In-Home Services for the Elderly: Cost Sharing Expands Range of Services Provided and Population Served
HRD-90-19
Published: Oct 23, 1989. Publicly Released: Nov 17, 1989.
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Highlights
Pursuant to a congressional request, GAO examined existing state approaches to cost-sharing for in-home services for the elderly, focusing on the: (1) extent to which cost-sharing was currently used; (2) types of services that states cost-shared; (3) benefits and disadvantages of cost-sharing; (4) types of fee schedules used; and (5) characteristics of clients participating in cost-sharing programs.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress should consider amending the Older Americans Act to specifically authorize state and area agencies on aging to establish mandatory charges for in-home services for the elderly funded under Title IIIB of the act. Congress could build in protections that are similar to current practices in agencies that cost-share. Such protections could include: (1) excluding from cost-sharing certain services already strongly supported by voluntary contributions; (2) adding measures to ensure that the very-low-income elderly continue to receive free services; and (3) limiting fees to a reasonable proportion of income for fee-paying clients. |
Closed – Not Implemented
|
The agency has held hearings and is now proposing that the Older Americans Act be amended. Reauthorization was passed on September 12, 1991 by the House and Senate. The Committee has requested another study by PEMD to provide further information for a decision. The Older Americans Act was reauthorized without cost sharing. The Senate Aging Committee blocked action. |
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Topics
Aid for the elderlyCost sharing (finance)Elder careElderly personsHealth care cost controlHome health care servicesMedical services ratesPopulation statisticsState-administered programslocal relations