Later this month, NACo’s Healthy Counties initiative will hold its annual forum for county and community health leaders to discuss ways to improve the health of their communities. This year’s forum in Salt Lake County, Utah will focus on the needs of the elderly, including ways counties combat elder abuse.
The following article analyzes the role the federal government plays in this effort.
Federal funding that aids state and local governments’ efforts to fight elder abuse through Adult Protective Services (APS) and other local initiatives flows through three federal programs:
The Older Americans Act (OAA) first became law in 1965, along with Medicaid and Medicare, as part of President Lyndon B. Johnson’s Great Society reforms. OAA is a foundational piece of the federal government’s efforts to serve older adults. States must pass OAA funding through to Area Agencies on Aging, 30 percent of which are county-based. While OAA programs are mostly aimed at providing in-home support and nutrition services for seniors, the act was amended in 1992 to establish programs to fight elder abuse.
Despite this change to the law, elder-abuse programs receive a miniscule portion of overall OAA funding. In FY15, when OAA received about $1.9 billion in total funding, elder-abuse programs received about $30 million, or less than 2 percent of total funds for OAA programs. Counties and county-based Area Agencies on Aging may be eligible for certain grants under these programs, but OAA is generally not a significant source of elder-abuse prevention funding at the local level.
The Elder Justice Act (EJA), enacted in 2010 as part of the Affordable Care Act, represents an effort by Congress to provide a funding stream specifically to address elder abuse and support adult protective services (APS) programs, including those operated by counties. However, the level of funding the legislation has received since it was enacted is negligible and may reflect federal appropriators’ current prioritization of elder-abuse prevention efforts.
At its enactment in 2010, EJA authorized $777 million in funding for the four years spanning FY11– FY14. In that span, the legislation received a total of $8 million in actual funding; moreover, this funding was not appropriated for the EJA, but rather was transferred from the Prevention and Public Health Fund.
EJA finally received $4 million in appropriated funding in FY15, and is set to receive $8 million in FY16. Counties are eligible for grant programs funded through EJA, including a current U.S. Department of Justice grant opportunity that will provide legal assistance and support services to victims of elder abuse, neglect and exploitation, and to promote pro bono capacity building in the field.
Given its authorization levels, the Elder Justice Act has great potential to provide support for local programs that target elder abuse, but until appropriators begin to fund the programs established by the legislation, that potential will far outweigh the act’s impact.
OAA and EJA are not the only federal acronyms that play a part in funding local elder-abuse prevention efforts; SSBG, which stands for the Social Services Block Grant, is perhaps the most important piece in this conversation. SSBG is a block grant that provides funding that can be used for nearly 30 different types of services for vulnerable populations, including APS —adult protective services..
SSBG is generally of great importance to counties because in 11, mostly highly populated, states such as California, New Jersey, New York, North Carolina, Ohio, Pennsylvania and VirginiaSSBG funding is passed directly to counties to administer social services programs.
In a 2012 survey conducted by NACo and its affiliate, the National Association of County Human Services Administrators (NACHSA), counties from states that administer SSBG locally singled-out APS as the most common use of SSBG funds. Many respondents also stated that SSBG funds are the only federal funds that can be used for county APS programs (the survey was conducted before the Elder Justice Act received any funding).
In a typical response, from Wilson County, N.C., officials state that SSBG is the main funding source for adult services within the 100 county departments of social services in North Carolina. “In fact, most of our counties only use SSBG for adult services because there are simply no other funding sources. Without SSBG funds, our state’s ability to provide services to abused, neglected and/ or exploited seniors and disabled adults would be crippled to the point that these very services could become almost nonexistent in many North Carolina counties.”
In FY16, SSBG is set to be funded at $1.7 billion. While it is difficult to determine what percentage of these funds would ultimately help counties battle elder abuse, it is clear that SSBG is a pivotal part of counties’ efforts to protect their elders.Hero 1