Aging

One of the primary roles of the Department of Aging is to ensure Pennsylvania's older adults kept safe from violence, abuse, neglect, abandonment, and financial or other forms of exploitation. The Department oversees the execution of the Older Adult Protective Services Act (OAPSA), which guides the work of the 52 area agencies on aging that provide Protective Services in cases of suspected abuse of an older adult.

Anyone can report a suspected case of abuse by calling the statewide hotline at: 1-800-490-8505. When these calls are received, information is gathered from the caller about the circumstances or allegations to complete an electronic form called a Report of Need. The Report of Need prompts a series of events to ensure the safety and well-being of any potential older adult victim.

The quantity of Reports of Need received has steadily increased over all reporting years. While this indicates that the number of older adults in need of protective services has increased, it also speaks to the effectiveness of the department in educating the public as to the availability of services and create an awareness of the problem so that more people will recognize and report suspected cases of abuse. In addition, the ongoing education of mandatory reporters of elder abuse continues to ensure suspected cases of abuse are reported by providers.

A little less than 80% of Reports of Need are investigated. Sometimes Reports of Need do not require investigation, but rather require referrals to other community services, for example. Other Reports of Need might not be investigated because they do not fit within the parameters of Pennsylvania’s Older Adult Protective Services Act (OAPSA), for instance reports made about older adults who don’t live in PA or individuals under 60 years old.  The law requires that a Report of Need is taken, but these cases are referred to the appropriate entity for investigation.

When a Report of Need requires an investigation and the report is substantiated, it means that the older adult has been found to be in need of protective services. Those services can range from simple things like education for family or caregivers or in-home services like meals or personal care. Services can also be more complex, like overnight shelter/supervision, legal assistance or guardianship.

Whatever the need may be, the area agencies on aging strive to advocate for the older adult to develop a plan that reflects the least-restrictive alternatives to eliminate the imminent risk to the older adult’s person or property.

The Long-Term Care Ombudsman Program is designed to support and empower consumers by resolving individual complaints involving long-term care service while working to improve and enhance the long-term living system for the residents and their families.

Pennsylvania Ombudsmen are federally mandated, legally-based and state certified via standardized training to actively advocate and give voice to older consumers of long-term care services, whether delivered in the community or a facility-based setting. Pennsylvania Ombudsmen champion the rights of these consumers to achieve the highest quality of life and care wherever they reside. Ombudsmen may be staff, volunteers or PEER (Pennsylvania Expert Empowered Residents) residents; all are united through an impassioned commitment to listen, educate, investigate, mediate and empower through a visible presence. 

Ombudsmen are required to make their services known to residents and do so through regular facility visits and posting of information about the program at long-term care facilities. Residents or family can call or email to be connected to an ombudsman advocate who can assist them with issues related to the quality of their long-term care services.

The National Ombudsman Reporting System (NORS) requires specific reporting on every case and complaint handled by Ombudsman staff and volunteers. Part of that information includes a final resolution or outcome of the complaint.  The best status outcome is that the complaint was resolved to the client’s satisfaction. This measure represents the percent of all combined Ombudsman case outcomes resolved to client satisfaction.

The Pennsylvania Caregiver Support Program works to ease the stresses of caregiving by focusing on the well-being of the caregiver.  Depending upon household income, the program can provide the primary caregiver with reimbursement for out-of-pocket costs associated with caregiving, such as respite, caregiving-related services and supplies.  The program also offers education, training, counseling, and other programs to ease caregiver burden.

The Department of Aging oversees the Caregiver Support Program which is provided by the 52 local area agencies on aging throughout the commonwealth. Caregivers are assigned a care manager who will come to the care receivers' home, conduct a comprehensive assessment of the needs of the caregiver, provide support, and work with them to develop a person-centered plan of care.

Caregivers can be adults over 18 years old caring for an older adult 60 years old or older, who needs assistance with activities of daily living or caring for persons of any age with Alzheimer’s disease or other dementias. Caregivers can also be adults over 55 years old caring for an adult 18-59 with a non-dementia related disability. Finally, caregivers in this program can be adults over 55 years old caring for a dependent child under age 18, for example grandparents raising grandchildren.

