Better serving seniors

Vicki Harper, a Human Services Case Manager with Marion Senior Services, left, and Capt. Chris Hickman of Ocala Fire Rescue, center, talk with Shirley McEarchern, 87, the widow of former Ocala Fire Rescue Chief George McEarchern, as they take her vitals and provide support at her home in Ocala, Fla. on Wednesday, Feb. 15, 2023. Harper and Hickman work together as the Co-Response Team that continually visits elderly people and others in the Ocala community who need medical assistance and support. The program is unique and caring, with referrals coming from Ocala Fire Rescue and other agencies in Ocala. The Co-Response Team works in partnership with AdventHealth, Hospice of Marion County, the Marion County Health Department, Interfaith Emergency Services and Community Companion Care. [Bruce Ackerman/Ocala Gazette] 2022.

Area at-risk seniors who previously tumbled through the gaps of available resources now have a big safety net, thanks to a new and unique collaboration between Marion Senior Services (MSS) and a host of other agencies.

The Elder Co-Responder Program for Marion County assists seniors with medical and mental health issues, food insecurity, as well as the strain of caregiving and social isolation by linking them to vital organizations and agencies that can provide them with aid and relief.

The program, a first-of-its-kind in Florida, officially launched in 2020 but gained traction in 2021 when it received crucial funding from Lutheran Services Florida in the amount of $150,000. Last year, Lutheran Services backed the program with another $145,000 infusion, funding the program through June of this year.

“We were watching seniors fall through the gaps, despite our best efforts, and we were determined to find a better way to help them,” said Jennifer Martinez, executive director of the nonprofit MSS since 2015. The agency provides supportive care to seniors and the disabled community, including meals and transportation.

“We wanted to find a more dignified and unified way to approach their problems,” she said of the program’s beginnings.

What initially started out as a joint effort between MSS, Lutheran Services and the Marion County Sheriff’s Office (MCSO), under the approval of Sheriff Billy Woods, the program now also includes Ocala Fire Rescue (OFR), the Ocala Police Department, the Fifth Judicial Circuit, The Vines, AdviniaCare, Hospice of Marion County, the Florida Department of Children and Families (DCF), NAMI (National Alliance on Mental Illness) of Marion County, Florida Department of Elder Affairs, Interfaith Emergency Services, SMA Healthcare, the Florida Public Guardian Programs, Community Companion Care, AdventHealth Ocala and HCA Florida Ocala Hospital.

The partnering agencies regularly check in with one another to identify seniors in crisis. Seniors who call 911 excessively or who frequently visit emergency rooms when they don’t have a real emergency are especially targeted because they strain the emergency response system needlessly.

“We triage and prioritize those who need help the most and keep track of them through case management and a care plan,” said Briana Kelley, Ph.D., a human services counselor at MSS, whom Martinez credits as the mastermind behind the program.

“Our goal is to reduce the time spent with them each week and move positively toward a goal,” Kelley said.

A paramedicine team, comprised of OFR Capt. Chris Hickman and MSS clinician Vicky Harper, visit the seniors in crisis several times a week and delve deep into the core issues affecting them, give them care, and direct them to the proper resources.

“We’re able to directly help folks that are underserved and under-cared for,” said Hickman. “It allows us to home in on specific needs and look at the person as a whole.”

Sometimes, he said, it may come down to a senior not having a primary care doctor or regular access to health care, or even medicine.

“Do they have the medications they need?” said Hickman. “If they have no insurance, we have a program in the community that will help them pay for medication.”

Lately, the team has been dealing with a lot of dementia patients in its large baby boomer population, which can be challenging.

“We just went to a presentation on dementia and now we’re able to use a lot of the techniques we learned to de-escalate things,” said Hickman.

Kelley said there are myriad barriers and deterrents that exist for the county’s growing senior population, many of whom don’t have family members or a guardian nearby to help them navigate potential resources.

“We identify gaps of service and find ways to meet their needs,” said Kelley, who has been with the agency since February 2020.

“We figure out ways to keep their quality of life and independence going as long as possible,’’ she added. “If they need to transition, then we do that. If hospice is necessary, then we’ll make the referral to hospice. If Alzheimer’s training is needed, we make that referral, too.”

Kelley noted, “We also have a lot of seniors who are raising their grandchildren and need support.”

So far, the program has assisted 75 seniors who are case-managed over a 90-day period, as well as many “one-time” contacts and contact with high utilizers–those who call 911 too much and visit emergency rooms unnecessarily, Kelley said.

Sgt. Clint Smith of the MCSO said the agency has benefitted from the partnership, especially after it started looking into the number of 911 calls from a dozen seniors with mental or cognitive health issues who were constantly calling the agency for non-law enforcement matters.

“Those 12 individuals took up 1,330 hours of time from the sheriff’s office for non-emergencies in 2021,’’ said Smith. “What we’ve seen from partnering with Marion Senior Services is an average of a 54% decrease in calls from those 12 individuals for 2022. That’s huge for us; that’s 700 hours of time we’ve saved.”

Now, when deputies respond to a call that ends up not being a law enforcement issue, Smith said, they act as a referral service and help point the caller in the right direction, hopefully staving off any more unnecessary calls to 911.

“That’s the benefit from it; now we can spend time fighting crime and doing the things we’re expected to do,” said Smith, a 17-year veteran of the MCSO. “It’s the right thing to do and it helps the community.”

Martinez said she has been actively seeking funds from lawmakers in Tallahassee to keep the program going. A recent appropriations request by MSS for $483,000 is being backed by Rep. Stan McClain in Florida’s House of Representatives and Sen. Dennis Baxley in the Florida Senate, with support from Sen. Keith Perry.

The monies would support the hiring of three more staffers, including a dedicated crisis intervention specialist, another clinician and a care coordinator, said Martinez.

“We are so thankful for the support of our local legislators,” she said.

In the meantime, Martinez has been a featured speaker at several events, including the Southeastern Association of Area Agencies on Aging conference in September, during which she outlined Marion’s program.

“A couple of area agencies came up to me afterward and said they wanted to duplicate what we are doing,” said Martinez. “I’ve also pitched our program to the Department of Elder Affairs and they are looking to come and see the program for themselves.”

Being a potential model for other similar organizations to emulate is gratifying, but ever-so-slightly nerve-racking, too.

“We are still learning as we go,” said Martinez. “It’s like building an airplane while in flight.”

To learn more, go to marionseniorservices.org