Back to Basics: Stewardship, Oversight, and Advocacy Responsibilities

Edwin Walker, Senior Advisor

Alice Kelsey, Deputy Director for the Administration on Aging

Percy Devine, Regional Administrator

Costas Miskis, Regional Administrator

February 15, 2024

Administration for Community Living (ACL)

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Welcome

Edwin Walker, Senior Advisor

Kari Benson, Deputy Assistant Secretary for Aging 

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Agenda

Back to Basics

Final Rulemaking and Implementation

Advocacy

Oversight, Monitoring, Data & Reporting

Resources 

Please note: When a hyperlink is provided on a slide, the notes section will include the full website link.

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What does back to basics mean?

Meeting the mission and vision of the Older Americans Act (OAA) by holistic program management:

Program, fiscal, data, evaluation, training, communications, policies & procedures, all in alignment 

Maintaining integrity of advocacy activities; and 

Targeted, effective, efficient activities

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Back to Basics: Why now? 

Coincides with the first comprehensive update to OAA program regulations in 36 years 

Emerging from the COVID-19 pandemic 

Recent spate of retirements

New and developing business opportunities

Increased interest in stewardship of public funds

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What does a balanced, collaborative approach look like?

Collaboration is required in the mission of both State agencies and area agencies (§ 1321.5 Mission of the State agency; § 1321.55 Mission of the area agency).

Development of your Aging Network 

State and Area Plans on Aging (§ 1321.27; § 1321.65)

Coordination with Tribes and Title VI grantees (§ 1321.53 State agency Title III and Title VI coordination responsibilities; § 1321.69 Area agency on aging Title III and Title VI coordination responsibilities; § 1321.95 Service provider Title III and Title VI coordination responsibilities; § 1322.31 Title VI and Title III coordination)

Policies and Procedures (§ 1321.9 State agency policies and procedures; § 1321.59 Area agency policies and procedures; § 1321.73 Policies and procedures [Service providers])

Communications and training 

Working with boards, committees, commissions on aging, and other partners

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What does stewardship really mean?

We cannot achieve the vision and goals of the OAA without proper stewardship of federal spending 

OAA grantees and sub-grantees must meet all applicable laws, regulations, and terms and conditions of Federal awards

Staying focused on the intent of the OAA: serving older adults in greatest social need (GSN) and greatest economic need (GEN) (§ 1321.3 Definitions, § 1321.27 Content of State plan; § 1321.65 Submission of an area plan and plan amendments to the State agency for approval.)

Ensuring conflicts of interest (COIs) are appropriately addressed (§ 1321.47 Conflicts of interest policies and procedures for State agencies; § 1321.67 Conflicts of interest policies and procedures for area agencies on aging)

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Final Rule making & Implementation 

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Final rule as published: https://www.govinfo.gov/content/pkg/FR-2024-02-14/pdf/2024-01913.pdf

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Purpose of the Final Rule Updating the OAA Regulations

Update regulations to align with the current statute

Reflect the needs of today’s older adults

Promote appropriate stewardship of OAA resources

Clarify programmatic requirements

Support the national aging network that delivers OAA services

Improve program implementation to better serve older adults and caregivers

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Effective and Compliance Dates

Effective Date: 30 days after publication in the Federal Register, or March 15, 2024. 

Compliance Date: October 1, 2025. 

As the final rule goes into effect, we look forward to providing technical assistance and engaging with stakeholders regarding implementation of the final rule.

For State Units on Aging (SUAs) that are unable to meet the October 1, 2025 compliance date, ACL will have a supportive corrective action process in place.

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Layout of the Final Rule:​Preamble (Sections I-III) & Regulatory Text

The Final Rule has two basic sections:​

The first portion is preamble:​

Background​, explanation of provisions of the final rule, analysis and responses to public comments​, required regulatory analyses​

The second portion is the final regulatory text in full for 45 CFR parts 1321 (Title III), 1322 (Title VI), and 1324 (Title VII)

For a more detailed orientation to the final rule (e.g., slides from the 2/8 national stakeholder webinar, additional resources), please visit ACL's OAA Regulations webpage: https://acl.gov/OAArule

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CFR = Code of Federal Regulations

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General Note on the OAA Final Rule

The vast majority of what is included in the final rule are long-established OAA requirements – i.e., reaffirming what is in statute, prior regulations, or existing policies – rather than new requirements. 

