Item No. 1 of 1

INVESTIGATOR: Crenshaw, K.

PERFORMING INSTITUTION:
ALABAMA A&M UNIVERSITY
4900 MERIDIAN STREET
NORMAL, ALABAMA 35762

SUCCESSFUL AGING INITIATIVE: COMMUNITY BASED EDUCATION TO PROMOTE HEALTH AND ASSET MANAGEMENT FOR ALABAMA`S OLDER ADULTS

NON-TECHNICAL SUMMARY: This project proposes to expand the capabilities and capacity of the Alabama Cooperative Extension System's Urban Affairs and New Nontraditional Programs unit's (UANNP) ongoing plan of work for the Successful Aging Initiative (SAI)to expand its reach within Alabama's underserved and limited-resource elderly audiences in urban and rural populations. Building and expanding capacity in this area addresses Extension application focus on financial management and health care strategies for the target audience. It is the goal of UANNP to establish a Lifelong Learning Institute designed to: 1) to develop and conduct community-based educational programs and workshops from which estate plans are developed to manage one's financial and healthcare outcomes within the target audience; 2) to provide train-the-trainer curriculums targeting UANNP agents, older adult service providers, caregivers, social work students (AAMU geriatric social worker department), geriatric care managers, religion/civic leaders, (hereinafter collectively referred to as "trainees") how to best navigate the barrage of available new health and social services for this clientele; and, 3) to create a state-of-the-art, interactive financial management website with an emphasis on estate planning for an innovative, user-friendly extension outreach delivery system. In 2000, UANNP launched a comprehensive legal education program, LegalEASE, from which the Initiative was developed. The Initiative represents a partnership between UANNP and the Alabama's Bureau of Geriatric Psychiatry (Bureau). The partnership's purpose is to provide valuable skills and knowledge to the fastest growing segment of our population, older adults. The Initiative offers workshops/conferences, educational curriculums and trainings on current issues relevant to law & aging (estate planning/Elder Law), health & aging (with an emphasis in dementia education and associated health), and finance & aging. Recognizing a deficiency in meeting the needs of underserved, limited resource segments of the elderly population, this Initiative focuses directly on this clientele. Our Initiative partner, the Bureau, was established by the Alabama Department of Mental Health and Mental retardation; and, strives to develop a continuum of care for elderly mentally ill patients and behaviorally disturbed dementia victims. The Bureau provides mental health services to people over 65, offering a mix of acute care, long-term care and community-based services including educational support to community providers and university educational/training programs. The Alabama legislature through its Dementia Education and Training Act (DETA) works to help Alabamians understand dementia-related diseases and connects all citizens with resources in their communities that can support in the education and care of an Alzheimer's or other dementia-related patient.

OBJECTIVES: This project proposes to expand the capabilities and capacity of the Alabama Cooperative Extension System's Urban Affairs and New Nontraditional Programs unit's (UANNP) ongoing plan of work for the Successful Aging Initiative (SAI)at Alabama A&M University. SAI seeks to increase its capacity and quality of extension educational programs to this clientele. The primary goal of this project is to establish an "Institute" designed to expand the program delivery systems and technological strategies of UANNP to provide interactive, dynamic programs and training to promote health and asset management for this clientele. The specific objectives are to: a. Develop and structure the Institute such that our target clientele gains and utilizes new knowledge about the role estate planning plays in health and asset management; b. Create and implement community-based educational programs, workshops and activities in 7 urban and 5 rural (Black Belt, Alabama) counties statewide such that 20 percent of target audience will reports greater knowledge and behavior change by the end of year two; c. Provide certifying train-the-trainer curriculums to a minimum of 30 trainees by year two such that certified trainees will provide trainings and/or conduct programs in their respective communities to a minimum of 3,000 target clientele by end of year two; and, d. Create a user friendly, state-of-the-art financial/resource management website with a baseline user rate of 200 weekly and increasing by 10 percent annually. Products, Results and Measurable Outcomes: The following results and measurable outcomes are expected to have occurred by the end of this project: Development of Institute; Equip a cadre of trainees to deliver the Institute curriculums, training or programmatic activities in the twelve piloted counties; The Institute will identify and train a minimum of 30 trainees by year two. To assess the effectiveness of the Seniors CAN program, participants complete three self-rating scales with baseline measured at the first class and post- intervention at the last class: The Mastery Scale, Revised UCLA Loneliness Scale, and Perceived Stress Scale; Over 4,500 participants who attend one of the seven (7) currently scheduled annual Initiatives or activities will complete a pre- and post- assessment; Data will be used to fully define the scope of need in each community for programming and targeted educational activities and resources; Clientele who complete the UANNP publication, Estate Planning Basics, A Guide to Life Organization create a $3,500 direct savings; The project estimates 300 completed in year two with a $1,050,000 savings statewide; Clientele who execute a free will with their county's Area Agency on Aging experience an average savings of $350; The project estimates 50 completed in year one with a direct savings of $17,500, and a preventative savings of $60,000 ($1,200 x 50 = $60,000 or Average cost to probate an intestate (die without will) estate in Alabama x Clientele participants);Clientele who execute an Advance Directive, A Gift to Your Family, a free publication issued by the Alabama State Bar.

