Aging services overhaul: The quiet reform that’s setting a national example

If you’re over 60—or care about someone who is—you’ll want to keep an eye on what just happened behind the scenes in the world of aging services. A quiet but powerful transformation is reshaping how seniors receive support, care, and services. While most people haven’t heard about these sweeping updates yet, experts say they could soon set the tone for aging programs across the country.

So what’s changing, and why does it matter so much? Let’s take a closer look at the new model that’s being held up as a national example of how to support aging with dignity.

Missouri becomes the first to comply

The Missouri Department of Health and Senior Services (DHSS) State Unit on Aging, in collaboration with the state’s ten Area Agencies on Aging (AAAs), announced that Missouri has become the first state in the nation to fully comply with the new Older Americans Act (OAA) final rule—meeting the October 1, 2025 deadline.

“Missouri is proud to be leading the way in implementing the Older Americans Act final rule,” said Mindy Ulstad, DHSS Chief of the Bureau of Senior Programs.

“Through collaboration, transparency and accountability, we are ensuring that programs serving older Missourians and their caregivers are stronger and more responsive to those in need than ever.”

Also read: A new kind of home care is giving these seniors a reason to smile—what you need to know

What the update means

In February 2024, the Administration for Community Living, part of the US Department of Health and Human Services, published the first update to the OAA since 1988.

The goal: to modernize the national aging network and improve accountability and quality in senior services.

The rule required states to comply by October 2025—or submit a corrective action plan. Missouri, however, acted quickly and became the first to meet the standard.

How Missouri did it

To reach full compliance, DHSS and the AAAs convened a two-day joint planning session to develop statewide policies and procedures.

That session produced key outcomes, including:

• Agreement on definitions and policies for the State Unit on Aging, AAAs, and service providers


• A new area plan process that improves transparency for the public


• Standardized monitoring documents to help contractors meet the new rules


• Updated data reporting requirements to ensure accuracy and consistency statewide

Also read: What a new $60 million HHS funding plan could mean for seniors and caregivers

The State Unit on Aging also launched a wide-reaching training and implementation campaign to prepare partners at every level.

These included:

• Multiple in-person and virtual trainings with recordings for ongoing access


• Sample documents and one-pagers for easier adoption of the new requirements


• Training sessions on the following topics:


• Conflict of interest safeguards


• Performance and data reporting standards


• Advisory council requirements


• Client and service prioritization


• Contract and commercial relationship requirements


• Policy and procedure updates


• Service provider standards


• Fiscal accountability


• Area plan process requirements

Additional targeted trainings were held specifically for service providers and their boards of directors to ensure leadership at every level was prepared to meet the new compliance standards.

Also read: Support that feels like home: How today’s care services help seniors stay confident and independent

Statewide collaboration and leadership

“Missouri’s ten Area Agencies on Aging applaud the swift action by the State Unit on Aging to ensure Missouri is among the first states to move into compliance with the Administration for Community Living’s final rule on the Older Americans Act,” said Julie Peetz, Executive Director of the Missouri Association of Area Agencies on Aging.

“This update, the most substantial since 1988, is critical for modernizing the national aging network. Our proactive compliance demonstrates Missouri’s deep, unified commitment to prioritizing the most vulnerable older adults, streamlining service delivery, and securing the long-term sustainability of programs like nutrition assistance, in-home care, and legal aid.”

Building stronger senior communities

As part of the broader effort, DHSS hosted the first-ever Missouri Senior Center Summit on October 6.

The event brought together AAA representatives, senior center administrators, and board members from across the state to exchange best practices, strengthen communication, and reinforce alignment with the updated OAA regulations.

Through its unified approach and early compliance, Missouri has become a national example of how to modernize services for older adults—promoting accountability, accessibility, and long-term sustainability for programs that support seniors and caregivers alike.

Read next:

• Social Security Scrutiny grows as senator warns of concealed systemic problems
• Proposed budget changes could affect senior services—here’s what to know
• Thinking of working in retirement? Here’s where seniors are thriving

Key Takeaways

• Missouri is the first state to fully comply with the updated Older Americans Act (OAA) final rule, before the October 1, 2025 deadline.
• The DHSS and Area Agencies on Aging jointly created comprehensive new policies, monitoring tools, and data standards through a two-day planning session.
• An extensive training rollout covered all levels of service, including boards, and addressed conflict of interest, fiscal standards, and client prioritization.
• The October 6 Senior Center Summit united leaders statewide to reinforce alignment and share best practices in senior service delivery.

What do you think about the new federal rules on aging services—do they go far enough to meet the needs of older Americans? Have you or a loved one ever struggled to get clear information or services from your local aging agency? What would you like to see change? Let us know in the comments below.