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Legislation on the Elderly in the United States

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Legislation On The Elderly In The United States

Final Paper

The Older American Act of 1965 was signed into law on July 14, 1965. This act established the Administration on Aging within the Department of Health, Education, and Welfare and called for the creation of State Units on Aging. This act was considered one of the most important contributions on aging legislation enacted by congress. This report is a review of legislation regarding Older American Act.

TABLE OF CONTENTS

Introduction on the history of Legislation on the Elderly ……………………………………2
Background Early Acts Enacted to meet the needs of the Elderly……………………………2 Early Acts Enacted leading up to OAA of 1965 …………………………………………..3 Review of Older American Act…….. ………………………………………………………4
Older American Title Review…………..…………………………………………………….5
Amendments………………………………………………………………………………….9
Strength and Weakness of Older American Act……………………………………………..14
Recommendation…………………………………………………………………………….15
Conclusion … ………………………………………………………………………………16
References……………………………………………………………………………………17

Introduction
The new deal program of the 1930’s was enacted by congress to address economic issues during the Great Depression. The Social Security Act of 1935 was a response to criticism for the lack of aid to retired workers age 65 and older and who no longer worked (justfacts.com). This law created "a system of Federal old-age benefits" (justfacts.com). The new act provided pensions, unemployment insurance to nonagricultural` workers, commerce workers, aid to the blind, deaf, disabled and dependent children. Social security provided old age assistance and old age survivors insurance. Social security payment amounts were based on payroll tax contributions. President Roosevelt named this act as “a cornerstone in a structure which is being built but it is by no means complete.” The Social security act is known as one of the best known pieces of legislation enacted by congress.

Background
The newly enacted social security act first payment was to begin in 1942. Retroacted lump sum payments for 1937 to 1942 would be paid in full to retirees. The 1937 Railroad Retirement Act provided pension benefits for retired railroad employees and spouses. A bipartisan Social Security Board (SSB) was created to manage functions of social security or Title II of the Social Security Act and its responsibilities included: the maintenance of wage records; supervision of field offices; examination and approval of claims, including related claims functions (ssa.gov). The SSB was to provide employers, employees and the public with information on how earnings were to be reported, what benefits were available and how they were to be provided. The SSB had to enroll employer and employees by January 1, 1937 in order for credits toward old-age insurance benefits to begin for employees. Resources for SSB were not available to accomplish such a task, so the U.S. Postal Service was contracted to distribute forms in November 1936. The post offices collected the completed forms, typed the Social Security number (SSN) cards, and returned the cards to the applicants. Applications were forwarded to the SSB offices were social security numbers were registered and employment history was recorded. Between 1936 and 1937 over 35 million social security cards were issued through this beginning process (SSA).

These previous Acts lead to the first National Conference on Aging in 1950, which was led by the Federal Security Agency. The changing demographics of the United States population was growing, this was credited to the number of elderly people living longer lives. The 1950 conference was to assess the challenges posed by the changing population. In the 1950s and early 1960s, various acts and legislation was enacted which helped establish what is called the Older American Act of 1965.

Early Acts Enacted leading up to OAA of 1965

1952- First federal funds were appropriated for social services programs for older persons under the Social Security Act.

1956- A special staff on Aging was established within the office of Health, Education, and Welfare to coordinate responsibilities of the Aging. Disability Insurance was created, and expanded over the following years.

1958- Legislation was introduced to congress, calling for a White House Conference on Aging.

1961- The first White House Conference on Aging was held in Washington D.C. Social Security Amendments lowered the retirement age for men from 65 to 62, liberated the retirement test, and increased their minimum benefits and likewise increased benefits to aged widows. Payroll taxes were 6%.

1962-Legislation introduced to Congress, to establish an independent and permanent Commission on Aging. Statistics showed that there were more than 18 million Americans over 65. Most of them had low incomes and were threatened by illness and medical expenses they could not afford.

Review of Older American Act
The Older Americans Act (OAA) was passed by Congress in 1965 as a response to policymaker concerns about the lack of services available for older Americans (www.elderguru). The original act gave authority for grants to states for community planning, social services, research and development projects, and training on aging related issues (www.elderguru). The act established the Administration on Aging (AoA) to administer the grant programs and to serve as the federal agency to oversee matters that pertain to older Americans (www.elderguru).
The Older American Act of 1965 was signed into law on July 14, 1965. This act established the Administration on Aging within the Department of Health, Education, and Welfare and called for the creation of State Units on Aging. This act was considered one of the most important contributions on aging legislation enacted by congress. Over the past two decades, many older Americans have benefited from programs and service under the “Older American Act”. The act has served economic as well as social needs, for older Americans. Under privilege elderly minority have greatly benefited from services offered by the act, that help assist in maintaining independence from being institutionalized because federal law established to serve older Americans.

