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Klickitat County Senior Programs

Klickitat County Senior Services

Description of Programs

Information and Assistance

‘Information and Assistance’ (I&A) is the entry point of the Senior Services network. Our telephones are answered "Senior Services, Information and Assistance."

‘Information’ gives you just that – information. What do you need to know? Van schedules? What’s for dinner at the Senior Center? How to find information about Medicare or Social Security? How to apply for food stamps or the P.U.D. discount? If we don’t already know the answer, we can direct you to someone who does.

The ‘Assistance’ part of Information and Assistance is actually doing something for you. We may call and make an appointment for you, help you figure out your insurance billings or fill out your application for a benefit, or, if you wish, accompany you at an eligibility review or fair hearing of another agency.

The purpose of Information & Assistance is to help seniors access information and services needed to live independently in the community.

Information and Assistance is available to all senior citizens (over 60) regardless of income. Of course some of the programs we tell you about or assist you in applying for may have income or age guidelines of their own. There is no charge for Information and Assistance, but we welcome donations.

Case Management

‘Case Management’ is another step beyond ‘Assistance.’ A better name might be "Care Management" because it provides help in arranging for Long Term Care needs.

Case Management may be called for when a person is released from the hospital after an illness or accident. It may be needed because a family caregiver is unable to handle increasing care needs. Case Management may be called because a family wants to know what options they have in caring for an elder, or because a person needing care wants to talk to someone about their options.

Case Management helps to identify what care needs a person has by performing an Assessment of their needs and resources. Then the Case Manager works with the individual or family to determine their options for getting needed care. Finally a ‘Plan of Care’ or ‘Service Plan’ is drawn up which reflects the person’s choices for receiving care. The plan details what problems must be solved, what activities will solve the problems, and who is responsible for each activity. Most Service Plans are a mix of services provided by family members, outside agencies and sometimes the person themselves. Services from outside agencies may be state supported or privately paid.

Case Management has three guiding principles: 1) The best plan is the one that allows the most independence and self-care, 2) Outside services should supplement, not replace, care being provided by families and friends. 3) The person needing care or authorized to represent them makes the decisions about their care. Case Management is there to help develop a plan of care that suits the individual and his/her situation. This includes a person’s preferences as well as needs. Case Management stays involved to assure that the plan is implemented properly. Sometimes changes are made to reflect changes in the client’s condition or because the plan does not work as anticipated. The Case Manager helps solve problems that come up as the plan is implemented.

Case Management as described above is available without regard to income. Donations are gratefully accepted.

Ongoing Case Management

Recent changes at the state level have changed the way that we work with the state offices. The local state worker (in Home and Community Services) is now considered the ‘Front Door’ for people who will be receiving state-funded services. The HCS worker will do the case management described above and authorize state services. Our Case Managers receive the case when the service plan has been substantially implemented, and are responsible for ongoing case management and re-authorization of services. Case Management remains in effect for as long as state services are received.

People who privately employ caregivers as a part of their service plan have an option to purchase Private Case Management from Senior Services. In Private Case Management the case manager selects and provides supervision for the person hired. Case Management makes sure that the worker understands what tasks are to be provided and knows how to competently perform them. Case Management makes sure that service is provided in accordance with the client’s wishes and disciplines or discharges the worker as needed. This service protects a vulnerable person from being manipulated and exploited by persons that they hire to provide care. The person receiving care, or their representative, remains responsible for paying the worker and any legally required withholding for taxes and benefits. They may hire a bookkeeper to perform these functions or rely on family or others.

Private Case Management is billed on a per hour basis, based on the actual cost of the Case Manager’s time. The recipient of the service signs an agreement with Senior Services.

In –Home Services

Senior Services provides Personal Care and Housekeeping services through a number of different programs. In general, housekeeping is provided only to those also needing personal care services. For state funded services, initial authorization is by Home and Community Services. The file is transferred to our Case Mangers for ongoing case management and re-authorization once the Service Plan has been put into place. Each of the In-Home programs has slightly different guidelines both for financial eligibility and what kinds of services can be provided.

Medicaid Personal Care – is available to those who are Categorically Eligible for Medicaid, and who need help with at least one Personal Care task such as bathing, eating, dressing, toileting, personal hygiene, or body care. Assistance with household tasks may be provided only if personal care assistance is needed.

C.O.P.E.S. – is available to persons who would be expected to need nursing home care without the availability of services. The person must need substantial or total assistance with two or more personal care tasks OR need minimal, substantial, or total assistance with three or more tasks. C.O.P.E.S. is available to those who earn more than the Medicaid standard, but they must contribute to the cost of care.

Chore Services – the original in-home program, is no longer available to new clients. The Chore program was available to those with higher incomes and more resources and it provided household help to people who might not need help with their personal care. It was funded only with state money. Only a few long time clients who could not be moved to Medicaid programs still receive Chore Services.

The cost of providing Medicaid services (including Medicaid Personal Care and C.O.P.E.S.) or Chore Services may, in some circumstances, be recovered from the estates of program participants. The details are complicated and individualized advice should be obtained.

Senior Personal Care – is a small state funded program that is available to some whose resources or income are too high for federally supported programs. Participation in cost is on a sliding fee scale.

