Nutrition NAPIS Data Collection Webinar

Nutrition NAPIS Data Collection Webinar

November 7, 2019 0 By Ewald Bahringer


great good afternoon this is Jennifer Mead from the state unit on Aging and I’m wondering if for those who are on if we should do a quick check if the sounds ok I’m wondering if one of you might be willing to send in a message via chat and just let us know if you can hear as we get started you can hear it great and also if you can see the first slide that says NAPIS data and nutrition programs somebody might be willing to chat that into good ok thank you all I appreciate that just with technology I always want to make sure that we’re doing ok so welcome again thank you very much for joining us this afternoon I think we’ve got a great presentation and glad that a number of folks were able to join us those of you who registered for the webinar this afternoon should have received a copy of the PowerPoint via email but the webinar and the PowerPoint will be posted to the sua website within a few days after today’s presentation so if you didn’t receive that we can definitely make sure that you get it to help with background noise we have everyone except our speakers on mute today but we’ll welcome your questions and suggestions so encourage you to type in to the QA or chat we have a little bit of background noise I’m gonna pause for a moment and see if we can figure that out before we go forward remember we’re not showing any slides right now so are you able to share your screen yes thank you for pointing that out let’s see Lori’s doing How that Lacey? yep okay one other by the way I didn’t click good all right so hopefully we’ve got sound and we’ve got visual at this point but please Jennifer this is Sandy Karsten can you hear me yeah okay good just for a little while that would be great but really glad that you joined us okay how do I do that oh right now you’re part of the broadcast so right I’m not your how okay but maybe you can then just watch for the sound and make sure that you’re not I’m not sure how to mute myself is all I’m saying Lori or Jennifer you guys can mute her okay good all right apologies for the technical challenges here I think we’re set and will again we’re talking about NAPIS data and nutrition programs today and thanks for you all joining in I’ll repeat just real quick webinar and PowerPoint will be posted to the sua website a couple days after today’s presentation and please feel free to use the Q&A or chat section if you have questions or comments along the way I’ve got Lori Watt in the room here helping with all the technology and this is Jennifer Mead with the state unit on Aging so today’s webinar is focusing on strategies to increase collection and reporting of data and I wanted to start off just with a quick review well I will be starting us off with a quick review of the data in question what we’re currently seeing from nutrition programs across the state then Lacey Hansen from our state unit on Aging team will be providing some guidance on how to ask questions ask people for information Lacey trains I&R staff who are also regularly asking these personal and demographic questions and she’s got a lot of great experience with this issue and then we’ve asked for Area Agencies on Aging to share how they go about collecting the data sharing with us what’s worked for them and lessons that they’ve learned so will not be getting into how to enter collected data into Oregon access today we know that for a number of you this is also a significant concern and we’re working on further training focused on that aspect of reporting of the data we’ll keep you posted on the timing for that next piece of training but today we’re really going to be focused on how we collect the information from participants in nutrition programs all right let me go on to the next slide here so just starting with some some definitions in terms probably familiar to you but NAPIS is the national aging program information system this is a refers to the data that’s completed to comply with the administration on Aging requirements area agencies on aging are required to collect and report the data in the Oregon Access client database and the state unit on Aging is required then to submit that data annually in the state program report that we very often just refer to as the SPR so lots of good acronyms but that’s the basic system in terms of the data reporting NAPIS data why collected well at the most basic level it’s a requirement of the administration on Aging and its carrying out of the older Americans Act the data also does allow us to demonstrate who’s being reached or who isn’t and from the nutrition programs it can be helped to demonstrate how the program is meeting its goals the nutrition program goals of reducing hunger and food insecurity promoting socialization and promoting the health and well-being of older adults so it really helps us look at whether we’re who were reaching and whether we’re meeting some of those goals and really also helping us point out some differences between the congregate and home-delivered meal participants with the required nutrition risk screening information a number of you have developed great ways to target nutrition education and additional referrals based on that nutrition risk screening so that can also provide really valuable information and then ideally there’s the ability to use the NAPIS data and nutrition risk information to leverage funding and to promote programs I think a number of you already do this and it seems like there going to be more opportunities as aging service providers partner with health care to reduce hospital readmissions or to support people with various chronic conditions so this slide provides a quick summary of the administration on Aging and the administration for community living requirements for nutrition program data again I think this is familiar information to those of you who are on the phone but just wanted to review it to make sure we’re on this all on the same page the NAPIS data has to be collected initially and then updated annually for each participant for home-delivered meal clients the NAPIS data should also include the activities of daily living and the instrumental activities of daily living information and then the nutrition risk screening which is done via a form called the determined screening questions have to be completed initially and updated annually for both congregate and home-delivered meal participants the NAPIS form and the nutrition screening form are always posted on the sua website so that those are that’s the basic information that has to be collected and and the frequency that it needs to be collected and again this is a federal requirement and this is true of nutrition programs across the country this is the nutrition of the NAPIS form as we have it posted on the sua website it’s updated annually as the federal poverty limit amounts change right now we have it posted on the sua website in both English and Spanish I think most of your nutrition programs use their own version of the form and that’s fine as long as you’re able to collect the required demographic and risk screening information so we do updatein this format every year but again I think most of you take take the same information and put it in a format that works for you in your local sites one note I would just make about this form is that after some discussion we’ll be removing that last section five the special diet needs I think historically that got