Older American Act establishes certain programs that must be implemented by states and the federal government and provides the funds (or most of the funds) for these programs (senior-site). Each state establishes a Department of Aging to implement the provisions of the Older American Act and acts as a unifying force for services to seniors. States individually provide additional funds and other entitlement programs for senior citizens, along with local Area Agencies on Aging work together with other private nonprofit agencies to implement the desired programs.

Older American Act Title Review
1. Title I : Declaration of Objectives
a. Title I sets out broad social policy objectives oriented toward improving the lives of all older people, including adequate income in retirement, the best possible physical and mental health, opportunity for employment, and comprehensive long-term care services (Cohen, 1963).
2. Title II : Establishment of the AoA
a. Establishes AoA within the Department of Health and Human Services (HHS) as the chief federal agency advocate for older people and sets out the responsibilities of AoA and the Assistant Secretary for Aging.
b. Among other things, Title II requires AoA to create the National Eldercare Locator Service to provide nationwide information through a toll-free telephone number so that users can identify community resources for older people. It also establishes national resource centers for long-term care ombudsman services and elder abuse prevention activities ((Muramatsu, 2002).
3. Title III : Grants for State and Community Programs on Aging
a. Grants support the activities of 56 state agencies on aging and 655 area agencies on aging, which can be nonprofit or public agencies. These agencies act as advocates on behalf of, and coordinate social service programs for, older people (Cohen, 1963).
b. Authorizes funds for supportive and nutrition services, fam¬ily caregiver support, and disease prevention and health pro¬motion activities (Sharkey, 2002).
c. State agencies are required to pass all Title III funds to area agencies to administer within their state-defined planning and service areas (Gelfand, 2002).
d. Target population — Title III services are available to all people age 60 and over, but they are targeted to those with the greatest eco¬nomic or social need (Emlet, 2004).
I. Supportive services. The supportive services program funds a wide range of social services aimed at helping older people remain independent in their own homes and communities. States are required to devote some funding to access services (such as transportation, and information and assistance), home care, and legal assistance. This program also supports other services, such as case management, adult day care, and activities of senior centers (Straight, 2003).
II. Nutrition services. The elderly nutrition program, the oldest and perhaps most well-known Older Americans Act service, pro¬vides meals and socialization to older people in congregate set¬tings, such as senior centers and churches (the “congregate meals” program), and meals to frail older people in their own homes (the “home-delivered meals” program). The purposes of the program are to reduce hunger and food insecurity, promote socialization among older people, and provide meals to the homebound (Sharkey, 2002).
III. Family caregiver support. The National Family Caregiver Sup¬port Program provides grants to states to develop a variety of ser¬vices to assist family caregivers. These include information and assistance about available services, individual counseling, organi¬zation of support groups and caregiver training, respite services to provide families temporary relief from caregiving responsibilities, and supplemental services (such as home care and home adapta¬tions) on a limited basis to complement care provided by family and other informal caregivers (Kietzman, 2004).
IV. Disease prevention and health promotion. Programs to prevent or delay chronic conditions and promote health among older people receive the smallest amount of funding among Title III programs. The law provides “seed money” for these activities and intends that state and area agencies leverage other fund¬ing sources to complement Title III funds.
4. Title IV: Activities for Health, Independence, and Longevity (Research, Training, and Demonstration Programs)
a. Provides authority for training, research, and demonstra¬tion projects in the field of aging (Kietzman, 2004).
5. Title V: Community Service Senior Opportunities Act
a. Provides part-time jobs for unemployed low-income people age 55 and older who have poor employment prospects (Morris, 1995).
6. Title VI : Grants for Services for Native Americans
a. AoA awards Title VI grants to Indian tribal organizations, Native Alaskan organizations, and nonprofit groups representing Native Hawaiians. Grants are used to fund supportive and nutrition ser¬vices for older Native Americans.
7. Title VII : Vulnerable Elder Rights Protection Activities
a. Authorizes the long-term care ombudsman program as well as a program to prevent elder abuse, neglect, and exploita¬tion (Netting, 1995).
I. Long-term care ombudsman program. The purpose of the pro¬gram is to investigate and resolve complaints of residents of nurs¬ing facilities, board and care facilities, and other adult care homes. It is the only Older Americans Act program that focuses solely on the needs of institutionalized persons.
II. Prevention of elder abuse, neglect, and exploitation. Under this program, states are required to carry out activities to make the public aware of ways to identify and prevent abuse, neglect, and exploitation and to coordinate activities of area agencies on aging with state adult protective services programs, among other things.

