Older Americans Act:

HHS Could Help Rural Service Providers by Centralizing Information on Promising Practices

GAO-19-330: Published: May 23, 2019. Publicly Released: Jun 24, 2019.

Additional Materials:

Contact:

Kathryn A. Larin
(202) 512-7215
larink@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

As the U.S. population ages, demand will increase for home- and community-based services that help older adults stay in their homes. But meeting this demand may be difficult, especially in rural areas.

For instance, rural older adults may have:

Less access to certain services, such as home-delivered meals

Longer travel distances for health care, groceries, and support services—with fewer transportation options

Fewer available caregivers due, in part, to a dwindling working-age population in rural areas

We recommended centralizing information on promising practices to help local agencies and providers better serve rural older adults.

Volunteer Delivering a Week's Worth of Meals in Rural Maine

Volunteer walking up steps to a home carrying a bag with meals for an older adult.

Volunteer walking up steps to a home carrying a bag with meals for an older adult.

Additional Materials:

Contact:

Kathryn A. Larin
(202) 512-7215
larink@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

Why This Matters

Rural areas cover the vast majority of the country and tend to be “grayer” than urban areas, with higher percentages of older adults. Many older adults prefer to stay in their homes as they age, but it can be difficult to connect rural older adults to needed services.

Key Takeaways

To stay in their homes as they age, older adults often need services such as in-home care, meal delivery, and transportation to medical appointments. Under the Older Americans Act of 1965, the Department of Health and Human Services (HHS) funds grants to help state and local agencies provide these services. Rural older adults are identified as important service recipients because of their economic and social needs.

However, studies indicate that rural older adults received certain services, such as home-delivered meals, less frequently than urban older adults. Local officials and service providers told us how reaching older adults in remote, sparsely populated areas can add to the cost and effort of providing services, and how a dwindling working-age population can mean fewer caregivers and volunteers to help.

HHS supports over two dozen national resource centers that publish information on promising practices for delivering services to older adults, including some that may be useful for rural agencies. Yet this information is spread across national resource center websites and is not centrally accessible. Local officials were often not aware of pertinent resources. Several said that more information on rural promising practices or other resources would be helpful.

Rural and Urban Population Aged 65 and Older, by County

Rural and Urban Population Aged 65 and Older, by County

What GAO Recommends

HHS should centralize access to and promote awareness of promising practices or other useful information pertinent to serving rural older adults. HHS agreed.

How GAO Did This Study

We analyzed 2017 HHS survey data; reviewed relevant federal laws, agency documents, and studies; and interviewed service providers in 12 rural localities in eight states. We also interviewed HHS officials, national associations, and experts on rural issues.

For more information, contact Kathryn A. Larin at 202-512-7215 or larink@gao.gov.

Recommendation for Executive Action

  1. Status: Open

    Comments: HHS agreed with this recommendation, stating that it would encourage its resource centers to identify promising practices and other information specific to rural communities so that these resources would be searchable. In December 2019, ACL stated that it would continue to list all resource centers on its website so that anyone can find resources specific to any topic funded by ACL. The agency also noted that it would begin implementation of this action with new resource centers funded with FY 2020 appropriations. GAO continues to encourage ACL to centralize access to information pertinent to rural older adults by making it easily searchable across these websites or compiling it in other ways and promoting awareness of this information.

    Recommendation: The Administrator of ACL should take steps to better centralize access to and promote awareness of information on promising practices or other useful information pertinent to serving rural older adults.

    Agency Affected: Department of Health and Human Services: Administration for Community Living

 

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