This week the U.S. House Appropriations Committee approved, along a party-line vote, a bill to fund the Departments of Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) for federal fiscal year (FFY) 2018. Overall, the Labor-HHS bill, which funds Older Americans Act (OAA) and many other aging programs, received an allocation that was $5 billion less than FY 2017 levels, which resulted in cuts to a number of federal workforce, education and health programs in the committee-passed bill.
It is notable that House leadership, in assigning top-line spending levels for all 12 appropriations subcommittees in FY 2018, broke parity between defense and non-defense spending required by the Budget Control Act. House appropriators are subsequently moving forward spending proposals that significantly increase defense spending while constraining overall domestic funding levels. While the committee also rejected many of the cuts and eliminations requested in President Trump’s FY 2018 budget, the budget environment for non-defense programs, including OAA and other aging programs, is shaping up to be incredibly difficult this year.
The National Association of Area Agencies on Aging (n4a) examined the House Labor-HHS spending bill with special attention to programs that help older adults remain in their homes and communities. The following analysis focuses on key programs that serve older Americans and their caregivers.
OAA and AoA/ACL Programs-Administration for Community Living (ACL), HHS:
Programs serving older Americans under OAA were largely level funded at FY 2017 amounts in this House Labor-HHS spending plan. Considering the current challenging federal budget environment, the fact that most core OAA programs were spared cuts, and that modest increases achieved last year were preserved, is a significant advocacy win. Overall the House bill would fund ACL at $2.237 billion, which is $243 million above FY 2017 levels.
This $237 million increase is deceiving, however, because the House bill proposes transferring the Senior Community Service Employment Program (SCSEP, OAA Title V) from the Department of Labor (DOL) to ACL. The total transfer from DOL to ACL outlined in the bill is $300 million (a $100 million, or 25 percent, cut from FY 2017), which means that the overall ACL allocation is actually $57 million less than the FY 2017 final funding level. Unfortunately, the bulk of that cut is due to the committee’s proposed elimination of the State Health Insurance Assistance Program (SHIP) (-$47.1 million) and Elder Justice support activities (-$2 million).
During full committee consideration of the Labor-HHS bill, Rep. David Price (D-NC) offered an amendment to restore funding for SHIP, SCSEP and Elder Justice to last year’s levels, but the amendment was defeated 22 to 30 along a party-line vote. Notably, however, both Rep. David Young (R-IA) and Labor-HHS Subcommittee Chairman Tom Cole (R-OK) expressed interest in possibly rectifying at least some of this funding moving forward. Advocates will need to continue to push lawmakers to reject SHIP elimination and cuts to SCSEP and Elder Justice programs.
Older Americans Act Title III Programs:
In what can be considered a win for advocates in this incredibly difficult budget environment, funding for OAA Title III B Home and Community-Based Supportive Services ($350 million), III C Nutrition Services ($450 million for Congregate and $227 million for Home-Delivered Nutrition Services), and III E Family Caregiver Support ($150 million) was flat.
Native American Nutrition, Supportive Services and Caregiver Support:
OAA Title VI Native American Aging Programs that serve some of the most economically vulnerable older adult populations in the country were also flat-funded in the House Labor-HHS bill. Nutrition and supportive services would be funded at $31.1 million, and caregiver support services would receive $7.5 million, which maintains a recent, congressionally driven, significant increase to both programs that serve Native American, Alaskan Native and Native Hawaiian elders.
Elder Justice and Adult Protective Services:
The budget request also level funds OAA Title VII Long-Term Care Ombudsman Program ($15.8 million) and Prevention of Elder Abuse and Neglect ($4.8 million) programs. Unfortunately, the bill rolls back a $2 million increase achieved last year for Elder Rights Support Activities, including the Elder Justice Initiative—an ACL priority under the Obama Administration—and funds these programs at $11.9 million ($2 million less than in FY 2017). This is the first House or Senate bill in several years that cuts funding for efforts to develop a national Adult Protective Services (APS) data system and to continue APS research.
Aging and Disability Resource Centers:
Funding for Aging and Disability Resource Centers (ADRCs) was also level funded at $6.1 million. Since $10 million in annual mandatory funding for ADRCs expired in September 2014, advocates and Administration officials have been unable to fill that gap with additional discretionary (annually appropriated) or restored mandatory funding.
