Existential concerns for services provided to older Iowans, individuals with disabilities, and family caregivers are at an all-time high. To follow President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative,” the U.S. Department of Health and Human Services (HHS) initiated a reorganization. This will directly impact the services offered by Area Agencies on Aging (AAAs). It will also affect other partner organizations nationwide. Although, as of this writing it is unclear which branch this will be, the announcement indicates that ACL programs will integrate into the Administration for Children and Families (ACF) or the Centers for Medicare and Medicaid Services (CMS). They may also integrate into the newly established Office of Strategy (OS). The OS resulted from the merging of the Assistant Secretary for Planning and Evaluation with the Agency for Healthcare Research and Quality (read the press release here). Regardless of the location of the office or agency that oversees Older Americans Act (OAA) programs and services, officials have stated that current programs through OAA should not experience significant disruption. (see related stories here: NPR, Disability Scoop).
As advocates for older Iowans, representatives from Iowa’s Area Agencies on Aging (AAAs) and the Iowa Association of Area Agencies on Aging (i4a) hosted a coffee with Iowa legislators at the Iowa Capitol on March 27, 2025, and attended the annual USAging policy briefing in Washington D.C., March 31-April 1 where representatives visited each of the Iowa Congressional offices. During the visit to the Iowa Capitol, AAA representatives shared messages from congregate meal attendees. These messages highlighted the importance of meals they receive through State and Federal appropriations. In Iowa, over 23,000 individuals received 1.8 million meals during FY24. However, with an aging population, expected to be 20% of all Iowans over the age of 60 by 2050, there is growing concern about how the AAAs will meet the food and nutrition of older Iowans who may need access to meals, whether congregate meals or home-delivered (e.g., Meals on Wheels, Mom’s Meals) without additional resources. Appropriations from Iowa’s General Assembly have been “flatlined” for over a decade, including during the pandemic (see 2025 Policy Agenda). Iowa legislators learned about the need for increased funding for food and nutrition programs. The aging network continues to advocate for additional appropriations to establish a Dementia Services program. This program would provide more access to information and assistance, caregiver support, and strengthening of dementia-friendly communities. There is also a focus on the potential to enhance pre-clinical assessment access in the field. See Dementia Friendly Iowa to learn more about some of the initial activities.
Dementia Friendly Iowa and the i4a 2025 policy agenda priority to increase appropriations for home and community-based services that help fund the nutrition program were also key talking points during the visits to the Iowa Congressional offices in Washington D.C. In addition to the above talking points, staff in the Congressional offices learned the importance of the Older Americans Act. They were introduced, or re-introduced, to the aging network. They also learned about the services provided by over 600 AAAs and over 20,000 local providers across the U.S. The Older American Act (OAA) was not reauthorized in the final month of the last Congress. Congressional staff were encouraged to share with Iowa’s elected officials that the OAA needed their support in order for older Iowans to have access to local supports and services that help them stay in their community and living arrangement of choice for as long as possible. Further, the OAA provides support services for caregivers, reduces social isolation and loneliness, prevents or reduces the risk of elder abuse, and provides access to care support and evidence-based programs that optimize healthy aging.
You are encouraged to reach out to your elected State and Federal representatives and senators to let them know how important AAAs are to ensuring that older Iowans, adults with disabilities, and caregivers have the supports and services they need to remain in their homes and communities that reduce costs for Medicaid and Medicare.
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