Older American Act Amendments of 2006

1. Older American Act Amendments of 2006 Some slides borrowed from NASUA (with apologies)

2. Generally, no details are provided in the Act…. We will have to wait for AoA to provide guidance (Program Instructions or other documents) before we will know what some of the changes actually mean.

3. Reauthorizes programs under OAA for five years: 2006 – 2011. • Establishes authority for implementing Choices for Independence. • Emphasizes role of AoA, SUA’s, and AAAs in the coordination and provision of HCBS.

4. AAA Advisory Council…. Specifies that the AAA advisory council must now include family caregivers and service providers.

5. Congress strengthened the elder justice functions in the Act by including some “Elder Justice Act” provisions.No funding….just the verbiage!

6. Title I – General Provisions New or amended definitions for: • Self-directed care. • Person at risk for institutional placement. • Defines assisted living facilities. • Aging and Disability Resource Center. • Long term care. • Assistive technology.

7. Title II - AoA Elder Abuse Prevention (language taken from the failed Elder Justice Act) • Authorizes AoA assistant secretary to designate a person responsible for elder abuse prevention & services • Develop long term plan for a comprehensive coordinated elder justice system

8. Elder Abuse Prevention Continued…… The Long term plan will include: • Federal guidelines for annual data collection and reporting by states. • Establish an information clearinghouse. • Fund research & TA.

9. New Mental Health language…. More focus on importance of mental health services in OAA. Specifies that AAAs will work with their local mental health agencies. Support state efforts in education, prevention, detection and treatment of mental disorders such as Alzheimer’s and depression.

10. Expands Role of Assistant Secretary….. Significantly broadens the scope of functions of the assistant secretary. Establishes authority to implement Choices for Independence. Principles of Choices for Independence are embedded throughout the Act.

11. Expanded role continued….. Evaluate the impact of Medicare and Medicaid on OAA programs and clients. Discretion to establish a National Center on Senior Benefits Outreach and Enrollment (to encourage seniors to apply for and receive services).

12. Expanded role continued….. Establish ADRCs in all states. Establish technical assistance programs to assist states in carrying out the provisions of the Act. Develop performance measures, in coordination with CMS, for use by states to assess their LTC systems.

13. Expanded role continued….. Establish Interagency Coordinating Committee on Aging: • DOL, HUD, DOJ, DOT, Treasury, SSA, USDA, Homeland Security. • Report to Congress on work of the Committee and recommendations for improving federal coordination on LTC and other aging issues.

14. Title III – Amendments impact….. Interstate funding formula: • Updates “hold harmless” to 2006 levels. • This assures that no state will receive less than its percent share of Title III money than it gets in 2006, and • Phases out over five years the provision of the 2000 amendments that limited the shifting of funds toward higher-population-growth states (the “guaranteed growth” provision).

15. Title III – Amendments impact….. New targeting language throughout the act to include “people with limited English proficiency”. Retains targeting language for low-income older individuals, including low-income minorities and older individuals residing in rural areas.

16. Title III – Amendments impact….. Updates state assurances to include language consistent with Choices for Independence: • Promote the development and implementation of state-wide systems of long-term care. • Comprehensive, coordinated. • Responsive to needs and preferences of older people and their caregivers.

17. New focus on… Disaster planning….working with state & local emergency response agencies. Evidence-based health promotion and disease prevention programs. Planning ahead to accommodate expansion of older population eligible for services (impact of the Boomers).

18. New focus on… Reaching older people at risk for institutional placement. Consumer direction. Use of trained volunteers in OAA programs. New language about providing more opportunities for Civic Engagement.

19. Changes in Client Contributions….. Voluntary contributions allowed for all services. Contributions shall be encouraged for people with incomes above 185 percent of FPL. Contribution levels based on actual cost of services. No change in cost sharing provisions.

20. Caregiver Support Program… Eligibility broadened to include: • Grandparent or relative caregiver must be related by blood, marriage or adoption. The age of the grandparent or relative caregiver has been reduced to 55 or older. • Older individuals caring for adults with disabilities.

21. Caregiver Priority… Priority for caregivers of people with Alzheimer’s disease and other dementia. Priority for grandparents or relative caregivers caring for children with severe disabilities. Priority for caregivers who are older individuals with greatest social, economic need.

22. Title V Employment Program… Changes effective July 1, 2007. New terminology: The Community Service Senior Opportunities Act. This new “Act” downplays “placement” and emphasizes community service opportunities & civic engagement. Limits participation to 48 months with an average of 27 months for most participants (some exceptions allowed).

23. Title VII - Elder Rights Protection Activities… New focus in Title VII: • Financial literacy and financial exploitation. • Establishing shelters and safe havens to provide temporary care & protection. • Multidisciplinary approaches to elder rights protection. • AoA will develop accountability measures.