We need your help! Your input and insight is needed to help evaluate current and projected senior housing and other long-term care needs in the community.

Converse County's Long-Term Care Steering Committee is currently evaluating the county's long-term care needs and identifying new opportunities for providing services to our elderly citizens. Today’s elderly have many long-term care choices. In fact, most communities offer a continuum of care including support services (e.g., transportation or meals), home-health care, independent living, boarding homes, assisted living facilities, skilled nursing homes, and hospice facilities. Converse County has many high quality services for seniors, but there appears to be a need for additional pieces of that continuum of care model.

To help evaluate current and projected senior long-term care housing needs in the community, Converse County and Memorial Hospital of Converse County jointly came together to fund a market and financial feasibility study for long-term care in Converse County. Part of the feasibility study process will be to complete an analysis of projected long-term care needs, market demand, growth potential and competition in Converse County, with special emphasis on the need for one or more Assisted Living Facilities in the county. Community Builders, Inc. (CBI), was hired to complete the Feasibility Study.

Please complete this survey so that we can evaluate how residents in Converse County view long-term care needs in our community. Please complete the survey before November 20, 2013. You can drop your completed survey off at any of the following locations:

• Glenrock Health Center
• Glenrock Town Hall
• Oregon Trail Clinic
• Glenrock Senior Center
• Memorial Hospital of Converse County/Ambassador Desk
• Douglas Senior Center
• Converse County Courthouse - Clerk's Office
• Frontier Drug

If you prefer to complete the survey online, it can be accessed at the following link:

http://www.surveymonkey.com/s/CCLTCCommunitySurvey

Thank you on behalf of the entire Converse County Long-term Care Steering Committee:

Rick Grant, County Commissioner
Bob Kayser, MHCC Chairman, Board of Directors
Gay Bolln, MHCC Board of Directors
Dr. Charles Lyford, MHCC Board of Directors
Ryan Smith, MHCC CEO
Denise Lyons, Converse County Hospital Foundation Executive Director
Jan Pope, Glenrock Citizen
David Kreycik, Douglas Citizen

* 1. Where do you live?

* 2. Which of the following services, if any, do you currently receive? (select all that apply)

* 3. Long-term care includes a continuum of care to assist the elderly or disabled in completing activities of daily living. It includes home health care, subsidized senior housing, boarding homes, assisted living facilities, and nursing homes. Is there a need for more of these services in the community?

* 4. If your response to the previous question was yes, what additional services are needed in Converse County? (select all that apply)

* 5. If you were to seek out long-term care housing for you or a family member, what factors would be important to you? (select all that apply)

* 6. If a new Assisted Living Facility were to be built in the area, and assuming that you can afford the cost, would you or a family member be willing and likely to use it in the future?

* 7. Do you know of anyone who has moved away from Converse County to receive long-term care services elsewhere? (select all that apply)

* 8. If you know of someone who has moved away from the community to receive long-term care services, please indicate their reason(s) for moving, if you know: (select all that apply)

* 9. If an Assisted Living Facility (or other long-term care facility) is considered for Converse County, what would be the best way to fund the capital construction of said facility? (choose all that apply)

* 10. As you personally age and may need to consider a long-term care facility, where would you most want to spend your "golden" years?

* 11. What is the best way to gather input from community members who need (or will need) long-term care?

* 12. Please share any other information you think should be considered for this long-term care plan.

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