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Questions to ask when it comes to requirements and flexibilities: 

Is this an OAA law or regulation requirement? 

Is it another federal law or regulation? 

Is this a state policy or procedure? 

Is this an area agency on aging (AAA) policy or procedure? 

Is this a local service provider policy or procedure? 

Based on who is responsible for the requirement, what are your options for changing it or advocating for changing it?

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Policies and Procedures 

Policies and procedures at the state, AAA, and service provider level are essential for proper stewardship of Federal grant funds, and must meet the following requirements (not an exhaustive list): 

Older Americans Act, Public Law (P.L.) 89-73 as amended through P.L. 116-131, enacted March 25, 2020.

Executive Orders

45 CFR parts 1321, 1322, 1324: Older Americans Act Regulations

45 CFR part 75 & 2 CFR part 200: Uniform Administrative Requirements, Cost Principles, and Audit Requirements 

ACL policies and procedures

Award terms and conditions

State and local laws and regulations 

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Review how you currently implement OAA requirements 

Identify existing:

Policies and procedures

Administrative rules

Program manuals, training materials 

Program instructions, area plan templates

AAA and/or service provider contracts  

Reporting requirements

Review and assess

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Decide how you will make updates

Identify what needs to be updated

Your SUA’s existing policies and procedures may already fully meet OAA Final Rule requirements

E.g., § 1321.49 Intrastate funding formula

Some OAA Final Rule requirements allow the SUA to exercise certain flexibilities, at the SUA’s option

E.g., § 1321.101 Flexibilities under a major disaster declaration

Prioritize – where will you start? How will you break into manageable bites?

Identify who is responsible for determining the what/who/how

One or more individual staff members?

Workgroups?

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Identify who needs to be involved in the updates 

State, AAA, service providers (§ 1321.7 Organization and staffing of the State agency; § 1321.57 Organization and staffing of the area agency; § 1321.79 Responsibilities of service providers under State and area plans); Tribes, Tribal organizations, and Title VI program directors (§ 1322.19 Responsibilities of service providers; § 1322.31 Title VI and Title III coordination)

Executive leadership; 

Program managers;

Board/Advisory Council members (§ 1321.63 Area agency advisory council);

Community members via public input processes; 

Staff members and volunteers; 

Workgroups; and/or

Other

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Collaboration Examples

Example: addressing new “greatest social need” definition (§ 1321.3; § 1321.27; § 1321.65)

May review data, conduct public input process, meet with AAAs/service providers, discuss with organizations serving identified populations

Example: state fiscal staff to review compliance with existing fiscal requirements (§ 1321.9(c)(2))

May create cross-departmental workgroup to ensure fiscal, data, and program management are aligned

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How will you communicate updates? 

Consider your collaborative approach toward communicating revised guidance, program manuals, contracts, etc.:

Centralized website repository of documents

State and local conferences 

Webinars 

SUA meetings with AAAs; AAA meetings with service providers 

Workgroups 

Meetings with tribes and tribal organizations 

Facilitating peer-to-peer sharing opportunities

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Once updates are made...

How will you monitor them? 

How will you evaluate them? 

How will you periodically review, update, and train your network? 

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Advocacy

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Celebrating the Older Americans Act

“The Older Americans Act clearly affirms our nation’s sense of responsibility toward the well-being of all of our older citizens. But even more, the results of this act will help us expand our opportunities for enriching the lives of all of our citizens in this country, now and in the years to come.” 

President Lyndon B. Johnson upon signing the OAA in 1965

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Advocacy 

The role of the State agency is to, 

“serve as an effective and visible advocate for older individuals by reviewing and commenting upon all State plans, budgets, and policies which affect older individuals and providing technical assistance to any agency, organization, association, or individual representing the needs of older individuals[.]” -OAA Section 305(a)(1)(D)

The AAA will,

“serve as the advocate and focal point for older individuals within the community by (in cooperation with agencies, organizations, and individuals participating in activities under the plan) monitoring, evaluating, and commenting upon all policies, programs, hearings, levies, and community actions which will affect older individuals[.]” -OAA Section 306(a)(6)(B)

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AAA Advocacy Responsibilities

Special advocacy responsibilities apply upon designation as a AAA (§ 1321.19 Designation of and designation changes to area agencies; § 1321.61 Advocacy responsibilities of the area agency.)

