HHS - HHS Budget

	2003	2004	2005	2005 +/-2004
National Family Caregiver Support..................	$155	$159	$162	+$3
Home and Community-Based Supportive Services and Centers.....................	356	354	357	+$3
Nutrition Services:
Home-Delivered Meals................................	$181	$180	$181	+$1
Congregate Meals........................................	385	387	389	+2
Nutrition Services Incentive Program............	149	148	149	+1
Subtotal, Nutrition Programs ................	$715	$715	$719	+$4
Program Innovations........................................	$29	$34	$24	-$10
Aging Network Support Activities...................	13	13	13	0
Preventive Health Services...............................	22	22	22	0
Grants for Native Americans............................	27	26	26	0
Protection of Vulnerable Older Americans.......	19	19	19	0
Alzheimer's Disease.........................................	13	12	12	0
Program Administration...................................	18	17	18	+1
Senior Medicare Patrols (HCFAC).................	3	3	3	0
White House Conference on Aging..................	0	3	5	+2
Total, Program Level.............................	$1,370	$1,377	$1,380	+$3
Less Funds Allocated From Other Sources:
Senior Medicare Patrols (HCFAC)..............	-$3	-$3	-$3	$0
Total, Budget Authority.........................	$1,367	$1,374	$1,377	+$3

The FY 2005 budget request for AoA is $1.4 billion. This amount includes increases to test new models of home and community-based care and provide nutrition, caregiver, and supportive services. The budget also includes $5 million for the second year of funding for the White House Conference on Aging.

One of the most critical issues facing elderly Americans today is that of long-term care. Elderly citizens overwhelmingly state a preference to live at home as long as possible. Even small amounts of support can make a significant impact in enabling elders to remain in their homes and out of institutional care. The FY 2005 budget continues to emphasize AoA programs that work together to support elders at home and in the community. Services are provided through a nationwide network of State, Tribal and area agencies on aging and by over 29,000 local service providers.

Family caregivers have always been the main source of long-term care services provided in the United States. AoA is committed to assisting family caregivers by providing them with the resources to help them keep their loved ones at home or in the community. The FY 2005 budget includes $162 million for the National Family Caregiver Support Program. For a minimal cost, this national program provides information, training, counseling, respite and assistance services that support the efforts of America's caregivers. Research indicates that informal caregiving supports can have a significant impact on the status of caregivers, delay the need for institutionalization, and significantly reduce costs to Medicare, Medicaid and private payers.

Home and Community-Based Supportive Services provide a variety of activities that enable elderly Americans to remain at home and in their communities. Three categories of services – access, in-home, and community – work together to improve the quality of life for elderly Americans. The budget for these services totals $357 million.

Activities including transportation assistance, information and referral, chore, homemaker and personal care services, and adult day care, to help seniors to remain independent for as long as possible. AoA has established a target to provide an estimated 40 million rides in FY 2005 to help seniors visit health professionals, pharmacies, and grocery stores. Information and referral services will empower individuals and families to make informed choices about their service and care needs. Personal care and homemaker services will enable elders to live with dignity at home through assistance with activities of daily living. These services are provided through senior centers and in other community-based settings.

The budget requests a total of $719 million for nutrition programs. Through a variety of State and community mechanisms, these programs provide nutritious meals to the nation's most frail and at-risk elderly. Through the three nutrition programs and additional leveraged resources, AoA's goal is for States to provide more than 300 million meals in FY 2005. These programs also provide supplemental nutrition screening, education, and counseling services which further enable elders to maintain their own health and independence.

Scientific evidence shows that adequate nutrition is essential for healthy aging and the prevention or delay of chronic disease and related disabilities. Research also indicates that meal preparation at home is difficult or impossible for many older Americans, and that the availability of a home-delivered meal is crucial to their ability to function independently at home. For example, 79 percent of home-delivered meal recipients have at least one limitation with activities of daily living, and 30 percent have limitations with three or more – a level of frailty consistent with nursing home residents. In many cases, home-delivered meals are the first in-home service an older adult receives, and the program is therefore also a primary access point for other in-home supportive services.

The Congregate Nutrition Services program supports the provision of meals to elderly individuals in a variety of social settings such as senior centers and faith-based organizations. In addition to serving as a primary source of food for many participants, the program presents critical opportunities for social engagement and meaningful volunteer roles which contribute to individuals’ overall health and mental well-being.

In FY 2003, the Department successfully transferred the Nutrition Services Incentive Program (NSIP) from the Department of Agriculture to AoA. Funds continue to be distributed by its historic formula, which is based on the number of meals served in the prior year. Under the Older Americans Act, States can elect to receive commodities in lieu of cash for part or all of their NSIP allocation. In FY 2004, 11 States have elected this option.

AoA continues to seek ways to leverage funding at the State and community level to support seniors at home. To this end, it is crucial to ensure that seniors have access to all available resources in their home communities.

In FY 2003, AoA first partnered with the Centers for Medicare and Medicaid Services to establish Aging and Disability Resource Centers in 12 States. These centers serve as reliable resources and help to eliminate the confusion and frustration many older Americans face as they search for information about long-term care by providing objective information about the options – both public and private – that are available to them. They also provide information on best practices and assist States in replicating the significant strides that several other States have made in creating more citizen-centered systems of care by reducing nursing home expenditures and increasing community-based choices, while containing costs.

In FY 2004, AoA expects to establish centers in an additional 12 States, and is requesting an investment of $11 million (an increase of $6 million) in FY 2005 to further expand this collaboration with CMS.

In FY 2003, AoA launched an Evidence-Based Prevention Grants program to demonstrate how community-based aging services providers can effectively deliver programs that can reduce the risk of disease and disability in the older population. AoA funded 13 local projects and a national technical assistance center. AoA is partnering with CDC, ARHQ, and the National Institute on Aging, as well as several private foundations on this initiative, which is translating research into practice at the community level. This activity will continue in FY 2005. The net $8 million reduction in Program Innovations is due to the completion of one-time projects.

The FY 2005 request includes $26 million for grants for Native Americans. These grants will enable 243 Tribal organizations serving approximately 300 tribes to continue to provide services to American Indians, Alaskan Natives, and Native Hawaiians who are over the age of 60, by providing nutritional and supportive services which help them remain healthy and independent.

The FY 2005 request includes $54 million to fund activities which educate older Americans about healthier lifestyles in order to delay or prevent the onset of chronic disease; protect vulnerable older Americans from abuse/neglect and empower them to assert greater control over their living situations; and identify additional local resources available for older Americans and their families.

The FY 2005 budget also includes $12 million for the Alzheimer's Disease Demonstration Grant program. These grants improve the quality of services provided to those suffering from Alzheimer's Disease by incorporating new research findings, innovative approaches to care, and cultural competencies into actual home and community-based services.

The FY 2005 Budget requests a total of $5 million for a White House Conference on Aging, to take place by December 2005, as called for in the Older Americans Act. The Conference will provide a national forum on aging issues.

A total of $18 million is requested to maintain staffing levels, and for related program management and support activities necessary to effectively administer a wide array of AoA programs. This request also supports efforts to strengthen management through greater efficiencies and economies of scale in information technology, financial systems, and personnel operations.

FY 2005 Budget in Brief

Administration on Aging