NC2 Other Federal Funds Indication of other federal funds used for OAA services. (multiple selection) Yes Multiple Boolean (multiple select) 01=Medicaid 02=Medicaid Waiver 03=SSBG 04=CSBG 05=USDA 06=DOT 98=Other 99=None • If 99=None is selected; other codes are not available. NC3 Federal Funds Comments Comments on Federal Funds, if appropriate. No Single String N/A (not a element) • Maximum length of 700 characters with spaces. Network Staff and Volunteers Subcomponent The Network subcomponent includes data regarding staffing and volunteers and the state and Area Agency on Aging level of the network. All data elements are single quantifier. All data elements are numeric (integer) and not a coded element. Element Number Data Element Element Description Required Business Rules/Notes SV1 SUA Staff Number of paid full-time (average 35+ hours a week) at SUA as of September 30 of reporting year. Ombudsman staff are not included in count. Yes SV2 SUA Staff Number of paid part-time (average less than 35 hours a week) at SUA as of September 30 of reporting year. Ombudsman staff are not included in count. Yes
SD2 Title III Expenditure - Older Adults outlays/payments made by the SUA and/or AAA’s using OAA federal funds to provide Title III B services through Self-Directed Care. Numeric dollar amount (2 decimal) SD3 Other - State Expenditure - Older Adults Outlays/payments made by the SUA and/or AAA’s using state funds to provide Title III B services through Self-Directed Care. Numeric dollar amount (2 decimal) SD4 Other - Non-State Expenditure - Older Adults Outlays/payments made by the SUA and/or AAA’s not using OAA or state funds to provide Title III B services through Self-Directed Care. Numeric dollar amount (2 decimal) SD5 Program Income Expended - Older Adults Gross income received and expended by the grantee and all sub grantees such as voluntary contributions or income earned only as a result of the grant project during the grant period. Numeric dollar amount (2 decimal) SD6 Persons Served - Caregivers Older Adult Total Unduplicated Count of Caregivers of Older Adults who use self-direction to obtain services funded in whole or part by Title of the OAA Numeric (integer) • Value must be equal to or less than element #SC4: Caregivers of Older Adults (Title III-E registered services) SD7 Title III Expenditure - Caregivers Older Adult Total outlays/payments made by the SUA and/or AAA’s using OAA federal funds to provide Title III-E services for Caregivers of Older Adults through Self-Directed Care. Numeric dollar amount (2 decimal) SD8 - State Expenditure Older Adult Outlays/payments made by the SUA and/or AAA’s state funds to provide Title III-E services for Caregivers of Older Adults through Self-Directed Care. Numeric dollar amount (2 decimal)
SD14 Other - Non-State Expenditure - Older Relative Caregivers Outlays/payments made by the SUA and/or AAA’s not using OAA or state funds to provide Title III-E services for Caregivers of Children and Disabled Adults through Care. Numeric dollar amount (2 decimal) SD15 Program Income Expended - Older Relative Caregivers Gross income received and expended by the grantee and all sub grantees such as voluntary contributions or income earned only as a result of the grant project during the grant period. Numeric dollar amount (2 decimal) Respite Voucher III-E) Subcomponent The Network subcomponent includes data regarding caregivers that used Respite Vouchers to receive respite services. The use of vouchers is an approach to service delivery. Actual respite service information will be collected within the appropriate respite service area. All data elements are required and single quantifier. Element Number Data Element Element Description Type Business Rules/Notes RV1 Persons Served -Caregivers Older Adult Total Unduplicated Count of Caregivers of Older Adults who use vouchers to obtain respite services funded in whole or in part by Title III-E of the OAA. Numeric (integer) • Value must be less than or equal to element #CG1 (total persons served respite).
