Public Hearing

before



ASSEMBLY SENIOR ISSUES AND

COMMUNITY SERVICES COMMITTEE



"Testimony of the Commissioner of Health and Senior

Services, Christine Grant, concerning the New Jersey EASE program"






LOCATION: Committee Room 9

State House Annex

Trenton, New Jersey

DATE: November 28, 2000

10:00 a.m.





MEMBERS OF COMMITTEE PRESENT:





Assemblyman Melvin Cottrell, Chairman

Assemblyman Kenneth C. LeFevre, Vice-Chairman





ALSO PRESENT:





Rafaela Garcia Leigh A. Maris Dana Burley

Office of Legislative Services Assembly Majority Assembly Democratic

Committee Aide Committee Aide Committee Aide

Christine M. Grant

Commissioner

New Jersey Department of Health and Senior Services 1



William Conroy

Deputy Commissioner

Senior Services

New Jersey Department of Health and Senior Services 17



Philip Rubenstein

Executive Director

Ocean County Office of Senior Services 21



Renee W. Michelsen

Manager

Senior Services

Atlantic Health System 25



Marylou Gagnon

Director

Division of Intergenerational Services

Office on Aging

Atlantic County Department of Health 28



Caroline Willner

Member

Advisory Council

Warren County Office on Aging 34



Margret McCarthy

Member

Advisory Council

Monmouth County Office on Aging, and

Member

Monmouth County Coordinating Council 37



John A. Wanat

Executive Director

Monmouth County Office on Aging, and

President

New Jersey Association of Area Agencies on Aging 38



Pamela S. Pedrick

Executive Director

Salem County Office on Aging 43



Jaklyn DeVore

Director

Essex County Division on Aging 45



Anne Ciavaglia

Director

Bergen County Division of Senior Services 53



APPENDIX:



News release plus fact sheets

submitted by

Christine M. Grant 1x



Highlights plus graphs

submitted by

Philip Rubenstein 22x



Graph plus attachments

submitted by

Marylou Gagnon 35x



Graphs

submitted by

Pamela S. Pedrick 47x



Testimony

submitted by

Thomas A. Cavalieri, D.O.

Chairman

Department of Medicine

UMDNJ School of Osteopathic Medicine, and

Chair

New Jersey Commission on Aging 52x



rs: 1-58

ASSEMBLYMAN MELVIN COTTRELL (Chairman): This hearing is conducted today because I'm concerned about the effectiveness of the highly-touted program after reading the media reports outlining several areas where the program has failed to achieve its goals. This hearing is (indiscernible) positive.

So the first one I'd like to have speak is Commissioner Christine Grant.

C O M M I S S I O N E R C H R I S T I N E M. G R A N T: Good morning, all.

I'm being joined by--

Thank you for having us here this morning.

I'm being joined by Bill Conroy, who is our Deputy Commissioner for Senior Services. And we have several other staff here, as well.

Can you hear me? Is it on? (referring to PA microphone)

ASSEMBLYMAN LeFEVRE: Is the red light on?

COMMISSIONER GRANT: It was, then it went off again.

ASSEMBLYMAN LeFEVRE: It's on now.

COMMISSIONER GRANT: Okay.

Eileen O'Connor is here -- Nancy Day, several other staff -- and as you will hear, some of our wonderful colleagues from the county--

I'm pleased to be able to present information about New Jersey EASE. My testimony is somewhat lengthy, because we have a lot to say. So, if you will bear with me, I want to make sure that we get out all the information that I think you'll need. But of course, we'll be happy to answer any and all questions.

As you may know, New Jersey EASE, Easy Access, Single Entry, provides one-stop shopping for all senior information and services. Seniors and their families can receive clear, accurate, and timely information on the many Federal, State, and local senior programs that are available to them by calling the national toll-free telephone number, 1-877-222-3737.

Using the toll-free New Jersey EASE number, the caller is then connected to his or her local county office on aging, which is the New Jersey EASE lead agency. During regular business hours, the caller's going to be able to talk with a live person, not a recorded menu or an answering machine. And a trained Information and Assistance specialist will work directly with the senior and their family, providing information about programs and services.

New Jersey EASE was launched just four years ago, when Governor Whitman challenged the Department of Health and Senior Services to work with the county governments to develop a system that would make it easier for seniors and their families to receive information and apply for help.

When the Department began working on this project, Governor Whitman had three requirements. First, it had to be easy to use. Second, it had to be county-based, because each county knew best what services were available. And third, a real person had to answer the calls, no menus, no voice mails. Today's New Jersey EASE program meets all three requirements.

Perhaps the most important aspect of New Jersey EASE is the partnership between the State and the county governments. This state-county partnership has resulted in the sea change, frankly, from the aging services system of the past, which sometimes was fragmented and which could send frustrated callers from one phone number and agency to another.

Putting New Jersey EASE into place did not happen overnight. We had to roll it out incrementally, four counties at a time, working with each county over a period of nine months to a year. Ocean was the first county to fully implement New Jersey EASE in March of 1997.

That year, also, Atlantic, Morris, Somerset, and Union came on line. In 1998, Burlington, Camden, Cumberland, Essex, Monmouth, Salem, Sussex, and Warren completed their system modifications and the training necessary to join New Jersey EASE.

In 1999, Cape May, Gloucester, and Middlesex came on line. In the year 2000 -- this year -- Bergen, Hudson, Mercer, Passaic adopted New Jersey EASE. And very recently, Hunterdon County has now joined and is establishing their system. So all 21 counties are participating in New Jersey EASE.

Also, New Jersey EASE was originally conceived as an essentially budget-neutral project. By that I mean the State provided initial financial start-up support for counties so that basically they could transition or reorganize their preexisting informational technology systems and programs and then continue to operate the new information service with essentially the same level of funding that they had been devoting to that activity previously.

Participating counties have dedicated county-supported time and resources to make New Jersey EASE work for their residents and their county. And in addition to the State start-up support that I mentioned, we also provided support including training, technical support, and the collateral materials that are necessary to provide the care management.

I mentioned that it's a county-State partnership, so each party has a responsibility -- set of responsibilities to make the system work. Some counties are ahead of others in developing certain aspects of New Jersey EASE. However, all counties, with the exception of Hunterdon, which, as I mentioned, is in the process of coming on line fully, have already established all the core services of New Jersey EASE.

In this partnership-- I like to explain that the responsibilities of the State are:

first, to provide the leadership necessary to encourage the development of New Jersey EASE in the first place, and to provide the technology tools and the staff training needed to implement the program effectively;

second, to provide the technical assistance to develop the county plan, to create the county protocols that are necessary to provide the services, to increase the county computer and telephone capacities, and to implement what we call the Comprehensive Assessment Tool, which basically is what is used in trying to asses from the caller what their needs are;

in addition -- third, to provide a broad range of training, which is, frankly, free of charge to all the county New Jersey EASE personnel, and to develop--

The State develops and funds the nationwide New Jersey EASE toll-free number. We also have financial responsibility to develop the statewide computer network and computer software that's going to be used for the benefit screening and care management tracking. And we've also provided some funding for counties to purchase software and hardware. That funding is already under way.

In order for the system to meet the public expectations of what a good system is about, the Department, with the counties, has created performance standards. So, together with our county partners, the Department monitors how calls are answered and to ensure that they are responded to and responded to appropriately.

The Department has recently launched a major public awareness campaign about New Jersey EASE, and this is designed to encourage the use of the toll-free number and access the advice and information available.

Now, the responsibility of each county includes, first, to provide the public with the accurate, helpful information and advice about the services that the public may be eligible for. So that's the service provided in the form of accurate, helpful information and advice.

Second, the county is responsible to identify the lead New Jersey EASE agency in each county. All of our 21 counties have chosen to identify their office -- their county office on aging as the lead agency.

Third, counties are required -- expected to develop a plan to deliver the New Jersey EASE core services, which, for example, include the Information and Assistance -- the core of the services provided, and also, the Outreach and Care Management part of the system. Each of the county offices are collaborating with outside agencies in their counties, which actually deliver the services which are recommended.

Fourth, the counties are required to identify the staff, from county government and from the nonprofit agencies, in their communities that are working with the public and ensure that these agencies have staff that are sent and participate in the training that's offered.

Counties are also expected to be a member of the family of New Jersey EASE to develop a consistent, uniform system to deliver the core services. They ensure that the toll-free number is operational, which is an important facet of this. And they are able to conduct their own public awareness campaigns within their county.

Let me just briefly describe some of the major accomplishments of New Jersey EASE to date. Even without the publicity -- because I mentioned we've just launched what is really the first statewide public awareness campaign -- more than 23,000 calls were made on the toll-free line to county offices on aging since January of 1999. Some 62,000 more calls have come into the Department of Health and Senior Services' State Senior Information Hotline. And 200,000 other calls were placed directly to county offices on aging, using local phone numbers, since January 1999.

These numbers, in my view, are, frankly, fairly impressive, given the fact that the calls were made before the State began what I like to call the hard launch -- our advertising campaign about the program. And keep in mind that when Governor Whitman unveiled the toll-free phone number early in 1999, as I mentioned, only 13 counties at that time had already fully implemented the program. So, even with only some of the counties up and running, we have had -- we had a great number of calls.

