AGING ACTION INITIATIVE
THE FIRST SIX MONTHS
April 2015
TABLE OF CONTENTS
Contents
Executive Summary _____________________________________________________________________________________ 1
Aging in Marin ___________________________________________________________________________________________ 2
Planning for Action _____________________________________________________________________________________ 4
Action Plans ______________________________________________________________________________________________ 6
Implementation – Year One ___________________________________________________________________________ 7
Looking Ahead – Beyond Year One ___________________________________________________________________ 8
Appendix A – Aging Action Initiative Fact Sheet _______________________________________________________ 9
Appendix B – Action Plans _____________________________________________________________________________ 13
Acknowledgements ___________________________________________________________________________________ 22
[Note: Click on almost any underlined word, phrase, or image in this document (including headers) to jump
to the hyperlinked information]
EXECUTIVE SUMMARY
Executive Summary
ACKNOWLEDGEMENTS
The Aging Action Initiative (AAI) could not have been launched without the hard work and dedication of
many people in our community. Some had the foresight to highlight the need and organize resources, some
helped frame and facilitate the process and many others took time out of their already very busy workday to
participate and lend their expertise and voice to the planning process. Over 85 individuals in more than 45
organizations participated in 21 planning sessions over the past six months.
We hope that the increased attention and focus on aging in Marin will continue to grow throughout the first
year’s implementation process, laying the groundwork for further collective action and greater impact.
AGING IN MARIN – 33% BY 2030
The wave of older adult baby boomers is already coming ashore. We are currently the oldest county in the
Bay Area and we’re aging more than one-and-a-half times as fast as that of the rest of the state. By 2030 more
than 33% of our citizens will be over 60 years old and about 14% of all citizens will be over 75. Soon, for the
first time in history, there will be more people on this planet over the age of 65 than under the age of 5.
PROCESS HIGHLIGHTS
So, how are we as a county adequately addressing this changing landscape and the current and future needs
of our older adults in Marin? – This is the question, asked in 2013 by County Supervisors, which inspired the
development of the Aging Action Initiative. After recognizing the need for more action, the Supervisors setaside start-up implementation funds to catalyze county-wide coordinated action and the staff in the office of
Aging and Adult Services went to work. In 2014 the County conducted a review of studies, interviewed a
number of key aging service providers, and launched into the first phase of the initiative by choosing four
key issues areas to focus on: Care Coordination, Mental Health, Dementia and Cognitive Impairment, and
Food and Nutrition. After a short intense six months of planning, nine Action Teams are off and running.
ACTION PLAN HIGHLIGHTS
Out of the four initial workgroups emerged the following nine Action Teams:
 Resource Referral and Information
 SSI/CalFresh Legislative Action
Assistance Coalition
 Mobile Farmers’ Market Van
 Nutrition Education Cooking Class
 Dementia Field Tool
 Congregate Dining Assessment
 Mental Health Field Tool
 Mental Health & Dementia Early Intervention
 Safety Net & Elder Economic Index Gaps
Workshop
LOOKING AHEAD
By starting with doable year-one actions and building on success, our hope is that the communication and
relationships that unfold through this initial collaboration will build momentum for enhanced and expanded
collective impact. In addition to AAI, there are several other age related initiatives beginning to emerge in
the county. Knitted together, these efforts have the potential to truly make a difference in the lives of Marin’s
older adults and the communities in which they live.
Page 1
AGING IN MARIN
Aging in Marin
Aging is a unique and complex issue for us both personally and as a society. Unlike many other social service
matters, aging is an equal opportunity issue – it happens to everyone regardless of gender, race, income or
sexual orientation, and no one gets out alive.
It is also a very complex issue in that it touches on every aspect of our lives, from housing and
transportation to health and emotional wellness. As we age, our food requirements change, our social lives
shift, our perspectives are different, and our brains often begin to play unwelcome tricks on us. And while
we all share a need for shelter, food and community we each experience aging differently. Today more than
ever, there is no “typical 65 year old” and yet our socio-political policies and service delivery systems are
still predominantly based on fifty year old models of ‘averages’ and norms calculated for the economics of
social security.
From 2009-2014, more than a dozen community assessments addressing aging were conducted in Marin.
Here are a few of the key highlights from those reports (click here to see the full list of reports):





