Bridging the Aging and Developmental Disabilities Service ... - rrtcadd

• State funding authorized by the state legislature plus the availability of local funding
resources.
• The optional services states include in their Medicaid state plan.
• States’ use of the 1915 (c) Medicaid waiver to fund home and community-based services.
• Whether states use a fee-for-service or a managed care model of service delivery.
The Aging Service System
The Older Americans Act (OAA) of 1965 (P.L. 89-73) was legislated to maximize the
independence of older people and help vulnerable older adults remain in their home and
community by providing a limited array of services to support these outcomes. The OAA and its
amendments established a national infrastructure consisting of the Administration on Aging
(AoA) and the national network of state units on aging, area agencies on aging, tribal and Native
American organizations, and community agencies to plan and deliver its services, and to
advocate progressive public policies and programs. The AoA within the Department of Health
and Human Services administers OAA programs and services and is the federal focal point for
addressing issues affecting older persons. OAA services are targeted to older adults with the
greatest social and economic need and who are at risk of institutionalization. States and Area
Agencies on Aging (AAAs) use OAA funds to leverage other funding sources. Key components
of the OAA include:
• Title III provides nutrition programs, supportive services (e.g., information and access,
home care, adult day services, case management, and senior center activities), the
National Family Caregiver Support Program, and disease prevention and health
promotion programs. Title III services are entitlements that are available to all people age
60 and older (with some exceptions) at no cost, although participants are encouraged to
make voluntary contributions to specific programs (such as congregate meals). Nearly
two-thirds of the OAA budget is allocated to Title III services.
• Title IV funds research, training, demonstration and technical assistance projects to
improve aging services.
• Title V funds the Community Service Employment Program which provides job training
and employment for low income older people.
• Title VII funds the Long-Term Care Ombudsman and Elder Abuse programs.
The OAA was last reauthorized in 2006 and the scheduled reauthorization in 2011 did not occur.
The various amendments since 1986 have contained provisions for support services to older
families caring for adult children with disabilities and for state plans to coordinate services for
18, 19, 20
older adults with severe disabilities which include developmental disabilities.
Bridging the Aging and Developmental Disabilities Service Networks Page 16