Ms. BERRY. Thank you. Chairman ROYBAL. You are an excellent administrator. I appreciate and the Nation does, the things that you do and the decisions you have made, but I think we have to do a little bit more with regard to two issues again: one is cost-sharing and the other is the White House Conference on Aging. I just can't understand why it hasn't been held, it seems to me that no member of this committee can actually explain to their constituency why the White House Conference has just been abandoned, at least temporarily and perhaps forever; we don't know. These are the two things I hope you will take back to the Administration and let them know our concerns, and we will work with you to make things better. MS. BERRY. Thank you. Chairman ROYBAL. May I thank you again, Dr. Berry, and- Chairman ROYBAL. -thank you for your testimony. The Chair will now ask William D. Bechill, Robert York and Michael Mangano to take their respective seats and present their testimony. We will first hear from William D. Bechill who is a former Commissioner of the Administration on Aging. We have heard from the present Commissioner and now would like to hear from a former Commissioner. Mr. Bechill, will you please proceed in any manner you may desire. STATEMENT OF WILLIAM D. BECHILL, SCHOOL OF SOCIAL WORK, UNIVERSITY OF MARYLAND Mr. BECHILL. Thank you very much, Mr. Chairman and members of the committee. I appreciate having a chance to again appear before you on another reauthorization of the Older Americans Act. This is either the eighth or ninth time that I have made an appearance here on reauthorization of the Act since it started in 1965, and I am conscious, Mr. Roybal, of the fact that you were one of the members in the House of Representatives who voted for the original Act by a vote of 391 to 1. Chairman ROYBAL. That is right. Mr. BECHILL. This is an excellent program. Any of us who have been associated with it feel very proud of the progress and achievements that have been made in behalf of older people over the last 26 years through this program. The 1991 reauthorization will be a critical one for the program. I do not recall any time in the history of the Act where there has been as much attention or study given to some of the issues and some of the operations of the Act. This is a tribute, I think, to after 26 years the Act has emerged as a very important piece of legislation, of national policy in behalf of older people. I want to comment, Mr. Chairman, on some of the issues that I will be summarizing. First, I would like to, even though it is not included in the testimony, mention my interest in having a 1991 White House Conference on Aging held. I am not trying to take the Commissioner on Aging off the hook, but you need to know that there are some division in the field as to the usefulness of a White House Conference on Aging. I do not share their views. I think a conference should be held. I think past conferences have always contributed to social policy development in behalf of older people so I support the holding of the conference. I want to comment particularly on the recent decision by Secretary Sullivan to make the Administration on Aging an independent agency. It was a most important step. In my testimony I make reference to the fact that some guarantees should be built into the Act to assure that the Commissioner on Aging does, in fact, have control over the budget and personnel of the Administration on Aging. It is very important for the Commissioner to have that type of autonomy. Title II of the Older Americans Act places a great deal of responsibility and specific functions on the Commissioner by name, and it is very important that the Administration on Aging and the Commissioner have resources. The field of aging is very fortunate to have Dr. Berry as the Commissioner on Aging. She is an extremely competent person, but she does need help to carry out the functions assigned to her, more help than she has at the moment. I mention increased authorizations in funding for Title III. I believe that Title III should have greatly increased authorizations if they are to meet the growing needs of an increasing older population. Title III has become the major delivery system in the nation for the provision of many services for older people. As a result of past Congressional mandates, there is extreme pressure on Title III. There is competition for funds from those interested in supportive services at senior centers, from those interested in congregate and home-delivered nutrition services, from those interested with legal services and other groups, and I believe that the scarcity in the competition for funding especially at the area and state level is what is behind the interest, almost the preoccupation it seems, with such proposals as mandatory cost-sharing and the public/private partnerships put forward by the Administration on Aging. I share Dr. Berry's view that this is-mandatory cost-sharing has become a divisive issue. It is hard for me, as one of the original founders of the National Association of State Units on Aging, to go against the position of that organization, and I recognize the views that State and Area Agencies-have in terms of mandatory cost-sharing, but it is an issue that needs airing and decision making by the Congress on a thoughtful basis. The General Accounting Office has made a report on increasing minority participation. It is an excellent report. It revealed something that a lot of people had expected, that we didn't have an adequate data base for the collecting of information. The recommendations go to directing that deficiency, and