CLIENT TRACKING DICTIONARY. October West Virginia Bureau of Senior Services

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1 CLIENT TRACKING DICTIONARY October 2011 West Virginia Bureau of Senior Services

2 TABLE OF CONTENTS Fund Identifiers 1 TITLE III Fund Identifiers Title III, III-D, Caregiver by Cluster 2 LIFE, FAIR, and Lighthouse 3 Services 4 Providers 5 Service Definitions 7 Instructions/Explanation for Reporting Service Units Measured by the Hour 16 Group Meals Reporting Procedure for Meals Served at Special Events 18 Program Descriptors 19 Section 1 25 West Virginia Bureau of Senior Services Client Tracking Contact Information 26 West Virginia Bureau of Senior Services Area Agency Designation 27 West Virginia Providers and Sites 28 West Virginia Provider Information and Service Array 40 Page Section West Virginia Bureau of Senior Services Client Intake Form (BIF), Nutritional Health Assessment 111 BIF General Instructions 113 Nutritional Health Assessment Determination Sheet 116 Specific Instructions for Completing a West Virginia Bureau of Senior Services Intake Form (BIF) 117 FAIR Caregiver Respite Supplemental Monthly Service Recording Log 120 Quick Reminder for Building Rosters 121 Rosters SAMS Job Aid 122 Sample Roster 133 Service Entry Recommended Procedures SAMS Job Aid 134 Report Description by Category 146 Sample Report 157

3 FUND IDENTIFIERS The Bureau of Senior Services (the Bureau) tracks services provided by assigning codes to determine the source of funding. In order to receive proper credit, the Fund Identifier must be entered on the Service Rosters and Group Service Templates in preparation for data entry.* Title III old funding codes 30, 31, 32, 36 Title III-D old funding code 35 FAIR old funding code 29 LIFE old funding code 28 Lighthouse old funding code 51 Local old funding codes 40, 41, 42 *Failure to use the Fund Identifier will result in a necessary editing of the consumer s service delivery database. The Fund Identifier is now required. 1

4 TITLE III Fund Identifiers Title III, III-D, Caregiver Cluster 1, 2, 3, Other Services, III-D, III-Caregiver CLUSTER 1 Fund Identifier OTHER SERVICES Fund Identifier Personal Care Title III Group Congregate Meals Title III Homemaker Title III Group Client Support Title III Chore Title III Individual Client Support Title III Home-Delivered Meals Title III Adult Day Care Title III Case Management Title III CLUSTER 2 Fund Identifier TITLE III-D Fund Identifier Assisted Transportation Congregate Meals Title III Title III III-D Information and Assistance Nutrition Counseling Title III III-D Medication Management III-D Group Client Support III-D Individual Client Support Title III-D Title III-D Title III-D Title III-D CLUSTER 3 Fund Identifier TITLE III Fund Identifier Transportation Title III Caregiver Counseling/ Legal WVSLA Only Title III Support Groups Title III Nutrition Education Title III Congregate/In-Home Information and Assistance Title III Respite Title III Outreach Title III *Supplemental Services Title III Other Title III *Access Assistance Title III Caregiver Information and Assistance Title III *Not currently used in Wet Virginia 2

5 LIFE, FAIR, and Lighthouse (No Nutrition Services are Reported Under LIFE Use Title III) SERVICE Adult Day Care Assisted Transportation Caregiver Counseling/Support Groups Caregiver Training Case Management Chore Congregate Respite Group Client Support Homemaker Individual Client Support Information & Assistance Legal (WVSLA only) LIFE In-Home Respite Nutrition Counseling Nutrition Education Outreach Personal Care Tax/Other Financial Related Assistance Transportation FAIR Alzheimer s In-Home Respite FAIR Congregate Respite Lighthouse Personal Care FUND IDENTIFIER LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE LIFE FAIR FAIR Lighthouse 3

6 SERVICES ROSTER SERVICES SERVICE FUND IDENTIFIERS UNIT Adult Day Care LIFE, Title III 1 Hour Assisted Transportation LIFE, Title III, Lighthouse 1 Trip, 1 Way Caregiver Counseling/Support Groups LIFE, Title III 1 Hour Caregiver Information and Assistance LIFE, Title III 1 Contact Caregiver Training LIFE, Title III 1 Hour Case Management LIFE 1 Hour Chore LIFE 1 Hour Congregate Meals Title III 1 Meal Congregate Respite LIFE, FAIR, Title III 1 Hour FAIR Alzheimer s In-Home Respite FAIR 1 Hour FAIR Congregate Respite FAIR 1 Hour Home-Delivered Meals Title III 1 Meal Homemaker LIFE, Title III 1 Hour III-D Individual Client Support III-D 1 Hour III-D Information and Assistance III-D 1 Hour Individual Client Support LIFE, Title III 1 Hour Information and Assistance LIFE, Title III 1 Contact LIFE In-Home Respite LIFE, Title III 1 Hour Lighthouse Personal Care Lighthouse 1 Hour Nutrition Counseling LIFE 1 Hour Outreach LIFE, Title III 1 Contact Personal Care LIFE, Title III 1 Hour Title III In-Home Respite Title III 1 Hour Transportation LIFE, Title III, Lighthouse 1 Trip, 1 Way GROUP SERVICES SERVICE FUND IDENTIFIERS UNIT Group Client Support LIFE, Title III 1 Hour Group Congregate Meals Title III 1 Meal III-D Group Client Support III-D 1 Hour III-D Medication Management III-D 1 Contact Legal (WVSLA only) Title III 1 Hour Nutrition Education LIFE 1 Session Tax/Other Financial Related Assistance LIFE 1 Hour 4

7 PROVIDERS Region 1 Providers Bi-County in Harrison Bi-County Nutrition in Doddridge Brooke County Committee on Aging Brooke Hancock Nutrition in Brooke Brooke Hancock Nutrition in Hancock Calhoun County Committee on Aging Committee for Hancock County Senior Citizens Council of Senior Citizens of Gilmer County Council of Senior Tyler Countians Doddridge County Senior Citizens Family Service Upper Ohio Valley Harrison County Senior Citizens In Touch and Concerned Marion County Senior Citizens Marshall County Committee on Aging Ohio Family Services in Brooke Ohio Family Services in Hancock Ohio Family Services in Marshall Ohio Family Services in Ohio Ohio Family Services in Wetzel Pleasants County Senior Citizens Center Pleasants Senior Nutrition Ritchie County Integrated Family Services Senior Monongalians West Virginia Senior Legal Aid, Inc. Wetzel County Committee on Aging Wirt County Committee on Aging Wood County Senior Citizens Association Region 2 Providers Boone County Community Services Organization Cabell County Community Services Organization Coalfield Community Action Partnership (Mingo) Jackson County Commission on Aging Kanawha Valley Senior Services Lincoln County Opportunity Co. Mason County Action Group PRIDE in Logan County Putnam Aging Program Putnam Nutrition in Clay Putnam Nutrition in Kanawha Roane County Committee on Aging Wayne County Community Services Organization 5

8 PROVIDERS (cont.) Region 3 Providers Aging and Family Services of Mineral County Barbour County Senior Center Berkeley Senior Services Grant County Commission on Aging Hampshire County Committee on Aging Hardy County Committee on Aging Jefferson County Council on Aging Lewis County Senior Citizens Center Pendleton Senior and Family Services Preston County Senior Citizens Randolph County Domestic and Training Senior Life Services of Morgan County Taylor County Senior Citizens The Committee on Aging for Randolph County Tucker County Senior Citizens Upshur County Senior Citizens Opportunity Center Region 4 Providers Braxton County Senior Citizens Center Clay County Development Corp. Council on Aging (Wyoming County) Fayette County Office Greenbrier County Committee on Aging McDowell County Commission on Aging Mercer CASE Senior Center Monroe County Council on Aging Nicholas Community Action Partnership Nicholas County Senior Center Pocahontas County Senior Program Raleigh County Commission on Aging Summers County Council on Aging Webster County Commission of Senior Citizens 6

9 SERVICE DEFINITIONS Service Unit Fund Identifier Form Definition Adult Day Care 1 Hour LIFE, Title III Roster To provide personal care for dependent adults in a supervised, protective, congregate setting. Services offered in conjunction with adult day care typically include social and recreational activities and training. Assisted Transportation 1 Trip, one way LIFE, Title III Roster To provide assistance to a person who has difficulties (physical or cognitive) using regular vehicular transportation. Transportation provided to each destination is considered a unit. Caregiver Counseling/ Support Groups Caregiver Information and Assistance 1 Hour LIFE, Title III Roster To provide advice, guidance, and instruction about options and methods for providing support to caregivers in an individual or group setting. 1 Contact LIFE, Title III Roster Provides on an individual basis information to caregivers about opportunities and services available; assesses problems and capacities of the caregiver; links the caregiver to the opportunities and services available; and to the maximum extent practicable, ensures that the caregiver receives the services needed, and is aware of the opportunities available, by establishing adequate follow-up procedures. Caregiver Training 1 Hour LIFE, Title III Roster Provision of training for caregivers to assist them in the performance of in-home services for dependent seniors. 7

10 SERVICE DEFINITIONS (cont.) Case Management 1 Hour LIFE Roster To assess older individuals needs and to arrange, coordinate, and monitor an optimum package of services to meet those needs. Includes services and coordination such as comprehensive assessment of the client (including physical needs); development and implementation of a service plan with the client to mobilize the formal and informal resources and services identified in the assessment to meet the needs of the client, including coordination of the resources and services; coordination and monitoring of formal and informal service delivery, including coordination and monitoring to ensure that services specified in the plan are being provided; and periodic reassessment and revision of the status of the client. A comprehensive and individual assessment of a client must be completed in order to identify and actively obtain all the services available through any service providers in the community that can meet the individual s needs. To provide this service, staff specifically trained in the case management approach to service delivery must perform all of the following functions for each client: intake/screening, assessment, care planning, arranging for services, follow-up, monitoring, and reassessment. An integral part of the intake/screening and assessment process must include medical support 8

11 SERVICE DEFINITIONS (cont.) Cast Management (cont.) evaluation provided by a physician or registered nurse. Nutritional Health Assessment form must be completed for each case management client. Chore 1 Hour LIFE, Title III Roster To perform household chores such as heavy cleaning (moving furniture, turning mattresses) and yard and walk maintenance, which the client is unable to perform. This service does not require the services of a trained homemaker or other specialist, nor does it require a care plan. Congregate Meals 1 Meal Title III Roster To provide to an eligible client or other eligible participant, at a congregate site, a meal that: (a) complies with the Dietary Guidelines for Americans (published by the Secretaries of the U. S. Department of Health and Human Services and the Department of Agriculture) AND (b) provides a minimum of one-third of the daily recommended dietary allowances (RDA, Food and Nutrition Board of the National Academy of Sciences). Congregate Respite 1 Hour LIFE, Title III Roster Temporary substitute supports or living arrangements delivered in an adult day care or institutional setting to provide a brief period of relief or rest for caregivers. 9

12 SERVICE DEFINITIONS (cont.) FAIR Alzheimer s In-Home Respite 1 Hour FAIR Roster To provide brief periods of relief or rest in the home for caregivers of individuals who have Alzheimer s or related dementia. The caregiver is the client. FAIR Congregate Respite 1 Hour FAIR Roster Temporary substitute supports or living arrangements delivered in an adult day care or institutional setting to provide a brief period of relief or rest for caregivers. The caregiver is the client. Group Client Support 1 Hour LIFE, Title III Consumer Group Service Provision of services/activities to groups of clients to enhance their well-being. Group Congregate Meals 1 Meal Title III Consumer Group Service To provide a meal in a group setting (i.e., county picnic) for which BIFs are not completed. See page titled Group Meals Reporting Procedure for Meals Served at Special Events. Home-Delivered Meals 1 Meal Title III Roster To provide to an eligible client or other eligible participant at the client s place of residence a meal that complies with the Dietary Guidelines for Americans (published by the Secretaries of the U. S. Department of Health and Human Services and the Department of Agriculture) and provides a minimum of one-third of the daily recommended dietary allowances (RDA, Food and Nutrition Board of the National Academy of Sciences). Nutritional Health Assessment form must be completed and the score recorded on the BIF for each Home-Delivered Meal recipient. (See HDM Policies and Procedures Manual and Carry-Out Meal Policy.) 10

