This report presents the results of OPPAGA's program evaluation and justification review of the Department of Elder Affairs' Services to Elders Program. The purpose of the Services to Elders Program is to administer services and long-term care programs to the elderly. The program's major goal is to help elders remain in their own communities in the least restrictive, most appropriate, and safest setting to prevent unnecessary or premature nursing home placement.

The Services to Elders Program benefits Florida's elders and should be continued.

With the exception of its administrative and oversight functions and pre-admission screening activities, the program is essentially (94%) privatized. Although it is possible to privatize certain functions, such as nursing home pre-admission screening, we did not identify a compelling reason to privatize this function.

• The Services to Elders Program is generally meeting legislative goals, but improvements are needed to enhance program performance.
• To ensure that accurate data is reported to the Legislature and other policymakers, the program should continue to improve and monitor the accuracy of the data on abused and neglected clients.
• To maximize the number of Medicaid-eligible clients that are transferred from the Community Care for the Elderly program to the waiver, the program should improve efforts to inform clients about the Medicaid waiver program, work with the Department of Children and Families to improve the timeliness of the financial eligibility process, and monitor the provider agencies' adherence to the contractual requirements for transferring clients more closely and sanction providers that do not comply.

We found several deficiencies with the current management system that diminish the program's overall efficiency and effectiveness. To improve the current program management and oversight systems, the program should take the actions discussed below.

• Program officials should enhance written instructions to provide clear and comprehensive guidelines for all policies and procedures as the client services manual is updated.
• Program officials should establish minimum standards for Area Agencies on Aging (AAA) monitoring procedures and instruments by the end of Fiscal Year 2001-02.
• Program headquarters should take corrective actions upon all AAAs that fail to comply with contract agreements within a reasonable time as specified by headquarters and enforce AAAs to correct incompliant providers as needed.

Although the program experienced problems implementing the Long-Term Care Community Diversion Pilot Project, it is moving along with implementation plans for two additional pilot projects, Program for All-Inclusive Care for the Elderly and Social Health Maintenance Organization.

As required by s. 430.709, Florida Statutes, the program contracted for an independent evaluation of the Long-Term Care Community Diversion project. However, the preliminary evaluation did not report on the cost of services, as required by law, nor did it assess client outcomes.