Connecticut General Assembly

OFFICE OF LEGISLATIVE RESEARCH

October 15, 2003 98-R-0015

TO:

FROM: Helga Niesz, Principal Analyst

RE: State Departments on Aging

You asked which states have a separate Department on Aging and which agencies deal with aging issues in those states that do not have a separate department. For the states that have separate departments, you want to know when they were established and what functions they perform.

SUMMARY

Ten states have separate departments on aging: California, Florida, Illinois, Iowa, Kansas, Ohio, Pennsylvania, Rhode Island, Texas, and Virginia. Nine states have a separate agency, office, board, or commission on aging that has substantive program functions and is designated the state unit on aging under the federal Older Americans Act: Alabama, Idaho, Maryland, Massachusetts, New Mexico, New York, Minnesota, Tennessee, and West Virginia.

In Connecticut, the Commission on Aging is independent, but is in the Department of Social Services (DSS) for administrative purposes only. Its main function is to advocate for the elderly. The commission prepares an annual report, conducts public hearings on issues affecting the elderly, review and comments on DSS policies that affect the elderly, meets with other state officials, conducts studies and reports on issues affecting the elderly, and disseminates information to the community on the nature and scope of problems faced by the elderly. The substantive programs and funding are located in DSS, which is designated as the state's unit on aging for federal funding purposes. The federal funds are funneled through the DSS Elderly Services Division, which makes grants of state and federal money to the five area agencies on aging in the state.

In the other 30 states, aging programs and issues are handled either by (1) a division of a larger department, most often the human services or social services department, or (2) an office or division within the Governor's Office itself that performs the advocacy and sometimes the administrative functions of certain elderly-related programs.

CONNECTICUT'S FORMER DEPARTMENT ON AGING

The former Connecticut Department on Aging was established in 1969 and abolished in 1993. Its program and funding functions were given to the Department of Social Services Elderly Services Division and its advocacy function was assigned to the newly formed Commission on Aging, which is independent but located within DSS for administrative purposes.

The department was designated the state unit on aging under the federal law, so it received the federal Title III nutrition, transportation, and other elderly related funds under the federal Older Americans Act. It planned, coordinated, managed, and funded social, health, educational, cultural, and nutrition programs assisting the elderly. It had about 66 employees and an operating budget of over $2 million. It oversaw the then $28 million state ConnPACE program, a $17 million grants program, and had within it the Nursing Home Ombudsman Office. DSS is currently the state's unit on aging and exercises most of these program functions.

A Department on Aging research and planning unit developed the State Plan on Aging and monitored its implementation, analyzed the effectiveness of programs, and made recommendations for improvements. It collected data on the social, economic, and demographic character of the state's elderly population. It also worked with other public and private organizations to organize and coordinate joint initiatives addressing the elderly's concerns. Its program information unit, through its toll-free line, provided information and assistance to the elderly.

The department ran a conservator of the estate program for frail elderly. It also had a legal services developer who assisted groups and organizations concerned with elderly issues. The department oversaw continuing care retirement communities. Its community services division dispensed the grant funds under the Older Americans Act to the five area agencies on aging providing social and nutrition services to the elderly and administered various older worker, retired volunteer, and other programs.

STATES THAT HAVE SEPARATE DEPARTMENTS

California

California's Department of Aging, established in 1978, is designated the state unit on aging under federal law. It is technically part of an umbrella Health and Welfare Services Agency. The department administers the federal programs such as elderly nutrition services and the state Multi-Senior Services Program, which does case management to provide home and community based services to the elderly. Its health insurance counseling program (HICAP) advises the elderly about medical, long-term, and other insurance. It further administers a long-term care ombudsman program, a “Brown Bag” program where volunteers glean food from local supermarkets for the elderly, a senior companion program, Alzheimer's day resource center services, and adult day health care. It does some advocacy, but the state also has a separate Commission on Aging to advocate for the elderly, as Connecticut's commission does.

Florida

The mission of Florida's Department of Elder Affairs, established in 1992, is to maximize opportunities for self-sufficiency and personal independence of Florida's elders and to plan, advocate and administer programs and policies that assure accessible, responsive, and comprehensive services and long-term care. It was previously part of a larger Department of Health and Rehabilitative Services.

