The Aging Network

The following definitions should be used when completing the SPR.

A. Client Descriptors

1. Minority Status -- Minority older persons are confined to the following designations:

• African American, Not of Hispanic Origin -- A person having origins in any of the black racial groups of Africa.
• Hispanic Origin -- A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.
• American Indian or Alaskan Native -- A person having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.
• Asian American/Pacific Islander -- A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands, Samoa and the Hawaiian Islands.
• Non-Minority -- Any person who is not considered a minority.

2. Impairments in Activities of Daily Living -- Beginning with FY97 AoA is introducing a definition for ADL impairments which reflects AoA analysis and testing in FY95 and FY96. The definition of ADL impairment to be implemented in FY97 is as follows: "the inability to perform one or more of the following six activities of daily living without personal assistance, stand-by assistance, supervision or cues: eating, dressing, bathing, toileting, transferring in and out of bed/chair, and walking. "

3. Impairments in Instrumental Activities of Daily Living -- AoA is introducing, effective in FY97, a definition for IADL impairments to be used for OAA reporting purposes. The definition will be: the inability to perform one or more of the following eight instrumental activities of daily living without personal assistance, or stand-by assistance, supervision or cues: preparing meals, shopping for personal items, medication management, managing money, using telephone, doing heavy housework, doing light housework, and transportation ability.

Transportation ability refers to the individual's ability to make use of available transportation.

4. Poverty -- Persons considered to be in poverty are those whose income is at or below the official poverty guideline (as defined each year by the Office of Management and Budget, and adjusted by the Secretary (DHHS) in accordance with subsection 673 (2) of the Community Services Block Grant Act (42 U.S.C. 9902 (2)).

5. Living alone -- A one person household (using the Census definition of household) where the householder lives by his or herself in an owned or rented place of residence in a non-institutional setting, including board and care facilities, assisted living units and group homes.

B. Service Definitions

Standardized names, definitions and service units are provided for the fourteen services which are singled out in the SPR for reporting.

1. Personal Care (1 Hour) -- Providing personal assistance, stand-by assistance, supervision or cues for persons with the inability to perform with one or more of the following activities of daily living: eating, dressing, bathing, toileting, transferring in and out of bed/chair or walking.

2. Homemaker (1 Hour) -- Providing assistance to persons with the inability to perform one or more of the following instrumental activities of daily living: preparing meals, shopping for personal items, managing money, using the telephone or doing light housework.

3. Chore (1 Hour) -- Providing assistance to persons having difficulty with one or more of the following instrumental activities of daily living: heavy housework, yard work or sidewalk maintenance.

4. Home Delivered Meals (1 Meal) -- Provision, to an eligible client or other eligible participant at the client's place of residence, a meal which:

• (a) complies with the Dietary Guidelines for Americans (published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture;
• (b) provides, if one meal is served, a minimum of 33 and 1/3 percent of the current daily Recommended Dietary Allowances (RDA) as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences;
• (c) provides, if two meals are served, together, a minimum of 66 and 2/3 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second meal shall be balanced and proportional in calories and nutrients; and,
• (d) provides, if three meals are served, together, 100 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second and third meals shall be balanced and proportional in calories and nutrients.

5. Adult Day Care/Adult Day Health (1 hour) -- Provision of personal care for dependent adults in a supervised, protective, congregate setting during some portion of a twenty-four hour day. Services offered in conjunction of adult day care/adult day health typically include social and recreational activities, training, counseling, meals for adult day care and services such as rehabilitation, medications assistance and home health aide services for adult day health.

6. Case Management (1 Hour) -- Assistance either in the form of access or care coordination in circumstances where the older person and/or their caregivers are experiencing diminished functioning capacities, personal conditions or other characteristics which require the provision of services by formal service providers. Activities of case management include assessing needs, developing care plans, authorizing services, arranging services, coordinating the provision of services among providers, follow-up and reassessment, as required.

7. Congregate Meals (1 Meal) -- Provision, to an eligible client or other eligible participant at a nutrition site, senior center or some other congregate setting, a meal which:

• (a) complies with the Dietary Guidelines for Americans (published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture;
• (b) provides, if one meal is served, a minimum of 33 and 1/3 percent of the current daily Recommended Dietary Allowances (RDA) as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences;
• (c) provides, if two meals are served, together, a minimum of 66 and 2/3 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second meal shall be balanced and proportional in calories and nutrients; and,
• (d) provides, if three meals are served, together, 100 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second and third meals shall be balanced and proportional in calories and nutrients.

8. Nutrition Counseling (1 Hour) -- Provision of individualized advice and guidance to individuals, who are at nutritional risk, because of their health or nutritional history, dietary intake, medications use or chronic illnesses, about options and methods for improving their nutritional status, performed by a health professional in accordance with state law and policy.

9. Assisted Transportation (1 One Way Trip) -- Provision of assistance, including escort, to a person who has difficulties (physical or cognitive) using regular vehicular transportation.