Element Number Data Element Element Description Required Services CD1 Consumers - Total Total Count of Consumers that received a specific service. Yes • Registered services w/ ADLs and IADLs - unduplicated (note: data element SC1 captures total registered consumers) • Each Registered service separately • Restricted service: Legal Assistance • Nutrition Education (non-registered service; estimated audience size) • Health Promotion – Evidence Based • Health Promotion – Non-Evidence Based • Other services – unduplicated count (note details are reported in the subcomponent – “other services”) CD2 Age - Total • <60 • 60-64 • 65-74 • 75-84 • 85+ • Age Missing Total Count of Consumers by age group that received service. Yes • All registered services – unduplicated • Registered services w/ ADLs and IADLs - unduplicated • Each registered service separately • Restricted service: Legal Assistance CD3 Gender Identity - Total • Female • Male • Other • Gender Missing Total Count of Consumers by gender identity that received service. Yes • All registered services – unduplicated • Registered services w/ ADLs and - unduplicated • Each registered service separately • Restricted service: Legal Assistance CD4 Geographic Distribution - Total • Rural • • Geographic Distribution Missing Total Count of Consumers by geographic distribution (e.g. rural, non-rural) that received service. Yes • All registered services – unduplicated • Registered services w/ ADLs and IADLs - unduplicated • Each registered service separately Restricted service: Legal Assistance
CD5 Poverty Status - • At or Below Poverty • Above Poverty • Poverty Status Missing Total Count of Consumers by poverty status that received service. Yes • All registered services – unduplicated • Registered services w/ ADLs and - unduplicated • Each registered service separately • Restricted service: Legal Assistance CD6 Household Status - Total • Lives Alone • Lives with Others Lives in Long Term Care (LTC) Facility • Household Status Missing Count of Consumers by household status that received service. Yes • All registered services – unduplicated • Registered services w/ ADLs and IADLs - unduplicated • Each registered service separately Restricted service: Assistance CD7 Ethnicity - Total • Hispanic or Latino • Not Hispanic or Latino • Ethnicity Missing Total Count of Consumers by ethnicity that received service. Yes • All registered services – unduplicated • Registered services w/ ADLs and - unduplicated • Each registered service separately • Restricted service: Legal Assistance CD8 Race - Total • American Indian or Alaska Native • Asian or Asian American • Black or African American • Native Hawaiian or Pacific Islander • White • Race Missing Total Count of Consumers by race that received service. Race is duplicated person count -- NOT unduplicated. Multi-racial Consumers are counted for each racial identity. Yes • All registered services – unduplicated • Registered services w/ ADLs and IADLs - unduplicated • Each registered service separately Restricted service: Legal Assistance CD9 Minority Status - • Minority • Not Minority • Minority Status Missing Total Count of Consumers by minority status that received service. Racial and ethnic minority populations are defined as: Asian American, Black or African American, Hispanic or Latino, Native Hawaiian and Pacific Islander, American Indian and Alaska Native. (CDC) Yes • All registered services – unduplicated • Registered services w/ ADLs and IADLs - unduplicated • Each registered service separately • Restricted service: Legal Assistance
CD10 ADL Score - Total • 0-1 • 2 • 3+ • ADL Missing Total Count of Consumers by ADL score that received service. Yes • Registered services with ADL/IADL - unduplicated • Each registered service separately for this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) CD11 IADL Score - Total • 0-1 • 2 • 3+ • IADL Missing Total Count of Consumers by IADL score that received service. Yes • Registered services with ADL/IADL - unduplicated • Each registered service separately for this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) CD12 Nutrition Risk Score - Total • 0-5 • 6+ • Score Missing Count of Consumers by Nutrition Risk Score that received service. Yes • Registered services with Nutrition Risk Score - unduplicated Each registered service separately that requires Risk Score (Home-delivered nutrition, congregate nutrition, nutrition counseling) CD13 Age - At or Poverty • <60 • 60-64 • 65-74 • 75-84 • 85+ • Age Missing Count of Consumers at or below poverty by age group that received service. Yes • All registered services - unduplicated • Registered services with ADL/IADL - unduplicated • Each registered service separately Restricted service: Assistance CD14 Gender Identity - At or Below Poverty • Female • Male • Other • Gender Missing Total Count of Consumers by gender identity that received service. Yes • All registered services - unduplicated • Registered services with ADL/IADL - unduplicated • Each registered service separately Restricted service: Legal Assistance
