Edwin Walker: Hello everyone, and thanks for joining us today for our older Americans act regulations webinar it's in follow up to us, issuing a request for information.

Edwin Walker: i'm Edwin Walker the Deputy Assistant Secretary for aging at the administration on aging within the administration for community living within the Department of Health and human services.

Edwin Walker: And i've been here at the administration on aging for 30 years, yes, since 1992.

Edwin Walker: and actually one of the things I was hired to do, back then, was to draft older Americans act regulations in order to implement the act as it was reauthorized at that time in 1992 with the addition of the then new title seven.

Edwin Walker: Well, that tells you how my career hasn't gone exactly as planned, but we did develop draft regulations back in the mid 1990s, however, we weren't successful in getting them to the finish line.

Edwin Walker: due in part to a change and approach from being compliance oriented to being redirected to provide technical assistance to and in partnership with the aging services network.

Edwin Walker: To collectively achieve success and to bring about continuous quality improvement.

Edwin Walker: Through the years we've used other vehicles to provide guidance like state plan guidance or frequently asked questions or even direct technical assistance and responses to environments.

Edwin Walker: we've lived through through many different areas, including the era of deregulation, yet we have experienced multiple reauthorization and we've seen many, many program change changes and challenges.

Edwin Walker: All of this, to say that now the stage is set to deliver a new set of guiding regulations to enhance program to reflect the evolution and changing environments in the field of aging human services and healthcare.

Edwin Walker: So I want to talk a little bit about our process in our process for achieving this is one that is reflective of our general approach, that is to be fully collaborative and engaging with you.

Edwin Walker: So our request for information was designed to seek your input The goal is to check and compare your input with the issues that we and the administration for aging and administration.

Edwin Walker: Community living have noted internally through the years from the multiple engagements with our regional administrators and other programming fiscal staff, as they have engaged with you, we wanted to.

Edwin Walker: Talk about how we do this because we've given a lot of thought and within the administration.

Edwin Walker: We want it, we didn't want to move forward under the assumption that we have already collected all the issues or that the ones that we have collected that we have them totally right.

Edwin Walker: So we We really need to hear from you, you know, one of the key beauties of and a hallmark of the success of the older Americans act.

Edwin Walker: has been that it's designed to be reflective of local needs and in that regard, we want to ensure that our guiding regulations are reflective of your needs now let me conclude and indicate that I am so.

Amy Wiatr-Rodriguez: pleased that.

Edwin Walker: amy why to Rodriguez our regional administrator for region five located in Chicago.

Edwin Walker: And who is also currently serving as the acting deputy administrator for the Center for regional operations has stepped up and volunteered to lead and shepherd.

Edwin Walker: Our regulations development process I personally and so very grateful to her and i'm pleased to present her to you now amy.

Amy Wiatr-Rodriguez: Great Thank you so much, everyone, thank you for that overview and for your very kind introduction.

Amy Wiatr-Rodriguez: I am so pleased to be working with you and other acl colleagues and all of you on this webinar as we consider updating our older Americans act Title three, six and seven regulations.

Amy Wiatr-Rodriguez: Again, I am so pleased to be helping with this, and with that we can move to the next slide i'll note that we are recording the session, and we will make the the slides and recording available and so to begin let's start by going back in time and thinking about where were you in 1988.

Amy Wiatr-Rodriguez: I hope there are some time some fun times to remember, but for some of our younger colleagues, they may not have even existed yet.

Amy Wiatr-Rodriguez: For those of us who are old enough to reminisce about 1988 i've seen people remembering this as the birth year for children or grandchildren.

Amy Wiatr-Rodriguez: Maybe thinking about what grade or year they were in school, recalling some big hair and makeup and fashion and for me at least remembering some great 80s music.

Amy Wiatr-Rodriguez: In terms of what was going on in popular culture in 1988 this slide contains some reference points in terms of movies literature, music and home economics, you can go to the next slide.

Amy Wiatr-Rodriguez: Another way of getting into the 1988 mindset is to consider what didn't exist yet specific to our older Americans act programs.

Amy Wiatr-Rodriguez: The national family caregiver support program was not a part of the older Americans Act, the Americans with Disabilities Act was not law.

Amy Wiatr-Rodriguez: Technology was certainly not where it is today, for those of you that remember cassette tapes and floppy disks and pop culture figures of today, like the members of bts were not even born yet.

Amy Wiatr-Rodriguez: Again, the reason why we're talking about 1988 is because that's when the current regulations for the older Americans act Title three and six were last updated.

Amy Wiatr-Rodriguez: We go to the next slide and since i'm not sure how familiar, everyone is with the Federal Government lingo of laws and regulations, just to make sure we're all starting from the same place the slide gives a quick overview.

Amy Wiatr-Rodriguez: So the older Americans act is a law, this means that the older Americans act passed both Houses of Congress and it's been signed into law by the President

Amy Wiatr-Rodriguez: Individual laws are gathered in the United States code and a subsequent slide will have a link to the current older Americans act law text.

Amy Wiatr-Rodriguez: Regulations, then our rules made by federal agencies, like a cl to guide the implementation of the law.

Amy Wiatr-Rodriguez: Regulations are compiled in the code of federal regulations are you here to talk about CFR and published in the Federal Register.

