The Older Americans Act (OAA), originally enacted in 1965, supports a range of home and community-based services, such as meals-on-wheels and other nutrition programs, in-home services, transportation, legal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 minority persons, older individuals with limited English proficiency, and older persons residing 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 State 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.
Annual OAA discretionary funding has declined over the 10-year period from Fiscal Year 2009 to Fiscal Year 2018, and funding levels each year have remained below the Fiscal Year 2010 level when funding was at its highest level ($2.328 billion). Fiscal Year 2018 funding totaling $2.038 billion was eight percent more than Fiscal Year 2017 levels. Congress has passed legislation, now Public Law 115-245, that maintains this increase and further increases funding for some OAA programs. A chart (https://www.ncoa.org/wp-content/uploads/FY19-LHE-final.pdf) from the National Council on Aging shows the allocation of Older Americans Act funds as well as funding for other aging programs.
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 at http://edworkforce.house.gov/uploadedfiles/bill_summary_-_older_americans_act_reauthorization_act_of_2016.pdf. It is expected that the 116th Congress, which convenes in January 2019, will consider the next Older Americans Act Reauthorization.
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.