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Ms. MORELLA. And just to ask you a couple of questions: I have also been perusing the testimonies of people who are going to be following you, Dr. Berry, knowing that I only had one shot at you, and looking at, let us say, the GAO report, it states that minority participation in Older Americans Act programs and services cannot be measured adequately at this time it is on page six] and that some states have developed computerized client-tracking systems that potentially will allow them to measure minority participation.
Then it goes on to say, however, that we cannot really use these state systems to tell us how effective it is because AoA has not developed any standards that would be needed for data input to these computer systems. I wondered if you could tell us whether this is in the process. I don't even know which states have developed these client-tracking systems.
Ms. BERRY. Yes. We are very concerned about the data collection issue.
Ms. MORELLA. I would be interested in that also, but are you moving ahead or what can you do? Can we help you in some way?
Ms. BERRY. Yes. The whole matter of State reporting and data collection is an important issue that the Administration on Aging has struggled with for a number of years. We have invested a significant amount of resources in trying to obtain adequate data.
I have established a task force of State directors on aging who will be meeting with me in June, directors from the States of Arizona, Florida, Missouri, Nevada, New York, Oklahoma, South Carolina, Washington, and Maryland, to talk with me about some of the issues that relate to getting good data.
There is diversity across the country with regard to the efficacy of the systems that are in place. I also asked the State directors to share with me some of the problems that they are experiencing, they have done that, and I have a compiled report. Some of the problems relate to technology. Some of the problems relate to duplication in terms of counting persons. I believe that we have to develop a process for collecting core statistics, so that we can collect this information as part of the State program report.
I think the State program report needs modification. As I mentioned in my opening statement, I believe we should pay attention to the people who are most closely involved in serving older people. They have told us that some of our categories in the data collection taxonomy need work. It is my intent to try to address this problem that you so eloquently identified.
Ms. MORELLA. That is good. Those states that you mentioned that will be represented with you in June; are those the states that do have that client-tracking system established? Is that why they were chosen?
Ms. BERRY. Some of them do. Others have come to us through the National Association of State Units on Aging and have expressed an interest in trying to help us clean up the problem.
Ms. MORELLA. Okay. Good. Thank you. I am pleased that you are moving ahead on that, and then, again, we seem to be looking at an area where more needs to be done on demographics.
It seems as though a recent survey of State Units on Aging found that the most commonly cited technical assistance requirement
a repeated theme here. Either the Census Bureau is not giving you and the states the kind of information that they do have
Ms. BERRY. We are working with the Census Bureau.
Ms. MORELLA. -and could share. Maybe you are not asking for it, or maybe there is something else that you should be doing. I wonder if you would explore that.
Ms. BERRY. I must confess that I am not as up on it as I should be. However, we have in the 1991 Discretionary Grants Program some resources to work with the Census Bureau to try to make sure that we have adequate information to show with State officials. We have met with the Census Bureau. We hope to have some information for fiscal year 1992 that will be better than what we had in 1991. This is a real area of concern.
Ms. MORELLA. It seems to me this is a perfect time too, with the census just having been completed; however, Dr. Berry, if you need our assistance, census also comes under the Committee on Post Office and Civil Service
Ms. BERRY. Thank you.
Ms. MORELLA. -on which I serve. I hope that you will let us know if we can help in some way. Thank you, Mr. Chairman. I appreciate that very much.
Chairman ROYBAL. Thank you. The Chair recognizes Mr. Downey for 5 minutes.
Mr. DOWNEY. Thank you, Mr. Chairman. Dr. Berry, it is good to have you here, and I want to commend you on the fine work that you are doing and your extraordinary accessibility. It is a pleasure to work with you.
Ms. BERRY. Thank you.
Mr. DOWNEY. I know I am getting redundant about this, but I can't help myself. What I would like to know is what happened to the 1991 White House Conference on Aging?
Ms. BERRY. The White House Conference has not been called, obviously. I would not say that the conference will not be called. We are currently reviewing all options for a White House Conference on Aging. A planning group has been meeting within the Department so that we are prepared to move forward. We do plan to convene a national advisory committee, I think that is about all I can say at this time. I cannot say that a conference will be held in 1991. Secretary Sullivan has indicated that it is still under consideration, however.
Mr. DOWNEY. Does it have a better chance, do you think, than the Yankees do of winning the World Series? I mean, give me some odds here. I mean, it has been under review for a long time. What is holding it up, do you think? I mean, is it a political problem?
Ms. BERRY. As you know, the conference is authorized. We are used to having one every 10 years. However, the conference is not mandated, and I can't really comment on the delay. I know that everywhere I go it is clearly an issue and a question; I will, certainly, take back to Secretary Sullivan the fact that the Committee has once again raised a concern about the conference and try to get a more definitive response.
Mr. Downey. Yes. I wish you would. I mean, I have also an excellent working relationship with Dr. Sullivan, who I deeply respect and admire, and I just simply can't for the life of me figure
out why we wouldn't want to go ahead with a conference on the aging and deal with some of the important questions that other members of the Education and Labor Committee and the Aging Committee have raised with respect to Alzheimer's—
Ms. BERRY. Yes.
Mr. DOWNEY. -long-term health care, respite care for people who are caregivers, all of those things so it would focus the attention that I think really needs to be focused on under the auspices of a White House Conference. In the meantime, if nothing is going to happen, then maybe we need to think of forcing the Administration to have it, which I hate to have to do; but if that becomes necessary, we would be prepared to.