added at some point and but we’re realizing that that probably doesn’t serve an immediate need for any of us at this point and each site may be able to offer to add the nutrition options that they have at their own local site but including all these options on our form is not helpful I think at this point and then this is the nutrition risk screening form that again is required of all older Americans Act funded nutrition programs initially and then as part of the annual updates can be done verbally or given to the participant to fill out again it doesn’t have to look exactly this way I think most of you incorporate these questions onto your own forms and that’s fine but the questions need to be asked so we have these two guidelines to live by on the one hand nutrition providers should make every effort to obtain the required NAPIS sand nutrition risk data from each participant and then on the other hand participants who decline to provide the information cannot be denied service we still want to serve those who refuse to provide the information so it’s a balancing act and I think some this is one of the puzzles that we have in collecting the data the administration for community living and we at the state unit on Aging fully recognized that some people will be adamant about not wanting to share information but if more than ten percent of participants are missing required information the administration for community living starts raising concerns they asked who and how the information is being requested and they asked us to re-think our approaches to how we’re gathering the information how we’re explaining the need for the data how we’re asking participants to provide the information and how we might be able to increase willingness to share the information so we at the state unit on Aging are really trying to explore this with you for the triple A’s we do encourage you to have well-thought-out systems and procedures for collecting the information and reviewing periodically to see if this is working
we’ve got a number of great folks on the webinar today who are going to be talking more about how they have worked to increase regular collection of the required data but here these are just some overall tips to keep in mind participants clearly need to know that the information they share will be handled confidentially so thinking about how we let participants know their information is being kept safe where and how we ask them to share that information what we do with the paperwork that we collect all of that’s really important to be thinking through we need to be clear on why the information is collected that it’s a requirement we’re connected to the federal funding that helps make the meals possible that it helps us know if the programs or serving community needs in her webinar this past January Shelly Zylstra from the administration for community living suggested that congregate sites but for congregate sites that can be helpful to provide a brief presentation at each meal site at least annually to remind participants of why they’re asked to do this each year we have a question that’s come in do we have numbers on average percentage of collection rates across the state great question and I’m actually going to I think going to cover that in the next slide or two so if I don’t cover it adequately please ask the question again but hold on just for a moment the third bullet on this I would just say tone and the wording the way things are asked can make a huge difference the person sitting at the entrance greeting folks who may be asking participants to fill out information making sure that they understand why the data is important and that they’re able to communicate that well is certainly going to be critical and then just do we I would say we recognize this isn’t easy and hopefully today’s webinar will help but we also encourage nutrition sites and triple A’s to have ways to look periodically at what’s being collected and to think through anyways the system at each site may be improved so moving on to some of the data and again hopefully this will answer these next couple slides will answer the question that was asked but if not please ask it again so this is an example of some of what we know based on the data that you collect this this slide is home-delivered meal data from the most recent federal fiscal year when we had about 13,500 home-delivered meals participants across the state this is data that was collected about the ADL’s and IADL’s and just as a reminder the ADL’s are kind of a basic self-care tasks and the IADL’s are the more complex skills needed to live independently successfully so for this past fiscal year you can see that over 50% of home-delivered meal participants had one or more ADL or basic self-care need and almost 70% of these participants had one or more IADL needs and I would say I mean again this is really helpful data to show and this is a testament to the work that you all are doing in reaching people who are truly in need of this service the caveat I guess I would say is we also know that we’re missing this information for over 2,000 or almost 16% of these statewide participants so these are home delivered meals I see there’s a typo there HDM rather but in any case home delivered meals participants we are we’ve got this great data but we are missing it for a significant number of people again just sharing some other data that from the past year this is the nutrition risk screening information again provide some really compelling information and helps us see the difference between congregate and home-delivered meal participants I pulled just a couple of the questions here to give you an example and this is the statewide data and again you can see this is for twenty five thousand six hundred congregate meal participants statewide in the same thirteen five hundred
or so home-delivered meal participants over the past year at the individual level the data can help you connect individuals to additional services so as people are filling this out this information can help you make appropriate referrals to other food resources to dental care services to information on community programs but at the aggregate level as I’m showing you here the data can really help local communities and triple A’s in the state identify the need for more services access to food again dental services and can help identify potential health education topics for nutrition ed and give you a sense of the differences between congregate and home-delivered meal participants again I think it’s really great data again the challenge is so unfortunately at this point we’re missing this information for about 50% of congregate meal participants and over 14% of the home-delivered meal participants and that makes it hard to know how accurate our information is we’ve got good information for those that we’re collecting it from but we’re missing it for a good number of folks and this is a busy slide I realized that there’s a lot to take in here but it gives my intention was to give you a quick overview of the percent of missing data in Oregon as a whole if you look at the columns that say statewide number in percent that shows you the amount of missing information state right for congregate participants that rose at the top and then home-delivered meal participants the rows at the bottom the last two columns give you a sense of the variation between triple A’s so the most complete column shows you four triple A’s that have been the most successful