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made available to all eligible older Americans, preference "is given to
providing services to older individuals with the greatest economic or
social needs, with particular attention to low-income minority
serving by spec
Mr. Chairman, we look forward to the continuing debate on these
vital issues. This concludes my prepared remarks. I understand that
you have a number of questions which I will be pleased to address.
Chairman ROYBAL. I will start out the questioning for the next 5 minutes. The first response I would like to have from you is your opinion on how you would improve the Older Americans Act and the services that are provided to the needy. That, Dr. Berry, should take 5 minutes.
Ms. BERRY. I believe that we have to provide greater flexibility to the State Agencies on Aging who are faced daily with the task of serving the growing numbers of seniors. Certainly, the demographics speak to the fact that we have to broaden our base and involvement only aging advocates, but those outside of the aging arena in forming new partnerships in terms of public/private assistance.
I am concerned that we not place limitations on state directors as they try to implement policies and programs to impact on the waiting lists particularly for in-home services. We know that the number of the “old old" is increasing. I am particularly concerned as well with some of the housing situations of older persons across the country. Many seniors moved into public housing facilities some years ago and do, in fact, need supportive services. It is critically important that our network reach out to those vulnerable seniors. Certainly we have to think in terms of targeting services. Quite frankly, I believe that targeting and cost-sharing go hand in hand in the sense that, with the scarcity of resources we confront, we have to make sure that available resources go to those who are most needy; so I am particularly concerned that the Commissioner be assigned this authority to approve the intrastate funding formula and that States have the option of cost-sharing.
Chairman ROYBAL. Dr. Berry, one of the things that is creating some problems regarding an individual's status and gratification for Older Americans Act programs is the matter of cost-sharing. You are advocating, I understand, cost-sharing instead of voluntary contributions. Is that correct?
Ms. BERRY. Yes, Mr. Chairman. I am proposing, based on the presentations at the forums, that the state directors on aging be permitted the option of asking those seniors who can pay to share in the cost of the services. I favor self-declaration as the way to get information regarding income. I certainly want to set up measures to protect the dignity of older people.
Chairman ROYBAL. Well, I agree with that, but the word "mandatory” is not exactly the same as the word "voluntary." Can you then calculate at this time what additional revenue you will generate from mandatory cost-sharing above the current voluntary collections?
Ms. BERRY. I don't think any estimates of the revenues to be gained have been made at this time, Mr. Chairman. I think the issue before us is whether or not we can continue with business as usual in light of the growing numbers of older persons in need.
Chairman ROYBAL. But if the business is good, why should you change it?
Ms. BERRY. I would respectfully submit for your consideration, Mr. Chairman, the fact that we do have growing numbers of seniors who are in need of additional services. Our voluntary contributions help with that. We have contributions which total close to $200 million a year. The Administration on Aging is taking an active role in trying to step up contributions.
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Chairman ROYBAL. All right. You know what you are getting in voluntary contributions now, but you have not made an estimate of what you would receive if you made it mandatory.
Ms. BERRY. I think our experience with voluntary cost-sharing programs would lead us to expect that the level of voluntary contributions will continue to grow. Contributions in the 36 States that are now administering cost-sharing programs with non-Older Americans Act resources do, in fact, show some gains. In these States there has been no negative effect on targeting. The resources that are provided by cost-sharing are used to expand services. I don't think anyone would argue effectively that we are looking for an onslaught of new resources from cost-sharing. I think the issue is whether or not those seniors who can pay should do so. As you know, we do serve many seniors who are not poor.
Chairman ROYBAL. Sure.
Ms. BERRY. The issue is whether or not we should ask them to share.
Chairman ROYBAL. It is confusing to me to find out just exactly the Administration's viewpoint on the issue of cost-sharing. First of all, I think it is acknowledged that seniors don't want charity. I have seen this over and over again in the various organizations I go to in my own district, and they tell you right out, “We don't want anything for nothing."
Ms. BERRY. We hear the same thing in our talks with older persons.
Chairman ROYBAL. “We want to be able to pay according to our income.” If that is the case and if the voluntary collections at the present time are going well. What happens if a change is made? If the senior citizen is like I am, I wouldn't necessarily respond to something mandatory along those lines. I just wouldn't go to that organization.
Ms. BERRY. Well, I would agree
Chairman ROYBAL. Aren't you afraid that you would lose some senior citizens and maybe hinder the program?
Ms. BERRY. The information that we do have does not lead us to believe that seniors would limit their participation in the programs because of the cost-sharing that we have proposed. We have a number of network officials who have gone on record, persons like Jane Gould, State Director in New York, Fay Washington, the Area Agency Director in Los Angeles, and Jeannette Takamora. There is a host of network officials who, as I have mentioned, are just as concerned as all of us are about making sure that there is a true balance out there between meeting the needs of older people and not placing an unfair burden on these seniors.
