For other versions of this document, see http://wikileaks.org/wiki/CRS-RL33880 ------------------------------------------------------------------------------ Order Code RL33880 Older Americans Act: FY2008 Funding and FY2009 Funding Proposals Updated October 8, 2008 Angela Napili Information Research Specialist Knowledge Services Group Older Americans Act: FY2008 Funding and FY2009 Funding Proposals Summary The Older Americans Act (OAA) is the major federal vehicle for the delivery of social and nutrition services for older persons. These include supportive services, congregate nutrition services (meals served at group sites such as senior centers, community centers, schools, churches, or senior housing complexes), home-delivered nutrition services, community service employment, the long-term care ombudsman program, and services to prevent the abuse, neglect and exploitation of older persons. The OAA also supports grants to older Native Americans and research, training, and demonstration activities. Funding for most OAA programs is provided through appropriations legislation for the Departments of Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS-Education). On February 4, 2008, the President submitted his FY2009 budget request, which would provide $1.731 billion for OAA programs, a 10% decrease from the FY2008 funding level of $1.924 billion. On July 8, 2008, the Senate Appropriations Committee reported its FY2009 Labor-HHS-Education bill (S. 3230, S.Rept. 110-410). The bill would provide $2.039 billion for OAA programs, 6% higher than the FY2008 funding level. On September 30, 2008, the President signed P.L.110-329, the Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009, which provides temporary FY2009 funding, at FY2008 funding levels, through March 6, 2009. For OAA's Title V Senior Community Service Employment Program (SCSEP), the FY2009 Budget requests $350.0 million, a 33% decrease from the FY2008 funding level of $521.6 million. S.Rept. 110-410 would provide $571.9 million in FY2009, a 10% increase from the FY2008 level. Funding for preventive health services under OAA's Title III would be eliminated under the FY2009 budget request. S.Rept. 110-410 would provide $21 million in FY2009, the same as the FY2008 funding level. The FY2009 budget request would also eliminate funding for Alzheimer's Disease Demonstration Grants. S.Rept. 110-410 would provide $11.5 million in FY2009, the same as the FY2008 level. For nutrition services under Title III, the FY2009 Budget requests $758.0 million, the same funding level as FY2008. S.Rept. 110-410 would increase funding for nutrition services by 6% in FY2009 to $801.5 million. The FY2009 Budget requests $28.0 million under OAA's Title IV for the new Choices for Independence demonstration, intended to help older Americans plan for their long-term care needs so that they can maintain their independence in the community. S.Rept. 110-410 would provide $28.0 million for Choices for Independence under Title II Aging Network support activities, rather than as a demonstration under Title IV. In FY2008, Congress appropriated $16.2 million to Choices for Independence under Title II Aging Network support activities. Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 FY2008 Funding and FY2009 Funding Proposals . . . . . . . . . . . . . . . . . . . . . . . . 1 Title II. Administration on Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Title III. Grants for State and Community Programs on Aging . . . . . . . . . . . 4 Title IV. Program Innovations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Title V. Community Service Employment for Older Americans . . . . . . . . . . 6 Title VI. Grants for Services for Native Americans . . . . . . . . . . . . . . . . . . . 7 Title VII. Vulnerable Elder Rights Protection Activities . . . . . . . . . . . . . . . . 8 Alzheimer's Disease Demonstration Grants . . . . . . . . . . . . . . . . . . . . . . . . . 8 List of Tables Table 1. The Older Americans Act, Alzheimer's Demonstration Grants, and White House Conference on Aging Funding, FY2000-FY2008, and FY2009 Funding Proposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 List of Figures Figure 1. Older Americans Act, FY2008 Funding . . . . . . . . . . . . . . . . . . . . . . . 