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1. Home
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3. Authorizing Statutes
4. Older Americans Act

# Older Americans Act

Older Americans Act

## About ACL

- About Community Living
- About the Aging and Disability Networks
- Mission & Vision
- Authorizing Statutes



  Developmental Disabilities Act
- Older Americans Act
- Workforce Innovation and Opportunity Act
- Elder Justice Act
- Health Insurance Portability and Accountability Act (HIPAA)
- Help America Vote Act
- Medicare Improvements for Patients & Providers Act
- Public Health Service Act
- Rehabilitation Act

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Congress passed the Older Americans Act (OAA) in 1965 in response to concern by policymakers about a lack of community social services for older persons. The original legislation established authority for grants to states for community planning and social services, research and development projects, and personnel training in the field of aging. The law also established the Administration on Aging (AoA) to administer the newly created grant programs and to serve as the federal focal point on matters concerning older persons.

Although older individuals may receive services under many other federal programs, today the OAA is considered to be a major vehicle for the organization and delivery of social and nutrition services to this group and their caregivers. It authorizes a wide array of service programs through a national network of 56 state agencies on aging, 618 area agencies on aging, nearly 20,000 service providers, 281 Tribal organizations, and 1 Native Hawaiian organization representing 400 Tribes. The OAA also includes community service employment for low-income older Americans; training, research, and demonstration activities in the field of aging; and vulnerable elder rights protection activities.

The links below offer a compilation of the OAA, an outline of changes made to the OAA at the most recent reauthorization (2020) and other related sources of information/data.

## 2020 Reauthorization of the OAA

The Supporting Older Americans Act of 2020 reauthorizes programs for FY 2020 through FY 2024. It includes provisions that aim to remove barriers to the aging network increasing business acumen and capacity building, provide states and localities with the flexibility of deciding the allocation of National Family Caregiver Services between the populations served, and extends authorization of the RAISE Family Caregiver Act and the Supporting Grandparents Raising Grandchildren Act by one additional year.

Read the compilation of the OAA of 1965, as amended through P.L. 116-131 (3/25/2020)

## 2016 Reauthorization of the OAA

The 2016 OAA Act reauthorizes programs for FY 2017 through FY 2019. It includes provisions that aim to protect vulnerable elders by strengthening the Long-Term Care Ombudsman program and elder abuse screening and prevention efforts. It also promotes the delivery of evidence-based programs, such as falls prevention and chronic disease self-management programs.

Read the official compilation of the OAA of 1965, as amended through P.L. 114-144 (PDF, 272KB).

The 2016 law included a provision that required the Assistant Secretary for Aging to issue guidance to states (PDF, 358KB) about serving Holocaust survivors, including guidance on promising practices for conducting outreach to that population.

Read ACL’s overview of the key changes (PDF, 48KB). This FAQ (PDF, 66KB) provides additional details.

## 2006 Reauthorization of the OAA

ACL developed materials about the 2006 reauthorization of the Older Americans Act. The FAQs provides guidance to the aging network.

**Frequently Asked Questions (FAQs)**

Below is a list of frequently asked questions (FAQs) listed alphabetically by topic to assist the Aging Network with implementation of the 2006 Amendments to the Older Americans Act (OAA).

Aging and Disability Resource Centers (ADRCs)
: **The 2006 Reauthorization provides the Assistant Secretary for Aging the authority to “implement in all States Aging and Disability Resource Centers.” In what ways can States begin planning and directing resources for this implementation?**
The Administration on Aging continues to seek and direct resources to assist States in the development and expansion of ADRCs. In addition, many States have creatively used other Federal resources to advance ADRCs. Many ADRC grantee States are seeking increased Federal Financial Participation (FFP) through Medicaid to support their ADRC efforts.
ADRC grantees are also utilizing State and other funding support, for example:
Six States have passed ADRC/single point of entry legislation Seventeen States have received State funding to support ADRC pilot sites Twenty-four ADRC grantee States report pursuing, or have already received, private grants to support their efforts at the State or local level.

Civic Engagement
: **Programs administered by the Corporation for National Community Service (CNCS), e.g., Legacy Corps, now permit applicants to use other sources of Federal funding as match. Does this mean that OAA funds can be used as match?**
To maximize flexibility of funding and to enhance services to older adults, Older Americans Act grantees have the option to use III E funds to meet the match requirements for certain programs administered by the National Community Service (CNCS). With this option, the Aging Network is afforded additional opportunities to better meet local home and community service and caregiver needs, and to further the goals of providing volunteer (Civic Engagement) opportunities to older adults and their caregivers.
It is imperative to note that 45 CFR Parts 74.23(a) and 92.24(b) do not allow OAA grantees to use any Federal funds (including CNCS funds) to meet the OAA non-Federal share (match) of project expenditures. It is also important to note that any proposed use of OAA funds (including funds that would be used as match for CNCS programs) must be consistent with the terms and conditions of the grant/contract award, including all applicable Older Americans Act provisions and uniform grant administration rules (45 CFR Parts 74 and 92).
A local provider may only use such funds for allowable services under Title III E, and such services must be part of the overall comprehensive system of services in the planning and service area. (Sec. 303(c)(2)). State and area agencies on aging remain fully responsible for administration and oversight of OAA funds, notwithstanding CNCS’s acceptance of any OAA funds under a grant/contract as cost sharing or matching.
For clarity, the following conditions must be met if OAA funds are to be used to match CNCS funds:
	- All specific terms and conditions of the OAA grant;
	- The intent of the OAA;
	- All applicable Federal, State and local legislation; and
The Federal agency (CNCS) has the statutory provisions necessary to allow its grantees to count other federal funds as matching contributions for their CNCS project costs.

Elder Justice
: **What new opportunities exist for States and Tribal organizations in the new Elder Justice provisions and how can elder justice provisions integrate with the AoA’s other long-term care reforms?**
New language in Title II and Title VII emphasize multi-disciplinary and collaborative approaches to addressing elder maltreatment when developing programs and long-term strategic plans for elder justice activities. AoA has funded the National Center on Elder Abuse (NCEA) to examine issues, current practices, and future directions for the enhanced coordination between elder rights and ADRC systems. In FY 2008, the NCEA will study successful collaboration between home and community-based service providers, Adult Protective Services, and Long-Term Care Ombudsman to ensure the safety and well-being of vulnerable seniors as they are diverted or transitioned from institutional settings to community based care.
States and Tribes will have the opportunity to work with AoA in developing a long-term plan to facilitate the development, implementation, and continuous improvement of a coordinated, multi-disciplinary elder justice system in the United States. New language in Title VII expands the options for States and tribal organizations to use some portion of the Title VII allotments for detection, assessment, intervention in, investigation of and response to elder abuse, neglect, and exploitation.
AoA’s elder abuse prevention program is exploring best practice examples of ADRCs incorporating crisis management and risk identification and successful collaborations between elder rights providers and ADRCs. Similarly, the National Long-Term Care Ombudsman Resource Center is providing training and technical assistance to long-term care ombudsmen in diversion and transition activities including coordination with ADRC’s. Additional coordination efforts include the statewide SMP Programs (Senior Medicare Patrol), the National Resource and Education Center on Women and Retirement Planning, and the National Legal Resource Centers Model Approaches to Statewide Legal Assistance, and Pension Counseling.

