FY 2007 HHS Annual Plan

Strategic Goal 6
Improve the Economic and Social Well-Being of Individuals, Families, and Communities, Especially Those Most in Need

On this page:
Program 6a: Temporary Assistance for Needy Families Administration for Children and Families (ACF)
Program 6b: Aging Services Program Administration on Aging (AoA)

Highlighted Programs:

HHS promotes and supports interventions that help empower disadvantaged and distressed individuals, families, and communities to improve their economic and social well-being. To achieve this strategic goal, HHS supports targeted efforts to increase the independence and stability of low-income families, people with disabilities, older Americans, Native Americans, victims of domestic violence, refugees, and distressed communities. HHS will also continue to support community and faith-based organizations that provide services to individuals and communities in need.

Approximately thirteen HHS programs in two OPDIVs contribute to achieving this strategic goal. Two programs are highlighted under this strategic goal including the Administration for Children and Families' (ACF) Temporary Assistance for Needy Families program and Administration on Aging (AoA) Aging Services Program.

Program 6a: Temporary Assistance for Needy Families
Administration for Children and Families (ACF)

Performance Measure: Increase the percentage of adult TANF recipients/former recipients employed in one quarter that were still employed in the next two consecutive quarters.

The purposes of the Temporary Assistance for Needy Families (TANF) program, Title IV-A of the Social Security Act, support HHS Strategic Goal 6.1. TANF provides assistance to needy families; reduces dependency by promoting job readiness, employment, and marriage; prevents and reduces out-of-wedlock pregnancies; and encourages the formation and maintenance of two-parent families. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), which established TANF, dramatically changed the nation's welfare system into one that requires employment while time-limiting assistance. States, territories, and tribes each receive a block grant allocation with a requirement for states to maintain a historical level of state spending for welfare and other services for low-income families known as Maintenance of Effort. The block grant covers benefits, administrative expenses, and services. States, territories, and tribes determine eligibility and benefit levels as well as services provided to needy families.

The Deficit Reduction Act of 2005 reauthorizes the TANF program for five years. This legislation strengthens the current work requirements to ensure that adult TANF recipients are engaged in work or activities leading to employment. It also contains recalibration of the caseload reduction credit, and eliminates the High Performance Bonus.

The performance measure on job retention supports HHS Strategic Goal 6 by encouraging employment stability for those most in need and thus improving their economic and social well-being. The job retention target for FY 2007 is 62 percent. ACF attained a job retention rate of 59 percent in FY 2004, falling short of the target of 68 percent. When setting the 68 percent target, ACF did not take into consideration the dampening effect of the caseload reduction credit, which significantly reduced state work participation rate targets and thus reduced state incentive for moving TANF recipients into employment. Results for previous years were similarly impacted. The revised targets for 2006 and 2007 were set in the PART process. ACF will re-evaluate the performance measures and targets to reflect the revised policies in the Deficit Reduction Act of 2005.

Program 6b: Aging Services Program
Administration on Aging (AoA)

Performance Measure: Increase the number of severely disabled clients who receive home-delivered meals.

The Aging Services Program of the Administration on Aging (AoA), which encompasses all AoA programs, provides grants to states, tribal organizations, and other community service providers. Together these entities comprise the National Aging Services Network, which makes comprehensive supportive services available to vulnerable elderly individuals and their family caregivers. These services help to keep America's rapidly growing older population healthy, secure and independent in the community, where they prefer to reside. AoA programs, for a fraction of the cost of institutional care, are helping families to keep their loved ones at home for as long as possible. These services complement existing medical and health care systems and support some of life's most basic functions: food for the undernourished; transportation for the immobile; respite and counseling for caregivers; and personal care to those who need assistance getting in and out of bed, feeding and bathing themselves.

Increasing the number of severely disabled clients who receive home and community-based services from AoA and the National Aging Services Network is one of AoA's four targeting measures. Targeting measures and the indicators associated with them - while supporting HHS' strategic goals - complement AoA's efficiency and client assessment measures, in that they ensure that AoA and the National Aging Services Network focus services specifically on the most vulnerable of the elder populations. The targeting mechanism allows AoA to discourage service providers from simply channeling resources to and reporting on the easy-to-serve clients to give the appearance of improved efficiency and quality performance while the hardest-to-reach and often the neediest go wanting. Instead, AoA and the aging network measure how well they serve those who are at most risk of institutionalization: the disabled, poor, and rural residents.

This measure of severely disabled clients receiving selected home and community-based services was new in FY 2005 and AoA expects to increase severely disabled clients served from our FY 2003 base of 280,454. AoA has established ambitious performance targets for this measure; projecting an eight percent increase in FY 2005; a 15 percent increase in FY 2006 and a 25 percent in FY 2007. As efforts to rebalance the provision of long-term services continue, with greater emphasis on home and community-based care, the National Aging Services Network will demonstrate its successful contribution to rebalancing by serving increasing numbers of disabled or frail older persons. The data that support this performance measure are collected in AoA's annual national surveys of aging network clients.

AoA's Community-Based Services Program, which constitutes over 90 percent of the AoA Aging Services Program as a whole, was subject to a PART review during the CY 2002 budget formulation process. During CY 2003, AoA was reassessed under an expanded PART review, covering the entire Aging Services Program and received a rating of Moderately Effective. AoA achieved the improved score through enhancements to its strategic plan, the development of efficiency measures, and the assignment of ambitious performance targets, such as the one for serving older persons who are severely disabled. AoA has continued to make improvements in response to the CY 2003 PART review by conducting detailed program evaluations for its program activities, and by better linking PART results and performance results to program budget requests.

Older Population by Age: 1900-2050 - Column Chart Source: U.S. Bureau of the Census

A review of aging demographics shows how critical the need for cost-effective services that allow seniors to remain independent is and will continue to be in the future: In FY 2002, there were more than 4.6 million seniors, age 85 and over - and these numbers are growing faster than any other age cohort. By 2007, they are projected to total 5.6 million and 9.6 million by the year 2030. While advances in medicine and technology are enabling seniors to live longer and more active lives than ever before, those of advanced age are also at increased risk of chronic disease and disability.

Older Americans with chronic conditions are often unable to perform basic activities of daily living, and may require assistance to remain at home and avoid the need for institutional care. The May 1999 General Accounting Office report, Adults with Severe Disabilities: Federal and State Approaches for Personal Care and Other Services, found that "obtaining personal care on what is often a daily basis is critical for avoiding institutionalization…. Without help from family, friends, or public programs, affording such assistance may be problematic".

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