Amy Wiatr-Rodriguez: A subsequent slide will have the link to our current older Americans act regulations text so you might think about this as the law gives an outline and the regulations help fill in the details.

Amy Wiatr-Rodriguez: Please note that States also have processes for state laws and state regulations.

Amy Wiatr-Rodriguez: Your State might refer to administrative code or administrative rules or have some other names for these two concepts.

Amy Wiatr-Rodriguez: And as a helpful hint if you're told about a requirement that a law or regulation requires it's always a good question to ask if it's a federal or state requirement and, in some cases, it may be about.

Amy Wiatr-Rodriguez: Go to the next slide.

Amy Wiatr-Rodriguez: So when acl sense notices of award we include what the requirements are for each grant there is an order of precedence or order of importance that is listed and what's on this slide is typical for the older Americans act Title three, six and seven awards right now.

Amy Wiatr-Rodriguez: It says that first the Statute or the law, which is the older Americans act must be followed, first, so if there's anything that says otherwise the law or the older Americans act overrule sad.

Amy Wiatr-Rodriguez: Second, or executive orders that would be issued by the President and we'll talk about one such executive order in a bit.

Amy Wiatr-Rodriguez: And third, our program regulations it's highlighted on the slide and for the older Americans act programs, this means the older Americans act regulations which we're going to discuss further today.

Amy Wiatr-Rodriguez: We move to the next slide and that will contain a link to the current older Americans act law text, so this is where you can find the current older American older Americans act law that was passed by Congress and signed into law by the President, most recently on march 25 of 2020.

Amy Wiatr-Rodriguez: We can go to the next slide it will show the current seven titles of the older Americans act law and for the purposes of our presentation today we'll focus on Titles three, six and seven.

Amy Wiatr-Rodriguez: Next slide.

Amy Wiatr-Rodriguez: So one thing to note and i'll probably say it again just acl can only issue regulations for what the law allows or authorizes us to do.

Amy Wiatr-Rodriguez: And so the current regulations, then how to implement the law, or what we are authorized to do are listed here.

Amy Wiatr-Rodriguez: So the first dot point is the set of regulations that gives requirements for the state area agency on aging and local Title three programs and you'll see that 1988 date and the parentheses.

Amy Wiatr-Rodriguez: The second point is the set of regulations for the Title six Part A programs to serve elders again the 88 date, as is in the third point, which is the set of regulations for the Title six Part B program for older hawaiian natives got 1988.

Amy Wiatr-Rodriguez: The final dot point is the set of regulations for the long term care Ombudsman program you will note a different date here of.

Amy Wiatr-Rodriguez: acl did issue Ombudsman program regulations in.

Amy Wiatr-Rodriguez: But other than changes relating to the Ombudsman program no other regulation changes were made.

Amy Wiatr-Rodriguez: And all of the regulations were updated in 2016 to reflect the creation of a cl and to consolidate the regulations and a single subchapter but no, no changes to content were made at that time, so we can move to the next slide.

Amy Wiatr-Rodriguez: And as Edwin alluded to the older Americans act has been reauthorized many times since the Title three and six regulations were established.

Amy Wiatr-Rodriguez: it's actually been reauthorized five times since then, and because of that this will just share some concerns on why you should care about the older Americans act regulations.

Amy Wiatr-Rodriguez: So, first, the current regulations don't line up with the law, which can be confusing so as we said, with the order of precedence, the laws what's most important so that is what what is followed.

Amy Wiatr-Rodriguez: But again, the regs might not line up with that so, for example, the current regulations talk about a Commissioner on aging, but the current law talks about the Assistant Secretary for aging, so we use the terminology that the law says.

Amy Wiatr-Rodriguez: Another example is that the current regulations don't say anything about the national family caregiver support program because it didn't exist yet so we follow what's in the law, but we may lack important implementation information.

Amy Wiatr-Rodriguez: Another concern is that without current and valid regulations, there can be confusion and how to implement the older Americans act.

Amy Wiatr-Rodriguez: Sometimes things that are written in the federal law might not be very clear when it comes to what does this actually mean, and how does it apply at the local community level.

Amy Wiatr-Rodriguez: regulations can help us answer important questions on how we are to best provide services to older adults elders and caregivers and without them we may struggle to answer certain questions are know that we're being appropriately consistent and how we do things.

Amy Wiatr-Rodriguez: Or maybe there are things in the regulations that are super outdated like a 1980s floppy disk would be today.

Amy Wiatr-Rodriguez: And if the older Americans act law is silent on those things, what is in the 1988 regulations still applies even if it doesn't make sense, with how we want to do things 30 plus years later.

Amy Wiatr-Rodriguez: We can move to the next slide, and this is exciting so we'll talk about the the rfp process, and since acl is beginning to consider updating the older Americans act regulations.

Amy Wiatr-Rodriguez: i'll give an overview of the process steps and again we're so so pleased and excited to kick off this process so again, as I mentioned before.

Amy Wiatr-Rodriguez: The acl can only regulate what the older Americans act authorizes us to do so per that order precedence we can't put anything in to the regulations that would conflict with what's in the act and, additionally, we hope that it's not a surprise, as I, you know go through this.

Amy Wiatr-Rodriguez: process steps overview There are detailed processes that acl would need to follow to result in revising the regulations so i'll talk about the steps so first our step, where we are here today.