Evidence-Based Health Promotion Disease Prevention Programs
: **What new opportunities does the 2006 Reauthorization offer the Aging Services Network for developing or enhancing evidence-based health promotion/disease prevention strategies?**
Evidence-based disease prevention is the utilization of clinically tested and proven tools and behavioral changes to manage an individual’s health and disease. Evidence-based prevention programs take place at the community level to help participants avoid hospitalizations and unnecessary physician visits.
Evidence Based Programming, regardless of funding source, is central to empowering older adults to take responsibility for their health by making informed health choices and adopting healthful behaviors. It is important to modernize programs by using the best available science and evidence and leveraging funding and expertise through community resources.
The 2006 Amendments reaffirm AoA’s commitment to ensuring that all older Americans have access to programs and services that help reduce the impact of disease and chronic disabilities and encourage the promotion of preventive measures to eliminate or reduce the occurrence of new diseases and disabilities. Under Titles III and IV, States continue to have the option to design programs to advance chronic disease self-care practices, increase physical activity, prevent falls, promote proper nutrition and diet, and address depression and/or substance abuse in older persons.

Mental Health
: **Mental health is referenced numerous times throughout the 2006 amendments to the Older Americans Act. What are these new provisions and how will they enable the Aging Services Network to more fully meet the needs of older Americans?**
For the first time, the Administration on Aging and the Aging Services Network are directed to apply a greater focus on the prevention and treatment of mental disorders. To effectively carry out the new mental health references in the Act, AoA will develop objectives, priorities and a long-term plan for supporting State and local efforts pertaining to education, prevention, detection and treatment of mental disorders, including age-related dementia, depression, and Alzheimer’s disease and related neurological disorders with neurological and organic brain dysfunction.
Although the 2006 Amendments include no specific requirements for States regarding the new Title II mental health provisions, there are significant opportunities for States to:
- Ensure that mental health programs and services are aware of the role ADRCs play in connecting consumers with resources to meet their needs.
	- Explore the availability of evidence-based mental health programs and incorporating them where practicable.
	- Strengthen partnerships between mental health programs and services and the Aging Services Network at the State and AAA/community levels.New accordion title

National Family Caregiver Support Program (NFCSP)
: **How does the Modernization of the Older Americans Act benefit family caregivers?**
AoA, in partnership with CMS, designed the Aging and Disability Resource Centers (ADRCs), now operational in 43 States and territories, to provide consumers and caregivers information on home and community-based long-term care services. ADRCs provide consumers information, options counseling, referral, assessment, educational and assistance in planning for future needs. AoA is emphasizing the importance of integration of proven evidence-based health promotion interventions, which can lessen disability related to chronic illnesses, prevent falls, and reduce the burden experienced by family caregivers of individuals who are older and/or disabled.
For individuals with a high-risk for nursing home placement, funds can be used by states to target these low and moderate income individuals and their caregivers who may be better served through home and community-based services. Through a variety of consumer-directed options, such consumers may select their own providers and direct how their services will be delivered.
**What eligibility changes were made to the National Family Caregiver Support program as a result of the Reauthorization of the Older Americans Act in 2006?**
The eligibility changes in the NFCSP are:
	- Family caregivers of a person with Alzheimer’s disease or a related dementia may be served regardless of the age of the person with dementia.
	- Grandparents and other relative caregivers providing care to children (under age 18 years) may receive services at 55 years of age and older;
	- Grandparent or relative caregivers, providing care for adult children with a disability, who are between 19 and 59 years of age, can now be served under the NFCSP as follows:

Caregivers must be age 55 years and older;
Priority is given to caregivers providing care for an adult child with severe disabilities; and
Services provided to these caregivers are not counted against the 10% ceiling for grandparents and other caregivers providing care to children under the age of 18 years.

**Can older caregivers providing care to their own adult children with disabilities be served in the NFCSP?**
Yes. Older caregivers providing care to their own adult children with disabilities can be served in the NFCSP.
**How should the term “related disorders with neurological or organic brain dysfunction” be defined in the “family caregiver” definition?**
Absent a comprehensive definition of “related disorders with neurological or organic brain dysfunction” States may identify such disorders based on their local experience, expertise and need.
**Are funds under the National Family Caregiver Support Program “earmarked” or targeted for specific services, e.g. respite?**
Funds under the National Family Caregiver Support Program (NFCSP) are not earmarked or targeted for any specific service. States have the flexibility to determine the funding allocated to provide the five categories of services authorized: 1) information about services; 2) assistance with access to services; 3) individual counseling, organization of support groups, and caregiver training; 4) respite care; and 5) supplemental services, on a limited basis.
The OAA calls for States to implement a comprehensive caregiver program which includes the five services outlined, however; a State may address one or more of the service categories with other sources of funding.
**Are direct payments to family caregivers to purchase services allowed in the National Family Caregiver Support Program?**
Direct payments to family caregivers are neither specifically included in, nor precluded by, the Older Americans Act. As such, direct payments to family caregivers may be possible to purchase services if so defined by the state.
**Are grandchildren cared for by grandparents required to have a disability or chronic illness in order to receive services?**
There is no requirement that the grandchildren have a disability. Under the NFCSP, states may design services for grandparents or older individuals who are relative caregivers. In these instances, the grandparent or relative caregiver must be an older individual (55+), who lives with the child, is the primary caregiver of the child, and has a legal relationship to the child or is raising the child informally. The child must be no more than 18 years old.
Note: The 2006 amendments to the Older Americans Act included an eligibility change which allows services to be provided to grandparents and other relative caregivers (55+) who are primary caregivers of an adult between the ages of 18 to 59 years with a disability. Biological or adoptive parents were not included in this change.
**Can respite and supplemental services be provided to grandparents and relative caregivers?**
States have the option of using a portion of NFCSP funds to provide respite and supplemental services to grandparents and relative caregivers.
To allow grandparents a break from their daily caregiving responsibilities, funds under respite could be provided to pay expenses such as after school programs, summer/day camps, weekend programs and individual in-home respite. Supplemental funds could be provided to pay for expenses such as school supplies, legal issues associated with custody/adoption and other needs determined at the local level.

Payer of Last Resort
: **If services are being provided to an older adult under the Older Americans Act, should the OAA continue providing payment for services if the person is later determined eligible for the same services under a Medicaid waiver?**
Title III of the Older Americans Act (OAA) does not create a legal requirement to finance services for any individual. Individuals age 60 and over may receive benefits under the OAA but no individual is entitled to them. An individual who is eligible for Medicaid benefits programs may also receive services under the OAA; however, the State may not require that OAA programs fund benefits that can be funded by Medicaid. Although individuals may not be entitled to specific services under the OAA, Medicaid-eligible individuals may receive such services.

Private Pay
: **Can the Aging Network implement private pay services?**
Private pay services can create opportunities to reach a segment of the population not traditionally served by the network, however; such activities are optional for States, Area Agencies and service providers. In general, private payment for services occurs when individuals pay the full cost of the services they receive. Because there is no public funding involved, private pay services are not subject to the ‘cost sharing’ provisions under the Older Americans Act (OAA, Sec. 315(a)).
Note: Private pay services to individuals and caregivers are also distinct from establishing “Private Pay Relationships” with profit-making organizations and are therefore not subject to Sec. 212(a) of the OAA.

