50Th Anniversary of OAA: Why Feeding Seniors Still Makes Financial Sense.

Posted on | July 31, 2015 | Comments Off on 50Th Anniversary of OAA: Why Feeding Seniors Still Makes Financial Sense.

Mike Magee

By now, most of my readers have heard that this is the 50th anniversary of Medicare and Medicaid. But some of you may be unaware that it is also the 50th anniversary of the Older Americans Act. The what?
The Older Americans Act of 1965 was signed by LBJ. Its’ goal was to secure an adequate safety net for older Americans by providing protections for equal opportunity, sufficient income in retirement, the best health services independent of economic status; adequate housing; long term care; civic, cultural, educational and recreational inclusion; self-determination; and appropriate protection against abuse.
Programmatically, this translated into nutrition and community-based services, elder rights programs, the National Family Caregiver Support Program, and health prevention strategies on a local level. In short it acknowledged for the first time that health was profoundly political. The law for the first time defined health as a collection of resources unequally distributed in society. Health’s “social determinants” such as housing, income, and employment, were critical to the accomplishment of individual, family, and community well being and were themselves politically determined. Health was recognized at the time by many throughout the world as a fundamental right; yet it was irreparably intertwined with our economic, social, and political systems.

This important law, targeted at those over 60, spoke to the interconnectedness of health.
As described in this week’s NEJM:

1. “ Nearly 13 million people receive regular OAA services, including meals, caregiver support, personal care, and transportation assistance. “

2. “Currently, more than 40% of OAA funding goes to nutrition services (Meals on Wheels), primarily meals delivered to homes or community centers. In 2014, nearly 140 million home-delivered meals and 90 million congregate meals were served.”

3. “The remaining 60% of OAA funding is spent on health-related services, including home and adult day care, support, and elder-abuse protection.”

4. “Programs are administered by the federal Administration for Community Living and local Area Agencies on Aging (AAAs) and Aging and Disability Resource Centers (ADRCs).”

5. “Recipients of daily meals also reported decreased isolation and worry about living at home. Moreover, 1 year of home delivered meals costs nearly the same as one emergency department visit and less than a 1-week nursing home stay.”

And yet few would be surprised that the funding of OAA is under constant attack. Eight years ago I stated that, “There is a growing political disconnect between those who make health policy and those most affected by health policy. While the former continue to reinforce silos and the status quo, the latter seek broad, fundamental and comprehensive reform. Such reform might include expansion of insurance coverage, realignment of financial incentives toward prevention, increased reimbursement of physicians and nurses for team coordination that includes home health managers, support for early diagnosis and screening, and expansion of education and behavioral modification for individuals and families.”

Properly feeding our elders remains a logical and defensible starting point.

For Health Commentary, I’m Mike Magee.