CD19 Minority Status - At or Below Poverty • Minority • Not Minority • Minority Status Missing Count of Consumers at or below poverty by minority status that received service. CDC Source: Racial and ethnic minority populations are defined as: Asian American, Black or African American, Hispanic or Latino, Native Hawaiian and Pacific Islander, American Indian and Alaska Native. Yes • All registered services - unduplicated • Registered services with ADL/IADL - unduplicated • Each registered service separately • Restricted service: Legal Assistance CD20 ADL - At or Below Poverty • 0-1 • 2 • 3+ • ADL Missing of Consumers at or below poverty by ADL score that received service. Yes • Registered services with ADL/IADL - unduplicated • Each registered service separately for which this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) CD21 IADL Score - At or Below Poverty • 0-1 • 2 • 3+ • IADL Missing Count of minority Consumers by poverty status that received service. Yes • Registered services with ADL/IADL - unduplicated Each registered service separately for which this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) CD22 Nutrition Risk Score - At or Below Poverty • 0-5 • 6+ • Score Missing Count of Consumers at or below poverty by Nutrition Risk Score that received service. Yes • All registered services - unduplicated • Registered services with ADL/IADL - unduplicated • Each registered service separately that requires Risk Score (Home-delivered nutrition, congregate nutrition, nutrition counseling)
CD23 Age - ADL 3+ • <60 • 60-64 • 65-74 • 75-84 • 85+ • Age Missing of Consumers ADL score of 3 and above by age group that received service. Yes • Registered services with ADL/IADL - unduplicated • Each registered service separately for which this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) Excluding Legal Assistance CD24 Gender Identity -ADL 3+ • Female • Male • Other • Gender Missing Total Count of Consumers with ADL score 3 and above by gender identity that received service. Yes • All registered services - unduplicated • Registered services with ADL/IADL - unduplicated • Each registered service separately • Excluding Legal Assistance CD25 Geographic Distribution - ADL 3+ • Rural • Non-rural • Geographic Status Missing Count of Consumers ADL score of 3 and above by geographic distribution that received service. Yes • Registered services with ADL/IADL – unduplicated • Each registered service separately for which this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) Excluding Legal Assistance CD26 Poverty Status - ADL 3+ • At or Below Poverty • Above Poverty • Poverty Status Missing Count of Consumers ADL score of 3 and above by poverty status that received service. Yes • Registered services with ADL/IADL – unduplicated • Each registered service separately for this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) Excluding Legal Assistance CD27 Household Status - ADL 3+ • Lives Alone • Lives with Others • Household Status Missing Count of Consumers ADL score of 3 and above by household status that received service. Yes • Registered services with ADL/IADL – unduplicated • Each registered service separately for which this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) Excluding Legal Assistance
CD32 Age - IADL 3+ • <60 • 60-64 • 65-74 • 75-84 • 85+ • Age Missing Count of Consumers IADL score of 3 and above by age group that received service. Yes • Registered services with ADL/IADL – unduplicated • Each registered service separately for this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) Excluding Legal Assistance CD33 Gender Identity - IADL 3+ • Female • Male • Other • Gender Missing Total Count of Consumers with IADL score 3 and above by gender identity that received service. Yes • Registered services with ADL/IADL – unduplicated • Each registered service separately for this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) Excluding Legal Assistance CD34 Geographic Distribution - IADL 3+ • Rural • Non-rural • Geographic Distribution Missing Count of Consumers IADL score of 3 and above by geographic distribution that received service. Yes • Registered services with ADL/IADL – unduplicated • Each registered service separately for this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) Excluding Legal Assistance CD35 Poverty Status - IADL 3+ • At or Below Poverty • Above Poverty • Poverty Status Missing Count of Consumers IADL score of 3 and above by poverty status that received service. Yes • Registered services with ADL/IADL – unduplicated • Each registered service separately for which this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt Excluding Legal Assistance)
CG2 Age - Total • 18-49 • 50-59 • 60-64 • 65-74 • 75-84 • 85+ • Age Missing Count of Caregivers of Older Adults by age that received service. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services) CG3 Gender Identity - • Female • Male • • Gender Missing Count of Caregivers of Older Adults by gender identity that received service. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services) CG4 Geographic Distribution - • Rural • Non-rural • Geographic Distribution Missing Total Count of Caregivers of Older Adults by geographic distribution that received service. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services) CG5 Poverty Status - • At or Below Poverty • Above Poverty • Poverty Status Missing Total Caregivers of Older Adults by poverty status that received service. Yes • Registered services – unduplicated (i.e. counseling, training, respite, access assistance – case management, supplemental services) CG6 Ethnicity - Total • Hispanic or Latino • Not Hispanic or Latino • Ethnicity Missing Caregivers of Older Adults by ethnicity that received service. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services)
