Stay up to date on Spectrum Generations and the latest news on aging in place. For all media inquiries, please contact the Community Engagement Officer Stephanie Hanner at [email protected]
Music lovers will delight as the Maine Marimba Ensemble performs captivating and complex poly-rhythmic arrangements of traditional and contemporary Zimbabwean music on their spectacular set of homemade marimbas.
Marimbas are percussion instruments whose roots are ancient, extending to early human instincts to strike wood, stone and metal slabs and objects that produced musical tones.
Join us on September 23 at Darrow’s Barn in Damariscotta for the high-energy, rhythmic sensation that is the Magic of Marimba!
Show begins at 7:00 p.m. Ticket prices are $7.50 in advacnce or $10.00 at the door.
For more information or to purchase tickets contact Spectrum Generations, Coastal Community Center at (207) 563-1363.
The National Survey of Area Agencies on Aging is conducted every two-to-three years and tracks important new trends in AAA programs, services and funding. How are AAAs engaging in new opportunities, such as livable and dementia-friendly community efforts? What funding sources are AAAs exploring to innovate and adapt to shifting policy priorities?
AAAs and local, state and federal partners and stakeholders can use data from the report in a variety of ways. Survey data is essential for analyzing policy issues, benchmarking services, supporting requests for funding, preparing local issue briefs, speaking with funders or legislators and more.
The Augusta Age-Friendly workgroup developed a Resource Guide to support those persons in the Augusta and Kennebec county area find helpful resources. The guide is organized according to the "8 Domains of Livability" that have been found to be aspects of community life that are essential to the health and well-being of older adults.
View the Resource Guide online here.
Spectrum Generations clients who receive services – particularly Meals on Wheels and participate in the USDA Commodity Supplemental Food Program – will not experience any delay or disruption in receiving those services. All Spectrum Generations locations will continue operating under normal business hours.
Meals on Wheels is funded primarily through the federal government, with additional assistance provided by generous individual donors, municipalities where we provide services, and through four United Way organizations (Kennebec Valley, Mid Coast Maine, Mid Maine, and Eastern Maine). We also have partnerships with businesses and local farms who supply food to make the meals.
Additional funding is provided through the State of Maine, however we have planned for this situation and are positioned to continue providing all services throughout a long-term state government shutdown, should that be the case.
All USDA Commodity Supplemental Food Program recipients will also be able to continue picking up their 30-lb. free food packs at their usual pickup station. The Commodity Supplemental Food Program is offered through the USDA who distributes both food and administrative funds through participating states.
If you have any concerns or questions, please call us at 1-800-639-1553 or TTY 1-800-464-8703.
Spectrum Generations will be hosting a free training series for family caregivers beginning July 10 running through August 14, at Sebasticook Valley Health, 130 Leighton Road, Pittsfield. Providing care for a loved one with a form of dementia presents many challenges and is specialized work. Family members often take on caregiving without preparation or training, participants learn what dementia is and how it affects the individual and develop skills on how to interact and communicate with a person with dementia.
Spectrum Generations’ Family Caregiver Support Program offers this six-week training called The Savvy Caregiver. Classes will meet beginning July 10 and be held on consecutive Mondays, 1:00 – 3:00 p.m. until August 14. Interested participants will learn to understand and manage challenging behaviors as well as other skill to improve outlook as a caregiver. Classes will include training, interactive exercises, and discussions.
This training is sponsored by the Office of Elder Services, Department of Health and Human Services, and funded by a grant from the US Administration on Aging. The training is free but pre-registration is required. For more information or to register, please call Tricia Payson at 620-1670.
Spectrum Generations is offering a free training opportunity for those who are interested in becoming a coach for A Matter of Balance. The training will be held June 1-2, from
1:00—5:00 p.m. at People Plus, 35 Union Street, Brunswick.
A Matter of Balance is a nationally recognized program designed to encourage physical activity and reduce the fear of falling. Workshops are typically conducted in eight sessions over for weeks, meeting twice a week for two hours each, and led by experienced volunteer coaches, who can now be trained for free by Spectrum Generations.
A Matter of Balance coaches have good communication and interpersonal skills, enthusiasm, dependability, and a willingness to lead small groups of older adults. Coaches also need to be able to lead the low to moderate level exercises, facilitate group discussions and engage in problem-solving strategy sessions.
