Arizona Skipped the Checkup on 79% of Its Senior-Care Dollars
Summary
Arizona's Department of Economic Security promised, in its own State Plan on Aging, to inspect each of its 8 senior-services contractors every 3 years. The Auditor General found reviews overdue for 5 of them as of August 2025 -- one region, receiving $7.2 million a year, hadn't been checked since March 2019, a lapse of 3 years and 5 months. Those 5 overdue regions together receive $61.6 million of the $78.3 million the state sends Area Agencies on Aging annually, or 78.6% of the program's funding. Meanwhile 1,642 older Arizonans sat on waitlists for services like home-delivered meals and case management as of April 2025.
A three-year promise, one region checked in 2019
The gap isn't evenly spread. Region 4, the Western Arizona Council of Governments (WACOG)⧉, was last reviewed on-site in March 2019 -- 41 months overdue as of August 2025, longer than the entire 36-month review cycle DES set for itself. WACOG runs services across La Paz, Mohave, and Yavapai counties and received $7.2 million in federal and State money from DES in fiscal year 2025. Region 8, the Inter Tribal Council of Arizona (ITCA), which serves member tribes statewide, was last reviewed in February 2020 -- 30 months overdue -- while receiving $3.0 million. Three more regions were overdue by lesser amounts: SouthEastern Arizona Governments Organization (SEAGO) by 10 months, Pima Council on Aging (PCOA) by 8 months, and the state's largest region by funding, AAA Region One (Maricopa County, $34.0 million a year), by 3 months.
Only 3 of the 8 regions were current on their reviews: Northern Arizona Council of Governments (NACOG, last reviewed February 2024), Central Arizona Aging (CAA, October 2023), and the Navajo Nation's Division of Aging and Long Term Care Services (Navajo DALTCS, May 2024). Even the Department's own remediation plan doesn't fully close the gap -- under the on-site review schedule DES developed for federal fiscal years 2026-2027, the audit found those same 3 currently-compliant regions would themselves be 1 to 2 months overdue by the time their next review comes up.
View data as table
| Region 4: WACOG | 41 mo | last reviewed March 2019 |
|---|---|---|
| Region 8: ITCA | 30 mo | last reviewed February 2020 |
| Region 6: SEAGO | 10 mo | last reviewed October 2021 |
| Region 2: PCOA | 8 mo | last reviewed December 2021 |
| Region 1: AAA, Region One | 3 mo | last reviewed May 2022 |
| Region 3: NACOG | not overdue | reviewed February 2024 |
| Region 5: CAA | not overdue | reviewed October 2023 |
| Region 7: Navajo DALTCS | not overdue | reviewed May 2024 |
Nearly 80 cents of every dollar, unchecked
Add up the funding to just the 5 overdue regions and it comes to $61.6 million of the $78.3 million DES sent Area Agencies on Aging in fiscal year 2025 -- 78.6% of the program's money running through contracts whose compliance review is currently past due. Counting the AAAs' own matching funds too, $94.3 million in total funding moved through Arizona's 8-agency network last year. Nationally, Arizona's 8 AAAs are a small slice of a much larger system⧉ -- the Older Americans Act, signed into law in 1965, funds 618 area agencies on aging across the country, and ACL's own guidance is explicit that it's the state and area agencies, not the federal government, that "remain fully responsible for administration and oversight" of that money.
What the last round of checks actually caught
The audit doesn't argue the reviews are a formality. It cites specific findings from AAAs' most recent monitoring visits: a subcontractor whose staff lacked required tuberculosis screening on file; a AAA that authorized respite care for a client who didn't actually meet eligibility documentation requirements; and a home-delivered-meals driver who was routinely signing for the meals himself rather than having clients sign, which the audit says raised the risk both that clients weren't getting the meals meant for them and that public money was being spent on meals nobody confirmed were delivered. In a fourth case, DES's own Adult Protective Services program referred an at-risk client to a AAA, and 3.5 months later the AAA still hadn't made contact -- despite a policy requiring 3 documented attempts, only 1 voicemail was on file.
Across the most recent review of each of the 8 AAAs, DES logged 5 findings against 52 recommendations -- and the audit notes DES has no formal process to verify that AAAs actually acted on those recommendations once issued. The reviews are, in other words, the main mechanism by which the state would catch problems like these, and it's the mechanism that's been running behind schedule.
Where the seniors are waiting
As of April 7, 2025, 1,642 older Arizonans were on waitlists for at least one of nine AAA services, across 6 of the 8 regions. NACOG -- one of the 3 regions current on its own monitoring review -- had the largest waitlist by far, 790 clients, including 478 waiting for case management and roughly 200 who'd been waiting more than a year. WACOG, the region furthest behind on monitoring, had the largest waitlist for a single service statewide: 214 clients waiting for home-delivered meals, the audit's own example of a driver-signature shortcut that made it harder to confirm those meals were reaching anyone at all.