We had determined to wait until the system was statewide before we launched what is now a full-blown publicity effort. So the calls, the indication to me of the number of calls made, were really a credit to the effort of those in the counties that word of mouth had already gotten out as to what New Jersey EASE offered people in each county.

As I mentioned, New Jersey EASE is a statewide initiative in all 21 counties. And in order to ensure that even more seniors and their families know about New Jersey EASE -- that is why we've launched this $495,000 public awareness campaign, which just started on November 1 with a fair amount of fanfare.

The campaign includes television, radio, newspaper ads, bus panels, brochures in English and Spanish, banners for public events, and an Internet Web site. And if you happen, for example, to watch CNN, maybe something caught your interest in the last couple of weeks. We have had regular coverage on CNN with New Jersey EASE, and we're really getting a very excellent placement of the publicity campaign. The newspaper, radio ads are appearing all over the state as we're speaking. And this campaign is scheduled to continue through June.

Starting on November 1, also, the New Jersey EASE toll-free numbers became available nationwide. That means that family members who are living outside of New Jersey, very understandably, might want to call back to New Jersey if they have a mother or father or other elderly family member living in the state. They can call from out-of-state, toll-free, to the county that they're interested in and get information about services so that they can follow through with their family member.

The New Jersey EASE toll-free number is now available through directory assistance. And starting in 2001, all the New Jersey phone directories are going to have the New Jersey EASE telephone number listed in the emergency phone number section, as well as in the county and State government sections of the phone books.

A key part -- another key part of New Jersey EASE, which we've been working on this year particularly, is the installation of technology that's going to allow the agencies and offices to interact with each other via computer. And this is going to allow counselors, really, to have one computerized form, if an individual may start receiving care management in one county that perhaps moves or receives services or has need to contact another EASE county office, that that second office can -- will be able to scroll up, on the screen, the members -- the person who's been calling -- their case management form. This obviously is going to be a tremendous boost of service not only for the public, but it's going to be a tremendous opportunity for the county offices on aging, as well.

Now, this kind of project can't be completed overnight. But I'd like to remind you that before New Jersey EASE, we really had no statewide secure computer network for the 21 county offices on aging. It's true that some of the county offices had their own computer system, but most weren't connected to the Internet, whereas today, as a result of the efforts between the counties and the State, all the county offices on aging have computers. They're all connected to the Internet. And they're changing the way they do business. And the level of service that they can provide is increased due to use of these new technologies.

Clearly, computerization of this, and any social service, is a work in progress. And we will continue to really try to work on any and all improvements that are needed as we go along. We've contracted with a technology specialist to ensure that we have a secure computer environment. And that's also very important.

I talked a little bit about funding. More than $400,000 -- $440,000, actually, of HINT funding was allocated to all 21 county offices on aging to upgrade their computer hardware and software. The new software is going to be installed in all 21 counties and 180 New Jersey EASE case management agencies -- those agencies that work with the county offices on aging. And these computer programs, as I mentioned, are going to provide benefit screening information so the care managers can pull up, on the screen, all the information they need while they're talking with the person on the other end of the phone to make a determination of that person's eligibility and get the kind of basic information so the person doesn't have to bounce around from program to program, but can find out if they're eligible for the program.

Starting next month, more than 100 care managers are going to be trained to use this care management tracking software. And beginning in February, Information and Assistance specialists at the county office on aging will receive training for the benefits screening software.

We've already provided training for almost 700 county Information and Assistance specialists, who answer the phones in each office, to make sure that anyone who answers the phone has received the training, understands what EASE is about and what's expected. And we've also trained almost 300 county care managers.

In December, we're going to be implementing a very exciting component of New Jersey -- related to New Jersey EASE activities -- called Telehealth. This program uses phone lines and televisions in the person's home, with their permission and interest, of course. And what it allows a care manager to do is to see and communicate, as you and I are communicating right now, through the person's television in their home to see how they're doing with their health-care needs and their personal activities of daily living.

I've seen this in operation. It's been a long time coming. This technology is just fabulous. And we also know that it allows the professionals in a care management setting to do such things as to check in on the person's blood pressure or even take some glucose readings, which obviously could have been a tremendous boon to an individual so he or she doesn't have to make yet another visit to a doctor, but can get some advice and input over the phone.

New Jersey EASE, as it continues to grow and evolve, has been, I believe, a very successful program that has a strong foundation to give seniors information services, even as the services are changing.

Now, let's put New Jersey EASE in context. New Jersey EASE is just one of the many new and expanded programs that Governor Whitman supported through what she calls her Senior Initiatives Program. Over the last three years, she has committed more than $60 million to these senior initiatives as a whole. New Jersey EASE care managers refer individuals who call to one or more of these programs, depending on their needs. These programs include home care, respite care, adult day care. And this is obviously all directed to allow more and more of our seniors to live with the dignity and independence that they want to.

Last year, the Governor, in addition to that $60 million senior initiative program, committed yet another $5 million to further expand Meals on Wheels so we would have no waiting lists across the state.

Secondly, some of that money is used to increase the availability of personal assistance services to those seniors who live in congregate homes and to strengthen our Adult Protective Services, and to complete the job that had been begun of doing criminal background checks for all home health aides working in the State.

Now, obviously, it's difficult to change the number and the spectrum -- to complete the spectrum of long-term care options overnight, but I do think that we in New Jersey have made a great deal of progress. For example, just seven years ago, we had no assisted living facilities in New Jersey at all. And today, we have 130 assisted living facilities, with residences available for more than 10,000 people.

Our Community Choice Counseling Program, which is a program for those who are in a nursing home and now individuals in a hospital where they can receive counseling to help -- if they want to leave the nursing home to get back into an independent -- a relatively independent living situation, that program has already helped more than 1700 seniors leave a nursing home and get back into an alternate living setting. And I'm fond of saying that, in the evaluation we did, only about 5 or 6 percent of people had to go back into a nursing home within the first year. So that's testimony of how well that program's working.

Overall, the number of people residing in nursing homes in New Jersey has decreased since 1997, even as our over-85 population continues to grow.

Now, seniors and their families can learn about all these programs through the New Jersey EASE number. And that's what it's about. That's the number I mentioned, 1-877-222-3737.

So, to summarize, we very strongly believe, and are confident, that New Jersey EASE, and the family of New Jersey EASE county programs, offers a valuable service to New Jersey's growing population of older adults and their families. The nationwide toll-free number allows our seniors and their families one-stop shopping no matter what county they live in, even if they have to call from out-of-state.

We're publicizing this service with an aggressive PR campaign. And we're going to continue to work with each of our county partners to provide the training that they want and need for their staff. We're going to continue to develop the computer software that's going to make it easier to do the first-class care management that New Jersey citizens want and deserve. And we're going to continue to make the point that any time you make changes in government programs or systems, public or private programs on any level, it takes time, it takes patience, it takes marketing of the information. And that's what we've been doing. And that's what we're going to be continuing to do.

Thank you.

ASSEMBLYMAN COTTRELL: Thank you.

I have some questions, and you've answered some of them. But I'd just like reaffirmation.

From the beginning, New Jersey EASE was to make it easier for citizens to access information, process applications, and get services they needed, simply by making one call. From what we're hearing, trying to find that number is a problem. What are you doing to make that number more visible to the people?

COMMISSIONER GRANT: Okay.

Well, how to make the number more available and understood-- I mentioned the fact that actually, on these TV ads -- these public service announcements, on the buses, on the posters -- we have handouts, our county offices on aging -- my colleagues, as they come before you today, I'm sure can answer that question, as well -- what they're going to be doing within each county-- But that's-- We're getting the number out everywhere and anywhere that we think people will be to read it. I indicated we're also now going to be having it in all of the phone books. You know, phone books come out in January, so we've got all 21 counties on line, and that means that we can have the number both in the emergency number section, which generally is in the front of the phone book, and then obviously we're going to have it in the county and the State sections, which are usually the thin sections somewhere in the middle of the phone book. So any other ideas would be welcome.

We're also preparing a packet of materials for all of the legislators to -- and would hope that, through your district offices -- and thank you for mentioning that -- that you can help us, because I know how many constituents call you for information.

ASSEMBLYMAN COTTRELL: Also, in today's world, the computer is vital to every organization. It's the way in which business is conducted. How can you expect to continue to do business if you do not provide them with the tools? What are you doing to address this problem?

COMMISSIONER GRANT: Well, I mentioned that with the HINT money, that we've been able to provide hardware to the county. Specifically, we provided 75 desktop computers. We've provided 28 laptops. For example, a number of the care managers-- At some point, if an individual needs an assessment in the home, they have to go into the home setting. They can use a laptop in a home setting and dial up, right there, some information.

We put the money out. Of the counties, 13 counties received money in 1999, and $15,600 was provided for each.

ASSEMBLYMAN COTTRELL: And another one I have-- If New Jersey EASE is to be a statewide program, how do you explain that in some counties, older adults may be able to get one type of service, and in another county that service is not available?