Religious Activities
: **Is prayer allowed at Title III funded congregate meal sites?**
The Older Americans Act does not forbid older adults from praying before a meal at a senior center or some other location that provides a meal with funding from the OAA. The AoA recommends that each nutrition program adopt a policy that ensures that each individual participant has a free choice whether to pray either silently or audibly, and that the prayer is not officially sponsored, led or organized by persons administering the Nutrition Program or the meal site.
**Are bible studies and other religious activities allowed at Title III funded program sites?**
Title III funded programs may not use OAA funds (or local matching funds) to support inherently religious activities, such as worship, religious instruction, or proselytization. If the organization engages in such activities, it must offer them separately, in time or location, from the programs or services funded with OAA funds, and participation must be voluntary.
This restriction does not mean that an organization that sponsors the Title III program (i.e., the contractor or grantee) may not engage in inherently religious activities, but only that the organization may not use OAA funds for such purposes.

Self Directed Care
: **To what extent does the OAA now encourage the Aging Services Network to implement self-directed care options in all service categories?**
State agencies on aging, area agencies on aging, and Tribes have the opportunity to expand the decision-making roles of consumers in the type, amount, management and budgeting of the home and community-based services they receive. Through effective and efficient models, including cash and counseling vouchers, expanded service choices, etc., AoA encourages the implementation of self-directed care provisions through OAA services whenever possible, however; each State will determine which services include such provisions and how they will be implemented.
**Can Title III service funds be used to provide fiscal management services (FMS) related to nursing home diversion and other home and community based programs designed to maintain older adults in the community?**
Financial Management Services (FMS) are an essential element of self directed care programs. FMS supports self directed programs by assisting individuals with enrollment, payroll and employment tax issues, and by performing fiscal accounting and expenditure reporting to the individual and to the sponsoring program.
Title III-B and III-E funds may be used to provide FMS so long as the services supported by FMS are allowable under these two program parts, e.g., transportation, information, support groups, respite, etc., and are provided to adults age 60 years and over (III-B) and/or to caregivers (III-E). It is incumbent upon States and area agencies on aging (AAA) to assure Title III expenditures for FMS meet all Older Americans Act requirements.

State Plans
: **The AoA Program Instruction (AoA-PI-08-01) points out that a national aging services Planning Model is available to assist States. Is this Model required to complete the State Plan? The Plan Model states that the Plan Narrative is to be 20 pages. Is this an absolute limit?**
The national aging services Planning Model was developed by the National Association of State Units on Aging (AoA Grant 90AM3032). It is available to assist States in the development of the State Plans. While strongly encouraged, its use is not required in law or regulation. This web based tool will provide the resources necessary to develop a comprehensive, yet concise, State Plan on Aging. It is a recommendation that the State Plan be 20 - 30 pages in length with the opportunity to attach data and other reports in appendices. Some states may need more narrative, but clarity and conciseness are the intended result.

Targeting
: **What implications do the new targeting provisions create for service delivery and long-term care modernization?**
Targeting references are made throughout the Older Americans Act (OAA), as amended in 2006. The Amendments maintain all of the previous targeting groups but revise the group “*limited English speaking*” to “*limited English proficiency*,” and add a new group, “*older individuals at risk for institutional placement*.” A reference to *older individuals with limited English proficiency* is added to all sections of the OAA where previously the phrase ‘with particular attention to low-income minority older individuals and older individuals residing in rural areas” was used.
The revision and addition of these two groups assures that the Aging Network will prioritize the provision of services to those individuals in greatest need of long-term care services, and address the specific needs of such individuals in all aspects of planning, advocacy and resource development.
**Does “greatest social need” as defined in the Older Americans allow communities to target funds to populations they identify as experiencing cultural, social or geographic isolation other than isolation caused by racial or ethnic status?**
While the definition of *“greatest social need”* in the Older Americans Act includes isolation caused by racial or ethnic status, the definition is not intended to exclude the targeting of other populations that experience cultural social or geographic isolation due to other factors. In some communities, such isolation may be caused by minority religious affiliation. In others, isolation due to sexual orientation or gender identity may restrict a person’s ability to perform normal daily tasks or live independently. Each planning and service area must assess their particular environment to determine those populations best targeted based on *“greatest social need”*.

Transportation
: **Does the 2006 Reauthorization include specific opportunities to more fully coordinate transportation services?**
In recognition of the importance of the role of the Aging Services Network, AoA entered into a memorandum of understanding with the Federal Transit Administration in January 2003. As a result of this collaboration, AoA has become a key partner at the federal level in promoting the coordination of transportation across programs and agencies.
The 2006 Reauthorization contains specific requirements for States and area agencies to develop and implement comprehensive and coordinated systems for home and community-based services, including transportation. These requirements afford the Aging Services Network with significant opportunities to strengthen coordination of transportation services and/or ensure its inclusion in the planning and delivery of transportation services. States and communities are encouraged to use the resources available at the National Aging and Disability Transportation Center, to assist in developing and enhancing coordinated transportation services.
**Programs administered by the Federal Transit Administration (e.g., 5310, 5311, & 5317) now permit applicants to use other sources of Federal funding as match. Does this mean that OAA funds can be used as match?**
To maximize flexibility of funding and to enhance services to older adults, Older Americans Act grantees have the option to use Title III B funds to meet the match requirements for programs administered by the Federal Transit Administration (FTA). With this option, the Aging Network is afforded additional opportunities to better meet local transportation needs and further the goals of United We Ride, including providing more rides for the same or fewer assets, facilitating access to services and increasing customer satisfaction.
It is imperative to note that 45 CFR Parts 74.23(a) and 92.24(b) do not allow OAA grantees to use any Federal funds (including FTA funds) to meet the OAA non-Federal share (match) of project expenditures. It is also important to note that any proposed use of OAA funds (including funds that would be used as match for FTA programs) must be consistent with the terms and conditions of the grant/contract award, including all applicable Older Americans Act provisions and uniform grant administration rules (45 CFR Parts 74 and 92).
A local transportation provider receiving Title III funds for transportation services may only use such funds for the transport of seniors (and caregivers who are escorting seniors). Such services must be part of the overall comprehensive system of services in the planning and service area. (Sec. 303(c)(2)). State and area agencies on aging remain fully responsible for administration and oversight of OAA funds, notwithstanding FTA’s acceptance of any OAA funds under a grant/contract as cost sharing or matching.
For clarity, the following conditions must be met if OAA funds are to be used to match FTA funds:
All specific terms and conditions of the OAA grant; The intent of the OAA; All applicable Federal, State and local legislation; and The Federal agency (FTA) has the statutory provisions necessary to allow its grantees to count non-FTA federal funds as matching contributions for their project costs.

**The 2006 Reauthorization provides the Assistant Secretary for Aging the authority to “implement in all States Aging and Disability Resource Centers.” In what ways can States begin planning and directing resources for this implementation?**

The Administration on Aging continues to seek and direct resources to assist States in the development and expansion of ADRCs. In addition, many States have creatively used other Federal resources to advance ADRCs. Many ADRC grantee States are seeking increased Federal Financial Participation (FFP) through Medicaid to support their ADRC efforts.

