Policy Analysis
Historical Context of the Current Policy and the Role of Historical Context in the Policy Development
The health of older adults was always been a complex issue for the healthcare system and social well-being of the US. Today, this problem remains critical, and it is especially important for low-income people, those living in rural areas, and other vulnerable groups. In 1965, the Older Americans Act (OAA) was enacted to support the mentioned people, and H. R. 4334: Supporting Older Americans Act of 2020 aims to improve it. The OAA expired in 2019, while it served to connect older Americans and care providers in terms of community-based support. Considering that the rate of aging in the US tends to grow, it is critical to reauthorize the mentioned act and also adjust it to meet the needs of persons aged 60 and over.
The rise in life expectancy, an increase in the number of pensioners, and a decrease in the working-age population make it essential to rethink the previous approach. In addition, the change in the social security system, which extends its effect over time to more and more categories of citizens, is a natural process in the development of the US. In 2016, the number of people who were eligible for the Act’s impact was 11.3 million. Speaking more precisely, 23.7 rides to medical facilities were performed, and 45.2 million home-delivered meals were provided (Center for Responsive Politics, n.d.). However, there is a need to extend these programs to serve more individuals as they need help.
The critical review of the historical context allows for noting that the reauthorization of Acts requires the approval of the Senate, which is accompanied by many appropriations. First, the House submitted the Dignity with Aging Act 2019 that was a request to repeatedly authorize the OAA. Second, the session on amending the policy was conducted by the House Committee on Education and Labor (House Committee on Education and Labor, n.d.). Third, the Senate took up the House bill for consideration. While the presented hierarchy for the policy reauthorization is clear in the historical context, it also becomes evident that adjustments are always needed to meet the changing needs of the target population.
Practice Implications and Its Influence on Service Delivery
The implementation of the Supporting Older Americans Act of 2020 would create many opportunities for older adults to receive the necessary health care services, medication, nutrition, counseling, and so on. The identified Act became the foundation for reauthorizing the OAA for a five-year period. Since it is requested to increase funding by seven percent for the first year and six percent for each subsequent year, one may suggest that the program would cover all Americans who need assistance (National Council on Aging, 2020). At the same time, additional grants are to be given to tribal organizations of Native Americans so that they can ensure that their communities have everything they need. The mentioned Act is to promote the reauthorization of the RAISE Family Caregivers Act that implies the creation of national assistance to support family caregivers and invest in related research. Ultimately, the new advisory council is expected to study and design relevant options for seniors who are socially isolated.
It is expected that the proposed policy change would improve the quality and speed of care delivery. For example, the changes in the nutrition programs would allow feeding more people and bring the attention of society to the problem of poor nutrition. The additional funding would contribute to research and the subsequent choice of the best practices and interventions. Moreover, the provision of adequate technical assistance would increase care delivery quality as well. Considering that many chronic diseases of older adults can be prevented or minimized through timely check-ups and proper diagnostics, this issue to be given special attention. For instance, fall prevention programs and health promotion activities can be used to reduce the number of patients with diabetes, injuries, psychological disorders, and so on. For those who had already developed one or several chronic conditions, timely visits to doctors and medication regimens are vital, the monitoring of which is another practical implication of the Older Americans Act of 2020.
Strengths and Limitations of the Policy
The provision of independence to older individuals is the key strong point of the proposed policy. The support for a healthy lifestyle is especially critical for seniors since they have established views of their life quality, possessing also a list of chronic diseases. Therefore, both treatment and preventive services are implied by the OAA. The work with the community-based organizations is another strength, which provides seniors with mental, brain, and behavioral aid services, allowing them to remain active and involved in society. People living alone and suffering from osteoporosis, depression, asthma, and other conditions need particular support since their movements and opportunities for leisure tend to be reduced (Bonamici, 2020). One more amendment to the policy includes screening for fall risk, suicide risk, and social isolation to uncover the factors that can lead to negative outcomes. The promotion of healthy lifestyles and behaviors can significantly facilitate the challenges of older adults.
Many family caregivers face difficulties in their practice, which may include a lack of pertinent information, training, resources, et cetera. The OAA introduces the National Family Caregiver Support Program (NFCSP) that offers direct support to family caregivers. These services can involve group and individual assistance, training, referral, and many other options that depend on their specific needs (Congressional Budget Office, 2019). In addition, the proposed policy authorizes aid to the Native American family caregivers, who can allocate the resources in their communities. Another strong point is that the NFCSP implies the evaluation and reporting requirements for caregivers, which clarifies their expected actions and the ways to succeed in their practice (Congress, 2020). For example, one of the specific care issues is caring for persons with Alzheimer’s disease, and the Act states that family caregivers can provide their services to people with this disease regardless of their age.
The limitation of the OAA is related to a lack of interest of policymakers in extending the areas that the policy would cover. For example, little attention is paid to evidence-based care interventions and their role in disease treatment and prevention. It goes without saying that research in the sphere of healthcare is extensive, but it needs to be linked to the practice. Currently, there is no emphasis on the use of these interventions that are proven to prevent diseases and promote health among seniors. Since the positive changes are especially important for older adults to give them hope and trust in a better life, the value of evidence-based practice cannot be underestimated.
Another limitation is the relatively low flexibility of the states to apply for funding and other types of assistance. In some states, there is a greater level of cardiovascular problems, while others are more likely to encounter falls and diabetes in older adults. Therefore, it is essential to provide each of the states with the services they need, taking into account human resources as well. The amendment to the new authorization of the policy can be necessary for terms of clarifying the process and opportunities for seeking the required help. Likewise, it is noted regarding the Native Americans, certain details can be added for various ethnicities and communities, especially those that report about the highest disease levels or lack health care services.
Recommendations for Improvements or Changes to the Policy
Considering that insufficient attention is paid to evidence-based care, the first recommendation is to clarify and promote the value of linking research and practice in caring for older adults. Among the benefits of evidence-based care strategies and programs, there are the increased quality of life, reduced pain and disability, improved self-efficiency among patients, and better mental health. In turn, the community advantages are better health experience, the facilitation of partnerships among community-based organizations, more effective use of community resources, and reduced number of visits to doctors. The need for the rigorous study of interventions should be declared by the policy so that care providers, counselors, and other persons under the OAA would implement it in their practice.
The second recommendation refers to the detailed definition of the flexibility among the states regarding their application for the necessary services. More family caregiving assistance can be vital for some states, while others would benefit from technical help and advanced equipment. It would be better if an additional section of the Act would clarify these issues, giving more clarity to how and how states can use the new policy to improve the care for their people.
References
Bonamici, S. (2020). H.R. 4334: Supporting Older Americans Act of 2020. Web.
Center for Responsive Politics. (n.d.). Bill profile: H.R.4334. Web.
Congress. (2020). H.R.4334 – Supporting Older Americans Act of 2020. Web.
Congressional Budget Office. (2019). H.R. 4334, Dignity in Aging Act of 2019. Web.
House Committee on Education and Labor. (n.d.). Dignity in Aging Act (H.R. 4334). Web.
National Council on Aging. (2020). Legislation. Web.