Strategic Plan And Gaps Analysis For Long Term Care Services
STRATEGIC PLAN AND GAPSANALYSIS FOR LONG TERMCARE SERVICESDeveloped and Prepared by the NY ConnectsNiagara County Long Term Care Advisory CouncilNY Connects Niagara County supports self-determination andpromotes consumer choice regarding long term care services for thesenior, physically disabled and developmentally disabled populationsof Niagara County. NY Connects Niagara County will provideaccessible, coordinated, unbiased and person-centered informationand referral services responsive to the long term care needs ofNiagara County residents and caregivers, regardless of payor source.
Strategic Plan and Gaps Analysis For Long Term Care ServicesTable of ContentsPageIntroduction .2NY Connects Niagara County Long Term Care Advisory Council .2Long Term Care System Analysis Survey .3Survey Results .4Demographic Information .4Health Status Information .8Target Areas of Need and Strategic PlanIntroduction .13Education 14Healthcare Services Availability .15Housing .16In-Home Care 17Nutrition Services .18Transportation .20Workforce 21Page 1
Strategic Plan and Gaps Analysis For Long Term Care ServicesIntroductionThis report summarizes the results of the 2009 Long Term Care survey developed and conducted bythe NY Connects Niagara County Long Term Care Advisory Council. The report includes data collectedfrom a cross section of the variety of groups served by long term care services in Niagara County,reflects the diversity of needs being addressed by the long term care system currently in place andincludes recommendations for future planning.NY Connects Niagara CountyLong Term Care Advisory CouncilThe NY Connects Niagara County Long Term Care Advisory Council was formed in September 2007 andis comprised of 33 individuals and professionals representing a wide array of agencies and programsthat serve the aging and disabled populations of Niagara County. The Long Term Care Advisory Councilmembership includes residential and comprehensive care service professionals, in-home and inpatienthealth care services staff, educational and social service workers and community members comprisedof caregivers and clients of services.New York State offered the option to include developmentally disabled services and the Council, at itsinception, made the determination that long term care services for the disabled cover the lifespanfrom birth to death, and thus has included services to this population in the scope of its work.It is the mission of the Long Term Care Advisory Council of Niagara County to objectively consider andevaluate the needs of Niagara County residents who are seeking long term care and assistance. TheCouncil identifies gaps in the current service delivery system and makes recommendations to the NYConnects Niagara County Long Term Care Coordinator, related to program development and serviceimplementation, to best meet the needs of the aging and disabled populations in Niagara County.Through collective vision and collaboration, the NY Connects Niagara County Long Term Care AdvisoryCouncil has adopted, embraces and actively promotes its mission statement.Page 2
Strategic Plan and Gaps Analysis For Long Term Care ServicesLong Term Care System Analysis SurveyNY Connects Niagara County’s Long Term Care Advisory Council (LTCAC) was charged with conductingan analysis of Niagara County’s long term care system. Through collaboration and teamwork, theLTCAC created a survey that was designed to collect information from caregivers, consumers, familymembers and professionals about care needs and issues, use of currently available long term careservices and input regarding the existing long term care system in Niagara County. The survey inquiredabout both current and future health care needs.The survey was distributed to three main populations and through a variety of methods. The targetedpopulations were older adults, disabled residents of any age and the general public. Methods ofdistribution included home delivered meals clients, congregate dining participants, senior centers, theNioga Library System, and agencies represented on our LTCAC that service developmentally disabledresidents, older adults and caregivers throughout Niagara County. As a result, the sample size was2,250 and 488 surveys were returned (22%). The survey results are reported on pages 5 - 18.Page 3
Strategic Plan and Gaps Analysis For Long Term Care ServicesSurvey ResultsDemographic Information:Respondents IdentifyThemselves As:Consumer40% Caregiver60%Zip Code 2098531311365311520*All graphs are based on 488 total survey responses.Page 4
Strategic Plan and Gaps Analysis For Long Term Care ServicesDemographic Information:Age1%5%Under 409%40 - 497%50 - 5927%60 - 6914%70 - 7980 - 8916%90 and Over21%No AnswerGender3541228MaleFemaleNo ResponseLives AloneYesNoNo Response3%48%49%*All graphs are based on 488 total survey responses.Page 5
Strategic Plan and Gaps Analysis For Long Term Care ServicesDemographic Information:Veteran3986323YesNoNo ResponseRace/Ethnicity422341511245Income - Family Size 111%24%Under 10,400Under 13,000Under 15,60028%Under 19,24017%10%10%Over 19,240No Response*All graphs are based on 488 total survey responses.Page 6
Strategic Plan and Gaps Analysis For Long Term Care ServicesDemographic Information:Income - Family Size 218%14%Under 14,000Under 17,5008%4%17%39%Under 21,000Under 25,900Over 25,900No ResponseIncome - Family Size 38%Under 17,60020%Under 22,000Under 26,40016%40%Under 32,560Over 32,560No Response16%Income - Family Size 49%Under 21,20027%Under 26,500Under 31,800Under 39,2209%46%9%Over 39,220No Response*All graphs are based on 488 total survey responses.Page 7
