State needs assessment finds persistent service gaps, low awareness among older and vulnerable adults

Tracy Lee, a manager with the Division of Aging and Adult Services, told the Davis County Senior Services Advisory Board on April 1 that a statewide needs assessment funded by the Administration for Community Living collected nearly 1,000 responses and found largely unchanged needs among older and vulnerable adults compared with a previous 2019 study.

The assessment drew 767 respondents who identified as vulnerable adults (defined for the study as people 60 and older, caregivers of someone 60 or older, or people 18–64 with a disability). Of those, 89 responses were from Davis County. "We had almost a thousand responses," Lee said. "We had 767 who identified as a vulnerable adult ... 89 were from Davis County."

The study used separate surveys for stakeholders (professionals) and for vulnerable adults and caregivers, plus focus groups and interviews. Stakeholder respondents rated mental-health partnerships, health-care providers and Adult Protective Services (APS) as priority collaborators. Stakeholders also cited social isolation, lack of dignity and financial limitations as key barriers to accessing services — particularly in rural areas. Lee said, "The biggest indicator to someone being abused, neglected, or exploited is isolation."

Among vulnerable adults, 49% reported they were not familiar with Adult Protective Services; 62% said they had not contacted their area agency on aging or were unaware of services available, though 77% of those who had contacted an area agency said their needs were met. Lee described a noted discrepancy between reports of needs being met and existing wait lists. "You give them area agency on aging, they call and they find out there's a wait list for Meals on Wheels," she said, adding the division fields a Care Coordination Program that provides short-term, hand-held case-management assistance while people wait for longer-term services.

Top service needs reported across respondents were housing, financial services (including help with managing money and protected payees), day services, transportation, advocacy and legal services, in-home services and residential placements. Lee said outdoor labor (home exterior chores) unexpectedly ranked high among services that would help people remain at home, followed by in-home services and safety modifications such as grab bars or ramps.

The assessment found greater vulnerability among nonwhite respondents, rural residents and households with incomes under $20,000. Lee said the survey offered Spanish language and phone-response options and that outreach included case managers and homeless resource centers via the division’s networks, but that one-on-one outreach to homeless persons was limited. "There was an option to call in for those who weren't familiar with Internet, and we also had the option to take it in Spanish," she said.

Lee described steps already underway in response to the findings: a statewide work group split into subgroups to (1) improve knowledge and resource sharing with health-care professionals, (2) address food insecurity, and (3) boost public awareness of available resources. She highlighted a training partnership with Intermountain Health that added a 15-minute adult-services resource module to mandatory training for healthcare employees.

The report includes county-level metrics; Lee said Davis County figures are available on request. She encouraged board members to use the public-facing brief and contact the division for the full, 68-page report and raw county data. "This is all public facing. We will share any data," Lee said.

Board members asked about representativeness and rural response rates. Lee acknowledged the survey achieved statistical reliability statewide for the public-facing results but fell short on rural-sample thresholds; she said nearly 2,000 people began the survey but many dropped out before completion, often on questions about abuse, neglect and exploitation. She noted the team offered incentives and focus-group stipends to improve participation.

The board and staff discussed follow-up measures including targeted outreach to healthcare professionals, expanded materials for APS and financial exploitation prevention, and an existing care-coordination program that helps clients apply for services and get on waiting lists. Lee said the division will continue to share county-level data and work with local partners to address the gaps identified.

The board did not take a formal vote on the needs assessment itself; Lee asked members to contact her or county staff for additional data or to join further work-group efforts.