Chairman ROYBAL. Dr. Berry, my time has expired, and I should not be saying this to you, but I will since I have got the floor at the moment. On many occasions I visited senior citizen centers and happened to be there for lunch. I have seen individuals come in and pay the full amount, and in one particular instance I remember, it was 60 cents. I saw others come in and only put in a quarter, and in talking to these people, they said they didn't want anything for nothing, 25 cents was all they could afford, and they made their contribution, and they felt at least they paid for some
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I think voluntary contributions is much better system, and if one would actually come out with figures as to what you can mandatorily collect from senior citizens versus the voluntary collection, perhaps it could be more convincing. No pilot project of any kind has ever been set up anyplace, I understand.
Ms. BERRY. Mr. Chairman, I think your example is a very good one in terms of what is happening across the country. Seniors do contribute. We are finding that seniors in the minority communities tend to contribute even more. The voluntary contributions are working, but I would go back to the point that we can't just be concerned about the seniors who are inside the senior center. There are many seniors who are outside the center who are waiting to be served. There are many things that we can do to try to bring in additional resources through public/private partnerships. I would just add, in conclusion, that there were many seniors at our forums who said that they had no problem in cost-sharing. Many of the State directors that are currently operating cost-sharing programs do, in fact, have stepped-up participation of seniors.
Participation by older persons has not fallen off. They are more concerned about the quality of services they receive when they pay. When they pay for services they tend to be more inquisitive about the scope and quality of those services. This is particularly evident in the area of in-house services. Cost-sharing may help us achieve better oversight of the services provided by the network.
Chairman ROYBAL. The Chair recognizes Mr. Martinez
Chairman MARTINEZ. Thank you, Mr. Chairman. Ms. Berry, there are a few questions that I have that I think are as important as the cost-sharing, not that the cost-sharing isn't an important thing, but as we have held these five hearings, we have pretty much determined that there are a lot of states that are doing it but strictly on a voluntary basis, and there is only the self-declaration. If we went to some kind of a cost-sharing plan, I can only envision it in those expensive services that are provided because the states can't wholly afford to provide it themselves and so that may be for those that can afford it but solely on a self-declaration.
I believe there would have to be language in any bill or legislation that would say self-declaration very clearly because as we know, when you give a bureaucrat the power, sometimes they don't always use it judiciously, and we might end up with an overenthused or active bureaucrat who wants to prove to the world he is worth his salt and go out and start requiring mandatory information that will drive people away from the service. Would you agree with that?
Ms. BERRY. I agree wholeheartedly, Mr. Chairman. We would certainly support self-declaration
Chairman MARTINEZ. Let me ask you on another issue then: I am concerned with your reorganization, and you know that in my opening statement I commend the Secretary for that reorganization. Those are some of the things that we were thinking about putting into the legislation as we reauthorized, but in the move too, I am interested to know what happens to the Federal Council on Aging.
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Now, it would seem to me that would be appropriate with your now separate entity, but as I understand, it is going to stay in the Children and Families portion of it.
Ms. BERRY. The Federal Council on Aging at present is placed as an adjunct to the Administration for Children and Families. The Secretary has set up a transition team to plan for implementing the reorganization. The placement of the Federal Council is one of the issues the transition team will address. I expect, Mr. Chairman, that the Federal Council will be placed within the jurisdiction of the Administration on Aging.
Chairman MARTINEZ. Very good. I hope so. Now, there is one other thing that I have. Under the old system, the Office of Human
Ms. BERRY. Development.
Chairman MARTINEZ. —had the authority for the contract although they were contracting services that you contracted for them. Now that you have moved, are you going to have that contract and authorization?
Ms. BERRY. The Secretary has assured me that the Administration on Aging staff will be enhanced so that we will have grants capability as well as contract authority. In the interim, we will use the logistical support of the Office of the Secretary.
Chairman MARTINEZ. All right. One question along that same line. We have always been concerned, or since we have taken jurisdiction, about your control of the budget and the staffing of AoA. We understand there is a limited number of staff people. In fact, the staffing has diminished, hasn't it, over the past several years? Ms. BERRY. That is correct.
Chairman MARTINEZ. Now, are you going to have authorization of staffing, and are you going to have some ability to input to the budget?
Ms. BERRY. The current arrangement that Secretary Sullivan has laid out gives me direct access to the Secretary on matters of budget and legislation, I expect, Mr. Chairman, to make a healthy request to the Secretary in terms of staffing. I think the Administration on Aging can be enhanced with additional staff.
Chairman MARTINEZ. Very good. Now, the information that was asked for by the Chairman on data collection to determine whether or not cost-sharing could be effective, our committee has asked the GAO to do a study of this. The only problem is that any findings are a year away, and that is a little long, but there is some of that information that is readily available, and we have put the GAO in touch with the County of L.A. because the County of L.A. has a data collection system that is absolutely phenomenal, and they have the ability to profile the people that are being serviced, and the income levels of those that are being serviced, and a lot of pertinent information to really be able to deliver services, and I had asked you earlier if you would be in touch with them, and maybe some of that information could be compiled so that we can, as we go down the road to reauthorization, utilize that information.
The other thing is that also they have entered into a program which, in your written testimony, you allude to a similar program