1. Older Americans Act Overview
11/29/2018
Virginia Department for the Aging
Older Americans Act Overview

2. Federal Executive Branch
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U.S. Department of Health and Human Services
Administration on Aging
Tribal Organizations
(244)
State Units on Aging (56)
Area Agencies on Aging (629)
Local Service Provider Organizations (29,000)
CONSUMERS

3. Older Americans Act (OAA)
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1965 Great Society Legislation
OAA has be reauthorized 16 times
2006 amendment authorizes the Act for 5 years through 2011
Requires States to Advocate (Not Lobbying) for Older Individuals
Advocacy or Advocate is mentioned 26 times
The Older Americans Act was originally signed into law by President Lyndon B. Johnson on July 14, Signed just 16 days before President Johnson signed the Social Security Act of 1965 on July 30, 1965 that created Medicare and Medicaid.
The month of May first received its designation in 1963 when President John F. Kennedy proclaimed it “Senior Citizens Month.” President Jimmy Carter in 1980 changed the name to “Older Americans Month.” Every President since JFK has issued a formal proclamation during or before the month of May asking that the entire nation to pay tribute in some way to older persons in their communities.
The original 1965 version of the Older Americans Act was 8 pages long.
The 2000 version is 126 pages long.
The position of Commissioner of Aging was elevated to Assistant Secretary for Aging within the Department of Health and Human Services in 1993.
Assistant Secretaries for Aging – swearing in dates
May 4, Kathy J. Greenlee
August 8, Josefina G. Carbonell
December 8, 1997 Jeannette C. Takamura, Ph.D.
May 6, Fernando M. Torres-Gil first Assistant Secretary for Aging
1989 Joyce T. Berry, Commissioner on Aging
1984 Carol Fraser Fisk, Commissioner on Aging
1981 Lennie-Marie Tolliver, Commissioner on Aging
1978 Robert G. Benedict, Commissioner on Aging Arthur S. Flemming, Commissioner on Aging
1968 John Martin, Commissioner on Aging
1965 William Bechill named first Commissioner on Aging
On July 14, 1965, President Lyndon Baines Johnson signed the Older Americans Act into law.  At the ceremony, President Johnson said, 'The Older Americans Act clearly affirms our Nation's sense of responsibility toward the well-being of all of our older citizens.  But even more, the results of this act will help us to expand our opportunities for enriching the lives of all of our citizens in this country, now and in the years to come...  Under this program every State and every community can now move toward a coordinated program of services and opportunities for our older citizens.'
Full Remarks at the Signing of the Older Americans Act. This year, the century has reached the age of 65, and nearly one out of ten Americans have lived that full span or longer.
Lengthening the life span is a major achievement of our time. It is also the source of one of the major challenges to the values and the vision of our Great Society.
The Older Americans Act clearly affirms our Nation's sense of responsibility toward the well-being of all of our older citizens. But even more, the results of this act will help us to expand our opportunities for enriching the lives of all of our citizens in this country, now and in the years to come.
The grants under this law will be modest in dollars, but will be far-reaching in results. Its results will come where they are needed-always at the hometown level. I am hopeful, as I know and believe that the Congress is hopeful, that this will permit us to find greater uses for the skills and the wisdom and the experience that is found in the maturity of our older citizens.
The importance of meeting this challenge just cannot be overstated. At present, 1.5 million Americans reach age 65 each year--1 1/2 million. Since 1900 the proportion of persons in our population age 65 and over has already doubled. What a tribute that is to our medical profession. And you haven't seen anything yet.
I understand that of all the persons that have reached age 65 since the dawn of civilization, 25 percent of them are alive today. These older generations need to participate in what we are doing and, as a Nation, we can profit from their participation.
I am very proud to have the privilege of now signing into law this measure for the benefit of the men and women who have done so much in this century to build in America a just, a decent, a free, and a peaceful society. I hope that every person within the sound of my voice will be willing to continue to unite behind us in not only expanding the life expectancy in this country, but in trying to help our neighbors in the world to achieve the same remarkable results that all of you members of both parties, by working together, have achieved in this country.
Thank you very much. Note: The President spoke at 11:55 a.m. in the Rose Garden at the White House.
President Johnson signing the OAA in 1965

