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Virtual Town Hall Video Transcription

Dr. Chaudron Gille, Provost of the University of North Georgia: Hello, my name is Chaudron, Gille, and I'm Provost of the University of North Georgia. It is my pleasure to welcome you to today's town hall COVID-19 Impact and Resources for Older Adults. The University of North Georgia is proud of its Carnegie designation as a community engaged University. Our partnerships with the community are even more important in challenging times, like those that we are all experiencing with the coronavirus. Whether it's through our students who are serving in the National Guard, our faculty who are using our labs to 3D print masks for the hospital, or through opportunities like today's Town Hall, we are all in this together, and the University is pleased to play its role. I will be serving as the moderator for today's discussion, but first I'd like to turn the program over to Dr. Pamela Elfenbein, Director of the UNG Center for Healthy Aging, to introduce our panelists, Pamela.

Dr. Pamela Elfenbein, Director for the Center of Healthy Aging: Hi, I'm Pamela Elfenbein, and I'd like to welcome you on behalf of the Center for Healthy Aging here at the University of North Georgia. With coronavirus, we've seen specific issues and considerations arise for older adults and persons with chronic conditions. And, the UNG Center for Healthy Aging noted a gap in communications regarding COVID-19 directed towards older adults. There's a lot of conversation about, but not much conversation with us. We are for you. This virtual town hall to respond directly to your questions and provide accurate guidance and approaches to protect ourselves, our families and our communities. If you haven't already sent us your questions, we will still try to respond to your inquiries during this town hall. Just send your questions to and now it's my privilege to introduce you to today's panelists. We are thankful that they were able to carve out time in their incredibly busy schedules to be with us here today.

So first, I'd like to introduce you to Abby Cox. Abby is the director of the Department of Human Services, Division of Aging Services. In this capacity, she administers a statewide system of services for older adults, their families and caregivers. She works closely with other agencies and organizations to effectively and efficiently respond to the needs of older Georgians. There were three of their many goals of the DAS, The Division of Aging Services that we are going to be responding to today. One, provide long term services and supports that enable older Georgians, their families, caregivers and persons with disabilities to fully engage and participate in their communities for as long as possible to. Insure older Georgians, persons with disabilities, caregivers and families have access to information about resources and services. That's accurate and reliable, and three prevent abuse, neglect and exploitation while protecting the rights of older Georgians and persons with disabilities. So I'd like to introduce you to Abby now and ask her to briefly tell us about the Division of Aging Services, what programs it oversees, where the funding comes from, and as Director of DAS, what's her role and how has it been affected by COVID-19? So Abby.

Abby Cox, Director of Georgia Department of Human Services-Division of Aging Services: Thank you, thank you for the opportunity to come to be a part of this panel discussion. I think this is a great opportunity for us all to engage in conversation about COVID-19 and how it is impacting older adults and individuals with disabilities. So Pamela, as you so eloquently said, you've captured the essence of what we do with the Division of Aging Services about some of the programs that we run. Most of them are programs that seek to keep people in their homes in their communities for as long as it is safely possible. Some of those programs include home and community based services. Home and community based services can include everything from a meal that a person might receive in their home. Some supports they might receive in their home anything from an aide to assistive technology that they might have. Again, the goal of that is is to keep it person in their home and out of the institutional setting, we also have a lot of caregiver support that we that we offer. We have aging and disability resource connection. As you had mentioned, we want to connect individuals with resources in their local areas so that they are again able to stay in their homes for as long as it safely possible. We also have a senior employment program. We also have Georgia CARES, which helps individuals with their Medicare related questions.