13 SERVICE DEFINITIONS (cont.) Homemaker 1 Hour LIFE, Title III Roster To provide assistance to persons having difficulty with one or more of the following seven instrumental activities of daily living: preparing meals, shopping for personal items, medication management, managing money, using the telephone, doing heavy housework, doing light housework. The former services Housekeeping and Shopping are now included in this definition. Housekeeping involves house cleaning, laundry and meal preparation. Shopping involves assistance in obtaining food, clothing, medical supplies and household items for seniors confined to their homes/places of residence. Homemaker does not require a care plan. If the senior is capable of going with the provider to obtain needed supplies, Homemaker would not be the service provided. Transportation or Assisted Transportation would be used. III-D Group Client Support 1 Hour Title III-D Consumer Group Service Provision of services/activities to groups of clients to enhance their well-being. III-D Individual Client Support III-D Information and Assistance 1 Hour Title III-D Roster Provision of services/activities to individual clients to enhance their well-being. 1 Contact Title III-D Roster Provides individuals with current information on opportunities and services available within their communities, including information relating to assistive technology; assesses the problems and capacities of individuals; links individuals to the 11

14 SERVICE DEFINITIONS (cont.) III-D Information and Assistance (contd.) III-D Medication Management 1 Contact Title III-D Consumer Group Service opportunities available; to the maximum extent practicable, ensures that individuals receive the services needed, and are aware of opportunities available, by establishing adequate follow-up procedures. The former service Referral is included in this definition. Provision of management, screening, and education to prevent incorrect medication and adverse drug reactions. Individual Client Support 1 Hour LIFE, Title III Roster Provision of services/activities to individual clients to enhance their well-being. Information and Assistance 1 Contact LIFE, Title III Roster Provides individuals with current information on opportunities and services available within their communities, including information relating to assistive technology; assesses the problems and capacities of individuals; links individuals to the opportunities available; to the maximum extent practicable, ensures that individuals receive the services needed, and are aware of opportunities available, by establishing adequate follow-up procedures. The former service Referral is included in this definition. Legal (WVSLA only) 1 Hour Title III WVSLA only Consumer Group Service To provide legal advice and representation by an attorney (including counseling or other appropriate assistance by a paralegal or law student under the supervision of an attorney, or representation by a non-lawyer where permitted by law) to seniors with 12

15 SERVICE DEFINITIONS (cont.) Legal (WVSLA only) (cont.) economic and/or social needs. Legal services may include resolution of non-criminal legal matters, protection of legal rights, securing rights and entitlement, tax and financial counseling, advocacy on consumer concerns, referrals to (other) lawyers, income tax preparation, and will clinics. LIFE In-Home Respite 1 Hour LIFE, Title III Roster Temporary, substitute supports or living arrangements delivered in the home to provide a brief period of relief or rest for caregivers. Lighthouse Personal Care 1 Hour Lighthouse Roster In-home personal care, mobility, nutrition, and environmental services for medically eligible individuals age 60 or over. Nutrition Counseling 1 Hour LIFE Roster One-on-one advice and guidance to individuals who are at nutritional risk because of their history, current dietary intake, medication use, or chronic illnesses. Options and methods for improving their nutritional status must be provided by a registered dietitian or other health professional functioning within his/her legal scope of practice. Nutritional Health Assessment form must be completed for each Nutrition Counseling client. Nutrition Education 1 Session LIFE Consumer Group Service To promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to clients and caregivers in a group or individual setting. 13

16 SERVICE DEFINITIONS (cont.) Nutrition Education (cont.) Any program offered as Nutrition Education must be reviewed/approved by a registered dietician or individual of comparable expertise. This would minimally include the review of the agenda and training materials. Once approved, the training may be repeated. Outreach 1 Contact LIFE, Title III Roster To seek out and identify inactive (one year or longer) or previously unknown individuals and to encourage them to utilize existing services and benefits. Outreach visits may also be used as a means of clarifying the needs of an already identified client when it is determined assistance cannot be provided by phone or in the office. This service can also be initiated by a telephone contact (e.g., by utilizing a list of potential clients from another agency, but not a referral). Coordinating Title III or LIFE services for a new client can be counted as an Outreach unit. If, while performing other responsibilities in the field (e.g., taking LIEAP application), a new client is found and the individual s situation and related needs are evaluated, an Outreach unit may be counted. Personal Care 1 Hour LIFE, Title III Roster To provide personal assistance, stand-by assistance, supervision, or cues for persons having difficulties with one or more of the following five activities of daily living: eating, dressing, bathing, toileting, and transferring in and out of bed. 14

17 SERVICE DEFINITIONS (cont.) Tax/Other Financial Related Assistance 1 Hour LIFE Consumer Group Service Provision of tax or financial counseling or related advocacy. Examples include information about and assistance with Homestead Exemption, insurance and every day IADL related functions. Title III In-Home Respite 1 Hour Title III Roster Temporary, substitute supports or living arrangements delivered in the home to provide a brief period of relief or rest for caregivers. Transportation 1 Trip, one way LIFE, Title III Roster To provide a vehicular means of transportation for a person who requires help in going from one location to another. Does not include any other activity. Transportation to each destination is considered a unit. Recreational travel cannot be counted. 15

18 INSTRUCTIONS/EXPLANATION FOR REPORTING SERVICE UNITS MEASURED BY THE HOUR Rounding up may make the service logs add up to more hours in the day than are reported on the time sheet (e.g., the time sheet shows 8 hours but if the data would be cross-referenced with the Roster, it may add up to 10 hours). It is an accepted practice in social work to round up to the nearest 1/4 hour (.25 units). Although it may sometimes cause the daily logs to total more than the workday time sheet, supervisors would rarely cross-reference the two documents. If the documents were to be cross-referenced, the supervisor would quickly recognize that rounding up would cause this appearance of mismatch. Individual Client Support is delivered from a Roster and the unit of measure is one hour. A Roster is generated monthly for all single services. A unit of measure is counted based on one hour: 1/4 Hour =.25 Unit 1/2 Hour =.50 Unit 3/4 Hour =.75 Unit 1 Hour = 1 Unit A unit is always rounded up to the nearest 1/4 hour. Examples: 1. If a client is served for 5 minutes, the recording log would reflect.25 unit (or 1/4 hour) for that day. 2. If a client is served for 25 minutes, the recording log would reflect.50 unit (or 1/2 hour) for that day. Group Client Support is a group service and the unit of measure is one hour. A Group Service is delivered using the Consumer Group template. A unit is counted based on one hour: 1/4 Hour =.25 Unit 1/2 Hour =.50 Unit 3/4 Hour =.75 Unit 1 Hour = 1 Unit 16

19 A unit is always rounded up to the nearest 1/4 hour. Example: Twenty-five clients were served. It took 40 minutes (3/4 Hour =.75 Unit) to complete the service. Units Delivered =.75 Clients Served = 25 17

20 GROUP MEALS Reporting Procedure for Meals Served at Special Events There are two options for reporting these meals: Option 1: The standard process of completing the BIF and Service Roster may be used. Option 2: The provider submits a letter of documentation to the area agency when a group meal is provided. The letter should include the following: 1. A certification that the meal provided meets one-third RDA and that foods of U.S. origin were utilized (e.g., dietician approved menu). 2. The number of 60+ persons and eligible spouses who received the meal. 3. Explanation as to why the normal reporting procedure could not be followed (e.g., county picnic, special event). NOTE: For meals provided on a regular basis such as Manna Meals, Homeless Meals, etc., a BIF and Service Roster must be completed. 18

21 PROGRAM DESCRIPTORS NAME Activities of Daily Living (ADLs) At-Risk, Frail Elderly (A.R.E.) Caregiver Congregate Meal (C1) DESCRIPTION Bathing, dressing, eating, walking in home, transferring, toileting. Those older individuals who are in jeopardy of institutionalization due to a documentable mental or physical impairment, or a combination of both, that results in substantial functional limitations in two or more activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Individuals potentially able to be deinstitutionalized with the availability of adequate support systems who meet the above criteria would also be defined as A.R.E. Older individuals who are victims of Alzheimer's disease or a related disorder with neurological and/or organic brain dysfunction are classified as A.R.E. individuals for reporting purposes. Older individuals who have a permanent physical disability that severely limits their independence (e.g., blind or confined to a wheelchair) are classified as A.R.E. individuals for reporting purposes. A person who is an informal provider of in-home care to an older individual. (Informal means that the care is not provided as part of a public or private formal service program.) A person who provides a service under FAIR/Title III is considered a caregiver and is eligible to be BIF d and entered into the database. A caregiver can be an individual of any age who is the primary individual taking care of the care receiver. The caregiver may or may not be living with the care receiver. The completion of a BIF on the caregiver is due to AoA s emphasis on caregiving. In the FAIR program, the caregiver is an informal provider of in-home care to an individual with Alzheimer s or a related dementia. Eligible individuals include the following: (a) persons age 60+; (b) spouses of clients, regardless of age; (c) handicapped/disabled individuals who have not attained 60 years of age, but reside in housing facilities primarily occupied by the elderly at which a congregate nutrition program is offered; (d) individuals with disabilities who reside at the home of eligible participants and accompany them to the congregate site; 19

22 PROGRAM DESCRIPTORS (cont.) Congregate Meal (C1), cont. Congregate Meal Sites Deleting or Merging a Client Eligibility of a Handicapped Person Eligibility of a Person Under 60 (e) individuals who are temporarily incapacitated/ill and receive a carry-out meal; and (f) individuals who are eligible for a carry-out meal based on a justified exception. See Carry-Out Meal Policy for (e) and (f). Volunteers under the age of 60 working at the nutrition site are eligible for meals, provided the individual is an ongoing volunteer of the program and works a minimum of 24 hours per quarter (3-month period). Volunteers who are 60+ are automatically eligible for a meal. Those facilities and/or locations where congregate meals are served to eligible persons, the cost of which is supported in whole or part by Title III funds. Deleting a client is not the same as inactivating a client. A client is merged when the client has been issued more than one client number and is listed in the consumer more than once. (The services under the duplicate number MUST be combined with the original client.) The provider notifies a SAMS administrator with the information to accomplish the task via a phone call or . Deletes will not be allowed unless a Merge takes place facilitating a consumer without services. Meals: If a handicapped person is living in a senior housing facility that is a meal site or is under 60 and living with an eligible client, the handicapped person is eligible for meals. Bus/Van Transportation: A handicapped person is eligible for transportation service regardless of age. Older Americans Act: Except for the services listed above, no Older Americans Act services are available to an individual who is UNDER 60 years of age. Person is the spouse of an eligible client Meals only. Volunteer Must meet specific criteria (see Volunteers). Handicapped and resides with an eligible client (see Eligibility of a Handicapped Person). 20

23 PROGRAM DESCRIPTORS (cont.) Ensure FAIR Farmers Market Greatest Economically Needy (GEN) Greatest Socially Needy (GSN) Two cans of Ensure can be counted as a meal ONLY when a doctor has indicated that person needs Ensure in lieu of a meal; otherwise, Ensure is not counted. This can be counted as Congregate or Home-Delivered based on who is served the Ensure and where most would probably be Home-Delivered. This is in the home-delivered meal policy and nutrition contract. Family Alzheimer s In-Home Respite This is a Title IIIB service and it must have been budgeted and projected in the provider's annual projections in order to count as Outreach or Group Client Support. If this service is counted as Outreach, a BIF must be completed for each consumer. If this service is counted as a Group Client Support service, no BIF is required. The criteria are based on figures defined by the U.S. Department of Health and Human Services as income level at or below the poverty line. A means test is not to be used to determine greatest economic need. Refer to the current year poverty guidelines (issued every January). Those elderly individuals having non-economic factors that include physical and mental disabilities, language barriers, and cultural or social isolation including that caused by racial or ethnic status, which restrict ability to perform normal daily tasks or threaten capacity to live independently. An individual would be classified as GSN if he/she is a resident of a long-term care facility, has a disability not fully corrected, or needs assistance to leave the home. OR An individual would be classified as GSN if any two of the following factors apply: client is a member of a racial or ethnic minority group, is over 75 years of age, lacks a telephone, has a language/literacy barrier, lives alone, or lacks means of transportation. 21

24 PROGRAM DESCRIPTORS (cont.) Group Client Support Home-Delivered Meals (C2) Household Inactivate a Client Individual Client Support Instrumental Activities of Daily Living (IADLs) Includes Assessment, Instruction/Training, and Material Aid. Eligible individuals include the following: (a) persons 60+ who are homebound by reasons of illness, incapacitating disability, or are otherwise isolated (must meet GSN criteria); (b) the spouse of an eligible Home-Delivered Meals client regardless of age or condition, if it is in the best interest of the homebound older person; (c) individuals with disabilities who reside at the home of persons eligible for this service. Includes all the persons who occupy a housing unit. A housing unit is a house, an apartment, a mobile home, a group of rooms, or a single room that is occupied (or if vacant, is intended for occupancy) as separate living quarters. Separate living quarters are those in which the occupants live and eat separately from any other persons in the building and which have direct access from the outside of the building or through a common hall. The occupants may be a single family, one person living alone, two or more families living together, or any other group of related or unrelated persons who share living arrangements. (People not living in households are classified as living in group quarters.) Inactivating a client is not the same as deleting a client. A client should only be inactivated when the client has NOT received services from another provider, client moves out of state, or client passes away during the current fiscal year. Includes: Chore, Counseling, Discount, Home Repair, Housing, Assistance, Letter Reading/Writing, Prescription Aid, Telephoning, Visiting, Crisis Intervention, and Home Care. Transportation, meal preparation, shopping, light housekeeping, manage money, heavy housework, telephone, managing medications. 22

