NCRCC Western Region Meeting Minutes
11/16/11
United Way Building
Asheville, NC

Attendance: Phyllis Phillips, Jackson County Department of Aging, Chris Robbins, ESUCP NC and VA Kara Patrick, Maxim Health Care Chris Stevens, Maxim Health Care Traci Allen, Forgiven, I Serve Him (FISH) Jordan Arnold, ESUCP, Donna Case, Council on Aging, Buncombe County, Kim Webb, Council on Aging, Buncombe County, Marci Bangonan, Marci’s Adult Day, Tonia Holderman, Pisgah Valley Retirement, Katie McElroy, Home Instead Senior Care, Sheila Reeves, ESUCP Robert Patterson, Seniors Helping Seniors Cynthia Alleman, Alleman Law Firm Linda Kendall-Felds, DAAS Lifespan Respite Jean Alvarez, Autism Society of NC Suzannah Tebbe Davis, Homewatch Caregivers Roxann Colwell, Family Support Network of WNC Michelle Templin, AAA, Nancy Hogan, Project C.A.R.E., Ruth Price, Project C.A.R.E. Carol McLimons, Land of Sky Regional Council Len Erker, Project C.A.R.E. Phyllis Stephenson, NCRCC Director, welcomed everyone and introductions were made. A special thank you is in order for Phyllis Phillips, who served as welcome person for this region. Announcements were made and the date for the next meeting was selected as either 2/22/2012 or March 7 at the United Way Building. Announcements were made and a work group was established to begin work on the spring provider fair to be held in Asheville. Members of the work group are: Suzannah Tebbe-Davis, Chris Stevens, Robert Patterson, Roxann Colwell, Jane MacLeod, Phyllis Stephenson and possibly Teresa Linsley (Chris Stevens will contact her).This will be a short-term work group that will meet by conference call to re-connect with the church mentioned last year as a meeting place for the Latino community, create fliers, and plan community outreach for the event to be held in April or May. The goal is to make consumers aware of services available to them in an open-house format. The first call-in will be in early December with a work session in February. Michelle Templin announced that the Enrichment Center in Cleveland County now offers overnight respite care. They have two facilities- one in Shelby and one in Kings Mountain. This is exciting news about an expanded program! Phyllis gave an overview of the National Respite Conference workshops held November 2-4 in Phoenix, Arizona and showed three PowerPoint presentations from the conference: 1) Ryan’s House (a respite home in Phoenix for children with life-threatening illnesses and their families) www.ryanhouse.org 2) a family caregiver survey which has many statistics about caregivers and their needs useful for programmatic planning, budgeting, etc. (thefamilycaregiver.org) 3) the Southwestern Region training Partnership, which details online training for respite providers. The training is the key to their provider network. These slide presentations can be viewed on the ARCH website within a week or two. www.archrespite.org The central region is having a webinar instead of a meeting on December 14 from 10:30-12:00. The call-in number will be shared so all who wish to can participate. Linda Kendall-Fields gave an overview of the Lifespan Respite grant and the role of the state advisory committee. She discussed the importance of gathering the information on each program in the state for the Just One More part of the grant. Each person in attendance was asked to please complete the program form to help us capture this information so we will have a complete listing of respite resources. Send all information to Jane MacLeod who will share it with Linda. This form will be posted on the NCRCC website for those who do not have a copy. Linda also stated that North Carolina has received an expansion grant of $140,000 for direct services and hopes to use this money to get new respite hours for people who haven’t had respite yet. Linda may be contacted for further information. Submitted by: Jane MacLeod NCRCC Program Coordinator

NC Respite Care Coalition
Minutes 8/22/11
30th  District Domestic Violence Sexual Assault Alliance
Waynesville, NC