Serve as public advocate for the development and enhancement of comprehensive and coordinated community-based systems of services in each community throughout and specific to each planning and service area (PSA) (§ 1321.13 Designation of and designation changes to planning and service areas.)

Understand the needs of and represent the best interests of older adults and caregivers (particular attention on greatest social need and greatest economic need) at all levels (from local, county, regional to federal) and in interactions with different advocacy organizations, collaborations, and coalitions (§ 1321.3).

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Examples of Effective Advocacy

Additional funding for services, expansion of services, elimination of wait lists

Better outreach and support to those in greatest social need and greatest economic need

Systems to better recognize and address needs of older adults and family caregivers

Addressing ageism and promoting age-friendly policies

Participation in advocacy coalitions

Education to local, state, and federal legislators and decision makers

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State and Area Plans on Aging

The State agency is required to submit a state plan, that is informed by area plans, and have input processes (§ 1321.27; § 1321.29 Public participation).

The AAA is required to submit an area plan that is informed by local needs and public input (§ 1321.65).

State and area plans can be used in promoting 

your local and state advocacy messages.

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Conflicts of Interest

Because of the advocacy responsibilities, ensuring conflicts of interest avoided, identified, and remedied at the individual and organizational level is critical to the integrity of the OAA (§ 1321.9; 1321.59).

COI provisions of the final rule help to ensure that State agencies, AAAs, and service providers carry out the objectives of the Act consistent with the best interests of those they serve (§ 1321.47; § 1321.67)

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Oversight, Monitoring, Data & Reporting

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Oversight and Monitoring

The OAA final rule: 

Clarifies the state agency’s and AAA’s responsibility to establish and maintain policies and procedures to monitor the programmatic and fiscal performance of programs and activities carried out under Title III of the OAA (§ 1321.9(a) and (b); § 1321.59(a) and (b)).

ACL is responsible for ensuring grantees are conducting oversight and monitoring of OAA programs & requirements

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Program Oversight & Monitoring  

Monitoring can include:

Identifying risks

Utilizing a checklist or other monitoring tool

Reviewing audit reports

Holding regular touch base meetings with subgrantees

Reviewing monthly/quarterly/annual fiscal and program data reports 

Observing program activities (e.g., conducting site visits, attending classes, presentations, or public hearings)

Reviewing technical assistance and other questions

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Program Monitoring Examples 

An SUA compares a AAA’s program reports with, and assesses progress on, the goals in their area plan (§ 1321.9(c)(4); § 1321.65).

A AAA conducts a site visit to a nutrition program provider to ensure they are:

meeting dietary, health, safety and other program requirements (§ 1321.59(b); § 1321.87 Nutrition services),

targeting priority service populations (GSN, GEN) (§ 1321.3; § 1321.83 Client and service priority), and

submitting accurate data on their reports (§ 1321.9(b)).

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Fiscal Oversight & Monitoring 

It is critical to have effective systems in place to ensure appropriate and efficient oversight:

The rule includes various requirements for State agencies to establish fiscal policies and procedures related to the Act (§ 1321.9(c)(2)) and AAAs to establish policies and procedures in compliance with those (§ 1321.59(a)).

e.g., match, transfers, maintenance of effort 

The State agency is responsible for monitoring the program and financial activities of subrecipients and subgrantees, including: 

(i) Evaluating each subrecipient's risk of noncompliance to ensure proper accountability and compliance with program requirements and achievement of performance goals;

(ii) Reviewing subrecipient policies and procedures; and

(iii) Ensuring that all subrecipients and subgrantees complete audits as required in 2 CFR part 200, subpart F and 45 CFR part 75, subpart F.

The AAA is also responsible for monitoring service providers in compliance with the AAA’s policies and procedures (§ 1321.59(b)).

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Fiscal Monitoring Examples

Conduct financial monitoring activities (§ 75.341-.343 Performance and Financial Monitoring and Reporting)

Reconcile 

invoices to actual served

reimbursement requests to actual expenditures

advance payments to actual expenditures (§ 1321.9(c)(2)(xviii))

Separation of duties, with appropriate controls in place, including where cash is received (e.g., program income)

Program income properly reported and expended (§ 1321.9(c)(2)(xii))

Reviewing documentation of in-kind expenditures 

Review expenditures to ensure meeting Long-Term Care Ombudsman (LTCO) expenditure minimums (§ 1321.9(c)(2)(vii))

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Program Reporting Requirements 

ACL has implemented a national reporting system (Older Americans Act Performance System (OAAPS)). 

