Sneak Preview: GAO Urges ACL To Centralize Service Information

Jerry Ashworth
July 12, 2019 at 11:04:16 ET
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(The following was excerpted from a recent article in the Federal Grants Management Handbook.) The Department of Health and Human Services (HHS) Administration for Community Living (ACL), in response to a recent Government Accountability Office (GAO) recommendation, plans to encourage national resource centers to provide helpful information that is easily searchable on their websites to assist older adults in rural communities. However, GAO emphasized that ACL can do more to centralize this information so that it can be shared among the centers.

While the U.S. Census Bureau notes that the nation’s population is aging — with some 20 percent of Americans projected to be 65 years or older by 2030 — most of these individuals will want to receive services in their homes and communities rather than at an institution such as a nursing home. Title III grants provided under the Oder Americans Act (OAA) of 1965, as amended (Pub. L. 114-144), provide federal funding administered by ACL for home- and community-based services, such as home-delivered meals, elderly transportation, physical therapy and support for family caregivers. States and area agencies on aging (AAA) work with ACL regional offices to determine how they will target their funds to meet OAA requirements, which includes prioritizing funding to go to older adults, including those in rural areas, with the greatest economic and social need.

Federal surveys have found that 19 percent of older adults in the U.S. live in rural areas, and rural areas tend to have a larger proportion of older adults than urban areas. “This ‘graying’ of rural areas is caused by several factors, including that working-age adults move out of rural areas to find more employment opportunities, and that some older adults move to rural areas to retire,” GAO explained. “Further, the older people who live in rural areas tend to be older, poorer and less healthy than those in other areas, and also face distinct challenges to accessing the services needed to age in place, such as reliable transportation to faraway medical appointments.”

The report cites ACL’s 2017 National Survey of OAA Participants, which noted that among those using case management services, a smaller percent of rural participants (43 percent) reported that they received services compared to urban participants (60 percent). In addition, a smaller percentage of rural participants (73 percent) reported that they had received a meal from a home-delivered meal service, compared with 83 percent of urban participants. Further, a smaller percentage of rural caregivers reported receiving caregiving information compared with urban caregiver participants.

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