Amy Wiatr-Rodriguez: We want to receive feedback from stakeholders, and when we say stakeholders, we mean tribes villages tribal organizations state area agencies on aging local service providers, associations and advocacy groups and others, we want to extend our request very broadly and widely.

Amy Wiatr-Rodriguez: We may offer opportunities for listening sessions or verbal Comments like we may add upcoming conferences or like we did at our Title six program for our tribal aging programs last month.

Amy Wiatr-Rodriguez: And please note that for transparency purposes any sessions we have must be open to all and any verbal comments should be followed up by written comments.

Amy Wiatr-Rodriguez: Second, we are pleased to review in today's webinar that acl is offering a request for information or rf I.

Amy Wiatr-Rodriguez: process in advance of issuance of a notice of proposed rulemaking so the intent of the RSI is to give acl feedback on what you would like to see as acl drafts regulations revisions and i'll go a little bit more into detail with the Roi after I review the overall process.

Amy Wiatr-Rodriguez: So if we go to the next slide.

Amy Wiatr-Rodriguez: So what we gather from this rfp process and from what we hear from stakeholders through other venues will be will go in and inform than the notice of proposed rulemaking, so this is kind of the third step.

Amy Wiatr-Rodriguez: This is the formal opportunity for review and comment of proposed regulations revisions.

Amy Wiatr-Rodriguez: written comments submitted as a part of this process would be given more weight than comments provided otherwise, as this is the very formal process to go through.

Amy Wiatr-Rodriguez: And this would be an opportunity for aging network, stakeholders and the general public to review and comment on whatever proposed regulations.

Amy Wiatr-Rodriguez: or regulations changes, we would we would consider issuing so after we go through that that formal notice of proposed rulemaking period.

Amy Wiatr-Rodriguez: acl would review the formal feedback that we review that we received, we would make any changes as a result of that go through many, many internal reviews within a cl as well as hhs and elsewhere, before issuing a final rule.

Amy Wiatr-Rodriguez: Upon issuing a final rule we would provide lots of training and technical assistance on how to make any updates or changes that would be required, as a result of the revised regulations, including a time frame for implementation.

Amy Wiatr-Rodriguez: You can go to the next slide.

Amy Wiatr-Rodriguez: And so, with that overview of the process let's dive a little deeper into the RSI so the RSI was published in the Federal Register last week Friday may six and you can access the Roi on the link on the slide.

Amy Wiatr-Rodriguez: Please note that feedback and response to the RSI should be submitted by Monday June six.

Amy Wiatr-Rodriguez: Next slide.

Amy Wiatr-Rodriguez: As noted in the RSI acl seeks input from individuals and organizations regarding the services provided under Titles three, six and seven.

Amy Wiatr-Rodriguez: Including supportive services nutrition evidence based disease prevention health promotion caregiver legal long term care Ombudsman and other services that are provided by the agent network and under the older Americans act.

Amy Wiatr-Rodriguez: Next slide.

Amy Wiatr-Rodriguez: We intend to be comprehensive in the feedback that we are seeking, including, we would like to hear about challenges faced by older adults elders and family caregivers and receiving services under the act.

Amy Wiatr-Rodriguez: As well as challenges faced by States territories tribes and tribal organizations area agencies on aging and service providers in delivering services under the act.

Amy Wiatr-Rodriguez: Next slide.

Amy Wiatr-Rodriguez: Ensuring equity in older Americans act funded services is not new, for the agent network, the older Americans Act has long required that funding be targeted to those with the greatest social need.

Amy Wiatr-Rodriguez: And acl guidance has previously stated that, while the definition of greatest social need in the older Americans act includes isolation caused by racial or ethnic status.

Amy Wiatr-Rodriguez: The definition is not intended to exclude the targeting of other populations that experience, cultural, social or geographic isolation due to other factors.

Amy Wiatr-Rodriguez: For example, in some communities such isolation may be caused by minority religious affiliation and others isolation due to sexual orientation or gender identity may restrict a person's ability to perform normal daily tasks or live independently.

Amy Wiatr-Rodriguez: And in January of 2021 the President issued an executive order executive order 13985 advancing racial equity and support for underserved communities through the federal government.

Amy Wiatr-Rodriguez: You can access the executive order via text via the link on this slide and the goal in advancing equity is to provide everyone with the opportunity to reach their full potential.

Amy Wiatr-Rodriguez: And through this RSI acl seek feedback on how older Americans act programs can advance equity in alignment with this executive order.

Amy Wiatr-Rodriguez: Next slide.

Amy Wiatr-Rodriguez: So, now that we've gone through the details of the RSI.

Amy Wiatr-Rodriguez: This slide gives some considerations and next steps for right now and first is, have you reviewed the current regulations again this slide includes the links to the current regulations.

Amy Wiatr-Rodriguez: And one other thing I want to note is that given expectations for coordination among the various titles.

Amy Wiatr-Rodriguez: We encourage individuals and organizations to review and comment on all as appropriate so don't just restrict yourself to the one that you think that you work.

Amy Wiatr-Rodriguez: or know about primarily we really encourage coordination and looking at our older Americans act programs holistically and as a system that we have out there to best serve our older adults elders and family caregivers.

Amy Wiatr-Rodriguez: Next slide.

Amy Wiatr-Rodriguez: So, secondly, are there additions deletions or changes, you would like to see in the current older Americans act regulations.