The eight-hour training for coaches is free and materials are provided. For more information or to register for the training, contact Lyn Neiz at 930-8082 or [email protected]
Spectrum Generations' COO, Kristin Overton to Senator Brakey, Representative Hymanson, the members of the Joint Committee on Health & Human Services, and Deputy Commissioner Porteus regarding proposed cuts to Targeted Case Management. .
Hello Senator Brakey, Representative Hymanson, and members of the Joint Committee on Health & Human Services and Deputy Commissioner Porteous,
Spectrum Generations attended the presentation by Burns & Associates Tuesday regarding the proposed rates on a number of services, including Targeted Case Management in Section 13. On several occasions we heard the committee ask for a recommendation regarding how to balance the cuts versus the increases without causing harm to current services; enabling capacity to remain in the community and quality TCM services available to consumers. I'd like to propose a solution, taking into account the 10% stop-loss which was recommended by the Department.
Solution: DHHS stated in their testimony that they would be reviewing rates annually; adjusting them as necessary so that the current unbalance is not experienced again. Our suggestion is not to cut the current TCM rate but have a rate freeze placed on it for the next 4 years.
Justification: The average rate of inflation is approximately 2%-3% per annum; freezing the rate at $21.52 for 4 years (through the end of 2022) would allow inflation to serve as the balancing mechanism, not a rate cut. The rate would slowly come into balance with the new model by the end of freeze period. After 2022, the model's suggested annual or bi-annual calculation would then apply to TCM as well. This compromise solves the concern that a rate cut would negatively impact services, threatening the ability for current providers to maintain the level of quality services to those individuals who need it most, including those who are being released from the State. It should also meet the DHHS needs to get all service rates in balance.
I believe this would be a strong compromise which would promote a consistent rate model while bringing the rate into alignment with the model in a manner which would promote continued availability of services for consumers receiving TCM services.
Thank you for taking the time to consider this proposal. As always, I am available for further discussion of questions at your convenience.
Thank you to everyone who voted in support of Spectrum Generations' Meals on Wheels program in this year's Bangor Savings Bank Community Matters More campaign!
We were recently notified that we have won a $5,000 grant!
Today, April 21, our Nutrition Director Karen Wiswell testified before the Health and Human Services Committee. Below is her statement in full, asking for support of LD 692, increasing funding to Meals on Wheels throughout Maine.
Dear Senator Brakey and Representative Hymanson and other members of the Committee on Health and Human Services, my name is Karen Wiswell and I am the Director of Nutrition and Community Center Operations for Spectrum Generations, the Central Maine Area Agency on Aging. I am providing my testimony in support of LD 692, Resolve, To Provide Meals to Homebound Individuals.
For over 44 years, Spectrum Generations has provided Nutrition services such as Meals on Wheels and congregate dining. All meals are made fresh in our 2 commercial kitchens and delivered by volunteers. Our We Sustain Maine program, incorporates up to 32% Maine produced foods into the meals; all of which provide 1/3 of the Recommended Dietary Allowances in each meal. We utilized 410 volunteers who donated 27,703 hours in 2016 to serve and pack meals, to deliver to the local Spectrum Generations community center, and to pick up thermal bags containing all the meals for an entire route. Our programs run very lean and efficiently. Every Area Agency on Aging makes a strong effort to have the recipient pay for a portion of their meal. At Spectrum Generations, it is a recommended donation of $4.00 however our average donation amount is $0.46 per meal.
The meals we deliver to our consumers are a life line – a meal, a check-in, and a friendly visit. We’ve passed you personal notes written on plates from people on our program and in the communities you may represent, in order to show the impact that these meals make to our consumers. 10 years ago, Spectrum Generations delivered 184,394 meals. Since then, the need has continued to rise; by 40,099 meals to be exact. In 2016, 1,665 individuals received at total of 224,493 home delivered meals.
In those 10 years, state and federal funds for Meals on Wheels have remained fairly flat. The annual budget for Spectrum Generations Meals on Wheels program totaled $1.1 million in 2016. Of this, 32.6% was raised individually by Spectrum Generations and its supporters; a total of $362,243.