Attendance: Sue Fowler- 30th Alliance, Karen Arias- 30th Alliance; Kim Gardner- 30th Alliance, Susan Tebbe-Davis- Homewatch Caregivers, Kim Henley- Easter Seals UCP NC and VA, Phyllis Philips- Jackson County Dept. on Aging, Donna Case- Buncombe Co. DSS, Kim Webb- Council on Aging Ellison Jones- Triangle J AAA, Joe Yurchak- Autism Society, Pat Ashburn- Rainbow Tree Jan Cordell- Rainbow Tree, Reggie Cordell- Rainbow Tree, Larry Reeves- Alzheimer’s Assoc., Linda Kendall-Fields-Lifespan Respite Advisory Committee, Sheila Reeves- ESUCP NC and VA, Sarah Owen- Rainbow Tree, Carol McLimans- Land of Sky Regional Council, Phyllis Stephenson- NCRCC and ESUCP NC and VA, Jane MacLeod- NCRCC and ESUCP NC and VA. Phyllis welcomed attendees and introductions were made. The 30th Alliance presented their program: They have a grant for victims of violence with disabilities. They are a regional agency that serves the seven western counties of NC. Their primary goal is building capacity- looking at the issues and finding funding to match the needs.30th Alliance is particularly focused on the Latina population. Karen Arias is their Latina advocate and she specializes in immigrant issues and victimization. She steps in when cultural barriers might prevent disclosure. They have outreach to churches and she keeps up with immigration issues. She works with ESL classes and helps all to understand the legal process. Once an arrest is made in a d.v. case, there is danger of deportation. However, the victim is allowed to seek help, to separate the issue from immigration. Karen does a lot of in-house training and works to dispel myths about Hispanics. For example, Hispanics have 0% infant mortality rate; they do pay taxes through business, they work very hard at employment and don’t usually use the health system. It is very difficult to get citizenship in the US and it is also difficult to leave your own country- it can take 10 years. Domestic trafficking is a big issue- it’s a subculture. It takes about 48 hours for a runaway teen to become part of the sex trafficking culture. Asheville has a Hope House to work with these families and kids. Karen works with a lot of people from Mexico. These people have been shaped do things a certain way, such as take in grandparents. They have had to do this in their own their own country. There is always a fear of deportation. NC Stop- this is a statewide coalition for trafficking and they conduct a webinar every month. North Carolina is 7th in the country for sex trafficking. This agency wants to build programs and enhance services. They also administer an elder abuse program and do training on this topic. Karen can serve across the spectrum as long as the client is Hispanic.3oth Alliance is the only program in the state that serves victims who have disabilities. They work closely with law enforcement. In 90% of 911 calls regarding domestic violence, there are children involved. They would also like to have a program to help children who have witnessed violence. Referrals come from schools and hospitals. They have set up an Adult Protection collaboration. The victims are primarily female, although some men are victims too. 30th Alliance offered their elder abuse training to law enforcement. Corinna Smith spoke about the victimization of those with disabilities. They are trying to change the culture of agencies so people with disabilities will be able to report victimization. They have tried to make their agency environment friendly and accessible which was noted by attendees today- the homey atmosphere and home cooked food. 55% of people with disabilities nationwide have been victims of abuse. They are paying attention to the culture of agencies where victims go for help. The staff is often not equipped for disabilities. Providers need to learn what they need so that staff recognizes if people are anxious. Discussion followed about monitoring in public facilities and what is required and needed. The comment was made that with the state budget cuts, there may be fewer eyes on the most vulnerable. Consider articles in newsletters to educate and keep people informed. Kim Gardner spoke about their elder abuse program in which they do training and outreach. They serve 7 counties and those ages 60 and over. The majority are family members, often adult children. Kim serves on several committees to evaluate care in facilities. Outreach includes education, especially financial to prevent exploitation. The dementia task force developed a tool kit and training to help those with respite caregiving and those who want to be respite providers. DVD is in process. Examples of signs to be alert for: unexplained bruising, ligature marks. It can be hard to get patients to disclose- they are hesitant to turn in their children. Medications can also be abused (sold or withheld). This is an area that needs further research and education about why people are not reaching out for help. Linda Kendall-Fields from the state advisory committee gave announcements about Money Follows the Person- housing and caregiving will be designating funding. There will be materials on this coming out. Lifespan respite mini-grants will be announced soon. NCRCC updates: There will be RFP’s for the mini-grants; the programs must have a sustainability component. The NCRCC is beginning the third year of the Lifespan grant. This year the focus has been on cultural diversity. Jane will put together a notebook of materials and handouts we have received from each meeting and bring to subsequent meetings. In the east, the last focus was on diversity in faiths in caregiving- what do providers need to know about a person’s faith in order to provide appropriate care. Other state-wide news: All LME’s are forming 1915-BC waivers under which they will have more authority over services. For CAP it will mean lower rates for high end services, which may lead to fewer services being provided. Next meeting: November 16, Asheville- location to be announced. The program will be presentations on materials from the National Respite Conference, changes for respite providers and integrating outreach for the Latino population- planning for the fair in the spring. Submitted by: Jane MacLeod NCRCC Program Coordinator

