of complaints of error, fraud and abuse; a corp of professional volunteers; additional models for 

outreach; innovative training models; and a professional volunteer recruitment steering committee. The products of this 

MMF program are a final report; training models; and models for outreach.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

160,000

160,000

Two Peachtree Street, NW, Suite 9-398 

Program: 

GA Department of Human Resources

Senior Medicare Patrol Project 411

90AM2601
Page 138 of 223 

Medi$ave Program

Hartford, CT 06106-6106

Contact: Mimi Peck-Llewellyn (860)424-5862

The vulnerable at-risk elderly will be protected in this third year of a three year cooperative agreement project that will 

prevent Medicare/Medicaid (MMF) fraud, waste and abuse. The goal of this MMF project is to increase beneficiary 

awareness of Medicare and Medicaid fraud and abuse, including understanding health care statements (bills). The 

objectives of this MMF project are: 1) to expand current programming for recruiting, training and maintaining retired 

seniors and other professionals in the aging network; 2) to increase beneficiary awareness of M/M fraud and abuse, 

including understanding health care statements (bills) and the importance of keeping track of medical appointments and 

procedures; 3) to further educate the medical community on M/M related issues; and 4) to establish a collaboration with 

the medical community to reduce billing errors. The major outcomes of this MMF are: a pilot project that will train and 

assist medical professionals to address servicing concerns; office training for billing and front desk staff of three local 

physician groups; mailing of project brochures to all Medicaid coverage groups who are elderly and/or disabled; and an 

established fraud, waste and abuse tracking system. The products of the MMF program are a final report; project 

brochures; a state-wide health journal; a data tracking system.

Project Period: 07/01/2002 - 06/30/2006

FY Grant Amount

FY 2002

FY 2003

FY 2004

FY 2005

160,000

160,000

160,000

40,000

25 Sigourney Street, 10th Floor 

Program: 

CONNECTICUT DEPARTMENT OF SOCIAL SERVICES

Elderly Services Division

Senior Medicare Patrol Project 411

90AM2602

Puerto Rico Project Alert to Fraud

San Juan, PR 00902

Contact: Rossana Lopez Leon (787)721-4560

This is the third year of a Senior Medicare Patrol Project, known as Project ALF, managed by the Governor's Office of 

Elderly Affairs in Puerto Rico, a State Unit on Aging. It is run under a cooperative agreement with the Administration on 

Aging for a three year period. Goal: to develop a Senior Medicare Patrol which will combat Medicare and Medicaid fraud, 

error and abuse. Objective: to recruit and train retired professional volunteers in order to educate the Hispanic population 

on the island about Medicaid and Medicare and how to detect and report fraud, error and abuse. Outcomes: develop an 

information system; informal orientation sessions; recoup dollars lost to Medicaid and Medicare as a result of fraud and 

abuse; a public education plan; recruit and train a cadre of 50 retired volunteers; implement outreach strategies; training 

seminars for 200 aging network staff, providers and recipients; partnership with state Medicare experts; provision of 

prevention information to an estimate of 5,000 older persons. Products: final report, outreach strategy, and materials for 

training seminars.

Project Period: 07/01/2002 - 05/30/2006

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

182,000

160,000

Po Box 50063 Old San Juan Station

Program: 

GOVERNOR'S OFFICE FOR ELDERLY AFFAIRS

Senior Medicare Patrol Project 411

90AM2603
Page 139 of 223 

Delaware Medicare Patrol Project

New Castle, DE 19720-9720

Contact: Carol Barnett (302)577-4791

This is the third year of a grant whose purpose is to educate Delaware Medicare beneficiaries, caregivers and 

professionals about the different agencies available to help them make informed decisions regarding Medicare and issues 

they may encounter. Objectives: recruit and train volunteers to assist in educating Delaware's caregivers and Medicare 

beneficiaries; establish and promote Spanish Call Line; increase awareness and educate new and existing partners and 

the public though newsletters, media outreach and presentations at conferences; strengthen existing partnerships. 

Outcomes: successful ways to reach people on Medicare and those approaching Medicare age, as well as those caring 

for a Medicare beneficiary; Medicare Road Show; 7 events structured to focus on education about the Medicare 

Prescription Improvement and Modernization Act of 2003; and presentations on the various drug cards and CMS break 

out sessions. Collaborators: this statewide cooperative effort includes Delaware Medicare Fraud Alert, Delaware Medicare 

Partners Coalition, Quality Insights of Delaware, ElderInfo (Ship Program), Senator Carper's and Senator Biden's Offices, 

Congressman Castle's office, CMS, TrailBlazer Health Enterprises, SSA, Dept. of Veteran Affairs, Nemours Clinic, 

CareDelaware, Delaware Prescription Assistance Program, and Empire Medical Services. Products: Spanish hotline, 

media materials, newsletters, presentations, and the Medicare Road Show.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

160,000

160,000

160,000

1901 N. DuPont Highway 

Program: 

DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES

Senior Medicare Patrol Project 411

90AM2604

Senior Nevada Advocates on Guard (SNAG)

Las Vegas, NV 89101-9101

Contact: JoAnne C. C Embry (702)486-3154

This is a three year cooperative agreement with the Nevada Office of the Attorney General. The collaborators are: the 

Nevada Division for Aging Services ( DAS ) and SHIP, the Nevada Attorney General, AARP, Medicare Advisory 

Foundation, FBI, Center for Medicaid and Medicare (M/M) Services, Family Resource Centers, Clark County Senior and 

Advocate Program. The goal of this MMF project is to develop the Senior Medicare Patrol (SMP) by preparing senior 

consumers to be aware of Medicare/Medicaid fraud (MMF), error and abuse. The objective of this MMF project is to recruit 

and train retired professional seniors to educate M/M beneficiaries to detect and report fraud, error and abuse. The major 

outcomes of this MMF project are: 60 volunteers trained; 40 senior centers and senior agencies contacted; information 

disseminated to frail, homebound and rural; Hispanic SMP volunteer educators recruited.; training materials developed for 

outreach through the Family Resource Centers. The products of the MMF program are a final report; outreach training 

materials.

Project Period: 07/01/2002 - 06/30/2006

FY Grant Amount

FY 2002

FY 2003

FY 2004

FY 2005

160,000

190,000

168,000

42,000

555 East Washington Avenue, Suite 3900 

Program: 

NEVADA OFFICE OF THE ATTORNEY GENERAL

Senior Medicare Patrol Project 411

90AM2605
Page 140 of 223 

Montana Medicare Waste Project

Missoula, MT 59801-9801

Contact: Susan Kohler (406)728-7682

This is the third year of a three year cooperative agreement for a Montana based Senior Medicare Patrol (SMP) project 

managed by the Missoula Area Agency on Aging (AAA). The collaborators are the State Health Insurance and Counseling 

Program (SHIP); the U.S. Attorney for Montana; Area Agencies on Aging (AAAs); Senior Citizen Centers; and Blue 

Cross/Blue Shield of Montana. The goal of this Medicare/Medicaid Fraud project is to bring awareness to 

Medicare/Medicaid (M/M) beneficiaries and their caregivers in Montana about error, fraud and abuse in these M/M 

programs. The objective of this MMF project is to recruit and train 50 rural senior volunteers to equip 6000 Medicare 

beneficiaries to detect and report cases of error, fraud and abuse. The major outcomes of this MMF program are: an 

alliance of public, private, and charitable organizations; increased volunteer resources and educators; 50 newly trained 

rural volunteers; 6000 Medicare beneficiaries trained; strengthened community coalitions; involved AAAs; a strong 

collaboration effort; and a strong information and assistance network. The products will be listed in the final report.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

200,000

222,000

200,000

337 Stephens Ave 

Program: 

Missoula Area Agency on Aging

Senior Medicare Patrol Project 411

90AM2606

Senior Medicare Patrol Project of the District of Columbia

Washington, DC 20003-0003

Contact: Joe Harris (202)675-9242

This is a three year cooperative agreement for a Senior Medicare Patrol (SMP) Project of the District of Columbia 

administered by the grantee, the Friendship House Association, Inc. The collaborator with the Friendship House 

Association, Inc. is the Greater Washington Urban League, Inc. The goal of this Medicare/Medicaid Fraud (MMF) project is 

to increase the awareness of low income and limited education individuals on methods to reduce or prevent the incidence 

of MMF fraudulent practices. The objective of this MMF project is to educate the hard-to-serve seniors in Wards 5-8 to 

detect and report error, fraud and abuse in these health programs. The major outcomes of this MMF project are: a 

replicable model; standardized measures to evaluate program; improved knowledge on MMF; referral of fraud cases to 

the Medicare hotline; and increased awareness of SMP program to seniors and to service providers. The products of this 

MMF program are: a final report; and a report on the number of complaints of error, fraud, and abuse in Wards 5-8.

Project Period: 07/01/2002 - 06/30/2005

FY Grant Amount

FY 2002

FY 2003

FY 2004

159,970

159,970

159,970

619 D Street SE 

Program: 

FRIENDSHIP HOUSE ASSOCIATION, INC.

Senior Medicare Patrol Project 411

90AM2608
Page 141 of 223 

Maryland Curb Abuse in Medicare and Medicaid (CAMM)

Baltimore, MD 21201-2374

Contact: Michelle Holzer (301)767-1100

The Maryland Department of Aging's "Senior Medicare Patrol Project", known as the CAMM (Curb Abuse in Medicare and 

Medicaid) Project will achieve the following objectives: 1) maintain a volunteer corps of at least 50 individuals' (during the 

reporting period, a monthly average of 94 volunteers were registered) who will provide education to their communities 

about Medicare and Medicaid fraud, waste, and abuse (during the reporting period ending 12/31/2004, 2,966 one-on-one 

sessions with clients occurred; 2) increase public awareness about the problem of fraud and abuse (14,570 people were 

reached through media events and 428 complaints were received); and 3) determine the project's effectiveness through 

measurable outputs. Program outcomes will be: 1) volunteer recruitment, outreach, assistance and community education 

targeted to vulnerable populations; and 2) a strong partnership between service agencies, advocacy groups, and 

enforcement and regulatory agencies developed. The Maryland Department of Aging will heighten public awareness of 

Medicare and Medicaid fraud, waste, and abuse through the use of media and public presentations, conducted throughout 

the grant service area, by a corps of well-trained, retired volunteers, working in concert with thirteen Area Agencies on 

Aging. Products will be listed in the final report.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

197,000

175,000

175,000

301 West Preston Street, Suite 1007 

Program: 

MARYLAND DEPARTMENT OF AGING

Senior Medicare Patrol Project 411

90AM2697

Senior Medicare Patrol Project

Raleigh, NC 27604

Contact: Kevin Robertson (919)733-0111

The North Carolina Department of Insurance (DOI) began its Senior Medicare Patrol Project ("Medicare Lookout") through 

their Seniors' Health Insurance Information Program (SHIIP). The goal is to enable Medicare beneficiaries to understand 

the Medicare system better, to understand their Medicare notices, and to report problems to the appropriate project 

partner. Our statewide focus will build upon the North Carolina Division of Aging (DOA) Senior Medicare Patrol Project. 

We will use core Specialists (community-based organizations, senior volunteers) to form 6-12 regional core Medicare 

Lookout initiatives. These Specialists will recruit exemplary SHIIP volunteers to overcome the barriers to reaching 

Medicare beneficiaries identified by DOA's project and by those of other states. We will build upon DOA's successes by 

expanding the innovative presentations using skits and plays throughout the state, targeting special populations, and 

concentrating outreach through a dedicated core of volunteers. DOA will assist in our start-up and will continue to support 

the project through its duration. Our Medicare mission and vast network make us a logical home for this project. By the 

middle of the 3rd project year, we will have in place a plan and structure to continue the effort without AoA funds.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

175,000

175,000

111 Seaboard Avenue 

Program: 

NORTH CAROLINA DEPARTMENT OF INSURANCE

Senior Medicare Patrol Project 411

90AM2698
Page 142 of 223 

Statewide Medicare/Medicaid Fraud Project Utilizing WSHIIP Staff and Volunteers

Cheyenne, WY 82002

Contact: Joan Franklin 

For the past three years, the Wyoming Department of Health, Aging Division (AD), a single state planning and service 

area, has collaborated and subcontracted with Wyoming Senior Citizens, Inc. (WSCI), a statewide nonprofit agency, 

implementing and administering the Wyoming Senior Medicare/Medicaid Error Patrol Project. The Aging Division and 

WSCI propose to continue and expand this statewide project through this grant. Wyoming's vastly rural demographics, 

coupled with the fact that Wyoming has the 7th fastest growing aging population per capita in the nation, has presented 

numerous challenges in combating Medicare/Medicaid error, fraud and abuse. The Aging Division and WSCI have 

implemented a systematic, four-part project that educates and provides a referral network on Medicare/Medicaid error, 

fraud and abuse to Wyoming's 39,000 Medicare and 3,700 Medicaid recipients. The Aging Division and WSCI will 

continue and expand on the four-part project during the next three year funding period. The four-part project will focus on 

information and technology; training; referral and direct services; and public information.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

175,000

175,000

6101 Yellowstone Road, Room 259B 

Program: 

WYOMING DEPARTMENT OF HEALTH

Senior Medicare Patrol Project 411

90AM2699

Mississippi Medicare Assistance Patrol Project (MsMAPP)

Jackson, MS 39202

Contact: Betty Green (601)359-4925

The Governor of Mississippi designated the Mississippi Department of Human Services (MDHS), Division of Aging and 

Adult Services (DAAS), as the unit of state government to work with the Administration on Aging (AoA) through the Older 

Americans Act, to direct services to the age 60 and older population and other Medicare beneficiaries. Consistent with the 

mission of the DAAS, the Mississippi Medicare Assistance Patrol Project (MsMAPP) design will establish a network of 

trained persons to serve in their communities as volunteer experts to assist in combating health care error, fraud, and 

abuse. The MsMAPP organizational structure will be led by the MsMAPP program coordinator for the project. The MDHS 

State Office staff oversees the implementation and reporting needs of the grant. The project will incorporate partnerships 

with three AAAs (Central Mississippi, South Delta, and Southern Mississippi) and a legal services provider, the North 

Mississippi Rural Legal Services (NMRLS). Coordination of this grant will occur with the State Health Insurance Program, 

which is referred to as Mississippi Insurance Counseling and Assistance Program (MICAP) in this state. This coordination 

between the MsMAPP and the MICAP program is an important link in rural Mississippi. Each AAA in Mississippi has an 

existing MICAP program and the three AAAs identified in this grant have a broad program base. The staff person 

employed by the NMRLS is a consulting professional for Medicare and Medicaid issues and will provide services in five 

AAAs in North Mississippi. Functionally, the MsMAPP will recruit, train, and retain a cadre of retired persons who will 

serve as experts and educators for older persons in their local communities. The project will maintain a system of tracking 

error, fraud, and abuse referrals to appropriate agencies. Products: Tracking system and a final report.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

175,000

175,000

750 North State Street 

Program: 

MISSISSIPPI DEPARTMENT OF HUMAN RESOURCES

Senior Medicare Patrol Project 411

90AM2700
Page 143 of 223 

Minnesota Medical Care and Anti-Fraud Demonstration Project

St. Paul, MN 55164-0976

Contact: Krista Boston (976)296-2879

Since 1997, MN Board on Aging (MBA) has partnered to decrease fraud, errors, & abuse in Medicare. The Senior 

Medicare Patrol in MN (Medicare FYI) has been fully integrated into the statewide MN State Health Insurance Assistance 

Program (SHIP). In the previous project period, MN Medicare FYI project staff spent much time researching strategies to 

expand the project to combat Medicaid fraud & recover Medicaid dollars. The evolution of the MN Senior Medicare Patrol 

Project, to include a focus on Medicaid, resulted in new partners, e.g. initial activities with the Surveillance Integrity Review 

(SIRS) Unit, MN Dept. of Human Services (DHS), and continued collaboration with MN Home Care Association. As a 

result, MBA intends to build upon these collaborations & continue efforts to decrease Medicare Fraud, with renewed effort 

at raising Medicaid fraud, errors & abuse awareness. MBA will focus on educating consumers on Medicaid fraud, errors & 

abuse by partnering with the SIRS Unit of DHS. Since many MN Medicaid clients receive limited explanation of services, 

or have a minimal understanding of benefits, educating consumers on how to keep track of their services may save 

significant Medicaid $$. The MBA plans to continue focusing Medicare FYI efforts: 1) building on the existing volunteer 

network & expanding developed activities, e.g. technology to educate seniors, caregivers and professionals; 2) identifying 

& emphasizing the importance of reporting both Medicare & Medicaid fraud; 3) distributing outreach and informational 

materials to consumers through multiple communication methods; 4) utilizing the dramatic changes occurring in MN 

long-term care system to educate seniors, their caregivers, county staff & legislators about Medicare & Medicaid fraud, 

errors, & abuse; and 5) focusing information distribution on points of entry to information including pharmacies, physicians, 

& clinics. Products will include a final report, with systems of tracking for replication.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

197,000

175,000

175,000

PO Box 64976 

Program: 

MINNESOTA BOARD ON AGING

Senior Medicare Patrol Project 411

90AM2701

Senior Medicare Patrol

Lac du Flambeau, WI 54538

Contact: Holt Wendell (715)588-3324

Great Lakes Inter-Tribal Council (GLITC) is a consortium of federally recognized Indian tribes in Wisconsin and Upper 

Michigan. Started in 1963 as a Community Action Agency under the auspices of the federal Office for Economic 

Opportunity, it was a vehicle for delivery of services and programs to its member reservations and the rural Indian 

communities of Wisconsin. With the development of local tribal government capacity and the ever increasing push for 

self-determination, the member tribes have assumed the responsibility of more administration of services to their own 

communities. The role of GLITC has therefore changed from one of delivering services directly to the reservation 

community residents, to one of assisting the member tribes in a delivery system of services and programs to back up and 

supplement the tribes' own service capacity. The objectives of this project are to: I) enroll volunteers to educate their 

peers in the prevention of error, fraud, abuse, and waste of Medicare/Medicaid and other health care assistance 

programs; 2) educate the general public in the prevention of error, fraud, abuse, and waste of Medicare/ Medicaid and 

other health care assistance programs; and 3) refer Medicare/Medicaid & other health care assistance program error, 

fraud, abuse, & waste to the appropriate organization(s). Tools needed to enroll, train, & educate participants in the 

program will be developed by the staff of Great Lakes Inter-Tribal Council, (GLITC) in cooperation with Indian Health 

Service Programs, Wisconsin Judicare, Tribal Benefit Specialists & member tribes. Once these objectives have been 

addressed at the sites, we expect that 90% of Elders and other consumers at these various sites will be educated and 

aware to identify error, fraud, abuse, and waste of Medicare/ Medicaid & other health care assistance programs. Data will 

be collected on an ongoing basis through contact with site volunteers. Products will be in final report.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

100,000

100,000

100,000

2932 Highway 47 North P O Box 9

Program: 

GREAT LAKES INTER-TRIBAL COUNCIL, INC.

Senior Medicare Patrol Project 411

90AM2702
Page 144 of 223 

Utah Medicare Education Team

Salt Late City, UT 84103

Contact: Sallie Richardson (801)328-8891

Utah Legal Services, Inc. proposes to continue its Utah Medicare Education Team (UMET) project to educate seniors 

about Medicare and Medicaid. The project will use the services of retired professionals, who volunteer statewide, to help 

Medicare beneficiaries read and understand Medicare billing statements and identify possible errors or problems. The 

project will build on its productive network of collaborative partners to expand its outreach, especially to those age 85 

years and older, women living alone, minorities, and those with language, cultural, illiteracy, or other barriers. The project 

will seek volunteer recruits who are non-English speakers and persons in rural areas. Retention of volunteers is critical to 

the continued success of the project. Along with ongoing recruitment and training, major efforts will be taken to recognize, 

honor, and actively involve volunteers. The project plans to strengthen ties with federal and state agencies and 

organizations concerned about Medicare benefits, in an effort to maximize resources and minimize duplication. The 

project will also increase its visibility by participating in high profile media activities. Products of the renewed project will 

include training materials, UMET website, administrative forms, and brochures.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

184,000

175,000

175,000

205 North 400 West 

Program: 

UTAH LEGAL SERVICES, INC.

Senior Medicare Patrol Project 411

90AM2703

South Dakota Anti-Fraud Education Project

Sioux Falls, SD 57104

Contact: Candise Gregory (605)336-2475

East River Legal Services Corporation (ERLS) has received Senior Medicare Patrol Projects since 2000. ERLS provides 

public education & one-on-one peer counseling on Medicare and Medicaid fraud throughout South Dakota to ensure 

consumer awareness of the problem, and provide knowledge on evaluating and reporting suspected fraud. To 

accomplish this goal of public education, we are utilizing our established network of partners, an advanced media 

campaign, and an established pool of very capable, well trained retired senior volunteers, many of whom have over five 

years of Medicare counseling experience. Our objectives are: 1) individual consumer counseling, evaluation of suspected 

fraud, and referral for further investigation of appropriate cases; 2) development of community partnerships with small 

local businesses in rural communities across South Dakota; 3) ongoing training for established volunteers, recruitment of 

additional volunteers as needed; 4) dissemination of fraud educational materials to the public statewide; 5) fraud 

education on Reservation lands in South Dakota; 6) special outreach to rural areas; 7) increase client contacts & 

dissemination of fraud information; and 8) careful tracking of measurable outcomes. The ERLS/Senior Fraud Patrol 

Program provides a myriad of tools to assist partners & volunteers with project objectives. These products include: 2 day 

training for new volunteers; a training manual and resource materials for volunteer counselors; annual update training for 

existing volunteers; Personal Health Care Journal; "How to Read your Medicare Summary Notice" brochure; a fraud 

booklet "Avoiding Scams and Fraud"; a 5-Part Anti-Fraud Video Series; and sponsorship and participation in major fraud 

events throughout the year.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

175,000

175,000

335 N Main Avenue, Suite 300 

Program: 

EAST RIVER LEGAL SERVICES CORPORATION

Senior Medicare Patrol Project 411

90AM2704
Page 145 of 223 

Louisiana Medicare Abuse Patrol Program

Leesville, LA 71446

Contact: Marvis Chance (887)239-0275

Since March 1, 2002, the Louisiana Medicare Abuse Patrol Program has been administered by the Vernon Parish Council 

on Aging (VPCOA). This partnership has been built upon the support of such organizations and agencies as the 

Governor's Office of Elderly Affairs, Parish Councils on Aging, (TRIAD), the Vernon Parish Sheriff's Department, and 

numerous other agencies that work on behalf of the senior citizens of Louisiana. This project has recruited and trained 

professional volunteers from fourteen parishes in the western and central sections of Louisiana. These retired 

professionals have participated in informative training sessions that have educated them to the perils faced by the 

Medicare Program due to fraud, waste and abuse. These volunteers also provide one-on-one counseling, as needed to 

their peers. This project, when funded for another three (3) years, wiII be able to move into additional parishes, thus 

bringing this valuable resource to others across the state. The Louisiana Medicare Abuse Patrol Program (LAMAPP) staff 

has been trained to respond to callers using the agency's toll free number 1-877-239-0275. Calls related to possible fraud 

are immediately documented and referred to trained LAMAPP staff members, who then refer the inquires to their 

respective Councils on Aging, and insure that these cases are worked until they are resolved. The Advisory Council 

assists the project director in developing training and outreach materials for use by both staff members and LAMAPP 

volunteers, and also in compiling data to measure the program's success. Consultants will assist the project director in 

developing and presenting the training and outreach curriculum, assisting in the grant writing process and helping to 

develop data collection instruments for accurate analysis and reporting of program results. Products will include training 

and outreach curriculum and data collection instruments.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

122,280

110,280

110,280

200 North Third Street 

Program: 

Vernon Council on Aging, Inc.

Senior Medicare Patrol Project 411

90AM2705

Senior Medicare Patrol

Columbia, SC 29201

Contact: Gloria McDonald (803)898-2850

The SC Dept. of Health and Human Services (DHHS)-Bureau of Senior Services is a state government entity, whose 

mission is to provide statewide services that address the needs of older people, including assisting Medicare/Medicaid 

beneficiaries identify waste, fraud, and abuse on Medicare Summary Notices (MSN). This is accomplished through a 

statewide aging network with Area Agencies on Aging and Councils on Aging in each county.The SMPP is managed in the 

Lt. Governor's Office, Div.of Aging Services.This unit is committed to meeting beneficiary needs and ensuring this service 

is delivered to appropriate clients. The Division of Aging Services will be the lead entity with identified partners, including 

the American Association of Retired Persons, implementing the activities of the project. This project will bring together 

agencies whose goal is to stop Medicare fraud and abuse by using knowledge and expertise to develop a comprehensive 

volunteer based fraud detection system. The Division of Aging Services will use current Insurance Counseling Assistance 

Referral for Elders (I-CARE/SHIP) volunteer insurance counselors to promote awareness, and to detect/report findings of 

fraud. A Medicare/Medicaid fraud and abuse manual has been developed and will be expanded to include current 

fraudulent practices. Volunteers will be trained to review Medicare Summary Notices (MSN), and to empower 

beneficiaries to screen MSNs for inappropriate charges and services. Following training, a test will measure volunteer 

comprehension. Regional coordinators will identify fraud and submit to the Fraud Project Specialist, who will forward 

aggregate reports to AoA. In addition to counseling contact forms, information brochures and a manual, a computerized 

data collection system will be developed to track outcomes. Products will include a final report and a fraud and abuse 

manual.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

175,000

175,000

1301 Gervais Street, Suite 200 

Program: 

South Carolina Office of Lieutenant Governor

Office on Aging

Senior Medicare Patrol Project 411

90AM2706
Page 146 of 223 

Via Christi Senior Medicare Patrol

Wichita, KS 67203-4999

Contact: 

The Via Christi Senior Medicare Patrol Project will train retired registered nurses (RNs) participating in the Congregational 

Health Ministry Network (Parish Nursing) of Via Christi to serve as expert resources and educators in the detection of 

health care errors, fraud and abuse. RNs will provide information, assistance and support to Medicare and/or Medicaid 

beneficiaries that will result in: (1) increasing knowledge of the scope of benefits and services; and (2) increasing 

knowledge of appropriate utilization by the beneficiary and subsequent accurate charges made by health providers to 

these programs. During the first phase of the project (year 1), the Via Christi Regional Medical Center (VCR IC), in 

collaboration with the Kansas Department on Aging, will establish and convene a steering committee representative of 

organizations, agencies, educational institutions and service providers committed to improving beneficiary abilities to 

detect and stop health care error, fraud and abuse. This project will complement the existing Senior Health Insurance 

Counseling for Kansas (SNICK) program and fraud prevention hotline services. During the second phase of the project 

(year 2), curriculum will be prepared, at least 50 parish nurses will receive training, and selection of the project service 

area (counties) completed. The third phase of the project (year 2 and year 3) will result in trained parish nurses directly 

providing community-based information activities and support services to beneficiaries in at least 15 counties of the state, 

with at least 10 counties located in rural areas of the state and at least three (3) counties possessing a recognized 

percentage (5% or more) of residents of minority/ethnic heritage. It is projected that at least 1,500 beneficiaries will receive 

information through a minimum of 30 sessions conducted by retired parish nurses, by project conclusion.

Project Period: 07/01/2003 - 05/31/2005

FY Grant Amount

FY 2003

FY 2004

78,293

73,165 2622 W. Central 

Program: 

VIA CHRISTI FOUNDATION, INC.

Senior Medicare Patrol Project 411

90AM2707

Indiana Senior Medicare Patrol Project

Indianapolis, IN 46250

Contact: Melissa Durr (317)598-9300

The Indiana Senior Medicare Patrol Project, sponsored by the IAAAA Education Institute (IAAAA), proposes an innovative 

project that will build upon its success as contractor to the State of Indiana for the current project. IAAAA will collaborate 

with many statewide organizations to recruit, train and support beneficiary volunteers and others to educate and inform 

Indiana residents about Medicare errors, fraud and abuse. We will use past success, best practices, and tools from the 

Technical Assistance Resource Centers to refine and develop training and outreach materials. The project will target 

homebound seniors, low-income seniors, rural seniors and low literacy seniors for intense education and outreach. We 

will develop and use tools to measure success and evaluate our progress toward our desired outcomes. As a result of our 

efforts, we will achieve the following outcomes: 1) a 33% increase in the number of complaints filed over the life of the 

project, and 2) a 10% increase in knowledge by project volunteers about Medicare errors, fraud and abuse. Products will 

consist of a final report, and training and outreach materials.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

184,000

179,000

179,000

5875 Castle Creek Parkway North Drive, Suite 315 

Program: 

IAAAA EDUCATION INSTITUTE, INC

Senior Medicare Patrol Project 411

90AM2708
Page 147 of 223 

New York State Operation Restore Trust

Albany, NY 12223-1251

Contact: Wanda Troche (518)474-5478

This is the second year of a three year demonstration project to recruit and train retired professional volunteers to educate 

groups of Medicare beneficiaries and their families about the importance of recognizing and reporting Medicare and 

Medicaid fraud, error and abuse. Beneficiaries, caregivers and information assistants will be trained to detect payment 

errors and procedures for reporting suspected fraud in order to recoup improper payments. Target Population: minorities, 

women, low income, non-English speaking and handicapped persons. Collaborators: CMS, Hands on The Hudson 

Valley, Lifespan Ombudsman program, and the NY Commission for the Mentally Disabled. Activities/Outcomes: Training 

modules for diverse trainees and Internet training; an informed and energized public, fighting against health care fraud; 

and strengthened local community and state coalitions working to protect health care for seniors. Products: final report 

and training modules.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

197,000

175,000

175,000

2 Empire State Plaza 

Program: 

New York State Office for the Aging

Senior Medicare Patrol Project 411

90AM2709

Health Care Waste, Fraud and Abuse, Senior Medicare Patrol Project

Concord, NH 03301-3857

Contact: Lloyd Farnham 

New Hampshire's Division of Elderly and Adults Services (DEAS), in partnership with Community Services Council of New 

Hampshire (CSCNH), has successfully administered a Senior Medicare Patrol Project (SMPP) since 1997. As one of the 

first twelve local demonstration projects in the country, New Hampshire developed a unique model by combining SMPP 

with the State's Health Insurance Assistance Program (SHIP). As such, New Hampshire has operated an effective 

practice model for its seniors and people with disabilities. The following objectives are planned for this period: 1) increase 

the number of formal and informal sites for assistance, education and outreach. New and traditional information and 

counseling sites will be established in rural hospitals, low-income clinics, senior centers and local community centers 

where senior attend social programs and workshops. Informal outreach will also be extended to NH legislative 

representatives; 2) expand volunteer recruitment to rural and low-income areas in northern and western regions of the 

state, where some of the most vulnerable and isolated population resides; and 3) expand education on Medicaid and other 

assistance programs for SMPP volunteers; and 4) enhance and monitor program effectiveness by developing new 

partnerships and coalitions with state /local/federal agencies and professional retiree organizations, conducting pre-and 

post tests surveys, reviewing and revising training components, and holding program evaluation meetings with contractor 

and grantee. New training materials, Medical Assistance Resource Guide, Prescription Drug Options, and NH Health 

Records, and Fraud Tips will be produced

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

197,000

175,000

175,000

129 Pleasant Street 

Program: 

NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Senior Medicare Patrol Project 411

90AM2710
Page 148 of 223 

Seniors Organized to Restore Trust (SORT)

Warrensburg, MO 64093

Contact: Diana Hoemann (660)747-3107

Seniors Organized to Restore Trust (SORT), third phase, is a project that builds upon a strong organizational base and 

well-trained volunteers already in place to expand the number of seniors throughout the State of Missouri who detect, 

report and combat Medicare and Medicaid error, fraud and abuse, by adding a new component to an already successful 

program. The objectives of the project are: to train staff representatives from each of the ten Area Agencies on Aging to 

serve as SORT Coordinators in their respective areas; to maintain and expand the current pool of SORT Specialists to a 

total of 372 Specialists working one-on-one with Medicare beneficiaries; to establish a statewide speaker's bureau to 

assist with Medicare and Medicaid beneficiary training; to continue statewide outreach efforts with a particular emphasis 

on rural and minority; to update all AAA web sites in the state, as well as the Elder Services Program web site to include 

fraud and abuse information; and to expand the SORT Steering Committee. The approach includes working with the 

Missouri Alliance of Area Agencies on Aging and their 298 senior centers, and the Missouri Attorney General's Office and 

Secretary of State's office, to develop a comprehensive approach to fraud affecting seniors, including identity theft, elder 

abuse and neglect, consumer fraud and health care error, fraud and abuse. Major products resulting from SORT, the third 

phase, include improved training materials that will appeal to retired professional volunteers. Anticipated outcome: a 

project that is systematically evaluated for effectiveness and which demonstrates integration of the Senior Medicare Patrol 

project's message into the Aging Services Network.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

193,442

173,442

173,237

106 West Young, PO Box 1078 

Program: 

DISTRICT III AREA AGENCY ON AGING

Senior Medicare Patrol Project 411

90AM2711

Empowering Consumers of Healthcare Organizations (ECHO)

Lincoln, NE 68509-5044

Contact: Cindy Kadavy 

The Senior Medicare Patrol Project's overall goal is to substantially increase the involvement of older persons and the 

Aging Network in an effort to curb losses within the Medicare and Medicaid programs - losses due to error, waste or fraud. 