The department is designated by the governor as the state unit on aging. It administers various programs for home and community care; Alzheimer's disease; emergency home energy assistance; nursing home preadmission assessment; elder abuse prevention; long-term care policy and planning; long-term care ombudsman council; senior community service employment program; volunteer training, assistance, and recruitment; comprehensive health insurance counseling for Medicare beneficiaries; and hospice, assisted living facilities, and adult family care homes policies.

The department proposes, supports, and follows legislation concerning elders. In its advocacy role, it can examine programs, budgets, and legislation affecting elders and make recommendations to the governor and the legislature.

Illinois

Illinois' Department on Aging, established in 1973, administers a number of federal and state-funded programs. Most important is the Community Care Program, which features case management service provided by a statewide network of community-based case coordination units that arrange for home health care, homemaker services, adult day care, or senior companion services as needed. The department participates in a managed community care demonstration project. It further implements a Choices for Care Program: a universal screening initiative for people seeking admission to a nursing facility. It administers a long-term care ombudsman program and an elder abuse and neglect program, which is locally coordinated through 47 provider agencies that conduct investigations and work with the elderly in resolving abusive situations. It also runs a senior help line that provides information about the various programs available to the elderly.

The department helps fund the state's 23 retired senior volunteer programs and nine foster grandparent programs.

In addition, the Illinois Council on Aging, an advisory body, makes recommendations to the department, the governor, and the General Assembly on programs and services for the elderly.

Illinois also has a Coordinating Committee of State Agencies Serving Older Persons, created in 1988, to facilitate planning and effective delivery of programs and services. The committee, composed of 22 state agencies and commissions, serves as a clearinghouse for state agencies and programs for the elderly, keeps informed on priorities directed toward the elderly, ensures optimum efficiency of state resources, promotes a coordinated state response to proposals for the elderly, and acts as a resource to study and recommend action on elderly issues that are beyond state government's scope.

Iowa

Iowa's Department of Elder Affairs was first created as the Commission on the Aging. In 1986, the commission's responsibilities were included in the duties of the new Department of Elder Affairs. The law establishing the department sets forth the state's commitment to its elders and their dignity, independence, and rights. The department is designated as the state's unit on aging under federal law. It is both an advocate for the elderly and responsible for developing a comprehensive and coordinated system of services and activities for the elderly through 13 designated area agencies on aging. The department's areas of concern are income, health, housing, education opportunities, employment, transportation, nutrition, volunteer opportunities, recreational activities, spiritual well-being, and community involvement in the problems of the elderly.

The department's policy-making body is an 11-member commission, appointed by the governor and legislative leaders. The commission designates the area agencies on aging and approves and monitors the area plans for area agencies. .

Kansas

Kansas' Department of Aging, established in 1977 is the state's focal point for aging services and information. The department administers state and federal elderly nutrition programs, information and referral, legal services, the state long-term care ombudsman, client assessment, homecare, elder rights protection, Alzheimer's and related disorders helpline, community-based services, and case management. It does this through grants to the area agencies on aging. In addition, a State Advisory Council on Aging advises the department.

Ohio

Ohio's Department of Aging has existed for at least 15 years and is designated the state's unit on aging under federal law. The department is charged with advocacy for the elderly and funds the following substantive programs: in-home care services for frail and low-income seniors, an Alzheimer's assistance helpline and respite program, a benefits eligibility screening service, retirement and long-term care planning assistance, the federal Title V senior employment services program, an elder rights and ombudsman program, consumer discounts from businesses, a health insurance information program, housing subsidies for seniors living in adult foster homes and group homes, and senior citizen tutors and mentors for school children. In addition, the 12 members of an Advisory Council for the Aging advise the department and act as ambassadors to the community.

Pennsylvania

Pennsylvania's Department of Aging, established in1978, advances the well-being of the state's older citizens, coordinates the administration of federal and state aging programs, and promotes creation and growth of organizations designed to maximize independence and involvement of older Pennsylvanians. The department administers the state's pharmaceutical assistance contract for the elderly and the federal Title III funds. It monitors program and fiscal reports of area agencies on aging and provides technical assistance to them. It develops the State Aging Plan and is designated as the state's unit on aging under federal law. It coordinates and conducts social research and special studies. It reviews other state agencies' elderly-related proposed regulations. It administers the Long-term Care Assessment and Management Program, an interdepartmental effort that combines pre-admission assessment of nursing home applicants with a range of case-managed community-based care options to ensure that institutionalization occurs only when less restrictive options are inadequate. The department also has a state long-term care ombudsman.

