Below are the full success and client stories from the Warren County Elderly Services Program (ESP) 2024 Annual Report. These stories illustrate the impact ESP has on older adults and caregivers in Warren County.
Click here to view the program’s 2024 annual report. To request a paper copy, email us.
Healthy Aging grant improves lives for Warren County older adults
In 2023, Warren County commissioners received a $288,032 Healthy Aging grant from the Ohio Department of Aging. The grants were intended to support the creation of new programs or bolster existing programs that focus on delivering services and supports that keep at-risk aging Ohioans in their homes and communities for as long as possible.
The grants were one-time allocations funded by ARPA and were required to be spent by Sept. 30, 2024. More than $40 million in Healthy Aging grant funding was awarded across Ohio’s 88 counties.
Counties were required to allocate a portion of the funding to food and housing assistance and internet access and digital literacy services. The remaining funds could be used to provide evidence-based services which aligned with Ohio’s 2023-2026 State Plan on Aging.
As the Area Agency on Aging for Warren County and the county’s partner in administering the local senior services tax levy, Council on Aging (COA) worked with the ESP Advisory Council to make recommendations to county commissioners on how to use the grant dollars to address some of the most urgent, unmet needs of older adults in Warren County.
County Commissioners collaborated with COA to use funds for essential services for older adults in 2024. COA successfully delivered the services supported by the grant, serving 535 individuals.
Citing the end of pandemic relief funding, high inflation and the rising demand for home and community-based services, COA’s Vice President of Program Operations, Ken Wilson, said that the Healthy Aging grant funding arrived at a critical time.
“The Healthy Aging Grants provided an opportunity to take some pressure off local senior services tax levies and the Elderly Services Programs that they fund,” Wilson said. “This funding – although not permanent – helped us meet critical community needs and avoid waiting lists for services.”
Warren County received $288,032 in Healthy Aging Grant funding and served 535 individuals in the county. Of note, the funding enabled 89 eligible older adults to receive AddnAide technology training to connect with community-based caregivers to receive in home care services. These were individuals who, because of the national home health aide shortage, were unable to be served by a traditional home care agency.
- Provided food assistance to 395 eligible older adults via home-delivered meals program
- Provided home modifications to support independent living to 53 eligible older adults, with the most common modifications including grab bars and ramps.
- Benefits Specialist staff at COA connected 26 county older adults with benefits available through their Medicare Advantage Plan, including emergency response services and medical transportation. Accessing such services through available health insurance benefits reduces expenses for the levy-funded Elderly Services Program.
“These grants helped us serve more vulnerable older adults, without placing additional strain on county senior services tax levies,” Wilson said. “We were able to provide critical services that met the aim of the grant’s purpose – to help older adults live safely and independently in their homes and communities. The grants also strengthened our relationship with local leaders and key service provider partners in the county.”
All Healthy Aging grants funds were spent by the Sept. 30, 2024 deadline.
Competitive bidding yields big savings for Elderly Services Program
As ESP’s administrator, COA contracts with service providers to deliver services to clients. Contracts are awarded through a competitive bidding process. As with all COA services, the goal is to contract with the highest quality providers at the lowest possible price to serve as many clients as possible with the tax dollars available.
In 2024, COA issued a Request for Proposals (RFP) for Electronic Monitoring Systems (EMS). More than the traditional “lifeline” device, EMS is a flexible service that meets a variety of needs, including medication dispensers, smoke and carbon monoxide detectors, Alzheimer’s boundary alarms and GPS tracking devices, among others. It is a popular service within ESP – more than 1,300 enrolled individuals used the service in 2024.
EMS providers offer similar services, often utilize identical hardware and have very scalable cost structures. With that in mind, COA sought a volume discount (across four counties) with a high-quality provider via a five-year contract. Since 2015, the previous single-sourced contract has saved nearly $5 million for senior services levies in Butler, Clinton, Hamilton and Warren counties.
In the case of the 2024 EMS RFP, COA anticipates the new five-year contract with Guardian Medical Monitoring will save an additional $1.5 million (20% reduction in previous contract costs), which amounts to $244,507 in savings for Warren County ESP. The new monthly service rate for EMS is $19 – a rate that is 42% lower than the Medicaid rate for the same service.
COA-backed rule change benefits home-delivered meals clients; cuts expenses
As the Area Agency on Aging for southwestern Ohio, Council on Aging (COA) advocates on behalf of older adults and the provider network that serves them. In 2024, COA advocated for changes to a rule that reduced costs, eliminated regulatory burden and eased service access for clients.
Due to COA’s persistence, the change came about in 2024 after more than 10 years of work. In 2011, COA, other organizations and service providers began advocating with the Ohio Department of Aging (ODA) to loosen or remove the “diet order” in Ohio’s administrative code for clients receiving therapeutic home-delivered meals. Therapeutic meals follow specific nutritional guidelines for those who require a certain diet for health conditions, or are mechanically altered (chopped, mashed, etc.) for safe chewing and swallowing.
The diet order required a prescription from a physician for a client to receive therapeutic meals. “The requirement imposed a huge burden on home-delivered meal providers and COA’s care management staff,” said Ken Wilson, COA’s vice president of program operations, who was instrumental in advocating for the rule change. Additionally, “other states didn’t have the requirement,” he said.
COA submitted a formal proposal for a change in 2019, but it received no traction. Then, COA Government Relations Director Nan Cahall suggested making the case for a rule change through Ohio’s Common Sense Initiative (CSI), which reviews state agency regulations as potential obstacles to business.
