The passage of the Older Americans Act (OAA) in 1965 created a nationwide aging network consisting of the federal Administration on Aging, State Offices for the Aging and local Area Agencies on Aging. In 1968, the New York City Department for the Aging was established as the Mayor’s Office for the Aging and funded by OAA as a three-year demonstration project.
Among the new Office’s first initiatives were two groundbreaking cross-ethnic research projects examining the needs of urban elderly. These studies earned the new agency a national reputation as the premier voice for urban elderly. The Office also opened four neighborhood sites to identify and coordinate the services then available for older people and to provide information and referral services. The first major program of this new agency was a Half Fare program for older New Yorkers. Now called Reduced Fare and operated by the Department of Transportation, this program remains a major benefit for older persons.
Designation as Area Agency on Aging and Department for the Aging
In 1973, the Mayor’s Office for the Aging was designated the Area Agency on Aging (AAA) for New York City, with responsibility for planning, coordinating and funding gap-filling services for the elderly in the city’s five boroughs. Drawing upon Older American Act funding for nutrition programs, the Office/AAA greatly expanded the City’s existing hot meals programs by creating new senior center nutrition sites in under-served and unserved communities. To operate these sites, the Office contracted with local voluntary agencies - a contract model for service delivery DFTA uses to this day. The Office also initiated home-delivered meals at this time.
In 1975, through an amendment of the New York City Charter, the Mayor’s Office for Aging officially became the New York City Department for the Aging, with Alice Brophy, who had headed up the Mayor’s Office for the Aging since 1968, as Commissioner.
The 1970s marked the Department’s period of greatest growth. Senior center/nutrition programs flourished and new programs were initiated with Older Americans Act funding. These included legal, homecare and transportation services; assistance to elderly crime victims; the Title V program (senior employment services) and the Foster Grandparent Program. In addition, the Department launched a Central Information and Referral Unit. State funding became available for recreation and cultural activities at senior centers, and in 1979, New York State’s Community Services for the Elderly (CSE) program began providing additional funds specifically to serve frail elderly persons through homecare, transportation and expanded home-delivered meals.
Under the visionary leadership of Commissioner Janet Sainer, appointed in 1978 by Mayor Ed Koch, innovative programming and public/private initiatives became a hallmark of the Department. During her 12-year stewardship, Sainer deployed tax levy dollars and philanthropic funding to the development of an Intergenerational Work Study Program, DFTA’s Health Promotion Services, the first municipally sponsored information, referral and counseling service for Alzheimer’s disease in the nation (today, DFTA’s Alzheimer’s and Caregiver Resource Center), a program to train older workers (today, DFTA’s Senior Employment Services), the Partnership for Eldercare (one of the first public/private initiatives in the country to target caregivers) and Citymeals-on-Wheels, a program incubated at DFTA that now operates independently to provide weekend meal delivery to homebound elderly who receive federally-financed weekday meals.
State resources for services also expanded under Commissioner Sainer, with implementation of both the Supplemental Nutritional Assistance Program (SNAP) that provided additional services for nutritionally at-risk elderly and the Expanded In-Home Services for the Elderly Program (EISEP). To implement EISEP, DFTA reorganized its case management and home care service delivery systems, a move which vastly changed the configuration of services for the older persons in New York City.
Senior centers operated by the Human Resources Administration were transferred to DFTA in 1992-93. The contracting out of these centers to community partners almost doubled DFTA’s senior center network. The 1990s also saw a massive increase in the department's home-delivered meals service. To support increased service levels throughout the system, DFTA’s budget grew from about $100 million to about $225 million, with the City’s share of this funding almost matching federal levels.
Governmental accountability and efficiency became a byword of the 1990s. To meet State and federal requirements for better data about clients served, DFTA developed PDS (Provider Data System) a computerized reporting system for provider use. At the same time, the City developed its current contract procurement rules requiring competitive bidding and unit-based reimbursement wherever possible.
In 1993, when the states received federal funding to provide information about Medicare and other insurance programs to older persons, DFTA established HIICAP (Health Insurance Information, Counseling and Assistance Program) to administer the State Health Insurance Program (SHIP) in New York City. A year later, the Department launched the Grandparent Resource Center, becoming the first municipality in the country to recognize the unmet needs of many older persons who found themselves providing parental care to their grandchildren or other young relatives whose birth parents were lost to AIDs, drug abuse, or military service in Iraq.
In 1999, New York City allocated $4 million to strengthen the City’s 12 existing state-supported NORC programs (social service programs in Naturally Occurring Retirement Communities) and to establish 16 new programs as part of a major public/private partnership to support aging-in-place. DFTA assumed responsibility for all NORC programs in the City, working with the State and other stakeholders including the United Hospital Fund. In 2005, New York City won an award for the excellence of its NORC programs in a “Livable Communities” competition sponsored by the federal Administration on Aging.
Along with advocates throughout the country, DFTA welcomed the enactment in 2000 of the National Family Caregivers Services Program (NFCSP). By establishing services to help them cope, this addition to the Older Americans Act recognized the importance of unpaid family caregivers to the economy of a nation with a rapidly increasing population. With NFCSP funding, DFTA expanded its Alzheimer’s and Long Term Care Resource Center (renamed Alzheimer’s and Caregiver Resource Center) and funded community-based caregiver programs in every borough.
The enactment of the NFCSP reflected the nation’s intensifying focus on planning for the current and future needs of a “graying,” more diverse America in the twenty-first century. Not only would people live longer, but waves of aging baby boomers would swell the senior population. By 2030, the country’s older population was expected to double – and to constitute almost 20% of the entire population. It would also be strikingly more diverse across every dimension – ethnicity, culture, experiences and expectations as well as education, health status and lifestyle.
DFTA has responded to the challenge through a string of initiatives and service reconfigurations aimed at shaping a culturally competent aging services system that is accessible to all and that addresses healthy and productive aging as well as the service needs of older New Yorkers. Since 2007, the Department has proudly joined the Mayor, City Council, Academy of Medicine and dozens of other organizations now working to make New York one of the world’s great Age-Friendly Cities as part of an international effort led by the World Health Organization (WHO). In 2010, Mayor Bloomberg accepted from WHO the first Certificate of Membership in the Global Network of Age-Friendly Cities to be awarded to any city, in recognition of the work New York has already accomplished.
Today, the Department faces additional challenges as it seeks to weather the formidable downturn in the nation’s economy and its impact on aging services. Under the leadership of Commissioner Lilliam Barrios-Paoli, DFTA is maintaining essential services despite reduced funding and working with its partners to develop strategies to maximize resources. Furthermore, the Department is developing models such as its Innovative Senior Centers. Seed beds for creativity and innovation, the centers will not only strengthen the network going forward, they will set a standard for urban communities everywhere that want to re-envision their senior centers for the twenty-first century.