ADRC grantees are also utilizing State and other funding support, for example:

Six States have passed ADRC/single point of entry legislation Seventeen States have received State funding to support ADRC pilot sites Twenty-four ADRC grantee States report pursuing, or have already received, private grants to support their efforts at the State or local level.

**Programs administered by the Corporation for National Community Service (CNCS), e.g., Legacy Corps, now permit applicants to use other sources of Federal funding as match. Does this mean that OAA funds can be used as match?**

To maximize flexibility of funding and to enhance services to older adults, Older Americans Act grantees have the option to use III E funds to meet the match requirements for certain programs administered by the National Community Service (CNCS). With this option, the Aging Network is afforded additional opportunities to better meet local home and community service and caregiver needs, and to further the goals of providing volunteer (Civic Engagement) opportunities to older adults and their caregivers.

It is imperative to note that 45 CFR Parts 74.23(a) and 92.24(b) do not allow OAA grantees to use any Federal funds (including CNCS funds) to meet the OAA non-Federal share (match) of project expenditures. It is also important to note that any proposed use of OAA funds (including funds that would be used as match for CNCS programs) must be consistent with the terms and conditions of the grant/contract award, including all applicable Older Americans Act provisions and uniform grant administration rules (45 CFR Parts 74 and 92).

A local provider may only use such funds for allowable services under Title III E, and such services must be part of the overall comprehensive system of services in the planning and service area. (Sec. 303(c)(2)). State and area agencies on aging remain fully responsible for administration and oversight of OAA funds, notwithstanding CNCS’s acceptance of any OAA funds under a grant/contract as cost sharing or matching.

For clarity, the following conditions must be met if OAA funds are to be used to match CNCS funds:

- All specific terms and conditions of the OAA grant;
	- The intent of the OAA;
	- All applicable Federal, State and local legislation; and

The Federal agency (CNCS) has the statutory provisions necessary to allow its grantees to count other federal funds as matching contributions for their CNCS project costs.

**What new opportunities exist for States and Tribal organizations in the new Elder Justice provisions and how can elder justice provisions integrate with the AoA’s other long-term care reforms?**

New language in Title II and Title VII emphasize multi-disciplinary and collaborative approaches to addressing elder maltreatment when developing programs and long-term strategic plans for elder justice activities. AoA has funded the National Center on Elder Abuse (NCEA) to examine issues, current practices, and future directions for the enhanced coordination between elder rights and ADRC systems. In FY 2008, the NCEA will study successful collaboration between home and community-based service providers, Adult Protective Services, and Long-Term Care Ombudsman to ensure the safety and well-being of vulnerable seniors as they are diverted or transitioned from institutional settings to community based care.

States and Tribes will have the opportunity to work with AoA in developing a long-term plan to facilitate the development, implementation, and continuous improvement of a coordinated, multi-disciplinary elder justice system in the United States. New language in Title VII expands the options for States and tribal organizations to use some portion of the Title VII allotments for detection, assessment, intervention in, investigation of and response to elder abuse, neglect, and exploitation.

AoA’s elder abuse prevention program is exploring best practice examples of ADRCs incorporating crisis management and risk identification and successful collaborations between elder rights providers and ADRCs. Similarly, the National Long-Term Care Ombudsman Resource Center is providing training and technical assistance to long-term care ombudsmen in diversion and transition activities including coordination with ADRC’s. Additional coordination efforts include the statewide SMP Programs (Senior Medicare Patrol), the National Resource and Education Center on Women and Retirement Planning, and the National Legal Resource Centers Model Approaches to Statewide Legal Assistance, and Pension Counseling.

**What new opportunities does the 2006 Reauthorization offer the Aging Services Network for developing or enhancing evidence-based health promotion/disease prevention strategies?**

Evidence-based disease prevention is the utilization of clinically tested and proven tools and behavioral changes to manage an individual’s health and disease. Evidence-based prevention programs take place at the community level to help participants avoid hospitalizations and unnecessary physician visits.

Evidence Based Programming, regardless of funding source, is central to empowering older adults to take responsibility for their health by making informed health choices and adopting healthful behaviors. It is important to modernize programs by using the best available science and evidence and leveraging funding and expertise through community resources.

The 2006 Amendments reaffirm AoA’s commitment to ensuring that all older Americans have access to programs and services that help reduce the impact of disease and chronic disabilities and encourage the promotion of preventive measures to eliminate or reduce the occurrence of new diseases and disabilities. Under Titles III and IV, States continue to have the option to design programs to advance chronic disease self-care practices, increase physical activity, prevent falls, promote proper nutrition and diet, and address depression and/or substance abuse in older persons.

**Mental health is referenced numerous times throughout the 2006 amendments to the Older Americans Act. What are these new provisions and how will they enable the Aging Services Network to more fully meet the needs of older Americans?**

For the first time, the Administration on Aging and the Aging Services Network are directed to apply a greater focus on the prevention and treatment of mental disorders. To effectively carry out the new mental health references in the Act, AoA will develop objectives, priorities and a long-term plan for supporting State and local efforts pertaining to education, prevention, detection and treatment of mental disorders, including age-related dementia, depression, and Alzheimer’s disease and related neurological disorders with neurological and organic brain dysfunction.

Although the 2006 Amendments include no specific requirements for States regarding the new Title II mental health provisions, there are significant opportunities for States to:

- Ensure that mental health programs and services are aware of the role ADRCs play in connecting consumers with resources to meet their needs.
	- Explore the availability of evidence-based mental health programs and incorporating them where practicable.
	- Strengthen partnerships between mental health programs and services and the Aging Services Network at the State and AAA/community levels.New accordion title

**How does the Modernization of the Older Americans Act benefit family caregivers?**

AoA, in partnership with CMS, designed the Aging and Disability Resource Centers (ADRCs), now operational in 43 States and territories, to provide consumers and caregivers information on home and community-based long-term care services. ADRCs provide consumers information, options counseling, referral, assessment, educational and assistance in planning for future needs. AoA is emphasizing the importance of integration of proven evidence-based health promotion interventions, which can lessen disability related to chronic illnesses, prevent falls, and reduce the burden experienced by family caregivers of individuals who are older and/or disabled.

For individuals with a high-risk for nursing home placement, funds can be used by states to target these low and moderate income individuals and their caregivers who may be better served through home and community-based services. Through a variety of consumer-directed options, such consumers may select their own providers and direct how their services will be delivered.

**What eligibility changes were made to the National Family Caregiver Support program as a result of the Reauthorization of the Older Americans Act in 2006?**

The eligibility changes in the NFCSP are:
	- Family caregivers of a person with Alzheimer’s disease or a related dementia may be served regardless of the age of the person with dementia.
	- Grandparents and other relative caregivers providing care to children (under age 18 years) may receive services at 55 years of age and older;
	- Grandparent or relative caregivers, providing care for adult children with a disability, who are between 19 and 59 years of age, can now be served under the NFCSP as follows:

- Caregivers must be age 55 years and older;
- Priority is given to caregivers providing care for an adult child with severe disabilities; and
- Services provided to these caregivers are not counted against the 10% ceiling for grandparents and other caregivers providing care to children under the age of 18 years.

