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For nearly 60 years, the Older Americans Act (OAA) has helped older adults nationwide. It provides important services like meals, transportation, caregiver support, and protection from abuse. These programs help seniors stay healthy, safe, and independent in their homes and communities.

 What Is the Older Americans Act?

The OAA was created in 1965 because there weren’t enough local services for older people. The Act funds programs like:

• Meals delivered to seniors’ homes
• Rides to medical appointments or the grocery store
• Help for family caregivers
• Legal aid
• Health and wellness programs
• Protection from abuse and neglect

These services are available in every community and help millions of older adults each year.

 Who Helps Make It All Happen?

 Area Agencies on Aging (AAAs) are local groups that run many of the OAA programs. They make sure older adults, especially those who are low-income or live alone, get the help they need. AAAs work hard to keep services simple and flexible so they meet each community’s needs.  Encompass Community Supports is your local AAA.

 Why is it Important?

By 2030, over 30% of our residents will be over the age of 60.  Right now, we already have more older adults over age 65 living here than in most parts of Virginia or the United States.

Source:  US Census Bureau, American Community Survey 2019-23

 What’s the Problem?

A new government budget proposal would break up the OAA programs and move them into two different federal agencies:

• Centers for Medicare & Medicaid Services (CMS)
• Administration for Children and Families (ACF)

This plan would also cut funding for key programs in 2026, including:

• Health and disease prevention
• Long-Term Care Ombudsman (who protect nursing home residents)
• Help with Medicare
• Resources for aging and disability
• Programs that prevent elder abuse

These programs are critical for helping seniors stay healthy and live at home. Cutting them would hurt the people who rely on them most.

 What Could Happen If These Changes Go Through?

• Local agencies would have less money and more red tape
• Older adults could lose services they depend on
• Seniors may have to move into nursing homes earlier than needed – a situation no one wants unless absolutely necessary
• Costs for care could go way up
• Families and caregivers would have a harder time finding support

 What Can You Do?

Call your Members of Congress! Tell them:

• Keep OAA programs together under the Administration for Children and Families (ACF)
• Don’t cut funding for programs that protect and support older adults
• You can find the contact information on your Members’ websites: house.gov and senate.gov

We believe older Americans deserve care that is organized, affordable, and focused on their needs—not scattered across agencies or lost in budget cuts.

 

Deadline: May 9, 2025

Congress has been told to find ways to cut government spending. The House Energy and Commerce Committee must cut $880 billion — and a big part of that may come from Medicaid.

Why this matters:

Medicaid is very important for many veterans, especially those who have low incomes, disabilities, or don’t get full healthcare from the VA.

• Nearly 1 in 10 veterans between the ages of 19 and 64 use Medicaid
• About 683,000 veterans live in Virginia. That’s 9.1% of the adult population—one of the highest in the U.S
• That means up to 68,000 veterans in Virginia could lose care if Medicaid is cut

 Medicaid is a safety net:

• Some veterans rely on Medicaid as their only health coverage
• Others use it along with VA, private, or military health benefits
• In 2015, nearly 2 out of 5 veterans on Medicaid had no other coverage
• It supports veterans dealing with long-term health problems such as chronic and mental health conditions and traumatic brain injuries

 Medicaid also helps by:

• Covering services the VA may not provide (like nursing homes, home care, and long-term support)
• Helping low-income veterans afford care
• Covering some spouses and children of veterans
• Filling in gaps when VA care isn’t enough

Veterans can use Medicaid and VA benefits together. This helps them get more complete care—especially if they don’t have limited income.

Veterans are more likely to struggle with substance use.  Around 1 in 10 veterans have a substance use disorder, compared to about 7–8% of all adults. Alcohol is the most common issue, but many also misuse prescription drugs, especially opioids. Veterans face unique challenges like combat stress, PTSD, chronic pain, and difficulty adjusting to civilian life, all of which increase the risk of substance use.

Veterans are at higher risk of suicide.  According to the National Veteran Suicide Prevention Annual Report, the suicide rate for veterans in Virginia is 26.6 per 100,00 totaling 184 suicides.  In Virginia overall, the suicide rate is 14.5 per 100,000.

Medicaid is the largest source of funding for mental health and substance use disorder treatment.  Medicaid cuts mean losing access to treatment.

It is important that our legislators hear from you.  Your voice matters!  Call https://thenationalcouncil.quorum.us/campaign/113801/ or write https://thenationalcouncil.quorum.us/campaign/107658/ today to support Medicaid.

Most parents expect that their children will grow up, move out, and live on their own. But for families of children with disabilities, the future looks different. Many of these children will need lifelong support—emotionally, physically, and financially.

