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Helping Seniors Access Community Social Services and Social Determinants

The reauthorization of the Older Americans Act (OAA) was perfect timing when COVID-19 reared its ugly head. Last March, President Trump signed a bipartisan reauthorization of a landmark law that provides more money for programs that help millions of older Americans age in their homes and communities through services including Meals on Wheels, family caregiver support, and transportation.

The Supporting Older Americans Act of 2020 extends the Older Americans Act (OAA) for five years and increases funding levels for its programs by 7 percent in federal fiscal year 2020 and by 6 percent each year from 2021 to 2024.
Enacted in 1965 – the same year that Congress enacted Medicare, Medicaid, and the Civil Rights Act – the OAA expired on Sept. 30, but the services under the law have continued. The statute provides money to every state based on its share of the nation’s older adults and helps about 11 million people (generally over age 60) each year.

Highlights of the Reauthorized Older Americans Act

According to Forbes, the bill’s two main highlights are: reauthorizing the Older Americans Act for five years and providing a 35% increase in funding over that time period. It also reaffirms that this law addresses two growing societal challenges: 1) social determinants of health  (economic and social conditions influencing difference is health status) and 2) social isolation and loneliness.

How It Will Help With Caregiving and Nutrition

For caregivers, The Older Americans Act legislation will: provide new grants to home care workers; continue funding the 2018 RAISE Family Caregivers for another year (that law helps relatives and partners who provide medical assistance to loved ones); and, for the first time, provide caregiver and long-term care services to those with early-onset Alzheimer’s disease.

On the nutritional front, the bill addresses two other trending issues for older adults. It takes into account cultural considerations and medically tailored meals for the federal nutrition program and the legislation provides screening for malnutrition for the first time.

Before the bill passed, evaluations of some existing Older Americans Act programs demonstrated their significant value to beneficiaries.

For example, 61% of home-delivered meal participants said they’d skip meals or eat less in the absence of these programs. And a review of the law’s National Family Caregiver Support Program found that its caregiver services reduce caregiver burden as well as help family caregivers continue in their role for longer.

Services Provided Under the Older Americans Act

Meals on Wheels. The leadership organization that helps support more than 5,000 community-based programs in the United States has been under increased demand due to COVID-19.

Beyond Meals on Wheels programs, the OAA funds the following senior-focused services:

Caregiver support: For the 11 million seniors who depend on family/informal caregivers, that is perhaps one of the most important services offered by the OAA. Chronic diseases that require complex medication management. Alzheimer’s, dementia, and related cognitive disorders that cause difficult behaviors such as wandering or aggression. Caregiver burnout due to balancing kids, careers, and aging parents. These are among the challenges informal caregivers are facing at home (or in the home of their senior loved ones), and they are often the reason seniors are unable to stay home safely.

Job training: The Senior Community Service Employment Program (SCSEP), helps older adults—particularly those in rural areas who have been unemployed for an extended period of time—return to the workforce.

Senior centers: More than 60% of the country’s senior centers are “designated focal points for the delivery of OAA services.” These serve as one-stop shops for social and recreational activities; educational, arts and intergenerational programs; public benefits counseling; health, fitness and wellness programs, and more.

Benefits enrollment: Low-income seniors with Medicare access may find additional financial support for food, healthcare, and more through any of the nation’s 84 Benefits Enrollment Centers (BECs).

Health promotion: Several evidence-based programs—tasked with supporting healthy lifestyles and promoting healthy behaviors—are supported by the OAA. With the goal of reducing the need for more costly medical interventions, at the heart of these programs are the seniors “living in medically underserved areas of the state and those who are of greatest economic need.”

Elder abuse prevention: Frail, isolated, community-based seniors are particularly vulnerable when it comes to elder abuse (financial, sexual, physical, and mental/emotional). The OAA authorizes elder rights services to address this vital need.

Transportation: From public transit to shared ride options, the OAA provides safe, ADA compliant, reliable, and predictable modes of transportation for seniors, including one-on-one assistance. The OAA also supports seniors who are able to set up their own transportation through awareness of/connections to available community services and resources.

Challenges: The Future of OAA

The OAA received just 1.1% a year, on average, in federal money from FY 2001 to 2019. The nutrition programs have fared slightly better, but when adjusted for inflation, total funding appropriated for Older American Act nutrition services during those years actually fell by 8%.

NEW SURVEY DATA: DEMAND ON MEALS ON WHEELS NATIONAL NETWORK SWELLS AND WAIT LISTS GROW DUE TO COVID-19 PANDEMIC

A new survey conducted by Meals on Wheels America finds that nearly all local Meals on Wheels programs are experiencing increased demand, with four in five programs reporting that new meal requests have doubled since March 1, 2020, when concerns over COVID-19 and social distancing measures began taking hold. Programs reported substantive shifts in their operations in April, compared to the week prior to March 1:

  • 89 percent of programs have seen an increase in meal requests; of those, 79 percent report the number of new requests for meals has at least doubled
  • 17 percent of West Coast programs are seeing 900 percent more new requests for meals per week
  • Programs are serving 56 percent more meals and 22 percent more seniors per week
  • 29 percent of rural programs have increased the number of seniors served by 50 percent or more
  • Waiting lists for meals, which existed before the COVID-19 crisis, have grown by 26 percent
  • Aside from funding, 63 percent of programs report that acquiring safety supplies (gloves, masks, etc.) is the biggest challenge

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