Older Americans Act Reauthorization 2011 Julie Jarvis Director, Program Development and Planning Karen Webb Mana

1. Older Americans Act Reauthorization 2011 Julie Jarvis Director, Program Development and Planning Karen Webb Manager of Older Americans Act Programs June 10, 2010

2. Older Americans Act Congress enacted the Older Americans Act in 1965. Established of: • Administration on Aging (AoA) • State agencies on aging

3. Older Americans Act Mission: To help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly.

4. Older Americans Act The Older Americans Act authorizes: • seven titles • all programs are administered at the federal level by AoA • fiscal year 2009 federal funding level was $2.3 billion

5. Older Americans Act • almost two-thirds of the funding supports state and community grants • subsidized job programs for older people, research, demonstration and training programs, grants for Native American organizations and national programs

6. Older Americans Act Seven Titles Title I: Declaration of Objectives • Social policy objectives oriented toward improving the lives of all older people Title II: Establishment of the AoA • National Eldercare Locator Service • National resource centers for long-term care ombudsman services and elder abuse prevention activities

7. Older Americans Act Seven Titles Title III: Grants for State and Community Programs on Aging • Grants support the activities of 56 state agencies on aging and 629 area agencies on aging • These agencies act as advocates and coordinate social service programs

8. Older Americans Act • These grants account for two-thirds of total Older Americans Act funds in FY 2009 (1.4 billion out of 2.3 billion) • Title III services are available to all people age 60 and over but targeted to those with the greatest economic or social need.

9. Older Americans Act Title III authorizes funds for: • Supportive services – (transportation, I&A, home care, legal assistance and adult day services) • Nutrition services: • Congregate Meals – provides meals and socialization • Home Delivered Meals – provides meals to frail older people in their own homes

10. Older Americans Act • Family Caregiver Support – provides assistance to family caregivers: • I&A • Individual counseling • Support groups and caregiver training • Respite services • Disease prevention and health promotion programs • prevent or delay chronic conditions • promote health among older people

11. Older Americans Act Seven titles continued: Title IV: Activities for Health, Independence, and Longevity • Choices for Independence initiative • Aging and Disability Resource Centers (ADRCs)

12. Older Americans Act Title V: Community Services Senior Opportunities Act • part-time jobs for unemployed low-income people age 55 and older Title VI: Grants for Services for Native Americans • Fund supportive and nutrition services for older Native Americans

13. Older Americans Act Title VII: Vulnerable Elder Rights Protection Activities • Long-term care ombudsman • Prevention of elder abuse, neglect, and exploitation

14. Older Americans Act 2006 Reauthorization: The reauthorization takes place every five years. The Older Americans Act Amendments of 2006 reauthorized all programs under the Act through FY 2011.

15. 2011 Older Americans Act Reauthorization

16. Considerations • Capacity of the Aging Service Network • Changing Demographics/Populations Served • Federal Funding Trends • 2006 OAA Initiatives • Future Challenges

17. Aging Services Network Capacity 56 629 244 0ver 30,000 Over 500,000 Millions 17

18. HHS Expenditures 0.21%

19. Federal Funding Trends Flat Older Americans Act Funding • In 1980, with 35.6 million Americans age 60+, the Older Americans Act received $2.5 billion (in 2007 dollars, after adjusting for inflation). • In 2007, with 53 million Americans age 60+ , the Older Americans Act funding was $1.85 billion. • Additionally the number of older Americans age 85 and older has more than doubled in that same period.

20. Leveraged Federal Funds For every $1 in federal funding, state and local agencies on aging acquire more than $2 in other funding 20

21. Changing Demographics

22. Changing Population Served The characteristics of the population served by the Aging Services Network continues to diversify, with nearly two-thirds of states and AAAs serving both older adults and physically disabled younger adult populations regardless of age.

23. Home and Community Based Services: Cost Effective Alternative Medicaid Costs have Soared • In 1980 the Medicaid budget was $22 billion ($90 billion in 2007 dollars, adjusted for inflation) • In 2007 the Medicaid budget soared to $333 billion • In Ohio the Medicaid budget is now close to 25% of the entire state budget with 37% providing long term care

24. Role of Area Agencies on Aging (AAAs) • Advocacy • Planning and Coordinating • Information and Assistance • Leadership • Partnership and Collaboration • Focal Point for Services • Assessing Needs

25. Areas of Service System Development

26. AAAs as Points of Entry • More than two-thirds of AAAs are involved in providing a seamless intake, assessment and eligibility determination for their consumers • More than three-quarters are involved in positioning their organization as a point of entry for long term care in their service area • Many types of access models are currently being utilized • New target populations identified

27. Promoting Healthy Aging through Evidence Based Programs • Over half of AAAs are involved in providing evidence-based programs to prevent/manage chronic disease or disability • Over half of AAAs partner with organizations to expand their evidence based wellness programs

28. Enhanced Nursing Home Diversion • 9 out of 10 AAAs give priority to consumers with greatest impairment and to those at risk of nursing home placement in a least some of their programs. • 31.4% have a formal nursing home diversion program • Nearly all AAAs assess potential long term care consumers in a number of areas including functional, health, nutrition and caregiver informal support system status

29. Long Term Care Planning • On average AAAs provide five long term care planning services • The most common services include information about long term care services, conducting educational presentations on long term care options and providing information about establishing legal directives • Two-thirds have made progress or have in place programs and services that assist a consumer to plan in advance for long term care and encourage individuals to take responsibility for their long term care needs

30. Providing Consumer Directed Services and Supports • Nearly half provide consumer/self directed services in which individuals have choice and control over their services and supports • The most common services are personal care, respite care, Family Caregiver Support and chore services • Overall agencies expect to increase the number of consumer directed services offered over the next year

31. Most Common Consumer Directed Services

32. N4A OAA Reauthorization Recommendations • Home and Community Based Services • Increase Authorization Levels • Local Flexibility • Nutrition Programs • Health Promotion/ Disease Prevention • Build Capacity of Aging Services Network • Broaden Planning Role • Information and Referral • Transportation • Housing

33. More Information about Reauthorization • Administration on Aging (AoA) www.aoa.gov National Association of Area Agencies on Aging (N4A) www.n4a.org State Units on Aging (SUA) www.nasua.org National Council on Aging (NCOA) www.ncoa.org

34. Thank you!