NCRCC Western Region Meeting Minutes
5/17/11

Phyllis Stephenson, NCRCC Director, welcomed everyone and introductions were given. Attendance: Phyllis Phillips, Jackson County Department on Aging; Kathy Smith, Eastern Band of Cherokee Indians; Tavish Panozzo, ECBI; Jan Cordell, Rainbow Tree; Reggie Cordell, Rainbow Tree; Dave Piper, Davidson Homes; Sheila Reeves, ESUCP NC and VA; Joe Yurchak, Autism Society; Cindy Miles, Region A- AAA; Kristy Dotson, Alzheimer’s Association; Walter Anderson, Region A – AAA; Tavish Panozzo, Cherokee Home Health; Jordan Arnold, ESUCP; Jane Sherman,?; Maryanne Quinn, Family Preservation Community Services; Linda Fitzsimmons, Barium Springs; Marcia Lewis, Barium Springs; Sandy Fowler, Barium Springs, Larry Reeves, Alzheimer’s Association; Sue Fowler, 30th JD Alliance; Karen Arias, 30th JD Alliance; Kim Garner, 30th Alliance; Phyllis Stephenson, ESUCP and NCRCC; Jane MacLeod, ESUCP and NCRCC. Special guests: Jerry Wolfe, ECBI Tribal elder; Teresa McCoy, ECBI elder council member; Warren Dupree, American Legion Post Steve Youngdeer 143; Color Guard from American Legion Post 143 The NCRCC meeting was opened with a presentation of the national colors by the Color Guard of American Legion Post 143 and a recitation of the pledge of allegiance in English and Cherokee. Teresa McCoy of the Eastern Band of Cherokee Indians gave a welcome to the group and introduced Jerry Wolfe, tribal elder. Mr. Wolfe spoke to the group about many traditions and cultural aspects of the Cherokee tribe. He recalled many traditions from his childhood and how different life was when children learned from nature and depended on walking for transportation in this rural community. Mr. Wolfe told of stories passed down from generation to generation and the strong sense of community that has existed in this tribe and continues to this day. He talked about how the tribe used to have “free hands”, people who could do any tasks and would help anyone who needed help. Some communities still have this. The Cherokee Boys Club, started many years ago, is still in operation and was instrumental in training boys in hands- on skills. Mr. Wolfe also spoke about the effect of having Harrah’s Casino in the town. There was much discussion at the time about whether this would be a good decision to allow Harrah’s to lease the land from the tribe or if it would be a detriment to the community. The conclusion seems to be that it has been a benefit to the community. The money generated at the casino has been put back into the community in services of many types for seniors and others, such as Meals on Wheels. Mr. Wolfe shared much about the tribe and it was clear that the emphasis of the Cherokee is on the sense of community they share. Many services needed by the Cherokee are provided within the tribe including their own hospital and home health care programs. Warren Dupree of the American Legion Post spoke briefly about the services provided by the American Legion in helping veterans to maintain their independence. He spoke about the proud history of the Cherokee and how many of them served in WWII. The American Legion will be honoring female veterans at the Cherokee Indian Fair. There is also a home based program that keeps veterans in their homes and trains family members to help their loved ones who are ill. Kathy Harrison of Cherokee Home Health spoke to the group about services provided through her agency to tribal members. Tavish Panozzo also spoke about her work with home health and CAP clients on the boundary. Her agency provides respite, Meals on Wheels, equipment needs and others. Another issue identified for the future is abuse of the per capita income provided to tribal members; i.e., some Native Americans have been taken advantage of people by coming into the community and exploiting them due to their lack of knowledge and education about exploitation. Kathy Smith stated they are designing a children’s home which was part of the Cherokee Boys Club for any child who needs a place to live. This area does have foster care; they try to place children in Native American homes. Issues identified in this region are a high teen pregnancy rate, prescription drug abuse, and some beginning gang activity. Phyllis Stephenson gave updates on the NCRCC: the coalition’s continuing work with DAAS on the Lifespan Respite grant (next statewide meeting 5/20/11), regional updates (our continuing work with culturally diverse communities to identify respite needs in each part of the state.) The National Respite Conference is November 2-4 in Phoenix, Arizona. The next meeting is Tuesday August 23 in Waynesville at 30th Alliance. Address: 1870 S. Main St. Waynesville, NC Phone: 828 452-2122. Kim Gardner, Karen Arias and Sue Fowler will be our hosts. At the conclusion of the meeting, several attendees took a tour of the Cherokee Hospital with Jody Bradley from Public Relations. It was most informative to see the clinics and services offered free of charge to Cherokee members. Submitted by: Jane MacLeod NCRCC Program Coordinator

