Senators Collins, Casey, Pushing for Reauthorization of Older Americans Act

Published in Woonsocket Call on May 19, 2019

With the Older Americans Act (OAA) scheduled to expire on September 30, 2019, the U.S. Special Senate Committee on Aging puts the spotlight on the importance of this critical law to older American’s, calling for its reauthorization.

Enacted in 1965, the OAA helps more than 11 million seniors age in their communities by funding programs that support grandparents raising grandchildren, reduce social isolation, provide congregate or home-delivered meals and offer respite care among other services.
OAA was last reauthorized in 2016 for a period of three years.

Bipartisan Push in Senate to Reauthorize OAA

While the Senate Aging Committee does not have legislative jurisdiction over OAA, the panel traditionally has put attention on the OAA by holding hearings or special events at the start of any reauthorization process. And the Chair and Ranking Member of the Senate Aging Committee – Senators Susan Collins (R-Maine) and Robert Casey (D-Pa.)—have taken an especially keen interest in this year’s OAA reauthorization process. The Senators are leading a bipartisan coalition of Senators pushing for reauthorization, which includes Senate HELP Committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wa) as well as Senators Mike Enlzi (R-Wyo.) and Bernie Sanders (I-Vt.).

In Collin’s opening statement, she pledged to “get across the finish line, on time, a robust and bipartisan Older Americans Act that will strengthen support for its bread and butter programs, while providing more flexibility for states to meet local needs.”

At the Senate Aging hearing, Collins says she plans to focus on five priority areas in the reauthorization of OOA, specifically family caregivers, nutrition, social isolation, transportation and elder justice. “By enriching the lives of seniors, the Older Americans Act improves the lives of all Americans,” says the Maine Senator, kicking off the two hour and 26-minute hearing, aptly titled, “The Older Americans Act: Protecting and Supporting Seniors as they Age.”

“The Older Americans Act is a shining example of a federal policy that works. Every $1 invested into the Older Americans Act generates $3 to help seniors stay at home through low cost, community-based services,” says Collins.

“The Older Americans Act reminds us who we are as a country. It represents our commitment to the generations who made us who we are today. And, it lifts up the seniors who need our help the most, added Casey in his opening statement.

Before the May 18 hearing, Casey noted that he had reached out to 34 Area Agencies on Aging, representing 60 percent of the counties in his home state, for their feedback about OAA’s effectiveness in delivering services to older Pennsylvanians. He asked these two questions: “How is the OAA currently working?” and “How should this important law be strengthened?”

“In every city and every town, the aging network said that there is no match for the high-quality services that senior centers and Area Agencies on Aging provide to older Pennsylvanians. The OAA programs support Pennsylvanians and their caregivers by providing meals, respite and protection from fraud and abuse. And importantly, the OAA also helps seniors age in the location of their choice, which of course is most often their homes and communities.”

Senate Panel Witnesses Give Thumbs-up to OAA

Larry Gross, the chief executive officer of the Southern Maine Agency on Aging shared with the attending Senators his more than four decades of experience serving seniors in both urban and rural areas. He explained how OAA bolsters nutrition programs, supports family caregivers, reduces social isolation and addresses elder justice. He highlighted a partnership with Maine Medical Center showing that home-delivered meals reduce hospital readmissions, and discussed innovations that he has led to improve senior nutrition and build community.

Faith Lewis, a great-grandparent from Simpson, Pennsylvania, shared her personal experience raising her 5-year-old great-granddaughter and the importance of OAA program support that assist grand families like hers. She receives support through the National Family Caregiver Support Program and regularly attends a support group for grandparents raising grandchildren that is hosted by her local Area Agency on Aging.

Lance Robertson, the Administrator & Assistant Secretary for Aging at the administration for Community Living, gave an overview of OAA, including its history, sustainability, and variability across states and communities. He shared background and data on how OAA has helped millions of seniors to age in their local communities. He also discussed his agency’s mission to connect people to resources, protect rights and prevent abuse, expand employment opportunities, support family caregivers and strengthen aging networks.

Finally, Richard Prudom, the Secretary of Florida’s Department of Elder Affairs, Mr. Prudom talked about his work with his state’s 11 Area Agencies on Aging. He offered a state perspective on interfacing both with the administration for Community Living as well as with the Area Agencies on Aging to develop programs that meet the needs of communities. He focused on priorities in supporting family caregivers, advancing senior nutrition, combating elder abuse and addressing disaster preparedness.

AARP Talks About Impact of OAA Programs

Wendy Fox-Grage, Senior Strategic Policy adviser at the Washington, DC-based AARP, in a Feb 19 blog posting, says that despite “woeful inadequacy of current funding, OAA enables 11 million older Americans to live independently. Recent evaluations confirm the positive impact on the Act’s nutrition and family caregiver program, she says.

As to evaluating the impact of OAA’s nutrition programs, Grage says that forty-two percent of congregate meal participants and 61 percent of home delivered meal participants would skip meals or eat less in the absence of these programs. Congregate meal participants are also less likely to be admitted to nursing homes, and congregate meal participants who live alone are less likely to be admitted to hospital than nonparticipant, she says.

