Area Agencies on Aging in Missouri

Structure of Area Agencies on Aging (AAAs) in Missouri

Missouri’s aging services network is built around ten Area Agencies on Aging (AAAs), which serve the state’s older adults under the Older Americans Act (OAA). These AAAs are responsible for coordinating services such as nutrition programs, transportation, caregiver support, and in-home care to help seniors remain independent.

The Missouri Department of Health and Senior Services (DHSS), Division of Senior and Disability Services (DSDS) provides state-level oversight, ensuring that AAAs follow federal and state guidelines.

Key Aspects of Missouri’s AAA Structure:

1. Ten Regional AAAs Cover the Entire State:
   • Missouri’s AAAs are regionally based, each serving multiple counties.
   • This structure ensures that aging services are distributed evenly across urban and rural areas.
   • Similar to Mississippi, Alabama, and North Carolina, Missouri uses a regional model rather than county-specific AAAs.
2. State Oversight by the Department of Health and Senior Services (DHSS):
   • Missouri’s DHSS, Division of Senior and Disability Services (DSDS) oversees all AAAs.
   • DHSS distributes federal and state funds and monitors compliance with OAA requirements.
   • This is similar to Georgia and Tennessee, where state agencies oversee aging services but allow regional AAAs to operate independently.
3. AAAs Act as Coordinators, Not Direct Providers:
   • Missouri’s AAAs contract with local organizations rather than delivering services directly.
   • They fund senior centers, meal providers, and transportation services instead of running those programs in-house.
   • This is the same model used in Texas, Indiana, and Virginia, where AAAs distribute funding rather than operate services directly.
4. Aging & Disability Resource Centers (ADRCs) Integrated with AAAs:
   • Missouri’s AAAs also function as ADRCs, providing a single-entry point for seniors and people with disabilities seeking:
     • Medicare and Medicaid assistance
     • Long-term care options counseling
     • Nursing home transition services
   • This model is common in states like Wisconsin, North Carolina, and Ohio, where ADRCs are embedded within AAAs.
5. Services Provided Include:
   • Home-delivered meals (Meals on Wheels) and congregate meals
   • Transportation assistance
   • Caregiver support and respite care
   • Medicare counseling (SHIP program)
   • Legal assistance for seniors
   • Long-term care ombudsman services
   • Health promotion and fall prevention programs
   • Senior employment and volunteer opportunities
6. Emphasis on Home and Community-Based Services (HCBS):
   • Missouri prioritizes aging in place, helping seniors stay at home rather than moving into nursing homes.
   • Medicaid waiver programs fund in-home support services like personal care, homemaker services, and adult day care.
   • This focus aligns with states like Minnesota, Oregon, and Washington, but Missouri has a more balanced approach that still includes institutional care options.

Comparison with Other States

Similarities:

• Federal Compliance with the Older Americans Act (OAA):
  • Missouri’s AAAs operate under the Older Americans Act (OAA) and receive funding from the Administration for Community Living (ACL), just like all other states.
• Regional AAA Model:
  • Missouri has ten regional AAAs, covering multiple counties, similar to:
    • North Carolina (16 AAAs)
    • Tennessee (9 AAAs)
    • Mississippi (10 AAAs)
• State-Level Oversight:
  • The Missouri DHSS oversees AAAs, similar to models in Georgia, Alabama, and Kentucky, where a state agency supervises the funding and compliance of AAAs.
• Contract-Based Service Delivery:
  • Missouri’s AAAs contract out services rather than providing them directly, following the same model as Texas, Indiana, and Virginia.
• Integrated Aging & Disability Resource Centers (ADRCs):
  • Like Wisconsin, Ohio, and North Carolina, Missouri has ADRCs within AAAs, making it easier for seniors and people with disabilities to access services.

Differences:

• More Balanced Approach Between Home & Institutional Care:
  • While Missouri prioritizes home-based care, it still maintains a strong nursing home infrastructure compared to states like Minnesota and Oregon, which heavily favor home-based services.
• Fewer AAAs Than Some States with Larger Populations:
  • Missouri has ten AAAs covering multiple counties, while states with similar populations—such as Michigan (16 AAAs) and Pennsylvania (52 AAAs)—have more localized aging networks.
• More State Oversight Than Some States:
  • Missouri’s DHSS has more direct involvement in AAA operations than states like California and Texas, where AAAs operate with more independence.
• Strong Coordination with Medicaid Waiver Programs:
  • Missouri integrates Medicaid-funded in-home care with AAA services, while in Florida and Texas, private managed care organizations handle most Medicaid long-term care programs.

Conclusion

Missouri’s ten AAAs serve as regional hubs for senior services, operating under the oversight of the Missouri Department of Health and Senior Services (DHSS). Unlike some states where AAAs provide services directly, Missouri’s AAAs contract with local providers for home-delivered meals, transportation, caregiver support, and other essential programs.

Compared to other states, Missouri’s AAA model is structured similarly to states like North Carolina and Mississippi, where regional agencies serve multi-county areas with strong state oversight. Missouri also integrates Aging & Disability Resource Centers (ADRCs) into its AAA network, ensuring a single-entry system for long-term care services, much like Wisconsin and Ohio.

While Missouri prioritizes home-based care, it maintains a balance with institutional services, unlike states that focus more heavily on nursing home alternatives. Its contract-based service delivery model, Medicaid coordination, and state-supervised AAA structure set it apart from states with more decentralized or privatized systems, such as Florida, Texas, and California.

List of Area Agencies on Aging in Missouri