The he Capac apacity ity of of th the Ag e Aging ng Service vices s Netw twork: ork: Top op 10 Thi hings ngs to to Kno now w fo for Reautho uthorization rization 1
1965 1965 1972 1972 1973 1973 1975 1975 OAA, Medicare, SSI, Congr gregat gate Meals AAAs enacted ted SSBG Medic dicaid 1990 1990 1992 1992 1981 1981 1987 1987 Americans with th Elder der Righ ghts ts title Medic dicaid d Waive ver LTC Ombuds dsma man Disabil biliti ties Act added 2006 2005 2005 1999 1999 2000 2000 ADRC, C, Health th Medic dicare Part t D Olmstea tead d Decision on Family y Caregi giver Promotion motion, Nursing g Enrol ollmen ment t Begi gins Home Diversion on 2
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Total Spending $3.8 Trillion Source: Office of Management and Budget data, President's FY 2010 Budget 4
AoA State Units 56 on Aging Area Agencies on 629 Aging Title VI Native American 244 Aging Programs 0ver 30,000 Service Providers Volunteers Over 500,000 Family Caregivers millions 5
The age wave has begun . 6
2000 2020 Source of charts: U.S. Census Bureau, “65+ in the United States: 2005,” December 2005. 7
80 70 numbers in millions 60 50 40 30 20 10 0 1900-2030 8
The characteristics of the population served by the Aging Services Network continue to diversify, with nearly two-thirds of states and AAAs serving both the elderly and physically disabled younger adult populations regardless of age . 9
14% 60 years of age and 22% older population only 60 years of age and older population and disabled population 64% regardless of age 10
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Federal funding continues to decline despite growth in the number of eligible Americans. 12
Average of 30% of SUA budget 2% is OAA funding Less than $1 20% million Between $1 and $25 million Between $26 and 56% $50 million 22% More than $50 million 13
Average Budget: $ 7.5 million Lowest Quartile: $ 2.0 million Second Quartile: $ 3.8 million Third Quartile: $ 8.7 million Average Percent of Budget from OAA: 40.4 Lowest Quartile: 21.5 Second Quartile: 36.0 Third Quartile: 56.0 14
Although funding from the Administration on Aging has not kept pace with the numbers of individuals 60 plus, states, the Area Agencies on Aging and the other network partners have successfully leveraged federal funding. 15
For every $1 in federal funding, state and local agencies on aging acquire more than $2 in other funding Volunteers lend time and Providers add support additional support and in- AAAs add local kind funding and contributions support and and deliver purchase States add services services states’ share of federal funds, provide additional AoA state-only provides support and seed distribute funding and funds oversight 16
OAA OAA Fami milies es Medi dicai caid Aging Local cal Stat ate- Services Govt vt Only y Fundi ding ng Fundi ding ng Network Other er Targ rgete ete Federa eral d Tax/ x/ Lottery ttery Fundi ding ng Privat ate Fundi ding ng 17
Foundation/private grants State lottery Targeted tax Local (i.e., county or city) funding State appropriation Medicaid Older Americans Act 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percent of States 18
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The Aging Services Network continues to develop a comprehensive strategy of services for long-term services and supports for all Americans of all ages and abilities that can help bend the cost curve on entitlements . 20
Supporting Family • National Family Caregiver • Lifespan Respite Care Caregivers •Alzheimer’s Disease • Native American Caregiving Support Program • Information and Referral, Case Management Maintaining Health and • Home Delivered, Congregate, and Native American Nutrition Independence • Personal Care, Homemaker Assistance, Adult Day Care • Transportation Protecting Vulnerable Older • Long-Term Care Ombudsman Americans • Prevention of Elder Abuse and Neglect • Aging and Disability Resource Centers, Evidence Based Disease Prevention, Community Supporting the National Living Incentives Aging Network Services • Program Innovations • Aging Network Support Employing Senior Workers • Seniors Community Service Employment for Older Americans Program 21
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Long-Term Care Planning by AAAs Information about and referral to 94.1 long-term care services Outreach and educational presentations 89.9 Information about establishing legal 84.2 directives such as living wills Options counseling through other 69.6 services such as case management Elder rights education 69.4 Information about long-term care insurance 65.2 Options counseling through an ADRC 33.4 Participation in AoA "Own Your Future" campaign 15.6 0 10 20 30 40 50 60 70 80 90 100 24
Planning and development of policy Quality for home and community based services Eligibility determination Financing Regulation of home and community based providers Quality for institutional services 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Percent of States 25
Yes 40% No 46% My state is in the process of making changes to 14% achieve this goal. 26
The Aging Services Network is evolving towards more consumer-driven activities . 27
State funded HCBS Medicaid HCBS In OAA programs 0 5 10 15 20 25 30 Number of States 28
Percentage of AAAs who provide consumer-directed options in the following services. Respite Care 26.0 Personal Care 25.3 Homemaker 23.5 Family Caregiver Support Program 22.6 29
The Aging Services Network is providing evidence-based health promotion and disease prevention programs that allow older adults and individuals with disabilities to remain in their homes and communities. 30
Percent of States 10% 20% 30% 40% 50% 60% 70% 80% 90% 0% A Matter of Balance Chronic Disease Self-Management EnhanceFitness EnhanceWellness Healthy IDEAS or PEARLS Medicaid Management Improvement System 31
Over half (55.6%) of AAAs are involved in providing evidence-based programs to prevent/manage chronic disease or disability. Most common- • Chronic Disease Self-Management Program • A Matter of Balance • EnhanceFitness • EnhanceWellness 32
States and Area Agencies on Aging are encouraging the development of livable communities for all ages--the development of services and infrastructure to assist people across their lifespan - through planning initiatives and partnerships . 33
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Housing Health Transportation Land Use Planning Public Safety Parks and Recreation Workforce Development/Education Volunteerism/Civic Engagement Arts and Cultural Activities Economic Development/Fiscal Impact 35
States and communities continue to face extraordinary pressure due to the economic decline. 36
Strengthen core OAA functions and infrastructure to build on proven best practices to create a system that empowers and facilitates consumer choice, from private pay to Medicaid, while building on and complementing the energy of a growing aging service industry. 37
Build on 40 years of Experience as Trusted Resource Build on Track Record of HCBS Build on Momentum & Success of Demonstration Grants Build on Reach of Network to Serve Broad & Diverse Populations 38
Budget Crisis / Stagnant Funding Need for Staff Increase Technology Investment Aging Baby Boomers 39
Martha Roherty Sandy Markwood Executive Director CEO NASUA n4a 1201 15 th Street, NW 1730 Rhode Island Avenue, NW Suite 350 Suite 1200 Washington, DC 20005 Washington, DC 20036 202-898-2578 202-872-0888 www.nasua.org www.n4a.org mroherty@nasua.org smarkwood@n4a.org 40
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