SENIOR LIVING: Aging Entitlement Programs—Hope, After All?

By FRANK KENNEY Executive Director, Senior Services of Grant County, Inc

As you might recall, in our last column we discussed the projected global population decline, our rapidly growing aging population and the critical problems these two demographic phenomena have generated for our federal government. In the article I stated that “the only recourse is to chart a new policy course, proposing bold, meaningful, new reforms…(and) the odds of that happening anytime soon, seem very large. Dismal even.”

I may have been a bit premature with my forecast. On February 15, 2007, Ms Josefina Carbonell, Assistant Secretary for Aging testified before the U.S. Senate’s Special Committee on Aging. Ms Carbonell focused her testimony on new “pilot” programs coming on line through the Older Americans Act. She began her presentation with the following statement:

“We are witnessing sweeping and fundamental transformations in the way we think about and deliver health and long-term care in this country. All these changes are happening at a time when we are experiencing unprecedented growth and diversity in our aging population. Last year, the first wave of America’s 78 million Baby Boomers began turning age 60. Every seven seconds today, and for the next 20 years—someone in America will reach this milestone.”

Ms Carbonell stated that the framers of the Older Americans Act anticipated the growth in our older population, and it “charted out a bold vision for a nationwide network of public and private agencies and organizations focused on a common mission—to ensure the dignity and independence of older people.” The Act has directed the creation of an Aging Services Network, a collaboration between the Administration on Aging, the Social Security Administration and the Department of Housing and Urban Development.

An assessment of the needs of the clients and stakeholders was performed and a number of new “demonstration projects” initiated.

The first project to come on line in 2003 was the “Aging and Disability Resource Center.” Through these ADRCs, it is the Agency’s aim to help states re-engineer their systems of consumer information and access through the establishment of “one-stop-shop” entry points to long-term care. The goal is to make it easier for consumers to learn about and access services that are available to them in their communities. The ADRCs will help break down multiple barriers for consumers, including fragmented and complex funding streams with duplicative intake and eligibility processes. This demonstration project is working in 100 communities in 43 states serving both those in need of public resources like Medicaid as well as individuals using private resources.

In 2004 a pro-active initiative called the “Own Your Future Campaign” was started. It’s focus is to educate individuals on the importance of planning ahead for one’s long-term care. To date, the project has reached nearly 4 million consumers over the age of 45 in nine states, and there are plans to expand the Campaign to five additional States later this year. Another component of the Campaign is a recently launched website at www.longtermcare.gov. This is the first Federal website specifically designed to help people plan ahead for their long-term care. While no one likes to think about a time when they might need long-term care services such as help with basic daily activities like bathing, dressing or using the bathroom independently, about 60 percent of people over age 65 will require some long-term care services at some point in their lives. Planning is essential for you to be prepared.

To promote the use of flexible, consumer-directed models for high-risk individuals, a “Cash and Counseling” model has been successfully tested in three states. This model puts consumers in the driver’s seat, when it comes to making decisions about the types of care they receive and the manner in which they receive it. According to Ms Carbonell, “using flexible service models and giving people more control over their care is going to require us all to think very differently about how we deliver services and measure quality. we have to begin to let our Older American Act dollars follow people’s needs, not service categories.”

Ms. Carbonell went on to say that she was thrilled to see Congress embrace the key elements of the modernization agenda she’d just described as part of the reauthorization of the Older Americans Act in 2006.

In December the Aging Services Network convened a national summit in Washington. It brought together over 1,300 people from all parts of The Network for a peer-to-peer exchange of best practices, strategies, and tools that State and local governments and community-based organizations can use to help older people remain healthy and independent. In FY 2008, their goal is to continue to increase this efficiency while maintaining high-quality services for those most in need. They aim to test whether their investments in Aging and disability Resource Centers, Consumer Directed Care, and Evidence-Based Programs, will lead to continual improvements.

Ms Carbonell ended her testimony saying “I believe putting consumers front and center is the best way to ensure our success in modernizing our Older Americans Act programs and the Aging Services Network for the 21^st century.

That’s the plan. Officials in Washington have outlined an ambitious agenda to modernize and improve the services to our aging population. Regardless of how it “pans” out, I feel a little better knowing that some of our leaders are at least asking the right questions, and creating projects that are beginning to address the over arching needs we face as we approach and enter our retirement years.

For more information on this topic you can contact me at 505-388-2523 or rsvpgrant@zianet.com. I also suggest you visit our web site at www.grantcountyseniorservices.org in order to better appreciate the services we currently offer our elders.