OLDER AMERICANS ACT AMENDMENTS OF 2006

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OLDER AMERICANS ACT AMENDMENTS OF 2006

• Summary of Key Provisions
• National Association of State Units on Aging

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Presenter

• Kathy Miller, Policy Director
• National Association of State Units on Aging,
  Washington DC

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Reauthorization Process

• NASUAs role
• Consensus document produced in 2004 with input
  from all state aging directors, senior staff
• Direction from NASUA resolutions committee and
  NASUA Board of Directors

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NASUA Consensus Document

• Recognized growth in aging population
• Evolving role of state agencies on aging
• Administration of Medicaid HCBS waivers, APS,
  services for people with disabilities

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NASUA Recommendations

• Separate title and funds for Aging and Disability
  Resource Centers (ADRCs)
• New authorization for HCBS ombudsman program
• New resources for states to conduct outreach/
  counseling on entitlements and other benefits

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NASUA Input

• Individual meetings with congressional staff
• Meetings with other aging groups such as n4a
• Presentation to AoA senior staff
• Participated in congressional hearings and
  roundtable discussion

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Overview of H.R. 6197

• Reauthorizes programs under OAA for five years
  2006 2011
• Establishes authority for implementing Choices
  for Independence
• Emphasizes role of AoA and state and area
  agencies on aging in HCBS

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Overview of H.R. 6197

• Makes significant changes to Title V employment
  program including
• Codify certain eligibility criteria
• Limit time in employment
• Establish core indicators of performance

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Overview of H.R. 6197

• Strengthens elder justice functions by including
  some Elder Justice Act provisions in OAA

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Reauthorization Process

• More than one year between initial Congressional
  hearings and final passage of H.R. 6197
• Reauthorization in 2000 took five years to
  accomplish

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House action

• May 10 subcommittee markup
• May 17 full committee markup
• June 21 passed house by voice vote
• September 26 passed house (again)

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Senate action

• Senate bill released June 27
• Markup in full committee June 28
• Passed Senate September 30

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Reaching agreement

• House-passed bill differed from Senate HELP
  committee bill
• Differences were worked out in a pre-conference
  agreement

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Final agreement

• Final bill included some surprises and
  compromises
• Change in the interstate funding formula
• Expansion of populations served in NFCSP
• Change in treatment of states vs. national
  contractors in Title V program

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Title I General Provisions

• New or amended definitions
• Self directed care
• Person at risk for institutional placement
• Aging and Disability Resource Center
• Long term care

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Title II - AoA

• Elder Abuse prevention
• Authorizes AoA assistant secretary to designate a
  person responsible for elder abuse prevention
  services
• Develop long term plan for a comprehensive
  coordinated elder justice system

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Elder Abuse Prevention

• Long term plan includes
• Federal guidelines for annual data collection and
  reporting by states
• Information clearinghouse
• Research TA

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Mental Health

• More focus on importance of mental health
  services in OAA
• Support state efforts in education, prevention,
  detection and treatment of mental disorders such
  as Alzheimers and depression

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Functions of Assistant Secretary

• Significantly broadens the scope of functions of
  the assistant secretary
• Establishes authority to implement Choices for
  Independence
• Principles of Choices for Independence are
  embedded throughout the Act

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Functions of Assistant Secretary

• Focus on coordination of other federal programs
  serving older people Food Stamps, SSI, housing
• Collaboration with other federal agencies

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Functions of Assistant Secretary

• Evaluation of impact of Medicare and Medicaid
  programs on OAA programs
• Discretion to establish a National Center on
  Senior Benefits Outreach and Enrollment

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Functions of Assistant Secretary

• Establish ADRCs in all states
• Establish technical assistance programs to assist
  states
• Develop with CMS performance measures for use by
  states to assess their LTC systems

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Functions of Assistant Secretary

• Establish Interagency Coordinating Committee on
  Aging
• DoL, HUD, DoJ, DoT, Treasury, SSA, USDA, Homeland
  Security
• Report to Congress on work of the Committee and
  recommendations for improving federal
  coordination on LTC and other aging issues

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Title III Amendments

• Formula
• Targeting
• Choices for Independence principles
• Caregiver program changes

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Allotments to States

• New interstate funding formula
• Updates hold harmless to 2006 levels
• Phases out the guaranteed growth provision over
  five years

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Targeting Language

• New targeting language throughout the act to
  include people with limited English proficiency
  
• Retains targeting language for low-income older
  individuals, including low-income minorities,
  older individuals residing in rural areas

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Organization in Title III

• Updates state assurances to include language
  consistent with Choices for Independence
• Promote the development and implementation of
  state-wide systems of long term care
• Comprehensive, coordinated
• Responsive to needs and preferences of older
  people and their caregivers

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New focus on

• Disaster planning
• Evidence based programs
• Planning ahead to accommodate expansion of older
  population eligible for services

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New focus on

• Reaching older people at risk for institutional
  placement
• Consumer direction
• Use of volunteers in OAA programs

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Consumer Contributions

• Voluntary contributions allowed for all services
• Contributions shall be encouraged for people with
  incomes above 185 percent of FPL
• Contribution levels based on actual cost of
  services
• Supplement, not supplant program funds
• No change in cost sharing provisions

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Caregiver Support Program

• Authorization increased to 187 million by 2011
• Eligibility broadened to include
• Grandparents 55 or older (10 percent state
  set-aside still applies)
• Older individuals caring for people with
  disabilities of any age

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Caregiver Priority

• Priority for caregivers of people with
  Alzheimers disease and other dementia
• Older individuals caring for people, including
  children, with severe disabilities
• Caregivers who are older individuals with
  greatest social, economic need

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Title IV -- Research

• Activities for health, independence and
  longevity
• New focus on
• Planning
• Technology
• Alzheimers disease
• Transportation
• NORCs

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Title V Employment Program

• Older American Community Service Employment
  Program
• Changes effective July 1, 2007
• Limits time in program to two years, with certain
  exceptions
• Underemployed individuals are eligible

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Performance Measures

• Establishes five core indicators of performance
• Hours of community service employment
• Entry into unsubsidized employment
• Retention for 6 months in unsubsidized employment
• Earnings
• Number of individuals served

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Performance Measures

• Additional measures
• Retention for one year in unsubsidized employment
• Satisfaction of employers and participants

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Performance Measures

• Unsubsidized placement
• Increases incrementally the expected level of
  performance to 25 percent by 2011
• Current law establishes 20 percent minimum

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Sanctions

• Sanctions for not meeting performance measures
  are different for states and contractors

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Sanctions on States

• After three consecutive years of not meeting
  performance measures states must conduct a
  competition to award grant funds allotted to the
  state.

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Sanctions on national grantees

• After four consecutive years of not meeting
  performance measures, national grantees cannot
  compete in the subsequent grant cycle (now four
  years).

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Title VII - Elder Rights Protection Activities
Chapter 3

• New focus in Title VII/Chapter 3
• Financial literacy
• Shelters and safe havens
• Multidisciplinary approaches
• Accountability measures

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Resources

• Questions? Kmiller_at_nasua.org
• http//www.AoA.gov
• http//thomas.loc.gov/ (H.R. 6197)