Josefina G. Carbonell: 1950—: Head of U.S. Administration on Aging

Nominated to head the Administration on Aging (AoA) on June 7, 2001, Carbonell was unanimously accepted by the Senate Committee on Health, Education, Labor and Pensions and confirmed by the U.S. Senate on August 1, 2001. Sworn in one week later, Carbonell became the first Floridian to serve in the AoA and the third Cuban American to hold a prominent position in the George W. Bush administration. By accepting this new challenge, Carbonell left a functioning geriatric service complex comprised of 500 volunteers staffing 21 sites and serving over 55,000 registered clients. One of her final accomplishments for LHANC was the founding of the first senior center dedicated to the care of Haitians in South Florida. In a United States government press release, Health and Human Services Secretary Tommy G. Thompson lauded her "first-hand knowledge of the real issues faced by a dynamic population of older Americans and their families."

Carbonell brought to the AoA her considerable skill in refugee resettlement and in leading a family-centered agency that was both intergenerational and culturally diverse. She earned respect for publicizing the hardship of long-term caregiving and for recognizing the "graying of America." Upon taking office, Carbonell began developing policy and planning service delivery for the elderly and their caregivers. Similar to the maze of networked and interdependent programs in Dade County, the AoA relied on state and local agencies, volunteers, and tribal organizations to answer the challenges raised by the increasing longevity of the U.S. population.

A recognized expert on health, nutrition, and emotional support, Carbonell missed the personal touch of aiding elderly Miamians, but thrived on the demands of a federal job touching millions of lives. Her office developed plans for upgraded outreach and case management; the AoA handled referrals to existing service agencies, for transportation and personal care, and for daycare and meal preparation and delivery. Carbonell's staff also surveyed methods of preventing elder abuse, declines in health and vigor, and financial and legal problems. For family caregivers, AoA bolstered support, education and demonstration, and research.

In November of 2001, Carbonell observed National Family Caregiver Month with an appearance on the radio station WMKV-FM. She described her own family's needs and expressed hope in a fully implemented federal aid program, National Family Caregiver's Support Program (NFCSP), a $125 million boost to the Older Americans Act. The program, one of her first successes in Washington, is a flexible model based on first-person reports on nurturing the homebound and on current research into caregivers' problems. NFCSP coordinates numerous sources of assistance at the community, local, and state levels. To gain information from frustrated families, Carbonell's staff set up listening sessions to determine needs; they also collected data on inconsistencies in service by identifying communities that lack support and on those unaware of government aid.

Carbonell envisioned the future of NFCSP as providing help for caregivers juggling home duties with jobs. Her concerns included stress from unrelieved stretches of tending the elderly and sick, the increasing costs of prescription drugs and medical treatment, and the fatigue, worry, and frustration that cause caregivers to make workplace errors and miss meetings and work-days. She asserted in Today's Caregiver that "the business community needs to look at long-term care and support services as a benefit. So we will be working together with the private sector in developing ideas and coming up with solutions."

In the long-term, Carbonell proposed adding support for improved planning in the face of demands resulting from aging and debilitation. She advocated using faith-based communities, training sessions, youth assistance at household chores, and respite programs that replace caregivers temporarily with volunteers. In sympathy with hard-pressed families, she commented to Today's Caregiver, "I think we struggle as we try to do everything, and we just have to realize that we're not alone." She urged all citizens to network with other families, to talk honestly about hardships and to share experiences and advice.