Those are all federally authorized programs, but we have several that are required of us by state statute and those include Adult Protective Services and you had touched on that we are very concerned about the abuse, neglect and exploitation of older adults and individuals and the community setting. That's where we do our investigations. If there is an allegation of abuse, neglect or exploitation, we're also the Guardian of last resort when the probate court appoints us in that capacity, we assist individuals who are no longer able to. To make decisions about their care, we do not handle money we would have a conservator would be appointed, but we do serve as Guardian of last resort again when the probate court appoints us in that capacity. We do a lot of training through our forensic special initiatives, unit of law enforcement, another mandated reporters, and we've got a lot of really exciting initiatives that we have been spearheading here in Georgia. And these are things that we all should be proud of. We've really advanced to our work around Alzheimer's and related dementia is. With the state plan also with our our project that we are doing with Emory University called the Georgia memory that project where we have 5 memory assessment clinics established across the state with the sole goal of early detection and diagnosis of all forms of dementia. Assistive technology is definitely an area where we have been growing by leaps and bounds as a state and making sure that we can get the proper assistive technology into the hands of those who need it most so that they can remain that owns. And then the last special initiative that I wanted to mention is that work around senior hunger. Unfortunately we have a very high rate of food insecurity here in the state of Georgia and with a lot of disease states, there's nothing that I can do to stop that. But senior hunger is something that we can do something about, and so we must come together as a state across disciplines to address it in our own unique ways across the state. So a lot of good work going on, but we don't do it alone at the state office, we work very closely with our 12 Area Agencies on Aging we're lucky to have Pat Freeman from Legacy Link on the panel today, but we have 12 area agencies on aging across the state and we have nine Centers for independent living and so we work very closely with them to administer most of our federal federally authorized programs.

Dr. Pamela Elfenbein: Thanks Abby. Now now it's my privilege to introduce you to Pat Freeman. Pat Freeman is the CEO of Legacy Link. That's the Area Agency on Aging for the Georgia mountain region and Legacy Link is responsible for advocacy, planning and administration of programs. All those programs that Abby just spoke to you about, and coordination and monitoring of services in a 13 County area in northeast Georgia. Legacy Link offers a wide variety of programs including all those community based services. home based services, and wellness and volunteer service programs in the older adult worker training program and also overseas the Ombudsman program. Mrs Freeman has headed the agency since its inception in 1996. So Pat if you would be so kind as to briefly tell us a little bit about Legacy Link about some of the programs in your region. What region does the Georgia mountain Area Agency on Aging serve and as CEO of Legacy Link, what's your role and how has it been affected by a COVID-19? Pat.

Pat Freeman, CEO of Legacy Link - the Northeast Georgia Mountains Area Agency on Aging: Someday I'll write a book about how it's been affected by it, as many of us are. Our jobs are very much affected by the pandemic. A Legacy Link is a nonprofit and we are designated by the state office on aging that you just heard about for 13 counties. But we also have contracts with federal and state funders. To provide services and a number of counties, one of the one of the programs that is spread out the most is employment and training, and we do that program in 120 counties and then we do case management. The RNs and case managers., the social workers do the home visits an work to help families keep their loved ones at home as long as possible then. We also operate the Long Term Care Ombudsman program in 29 counties across the top of the state. Uh. I'd say that Abby did a beautiful job of describing the different services and I would just want to add that we have contracts with that office that run these programs. But what that means is that we turn around an contract with local governments and agencies to actually provide the services. And I would just mention that one way that our agency has been affected and the change due to the virus is that we can no longer do face to face visits with anyone. All of those visits that used to be made are all done now by telephone, and the staff is working from their homes now. I think I'll stop at that point and I just want to thank you Pamela, for asking me to be a part of this.

Dr. Pamela Elfenbein: Thank you Pat. So the last person on our panel today is Pam Clayton. Pam Clayton is vice president or quality advancement and regulatory affairs for the Georgia Health Care Association and the Georgia Center for Assisted Living. The Georgia Health Care Association is a nonprofit Association of skilled nursing centers, assisted living communities, and home and community based managers. They have advocated for Georgia's older adults since 1953, representing the best interest of patients residents and consumers, as well as owners, administrators and staff. The Georgia Health Care Association and the Georgia Center for assisted living also works closely with government agencies and other trade and professional associations. Residents and consumers, and some awesome. Helping amending implementing sound legislation. Regulatory policies and standards of care. So with that I'm going to turn it over to to Pam have her tell us briefly about the Georgia Health Care Association and the Georgia Center for assisted living. Little bit about the programs and services and also tell us as vice president of quality Advancement and Regulatory Affairs what her role is and how it's been affected by COVID-19.

