Area Plan For Fiscal Years 2008-2010
Plan for FY2008

Helping older adults remain independent since 1978
(as of 06/21/07)

The Purpose of this Document

This is a summary of our Area Plan for our next three-year planning period for services to senior adults in Southern Illinois. Our plan outlines the use of federal and state funds that are available under the Older Americans Act for our activities and to fund other agencies which provide services to older adults in Southern Illinois.

We are very interested in receiving feedback about our plan, especially from older adults. We will consider future changes to our Area Plan based on the comments or questions we receive.

Use this link to give us feedback and make comments.

Who We Are

We are one of over 650 Area Agencies on Aging in the United States established by a federal law called the Older Americans Act. We are a nonprofit agency, established in 1978. We have representation on our Board of Directors from all thirteen counties we serve in southernmost Illinois (see the map below). We promote the well being of older adults in Southern Illinois and assist them in maintaining their independence in the community.

We receive federal and state funding through the Illinois Department on Aging, prioritize the aging-related services to be funded, decide how to distribute this funding to local agencies which provide aging-related services in Southern Illinois, and monitor the services they provide. See below for more information on our agency.

Counties We Serve

We serve Alexander, Franklin, Gallatin, Hardin, Jackson, Johnson, Massac, Perry, Pope, Pulaski, Saline, Union, and Williamson counties in Southern Illinois.

How We Prepared For Our Area Plan

In the fall of 2006 we gathered information from senior adults, the general public, and professionals concerning aging network services and the service needs of older adults. Our activities included focus groups, surveys, and speak outs at senior centers.

With the help of the SIUC Department of Social Work, focus group sessions were held with grandparents raising grandchildren, community members at a senior center, and caregivers of older people and participants at an adult day service center.

We also held speak outs at four senior centers in different parts of our planning and service area. We invited participants to talk about services and issues important to them.

We conducted surveys at our speak out sites, and also collected surveys from several of our smaller rural meal sites. In addition we surveyed a lower income group who use services from a rural community action agency, and also arranged for a church group to fill out surveys. The surveys listed a variety of topics, including nutrition, transportation, health screening, health and mental health, memory loss, medication issues, advocacy in nursing homes, and activities at senior centers. Finally, we sought input on these issues, as well as gaps in services from several professional agency staff members through survey forms.

We reviewed the results of all these efforts, plus other reports and related information. As a result of these activities, our Area Plan includes a priority list of in-home and community-based services for senior adults, identifies service gaps, and outlined special initiatives that our staff will pursue for the three year period of our Area Plan.

Summary of Our Information Gathering

Speak outs and written surveys at senior centers and among recipients of home delivered meals showed a continued high level of support for meals. Meal site participants stressed that not only are good meals important, but so is the social interaction, being in a "loving, caring community" as one person put it. There were also comments on the frustrations of "getting the word out" about the benefits of senior centers, and fighting a public perception that one must be "poor" to receive the benefits offered at centers. There is a similar high level of support for home delivered meals. The written survey question regarding "food pantries / having enough to eat" was scored as important particularly by recipients of home delivered meals, those at rural congregate meal sites, and also by a group of low-income respondents surveyed at a community action agency.

Comments at the speak outs and the results of the surveys showed that most respondents consider that transportation, help with prescription drugs including Medicare Part D, and a variety of health screening and preventive health measures were important. Programs designed to enhance mental vitality were marked as important by many of the senior meal site participants. Adult day services were also listed as important by senior center participants and recipients of home delivered meals. Legal services was indicated as a needed service at all of the speak outs, and was marked as important on the survey by many, but not all participants. Similarly, "help / advocacy for nursing home residents" seemed important to many, although not all participants. "Help fixing up my home" was marked as important particularly by the low-income respondents at the community action agency.

We also surveyed a church group who were of a variety of ages. They viewed many of the services listed above as being either important or very important, as well. The church group also indicated that elder abuse prevention is important, as did about 88 percent of the participants of rural senior sites. The church group also gave high ratings to most health related program questions.

Our survey of professionals showed that they felt that the most important services were help paying for prescription drugs, transportation, legal services, elder abuse prevention, and having enough to eat. They felt that barriers senior adults face are lack of knowledge about services, lack of transportation particularly in isolated areas, and "automated technology." When asked what services should be in place for the baby boomer generation, there were many ideas given including more assisted / retirement living options and a larger variety of activities and services.