the amount of missing data you can see it’s zero to six percent of missing data and then the last column which represents the triple A’s with the most missing data and clearly they’re triple A’s that are having some significant challenges in collecting the information represented in that column again keeping in mind the administration for community living the rule of thumb where they start to get really concerned if the missing data is higher than 10% you can see that we’ve got some work ahead of us as a state so with this background for why we’re focusing on the issue and some of what we’re seeing with the data at this point I’d like to turn things over to Lacy Hanson to give us some guidance on collecting the information Lacey is the ADRC program and technical specialist who coordinates training for our I&A programs and I&A staff statewide and I really appreciate having her share her expertise on collecting information Lacey I’m going to go ahead and forward the slide to the next slide and then keep me posted as you want me to keep moving them forward great thanks Jennifer hello everyone and thanks for that really good introduction so I have trained on this and I’m also I did I&R myself for five years and I know that asking personal questions is not always fun but as Jennifer just demonstrated information is power and it’s it’s a really important piece of the work that we do so go ahead to the next slide some tips for for doing this work so the best advice I can give is to just treat it like a normal piece of the work be comfortable with it and be confident so asking personal questions can feel uncomfortable but it’s essential for the survival of these programs Jennifer again just demonstrated that if we’re not able to show who we’re serving or even how many people were serving by not even giving out the surveys then we could lose funding if you present the information with confidence and know why it’s important so that you’re ready to make it have that explanation but also just delivering it with with ease and and just as part of the process for receiving these services you’ll you’ll have a much better time getting responsive practice some scripting and on the next slide I have some examples of scripting don’t go there yet nope go back please big sorry um but scripting I think is really helpful for all of us when we’re talking about potentially uncomfortable situations if you practice some words that are comfortable for you to say and have the desired effect on your audience then you can continue using that and it helps take away some of the tension when you’re when you’re delivering that so especially when our I&R staff are on the phone using scripting can really help to get a desired response without too much of an emotional impact it’s really important that we don’t apologize for asking these questions and we we can’t do this work without at least asking it’s part of the job it’s part of the federal requirements and again it’s important to remember that the federal government doesn’t treat this lightly either and they’re not asking just so that we can meddle and find out the personal information about our clients it’s so that they can make sure that if our community is made up well whatever the demographics of our communities so that we can show that we’re serving the diverse community and we’re making sure we’re reaching the people who need the food and services that we provide and not just reaching a certain aspect of the community so that’s one of the really important reason that the federal government asks for some demographics for all of our services it’s to make sure that that we’re doing a good job of doing outreach and support and and reaching the community as it stands and then just a reminder that it’s optional for our meal sites clients to answer the questions but it’s not optional for us to ask and that’s the same with I&R it’s part of our job to ask these questions and and volunteers as well it’s a requirement of the service but it is optional for the participants if they wish not to participate in the in the survey so next slide please so here are some helpful scripting and Jennifer already sent out the PowerPoint I encourage you to finesse these as as you like print them out provide them to staff have them on a little note card that they can have as a meal sites if it’s helpful so this one is a variation of what I encourage all our I&R staff to do here’s a form we ask everyone to fill out once per year so that we can continue providing this service so this phrase lets them know that it’s not that you just saw them walk in and you want to know about their personal business this is something that everyone is asked to do as part of our process I think especially because participants may be given this survey at different times because of the the once per year requirement you don’t want anyone to feel like they’re being singled out so this is the form we ask everyone to fill out once a year and that’s these are standard questions that we ask all our visitors they help us show that we’re doing the work and help us learn more about the needs of our community and as Jennifer said in in her slides before this all of that is true and then if you if you’d prefer not to answer a question you can skip it but please do what you can it really helps us keep this program running so I think if you can be confident and brave in doing this work if somebody box it at filling out the survey see if you can at least get them to fill out a few of the details so this may not always be an option but if you can have them fill out what they’re what they are comfortable with then we can at least recover some of that data that will help us continue these programs so those are some some tips that I hope will help the most important thing is that you normalize the process and and make sure that you as a professional whether it’s a volunteer or your triple-a staff if it’s part of the work and it’s it’s part of what we all have to do to get this service to be available for so many people and do such good work so it’s it’s important that we do it and just do whatever you need to make it comfortable but but you got it to it so those are my tips and I’m always happy to to talk to anyone who has questions about this and my contact information is on that SUA website I believe but we can get it to you great Thank You Lacey appreciate that at this point we’re going to move on and again really appreciate a number of the triple A’s that have been more successful in collecting this information being willing to share some of their experience and tips on what’s worked and what hasn’t Juliann Davis from Community Action Team in Columbia County is going to be joining us a little bit later but we also have sandy Williams from Douglas County senior and Disability Services sandy Carson melanne Council of Governments senior and disabled services and Gini Butler from Washington County disability aging and veteran services so four different perspectives we’ve asked these once again because they’ve been successful but I guess I just want to say leading into this that we recognize that every triple a and every nutrition program operates differently so just encourage you we recognize that what works in one area may not be directly useful to you but hopefully the ideas that these folks are willing to share can prompt some ideas and approaches that can help you as you think through much what might work for your programs so Sandy I’m really wondering if you would