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PROGRAMS BENEFITS EVERYONE IN THE LONG RUN. WE HAVE SENT THE DRAFT REPORT CONTAINING OUR FINDINGS ON DISSEMINATION TO AOA FOR THEIR REVIEW AND
BEFORE CLOSING, I WOULD LIKE TO PRESENT OUR FINDINGS ON A FOURTH REPORT
THAT WE BELIEVE IS OF INTEREST TO THE SUBCOMMITTEE WE RECENTLY UNDERTOOK
A STUDY TO ASSESS THE EXPERIENCE OF STATE PROGRAMS FOR THE ELDERLY WHICH PROVIDE IN-HOME AND ADULT DAY CARE SERVICES ON A COST SHARING BASIS.
WE SELECTED EIGHT STATES WITH COST SHARING PROGRAMS IN PLACE AND FOUR STATES WITH OUT SUCH PROGRAMS. WE INTERVIEWED OVER 160 RECIPIENTS WHO ARE
CURRENTLY COST-SHARING FOR THEIR IN-HOME AND ADULT DAY CARE SERVICES IN
THE COST-SHARING STATES WE SELECTED. NEARLY 90 PERCENT OF THE RECIPIENTS INTERVIEWED CONSIDER IT FAIR THAT THEY HAVE TO PAY SOMETHING FOR THE SERVICES THEY RECEIVE. IN ADDITION, OVER 90 PERCENT OF THE RECIPIENTS WE INTERVIEWED REPORTED THAT THE SERVICES THEY RECEIVE ARE WORTH WHAT THEY PAY FOR THEM.
RECIPIENTS WERE ALSO SATISFIED WITH THE AMOUNT OF MONEY THEY WERE EXPECTED TO PAY AND WITH THE WAY THEIR SHARE WAS CALCULATED. TYPICALLY, INCOME RELATED SLIDING FEE SCALES ARE USED TO DETERMINE A RECIPIENTS SHARE, BASED ON SELF-DECLARED INCOME OF THE RECIPIENT. FEW RECIPIENTS FOUND IT A HARDSHIP TO PAY THEIR SHARE, AND MOST SAID THAT PROVIDERS HAD TAKEN THEIR FINANCIAL CIRCUMSTANCES INTO ACCOUNT AND HAVE MADE EVERY EFFORT TO PROVIDE NEEDED
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.
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
- AREA AGENCIES ON AGING COORDINATION WITH HOSPITAL DISCHARGE
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 Wr. York. STATEMENT OF ROBERT L YORK, ACTING DIRECTOR FOR PRO
GRAM EVALCATION IN HUMAN SERVICE AREAS. C.S. GENERAL ACCOCNTING OFFICE, PROGRAM EVALLATION AND METHOD OLOGY DIVISION
Mr. York. Thank you, Mr. Chairman. With me today at the table is Sushil Sharma, and also Patrick Grasso and dian 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 the data that are available to assess the effectiveness of targeting efforts, what technical assistance on targeting sot provides the State Cuits on Aging, and 3) the extent of unmet technical assistance needs of State Cmts with regard to targeting. Your request that we examine the organizational placement of sot within the Office of Human Deveiopment 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 ow-income minority persong, 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 impossibie to determine minority participation rates in Older Americans Act programs. tatil these problems are resolved, the Congress will lack key policy information such as whether minority participatica 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 AA-related providers of technical assistance, all 10 AoA regional offices, and all Il 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 AA services to those elderly persons with the greatest social or economie needs and lowincome minority older persons have created a variety of technical assistance needs. Most of the regional offices and the national re source 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 se rious 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.