Strategic Plan and Gaps Analysis For Long Term Care ServicesHealth Status Information:Health StatusExcellent15Very Good81Good166Fair140Poor42No 2733211617*All graphs are based on 488 total survey responses.Page 8
Strategic Plan and Gaps Analysis For Long Term Care ServicesHealth Status Information:Assistance Needed Now and in the Future180160140120100806040200Now3 - 5 YearsExpectation of Who Will Provide Assistance104Spouse/Partner156Adult Child65Other RelativeFriend/Neighbor3665AgencyOther31107Don't KnowNo Response57*All graphs are based on 488 total survey responses.Page 9
Strategic Plan and Gaps Analysis For Long Term Care ServicesHealth Status Information:Applied For or Sought Services For:Adult Day Care33Adult Care Home22Affordable Housing60Assisted Living49Caregiver Training9Early Intervention17Employment & Training45Escort to Medical Appointments61Home Care79Home Modification/Adaptation Programs32Hospice Care22Housekeeping/Chores/Laundry75Home Delivered Meals/Congregate Meals92Legal Services65Long Term Home Health Care39Medicaid Service Coordination43Medication Management22Mental Health Services35Nursing Home36Personal Care37Personal Emergency Response Systems41Prescription Assistance45Recreation/Social Activities32Rehabilitation45Respite Care22Substance Abuse Services10Transportation95Utility AssistanceTBI Medicaid WaiverOMRDD Medicaid Waiver51215*All graphs are based on 488 total survey responses.Page 10
Strategic Plan and Gaps Analysis For Long Term Care ServicesHealth Status Information:Not Enough Money In The Past12 Months For:9080706050403020100Barriers To ServicesAgeAvailability of Services in Residence e Of What Is Appropriate/AvailableNeed To Contact Multiple AgenciesNo Response050100150200250*All graphs are based on 488 total survey responses.Page 11
Strategic Plan and Gaps Analysis For Long Term Care ServicesHealth Status Information:Paying For Help136122105103667251208*All graphs are based on 488 total survey responses.Page 12
Strategic Plan and Gaps Analysis For Long Term Care ServicesTarget Areas of Need and Strategic PlanIntroductionThe Long Term Care Advisory Council (LTCAC) identified seven Target Areas of Need to be addressed inthis Strategic Plan. This was accomplished by working cohesively during one LTCAC meeting. Followingthis session, smaller groups analyzed each target area and identified assets/strengths andissues/challenges and developed goals and strategies to address them. To conclude the process, eachtarget area was reviewed by the LTCAC as a whole at a subsequent meeting.The LTCAC has agreed that a “working” strategic plan is the best approach to addressing the fluidneeds of the residents of Niagara County. As a result, the plan effectively addresses the ongoing longterm care needs of our community. As progress is made in implementing our strategies and achievingour goals, the Strategic Plan will be periodically revised to reflect our achievements and the needs ofour residents as they evolve.Page 13
Strategic Plan and Gaps Analysis For Long Term Care ServicesTarget Area: EducationAssets and Strengths : Community access television provides vehicle to educate the public as to available services.Five local hospitals and other healthcare providers offer public health education programs.Personal Care Aide (PCA) and Home Health Aide (HHA) training is provided through licensed andcertified agencies.Orleans/Niagara BOCES, Niagara County Community College and Niagara University providedegree/certificate programs for the workforce.NY Connects Niagara County’s Long Term Care Advisory Council works cooperatively with a diversegroup of agencies to reach all sectors of the population.Niagara County Office for the Aging actively promotes awareness of services and provides accessand funding.New York State and Niagara County Departments of Health support educational services and publiceducation programs.Local coalitions of agencies (C.A.S.E., Association of Human Services, Network in Aging, etc.)sponsor educational programs and networking opportunities.Niagara County’s service providers sponsor a variety of health fairs for the public.Issues and Challenges : Misperception of cost of needed services and how they will be paid for.Consumer’s access to information is limited by a wide array of issues, such as transportation to andfrom educational events and the cost of marketing educational programs.Consumer’s denial of future health care needs and fear of interference in lifestyle and loss ofindependence.Shortage of direct care professionals and primary care physicians, especially geriatricians, causeslack of time to educate individual patients.Consumers and advocates are overwhelmed by the complexity of the service system and associatedfunding.Goals: Coordinated effort to bring education to underserved areas.Centralized, coordinated access to information, i.e. NY Connects.Enhance community’s knowledge of and access to long term care resources.Promote self-reliance by encouraging members of the community to be proactive in planning fortheir future health care needs.Strategies : NY Connects Niagara County will act as an assertive leader in coordinating and disseminatinginformation to residents of Niagara County.Seek ways for the Long Term Care Advisory Council to disseminate information to constituents,including the use of pharmacies.Schedule public information opportunities with caregivers on evenings and weekends for largerparticipation of working caregivers.Develop and utilize a generic template that can be used by various persons on the Long Term CareAdvisory Council for community presentations.Page 14
