TALKING POINTS
DEPARTMENT FOR THE AGING CONCEPT PAPERS -
MEALS-ON-WHEELS AND SENIOR CENTERS
FEBRUARY 21, 2008

As requested at the Feb. 20th CSCS membership meeting, we have prepared talking points regarding the DFTA restructuring of services.

1. Can we slow down the process of rfp’s and restructuring of services? We aren’t against change – there are dangers in too much, too fast.
   The current schedule for rfp’s and transition to new agencies providing services is too much, too fast. The process needs to be slowed down so that there is at least 6 months between rfp’s and transitions.

2. Why is it important to slow down the process?

   1. This leaves appropriate time between rfp’s, the award date, and transition for agencies with old and new contracts to start up. Three months is needed for the transition time as agencies finalize their contract with DFTA, gear up by hiring new staff, putting together their expanded agency infrastructure, and work with the glitches (big and small) bound to occur during the transition – all while running their agency.

   2. More importantly, leaving sufficient time maximizes preventing seniors from falling through the cracks given the fast time line on all these changes within the remaining time of the Bloomberg administration.

   3. DFTA also needs time to develop its internal capacity with staff for these rapid changes to successfully transition agencies in a new structure.

   4. It also leaves time within the Bloomberg administration for the implementation (10 months for MOW and six months for senior centers) of the restructuring.

3. Is there adequate funding available to fulfill the contract responsibilities?
   No. DFTA, like all city agencies, is being asked to take a 3% cut, $3.3 million in FY08, and $5.5 million in FY09 (total $8.8 million). DFTA should be exempt from cuts during this time of major restructuring. It is a small agency and cuts can only impact services. There is about $20 million already exists at DFTA that should be maintained for services:

   1. Exempt DFTA from 3% and 5% across-the-board cuts - $8.8 million. DFTA is absorbing the FY08 3% cut.

   2. Baseline (make permanent) all City Council funding to DFTA –
      meals, rent, vans, Health Aging Initiative, cultural arts programs –
      $12.5 million

   3. Accruals – DFTA annually returns unused funds to OMB. We are uncertain of the exact amount at this time, but estimate it to be around $5 million.

   4. DOH funding – DOH chaired the senior center workgroup. It has been suggested that DOH contribute funds and resources to senior centers so that funding is not only up to DFTA

4. What does “regionalization” of senior centers mean? Will senior centers close? Where does transportation fit in?

   1. DFTA has not been specific in what they mean by “regionalization”. It does seem to imply that what could happen, for example, is that each Community District would receive a specific amount of funding and all senior centers would have to compete for those funds. CSCS and about 40 other organizations participated in a series of senior center workgroup meetings organized by DFTA and DOH and the idea of “regionalization” was never mentioned leaving no opportunity to raise concerns prior to the release of the concept paper. What will be the impact on accessibility for seniors using the industry rule of thumb that a ten block radius is the maximum distance seniors can easily access a local center.

   2. DFTA has stated that some senior centers would close, but hasn’t said how many and which ones. At the Feb. 14th City Council hearing, Council members asked why the city would close senior centers when the senior population is growing – we’ll never get back the space once it is lost. Mayor Bloomberg’s NYCPlan2030 states that there will be a 44% increase in seniors by 2030 and that the city will “need more senior centers and supportive housing”. DFTA’s plan moves in the opposite direction.

   3. No information has been shared about what the funding formula for Community Districts and individual senior centers would be. The concept paper did highlight poverty. Senior centers have always existed for seniors of all income groups in their communities. While low-income seniors do need additional resources, it cannot come at the expense of seniors attending other senior centers. Ironically, the larger the regions of service, the more low income, and minority populations will be underserved.

   4. DFTA should do pilot projects - This is an untested senior center model and the whole system cannot change at once. This is an “extreme makeover”.