be willing to go first since we don’t have Juliann on the line yet and probably means unmuting yourself but if you’re willing to tell us a little bit about how data collection works for your nutrition programs that would be super right definitely so each of our congregate sites we already have a prepared roster and so when new clients come in their names are written down on the roster this kind of helps our case managers know that a new client has came in our food service workers know that a client has came in because often that you know volunteers are the ones that are you know at the front desk greeting that the clients as they come in so the food service worker usually oftens chats with the new guests and at the meal site and if it’s a client who’s going in that’s coming in a couple different times then that’s when a case worker or the food service worker sits down and fills out the NAPIS form and our congregate sites have been using the actual NAPIS’s form off the website and they have been all they fill out a majority of it besides like the section 4 in the section 5 and then that is entered into Oregon access and each month our meals are in off the roster sheets are calculated in our office assistant puts all that each meal into Oregon access and batches them and then if she comes across a client name on a roster that’s not an Oregon access and she also lets the case manager know and so then that’s an opportunity for the case manager to then kind of follow up with that client and see and get their their information Thank You sandy is there anything else that you wanted to add at this point it will have a chance for questions and discussions across and then I once every go ahead I guess the only other thing is yeah they the case managers go in once a year to the congregate sites and sit down and kind of do you know and fill out to redo the NAPIS’s forms and and check in so they’ve got that where the case managers just go into the sites and to do the yeary update okay I think you made so we had just gotten a question in about how that the follow-up annual information then is collected so so it wouldn’t mean that each client gets their yearly exactly out a year if they came in and it’s they’ve been attending for you know six months then yeah but they were there when they were doing the the renewal or you know update them you know they get theirs done earlier you know but okay great and then there was an another follow-up question about the putting the participant information into Oregon access and again it sounded like that was a way that you were also able to flag if somebody hadn’t completed or hadn’t filled out an NAPIS this form can you just talk through that process once more correct so when we have a client on our roster sheet and we give our roster sheets to our office assistant and she goes to put them in Oregon access their I guess batch them with meals if she can’t find a client then she let’s the a case manager know that you know I was unable to find Joe Smith and so then the case manager can then either find Joe Smith in Oregon access or go and have Joe Smith fill out you know you know fill out the form with him great and just I should have asked upfront sandy but just as a context how many meal congregate meal sites do you have in Douglas County we have seven okay great we’re getting a couple questions about kind of entering into Oregon access I’m going to hold off on those because again I think we’re going to want to do some additional training or do it or yeah additional training on that aspect of it at this point we’re really kind of focused on the collecting the information from participant piece but so I will follow up with those questions with the individuals that are asking but I think we’re not going to get into that right on the webinar now all right sandy anything else that you want to share at this point that’s really helpful don’t think so okay well and again we’ll come back to you as more questions come through but that’s terrific all right Sandy Karsten we’ve got our duo of Sandy’s today sandy I’m wondering if you can chime in now and tell us a little bit about how things work with Lane County and again what I didn’t do well with sandy Williams but maybe start us off by just giving us an overview of the number of meals sites and the basic operation of those in Lane County okay so in Lane County we have 11 cafe 60’s which are our congregate meal sites and nine of them are also Meals on Wheels dispatch locations the primary the first part I’m going to talk about is is about how we collect the congregate data because it’s quite different for the home-delivered meal data and I’ll talk about that later a new participant to the cafe 60 is hopefully welcomed in person by the staff person that isn’t always possible but in that in in as an alternative volunteer will welcome them and by the depending on how the temperature of the visit is we ask by the third visit if not before that the newcomer fill out what we call our Cafe 60 registration form and in in the ideal situation the site coordinator will actually try to sit with them well they do that but many days don’t permit that and so the participant may be filling it out on their own one of the things that I wanted to say is that a messaging the one way that we message it on the form is to say that your answers are appreciated because this information helps document the need for funding this program which is a slightly different it’s more specific reason for in needing their help with this so that’s how we handle the new participant the beginning of every fiscal year is just our policy and practice that everybody has to fill out a new form the first time they participate after July 1st and so that’s just kind of a routine process and again the messaging we use can use their I think different staff do it differently and I think this messaging information is helpful I’m gonna I think it’ll be helpful for us to try to assist staff with justifying the reasons a little bit better but one of the reasons that we can also use is that we do collect emergency information on the form so if they become ill or need help while they’re visiting us there’s an emergency contact that we can make contact with and that’s right up early in the form so it’s it’s kind of a reason that might make sense to them why would we would be collecting some of this information as I said in most cases the participants complete their own form because our we have limited staff and they don’t have time to do it individually with everyone obviously if someone can’t see or write the the staff personal review the current form on file or help them and help them fill it out or ask them if the data is still correct and then fill out the new form for the person the we do in our form and I think there’s a sample of the form art the form that we use that we can talk about later the in order for a person to be listed on our what we call our roster our reservation roster there the there is a cell where the staff person enters the most recent registration date and if that date is not in the current fiscal year that cell turns red so it’s a flag for them immediately that they need to follow up with the person and obtain the form and I and since we started doing that several years ago I think it’s been very very effective at easily helping the site coordinator see that all the forms are collected let’s see I’m looking at my notes the form that we use is a two part NCR form and for those of you who don’t