From private pay services to social entrepreneurship: A phenomenological study of the experiences of CEOs of nonprofit area agencies on aging

The preamble of the Older Americans Act of 1965, as amended, outlined a sweeping and comprehensive array of services to older adults which in its inception were largely funded by federal combined with state and local funding. Despite the commitment of public funding, research documented the Aging Services Network's historical struggle with the financial and service delivery system needed to accomplish the intent of the Older Americans Act. More recent studies have called attention to an increasing aging population, the corresponding need for resources, and a growing interest among area agencies on aging in developing alternative sources of income, including private pay services, cross sector collaborations, and social entrepreneurship as defined for this study. In that context, the literature called attention to the interests and failures of for-profits, nonprofits, and governments through the emphasis on the trichotomy of the sectors and three failures theory. Although the economic concerns of nonprofits and increased emphasis on social entrepreneurship, partnerships and collaborations were noted as a response to limited donations and public funding, in general, commercialization by nonprofits has been considered controversial and a threat to mission. Through this phenomenological study and the thick, rich descriptions obtained from semi-structured interviews, the CEOs of seven nonprofit area agencies on aging described their motivation and experience relative to private pay services as being consistent with their mission of serving all older adults, maintaining the independence of older persons and making sure they have choice and access to services.