Providing lifelong support for a child with disabilities can be incredibly expensive.  Parents face both typical parenting expenses plus ongoing medical care, therapy, specialized equipment, home modifications, personal care aids, school and job supports.

That’s why Virginia’s Medicaid Waivers are so important. They help children and adults with disabilities get the care they need to live safely at home, be a part of their community, and have the best opportunity to thrive.​

These waivers are important because they offer services like housing, job supports, nursing care, crisis help, and assistive technology. Medicaid waivers are for people who would normally need care in a nursing home or similar facility but instead get that care at home or in their community.

Virginia offers several Medicaid waiver programs, including:

• Developmental Disability (DD) Waivers: These serve individuals of any age with a developmental disability, such as autism or intellectual disability, who qualify for institutional level of care.  Options include the Building Independence (BI) Waiver for adults 18 and older who can live independently with minimal supports, the Family & Individual Support (FIS) Waiver for individuals living with family or in their own homes, and the Community Living (CL) Waiver for those needing 24/7 support. ​
• Commonwealth Coordinated Care Plus (CCC Plus) Waiver: These waivers serve people of all ages with physical or medical needs.

Encompass Community Supports (ECS), as your local community services board, is the entry point for the DD Waivers.

If a child or adult loses their Medicaid waiver, the impact can be devastating.  They may lose access to critical services, face caregiver burnout, and struggle financially.  Parents may have to quit work to care for their child full time, leading to more economic strain.  Without waiver support, families may be forced to place their loved ones in institutions—not because it’s better, but because it’s the only option left.

Waivers are not luxuries, they are lifelines.  They allow families to keep loved ones at home, in their communities, and surrounded by those who know and love them most.

Call your local legislator today to oppose Medicaid funding cuts:  https://www.house.gov/representatives/find-your-representative

The Substance Abuse and Mental Health Services Administration (SAMHSA) is facing major changes and budget cuts. The U.S. Department of Health and Human Services (HHS) is planning to reduce costs by merging several agencies, including SAMHSA, into a new entity called the Administration for a Healthy America. As part of this effort, HHS will cut around 10,000 jobs and shrink the number of its divisions from 28 to 15, aiming to save $1.8 billion per year.

These cuts could reduce SAMHSA’s staff by up to 50%, affecting vital programs like the National Suicide Prevention Lifeline and many mental health and substance use treatment services. Locally, ECS is very concerned that this could lead to more overdoses, suicides, and challenges in accessing behavioral health care.

Opioids are still the leading cause of death for Americans aged 18-44. While deaths have decreased, that doesn’t necessarily mean fewer opioids and fentanyl—it may reflect better treatment and emergency response.

Community Services Boards like ECS rely on SAMHSA funding for crisis intervention, outpatient treatment, and addiction services. SAMHSA also supports programs for medication-assisted treatment (MAT) for opioid addiction and harm reduction, such as Narcan distribution. Cutting these programs could mean more overdoses and mental health emergencies. With fewer community-based services, more people may end up in emergency rooms or jail instead of getting the care they need. Losing access to treatment can also make it harder for people to keep jobs, maintain housing, and support their families.

These plans are still under review and could change, but if implemented, they would mark a major shift in federal mental health and addiction services. The impact wouldn’t just be on individuals with mental health and substance use disorders—it would affect entire communities by limiting life-saving services, increasing strain on emergency responders, and worsening public health outcomes.

Calling your local legislator today to oppose these funding cuts:  https://www.house.gov/representatives/find-your-representative

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People in small towns and rural areas depend on Medicaid for healthcare. If the government reduces Medicaid funding, it could put these communities and their hospitals at serious risk.

Any substantial cut to Medicaid will impact hospitals.  Many rural hospitals already struggle financially; Medicaid helps keep them open. If funding is cut, hospitals could face financial stress, reduce services, or even close.

Did you know that, in 2023:

• Medicaid paid for about one fifth (19%) of ALL hospital spending. Medicare covered 25%, and private insurance covered 37%.
• About one-third (32%) of all Medicaid spending went to hospital care.
• Medicaid covered around 40% of all births in the U.S. and nearly half of births in rural areas.  Childbirth is the most common reason for inpatient hospital stays.
• Expanding Medicaid under the Affordable Care Act (ACA) has helped prevent hospital closures.

Medicaid cuts can make it harder to get care. Fewer doctors, longer wait times, and the loss of key services—like maternity care, mental health support, and emergency treatment—could force rural residents to travel for medical help. This is especially dangerous for people with chronic illnesses like diabetes, heart disease, and cancer.