25 PROGRAM DESCRIPTORS (cont.) Legislative Initiative For the Elderly (LIFE) Lighthouse Living Alone Low Income Minority Status The West Virginia Legislature provides lottery proceeds for direct services for seniors. LIFE funds can be used in support of existing Title III or former Senior Support services and/or provision of new Title III or former Senior Support services, as listed in the Client Tracking Dictionary. Personal Care Services. ANY MONEY received for Lighthouse must be used for Lighthouse only. A one-person household where the householder lives by himself or herself in an owned or rented place of residence in a non-institutional setting, including board and care facilities, assisted living units, and group homes. See Greatest Economically Needy (GEN). Minority older persons are confined to the following designations: American Indian or Alaskan Native: A person having origins in any of the original peoples of North America (including Central America), and who maintains tribal affiliation or community attachment. Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian subcontinent for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. Black or African American: A person having origins in any of the black racial groups of Africa. Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa or other Pacific Islands. (FYI White: A person having origins in any of the peoples of Europe, the Middle East, or North Africa.) 23

26 PROGRAM DESCRIPTORS (cont.) Nutritional Health Assessment Rural Title III Volunteers A tool to determine a client's nutritional risk status. The assessment must be completed for recipients of Case Management, Nutrition Counseling, and Home- Delivered Meals. An area that is not urban. Urban areas comprise (1) a central place and its adjacent densely settled territories with a combined minimum population of 50,000 and (2) an incorporated place or a census-designated place with 20,000 or more inhabitants. This is the U. S. Administration on Aging s definition as modified from the U. S. Census Bureau. Services of the Older Americans Act include: III-B Supportive services such as transportation, shopping, and in-home services which are coordinated through the senior center. III-C Nutrition services, congregate (C1), and home-delivered (C2) meal programs. III-D Disease Prevention and Health Promotion services focus on health programs that assist in self-improvement and awareness of health issues. III-E National Family Caregiver Support Program provides support to individuals who care for frail, older family members. Persons who work at least 24 hours per quarter in the Aging Program. These individuals may be reimbursed for out-of-pocket expenses relative to their volunteer work. Paid staff, regardless of funding source, are not classified as volunteers for reporting purposes. The fact that a volunteer may be reimbursed for miscellaneous expenses does not define him/her as paid staff. Board and advisory council members of the Aging Program are not classified as volunteers. 24

27 SECTION 1 West Virginia Bureau of Senior Services Client Tracking Contact Information West Virginia Bureau of Senior Services Area Agency Designation West Virginia Providers and Sites West Virginia Provider Information and Service Array 25

28 WEST VIRGINIA BUREAU OF SENIOR SERVICES CLIENT TRACKING Address: 26 North Kanawha Street, Suite 101 Buckhannon, WV Telephone: , Fax: Contacts: Jack Adrian Mary Cameron WEST VIRGINIA BUREAU OF SENIOR SERVICES SAMS CONTACT Address: 1900 Kanawha Boulevard, East Charleston, WV Telephone: Fax: Contact: Susan Silverman 26

29 West Virginia Bureau of Senior Services Area Agency Designation Northwestern Area Agency on Aging Post Office Box Bridge Street Plaza Wheeling, WV Phone: Fax: Website: waaa.htm WVSC-Metro Area Agency on Aging 1 Dunbar Plaza Suite 102 Dunbar, WV Phone: Fax: landerbr@wvstateu.edu Website: metro-aaa/metro-aaa Upper Potomac Area Agency on Aging Post Office Box 869 Petersburg, WV Phone: Fax: upaaa@regioneight.org Website: index.html Appalachian Area Agency on Aging 1460 Main Street, Box 2 Princeton, WV Phone: Fax: stanleyramona@citlink.net Website: 27

30 PROVIDERS AND SITES (includes old site code numbers as further point of reference) REGION 1 Provider Sites Bi-County in Harrison (nutrition) Bridgeport Manor C Lost Creek C Lost Creek C Nutter Fort C Nutter Fort C Nutter Fort MOW Salem C Salem C Shinnston C Shinnston C Bi-County Nutrition in Doddridge (nutrition) West Union C West Union C Brooke County Committee on Aging Brooke County Hancock Brooke Hancock Nutrition in Brooke Follansbee Freedom Place Wellsburg Windsor Heights Brooke Hancock Nutrition in Hancock Chester New Cumberland Weirton Sr. Center Calhoun County Committee on Aging Calhoun County Westfork Site Committee for Hancock County Senior Citizens Hancock County L Hartung No Name Transportation/John Transportation/Mini Transportation/Jerry Wellness Center Council of Senior Citizens of Gilmer County Gilmer County Gilmer County Mike Tomey Roger Weese Council of Senior Tyler Countians Middlebourne Site Sistersville Site Tyler Co

31 PROVIDERS AND SITES (cont.) Provider Sites Doddridge County Senior Citizens Ara Lee Kelley Charles Hawkins Debbie Montoya Diane McKinney Forest Plauger Jackie Lebel Jean Heflin Jim Weekley Ronna Lipscomb Sharon Scott Family Service Upper Ohio Valley Family Services Harrison County Senior Citizens Adrian Alonso Art Malcolm Dexter VanGilder Glenn Wilson Harrison Co Sr Ctr Marvin Minor Randy Lantz Rodney Lowther In Touch and Concerned In Touch & Concerned Marion County Senior Citizens David Summers Downtown-Route East Side Fairmont Site Fairview Juanita Satterfield Mannington Marion Senior Center MCSC Van Transport Rivesville Victoria Nichols Marshall County Committee on Aging Marshall County Ohio Family Services in Brooke Fam. Serv. Brooke Ohio Family Services in Hancock Fam. Serv. Hancock Hancock Co

32 PROVIDERS AND SITES (cont.) Provider Sites Ohio Family Services in Marshall Benwood Cameron Fam. Serv. Marshall Golden Towers Ohio Family Services in Ohio Human Resources Ohio Ohio Ohio Co Ohio Co Ohio Home Care Warwood Ohio Family Services in Wetzel Hundred New Martinsville New Martinsville Tower Pine Grove Wetzel Pleasants County Senior Citizens Center Pleasants Co Pleasants Senior Nutrition St. Marys Nutrition Ritchie County Integrated Family Services Harrisville Site Pennsboro Site Ritchie Co Senior Monongalians Arnettsville Chestnut Hills Core Site Mall Site Monongalia County Home Delivered Unity House Unity Manor Wetzel County Committee on Aging Wetzel Site Wirt County Committee on Aging Elizabeth Site Wirt County Wood County Senior Citizens Association Market St Mineral Wells Site Unity Plaza Vienna Site Williamstown Site Wood County

33 PROVIDERS AND SITES (cont.) REGION 2 Provider Boone County Community Services Organization Cabell County Community Services Organization Coalfield Community Action Partnership/ Mingo Sites Boone Co Office Laurel City Laurel City C Madison Madison C Morrisvale Racine Racine C Van Van C Wharton Whitesville Whitesville C Cabel-Hunt Care Manager Christine Palmer Kitchen FF E Van FF East FF West Marie Redd Senior Milton My Friends House Salt Rock West Westview Manor Concerned Citizen Delbarton Center Gilbert Kermit Mary E Brown Mingo EOC Jackson County Commission on Aging Jackson County Jackson County Kenna Ravenswood Ripley Sandyville

34 PROVIDERS AND SITES (cont.) Provider Sites Kanawha Valley Senior Services Carver Cedar Grove Chesapeake Clendenin 14 East Bank Hansford 17 KVSS Office Putnam Lighthouse Sissonville 22 Lincoln County Opportunity Co. Hamlin Harts Lincoln Comm Carr Logan Lighthouse McCorkle Ctr (SW CAC) West Hamlin Mason County Action Group Hartford Mason Mason County Point Pleasant PRIDE in Logan County Chapmanville Towers McDade Hall Mill Creek Pride in Logan Wesley House Putnam Aging Program Buffalo Hometown Hurricane Nitro-Putnam Putnam Office Putnam Nutrition in Clay Maysel Manor Maysel Manor

35 PROVIDERS AND SITES (cont.) Provider Sites Putnam Nutrition in Kanawha Cans Cans Chelyan Chesapeake Clendenin 14 Clendenin Dunbar East End Family Res Elkview Elkview Home Delivered Hansford 17 Hansford Nitro Nitro Rand Rand Shawnee Shawnee Sissonville Sissonville 22 South Charleston South Charleston Roane County Committee on Aging Roane County Roane Senior Ctr Wayne County Community Services Adkins-Rollins Organization Bison Dunlow Fort Gay Stepptown MP SC Wayne Westmoreland NC

36 PROVIDERS AND SITES (cont.) REGION 3 Provider Sites Aging and Family Services of Mineral County Elk Garden Site Frankfort Site Keyser Site Mineral Co Piedmont Barbour County Senior Center Baughman Frozen Baughman Towers Belington Frozen Belington Site Philippi Frozen Philippi Site Berkeley Senior Services Ambrose Towers High Street North Berk Satellite Senior Towers Stonewall Woodbury Apts Grant County Commission on Aging Dorcas Congregate Grant County Maysville Congregate Mt Storm Congregate Hampshire County Committee on Aging Capon Bridge Mildred Pfeil Adult Romney Site Springfield Site Hardy County Committee on Aging Hardy Co Mathias Nutrition Site Moorefield Nutrition Site Wardensville Site Jefferson County Council on Aging Blue Ridge Mtn Breakfast/Jeff Co Charles Towers Harpers Ferry Site Ranson Site

37 PROVIDERS AND SITES (cont.) Provider Sites Lewis County Senior Citizens Center 92 Dodge Van Jane Lew Site Junior Southern Lewis Co Suburban-Gary Trans/Larry Hammond Trans/Rick Trans-Marie Trans-Ron Weston Arbors Weston Site Pendleton Senior and Family Services Brandywine Franklin Franklin Ensure Hoover Loveain Warner Trans Peggy Thompson Pendleton County Phyllis Sue Raines Riverton Bus Riverton Ensure Preston County Senior Citizens Kingwood Site Newburg Site North Preston Site Preston Senior Ctr Rowlesburg Site Terra Alta Site Tunnelton Site Union District Valley District Randolph County Domestic and Training Randolph Domestic Senior Life Services of Morgan County Berkeley Springs Chrysler Paw Paw Van # Van # Van Van

38 PROVIDERS AND SITES (cont.) Provider Sites Taylor County Senior Citizens Eliz Cather Towers Flemington Site Grafton Site Nancy Poling Taylor County The Committee on Aging for Randolph County Elkins Manor Elkins Site Harman Mill Creek Site Rand Life Juanita D Randolph Co Tucker County Senior Citizens Parsons Site Thomas/Davis Upshur County Senior Citizens Opportunity Buckhannon Manor C Center Buckhannon Site Ellamore Rock Cave Upshur County

39 PROVIDERS AND SITES (cont.) REGION 4 Provider Sites Braxton County Senior Citizens Center Betty Braxton Van Braxton Co Site Braxton Van Trans Dewey Trans. Russel C Clay County Development Corp. Arlene Cloutier Betty Moore Clay County Correna Schoonover Elizabeth Hickman Molly Hypes Council on Aging (Wyoming County) Bus Bus Bus Bus Bus Bus Bus Bus Bus Bus Bus 38 Bus Elklick Itmann McDowell Co Wyoming Co Fayette County Office Ansted Site Meadow Bridge Site Oak Hill Site Smithers Site Greenbrier County Committee on Aging Alderson Lewisburg W Greenbrier Senior Ctr White Sulphur Springs Williamsburg

40 PROVIDERS AND SITES (cont.) Provider Sites McDowell County Commission on Aging Bradshaw Iaeger Keystone McDowell County War Welch Mercer CASE Senior Center Bluefield Nutrition Bluefield Salvation Army Nut Bob David s Bus Debbie Richardson Kimberly Linda Natoake Nutrition No Name Princeton Sr Center Nut Sandy Lawrence Sarah Byrd Skip Special Trips Prin Trans. Brian Trent St Nutrition Monroe County Council on Aging Alderson Monroe Senior Center Union Nicholas Community Action Partnership Craigsville Extended Route Leivasy Richwood Summersville Nicholas County Senior Center Russell Hines Pocahontas County Senior Program Green Bank Marlinton Site Raleigh County Commission on Aging Beckley Senior Center Coal City Comm. Center Fayette Manor House Mercer County Pettus RB Tech Center Raleigh Co Wildwood House

