Missouri Impact Statement

Administration on Community Living (ACL) and Health and Human Services Reorganization

Programs under the U.S. Department of Health and Human Services (HHS) provide critical services to Missourians.

The abrupt restructuring, including the elimination of the Administration for Community Living (ACL), will likely disrupt services that maintain the health and safety of our most vulnerable citizens – including older Americans and people with disabilities.

Missouri utilizes several ACL programs across the state. Working together, these programs leverage our historic strengths to create synergetic services. The summary of ACL programs in Missouri demonstrates our statewide impact.

The People Served:

Missouri Developmental Disabilities Council (MODDC), in partnership with the Developmental Disabilities (DD) network as outlined in the DD Act, works across all government systems to advance and provide state and local solutions for Missourians with disabilities. MODDC is a nonpartisan, self-governing organization charged with identifying the most pressing needs of people with developmental disabilities in our state. They are committed to advancing public policy and systems change that help individuals gain independence, access to employment opportunities, and navigate complicated service systems, alleviating pressure on state resources.

Missouri Assistive Technology (MoAT) helped more than 21,000 Missourians by improving access to

assistive technology and related services that support daily living and productivity. MoAT worked with people of all ages who use assistive technology, including older adults, families, teachers, therapists, and professionals across the state.

Missouri Council on Aging (MCOA) serves all those who are aging and people with disabilities, along with their caregivers and fellow statewide advocates by working together to make Missouri a place for all to age well.

Missouri Association of Area Agencies on Aging’s (ma4) and Area Agencies on Aging (AAAs) have a 50+ year history of serving serves adults aged 60 and over, caregivers of older adults, and younger adults with disabilities. While services are available regardless of income, Missouri’s AAAs typically serve the most vulnerable older adults who need some support to age in place –as opposed to moving into costlier

institutional care. The “typical” profile of a Missouri AAA client is a female, age 77, isolated, living alone, with four or more chronic health conditions.

Missouri Statewide Independent Living Council (MOSILC) reports Missouri’s 21 Centers for Independent Living (CIL) serve all people with disabilities, regardless of age or disability, including veterans. CILs also offer services to family members, friends, and the community in general. The federal authorizations for CILs and SILCs are found in the Rehabilitation Act of 1973, Title VII, chapter 1. In the past FFY, they provided services to over 14,000 consumers.

Missouri Centers for Independent Living (MOCIL) support individuals of all ages with disabilities, their families, and caregivers, with a strong focus on ensuring rural and underserved areas have access to essential services, reducing disparities across Missouri. In the past federal fiscal year, Centers provided case management to over 18,600 Missourians. As a network of 21 Centers across Missouri, they serve at the local level, addressing community needs, diverting nursing home admission, partnering with the VA to provide Veterans Directed Care programs, and assisting youth with disabilities live independently.

Services We Provide:

MODDC’s investment in programs, educational resources, grants, and coalition building leads to smarter

policies and programs that work for Missouri. By including nonpartisan education driven by people with disabilities and families navigating these systems, Missouri can avoid costly decisions that ultimately don’t work for

Missourians.

MoAT offers a range of services designed to help people find and use the appropriate assistive technology (AT) for their needs. Device demonstrations show different technology options to help people make informed choices.

Device loans allow short-term use of equipment at home, school, or work before making a purchase. AT reuse programs refurbish and redistribute gently used equipment at low or no cost. Training and technical assistance provides support to families, educators, and service providers. Information and assistance help individuals navigate product choices and available funding. Financial loan programs offer low-interest loans for the purchase of needed equipment.

MCOA provides education for advocates, professionals, older adults, and people with disabilities about

legislation impacting older adults and people with disabilities. They also provide programming centered around their policy priorities of economic security and stability of older adults through the expansion of senior levy funds, increasing caregiver support, and protecting older adults from financial fraud.

Ma4, AAAs and 214 Senior Centers throughout Missouri are community anchors and serve over 250,000 older adults across 115 counties. AAAs provide a vital network dedicated to empowering older adults and their caregivers to live with maximum health, independence, and quality of life. They act as crucial connectors, linking

individuals to a wide array of essential services that foster dignity and well-being. These impactful services include: providing information and referrals to navigate available resources; delivering nutritious meals through home delivery and senior centers; offering essential in-home support like homemaking and personal care; arranging transportation for medical appointments and errands; providing critical caregiver support through respite and education; and implementing programs that promote health and wellness. With remarkable resourcefulness and cost-efficiency, Missouri’s AAAs maximize every available dollar. Their creative solutions, such as bringing catered meals to seniors in communities lacking traditional centers, ensure broad access to vital support. Ultimately, AAAs empower older adults to age in place – a choice that respects their preferences and provides a more affordable and often preferred alternative to nursing home care.

MOSILC shares that Centers for Independent Living provide five core services: information and referral, independent living skills, services that facilitate transition from nursing homes and other institutions to the community, provide assistance to those at risk of entering institutions, and facilitate transition of youth to postsecondary life, advocacy (both systemic and individual), and peer support. The Independent Living movement is the core that assists people with disabilities to lead a life of their choice in their community. The goal is independence and less reliance on the social safety net.

MOCIL Centers for Independent Living deliver over 86,000 essential disability services annually, helping individuals achieve their unique independent living goals. These services include independent living skills training, personal assistance services, advocacy, information and referral, and transition supports that reduce reliance on institutional care and promote full community participation.

