April 3, 2025
In the wake of the Department of Health and Human Services announcing a “dramatic restructuring” of the agency, reassurances that the changes will not affect critical services are anything but reassuring to groups that provide services to older adults.
In a letter to HHS Secretary Robert F. Kennedy Jr., the Leadership Council of Aging Organizations shared its concerns regarding the potential effects of the agency’s restructuring on the well-being of older adults. Among members of the LCAO are LeadingAge, the Post-Acute and Long-Term Care Medical Association, or PALTmed, the Alzheimer’s Association, PHI, SAGE, Justice in Aging and ADvancing States.
The restructuring of HHS announced by the agency last week included the reduction in workforce of 10,000 full-time employees. Specifically, HHS announced it would eliminate the Administration for Community Living and move its programs to other HHS agencies, including the Centers for Medicare & Medicaid Services, the Administration for Children and Families, and the Assistant Secretary for Planning and Evaluation (which is being merged with the Agency for Healthcare Research and Quality to create the Office of Strategy).
In particular, LCAO focused its letter on programs administered by the ACL. The coalition asked Kennedy to prioritize the “continued efficient, effective and coordinated delivery of services to older adults and people with disabilities.”
Those groups, the letter-writers said, “rely upon these programs to be able to remain at home and in the community, understand and access their Medicare and Medicaid benefits, age with maximum health and wellness, stay safe and free from abuse, and to support their family caregivers who enable older adults to stay out of more costly long-term care institutions.”
Older adults, including those living in affordable senior housing communities, depend on a variety of programs authorized and funded by the Older Americans Act and administered by the “vanishing” ACL, according to LeadingAge Senior Vice President of Policy and Advocacy Linda Couch, are .
For example, she said, many affordable senior housing residents rely on home-delivered meals, and many affordable senior housing communities are congregate meal sites, providing nutrition and social connectedness in the building and in the broader neighborhood.
Area Agencies on Aging also manage referrals to home- and community-based services funded through other programs. Couch said the lack of OAA funding could diminish staffing at those agencies, affecting the flow of referrals and ability of older adults to receive unbiased counseling about selecting a Medicare program.
“All of these programs rely on efficient administration of OAA funds; future OAA funding will certainly rely upon the accountability of these programs to meet their goals,” she said. “We urge HHS to clarify what these changes mean for older adults and those who support and advocate for them.”
The coalition asked for clarification in several areas, including how the reorganization will serve Kennedy’s goal of healthy aging, how existing aging programs will fit into the new organizational structure, what steps are being taken to ensure programs and services for older adults will not be impacted during the transition, and how changes will affect funding, staffing and service prioritization to older adults who want to remain in their homes and communities.
Alex Bardakh, PALTmed senior director of advocacy and strategic partnerships, told McKnight’s Senior Living that groups like PALTmed want to know how this reorganization is helping the healthy aging process if older adults potentially can’t access the services they need.
He called the HHS reorganization and potential cuts to Medicaid a “perfect storm” and said uncertainties exist about what the organization will look like, how remaining staff members will handle the remaining volume of work, and how much time the transition will take.
The questions the coalition asked in the letter, Bardakh said, are important to answer because although efficiency in programming is important, it’s just as important to understand how those changes are expected to make those programs more efficient.
“What do you say to people worried about losing or having services interrupted?” he asked, adding that he has heard many analogies about the need to experience pain to achieve efficiency goals. “What’s the message to them?”