In order to deliver more meals to meet the surging need, all five of Maine’s Area Agencies on Aging have engaged in more and more fundraising opportunities. In 2016, the sum total was $1,060,263. These efforts include United Way campaigns, municipal funding requests, partnerships with for-profit businesses such as Darling’s Auto Group or Evergreen Subaru, large private fundraising events such as the Sukeforth Family Festival of Trees and the Celebrity Chef Dinner, and small events such as baked bean cook-off’s, bake sales, bottle drives, and awareness walks.
There is currently a waitlist for recipients of Meals on Wheels in more than half the state. In order to provide the necessary meals for this vulnerable population, I urge you to pass LD 692.
Thank you for your time,
Participating in this year's Maine Quality Counts conference, CEO Gerry Queally presented on our Community-based High Risk Intervention Service, together with Nancy Connelly from Southern Maine Agency on Aging.
Our COO, Kristin Overton, with Health & Wellness Manager, Jennifer Fortin, also presented a popular poster session on our Healthy Living for ME program which focuses on managing chronic health conditions through exercise and prevention classes.
Spectrum Generations’ Legacy Corps Program, which caters to the caregiving needs of veterans and their families, recently received two national awards. Bestowed by the University of Maryland, the awards are a direct reflection of the efforts made to grow the program and enhance people’s lives through the support it offers.
The Eisenhower Award was presented to Spectrum Generations as a symbol of our leadership in modeling how to retain members. The Startup Award was presented in recognition of demonstrated growth of the program through both volunteers and families seeking services, year over year. The two awards were out of only four presented, nationwide.
Legacy Corps is a national AmeriCorps project that operates in 9 states at 16 project sites. At Spectrum Generations, the Legacy Corps program provides companionship respite care for veteran and military families and their caregivers, throughout central and midcoast Maine. The volunteers are trained and carefully matched with each client they work with to help support the specific needs veterans and military families often face, as well as decrease feelings of burden and stress for caregivers when caring for a loved one.
Veterans of any age, and their families members are welcome to contact Spectrum Generations' Tricia Payson at 620-1670 for more information on how to begin services. Volunteers for the program are also needed and invited to contact Betty LaBua at 620-1662 for more information on upcoming training opportunities.
More information can be seen at spectrumgenerations.org/legacycorps
Spectrum Generations is participating in the 15th Annual March for Meals – a month-long, nationwide celebration of Meal on Wheels and the homebound and vulnerable seniors who rely on its vital safety net. This year’s Community Champion week will be celebrated at Spectrum Generations Community Centers during the week of March 20. During this time local celebrities and state officials will be invited to deliver and serve meals, attend our luncheons at Centers and to raise awareness of hunger for our homebound seniors and disabled.
“The Meals on Wheels program is more than just a meal! It addresses three of the biggest threats of aging: isolation, hunger and the loss of independence,” said the Meals on Wheels of America spokesperson.
”The services that we provide the seniors of Central Maine are critical and the need is rapidly increasing,” said Karen Wiswell, Director of Nutrition. “Together, we can keep seniors living independently, healthier at home and feeling more connected to their community as they age.”
Please join us at one of Spectrum Generations six community centers located in Waterville, Skowhegan, Hallowell, Belfast, Damariscotta and Brunswick to celebrate March for Meals.
Since 2002, Meals on Wheels America has led the annual awareness campaign in an effort to fill the gap between the seniors served and those in need that is widening due to increased demand with a rapidly aging population combined with declining public and private resources, and rising food, transportation and operational costs. This March, hundreds of local Meals on Wheels programs, like Spectrum Generations will reach out to our communities to build the support to deliver nutritious meals, friendly visits and safety checks to America's seniors all year long.
For more information on how you can volunteer, contribute or speak out for the seniors in Central Maine and contact your local nutrition coordinator.
National Nutrition Month® is a nutrition education and information campaign created annually in March by the Academy of Nutrition and Dietetics. The campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits.
The theme for 2017 is "Put Your Best Fork Forward", which acts as a reminder that each bite counts. Making just small shifts in our food choices, can add up over time. The 2015-2020 Dietary Guidelines for Americans suggest starting with small changes in order to make healthier lasting changes you can enjoy. Next year's theme for National Nutrition Month® inspires us to start with small changes in our eating habits – one forkful at a time. So whether you are planning meals to prepare at home or making selections when eating out, Put Your Best Fork Forward to help find your healthy eating style.
