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Home > About Us > Fact Sheets > HHS Programs and Initiatives for an Aging America |
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Fact Sheets
May 3, 2001 Contact: HHS Press Office 202-690-6343 HHS Programs and Initiatives for an Aging America
The number of older Americans will continue to grow as the baby boom generation grows older and Americans continue to enjoy longer, healthier lives. Older people in this country are healthier than ever before. However, there are still millions of older adults who live with chronic illnesses and must rely upon family, friends and public support systems to help them manage their everyday lives. The U.S. Department of Health and Human Services (HHS), along with the Social Security Administration, is the leading federal agency serving the needs of older individuals. Through medical insurance offered by Medicare, public support for long-term care options such as home health care and nursing homes through Medicaid, assistance for family caregivers, nutrition services, grant programs and research into the causes and effects of aging, HHS agencies are striving to support older Americans and to help them lead healthy, active lives. President Bush's fiscal year 2002 budget includes a number of priorities to enhance the well being of older individuals, including Medicare reform and Immediate Helping Hand, which provides for immediate financial support for states to provide prescription drug assistance. In addition, the administration is dedicated to reform of the Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration) (CMS), which oversees the Medicare program, to ensure that it is as responsive as possible to beneficiary needs. return to top of page
Because America's older population is so rapidly growing, planning and caring for the needs of the aging is an HHS priority. In fiscal year 2001, HHS programs to provide services and assistance for the aging - as well as research into the processes and disabilities associated with aging - totaled $2.8 billion. President Bush's fiscal year 2002 budget increases that funding to $3.0 billion. In addition to spending on HHS programs for services, planning and research for the elderly, the department administers the Medicare and Medicaid programs, the largest health coverage programs for older Americans. According to the Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration) (CMS), the agency that oversees Medicare and Medicaid, 2000 Medicare spending for the health care of the program's almost 40 million aged and disabled enrollees totaled $215 billion. Total federal spending on the aged through the federal-state Medicaid program in 1999 was $27.6 billion, to which states contributed an additional $21.3 billion. Medicaid provides health care coverage for low-income persons and covers physician and hospital services as well as prescription drugs. Medicaid also is the largest public payer for long-term care services such as nursing homes and community-based services. return to top of page
Medicare was created in 1965 as a health insurance program for those aged 65 and older to complement the retirement, survivors and disability insurance benefits available under the Social Security Act. Today's Medicare program has more to offer beneficiaries than ever before, including more preventive benefits, new patient protections and more responsible customer service. The administration and HHS are taking the necessary steps to improve and secure Medicare coverage for older Americans today and in the future. Specific programs and initiatives currently underway include the following: Preserving the Medicare Benefit This spring, the Medicare Trustees reported that the Hospital Insurance trust fund will remain solvent until the year 2029, based on the most probable economic and demographic assumptions. President Bush is committed to modernizing the Medicare program, devoting $110 billion beginning in fiscal year 2005 for modernization. Under the President's principles for reform, Medicare should: • Provide better coverage options, streamline regulations and provide higher quality care • Ensure that all seniors have affordable access to prescription drug coverage as part of a modernized Medicare program • Provide better options for protection against high out-of-pocket expenses, particularly for low-income seniors • Ensure greater overall financial security, including an accurate measure of the financial status of the program as a whole, without raising payroll tax rates Prescription Drug Proposal Although a prescription drug benefit was not included in Medicare when the program was created in 1965, the advances in medicine and drug treatments today make a drug benefit essential for the health and well-being of senior citizens. The President's Immediate Helping Hand prescription drug proposal will give immediate financial support to states so they can provide prescription drug coverage to beneficiaries with low incomes or high out-of-pocket drug costs. HHS' proposed fiscal year 2002 budget allocates nearly $46 billion for Immediate Helping Hand, which is designed to provide drug coverage to those most in need until the administration and Congress enact broader Medicare reforms, including the creation of a prescription drug option for all beneficiaries. Reducing payment errors and fraud To ensure Medicare pays correctly for covered services, HHS has expanded efforts to help doctors and health care providers understand and follow Medicare law and regulations. CMS also is working to simplify requirements and modernize its accounting systems to further reduce payment errors. These efforts are