For those of us with family members or loved ones with a serious illness, the Older Americans Act (OAA) provides lifelines to many programs and supportive services. For example, here are a few of the ways the OAA supports us by funding:
- Respite care and other supports for family caregivers
- Transportation to the hospital and medical appointments
- Home-delivered meals for those unable to travel to a senior center or congregate meal site
- Area Agencies on Aging (AAA’s) and other community-based organizations (CBO’s) that assess need and coordinate many aspects of care for people with serious illness and their caregivers
A recent C-TAC newsletter reported on the reauthorization process and how C-TAC is advocating for specific language in the OAA to benefit people with serious illness and their family caregivers. The article outlines the two-part process: reauthorization (legislation that defines and describes the OAA’s programs and services), and appropriations (designating funding amounts for each part of the legislation). Both steps in the process require us to make our preferences known to our legislators.
On July 31, the authorizing committee for the OAA in the Senate – the Health, Education, Labor, and Pensions (HELP)Committee held an executive session on S.4776, the Older Americans Reauthorization Act, and two other bills: S.4755, the Traumatic Brain Injury Program Reauthorization, and H.R. 7213, the Autism CARES Act. In their opening remarks, Chairman Bernie Sanders (D-VT) and Ranking Member Bill Cassidy (R-LA), expressed support for various components of the bills and applauded the bipartisanship demonstrated to negotiate and move the three bills forward. Many senators shared personal stories on the importance of the three bills. Judging from their comments and their votes, the senators strongly support the OAA: the reauthorization (S.4776) passed by a vote of 20-1, with Senator Rand Paul (R-KY) delivering the single no vote.
The OAA bill includes a range of changes, with impacts on local CBOs to the federal government’s Administration for Community Living (ACL) and all programs in between. The changes can be subtle or overt and take the form of a clarification, a codification, a specification, or a renewal. C-TAC requested several specific additions to the legislation which did not make it into the bill, but let the legislators know that, “Maintaining, strengthening, and modernizing the Older Americans Act is crucial to ensure that it continues to effectively meet the evolving needs of older adults, especially those who suffer from serious illness. Ensuring access to the social supports provided through the Aging Network is especially crucial for those older adults living with serious illness.”
Here are the highlights of the bill’s provisions that are especially important to C-TAC and our advocacy efforts:
Title I: Strengthening the Aging Network to Meet the Needs of Older Individuals
Sec. 102: Amends an existing position within the Administration for Community Living (ACL) to include responsibilities on substance use disorders and cognitive impairments in addition to mental health and directs a report to be submitted to Congress within 2 years. C-TAC believes that this is a much-needed modernization of the OAA.
Sec. 106: Clarifies that, while Area Agencies on Aging (AAA’s) need to notify state agencies of all contracts and other agreements, state agencies do not review and approve area agencies on aging contracts when using non-OAA dollars. C-TAC works closely with USAging (the national organization representing Area Agencies on Aging) to support their efforts to secure non-OAA contracts and funding.
Sec. 110: Directs the Administrator of ACL to identify opportunities to improve coordination between the aging and disability networks and identify lessons learned from disability networks, including centers for independent living. Within two years, the Administrator shall issue guidance to state agencies and Area Agencies on Aging on strategies to leverage disability networks to strengthen the provision of services under OAA.
Sec. 113: Authorizes the 2025 White House Conference on Aging. This conference occurs every ten years, most recently in 2015 and 2005. C-TAC supports and has been a part of the most recent WHCoA activities.
Title II: Improving Health Outcomes and Encouraging Independence for Older Individuals
Sec. 208: Requires the Secretary of the Department of Health and Human Services (HHS) to provide a report to Congress assessing health outcomes for older adults living with or nearby family members compared to older adults who do not live near family and the degree to which programs under OAA promote living in these settings.
Title III: Enhancing Innovation and Flexibility in Nutrition Services
Sec. 301: Promotes the provision of innovative nutrition interventions and tailoring nutrition services to the needs of individuals, to the extent feasible. This can be critically important for those with serious illnesses.
Sec. 303: Codifies an allowance for up to 25 percent of congregate nutrition program funding to be used for carry-out meals. Post-pandemic, getting these funds into the home delivered meals program and for use at home has been extremely helpful, and C-TAC supports this approach.
Title IV: Supporting Family Caregivers
Sec. 402: Emphasizes respite care for family caregivers, particularly of individuals with Alzheimer’s disease.
Sec. 406: Reauthorizes the RAISE Family Caregivers Act through Fiscal Year 2029. C-TAC has been a strong supporter of the recommendations and strategies coming out of the RAISE Advisory Council.
Title VII: Strengthening the Long-Term Care Ombudsman Program and Elder Abuse Protections
Sec. 701: Clarifies that the existing national director for the Long-Term Care Ombudsman Program (LTCOP) shall be a full-time position. C-TAC is quite concerned that those living in nursing homes and assisted living facilities with serious illness and nearing the end of life may not be able to have their care preferences honored. The LTCOP helps to protect the rights of residents and their wishes.
Sec. 705: Directs the National Academies of Sciences, Engineering, and Medicine to study the State Long-Term Care Ombudsman programs including an assessment of the recommended staff-to-bed ratio for such programs.
Title VIII: Authorizations of Appropriations
C-TAC has supported significant increases in the authorization and appropriations levels for all titles of the OAA. This bipartisan bill provides a modest 4.62 percent increase in authorizations for all titles of the act.
The OAA bill that passed out of the HELP Committee has a long way to go on its legislative journey, but it has a strong bipartisan start. This fall, the full Senate needs to pass the bill and send it to the House for consideration. The House Committee on Education and Workforce has not yet drafted or marked-up its version of the OAA reauthorization. They could start with the Senate version and modify it or start from scratch or simply agree to the Senate bill. At this point, the chances of passage in the House are growing slim, but there are a few work weeks left in September and October, and there will be a lame duck session after the elections.
On the Appropriations Front
C-TAC continues to support increased funding levels for the OAA in the appropriations process, as well. We need to raise the level of funding for the services and programs of the OAA as much as possible each year – in part because the need is so great and in part because of the compounding effect of each year’s appropriation going up (hopefully).
In the last couple of decades, funding has not even kept up with inflation. On August 1, the U.S. Senate Committee on Appropriations passed the FY 2025 funding bill for the Department of Health and Human Services (HHS). The Senate committee adopted the bill through a bipartisan manager’s amendment, with no other amendments offered. During the markup, senators expressed their hopes for a House-side bipartisan agreement on final appropriations. However, the partisan Republican House bill is quite different and there is little chance of reaching a compromise agreement before the end of the fiscal year (September 30). Thus, a continuing resolution will most likely be needed to avoid a government shutdown. Here is the FY25 LHHS Senate Report for the bill with all the details.