The consumer market overflows with publications on nutrition, fitness and health. The publications listed here represent resources covering a broad range of nutrition and health topics and provide reliable, timely nutrition information for personal, school, library and community use. Most are available at local libraries and bookstores.
Learn how to attract pollinators to your garden
Spectrum Generations’ Coastal Community Center at 521 Main Street, Damariscotta, will be hosting a companion planting workshop led by master gardener Jean Vose on Thursday, March 9, from 1:00 – 3:00 p.m.
Program participants will learn how to plant different crops in proximity for pest control, pollination, creating a beneficial habitat, and improved garden productivity. They will also be given a list of new plant combinations to investigate and other related informational handouts.
Suggested donation is $5. For more information or to register, contact the Coastal Community Center at 207.563.1363.
Jean Vose is a master gardener from the Knox and Lincoln Counties Extension Association, with over 30 years of gardening experience who will lead the workshop and share information about her favorite companion plants for home-scale vegetable production as well as recommendations from the books Companion Planting for the Kitchen Gardener and Rodale’s Successful Organic Gardening® Companion Planting.
Meals on Wheels America today released Hunger in Older Adults – a report seeking to increase the understanding of a variety of food assistance programs that can work in combination to more effectively address the needs of the more than 10 million older Americans facing hunger each year. The need for this resource became apparent amidst a pilot project funded by AARP Foundation and Caesars Foundation that sought to use tablet technology as a means to increase enrollment of eligible individuals in the Supplemental Nutrition Assistance Program (SNAP). In doing this work, the need for additional information about the full range of federal food assistance programs emerged.
“Hunger in Older Adults is intended to help expand access by eligible homebound older adults to available food assistance programs,” said Ellie Hollander, President and CEO of Meals on Wheels America. “What we quickly uncovered was that there is limited guidance available for those seeking to assist both homebound and ambulatory older adults in accessing needed food assistance.”
While national, state and local assistance programs often operate independently, are administered by different agencies and/or lack both public and private funding, using these programs in a coordinated way can more effectively address the myriad of health, environmental, physical and economic barriers to food security that many older adults face. Through best practices and actionable strategies, this report seeks to engage Aging Network leaders and advocates as partners to increase use of food assistance programs by older adults as this vulnerable population is set to double by 2050.
For the first time in one place, the Hunger in Older Adults report:
- Examines national programs that address these issues, silos in these systems, and potential strategies;
- Synthesizes publicly available research and information from government, organizations, academic studies, aging services reports and technical assistance materials;
- Examines the multiple ways that State Units on Aging (SUAs) tackle food insecurity to better address senior hunger issues within their state;
- Illuminates some of the challenges and opportunities for the community-based nutrition services network in serving older adults; and
- Recommends actions for leaders and advocates to better communicate, coordinate or collaborate, and develop the most effective interventions.
“It is our hope that this report will help the aging services network strengthen their ability to serve vulnerable older adults in communities across the country,” said Lisa Marsh Ryerson, President of AARP Foundation.
"The Caesars Foundation is proud to support Meals on Wheels and the AARP Foundation in its work to address hunger among older adults," said Executive Director Thom Reilly. "Initiatives such as the Supplemental Nutrition Assistance Program, or SNAP, are critical to our ability to help people meet their basic needs."
Click here to view the full report.
The Central Lincoln County (CLC) YMCA and Spectrum Generations Coastal Community Center (Damariscotta) today announced they have entered into a Memorandum of Understanding to form a community partnership effective mid-March, 2017.
Pending final business plan approval by the Spectrum Generations Board, their Coastal Community Center envisions relocating to the new CLC YMCA building in early 2018, where it will continue to support its mission to promote lifelong learning, health, wellness, nutrition, community engagement and the social well-being of all older and disabled adults.
Meagan Hamblett, CEO of CLC YMCA, said, “We’re excited about this collaborative opportunity with Spectrum, which could not have been made possible without the upcoming renovation and new construction of our YMCA facility. Timing is everything because now our architect can make office space adjustments to the facility design to accommodate Spectrum staff. Both organizations are committed to working together for the greater good, making a positive and healthier impact on our community.”