Nebraska's ECHO Project plans to continue working toward the following: 1) Be Aware, Be Informed - combat health care 

error, fraud and waste in Nebraska, through awareness campaigns and promotions, educational presentations and 

distribution of informational material, direct technical assistance and support of Medicare and Medicaid beneficiaries 

throughout the state; 2) Be Involved - continue the recruitment of retired professionals, who will serve in their communities 

as volunteer resources, peer educators and beneficiary advocates. Provide the training, coordination, support and 

recognition necessary to maintain their efforts and keep them involved as an integral part of the ECH0 Project in the effort 

to curb health care fraud and waste in Nebraska. Reach out to special populations, and provide additional outreach to the 

most vulnerable of Nebraska's beneficiaries, nursing home residents, through the intervention of trained and certified 

volunteer Ombudsman Advocates. This population is also one of the largest groups of consumers of health care services; 

and 3) Build Coalitions - Continue to develop and expand collaborations between local, regional and state organizations 

and agencies; build and strengthen community coalitions of older Americans and service providers; and create 

partnerships working toward the same goal of combating error, fraud and waste within the Medicare and Medicaid 

systems. Products - Final report, educational presentations, campaigns and promotions.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

175,000

175,000

PO Box 95044 

Program: 

NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES

Senior Medicare Patrol Project 411

90AM2712
Page 149 of 223 

Sagewatch

Honolulu, HI 96813-2831

Contact: Derrick Ariyoshi (808)586-0100

Since 1997, SageWatch has grown to be a recognized statewide organization responsible for training several hundred 

dedicated, dynamic, and highly motivated individuals to be certified SageWatch volunteers who donate hundreds of hours 

each year to make the SageWatch Program. Activities of the SageWatch Program are guided by an advisory council 

composed of representatives of health care provider associations, Medicare contractors, Medicaid investigators, senior 

health care organizations, Area Agencies on Aging, immigrant and native Hawaiian organizations, and consumer 

advocates. In addition, EOA's SAGEPLUS (SHIP) and the Long Term Care Ombudsman Programs work closely with the 

SageWatch Program. The five goals of SageWatch are: 1) to recruit, train and retain culturally diverse retired 

professionals as volunteer presenters; 2) to provide outreach to special population groups, ie. non-English speaking and 

ethnic groups, low income, minority, women, disabled, rural, frail, underserved; 3) to conduct a public awareness 

campaign; 4) to demonstrate collaboration among concerned agencies; and 5) to increase use of website for 

disseminating information, recruiting volunteers, receiving reports of fraud and abuse, and receiving requests for 

presentations. Products will consist of a final report, including outreach materials, teaching materials and copies of data 

collection tools.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

196,910

174,860

175,000

250 South Hotel St., Suite 406 

Program: 

Executive Office on Aging

Senior Medicare Patrol Project 411

90AM2713

Medicare Fraud Senior Patrol Care Project

Bismark, ND 58502-1893

Contact: Vicki Anderson (701)222-2110

This is the second year of a three year cooperative agreement for Legal Services of North Dakota (LAND) to operate a 

Senior Medicare Patrol Project. Objectives: 1) to train staff, volunteers and Medicare beneficiaries to identify signs of 

Medicare error, fraud, and abuse, and report suspicions to a Fraud-Fighter hotline for investigation and referral; 2) to 

develop and distribute educational materials to staff, volunteers, and beneficiaries; 3) to sponsor two regional conferences 

per year and co-sponsor elder-related conferences, presentations, and exhibits; and 4) to develop media and website 

materials along with "Senior Surf Days" web training to educate partners and the public. LAND and its partners will 

accomplish all goals in a seamless way, to ensure effective use of resources. All trainings, education, presentations, 

materials developed and conferences will be worked into currently existing elder-related functions where possible. 

Expected outcomes: staff, volunteers and beneficiaries will recognize signs of potential Medicare error, fraud and abuse; 

report suspicions promptly and without fear to appropriate agencies; reduce inaccurate or inappropriate billings; and 

restore faith that funds will be available for current beneficiaries and future generations. Major products from this project 

are: a personal health care journal for use by beneficiaries; a specialized Medicare Summary Notice (MSN) brochure; 

video and audio tape training materials covering Medicare error, fraud and abuse for use by staff, volunteers, beneficiaries 

and their caregivers; materials for the media, website, and public distribution.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

145,000

125,000

125,000

1025 North 3rd Street 

Program: 

LEGAL SERVICES OF NORTH DAKOTA

Senior Medicare Patrol Project 411

90AM2714
Page 150 of 223 

Vermont Medicare Partnership Project

Montpelier, VT 05602

Contact: Anita Hoy (802)229-4731

This is the second year of a three year cooperative agreement to operate a state-wide Senior Medicare Patrol Project. 

The project will: (1) develop or identify "best practice" programming for recruiting, training and maintaining retired seniors 

and other professionals in Vermont's elder network for work in this project; (2) increase elders' ability to be active partners 

in health care decisions and raise beneficiary awareness of Medicare program benefits and operations, including 

understanding health care statements and keeping track of medical services; and, (3) build further collaborations with 

health care providers to actively engage in planning and supporting this project and to make information given to elders 

understandable and useful. The objectives will be met by: (1) developing and implementing a statewide program with 

central coordination out of the Community of Vermont Elders (COVE) and regional program operations performed by the 

five Area Agencies on Aging (AAAs) in the state; (2) gathering information and materials from other statewide SMPP's, 

particularly those focused on rural populations, and working with technical assistance providers to identify "best practices" 

and modify programs to meet Vermont's reality and culture; and (3) creating a program advisory group including seniors, 

advocates and providers to increase ownership of the program by involving stakeholders in its design and evaluation. As a 

result of these efforts, the project will use national best practices and the expertise of local seniors, advocates and 

providers to increase beneficiary ability to actively participate in health care decision making, including a greater 

understanding of the Medicare program. Products are a final report and project data forms.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

175,000

175,000

PO Box 1276 

Program: 

COMMUNITY OF VERMONT ELDERS

Senior Medicare Patrol Project 411

90AM2715

The Senior Medicare Patrol Project

Madison, WI 53718-6751

Contact: Elizabeth Conrad (608)224-0606

The Coalition of Wisconsin Aging Groups (CWAG) proposes to continue building on its successful six-year Senior 

Medicare Error Patrol Project. The project has been a highly collaborative effort with the cooperation and assistance of 

many statewide partners. In the last year of the current grant cycle, a volunteer coordinator was added to the team. We 

will continue to train volunteers who will be organized into regions aligned with the nine district boundaries of the 

Coalition's membership areas. The addition of the Volunteer Coordinator will allow us to place more emphasis on the 

retention of already trained volunteers and maximize their utilization in presentations statewide. In addition, new 

volunteers will be trained, organized and integrated into the new district system. Training will include: an overview of 

Medicare/Medicaid laws; methods for identifying and reporting Medicare/Medicaid fraud, waste and abuse; and 

instructions on reading a Medicare Summary Notice, and on the basics of public speaking. The targeted audience will be 

low-income, limited literacy, rural, minority and inner city elders. Volunteers will serve as local resources available to give 

presentations, answer questions and advocate for peers. Partners (Medicare contractors, U.S. Attorneys' Offices, etc.) will 

assist with training. All referrals will be received and screened via a toll-free number. Products will be a monthly Fraud 

Alert newsletters, standardized PowerPoint presentations, a volunteer manual, press releases, training materials and new 

brochures on additional subjects. The new grant cycle has two additional new features: 1) an emphasis on working with 

caregiver support groups and education forums; and 2) an expansion of the marketing and media campaign started in the 

last grant cycle. Thus the new name - "The Medicare Integrity Project" - and the tag line - "Helping to Keep the Promise" - 

on all of our materials.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

197,000

175,000

175,000

2850 Dairy Drive, Suite 100

Program: 

Coalition of Wisconsin Aging Groups

Senior Medicare Patrol Project 411

90AM2716
Page 151 of 223 

Senior Medicare Error Patrol Project - Operation Restore Trust Iowa

Des Moines, IA 50309-3609

Contact: Shirley Merner 

Iowa's objective for its Senior Medicare Patrol project is to recruit, train and maintain retired volunteers of diverse cultural, 

ethnic and socioeconomic backgrounds. Volunteers are instructed to effectively provide education through public events 

and group sessions in their communities. The volunteer's role is to be an expert resource, assisting older persons in 

becoming educated about their health care expenditures under Medicare and Medicaid, utilizing strategies to detect 

errors, fraud and abuse, and report their concerns. ORT approaches our objectives through collaborative ventures, guided 

by a State Advisory Committee, contracts with Area Agencies on Aging for local recruitment and supervision of volunteers, 

and partners with Senior Health Insurance Information Program for the provision of one-on-one counseling. Critical to the 

accomplishment of these goals is collaboration with other government and private agencies. The outcome of the 

successful completion of the aforementioned objectives is to increase the ability of Iowans to identify errors, fraud, and 

waste in the Medicare/Medicaid programs. This creates responsible consumers of the health care benefits of these 

programs. ORT will expand the Public Awareness Campaign to include major products such as caregiver information kits, 

pamphlets, video news releases, and media rolodex cards. ORT's web site is a key piece of promotion and coordination, 

encouraging beneficiaries to question, learn and take an active role in protecting their health care benefits. The website 

will be expanded to include provider education, a press room kit and links to Medicare resources. A major product of this 

effort is the administration of a standardized assessment tool to measure the effectiveness of the beneficiary education 

provided by Senior Medicare Waste Patrol Project volunteers nationwide.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

197,000

175,000

175,000

200 Tenth Street 

Program: 

IOWA DEPARTMENT OF ELDER AFFAIRS

Clemens Building, 3rd Floor

Senior Medicare Patrol Project 411

90AM2717

Health Care Fraud, Waste and Abuse Senior Volunteer Education Project

Warwick, RI 02889

Contact: Lisa Purcell (401)521-7930

This is the second year of a three year demonstration project to recruit and train retired professional volunteers to educate 

groups of Medicare beneficiaries and their families about the importance of recognizing and reporting Medicare and 

Medicaid fraud, error and abuse. Beneficiaries will be trained to detect payment errors and how to report suspected fraud 

in order to recoup improper payments. The target population is Medicare beneficiaries and their families. Collaborators 

include the Alliance for Better LTC in Providence, Urban League of RI, Cox Communications, US Senator Jack Reid, and 

the Rhode Island Dept. of Elderly Affairs. Anticipated activities/outcomes: volunteers recruited from culturally diverse 

communities; State Health Insurance Program (SHIP) volunteers trained to educate clients about health care fraud; 

ombudsmen trained to assist with residents in long-term care and assisted living facilities; case managers trained to 

provide one on one counseling of homebound Medicare beneficiaries; community awareness of the problem increased 

through workshops; and training modules developed to ensure an understanding of the Medicare Summary Notice. 

Products are a training module and final report to AoA.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

197,000

175,000

175,000

765 West Shore Road 

Program: 

AGING 2000, INC.

Senior Medicare Patrol Project 411

90AM2718
Page 152 of 223 

The Pennsylvania Health Care Fraud Education Project

Philadelphia, PA 19103

Contact: Rebecca Nurick (215)545-5728

This is the second year of a three year demonstration project to recruit and train retired professionals to educate groups of 

Medicare beneficiaries and their families about the importance of recognizing and reporting Medicare and Medicaid fraud, 

error and abuse. Beneficiaries will be trained to detect payment errors and how to report suspected fraud in order to 

recoup improper payments. Target population: minority, non-English speaking, rural and isolated beneficiaries. 

Collaborators: Mayor's Commission, Philadelphia; RSVP, Harrisburg; AARP of PA; and PA Dept. of Aging. Anticipated 

Activities/Outcomes: educate the general public in the prevention of error, fraud and abuse in the Medicare and Medicaid 

program; refer cases of suspected error to the appropriate organization; enroll volunteers to educate their peers in fraud 

reduction; improve communication between law enforcement, private sector providers, and beneficiaries concerning fraud 

activities in PA; provide consultation with individual seniors, as needed, to review Medicare issues; and establish 

relationships with community leaders and service providers to educate culturally diverse elderly persons. Product will be 

included in final report to AoA.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

175,000

175,000

100 North 17th Street, Suite 600 

Program: 

CENTER FOR ADVOCACY FOR THE RIGHTS AND INTERESTS

 OF THE ELDERLY

Senior Medicare Patrol Project 411

90AM2719

SCAMS, Senior Counselors Against Medicare Swindlers

Sacramento, CA 95819

Contact: Julie R Schoen (714)560-0309

Since it's inception seven years ago, the purpose of the SCAMS (Senior Counselors Against Medicare Swindlers) project 

of California Health Advocates (CHA) has been to recruit and train senior volunteers, and to involve them in educating the 

CA community to prevent, detect and report Medicare fraud, waste and abuse. The next level of achievement will be to 

develop and utilize an Outcomes Measurement Tool to evaluate the efforts of our volunteers and build upon our solid 

foundation of statewide Health Insurance Counseling Advocacy Programs (HICAPs). This will include adult protective 

services, financial abuse strategists and others in the community throughout California, working together to protect 

Medicare and it's beneficiaries from waste, fraud and abuse. The goals of SCAMS: initiate a survey tool to measure 

education outcomes; implement a new fraud education outreach method, i.e. web-based trainings; prepare an outreach 

campaign for disabled Medicare beneficiaries; and continue to recruit, train and retain retired professional volunteer 

educators and counselors, emphasizing a culturally competent training and outreach curriculum. Major annual 

outcomes-observable end results: baseline surveys (50 surveys/mo.) designed to reflect program impact on participant's 

observable behavior; web-based trainings by a minimum of 4 collaborative agencies - Offices on Aging, Latino Health 

Access, LTC Ombudsman Program, Financial Abuse Specialist Teams.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

197,000

175,000

175,000

5380 Elvas Avenue, Suite 104 

Program: 

CALIFORNIA HEALTH ADVOCATES

Senior Medicare Patrol Project 411

90AM2720
Page 153 of 223 

Illinois Senior Medicare Patrol

Oak Park, IL 60301

Contact: Laura Rosenfeld (708)383-0258

The Senior Medicare Patrol (SMP) program is a collaborative effort lead by the Suburban Area Agency, in partnership with 

the Northeastern Illinois Area Agency, Chicago Department on Aging and the Southern Illinois Collegiate Common 

Market. We will build upon the solid success of the program, having been one of the original demonstration projects, to 

reach new audiences with important messages that can help to preserve the integrity of our healthcare system. The 

objectives of the project are: to increase awareness among Medicare consumers participating in the SMP program about 

how to prevent, detect, and report suspected errors and fraud; and to improve the knowledge of volunteer trainers 

regarding a) Medicare benefits and services, local options, provider concerns, and b) how to read and understand 

Medicare Summary Notices (MSNs), Explanations of Benefit (EOBs) and Advance Beneficiary notices (ABNs). We will 

use the following approaches: recruit and train retired professionals to volunteer as SMP expert resources; work with eight 

partner agencies to conduct the program throughout Illinois; develop, adapt and disseminate materials to improve the 

knowledge of trainers, volunteers and Medicare beneficiaries on the prevention, identification and reporting of suspected 

errors and fraud; and to inform and educate diverse Medicare beneficiary communities through presentations and 

outreach events. A special emphasis will be placed on reaching out to rural, low functionally literate, and limited and 

non-English speaking beneficiaries utilizing partnerships with community based organizations and innovative and grass 

roots methods. The major products from this project will be: a "Train the Trainer" manual; a Press Kit with sample media 

messages; Fraud Alert publications in English, Spanish and possibly other languages; and a Training Video for new 

volunteers including sample SMP presentations.

Project Period: 07/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

297,000

275,000

275,000

1048 Lake Street Suite 300

Program: 

SURBURBAN AREA AGENCY ON AGING

Senior Medicare Patrol Project 411

90AM2721

West Virginia Senior Medicare Information and Error Patrol Project

Washington, DC 20049-0049

Contact: Scott Adkins (202)434-2787

AARP assumed responsibility as the new Senior Medicare Patrol project (SMPP) grantee in W.VA , 7/31/03. AARP WV is 

a SMPP Advisory Comm. member, ensuring smooth transition & continued project development in the state. W. 

Virginians are especially dependent on Medicare & Medicaid programs, & billing errors, waste, fraud, or abuse reduce 

access & availability. WV SMIEPP will address these issues as follows: The goal is to establish systems & mechanisms to 

educate Medicare & Medicaid beneficiaries to identify & resolve billing errors & report possible fraud/abuse, thus reducing 

the incidence of waste, fraud & abuse in vital programs & services. Objectives:1) strengthen development of infrastructure 

to detect/combat health care billing charge errors, fraud, waste, & abuse in Medicare & Medicaid programs; 2) recruit/train 

Volunteer Educators to inform & educate Medicare & Medicaid beneficiaries; 3) expand partnerships thru links with public 

& pvt. agencies; 4) conduct outreach & develop promo materials; 5) establish Intake, Reporting, Referral & Follow-up 

system. Objectives: using these approaches & interventions - Continue existing consortia with agencies, org's, community 

groups, & individuals committed to increasing knowledge among Medicare & Medicaid consumers & eliminating 

healthcare billing errors, waste, fraud & abuse; Continue training individuals to serve as SMIEPP Educators; Conduct 

consumer education, inc. at least one Medicare Update seminar; Develop a complaint intake, investigation, mediation, & 

resolution system. WV SMIEPP will incorporate reporting mechanisms that identify problems & suggested improvements 

in Medicare. Outcome: inform & educate Medicare/Medicaid recipients & public on preventing &/or detecting & reporting 

suspected error, fraud, or abuse. Major products: manuals; data collection & evaluation instruments; training packages; 

AV's for public & healthcare provider education on preventing potential Medicare & Medicaid error & fraud.

Project Period: 07/01/2003 - 06/30/2007

FY Grant Amount

FY 2003

FY 2004

FY 2005

175,000

180,000

179,467

601 E Street NW 

Program: 

AARP Foundation

Senior Medicare Patrol Project 411

90AM2724
Page 154 of 223 

ARIZONA PERFORMANCE OUTCOME MEASUREMENT SYSTEM

Phoenix, AZ 85007-5007

Contact: 

Arizona has entered into a cooperative agreement with AoA to develop and test performance outcomes measures for 

home-delivered meals, congregate meals, transportation, information and assistance and homemaker services.

Project Period: 09/30/2000 - 06/30/2004

FY Grant Amount

FY 2000 115,000

1789 West Jefferson - 905A 

Program: 

Arizona Department of Economic Security

Performance Outcomes Measures Project 501

90AM2413

DEVELOPING PERFORMANCE OUTCOME MEASUREMENT SYSTEMS: THE UAI 

PROJECT

Richmond, VA 23229

Contact: 

This is a one year cooperative agreement with the State of Virginia to continue the development of performance outcome 

measures (POM) that all levels of the aging network can use for program assessment and management purpose. The 

goal of this cooperative agreement is to improve the capability of the State Unit on Aging (SUA) and Area Agencies on 

Aging (AAAs) to use POM to improve programs. The State of Virginia has established a partnership with a AAA to work 

with the Administration on Aging (AoA) and WESTAT, Inc.. The objectives of this POM project are: 1) to develop 

performance measures across several program domains under the Older American Act (OAA); 2) to conduct sample 

surveys using the POM instruments; and 3) to use data from the surveys to improve program management and to help 

justify future program expenditures. The anticipated outcome of the POM program is that the State of Virginia will expand 

POMs. The products from this cooperative agreement include a final report; data from the outcome measures surveys; 

reports on the results of all aspects of the project; presentations with AoA and the contractors in annual POM projects..

Project Period: 09/30/2000 - 04/30/2004

FY Grant Amount

FY 2000 65,000

1600 Forest Ave., Suite 102 

Program: 

COMMONWEALTH OF VIRGINIA

Department of Aging

Performance Outcomes Measures Project 501

90AM2427
Page 155 of 223 

Performance Outcome Measures Project

Tallahassee, FL 32399-7000

Contact: Horacio Soberon-Ferrer 

AoA has entered into a 24 month cooperative agreement with the Florida Department of Elder Affairs to continue the 

development of performance outcome measures (POM) that all levels of the aging network can use for program 

assessment and management purpose. The goal of the project is to improve the capability of the State Unit on Aging 

(SUA) and Area Agencies on Aging (AAA) to use POM to improve programs. The State of Florida has established a 

partnership with the following AAAs, Tallahassee, Jacksonville, St. Petersburg, Tampa, Orlando, West Palm Beach, Ft. 

Lauderdale and Miami, to work with AoA and WESTAT, Inc.. The objectives of this cooperative agreement are: 1) to 

develop POM across several programs in the Older Americans Act; 2) to conduct sample surveys using POM 

instruments; 3) to use data from the surveys to improve program management and to help justify future program 

expenditures; 4) to administer survey questionnaires in the following areas: Nutrition, Caregiver Support, Home Care 

Satisfaction, Information and Assistance, Emotional Well Being, Social Functioning, Barriers to Service, and Capacity 

Building; 5) to make available, through a website or email list, project materials. The anticipated outcome of this POM 

program is that Florida will expand POM . The products of this POM project are a final report; data from the surveys; and 

presentations with AoA and its contractors about annual POM projects.

Project Period: 09/30/2002 - 12/31/2004

FY Grant Amount

FY 2002 45,000

4040 Esplanade Way 

Program: 

FLORIDA DEPARTMENT OF ELDER AFFAIRS

Performance Outcomes Measures Project 501

90AM2653

Statewide Telephone Survey for Performance Measurement

Columbia, SC 29201-8206

Contact: Bruce E. E Bondo (803)898-2850

AoA has entered into a 24 month cooperative agreement with the South Carolina Department of Health and Human 

Services (SCDHHS) to continue the development of performance outcome measures (POM) that all levels of the aging 

network can use for program assessment and management purposes. The goal of this project is to improve the capability 

of the State Unit on Aging (SUA) and Area Agencies on Aging (AAA) to use POM to improve programs. South Carolina 

has established a partnership with the University of South Carolina (USC) to work with AoA and WESTAT, Inc.. The 

objectives of this project are: 1) to develop POM across several program in the Older Americans Act; 2) to conduct sample 

surveys using the POMs instruments; 3) to use data from the surveys to improve program management and to help justify 

future program expenditures; 4) to obtain data available through AAAs in the areas of Nutrition, Physical Functioning, 

Information and Assistance, Caregiver Support, and Transportation; 5) to contract with USC for data collection; 6) to work 

with AoA and its contractor(s) to assure that sampling plan and data collection procedures will produce data compatible 

with data produced under the second National Survey of Performance Measurement (POM). The expected outcome of 

this POM program is that South Carolina will expand POM. The products from this POM project are a final report; data 

from the surveys; and presentations with AoA and its contractors about the annual POM projects.

Project Period: 09/30/2002 - 09/29/2004

FY Grant Amount

FY 2002 75,000

1301 Gervais Street, Suite 200 

Program: 

STATE OF SOUTH CAROLINA

Office of the Lieutenant Governor

Performance Outcomes Measures Project 501

90AM2654
Page 156 of 223 

Developing Model State Performance Outcome Measurement Systems in State and 

Community Program on Aging

Des Moines, IA 50309-3609

Contact: Jayne Walke 

AoA has entered into a 24 month cooperative agreement with the Iowa Department of Elder Affairs (IDEA) to continue the 

development of performance outcome measures (POM) that all levels of the aging network can use for program 

assessment and management purpose. The goal of the project is to improve the capability of the State Unit on Aging 

(SUA) and Area Agencies on Aging (AAA) to use POM to improve programs. The State of Iowa has established a 

partnership with Hawkeye Valley AAA to work with AoA and WESTAT, Inc.. The objectives of this program are: 1) to 

develop POM across several programs in the Older Americans Act (OAA); 2) to conduct sample surveys using the POM 

instruments; 3) to use data from the surveys to improve program management and to help justify future program 

expenditures; 4) to administer survey questionnaires to a statistically-valid sample of clientele in the areas of Nutrition, 

Transportation, Caregiver, Support,Physical Functioning, and Case Management; 5) to cooperatively finalize survey 

questionnaires; and to send representatives to no fewer than two national meetings concerning project administration. The 

expected outcome of this POM program is that the State of Iowa will expand POM. The products of this POM project are a 

final report; data from the surveys; and presentations with AoA and its contractors about the annual POM projects.

Project Period: 09/30/2002 - 06/30/2004

FY Grant Amount

FY 2002 45,000

Clemens Building, 3rd Floor 200 10th Street

Program: 

Iowa Department of Elder Affairs

Performance Outcomes Measures Project 501

90AM2655

Performance Outcome Measures Project - Statewide Surveys of Program Performance

Tallahassee, FL 32399-7000

Contact: Horacio Soberon-Ferrer 

This is a 24 month cooperative agreement with the Florida Department of Elder Affairs (SUA) to continue the development 

of performance outcome measures (POM) that all levels of the aging network can use for program assessment and 

management purpose. The goal of the agreement is to improve the capability of the State Unit on Aging (SUA) and Area 

Agencies on Aging (AAA) to use POM to improve programs. Florida has established a partnership with the University of 

Florida (U. of FL) to work with the Administration on Aging (AoA) and WESTAT, Inc.. The objectives of this project are: 1) 

to develop POM across several programs in the Older American Act (OAA); 2) to conduct sample surveys using the POM 

instruments; 3) to use data from the surveys to improve program management and to help justify future program 

expenditures; 4) to obtain a statistically-valid statewide sample, using data available through a statewide proprietary client 

and provider database as well as ad hoc surveys conducted by the state agency's planning and evaluation unit in the 

following areas Nutrition, Caregiver Support, Home Care Satisfaction, and Information and Assistance; 5) to contract with 

the U. of FL or another suitable contractor for data collection; 6) to work with the AoA and its contractor(s) to assure that 

sampling plan and data collection procedures will produce data compatible with data produced under the second National 

Survey of Performance Measurement (POM). The expected outcome of this project is that Florida will expand POM. 

Products include a final report; data from the POM surveys; and presentations with AoA and its contractors about annual 

POM projects.

Project Period: 09/30/2002 - 12/31/2004

FY Grant Amount

FY 2002 75,000

4040 Esplanade Way 

Program: 

FLORIDA DEPARTMENT OF ELDER AFFAIRS

Performance Outcomes Measures Project 501

90AM2660
Page 157 of 223 

Statewide Survey of Program Performance

Columbus, OH 43215-5928

Contact: Marcus Molea 

This is a 24 months cooperative agreement with the Ohio Department of Aging (SUA) to continue the development of 

performance outcome measures (POM) that all levels of the aging network can use for program assessment and 

management purpose. The goal of the project is to improve the capability of the State Unit on Aging (SUA) and Area 

Agencies on Aging (AAA) to use POM to improve programs. Ohio has established a partnership with the AAA across the 

state to work with the Administration on Aging (AoA) and Westat, Inc.. The specific objectives are: 1) to develop 

performance measures across several programs in the Older Americans Act (OAA); 2) to conduct sample surveys using 

the POM instruments; 3) to use data from the surveys to improve program management and to help justify future program 

expenditures; 4) to contract with Westat, Inc. to obtain a statistically-valid statewide sample, using data available through 

AAAs across the state in the areas of Nutrition, Caregiver Support, and Transportation; 5) to contract with Westat, Inc. for 

data collection; 6) to work with the AoA and its contractor(s) to assure that sampling plan and data collection procedures 

will produce data compatible with data produced under the second National Survey of Performance Measurement (POM). 

The anticipated outcome from this project is that Ohio will expand POM. The products of this project are a final report; data 

from the POM surveys; and presentations with AoA and its contractors about the annual POM projects.

Project Period: 09/30/2002 - 09/30/2004

FY Grant Amount

FY 2002 75,000

50 West Broad Street, 9th Floor 

Program: 

OHIO DEPARTMENT OF AGING

Performance Outcomes Measures Project 501

90AM2662

Performance Outcome Measures Project

Springfield, IL 62701-1789

Contact: Cheryl Sugent 

The Administration on Aging (AOA) has entered into a 24 months cooperative agreement with Illinois Department on 

Aging (SUA) to continue the development of performance outcome measures (POM) that all levels of the aging network 

can use for program assessment and management purpose. The goal of this project is to improve the capability of the 

State Unit on Aging (SUA) and Area Agencies on Aging (AAA) to use POM to improve programs. Illinois has established a 

partnership with East Central Illinois Area Agency on Aging to work with AoA and WESTAT, Inc.. The specific objectives 

are: 1) to develop POMs across several programs in the Older Americans Act (OAA); 2) to conduct sample surveys using 

the POM instruments; 3) to use data from the surveys to improve program management and to help justify future program 

expenditures; 4) to administer survey questionnaires to a statistically-valid sample of clientele in the areas of Nutrition, 

Emotional Well Being, Social Functioning, Physical Functioning, Caregiver Support, Transportation, Home Care (Respite 

and Home Health), and Information and Assistance; 5) to work with the AoA and its contractor(s) to cooperatively finalize 

survey questionnaires; 6) and to send representatives to no fewer than two national meetings concerning project 

administration. The anticipated outcome of the effort is that Illinois will expand POM. The products are a final report; data 

from POM surveys; and presentations with AoA and its contractors in annual POM projects.

