This chapter highlights some of the current health programs and policies in place and changes in demographic trends for older adults living within American society. In addition, substantial changes within the social, political, and cultural expectations of communities over the past century pose challenges for policies and programs serving older adults. The chapter presents several issues emerge as realities within the context of policy development and program planning for older adults. These issues include changes in living arrangements, education levels, economic well-being, and rural population settings; trends in morbidity and mortality; and changes within the social, political, and cultural expectations of communities. Despite the availability of programs and services resulting from health policies, many programs have focused upon “medically necessary” services and have lacked a health promotion, health education, or community-based focus.
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- Go to chapter: Background and Demographic Profile of People Growing Older and/or People With Disabilities
This chapter discusses Older Americans Act (OAA). In the original act, the principles are defined through six specific titles. Title one: outlines the objectives and defines the administrative oversight for the OAA. It provides definitions for the administrative structure to carry out the OAA. This organization includes the secretary, commissioner, and the role that individual states will take on in the administration of the act. Title two: administration on aging establishes the infrastructure for the administration of aging services and outlines the main activities of this administrative structure. Title three outlines the authorization process of appropriations for the purpose of community planning, services, and training. Title four is about research and development projects. Title five: training projects outlines the provision of funds for training projects to benefit individual states. Title six outlines the advisory committees that govern the administration of the OAA.
This chapter helps the reader to understand how to use tools such as health behavior models, the media, coalitions, and needs assessments to bring a vision to fruition and how to use advocacy tools for policy and program development. It also helps them to understand how to use advocacy tools to influence the practice arena for older adults and people with disabilities. The chapter reviews the various tools and strategies, along with policies that have been addressed thus far, and integrate these issues and skills with one’s vision for either program planning or policy development. When considering program development, all tools and strategies related to policy development apply equally. Some additional strategies or tools to use for program development include the health behavior models. This chapter attempts to integrate the theories and concepts and suggest how a program planner or policy advocate can apply them.
This chapter briefly discusses the history of the Affordable Care Act (ACA) and community and presents specific components of the ACA in relationship to community prevention. The chapter deals with specific aspects of the legislation that impact older adults and people with disabilities. It presents a short review of the ten titles: Title one: quality, affordable health care for all Americans; Title two: role of public program; Title three: improving the quality and efficiency of health care; Title four: prevention of chronic disease and improving public health; Title five: health care workforce; Title six: transparency and program integrity; Title seven: improving access to innovative medical therapies; Title eight: Class Act; Title nine: revenue provision; Title ten: strengthening quality, affordable health care for all Americans. The chapter explains some of the legislative highlights, policies, and programs that have been articulated within each of the specific titles of the ACA.
This chapter helps the reader to understand the history of the Elder Justice Act (EJA). It provides specific components of the EJA and how programs and services flow for older adults and people with disabilities. The chapter discusses the limitations in programs and services within the EJA. The EJA requires the oversight and the appropriation of federal funding to protect people growing older and people with disabilities from abuse. It addresses legal issues with a special emphasis on the concept of a power of attorney. The chapter explores several legal issues that face older adults. It also address elder abuse, power of attorney, and a differentiation made between the types of power of attorney and the healthcare power of attorney. In addition, the chapter explores legal services provided to older adults as a result of the Older Americans Act, and outlines the challenges within the realm of legal issues.