Amy Wiatr-Rodriguez: A third consideration do your various stakeholders or groups of which you're a member have additions deletions or changes they'd like to see in the current older Americans act regulations.

Amy Wiatr-Rodriguez: And then, finally, we encourage you to get your good thoughts and ideas down in writing and to please share them with us.

Amy Wiatr-Rodriguez: By sending them to the email address on the slide which is Oh, a regulations at a cl that hhs.gov and if you can include a regulations in the subject line and send them to us by Monday June six, we would be very, very grateful and appreciative.

Amy Wiatr-Rodriguez: So with that we can go to the next slide and just again we add a cl want to thank you so much for your care and concern for older adults.

Amy Wiatr-Rodriguez: elders family caregivers and the staff volunteers and Community stakeholders that comprise the image amazing aging network across the country.

Amy Wiatr-Rodriguez: We at acl are so excited and energized to work on revising these regulations so that they can appropriately support the good work that the older Americans act makes possible.

Amy Wiatr-Rodriguez: And so, at this time, we can see if the technology will allow us to entertain questions or comments from those of you who have are joining us today.

Amy Wiatr-Rodriguez: And to do that, you can certainly and we welcome you to enter your comments in the chat.

Amy Wiatr-Rodriguez: You can also raise your hand others little icon, at least on the bottom of my screen to raise your hand and that way we can go through and unmute you to ask your questions or make comments and again thank you and we look forward to engaging with you all on this.

Amy Wiatr-Rodriguez: All right, and so.

Amy Wiatr-Rodriguez: I am going to see.

Amy Wiatr-Rodriguez: So we have one comment is there any thought of extending this June six deadline, it is a very short turnaround considering the pressures out in the field yeah and I don't know Edwin do you want to take that or do you want me to.

Amy Wiatr-Rodriguez: Sure yeah so we we we reviewed and in terms of the amount of work and review and processes, we certainly want to to initiate and get started on this.

Amy Wiatr-Rodriguez: So that we can actually have a revision that we were able to get out there and implement Certainly this is not the only opportunity through the RSI to give feedback but it's one that we are starting with, and so I don't know Edwin anything else you want to add to that.

Edwin Walker: No that sounds perfect amy actually.

Edwin Walker: responded to some of the questions that we're getting in writing so.

Edwin Walker: Perfect continue right on.

Amy Wiatr-Rodriguez: Okay wonderful so another question that i'm seeing is and and mercia or anyone if there is somebody who wants to ask a question verbally, please, please interject and i'll just keep looking at the chat until we hear if there's somebody who wants to ask a question verbally.

Amy Wiatr-Rodriguez: So there's another question, do you recommend reviewing the law and the regulations and comment on the discrepancies.

Amy Wiatr-Rodriguez: Certainly that is is one approach, however, you would like to go about it, you know reviewing the law, the regulations, as well as experiences that you've had.

Amy Wiatr-Rodriguez: In in providing services or receiving services we're not prescribing any particular way to go about that again Edwin anything you want to add.

Edwin Walker: No you're you're great.

Amy Wiatr-Rodriguez: Okay.

Amy Wiatr-Rodriguez: Okay okay keep going all right, another question, is there a primary goal in this process, for example, creating more flexibility.

Amy Wiatr-Rodriguez: I think there are multiple goals you know one is making sure that the Act and the the regulate that the regulations are able to support implementation of the Act and again as we've said because of the multiple reauthorization.

Amy Wiatr-Rodriguez: Since the the regulations for last updated their current isn't currently isn't a lot of alignment, certainly, we would also.

Amy Wiatr-Rodriguez: You know, in areas where maybe creating more flexibility is possible, again, as we are authorized to do under the act, we certainly would appreciate your comments and suggestions recommendations on that.

Amy Wiatr-Rodriguez: And yeah we're we're we're very open I don't know that it's one particular primary goal just a lot, a lot of work that's overdue to really again make sure that the regulations can help support the implementation of the act.

Amy Wiatr-Rodriguez: Okay, another question is, is there a reason that other titles are not included, for example, substantial changes and additions have been made to title for by the various three authorizations.

Amy Wiatr-Rodriguez: So with that one, I will say number one, we need to start somewhere, you know the the whole thing like, how do you how do you whatever eat an elephant is one bite at a time, we need to break off a chunk that we can start that's.

Amy Wiatr-Rodriguez: Where we can begin and another thing to consider is that while there may be changes that were made for reauthorization.

Amy Wiatr-Rodriguez: We also see that the bulk of the appropriations, so, in other words the funding to actually implement things is entitled, three, six and seven, and so we are prioritizing and focusing on those titles.

Amy Wiatr-Rodriguez: Okay.

Nicole Becerra: Okay amy i'm going to interject and i'm going to unmute Joe Hannah she has a question.

Nicole Becerra: Johanna Schneider if you can hear me, you can unmute yourself and speak.

sorry about that um I was wondering if there has been any consideration into putting in I understand that this would be quite difficult but.

Right now, the older Americans act, there is no table of contents or dependencies or anything to help navigate this very long document.

And it is difficult, at least at the State level, to be able to reference it I know when we work with our Community partners, there are times that they want to reference the older Americans act and we have to go back through and say Where are you seeing this.

We have to ball state policy, let me review this and make sure that we're on the same page.