What We Bring to Missouri:

MODDC brings financial resources to Missouri to engage in strategic advocacy and early sustainable interventions. Their systems change work focuses on reducing unnecessary institutionalizations, avoiding costly medical care, reducing long-term dependency on public benefits, and driving smarter policies. Economically MODDC continues to provide financial literacy and self-sufficient tools that contribute to productivity rather than depending on state-funded services; eliminate service duplication to ensure taxpayer dollars are used efficiently.

MoAT services generated nearly $2 million in savings and value through equipment reuse, short-term loans, and joint efforts with other organizations. This reduced costs for families and public programs while helping more people get the devices, they need to manage their day-to-day lives

MCOA is the primary advocate for senior levy funds which generate over $18million annually across Missouri, these funds alleviate the burden of national and state funding requests for older adult programming and services, this model allows communities to have local control of funding which is generated by their community and can be tailored to precisely what their community needs. When federal and state funding disappears, MCOA see a greater demand for these funds to fill the basic needs of older adults in the communities, traditionally fulfilled by other payers.

ma4: To maximize impact, for every $1 of OAA funding, Missouri’s AAAs strategically leverage $3 in funding by braiding and blending it with federal, state, and local resources. This collaborative funding model builds comprehensive service networks for older adults, incorporating support from sources like state general revenue, local tax levies, USDA nutrition programs, Medicaid waivers, Social Services Block Grants, philanthropic

organizations, client contributions, and even partnerships with healthcare payers. This strategic leveraging of OAA funds allow AAAs to significantly extend their reach, address a wider range of needs within their communities, and serve a greater number of older adults than OAA funding alone would permit. The tangible results of these

leveraged dollars include vital resources such as extra groceries, pet food, adult incontinence aids, and durable medical equipment, contributing to a more robust and sustainable support system for the aging population.

MOSILC notes that Centers for Independent Living (CIL) received over $1,500,000 in federal funds during the past FFY. CILs also receive funding through fee for service programs along with grants from entities working with people with disabilities.

MOCIL or Missouri’s Centers for Independent Living utilize a combination of federal grants, fee-for-service programs, and community partnerships to maximize resources, ensuring cost-effective delivery of services across the state. Even in areas where state and local resources are limited, CILs sustain critical supports that enable independence for Missourians with disabilities.

How We Create A Better Missouri:

MODDC’s unique position collaborates across all government systems to enhance services and supports. Through statewide relationships MODDC develops and enhances systems that keep families together, prioritize self-determination of each individual person, and create sustainable improvements. MODDC’s advocacy helps create streamlined systems that eliminate duplication and elevate efficiency to better serve our Missourians with disabilities and our state economy.

Through their work, MoAT helps strengthen Missouri by making it easier for people to meet their goals at home, at school, and in the workplace. The result is a stronger state—where more Missourians can contribute, stay active, and improve their quality of life.

MCOA firmly believes that Missouri should be a place where everyone can age well and do so on their own terms. By advocating for older adults and programs that support us as we all age, we work to ensure that Missouri is a supportive place for all to age safely and with dignity.

ma4 cultivates a stronger Missouri by recognizing and supporting the immense value of its older adults. By delivering crucial services like nutrition assistance, transportation, in-home support, and caregiver resources, AAAs empower seniors to maintain their health, independence, and active participation in community life. This not only enriches the lives of individuals but also strengthens the social capital of Missouri through continued civic engagement, vital intergenerational connections, and the preservation of the wisdom and skills held by our aging population. Furthermore, by enabling seniors to age in place and avoid premature institutionalization, AAAs contribute to a more efficient allocation of healthcare and public resources, fostering a more sustainable and prosperous Missouri for everyone.

MOSILC supports Centers for Independent Living (CIL), CILs give people with disabilities a place to obtain

services, especially in very rural areas of Missouri. Services can range from peer support groups, youth classes on learning how to find and keep employment, and social interaction with peers. CILs also are unique in that their staff and boards of directors are required to have over 51% people with disabilities. Missouri’s CILs report approximately 70% of staff and board members have a disability.

MOCIL Centers for Independent Living empower individuals with disabilities to remain in their homes, contribute to their communities, and navigate life transitions successfully. By helping people avoid costly institutional care and increasing workforce participation, MOCIL enhances both community resilience and the state’s economic health.

Missourians Need These Programs:

The abrupt downsizing of the department and elimination of ACL will impact Missourians with disabilities and our aging population. With a growing need and established reliance on these programs, Missourians cannot afford service disruptions.

Currently, one in four Missourians is 60 years of age or older. This trend is projected to continue, with the number of Missourians aged 60 and above soon equaling the number of youth ages 20 and under (23% aged 60+, compared to 24% aged 20 and under). Approximately 887,000 Missourians have a disability of some kind.

Disability is a group that anyone can become a member of at any time in their life. There are 800,000 informal

(unpaid) caregivers in Missouri who provide over 750 million hours of unpaid care annually. Each of these populations is amplified by the circle of caregivers, family members, medical supports and others that support them.

Since 2012, these programs have been administered through the Administration for Community Living (ACL). The reorganization of these services on the federal level only elevates the need for Missouri to protect these programs. Discontinuations or disruptions in any of these services will cost Missouri families and put pressure on other state resources to fill service gaps. Please ensure that while our government works towards efficiencies

which are in line with all these organizations’ missions, disruptions to these services are not experienced by Missourians who rely on them.

Please ensure that while our federal departments

join us in systems change efforts to eliminate inefficiencies and barriers for citizens, it is not at the expense of

Missouri’s most vulnerable.