In addition, a Council on Aging, composed of five regional councils on aging, assists the secretary of aging in preparing the State Aging Plan. It also prepares an annual report evaluating the quality of aging programs, holds public hearings on aging-related issues, and consults with the secretary of aging on the department's operation.

Rhode Island

Rhode Island's Department of Elderly Affairs was established in 1977. Before that, it was a Division on Aging in the Department of Community Affairs. The department is designated the state's aging unit under federal law. It runs programs for elderly abuse and protective services, health promotion, home and community care, heating assistance, information about housing, a housing rental security deposit program, other information and referral, legal services, job training, pharmaceutical assistance, the senior community service program, and senior companions. The department also has a long-term care ombudsman. Because the state is so small, there are no local area agencies on aging, and the department contracts directly with providers for the elderly nutrition, homecare, and other services supported by federal and state funds.

Texas

The Texas Department on Aging (TDoA) has been an independent agency since 1981. Previously known as the Governor's Committee on Aging, the Department was formed to act as the state's unit on aging and administer federal funds, as well as contributions from the state and local communities.

The department coordinates, conducts, and reports on its advocacy efforts. It tracks national and state legislation of concern to the elderly and makes it available to the aging network, the public, and news media. It also focuses on its long-term care ombudsman program; legal assistance development; prevention of elder abuse, neglect, and exploitation; and outreach, counseling, and assistance. The funding that is funneled through the department provides elderly nutrition services, transportation, the retired senior volunteer program, and information. It also supports community services such as home repair, legal services, homemaker services, personal assistance services, and adult day care services.

Virginia

The Virginia Department for the Aging, established in 1982, is the designated state unit on aging. As such, it is responsible for planning, coordinating, funding, and evaluating federal and state-funded programs. These include a full range of nutrition, transportation, health, education, and social services to improve older Virginians' quality of life.

Although the department was not officially created until 1982, it had its beginnings in 1958 as the state's Commission to Study Facilities and Services Available to the Elderly. By 1970, responsibility for developing and coordinating programs for the elderly was housed in what was then called the Division for State Planning and Community Affairs. In 1973, the General Assembly appointed a Commission on Aging and in 1974 they turned it into an Office on Aging as an independent agency reporting to the Governor. Also in 1974, the Governor's Advisory Board on Aging was created. In 1979, the Director of the Office on Aging reported to the newly established Secretary of Health and Human Resources. In 1982, the General Assembly recognized the significance of programs for older Virginians by upgrading the Office on Aging to full departmental status.

STATES THAT HAVE AN INDEPENDENT OFFICE, COMMISSION, OR BOARD ON AGING THAT ADMINISTERS SUBSTANTIVE PROGRAMS

Alabama

Alabama's independent Commission on Aging, established in 1957, is designated the state unit on aging under federal law and receives the federal funds for elderly nutrition and related programs, which it grants to the 13 area agencies on aging. The commission administers the long-term care ombudsman program and the elder abuse prevention program. It also engages in advocacy. It receives a small amount of money under a Medicaid waiver for homecare. It receives some supplementary state money.

Idaho

Idaho's Commission on Aging, has existed for about three years. It is the designated state unit on aging and receives federal funding for Title III programs such as elderly nutrition and transportation, homecare and Alzheimer's services, which it parcels out to the area agencies on aging. It receives state funding for an ombudsman and adult protection program. It also carries out advocacy functions.

Maryland

Maryland's Office on Aging, established in 1975, is an independent agency within the executive branch. It is the conduit for state and federal Title III funds and is designated the state's unit on aging. It oversees the delivery of programs, services, and benefits through the state's network of 19 area agencies on aging. The area agencies either provide services directly or contract with other public or private agencies. The office's mission is to provide leadership and advocacy for the state's elderly through information, education, programs and services, and to promote and enhance choice, independence, and dignity.

