By Beth Blevins
In rural and frontier Oregon, as in many other parts of the country, the aging population is rising, bringing new challenges to healthcare and other services. To address these needs, the Oregon Office of Rural Health (ORH) hosts the annual Forum on Aging in Rural Oregon.
“We bring people together who are working on aging issues, to share best practices and learn from each other,” said Robert Duehmig, ORH Interim Director. “It’s important that Oregon’s rural and frontier communities are supportive of the aging population, so folks don’t have to leave when their care needs increase. There’s not a lot of assisted living or senior homes in rural and frontier communities, so when somebody has to leave their home for care, it usually means going quite a distance.”
The Forum was the vision of Scott Ekblad, former ORH Director, Duehmig said. “His vision was to highlight and share rural organizations’ programs with other communities that have similar resources and geographies.” In this way, he said, “rather then keep that innovative work siloed, the Forum offers a way for other folks to hear about this great work—there are a lot of really cool programs and projects going on in rural and frontier communities.”
To address as many aging-related topics in as many communities as possible, each year the Forum is held in a different region of the state, said Rosalee Locklear, ORH Field Services Program Manager. “We rotate to a different area of the state to highlight communities in and around that specific region,” she said. “And we rotate committee members to bring in folks from that local area, because they know the needs of their community best, and they help us spread the word about the Forum.”
The topics chosen for each Forum are based on evaluations from the previous year’s Forum, in conjunction with feedback from the Planning Committee, Locklear said. “After the Forum we ask attendees to fill out evaluations to understand what they liked and what they want to see in the future. Then the Planning Committee and I discuss the data,” she said.
In the evaluations, attendees also share how they will use what they learned at the Forum. After last May’s Forum, which included presentations on loneliness and grief, aging and disability, and clinical considerations for cannabis use, their comments included: “I’m more motivated to work harder against loneliness and social isolation in our community,” and “The pharmacology was helpful, knowing when a client is taking too many medications and who to contact regarding this.”
Tied in with and awarded after the annual aging forums, ORH’s Elder Service Innovation Grants are intended to fund new projects or those building upon existing services. “Through the grants, we’re able to support small organizations that do innovative projects,” Locklear said. “There’s not a lot of funding for those sort of programs.”
The Forum is funded through three sources: paid registrations, organization partnerships, and the Medicare Rural Hospital Flexibility Program, Duehmig said. “We absolutely have to have partners to make it possible,” Locklear said. “We like to reach out to organizations in communities where we host the Forum to showcase their support of this event.” Partners have included hospital and health systems, health care organizations and foundations, government aging organizations, and education institutions, she said.
Right now, ORH is the only State Office of Rural Health (SORH) that hosts a forum dedicated to aging in rural and frontier communities. “To my knowledge there are not a lot of SORHs that are specifically addressing their aging population this way, but other states are interested in supporting their aging communities,” Locklear said. ”For example, the Washington SORH has done an evaluation of their state’s home health and hospice agencies.”
“I’d be happy to have a conversation about what we do with anyone who is interested, and to help other people do something similar,” she added.
When ORH first began the Forum on Aging in Rural Oregon, Duehmig said, they did not know it would be an annual event. “But as long as the need is out there and we can meet that need through this particular mechanism, we will keep doing it,” he said. “I think the support for it is still strong and the need for that kind of information remains vital.”
Want to know what to expect at an Oregon Office of Rural Health (ORH) conference? Check the ORH app! The app offers information on the ORH-sponsored Oregon Rural Health
Conference and Forum on Aging in Rural Oregon, including meeting agendas, speaker bios, and sponsor information. The app also includes information on ORH and ORH staff, and instant access to ORH videos and ORH’s Twitter and Instagram accounts.
According to Robert Duehmig, ORH Interim Director, the app was created as part of ORH’s larger goal to become more paperless. “We don’t want to waste paper so we can be environmentally sound,” Duehmig said. “But the other reason is that our conferences are never near the office, so we would have to travel with all that stuff or ship it out.” Additionally, he said, “more and more people don’t want to go to a conference and bring home tons of stuff, so we make it easier for them to view that information on their mobile devices.”
The content of the app changes with each new conference. Since the last conference (as of this writing) was the ORH Rural Aging Forum, it is now featured on the app.