**Can older caregivers providing care to their own adult children with disabilities be served in the NFCSP?**

Yes. Older caregivers providing care to their own adult children with disabilities can be served in the NFCSP.

**How should the term “related disorders with neurological or organic brain dysfunction” be defined in the “family caregiver” definition?**

Absent a comprehensive definition of “related disorders with neurological or organic brain dysfunction” States may identify such disorders based on their local experience, expertise and need.

**Are funds under the National Family Caregiver Support Program “earmarked” or targeted for specific services, e.g. respite?**

Funds under the National Family Caregiver Support Program (NFCSP) are not earmarked or targeted for any specific service. States have the flexibility to determine the funding allocated to provide the five categories of services authorized: 1) information about services; 2) assistance with access to services; 3) individual counseling, organization of support groups, and caregiver training; 4) respite care; and 5) supplemental services, on a limited basis.

The OAA calls for States to implement a comprehensive caregiver program which includes the five services outlined, however; a State may address one or more of the service categories with other sources of funding.

**Are direct payments to family caregivers to purchase services allowed in the National Family Caregiver Support Program?**

Direct payments to family caregivers are neither specifically included in, nor precluded by, the Older Americans Act. As such, direct payments to family caregivers may be possible to purchase services if so defined by the state.

**Are grandchildren cared for by grandparents required to have a disability or chronic illness in order to receive services?**

There is no requirement that the grandchildren have a disability. Under the NFCSP, states may design services for grandparents or older individuals who are relative caregivers. In these instances, the grandparent or relative caregiver must be an older individual (55+), who lives with the child, is the primary caregiver of the child, and has a legal relationship to the child or is raising the child informally. The child must be no more than 18 years old.

Note: The 2006 amendments to the Older Americans Act included an eligibility change which allows services to be provided to grandparents and other relative caregivers (55+) who are primary caregivers of an adult between the ages of 18 to 59 years with a disability. Biological or adoptive parents were not included in this change.

**Can respite and supplemental services be provided to grandparents and relative caregivers?**

States have the option of using a portion of NFCSP funds to provide respite and supplemental services to grandparents and relative caregivers.

To allow grandparents a break from their daily caregiving responsibilities, funds under respite could be provided to pay expenses such as after school programs, summer/day camps, weekend programs and individual in-home respite. Supplemental funds could be provided to pay for expenses such as school supplies, legal issues associated with custody/adoption and other needs determined at the local level.

**If services are being provided to an older adult under the Older Americans Act, should the OAA continue providing payment for services if the person is later determined eligible for the same services under a Medicaid waiver?**

Title III of the Older Americans Act (OAA) does not create a legal requirement to finance services for any individual. Individuals age 60 and over may receive benefits under the OAA but no individual is entitled to them. An individual who is eligible for Medicaid benefits programs may also receive services under the OAA; however, the State may not require that OAA programs fund benefits that can be funded by Medicaid. Although individuals may not be entitled to specific services under the OAA, Medicaid-eligible individuals may receive such services.

**Can the Aging Network implement private pay services?**

Private pay services can create opportunities to reach a segment of the population not traditionally served by the network, however; such activities are optional for States, Area Agencies and service providers. In general, private payment for services occurs when individuals pay the full cost of the services they receive. Because there is no public funding involved, private pay services are not subject to the ‘cost sharing’ provisions under the Older Americans Act (OAA, Sec. 315(a)).

Note: Private pay services to individuals and caregivers are also distinct from establishing “Private Pay Relationships” with profit-making organizations and are therefore not subject to Sec. 212(a) of the OAA.

**Is prayer allowed at Title III funded congregate meal sites?**

The Older Americans Act does not forbid older adults from praying before a meal at a senior center or some other location that provides a meal with funding from the OAA. The AoA recommends that each nutrition program adopt a policy that ensures that each individual participant has a free choice whether to pray either silently or audibly, and that the prayer is not officially sponsored, led or organized by persons administering the Nutrition Program or the meal site.

**Are bible studies and other religious activities allowed at Title III funded program sites?**

Title III funded programs may not use OAA funds (or local matching funds) to support inherently religious activities, such as worship, religious instruction, or proselytization. If the organization engages in such activities, it must offer them separately, in time or location, from the programs or services funded with OAA funds, and participation must be voluntary.

This restriction does not mean that an organization that sponsors the Title III program (i.e., the contractor or grantee) may not engage in inherently religious activities, but only that the organization may not use OAA funds for such purposes.

**To what extent does the OAA now encourage the Aging Services Network to implement self-directed care options in all service categories?**

State agencies on aging, area agencies on aging, and Tribes have the opportunity to expand the decision-making roles of consumers in the type, amount, management and budgeting of the home and community-based services they receive. Through effective and efficient models, including cash and counseling vouchers, expanded service choices, etc., AoA encourages the implementation of self-directed care provisions through OAA services whenever possible, however; each State will determine which services include such provisions and how they will be implemented.

**Can Title III service funds be used to provide fiscal management services (FMS) related to nursing home diversion and other home and community based programs designed to maintain older adults in the community?**

Financial Management Services (FMS) are an essential element of self directed care programs. FMS supports self directed programs by assisting individuals with enrollment, payroll and employment tax issues, and by performing fiscal accounting and expenditure reporting to the individual and to the sponsoring program.

Title III-B and III-E funds may be used to provide FMS so long as the services supported by FMS are allowable under these two program parts, e.g., transportation, information, support groups, respite, etc., and are provided to adults age 60 years and over (III-B) and/or to caregivers (III-E). It is incumbent upon States and area agencies on aging (AAA) to assure Title III expenditures for FMS meet all Older Americans Act requirements.

**The AoA Program Instruction (AoA-PI-08-01) points out that a national aging services Planning Model is available to assist States. Is this Model required to complete the State Plan? The Plan Model states that the Plan Narrative is to be 20 pages. Is this an absolute limit?**

The national aging services Planning Model was developed by the National Association of State Units on Aging (AoA Grant 90AM3032). It is available to assist States in the development of the State Plans. While strongly encouraged, its use is not required in law or regulation. This web based tool will provide the resources necessary to develop a comprehensive, yet concise, State Plan on Aging. It is a recommendation that the State Plan be 20 - 30 pages in length with the opportunity to attach data and other reports in appendices. Some states may need more narrative, but clarity and conciseness are the intended result.

**What implications do the new targeting provisions create for service delivery and long-term care modernization?**

Targeting references are made throughout the Older Americans Act (OAA), as amended in 2006. The Amendments maintain all of the previous targeting groups but revise the group “*limited English speaking*” to “*limited English proficiency*,” and add a new group, “*older individuals at risk for institutional placement*.” A reference to *older individuals with limited English proficiency* is added to all sections of the OAA where previously the phrase ‘with particular attention to low-income minority older individuals and older individuals residing in rural areas” was used.

The revision and addition of these two groups assures that the Aging Network will prioritize the provision of services to those individuals in greatest need of long-term care services, and address the specific needs of such individuals in all aspects of planning, advocacy and resource development.

