Millions of older adults receive services provided under the Older Americans Act · Nutrition counseling and education · Meals · Case Management. Since the enactment of Medicare and Medicaid in 1965, the federal government has played a critical role in providing support to older adults and low-income people, with Medicare health insurance coverage for people 65 and older and Medicaid for low-income people, including older adults. The Older Americans Act, enacted that same year, is perhaps less well-known than Medicare and Medicaid, but it also provides significant support to older adults through a wide range of community social service programs, including home and group meals, transportation services, caregiver support, chronic disease prevention services, and the Ombudsman for Long-Term Care program. However, these programs and services may suffer some interruptions in light of the Trump administration's organizational changes and staff reductions in the Department of Health and Human Services (HHS), which houses the Administration for Community Living (ACL), the agency that has administered the programs and services authorized by the Older Americans Act. According to the BLS, about 3.5 million people work as home health and personal care aides in the U.S.
Department of State and provide care for people of all ages. Of these workers, 878,310 work in home health care services, 237,370 in continuing care and assisted living communities, and 47,860 in skilled nursing care facilities. The federal government requires that nursing homes provide “sufficient staff” to safely care for residents, but does not specify a proportion or standard that constitutes sufficient staff. Everyone should have access to affordable and reliable healthcare as they age. Medicare and Medicaid are important programs that work together to ensure that older Americans get the care they need to stay healthy and independent.
The OAA established specific objectives to maintain the dignity and well-being of older people and created the primary means of organizing, coordinating, and providing community-based services and opportunities for older Americans and their families. In 1978, the OAA was amended to include Title VI, which established programs for the provision of nutrition and support services to the elderly Native Americans (American Indians, Alaska Natives, and Native Hawaiians). Since then, the program has been expanded to include support services for caregivers. Women make up the majority of older adults who receive SSI because they are more likely to have spent time without work caring for their family, to have worked in low-wage or part-time jobs, or in jobs where they did not receive Social Security credits. More than 1.2 million older adults receiving SSI earned enough credit for their work to qualify for a modest Social Security benefit.
Financial eligibility requirements are slightly higher for those who qualify for long-term services and supports, including home care, than for other Medicaid plans in general. The amount that people receive when they start receiving their benefits sets the basis for the amount they will receive for the rest of their lives. Based on the president's proposed HHS budget for fiscal year 2026, the Trump administration proposes uniform funding for most programs and services under the Older Americans Act, including home and community support services, nutrition programs, support services for caregivers and families, and programs for the protection of vulnerable older adults, such as the Ombudsman for Long-Term Care program. Eligible tribal organizations receive grants to support the provision of home and community support services to their elders, including nutrition services and support for family and informal caregivers.
