Testimony of

Kathy Greenlee

Assistant Secretary

Administration on Aging

U.S. Department of Health and Human Services

Before the

Special Committee on Aging

United States Senate

on

“Meals, Rides, and Caregivers: 

What Makes the Older Americans Act so Vital to America's Seniors”

May 26, 2011
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Thank you, Senator Kohl, Senator Corker, and Members of the Special Committee on 

Aging, for the opportunity to testify today at this hearing on the reauthorization of the 

Older Americans Act (OAA). Over the past year, the Administration on Aging (AoA) 

has conducted the most open process for seeking input on the reauthorization of the OAA 

in its history. I am pleased to discuss the input we received from across the country on 

this important legislation that provides vital home and community-based services to older 

adults and their caregivers, to summarize the important themes we have heard, and to 

highlight a few of the priority areas we would like to discuss with this Committee and the 

Congress as the reauthorization process moves forward.

At the outset, I would like to commend you, Senator Kohl, for your leadership as 

Chairman of the Special Committee on Aging, and for your many years of public service 

as an astute and effective advocate for policies that better protect and serve vulnerable 

Americans of all ages. We are particularly grateful for your many insights and for your 

stalwart support in shaping and improving our community- and family-based Older 

Americans Act programs, which play a vital role in helping to maintain the health and 

well-being of millions of older Americans.

For more than 45 years, the OAA has quietly but effectively provided nutrition and 

community support to millions of people across the nation. As the former Secretary of 

Aging from Kansas, and now having the honor to serve as the Assistant Secretary for 

Aging and listening to individuals and families in a variety of settings, I have seen and 

heard firsthand how the OAA reflects the American values we all share:
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Supporting freedom and independence;

Helping people maintain their health and well-being so they are better able to live 

with dignity; 

Protecting the most vulnerable among us; and

Providing basic respite care and other supports for families so that they are better 

able to take care of loved ones in their homes and communities for as long as 

possible, which is what Americans of all ages overwhelmingly tell us they prefer. 

One of the real strengths of the OAA is that it doesn’t matter if an individual lives in a 

very rural or frontier area, or in an urban center – the programs and community-based 

supports it provides are flexible enough to meet the needs of individuals in diverse 

communities and settings. Over the past year alone, nearly 11 million older Americans

and their family caregivers have been supported through the OAA’s comprehensive home 

and community-based system. These services complement 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 assistance to elders in their 

homes by delivering or preparing meals, or helping them with bathing. This assistance is

especially critical for the nearly three million seniors who receive intensive in-home 

services, half a million of whom meet the disability criteria for nursing home admission

but are able to remain in their homes, in part, due to these community supports. 

What is more, the need for this support is growing rapidly. Every day, more than 9,000 

baby boomers turn 65. In just four years, the population aged 60 and older will increase 
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by 15 percent, from 57 million to 65.7 million. During this period, the number of seniors 

with severe disabilities who are at greatest risk of nursing home admission and Medicaid 

eligibility will increase by more than 13 percent. 

The reauthorization of the Older Americans Act provides us with the opportunity to 

strengthen and build upon a long record of success in serving our families and 

communities, and to help meet the growing need. To support this discussion, over the 

past year the Administration on Aging received reports from more than 60 

reauthorization listening sessions held throughout the country, and received online input 

from interested individuals and organizations, as well as from seniors and their 

caregivers. This input represented the interests of thousands of consumers of the OAA’s 

services. We continue to encourage ongoing input and discussions.

During this process, we heard an overriding issue that was also raised during the 

conversations and activities of the Vice President’s Middle Class Task Force, and that is 

that many families are doing the best that they can, but that they are often struggling

between balancing the demands of child care and elder care. Families tell us that when 

they may need some help in supporting their efforts to care for loved ones, they don’t 

want assistance that is confusing or frustrating. They simply want to know where they 

can turn for some help. Something that’s easily accessible, without a lot of strings 

attached or hoops to jump through. And that, essentially, is what the OAA has been 

about since its enactment – listening to what our seniors and families need, and providing 

critical and cost-effective supports that help maintain the independence they want. 
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During our input process we were consistently told that, as it’s currently structured, the 

OAA is very helpful, flexible and responsive to people’s needs. During this process, we

heard a few themes:

Improve program outcomes by:

Embedding evidence-based interventions in disease prevention programs;

Encouraging broader partnerships and alliances that result in comprehensive, 

person-centered approaches; 

Providing flexibility to respond to local nutrition needs; and

Increasing efforts to fight fraud and abuse in Medicare and Medicaid.

Remove barriers and enhancing access by:

Enhancing caregiver supports to parents caring for their adult children with 

disabilities;

Ensuring that ombudsman services are available for all nursing facility residents, 

not just older residents; and

Utilizing Aging and Disability Resource Centers as single access points for longterm care information and to public and private services;

The following are some examples of areas that we would like to discuss with the

Congress as you consider legislation: 

Ensuring that the best evidence-based interventions for helping older 

individuals manage chronic diseases are utilized. A number of evidence-based 

programs have shown to be effective in helping participants adopt healthy 
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behaviors, improve their health status, and reduce their use of hospital services 

and emergency room visits. 

Improving the Senior Community Service Employment Program (SCSEP)

by integrating it with other seniors programs. The President’s FY 2012 budget 

proposes to move this program from the Department of Labor to the 

Administration on Aging within HHS. The goal of this move is to better integrate 

this program with other senior services provided by AoA. We would like to 

discuss adopting new models of community service for this program, including 

programs that engage seniors in providing community service by assisting other 

seniors so they can remain independent in their homes.

Combating fraud and abuse in Medicare and Medicaid by making 

permanent the authority for the Senior Medicare Patrol Program (SMP) as 

an ongoing consumer-based fraud prevention and detection program. The 

SMP program serves a unique role in the Department’s fight to identify and 

prevent healthcare fraud by using the skills of retired professionals as volunteers 

to conduct community outreach and education so that seniors and families are 

better able to recognize and report suspected cases of Medicare and Medicaid 

fraud and abuse.

The Older Americans Act has historically enjoyed widespread, bipartisan support. Based 

in part upon this extensive public input process, we think that reauthorization can 
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strengthen the Older Americans Act and put it on a solid footing to meet the challenges of 

a growing population of seniors and continue to carry out its important mission of helping 

elderly individuals maintain their health and independence in their homes and 

communities.

Thank you again, Senator Kohl and Senator Corker, for your leadership on these 

important issues and for the invitation to testify here today. I would be happy to answer 

any questions.