Beth Stern: Taking the next step for older Americans

Editor’s note: This commentary is by Beth Stern, who is executive director of Central Vermont Council on Aging and president of the Vermont Association of Area Agencies on Aging.

President Obama signed the reauthorization of the Older Americans Act on April 19 — five years after the previous reauthorization expired in 2011. Those of us who are elders, or who work with elders, or who will someday be older should celebrate this long overdue action.

The Older Americans Act “affirms our nation’s commitment to the health and well-being of older adults.” The funding from the Older Americans Act makes up about half of the budgets of Vermont’s area agencies on aging, and supports core services which preserve the right of all older adults to live independently and with dignity, to participate in community, to volunteer, and to make their own decisions about their lives. This includes nutrition services, options counseling, transportation and other supportive services either contracted or done directly by agency staff.

The new act contains some important new provisions including encouraging the use of local foods in senior meals, encouraging intergenerational senior centers, promoting evidence based wellness programs, and increased technical assistance for transportation. Additionally the act will provide tools to assist elders and their families choose home based services, training on elder abuse prevention, support of better oral health, guidance on serving Holocaust survivors and much more.

However, signing the act is not enough. It would seem that something as bi-partisan as an act authorizing services to older Americans, one that took five years to authorize, must be pretty special. One would hope that the new Older Americans Act might actually mean that elder services, which have been underfunded for decades, would actually get the funding and attention they need and deserve.

It’s no secret that Vermont is an aging state. Each day, 23 Vermonters turn 65 and many will live well into their 80s and 90s.

 

Reality is unfortunately not the same as hope. The act contains modest increases of about 7 percent over the next three years, until 2019 when it will need to be reauthorized again. However, funding recommendations are just that – recommendations to the appropriators. Those who make the actual decisions on funding can take them or leave them. Elder services and programs could get the recommended increase, flat funding, or a decrease. It all depends on the will of our Congress, and we know how functional Congress is these days.

Older Americans Act funding is not in danger of being zeroed out, so those out there who rely on home delivered meals, caregiver support, options counseling or other services through your area agency on aging or our contractors should not panic. However, due to sequestration and other cuts, Older Americans Act funding levels are stuck at 2004 levels. While the state and federal government profess to be aware of the demographics facing us, funding levels remain woefully inadequate to account for inflation and the rising numbers of seniors. Without additional funding, some agencies serving elders will likely need to institute waiting lists or reduce services over the next few years.

It’s no secret that Vermont is an aging state. Each day, 23 Vermonters turn 65 and many will live well into their 80s and 90s. State Medicaid funding for Vermont’s hospitals and nursing facilities has risen steadily over the years – 32 percent for nursing homes over the last 10 years – while too many community providers struggle with deficits, stagnant wages, talent flight and downsizing. Vermont legislators just took an important first step to increase Medicaid rates by 2 percent to home and community-based services (including AAAs). While we are very grateful for the growing recognition among lawmakers that services from community providers like the AAAs, home health agencies and mental health providers are absolutely essential, we must continue to push for adequate funding into the future. Most community providers lack operating reserves, and far too many measure their “cash on hand” at just a few days. If we are to honor the desire of 95 percent of Vermonters to “age in place” — and the state’s avowed health reform priority to keep people at home — we cannot starve the providers who make this possible.

Those of us who work within this field were thrilled when the Older Americans Act passed and we thank our congressional delegation for their important part in moving this bill forward. However, our work is not done. May is Older Americans month. It’s a great time to demand increased, fair and adequate funding from the state and from the Older Americans Act — to support those very services which are supposed to help elders live at home, stay healthy, be involved in community and stay out of expensive nursing homes and emergency rooms. It’s not enough for the president to sign an “act” and feel good. We have to demand that it mean something more than the piece of paper it’s written on.

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