**Does “greatest social need” as defined in the Older Americans allow communities to target funds to populations they identify as experiencing cultural, social or geographic isolation other than isolation caused by racial or ethnic status?**

While the definition of *“greatest social need”* in the Older Americans Act includes isolation caused by racial or ethnic status, the definition is not intended to exclude the targeting of other populations that experience cultural social or geographic isolation due to other factors. In some communities, such isolation may be caused by minority religious affiliation. In others, isolation due to sexual orientation or gender identity may restrict a person’s ability to perform normal daily tasks or live independently. Each planning and service area must assess their particular environment to determine those populations best targeted based on *“greatest social need”*.

**Does the 2006 Reauthorization include specific opportunities to more fully coordinate transportation services?**

In recognition of the importance of the role of the Aging Services Network, AoA entered into a memorandum of understanding with the Federal Transit Administration in January 2003. As a result of this collaboration, AoA has become a key partner at the federal level in promoting the coordination of transportation across programs and agencies.

The 2006 Reauthorization contains specific requirements for States and area agencies to develop and implement comprehensive and coordinated systems for home and community-based services, including transportation. These requirements afford the Aging Services Network with significant opportunities to strengthen coordination of transportation services and/or ensure its inclusion in the planning and delivery of transportation services. States and communities are encouraged to use the resources available at the National Aging and Disability Transportation Center, to assist in developing and enhancing coordinated transportation services.

**Programs administered by the Federal Transit Administration (e.g., 5310, 5311, & 5317) now permit applicants to use other sources of Federal funding as match. Does this mean that OAA funds can be used as match?**

To maximize flexibility of funding and to enhance services to older adults, Older Americans Act grantees have the option to use Title III B funds to meet the match requirements for programs administered by the Federal Transit Administration (FTA). With this option, the Aging Network is afforded additional opportunities to better meet local transportation needs and further the goals of United We Ride, including providing more rides for the same or fewer assets, facilitating access to services and increasing customer satisfaction.

It is imperative to note that 45 CFR Parts 74.23(a) and 92.24(b) do not allow OAA grantees to use any Federal funds (including FTA funds) to meet the OAA non-Federal share (match) of project expenditures. It is also important to note that any proposed use of OAA funds (including funds that would be used as match for FTA programs) must be consistent with the terms and conditions of the grant/contract award, including all applicable Older Americans Act provisions and uniform grant administration rules (45 CFR Parts 74 and 92).

A local transportation provider receiving Title III funds for transportation services may only use such funds for the transport of seniors (and caregivers who are escorting seniors). Such services must be part of the overall comprehensive system of services in the planning and service area. (Sec. 303(c)(2)). State and area agencies on aging remain fully responsible for administration and oversight of OAA funds, notwithstanding FTA’s acceptance of any OAA funds under a grant/contract as cost sharing or matching.

For clarity, the following conditions must be met if OAA funds are to be used to match FTA funds:

All specific terms and conditions of the OAA grant; The intent of the OAA; All applicable Federal, State and local legislation; and The Federal agency (FTA) has the statutory provisions necessary to allow its grantees to count non-FTA federal funds as matching contributions for their project costs.