11 Figure 2. Funding for Older Americans Act Programs, FY2000-FY2008, and FY2009 Proposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Older Americans Act: FY2008 Funding and FY2009 Funding Proposals Introduction Originally enacted in 1965, the Older Americans Act (OAA) supports a wide range of social services and programs for older persons.1 These include supportive services, congregate nutrition services (meals served at group sites such as senior centers, community centers, schools, churches, or senior housing complexes), home- delivered nutrition services, community service employment, the long-term care ombudsman program, and services to prevent the abuse, neglect, and exploitation of older persons. Except for Title V, Community Service Employment for Older Americans, all programs are administered by the Administration on Aging (AoA) in the Department of Health and Human Services (HHS). Title V is administered by the Department of Labor (DOL) Employment and Training Administration. Table 1 summarizes OAA appropriations from FY2000 through FY2008, the President's FY2009 Budget Request, and the Senate-reported Labor-HHS-Education bill (S. 3230, S.Rept. 110-410). It includes funding for the Alzheimer's Disease Demonstration Grants and the 2005 White House Conference on Aging. Figure 1 shows the distribution of FY2008 OAA funding by program. Figure 2 shows total OAA funding from FY2000 through FY2008 and total OAA funding proposed in the FY2009 Budget Request and S.Rept. 110-410.2 FY2008 Funding and FY2009 Funding Proposals On December 26, 2007, the President signed the Consolidated Appropriations Act, 2008 (P.L. 110-161), which provided $1.924 billion for OAA programs in FY2008, 4% more than the FY2007 level. This figure includes the act's across-the-board reduction of 1.747% for items in the Labor-HHS-Education division.3 1 The OAA was reauthorized in 2006 by P.L. 109-365. For further information, see CRS Report RL31336, The Older Americans Act: Programs, Funding, and 2006 Reauthorization (P.L. 109-365), by Carol O'Shaughnessy and Angela Napili. An unofficial compilation of the OAA, as amended, is at the Administration on Aging website [http://www.aoa.gov/ OAA2006/Main_Site/oaa/oaa_full.asp]. 2 For information on OAA appropriations in earlier years, see CRS Report RL32437, Older Americans Act: History of Appropriations, FY1966-FY2004, by Carol O'Shaughnessy. 3 The Consolidated Appropriations Act (P.L. 110-161) Division G, on Labor-HHS- Education appropriations, includes an across-the-board reduction of 1.747% to accounts, (continued...) CRS-2 On February 4, 2008, the President submitted his FY2009 Budget Request, which would provide $1.731 billion for OAA programs, a 10% decrease from the FY2008 funding level. On June 26, 2008, the House Appropriations Committee met to mark up its draft FY2009 Labor-HHS-Education appropriations bill, but the session was suspended before final action. On July 8, 2008, the Senate Appropriations Committee reported its FY2009 Labor-HHS-Education bill (S. 3230, S.Rept. 110-410). It would provide $2.039 billion for OAA programs, 6% higher than the FY2008 funding level. On September 30, 2008, the President signed a continuing resolution, P.L.110- 329, the Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009. P.L. 110-329 provides temporary FY2009 funding, at FY2008 funding levels, through March 6, 2009. Under the continuing resolution, OAA funds are made available at the same level and under the same conditions as in FY2008. The following provides details of funding under Titles II through VII of the OAA. Title I (Declaration of Objectives) does not authorize appropriations. Title II. Administration on Aging Title II establishes AoA within HHS as the chief federal agency advocate for older persons and sets out the responsibilities of AoA and the Assistant Secretary for Aging. The Assistant Secretary is appointed by the President with the advice and consent of the Senate. Funding authorized under Title II goes toward program administration and Aging Network support activities. Aging Network support activities currently include the following: ! the National Eldercare Locator, a nationwide toll-free phone number and website that helps identify community resources for older persons; ! the Pension Counseling and Information Program, which funds regional counseling projects that help older Americans learn about and receive the retirement benefits to which they are entitled; ! the Senior Medicare Patrol Program, which funds projects that educate older Americans and their families to recognize and report Medicare and Medicaid fraud; ! the National Long-Term Care Ombudsman Resource Center, which provides training and technical assistance to state and local long- term care