Transcript Document

The Capacity of the Aging
Services Network:
Top 10 Things to Know for
Reauthorization
1965
OAA, Medicare,
Medicaid
1972
1973
1975
SSI, Congregate Meals
AAAs enacted
SSBG
1981
1987
Medicaid Waiver
LTC Ombudsman
Americans with
Disabilities Act
2000
2006
Family Caregiver
First Boomers Turn 60
1992
Elder Rights title
added
1990
1999
Olmstead Decision
2006
ADRC, Health
Promotion, Nursing
Home Diversion
Total
Spending
$2.73
Trillion
OAA
=0.066%
A Joint Proposal of NASUA and n4a
4
AoA
State Units
on Aging
Area Agencies on
Aging
Title VI Native American
Aging Programs
Service Providers
Volunteers
56
629
244
0ver 30,000
Over 500,000
•The age wave has begun.
2000
2020
Source of charts: U.S. Census Bureau, “65+ in the United States: 2005,” December 2005.
80
numbers in millions
70
60
50
40
30
20
10
0
1900-2030
50
45
40
35
30
25
20
15
10
5
0
65-74
75-84
85 and older

The characteristics of the population served
by the Aging Services Network continue to
diversify, with nearly two-thirds of states and
AAAs serving both the elderly and physically
disabled younger adult populations
regardless of age.
22%
14%
64%
60 years of age and
older population
only
60 years of age and
older population
and disabled
population
regardless of age
80%
70%
Percent of States
60%
50%
40%
30%
20%
10%
0%
Figure 7. Proportion of AAAs who are the Single Point of Entry for at least
some services, by target population and year
90
82.4
2007
77.1
80
2008
70
63.4
60
49.4
50
40
34.8
39.2
48.2
35.7
30
25.4
18.5
20
10
0
All age groups
Older Adults 60+
Children 0-17
Adults ages 18-59
Private pay clients

Federal funding continues to decline despite
growth in the number of eligible Americans.
Average of 30%
of SUA budget
is OAA funding
2%
20%
56%
22%
Less than $1
million
Between $1 and
$25 million
Between $26 and
$50 million
More than $50
million


Average Budget:
$ 7.5 million
Lowest Quartile:
Second Quartile:
Third Quartile:
$ 2.0 million
$ 3.8 million
$ 8.7 million
Average Percent of Budget from OAA: 40.4
Lowest Quartile:
Second Quartile:
Third Quartile:
21.5
36.0
56.0
Although funding from the
Administration on Aging has not kept
pace with the numbers of individuals 60
plus, states, the Area Agencies on Aging
and the other network partners have
successfully leveraged federal funding
For every $1 in federal
funding, state and local
agencies on aging
acquire more than $2 in
other funding
AoA
provides
seed
funding and
oversight
States add
states’ share of
federal funds,
provide
additional
state-only
support and
distribute
funds
AAAs may add
local funding
and support and
purchase
services
Providers add
additional
support and inkind
contributions
and deliver
services
Volunteers lend
time and
support
OAA
Local
Govt
Funding
Medicaid
Aging
Services
Network
Other
Federal
Funding
Private
Funding
StateOnly
Funding
Targeted
Tax/
Lottery
Foundation/private grants
State lottery
Targeted tax
Local (i.e., county or city) funding
State appropriation
Medicaid
Older Americans Act
0%
10%
20%
30%
40%
50%
60%
Percent of States
70%
80%
90%
100%
fu
nd
wa
i
ve
r
IP
*
ng
in
G
g
er
r
a
c
n
o
O
tf
-p
th
un
ay
er
ds
/
ch
co
ar
st
ita
sh
bl
ar
e
e
do
na
tio
Tr
ns
F
an
un
sp
dr
or
ai
ta
sin
tio
g
n
fu
nd
in
Pr
g
iv
M
at
e
ep
di
ay
ca
id
co
ns
um
Fa
ith
er
s
-b
as
H
ed
U
D
or
**
ga
ni
za
tio
ns
In
di
M
an
ed
H
ic
ar
ea
e
lth
Se
rv
ic
e
um
te
ca
id
SH
nd
i
e
61.7
Co
ns
ed
i
fu
re
ve
nu
Lo
ca
l
ne
ra
l
70.3
er
sta
M
ge
71.7
th
te
80
70
60
50
40
30
20
10
0
O
St
a
Figure 1: Proportion of agencies with funds from various sources
(in addition to OAA funding)
56.8
54.2
53.8
53.2
51.1
35.8
34.6
28.3
17.7
10.2
9.0
7.3
0.6