   5. DFTA has not been forthcoming in its plans for the vans operated by senior centers for transportation to the center, doctor, etc. It is our understanding that DFTA is thinking about transportation hubs of some kind. However, once again, this would fragment services from senior centers that are best equipped to meet the transportation needs of the seniors. Funds for vans usually come from discretionary funds from City Council, BP’s or state representatives who are unlikely to fund a hub and not a locally based transportation program.

5. What does it mean to bring the Bronx Senior Options meals-on-wheels program to the other boroughs? DFTA’s MOW concept paper suggests reducing MOW contracts from 97 to 10-20 contracts. Will the administration commit to provide adequate funding so there are no waiting lists for MOW?

   1. First and foremost, any restructuring of the MOW system should include a commitment from the administration that there will be adequate funding so that no senior ever sits on a MOW waiting list. Adequate funding for case management is needed because sometimes there are waiting lists for the initial assessment due to inadequate staffing.

   2. The Independent Budget Office (IBO) did a review of the KPMG evaluation of the Bronx Senior Options program, which reduced contracts from 17 to 2. It found that only $200,000 was saved; additional meals were provided through Citymeals as they do in all the boroughs. DFTA did not fund new meals; and the per meal cost is about $6.50 plus some unaccounted for transportation costs making it comparable to costs in other boroughs; the ratio of hot/cold is 60/40 which is more than the DFTA mandated 70/30 level.

   3. There is only one caterer for the whole borough, which provides the same exact food – hot or frozen. The MOW system needs to allow for a menu of options: meet the tastes of a diverse population, therapeutic meals (e.g.-diabetic) and frozen meals. There should be no mandate as to the percentage of frozen meals – it is merely one possible option. Appropriate assessment of clients is critical to MOW options.

   4. 20 regions = 800 meals per contract; 30 regions = 600 meals; 45 regions = 400 meals.

   5. A lead nonprofit agency should be in charge of the meal preparation and delivery by subcontracting with local senior centers to provide a true choice of menus. This would retain the community-based MOW program.

6. How can the community-based aging senior services network achievements be presented and strengthened in a more productive manner? What are DFTA’s goals and measures? Where is the voice of seniors?

   1. The glass half empty - It is disturbing that the achievement of case management agencies, meals-on-wheels providers, and senior centers has been presented in a negative light. Harping on “underutilization” of meals, doing business “the same way for 40 years”, and that restructuring will create sufficient funding does not allow for an environment where planning and implementation in a true partnership between DFTA and service provider can happen. What has DFTA done to turn around underutilized senior centers, which is central to its mandate as an advocate for the city’s elderly?

   2. The glass half full -The State Office for the Aging (SOFA), in a time of a state budget deficit, received a 9% increase to its budget because it present the aging services network for what it is – the nursing home diversion program and Medicaid cost containment program the state (and city) is looking for. Some of these funds are for pilot programs. DFTA should pilot changes to senior centers before they rfp out all 329 simultaneously. SOFA explained that after decades of inadequate budgeting, there needs to be an investment of funds. Presenting the aging services network in this positive light resulted in additional dollars, not cuts. It also shows tremendous understanding and respect for the challenges and achievements of the community-based network over the past four decades.

   3. Where is the voice of seniors? – What do seniors expect from senior centers? MOW? Case management? What motivates them to continue to attend their senior center? This voice must be heard, but time is needed.

   4. How do you define success? Many providers are concerned about the lack of specificity and confusion implicit in DFTA’s stated goals, measures, standards and plan. For instance: what, specifically, is meant by “collaborative” efforts? How are partnerships formed to address the needs of various populations such as ethnicity, disabilities, geographical neighborhoods and so on?

   5. Variety of programs are offered but not counted by DFTA in its utilization rate - CSCS’ Senior Center Program Survey, responded to by 130 senior centers within days, showed that senior centers across the city have changed how they do business by offering health and wellness programs, arts, computer classes and have moved well beyond “bingo and nutrition”. To be respectful of the wishes of seniors, bingo, cards, etc. should be offered as well as long as there are seniors who want to partake in those activities.