41 PROVIDERS AND SITES (cont.) Provider Sites Summers County Council on Aging Hinton/Summers Co Pipestem Special Trip Wheelchair Webster County Commission of Senior Citizens Camden on Gauley Forest Park Hackers Valley Site Webster Springs Site

42 AGING AND FAMILY SERVICES OF MINERAL COUNTY (Region 3) Address: 1 South Main Street Keyser, WV Telephone: Fax: Contact: Website: Director: Scott Mallery smallery@wvaging.com R. Scott Mallery Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Case Management Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information & Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Title III In-Home Respite Transportation Sites: Elk Garden Site Frankfort Site Keyser Site Mineral Co Piedmont

43 BARBOUR COUNTY SENIOR CENTER, INC. (Region 3) Address: P O Box 146 (101 Church Street) Philippi, WV Telephone: Fax: Contact: Website: Director: Brenda Wilmoth bcsc@bcscwv.org Brenda Wilmoth Services Provided: Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Medication Management Individual Client Assistance Information and Assistance Lighthouse Personal Care Title III In-Home Respite Transportation Sites: Baughman Frozen Baughman Towers Belington Frozen Belington Site Philippi Frozen Philippi Site

44 BERKELEY SENIOR SERVICES (Region 3) Address: 217 North High Street Martinsburg, WV Telephone: Fax: Contact: Website: Director: Beverly Gerlach Linda Holtzapple Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Chore Congregate Meals Congregate Respite FAIR Alzheimer s In Home Respite FAIR Congregate Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Legal Assistance Lighthouse Personal Care Nutrition Education Outreach Title III In Home Respite Transportation Sites: Ambrose Towers High Street North Berk Satellite Senior Towers Stonewall Woodbury Apts

45 BI-COUNTY IN HARRISON (Region 1) Address: 416½ Ohio Avenue Nutter Fort, WV Telephone: Fax: Contact: Director: Wanda Carrico Wanda Carrico Services Provided: Congregate Meals Home-Delivered Meals Sites: Bridgeport Manor C Lost Creek C Lost Creek C Nutter Fort C Nutter Fort C Nutter Fort MOW Salem C Salem C Shinnston C Shinnston C

46 BI-COUNTY NUTRITION IN DODDRIDGE (Region 1) Address: 416½ Ohio Avenue Nutter Fort, WV Telephone: Fax: Contact: Director: Wanda Carrico Wanda Carrico Services Provided: Congregate Meals Home-Delivered Meals Sites: West Union C West Union C

47 BOONE COUNTY COMMUNITY SERVICES ORGANIZATION (Region 2) Address: P O Box 247 (347 Kenmore Drive, Suite 1-A) Madison, WV Telephone: ; Fax: Contact: Director: Sara Bowe bcco.jeaster@suddenlinkmail.com Judy Easter Services Provided: Adult Day Care Assisted Transportation Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Boone Co Office Laurel City Laurel City C Madison Madison C Morrisvale Racine Racine C Van Van C Wharton Whitesville Whitesville C

48 BRAXTON COUNTY SENIOR CITIZENS, INC. (Region 4) Address: 33 Senior Center Drive Sutton, WV Telephone: ; ; ; Fax: Contact: Director: Mary Chapman Mary Chapman Services Provided: Adult Day Care Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Case Management Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Nutrition Counseling Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Betty Braxton Van Braxton Co Site Braxton Van Trans Dewey Trans. Russel C

49 BROOKE COUNTY COMMITTEE ON AGING (Region 1) Address: 948 Main Street Follansbee, WV Telephone: Fax: Contact: Website: Director: Laura Beckelhimer Joy Crawford Services Provided: Adult Day Care Assisted Transportation Caregiver Information and Assistance Caregiver Training Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite FAIR Congregate Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Brooke County Hancock

50 BROOKE HANCOCK NUTRITION IN BROOKE (Region 1) Address: 948 Main Street Follansbee, WV Telephone: Fax: Contact: Director: Laura Beckelhimer Joy Crawford Services Provided: Congregate Meals Group Congregate Meals Home-Delivered Meals Sites: Follansbee Freedom Place Wellsburg Windsor Heights

51 BROOKE HANCOCK NUTRITION IN HANCOCK (Region 1) Address: 948 Main Street Follansbee, WV Telephone: Fax: Contact: Director: Laura Beckelhimer Joy Crawford Services Provided: Congregate Meals Group Congregate Meals Home-Delivered Meals Sites: Chester New Cumberland Weirton Sr. Center

52 CABELL COUNTY COMMUNITY SERVICES ORGANIZATION, INC. (Region 2) Address: th Avenue Huntington, WV Telephone: Fax: Contact: Website: Director: Rose Holley Robert E. Roswall Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Cabel-Hunt Care Manager Christine Palmer Kitchen FF E Van FF East FF West Marie Redd Senior Milton My Friends House Salt Rock West Westview Manor

53 CALHOUN COUNTY COMMITTEE ON AGING, INC. (Region 1) Address: P O Box 434 (#3 Market Street) Grantsville, WV Telephone: ; Fax: Contact: Website: Director: Rick Poling rpoling@cccoa-wv.org Rick Poling Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Congregate Meals FAIR Alzheimer s In-Home Respite FAIR Congregate Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Calhoun County Westfork Site

54 CLAY COUNTY DEVELOPMENT CORPORATION (Region 4) Address: P O Box 455 (174 Main Street) Clay, WV Telephone: Fax: Contact: Website: Director: Pamela Boggs claycountyseniorcenter@hotmail.com Pamela Taylor Services Provided: Adult Day Care Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Case Management Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Nutrition Counseling Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Arlene Cloutier Betty Moore Clay County Correna Schoonover Elizabeth Hickman Molly Hypes

55 COALFIELD COMMUNITY ACTION PARTNERSHIP, INC. (MINGO) (Region 2) Address: P O Box 1406 (815 Alderson Street) Williamson, WV Telephone: Fax: Contact: Director: Dalena Jewell tsalmons@coalfieldcap.org Tim Salmons Services Provided: Assisted Transportation Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Transportation Sites: Concerned Citizen Delbarton Center Gilbert Kermit Mary E Brown Mingo EOC

56 COMMITTEE FOR HANCOCK COUNTY SENIOR CITIZENS (Region 1) Address: P O Box 1284 (647 Gas Valley Road) New Cumberland, WV Telephone: Fax: Contact: Website: Director: Mark Knabenshue emknabenshue@hancocksrsvs.org Mark Knabenshue Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training FAIR Alzheimer s In-Home Respite Group Client Support III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Legal Assistance Lighthouse Personal Care Outreach Personal Care Title III In-Home Respite Transportation Sites: Hancock County L Hartung No Name Transportation/John Transportation/Mini Transportation/Jerry Wellness Center

57 COUNCIL OF SENIOR CITIZENS OF GILMER COUNTY (Region 1) Address: 720 North Lewis Street Glenville, WV Telephone: Fax: Contact: Director: Jo Ann McHenry Sallie Mathess Services Provided: Assisted Transportation Caregiver Information and Assistance Caregiver Training Chore Congregate Meals FAIR Alzheimer s In-Home Respite FAIR Congregate Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Gilmer County Gilmer County Mike Tomey Roger Weese

58 COUNCIL OF SENIOR TYLER COUNTIANS, INC. (Region 1) Address: P O Box 68 (504 Cherry Street) Middlebourne, WV Telephone: Fax: Contact: Director: Amy Haught amy.cstcwv@frontier.com Amy Haught Services Provided: Assisted Transportation Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Nutrition Education Outreach Title III In-Home Respite Transportation Sites: Middlebourne Site Sistersville Site Tyler Co

59 COUNCIL ON AGING (WYOMING COUNTY) (Region 4) Address: P O Box 130 (Old Itmann School Building, Route 10) Itmann, WV Telephone: ; Fax: Contact: Website: Director: Jennifer Gibson gibsonj@wccoa.com Jennifer Gibson Services Provided: Assisted Transportation Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Personal Care Title III In-Home Respite Transportation Sites: Bus Bus Bus Bus Bus Bus Bus Bus Bus Bus Bus Bus Elklick Itmann McDowell Co Wyoming Co

60 DODDRIDGE COUNTY SENIOR CITIZENS, INC. (Region 1) Address: P O Box 432 (403 West Main Street) West Union, WV Telephone: Fax: Contact: Director: Jackie Lebel dcscoffice@gmail.com Marvin "Smokey" Travis Services Provided: Assisted Transportation Chore FAIR Alzheimer s In-Home Respite FAIR Congregate Respite Group Client Support Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Ara Lee Kelley Charles Hawkins Debbie Montoya Diane McKinney Forest Plauger Jackie Lebel Jean Heflin Jim Weekley Ronna Lipscomb Sharon Scott

61 FAMILY SERVICE UPPER OHIO VALLEY (Region 1) Address: 51 11th Street Wheeling, WV Telephone: ; Fax: Contact: Website: Director: Lonnie Wineman Lonnie Wineman Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Congregate Respite Group Client Support Group Congregate Meals III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Transportation Sites: Family Services

62 FAYETTE COUNTY OFFICE (Region 4) Address: P O Box 770 (108 Lewis Street) Oak Hill, WV Telephone: Fax: Contact: Director: Beth Burdette jszamiela@yahoo.com Janet Zamiela Services Provided: Adult Day Care Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Case Management Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Counseling Nutrition Education Outreach Personal Care Title III-In Home Respite Transportation Sites: Ansted Site Meadow Bridge Site Oak Hill Site Smithers Site

63 GRANT COUNTY COMMISSION ON AGING (Region 3) Address: 111 Virginia Avenue Petersburg, WV Telephone: Fax: Contact: Website: Director: Dottie Oates Darlene Keplinger Services Provided: Assisted Transportation Caregiver Information and Assistance Caregiver Training Congregate Meals FAIR Alzheimer s In-Home Respite FAIR Congregate Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Personal Care Title III In-Home Respite Transportation Sites: Dorcas Congregate Grant County Maysville Congregate Mt Storm Congregate

64 GREENBRIER COUNTY COMMITTEE ON AGING (Region 4) Address: P O Box 556 (1003 Greenbrier Street) Rupert, WV Telephone: Fax: Contact: Director: Ann Pence gcca@suddenlinkmail.com John Wyman Services Provided: Adult Day Care Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Case Management Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Counseling Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Alderson Lewisburg W Greenbrier Senior Ctr White Sulphur Springs Williamsburg

65 HAMPSHIRE COUNTY COMMITTEE ON AGING (Region 3) Address: P O Box 41 (Route 50 East) Romney, WV Telephone: (TDD); ; Fax: Contact: Website: Director: Dana Hott Diane Smith (nutrition only) aginginhamp@hardynet.com Sandra Viselli Services Provided: Adult Day Care Congregate Meals FAIR Alzheimer s In-Home Respite Home-Delivered Meals III-D Group Client Support III-D Medication Management Individual Client Support Lighthouse Personal Care Title III In-Home Respite Transportation Sites: Capon Valley View Mildred Pfeil Adult Romney Site Springfield Site

66 HARDY COUNTY COMMITTEE ON AGING (Region 3) Address: P O Box 632 (409 Spring Avenue) Moorefield, WV Telephone: ; Fax: Contact: Director: Arlene Coon hccoa1@hardynet.com Phyllis Helmick Services Provided: Adult Day Care Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance Individual Client Support Information and Assistance Lighthouse Personal Care Sites: Hardy Co Mathias Nutrition Site Moorefield Nutrition Site Wardensville Site

67 HARRISON COUNTY SENIOR CITIZENS, INC. (Region 1) Address: 500 West Main Street Clarksburg, WV Telephone: Fax: Contact: Website: Director: Cindy Freeman Cindy Freeman Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Training Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Legal Assistance Lighthouse Personal Care Personal Care Title III-In Home Respite Transportation Sites: Adrian Alonso Art Malcolm Dexter VanGilder Glenn Wilson Harrison Co Sr Ctr Marvin Minor Randy Lantz Rodney Lowther

68 IN TOUCH AND CONCERNED (Region 1) Address: 693 Fairmont Road Morgantown, WV Telephone: Fax: Contact: Website: Director: Valerie Hose Romec Valerie Hose Romec Services Provided: Assisted Transportation Individual Client Support Information and Assistance Transportation Sites: In Touch & Concerned

69 JACKSON COUNTY COMMISSION ON AGING, INC. (Region 2) Address: P O Box 617 (121 South Court Street) Ripley, WV Telephone: Fax: Contact: Website: Director: Amanda Hanna jccoawv@hotmail.com Gerry Dunbar Services Provided: Assisted Transportation Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Lighthouse Personal Care Outreach Personal Care Title III In-Home Respite Transportation Sites: Jackson County Jackson County Kenna Ravenswood Ripley Sandyville

70 JEFFERSON COUNTY COUNCIL ON AGING (Region 3) Address: 103 West 5th Street Ranson, WV Telephone: Fax: Contact: Amy Wellman Acting Director: Amy Wellman Services Provided: Adult Day Care Assisted Transportation Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Education Outreach Transportation Sites: Blue Ridge Mtn Breakfast/Jeff Co Charles Towers Harpers Ferry Site Ranson Site

