Person Centered Funding

Dear Service Provider:

Northeast Iowa Area Agency on Aging Inc. (NEI3A) will continue to utilize a combination of federal, state, and local funds to purchase service(s) for elders during the upcoming fiscal year.  These funds are utilized as “funding of last resort”.  Therefore, an intake will be required before funding is authorized.

The button below contains the following forms:

  • Provider Rules
  • Taxonomy; and
  • Provider application and agreement for FY23 (July 1, 2022-June 30, 2023)
Required Forms

Please complete the first page of the agreement.  Please sign the agreement and mail it to the address below. 

NEI3A periodically requests documents for audit purposes.  We are updating our files this fiscal year and request you include with your signed agreement the following:

  • Proof of insurance
  • Documents detailing policies and procedures regarding compliance with applicable employment laws that prohibit discrimination
  • Documents detailing policies and procedures regarding confidentiality
  • Documents detailing policies and procedures regarding audit standards
  • Documents detailing policies and procedures regarding consumer grievances

Thank you for helping us assist older persons to maintain the independence they desire.  If you have questions, please contact Greg Zars at gzars@nei3a.org.

Please email back the NEI3A Individual Consumer Purchase of Services form no later than June 15, 2022 to kshannon@nei3a.org or via postal mail to:

Northeast Iowa Area Agency on Aging Inc.
Kristi Shannon
203 1st Ave NE
Waverly, IA 50677