Marin is the oldest county in the Bay Area
Services: High cost of living + increase in demand for elder support services = gap in service
availability (service workers can’t afford to live in Marin)
Transportation: Low-density, suburban, hilly topography limits transportation alternatives for older
adults
Housing: 30% of Marin’s 65+ population live alone
Poverty: About 21% of older adults live within the “elder eligibility gap” (see below)
Not only is Marin County home to more older
adults—as a percentage of the population—
than any other county in the state, those over
85 years make up the fastest growing
segment of that population.
“This projected trend is even more
remarkable when compared to the
population growth of Marin County overall.
Marin is the slowest growing county in the
Bay Area [with projected growth at 8.6%
from 2005 to 2035]. However, within this
same time period, the percentage of
residents over age 60 is expected to rise
dramatically. Senior Mobility Action &
Implementation Plan – Existing Conditions
Report 2010
Page 2
AGING IN MARIN
Due to the high cost of living in Marin, especially for housing, over 9,000 older adults live below the Elder
Economic Index. And because 7,000 of them are above the Federal Poverty line, they are not eligible for
many forms of public assistance.
Page 3
PLANNING FOR ACTION
Planning for Action
So, What Can We Do Together to Build an Age Friendly Marin?
Building on the large body of knowledge already assembled in numerous community assessment reports,
the Aging Action Initiative was designed around two themes:
Action & Collective Effort
The overriding concept was to rapidly launch collective actions that:



Were doable within a year,
Met important, well known needs, and
Coordinated, complemented and/or leveraged existing programs and services
Putting all these elements together, the intention was to not only enhance services to the community but
also provide agencies with a sense of momentum and success in working together so as to strengthen interagency relationships and in doing so weave together a stronger overall safety net for older adults in Marin.
[For more information about the overall process and context see the Fact Sheet in Appendix A]
Page 4
PLANNING FOR ACTION
In launching the initiative, the County’s Aging & Adult Services Department did a scan of recent reports and
conducted interviews with key stakeholders [click here to see the full report]. With this information it was
decided to focus the process on four issue areas that were not already being addressed by other county
efforts, such as the Marin Community Foundation’s support for affordable housing solutions and Marin
Transit’s Marin Mobility Management program. A Steering Committee was formed to identify project
participants and to provide feedback on the best path forward.
The four workgroups that were assembled were:
 Food & Nutrition
 Mental Health & Wellness


Dementia & Cognitive Impairment
Care Coordination
Within these four workgroups, over 65 participants attended five workgroup meetings and two large
convenings. Over six months, from November 2014 to March 2015, the process moved from cultivating a
shared understanding of an issue’s context to actionable project plans. At the mid-point and at the end, the
workgroups came together in large convenings to learn from each other, cross-pollinate ideas, and expand
the relationship network.
Context Maping
Brainstorming
Each meeting’s agenda built on the prior meeting’s
outcomes and every session started with a brief
overview of the process up to that point. Extensive use
of graphic recording helped participants “see” each
other’s ideas, allowed the group to collectively
recognize patterns of information, and facilitated
consensus building.
Page 5
Prioritizing
Action Planing
ACTION PLANS
Action Plans
Out of the four workgroups emerged the following nine Action Plans:

No Wrong Door: Strengthening our Network Through Shared Information
Sharing knowledge and improving access to resource referral and information assistance

Lifelong Learning: Nutrition Education Cooking Class

Eating Together: Leveraging Our Successes in Congregate Dining

Legislative Action: Improving the SSI/SSP – CalFresh Interrelationship
Advocate for changes to SSI/SSP as it relates to government funded food assistance programs

Mobile Markets: Replacing Food Deserts with Farm Fresh Nutrition

Early Intervention Training Workshop
Sensitivity, awareness & referral assistance for
cognitive impairment and behavior issues in older
adults

Responding with Compassion: Dementia
& Memory Loss Field Tool
Sensitivity, awareness & referral assistance at “Point
of Service” encounters

Responding with Compassion: Mental Health/Wellness Field Tool
Sensitivity, awareness & referral assistance at “Point of Service” encounters