71 KANAWHA VALLEY SENIOR SERVICES (Region 2) Address: 2428 Kanawha Boulevard, East Charleston, WV Telephone: Fax: Contact: Website: Director: Vicki Stanley Vacant Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Individual Client Support Information and Assistance LIFE In Home Respite Lighthouse Personal Care Nutrition Education Outreach Title III In-Home Respite Transportation Sites: Carver Cedar Grove Chesapeake Clendenin 14 East Bank Hansford 17 KVSS Office Putnam Lighthouse Sissonville 22 69

72 LEWIS COUNTY SENIOR CITIZENS CENTER, INC. (Regions 1 and 3) Address: 171 West 2nd Street Weston, WV Telephone: , Fax: Contact: Website: Director: Dinah Mills dinahlynnmills@aol.com Dinah Mills Services Provided: Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: 92 Dodge Van Jane Lew Site Junior Southern Lewis Co Suburban-Gary Trans/Larry Hammond Trans/Rick Trans-Marie Trans-Ron Weston Arbors Weston Site

73 LINCOLN COUNTY OPPORTUNITY CO., INC. (Region 2) Address: 360 Main Street Hamlin, WV Telephone: Fax: Contact: Website: Director: Kathy Curry Alice Tomblin Services Provided: Assisted Transportation Congregate Meals Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Nutrition Education Outreach Title III In-Home Respite Transportation Sites: Hamlin Harts Lincoln Comm Carr Logan Lighthouse McCorkle Ctr (SW CAC) West Hamlin

74 MARION COUNTY SENIOR CITIZENS, INC. (Region 1) Address: 105 Maplewood Drive Fairmont, WV Telephone: Fax: Contact: Website: Director: Sandra Thomas Debbie Harvey Services Provided: Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Education Outreach Tax/Other Financial Related Assistance Title III In-Home Respite Transportation Sites: David Summers Downtown-Route East Side Fairmont Site Fairview Juanita Satterfield Mannington Marion Senior Center MCSC Van Transport Rivesville Victoria Nichols

75 MARSHALL COUNTY COMMITTEE ON AGING (Region 1) Address: 805 5th Street Moundsville, WV Telephone: Fax: Contact: Website: Director: Joyce Howard Joyce Howard Services Provided: Assisted Transportation Chore Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Lighthouse Personal Care Personal Care Title III In-Home Respite Transportation Sites: Marshall County

76 MASON COUNTY ACTION GROUP, INC. (Region 2) Address: 101 2nd Street Point Pleasant, WV Telephone: Fax: Contact: Website: Director: Melissa Wolfe Renae Riffle Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Case Management Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite FAIR Congregate Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Nutrition Counseling Nutrition Education Outreach Personal Care Transportation Sites: Hartford Mason Mason County Point Pleasant

77 McDOWELL COUNTY COMMISSION ON AGING (Region 4) Address: 725 Stewart Street Welch, WV Telephone: Fax: Contact: Christine Kendrick Interim Director: Lisa Sanderson Services Provided: Adult Day Care Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Caregiver Training Case Management Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Bradshaw Iaeger Keystone McDowell County War Welch

78 MERCER CASE SENIOR CENTER (Region 4) Address: 307 Federal Street, Suite 323 Bluefield, WV Telephone: ; Fax: Contact: Website: Director: Linda Bilotta Oraetta Hubbard Services Provided: Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Bluefield Nutrition Bluefield Salvation Army Nut Bob David s Bus Debbie Richardson Kimberly Linda Natoake Nutrition No Name Princeton Sr Center Nut Sandy Lawrence Sarah Byrd Skip Special Trips Prin Trans. Brian Trent St Nutrition

79 MONROE COUNTY COUNCIL ON AGING (Region 4) Address: P O Box 149 (Route 219) Lindside, WV Telephone: Fax: Contact: Director: Mike Will mccoa.lindside@yahoo.com Mike Will Services Provided: Assisted Transportation Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Information and Assistance Lighthouse Personal Care Outreach Personal Care Title III In-Home Respite Transportation Sites: Alderson Monroe Senior Center Union

80 NICHOLAS COMMUNITY ACTION PARTNERSHIP, INC. (Region 4) Address: 1205 Broad Street Summersville, WV Telephone: Fax: Contact: Director: Della Legg Dave Jarroll Services Provided: Assisted Transportation Caregiver Information and Assistance Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management LIFE In-Home Respite Lighthouse Personal Care Personal Care Title III In-Home Respite Transportation Sites: Craigsville Extended Route Leivasy Richwood Summersville

81 NICHOLAS COUNTY SENIOR CENTER, INC. (Region 4) Address: P O Box 818 (151 Sids Way) Summersville, WV Telephone: Contact: Russell Hines Summersville@seniorcenter.org Services Provided: Congregate Meals Group Congregate Meals Home-Delivered Meals Sites: Russell Hines

82 OHIO FAMILY SERVICES IN BROOKE (Region 1) Address: 51 11th Street Wheeling, WV Telephone: ; Fax: Contact: Website: Director: Lonnie Wineman Lonnie Wineman Nutrition Director: June Leindecker Services Provided: Group Client Support III-D Group Client Support III-D Individual Client Support III-D Information and Assistance Individual Client Support Sites: Fam. Serv. Brooke

83 OHIO FAMILY SERVICES IN HANCOCK (Region 1) Address: 51 11th Street Wheeling, WV Telephone: ; Fax: Contact: Website: Director: Lonnie Wineman Lonnie Wineman Nutrition Director: June Leindecker Services Provided: Group Client Support Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance Individual Client Support Lighthouse Personal Care Sites: Fam. Serv. Hancock Hancock Co

84 OHIO FAMILY SERVICES IN MARSHALL (Region 1) Address: 51 11th Street Wheeling, WV Telephone: ; Fax: Contact: Website: Director: Lonnie Wineman Lonnie Wineman Nutrition Director: June Leindecker Services Provided: Congregate Meals Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance Individual Client Support Sites: Benwood Cameron Fam. Serv. Marshall Golden Towers

85 OHIO FAMILY SERVICES IN OHIO (Region 1) Address: 51 11th Street Wheeling, WV Telephone: ; Fax: Contact: Website: Director: Lonnie Wineman Lonnie Wineman Nutrition Director: June Leindecker Services Provided: Assisted Transportation Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Lighthouse Personal Care Personal Care Transportation Sites: Human Resources Ohio Ohio Ohio Co Ohio Co Ohio Home Care Warwood

86 OHIO FAMILY SERVICES IN WETZEL (Region 1) Address: 51 11th Street Wheeling, WV Telephone: ; Fax: Contact: Website: Director: Lonnie Wineman Lonnie Wineman Nutrition Director: June Leindecker Services Provided: Congregate Meals Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Sites: Hundred New Martinsville New Martinsville Tower Pine Grove Wetzel

87 PENDLETON SENIOR AND FAMILY SERVICES, INC. (Region 3) Address: P O Box 9 (231 Mill Road) Franklin, WV Telephone: Fax: Contact: Director: Sherry Halterman pendletonseniorcenter@frontier.com Carolyn Wells Services Provided: Assisted Transportation Caregiver Training Case Management Chore Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Legal Assistance Lighthouse Personal Care Nutrition Counseling Nutrition Education Outreach Title III In-Home Respite Transportation Sites: Brandywine Franklin Franklin Ensure Hoover Loveain Warner Trans Peggy Thompson Pendleton County Phyllis Sue Raines Riverton Bus Riverton Ensure

88 PLEASANTS COUNTY SENIOR CITIZENS CENTER (Region 1) Address: 209 2nd Street St. Marys, WV Telephone: Fax: Contact: Director: Carol Whaley Marie Taylor Services Provided: Assisted Transportation Chore FAIR Alzheimer s In-Home Respite Group Client Support Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Pleasants Co

89 PLEASANTS SENIOR NUTRITION (Region 1) Address: P O Box 576 (219 2nd Street) St. Marys, WV Telephone: Fax: Contact: Director: David Hoyt seniornutrition@creeds.net David Hoyt Services Provided: Congregate Meals Group Congregate Meals Home-Delivered Meals Sites: St. Marys Nutrition

90 POCAHONTAS COUNTY SENIOR PROGRAMS (Region 4) Address: P O Box 89 (State Route 219N, HC69, Box 7) Marlinton, WV Telephone: Fax: Contact: Director: Teresa Alkire pocahontascoseniors@gmail.com John R. Simmons Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Chore Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Education Outreach Title III In-Home Respite Transportation Sites: Green Bank Marlinton Site

91 PRESTON COUNTY SENIOR CITIZENS, INC. (Region 3) Address: P O Box 10 (108 Senior Center Drive) Kingwood, WV Telephone: ; Fax: Contact: Director: Connie Beverage prestonseniors@atlanticbb.net Sidney Murphy Services Provided: Caregiver Information and Assistance Congregate Meals FAIR Alzheimer s In Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Information and Assistance Lighthouse Personal Care Title III In-Home Respite Transportation Sites: Kingwood Site Newburg Site North Preston Site Preston Senior Ctr Rowlesburg Site Terra Alta Site Tunnelton Site Union District Valley District

92 PRIDE IN LOGAN COUNTY, INC. (Region 2) Address: P O Box 1346 (699 Stratton Street) Logan, WV Telephone: Fax: Contact: Website: Vicky Browning vicky@prideinlogan.com Aging Program Director: Vicky Browning Executive Director: Reggie Jones Services Provided: Assisted Transportation Congregate Meals FAIR Alzheimer s In Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Information and Assistance Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Chapmanville Towers McDade Hall Mill Creek Pride in Logan Wesley House

93 PUTNAM AGING SERVICES, INC. (Region 2) Address: 694 Winfield Road St. Albans, WV Telephone: Fax: Contact: Website: Joyce McCormick-Arthur Interim Director: Joyce McCormick-Arthur Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Title III In-Home Respite Transportation Sites: Buffalo Hometown Hurricane Nitro-Putnam Putnam Office

94 PUTNAM NUTRITION IN CLAY (Regions 2 and 4) Address: 694 Winfield Road St. Albans, WV Telephone: Fax: Contact: Website: Joyce McCormick-Arthur jarthur@putnamaging.com Interim Director: Joyce McCormick-Arthur Services Provided: Congregate Meals Group Congregate Meals Home-Delivered Meals Sites: Maysel Manor Maysel Manor

95 PUTNAM NUTRITION IN KANAWHA (Region 2) Address: 694 Winfield Road St. Albans, WV Telephone: Fax: Contact: Website: Joyce McCormick-Arthur Interim Director: Joyce McCormick-Arthur Services Provided: Congregate Meals Group Congregate Meals Home-Delivered Meals Sites: Cans Cans Chelyan Chesapeake Clendenin 14 Clendenin Dunbar East End Family Res Elkview Elkview Home Delivered Hansford 17 Hansford Nitro Nitro Rand Rand Shawnee Shawnee Sissonville Sissonville 22 South Charleston South Charleston

96 RALEIGH COUNTY COMMISSION ON AGING (Region 4) Address: 1614 S. Kanawha Street Beckley, WV Telephone: Fax: ; Contact: Website: Director: Daniel Simmons Jack Tanner Services Provided: Adult Day Care Assisted Transportation Caregiver Counseling/Support Groups Caregiver Information and Assistance Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Outreach Personal Care Title III In-Home Respite Transportation Sites: Beckley Senior Center Coal City Comm. Center Fayette Manor House Mercer County Pettus RB Tech Center Raleigh Co Wildwood House

97 RANDOLPH COUNTY DOMESTIC AND TRAINING, INC. (Region 3) Address: 19 Pleasant Avenue, Suite 2 Elkins, WV Telephone: Fax: Contact: Henry Nefflen rcdp@meer.net Services Provided: Chore Group Client Support III-D Group Client Support III-D Individual Client Support III-D Information and Assistance Information and Assistance Sites: Randolph Domestic

98 RITCHIE COUNTY INTEGRATED FAMILY SERVICES (Region 1) Address: P O Box 195 (S. Court Street & Edgeview Lane) Harrisville, WV Telephone: Fax: Contact: Director: Cindy Summers rcseniors@zoominternet.net Lee Jones Services Provided: Adult Day Care Congregate Meals FAIR Alzheimer s In Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Harrisville Site Pennsboro Site Ritchie Co

99 ROANE COUNTY COMMITTEE ON AGING, INC. (Region 2) Address: 811 Madison Avenue Spencer, WV Telephone: Fax: Contact: Website: Director: Dorothy Park Chuck Ricks Services Provided: Assisted Transportation Caregiver Training Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Lighthouse Personal Care Title III In-Home Respite Transportation Sites: Roane County Roane Senior Ctr

