Remarks of Josefina Carbonell Assistant Secretary For Aging Administration On Aging To The N4a 29th Annual Conference, Changing The Way We Do Business: Shaping The Future Of The Aging Network, July 12, 2004

Omni Hotel at the CNN Center
Atlanta, Georgia

This text is the basis of the oral remarks of the Assistant Secretary for Aging. It should be used with the understanding that some material may be added or omitted.

Introductory Remarks

Good afternoon!

• It’s a pleasure to be with you this afternoon at your 29th annual conference.
• I know from speaking with many of you that the conference is off to a great start and promises to provide you with many new tools and resources to take back to your communities.
• I want to thank the n4a Board of Directors and staff for inviting me to speak with you today. I look forward every year to this opportunity to update you on AoA’s agenda, and to learn from you about the good work you are doing all across the country.
• I especially welcome the opportunity to address the theme for this general session: Changing the Way We Do Business: Shaping the Future of the Aging Network. There are many challenges ahead of us, but as you will see, I believe these challenges present us with new opportunities for creating a better America for older adults and their caregivers.
  
• Before I begin, I’d like to announce that we are in the final stages of preparing for our National Survey of Area Agencies on Aging. My staff has been working with Sandy Markwood and the N4A staff to design a survey that will provide us with important information about area agencies on aging that people in Washington and around the country need to know.
• Too many people do not know enough about the contributions of area agencies on aging, and we want to change that. This national survey, which will better document who you are, what you do, and especially, who you serve, will help us change that.
• The ability to demonstrate our effectiveness is critical to ensuring that the aging network is able to compete with other priorities in Federal, state and local budgets.
• The client surveys we have conducted have had very positive effects already. AoA and the aging network are getting high marks for performance in Washington.
  
• The Office of Management and Budget and Congressional staff are impressed that 88 percent of caregivers can care longer for the elders they love because of your services.
• They are impressed that 30% of the home-delivered meals and homemaker clients you serve are nursing-home eligible but are at home because of your services.
• They are impressed that the 38% of your transportation clients rely on your services for virtually all of their local mobility needs.
• They are beginning to see the results you are producing. With the area agency survey, they will learn more about you and how you achieve those results.
• We are designing the survey so that you can answer the questions over the Internet, and we promise not to take up too much of your time.
• So please, watch for this survey, and help us and N4A obtain more complete information about area agencies on aging across the country.

Work in Progress

• We have accomplished a great deal since the passage of the Older Americans Act.
• Perhaps the greatest accomplishment of the Act has been the creation of a nation-wide infrastructure – the Aging Services Network – that is grounded in the core values associated with individual dignity and independence, and is unique in its capacity to effectively reach and serve large numbers of Americans in every state and territory.
• We have built the foundation of this nation’s formal system of home and community based services. And we have done it in partnership with older Americans and their families.
• Because of this foundation, we are positioned to serve as key partners with other Federal, state, local and private entities that serve older people. The work we are engaged in today reflects the quality of the foundation we have erected.
  
• Right now we have the opportunity to play a key role in the modernization of Medicare, which is perhaps the greatest contribution this country has made to its older citizens.
• The Medicare Modernization Act provides prescription drug coverage to Medicare beneficiaries and offers many more opportunities for prevention services and health benefits.
• And yes, there continues to be a lot of talk about the complexity of the new benefits.
• We need to get to beneficiaries with accurate information on what the Medicare Modernization Act is about – a new Medicare with new benefits that will help those most in need receive the assistance they need.
• AoA is partnering with CMS, the Access to Benefits Coalition and other public and private organizations to support community level efforts to educate and enroll low-income Medicare beneficiaries in the drug discount card program.
  
• Towards this end, last Friday we issued an RFP for the AoA and CMS Medicare-Approved Drug Discount Card Outreach Campaign.
  
• Through this campaign we will be making available up to $3.7 million to community-based organizations to provide Medicare-approved drug discount card outreach, education and enrollment activities targeted to low-income and underserved beneficiaries.
• Proposals are due July 30 and awards will be issued in mid to late August. The RFP is available on AoA’s web site www.aoa.gov.
• We strongly encourage you to work with the community-based organizations in your area to apply for this funding either individually or in collaboration with others.
• In addition to ensuring that resources go directly to the community level, we also recognize that resources must be provided to ensure that national aging leadership organizations can provide the level of support required.
  
• I am pleased to announce that we are providing support to both n4a and the National Association of State Units on Aging to enhance their ability to play a leadership role in this effort of critical importance to older adults.
• The Medicare Modernization Act provides the Aging Network the opportunity to demonstrate the significant role we play in quickly and effectively empowering older Americans to make informed choices on matters of importance.
• And what is more important than health care!
• This is just one of many opportunities that demonstrate the important added value our network brings to our health and long term care system.
  
• Another is the Aging and Disability Resource Center initiative. We are serving as the front-end entry point for the entire system of care. Twenty-four states have now received Aging and Disability Resource Center grants to develop streamlined access to long-term care for people with disabilities of all ages. In nearly all of those states, the State Unit on Aging has taken the lead and is working with Area Agencies on Aging to pilot their Resource Center programs. And AoA and CMS are committed to funding additional states to create Resource Centers in FY 2005.
• We are also keeping older people healthy longer and assisting them in their efforts to stay engaged in community life.
• From the beginning, the Aging Services Network has been focused on the delivery of health promotion and disease prevention services at the community level.
  
