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3 <br />F'g ? of ? <br />Issues identified in Oran a Count <br />1. We have a manpower shortage in the home health <br />aide /chore service field because of low wages, lack of <br />benefits and no career advancement to maintain a <br />reliable, professionally trained pool. In addition, <br />other factors influencing this issue are higher cost <br />of living in the Triangle area, low employment rate <br />resulting in local competition for ablbe para- <br />professional wor k -ers. <br />2. We need greater-linkage and coordination in the <br />management of all long term services regardless of <br />the setting (in -home services community services <br />special living arrangements, nursina home care etc) <br />for the -Frail elderly because of the growing number, <br />the unclear or overlapping service provider roles, <br />the variety of funding resources and eligibility <br />requirements and no clearly defined case management <br />System. <br />. We lack an adult day health care facility in Orange <br />County because of high capital investment, the lack of <br />public funding to assistance families, the need for <br />special client transportation. <br />4. We lack; affordable health insurance coverage for home <br />care because of various factors- cost, public vs <br />private responsibility issue, lack of agreement on <br />type of coverage necessary. <br />C. We need to establish and design more a= Tordable <br />housing (both public and private) that would provide <br />assisted living (yard work, household tasks, or <br />personal care) because of increasing number of old -old <br />who desire to live in own home. There is a need for <br />housing with design features that to {::e into account <br />vision, dexterity and mobility limitation over time. <br />6. The cost of Dersonal care services by count <br />government has increased and service has been reduced <br />because of contracting out to private agencies. <br />Without substantial increase in public funding, <br />current resources will provide care for a much reduced <br />population. <br />7. There is a need for resources to provide rest home and <br />in -house services to elderly ersons with mental <br />illnesses because existing services are overwhelmed by <br />demand; thus, have very limited ability to do the <br />case- finding and outreach services in rest homes and <br />in the community. <br />