National Survey of Legal Assistance for the Elderly: Results and Implications

Report of Survey Findings by Respondent Type

This section provides a fairly detailed report on the survey data organized according to the various categories of respondents. That is, the Legal Services Developers section highlights data reported by Legal Services Developers; the Area Agencies on Aging section highlights data reported by Directors of Area Agencies on Aging; the Title IIIB Providers section highlights data reported by Directors and Managing Attorneys of Title IIIB-funded legal assistance providers who do not receive LSC funds; the Title IIIB/LSC Providers section highlights data reported by Directors and Managing Attorneys of Title IIIB/LSC-funded legal assistance providers; and the LSC Providers section highlights the survey data reported by Directors and Managing Attorneys of LSC-funded legal services providers. These breakdowns are designed to assist in more fully understanding the above highlighted issues as well as the variances among the three provider types.


Legal Services Developers

Tenure of Legal Service Developers

Legal services developers were asked to report how long they have held their position. Based upon their responses the average tenure of developers is 4 1/2 years, although time in the position ranged from only a few months to over sixteen years.

 

Time Devoted to LSD Responsibilities

The amount of time a Legal Services Developer allocates to the position and duties varies; many individuals serving in that position have other job titles and responsibilities. Survey data show that percentage of time spent on the position ranges from 2-100%. Of their time spent on the LSD position and duties, the average developer spends 46% of it with LSC programs promoting legal services for the elderly and elder rights advocacy. Just over 43% of the LSD respondents indicated that they spend less time on their LSD duties than when they started in the position. The primary reasons cited for spending less time as developer included funding cuts, increases in other work responsibilities and reduction in staff. In contrast, 16% of developers indicated they spend more time on LSD responsibilities. Reasons cited for spending more time as developer included increased community and coalition involvement, increased knowledge of LSD responsibilities and an increase in specific projects.

 

Priority of Legal Services

Legal Services Developers were asked to speculate as to how funding for legal services would change in their state if legal were no longer a priority service in the Older Americans Act. Over 70% indicated that they would expect funding for legal services to decrease if it were no longer a priority service. Approximately 20% indicated that they would not expect funding for legal services to change, while 9% indicated that they did not know how funding levels would be affected if legal were removed as a priority service.

 

Involvement in LSC Planning

The majority (56.5%) of responding LSDs reported that neither they nor anyone in the state agency were involved in state LSC planning. Of the 34.6% that were involved, the majority were “engaged in planning discussions” or “participated in informal networking.” Only a little over 30% of those involved in planning were formally involved (i.e. served on a planning committee) in the process. Results showing that where LSDs are involved in LSC planning, they are involved only informally suggest that LSDs must initiate, and perhaps work harder to ensure that the needs of older persons are considered.

 

Tracking LSC Changes

Legal Services Developers were asked whether they have implemented, or are in the process of implementing a plan to track how LSC changes affect legal services for older persons. Nearly 70% of the LSDs who responded reported that they had no plan implemented or no plan in the process. Twenty-four percent of responding LSDs reported that they have a plan for tracking how LSC changes affect legal services for older people.

 

Statewide Standards for Title IIIB Legal Assistance

Legal Services Developers were asked to report on whether their state currently has statewide standards for the delivery of Title IIIB legal assistance to older individuals. Sixty-seven percent of responding LSDs reported that their state did have statewide standards in place. Twenty percent reported that no statewide standards were in place in their state. Just over 2% reported “Don’t Know” and 11% reported “Other.”

 

Working with Area Agencies on Aging

When asked if AAAs in their state had changed with whom they contract for legal services, just over 41% of the responding LSDs reported “No.” Thirty-seven percent of the responding LSDs reported that AAAs had changed with whom they contract for legal assistance. Seven percent reported “Don’t know”; 9% reported “Other.”

Legal Services Developers were also asked if AAAs in their state have changed their funding levels for legal services. Fifty percent reported that funding levels in their state had not changed; twenty-two percent reported a decrease in the level of funding; only 9% reported an increase.

