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Statement by
Kathy Greenlee
Assistant Secretary
Administration on Aging
U.S. Department of Health and Human Services (HHS)

Meals, Rides, and Caregivers: What Makes the Older Americans Act so Vital to America’s Seniors 

Special Committee on Aging
United States Senate

Thursday May 26, 2011

Thank you, Senator Kohl, Senator Corker, and Members of the Special Committee on Aging, for the opportunity to testify today at this hearing on the 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 received from across the country on this important legislation that provides vital home and community-based services to older adults and their caregivers, to summarize the important themes we have heard, and to highlight a few of the priority areas we would like to discuss with this Committee and the Congress as the reauthorization process moves forward.

At the outset, I would like to commend you, Senator Kohl, for your leadership as Chairman of the Special Committee on Aging, and for your many years of public service as an astute and effective advocate for policies that better protect and serve vulnerable Americans of all ages.  We are particularly grateful for your many insights and for your stalwart support in shaping and improving our community- and family-based Older Americans Act programs, which play a vital role in helping to maintain the health and well-being of millions of older Americans.

For more than 45 years, the OAA has quietly but effectively provided nutrition and community support to millions of people across the nation.  As the former Secretary of Aging from Kansas, and now having the honor to serve as the Assistant Secretary for Aging and listening to individuals and families in a variety of settings, I have seen and heard firsthand how the OAA reflects the American values we all share:

  • Supporting freedom and independence;
  • Helping people maintain their health and well-being so they are better able to live with dignity;
  • Protecting the most vulnerable among us; and
  • Providing basic respite care and other supports for families so that they are better able to take care of loved ones in their homes and communities for as long as possible, which is what Americans of all ages overwhelmingly tell us they prefer. 

One of the real strengths of the OAA is that it doesn’t matter if an individual lives in a very rural or frontier area, or in an urban center – the programs and community-based supports it provides are flexible enough to meet the needs of individuals in diverse communities and settings.  Over the past year alone, 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.  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 an overriding issue that was also raised during the conversations and activities of the Vice President’s Middle Class Task Force, and that is that many families are doing the best that they can, but that they are often struggling between balancing the demands of child care and elder care.  Families tell us that when they may need some help in supporting their efforts to care for loved ones, they don’t want assistance that is confusing or frustrating.  They simply want to know where they can turn for some help.  Something that’s easily accessible, without a lot of strings attached or hoops to jump through.  And that, essentially, is what the OAA has been about since its enactment – listening to what our seniors and families need, and providing critical and cost-effective supports that help maintain the independence they want.  During our input process we were consistently told that, as it’s currently structured, the OAA is very helpful, flexible and responsive to people’s needs.  During this process, we heard a few 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;
  • Ensuring that ombudsman services are available for 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 FY 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 making permanent the authority for 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 Kohl and Senator Corker, 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: June 18, 2013