The Aging Services Network continues to
develop a comprehensive strategy of services
for long-term services and supports for all
Americans of all ages and abilities that may
help bend the cost curve on entitlements.
•National Family Caregiver
Supporting Family
Caregivers
Maintaining Health and
Independence
Protecting Vulnerable
Older Americans
Supporting the National
Aging Network Services
Employing Senior
Workers
•Lifespan Respite Care
•Alzheimer’s Disease
•Native American Caregiving Support Program
•Information and Referral, Case Management
•Home Delivered, Congregate, and Native American Nutrition
•Personal Care, Homemaker Assistance, Adult Day Care
•Transportation
•Long-Term Care Ombudsman
•Prevention of Elder Abuse and Neglect
•Aging and Disability Resource Centers, Evidence Based
Disease Prevention, Community Living Incentives
•Program Innovations
•Aging Network Support
•Seniors Community Service Employment for Older
Americans Program
Long-Term Care Planning by AAAs
Information about and referral to
long-term care services
94.1
Outreach and educational presentations
89.9
Information about establishing legal
directives such as living wills
84.2
Options counseling through other
services such as case management
69.6
Elder rights education
69.4
Information about long-term care insurance
65.2
Options counseling through an ADRC
33.4
Participation in AoA "Own Your Future" campaign
15.6
0
10
20
30
40
50
60
70
80
90
100

The Aging Services Network is evolving
towards more consumer-driven activities.
State funded HCBS
Medicaid HCBS
In OAA programs
0
5
10
15
20
Number of States
25
30
Percentage of AAAs who provide consumer-directed options in the following services.
Respite Care
26.0
Personal Care
25.3
Homemaker
23.5
Family Caregiver Support Program
22.6

The Aging Services Network is providing
evidence-based health promotion and
disease prevention programs that allow older
adults and individuals with disabilities to
remain in their homes and communities.
Medicaid Management Improvement
System
Healthy IDEAS or PEARLS
EnhanceWellness
EnhanceFitness
Chronic Disease Self-Management
A Matter of Balance
Percent of States
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Over half (55.6%) of AAAs are involved in
providing evidence-based programs to
prevent/manage chronic disease or disability.
Most common• Chronic Disease Self-Management Program
• A Matter of Balance
• EnhanceFitness
• EnhanceWellness

States and Area Agencies on Aging are
encouraging the development of livable
communities for all ages--the development
of services and infrastructure to assist people
across their lifespan--through the use of
various grant initiatives and state-fundedonly programs.
Planning and development of policy
Quality for home and community based services
Eligibility determination
Financing
Regulation of home and community based providers
Quality for institutional services
0%
10%
20%
30%
40%
50%
60%
Percent of States
70%
80%
90%
Yes
40%
46%
14%
No
My state is in the
process of making
changes to
achieve this goal.
Figure 2: Most Common AAA Partnerships
Transportation Agencies
87.8
Adult Protective Services
86.5
Advocacy Organizations
85.9
Emergency Preparedness Agencies
80.9
Federal programs
80.1
Medicaid
79.3
Long-Term Care Facilities
78.3
Health care providers
77.3
Public housing authority
76.9
Charitable Organizations
75.5
Other social service organizations
75.3
0
20
40
60
80
100
Figure 5: Enhanced Nursing Home Diversion
(Proportion of AAAs who are involved in efforts consistent
with nursing home diversion)
100
90
89.5
90.5
80
70
60.5
60
50
40
30
20
21.0
13.7
10
0
Consumers with greatest Consumers most at risk Currently paritipate in an Organization has a formal Facilitates the transition
impairment get priority for
for nursing home
AoA NH Diversion
nursing home diversion
of consumers from
services in at least some placement get priority for
Modernization grant
program other than NH institutional placements
programs
services in at least some
Diversion grant
into the community
programs

States and communities continue to face
extraordinary pressure due to the economic
decline.
Home delivered meals
General Information Requests
Information and Referral
Transportation
Personal care
Adult Protective Services
Housing assistance/foreclosure counseling
Medicaid HCBS elderly
Respite
Senior employment and community service
Food stamps
Homemaker
Low Income Home Energy Assistance Program
Congregate meals
Long Term Care Ombudsman Programs
State Health Insurance Assistance Programs
State Pharmaceutical Drug Assistance Programs
Adult day care
Chore
Medicaid HCBS disabled
Senior centers
Disease prevention or wellness programs
No Increase
% of States
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
Strengthen core OAA functions and
infrastructure to build on proven best practices
to create a system that empowers and facilitates
consumer choice, from private pay to Medicaid,
while building on and complementing the energy
of a growing aging service industry.
1.
2.
3.
Move from an agency-based system to a consumerdriven system that builds on emerging markets
Recognize and strengthen the critical role of SUAs, AAAs
& Title VI entities in long-term services & supports
Strengthen the states’, AAAs’ & Title VI entities’
community planning role in the development of Livable
Communities for All Ages
Number of States
50
45
40
35
30
25
20
15
10
5
0
Irene Collins, President
c/o Martha Roherty
Executive Director
NASUA
1201 15th Street, NW
Suite 350
Washington, DC 20005
202-898-2578
www.nasua.org
[email protected]
Lynn Kellogg, President
c/o Sandy Markwood
CEO
n4a
1730 Rhode Island Avenue, NW
Suite 1200
Washington, DC 20036
202-872-0888
www.n4a.org
[email protected]