COMMISSIONER GRANT: Well, the premise of the New Jersey EASE program again is-- I said that the Governor wanted a program, and I think that squares exactly with what experts around the country would say at the level where the services are available. And that means the county level. And of course, it's true that counties differ with respect to what agencies are available in a county. The specific agencies -- and specific agencies might provide a slightly different kind of service. What we're focusing on is trying to make sure that in every county, there would be access to some home care, some respite care, some adult medical day care. But the nature of the services is going to take a slightly different -- will have a slightly different look or a different look depending on the counties that they're in. We know that New Jersey counties themselves vary in many different respects, and there's no reason to think that you'd want a one-size-fits-all. Some of our rural counties need, perhaps, more emphasis on some of the programs as distinct from some of our more urban counties.

So I think that's a strength. We talk a lot about the strength that comes from the diversity of New Jersey. And I think that if we prematurely wanted a one-size-fits-all for our senior programs so they absolutely look alike, that we'd miss out on some of the very innovative, imaginative programs that are being developed at the counties.

ASSEMBLYMAN COTTRELL: Assemblyman LeFevre, do you have any questions?

ASSEMBLYMAN LeFEVRE: Commissioner, thank you for your testimony. I do appreciate it.

I represent the second legislative district, which makes up approximately 85 percent of Atlantic County. And I don't mean to speak on behalf of Atlantic County today. I know there's representatives here today that can do that. But I believe that it's been a very positive relationship since the introduction of the EASE program. As you mentioned in your testimony, Atlantic County was one of the initial counties that really was brought into the program. But it's been nothing but, I think, a direct, positive impact.

But one of the areas, and a major complaint, is the shortage of home care workers. This has always been a cyclical kind of a problem. It's a difficult service to provide. And not only is the home care population fragile and very demanding in their need requirements, but the rates paid to the organizations, as part of the rate setting, has allowed the agencies -- has not allowed the agencies to sustain a stable workforce.

Any thoughts about what we can do to help that process along?

COMMISSIONER GRANT: Well, my thought is that we all have to work together. We spent a lot of time talking with our colleagues in a variety of senior settings. And certainly, home care is troubled with the lack of a workforce.

While rates paid are one part of the puzzle, I think, unfortunately, it's even a more basic issue. And that is that the pool -- given this very, very tight labor market-- We just don't have the pool of workers that are out there.

I would like to address the core issue -- to do a better job, perhaps, at the vocational level -- promoting home care as a very dignified, wonderful career opportunity for individuals. Technically, the Department of Human Services in this State does a negotiation with the home care providers. I'm not saying that to put that question off. I think it's a fair question. But it's not simply a matter of the rates.

And another way that we're trying to complement this shortage in the labor pool is that we have created the caregiver program -- the family caregiver program, which basically is training hundreds of family members to provide some of the hands-on support that a family member needs. And for the first time in, really, one of the very few states in the country-- We are going to be allowing the caregiver relative to actually receive, albeit modest, but some compensation.

Now, I'm not suggesting that that's going to substitute, ever, for the need to grow our home care workforce, but it's a positive step that has been taken, not only because the family caregiver's a good person to provide care in many cases, but it also, in some sense, allows a person to stay in their home and get home care services where the labor is not available.

So I don't have a complete answer, but hopefully that is helpful.

ASSEMBLYMAN LeFEVRE: My concern is that we're doing an awful lot. And I commend you for doing the outreach and the awareness program -- the advertising program that you've just embarked upon. But at the end of the day, if you've got clients out there that you can't really serve because of this particular issue -- let's say home care workers are not there, what are we doing-- Unfortunately, it's one these other type-- There are many of these programs that exist where you can't really respond to the needs of your constituency.

So I think this is something that we really need to take a look at. I think it's about $75 a case a month -- is what's the current allotment. That seems to me to be insignificant. But again I throw that out as a challenge to you to take a look at.

COMMISSIONER GRANT: And we will continue to look at that issue.

ASSEMBLYMAN LeFEVRE: The other thing you mentioned briefly -- about performance standards. When did this begin to be implemented -- the performance standards of the county? Is that something that's relatively new -- is part of your equation?

COMMISSIONER GRANT: It is relatively new.

Actually, maybe Bill Conroy could address that more specifically.

D E P U T Y C O M M I S S I O N E R W I L L I A M C O N R O Y: Performance standards were developed by the New Jersey EASE advisory committee to look at standards around the delivery of care management so that there was some baseline of standard of how the individual case managers would literally deliver the care management services to seniors. So it included everything from structural standards, such as what are the qualifications of a care manager, to what are some of the process activities or criteria that a care manager would follow in doing intake and conducting assessment and preparing a care plan.

ASSEMBLYMAN LeFEVRE: How long have you been doing this? Is this a relatively new component?

DEPUTY COMMISSIONER CONROY: Yes, it is relatively new. In fact, it's right now being tested in two counties. And we've engaged in a consultant research, who's a vice president in nursing in New York City, who's going to help us look at the care standards and determine whether or not they're complete, whether they're workable, and whether counties can comply with them.

ASSEMBLYMAN LeFEVRE: But to date, there hasn't been any counties that have been taken to the woodshed, let's say, and have failed to meet the standards?

COMMISSIONER GRANT: Let me step in there.

No, there are no counties that have been taken to the woodshed. And I would hope that that's not needed for a couple of reasons. Again, these standards are being developed with the input from the counties, because this is not a top-down regulatory program. And I really hope the public leaves with that understanding that if this is going to work, the county personnel-- And when you hear some of the people today, you're going to see the high quality of people that are running these programs. They've really got to take ownership over the sort of total quality improvement. And I personally am confident that they will.

They also-- There is the sort of peer pressure as they look at each other and see what each of the programs are providing. I think that that will go a long way to raising -- continuing to raise, every year, the level and the quality of the services, as some of the counties for whom this is a more recent kind of activity get on line.

Now, that does not mean that, obviously, the State Department, at some point-- If there are problems, we'll sit and talk with the counties.

DEPUTY COMMISSIONER CONROY: Assemblyman, may I just also add that the individual counties have a huge investment in -- financial investment in the delivery of the whole panoply of senior services that are delivered under the Older Americans Act. And in aggregate, they've invested, in the past year, about $18 million in the delivery of services. So each of the counties are, obviously, through their own form of government -- have direct accountabilities to the county taxpayers in the use of these dollars, as well.

ASSEMBLYMAN LeFEVRE: One of the other areas that I've always had a great concern-- As a matter of fact, I chaired a task force last year looking at grandparents raising grandchildren. How is that blended into your efforts? Is there anything that you're dispensing, on behalf of the State through the EASE program, that would help that segment of our economy?

COMMISSIONER GRANT: Not per se. We have had-- However, the Department of Human Services has taken very seriously this very important issue and is-- And you might want to find out-- I can't speak specifically to what they're doing. But we have actually talked as a staff. We can't do it all at once, but we have talked as a staff about the importance of making sure-- And that might be something, as we get into some conversation with what's called One EASE E-Link, which not only has the New Jersey EASE services that would be part of the database, but all the services available, which we would call a kinship care service--

So it's an important issue. I did convene actually, earlier this year, a kinship care working group within the Department of Health and Senior Services. And they're going to be holding a colloquium the early part of next year -- actually the early part of the second quarter of next year -- to spotlight this issue. So it's a topic which concerns me greatly, but is a little different from what New Jersey EASE -- where New Jersey EASE is at today. That does not mean that an individual county, if someone calls with concerns and needs access to FamilyCare or KidCare insurance for their young child for whom they're guardian, that they would not get that information. I would hope they would. And over time, we'll certainly make sure that -- try to make sure that that information is available to all the offices on aging, which I think it is right now.

ASSEMBLYMAN LeFEVRE: Well, it's a rapidly growing segment of our population.

Again, my final comment is that Atlantic County, I think, has enjoyed the new collaboration through this program. And that's what's been relayed to me by the county officials. So I congratulate you for that.

COMMISSIONER GRANT: And I'm pleased to hear that.

Thanks for the opportunity today.

ASSEMBLYMAN COTTRELL: Thank you very much, Commissioner. We appreciate your testimony. And you put a lot of highlight on the hearing.

COMMISSIONER GRANT: Thank you.

ASSEMBLYMAN COTTRELL: The next speaker will be Phil Rubenstein, from Ocean County Senior Services.

P H I L I P R U B E N S T E I N: Good morning.

ASSEMBLYMAN COTTRELL: Good morning.

MR. RUBENSTEIN: My name is Phil Rubenstein. I'm the Executive Director of the Ocean County Office of Senior Services.

A little while back, I read a news article in one of the prestigious newspapers in the northern part of the state. And I was shocked -- absolutely shocked on the article that I read.

There was a man by the name of Mr. Watson, who was the head of IBM many, many years ago. And the first thing he told his employees was, "Think, and do your homework before you do the job." This article that was written, apparently, did not cover Ocean County. Ocean County, as the Commissioner indicated, was the first county to come under the New Jersey EASE program. And as she indicated, it means Easy Access, Single Entry.

