The November 3, 2021 version of the Build Back Better Act continues to invest in services for older Americans that are carried out by the U. S. Administration for Community Living (ACL) within the Department of Health and Human Services (HHS).

In response to the COVID-19 pandemic, Congress has passed laws providing additional funding for ACL’s Older Americans Act (OAA) programs, among other activities. The Build Back Better Act currently provides more than $1.2 billion for OAA programs, which supports a wide range of social services and programs for individuals aged 60 or older.

With respect to the distribution of OAA program funds in the Build Back Better Act, the ACL will continue to allocate these federal funds which are authorized under OAA statutory funding formulas to State Units on Aging (SUAs) and tribal organizations. SUAs, in turn, award these funds to Area Agencies on Aging (AAAs) based on an intrastate funding formula developed in accordance with guidelines approved by the Assistant Secretary for Aging.

The following is an overview of funding allocated to the ACL for fiscal year (FY) 2022, which supports the aging services network and infrastructure. These funds are not supplanting OAA FY 2022 regular appropriations funding.

$1.2 billion in Older Americans Act: Build Back Better Act Appropriations

o $75 million for the Research, Demonstration, and Evaluation Center for the Aging Network;

o $655 million to support (Title III, part B) grants to state and community programs on aging to coordinate HCBS services, with a focus on improving the availability of supportive services, which includes investing in the aging services network workforce and investments in facilities;

o $140 million to support (Title III, part C) congregate nutrition services and home delivered meals for older Americans, including to support the modernization of infrastructure and technology, kitchen equipment and delivery vehicles;

o $150 million to support (Title III, part E) the National Family Caregiver Support Program;

o $50 million to support (Title VI, part C) grants for supportive and nutrition services to older Native Americans;

o $50 million for (Title VII) long-term care (LTC) ombudsman program grants, as well as Elder Abuse, Neglect, and Exploitation Prevention Programs.

The majority of the Title VII funding ($18.9 million, or 80%, in FY 2021) is directed to the long-term care ombudsman program, which investigates and resolves complaints of residents in nursing facilities, board and care facilities, and other adult care homes. In addition, $10 million in funding for the LTC ombudsman program has been provided under the P.L. 117-2, in response to the COVID-19 pandemic. According to ACL, in 2019, ombudsmen handled more than 198,500 resident complaints and provided more than 559,999 consultations to individuals and long-term care facilities.

o $59 million for (Title IV) funds to support technical assistance centers or national resource centers culturally appropriate care management, and services for older individuals with the greatest social need, including racial and ethnic minority individuals;

o $15 million for technical assistance centers or national resource centers for older individuals who are underserved due to their sexual orientation or gender identity;

o $1 million for national training and technical assistance centers efforts to support expanding the reach of the aging services network to more effectively assist older individuals in remaining socially engaged and active, and to address social isolation of older individuals;

o $5 million to carry out (Section 417) multigenerational civic engagement projects.

The Build Back Better Act would allocate funds to ACL to support a few additional aging network and infrastructure initiatives, which includes:

o $20 million for the Technical Assistance Center for Supporting Direct Care and Caregiving. These funds will remain available until September 30, 2031, for necessary expenses to establish, directly or through grants, contracts, or cooperative agreements, a national technical assistance center. 

The Technical Assistance Center would support direct care workforce recruitment, education and training, retention, career advancement, and support family caregivers and caregiving activities. The Center would be responsible for developing and disseminating a set of replicable models or evidence-based or evidence informed strategies or best practices for reducing barriers to accessing direct care services. Additionally, increasing access to alternatives to direct care services, including assistive technology and providing recommendations for education and training curricula for direct support workers. Also, provide recommendations for activities to further support paid and unpaid family caregivers, including expanding respite care.

o $40 million, for FY 2022, that would be available to support unpaid caregivers behavioral health needs. The Assistant Secretary for Aging shall use the funds to make awards to States, public agencies, private nonprofit agencies, institutions of higher education, and organizations, including Tribal organizations, to address the behavioral health needs of family caregivers and older relative caregivers.

The Build Back Better Act also provides $1 billion to the Department of Labor to implement a new Direct Care Worker Grant Program. The program would fund competitive grants to recruit and retain direct care workers, including raising wages and creating training opportunities to help address the direct care workforce shortage. DOL will collaborate with ACL on administering the grants.