I was pleased to hear Dr. Berry speaking to that point. There are many other ways beyond a more adequate data collection system to improve the targeting to increase minority participation. Some of those are underway. There are some excellent statements that have been provided by both the National Association of Area Agencies on Aging and the National Caucus and Center on the Black Aged. I am sure when those organizations present testi mony they will give you some more specific ideas for additional targeting provisions. I want to spend most of the remaining time talking about mandatory cost-sharing. This is an issue that was first advanced in 1983 by the National Council of State Public Welfare Administrators and later became the position of the American Public Welfare Association. It is based on the assumption that in an era of soaring costs of the care of the frail elderly and declining budgets at the state level, and I am using almost word for word their language, the states should have the option of implementing a mandatory cost-sharing for Title III of the Act. It was argued at that time, and I believe this argument is being made today, that this approach would permit much greater coordination of Title III programs with the Title XX Social Services block grant program and Medicaid as well as with other programs such as food stamps serving older persons which are, as you know, means-tested. Those advocating this approach argue that mandatory cost-sharing would result in improved targeting of the lowincome older population including the minority aging. As you may already know, I am strongly against the introduction of mandatory cost-sharing. It would be an abandonment of the intent and philosophy of the Older Americans Act. Mandatory costsharing is not just a significant new way to raise funds in the Title III program. It also implies a shift in the Older Americans Act programs to a highly residual and selective model in which services are basically for certain subgroups of older people. The widespread use of income eligibility forums and assessment will, in my judgment, stigmatize the program in the eyes of older people, and this will result, in my opinion, in reduced participation not only among middle class older persons but low-income seniors as well. It is interesting to note the strong opposition to mandatory costsharing that has been voiced by the National Caucus and Center on the Black Aged. It is their position, a carefully developed one, that mandatory cost-sharing would discourage minority participation in Older Americans Act programs. I agree with their position. The Older Americans Act has worked very well with voluntary contributions. I am unimpressed with the arguments for mandatory cost-sharing. The Older Americans Act has always operated under the assumption that its services would be available to all older persons without eligibility and income reviews as a condition of eligibility. The introduction and implementation of mandatory cost-sharing in the Title III grant program would convert it eventually to a traditional welfare program. I also discuss public/private partnerships. I think this is a very creative idea, and I support going ahead with it because I think this would add to the resources of the field. There can be safeguards, and I know Dr. Berry is aware of that. Her guidelines that went out with the elder care program, spoke to that point. I would like to conclude with two new initiatives very briefly. One is the initiative by the National Association of State Units on Aging calling for a New Title Grant for Elder Rights program. This would be a very significant way of giving more attention particularly to programs like the State Long-Term Care Ombudsman pro gram, the whole problem of elderly abuse, and most important institutionalize a permanent outreach program regarding the Supplemental Security Income, Medicaid, and other related programs. And the second is the proposal made to have a major health promotion and prevention program that would be based at senior centers and other sites. This is a most innovative proposal, one that has been made by the National Council on Aging and its National Institute of Senior Centers. There are over 12,000 senior centers in the Nation, and several would be very appropriate sites for such an operation. Mr. Chairman, this concludes my testimony. Thank you again for inviting me here today. It is always a privilege to appear before this committee, and I would be glad to provide any additional information on any part of the testimony or any part of that Act that you may wish. Chairman ROYBAL. Thank you, Mr. Bechill. [The prepared statement of Mr. Bechill follows:] TESTIMONY OF WILLIAN D. BECHILL School of Social Work, University of Maryland to House Select Committee on Aging and Subcommittee on Human Resources House Education and Labor Committee, House of Representatives on the 1991 REAUTHORIZATION OF THE OLDER AMERICANS ACT April 25, 1991 INTRODUCTION Mr. Chairman, and members of the committee, thank you for this opportunity to again testify on a reauthorization of the Older Americans Act. It is always a privilege to appear before the Congress on legislation pertaining to the future development of the Act. In its twenty-six year history, the Older Americans Act has been amended twelve times. As the result of the many changes made by the Congress since the original law was enacted in 1965, the Act has evolved from one whose initial appropriation was only $7.5 million to one whose total appropriations is now over $1.3 billion. The Act has become a major source of Federal support for a wide 1 |