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Older Americans Act - Issues Under The Older Americans Act

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Eligibility for benefits. The spirit and formal wording of the OAA holds that all citizens over the age of sixty are eligible for OAA-funded services. Yet, whether the amount is $7.5 million or $1.3 billion, there is nowhere near enough funding for all those over sixty to benefit from the program. Even so, from the very beginning there has been strong pressure that the OAA should not be "means-tested," that is, have provisions whereby individuals would have to demonstrate that their income is below a given level before they could receive services. Such programs have long been associated with "welfare," and Congress has consistently made clear that it did not want services under the OAA to have any such connotation.

The eligibility dilemma OAA administrators have long faced, then, is how to concentrate or target benefits on older people deemed the most in need of services without imposing a formal means test. The emphasis on who, in fact, are vulnerable populations for OAA purposes has varied over time, but the following conditions and populations have been invoked: those in greatest economic or social need, rural older people, low-income minority individuals, the frail and disabled, and members of different racial and ethnic groups. Apart from these variations in emphasis, the more important point is that OAA programs in most parts of the country have devoted services disproportionately to older people who are poor, of minority status, and frail (Holt; Justice).

In more recent years, this last issue of frailty has increasingly dominated both eligibility and spending decisions under the OAA. The aging of the American population and especially the aging of the older population itself have meant that more individuals are suffering from chronic illness and disability than ever before. As a result, many state and area agencies find themselves doing what is occasionally referred to as "functional means-testing," that is, determining how limited people are when it comes to basic daily tasks such as dressing and walking. Services are now usually limited to those with several such "deficits," and they are frequently available only to individuals with limited incomes. Adding a home-delivered meals component to the OAA's nutrition program and adding a new subtitle to the act directed at in-home services makes clear this new emphasis on frail elderly people.

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