100 SENIOR LIFE SERVICES OF MORGAN COUNTY (Region 3) Address: 187 South Green Street, Suite 5 Berkeley Springs, WV Telephone: Fax: Contact: Website: Director: Sydney Placido slsmc1@hotmail.com Joel Tuttle Services Provided: Assisted Transportation Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Information and Assistance Lighthouse Personal Care Outreach Personal Care Title III In-Home Respite Transportation Sites: Berkeley Springs Chrysler Paw Paw Van # Van # Van Van

101 SENIOR MONONGALIANS, INC. (Region 1) Address: P O Box 653 (5000 Greenbag Road, Suite 7, Mountaineer Mall) Morgantown, WV Telephone: Fax: Contact: Website: Director: Diana Moore dmoore@seniormons.org Betsy Robinson Services Provided: Assisted Transportation Caregiver Counseling/Support Groups Caregiver Training Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Arnettsville Chestnut Hills Core Site Mall Site Monongalia County Home Delivered Unity House Unity Manor

102 SUMMERS COUNTY COUNCIL ON AGING (Region 4) Address: 120 2nd Avenue Hinton, WV Telephone: Fax: Contact: Website: Director: Cindy Garrett Mr. Lin Goins Services Provided: Assisted Transportation Case Management Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Hinton/Summers Co Pipestem Special Trip Wheelchair

103 TAYLOR COUNTY SENIOR CITIZENS, INC. (Region 3) Address: Route 2 Box 514 (US Rt. 119 & US Rt. 250) Grafton, WV Telephone: Fax: Contact: Director: Rose Mary Knight taylorcscfm@aol.com Frank Mayle Services Provided: Assisted Transportation Chore Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Referral Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Personal Care Title III In -Home Respite Transportation Sites: Eliz Cather Towers Flemington Site Grafton Site Nancy Poling Taylor County

104 THE COMMITTEE ON AGING FOR RANDOLPH COUNTY, INC. (Region 3) Address: P O Box 727 (5th Street & Railroad Avenue) Elkins, WV Telephone: Fax: Contact: Website: Director: Rebecca Poe randolphcountyseniorcenter@yahoo.com Rebecca Poe Services Provided: Assisted Transportation Chore Congregate Meals FAIR Alzheimer s Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Elkins Manor Elkins Site Harman Mill Creek Site Rand Life Juanita D Randolph Co

105 TUCKER COUNTY SENIOR CITIZENS, INC. (Region 3) Address: 206 3rd Street Parsons, WV Telephone: Fax: Contact: Director: Joyce Carr Roxanne Tuesing Services Provided: Adult Day Care Assisted Transportation Caregiver Counseling/Support Groups Care Information and Assistance Caregiver Training Case Management Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite FAIR Congregate Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance LIFE In-Home Respite Lighthouse Personal Care Nutrition Counseling Nutrition Education Outreach Personal Care Title III In-Home Respite Transportation Sites: Parsons Site Thomas/Davis

106 UPSHUR COUNTY SENIOR CITIZENS OPPORTUNITY CENTER, INC. (Region 3) Address: 28 North Kanawha Street Buckhannon, WV Telephone: Fax: Contact: Website: Director: Mary Cameron Allen Cook Services Provided: Assisted Transportation Chore Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Individual Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Lighthouse Personal Care Personal Care Title III In-Home Respite Transportation Sites: Buckhannon Manor C Buckhannon Site Ellamore Rock Cave Upshur County

107 WAYNE COUNTY COMMUNITY SERVICES ORGANIZATION, INC. (Region 2) Address: 3609 Hughes Street Huntington, WV Telephone: Fax: Senior Center 1300 Norfolk Avenue Wayne, WV 25570; , Contact: Website: Director: Kevin Marcum Rose Meredith Services Provided: Assisted Transportation Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Information and Assistance Lighthouse Personal Care Nutrition Education Outreach Title III In-Home Respite Transportation Sites: Adkins-Rollins Bison Dunlow Fort Gay Stepptown MP SC Wayne Westmoreland NC

108 WEBSTER COUNTY COMMISSION OF SENIOR CITIZENS (Region 4) Address: 148 Court Square Webster Springs, WV Telephone: Fax: Contact: Director: Debbie Moore Phillip Cooper Services Provided: Adult Day Care Assisted Transportation Congregate Meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home -Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Title III-In Home Respite Transportation Sites: Camden on Gauley Forest Park Hackers Valley Site Webster Springs Site

109 WETZEL COUNTY COMMITTEE ON AGING (Region 1) Address: 145 Paducah Drive New Martinsville, WV Telephone: Fax: Contact: Director: Melissa O Neil wetzelccoa@suddenlinkmail.com Mary Ash Services Provided: Assisted Transportation Caregiver Information and Assistance Chore FAIR Alzheimer s In-Home Respite Group Client Support Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Personal Care Title III-In Home Respite Transportation Sites: Wetzel Site

110 WIRT COUNTY COMMITTEE ON AGING, INC. (Region 1) Address: P O Box 370 (Washington Street) Elizabeth, WV Telephone: Fax: Contact: Director: Billie Ashley wccoa@suddenlinkmail.com Lorraine Roberts Services Provided: Adult Day Care Assisted Transportation Chore Congregate Meals Congregate Respite FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Lighthouse Personal Care Transportation Sites: Elizabeth Site Wirt County

111 WOOD COUNTY SENIOR CITIZENS ASSOCIATION, INC. (Region 1) Address: P O Box 1229 (914 Market Street) Parkersburg, WV Telephone: Fax: Contact: Director: Missy Blackwell mdennis@suddenlinkmail.com Michael Dennis Services Provided: Assisted Transportation Caregiver Information and Assistance Congregate meals FAIR Alzheimer s In-Home Respite Group Client Support Group Congregate Meals Home-Delivered Meals Homemaker III-D Group Client Support III-D Individual Client Support III-D Information and Assistance III-D Medication Management Individual Client Support Information and Assistance Lighthouse Personal Care Outreach Title III In-Home Respite Transportation Sites: Market St Mineral Wells Site Unity Plaza Vienna Site Williamstown Site Wood County

112 SECTION 2 West Virginia Bureau of Senior Services Client Intake Form (BIF), Nutritional Health Assessment BIF General Instructions Nutritional Health Assessment Determination Sheet Specific Instructions for Completing a BIF FAIR Caregiver Respite Supplemental Monthly Service Recording Log Rosters Quick Reminder for Building Rosters, SAMS Job Aid, and Sample Roster Service Entry Recommended Procedures SAMS Job Aid Report Description by Category and Sample Report 110

113 WEST VIRGINIA BUREAU OF SENIOR SERVICES CLIENT INTAKE FORM 1. GENERAL INFORMATION 1. Date of Assessment: 2. Worker: 3. Type of Assessment: 1=Initial 2=Reassessment 4. Action: 1=Modify client record 2=Inactivate client 5. Type of Contact: 1=In Office 2=In Field 3=By Telephone Name 6.a. Last Name: 6.b. First Name: 6.c. Middle Initial: 6.d. Also known as first name: 7. Date of birth: 8. Gender: M=Male F=Female Residential Address 9.a. Street address: 9.b. City: 9.c. State: 9.d. Zip: Mailing Address 10.a. Street address or post office box: 10.b. City: 10.c. State: 10.d. Zip: 11. Telephone: ( ) 12. Speaks English: 1=Yes 2=No 13. Language limitations: 1=Does not read 2=Reads only 3=Writes only 4=Reading/Writing limited 14. Marital Status: 1=Married 2=Single 3=Widowed 4=Separated 15. Race: 1=White, non-hispanic 2=White-Hispanic 3=American Indian/Native Alaskan 4=Asian 5=Black/African American 6=Native Hawaiian/Other Pacific Islander 7=Other 16. Ethnicity: 1=Hispanic or Latino 2=Not Hispanic or Latino 17. Current Living Arrangement: 1=Alone 2=w/Spouse 3=w/Child 4=w/Relative 5=w/Non-Relative 18. Current monthly income: $ 19. Number in household: 1=One 2=Two 3=Three 4=Four 5=Five 6=Six or more 20. Income level below the national poverty level: 1=Yes 2=No 21. Transportation: 1=Has car 2=Public 3=Senior Citizens Center 4=Family/Friends 5=None 22. Demonstrates Greatest Social Need : 1=Yes 2=No 23. If FAIR/III-E Caregiver, Relationship to Care Receiver: 1=Husband 2=Wife 3=Son/Son-in-law 4=Daughter/Daughter-in-law 5=Other Relative 6=Non-Relative 24. Client is a Veteran: 1=Yes 2=No Emergency Contact: WV BoSS Intake Form rev. 12/10 Page 1 111

114 2. NUTRITIONAL HEALTH ASSESSMENT 1. I have an illness or condition that made me change the kind and/or amount of food I eat. 1=Yes 2=No 2. I eat fewer than 2 meals per day. 1=Yes 2=No 3. I eat few fruits or vegetables, or milk products. 1=Yes 2=No 4. I have 3 or more drinks of beer, liquor or wine almost every day. 1=Yes 2=No 5. I have tooth or mouth problems that make it hard for me to eat. 1=Yes 2=No 6. I don t always have enough money to buy the food I need. 1=Yes 2=No 7. I eat alone most of the time. 1=Yes 2=No 8. I take 3 or more different prescribed or over-the-counter drugs a day. 1=Yes 2=No 9. Without wanting to, I have lost or gained 10 pounds in the last 6 months. 1=Yes 2=No 10. I am not always physically able to shop, cook and/or feed myself. 1=Yes 2=No 3. ADL s/iadl s During the past 7 days, and considering all episodes, how would you rate the client s ability to perform the following: 3.a. Activities of Daily Living: Circle one for each 1=No assistance, 2=Some assistance, 3=Much assistance, 4=Unable to perform 1. Bathing Dressing Eating Walking in home Transferring Toileting b. Instrumental Activities of Daily Living: Circle one for each 1=No assistance, 2=Some assistance, 3=Much assistance, 4=Unable to perform 1. Transportation Meal Preparation Shopping Light Housekeeping Manage Money Heavy Housework Telephone Managing Medications WV BoSS Intake Form rev. 12/10 Page 2 112

115 WEST VIRGINIA BoSS INTAKE FORM General Instructions 1. PURPOSE The Boss Intake Form (BIF) is used to identify clients who are served by providers contracting with the Area Agency on Aging. The BIF is the means through which clients are registered. Following registration, services provided are posted to the client s record. The process is the means for calculating the unduplicated count required by the Older Americans Act. The system identifies clients by their last name, first name, and date of birth. A unique client ID number is assigned when the BIF is entered into the computer database. In addition to identifying clients, the BIF records demographic information about clients that is used for statistical reporting to the state and federal governments. All clientspecific information remains confidential. 2. REGISTERING CLIENTS A. A staff worker must complete a BIF on every individual who receives services from the provider unless the service is considered a Group Service. The BIF form is completed when the new client begins receiving services. A BIF is not needed for Medicaid Waiver clients provided they do not receive any other services. B. If the client is registered by another provider within the same region, you would not need to complete another BIF. (Refer to Search Online.) C. The BIF form must be completed as accurately and fully as possible. Print all entries. Each field must be completed. If you do not know the correct response, make a good faith guess. PLEASE DO NOT LEAVE A SECTION BLANK. 3. TO SUBMIT A BIF FORM A. Completed BIF forms for new clients need to be submitted as soon after completion as possible. B. Check the BIF form to be sure all required information has been entered. 113

116 C. If the client does not appear on your printout and you are not certain a BIF has been completed, contact your BOSS SAMS Administrator and give the client s name and date of birth. Always check the Master Database using Search before submitting a new BIF. 4. TO SUBMIT CHANGES Once a BIF form has been completed and entered, the information on this form becomes part of the client record. All major changes in a client s situation must be reported. The Modify Client Record box should be checked in the ACTION section of the form. To CHANGE one or more items on an existing client s BIF: A. Check Modify Client Record in the ACTION section when one or more items on the BIF are incorrect. B. Write the Client Identification Number on top of the form. C. Enter the Date of Assessment. D. Enter the Worker completing the BIF. E. Enter the client s Last Name, First Name, Middle Initial, and Date of Birth. F. Enter ONLY the information to be changed. NOTE: This procedure can also be used when updating an incomplete BIF. 5. TO DELETE OR MERGE A CLIENT A. Write the word Delete or Merge in the ACTION section when a client is listed more than once on the client list. B. Write the incorrect client identification number on the top of the form. C. Enter the CORRECT client identification number to the right of, above, or below the incorrect client number. D. Indicate the Provider Name under which the incorrect client number is registered on the top of the form. 114

