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SERVICES AT CHARGES THEY COULD AFFORD.

FOR THEIR PART, STATE AND LOCAL OFFICIALS WE INTERVIEWED FROM COST-SHARING

STATES SAY MONEY FROM RECIPIENTS OF ADULT DAY CARE AND IN-HOME SERVICES

HELPS EXPAND THEIR PROGRAMS AND SERVE MORE RECIPIENTS. MORE THAN THREE

QUARTERS OF STATE AND LOCAL OFFICIALS INTERVIEWED IN COST SHARING STATES

FEEL POSITIVELY ABOUT THE COST SHARING FEATURE OF COMMUNITY SERVICE

PROGRAMS FUNDED BY THEIR STATES. NINETY PERCENT OF THE RESPONDENTS IN THE

COST SHARING STATES SUPPORT COST SHARING FOR ADULT DAY CARE AND IN-HOME

SERVICES UNDER TITLE III AND 73 PERCENT SUPPORT COST SHARING FOR OTHER TITLE

III SERVICES SUCH AS TRANSPORTATION, LEGAL SERVICES AND HOME DELIVERED MEALS.

INTERESTINGLY, EVEN STATE AND LOCAL OFFICIALS IN THE NON COST SHARING STATES

WE SAMPLED SHARE THIS VIEW.

CONCLUSION

BEFORE CONCLUDING, WE WOULD LIKE TO SAY THAT OUR WORKPLAN ITEMS FOR

FUTURE YEARS INCLUDES AN INCREASING NUMBER OF STUDIES AND AUDITS ON AOA

ACTIVITIES. WE CURRENTLY HAVE A STUDY UNDERWAY ON THE OMBUDSMAN PROGRAM

AND PLAN TO INITIATE REVIEWS IN THE NEXT COUPLE OF YEARS ON:

- DELIVERY OF VARIOUS SERVICES INCLUDING NUTRITION AND

ELDERLY ABUSE PROTECTIONS

INTEGRATION OF DEPARTMENT SERVICES

· ADMINISTRATIVE COSTS

SERVICES PROVIDED BY AREA AGENCIES ON AGING

THE LEVEL OF UNMET NEEDS WITHIN THE AGING POPULATION

AREA AGENCIES ON AGING COORDINATION WITH HOSPITAL DISCHARGE

PLANNERS

AS WE COMPLETE OUR WORK, WE WOULD WELCOME THE OPPORTUNITY TO MEET WITH

MEMBERS OF THIS SUBCOMMITTEE AND THE MEMBERS OF THE HOUSE COMMITTEE ON

AGING TO PRESENT OUR FINDINGS.

THIS CONCLUDES MY TESTIMONY AND WE ARE AVAILABLE TO ANSWER YOUR

Chairman ROYBAL. The Chair recognizes Mr. York.

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STATEMENT OF ROBERT L. YORK, ACTING DIRECTOR FOR PRO

GRAM EVALUATION IN HUMAN SERVICE AREAS, U.S. GENERAL
ACCOUNTING OFFICE, PROGRAM EVALUATION AND METHOD-
OLOGY DIVISION

Mr. YORK. Thank you, Mr. Chairman. With me today at the table is Sushil Sharma, and also Patrick Grasso and Alan Stein-Serousi.

It is a pleasure to be here today to share the results of our work on the targeting of minority groups in programs and services of the Administration on Aging. In our testimony today, we will present information on (1) the data that are available to assess the effectiveness of targeting efforts, (2) what technical assistance on targeting AoA provides the State Units on Aging, and (3) the extent of unmet technical assistance needs of State Units with regard to targeting. Your request that we examine the organizational placement of AoA within the Office of Human Development Services seems to be overtaken by the recently announced reorganization.

First, what data are available on the effectiveness of targeting? The degree to which low-income minority older persons participate in Title III programs has been a recurring issue. Further, if efforts are undertaken to improve targeting to low-income minority persons, for example, the success of such effort should be demonstrable by data showing increased participation rates of this group.

However, as we recently reported to the Senate Subcommittee on Aging of the Committee on Labor and Human Resources, we found a variety of serious problems with Title III participation data that make it impossible to determine minority participation rates in Older Americans Act programs. Until these problems are resolved, the Congress will lack key policy information such as whether minority participation is increasing or not and which strategies aimed at increasing minority participation are effective.

Second, the national survey on technical assistance. You also asked us to review technical assistance for targeting that AOA provides to State Units on Aging. In response, we conducted interviews, and we mailed questionnaires to AoA-related providers of technical assistance, all 10 AoA regional offices, and all 11 national resource centers. We also sent questionnaires to 51 State Units on Aging. We had an overall response rate of 99 percent.

The requirements of the Act for focusing AOA services to those elderly persons with the greatest social or economic needs and lowincome minority older persons have created a variety of technical assistance needs. Most of the regional offices and the national resource centers reported that they provide a great deal or a very great deal of technical assistance on targeting issues.

However, our survey found that many state officials still have serious concerns about unmet needs for technical assistance in how to determine what services are needed by low-income minority older persons. They also report serious concerns about what steps to take to increase participation by low-income and minority elders.

Another serious technical assistance concern is interpreting the requirements of Federal laws and regulations. If State Units and

Area Aging Agencies are to improve their targeting, they need data on the geographic distribution of elderly persons with the greatest social or economic needs. This information could be useful to Area Agencies, for example, in planning the location of new facilities, wherein the standard of comparison to determine if the agency is, in fact, providing sufficient services to minority group members.

Currently, such demographic information is neither readily accessible to State Units and Area Agencies, nor is it up to date. We have learned that the Census Bureau has developed its capacity to generate information for states and counties as Dr. Berry indicated earlier, but we are still concerned about periods between the decennial censuses.

Finally, recommendations. Based on the results of our ongoing work, we recommend that the Commissioner on Aging take steps (1) to modify the current data collection instrument and methodology and to standardize data collection procedures toward the goal of providing meaningful data on minority participation in AoA programs, (2) to acquire from the U.S. Census Bureau timely demographic information for use by State Units and Area Agencies, and (3) to identify those State Units and Area Agencies that continue to have serious unmet needs for technical assistance on targeting issues and then provide the necessary assistance.

Mr. Chairman, that concludes my remarks. I would be happy to answer any questions.

Chairman ROYBAL. Thank you very much.
[The prepared statement of Mr. York follows:]

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Mr. Chairman and Members of the committees;

It is a pleasure to be here today to share the results of our

work on the targeting of minorities in programs and services

administered by the Administration on Aging (AOA).

In our

testimony today, you asked us to present information on (1) the data that are available to assess the effectiveness of targeting, (2) how AoA provides technical assistance onmtargeting to state units on aging, (3) the unmet technical assistance needs of state units with regard to targeting, and (4) the ability of the AOA to administer older Americans Act programs under its current organizational placement within the Office of Human Development Services of the Department of Health and Human Services.

BACKGROUND

Before turning to the results of our work, I think it is

important to discuss its context.

One of the most significant

demographic facts affecting America's present and future course is

the aging of its population. Both numerically and as a percentage of the U.S. population, the 65-and-older age group has grown, and will continue to grow, more rapidly than other age groups. In

1989, 29.6 million Americans, about 12 percent of the total U.S. population, were 65 years of age or older. By 2030, an estimated 66 million people will be 65 or over, and they will then represent

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