 

Minimum Percentage of Funding for Title IIIB Legal Assistance

The Older Americans Act requires that each state set a percentage of Title IIIB funds to be spent by AAAs on legal services. Legal Services Developers were asked to state the set minimum percentage of funding that is to be spent in their state. The average percentage was 4.4%; the median is 5%. That is, on average, 4.4% of all Title IIIB funds in a given state are to be spent on legal assistance services for older persons.

Click here for a complete listing of each state’s LSD.




Area Agencies on Aging

 

Providers of Title IIIB Legal Assistance

Area agencies on aging were asked to identify the types of providers they utilize for the provision of IIIB legal assistance. Sixty-two percent of AAAs indicated they use LSC providers (Title IIIB/LSC providers); 25% indicated they use private attorneys (Title IIIB providers); 13 % indicated “Other.”

Area agencies on aging were asked if they had changed legal assistance providers over the past few years, 89% indicated that they had not. Of the 33 AAAs that had switched their providers in the past few years, over 60% indicated that the change was not due to LSC cuts and/or restrictions on activities.

 

AAAs Involvement with LSC Planning

Area agencies on aging were asked if they had been involved with the LSC state planning. Over 88% indicated that they had not been involved in this planning process. Of the 32 AAAs that were involved in the process, over half were engaged in planning discussions concerning legal assistance for older persons; half participated in informal networking. Under 20% of those that were involved in the process indicated that they exerted influence to promote legal assistance for older persons in the planning.

 

AAA Funding of Legal Assistance

Area agencies on aging were asked if they had changed their level of funding allocated for legal assistance in the past two years. Sixty-one percent indicated “no change” in the level of funding; 25% indicated a decrease in funds allocated for legal assistance; 11% indicated an increase in funds. The average AAA allocates approximately $39,360 per year to legal assistance; the average percentage of Title IIIB funds allocated to legal assistance each year is 9.55%. Only 22% of AAAs supplement the Title IIIB funds allocated to legal assistance.

 

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Impact Work and Advocacy

Area agencies on aging were asked to identify in what types of impact work their legal assistance providers engaged. Over 48% indicated that their legal assistance providers conducted litigative advocacy; almost 38% indicated their providers engaged in administrative advocacy; and 22% indicated their providers engaged in legislative advocacy.

Area agencies on aging were also asked whether they encouraged or discouraged their legal assistance providers to engage in elder rights impact work. Forty-seven percent indicated that they encouraged their legal assistance providers to engage in impact work; 42% indicated they took no position regarding elder rights impact work; only 1% indicated they discouraged their providers from engaging in elder rights impact work.

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Priority of Legal Assistance

Area agencies on aging were asked to speculate as to how funding for legal assistance would change if legal were no longer a priority service in the Older Americans Act. Almost 55% indicated that they would expect funding for legal assistance in their state to decrease if it were no longer a priority service. Approximately 22% indicated that they would not expect funding for legal to change, while 21% indicated that they did not know how funding levels would be affected if legal were removed as a priority service.

Finally, AAAs were asked to rate the importance of legal compared to other AAA-funded services. Approximately 50% of AAAs rated legal as a “fairly important” service; 36% rated legal as an “extremely important” service; and 7% rated legal as a “relatively unimportant” service; the remaining 7% indicated “No Opinion” or did not respond to the question.



Title IIIB Providers

 

Relationship with and Funding from Area Agencies on Aging

Title IIIB legal assistance providers were asked from how many Area Agencies on Aging (AAA) they receive Title IIIB funding. Ninety percent of these providers indicated that they receive funding from one or two AAAs. Title IIIB providers were also asked if their Title IIIB funding has changed over the past two years. Almost 50% indicated that there has been “no change” in their Title IIIB funding; 28% indicated a decrease in funding; 12% indicated an increase. Over 50% of those providers that had experienced a change in their funding attributed it to overall cuts in Title IIIB.

