Recommendations & Action Items

The MPA provides a blueprint for enhancing communities to ensure that Missourians have the resources and support needed to thrive as they age. The MPA offers innovative recommendations across seven focus areas for state and local governments, businesses, and community-based organizations. Each recommendation is focused on achieving DHSS’s overarching vision of “Optimal health and safety for all Missourians, in all communities, for life.”

The recommendations presented in the following sections were developed through a collaborative process that included reviewing stakeholder input, analyzing promising practices, and expert discussions within the subcommittees. Each section summarizes the subcommittee’s area of focus, key themes and priorities raised during public engagement, and the resulting topic-specific recommendations and action items.

Inherent in the MPA are cross-cutting themes and recommendations that require multi-organizational collaboration, which are never unilateral or simple. To support stakeholders in determining how to implement MPA recommendations, DHSS has suggested categorizing action items by the level of effort required to achieve success: lower effort (L), medium effort (M), and complex effort (C), as explained below.

Themes and recommendations also overlap between focus areas and domains. Where applicable, overlapping topics within action items are indicated with the abbreviation of the subcommittee with which they overlap (icons shown in the chart below).

Recommendation: Reimagine volunteerism and promote civic engagement for older adults through cross-sector partnerships. (DLE1)

We can maximize the potential of the older population as volunteers in their communities by recognizing their exceptional level of skills, experience, passions, and desire to support their community in an organized manner.  The “buddy system” can ensure older volunteers have contact with others to build friendships, have someone to check in on them, and have someone to contact in an emergency. This can address social isolation and loneliness and support older adults in maintaining a sense of purpose.

Action Items:

• DLE1.1: Convey the capacity and potential of older adults as volunteers by partnering with nonprofit organizations to promote awareness of the valuable skills, experiences, and passions older adults bring to service roles. L
• DLE1.2: Discuss and disseminate best practices in recruiting and supporting older adult volunteers. L
• DLE1.3: Encourage organizations to adopt a “buddy system” that pairs older adult volunteers together to reduce isolation, promote social connection, and provide mutual support. L
• DLE1.4: Work with state and local governments to create information for individuals preparing for retirement to become involved in civic or social activities to help transition into retirement more smoothly. L
• DLE1.5: Encourage employers to provide information on civic and volunteer engagement opportunities to individuals preparing for retirement. L
• DLE1.6: Promote the ‘double advantage’ of older adult volunteerism of benefiting the older volunteers while boosting the capacity of the nonprofits. L
• DLE1.7: Promote the benefits of employers providing time off to volunteer in the community. L
• DLE1.8: Work with health care organizations to highlight the benefits of “prescribing” volunteerism to patients identified as being socially isolated or lonely. M

Recommendation: Strengthen employment access and economic stability for older adults and adults with disabilities. (DLE2)

Older adults and individuals with disabilities need access to meaningful employment opportunities that support financial independence. This includes improving awareness and availability of state-funded employment support programs, addressing benefit cliffs and earned income limitations, promoting flexible and phased retirement options, and incentivizing employers to hire and retain workers through tax policy and education. Employment should be treated as an economic necessity and a pathway to social connection.

Action Items:

• DLE2.1: Inform employers of the value of hiring, developing and retaining older workers and workers with disabilities.
• DLE2.2: Educate employers on the benefits of pursuing various workplace programs, such as the American Association of Retired Persons (AARP’s) Employer Pledge Program, which demonstrate commitment to older workers. L
• DLE2.3: Increase financial incentives and awareness of the Missouri Work Opportunity Tax Credit (WOTC), which provides incentives to employers to hire individuals in certain targeted groups. M
• DLE2.4: Support removing the age 65 cap on the federal Earned Income Tax Credit. M
• DLE2.5: Establish new and enhance existing non-SCSEP partnership opportunities with non-profits that offer employment support programs (MERS Goodwill, Oasis Institute, Salvation Army, Urban League of St. Louis and Kansas City, Catholic Charities of Kansas City/St. Joseph, Missouri Works Initiative, etc.) and help these entities increase the visibility of these programs. M
• DLE2.6: Assess the availability and affordability of caregiving services for older adults and identify opportunities to expand such services to minimize the impact on employment, daily life activities, and volunteering for employees who are also caregivers. M | FC
• DLE2.7: Review existing earned income and asset caps for all state-provided benefit programs to determine if changes would increase employment opportunities for older workers and workers with disabilities and enhance programs that educate beneficiary recipients on the impact of additional employment income on benefit levels. M
• DLE2.8: Implement best practices to Missouri’s age and disability-related employment laws to encourage more hiring of older adults and individuals with disabilities. C
• DLE2.9: Implement cost-beneficial enhancements to all state-funded, non-SCSEP employment support programs to better support older workers and workers with disabilities and significantly increase target audience awareness of these programs and make them easier to access. C
• DLE2.10: Implement/modify tax credits to support employment for older workers and workers with disabilities of all ages. C
• DLE2.11: Establish new tax credits to incentivize donations to non-profit organizations that provide services to older workers and workers with disabilities (similar to the Youth Opportunity Tax Credit). C
• DLE2.12: Implement value-based purchasing/financial incentives at each state agency to improve the quality of state-funded employment support programs. C
• Recommendation: Improve access to recreation, fitness, and public spaces for older adults and adults with disabilities. (DLE3)

Improving access to recreational and community spaces, physical activity programs, and decision-making processes helps combat social isolation, promotes healthy aging, and ensures older adults and individuals with disabilities can fully participate in daily life. These strategies promote well-being by making public spaces more accessible, responsive, and supportive of active community engagement.

Action Items:

• DLE3.1: Work with Missouri State Parks and the Missouri Parks Association to increase Seniors to Parks programs within the state. L
• DLE3.2: Systematically and consistently engage older adults, adults with disabilities, and caregivers to help identify issues, plan, develop community solutions and go to where they are already; don’t expect them to come to you. (“Outside-in” approach). M
• DLE3.3: Encourage health plans/Medicare/Medicaid to cover recreational fitness and patient companion programs for older adults and adults with disabilities and implement these programs. C
• DLE3.4: Work with state and local governments, public universities, and businesses to improve accessibility (universal design) to buildings and parks. C | HAIP

Recommendation: Expand educational and digital access for older adults and adults with disabilities. (DLE4)

Enhancing access to educational opportunities and digital literacy can help older adults and individuals with disabilities remain connected, informed, and actively engaged in their communities. By strengthening partnerships with educational institutions and expanding access to technology education, Missouri can promote lifelong learning, workforce development, and community participation across generations.