Amy Wiatr-Rodriguez: yeah so when it comes to actually making changes to the older Americans act that would be outside of this process because again that's changing the law.

Amy Wiatr-Rodriguez: So that that's outside of this process, but certainly making comments in terms of perhaps regulations, making sure that they are easy to navigate and again the regulations are to help implement the older Americans act.

Amy Wiatr-Rodriguez: We certainly would appreciate and encourage you to make any comments like that that you think would be helpful for the regulations that makes sense.

Nicole Becerra: Thank you amy the next person i'm going to unmute is Karen Karen you can go ahead and unmute yourself and ask your question.

Karin NeviusKifkoff@1: So I think my hand was up by accident, so please.

go on to the next.

Nicole Becerra: Thank you for that OK, the next person that i'm going to unmute is Adam Adam willowy you can unmute yourself.

Nicole Becerra: and ask your question.

Adam Willoughby: Great Thank you so much amy and for this presentation very helpful um i'm Adam Willoughby from state of California, and you know, we look forward to submitting some comments, I guess, my question is sort of like.

Adam Willoughby: along the lines of you know, the format of submission, so what I mean is that.

Adam Willoughby: I think in one instance we could provide some explicit language modifying an existing regulation in other instances we have sort of identified topics for consideration, but not necessarily language right.

Adam Willoughby: We would think that you know getting to the point of you know, agreeing on some language would be a deliberative process and we're just not there yet right, so we have like.

Adam Willoughby: One area where we could say hey here's some language to consider and then we have other areas where we say these these are areas of consideration that you know we'd like to dig into so just wondering if you could sort of expand on that a little bit Thank you.

Amy Wiatr-Rodriguez: yeah wonderful, thank you for that question, and we welcome all of it.

Amy Wiatr-Rodriguez: As much specificity as you're able to give, of course, we appreciate that, but we understand that there might be things to where you just your you can identify this as an issue I might not know how to resolve it.

Amy Wiatr-Rodriguez: But yes, we welcome that all and thank you for raising that that point encourage everyone, you know with what Adam said if if you, no matter how detailed or you know if it's just more of a general.

Amy Wiatr-Rodriguez: Recommendation we welcome at all.

Nicole Becerra: In pune amy and going to now unmute Nancy D Miller and Nancy you can unmute yourself and ask your question.

Nancy D Miller: Thank you so much.

Nancy D Miller: i'm the executive director CEO of an agency serving people who are blind and.

Amy Wiatr-Rodriguez: Oh, am I.

Amy Wiatr-Rodriguez: To be loose Nancy.

Nicole Becerra: Know please unmute yourself again i'm sorry.

Okay.

Amy Wiatr-Rodriguez: yeah I can hear you now, thank you.

Nancy D Miller: Okay, we operate in an older adult Center that is funded through the older Americans act and many of our staff are blind.

Nancy D Miller: I would like to share the PowerPoint and the regulations with them, are you aware, if those are accessible to staff reading through a screen reading software, will they be able to access that information.

Nancy D Miller: And also, we offer six evidence based programs, and one of the problems that we've encountered is that the training is not accessible for blind instructors Is that the kind of feedback that you're looking for.

Amy Wiatr-Rodriguez: The answer is yes and yes to both of your questions, yes we're ensuring that the slides the presentation will meet five await accessibility and, yes, we welcome your your feedback on on the issues that you're encountering there, thank you.

Nancy D Miller: Thank you.

Nicole Becerra: Thank you Nancy the next person i'm going to be a meeting is trudy.

Nicole Becerra: trudy you may unmute yourself and ask your question.

Trudy Gaillard: Good afternoon, thanks for taking my question got too much stuff yeah.

Trudy Gaillard: I am have recently started volunteering.

Trudy Gaillard: With.

Trudy Gaillard: agencies that work with older adults and what we find is that.

Trudy Gaillard: Because of the backlog, and I know that.

Trudy Gaillard: Because.

He kind of said that.

Trudy Gaillard: yeah yeah.

Amy Wiatr-Rodriguez: yeah yeah.

Amy Wiatr-Rodriguez: Getting some back back feedback here, and I think I, it was a little bit hard to hear at the end, but I think you were referencing that the needs for additional funding and absolutely That is something that we you know realizes a need and have heard before.

Amy Wiatr-Rodriguez: However, the regulations process isn't really a process that that affects the funding that's, something that would happen through an appropriations process.

Amy Wiatr-Rodriguez: The regulations are more target or more geared toward, how do you implement what do you do with the funding that has been received, but it is not changing the regulations will not have any impact on the funding that that's appropriate for the programs that's a different process.

Trudy Gaillard: Okay, thank you.

Amy Wiatr-Rodriguez: But definitely have an issue absolutely, thank you for raising that and thank you for volunteering.

Nicole Becerra: Thank you, the next person i'm going to unmute is Todd coffee Todd you may unmute yourself.

Amy Wiatr-Rodriguez: And i'm not hearing anything from Todd.

Todd Coffey: Try it now, can you hear me yeah yeah.

Todd Coffey: So we are in the process, trying to increase flexibility of our regulations in Colorado and we're, starting with the regulations, because it has precedent over the policy and procedure and i'm wondering if there was any consideration to start with the.

Todd Coffey: reauthorization of the older Americans act and then move to the CFR, because any flexibility is going to be contingent on the older Americans act supporting that change in the CFR and if that's not going to be possible if there's a way to make sure that there's not duplicative.