Almost two-thirds of Title IIIB providers indicated that they were actively involved in planning and discussions with their AAA(s). As there may be a bias towards indicating an active relationship with their AAA, it is telling that almost 30% of the Title IIIB providers indicated they were not involved in such discussions. Similarly, only two-thirds of the Title IIIB providers indicated that they had made special efforts to communicate with their AAA; a full quarter of Title IIIB providers indicated that they did not make special efforts. Over 95% of those providers that indicated they were involved in discussions with their AAA stated that these discussions include how best to target legal assistance for the most vulnerable older persons; almost 80% stated these discussions address the delivery of impact work.

 

Funding of Legal Assistance

Funding for legal services to older persons comes from only a handful of places, the two traditional sources being Title IIIB funds and LSC funds. Of the responding Title IIIB providers, just over 30% indicated that they had at some time received LSC funds. Only 45% of Title IIIB providers indicated that they had sought funds from sources other than OAA and LSC for legal assistance for the elderly. Of those that did seek funding from other sources, the most popular alternative sources of funding sought were IOLTA, private foundations, and United Way. Of the 45% of Title IIIB providers that sought funds from other sources, the graph below depicts the percentage that sought funding from particular sources (in the graph, “Other” includes Federal grants not including OAA and LSC funds, donations, fundraising efforts, and miscellaneous). Almost 60% of Title IIIB providers who sought additional funding indicated that they were successful in their search; only 13% indicated that they were not successful in obtaining supplemental funds. Over 40% of Title IIIB respondents attributed the need for additional funds to Title IIIB reductions.

 

Changes to the Intake System

Almost 80% of the Title IIIB providers indicated that they had not made changes to their intake systems over the past two years; only 18% indicated that they had changed their system. Over 50% of the Title IIIB providers with new intake systems indicated that their new system relied on either phones (hotlines, phone intake) or advanced technology (computer kiosks, etc.). Two-thirds of those Title IIIB providers that changed their intake system indicated that the new system simply supplemented, rather than replaced, the existing system.

 

Changes in Types of Cases

Title IIIB providers were asked if they had witnessed a change in the types of cases they handled for older persons. For example, the survey asked if cases involving health care, housing, or elder abuse had increased or decreased over the past two years. The most prevalent answer to all types of cases was “no change.”

However, Title IIIB providers were most likely to indicate an “increase” in those types of cases most relevant for groups that The Center for Social Gerontology considers the most vulnerable older persons. Specifically, 42% of Title IIIB providers indicated an increase in elder abuse, neglect, and exploitation cases; 38% of Title IIIB providers indicated an increase in health care, insurance, and health-related benefits cases; and 29% indicated an increase in guardianship cases (p<0.001).

 

Change in Level of Service

Title IIIB providers were asked if the level of service they provide to their older clients had changed over the past two years. Specifically, respondents were asked if there had been a change in the level of phone/brief advice, preparation of documents, or representation/litigation provided to older clients. Although the most prevalent answer was “no change,” over one-third of Title IIIB providers indicated an increase in both phone/brief advice and preparation of documents; 22% indicated an increase in representation/litigation. Significantly, Title IIIB providers and Title IIIB/LSC providers were much less likely than LSC providers who do not receive Title IIIB funds to indicate a decrease in the more complex levels of service (p<0.001).

Over 40% of Title IIIB non-LSC providers indicated their caseload had increased over the past two years. Furthermore, 17% perceived an increased level in referrals from LSC providers and 20% indicated a decrease in their ability to refer to LSC providers. Over 40% of those Title IIIB providers that indicated these changes in the delivery of legal assistance to older people attributed them to the LSC funding cuts and restrictions.

 

Changes in Types of Older Persons Served

Title IIIB providers were asked if, over the past two years, there had been a change in the types of minority elderly, low-income elderly, or nursing home residents they serve. Although “no change” was again the most prevalent response, over one-quarter of Title IIIB providers indicated an increase in the number of low-income elderly and nursing home residents they served. Over one-third of Title IIIB providers indicated an increase in the number of frail/socially vulnerable clients they served.

Title IIIB providers were also asked if there had been a change in the number of clients they meet outside of the office. Almost 60% indicated “no change” in the number of out-of-office visits they conduct; 19% indicated an increase in out-of-office consultations.