Action Items:

• DLE4.1: Assess existing governmental, non-profit, and for-profit programs that offer technology education to older adults and adults with disabilities and identify additional programs and/or activities to increase availability, awareness, and usage. L | SS
• DLE4.2: Work with community colleges and universities to increase access to classes for older adults. M
• DLE4.3: Improve access and participation in degree and certificate programs, continuing education classes, and enrichment programs. M
• DLE4.4: Include courses on working with older adults and adults with disabilities as part of Community Health Worker credentialing. M
• DLE4.5: Develop intergenerational programs as part of Geriatric Workforce Enhancement Programs (GWEP) to increase the numbers of college students working with older adults and adults with disabilities in communities. M

Recommendation: Increase Access to Caregiver Resources and Innovative Community-Based Supports. (FC1)

Family caregivers often struggle to navigate the landscape of available supports. Missouri can improve outcomes by ensuring that information about services and support, including respite care and caregiver rights, is easy to find and access. Leveraging existing systems and promoting consistent dissemination of resources will reduce confusion and increase utilization.

Action Items:

• FC1.1: Leverage existing infrastructure (e.g., 211) and emerging technology (e.g., electronic medical record systems, Community Information Exchange) to improve visibility and utilization of resources. L | NWD
• FC1.2: Educate and incentivize consumers to complete long-term and advance care planning, including advance directive documentation. L
• FC1.3: Evaluate and scale innovative community-based and volunteer programs (e.g., senior companion programs, phone-based outreach, peer support groups, volunteer respite services). M | DLE
• FC1.4: Create and socialize a comprehensive list of resources available to family caregivers of all ages and across the lifespan to both consumers and professionals; ensure inclusion of respite and care alternatives; identify and include requirements for federal, state, and/or organizational benefits. M | NWD

Recommendation: Invest in the Caregiving Workforce to Better Support Families. (FC2)

In addition to the valuable role family caregivers play, paid direct care workers provide important supports not just to older Missourians, but also their caregivers. Investing in workforce development, especially for home- and community-based workers, can reduce strain on families, support continuity of care, and help caregivers balance their roles.

Action Items:

• FC2.1: Consider innovative workforce strategies such as thorough and paid training, providing transportation to client sites, full-time employment, expanding benefits, guaranteeing a minimum number of hours or advancing pay in emergencies. L
• FC2.2: Consider innovative policies to support employees in health care fields, such as expanding the cap on income for those on social security and/or disability. C
• FC2.3: Leverage and centralize available training and education for professional care providers and family caregivers to improve care. L
• FC2.4: Consider replicating community-based or volunteer-powered programs. M | DLE
• FC2.5: Provide credentialing to direct care workers to support career development. M
• FC2.6: Provide professional care employers (e.g., Home Care, Adult Day) with assistance and incentives to develop and extend benefits for direct care workers to support respite and family caregiving needs. C

Recommendation: Support Working Family Caregivers Across Employment Sectors. (FC3)

Missourians who balance paid employment with caregiving responsibilities often lack the workplace supports they need to sustain both roles. Policy and employer-driven changes that promote flexibility and protect job security can ensure family caregivers are not forced to choose between earning a living and caring for a loved one.

Action Items:

• FC3.1: Promote caregiver employment supports for all, recognizing potential differences between jobs that require in person attendance (e.g., health care, food service) and remote or flexible roles. M
• FC3.2: Incentivize public and private employers to support family caregivers in remaining in the workplace through innovative models to support family caregivers (tax credits, family leave/bereavement policies, flexibility etc.) and consider hurdles based on employment site (required in person attendance versus remote). C

Recommendation: Strengthen Support for Kinship Caregivers. (FC4)

Kinship caregivers are often overlooked in formal systems. By recognizing and supporting these caregivers – financially, legally, and through planning tools – Missouri can reduce crises and improve outcomes for both caregivers and care recipients.

Action Item:

• FC4.1: Allow funding for support of kinship caregivers providing care outside the formal foster care system, including but not limited to legal services, financial assistance and respite care. C

Recommendation: Develop a state oversight agency appointed by the Governor. (HAIP1)

Aging and housing challenges span multiple agencies, funding streams, and service systems. Without centralized oversight, efforts to address them can be fragmented and duplicative. Establishing high-level leadership enables accountability, cross-sector collaboration, and a unified strategy to help Missouri residents age safely and independently in their homes and communities.

Action Items:

• HAIP1.1: Appoint a Deputy Cabinet Secretary/Special Council with cross-departmental authority to oversee and execute the following recommendations. M | NWD
• HAIP1.2: Form a cross-departmental task force that includes leadership from each agency responsible for implementing the MPA. This cross-departmental task force shall ensure there is a strategic plan that coordinates all MPA goals, responsibilities, and evaluation metrics. M | NWD

Recommendation: Focus on finance and funding. (HAIP2)

Stable, affordable, and accessible housing cannot be achieved without sustained financial investment. Strengthening funding mechanisms is critical to meeting the growing demand and ensuring access to safe housing options across the state for all.

Action Items:

• HAIP2.1: Determine if hospitals, Home Health Agencies, Programs of All-inclusive Care for the Elderly (PACE), Accountable Care Organizations, and providers are willing to pay for home modifications to drive down readmissions and allow for faster discharges. M | HAIP
• HAIP2.2: Increase funding to Department of Health and Senior Services (DHSS) and Department of Mental Health (DMH)/Division of Developmental Disabilities waiver programs and Older Americans Act (OAA) Funding administered through the state’s Area Agencies on Aging (AAAs) to incentivize more contractors to provide home modifications services. Additionally, the limits on home modifications should be increased, and automatic incremental increases should be added for the Consumer Price Index (CPI)/inflation. C
• HAIP2.3: Create a tax credit or financial relief for family members with disabilities who are financially challenged and live with their family members, provided that the family members provide care to the individual. C | FC
• HAIP2.4: Increase state and local funding available to support affordable housing services and development, particularly funding for home maintenance, modifications, and repairs. C
• HAIP2.5: Increase funding to the LIHTC program to meet Missouri's affordable housing needs. C
• HAIP2.6: Allocate adequate funding for the analysis of statewide demographic data to ensure effective and efficient resource allocation. Based on the data analysis findings, the Missouri Housing Development Commission (MHDC) should receive funding to expand universally designed apartments through the LIHTC. C
• HAIP2.7: Redirect housing funds to incentivize developers to invest in affordable and accessible housing. C
• HAIP2.8: Incentivize relevant state and local stakeholders (e.g., housing finance agencies, developers, community organizations) to integrate universal design elements into all housing types. C
• HAIP2.9: Missouri must comply with the Fair Housing Act, bringing federal funding back to Missouri. C

Recommendation: Focus on law, legislation, and legal issues. (HAIP3)

Policy and legal frameworks shape the housing landscape in important ways. Updating existing statutes and exploring thoughtful reforms can help remove impediments to housing access, strengthen protections, and ensure programs work effectively for those who need them. This includes aligning state laws with best practices while building on Missouri’s ongoing efforts to improve access and support for all.