Spectrum Generations has been serving central and midcoast Maine’s older adults since 1972 and is a fixture in Lincoln County, providing services to 2200 people, including more than 15,000 Meals on Wheels in the most recent fiscal year. Spectrum Generations also provides caregiver support, education, and respite, Medicare counseling, and offers classes, workshops, social clubs, and weekly lunch-and-learn dining opportunities featuring local speakers focusing on a variety of topics. Their annual Aging in the Right Place Symposium continues to be a source for many in Lincoln County who are retired, nearing retirement, or looking for resources to support an elderly parent or loved one.
Gerard Queally, CEO of Spectrum Generations said, “We always look to collaborate with organizations and individuals and partnering with CLC YMCA makes sense. As with many community based non-profits, we strive to serve the needs of our neighbors and our ability to do that comes from these strong partnerships. Joining forces with the CLC YMCA allows us to share space and resources, opening up many avenues for us to increase the number of seniors we can serve while enhancing programs and service offerings. This is a big win for improving the health culture of our seniors in mid-coast Maine.”
Dennis Anderson, Board Chair, CLC YMCA, added, “Bringing Spectrum Generations on board opens new opportunities for this community, especially for our signature demographic seniors. At a time when social isolation and all its negative side effects are reaching epidemic levels, a partnership like this offers so many new prospects to help overcome these health and quality of life challenges in Lincoln County. We look forward to building upon the incredible work spectrum generations is already doing in our communities."
Personal fitness assessments, a new fitness series, information sessions and trainings are now being offered at Spectrum Generations’ Cohen and Muskie Community Centers in Hallowell and Waterville, respectively.
If you are ready to start an exercise program but are unsure of where to start, or are intimidated by group exercise or the gym, Robin Maginn, Advanced Certified Senior Personal Trainer and Senior Exercise Instructor, is offering a free one-on-one fitness assessment. Her safe, whole-body approach will help you meet your fitness goals this New Year. When you sign up for a fitness assessment, you’ll receive discounts on upcoming classes.
A new fitness series, “It’s All About…” will focus on different muscle areas like legs, arms, and the core, and help with issues related to posture and balance. The classes will be held monthly at each center. The Muskie Center located at 38 Gold Street in Waterville will host on the second Tuesday of each month from 2:00 – 3:00 p.m.; the Cohen Center on Town Farm Road in Hallowell will host on the second Thursday of each month also from 2:00 – 3:00 p.m. Cost to attend is $10 and registration is required.
Each center offers a variety of movement and fitness classes. For more information about future class dates, health and wellness programs or to sign up for these classes, call the Cohen Community Center at 626-7777 or Muskie Community Center at 873-4745.
Robin Maginn has been a fitness instructor and personal trainer for 20 years, helping individuals of all health levels achieve their personal fitness goals and is certified by the Senior Fitness Association, the international association exclusively for fitness professionals who serve older adult populations, and teaches many other health and fitness classes at Spectrum Generations.
Classes being offered as a part of the Spectrum Generations Chronic Disease Self-Management Network
Spectrum Generations will be hosting Tai Chi classes starting on January 4, 2017, at the Muskie Community Center at 38 Gold St, in Waterville from 8:00 a.m. – 9:00 a.m., Mondays and Wednesdays. Classes will be taught by certified, trained professionals who will help participants improve balance, strength, and improve overall health and wellness.
This program is specifically designed for those with arthritis and has been proven to be safe and effective. Tai Chi exercises the entire body, joints, muscles and internal organs while also strengthening the mind. Participants will focus on improving strength, balance, mental health, and relieving stress.
Tai Chi can be particularly beneficial for those interested in:
- Improving strength, flexibility, balance and mobility
- Improved breathing, internal energy and relaxation
- Improving balance and preventing falls
- Decreasing pain, depression, stress and loss of ability to do things
- Overall increased health
For more information or to register for the upcoming Tai Chi class offerings, contact Lyn Neiz, Evidence Based Programs Coordinator at (207) 930-8082 or via email at [email protected].
Spectrum Generations announces the Caregiver Respite Program has funds available. Although there are many rewards in caring for a friend or family member with dementia, family caregivers can become stressed and exhausted over time. Respite, the opportunity to take a break, is vital to caregiver well-being.
The Caregiver Respite Program supports family caregivers by helping to cover the cost for someone else to provide care for the person with dementia. This may take place in the home, at an adult day-care program, or overnight in a facility (on a limited basis). The care may be provided by a family member, friend, or neighbor, someone from a homecare agency or an adult day program. The respite program allows caregivers the opportunity to take some time for themselves to re-energize, do something for fun, or get necessary errands done.
