Unmet Needs That Represent Serious Concerns

We also asked state unit officials to identify which of their unmet needs for overall technical assistance represent serious concerns for them. The respondents most frequently identified technical assistance for targeting, with 32 percent of the state unit officials identifying targeting issues. Specifically, they indicated a need for more technical assistance on outreach initiatives to low income and minority elders, on demographic data, and on how to perform needs

assessments.

Another unmet need that represented a serious concern, was for technical assistance regarding data collection. Twenty-eight percent of the state unit officials specifically identified this unmet need. In addition, some expressed a specific need for technical assistance on how to develop and/or implement computerized data collection systems. As I mentioned earlier, without accurate data on participation in Older Americans Act programs, it is not possible to determine the effectiveness of targeting initiatives.

Sixteen percent of the state unit officials indicated that they have a serious unmet need for technical assistance in interpreting legislation, policies, and. regulations. While the respondents did not necessarily specify legislation and

regulations pertaining to targeting, this issue has been a

major focus of recent amendments to Older Americans Act and AoA

regulations.

They also

Finally, 10 percent of the state unit officials noted a serious unmet need for technical assistance in monitoring plans and contracts, and assuring compliance with laws and regulations by area agencies and service providers. mentioned a need for regional offices to provide more monitoring. Again, while they did not specifically mention monitoring of targeting mandates, we believe this unmet need is relevant to targeting. It is in their plans that area agencies specify how they intend to meet the needs of those elderly individuals they have identified for targeting. State units that are able to monitor the area plans effectively can provide more technical assistance on targeting to those area agencies that are not meeting their targeting goals.

Although it is evident that state units on aging have unmet needs for technical assistance on targeting, some of which represent serious concerns, we recognize that an obstacle to the provision of technical assistance is the paucity of staff at AoA's regional offices. Regional offices have approximately 7 to 8 staff, with limited funds for training.

This means that regional office personnel are

constrained in their ability to develop the necessary expertise

for the provision of technical assistance. Moreover, AoA has limited travel funds to allow regional office staff to visit states and provide hands-on technical assistance.

THE ABILITY OF AOA TO ADMINISTER PROGRAMS UNDER ITS CURRENT

STRUCTURE

You also asked us to examine the ability of AoA to administer Older Americans Act programs under the current organizational structure within the Office of Human Development Services of the Department of Health and Human Services. As you know, the Department of Health and Human Services recently announced that it is merging most programs administered by the Office of Human Development Services into the new Administration for Children and Families, but that AoA will not be included in this reorganization. Rather, the Commissioner on Aging will report directly to the Secretary. Because we do not yet know the precise nature of this arrangement, it would be premature for us to comment on this development at today's hearing.

SUMMARY

As a result of our study of the technical assistance that AoA provides to state units on aging, we have focused on First, in order for state units and area

several issues.

agencies on aging to evaluate the effectiveness of their targeting strategies, they must have a sound methodology to ensure that they can collect accurate data on the participation rates of targeted populations in Older American Act programs. However, as I have already noted, there are major unresolved problems in AOA's data collection methodology. Therefore, AoA cannot currently assess the effectiveness of targeting

initiatives.

Second, for state units to identify the number of elderly persons with the greatest social or economic needs, as well as elderly minorities, they must have access to census data on the geographic distribution of elderly persons in their state or planning and service areas. Currently, such information is neither readily accessible to state units and area agencies nor is it up-to-date. As many state unit officials indicated in our survey, they continue to have unmet needs for such information.

Third, in order to develop methods to target those elderly persons with the greatest social or economic needs and minority elderly persons, our survey indicated that many state units need more technical assistance. Specifically, state unit officials noted serious concerns about their unmet needs for technical assistance in the areas of needs assessments, outreach initiatives, federal laws and regulations, and the

monitoring of area plans and service providers. These needs exist in spite of the fact that most of the regional offices and the national resource centers reported that they provide a great or very great deal of technical assistance for targeting. Fourth, despite the manifest need, AoA appears to lack adequate staff, as well as travel and training funds, to provide such technical assistance.

RECOMMENDATIONS

Based on the results of our ongoing work (and as we stated in our previous testimony), we recommend that the Commissioner on Aging take steps to (1) modify the current data collection instrument and methodology to ensure accurate participation data related to programs and services authorized under the Older Americans Act, and (2) develop specific standards for the data input to computer systems currently being used or contemplated by the states so that the information generated can be compared across states. We also recommend the Commissioner on Aging take steps to (3) acquire from the U.S. Census Bureau the necessary demographic/census information to be used by the state units and area agencies to identify and target elderly populations in their respective geographic areas, and (4) identify those state units that continue to have serious unmet needs for technical assistance for targeting, and then provide those agencies with the necessary assistance.