Todd Coffey: language and the CFR that existed in the older Americans acting that way, if something does change and the older Americans act, we will be able to go in later and change the CFR.

Todd Coffey: census happens, you know once every 40 or 50 years, I just want to make sure that we get it right, the first time.

Amy Wiatr-Rodriguez: yeah.

Amy Wiatr-Rodriguez: Great observation I think, where we are is, we have the law, but the current law is and we are looking at regulations to.

Amy Wiatr-Rodriguez: implement the current law.

Amy Wiatr-Rodriguez: If the law were to change in the future, that would be then a process then to go through and revise the regulations at that point in time to comply with the law.

Amy Wiatr-Rodriguez: But I think it may be, would be premature to assume that you know, the law is going to change or to know what the changes are.

Amy Wiatr-Rodriguez: So we're kind of living in in the reality of where we are right now but but definitely appreciate and again encourage you to share any feedback like that that you have in terms of you know, making sure that.

Amy Wiatr-Rodriguez: You know that the act is appropriately flexible where you think it should be appropriately prescriptive where you think it should be.

Nicole Becerra: Thank you, and it looks like we have a question from Chris grant you can unmute yourself and ask your question.

Criss Grant: Sorry, that was an accident for my hand to be raised, thank you.

Nicole Becerra: Thank you Okay, and looks like we have another question from Daphne.

Nicole Becerra: canal, you may unmute yourself and ask your.

question.

Dabney Conwell: Thank you.

Dabney Conwell: I was asking if we could put the oh a rag links into the chat so that we could have access to those before the powerpoints go live within the 14 days.

Amy Wiatr-Rodriguez: yeah yes, let me see if I I don't know that's something that i'm not sure, maybe Nicole or Chris, would you be able to help with that.

Amy Wiatr-Rodriguez: And I think you.

Nicole Becerra: I can, I can put the links up, as well as we are able to send out the PowerPoint to.

Nicole Becerra: attendees today.

Nicole Becerra: We can send that PowerPoint out, however, the transcripts and the recording will not be available just yet, so please be mindful of that just the PowerPoint will be sent within the next 24 hours.

awesome Thank you.

Nicole Becerra: looks like Jeff beat me to putting the.

Nicole Becerra: link up, so the next person.

Nicole Becerra: Who has their hand up is Sarah i'm going to unmute you, you may ask your question.

Sara Candelaria: Can you hear me yeah.

Amy Wiatr-Rodriguez: Go ahead, sir.

Sara Candelaria: Good morning from new Mexico i'm just looking at all the postings and the announcement about these regulation review has really had me thinking about a lot of things.

Sara Candelaria: As a service provider we do what we can to make sure that we're following the regulations and the guidelines, but to make sure that i'm understanding this correctly.

Sara Candelaria: What you're asking for his feedback on, you know how we can improve operations and expand services with regard to the regulations correct.

Amy Wiatr-Rodriguez: I think that's a good way of putting it.

Sara Candelaria: Okay, and and it's i'm just trying to get some clarity, because I know a lot of tribal providers I don't know how many are on this call, but.

Sara Candelaria: They seem to get intimidated by things like this and we, when we come together, we all talk about the challenges that we face, and you know the obstacles that some of these regulations, create and I just want to make sure that if they're on the understand it yeah and I know i'm.

Sara Candelaria: One of the things was lowering the the age eligibility we've been trying to work with the state and which they did, but no additional funding was provided to accommodate the H lowering the age eligibility there's just a high rate of.

Sara Candelaria: Health disparities and then country, especially in rural areas that it's really hard to meet the.

Sara Candelaria: State at age within the regulations, because you know a lot of our elders unfortunately because of these health disparities don't make it to that age so we're looking at.

Sara Candelaria: The way and i've understood this i've been doing this now for eight years, is that the this Title six program is really more so, a prevention method for elders who are of age to receive services but.

Sara Candelaria: I was really looking at something more towards intervention at a younger age to help our elders REACH.

Sara Candelaria: In 60 and older because that's one of the challenges we face and i've done my best to be a good advocate, but I just want to make sure that this requests for the feedback on the regulations had to do with some of those issues that that we talked about.

Amy Wiatr-Rodriguez: yeah Thank you so much for those comments Sarah I think you know, I was trying to write notes a couple of different things that you said.

Amy Wiatr-Rodriguez: Number one we don't want anyone to feel intimidated by the the comments that you submit.

Amy Wiatr-Rodriguez: So please you know it we like plain language to, as you can identify a problem or something that you've talked about with your peers or colleagues, you don't need to make it fancy or flowery.

Amy Wiatr-Rodriguez: You can just let us know that, of course, if you want to make it fancy or flowery or put a lot of detail in we're happy with that too.

Amy Wiatr-Rodriguez: Most mostly we just want your feedback we want you, we want to know what you're thinking and what your concerns are.

Amy Wiatr-Rodriguez: Secondly, we we want to know your thinking and your concerns and I guess, I would encourage you to send those to us.

Amy Wiatr-Rodriguez: But, but again note, there are some things that that we may not be able to change again because there are things that are in the act so we can't change the law in this process and so.

Amy Wiatr-Rodriguez: You know, things were maybe their age requirements or other types of requirements we may not be able to change.