NCRCC Western Region Meeting Minutes
2/22/11

Attendance: Phyllis Phillips, Jackson County Department on Aging; Kathy Smith, Eastern Band of Cherokee Indians; Tavish Panozzo, ECBI; Jan Cordell, Rainbow Tree; Rea Cordell, Rainbow Tree; Chris Stevens, Maxim Healthcare; Jen Branham, Western Highlands; Sherry Dills, NC Access Care; Marci Bangonan, Marci’s Adult Day; Donna Case, Council on Aging; Kim Webb, Council on Aging; Dave Piper, Davidson Homes; Lee Anne Tucker, Land of Sky Regional Council; Tracy McElroy, Project Care; Ellison Jones, Triangle J AAA; Sheila Reeves, ESUCP NC and VA; Theresa Linsley, F.I.R.S.T; Joe Yurchak, Autism Society; Carol McLimons, LOSRC; Cindy Miles, Region A- AAA; Kristy Dotson, Alzheimer’s Association; Kirsten Mitchell, Black Mountain Neuro -Treatment Center; Walter Anderson, Region A – AAA; Linda Kendall-Fields, DAAS/LOS; Susannah Tebbe, Home Watch Caregivers; Dawn Kelly, ComServ; Deborah Russell, Home Instead Senior Care. The focus of today’s meeting was exploring diverse communities in the western area and identifying barriers to service. Announcements from programs: Dave Piper at Children’s Home- they will now provide weekend respite and have a newly licensed day care. Presenter: Theresa Linsley with F.I.R.S.T.(Families’ Information Resources Support and Technology) discussed access and information needs in the Latino community in the Asheville area. Theresa stated that one of the biggest barriers to families receiving services is their reluctance to work with agencies. She stated agency representatives need to change families’ thinking so that they feel it is ok to work with agencies on their needs. F.I.R.S.T. has 125 families who have children with disabilities, some of whom are at risk. Theresa is the contact person and helps them with many issues. The children have been born in the U.S. but their parents are undocumented, which can be a barrier to receiving services. Poverty is a huge problem. The parents need education about what’s available; then they can do things on their own. Discussion ensued as to how the community and the NCRCC can help with connecting these families with the resources they need. Ideas: • Provide parents with training so they can be respite providers for each other • Provide NCI (North Carolina Interventions training (Rainbow Tree volunteered to do this) • Consider group respite for families • Providers may go with Theresa to meet the family to allay their fears. Providers should be considerate and not ask probing questions that add to fear of deportation. • Link up with case managers for those who have Medicaid • Use NC Access for translators • Research ways to provide resources at the health department since that is the first contact many families have with “the system”. • Use NC CareLink as a tool so people will know what’s available. The NCRCC will have this tool at the next meeting so agencies can enter their information directly into CareLink. • More participation in the local community; for example, outreach at churches. Perhaps have something after church services. • Another resource is the Latino Steering Committee- agencies that work with this population can bring their brochures and information on the 3rd Wednesday of each month at Catholic Services on Orange Street In Asheville. • The NCRCC can create a listserv on its website. Our challenge as a coalition is how to take everyone’s ideas and create a plan for outreach. Presenter: Sherry Dills NC Access Care This agency has fourteen networks and case management in the seven western counties of NC. They serve all ages and much of the area is rural. In relation to creating better access to care, it is necessary to dispel the idea of DSS as punitive. Building trust in this area is very important and being careful not to generalize about a particular population. Referrals come from several sources- the state, hospitals, anyone serving the chronically ill. Residents may have more pressing issues than their health; i.e., more basic needs such as electricity which must be addressed. Presenter: Kristy Dotson- Alzheimer’s Association, Cherokee Barriers to services can be easier to overcome for case managers who are originally from the area because they already understand the local culture. Kristy noted that family is very important to residents in this area as well as the belief that family should care for each other. Local residents have a lot of pride and responsibility for their own people. Cherokee tribal people have excellent services for their members. Funding for these services is through the Native American Act Title VI. Home Health services are provided on the reservation (skilled nursing, respite and CAP services). This program currently does not serve grandparents raising grandchildren. Word of mouth is their best outreach. The Cherokee Hospital does Information and Referral. Some residents do go outside the reservation for care and are more open to outside services. Nurses are still working with some cultural issues, such as the use of medicine men. The Cherokee are a very proud nation and may not like to ask for help. However, it is not impossible for outsiders to come in. The advice for providers is to let the residents teach about themselves. Connections are very important. Issues agencies are dealing with in the community include substance abuse and children addicted to methamphetamines, as well as prescription drug abuse. There is also a relatively high diagnosis rate of Alzheimer’s. If an enrolled member is in the five county area, he/she is eligible for services. It was suggested that the NCRCC meet next in Cherokee to increase our knowledge base.A committee was established to make contacts and establish a meeting place. The NCRCC will continue to research issues in the diverse communities and how access to respite care and other services can be increased. The next meeting will be in May. The date and location will be announced. Submitted by: Jane MacLeod NCRCC Program Coordinator