Action Items:

• HAIP3.1: Provide counsel through legal aid for older adults, adults with disabilities, and low-income individuals when evicted. Eviction cannot occur until the action has passed through the court system. M
• HAIP3.2: Expand the LIHTC Program to meet Missouri's growing need for affordable housing. C
• HAIP3.3: Evaluate and replace LIHTC housing where it is being lost. Prioritize developments where properties are expiring. C
• HAIP3.4: Address comprehensive housing and zoning issues that can increase the development of universal design housing and community living programs. C
• HAIP3.5: Adopt standardized building codes. C
• HAIP3.6: Implement policies to establish standards and set percentage targets for new construction. C
• HAIP3.7: Pass zoning changes that expand housing options and requirements to offer upgrade packages for privately funded construction. C
• HAIP3.8: Pass a law regarding pre-housing fees that do not require renters to repeatedly apply with property management companies, complete multiple applications, and pay costly, non-refundable application fees. C
• HAIP3.9: Pass a housing reform bill that will make it easier for individuals to access housing vouchers on every level, from city to state. C
• HAIP3.10: Update existing state programs and legislation pertaining to existing property tax assistance programs. C
• HAIP3.11: Expand the Circuit Breaker - Missouri Property Tax Credit (MO-PTC), to ensure that eligible older adults and individuals with disabilities can participate. C
• HAIP3.12: Develop a “Clean Slate” policy on eviction expungement for renters so that previous evictions do not remain on the record for an extended period. C

Recommendation: Focus on improving program administration and processes.

Many strong programs already exist in Missouri, but clearer processes, improved coordination, and easier access to services can make them even more effective. Streamlining operations and fostering collaboration across sectors can help ensure programs are responsive, accessible, and well positioned to meet residents’ evolving needs.

Action Items:

• HAIP4.1: Centralize information and resources for Missouri residents to access information on affordable housing. L | NWD
• HAIP4.2: Coordinate housing maintenance programs to help people who are aging and individuals with disabilities remain in their homes. L
• HAIP4.3: Encourage regional networks of home repair providers to collaborate to provide services and share referrals. L
• HAIP4.4: Streamline provider enrollment for contractors into State Medicaid Waiver programs. M
• HAIP4.5: Use state departments and other stakeholders to facilitate opportunities for small developers to partner with large not-for-profit developers to increase financial sustainability into the LIHTC 15/30-year affordability period. M
• HAIP4.6: Develop a way for individuals who leave nursing homes to document their actual income, as it is currently difficult for those on SSI to show the amount of money going to the nursing facility, rather than just their allocated spending money. M | LTSS
• HAIP4.7: Create a Missouri Housing Ombudsman to oversee a statewide system for Missourians to access assistance regarding rental issues. C
• HAIP4.8: Prioritize access to assistive, health-related, and remote monitoring technologies and support their use by expanding the state’s broadband infrastructure. C
• HAIP4.9: Develop statewide minimum standards for rental properties with penalties for those out of compliance. C
• HAIP4.10: Allow subcontracting of construction through state Medicaid programs. C

Recommendation: Conduct public education and awareness campaigns. (HAIP5)

Awareness of available resources is often the first step in accessing support. Education and outreach, tailored to tenants, landlords, and communities, can help expand understanding of housing rights, financial supports, and accessibility options. These efforts build on existing work and can play another key role in helping Missourians make informed choices about their housing futures.

Action Items:

• HAIP5.1: Promote examples of existing programs and resources for home maintenance, modifications, and repairs in Missouri and other states to highlight different approaches that could be replicated or expanded in Missouri. L
• HAIP5.2: Educate aging adults via public service announcements, television, and radio on the availability of coordinated housing supports in Missouri. L
• HAIP5.3: Create a list and/or flow chart of available funding (PACE, Veterans Affairs, DHSS, DMH, etc.). L
• HAIP5.4: Ensure organizations providing essential and connective services to individuals who are aging, individuals with disabilities, and their caregivers, are aware of funding sources. L
• HAIP5.5: Develop promotional materials and initiation of outreach efforts. L
• HAIP5.6: Promote existing property tax assistance programs available at the state and local levels. L
• HAIP5.7: Educate renters on renters’ rights, how to get legal assistance for the defense of eviction, ADA requirements of landlords, and the renters' expectations. L
• HAIP5.8: Establish and maintain a website, develop promotional materials, and initiate outreach efforts around universal design education and public awareness for state and local stakeholders and the general public. L
• HAIP5.9: Educate individuals and entities on the state law which prohibits evictions for survivors of domestic violence in the home when police are called to assist the survivor. L | SS
• HAIP5.10: Adopt a definition of universal design to provide clarity of purpose, increase inclusion, and create a single definition used across governmental agencies. M
• HAIP5.11: Support a statewide educational campaign highlighting information and benefits for communities and developers about affordable housing success, universal design in new developments, accessory dwelling units, and community and intergenerational living. M
• HAIP5.12: Create a “one-stop shop” within the NWD organization and aging media resources, tools, and plans to be used by the Cross-Departmental Task Force to communicate Missouri's affordable housing needs and resources. Upload all resources and documents into one site for Missouri. M | NWD
• HAIP5.13: Educate landlords on ADA responsibilities, eviction laws and renters’ rights. M

Recommendation: Promote Advanced Planning and Affordability.

Informed choice begins with advanced planning for LTSS care which has a direct impact on the affordability of that care. Therefore, this committee recommends actions that will enable more Missourians to:

• Make LTSS decisions prior to needing such services due to aging, disability, or life altering event.
• Utilize financial arrangements that improve affordability of LTSS options.

Action Items:

• LTSS1.1: Educate professionals and the general public about who pays for LTSS now, including limitations with current Medicare programs (both traditional and Advantage plans) and LTSS coverage. L
• LTSS1.2: Offer structured education sessions on financial literacy, formal savings arrangements, and legal decision-making tools, including utilization of Charting the Life Course, at various life transition points to help normalize LTSS decisions for consumers and their loved ones (i.e., upon entry into middle school, high school graduation, marriage, birth of children/grandchildren, retirement planning, etc.) L
• LTSS1.3: Market existing financial arrangements available for LTSS, including public education campaigns (i.e., ABLE accounts, Qualified Income Miller Trust, Shared Care Tax Credit, Long-Term Dignity Savings Accounts, long-term care insurance, etc.) M | FC
• LTSS1.4: Explore and develop new long-term care tax credit, savings models, and/or investments that incentivize consumer contributions with associated match (i.e., Washington Cares Fund). C

Recommendation: Maintain access to existing LTSS options. (LTSS2)

Missouri’s investments in its current array of LTSS must be maintained while finding opportunities to increase the quality of care provided. This includes supporting provider reimbursement rates of Medicaid LTSS across settings (i.e., home, community, and congregate settings), including sufficient caregiver wages to remain competitive with market conditions.  It also requires continued funding to support additional Medicaid waiver slots to appropriately serve individuals as they age and avoid waitlists.  This committee recommends actions to:

Action Items:

• LTSS2.1: Review existing service authorization processes and develop options to encourage person-centered service delivery. L
• LTSS2.2: Explore opportunities available to advance quality and integrity of HCBS through oversight, education, and outreach. L
• LTSS2.3: Increase public education regarding transparency of existing long-term care facility survey results and complaints and resources available to facilities in need of remediation. L
• LTSS2.4: Build and enhance value-based payment options to ensure quality care, driven by positive outcomes, is given by providers. M
• LTSS2.5: Pursuant to the federal Medicaid Access Rule, establish and manage a grievance process for consumers receiving HCBS to notify the state regarding complaints, trends, and compliance with person-centered planning and the HCBS Settings Rule requirements.  Similarly, Missouri will operate and maintain an electronic incident management system to identify, report, triage, investigate, resolve, track, and trend critical incidents among HCBS participants. M
• LTSS2.6: Invest in additional paid ombudsmen to meet the needs of residents and support a more extensive network of volunteer ombudsmen. M | DLE
• LTSS2.7: Invest in additional state surveyors of long-term care facilities at a competitive wage to address the needs for increased regulatory oversight and growing complaints. M
• LTSS2.8: Enhance existing monitoring and quality assurance of LTSS in congregate settings. M
• LTSS2.9: Increase access to, and effective utilization of, assistive and enabling technologies, including the support infrastructure to link participants to the appropriate technology to meet their identified needs and the follow-up to ensure said technology continues to meet needs over time. C | FC
• LTSS2.10: Explore and implement the provision of therapies (OT, PT, cognitive, and speech) outside of a clinic or facility setting. C | WPH
• LTSS2.11: Support provider reimbursement rates of Medicaid LTSS across the settings (home, community, and congregate settings) including sufficient caregiver wages to remain competitive with market conditions. C | FC
• LTSS2.12: Continue to fund additional Medicaid waiver slots to appropriately serve individuals as they age and avoid waitlists. C

Recommendation: Increase access to more LTSS options. (LTSS3)

While existing LTSS options must be maintained, Missouri and its partners must do more to ensure there are sufficient services and supports to meet increasing demand for choice and person-centered care options.  This committee recommends actions to:

• Expand the array of LTSS options and where they are provided. 

Action Items:

• LTSS3.1: Analyze promising LTSS models of care identified by national health policy organizations and determine feasibility for implementation in Missouri’s LTSS system. L
• LTSS3.2: Support additional advancements in the Show Me Homes program (i.e., Money Follows the Person) to ensure more residents of congregate settings are aware of the array of LTSS options available, including transition services. M | HAIP
• LTSS3.3: Explore and invest in additional “intentional communities” through grants to local organizations to coordinate and ensure services are available to support aging in place such as Naturally Occurring Retirement Communities (NORC), Community Aging in Place—Advancing Better Living for Elders (CAPABLE), Independent Supportive Living (ISL) arrangements, and multigenerational communities. M | HAIP
• LTSS3.4: Increase person-centered practices in all LTSS settings through enhanced training that respects self-determination (i.e., The Eden Alternative, Charting the Life Course, etc.) M
• LTSS3.5: Serve more Missourians through additional Adult Day Care Centers, Day Habilitation Centers, PACE, and Prescribed Pediatric Extended Care (PPEC) facilities across the state. C | FC
• LTSS3.6: Expand comprehensive behavioral health services for individuals with severe mental illness living in both community and congregate settings that meet individual needs in the least restrictive setting. C
• LTSS3.7: Expand access to additional LTSS options serving individuals in need of memory care, traumatic or acquired brain injury rehabilitation, tracheotomy care, ventilator care, and/or who are blind or have hearing impairments. C

Recommendation: Support workforce recruitment and retention. (LTSS4)

Expansion of LTSS options requires investment in staffing to ensure care and support is delivered according to best practices and established standards meet the needs of the intended beneficiaries. Therefore, this committee recommends actions to:

• Increase the number of paid caregivers working across LTSS settings.
• Support a thriving caregiver network that is appropriately trained and paid competitive wages to provide quality LTSS to consumers.

Action Items:

• LTSS4.1: Develop a comprehensive crosswalk of entry level caregiver positions in Missouri, regardless of LTSS setting, and their associated responsibilities, training, and requirements. Crosswalk will contain, at a minimum, the following professions: direct service worker/personal care attendant, certified nurse aide, direct service professional (including apprenticeship option), medication aides, and community health workers.
  L | FC
• LTSS4.2: Identify gaps in current caregiver training practices and develop opportunities for targeted training development, including both online training options and hands-on learning labs (i.e., communication and other soft skills, trauma-informed care, Occupational Safety and Health Administration (OSHA), dementia, body mechanics, chronic health conditions, holistic care, behavioral health, etc.). L | FC
• LTSS4.3: Seek ongoing feedback from various paid caregivers to identify areas where caregivers are excelling and opportunities for workforce improvement. L | FC
• LTSS4.4: Rebrand aging and caregiving fields through public media workforce recruitment campaigns which highlight the benefits of caregiving careers and the various training options available. L | FC
• LTSS4.5: Explore opportunities to support caregivers in training, including, but not limited to, formal mentorships, financial scholarships, stipends, paid apprenticeship/pre-apprenticeship options, etc. L | FC
• LTSS4.6: Create a caregiving career lattice that identifies advancement opportunities to both medical and social service fields. M | FC
• LTSS4.7: Identify and address any hurdles that may limit an increase in training enrollment such as limitations on approved websites or lack of qualified instructors. MLTSS4.8: Resolve pipeline issues related to workforce shortage for registered nurses and licensed practical nurses that are responsible for both skilled care and oversight of entry level caregiver positions. C
• LTSS4.9: Invest in early exposure to LTSS careers through purposeful engagement with middle and high school students and nursing students (i.e., shadowing opportunities, volunteerism, and internships). C
• LTSS4.10: Develop standardized curriculum for high school, community college, or other training programs that adequately prepares caregivers to serve in any type of LTSS setting or population of choice. Such training materials should be available in languages other than English (including American Sign Language). C | FC

Recommendation: Provide comprehensive service navigation. (LTSS5) NWD

Any comprehensive system of LTSS requires careful navigation to appropriately address Missourians’ needs in a timely manner and regardless of payer source.  Therefore, this committee recommended the state and its partners:

• Continue to develop a person-centered intake and referral system, utilizing braiding and blending of funds as appropriate, to assist Missourians in navigating the LTSS system. NWD
• Invest in consumer-friendly technology that allows the sharing of health care, social services, and LTSS information to ensure that all Missourians are receiving person-centered care with minimal duplication of effort. NWD

Action Items:

