the future of the older americans act and the aging network a time of challenge, change and...

The Future of the Older Americans Act and the Aging Network A Time of Challenge, Change and Opportunity

Sandy MarkwoodNational Association of Area Agencies

on Aging

Federal Programs for Older Americans

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Older Americans Act of 1965, P.L. 89-73July 14, 1965

Lyndon Johnson signing the OAA, 1965

Older Americans ActMission of the Aging Network

To support older adults to live with dignity and independence at home and in the community for as long as possible.

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Timeline of Federal Aging Programs

Aging Network Reach to Older Americans through the OAA

─Handle nearly 12 million information and referral contacts a year

─ Support caregivers over 14.7 million times, providing 9.5 million respite care services

─Provide over 28 million rides to the doctor, grocery stores and other critical destinations

─ Serve 237 million meals per year─Deliver 14 million hours of homemaker services and

more than 17 million hours of personal care

Support for Aging Services Not Keeping Pace

From 1980 – 2010

Number of Older Americans 65+

Funding for the Administration on Aging

60%

59%

OAA Appropriations Have Not Kept Pace With Demand

2005 2006 2007 2008 20090

20,000,000

40,000,000

60,000,000

80,000,000

100,000,000

120,000,000

Age 60 and above & Below 250% FPL

Age 60 and above & Below 200% FPL

Number of Persons Receiving OAA Services

Year

Year

Nu

mb

er

of

Pe

rso

ns

Source: NASUAD Analysis of U.S. Census data (Current Population Survey) and AGid

Current Aging Funding Not Keeping Pace

1980

$9.24Per adult 65+

2010

$3.85 Per adult 65+

Aging Services Not Able to Meet Needs

57 million older adults 60+

Only 11 million served by Older Americans Act

Profile of Older American Today: The Need for Aging Services

• 3.6 million older adults live in poverty• Median income of older adults- $15,362 for

older woman/$27,707 for older men• 1 in 7 older adults are threatened by hunger• 10% of older adults are abused, neglected

and/or exploited annually• 80% of older adults have at least one chronic

disease/50% have at least two

We Can and Need to Do Better!

As the Numbers of Older Americans Continues to Grow

…So too should America’s investment in Aging Services and Supports

Aging Crossroads

Challenges in Funding

But Big Opportunities Still Exist for Aging Services and the Aging Network to Support Seniors!

• Budget Control Act (BCA) of 2011 continues sequester through 2021

• “Out years” (FY ‘14-’21) sequester operates differently• Forces the BCA caps lower instead of an across-the-

board cut• Pressure is on appropriators to decide where to cut, but

pie made much smaller

Funding Challenges: Appropriations/Sequestration

Projected Growth in Federal DebtSource: Center on Budget and Policy Priorities

Sequestration in 2013

NDD categories

Impact of OAA Funding Cuts

AAAs Reporting (June 2013) of those impacted so far• 25% fewer home-delivered meals• 28% fewer congregate meals• 33% fewer supportive services 26% fewer

caregiver services

Funding Aging Services is the Fiscally Sound Strategy

Annual Cost of Institutional Care• Private Pay Nursing Home $81k• Private Pay Assisted Living $42k• Medicaid Nursing Home $54K

Annual Cost of Home & Community-based Care• Homemaker/Adult Day Care $18-$20k• Home and Community-based Medicaid $24k

New Options and Opportunities for Aging Services

• Care Transitions• Bridging the Gap between Acute Care

and Home Care• Focus on Evidence-based Health

Programs• Managed Care for Long Term Services

More Opportunities

• Assessments• Care Management• Focal Point for Home and Community-

based Services for All Ages• Private Pay/Cost Sharing• Promoting Livable Communities

What Will New Opportunities Require of the Aging Network

• Exploring New Partnerships with Health Care Industry, Disability Community, VA, others

• Setting Up New Contracting Arrangements with Other AAAs, Service Providers, and Partners

• Competing in a Different Environment• Establishing New Pricing/Billing Systems• Changing the Culture of AAAs and Service

Providers but NOT Changing the Mission

Reauthorizing the Older Americans Act for the Future

What Does the Future Hold?

Congressional Action

Senate• 2012 Senator Sanders Comprehensive Bill

Introduced- Lots of Individual Bills Introduced• 2013 Senator Sanders Bill Introduced

House• No Action Yet

Importance of Your Role and Your Voice for Missouri’s Older Adults, People with Disabilities and Caregivers

Contact:

Sandy MarkwoodNational Association of Area Agencies on Aging1730 Rhode Island Avenue, NW, Suite 1200Washington, DC 20036202/872-0888smarkwood@n4a.org