A Q&A with Rebecca May-Cole

This year will mark Rebecca May-Cole’s first decade leading the Pennsylvania Association of Area Agencies on Aging (P4A), which oversees the state’s 52 Area Agencies on Aging, a key support system for older Pennsylvanians. May-Cole, a lifelong public servant, has no shortage of priorities, all of which revolve around the state’s always-growing elderly population.

This conversation has been edited and condensed for length and clarity.

What is the elevator pitch for P4A?

P4A, which was established in 1977, supports the state’s Area Agencies on Aging, the AAAs – to help them serve older adults in Pennsylvania. At the end of the day, we want to make sure that older adults are receiving the services and supports they need and are able to age with dignity in the place of their choosing – which, for the majority of people, is going to be in their homes. When it comes to serving the AAAs, we focus on the quality of the work that's done, and the consistency of the work that's done, and making sure that we can continue to provide those services to older adults.

What are some of your short-term and long-term objectives for the agency?

As far as the Area Agencies on Aging are concerned, it goes back to those three main areas that I mentioned, the quality, consistency and sustainability. We have 52 AAAs that serve all 67 counties. We've had a dramatic increase in the number of older adults in Pennsylvania. We're fortunate that we have a lottery fund to help support older adults and the needs that they have, but we haven't been able to keep up with the need. But my biggest focus is to enable the AAAs to serve older adults, keep them in their homes for as long as safely possible. The people who run these organizations are extremely committed to the work that they do. Nobody goes and works for AAAs because they want to make big bucks. We're respecting and honoring them and valuing them in a way that our society doesn't do enough of. We also see a lot of ageism in our world these days; the AAAs are trying to work against that and make sure that we're valuing older people, we're providing what they need to be able to live and contribute to the communities.

What are the best-case and worst-case budget scenarios for your agency?

When it comes to the state side, meaning the lottery, the worst-case scenario would be flat funding. That effectively is a cut because of inflation alone. There's the nice case, which is that we get the $20 million increase that the governor proposed. The best-case scenario would be that the AAAs receive the additional $105 million that we're asking for – if you account for the increase in the state’s aging population and the increase in inflation since 2019, in order to serve people where we were at 2019 levels, we would need $105 million more.

Our agencies were generally flat-funded last year, and have been underfunded for decades. They're making difficult decisions around closing services, closing senior centers, putting people on waiting lists, because the funding has just not been adequate, which I think has a lot to do with going back to the ageism and how we value older adults.

Have you been affected by federal funding uncertainty?

Very much. About 20% of the funding that flows through the state Department of Aging comes from the federal government. It would be a massive hit if that funding went away, but even a decrease in this current environment is still going to be a major problem. It's part of why it's even more critical that we see an increase in the state funding, because it looks like there could be some dramatic cuts on the federal side of things. Nobody has a crystal ball, so we don't really know what that's going to look like, but there is a lot of contingency planning going on. It's really unfortunate, because I think it's making people scared, especially older adults. They don't know what services they're going to be able to continue to receive. And as people age and need more services, we worry about being able to meet their needs.

One in three Pennsylvanians will be considered older Americans in 2030 – how prepared are we for that?

I think, as a whole, we're not ready. I think the AAAs can be ready – if given the resources that they need. They are the best ones to be ready to serve older adults, but at this point, there's no way that we're going to be able to meet the needs of these folks. We will do our best, but it's really going to come down to focusing on a very small number of services. A lot of what the AAAs do is help to keep people in their homes and also help prevent them from needing more expensive kinds of services. If we're limited to sort of the bare minimum, we're looking at investigating abuse, and we're looking at providing congregate meals, and that's the extent of it. In all honesty, it ends up costing more in the long run. It's so much more expensive to serve people in a nursing facility versus in the home; it's just short-sighted in many ways to not put adequate support and resources toward these services now, before somebody needs significant help.