Massachusetts

Massachusetts' Executive Office of Elder Affairs, established in 1973, is a cabinet-ranked agency headed by a secretary. It is the state's designated unit on aging and receives federal and state money for its programs. The programs include homecare, elderly nutrition, advocacy, protective services, regulation of assisted living facilities, information referral, monitoring and auditing of homecare corporations, providing technical assistance, long-term care ombudsman, health insurance counseling, overseeing grants and contracts, monitoring legislation, administering an elder employment program and a senior volunteer program, and coordinating local councils on aging.

Minnesota

The Minnesota Board on Aging was first created in 1957 as the Council on Aging and became the Board on Aging in the mid-1970s. It is designated the state's aging unit under federal law and administers the federal elderly grants and programs by funneling federal money to the area agencies on aging. It receives some state supplementary money for the elderly nutrition programs. It also administers the long-term ombudsman program, and advocates for the elderly. The governor appoints the board's 25 members.

The board is located in the Department of Human Services for administrative purposes only. The board makes its own decisions but is staffed by the department's Aging and Adult Services Division, which also administers other substantive state programs that provide protective services, supportive assistance, and alternative housing arrangements for the elderly.

New Mexico

New Mexico's State Agency on Aging is an independent agency, which has existed for about 20 years. It is designated the state unit on aging and is the conduit for federal funds. It administers elderly nutrition programs; homemaker and home health care services; an ombudsman, senior volunteer, and foster grandparents programs; entitlement and insurance counseling; health promotion; employment of low-income seniors; and the Senior Citizen Olympics.

Last year there was an effort to consolidate the agency into another department, but this did not pass.

New York

New York's Office for the Aging was created by the governor's executive order in 1961. It was one of the first state units on aging under the federal Older Americans Act. It became an independent agency in the executive department in 1965 and became the state's central agency to plan and coordinate programs and services for the aging at all levels in both the public and private sector. It does advocacy, planning, and coordination, and it administers various titles under the Older Americans Act and a variety of state-funded programs that serve the elderly. Most programs are administered by local offices for the aging. These include congregate meals and home delivered meals, homecare services, senior employment and job training programs, the long-term care ombudsman, legal assistance, energy services, weatherization referral, health insurance counseling, Medicare information, and community services. The Department of Health runs a pharmaceutical assistance program, but the state and local offices for the aging do outreach to identify potential program participants.

The office also advises and assists the governor in developing elderly-related policies; coordinates state programs and services for the elderly; stimulates community interest in problems of the elderly; promotes public awareness of available resources; ensures development of local programs; and fosters and supports studies, research and education on the elderly.

Tennessee

Tennessee's Commission on Aging was established in 1963. It is not part of a department but it includes on its board the heads of the departments that provide various programs and services to the elderly.

The commission is the state's designated unit on aging under federal law and receives and disposes of the federal funds and some small amount of supplementary state funding for elderly nutrition and related programs. The nursing home ombudsman is also located with the commission. The commission performs some advocacy for the elderly. Other functions are located in different departments. For example, the Department of Human Services contains an Adult Protective Services Division.

West Virginia

West Virginia's Bureau of Senior Services has technically existed for only a year, but it was previously called the Commission on Aging, which was created about 30 years ago. The bureau is a cabinet status agency headed by a commissioner. It is designated the state aging unit under federal law and administers the federal elderly nutrition and related programs. It employs a long-term care ombudsman and does advocacy, including advocacy on elder abuse issues. The state also provides some supplementary funding.

Last year's legislation created the Bureau of Senior Services by combining the former Commission on Aging with the community care programs and the aged and disabled Medicaid waiver program that provides homecare. These two programs were previously in an Office of Aging under the umbrella Department of Health and Human Resources.

STATES THAT HAVE THEIR AGING UNIT AND PROGRAMS AS PART OF A LARGER DEPARTMENT OR AGENCY

Thirty other states place the aging unit and the substantive programs in various larger departments as follows in Table 1 below. Most locate it in the equivalent of a social services department. A few put it, or at least the advocacy functions, in the Governor's Office.

Table 1

Location of State Aging Functions in States without an Independent Agency

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