Amy Wiatr-Rodriguez: But I think I don't want to create a barrier of being like well i'm not sure what are what are those so just send that feedback to us.

Amy Wiatr-Rodriguez: But just recognize, we may not be able to make the change is recommended, but, but I think it's still helpful for us to know what it is that you would like to see changed.

Sara Candelaria: Thank you um one more thing is that I, I really when I first came into this position, it was kind of like being fed to the wolves I had no idea where to start, and of course we start at the regulations but.

Sara Candelaria: I think, having continued open dialogue with people such as yourself with with also with Edwin.

Sara Candelaria: And really review these regulations more often, rather than every so many years what really be more assistance than, then you know waiting until.

Sara Candelaria: You know i've been here, eight years, and this is the first time that we've really been presented this opportunity, but at the same time i'm working with our tribal leadership, I would really prefer.

Sara Candelaria: methods such as a, I guess, this time we can't because of the pandemic, but more tribal consultation, one on one tribal consultation with individual tribes just to kind of give them the opportunity to.

Sara Candelaria: voice their concerns and some of the challenges that they face, but that's that's just another thought, but we will be sending something this work i'm from the public's actually be in new Mexico so.

Sara Candelaria: i'm working with my tribal administrator so lots of governors to sent in a response, but thank you for this opportunity and Edwin it's good to see you and you just give away your age by telling me how long you've worked for acl.

Sara Candelaria: Thank you.

Amy Wiatr-Rodriguez: Thank you so much.

Nicole Becerra: Thank you.

Nicole Becerra: That was the last person that had their hand raised, however, their chat feature has quite a few questions we could continue to answer and as well as the question and answer section.

Nicole Becerra: If we can get to the chat section first only because I can copy the question and answer section to possibly do a transcript to respond, but I cannot copy the chat the chat so yeah.

Amy Wiatr-Rodriguez: Absolutely yeah i've got one up that I can go to, or do you want, do you want to read through Nicole.

Nicole Becerra: You can keep moving forward, I.

Nicole Becerra: Think at a pace there.

Amy Wiatr-Rodriguez: Okay, all right wonderful, so I see a question from amanda, how do you recommend we structure feedback for the national family caregiver support program policies without an existing CFR.

Amy Wiatr-Rodriguez: Specific for that program would a word document with challenges recommendations for additions or clarifications be appropriate.

Amy Wiatr-Rodriguez: Yes, that sounds great yeah and, as I said before, we appreciate as much specificity and detail as you're able to provide.

Amy Wiatr-Rodriguez: But if if all you have, if you have just general things and don't really have that specific detail, we welcome that, and we welcome whether it's in a word, document or excel i'm happy to see we're happy to review that whatever whatever format I think works for you, we We appreciate that.

Amy Wiatr-Rodriguez: Okay.

Amy Wiatr-Rodriguez: All right, so I see a comment from lori would support language change to move from client cost share to recommended sliding contribution scale.

Amy Wiatr-Rodriguez: Again share share your your feedback share your recommendations and recognize that there may be some things that are in the Statute that again we can't conflict with but certainly want to see how we might be able to you know best implement the law in the regulations.

Amy Wiatr-Rodriguez: let's see I think this was Joe hannah's comment about the table con alone.

Amy Wiatr-Rodriguez: Are you seeking input on senior corps as well.

Amy Wiatr-Rodriguez: I believe, specifically, that would be outside the context of Title three six or seven However, if you have comments that maybe are about coordination with Title three, six and seven.

Amy Wiatr-Rodriguez: i'm not i'm not sure what what feedback, you might have so as long as it's in it's relevant to Title three six or seven of the older Americans act, yes, we we welcome that.

Amy Wiatr-Rodriguez: see a question from Melanie is acl going to be keeping track of the changes thought that cannot be made in the regulation, because of the limitations in the older Americans act statutory language.

Amy Wiatr-Rodriguez: I think yeah that's a great point and something that we've talked about internally like this might be good to help us understand what things that network might like to see in a future reauthorization.

my Wiatr-Rodriguez: let's see and it's talking asking interested in hearing other state units on aging or working collaboratively with long term care Ombudsman or other agencies to submit one set of comments from multiple agencies.

my Wiatr-Rodriguez: Or if most states are encouraging partners to submit individually and again we're happy with with all of the above, whatever whatever coordination you.

Amy Wiatr-Rodriguez: would like to do, or, if you want to do things, individually or both, I i've heard from at least one aging network partner that they that that may be the the options that that both things are are pursued.

Amy Wiatr-Rodriguez: See.

Amy Wiatr-Rodriguez: Michael is noting with the major disaster declaration there was more flexibility and program like Title three be for services like grocery bags to address food scarcity and Title three see for home delivered meal options, despite many of the relief packages.

Amy Wiatr-Rodriguez: Our nutrition providers are struggling with administrative costs, we are concerned about sustaining these rates and request for increases beyond.

Amy Wiatr-Rodriguez: federal fiscal year 24 and it's again, you know kind of this is one of those areas where we're the regulations aren't able to address appropriations appropriations is getting money for the services and the programs.

Amy Wiatr-Rodriguez: And this isn't the process for that that would be the appropriations process but certainly if there are considerations related to experiences that you had through the major disaster declaration.