10. Transportation (1 One Way Trip) -- Provision of a means of going from one location to another. Does not include any other activity.

11. Legal Assistance (1 Hour) -- Provision of legal advice, counseling and representation by an attorney or other person acting under the supervision of an attorney.

12. Nutrition Education (1 Session) -- A program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants or participants and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise. [Note: this is the only service of the 14 listed services in the SPR where the unit measure (one session) refers to either an individual or group service. In this case, for example, a group of people attending a session on nutrition issues for the elderly would count as one unit of "Nutrition Education".]

13. Information and Assistance (1 Contact) -- A service for older individuals that (A) provides the individuals with current information on opportunities and services available to the individuals within their communities, including information relating to assistive technology; (B) assesses the problems and capacities of the individuals; (C) links the individuals to the opportunities and services that are available; (D) to the maximum extent practicable, ensures that the individuals receive the services needed by the individuals, and are aware of the opportunities available to the individuals, by establishing adequate follow-up procedures. [Note: states are reminded that the service units for information and assistance refer to individual, one-on-one contacts between an information and assistance provider and an elderly client or a care giver. An activity that involves a contact with several current or potential clients/caregivers (what is considered group services) should not be count as a unit of information and assistance. Group services might be defined as "public education" or a similiar designation which states may adopt and, at the option of the state reported in Section IV. -- Profile of Other Non-Registered Services Supported By Title III (Optional)

14. Outreach (1 Contact) -- Interventions initiated by an agency or organization for the purpose of identifying potential clients (or their care givers) and encouraging their use of existing services and benefits. [Note: states are reminded that the service units for outreach refer to individual, one-on-one contacts between a service provider and an elderly client or care giver. An activity that involves a contact with several current or potential clients/care givers (what is considered group services) should not be counted as a unit of outreach. Group services might be defined as "public education" or a similiar designation which states may adopt and, at the option of the state reported under in Section IV. -- Profile of Other Non-Registered Services Supported By Title III (Optional)

Respite care services which offer temporary, substitute supports or living arrangements for older persons in order to provide a brief period of relief or rest for family members or other caregivers, should be assigned to the service which best matches the form of respite being offered -- such as homemaker or personal care. If the respite care service is designed to offer a temporary, alternative living arrangement, do not assign the respite care service to any of the fourteen services. In SPR Section IV., list this activity as institutional respite care and also include the expenditure/resource data for this service as part of the total for "other service" in Section III.]

C. Other Definitions

A variety of other terms are used in the SPR. Definitions for these terms are as follows:

• Agency Executive/Management Staff -- Personnel such as SUA director, deputy directors, directors of key divisions and other positions which provide overall leadership and direction for the state or area agency on aging.
• Other Paid Professional Staff -- Personnel who are considered professional staff who are not responsible for overall agency management or direction setting but carry out key responsibilities or tasks associated with the state or area agency the following areas:
• Planning -- Includes such responsibilities as needs assessment, plan development, budgeting/resource analysis, inventory, standards development and policy analysis.
• Development -- Includes such responsibilities as public education, resource development, training and education, research and development and legislative activities.
• Administration -- Includes such responsibilities as bidding, contract negotiation, reporting, reimbursement, accounting, auditing, monitoring, and quality assurance.
• Access/Care Coordination -- Includes such responsibilities as outreach, screening, assessment, case management, information and referral.
• Service Delivery -- Includes those activities associated with the direct provision of a service which meets the needs of an individual older person and/or caregiver.
• Clerical/Support Staff -- All paid personnel who provide support to the management and professional staff.
• Minority Provider -- A not for profit organization whose controlling board is comprised of at least 51% minority individuals or a business concern that is at least 51 percent owned by one or more individuals who are either an African American, Hispanic origin, American Indian/Native Alaskan/Native Hawaiian, Asian American/Pacific Islander minority or a publicly owned business having at least 51 percent of its stock owned by one or more minority individuals and having its management and daily business controlled by one or more minority individuals.
• New Persons Served -- Any client who has never been previously registered as a client for the service, either in the current fiscal year or a prior fiscal year by any provider funded with Older Americans Act funds.
• Total OAA Expenditures -- Outlays/payments made by the AAA or SUA using OAA federal funds in the form of an advance or a reimbursement for a payment request submitted by a provider for the service.
• Percent of Total Service Expenditures -- The portion of total service expenditures for the year which were covered by the federal portion of the Older Americans Act funding.
• Program Income -- Gross income received by the grantee or subgrantee directly generated by the grant supported activity, or earned only as a result of the grant agreement during the grant period. [Note: this is the same definition of program income as used in 45 CFR Part 92-Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments.]
• Rural -- Beginning with FY97, the AoA is introducing a standard definition for rural for purposes of SPR reporting. A rural area is: any area that is not defined as urban. Urban areas comprise (1) urbanized areas (a central place and its adjacent densely settled territories with a combined minimum population of 50,000) and (2) an incorporated place or a census designated place with 20,000 or more inhabitants.