Currently, ORH is the only SORH that offers its own app and it is one of the few apps devoted to “rural health events.” The app is available on both Android and iOS platforms. (Search for “Oregon Office of Rural Health” in either app store).
Once per quarter, NOSORH facilitates an Aging in Rural Learning Group for State Offices of Rural Health. The Learning Group is a great opportunity for participants to join group discussions and informative presentations on various aging programs, projects and topics. People living in rural communities are poorer, sicker and (getting) older. With that knowledge comes the challenge of determining the SORH role without overstepping. The Aging in Rural Group attempts to chip away at that dilemma.
Interestingly, there are many resources readily available on the subject aging in rural. Here are a few web links that you may find useful as you begin your foray into rural aging populations:
Administration for Community Living – https://acl.gov/
The Administration for Community Living was created around the fundamental principle that older adults and people with disabilities of all ages should be able to live where they choose, with the people they choose, and with the ability to participate fully in their communities.
National Institute on Aging (NIH) – https://www.nia.nih.gov/
NIA, one of the 27 Institutes and Centers of NIH, leads the federal government in conducting and supporting research on aging and the health and well-being of older people. The Institute seeks to understand the nature of aging and the aging process, and diseases and conditions associated with growing older, in order to extend the healthy, active years of life.
Department of Justice – Elder Justice Initiative – https://www.justice.gov/elderjustice
The mission of the Elder Justice Initiative is to support and coordinate the Department’s enforcement and programmatic efforts to combat elder abuse, neglect and financial fraud and scams that target our nation’s seniors. We engage in this work by focusing on the following mission areas: Building Federal, State and Local capacity to fight elder abuse, promoting justice for older Americans, supporting research to improve elder abuse in policy and practice, and helping older victims and their families.
These are just a sample of the many resources available to SORH that are interested in the rural aging population arena. If you have interest in engaging with the Aging in Rural Group please reach out to Scott Ekblad, Group Facilitator (firstname.lastname@example.org), or Tammy Norville (email@example.com).
Have you (or someone you know) received a phone call from your grandchild saying they’ve been arrested and need your help? What about someone calling claiming to be from the IRS and there was a problem with your taxes? These are a just two examples of fraud discussed at the Department of Justice (DOJ) Rural and Tribal Elder Justice Summit, the first meeting of this type hosted by the DOJ Elder Justice Initiative.
Through a developing partnership with the DOJ, NOSORH was able to introduce National Rural Health Day (NRHD), the Power of Rural movement, the work of NOSORH and State Offices of Rural Health to the participants of this two-day event. The Summit was held in Des Moines, Iowa, on November 14-15 and featured speakers Matthew Whitaker, Acting Attorney General; Pamela Teaster, Virginia Tech Center for Gerontology Director and Professor; and Marit Anne Peterson, Minnesota Elder Justice Center Program Director. The topics covered were as varied as the speakers and were delivered by panels of experts. Topics included Federal Efforts to Support Rural and Tribal Communities, Challenges and Opportunities in Rural and Tribal Communities, and Harnessing the Power of Technology to Respond to Elder Abuse in Rural and Tribal Communities.
Tammy Norville, NOSORH Technical Assistance Director, shared information regarding NRHD and the Power of Rural movement, providing a great segue to information about SORHs after discovering that most participants were not familiar with State Offices. Following her remarks, Norville made several connections with participants, including Lance Robertson, Assistant Secretary for Aging and Administrator of the Administration for Community Living. Robertson introduced Norville to his team to begin discussions regarding the Aging in Rural Interest Group.
Overall, the first Rural and Tribal Elder Justice Summit was successful and moved the developing partnership between NOSORH and the DOJ Elder Justice Initiative Team forward.
Contact Tammy Norville (firstname.lastname@example.org) for additional information.
NOSORH committees are great focal points for engaging in many NOSORH initiatives. Descriptions of all committees and contact information can be found on the NOSORH website.
Aging in Rural Group – The Aging in Rural Group held its October meeting at the NOSORH Annual Meeting in Cheyenne, Wyoming. The group was fortunate to have two experts on hand to provide perspective and introduce the group to innovative programs. Dr. Kathy Black, Principal Investigator, Age-Friendly Sarasota, and faculty at University of South Florida Sarasota-Manatee, presented a plenary session on Rural Health Alignment with Age – Friendly Communities before joining the group discussion. She shared a vast array of resources and tools available for use in aging work. Shelly Jackson, OVC Visiting Fellow, Elder Justice Initiative, US Department of Justice, spoke to the group at length regarding the Rural and Tribal Elder Justice Initiative and associated resources. The group will continue to follow the work of these two highly regarded experts and will provide any relevant information and/or resources in coming months. If you have interest in joining the Aging in Rural group, please email Tammy Norville at email@example.com.
