18 Miss. Code. R. 2-1-III

Current through August 31, 2024
Section 18-2-1-III - NARRATIVE

Vision

The Vision of the Mississippi Department of Human Services Division of Aging and Adult Services is to see "Every older Mississippian living the best life possible."

Mission Statement

The mission of Division of Aging Adult Services is to "Protect the rights of older Mississippians while expanding their opportunities for and access to quality service."

A. Division of Aging and Adult Services

The Mississippi Department of Human Services, Division of Aging and Adult Services (DAAS) is the state entity designated by the Governor to receive and administer federal funds received through the Older Americans Act. Working with a network of local Area Agencies on Aging and local service organizations, DAAS plans and administers programs and services to improve the quality of life for all of Mississippi's older citizens. As the official state office on aging, the DAAS works closely with a network of planning and service agencies to ensure comprehensive activities, programs and services for older Mississippians are offered statewide. Additionally, the DAAS works with many other state agencies as well as with the private sector, to create recognition of the needs and interests of older adults and to develop new resources.

As the SUA, the DAAS proactively carries out a wide range of functions related to advocacy, planning, coordination, interagency linkages, information sharing, brokering, monitoring, and evaluation. The DAAS pays special attention to those older adults who have the greatest social, economic, and health needs and to low income minority elders.

The basic responsibilities of the DAAS include:

1. Developing and administering the State Plan

The State Plan is based on information gathered from consultations between the DAAS and AAAs and on Area Plans submitted to the DAAS for approval. Through direct contact with the AAAs and review of the Area Plans, the DAAS assesses the needs of older persons, establishes statewide priorities, examines procedures for implementing the Plan, and assures consistency among the State and AAA objectives. The State Plan provides for proper and efficient methods of administering Aging programs.

2. Conducting public hearings on the State Plan

The DAAS holds public hearings on the proposed State Plan that afford opportunities for comment to older persons, area agencies on aging, service recipients, the general public, officials of general purpose local government, and other interested parties. This process guarantees all interested parties an opportunity to communicate their views verbally or through written correspondence regarding the State Plan, and on matters of general policy arising in the development and administration of the State Plan, and its effect on service delivery at the community level. Public hearings are planned and conducted jointly with the ten AAAs annually. A copy of the 2010 schedule and a copy of a public information "flyer" is provided in the State Plan. Hearings subject matter includes Title III services and VII programs for Elder Rights Protection as well as other programs funded through the AAA.

3. Serving as an advocate for older persons in the State

The DAAS serves as the effective and visible advocate for the elderly by engaging in direct action; encouraging and supporting participation by older persons in activities which help them promote their own interest; and assuming a strong leadership role to guide, direct, and support other State advocacy efforts. Direct advocacy includes such activities as: representing the interests of older persons before legislative and other formal bodies within the State; drafting or reviewing proposed legislation upon request from the legislative body; and reviewing and commenting on State agency plans, budgets, and policy impacting older persons and long-term care systems. The DAAS also guides, facilitates, and supports other elderly advocates within the State by providing technical assistance, training, and support to AAAs, organizations representing the elderly, and other coalition groups, associations, or individuals advocating for older persons.

4. Dividing the State into Planning and Service Areas (PSA)

The DAAS has divided the state into PSAs which are geographic regions composed of one or more local government boundaries. PSAs correspond geographically with the ten multi-purpose, non-profit, quasi-governmental, economic development districts called Planning and Development Districts (PDDs). The following factors are considered when identifying PSAs: distribution of persons age 60 and over, including those with greatest economic or social needs; services needed and the resources to meet the needs; views of local public officials; and boundaries of local government, regional planning councils, Indian Reservations, and economic development districts.

5. Designating and funding AAAs within PSAs

Upon definition of PSAs, AAAs for each PSA are designated and funded to develop comprehensive coordinated service delivery systems to meet the needs of older persons in the local communities. The ten AAAs are designated as a separate organizational unit within a multi-purpose agency (PDD). See attached map of the geographic boundaries of the PSA/AAA.

6. Coordinating strategic planning for systems and activities relating to the OAA purpose

The DAAS develops strategic plans and policy to guide and direct AAAs, improve upon existing relationships and establish new linkages among federal, state, area, and community agencies and organizations to enhance the coordination of service delivery. Pilot programs and new service models established on the state level will be used by the AAAs to replicate planning for and delivery of services at the community level.