APPROACH: A number of identified stakeholders and Initiative partners have agreed to advise and serve on the committee for this project. The committee will meet as needed during the project development and implementation phase to ensure proper and efficient project administration. All project activities will occur within an eight quarter period (two years). Attorney Kevin Crenshaw, the principal investigator for this project, will construct the framework and all programmatic activities of the Institute. Procedurally, during quarters one through four (1-4) the project will: A. Set-up timeline of grant activities and evaluation in Microsoft Project Manager 2010 to ensue successful project management; B. Begin preliminary development of inter-active financial/resource management website; C. Outline training schedule and locations for the following: 1.Seniors CAN, an educational health promotion curriculum; 2. DETA trainings for trainee; 3."Will Drafting Clinics" and "Life Care Management" Workshop, coordinated and delivered a Certified Elder Law Attorney, and 4.Navigating Senior Care Resources Training Program, a Professional Geriatric Care Manger and Director of American Senior Assistance Program, Incorporated (a geriatric care management firm); D. Develop program, delivery methods and outcome strategies with the Dementia Education & Training Act program addressing cultural differences, and how "lifestyle" directly affect health outcomes of target clientele; E. Fully implement statewide collaborations & partnerships in the Institute's twelve piloted urban and rural (Black Belt, Alabama) counties across the state; F. Train-the-Trainer /Professional Development on identified Institute curriculums; and, G. It is estimated to take twelve to eighteen months to fully create the inter-active financial/resource management website with a focus on estate planning with form submissions capability, repository of documents, streaming video and audio capability, and social media. The website has a built-in counter and embedded evaluation mechanism to assess projected outcomes and impact. Procedurally, during quarters five through eight (5-8) the project will: A. Develop awareness campaign about the Institute, train to promote health and resource management strategies for target clientele; deliver promotional materials and publications statewide by ACES, UANNP agents and trainees; B. Finalize the development and coordinate of the Institute's twelve month delivery schedule into the plan of work for UANNP agents and identified trainees outlining programs/activities and trainings for target clientele; C. Identify and solicit trainees to develop the Institute's training pool; AAMU social work students and third-year law students from the Alabama Law School's Elder Law Clinic will be trained to deliver either the: a) Will Drafting Clinic, b) Heir Property in Alabama, and/or c) Life Care Management Workshops; and, D. Assess and evaluate website development; In quarters seven trainees will attend a one-day workshop on the web-based programs operation.