ombudsmen; and ! the National Center on Elder Abuse, which provides information to the public and professionals, and provides training and technical 3 (...continued) items, programs, projects, and activities in the bill text and the Explanatory Statement narrative, with some exceptions (Title V, §528). CRS-3 assistance to state elder abuse agencies and to community-based organizations. ! The Choices for Independence initiative, which helps older Americans plan for long-term care services and supports so that they can maintain their independence in the community.4 Choices for Independence reflects recently authorized provisions in the Older American Act Amendments of 2006 (P.L. 109-365) related to Aging and Disability Resource Centers (ADRCs), evidence-based prevention programs, and consumer-directed services targeted to persons at high risk of nursing home placement and spend-down to Medicaid.5 The FY2008 Consolidated Appropriations Act (P.L. 110-161) provided $49.7 million for Title II in FY2008, including an $18.5 million increase from FY2007 for Aging Network support activities. This increase included $16.2 million for the new Choices for Independence initiative. Choices for Independence is explained in more detail in the Title IV section below. The Administration's FY2008 budget request would have funded Choices for Independence at $28.0 million under Title IV, which authorizes funds for training, research, and demonstration projects. However, the House-passed, Senate-passed, and conference report versions of FY2008 Labor-HHS-Education appropriations bills, as well as the FY2008 Consolidated Appropriations Act (P.L. 110-161), all provided funding for Choices for Independence under Title II Aging Network support activities.6 The House committee report explained that "[t]hese established programs, which began as demonstration projects, provide critical support for the national aging services network."7 The FY2009 Budget requests $31.8 million for Title II, and repeats the FY2008 Budget's proposal to fund Choices for Independence as a demonstration project under Title IV, rather than under Title II. The Senate-reported Labor-HHS-Education proposal requests $62.4 million for Title II in FY2009, including $28.0 million for Choices for Independence under Title II Aging Network support activities. 4 HHS, AoA, Fiscal Year 2009 Justification of Estimates for Appropriations Committees, pp. 61and 69, at [http://www.aoa.gov/about/legbudg/current_budg/docs/FinalAoAFY2009 CongressionalJustification01282008.pdf]. 5 H.Rept. 110-231, p.207. 6 The House Appropriations Committee recommended that $16.5 million be used for Choices for Independence (H.Rept. 110-231, p. 207). The Senate Appropriations Committee recommended that $28.0 million would be used for the Choices for Independence Initiative (S.Rept. 110-107, p. 203). The conference report for H.R. 3043 would have provided $22.3 million for Choices for Independence activities (H.Rept. 110-424, p. 160). 7 H.Rept. 110-231, p.207. CRS-4 Title III. Grants for State and Community Programs on Aging The major program under the OAA, Title III -- Grants for State and Community Programs on Aging -- authorizes grants to 56 state and 655 area agencies on aging to act as advocates on behalf of, and to coordinate programs for older persons.8 Title III accounted for 67% of the OAA's total FY2008 funding. States receive separate allotments of funds for supportive services and centers, family caregiver support, congregate and home-delivered nutrition services, the nutrition services incentive grant program, and disease prevention and health promotion services. In FY2006, 9.5 million older persons were served by Title III programs.9 The FY2008 Consolidated Appropriations Act (P.L. 110-161) provided $1.284 billion for Title III, a 2% increase over the FY2007 level of $1.263 billion. Under the FY2008 Consolidated Appropriations Act, the Title III-C congregate meals program and the home-delivered meals program each had a 3% funding increase, and nutrition services incentives grants had a 4% increase from the previous year. Both Senate and House Appropriations Committee reports noted that funding for OAA nutrition programs had remained relatively flat over the past several years while the population of older Americans continued to increase. According to committee reports, the Senate Appropriations Committee "hopes that the funding increase provided will help alleviate the fiscal strain affecting these programs," and the House Appropriations Committee