know what that means the back part is a carbon and that’s shown on the next slide so the first page is completely filled out by the participant and the confidential data in the box below is hatch hash marked out so that that page is kept at the site so that the site has information about their their folks they have their birth date and they have their emergency information the top page which has all the data is sent to our main office where there is a clerk who does entry into Oregon access we have challenges if you want to go back I’m sorry to the first page we have some challenges we’re not below 10% in all categories in sum we have some challenges with ethnicity and with income and living alone and so we’re experimenting with some different ways of laying out the form this year it’s been really helpful to have the data about our effectiveness for this Triple A so I would really encourage triple A’s to ask the state what your what your percentage of response rate is specifically so that you can look and see maybe where some of the messaging needs to be changed or where maybe the form needs to be changed and then I guess I want to say for the home-delivered meal assessments these are done in the home by our senior connection area coordinators which are OAA case managers and they have all of the NAPIS’s elements and the nutrition risk and many more data collection elements embedded into a their data collection system and once they completely complete they’re in home assessment and fill out the data in the database a meals-on-wheels risk score is generated which is then transferred to a printed to a authorization that’s emailed to our meal sites that allows our site coordinators to go ahead and begin service or if they have a waiting list to rank the authorizations in priority order and that has been highly motivating for case managers to know that collecting that data will get this client higher on a waiting list if there is one and we’re really proud our data collection scores for home delivered meals are are considerably below 10 percent missing data so you know it’s it’s ideal to have face to face human interaction with this and then I think also it’s very motivating to the staff to know that there’s a real reason that this data helps that person access services
and I think that’s all I have for now that’s terrific sandy and boy it’s helpful to see your form there we’ve gotten a question asking about whether your forms are on the computer or on a computer program when you reference the red flag coming up but this form is a paper form that the client fills out when when a person says they’re going to start becoming regular the site coordinator we have an Excel database that they use to keep track of the participants and their meal orders and their services and their and for the congregate program basically it’s their meals and whether or not they filled out the registration form there’s very little data collected in that in that format the the Oregon access data all comes here to the main office to be entered so they’re they’re not entering the whole gamut at the site but they do have the little red flag available to them on there on that Excel spreadsheet yeah that sounds great and it’s helpful to see your form it’s interesting about what you were saying about looking at the form in terms of missing information I thought had crossed my mind too about the living alone information that missing in a lot of areas and at least on the state form it’s not in a very visible location so anyway I was interested that you’re also looking at kind of layout of the form and whether that may be impacting questions asking yeah we’ve actually for this new fiscal year we’ve eliminated one of our emergency contact rows which freed up some space to really expand the font for the nutrition risk and for the income and number in households and it’ll be very interesting next year to see if that if that may have made a change and I’m seeing just on that the way we have ethnicity and race laid out we may want to look at separating those because I sort of wonder if we have them together and I wonder if people think they just have to pick one amongst all of those choices because our ethnicity collection is fairly low
interesting what how things can look very clear to us and then once you start testing them you realize them clearly participants sandy there’s one other question that came in that’s kind of a general one but given experience with these programs I’m wondering if you can also just help address this when someone comes in and doesn’t answer or maybe is coming in these first couple times before they’re a regular participant are you entering those people in as a guest yes yeah they get entered in and they’re just they just have a red flag and once the site sent sends us the their monthly Excel spreadsheets you know we are likely to harp on them you know what about what about registering this person so there there is a little feedback loop for people but yeah we do we do start to serve them whether or not they filled out the form great thank you very much well I’m gonna keep going and again as with Sandy Williams will probably come back to you with more questions but let me check in and see if Juliann Davis has joined us on the call it looks like she still may be getting on so let me move on to you Jeannie if you’re willing to talk to us about how the program works in Washington County and again if you can start by kind of the overview of the of how your program is set up that would be helpful just for some context absolutely thanks for the invitation so in Washington County we contract out our meals to meals on wheels people currently we have six meal sites throughout this very large County we didn’t have seven a few of those areas were closer together so we in cooperation with Meals on Wheels closed one of those sites and had participants go to the other two sites that were close by but as a contracted service we of course include all of those NAPIS’s information as a requirement in their contract the language is pretty clear and we monitor their contract at least annually but we also meet with them quarterly just to communicate you know what’s the data look like talk about things that are working well with their contract and maybe some any concerns that we might have in our area we also as part of our contract in these quarterly meetings we provide technical assistance to our contractor because they are you know essentially running the federal program for us we want to be able to provide any technical assistance we can not only to the site managers and the corporate folks at meals-on-wheels that we also offer to go out into the different meal sites and meet with the volunteers there at those sites currently meals-on-wheels has done a really good job of setting up their orientation for their volunteers and their greeters and the volunteers in their meal sites they haven’t asked us to come in and do presentations but we’re actually in the process of putting together a joint orientation where they’ll have the perspective from meals on wheels about why this NAPIS data is important but then they don’t get as far into the weeds about older Americans act as we potentially would so we’re talking about a joint orientation where we as the triple-a would come in and provide some of that context around older Americans act just reinforcing and underlining the importance of this data so that’s kind of the foundation of our meal service here in Washington