The first thing the board of freeholders did in a meeting with myself is -- let's see how we can put this thing together. And we put it together by one way: putting all the agencies on one campus. And that's what we did. We put Senior Services, Veterans', Human Services, the Office of the Disabled, the State Unemployment Office, all the Board of Social Services, all the Adult Protective Services, all on campus with just a matter of 50 to 100 feet away from each other from each building. There are six buildings. We're exactly one mile away from the Department of Health. We are one mile away from the Ocean County Visiting Home Care.

Now, when people call, the first thing we do -- we find out what is the problem. If it is a problem that we can solve in our office, we give them the answer right there and then. If it's a problem that we have to indicate to another department, it's just a simple situation. If they want to do it in person, they can walk 100 feet to the next department. We contact them. We tell them we're coming over. Whatever the problem is-- And we have, in Ocean County, 25 programs going on at the present time regarding nutrition, home delivered meals, six outreach centers in every geographic area of the county, visiting home care, home health services, caregivers.

Now, it was indicated here regarding the National Caregivers Act-- "Let us bring forth--" Caregivers started in Ocean County approximately six years ago. We started with a caregivers' program, which was funded by the board of freeholders.

Today, the caregivers' program is one of the most successful programs of all the 25 programs that are going on. We were working with Washington with our representatives, both in the House and the Senate, regarding caregivers. This was the projected future, because the senior citizens -- when they came into Ocean County-- By the way, Ocean County has one of the largest senior citizen populations in the entire state. It's on the Congressional Record that Ocean County is the St. Petersburg of the Northeast. That's in the Congressional Record. We have more retirement communities from the state of Maine -- and I'm not including Florida. God forbid, I don't want to include Florida. (laughter) But that's the situation. The caregivers' program was so strong that we put in three more caregivers' programs in every geographic area of the county.

Now, how is this all coming together? People call up -- children call up. They need help. They heard about New Jersey EASE. They've called our number -- maybe an 800 number, as the Commissioner indicated. And we immediately contact the caregivers' program in that geographic area to take care of the necessary individual. And by the way, caregivers is all on volunteers. The only payment is actually the director of the respective caregiver program. We're having hundreds and hundreds of volunteers in Ocean County helping people helping people.

Today, as you probably heard, the reauthorization of the Older Americans Act indicated a national caregivers' program for close to $125 million.

I have to say, and I'm very proud to say, that we were the forerunners to fight for this program. And it came through with the help of our Senators Lautenberg, Torricelli, and our congressmen.

When I hear criticism of the New Jersey EASE program, it hurts, because it was one of the best programs that our Governor put forth. I have great respect for Governor Whitman.

By the way, I have spent 57 years as a public servant, 30 years with the Federal government, and 27 with the county. I have known many, many politicians in my career, some of them I'd like to forget. But the situation is-- I know Governor Whitman is one of the most compassionate individuals that I've ever met. When she saw the entire proposal of New Jersey EASE, it was a window of opportunity to help senior citizens. And she did not pull down the shade. She took it off.

And let me tell you, the New Jersey EASE program is working so well in Ocean County, because we had a tremendous public relations program as it went on.

Now, what went on due to this article that started this whole procedure is that maybe there wasn't enough public relations at that time, but they are now doing a tremendous public relations program.

I was listening to CNN just a couple of days ago, and I heard about New Jersey EASE. This maybe should have been done a couple of years ago. I don't know. Maybe we made a mistake there -- I mean the State. But we cannot rely on the State to bring forth all the necessary programs for the elderly population. This is a Federal program that must also be helped by the Federal government.

The State has been doing very, very well. And when I hear criticism of a program like New Jersey EASE, I say that criticism is wrong, because they did not do their homework -- whoever wrote that article. And I was very, very upset at that time, and I'm still upset. I don't ordinarily come down to these type of hearings. But this specific hearing I specifically came down to inform this Committee that New Jersey EASE is one of the best programs that the Department of Senior Services ever brought forth.

We have a long way to go. We have much more to do for the elderly population of this State. With the cooperation of the State and the cooperation of the Federal government, we're going to succeed.

I'm just going to give you an illustration of an article that was in one of the Ocean County newspapers. And this was written-- This was a person who called up on the New Jersey EASE program. And then she said, in this article, "I was amazed at how helpful the New Jersey EASE people were and how nonbureaucratic the process was. They cut through the red tape and were genuinely concerned. It's a wonderful program, and more people should know about it." This is just one paragraph of the article. And this is just an example of what New Jersey EASE is.

I want to conclude with one paragraph. All of you should remember that some day we're going to have to help others. And New Jersey EASE is a program that is truly, truly helping the elderly people of our state. And I sincerely hope that other states will copy what Governor Whitman has brought forth in the State of New Jersey.

Thank you.

ASSEMBLYMAN COTTRELL: Thank you very much, Phil.

Renee Michelsen, Atlantic County Health System.

R E N E E W. M I C H E L S E N: Thank you for this opportunity to testify today.

I am Renee Michelsen, the Manager of Senior Services for Atlantic Health System in Morris County. I have been a supervisor of community-based elder care services at Morristown Memorial Hospital since 1984. I am part of the New Jersey EASE development team in Morris County and statewide.

The benefits of New Jersey EASE are many, but today I would like to concentrate on one service that's closest to my heart, and that is care management.

Morris County is a prototype for the rest of the state of how care management can be implemented to benefit our frail, elderly consumers. For those of you who are unfamiliar with care management, let me just tell you a little bit about what the service really is. It involves an in-home assessment of the consumer and the family situation, a development of a plan of care specific to that individual, and an assistance with connection to the recommended services, as well as ongoing follow-up to be sure the consumer's needs continue to be met. In Morris County, this care management is provided by several New Jersey EASE providers working in harmony. This interagency team has one single goal: to serve the needs of the frail, elderly population.

To accomplish this goal, the care manager plays many roles. The most helpful role is that of advocate. It is without question, in New Jersey, a confusing journey through the maze of available services. It is the job of the care manager to serve as a guide on this trek. Not only does the care manager help point the way, but advocates for the consumer whenever needed. The care manager negotiates with providers, helps complete confusing forms and applications, and provides support for long-term planning.

The care manager is the one-stop connection for the family to understand and sort through the available resources and options. The typical families that come to me are in need of caregiving, and their situation is the result of a health crisis. And they need information quickly and accurate information. The care manager provides that and serves as a knowledge bank of resources, especially about eligibility, criteria, and the logistics of application processing. The care management service reduces the time the family spends in attempting to get help.

The often most underserved consumers are the greatest concern of mine. And those are the ones who do not have caregivers. Those are the ones who are truly vulnerable. Without a care manager, through New Jersey EASE, to be proactive on the client's behalf, the chance of institutionalization would be much greater. For example, the 80-year-old legally blind widow who has ants in her apartment and doesn't know it -- the care manager helps her deal with the landlord and resolve the problem -- or 92-year-old man who can no longer drive to get to doctors' appointments or the grocery store -- and until the care manager intervenes, he goes without adequate medical care and food.

I could give you examples of hundreds of cases of frail people who would not have obtained the help they need without the help of a New Jersey EASE care manager.

The New Jersey EASE model creates a standard for care management that has the potential to bring consistency to all of our 21 counties. It provides a template of help for consumers to be empowered and to maximize the resources that do exist. We always hear a lot about what doesn't exist and what we don't have, but we must focus on maximizing the resources that each community does have. New Jersey EASE formalizes the process of care management for the frail elderly. Prior to New Jersey EASE, there was no formal process.

In Morris County, New Jersey EASE has helped the agencies to work together for the benefit of the frail consumers. By supporting New Jersey EASE, we support the future and provide recognition that there is a growing population of aging seniors who will require intervention and advocacy to be able to remain in their own homes with dignity.

Our future challenges of New Jersey EASE are many. And one is to explore how do we move forward from where we are today to a more sophisticated system of care management that's equal in all counties. That's the next phase of New Jersey EASE.

The higher level question is how do we move forward to a truly unified, statewide care management system? The care management providers need to quantify what we do and speak as a single voice to our public about what we do and why. It's not only up to government to do the publicity, but the workers themselves and the agencies providing the services.

New Jersey EASE is the venue for our vision. There are many components of New Jersey EASE, and care management is just one. But care management has a working model, which has proven itself in some counties and can be duplicated in the rest. The potential to make a difference through care management is profound. And the opportunity is upon us at both the county and State level. The groundwork has now been done, and it's just time to fine tune our system and maximize the potential of New Jersey EASE.

Thank you.

ASSEMBLYMAN COTTRELL: Thank you very much.

Marylou Gagnon, Atlantic County.

M A R Y L O U G A G N O N: Good morning.

I'm Marylou Gagnon, and I'm the Director of Atlantic County Division of Intergenerational Services, Office on Aging.

It's a pleasure for me to be here to speak to you today about the New Jersey EASE program and its partnership with Atlantic County and how we've developed our service system.

