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GAO-15-601R 1 (2015-06-10)

handle is hein.gao/gaobaaize0001 and id is 1 raw text is: G A U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 June 10, 2015 The Honorable Bernard Sanders Ranking Member Subcommittee on Primary Health and Retirement Security Committee on Health, Education, Labor, and Pensions United States Senate Older Americans Act: Updated Information on Unmet Need for Services Dear Senator Sanders: The Older Americans Act of 1965 (OAA) was enacted to, among other things, help older adults remain in their homes and communities. Programs authorized and funded by OAA Title III grants provide a broad range of assistance to older adults in need of such services, including congregate and home-delivered meals, home-based care, and transportation services.1'2 While Title III programs are not entitlements, all people age 60 and older are eligible for services.3 In fiscal year 2014, approximately $1.156 billion was provided in grants to states for home and community-based services under Title III of the OAA. In 2011, we analyzed 2008 data and found that approximately 9 percent of low-income older adults received meals like those provided by Title III programs (an estimated 1.6 million out of 17.6 million low-income older adults).4 We also found that approximately 12 million of 16 million older adults who had difficulties with daily activities received limited or no home- based care and that about 8 million individuals age 65 and older likely needed transportation services. While funding provided to states for Title III programs has decreased somewhat 1 42 U.S.C. §§ 3021-3030s-2. The act requires the Administration on Aging within the Department of Health and Human Services to provide funding and technical assistance to states and local agencies involved in planning and delivering these services and supports. 2 In addition to Title III programs, older adults, especially those with low incomes, may also receive similar services through other federal and state programs, such as Medicaid. 42 U.S.C. § 1396(a)(1 0)(A)(ii)(VI). According to the Centers for Medicare & Medicaid Services, Medicaid is the primary payer for long-term services and supports for low-income individuals. 42 U.S. C. §§ 1396-1396w-5. Federal expenditures for Medicaid home and community-based services were at least $37.6 billion in fiscal year 2013. For more information on these services, and various federal programs' support for them, see GAO, Older Adults: Federal Strategy Needed to Help Ensure Efficient and Effective Delivery of Home and Community-Based Services and Supports, GAO-i 5- 190 (Washington, D.C.: May 20, 2015). 3 42 U.S.C. §§ 3002(40). 4 Our analysis focused on adults age 60 and older living in households below 185 percent of the poverty threshold. GAO, Older Americans Act. More Should Be Done to Measure the Extent of Unmet Need for Services, GAO-I 1-237 (Washington, D.C.: Feb. 28, 2011). GAO-15-601R Older Americans Act and Unmet Need Update Page 1

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