As planned, Choices would build on various existing programs, including the Cash & Counseling Demonstration Project (1) (allowing consumers to select family members, friends and neighbors as government-paid caregivers) and the Aging and Disability Resource Centers (2) (providing a single point of entry into the aging network, making services more accessible), and integrate other in-home service demonstration projects and best practices into a three-point strategy focused on:

1. empowering individuals to make informed decisions about their long-term support options;
2. providing more choices for individuals at high-risk of nursing home placement; and
3. enabling older people to make behavioral changes that will reduce their risk of disease, disability, and injury.

Choices would allow states and communities greater flexibility under the Older Americans Act to help older individuals to remain in their homes and delay what may be their premature entry into nursing homes. The program would provide flexible funding targeted at individuals, not service categories, as with the current titles under the Act. This flexible funding method should make it easier for states to respond to individualized needs and preferences and promote the use of consumer-directed approaches, including “cash and counseling” models giving consumers more control over the care they receive. Choices also will stress preventive medicine and health promotion, empowering older Americans to make lifestyle changes that will reduce their risk of disease, disability, and injury. A growing body of scientific evidence supports the benefits of low-cost programs empowering older individuals, including those functionally impaired, to better maintain their health. These programs focus on interventions such as chronic disease self-management, falls prevention, exercise, and nutrition.

Additionally, Choices would strengthen the role of the Older Americans Act in translating research into practice. Choices would do so by promoting the use of evidence-based health promotion and disease prevention programs at the community-level through local aging services provider organizations, such as senior centers, nutrition programs, senior housing projects, and faith-based groups. The nationwide deployment of these programs will improve quality of life while reducing health-care costs.

(1) Cash & Counseling : www.cashandcounseling.org/about/partners, and

AoA Memorandum: Cash & Counseling Projects: www.hhp.umd.edu/AGING/CCDemo/AOA.html

(2) AoA: Aging and Disability Resource Centers: www.aoa.gov/prof/aging_dis/aging_dis.asp

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