intended the increase "to be a significant first step in properly investing in the care of the nation's frail elderly."10 The FY2009 Budget proposes that funding for almost all Title III programs remain at their FY2008 levels. The exception is the Title III-D disease prevention and health promotion program; its funding ($21.0 million in FY2008) would be eliminated under the FY2009 Budget. The Budget Justification explains that "Integrating the provision of prevention services into AoA's core program structures will provide a more effective means to address preventive health needs than the previous approach of using a small funding stream to provide States with unfocused seed money."11 Therefore, the President's FY2009 budget request for all Title III programs is $1.263 billion, a 2% reduction from the FY2008 level. The Senate-reported Labor-HHS-Education proposal would provide $1.339 billion for Title III programs in FY2009, a 4% increase from FY2008. The report states that the Senate Appropriations Committee "is aware that many local senior nutrition 8 The 56 state agencies on aging include units in 50 states, 5 U.S. territories, and the District of Columbia. More information is at [http://www.aoa.gov/prof/agingnet/agingnet.aspx], the AoA website. 9 AoA, Aging Network, 2006 State Program Reports, "Table 1. Estimated Unduplicated Count of Persons Served Under Title III of the OAA," at [http://www.aoa.gov/prof/agingnet/ NAPIS/SPR/2006/Tables/Table1.pdf]. 10 S.Rept. 110-107, p. 201. H.Rept. 110-231, pp. 205-206. 11 HHS, AoA, Fiscal Year 2009 Justification of Estimates for Appropriations Committees, p. 35. CRS-5 programs are facing a crisis due to rising fuel and food costs."12 For Title III-C nutrition programs, S.Rept. 110-410 would provide a 6% increase over the FY2008 levels. For Title III-D disease prevention and health promotion, S.Rept. 110-410 would maintain funding at the FY2008 level of $21.0 million. Title IV. Program Innovations Title IV of the OAA authorizes the Assistant Secretary for Aging to award funds for training, research, and demonstration projects in the field of aging. In recent years, AoA has funded a number of national efforts that support the work of state and area agencies on aging, including national resource centers that focus on legal assistance, retirement needs of minority populations, and the vulnerable elderly. Other recent projects have included funding for Aging and Disability Resource Centers (ADRCs). The ADRC program provides competitive grants to states to help them develop and implement "one stop" access points to information on long-term care support options. The program is currently operating in 40 states, two territories, and the District of Columbia.13 Other activities have included outreach to help Medicare beneficiaries understand their benefits under the Medicare Modernization Act (MMA), conducted in cooperation with the Centers for Medicare and Medicaid Services. The FY2008 Consolidated Appropriations Act (P.L. 110-161) provided $14.7 million for Title IV in FY2008, $9.4 million less than the FY2007 level. For Title IV, the President's FY2009 budget request is $32.9 million. About 85% ($28.0 million) of requested Title IV funds would be used for the Choices for Independence demonstration described below. The balance of the request would be used to maintain support for ongoing activities, including national resource centers that provide technical assistance to aging service providers, multigenerational civic engagement activities, and program evaluation. According to the Administration's FY2009 Budget Justification, the Choices for Independence demonstration will be a randomized controlled experiment in three to five states. It will test whether Medicare and Medicaid savings can be achieved through home and community-based alternatives to nursing homes. Choices for Independence has three components. First, Aging and Disability Resource Centers provide public education, information, and assistance with planning for long-term care. Consumers receive information on private financing options (such as long-term care insurance and home equity conversions), home modification, assistive technology, and options for alternative living arrangements. Second, the "Evidence-Based Prevention" component helps seniors change behavior to reduce risk of disease and disability. Funds support activities in areas such as falls prevention, exercise, chronic disease self-management, medication management, and nutrition. This component builds on existing Title IV evidence-based disease prevention projects. Third, the "Nursing Home Diversion" component gives states a "flexible funding source" they could use to help seniors avoid institutionalization. This component would provide financial incentives to low-to-moderate-income individuals who are at risk of nursing home placement but 12 S.Rept. 110-410, p.163. 