Thursday, March 29, 2007

Secretary of Aging on PA's AAA Network

Nora Dowd Eisenhower, as Secretary of the Pennsylvania Department of Aging, offered testimony before the Aging and Youth Committee, of the Pennsylvania State Senate, on March 27, 2007. [Why? See the Update below.]

Secretary Eisenhower reported to that Senate Committee's Chairs -- Patricia H. Vance and Leanna M. Washington -- and to the other members, about local services offered to residents over sixty years old by the statewide network of "Area Agencies on Aging", in conjunction with her Department and other state agencies, such as the Department of Public Welfare.

She distinguished the roles of the Department of Aging from those of the local agencies:

It is the responsibility of the Department to ensure:

  • that consumers receive fair and consistent treatment in every county,
  • that state and federal funds are used judiciously, and
  • that we define our expectations of the network which include issuing clear guidance and direction around performance outcomes, data tracking, cost reporting, and customer service.

The AAA network is equally responsible to assure high-quality, timely services for our seniors. In achieving this, each AAA is accountable:

  • to use tax dollars responsibly,
  • to have a productive, well-trained staff, and to
  • operate in an efficient manner.

It is our collective responsibility to provide the highest quality services to our elders in need and to be accountable to Pennsylvania taxpayers.

Recent discussions between these two levels of government resulted in "our shared commitment to three basic goals":

  • Consistency and equity in eligibility determinations across the Commonwealth. In order to gauge consistency, we monitor the number of medical conditions identified and the amount of help (Activities of Daily Living – ADLs) that a senior needs, such as feeding, bathing, dressing and toileting. We want to make sure that similarly situated, clinically comparable consumers can count on similar outcomes – equivalent eligibility determinations – no matter where in the state they reside.
  • Consistency in cost. We’re trying to make sure that the cost of performing the eligibility assessments is reasonably consistent and uniform across the Commonwealth so that our resources are fairly distributed among the AAAs and throughout the state.
  • Consistency in productivity. Again, I believe our partners at the AAAs share our commitment to prudent use of the Commonwealth’s resources. In this regard, we have pledged to share with the AAAs data on the relative numbers of staff the agencies dedicate to the assessment process, as well as comparative data on the number of assessments completed by the staff over the course of a year. We want to make sure that we are all managing the system effectively and getting the best possible results from our tax dollars.
She acknowledged that "challenges exist at both levels, and that change is needed within the Department, as well as in the network."

She reviewed some of the recently implemented changes that affect seniors in need of services or resources, which are available through the Aging system. She then explained the present steps for a resident to initiate requests, and for the agencies to respond.

She also took note of "some of the concerns I have been hearing from directors, counties, legislators, and other stakeholders":

First, I want to assure county commissioners and workers that the dialogue has just begun. We do not foresee any impact on jobs.

Second, we are committed to spending the time to get this right, to address these important issues.

Third, we will not make any changes that result in a less responsive system for consumers; in fact our goal is the opposite.

She ended her testimony with these assurances:

In closing, I want to assure you that we are committed to a productive process that directly engages the AAA network, and we share the same goals of creating a timely, effective, equitable, and accountable system that allows us to serve the greatest number of older Pennsylvanians.

The text of her complete testimony, as posted by the Department of Aging on March 28, 2007, can be found online here.

Update: 03/30/07:

Do you want to learn the "story behind the story" as to why such testimony was presented before the Senate's Aging & Youth Committee?

Well then, see: "Rendell's elder services plan is raising doubts", by Gary Rotstein, published in the Pittsburgh Post-Gazette on Tuesday, March 27, 2007.

Here are some excerpts:
The Rendell administration wants to centralize the state's system for evaluating older adults who apply for government-funded services, but local aging officials worry the plan will just delay getting help to consumers.

The state Senate Aging and Youth Committee meets in Harrisburg today to hear about the plan from both Pennsylvania Department of Aging officials and representatives of county aging agencies. The agencies would be stripped of one of their primary functions if the plan is implemented in 2008, as the Rendell administration wants.

The proposal calls for a private or public agency to be contracted anew to assess the status of adults seeking aging services, which can include qualifying for in-home assistance, subsidized nursing home care or other help. Fifty-two aging agencies across the state now perform the evaluations and follow up by coordinating services for those who are eligible. * * *

Local aging officials * * * say state officials failed to consult with them about the changes, which they contend would add an extra step and possible confusion for the often-frail individuals seeking help. Two people and agencies, instead of one, would be responsible for evaluating someone's health and resources and arranging help.

Officials from the agencies covering Allegheny, Westmoreland, Fayette, Greene and Washington counties, among others, fail to see any positives from such a move. * * *

After reading the entire newspaper article, go back and reread the Secretary's testimony. It will make more sense in the reported setting.