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One Agency on Aging?

State services for older residents fragmented among 23 agencies

Tennessee State News January 2011

Hollis Bennett/Wonderful Machine

Ronald Henson, right, a care manager at FiftyForward, helps Pamela Cook navigate the many state agencies that offer programs for older residents.

Pamela Cook needs a battery for her wheelchair. The 64-year-old widow from Nashville also needs Meals on Wheels, help monitoring her diabetes and assistance getting to the bus when she wants to visit her daughter in Louisiana. But the services she seeks are spread over a challenging maze of nearly two dozen state agencies.

To navigate that maze, she's been helped by Ronald Henson, a care manager with FiftyForward, a nonprofit organization that provides a variety of services for adults over 50 in Middle Tennessee.

"I'm glad I've got Ron as my helper or I would sit around here and do nothing," Cook said. "I need all the support I can get."

Henson knows his way around the system, thanks to years of experience. But without guidance from someone like him, many older people don't know where to turn. Because of the potential for confusion, some advocates fear that people who truly need help from the state will simply give up.

"What this leads to is them not utilizing services for which they are eligible and not necessarily having the quality of life that could be afforded to them," said Adrienne Newman, associate executive director at FiftyForward.

The number of older people in search of services is already rising, said Rebecca Kelly, AARP Tennessee state director. Another boomer turns 50 every seven seconds. Already there are more than 2 million in Tennessee. The first boomers turn 65 on Jan. 1; by 2020, almost one in six Tennesseans will be over 65.

"It is an age wave that is hitting the country," Kelly said. "I am not sure anyone is prepared for it. Certainly not Tennessee with its current fragmented system of services.

"AARP wants to be sure the planning we are doing right now is sufficient to sustain and support the influx of people turning 65 over the next few decades," she said.

Currently, aging services are spread across 23 agencies and departments. Last year, AARP supported an unsuccessful effort to create a Cabinet-level agency to consolidate aging services. Now AARP wants experts in the field, government officials and other groups to find a new solution.

New Gov. Bill Haslam, R, has agreed to hold a summit on aging within his first six months in office, and has indicated he is committed to coordinating services to make the system easier to use.

"We're going to have increasing demands," Haslam said of the aging population. "We're always going to be dealing with restricted money. We're not ever going to have enough money, so we have to work smarter … by having better information exchange and making it easier for the customer."

Martha Roherty, executive director of the National Association of States United for Aging and Disabilities, said, "It is an amazing achievement that the governor recognizes the value of having a summit early in his administration … It signifies really good things coming to Tennessee."

AARP agrees. Although the cost of consolidating all the aging services into one agency hasn't been determined, Kelly said she doesn't think it would be more than the state currently spends.

"Tennessee needs to find the right system that works for Tennesseans. But we have a lot to learn from other states who have already consolidated and streamlined and gone before us," she said.

Only about a third of the states, including Tennessee, still have aging services fragmented among numerous state departments.

Most states are trying to emulate Wisconsin, whose Bureau of Aging and Disability Resources serves as the single point of entry for people over 60 and those with disabilities to get information about available resources.

Hollie Deese is a freelance writer based in Gallatin, Tenn.

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