13 A directory of ADRCs is at the Aging and Disability Resource Center Technical Assistance Exchange website, [http://www.adrc-tae.org]. CRS-6 who are not yet eligible for Medicaid. ADRCs would help older people and their families develop a plan to meet their long-term care needs. According to the Budget Justification, the Choices for Independence initiative would require a 25% state match for all three components, and states would have to meet certain performance and outcome standards as a condition of participation.14 The Administration estimates that through the FY2009 Choices for Independence demonstration, there would be 156,000 ADRC contacts, 10,000 participants in the evidence-based chronic disease self-management program, and 359 clients served through the nursing home diversion component.15 As mentioned previously, the FY2008 Consolidated Appropriations Act funded various Choices for Independence activities under Title II Aging Network support activities, rather than as a demonstration project under Title IV. S.Rept. 110-410 would provide $10.1 million for Title IV programs in FY2009. The Senate proposal would again fund Choices for Independence activities under Title II Aging Network support activities, rather than as a demonstration project under Title IV. Title V. Community Service Employment for Older Americans Title V, also known as the Senior Community Service Employment Program (SCSEP), has as its purpose the promotion of useful part-time opportunities in community service activities for unemployed low-income persons who are 55 years or older and who have poor employment prospects. For FY2008, the community service employment program represents more than a quarter of the OAA's funds ($521.6 million out of $1.924 billion). Enrollees work part-time in a variety of community service activities. DOL estimates that in FY2008 the program will provide for 59,316 job slots, serving about 105,914 participants, at a cost of $4,925 per participant.16 Enrollees are paid no less than the highest of the federal minimum wage, the state or local minimum wage, or the prevailing wage paid by the same employer for similar public occupations. In addition to wages, enrollees receive physical examinations, personal and job-related counseling, and transportation for employment purposes, under certain circumstances. The 2006 Older Americans Act reauthorization amendments (P.L. 109-365) maintained the program focus on employing older people in community service jobs and reemphasized the community service aspects of the program. While the program is to move participants into unsubsidized employment, the amendments recognized that many older people who have special needs may need to remain in subsidized 14 HHS, AoA, Fiscal Year 2009 Justification of Estimates for Appropriations Committees, pp. 4, 61, and 64-67. 15 HHS, AoA, Fiscal Year 2009 Justification of Estimates for Appropriations Committees, p. 66. 16 DOL, FY2009 Congressional Budget Justficiation, Employment and Training Administration, Community Service Employment for Older Americans, pp. CSEOA-18-19, at [http://www.dol.gov/dol/budget/2009/PDF/CBJ-2009-V1-05.pdf]. CRS-7 employment and that the program supplements the income for some workers who cannot find jobs in the private economy.17 The Consolidated Appropriations Act (P.L. 110-161) provided $521.6 million for Title V in FY2008, an 8% increase over the FY2007 funding level. The Explanatory Statement explained that the increase allows for the federal minimum wage increase to $6.55 per hour effective July 24, 2008.18 (The program year for FY2008 funds begins July 1, 2008.) The Administration's FY2009 budget requests $350.0 million for Title V, a reduction of 33% from the FY2008 level. According to the Administration, the proposed level would fund approximately 36,300 job slots serving 71,795 participants in 2009, at a cost per participant of $4,875. A 2003 DOL/Office of Management and Budget program assessment rated the program ineffective, in part because of "lack of competition in the program" and "its duplication of other federal programs." The DOL Budget Justification states that "In