Older Americans Act Funding
Home- and Community-Based Services
The OAA budget charts on the preceding page, listing congregate meals and home-delivered meals as categories separate from Home- and Community-Based Services (HBCS), may very well beg the question: “Aren’t home-delivered meals (by definition) and congregate meals (served in senior centers, community centers, church basements, etc.) home- and community-based services?”
They most certainly are. But, as Congress has a tradition of ensuring that senior nutrition services are prioritized, Congregate Meals (aka Title III-C1) and Home-Delivered Meals (aka Title III-C2) have retained line-item budgeting status distinct from, rather than as components of, Home- and Community-Based Services (aka “supportive services,” Title III-B). It should be noted, though, that the OAA allows states to shift up to 30 percent of funding from home-delivered and/or congregate meals to general HCBS programs and vice-versa (about $33 million is transferred to HCBS, annually). Further, states can transfer up to 40 percent of funding between congregate and home-delivered meal programs (about $30 million is transferred to home-delivered meals, annually).
In short, nutrition services are separate from general HCBS for technical, budgetary purposes, but are one and the same as general HCBS for all practical purposes. To simplify understanding of the distribution of the various HCBS services funded and distributed via the Older Americans Act, the budget chart on the following page categorizes home-delivered and congregate meals as components (or subsets) of HCBS. As the chart shows, home-delivered and congregate meals (totaling $440,966,529) comprised 56 percent of the $787,662,815 OAA dollars allocated for all HCBS programs in 2005 (the latest year for which such figures are available.)
The following HCBS chart lists Other Services, which at $106 million is the third highest category in the chart. This category is composed of more than 20 services, from advocacy to home modification to “wanderer locator” (motion detectors for people with Alzheimer’s disease). The services are placed together under one heading by AoA as a means of keeping the chart from becoming unwieldy and overly cumbersome. More etailed information regarding the HCBS budget chart may be accessed via the AoA Website: www.aoa.gov/prof/agingnet/NAPIS/SPR/2005SPR/profiles/us.pdf
Fiscal Year 2005 Funding for OAA HCBS Services
(in Millions of Dollars)
Total = Approx. $787 Million (slightly less due to rounding)
Please Note:
The “Other Services” category in the chart above is a catch-all for a range of Home- and Community-Based Services, including: Advocacy, Alternative Living Arrangements (i.e., help in finding); Benefits Specialist; Companion & Friendly Visitor Services; Competency Evaluations; Counseling (Mental Health); Employment Assistance; Environment Accessibility; Exercise & Physical Education; Financial Management; Geriatric Assessment; Grocery Shopping; Guardianship (Legal); Home Modification; Letter Writing; Occupational Therapy; Support Groups (e.g., Arthritis and Parkinson’s disease); Translation (English/Spanish); Public Utility Assistance; Volunteer Recruitment & Development; and Wanderer Locator (electronic motion sensors). Also, “Case Management” refers to administrative and professional efforts coordinating a comprehensive range of senior services for individuals. For example, case managers often spend hours, days and weeks contacting, procuring, arranging funding for and following up on various services for clients. “Outreach” is used to get the word out on the availability of services (many of them free of cost) to older Americans. This outreach often takes the form of paid advertisements on TV, radio and in newspapers, as well as actual door-to-door, person-to-person communications. “Transportation” actually represents the combination of two categories, Transportation (actual services, $67.6 million) and Assisted Transportation (covering individuals needing personal assistance with transportation, such as the visually impaired, $3.8 million). Likewise, the “Nutrition Education” category is composed of Nutrition Education (usually group instruction overseen by a licensed dietitian, $3.4 million) and Nutrition Counseling (usually individual counseling by a licensed dietitian, $1.3 million).