Focus groups were used to examine specific issues within our region. The grandparents raising grandchildren (GRG) group was small, and had both younger and older participants. The comments of this group, along with the results of the surveys of the GRG group taken at a seminar sponsored by our agency, showed that they have legal, financial, and medical needs related to their grandchildren. Many cited the need for more information, and some mentioned child rearing or child behavior information as important. About half of the GRG group felt that a support or "chat" and information sharing group would be beneficial.

The adult day service (ADS) and caregivers focus group felt that ADS was a very helpful service both for the ADS participant and their caregivers. Benefits mentioned included socialization, sense of reward or joy, providing needed nutrition, and reducing depression. When asked what other resources needed to be more readily available, additional home services was most frequently mentioned. Suggestions for how to get the word out about ADS centers included community education, providing information to professionals, group talks, and short, well written pamphlets and flyers.

A focus group at the Cairo senior center consisted of a variety of community members, who discussed questions about the relationship between the center and the community. The participants were aware of many of the services available through the senior center, but felt others were not aware. They made suggestions for letting senior adults and the community know about services, including involving local schools, youth, and having open houses and game nights. Some suggested expanding senior center hours and involving local officials and churches more in the effort to reach out into the community.

Survey of Needs and Services

Issues We Considered

Use this link to view the issues we considered for this Area Plan.

The Services We Fund

Use this link to view a chart of services and projected persons to be served.

How many We Served Last Year

Use this link to view the client data our service provider agencies reported last year.

Our Policies on Awarding Funds

Proposed changes for FY2008–

Because the State has substantially increased funding for Comprehensive Care Coordination (CCC), we propose to move 57.75 percent of the funds that we previously awarded for Case Management (Title III-B, State Match, and both State CBS fund amounts) to local providers. We anticipate that the remaining funds will be used to help fill gaps not covered by CCC, such as:

• Intake activities when no assessment is conducted,
• Ongoing intensive case work after the CCC approved three-month period, or when CCC will not pay for the first three months of this activity, when the clients meet EAAA established criteria,
• Ongoing intensive monitoring for CCC clients who do not qualify for CCC case work when the clients meet EAAA established criteria, and
• Costs associated with conducting Flexible Senior Services, Assistive Technology, Home Modification, and Emergency Home Response Systems under the Alternative Senior Services program when it is not paid for under CCC intensive case work.

Family Caregiver Title III-E funds can be used for assessment, intensive case work, and intensive monitoring for caregivers under age 60 who are caring for older people, and for grandparents age 60 and over who are raising grandchildren, since these individuals are not eligible for CCC.

All of the activities above will be paid by EAAA at the IDOA approved reimbursement rates for each activity, if appropriate. We will review this policy next year to determine if more or less funding is needed for these non-CCC eligible case management activities.

Instead of only 55 percent, we propose to use only 50 percent of our Caregiver Support Title III-E funds for Information & Assistance, Outreach, and Case Management services to caregivers and grandparents raising grandchildren.

Finally, we have reviewed our reimbursement rates for services and are proposing Board approved increases to the reimbursement rate for several services.

History of our funding policies–

In March 1987, our Board of Directors adopted the policy of funding one service provider agency per county for supportive and nutrition services, and funding one area-wide provider for the services of Case Management (including CCU designation), Ombudsman, Elder Abuse, and Legal services. New programs and services were included in this consolidation policy as they were funded. The only exception to this consolidation policy has been Board approved grants, such as for Family Caregiver Education/Training and Support Groups.

For FY 1987, our Board of Directors adopted a funding formula using 1980 U.S. Census data which distributed 97.5% of service funds based on the number of senior adults in each sub-area: 1) at or below the poverty level (50%), 2) minority senior adults (16.67%), 3) senior adults aged 75 or older (16.67%), and 4) senior adults living alone (16.66%). The remaining 2.5% of the funds were distributed equally among counties that were more rural, as defined by having a population density which was less than the average population density for the entire area. In addition, the amount allocated to two counties (Jackson and Perry) received a one-time raise to hold them harmless from this new formula since they would have received less funding than the previous year.

