From June 16 to August 15, 2023, ACL collected input on proposed updates to the regulations for most of its Older Americans Act (OAA) programs. The culmination of many years of engagement with the national aging network, the proposed rule reflects input received through a formal request for information and a series of listening sessions, including formal tribal consultations and other engagement with tribal grantees. ACL sought feedback on the proposed rule from all who are interested in improving the implementation of OAA programs and services.
Updates needed to meet the needs of today’s older adults
The last substantial update to most OAA program regulations was in 1988, and our world has changed dramatically in the 35 years since. 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 health care, as non-medical services that help people avoid hospitalization and institutional care – like those provided through OAA programs – are increasingly being incorporated into health care service delivery models. In addition, the OAA has been amended by Congress seven times since 1988.
One important thing has not changed: older adults overwhelmingly want to continue to live independently, in the community – and nearly 95 percent of them do.
Updates are needed to align regulations to the current statute and reflect the needs of today’s older adults. The proposed rule addresses issues that have emerged since the last update and clarifies a number of requirements. It aims to better support the national aging network that delivers OAA services and improve program implementation, with the ultimate goal of better serving older adults.
“Like the Inflation Reduction Act, which has cut health care 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,” said U.S. Department of Health and Human Services Secretary Xavier Becerra. “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,” said Acting Assistant Secretary for Aging and ACL Administrator Alison Barkoff. “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.”
The proposed rule addresses issues that have emerged since the last update and clarifies a number of requirements for programs authorized under Titles III (grants to state and community programs on aging), VI (grants to Indian tribes and Native Hawaiian grantees for supportive, nutrition, and caregiver services), and VII (allotments for vulnerable elder rights protection activities). It aims to better support the national aging services network that delivers OAA services and improve program implementation, with an ultimate goal of better serving older adults. For example, the proposed rule:
- Clarifies requirements for state and area plans on aging and details requirements for coordination among tribal, state and local programs.
- Clarifies and strengthens provisions for meeting OAA requirements for prioritizing people with the greatest social and economic needs.
- Specifies the broad range of people who can receive services, how funds can be used, fiscal requirements, and other requirements that apply across programs.
- Clarifies required state and local policies and procedures. For example, the proposed rule establishes expectations for state and local policies regarding conflicts of interest.
- Improves consistency of requirements for programs specifically for tribal elders and caregivers (authorized under Title VI of the OAA) and programs that serve all populations of older adults (authorized under Title III).
- Incorporates 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.
- Addresses emergency preparedness and response, incorporating lessons from the COVID-19 public health emergency.
- Establishes expectations for legal assistance and activities to prevent elder abuse.
- Clarifies the role of the aging network in defending against the imposition of guardianship and in promoting alternatives.
- Updates definitions, modernizes requirements and clarifies flexibilities within the 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.
About the Older Americans Act
First passed in 1965 and last reauthorized on March 25, 2020, the OAA authorizes a wide range of programs and services, most of which focus on helping older adults age in place. These services include home-delivered and congregate meals, support for family caregivers, preventive health services, personal and home care services, transportation, legal assistance, elder abuse prevention, and so much more. In addition, the OAA provides ombudsman services for people who live in long-term care facilities.
Through the aging services network, the OAA has helped older adults continue to work and volunteer, live independently and age with dignity, to the great benefit of all. Because of the OAA, neighborhoods and organizations across the country are able to continue to draw upon the wealth of knowledge that comes only with life experience.
Through its Administration on Aging, ACL administers most of the provisions of the OAA. (The OAA Senior Community Services Employment Program is administered by the Department of Labor and is not covered by this proposed rule.)