Cost Sharing for Older Americans

PURPOSE

To assess the experience of State programs for the elderly which provide in-home and adult day care services on a cost-sharing basis.

BACKGROUND

The Commissioner on Aging requested this study as a source of information on State experiences with cost-sharing programs. The Older Americans Act (OAA) of 1965 created the Administration on Aging and provides financial assistance to States for social service and nutrition programs for the 60-plus population. For FY 1990, appropriations were $709 million, down 20 percent from 1981 when adjusted for inflation. State and area agencies on aging cannot charge fees for title III services, although the law permits soliciting recipients for voluntary contributions. States, however, are free to charge for services provided through State funding rather than Federal title III funding. About 40 States have cost-sharing for some State-funded programs, and income-related sliding fee scales are generally used to set cost-sharing amounts.