5- A broker who connects clients to existing programs and services

As listed above, the older adult has various requirements, needs, and wants that the human services professional should be able to help them satisfy.  

Government Programs

      Some items needed by older adults are currently covered under

the Older Americans Act (OAA) or Social Security through Medicare

and Medicaid. But there have been significant cut backs on the

funding the OAA and Social Security has looming problems of its

own. Besides, not all of the needs for goods and services are being

met by the Public Sector.

                       The Older Americans Act of 1965-- (OAA)

      The Older Americans Act was passed in 1965, and provides many benefits for the elderly. One of these benefits is the Senior Citizen Center. The Senior Citizen Center is a place for seniors to congregate and share common backgrounds. Senior Citizen Centers, by law, are the "Information and Resource" centers that are mandated by law to be the senior’s resource to all other government programs. This "information and referral service" may include:
- Quality Aging Program                    -Transportation Program
- Nutrition programs, both congregate and Meals on Wheels
- Activities and socials                       -Senior Companion Program
- Homemakers Home Health Aid Program     -Hospice Program
- Foster Grandparent Program         -Telephone Reassurance
- Alternative Program                         -Senior Employment Program
- Retired Senior Volunteer Program          -Legal Services
- Health Screening Center
      Many of the ideas presented at these centers have given retirees the feeling of worth and self respect. That in return, has improved their health and life satisfaction.

                                   Senior Companion/Foster Grandparent

      Both of these programs were designed to help low-income

retirees supplement their income needs. These programs,

administered through the local Area Agency on Aging, provide tax-

free income (which also is not counted against social security

benefits in any way) and also pays related costs.

SOCIAL SECURITY ADMINISTRATION – SSA

When: 1935 - Franklin D. Roosevelt's "New Deal"

What:  Social Insurance (also called transfer income)

Who: Elderly, vocational rehabilitation and unemployment. Originally covered elderly, survivors, and disabled.

Why: Move elderly out of the workforce; make jobs for younger people.

How: FICA - Federal Income Contributory Act (Originally, 1/2 of 1% of the first $3,000 earned. The first benefit paid was in 1940 to Ida Fuller - $22/month)

SUPPLEMENTAL SECURITY INCOME – (SSI)

When: Passed 1972; implemented 1974

What: Income floor for the worthy poor; is means tested

Who: Aged (65+), blind (vision 20/200), and disabled of any age

Why: Provide cash assistance

How: General revenues

      The Program of All-Inclusive Care for the Elderly (PACE) was measured as to it's effectiveness by Mukamel and associates (1998). As a program of the US Health Care Administration, the first 11 of these sites were part of the study prior to the expansion to about 100 sites in 2000. The improvement of functional status was measured against the cost and payment methods of providing these programs. The results of this study show that most of the improvement that a patient will achieve is found in the first few months. Although Mukamel and associates did not consider the Hawthorn Effect, this author wonders if the fuss over the elderly person is the real reason for that initial improvement. After the early period of time, there was very little improvement on all fronts. It was noted that patients who had ADL problems with bathing were the most improved after six months and again measuring them at 18 months.  Those with ADL problems in transference were the least improved at any measurement time.

      Of interest was the fact that the patients who were involved in the first PACE project, those in On Lok Senior Health Services in California were more likely than the patients in other locations to improve, even after considering the differences in the case mix of the programs. The article gives credit to On Lok as a more effective program. However, this author wonders if better outcomes were somewhat the result of the fame of the On Lok program and/or the fact that it has been around the longest. The article does acknowledge that there many be a learning curve that is not easily transferred to the newer sites, leaving On Lok more effective due to more practice and knowledge.