Focus on Aging: Federal Partners’ Webinar Series / Supporting Older Adults in Emergencies

>> WELCOME TO THE FIRST 2020 FOCUS ON AGING, FEDERAL PARTNERS WEBINAR SERIES THIS IS A COLLABBATION AMONG ACL, CDC, HRSA AND NIH IT WILL BE RECORDED FOR FUTURE VIEWING YOU WILL RECEIVE A E-MAIL WITH A LINK TO THE WEBINAR AS WELL AS SOME LINKS TO SOME ADDITIONAL RESOURCE MATERIALS NEXT SLIDE IF YOU HAVE QUESTIONS, PLEASE SUBMIT THE QUESTIONS VIA THE LIVE FEEDBACK FORUM AT THE BOTTOM OF THE VIDEO CAST PAGE IT CAN BE FOUND AT THE BOTTOM OF THE VIDEO CAST PAGE AND CLICK THE LIVE FEEDBACK LINK WHICH WILL APPEAR TO SUBMIT QUESTIONS WE’LL DO OUR BEST TO ANSWER AS MANY QUESTIONS AS TIME ALLOWS WE HAVE A GREAT GROUP OF PRESENTERS TODAY FIRST, AARON LONG, FROM ACL WILL SET THE STAGE FOLLOWED BY DR. SAMIR FROM SCI-FI HEALTH WHO WILL HIGHLIGHT RECENT EFFORTS FROM THE RED CROSS MARGI SANDERS FROM NORTHEAST OHIO MEDICAL UNIVERSITY WILL TALK ABOUT PREPAREDNESS FROM A NURSING HOME PERSPECTIVE AND JEFF KLEIN WILL HIGHLIGHT RESPONSE ACTIVITIES AS AN HCBS PROVIDER DR. KATHY HIRE FROM THE UNIVERSITY OF SOUTH FLORIDA WILL DISCUSS RECOVERY DR. NIA REID FROM CDC WILL PRESENT INFORMATION ON COVID-19 AS RELEVANT TO OLDER ADULTS I WILL TURN IT OVER TO MY COLLEAGUE, AARON LONG, FROM ACL >> SORRY ABOUT THAT GOOD MORNING I AM GOING TO SPEND A COUPLE MINUTES JUST LAYING A LITTLE BIT OF GROUNDWORK ON THE ISSUE THAT WE’RE ADDRESSING IN TODAY’S WEBINAR BEFORE WE HEAR FROM OUR EXPERTS SO, IN THIS SLIDE, WE’RE TALKING ABOUT THE EMERGENCY DISASTERS COME IN MANY FORMS WITH DIFFERENT CAUSES THERE ARE TWO BUCKETS WHERE EMERGENCY DISASTERS CAN BE PLACED A HUMAN DISASTER AND A NATURAL DISASTER NATURAL DISASTERS ARE ADVERSE EVENTS FROM NATURL THINGS ON THE EARTH INCLUDING HURRICANES, FLOODS, EARTHQUAKES, AND A WIDE VARIETY OF OTHER NATURAL-CAUSING DISASTERS HUMAN INSTIGATED DISASTERS ARE TECHNOLOGICAL OR HUMAN HAZARDS EXAMPLES INCLUDE OUR CURRENT PANDEMIC, FIRES, INDUSTRIAL ACCIDENTS, ET CETERA THERE ARE REGIONS OF THE COUNTRY MORE PRONE TO EXPERIENCE NATURAL DISASTERS EXAMPLES WOULD BE FLORIDA AND HURRICANES, HOUSTON, TEXAS WITH FLOODS, FIRES IN CALIFORNIA OVER TIME, THEY’VE DEVELOPED PRACTICES AND RESOURCES TO ADDRESS THOSE TIMES WE’RE QUITE CERTAIN THAT THE PRESENT NATION WIDE EMERGENCY THAT WE’RE WORKING THROUGH WILL RESULT IN EXTENSIVE LEARNING ON HOW TO PREPARE, RESPOND AND RECOVER TO EMERGENCIES OF THIS MAGNITUDE NEXT SLIDE AS LAID OUT IN THE TABLE IN THE SLIDE THERE’S MANY CONSIDERATION FOR OLDER ADULTS IN EMERGENCY SITUATIONS EVACUATION CONCERNS, PEOPLE THAT ARE CAREGIVERS OR HAVE CAREGIVERS, THERE COULD BE CONCERNS ABOUT SEPARATING FROM CAREGIVERS LACK OF TRANSPORTATION ARE PEOPLE ABLE TO EVACUATE INDEPENDENTLY AND DO THEY STILL DRIVE? DO THEY HAVE MOBILITY ISSUES? ARE THEY ABLE TO GET OUT OF THEIR RESIDENTS? SOMETIMES PEOPLE CAN’T BRING THEIR PETS AND THAT IS A VERY TROUBLING SITUATION ALSO PEOPLE WORRY IF THEY EVACUATE FROM THEIR HOME, THEIR FAMILIES WON’T BE ABLE TO FIND THEM AND THEY HAVE CONCERNS ABOUT PERSONAL PROPERTY AND THEIR PERSONAL SAFETY ACCESS IS ALWAYS A CONCERN AS WELL DO PEOPLE HAVE ACCESS TO MONEY DURING AN EMERGENCY? DO THEY HAVE MONEY AND FOOD? MEDICAL INFORMATION IF THEY HAVE TO EVACUATE, DO THEY HAVE ENOUGH MEDICATIONS AS THE TREATMENT AVAILABLE THAT THEY MIGHT NEED DO THEY HAVE THE MEDICAL EQUIPMENT THAT THEY NEED DO THEY REQUIRE, IF THEY HAVE TO EVACUATE, WILL THEY HAVE ATTESTANCE WITH THEIR ACTIVITIES OF DAILY LIVING? IF THEY CAN’T EVACUATE, WILL

THERE BE UTILITIES AVAILABLE AND ELECTRICITY, GAS AND WATER DO THEY HAVE ACCESS IF THEY’RE NOT IN THEIR HOMES TO THEIR LEGAL DOCUMENTS ANOTHER CONCERN IS MANAGEMENT OF CHRONIC DISEASES WILL THEY HAVE TO INTERRUPT THEIR DISEASE MANAGEMENT? HOW WOULD MILD COGNITIVE IMPAIRMENT IMPACT THAT? ALZHEIMER’S AND RELATED DEMENTIA IN AN EMERGENCY SITUATION IS A SERIOUS CONCERN AS WELL AS HEART DISEASE, BLOOD PRESSURE, HAVING ACCESS TO ALL THE TREATMENTS THAT THEY NEED AND COMMUNICATION CHALLENGES ARE QUITE SIGNIFICANT THERE IS A LIKELIHOOD THERE COULD BE SOME INTERRUPTIONS IN COMMUNICATIONS IS THERE A PHONE SERVICE? THESE DAYS WE ARE WORRIED ABOUT LOSS OF OUR INTERNET SERIOUS CONCERN IN COMMUNICATION OF LATE IS ISOLATION AND LONELINESS NEXT SLIDE, PLEASE DURING THE REMAINDER OF THE WEBINAR WE’LL HEAR FROM NUMEROUS PERSPECTIVE EXPERTS ON PREPAREDNESS RESPONSE AND RECOVERY AND I WANTED TO LAY THE EXPECTATIONS AND WHAT WE’RE TALKING ABOUT WHEN WE TALK ABOUT PREPAREDNESS THAT IS PLANNING FOR EMERGENCIES BEFORE THEY HAPPEN AND IT ALLOWS FOR RAPID IDENTIFICATION, EVALUATION AND RESPONSE TO EMERGENCY SITUATIONS RESPONSE IS AN ORGANIZATION RESPONSE TO AN UNEXPECTED OR DANGEROUS SITUATION DESIGNED TO LESSEN THE IMPACT OR THE EVENT ON PEOPLE, COMMUNITIES AND THE ENVIRONMENT AND RECOVERY IS ACTIONS TAKEN AFTER AN EMERGENCY DESIGND TO AID IN RETURNING TO NORMAL OR A SAFER ENVIRONMENT RECOVERY ACTIVITIES TAKE PLACE AFTER THE EMERGENCY HAS SUCCEEDED, I GUESS SO, FOLLOWING BEHIND ME ARE SOME PRESENTATION THAT’S WILL PUT ALL THESE THINGS INTO PERSPECTIVE FOR YOU AND NOW I’M GOING TO TURN THE WEBINAR OVER SAMIR SIN SINHA TO DISCUSS HIS SLIDE NEXT SLIDE, THANKS >> THANK YOU, VERY MUCH HOPEFULLY EVERYBODY CAN HEAR ME OK SO MY NAME IS DR. SAMIR SINHA AND I’M FROM TORONTO, CANADA I HAVE THE HONOR OF BEING THE FIRST GEREATRITION TO BE A MEMBER OF THE SCIENTIFIC ADVISORY COUNCIL AND I ALSO HAVE A JOINT FACULTY APPOINTMENT AT JOHN HOPKINS WHERE I FINISHED MY GERRY AT TRICKS TRAINING AT THE AMERICAN RED CROSS, A LOT OF WORK IS BEING DONE TO HELP ADVANCE TRAINING AROUND FIRST AID, CARDIAC RESUSCITATION BUT IT’S AROUND DISASTER HELP AS A MEMBER OF THE SCIENTIFIC ADVISORY COUNCIL, SOME OF THE WORK I’VE BEEN DOING IS PART OF THE DISASTER HEALTH AND PREPAREDNESS COUNCIL IS THINKING ABOUT OLDER ADULTS AND OLDER AMERICANS AND HOW WE CAN BETTER SUPPORT THEM IN OPTIMIZING EMERGENCY AND DISASTER REPAIREDNESS IN RESPONSES WE’LL GO TO THE NEXT SLIDE SO THE OBJECTIVES REALLY FOR THIS PRESENTATION ARE REALLY TO UNDERSTAND HOW AND WHY OLDER ADULTS ARE NEGATIVE EFFECTED BY NATURAL DISASTERS AND IDENTIFY KEY DOMAINS WHICH TO CONSIDER, EMERGENCY AND DISASTER PREPAREDNESS AND RESPONSES BUT DESCRIBE SOME KEY STRATEGIES TO PROMOTE BETTER, OLDER ADULTS, AND RESPOND TO DISASTERS GO THE TO NEXT SLIDE AND THE NEXT ONE TO SET THE CONTEXT HERE, OLDER ADULTS EXPERIENCE MORE CASUALTIES AFTER A NATURAL DISASTER WE’LL GO TO THE NEXT SLIDE AND THE NEXT ONE SO, WHEN WE’RE SETTING THE CONTEXT HERE, WE CAN SEE FROM THE GRAPH THAT YOU WILL JUST SEE HIGH THASEETHAT IN 2005, 49% WERE IN PEOPL E WHO WERE 75-YEARS-OLD OR OLD OLDER MANY VICTIMS DIED IN THEIR OWN HOMES AND NURSING HOMES WERE ABANDONED BY THEIR CAREGIVERS A REAL TRAGEDY WHEN WE THINK ABOUT HURRICANE SANDY A LITTLE MORE RECENTLY, WE KNOW AGAIN, ALMOST HALF OF THOSE WHO ACTUALLY DIED IN THE STORM WERE 65 AND OLDER AND IN THIS CASE, MANY OF THESE OLDER ADULTS AND A COLDER CLIMATE WERE FOUND TO DIE FROM STORM-RELATED INJURIES, HYPOTHERMIA AND OTHER CAUSES WE’LL GO TO THE NEXT SLIDE AND WHEN WE ACTUALLY SAW SOME PROGRESS AFTER SANDY IN