Project Period: 09/30/2002 - 03/31/2004

FY Grant Amount

FY 2002 30,000

421 East Capitol Avenue #100 

Program: 

Illinois Department on Aging

Performance Outcomes Measures Project 501

90AM2664
Page 158 of 223 

Statewide Performance Outcomes Measures Survey

Des Moines, IA 50309-3609

Contact: Jayne Walke 

This is a 24 months cooperative agreement with Iowa Department of Elder Affairs (SUA) to continue the development of 

performance outcome measures (POM) that all levels of the aging network can use for program assessment and 

management purpose. The goal of the agreement is to improve the capability of the State Unit on Aging (SUA) and Area 

Agencies on Aging (AAA) to use POM to improve programs. Iowa has established a partnership with AAAs across the 

State to work with AoA and Westat, Inc.. The objectives are: 1) to develop performance measures across several 

programs in the Older Americans Act (OAA); 2) to conduct sample surveys using the POM instruments; 3) to use data 

from the surveys to improve program management and to help justify future program expenditures; 4) to obtain a 

statistically-valid statewide sample, using data available through AAAs across the state in the following areas Nutrition, 

Caregiver Support, and Information and Assistance; 5) to contract with Westat, Inc. for data collection; 6) to work with the 

Administration on Aging (AoA) and its contractor(s) to assure that sampling plan and data collection procedures will 

produce data compatible with data produced under the second National Survey of Performance Measurement (POM). The 

anticipated outcome of this project is that Iowa will expand POM and will contract with Westat, Inc.. The products of this 

project are a final report; data from the POM surveys; and presentations with AoA and its contractors about the annual 

POM projects.

Project Period: 09/30/2002 - 09/29/2004

FY Grant Amount

FY 2002 75,000

Clemens Building, 3rd Floor 200 10th Street

Program: 

Iowa Department of Elder Affairs

Performance Outcomes Measures Project 501

90AM2667

Arizona Performance Outcomes Measurement System

Phoenix, AZ 85007-5007

Contact: Lynn Larson 

The Aging and Adult Administration (A and AA) seeks funds to continue the Arizona Performance Outcomes 

Measurement System (AzPOMS). AzPOMS objectives are the following: 1) improve accountability and compliance with 

Government Performance and Results Act (GPRA); 2) test current POMP measures; 3) participate in the development of 

new measurements; 4) gather demographic and programmatic information; 5) link data measurement systems; 6) share 

collected data; 7) identify trends and continuous improvement efforts; and 8) utilize data collected to link measurable 

outcomes. AzPOMS is a collaboration of the A and AA, the Department of Health Services, and the Area Agency on 

Aging, Region One. AzPOMS collaborators will participate in the development and/or revision of following performance 

measures: nutritional risk, National Family Caregiver Support Program, case management, and senior center assessment. 

AzPOMS collaborators will also review and disseminate results and determine program effectiveness. The following 

outcomes are anticipated: a network to determine the program effectiveness; a long-range planning tool; compliance with 

GPRA; a statewide, standardized instrument; linkages to federal, state, and local data measurement systems; analysis 

and evaluation of the results to support capacity building; and best practices. It is the intent of the AzPOMS collaborators 

to disseminate the results of the POMP surveys through a reporting format that would provide information to the 

Administration on Aging, State Unit on Aging, other Area Agencies on Aging, and other interested parties. In addition, the 

AzPOMS work plan activities and outcomes will be placed on the Aging and Adult Administration website for expansion of 

the AzPOMS network and sharing of best practices.

Project Period: 09/30/2003 - 09/29/2004

FY Grant Amount

FY 2003 30,000

1789 West Jefferson - 905A 

Program: 

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

Aging and Adult Administration

Performance Outcomes Measures Project 501

90AM2783
Page 159 of 223 

Performance Outcome Measurement

Raleigh, NC 27699-8390

Contact: Phyllis Stewart 

The North Carolina Division of Aging will pilot-test performance outcome measures in three areas: (1) a statewide 

telephone survey of approximately 350 caregivers served by the Family Caregiver Support Program (FCSP), including a 

third year follow-up of a small sample of caregivers in this program initially interviewed in summer 2002; (2) a statewide 

telephone survey of about 389 cognitively intact recipients of home-delivered meals; and (3) self administered, written 

surveys of approximately 540 participants at senior centers and satellites in two Area Agency on Aging regions. This 

project will supplement previously gathered senior center management perspectives with consumer perspectives, improve 

our understanding of caregivers reached by the Family Caregiver Support Program relative to caregivers of traditional 

service recipients, provide statewide data on outcomes for home-delivered meals clients, and model the feasibility and 

value of all three surveys for future use. Project products will include supplementary training materials for senior center 

personnel, three sets of data submitted to the Administration on Aging, and printed and web-based reports on the findings 

of each survey.

Project Period: 09/30/2003 - 12/04/2004

FY Grant Amount

FY 2003 30,000

2101 Mail Service Center 

Program: 

NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

Performance Outcomes Measures Project 501

90AM2784

Iowa's Performance Outcome Measure's Project - FY 2003

Des Moines, IA 50309-3609

Contact: Jayne Walke 

The Iowa Department of Elder Affairs, partnering with Hawkeye Valley Area Agency on Aging, will continue to develop, 

field-test and expand the use of performance outcome measures in Iowa's Aging network by concentrating its fifth year on 

revising and testing survey tools for its nutrition program, changing the emphasis from nutritional risk to program 

assessment; developing and field testing performance measurement methods for the National Family Caregiver Support 

Program; and developing and administering an enhanced case management performance measurement survey tool. 

Expected outcomes: family caregivers will have an increased understanding of what services are available to help them; 

caregivers' and care recipients' preferences for care will demonstrate needed services; case managed and nutrition clients 

will participate in determining how their services may be improved, service providers will receive helpful data in shaping 

their programs; and care recipients may maintain their independence for a longer period of time. Resultant products will 

include tested survey tools for caregivers, and nutrition and case management clients. Insight on best tool administration 

practices will be gathered and client satisfaction accessed. Additional Iowa data will be useful in completing additional 

reports and more outcome information will be available on Iowa's Aging web page. These products will be disseminated to 

the Administration on Aging, other states, to the Iowa Association of Area Agencies on Aging, County Council's on Aging, 

and local officials in all areas where outcomes were measured, and to our aging partners throughout Iowa, including 

legislators.

Project Period: 09/30/2003 - 09/29/2004

FY Grant Amount

FY 2003 29,972

Clemens Building, 3rd Floor 200 10th Street

Program: 

Iowa Department of Elder Affairs

Performance Outcomes Measures Project 501

90AM2785
Page 160 of 223 

Building an Outcome-Based Evaluation System for Rhode Island's Aging Services 

Network: Phase IV

Cranston, RI 0292 -0

Contact: Donna M. M Cone 

Rhode Island Department of Elderly Affairs (RIDEA), working in partnership with four community-based provider agencies 

and the University of RI, will collaborate with other Performance Outcome Measures Project (POMP) grantees to achieve 

the goal of improved program assessment tools by: 1) revising performance measurement tools for the nutrition program 

to change the emphasis from nutritional risk to program assessment; 2) developing performance measurement methods 

for the National Family Caregiver Support Program; and 3) developing an enhanced case management performance 

measurement instrument. RIDEA and its partners will adopt and test revised forms of the Nutritional Survey for congregate 

meals and home delivered meals and the Caregiver Satisfaction Survey; and the enhanced case management 

performance measurement instrument, utilizing field testing based on sampling methodology. Products to be developed 

include: 1) data used by RIDEA to evaluate programs and services and transmitted to AoA for GPRA performance 

reporting; and 2) expanded and refined outcome-based evaluation system for Rhode Island's elder services delivery 

system.

Project Period: 09/30/2003 - 03/31/2005

FY Grant Amount

FY 2003 30,000

Benjamin Rush Building #55 - 35 Howard Avenue 

Program: 

Rhode Island Department of Elder Affairs

Performance Outcomes Measures Project 501

90AM2786

Performance Outcome Measures Project Grant

Indianapolis, IN 46207-7083

Contact: Douglas S. S Beebe 

The Indiana Bureau of Aging and In-Home Services will conduct a one-year project to revise the nutrition performance 

measurement tool to emphasize program assessment, and develop performance measurement instruments for the 

National Family Caregiver Support Program and for senior centers. Three Area Agencies on Aging will participate in this 

collaborative project with other grantees and the national research corporation contracted by AoA to support the 

performance outcomes measures project. The goal of the Indiana project is to demonstrate the efficacy of specified 

programs and services for elderly and disabled citizens. Anticipated outcomes are: performance measures that will 

produce information about the nutrition, National Family Caregiver Support, and senior center programs; performance 

measures tested and deemed suitable for future use at the state and local level, once the project ends; increased 

knowledge of recipients and their needs that will benefit the nutrition, caregiver and senior center programs and affect a 

more person-centered service delivery system; and enhanced partnerships with AoA, Area Agencies on Aging, and other 

organizations that will affect services for the aged and disabled in Indiana.

Project Period: 09/30/2003 - 09/29/2004

FY Grant Amount

FY 2003 30,000

402 N. Washington St. PO Box 7083

Program: 

INDIANA DIVISION OF DISABILITY, AGING AND REHAB

Performance Outcomes Measures Project 501

90AM2787
Page 161 of 223 

Performance Outcome Measure Project

Springfield, IL 62701-1789

Contact: Betsy Creamer 

The Illinois Department on Aging (IDoA) will collaborate with the Administration on Aging (AoA) to develop performance 

outcome measures which will document the impact of Aging Network services on the lives of older adults and family 

caregivers. IDoA will work with the East Central Illinois Area Agency on Aging (ECIAAA) on the Performance Outcomes 

Measures Project (POMP). Goal : Develop the foundation for a state-based system to measure outcomes of Older 

Americans Act services based on statistically-valid sampling. Objective # 1: Pilot test a state-based system to measure the 

outcomes of four service categories authorized under the Older Americans Act. These services will include: Nutrition, 

Case Management, Family Caregiver Support Program, and Senior Centers. Objective # 2: Disseminate the results of the 

POMP project to the Aging Network in Illinois to build support for a statewide system. Products: Performance Outcome 

Measure surveys and instruments will be developed in collaboration with AoA and a national research corporation 

identified by AoA. These surveys and instruments can be readily used elsewhere in Illinois and throughout the United 

States.

Project Period: 09/01/2003 - 03/31/2006

FY Grant Amount

FY 2003 30,000

421 East Capitol Avenue #100 

Program: 

ILLINOIS DEPARTMENT ON AGING

Office of The Director

Performance Outcomes Measures Project 501

90AM2788

2004 Performance Outcome Measures Project (POMP)

Tallahassee, FL 32399-7000

Contact: Jay Breeze 

The goal of the Department of Elder Affairs 2004 POMP is to identify performance measures that best capture the value of 

the benefits of home and community based programs and services that help prevent or delay institutional placement of 

frail elders. The data required for the development and testing of the measures will come from two sources, the 

Department of Elder Affairs' proprietary client and provider database (CIRTS), and ad-hoc surveys conducted by the 

Department's Planning and Evaluation Unit. POMP objectives and overall program approach are as follows: a) develop, 

test and refine a system of practical and reliable program-measurement instruments to assess program effectiveness, 

efficiency, and sustainability in the four areas targeted in the grant announcement; b) implement 

performance-measurement instruments statewide to assess performance differences among Florida's eleven Area 

Agencies on Aging; c) strengthen monitoring capabilities to assess the performance of DOEA contractors; d) create a set 

of nationally benchmarked, uniform, performance measurement instruments. The project outcome will be the development 

of a performance measurement system in the targeted areas.

Project Period: 09/30/2003 - 09/29/2005

FY Grant Amount

FY 2003 26,401

4040 Esplanade Way 

Program: 

Florida Department of Elder Affairs

Performance Outcomes Measures Project 501

90AM2789
Page 162 of 223 

Implementing Outcomes Measures in Ohio

Columbus, OH 43215-5928

Contact: Marc Molea 

The goal of the Ohio Department of Aging's (ODA) POMP V initiative is to operationalize performance outcome measures 

into aging network programs and processes. ODA will partner with Scripps Center for Gerontology, Council on Aging of 

Southwest Ohio, PSA 3 Agency on Aging, Inc., and other AAAs to utilize a modified caregiver performance measurement 

instrument to determine the extent that the services provided through selected AAA's Family Caregiver Support Programs 

are meeting the needs of family caregivers and reducing caregiver stress; hold a one-day forum for program staff to 

illustrate how utilizing performance outcomes can be used to improve program quality and effectiveness; operationalize 

the case management performance measurement instrument; partner with AoA to develop and test a performance 

measurement instrument for recipient assessment of senior center services. ODA will use a number of vehicles for 

sharing the results of POMP V initiatives, including holding an Outcome Measures Forum and regularly updating AAAs, 

providers and the general public on POMP V progress and results through Aging Connections, ODA's monthly newsletter 

and on ODA's Web Site.

Project Period: 09/30/2003 - 12/31/2004

FY Grant Amount

FY 2003 30,000

50 West Broad Street, 9TH Floor 

Program: 

Ohio Department of Aging

Performance Outcomes Measures Project 501

90AM2790

Performance Outcomes & Consumer Satisfaction Measures

Albany, NY 12223-1251

Contact: Larry Shapiro (518)474-5478

 The New York State Office for the Aging will implement a collaborative approach to develop and test three outcome 

measurement instruments that measure client satisfaction and the program impact of aging network services. The goal of 

the project is to work with AoA in developing reliable and valid outcome measures that can help the aging network collect 

outcome data for budget justification and program improvement. Three outcome measures will be developed and tested: 

Nutrition, Caregiver Support and Case Management measures. Objectives are: (1) outcome measures will be developed 

to assess the value of nutrition, case management and family caregiver support programs and services; (2) outcome data 

of select outcome measures will be collected by the participating AAAs; (3) a refined sampling strategy will be developed 

and implemented; and (4) a collaborative model among state, local and research partners will be implemented. Products 

will include documentation of the survey implementation process, codebooks for outcome databases, evaluation tools, 

evaluation results and conference proceedings. These products will be disseminated to aging service providers and 

researchers at local, state and national levels.

Project Period: 09/30/2003 - 09/29/2005

FY Grant Amount

FY 2003 30,000

3 Empire State Plaza 

Program: 

New York State Office for the Aging

Performance Outcomes Measures Project 501

90AM2791
Page 163 of 223 

Performance Outcomes Measures Project - Priority Area 1: Standard POMP

Albany, NY 12223-1251

Contact: I-Hsin Wu (518)476-2730

New York will use a collaborative approach to develop and test a comprehensive consumer outcome instrument and a 

provider survey. The goal of the project is to continue working with performance measurement surveys to fill in gaps in in 

the POMP measurement tools. The project objectives are: 1) the development of consumer and provider performance 

measurement instruments for home-based services; 2) the collection of data on consumer outcomes and provider 

characteristics; 3) recommendations regarding the consumer assessment survey for posting on the POMP website; and 4) 

implementation of a collaborative model with state, local and research partners. Products will include consumer outcome 

and provider characteristic surveys and data; documentation of the survey implementation process; evaluation results; 

and conference proceedings. These products will be disseminated to aging service providers and researchers at the local, 

state and national level.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004 50,000

2 Empire State Plaza 

Program: 

New York State Office for the Aging

Special Projects

Performance Outcomes Measures Project 501

90AM2867

Performance Outcomes Measures Project - Priority Area 1: Standard POMP

Raleigh, NC 27699-2101

Contact: Phyllis Stewart (919)733-8400

North Carolina will assist with the development and pilot testing of two performance outcome measurement surveys 

related to services provided under Title III of the Older Americans Act. These include a service provider survey and a 

survey of older adults to obtain information about services received and consumers' assessment of service impact and 

quality. The goal of the project is to increase national, state and local knowledge of services and service packages for the 

purpose of planning, outreach and improved service delivery. Project objectives include: supporting the identification of 

appropriate cross-service performance measures; pilot testing the measures by conducting interviews with clients and 

service providers in one North Carolina region; and providing usable data, sharing findings and making recommendations 

for revisions to existing instruments and approaches. Project products will include training materials, data sets and reports 

on the findings of each survey.

Project Period: 09/30/2004 - 03/31/2006

FY Grant Amount

FY 2004 50,000

2101 Mail Service Center 

Program: 

North Carolina Department of Health and Human Services

Aging and Adult Services

Performance Outcomes Measures Project 501

90AM2868
Page 164 of 223 

Performance Outcomes Measures Project - Priority Area 1: Standard POMP

Tallahassee, FL 32399-7000

Contact: Jay Breeze (850)414-2000

The overall goal of Florida's standard POMP project is to expand the utilization of performance outcome measurement by 

Florida's elder services network. Florida will: 1) conduct a statistical analysis of POMP developed surveys and data to 

measure the specific items that correlate most highly with a global measure of performance; 2) conduct a statistical 

analysis of the internal validity of existing POMP surveys as related to the development of: a) a composite consumer 

assessment instrument to collect data to measure home and community-based service performance, and b) a tool to 

measure the capacity of the elder-services network to meet the demand for home and community based services; 3) 

share materials and data for replication through website postings and other dissemination.

Project Period: 09/30/2004 - 09/29/2006

FY Grant Amount

FY 2004 50,000

4040 Esplanade Way, STE 280 

Program: 

Florida Department of Elder Affairs

Planning and Evaluation Unit

Performance Outcomes Measures Project 501

90AM2869

Performance Outcomes Measures Project - Priority Area 1: Standard POMP

Columbus, OH 43215-5928

Contact: Marc Molea (614)466-7246

The goal of Ohio's POMP 6 initiative is to expand the use of performance outcome measurement in in Aging Network 

programs. Ohio will partner with AoA, other states and Ohio's Area Agencies on Aging to: 1) develop inclusive survey 

instruments (recipient and provider) that can be used to measure consumer outcomes and service delivery for a wide 

range of community services, and to refine and test the surveys; 3) develop protocols to connect and compare POMP 

results with National Aging Program Information System and Census data; and 4) enhance evaluation capacity by using 

Senior Community Service Employment Program participants to administer survey instruments.

Project Period: 09/30/2004 - 07/31/2006

FY Grant Amount

FY 2004 50,000

50 West Broad Street 9th Floor 

Program: 

Ohio Department of Aging

Planning, Development & Evaluation

Performance Outcomes Measures Project 501

90AM2870
Page 165 of 223 

Performance Outcomes Measures Project - Priority Area 1: Standard POMP

Phoenix, AZ 85007

Contact: Henry Blanco (602)542-4446

Arizona will build upon its Arizona Performance Outcomes Measurement System (AzPOMS) to expand the use of 

performance outcome measurement to assess program effectiveness. AzPOMS is a collaboration of the state, the Area 

Agency on Aging, Region One, Inc. and its service providers. AzPOMS will accomplish the following objectives in 

Maricopa County: 1) develop, refine and field test a comprehensive service recipient survey; 2) develop, refine and field 

test service provider surveys as a means of informing the performance measurement effort; and 3) develop 

recommendations for final versions of surveys to be posted on the POMP website. Expected AzPOMS outcomes are field 

testing of the provider and recipient surveys and reliable data analysis to improve program effectiveness and service 

delivery.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 50,000

1789 W. Jefferson (950A) 

Program: 

Arizona Department of Economic Security

Division of Aging and Cummunity Services

Performance Outcomes Measures Project 501

90AM2871

Performance Outcomes Measures Project - Priority Area 1: Standard POMP

Springfiield, IL 62701-1789

Contact: Joseph Lugo (217)785-2870

Illinois will collaborate with the Administration on Aging to develop performance outcome measures that will document the 

impact of Aging Network services on the lives of older adults and caregivers. The East Central Illinois Area Agency on 

Aging will participate in the project. The goal is to develop the foundation for a state based system to measure outcomes 

of Older Americans Act services based on statistically valid sampling. The objectives are to pilot test a recipient survey 

and a provider survey and to disseminate the results to the Aging network in Illinois to build support for a statewide 

system. Products of the projects will be the survey tools suitable for use in Illinois and throughout the United States.

Project Period: 09/30/2004 - 09/29/2005

FY Grant Amount

FY 2004 47,500

421 East Capitol Avenue, #100 

Program: 

Illinois Department on Aging

Division of Planning, Research, and Develpment

Performance Outcomes Measures Project 501

90AM2872
Page 166 of 223 

Performance Outcomes Measures Project - Priority Area 1: Standard POMP

Des Moines, IA 50309-3609

Contact: Jane Walke (515)242-3301

The Iowa Department of Elder Affairs, partnering with Hawkeye Valley Area Agency on Aging, will develop, field test and 

expand outcome measures used in Iowa's Aging Network by concentrating on: 1) developing service provider surveys; 

and 2) developing consumer assessment surveys to be posted on the POMP website. Expected outcomes are: 1) clients 

determine how services may be improved; 2) service providers receive assistance in developing outcome measures; 3) 

care recipients maintain independence longer; and 4) surveys and results are posted on area agencies websites. 

Products will include pilot tested service recipient and provider surveys and survey administration tools. The products will 

be disseminated to AoA, other states, the Iowa Association of Area Agencies on Aging, County Councils on Aging, aging 

partners, legislators and local officials.

Project Period: 09/30/2004 - 03/31/2006

FY Grant Amount

FY 2004 50,000

Clemens Bldg, Third Floor - 200 10th Street 

Program: 

State of Iowa

Department of Elder Affairs

Performance Outcomes Measures Project 501

90AM2873

Performance Outcome Measures Project: Advanced POMP

Albany, NY 12223-1251

Contact: I-Hsin Wu (518)474-4425

New York will be participating in the nursing home predictor statistical modeling component of Advanced POMP, in which 

the technical assistance contractor will work with the model developed by Florida, adjusting it consistent with data New 

York is able to provide. New York, as co-leader of the Advanced POMP workgroup, will also be working closely with the 

project officer and technical assistance contractor to identify national data sources appropriate for comparison purposes. 

The Advanced POMP goal applicable to this project is Goal 1: Demonstrate Cost Avoidance Attributed to Older Americans 

Act Services. 

Anticipated outcomes for this project are: 1) a nursing home predictor model developed and tested; and 2) appropriate 

comparison group data from national surveys identified to enable nursing home diversion estimation.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

15,000

50,000 2 Empire State Plaza 

Program: 

New York State Office for the Aging

Performance Outcomes Measures Project 501

90AM2874
Page 167 of 223 

North Carolina Performance Outcome Measures Project: Advanced POMP

Raleigh, NC 27699-2101

Contact: Phyllis Stewart (919)733-4534

North Carolina will be participating in the nursing home predictor statistical modeling component of Advance POMP, in 

which the technical assistance contractor will work with the model developed by Florida, adjusting it consistent to data that 

North Carolina is able to provide. North Carolina plans to use 27 month retrospective data to determine service utilization 

and identify reasons for terminated service. The data set will be compared with Medicaid claims data, to estimate cost 

savings. The Advanced POMP goal applicable to this project is Goal 1: Demonstrate Cost Avoidance Attributed to Older 

Americans Act (OAA) programs. Anticipated outcomes for this project are: 1) a nursing home predictor model will be 

developed and tested; and 2) Medicaid cost savings attributed to OAA programs will be estimated.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

15,000

40,000 2101 Mail Service Center 

Program: 

North Carolina Department of Health and Human Services

Aging and Adult Services

Performance Outcomes Measures Project 501

90AM2875

Building an Outcome Based Evaluation System for RI's Aging Services Network: 

Advanced POMP

Cranston, RI 02920

Contact: DR Donna M Cone (401)462-0500

Rhode Island will be participating in the nursing home predictor statistical modeling component of Advanced POMP, in 

which the technical assistance contractor will work with the model developed by Florida, adjusting it consistent with data 

Rhode Island is able to provide. In addition, Rhode Island is developing a protocol to measure the impact of congregate 

meal program participation on targeted health outcomes, improvement of healthy behaviors and reducing known 

indicators of nutritional risk. The Advanced POMP goals applicable to this project are Goal 1: Demonstrate Cost 

Avoidance Attributed to Older Americans Act (OAA) programs, and Goal 3: Demonstrate Effectiveness of OAA programs. 

The anticipated objectives of this project are to: 1) pilot test a nursing home predictor model to demonstrate cost benefits 

of Rhode Island home and community care programs; and 2) document impacts of congregate meal programs and 

estimate cost savings related to impacts.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

15,000

44,985 35 Howard Avenue, Bldg. # 55 

Program: 

Rhode Island Department of Elderly Affairs

The John O. Pastore Center

Performance Outcomes Measures Project 501

90AM2876
Page 168 of 223 

Florida Advanced POMP

Tallahassee, FL 32399-7000

Contact: Jay Breeze (850)414-2000

Florida is providing project leadership by independently developing a nursing home predictor model and sharing it with the 

grantee workgroup for broader testing. Florida serves as the co-leader of the Advanced POMP workgroup and has 

developed the vision for Goal 1: Demonstrate Cost Avoidance Attributed to Older Americans Act (OAA) Programs. Florida 

is currently expanding the nursing home risk model to predict risk of other adverse events such as hospitalization, 

emergency room visits and functional decline. Objectives are: 1) produce an algorithm to compute reductions in nursing 

home placements due to use of in-home services; 2) produce an algorithm to compute reductions in hospital use due to 

use of in-home services; and 3) produce an algorithm to compute reductions in acute medical care due to use of in-home 

services.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

15,000

50,000 4040 Esplanade Way, STE 280 

Program: 

Florida Department of Elder Affairs

Planning and Evaluation Unit

Performance Outcomes Measures Project 501

90AM2877

Delaware Performance Outcome Measures Project: Advanced POMP

New Castle, DE 19720

Contact: Melissa A Hinton (302)255-9390

Delaware will be participating in the nursing home predictor statistical modeling component of Advanced POMP, in which 

the technical assistance contractor will work with the model developed by Florida, adjusting it consistent with data that 

Delaware is able to provide. In addition, Delaware will conduct an independent review of cost avoidance methodology 

used for social programs. The Advanced POMP goal applicable to this project is Goal 1: Demonstrate Cost Avoidance 

Attributed to Older Americans Act Programs. The anticipated outcomes of this project are: 1) a nursing home predictor 

model will be developed and tested; and 2) a report documenting the methodological review of cost avoidance studies of 

social programs will be developed.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

9,694

37,751 Main Annex First Floor 

Program: 

Delaware Department of Health & Social Services

1901 N DuPont Highway

Performance Outcomes Measures Project 501

90AM2878
Page 169 of 223 

Implementing Outcome Measures in Ohio: Advanced POMP

Columbus, OH 43215-3363

Contact: Marc Molea (614)466-7246

Ohio will work on the development of a nursing home predictor model, using data available in Ohio and based, in part, on 

a high risk screening tool being developed for their Medicaid waiver program. They will use key factors determined to be 

statistically significant predictors for the Medicaid waiver population and they will test the reliability of the high risk 

screening tool for the population receiving Older Americans Act (OAA) services. Once the tool is validated and introduced 

into use, cost savings estimates can be generated. The Advanced POMP goal applicable to this project is Goal 1: 

Demonstrate Cost Avoidance Attributed to OAA Programs. The anticipated outcomes for this project are: 1) a nursing 

home predictor model will be developed and tested; and 2) a high risk screening tool for OAA programs will be developed 

and tested.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

15,000

40,000 50 West Broad Street, 9th Floor 

Program: 

Ohio Department of Aging

Performance Outcomes Measures Project 501

90AM2879

Arizona Performance Outcome Measurement System: Advanced POMP

Phoenix, AZ 85007

Contact: Henry Blanc (602)542-4446

Arizona's Advanced POMP project is focusing on the efficacy of senior centers. They will conduct a 24 month longitudinal 

study of new senior center clients to assess the impacts of nutrition and health promotion/ disease prevention programs. 

The Advanced POMP goal applicable to this project is Goal 3: Demonstrate the Effectiveness of Older Americans Act 

Programs. The anticipated outcome of the project is the design of a methodology to demonstrate the positive impact of 

select senior center services.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

15,000

50,000 1789 W. Jefferson (950A) 

Program: 

Arizona Department of Economic Security

Division of Aging and Community Services

Performance Outcomes Measures Project 501

90AM2880
Page 170 of 223 

Georgia Performance Outcome Measurement Cost Avoidance Project: Advanced POMP

Atlanta, GA 30303-3142

Contact: Arvine R Brown (404)651-6314

Georgia will be participating in the nursing home predictor statistical modeling component of Advanced POMP, in which 

the technical assistance contractor will work with the model developed by Florida, adjusting it consistent with data that 

Georgia is able to provide. Georgia will be the first state to test the Florida model. In addition, Georgia has an extensive 

data base with detailed information on waiting list clients which can be used to establish a comparison group. The 

applicable Advanced POMP goal for this project is Goal 1: Demonstrate Cost Avoidance Attributed to Older Americans Act 

Programs. The anticipated outcomes of this project are: 1) a nursing home predictor model will be developed and tested; 

and 2) waiting lists will be used as a comparison group to enable nursing home diversion estimation.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

11,250

18,772 2 Peachtree Street., NW, STE 9-398 

Program: 

Georgia Department of Human Resources

Division of Aging Services

Performance Outcomes Measures Project 501

90AM2881

Performance Outcome Measures Project: Advanced POMP

Des Moines, IA 50309-

Contact: Jayne Walke (515)242-3301

Iowa will be participating in the nursing home predictor statistical modeling component of Advanced POMP, in which the 

technical assistance contractor will work with the model developed by Florida, adjusting it consistent with data that Iowa is 

able to provide. In addition, Iowa will conduct an independent analysis of the optimal service case mix using data 

collected by the recipient survey conducted during an earlier POMP project, as well as administrative data. The applicable 

Advanced POMP goals for this project are Goal 1: Demonstrate Cost Avoidance Attributed to Older Americans Act (OAA) 

Programs and Goal 2: Demonstrate the Efficiency of OAA Programs. The anticipated outcomes of this project are: 1) a 

nursing home predictor model will be developed; and 2) the most efficient service mixes will be identified.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

15,000

40,000 200 10th Street, Clemens Bldg., Third Floor 

Program: 

State of Iowa

Iowa Department of Elder Affairs

Performance Outcomes Measures Project 501

90AM2882
Page 171 of 223 

Performance Outcomes Measurement Project: Advanced Pomp

Columbia, SC 29201-

Contact: Bruce Bondo (803)898-2850

For Advanced POMP, South Carolina has developed an independent analysis path to follow, predicated on their rich data 

base of health services utilization. They will examine the relationship between select older Americans Act services and 

the use of hospital or emergency room services for conditions such as dehydration and pneumonia. They will then 

examine service thresholds to determine if the amount of service impacts emergency room or inpatient hospitalization. 

Finally, they will examine health care expenditure records for the OAA population vs. the Medicaid non-OAA population to 

estimate savings in health care costs attributed to OAA services. The Advanced POMP goals applicable to this project 

are: 1) Demonstrate Cost Avoidance Attributed to OAA Programs; and 3) Demonstrate Program Effectiveness. The 

anticipated outcomes for this project are: 1) a methodology will be developed to demonstrate a reduction in hospital visits 

due to OAA services; 2) service effectiveness thresholds will be developed for select services; and 3) health care cost 

savings attributed to OAA programs will be identified.

Project Period: 09/30/2004 - 09/29/2007

FY Grant Amount

FY 2004

FY 2005

15,000

50,000 1301 Gervais Street, Suite 200 

Program: 

Lieutenant Governor's Office on Aging

Performance Outcomes Measures Project 501

90AM2883

Systems-Building in State Family Caregiver Support and Health Promotion Programs

Washington, DC 20005-0005

Contact: James Whaley (202)898-2578

The goal of this demonstration project is to build state capacity in collaboration with AoA. The second goal of the project is 

to assist the State Units on Aging (SUA) to compile and disseminate information about the Older Americans Act and other 

programs which they administer. The purpose of this activity is to develop a database software product for use by SUAs in 

their reporting under the National Aging Program Information System. The product is intended to facilitate the submission 

of this report in a timely manner to AoA, with the least possible burden to SUAs. The objectives of this program are: 1) to 

develop a software application for use by AAAs to facilitate state transmission of state program reports; 2) to provide 

training and technical assistance when the application is made available to the states; and 3) conduct a study of state 

agency and area agency management information systems and innovative approaches to streamlining data collection 

activities. The expected outcomes of the program include: transmission of information eased; training and technical 

assistance provided; and software reporting tools developed (edit and validity checking). The products include software for 

all State Units on Aging, a final report and recommendations for management information systems.

