U.S. Department of Health & Human Services – Reorganization of Older Americans Act Programs
May 2025. ma4 joined other Missouri programs impacted by federal changes, including the abrupt elimination of the federal Administration for Community Living (ACL). We urge citizens to contact their Congress Members to ensure that any federal restructuring would ensure protection of programs and services to support older adults and adults with disabilities. We demand that, while our federal departments join us in systems change to eliminate inefficiencies and barriers for citizens, it is not at the expense of Missouri’s most vulnerable.
Medicaid Meal Reimbursement Rate
2025. Home-delivered Medicaid Meals provide essential nutrition and support to Missouri’s most vulnerable: homebound older adults and adults with disabilities. This program is a crucial investment in their well-being, preventing costly and often unwanted placement in nursing homes. However, years of underfunding have created a severe crisis. The current Medicaid reimbursement rate fails to cover the actual costs of providing these meals, forcing Area Agencies on Aging (AAAs) to operate at a significant deficit. This financial
strain is compounded by rising food prices, difficulty hiring and retaining staff due to uncompetitive wages, and the increasing demand from Missouri’s growing senior population.
While the actual cost of each meal is @ $9.97/meal, the Medicaid reimbursement rate is $6.21/meal.
The recently released Mercer Rate Study, commissioned by Missouri Department of Health and Senior Services, developed modeled rate ranges of $10.07 to $10.99/meal.
Missouri’s ten AAAs deliver @ 2.3 million Medicaid meals annually.
AAAs are being forced to divert resources from other critical programs, and the sustainability of the entire home-delivered meal system is in jeopardy. Failure to address this funding gap will lead to lengthy waitlists for individuals not meeting Medicaid eligibility for home-delivered meals, denying vulnerable individuals access to life-sustaining nutrition. The alternative—costly and often unnecessary nursing home care—will place an even greater burden on taxpayers and diminish the quality of life for our most vulnerable citizens.
Missouri seniors urgently need an increase in the Medicaid home-delivered meal reimbursement rate to ensure the program’s viability and protect the well-being of Missouri’s seniors and adults with disabilities. (Note: These Medicaid meals are separate from federally funded Older Americans Act Meals on Wheels.)
ACL Elimination
2025. ma4 joins ACL-funded stakeholders in protesting the elimination of the federal Administration for Community Living (ACL) by the U.S. Department of Health and Human Services (HHS). The current proposal of splintering Older Americans Act (OAA) programs into different federal departments will likely disrupt services that maintain the health and safety of our most vulnerable citizens – including older Americans and people with disabilities.
Any HHS restructuring should prioritize ensuring that OAA programs are fully funded and intact under one entity such as the Administration for Children and Families (ACF).
Senior Services Growth & Development Program
2023. During the 2023 legislative session, funding was finally appropriated, including transfer authority, to fully fund the Senior Services Growth & Development Program! Thank you to the Missouri Legislature. This funding will support Area Agencies on Aging and programs and services through Senior Centers.
This fund was established In May 2019, with overwhelming bipartisan support, the Missouri Legislature passed SB275 which established the Senior Growth and Development Program Fund (SGDPF). The purpose of the fund is to supplement the funding the AAAs receive through GR and Federal funding.
Restoration of the Full Mo Rx Program
2023. The Missouri Rx Plan provides pharmaceutical benefits to elderly and disabled Missourians who are struggling financially and facilitates coordination of benefits between the Missouri Rx plan and the federal Medicare Part D drug benefit program. In 2017, 58,000 seniors (1 in 4) lost prescription drug coverage through MO Rx due to drastic budget cuts. In 2019, the legislature restored some funding but has still not restored the full funding for thousands of seniors and adults with disabilities.
Modernization of the Older Americans Act
September 2021. In the 57 years since inception of the OAA, various amendments have introduced new areas of focus, resulting in more work for the states and AAAs, without further reimbursement. To compound the challenges of additional responsibility without further reimbursement, Area Agency requests for an update of many OAA standards have been met with decades of bureaucratic delay. As a result, outdated limitations within the OAA thwart the progress and innovations that must be made to meet the burgeoning present and emerging needs of an expanding population of older adults.
RUCA Opposition Statement
August 2021. Recently, the Administration for Community Living (ACL) determined new data reporting standards for AAAs across the nation. The data used in these reports help ACL, AAAs and other stakeholders understand performance, impact of services on priority groups, and overall health of the aging and disability network. These new standards have reclassified nearly 25% of Missouri’s rural population o the status of urban.