Additional responsibilities of the DAAS include:

- Training - The DAAS is responsible for identifying and prioritizing training needs of the State's Aging Network. The DAAS plans and provides the necessary training directly or supports the training efforts of AAAs. The DAAS contracts with universities and colleges throughout the State to provide needed training for the Aging Network personnel.

- Resource Coordination - The DAAS coordinates resources which can be directed toward services for older persons at the state and local levels. Resource coordination is often achieved through inter-agency agreements with other state departments and agencies.

- Monitoring and Evaluation - The DAAS' function for oversight of monitoring and evaluating of AAAs to ensure program and fiscal accountability and adequate progress in implementing the actions set forth in the Area Plan is fulfilled through a working partnership with the Division of Program Integrity Bureau of Audit and Evaluation, Mississippi Department of Human Services.

- Intrastate Funding Formula (IFF) - In consultation with the AAAs, using the best available data, the DAAS developed an intrastate funding formula with a descriptive statement of its assumptions and goals. The formula includes a numerical statement of funding based on the economic, ethnic, and geographic data of the age 60 and older population by AAA. Economic need, social need, and geographic isolation, and the effect on minority individuals, are considered. The formula is weighted 30% age sixty plus, 25% age sixty plus below poverty level, 30% sixty plus minority below poverty level and 15% sixty plus rural. The IFF is attached as a part of the state plan.

- Inclusion - The DAAS provides that activities are planned and directed toward increasing access to services by older individuals in special population categories that might otherwise be overlooked. The goal of the DAAS and the AAAs is to include persons who live in rural areas, do not speak English, or are economically and/or socially needy (particularly economically needy minority), disabled, or Native American. All programs and activities are available to the sixty and older population in Mississippi, where applicable, without regard to income (non means-tested).

- Leadership - As the leader and focal point of the Aging Network, the DAAS assumes a strong role in guiding and directing each of the entities which constitute the State's Aging Network. In this way, the DAAS can impact other programs which have a direct or indirect relationship with aging programs and enhance the coordination and pooling of resources. The DAAS' strong leadership is necessary to promote an optimal service delivery system for older persons throughout the State.

B. Area Agencies on Aging

Area Agencies on Aging, mandated by the Older Americans Act, are designated by the DAAS to plan, coordinate, and advocate for the development of comprehensive and coordinated service delivery systems for all elderly and provide funds for services. The ten AAAs in the State are private, non-profit organizations and serve as focal points offering a comprehensive array of services at the local level.

AAAs are required to have a full-time director and adequate staff to carry out its purposes; however, staffing patterns vary because of different funding sources available to individual AAAs including federal, state, county, city, or private sources. The OAA allows up to 10% of all Title III funds received by an AAA to be used for administrative costs.

AAAs must develop a comprehensive coordinated service delivery system to meet the needs of older persons and serve as advocates and focal points for older persons in the PSA. Only activities consistent with the AAA mission as prescribed in the OAA and in state policies are included in the development of the system.

C. Area Agencies on Aging - Area Plan

AAAs receive funds from the DAAS through submission and approval of a four year Area Plan, with annual updates or amendments, which identify and prioritize the needs of older persons and specify what services will be provided to meet those needs. The Area Plan describes the development of a comprehensive coordinated service delivery system in the AAA. Based upon the local assessment of need, the Area Plan, or annual update, specifies details of the amount of funds budgeted for each priority service during the fiscal year. Preference in service provision is directed to the elderly with the greatest economic or social need. Activities, objectives, and programs for implementation of Title III and Title VII (Elder Abuse Prevention and Ombudsman) are defined in the Area Plans, funds are allocated through the IFF, and coordinated with other available resources and programs.

The Area Plan has the following objectives:

- Serve as a planning document that describes priority needs to set forth objectives and action steps to be undertaken by the AAA on behalf of older persons in the PSA;

- Formulate a formal commitment to the DAAS setting objectives to be undertaken by the AAA;

- Formalize a commitment to the DAAS describing the manner in which the AAA plans to utilize OAA funds under the various parts in accordance with their purpose and carry out its administrative functions; and

- Formalize a commitment to DAAS to fulfill the AAAs role as planner and advocate on behalf of seniors.

