The Older Americans Act (OAA) is the foundation of the Aging Services Network, the programs and organizations that provide community-based supports and services to our nation’s older adults. First enacted in 1965 as the smaller sibling of the much more famous kin, the Medicare and Medicaid programs, the OAA has proved invaluable in supporting the programs and policies that help older people and their families navigate the changes and challenges that come with aging. The supports and services provided by the OAA are major contributors to the quality of life for individuals dealing with serious illness. C-TAC has been a strong supporter of expanded funding for the OAA and the aging network of providers.
The OAA is on a four-year reauthorization cycle, and is authorizing legislation, i.e., Congress has endowed the federal agencies and programs in the OAA with the legal authority to exist and operate. As such, it needs to be reviewed periodically and have its funding allocations updated. The committees of jurisdiction for the OAA are the Committee on Health, Education, Labor, and Pensions (HELP) in the Senate, and the Committee on Education and the Workforce in the House. Although the Senate Special Committee on Aging holds hearings and provides input and oversight on the reauthorizing legislation, it does not have statutory power.
In terms of the process, once the OAA is reauthorized, funding needs to be appropriated by the Congress because an authorization does not provide funding for the activities enacted. In addition, an amount of money must be provided in the government spending bills known as “appropriations” which enables the federal agencies involved to disburse funds to the programs and services, for example, to the Area Agencies on Aging and Home-Delivered Meals (aka Meals on Wheels) programs.
During the reauthorization process, Congress assembles information on the federal agencies and programs involved in the OAA. Advocates, organizations, businesses, and federal staff all weigh in on program modifications/improvements, how much funding should be authorized for which programs, and whether new programs should be created. Information is gathered via hearings, listening sessions, Hill Days, letters, and RFIs (Requests for Information).
This year, C-TAC and others were invited to submit suggestions via an RFI to the Senate HELP Committee. C-TAC noted in its comments that the OAA does not include explicit definitions of advance care planning or serious illness. It would be especially appropriate to see these terms in the definitions of services provided by organizations and agencies in the Aging Network, such as Aging and Disability Resource Centers, case management services, and information and assistance services. Similarly, C-TAC supports that the multi-year strategic plans required by the OAA include specific references to people with serious illness and health care proxies. Another request is for a new grant program, for AAAs and other aging-focused nonprofits, to support initiatives related to serious illness care and advance care planning which would enhance the services for these older adults in current programs, such as the Geriatric Workforce Enhancement Programs and telehealth programs.
C-TAC has a strong partnership with USAging, which represents and supports the national network of Area Agencies on Aging and advocates for the Title VI Native American Aging Programs that help older adults and people with disabilities live with optimal health, well-being, independence, and dignity in their homes and communities. In addition to C-TAC’s current work with USAging on a project funded by The John A. Hartford Foundation to expand aging network projects to support advance care planning by older adults, we support efforts to secure funds from Medicare and Medicaid and other sources to expand critical supports and services in the community. Reauthorizing the OAA and its programs at significantly higher funding levels is an important step toward providing individuals with serious illness the local services they need.
Several hearings have been conducted to gather information, including The Older Americans Act: The Local Impact of the Law and the Upcoming Reauthorization (Senate HELP Committee) and by the Senate Aging Committee, The Older Americans Act: Supporting Efforts to Meet the Needs of Seniors and Uplifting Families, Workers, and Older Adults: Supporting Communities of Care.
So, what’s next? With this Congress one is never certain whether the “regular order” will be followed, but the Senate is well on its way through the HELP and Aging Committees to drafting the OAA reauthorization bill. Pundits are guessing that the bill will be available for review in late July but will not be marked-up by the HELP Committee until the fall. The House has not begun its reauthorization process, at least in a public way. The Act expires on September 30, 2024, but as long as funding is made available by appropriators, the programs will continue.