PARTICULAR, THEIR CENTERS FOR MEDICARE AND MEDICAID SERVICES ESTABLISHED RULES FOR ALL PROVIDERS AND SUPPLIERS AND SO THE RULES GOVERN THE FOLLOWING DOMAIN RISK ASSESSMENT AND EMERGENCY PLANNING, POLICIES AND PROCEDURES, COMMUNICATION PLANS AND TRAINING AND TESTING THIS WOULD INVOLVE, FOR EXAMPLE, HOSPITALS, THIS WOULD INVOLVE NURSING HOMES THAT FALL UNDER CMMS BUT THIS WOULD NOT ACTUALLY APPLY TO ASSISTED LIVING FACILITIES WE’LL GO TO THE NEXT SLIDE CHALLENGE WAS IS THAT EVEN AFTER THOSE EMERGENCY RULES, OR THOSE RULES CAME INTO EFFECT, WE HAD HURRICANE IRMA AND HARVEY AND WE CONTINUE TO SEE CHALLENGES SUCH AS WHAT HAPPENED IN IRMA WHERE 14 RESIDENTS OF A NURSING HOME DIED DUE TO HEAT-RELATED ISSUES WHEN THEY WERE LEFT WITHOUT ELECTRICITY TO POWER THEIR AIR-CONDITIONING SYSTEMS THE STATE OF FLORIDA HAS ENACTED EMERGENCY RULES TO COVER ENVIRONMENTAL CONTROL FOR NURSING HOMES NO OTHER STATE ACTUALLY HAS THESE RULES HURRICANE HARVEY, AS WE SAW, IT WAS ACTUALLY AN ASSISTED LIVING FACILITY SO NOT A CMMS ORGANIZED NURSE FEDERALLY FUNDED NURSING HOME, F YOU WILL THIS CASE HIGHLIGHTED A GAP UNTIL THE LACK OF UNIFORM EMERGENCY PREPAREDNESS REGULATIONS FOR VULNERABLE, OLDER ADULTS IN THESE SETTINGS WE’LL GO TO THE NEXT ONE GO TO THE NEXT SLIDE SO, REALLY THE KEY IS THAT PERSISTENT POOR OUTCOMES HIGHLIGHT FIRST CYST AN PERSISTENT GAPS WITH THE AMERICAN RED CROSS BEING ONE OF THE LARGEST ORGANIZATIONS HELPING, THAT IS A NON GOVERNMENTAL AGENCY THAT HELPS, THIS IS SOMETHING THAT WE WERE NOTICING AND AS A SCIENTIFIC ADVISORY COUNCIL DECIDED TO DO FURTHER WORK TO SUPPORT IMPROVEMENT IN THIS AREA WE’LL NEXT GO TO THE NEXT SLIDE SO, WHY DOES DISASTER PREPAREDNESS FOR OLDER ADULTS MATTER W KNOW THAT AGAIN, THE DISPROPORTIONATE NUMBER OF OLDER ADULTS ARE AFFECTED AND WE KNOW THE AMERICAN POPULATION IS AGING LIKE ALL OTHER NATIONS AROUND THE WORLD, AND THERE’S GOING TO BE AN INCREASE DEMAND FOR EMERGENCY RESPONSE SERVICES PROVIDE TO HEALTHCARE PROFESSIONALS AND EMERGENCY RESPONDERS AND THEY’LL BE AN INCREASE NEED FOR AGE-FRIENDLY AND SENSITIVE PROCEDURES AT ON ORGANIZATIONAL GOVERNMENT LEVEL AND WE EXPECT THAT THERE’S GOING TO BE AN INCREASE IN THE AMOUNT AND SEVERITY AND FREQUENTLY OF NATURAL DISASTERS AND THE COST OF THESE ARE HUGE YOU CAN JUST SEE THE COST ALONE RELATED TO ALL THE VARIOUS HURRICANES WE’VE LISTED AT THE BOTTOM WHAT MAKES OLDER ADULTS PARTICULARLY VULNERABLE IN THE CONTEXT OF DISASTERS? SOME PEOPLE SAY IS IT JUST AGE? WE’LL GO TO THE NEXT SLIDE REALLY, THIS IS A LITTLE CHART WE DID WHEN WE DID A SCOPING REVIEW TRY AND UNDERSTAND THE ISSUES OF IT BETTER I WON’T GO THROUGH ALL THESE IN DETAIL BUT YOU CAN SEE WHEN WE THINK ABOUT OLDER ADULTS, THEY ARE LIVING WITH MORE CHRONIC HEALTH CONDITIONS, THEY MAY BE LIVING WITH MORE PHYSICAL IMPAIRMENTS THAT LIMIT THEIR MOBILITY, SENSORY IMPAIRMENTS THAT MAY AFFECT THEIR ABILITY TO ACTUALLY RESPOND AS WELL AND THERE’S A GREATER RATE OF DEMENTIA THAT WE SEE AS WE AGE THERE’S ALSO OTHER ISSUES THAT JUST PSYCHOLOGICAL AND SOCIAL FACTORS, ISSUES RELATES TO SOCIAL DETERMINANTS OF HEALTH IF YOU CAN AFFORD TO PREPARE YOURSELF AND WE HAVE TO THINK ABOUT FAMILY AND CAREGIVER CONSIDERATIONS AS WELL WE’LL GO TO THE NEXT SLIDE AND THE NEXT SLIDE WHEN WE LOOK AT A FRAMEWORK TO ACTUALLY ANALYZE THIS, THIS IS AN ECOLOGICAL FRAMEWORK THAT WE ACTUALLY USE TO UNDER PIN THE WORK THAT WE DO BECAUSE AGAIN, OUR SCIENTIFIC ADVISORY COUNCIL, WE REALLY TRY AND DO RIGOROUS RESEARCH IN ANALYSIS AND WE DID THIS IN PARTNERSHIP WITH THE AMERICAN ACADEMY OF NURSING WE LOOKED AT THESE ISSUES WE LOOKED AT FRAMEWORK OF OLDER ADULTS AND CAREGIVERS THE FRAMEWORK OF HEALTHCARE PROFESSIONALS ORGANIZATIONS, COMMUNITY PROGRAMS AND AGENCIES AND ALSO THE LEVEL OF GOVERNMENT AND POLICY AND HOW WE CAN FURTHER INFLUENCE THAT WE’LL GO TO THE NEXT SLIDE THIS IS THE QUESTION WE ASKED, JUST I WANT TO SHOW YOU THE SCIENCE BEHIND OUR RECOMMENDATIONS SO REALLY THIS IS WHAT WE CALL A QUESTION THAT IS THE BIG QUESTION WE ASK — WHAT EVIDENCE EXISTS FOR OLDER ADULTS, 65 PLUS, IN ANY JURISDICTION OF ANY INTERVENTION OR ACTION FOR THEM AND OR BY THEM COMPARED TO ADULTS UNDER 65 TO PREVENT, RESPOND OR RECOVER FROM A NATURAL MANATURAL MAN MADE DISASTER THIS IS WHAT WE DID WE DID A WHOLE SEARCH LOOKING AT VARIOUS DATA BASIS AND WE LOOKED AT MEDIA ARTICLES AND WE LOOKED AT ANYTHING WE COULD FIND AND YOU WILL SEE FROM ARTICLES WE FOUND 993 WE IDENTIFIED 56 NOT A HUGE NUMBER THAT ACTUALLY REALLY TALKED ABOUT THAT BIG OVER ALL QUESTION WE ALSO LOOKED AT 35 OTHER SOURCES SUCH AS OR 35 SOURCES IN

PARTICULAR LIKE DISCUSSION PAPERS, BOOK CHAPTERS, AND ANYTHING THAT WE COULD FIND THAT RELATED TO THIS TOPIC WE’LL GO TO THE NEXT SLIDE WE ACTUALLY GRADED ALL THE INFORMATION SO WE ACTUALLY TOOK A LOOK AT ALL THESE AND SAID IS THIS OR IS I IS IT WEAK EVIDENCE THERE? WE’LL GO TO THE NEXT SLIDE REALLY, WE THEN ACTUALLY TOOK THE EVIDENCE THAT WE FOUND — YOU SEE WE DIDN’T HAVE A LOT OF RESOURCES TO GO BY THE LITERATURE REALLY GAVE US IDEAS BUT IT REALLY — WE WANTED AN EXPERT LENS FURTHER SO IN ADDITION TO OUR SCIENTIFIC ADVISORY COUNCIL THAT HAS 50 SCIENTISTS AND CLINICIANS LIKE MYSELF, WE ALSO ACTUALLY HELD A POLICY ROUNDTABLE AND WASHINGTON D.C. AND WE’LL GO TO THE NEXT SLIDE AND WE HAD, THE RATIONALE TO DO THIS IS WE WANTED TO LOOK AT THE DATA AROUND THESE DIFFERENT GROUPS AND WE REALLY WANTED TO DEVELOP AND GET EXPERT INPUT SO WE CAN COME UP WITH EVIDENCE-INFORMED POLICY WHITE PAPER AS WELL AND SO THESE ARE JUST SOME OF THE ORGANIZATION THAT’S WE’RE ABLE TO PARTICIPATE IN THIS DAY YOU WILL SEE SOME OF THE ORGANIZATIONS THAT ARE SPONSORING THIS WEBINAR AS WELL AGAIN, THIS IS AN OPPORTUNITY FOR US JUST TO HAVE A CLOSED DOOR DISCUSSION WHERE WE CAN OPENLY TALK ABOUT THINGS AND COME UP WITH SOME CLEAR RECOMMENDATIONS WE’LL GO FORWARD JUST A PICTURE SHOWING YOU THE FOLKS WHO MET THAT DAY AFTER A LONG, BUSY DAY OF CHATS WE’LL GO TO THE NEXT SLIDE AND THESE WERE THE THINGS, WE CAME UP WITH 25 EVIDENCE-BASED RECOMMENDATIONS AND YOU CAN SEE HERE WE CAME UP WITH RECOMMENDATIONS SPECIFICALLY AROUND THESE DOMAINS WE’LL GO TO THE NEXT SLIDE AND YOU CAN READ ALL ABOUT THEM IN OUR CLOSING THE GAPS REPORT IN JANUARY OF 2020.UST RELEASED I THINK AFTER THIS WEBINAR, WE’LL MAKE SURE THAT PEOPLE GET A LINK SO THEY CAN GET A COPY TO SUPPORT YOU CAN GOOGLE IT BUT YOU CAN SEE ALL THE INPUT AND INFORMATION HERE WE’LL GO TO THE NEXT SLIDE WHAT CAN WE DO? THINGS THAT WE CAN DO IS NUMBER ONE, WE CAN JUST RAISE THE TOPIC OF DISASTER EMERGENCY PREPAREDNESS WITH OLDER ADULT AND THEIR CAREGIVERS AND THESE ARE SOME OF THE OTHER IDEAS HERE ADVANCING CARE PLANNING SHOULD INCORPORATE EMERGENCY DISASTER PREPAREDNESS WE WANT TO RECOGNIZE OLDER ADULTS PREFERENCES AND LIMITATIONS WHAT ARE THE TYPES OF DISASTERS THAT COULD OCCUR IN THEIR AREA AND IF AN OLDER PERSON IS POWER-DEPENDENT, MAKE SURE THEY HAVE BACK UP POWER SOURCES AND THEY’RE VULNERABLE, CAN THEE RELY ON THESE THINGS? GET PEOPLE INVOLVED AND MAKE SURE PEOPLE HAVE A 30-DAY SUPPLY AND MATERIALS READY TO STAY OR GO SO RIGHT NOW WE’RE WORKING ON MATERIALS THAT HAVE BEEN FUNDED BY FEMA SO THAT WE CAN ACTUALLY% HAVE THESE IN THE HANDS OF OLDER AMERICANS AND THEIR CAREGIVERS WE’LL BE LAUNCH THOSE BY THE END OF JUNE OTHER THINGS THAT WE CAN DO ARE MAKING SURE THAT WE WANT TO THINK ABOUT THINGS THAT OUR COLLEAGUES AND OUR AFFILIATED CARE ORGANIZATIONS DO THINKING ABOUT CAN YOUR COLLEAGUES BENEFIT FROM TRAINING AND THE CARE TO SUPPORT OLDER ADULT THIS IS DO ALL ORGANIZATIONS HAVE CLEAR PRE FAREDNESS DISASTER PLANS AND PROCEDURES? ARE THEY ABLE TO LEVERAGE DATA SOURCES TO IDENTIFY AT RISK INDIVIDUALS? ARE LOCAL SHELTERS ABLE TO ACCOMMODATE PEOPLE WITH DIFFERENT PHYSICAL AND COGNITIVE ABILITIES AND INFORMATION HAND OFFS IS REALLY IMPORTANT WHEN TRANSFERRING PEOPLE AT THE TIME OF DISASTERS AS WELL SO I JUST WANT TO SAY THANK YOU AND AGAIN, IF YOU WANT TO GET MORE INFORM TH INTO THE DETAILS IT’S IN OUR POLICY REPORT I THANK EVERYONE FOR THEIR ATTENTION >> GOOD AFTERNOON FIRST OF ALL, I’D LIKE TO START WITH ACKNOWLEDGING ALL OUR DOCTORS WHO WERE INSTRUMENTAL WHO HELPED WITH THE GUIDE I’M WALKING THROUGH WITH YOU I’M GOING TO FOCUS ON ONE METHOD OF PREPAREDNESS AS A GUIDE FOR WHAT MIGHT BE USEFUL NEXT SLIDE, PLEASE THE RECENT EVENTS AROUND COVID-19 HAVE EXPANDED THE NEED FOR EMERGENCY PREPAREDNESS AND RESPONSE TRAINING FOR ALL HEALTHCARE AND RESIDENTIAL FACILITIES BEING PROACTIVE AND PREPARING FOR EMERGENCIES WHETHER THEY’RE BIOLOGICAL, ACCIDENTAL OR NATURAL DISASTERS IS CRITICAL FOR SAVING THE LIVES OF SOME OF OUR MOST VULNERABLE