For FY 1988, the Board approved a policy that if funds were reduced, the allocations awarded to sub-areas and single, area-wide agencies would be reduced equitably by the percentage of the reduction. This policy of maintaining each agency’s "relative position" to each other based on the percentage of funds previously awarded was reaffirmed by the Board for FY 1989 and based on funding awarded in FY 1988. In FY1992 when Union County was combined with Jackson County as a single service sub-area, the funding for Union County (5.39%) was switched in the funding formula to this new combined service sub-area.

The concept of "relative position" does not include funds appropriated for specific purposes, such as NSIP and some state funding (state funding for Ombudsman and HDM, for example). Also, the concept of "relative position" is considered by funding source, not as a total amount awarded to each sub-area, i.e. Nutrition Service funding changes are applied only to service provider agencies funded for Nutrition Services. Finally, NSIP funds are awarded based on the number of eligible meals served in the previous fiscal year.

For FY 1991, our Board approved an 0.5% increase in the funding formula percentages for Case Management and Legal Assistance services. There was some opposition to this change after it was approved.

In 1992, we proposed using the 1990 U.S. Census data in our funding formula and offered several alternative funding formulas. We received overwhelming feedback at that time from our service providers not to change our funding formula or the concept of relative position based on the percentage of funds awarded to each sub-area in FY1988.

In 2004, our Board reviewed the 2000 U.S. Census data and how it would change funding for each sub-area, but decided not to change the funding formula. Thus, we continue to use the concept of relative position based on the percentage of funds awarded to each sub-area in FY 1988 which uses the 1980 Census data.

Our Policy on Changes to Funding

The following policy was adopted in April 1996 and will continue to be observed. Any increase or decrease in funding will be applied equitably by funding source to all service provider agencies awarded such funding. For example, if Nutrition Service funding is increased or decreased, only service provider agencies funded for Nutrition Services would be affected.

If funding for the Family Caregiver Program is increased, we plan to use the additional funding for caregiver respite care, counseling, and legal assistance services.

Services or programs which require a minimum percentage of funds, Legal Assistance for example, or for which the Illinois Department on Aging has issued a specific guideline, such as the Ombudsman program, will be maintained at appropriate levels unless the Illinois Department on Aging waives these requirements.

If new sources of funds are received, such as funds under a new title under the Older Americans Act or a new source of state funds, our Board will determine the services, sub-areas, and funding levels at that time.

We have adopted the following contingency plan if existing programs or services and their funding sources are collapsed into another (host) program:

1. If the Illinois Department on Aging specifies the amount of funding for one or more collapsed programs:

• if an exact amount is specified for every program, we will award funds as specified by the Department to each program; or
• if an exact amount is specified for some programs, but not every program, we will award funds as specified and award any remaining funds among priority services using the concept outlined above in the first paragraph of "Our Policy on Unexpected Increases/Decreases in Funding."

2. If the Department doesn’t specify the amount of funding for any of the collapsed programs:

• if the total amount of funding is the same or less than the amount awarded in the previous fiscal year for the host program, we will only fund services under the host program. Funds will not be awarded to the collapsed program; or
• if the total amount of funding is more than the amount awarded in the previous fiscal year for the host program, we will fund the host program at the previous fiscal year's level and fund the collapsed program(s) with the remaining funds up to the level in the previous fiscal year. Any remaining funds will be awarded to either or both programs if they have services designated by our Board as priority services. If both programs have priority services, funds will be awarded to both based upon their percentage of the total funds awarded in the previous fiscal year.

¹ NSIP stands for “Nutrition Services Incentive Program,” formerly this source of funds came from the USDA in lieu of commodities.
² Unspent funds from the current year can be carried over to next year, but spent only on direct services.

Waiver Requests

We do not need to apply for any waivers at this time.

Waivers are generally requested in order to allow the Area Agency on Aging to deviate from funding requirements or when the Area Agency on Aging wishes to provide services directly, rather than award funds to a local service provider agency to provide services.

What Our Agency Does

1. Administration and Monitoring.

• We receive federal and state funds related to the Older Americans Act and award these funds to local service provider agencies who provide Supportive, Nutrition, Health Promotion, and Family Caregivers Program, and Abuse Prevention services to older adults, family caregivers, and grandparents raising grandchildren. We provide information, training, technical assistance, and review monthly reports and annual financial audits from our service provider agencies, in addition to conducting on-site monitoring and evaluation. We require that our service provider agencies comply with requirements of federal and state regulations, such as fire, safety, and public health and sanitation rules and regulations.