County I’ll talk about some strengths and best practices that we’ve observed with meals on wheels people but also some of the barriers and challenges that they have with collecting this data so historically Meals on Wheels people has collected the NAPIS’s data for congregate folks as they’ve entered the meal site of course after their second or third visit that’s something that they enter into a really great database that they have called serve tracker and then as those new NAPIS’s forms and risk forms are needed that serve tracker Flags those site managers that this is coming due so that’s been their strategy in the past for congregate meals for home delivered meals it’s kind of a similar process they have service coordinators that go out and do in takes for the home-delivered meal participants and at that time they’re helping to complete the NAPIS’s form and the the risk form right there in the consumers home they’re looking at employing while they’re launching a new strategy starting in July for congregate site so the home-delivered meal sites or the home-delivered meal participants the data is pretty good because they’re making sure that they’re collecting it at intake and they’re flagged those service coordinators are flagged each year on who’s coming due for a home visit so the data there looks pretty good so the congregate sites still strong but not as strong so now they’re looking at doing what they’re calling a snapshot and they’re gearing up for that in May and June so they’re working with all of the meal site coordinators and the volunteers in each meal site to say hey in July we’re going to be doing this snapshot and we’re going to blitz through each of the meal sites with these NAPIS’s forms and they’re going to enter them all into this serve tracker so they’ll know exactly how many forms were handed out and exactly how many were returned so interesting to see the difference between the data from this last fiscal year versus next fiscal year and if this snapshot is they’re calling it really will provide the additional data at that time they’re asking that we may come in and go visit the sites with them so that we can again provide that context of this is you know older Americans Act funding or a bulk of it is we fund about almost 50% of the meals in Washington County but letting them know that this is federal funding and that this data is tied to it and why it’s really important for that to continue so that’s one of their strengths is that they’re just constantly relooking at the data what are better ways that they can try to collect additional data they have merged the NAPIS form and the risk form into one form that’s easier for these participants to complete and they’ve also translated it independently into multiple languages which the form is not available currently and all the languages that we serve here in washington county has a very diverse County so the meals on wheels people have just gone and translated those forms themselves which is wonderful in the congregate sites there are now service coordinators so they have this meal site coordinators who oversee the meal site and then the service coordinators who are really responsible for collecting more of the data they’re on site to meet more one-on-one with consumers who may be hesitant and maybe don’t want to fill out an app and those congregate sites they can pull them aside and have that one-on-one time to just check in and maybe give them a little bit more information about why the data is important and pull them aside and make it feel like it’s more I one on one check-in rather than trying to pull this data out of them so that was a good strategy and of course the service coordinators are already going out and doing home visits I talked a little bit about that serve tracker that they have that’s tracking who has had their information entered each year and who is coming due which helps to flag them meals-on-wheels corporate is obvious he has access to that surf tracker and as they’re seeing maybe numbers dip of forms that are returned or data that’s entered they’re able to then go back to the site managers and follow up with them to say okay you know here’s the twenty names of folks that looks like they were due two months ago and we haven’t we don’t have updated data on them and of course sometimes it takes a little bit more incentive for even the site managers to collect the data so meals-on-wheels people is now tying the data collection to job performance and is also tying it to their annual metrics and raises so I thought that will be incredibly motivating to also be interested to hear how that changes their data collection that’s for the site managers that it would be tied to their performance and then meals-on-wheels is also designing a new training and orientation for all of the volunteers that are coming on site and they’re helping with greeting they’re helping with collecting data even those that are serving meals so that say someone comes in and they enter the congregate site they pass by the table they might sign in but they declined to enter an NAPIS form at that time the other volunteers that are maybe clearing tables or helping set up salad bars they’re also going to have the same training so that if that consumer were to go to them and say why do they keep asking me this information they’ll have the same foundation of orientation and training that says this well this is why they ask they’re not just being nosy this is really important information that they need to collect to keep our meal program going I thought that was also a really good practice some of the barriers and challenges that they’ve reported is that even with these translated forms for those that they’re potentially handing out to consumers that speak other languages they take the form they might go sit down and have their meal but each site doesn’t have either a volunteer or a site manager that might speak Cantonese or Vietnamese so they’re not able to help them complete the form and they’re reporting that as a barrier they were also reported that a challenge is that there’s no designated funding tied to this collection of data it’s just wrapped into their total contract which they find challenging to kind of carve out positions and help to make sure that there’s one person really overseeing the data collection for each of these sites and then finally one of the barriers or challenges that they are experiencing is that there’s a lot of turnover in volunteers and you know occasionally site managers but mostly the volunteers the greeters and just having that consistent orientation is going to be really helpful once it’s developed because new volunteers come in they don’t know who the Area Agency on Aging is or what we do or that a bulk of the funding that that supports those meals actually comes from us and that it’s tied to us so as having that joint orientation and giving that foundation of knowledge to folks as they are just ramping up to volunteer with Meals on Wheels people will be really helpful but currently that turnover volunteers they’re reporting as a challenge I guess one other piece that I didn’t mention is that since we contract this service out part of our advisory council we at one point had a nutrition subcommittee but since that requirement went away we no longer have that designated nutrition subcommittee but we do provide meal site evaluation forms to our advisory members I would say most of which are seniors and we ask them to take that meal site