CITIZENS LESSONS LEARNED FROM HURRICANE KATRINA IN 2005 REINFORCED THE IMPORTANCE OF PREPAREDNESS AND TIMELY RESPONSE LONG-TERM CARE FACILITIES HAVE UNIQUE NEEDS AND MUST BE ESPECIALLY DILIGENT FOR DISASTERS AND PROTECTING THEIR RESIDENTS THERE IS NO UNIFORM ONE-SIZE-FITS-ALL WHEN IT COMES TO PREPARING FOR EMERGENCIES PLANS MUST VARY IN ACCORDANCE WITH GEOGRAPHIC LOCATIONS, LOCAL COMMUNITY RESOURCES, POTENTIAL HAZARDS AND SPECIFIC INSTITUTIONAL RESPONSE CAPABILITIES IT’S ADMINISTRATORS SHOULD CONSIDER THEIR PLANS IN PARTNERSHIP WITH LOCAL EMERGENCY MANAGEMENT AND AUTHORITIES AND HEALTH DEPARTMENTS NEXT SLIDE, PLEASE MOST FACILITIES HAVE PROTOCOLS THAT ADDRESS INFECTIOUS DISEASE MANAGEMENT IN PLACE AS WELL AS DISASTER PROTOCOLS IN RESPONSE TO THINGS LIKE FIRES, TEMPORARY POWER OUTAGES, TORNADOES, AND OTHER NATURAL DISASTERS HOWEVER, THIS NEW ERA, CURRENT PRO KOHL’S MUSPRODUCT KOHL’SPROTOCOLSTO DI SASTERS AND BACTERIA QUARANTINE, VACCINATION AND TREATMENT FOR ELDERS ARE OF GREAT CONCERN SO, WHAT I’M GOING TO TALK ABOUT IS TABLE-TOP EXERCISES IT MAY BE DEFINED AS EMERGENCY PREPAREDNESS TRAINING ACTIVITIES WHICH TAKE PLACE IN A CLASSROOM ENVIRONMENT DURING WHICH PERSONNEL ARE PRESENTED WITH SIMULATED EVENTS TO WORK THROUGH THE RESPONSE ACTIONS CTEs, TABLETOP EXERCISES, ARE USED AS A GUIDED DISCUSSION FORMAT TO PROVIDE TRAINING, DEVELOPMENT AND TEAM-BUILDING THEY DIFFER FROM AN EXERCISE IN WHICH THE PLAYERS ACTUALLY RESPOND TO A SIMULATED EVENT TTE IS A METHOD OF TRAINING THAT FOCUSES ON INDIVIDUAL AND TEAM PERFORMANCE THE OBJECTIVE FROM A TABLETOP EXERCISE IS TO PROVIDE COST EFFECTIVE TRAINING WITH MINIMAL INTERFERENCE TO THE PROGRAM OPERATIONS WHILE MEETING THE NEEDS OF RESPECTIVE FACILITIES THE RULES OF TRAINING IN LONG-TERM CARE FACILITIES REALLY ARE TO DO A NUMBER OF THINGS, READY AT THE FACILITY PARTICULARLY IN REGARDS TO THEIR POLICY AND RESOURCES TO MEET THOSE CHALLENGES THAT WE OCCUR RESPONSE OF THE STAFF TO ENSURE THE HEALTH AND SAFETY OF THEIR RESIDENTS AND THEIR FAMILIES AND VISITORS AND STAFF AND FINALLY, COMMUNICATION STRATEGIES TO ENSURE AN ADEQUATE FLOW OF INFORMATION AT ALL LEVELS WITHIN THE FACILITY AND EXTERNALLY WITHIN THE COMMUNITY SO USING TABLETOP EXERCISES, STAFF MEMBERS HAVE THE OPPORTUNITY TO ACTIVELY DISCUSS EMERGENCY SCENARIOS AND SMALL GROUPS THESE ARE FREQUENTLY USED IN PUBLIC-HEALTH FORMS AND THIS METHOD HELPS PREPARE FOR THE UNEXPECTED BY BUILDING CONSENSUS THROUGH A TEAM APPROACH AND INTERACTIVE COMMUNICATION THESE EXERCISES ALLOW ADMINISTRATORS AND STAFF MEMBERS TO CONSIDER THEIR ABILITY TO MANAGE THE EXPECTED AND THE UNEXPECTED SITUATIONS IN AN EMERGENCY TABLETOP EXERCISES STIMULATE STAFF TO THINK THROUGH THE EFFECTIVENESS OF EXISTING EMERGENCY AND INFECTIOUS DISEASE POLICIES AND THEN TO, AND I HAVE THIS IN QUOTES, TEST THE POLICIES IN A MOCK SCENARIO DISCUSSION DRAWS OUT THE “WHAT IFS.” FOR EXAMPLE, WHAT IF THERE WERE NO EMS SERVICES OR HOSPITAL BEDS AVAILABLE? OR WHAT IF ALL THE POWER WAS OFF FOR FIVE DAYS FOR THE ENTIRE COMMUNITY? THE DISCUSSIONS AND POWER STAT THAT ALL LEVELS TO FIND AND ACKNOWLEDGE THEIR ABILITIES WORKING IN A LONG-TERM CARE FACILITY IS CHALLENGING AND REQUIRES A GREAT DEAL OF CREATIVITY AND RESOURCEFULNESS STAFF MEMBERS’ ABILITIES TO MANAGE PROBLEMS AND CONFRONT DIFFICULT ISSUES OFTEN GO UNRECOGNIZED TABLETOP EXERCISES PROVIDE AN OPPORTUNITY FOR POSITIVE FEEDBACK IN REINFORCE THOSE SKILLS SO, THIS IS OUR SIX-STEP MODEL WHICH ILLUSTRATES AN EFFECTIVE PROCESS FOR LONG-TERM CARE ADMINISTRATORS AND STAFF TO STRENGTHEN THEIR POLICIES AND PROCEDURES FOR EMERGENCY PREPAREDNESS AND RESPONSE ED MOTTLE CAN BE USED TO PREPARE FOR WILD VARIETY OF CRITICAL INCIDENTS OR INFECTIOUS OUTBREAKS WITHIN A FACILITY OR WITHIN THE SURROUNDING COMMUNITY SOME EXAMPLES INCLUDE LOCAL WATER CONTAMINATION, EXTENDED POWER OUTAGE, OUTBREAK OF A NEW INFECTIOUS DISEASE SUCH AS

COVID-19, AND ANTIBIOTIC RESISTANT BACTERIA AND EVEN THINGS LIKE BOMB THREATS OR OTHERS THE PURPOSE OF THIS EXERCISE IS TO TAKE AN EXISTING POLICY AND APPLY IT TO AN EVENT THERE BY ILLICITTING DISCUSSION THAT’S IDENTIFY AND STRENGTHEN WEAKNESSES OF THE POLICY NEXT SLIDE, PLEASE SO, THE SIX-STEP MODEL INCORPORATES ADMINISTRATOR REVIEWS OF THE POLICIES, APPLICATION AND A WALK THROUGH FROM THE POLICIES BY AN INTER DEPARTMENTAL TEAM OF STAFF MEMBERS USING THE TABLETOP EXERCISES ANALYSIS OF THE INPUT FROM THE TEAM OF TABLETOP PARTICIPANTS AND AFTER-ACTION REPORT AND THEN ANY OF THE APPROPRIATE REVISIONS TO THE POLICIES OR TO THEIR PROCEDURES NEXT INSERVICE TRAINING FOR ALL STAFF ON THE CHANGES AND COMMUNICATION OF THE CHANGES TO INTERNAL AND EXTERNAL STAKEHOLDERS NEXT SLIDE, PLEASE STEP-BY-STEP, THE FIRST THING THAT YOU WOULD DO IS WRITE THE TABLETOP EXERCISE BASED ON THE WRITTEN OBJECTIVES THE PURPOSE OF THIS IS TO ILLICIT CONSTRUCTIVE DISCUSSION AS PARTICIPANTS EXAMINE AND RESOLVE PROBLEMS IN A TIME-SEQUENCED SCENARIO WRITE THE TTE INVOLVING CRITICAL INCIDENTS OR INFECTIOUS DISEASE OUTBREAK RELATIVE TO THE SELECTED FOCUS AREA AND TAILOR THE SCENARIO TO THE RESIDENT POPULATION STAFF COMPETITION, LOCAL HAZARDS AND COMMUNITY RESOURCE DESIGN QUESTIONS AFTER EACH SEQUENCE THAT WILL ACHIEVE OBJECTIVES SO, ASKING KIND OF SOME OF THE FOLLOWING QUESTIONS WHEN WE’RE THE POLICIES LAST UPDATED AND WHAT ARE THE SAFETY AND RISK CONSIDERATIONS FOR STAFF AND THEIR FAMILIES, SPECIFIED PARAMETERS FOR INTERNAL COMMUNICATION AND THE MEDICAL DIRECTOR AND THE STAFF CORPORATE OFFICE, RESIDENTS, BOARD OF TRUSTEES AND GUIDELINES FOR COMMUNICATING WITH MEDIA NEXT SLIDE, PLEASE NEXT YOU WOULD IDENTIFY THE PARTICIPANTS FOR THE TABLETOP EXERCISE AND I NEED TO GO BACK FIRST YOU ARE GOING TO WRITE THE OBJECTIVES AND I THINK I TALKED ABOUT SOME OF THESE THAT BASICALLY THE NEEDS OF THE FACILITY AND THE TRAINING NEEDS OF THE PERSONNEL AND WHAT THE COMPLIANCE REGULATORY COMPLIANCES MIGHT BE OR JUST SOME OF THE THINGS YOU NEED TO CONSIDER NEXT SLIDE, PLEASE YOU WILL BE IDENTIFYING THE PARTICIPANTS FOR THE TTE AND IDEALLY, PARTICIPANTS OF THE EXERCISE WOULD INCLUDE A FACILITATOR AND A RECORDER WHICH IS ACTUALLY OPTIONAL AND BECAUSE YOU COULD, THE FACILITATOR COULD ACT AS THE RECORDER IF NEEDED AND HOW TO HAVE TTE MEMBERS IF AVAILABLE STAFF IS LIMITED, IT COULD BE CONDUCTED WITH FIVE TO SIX TEAM MEMBERS A FACILITATOR IS NOT AVAILABLE IN YOUR FACILITY, IT COULD BE RECRUITED FROM AN AGENCY THAT PROVIDES SIMILAR SERVICE THE TEAM MEMBER SHOULD BE EXPERIENCED EMPLOYEES WITH A GOOD-WORKING KNOWLEDGE OF THE FACILITY SOME OF THESE WOULD BE THE ROLES WHAT THESE FOLKS WOULD BE EXPECTED TO DO AS A FACILITATOR, RECORDER AND TEAM MEMBER THE FACILITATOR WOULD BE THE ONE REALLY TAKING CHARGE OF THE ACTIVITY FACILITATING THE DISCUSSION AND CERTAINLY MAKING SURE TIME CONSTRAINTS ARE MET KEEPING DISCUSSION ON TRACK WITH THE OBJECTIVES AND YOU CAN SEE WHAT THE RECORDER IS THE PERSON WHO IS GOING TO BE STATING THE OBJECTIVES AND RECORDING THE ENTIRE DISCUSSION AND THEN PREPARING THE DISCUSSION SUMMARY TEAM MEMBERS ARE ASKED TO ACTIVELY PARTICIPATE AND IF WE

