Project 2020: Fulfilling the Promise

of the Older Americans Act

Background

2

Winter meetings of NASUA and n4a Boards have met dozens of times to

hammer out agreements Reauthorization of Older Americans Act

language Seeking appropriations to match the

authorizing language Using the past five years tested and proven

best practices

A Joint Proposal of NASUA and n4a

First, do no harm. Build on current aging services network, not replace it. Encourage individuals ability to live independently. Continue to serve the unique needs of rural, poor,

minority, and disabled and aging populations. Support consumer directed initiatives. Services should not be greater than the Medicaid waiver

program. Encourage the increased use of technology to support

efforts. Recognize that individuals, AAAs, SUAs, providers, and

the federal government all have to contribute to make the program successful.

NASUA/n4a Principles

3A Joint Proposal of NASUA and

n4a

Medicaid Nursing Facility Spending

FY00 FY01 FY02 FY03 FY04 FY05 FY0636

38

40

42

44

46

48

50

Billions o

f D

ollars

4A Joint Proposal of NASUA and

n4a

Need for Action

5A Joint Proposal of NASUA and

n4a

0

10

20

30

40

50

60

70

80

Growth of Persons Age 65+

1900-2030

num

bers

in m

illions

Percent of Individuals with Limitations in Activities of Daily Living by Age Group

A Joint Proposal of NASUA and n4a 6

Bathing/Shower-ing

Dressing Eating Getting in/out of bed/chairs

Walking Using toilet0

5

10

15

20

25

30

35

40

45

50

65-7475-8485 and older

Who We Serve?◦ 27% of consumers are poor◦ 33% of consumers live in rural areas◦ 20% of consumers are minority◦ 52% of older persons report having a disability

Who Are We?◦ 56 State Units on Aging◦ 655 Area Agencies on Aging◦ Thousands of Service Providers

The Aging Services Network

7A Joint Proposal of NASUA and

n4a

1. Person-Centered Access to Information2. Evidence-Based Health Promotion and

Disease Prevention2. Enhanced Nursing Home Diversion

Services

Components of the Proposal

8A Joint Proposal of NASUA and

n4a

Component of Program

Service

Person-Centered Access to Information

Provides assistance, access, counseling and awareness of long-term care services and supports

Evidence-Based Disease Prevention and Health Promotion

Targets scientifically proven interventions to reduce chronic disease and disability to affected elderly individuals

Enhanced Nursing Home Diversion Services

Provides consumer directed community care to individuals at high risk of institutionalization

Components of the Proposal

9A Joint Proposal of NASUA and

n4a

Component of Program

Eligibility Criteria

Estimated Number of Recipients (5 years)

Estimated Number of Recipients (10 years)

Person-Centered Access to Information

Anyone interested in Long-Term Care

40 million 105 million

Evidence-Based Disease Management and Health Promotion

Individuals 60 or older or who are at risk of falls

1.2 million 3.9 million

Enhanced Nursing Home Diversion Services

300 percent of SSI with assets in excess of $25,000

118,000 164,000

A Joint Proposal of NASUA and n4a 10

Number of Recipients

Components of Program

Estimated Federal Net Change (5 years)

Estimated Federal Net Change (10 years)

Person-Centered Access to Information

$305 million $1.1 billion

Evidence-Based Disease Prevention and Health Promotion

-$852 thousand $51 million

Enhanced Nursing Home Diversion Services

-$1.6 million $153 million

Federal Savings

11A Joint Proposal of NASUA and

n4a

Federal State Total

Outlays $582.7 million $194.2 million $776.9 million

Savings $1.7 billion $1.3 billion $3.0 billion

Net Change $1.1 billion $1.1 billion $2.2 billion

A Joint Proposal of NASUA and n4a 12

Person-Centered Single-Entry Point Systems

*Over 10 years

Federal State Total

Outlays $823.3 million $145.3 million $968.5 million

Savings $874.3 million $_____* $874.3 million

Net Change $51.1 million -$145.3 million -$94.2 million

A Joint Proposal of NASUA and n4a 13

Evidence-Based Health Promotion and Disease Prevention

*Over 10 years

Federal State Total

Outlays $7.4 billion $4.5 billion $11.9 billion

Savings $7.6 billion $5.8 billion $13.4 billion

Net Change $152.7 million $1.4 billion $1.5 billion

A Joint Proposal of NASUA and n4a 14

Enhanced Access to Home and Community Based Services

*Over 10 years

Technology Grants (examples of some uses)◦ To build web portals for ADRCs◦ To develop on-line training programs for disease

management◦ To build health information exchanges for

community centers Technical Assistance

◦ State and community level-specific, tailored technical assistance

Evaluation

Other Components

15A Joint Proposal of NASUA and

n4a

Competitive Grant program Nursing Home Diversion Component rolled

out in three phases Maximizes state flexibility in design of their

program to best suit needs of their state State’s match

◦ 25 percent of ADRC program◦ 15 percent of evidence-based program◦ Difference between FMAP plus 5 for Nursing Home

Diversion program

A Joint Proposal of NASUA and n4a 16

How would it work?

A Joint Proposal of NASUA and n4a 17

What’s Next?

A Joint Proposal of NASUA and n4a 18

For additional information

Martha Roherty, Executive DirectorNASUA

1201 15th Street, NWSuite 350

Washington, DC 20005202-898-2578

mroherty@nasua.org

Sandy Markwood, CEOn4a

1730 Rhode Island Avenue, NWSuite 1200

Washington, DC 20036202-872-0888

smarkwood@n4a.org