If You Ask Them, They Will Support: A National Study of Local Initiatives Developed to Provide Social Care to Older Adults in the Community.

OBJECTIVES: Some communities across the nation are utilizing alternative funding sources to better support home and community-based services for older adults. METHODS: A variety of methods identified local initiatives across the United States. An online survey was distributed to a total of 377 communities in 15 states identified as using locally raised funds to provide aging services, yielding a 55% response rate. RESULTS: Total funding from programs generated almost 400 million dollars annually with funding ranging from $8000-$47 million. Commonly provided services with local funds include home-delivered and congregate meals, transportation, and homemaker services with provision varying by the size of the levy initiative. Additionally, six in 10 initiatives reported local funds being used to provide at least one family or friend caregiver service. CONCLUSION: Locally-funded initiatives fill a gap in long-term services needs for older adults, yet policy concerns regarding potential inequities across states and communities warrant attention.

Local Initiatives to Fund Services for Older Americans: Community Recognition of the Importance of Social Care.

Despite the growing proportion of older adults in the United States, federal and state funding for nonmedical supportive services remains limited. To meet increasing demand, some communities across the nation are exploring alternative funding sources for aging services. Although no systematic database exists to track such local programs, through an array of data sources including a national survey, telephone contacts, and a web review, we identified 15 states that are using local funding to support aging services. Communities are using a variety of local revenue streams, such as property tax levies, payroll, and sales taxes to provide services for older adults and/or their family or friend caregivers. There are considerable differences in community approaches including the following: amount of revenue generated, service eligibility criterion, type of services covered, and management infrastructure. Critical policy questions surrounding equity issues within and across states are raised as communities create these alternative funding mechanisms.