PROGRESS: 2012/09 TO 2015/08
Target Audience:Through our grant activities and efforts, the target audience reached for this project is Alabama's undeserved and limited-resource older adults (50 +), their family members and caregivers within the state's urban and rural communities. Changes/Problems:As addressed in our continuation grant, the target audience has many reservation and perceived barriers to Estate Planning that is based on a lack of knowledge, mistrust and cultural differences. We believe, however, with the establishment of the Institute, Train-the-Trainer trainings and continued educational outreach even greater impact and outcomes will be accomplished. The continuation of work under the continuationgrantcycle (2014-2016) will be a combonation of meeting itsobjectivesand clearly establishing the post award actions under the initial cycle (2012-2014). What opportunities for training and professional development has the project provided?1. SAI conducted its Life Care Management Plans (LCP) with Four hundred ninety two (492) older adults statewide. Two local attorneys, four licensed social workers, two nurse practitioners, and seven AAMU social work graduate students received 30 hours of training in developing, coordinating and consultation of a Life Care Management Plan. A no cost activity, participants developed a LCP with a direct saving of $375 each; and, a total net savings of $184,500 (492 x $375.00); and, 2. Conducted a two-day comprehensive "Train-the-Trainer" training to equip a cadre of 32 individuals selected by UANNP county agents and SAI partners to deliver the Institute's curriculums, trainings and/or programmatic activities in the twelve identified counties assist in program delivery, and education Equip a cadre of trainees. How have the results been disseminated to communities of interest?Notwithstanding the Journal publication, the establsihment of the Institute and the approval by the University's Board of Trustees has altered the way in which we initially plan to market the objectives, and outcomes of under this grant period. Given the continutiaon under this grant, from 2014-2016 post award action will fully illuminate the results and impact of the combined grant cycles. What do you plan to do during the next reporting period to accomplish the goals?Although this is a final report under grant cycle 2012-2014, under the continuation grant (2014-2016) will more fully connect the accomplished goals and post award actions. Specifically, we address the top fivepreceived barriers to Estate Planning identified by assessment ofour target audience in aneffort to achieve greater compliance and higher outcomes/impact.

IMPACT: 2012/09 TO 2015/08
What was accomplished under these goals? Seven (7) Extension agents participated in four (4) train-the-trainer & in-service/professional development sessions on the following: 1) Navigating Senior Care Resources, 2) Estate Planning Basics: A Guide to Life Organization, and Facilitator's Power Point Presentation, and, 3) Food Safety for Older Adults; ASSET MANAGEMENT: Eight thousand one hundred seventy two (8,172) participants participated in the Estate Planning Workshop series using UNP publication, Estate Planning Basics, A Guide to Life Organization. One thousand-two hundred seventy four (1,274) participants completed their estate plan booklet (inclusive of a valid will, power of attorney for finance and an advance directive) creating a base, individual savings of $3,500.00 each and a total combined savings of $4,459,000 statewide. Specifically, conducted three (3) Estate Planning & Heir Property Clinics and two (2) Will Writing Clinics in three of the five identified Black Belt Counties with 241 participants collectively (those outcomes are reflected in the total statewide assessments, trainings and completions); and, HEALTHCARE MANAGEMENT: Seniors CANN: a. Food Safety 1 & 2, b. Strategies: Cutting Cost, c. Strategies: Navigating and Using Resources, d. Productivity & Aging--total statewide attendance 2,184 underserved clientele. Participants were engaged in five sessions of experiential learning opportunities using: Food Safety for Older Adults, a wellness guide provided by The U.S. Department of Agriculture and Health and Human Services, thermal lunch bags, food safety bingo, and Glo gel germ kits. Eighty-one percent (81%) indicated increased knowledge of food safety, how to access educational and community resources, utilize planning strategies and skill to address daily life issues of older adults from cost-cutting strategies to productivity & aging; SAI conducted its Life Care Management Plans (LCP) with Four hundred ninety two (492) older adults statewide. Two local attorneys, four licensed social workers, two nurse practitioners, and seven AAMU social work graduate students received 30 hours of training in developing, coordinating and consultation of a Life Care Management Plan. A no cost activity, participants developed a LCP with a direct saving of $375 each; and, a total net savings of $184,500 (492 x $375.00); By assessment, Eighty-six percent (86%)of attendees statewide indicted and increased knowledge of estate planning basis (asset management and healthcare management) and how to use age-related subsidized and/or free services and educational resources; Identified web designer; secured web domain name: www.SuccessfulAgingAL.com; and, currently, in the final stage of content development and website design; and, Conducted a statewide assessment to approximately 1,030 SAI participants (African American = 812 and Caucasians= 152). Data analysis to questionnaire "Perceptions of Estate Plans" forms the basis of this continuing grant proposal. Conducted a two-day comprehensive "Train-the-Trainer" training to equip a cadre of 32 individuals selected by UANNP county agents and SAI partners to deliver the Institute's curriculums, trainings and/or programmatic activities in the twelve identified counties assist in program delivery, and education Equip a cadre of trainees; and, The Alabama A&M University Board of Trustees approved the establishment of the Virginia Caples Lifelong Learning Institute (VCLLI) as an academic unit to be housed on the University's campus. The VCLLI will launch a soft academic opening Spring 2016 with a maximum of 50 participants. The VCLLI's official Inaugural Dedication Ceremony scheduled March 2016. Full curriculum offering Fall 2016.