CAN GO TO THE NEXT SLIDE, PLEASE I’M SORRY I NEED YOU TO BACK UP MY BAD ROLES ARE TO ESTABLISH AND MAINTAIN AN ENTHUSIASTIC CLIMATE AND A SUPPORTIVE ATMOSPHERE AND ENCOURAGES RESPECTFUL CONTRIBUTIONS FROM EACH PARTICIPANT, PROBES AND ENCOURAGES QUESTIONS GIVES PERSONAL BIAS AND OPINIONS THESE ARE FOCUSED ON THE OBJECTIVES AND CONTROL PARTICIPANTS WHO TRY TO DOMINATE THE CONVERSATION LISTEN ACTIVELY TO ALL CONTRIBUTORS THE RECORDER TAKES NOTES OF THE DISCUSSION THROUGH THE TTE LISTENS AND RECORDS IN AN UNBIASED MANNER AS WELL AND AS I SAID, PREPARES THE SUMMARY FINALLY, THE TEAM MEMBERS — I WOULD ENCOURAGE TO SELECT INDIVIDUALS ON THE BASIS OF THEIR DISCIPLINE OR SPECIALTY AREA YOUR LEVELS OF RESPONSIBILITY AND THEIR ROLES WITHIN THE FACILITY CONSIDER HAVING REPRESENTATIVES FROM DIFFERENT DEPARTMENTS, THINGS LIKE ADMINISTRATION, NURSING, AGE, MAINTENANCE, INFECTIOUS CONTROL, SAFETY, DIRE TARRY AND HOUSEKEEPING IT’S IMPORTANT TO SELECT INDIVIDUALS WHO ARE REPRESENTATIVES OF THEIR PEERS AND RESPECTED IN ALL LEVELS OF PERSONNEL THE ENTHUSIASM OF THE TEAM MEMBERS WILL CARRY OVER AND SECURE BUY-IN WHEN IT COMES TIME FOR STAFFING SERVICES AS I ALLUDED TO, THE QUALITY OF THE TTE DEPENDS LARGELY ON THE PARTICIPANTS, RECRUITMENT OF ENTHUSIASTIC STAFF MEMBERS IS IMPORTANT STAFF MEMBERS SHOULD BE APPROACHED IN A POSITIVE MANNER WITH ACKNOWLEDGMENT OF THEIR SKILLS AND LEADERSHIP ABILITIES PARTICIPATION SHOULD BE VIEWED AS A PERK WITHOUT PENALTY OF ADDICTIONAL WORK REALLY, THEM KNOWING THAT THIS ACTIVITY CAN BE FUN AS WELL AS REWARDING THE NEXT STEP IS TO DISCUSS AND DOCUMENT THE TABLETOP EXERCISE OUTCOMES YOU ARE GOING INFORM DISCUSS THE OUTCOMES IN RELATIONSHIP TO THE OBJECTIVES AND THEN ADDRESS WHAT OBJECTIVES WERE ACCOMPLISHED WHAT MAY NOT HAVE BEEN ACCOMPLISHED AND WHY AND THEN OTHER OBJECTIVES THAT MIGHT HAVE BEEN IDENTIFIED AS A RESULT OF THE TTE IDENTIFY STRENGTHENS AND WEAKNESSES AND NEEDED REVISIONS, IMPROVEMENTS OR CHANGES TO POLICY NEXT SLIDE, PLEASE REVISE POLICIES AND PROCEDURES ON REALLY DEVELOPING A WRITTEN ACTION PLAN FOR IMPLEMENTATION WHICH NEEDS NECESSARY APPROVALS IDENTIFY INTERNAL AND EXTERNAL RESOURCES THAT MIGHT BE NEEDED TO IMPLEMENT THESE POLICIES AND PROCEDURES AND ADDRESS ADDITIONAL KEY PLAYERS WHO MAY BE NEEDED TO HELP IMPLEMENT THIS ACTION PLAN IT’S TIME TO SIGN RESPONSIBILITY FOR THE IMPLEMENTATION ESTABLISH A FULL TIMELINE FOR COMPLETION NEXT SLIDE, PLEASE NEXT STEP OF COURSE IS TO CONDUCT AN INSERVICE TRAINING FOR STAFF SO, THE TABLETOP EXERCISE REPLICATES EMERGENCY CONDITIONS WITHOUT JEOPARDIZING THE SAFETY OF RESIDENTS OR PERSONNEL THEY CAN LEARN THEIR BEHAVIOR AND THEIR RESPONSES ON OTHERSAS WELL AS GAIN IN SIGHT INTO THE ROLE OF OTHERS THIS CROSS-OVER KNOWLEDGE CAN SUPPORT DAILY WORK EFFORTS AND FOSTER COHESIVENESS AMONG MEMBERS BASED ON THE PRINCIPLES OF ADULT LEARNING, TABLETOP EXERCISES PROVIDE A VALUABLE OPTION FOR STAFF DEVELOPMENT PARTICULARLY IF YOU ARE CREATIVE, I HIGHLY RECOMMEND BRINGING FOOD, TO FEED YOUR ATTEND’S AND IT’S SOMETHING THEY ALL REALLY APPRECIATE AN IMPORTANT COMPONENT ARE PREPAREDNESS IN LONG-TERM CARE FACILITIES IS TO ENSURE THE STAFF AND THEIR FAMILIES ARE PREPARED FOR AN EMERGENCY STAFF DEVELOPMENT SHOULD INCLUDE A DISCUSSION ON PERSONAL AND HOME PLANNING THERE’S A WEALTH OF INFORMATION AVAILABLE ON THE RED CROSS AND FEMA WEB SITES THE CHANGES IN POLICIES AND OR PROCEDURES MUST BE COMMUNICATED TO ALL STAFF MEMBERS SO THAT THEY UNDERSTAND THE IMPORTANCE OF THEIR RESPECTIVE ROLES AND RESPONSIBILITIES IN EMERGENCY PREPAREDNESS AND RESPONSE

NEXT SLIDE, PLEASE FINALLY, COMMUNICATION WITH INTERNAL AND EXTERNAL STAKEHOLDERS THIS LAST STEP IS IMPORTANT BECAUSE COMMUNICATION IS KEY FOR SUCCESSFUL CHANGE IT’S IMPORTANT THAT YOUR PREPAREDNESS PLANS BE COMMUNICATED TO STAFF AND OTHER KEY STAKEHOLDERS OLDER PEOPLE, THEIR FAMILIES, FRIENDS, NEIGHBORS AND CAREGIVERS, COMMUNITY, GOVERNMENTAL, LAW ENFORCEMENT AND PUBLIC-HEALTH PLANNERS, AS WELL AS OFFICIALS POLICYMAKERS AND STATE, LOCAL AND FEDERAL LEVELS, HEALTH PROFESSIONALS AND KEY MEMBERS AND PROFESSIONAL ORGANIZATIONS, BOARD MEMBERS AND EXECUTIVE STAFF MEMBERS FIRST RESPONDERS, AND HEALTHCARE PROFESSIONALS, TO THINK GLOBALLY BUT ACT LOCALLY IN PRE EVENT, EVENT AND POST EVENT ASPECTS OF ANIEN AR YO IN AN INFECTIOUS INCIDENT OR NATURAL DISASTER NEXT SLIDE THESE ARE SOME SELECTED RESOURCES AND I’M SORRY, MY LANDSCAPERS ARE WORKING IF YOU GET BAD FEEDBACK >> GREETINGS EVERYBODY WE FIND OURSELVES RESPONDING TO A SET OF ISSUES THAT REALLY CHALLENGE US TO FUNCTION BOTH INDIVIDUALS, WE HAVE TO MAKE THIS JOURNEY IN MANY RESPECTS ALONE AND WE MAKE IT IN A COLLABORATION OF OUR AGENCY, PARTNERS, OUR OWN STAFF AND BROAD COMMUNITY AND IT REALLY REPRESENTS A UNIQUE SET OF CHALLENGES FOR US THE COMMUNITY-BASED AGENCIES REALLY GOT TO BE NIMBLE IN THIS ENVIRONMENT AND IT’S NOT ALWAYS IN OUR D.N.A IT REQUIRES US TO ACT NOW ALSO NOT ALWAYS IN OUR D.N.A TO LOOK TO ALONG A HORIZON THAT IS UNKNOWN AND THE TIMING AND CHARACTER OF THAT HORIZON IS LOADED WITH UNKNOWABLES THAT WE CAN’T WRAP OUR ARMS AROUND AND FINALLY, IN THE MIDTERM, TO PREPARE FOR TOMORROW, LITERALLY TOMORROW OR THE NEXT DAY WE’RE RESPONDING IN THE NOW AND ADJUSTING FOR THE TOMORROWS AND LOOKING TO THE HORIZON NEXT SLIDE, PLEASE AND SO AS AN AGENCY, WE’RE A LITTLE BIT SCHIZOPHRENIC AND WE HAVE TO THINK ABOUT HOW WE HONOR OUR OWN MISSION AND HOW OUR AGENCY RESPONDS AND ALSO WE HAVE TO LOOK AT THE CONTEXT WITH WHICH WE FUNCTION AS PART OF OUR BROADER AGING NETWORK IN HOW WE FUNCTION IN THAT NETWORK AND THAT NETWORK ALSO INCLUDES A REQUIREMENT FOR COMMUNITY COLLABORATION AT LOCAL REGIONAL AND NATIONAL LEVELS THAT IS ALSO NOT NECESSARILY IN THE D.N.A. OF EVERY COMMUNITY-BASED ORGANIZATION SO NEVADA SENIOR SERVICES, WHICH HAS A FAIRLY WIDE SERVICE FOOTPRINT AS A COMMUNITY SERVICES PROVIDER, IN THE COVID-19 WORLD, HOW DO WE COORDINATE OUR PERSON-CENTERED FAMILY RESPONSE? DEALING WITH THE INDIVIDUAL AND THE FAMILY CONTEXT IN WHICH THEY OPERATE AND THEN HOW DO WE GENERATE VIRTUAL ACTIVITIES THAT PROMOTE CONNECTIVENESS IN AN ENVIRONMENT THAT HAS CHANGED WHERE THAT FACE-TO-FACE CONNECTIVITY, THE EYE-BALL-TO-EYE-BALL RESPONSIVENESS MAY NOT BE COORDINATED WHEN WE LOOK AT RESPONSE AS AN AGENCY, ONE OF OUR KEY INITIATIVES, HOSPITAL TO HOME, IS A PROGRAM THAT WAS ORIGINALLY DEVELOPED FOR DEMENTIA CAPABLE CARE TRANSITIONS TO HELP OUR COGNITIVLY IMPAIRED PERSONS LIVE ALONES AND FAMILY SUPPORTED PERSONS TO GET BACK INTO THE COMMUNITY WHEN COVID-19, ONE OF THE THINGS THAT HAPPENED TO THAT PROGRAM WITH SUPPORT OF ACL, WHO HAD SPONSORED THE DEVELOPMENT TO THAT PROGRAM WAS WE WIDENED THE LENS WE STARTED LOOKING AT DEMENTIA CAPABILITY FROM THE PERSPECTIVE OF PEOPLE IMPACTED DIRECTLY BY COVID-19, THEY HAD A DIAGNOSIS PEOPLE IMPACTED BY COVID-19, THEY HAD AN E AN AN EXPOSURE OR PEOPLE

WHO WERE DISCHARGED FROM EMERGENCY DEPARTMENTS OR HOSPITALS WHO BY VIRTUE OF COVID-19 WERE ISOLATED AND THAT CREATED VULNERABILITIES AND IMPACTS THAT WERE UNKNOWABLES FOR US BUT WE NEEDED TO ADDRESS IN ORDER TO AVOID REHOSPITALIZATION, READMISSION, DANGEROUS USE OF OTHER HEALTHCARE USES AND SUPPOSE PORTING THEM IN THE COMMUNITY WAS A VERY SIGNIFICANT ADJUSTMENT TO THE WAY WE DO BUSINESS WE STARTED TO MOVE INTO VIRTUAL PROGRAMS FOR OUR GERIATRIC DEPARTMENT THEY WERE PROVIDING VIRTUAL ASSESSMENT AND CASE MANAGEMENT AND SUPPORT OUR AGING AND DISABILITY RESOURCE CENTER, WHICH WAS ALREADY TO A GREAT EXTENT TELEPHONE ENABLED, BECAME MORE VIRTUAL AND WE STARTED LOOKING AT HOW DO WE ENHANCE COMMUNITY CONNECTIVELY IN THE CONTEXT WE’RE LIVING OUR REACH PROGRAM BECAME VIRTUAL BRI CARE CONSULTATION DEMANDS DOUBLED OVERNIGHT VIRTUAL SUPPORT GROUPS DOUBLED OVERNIGHT TELEPHONE REASSURANCE BECAME A WAY OF DOING BUSINESS AND WE HAD TO ADJUST FOR THE FACT OUR ADULT DAYCARE PERSON MANY OF WHOM ARE NOW AT HOME, NEEDED RESOURCE AND SUPPORTS AT HOME SO WE HAD SIMULTANEOUSLY BOTH AN INPERSON PROGRAM FOR A SCALED DOWN GROUP OF FOLKS WHO NEEDED IN-PERSON CARE AND VIRTUAL FOR A POPULATION THAT WAS USED TO THAT INPERSON ENVIRONMENT BUT NEEDED TO GET THAT AT HOME SAME THING HAPPENED TO OUR INHOME RESPITE PROGRAM DUEL RESPONSE IN HOME AND GETTING OUR RESPITE WORKERS INTO THOSE HOMES FOR THE PEOPLE WHO NEEDED IT AND WELCOMED IT AND REMOTE RESPITE SUPPORT FOR THOSE WHO WERE MORE COMFORTABLE OPERATING AT A DISTANCE HOME MODIFICATIONS, VIRTUAL OCCUPATIONAL THERAPY ASSESSMENT BUT IN HOME INSTALLATIONS MODIFIED TO FIT THE ENVIRONMENT IN WHICH WE LIVE AND OUR WELLNESS PROGRAMS INCLUDING A NEW ONE CHASING THE CORONAVIRUS BLUES AWAY WHICH WE’LL TALK ABOUT IN A SECOND WE STARTED CREATING A MANUAL SERVICES THAT COULD CROSS PROGRAMS SO WE STARTED THE THEME GROUPS AND LOOKING AT INNOVATION AND HOW WE CAN ENHANCE SENSORY ACTIVITIES IN THE HOME TASTE, SMELL HEARING AND TOUCH CAN WE GET POPCORN AND NOW INTEGRATING MULTIPLE SENSES AND INSPIRATIONAL NEWS SO THAT WE CAN ENHANCE THE MENTAL HEALTH OF OUR FOLKS AT HOME BRAIN GAMES TO CREATE STIMULATION DOING THINGS WITH PRODUCTS AROUND THE HOUSE LIKE ORGANIC CLAY AND BREATHING, VISUALIZATION, BOTH FOR THE PARTICIPANTS AND FOR THE FAMILY CAREGIVERS HOW ABOUT A MORNING WAKE UP ROUTINE DOGGY TALK FOR THOSE WHO LOVE ANIMALS SHARING AND CONNECTING SO, ONE OF MY FAVORITES ARE INTEGRATION OF AMERICAN SIGN LANGUAGE FOR PEOPLE WHO ARE HEARING YES, PEOPLE WHO ARE HEARING AND IT’S AMAZING HOW THE INTEGRATION OF SIGN LANGUAGE FACILITATES SO MANY OF THE OTHER ACTIVITIES SO, NOT ONLY IS IT BENEFICIAL FOR OUR HEARING IMPAIRED PARTICIPANTS, BUT FOR MANY OF OUR FOLKS WHO NEED COGNITIVE STIMULATION AND LEARNING SOMETHING THAT REQUIRES MOTOR PLANNING AND SEQUENCING IS JUST A GREAT TOOL ONE OF MY FAVORITES HAS BEEN CHASING AWAY THE CORONA BLUES ELLEN GROSS MAN, WHO IS A VERY CREATIVE PERSON AND LEADS OUR WELLNESS EFFORTS, BROUGHT A SENSE OF HUMOR TO WHAT WE KNOW IS A DIFFICULT ISSUE OF ASSISTING PEOPLE TO MAINTAIN A POSITIVE ATTITUDE AND TO FIND JOY IN WHAT IS A VERY DIFFICULT SITUATION SO WE PROVIDE THIS PROGRAM VIA ZOOM AND GROUPS SINCE INCEPTION A WEEK OR TWO AGO, HAS BEEN INCREDIBLY POPULAR SO, AS AN AGENCY, WE STOOD UP AND NOW AS A COMMUNITY WE STAND UP SO, NEVADA, UNDER THE BANNER OF ITS GOVERNOR, ADAPTED WHAT WE CALL NEVADA CAN, WHICH IS A COLLABORATION OF THE ENTIRE