## Historical Evolution of Programs for Older Americans

See the Timeline of Programs for Older Americans
: 1920
The Civil Service Retirement Act provided a retirement system for many governmental employees.
1935
The Social Security Act passed; provides for Old Age Assistance and Old Age Survivors Insurance.
1937
Railroad Retirement Act provided pensions for retired railroad employees and spouses.
1950
President Truman initiated the first National Conference on Aging, sponsored by the Federal Security Agency.
1952
First federal funds appropriated for social service programs for older persons under the Social Security Act.
1956
Special Staff on Aging established within the Office of the Secretary of Health, Education and Welfare, to coordinate responsibilities for aging.
Federal Council on Aging created by President Eisenhower.
1958
Legislation introduced in Congress, calling for a White House Conference on Aging.
1959
Housing act authorized a direct loan program for non-profit rental projects, for the elderly at low interests rates, and lowered eligibility ages for public-low-rent housing, for low-income women to age 62.
1960
Social Security Administration eliminated age 50 as minimum for qualifying for disability benefits, and liberalized the retirement test and the requirement for fully insured status.
1961
First White House Conference on Aging held in Washington, D.C.
Social Security Amendments lowered the retirement age for men from 65 to 62, liberalized the retirement test, and increased minimum benefits and benefits to aged widows.
1962
Legislation introduced in Congress, to establish an independent and permanent Commission on Aging.
1965
Older Americans Act signed into law on July 14 1965. It established the Administration on Aging within the Department of Health, Education and Welfare, and called for the creation of State Units on Aging.
William Bechill named first Commissioner on Aging
Medicare, Title XVIII, a health insurance program for the elderly was established as part of the Social Security Act.
Medicaid, Title XIX, a health insurance program for low-income persons, was added to the Social Security Act.
1967
Older Americans Act extended for two years, and provisions made for the Administration on Aging to study the personnel needs in the aging field.
Age Discrimination Act signed into law.
Administration on Aging moved from the Office of the Secretary of HEW and placed in the newly created Social and Rehabilitative Service Agency within the Department.
1968
John Martin named Commissioner on Aging
1969
Older Americans Act Amendments provided grants for model demonstration projects, Foster Grandparents, and Retired Senior Volunteer Programs.
1971
Second White House Conference on Aging held in Washington, D.C.
1972
A new Title VII is created under the Older Americans Act authorizing funds for a national nutrition program for the elderly.
1973
Older Americans Act Comprehensive Services Amendments established Area Agencies on Aging. The amendments added a new Title V, which authorized grants to local community agencies for multi-purpose senior centers, and created the Community Service Employment grant program for low-income persons age 55 and older, administered by the Department of Labor.
Arthur S. Flemming named Commissioner on Aging
Comprehensive Employment and Training Act was enacted; included older persons.
1974
Title XX of the Social Security Amendments authorized grants to states for social services. These programs included protective services, homemaker services, transportation services, adult day care services, training for employment, information and referral, nutrition assistance, and health support.
Older Americans Act amendments added transportation under Title III model projects.
Housing and Community Development Act enacted; provided for low-income housing for the elderly and handicapped, pursuant to the Housing Act of 1937.
National Institute on Aging created to conduct research and training related to the aging process, and the diseases and problems of an aging population.
Title V of the Farm and Rural Housing Program of 1949 expanded to include the rural elderly as a target group.
1975
Older Americans Act Amendments authorized grants under Title III to Indian tribal organizations. Transportation, home care, legal services, and home renovation/repair were mandated as priority services.
1977
Older Americans Act Amendments required changes in Title VII nutrition program, primarily related to the availability of surplus commodities through the Department of Agriculture.
1978
Older Americans Act Amendments consolidated the Title III Area Agency on Aging administration and social services, the Title VII nutrition services, and the Title V multi-purpose senior centers, into a new Title III and added a new Title VI for grants to Indian Tribal Organizations. The old Title V became the Community Service Employment grant program for low-income persons, age 55 and older (created under the 1978 amendments as Title IX).
Robert G. Benedict named Commissioner on Aging
Congregate Housing Services Act authorized contracts with local public housing agencies and non-profit corporations, to provide congregate independent living service programs.
OAA amendments required each state to establish a long-term care ombudsman program to cover nursing homes
1981
Third White House Conference on Aging held in Washington, D.C.
Lennie-Marie Tolliver named Commissioner on Aging
Older Americans Act reauthorized; emphasized supportive services to help older persons remain independent in the community.
Act expanded ombudsman coverage to board and care homes
1984
Reauthorization of the Older Americans Act clarified and reaffirmed the roles of State and Area Agencies on Aging in coordinating community-based services, and in maintaining accountability for the funding of national priority services (legal, access, & in-home).
Carol Fraser Fisk named Commissioner on Aging
1987
Omnibus Budget Reconciliation Act provides for nursing home reform in the areas of nurse aide training, survey and certification procedures, pre-admission screening an annual reviews for persons with mental illness.
Reauthorization of the Older Americans Act added six additional distinct authorization of appropriations for services: in-home services for the frail elderly; long-term care ombudsman; assistance for special needs; health education and promotion; prevention of elder abuse, neglect, and exploitation; and outreach activities for persons who may be eligible for benefits under supplemental security income (SSI), Medicaid, and food stamps. Additional emphasis was given to serving those in the greatest economic and social need, including low-income minorities.
The Nursing Home Reform Act (Omnibus Budget Reconciliation Act) mandated that nursing facility residents have “direct and immediate access to ombudspersons when protection and advocacy services become necessary.” Simultaneously, the OAA reauthorization charged states to guarantee ombudsman access to facilities and patient records, provided important legal protections, authorized state ombudsmen to designate local ombudsman programs and required that ombudsman programs have adequate legal counsel.
1989
Joyce Berry named Commissioner on Aging
1990
Americans with Disabilities Act extended protection from discrimination in employment and public accommodations to persons with disabilities.
Cranston-Gonzalez National Affordable Housing Act reauthorized the HUD Section, 202 Elderly Housing program, and provided for supportive service demonstration programs.
Age Discrimination in Employment Act made it illegal, in most circumstances, for companies to discriminate against older workers in employee benefits.
1992
Reauthorization of the Older Americans Act places increased focus on caregivers, intergenerational programs, protection of elder rights and calls for a 1995 White House Conference on Aging.
The elevation of Commissioner on Aging to Assistant Secretary for Aging.
OAA amendments added a new Title VII “Vulnerable Elder Rights Activities” which included the long-term care ombudsman; prevention of elder abuse, neglect and exploitation; elder rights and legal assistance development; and benefits outreach, counseling and assistance programs. The legislation emphasized the value of the four programs coordinating their efforts. The amendments highlighted the role of local ombudsman programs and the state ombudsman’s role as leader of the statewide program and advocate and agent for systemwide change.
1993
Fernando M. Torres-Gil was sworn in as the first Assistant Secretary for Aging in the Department of Health and Human Services on May 6, 1993.
1995
White House Conference on Aging convened May 2–5, 1995 in Washington, D.C.
30th Anniversaries of Older Americans Act, Medicare, Medicaid & the Foster Grandparent Program.
60th Anniversary of Social Security
Operation Restore Trust Initiated
1997
Jeanette C. Takamura, Ph.D., was sworn in as Assistant Secretary for Aging in the U.S. Department of Health and Human Services on December 8, 1997.
1999
International Year of Older Persons: A Society for All Ages
2000
Older Americans Act Amendments of 2000 signed into law (P.L. 106-501), establishing the new National Family Caregiver Support Program, and reauthorizing the OAA for 5 years on November 13, 2000.
2001
HHS Secretary Tommy G. Thompson released $113 million for first National Family Caregiver Support Programs grants to states on February 15, 2001.
Josefina G. Carbonell sworn in as Assistant Secretary for Aging on August 8, 2001.
2002
Kick off of 30th Anniversary of the Older Americans Act Nutrition Program in March.
2003
Enactment of the Medicare Prescription Drug, Improvement and Modernization Act (MMA)
2005
5th White House Conference on Aging was held in Washington, D.C.
2006
Medicare Part D Prescription Drug program (part of MMA) went into effect
Enactment of the Lifespan Respite Care Act (administered by AoA)
Older Americans Act Amendments of 2006 signed into law (P.L. 109-365), embedding the principles of consumer information for long-term care planning, evidence based prevention programs, and self-directed community based services to older individuals at risk of institutionalization. OAA was reauthorized for 5 years on October 17, 2006.
2009
Kathy Greenlee appointed by President Obama as 4th Assistant Secretary for Aging
2010
Enactment of the Affordable Care Act
2011
First of the nation’s baby boomers turn 65
2012
Administration for Community Living established on April 18, 2012, bringing together the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities.

### 1920

The Civil Service Retirement Act provided a retirement system for many governmental employees.

### 1935

The Social Security Act passed; provides for Old Age Assistance and Old Age Survivors Insurance.

### 1937

Railroad Retirement Act provided pensions for retired railroad employees and spouses.

### 1950

President Truman initiated the first National Conference on Aging, sponsored by the Federal Security Agency.

### 1952

First federal funds appropriated for social service programs for older persons under the Social Security Act.

### 1956

Special Staff on Aging established within the Office of the Secretary of Health, Education and Welfare, to coordinate responsibilities for aging.

Federal Council on Aging created by President Eisenhower.

### 1958

Legislation introduced in Congress, calling for a White House Conference on Aging.

### 1959

Housing act authorized a direct loan program for non-profit rental projects, for the elderly at low interests rates, and lowered eligibility ages for public-low-rent housing, for low-income women to age 62.

### 1960

Social Security Administration eliminated age 50 as minimum for qualifying for disability benefits, and liberalized the retirement test and the requirement for fully insured status.

### 1961

First White House Conference on Aging held in Washington, D.C.

Social Security Amendments lowered the retirement age for men from 65 to 62, liberalized the retirement test, and increased minimum benefits and benefits to aged widows.

### 1962

Legislation introduced in Congress, to establish an independent and permanent Commission on Aging.

### 1965

Older Americans Act signed into law on July 14 1965. It established the Administration on Aging within the Department of Health, Education and Welfare, and called for the creation of State Units on Aging.

William Bechill named first Commissioner on Aging

Medicare, Title XVIII, a health insurance program for the elderly was established as part of the Social Security Act.

Medicaid, Title XIX, a health insurance program for low-income persons, was added to the Social Security Act.

### 1967

Older Americans Act extended for two years, and provisions made for the Administration on Aging to study the personnel needs in the aging field.

Age Discrimination Act signed into law.

Administration on Aging moved from the Office of the Secretary of HEW and placed in the newly created Social and Rehabilitative Service Agency within the Department.

### 1968

John Martin named Commissioner on Aging

### 1969

Older Americans Act Amendments provided grants for model demonstration projects, Foster Grandparents, and Retired Senior Volunteer Programs.

### 1971

Second White House Conference on Aging held in Washington, D.C.

### 1972

A new Title VII is created under the Older Americans Act authorizing funds for a national nutrition program for the elderly.

### 1973

Older Americans Act Comprehensive Services Amendments established Area Agencies on Aging. The amendments added a new Title V, which authorized grants to local community agencies for multi-purpose senior centers, and created the Community Service Employment grant program for low-income persons age 55 and older, administered by the Department of Labor.