Older Americans Act Amendments of 1967 In 1967 the Age Discrimination Act was signed into law. That year also saw the AoA moved into a newly created Social and Rehabilitative Service Agency within the Department. The Age Discrimination Employment Act (ADEA), prohibits employment discrimination nationwide based on age with respect to employees 40 years of age or older. The ADEA also addresses the difficulty older workers face in obtaining new employment after being displaced from their jobs, arbitrary age limits.
The purpose of this act was to prevent discrimination against employee 40 and older. This act is a part of Title VII of the 1964 Civil Right Act. Discrimination in employment based on race, color, sex, national origin, or religion is protected under the 1964 Civil Rights Act. Women and minorities, have face many barriers against gaining equal rights to vote, employment, and equal pay and so worth. Limited equal opportunities in the work place are recognized employers are adapting diversity throughout organizations.
This act was to prevent against age discrimination by employers pertaining to protection discrimination from promotion, training, advancement, hiring, salary compensation and termination.
In a 2005 case Smith V. City of Jackson, Mississippi the city attempt to revising pay scale among city police officer. “Officers with less than five years’ service received proportionately greater raises than those with more seniority, and most officers over 40 had more than five years of service. Petitioners, a group of older officers, filed suit under the Age Discrimination in Employment Act of 1967 (ADEA), claiming, inter alia, that they were adversely affected by the plan because of their age” (cornell.edu).

Older Americans Comprehensive Services Amendments of 1973
First time Federal law authorized the creation of local agencies whose purpose is to plan and coordinate services for older persons and to act as advocates for programs on their behalf.
Older Americans Act Comprehensive Services Amendments established Area Agencies on Aging. The amendments added a new Title V, which authorized grants to local community agencies for multi-purpose senior centers, and created the Community Service Employment grant program for low-income persons age 55 and older, administered by the Department of Labor. Comprehensive Employment and Training Act was enacted; included older persons.
This act was to strengthen and make improvements to the 1965 Older American Act, creation of programs and service to benefit older Americans. One program that was erected from this act was the Senior Community Service Employment Program (SCSEP), it success lead to a national organization under the Older American Act of 1973. SCSEP had operation throughout counties in the nation.
The benefits of this program were measured through an independent national survey conducted by charter Oaks group for PY 2005 concluded; 89% percent of the participant of this program reported that the health was same or better while they were in the program and 69% of SCSEP participants surveyed reported that their outlook on life was a little more positive or a lot more positive while participating in the program;
Older Americans Act Amendments of 1981
Made modifications to give state and area agencies on aging more flexibility in the administration of their service programs. These amendments also emphasized the transition of participants to private sector employment under the community service employment program.
In 1990 a study found that Native American Indians age 45 experienced the same functional limitations in their activities of daily living as did non-Indian people at age 65 (Saravanabhavan, 1994). 51 percent out of 100 Native American Indians interviewed were ages 45 to 69 years old. On an average, those interviewed reported three disabling conditions each (Saravanabhavan, 1994). Due to the "early" aging of Native American Indians, the United States Congress amended the Older Americans Act in 1981 (Older Americans Act, Amendments of 1981, Title VI as cited in Gelfand, 1987) to allow Indian tribes to define elderly for their respective communities. Elderly can refer to persons ages 50 years or older, 55 years or older, and 60 years or older. Each tribe can set its own minimum age for eligibility for services. Of the tribes, 41% have set the minimum at age 55 (Gelfand, 1987).

Older Americans Act Amendments of 1987
Approved six additional distinct authorizations of appropriations for services: in-home services for the frail elderly; long-term care ombudsman services; assistance for special needs: health education and promotion services; services to prevent abuse, neglect and exploitation of older individuals; and outreach activities for persons who may be eligible for benefits under the supplemental security income (SSI), Medicaid and food stamp programs. The theory of community economy reveals the potential for positive interaction between care’s informal and formal sectors. Informal caregiving plays a significant role in health care delivery throughout the world, especially in relation to care of the elderly and chronically ill (Healy, 2008). The theory (and politics) of the community economy is the concept Gibson-Graham (2006) uses to define how the disparate elements of the diverse economy might be connected to one another (Healy, 2008). Theory of community economy in the context of an action research project to generate a new politics of health care reform (Healy, 2008).

