Older Americans Act uncertainty

Mac McLean / The Bulletin

Senior advocates at the nation’s capitol hope a bill re-establishing the nearly $2 billion network of senior support services contained in the Older Americans Act will coast through the U.S. Congress by the end of next year.

But they’re worried it could be derailed by a funding debate that could put Oregon, Washington and other states with rapidly growing senior populations at odds with the rest of the country over who gets the biggest piece of an already dwindling pie.

“Right now we’re at risk of losing our momentum,” said Marci Phillips, public policy director for the National Council on Aging, an nonprofit organization that advocates for the needs seniors and the community organizations that support them.

First adopted in 1965, the Older Americans Act sets a basic framework dictating how dozens of federally funded programs that help people who are 60 or older should operate. It establishes a network of Area Agencies on Aging like the Central Oregon Council on Aging — which serves Crook, Deschutes and Jefferson counties — to manage these programs on the local level and make sure people in their communities get the help they need.

“Everybody needs a little something different,” said Amy Gutwals, senior director for public policy and advocacy with the National Association of Area Agencies on Aging. “(These programs) help keep people out of nursing homes and they help build stronger communities.”

The Older Americans Act also contains a reauthorization clause that requires the U.S. Congress to review its provisions every five years and determine whether its programs need to be changed, removed or expanded before the next five-year cycle starts.

Earlier this year, U.S. Sen. Bernie Sanders, I-Vt., kicked off the Older Americans Act’s reauthorization process when he sponsored a piece of legislation that made only technical changes to the act’s provisions.

That bill cleared its first hurdle when it was unanimously approved by the Senate Committee on Health, Education, Labor and Pensions on Oct. 30.

Phillips said this vote shows the Sanders bill has a significant amount of bipartisan support that could put it on a fast track to the Senate floor.

“The best chance we have to move forward in the Senate this year is through a unanimous consent agreement,” she said, referring to process where senators decide to allow a bill to move through their legislative body without significant debate or the threat of a filibuster.

But this progress could be held up by a 7-year-old clause that guarantees each state receives a minimum amount of federal funding for its Older Americans Act programs regardless of how quickly its senior population has grown.

During the act’s last reauthorization in 2006, members of the U.S. Congress adopted a provision that required each state to get a minimum level of federal funding that was based on the number of residents who were 60 or older when the last census was completed in 2000. Gutwals said this provision, known as the 2006 hold harmless provision, was widely accepted at the time because it meant states could count on receiving a certain amount of money from the federal government to manage their senior programs year after year.

It also didn’t stop states that had a fast-growing senior population — and thus needed more money to manage their senior programs than in previous years — from getting extra money from the federal government.

Hit by economy

But things changed, she said, when the economy took a downswing and froze the amount of money distributed through the Older Americans Act even though the population it serves was increasing at a rapid pace.

“We’ve just had hit after hit after hit,” Gutwals said. “You’re really starting to compromise these programs ... you’re really starting to put the seniors (who depend on them) at risk.”

Gutwals said the situation got even worse when the series of automatic spending cuts known as the sequester took effect last spring. She said these cuts created an interesting situation for the Older Americans Act because it triggered the 2006 hold harmless provision in a way that no one saw coming.

According to the U.S. Census Bureau, 14 states including Oregon and Washington saw their 60-plus population grow by more than 45 percent between 2000 and 2012, while four states and the District of Columbia saw an increase of less than 20 percent.

Because of these differing growth rates, some states saw an increase of at least 5 percent in the amount of money they received through the Older Americans Act between 2006 and 2012, while others did not.

Gutwals said this meant the states with the slowest growth rates in their senior population, the ones that saw the smallest increase in Older Americans Act funding, could not absorb the 5 percent budget cut called for by the sequester without violating the 2006 provision.

The money that was supposed to be taken from their budgets had to be taken from another state’s budget, she explained. According to one report, 11 states saw a double-digit cut to Title III program services while 16 states saw a cut of less than 1 percent. Oregon falls into the previous category because it had to deal with a 10.5 percent cut to its budget for this line item, which helps fund an array of social services, nutrition, caregiver support and health promotion programs that help millions of seniors each year.

