Edwin L. Walker
Deputy Assistant Secretary for Policy and Programs
Administration on Aging
Reauthorization of the Older American Act
Special Committee on Aging
United States Senate
Wednesday April 27, 2011
Thank you, Senator Whitehouse, for the opportunity to testify before this Senate Special Committee on Aging hearing on the upcoming reauthorization of the Older Americans Act (OAA). Over the past year, the Administration on Aging (AoA) has conducted the most open process for seeking input on the reauthorization of the OAA in its history. I am pleased to discuss the input we have received from across the country, and to learn more about the perspectives from Rhode Island on this important legislation that provides vital home and community-based services to older adults and their caregivers.
At the outset, I would like to commend you, Senator Whitehouse, for your leadership as a member of the Senate Special Committee on Aging, and also as member of the Senate Committee on Health, Education, Labor and Pensions, the Budget Committee, and the Judiciary Committee, all of which have jurisdiction over important seniors issues, including the HELP committee which has jurisdiction over the OAA programs themselves. We are grateful for the support you have provided to these programs that play such a vital role in helping to maintain the health and well-being of millions of older Americans, as well as for your strong leadership in improving the quality of care for families, for protecting against consumer fraud, and supporting elder rights.
I am impressed by the level of commitment and dedication of Rhode Island’s aging services network and by the interest and enthusiasm of your older citizens and their families. I would like to commend Catherine Taylor, Director of the Rhode Island Department of Elderly Affairs, for the excellent work that she and her agency provide so that elderly individuals are better able to maintain their health and independence in their homes and communities. I also want to express my appreciation for the great work that the Narragansett Indian Tribe, and other providers of supportive services, delivers on a daily basis so that tens of thousands of seniors can maintain their independence.
Rhode Island has one of the highest per capita populations of seniors in the country, and plays a large role as a leader in many aspects related to the health and well-being of seniors and soon-to-be seniors. More than 10,000 of Rhode Island’s residents over the age of 60 receive nutrition assistance in congregate settings or through meals delivered to their homes each year, and thousands more receive other vital community supports through the OAA that help them remain in their homes. By applying for and winning a number of competitive Federal grant awards, the Rhode Island Department of Elderly Affairs has taken full advantage of opportunities which seek to more efficiently support the needs of frail seniors and their families. I would like to highlight just a few:
- Testing innovative interventions for facilitating the safe discharge of elderly hospital patients and nursing facility residents to their homes in the community;
- Establishing caregiver services for persons with dementia which can better help them live with independence and dignity;
- Developing person-centered, self-management programs that provide older adults with the information and tools they need to help them cope with chronic diseases such as diabetes, heart disease, lung disease or arthritis; and
- Having a long history of educating and informing seniors through the Senior Medicare Patrol program so that they are better able to help prevent and combat waste, fraud and abuse in Medicare and Medicaid.
We have much to learn from the insights and perspectives of your citizens. I am honored to be here today.
On July 14, 1965, President Johnson signed the Older Americans Act into law. Sixteen days later, on July 30, he signed legislation creating Medicare and Medicaid. These three programs, along with Social Security enacted in 1935, have served as the foundation for economic, health and social support for millions of seniors, individuals with disabilities and their families. Because of these programs, millions of older Americans have lived more secure, healthier and meaningful lives.
For more than 45 years, the Older Americans Act has quietly but effectively provided nutrition and community support to millions of people across the nation, and in Rhode Island. It has also protected the rights of seniors, and in many cases, has been the key to their independence. The programs supported by the OAA provide community-based supports that assist families caring for their loved ones and help seniors stay in their homes for as long as possible. Over the past year, nearly 11 million older Americans and their family caregivers have been supported through the OAA’s comprehensive home and community-based system. These services complement medical and health care systems, help to prevent hospital readmissions, provide transport to doctor appointments, and support some of life’s most basic functions, such as assistance to elders in their homes by delivering or preparing meals, or helping them with bathing. This assistance is especially critical for the nearly three million seniors who receive intensive in-home services, half a million of whom meet the disability criteria for nursing home admission but are able to remain in their homes, in part, due to these community supports.
What is more, the need for this support is growing rapidly. Every day, more than 9,000 baby boomers turn 65, equivalent to the population of a small town. In just four years, the population aged 60 and older will increase by 15 percent, from 57 million to 65.7 million. During this period, the number of seniors with severe disabilities who are at greatest risk of nursing home admission and Medicaid eligibility will increase by more than 13 percent.
The reauthorization of the Older Americans Act provides us with the opportunity to strengthen and build upon a long record of success in serving our families and communities, and to help meet the growing need. To support this discussion, over the past year the Administration on Aging received reports from more than 60 reauthorization listening sessions held throughout the country, and received online input from interested individuals and organizations, as well as from seniors and their caregivers. This input represented the interests of thousands of consumers of the OAA’s services. We continue to encourage ongoing input and discussions.
During this process, we heard a number of themes:
Improve program outcomes by:
- Embedding evidence-based interventions in disease prevention programs;
- Encouraging broader partnerships and alliances that result in comprehensive, person-centered approaches;
- Providing flexibility to respond to local nutrition needs; and
- Increasing efforts to fight fraud and abuse in Medicare and Medicaid.
Remove barriers and enhancing access by:
- Enhancing caregiver supports to parents caring for their adult children with disabilities;
- Providing ombudsman services to all nursing facility residents, not just older residents; and
- Utilizing Aging and Disability Resource Centers as single access points for long-term care information and to public and private services;
The following are some examples of areas that we would like to discuss with the Congress as you consider legislation:
- Ensuring that the best evidence-based interventions for helping older individuals manage chronic diseases are utilized. A number of evidence-based programs have shown to be effective in helping participants adopt healthy behaviors, improve their health status, and reduce their use of hospital services and emergency room visits.
- Improving the Senior Community Service Employment Program (SCSEP) by integrating it with other seniors programs. The President’s 2012 budget proposes to move this program from the Department of Labor to the Administration on Aging within HHS. The goal of this move is to better integrate this program with other senior services provided by AoA. We would like to discuss adopting new models of community service for this program, including programs that engage seniors in providing community service by assisting other seniors so they can remain independent in their homes.
- Combating fraud and abuse in Medicare and Medicaid by converting the Senior Medicare Patrol Program (SMP) as an ongoing consumer-based fraud prevention and detection program. The SMP program serves a unique role in the Department’s fight to identify and prevent healthcare fraud by using the skills of retired professionals as volunteers to conduct community outreach and education so that seniors and families are better able to recognize and report suspected cases of Medicare and Medicaid fraud and abuse.
The Older Americans Act has historically enjoyed widespread, bipartisan support. Based in part upon this extensive public input process, we think that reauthorization can strengthen the Older Americans Act and put it on a solid footing to meet the challenges of a growing population of seniors and continue to carry out its important mission of helping elderly individuals maintain their health and independence in their homes and communities.
Thank you again, Senator Whitehouse, for your leadership on these important issues and for the invitation to testify here today. I would be happy to answer any questions.
Last revised: April 27, 2011