showing significant results. Medicare's estimated error rate has fallen by more than half, from 14 percent in fiscal year 1996 to 6.8 percent in fiscal year 2000. In cases where evidence may suggest fraudulent billing practices, the HHS Office of Inspector General works closely with other law enforcement agencies and CMS to investigate and enforce the laws in order to protect beneficiaries and taxpayers. These efforts recovered $1.2 billion in fines, settlements and judgements during fiscal year 2000. Supporting Preventive Medicine To protect the health of older Americans, Medicare has expanded coverage of mammograms, pap smears, colorectal cancer screening, bone mass measurement for beneficiaries at risk for osteoporosis and other bone abnormalities, and diabetes self-management. The National Medicare Education Program To help Medicare beneficiaries make the best use of new benefits and program flexibility, CMS is conducting its most extensive education program to date to help answer beneficiaries' questions about Medicare. The comprehensive information program, Medicare & You, provides beneficiaries with accurate, easy-to-understand information about their benefits, rights and health insurance options so they can become more active participants in their health care decisions. The program includes the Medicare & You handbook mailed to all Medicare beneficiary households every fall (and each month to new beneficiaries), a toll-free Medicare helpline at 1-800-MEDICARE (1-800-633-4227) and the Medicare beneficiary Internet site, http://www.medicare.gov. The Healthy Aging Project In 1998, HHS launched a $3.7 million five-year project to identify the best ways to promote health and prevent physical decline among older Americans, particularly Medicare beneficiaries. The Healthy Aging Project is designed to identify strategies that have been successful in promoting a healthy aging experience and will find and test ways to reduce behavioral risk factors and encourage the use of preventive medicine. Health care providers will be able to use this information to improve the delivery of preventive services. return to top of page
For those who use the formal long-term care system, such as nursing homes and home health care, Medicaid is the primary public payer, covering 39 percent of long-term care expenses in 1999. Initially, Medicaid coverage of long-term care was limited to services provided in institutional settings, such as nursing homes. However, in an effort to provide the most cost-effective services and in response to clear indications that consumers want a choice to receive services at home, states have substantial flexibility to provide home- and community-based services under waivers in the Medicaid program. Current long-term care programs and initiatives include the following: Support for Family Caregivers Congress enacted the Older Americans Act Amendments of 2000, establishing the National Family Caregiver Support Program. This critical program provides respite care and other supportive services to help hundreds of thousands of family members who are struggling to care for their older loved ones who are ill or who have disabilities. Congress provided $125 million for this new program in fiscal year 2001. In February 2001, HHS Secretary Tommy G. Thompson announced the release of $113 million in grants to states to begin implementing this program. Home- and Community-Based Services Through the Medicaid program, HHS now supports about 240 state home and community-based service waivers that provide beneficiaries with alternatives to institutional care and enable seniors and people with disabilities to receive services at home. In cooperation with state agencies and consumers, HHS also participates in a resource network to bring the federal government, states and consumers together to expand access to quality home- and community-based services. More information on the resource network is available at http://www.hcbs.org. Nursing Home Quality Improvement About 1.6 million elderly and disabled Americans receive care in nearly 17,000 nursing homes across the United States. Under the Medicare and Medicaid programs, states have the primary responsibility for conducting on-site inspections and recommending sanctions against nursing homes that violate health and safety requirements. The President's budget commits $67.3 million to the Nursing Home Oversight Improvement Program in fiscal year 2002, enabling CMS to continue to ensure quality care for the nation's nursing home residents. As part of this program, CMS works with states to: impose immediate sanctions against nursing homes that have caused harm to a resident in consecutive survey cycles; focus on preventing bed sores, malnutrition and abuse as part of the annual nursing home survey; investigate complaints alleging actual harm to residents within 10 days; and stagger surveys and conduct visits on weekends, early mornings and evenings when problems are more likely to occur. return to top of page