Pam Clayton, VP Quality Advancement & Regulatory Affair at the Georgia Healthcare Association: Pam, thank you. Good afternoon everyone and thank you so much for the opportunity to be here with you today. It's certainly been a challenging time across the state of Georgia as well as across the nation in those that we serve have been particularly affected. The Georgia Health Care Association supports over 350 skilled nursing care centers, assisted living providers, and home and community based services across the state. And so we are so blessed to be able to interact with them on a regular regular basis and support their efforts that relate to quality of care of regulatory impact. Those things that seem to change on an all too frequent basis. Educational initiatives as well as governmental, and legislative policy that impacts the day-to-day within those care settings. And as with most of you. Uh, it feels like this Covid pandemic has been all consuming for some time now, and certainly in my role of working with quality advancement and regulatory affairs. I've been very involved with the providers trying to be a resource in terms of questions and support related to current guidance things as specific as isolation precautions, talking through PPE needs trying to secure resources. So definitely it's something that we have been affected by up close and personal, and just as you all I know are anxious to see this really turn in a positive direction soon and return to some level of normalcy but very appreciative of the opportunity to be here with you today.

Dr. Pamela Elfenbein: Thank you Pam. Chaudron is going to be moderating the questions for us, so we're gonna turn it over to Chaudron now.

Dr. Chaudron Gille: Thank you Pamela. This first question I think is appropriate for all of our panelists. We'd like to know broadly what is being done to keep older Georgians safe and to protect the vulnerable frail elderly. Can you address that question and talk about how you're different agencies have modified their practices due to Covid-19? Start with Abby.

Abby Cox: OK, this is a great question and this is a question that requires a lot of collaboration, and I am so proud of the good collaborative efforts that have gone on, not only with our federal partners with the administration for community living, but with our sister agencies. And so that we can make sure that as we rewrite policies so that they fit the time that we're in, We're not making work harder for the end provider or the end consumer, but most notably we've got to being very close communication with our area agencies on aging who are working to directly provide a lot of the services that are going on. So to that end we have set up biweekly calls with our area agencies on aging. I put out a daily FAQ to them so that when one area agency on aging might ask a question, we get it in writing and get it out to= everybody as soon as possible. But we do have to look at all of our policies to see what we need to be changing to serve individuals in this time. So an example of that that's probably on everybody's minds are those senior centers that we've got across the state. We knew very early that though we're going to have to work with our area agencies on aging about how. How do we best proceed with senior centers? The AAA's and their local counties make the call on when senior centers close and when they will reopen, but they certainly turned to us for guidance, and so we we put out guidance about being able to serve individuals in their homes who traditionally would have been going into a Senior Center for programming or for meals so that the funding for that was seamless and we could start serving those people immediately.

Some of our area agencies on aging have really been innovative, and the virtual programming that they have started right away. So that individuals who, again, once we're in a Senior Center there still staying connected, it just looks a little bit different, so some of that virtual programming is done through Facebook. Some of it is done through local TV programming, some of its done through local radio stations. We know that broadband is an issue across the state, and we can't count on some of these virtual options to work across the state. So there's been some great examples of a local radio station that has educated people about scams going on. They've led people in exercises, they've educated caregivers on some supports that are out there for them. So we've really turned to our area agencies on Aging and try to help them innovate as quickly as possible. So meals are now being delivered to individuals so that they're not going into a Senior Center and getting those. We also know right now that senior centers and adult day programs were opportunities for caregivers to have some respite and maybe do things Out in their local community that gave them purpose and meaning, and now everybody stuck inside together and so we need to be making sure that our caregivers are supported too. So we've been talking to our area agencies on aging about programs that are available for caregivers right now, so that again they can still feel supported. And then we've really had to take a close look at our Adult Protective Services and public guardianship programs. Those programs require in-person visits and in the absence of having PPE for those case managers to go out and do the investigations and do the in person visits, we've had to turn to purely telephonic means right now. So when we receive an allegation of abuse, neglect or exploitation, we're calling the alleged victim were calling collateral witnesses and trying to get as much information as we can, and we're continuing to remain in contact weekly with the alleged victim, hoping that we can do as much work as we can telephonically.

If it's an emergency situation, obviously we get law enforcement out there right away. We work hand in hand with them, but we're not going to close that case until we are able to do that in person visit, so we anticipate hopefully having PPE very soon so we can get our case managers back out there doing those critical in person visits for public guardianship. Also, we have not been able to do the in person visits that that are so critical for the work of a case manager working hand in hand with a person under guardianship, so we've turned a telephonic means there, some case managers have become really innovative and using FaceTime to talk with the persons under guardianship, but we've been able to very successfully pivot, and. make sure that the most vulnerable Georgians that we serve are safe and that they are protected and a time like this.

