Older Americans: HHS Should Apply Leading Practices as It Coordinates Overlapping Programs

What GAO Found

Services funded under the Older Americans Act of 1965 (OAA), as amended, overlap with 36 other federal programs but do not duplicate the social services and assistance they provide to older adults, according to GAO's analysis. GAO found that these programs differ in the population served, goals and services provided, or both. The overlapping programs can complement OAA-funded services, for example by providing more specialized services relevant to an agency's expertise. The areas of need served by these programs include health, nutrition, transportation, and employment. Nine departments and agencies administer the 36 non-OAA programs, which indicates there is fragmentation of services for older adults.

The Department of Health and Human Services (HHS), Administration for Community Living (ACL), which administers most OAA programs, is taking steps to manage fragmentation by coordinating with other federal agencies that serve older adults. Coordination among federal agencies can enhance complementary efforts and mitigate potential negative effects of fragmentation. ACL acts as the lead agency of the Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities (Coordinating Committee), which began work in 2023 after receiving initial funding. The Coordinating Committee is composed of 18 federal agencies-including the Departments of Agriculture, Labor, Transportation, and Housing and Urban Development-which have taken initial steps to work together to avoid duplicative work and leverage resources (see figure). For example, in May 2024 the Coordinating Committee published a strategic framework as a basis to develop a national set of recommendations to advance healthy aging and age-friendly communities for older adults. The Coordinating Committee is in the process of further developing strategic goals, in part, by hosting listening sessions that include older adults. GAO has identified leading practices for effective interagency collaboration, including defining common outcomes and ensuring accountability, which could inform ACL's work with the Coordinating Committee. Incorporating these practices could increase the effectiveness of the coordination in managing fragmentation of services.

Key Milestones of the Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities

Why GAO Did This Study

In fiscal year 2024, OAA-funded services received about $2.4 billion in appropriations. These services exist alongside other federal programs that provide social services for older adults. GAO regularly reports on federal programs with potentially fragmented, overlapping, or duplicative efforts, with the goal of improving the efficiency and effectiveness of government.

GAO was asked to review potential duplication between programs authorized under OAA and federal programs authorized under other laws. This report examines (1) the extent to which duplication, overlap, and fragmentation exist between OAA-funded services and other federal programs for older adults; and (2) the steps agencies have taken to manage any duplication, overlap, and fragmentation between OAA-funded services and non-OAA programs.

GAO identified comparable federal programs based on data from the Assistance Listings on SAM.gov and analyzed information collected from the administering agencies to determine the extent of overlap, if any. GAO also spoke to a nonrepresentative selection of seven stakeholder organizations, reviewed relevant policies and documentation, and interviewed agency officials.