I have one other question, Dr. Berry, many states contract to Area Agencies on the Aging to perform what are known as case management services. I am sure you are familiar with that, and currently, as I understand it, there are no standards for qualifications required of these case managers, which poses a serious threat to the provisions of the quality of care, And, in addition, there is a tremendous amount of duplication because some of the states require home care agencies to perform case management assessments for conditions of licensure. In effect, you have two entities performing both services. Are you concerned about the inadequately qualified personnel to be performing assessments in preparing case plans, and if you are, what safeguards do you think we could implement to protect these people?
Ms. BERRY. Yes, sir. I am very much concerned about how care is provided in the home, and by whom, and how we assure accountability of services to seniors in the home. We recently convened a meeting here with the Brandeis Resource Center on long-term care to look at how we assure that there are adequately trained persons to deliver services in the home. I will come out shortly with a report related to these issues.
I think that there is more that needs to be done, and I look forward to a dialogue with the State and Area Agencies on this, as well as with the Congress. I think there has always been a dilemma of trying to make sure that there are standards and make sure that there are adequate providers available who can meet the tremendous needs that are there. However, but I think we do have to step back and make sure that there is quality of care provided, so I would agree with you wholeheartedly.
Mr. DOWNEY. Thank you, Dr. Berry. Thank you, Mr. Chairman. Chairman ROYBAL. The Chair recognizes Ms. Snowe.
STATEMENT OF REPRESENTATIVE OLYMPIA J. SNOWE Ms. SNOWE. Thank you, Mr. Chairman. I would ask unanimous consent to include in the record my opening statement.
Chairman ROYBAL. Without objection, it will be ordered.
STATEMENT OF REPRESENTATIVE OL YNMPIA J. SNOWE
Mr. Chairmen, I want to commend you both for holding this
important hearing today on the reauthorization of the older
Americans Act of 1965.
Last year, we celebrated the 25th Anniversary of the older
For a quarter of a century, this landmark
legislation has provided the strength, basic principles and flexibility to affirm the independence of millions of the Nation's older persons. It now provides the only national network of services and programs in local communities throughout the country for a rapidly expanding, and changing, aging population.
Barly last year also, as you may know, the Human Services
Subcommittee of the Select Committee on Aging, of which I am the
Ranking Minority Member, first began holding an extensive series of hearings on the older Americans Act, in anticipation of the
Since than, open dialogue on issues of
concern to the 1991 reauthorization have continued through many
forums, hearings, and discussions here in Congress, in Washington
meetings and in communities throughout the country.
Through this past year, we have taken a hard look at the Act's mission, challenges, and specific programs, as well as resources. As we look ahead, particularly into the next century,
we face dramatic demographic changes in the older population. Will the aging network have the capability to provide needed
services to an escalating frail elder population?
What must we
do now to prepare for that reality?
For the 1991 reauthorization, many issues are budget driven,
especially the question of how to most effectively target the
limited resources of the older Americans Act to older individuals
most in need
particularly low-income minorities.
That is a
major concern of our hearing today and I look forward to hearing
from our witnesses.
I would also like to add that the testimony
from the General Accounting Office which is being presented today
is based on a larger study which I initiated.
Committee's Subcommittee on Human Services, of which I am the
Ranking Minority Member, is planning a more detailed hearing on
that study at a later date.
Ms. SNOWE. Dr. Berry, I would like to welcome you here today as well. It is always good to hear from you and your expertise on issues that are very important to all of us. And I just would like to reiterate what the gentleman from New York, Mr. Downey, indicated about a White House Conference on Aging. I have introduced legislation that will require the President to call a conference in 1993. I do think it is important; so I certainly want it to be on the record where I stand on this issue because it is a good way of identifying the current needs, as well as the future needs of the senior citizens in this country.
First of all, I would like to ask you what do you intend, or perhaps you have already done so, to recommend with respect to costsharing? Have you made recommendations to OMB and to the President for cost-sharing proposals, and for what services if you have made that recommendation?
Ms. BERRY. I would like to be able to say that the Administration's bill is here. It is obviously not, however. It is in process. We have had internal discussions about cost-sharing. We certainly recognize it as a very important issue as you do. I have to mention again the fact that the network officials were very vocal on the fact that they should be permitted the option of providing services on a cost-shared basis. I personally am very attracted to that.
Ms. SNOWE. Do the services on a cost-sharing basis vary from state to state in terms of what they require for cost-sharing? I mean, do they all do it for adult day care and in-home services, or do they go beyond that, to home-delivered meals?
Ms. BERRY. While there are some-- yes. While there is some commonality of cost, there is variability across state lines. And that is one issue among many that we have to look into as we try to move forward with proposals related to cost-sharing. However, I think the point that I made earlier about the low-income and the poor erderly not being adversely affected by cost-sharing programs should be kept in mind.
Chairman MARTINEZ. Would the gentlelady yield on that point? Ms. SNOWE. I would be glad to yield.
Chairman MARTINEZ. You know, I think there is something that the committee has to get clear here, and maybe Dr. Berry can allude to this. Of the 29 states that have cost-sharing, they are dealing with state monies because they can with state money, not with Federal monies. They can do a mandatory cost-sharing, and they are doing it.
Ms. BERRY. Right.
Chairman MARTINEZ. The Federal money is where there is not mandatory cost-sharing. It is done on a voluntary basis where there are only Federal monies; again, I say where there are only Federal monies used. In the congregate meals, they raise $120 million on a voluntary basis, in the in-home care meals they raise $50 million, and then for the in-home care services, they raise another $20 million, but none of those places where they did it on Federal monies were there any information that was other than self-declaration, and I would not want to see a Federal program move to anything other than that.
If the states want to and Mr. Fawell, in several of the hearings, talk about state matching funds, that is the place to do it. If the