Financial, health and social concerns can pose daily challenges to
millions of America's seniors. For some of the most vulnerable seniors
over the past few decades, one thread has often meant the difference
between connecting with necessary services and support—or missing
out.
That thread is the
Older Americans Act (OAA), a low-key but venerable social program passed
in 1965 as part of President Lyndon Johnson's Great Society initiative.
The Act, which was designed to help seniors continue living
independently and with dignity, has impacts that are small in scope but
wide in scale: nearly 7 million seniors—about 15 percent of Americans
aged 60 and over—rely on it for free meals, job assistance,
transportation, home health care, legal aid, protection from abuse and a
myriad of other services.
Last year, OAA paid
for more than 200 million meals and 45 million rides, according to U.S.
Assistant Secretary for Aging Josefina Carbonell. And Sen. Mike DeWine
(R-OH), former chairman of the U.S. Senate Subcommittee on Aging, in
interviews and editorials has described the Act as "the closest thing on
record to a national policy on aging."
"Not only are these
services a lifeline for seniors, they're a tremendous benefit for
younger generations," points out Scott Frey, senior policy analyst at
the National Committee to Preserve Social Security and Medicare.
When the Lifeline Frayed
The Act in Brief
The Older
Americans Act, which was passed in 1965, is designed to help
seniors stay in their homes and communities as long as possible.
Its programs and services include:
•
Home-delivered meals • Home health care • Transportation
assistance • Elder abuse protection • Senior employment •
Adult day care • National Family Caregiver Support Program •
Legal help and counseling
The OAA will
continue to be refashioned to reflect important social,
demographic and economic trends, says U.S. Assistant Secretary for
Aging Josefina Carbonell.
"I want to
build on [our] successes and enhance programs to better serve
people, provide better access to services, improve resources and
improve coordinating abilities," she says. "I want to focus on
innovations and ... utilizing research to foster knowledge and
prepare for the retirement of the baby
boomers." |
Congress has
reauthorized the OAA 13 times since its inception, usually with
near-unanimous agreement. Yet in 1995, that suddenly changed. Congress failed to
renew the Act. Relatively small disputes over implementation spiraled
out of control among Republicans, Democrats and not-for-profit seniors'
organizations that help provide OAA services, leading to a stalemate
that dragged on stubbornly for five years.
While the OAA hung
in legislative limbo, Congress continued to "flat-fund" its programs at
existing levels, without increases for inflation or the rising numbers
of seniors. The effect on services was palpable. "We've seen waiting
lists grow," Frey reports. "Some seniors wait so long for a service that
they no longer need it—they end up in a nursing home."
In late 2000,
Congress finally achieved a compromise. The breakthrough came, many
observers say, when Sen. Charles E. Grassley (R-IA), then chairman of
the Special Committee on Aging, galvanized and unified the disputing
parties by proposing an initiative to provide government support to
family caregivers—the 23 million Americans who take care of more mature
relatives as well as the seniors who care for young children.
The National Family
Caregiver Support Act "served as a catalyst in the OAA's
reauthorization," Carbonell affirms. "It had widespread bipartisan
support."
Today, with the OAA
safely renewed through September 2005, senior advocates are applying
lessons from the reauthorization crisis to forge an even stronger,
better-funded Act—one whose relevance for a graying America will never
again be questioned or jeopardized.
Reinforcing the Act
Sen. DeWine calls
OAA 2000 "a modernized and streamlined" version of the Act. All of the
titles are preserved, while a compromise on cost-sharing gives states
the option of charging sliding-scale fees (based on seniors' voluntary
self-declaration of their income) for costlier services like
transportation. The deadlock over Title V (Senior Employment Program)
was resolved by requiring service providers to coordinate their efforts
through the aging agencies, among other modifications.
Most important, the
reauthorization flushed OAA programs with new money: an increase of $170
million over fiscal year 2000, for a total budget of $1.1 billion. The
lion's share of the increase, $125 million, went to the caregiver
support initiative, but nearly every OAA program received a raise
(except Title V, which was frozen at $440 million).
Nevertheless, OAA
2000 barely begins to rectify the funding gap that grew during the
reauthorization snafu. Take the National Family Caregiver Support
Program. Divvying $125 million up among 23 million caregivers, not to
mention the program's administration, translates to about $5 per
caregiver. "It's a drop in the bucket," one congressional aide says.
But underfunding is
nothing new to the OAA. "Since 1980, the Act has lost about 40 percent
of its original purchasing power due to repeated flat-funding in the
face of a growing senior population," Frey notes. "A lot of OAA programs
are forced to depend on volunteerism for their very
existence."
In fact, Frey
acknowledges, the number of seniors who are being helped by OAA programs
might be significantly higher than the current 7 million if funding were
adequate. "These programs do turn seniors away," he says.
Viewed in that
perspective, the five-year reauthorization hiatus seems merely a
particularly egregious example of the chronic undervaluation that dogs
the OAA.
"No member of
Congress would stand up and say they want to eliminate the Act," Frey
points out. Yet its successes look like a loaves-and-fishes story when
compared to its
tiny budge—at $1.1 billion, a minuscule portion of the $450 billion administered by
the Department of Health and Human Services (HHS).
One positive effect
of the reauthorization predicament was that seniors' organizations
raised their advocacy of the Act to new heights, especially toward the
end. "We said, 'Five years is enough,'" Frey recalls. "We really began
to educate the public, rally them to contact Congress. The senior
community brought a lot of pressure to bear." The National Council on
the Aging, for instance, launched a national "Silver Ribbon Campaign" to
raise public awareness, under the slogan "Free the Older Americans Act!"
Also, President
Bush's fiscal year 2002 budget request seeks to augment HHS' aging
programs by 7 percent, from $2.8 billion to $3 billion—roughly twice the
percentage increase requested for domestic discretionary spending
overall, Carbonell noted. But more funding will be needed, says Frey.
"Just look at the demographic bubble that's about to burst open when all
the baby boomers reach retirement age."
Hopefully, Congress
will agree. The sooner these programs receive proper recognition and
funding, the better for America's seniors.
Kristin K. Nauth
is an associate editor of Swift News Service in Washington,
D.C.
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