Administration for Community Living Release of the FY 2015 Budget Request to Congress
Tuesday, March 4, 2014
On March 4, 2014, the Administration for Community Living’s (ACL) budget request to Congress for Fiscal Year 2015, totaling $2.1 billion, was released as part of the U.S. Department of Health and Human Services (HHS) budget request. ACL was formed in April 2012 to help people with disabilities and older adults live in their homes and participate fully in their communities, and to harmonize efforts to promote community living, which can save Federal funds. Compared to FY 2014, the current request would make modest strategic investments, while maintaining funding for most core areas.
The Budget proposes to advance the rights of elder Americans by investing in ACL’s Elder Justice Initiative. There is no single set of national elder abuse prevalence data, yet the number of reported cases of elder abuse, neglect, and exploitation is rising. Data suggest that more than 5 million, or 10 percent, of elders are abused, neglected, and/or exploited annually. Research shows that older victims of even modest forms of abuse have dramatically higher (300 percent) morbidity and mortality rates, which results in a growing number of seniors who access the health care system more frequently (including emergency room visits and hospital admissions), and are ultimately forced to leave their homes and communities prematurely. Additionally, we know that people with disabilities, including older adults, are 4 to 10 times more likely to be victims of violence, abuse or neglect. The FY 2015 budget includes $25 million for continuing to work on Adult Protective Services National Data System and technical assistance; demonstration grants to States to strengthen the evidence base so that states, tribes, and communities on the front lines of this serious problem can enhance and test new models, and reinforce infrastructure to detect and report incidences of abuse, neglect and exploitation; evaluation activities; and advancement of a coordinated Federal research strategy to fill the gaps in knowledge and fund initial research on high priority areas.
The budget also includes $5 million for a new Youth Transitions Initiative to address the comprehensive needs of youth with intellectual and developmental disabilities as they transition from adolescence and high school into adulthood that includes post-secondary education, work opportunities, and reducing their likelihood of becoming solely dependent on Social Security, Medicaid, or other similar benefits. This is part of a larger Departmental initiative targeting youth in difficult transitions, and is intended to help coordinate transition approaches across multiple domains and systems—health, education, employment, human services, and community living. This initiative will support grants to States to promote innovative utilization of health and long-term services and supports in coordination with education, vocational rehabilitation, and employment services; encourage integration of health and long-term services and supports transition planning into secondary and post-secondary education programs; provide technical assistance and training to ensure integration of health and long-term supports with education, vocational rehabilitation and employment services; and establish and implement a coordinated Federal evaluation agenda to ensure that outcomes across systems are measured and reported.
Rounding out ACL’s strategic investments, the budget includes three new requests. First, $20 million is requested in each of the next five years in mandatory funding to continue support for Aging and Disability Resource Centers. Over the next five years, these funds will enable approximately 35 states to finalize the development and operation of high-performing “No Wrong Door” Systems of Access to long term services and supports for all populations and all payers, consistent with national standards that ACL is now developing in partnership with the Center for Medicare & Medicaid Services, the Veterans Health Administration and eight states. Second, the budget provides $5 million for a Holocaust Survivor Assistance Fund that would create a public-private partnership to enhance supportive services for this population. Finally, $3 million is requested for the decennial White House Conference on Aging to bring together stakeholders and consumers from across the country to discuss the range of aging issues they face.
The request would maintain $1.4 billion in support of a vibrant array of existing programs that focus on health and independence for seniors and their caregivers. Authorized under the Older Americans Act and administered by the national aging services network, these core programs include home and community-based services, nutrition programs, preventive health services and services to assist caregivers. These programs help make it possible for seniors to remain in their homes for as long as possible. Services complement existing medical and health care systems, help to prevent hospital readmissions, provide transport to doctor appointments, and support some of life’s most basic functions, such as providing assistance in elders’ homes to help them with bathing or preparing food. The national aging services network also helps consumers learn about and access the services and supports that are available in the community and addresses issues related to caregivers. These services are less expensive than institutional care and performance data show that they are very effective. The request also includes $27.7 million from the Prevention and Public Health Fund to support seniors and caregivers through continued funding for Chronic Disease Self-Management Education, Falls Prevention, Alzheimer’s Disease Initiative Services and an Alzheimer’s Outreach and Communications Campaign.
Overall, the budget would fund $160 million for programs authorized under the Developmental Disabilities Assistance and Bill of Rights Act that fund capacity-building and systems change efforts to assure that people with intellectual and developmental disabilities and their families participate in the design of and have access to needed community services, individualized supports and other forms of assistance the promote self-determination, independence, productivity, and integration and inclusion in all facets of community life. These funds will support a variety of partnerships with states and territories, including State Councils on Developmental Disabilities, Developmental Disabilities Protection and Advocacy programs (including the Help America Vote Act protection and advocacy access program), University Centers for Excellence in Developmental Disabilities, and Projects of National Significance.
Finally, building on the transfers in FY 2014 of two complementary programs—the State Health Insurance Assistance Program from the Centers for Medicare & Medicaid Services and the Paralysis Resource Center from the Centers for Disease Control and Prevention—the FY 2015 budget again proposes the transfer of the Senior Community Service Employment Program (SCSEP) from the Department of Labor. Authorized under Title V of the Older Americans Act, SCSEP would receive $380 million, the same level as proposed in the FY 2014 request. ACL will make improving performance a priority, including targeting the program to people with the greatest need. This transfer recognizes that SCSEP can be more effective when its services are closely integrated with the supports provided by ACL’s existing aging services programs, thus allowing older Americans to remain economically independent and in their communities.