PUBLICATIONS (not previously reported): 2012/09 TO 2015/08
Type: Journal Articles Status: Published Year Published: 2015 Citation: An Assessment of Estate Planning Among Older Adults in Alabama in the February issue of the Journal of Extension: http://www.joe.org/joe/2015february/rb7.php UNP-0125, Estate Planning Basics: A Guide to Life Organization. Revised Edition January, 2013. UNP-0135, What You Need to Know About Advance Directives. October, 2013. UNP-0134, What You Need to Know About Wills. October, 2013. Power Point Presentation, Elder Law Basics 2013 In this lesson you will learn what is included in an estate plan. Gain a basic understanding of estate-planning tools for Asset Management and Healthcare Management: Wills, Power of Attorney, Property Ownership, Probate, Estate Taxes/Gifts, Trusts, Long-Term Care and Medicaid Planning.

PROGRESS: 2012/09/01 TO 2013/08/31
Target Audience: Through our grant activities and efforts, the target audience reached for this project is Alabama’s undeserved and limited-resource older adults (50 +), their family members and caregivers within the state’s urban and rural communities. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? SAI piloted its Life Care Management Plans (LCP) with two-hundred six (206) older adults at the Huntsville/Madison Co. Annual Conference. Under the instruction of Ms. Chanda Crutcher, licensed geriatric care specialist and SAI project partner, two (2) local attorneys, four (4) licensed social workers, two (2) nurse practitioners and seven (7) AAMU social work graduate students received 30 hours of training in developing, coordinating and consultation of a Life Care Management Plan. A no cost activity, participants developed a LCP with a direct saving of $375.00 each; and, a total net savings of $77,250 (206 x $375.00); and, Attorney Kevin H. Crenshaw, SAI project PI, attended the 35 Annual Estate Planning Seminar conducted by the Alabama State Bar’s Institute for Continuing Legal Education (6 MCLE Credit Hours including 1 hour of ethics). How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