The Area Plan reports demographic information of the PSA, including census and local population statistics on those persons age 60 and older, minority elderly, low-income elderly, low-income minority elderly, and rural geographic. Other important components of the Area Plan include: assessment and prioritization of older persons= needs, identification of services to meet the needs, identification of gaps in service or factors impeding the effective delivery of service, identification of alternative solutions, activities, or services to fill unmet needs, bridge gaps and/or correct deficiencies in the service delivery system for older persons.

The Area Plan defines the programs, services, and activities to be undertaken during a prescribed time frame and the methods by which services will be provided. Consideration of the extent of particular needs in the economic and socially needy and minority population is addressed in the process of determining service provision (particularly to low-income minority). Services may include congregate meals, home-delivered meals, nutrition education, information assistance/referral and outreach, transportation, homemaker, adult day care, respite, ombudsman, legal services, and others. Coordination of these home and community-based services with designated community focal points for service delivery are also set forth in the Plan.

The Plan assures that the AAA spends an adequate portion of its OAA Title III-B social services allotment to provide access, in-home, and legal services, unless it documents to the DAAS that services from other sources meet the needs of older persons in the PSA for that category of service. Access, in-home, and legal services are discussed below.

- Access services facilitate access to services in the community including: transportation; outreach; and, information, assistance/referral. The Plan must provide for information and referral/ assistance so that all persons within the PSAs are assured reasonable access to these services. AAAs that have Native Americans residing within its borders will pursue activities to increase access to services and benefits as applicable. Outreach, an important aspect of access, is arranged at the community level to identify elders eligible for assistance and inform them of the availability of assistance, with special emphasis on reaching economic and socially needy and low-income minority elders.

- In-home services enable elders to remain in their homes for as long as possible in order to prevent premature institutionalization. The service mix may include nutrition (the AAA accommodates, wherever possible, the particular dietary needs of participants), homemaker, visiting and telephone reassurance, case management, and respite.

- Legal services increase availability of legal aid and assistance for elders to secure their rights. These services include legal counseling and other legal assistance. Additionally, the AAA attempts to involve the private bar association in the provision of legal services on a pro bono or reduced-fee basis for older persons.

The Area Plan includes assurances relative to affirmative action plans, compliance with Civil Rights Act requirements, compliance with the Section 504 of the Rehabilitation Act of 1973, as amended, Debarment policy, Drug-free workplace policy, and other requirements. In addition, all services provided by the AAA or local service providers meet existing State and local licensing, health regulations, and safety requirements for the provision of service. The Area Plan contains objectives for appropriate procedures for data collection and the compilation and transmittal of data to the DAAS, including the National Aging Program Information System (NAPIS) and the National Ombudsman Reporting System (NORS) requirements. The Area Plan includes information compiled on courses of post-secondary education offered to older persons (Mississippi waives post-secondary tuition for persons age sixty and over) and made available to elders at focal points within the community.

Priority needs of older persons, how these needs will be met, and how services are to be provided with OAA and other sources of funds, are identified and assigned in the Area Plan. In addition, the Plan establishes the manner in which the AAA will develop a comprehensive and coordinated service delivery system. Therefore, all activities undertaken as a responsibility of the AAA, whether funded by public or private funds, are described in the Area Plan and must comply with all laws, regulations, and policies.

The Area Plan activities are evaluated and considered by the public during the public hearing process each year. At that time, input is solicited from older persons, older persons who are service recipients, the general public, officials of local government, and other interested parties. The Plan is submitted to the DAAS for approval prior to the receipt of OAA funds at the AAA level.

AAAs are required to designate, if feasible, focal points for comprehensive service delivery within each community. The AAAs must specify in the Area Plan specific communities in which focal points are designated and developed.

Formal subgrants are made to the AAAs to carryout the plan narrative. The Subgrant budget must include proposed expenditures for administration, planning, program development, and service provision under the Plan. Budgets submitted with each plan assure that not less than the total amounts expended in Federal Fiscal Year 2000 in carrying out the Long-Term Care Ombudsman Program are expended. In order to demonstrate AAA efforts to coordinate resources with other agencies, the Plan must indicate the amount of resources (other than OAA funds and non-federal matching funds) which support the development of a comprehensive and coordinated service delivery system in the PSA.

D. Area Agency on Aging Advisory Councils

Advisory Councils are voluntary groups of citizens who provide information, guidance, advice, and support to the AAA to plan, develop, coordinate and administer services to older persons. The Council helps the AAA carry out the intent and objectives of the OAA. The Council fulfills this obligation by working with the AAA staff and community leadership.