FY2009, the workforce investment system will play a stronger role in placing job-ready older workers in unsubsidized employment as an alternative to placing them in SCSEP subsidized employment."19 S.Rept. 110-410 would provide $571.9 million for Title V programs in FY2009, a 10% increase over the FY2008 level. The federal minimum wage is scheduled to increase to $7.25 per hour effective July 24, 2009. (The program year for FY2009 funds begins July 1, 2009.) Title VI. Grants for Services for Native Americans Title VI authorizes funds for supportive and nutrition services to older Native Americans. Funds are awarded directly by AoA to Indian tribal organizations, Native Alaskan organizations, and non-profit groups representing Native Hawaiians. To be eligible for funding, a tribal organization must represent at least 50 Native American elders age 60 or older. In FY2007, grants were awarded to 237 tribal organizations representing approximately 300 Indian tribes and two organizations serving Native Hawaiian elders.20 The program provides services such as transportation, home- delivered and congregate nutrition services, information and referral, and a wide range of home care services. 17 For further information, see CRS Report RL31336, Older Americans Act: Programs, Funding, and 2006 Reauthorization, by Carol O'Shaughnessy and Angela Napili. 18 U.S. House Committee on Appropriations, Consolidated Appropriations Act, 2008, Committee Print of the Committee on Appropriations, U.S. House of Representatives, on H.R. 2764 / Public Law 110-161, January 2008, p. 1471, at [http://www.gpoaccess.gov/ congress/house/appropriations/08conappro.html]. The minimum wage increase is in P.L. 110-28, §8102. 19 DOL, FY2009 Congressional Budget Justficiation, Employment and Training Administration, Community Service Employment for Older Americans, pp. CSEOA-10, 14, and 18-19. 20 HHS, AoA, Fiscal Year 2009 Justification of Estimates for Appropriations Committees, p. 45. CRS-8 The 2000 amendments (P.L. 106-501) added a new part to Title VI authorizing caregiver support services to Native American elders. Respite, caregiver training, information and outreach, counseling, and support groups are among the services provided. The FY2008 Consolidated Appropriations Act (P.L. 110-161) provided $33.2 million for Title VI, a 3% increase over the FY2007 level. The FY2009 budget request and S.Rept. 110-410 would both provide $33.2 million for FY2009, the same as the FY2008 funding level. Title VII. Vulnerable Elder Rights Protection Activities Title VII authorizes the long-term care ombudsman program as well as elder abuse, neglect, and exploitation prevention programs. Most Title VII funding is directed at the long-term care ombudsman program. Of its $20.6 million funding in FY2008, three-quarters was for ombudsman activities. The purpose of the program is to investigate and resolve complaints of residents of nursing facilities, board and care facilities, and other adult care homes. In FY2006, ombudsmen handled nearly 286,000 complaints, conducted investigations on over 190,000 cases, and provided almost 440,000 consultations to long-term care facilities' staff.21 The FY2008 Consolidated Appropriations Act (P.L. 110-161) provided $20.6 million for Title VII, a 2% increase over the FY2007 level. The Administration's FY2009 budget request and S.Rept. 110-410 would both provide $20.6 million, the same as the FY2008 level. Alzheimer's Disease Demonstration Grants The FY2008 Consolidated Appropriations Act (P.L. 110-161) funds Alzheimer's Disease Demonstration Grants at $11.5 million, 2% less than the FY2007 level. This program is administered by AoA but it is not part of the Older Americans Act.22 The Administration's FY2009 budget request would eliminate Alzheimer's Disease Demonstration Grant funding. The Administration argues that the program, active since 1992, "has served the purpose of generating new models and approaches that States can now incorporate into their own State and community programs." The Budget Justification also notes that states can use Title III funds, including Family Caregiver funds, to provide care for persons with Alzheimer's.23 S.Rept. 110-410 would maintain funding for Alzheimer's Disease Demonstration Grants at $11.5 million, the same as the FY20008 level. 21 HHS, AoA, Fiscal Year 2009 Justification of Estimates for Appropriations Committees, p. 52. 22 The program was authorized under Sections 398 to 398B of the Public Health Service Act (42 U.S.C. 280c-3 to 280c-5). Authorization of appropriations expired in 2002. 