Older Americans Act Amendments of 1992
A new title VII, Vulnerable Elder Rights Protection Activities, was created to consolidate and expand certain programs that focus on protection of the rights of older persons.
Adult protective services play an increasing role in elder-abuse prevention through professional and public information campaigns carried out on the local, state, and national levels. Along with forming community teams, local staff provides training to professionals, potential victims, and families. Statewide conferences and coalitions provide public information and professional education (Marlatt, 1997). The social-casework model used by APS is difficult to explain and defend to administrators and legislators. Building a trusting relationship with a fearful client takes time and skill. Meaningful measurement of protective-services outcomes has not yet been fully developed--a task further hampered by the wide variation among fifty state-specific programs and by the lack of uniform definitions and up-to-date data-management systems.
Older Americans Act Amendments of 2000
Authorized the National Family Caregiver Support Program under title III; required the Secretary of the Department of Labor (DoL) to establish performance measures for the senior community service employment program;
President Clinton signed into law, the Senior Citizens' Freedom To Work Act of 2000. This law eliminates the Social Security retirement earnings test in and after the month in which a person attains full retirement age--currently age 65. Elimination of the retirement test would be effective with respect to taxable years ending after December 31, 1999 (ssa.gov).

Older Americans Act Amendments of 2006
The Older Americans Act Amendments (OAA) of 2006 authorizes congress to fund programs for 5 more years through 2011 and it increases the emphasis on home and community-based services as well as community-directed care. As part of the 2006 reauthorization of the OAA, congress stated that although diet is the preferred source of nutrition, use of a single daily multivitamin-mineral supplement (MVM) may be an effective, safe, and inexpensive way of addressing nutritional gaps that exist among older adults, especially the poor, to help prevent common nutritional deficiencies (Marra, 2008). The OAA Nutrition Program is to reduce hunger and food insecurity, promote socialization, and promote the health and well-being of older adults (Marra, 2008). Each year the OAA Nutrition Program serves about 238 million meals to 2.6 million older adults, approximately 59% of whom are homebound. With an annual total expenditure of $1.23 billion, including a $735 million federal appropriation, the OAA Nutrition Program is the nation's largest food and nutrition assistance program targeting older adults (Marra, 2008).
Strengthens and weakness of Older American Act
Strengthens:
1. Reduction rate of threats to the health and well-being of Americans - 90%.
2. Enhance the ability of the Nation's health care system to effectively respond to terrorism and other public health challenges. The agency met their goal, serving 89,034 seniors.
3. Increase the percentage of the Nation's children's and adults who have access to regular health care services and expand consumer choices. 67% of the population targeted was served.
4. Enhance the capacity and productivity of the Nation's health science research enterprise. This encompasses goals such as establishing an Alaskan Native Stroke Registry, and beginning to enroll patients. They have met their goal.
Weakness:
1. Title III : Grants for State and Community Programs on Aging, this area the act still need a lot of improvement on providing care for older American in nursing homes. Today there are website to review state survey results pass or fail to present date. Violations are still enormous at a lot of Medicaid/Medicare facilities. This area of legislation needs the most attention the care for our seniors. Nursing home make billions of dollars benefiting from the old and fray, therefore better care and owners of facilities need to be held more accountability and not just a minor fine. Overworked, understaffed nurses and residents receiving very poor care as a result of poorly managed facilities.

2. Improvements on training individual working to care for older American such as nursing assistant who see clients more often than any other healthcare professional. Training for these individual to recognize symptoms such as depression, weakness, and so forth. By addressing symptoms early on, will help minimize issues down the road.

3. Social Worker need advance training to help with issues surround emotional and mental health issues among older American. Organizations such as National Association of Social Workers (NASW) have pushed for more funding for local community organization to offer these types of services. Positive Act of 2007 was reintroduced recently, NASW is recruiting additional sponsors to support such a bill in congress.

4. Creations of policies that enforce that leadership role on state agencies on aging help elimate institutions that provide care address all violation and just seek profits.

