Older Americans Act: Programs and Funding

Older Americans Act: Programs and Funding

Order Code 95-917 EPW
Updated August 31, 2000
CRS Report for Congress
Received through the CRS Web
Older Americans Act: Programs and Funding
Carol O’Shaughnessy and Paul J. Graney
Updated by Cristal A. Thomas
Domestic Social Policy Division
Summary
The Older Americans Act (OAA) is the major vehicle for the delivery of social and
nutrition services for older persons. Originally enacted in 1965, the Act supports a wide
range of services for older persons, a community service employment program, and
research, training, and demonstration activities, among other programs. Authorization
of appropriations for the Act expired at the end of FY1995. Its programs have continued
to be funded by appropriation laws.1 For FY2000, $1.507 billion was appropriated for
OAA programs administered by the Departments of Labor, Health and Human Services,
and Agriculture.
The Administration proposed $1.668 billion for FY2001, an increase of 10.7% over
FY2000 appropriations. The major part of this increase would be $125 million for
caregiver support services. The House has approved $1.530 billion for FY2001 for
Older Americans Act programs; the Senate has approved $1.529 billion. This report will
be updated as legislative activity occurs.
Programs
Administration on Aging (AoA). Title II of the Older Americans Act establishes
AoA, within the Department of Health and Human Services (HHS), as the chief federal
agency advocate for older persons. It also authorizes the Federal Council on Aging,
whose purpose is to advise the President and the Congress on the needs of older persons.
The last time the Council received funding was in FY1995. The FY1999 Omnibus
Appropriations Act contains a permanent provision prohibiting the expenditure of funds
for the Council.
Grants for States and Community Programs on Aging. Title III authorizes grants
to state and area agencies on aging to act as advocates on behalf of, and to coordinate
programs for, the elderly. The program, which supports 57 state agencies on aging, 655
1 For further information on reauthorization activity in the 106th Congress see: CRS Report
RL30055, Older Americans Act: 106th Congress Issues, by Carol O’Shaughnessy.
Congressional Research Service ˜ The Library of Congress

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area agencies on aging, and 27,000 service providers, currently funds five separate service
programs. States receive separate allotments of funds for supportive services and centers,
congregate and home-delivered nutrition services, U.S. Department of Agriculture
(USDA) commodities or cash in lieu of commodities, and preventive health services.
Allotments for in-home services for the frail elderly are included in the grants for
supportive services and centers. Three other programs — assistance for special needs,
school-based meals and multigenerational activities, and supportive activities for caretakers
— are not funded. Title III services are available to all persons aged 60 and over, but are
targeted to those with the greatest economic and social need, particularly low-income
minority persons. Means testing is prohibited. Participants are encouraged to make
voluntary contributions for services they receive.
Funding for supportive services, congregate and home-delivered nutrition services,
and preventive health services is allocated to states by AoA based on each state’s relative
share of the total population of persons aged 60 years and over. States are required to
award funds for the local administration of these programs to area agencies on aging.
USDA provides commodities or cash in lieu of commodities to states, based on a formula
that takes into account the number of meals served by the AoA programs.
The Title III nutrition program is the Act’s largest program. FY2000 funding of
$661 million represents 44% of the Act’s total funding and 67% of Title III funds. Most
recent data show that the program provided about 237 million meals to almost 3 million
older persons. Forty-eight percent of the meals were provided in congregate settings, such
as senior centers, and 52% were provided to frail older persons in their homes.
Data from a national evaluation of the nutrition program show that, compared to the
total elderly population, nutrition program participants are older and more likely to be
poor, to live alone, and to be members of minority groups. They are also more likely to
have health and functional limitations that place them at nutritional risk. The report found
the program plays an important role in participants’ overall nutrition and that meals
consumed by participants are their primary source of daily nutrients. The evaluation also
indicated that for every federal dollar spent, the program leverages on average $1.70 for
congregate meals, and $3.35 for home-delivered meals.2
The supportive services and centers program provides funds to states for a wide array
of social services and activities of approximately 6,400 multipurpose senior centers. The
most frequently provided services are transportation, information and assistance, home
care, and recreation. In FY1997, the program provided about 46 million rides, over 5.4
million hours of adult day care, and nearly 16 million hours of home care services (i.e.,
personal care, homemaker, or chore services).
Research, Training, and Demonstration Program. Title IV of the Act authorizes
the Assistant Secretary for Aging to award funds for training, research, and demonstration
projects in the field of aging. Funds are to be used to expand knowledge about aging and
the aging process and to test innovative ideas about services and programs for older
2 U.S. Department of Health and Human Services. Office of the Assistant Secretary for Aging.
Serving Elders at Risk: The Older Americans Act Nutrition Programs, National Evaluation of the
Elderly Nutrition Program, 1993-1995, June 1996.