Dr. Chaudron Gille: Thank you Abby. Up at would you like to respond? What services are still being provided an what have you had to modify as a result of Covid?

Pat Freeman: Well, I guess I'll start with modification because that's as I mentioned, the RNS and a social work case managers cannot do face to face visits - that's been prohibited since the middle of March, so that's the big change. But there's lots of telephone work going on. Telephone is certainly our friend now for all of the services the in home care that we contract with is still going on with. The workers are going in for home care, but some of the clients are fearful of someone from the outside coming in because of the coronavirus. So in some cases the clients have given up part of that service, so that's been a change. The senior centers have been rising to the occasion they've come up with all kinds of fun things to do. They do daily telephone calls. They've done activity bags filled full of things. We're switching money from congregate, since we don't have groups sitting together anymore over to home delivered, and in some cases there doing just a drive by ,and people, the clients, come by and pick up the food. So there's a lot of different things going on. In one case a one Senior Center they have discovered they can play bird bingo over the telephone. And with a computer, so they're coming up with all kinds of ways to keep people involved.

Dr. Chaudron Gille: Certainly keeping people engaged is a concern for everyone and Pam as we turn to you and talk about how in your environment and with the long term care facilities, the modifications have been made. Several people wrote in concerned about the fact that they can no longer visit their relatives. Would you talk about what's happening in our long term care facilities as a result of Covid?

Pam Clayton: Absolutely, and thank you for that. I know that it has been a very challenging time as certainly the way that we typically function is really a part of the community has had to change by necessity with this. A pandemic and as a part of that we have had to limit visitation. We had to restrict entry. Uh, to only those that are providing essential services and this is very much a transition for us and an I know that it's been difficult for family members to not be able to see their loved ones in person. And certainly we have tried to look at alternate means for interaction through virtual technologies and that sort of thing. Certainly drive bys have occurred in our setting and we have had to adapt in a lot of different ways to ensure that residents are able to enjoy that meaningful connection, and so we we continue with that. I know that folks are are very interested to know when will that end and that is being monitored. On-going as we look at current recommendation and guidance and that that is a real- time effort as we collaborate with other stakeholders and agencies.

I think probably one of the biggest things that has been challenging for us as well. We're a high touch profession and when you think about the necessity of limiting those interactions, and you know to the minimum number necessary, that is been a real adjustment because we are always about that person centered interaction. Really spending quality time with the residents and the patients and the need to limit that interaction. As I said to, to bundle care and services and also oftentimes your PPE. And that includes maybe facials and mask of that also impacts. So all of those things have definitely impacted in a very real way, and we we are working with the other stakeholders to be a real part of the health care continuum as you think about the concerns for hospital capacity and surge. Where is the appropriate place to care for individuals?

You know part of our role and support to the centers has been to look at, you know where might be appropriate to have a designated Covid units and where can that be offered in a safe way, and to, you know, really make sound admission decisions to be a really partner in this need that has affected across the continuum. So things do look different. It has, uh, been challenging. You know restrictions and, and you know limited Visitation is not a part of what our service model typically looks like, and again, we're excited to return to a greater level of normalcy, but we want to do that when we can do it safely and not minimize some of the gains that we've made through those sacrifices. That individuals who made up to this point.

Dr. Chaudron Gille: I appreciate all three of you talking about the virtual technology drive bys. Adapting to this very real environment that we have of being more physically distant or are practicing social distancing with that in mind, Abby would you talk about the advice that you're giving to older adults and family caregivers about resources that are available for those who are home alone or who are isolated what? What can you offer?

Dr. Pamela Elfenbein: Chaudron, Abby must have just lost her connection, so could we go on to the next question while she tries to get back in?

Dr. Chaudron Gille: Certainly I'll move on to a question for Pat and similarly, what services are available for or what hotline advice and issues do you see that y'all are addressing the most?