• LTSS5.1: Establish an ongoing statewide LTSS Navigation Council. L | NWD
• LTSS5.2: Ensure that veterans and their qualifying spouses are included in the development of the No Wrong Door framework. L | NWD
• LTSS5.3: Develop education and training to help more LTSS professionals recognize their role as system navigators. L | NWD
• LTSS5.4: Develop an LTSS 101 training for professionals and the general public to understand the cadre of services available in LTSS and the best place to contact for further information and assistance (to include policy recommendations for each cabinet-level department to include LTSS 101 training as a part of orientation, annual training, etc. as needed to assure all state departments can get any Missourian to a designated access point). L | NWD
• LTSS5.5: Develop a website to locate assistance for aging and disability-related services in Missouri which meets plain language and accessibility functions, including use of artificial intelligence technology to enhance access to information and assistance.
  L | NWD
• LTSS5.6: Develop enhanced training for all information and referral staff across the aging and disability networks to ensure they can assist individuals in navigating the LTSS system to find the best services and supports for their unique needs. L | NWD
• LTSS5.7: Develop training for healthcare professionals to ensure they are aware of the cadre of services available in the aging and disability network to better enable them to make appropriate patient referrals. L | NWD
• LTSS5.8: Develop training for individuals in the aging and disability networks to enable them to make appropriate referrals to healthcare professionals. L | NWD
• LTSS5.9: Review the peer support model used in the disability network and determine if similar credentialing can be developed for peer supports for older adults. M | DLE | NWD
• LTSS5.10: Offer consumers the opportunity to learn how to access and utilize technology and information systems that includes their information to make informed choices about their care. M | NWD
• LTSS5.11: Revamp LTSS intake processes to utilize a standardized screening and assessment that utilizes a whole person-centered concept. C | NWD
• LTSS5.12: Establish accessible “hubs” (physical and/or virtual) to engage with clients and their families to help them set up planning options that will assist individuals with accessing the services and supports that fit their unique needs. C | NWD

Recommendation: Strengthen legal protections against abuse, neglect, and financial exploitation. (SS1)

The subcommittee recommends revising statutes to close legal gaps, improve enforcement, and provide clearer guidance for professionals and families. Priorities include updating adult protective services laws, strengthening Power of Attorney statutes, and enhancing penalties for crimes targeting older Missourians.

Action Items:

• SS1.1: Strengthen and update older adult abuse statutes (including, but not limited to, those governing adult protective services, mandatory reporting and penalties for abuse and neglect, and criminal offenses related to theft, fraud, and exploitation of vulnerable adults). C
• SS1.2: Review appropriate statutes and work with experts to identify legislative sponsors, develop/draft and lobby for changes to policy. C
• SS1.3: Hire appropriate legal expertise to do a comprehensive review of the statutes with recommendations to reform, simplify, and identify impediments—for example, prosecutors may not use the older adult abuse laws because they are not clearly defined and are complicated. C
• SS1.4: Strengthen and update Power of Attorney statutes and make Power of Attorney resources available and more robust in all areas of the state. C
• SS1.5: Strengthen classification of crimes where survivors are older adults. C

Recommendation: Expand public education and awareness about safety risks and protective actions. (SS2)

Expanding public education and awareness is essential to prevent abuse, neglect, and exploitation before it occurs. Many older adults and adults with disabilities are unaware of financial protections, common scams, or how to navigate legal tools like a power of attorney. Public-facing education efforts—especially those tailored to different learning styles, languages, and cultural contexts—can empower individuals and families to take proactive steps.

Action Items:

• SS2.1: Create/modify and provide relevant and engaging training related to all aspects of financial security, including saving, budgeting, tax credits, benefits, estate planning, power of attorney, and investing. L
• SS2.2: Create/modify and provide relevant and engaging training related to scams, frauds and neighborhood watch information. L
• SS2.3: Create and provide relevant and engaging training related to AI scams. L
• SS2.4: Provide relevant and engaging training related to financial exploitation and abuse for banks/financial institutions and the general public. L
• SS2.5: Provide relevant and engaging training and education related to physical safety for the general public. Review current resources related to physical safety and create new resources to fill gaps (especially around neighborhood safety, falls prevention, safe environment, public transportation, driving, and crime prevention). L
• SS2.6: Improve the dissemination of information about safety and security to the public and professionals by creating a website to house all information related to the safety and security of aging Missourians and adults with disabilities.  Create print, TV, and radio campaigns to better educate the public, and have print materials available at state offices and other places in the community. Consider using the Senior Resource Guide (produced by Legal Services of Eastern Missouri) as a model resource. L
• SS2.7: Develop public education on Power of Attorney, including the definition of a power of attorney, common challenges, and work with Missouri Bar to offer safeguards. L
• SS2.8: Create a paid position to manage safety and security resources on state agency websites and possibly provide training across the state. (This could be a shared position that manages resources and training related to all aspects of aging in Missouri). M
• SS2.9: Create new, or strengthen existing, public education to increase trust in the state government and prevent exploitation and abuse. Work with community organizations to create and share resources with Missourians. M

Recommendation: Increase training and accountability for mandated reporters and professionals. (SS3)

Many professionals and mandatory reporters, especially those in financial institutions, health care, and law enforcement, could benefit from clearer guidance and tools. Training should be accessible and tailored to the real-world situations that professionals encounter. Raising expectations for accountability and equipping professionals with the right knowledge can help enable timely, appropriate intervention.

Action Items:

• SS3.1: Create and/or modify and provide education and outreach materials to promote accurate understanding of aging and disability, highlighting strengths, contributions, and the value older adults and adults with disabilities bring to the community. L
• SS3.2: Educate law enforcement and first responders on how to respond to individuals with dementia, developmental disabilities, and other cognitive disabilities where people may have communication challenges. L
• SS3.3: Educate law enforcement and first responders on how to report and prosecute cases related to abuse, neglect, and exploitation. L
• SS3.4: Educate the general public about the process of reporting and prosecuting abuse, neglect, exploitation, and other crimes. Include information to educate about abuse and reduce stigma around abuse and its reporting. L
• SS3.5: Improve education to mandated reporters about their responsibilities when abuse, neglect, or exploitation is suspected by:
  
  Creating/modifying and providing relevant and engaging training to provide education to banks/financial institutions.
  
  Creating a toolkit to share with all mandated reporters; targeting professionals and informal caregivers/family members.
  
  Encourage reporting by promoting messages that emphasize the importance of reporting suspected abuse, neglect, or exploitation. L

Recommendation: Promote collaboration through multidisciplinary teams (MDTs) and interagency coordination. (SS4)

No single agency or system can meet all the needs of vulnerable adults, especially in complex cases. Strengthening cross-agency communication, aligning protocols, and expanding the use of MDTs can reduce duplication, streamline interventions, and improve survivors’ outcomes. Missouri’s ongoing expansion of MDTs provides a foundation for building more unified, trauma-informed systems of support.