This situation created a bit of animosity that surfaced during the act’s reauthorization hearing on Oct. 30, when U.S. Sen. Richard Burr, R-N.C., introduced an amendment that would remove the 2006 provision and the minimum funding levels it set for all states.

“The current funding formula for the Older Americans Act is unfair,” said Burr, whose state saw its senior population increase by 47.7 percent between 2000 and 2012, according to the census. “(It) penalizes states like North Carolina that have fast-growing populations of seniors and distorts funding so that these states do not get their fair share.”

By changing the funding formula, Phillips said, Burr’s amendment would create a situation where the states with the fastest growing senior populations would see an increase in the amount of money they received through the Older Americans Act. Oregon could see a 6.5 percent increase in its OAA funding, she said, while Washington could see a 7 percent increase.

But unless more money was given to the Older Americans Act, these funding increases would come at a loss to states with slow growing senior populations that would still have to serve an increasing number of senior citizens in need with less money than they had the year before.

“Whenever you have a funding formula change and there’s no new money, then somebody’s going to get hurt,” Phillips said.

And though Burr’s amendment failed by a vote of 7-14, Phillips said she’s worried it may have started a debate that could add a bit of controversy to the Older Americans Act’s reauthorization efforts and slow down a process he and Gutwals had hoped would be as smooth as possible.

That’s because no matter what happens in the Senate, the act’s reauthorization still needs to clear the U.S. House of Representatives.

“If we can’t get this done by the end of 2014,” Phillips said, referring to when the 113th session of Congress is scheduled to run out, “then we have to start this whole process over again.”

About the act

First adopted in 1965, the Older Americans Act contains seven titles or sections that serve as the basis for creating and funding hundreds of programs that benefit the country’s senior population. Here is a synopsis of what each title does:

Title I

• Lists a series of goals focused on making sure older Americans have adequate incomes when they retire, are in the best physical and mental shape possible, have an opportunity for continued employment and that they have a comprehensive network of long-term care services and supports.

Title II

• Area Agencies on Aging: Establishes the national network of Area Agencies on Aging — including the Central Oregon Council on Aging, which serves Crook, Deschutes, and Jefferson counties — as the chief advocate for the country’s senior population and the coordinator of most OAA programs.

• Resource connections: Establishes the National Eldercare Locator Service and a network of Aging and Disability Resource Centers as a way for people to find out more about the community services located in their area and what long-term care programs work best for their needs. (Both programs received $27.3 million in fiscal year 2012)

Title III

• Social services: Provides grants to certain adult day care, information and assistance, home care, legal assistance, transportation and senior center programs designed to help people stay independent at home and in their communities. (Received $366.9 million in fiscal year 2012)

• Nutrition: Creates congregate dining and home-delivered meals (Meals on Wheels) programs that help reduce hunger and food insecurity among the country’s senior population and gives them access to socialization. (Received $816.3 million in fiscal year 2012)

• Caregiver support: Establishes the National Family Caregiver Support program to help family caregivers find information about support services, find counseling services or support groups, training courses and respite care services. (Received $153.6 million in fiscal year 2012)

• Health promotion: Provides “seed money” to programs that help prevent or delay chronic conditions among the country’s older population and come up with ways to promote healthy behaviors and lifestyles. (Received $21.2 million in fiscal year 2012)

Title IV

• Program innovations: Supports programs that are designed to expand our knowledge about the aging process and test innovative ways these programs can be delivered through the community. (Received $23.6 million in fiscal year 2012)

Title V

• Senior Community Service Employment Program: Provides part-time jobs with nonprofit and community-based organizations that are geared toward low-income people who are 55 or older and have poor job prospects. (Received $448.3 million in fiscal year 2012)

Title VI

• Awards grants to help Indian tribal organizations, Alaskan Native organizations, and nonprofit organizations that serve native Hawaiians run social services programs, nutrition services programs and family caregiver support programs in their communities. (Received $34.0 million in fiscal year 2012)

Title VII

• Long-term Care Ombudsman: Establishes a network of long-term care ombudsmen who represent residents of a long-term care facility and help them interact with their community and their facility’s management.

• Elder abuse prevention: Requires states to create programs designed to teach the public about ways they can identify and prevent elder abuse, neglect and financial exploitation in their communities. (Both programs received $21.8 million in fiscal year 2012)

Source: The National Health Policy Forum at George Washington University.