Older Americans Act Programs Being Revamped for the First Time in 35 Years

The move comes as an estimated 10,000 baby boomers retire every day.

It may come as a shock to realize that the nation’s oldest baby boomer and the current U.S. life expectancy this year became the same age: 77.

That might help explain why the federal Administration for Community Living (ACL) is seeking input on a broad range of proposed updates to most of its Older Americans Act (OAA) programs, which haven’t been substantially changed since 1988.

“Our world has changed dramatically in the 35 years since,” the ACL said in a post to its website. “The population of older adults has nearly doubled and has grown increasingly diverse. Older adults are living longer than ever before, and their expectations are different from those of earlier generations. Increased understanding of the impact of the social determinants of health is reshaping healthcare, as non-medical services that help people avoid hospitalization and institutional care – like those provided through OAA programs – are increasingly being incorporated into healthcare service delivery models.”

Specifically, officials said that the proposed changes are needed to align regulations to the current version of the OAA statute and reflect the aims of the services offered under it.

“Like the Inflation Reduction Act, which has cut healthcare costs for millions of older adults, and the steps we have taken to strengthen Medicare and Medicaid, the update to the Older Americans Act regulations reflects President Biden’s commitment to supporting the health and well-being of older adults,” U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra said in a statement (the ACL is an umbrella program of HHS). “By strengthening the stability and sustainability of Older Americans Act programs and promoting equitable access to its services, the proposed rule will help ensure that older people, particularly those in greatest need, have the support they need to live independently and age with dignity.” 

“The overwhelming majority of older adults want to live in the community as they age, and almost 95 percent of them do. For many, services provided through the Older Americans Act – such as rides to doctors’ appointments, nutritious meals, in-home services, and support to family caregivers – make this possible,” Acting Assistant Secretary for Aging and ACL Administrator Alison Barkoff added. “This proposed rule will strengthen the system of support that allows millions of older adults to stay in their own homes. With our population aging rapidly, and nearly three out of four people needing assistance to age in place, this is more important than ever.”

Officials said the proposed rule specifically would include the following:

• Clarify requirements for state and area plans on aging and detail requirements for coordination among tribal, state, and local programs;
• Clarify and strengthen provisions for meeting OAA requirements, prioritizing people with the greatest social and economic needs; 
• Specify the broad range of individuals who can receive services, how funds can be used, fiscal requirements, and other requirements that apply across programs;
• Clarify required state and local policies and procedures. For example, the proposed rule establishes expectations for state and local policies regarding conflicts of interest;
• Improve consistency of requirements for programs specifically for tribal elders and caregivers, and programs that serve all populations of older adults; 
• Incorporate guidance for the National Family Caregiver Support Program and the Native American Caregiver Support Program, which were authorized since the last update to the OAA regulations; 
• Address emergency preparedness and response, incorporating lessons learned from the COVID-19 public health emergency (PHE); 
• Establish expectations for legal assistance and activities to prevent elder abuse;
• Clarify the role of the aging network in defending against the imposition of guardianship and in promoting alternatives; and
• Update definitions, modernize requirements, and clarify flexibilities within senior nutrition programs. For example, ACL proposes provisions that would allow for continuation of innovations utilized during the COVID-19 pandemic, such as “grab and go” meals provided under the congregate meals program.

The OAA was passed in 1965 as part of President Lyndon B. Johnson’s “Great Society” reforms, becoming the first federal program specifically created to provide services to older adults. It is generally reauthorized by Congress every four years, and it continues to benefit Americans over 60 – of which there is a rapidly growing number.

Baby boomers are defined as the estimated 76 million Americans born between the years of 1946 to 1964, when the U.S. birth rate hovered between about 21 and 26 births per 1,000 people annually – it has fallen by more than a third since. The trend pushed the country’s median age to a whopping 38.8 as of earlier this year.

A Forbes article published late last year noted that an estimated record 26 million Americans more than 50 live alone, and by the end of the decade, all baby boomers will be over the age of 65.

Comments on the proposed rule may be submitted by “all who are interested in improving implementation of OAA programs and services,” officials said, with input from aging and disability networks, as well as OAA beneficiaries, labeled “particularly crucial.” Comments can be made anytime through Aug. 15, in one of two ways: online at Regulations.gov (enter “2023-12829” in the search bar, select ACL’s proposed rule, and then click the blue “comment” box at the top left of the page) or by mail sent to the Administration for Community Living, Administration on Aging, Attention: ACL-AA17-P, 330 C Street SW, Washington, DC 20201.  

To read a brief summary of the proposed rule, go online to: https://acl.gov/sites/default/files/oam/2023/Overview%20-%20Proposed%20OAA%20Regulations%20-%202023%20-%20final.pdf

To read the full Federal Register posting in its entirety, go to: https://www.federalregister.gov/documents/2023/06/16/2023-12829/older-americans-act-grants-to-state-and-community-programs-on-aging-grants-to-indian-tribes-for

Mark Spivey is a national correspondent for RACmonitor and ICD10monitor who has been writing and editing material about the federal oversight of American healthcare for nearly 15 years. He can be reached at mcspivey33@gmail.com.