Action Items:

• SS4.1: Implement a multidisciplinary team approach when responding to complicated cases of abuse, neglect, and financial exploitation. M
• SS4.2: Improve interactions between aging Missourians/adults with disabilities in Missouri and Law enforcement and other first responders by increasing programs that bring additional professionals into the police force and other first responder groups to help with situations involving individuals with dementia, developmental disabilities, communication challenges (such as Deaf and Hard of Hearing communities). Consider requiring additional education regarding target populations as a requirement for credentialing. M
• SS4.3: Identify ways for DHSS special investigators to continue to improve collaboration with local jurisdictions. Review other states’ processes to explore expansion of authority. M
• SS4.4: Develop a coordinated and integrated response to abuse, neglect, and exploitation that is consistent and centered on the abused person, including creating common definitions and language, defining processes, removing redundancies, and identifying opportunities to streamline and share information. M

Recommendation: Improve data collection and information-sharing across systems. (SS5)

Improving how Missouri collects, shares, and uses data across systems is critical to identifying safety risks, targeting resources, and driving meaningful change. The Safety and Security Subcommittee highlighted the need for better coordination among government agencies, financial institutions, and community partners to detect patterns of abuse and exploitation, strengthen preventative strategies, and streamline responses. Leveraging tools like AI and screening frameworks, while also expanding access to public-facing data and resources, will support a more informed and proactive safety infrastructure statewide.

Action Items:

• SS5.1: Explore RADAR card expansion and/or develop screening questions to improve financial safety. The RADAR card provides resources and information to law enforcement who may interact with an older person or a person with disabilities. Develop/adapt RADAR card for other stakeholders and those who are in contact with older adults and/or individuals with disabilities. L
• SS5.2: Explore resources related to screening questions. Develop a plan to keep resources updated, provide training, and explore dissemination avenues to amplify the message and tool. L
• SS5.3: Establish a clearinghouse/library of existing resources on older adult abuse by:
  
  Reviewing Missouri Senior Report for possible use as a template or expand partnerships to add additional data and resources to the report.
  
  Considering the location of the library. It should be maintained in a logical place like the Missouri Council on Aging (MCoA) or DHSS.
  
  Simplifying information, keeping in mind consumer readability and relatability.
  
  Reviewing and leveraging materials from UMKC’s LifeCourse Framework Safety and Security domain, which encompasses staying safe and secure, including planning for emergencies, well-being, guardianship options, and legal rights and issues. M
• SS5.4: Explore AI, machine learning and the possible use of data mining, etc. by financial institutions and other organizations to combat fraud. Explore creating an AI task force to review current government structures and IT systems. Leverage relationships with the private sector to consult with the state. C

Recommendation: Support state investments in transportation infrastructure to leverage federal funding. (TM1)

Strategic investment in public transit, active transportation infrastructure, and mobility services enables Missouri to more fully leverage available federal transportation funds. Prioritizing state funding helps modernize systems, improve access, and reduce long-term costs for older adults and individuals with disabilities.

Action Items:

• TM1.1: Continue investment in MEHTAP to cover a portion of the transportation costs incurred by agencies providing mobility services to older adults and individuals with disabilities. M
• TM1.2: Reduce hurdles from local match requirements that prevent providers from accessing federal funds. M
• TM1.3: Increase state funding for public transit to align with peer states (e.g., Kansas), reaching an average of $3 per capita to ensure Missouri public transit is more adequately funded. C
• TM1.4: Increase state funding for transit capital match. C
• TM1.5: Establish a state funding source for bicycle/pedestrian projects, as Missouri currently has no dedicated state funding for active transportation projects. C
• TM1.6: Increase funding resources or other incentives for additional carriers to offer reduced fares/discounts for seniors and adults with disabilities (e.g., MEHTAP-funded fare reductions, free fare programs in Kansas City and St. Louis Metro). C
• TM1.7: Increase recurring state funding for the MO River Runner (Amtrak) and consider additional funding for other Amtrak routes and stops. C
• TM1.8: Implement a low-cost repair program for seniors to address transportation roadblocks due to vehicle disrepair. C

Recommendation: Support expansion of coordination among agencies and transportation modes. (TM2)

Coordinated transportation systems across regions, providers, and services improve access and efficiency, especially for older adults and individuals with disabilities. Mobility management, technology, and shared service models are key strategies for expanding capacity and reducing service gaps.

Action Items:

• TM2.1: Conduct a statewide gap analysis to identify where providers do not have capacity to meet transportation needs, study other states' paratransit coordination models. L
• TM2.2: Promote awareness and expansion of online and phone-based mobility management resources (e.g., MO Rides). L
• TM2.3: Conduct regional training for transit and human services staff to increase knowledge of how to coordinate across transportation providers. L
• TM2.4: Improve access to book-ahead and on-demand transportation, including promoting and expanding subsidized options. M
• TM2.5: Expand use of regional call centers and booking apps while maintaining call-in options for those without smartphones or credit cards. M
• TM2.6: Engage public and private partners—including churches, senior centers, towns—to increase same-day or flexible ride options. M
• TM2.7: Increase funding for providers to improve call-handling capacity and prevent riders from being turned away. M
• TM2.8: Invest in state-supported mobility management infrastructure. C
• TM2.9: Invest in shared dispatch or trip scheduling systems that allow different providers to share rides or coordinate trips. C

Recommendation: Improve or implement programs to assist with vehicle and driver shortages. (TM3)

Reliable transportation services depend on vehicle availability and a trained, supported driver workforce. Addressing maintenance, procurement, workforce compensation, and insurance challenges will strengthen the state’s transportation infrastructure and resilience.

Action Items:

• TM3.1: Promote electric vehicles and alternative fuel transit fleets. L
• TM3.2: Explore opportunities for transportation insurance cooperatives or other strategies to reduce costs for programs relying on volunteer drivers. L
• TM3.3: Develop or expand statewide transportation operator training/apprenticeship programs to build workforce pipelines. M
• TM3.4: Address vehicle maintenance and availability by promoting awareness of repair funding options and encouraging investment from philanthropy or state resources to support emergency vehicle repairs. M
• TM3.5: Increase compensation for drivers and address regional wage disparities to support driver retention. C
• TM3.6: Work for the passage of the Volunteer Driver Tax Appreciation Act to increase the charitable mileage reimbursement rate from $0.14 to the IRS business rate. C
• TM3.7: Develop state funding opportunities for vehicle and equipment procurement outside of the 5310 program to address federal backlog issues. C
• TM3.8: Expand use of electric vehicles or alternative fuel fleets and provide match funding to support federal grants or infrastructure development. C
• TM3.9: Increase pay for transportation drivers and address pay differences. C

Recommendation: Encourage innovation in flexible transit options, including rural communities. (TM4)

Missouri should promote innovations that improve first/last mile connectivity, increase regional mobility, and ensure residents in all areas—including rural communities—can travel easily across county lines and access other transit modes. These solutions must include expanded micro-transit, intercity options, and greater support for existing MoDOT-funded providers and volunteer programs that fill key gaps in service.