Hospitals are legally required to treat and stabilize all patients, even if they can’t pay.  Medicaid provides hospitals with funding to help cover these costs.  Without it, hospitals still have to treat people, but with less money.  Hospitals that stay open could be forced to reduce services, leading to fewer staff and longer wait times.  This affects everyone in the community—not just Medicaid patients.

There are economic impacts too.  Hospitals are often among the largest employers in rural areas. When they close or cut staff, it affects not just healthcare workers but also local businesses that rely on hospital employees and patients.

Medicaid funding is critical to keeping rural hospitals running and ensuring people get the care they need. Protecting it helps both hospitals and communities stay strong.

Voice your support for Medicaid by:

• Sending a letter to your elected officials.  The National Council for Mental Wellbeing has drafted a letter you can customize and send –  https://thenationalcouncil.quorum.us/campaign/107658/
• Calling your local legislator:  https://www.house.gov/representatives/find-your-representative

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Last Friday, a government shutdown was avoided when Congress passed a short-term funding bill. This keeps the government running through September 30, 2025, with most funding staying the same.

Now, Congress has to determine:

1. Reconciliation – The House and Senate must agree on a budget plan. Medicaid cuts have been proposed, but nothing is final yet. You can still speak up.
2. Fiscal Year 2026 (FY26) Appropriations – This decides how the government will spend money on programs and services from October 1, 2025, to September 30, 2026.

Medicaid matters for older adults.  Many people think Medicare covers all healthcare for those over 65, but it doesn’t. Medicaid helps fill the gaps, paying for things like:

• Nursing home care
• In home care and community services
• Premiums, deductibles, and co-pays

A nursing home costs about $108,000 per year—far too expensive for many. That’s why 2 out of 3 nursing home residents rely on Medicaid. Medicaid also funds in-home care, helping seniors stay at home and avoid costly hospital visits or nursing facilities. By working alongside Medicare, Medicaid ensures seniors get the care they need while improving their quality of life and financial security. It also supports caregivers by offering respite care, giving them a much-needed break. 

Did you know?

• 1 in 4 Medicaid enrollees are age 65 or older or have a disability
• More than half of Medicaid’s budget is spent on those over 65 and people with disabilities
• Older adults make up 26% of Medicaid enrollees, but use 42% of the funding
• Medicare does not cover long-term care

The Older Americans Act (OOA) helps too.  The OOA provides funding for services that help older adults, such as meal programs, caregiver support, and transportation.  So far, there are no specific proposals to cut OOA funding.  But Medicaid and OOA work together; OOA often fills gaps for those that do not qualify for Medicaid.  If Medicaid is cut, OOA programs would be overwhelmed with an increase in need with no new resources to meet that demand.

Cuts to Medicaid mean fewer services for older adults who need help. Contact your representative today.

• The National Council for Mental Wellbeing has drafted a letter you can customize and send –  https://thenationalcouncil.quorum.us/campaign/107658/
• Calling your local legislator:  https://www.house.gov/representatives/find-your-representative.

The U.S. government, like a household, has to figure out how to raise money and how to spend it. The government mainly gets its money from taxes and borrowing.  The taxes come from various sources, such as income, payroll, and corporate taxes. If the government doesn’t have enough money from taxes, it borrows by issuing Treasury securities. Then, the government funds various departments and programs.

The process leads to a lot of debate about taxes, how the money is spent, and the national debt.

The current House resolution wants to cut $4.5 trillion in taxes, mostly for the wealthy and corporations. At the same time, it wants to spend more money on things like immigration ($100 billion), Homeland Security ($90 billion), and the military ($100 billion). To make this work in the short term, the plan would raise the debt ceiling by $4 trillion.

The plan to balance the tax cuts includes cutting $2 trillion in spending. This includes cutting $880 billion over 10 years from the part of the budget that covers Medicare and Medicaid, and $230 billion from the part of the budget that covers the Supplemental Nutrition Assistance Program (SNAP), formally known as food stamps.

If approved, Virginia would face:

• $2.7 billion less for Medicaid (a 14% cut)
• $900 million less for public university students (Loans and Pell Grants)
• $273 million less for nutrition programs (a 15% cut to SNAP and Child Nutrition programs)

In addition, if this plan is approved, the federal budget deficit would increase by $173 billion in FY 2026. The spending cuts aren’t enough to cover the proposed tax cuts.