Project Period: 09/30/2002 - 09/29/2006

FY Grant Amount

FY 2002

FY 2003

FY 2004

FY 2005

250,000

400,000

295,632

75,000

1201 15th Street, NW, Suite 350 

Program: 

NATIONAL ASSOCIATION OF STATE UNITS ON AGING (NASUA)

Systems-Building in State Family Caregiver Support and Health Promotion Programs 599

90AM2666
Page 172 of 223 

OPTIONS OF CARE FOR OLDER ADULTS

Washington, DC 20002-0002

Contact: THOMAS B. B HOPPIN 

This state-wide project is a model research and education initiative to demonstrate the use of the Internet in promoting 

caregiving for older adults. It will develop and test the effectiveness of linking WWW/Internet with state and local agencies 

to facilitate information access regarding health and caregiving. The Pennsylvania (PA) Department on Aging (PDA) and 

PA State University (PSU) are partners with SPRY Foundation in this project. The target audiences for this CaregiverPA 

project are caregivers and other adult consumers in PA. The goals are: 1) to develop a model state-wide communications 

system, which provides the widest possible target audience with enhanced access to, and understanding of, care 

alternatives for older adults; 2) to market the CaregiverPA web site in PA; 3) to establish the web site in PA; 4) to expand 

and disseminate this model; and 5) to develop a national training program on how to use the Internet for caregiving. The 

objectives are: 1) to revise the web site; 2) to market the web site using the marketing plan; 3) to contact identified states 

and set up this model; 4) to work with at least four identified states to reproduce this web site; 5) to develop, test, and 

disseminate a training program in the role of the Internet in caregiving for both professional and lay caregivers. The 

outcomes are: a CaregiverPA model web site for promoting caregiving; caregiving information access; a revised website; 

dissemination of the model; a national training program on how to use the Internet for caregiving. The products are: a final 

report, a CaregiverPA marketing plan, and a national conference on Caregiving and the Internet.

Project Period: 09/01/1999 - 04/30/2004

FY Grant Amount

FY 1999

FY 2000

FY 2002

FY 2003

197,399

197,400

362,229

40,000

10 G Street, NE, Suite 600 

Program: 

SETTING PRIORITIES FOR RETIREMENT YEARS FOUNDATION

Congressional Mandates 601

90AM2290

Elder Abuse Cross System Linkage Project; Financial Exploitation Project

Harrisburg, PA 17101-1919

Contact: (717)783-6207

This project was originally entitled the Elder Abuse Cross System Linkage Project, managed by the Pennsylvania 

Department of Aging. Its goals were to: (1) help identify and prevent elder abuse in nursing facilities in Pennsylvania by 

electronically linking the databases of the three Pennsylvania Departments responsible for either the licensing and 

regulation of nursing home facilities, or the resolution of complaints about nursing home care; (2) train department staff on 

using the linked databases and resulting information to better identify persistent quality of care problems; 3) more 

aggressively investigate and resolve complaints; and 4) more effectively safeguard the safety and well-being of nursing 

home residents. Expected outcomes: worked with nursing facilities to identify and prevent elder abuse; developed 

linkages with databases on quality of care problems; resolved nursing home complaints; and trained staff on using linked 

databases. The products of this Elder Abuse project were a final report, and a report on number of elder abuse complaints 

resolved. In its final phase, the project focused on financial exploitation, with goals of educating the public to avoid 

financial exploitation; and teaching financial literacy and enhancing the capacity of professionals to investigate cases of 

suspected financial exploitation. Outcomes: successful training with AoA Power 2000 materials in nine venues, with 129 

mostly low-income participants; and the development of a model for addressing financial exploitation of the elderly.

Project Period: 09/01/1999 - 06/30/2004

FY Grant Amount

FY 1999

FY 2001

740,250

310,641 555 Walnut Street, 5th Floor 

Program: 

PENNSYLVANIA DEPARTMENT OF AGING

Congressional Mandates 601

90AM2302
Page 173 of 223 

INDIAN HEALTH DATA BUREAU

Albuquerque, NM 87111-3851

Contact: Dave Baldridge (505)292-2001

The project goal builds on and advances two initiatives related to the AoA priority of reducing health disparities between 

minority and majority elderly. The first objective under the first initiative is for the National Indian Council on Aging (NICoA) 

to develop culturally-relevant multi-media educational materials about Medicare and related federal benefits that better 

target Indian elders, and put those educational materials to work at 6 demonstration sites using tribal representatives to 

inform elders about their eligibility for program benefits. The second objective under the second initiative is for the NICoA 

to equip tribal health directors with information/documents/tools to use Medicare and Medicaid data effectively for better 

reimbursement and better targeting of services to the elderly/disabled Indian populations. The anticipated outcomes of this 

project include: 1) the successful completion of 2 initiatives; a reduction of Native American health disparities; multi-media 

educational materials; 6 demonstration sites developed; tribal elders better equipped to assist the elderly/disabled Indian 

populations; and increased Medicare and Medicaid benefits.

Project Period: 03/01/2000 - 02/28/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

130,000

130,000

130,000

10501 Montgomery Blvd, NE, STE 210 

Program: 

National Indian Council on Aging, Inc

Congressional Mandates 601

90AM2325

ESTABLISHMENT OF THE NATIONAL CENTER FOR SENIORS' HOUSING 

RESEARCH

Upper Marlboro, MD 20774-0774

Contact: 

Under this cooperative agreement, the grantee , the National Research Center (NRC), has established a National Center 

for Seniors' Housing Research (NCSHR) to assist older Americans live comfortably, safely and independently in their own 

homes as they age, regardless of income or ability-level. The goal of this Center is to develop innovative solutions to 

accommodate changing housing needs for older Americans who wish to age in place. This information is available to the 

home building industry, particularly to remodelers, to consumers and to the Aging Network. The project activities for this 

Center include: web-based information about the value and application of universal design principles; available products 

which enhance independent living; support and analysis of the National Older Adults Housing Survey; examination of the 

cost and safe techniques for home modification for an aging population, with improved training for building contractors 

about the needs of the aging population; an annual student design competition to stimulate innovative residential design 

for aging in place; stimulating partnerships between the Aging Network and the home building industry to foster user 

friendly environments; and use of assistive technology and replication of the features incorporated in the new "Life-Wise" 

house. .

Project Period: 03/01/2000 - 01/01/2006

FY Grant Amount

FY 2000

FY 2002

FY 2003

553,285

930,699

445,113

400 Prince Georges' Blvd. 

Program: 

NAHB RESEARCH CENTER, INC.

Congressional Mandates 601

90AM2328
Page 174 of 223 

ADVANCING THE ROLE OF VOLUNTEERISM IN DELIVERING HOME 

MODIFICATION SERVICES TO AN AGING POPULATION

Washington, DC 20036-0036

Contact: 

Project's Overall Design: This is a continuation of an earmarked Title IV discretionary grant that was initially funded in 

June 2000. Rebuilding Together continues to expand the scope of the "Safe at Home" grant activities through its 269 

affiliate members. Of special emphasis this year is falls prevention and supporting home modifications for aging-in-place. 

Expanding partnerships between the affiliate chapters and the Aging Network is an overarching goal. Part of the 

partnership and coalition building centers around joint training activities to help the affiliates gain increased understanding 

of universal design for helping seniors remain at home and to help the Aging Network gain new and valued partners for 

helping low-income seniors. 

FY 2005 Outcomes: Rebuilding Together will disseminate a new brochure and toolbox to stimulate greater public attention 

about the value of home modification in helping senior and their caregivers with continued independence. An additional 

2,000 people will be trained in home safety assessments. Twenty to forty affiliates will expand their home modification 

programs for the seniors. Funds will be used to leverage an additional $250,000 in product discounts and donations for 

the home modification efforts. The grant efforts this year will benefit some 4,000 sites for safe aging-in-place. This 

organization will continue to exhibit and make presentations at major aging conferences throughout the year, both 

nationally and locally. Rebuilding Together collaborates with the organizations sponsoring Aging-in-Place week in 

November, the National Home Modifications Action Coalition and the NCOA falls prevention programs. 

Project Period: 06/01/2000 - 07/31/2006

FY Grant Amount

FY 2000

FY 2002

FY 2003

FY 2005

322,756

493,500

392,234

391,642

1536 16th Street, NW 

Program: 

REBUILDING TOGETHER, INC.

Congressional Mandates 601

90AM2334

THE HEALTHY AGING PROJECT

Portland, OR 97201-3098

Contact: 

The goal of this eighteen month research project is to demonstrate the most effective form of health services. The 

objectives of this project are: 1) to focus on setting individual health goals for participants; 2) to meet these goals through 

varied mechanisms, including nurse coaching, support for healthier behavior and coordination of the full continuum of 

health services; 3) to enroll 800 participants, with special emphasis on low-income and minority populations; 4) to develop 

a number of outcome measures including improvement in targeted outcomes established for each participant. The 

anticipated outcomes are improved health promotion; personalized health goal; coordination of health services; 

low-income and minority elderly participation. The products of this project are a final report, and a report on a research 

study of 800 seniors.

Project Period: 08/01/2000 - 07/31/2004

FY Grant Amount

FY 2000

FY 2002

922,160

444,150 3181 SW Sam Jackson Park Road - SN4N 

Program: 

Oregon Health Sciences University

Congressional Mandates 601

90AM2379
Page 175 of 223 

NATIONAL RESOURCE CENTER ON NATIVE AMERICAN AGING AT THE 

UNIVERSITY OF NORTH DAKOTA

Grand Forks, ND 58202-8202

Contact: Alan Allery 

The goal of the University of North Dakota's National Resource Center (NRC) on Native American Aging project is to 

focus on health issues of Native American elders, including long-term care and in-home care, access to services and 

elder abuse. The objectives of this NRC project are: 1) to assist in the development and utilization of community resources 

to assist Native elders with living life to the fullest extent possible; 2) to develop programs and activities for Native 

Americans; 3) to conduct "Survey of Elders" needs assessments; 4) to study and analyze the impact of "Motor Vehicle 

Crashes" on Native elders; 5) to conduct "Geriatric Leadership Seminars"; 6) to develop and distribute several curricula 

materials; 7) to hold trainings for Community Health Representatives to better identify and intervene appropriately in 

health problems for the elderly; and 8) to support health promotions through screenings, education, and activities via 

satellite network videos. The anticipated outcomes of this project are: a stronger NRC; expanded knowledge of this Native 

American Aging project; increased use of community resources; updated elderly needs assessment; senior leadership 

seminars; new curricula materials; training materials; health promotion materials. The products of this project are a final 

report; papers on long-term care; in-home care materials; elder abuse materials/data; an elderly survey; a motor vehicle 

crashes report; and seminar materials.

Project Period: 09/01/2000 - 01/31/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

327,365

346,471

346,471

Box 7090 

Program: 

University of North Dakota

Congressional Mandates 601

90AM2380

HISPANIC LIFE CYCLE PLANNING PROJECT

Pasadena, CA 91101

Contact: Carmela G. G Lacayo (626)564-1988

The Asociacion Nacional Pro Personas Mayores (ANPPM) developed bilingual life/cycle and pre-retirement planning 

materials for Hispanic elders and their adult children, age 45 plus. A series of materials focused on basic introductions to 

life/cycle planning were used to educate bilingual and monolingual Hispanic adults about the importance of understanding 

their aging process and the economic realities of growing old in America. The materials covered preventive health, 

long-term care needs and basic financial planning for low-income workers. Project objectives were to: 1) develop a 15 

minute video introduction to the basics of life cycle planning from a cultural perspective; 2) develop a Spanish/English 

workbook that provided a basic introduction to life/cycle planning for low income workers; 3) create a resource manual for 

Hispanic CBOs to develop ongoing life/cycle training programs at the local level; 4) conduct 10 workshops for adult 

children of Hispanic older persons, in 8 cities across the nation; 5) conduct 5 workshops for Hispanic older persons age 

60+ with a focus on safe money management and durable power of attorney; 6) promote active involvement of private 

sector financial institutions and health care providers in the project; and 7) disseminate a replicable pre-retirement training 

model for low income Hispanic workers. Outcomes included: an Hispanic life/cycle plan; and materials on the Hispanic 

cultural aging process and the impact on low income Hispanic workers. In addition to bilingual materials in print and CD 

formats, a final report was produced.

Project Period: 09/01/2000 - 05/31/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

150,000

150,000

150,000

234 E. Colorado BI., STE 300 

Program: 

Asociacion Nacional Pro Personas Mayores

Congressional Mandates 601

90AM2384
Page 176 of 223 

PARTNERS IN LONG TERM CARE INITIATIVE

Philadelphia, PA 19141

Contact: 

The Albert Einstein Medical Center established a comprehensive community-based and integrated service system for frail 

and chronically ill elders and their caregivers by establishing linkages with aging services partners in the Southeastern 

Pennsylvania region. Through the project, Einstein intended to enhance the quality of existing relationships and to 

stimulate the development of new linkages to better meet the needs of older persons. The prototype system had three 

components, a PACE model life Center to provide a continuum of care system of services to the frail elderly; a Personal 

Care Partnership Program (PCPP) for personal care home residents; and a culturally appropriate training program for 

Korean American caregivers. Project objectives were concentrated in the areas of planning, developing and establishing 

an infrastructure for this comprehensive community based system. Einstein documented planning of the system to 

contribute to the body of knowledge in the field. Anticipated outcomes included: a system of care for elderly; a PACE 

model; a Korean-American training module; and an adult care facility for low income elders. Major products included a 

culturally appropriate training module for Korean-American caregivers, a comprehensive assessment and a final report.

Project Period: 09/30/2000 - 10/31/2005

FY Grant Amount

FY 2000

FY 2001

920,000

493,500 5501 Old York Road 

Program: 

ALBERT EINSTEIN MEDICAL CENTER

Congressional Mandates 601

90AM2388

NATIONAL POLICY AND RESOURCE CENTER ON NUTRITION AND AGING: 

NUTRITION 2030

Miami, FL 33199

Contact: (305)348-1517

The overall goal of this project is to support the Older Americans Act Nutrition Programs. Specific goals are: 1) to meet the 

challenge of reducing health disparities in older adult participants of the Elderly Nutrition Program (ENP) through improved 

outreach and culturally competent service provision; 2) to improve nutrition-related outcomes in ENP participants, 

especially minorities; 3) to increase program accountability; and 4) to modernize nutrition services. The approach will 

employ training and technical assistance, information dissemination, knowledge building and policy analysis, outcomes 

measurement, and partnership building. The objectives of this project are: 1) to provide improved access to timely 

practical nutrition; 2) to provide aging information and resources; 3) to improve outreach; 4) to improve nutrition services; 

and 5) to improve the measurement of outcomes through practical guidance, modeling and policy analysis. The expected 

outcomes are: an improved nutrition program services; reduction of health disparities in older adults; expanded outreach; 

improvement of cultural-nutrition; increased minority participation; improved access; improved nutrition outcomes; policy 

analysis. The products of this project are: a Center Website; 3 listservs; 2 issues panels; a state nutritionist meeting; 

nutrition intensive at 3 Aging Services Network meetings; 6 journal articles and 8 newsletter articles; 4 meeting 

backgrounds, proceedings, recommendations; the establishment of a Long- Term Care Institute; and a final report.

Project Period: 09/01/2000 - 08/31/2004

FY Grant Amount

FY 2000

FY 2001

FY 2002

297,400

682,017

536,400

11200 SW 8th Street, OE 200 

Program: 

THE FLORIDA INTERNATIONAL UNIVERSITY BOARD OF TRUSTEES

Florida International University Board of Trustees

Congressional Mandates 601

90AM2390
Page 177 of 223 

SENIOR CARE

Chicago, IL 60604

Contact: (312)986-4135

The goal of the Metropolitan Family Services project is to demonstrate a "SeniorCare" program that is modeled after AoA's 

National Family Caregiver Support Program. SeniorCare has five objectives: 1) to provide individualized information on 

available resources; 2) to provide assistance in locating services; 3) to provide caregiver counseling, training, and peer 

support; 4) to provide needed respite care; and, 5) to provide limited supplemental services to fill gaps. The expected 

outcomes include: increased access to individualized information on resources to support caregivers; support for families 

providing care resulting in better quality of life for care providers; increased public awareness of the challenges of 

caregiving, as well as relevant resources; increased integration of community based providers to support the needs of 

caregiving families; expansion of the model Health Education Program; increased understanding in the field of the 

ethno-cultural impact of the caregiving experience and how to provide culturally sensitive support; a SeniorCare program; 

a model Health Education program; and a culturally sensitive program. The products of this Senior Care projects are a 

final report, and caregiver training.

Project Period: 09/30/2000 - 03/31/2004

FY Grant Amount

FY 2000

FY 2001

250,000

455,007 14 E. Jackson Blvd., Suite 1400 

Program: 

Metropolitan Family Services

Congressional Mandates 601

90AM2397

LIFE COURSE PLANNING RESOURCES ACTIVE AGING RESOURCES

Anchorage, AK 99504-9504

Contact: Clara (Billie) Lewis (907)258-7823

The grantee, the Anchorage Senior Center, will manage this Life Course (LC) project. The goal of this LC project is to 

develop a model senior center that will offer health education, health promotion, health nutrition, and life course planning 

in order to keep Native Tribes and others as independent and self-reliant as is possible. The objectives of this project are: 

1) to provide information on life course planning for seniors; 2) to provide resources for the target population, i.e. the active 

aging; 3) to develop a senior center that will be responsive to the needs of the Native Tribes and others; 4) to develop 

local programs for seniors in a cultural setting; 5) to implement outreach to Alaskan Tribes. The anticipated outcomes of 

this LC project are: a model senior center; an array of programs; senior services; improved staff resources; improved 

health education, health promotion, health nutrition, and life course planning; more older Alaskans will be independent; 

increased number of self-reliant seniors; targeted outreach to Alaskan natives; an evaluation. The products of this project 

are a final report, and project surveys.

Project Period: 12/01/2000 - 11/30/2003

FY Grant Amount

FY 2001

FY 2002

FY 2003

733,333

733,333

733,334

1300 E. 19th Avenue 

Program: 

Anchorage Senior Center

Congressional Mandates 601

90AM2438
Page 178 of 223 

CAREGIVERS OF SENIOR RESOURCES, EDUCATION, SERVICES AND TRAINING 

(REST) PROJECT

SAINT PETERSBURG, FL 33733-3489

Contact: 

This is a three year Caregiver demonstration project that designed and evaluated a comprehensive assessment and 

referral system of family caregiver resources. The project will create a best practice model for a caregiver support program 

over a three year period. There will be a partnership between the St. Petersburg Junior College and the Area Agency on 

Aging (AAA). The goal is to develop a comprehensive system of supporting caregivers. The objectives are: 1) to develop a 

pilot project for assessments; 2) to expand program staff both at the college and at the AAA; 3) to utilize volunteers with 

the resource centers; 4) to establish focus groups; 5) to disseminate project materials; 6) to develop a care management 

system; 7) to establish caregivers resource centers; and 8) to serve a mix of minorities. The expected outcomes are: 

improved quality of life for care recipients and their families; a comprehensive assessment; a referral system of family 

caregiver resources; a best practice model for a caregiver support program; assistance with the diverse needs of 

caregivers; and less caregiver stress. The products of this caregivers project are: a final report; a website; an assessment 

and referral guide; a project directory; an evaluation; and focus groups materials.

Project Period: 09/01/2001 - 08/31/2004

FY Grant Amount

FY 2001 874,482

PO BOX 13489 

Program: 

ST. PETERSBURG COLLEGE

Congressional Mandates 601

90AM2462

STRATEGY FOR PREVENTING DECLINE IN THE PHYSICAL & MENTAL HEALTH OF 

RURAL ELDERS THROUGH SOCIALIZATION & INTERCONNECTION

Burlington, VT 05401-5401

Contact: 

The goal of the Vermont Champlain Senior Center (SC) is to develop a Strategy for Preventing Decline in the Physical and 

Mental Health of Rural Elderly. The objectives of this project are: 1) to encourage a diverse group of elders to access 

senior center services; 2) to install computers in six senior centers across the state of Vermont; 3) to train seniors to use 

computer software and to access the Internet; 4) to create a virtual senior center so that individuals will be able to access 

some senior center services online. The anticipated outcomes are: a practical strategy for preventing a decline in the 

physical and mental health of rural seniors; increased use of six senior centers and access to senior center services; new 

computers/technology for seniors to use in senior centers; online services for seniors; rural seniors kept active; access to 

the Internet and technology programs for rural elderly; technology training program for minorities. The products of this 

project are a final report, and new computer software.

Project Period: 08/01/2001 - 07/31/2004

FY Grant Amount

FY 2001

FY 2002

FY 2003

98,700

98,700

73,543

241 North Winooski Avenue 

Program: 

CHAMPLAIN SENIOR CENTER INC

Champlain Senior Center, Inc.

Congressional Mandates 601

90AM2463
Page 179 of 223 

INTEGRATING CARE MANAGEMENT INTO DEMENTIA SPECIFIC PRIMARY CARE

Boca Raton, FL 33431-3431

Contact: 

The grantee, Florida Atlantic University, supports this three year Dementia Disease demonstration (DD) project in 

collaboration with the Alzheimer's disease (AD) and related Dementias groups. The goal of the project is to provide 

comprehensive, coordinated care to individuals with memory concerns and to their caregivers. The approach is to expand 

the services and to integrate the bio-psycho-social aspects of care. The objectives are: 1) to provide dementia specific 

care, i.e, care management fully integrated into the services provided; 2) to train staff, students and volunteers; 3) to 

implement the system infrastructure to support services to individuals with early stage dementia and to their caregivers; 4) 

to develop linkages with community agencies; 5) to expand the assessment and intervention services; 6) to evaluate the 

impact of the added services; and 7) to disseminate project information. The expected outcomes of this DDD project are 

to: have patients maintain as high a level of mental function and physical function (Yoga) as possible; help their caregivers 

cope with the changes; and, evaluate the patients before and after the project. The products from this project are a final 

report; an evaluation; a website; articles for publication; data collection in driver assessment and in-home cognitive 

retraining; and abstracts for national conferences.

Project Period: 08/15/2001 - 08/14/2004

FY Grant Amount

FY 2001

FY 2002

421,449

987,000 777 Glades Road 

Program: 

FLORIDA ATLANTIC UNIVERSITY

Congressional Mandates 601

90AM2465

WEST VIRGINIA UNIVERSITY PLAN OF ACTION ON RURAL AGING

Morgantown, WV 26506-6845

Contact: Janet Williams (304)293-0628

This is a cooperative agreement between the Center on Aging at the West Virginia University and the Administration on 

Aging (AoA). The Rural Aging project is a demonstration project. There are two goals in this project: 1) to assist AoA to 

collect information for a report summarizing the status of rural aging programs in America; 2) to operationalize 

recommendations from the International Conference on Rural Aging, organized by the WVU under a previous grant, by 

developing and evaluating eight systems-building models in rural demonstration sites in WV and Ohio. The intent is to 

effect sustainable change in delivery of services to improve the health of older individuals in rural areas. Outcomes 

included a summary report of the status of rural aging programs in the USA; systems-building models from the eight 

demonstration sites in two states; improved delivery of rural services; improved health of seniors. The products of this 

project are a final report, a summary report of the status of rural aging programs and an evaluation of the eight models.

Project Period: 09/01/2001 - 01/31/2004

FY Grant Amount

FY 2001 987,000

PO Box 6845 886 Chestnut Ridge Road

Program: 

WVA RESEARCH CORPORATION ON BEHALF OF WEST VIRGINIA UNI

Congressional Mandates 601

90AM2471
Page 180 of 223 

ST. LOUIS AGING SERVICES ACADEMY

ST. LOUIS, MO 63105-3105

Contact: 

The St. Louis County Department of Human Services conducted the pilot for an Aging Services Academy that would 

deliver customized training to prospective and recent retirees in the age group 50 to 59 years. The project served as a 

vehicle for developing curriculum that could provide at least 50 older individuals with customized training, resources and 

support to pursue expanded retirement opportunities. The strategy was to develop core curricula for classroom instruction 

in basic gerontology and basic computer skills and computer literacy, thereby empowering aging individuals. Partners 

include the Mid-East AAA Title V Employment Program, the St. Louis County Older Residents Program, and St. Louis 

Senior Computer Training. Training was reinforced through paid internships with eldercare organizations. Expected 

outcomes included: a model Aging Services Academy with curricula for three core learning components (including 

computer training); customized classroom instructional and marketing materials; a cadre of mature workers to serve as a 

model for countering negative stereotypes; a limited number of paid internships; and strengthened partnerships with 

community and older worker programs in the area. Initially, the project was scheduled to cover a 17 month period, 

however after successfully securing private funding, it remained active for more than 36 months. At termination of the 

federal project period, the project was to be operated by the State. The products for dissemination include a final report, 

curricula, conferences materials and a project guide.

Project Period: 09/30/2001 - 02/28/2005

FY Grant Amount

FY 2001 418,950

121 S. MERAMEC AVENUE , 3RD FLOOR 

Program: 

SAINT LOUIS COUNTY GOVERNMENT

Congressional Mandates 601

90AM2478

TECHNOLOGY LEARNING CENTER FOR SENIORS

Madison, IN 47250-7250

Contact: 

The goal of the Ivy Tech State College (ITSC) is to develop Technology Learning Centers (TLC) for seniors in two 

campuses across the State of Indiana. The objectives of this TLC project are: 1) to increase the number of older persons 

taking computer and Internet training courses; 2) to develop a curriculum which will consist of at least 12 courses; 3) to 

offer workshops at each campus to accommodate those wishing basic computer skills, as well as advanced study; 4) to 

offer computer and Internet courses at senior centers in the local community. The expected outcomes of this TLC project 

are: seniors experienced with technology; seniors trained at 2 campuses; increased number of seniors trained in computer 

and use of Internet; expanded offerings at ITSC; special curriculum offered to community seniors. The products of this 

TLC project are a final report; a curriculum; workshops; two TLCs for seniors; basic computer courses.

Project Period: 09/30/2001 - 12/31/2003

FY Grant Amount

FY 2001 713,601

590 Ivy Tech Drive 

Program: 

Ivy Tech State College

Congressional Mandates 601

90AM2493
Page 181 of 223 

REYNOLDS CENTER ON AGING PROGRAMS FOR RURAL ARKANSAS

Little Rock, AR 72205-2205

Contact: 

This is a three year demonstration project that focuses on the rural health of African-Americans. The goal of this rural 

health project is to assess the health status of rural and urban older Arkansans and improve their quality of life. The 

approach includes raising functional and cognitive performance levels, through (e.g.) senior exercise programs 

(functional) and measurement of cognitive abilities through mental testing. The rural health (RH) project objectives are: 1) 

to conduct a population-based survey (assessment); 2) to conduct long-term follow -up studies on risk factors for 

cognitive and functional decline; 3) to conduct pilot studies of targeted interventions; and 4) to assess the effectiveness of 

the seven Rural Centers of Excellence in Geriatrics. The expected outcomes of this RH project are: a survey; longitudinal 

studies; pilot studies; and data collection tools and materials. The products of this RH program are: health status studies; a 

training manual; a survey; data collection; and evaluation instruments. These products will be disseminated to local 

participating agencies and health care researchers. The collaborators include the University of Arkansas for Medical 

Sciences, Veterans Medical Center, six senior centers, North Little Rock Women's City Club, the Heritage House and the 

Willow House (HUD Housing Facilities), and others.

Project Period: 09/01/2001 - 08/31/2004

FY Grant Amount

FY 2001 888,235

4301 West Markham , Slot 812 

Program: 

UNIVERSITY OF ARKANSAS MEDICAL CENTER

Congressional Mandates 601

90AM2518

MEDICAL ERRORS: THEIR OCCURENCE AMONG INPATIENTS AND AT 

TRANSITIONS BETWEEN INPATIENT AND OUTPATIENT CARE

Billings, MT 59101-9101

Contact: 

This is a two year demonstration project whose goal is to study the occurrence of medical errors and factors affecting their 

occurrence among Medicare beneficiaries admitted as in-patients to Deaconess Hospital. The objectives of the health 

program are: 1) to determine the causes of and risk factors for medication errors; 2) to study the effect of computerized 

physician order entry system (CPOE) and bar-coding medication dispensing systems (B-CMDS); and 3) to provide new 

information in the field. The expected outcomes are: an upgraded, existing electronic medical record system; a 

longitudinal study of 800 older people with 500 older outpatients in a control group; trained physicians and hospital 

personnel; an evaluation (to measure the impact of technology on reducing medical errors; reduction of medication errors 

in large rural areas); published findings on the AoA website; determination of patient risk factors that may predispose 

elderly persons to medication errors, with a focus on errors that occur during transitions between inpatient and outpatient 

care; examination of specific patient risk factors (e.g., cognitive deficits and frailty) that would affect medication 

management in the outpatient setting; examination of both charted errors and formal reports of error; and a senior rural 

residence study. The products are: a final report; articles in medical journals and aging magazines; an elderly Medicare 

population study.

Project Period: 09/30/2001 - 02/28/2004

FY Grant Amount

FY 2001 1,381,800

PO Box 3566 2917 Tenth Avenue North

Program: 

Deaconess Billings Clinic Foundation

Congressional Mandates 601

90AM2519
Page 182 of 223 

CARING FOR ALZHEIMER'S PATIENTS AND THEIR CAREGIVERS IN THE DIVERSE 

COMMUNITY

New York, NY 10007-0007

Contact: Joan Senecal 

The grantee, the Aging in New York Fund/Department for the Aging (ANYF/DFTA), manages this two year demonstration 

Alzheimer's Disease (AD) project in collaboration with the Zachary and Elizabeth M. Fisher (ZEF) Foundation and the ZEF 

Center for AD Research Foundation at Rockefeller University and the ZEF Education and Resources Program at NYU. 

The goal of the project is to provide the opportunity to further assess the role of ethnicity in the use of caregiver support 

options and the degree of caregiver burden through expanded knowledge base of the disease course and service options. 

The objectives of this AD project are: 1) to improve awareness of AD process and increase service utilization for AD 

patients and their caregivers; 2) to improve service delivery; 3) to do research links between the use of caregiver supports 

and reported burden by ethnicity; 4) to develop improved anti-agitation compounds for the AD patients; 5) to improve 

patient mobility and management,;and 6) to broaden the dissemination of AD information, services and linkages. The 

expected outcomes of this AD program are: a reduction in reported burdens; on-going AD education; increased mobility 

through exercise; reduced agitation in AD patients; and increased awareness of AD and caregiver options. The products 

of this AD project are a final report; dissemination of AD findings; the documentary and publicity campaign; and AD project 

resources.

Project Period: 09/30/2001 - 09/29/2004

FY Grant Amount

FY 2001

FY 2002

3,637,095

3,637,095 2 Lafayette Street 

Program: 

Aging in New York, Inc.

