Area agencies on aging warn funding shortfall threatens services, ask legislature for $105 million

HARRISBURG — Leaders of the Pennsylvania Association of Area Agencies on Aging told the House Aging & Older Adult Services Committee on Wednesday that the statewide network of area agencies on aging (AAAs) is facing growing demand and a budget shortfall that risks cutting senior centers, meals and other preventive services.

The panel — J. R. Reid, board president of P4A and executive director of the Lehigh County Office of Aging and Adult Services; Beth Herold, director of the Butler County Area Agency on Aging and P4A board vice president; and Rebecca May Cole, executive director of P4A — said AAAs are the “first line” of service for older Pennsylvanians and that reductions will push more people into costlier state-funded care.

“Area agencies on aging…are the ones that deliver services for older adults,” Rebecca May Cole told the committee. “They are the ones that people call first.” She said AAAs were created under the Older Americans Act of 1973 and that Pennsylvania has 52 AAAs covering all 67 counties.

Why it matters: Committee members heard that AAAs provide information and referral, senior-center programming, nutrition (including home-delivered meals), transportation, care management, ombudsman visits to long-term care settings, and elder-protective services. Panelists said early, locally provided supports can prevent crises that otherwise require Medicaid-funded long-term care.

Panelists described the state funding picture and the request they delivered to lawmakers. Cole said a P4A analysis comparing pre‑COVID service levels to today shows inflation and a rising older-adult population have left AAAs with a funding gap. “If you control for inflation and the increased population, we would need an additional $105,000,000 just to serve people at the level that we did in 2018–2019,” she said, and asked legislators to support that figure as an appropriation to the PennCare (lottery-funded) line item.

The group also urged lawmakers to consider directing some proceeds from possible legalization and taxation of skill games into the lottery fund; they said unregulated skill games compete with the state lottery and threaten PennCare proceeds.

Services and enrollment: The panel summarized how AAAs fit into the Medicaid long-term-care enrollment pathway. AAAs perform functional eligibility assessments and provide options counseling and information, while an independent enrollment broker (currently Maximus) conducts choice counseling and helps eligible individuals choose between the LIFE program (known nationally as PACE) and managed-care organizations under Community HealthChoices (CHC). “When the IEB finds out that you’re eligible, then goes into your home and explains to you what it is that can come next,” Cole said.

Cole stressed a limit on AAA services after a person enrolls in Medicaid-managed care: once someone moves to CHC, AAAs generally cannot provide the Medicaid-funded services they previously delivered; the AAAs can continue to provide protective services in cases of abuse, neglect or exploitation.

Demand and workforce: Panelists supplied network statistics and service pressures. P4A figures cited by speakers: 52 AAAs covering 67 counties; roughly 3,000 employees statewide; more than 11,000 volunteers; and reach to over half a million people annually. Beth Herold said Pennsylvania has about 450 senior centers and described the centers’ role in socialization, exercise, nutrition and education.

Speakers said AAAs are implementing or expanding waiting lists for in-home services, reducing staff hours and postponing hires because of flat state funding and rising operating costs. They and committee members also raised a direct-care workforce shortage affecting both in-home care and nursing facilities.

Elder abuse and financial exploitation: Panelists said financial exploitation has become the most commonly reported and substantiated form of elder abuse in recent years. Herold described the ombudsman program’s role visiting long-term care facilities and advocating for residents. Cole cited an estimate given in testimony that Pennsylvanians 60 and older lost about $2.2 billion to scams in the preceding year.

Survey results and consequences: P4A reported that a network survey found roughly 92% of AAAs facing a budget shortfall and that AAAs nationwide expect to close about 40 senior centers and eliminate approximately 100 programs state‑wide if current funding trends continue. The panel said those cutbacks would reduce early-intervention services that help prevent more expensive institutional care.

Legislative and operational requests: Panelists asked lawmakers to (1) support a $105 million increase to the PennCare/lottery line item for AAAs; (2) engage the governor’s office on the request; and (3) consider routing a portion of any future skill-game tax or regulation revenue to the lottery fund. They also urged better cooperation with banks and law‑enforcement to combat financial exploitation and supported legislative updates to Pennsylvania’s Older Adult Protective Services Act to address online fraud and modern banking issues.

No formal votes were recorded at the informational hearing. Committee members asked technical questions about enrollment mechanics, the role of the independent enrollment broker, and the limits of AAA authority after Medicaid enrollment. Several representatives described local examples of AAA outreach in district offices and said they would continue discussions with AAAs and federal representatives about Older Americans Act funding and pending federal uncertainties.

What’s next: Panelists encouraged committee members to visit local AAAs and senior centers and said contact information was included in the committee packet. They reiterated that AAAs provide preventive, locally tailored services that, in their view, reduce the state’s long-term Medicaid costs by keeping people safely at home.