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The U.S. Department of Health and Human Services (HHS) and the Social Security Administration are the leading federal agencies serving the needs of older individuals. Through medical insurance offered by Medicare, public support for long-term care options such as home health care and nursing homes through Medicaid, assistance for family caregivers, nutrition services, grant programs and research into the causes and effects of aging, HHS agencies are striving to support older Americans and to help them lead healthy, active lives.

Today, one in every six Americans, or 45 million people, is 60 years of age or older. In 30 years, more than 89 million Americans will be at least 60 years old, according to the U.S. Census Bureau. Many baby boomers, who are now in their late 30s, 40s, and 50s, can expect to live well into their 80s and 90s. Statistics about older Americans are available at www.aoa.gov/aoa/STATS/statpage.html.

HHS' Centers for Medicare & Medicaid Services (CMS) administers the largest health coverage programs for older Americans. Medicare alone serves 40 million senior citizens and disabled Americans. Medicaid provides additional coverage, including long-term care, to millions of low-income older Americans, with the costs shared between federal and state governments.

Primarily through its Administration on Aging (AoA), HHS also provides essential services such as nutrition, transportation and in-home services to help older Americans and their caregivers.

HHS' budget for programs to provide services and assistance for older Americans and their caregivers totals $252.4 billion in fiscal year 2002, including $212.3 billion in Medicare and $36.8 billion in Medicaid.

HHS' National Institute on Aging (NIA), part of the National Institutes of Health (NIH), is the nation's leading research organization focused on issues of aging. Overall, the NIH will spend nearly $1.9 billion on aging-related research in fiscal year 2002, including about $896 million at NIA.

Medicare was created in 1965 as a health insurance program for those aged 65 and older to complement the old-age, survivors and disability insurance benefits available under the Social Security Act. President Bush and HHS are taking needed steps to strengthen the Medicare program and ensure its long-term stability for older Americans today and in the future. HHS' fiscal year 2003 budget proposes $190 billion over 10 years in net additional spending for improving Medicare.

Strengthening and modernizing Medicare. In his Jan. 29 State of the Union address, the President renewed his commitment to provide prescription drug coverage in Medicare, based on the framework for bipartisan legislation that he proposed in July 2001. The framework would give seniors better health care options, including making Medicare prescription drug coverage available to all seniors and providing better preventive coverage and better protection against high medical costs. Because the Medicare drug benefit and other improvements will take several years to set up, HHS is also taking steps now to improve Medicare benefits immediately, including developing a Medicare-endorsed prescription drug card program and helping states implement comprehensive drug coverage for low-income beneficiaries as quickly as possible. See www.whitehouse.gov/news/releases/2002/01/20020128-14.html.

National Medicare Education Project. CMS maintains an extensive national education program to provide beneficiaries with accurate, easy-to-understand information about their benefits, rights and health insurance options so they can become more active participants in their health care decisions. The program includes the Medicare & You handbook mailed to all Medicare beneficiary households every fall, a 24-hour toll-free helpline at 1-800-MEDICARE (1-800-633-4227) and a consumer Web site at www.medicare.gov.

As the baby boom population approaches retirement, a comprehensive and reliable system for providing long-term care will be imperative to meet the needs of this growing aging population. Medicaid is the primary public payer for home health and nursing home care, covering 40 percent of long-term care expenses in 2000. Through Medicaid, states also have substantial flexibility to provide home- and community-based services as an alternative to institutional care. Current HHS long-term care programs and initiatives include the following:

Support for Family Caregivers. Launched in 2001, the National Family Caregiver Support Program provides respite care and other supportive services to help hundreds of thousands of family members who are caring for their older loved ones who are ill or who have disabilities. In February 2002, HHS Secretary Tommy G. Thompson announced the release of $128 million in grants to states. See www.aoa.gov/carenetwork/.

Home- and Community-Based Services. Medicaid supports about 260 state home- and community-based service waivers that provide beneficiaries with alternatives to institutional care and enable seniors and people with disabilities to receive services at home. HHS also participates in a resource network to bring the federal government, states and consumers together to expand access to quality home- and community-based services. See www.hcbs.org.

Nursing Home Quality Initiative. CMS has developed new, comparative quality measures to provide seniors and their families with information about the quality of care in local nursing homes. In April 2002, CMS released the data for Colorado, Florida, Maryland, Ohio, Rhode Island and Washington at www.medicare.gov and in newspaper ads as a pilot project. This comparative tool complements other HHS efforts to ensure the health and safety of residents in nursing homes that participate in Medicare and Medicaid. See www.cms.hhs.gov.

Long-Term Care Ombudsman Program. HHS' AoA funds the recruitment and training of volunteers to investigate and resolve complaints made by or on behalf of residents of long-term care facilities. AoA also supports state efforts to enhance seniors' access to quality legal assistance programs; conduct elder abuse, neglect and exploitation public awareness campaigns; and train law enforcement and other professionals. See www.aoa.gov/ltcombudsman/.

HHS oversees many programs that provide needed services to older Americans and their caregivers. As part of these efforts, AoA leads a national aging network of 56 state offices on aging, 655 area agencies on aging, 236 tribal organizations representing 300 tribes, and thousands of service providers, senior centers, caregivers and volunteers. Services include:

Nutrition and Supportive Services. Through the Older Americans Act nutrition programs, AoA provides meals served in senior centers and other group settings and meals delivered to frail, homebound elders (commonly known as "meals on wheels"), transportation as well nutrition counseling, health education activities and related efforts. AoA also funds health promotion and disease prevention efforts by states and local communities. See www.aoa.gov/.

The Eldercare Locator. The toll-free Eldercare Locator helps callers find necessary, convenient services and resources for their older loved ones in their own communities or throughout the country. The locator is available at 1-800-677-1116, Monday-Friday, from 9 a.m. to 8 p.m. ET. See www.eldercare.gov/.

Insurance, Benefits and Pension Counseling. AoA supports programs that help older Americans access their pensions and make informed insurance and health care choices. See www.aoa.gov/pension/.

Substance Abuse and Mental Health. HHS' Substance Abuse and Mental Health Services Administration offers services and other resources to older Americans, such as guides to help older Americans and caregivers understand and find appropriate services for seniors. See www.samhsa.gov.

HHS is also committed to investigating the causes and effects of the aging process to improve the lives of older Americans. NIA leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life, includes studies of the biology of aging, geriatrics and Alzheimer's disease.

Current NIA research is providing insights into the genetic and environmental influences on aging and age-related diseases; how cellular changes with age can occur, allowing development of new therapies to prevent disease and maintain function; and new approaches toward promoting healthy behaviors, such as exercise, among older people.

More information about NIA's research and consumer resources is available at www.nia.nih.gov or by calling 1-800-222-2225.

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