In December 1995, Atlantic County administration consolidated the Division of Aging and Disabled, Office of Youth Services, and Human Services Planning into the Division of Intergenerational Services. The Division's mission is to provide information and access to services for all residents, regardless of age.

In July 1996, the State Department of Health and Senior Services initiated New Jersey EASE, a program designed to provide a coordinated service system for older adults. The Atlantic County Division of Intergenerational Services was selected to serve as one of the four pilot counties for the EASE initiative. Atlantic County was chosen to pilot the integration model based on our consolidated service system, funding streams, and cross-trained staff.

Some of the progress that we've made since establishing New Jersey EASE is, we've established a toll-free number. In our county, it's 1-888-426-9243. Trained staff is available Monday through Friday to provide information and assistance for all age groups.

At the time of a call, if an individual family member or senior citizen themselves requires more than just basic information on such services as pharmaceutical assistance, available home care, we can dispatch an outreach worker. This is a core service of New Jersey EASE -- free service to any of our residents. We go out and make an evaluation, we talk to the family -- to the senior citizen about what their needs may be, help match services according to those needs, and determine eligibility for programs. This can all be done by calling our toll-free number.

The Division also assumed the direct responsibility for the provision of Information and Assistance, Outreach, which is a home visit, and then follow-up Care Management, as the individual from Morris County was just telling you. We have been providing care management services in Atlantic County since the early 1980s. And I believe it's pivotal in the success of keeping seniors -- remaining -- allowing them to remain living in a community setting.

The Division also provides care management for New Jersey EASE, for Medicaid waiver funding programs, and two of the new senior initiatives that the Governor has rolled out -- Jersey Assistance for Community Caregiving -- that's a State-funded program -- and for another Medicaid-funded program, New Jersey EASE Home Care. We have been providing case management for a Medicaid waiver funded program called the Community Care Program for the Elderly and Disabled. We've been doing that since 1983. I believe it's a tremendously successful program. It keeps individuals that are financially and medically eligible for nursing home placement -- but it allows them to remain living at home in the community at 70 percent of what it would cost to have those individuals go to a nursing home setting.

This is a Medicaid-funded program, established, as I said, in the early 1980s, and it is budgeted according to slot. Every county in the State of New Jersey has this program. It's called CCPED. It's slot-driven. In Atlantic County, we are limited to 225 slots.

The great thing that the Office of Labor and Program Administration, with Christine Grant -- our Division of Senior Affairs has done with the new programs -- the Jersey Assistance for Community Caregivers and New Jersey EASE Home Care -- is they've given each county a spending authorization.

In Atlantic County, we've been granted $200,000 to spend for individuals for JACC, Jersey Assistance for Community Caregivers, and well over $614,000 for New Jersey EASE Home Care. This allows us-- As long as we stay under a certain cap per month in these programs, we can service an unlimited number of individuals up to that spending authorization.

In the Medicaid waiver program -- the 225 slots -- we have about $1800 to expend per month per client. Depending on the needed services, you may not be expending that money up to cap per month, but we really can't spend that money. It's in a cap. It's in a slot. Whereas, the new money -- this block grant, if you will -- authorization allows us to spend just what you need per client up to a certain cap. That meets the remaining. So an example would be, if for Marylou Gagnon to remain home per month is $1000, I have then additional money under the cap to spend on someone else. So it's a real departure, if I made that clear, from a slot-driven program to the -- sort of this block grant spending authorization. We found that tremendously exciting.

Another great thing about these two new programs is, it's expanded what normally is covered through Medicaid. Medicaid -- you can get adult and social day care, you can get home care services, home health services, case management, respite. In Jersey Assistance for Community Caregivers and also New Jersey EASE Home Care, as the Commissioner was referring to, is reimbursement for your informal caregiver. It's something in -- called client-employee provider. So it will allow an informal caregiver -- if a client is capable of self-directing their own care -- and an informal caregiver is approved to provide this kind of care -- they can then get reimbursed for providing that care. We have many informal caregivers right now -- that without them, their loved ones could not remain living at home. So we think that this will be a tremendous benefit to not just the caregiver, but also, as the Commissioner was referring to, helping us with our tremendous need to expand the provision of home care -- home health aid services.

Another-- Without New Jersey EASE -- with their Adult Protective Services program-- Again, it's available in all 21 counties in New Jersey and has been for quite some time. But it wasn't always administered by your offices on aging. That now -- funding stream -- comes through and is administered by each office of aging. It comes through something called our area plan that Mr. Rubenstein was referring to, through Older Americans Act funding.

Also, under New Jersey EASE, some funding stream called Social Service Block Grant, that was previously administered through, I believe, the Division of Youth and Family Services, under Human Services, now comes through the area plan. So it really gives-- What New Jersey EASE really has allowed each office of aging -- is to become the lead designated agency for older adult services in the State of New Jersey.

Also, in Atlantic County, and will be expanded to all other counties in the State of New Jersey, was something that the Commissioner was speaking to us about, is the One EASE E-Link initiative. This began in Atlantic, Cape May counties, and it's a computerized case management system, as I said, that will allow us to communicate. We can do an assessment on an individual when we go to their home and then communicate that, electronically, to providers -- the information that we normally would have to fax or call. It will really expedite and allow us to serve the client in a much more timely and-- We'll be able to share information. It will really help families that normally have to repeat information two and three times to different agencies, mainly your identifying information, your name, your address, your phone number, social security number. Once-- If you come through New Jersey EASE program, and this is registered -- then we are able to communicate this to other agencies, as appropriate. That should reduce all the necessary repetition that a family has to go through.

In summary, I would just like to say that I believe New Jersey EASE has formed a tremendous partnership between the State Division of Senior Affairs, the Division of Consumer Support, and each local office on aging, to streamline the service delivery system for older adults. I am confident that this partnership will allow our senior citizen population to remain living independently in a community. Over the next decade, we anticipate an overall reduction in nursing home placement by use of community-based services and informal supports.

The EASE initiative has just begun, and we need to work together to assure the availability of home- and community-based services by advocating for a rate increase in homemaker services; develop affordable assisted living residences which accept Medicaid reimbursement; support legislation which protects individuals who spend down their assets to the Medicaid limits, a bed in the same assisted living facility for which they pay privately; and expand affordable health-care insurance options, including prescription drug coverage for seniors.

Since 1996, with great effort on the part of the Division, the Department of Health and Senior Services, and the local counties, we have made some significant accomplishments. And it has been nothing less than a privilege to be a part of it.

Thank you.

ASSEMBLYMAN COTTRELL: Thank you very much.

ASSEMBLYMAN LeFEVRE: Mr. Chairman, I just--

Thank you, Marylou.

I think everyone here today can feel the energy that this young lady brings to her job. And Atlantic County is lucky to have you.

Isn't Atlantic County a great place? (laughter) I'm not biased.

MS. GAGNON: Thank you. Thank you.

ASSEMBLYMAN COTTRELL: The next speaker is Caroline Willner, Advisory Council, Office on Aging.

C A R O L I N E W I L L N E R: My name is Caroline Willner, and I have the privilege of serving on the Advisory Council to the Office on Aging of Warren County, as a volunteer.

I've been asked to read the statement of our Chairwoman, Elizabeth Adams, in regard to the articles written in the 10/31/00 and 11/06/00 edititions of The Star-Ledger, which were entitled "Shortchanging Seniors" and "Promises to Elderly Unfilled."

"I have been involved in the Office on Aging--"

This is Mrs. Adams writing, not myself.

"I have been involved in the Office on Aging network since August 1989, and collectively, our Office on Aging Advisory Council has over 100 years of experience working with our local Office on Aging and within the community.

The progress made over the last four years for, and on behalf of, our senior citizens is staggering. This is unquestionably due to the new projects implemented through the Governor's Senior Initiatives, through the newly created Department of Health and Senior Services, and through the unparalleled efforts of our Office on Aging.

A broad brush was used when it was stated that the New Jersey EASE program is not working throughout the State. This is simply untrue. The Warren County Office on Aging has been successfully implementing New Jersey EASE for over four years. In fact, New Jersey EASE is working in many offices on aging throughout the state. However, no reference was made regarding the successes of the program in The Star-Ledger articles.

There have been delays in implementing the computerized intake system. This is partly due to the fact that the EASE data program was included in with all other statewide data systems which were being developed. This combined database will eventually form One EASE E-Link, and is intended to make the entire statewide service system more accessible for residents of all ages.

Serving our older adults is not dependent upon technology. Offices on aging now have more tools and more funding than ever to assist older adults. New Jersey EASE has enabled this development. Offices on aging now have the ability to directly access programs and funding to help seniors remain independent and in the community.

The Warren County Office on Aging has extensively publicized, in our local newsletter and throughout our county, the toll-free New Jersey EASE number. We feel it is working and is assisting people to access services.

In our county, where there are several phone companies, the New Jersey EASE toll-free number eliminates long-distance charges for our clients and costs nothing to our Office on Aging to maintain. Without question, we do promote the toll-free number. We feel it's our job to make access to services easier for older adults.