Private Pay Chore Services – is available to those not eligible for other programs. Since the recipient of the service pays the cost, an agreement is negotiated for the services they wish to purchase.

Respite – provides time off for unpaid caregivers. The cost is on a sliding fee scale based on the income of the person needing care (not the caregiver’s income.)

Family Caregiver Support

Family Caregiver Support - is a new program that was added when the Older Americans Act was reauthorized in 2001. It is a flexible program designed to help meet the needs of unpaid family caregivers. It can provide assistive supplies and tools, support and consultation, homemaker services, a personal care companion, and/or respite for the caregiver.

Nutrition Program

Congregate Meals – are served at four "meal sites" in Klickitat County. A hot nutritious meal containing at least one third of the Recommended Daily Amount (RDA) of nutrients needed by the elderly is served at 12:00 Tuesdays and Thursdays at the Goldendale Senior Center, Mondays and Wednesdays at the Pioneer Center in White Salmon, and Tuesdays at the Lyle Community Center. A meal is served once a month on the 4th Tuesday in Bickleton at 11:00 at the Grange hall. A donation of $3.00 is requested from those over 60. Those under 60 must pay the full cost of the meal (currently $6.00). Those under 60 who volunteer at the meal site are treated as seniors.

The Congregate Meal Program is based on the knowledge that people do not eat well in the absence of other people. We are social beings, and mealtime is an important social event in our lives. Seniors who may have become isolated are encouraged to take part in the meal program as a step towards getting involved with people again. Eating at the meal site helps prevent seniors, especially those living alone, from drifting into isolation. A recent study confirms that seniors who attend meal sites are healthier and more independent than their counterparts who do not attend.

Home Delivered Meals – are delivered to a senior’s home when attendance at a meal site is not practical. Home Delivered Meals participants are generally homebound. Often HD meals are sent out after a hospital stay or when the spouse that usually prepares the meals becomes ill or dies. The goal is to encourage the senior to attend the mealsite if and when it is possible, but HD meals provide nutrition when the senior is unable or unwilling to attend mealsite. An Assistance worker visits the home and does a short assessment before Home Delivered Meals can be provided. HD meals recipients are often at high risk for becoming isolated. Participation in the program assures that the recipient will have some contact with others.

Hot meals are delivered when the meal sites operate. Delivery is limited to the area that can be served while the meals remain at a safe temperature. Frozen meals are available to those who need them on other days or who live too far from the meal sites. As with other programs funded by the Older Americans Act, Home Delivered Meals participants are asked for a confidential donation. The requested donation is $3.00.

C.O.P.E.S. program recipients may receive Home Delivered Meals as a part of that program.

Transportation

Transportation – has always been at the top of the list of Senior Citizen priorities in Klickitat County. At every planning meeting it is always made clear. Seniors feel that loss of transportation is the biggest threat to their independence in our big rural county. Getting older means facing the inevitable time when we can no longer drive safely. At first night driving, busy traffic, and long trips become difficult. Eventually, if we live long enough, the safety of others and ourselves demands that we give up driving altogether. Those who have never had strong driving skills face this time sooner than those with a lifetime of safe driving habits to fall back on.

We provide transportation in vans when practical. Vans are perfect for taking seniors to the meal site and shopping. All of our vans are now equipped with wheelchair lifts so that people who depend on wheelchairs can be comfortably and safely transported. We often use Volunteer Drivers to provide trips to medical appointments or whenever it is more cost-effective. These volunteers use their own vehicle and are reimbursed for mileage.

All of our drivers, paid and volunteer, are screened for suitability and safe driving skills. They receive training in assisting passengers, defensive driving, and CPR certification. Volunteer vehicles are required to be in good repair. Paid drivers receive additional training and are covered by mandatory drug testing requirements.

The goal of Senior Transportation is to make sure that alternative means of transportation are available so that no one is prevented from living independently because of the lack of basic transportation. We can’t match the independence provided by a car in the driveway ‘raring to go’, but we can make sure that basic transportation needs are met. Many enjoy the sociability of riding in our vans as they do their shopping and errands.

The terms of our contract with the South West Agency on Aging (SWAA) define "essential transportation" as trips to our meal sites, trips to medical destinations, shopping, and social/financial trips to banks, the post office, etc. Trips to other destinations are possible through grants from the Federal Transit Administration (FTA) and support from the Klickitat County Commissioners.

Medicaid Transportation – is provided to those who are eligible for Medical Assistance through the Medicaid Program. Since many Medicaid recipients are senior citizens, providing service to them under Medicaid Transportation makes our other funding sources stretch further.



Date of Source Material: 10/22/2008
Source: Klickitat County Senior Services

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Contact:
Sharon Carter: Director

Office Hours: 8am-5pm

Goldendale Office
Annex II 115 W. Court
MS-CH-21
Goldendale, WA 98620

Phone: (509) 773-3757
or 800 447-7858
Fax: (509) 773-6965


White Salmon Office:
P.O. Box 1877
501 NE Washington Street
White Salmon, WA 98672

Phone: (509) 493-3068
or 800 447-7858
Fax: (509) 493-4109

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