4. Older Americans Act (OAA) History
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1965 Created Administration on Aging (AoA)
1969 Created nine national model demonstration projects – such as Senior Services of Southeastern Virginia
1972 Established congregate (group meal) nutrition program
1974 Added transportation
1978 Established home-delivered nutrition. Mandated Long-Term Care Ombudsman Program to serve as a visible advocate for the elderly
1981 Emphasized supportive services to help older persons remain independent in the community
1992 Added "Vulnerable Elder Rights Activities”
2000 Created the National Family Caregiver Support Program
1935 Social Security Act passed; provides Old Age Assistance and Old Age Survivors Insurance.
1937 Railroad Retirement Act provides pensions for retired railroad employees and spouses.
1950 President Truman initiated first National Conference on Aging
1952 First federal funds appropriated for social service programs for older persons under the Social Security Act.
1956 Special Staff on Aging established within the Office of the Secretary of Health, Education and Welfare, to coordinate responsibilities for aging.
Federal Council on Aging created by President Eisenhower.
1958 Legislation introduced in Congress, calling for a White House Conference on Aging.
1961 First White House Conference on Aging held in Washington, D.C.
1962 Legislation introduced in Congress, to establish an independent and permanent Commission on Aging.
1965 OAA signed into law on July 14, It established the Administration on Aging within the Department of Health, Education and Welfare, and called for the creation of State Units on Aging.
1967 OAA extended for two years, and provisions made for the Administration on Aging to study the personnel needs in the aging field.
Age Discrimination Act signed into law.
1969 OAA Amendments provided grants for model demonstration projects, Foster Grandparents, and Retired Senior Volunteer Programs.
1972 Title VII created under the OAA authorizing funds for a national nutrition program for the elderly.
1973 OAA Comprehensive Services Amendments established Area Agencies on Aging. The amendments added a new Title V, which authorized grants to local community agencies for multi-purpose senior centers, and created the Community Service Employment grant program for low-income persons age 55 and older, administered by the Department of Labor.
1974 OAA amendments added transportation under Title III model projects.
National Institute on Aging created to conduct research and training related to the aging process, and the diseases and problems of an aging population.
1975 OAA Amendments authorized grants under Title III to Indian tribal organizations. Transportation, home care, legal services, and home renovation/repair were mandated as priority services.
1977 OAA Amendments required changes in Title VII nutrition program, primarily related to the availability of surplus commodities through the Department of Agriculture.
1978 OAA Amendments consolidated the Title III Area Agency on Aging administration and social services, the Title VII nutrition services, and the Title V multi-purpose senior centers, into a new Title III and added a new Title VI for grants to Indian Tribal Organizations. The old Title V became the Community Service Employment grant program for low-income persons, age 55 and older (created under the 1978 amendments as Title IX).
Congregate Housing Services Act authorized contracts with local public housing agencies and non-profit corporations, to provide congregate independent living service programs.
OAA amendments required each state to establish a long-term care ombudsman program to cover nursing homes
1981 OAA reauthorized; emphasized supportive services to help older persons remain independent in the community.
Act expanded ombudsman coverage to board and care homes
1984 OAA reauthorization clarified and reaffirmed the roles of State and Area Agencies on Aging in coordinating community-based services, and in maintaining accountability for the funding of national priority services (legal, access, & in-home).
1987 Omnibus Budget Reconciliation Act provides for nursing home reform in the areas of nurse aide training, survey and certification procedures, pre-admission screening an annual reviews for persons with mental illness.
Reauthorization of the OAA added six additional distinct authorization of appropriations for services: in-home services for the frail elderly; long-term care ombudsman; assistance for special needs; health education and promotion; prevention of elder abuse, neglect, and exploitation; and outreach activities for persons who may be eligible for benefits under supplemental security income (SSI), Medicaid, and food stamps. Additional emphasis was given to serving those in the greatest economic and social need, including low-income minorities.
OAA reauthorization charged states to guarantee ombudsman access to facilities and patient records, provided important legal protections, authorized state ombudsmen to designate local ombudsman programs and required that ombudsman programs have adequate legal counsel.
1990 Americans with Disabilities Act extended protection from discrimination in employment and public accommodations to persons with disabilities.
Age Discrimination in Employment Act made it illegal, in most circumstances, for companies to discriminate against older workers in employee benefits.
1992 OAA amendments increased focus on caregivers, intergenerational programs, protection of elder rights.
Added Title VII "Vulnerable Elder Rights Activities" which included the long-term care ombudsman; prevention of elder abuse, neglect and exploitation; elder rights and legal assistance development; and benefits outreach, counseling and assistance programs.
2000 OAA Amendments established the National Family Caregiver Support Program, and reauthorizing the OAA for 5 years.