23 HHS, AoA, Fiscal Year 2009 Justification of Estimates for Appropriations Committees, p. 76. CRS-9 Table 1. The Older Americans Act, Alzheimer's Demonstration Grants, and White House Conference on Aging Funding, FY2000-FY2008, and FY2009 Funding Proposals ($ in millions) OAA Programs, Alzheimer's FY2009 FY2009 Demonstration Grants, and White FY2000 FY2001 FY2002 FY2003 FY2004 FY2005k FY2006l FY2007m FY2008 p S.Rept. Request House Conference on Aging 110-410 Title II: Administration on Aging $16.461 $17.232 $20.501 $20.233 $30.618 $31.567 $30.812 $31.518 $49.653 $31.829 $62.388 Program administration 16.461 17.232 18.122 17.869 17.324 18.301 17.688 18.385 18.064 18.696 $18.696 Aging network support activities n/a n/a 2.379f 2.364f 13.294h 13.266h 13.124h 13.133h 31.589o 13.133r 43.692r Title III: Grants for State and 987.617 1,151.285 1,230.293 1,240.891 1,243.059 1,250.192 1,242.378 1,263.232 1,283.816 $1,262.790 $1,338.855 Community Programs on Aging Supportive services and centers 310.082 325.082 357.000 355.673 353.889 354.136 350.354 350.595 351.348 351.348 361.348 Family caregiversa n/a 125.000 136.000 149.025 152.738 155.744 156.060 156.167 153.439 153.439 155.000 Disease prevention/health promotion 16.123 21.123 21.123 21.919 21.970 21.616 21.385 21.400 21.026 0 21.026 Nutrition services 661.412 680.080 716.170 714.274 714.462 718.696 714.579 735.070 758.003 758.003 801.481 -- Congregate meals (374.336) (378.412) (390.000) (384.592) (386.353) (387.274) (385.054) (398.919)n (410.716) (410.716) (434.269) -- Home-delivered meals (146.970) (152.000) (176.500) (180.985) (179.917) (182.826) (181.781) (188.305)n (193.858) (193.858) (205.005) -- Nutrition services incentive grants (140.000) (149.668)e (149.670) (148.697)g (148.192) (148.596) (147.744) (147.846) (153.429) (153.429) (162.207) Title IV: Program Innovations 31.162 37.678 38.280 40.258 33.509i 43.286 24.578 24.058 14.655 32.918r 10.102r Title V: Community Service 440.200 440.200 445.100 442.306 438.650 436.678 432.311 483.611n 521.625 350.000 571.925 Employment for Older Americans Title VI: Grants to Native Americans 18.457 23.457 31.229 33.704 32.771 32.702 32.353 32.375 33.214 33.214 33.214 Supportive and nutrition services 18.457 23.457 25.729 27.495 26.453 26.398 26.116 26.134 26.898 26.898 26.898 Native American caregiversb n/a 0 5.500 6.209 6.318 6.304 6.237 6.241 6.316 6.316 6.316 Title VII: Vulnerable Elder Rights 13.181 14.181 17.681 18.559 19.444 19.288 20.142 20.156 20.633 20.633 22.133 Protection Activities d d d d Long-term care ombudsman program 14.276 14.162 15.000 15.010 15.577q 15.577 17.077 d d d d q Elder abuse prevention 5.168 5.126 5.142 5.146 5.056 5.056 5.056 Legal assistance 0 0 0 0 0 0 0 0 0 0 0 Native Americans elder rights program 0 0 0 0 0 0 0 0 0 0 0 Total Older Americans Act Programs $1,507.078 $1,684.033 $1,783.084 $1,771.057 $1,798.051 $1,813.713 $1,782.574 $1,854.950 $1,923.596 $1,731.384 $2,038.617 Alzheimer's Demonstration Grantsc $5.970 $8.962 $11.500 $13.412 $11.883 $11.786 $11.660 $11.668 $11.464 0 $11.464 j j j White House Conference on Aging 0 0 0 0 $2.814 $4.520 0 0 0 0 0 CRS-10 Sources: FY2000-FY2006: Appropriations legislation and committee reports, various years. FY2007-FY2008: Consolidated Appropriations Act, 2008, Committee Print of the Committee on Appropriations, U.S. House of Representatives, on H.R. 2764 / Public Law 110-161, January, 2008, pp. 1776, 1809-1810, at [http://www.gpoaccess.gov/congress/house/appropriations/08conappro.html]. FY2009: U.S. Department of Health and Human Services, Administration on Aging, Fiscal Year 2009 Justification of Estimates for Appropriations Committees; U.S. Department of Labor, Fiscal Year 2009 Budget in Brief; S.Rept. 110-410. a. Authorized by the Older Americans Act Amendments of 2000 (P.L. 106-501, §316). Funding for Native American family caregiving is shown in Title VI. b. Authorized by the Older Americans Act Amendments of 2000 (P.L. 106-501, §604). c. The FY1999 Omnibus Consolidated Appropriations Act (P.L. 105-277) transferred the administration of the program from the Health Resources and Services Administration to AoA. The program was authorized under Sections 398 to 398B of the Public Health Service Act (42 U.S.C. 280c-3 to 280c-5). Authorization of appropriations expired in 2002. d. Separate amounts not specified. e. Congress originally appropriated $150 million, then rescinded $332,000 (0.22%) pursuant to Section 1(a)(4) of P.L. 106-554. f. Includes