Aging, Department on
A Report on Management Controls at the Texas Department of Aging
(12-27-95)
Overall Conclusion
The Department does not have traditional, formal contracts in place with those who actually provide program services and has not adequately monitored the Area Agencies on Aging (AAAs) to ensure that high-quality services have been delivered to the appropriate people at a fair price. Developing contracts, implementing efficient and risk-based monitoring practices, and fully analyzing available performance data would better enable the Department to ensure the safe, efficient delivery of quality services.
Key Facts And Findings
The Department has not developed traditional, formal contracts with the 28 AAAs. These AAAs are responsible for administering the $52 million program for the Department. As a result, the Department has little recourse should performance problems occur.
The Department has not adequately used available information to measure and manage AAA performance. For example, the Department has not analyzed the cash rates it approves to determine if rates are reasonable. In reviewing reimbursement rates for meals served in a group setting, we found that the Department reimbursement rates ranged from no reimbursement to $4.00 per meal.
The Department has not adequately monitored some AAAs, and, in turn, some AAAs have not adequately monitored their providers. For example, we found that as of April 1995, one AAA had not conducted a program monitoring visit since March 1994. AAA providers offer nutrition, transportation, and in-home services to elderly individuals. Therefore, it is important that the AAAs monitor providers to ensure that vehicles are properly maintained, drivers are trained in the safe use of wheelchair lifts and other special equipment, that the possibility of food-borne illness is minimized, and that in-home workers are qualified to perform their duties.
The rates developed by the Department are not aligned with the actual cash cost to provide services. Volunteer and in-kind contributions are given a value and included in the rates paid to AAAs, clouding the true cash cost of providing services. Changes to the current rate-setting process could improve accountability by making rates comparable among AAAs and with the contracted rates providers have with other agencies.
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