Community Support Expenditures

Community Support Expenditures in District of Columbia

District of Columbia

Most older adults value living in their own home safely and independently. Several federal and state programs offer support to older adults allowing them to remain independent at home, ultimately saving money for both older adults and the federal programs that help fund nursing home care. 

Since the Older Americans Act (OAA) of 1965, the Administration on Aging has provided funding to states for community, social and nutritional services that assist adults ages 60 and older and their caregivers. The funding is used by states for programs supporting transportation, personal care, adult day care, homemaker assistance, case management, home-delivered meals, congregate meals, physical fitness and nutrition education. 

These funds are targeted toward adults ages 60 and older with an emphasis on individuals in greatest social and economic need, particularly low-income older adults, racial and ethnic minorities, older adults living in rural communities and those at risk of institutional care. The Administration on Aging provided services to 1 in 7 older adults in 2018. 

While the community support measure in this report is limited to OAA dollars, other state and federal funding exists to support older adults. In fiscal year 2019, $95 billion, or 58.6%, of all Medicaid long-term services and support spending went toward home- and community-based services such as home health aides, adult daycare, meal programs and in-home modifications and assistive equipment.

Of the 10.8 million individuals served by OAA support programs in 2018:

• 33.5% were living below the poverty line.
• 34.6% were living in a rural area.
• 32.2% self-identified as a racial or ethnic minority (Asian; Black or African American; Hispanic or Latino; Native Hawaiian or other Pacific Islander; American Indian; or Alaska Native). 

OAA programs also serve a disproportionate amount of older individuals who live alone, which is a risk factor for nursing home admission and social isolation.

Investment in social services for older adults may help them maintain function and independence. A study published in 2013 found that increases in home- and community-based services for older adults, such as home-delivered meals, congregate meals or community centers, were associated with a decrease in the proportion of low-care residents in nursing homes.

Results from the 2021 National Survey of OAA Participants spoke to the effectiveness of community support services— 80% of congregate meals clients and 89% of home-delivered meals clients reported that these services helped them continue to live independently at home.

To learn about the programs and services funded in your community, visit the Administration on Aging’s Eldercare Locator.

Administration on Aging, and Administration for Community Living. 2021. “FY 2018 Older Americans Act Report to Congress.” U.S. Department of Health and Human Services. https://acl.gov/sites/default/files/about-acl/2021-06/ACL_FY2018%20OAA%20Report%20to%20Congress.pdf.

Klinenberg, Eric. 2016. “Social Isolation, Loneliness, and Living Alone: Identifying the Risks for Public Health.” American Journal of Public Health 106 (5): 786–87. https://doi.org/10.2105/AJPH.2016.303166.

Murray, Caitlin, Alena Tourtellotte, Debra Lipson, and Andrea Wysocki. 2021. “Medicaid Long Term Services and Supports Annual Expenditures Report: Federal Fiscal Years 2017 and 2018.” Chicago, IL: Mathematica. https://www.medicaid.gov/medicaid/long-term-services-supports/downloads/ltssexpenditures-2017-2018.pdf.

Thomas, Kali S., and Vincent Mor. 2013. “The Relationship between Older Americans Act Title III State Expenditures and Prevalence of Low-Care Nursing Home Residents.” Health Services Research 48 (3): 1215–26. https://doi.org/10.1111/1475-6773.12015.

Ujvari, Kathleen, Wendy Fox-Grage, and Ari Houser. 2019. “Spotlight: Older Americans Act.” AARP Public Policy Institute. https://www.aarp.org/content/dam/aarp/ppi/2019/02/older-americans-act.pdf.