2. Advocacy, Coordination, and Program Development.

The Illinois Department on Aging allows Area Agencies to retain a small amount of federal Supportive Service funding for advocacy, planning, coordination, and program development. The following is a partial list of our activities –

• Inform our Congressmen and State Legislators about issues affecting older adults.
• Develop and revise implementation plans for new and current programs which assist older adults.
• Work cooperatively with state and local agencies, coordinating our services with theirs, and ensuring that older adults receive all services to which they are entitled.
• Maintain a presence on governing bodies and advisory councils which make public policy affecting older adults.
• Maintain an information resource library and serve as a clearinghouse for information relating to older adults and services to agencies and organizations.
• Publish a Service Provider Resource Guide annually which includes a Family Caregiver Help Guide and Government Program Eligibility Guidelines.
• Maintain an extensive EAAA which contains voluminous information about aging and resources in Southern Illinois.
• Survey older adults and social service agencies in the area to identify service needs and priorities.
• Respond to requests from older adults and make referrals to appropriate agencies.
• Nominate older adults for state and regional awards.
• Provide information to groups which provide alternative housing and assisted living for older adults.
• Develop volunteer opportunities for older adults especially with younger generations.
• Develop the Holiday Meals-on-Wheels program by raising local funds (United Way and donations) to provide home delivered meals to homebound senior adults on holidays when government supported programs are closed. Organize, contract with, and reimburse local groups to prepare and deliver meals these meals.
• Provide information, assistance, and training on prescription drug programs.
• Coordinate the distribution of Farmers Market coupon booklets.
• Coordinate with demonstration programs for senior adults.
• Work cooperatively with the SIUC School of Social Work.
• Sponsor seminars for caregivers of senior adults, and for grandparents raising grandchildren.
• Release numerous newspaper and radio articles on aging.
• Speak before various groups about aging-related services.
• Develop programs to transition senior adults out of nursing homes into the community.
• Develop local funding sources, including local property tax referenda.
• Work with nursing facilities and the Ombudsman to advance culture change in nursing facilities.
• Educate senior adults on dementia and aging and memory clinics in our area.
• Report alleged fraud and abuse of Medicare.
• Encourage and assist area fire departments to adopt the Illinois Remembering When program.

3. Area Plan Initiatives.

Area Plan initiatives are issues of concern for senior adults we have identified through our planning process. Our staff have decided to address some of these concerns through special project initiatives. These issues may be reviewed by using the link below.

Funding Retained for Our Use

The Older Americans Act allows Area Agencies on Aging to retain federal funds for administering grants, and monitoring service provider agencies. The Department on Aging allows each Area Agency on Aging to use an additional amount of federal funds for advocacy, planning, coordination, program development, and Area Plan initiatives. We maintain our “relative position” in regards to funding compared to our funded agencies. When considered as a percentage of all the sources for funding programs under the Older Americans Act, our agency’s budget represents less than 8 percent of the total.

Unless we obtain a waiver from the Department on Aging, we do not retain funds from the Older Americans Act to provide client services directly, except for the required services of advocacy, planning, coordination, program development, and Area Plan initiatives. We don’t retain participant contributions, Nutrition Service Incentive Program (NSIP), nor most State funds for our activities.

Our Staff

Two part-time positions were eliminated in 1991. Two full-time positions were eliminated, one in 1993 and the other in 2000. One full-time position (Secretary) was reduced to part-time in 1997. One part-time position (Data Entry) was created in 2003. One temporary, part-time position funded by the Community Care Program was created in 2002 and eliminated in 2004. One temporary, full-time position funded by the State Pharmaceutical Assistance Program was created in 2005, reduced to temporary, part-time in 2006, and will be continued as funding is available in order to assist Medicare and Illinois Cares Rx beneficiaries.

Use this link to view our current staff positions.

Our Staff’s Other Activities

Use this link to view the other staff activities.

Our Board of Directors and Advisory Council Members

Use this link to view a list of our Board and Advisory Council members.

Census Information

Use this link to view the Census information for older people in Southern Illinois.