In conclusion, though it may be assumed that Union, Mercer, and Essex counties represent all county offices on aging throughout the state, they do not. New Jersey EASE is a very complex local and statewide initiative, which involves a totally new way of funding and providing services. Is our staff working harder? In Warren County, they are. Are our local seniors better off as a result of New Jersey EASE? In Warren County, they are. If the New Jersey EASE program were allowed to function as intended, all New Jersey seniors would be better served. New Jersey EASE has replaced a chaotic and fragmented system.

We are proud of our Office on Aging, and we are proud to be part of the New Jersey EASE initiative.

Sincerely yours, Elizabeth C. Adams, Chair, Warren County Office on Aging, Advisory Council."

ASSEMBLYMAN COTTRELL: Thank you very much.

MS. WILLNER: Thank you.

ASSEMBLYMAN COTTRELL: The next speaker is Margret McCarthy.

M A R G R E T M c C A R T H Y: Good morning.

My name is Margret McCarthy, and I am a senior living in Freehold. And I am delighted to have the opportunity to speak to you about the New Jersey EASE, New Jersey Easy Access, Single Entry program. For the last two years, I have been a member of the Advisory Board to Monmouth County Office on Aging.

A year ago, I, and seven seniors from the Senior Citizens Activities Network at Monmouth Mall, Eatontown, participated in an acting skit to promote the 1-877-222-3737 toll-free number. We preformed that skit at the 1999 Human Service Conference held at the Garden State Arts Center. Our purpose was to acquaint some 200 Human Service professionals with the ease in which one can obtain information about senior services through the use of this one toll-free number. The skit was so well received, both by seniors and professionals, that we are now videotaping it so that it can be seen at the 180 senior clubs in our county that serve over 12,000 seniors.

As a member of the Monmouth County Advisory Board and a member of the Monmouth County Municipal Coordinating Council, I and my colleagues have made a major effort to acquaint the seniors of our county with the use of the toll-free number. But, like most local marketing efforts, you cannot hit every single person who needs the information, so we were delighted to hear that the Department of Health and Senior Services was initiating a $495,000 public relations campaign to promote the New Jersey EASE toll-free number. I have already seen posters, brochures, and newspaper ads, as well as seen TV and heard radio spot announcements.

I can speak from personal experience that seniors are receiving detailed information and services through the Office on Aging.

On a personal note, I am a member of the Senior Citizens Activities Network, which is supported in part from the Older Americans Act administered by the Office on Aging in my county. This educational center is specifically geared to keep older adults active and independent. I have learned to tap dance, use a computer, and act, amongst other things, at this center. But equally important, this center is part of the New Jersey EASE system that the State Department of Health and Senior Services is developing to maintain the health and dignity of our aging population.

I applaud the State Department of Health and Senior Services and the Monmouth County Office on Aging for the excellent services that they are providing from the New Jersey EASE system. And I look forward to the many more innovations that are in store for this system.

Thank you for the opportunity to address you this morning.

ASSEMBLYMAN COTTRELL: Thank you very much for your testimony.

The next speaker is John Wanat. He's from the Monmouth County Office on Aging.

J O H N A. W A N A T: Good morning.

My name is John Wanat. I am the Executive Director for the Monmouth County Office on Aging. And I'm also the President of the New Jersey Association of Area Agencies on Aging. And I want to say that, as you've heard already this morning, New Jersey EASE is alive and well and working very well in the State of New Jersey.

In repeating what my colleague Phil Rubenstein said, I was appalled at the article that appeared in The Star-Ledger that blanketed all of us with the promise to the elderly being unfulfilled. And it appeared a day before a major public relations kickoff that promoted the new 1-877-222-3737 number that was going to appear just a day after this article had appeared.

This toll-free line is designed to meet the needs of seniors and to access services. The article gives the impression that the statewide program is failing. This definitely is not the case.

At this time, it is most appropriate to quote, and I will, Rosalie Kane, a leading authority in the long-term care policy, who was reported in that same article as saying, "Most states attempting to reduce their nursing home budgets run into roadblocks." She goes on to say, "It's typical that information systems take years longer than anyone expects to get them up and running." I call them growing pains, and I think they are. But they can also stunt the growth immediately. And in some states, they have, but they haven't in New Jersey.

We agree wholeheartedly with her statement. The State's initiative is just coming out of the period of growing pains. New Jersey EASE is strategically healthy and able to serve the state's seniors in spite of these growing pains and the massive changes that are occurring because of our growing pains.

As with any major project, the initial stages are slow and complex until all the bugs are worked out. The State has said from the beginning that this is a work in progress. And Christine Grant said that earlier. This process has received a great deal of support and commitment from all the county offices on aging in this state. And we've been doing this job for many years. The State has finally put it into a nice, concise way in which we can handle things.

The goals of New Jersey EASE are consistent with the goals of the Older Americans Act, which was established in 1965, and which was just reauthorized in the Congress. It was also the intent of the Older Americans Act to assist the elderly in providing them with the necessary services that would keep them independent in the community and assist them in maintaining their dignity and their ability to age in place.

The Governor's initiatives were, and are, bold and compassionate efforts to keep our aging population independent within the community that they live. Her efforts and ours have decreased the number of people in nursing homes since 1997. And even though the 85-plus population has been increasing, assisted living facilities, which did not exist seven years ago, now total 130 in the state, and are growing. Even more impressive is the fact that 80 of these facilities accept Medicaid.

Since the toll-free hotline was launched in early 1999, over 23,000 calls were received on that line, and another 200,000 calls went directly to the county offices on aging at their local numbers. County offices on aging staff answer these calls, and they're trained information and assistance specialists who give specific, exact information to the caller. And they direct the caller to the appropriate service that they've requested and sent them the information that they need.

Allow me to spend a few minutes to give you a couple of examples of the types of calls and the service that we are able to provide through our New Jersey EASE hotline.

The first involves a 91-year-old female. Her family called because they were fearful of her living alone at home. Our New Jersey EASE Information and Assistance specialist linked the family to an appropriate home health-care agency, Home Friends, in particular, and to our transportation services, known as SCAT. The client continues to remain in her home and has maintained her dignity. And it was one phone call that helped her in that assistance.

The second involves a 61-year-old client who was suffering from a skin and nervous condition. She called because she was emotionally and physically upset, and she was taking care of her disabled mother. And she was at her wits' end. She was calling because she was contemplating placing her mother into a nursing home. New Jersey EASE referred both the client and the mother for Social Service Block Grant for homemaker service and was able to provide home assistance and assistance for both of them. Now, they're both at home and doing well, and the conditions have improved.

The third involves an 81-year-old blind female residing alone, who contacted New Jersey EASE regarding Meals on Wheels. And during the assessment process that takes place, it was determined that she would greatly benefit from the Home Friends program that we administer through the Office on Aging, as well as the socialization factor and the home assistance program for financial assistance. So, she not only got to get Meals on Wheels, she got home energy assistance, and she also got a friendly caller to call her on a regular basis so her socialization factor was taken care of.

Now, that's what I call aging in place with an assistance that comes from the New Jersey EASE network. And we can go on all day long, because those phone calls come in on a daily basis. In my office, there are three Information and Assistance specialists answering those calls all day long and giving them direct information. And with one telephone call, they get that kind of information.

We receive these calls on a daily basis. However, seniors, as Margret McCarthy pointed out, have known about this number for a long period of time, because we've done outreach within our community. And now the Department of Health and Senior Services has launched a major public relations campaign to promote that 1-877-222-3737 number. As a matter of fact, as I drove into the state here today and to the Capitol Complex, that was one of the big billboards I saw as I came into Trenton. So people other than seniors -- because seniors have been getting this information for a long period of time through our normal outreach programs through the Office on Aging.

In my opinion, the people who will really need this information, and where this money is really going to go and be targeted to, are to the folks who are in my age category who are known as the sandwich generation. We still have children at home, and we have aging parents and aunts and uncles who need services. The working folks don't know who to call. If you ask the Margret McCarthys, they can tell you that number. And she probably has that number memorized. What we need to do is make sure that the sandwich generation, the people who are still working, get to know about what numbers they can call for the information with one simple telephone call. And our number that has been promoted is now reaching those individuals, and they're calling us because of the public relations campaign.

The State Department of Health and Senior Services, and the 21 counties' offices on aging, are committed to continuing to provide seniors and loved ones with the best services that can be provided in this country, not only in the state. We continue to work every day to strengthen our system. We believe that this is a work in progress. And as Phil pointed out, we believe it will become a national model in the years to come.

Thank you for giving me the opportunity to say a few words on behalf of a working program, New Jersey EASE, in the State of New Jersey.

ASSEMBLYMAN COTTRELL: Thank you very much for testifying.

The next speaker is Pamela S. Pedrick.

P A M E L A S. P E D R I C K: Good morning.

My name is Pamela Pedrick.

Thank you for allowing me to be here.

I'm the Director of the Salem County Office on Aging, which is one of the most diversified offices on aging in the State of New Jersey.

Our rural setting has necessitated the Office on Aging to become a multifunded agency. Services provided are funded through the Older Americans Act, Senior and Disabled Residents Transportation, Adult Protective Services, and of course, New Jersey EASE core services, Information and Assistance, Care Management, and Outreach.