evaluation go out out into the community to visit a meal site you know it doesn’t have to be monthly but just to go out test the meals and part of that meal site evaluation was indicates were you asked to fill out a form that collected demographic information so we have a way to monitor how consistent that is per meal site through our Advisory Council members and with that I think that’s about all that I had to provide terrific Jeanne that was really helpful and it’s great to hear I mean each each of you who’ve been sharing have such a different set up in your for your Triple A so I think it’s really helpful to hear these different perspectives a couple questions that have come in a Jeanie for you one was whether the NAPIS’s forum is translated into Chinese Korean and or Vietnamese this is interest from Multnomah County and do you happen to know the languages that your forms have been translated and do not but I okay when with meals on wheels people and ask I would assume if that question came from Multnomah County that the form that they’re using in Washington County are likely are the same that they’re using in Multnomah County and I don’t know if they’ve done an exhaustive translation which would be pretty challenging but we can definitely find out which languages they’re translated into so we’ll follow up with those who are on the call with that information that Jeanie that would be great another question was whether you you and the meals-on-wheels people might be willing to do that share the orientation training that you’re developing because that might be helpful as a basis for training in other areas absolutely as a Triple A we we struggle to get the services that we provide out into the community as it is so we’re looking at creating a video one of those cute little cartoony type videos where they have a voiceover and that would be part of our orientation we’re looking at you know what that would cost and then it would be more it would break up the orientation and not have it just the us speaking to them they’d be able to watch a little video but yes if that’s a piece of it we can share it but then ultimately if it’s a some kind of a curriculum yeah I’m sure that you know zone wheels people would be happy to share their portion of it and we certainly are always willing to share sounds great by the way we got got a comment on from somebody from Meals on Wheels of people and I think they’re responding to the question about whether the form is available in Chinese Korean and Vietnamese and saying yes so again Jeanne maybe you can follow up with we can follow up in terms of all the languages but it sounds like that’s probably a yes and then just another question about the serve tracker and this may be one that we need to follow up with specifically but what the individual is asking but the collecting meals on wheels people with collecting the information from serve tracker but then somehow reporting the data on to you to get it into Oregon access it sounds like correct well we still get the old-school NAPIS’s forms they send them in to us for each as new participants come on board they also put it into a spreadsheet that we enter the information that way I’m hoping with this new snapshot that they’re doing we’ll definitely have to have that conversation on is there an easier way for us to upload that information in to Oregon access or just to make that data entry easier so we’re not ending up with 400 new NAPIS forms all at once right now they kind of trickle in throughout the year so it’s not completely overwhelming but yes we still enter all of that data independently here at the Triple A great and thanks to Maggie for meals-on-wheels people we got another update on the languages Chinese Vietnamese Korean Spanish and Russian some of those it sounds like they’re being worked on but apparently are the languages that they’ve fit the NAPIS’s form is either available or soon will be available in all right I want to move on and we’ll come back to other additional questions that are coming in but I want to move on to Julian Davis thank you very much Jeanie Julian are you on the phone at this point I am thank you hear me and I all right now got to hear you well and thanks for coming out of your workshop to join us but yeah if you’re willing to just give us a little overview from how the meal number of meal programs and how they’re set up in Columbia County and then some tips that you might have that would be super okay for our our County we have independent senior centers that are serving all of our meals except for Vernonia but the NAPIS storms are collected the same way in Vernonia they are in any of our other centers each of our centers have have somebody when people come in that check people in that are requesting NAPIS’s be filled out and in st Helens were actually pretty successful at getting almost everybody to fill went out her name is Marvel and she is a marvel at getting people to actually feel the NAPIS forms out and we get them regularly from st Helens the other three center or the other two centers that it kind of differs what we’ve started doing is our we have a case manager up in North County and she actually goes into both cloud scan I and Rainier centers on a regular basis and talks to the meal participants ie will usually give her a name or a list of names of people who either need updates or we haven’t they’ve been on the meal counts for a while and yet they’re not showing up with new NAPIS forms and she’ll actually go in and get those for us so it’s our case managers that are following up on making sure that that we’re getting the data that we need and in st Helens like I said Marvel gets most of them I don’t have a huge problem although we do about once a quarter go into st Helens and talk about why we are requesting this and answer any questions that people have about where funding is coming from and you know why we’re we’re needing this information where does it go and those kinds of questions and then Vernonia because we’re doing the restaurant meals currently until we get to Senior Center rebuilt actually it’s a voucher system program and so when people come in to sign up for vouchers they’re part of them signing up for the vouchers as they’re filling out the NAPIS Form so that’s how we do it in our counties or in our County we have we have a pretty good success rate in most everywhere except Clatskanie and Clatskanie I tends to be a smaller community and for whatever reason even though they have volunteers that are pretty much there for every meal so they know who is a new person and who isn’t a new person they tend to be less inclined to ask them for the NAPIS forms they just kind of have it on the front desk and hope that people will walk by and you know say oh what’s this on the frond desk and take it so we’ve we’ve been trying to encourage them to to ask people you know if they would be willing to fill out a form and and like I said Marge has been up there and will actually sit down kind of one-on-one and talk to the people who you know are unsure or have questions which has helped a little bit as far as as far as this getting the information back from North County for home-delivered meals our case managers do all of the assessments for home-delivered meal service and qualify people for that service and so we get those NAPIS’s forms at that assessment and you know every year thereafter as we redo the assessments so we kind of took that back from the senior centers because people were on meals on wheels