Congressional Mandates 601

90AM2552

Enhanced ACCESS to Bene*Fits (TM) Initiative

New York, NY 10036-0036

Contact: Igal Jellinek (212)398-6565

The goal of this Council of Senior Centers (CSCS) ACCESS to Bene*Fits/tm Initiative is to increase access to health care, 

nutritious meals, prescription medications and supportive services. It puts dollars into the pockets of needy seniors and 

the businesses and communities where they live. It will provide community-based host sites with qualified volunteers, 

technical assistance, training and ongoing assistance they need to get older New Yorkers the benefits for which they may 

be entitled. A computerized software program will analyze seniors' eligibility for 39 public and private benefits and 

entitlements, and then staff and trained volunteers will assist seniors in applying for and obtaining them. The objectives 

are: 1) to screen New Yorkers age 60 and over to determine benefits and entitlements they are eligible for, but are not 

receiving ; 2) to assist older persons in completing the application process, including gathering necessary documentation; 

3) to provide follow-up and advocacy to ensure applications are processed and applicants receive notification of 

status/begin receiving benefits in a timely fashion; and 4) to increase participation at senior centers among the seniors 

screened through ACCESS. The expected outcomes are an evaluation; interviews with project seniors; assistance with 

filling out applications; and the senior center as the "point of intake". The product is the final report.

Project Period: 07/01/2002 - 06/30/2004

FY Grant Amount

FY 2002 74,025

49 West 45th Street, 7th Floor 

Program: 

Council of Senior Centers and Services of New York City

Congressional Mandates 601

90AM2607
Page 183 of 223 

Promoting Senior Independence and Safety Through Intervention Within Community 

NORCS

Pittsburg, PA 15217-5217

Contact: Barbara Gottlieb (412)521-1011

The Naturally Occurring Retirement Community (NORC) Initiative is a multi-site project administered by the U.S. 

Administration on Aging (AoA) since August 2002. The Initiative focuses on developing and testing strategies to support 

older adults as they age in place in naturally occurring retirement communities. These communities are predominantly 

comprised of long-term residents age 60 and older who wish to age in place as they experience limitations in their 

activities of daily living. This is the Pittsburg NORC Demonstration model, a 12 months project, and one of five NORCs 

funded by AoA. The grantee will administer this project, and will collaborate with UJF, JFCS, and the Jewish Community 

Center (JCC). The goal is that neighborhood seniors and their families are made aware of and have access to programs 

and services so they can remain independent and safe. The objectives are: 1) to serve 60 targeted seniors at risk with two 

interdisciplinary "care teams"; 2) to educate seniors and their families about services; 3) to identify each clients' family or 

support network members and engage them in the senior's care management. Outcomes are: seniors and families will 

have expressed greater comfort in living safely and independently; clients will have shown a higher level of usage of 

services; participants will have shown an increased knowledge; collaborating agencies will have acted as being more 

effective and more efficient. The products of this project are a final report, public forums, and protocols.

Project Period: 08/01/2002 - 07/31/2004

FY Grant Amount

FY 2002 197,400

200 JHF Drive 

Program: 

Jewish Association on Aging

Congressional Mandates 601

90AM2609

Test Replicability of Community Options by Seeding Four (4) NORC Sites

Cleveland, OH 44115-4115

Contact: Renee Berry (216)321-1668

The Naturally Occurring Retirement Community (NORC) Initiative is a multi-site project administered by the U.S. 

Administration on Aging (AoA) since August 2002. The Initiative focuses on developing and testing strategies to support 

older adults as they age in place in naturally occurring retirement communities. These communities are predominantly 

comprised of long-term residents age 60 and older that wish to age in place even as they experience limitations in their 

activities of daily living. This is the Cleveland NORC project, a 12 month project, and one of the five NORC demonstration 

projects. The Jewish Community Federation (JCF) of Cleveland is the grantee. The goal of this NORC project is to employ 

the concepts of community organizing and consumer direction which will empower seniors to remain healthier in their 

homes, living full, satisfying lives as long as possible. The objectives are: 1) to provide seed funding for four non-profit 

organizations to sponsor NORC initiatives that replicate the Community Options model; 2) to prepare an evaluation of the 

five NORCs; 3) to hire a consultant to develop a 3-5 year business plan; and 4) to fund a research course buyout for one 

Ohio University faculty member who will conduct a multi-year longitudinal study of aging. Working with the Jewish 

Community Federation of Cleveland (JCF) will be Brandeis University. Outcomes are: increased access to supportive 

health services; increased satisfaction with their quality of life; increased seniors participation; increased social interaction; 

and increased knowledge base; and an evaluation. The products of this effort are a final report; a 3-5 year business plan; 

and a longitudinal study of aging.

Project Period: 08/01/2002 - 07/31/2004

FY Grant Amount

FY 2003 987,000

1750 Euclid Avenue 

Program: 

Jewish Community Federation of Cleveland

Congressional Mandates 601

90AM2610
Page 184 of 223 

Supportive Neighborhoods

Baltimore, MD 21215

Contact: Hannah Pollack Feller (410)466-1990

The Naturally Occurring Retirement Community (NORC) Initiative is a multi-site project funded by the U.S Administration 

on Aging (AoA) since August 2002. The Initiative focuses on developing and testing strategies to support older adults, as 

they age in place in naturally occurring retirement communities. These communities are predominantly comprised of 

long-term residents age 60 and older who wish to age in place, even as they experience limitations in their activities of 

daily living. The goal of this Comprehensive Housing Assistance, Inc. (CHAI) project is to develop a network of 

neighborhoods that will support resident seniors, mostly Russian-Americans who have language barriers and acculturation 

issues, and are in need of transportation and practical information. The objectives are: 1) to perform outreach; 2) to create 

a Supportive Neighborhood Council, 3) to develop transportation programs, 4) to perform program enhancements; 5) to 

increase intergenerational opportunities for socialization through volunteer initiatives, 6) to expand Senior-Friendly 

Apartments programs; and 7) to compile and disseminate information. The partnerships involved with CHAI are Jewish 

Community Center of Greater Baltimore (JCC); Myerberg Senior Center; and Jewish Family Services of Central Maryland 

(JFS). Expected outcomes are: a senior friendly apartment program; a supportive neighborhoods program and council; 

augmentation of existing NORC models; replication of NORCS; and volunteer opportunities.

Project Period: 08/01/2002 - 11/30/2006

FY Grant Amount

FY 2002

FY 2003

FY 2005

987,000

513,826

697,122

5721 Park Heights Avenue 

Program: 

Comprehensive Housing Assistance, Inc.

Senior Friendly Neighborhoods

Congressional Mandates 601

90AM2611

Naturally Occurring Retirement Communities

St. Louis, MO 63146

Contact: Stephen Cohen (314)432-0020

The Naturally Occurring Retirement Community (NORC) Initiative is a multi-site project administered by the U.S. 

Administration on Aging (AoA) since August 2002. The Initiative focuses on developing and testing strategies to support 

older adults as they age in place in naturally occurring retirement communities. These communities are predominantly 

comprised of long-term residents age 60 and older that wish to age in place as they experience limitations in their 

activities of daily living. This is the St. Louis NORC model. It is a 12 month demonstration project. The grantee, the Jewish 

Federation (JF) of St. Louis (MO), administers this project and will partner with the Center for Aging of Washington 

University of St. Louis. The goal of this NORC project is to create a public-private partnership model to improve the quality 

of life of older residents within a geographically based NORC by developing a coordinated care and supportive service 

delivery network. The objectives are: 1) to complete an assessment of NORC resident characteristics related to service 

needs and utilizations; 2) to determine the types, levels, mixtures, and patterns of informal and formal care and supportive 

services; 3) to determine the services required by residents to live independently; 4) to develop key project partnerships; 

5) to pilot intervention implementation and evaluation; and 6) to create a five-year plan for coordinated service delivery. 

Outcomes are: consumer satisfaction; new knowledge; coordinated/targeted service delivery; improved health status, and 

a better quality of life. The products of this effort are a final report; service needs assessment; a service map; and an 

inter-agency service delivery plan.

Project Period: 08/01/2002 - 12/31/2006

FY Grant Amount

FY 2002

FY 2005

1,263,360

220,298 12 Millstone Campus Drive 

Program: 

Jewish Federation of St. Louis

Congressional Mandates 601

90AM2612
Page 185 of 223 

Integrated Comprehensive Service Model in Six Downtown Condominiums

Philadelphia, PA 19103

Contact: Robin Heller (215)496-9700

The Naturally Occurring Retirement Community (NORC) Initiative is a multi-site project administered by the U.S. 

Administration on Aging (AoA) since August 2002. The Initiative focuses on developing and testing strategies to support 

older adults as they age in place in naturally occurring retirement communities. These communities are predominantly 

comprised of long-term residents age 60 and older that wish to age in place as they experience limitations in their 

activities of daily living. This is the Philadelphia NORC model, a 12 month project, one of five NORC demonstration 

projects, and sponsored by the Jewish Family and Children's Service of Greater Philadelphia (JFCS). JFCS will partner 

with Albert Einstein Medical Center. The goal of this NORC project is to integrate social services, socialization groups, 

educational activities and preventive health services to enhance the safety, well-being, and continued independence of 

the residents. The objectives are: 1) to serve senior residents of six apartment buildings through the program "Services to 

Apartment Residents (STAR)"; 2) to do an on-site feasibility study within a Philadelphia neighborhood. Outcomes 

include:1) program availability to 60% of the 3,500 residents in the buildings; 2) an advisory board of 12 members will be 

established; 3) eight advisory board meetings conducted; 4) weekly team meetings with an interdisciplinary team on-site; 

5) monthly health screening. The products of this effort are a final report; a needs assessment; a service plan; and a 

brochure.

Project Period: 08/01/2002 - 07/31/2006

FY Grant Amount

FY 2002

FY 2003

FY 2004

FY 2005

196,300

245,146

196,235

293,731

2100 Arch Street 

Program: 

JEWISH FAMILY AND CHILDREN'S SERVICE OF

GREATER PHILADELPHIA

Congressional Mandates 601

90AM2613

Nourishing the Human Spirit: Social-Therapeutic Dining a la Eden

Woodland Hills, CA 91364-1364

Contact: Donna Bender (818)876-1556

The non-profit organization, Motion Picture and Television Fund, is a one-year congregate dining program. The goals of 

this nutrition project are to: 1) implement an integrated activities-congregate dining program for long-term care residents 

currently receiving meals via in-room tray service; and 2) enhance satisfaction, functionality and quality of life among 

residents participating in this new program. The objectives are to: 1) create social-therapeutic congregate dining; 2) 

provide stimulating and strength/mobility-building activities integrated with the dining program; 3) improve clinical 

observation and therapeutic practice; and 4) train restorative nurse assistants and certified nursing assistants. The 

expected outcomes are: a 30% reduction in resident dissatisfaction in identified food/activities problem areas; improved 

resident strength, flexibility and social interaction; and shared "best practices". The products are a final report; an activities 

tool kit; a training program; a survey; and an aide training program.

Project Period: 09/01/2002 - 01/31/2004

FY Grant Amount

FY 2002 98,700

23388 Mulholland Drive 

Program: 

Motion Picture & Television Fund

Congressional Mandates 601

90AM2614
Page 186 of 223 

SENIOR PROGRAMS AND SERVICES

Mt. Vernon, NY 10550-0550

Contact: Sheila Belle (914)813-6430

Westchester County Department of Senior Programs and Services is the grantee for this 12 month demonstration project. 

The project, entitled Senior OutReach to Seniors (S.O.S.), has the goal of helping seniors live independently in their 

apartments for a longer period of time, through interventions. The objectives of this SOS project are: 1) to provide 

programs and services, such as health, fitness, socialization, entertainment and the arts, to the Hispanic tenants in 30 

apartment buildings where seniors live; 2) to hire a part-time bi-lingual (Hispanic) social worker to assist; 3) to train 

Hispanic tenant leaders; and 4) to train the Hispanic seniors to take charge of their health, employ nutrition and exercise. 

The outcomes of this SOS program are: an increase in the number of new S.O.S. buildings by at least 3; an increase in 

the number of seniors who receive programs and services; and an increase in the knowledge and level of senior 

participants, especially Spanish speaking seniors. The products of the SOS program are: a final report; a training program 

for Hispanic tenant leaders; project data; and an evaluation.

Project Period: 08/01/2002 - 07/31/2004

FY Grant Amount

FY 2002

FY 2003

19,740

49,029 9 South First Avenue, 10th Floor 

Program: 

Westchester County Department of Senior Programs and Se

Congressional Mandates 601

90AM2617

Cyber Cafes for Senior Citizens

Oklahoma City, OK 73112-3112

Contact: Lyn Hester (405)848-3173

Integris Health Systems established a number of Cyber Cafes for seniors in Oklahoma City. Cafes served as centers for 

seniors to train seniors in basic computer skills and learn how to access the Internet. The primary purpose of the cafes 

was to reduce the incidence of isolation among seniors age 50 and above, and provide them access to information 

through the Internet. Project staff coordinated with community partners to target and recruit isolated seniors. Faculty from 

local technical and high schools taught more advanced classes, while high school students trained seniors in basic 

computer operations. The project met or exceeded anticipated outcomes, which included a prototype inter-generational 

model for instructing older adults in basic computer skills and Internet access, outreach to seniors age 50 and above, 

reduced senior isolation and established metro and satellite computer locations. Cooperation with AAAs, the Sheriff Office 

and Police Dept, Daily Living Centers (assisted living center), major shopping malls, high schools' students and faculties 

resulted in donations of equipment and funds and establishment of additional cyber cafes. In addition to the Senior Cyber 

Cafe model, products include a final report.

Project Period: 09/30/2002 - 09/29/2004

FY Grant Amount

FY 2002 98,700

3366 NW Expressway, Suite 800 

Program: 

INTEGRIS HEALTH

Congressional Mandates 601

90AM2619
Page 187 of 223 

Elder Abuse Education Program

Wheaton, IL 60187-0187

Contact: Mary Lee Tomsa/Mary Persinger (620)682-6924

This demonstration will develop an Elder Abuse Education (EAE) program and deliver it to local professionals. This EAE 

program will include information on the indicators of elder abuse, the stresses associated with caregiving, the dynamics of 

"elder domestic violence", and how to report abuse and get help to those at risk. The goal of this project is to provide 

educational sessions to law enforcement, health care, and senior service professionals in order to increase their 

knowledge of indicators of elder abuse, neglect, and exploitation, and awareness of intervention options. The major 

objectives are: 1) to hire and train a qualified Case Manager Coordinator; 2) to develop an education program and 

materials; 3) to provide 35 educational sessions; and 4) to analyze evaluation survey results to measure the effectiveness 

of the educational program. The expected outcomes are: trained professionals will show a 70% increased awareness of 

elder abuse indicators and interventions; and dissemination. The products of this project are a final report; a presentation; 

a program evaluation and evaluation tools; training materials and handouts; a survey; and a curriculum.

Project Period: 09/01/2002 - 12/31/2004

FY Grant Amount

FY 2002 98,700

421 N. County Farm Road 

Program: 

DuPage County Department of Human Resources

Congressional Mandates 601

90AM2620

Iowa Seamless Project

Des Moines, IA 50309-3609

Contact: Greg Anliker 

This is a 3 year demonstration that will improve the system of home and community based services (HCBS) in Iowa. The 

goal is a consumer-directed, seamless delivery system of community based long-term care options for Iowa's consumers. 

The crux of this grant involves planning and consensus building and the development of a unified information system. 

Letters of support from the state Medicaid agency and the state Health department document their commitment to work 

with the State Unit on Aging (SUA) toward a more unified system of services. The objectives are 1) to design a data 

management and service delivery system and gain consensus from key partners; 2) to develop reasonable and fair 

criteria for eligibility and participation in HCBS provided, including fees where appropriate; 3) to determine rules, 

regulations, and laws to be revised and/or waived. Outcomes of the project are a data management system that allows 

better access to programs funded and administered through 3 state departments to elders and their caregivers in Iowa; 

client participation criteria developed for programs funded through the 3 state departments; rules, regulations, and laws 

identified to be changed and/or waived to improve access and efficiencies for elders and their caregivers, service 

providers, and government entities; increased personal empowerment and/or family control in planning and directing care; 

increased consumer and caregiver satisfaction; and a reasonable and fair criteria for eligibility. The products are a final 

report, an evaluation, and a unified data management information system.

Project Period: 09/01/2002 - 02/28/2006

FY Grant Amount

FY 2002

FY 2003

FY 2004

1,480,500

980,584

981,177

Clemens Building, 3rd Floor 200 10th Street

Program: 

IOWA DEPARTMENT OF ELDER AFFAIRS

Congressional Mandates 601

90AM2622
Page 188 of 223 

F.A.S.T. - Facilitating Access Through Senior Technology

Hot Springs, AR 71913-3491

Contact: Sherial Bradley (501)321-2811

This is a two year demonstration seniors computer technology project. The Area Agency on Aging for West Central 

Arkansas will work in five rural counties. The goal of the program is to utilize modern technology in this poor, rural, 

underserved area to improve access to computers, and improve the perception of and deliver services to seniors. 

Interventions will include the utilization of lap-top computers when performing in-home visits, to gather data and quickly 

determine eligibility for services. The objectives of this Senior Computer program are: 1) to develop a research plan; 2) to 

conduct a minimum of three site visits; 3) to utilize information from site visits to formulate specifications for a central 

database; 4) to put into operation software, lap top /desk top computers, and bar code scanners to provide access to a 

central database; and 5) to evaluate and disseminate the effectiveness of the project. Outcomes of this Seniors Computer 

program are the pre and post research; dissemination; introduction of technology into seniors' homes, resulting in 

increased information and service accessibility; and the implementation of barcode scanning eliminating costly and 

cumbersome paper forms. The products of the Senior Computer project are: a final report, project information and 

research data; project summary; pre/post research analysis; abstracts for Arkansas Aging Conference; and data 

questionnaires.

Project Period: 09/01/2002 - 12/31/2004

FY Grant Amount

FY 2002 449,085

905 West Grand Avenue 

Program: 

Area Agency on Aging of West Central Arkansas

Congressional Mandates 601

90AM2623

Developing a Universal Kitchen Design

Ames, IA 50011-0011

Contact: Ronald Cox (515)294-9592

Iowa State's intended goal is to aid older persons who want to remain independent by developing a prototype universal 

design kitchen system of appliances and cabinets. The key evaluation question addressed was whether the refined 

kitchen could be manufactured at an affordable price for the mass market. It appears that the grantee successfully 

completed project objectives. A model cabinet system was developed. Focus groups were conducted to test the universal 

usability of the kitchen prototype and subjects were video taped to evaluate market appeal. Based on demographic data 

that indicates women have a longer life span than men, a greater likelihood exists for women to find themselves living 

alone as they age. Therefore, during year 1, focus groups were composed exclusively of women, age 65 plus. However, 

during year 2, focus groups were expanded to include both genders, persons of diverse abilities and age groups 20-29, 

40-49, and 60 plus. Further, rural and urban residents participated in the project. Data collected was transcribed and 

analyzed. Consultations were conducted with Maytag Corporation and Bertch Cabinet Manufacturing regarding feasibility 

of manufacturing a prototype system; assessment of the market appeal of the prototype to consumers and providers; and 

evaluation of the manufacture of the prototype for a mass market. Partners included community representatives and 

Progress Industries Foundation. A report was prepared and findings disseminated.

Project Period: 09/30/2002 - 12/31/2004

FY Grant Amount

FY 2002

FY 2003

197,400

294,175 2272 Howe Hall, Suite 2620 

Program: 

Iowa State University of Science & Technology

Congressional Mandates 601

90AM2624
Page 189 of 223 

Experience Corps

San Francisco, CA 94107-4107

Contact: Cathy Maupin (415)430-0141

In this promising national project, the Experience Corps' (EC) goal is to harness the social capital of older Americans to 

improve the prospects of low-income children in public elementary schools and community youth organizations (CYOs). 

After establishing a track record of success over the past five years, with funding primarily from the Robert Wood Johnson 

Foundation (RWJ), the Experience Corps is poised to enhance its 15 existing sites and expand the program to an 

additional six sites. This project will provide an essential key to success for this initiative. RWJ is focused on local program 

administration and volunteer cost. There are three objectives to this EC project: 1) to help build the capacity of expansion 

sites to recruit new volunteers and elevate their profile in the community; 2) to help the remaining Experience Corps sites 

prepare the preliminary work for future expansion; and 3) to bolster Civic Ventures' capacity to support the recruitment, 

training, and implementation of Experience Corps to other sites. The anticipated outcomes of this EC project are: support 

of technical assistance by Civic Ventures; a dissemination effort targeted at a wide array of audiences of practitioners, 

policymakers, and funders in the productive aging field; support of low-income children in public elementary schools and 

CYOs; expansion of EC program to additional 6 sites; and trainings. The products of the EC program are a final report, 

training materials, and a cadre of senior volunteers.

Project Period: 09/01/2002 - 06/30/2004

FY Grant Amount

FY 2002 789,600

139 Townsend Street, Suite 505 

Program: 

Civic Ventures

Congressional Mandates 601

90AM2625

Helping Hands

Pine Bluff, AR 71611-1611

Contact: Dixie Clark (870)543-6300

This is an in-home and community-based services long-term care (LTC) demonstration project called "Helping Hands". 

This 17 month LTC project will serve Black Americans and Hispanics who reside in the town of Leola and in the 

agricultural counties along the Mississippi River in SE Arkansas. The goal of this LTC project is to improve the quality of 

life for the at risk elderly by delivering in-home and community-based LTC services. LTC project objectives are: 1) to 

develop a model service delivery agency; 2) to identify significant barriers to providing and/or receiving services; 3) to 

enhance access to home and community-based services, 4) to assess, compile, and analyze the elderly's life satisfaction. 

The expected LTC project outcomes are: enhanced care and services; access to services and care; increased personal 

empowerment and/or family control in planning and directing care; a higher degree of life satisfaction for clients and their 

families; an evaluation; and a trained referral nurse. The products of this LTC program are: a final report with lessons 

learned; an annual training plan; and 14 computer work stations for reporting NAPIS data.

Project Period: 09/01/2002 - 01/31/2004

FY Grant Amount

FY 2002 493,500

PO Box 8569 

Program: 

Area Agency on Aging of Southeast Arkansas, Inc.

Congressional Mandates 601

90AM2635
Page 190 of 223 

Older Adults Intervention Systems (OASIS)

Los Angeles, CA 90015-0095

Contact: Moeed N. N Khan (818)883-6015

This is a one year Older Adults Intervention Systems (OASIS) demonstration project managed by a faith-based 

organization at the Guadalupe Community Center in Canoga Park, CA.. The goal of this OASIS project is to implement a 

multi-pronged approach that is relevant and effective in meeting the social and family needs of older adults and their 

caregivers, particularly those with limited English proficiency. The objectives of the OASIS demonstration project are: 1) to 

conduct a needs assessment study; 2) to provide the delivery of direct services; and (3) to establish and implement 

Faith-based outreach teams; 4) to develop a needs assessment survey of providers serving older adults to determine the 

use and availability of services; 5) to identify the barriers to the use of those services; and 6) to identify gaps and unmet 

needs in the catchment area. The anticipated outcomes of the OASIS project are: faith-based outreach teams; direct 

services; 500 older adults and their caregivers will be provided information and referral services; and faith-based outreach 

teams will provide supportive assistance to about 700 older adults. The products of the OASIS program are a final report; 

and a needs assessment study and survey.

Project Period: 09/30/2003 - 02/28/2005

FY Grant Amount

FY 2003 434,119

PO Box 15095 James M. Wood Blvd.

Program: 

CATHOLIC CHARITIES OF LOS ANGELES, INC.

Congressional Mandates 601

90AM2637

Music Therapy Model Demonstration Program for Adult Day Healthcare

Winchester, VA 22601-2601

Contact: Jane Bauknecht (540)722-2273

The Adult Care Center of Northern Shenandoah Valley, Inc. will establish a music therapy (MT) demonstration model for 

persons with probable Alzheimer's disease and related disorders (ADRD). The goal of this MT project is to demonstrate 

the use of music therapy and to study the impact of music therapy on patients with ADRD . The objectives are: 1) to 

establish protocol for music therapy in an adult care health center; 2) to conduct both quantitative and qualitative 

assessments in relation to each function of music therapy; 3) to apply ongoing data derived from behavioral observations 

and physiological measures and also to incorporate this in determining the best use of music therapy. This MT project will 

be interdisciplinary, i.e., psychology, physical therapy, occupational therapy and nursing will be represented in the project 

design. The anticipated outcomes of this MT project are: an examination of music therapy on ADRD patients; protocols for 

MT; assessments; and dissemination. The products of this MT project are: a final report; an assessment; music therapy 

studies and reports; and protocols for MT.

Project Period: 07/01/2002 - 01/31/2004

FY Grant Amount

FY 2002 148,050

115 Wolfe Street 

Program: 

ADULT DAY CARE OF NORTHERN SHENANDOAH VALLEY, INC.

Adult Day Care of Northern Shenadoah Valley, Inc.

Congressional Mandates 601

90AM2638
Page 191 of 223 

Legal Backup/Financial Elder Abuse Attorney Project

Madison, WI 53718-6751

Contact: (608)224-0606

The Elder Law Center of the Coalition of Wisconsin Aging Groups (CWAG) will support an attorney who will work half-time 

as a legal backup attorney to reduce existing case loads, and half-time to develop an educational program on financial 

elder abuse. The objectives of this legal project are: 1) to employ four attorneys who provide legal backup to 75 benefit 

specialists (paralegals) in 65 Wisconsin counties; 2) to use benefit specialists, partially funded through the Older 

Americans Act, to represent elderly individuals on issues of public benefits; 3) to coordinate with the benefit specialists; 

4) to disseminate information on financial elder abuse; 5) and to set up programs in counties to educate people on 

prevention and remedies for elder abuse. The anticipated outcomes of this legal program are: a reduction of existing case 

loads; a new educational program on financial elder abuse; four attorneys for legal backup; 75 benefit specialist 

(paralegals) to represent the elderly; legal assistance in 65 counties; dissemination of financial elder abuse cases; 

prevention and remedies for elder abuse; and an educational program on financial elder abuse.

Project Period: 09/01/2002 - 12/31/2004

FY Grant Amount

FY 2002

FY 2003

134,232

98,058 2850 Dairy Drive Suite 100

Program: 

COALITION OF WISCONSIN AGING GROUPS

Congressional Mandates 601

90AM2639

Assessing and Delivering Multicultural Services to Senior Citizens in Wayne County

Westland, MI 48186-8186

Contact: Suzanne Wisler (734)727-7373

Wayne County is Michigan's most ethnically diverse county. The Detroit Area Agency on Aging (AAA 1-A) serves 70% of 

Michigan's elderly. The goal of this project is to provide ACCESS to services for a diverse Middle East immigrant senior 

population, and to overcome language and cultural barriers. This project proposes a two-pronged approach. The first 

phase is a needs assessment strategy to assess the services the County's elderly need. The second phase aims to 

improve access to and quality of mental health and health support services. The objectives of this project are: 1) to 

improve the nutritional and health care status of underserved populations; 2) to ensure that services are of high quality 

and more responsive to the needs of underserved populations; and 3) to reduce caregiver stress. The expected outcomes 

of this program are: an evaluation; results from the service enhancements; dissemination to both AAAs and their service 

networks; a publication; information to the Wayne County Health Department, advocacy groups, community leaders, the 

social work departments/schools of participating universities, and appropriate media outlets; and senior services. The 

products of this program are: a final report; brochures; needs assessment; and a caregiver stress report.

Project Period: 09/01/2002 - 09/30/2004

FY Grant Amount

FY 2002 781,229

30712 Michigan Avenue 

Program: 

County of Wayne

Congressional Mandates 601

90AM2645
Page 192 of 223 

SOS Nutrition Project: MNT and Therapeutic Meals for Homebound Seniors with Three 

Chronic Diagnoses

Charoltte, NC 28211-8211

Contact: Carol Baker (704)336-3258

The grantee, the Mecklenburg County Department of Social Services, supports this clinical trial of community based 

medical nutrition therapy (MNT), in collaboration with the University of North Carolina Charlotte. Medical nutrition therapy 

is a benefit under Medicare that provides nutrition counseling for specific diseases, diabetes and renal disease. There is 

interest from Congress and the medical profession to also cover cardiovascular disease, specifically hypertension and 

dyslipidemia. The goal of this grant is to test two different community interventions associated with medical nutrition 

therapy. Project A is a controlled, randomized clinical trial with the goal of determining the efficacy/cost-effectiveness of 

medical nutrition therapy and therapeutic meals for homebound seniors with hypertension and dyslipidemia. Project B is a 

feasibility/demonstration project for the provision of Medicare reimbursed medical nutrition therapy and therapeutic meals 

to homebound seniors diagnosed with pre-end stage renal disease and/or diabetes. Project B will demonstrate how public 

social service agencies can establish and manage this Medicare funded service and demonstrate the ability of the aging 

network to integrate social and medical services. The evaluation of Project A will be an analysis of change in serum 

cholesterol and blood pressure, changes in food and nutrient intake, and cost-effectiveness. The evaluation of Project B 

will be a process evaluation for the implementation of medical nutrition therapy and therapeutic meals in the community. 

The expected outcomes of the two projects are improved community based nutrition service interventions for older adults. 

Products are: a final report; an evaluation for Projects A and B; presentations at conferences, publications in 

peer-reviewed journals; and a "How-To" manual for the aging network.

Project Period: 09/30/2002 - 08/15/2006

FY Grant Amount

FY 2002

FY 2004

927,973

686,049 301 Billingsly Road 

Program: 

MECKLENBURG COUNTY DEPARTMENT OF SOCIAL SERVICES

Congressional Mandates 601

90AM2665

Seniors Parenting Again Program

Chicago, IL 60604

Contact: Colleen M. M Jones (312)986-4135

Metropolitan Family Services proposes a one-year community-based program for low to moderate income seniors who 

are primary caregivers for children and adolescents. This office and home-based program will be located on the south 

side of Chicago, Illinois and target older adult residents of the Roseland, Pullman, West Pullman, Washington Heights, 

Morgan Park and Riverdale communities. The goal of the Seniors Parenting Again Program is to increase the capacity of 

senior caregivers to cope with their "parenting again" responsibilities. Program objectives are to: 1) reduce stress, 

depression, and anxiety, and 2) increase general well being of caregivers raising children and adolescents. Products will 

include: family stabilization plans for senior parenting families; a senior parenting resource guide tailored to the specific 

communities in which families live; assessment tools, and evaluation tools. Products will be disseminated to the State, 

service providers, and seniors in the community.

Project Period: 09/01/2003 - 07/01/2006

FY Grant Amount

FY 2003 220,631

14 E. Jackson Blvd., Suite 1400 

Program: 

METROPOLITAN FAMILY SERVICES

Congressional Mandates 601

90AM2726
Page 193 of 223 

Development of a National Data Collection System for Improving at the End of Life

Cary, NC 27513

Contact: Larry Smith (919)677-4115

The Carolinas Center for Hospice and End of Life Care will conduct a 3-year project to gather and report data on the 

experience of death and dying. The goal is to develop an accessible database of measures that provides actionable 

information for healthcare providers, community service providers, health services researchers, and state policy makers. 

Data elements that currently exist in several databases will be obtained for the new dataset and we will partner with state 

centers for health statistics and/or academic research centers to collect new measures via ongoing data collection efforts. 

The primary outcome will be an accessible dataset hosted on the Internet by The National Hospice and Palliative Care 

Organization. Products will include complete data for North and South Carolina and a procedure manual for other states to 

collect and contribute data to the dataset. The products will be disseminated via newsletters, journal articles, professional 

conferences, and the Internet.

