- By Bob Blancato
Editor’s note: This article is part of a year-long project about aging well, planning for the changes that aging brings and shaping how society thinks about aging.
Next year will be important and symbolic for aging programs and services, as we celebrate the 80th anniversary of Social Security, the 50th anniversaries of Medicare and Medicaid and the fifth anniversary of the Affordable Care Act.
Another reason to celebrate in 2015: the 50th anniversary of the Older Americans Act.
This law has provided millions of adults with much-needed services. Currently, one in five older adults — 11 million people — receive services from an Older Americans Act program. I hope the anniversary will be the opportunity to give this remarkable law its due recognition while charting its future path.
(MORE: Transforming Life As We Age)
For all the Older Americans Act accomplishes for so many (providing nutrition, caregiving, transportation, legal services and elder abuse prevention), it struggles from chronic underfunding and has for the past 20 years.
Today, the groundbreaking law has a new problem: we are now more than four years late in renewing it. This is especially hard to explain when one considers the bipartisan, non-controversial nature of previous reauthorizations, including the last successful one in 2006 led by a Republican Senate.
Why Does the Older Americans Act Matter?
The Older Americans Act matters because of what it provides and the outcomes it produces. Its programs and services have achieved the main goal of the Act when it was passed — to allow older adults to remain independent, either in their community or in their homes. It is worth noting that the Act, by law, targets its services to those in the greatest economic or social need, with particular attention to low-income minorities, rural residents and those with limited English proficiency.
The Older Americans Act also matters because it has provided important part-time community service employment opportunities for thousands of low-income adults over age 55 through the Senior Community Service Employment Program. Many of these community service jobs have benefited other older adults.
Another reason this law matters is that in anticipation of the increased number of boomers becoming family caregivers, amendments to the law in 2000 established the foresighted National Family Caregiver Support Program. The only federal program of its kind, it provides resources to allow individuals the tools to be effective caregivers when the need arises. It also aids the growing number of grandparents raising grandchildren in the U.S.
Finally, the Older Americans Act matters because its programs are in every state and almost every Congressional district in the U.S. It operates through an outstanding aging network consisting of state units on aging, area agencies on aging and thousands of service providers. The Act stresses local decision-making on what are the best and most needed services for older adults.
Nutrition and Money
The largest program in the Older Americans Act is by far also its most successful — nutrition. Under this program, older adults are provided with meals and nutrition education in either congregate sites (at places such as senior centers, churches or senior housing facilities) or through home-delivered meals. The purposes of the program are as relevant today as when they were created in the 1972 amendments to the original law:
- To reduce hunger and food insecurity
- To reduce isolation for older adults
- To promote the health and well being of older adults by giving them access to nutrition and other disease prevention and health promotion services
The nutrition program reaches those in critical need. In the home-delivered program, it is estimated that 44 percent in the program are in poverty, 52 percent are at high nutritional risk and almost two-thirds rely on the meals for half or more of their daily food intake. In the congregate program, 58 percent rely on the meal for half or more of their daily food intake.
The Older Americans Act, and especially its nutrition program, really matters because it saves Medicaid and Medicare countless millions of dollars.
Today, the average age of a congregate meal participant is in the upper 70s; for the home-delivered program it rises to the low 80s. The eligibility age is 60. When they joined, many of these older adults were at risk for being in a hospital or a nursing home due to their poor diet. Yet, 15 to 20 years later, they are still in the nutrition program and avoided a nursing home or extensive hospitalization.
The total federal expenditure for the nutrition program over the past 20 years does not equal one year of total expenditures for Medicaid. Simply put, the Older Americans Act has great value that goes unrecognized.
Why The Act Is Stalled
Theories abound as to why the Act is stalled in 2014. Some say the political environment is so toxic it prevents even laws like the Older Americans Act from being taken up. Others point to the very limited number of champions of the Act in Congress. Some point to the Obama administration and its sometimes tepid interest in the Act’s reauthorization.
Some say that advocates have not created a sufficient “buzz” to make taking action on the Act a political imperative. Others say the case has not been sufficiently made that funding the Older Americans Act is an investment that provides a great return, by promoting wellness for older adults and saving Medicaid and Medicare dollars.
It is likely that all of these theories contribute to the current situation. The champions in Congress are there, but there are not enough of them. Senator Bernie Sanders (I-Vt.) stands above all others. He produced a strong and bipartisan Older Americans Act reauthorization bill and got it passed by the Senate Health Education Labor and Pensions Committee, but it has stalled due to technical battles. Sanders is joined by Tom Harkin (D-Iowa), Barbara Mikulski (D-Md.) and Lamar Alexander (R-Tenn.) as leaders on the Act in the Senate. On the House side, Reps. Suzanne Bonamici (D-Ore.) and Chris Gibson (R-N.Y.) have taken leadership roles, but few others have.
The Obama administration, despite strong leadership in attempting to build the evidence base for the Older Americans Act and in elder justice, has not shown the robust leadership on reauthorization that some advocates had hoped. The administration failed to produce an actual legislative proposal to renew the Act and without direct involvement by Congress created the controversial federal Administration for Community Living.
Lame Duck Session And Starting Over
It should be noted that the lame duck session of the 113th Congress has convened and is in its final days. There is the remote chance that Congress can pass a reauthorization, either the Sanders bill as passed in committee or a straight renewal of the current law. If not, the reauthorization process must start from scratch in the new Congress next year.
It is clear that the Older Americans Act needs more visibility both inside and outside of Washington. It should not be that hard of a sell. It is a proven program, has a strong value proposition and provides services that have an evidence base to show positive outcomes in the lives of older adults.
As we approach the 50th anniversary of the Act in 2015, we should commit to lessen concerns about its future. The future of the Act is how it continues to serve older adults, including boomers who have been eligible for its programs. It is an ongoing investment in a better quality of life for older Americans. The advocacy voice of boomers needs to be raised on behalf of the nation’s most important resources, our older adults. They do matter and will matter a lot more as our population continues to age.