By Liz Seegert
It took five years for Congress to reauthorize the Older Americans Act, (P.L. 114-144), but President Obama finally signed it into law on April 19, 2016. The new legislation funds the OAA through FY2019. It includes several important updates to the original 1965 legislation (and subsequent revisions), including funding increases, greater focus on elder abuse, help for non-profits, service organizations and consumers, more emphasis on home and community based services, and technical assistance for senior centers.
Key components of the current law:
- Authorizes a 6 percent increase in funding for key programs over the next three years. OAA funding is passed to states, who are typically required to pass it on to local area agencies on aging (AAAs).
- Tweaks the formula for allocating funds to the states — those with growth in their 60 populations get increases; states that lose population are hit with only minimal funding cuts.
- Reestablishes funding for many services that allow millions of older adults to remain in their homes including Meals on Wheels, transportation, caregiver support, legal services, elder abuse protection through 2019.
Disease prevention and health promotion
The law includes some important criteria for health and wellness:
- Requires evidence-based disease prevention and health promotion initiatives
- Promotes chronic condition self-care management and falls prevention services
- Improves care coordination for individuals with multiple chronic illnesses by sharing best practices across agencies; provides technical assistance to states and organizations to do so
Elder abuse, neglect and fraud prevention
- Funds behavioral health and falls prevention screening, as well as screening for elder abuse and neglect
- Requires collection, analysis and reporting on best practices for responding to elder abuse, neglect and exploitation in long term care facilities
- Requires programs authorized under the Act to include training in abuse prevention and provision of elder justice services
- Includes training of senior volunteers to prevent and identify health care fraud and abuse.
- Increases public awareness of elder abuse and remove barriers to education, prevention, investigation, and treatment
- Lifts certain restrictions on who can advocate on behalf of older adults;
Supportive services and senior centers
- Promotes more home and community-based careReauthorizes the National Eldercare Locator Service and pension counseling and information programs
- Encourages development of tools to help consumers choose home and community-based support services, provides for the development of a tool to assist consumers in selecting in-home care or community-based support services
- Encourages more information and referrals regarding available home and community-based services for individuals who are at risk of or who live in institutional care
- Modernizes multipurpose senior centers, including efforts to use the skills and services of older adults in both paid and unpaid work
- Improves Transportation ServicesProvides information and technical assistance to states, area agencies on aging, and service providers, in collaboration with relevant federal agencies,
- Works with with relevant stakeholders on on delivering efficient person-centered transportation services, including across geographic boundaries
Nutrition services
- Reauthorizes congregate nutrition services, (at locations like senior centers and churches)
- Reauthorizes home delivered nutrition services, (Meals on Wheels)
- Reauthorizes the Nutrition Services Incentive Program
- Encourages use of locally grown foods in meal preparations, and partnerships with local growers
- Reauthorizes delivery of supportive services, including nutrition services, to older American Indians, Alaskan Natives, and Native Hawaiians.
Caregiver support
Makes funding for the caregiver allotment permanent.
History of the OAA
When President Lyndon Johnson signed The Older Americans Act In 1965, it laid the groundwork for services and supports that permit millions of older adults to live independently and to age in their own homes and communities with dignity. The law provided grants to states for aging-related community planning, social services, training and development projects.
The OAA established and supports:
- Administration on Aging (AoA) established under the Department of Health and Human Services as the federal level advocate for the aging population; it is the coordinator for service delivery to the elderly
- National Eldercare Locator Service – a toll free hotline (and website) for identifying community resources
- Services including transportation, home care, legal aid, case management, and adult day care, to promote independence
- Nutrition Programs including congregate and home delivered meals
- National Family Caregiver Support Program to provide respite services, education, training, and counseling to seniors and to the caregivers of seniors
- Health Promotion, including education, counseling and consultation
- Aging and Disability Resource Centers to facilitate the dissemination of information on available resources
- The Older American Community Service Employment Program (OAA Title V) which works with the Department of Labor to provide employment opportunities for seniors
- Grants to Tribal Organizations
- The Long-term Care Ombudsman Program
- Elder abuse, neglect, and exploitation education services
The OAA authorizes four programs:
Supportive services and Senior Centers are central to helping older adults remain independent in their own homes and communities. This includes: outreach, education, transportation, and home care services.