Arthur S. Flemming named Commissioner on Aging

Comprehensive Employment and Training Act was enacted; included older persons.

### 1974

Title XX of the Social Security Amendments authorized grants to states for social services. These programs included protective services, homemaker services, transportation services, adult day care services, training for employment, information and referral, nutrition assistance, and health support.

Older Americans Act amendments added transportation under Title III model projects.

Housing and Community Development Act enacted; provided for low-income housing for the elderly and handicapped, pursuant to the Housing Act of 1937.

National Institute on Aging created to conduct research and training related to the aging process, and the diseases and problems of an aging population.

Title V of the Farm and Rural Housing Program of 1949 expanded to include the rural elderly as a target group.

### 1975

Older Americans Act Amendments authorized grants under Title III to Indian tribal organizations. Transportation, home care, legal services, and home renovation/repair were mandated as priority services.

### 1977

Older Americans Act Amendments required changes in Title VII nutrition program, primarily related to the availability of surplus commodities through the Department of Agriculture.

### 1978

Older Americans Act Amendments consolidated the Title III Area Agency on Aging administration and social services, the Title VII nutrition services, and the Title V multi-purpose senior centers, into a new Title III and added a new Title VI for grants to Indian Tribal Organizations. The old Title V became the Community Service Employment grant program for low-income persons, age 55 and older (created under the 1978 amendments as Title IX).

Robert G. Benedict named Commissioner on Aging

Congregate Housing Services Act authorized contracts with local public housing agencies and non-profit corporations, to provide congregate independent living service programs.

OAA amendments required each state to establish a long-term care ombudsman program to cover nursing homes

### 1981

Third White House Conference on Aging held in Washington, D.C.

Lennie-Marie Tolliver named Commissioner on Aging

Older Americans Act reauthorized; emphasized supportive services to help older persons remain independent in the community.

Act expanded ombudsman coverage to board and care homes

### 1984

Reauthorization of the Older Americans Act clarified and reaffirmed the roles of State and Area Agencies on Aging in coordinating community-based services, and in maintaining accountability for the funding of national priority services (legal, access, & in-home).

Carol Fraser Fisk named Commissioner on Aging

### 1987

Omnibus Budget Reconciliation Act provides for nursing home reform in the areas of nurse aide training, survey and certification procedures, pre-admission screening an annual reviews for persons with mental illness.

Reauthorization of the Older Americans Act added six additional distinct authorization of appropriations for services: in-home services for the frail elderly; long-term care ombudsman; assistance for special needs; health education and promotion; prevention of elder abuse, neglect, and exploitation; and outreach activities for persons who may be eligible for benefits under supplemental security income (SSI), Medicaid, and food stamps. Additional emphasis was given to serving those in the greatest economic and social need, including low-income minorities.

The Nursing Home Reform Act (Omnibus Budget Reconciliation Act) mandated that nursing facility residents have “direct and immediate access to ombudspersons when protection and advocacy services become necessary.” Simultaneously, the OAA reauthorization charged states to guarantee ombudsman access to facilities and patient records, provided important legal protections, authorized state ombudsmen to designate local ombudsman programs and required that ombudsman programs have adequate legal counsel.

### 1989

Joyce Berry named Commissioner on Aging

### 1990

Americans with Disabilities Act extended protection from discrimination in employment and public accommodations to persons with disabilities.

Cranston-Gonzalez National Affordable Housing Act reauthorized the HUD Section, 202 Elderly Housing program, and provided for supportive service demonstration programs.

Age Discrimination in Employment Act made it illegal, in most circumstances, for companies to discriminate against older workers in employee benefits.

### 1992

Reauthorization of the Older Americans Act places increased focus on caregivers, intergenerational programs, protection of elder rights and calls for a 1995 White House Conference on Aging.

The elevation of Commissioner on Aging to Assistant Secretary for Aging.

OAA amendments added a new Title VII “Vulnerable Elder Rights Activities” which included the long-term care ombudsman; prevention of elder abuse, neglect and exploitation; elder rights and legal assistance development; and benefits outreach, counseling and assistance programs. The legislation emphasized the value of the four programs coordinating their efforts. The amendments highlighted the role of local ombudsman programs and the state ombudsman’s role as leader of the statewide program and advocate and agent for systemwide change.

### 1993

Fernando M. Torres-Gil was sworn in as the first Assistant Secretary for Aging in the Department of Health and Human Services on May 6, 1993.

### 1995

White House Conference on Aging convened May 2–5, 1995 in Washington, D.C.

30th Anniversaries of Older Americans Act, Medicare, Medicaid & the Foster Grandparent Program.

60th Anniversary of Social Security

Operation Restore Trust Initiated

### 1997

Jeanette C. Takamura, Ph.D., was sworn in as Assistant Secretary for Aging in the U.S. Department of Health and Human Services on December 8, 1997.

### 1999

International Year of Older Persons: A Society for All Ages

### 2000

Older Americans Act Amendments of 2000 signed into law (P.L. 106-501), establishing the new National Family Caregiver Support Program, and reauthorizing the OAA for 5 years on November 13, 2000.

### 2001

HHS Secretary Tommy G. Thompson released $113 million for first National Family Caregiver Support Programs grants to states on February 15, 2001.

Josefina G. Carbonell sworn in as Assistant Secretary for Aging on August 8, 2001.

### 2002

Kick off of 30th Anniversary of the Older Americans Act Nutrition Program in March.

### 2003

Enactment of the Medicare Prescription Drug, Improvement and Modernization Act (MMA)

### 2005

5th White House Conference on Aging was held in Washington, D.C.

### 2006

Medicare Part D Prescription Drug program (part of MMA) went into effect

Enactment of the Lifespan Respite Care Act (administered by AoA)

Older Americans Act Amendments of 2006 signed into law (P.L. 109-365), embedding the principles of consumer information for long-term care planning, evidence based prevention programs, and self-directed community based services to older individuals at risk of institutionalization. OAA was reauthorized for 5 years on October 17, 2006.

### 2009

Kathy Greenlee appointed by President Obama as 4th Assistant Secretary for Aging

### 2010

Enactment of the Affordable Care Act

### 2011

First of the nation’s baby boomers turn 65

### 2012

Administration for Community Living established on April 18, 2012, bringing together the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities.

*Last modified on 10/31/2023*

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## ACL Administration for Community Living

## What We Do and Why We Do It

ACL was created around the fundamental principle that all people, regardless of age or disability, should be able to live independently and fully participate fully in their communities. Learn more about community living.

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## Site Support

- Home
- Accessibility
- Disclaimers
- Contact Us
- Freedom of Information Act (FOIA)
- Privacy Policy
- Site Map
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- Vulnerability Disclosure Policy

## Other ACL Sites

- Disability Assistance and Information Line
- Eldercare Locator
- ElderJustice.acl.gov
- LongTermCare.gov
- OlderIndians.gov

## Related Sites

- Grants.gov
- HHS.gov
- No Fear Act
- Plain Writing (on HHS.gov)
- USA.gov
- WhiteHouse.gov
- Vote.gov

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An official website of the Administration for Community Living, an operating division of the U.S. Department of Health and Human Services.