Older Americans Act

Older Americans Act Background

In 2019, the Older Americans Act (OAA) was up for Congress’ periodic reauthorization. Whether they know it or not, older adults across the U.S. rely on critical programs and services funded by the OAA to help them live safely in their homes and communities as they age.

By the year 2030, more than one in five people in the U.S. will be age 65 or older. Increasing our investment in cost-effective OAA programs and services is a critical step in responding to the needs of our aging America.

The OAA expired September 30, 2019, which makes securing a bipartisan reauthorization a top policy priority. Advocacy is especially needed in the Senate where the bill is currently stalled over issues related to the Act’s federal funding formula.

The OAA was passed in 1965 alongside Medicare and Medicaid, as part of a historic effort by lawmakers to take care of those over 65. The vital OAA dollars sent to states and communities every year provide a wide range of services that prevent unnecessary nursing home placement, promote healthy aging and help people age with independence and dignity where they want to be, in their homes and communities.

The OAA helps millions of older adults each year by providing in-home supportive services that assist them to bathe, get dressed or maintain a clean and safe home. It provides transportation programs to keep older adults engaged in the community.

OAA-supported home-delivered meals or dining at community centers supports the nutritional and social needs of older adults, while evidence-based community programs help people manage their chronic conditions and prevent falls. Family caregiver supports offered through OAA assist those who help older adults.

Unfortunately, OAA funding is lagging far behind senior population growth, as well as economic inflation. The biggest chunk of the act’s budget — nutrition services — dropped by 8 percent over the past 18 years when adjusted for inflation, an AARP report found in February. Home-delivered and group meals have decreased by nearly 21 million since 2005.

Only a fraction of those facing food insecurity get any meal services under the act; a U.S. Government Accountability Office report examining 2013 data found 83 percent got none. Nearly 8 percent of Americans 60 and older were “food insecure” in 2017, according to a recent study released by anti-hunger group Feeding America.

To get OAA funding back to 2010 levels would require a 30 percent increase. Meanwhile, 10,000 people a day turn 65. This means that the waiting lists are growing faster than the funding.

Today, there are more than 70 million Americans aged 60 years and older, and the U.S. Census estimates that number will increase to 100 million by 2040. The last OAA reauthorization took Congress five years. However, even though the current authority ran out on September 30, 2019, Congress can keep paying for the programs.

At the National Indian Council on Aging, we are advocating for these programs in Washington, D.C., and working to ensure that federal lawmakers understand how important OAA is to their constituents. However, we need you to help make our voices stronger. Please take a few moments to contact our elected officials to share your OAA story and educate them about how these vital OAA services help older adults and caregivers in your community.

Tell your members of Congress that they must reauthorize the expired OAA. If your Senator sits on the Senate HELP Committee or if your Representative serves on the House Education and Labor Committee, it is especially important that you urge them to support moving OAA reauthorization forward. Additionally, the Capitol Switchboard (202-224-3121) can connect you to your lawmakers’ offices.

You can also find the website information for your House and Senate Members and urge them to support moving OAA reauthorization forward. If your representative and/or senator is not on the key committees, ask them to contact their colleagues who are on the Senate HELP or House Education and Labor Committees, which both have jurisdiction over OAA.

Show your support for OAA reauthorization by urging House and Senate offices to call the Committees to ask about the status of OAA reauthorization negotiations.

There were over 258,616 American Indians over the age of 65 in 2016. The population of elder Natives is expected to grow by 116 percent by 2030. They’re estimated to increase to 309,000 by next year, 443,000 in 2030, and more than 648,000 by 2060.

In 2018, there were 296 tribes receiving Older Americans Act (OAA) Title VI funds. OAA language indicates that Title VI programs be comparable to those under Title III, but unfortunately this is not the case.

The National Indian Council on Aging (NICOA) recommends increasing funds for caregiver programs, fully funding Title VII-B, increasing the funding for Title VI, moving Title V “set aside” funds to Title VI, implementing and establishing a White House Conference on Indian Aging; and elevating the director of the Office for American Indians, Alaska Natives and Native Hawaiians Programs to assistant secretary of American Indian and Alaska Native Elders.

The increased funding for Title VI should ensure that tribes receiving Title VI funds maintain funding levels that will ensure services are delivered and at 1.5 times the inflation rate, as costs are higher on tribal lands. The “set asides” of Title V (SCSEP) are an acknowledgment of the unique government-to-government relationship enjoyed by tribes. Moving Title V “set aside” funds to Title VI would consolidate programs for Native elders in one office rather than fragmented among several federal agencies.

Title VII-B has never been funded and with the increasing incidence of elder abuse, fraud and neglect in Native communities, this is a need that must be addressed. Many tribes don’t have their own specialized elder protective service so there may not be anyone to report abuse to, or insufficient resources for a response even if a report was made.

For over 40 years, tribal elders and officials have been recommending the implementation and establishment of a White House Conference on Indian Aging. The meeting would recognize the federal trust responsibility and be equal to a national consultation between Native elders and the U.S. government.

Some studies indicate that one in five elders will suffer from Alzheimer’s disease or dementia. Last year, over 6 million people were diagnosed with Alzheimer’s or dementia, requiring 18 billion hours of caregiver support. Assuming national rates are the same in Indian Country, if one in five Native elders suffer from Alzheimer’s or dementia, that number today would be 61,800.

The elevation of the director of the Office for American Indians, Alaska Natives and Native Hawaiians Programs to assistant secretary of American Indian and Alaska Native Elders is another recommendation submitted over the last 40 years to no avail. The elevation of this office to assistant secretary, with jurisdictional authority, is a recognition of the importance of the unique government-to-government relationship between Native tribes and the U.S. government.

The OAA is the key legislative framework for developing, coordinating, and delivering home and community-based services that allow American Indian and Alaska Native elders to maintain their independence. The Title VI program of the OAA provides support and nutrition services which aid American Indians and Alaska Natives across the country.

The OAA provides a long-term care ombudsman program to protect the rights and wellbeing of those living in long-term care facilities. It also authorizes the only federal workforce program that provides training to help low-income elders transition to employment in their community. Sadly, the OAA is consistently subject to sequestration, resulting in unnecessary and harmful cuts each year.