University of Maryland Law to Protect the Rights and Well-Being of Older Americans Paper According to the Centers for Disease Control and Prevention (CDC), in 2015 there were roughly 53 million (1 out of 5) adults in the US living with some type of disability. In a more recent study, the CDC concluded this number has grown to over 63 million (1 out of 4) adults in just 3 short years (2018). Whether it be physical or mental, it is clear the number of people living and aging with a disability is growing year after year and more and more people are looking for answers.
What do persons with disabilities want as they go through the journey of their life span and approach the natural progression of aging?
As the aging process continues through the life span, people with disabilities must have every opportunity to be recognized as respected members of the community. Community services and supports that are geared to older community members must accommodate the supports needed by those who have also experienced lifelong disabilities.
People with disabilities who are aging should:
Be afforded the same rights, dignity, respect, and opportunities as other older people in their communities;
Be empowered, together with their families if asked, to advocate for themselves;
Be free from discrimination on the basis of disability and/or aging;
Have access to appropriate community-based social services, transportation, legal services, and other services;
Have access to a full array of affordable housing services appropriate to their age and physical and mental condition;
Have access to a full array of health care services appropriate to their age and physical and mental condition, including preventive health care, ongoing habilitation, and rehabilitation services for as long as they are needed, including appropriate end-of-life care;
Receive the supports they need to live, work, play, and retire when, where, and how they prefer, including supports for family members who can assist them in the pursuit of quality and self-determined aging experience;
Be free from the fear of inappropriate institutionalization;
Be free from the fear of elder abuse and neglect by family members, providers or community members; and
Have access to financial supports that will provide them with retirement opportunities like those that are available to other older people who no longer work.
Be treated just like anyone else during their natural human aging process of life.
Disability studies support the advocacy efforts of all people and their organizations to ensure the right to have a full and healthy life for all individuals with disabilities. Law to Protect the Rights and Well-being of Older Americans
Older Americans Act of 1965
Introduction
The Older Americans Act (OAA), originally enacted in 1965, supports a range of home and
community-based services, such as meals-on-wheels and other nutrition programs, in-home
services, transportation, legal services, elder abuse prevention and caregivers support. These
programs help seniors stay as independent as possible in their homes and communities. In
addition, OAA services help seniors avoid hospitalization and nursing home care and, as a
result, save federal and state funds that otherwise would be spent on such care.
Who Benefits from the Older Americans Act?
The intent of the OAA is to promote the dignity of older adults by providing services and
supports that enable them to remain independent and engaged citizens within their
communities. The original OAA established the Administration on Aging (AoA) and the aging
services network that provides essential home and community-based supportive services. AoA
is now part of the Administration for Community Living (ACL) within the Department of Health
and Human Services (DHHS). OAA funding is distributed to 56 state agencies, over 200 tribal
organizations, two native Hawaiian organizations, more than 600 area agencies on aging and
20,000 local service providers. While the program is open to older individuals, generally defined
as 60 and older, it focuses on offering assistance to persons with the greatest social or
economic need, such as low-income or older adults living in rural areas. Most services do not
require means testing or copayments, but donations may be requested and some newer
programs may have cost sharing on a sliding scale. Unfortunately, years of limited funding have
restricted access to OAA services, resulting in waiting lists for many of these essential programs.
The benefits of OAA programs are not just for older adults. They also support families by
offering services to caregivers, and they provide jobs in the health and long-term care sectors in
local communities around the country.
What are the Benefits?
The OAA authorizes a range of services and supports that help older Americans remain as
independent and productive as possible in their own homes and communities. The OAA
consists of seven titles. Titles I and II declare the Act’s objectives and establish the AoA, the
federal coordinating agency for OAA services. Title III – Grants for States and Community
Programs on Aging – covers supportive services such as case management, senior center
services, in-home services, transportation, and information and referral. Also included under
Title III are nutrition programs, such as meals-on-wheels and senior center group meals; family
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caregiver support; and health promotion and disease prevention services. Funds for Title III
programs are distributed based on a state’s proportionate share of either the age 60 or older
population or, in the case of caregiver support programs, the age 70 or older population. Each
state then has its own formula for allocating OAA funding to area agencies on aging which
enables the delivery of services to local areas.
Title IV of the OAA provides support for training, research and demonstration projects while
Title V authorizes the Senior Community Service Employment Program (SCSEP). This program,
which is managed by the Department of Labor, provides support for part-time employment for
individuals 55 and over who are low-income, unemployed and have poor employment
potential. Title VI covers Grants for Services for Native Americans and provides funding to tribal
organizations, Native Alaskan organizations and nonprofits representing Native Hawaiians.