Access to Services: Gaps & Cracks in our Older Adult Safety Net
For more information about each workgroup issue area and each action item, please visit
see the Fact Sheet in Appendix A, or view each Action Plan in Appendix B.
Page 6
IMPLEMENTATION – YEAR ONE
Implementation – Year One
Year One implementation will be overseen by the Aging Action Initiative Steering Committee and supported
by a Project Coordinator. This steering committee, as currently structured, consists of 8-10 individuals
representing non-profit aging services providers, the Marin County Commission on Aging, Marin Interfaith
Council, Marin Community Foundation and County of Marin Aging and Adult Services. The steering
committee will meet at least quarterly to provide direction on the project and to share in the oversight and
accountability of the Initiative, making it a truly collective and collaborative effort.
The Project Coordinator will provide administrative coordination, project management and group
facilitation to support the Action Teams of the Aging Action Initiative in achieving Year-One outcomes.
The Action Teams range in size from 2-15 participants and are each composed of members who have
committed to various roles, such as lead champion, active participant, or content advisor. The Teams will
meet as needed in order to achieve the goals established for Year-One. Most of the teams will need only
logistical support for the scheduling of meetings and basic communication while other teams, notably the
Information and Assistance Coalition and coordination between the Mental Health and Dementia Teams,
will require some meeting facilitation and project management. This additional coordination support may
include research on best practices or models from other communities. In addition to the above mentioned
project coordination, funding has been made available by the County of Marin to provide for resources such
as hiring trainers for workshops, designing marketing materials and websites, and providing stipends for
individuals to disseminate information in the community.
It is anticipated that at least one convening of all the participants will be held mid-point in Year-One.
Page 7
LOOKING AHEAD – BEYOND YEAR ONE
Looking Ahead – Beyond Year One
By starting with doable year-one actions and building on success, the hope is that the communication and
relationships that unfold through this initial collaboration will build momentum for enhanced and expanded
collective impact. These actions alone will not, in and of themselves fill all the service gaps, completely
eliminate the stigmas associated with being hungry or forgetful, or connect every older adult with the
coordinated care they need. They do however, represent a strong step forward. And just because we can’t do
everything doesn’t mean we shouldn’t take that first step.
In addition to the steps taken by the Aging Action initiative, there are many
other, more long-term, age related efforts taking place throughout the
county. Age Friendly Community certification plans are emerging in a
number of municipalities. An effort is underway to develop an Aging &
Disability Resource Center. The Buck Institute for Research on Aging is a
world renowned think-tank and research facility right in our own backyard.
Mobility Management, Healthy Marin Partnership and Area Agency on Aging
plans are being updated. And new senior housing is being developed by
Whistlestop-Eden Housing, and the Fairfax Lutheran Church. Brought
together, all these efforts have the potential to change the County’s service
delivery landscape and significantly make a difference in the lives of Marin’s
older adults and the communities in which they live.
Certainly there is more work to be done knitting together a common
agenda, cultivating shared measures of success, coordinating the
alignment of independent actions, and supporting continuous
communication. The Aging Action Initiative’s year-one project
coordination infrastructure, provided to the Action Teams, will offer
a unique glimpse into what’s possible when commitment to
collaboration is strengthened by a backbone of support.
Page 8
APPENDIX A – AGING ACTION INITIATIVE FACT SHEET
Appendix A – Aging Action Initiative Fact Sheet
Page 9
APPENDIX A – AGING ACTION INITIATIVE FACT SHEET
Page 10
APPENDIX A – AGING ACTION INITIATIVE FACT SHEET
Page 11
APPENDIX A – AGING ACTION INITIATIVE FACT SHEET
Page 12
APPENDIX B – ACTION PLANS
Appendix B – Action Plans
Page 13
APPENDIX B – ACTION PLANS
Page 14
APPENDIX B – ACTION PLANS
Page 15
APPENDIX B – ACTION PLANS
Page 16
APPENDIX B – ACTION PLANS
Page 17
APPENDIX B – ACTION PLANS
Page 18
APPENDIX B – ACTION PLANS
Page 19
APPENDIX B – ACTION PLANS
Page 20
APPENDIX B – ACTION PLANS
Page 21
ACKNOWLEDGEMENTS
Acknowledgements
We would like to specifically acknowledge the following people for their leadership and special contribution
to this effort:







Marin County Board of Supervisors – Catalysts for Action and Funding Support
o Katie Rice, President
o Steve Kinsey, Vice-President
o Judy Arnold, 2nd Vice-President
o Kate Sears
o Damon Connolly
Larry Meredith, PhD, Former Director Health & Human Services, County of Marin
Heather Ravani, Assistant Director, Health & Human Services, County of Marin
Lee Pullen, Director of Aging & Adult Services, County of Marin – Project Leadership
Gary Lara, Administrative Assistant Aging & Adult Services, County of Marin – Administrative
Support Services
Shelley Hamilton, CEO MarinSpace – Process Facilitation and Project Management Consultant
Marsha Nye Adler, Consultant – Preliminary Project Scoping Consultant
We would also like to thank the following individuals and their agencies for participating in the action
planning process described in this report.
Steering Committee
FIRST
LAST
ORGANIZATION
Allan
Bortel
Commission on Aging
Carol
Hovis, Reverend
Marin Interfaith Council
Nancy
Masters
JCFS—Seniors at Home
Jim
Monson
Commission on Aging
Joe
O'Hehir
Whistlestop
Dana
Pepp
DPP Consulting
Skip
Schwartz
West Marin Senior Services
Sharon
Turner
Commission on Aging
Shirin
Vakharia
Marin Community Foundation
Jim
Ward
Senior Access
Page 22
ACKNOWLEDGEMENTS
Care Coordination Workgroup
FIRST
LAST
ORGANIZATION
Brian
Alexander, CAO
Novato Hospital
Ana
Bagtas
Marin Aging and Adult Services
Paul
Branson
Marin Transit
Lisa
Brinkman
The Villages
Deanna
Euritt, ED
Novato Human Needs Center
Jon
Gaffney
Marin Transit
Eli
Gelardin
Marin Center for Independent Living
Dustin
Harper
Institute on Aging
Carol
Hovis, Reverend
Marin Interfaith Council
Sharon
Jackson, CRC
Marin General
Patricia
Kendal
Kaiser Permanente
Andrea
Kmetz
Meritage Accountable Care
Nancy
Masters, Chair
JCFS—Seniors at Home
Pam
Osborn
West Marin Senior Services
Mitesh
Popat, MD, MPH
Marin Community Clinic
Teri
Rockas
Healthy Marin Partnership
Linda
Tavaszi, CEO
Marin Community Clinic
Laurie
Vermont
Whistlestop
Lynn
Von der Werth
Sutter Care at Home
Mental Health and Wellness Workgroup
FIRST
LAST
ORGANIZATION
Julia
Chu, Ph.D.
Seniors at Home Boost Program
Mac
Coffey, Ph.D.
Family Service Agency: Buckelew Program
Maya
Gladstern
Marin Advocates for Mental Health
Marianne
Gontarz-York, LCSW
Marin County Commission on Aging
Diane
Gruhl
Whistlestop
Sharon
Jones, LMFT
Marin County Aging and Adult Services
Lewis
Jordan
Marin Housing Authority
Madeline
Kellner
IHSS Pubic Authority
Patty
Lyons, Chair
Senior Peer Counseling HOPE services
Nancy
Rhine, MS, LMFT
Interfaith Counseling Center
Laila
Salaam
IHSS Pubic Authority of Marin
Gary
Scheppke
Marin County Mental Health Board
Steven
Siegel
Coastal Health Alliance
Angela
Struckmann
Aging & Adult Services, County of Marin
Peg
Super
NAMI Marin
Janice
Wells, Prog. Mgr. I
Marin County Mental Health Services
Page 23
ACKNOWLEDGEMENTS
Dementia and Cognitive Impairment Workgroup
FIRST
LAST
ORGANIZATION
Clay
Angel
Kaiser Permanente
Edgar
Angelone, Dr.
Marin Neuropsychology Center
Dustin
Ballard, MD
Marin Emergency Medical Services
Deborah
Barnes, PhD
UCSF
Marge
Belknap, Dr.
Former COA Commissioner
Shelley
Dombroski
Alzheimer’s Association Marin
Richard
Jensen
Love is the Answer (LITA)
Mary
McEachron
Buck Institute for Research on Aging
Maureen
McInerney, Sr.
Dominican Sisters of San Rafael (Marin IFC)
Dana
Pepp
DPP Consulting
Deanna
Randall
Alzheimer’s Association Marin
Holly
Rylance
Lifelong Medical Group
Jerry
Schlegel, Dr.
Kaiser, San Rafael, Dementia Task Force
Candice
Simonds
Lifelong Medical Group
Jim
Ward, Chair
Senior Access
Cheryl
White
The Cedars of Marin
Food and Nutrition Workgroup
FIRST
LAST
ORGANIZATION
Chloe
Cook
West Marin Senior Services
Amy
Dietz
Marin Aging and Adult Services
Becky
Gershon
SF-Marin Food Bank
Carol
Jacobs-Courtz
City of San Rafael / Goldenaires
Sheila
Kopf
SF-Marin Food Bank
Sharon
Mooney
West Marin Senior Services
Brigitte
Moran
Agricultural Institute of Marin County
Krista
Pelletier
Whistlestop
Steve
Schwartz
Interfaith Sustainable Food
Rebecca
Smith
Public Health
Mary Kay
Sweeney
Homeward Bound of Marin
Shirin
Vakharia
Marin Community Foundation
Julia
Van Soelen Kim, MPH, MS
UC Cooperative Extension (FPC)
Jeff
Westman
Marin Organic
Marv
Zauderer
Extra Food
This report was produced by Shelley Hamilton, CEO MarinSpace with assistance from Lee Pullen, Director of Aging & Adult Services,
County of Marin. (April 2015)
Page 24