Pat Freeman: For the hotline inquiries, a lot of those. My stamp tells me are about sons and daughters of older people more than the older person calling because many times the sons and daughters are living. Hours away, perhaps, and not able to see their parents. And then even if they're here, they're not able to go in and see them. So that is one concern about how are they doing? When does my mother get to have visitors? So it's really hard for some people to understand. As Pam said you, you try to do this as well informed as you can and taking the best of advice from the medical field. And to tag onto that Pat, are there specific challenges that the senior population who have limited resources are facing in terms of their housing or planning for the future financial challenges? Are you planning different things for this population or additional resources for that population? Well you mentioned housing and I think you'll find that that's a big issue statewide even nationally for affordable housing and for senior housing. And so we do get inquiries about that and we have staff that have done counseling with people about locating homes that are affordable and safe. And for our Medicaid waver programs, called Community CARES, and the Source program. That that funding helps with a whole variety of things, including the facility that the person might live in, and also other services as well. So we're hooked up as the other 11 area agencies are into a computerized database of telephone resources, so it has somewhere around, I think, 24,000 resources statewide. So someone needs to find something that maybe is going on in South Georgia. You can get answers for that as well. So we go to that base or activities as well as for essential help that a person might need.

Dr. Chaudron Gille: Thank you Pat. I see that Abby's back with us. So Abby, I'm going to come back to the question that I had for you. What advice are you giving older adults and family caregivers about resources for those who may be home alone?

Abby Cox: That's a great question, and we've had a group spearheading some work on social isolation. Because this is one of the elements before COVID-19 that we were very concerned about. But of course given COVID-19, this makes social isolation even more concerning. I think that the statistic that we sometimes see is that social isolation has the effect of smoking 15 cigarettes in one day. That's how bad social isolation can be for us. The good news is that there are options out there. Some of the virtual programming that Pat and I've spoken about are are great ways to keep people connected, but there's also telephone reassurance that's going on from a lot of our meal providers and area agencies on aging. Just simply to call and check in with somebody that call can do so much. I'm delivering meals and it's been interesting to see that process right now. What happens is? You go to the individuals home, you call them before and then let them know that I, you know, you're bringing the the food up there and then you step back and you have a conversation with that individual. So it's a great opportunity for me to get have eyes on an individual engage in some conversation, and if there are some concerns, talk with that individual. Also take it back to that provider organization so that they can help. Make sure that that person gets connected with their area agency on aging. Certainly social isolation is something that as we move forward. It's probably one of our key areas and we think about it. I think sometimes in terms of the the recipient of meals or the recipient of the virtual programming, but I just want to reiterate here that the caregivers are so critical in this conversation we have got to be supporting those caregivers so that they don't feel the effects of social isolation. Compounded with having to take on additional duties with their with their loved one that they once weren't doing. So we really need to be lifting them up in this conversation as well.

Dr. Chaudron Gille: Thank you Abby. And I'm gonna turn now to Pam Clayton and for those of you who may have tuned in late. Pam is vice president of quality advancement and regulatory affairs with the Georgia Health Care Association in Georgia. Center for assisted living. And Pam, when we think about our family members and friends that are in assisted living situations, I think there are two main areas of concern or fear and certainly one is this fear of the impact of social isolation on their mental health and the other you touched on briefly when you talked about the need for PPE for the employees in these facilities. I think there is concern about the the residents and their family members may have about their safety, their and their potential exposure to the virus. So can you address those two concerns? What's being done in terms of making sure that we have output protective equipment and and protecting our residents from exposure? And then also addressing the fears of the impact of social isolation.

Pam Clayton: Absolutely thank you for that, and again, some of the protective measures that have been put into place that are necessary due to the very contagious nature of this novel virus and what we know to be a significant, potentially adverse impact on older adults and especially those with underlying chronic conditions. You know, some of the key recommendations relate to isolation precautions and so certainly that does heighten concerns for the risk of social isolation, and we have just been so proud of the centers as they have thought creatively about how to mitigate some of those risks. And really have thought of outside of the box in terms of how they offer activities and opportunities for engagement. Again, we know that there have been a lot of virtual interaction with the interactions that have occurred and encourage. And, I'm really excited to share that CMS recently made us aware of an expedited fund application for centers to be able to apply for funds to support bringing in additional technology to assist with some of these virtual connections. So while that center certainly probably had some capacity for technology within their centers already were very pleased at CMS recognizes the need to augment that technology and has provided for an expedited application process for that. But we we see the centers send in pictures and information about a creative activities, overhead trivia, different things that they're doing in order to stimulate the residents and we know that this is really critical at this time and we encourage family members too.