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persons. Title IV has supported a wide range of projects, including community-based
long-term care, support services for Alzheimer’s disease, and career preparation and
continuing education in the field of aging.
Senior Community Service Employment Program. Title V of the Act authorizes
a program to provide opportunities for part-time employment in community service
activities for unemployed, low-income older persons who have poor employment
prospects. The program has three goals: to provide employment opportunities for older
persons; to create a pool of persons who provide community services; and to supplement
the income of low-income older persons (income below 125% of the federal poverty
level). Enrollees work in a variety of community service activities and are paid the higher
of the national or state minimum wage or the local prevailing pay for similar employment.
The program, which is not considered a job training program, supports over 61,500 jobs
in program year (PY) 2000 (July 1, 1999-June 30, 2000).
Title V is administered by the Department of Labor (DOL), which awards funds to
10 national organizations and to all states. Funding is distributed using a combination of
factors, including a “hold harmless” for employment positions held by national
organizations in 1978, and a formula based on states’ relative number of persons aged 55
and over and per capita income. Funds are distributed so that national organizations
receive 78% of the total appropriation, and states receive 22%.
Grants for Services for Native Americans. Title VI authorizes funds for supportive
and nutrition services to older Native Americans. Funds are awarded directly by AoA to
Indian tribal organizations, Native Alaskan organizations, and non-profit groups
representing Native Hawaiians.
Vulnerable Elder Rights Protection Activities. Title VII authorizes five separate
vulnerable elder rights protection activities. States receive separate allotments of funds
for the long-term care ombudsman program and elder abuse prevention activities. Three
other authorized programs — elder rights and legal assistance, Native Americans elder
rights program, and outreach, counseling, and assistance — are not funded. Funding for
vulnerable elder rights protection activities is allotted to states based on the states’ relative
share of the total population age 60 and older. State agencies on aging may award funds
for these activities to a variety of organizations for administration, including other state
agencies, area agencies on aging, county governments, nonprofit services providers, or
volunteer organizations.
The largest elder rights protection program is the long-term care ombudsman
program, whose purpose is to investigate and resolve complaints of residents of nursing
facilities, board and care facilities, and other adult care homes. It is the only Older
Americans Act program that focuses solely on the needs of institutionalized persons and
is authorized under both Title III (supportive services and centers) and Title VII. State
and other nonfederal funds represent a significant amount of total funds for the program.
In FY1997, about $43 million in federal and nonfederal funding was devoted to support
this program. About 62% of the program effort was supported by Older Americans Act
sources; nonfederal and other funds represented about 38% of the total program support.

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FY2000 Funding
On November 29,
1999, the President
signed appropriations
for the Departments of
Labor, Health and
Human Services, and
Education and Related
Agencies (L-HHS-ED)
( P . L . 1 0 6 - 1 1 3 ) .
Earlier, on October 22,
1999, the President
signed appropriations
for the Department of
Agriculture (P.L. 106-
78) which includes a
portion of funding for
the OAA nutrition program.
For FY2000, the OAA is funded at $1.507 billion, $51 million more than in FY1999.
This increase is 7.7% below the President’s FY2000 request, but 3.5% above FY1999
appropriations. Sharp increases were included for the home-delivered nutrition program
under Title III, and for Title IV training, research and demonstration activities. Funds for
the home-delivered meals program increased by $35 million, 31% more than in FY1999.
FY2000 funding for Title IV research, training and demonstration programs is $31.2
million for FY2000, $13.2 million over FY1999, an increase of 73%. The conference
report on the bill specified that $24 million, or 77% of the total, is to be distributed to 18
specific Title IV projects.
FY2001 Budget Request and Appropriation Activity
The Administration’s FY2001 budget request includes funding of $1.668 billion for
the OAA programs, an 11% increase over the FY2000 level. The major part of this
increase would be $125 million under the supportive services category to provide grants
to states to assist caregivers of the frail elderly. Assistance would range from information
and counseling for caregivers to respite and home care and adult day care services. The
proposal would fund caregiver services through the appropriations process without the
authorization of a new separate caretgiver programs as proposed in the Administration’s
reauthorization proposal. For further information see CRS Report RL30055, Older
Americans Act: 106th Congress Legislation.
The House- and Senate-passed L-HHS-Ed and Department of Agriculture
appropriations bills include $1.530 billion and $1.529 billion for OAA programs,
respectively. One major difference between the House and Senate levels is accounted for
in the amount proposed for the Title IV training, research, and discretionary programs; the
Senate L-HHS-Ed bill includes $31 million, the same amount available in FY2000, while
the House bill includes $9 million. In addition, the House bill includes $170 million for the

