Relevance to Centers for Independent Living (CILs)
The Older Americans Act (OAA) was written to address the needs of older Americans who are at risk of losing their independence. Its main purpose is to establish programs that offer services to this population. Funds are provided to states to implement programs established by the Administration on Aging. Also, states are provided funding for training and research.
In this section, CILs will learn about the Older Americans Act and the programs it establishes for older Americans. OAA, Title IIIB - Supportive Services is an area where CILs may find opportunities to become more involved in working with older Americans through collaboration with the Area Agencies on Aging. The AAAs channel funds from State Units on Aging at the local level through contractors that provide services. CILs should contact their Area Agency on Aging (AAA) to discuss possibilities for becoming contractors for services.
CILs have a successful history of helping people maintain independence and integrate in the community through their four-core service programs: Information & Referral, Individual and Systems Advocacy, Independent Living Skills Training, and Peer Counseling. Older Americans can benefit from these services.
On July 14, 1965, President Lyndon B. Johnson responded to the increasing number of elders and their needs by signing into law the original Older Americans Act. The purpose of this Act is to focus on establishing programs that offer services to older Americans who are at risk of losing their independence, mainly those who are frail, disabled, of low income status and living alone. These programs and services are offered free of charge to older consumers. Funds are also provided to states for training and research.
The system works as follows:
• The Federal government's Older Americans Act creates certain programs that must be put into practice by the states. The federal government provides a majority of the funds for these programs.
• Each state forms their own Department of Aging to implement the requirements set by the Older Americans Act and serves as a unifying force for services to seniors. States may also provide additional funding and other entitlement programs targeted to the "most needy" and minority elders.
• Each state establishes local/regional Area Agencies on
Aging (AAAs, known as triple A's) that work in partnership with other private
nonprofit agencies to implement the desired programs.
The Older Americans Act (OAA) is divided by titles with specific objectives:
Title I | Title II | Title III | Title IV | Title V | Title VI | Title VII
Title I sets out the broad, national social policy objectives leaning toward improving the lives of older Americans.
These objectives are:
• sufficient income for retirement
• the best possible physical and mental health
• suitable housing designed and located to meet special needs
• full restorative services for those who require institutional care, including a comprehensive assortment of community-based long-term care services
• opportunity for employment without age discrimination
• retirement with health, honor, and dignity
• pursuit of civic, cultural, education and training and recreational opportunities
• competent and efficient community services with emphasis on maintaining a continuum of care for those elderly at risk
• benefits from research designed to maintain and improve health and happiness
• independence for older persons to plan and manage their lives, participate in the planning and operation of services designed for their benefit and protection against elder abuse, neglect and exploitation.
Title II of the OAA created the Administration on Aging (AoA) to administer its program. It is directed by the Assistant Secretary of Aging and is responsible for carrying out the provisions of the OAA. The AoA is an agency within the U. S. Department of Health and Human Services (DHHS).
The President appoints the Assistant Secretary of Aging who reports directly to the Secretary of the Department of Health and Human Services. The Assistant Secretary's role and responsibility is to consult with other federal agencies involved with programs that have an impact on the elderly. It also established the Federal Council on Aging - an advisory board to the President and Congress.
Other programs established within the AoA are the Long-Term Care Ombudsman Programs and Nutritional Programs. Under the Older Americans Act, a National Center on Elder Abuse and a National Aging Information Center were established.
Title III defines the types of services that should be provided at the local level to develop comprehensive and supportive services to help elders maintain functional independence. The program supports 57 state agencies and 670 Area Agencies on Aging. Funds are distributed on the basis of each state's population aged 60 and over as compared to other states.
Title III is intended to form a "network on aging," linking the AoA, state and area agencies on aging, other public and private agencies and social and nutritional service providers. In many states, this agency is the Office on Aging (also known as State Unit on Aging).
Each State Unit on Aging (SUA) designated by the Governor is responsible for aging services and for developing a three-year statewide service plan for serving elders. The designations of the local Area Agencies on Aging (AAAs) are established to provide services in the local geographic areas.
The AAA is also required to develop a three-year service plan to be approved by their state agency (SUA). An area agency can be a unit of the county, city, town government or even a private nonprofit organization. Usually, preference is given to an already established Office on Aging.
Amendments to Title III have been added over the years. Areas of service added to Title III are related to Alzheimer's disease disorders, case management services, transportation, in-home services, legal services, and home repair and renovation programs.