AoA is the federal focal point and advocacy agency for older persons. It provides funds to support programs and services, and it assists in protecting the rights of vulnerable and at-risk older persons. Working in close partnership with other agencies in HHS and throughout the executive branch of government, AoA leads a national aging network of 56 state offices on aging, 655 area agencies on aging, 235 Tribal organizations representing 300 tribes, and thousands of service providers, senior centers, caregivers and volunteers. AoA and other HHS agencies administer key services for older Americans, including the following: Preventive Health Services through the Older Americans Act States and communities have the flexibility to meet the health promotion and disease prevention needs of seniors through the Older Americans Act. Services available - such as medication management, health screening and assessments, nutritional counseling and education and exercise programs - encourage older individuals to live healthy lifestyles that can reduce the incidence of debilitating illnesses. The Eldercare Locator A national toll-free service, the Eldercare Locator helps callers find necessary, convenient services and resources for their older loved ones in their own communities or throughout the country. The locator is available at 1-800-677-1116, Monday-Friday, from 9 a.m. to 8 p.m. ET. Insurance, Benefits and Pension Counseling Programs These programs help older Americans access their pensions and make informed insurance and health care choices. Long-Term Care Ombudsman Programs AoA administers critical programs designed to protect the basic rights of vulnerable older adults. The Long Term Care Ombudsman program recruits and trains volunteers to investigate and resolve complaints made by or on behalf of residents of long-term care facilities. The agency also supports state efforts to enhance seniors' access to quality legal assistance programs; conduct elder abuse, neglect and exploitation public awareness campaigns; and train law enforcement and other professionals. The Elderly Nutrition Program This program helps older Americans build a foundation for health through improved diets, increased physical activity and improved lifestyle choices by providing: nutritious meals in community settings; nutritious home-delivered meals, also known as Meals-on-Wheels, to homebound older adults; nutrition and health promotion education to improve health behaviors; nutrition counseling to help manage nutrition-related chronic diseases; and linkages to other supportive and health-related services, such as physical activity or fitness classes and health screenings. The President's fiscal year 2002 budget request includes $378 million, a $4 million increase, for congregate nutrition services and $158 million, a $6 million increase, for home-delivered nutrition services. Tribal programs These programs provide services designed to meet the needs of older American Indians, Alaska Natives and Native Hawaiians. Grant awards are made directly to Tribal organizations and organizations representing Native Hawaiians to provide nutrition services, including congregate and home-delivered meals, supportive services such as transportation, and support for family caregivers. In fiscal year 2001, a total of $23.5 million was awarded to 233 Indian tribal organizations and two Native Hawaiian organizations. An additional $5 million was awarded for the newly established Native American Caregiver Support Program. Mental Health and Substance Abuse Programs HHS' Substance Abuse and Mental Health Services Administration (SAMHSA) has supported a collaborative project with the National Council on Aging to identify ways to engage providers of aging services in substance abuse and mental health education, screening, prevention, treatment referrals and follow-up activities. Together, they are developing a kit for use by aging services organizations to better address alcohol, medication and mental health issues among older adults. Working with the Health Resources and Services Administration and other HHS agencies, SAMHSA is evaluating various methods of delivering and financing mental health and substance abuse services for older adults in primary health care settings. In addition, SAMHSA developed the Treatment Improvement Protocol, designed to assist the health care community to better detect and treat alcohol and medication abuse among older patients. return to top of page
Funding for NIA programs in fiscal year 2001 is $786 million. The President's fiscal year 2002 budget increases that investment to $880 million. Examples of NIA's areas of research include studies of the biology of aging, geriatrics and Alzheimer's disease. In addition to research programs conducted through NIA, HHS' Agency for Healthcare Research and Quality (AHRQ) sponsors and conducts research on the health care quality, and cost, use and access. AHRQ's research translates into practice biomedical advances that have improved the health of those who suffer from age-associated chronic conditions. AHRQ-supported research also has provided new and practical information on priority topics for older Americans, such as disease prevention, managing health problems and long-term care. AHRQ also has available a publication entitled, Staying Healthy at 50+. The booklet, which is also available in Spanish, includes tips and recommendations on health habits, screening tests and immunizations to help people age 50 and older stay healthy. Staying Healthy at 50+ includes easy-to-use charts to help track personal health information, questions to ask health care providers, and other sources for health information and is available at http://www.ahrq.gov/ppip/50plus. Finally, HHS' Office of Disability, Aging and Long Term Care Policy also engages in research on aging. The office supports research on key aging issues such as the demographics of aging, Medicare and Medicaid home health care, managed care for persons with disabilities, long-term care, and retirement and pension systems. Current research projects include work on long-term care insurance, nursing home quality, assisted living and consumer-directed care. Note: All HHS press releases, fact sheets and and other press materials are available at http://www.hhs.gov/news.
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