AGING NETWORK NEXT SLIDE, PLEASE IT REALLY FOCUSED ON MARSHALLY ALL OUR RESOURCES STATE WIDE TO RESPOND TO CREATE COLLABORATION AMONG OUR AGING SERVICES PROVIDERS AND UNDER THE LEADERSHIP OF OUR NEVADA AGING DISABILITY SERVICE DIVISION AND IT’S CAPABLE ADMINISTRATOR, DINA SCHMIDT WHO CHAIRS THIS EFFORT YOU CAN SEE, THE INTENT WAS TO BRING TOGETHER GOVERNMENT, COMMUNITY-BASED ORGANIZATIONS, CLINICAL PROVIDERS INCLUDING TELEMEDICINE, PRIMARY CARE, TELE SOCIAL WORK AND THE UNIVERSITY SYSTEM INTO AN INTEGRATED RESPONSE NEXT SLIDE, PLEASE TO OUR MOST VULNERABLE BY MOBILIZING ALL THESE RESOURCES AND GENERATING ACCESS AROUND THE STATE AND THE COLLABORATION IN A WAY THAT WOULD FACILITATE THE EASE OF PEOPLE AND WANTED TO GET ENGAGE BECAUSE THEY NEEDED SERVICES OR WANTED TO GET ENGAGE BECAUSE THEY WANT TODAY ALLOW A FEAR IN FIND A WAY TO MITIGATE THE IMPACT OF COVID-19 NEXT SLIDE SO YOU CAN SEE, THESE ARE SOME OF THE TOUCH STONE AREAS AND THE WAY WE CAN COMMUNICATE THROUGH AN INTEGRATED WEBSITE, THE NEVADA CAN SITE WHICH WE’LL LOOK AT IN A MOMENT ISOLATION AND TRYING TO FIND EASY PUSH-BUTTON WAYS THROUGH INSTANT COMMUNICATION TO PROVIDE WARM HAND OFFS TO SERVICES NEXT SLIDE THAT PEOPLE WOULD REACH OR BE SUPPORTED IN THEIR REACH THE OBJECTIVES OF NEVADA CAN STATE WIDE WOULD PROVIDE CREDITABLE INFORMATION AND RESOURCE AVAILABILITY TO UTILIZE STUDENTS AND VOLUNTEERS TO PROVIDE ELDER CONNECTIVITY AND MAKE SURE ESSENTIAL SERVICES, FOOD, MEDICATION, PET FOOD, MEDICAL SUPPLIES, WERE REACHING THOSE MOST VULNERABLE AND THAT OUR COUNTY SERVICE AGENCIES AND NOT FOR PROFITS WERE SUPPORTED WITH VOLUNTEERS TO HELP WITH THINGS LIKE HOME DELIVERY OF ESSENTIAL ITEMS AND WE CAN MARSHAL TELE HEALTH TO REACH PEOPLE AND THEIR HOMES TO MOBILIZE A STATE WIDE MEDIA CAMPAIGN, LAUNCH AND MAINTAIN AN INTEGRATED AGENCY WEBSITE WITH INFORMATION AND REFERRAL ACCESS TO PROGRAM RESOURCES ACTIVITY FOR ESSENTIAL DAILY NEEDS AND VIRTUAL SOCIAL SUPPORT AND TELE HEALTH NEXT SLIDE, PLEASE AND SO, THE WEBSITE WE STOOD UP, WHICH IS INTEGRATED WITH OUR 211 SYSTEM, IS DESIGNED TO FACILITATE THAT IN ONE OR TWO CLICKS THIS IS OUR ENTRY POINT AND TO THE SYSTEM YOU WILL NOTICE 211 UP AT THE TOP NEXT SLIDE, PLEASE AND EASY BUTTONS NEXT SLIDE, PLEASE SO TELEPHONE NUMBERS AND ACCESS POINTS THROUGHOUT THE STATE, NEXT SLIDE, PLEASE AND ACCESSIBLE TO FOOT AND REPORTER ELDER VIEWS AND SOCIAL ISOLATION AND SHOPPING ASSISTANCE AND NEXT SLIDE, PLEASE AND A VEHICLE FOR HOW HELP CAN BE REQUESTED, NEXT SLIDE, PLEASE AND THEY CAN GET A WARM RESPONSE AND THAT IS THE KEY HOW DO WE MAKE IT EASY HOW DO WE MAKE IT SIMPLE AND HOW DO WE INTEGRATE AS A COMMUNITY-BASED SERVICES AGENCY FROM OURSELVES AND THROUGH OUR COLLEAGUES AND OUR BROADER COMMUNITY AND HOW DO WE MAKE THE LOCAL AND STATE SITUATION BETTER WHILE WE’RE STILL ADDRESSING AS AN AGENCY HONORING OUR MISSION AND ADAPTING OUR SERVICES TO MEET THE NEEDS OF THIS VERY CHALLENGING ENVIRONMENT WITH THAT, I’M HAPPY TO TURNOVER THE PRESENTATION TO KATHY HIRE TO TALK ABOUT RECOVERY >> THANK YOU, GOOD DAY TO EVERYONE I’M DELIGHTED TO BE HERE AND I WANT TO THANK OUR WONDERFUL GOVERNMENT COLLEAGUES WHO HAVE ORGANIZED THIS IMPORTANT AND INTERESTING SESSION I’M PLEASED TO HAVE THIS OPPORTUNITY TO SHARE THE WORK ON THE EFFECTIVE HURRICANES ON THE WELL-BEING OF RESIDENTS OF NURSING HOMES AND ASSISTED

LIVING UNDERSTANDING THE EFFECT OF HURRICANES BEGAN IN 2004 WHEN FOUR HURRICANES, INCLUDING TWO MAJOR HURRICANES, CRISSCROSSED FLORIDA IN 44 DAYS SINCE THAT TIME, I’M WORKED TO UNDERSTAND WHY MORTALITY IS UNDER REPORTED AND WHY NURSING HOMES DO NOT HAVE THE PRIORITY THAT I BELIEVE THEY SHOULD WITHIN EMERGENCY MANAGEMENT SYSTEMS, AND WHAT THE CONSEQUENCES OF HURRICANES MEAN FOR FRAIL, OLDER ADULTS, I HAVE 13 MINUTES TO SHARE 16 YEARS OF FINDINGS, MY PREN WILL NOT INCLUDE ALL THE DETAILS YOU NORMALLY HEAR BUT I HAVE A LIST OF OUR PUBLICATIONS AT THE END OF THE PRESENTATION AS WELL AS A FEW RESOURCES, IF YOU HAVE QUESTIONS, PLEASE, CONTACT ME OR ANY OF THE COLLEAGUES NEXT SLIDE, PLEASE IT SHOWS THE PEOPLE WHO HAVE BEEN WORKING WITH ME FOR YEARS AND OUR PRIOR WORK — ANY OF THESE PEOPLE WHO ARE STUDENTS AT BROWN AND AT USF AND AS WELL AS MY DEER COLLEAGUES WILL BE HAPPY TO HEAR QUESTIONS OUR NEXT SLIDE OUR INITIAL WORK SO FOCUSED ON HURRICANES KATRINA, REDA, AND IKE OUR WORK INDICATES THAT ONE, MORTALITY AS A RESULT OF BEING IN THE PATH OF A HURRICANE IS UNDER REPORTED STATES COUNCIL BODIES THAT HAVE DEATHS DURING AN IMMEDIATELY FOLLOWING THE HURRICANE OUR METHOD, WHICH I’LL EXPLAIN SHORTLY, CALCULATES HOSPITALIZATIONS AND MORTALITY FOR THE 350 AND 90 DAY AFTER THE STORM RECOGNIZING THIS WEBINAR IS HIGHLIGHTING THE SPECIAL NEEDS OF RESIDENTS WITH ALZHEIMER’S AND RELATED DEMENTIA AND I’M HIGHLIGHTING THE STUDY LED BY LISA BROWN THAT CALCULATES THE ADDED RISK OF MORTALITY FOR THOSE WHO ARE MOST COGNITIVE TEE IMPAIRED AND THIRD, KELLY THOMAS WORKED TO ESTABLISH THAT HOSPITALIZATION INCREASED, NORTHERN TAL TEENOTMORTALITY FOR THE MOST RESIDENTS HURRICANE IRMA WAS A CATEGORY THREE, MASSIVE STORM THE ENTIRE STATE WAS IN THE PATH AND IT LANDED IN THE KEYS AND LANDED IN NAPLES, FLORIDA, ON SUNDAY AFTERNOON, SEPTEMBER 10th, 2017 NEXT SLIDE, PLEASE OUR METHODOLOGY IS MORBIDITY AND HOSPITALIZATION RATES IS AS FOLLOWS FIRST, WE CREATE THE GEOGRAPHIC PATH OF THE STORM AND WE IDENTIFY ALL NURSING HOMES AND ASSISTED LIVING IN THAT PATH AND WE DETERMINE WHICH RESIDENTS WERE IN THOSE NURSING HOMES AND ASSISTED LIVING AS OF A CERTAIN STATE IN THIS CASE SEPTEMBER 1th FIRST WE USE THE MOST RECENT RESIDENTS ASSESSMENT AND LINK THAT ASSESSMENT AT INDIVIDUAL LEVEL TO HOSPITALIZATIONS AND MORTALITY AND OTHER RECORDS THAT WE HAVE ACCESS TO AND WE IDENTIFY ALL THE NURSING HOME RESIDENTS IN THOSE SAME NURSING HOMES TWO YEARS PRIOR TO CREATE A COMFORTABLE GROUP OF RESIDENTS OR CONTROL GROUP AS IT WERE NEXT SLIDE, PLEASE THIS SLIDE NOTES THE INCIDENT RATE AND THE ODD RATIOS OF FIRST HOSPITALIZATION AND MORTALITY IN RESIDENTS EXPOSED TO HURRICANE IRMA COMPARED TO THAT CONTROL GROUP IN 2015 WITHIN 30 DAYS, THE ODDS OF A FIRST HOSPITALIZATION WERE 1.12 AMONG THOSE EXPOSED AND 1.07 AT 90 DAYS THE ODDS OF MORTALITY WERE 1.13, 13% AT 30 DAYS AND 1.07 AT 90 DAYS ALL THESE ODD RATIOS ARE SIGNIFICANT THIS IS CONSISTENT WITH OUR EARLIER WORK LOOKING AT THE TOTAL EFFECT OF THE STORM ON THE RESIDENTS WHO ARE IN THE BUILDINGS IN THE PATH OF THE THE STORM WHAT WE CALL THE EXPOSURE OUR CURRENT WORK HAS ADVANCED

