How the Older Americans Act Applies to You

home health worker taking care of elderly patient
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Over the last 50 years or more, the United States has seen a lot of inventions and innovations, particularly in health care. In fact, there has been so much progress in medicine that the average life expectancy is now nearly 80 years or older. Still, many people are living much longer than that. As a result, there will be greater need for programs like the Older Americans Act (OAA) to keep pace with the country's aging population.

Operating in every Congressional district nationwide, the OAA provides federal funding for senior services like meals on wheels, preventative healthcare, caregiver support, transportation, and protection from abuse and financial exploitation. What's more, the OAA has been one of the most effective programs ever enacted. In fact, proponents of the program indicate that it saves Medicaid and Medicare considerable amounts of money by allowing older adults to remain in their community or at home.

A Closer Look at OAA

Enacted in 1965 by President Lyndon B. Johnson, the OAA provides essential services for the nation's most vulnerable seniors. It was implemented around the same time as the Medicare and Medicaid systems with the goal of helping seniors stay healthy and at home for as long as possible. Not only does this goal give the country's seniors the type of independence they want, but it also helps seniors remain an active part of their community for as long as possible.

In turn, this reduces the costs that can occur when seniors are not supported. Ultimately, the OAA reduces the financial burden on the Medicare and Medicaid systems by being proactive rather than reactive when it comes to senior health.

Under the OAA, each state receives funds according to a formula based on that state’s share of the U.S. population aged 60 and older.

The primary goal of the OAA is to offer services to older adults by helping them “age in place” in their homes and communities as their health and function decline. In general, states are required to offer services to older individuals with the greatest economic and social needs. They are particularly focused on helping low-income individuals, minorities, and older individuals living in rural areas.

Of all the OAA programs, the Meals on Wheels program is probably the most well known. Under this program, states are able to provide food for homebound adults, which in turn reduces malnutrition. In addition to reducing hunger, helping seniors eat healthy and stay nourished also reduces the number of emergency room visits, since malnutrition and dehydration are often the leading cause of senior hospital admissions. What's more, the volunteers who deliver the meals serve another role as well. They are often the only person an aging senior will see on a regular basis. This personal contact helps identify situations where a senior may need additional assistance before the consequences become too dire.

According to a study conducted by the Center for Effective Government, for every $1 in federal spending on Meals on Wheels, there is as much as a $50 return in Medicaid savings alone.

 Consequently, OAA programs like Meals on Wheels allow seniors to continue living at home. This helps reduce the likelihood that these older adults will require more costly healthcare options like hospitals and nursing homes.

Where OAA Falls Short

Most proponents of OAA programs maintain that the OAA is largely underfunded, especially as the population continues to age. In fact, a report by AARP indicates that OAA funding is not keeping up with the growth of the age 60 and older population. For instance, the funding for OAA programs in 2014 was roughly the same as it was in 2004, but the 60 and older population grew by approximately 30 percent.

From 2004 to 2020, this population is projected to grow by more than 55 percent. Consequently, there are a lot of needs that are going unmet.

The result then is that these needs are "medicalized" and delivered in high-cost settings. For example, if a senior living alone cannot get of the house to purchase food, or is too frail to prepare food, he can easily become malnourished and dehydrated. This, in turn, leads to higher hospitalization rates. What's more, without proper in-home health care or assistance, elderly people are often forced to enter nursing homes long before they should.

Another example where lack of funds is causing OAA to fall short is in the delivery of meals. According to a U.S. Government Accountability Office (GAO) report on the OAA, many older adults with low incomes who were likely to need meals did not receive them. In fact, GAO found that only about 9 percent of an estimated 17.6 million low-income older adults received meals while an estimated 19 percent of low-income older adults were food insecure. What's more, about 90 percent of them did not receive any meal services. GAO also found that many people age 60 and older who had difficulties with daily activities received limited or no home-based care.

How OAA Applies to You

Whether you are caring for an older parent or wondering if the OAA's services might be available to you, start by contacting your local Area Agency on Aging. They will help you identify what you or your family member qualifies for. Keep in mind that under the OAA, each area provides meal and nutrition programs as well as in-home healthcare. Sometimes they will even provide physical therapy, aides to help with daily tasks and chores, education and training for family members, as well as meet a senior's transportation needs. In some cases, they even provide job training and legal assistance when abuse or exploitation has occurred.

Even if you do not qualify for services under the OAA, your Area Agency on Aging can direct you to community programs that you or your family member do qualify for. Typically, these agencies are a hub of resources for issues regarding aging and can help you get the services you or your family member needs.

Sources:

Fox-Grage, Wendy and Uivari, Kathleen. "The Older Americans Act." Insight on Issues, AARP Public Policy Institute, May 2014. https://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/2014/the-older-americans-act-AARP-ppi-health.pdf

Montgomery, Ann. "The Older Americans Act In 2016: The Future Is Now." Altarum, April 26, 2016. https://altarum.org/health-policy-blog/the-older-americans-act-in-2016-the-future-is-now

U.S. Government Accountability Office. Older Americans Act: More Should Be Done to Measure the Extent of Unmet Need for Services. GAO-11-237, February 2011. http://www.gao.gov/new.items/d11237.pdf