If you know that there is something that would be particularly meaningful for your loved one, and maybe would help to decrease the risk of social isolation or the impacts of that, make the centers aware so that we can really try to provide personalized approaches to those interactions and things that we would plan for the individual residents because it is very important. Another thing that I think is really key right now related to the potential effects of social isolation is our ability to have a maximized use of Tele-Health. There are some waivers that have been put into place as a result of the public health emergency related to tele-health services which will give us greater access to mental health professionals and the services that they can provide. Additionally, I think it's important to know and should be some comfort to family members and representatives to know that. I think awareness is key and so there definitely has been a heightened focus around the risks of social isolation and so just by virtue of heightened awareness, I'm hopeful that if anyone is experiencing an adverse impact from the isolation that we would catch it early, we would identify that early on and this would ensure early intervention, and I think that our staff are very focused on a really monitoring, closely monitoring residents when they are interacting with them for any changes. And this is a related of course, to monitoring for signs and symptoms that may be suggestive of the Covid virus. But also, I think it would enable us to quickly identify if there seems to be a change in their emotional wellbeing or behavior. So, I think that is something for families to be aware of it.

Again, I just encourage you to engage to make us aware of specifics that might be particularly meaningful to your loved one. Related to personal protective equipment and the supply of PPE, that certainly has been a challenge since the onset of the pandemic. And while some channels for procurement are beginning to open, and we're very thankful for that. Inventory and cost remain a significant issue. Some centers are using in a day the PPE that they would have is historically used in a months’ time, so you can certainly appreciate the challenges around supply and demand. You may have heard that the federal government indicated that they would be issuing a PPE allocation to every nursing center across the nation of a week supply in May. Those are supposed to be dispersed and then in June there should be another week supply of PPE inventory that would be provided to every skilled nursing center across the nation. So, we're really looking forward to that inventory augmenting our supply also.

Dr. Chaudron Gille: Thank you, Pam. I think you know as we look to the future, it's encouraging to hear about the additional funds available to support the use of technology and the work that's being done to improve the pipelines of protective equipment that are available to the staff there. One of the things that we see in some of the questions that were sent in are several questions about preparation for the future and concerns about the state budget cuts, and how that may impact your operations. I'm going to turn first to Pam, we'll start with you if you would like to add anything to what you've already said. And then Abby we'll turn to you and then Pat to respond to potential implications of state budget cuts.

Pam Clayton: So I'll just briefly say that you know, obviously we are very concerned about the impact of the states budget shortfalls on available funds right now. We're certainly looking for additional support from a funding standpoint, because costs at every level have increased significantly. If you can get PPE, it's going to be at an increased cost. Additionally, staffing costs very much increased at this point in time as you're looking at in some cases contract staffing, but also paying what we like to refer to as some hero pay for those staff that are continuing to show up and be so dedicated. And we're so thankful for them. Also the impact of of raw food costs have certainly impacted in our setting. And finally there have been necessary shifts in typical admission practices and so therefore census changes have resulted and revenue therefore, is impacted in a significant way in our setting. So costs have gone up. Revenues have gone down, and we know that across the state, they're grappling at every level with how to manage the shortfalls.

Dr. Chaudron Gille: Thank you Pam. Now to Abby Cox Directory for Department of Human Services in the Division of Aging. Abby, what do you anticipate the impact of the state's budget shortfalls being or what steps are y'all taking to prepare?