OUR INITIAL FINDING BECAUSE WE’RE NOW LOOKING AT BOTH THE SHORT STAY AND THE LONG STAY RESIDENTS SHORT STAY AND NURSING HOMES ARE 29 DAY PRIOR TO THE HURRICANE AND THE LONG STAY ARE THERE FOR OVER TWO AND A HALF YEARS WE STILL SEE THE INCREASED OVER ALL HOSPITALIZATION FOR BOTH GROUPS AND THIS IS SIGNIFICANT FOR BOTH GROUPS AT THE 30 AND 90-DAY RATES FOR FIRST HOSPITALIZATION (INAUDIBLE) THEY’RE THE ONES THAT ARE HAVING THE INCREASED MORTALITY AT BOTH 30 AND 90 DAYS THESE ARE THE RESIDENTS WHO ARE MOST AT RISK NEXT SLIDE, PLEASE ALL HURRICANE GRIEF DESTRUCTION, HAVOC, CHAOS, IRMA RESULTED IN WIDESPREAD AND SUSTAINED ELECTRICAL OUTAGES THIS MATCH SHOWS THE PATH AND THE SUSTAINED EFFECT OF THESE HURRICANE OUTAGES 6 MILLION HOMES AND BUSINESSES LOST POWER AT THE HEIGHT OF THE STORM ALL THOSE DARK AREAS ON THE LEFT ARE AREAS WHERE POWER WAS OUT EVEN ON THE AREAS ON THE RIGHT, THREE DAYS LATER, YOU WILL SEE SUBSTANTIAL NUMBERS OF PLACES WITHOUT POWER IT WILL LARGE NUMBERS OF NURSING HOMES WITHOUT POWER FOR OVER A WEEK AND THAT’S WHY, FLORIDA BECAME THE FIRST STATE TO REQUIRE ALL NURSING HOMES AND ASSISTED LIVING TO HAVE ALTERNATIVE POWER SOURCES ON RAISING THE ELECTRIC POWER OUTAGE BECAUSE THIS IS WHERE OUR QUALITATIVE DATA MAY HAVE INSIGHTS INTO THE EFFECT OF THE STORM ON RECOVERY WHILE HURRICANES ARE ONLY ONE TYPE OF DISASTER, THE TIME TO RESTORE THINGS TO WHAT PEOPLE CALL NORMAL VARIES, AND IT’S BASED ON THE PHYSICAL DAMAGE, ELECTRICAL RESTORATIONS, WATER RESTORATIONS, INTERNET RESOURCES, ALL THE THINGS THAT WE TAKE FOR GRANTED WHEN THINGS ARE NORMAL AGAIN, I DON’T HAVE TIME TO DESCRIBE OUR METHODS IN DETAIL WE RECRUITED ASSISTED LIVING IN NURSING HOMES IN THE PATH OF THIS STORM WE HOPE THAT DISCUSSING AND TALKING TO YOU ABOUT THE TIME TO RECOVERY AFTER A HURRICANE WHILE NOT QUITE THE CHRONIC DISASTER WE’LL EXPERIENCE WITH COVID-19 IT WILL HELP US BEGIN TO PROVIDE INSIGHTS THAT WE’LL FIND USEFUL AND HELPFUL AS WE NAVIGATE THESE WATERS THE WORK THAT WE HAVE DONE IS BASED ON THE QUALITATIVE DATA IS BASED ON 95 INTERVIEWS WITH BOTH ASSISTED LIVING AND NURSING HOME PROVIDERS NEXT SLIDE BASED ON OUR QUALITATIVE >> Commissioner Vaughn: INTERVIEWS WE SUGG EST FOUR AREAS THAT ARE IMPORTANT AS WE THINK ABOUT RECOVERY I’M NAMING THEM HERE AND WE’LL DISCUSS THEM IN MORE DETAIL IN THE SLIDES THAT HIGHLIGHT EACH THEME FIRST, THE CHALLENGE OF HOW TO COMMUNICATE WITH FAMILIES SECOND, THE EFFECT TEST DISASTER ON RESIDENTS WITH DEMENTIA WHICH WE REPEATEDLY HEARD WITH EXHAUSTION AND DIS ORIENTATION AND THIRD, THE EFFECT OF THE HURRICANE ON STAFF WHICH AGAIN IS EXHAUSTION, SOMETIMES PTSD AND MANY TIMES UNFORTUNATELY, LEAVING THE INDUSTRY AND FINALLY, THE NURSING HOME AND ASSISTED LIVINGS ABILITY TO RECEIVE HELP FROM THE EMERGENCY MANAGEMENT OFFICES AT THE STATE AND LOCAL LEVEL THE LONGEST CAREGIVERS IS STRESSFUL AND CHALLENGING TO KNOW WHAT WAS GOING ON THIS SHOULD BE HEART-ACHING FAMILIAR TO AWFUL US ADMINISTRATORS DISCUSSED WAYS TO KEEP FAMILIES INVOLVED, ESPECIALLY LONG DISTANCE CAREGIVERS AS THIS ASSISTED LIVING A STRAIGHT OR INDICATED, SOME OF THE CAREGIVERS WOULD TAKE SNAPSHOTS AND PUT THEM ON Facebook TO LET FAMILY MEMBERS SNOW THEY TAKE LITTLE VIDEOS AND SENT THOSE WE DID HAVE A COUPLE OF PEOPLE THAT WERE ABLE TO SKYPE THAT WAS A WAY TO GET A BETTER IDEA MEANING HOW WELL THE RESIDENTS WERE DOING AS MOST OF US REALIZED, CONSTANT MESSAGES OF FEAR FROM TV OR NEWS IS DISTRESSING THE ADVICE, TURN OFF THE TV AND FIGURE OUT OTHER ACTIVITIES TO DO OUR EARLIER WORK AND VIEWS WITH NURSING HOME AND ASSISTED LIVING

ADMINISTRATORS SUGGEST THERE’S TRAUMA FROM THE NURSING HOME RESIDENTS EXPERIENCE FROM THE DISASTER AND DISRUPTION TO THEIR SCHEDULE AND THE FEAR STAFF WITH THEM ARE ALSO EXPERIENCING THE EFFECT OF RENAMING FOR A CONSIDERABLE AMOUNT OF TIME CHANGES THIS IS OUR RECOVERY PERIOD AS THE FIRST QUOTE INDICATES, THE MEMORY CARE FOLKS PARTICULARLY WERE VERY AGITATED FOR A WEEK AFTER RETURNING TO THEIR FACILITIES THE INTERVIEWS REINFORCE THINGS THAT DECLINING COGNITION, CONFUSION, AND ON GOING STRESS THE RECOMMENDATION WE HEARD FROM MANY IS CAPTURED IN THIS SECOND QUOTE HAVING A ROUTINE AND THAT ROUTINE, FILLED WITH ACTIVITIES, THAT KEEP THEM IN GAGED IS BEYOND IMPORTANT WE CONTINUOUSLY HEARD THAT THE DISASTER REQUIRED A LOT OF HANDS-ON HELP AND ATTENTION TO RESIDENTS ALL STAFF WORKED VERY HARD AND AS THIS FIRST QUOTE INDICATES, THE TIME AFTER THE STORM WAS WHEN THE REAL WORK STARTED WE HAD TO MAKE EXTRA EFFORTS TO KEEP RESIDENTS SAFE THIS WAS BECAUSE, DESPITE THE PASSING OF THE STORM, WORK WAS NOT NORMAL THERE WAS ON GOING CONCERNS BECAUSE DESPITE THE HURRICANE PASSING, A GREAT DEAL OF WORK NEEDED TO BE DONE AND THERE WAS PHYSICAL PROBLEMS WITH THE PLAN AND WE ALREADY TALKED ABOUT THE ISSUES OF ELECTRICITY THIS IS THE RECOVERY PERIOD THAT I’M TALKING ABOUT AND BECAUSE ABOUT TWO-THIRDS OF THE BUDGET OF NURSING HOMES IS PAID TO DRICK CARE WORKERS THIS QUOTE SUMMARIZES THE WORK OF THESE DIRECT CARE WORKERS THERE NEEDS TO BE, ANYWAY YOU CAN WRITE THIS UP, THE FACT THAT SOME OF THE LOWEST PAID PERSONNEL ARE THE ONES WHO WOK THE HARDEST EVERYONE WORKS HARD BUT THEY, THEY POUR THEIR GUTS OUT AND AS I ALLUDED TO FROM THE BEGINNING, DESPITE REAL IMPROVEMENTS, AT LEAST IN FLORIDA, WITH EMERGENCY MANAGEMENT OFFICES WORKING WITH MANY NURSING HOME HOMES AND ASSISTED LVING, THEY STRUGGLE TO GET THE ATTENTION OF THE OFFICES THAT DEPLOY THE RESOURCES AT THE STATE AND LOCAL LEVEL ESPECIALLY AS WE DEAL WITH COVID-19 THE QUOTES HERE ABOUT EMERGENCY MANAGEMENT THAT I KEPT EXPRESSING WE’RE A NURSING FACILITY AND THE BOTTOM LINE WAS, I DON’T THINK THEY CARED THAT’S REALLY TROUBLING OUR WORK SUGGESTS TRAINING DOES HELP TWO PROGRAMS, BOTH IN THE PUBLIC DOMAIN MAY BE USEFUL TO NURSING HOME STAFF THAT WOULD BENEFIT FROM TRAINING ON MANAGING ADVERSE HEALTH, MENTAL HEALTH EFFECTS OF DISASTER ON RESIDENTS PSYCHOLOGICAL FIRST AID IS A TECHNIQUE USED ON STAFF NOT JUST LICENSED CLINICAL PRACTITIONERS IT WILL CREATE RESIDENT CENTERED PLEASANT EVENTS THIS IS A CHECKLIST THAT CAN BE USED TO IDENTIFY PLEASANT AND POSITIVE ASPECTS OF LIFE, THINGS THAT WILL BRING RESIDENTS PLEASURE NEXT SLIDE, PLEASE TO SUMMARIZE, MORTALITY IS BEYOND AN INITIAL BODY COUNT OUR CURRENT WORK INDICATES AND IS SUBSTANTIAL STATING OVERTIME MORTALITY IN NURSING HOME POPULATIONS IS SIGNIFICANTLY AND CONTINUOUSLY UNDER REPORTED SECONDLY, NURSING HOMES REMAIN A LOWER PRIORITY AND EMERGENCY OPERATIONS CENTERS DESPITE LOTS OF US TRYING TO CHANGE THAT THIRD, THE CONSEQUENCE OF NOT PRIORITIZING NURSING HOME RESIDENTS GIVES A WORSENING OF COGNITIVE AND FUNCTIONAL DECLINE OBVIOUSLY THAT’S VERY TROUBLING IF ANYONE FEELS THEY CAN RESTER ON THEIR LAURELS, EVEN IF THIS CHRONIC DISASTER PERIOD OF COVID-19, OTHER DISASTER AND WILL OCCUR HURRICANE SEASON BEGINS JUNE 1, BUT THERE’S ALREADY A STORM LURKING OUT IN THE BAHAMAS THANK YOU AGAIN FOR YOUR ATTENTION AND YOUR COMMITMENT TO OLDER ADULTS AND ESPECIALLY TO THOSE WITH COGNITIVE IMPAIRMENT THE NEXT THREE SLIDES ARE BASICALLY THE RESOURCES AND REFERENCES >> THANK YOU, KATHY GOOD MORNING OR GOOD AFTERNOON DEPENDING ON WHICH TIME ZONE YOU ARE IN MY NAME IS NIA RADIOE REED AND I AM HELPING WITH THE CDC’S EMERGENCY