Some states provide a variety of services. Most services fall under three broad categories:
1) access services, such as transportation, outreach, information and assistance, and case management,
2) in-home services, including homemaker and home health aides, chore and maintenance, and supportive services for families of older individuals who have Alzheimer's disease, and
3) community services such as adult day care, legal assistance and recreation.
This title contains two parts:
(C-1) Congregate Nutrition Services, and
(C-2) Home-Delivered Nutrition Services
The services provided under these two parts are similar but are targeted to different populations of older people. Congregate programs accept donations and home-delivered meals programs are permitted to charge a fee for their services based on income levels in the community.
A state may transfer up to 20% of the funds appropriated among Supportive Services, Senior Centers and Nutrition Services according to the need for these services in the State.
The main objective of in-home services to the frail elderly is to direct resources to those older Americans most at risk of losing their independence (minorities and low income). Services include housekeeping and home health aides, visiting and telephone reassurance, chore and maintenance services, in-home respite care and adult day care respite, minor home modifications to facilitate continued occupancy by older individuals, personal care and other in-home services as defined by the State and Area Agencies on Aging.
Funds are used to encourage other resources to increase public understanding of how healthy lifestyle choices throughout life reduce the risk of chronic health conditions in later years.
Some of the categories of programs and services are routine health screening, physical fitness programs, health promotion programs on chronic disabling conditions, nutritional screening and educational services, educational programs on preventive health services, counseling regarding social services and follow-up health services, in-home injury control services and gerontological counseling.
Title IV has been a mainstay of training and research efforts in the field of aging. In recent years the following projects were supported:
1. community-based long-term care
2. adult literacy
3. Alzheimer's disease support services
4. training programs to assist persons employed or preparing for employment in the field of aging
5. studies in the area of healthcare, housing, social studies, retirement roles, and the needs of low-income and minority older persons
6. funding to support innovative approaches to provide services under this Act.
This title covers a part-time job employment program for low-income persons age 55 or over who are unemployed or whose prospects for employment are limited. Program participants work at community and government agencies and are paid the federal or state minimum wage whichever is higher. They may also receive training and can use their participation as a bridge to other employment positions that are not supported with Federal funds.
Title V also describes the role of groups that contract to provide community service employment for older adults.
Nationwide, there are 221 programs that administer Title VI of the Older Americans Act. Under Title VI, the Administration on Aging (AoA) awards grants to provide supportive and nutritional services that are in keeping with the unique cultural needs of older Native Americans.
Title VI is divided into two parts:
1. Part A-Indian Program
2. Part B-Native Hawaiian Program
Part A provides for meals and supportive services to Indian tribes. All grantees are provided information and referral unless other arrangements exist. Other supportive services included transportation, counseling and home assistance services.
Part B provides for nutrition and supportive services to meet the exclusive needs of Native Hawaiians. All grantees are to provide information and referral services unless other arrangements exist. Other supportive services include those listed in Title III of the OAA.
Title VII addresses the need for strong advocacy to protect and enhance the basic rights and benefits of vulnerable older people. It encourages state agencies to concentrate their advocacy efforts on issues affecting those who are the most socially and economically vulnerable. It was designed to empower older persons and prevent elder abuse and consumer fraud.
It has a dual focus to bring together and strengthen four existing advocacy programs:
1. The Long-Term Care Ombudsman Program,
2. Programs for the Prevention of Abuse, Neglect and Exploitation,
3. State Elder Rights and Legal Assistance Development Programs, and
4. Insurance/Benefits Outreach, Counseling and Assistance Programs
Title VII calls on state agencies to take a holistic approach to elder rights advocacy by coordinating the four programs and fostering collaboration among programs and other advocates in each state to address - at a system level - issues of the highest priority for the most vulnerable elders.
The Older Americans Act Amendments of 2000 was signed into law on November 13, 2000. Public Law 106-501 extends the Act's programs through FY 2005.
It contains a new program called the National Family Caregiver Support Program (NFCSP). Under this program, State Agencies on Aging will work with the Area Agencies on Aging and community and service provider organizations to provide support services including information and assistance to caregivers, counseling, support groups, respite and other home and community-based services to families caring for frail older members. Also, it recognizes the needs of grandparents who are caregivers of grandchildren and other older individuals who are relative caregivers of children who are 18 and under. Again, priority is given to older individuals and those in the greatest social and economic need.
Historically, funding for aging programs and services was minimal. Congress does not appropriate all the funding at its disposal. This funding gap forces many states and regions to increase their financial support for many programs and services authorized through the Older Americans Act.