5. Older Americans Act (OAA)
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Title I: Objectives / Definitions
Adequate Income
Best Possible Physical and Mental Health
Suitable Housing
Institutional & Community-Based Long-Term Care
Employment Without Age Discrimination
Retirement in Health, Honor, Dignity
Participation in Civic, Cultural, Educational Activities
Community Services such as Transportation
Education About Sustaining and Improving Health
Protection From Abuse, Neglect, and Exploitation
Title II: Administration on Aging
Authorizes, Organizes, and Finances
Title I is largely unchanged from 1965.
Contains aspirational goals from the Great Society social reform era.
DECLARATION OF OBJECTIVES
It is the joint and several duty and responsibility of the governments of the United States...to assist our older people to secure equal opportunity to the full and free enjoyment .:
An adequate income in retirement in accordance with the American standard of living.
Best possible physical and mental health which science can make available
Suitable housing ... which older citizens can afford.
Full restorative services for those who require institutional care, and a comprehensive array of community-based, long-term care services ... to ... sustain older people in their communities and in their homes, including support to ...persons providing ... care.
Opportunity for employment with no discriminatory personnel practices because of age
Retirement in health, honor, dignity—after years of contribution to the economy.
Participating in and contributing to ... civic, cultural, educational and training and recreational opportunities.
Efficient community services, including access to low cost transportation, which provide a choice in supported living arrangements ... with emphasis on maintaining a continuum of care for vulnerable older individuals.
Immediate benefit from proven research knowledge which can sustain and improve health and happiness.

6. Older Americans Act (OAA)
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Title III: State and Community Programs
Part A:
Defines the Purpose
Maximize Independence and Dignity
Remove Individual and Social Barriers
Continuum of Care
Managed In-home and Community-Based Long-Term Care Services
State Units on Aging (SUAs)
Develop and Administer State Aging Plan
Advocate for Older Individuals
Designate Area Agencies on Aging (AAAs)
Establish Policies, Procedures, Service Standards
Provide Technical Assistance
Area Agencies on Aging (AAAs)
Develop and Administrator Local Aging Plan
Establish Advisory Council
Provide Services
Establish Focal Points to Provide Services
Facilitate Coordination of Community Long-Term Care Services
Part B: Support Services & Senior Centers
Community-Based Services and In-Home Services: adult day care, checking (reassuring contact), chore, homemaker, personal care, residential repair and renovation.
Access Services: care coordination, information and assistance, transportation.
Part C: Nutrition / Meals
Subpart 1: Congregate (Group)
Subpart 2: Home Delivered
Part D: Disease Prevention and Health Promotion
Part E: National Family Caregiver Support Program
It is Title III that funds a large proportion of the AAA activities.

7. Older Americans Act (OAA)
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Older Americans Act (OAA)
Title IV: Activities for Health, Independence and Longevity
Demonstration Grants / Programs
Aging & Disability Resource Center Grants
Alzheimer's Disease Grants
Evidence Based Programs (Chronic Disease Self-Management Program)
Title V: Community Service Senior Opportunities Act
Older American Community Service Employment Program
States
National Contractors
Title VI: Grants for Native Americans
Federally recognized American Indian Tribes
Native Hawaiian Program
Title VII: Vulnerable Elder Rights Protection Activities
Ombudsman
Elder Abuse, Neglect and Exploitation
State Legal Assistance Development
Title VIII: Tom Osborne Federal Youth Coordination Act

8. History of AAAs
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1969 OAA amendment created model demonstration projects across the nation. Southeastern Virginia Areawide Model Project (SEVAMP) – Senior Services of Southeastern VA was one of the original nine.
1972 OAA amendment created the nutrition program. Funds from this program allowed Virginia to establish a congregate (group) meal program in the 21 planning and service areas.
1973 OAA amendment called for the creation of the AAAs.
Regions of the state (generally by planning and service areas) developed a plan for their area. With approval of the plan grants were given to start the AAA.
Most AAAs were established in
As a result of the 1973 amendments to the federal Older Americans Act (OAA), states were required to divide their state into Planning and Service Areas (PSAs), and to designate Area Agencies on Aging (AAAs) to develop and implement programs and services for older persons at the local level.

9. OAA Services are Targeted To:
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Older American’s Act – Section 102
Greatest Economic Need – income at or below the poverty line.
Greatest Social Need – noneconomic factors, physical and mental disabilities; language barriers; and cultural, social, or geographical isolation (rural), including isolation caused by racial or ethnic status, that restricts the ability of an individual to perform normal daily tasks; or threatens the capacity of the individual to live independently.
Frail – functionally impaired unable to perform at least two activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision.

10. OAA Eligibility for Services
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OAA Eligibility for Services
Age 60 and over (except Title III-E Grandparents and Title V is 55)
Not an entitlement (guaranteed access to benefits) like Social Security, Medicare or Medicaid
Services can be curtailed due to lack of funding
Self-declaration of income – Not means tested. There is no verification of ability to pay, but programs target poverty
Income information maybe asked to determine fee-for-service/cost sharing

11. The AAA Service Dilemma
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The AAA Service Dilemma
Services can be curtailed due to lack of funding
Coping Strategies:
Limit the number of different services provided
Limit number of people served (waiting lists)
Limit where services are provided (some local governments pay for more meal sites than others)
Target those most in need.

12. Concluding Comments or Questions???
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Concluding Comments or Questions???