 

Changes in Outreach for Title IIIB Assistance

Title IIIB providers were asked to indicate changes in their outreach practices; over fifty percent indicated “no change” for each of the following outreach categories: number/location of offices, number of intake sites, use of secondary referral sources, community education to target populations, and use of print media to advertise services. However, 23% of the Title IIIB providers indicated an increase in the use of secondary referral sources; 32% indicated an increase in community education to targeted populations; and almost 25% indicated an increase in the use of print media.

 

Impact Work and Elder Rights Advocacy

Title IIIB providers were asked if there had been any changes in the level of impact work provided over the past few years. Title IIIB Providers were asked specifically about class action suits, legislative advocacy and administrative reform. Approximately two-thirds of Title IIIB providers indicated that there had been “no change” in the levels of any of these types of impact work. At least 7% indicated a decrease in all types of impact work specified; 7% indicated an increase in legislative advocacy and administrative reform; 10% did not indicate how the level of impact work provided had changed over the past few years.



Title IIIB/LSC Providers

Relationship with and Funding from Area Agencies on Aging

Title IIIB/LSC legal assistance providers were asked from how many Area Agencies on Aging (AAA) they received Title IIIB funding. Over 85% of these providers indicated that they receive funding from one or two Area Agencies on Aging (AAA). Title IIIB/LSC providers were also asked if there has been a change in the funding from their AAA over the past two years. Almost 50% indicated that there has been “no change” in their OAA funding; 33% indicated a decrease in funding; 16% indicated an increase. Over 50% of those providers that had experienced an increase or decrease in their funding attributed this change to overall changes in Title IIIB.

Over 60% of Title IIIB/LSC providers indicated that they were actively involved in planning and discussions with their AAA(s). As there may be a bias towards indicating an active relationship with their AAA, it is telling that over 35% of the Title IIIB/LSC providers indicated they were not involved in such discussions. Similarly, not quite two-thirds of the Title IIIB/LSC providers indicated that they had made special efforts to communicate with their AAA; over 30% of Title IIIB/LSC providers indicated that they did not make special efforts. Over 95% of those Title IIIB/LSC providers that indicated they were involved in discussions with their AAA stated that these discussions include how best to target legal assistance for the most vulnerable older persons; only 60% stated these discussions include the delivery of impact work.

 

Funding of Legal Assistance

One-half of the Title IIIB/LSC providers that responded to the survey indicated that they had sought additional funds for legal services to older persons beyond funding they received from AAAs and LSC. Of those who sought additional funding the most popularly sought alternative sources were private foundations and United Way. Of those that sought other sources of funds, the graph on the following page depicts the percentage that sought funding from various other sources (in the graph on the following page, “Other” includes Federal grants (other than Title IIIB or LSC), donations, fundraising efforts, and miscellaneous). Over 60% of the Title IIIB/LSC respondents indicated that they were successful in their search for additional funding; 23% indicated they were not successful in obtaining other funds. Over 80% of Title IIIB/LSC respondents attributed the need for additional funds at least in part to the recent LSC funding cuts.

 

Changes to the Intake System

Not quite one-third of the Title IIIB/LSC providers indicated that they had made changes to their intake systems over the past two years. Sixty-five percent of respondents who reported changes in their intake system indicated that their new intake system simply supplemented their previous system. Over 70% of the Title IIIB/LSC providers with new intake systems indicated that their new system was a hotline or phone intake system.

 

Changes in Types of Cases

Title IIIB/LSC providers were asked if they had witnessed a change in the types of cases they handled for older persons. For example, the survey asked if cases involving health care, housing, or elder abuse had increased or decreased over the past two years. The most prevalent answer to all types of cases was “no change.” However, 38% of Title IIIB/LSC providers indicated an increase in health care, insurance and benefits cases; 26% indicated an increase in elder abuse, neglect and exploitation cases; and 25% indicated an increase in public benefits (SSI, Social Security, etc.) cases.