CG13 Ethnicity - At or Below Poverty • Hispanic or Latino • Not Hispanic or Latino • Ethnicity Missing Count of Caregivers of Older Adults at or below poverty by ethnicity that received service. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services) CG14 Race - At or Below Poverty • American Indian or Alaska Native • Asian or Asian American • Black or African American • Native Hawaiian or Pacific Islander • White • Race Missing Count of Caregivers of Older Adults at or below poverty by race that received service. Race is duplicated caregiver count -- NOT unduplicated. caregivers are counted in each race indicated. Yes • Registered services – unduplicated (i.e. counseling, training, respite, access assistance – case management, supplemental services) CG15 Minority Status - At or Below Poverty • Minority • Not Minority • Minority Status Missing Count of Caregivers of Older Adults at or below poverty by minority status that received service. CDC Source: Racial and ethnic minority populations are defined as: Asian American, Black or African American, Hispanic or Latino, Native Hawaiian and Pacific Islander, American Indian and Alaska Native. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services)
CG16 Relationship - At or Below Poverty • Husband • Wife • Domestic partner, including civil union • Son/Son-in-Law • Daughter/ Daughter-in-Law • Sister • Brother • Other Relative • Non-Relative • Relationship Missing of Caregivers of Older Adults at or below poverty by relationship that received service. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services) Older Relative Caregivers of Children and Adults with Disabilities for Select Services (Title III-E) Subcomponent The Service subcomponent includes data regarding specific demographics and characteristics of older relative caregivers (caring for children or adults under age 60 with disabilities). All data elements are single quantifier. Note some variables are not required for the first 3-years of data collection All data elements are numeric (integer) and not a element. Element Number Data Element Element Description Required Services
OR6 Ethnicity - • Hispanic or Latino • Not Hispanic or Latino • Ethnicity Missing Total Older Relative Caregivers by ethnicity that received service. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services) OR7 Race - Total • American Indian or Alaska Native • Asian or Asian American • Black or African American • Native Hawaiian or Pacific Islander • White • Race Missing Total Older Relative Caregivers by race that received service. Race is duplicated caregiver count -- NOT unduplicated. Multi-racial caregivers are counted in each race indicated. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services) OR8 Minority Status - Total • Minority • Not Minority • Minority Status Missing Total Older Relative Caregivers by minority status that received service. CDC Source: Racial and ethnic minority populations are defined as: Asian American, Black or African American, Hispanic or Latino, Native Hawaiian and Pacific Islander, American Indian and Alaska Native. Yes • Registered services – unduplicated (i.e. counseling, training, respite, access assistance – case management, supplemental services) OR9 Relationship - Total • Grandparents • Parents • Other Older Relative • Older Non-Relative • Relationship Missing Total Older Relative Caregivers by relationship that received service. Yes • Registered services – unduplicated (i.e. counseling, training, total respite, access assistance – case management, supplemental services)
Element Number Data Element Element Description Type Codes and Values SCG1 Service Name Name of a service provided using OAA funds, in whole or in part, that do not fall into the defined service categories for Title III-E Alphanumeric String (30 characters) SCG2 Service Unit Name Service Unit type. e.g. Activity, hours, session Alphanumeric String (15 characters) SCG3 Service Domain Category of service provided. Numeric Code 01=Assistive Technology/ Durable Equipment/ Emergency Response 02=Consumable supplies 03=Home Modifications/ Repairs 04=Legal and/or Financial Consultation 05=Homemaker/chore/personal care 06=Transportation 07 = Nutrition services 08=Other SCG4 Estimated Persons Served Total Estimated Unduplicated Person served Numeric (integer) SCG5 Estimated Service Unit Total estimated service units provided. Numeric (integer) SCG6 Title III Expenditure Total outlays/payments made by the SUA and/or AAA’s using OAA federal funds, in whole or in part, to provide the service. Numeric dollar amount (2 decimal) SCG7 Other - State Expenditure Outlays/payments made by the SUA and/or AAA’s using state funds to provide the service. Numeric dollar amount (2 decimal) SCG8 Other - Expenditure Outlays/payments made by the SUA and/or AAA’s not OAA or state funds to provide the service. Numeric dollar amount (2 decimal)
SOR3 Service Domain Category of service provided. Numeric Code 01=Assistive Technology/ Durable Equipment/ Emergency Response 02=Consumable supplies 03=Home Modifications/ Repairs and/or Financial Consultation 05=Homemaker/chore/personal care 06=Transportation 07 = Nutrition services 08=Other SOR4 Estimated Persons Served Estimated Unduplicated Person served Numeric (integer) SOR5 Estimated Service Unit Total estimated service units provided. Numeric (integer) SOR6 Title III Expenditure Total outlays/payments made by the SUA and/or AAA’s using OAA federal funds, in whole or in part, to provide the service. Numeric dollar amount (2 decimal) SOR7 Other - State Expenditure Outlays/payments made by the SUA and/or AAA’s using state funds to provide the service. Numeric dollar amount (2 decimal) SOR8 Other - Expenditure Outlays/payments made by the SUA and/or AAA’s not using OAA or state funds to provide the service. Numeric dollar amount (2 decimal) SOR9 Program Income Expended Gross income received and expended by the grantee and all sub grantees such as voluntary contributions or income earned only as a result of the grant project during the grant period. Numeric dollar amount (2 decimal)