it didn’t you know we’re not eligible we’re having a real difficult time so we finally took that back in house and said from a triple-a perspective we’re going to do all of the assessments for meals on wheels and at that time get all of the NAPIS forms so we pretty much get all of our meals on wheels NAPIS forms I’m sorry I haven’t been on the call for this whole time so I don’t know what else I’m supposed to be telling you about was there something I missed no it that was fabulous there was a general comment that came in about a barrier that folks deal with especially at the congregate program that individuals who are showing up don’t necessarily know what their income level is they you know just came in for lunch and now they’re being asked to check a box regarding income level and again Julianne this wasn’t specifically at you but I wonder if you have any thoughts or comments on that usually they will ask sometimes they come in without anything filled in in the income level but we went the old NAPIS forms you know had the range like they would have household of one and they’d have zero to whatever it was 903 and then 904 whatever and they’d have a range we went to just either above or under poverty so it’s zero to whatever that household of one to look at a NAPIS form I don’t know off the top of my head but it’s zero to whatever that poverty level for a household of one or actually I probably have one sitting somewhere around here or above that poverty level so they just they’re only picking either below or above poverty level for a household of one two three or four that’s as far as we went and we tend to get more people they kind of know that they’re either under this amount or over this amount it’s easier for them than having to pick you know three or four different ranges but that’s just what we’ve done and I don’t know if because we don’t use the state NAPIS forms we kind of have a took it and made an NAPIS of our own because we’ve had to add things like whether or not they’re veterans for internal data collecting and in doing that we’ve kind of changed the form slightly the questions are the same as far as the nutrition assessment and all of that but the the format slightly different because right what we’re collecting internally yeah yeah but that’s kind of what we did but great it helped us to get more people because they kind of have a general idea of what they’re making but when you only give a one number you’re either below this or above this it seems to be a better choice for people but that’s just my you know I get more responsive now so I’m assuming that that’s just a better way of doing it for our people but you know I don’t know if you guys collect ranges and if if that’s something that agencies need are those particular ranges and you know that might not be something everybody yep no that’s how cool and the state form does the same that’s what you’re saying below or above that that number but yeah anyway that’s helpful thank you Juliann and you need to head back to your workshop are you going to stay on the phone at this point nope I’m I’m here for the rest they’re doing the action plans and so I don’t need to be there okay well thank you again for stepping out of what you were doing but yeah so let me go back one more question has come in for Sandy Williams from Douglas County and then please I would encourage folks to keep sending in your questions we can ask all four of our folks at this point we’ve still got ten or so minutes that we can use if it’s helpful question for Sandy Williams and that was can you talk a little bit about your home delivered meals program and how the data is collected with those folks I think we focused on the congregate sites but if you could talk a little bit about your how the data is collected for home-delivered meal participants that would be super okay our case managers um collects the NAPIS status information from our home delivers so if we going to refer all the case manager calls and it does some of the collecting initially over the phone but and but then they go out and have a face-to-face conversation and you know fill it out and they we actually do visits every six months our case managers will go out to our home deliver clients every six months and redo evaluation and then so yes that’s how all right thank you that’s terrific there was a question a suggestion that said that maybe it would be helpful for the state unit on Aging to develop an explanation of the need for the data something that could be produced and to ensure a uniform message I think that’s a great suggestion we could certainly put some information together that then folks could use or adapt but good idea I’m looking to see Lori are there other questions that we’ve missed at this point no nothing all right well those of you on the phone we’ll give it another minute or two in the meantime let me just circle back any of our speakers at this point and Lacey I would include you too anything else Lacey or Julianne Sandy and Sandy and Jeanne anything else that’s come to mind that in hearing other folks speak that makes you want to contribute anything more at this point any other suggestions or ideas um this time oh okay I’m being I’m I’m getting some side talk here from for Monica Sandgren who’s recommending that I talk about something and I confess that I’m not done meal sites myself so I’m gonna do what she recommended that I talk about but it has to do with asking questions in person so if that’s an aspect of some of your work than this we’ll address that so um just a tool that that was developed in an in a busy call center and I continue to recommend for some I&R staff is for asking some of those questions it helps to group them together so saying would you mind sharing your gender race and ethnicity if something sort of magical happens where people kind of forget to worry about the context of the questions and and are more focused on remembering the list of questions that were asked and and also it helps because the word race doesn’t come across always very well it’s a soft sounding word and so sometimes just pairing it with with ethnicity helps bring context into it but then also gender race and ethnicity are clearly demographic questions I think it it shows rather than just directly asking someone their race or their gender for example it it makes it clear at least in my mind that this is a list of questions that that I have in front of me that I’m being told to ask so getting creative with preparing questions together can be helpful and I just encourage people to try out some different things see what what feels most comfortable and and make it work for you great Thank You Lacey all right I’m not seeing any other questions come in so I think we can wrap up our webinar today I want to really thank Jeanne and Sandy and Sandy and Julianne for being willing to share what’s working with your programs again I recognize every triple a every nutrition program operates slightly differently is but I hope that those of you who’ve been listening in today at least have heard some ideas that might help as you think about the data collection and reporting at your sites thank you all very very much for calling in today we will be getting this webinar and the PowerPoint posted within the next couple days on the sua website and if you have any follow-up questions please just let me know my name again is Jennifer Mead and but wish you all a good rest of your afternoon and thank you all very much for joining us today