View data as table
| Region 3: NACOG | 790 | 478 for case management |
|---|---|---|
| Region 2: PCOA | 366 | |
| Region 4: WACOG | 257 | 214 for home-delivered meals |
| Region 1: AAA, Region One | 169 | |
| Region 5: CAA | 52 | |
| Region 6: SEAGO | 8 |
The Department's response
DES agreed with the finding. In its September 24, 2025 response, the Department wrote that it "has resumed regular on-site monitoring reviews" and committed to implementing all 3 of the Auditor General's recommendations, including building a formal process to verify that AAAs follow through on what earlier reviews found. The audit itself doesn't assess whether that resumption is sufficient -- it evaluates the record as of August 2025, when the gap was still open.
- Five of Arizona's 8 senior-care contractors went unchecked past their own 3-year deadline, one for 41 months. WACOG's last on-site review was March 2019 -- longer overdue than the entire review cycle it was supposed to be on.
- The overdue regions aren't the small ones. They account for $61.6 million of the $78.3 million DES sends Area Agencies on Aging each year -- 78.6% of the program's funding was running through contracts DES hadn't recently checked.
- When reviews do happen, they catch real problems -- missing tuberculosis screenings, an ineligible respite-care recipient, an unanswered at-risk referral, and a meals driver signing for clients himself -- while 1,642 older Arizonans, nearly half of them in one region alone, waited for the services those reviews are meant to safeguard.
All Arizona-specific figures come from the Arizona Auditor General's September 2025 performance audit, Arizona Department of Economic Security -- Contract Oversight of Area Agencies on Aging (Report 25-115), read in full via direct PDF fetch and saved to the Wayback Machine at read time. National Older Americans Act context (enactment date, size of the national AAA network, and the oversight-responsibility language) comes from the U.S. Administration for Community Living's own authorizing-statute page. The percentage figures in this piece (78.6% of overdue-region funding, 48.1% of waitlisted clients in one region, and the month conversions for 'X years, Y months overdue') are this outlet's own arithmetic on the audit's own stated counts; the audit does not itself state these percentages. A blind adversarial verifier, working from the primary documents alone with no access to this draft, independently checked every itemized fact; see verification.json.
Sources(2) ▾
- Arizona Auditor General, Arizona Department of Economic Security—Contract Oversight of Area Agencies on Aging (Performance Audit, Report 25-115) (2025-09-30) — The primary document: the Arizona Auditor General's performance audit, conducted as part of the statutory sunset review of the Department of Economic Security (DES), assessing whether DES provided sufficient oversight of Arizona's 8 Area Agencies on Aging (AAAs) consistent with its own State Plan on Aging. Source for the FY2025 funding totals by region (Table 2, p.5); the client waitlist counts by region and service (Table 1, p.4); the State Plan's 3-year on-site monitoring commitment and the finding that reviews were overdue for 5 of 8 AAAs (Finding 1, pp.6-9, Table 3, p.8); the specific examples of prior monitoring findings (tuberculosis screening, an ineligible respite recipient, an unanswered Adult Protective Services referral, a delivery driver signing for meal recipients, pp.7-9); the findings-vs-recommendations count and the absence of a formal implementation-verification process (p.9); the Department's plans for federal fiscal years 2026-2027 on-site reviews, including that the schedule would leave the 3 not-overdue AAAs 1-2 months overdue by their own turn (p.7); and the Department's written agreement with the finding and its recommendations (Department Response, unpaged, and p.9). azauditor.gov · original document
- U.S. Administration for Community Living (ACL), U.S. Department of Health and Human Services, Older Americans Act (OAA) — Authorizing Statute (2026-06-30) — ACL's own summary of the Older Americans Act it administers. Source for the Act's July 14, 1965 enactment date; the size of the national network the Act funds (56 state agencies on aging, 618 area agencies on aging); and the statement that state and area agencies on aging — not just the federal government — remain fully responsible for administering and overseeing OAA funds, which frames why the Arizona audit's monitoring gap matters. acl.gov · original document
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Arizona's Department of Economic Security (DES) is the state's designated agency for administering Older Americans Act funds, and it contracts with 8 regional Area Agencies on Aging (AAAs) to deliver services like home-delivered meals, case management, and respite care to older Arizonans. DES's own State Plan on Aging commits it to an on-site compliance review of each AAA every 3 years -- a commitment a performance audit released by the Arizona Auditor General⧉ in September 2025 found DES hadn't kept for 5 of the 8 AAAs as of August 2025, with reviews running from 3 months to 3 years 5 months late.