Amy Wiatr-Rodriguez: or some of the innovations and new service models or new services that were provided that you would like to see continued enhanced you know addressed in the regulations in any way.

Amy Wiatr-Rodriguez: Those are some perfect examples of things that we also would like to hear from you on in terms of your feedback for the regulations.

Amy Wiatr-Rodriguez: And sorry and can flexibility and the regulations process provide more flexibility for some of these funding issues as experienced during the pandemic I think yeah just kind of, as I said.

Amy Wiatr-Rodriguez: Would recommending lowering the age, this is from Lynn would recommending lowering the age eligibility requirement for the grandparents and relatives as parents, the appropriate in this process.

Amy Wiatr-Rodriguez: Again, certainly sharing any feedback but recognizing their things that may be in the older Americans act law that set certain age requirements that we would not be able to change through this regulations process.

Amy Wiatr-Rodriguez: Okay.

Amy Wiatr-Rodriguez: Seeing the link for the regs okay going through that.

Amy Wiatr-Rodriguez: blake says, please make sure that any changes flow forward to the a 133 compliance supplement great comment.

Amy Wiatr-Rodriguez: let's see question from oh go ahead.

Edwin Walker: Go ahead, I was just gonna say there was a similar or related comment in the question and answer which I answered in writing perfect it related to where we go into include aspects from our fiscal guides.

Edwin Walker: And the answer is clearly we are looking to have fiscal guiding regulations as well during this brief.

Amy Wiatr-Rodriguez: Absolutely.

Amy Wiatr-Rodriguez: Great.

Amy Wiatr-Rodriguez: And so amanda is adding on to the question regarding evidence based leader curriculum not available for people who are blind.

Amy Wiatr-Rodriguez: If a curriculum did not meet Ada compliance would acl be responsible for regulating the organization that created the content and how could would that affect other providers from delivering that Program.

Amy Wiatr-Rodriguez: I think those are concerns and questions that if you have thoughts suggestions for us on that, again, we very much would appreciate your feedback on that.

Amy Wiatr-Rodriguez: Again, the regulations are really how to implement the law so any of those types of implementation considerations are things that we are very interested in hearing your feedback on.

Amy Wiatr-Rodriguez: let's see there is a question will questions ideas comments submitted in the RSI be publicly available, and that is one i'm not sure exactly on I don't know add one, do you know the details on that.

Amy Wiatr-Rodriguez: I believe we address it by just don't remember that the.

Edwin Walker: answer is that.

Edwin Walker: The actual comments are not going to be publicly available, but when we respond with regard to our preamble in our notice of proposed rulemaking and certainly in our final rule will be summarizing the types of comments we proceed so that they will be categorized.

Amy Wiatr-Rodriguez: Okay, all right, and then a question from Tina does acl have a proposed timeframe for releasing the revised regulations for these titles and edwin's laughing I knew he would.

Amy Wiatr-Rodriguez: Because a lot of this is is quite honestly, out of our control I mentioned, we have to go through review processes internally within a cl and hhs and others and so.

Amy Wiatr-Rodriguez: We are working as quickly as we can to to do this in being mindful of we want to get you know feedback we need to do these you know steps in the process, but in terms of being able to give a date.

Amy Wiatr-Rodriguez: That is beyond our control as soon as we know, any updates and things we certainly will share them any steps in the process, as we go through any updates that we have to that we will share them as as quickly as possible.

Amy Wiatr-Rodriguez: Lynn is asking how do you intend to approach the national family caregiver support program since it did not exist in 1988.

Amy Wiatr-Rodriguez: And I think we want to approach it based on your feedback based on your comments.

Amy Wiatr-Rodriguez: Certainly, will also base it on our experiences and our you know thoughts things that have come up to us, but we, this is one of the things we definitely want to hear from you on and we need to hear from you on so that we can you know do do it justice.

Amy Wiatr-Rodriguez: and Michael is commenting good question on national family caregiver support program they had a discussion, how they could expand coverage for adaptive technology.

Amy Wiatr-Rodriguez: and other supplemental services, giving many seniors are still not attending senior centers.

Amy Wiatr-Rodriguez: again welcome that kind of feedback exactly those are the types of things that we want to hear about how can, how can the regulations help guide implementation of the law based on our experiences and where we are right now.

Nicole Becerra: amy it looks like we're getting to time.

Amy Wiatr-Rodriguez: All right.

Nicole Becerra: yeah so many questions so many great questions I have been able to record the questions in the question and answer section, so we can at least write a written response for those questions and again we can send out the PowerPoint.

Nicole Becerra: However, the recording and the transcripts will not be available just yet, so we will send links for those as well.

Amy Wiatr-Rodriguez: Great, and so I guess Edwin you want to have the last words here just thanking everyone.

Edwin Walker: Sure, I definitely want to thank you all this has been a tremendous turnout, thank you for the questions continue to send us information that's what the.

Edwin Walker: Request for information was all about.

Edwin Walker: As I indicated, from the very beginning, we cannot do this or we don't want to do this without you we want to be reflective of you, and what you are experiencing as program administrators and.

Edwin Walker: Individuals dedicated to the field of aging and we're all doing this on behalf of older people to improve their lives and their quality of life, thank you again so very much have to thank you amy you did a tremendous job, thank you, Nicole, and all the support both thank our current.

Edwin Walker: person as well, thank you so very much everyone have a great day.