The Caregiver Respite Program can reimburse up to $3,040 a year (which is 80% of a total annual cap of $3800) of what it costs to have someone come into the home a few hours a week, or several hours of adult day care per week. It can also help with the cost of up to two full weeks of overnight continual care in an assisted living or nursing facility. Furthermore, up to $2,000 (lifetime) can be used to help cover the cost of home modifications needed to promote independent living.
In order to qualify for the Caregiver Respite Program, there must be a written diagnosis of Alzheimer’s disease, dementia, or related memory disorder from a physician, liquid assets cannot exceed $50,000 for one person or $75,000 for a couple, and there must not be any assistance from any other state subsidized programs.
For more information, or to apply, contact the Family Caregiver Program at Spectrum Generations at 1-800-639-1553.
The 2nd Annual Sukeforth Family Festival of Trees will be held at the Hathaway Creative Center in Waterville:
November 18-20 and 25-27
Fridays & Saturdays, 10:00 a.m. - 8:00 p.m.
Sunday, 11/20, 10:00 a.m. - 6:00 p.m.
Sunday, 11/27, 10:00 a.m. - 4:00 p.m.
$2.00 entrance fee for adults, children under 12 free
Raffle tickets will be available for purchase, and can be placed in buckets under any beautiful tree. Each tree's winner gets to take the tree home, fully decorated and all ready for the holidays, with everything that is on it and under it!
Santa's Snack Shack and Santa himself will also be available during Festival hours.
We greatly appreciate the Sukeforth Family as they host this event in support of Spectrum Generations and Hospice Volunteers of Waterville!
Spectrum Generations and the Southern Maine Agency on Aging (SMAA) have recently been awarded $636,500 and $478,779 respectively, from the US Department of Health and Human Services (HHS) to build a sustainable network of evidence based health and wellness programs dedicated to older adults and disabled persons. The agencies received two of only 16 grants awarded throughout the country for these initiatives by the US HHS Administration for Community Living.
Gerard Queally, CEO of Spectrum Generations said, “The awarding of these two grants present an enormous opportunity for Maine to develop a sustainable, statewide Evidence Based Health and Wellness network. It speaks to the confidence the Administration on Community Living has in the Area Agencies on Aging in our state and to the collaborative nature in which both grant applications were written. All of Maine’s health systems and many other community-based organizations, like Somerset Public Health, fully supported the application and their older patients and members will now have an increased opportunity to attend classes in or close to the communities in which they live. This is a big win for improving the health culture of Maine.”
Spectrum Generations will focus its program on chronic disease self-management and education, chronic pain self-management, and diabetes self-management, while expanding the delivery infrastructure and geographic reach of educational offerings. Citing CDC statistics that 86% of healthcare costs are attributed to chronic diseases like diabetes and heart disease, anticipated outcomes include increased participant confidence and self-efficacy, decreased emergency room visits and hospital admissions, and incorporation of healthy eating and exercise into daily routines.
The Southern Maine Agency on Aging will use the grant to develop an evidence-based falls prevention program network across the State of Maine. Statewide AAA’s will develop more systematic outreach strategies, build relationships with health providers including MaineHealth Accountable Care Organization, and ultimately embed and sustain falls prevention programs within regional healthcare systems.
Laurence W. Gross, SMAA’s Executive Director stated, “This grant will significantly increase the number of older adults across Maine who are referred to and participate in evidence-based falls prevention programs. SMAA has a strong history of partnership with ACL. In 2014, we were awarded a three-year, $954,457 grant, – The Alzheimer’s Disease Initiative: Specialized Support Services – to improve services for adults living with dementia. We are thrilled for this next opportunity to continue partnering with ACL as we now work to reduce the risk of falls for older Mainers.”
Spectrum Generations and the Southern Maine Agency on Aging expect that by collaborating with other Maine Agencies on Aging, as well as with health systems, state health departments and other community-based health organizations, that the quality of life for older adults and those disabled persons living in Maine will improve. By focusing on improving balance issues and chronic disease and pain management, the ideal outcomes will be increased capacity of targeted population to live healthier lives while maintaining their ability to age in place. In addition, results will show the efficacy of these programs and help determine the structure of future services within the healthcare arena.