As to caregiving, Grage noted that family caregivers received four hours or more of respite care per week reported a decline in burden over time and those who received at least one education/training, counseling, or support group session experienced an increase in self-reported confidence over time.

AARP joins Senators Collins and Casey’s call on Congress to reauthorize the Older Americans Act before the end of September. OAA’s 11 million beneficiaries, 700,000 caregivers, and providers in the nation’s aging network — consisting of the federal Administration on Aging, State Units on Aging, local Area Agencies on Aging, and local service providers – also wait for Congress to make its move and reauthorize the Act.

Courtesy of AARP: Long-Term Care Data at Your Finger Tips

Published in the Woonsocket Call on September 2, 2018

Across the States 2018: Profiles of Long-Term Services and Supports, by Ari Houser, Wendy Fox-Grage, Kathleen Ujvari, of AARP’s Public Policy Institute, was released days ago. The jampacked 84-page AARP reference report gives state and federal policy makers comparable state-level and national data culled from a large number of research studies and data sources, some of the data gleaned from original sources.

AARP considers the 10th edition of Across the States, published for the past 24 years, “the flagship publication” to assist policy makers make informed decisions as they create programs, and policies for long-term services and supports (LTSS). State-specific data “is easily found, “at your fingertips,” claims AARP.

Across the States, released August 27, 2018, includes a myriad of aging topics include: age demographics and projections; living arrangements, income, and poverty; disability rates; costs of care; private long-term care insurance; Medicaid long-term services and supports; family caregivers; home- and community-based services (HCBS); and nursing facilities. Each state profile is a four-page, user-friendly, print-ready document that provides each state’s data and rankings.

Looking at Trends

AARP Public Policy Institute researchers have identified four trends in reviewing state data. Of most importance to Congress and state legislatures, Across the States gives a warning that America’s population is aging. The nation’s age 85 and over population, those most in need of aging programs and services, is projected to triple between 2015 and 2050, a whopping 208 percent increase.

But, by comparison, the population younger than age 65 is expected to increase by only 12 percent. The under age 65 population, currently, 85 percent of the total population, is projected to be 78 percent in 2050. Bad news for propping up the Social Security system with the worker-to – beneficiary ratio declining.

Across the States researchers say that the demographic shift of an increasing older population will have an impact on family caregiving. “The caregiver support ratio compares the number of people ages 45–64 (peak caregiver age) to the number ages 80+ (peak care need),” notes the report. Today, there are about 7 people ages 45–64 for every person age 80. By 2050, that ratio will drop to 3 to 1.

America’s older population is also becoming more diverse, reflecting overall trends in the general population. Across the States researchers note that the Hispanic population age 65 and over is projected to quadruple between 2015 and 2050.

Finally, Across the States report notes that State Medicaid LTSS systems are becoming more balanced due to the increase of state dollars going to fund home and community-based services (specifically to care for older people and adults with disabilities). But, this trend varies in level of balance, say the researchers, noting that: “The percentage of LTSS spending for older people and adults with disabilities going to HCBS ranged from 13 percent to 73 percent in 2016. While 40 states became more balanced, 11 states became less balanced for older adults and people with physical disabilities in 2016 compared with 2011.”

Taking a Closer Look

Across the States notes that the age 85 and over population is projected to significantly outpace all other age groups when the aging baby boomers begin turning age 85 in 2031. In 2015, people ages 85 and older made up 2 percent of the US population. By 2050, they are projected to represent 5 percent. By contrast, in the Ocean State the age 85 and over population was 2.7 percent of the state’s population. By 2050, look for the oldest-old population to inch up to 5.4 percent.

Throughout the nation the cost for private pay nursing facility care is well out of reach of most middle-income families. Across the States notes that in 2017 the annual median cost for nursing facilities is $97,455 for a private room and $87,600 for a shared room. But, in Rhode Island the annual cost is higher, with a private room costing $ 104,025 and $ 101,835 for a shared room. The researchers say that for the cost of residing in a nursing facility for one year, a person could pay for three years of home care or five years of adult day services.

Because of the high costs, most people go through their life savings paying for costly care and ultimately have to rely on the state’s Medicaid program. Nationally, the percent of Medicaid as primary payer in 2016 was 62 percent (61 percent in Rhode Island).

According to Across the States, family caregivers provided $470 billion worth of unpaid care in 2013, more than six times the Medicaid spending on home and community-based services. In Rhode Island, 134,000 provided 124 million hours of care annually with an economic value $ 1.78 billion. But, AARP’s report warns federal and state policy makers about the stark demographics in America’s future that will for the nation’s “Oldest Old” to scramble to find a caregiver, due to a shortage. Will state’s have the financial resources to fund programs and services to make up for this demographic reality.

For a copy of Across the States report and Rhode Island specifics, go to: http://www.aarp.org/content/dam/aarp/ppi/2018/08/across-the-states-profiles-of-long-term-services-and-supports-full-report.pdf.