Other Key Aging Programs
Prevention and Public Health Programs:
As in past years, the House Labor-HHS bill proposes to eliminate funding for the Prevention and Public Health Fund (PPHF), which was created in 2010 via the Affordable Care Act (ACA). PPHF provides a source of mandatory funding for activities devoted to boosting public health and using proven prevention strategies to reduce Americans’ rates of illness and disability. However, appropriators provided continued discretionary funding for several disease prevention and health promotion initiatives targeting older adults—essentially shifting them to the other side of the federal ledger. The Labor-HHS bill proposes discretionary funding for the Chronic Disease Self-Management Program (CDSMP) at $3 million below FY 2017 levels, which amounts to a 38 percent cut for these activities. Elder Falls Prevention would be level-funded at $5 million under the budget request, but because this funding would come out of the ACL/AoA discretionary budget, it puts pressure on other discretionary programs. Funding for Alzheimer’s Disease Program, which provides funding for Alzheimer’s outreach and awareness campaign activities and long-term services and caregiver support programs, would also move to the discretionary side of the ledger and receive essentially flat funding at $19.5 million.
Lawmakers rejected requests from the Administration to eliminate funding for the Senior Corps programs (RSVP, Foster Grandparents and Senior Companion) under the Corporation for National and Community Service (CNCS) and level-funded all Senior Corps programs at FY 2017 allocations. This is a win of this round, but because volunteers secured through Senior Corps programs routinely supplement workforce needs at Area Agencies on Aging and other community-based organizations serving seniors, n4a will continue to advocate that the Senate also protect funding for these key programs in final funding bills.
Block Grant Programs Supporting Older Adults:
In the FY 2018 budget request to Congress, the Administration asked lawmakers to eliminate funding for key federal block grant programs that supplement and support the work of the Aging Network and other CBOs serving older adults at the local level. The House largely rejected the President’s requests to pull funding from these programs, and approved funding for the Community Services Block Grant at $600 million, a $115 million or 16 percent cut, and the Social Services Block Grant at a level $1.7 billion. The committee also approved flat funding the Low-Income Home Energy Assistance Program (LIHEAP), at $3.9 billion. LIHEAP helps low-income households and families, including many older adults, with heating and energy bills throughout the year.
Currently many in Congress and the Administration support harmful basic budgetary principles reflected in both the President’s budget request and initial House appropriations bills, such as breaking current funding parity between defense and non-defense programs outlined in the Budget Control Act. Congressional Republicans in both the House and the Senate will likely continue to push boosts to defense programs and other policies, including stringent budget caps and offsets for debt limit increases, which will prolong pressure on domestic discretionary programs.
In the coming weeks, the Senate will have to consider their own Labor-HHS funding bill, and ultimately both chambers would have to pass identical Labor-HHS spending measures before FY 2018 federal funding for OAA and other aging programs is finalized. In the Senate, appropriations bills require 60 votes to pass, which means that at least eight Democrats would have to approve the measure. Senate Democrats have been committed to maintaining parity and alleviating at least some of the pressure from budget caps, so a bill that does neither likely wouldn’t gain enough Democratic support to pass.
Ultimately, lawmakers on both sides of Capitol Hill may be unable to push FY 2018 funding bills through normal legislative channels, and House and Senate Leadership may resort to either passing a continuing resolution that would simply extend current funding levels into next year, or drafting a funding bill that rolls multiple individual appropriations bills into one, known as an “omnibus.” As it stands, spending bills are still subject to the reduced budget caps for FY 2018, which trigger an across-the-board may sequester. However, lawmakers want to avoid another sequester, and they could come to some agreement to raise top-line budget caps. Whether the President would sign any funding bill that increases budget caps is unknown, and there could still be a government shutdown showdown later this fall.
Despite the murky forecast at this point, it is imperative that national and grassroots advocates reject the cuts proposed in both the House Labor-HHS bill and more broadly in President Trump’s budget request, and that we continue our fight to stop sequestration-level budget caps.
Source: National Association of Area Agencies on Aging Legislative Update, July 20, 2017
For more information:
2018 Appropriations Advocacy - National Association of Area Agencies on Aging