Action Items:

• TM4.1: Support existing MoDOT-funded transit providers to continue delivering essential transportation services, especially in rural areas. L
• TM4.2: Support volunteer driver programs that help fill service gaps, such as Jewish Family Services Jet Express, New Growth Transit in West Central MO, and ITN in St. Charles County. L
• TM4.3: Improve intercity transit services to connect residents to other modes of transportation and across counties. M
• TM4.4: Expand micro-transit for first/last-mile connections to public transit. M
• TM4.5: Enhance connectivity between cities and towns to enable seamless travel statewide. C

Recommendation: Provide education and training to older drivers, including safe driving, information about transportation options other than personal vehicles, and how to use mobility apps. (TM5)

Education and outreach are critical for ensuring that older adults and individuals with disabilities feel safe and confident using available transportation options. User-friendly guides and training programs help reduce confusion and promote independent mobility.

Action Items:

• TM5.1: Maintain and promote safe driver and public transit rider training programs. L
• TM5.2: Provide accessible rider guides on how to use public transportation, including apps and other mobility tools. L
• TM5.3: Improve outreach and publication of transit options so that residents are aware of available services. L | NWD

Recommendation: Utilize the Built Environment concept when developing or revitalizing infrastructure to assure community walkability, increase pedestrian safety, and provide accessible and connected transportation options for travelers of all ages and abilities. (TM6)

Investing in walkable infrastructure and age-friendly design promotes health, safety, and accessibility for all Missourians. State and local planning must support streets and neighborhoods that encourage movement, transit use, and aging in community.

Action Items:

• TM6.1: Train residents on how to identify and report environmental and infrastructure issues. L
• TM6.2: Sponsor trainings to support awareness and work to achieve accessibility and walkability. L
• TM6.3: Support local communities to create or implement active transportation plans and Complete Streets policies. M
• TM6.4: Develop and adopt Missouri’s first Statewide Active Transportation Plan through MoDOT. M
• TM6.5: Advance legislative priorities that promote walkable communities, including a statewide Complete Streets policy, transit-oriented development policies, and the removal of parking minimums. C

Recommendation: Ensure older Missourians are engaged in meaningful ways to determine what the transportation and mobility needs are and what solutions will work for them. (TM7)

Transportation systems must be designed with input from the populations they serve. Creating regular, meaningful opportunities for engagement helps ensure policies reflect real-world needs and foster solutions for all older adults and individuals with disabilities.

Action Items:

• TM7.1: Include older Missourians on transportation-related commissions, councils, and advisory boards. L
• TM7.2: Provide regular, accessible opportunities for feedback on transportation issues and solutions. L
• TM7.3: Conduct routine transportation needs assessments focused on older adults and individuals with disabilities. L

Recommendation: Improve access to healthcare services and screenings. This may include recommendations for increased coverage of services by health insurance organizations. (WPH1)

Action Items:

• WPH1.1: Increase access to a variety of health care services in the community and health care settings, including:
  • Addiction and overdose prevention measures.
  • Cognitive health screenings.
  • Fall risk assessments.
  • Hearing screenings.
  • Mental health screenings and support.
  • Physical and oral health screenings and treatment.
  • Suicide prevention measures.
  • Vaccines.
  • Vision screenings. C
• WPH1.2: Implement a variety of methods to increase access to health care, including:
  • Provide free and low-cost health care services in the community.
  • Enable transportation to and from health care appointments, paying special attention to rural communities. TM
  • Include vision, hearing, and oral health coverage as part of all health insurance plans, and require that insurance plans cover preventive services and more intensive services.
  • Enable providers to have adequate time allocated to meet with patients to discuss vision, hearing, and oral health issues. 
  • Increase and/or expand state-level health insurance for health conditions impacting older adults and adults with disabilities, including behavioral health and cognitive health conditions.
  • Increase access to dietitians and other nutrition professionals to support healthy eating.
  • Enable virtual/telehealth appointments with health care providers, including physical therapists and exercise trainers. C

Recommendation: Increase access to and availability of programs that promote health and wellness. (WPH2)

Action Items:

• WPH2.1: Incorporate elements into fitness programs to help engage a variety of participants (for example, including music in wellness classes). L
• WPH2.2: Promote websites and apps that provide educational programs, cognitive games, and safe social groups for older adults to join. L
• WPH2.3: Provide transportation assistance for programming scheduled at night and in the winter months, considering vision issues when driving in the dark. M | TM
• WPH2.4: Create more flexible fitness offerings for older adults who are caregivers for children, grandchildren, or family members with disabilities. M | DLE
• WPH2.5: Offer more options for programming outside the standard 8:00 am-5:00 pm window. M
• WPH2.6: Have programs available in multiple languages and/or have translation services. M
• WPH2.7: Expand access to fitness opportunities, including outdoor spaces that are suitable for older adults and those with disabilities. M
• WPH2.8: Increase the variety of programming available across regions, enabling all demographics to be included. M
• WPH2.9: Build welcoming spaces that encourage physical activity for individuals from different backgrounds and abilities. M
• WPH2.10: Develop methods for attracting instructors with unique skills and experience to cater to varying levels of fitness. M
• WPH2.11: Increase access to and availability of a variety of programs that promote health and wellness topics, including:
  • Behavioral health.
  • Cardiovascular health.
  • Chronic disease.
  • Cognitive health.
  • Diabetes.
  • End-of-life decisions (advance planning, wills, medical power of attorney, and funeral arrangements).
  • Evidence-based programs and practices.
  • Fall prevention.
  • Healthy eating and nutrition, including cooking skills.
  • Health maintenance and overall wellness practices.
  • Lifelong learning.
  • Physical fitness classes.
  • Sleep hygiene.
  • Social connection.
  • Stress management, problem solving, and emotional regulation (interpersonal boundaries and self-care). C
• WPH2.12: Implement a variety of methods to increase access to health and wellness programs, including:
  
  Create sustainable funding sources to ensure consistent availability of services and programs.
  
  Enable all communities to have a voice in making decisions about access and programming from initial stages.
  
  Provide virtual health and wellness programs.
  
  Utilize evidence-based program locator tools. C
• WPH2.13: Increase access to affordable, healthy foods in a variety of ways, including: C
• Enable access to healthy meals that can be home-delivered or congregate (and if needed, medically tailored and meet the needs of all).
• Make procedural changes to make Supplemental Nutrition Assistance Program (SNAP) more accessible to older adults and adults with disabilities. These changes could include establishing an Elderly Simplified Application Project, a Combined Application Project, or a Restaurant Meals Program.