• With our evidence-Based Prevention Program, we are taking health promotion and disease prevention to a new level and positioning the network as a nationwide vehicle for translating research into practice.
• We are working with the Centers for Disease Control, the National Institute on Aging, the Agency for Health Care Research and Quality, the nation’s leading foundations, and a group of 12 area agencies on aging and local service providers to demonstrate that our network can effectively deliver programs that have proven to be effective in reducing the risk of disease and disability among the elderly.
• We are also working with our partners to develop a special training program targeted at state and local agency staff in both the aging and health networks to help the rest of our network learn about and implement evidence-based prevention programs for the elderly at the community level. We plan to pilot the first training program before the end of the year.
  
• I hope by now you have all heard about the You Can! Steps to Healthier Aging Campaign, which will:
  • Partner with at least 2 thousand community organizations to reach at least
  • 2 million older Americans in
  • 2 years to spread the message about the importance of improving nutrition choices and increasing physical activity.
• We are counting on Area Agencies on Aging to become champions of the You Can! campaign, to promote it, and help us enroll.
• Our Network also affords us the opportunity to enhance the ability of older people to easily access an integrated array of health and long-term care services.
• Over the past year, AoA has focused on both streamlining access to long-term care and supporting sound health promotion and disease prevention interventions.
  
• There are excellent models being developed within the Aging Network of coordinated and integrated health and social supports that have improved access to community-based options for older Americans. A number of these models involve capitated financing arrangements, including partnerships with managed care organizations.
• As this approach to providing care continues to evolve, we look at strategic opportunities for the aging network in this arena.
• To help position the network in this area, later this month I will announce a new grants program to support the development of innovative models of managed care that include a leadership role for our network.
• And while we launch these vibrant new initiatives, you are continuing to help older people to remain in the community.
• This year, you are serving nearly 8 million seniors, over 3 million of whom have intensive care needs.
  
• Through the National Family Caregiver Support Program, you are reaching out to over 8 million family members, and are providing vital services to over 500,000 caregivers.
• You are strengthening America’s families and we are keeping impaired older people in their homes and communities and out of nursing homes.

Creating Opportunities

• As we look to the future, we will continue to face major challenges in our efforts to create a better America for aging citizens, particularly the challenge afforded by the aging “baby boom.”
• We turned challenges into opportunities when we created this Network, and we can do it again through vision, a focus on our mission, and charging ourselves to move forward toward ever better results.
  
• My vision for long-term care is to have a system in place in every community that provides a meaningful range of service options to older adults and their family members.
• This full range of service options should allow consumers to age in place in their homes and communities, and ensure that those who reside in facilities receive high-quality care.
• I see us enabling older adults to manage their chronic conditions effectively and to maintain their independence.
  
• In my vision for long-term care, we will provide targeted health promotion and disease prevention services that will effectively delay and prevent the onset of chronic conditions.
• I envision a balanced approach to long-term care. We will provide innovative and high quality home and community based services at the same time that we work to delay and prevent the chronic conditions that result in the need for those services.
  
• To realize this vision, we have a mission for AoA and the Aging Network that is focused on those we serve. 1) We will develop comprehensive and coordinated systems of care for all older Americans 60 years of age and older, and 2) we will help the nation prepare for the baby boom generation.
• As the baby-boom generation reaches retirement age, we will work with you to develop innovative approaches to meet the changing needs of older people.
• First, we must look to the baby boomers themselves to help us shape the future. And what better opportunity than our own caregiver program to begin that work now.
• We must seek creative ways to engage the baby boomers in helping us to make our long-term care system a long-term living system that older people will embrace as they age.
  
• Because of you and your colleagues, the groundwork for these efforts is already in place. We have a strong service delivery infrastructure that covers the entire country, and we have a robust history of innovation in health and long-term care.

Conclusion

• The initiatives I speak about reflect that we have already taken a strong step toward innovation in long-term care, with projects such as the Aging and Disability Resource Centers, the Cash and Counseling Next Steps Initiative, our partnership with the Federal Transit Administration, and the Evidence-Based Disease Prevention Program.
• With these and initiatives like them, we will make our vision of long-term living for older people a reality.
  
• We all must continue to play a leadership role in helping our nation respond to the needs of the older population. And we can’t just do it in Washington. We need to do it in state houses, in county and city halls, and, yes, in corporate board rooms and small businesses.
• If we are going to retain our leadership position in the future, we must demonstrate AND DOCUMENT the value we are adding to health and long life, and we must do it in a new way and in a new language that inspires the funders and policymakers to invest in our Network.
• We must do a better job of demonstrating the cost efficiencies we can achieve in providing quality services. We must produce and measure results.
  
• We must ground all of our programs and services in the best science available.
  
• We need to carve out a clear role for the aging services network in an environment that is increasing dominated by managed care arrangements.
• As we move forward to meet these challenges, we must never lose sight of our primary mission and core values that are inherent in the Older Americans Act.
• If we keep our focus on the consumer in the local community – I am confident the Aging Services Network will not only meet the challenges of today, but for the next forty years as well.
  

Disclaimer: This text is the basis of the oral remarks of the Assistant Secretary for Aging. It should be used with the understanding that some material may be added or omitted.

Assistant Secretary Josefina Carbonell addresses the 29th Annual National Association of Area Agencies on Aging (n4a) Conference in Atlanta, GA.

Assistant Secretary Josefina Carbonell presents n4a President Bob McFalls and n4a CEO Sandy Markwood 'star' awards for their efforts with older Americans. Also pictured is Constantinos I. Miskis, HHS Regional Administrator, Region IV.