The Older Americans Act (OAA), originally enacted in 1965, supports a range of home and community-based services, such as meals-on-wheels and other nutrition programs, in-home services, transportation, legal services, elder abuse prevention and caregivers support. These programs help seniors stay as independent as possible in their homes and communities. In addition, OAA services help seniors avoid hospitalization and nursing home care and, as a result, save federal and state funds that otherwise would be spent on such care.
Who Benefits from the Older Americans Act?
The intent of the OAA is to promote the dignity of older adults by providing services and supports that enable them to remain independent and engaged citizens within their communities. The original OAA established the Administration on Aging (AoA) and the aging services network that provides essential home and community-based supportive services. AoA is now part of the Administration for Community Living (ACL) within the Department of Health and Human Services (DHHS). OAA funding is distributed to 56 state agencies, over 200 tribal organizations, two native Hawaiian organizations, more than 600 area agencies on aging and 20,000 local service providers. While the program is open to older individuals, generally defined as 60 and older, it focuses on offering assistance to persons with the greatest social or economic need, such as low-income or older adults living in rural areas. Most services do not require means testing or copayments, but donations may be requested and some newer programs may have cost sharing on a sliding scale. Unfortunately, years of limited funding have restricted access to OAA services, resulting in waiting lists for many of these essential programs. The benefits of OAA programs are not just for older adults. They also support families by offering services to caregivers, and they provide jobs in the health and long-term care sectors in local communities around the country.
What are the Benefits?
The OAA authorizes a range of services and supports that help older Americans remain as independent and productive as possible in their own homes and communities. The OAA consists of seven titles. Titles I and II declare the Act’s objectives and establish the AoA, the federal coordinating agency for OAA services. Title III – Grants for States and Community Programs on Aging – covers supportive services such as case management, senior center services, in-home services, transportation, and information and referral. Also included under Title III are nutrition programs, such as meals-on-wheels and senior center group meals; family caregiver support; and health promotion and disease prevention services. Funds for Title III programs are distributed based on a state’s proportionate share of either the age 60 or older population or, in the case of caregiver support programs, the age 70 or older population. Each state then has its own formula for allocating OAA funding to area agencies on aging which enables the delivery of services to local areas.
Title IV of the OAA provides support for training, research and demonstration projects while Title V authorizes the Senior Community Service Employment Program (SCSEP). This program, which is managed by the Department of Labor, provides support for part-time employment for individuals 55 and over who are low-income, unemployed and have poor employment potential. Title VI covers Grants for Services for Native Americans and provides funding to tribal organizations, Native Alaskan organizations and nonprofits representing Native Hawaiians.
Finally, Title VII provides support for programs to ensure protection of the rights of older adults, including the Long-Term Care Ombudsman Program and elder abuse prevention services. The Long-Term Care Ombudsman Program is required to investigate and resolve complaints made by or on behalf of nursing facility residents or other institutionalized populations. Title VII funds are allocated based on the state’s proportion of residents age 60 and older.
The Older Americans Act has a broad and critical mission. However, it is plagued with modest resources to support the service continuum. Over the past 20 years, the OAA has lost ground due to our rapidly-increasing frail, older population, and federal funding that has not kept pace with either inflation or growth in the older population. Eligible seniors face waiting periods for many OAA services in most states.
The Budget Control Act of 2011 imposed cuts in non-defense discretionary (NDD) spending, which includes OAA programs, and resulted in dramatic reductions in senior nutrition and other programs in Fiscal Year (FY) 2013. Under provisions of the Bipartisan Budget Act of 2013, FY 2014 and 2015 funding was restored to pre-sequestration levels for nutrition programs, but other programs received less money than they did in FY 2012. President Obama’s FY 2017 budget proposes an increase of $28.4 million for the OAA, including $10 million for Older Americans Act Title III B Supportive Services and $14.4 million for Title III Nutrition programs. Other programs are flat funded, with requested amounts remaining the same as the programs received for FY 2016 due to the 2015 Bipartisan Budget Agreement.
The cumulative impact of decades of inadequate funding, a rapidly growing older population and unbalanced attempts at deficit reduction could threaten the very sustainability of OAA programs, as well as the health, dignity, and independence of older Americans. The Leadership Council of Aging Organizations (a coalition of 72 non-profit organizations serving seniors, including the National Committee) determined that in order for OAA funding to simply catch up with the growth in the senior population, its appropriation would have to be increased by at least 12 percent each year for several years.
The Older Americans Act Reauthorization Act, S. 192, was signed into law (Public Law 114-144) by President Obama on April 19, 2016. This bipartisan legislation was introduced by Senators Lamar Alexander (R-TN), Patty Murray (D-WA), Richard Burr (R-NC) and Bernie Sanders (I-VT). It reauthorizes the OAA for three years and makes improvements to benefit older Americans and their families. The major provisions of P.L. 114-144 are outlined in a fact sheet from the House Committee on Education and the Workforce.
NATIONAL COMMITTEE POSITION
The National Committee supports increased funding for Older Americans Act (OAA) programs to provide for the needs of our growing elderly population and to make up for past years of cuts in OAA services resulting from federal funding not keeping pace with inflation. The National Committee supported S. 192, the “Older Americans Act Reauthorization Act of 2016,” now Public Law 114-144, which reauthorizes the OAA for three years and provides much-needed assistance to older Americans. In particular, the National Committee supports provisions in the law that:
· Make improvements to the core programs of the Older Americans Act – including congregate and home-delivered meals, assistance for family caregivers, transportation and senior services - which would help ensure economic security and the ability of seniors to receive the supports and services they need to stay healthy and active in their homes and communities.
Protect against elder abuse and strengthen long-term care ombudsman services. Research shows a direct connection between elder abuse and increased need for costly services, such as nursing home care. Thus, beyond the ethical obligation to protect vulnerable older adults, these changes have the potential to achieve savings in other programs such as Medicare and Medicaid.
Promote healthy living through programs including fall prevention and chronic disease self-management. These programs improve the quality of life for individuals and prevent unnecessary medical costs.
As introduced, S. 192 would have revised and improved the Experimental Consumer Price Index for the Elderly (CPI-E). Beyond health and social services, many older Americans rely on Social Security benefits that are appropriately adjusted annually for inflation. For that reason, the National Committee strongly supports requiring the Bureau of Labor Statistics to revise and improve the Experimental Consumer Price Index for the Elderly (CPI-E), and regrets that this proposal was not included in Public Law 114-144. Adopting a fully-developed CPI-E that more accurately reflects the expenses faced by seniors as the measure for calculating the Social Security cost-of-living adjustment (COLA) would help ensure economic security for beneficiaries as they age.
Government Relations and Policy, April 2016