Change in Level of Service

Title IIIB/LSC respondents were asked if the level of service they provide to their older clients had changed over the past two years. Specifically, respondents were asked if there had been a change in the level of phone/brief advice, preparation of documents, or representation/litigation provided to older clients. Interestingly, of the three provider-types, Title IIIB/LSC providers indicated the largest increase in phone/brief advice — over fifty percent indicated an increase in this level of service (p<0.001). Over half of the Title IIIB/LSC providers indicated “no change” for the remaining two levels of service (preparation of documents and representation/litigation).

This increase in phone and brief advice may indicate that Title IIIB/LSC providers are shifting from more complex levels of service (representation/litigation) to more simple ones (phone and brief advice). Almost half of Title IIIB/LSC providers that indicated a change in their level of service attribute this change to LSC and/or Title IIIB funding cuts.

Changes in Types of Older Persons Served

Title IIIB/LSC providers were asked if, over the past two years, there had been a change in the types of minority elderly, low-income elderly, nursing home residents, or frail/socially vulnerable populations they serve. Although “no change” was the most prevalent response, almost 30% of Title IIIB/LSC providers did indicate an increase in the number of frail/socially vulnerable clients served.

Title IIIB/LSC providers were also asked if there had been a change in the number of clients they meet outside of the office. Twenty-eight percent indicated that they have decreased the number of out-of-office visits they conduct; 50% indicated that there was no change in out-of-office consultations. Over 70% of those respondents that indicated a change in meeting clients outside of the office attributed the change to LSC and/or Title IIIB funding cuts.

Title IIIB/LSC providers were also asked if there has been a change in the number of hours spent on legal assistance to the elderly. Over 30% indicated an increase in the number of hours spent on legal assistance to the elderly; 27% indicated a decrease in the number of hours spent serving this population. Over 50% of those Title IIIB/LSC providers that indicated a change in time spent attributed that change to LSC and/or Title IIIB funding cuts.

Changes in Outreach for Title IIIB Services

Title IIIB/LSC providers were asked to indicate changes in their outreach practices. Over 60% indicated “no change” in the number of intake sites, location of offices, use of secondary referral sources and use of print media. However, 26% of the Title IIIB/LSC providers indicated an increase in the use of community education to target populations; 20% indicated an increase in the use of secondary referral sources; and almost 20% indicated a decrease in the number of intake sites.

Organizational Structure & Staffing

Title IIIB/LSC providers were asked if they had restructured their organization in the past two years. Over 50% of the Title IIIB/LSC respondents indicated that they have down-sized their organization; 45% indicated they had not restructured. Over 90% of the Title IIIB/LSC providers that indicated they had restructured their organization attributed these changes at least in part to the recent LSC funding cuts.

Title IIIB/LSC providers were also asked if they had changed the composition of their staff over the past two years. Over half of the Title IIIB/LSC providers indicated that they had experienced decreases in the number of attorneys and support staff in their offices; 38% indicated decreases in the number of paralegals. Almost 80% of those indicating changes in the composition of their staff attributed these changes at least in part to the LSC funding cuts.

LSC State Planning

Title IIIB/LSC providers were asked if their state had developed a statewide LSC planning document. Not quite 60% of Title IIIB/LSC providers indicated that the state prepared an LSC planning document; over 25% of Title IIIB/LSC providers indicated that they “did not know” if the state had prepared an LSC planning document. Among those Title IIIB/LSC providers that indicated the state had developed a planning document, approximately 90% were involved in the planning process. Only slightly over 50% of those Title IIIB/ LSC providers involved in the LSC state planning process indicated that specific consideration was given to older people.



LSC Providers

Funding of Legal Services

Twenty-six percent of LSC providers that responded to the survey indicated they had previously received Older Americans Act Title IIIB funding. However, almost 60% of LSC providers indicated they had sought additional funds for legal services for older persons beyond funds they received from LSC or had previously received from Title IIIB. The most popularly sought sources of funding were private foundations, United Way and the state legislature. Of the almost 60% of LSC providers that indicated they had sought funds from other sources, the graph below depicts the percentage that sought funds from particular sources (in the graph below, “Other” includes Federal grants other than LSC or Title IIIB, donations, fundraising efforts, and miscellaneous). Less than 40% of the LSC respondents indicated that they were successful in seeking additional funds; 26% indicated that they were not successful in obtaining other funds. Almost 90% of LSC respondents attributed the need for additional funds at least in part to the recent LSC funding cuts.