Recommendation:
Recommendation to future amendments on the Older American Act is that all new legislation should require that all nursing facilities that receive Medicare/Medicaid should be brought up to the same standards as private nursing facilities. There seems to be a level of discrimination when it comes to care whether you are rich or poor. It should not matter how a facilities get paid. After review website that listed nursing facilities that fail to meet certain standards repeating year after year, it seem that investor are still have a financial gain.
More funding need to be appropriated to educating social worker that works closely with care takers of older Americans. Diagnose and treatment is the fastest way to reduce minor mental, medical, psychological issues. Local community services are sometimes not available to easily accessible. The older American Act has made great stride in providing care and service as seen today, although continued work still has to been completed. What is seen today is just the other corner being built.
Conclusion
As of 1989 parents can automatically apply for social security card for new born babies. Policies and system structure that address the 21 century issues surrounding the growing number of elderly living in the United States. Short term and long legislation should address current economic times as we see today with growing number of mistreated and homeless elderly people. Policies have been developed most dramatically in areas affecting the basic needs of older people--income, housing, consumer issues, and health and protective arrangements (such as powers of attorney and guardianship), which still need much improvement.

References:
Binstock, R. (1991). From The Great Society to The Aging Society--25 Years of The Older Americans Act. Generations, 15(3), 11-18. Retrieved from SocINDEX with Full Text database.
Cohen, E. (1963). What's Wrong with the Planning of Our Public Programs? Social Work, 8(2), 106-109. Retrieved from SocINDEX with Full Text database.
Emlet, C., & Poindexter, C. (2004). Unserved, Unseen, and Unheard: Integrating Programs for HIV-Infected and HIV-Affected Older Adults. Health & Social Work, 29(2), 86-96. Retrieved from SocINDEX with Full Text database. Gelfand, D., & Bechill, W. (1991). The Evolution of the older Americans Act: A 25-Year Review of The Legislative Changes. Generations, 15(3), 19-22. Retrieved from SocINDEX with Full Text database.
Gelfand, D. (1987). Older American Act. In G. L. Maddox (Ed.), The Encyclopedia of Aging (pp. 499-502). New York: Springier Publishing Company.
Healy, S. (2008). Caring for ethics and the politics of health care reform in the United States. Gender, Place & Culture: A JOURNAL OF FEMINIST GEOGRAPHY, 15(3), 267-284. doi:10.1080/09663690801996270.
Kietzman, K., Scharlach, A., & Dal Santo, T. (2004). Local Needs Assessment and Planning Efforts for Family Caregivers: Findings and Recommendations. JOURNAL OF GERONOTOGICAL SOCIAL WORK, 42(3/4), 39-59. doi:I 0.1 300/J083v42n03_04.
Marra, M., & Wellman, N. (2008). Multivitamin--Mineral Supplements in the Older Americans Act Nutrition Program: Not a One-Size-Fits-All Quick Fix. AMERICAN JOURNAL OF PUBLIC HEALTH, 98(7), 1171-1176. doi:10.2105/AJPH.2007.122762.
Marlatt, J. 1997. Adult Protective Services: A Status Report to the Administration on Aging. Washington, D.C.: Administration on Aging.
Morris, R., & Caro, F. (1995). The young-old, productive aging, and public policy. Generations, 19(3), 32. Retrieved from SocINDEX with Full Text database.
Muramatsu, N., & Campbell, R. (2002). State Expenditures on Home and Communiventty Based Services and Use of Formal and Informal Personal Assistance: A Multilevel Analysis. JOURNAL OF HEALTH & SOCIAL BEHAVIOR, 43(1), 107-124. Retrieved from SocINDEX with Full Text database.
Netting, F., Huber, R., Paton, R., & Kautz III, J. (1995). Elder Rights and the Long-Term Care Ombudsman Program. Social Work, 40(3), 351-357. Retrieved from SocINDEX with Full Text database.
Otto, J. (2000). The Role of Adult Protective Services in Addressing Abuse. Generations, 24(2), 33. Retrieved from SocINDEX with Full Text database.
Saravanabhavan, R., & Marshall, C. (1994). The Older Native American Indian With Disabilities: Implications for Providers of Health Care and Human Services. JORNAL OF MULTICULTURAL COUNSELING & DEVELOPMENT, 22(3), 182-194. Retrieved from SocINDEX with Full Text database.
Sharkey, J., & Schoenberg, N. (2002). Variations in Nutritional Risk Among Black and White Women Who Receive Home-Delivered Meals. JOURNAL OF WOMEN & AGING, 14(3/4), 99. Retrieved from SocINDEX with Full Text database. http://www.elderguru.com/what-is-the-older-americans-act-oaa-a... http://www.law.cornell.edu/supct/html/03-1160.ZS.html http://seniors-site.com/helpm/amer_act.html http://www.seniorserviceamerica.org/
http://www.ssa.gov/pubs/11000.html#part1…...

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