Project Period: 09/01/2003 - 08/31/2005

FY Grant Amount

FY 2003 245,146

2400 Weston Parkway 

Program: 

THE CAROLINAS CENTER FOR HOSPICE AND END OF LIFE CARE

Congressional Mandates 601

90AM2727

Creating a Seamless System of Care for Iowa's Aging Population

Des Moines, IA 50312-0312

Contact: Alice Breemer (515)271-1657

The two primary purposes for this grant are: 1) to support the development of a comprehensive repository of information 

about Iowa's aging population; and 2) a web-based educational program for caregivers who provide daily services to 

Iowa's aging population. The curriculum of this training will be based on the needs profiled from the data repository. Two 

of the products resulting from this project will include: 1) a data warehouse, in which numerous data bases containing 

information on the health care needs of older Iowans are stored and integrated; and 2) a web-based training program, for 

caregivers providing daily services for older Iowans. The availability of these products will be disseminated to all 

organizations participating in the project and to interested organizations outside of Iowa.

Project Period: 09/01/2003 - 01/31/2006

FY Grant Amount

FY 2003 481,078

3200 Grand Avenue 

Program: 

DES MOINES UNIVERSITY

Congressional Mandates 601

90AM2728
Page 194 of 223 

Caregiver Resource Center - Fountain Square

Indianapolis, IN 46227

Contact: Connie Beran 

Caring for a loved one who is suffering from dementia, Alzheimer's, or any number of debilitating conditions or diseases is 

a labor of love. The Center for Aging and Community at the University of Indianapolis will create the Indianapolis 

Caregivers Resource Center-Fountain Square (ICRC-FS). ICRC-FS will provide holistic resources and support services to 

individuals and families assuming a caregiver role. Partnering with other community organizations in the southeast-side 

Indianapolis urban neighborhood of Fountain Square, ICRC-FS will identify caregivers in need of support and provide 

services to meet those needs. The overall objective of this ongoing program is to provide needed tools of intervention for 

caregivers in Fountain Square by involving and engaging multiple community organizations. Outcomes include increased 

knowledge of care and community resources, coping skills, the importance of self-care, and avoiding burnout; and 

decreased self-reported incidences of caregiver burnout and elderly mistreatment (self-neglect, abuse, and exploitation).

Project Period: 09/01/2003 - 08/31/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

196,117

152,082

313,313

1400 East Hanna Avenue 

Program: 

UNIVERSITY OF INDIANAPOLIS

Congressional Mandates 601

90AM2729

Senior Center Healthcare Coordinator Program

St. Louis, MO 63103

Contact: David P. P Sykora 

The St. Louis Area Agency on Aging (AAA) will develop and implement a Senior Center Healthcare Coordinator Program 

that will create an organized system of health, wellness and nutrition programs, as well as medical and information 

services to improve the quality of life for seniors living in the City of St. Louis. The program's objectives are: 1) to increase 

the knowledge and understanding of healthcare issues by senior citizens; 2) to enhance the community services provided 

by senior centers; 3) to develop a supportive referral network; and 4) to provide community healthcare related education 

programs. The anticipated outcomes include: increased wellness of seniors; increased usage of healthcare providers; 

and improved ability of seniors to manage their own healthcare. The program will incorporate a recommended care plan, 

and a resource data bank. Upon completion of the 12-month project, information will be disseminated to partners, 

universities, community organizations and Area Agencies on Aging. The products are a final report; evaluation tools; 

assessment tools; and manuscripts.

Project Period: 09/01/2003 - 02/28/2006

FY Grant Amount

FY 2003 147,088

634 Grand Blvd. 

Program: 

CITY OF ST. LOUIS

Congressional Mandates 601

90AM2730
Page 195 of 223 

Life Long Learning and Sharing Program

Clinton, KY 42031

Contact: Mitzi Spraggs 

The goal of the Hickman County Senior Citizens' "Life Long Learning and Sharing" (LLLS) Program is to increase the 

awareness in seniors of their need to assume responsibility for their own longevity and productivity. The LLLS Program 

proposes to accomplish this through a computer training program designed to promote seniors' intellectual stimulation, 

social interaction, job skills development, and community volunteerism. Twenty-four senior citizens will participate in the 

LLLS Program. Expected outcomes include: increased seniors' knowledge of computer usage; increased number of 

seniors who come to the Senior Center to use the computer lab; increased number of seniors who take their newly 

acquired computer skills into the work force; and, increased number of seniors who take their newly acquired computer 

skills and use them in a volunteer capacity in the community. A survey of participants and a final report, including the 

results of this survey, will be developed and shared with the Purchase Area Agency on Aging's eight-county Aging 

Committee at the conclusion of the LLLS Program.

Project Period: 09/01/2003 - 08/31/2004

FY Grant Amount

FY 2003 6,000

212 East North Street 

Program: 

Hickman County Senior Citizens, Inc.

Congressional Mandates 601

90AM2731

ExperienceSeniorPower: Bridging the Digital Divide

Detroit, MI 48202-8202

Contact: Tony Fama (248)398-6438

For one year, the Society of St. Vincent de Paul will utilize ExperienceSeniorPower intergenerational computer 

programming. ExperienceSeniorPower teams disadvantaged senior citizens with at-risk children, teaching both computer 

skills. While studies indicate a lack of computer knowledge among poor senior citizens and children, 

ExperienceSeniorPower fills the "digital gap" for each group, assuring that by working together, both will enter the 

technology age. Project goals include teaching young and old computer skills, simultaneously. Children gain technological 

skill, leading to improved educational performance and greater economic opportunity, while learning from positive role 

models. For seniors, many of whom live in isolation, the computer becomes a gateway to the world, as they reach out to 

friends and family. Seniors self-esteem improves through learning a new skill and filling adoptive grandparent roles. The 

Society of St. Vincent de Paul, in collaboration with the Detroit Archdiocese and Maria Madeline Project, Inc., will provide 

ExperienceSeniorPower programming in 10 church-based community centers. Recognizing that children and seniors 

living in economic duress rarely have access to transportation, we will provide these services in their neighborhoods. 

Products include: a comprehensive, 170-page workbook in large print; a web site designed for senior citizens, insuring 

easy, senior-friendly on-line lessons; and assessment and evaluation tools that will be disseminated to participants. 

Computers are increasingly conditioning the kind of country in which we live. Digital Divide shines a light on the role 

computers can play in limiting social gaps throughout our society, particularly among young people.

Project Period: 09/01/2003 - 08/31/2004

FY Grant Amount

FY 2003 117,670

2929 East Grand Boulevard 

Program: 

SOCIETY OF ST. VINCENT DE PAUL

Congressional Mandates 601

90AM2732
Page 196 of 223 

Successful Aging in Community: Purposeful Relationships & Active Engagement

Champaign, IL 61866

Contact: Brenda Krause Eheart (217)893-4673

The proposed one-year project will be implemented in Hope Meadows, which is a planned neighborhood of older adults 

and foster/adoptive families. It will utilize housing on a former military base. The target population, approximately 65 older 

adult residents, will receive programmatic supports and training. The program will provide opportunities for seniors to 

engage in daily formal and informal volunteer activities with their neighbors - the parents, children and staff of Hope 

Meadows. While the senior volunteer program is evolving, it will be systematically codified. Defining and further 

developing this program in precise and quantifiable terms will help prepare it to become a national model. The program 

evaluation process will articulate the underlying program theory as fully as possible, specify indicators for outcomes and 

processes, and develop a plan for acquisition and analysis of data. This project promises significant benefits not only for 

the older adult volunteers at Hope Meadows, but also for policymakers aspiring to marshal older adults as community 

resources to address difficult social problems.

Project Period: 09/01/2003 - 08/31/2004

FY Grant Amount

FY 2003 490,292

1530 Rantoul 

Program: 

Generations of Hope

Congressional Mandates 601

90AM2733

Southcare Home Services

Glenside, PA 19038-0513

Contact: David Dobson (215)205-1754

Southcare Home Service (SHS) will demonstrate an innovative model of home-based care for the elderly, focused on 

enhancing health, safety and quality of life for frail, isolated seniors, while lowering the cost and facilitating 

consumer-directed care. The project will emphasize highly targeted nutritional and home safety interventions that will 

significantly reduce the risk of nursing home placement and costly hospital stays. SHS will provide an integrated 

"umbrella" program including: 1) home delivered meals and nutritional counseling and support focused on reducing 

obesity and diabetic problems; 2) non-medical homemaker and companion services, as well as respite for caregivers; 3) 

handyman services for minor home repairs, safety modifications, and general life safety maintenance of owner occupied 

housing; and 4) transportation to aid in the prevention of medical and nutritional problems. The project is expected to 

demonstrate an innovative model of service delivery, which will reduce the cost of services. In addition, it also will 

demonstrate opportunities for senior employment, volunteerism, and activity to improve the quality of life.

Project Period: 09/01/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2005

490,292

24,478 PO Box 967 

Program: 

SOUTHCARE NURSING CENTER INC.

Congressional Mandates 601

90AM2734
Page 197 of 223 

NORC Demonstration -- Chicago

Chicago, IL 60606-0606

Contact: Dana Rhodes (312)357-4944

The Jewish Federation of Metropolitan Chicago (JFMC) will partner with the Council for Jewish Elderly, responding to the 

growth of older adults who are aging in place and need help to continue living independently at home. Development of 

innovative community-based alternatives to hi-cost institutional care, averaging $37,000 a year, per resident, is 

paramount. Such alternatives may mitigate the long-term financial effects of the rapidly increasing number of seniors on 

our national health and social service systems. With more than ten million Americans living in "Naturally Occurring 

Retirement Communities (NORCs)", strategies are needed to bring services and resources to these buildings. JFMC will 

launch the NORC service model in 4 to 6 buildings in 3 diverse communities around Chicago. The overall goal is to 

enhance seniors' capacity for independent community living through increased access to needed support services. An 

estimated 600 older adults will benefit from on-site NORC service components, including direct services, education, & 

linkage to community resources, (inc. volunteer opportunities.) Specific outcomes include: 80% of NORC residents 

surveyed will indicate an increased awareness of and ability to access services/programs; 80% of NORC residents will 

indicate increased knowledge of aging issues; 70% of NORC residents will indicate a perceived opportunity for expanded 

involvement in their building community, and community at large. JFMC is one of 15 grantees receiving NORC 

demonstration grants since FY '02, when NORC demos commenced. As part of this larger effort, the project will be 

evaluated and results disseminated through various methods. In addition to providing critical support services to the 

elderly, it is expected that both cost effectiveness and service effectiveness will be improved by coordinating services at 

each NORC site and, where appropriate, integrating services at the facility itself.

Project Period: 09/01/2003 - 01/31/2007

FY Grant Amount

FY 2003

FY 2004

FY 2005

245,146

98,118

146,866

One South Franklin Street 

Program: 

JEWISH FEDERATION OF METROPOLITAN CHICAGO

Congressional Mandates 601

90AM2735

NORC Continuation Grant

Miami, FL 33137-3279

Contact: Bruce Yudewitz (305)576-4000

This project is intended to provide an innovative and flexible approach for the provision of a variety of social and 

supportive services to enable elderly residents to continue to function and live safely in their homes. Our approach will 

involve four sites, high-rise and gated communities in South Florida. The population is almost exclusively elderly 

individuals or couples who are living independently, but as they are aging, face various degrees of limitations to live fully 

independent lives. The project will involve a neighborhood worker (ombudsman) in each site. This individual will identify 

common needs of the residents, develop a plan, and broker for social services from existing providers, so that a group of 

residents can use these services more efficiently. The worker would also organize volunteers from the neighborhood to 

provide services like simple home repairs, friendly visits, or organize social outings. The Greater Miami Jewish Federation 

will be working with the Jewish Federations of Broward County, South Palm Beach County and Palm Beach, along with 

their network of affiliated agencies, providing services to the elderly. A regional committee consisting of the primary social 

service agencies and community volunteers from the Federations will provide oversight for the project, evaluate and make 

recommendations for programmatic adjustments and advocate within the Federation social service system for assistance 

and additional resources for the project.

Project Period: 09/01/2003 - 08/31/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

490,292

245,294

97,910

4200 Biscayne Blvd. 

Program: 

GREATER MIAMI JEWISH FEDERATION

Congressional Mandates 601

90AM2736
Page 198 of 223 

New Mexico NORC Project

Albuquerque, NM 87109-7109

Contact: Arthur Fine (505)291-1818

Jewish Federation of Greater Albuquerque will develop and assess innovative service delivery models to enable seniors 

to avoid premature institutionalization through supportive in-home services. In implementing a bio-psychosocial model for 

service delivery, services will include case management; fitness/exercise training; in-home counseling; transportation; 

home delivered meals; financial management; healthcare; and homemakers. Community support for these efforts will 

include Jewish Family Service (prime sub-contractor); New Mexico State Agency on Aging (project evaluation); 

Albuquerque Department of Senior Affairs (transportation/meals); building owners and management; University of New 

Mexico College of Nursing/Department of Geriatrics; United Way; and other community providers of services to seniors. 

These services will increase, maintain, and support the physical and emotional capabilities necessary for successful 

independent living of participants. Broad community support will minimize service duplication and identify service gaps. 

Due to New Mexico's high poverty rate for seniors, three of the four identified NORC sites are subsidized housing projects.

Project Period: 09/01/2003 - 12/31/2003

FY Grant Amount

FY 2003 220,631

5520 Wyoming Blvd. NE 

Program: 

Jewish Federation of Greater Albuquerque

Congressional Mandates 601

90AM2737

Las Vegas Senior Lifeline

Las Vegas, NV 89119

Contact: Beth Miller (702)732-0556

The Jewish Federation of Las Vegas will conduct a program to create and deliver multi-tiered levels of services to seniors 

in the Las Vegas area. The services will provide seniors the necessary tools and support systems to continue living an 

independent lifestyle in their own homes, as they age in place. Las Vegas Senior Lifeline will include these service 

components: multifaceted senior center; congregate and delivered meals; medical prescription and supplies; 

transportation; environmental home improvement; homemaker services; innovative home technology demonstration 

project. Significant partnerships will include our sister local agencies, UNLV, and national industry leaders. Our expected 

outcome is to fill many of the service gaps for our targeted senior population, so they may enjoy a greater quality of life 

and continued independent living. Products will include assessment and evaluation tools, a final report to be disseminated 

to appropriate agencies, and web page information.

Project Period: 09/01/2003 - 08/31/2006

FY Grant Amount

FY 2003

FY 2005

637,380

244,776 2317 Renaissance Drive 

Program: 

Jewish Federation of Las Vegas

Congressional Mandates 601

90AM2738
Page 199 of 223 

Supportive Communities

Bloomfield Hills, MI 48301

Contact: Linda Blumberg (248)642-4260

Comm. on Jewish Eldercare Services will aid Oak Pk./Southfield seniors (high # older adults)"age in place" & develop 

replicable Supportive Communities to create environments & provide services for physical &emotional well-being. 

Goals:enable older adults to stay home & be involved in community as long as possible. A 17 mo. program will involve the 

wider community thru intergenerational volunteer & social activities. Program partners: home-owners, businesses, 

churches, bldg. assoc's, org's & local municipalities. Program effectiveness & "lessons learned" will be evaluated, & 

results disseminated locally & nationally. We work with older adults & community groups (e.g. home & building owners, 

local municipalities, churches, service providers,businesses) in a 10 mi. Greenfield/Lincoln corridor,to create Supportive 

Communities.Goals: 1) coordinate social work, recreation, vol. & other svcs. so older adults can age in place at home, & 

enhance physical and emotional well-being; 2) collaborate with community partners & residents of all ages to involve 

seniors & strengthen their community.The program serves/connects older adults regardless of religion, race or national 

origin, to each other & the neighborhood. Strategies:1) resident councils & an advisory council of neighborhood partners; 

2) outreach to apt. & single family home residents; 3) social wk. svcs. to aid planning/connecting residents to services & 

resources; 4) recreation & other programs in specific buildings; program enhancement at activity hubs; 5) transportation; 

6) community programs & volunteer opportunities to bring residents of all ages & back grounds together. Outcomes: older 

adults in their community better able to continue living at home; non-senior

community residents more involved, providing more supports for older residents; the latter more involved & contributing to 

the community. The plan: create a replicable model, an evaluation & disseminate results to community groups.

Project Period: 09/01/2003 - 01/31/2007

FY Grant Amount

FY 2003

FY 2005

441,263

489,552 6735 Telegraph Road 

Program: 

JEWISH FEDERATION OF METROPOLITAN DETROIT

Congressional Mandates 601

90AM2739

Atlanta NORC Demonstration Projects

Atlanta, GA 30309

Contact: Faye Dresner (404)873-1661

The Jewish Federation of Greater Atlanta (JFGA), together with a coalition of community, state, and county partners, will 

plan and implement projects to maximize service delivery to consumers where they reside. The overarching goal of both 

projects will be to build the capacity of older adults to age in place, and community capacity to support them in this 

process. Two Atlanta sites are identified for NORC project development. One site has a disproportionately high 

percentage of older adults over 85; the second, a high percentage of older adults living below the poverty line. The NORC 

coalition will be part of a larger community initiative overseen by the Atlanta Regional Commission (ARC), an Area Agency 

on Aging, entitled Aging Atlanta. Aging Atlanta is one of 13 Robert Wood Johnson Foundation projects addressing 

long-term care. Each NORC site has three major objectives: 1) building individual capacity to age at home by addressing 

service provision and environmental issues; 2) building neighborhood capacity to support aging at home through informal 

support networks and a neighborhood advisory council; and 3) building a more "elder friendly" community through working 

with organizations, businesses and religious institutions to more effectively serve older adults. Each NORC program or 

service will be used as an opportunity to informally gather information from participants and assess unmet needs. At least 

50 residents per site will be engaged in some program or service. Expected outcomes: older adults will experience 

improved physical and mental health status; older adult residents will participate in & experience an increased sense of 

control over program & service delivery; older residents will have increased knowledge and use of existing programs & 

services; neighborhood businesses, institutions, & service providers will have increased understanding of how to serve 

older adults; and older adults will have increased access to services.

Project Period: 09/01/2003 - 08/31/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

98,058

73,588

97,910

1440 Spring Street, NW 

Program: 

JEWISH FEDERATION OF GREATER ALTANTA, INC.

Congressional Mandates 601

90AM2740
Page 200 of 223 

AgeWell - Promoting Senior Independence Through Community NORC Interventions

Pittsburgh, PA 15213

Contact: Sharon B. B Stern (412)992-5544

In year two, UJF Greater Pittsburgh will be the "lead agency", but operational responsibility will remain with 3 faith-based 

agencies serving seniors - the JAA, JCC, and JFCS. Partners will continue moving from a broad collection of programs 

toward a continuum of community services, more strongly linking programs of partner agencies and govt. agencies. 

Learning from year 1, the new "care teams" model will expand by increasing clientele at least 50% (30 new seniors 

assessed), and continuing relationships with '02 - '03 clientele thru professional care management. Initial analysis of the 

current year indicates a higher than anticipated level of professional care mgmt. may be needed in early post-assessment 

to help clients complete individualized care plans. Project leadership, with input from agency Exec's and full work group, 

will determine form/degree of this professional care management. Next year, aggregate findings of service needs, access 

barriers, and service gaps will be used to find or create ways to meet clients' and community needs. Important areas to be 

examined include difficulties that may have arisen in providing a seamless continuum of agencies' services to enable 

aging safely in place, as long as possible. To enhance this study, community planning abilities of UJF will be utilized. 

"Grab bars", for in-home safety, were a clearly identified need in '03 assessments (esp. in bathrooms) & will be addressed 

the coming year. We will continue to engage families & support networks in client care management, & work to ensure 

awareness of, and access to, services that support safe aging in place. External communication will increase thru: (a) 

Intensified community outreach; (b) quarterly public education sessions; (c) education programs for professional elder 

service providers. Further efforts: more training & development of care teams, & continued work with Unicentric to 

enhance database & system reporting capabilities.

Project Period: 08/01/2003 - 07/31/2006

FY Grant Amount

FY 2003

FY 2004

FY 2005

245,146

245,294

97,910

234 McKee Place 

Program: 

UNITED JEWISH FEDERATION OF GREATER PITTSBURGH

Congressional Mandates 601

90AM2741

Comprehensive Approach to Aging in Place (CAP)

Rockville, MD 20852

Contact: Judie Fien-Helfman (301)230-7200

The participating agencies have identified two neighborhoods in which the CAP project will be piloted for 17 mo's. This 

comprehensive approach has been piloted & utilized in Israel for 20 yrs. with great success.To our knowledge,there has 

been no replication in the U.S. to date. Both Montgomery Co. neighborhoods, Montrose (Rockville) and Kemp Mill (Silver 

Spring), were chosen for a high concentration of older adults aging in place & because they host a variety of community 

organizations which can serve as hubs for provision of services. We estimate that the program will reach 1,000-1,200 

older adults. We intend to test the viability of obtaining fees for services from both Seniors, and management 

companies/landlords, in exchange for inclusion in the NORC service delivery area. Landlord support is critical to creating 

an environment that encourages & allows seniors to age in place in their own homes, thereby stabilizing neighborhoods. 

This support also minimizes resident's premature relocation to assisted living or nursing homes. The goal of CAP is to 

provide a basket of services anchored by a community liaison, who ensures that seniors can access services they 

need.This service intervention will make it possible for some elderly people to postpone/eliminate the need to move to 

homes for the aged as their functioning declines. This comprehensive model, designed so that people are able to remain 

in their own homes, surrounded by friends and neighbors, will allow the participants to receive necessary services through 

their contact with the "community liaison" and other elements of the supportive community program. Core service 

elements: "One-stop shopping" for Information and Referral; Emergency Call System; Community Liaison on-call 24 hrs. 

for program coordination; social activities appropriate to participant interests; general assistance, e.g. medical 

appointment, shopping, personal care escorts; local transportation; and enhanced on-site wellness services.

Project Period: 09/01/2003 - 02/28/2007

FY Grant Amount

FY 2003

FY 2005

1,176,701

979,104 6101 Montrose Road 

Program: 

JEWISH FEDERATION OF GREATER WASHINGTON

Congressional Mandates 601

90AM2742
Page 201 of 223 

Older Communities in Transition

Los Angeles, CA 90048

Contact: Paul S. S Castro (323)761-8800

Jewish Family Service of Los Angeles (JFSLA) programs are based on collaboration & coalition building.This coordinated 

approach maximizes existing resources in the LA community, and helps create new programs and services of greatest 

benefit to populations served. Our approach to serving seniors is exemplified by the many programs at our senior centers, 

and the diversity of older adults receiving services. We work effectively with older adults to maintain health, independence 

& achieve highest functioning levels. This allow seniors to grow and age in place, avoid pre-mature institutionalization, and 

remain active and viable in the community. JFSLA designated 2 unique sites in LA to implement our Naturally Occurring 

Retirement Community (NORC) project, Older Communities in Transition. We propose to coordinate direct support 

services and evaluate innovative service methods to assist seniors living independently in W. Hollywood & MidWilshire 

districts of LA Co. Each site has a high density of seniors 65+, but are dissimilar in geography.This will allow for a contrast 

of the two NORCs.The project will reach out to 6,500 adults 65+ and bring coordinated support services to approx. 400 of 

those seniors of various ages, income levels, ethnicities and sexual orientation. Older Communities in Transition will 

provide an opportunity to collaborate with W. Hollywood, Park La Brea Management, Cedars Sinai Medical Center and 

AAA's to: 1) conduct a needs assessment to identify gaps in existing services for senior adults; 2) create innovative 

services in response to Seniors and family/caregiver needs. Services may include case management, health & recreation 

programs, mental health counseling, education, socialization, and other direct services to enable functioning in the least 

restrictive environment. Targeted outcomes: decreased isolation, increased home safety, increased access to healthcare, 

and creation of more integrated service delivery systems.

Project Period: 09/01/2003 - 09/30/2006

FY Grant Amount

FY 2003

FY 2005

490,292

636,418 6505 Wilshire Blvd., Suite 500 

Program: 

JEWISH FAMILY SERVICES OF LOS ANGELES

Congressional Mandates 601

90AM2743

St. Louis Park: A Nurturing Community for Seniors

Minnetonka, MN 55305

Contact: Mari Forbush (952)546-0616

Jewish Family and Children's Service will work with the Sholom Community Alliance and the city of St. Louis Park to 

coordinate and develop activities, services and environmental improvements for seniors who live in the city. The project's 

goal is to create an environment in St. Louis Park that nurtures healthy aging for its residents, and promotes residents of 

all ages to work toward this goal. Expected outcomes are seniors will live safely and healthily at home as long as possible; 

seniors will be aware of resources that promote health and reduce isolation; seniors will have easy access to activities and 

services; intergenerational volunteering will be significantly increased; and the project will be guided by seniors. Products 

will include a website, a resource directory, a newsletter and a distance learning program. The partners will involve a wide 

variety of additional stakeholders including faith communities, healthcare providers, businesses and civic groups.

Project Period: 09/01/2003 - 08/31/2006

FY Grant Amount

FY 2003

FY 2005

833,497

97,910 13100 Wayzata Blvd., Suite 400 

Program: 

JEWISH FAMILY AND CHILDREN'S SERVICES OF MINNEAPOLIS

Congressional Mandates 601

90AM2744
Page 202 of 223 

Project New Start

Harvey, IL 60426

Contact: Kathi Jackson (705)333-7040

St. Mark Professional Medical Center will operate a 12-month program of senior health promotion, disease prevention 

services and social resource referral to assist senior adults and their caregivers. The goals are: 1) to aid access and 

receipt of health and social services to existing senior support initiatives; 2) to facilitate participants' improved capacity to 

make more informed decisions about care; 3) and to establish new health education forum. Two hundred recipients will 

benefit from the project. The anticipated outcomes are: development of improved self-awareness skills for more 

involvement; increased competency for determination and communication of their own health and social needs; caregivers 

will gain support, skills and tools to master care giving decisions; increased participants' access and usage of related 

services; and participants' ability to identify and develop long-term goal and action plans for care. The products will include 

a final report, a health provider and social resource guide, and quarterly newsletters to participants.

Project Period: 09/01/2003 - 08/31/2004

FY Grant Amount

FY 2003 98,058

14618 S. Lincoln Avenue 

Program: 

ST. MARK PROFESSIONAL MEDICAL CENTER, LTD

Congressional Mandates 601

90AM2745

Technology Supported Health Promotions for Community Based Seniors: Healthy Town

Cleveland, OH 44115-3204

Contact: Shelia Niles,R.N.,MSN 

The Visiting Nurse Association Healthcare Partners of Ohio, in collaboration with the University of Akron and three Ohio 

Area Agencies on Aging, will conduct a 17-month community-based program for older adults. The goal of the project is to 

deliver health promotion/disease prevention interventions to 800 older adults who reside in a 13-county target area in 

Ohio. Outreach workers will conduct interventions using innovative software on laptop computers. Participants will be 

screened for adherence to disease prevention guidelines and risks related to mental health, falls, nutrition and injury. 

Expected outcomes include: improved prevention behaviors by individual participants, comprehensive prevention health 

planning for the regional target age group, and the development of a standardized intervention. Evaluation will include a 

follow-up survey conducted by University of Akron researchers. The intervention software, final report, manuscripts for 

publication and web page information will be made available to direct service organizations and Area Agencies on Aging.

Project Period: 09/30/2003 - 06/30/2006

FY Grant Amount

FY 2003

FY 2005

490,221

244,775 2500 East 22nd Street 

Program: 

VISITING NURSE ASSOCIATION HEALTHCARE PARTNERS OF OHIO

Congressional Mandates 601

90AM2747
Page 203 of 223 

Quality of Care Demonstration Project

North Canton, OH 44720

Contact: Jeannie Williams 

Problem - Stroke and its complications produce significant morbidity and mortality in the elderly, result in marked decline 

in quality of life, present a major challenge for caregiving staff, and consume extensive healthcare resources. Proposed 

Intervention - Nursing care for all residents within the St. Luke Lutheran Home, with a diagnosis of stroke and dementia, 

will be managed utilizing the tools of an integrated system of care, and a continuous quality improvement (CQI) process 

for continuous staff performance improvement. Evaluation - For each resident, care will be documented, and data 

collected and analyzed for individual residents. Resident episodes of care will be analyzed in total and in 4 sub-groups: 1) 

primary diagnosis of stroke alone, 2) primary diagnosis of dementia with associated stroke, 3) primary surgical diagnosis 

(eg. Hip Fracture) with associated stroke, and 4) primary medical diagnosis (eg. Congestive Heart Failure - CHF) with 

associated stroke. Clinical outcomes to be measured include: Utilization, Clinical Outcomes, Care Variation. MDS Quality 

Indicators, and Disease Management. Outcomes to be measured and demonstrated: 1) decreased return to hospital, 

together with increased discharge to the community; 2) improved clinical outcomes; 3) decreased complications of stroke; 

4) decreased variation in care processes; and 5) improved disease management. Dissemination - Results will be 

demonstrated by: 1) a system of care that will be adopted by St Luke Lutheran Home; 2) presentations to other nursing 

homes, and at regional, state and national long-term care meetings; 3) publication in peer- reviewed journals and trade 

Industry magazines; and 4) presentations to our sponsor, Congressman Ralph Regula, Canton. Key Ohio audiences 

benefiting from the results include: 1) residents/families of LTC facilities; 2) nursing staffs; 3) LTC facilities; and 4) payors, 

such as Medicare and Medicaid.

Project Period: 09/30/2003 - 09/29/2004

FY Grant Amount

FY 2003 245,146

220 Applegrove Street, NE 

Program: 

St. Luke Lutheran Community

Congressional Mandates 601

90AM2748

Senior Wellness

Flossmoor, IL 60422

Contact: Samuel Hinkle (708)957-9555

CHAMPIONS FOR CHANGE will initiate a Senior Wellness Program in Fall 2003 for seniors residing in south suburban 

Chicago communities. The program will be housed in a new multipurpose complex in Olympia Fields, Illinois. Several 

programs highlighting wellness will be offered for 50-60 seniors, in collaboration with Governor's State University 

(University Park, Illinois) Department of Health Services. The primary goal of the program is to enhance social service 

options for seniors in south Cook County. Activities will include recreation, social outings, health/safety seminars, physical 

fitness, mentoring programs for youth, nutrition planning, health screenings and monitoring. Seniors will also participate in 

a community theater group and will be responsible for an annual drama production. Another feature of the program will be 

the Grammpie Buddy Bear Club, which will involve daily interactions between seniors and preschoolers at a childcare 

center, which will be housed in the same facility.

Project Period: 09/01/2003 - 08/31/2005

FY Grant Amount

FY 2003 98,058

3200 Flossmoor Road, P.O. Box 427 

Program: 

CHAMPIONS FOR CHANGE

Congressional Mandates 601

90AM2749
Page 204 of 223 

Florida's Minority Elders: An Assessment of Physical and Mental Health Service Needs

Tampa, FL 33670-7900

Contact: Kathryn Hyer 

Disparities in the health and service utilization patterns of ethnic minority groups are evident in the research literature. 

Policymakers, however, lack data on the key indictors of physical and mental health needs and the barriers to services 

faced by these elders. The current project will address this problem by collecting such data through a survey of a 

representative sample of older African Americans, Cubans, other Hispanics, and Caucasians. A carefully designed, 

culturally appropriated instrument will be used to conduct telephone interviews (in English and Spanish) with a sample of 

2600 respondents (650 of each group). Data collected from the participants will be used to identify differences between 

ethnic groups and subgroups, physical and mental health disparities, and service needs and barriers to services. The 

results will be disseminated to government agencies, organizations, academics, and the public through reports. The 

findings will be used to develop policies and practices that reduce gaps between health and long-term care needs and 

services, which will begin to ameliorate disparities of health status among elderly in different ethnic minority populations. 

As the first step in the development of a minority aging program involving five Florida universities (USF, FSU, UF, FM, and 

FMU), this project will be used to create an agenda for the program, including additional research, policy analyses, and 

development of public education initiatives to be conducted in the coming years.