117 E. Enter the Date of Assessment, which is the date the deletion is being requested. F. Enter the Client Name and Date of Birth. Please note the following: When requesting a large number of deletions or merges, do not complete a BIF form for each client. Prepare a typewritten list on your provider s letterhead with the information described above. Your BOSS SAMS Administrator must be provided information on both the correct client (including client number and birth date) as well as the incorrect client name, birth date, and client number in order to merge the client services to the correct client number. A BIF cannot be deleted as long as the client has services recorded. Providers other than the one requesting a client number deletion can serve a client. A client can, however, be marked as Inactive if he/she is not receiving services from any other provider. See Item #6. 6. TO MARK A CLIENT INACTIVE A client is marked Inactive when the client has not received services from any other provider, moves out the county or state, or passes away during the current fiscal year. A. Check the Inactivate box in the ACTION section of the BIF form. B. Write the Client Identification Number on the top of the form. C. Enter the Date of Assessment. D. Indicate the Provider Name under which the client is registered on the top of the form. E. Enter the client s Last Name, First Name, Middle Initial, and Date of Birth. F. Indicate a reason for having the client inactivated on the bottom of the form. 115

118 The Nutritional Health Assessment is based on the Warning Signs described below. Use the word DETERMINE to remind you of the Warning Signs. DISEASE Any disease, illness or chronic condition that causes you to change the way you eat, or makes it hard for you to eat, puts your nutritional health at risk. Four out of five adults have chronic diseases that are affected by diet. Confusion or memory loss that keeps getting worse is estimated to affect one out of five or more older adults. This can make it hard to remember what, when, or if you ve eaten. Feeling sad or depressed, which happens to about one in eight older adults, can cause big changes in appetite, digestion, energy level, weight and well-being. EATING POORLY Eating too little and eating too much both lead to poor health. Eating the same foods day after day or not eating fruit, vegetables, and milk products daily will also cause poor nutritional health. One in five adults skips meals daily. Only 13% of adults eat the minimum amount of fruits and vegetables needed. One in four adults drinks too much alcohol. Many health problems become worse if you drink more than one or two alcoholic beverages per day. TOOTH LOSS/MOUTH PAIN A healthy mouth, teeth and gums are needed to eat. Missing, loose or decayed teeth or dentures that don t fit well or cause mouth sores make it hard to eat. ECONOMIC HARDSHIP Nearly 40% of older West Virginians have incomes of less than $10,000 per year. Having less or choosing to spend less than $25 $30 per week for food makes it very hard to get the foods you need to stay healthy. REDUCED SOCIAL CONTACT One-third of all older people live alone. Being with people daily has a positive effect on morale, well-being, and eating. MULTIPLE MEDICINES Many older Americans must take medicines for health problems. Almost half of older Americans take multiple medicines daily. Growing old may change the way we respond to drugs. The more medicines you take, the greater the chance for side effects such as increased or decreased appetite, changes in taste, constipation, weakness, drowsiness, diarrhea, nausea, and others. Vitamins or minerals when taken in large doses act like drugs and can cause harm. Alert your doctor to everything you take. INVOLUNTARY WEIGHT LOSS/GAIN Losing or gaining a lot of weight when you are not trying to do so is an important warning sign that must not be ignored. Begin overweight or underweight also increases your chance of poor health. NEEDS ASSISTANCE IN SELF CARE Although most older people are able to eat, one of every five has trouble walking, shopping, buying, and cooking food, especially as he/she ages. ELDER YEARS ABOVE AGE 80 Most older people lead full and productive lives. But as age increases, risk of frailty and health problems increase. Checking your nutritional health regularly makes good sense. 116

119 SPECIFIC INSTRUCTIONS FOR COMPLETING A WEST VIRGINIA BUREAU OF SENIOR SERVICES INTAKE FORM (BIF) If the client is able to complete the form on his own, let the client do so but offer assistance if asked. Should the client be unable to complete the form, the worker is to complete the form with the client s assistance. After the form is completed, please check to make sure ALL questions have been answered. If they have not, complete the blanks that were inadvertently missed. Should a client refuse to answer questions, complete the form to the best of your knowledge. Incomplete BIFs skew the total demographic for the provider, area agency on aging, and state reports. 1. GENERAL INFORMATION 1. Date of Assessment Enter the date the BIF is completed. 2. Worker Enter the worker s name or initials. 3. Type of Assessment Check whether this is an initial or reassessment. 4. Action Indicate whether the client record is being modified or changed to inactive. 5. Type of Contact Check the box to indicate whether contact with the client was made in the office, by a field visit, or by telephone. Select only one answer a., 6.b., 6.c. Name Enter the client s last name, first name, and middle initial. (Use only a PROPER name. Nicknames can be entered in 6.d.) Client is defined as a person 60 years of age or older, a spouse of a client age 60 years or older, volunteer, handicapped, Title III-E caregiver, FAIR caregiver, or Lighthouse eligible. For III-E and FAIR services, the client is the caregiver. 6.d. Also known as first name Enter a nickname the client may use. 7. Date of Birth Enter the month, day, and year of the client s birth. 8. Gender Check appropriate box. 9. Residential Address Enter the client s complete physical address. 10. Mailing Address Complete only if different from residential address. 117

120 11. Telephone Enter the client s telephone number. If the client does not have a telephone, enter NONE. Do not enter a neighbor s or friend s telephone number; report this information at the bottom of the BIF and enter it in the Remarks section of the SAMS. 12. Speaks English Check Yes or No. 13. Language Limitations Check only one answer. If client has no limitations, leave this section blank. 14. Marital Status Check only one answer. 15. Race Check the correct answer. The answer should reflect the race as stated by the client. If Other is checked, a client is NOT classified as a Minority for statistical purposes. 16. Ethnicity Check the correct answer. 17. Current Living Arrangement Check all that apply. If a client is a resident of a personal care, nursing, or assisted living facility, w/non-relative is to be checked. 18. Current Monthly Income Enter client s current monthly income. Household refers to the client and spouse. When the client lives with other family members, staff must make a determination if the client is financially independent from the family, or if the client is financially dependent on the family. (If the client has income and pays all expenses, the client is in a financial household of his own. If the family meets the client s financial obligations due to limited income, all family income is considered.) 19. Number in Household Indicate the number of people in client s household. 20. Income Level Below the National Poverty Level Check Yes or No. The U.S. Department of Health and Human Services issues annual poverty guidelines yearly. If the client s income falls below the guideline categories, the client is considered to be below poverty. The Poverty Guidelines are updated periodically in the Federal Register by the United States Department of Health and Human Services under the authority of 42 U.S.C. 9902(2). 21. Transportation Check only one answer. 22. Demonstrates Greatest Social Need A client is classified as GSN if the client is a resident of a long-term facility (nursing home, personal care home) or has a disability not fully corrected or needs assistance to leave the client s home. OR 118

121 A client is classified as GSN if ANY TWO of the following apply: a. The client is a member of a racial or ethnic minority b. Lacks a telephone c. Has a language/literacy barrier d. Lives alone e. Lacks means of transportation 23. If FAIR/Title III Caregiver, Relationship to Care Receiver If a FAIR or Title III Caregiver is your consumer, provide their relationship to the Care Receiver: husband, wife, son/ son-in-law, daughter/daughter-in-law, other relative or non-relative. The Caregiver is the client, not the Care Receiver. 24. Client is a Veteran Check Yes or No. Emergency Contact Enter any emergency contact information for the client. 2. NUTRITIONAL HEALTH ASSESSMENT Check Yes or No. Please answer all questions. 3. ADLs/IADLs Next to each activity, indicate by number (from 1 to 4) the degree of assistance needed. 119

122 FAIR CAREGIVER RESPITE SUPPLEMENTAL MONTHLY SERVICE RECORDING LOG Provider: Site: Person Completing Form: Service: FAIR Alzheimer s In-Home Respite Fund Identifier: FAIR Month: CLIENT NO. CAREGIVER NAME BIRTH DATE UNITS ENTER NUMBER OF UNITS ON DAY OF MONTH SERVICE WAS PROVIDED TOTAL Signature: Date: rev. 2/1/11 120

123 QUICK REMINDER FOR BUILDING ROSTERS 1. Roster Section: a. Name your Roster b. Select "Specified Service" from the dropdown list of choices c. Choose "All Funded Services" d. Select your Area Agency on Aging e.g., Upper Potomac AAA/R3 e. Provider = Your Provider name e.g., Barbour County Senior Center f. Site where you deliver the service - site name you are building the roster for Note: Site was not included in the Roster Cheat Sheet or SAMS Training but is a key identifier in WV 2. Service Properties a. Note the three dots... (ellipses) on right side of this line b. Click on or touch space bar c. Choose Add New d. Select Service e.g., [x] Congregate Meals check in the box beside the service name e. Select Fund from Fund Identifier dropdown e.g., Title III IMPORTANT! f. Select Apply and Close At Training we were told to Skip over all selections under the General Filters Section. You can select YES in the field "Include Inactive Consumers?" IF you want your Rosters to include those marked as inactive. 3. Service Filters: + Service Filter a. Choose Service Delivery from the Based On field drop down b. Select the Service to be delivered with this roster (put check mark in the box) e.g., [x] Congregate Meals c. Provider e.g., Barbour County Senior Center d. Site service will be delivered at - enter the site for which you are building the roster Remember: Site is important in WV Do not apply any other filters at this time unless you choose Date Range to limit dates of service to show names on roster e. Choose Preview f. SAVE or SAVE and CLOSE Look at the Roster to be sure it is correct e.g., only names that you expect to find on the specific roster (like on the old circle sheets) REFRESH works here too. (Keyboard Shortcut for Refresh is the F-5 Key) File Name: Quick Roster Help 121

124 SAMS Job Aid Rosters SAMS Job Aid Social Assistance Management System Job Aid Rosters Harmony Information Systems, Inc Sunset Hills Rd, Suite 500 Reston, VA (703) January 5,

125 SAMS Job Aid Rosters Rosters SAMS offers functionality in the way of Rosters to allow for bulk data entry for consumers that are receiving the same service, which are commonly used to enter nutrition services such as Congregate Meals. Rosters are defined entry lists comprised of a Roster Definition and the functionality to Record Service Data. In the sections that follow, you will learn how to create a roster and how to record service deliveries using a roster. Roster Definitions Before a roster can be used to record service deliveries for a group of clients in SAMS, it must first be created by defining the specific attributes for the service to be delivered and to set filters defining the consumers to display on the roster list. What kinds of rosters can be created? When defining a roster, a Type is selected to define the clients and services: Multi-Service used to record one or many different services offered by the provider for a group of consumers meeting the criteria of the roster. Specified Service used to record only one service specified for a group of consumers meeting the criteria of the roster. The service must be selected in the Service Properties. Service Plan (Multi-Service) used to record one or many services based on consumer care plans. No filtering need to be set as the roster will automatically bring in only consumers with active service plans containing the same service attributes. Service Plan (Specified Service) used to record only one service specified based on consumer care plans. No filtering need to be set as the roster will automatically bring in only consumers with active service plans containing the same service attributes. The service must be selected in the Service Properties. How are rosters defined to create service deliveries? A service delivery contains various attributes that define the record. In the creation of the Roster Definition, each of the desired attributes will be set and any deliveries made to consumers via the roster will assume all of these attributes. Who are the consumers that make up the roster list? The other half of a roster definition is to establish criteria to determine what consumers that exist in the database will show on the roster list. There are many fields that can be used in the determination by setting filters. Harmony Information Systems, Inc. Page 2 123

126 SAMS Job Aid Rosters Creating a new Roster: 1. Click the Rosters button. 2. Click New Roster on the toolbar. 3. Enter a Name to distinguish the roster on the main list. 4. Select the appropriate Type for the Roster. 5. Select the Care Program, Agency, and Provider (Subprovider and Site where appropriate) to use as attributes for all services to be recorded via this roster. 6. Click the browse button to the right of the Service Properties field if service selections need to be entered. 7. On the Roster Service Properties window, click the Add New button. Creating a new Roster (continued) Harmony Information Systems, Inc. Page 3 124

127 SAMS Job Aid Rosters 8. Select the appropriate Service and click Apply to add it to the list. 9. Repeat steps 7. and 8. to add all desired services to use in the roster. Tip: Add all appropriate services to a Multi- Service roster to allow for entry of many services from a provider to be recorded, or a Service Plan (Multi-Service) roster can be left blank with no services specified to allow for all active planned services to utilize the same roster for a provider. 10. Click Close to return to the Roster Definition. 11. Select the appropriate filtering criteria to narrow the resulting data set. Note: Filtering fields can be single-selection dropdowns, multiple-selection lists, or date fields. 12. Click the Preview button in the toolbar to see the resulting set of consumers meeting the filtering criteria set, if desired. Harmony Information Systems, Inc. Page 4 125

128 SAMS Job Aid Rosters Creating a new Roster (continued) 13. Click Save and Close to commit the roster definition to the database and return to the Roster List. 14. Click Refresh on the toolbar if necessary to display the new roster. Recording Services in Rosters Now that the shell of a roster has been created to define how the services are to be saved, it is possible to use the roster to record service data for the consumers. Below is an overview of a Record Service session in a Roster: Recording services in a Roster: 1. Click the Rosters button. 2. Select the desired roster in the list and click Record Service Data on the toolbar. 3. Select the Service Period for the month of the service and click OK. Recording services in a Roster (continued) Harmony Information Systems, Inc. Page 5 126