RESPONSE OF THE 2019 NOVEL CORONAVIRUS I’LL BE GIVEN A BRIEF OVERVIEW ON THE WORK THAT CDC HAS DONE AND THE ON GOING WORK HAPPENING FOR THE COVID-19 PANDEMIC EMERGENCY RESPONSE REGARDING OLDER ADULTS, NEXT SLIDE FIRST WHAT’S IS COVID-19? COVID-19 IS CAUSED BY A CORONAVIRUS CALLED SARS THEY’RE LARGELY FAMILY OF VIRUSES THAT ARE COMMON IN PEOPLE AND MAY BE FOUND IN DIFFERENT SPECIES OF ANIMALS INCLUDING CAM ELSE, CATTLE, CATS AND BATS RARELY ANIMAL CORONAVIRUS CAN EFFECT PEOPLE AND SPREAD BETWEEN PEOPLE NEXT SLIDE COVID-19 MAY BE PRESENT WITHOUT ANY SYMPTOMS OR SYMPTOMS CAN RANGE FROM MILD SUCH AS A COUGH TO SEVERE ILLNESS SUCH AS CARDIAC ARREST OTHER SYMPTOMS OF COVID-19 CAN INCLUDE SOME OR ALL OF THE FOLLOWING — COUGH, SHORTNESS OF BREATH OR DIFFICULTY BREATHING, FEVER, CHILLS, REPEATED SHAKING WITH CHILLS, MUSCLE PAIN, HEADACHE, SORE THROAT, OR NEW LOSS OF TASTE OR SMELL NEXT SLIDE THE VIRUS IS SPREADING EASILY AND SUSTAINABLY FROM PERSON TO PERSON AND YOU CAN BECOME INFECTED FROM RESPIRATORY DROPLETS WHEN CONTINUE AN INFECTED PERSON COUGHS OR TALKS YOU CAN TOUCH THE OBJECT THAT HAS THE VIRUS ON IT AND TOUCHING YOUR MOUTH, NOSE OR EYES, THEY CAN INHALED INTO THE LUNGS OR COMING INTO CLOSE CONTACT ABOUT SIX FEET OR TWO ARMS LENGTH WITH THE PERSON WHO HAS COVID-19 OLDER ADULT AND PEOPLE OF ANY AGE WITH SEVERE UNDERLYING MEDICAL CONDITIONS ARE AT HIGH-RISK FOR DEVELOPING MORE SERIOUS COMPLICATIONS FROM COVID-19, HOWEVER, EIGHT OUT OF 10 DEATHS IN THE U.S. HAVE BEEN IN OLDER ADULTS AGE 65 AND OLDER OLDER ADULTS ARE AT INCREASE RISK OF STRESS AND ANXIETY ASSOCIATED WITH COVID-19 BECAUSE OF THE INCREASE RISK, CDC IS ADVISING OLDER ADULTS TO STAY AWAY FROM THE GENERAL PUBLIC OR SHELTER IN PLACE AS STATES REOPEN CDC HAS AS VICED LONG-TERM CARE FACILITIES TO RESTRICT VISITORS THIS CAN LEAD TO SOCIAL ISOLATION AND DEPRESSION PARTICULARLY DEPRESSION FROM SOCIAL ISOLATION IS A CONCERN FOR OLDER ADULTS BECAUSE IT CAN AND HAS OFTEN BEEN MISTAKEN FOR NORMAL PART OF AGING AND BE INTERPRETED AS A COGNITIVE ISSUE THE U.S. BUREAU OF LABOR STATISTICS REPORT THAT AMERICANS AGE 65 AND OLDER HAVE NEARLY A 36% PARTICIPATION RATE IN THE WORKFORCE AND IF THERE’S NO TELEWORK ALLOWED, OLDER ADULTS MUST REPORT TO WORK IF YOU HAVE TO REPORT TO WORK, CDC RECOMMENDS TO PRACTICE SOCIAL DISTANCING, WEAR A DISINFECT YOUR WORK STATION WASH YOUR HANDS FREQUENTLY, GET SCREENED AND SCREEN ASKING AVAILABLE AND IF YOU ARE SICK TO FOLLOW CDC GUIDELINES ON HOW TO TAKE CARE OF YOURSELF BECAUSE DEMENTIA, PRIMARILY EFFECTS OLDER ADULTS AND OLDER ADULTS HAVE A HIGHER RISK FOR SEVERE ILLNESS ASSOCIATED WITH COVID-19, IT IS IMPORTANT TO NOTE THAT FOR PEOPLE LIVING DEMENTIA, CHANGES IN BEHAVIOR ARE WORSENING SYMPTOMS OF DEMENTIA SHOULD BE EVALUATED IT CAN BE OF COVID-19 AND INFECTION AND THEY INCLUDE INCREASED AGE STATION, CONFUSION OR SUDDEN SADNESS NEXT SLIDE, PLEASE AT THE MOMENT THERE ARE CURRENTLY TWO PROJECTS FOCUSED ON OLDER ADULTS THAT ARE FUNDED BY THE CDC FOUNDATION THE FIRST IS THE PROJECTS WHICH TARGETS PEOPLE AGE 65 AND OLDER AND THEIR CAREGIVERS PEOPLE WITH PREEXISTING MEDICAL CONDITIONS AND PEOPLE EXPERIENCING VIOLENCE INCLUDING SUICIDE AND INTIMATE PARTNER VIOLENCE AND ELDER ABUSE FINALLY, ECONOMICALLY DISADVANTAGED INDIVIDUALS THIS PROJECT AIMS TO DEVELOP, IMPLEMENT AND EVALUATE PUBLIC-HEALTH MESSAGES AND MATERIALS TO PROMOTE STRESS MANAGEMENT MENTAL HEALTH AND RESILIENCE DURING THE COVID-19 AND THE RECOVERY EFFORTS THE SECOND PROJECT IS THE INNOVATIVE TECHNOLOGIES PROJECT WHICH TARGETS OLDER ADULTS ONLY

AND THIS AIMS TO BRODEN AND BUILD SOCIAL AND EMOTIONAL SUPPORT SYSTEMS AND RESOURCES TO ADDRESS THE NEGATIVE EFFECTS OF SOCIAL ISOLATION AND STRESS AMONG OLDER ADULTS AND THEIR CAREGIVERS SOME OF THE ACTIVITIES WILL INCLUDE DI NOTEBOOKS, PROMOTING TELE HEALTH SERVICES AND BUILDING A VOLUNTEER PLATFORM NEXT SLIDE, PLEASE CDC RELEASED CONTENT REGULARLY INCLUDING THE ONE YOU SEE HERE AND SO AS WE LEARN MORE ABOUT RISK FACTORS FOR COVID-19, PLEASE CHECK OUT OUR WEBSITE OUR WEBSITE IS WWW.CDC.GOV/CORONAVIRUS/2019-NCO V NEXT SLIDE, PLEASE CDC ALSO HAS GREAT INFORMATIONAL RESOURCES AND ASSOCIATED WITH OLDER ADULTS AND INCLUDING GUIDANCE, ARTICLES, VIDEOS FOR THE COVID-19 EMERGENCY RESPONSE AND RECOVERY WHICH CAN ALL BE FOUND ON OUR WEBSITE OR BY CLICKING AN ANY OF THESE LINKS NEXT SLIDE, PLEASE FOR MORE INFORMATION, PLEASE CONTACT CDC AND INFORMATION, THAT IS 1-800-232-4636 AND OUR TELE TYPEWRITER COMMUNICATIONS CAN BE REACHED AT 1-888-323-6348 OR WWW.CBC.GOV THANK YOU AND NOW I’LL TURN IT BACK OVER TO OUR MODERATOR >> GOOD AFTERNOON THIS IS JOIN FROM THE HEALTH RESOURCES AND SERVICES ADMINISTRATION WE PROVIDE YOU WITH SOME EMERGENCY PREPARED AND RESOURCES AND AMERICAN HEALTH AND CENTERS FOR DISEASE AND NATIONAL OUTSIDERS AND AND THE NATIONAL INSTITUTE ON AGING THE LINKS ARE LIVE SO WHEN YOU RECEIVE THE SLIDE PRESENTATION YOU’LL JUST BE ABLE TO CLICK ON THE LINK AND IT WILL TAKE YOU TO THAT RESOURCE NEXT SLIDE, PLEASE IF YOU LIKE OUR PRESENTATION TODAY, WE HAVE MORE TO COME AND JUST BRIEF INFORMATION ABOUT THE FOCUS ON AGING FEDERAL PARTNERS WEBINAR SERIES, THIS WEBINAR SERIES ADDRESSES IMPORTANT TOPICS FOR PUBLIC-HEALTH AND HEALTHCARE PROFESSIONALS AND AGING SERVICES ORGANIZATIONS AND THE RESEARCH COMMUNITY, AND OTHER STAKEHOLDERS AND AGING IT’S A JOINT PROJECT OF FOUR FEDERAL AGENCIES THAT SUPPORT THE HEALTH AND WELLNESS OF OLDER ADULTS IN THE UNITED STATES INCLUDING THE ADMINISTRATION FOR COMMUNITY LIVING AND CENTERS FOR DISEASE CONTROL AND PREVENTION, INSTITUTE INSTITUTE OF AGEING AND HEALTH RESOURCES AND SERVICES ADMINISTRATION EACH WEBINAR WILL INCLUDE INFORMATION SPECIFIC TO INDIVIDUALS WITH ALZHEIMER’S AND OTHER TYPES OF DEMENTIA AS WELL AS THEIR CAREGIVERS OUR NEXT WEBINARS ARE AS FOLLOWS — IN SEP TEMBER, WE’RE GOING TO TALK ABOUT SOCIAL ISOLATION AND LONELINESS JANUARY 2021, WORKFORCE TO SUPPORT THE NEEDS OF OLDER ADULTS AND IN THE SPRING OF 2021, DISPOSE YOU’RE OF RESEARCH AND CLINICAL FINDINGS RELATED TO COGNITION THERE’S A LINK TO THE WEBINAR SERIES AT BOTTOM OF THE SLIDE WITH THAT I WOULD LIKE TO THANK ALL OF OUR OUTSTANDING SPEAKERS AND ALSO ALL OF OUR ATTEND’S FOR ATTENDEES FOR TAKING THE TIME TO JOIN US TODAY I’D LIKE TO TURNOVER THE SESSION TO GREYSON DONNELLY, WHO WILL BE RUNNING THE QUESTION AND ANSWER SECTION >> THANK YOU, JOAN THANK YOU FOR EVERYONE WHO HAVE QUESTIONS OR COMMENTS AS A REMINDER, IF YOU STILL WANT TO SEND A QUESTION, YOU CAN USE THE LIVE FEEDBACK IF YOU SCROLL DOWN YOU ASKED QUESTIONS WHETHER OR NOT YOU WILL RECEIVE THE SLIDES YES, YOU WILL SEE THE SLIDES AS WELL AS A LINK TO THE ACCORDING OF THIS VIDEO CAST

WE RECEIVED ANOTHER QUESTION THIS IS FOR LISA MCGWIRE WHERE WILL THERE BE A CEU FOR THIS WEBCAST? >> THANK YOU, GREYSON NOT FORTUNATELY, THERE WILL NOT BE A CBU OPTION AVAILABLE FOR THIS WEBCAST THANK YOU WE RECEIVED ANOTHER QUESTION THIS IS DIRECT I HAD T DIRECTED TO JEFFREY KLEIN I WONDER HOW YOU ARE ABLE TO MAKE SURE THAT EVERYONE HAD INTERNET OR ACCESS TO THE AT-HOME SERVICES? >> THANK YOU THE ANSWER IS IN OUR URBAN YEARS, WE FOUND WAYS TO PROVIDE ACCESS TO PEOPLE IN OUR RURAL AREAS IT’S DIFFICULT AND WE’RE NOT AS SUCCESSFUL DOING THAT WE HAVE TO RELY ON TELEPHONE-BASED TECHNOLOGIES IN THOSE COMMUNITIES TO REACH PEOPLE IT’S QUITE A CHALLENGE IN NEVADA WHERE WE HAVE A GREAT DEAL OF FRONTIER INDIVIDUALS WHERE WE DON’T HAVE, IF THEY’RE DIRECT INTERNET OR SATELLITE INTERNET IT IS A CHALLENGE WE TRIED TO USE THE TELEPHONE LINES AS MUCH AS WE CAN AND PARTICULARLY FOR TELEPHONE REASSURANCE AND INFORMATION SERVICES WE’RE ABLE TO GET EQUIPMENT TO PEOPLE BUT ONLY IF THEY’RE IN PARTS OF THE STATE THAT HAVE CONNECTIVITY >> THANK YOU ANOTHER QUESTION, JUST CAME IN, I’M NOT SURE WHICH PRESENTER WILL BE ABLE TO ANSWER THE QUESTION, HOW CAN OLDER ADULTS ACCESS MORE THAN 30 DAYS OF MEDICATIONS? DON’T MOST INSURANCE COMPANIES ONLY FILL FOR 30 DAYS? >> >> THIS IS JEFF A LOT OF PLANS YOU CAN REQUEST A 90-DAY OR EVEN LONGER MEDICATION DELIVERY WE ARE RECOMMENDING THAT SENIORS MAKE THAT SPECIAL REQUEST TO OUR KNOWLEDGE, MOST OF THE PLANS ARE HONORING THOSE REQUESTS IN TERMS OF SHIPMENTS TO HOME AND ALSO THROUGH LOCAL AREA PHARMACIES THERE SOMEWHERE PLANS THAT WILL ALLOW LONGER DISTRIBUTIONS WE HAVE ROUTINELY SUGGESTED MAKE THE 90-DAY REQUEST AND WE’VE BEEN REASONABLY SUCCESSFUL IN HAVING THOSE THINGS APPROVED >> I THINK ONE OF THE THINGS WHEN WE LOOKED AT THIS WAS THAT THE ONLY STATE WE COULD FIND IN OUR POLICY REVIEW WAS ACTUALLY FLORIDA THAT ACTUALLY HAS IMPLEMENTED AN EMERGENCY ORDER SO THAT IF YOU KNOW A HURRICANE IS COMING, THEN YOU CAN ACTUALLY GO TO YOUR LOCAL PHARMACY AND GET A 30-DAY SUPPLY EVEN IF YOUR SUPPLY IS FILLED UP THE CHALLENGE WAS THAT WITHIN THE U.S., IF YOU ARE NOT NECESSARILY OUT OF YOUR SUPPLY, IF YOU ARE STILL WITH A PRESCRIPTION YOU MAY NOT BE AUTHORIZED FOR RENEWAL AND SO, THERE’S AN OPPORTUNITY FOR US TO THINK ABOUT HOW WE CAN CLOSE THAT GAP IF YOU WILL >> THANK YOU I BELIEVE THIS QUESTION IS FOR MIA REED IS THERE ANY INFORMATION REGARDING NEURO COGNITIVE DISORDER BY ITSELF INCREASING THE RISK FOR COVID-19 FOR A PROGNOSIS OR INCREASING THE RISK FORGET PARTICULAR OTHER THAN THE FACT THEY MAY FORGET TO WASH THEIR HANDS? >> THANK YOU FOR THAT QUESTION THERE’S NOTHING, AS WE — THERE’S NOTHING OUTRIGHT NOW OUT RIGHT NOW ABOUT THAT WE’RE STILL LEARNING ABOUT THE VIRUS SO IF YOU HAVE QUESTIONS THAT I CAN’T ANSWER FOR YOU HERE TODAY, FEEL FREE, WE HAVE A TON OF INCREDIBLE EXPERTS WHO ARE AT EMERGENCY OPERATION CENTER WHO CAN HELP WITH THESE QUESTIONS FEEL FREE TO E-MAIL THE E-MAIL ADDRESS THAT IS ON MY SLIDES OR CALL THE 1-800-CDC NUMBER AND THEY SHOULD BE ABLE TO GET BACK TO YOU WITH THE DEFINITE ANSWER >> THIS IS DR. SINAH HERE, AS SAID, THERE’S NO EVIDENCE TO SUGGEST THAT BUT THERE IS CONCERN THAT WHEN A PERSON WHO HAS DEMENTIA WAS MENTIONED THEY MAY FORGET TO WASH THEIR HANDS AND ALSO, THOSE WHO WANDER WHO ARE LIVING IN NURSING HOMES, AND MAY WALK AROUND AND BE IN