IMPACT: 2012/09/01 TO 2013/08/31
What was accomplished under these goals? major activities completed; Educated and trained eight (8) Extension agents on overall grant, i.e., objectives, activities and proposed outputs/impact; Specifically, trained in the delivery of a. Revised UNP-0125, Estate Planning Basics: A Guide to Life Organization, b. Seniors CANN, c. Navigating Senior Care Resources, and d. Life Care Management Plans. Developed assessment tool to evaluate the barriers to estate planning, and pre- and post- evaluations for the Seniors CANN curriculum; Revised UNP-0125, Estate Planning Basics: A Guide to Life Organization to include a PowerPoint, Facilitator’s guide and pre- and post-evaluations; Conducted six (6) Annual Successful Aging Initiatives, a one-day comprehensive conference, that culminates the Senior CANN and Estate Planning Basics series of activities and conducted a combine total of 2,085; The Senior CANN lesson series/workshops were delivered to 1,142 participants. Participants were engaged in five (5) sessions of experiential learning opportunities utilizing: 1. Thermal lunch bags, 2. Food Safety Bingo, 3. Glo gel germ kits engaged Estate Planning Basics were conducted to 351 participants, statewide. Each participant received a vinyl, portfolio-style, document bag (legal size) to organize and maintain the identified important documents ; Life Care Management Plans training to a local attorney, four (4) geriatric social workers, two (2) nurse practitioners, and seven (7) graduate social work students in AAMU’s Geriatric Social Work Program; and, Identified web designer; Secured web domain name: www.SuccessfulAgingAL.com; currently, in the intermediate stage of content development and web-design. 2) Specific objectives met; Created and implemented community-based educational programs, workshop and activities in 7 urban and 5 rural (Black Belt, Alabama) counties; Conducted train-the –trainer curriculums to Extension agents, para-professionals and social work students; and, Identified web designer and in the intermediate stage of content and web development. 3) Significant results achieved, including major findings, developments, or conclusions (both positive and negative); and How helpful have the SAI conferences/activities been for you in understanding Estate Planning Basics: 69.81% Very Helpful 19.34% Helpful 0% Not Helpful 10.85% No Response ASSET MANAGEMENT Have a will? 41.98% Yes 35.38% No 22.64% No Response Have a Durable Power of Attorney 28.77% Yes 46.70% No 24.53% No Response Better Understanding of Finance & Aging 60.38% Yes 16.98% No 22.64% No Response Better understanding of long-term care and disability benefits: 56.13% Yes 18.40% No 25.47% No Response Better understanding of Social Security: 59.91% Yes 13.21% No 28.89% No Response HEALTH CARE MANAGEMENT Improved your food safety knowledge: 79.05% Yes 3.77% No 16.98% No Response Changed eating habits: 74.53% Yes 8.49% No 16.98% No Response Started/maintains routine low impact exercise: 50.00% Yes 24.06% No 25.94% No Response Improved your nutrition knowledge 79.05% Yes 3.77% No 16.98% No Response Desire to receive more information on the above? 67.92% Yes 7.55% No 24.53% No Response 4) Key outcomes or other accomplishments realized. Assessment data and analysis to questionnaire “Perceptions of Estate Plans.” See assessment analysis in Other Products/Outputs; and, One Hundred Thirty Eight (138) participants completed UNP publication, Estate Planning Basics, A Guide to Life Organization creating a base, individual savings of $3,500 each and a total combined savings of Four Hundred and Eighty-Three Thousand Dollars ($483, 000) statewide. Goals yet to be realized under this grant are as follows: Comprehensive SAI activities in the identified five (5) rural counties (Black Belt, Alabama; The project has identified the counties, established a partnership and MOUs with LRLEAN upon which our programmatic framework is being established to report accomplishments in the Final Report; Fully implement the Lifelong Learning Education and Training Institute to include but is not limited to the following: a. Board of Directors, b. Bylaws, c. Mission d. Objective/Goals, e. Organizational Chart, f. Operational Structure, g. Defined areas of expertise (based on continued finding in the needs assessments conducted statewide), h. identify and solicit trainees to develop the Institute’s training pool; and, Launching of the inter-active financial/resource management website with a focus on estate planning. The site will include form submissions capability, repository of documents, streaming video and audio capability, and social media. Additionally, the website will house a built-in counter and embedded evaluation mechanism to assess projected outcomes and impact.

PUBLICATIONS: 2012/09/01 TO 2013/08/31
Type: Other Status: Published Year Published: 2013 Citation: UNP-0125, Estate Planning Basics: A Guide to Life Organization. Revised Edition January, 2013. UNP-0135, What You Need to Know About Advance Directives. October, 2013. UNP-0134, What You Need to Know About Wills. October, 2013. Power Point Presentation, Elder Law Basics 2013 In this lesson you will learn what is included in an estate plan. Gain a basic understanding of estate-planning tools for Asset Management and Healthcare Management: Wills, Power of Attorney, Property Ownership, Probate, Estate Taxes/Gifts, Trusts, Long-Term Care and Medicaid Planning.