Abby Cox: First, I'd like to talk about some of the stimulus funding that we have received so that folks are aware of that. We first received the families first Corona Response Act. We received about 6.5 million dollars from the Families First stimulus funding. That was for congregate and home delivered meals. But as Pat mentioned earlier, right now, as long as the major disaster declaration is in place, our area agencies on aging have a lot of flexibility and moving those funds around because we know people are not going to the congregate setting the Senior Center setting for those congregate meals. We also received a CARES Act funding to the Department of Human Services, Division of Aging Services, and that total award was a little over $23,000,000 so that one was broken down between supportive services, home delivered meals, family caregiver support, the long term Care Ombudsman Program or aging and disability resource connection. Those totaled up to be again a little over $23,000,000. And then Lastly, we have a very innovative team lead for our Aging and Disability Resource Connection at the state office and one weekend she turned around and amazing proposal to go for more CARES Act funding specific for the aging and disability resource connection. We got the full amount that we requested, which was a little over 1.7 million dollars. So, we are then turning around and partnering with our area agencies on aging, but also with other entities. To put that funding out in very innovative ways so that we reach as many people as possible. So, we're working with sister agencies like the Department of Behavioral Health and Developmental Disabilities on a lot of the mental health concerns that we've all been talking about today. You know, sharing ideas around behavioral health coaching. Partnerships to expand behavioral health coaching models in Georgia's housing voucher program. Older adult certified peer specialist staff training. We are trying to work with them because we know that the mental health component of COVID-19 is a very serious in a very real issue. Also, assistive technology making sure we're getting the right technology into the hands of people so that we can serve them through programming and other ways. So those are very exciting developments that have happened since COVID-19, but as you said, we did receive a directive to as did all state agencies. Nobody was spared. We were directed to reduce our budgets by 14%, and if anybody was able to turn into tune into our Department of Human Services board meeting today, you would have heard that the Department put forward a plan to reduce our budget by 14% and and we don't know the effect for aging programs to date, and what I just want to stay very focused on is this is the start of a process. Of course, the Department had to put forward a plan to the board, and that plan will then go to the Governor's Office of Planning and Budget and over to the Legislature for them to begin taking it up. And as they begin their debates, we don't know what you know what might happen in those conversations that go on and then once they come up with a proposal for the state fiscal year 21 budget, you know the governor then has the final look at it and will sign off on the budget. And at that point we will know what the impact is to aging and will have a better sense at that time. So I would encourage people to go to the Department of Human Services website. You can pull up the PowerPoint from today's budget. And today's board meeting and then see the budget information. If you'd like more information on it. But again, I think it's critical to just be very engaged throughout this process, as legislators began taking up the budget.

Dr. Chaudron Gille: Thank you Abby. We'll turn to Pat Freeman now, CEO for Legacy Link. Pat, would you like to talk about the concerns about state budget cuts or perhaps other resources that you've been able to engage or seek to help support programming during the pandemic?

Pat Freeman: I want to thank Abby for that beautiful timeline, not by month, but just by activity and it is something that we need to be aware of and that our clients need to be aware of what's going on. So we think that communication is a big part of all of this activity, and we'll keep everyone informed. And we're very much appreciate what the state government lets us know about where the budgets are. So we just really are in the midst of looking at all of that and what the effect will be, but I would like to turn then to some of the pluses that Abby mentioned. We got just over $330,000 through one of the Bills from the Congress that is to be used for meals, so that's welcome and that money can be used until the end of September. Then we have another bill that was second one that was passed. We're getting just over $1,000,000 for meals and supportive services to help people in the community and in their home. It is, his is a real partnership at the area agency level. We have local governments. We have clients who donate and pay for part of their activities. We have the state government helping the area agency put all this together and then in some cases we have contracts directly with the federal government and so we just going on and we're happy that people have tuned into this forum today so that there's another group of people that will know what's happening.

Dr. Chaudron Gille: Pat, I have another question for you. Are there specific services that you could point to to support older adults in, say, grocery shopping or transportation needs at a time where they may be cautious about venturing out on their own?

Pat Freeman: Well, that's mostly done by volunteers and groceries are left at the door. And, as someone mentioned earlier, a phone call is made and someone will come and pick them up so you don't have direct contact. In some cases in the mountain counties, the van drivers are picking up groceries and again leaving them at the doorway. In Hall County we have a little bit more of resource to look at through ITN to do pick up some groceries. So it's a County by County look at the need. And then one of the issues now about getting volunteers is that volunteers don't want to get out, so we've lost some volunteers, but some of them are  sticking with their activities and they see this work as part of their mission.

Dr. Chaudron Gille: Thank you for that. I think we have far more questions than we could ever cover in today's meeting, but I know we had someone request about the possibility of being able to to record and replay today's session an also, I'm wondering about being able to post FAQs where perhaps we can work with our presenters to make the answers available to their other questions. Pamela. Before we go to our closing speaker, would you like to say anything about how these resources might be available after the town Hall?

Dr. Pamela Elfenbein: Well, we've been working behind the scenes with our IT folks who have been unbelievably supportive to bring this to you today and they have been recording this so as soon as we determine where it will be hosted will be putting that up as a link to that up on the Center for Healthy Aging website. We have lots more questions than we imagined, that we can't even get to half of them, and so I'm hoping that perhaps will be able to post some FAQs  and will work with Pat and Abby and Pam and see if we can get some responses to some of the questions and get them posted up on the Center for Healthy Aging website, and I appreciate all the comments that are coming in about the website and I'm glad that we've had this opportunity to engage with you, so thank you for being here with us. So, as you've heard throughout the program, there is great concern.

