Reports

Four articles provide an update of where the Older Americans Act (OAA) and the Aging Network stand in the face of demographic, economic, and health care issues. The first two cover the history of the legislative and budgetary developments of the network and report on a national survey of Area Agencies on Aging. The third summarizes political vagaries that network agencies encounter. The last advocates that civic engagement efforts must expand to cover disadvantaged and vulnerable older adults.

Many of the same social, health, and economic trends driving the development of home and community-based services in the U.S. are also present in Europe. A team of experts assembled by the World Health Organization presents evidence for the effectiveness of home care, shows how it can be improved, and explains the need for equitable access. It also explores the varied cultural and care contexts in Europe and provides suggestions on educating professionals and the public about these issues.

How can you shape programs and direct funds to use the power of self-direction in employment programs? This resource presents two examples of states that have achieved this. It also discusses characteristics of and barriers to facilitating consumer direction in employment.

About 52 million people provided family caregiving worth about $375 billion in 2007. That amount exceeds Medicaid long-term care spending in each state. Caregiving services included in the estimate are personal care, help with everyday tasks, and health-related interventions. The document presents data nationally and by state and concludes with policy recommendations to support and sustain family caregivers.

Everything from program structure, eligibility, services, financing and expenditures are covered here in concise summaries. This updated edition also contains graphics showing expenditures by service and the growth of Medicaid acute care spending as compared to private health plans. The tables at the end present data broken down by state. Refer to the 2007 version for historic perspective.

In Empowering Arizona’s Individuals with Developmental Disabilities (EAzI), consumers actively contribute to quality improvement as interviewers, interviewees, and focus group participants. Four focus groups were used to learn what criteria consumers use to judge the quality of HCBS. Aside from the report, there is also a flyer and website used in recruiting EAzI participants. The website has a way to get information in Spanish and an online application.

The Older Americans Act (OAA) requires states to submit a Plan on Aging every 1-4 years focused on reforming long-term care to help keep older people independent. Arkansas presents information on their organization, programs, goals, funding, and people served. Their plan covers areas including Cash & Counseling, Money Follows the Person, transportation planning, disaster preparedness, and others.

In 2005, VT became the first state to commit to a federal Medicaid funding cap in exchange for expanded eligibility definitions and access to home and community-based services under a Section 1115 waiver. Case studies and interviews are used to present key findings from the program. Key design features are also presented. Finally, future issues within VT and other states that might emulate the program are discussed.

The Older Americans Act (OAA) gave rise to important HCBS programs such as the Choices for Independence initiative, ADRCs, and Nursing Home Diversion grants. Here is a concise summary of the legislation, its reauthorization in 2006, and data on the types of support provided under these programs, recipients, and expenditures.

Older Americans speak up on the importance of services and policies that enable them to age in place through the use of home and community-based services (HCBS). Results show that respondents are not only concerned with HCBS as they remain in the home, but also as they move to nursing home alternatives such as assisted living facilities. They identify the availability of long-term care options as one that should be a top priority for AARP's advocacy.