CONTACT WITH’S, WE’RE SEEING A GREATER RISK WHEN THEY DON’T REMEMBER TO PHYSICALLY DISTANCE APPROPRIATELY AS WELL >> THANK YOU I WILL LET THE PANELIST DECIDE WHO IS MOST APPROPRIATE TO ANSWER THIS NEXT QUESTION IS THERE ANYONE WORKING ON MAKING SURE THAT PEOPLE WHO USE POWER AND MOBILITY CAN BE A EVACUATED WITH THEIR EQUIPMENT AND THEIR CAREGIVER IN EMERGENCIES? >> DR. A SINAH THE AMERICAN RED CROSS IS WORKING ON A POWER OUTAGE RESOURCE THIS IS BEEN FUNDED BY ONE OF THE FEDERAL AGENCY ZOOS THAT WE CAN BETTER SUPPOSE SORT PEOPLE WHO ARE DEPENDENT ON POWER AND A WHOLE VARIETY OF CIRCUMSTANCES RIGHT NOW, WHAT WE DID FIND IN OUR CLOSING THE GAP REVIEW WAS THERE ARE SOMETIMES UTILITY COMPANIES YOU CAN LET THEM KNOW YOU ACTUALLY ARE POWERED DEPENDENT SO THEY CAN GIVE YOU ADVICE AND THERE ARE VULNERABLE PERSONS REGISTRIES AT A COMMUNITY LEVEL WHERE YOU CAN REGISTER BASED ON THAT ISSUE SO THAT YOU MAY BE A CANDIDATE FOR PRIORITY SERVICE I THINK SOMEONE ELSE MAY BE ABLE TO ANSWER FURTHER >> MY EXPERIENCE IS THE SAME WILL ARE SPECIAL REGISTRY LISTS THAT CAN HELP YOU THERE’S ALSO A MEDICARE DATA BASE IN POWER THAT HELPS IDENTIFY PEOPLE WHO NEED POWER THROUGH THE REGISTRIES AND THROUGH THE POWER COMPANIES >> THANK YOU THE QUESTIONS ARE STILL ROLLING IN AND I WANT TO REMIND EVERYONE WE WILL COM PIE THE QUESTIONS THAT WE’RE NOT ABLE TO ANSWER LIVE AND TRY OUR BEST TO E-MAIL YOU A RESPONSE TO YOUR QUESTION LET ME BOOK LACK NOW I BELIEVE THIS IS A FOLLOW-UP FOR JEFFREY KLEIN DO YOU HAVE SUGGESTIONS FOR BRINGING PROGRAMS TO THOSE PERSONS WHO ARE NOT TECHNOLOGICALLY SAVVY? >> THE TECH SAVVY ISSUE IS REALLY A PROBLEM, PARTICULARLY IN OUR AGING POPULATION WHAT WE’VE ATTEMPTED TO DO AND WE’VE BEEN USING SOME OTHER RESOURCES TO DO IT IS TO GET PEOPLE, I HATE TO SAY, USE THE TERM, BUT PENCIL AND PAPER TECHNOLOGIES TO GET IT TO THEIR HOMES WE HAVE PEOPLE DROPPING OFF THOSE TECHNOLOGIES WITH FOOD DELIVERIES AND BAGS MIXING IT UP WITH OTHER KINDS OF DELIVERIES INCLUDING MEDICATIONS AND IF NECESSARY, WE’LL JUST SEND SOMEONE OUT TO SOMEONE’S HOME IT WILL CREATE PENCIL AND PAPER PROGRAMS AND ACTIVITIES THAT THEN CAN BE ACTIVATED BY TALKING TO SOMEONE IN A TELEPHONE REASSURANCE MODE AND IT SEEMS TO WORK REASONABLY WELL, PARTICULARLY IF THEIR FAMILY MEMBERS ARE AROUND SO YOU CAN TURN INTO A COMMUNITY ACTIVITY AND ALSO USING OUR CONFERENCE CALLING CAPABILITY SO WE TRY TO GET THEM SOME MATERIAL AND GET TWO OF THEM ADVANCE AND USE THE TELEPHONE AS BEST WE CAN INTERESTINGLY ENOUGH, ONE OF THE THINGS THAT WE’VE STARTED TO PLAY WITH A LITTLE BIT IS USING COMMERCIALLY AVAILABLE TELEVISION IF PEOPLE HAVE THE ABILITY TO RECORD, WHICH A LOT OF FOLKS DO, AND THEN TAKE AND FULLYING AN ACTIVITY OUT OF SOMETHING ON SPECIAL TV AND TURNING IT INTO AN ACTIVITY >> THANK YOU I THINK THIS NEXT QUESTION MIGHT BE OUR LAST QUESTION AND IT’S FOR ALL PANELISTS WHAT COMMUNITY PARTNERS HAVE BEEN HELPFUL IN ASSISTING WITH THE NEEDS OF OLDER ADULTS? ESPECIALLY IN PROVIDING ACCURATE INFORMATION >> HI, THIS IS NIA REED I REQUEST JUST SPEAK INFORM WHAT IS HAPPENING FOR THE COVID-19 RESPONSE WE HAVE REALLY HAD A LOT OF GREAT TALKS AND CONVERSATIONS AND HELP FROM ACL, AAPR AND ALL THE ORGANIZATIONS THAT ARE HERE WE’VE HAD A LOT OF GREAT INPUT AND EXPERTISE TO HELP WITH THIS EMERGENCY RESPONSE RELATED TO

COVID-19 >> THIS IS MARGI SANDERS, OUR HEALTH DEPARTMENT HAVE BEEN GREAT PARTNERS FOURS >> PUBLIC-HEALTH HAS REALLY CHANGED PARTICULARLY WITH COVID-19 THEY’RE DOING AN INCREDIBLE JOB HERE IN FLORIDA TOO >> OUR STATE UNIT, OUR STATE HAS BEEN AMAZING AND STABBING UP RESOURCE AND PROVIDING CONNECTIVITY AND BEAK A CONVENER AND A COLLABORATOR AND A SPECIAL TIP TO THE HAT TO ACL IT’S GREAT TO HEAR ERIN’S VOICE BECAUSE SHE HAS CONVENED GROUPS AND GERRY ATTIC AREAS AND ADULT DAYCARE AND IT’S BEEN HELPFUL REQUEST INFORMATION EXCHANGE AND DEALING WITH LONELINESS FACTORS THAT THOSE MUCH US FROM THE FRONTLINES FEEL DISCONNECTED FROM OUR COLLEAGUES BOTH DID GREAT RESOURCES FOR US >> THIS IS KATHY, THE ALZHEIMER’S ASSOCIATION HAS BEEN VERY GOOD AT TRYING TO CREATE MORE RESOURCES AND THEY’RE DOING A LOT OF WORK HERE IN FLORIDA WITH TABLETS AND WAYS TO DECREASE LONELINESS ALONG WITH OUR STATE AGING DEPARTMENT OF ELDER AFFAIRS >> LOOKING AT THE TIME, I THINK WE HAVE ONE MORE QUESTION WE CAN BRING TO THE PANELIST FOR ALL PANELISTS CAN SOMEONE COMMENT ON SPECIFIC INTERVENTIONS TO SUPPORT DIVERSE POPULATIONS? >> DR. SINAH WHEN WE THINK OF PANDEMICS LIKE COVID-19, WE FIND THAT DIVERSE AND MORE MARRIAGE BEGIN ALLIESED MARGINALI ZED ARE THE RISK THE MATERIALS ARE IN OWN OR IS OUR MAIN LANGUAGES AND SOMETIMES PEOPLE MAY HAVE CHALLENGES CONNECTING WITH INFORMATION BECAUSE THEY MAY HAVE A LACK OF INTERNET ACCESS OR OTHER RESOURCES THAT WAY AND SO IF ONE IS WORKING WITH A COMMUNITY, WE OFTEN RECOMMEND THROUGH THE RED CROSS AND OTHERS THAT PEOPLE TRY AND UNDERSTAND HOW BEST TO SHARE CREDITABLE INFORMATION AND FIND OUT WHAT THE GAPS MAY BE IN TERMS OF RESPONDING AND FIGURE OUT THE BEST WAY TO SHARE INFORMATION AND RESOURSE TO KEEP PEOPLE HEALTHY AND WELL THAT IS SOME OF THE STARTING POINTS THAT I WOULD SAY >> THANK YOU, NIA REED, REGARDING THE COVID-19 RESPONSE, CDC HAS BEEN VERY DELIBERATE MAKING SURE OUR FUNDED PROJECTS FOCUS ON AND ARE INCLUSIVE OF DIFFERENT POPULATIONS AND ESPECIALLY VULNERABLE POPULATIONS ON TOP OF BEING 65 OR OLDER, RACIAL AND ETHNIC MINORITIES AS WELL AS PEOPLE WHO ARE EXPERIENCING VIOLENCE WE’RE BEING DELIBERATE AND MAKING SURE WE FUND PROJECTS OR WE’RE PART OF PROJECTS THAT ARE — THEY HAVE THAT OUTREACH >> THANK YOU ALL AS A REMINDER TO ANY ATTENDEES, IF YOU STILL HAVE A LINGERING QUESTION, CAN YOU USE THE LIVE FEEDBACK FORUM AND WE WILL DO OUR BEST TO E-MAIL YOU A RESPONSE IF WE WERE UNABLE TO ANSWER IT LIVE WITH THAT I WILL TURN IT OVER TO LISA MCGWIRE >> THANK YOU FOR ATTENDING THE FIRST 2020 FOCUS ON AGING FEDERAL PARTNERS WEBINAR SERIES AS PART OF THE PLANNING COMMITTEE I WANT TO SHARE OUR GREAT APPRECIATION FOR THEIR TECHNOLOGICAL SO PHYSICAL INDICATION AND PROVIDING THE PLATFORM FOR US TODAY MAINLY ELIZABETH CRICKET, GREYSON DONNELLY AND NINA SILVERBERG IN A FEW DAYS, YOU WILL RECEIVE AN E-MAIL WITH A LINK TO THE RECORDING AND THE SLIDES AS WELL AS OTHER RESOURCE MATERIALS SO ONCE AGAIN, THANK YOU VERY MUCH FOR YOUR ATTENDANCE AND PARTICIPATION TODAY