NASUAD's Policy Priorities

1. Build the capacity of the Network through the reauthorization of the Older Americans Act. The Older Americans Act (OAA) provides a coordinated framework for the delivery of support services.  Building on this established framework, the reauthorization of the OAA should be used as an opportunity to promote the Network and enhance its capacity to meet the needs of an aging America.  Specifically, the Act should be amended to promote the crucial role the Network plays in the building of livable communities and its inherent ability to be the nexus of rebalancing the delivery of long-term services and supports.  Also, greater emphasis needs to be devoted to developing and sustaining innovative practices which improve the quality of life for seniors and people with disabilities and help them remain in their own homes and communities.  The federal funding for the vital programs included in the OAA needs to be increased and sustained to support the growing demand that the baby boom generation will place on the network. New funding and support should be in place prior to the expansion of any services.
   
   
2. Ensure stability in Medicaid during economic downturns.   Provide states with automatically triggered enhanced FMAP assistance during economic downturns so that they can better serve their constituents in this important federal-state partnership health insurance program. 
   
   
3. Reject unfunded mandates and provide states with the necessary flexibility to allow state leaders to determine how best to meet the needs of their residents in implementing the Affordable Care Act. Prohibit unfunded mandatesand provide states with clear and timely guidance on the Patient Protection and Affordable Care Act.
   
   
4. Project 2020:  Fulfilling the Promise of the Older Americans Act.  Provide the resources to implement consumer-centered and cost effective long-term care strategies authorized in the Older Americans Act.  Empower the Aging Network to implement these strategies through a three-pronged approach encompassing enhancing and fully funding Aging and Disability Resource Centers, evidence-based disease management and health promotion activities, and long term services and supports for at-risk Medicaid clients.  Analysis has shown that these three components, when implemented across the country, effectively coordinated with existing activity of State Units on Aging and Area Agencies on Aging, and targeted and managed properly, will cost less in the aggregate than if the aging services community maintains the current patchwork system for providing  services.  This program will have all states engaged in implementation within three years of passage.  According to initial estimates, the program has the potential to reach over 40 million Americans and will reduce federal Medicaid and Medicare costs by approximately $2.7 billion. 
   
   
5. Increase appropriations for programs that support and sustain state efforts to build their capacity to deliver home and community based programs.  In addition to significant funding increases for AoA, more funds are needed for the:
   
   
1. Food Stamp Program,
2. Low Income Home Energy Assistance Program, 
3. Employment programs for older workers and workers with disabilities,
4. Affordable and supportive housing programs,
5. Transportation programs,
6. Community Development Block Grant,
7. Community Services Block Grant Program
   
   
6. Promote economic security for older Americans and individuals with disabilities. A common concern for Americans of all ages and abilities is to achieve financial stability as they reach their retirement years.  Unfortunately, nearly a third of Americans above the age 65 are economically insecure, living at or below 200 percent of the federal poverty level.   Excluding Social Security income, in 17 states more than half of the elderly and, in 45 states, more than 40 percent of the elderly — have incomes below the poverty line.  Many seniors rely on public benefits to help them pay for necessary medical services, prescriptions, food and home energy costs to remain in their homes and community. Many individuals with disabilities also struggle to meet their basic needs.  As Congress and other institutions examine the fiscal condition of America, we must ensure public benefit programs, including Social Security, are sustainable.
   
   
7. Fully fund the Elder Justice Act.   Support the needs of our most vulnerable citizens living in nursing homes and assisted living facilities by fully funding the Elder Justice Act.  By fully funding the Act, America will show its commitment to vulnerable adults by elevating national awareness about elder abuse, neglect and exploitation; establishing a nationwide infrastructure that coordinates federal, state and local response to protect vulnerable adults from abuse, neglect  and exploitation ; increasing knowledge about elder abuse;  and creating new programs in long-term care.  As a corollary, Congress should allocate more funding for public adult guardianship programs to assist adults who do not have capacity to make fundamental decisions concerning his or her personal and financial well-being.
   
   
8. Increase support for workforce strategies.  The Workforce Investment Act reauthorization should be improved to meet the needs of Americans of all ages and abilities who are able to work. Public policies that remove barriers and support older Americans and people with disabilities in remaining or returning to the workforce should be championed. Workforce training and incentives should be available to assist older workers and individuals with disabilities find job placements. 
   
   
9. Support a solid investment at all levels of the workforce to support the growing need for long term supports and services.  A recent Institute of Medicine report addresses the shortage of a specially trained workforce for the upcoming baby boom population.  Incentives are needed to encourage geriatric training for workers, from specialty physicians to direct care workers.
   
   
10. Support a role for State Units on Aging in emergency preparedness and response legislation.  State units on aging meet the needs of victims of large- and small-scale emergencies.  Regardless of whether the emergency is caused by a natural disaster, pandemic, or an attack on our nation’s security, the development of emergency protocols is essential to provide states with the flexibility to coordinate across state lines. The development of a trigger for additional federal resources for the aging Network is vital to meet the unique needs of older adults and individuals with disabilities when these disasters arise.

11. Support efforts to increase the capacity of State Health Insurance and Assistance Programs (SHIPs) and local partners.  SHIPs are experiencing an unprecedented demand to provide outreach, counseling, and assistance to beneficiaries and their caregivers.  Factors such as the growing complexity of the Medicare and Medicaid program and the economic downturn are driving a larger number of beneficiaries to SHIP programs for in-depth counseling and assistance.  This demand is only going to increase with the implementation of the health reform legislation, the Patient Protection and Affordable Care Act (PPACA), P.L. 111-148, and the Health Care and Education Reconciliation Act of 2010 (HCERA), P.L. 111-152, together called the Affordable Care Act.  In response to this increased demand for services, states must be given the opportunity to develop innovative, cost-effective benefits outreach and enrollment strategies. Moreover, policies that integrate SHIPs into the Network must be encouraged; increased coordination and collaboration at the local, state, and federal level will lead to an efficient, consumer-focused service system. Additional funding is needed to meet the unprecedented demand for outreach, counseling, and assistance to beneficiaries and their caregivers.
    
    
12. Capitalize on the Resources for Civic Engagement.   The expected retirement of the Baby Boom Generation means that many individuals will have time to become more engaged in their communities as volunteers, mentors and resources.  Congress should help states to capitalize on this unprecedented opportunity to involve citizens in local communities through tax incentives, funding pilot programs and providing other inducements to communities and individuals to be involved.