Older Americans Act
The Older Americans Act (OAA) supports a range of community programs and social services for individuals aged 60 years and older. The law allows for a variety of programs that are designed to support older adults such as nutrition support, home services (such as home and personal care), community-based services (such as family caregiving support), disease prevention (such as screenings and chronic disease management), health promotion (such as physical fitness), and legal support services and elder justice programs. Each of these programs, called titles, are carried out by a network of entities at the state, community, and individual levels that establish a network of aging service entities—often referred to as the aging network. The titles, with the exception of one, under OAA are administered by the Administration on Aging (AOA) in the Administration for Community Living (ACL) at the U.S. Department of Health and Human Services (HHS). The AOA coordinates funding and activities at the state level through state units on aging and tribal organizations, which then oversee the activities and functions of Area Agencies on Aging (AAAs) who are charged with coordinating and facilitating activities of local service providers and direct service providers who carry out functions of the OAA’s programmatic services.
The OAA and Vision and Eye Health
With respect to vision and eye health, Title III-D of the OAA contains provisions related to disease prevention and health promotion services, and include routine health screening which may include hypertension, glaucoma, cholesterol, cancer, vision, hearing, diabetes, bone density, oral health, and nutrition screening. These services are particularly aimed toward aging individuals who demonstrate “greatest economic need” (such as lack of financial resources, income, or personal assets) and “greatest social need” (such as adults with limited English proficiency or who may lack family and social support). While the OAA allows for some cost-sharing in providing some services, adults seeking services are not to be turned away due to inability to pay or undergo “means testing” to determine their ability to pay for any care or support sought.
Prevent Blindness recognizes several opportunities available within the OAA’s programmatic structure that can enhance the role of healthy vision in the aging process. Our advocacy continues to focus on engaging with the ACL to identify where there are gaps in programs at the state, community, and individual levels where vision and eye health have a natural fit but may not necessarily be available or understood. For example, there is generally a lack of awareness within the aging network about the prevalence of vision loss, its connection to aging and overall health and wellness, and how to assist those who face it in navigating their new way of life and remaining active in their communities. Vision and eye health assessment must go beyond an individual’s visual acuity to also assess an individual’s visual function as a matter of improving their independence and ability to continue self-managing daily living activities. Doing so can help achieve a number of OAA programmatic goals in areas such as physical and mental health, combatting social isolation and loneliness which can enhance quality of life and life satisfaction, preventing falls and injury from falls, and improving community engagement within the older adult population.
The OAA, which must be periodically reauthorized by Congress, expires in 2024. In addition to working with the ACL to enhance where vision and eye health intersect with numerous programmatic approaches, Prevent Blindness will also engage with Members of Congress to ensure that any funding considerations or program expansions benefit aging individuals and enhance the aging network’s ability and capacity to promote vision and eye health as a component of health aging.