Recommendation: Strengthen community awareness and health literacy about health and wellness topics. (WHP3)

Action Items:

• WPH3.1: Educate on emergency preparedness, helping older adults feel empowered and capable in emergencies. L
• WPH3.2: Increase awareness of fair counseling and open enrollment for Medicare and other supplemental insurances. L
• WPH3.3: Offer health literacy education to help individuals discern valid and reliable resources for accurate health information. L
• WPH3.4: Increase awareness of "988" and ensure suitable images of older adults and adults with disabilities in marketing materials. L
• WPH3.5: Encourage individuals to try different types of exercise, promoting variety for increased engagement and health benefits. L
• WPH3.6: Educate on adaptable exercise methods for different ages, fitness levels, and moods (e.g. walking for cardiovascular health with modifications). L
• WPH3.7: Increase awareness of existing programs and increase education related to nutrition. Include topics such as:
  • Nutrient density and hydration.
  • Cooking for one person.
  • Maintaining an eating schedule.
  • Community health worker training.
  • Simplified nutritional information that is easy to read and understand on food packaging.
  • New and healthy recipes. L
• WPH3.8: Distribute communications using a variety of media methods (not all internet-based for example). L
• WPH3.9: Improve education for Statewide Access to Nutrition Assistance Programs: SNAP, Commodity Supplemental Food Program, Double up Food Bucks/Senior Famer's Markets, Food pantries/food banks, Area Agency on Aging (AAAs)/Senior Centers, home-delivered meals. L
• WPH3.10: Education and information should be ADA-compliant (i.e. font size on a flyer or website, color and contrast, modifications for those with hearing impairment, plain language). L
• WPH3.11: Provide education to reduce stigma around hearing loss and using hearing aids. L
• WPH3.12: Educate about how hearing loss can impact other areas of health and provide information about different types of hearing devices and how they can be used. L
• WPH3.13: Educate about the importance of using dentures and resources to repair or adjust dentures. L
• WPH3.14: Increase awareness and education on sexually transmitted infections (STI) and prevention. L
• WPH3.15: Increase access to literacy and education about behavioral health conditions. L
• WPH3.16: Increase addiction and overdose education. L
• WPH3.17: Increase suicide prevention awareness. L
• WPH3.18: Increase awareness of what benefits are already covered by insurance for behavioral health and cognitive health conditions and provide accessible educational material that includes holistic approaches for managing behavioral health conditions (i.e., food options, recipes). L
• WPH3.19: Ensure education materials are available in multiple languages and/or have translation services. L
• WPH3.20: Provide education materials, screenings, and services in community-based settings such as AAAs, community centers, and other community-based organizations. M
• WPH3.21: Enable education about the importance and opportunities to access health screenings and vaccines. M
• WPH3.22: Enable evidence-based health literacy principles to be adopted in health communications. M
• WPH3.23: Increase education about how medications can affect taste and cause dry mouth, which can impact nutrition. M
• WPH3.24: Explain benefits to patients- for example, dentists don’t always accept insurance. M
• WPH3.25: Educate the public on best practices to prevent negative outcomes related to behavioral health conditions. M
• WPH3.26: Provide stigma-reducing education about the signs and symptoms of behavioral health conditions that increase the willingness to seek treatment. M
• WPH3.27: Increase awareness of nutrition assistance services, such as nutrition counseling and weight management programs, that are covered by insurance. M
• WPH3.28: Provide stigma-reducing education about the signs and symptoms of conditions related to cognitive health, encouraging early diagnosis and treatment. M
• WPH3.29: Increase public awareness of the risk factors for cognitive impairment and dementia. M
• WPH3.30: Bridge the gap between recommended screenings and care and what is covered by insurance. C

Recommendation: Collaborate with the professional workforce to increase specialization and education for older adult health care. (WPH4)

Action Items:

• WPH4.1 Encourage older adults to attend “Welcome to Medicare” and Medicare Annual visits, along with all other preventive health care appointments (including vision/hearing/oral health) under any insurance provider. L
• WPH4.2 Enable older adults to undergo their annual falls risk assessment. L
• WPH4.3 Encourage service providers inform patients about available transportation resources to reduce missed appointments. L | NWD
• WPH4.4 Educate health care providers to prevent the negative outcomes of cognitive health conditions. M
• WPH4.5 Educate health care providers about nutrition assistance services, such as nutrition counseling and weight management programs, that are covered by insurance. M
• WPH4.6 Partner with medical schools to provide programs that increase the number of health care professionals entering geriatric specialties. Work with health care providers to provide education related to geriatric care for providers currently providing care in Missouri. M
• WPH4.7 Enable medication to be taken as prescribed and for all medication (prescribed and over the counter) to be reviewed by a physician and pharmacist annually. M
• WPH4.8 Provide adequate and appropriate training to health care providers about potentially sensitive aspects of utilizing glasses (in some cases), hearing aids, etc., and how to engage an older adult in conversations about why these screenings are important for a higher quality of life. This could include Continuing Medical Education (CMEs). M
• WPH4.9 Enable primary care providers to educate patients about the importance of vision, dental, and hearing screening, especially as they relate to additional risk for chronic health conditions like diabetes and dementia. M
• WPH4.10 Collaborate with providers and specialists to enable medical devices (hearing aids, dentures, glasses, etc.) to be adequately fitted and comfortable through a variety of means, including provider education, raising consumer awareness, and/or exploring options for coverage of fitting and adjustment services. M
• WPH4.11 Crosstrain workforce/professionals working with older adults and adults with disabilities to consider the whole person and can be referred to wraparound services. M | NWD
• WPH4.12 Support the identification and/or development of certifications for fitness instructors specializing in unique populations, including older adults. M
• WPH4.13 Ensure health care professionals are aware of what benefits are already covered by insurance for specific behavioral health conditions. M
• WPH4.14 Work upstream within health care systems to allow patients more time with providers when needed. C
• WPH4.15 Educate health care providers on best practices to prevent negative outcomes related to behavioral health conditions. C
• WPH4.16 Increase the number of health care professionals specializing in behavioral health conditions. C
• WPH4.17 Employ/train community health workers that specialize in health issues important to older adults to navigate complex health care systems. C

Recommendation: Adopt and integrate technological solutions to streamline older adult’s experience accessing and communicating health and wellness initiatives. Ensure older adults have access to technology education to adopt and utilize technology. (WPH5)

Action Items:

• WPH5.1: Promote the use of electronic health referrals. L
• WPH5.2: Educate on utilizing wearable health device data to improve health outcomes for both users and health care providers. L
• WPH5.3: Educate on adopting electronic health portals for improved care management. L
• WPH5.4: Encourage the use of wearable health monitors, emergency alert systems, and medication reminders to enhance safety and maintain independence while engaging in physical activity. L
• WPH5.5: Implement a Sequential Intercept Model to address gaps in behavioral health services and connect individuals to appropriate resources. C
• WPH5.6: Increase access to broadband internet across the state for older adults to access telehealth and other resources. C
• WPH5.7: Create infrastructure and incentives that allow and encourage medical, vision, hearing, and dental providers to share information and health records about the same patient to increase collaborative care. C
• WPH5.8: Enable tech support to be available for ongoing medical device usage when technology is involved (i.e. Bluetooth-enabled hearing devices). C
• WPH5.9: Maximize current services that are available by eliminating siloes (i.e. geography, funders, service areas) through creating a statewide consumer and provider database (Community Information Exchange pilot may be a model). C