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Part V:

Comparative Analysis of Services/Programs offered by the Area Agencies on Aging and Centers for Independent Living

Clipart: Pen & ink drawing. Repeat of drawing on page 35, Part IV. Pen & ink drawing. Picture of a man in a hat and coat holding a magnifying glass in his right hand. He is squatting and looking into / inspecting a home. The home is drawn much smaller than the man.

Relevance to Centers for Independent Living (CILs)

This section takes the comparison between CILs and the Area Agencies on Aging (AAAs) one step further by comparing the services offered by each agency. CILs will find that there are many similar services offered by the AAAs. Within their local area, AAAs contract out many services to other providers. CILs have a great opportunity to become contract service providers.

CILs' experience and success in providing services to people of all ages with disabilities can be a valuable asset to the AAAs along with providing additional financial support to CILs. CILs and the AAAs need to become aware of one another's organizational structure, purpose and services in order to develop a working collaboration. This could start with a telephone call to the executive director of the AAA(s) in your area.

Part V: Comparative Analysis of Services/Programs Offered by the Area Agencies on Aging and Centers for Independent Living

Components	AAAs	CILs
Professional Directive / Funding	Older Americans Act, Title III	Rehabilitation Act, Title VII
Eligible participant / consumer	Elder persons age 60+ who are frail, live alone and have low economic status.	Anyone with a disability (physical, mental or cognitive) of any age.
Core Services Provided	1. Information & Access Services 2. Nutritional Services 3. In-home Services 4. Preventive Health Services	1. Information & Referral 2. Individual and Systems Advocacy 3. Independent Living Skills Training 4. Peer Counseling
Additional services offered by the Agencies	1. Information and Referral / Assistance 2. Health Insurance Counseling 3. Client Assessment 4. Care Management 5. Transportation 6. Caregiver Support 7. Retirement Planning and Education 8. Employment Services 9. Senior Centers 10. Congregate Meals 11. Adult Day Care Services 12. Volunteer Opportunities 13. Meals-on-Wheels 14. Chore Services 15. Telephone Reassurance 16. Friendly Visiting 17. Energy Assistance & Weatherization 18. Emergency Response Systems 19. Home Health Services 20. Personal Care Services 21. Respite Care 22. Senior Housing 23. Alternative Community-Based Living Facilities 24. Legal Assistance 25. Elder Abuse Prevention Programs 26. Ombudsmen Services for Complaint Resolution	1. Transportation Assistance 2. Housing Assistance 3. Independent Living Skills Evaluation and Instruction 4. Vocational Assistance 5. Financial Management and Securing Income 6. Information Access/Technology 7. Mental Health Support Services (Peer Advocate) 8. Volunteer Program 9. Community Awareness of Disability Issues 10. Cooking and Nutrition Program 11. Personal Attendant Management 12. Assistive Technology Information & Services 13. Accessible Housing Information 14. Accessibility Information 15. Recreational Opportunities 16. Transition from High School 17. Education Enhancement Services 18. Deaf Services (Sign Language Interpreting, Awareness, Advocacy) 19. Brailling Service 20. Computer Usage 21. Social Skill Development 22. Sign Language Interpreter Coordination 23. Mobility Training 24. Architectural Barrier/ADA Compliance Consultation Service for Businesses and Institutions 25. Assistive Listening Systems 26. Legal Service Information

Areas of Programmatic Similarity

Both AAAs and CILs may assist their perspective participants in:	Both AAAs and CILs can work in the following areas:
1. legal services 2. housing 3. transportation arrangements 4. personal assistant programs 5. outreach programs 6. employment opportunities 7. education 8. counseling services 9. advocacy services 10. services for multiple disabilities 11. caregivers 12. home repair, renovation, modification 13. mental health services	1. Partner with other consumer advocacy groups 2. Partner with other community agencies (but not necessarily with each other) 3. Serve as a visible focal point for their perspective participants/consumers 4. Promote certain issues to remove barriers to participant/consumer participation 5. Promote public policy, legislation, and private sector initiatives that address the needs and priorities of the participant/consumer 6. Participant/consumer civil and benefit rights, decrease discrimination due to age, disability, and improve quality of life 7. Become involved in research and training to improve service provision, coordination, etc. 8. Become involved with Medicaid, Community Waiver Grants Funding

Both AAAs and CILs may assist their perspective participants in:

Both AAAs and CILs can work in the following areas:

1. legal services

2. housing

3. transportation arrangements

4. personal assistant programs

5. outreach programs

6. employment opportunities

7. education

8. counseling services

9. advocacy services

10. services for multiple disabilities

11. caregivers

12. home repair, renovation, modification

13. mental health services

1. Partner with other consumer advocacy groups

2. Partner with other community agencies (but not necessarily with each other)

3. Serve as a visible focal point for their perspective participants/consumers

4. Promote certain issues to remove barriers to participant/consumer participation

5. Promote public policy, legislation, and private sector initiatives that address the needs and priorities of the participant/consumer

6. Participant/consumer civil and benefit rights, decrease discrimination due to age, disability, and improve quality of life

7. Become involved in research and training to improve service provision, coordination, etc.

8. Become involved with Medicaid, Community Waiver Grants Funding

Areas of Programmatic Differences

Issues	Area Agency on Aging	Center for Independent Living
Population Served	Elderly persons, age 60+ Those most in need (frail, lives alone, low-economic status)	Anyone with disability. In 2003, 22.5% of people served by CILs were age 65 and over (40,000 out of 195,000 participants)¹
Identification/label of person served	Client, Patient, Resident	Consumer, Participant
Organizational Structure	Professional Control/Directed	Consumer Control/Self-Directed
Community & Self Perceptions of the Person with a Disability¹	A person who, as a result of an impairment, is unable to participate in a variety of roles due to functional limitations - needs rehabilitation, personal assistance or other services²	A person identified as having an impairment, who as a result of community perceptions and structural barriers is restricted from participating in a variety of roles, including roles related to education, employment, recreation, social, worship, and civic activities, etc.²
Nursing Home Placement	Person with impairment referred to nursing home when believed no longer able to live alone safely or needs skilled care	De-institutionalization: Community inclusion with home-based care while supporting greater self-determination & choice for the individual with limitations.
Service Provision	AAAs provide direct services and contract with local providers to furnish other professional services in the community for elderly consumers; a rehabilitative approach.	CILs provide direct services by people with disabilities for people with disabilities that encourage individual self-sufficiency, consumer-controlled in the least restricted environment; an independent living philosophy approach.
Housing	Assist independent elderly to obtain housing designed to accommodate their needs and preferences and alternative community-based living facilities that bridge the gap between independent living and nursing homes	Prohibited to run/own residential housing but promotes accessible housing programs. Purpose of CIL is to promote independent living. Works with private, local, state and federal agencies to develop accessible housing
Agency Service Providers	Healthcare professional staff/case managers	Independent living specialists and peer counselors
Service Plans	Case manager establishes the plan of care	Independent Living Plans are established by each consumer, unless the consumer chooses to waive a plan.

¹Three hundred and twenty-two CILs were federally funded in FY 2001-FY 2003. There are other CILs not federally funded.
²http://www.impactcil.org/phil_history/il_rehab.htm

Charts prepared by: Linda F. Fraas, MA, OTR/L, ATP, CEAC