Project Period: 09/30/2003 - 12/31/2006

FY Grant Amount

FY 2003

FY 2005

392,234

979,104 4202 E. Fowler Avenue, FAO 126 

Program: 

UNIVERSITY OF SOUTH FLORIDA

Division of Research Grants

Congressional Mandates 601

90AM2750

Center for Gerontological Studies at Northern Michigan University

Marquette, MI 49855

Contact: Patricia K. K Cianciolo 

Northern Michigan University will establish a Center for Gerontological Studies. The goal is to combine research, 

educational programming, and collaboration with community service providers as a means to benefit older adults in the 

rural Upper Peninsula. The Center's objectives are: 1) to promote interest in careers in aging; 2) to stimulate faculty 

research on rural aging; 3) to provide opportunities for education and collaboration with community service providers and 

professionals; and 4) to inform public policy about the needs of rural older adults. Expected outcomes are: 1) to establish 

the Center as a model for rural Center development; 2) to provide data from a needs assessment; 3) to partner with 

community providers and establish gerontology institutes to initiate joint projects for future funding; 4) to make 

presentations; and 5) to produce publications. Products will be disseminated to service providers, elected officials, 

educational institutions, AoA and the gerontology field at large.

Project Period: 09/30/2003 - 03/30/2005

FY Grant Amount

FY 2003 196,117

1401 Presque Isle Avenue 

Program: 

NORTHERN MICHIGAN UNIVERSITY

Congressional Mandates 601

90AM2769
Page 205 of 223 

Senior Rx Program for Dale County, Alabama

Ozark, AL 36360

Contact: Julie Jones (334)774-6025

The goal of this Dale County proposal is to use the program to assist Senior Citizens, who live within the ten municipalities 

in Dale County, to obtain free medications or pay a lower price for their prescriptions. There are seven counties (Barbour, 

Coffee, Covington, Dale, Geneva, Henry and Houston) participating in this program. The objectives are: 1) to accept 

applications to employ 4 to 5 employees; 2) to conduct two training seminars in order for the employees to be qualified to 

process the applications for the applicants. The applicants will be given a full description of the program by radio, 

television, telephone, etc. The program will be managed by Julie Jones, (Clerk/Supervisor) who is employed by Dale 

County Commission, and also has worked with the elderly on different programs for over seventeen years. The number of 

clients processed daily and other information will be kept on file. Within the seven counties, results of the program will be 

shared quarterly at our Southern Alabama Regional Council On Aging/Area Agency Meetings. Work Plans Daily will be 

filled out and followed. The overall Senior Rx Program is to assist low income elderly persons with their prescription drugs.

Project Period: 09/30/2003 - 09/29/2006

FY Grant Amount

FY 2003 39,223

202 Highway 123 South Suite C

Program: 

DALE COUNTY COMMISSION

Congressional Mandates 601

90AM2775

New Mexico NORC Project

Albuquerque, NM 87109

Contact: (505)291-1818

The Jewish Family Service in Albuquerque is conducting a three year demonstration project of supportive services 

programs for older adults aging in place in four urban, suburban and rural communities in New Mexico. The project goal is 

to enhance physical and emotional well-being through social, educational, and health related services identified with 

community partners and community residents. The project objectives are to: 1) develop and sustain collaborative 

partnerships with neighborhood associations, housing facilities, for and not-for profit organizations, and with state and 

local government agencies; 2) implement project in four locations: three rent supported apartments in Albuquerque, a 250 

unity condominium in the nearby town of Rio Rancho, a 250 home single family housing development in Albuquerque, and 

the rural isolated community of Ft. Sumner; 3) implement enhanced homemaker/housekeeper and handyman services; 4) 

develop on-site mental health counseling services; 5) enhance on-site fitness programming to minimalize fall-related 

injuries; 6) create a recognizable name for the program which includes outreach, case management and services; and 7) 

evaluate and disseminate information that measures changes in participant's health behaviors and emotional well- being 

and the quality of service delivery. Periodic assessments of service and activity participants are conducted to determine 

quality and effectiveness in meeting project objectives and the goal of enhancing physical and emotional well-being. 

Project progress, results and lessons learned will be distributed to local, state and national audiences, including the New 

Mexico state legislature and Department of Aging and Long-Term Care Services.

Project Period: 09/01/2003 - 08/31/2006

FY Grant Amount

FY 2004

FY 2005

514,984

489,552 5520 Wyoming Blvd., NE, Suite 200 

Program: 

JEWISH FAMILY SERVICE

Congressional Mandates 601

90AM2818
Page 206 of 223 

New York Summit on Elder Abuse

Rochester, NY 14618

Contact: Karen M Grella (585)244-8400 143

Lifespan will convene the first New York State Summit on Elder Abuse on May 10-12, 2004, in Albany, New York. The 

goal is for 80 to 100 participants to develop a range of recommendations designed to address the problem of elder abuse 

in New York State. Invited participants include representatives from government, direct service providers, academia, 

health care, law enforcement, and legal and financial services providers. The objective is to raise awareness about elder 

abuse and to begin planning for a possible statewide elder abuse prevalence study. The products will be the creation of a 

New York State Coalition on Elder Abuse and a Summit Report, Action Agenda, and "white paper," which will be 

disseminated broadly to guide future efforts.

Project Period: 04/01/2004 - 03/31/2005

FY Grant Amount

FY 2004 98,118

1900 South Clinton Avenue 

Program: 

LIFESPAN of Greater Rochester - Rochester, NY

Elder Abuse Prevention Program

Congressional Mandates 601

90AM2832

A Demonstration Project to Increase Access to Social Services by Indian Elders

Albuquerque, NM 87111

Contact: Traci McClellan (505)292-2001

The primary goal of the National Indian Council on Aging's (NICOA) Washington State Demonstration Project is to 

increase the number of Indian elders who access needed health and social services (including Veterans benefits) in the 

State of Washington. Providing individualized training and support to members of Indian communities to enable them to 

identify, contact and effectively assist elders in obtaining benefits, has the potential to simultaneously address many of the 

barriers faced. This strategy will allow needs identification and responses to be customized for each community, 

acknowledging that generalized training and service approaches are often limited in addressing the unique sets of needs 

and behaviors of individual Tribes. Although the proposed demonstration project is only for the state of Washington, 

NICOA expects that the methods and strategies developed, tested and documented through this project can be replicated 

by American Indian and Alaska Native tribes nationally.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 735,883

10501 Montgomery Blvd, NE 

Program: 

NATIONAL INDIAN COUNCIL ON AGING

Administration

Congressional Mandates 601

90AM2833
Page 207 of 223 

Naturally Occurring Retirement Community Targeting Riviera and Warwick Facilities

Margate, NJ 08402

Contact: David Nussbaum (609)822-4404

Jewish Federation of Atlantic and Cape May Counties in New Jersey will conduct a 17 month demonstration of social, 

health and case management service delivery to older adult residents of two apartment buildings on the Southern edge of 

Atlantic City, New Jersey. Nearly 60% of the residents of the Riviera Apartments and Warwick Condominiums are age 60, 

many of whom were displaced in their 40's and 50's with expansion of gambling casinos. The project will include 

partnership with the Atlantic County's Office of Aging, Jewish Family Service, Beron Jewish Older Adult Services, 

Seashore Gardens Living Center and the Jewish Community Center, with the guidance of a governing council. To attain 

its goals of sustaining resident functioning, increasing socialization, and community tenure, the project will organize 

residents and provide support for addressing their social, medical and emotional issues. A care coordinator will serve as 

a focal point for provider access, and staff the governing council consisting of residents (as majority members) and 

representatives of partnering organizations. Recreational, meal and other community services will be provided in the 

neighborhood community center. Chore, emergency homecare, home delivered meals and visiting nurse services will be 

delivered in the residences by professionals and a cadre of volunteers. Special attention will be given to care 

management of resident's transition home following a hospitalization. Evaluation activities will focus on ten areas of 

functioning, on the monitoring of medical hospitalizations and community tenure, and tracking connectedness of residents 

with respect to volunteer and recreational activities.

Project Period: 09/01/2004 - 06/30/2006

FY Grant Amount

FY 2004 122,647

501 N. Jerome Avenue 

Program: 

Jewish Federation of Atlantic & Cape May Counties

Congressional Mandates 601

90AM2835

Independence for Seniors

Richmond, VA 23226-3914

Contact: Larry D Jackson (804)282-5644

Jewish Family Services, Inc. of Richmond, Virginia and its collaborative agencies, Commonwealth Catholic Charities and 

Richmond Better Housing Coalition, will conduct a 17 month demonstration project of services to low and fixed income 

older adults in two Richmond neighborhoods in order to keep them independent and healthy in their own homes, as long 

as possible. A third site, in Southwestern Virginia (Roanoke), will be included in project activities through affiliation with 

Commonwealth Catholic Charities. In all sites, the goal of maintaining independence will be met by integrating social 

services, socialization and educational activities, and health and wellness in the daily lives of residents. Key elements of 

the project include outreach and involvement of residents and management stakeholders, and formation of resident 

advisory boards at each site. They will help project staff conduct and interpret needs assessment surveys of residents to 

identify priority, resident specific services, which are expected to include case management, bill paying, transportation, 

in-home care, heath and wellness activities, and educational and recreational activities promoting socialization.

Project Period: 09/01/2004 - 07/31/2006

FY Grant Amount

FY 2004 196,235

6718 Patterson Avenue 

Program: 

Jewish Family Services, Inc.

Congressional Mandates 601

90AM2836
Page 208 of 223 

Naturally Occurring Retirement Community Tidewater Demonstration Project

Norfolk, VA 23505

Contact: Betty Ann Levy (754)893-111

Jewish Family Service of Tidewater of Norfolk, Virginia, and its partnership agencies, the Jewish Community Center of 

South Hampton Roads and Senior Services of Southeastern Virginia, will conduct a 17 month demonstration project of 

services to isolated older residents in two apartment complexes in Norfolk and Virginia Beach, Virginia. A 2003 study of 

elderly in the Tidewater region revealed over 10,000 with a self-care disability and 15,000 elderly over age 75 living 

alone. Analysis of these findings revealed a number of locations with unusually high concentrations of profiled adults with 

limited access to community services, accentuated by language and cultural differences. Based on the experience of 

work with subsidized apartments and lessons from other urban NORC (Naturally Occurring Retirement Communities) 

programs, this project will work with community service providers, property owners, businesses and other neighborhood 

residents to bring social, health care and recreational services to the residents of Colony Point in Norfolk and Old 

Donation in Virginia Beach. Guidance for development of programs in each facility will be given by community advisory 

committees, including representation of residents and collaborating agencies and organizations. One of the key 

partnerships is with the local Area Agency on Aging for expanded transportation services - both for instrumental needs, 

such as grocery shopping and medical appointments, and to reach community activity centers. Volunteers will be 

recruited from residents and neighbors to strengthen intergenerational ties, while providing services.

Project Period: 09/01/2004 - 10/31/2006

FY Grant Amount

FY 2004 171,705

7300 Newport Avenue 

Program: 

Jewish Family Service of Tidewater, Inc.

Congressional Mandates 601

90AM2837

A Caring Approach to a Commonplace Continuum: Aging in Place in the Suburbs of 

New Jersey

Whippany, NJ 07981

Contact: Diane Klein (973)929-3094

United Jewish Communities of MetroWest New Jersey will conduct a 12 month demonstration project in community 

organization, service coordination and service provision for well and frail elderly in a section of suburban Parsippany, New 

Jersey, with the goal of maximizing their independence and having them remain in their own homes as long as possible. 

The project will be a testing ground for a suburban services model of supportive services in Naturally Occurring 

Retirement Communities developed in urban settings. The challenge for addressing older adults in suburban areas, in 

terms of structuring community building and integrated service delivery, is their critical mass. This project borders 5 

census tracts, and is 4 miles long and 2 miles wide. This includes approximately 1,150 adults age 75 and older, with 

varying levels of disability, income and English speaking ability. Metro-West will work with the Morris County Division on 

Aging and the Parsippany Department of Human Services, with local service providers, and churches and synagogues to 

increase a sense of community and increase outreach to the most isolated. Key partners in interpreting assessment data 

and planning services are the Jewish community Center, Jewish Vocational Service, Jewish Family Service, Daughters of 

Israel and Volunteers of Morris County. Initial assessments indicate that priority needs will be case management, 

companion and chore services, friendly visitation, geriatric nurse practitioner home visits, transportation, and telephone 

reassurance. A featured activity will be working with other United Jewish Federations and local AARP chapters in New 

Jersey to develop a cadre of advocates for seniors in the state.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 196,235

901 Route 10 

Program: 

United Jewish Communities of MetroWest, New Jersey

Planning Program Services

Congressional Mandates 601

90AM2838
Page 209 of 223 

The Jewish Family and Children's Service Senior Community Care Program

Tucson, AZ 85711-2016

Contact: Jane A Singer 

The Jewish Family and Children's Service of Boston will conduct a 17 month demonstration project that brings supportive 

services to three neighborhoods and housing developments in the greater Boston Metropolitan Area (Brookline, Malden 

and Swampscott), where the majority of residents are over age 65. The goal is to enable residents to live in their homes 

for as long as possible, with dignity, avoiding preventable nursing home placement. The typical resident in these settings 

is a widowed woman living alone, age 75 or older, with multiple chronic conditions, which limit mobility and ability to 

maintain independence. The project will offer a comprehensive array of affordable health, mental health, fitness, social, 

educational, recreational and personal care services delivered through on-site care planning and case management, and 

collaborative relationships between established local service provider agencies, property managers and residents. 

Resident councils will be formed at each site and volunteer participation of younger and older resident and neighborhood 

volunteers will be encouraged. Information for residents will be prepared in English and Russian , and a secured access 

website will be created for resident family members and service professionals to facilitate development and monitoring of 

care plans. Partners include the Jewish Family Services of the North Shore, the Urban Medical Group, Springwell Area 

agency on Aging, Mystic Valley Elder Services, Greater Lynn Senior Services, Brookline Council on Aging and Senior 

Center, Russian Community Association of Massachusetts, and the National Center on Women and Aging.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 196,235

4301 East Fifth Street 

Program: 

JEWISH FAMILY & CHILDREN'S SERVICE OF

SOUTHERN ARIZONA, INC.

Congressional Mandates 601

90AM2839

Supportive Senior Outreach Program

Sarasota, FL 34237

Contact: Rose Chapman (941)366-2224

Jewish Family and Children's Services of Sarasota-Manatee is collaborating with the University of South Florida, Senior 

Friendship Centers, and Catholic Charities to develop a supportive outreach program for older adults living independently 

in four Sarasota and surrounding neighborhoods. The project goal is to provide information and services that will enhance 

the physical and emotional well-being of adults age 60 and over so that they can successfully age in place in their own 

homes. Project objectives include: 1) outreach efforts to create community support; 2) direct social work services to those 

seniors in need of emergency financial assistance, care management, information and assistance, mental health 

supportive interventions, and volunteer support; 3) dissemination of information about the development, implementation, 

and effectiveness of the supportive services program. Anticipated outcomes are: 1) resident councils in each 

neighborhood to identify specific services and programs in the community to meet their needs; 2) connection of the 

councils to address common areas of need and gaps in service toward the goal of advocacy in the larger community; 3) 

partnerships with local aging resource and service providers to disseminate information effectively and efficiently to 

neighborhoods; and 4) a framework for engaging professionals in the field to work toward a common goal of facilitating 

senior friendly neighborhoods. Products are: a research report, including evaluation of service impact; a power point 

presentation at the national and local level; and a local website.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004

FY 2005

220,764

73,433 2688 Fruitville Road 

Program: 

Jewish Family & Childrens Service of Sarasota-Manatee,

Congressional Mandates 601

90AM2840
Page 210 of 223 

Crossroads NORC Demonstration Project

Seattle, WA 98122

Contact: Donald R Armstrong (206)861-3165

Jewish Family Service of Seattle, Washington, will conduct a 17 month comprehensive health promotion demonstration 

project in the Crossroads neighborhood of Bellevue, Washington. The three residential areas targeted within this 

neighborhood have a high concentration of older adults, but are diverse in their type of housing, place of birth and facility 

with the English language. They include immigrant elders from the former Soviet Union who live in two apartment 

complexes (Elbert House and Cascadian Apartments), and East Asians and American born elders predominately living in 

single family residents within a geographically defined census block. A variety of health promotional activities will be 

offered through partnership with the management of the apartment houses, the local area agency on aging, and the 

School of Nursing at the University of Washington. Bi-lingual outreach workers and staff of the Asian Counseling and 

Referral Service will help a nurse practitioner access older residents to conduct on-site health screenings and provide 

referral and advocacy services. Other activities planned include collection and development of multilingual health 

education materials, health fairs, short educational programs, physical fitness program and implementation of a fall 

prevention program.

Project Period: 09/01/2004 - 01/31/2006

FY Grant Amount

FY 2004 147,177

1601 16th Avenue 

Program: 

Jewish Family Service

Congressional Mandates 601

90AM2841

Services to Naturally Occurring Retirement Community Seniors in Indianapolis

Indianapolis, IN 46260

Contact: Lori A Moss (317)259-6822

The Jewish Federation of Greater Indianapolis, Eldersource, and the Jewish Community Relations Council of Indianapolis 

are collaborating in a 17 month demonstration project, developing two supportive service aging in place models for older 

adults living in the Indianapolis Metropolitan area. Using lessons learned from other Naturally Occurring Retirement 

Communities (NORCs), one model will develop and deliver services to older residents of an apartment complex. A 

second model will be based in a geographic area with a mix of single family and multi-family housing. Both models share 

the goal of decreasing isolation, promoting independence and increasing access to community organizations and 

services. Intergenerational support networks, created through neighborhood councils, will be organized to help recruit 

volunteers and support transportation, social activities, dissemination of information on programs and services, and 

in-home services. Service needs of individuals will be mediated by care coordinators and will be met by both the 

collaborative agencies and other community organizations. These agencies and organizations are members of an 

advisory committee, and include St. Vincent's Hospital, United Way of Central Indiana, Home Services Unlimited, the 

University of Indianapolis' Center on Aging, Central Indian Council on Aging In-Home Services, Hooverwood, Park 

Regency, and ATTAIN, a technology assistance agency created by the Indiana Division of Disability, Aging and 

Rehabilitative Services.

Project Period: 09/01/2004 - 01/31/2007

FY Grant Amount

FY 2004 829,094

6905 Hoover Road 

Program: 

Jewish Federation of Greater Indianapolis

Congressional Mandates 601

90AM2842
Page 211 of 223 

Aging in Place - In Search of Community

Buffalo, NY 14209

Contact: Marlene A Schillinger (716)883-1914

Jewish Family Service of Buffalo and Erie County is collaborating with partner agencies, the Amherst Center for Senior 

Services and the Jewish Community Center of Greater Buffalo, to conduct a demonstration of supportive services for older 

adults living in two conjoining neighborhoods. These neighborhoods are in the central corridor of Buffalo and a suburban 

community within the Township of Amherst, located immediately northeast of the city. The project goal is to promote 

maximum independence and encourage community awareness, social integration, and volunteerism, in order to support 

aging in place of older residents. Project objectives are: 1) outreach to neighborhood organizations and businesses to 

become program supporters and partners; 2) outreach to older adult residents, assessing their needs and making referrals 

and linkages to supportive services; 3) increase opportunities for social inclusion and promote volunteer initiatives; and 4) 

compile and disseminate information about the development, implementation and evaluation of a Naturally Occurring 

Retirement Community (NORC) without walls service model. Anticipated outcomes are: 1) needs assessment data on 

older residents; 2) indicators that the community and its organizations have increased their support for aging in place; and 

3) evaluation data supporting the efficacy of the NORC without walls intervention.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004

FY 2005

98,118

48,955 70 Barker Street 

Program: 

Jewish Family Service of Buffalo and Erie County

Congressional Mandates 601

90AM2843

Falls Prevention Program

Providence, RI 02906-5212

Contact: Susette Rabinowitz (401)351-4750

The Jewish Seniors Agency of Rhode Island will conduct a 17 month falls prevention program for residents of a 153 unit, 

two apartment building complex in Providence, Rhode Island. Residents will be visited by graduate students from the 

University of Rhode Island Geriatric Education Center and the College of Pharmacy Outreach Program, who will identify 

environmental hazards and conduct comprehensive prescription drug reviews in order to avoid interactions known to be 

risk factors associated with falls. The senior housing complex will also be a test site for a Tai Chi exercise program, under 

sponsorship of the Rhode Island Long-Term Care Coordination Council, to strengthen muscle tone, improve gait and 

increase balance. A final report will document participant gains in balance and agility and reduction of falls during the 

grant period.

Project Period: 09/01/2004 - 01/31/2006

FY Grant Amount

FY 2004 49,059

229 Waterman Street 

Program: 

Jewish Seniors Agency of Rhode Island

Congressional Mandates 601

90AM2844
Page 212 of 223 

Providing Services to Facilitate Aging in Place

Denver, CO 80246-8136

Contact: Janet Sherman (303)316-6490

Allied Jewish Federation of Colorado, in partnership with Jewish Family Service, will conduct a 17 month demonstration of 

supportive services for older adult residents in two Denver, Colorado high-rise apartment complexes. The primary goal of 

the project is to enhance physical and emotional well-being of resident older adults to sustain their independence. Allied 

Jewish Apartments is an age segregated (age 62 and over), low- income apartment complex of approximately 400 units, 

with 420 residents in its three buildings. Most (3/4ths) residents are age 70 and over, with half born in the old Soviet 

Union. There is a relatively high turnover rate, created by residents leaving for higher care facilities. Crestmoor Downs 

Apartments is a moderate income, age-integrated complex of seven low-rise apartments and townhouses that includes 

300 older residents. In each complex, a committee of residents, apartment complex staff and administrators and project 

staff will define goals, identify interventions and give oversight to interventions. Services will be coordinated through care 

managers, who will work directly with residents and help them identify and select service needs, including residence 

modification, home and personal care, transportation, medical care, and recreational and educational opportunities. 

Residents will have access to information, referral and advocacy services to help them understand services and resources 

in the community, and assist with applications for benefits. 

Project Period: 09/01/2004 - 01/31/2006

FY Grant Amount

FY 2004 194,924

300 S. Dahila St. Suite 300

Program: 

Allied Jewish Federation of Colorado

Congressional Mandates 601

90AM2845

Naturally Occurring Retirement Community Supportive Services Program

Rochester, NY 14607

Contact: Janet Sunkin (585)461-0110

Jewish Family Service of Rochester, in partnership with other community organizations, is conducting a demonstration of 

supportive services to older adults aging in place in two apartment complexes in suburban areas of Rochester, New York. 

The project goal is to enable older adults to access a continuum of supportive services, including transportation, social 

services and activities, which will keep them independent and connected to their community. Project objectives are: 1) 

conduct outreach to residents; 2) create resident's councils; 3) provide information and referral to social services and 

community resources; and 4) increase opportunities for volunteer activities. Anticipated outcomes are: 1) an increase in 

the ability of older adult residents to conduct activities of daily living and stay connected to their community; and 2) an 

increase in the ability of older adult's residents to access services and engage in activities that improve their physical and 

mental well being. Project evaluation is being performed by the University of Rochester Graduate School of Nursing.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004

FY 2005

98,118

48,955 441 East Avenue 

Program: 

Jewish Family Service of Rochester, Inc.

Congressional Mandates 601

90AM2846
Page 213 of 223 

Aging in Place in Bergen County, New Jersey

River Edge, NJ 07661

Contact: Alan P Sweifach (201)488-6800 364

United Jewish Appeal Federation of Northern New Jersey will conduct a 17 month demonstration project of health and 

supportive services for adults aging in place in suburban neighborhoods and towns. UJA will use methods developed for 

programs and services provided for residents of low and high rise urban apartments buildings and complexes within 

traditional Naturally Occurring Retirement Communities (NORCS). The goal is to deliver locally based, in or near-home, 

services that improve and maintain the physical well-being, socialization and general quality of life for older adults within 

the catchment area served by the Federation, which includes more than 10,000 persons over the age of 85. A major 

challenge for residents of the 4 towns targeted in this suburban area is limited public transportation, which seldom crosses 

municipal lines. Older adults who are frail and/or living alone with a minimal social support network will be provided 

access to an array of services, including case management; social, cultural, educational, recreational, and wellness 

programs; nutritionally balanced meals; adult daycare; home health care; and outpatient rehabilitation. Service delivery 

will build on the existing partnership between the Federation and beneficiary agencies and expand to include local and 

county government, additional social service agencies and older adult social and advocacy groups. Project collaboration 

will be guided by members of the Federation's Council for Older Adults, who include staff and lay leaders of the Bergen 

County Young Jewish Community Center, Jewish Community Center on the Palisades, Jewish Family Service, and the 

Jewish Home and Rehabilitation Center.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 196,235

11Kinderkamack Road 

Program: 

UJA Federation of Northern New Jersey

Strategic Planning and Allocation

Congressional Mandates 601

90AM2847

Naturally Occurring Retirement Community Demonstration Project

Lakewood, NJ 08701

Contact: Danny Goldberg (732)363-0530

The Jewish Federation of Ocean County, New Jersey will conduct a 17 month demonstration of social, health and case 

management service delivery to older adult residents living in three "gated", age-restricted adult communities built prior to 

1985 in Ocean County. A 2002 needs assessment of older adults living in Ocean County found that as residents of active 

adult communities age, they become increasingly isolated from friends and neighborhood services, in part because public 

transportation routes do not extend into their communities. This project will create a model for connecting at risk and frail 

residents of gated communities with supportive services of local institutions, resident associations and local businesses. 

Partnership organizations include Caregivers, Inc., Ocean County Community College, Community Services, Inc., and the 

Ocean County Department of Senior Services. The project will feature the development of new volunteer opportunities for 

older residents working with existing resident councils, including training to assist in planning new programs for 

socialization, health and wellness, learning and nutrition. A primary role for resident volunteers will be to help form 

caregiver, bereavement and social support groups which are available outside of gated communities for isolated 

individuals. Special efforts will be made to reconnect residents to the services and organizations supported by the Ocean 

County Senior Services (Area Agency on Aging). Anticipated challenges to the success of the project include the cost of 

transportation to county activity and service centers, the ability to maintain positive relationships with the community 

resident councils who wish to retain their community (and property value) images as active adult communities, and the 

sustainability of the project after federal funding.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 245,294

301 Madison Avenue 

Program: 

Jewish Federation of Ocean County

Congressional Mandates 601

90AM2848
Page 214 of 223 

The Madison Area Continuing Care Consortium (MACCC) NORC Project

Madison, WI 53705

Contact: John A Noreika (608)692-8486

The Madison Area Continuing Care Consortium, with its member organization Oakwood Lutheran Homes serving as fiscal 

agent, will conduct a 17 month demonstration project developing a community-based supportive services program for a 

five census tract residential urban area in Dane County, Wisconsin, which includes 3,442 residents age 65 and older. 

The demonstration will also fund the extension of this program to two low-income neighborhoods in a second phase 

which will be completed with foundation and private funding. The goal of developing a comprehensive integrated 

community-based system of care for older adults will be reached through coordination of the consortium's three continuing 

care retirement communities with community-based providers, and establishment of associations of residents living 

outside the consortium communities. The faculty and students of University of Wisconsin and Edgewood College will 

facilitate the integration process through all phases of the program, and beyond federal funding. To meet the goal of 

improving the quality of life of older adults and reduce the cost of care through improved coordination between medical 

and social service providers, the project expects to enroll at least 2,000 residents as members of a senior association. It 

is hoped that by invoking a modest sliding scale fee that guarantees core services and offering wellness and prevention 

activities, more affluent elders will become members and help subsidize the participation costs of lower income 

participants.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 343,412

6201 Mineral Point Road 

Program: 

Oakwood Lutheran Homes Association, Inc.

Congressional Mandates 601

90AM2849

Supportive Services in Naturally Occurring Retirement Communities

Boston, MA 02114

Contact: Rimma Zelfand (617)784-8274

The Jewish Family and Children's Service of Boston will conduct a 17 month demonstration project that brings supportive 

services to three neighborhoods and housing developments in the greater Boston Metropolitan Area (Brookline, Malden 

and Swampscott), where the majority of residents are over age 65. The goal is to enable residents to live in their homes 

for as long as possible, with dignity and avoiding preventable nursing home placement. The typical resident in these 

settings is a widowed woman living alone, age 75 or older, with multiple chronic conditions which limit her mobility and 

ability to maintain her independence. The project will offer a comprehensive array of affordable health, mental health, 

fitness, social, educational, recreational and personal care services delivered through on-site care planning and case 

management and collaborative relationships between established local service provider agencies, property managers and 

residents. Resident councils will be formed at each site and volunteer participation of younger and older resident and 

neighborhood volunteers will be encouraged. Information for residents will be prepared in English and Russian and a 

secured access website will be created for resident family members and service professionals to facilitate development 

and monitoring of care plans. Partners include the Jewish Family Services of the North Shore, the Urban Medical Group, 

Springwell Area Agency on Aging, Mystic Valley Elder Services, Greater Lynn Senior Services, Brookline Council on 

Aging and Senior Center, Russian Community Association of Massachusetts, and the National Center on Women and 

Aging.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 686,824

31 New Chardon Street 

Program: 

Jewish Family & Children's Service, Inc., Boston, MA

Senior Service

Congressional Mandates 601

90AM2850
Page 215 of 223 

Elder Consumer Protection Education Project

Gulfport, FL 33707

Contact: Rebecca C Morgan 

Stetson University College of Law is conducting a one-year consumer protection education project for elders, their 

families, and professionals. The goal is to develop an elder consumer protection statewide education program that will 

educate elder consumers, their families, and professionals about consumer fraud and how to minimize the risk of 

becoming victims. Stetson has conducted community outreach and educational programs for elders and their families and 

for professionals such as community presentations at local senior centers; held consumer forums on the campuses of the 

Law Center, churches and other venues; held monthly walk-in clinics at senior centers; developed a webpage for 

consumers and professionals; designed an "elder-friendly courtroom; developed, in collaboration with the Florida 

Department of Law Enforcement, statewide professional education training for law enforcement and investigators on how 

to investigate cases of health care and consumer fraud; and developed follow-up data collection activities. A national 

symposium on health care fraud and consumer fraud, financial exploitation, specifically targeted at the elderly was held.

Project Period: 09/01/2004 - 03/31/2006

FY Grant Amount

FY 2004 981,177

1401 61st Street South 

Program: 

STETSON UNIVERSITY COLLEGE OF LAW

Congressional Mandates 601

90AM2851

Geriatric Assessment Program-Rapid Response

Lapeer, MI 48446

Contact: Ruth A Schalm (810)667-5579

This project is a one year assessment education program called Rapid Response, the goal of which is to improve 

knowledge of community resources and options by the elderly population, families and professional caregivers. The 

Community Based Organizations (CBOs) involved include: local home health agencies, local retirement groups, local 

newspapers, local nursing homes, county senior coalition groups, local unions, and the business community. The target 

population is elderly persons 60 years and older, which includes 20 homebound elderly who are frail, with chronic health 

problems, isolated and with limited knowledge of community resources and options. There are 3 interventions for 20 

elderly for a 3-month period to enable them remain at home: 1) an in-home visit and assessment by the social worker or 

nurse; 2) a telephone call and assessment with an information and referral to community resources; 3) (six) verbal and 

written education sessions with home health agencies and retirement groups, and education and outreach for the general 

public, and articles for local newspapers. The Senior Resource Directory is to be used for all interventions. Anticipated 

Outcomes: 1) a pre-post test to measure new knowledge; 2) a client satisfaction survey on effectiveness of (GAP) Rapid 

Response program; 3) home visits and telephone contacts each month; 4) a Senior Resource Directory; 4) an 

evaluation; and 5) dissemination to senior coalitions and for replication of the program. 