Development Committee – The Development Committee’s discussion centered around sponsorship status and potential growth of sponsorship opportunities moving forward. If you have interest in joining the Development Committee, please forward contact information to Tammy Norville (firstname.lastname@example.org).
Flex Committee –Harvey Licht, Varela Consulting joined the Flex Committee to share information regarding the CMS Star Rating Program for Hospitals proposed rules. Harvey is working with the PPMT Committee to formulate NOSORH comments on these proposed rules and having him join the Flex call provided members an opportunity to ask questions and provide “boots on the ground” input for consideration. There was also continued discussion around the desire for access to quality, affordable, easily accessible education for Board Members as well as potential topics for the coming year. Generally, the Flex Committee does not meet in November nor December. However, the Flex Guidance is scheduled for release in December, so there will be a call on Thursday, December 27 at 3 PM ET to discuss the Guidance. If you have interest in joining the Flex Committee, please forward contact information to Tammy Norville (email@example.com).
Executive Committee– Last month, the Executive Committee reviewed recommendations from the Governance and Structure task force, prepared for the NOSORH membership meeting and planned the appointment and election of Regional Reps to the 2019 Board of Directors.
Communications- The Communications Committee continued making plans for National Rural Health Day, including webinar topics and presenters. The group discussed the option of printing hardcover copies of the Community Stars e-book for the first time.
Policy Program Monitoring Team- Last month, the PPMT worked to finalize comments on rural ACO. At the Annual Meeting, Harvey Licht shared information on tracking state coverage initiatives and led a discussion on the increasingly important role of states on ensuring access. Analysis of these initiatives and several links for tracking these initiatives were included in the presentation. The work of the PPMT in November will include reviewing appropriate measures and recommends for hospital star ratings, and tracking efforts on global payment systems.
The Oregon Office of Rural Health approached NOSORH this spring to establish an informal interest group to discuss the work of State Offices of Rural Health (SORH) around aging in place in rural America. Twenty-one states and the Federal Office of Rural Health Policy expressed interest in meeting periodically to discuss what they are working on or issues in their states pertaining to the elderly in rural communities. Fifteen participated in the inaugural call held on June 2. Topics discussed included the current work of SORH and work with palliative care programs and other home health agencies. Oregon and Washington shared information on conferences they are hosting in addition to a few grant initiatives they are working on. Additionally, the PACE (Programs for the All-Inclusive Care of the Elderly) program was reviewed along with the challenges of implementing in a rural setting.
The group will continue to meet quarterly to share resources and ideas on this increasingly important topic. The next call is tentatively scheduled for Tuesday, September 26 at 1:00 pm Eastern. Future topics will include: state strategies for funding, grant opportunities, food insecurity for seniors, chronic disease self-management, medication reconciliation, oral health, isolation, and best practices, resources and lessons learned when implementing programs in a rural setting.
If you have any questions of the group, you can reach out to members by emailing firstname.lastname@example.org.
If you are interested in joining the group for routine updates, contact Kassie Clarke at email@example.com.
Are you interested in discussing how State Offices of Rural Health can help rural people age in place? NOSORH is developing an interest group on aging in rural America to assist SORH in sharing experiences and resources on the unique issues surrounding the topic.
The Oregon Office of Rural Health recently conducted a study on long term care facilities finding there are few available and they are not sustainable. “Fighting ageism, understanding the value added for retirees and enabling aging in place were the themes that emerged the more conversations we had about aging in rural Oregon,” said Scott Ekblad, Executive Director for the Oregon SORH.
In response, Oregon is hosting the first annual Forum on Aging in Rural Oregon for community members, family caregivers, elder care professionals, primary care providers, policy makers and philanthropists interested in making it easier for seniors to age in place. “I am interested in talking with others who are also interested in sharing their ideas, experiences and resources on aging in rural,” continues Ekblad.
If you would like to join the conversation, starting in mid-May, please email Kassie Clarke.