The Advisory Council is a direct means for older Mississippians to have their interests represented in local AAA activities. Advisory Council members participate in programs, communicate with other service recipients, and are representatives of community groups, senior organizations, and AAA staff. An effective working relationship between the AAAs and the Advisory Council assists Council members to exercise their role and responsibility both to the AAA and to the community they represent. AAA Advisory Councils may serve as the Ombudsman Advisory Council if the council membership includes representatives from the long-term care community.

Each AAA determines the size of the Council, the manner in which participants are chosen, the frequency of meetings (at least quarterly), structure, focus and potential influence on the AAA. The AAA Council assumes a variety of responsibilities, but all Councils must advise the AAA in the following areas:

- Develop and implement the Area Plan;

- Conduct public hearings;

- Represent the interests of elders (advocacy); and,

- Review and comment on all community policies, programs, and actions affecting elders.

The AAA Advisory Council must officially sanction the final Area Plan before it is submitted to the DAAS for approval.

The Advisory Council also plays a significant role in implementing the Area Plan. Council members enhance community awareness of aging services and foster communication between the AAA and the community. Advisory Council members who are consumers of services, understand the development and implementation of the Plan through the services they receive.

The Council identifies gaps in services or deficiencies in the service delivery system; helps minimize duplication of effort in service delivery systems; and assures coordination with all service providers that are part of a continuum of care. The Council oversees the selection of service providers and provides oversight in the monitoring and evaluating process.

Advisory Councils are required to advise the AAA in the Area Plan public hearing process. Council members take a leading role in publicizing the hearings among the groups, clubs and organizations they represent. Council members assume responsibility for conducting the public hearings and ensure that suggestions made during the hearings are considered in the final version of the Area Plan. The Advisory Councils serve to strengthen relationships and enhance communication between the DAAS and AAAs and assure local community input at the State level.

E. Aging Service Providers

The AAAs contract with service providers to deliver home- and community-based services to older adults. Contracts with local service providers are reviewed by the DAAS to assure that integrity and public purpose of services are maintained, that all sources and expenditures of funds are disclosed, and that services are enhanced. In some rural areas, provision of direct services by the AAA is necessary. The AAAs must provide justification to the DAAS that direct provision is necessary to ensure an adequate supply of such service and/or for the economy of service, or that the service is directly related to the AAA=s statutory/administrative function. No services are provided directly by the AAA without an approved waiver from the DAAS.

Local service providers have direct "one-on-one" contact with older Mississippians. Service providers translate dollars into tangible services for the elderly. Service providers are technically defined in the Federal Regulations as an entity that is awarded a contract from an AAA to provide services under the Area Plan. Mississippi's service providers are primarily community action agencies or programs and organizations with a proven record of providing services to older persons.

Services provided by local provider agencies in the state include: home-delivered meals, congregate meals, nutrition education, homemaker services, outreach, adult day care, friendly visiting, shopping assistance, transportation, telephone reassurance, legal services, information assistance/referral, and multi-purpose senior center activities (among other services). Supporting and complementing the AAAs' efforts, service providers deliver quality, efficient, effective, and accessible services to senior citizens. Partnering with the AAAs and service providers are the private and public long-term care providers, community organizations, and medical entities which are concerned and involved with the delivery and quality of care for older Mississippians.

As part of the contract for services, AAAs must assure that local service providers give participants an opportunity to contribute to the cost of the services; however, services are not denied if the person will not, or cannot, contribute. Contributions are used to expand services provided at the community level and confidentiality is assured to protect the privacy of each older person who contributes.

The AAAs must assure that all contracts that include payment of any part of a cost, including administrative, incurred to carry out a commercial relationship or contract will be paid only if carried out to implement Title III. Preference in receiving service will not be given to any individual as a result of a contract or commercial relationship.

The AAAs monitor, evaluate, local service providers for their efficiency and effectiveness in delivering services. Written policies and procedures based on OAA requirements and implementing regulations, reflect the procedural requirements specified by the DAAS.

The AAAs provide training and technical assistance within the PSAs. This may be accomplished through in-service training at universities, workshops, or conferences, monthly technical assistance meetings, and project director meetings. These training activities directly impact the level of productivity and efficiency of AAA staff, service provider staff, and Advisory Councils.

18 Miss. Code. R. 2-1-III