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US Agencies Related to PAS
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The federal government provides many resources for the prevention and treatment of mental health problems, including providing money to states so they can provide a range of community-based mental health treatment and support services to adults and children. Decisions about the treatment and care of people with emotional problems and mental illness are made at the local and state levels so the types of services that are available, and how those services are funded, vary from state to state.
The Mental Health Agency in each state can provide information about what services are available locally, including information about admission, care, treatment, release and patient follow-up in public or private psychiatric residential facilities. The Mental Health Agency may also have contact details for the local chapters of self-help organizations that have information about any other services that are available locally.
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The Older Americans Act (OAA) is the primary vehicle for organizing and providing Home and Community-Based Services for older people and their families. All individuals 60 years of age and older are eligible for services under the OAA, although priority attention is given to those who are in greatest need.
The U.S. Administration on Aging administers the OAA. For a state to receive federal funds to implement to OAA, the Governor has to appoint a State Unit on Aging. State Units on Aging develop a statewide aging plan of how services and supports will be provided. Many states have divided the state into Area Agencies on Aging (AAAs) to administer OAA programs (13 states and Territories have single planning areas). In most cases, the AAA assesses the needs of older people although they do not provide direct services (they subcontract with other organizations).
There are 6 main types of services that may be available in states; (1) services to help people stay in their homes (e.g. chore and personal care services), (2) nutrition services, (3) preventive health services, (4) The National Family Caregiver Support Program (funded for the first time in 2000) to help people caring for spouses, parents, older relatives and friends as well as grandparents caring for grandchildren and caregivers of people 18 and under with mental retardation or developmental difficulties (5) protection for the rights of vulnerable older people (e.g. pension counseling programs) and (6) services to Native Americans.
To find local services and contact local Area Agencies on Aging, either contact the State Unit on Aging or call the ‘Eldercare Locator’ (a national toll-free service to help callers find services that may help them). The Eldercare Locator number is 1-800-677-1116.
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The Federal Government funds Protection and Advocacy (P&A) agencies in each state. These agencies are mandated by Congress to provide legal representation and other advocacy services, under all federal and state laws, to all people with disabilities. All P&As maintain a presence in facilities that care for people with disabilities, where they monitor, investigate and attempt to remedy adverse conditions. They help ensure people with disabilities have full access to educational programs, financial entitlements, health and long-term care, housing and employment opportunities.
Each P&A has a program to safeguard the rights of specific groups of people. For example: Protection and Advocacy for Individuals with Mental Illness (PAIMI); Protection and Advocacy for Individual Rights (PAIR); and Client Assistance Programs (CAP).
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Medicaid Home Health services can be provided to Medicaid participants other than those eligible for institutional care. All states offer Medicaid Home Health and they can vary the amount, scope and duration of benefits offered (so long as they remain sufficient to reasonably achieve their purpose and are the same for all eligibility groups). Examples of services provided are skilled nursing care to help with Activities of Daily Living (ADL) and therapies.
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States have the option of offering personal care services (PCS) as a Medicaid benefit. States have considerable discretion in defining PCS but programs typically involve non-medical assistance with activities of daily living (e.g., bathing and eating) for participants with disabilities and chronic conditions.
Unlike waivers, the PCS benefit must be available to all categorically eligible groups but states can opt to include the medically needy (those who spend down to the state standard because of medical expenses).
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Some Independent Living Centers (ILC) provide a list of local personal assistants or even administer programs to match people with personal assistants. The State Independent Living Council (SILC) is the state agency that has contact with these agencies as well as other state agencies.
An Ombudsman is an advocate for residents of nursing homes, board and care homes, and assisted living. They are authorized by federal and state law to provide information about:
The following link provides contact information for state Ombudsmen and Regional Offices.
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Additional information on what an Ombudsman does can be found at http://www.ltcombudsman.org
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