Changes to the Intake System

Over two-thirds of the LSC providers indicated that they had made changes to their intake systems over the past two years; almost half of these respondents indicated that their new intake system replaced their previous system. Interestingly, these figures are much higher than those reported by Title IIIB non-LSC providers where almost 80% indicated they had not changed their intake system. LSC cuts and encouragement from LSC in the form of planning program letters, which have periodically required LSC providers to analyze programs statewide and develop a comprehensive plan that includes intake systems are possible explanations for the disparity. Over 80% of the LSC providers with new intake systems indicated that their new system was a hotline or phone intake system; 13% indicated an increased reliance on advanced technology like kiosks, etc.

Changes in Types of Cases

LSC providers were asked if they had witnessed a change in the types of cases they handled for older persons. For example, the survey asked if cases involving health care, housing, or elder abuse had increased or decreased over the past two years. The most prevalent answer for all types of cases was “no change.” However, 21% of LSC providers indicated an increase in public benefits cases (SSI, Social Security, etc.); while 17% indicated a decrease in elder abuse, neglect and exploitation cases.

Change in Level of Service

LSC providers were asked if the level of service they provide to their older clients had changed over the past two years. Specifically, LSC respondents were asked if there had been a change in the level of phone/brief service, preparation of documents, or representation/litigation provided to older clients. Although the most prevalent answer was again “no change,” over 21% of LSC providers indicated an increase in phone/brief advice and a decrease in both preparation of documents and representation/ litigation. This change in levels of service implies that LSC providers are shifting from more complex levels of service (representation/litigation) to more simple ones (phone and brief advice). Over half of LSC providers that indicated a change in their level of service attribute this change to the LSC funding cuts.

Changes in Types of Older Persons Served

LSC providers were asked if, over the past two years, there had been a change in the types of minority elderly, low-income elderly, nursing home residents, or frail/socially vulnerable populations they serve. Although “no change” was again the most prevalent response, LSC providers indicated that the number of clients from these populations had decreased significantly more than the other legal assistance providers (Title IIIB non-LSC and Title IIIB/LSC providers) (p<0.001). Almost 25% of LSC providers answered “don’t know” in response to this question, indicating that these populations may not be specifically targeted by LSC providers.

LSC providers were asked if there had been a change in the number of clients they meet outside of the office. Almost 30% indicated that they have decreased the number of out-of-office visits they conduct; 36% indicated that there was no change in out-of-office consultations. Over 60% of those respondents that indicated a change in meeting clients outside of the office attributed this change to LSC funding cuts.

LSC providers were also asked if there had been a change in the number of hours spent on legal services to the elderly. Over 25% of LSC providers indicated a decrease in the number of hours spent serving this population; only 6.5% indicated an increase; 25% indicated no change in the number of hours; another 25% answered “don’t know.”

Organizational Structure & Staffing

LSC providers were asked if they had restructured their organization in the past two years. Almost 50% of the LSC respondents indicated that they have down-sized their organization; almost 10% indicated that they had merged with other LSC programs; and 10% were newly created organizations. Just over 20% indicated that they had not restructured at all. Almost two-thirds of the LSC providers that indicated they had restructured their organization attributed these changes to the recent LSC funding cuts.

LSC providers were also asked if they had changed the composition of their staff over the past two years. Over half of the LSC respondents indicated that they had experienced decreases in the number of attorneys, paralegals, and support staff in their offices. Almost 90% of those indicating changes in the composition of their staff attributed these changes to the LSC funding cuts.

LSC State Planning

LSC providers were asked if their state had developed a statewide LSC planning document. Over 80% of LSC providers indicated that the state prepared an LSC planning document. Among those LSC providers that indicated the state had developed a planning document, approximately 90% were involved in the planning process. Fifty-one percent of those LSC providers involved in the planning process indicated that specific consideration was given to older people. Eight percent indicated that elders were not specifically considered and 38% indicated that they did not know if they were.

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