ECS advocates for a budget that supports and cares for all, and helps everyone access the resources they need to live healthy, secure, and fulfilling lives. It’s important that the U.S. budget reflect the needs of everyone, especially vulnerable groups like children, older adults, low-income families, and those with disabilities. A fair budget helps ensure access to essentials like healthcare, education, affordable housing, and nutrition.

Now is the time to speak up.  Congressional leadership, the House and Senate, need to work together to decide on a budget.

You can make a difference by:

• Sending a letter to your elected officials. The National Council for Mental Wellbeing has drafted a letter you can customize and send –  https://thenationalcouncil.quorum.us/campaign/107658/
• Calling your local legislator:  https://www.house.gov/representatives/find-your-representative

Everyone deserves a chance to succeed and contribute to society, and a well-crafted budget can make that possible for all.

Public health is what we do as a society to create a community in which everyone has the opportunity to be healthy.  It is the science and art of preventing disease and promoting health. It is the organized community activities that we undertake to identify or prevent threats to the health of the community, including services, programs, and policy development.

Public health is an investment.  Did you know investing $1 in mental health collaborative care returns $6.50 in healthcare savings and improved worker productivity?

Here are more examples:

Virginia’s Medicaid offers comprehensive coverage. It includes primary care, specialty care, behavioral health and dental. A public health program, Medicaid aims to improve the overall health and well-being of the population, particularly vulnerable groups. Medicaid works to improve individual care and the health of entire communities. By reducing barriers to healthcare, Medicaid helps address health disparities, including those related to socioeconomic status, race, and geography.

You can make a difference. Voice your support for Medicaid by:

• Sending a letter to your elected officials. The National Council for Mental Wellbeing has drafted a letter you can customize and send – https://thenationalcouncil.quorum.us/campaign/107658/
• Calling your local legislator: https://www.house.gov/representatives/find-your-representative

Medicaid is a vital part of the public health infrastructure because it ensures that all individuals, regardless of their financial situation, have the opportunity to live healthier lives.

On February 25th, the House of Representatives passed a budget plan that suggests cutting $880 billion from programs under the Energy & Commerce Committee, with Medicaid being the largest program at risk.

Medicaid is a public health insurance program that provides health coverage to eligible low-income adults, working families, children, vulnerable seniors, and people with disabilities. About 1 in 5 people in the U.S. rely on Medicaid for health coverage.

Virginia expanded Medicaid in 2018 to cover more residents.  The federal government pays 90% of the expansion cost, and Virginia covers the remaining 10%. Virginia also passed a “trigger law” with this expansion. This means if the federal government gives less than 90%, Medicaid expansion will end.

Medicaid keeps people healthy at all ages and stages.  2 out of 5 births in the U.S. are paid for with Medicaid, it provides coverage to 2 in 5 children and almost 3 in 5 nursing facility residents.  Medicaid covers custodial nursing home care; Medicare does not.

Medicaid is the largest source of funding for mental health and substance use disorder treatment.  As your local Community Services Board, Encompass Community Supports (ECS) is the single point of entry into publicly funded mental health, intellectual and developmental disability, and substance use disorder services.  If Medicaid funding is cut, people will lose access to care.

Non-elderly adults and children in rural areas are more likely than those living in metro areas to rely on Medicaid for their health insurance.  In Rappahannock County, 34.1% of children are covered by Medicaid compared to 30% of children in Virginia.  31.9% of children in Culpeper use Medicaid for healthcare.

Cuts to Medicaid will also hurt state budgets, reduce jobs at local service providers, and increase costs from more emergency room visits and unpaid care.

Now is the time to speak up.  Congressional leadership, the House and Senate, need to work together to decide on a budget.   You can make a difference.  You can help protect Medicaid by:

• Sending a letter to your elected officials.  The National Council for Mental Wellbeing has drafted a letter you can customize and send –  https://thenationalcouncil.quorum.us/campaign/107658/
• Calling your local legislator:  https://www.house.gov/representatives/find-your-representative. 

Your voice matters—action today can help protect Medicaid and ensure vital healthcare for those who need it most.

Encompass Community Supports (ECS), formally known as Rappahannock-Rapidan Community Services, will continue to review the incoming executive orders and assess their potential impact on our organization.  We understand that you have many questions; we do too.

It will take time to review and understand the changes.  Our goal is to give clear and accurate information to our residents, clients, and staff. Thank you for being so patient.

What will not change is ECS’ unwavering commitment to improving the quality of life in Culpeper, Fauquier, Madison, Orange, and Rappahannock Counties by providing comprehensive mental health, substance use, developmental disability, housing, children’s, aging, case management, and transportation services.  We will continue to support and value every member of our community.

We’ll make sure to keep you updated as the situation evolves.