Dr. Chaudron Gille: Based on the questions that are being sent in, but also from our panelists in their agencies about mental health. During this time, both for the care providers and for older population, I think that's something we can all relate to, as our lives have been upended. And we really wanted to end today's program on a positive note. And so we have asked Simon Cordery, who is the Director for UNG's Counseling Services to come and join us and give us some guidelines for how we might bolster our own mental health. And encourage those in our families, and our friends and loved ones. Simon I'm going to turn it over to you.

Simon Cordery, Director of UNG Counseling Services: Thanks Dr. Gille, I'm happy to be here today. Thank you so much for having me. I know that we would all like answers about when this is going to end and what it's going to be like afterwards and we all as human beings don't like not knowing those kind of things. And, I realized that also this is not an ideal situation for especially our seniors. We all need people. We need relationships with people and so I know that that is. A struggle I think my best recommendation for everybody is that we kind of focus on the basics of self care. And when I talk about the basics of self care, I'm talking about having structure to your day, having a same bed time that you go to bed the same time you get up, the same time you eat your meals, as much structure as we can gives us a sense of normalcy and it also helps us understand what to expect. So things like, you know, returning emails at the same time, watching the news at the same time, participating in activities, making telephone calls at the same time,  things like that. Anything you can do to make your day structured is really helpful. Secondly, finding the time to make sure that we are eating those three square meals a day regularly, I know that when we don't have that structure, those meal time start to drift, And sometimes we skip meals and sometimes we never stop eating. So I want to make sure that we're keeping those mealtimes and eating those mealtimes. And also remember that you've got to find something to keep yourself stimulated. That can be as simple as writing, drawing, or in doing a puzzle, or it can be picking up a new hobby or learning a new skill. Whatever opportunities are available in your in your context Look for ways to try to keep your mind stimulated. Also socializing. We are creatures that need other people and so doing everything you can to be social.

As far as getting in contact with friends and relatives, be it via email or telephone or even good old fashioned postcards and I know since we've been in quarantine, my mom has sent me a lot more postcards than I'm used to getting. Those are always appreciated. So, I'm trying to find ways to keep socializing. The key here I think is to make sure that your voicing what your needs are to your friends and relatives and to those that can help you to reach out and ask for help and to remember that this is a situation that is not good for our mental health. And so if you're having struggles remember that there are services their professionals that can help. And I just wanted to give you the National Alliance of Mental Illness hotline number, it's 800-950-6264. And you can also try, that's available Monday through Friday, 10:00 a.m. till 6:00 p.m. Eastern Time. You can also send a text to 741741 and that is the after hours crisis text line for the the nation. So if you're struggling with your mental illness and you don't have resources, that's a great place to to reach out to you. I would say that we don't like not knowing when things are gonna end, and when we don't know when things are gonna end we tend to think that this is going to last forever, and I think it's important to remember that this is temporary and that it will get better. We just have to kind of keep taking care of ourselves the best we can communicate with others communicate, you know, see who else in in your circle of friends needs help and reach out. Thank you for your time and I wish you the best of luck.

Dr. Chaudron Gille: Thank you Simon. We appreciate you being with us today. I'd like to extend my thanks to all of our panelists and we appreciate your expertise and your willingness to participate today. And I'm going to turn it back over to Pamela to close this out.

Dr. Pamela Elfenbein: Thank you Chaudron. One thing that we haven't touched on is that we're getting a lot of emails from from our viewers about the relationship between the University students and the community, and I'd like to say that we're working on many different ways of engaging our students with older adults in the community. If you would like to continue that conversation, I invite you to email me and we can discuss what our students are capable of doing virtually and what it is that you need, and see what we can workout to work together. And with that I would again like to thank all of our panelists. They were amazing and that they took the time out of their day to do this because as you can tell, they're all quite busy, and to all of you for joining us today, and for the myriad of UNG folks behind the scenes who made today's Town Hall possible. Thank you all for joining us and I know that we're going to be seeing you again soon. Thank you.


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