2 Winter meetings of NASUA and n4a Boards have met dozens of times to hammer out agreements Reauthorization of Older Americans Act language Seeking appropriations to match the authorizing language Using the past five years tested and proven best practices A Joint Proposal of NASUA and n4a

First, do no harm. Build on current aging services network, not replace it. Encourage individuals ability to live independently. Continue to serve the unique needs of rural, poor, minority, and disabled and aging populations. Support consumer directed initiatives. Services should not be greater than the Medicaid waiver program. Encourage the increased use of technology to support efforts. Recognize that individuals, AAAs, SUAs, providers, and the federal government all have to contribute to make the program successful. 3A Joint Proposal of NASUA and n4a

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Who We Serve? 27% of consumers are poor 33% of consumers live in rural areas 20% of consumers are minority 52% of older persons report having a disability Who Are We? 56 State Units on Aging 655 Area Agencies on Aging Thousands of Service Providers 7A Joint Proposal of NASUA and n4a

1. Person-Centered Access to Information 2. Evidence-Based Health Promotion and Disease Prevention 2. Enhanced Nursing Home Diversion Services 8A Joint Proposal of NASUA and n4a

Component of Program Service Person-Centered Access to Information Provides assistance, access, counseling and awareness of long-term care services and supports Evidence-Based Disease Prevention and Health Promotion Targets scientifically proven interventions to reduce chronic disease and disability to affected elderly individuals Enhanced Nursing Home Diversion Services Provides consumer directed community care to individuals at high risk of institutionalization 9A Joint Proposal of NASUA and n4a

Component of Program Eligibility Criteria Estimated Number of Recipients (5 years) Estimated Number of Recipients (10 years) Person- Centered Access to Information Anyone interested in Long-Term Care 40 million105 million Evidence-Based Disease Management and Health Promotion Individuals 60 or older or who are at risk of falls 1.2 million3.9 million Enhanced Nursing Home Diversion Services 300 percent of SSI with assets in excess of $25, ,000164,000 A Joint Proposal of NASUA and n4a10

Components of Program Estimated Federal Net Change (5 years) Estimated Federal Net Change (10 years) Person-Centered Access to Information $305 million$1.1 billion Evidence-Based Disease Prevention and Health Promotion -$852 thousand$51 million Enhanced Nursing Home Diversion Services -$1.6 million$153 million 11A Joint Proposal of NASUA and n4a

FederalStateTotal Outlays$582.7 million$194.2 million$776.9 million Savings$1.7 billion$1.3 billion$3.0 billion Net Change$1.1 billion $2.2 billion A Joint Proposal of NASUA and n4a12 *Over 10 years

FederalStateTotal Outlays$823.3 million$145.3 million$968.5 million Savings$874.3 million$_____*$874.3 million Net Change$51.1 million-$145.3 million-$94.2 million A Joint Proposal of NASUA and n4a13 *Over 10 years

FederalStateTotal Outlays$7.4 billion$4.5 billion$11.9 billion Savings$7.6 billion$5.8 billion$13.4 billion Net Change$152.7 million$1.4 billion$1.5 billion A Joint Proposal of NASUA and n4a14 *Over 10 years

Technology Grants (examples of some uses) To build web portals for ADRCs To develop on-line training programs for disease management To build health information exchanges for community centers Technical Assistance State and community level-specific, tailored technical assistance Evaluation 15A Joint Proposal of NASUA and n4a

Competitive Grant program Nursing Home Diversion Component rolled out in three phases Maximizes state flexibility in design of their program to best suit needs of their state States match 25 percent of ADRC program 15 percent of evidence-based program Difference between FMAP plus 5 for Nursing Home Diversion program A Joint Proposal of NASUA and n4a16

A Joint Proposal of NASUA and n4a17

A Joint Proposal of NASUA and n4a18 For additional information Martha Roherty, Executive Director NASUA th Street, NW Suite 350 Washington, DC Sandy Markwood, CEO n4a 1730 Rhode Island Avenue, NW Suite 1200 Washington, DC