While Salem County's population figures are unchanged, in 1999 Rutgers University ranked it at number five in the seniors as a percentage of the population. So Salem County's elderly are aging in place.

With Salem County's strong sense of community, farms, and family, we have become the number one county in the State of New Jersey in farmland preservation, helping to keep our county a rural setting.

Our mission statement in Salem County is to enlighten and empower the elderly population of Salem County while supporting their independence, self-determination, and dignity. As our residents are aging in place, they have a strong desire to remain in their homes and communities.

New Jersey EASE has allowed our agency to be the focal point for all aging issues. This upholds the intent of the Older Americans Act, which is the foundation of the aging network.

With New Jersey EASE, a number of other agencies within the county have joined the partnership. This has opened-- This has created an open forum for addressing senior issues and handling customer needs.

During the last three years, this office and our New Jersey EASE partners have been able to provide services to more residents. With the growth of New Jersey EASE, additional program opportunities have become a reality.

User-friendly access is the goal that we strive to maintain in our office. We have people answering our phones who are willing to provide pertinent information and address the needs of the individuals that they speak with. When an individual needs assistance, they should be able to contact an agency that can answer all their questions or who has the ability to go out and get the answers for their questions.

With the introduction of the software, agencies and consumers will be able to enter a seamless system. But with all new systems, it takes time to implement them.

I have agreed with the concept of New Jersey EASE, and Salem County is committed to being part of this undertaking.

As we push ahead, I hope we will all remember the reason for the offices on aging and New Jersey EASE, and that is to ensure New Jersey's elderly residents have adequate information to make informed decisions with independency, dignity, and self-determination.

I thank you.

And I'm going to add one other point that's not on here. The Commissioner brought up the additional funds that were given for reducing the waiting list for Meals on Wheels. Salem County's Meals on Wheels had 85 people on their waiting list as of about June of last year. With the implementation of the CAT tool, which is a unified assessment tool, and the additional fundings, there are now no people on our waiting list.

ASSEMBLYMAN COTTRELL: Thank you very much for your testimony.

The next speaker is Jaklyn DeVore.

J A K L Y N D e V O R E: Good morning.

My name is Jaklyn DeVore, and I am the Director of the Essex County Division on Aging. And I am very happy for the opportunity to speak to you this morning about New Jersey EASE.

And while I can echo the sentiments of my colleagues and the Commissioner, what I want to do for you this morning is give you a few case scenarios of the things that we've actually seen in New Jersey EASE. So they're little case stories. And these are typical of what we see in New Jersey EASE in Essex County.

A social worker at a dialysis center contacted the Division's New Jersey EASE Information and Assistance Unit about Mr. T, who was receiving dialysis at the center several days a week. Mr. T lived on the third floor of his apartment house and was having difficulty negotiating the stairs, especially after his dialysis treatments. In addition, he was not bathed, was unshaven, and his clothing was not clean. The situation was getting worse, and the social worker asked the I and A worker to arrange in-home services for Mr. T.

The New Jersey EASE Information and Assistance team member contacted Mr. T, and as a result of their discussion, determined basic information, including his financial resources, services he was currently receiving, and services he might want. In assessing Mr. T's situation and his eligibility for publicly funded services, the New Jersey EASE staff member used the initial screening section of New Jersey EASE Comprehensive Assessment Instrument, the uniform screening tool used by New Jersey EASE programs statewide.

The I and A staff member determined that Mr. T's income and assets were within the eligibility guidelines for Medicaid. Under Medicaid, Mr. T could receive not only the home health aide services he needed, but also transportation, including assistance on the stairway in his apartment.

The I and A and outreach team members worked cooperatively in follow-up with the dialysis worker and the County Division of Welfare regarding Mr. T's Medicaid application. A member of the Welfare Division was invited to the monthly Essex County New Jersey EASE case conference, at which Mr. T's situation was discussed in depth. Conference participants include New Jersey EASE team members and representatives from other programs with which New Jersey EASE frequently interacts, such as the Adult Protective Services and respite programs. As a result of his participation, the Welfare Division representative understood the urgency for Medicaid services, and he agreed to expedite the Medicaid application process.

The outreach worker/care manager was able to arrange for Mr. T to receive bath service through the Division's respite program in the interim until Medicaid services began.

This New Jersey EASE intervention was successfully putting in place a network of supports and services which very likely would have allowed Mr. T to remain at home, had it not been for the presence of a disturbed daughter who lived with Mr. T. From the beginning, the daughter had attempted to interfere with Ms. J's visits and her arrangements for in-home services for her father. When Mr. T arrived at the dialysis with facial bruises, the center called in Adult Protective Services. After discussing his options with the APS worker, Mr. T asked to be relocated to a nursing home, where he could be safe and receive the level of services that he needed in order to have a reasonable quality of life.

This New Jersey EASE intervention is regarded as a successful one, although it resulted in the relocation of the client to a nursing home. In this case, it was the client's choice to seek nursing home placement.

The New Jersey EASE team is dedicated to helping seniors access the resources and services that will enable them to maintain the greatest independence and highest quality of life possible and to working with the client and respecting the client's choice in all decisions regarding selection of services and residential settings.

Nursing homes are an essential component in the continuum of care for older adults. The goal is not to eliminate or to isolate nursing homes, but to consider them as one option in a continuum of community residential settings and to make them attractive, responsive, and comfortable homes for those who require their services.

One of the things that I guess we need to say is that prior to New Jersey EASE, there was no group of people who got together to make these things happen. And that's what's important for us to understand. And I think that this is the best way to show it -- by showing you, actually, how these things work together.

The second case scenario that I'd like to tell you about is Mrs. U.

Mrs. U entered the New Jersey EASE system through a referral from Adult Protective Services. Mrs. U and her husband, who had been deceased for 10 years, owned a home and had several grown children. Before he died, he told her that the children would take care of her. He made the sons promise to always be there for their mother.

Now, Mrs. U found herself in a situation where she had lost her utilities, the water had been turned off, and her son, who had part ownership of the house, had moved to include the house in his bankruptcy and foreclosure proceedings.

A New Jersey EASE outreach worker went to view the situation and saw that she needed extensive assistance. Mrs. U was then referred to the New Jersey EASE care manager.

Her children did little to nothing to help her. Two daughters, who lived out of state, and having problems of their own, could do little but call and offer her a place for her to visit for a few days at a time. Her greatest sadness came from her five sons. The eldest lived one block away and never came to help. He only harassed her and even complained to the police about her being a threat.

The New Jersey EASE care manager became the extended family that Mrs. U needed to help her to face the challenges of becoming an independent woman.

She had no source of income and no money in the bank. The stress of worrying about the house caused mental anguish, as well as impacted on her physical illness.

The care manager worked with Mrs. U to help build up her self-esteem and confidence. She had sunken into a deep depression and was tired of living. Mrs. U was introduced to a counselor who helped her to refocus. The care manager became a friend and helped her to get signed up for general assistance through welfare. She began to receive food stamps and Medicaid to help her with her medical needs. Mrs. U had no work experience, but due to her medical conditions, appeared to be eligible to pursue assistance from SSI. The care manager accompanied her to various doctor appointments and to the Social Security office on numerous occasions. These appointments led to Mrs. U becoming eligible for SSI. This allowed her to achieve financial independence with dignity. She no longer felt like a burden on society. Her mental state began to improve. She still anguished over her children and their lack of concern.

The winter had come, and upon arriving at Mrs. U's house, the New Jersey EASE care manager found her inside, afraid to come out of the house. They had an appointment, which was mandatory -- her evaluation for SSI. The New Jersey EASE care manager escorted Mrs. U from the house, and they made it to the appointment on time. When they arrived back to the house, the New Jersey EASE care manager noticed a heavy-duty shovel perched by the side of the house. It was obvious what had to be done. The snow was at least 6 inches deep, and the path that led from Mrs. U's back door to the sidewalk out front had not been touched. She rarely used the front door and was deeply saddened, because she was afraid to venture out onto the walkway for fear of falling onto the snow and ice. The New Jersey EASE care manager could not walk away and leave her stranded. She took the shovel and cleared a path from the back to front of the house and even cleared the front walkway and steps just in time for the mailman to have a safe passage to the mailbox.

Successful networking with PSE&G community relations allowed Mrs. U to live in her house with the utilities restored. However, nothing could be done to stop the sale of the house. Arrangements were made with the realtor so that she could stay until other living accommodations could be found. The New Jersey EASE care manager contacted several senior housing sites and found a location that was convenient to public transportation and made possible, in Mrs. U's words, "The best Mother's Day present of her life." For the first time, her family came together. They all came to help pack and move her into her new apartment.

Mrs. U is currently living in a senior building. She has joined the Adult Day Care Program, which is located on site. She receives home-delivered meals through the Essex County nutrition program. Her mental status has greatly improved. The days of sadness have turned to smiles and feelings of usefulness. She no longer feels lonely. There are friends in her life, and she goes on trips.