The reported number represents the individual caregivers receiving support through the program. Support of caregivers translates into an enriched caregiving experience for thousands of older Pennsylvanians who rely on the support of friends and loved ones to assist them day-to-day in a variety of ways.

Congregate nutrition services provide meals and other related nutrition services in many different group settings, most commonly senior centers. Access to adequate nutritious meals is important because  older adults with proper nutrition are shown to be healthier, have less hospitalization and are more likely to be able to stay living independently in the community.

Congregate meals also provide another important benefit by offering a chance for socialization and volunteerism, which are additional goals of the program. There are over 500 senior community centers across Pennsylvania that make nutritious meals and social engagement available every day free of charge. Donations received help to make meals and other programming available to more older adults.

The measure of congregate meals served represents the number of older individuals who received a meal at a congregate meal site at any single point throughout the reporting period. Thousands of older adults receive meals at congregate meal sites each day. It is the purpose of this measure to convey how many older individuals were directly impacted by the congregate meal program.

Home delivered nutrition services provide meals and other nutrition-related services to Pennsylvanians over 60 years old, with priority given to those who are homebound. Access to in-home meals is extremely important because older adults who have adequate nutritious food are shown to be healthier, have less hospitalization and are  more likely to be able to stay living independently in the community.

In-home meals are sometimes the first service an older adult receives at home and often, this is the starting point for other home and community based services they may receive in the future. These services are important to many families as they help older individuals remain independent, while assisting caregivers with their caregiving responsibilities.

Nutritionally balanced meals are offered at a minimum of one per day, five days per week. The home-delivered meals number represents the number of older individuals impacted by the Department of Aging in-home meals programs.  Many other older adults receive home-delivered meals through comprehensive long-term services and supports they receive in Medicaid-funded home and community based services from Community Health Choices. Those in-home meals are not represented in these figures.

The primary influence upon this measure is the legislatively mandated upper income limits for PACE and PACENET enrollment.  If older persons have an increase in their income, they could exceed the upper income limits. Act 92 of 2021 extends the moratorium until December 31, 2023, allowing enrollees to maintain their PACE benefits despite disqualifying increases in their overall income due to Social Security cost-of-living adjustments. The original moratorium was set to expire December 31, 2021. The periodic legislative initiatives for Program "moratoriums" address the nominal increases in Social Security income, if the person is enrolled on December 31st.  Other increases in income are not part of the moratorium. Pennsylvanians with low utilization or employer sponsored prescription benefits may opt to forgo PACE and PACENET enrollment until there is a need for the comprehensive coverage offered by the Programs.

The primary influence upon this measure is the legislatively mandated upper income limits for PACE and PACENET enrollment.  If older persons have an increase in their income, they could exceed the upper income limits. Act 94 of 2021 expands the income eligibility limits for PACENET by $6,000 and removes the PACENET premium clawback, which will result in premium cost savings for some enrollees. The clawback will only apply to those individuals enrolled in the program’s Part D partner plans. This will reduce the premium obligation for about 28,000 individuals.  PACE and PACENET currently enroll more than 250,000 older Pennsylvanians. The income limit expansions mean that an additional 100,000 older adults are now eligible with an expected 20,000 older adults expected to enroll in 2022. Pennsylvanians with low utilization or employer sponsored prescription benefits may opt to forgo PACE and PACENET enrollment until there is a need for the comprehensive coverage offered by the Programs.

Three factors influence the number of prescriptions reimbursed by the Program: Program enrollment, third party coverage of the prescriptions, and the total days supply for the prescription.  Over the past several years, these three factors have had a combined effect of reducing the number of prescriptions reimbursed by the Program.  When enrollment is declining, the number of prescriptions is lower.  Each calendar year, Medicare Part D plans may elect to offer low cost generics, some with $0 copayments.  Many of these prescriptions are not adjudicated on the PACE system which leads to a lower number of total prescriptions. The allowance of 90 day supply claims by primary payers has reduced the total number of prescriptions reimbursed by the Program when providing a wrap-around benefit for the enrollee.