Nutrition Services are the oldest, largest, and best-known of all OAA programs. These services aim to prevent and end hunger, malnutrition, and food insecurity in a variety of ways. According to AARP, “More than 40 percent of the federal appropriation goes to meals provided in such congregate settings as senior centers and adult day centers; home-delivered meals, and nutrition counseling. Some 139 million home-delivered meals and 89 million congregate meals were served in 2011, which fed roughly 2.5 million people.
Caregiver Support: programs provide important information, counseling, support groups, training, and respite care to assist family caregivers.
Disease prevention and health promotion, a small but vital OAA program supports states in their efforts to engage in evidence-based interventions and various outreach activities in community venues.
Older Americans Act Services are available to individuals age 60 and older. There is no means test. Individuals must be given the opportunity to contribute to the cost of the service; however, no one can be denied service due to inability or unwillingness to contribute.
OAA services currently reach one in five older adults; various amendments over the last 50 years have put special emphasis on serving the most vulnerable among the older population – people with low income, members of minority groups, those at risk for institutionalization, people living in rural areas, and those with limited English proficiency. States and local entities are required to support OAA programs with cash and in-kind matching resources.
The 2016 reauthorization did not include LGBT-inclusive amendments sponsored by Sen. Michael Bennet (D-CO), Rep. Patrick E. Murphy (FL-18), Rep. Suzanne Bonamici (OR-01), and Rep. Ted Deutch (FL-21), an outcome that the LGBT advocacy organization SAGE, called “deeply disappointing.”
The Act is only an authorization that sets the ceiling on how much money Congress can authorize. The actual funding for all activities will be set through the process of annual appropriations.
Story ideas
Take a look at how older adults in your community benefit from various OAA programs:
- Talk to older adults receiving home based and congregate meals – what does it mean to have access to food and socialization? Homebound elderly often see food delivery as the highlight of their day and may be the only person they interact with that day.
- Talk to families that have used Elder locator services for loved ones – especially if they live far apart.
- Reach out to the local Area Agency on Aging to discuss and drop in on local programs supported by the OAA.
- Meet with caregivers who have used the respite program and other caregiver support services. What would they do without this support?
- Meet with older adults who were able to find employment through the Community Employment Program. How has it changed/improved their life?
- Talk to health providers, including nurses, social workers, and mental health professionals about the benefits of OAA funding, and what else is needed.
- Your Congressional or state representative likely has some pet programs s/he is helping secure funding for. What? Why? (is there a personal angle or story here?)
Resources
- OAA Primer from the National Health Policy Forum
- National Survey of Older American Participants — an excellent database to cull and analyze OAA participant and service data by numerous criteria
- This FAQ from the Administration on Aging
- OAA State Allocation Tables
- This list of Area Agencies on Aging
- This issue brief from the National Association of Social Workers (NASW)
- The office of OAA Sponsor Senator Lamar Alexander (R-TN), chair, Health, Education, Labor and Pensions Committee. Press Contact: Margaret Atkinson : 202-224-0387
Experts
Bob Blancato, executive director, National Association of Nutrition and Aging Services Programs and chair, American Society of Aging. rblancato@matzblancato.com
Anthony Sarmiento, president and executive director, Senior Service America. tsarmiento@ssa-i.org
Carol Crecy, director, Center for Communication and Consumer Services, Administration on Aging. 202-357-3547; Carol.Crecy@aoa.gov
Ellie Hollander, president & CEO, Meals on Wheels America
Press contact: Jenny Bertolette, communications director; press@mealsonwheelsamerica.org; 571-339-1603
Greg O’Neill, director, public policy & prof. affairs/Nat’l Academy on an Aging Society, Gerontological Society of America. goneill@geron.org
Anne Montgomery, senior policy analyst, Altarum Institute. Anne.Montgomery@altarum.org
Bruce Chernof, M.D., F.A.C.P., president and CEO, The SCAN Foundation. BChernof@TheSCANFoundation.org