approximately $1.2 million for the Eldercare Locator, and $1.2 million for Pension Counseling and Information Program. These programs were authorized by the Older Americans Act Amendments of 2000 (P.L. 106-501, §205). g. Congress transferred the program, previously funded by the U.S. Department of Agriculture, to AoA in FY2003. P.L. 110-19 repealed certain provisions regarding state agency and tribal grantee commodity purchases, as added by the Older Americans Act Amendments of 2006 (P.L. 109-365), and restored former commodity purchase provisions, with revisions. h. Includes funds for activities previously funded under Title IV: Senior Medicare Patrols, National Long-Term Care Ombudsman Resource Center, and National Center on Elder Abuse. Also includes funds for the Eldercare Locator, and Pension Counseling and Information Program. i. See tablenote h. Funds shown are reduced from FY2003 level due to transfer of some funds to Title II. j. P.L. 100-75 required the President to convene the conference no later than Dec. 31, 2005. It was held December 11-14, 2005. See [http://www.whcoa.gov]. FY2006 obligations for the White House Conference on Aging were funded by carryover balances of prior-year appropriations. k. FY2005 amounts reflect the 0.80% across-the-board reduction required by P.L. 108-447, Division J, Section 122. The Administration was given discretion on how to distribute the reduction among individual accounts and line items. l. FY2006 amounts reflect two rescissions: (1) There was a 1% across-the-board reduction required by P.L. 109-148, Division B, Title III, Chapter 8, Section 3801. (2) On June 14, 2006, the HHS Secretary notified the Appropriations Committees that he would transfer funds among HHS programs to finance activities related to the Medicare drug benefit call center. This transfer was a 0.069% across-the- board reduction and it reduced Administration on Aging funds by $0.9 million. It was authorized by Section 208 of P.L. 109-149. m. For FY2007, P.L. 110-5 specified dollar amounts for some, but not all, programs. Agencies had some flexibility to determine program amounts based on FY2006 appropriations. n. Funding level was specified in P.L. 110-5, Revised Continuing Appropriations Resolution, 2007. o. The Choices for Independence Initiative includes newly authorized provisions of the Older Americans Act Amendments of 2006 (P.L. 109-365) related to "aging and disability resource centers (ADRCs), evidence-based prevention programs, and consumer-directed services targeted at individuals who are at high risk of nursing home placement and spend-down to Medicaid" (H.Rept. 110-231, p. 207). The President's FY2008 budget requested Choices for Independence funds under Title IV, while the FY2008 Consolidated Appropriations Act (P.L. 110-161) provides the funds under Aging Network support activities under Title II. The President's FY2008 budget request would have provided $28.0 million for Choices for Independence. P.L. 110-161 provides $16.2 million for Choices for Independence (after a 1.747% across-the-board reduction). p. P.L. 110-161 applies an across-the-board reduction of 1.747% to figures in the bill text and Explanatory Statement narrative (Division G, Title V, §528). q. Separate amounts not specified in FY2008 Consolidated Appropriations Act tables. These figures were calculated by CRS by applying the 1.747% across-the-board reduction to figures in the Explanatory Statement narrative in the Congressional Record, December 17, 2007, p. H16242. r. The President's FY2009 budget requests $28.0 million for Choices for Independence activities under Title IV. S.Rept. 110-410 requests $28.0 million for Choices for Independence activities under Aging Network support activities under Title II. See tablenote o. CRS-11 Figure 1. Older Americans Act, FY2008 Funding ($ 1.924 billion) Source: Prepared by CRS based on Consolidated Appropriations Act, 2008, Committee Print of the Committee on Appropriations, U.S. House of Representatives, on H.R. 2764 / Public Law 110-161, January, 2008, pp. 1776, 1809-1810, at [http://www.gpoaccess.gov/congress/house/appropriations/08conappro.html]. Note: Sums may total to more than 100% due to rounding. CRS-12 Figure 2. Funding for Older Americans Act Programs, FY2000-FY2008, and FY2009 Proposals ($ in millions) Source: Prepared by CRS based on appropriations legislation. ------------------------------------------------------------------------------ For other versions of this document, see http://wikileaks.org/wiki/CRS-RL33880