HHS updates federal policies to support aging in place

The Administration for Community Living (ACL), a division of the U.S. Department of Health and Human Services (HHS), announced this week the publication of a final rule that will update regulations for implementing programs under the Older Americans Act (OAA). One of the intentions of the rule is to better support the desires of older Americans to age in place in their own homes, ACL said.

Passed by Congress in 1965, OAA established comprehensive services for older Americans by creating a national aging network at the state and federal levels. First signed into law by President Lyndon Johnson, OAA was reauthorized by Congress in 2016 and 2020, and it is currently in effect through the end of 2024.

“The first substantial update to most OAA program regulations since 1988, the rule aligns regulations to the current statute, addresses issues that have emerged since the last update and clarifies a number of requirements,” ACL said in an announcement of the rule.

ACL oversees a national aging network designed to deliver OAA services, and this new rule is aimed at better supporting the network by improving program implementation.

“[ACL has] the ultimate goal of ensuring that the nation’s growing population of older adults can continue to receive the services and supports they need to live – and thrive – in their own homes and communities,” the announcement stated.

The announcement outlined 11 key provisions in the update, including clarification of requirements for state and area plans on aging, as well as details about requirements for coordination among state, local and tribal programs. Consistency of definitions between these programs has been improved, HHS said, and “provisions for meeting OAA requirements for prioritizing people with the greatest social and economic needs” have also been “strengthened.”

The new final rule also specifies “the broad range of people who can receive services, how funds can be used, fiscal requirements, and other requirements that apply across programs.” It also “clarifies required state and local agency policies and procedures” including the establishment of “expectations regarding conflicts of interest.”

The final rule added guidance for state-based agencies, as well as the National Family Caregiver Support Program and the Native American Caregiver Support Program, both of which were established since the last update.

ACL updated provisions for emergency preparedness and response, taking lessons from issues discovered during the COVID-19 pandemic.

“Older Americans should be able to live independently and age with dignity,” HHS Secretary Xavier Becerra said in the announcement. “The Biden-Harris Administration is committed to expanding access to health care, nutrition services, caregiving, and opportunities to age in place for all older Americans. This update to the Older Americans Act regulations strengthens the system of supports that help older people live independently and age with dignity.”

Alison Barkoff, who leads ACL, said that the new rule stems from data that indicates an overwhelming desire among older Americans to age in place.

“For many, [aging in place] is possible because of the programs and services provided through the Older Americans Act – such as rides to medical appointments, nutritious meals, in-home services and support to family caregivers,” Barkoff said. “The updated regulations strengthen the stability and sustainability of these programs, and we are looking forward to working with our partners in the aging network to implement them.”

Late last year, the U.S. Department of Housing and Urban Development (HUD) announced its own $40 million investment to support aging-in-place services. The investment is designed to “expand the supply of service coordinators who support seniors and persons with disabilities” who live in affordable multifamily homes, HUD said.