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Investor Presentaiton

ATTACHMENT B-OAA INFORMATION REQUIREMENTS low incomes, individuals with greatest economic need, minority older individuals, older indi- viduals residing in rural areas, and older individuals with limited English proficiency; (iii) an analysis of how the programs, policies, and services provided by the State can be improved, including coordinating with area agencies on aging, and how resource levels can be adjusted to meet the needs of the changing population of older individuals in the State; and (iv) an analysis of how the change in the number of individuals age 85 and older in the State is expected to affect the need for supportive services. There are a few major changes that will impact Virginia's aging programs over the next decade and be- yond. They include the overall increase in the aging population and aging population that is living longer, funding streams that have not kept pace with the increased demands, the uncertainty of future federal funding, the growth in Medicaid and non-Medicaid HCBS, the push for health promotion and disease pre- vention efforts, and the expansion of CCC Plus in Virginia Medicaid. In Virginia, like many other states, rural localities continue to lose residents, and urban areas continue to see a growth in population. The result for the aging network are disproportionate levels of geographically and potentially socially isolated rural older adults who need services and supports, while the growth in urban areas has been marked by an increase in racially and ethnically diverse older adults and older adults whose primary language is not English. DARS leadership continue to monitor the shifting demographics, particularly as it relates to the upcoming 2020 Census effort, and the OAA priority population categories and those age 85 and older. The out- comes of the 2020 Census will prove invaluable to further identifying and assessing needs as they relate to characteristics. The business model of the aging network and AAAs is changing, and the key aging network partners in Virginia are already evaluating these changes for opportunities and challenges. DARS continues to seek opportunities to grow services through ACL grants and grants from other federal agencies and statewide partners. While usually time-limited in scope, grants have enabled the Common- wealth to build capacity, look for opportunities to imbed programming into core service offerings, and de- velop plans to sustain services into the future. With a particular eye for strong evaluations with all pro- jects, DARS hopes to create both evidence-based services and services that have a proven track record for increasing the effectiveness and efficiency of programs and saving public taxpayer dollars. Given the demographic shifts and funding limitations, AAAs have also begun to target traditional OAA ser- vices to individuals in the most critical need. To serve other populations and maintain a broad offering of services, AAAs have started to shift their business model to market available private pay services and to contract with CCC Plus health plans for additional funding revenue. The future development of perfor- mance measures at the national level could shift public funding from FFS reimbursement to pay-for- performance reimbursement. With keen awareness of the upcoming 2019 reauthorization of the OAA, DARS is monitoring potential changes and opportunities to enhance OAA services across the nation and within the Commonwealth of Virginia. In partnership with NASUAD, DARS is especially interested in discussions related to flexible fund- ing, increased financial commitments (start-up and ongoing) for innovative programs, and understanding of the evolving model and roles of the AAAs and the aging network. 95
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