Strategic Plan and Gaps Analysis For Long Term Care ServicesTarget Area: Healthcare Services AvailabilityAssets and Strengths: There are a significant number of individuals seeking services (asset and challenge).Niagara County has a large aging population (asset and challenge).Institutional settings, such as hospitals and nursing homes, are geographically distributedthroughout Niagara County to serve both urban and rural areas.Rehabilitation services are readily accessible throughout the county.Nursing homes and sub-acute rehabilitation beds are available to meet current needs.Home health care providers are actively working to meet the demands for service.Issues and Challenges: There are a significant number of individuals seeking services (asset and challenge).Niagara County has a large aging population (asset and challenge).Lack of services for homebound individuals such as in-home blood draws.Transportation affects accessibility - aides do not have transportation to clients and clients do nothave transportation to services.Lack of specialists practicing in rural areas and the northern part of the County and the challenge ofdrawing physicians into these areas.The need for dialysis service – only one free-standing facility.Individuals are not aware of available services.Challenge of insurance and billing that limits accessibility to participating service providers,requiring consumers to travel long distances or to seek out-of-county services.Goals: Attract providers, especially direct care staff, into rural areas to offer needed services.Increase and improve in-home services for homebound individuals.Bring Immediate Care Facilities into Niagara County.Make public more aware of available services.Strategies: Explore services that are lacking and develop a plan to attract new providers into the communityand centrally locate healthcare services.Educate public on services currently available.Initiate a dialogue with insurance companies to work collaboratively toward reaching stated goals.Page 15
Strategic Plan and Gaps Analysis For Long Term Care ServicesTarget Area: HousingAssets and Strengths: Several information and assistance programs are in place, such as NY Connects, the Niagara CountyOffice for the Aging and 2-1-1, to advise seniors and/or disabled residents of housing options.Shared aide sites throughout Niagara County that provide safe housing accessible to services.Apartments are available through the private sector that can accommodate senior and/or disabledresident’s needs.Issues and Challenges: Increasing need for home modification to allow senior and/or disabled residents to remain in theirhomes as long and safely as possible.The need to transition seniors to senior-friendly, affordable housing that is accessible to areaservices, activities and businesses.The need for comprehensive listing of presently available housing which best meets the needs ofsenior and/or disabled residents including information on area shops, services and grocery stores.The need to educate seniors and disabled residents on options regarding the above.Goals: Identify present resources which address the issues cited above.Increase awareness to allow eligible senior and disabled residents to access safe, affordable housingthat meets their needs.Educate senior and disabled residents as to presently available options for home modifications.Identify areas lacking in senior-friendly housing and pursue ways to fill in gaps.Address shortages in available funding for home modifications for the economically disadvantaged.Strategies: Develop and circulate manual detailing available senior and disabled-friendly housing withinformation on local restaurants, shopping centers, grocery stores and convenience centers.Meet with private sector and/or volunteer groups to explore possible options/resources/grants forhome modifications.Work with private sector to identify and fill-in gaps for affordable, safe housing accessible toservices, churches, supermarkets and activities.Establish a subcommittee to meet regularly to address issues, implement strategies and monitorprogress.Page 16
Strategic Plan and Gaps Analysis For Long Term Care ServicesTarget Area: In-Home CareAssets and Strengths Community interest and demand for in-home care.Community agencies and programs are focusing on in-home care.There is a willingness among agencies to collaborate to provide services.Introduction of the P.A.C.E. (Program for All-inclusive Care for the Elderly) model in the county.Senior services and day programs are available.Issues and Challenges The growing demand and reduced reimbursement for homecare services.Need for additional consumer education and awareness of services.Workforce shortage for in-home service providers.Workforce ability to get to those needing care, esp. a lack of rural transportation.Consumer’s lack of confidence in those providing the services.Inadequate salaries for those providing services.Old housing stock that would require extensive modification to provide handicap accessibility.Goals Increase workforce by improving wages, training, and transportation availability.Improve service availability by improving transportation.Increase education in the community about available in-home care options.From a public policy perspective, negotiate with the State to increase provider home-carereimbursement rates.Strategies Convene local in-home care providers into a “coalition” in order to work together to developtransportation alternatives for home care workers to get to rural areas – i.e. join resources/moneyto purchase a van to be used by this coalition to drive home care workers to/from rural locations.Have this coalition develop community-wide free workshops to prospective customers and theirfamily caregivers to increase awareness and understanding of the benefits, safety and confidence ofusing home care.This local coalition to work with New York State associations to continue to lobby for restoringfunding cuts made to home care and to lobby for increased funding.Page 17