Mrs. U went from a dark hole to a bright new horizon full of self-esteem, confidence, dignity, and unlimited opportunities. Essex County New Jersey EASE helped Mrs. U to realize a new beginning.

And my last scenario talks about Mrs. C.

Mrs. C, a 66-year-old grandmother, made a phone call to the Essex County Division on Aging, New Jersey EASE Information and Assistance Unit. She wanted information regarding lawyer services and medical transportation. After speaking to one of the Information and Assistance specialists, she was pleased with the referrals given and said that she would use the service again, should the need arise.

About one month later, Mrs. C called again. This time, she sounded troubled and was concerned about many areas of her life. In response to her distress, the Information and Assistance staff person offered to arrange to have a New Jersey EASE outreach worker speak with her in person. Mrs. C agreed to the visit.

A referral was made to the New Jersey EASE outreach worker, who contracted and then visited Mrs. C. During the visit, Mrs. C spoke about her need for a wheelchair, assistance with household chores, interest in home-delivered meals, and her fear of losing her home. The outreach worker realized that Mrs. C did not have family supports and concluded that her circumstances would require extensive case management.

A New Jersey EASE case conference was called. The meeting involved the three New Jersey EASE components, the Information and Assistance worker, the outreach worker, and the care manager. It was agreed that Mrs. C would be referred to the New Jersey EASE care manager, who would work with Mrs. C to develop a care plan to address her multiple problems and needs. She would then assist Mrs. C in obtaining services and would continue to work with her to provide ongoing support, monitor the services, and periodically reassess her needs.

In working with Mrs. C, the care manager uncovered many issues that were detrimental to her health, in addition to the ones for which she had requested help. She had been in denial about the catastrophic state of her financial affairs, and she wanted to keep her house. She was to be dispossessed.

Through diligent networking efforts, the care manager located an apartment in Mrs. C's town and was able to arrange for Mrs. C to move directly from her home to the apartment. This move allowed her grandson to be within walking distance of his high school. Her expenses would drastically reduce. Mrs. C was able to continue her home health services from the same agency where she had established a pleasant working relationship with her aide.

Regular monitoring by the care manager enables Mrs. C to have a more positive outlook and a sense of security about her future.

The effective collaboration of the New Jersey EASE team helped to reduce some of the stress in Mrs. C's life. The team member's acknowledgment of Mrs. C's dignity, her respect for her choices, and their concern and compassion worked to relieve one woman's feeling of isolation and hopelessness. Each such successful intervention attests to the success of the New Jersey EASE system.

And I just would like to echo again what some of my colleagues have said. It is a work in progress. And are we better off today than we were before it? I say, absolutely. And it is an honor and a privilege for me to be a part of the system that is making life much easier for seniors in the State of New Jersey.

Thank you.

ASSEMBLYMAN COTTRELL: Thank you very much for your testimony.

Anne Ciavaglia. Anne--

MS. GARCIA (Committee Aide): From Hackensack.

ASSEMBLYMAN COTTRELL: --from Hackensack, Division of Senior Service.

A N N E C I A V A G L I A: Good morning.

Thank you for the opportunity to present testimony on New Jersey EASE. My name is Anne Ciavaglia, and I'm the Director of the Bergen County Division of Senior Services, the lead agency designated to administer EASE in our county.

I am here today because I believe in the value and benefits that the EASE system brings to older adults and their caregivers. Evidenced through the positive results of EASE interventions, I am here today to share our current outcomes and to highlight those areas where your support and consideration are needed.

As a coordinated and uniformly designed process to access information and services, New Jersey EASE simplifies methods for older adults and their caregivers to obtain needed resources. Additionally, New Jersey EASE offers professional hands-on support to navigate what unfortunately tends to be a confusing direct service delivery system.

In January of this year, Bergen County launched EASE. Bergen New Jersey EASE is a public-private partnership, which utilizes community-based organizations and county employees to provide information and care management services. Recognizing the value of this service for older adults, Bergen County has included people with disabilities over the age of 18 to access services through this process. And I'd like to add to that point that caregivers of many adults with disabilities are our older adults.

Since its inception, over 3500 people have contacted and been assisted by an EASE access specialist. Nearly 300 individuals have received direct care management services. What we have set up in Bergen County in order to assure that the quality of service is provided and to refine our processes wherever needed, our Division forwards a satisfaction survey to each individual caller that contacts an EASE line.

I'd like to share just briefly with you the results of that survey.

Of all of those surveyed, 22 percent of the people responded. Ninety-six percent felt that their questions were answered; 93 percent indicated that they were satisfied with the assistance that they received; 98 percent reported that they were treated courteously. Under the comment section of the survey, 57 percent gave comments that were laudatory, and 4 percent gave comments which indicated that service they received was helpful. Eight percent of the respondents issued critical comments, all of which were followed up by the unit supervisor to assure that the services that they felt maybe weren't provided or they weren't able to access were responded to. The remaining folks that responded didn't give us any comments.

The provision of care management services through EASE has significantly benefited individuals and their caregivers. Care mangers are trained to conduct a comprehensive assessment, offer available service options, and access any potential funding sources to obtain needed supports. We heard today about the JACC Program, about the New Jersey EASE Home Care Program, and a number of other programs that are funded through Older Americans Act dollars.

The EASE care managers now have some additional tools, and have knowledge of all of the resources that are available, which allow them to offer some options to the consumers or to the clients and caregivers that we work with.

Furthermore, once a care plan is developed and implemented, ongoing monthly contact is maintained, with a required quarterly home visit conducted. So, once the services are put in place, that doesn't mean that the client is left alone and the caregiver is left alone. The care manager -- the standard that's required-- They must have a minimum of a monthly contact with that individual and have a quarterly home visit with that individual. And actually, every six months, they would complete reassessment to assure that if any needs have changed, that those needs can be addressed.

I'd like to share with you some comments from a letter that I received recently from a family member who received care management services. She wrote, "Thank you for the wonderful services provided through Bergen New Jersey EASE. Recently, I contacted your office with great concern regarding my grandmother. Your staff was kind and informative. In addition to other helpful information, they arranged for an EASE care manager to assist my family. The care manager shows great compassion, has a generous spirit, and her knowledge has been a gift from God. She has been a guardian angel. My family and I appreciate her kindness and professionalism. Thank you for making a difficult and emotional time less painful and confusing." That's a common commentary that we hear from many of the individuals who have accessed supports, information, and services through the EASE system.

In addition to the direct services, which are clearly benefiting individuals who have accessed this service, the EASE system is an excellent planning tool to identify areas where additional support and funding are needed. During this year's funding process for older adults, our Division designated priority service areas based on gaps which were identified through the EASE care management monthly reports. One of the things that we require from our care managers is that they report to us not only the services that they provide, but what services were needed but unavailable. That helps us, as an area agency on aging, to identify gaps in services to when we come to a point where we need to make some funding decisions, we can access that data and that information to better serve the populations that are in need. We have found that to be a real value overall in the full service delivery system.

This year's implementation of Bergen New Jersey EASE has initiated a more responsive system for servicing older adults, and by strengthening our collaborative ties with several major agencies, has made the delivery of services more efficient. Furthermore, as part of the Governor's initiative, the additional funding of $1.3 million for Bergen County through both the JACC and New Jersey EASE Home Care Programs is expected to significantly increase the availability of home care and other needed supports.

All of these initiatives, as you've heard from many of my colleagues, are still a work in progress. But that's okay, because it helps us to look at where we need to improve and to always refine the services and supports of our older adults.

Although it's not a simple task, the support and assistance of all levels of the Department of Health and Senior Services staff has allowed us to tailor our systems to address our local needs while following the quality standards statewide. They have given cause for optimism and have energized the network of professionals. It is anticipated that continued progress in refining, streamlining, and making our services more consumer friendly will improve our ability and your ability to provide essential services, particularly to those elderly who are in the greatest social and economic need.

Easy Access, Single Entry -- the operative term, I believe, is Access. The basic principle is that we're able to offer options. And until now, and in any situation in life, if we can't offer options, we can't really offer our constituency choices. And I really believe that that's what EASE is about, and that's what EASE has allowed us to do.

Thank you.

ASSEMBLYMAN COTTRELL: Thank you very much for your testimony.

And that was the last speaker I have.

Assemblyman, do you have something you'd like to say?

ASSEMBLYMAN LeFEVRE: Just to conclude, I think that, to clear, the comments made today by the majority of the speakers were very positive in nature. And apparently, the articles that appeared in October, maybe, highlighted some of the deficiencies in the program, but nonetheless, I think that it's been a very, very positive program. I'm encouraged by what I've heard today.

ASSEMBLYMAN COTTRELL: I appreciate everybody who testified today. I (indiscernible) highlight an essential program for me. It's going well, and it's made a lot of improvements. And like any program, it can always be better. So I'm very happy to send it back to the Speaker. I'm sure he will comment on it. My comment is, I'm very happy that everybody came out. (indiscernible) less patience than they have. And I'm very -- unfortunately, the other members here missed a great deal of information. And I cherish that information. And it will help make my decision much more easy.

Thank you very much for attending the hearing. And God bless every one of you.

(HEARING CONCLUDED)