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USDA nutrition program, including $10 million to be transferred from the Womens,
Infants and Children (WIC) nutrition program. The Senate bill includes $140 million for
this program.
Various OAA reauthorization bills, including H.R. 782, reported by the Committee
on Education and the Workforce, and S. 1536, approved by the Committee on Health,
Education, Labor and Pensions (HELP), would authorize a new caregiver support
program similar to the Administration’s proposal. H.R. 782 and S. 1536 are pending
House and Senate floor action. Neither the House or Senate bills appropriations bills
include funding for caregiver support activities since the program has not yet been
authorized.
Table 1. Older Americans Act and Alzheimer’s Demonstration Program,
FY1998-FY2000 Funding; FY2001 Request and House and Senate-Passed
Levels
($ in millions)
FY2001
FY2001
FY2001
OAA authorized programs and
President’s
House
Senate
Alzheimer’s demonstration grants
FY1998
FY1999
FY2000
request
passed
passed
TITLE II: Administration on Aging
$14.795
$15.395
$16.461
$17.232
$16.461
$17.232
Federal Council on Aging
none
none
none
none
none
none
AoA program administration
14.795
15.395
16.461
17.232
16.461
17.232
TITLE III: Grants for State and
Community Programs on Aging
961.798
952.336
987.617
1,137.617
1,032.617
1,002.617
Supportive services and centers
309.500
300.192
310.082
450.082 a
325.082
325.082
Caregiver support activities
(125.000)a
Preventive health
16.123
16.123
16.123
16.123
16.123
16.123
Nutrition services
626.412
626.261
661.410
671.412
691.412
661.412
Congregate meals
(374.412)
(374.261)
(374.412)
(374.412)
(374.412)
(374.412)
Home-delivered meals
(112.000)
(112.000)
(147.000)
(147.000)
(147.000)
(147.000)
USDA commodities
(140.000)
(140.000)
(140.000)
(150.000)
(170.000)
(140.000)
School-based
meals/multigenerational activities
none
none
none
none
none
none
In-home services for the frail elderly
9.763
9.763
none
none
none
none
Assistance for special needs
none
none
none
none
none
none
Supportive activities for caretakers
none
none
none
none
none
none
TITLE IV: Training, Research,
10.000
18.000
31.162
36.162
9.119
31.162
and Discretionary Projects and
Programs
Mental Health Initiative
(5.000)
TITLE V: Community Service
440.200
440.200
440.200
440.200
440.200
440.200
Employment
TITLE VI: Grants to Native
18.457
18.457
18.457
23.457
18.457
23.457
Americans
TITLE VII: Vulnerable Elder
noneb
12.181c
13.181d
13.181e
13.181
14.181
Rights Protection Activities
Long-term care ombudsman program
none
(7.449)
none
none
none
none
Elder abuse prevention
none
(4.732)
none
none
none
none
Elder rights and legal assistance
none
none
none
none
none
none
Outreach, counseling, and assistance
none
none
none
none
none
none
Native Americans elder rights prog.
none
none
none
none
none
none
Total - Older Americans Act
1445.250
1456.569
1507.078
1667.849
1530.035
1528.849

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FY2001
FY2001
FY2001
OAA authorized programs and
President’s
House
Senate
Alzheimer’s demonstration grants
FY1998
FY1999
FY2000
request
passed
passed
Programs
Alzheimer’s Demonstration Grantsf
5.99
5.97
5.97
5.97
5.97
5.97
a For FY2001, the Administration has proposed a $125 million caregiver support program under supportive services.
b No separate funding provided. The House Appropriations Committee included an unspecified amount for
ombudsman and elder abuse prevention under supportive services and centers. The conference committee
earmarked $4.449 million for ombudsman services and $4.732 million for elder abuse prevention in the Title
III supportive services program.
c FY1999, Title VII activities received a separate appropriation.
d The Senate Appropriations Committee recommended $8.449 million for ombudsman services and $4.732 million
for elder abuse prevention services, totaling $13.181 million.
e In its reauthorization proposal, the Administration proposed consolidating funding for the long-term care
ombudsman program, the elder abuse prevention program, the elder rights and legal assistance program, and
the outreach, counseling and assistance program.
f The FY1999 Omnibus Consolidated Appropriations Act (P.L. 105-277/H.R. 4328) transferred the administration
of the program from the Health Resources and Services Administration to AoA. The program is still authorized
under Section 398 of the Public Health Service Act.