COA partnered with home-delivered meals provider Meals on Wheels of Southwest OH & Northern KY to make its case: that the rule required a tremendous amount of unnecessary time and resources to obtain prescriptions from physicians who were generally not equipped to provide them quickly. And most importantly, it delayed older adults receiving the appropriate meals.
CSI investigated and met with ODA and the Ohio Department of Medicaid to advocate for the rule change. In 2024, the rule was successfully amended to allow flexibility in the prescription requirement.
“The change not only allows more personal choice and autonomy for older adults but is helping us achieve our main goal: to ensure the health and safety of our clients by providing the correct meal without unnecessary delays,” Cahall said.
COA and providers are also saving money as a result of the rule change. “We saw a 5% reduction in home-delivered meal expenses in our Elderly Services Program (ESP) in Warren County,” Wilson said. “This is helpful when we’re facing budget challenges. It allows us to serve more older adults.”
Additionally, Meals on Wheels was able to eliminate a $40,000/year position that was dedicated to prescription management.
COA service project restocks senior building community rooms
Service is one of Council on Aging’s (COA) values. Each quarter, COA employees complete a service project that benefits older adults living in its five-county service area.
For its summer 2024 project, staff brought new life to community rooms in five senior living buildings across COA’s service area. Often in these buildings, the community room is the heart of the building, where residents can join various enrichment activities and socialize with others. Most have a collection of games and other items residents can borrow or use right in the room.
Through the service project, COA staff collected and donated crafts, games, puzzles and books to replenish the supplies in these community rooms, including at Warren County’s Harding House.
Building residents shared with COA staff they were thrilled with the new activities and that they would enhance their daily lives.
FastTrack Home helps “sisters” through concurrent recoveries
Spending time in the company of Warren County residents Suzy and Lyrica brings to mind the famous quote, “friends are the family you choose.” The two happen to have the same last name, but that’s not why they refer to themselves as “sisters.” It’s because they have been best friends and roommates for decades, there for each other through thick and thin.
They met in 1995 when their respective churches merged and their pastors set in motion a plan to introduce the two – neither of whom had family – during the holidays, hoping they would become friends. “We hit it off so well, that we’ve been best friends ever since, literally sisters,” said Lyrica. “I wasn’t lonely anymore, because God gave me my Suzy.”
Shortly after they became roommates a few years later, Suzy, 72, began helping Lyrica, 60 – who was a professional dancer and minister of dance – in her busy dance studio. In addition to her involvement with the studio, Suzy continued to work full-time at Anthem Blue Cross Blue Shield, in part to have health insurance coverage for rheumatoid arthritis she’d had since her 20s.
The two eventually co-founded a church that operates globally and has 10,000 members. They traveled around the world together, but always coming back to their shared condo in Warren County.
It was just before a women’s mission trip to the Bahamas in 2012 that Lyrica felt a tightness in her chest. She required immediate surgery, where doctors performed six heart bypasses. Her heart problems were caused by a genetic condition called high LP(a), where high lipoprotein makes it more likely to have a heart attack, a stroke or aortic stenosis. In the aftermath of the surgery, Lyrica now deals with circulation issues, neuropathy, severe pain, Type 2 diabetes and Reynaud’s Syndrome. At 48, she was fully disabled.
Suzy was her caregiver through it all, even with her worsening arthritis and related surgeries. “It’s been a blessing,” said Suzy. “When I get surgery she’s here and when she gets surgery I’m here.”
By 2024, the stress on her back from years of dancing caught up with Lyrica, and she required major back surgery. She spent more than a week in the hospital and then moved to a skilled nursing facility for rehabilitation.
During this time, Suzy fell ill and spent three days in the hospital. Lyrica would normally be there to help her upon arriving home, but she was still in the nursing facility. Suzy learned about FastTrack home from her hospital discharge planner and was approved for home-delivered meals and homemaking assistance while she recovered at home.
FastTrack Home is a transitional care program administered by Council on Aging (COA) that provides services at no cost for up to 60 days to older adults upon return home from the hospital or skilled nursing facility. Its goal is to prevent expensive, and often traumatic, returns to the hospital.
“FastTrack Home, it really did save my life. I’ve had the arthritis and have limped around and bent over and stuff, but to be so totally decimated physically … it just blew my mind. And so those meals… it was the greatest thing,” Suzy said.
Nine days later Lyrica was home recovering from surgery and also enrolled in FastTrack Home. Like Suzy before her, Lyrica also received home-delivered meals and homecare assistance. Having help from a home health aide “was life-changing,” Lyrica said.
These days, Lyrica and Suzy stay much closer to home with Pookiebear – a small Yorkshire Terrier-Chihuahua mix trained as a diabetes service dog – and Murdoch, their cat. They host “home church” every Sunday at their condo.
At the condo is where they each receive supportive services from the Warren County Elderly Services Program (ESP). After receiving support for 60 days from FastTrack Home, they each qualified to transition to the longer-term ESP program. All FastTrack Home participants are evaluated at the end of their 60 days of service to determine if they qualify for long-term assistance.
Suzy continues to receive homemaking services as her arthritis makes it difficult for her to perform household tasks. She said, “My arthritis is deteriorating now so that having the vacuuming help and stuff is huge.”
Lyrica receives home-delivered meals, homemaking and personal care services. “I’m just so grateful,” she said.