129 SAMS Job Aid Rosters 4. For each consumer row in the list, enter the number of service units in either the Total Units column to reflect an aggregate total for the month, or in the appropriate column for each individual day that the service was provided to the client. Tip: Uncommitted service units added to the roster during the session will appear in blue. Complete all data entry before clicking Save to record all units at once. 5. Click Save to commit the service deliveries to the database. Adding Consumer to Roster (using session already open): 1. Click the Add Consumers button in the toolbar. 2. Enter the appropriate search criteria and click Find. Harmony Information Systems, Inc. Page 6 127

130 SAMS Job Aid Rosters Adding Consumer to Roster (session open) (continued) 3. Check the box next to the desired consumer(s) in the result set in the bottom window and click Add to Roster. 4. Repeat steps 3. and 4. to add additional consumers if desired. 5. Click Close to return to the roster session. Note: Consumers added to the roster in this method will appear in the current roster session only. When opened, a roster session displays only consumers meeting the filtering criteria. Alternate method: (to add services with the roster session already open): 1. Click the Add Service button in the toolbar. 2. Check the Sel? column next to the names of the consumers to enter services for. 3. In the Service section, select the Day to record the services for, or leave as (Any) to record the total for the month. Harmony Information Systems, Inc. Page 7 128

131 SAMS Job Aid Rosters Alternate method (continued) 4. Enter the number of Units. 5. Click Add then click Yes to confirm the service addition. 6. Repeat steps 2. through 5. to add additional services if desired. 7. Click Close to return to the roster session. Tip: In multi-service roster types, the Service can also be changed to record any services that are offered by the provider. Harmony Information Systems, Inc. Page 8 129

132 SAMS Job Aid Rosters Service Delivery Confirmation Wizard Another alternate method for entering bulk services in SAMS is using the utility called the Service Delivery Confirmation Wizard. This utility is used to confirm any active planned services for consumers in the timeframe selected in the confirmation session. Caution: Only services that have valid Service Plans in active consumer Care Plans can be recorded using the Delivery Confirmation Wizard. Delivery Confirmation Wizards for Planned Services The confirmation wizard sessions are available to be initiated at any time through the Tools menu, or alternately can be run from the Route section in cases of planned meal services. Refer to the Nutriton Training Manual for steps on the latter. Recording services via Delivery Confirmation Wizard: 1. In the Tools menu, select the Delivery Confirmation Wizard. 2. Select Weekly Service Plans in the Based On field. 3. Select the organization information for the Agency and Provider (Subprovider or Site where appropriate). Harmony Information Systems, Inc. Page 9 130

133 SAMS Job Aid Rosters Recording services via Delivery Confirmation Wizard (continued) 4. Click the browse button to the right of the Service/Subservice field and select the desired planned services to search for during the confirmation session. 5. Set the Start Service Day and End Service Day to reflect the range to return for the planned services. Note: The Start Service Day and End Service Day entered must be in the same calendar month. 6. Click Next. 7. Update the planned services where necessary under each individual day. Uncommitted planned services will appear in blue. Harmony Information Systems, Inc. Page

134 SAMS Job Aid Rosters Recording services via Delivery Confirmation Wizard (continued) 8. Click Save, then Yes to commit the service deliveries to the database. 9. Click Print to retain a paper copy of the session summary, or Close to end the confirmation session. Harmony Information Systems, Inc. Page

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136 SAMS Job Aid Service Entry Procedures SAMS Job Aid Social Assistance Management System Job Aid Service Entry Recommended Procedures Version 1.0 January 7, 2010 Harmony Information Systems, Inc. 25 New England Drive Essex Junction, Vermont (703)

137 SAMS Job Aid Service Entry Procedures Version Control: SAMS Job Aid: Service Entry Recommended Procedures Version Release Date Changes and Comments 1.0 1/7/2010 Initial Release Copyright Harmony Information Systems, Inc. All rights reserved. The software contains proprietary information of Harmony Information Systems, Inc.; it is provided under a license agreement containing restrictions on use and disclosure and is also protected by copyright law. Reverse engineering of the software is prohibited. Due to continued product development this information may change without notice. The information and intellectual property contained herein is confidential between Harmony Information Systems, Inc. and the consumer and remains the exclusive property of Harmony Information Systems, Inc. If you find any problems in the documentation, please report them to us in writing. Harmony Information Systems, Inc. does not warrant that this document is error-free. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written permission of Harmony Information Systems, Inc. Microsoft Word, Microsoft Office, Windows, and Window 2000/NT/XP are trademarks of the Microsoft Corporation. 135

138 SAMS Job Aid Service Entry Procedures Service Data Entry Procedures in SAMS The SAMS system offers flexibility with the methods of service data entry to allow for the specific types of contracted services. In recording service delivery records in SAMS, there are three distinct scenarios that apply to various services: 1. When an in-home service such as a Home Delivered Meal or Housekeeping service must be scheduled, the initial planning and setup for the specific days must be done in each client s record in the Care Plan found in the Care Management section. A care plan may contain multiple services that the client requires, each of which must be planned by creating a separate Service Plan. 2. Some services do not require planning and are to be entered as the services are incurred by each named client, such as a Congregate Meal or Senior Center Activity. 3. Finally, there are Cluster 3 services that do not require the service data to be tracked for each individual client as it is not always possible to collect the amount of appropriate demographics, although it is desirable to do so whenever possible. Since Cluster 3 services only require an estimated count of consumers for reporting rather than an unduplicated count, data entry can be aggregated when recorded for services such as Nutrition Education or Information & Assistance. NOTE Any method outline in this guide is only a recommendation based on best practices. Alternate methods of entry may be better suited for specific service types and organizations. Examples to follow will feature different types of Nutrition services. See the Appendix section for additional recommendations. Entering Scheduled In-Home Services Using the example of a Home Delivered Meal service, follow the steps below to first schedule the service with the creation of a Service Plan for each consumer who is to received the service, and then record the Service Delivery using the Service Delivery Confirmation Wizard as an easy way to verify and confirm the actual service in comparison to the plan. To enter Home Delivered Meal service plans: 1. From within a consumer record, click on the Care Management section and create or open the active Care Plan. 2. Go to the Service Plan section and click Add Service. Harmony Information Systems, Inc. Page 3 136

139 SAMS Job Aid Service Entry Procedures 3. Add the appropriate required service attributes for the Agency, Provider, and Service. 4. Select the optional service attributes as necessary or appropriate for the Sub Provider, Site, Subservice or Fund Identifier. 5. Add a Schedule for the services being planned. Set the Allocation Type to Weekly and enter the number of units appropriate for each day in the Week Detail. 6. Click Apply & Close for the Schedule and the Service Plan to complete the entry of the allocation. NOTE Weekly service schedules will drive the Routes and Delivery Confirmation Wizard sessions so make sure that units are entered on the appropriate days. To record Home Delivered Meal service deliveries: 1. From the Tools menu, choose the Delivery Confirmation Wizard. 2. Set the Based On to be for Weekly Service Plans, and enter filters for the appropriate Agency, Provider, Service of Home Delivered Meals, and Date range. Click Next. 3. Verify that the planned, unconfirmed services in Blue have been delivered to the consumer. Remove and change any exceptions and click Save. TIP Confirmation Wizard sessions can also be run by selecting a Route and clicking the Confirm Delivery button in the toolbar. By selecting a route to confirm services in this method, only the clients that exist on the route are included in the session. Refer to your Nutrition Training Manual or SAMS Users Guide for more information on Route creation and maintenance. Entering Non-Planned Services As an alternate method to adding service deliveries manually for every client that received a specific service such as a Congregate Meal, SAMS offers Rosters as a spreadsheet-like interface of clients, services, and dates to use for recording the actual units of service. Rosters do not require plans to be created but do require a Roster Definition to be created to define what consumers will be included on the list based on setting filtering criteria, and how the services will be created for each client by setting all of the appropriate service attributes. To create a Congregate Meal roster definition: 1. Go to the Rosters section and click New Roster in the toolbar. Harmony Information Systems, Inc. Page 4 137

140 SAMS Job Aid Service Entry Procedures 2. Set the roster Type as Multi Service. 3. Add the appropriate service attributes for the Care Program Name, Agency and Provider. 4. For the Service Properties, add the Service of Congregate Meals with all appropriate Fund Identifiers. 5. In the Service Filter section, set the Based On as Service Deliveries. 6. Set filters for the Agency, Provider, and Service of Congregate Meals. 7. Set the Date Range as Current Service Month and the Month Prior. NOTE Set the Date Range option for a longer period of time if necessary. 8. Enter a Name and click Save and Close to create the roster. TIP A well-defined naming convention for the rosters in an organization will help to differentiate which rosters are to be used by various staff and service providers. To record Congregate Meal service deliveries: 1. Select the appropriate roster from the list in the Rosters section, and click the Record Service Data button in the toolbar. 2. Select the appropriate month for the services being entered and click OK. NOTE If a consumer has not met the criteria of the roster definition outlined in the steps above, such as the example that they have not yet received a Congregate Meal from the Agency and Provider selected, you will have to first use the Add Consumers function of the roster. 3. Enter the appropriate services to the consumers on the days that the client actually received the services. 4. Click Save and Close to record the services. TIP Services can also be recorded as a Total for the entire month of service, however entering units on the actual days of service allows for easier reconciliation. For more information on adding consumers and services in roster sessions, refer to your Service Delivery Training Manual or SAMS Users Guide. Harmony Information Systems, Inc. Page 5 138

141 SAMS Job Aid Service Entry Procedures Entering Aggregate Services In the scenarios where the reporting only requires an estimated count of clients served for specific Cluster 3 services such as Nutrition Education, SAMS offers Consumer Groups to allow for tracking service delivery records with a headcount of consumers served in addition to the standard service attributes. A consumer group is a record created similar to a standard consumer, but with minimal demographic attributes and sections available. To create a Consumer Group: 1. Go to the Consumers section and change the Consumer Type dropdown to Consumer Groups. 2. Click the New button in the toolbar to open a new group record. 3. Enter a Description for the group and any identifying attributes for reporting such as NAPIS characteristics, Age, or Gender. TIP A well-defined naming convention for the consumer groups will be important to differentiate between like groups when choosing to enter services. 4. Review the Care Enrollment tab to assure that the default program enrollment is adequate for services to be entered to the group and the date range covers any services. 5. Click the Save and Close button in the toolbar to create the group. To record aggregate Nutrition Education service deliveries: 1. Go to the Consumers section and change the Consumer Type dropdown to Consumer Groups. 2. Open the appropriate consumer group record and go to the Service Delivery section. 3. Click the Add Service button on the toolbar. 4. Select the appropriate service attributes for the record including the Care Program, Agency, Provider and Service, and then number of Consumers Served and Total Units. You may also select other optional elements such as Fund Identifier or Subservice as required. 5. Click Apply & Close to record the service delivery. TIP Aggregate services can also be recorded in roster sessions as long as the roster definition is set up to include consumer groups. Refer to your Service Delivery Training Manual or SAMS Users Guide for more information. Harmony Information Systems, Inc. Page 6 139

142 SAMS Job Aid Service Entry Procedures Appendix A: Service Entry Examples Below are some example entries for each of the three types of services outlined above. Example for Planned Service Care Plan Service Plan: 1. Create the Service Plan 2. Enter Plan Attributes 3. Enter Schedule Harmony Information Systems, Inc. Page 7 140

143 SAMS Job Aid Service Entry Procedures Confirmation Wizard Session: 1. Set Session Attributes 2. Confirm Planned Services 3. Generate Services Harmony Information Systems, Inc. Page 8 141

144 SAMS Job Aid Service Entry Procedures Example for Non-Planned Service Roster Definition Setup: 1. Name the roster appropriately 2. Set the service attributes 3. Set filtering consistent with the service attributes (unless Service Plan type rosters are used for which no filtering needs to be set) Roster Session: 1. Enter services per client either by monthly total or by individual day 2. Save and Close to commit services to database Harmony Information Systems, Inc. Page 9 142

145 SAMS Job Aid Service Entry Procedures Example for Aggregate Service Consumer Group Creation: 1. Toggle the consumer type on the list to Consumer Groups 2. Give the group an appropriate name Harmony Information Systems, Inc. Page

146 SAMS Job Aid Service Entry Procedures 3. Set detail attributes to reflect the group name Aggregate Service Delivery: 1. In the Service Delivery section, Add a service 2. Enter appropriate service attributes with special attention paid to the Consumers Served and Total Units fields 3. Apply and Close the record to commit the service delivery to the database Harmony Information Systems, Inc. Page