Strategic Plan and Gaps Analysis For Long Term Care ServicesTarget Area: Nutrition ServicesAssets and Strengths Niagara County Office for the Aging provides approximately 400 home delivered meals daily forresidents age 60 and older. Nutritious lunches, cold suppers and weekend meals are available. Anassessment is done by outreach workers to determine other needs in the home.Meals on Wheels programs exist in the cities of Lockport, Niagara Falls and North Tonawanda.The Niagara County Office for the Aging Congregate Dining Program serves approximately 600meals daily to seniors at 20 nutrition sites across Niagara County.Other programs in Niagara County, such as WIC, food stamp programs, food pantries, soupkitchens, Farmer’s Markets coupons, grocery stores that deliver, Cornell Cooperative Extension’sEat Smart New York Program and child nutrition programs (Head Start, school food service includingsummer programs, etc.) are also available.Nutrition counseling and education are available through various programs.Senior Companions, families, neighbors and service workers are sources for grocery shopping andcooking for those who cannot prepare a meal for themselves.Senior centers and nutrition sites link seniors to other needed services in addition to providing asocial outlet for people.Issues and Challenges More volunteers are needed for all home delivered meals programs.Better coordination of nutrition services between programs is needed.Need for home delivered meals and in-home nutrition counseling for individuals under age 60 whohave a need to change or improve their nutritional intake. Meals programs are not readily availableto serve disabled individuals under age 60 who are having difficulty.The need for increased visibility of existing meals programs in the community.More transportation needed to bring residents to sites and local grocery stores.More grocery shopping services are needed.Poor nutritional intake due to inadequate finances, knowledge or poor habits leading to obesity,diab
Personal Care Nursing Home Mental Health Services Medication Management Medicaid Service Coordination Long Term Home Health Care Legal Services . Strategic Plan and Gaps Analysis For Long Term Care Services Page 11 Health Status Information: *All graphs are based on 488 total survey responses. 0 10 20 30 40 50 60 70 80 90 Not Enough Money In .
Types of important electrode configurations useful for extra high voltage practice in the field and in laboratories. Examples of this type are sphere-plane gaps, sphere-to-sphere gaps, point-to-plane gaps, rod-to-plane gaps, rod-rod gaps, conductor-to-tower gaps, conductor to-conductor gap above a ground plane, etc.
can gap down, it can gap up. A gap up occurs when one day's low is greater than the previous day's high. Both Gaps B and D in Figure 1.1 represent gap ups. Early technicians did not pay attention to gaps simply because they were conspicuous and easy to spot on a stock chart. Because gaps show that a price has jumped, they may represent
Sep 05, 2017 · STRATEGIC PLAN FORMAT 2017-2020 . The sample strategic planning format uses a one page Strategic Map format to identify areas of focus for the Plan. From the Strategic Map, a Strategic Plan is created to advance strategic priorities for the coming 1-3 years. The plan accomplishments a
(referred to in the gaps model as the company). Figure 5.2 represents the gaps model of service quality, highlighting the initial customer gap and corresponding four company gaps. FIGURE 5.2 The gaps model of service quality Source: Zeithaml and Bitner (2003: 532) The central focus of the gaps model is the customer gap, being the difference between
offense is trying to do before they do it. Yell/communicate with your teammates. Gaps- To coordinate stunts and defensive formations we denote gaps on the offensive line: 8/11/2012 TE T G X G T TE B Gaps C Gaps A Gaps Outside C B A BA C 3,4,5,6,7,8 A Gap- Space between the
Strategic Improvement Plan 2017-2020 Page 1 Strategic Improv. Plan Strategic Improvement Plan Template Forsyth County Schools Strategic Plan Goal Area Culture and Climate Forsyth County Schools Strategic Plan Performance Objective #1 Acquire, develop, and retain excellent staff for
Strategic Plan and the process . used to create the Plan in four sections: 1. The Process: An overview of the process used to create the Strategic Plan. 2. Strategic Insights: A summary of the six insights that provided a foundation for the development of the Strategic Plan. 3. Strategic Plan Overview: A one-page summary of the Strategic Plan. 4.
1. 4 Tools for strategic analysis 1. 4a SWOT 1. 4b TOWS 1. 4c Hambrick Model: Strategy Diamond 1. 4d BCG matrix 1. 4e General Electrics Stoplight Matrix 1. 4f Balance score card . 3 Management Strategic Management Strategic Analysis 1. 5 Summary 1.2 Introduction Strategic Management is the process of strategic decision-making that sets the long .