State Program Report (SPR): States, AAAs, and service providers are required to collect and report data on their OAA Title III (except Ombudsman) & Title VII Chapter 3 & 4 program activities (OAA Section 307 and Final Rule § 1321.9(b)) 

National Ombudsman Reporting System (NORS): The State Ombudsman is required to collect and report data on their Ombudsman program activities (Title III and VII) (§ 1324.13(g) [Functions and responsibilities of the State Long-Term Care Ombudsman])

Title VI Program Performance Report (PPR): Title VI grantees are required to collect and report data on their program activities (§ 1322.13(b) [Title VI policies and procedures]).

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Ombudsman Reporting Requirements 

The State agency must require the Ombudsman program to submit an annual report that (OAA section 712(h)):

describes the activities carried out by the Office, 

evaluates problems experienced by residents, 

analyzes the success of the Ombudsman program, and 

makes recommendations to improve the quality of life of residents. 

The annual report shall provide various information including analysis of Ombudsman program data (§ 1324.13(g))

This information is separate from and in addition to the data reported annually to ACL through the National Ombudsman Reporting System (NORS). 

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Other Program Reporting Requirements

Your SUA, AAA, Tribe/Tribal organization, and/or service provider may:

Incorporate data projections into State/area plans or other internal planning activities

Have additional reporting expectations

Use various software platforms to gather data submitted to ACL via OAAPS 

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Why The Network Collects Data on OAA Programs

Demonstrate Accountability & Stewardship 

Justify Continued Programming & Increases in Funding

Educate & Advocate

Understand Needs & Trends

Manage Programs

Drive Program Improvement

Improve Allocation of Resources

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ACL’s Use of Data in Our Stewardship, etc.

We use the data you share with ACL  to demonstrate accountability and stewardship:

Budget Justification and Related Documents

Annual Performance Plan and Report

Older Americans Act Report to Congress

Other: Risk Management, Government Accountability Office (GAO), Congressional inquiries

Impact of the OAA

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https://acl.gov/sites/default/files/common/OlderAmericansImpact2019.pdf 

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Targeting & Efficiency

How do you use the data you collect?

Targeting: Serving those with greatest social need & greatest economic need? (§ 1321.3)

What: Menu of services you (or subrecipients) are providing?

§ 1321.85 Supportive services; § 1321.87 Nutrition services; § 1321.89 Evidence-based disease prevention and health promotion services; § 1321.91 Family caregiver support services. § 1321.93 Legal assistance

Efficiency: Units per person served and expenditures per unit? With what sources of funding?

Who do your share your data with: Reports to local, regional, tribal & state entities?

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Quality

Does the data reflect reality?  

Is the data accurate & complete?

If so, are you happy with the reality or do you want to change it?

Does your program data reflect your policies and goals?

Do you want to change your policies and goals?

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Stewardship: Maintaining Balance

Quality

Targeting

Efficiency

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Resources

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Timeline Review

The OAA final rule is effective on March 15, 2024. 

ACL will provide training, technical assistance, and work with state agency and tribal organization grantees to come into compliance.

AAAs should work closely with their state agency and service providers should work closely with their AAAs or state agency for single planning and service area (PSA) states. 

The compliance date is October 1, 2025. 

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OAA Final Rule Resources

The Older Americans Act Final Rule

ACL's OAA Regulations webpage: ACL.gov/OAArule

Recordings of and Slides from Webinars

Fact sheets 

ACL announcement and additional resources 

Information on upcoming webinars or trainings

Coming soon: Slides and recording of this webinar

Please join us for a “Back to Basics” webinar on Fiscal Policies and Procedures on 4/4 at 2 p.m. Eastern

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Final rule as published 2/14: https://www.govinfo.gov/content/pkg/FR-2024-02-14/pdf/2024-01913.pdf

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Upcoming

What’s next

March 18-21: Tribal consultation & Title VI conference: https://teya.swoogo.com/2024-title-vi

April 4: 2 p.m. Eastern – Back to Basics - Fiscal Policies and Procedures

Upcoming Sessions: 

Nutrition;

Legal Assistance and Guardianship;

State and Area Plans on Aging; 

Contracts & Commercial Relationships; 

Emergency and Disaster Requirements; 

Title III & VI Coordination;

and more.

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Thank You! 

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