Finally, Title VII provides support for programs to ensure protection of the rights of older adults,
including the Long-Term Care Ombudsman Program and elder abuse prevention services. The
Long-Term Care Ombudsman Program is required to investigate and resolve complaints made
by or on behalf of nursing facility residents or other institutionalized populations. Title VII funds
are allocated based on the state’s proportion of residents age 60 and older.
OAA Funding
The Older Americans Act has a broad and critical mission. However, it is plagued with modest
resources to support the service continuum. Over the past 20 years, the OAA has lost ground
due to our rapidly-increasing frail, older population, and federal funding that has not kept pace
with either inflation or growth in the older population. Eligible seniors face waiting periods for
many OAA services in most states.
The Budget Control Act of 2011 imposed cuts in non-defense discretionary (NDD) spending,
which includes OAA programs, and resulted in dramatic reductions in senior nutrition and other
programs in Fiscal Year (FY) 2013. Under provisions of the Bipartisan Budget Act of 2013, FY
2014 and 2015 funding was restored to pre-sequestration levels for nutrition programs, but
other programs received less money than they did in FY 2012. President Obama’s FY 2017
budget proposes an increase of $28.4 million for the OAA, including $10 million for Older
Americans Act Title III B Supportive Services and $14.4 million for Title III Nutrition programs.
Other programs are flat funded, with requested amounts remaining the same as the programs
received for FY 2016 due to the 2015 Bipartisan Budget Agreement.
The cumulative impact of decades of inadequate funding, a rapidly growing older population
and unbalanced attempts at deficit reduction could threaten the very sustainability of OAA
programs, as well as the health, dignity, and independence of older Americans. The Leadership
Council of Aging Organizations (a coalition of 72 non-profit organizations serving seniors,
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including the National Committee) determined that in order for OAA funding to simply catch up
with the growth in the senior population, its appropriation would have to be increased by at
least 12 percent each year for several years.
OAA Reauthorization
The Older Americans Act Reauthorization Act, S. 192, was signed into law (Public Law 114144) by President Obama on April 19, 2016. This bipartisan legislation was introduced by
Senators Lamar Alexander (R-TN), Patty Murray (D-WA), Richard Burr (R-NC) and Bernie
Sanders (I-VT). It reauthorizes the OAA for three years and makes improvements to benefit
older Americans and their families. The major provisions of P.L. 114-144 are outlined in a fact
sheet from the House Committee on Education and the Workforce.
NATIONAL COMMITTEE POSITION
The National Committee supports increased funding for Older Americans Act (OAA) programs
to provide for the needs of our growing elderly population and to make up for past years of
cuts in OAA services resulting from federal funding not keeping pace with inflation. The
National Committee supported S. 192, the “Older Americans Act Reauthorization Act of 2016,”
now Public Law 114-144, which reauthorizes the OAA for three years and provides muchneeded assistance to older Americans. In particular, the National Committee supports
provisions in the law that:
Make improvements to the core programs of the Older Americans Act – including
congregate and home-delivered meals, assistance for family caregivers, transportation
and senior services – which would help ensure economic security and the ability of
seniors to receive the supports and services they need to stay healthy and active in their
homes and communities.
Protect against elder abuse and strengthen long-term care ombudsman services.
Research shows a direct connection between elder abuse and increased need for costly
services, such as nursing home care. Thus, beyond the ethical obligation to protect
vulnerable older adults, these changes have the potential to achieve savings in other
programs such as Medicare and Medicaid.
Promote healthy living through programs including fall prevention and chronic disease
self-management. These programs improve the quality of life for individuals and
prevent unnecessary medical costs.
As introduced, S. 192 would have revised and improved the Experimental Consumer Price Index
for the Elderly (CPI-E). Beyond health and social services, many older Americans rely on Social
Security benefits that are appropriately adjusted annually for inflation. For that reason, the
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National Committee strongly supports requiring the Bureau of Labor Statistics to revise and
improve the Experimental Consumer Price Index for the Elderly (CPI-E), and regrets that this
proposal was not included in Public Law 114-144. Adopting a fully-developed CPI-E that more
accurately reflects the expenses faced by seniors as the measure for calculating the Social
Security cost-of-living adjustment (COLA) would help ensure economic security for beneficiaries
as they age.
References:
National Committee to Preserve Social Security & Medicare. www.ncpssm.org
Government Relations and Policy, April 2016. Retrieved from:
http://www.ncpssm.org/PublicPolicy/OlderAmericans/Documents/ArticleID/1171/Older-Americans-Act
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