The Positive Aging Act
Background
Bipartisan legislation to improve the accessibility and quality
of mental health services for the country’s rapidly
growing older population was introduced in both the U.S. Senate
and House of Representatives in 2004 and is expected to be
reintroduced in 2005.
Sponsored by Senator Hillary Rodham Clinton (D-NY) and Representative
Patrick Kennedy (D-RI), the “Positive Aging Act”
is designed to make mental health services an integral part
of primary care services in community settings and to extend
them to other settings where seniors reside and receive services.
Original cosponsors of the legislation were Senator Susan
Collins (R-ME) and Representative Ileana Ros-Lehtinen (R-FL).
The “Positive Aging Act” would integrate mental
health screening and services in primary care settings through
demonstration projects that target urban and rural medically
under served areas. The evidence-based services under this
legislation will be provided by interdisciplinary teams of
mental health professionals working in collaboration with
other providers of health and social services.
Depression, dementia, anxiety, and substance abuse among
Americans over age 65 are growing problems that result in
functional dependence, long-term institutional care, reduced
quality of life, and potentially suicide. Missed opportunities
to diagnose and treat mental diseases are taking a huge toll
on the elderly and increasing the burden on families and the
health care system.
This legislation, which builds on the previous version of
the “Positive Aging Act,” is designed to make
mental health services an integral part of primary care services
in community settings and to extend them to other settings
where low-income seniors reside and receive services. The
bill will promote this geriatric mental health outreach to
seniors by authorizing new authorities and resources to the
Administration on Aging (AoA) and the Substance Abuse and
Mental Health Services Administration (SAMHSA) of the U.S.
Department of Health and Human Services.
Specifically, the “Positive Aging Act” would:
* Authorize creation of an Office of Older Adult Mental Health
Services in AoA to develop and implement initiatives to address
the mental health needs of older individuals. AoA would also
be authorized, under the Older Americans Act, to provide:
- Grants to states for the development and testing of model
mental health delivery systems utilizing evidence-based
protocols for the identification and treatment of mental
illness in the elderly;
- Demonstration project grants for the provision of screening
and treatment referrals for mental illness targeted to seniors
residing in rural areas; and
- Demonstration project grants to entities working in collaboration
with other providers of health or social services for the
provision of mental health screening and treatment services
to seniors residing in naturally occurring retirement sites
(NORCs) in urban areas.
* Amend the Public Health Service Act to create demonstration
projects to be administered by SAMHSA which would:
- Support the integration of evidence-based mental health
services by geriatric mental health specialists in primary
care settings; and
- Support the establishment of community-based mental health
treatment outreach teams in settings where older adults
reside or receive social services.
In addition, the legislation would:
- Create a new position of Deputy Director for Older Adult
Mental Health Services in the Center for Mental Health Services
at SAMHSA;
- Require appointment of representatives of older Americans,
their families, and geriatric mental health specialists
to the Advisory Council for the Center for Mental Health
Services;
- Include targeting substance abuse in older adults in
SAMHSA’s projects of national significance; and,
- Require state plans under Community Mental Health Services
Block Grants to include descriptions of the states’
outreach to and services for older individuals.
AAGP Position
AAGP has been involved in the development of this legislation
since its inception and worked closely with Senator Clinton,
Representative Kennedy, and their staffs on the drafting of
the bill’s provisions. Having bipartisan and bicameral
sponsorship is a major step forward in focusing attention
on this issue and advancing consideration of the “Positive
Aging Act.”
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