Project Period: 09/01/2004 - 02/28/2006

FY Grant Amount

FY 2004 58,870

1375 N. Main Street 

Program: 

Lapeer Regional Hospital

Congressional Mandates 601

90AM2852
Page 216 of 223 

Rural Geriatric Healthcare Initiative (RGHI)

Putnam, CT 06260

Contact: Annmarie Errichetti 

The Rural Geriatric Healthcare Initiative at Day Kimball Hospital in Putnam, Connecticut was designed to create a 

comprehensive geriatric assessment, planning and services program to ensure that seniors have access to timely and 

appropriate health care. The initiative proposes to take a community approach to primary health care, with provision of 

support and training for both family caregivers and professionals. Project objectives include: increase patient, family, and 

community awareness and use of available services to the elderly; decrease caregiver stress and therefore burnout; 

provide a resource to primary care physicians for the management of complex elderly patients; assist older adults to better 

manage their health through prevention and education; and, expand home health resources and home supports for the 

elderly, including case management for chronic illness. The Rural Geriatric Healthcare Initiative anticipates the following 

outcomes: increased awareness and knowledge of available services for the elderly; increased understanding among 

family caregivers of their relative's preferences and values; increased understanding of coping strategies for avoiding 

caregiver stress; establishment of a consultative, comprehensive geriatric assessment program; reduction in adverse 

events and medical errors among the elderly due to use of multiple pharmacies, and; reduction in unplanned 

hospitalizations and unnecessary emergency room visits.

Project Period: 09/01/2004 - 08/31/2005

FY Grant Amount

FY 2004 588,706

320 Pomfret Street 

Program: 

DAY KIMBALL HOSPITAL

Congressional Mandates 601

90AM2853

Enhancing Life Satisfaction of Older Adults

Dallas, PA 18612

Contact: Renee G Zehel (570)674-6307

This project was originally designed for one year and it has been granted a second year to complete the planned work. 

The original plan goal was to conduct two complimentary studies that focus on the ways in which the Internet can enhance 

life satisfaction for institutionalized older adults. The two studies will examine: 1) the potential impact of Internet/e-mail 

communication use by older people who are depressed and socially isolated; and 2) the impact that website design has 

on older people's accessibility to the Internet. The first study will involve 10 seniors with physical and/or sensory 

impairments at Mercy Center and twenty seniors at Summit Health Care without such impairments, who will receive 

specially designed training and then use the Internet to determine its impact on their levels of cognition, depression, and 

social isolation. The second study will involve testing 120 able-bodied seniors on information access using an existing 

website, versus a website re-built according to Section 508 and W3C standards. In addition to the original plan, the 

second year goal will be to expand the population to include community-dwelling elders experiencing the changes 

associated with normal aging. Objectives include developing, testing and disseminating information on the settings and 

adjustments of operating systems that will result in maximally effective computer interface. Products will include: 

assessment/evaluation tools; training protocols; webpage information and a final report.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004

FY 2005

196,235

97,910 301 Lake Street 

Program: 

COLLEGE MISERICORDIA

Assistive Technology Research Institute

Congressional Mandates 601

90AM2854
Page 217 of 223 

The Pennsylvania Model Advanced Care of Families and Persons with Dementia

Harrisburg, PA 17104

Contact: Donald E Walkovich (814)472-2852

The Pennsylvania Occupational Therapy Association will work with partners Thomas Jefferson University (TJU) and the 

American Occupational Therapy Association (AOTA) to develop and provide advanced training to a select group of fifty 

occupational therapists and occupational therapy assistants in Pennsylvania, in treatment of Alzheimer's disease and 

related dementias (ADRD). The first component of the training will be to access an existing basic ADRD training module 

produced by AOTA. The second component will be two one-day training sessions in Pennsylvania in areas lacking 

services, where there is great need for service, where there is interest in training, or in a geographic area that is 

underserved. The focus will be to provide interventions with families, individuals with dementia and formal providers in 

settings such as hospitals, nursing homes, home health, community centers, day programs and assisted living programs. 

The Pennsylvania Occupational Therapy Association will evaluate the use of pre-post assessment of participant 

knowledge and skills.

Project Period: 09/01/2004 - 08/31/2005

FY Grant Amount

FY 2004 73,588

100 S 21st Street 

Program: 

Pennsylvania Occupational Therapy Association

Congressional Mandates 601

90AM2855

North Philadelphia Development Center

Philadelphia, PA 19122

Contact: Paul J Ruddy (215)787-2930

This is a computer-focused program for low-income senior's age 60 and older. The goal is to provide 56 senior citizens 

with an opportunity for seven weeks of computer training and access to technology that will enhance their lives, encourage 

activity, and enable them to communicate with their family members and friends. Completion of the training will allow the 

seniors to apply their education towards employment or volunteerism in their community.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 98,118

1313 N. 4th Street 

Program: 

Olde Kensington Redevelopment Corporation

Congressional Mandates 601

90AM2856
Page 218 of 223 

The N.E.W. (Nutrition, Exercise Wellness of Spirit) Project

Moorefield, WV 26836

Contact: Phyllis L Helmick 

The project aims to develop a wellness program to increase health promotion behavior and health indices in an 

Appalachian population of Appalachian seniors (60+) who are obese, sedentary, have high cholesterol, elevated blood 

pressure, or diabetes. One hundred seniors who are at-risk will be selected and assigned to the program. Utilizing a 

nutritionist, menus will be developed to address their "geoculture perspective", and will meet all current FDA guidelines for 

elderly nutrition. Participants will be required to eat at a Senior Nutrition Site at least three times a week, exercise three 

times a week for one hour at a Wellness Center, and attend monthly health screening seminars. (Individual exercise 

plans will be developed and attendance for all activities will be documented.) In addition, interns from West Virginia 

University School of Medicine will provide scheduled monthly educational programs for them. It is anticipated that seniors 

will improve their understanding of food value, exercise more, and increase their sense of self-worth. Products will 

include: assessment tools, personal wellness profiles, exercise/wellness plans of care, an evaluation tool, an updated web 

page, and a final report.

Project Period: 09/01/2004 - 08/31/2005

FY Grant Amount

FY 2004 73,588

PO Box 632 

Program: 

HARDY COUNTY COMMITTEE ON AGING, INC

Congressional Mandates 601

90AM2857

The Copper Ridge Institute Model of Care

Sykesville, MD 21784-7650

Contact: Joyce Kroeller (410)970-2062

Copper Ridge Institute proposes to deliver an evidence-based model of care for people with Alzheimer's disease (AD) and 

other forms of dementia in a facility in Maryland that was not created or designed to provide care to patients with AD. The 

goal is to enhance the quality of care provided in this facility. The model involves intensive staff training and the use of 

specially designed patient protocols. The expected outcomes at this facility are nursing assessments, higher 

patient/family satisfaction, improved Maryland State Survey results, and lower staff turnover. The issues identified and 

lessons learned during this project will form the basis for future research, planning and education efforts. Products will 

include an evaluation of the CD-ROM training tool "'Dementia Care", an article and a strategic and marketing plan for the 

dissemination of the model of care.

Project Period: 09/01/2004 - 08/31/2005

FY Grant Amount

FY 2004 98,118

710 Obrecht Road 

Program: 

The Copper Ridge Institute

Congressional Mandates 601

90AM2858
Page 219 of 223 

The Use of Complementary and Alternative Medicine (CAM)

Winchester, VA 22601

Contact: Tara N Lescalleet 

The Adult Day Center proposes to use and advance the complementary and alternative medicine (CAM) model for a 

broad range of health-related needs for persons with probable Alzheimer's Disease and Related Disorders (ADRD). It 

plans to develop a 12-month CAM program and provide in-service training for staff and family caregivers on the use of 

CAM approaches relevant for persons with ADRD. The CAM modalities for intervention include: body work (therapeutic 

touch, shiatsu, massage therapy, and tai chi); creative arts therapies (music, art, dance, and drama therapy); natural 

environment (horticulture therapy, aromatherapy, and herbal medicine); the modality of spiritual/religious expression; and 

finally bibliotherapy (poetry therapy). This program will be presented to individuals, agencies, and organizations 

associated with geriatric care. Experts from eleven CAM disciples will convene to identify research and practice-based 

CAM approaches of potential application to adult day health care. A CAM model program will be implemented, including 

articulation of protocol for program planning, assessment and evaluation. Special emphasis will be given to the role of 

CAM practitioners, as consultants to administrators, family, direct care staff and volunteers using an interactive 

consultation model. Products include: six CAM based in-service training, Alzheimer's disease workshops for agencies, 

and an in service training monograph.

Project Period: 09/01/2004 - 02/28/2006

FY Grant Amount

FY 2004 98,118

115 Wolfe Street 

Program: 

Adult Care Center of the No. Shenandoah Valley, Inc.

Congressional Mandates 601

90AM2859

Development of an Actively Therapeutic Dementia Specific Day Program

Boca Raton, FL 33431-0991

Contact: Ruth M Tappen 

The University plans to open a new dementia-specific day program, which it believes will provide relief for caregivers and 

will have a potentially therapeutic effect on participants. The proposed day program will open in the new Louis and Anne 

Green Memory and Wellness Center building. It will offer therapeutic, wellness-oriented activities and services within a 

caring environment to individuals with mild and moderate levels of impairment. An interdisciplinary Planning Committee 

will be formed to develop and establish the new program. Expert consultants will review both the programming and 

operational aspects of the plan before implementation. Assessments of caregivers and clients will be conducted to collect 

data on the effectiveness of the proposed program. Anticipated outcomes of this project are to: 1) establish a financially 

sustainable dementia-specific day program; 2) provide respite by reducing demands on caregivers; and 3) improve the 

function and well-being of participants in the program.

Project Period: 09/01/2004 - 08/31/2005

FY Grant Amount

FY 2004 122,647

777 Glades Road, RD07 

Program: 

FLORIDA ATLANTIC UNIVERSITY

Congressional Mandates 601

90AM2860
Page 220 of 223 

Montessori-based Programs to Seniors with Dementia

Manassas, VA 20110

Contact: Phyllis Watson (703)361-5843

This is a senior adult day healthcare center with therapeutic recreational programs. Hearth and Home Senior Adult Day 

Healthcare Center plans to conduct a one-year project whereby 20 to 40 participants diagnosed with early to late stage 

dementia will participate in Montessori-based activities throughout the day, while attending the center. The goal is to 

develop high self-esteem and promote the highest level of function possible in all participants, while in the Center and in 

the home environment. Objectives include: independence; positive engagement; ability to make choices; ability to learn 

through meaningful activities, and influence home environment. Center staff, and later family caregivers, will be taught 

methods to use so that goals achieved at the center are reinforced at home. Products include: a final report; manuscripts 

for publication; a web page information; and assessment and evaluations.

Project Period: 09/01/2004 - 12/31/2005

FY Grant Amount

FY 2004 240,388

8730 Sudley Road 

Program: 

Hearth and Home Senior Adult Day Healthcare Center

Congressional Mandates 601

90AM2861

Maine Center for End of Life Care

Augusta, ME 04338-2239

Contact: Kandyce Powell (800)438-5936

The purpose of this proposal is to create a Center for End of Life Care in Maine. The overall goals are to increase 

knowledge and improve delivery systems for end of life. The Center's mission (and objective) will be to act as an 

incubator for change by exercising responsible stewardship and promoting innovation in the following focus (priority) 

areas: 1) community engagement, 2) clinical improvement, 3) research and data collection, 4) professional education, and 

5) advocacy. Four data collection projects will be designed and implemented to assess the state of dying in Maine, as 

well as its efforts to benchmark the Center's progress toward improving end of life care. An interdisciplinary mentoring 

program for end-of-life (EOL) care, including hospice and palliative care, will be created. It will develop and continue to be 

a role-modeling program, which is critical to the care and sensitivity of the dying and/or bereaved.

Project Period: 09/01/2004 - 06/30/2006

FY Grant Amount

FY 2004 245,294

P.O. Box 2239 

Program: 

Maine Hospice Council, Inc.

Congressional Mandates 601

90AM2862
Page 221 of 223 

Boise State Center for the Study of Aging

Boise, ID 83725

Contact: DR James T Girvan (208)426-5776

The Center for the Study of Aging (CSA) will be established at Boise State University (BSU), which will assist stakeholders 

in the research, educational delivery and policy to assure a healthier life for all Idahoans. The Center will employ the 

majority of strategies from the16 social sciences. It will set up a CSA infrastructure: assessment of current gerontology 

activities and future needs for the aging population and the health and social sciences service providers; and a Steering 

Committee, for strategic planning, and preparation for the development and delivery of training and education of 

state/local health and social sciences professionals and providers throughout the state. It will plan and develop an 

intervention with the Idaho Commission on Aging (ICOA) and the Idaho Office of the Attorney General, which will be an 

aging issue/educational seminar on elder abuse and fraud for law enforcement officers and prosecutors.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004

FY 2005

245,294

391,642 1910 University Drive 

Program: 

BOISE STATE UNIVERSITY

Congressional Mandates 601

90AM2863

La Pine Senior Nutrition Project

Bend, OR 97701

Contact: Susan Ross (541)383-6713

The goal of this project is to enhance the health and welfare of the County's disproportionately large and underserved 

elderly population through an enhanced nutrition intervention program. The County proposes to establish a local meal site 

and demonstrate how the it can effectively and efficiently increase access to healthy, nutritious, and safe meals, while 

simultaneously maintaining regular human contact with isolated and disadvantaged senior citizens. The intervention will 

promote good health and independence among isolated frail older persons.

Project Period: 09/01/2004 - 08/31/2005

FY Grant Amount

FY 2004 98,118

1130 NW Harriman 

Program: 

Deschutes County Board of County Commissioners

La Pine Senior Center

Congressional Mandates 601

90AM2864
Page 222 of 223 

Project Independence

Williamsburg, VA 23187

Contact: David Finifter (757)221-2468

The project will enhance the independence of older Americans through: improving community organizations' access to 

relevant research and lessons learned; providing a facility and administrative assistance to support collaborative 

interventions; improving community coordination of transportation and home support services and information; educating 

primary care physicians in the identification and evaluation of geriatric syndromes; educating in-home caregivers on the 

care of older adults; and providing the community a cardiac health education and exercise program. The overall goal is to 

demonstrate how communities can work with regional partners to develop and sustain a center that improves the health, 

dignity, and independence of older adults by integrating the research capacity of universities, colleges, and medical 

schools with the capabilities of service providers and community resources.

Project Period: 09/01/2004 - 08/31/2006

FY Grant Amount

FY 2004 392,440

Post Office Box 8795 

Program: 

COLLEGE OF WILLIAM & MARY

Dean of Research and Graduate Studies

Congressional Mandates 601

90AM2865

Advanced Practice Nursing Care Demonstration Project

Philadelphia, PA 19103

Contact: Robert M Kent (215)965-2373

The grantee, a subsidiary of the Presbyterian Foundation for Philadelphia, operates seven skilled nursing facilities. The 

goal of the project is to demonstrate that, through hiring an advanced practice nurse on a part-time basis and a student 

intern research assistant: (1) a nurse practitioner on staff will result in on-going advanced care assessments being 

conducted on site, and (2) direct communications between the on-site nurse practitioner and off-site physicians will result 

in more interventions in the nursing home and fewer trips to acute care hospitals. Anticipated outcomes are: (1) improved 

elder care and reduction of the number of co-morbid conditions requiring hospitalization; (2) reduction in the number of 

acute care hospital admissions between the study group and the control group; (3) reduction in the cost of acute care 

hospital visits, as documented between the study group and control group; and (4) improvement in the cost effectiveness 

of the nursing home health care delivery system.

Project Period: 09/01/2004 - 08/31/2005

FY Grant Amount

FY 2004 98,118

1845 Walnut Street, 12th Floor 

Program: 

New Courtland Elder Services

Congressional Mandates 601

90AM2866
Page 223 of 223 

Community Connections: Moving Seniors Toward Wellness

Alexandria, VA 22314

Contact: Enid A Borden 

The Meals on Wheels Association of America (MOWAA) will promote health, wellness and independence of older adults 

by transforming Senior Nutrition Programs (SNPs) from their current roles as primarily nutrition providers into core 

programs within a restructured continuum of care. The MOWAA will target older adults immediately discharged from the 

hospital, provide immediate post-discharge nutrition services and assist them in integrating back into the community 

through the provision or coordination of other health related, "wrap-around" services. The objectives are to: 1) change the 

external environment of SNPs through enhanced community partnerships; 2) change internal environment through 

development and incorporation of new services/service delivery systems by SNPs; and 3) facilitate SNP change through a 

Leadership Institute. The outcomes for the project are: changes in targeted older adults (nutrition, social support, health, 

etc.); changes in service (timeliness, care planning, wrap-around services, etc.); organization change (program capacity, 

community collaborations, increased hospital/community integration) and increased public/private collaborations. 

Products from the project include: final report including evaluation results for individual and community interventions; SNP 

"Best Practices" Report; "How To" Manual for SNPs; an on-going Leadership Institute; presentations at national 

conferences; and articles for publication.

Project Period: 09/30/2004 - 02/28/2007

FY Grant Amount

FY 2004 1,569,883

203 S. Union Street 

Program: 

MEALS ON WHEELS ASSOCIATION OF AMERICA

Congressional Mandates 601

90AM2884

Regional Partnership for Older Adults

Akron, OH 44320

Contact: Todd P Rockoff (330)835-0021

The Jewish Community Centers of Akron, Canton, Cleveland and Youngstown, Ohio, will collaborate in offering social 

recreation and physical wellness activities to older members of their communities during a 12 month period. Inactive 

community members will be encouraged to serve as volunteers as Center administrative support and pre-school program 

aides. Transportation will be provided for participants to and between the four Centers. Participants will be assessed for 

changes in their physical and well-being. The Centers will exchange information on their success in increasing 

participation and changes in wellness and socialization of the participants. A report on "lessons learned" will be included 

in the final report.

Project Period: 09/30/2004 - 03/31/2006

FY Grant Amount

FY 2004 245,294

750 White Pond Dr. 

Program: 

Shaw Jewish Community Center of Akron

Congressional Mandates 601

90AM2904
Index of Grantee Organizations

AARP Foundation 93, 99, 107, 153

Access to Justice Foundation 99

Adult Care Center of the Northern Shenandoah Valley, Inc. 190, 219

Aging 2000, Inc. 151

Aging in New York Fund, Inc. 23, 182

Alabama Department of Senior Services 47, 66, 127

Alamo Area Council of Governments 27

Alaska Commission on Aging 41, 129

Alaska Housing Finance Corporation 15

Albert Einstein Medical Center 176

Alliance for Aging 90

Allied Jewish Federation of Colorado 212

Alu Like, Inc. 76

Alzheimer's Disease & Related Disorders Association 22, 23

American Bar Association Fund for Justice and Education 107

American Health Quality Foundation 104

American Society on Aging 94

Anchorage Senior Center 177

Area Agencies on Aging Association of Michigan 130

Area Agency on Aging 1-B 16

Area Agency on Aging 10B, Inc. 17

Area Agency on Aging of Southeast Arkansas, Inc. 189

Area Agency on Aging of West Central Arkansas 188

Area Agency on Aging of Western Michigan 31

Arizona Department of Economic Security 46, 63, 136, 154, 158, 165

Arkansas Department of Human Services 7, 45, 62, 122, 129

Asian Community Center 82

Asociacion Nacional Pro Personas Mayores 34, 175

Atlanta Regional Commission 18, 135

Baltimore City Maryland 16

Benjamin Rose Institute 21

Better Business Bureau Education Foundation 122, 130

Blackfeet Tribal Business Council 74

Boise State University 221

California Department of Aging 13, 43, 68

California Health Advocates 120, 152

Catholic Charities of Diocese of Rochester 20, 80

Catholic Charities of Los Angeles, Inc. 190

Center for Advocacy for the Rights and Interests of the Elderly 120, 152

Central Council Tlingit and Haida Indian Tribes 75

Central Ohio Area Agency on Aging 127

Champions for Change 203

Champlain Senior Center Inc 178

Chinese American Service League 20

City of Chicago 111

City of Inglewood 22

City of Los Angeles Department of Aging 28

City of St. Louis 194

Civic Ventures 189

Coalition of Wisconsin Aging Groups 70, 118, 150, 191

College Misericordia 216

College of William and Mary 222

Colorado Division of Insurance, Dept. of Regulatory Agencies (DORA) 132

Commonwealth of Massachusetts 49, 79

Commonwealth of Virginia 44, 60, 87, 154

Community of Vermont Elders 150

Comprehensive Housing Assistance, Inc. 184

Confederated Salish and Kootenai Tribes 75

Connecticut Department of Social Services 58, 138

Connecticut Legal Services, Inc. 102

Contra Costa County Employment and Human Services 91

- 1 -
Index of Grantee Organizations

Council of Senior Centers and Services of New York City 182

Council on Aging of Southwestern Ohio 94

County of Wayne 191

Dale County Commission 205

Day Kimball Hospital 216

Deaconess Billings Clinic Foundation 181

Delaware Department of Health & Social Services 63, 139, 168

Des Moines University 193

Deschutes County Board of County Commissioners 221

District III Area Agency on Aging 124, 148

District of Columbia Office on Aging 64

DuPage County Department of Human Resources 187

East River Legal Services Corporation 144

Easter Seals, Inc. 97

Eastern Area Agency on Aging 80

Elder Law of Michigan, Inc. 100, 112, 114

Elder Services of the Merrimack Valley, Inc. 131

Elders in Action 32

Eric County Department of Senior Services 19

Executive Office of Elder Affairs 4

Executive Office on Aging 108, 149

Fairbanks Native Association 72

Family Caregiver Alliance 95

Florida Department of Elder Affairs 14, 48, 65, 137, 155, 156, 161, 164, 168

Florida Atlantic University 179, 219

Foundation for Osteoporosis Research and Education 37

Friendship House Association, Inc. 140

Generations of Hope 196

Generations United 96

Georgia Department of Human Resources 11, 84, 137, 170

Georgia Southwestern State University 83

Governor's Office for Elderly Affairs 138

Great Lakes Inter-Tribal Council, Inc. 121, 143

Greater Miami Jewish Federation 197

Gulf Coast Jewish Family Services, Inc. 19

Hana Community Health Center, Inc. 77

Hardy County Committee on Aging, Inc. 218

Hawkeye Valley Area Agency on Aging 104

Healthcare Consortium of Illinois 85

Hearth and Home Senior Adult Day Healthcare Center 220

Hickman County Senior Citizens, Inc. 195

IAAAA Education Institute, Inc. 123, 146

Idaho Commission on Aging 56, 125, 134

Idaho Legal Aid Services, Inc. 103

Illinois Department of Public Health 48

Illinois Department on Aging 12, 81, 157, 161, 165

Indiana Division of Disability, Aging, and Rehabilitative Services 13, 50, 69, 160

Integris Health 186

Iowa Department of Elder Affairs 7, 43, 62, 119, 151, 156, 158, 159, 166, 170, 187

Iowa State University of Science and Technology 188

Ivy Tech State College 180

Jamestown S'Klallam Tribe 78

Jewish Association on Aging 183

Jewish Community Federation of Cleveland 183

Jewish Family & Children's Service, Boston, MA 17, 214

Jewish Family & Children's Service of Greater Philadelphia 185

Jewish Family & Children's Service of Sarasota-Manatee 209

Jewish Family & Children's Service of Southern Arizona, Inc. 209

Jewish Family and Children's Services of Minneapolis 201

Jewish Family & Vocational Service of Middlesex County 123, 125

Jewish Family Service, Albuquerque 205

- 2 -
Index of Grantee Organizations

Jewish Family Service of Buffalo and Erie County 211

Jewish Family Service of Los Angeles 201

Jewish Family Service of Rochester, Inc. 212

Jewish Family Service, Seattle 210

Jewish Family Service of Tidewater, Inc. 208

Jewish Family Services, Inc., Richmond 207

Jewish Federation of Atlantic & Cape May Counties 207

Jewish Federation of Greater Albuquerque 198

Jewish Federation of Greater Atlanta 199

Jewish Federation of Greater Indianapolis 210

Jewish Federation of Greater Washington 200

Jewish Federation of Las Vegas 198

Jewish Federation of Metropolitan Chicago 197

Jewish Federation of Metropolitan Detroit 199

Jewish Federation of Ocean County 213

Jewish Federation of St. Louis 184

Jewish Seniors Agency of Rhode Island 211

Kansas Department on Aging 51

Kentucky Association of Senior Service Corps. 126

Kentucky Cabinet for Health Services 55

Knoxville-Knox County Community Action Committee 71

Lapeer Regional Hospital 215

Legal Aid Bureau, Inc. 101

Legal Counsel for the Elderly 100, 136

Legal Services for the Elderly, Maine 101

Legal Services for the Elderly, New York City 113

Legal Services of North Dakota 149

Legal Services of Northern California 117

LIFESPAN of Greater Rochester - Rochester, NY 206

Little Havana Activities & Nutrition Centers of Dade Co. 26

Louisiana Governor's Office of Elderly Affairs 1, 57, 61

Maine Department of Human Services, Bureau of Elder and Adult Services 6, 40, 65, 134

Maine Hospice Council, Inc. 220

Maryland Department of Aging 2, 49, 141

Mather Lifeways 87

Meals on Wheels Association of America 25, 223

Mecklenburg County Department of Social Services 192

Metropolitan Family Services 177, 192

Michigan Department of Community Health 38, 52

Mid County Senior Services 89

Minnesota Board on Aging 3, 41, 61, 143

Minnesota Senior Federation 112, 115

Mississippi Department of Human Resources 142

Mississippi Department of Mental Health 54

Missoula Area Agency on Aging 140

Missouri Department of Health and Human Services 50, 64

Montana Department of Public Health & Human Services 5

Motion Picture & Television Fund 185

Mount Sinai School of Medicine 71

NAHB Research Center, Inc. 173

National Alliance for Caregiving 98

National Asian Pacific Center on Aging 34

National Association of Area Agencies on Aging 24, 97

National Association of State Units on Aging 92, 98, 103, 171

National Caucus & Center on Black Aged, Inc. 33

National Citizens' Coalition for Nursing Home Reform 105

National Consumer Law Center 106

National Council on the Aging 30, 38, 73

National Family Caregivers Association 95

National Hispanic Council on Aging 119, 132

National Indian Council on Aging, Inc. 33, 173, 206

- 3 -
Index of Grantee Organizations

National Osteoporosis Foundation 36

National Senior Citizens Law Center 108

ND State Dept. of Human Services 58

Nebraska Department of Health and Human Services 55, 148

Neighborhood Centers Inc. 27

Nevada Dept. of Human Resources, Div. of Aging Services 39, 67

Nevada Office of the Attorney General 139

New Courtland Elder Services 222

New Hampshire Department of Health and Human Services 44, 109, 147

New Hampshire Legal Assistance 116

New Jersey Dept. of Health and Senior Services 4, 84

New Mexico Aging & Long-Term Services Department 70

New Mexico State Agency on Aging 9, 39, 133

New York State Office for the Aging 52, 105, 109, 147, 162, 163, 166

Normandale Ministry For Healing And Wholeness 86

North Carolina Department of Health and Human Services 10, 47, 66, 159, 163, 167

North Carolina Department of Insurance 141

North Central Area Agency on Aging, Inc. 30

Northern Mariana Islands Dept. of Community and Cultural Affairs 8

Northern Michigan University 204

Northwest Justice Project 117

Oakwood Lutheran Homes Association, Inc. 214

Ohio Department of Aging 89, 157, 162, 164, 169

Oklahoma Department of Human Services 54

Oklahoma Insurance Department 131

Olde Kensington Redevelopment Corporation 217

Oneida Tribe of Indians of Wisconsin 74

Oregon Health Sciences University 174

OWL, the Voice of Midlife and Older Women 113

Partners in Care Foundation, Inc. 28

Pennsylvania Department of Aging 51, 82, 172

Pennsylvania Occupational Therapy Association 217

Pennsylvania Office of the Budget 15

Pennsylvania State University 92

Pension Rights Center 110, 116

People, Inc. 73

People's Regional Opportunity Program 72

Philadelphia Corporation for Aging 26, 79

Pima Council on Aging 81, 110

Pro Seniors, Inc. 128

Puerto Rico Office of the Ombudsman for the Elderly 57, 121

Rebuilding Together, Inc. 174

Rhode Island Department of Elderly Affairs 5, 42, 69, 160, 167

Rosebud Sioux Tribe Native American Caregiver 77

Saint Louis County Government 180

San Mateo County - Health Service Agency 18

SD State Department of Social Services 60

Senior Service Centers of the Albany Area Inc. 29, 88

Senior Services of Seattle/King County 21,31

Seniors and People with Disabilities 135

Setting Priorities for Retirement Years Foundation 172

Shaw Jewish Community Center of Akron 223

Sheltering Arms Senior Services 32

Society of St. Vincent de Paul 195

South Carolina Lieutenant Governor's Office on Aging 3, 145, 155, 171

South Puget Intertribal Planning Agency 76

Southcare Nursing Center Inc. 196

Southeast Louisiana Legal Services Corp. 118

Southern Maine Agency on Aging 29

St. Andrews Resources for Seniors 78

St. Luke Lutheran Community 203

- 4 -
Index of Grantee Organizations

St. Mark Professional Medical Center, Ltd 202

St. Petersburg College 178

State Board of Agriculture Operating By and Thru Colorado State University 53

Stetson University College of Law 215

Suburban Area Agency on Aging 124, 153

Ten County Aging Board 85

Tennessee Commission on Aging and Disability 46, 68

Texas Dept. of Human Services 42

Texas Legal Services Center, Inc. 115

The Arc of the United States 96

The Carolinas Center for Hospice and End of Life Care 193

The Center for Social Gerontology, Inc. 91, 106

The Copper Ridge Institute 218

The Florida International University Board of Trustees 35, 176

The Hospice Institute of Florida Suncoast 90

The South Carolina Centers for Equal Justice 102

United Cerebral Palsy of Southern Arizona 83

United Jewish Appeal (UJA) Federation of Northern New Jersey 213

United Jewish Communities of MetroWest, New Jersey 208

United Jewish Federation of Greater Pittsburgh 200

University of Alabama 111

University of Alaska, Anchorage 36

University of Arkansas Medical Center 181

University of Denver (Colorado Seminary) 86

University of Hawaii at Manoa 88

University of Indianapolis 194

University of Maine 37

University of Massachusetts, Boston 114

University of New Hampshire 6

University of North Dakota 35, 175

University of South Florida 204

University of Southern California 93

Upper Cumberland Development District/AAA 126

Utah Department of Human Services 56

Utah Legal Services, Inc. 144

Vermont Department of Aging and Disabilities 40

Vermont Department of Disabilities, Aging and Independent Living 59

Vernon Council on Aging, Inc. 145

Via Christi Foundation, Inc. 146

Virginia Association of Area Agencies on Aging 128

Visiting Nurse Association Healthcare Partners of Ohio 202

Visiting Nurse Service of New York 24

Washington State Office of the Insurance Commissioner 133

West Virginia Bureau of Senior Services 1, 53

Westchester County Department of Senior Programs and Services 186

Wisconsin Department of Health and Family Services 12, 45, 67

Womens' Institute for a Secure Retirement 25

West Virginia Research Corporation on Behalf of West Virginia University 179

Wyoming Department of Health 59, 142

- 5 -