About Aging Services (Area Agencies on Aging)
Older Americans Act of 1965
The Older Americans Act establishes an effective interrelationship between the federal government, State aging units and local service coordinators called Area Agencies on Aging. All three centers of service, the Federal, the state and the local engage in detailed future planning in order to accomplish their jobs. Input at the local level is received from diversified advisory boards representing stakeholders in the elder community. Community meetings and feedback from patrons of senior centers are also used in the planning process. Over the past 40 years, a great deal of thought and energy and research has gone into devising a delivery system that is both efficient and cost effective. In fact, the 29,000 service providers nationwide providing care under the act are the largest single network of long-term care providers in the country.
Local agencies on aging represent geographic areas in a state that can be serviced effectively by that local unit. Area agencies on aging normally contract with local for profit or nonprofit or public providers to deliver benefits. An agency may be allowed to provide directly, supportive services, nutrition services, or in-home services if it can prove a case for providing these services more effectively. An agency may also provide directly, case management services and information and assistance services depending on the methods used for such services in that state. Agencies may also use employees from cooperating or sponsoring counties or cities to staff and administer programs such as senior centers. Much of the work performed comes from dedicated volunteers who are both individuals and employer sponsored teams. This entire aging network system seems to work very well in accomplishing the goals of the Older Americans Act.
The Administration on Aging
The Administration on Aging is established by the Older Americans Act as a separate agency under the Department of Health and Human Services. HHS has the largest single budget in the executive branch and includes the centers for Medicare and Medicaid services (CMS) , the FDA, Centers for Disease Control (CDC), the National Institutes of Health (NIH) and a number of other smaller agencies. The AoA is a small agency with only about 130 employees and compared to its huge sister agency, the CMS, its budget is very tiny. The work of the agency is carried out by a staff in Washington , DC and through 10 regional offices that serve the states, territories, the district of Columbia and about 250 tribal organizations throughout the country. The president appoints an Assistant Secretary of the Administration on Aging to manage its affairs.
The Administration on Aging has guided the development of the national aging services network that today consists of 56 State units on aging, 655 area agencies on aging, almost 250 Tribal organizations, 29,000 community-based provider organizations, over 500,000 volunteers, and a wide variety of national non-profit organizations. This nationwide infrastructure currently provides a wide array of home and community-based services to over 8 million elderly individuals each year, which is 17 percent of all people aged 60 and older, including 3 million individuals who require intensive services and meet the functional requirements for nursing home care. It also provides direct services to over 600,000 informal caregivers each year, who are struggling to keep their loved ones at home. The national aging network is the largest long-term care provider network in the country.
The AOA works closely with other agencies in the Department of Health and Human Services to help formulate and administer programs for the elderly. In fact over two thirds of state Medicaid programs for home care (home and community-based waivers) are administered by area agencies on aging. Investigative and demonstration grants and surveys are often jointly pursued by a number of agencies in the department.
Area Agencies on Aging -- Purpose and Description
Area agencies on aging are the designated managers for state service and planning areas. A service and planning area is a geographic area of the state with more than 100,000 people and containing a significant number of elderly over the age of 60 that can be effectively served by the area agency under the Older Americans Act. The following can be designated as an area agency on aging to manage a service and planning area:
- An already established entity that is meeting the requirements of the state.
- A city, a county, a council of government or a regional planning commission in the service and planning area where the elected official in charge has designated an agency or office in its government organization to act as an area agency on aging.
- A public or nonprofit private agency in a planning and service area which can meet the requirements from the state as an area agency on aging.
Any of these organizations must be able to meet the statutory requirements and state requirements and operate as an area agency on aging.
In many states, area agencies on aging operate as an office of a county and county employees are used to run the organization. In large urban areas cities may manage an area. In areas that are sparsely populated, area agencies may operate under a regional planning commission or a council of government with multi-county employees or with a nonprofit company providing the management. A number of states have chosen to divide their states into multi-county regions or service areas. Where none of these natural subdivisions fit, a large rural area may be defined as a service and planning area and receive a suitable name to identify it. Where county or city governments are unwilling or unable to provide management, a number of states have chosen to contract with nonprofit organizations to run those particular area agencies in their states. Of the 655 AAAs across the country, approximately 67 percent are public agencies such as cities, counties, councils of government or regional planning commissions and 33 percent are private, non-profit organizations.
Area agencies do not always call themselves an "area agency on aging" and may use other names to identify themselves. Many nonprofits that receive their operating funds from state aging units typically use their nonprofit name instead of identifying themselves as an area agency on aging. Large county and large city AAA's often disguise themselves under government designated aging departments. States divided into multi-county regions may identify themselves as region one or planning area 2 and so forth. These many name conventions can be confusing to the public since using another name may not alert seniors or their families to the services they would expect under the Older Americans Act, national aging network. On the other hand, many nonprofit agencies that except money under the older Americans act and operate service areas are required to offer the same services as government-sponsored agencies. Here are some examples of some of the names.
- Northwest Alabama Council of Local Governments
- Southern Alabama Regional Council on Aging
- South Alabama Regional Planning Commission
- Middle Alabama Area Agency on Aging Central
- Alabama Aging Consortium
- Division of Aging and Community Services/Aging and Adult Administration - Regions 1 to 8
- Central Coast Commission for Senior Citizens
- San Francisco Department of Aging and Adult Services
- Los Angeles City Department of Aging
- Los Angeles County Aging and Adult Services
- Denver Regional Council of Governments Aging Services Division
- South-Central Colorado Seniors, Inc.
- Senior Resources
- Senior Resource Alliance
- Alliance for Aging
- Southern Crescent Region
- Metro Atlanta Region Commission
- Heart of Georgia Region
- Chicago Department on Aging
- Northwest Indiana Community
- Action Corp.
- REAL Services, Inc.
- Aging and In-Home Services of Northeast Indiana, Inc.
- Senior Spectrum
- (and the list goes on and on)
The older Americans act funding is not the only source of money for area agencies on aging. Agencies may also manage other government programs such as Medicaid waivers for home care, social service block grants, transportation programs and other state home care service programs. Currently about two thirds of all Medicaid home and community waivers are managed by area agencies on aging. Many agencies may have 10 or more different government funding sources for programs under their management. Nonprofit organizations acting as area agencies on aging may also be receiving community donations as well. And on the other hand many nonprofits who are not area agencies may be accepting funding under the older Americans act to furnish programs such as community meals or homes served meals.