Images de page

range of community, social, nutrition, and employment opportunities for older persons in our nation. From the beginning, the Act also has had the intent of assisting all older persons, regardless of their income, health, or place of residence, to be active, self-sufficient, and independent. The Title 1 objectives of the Act are 11terally a B111 of Rights for all Older Americans, a unique statement of social policy and commitment.

Also, the Act has always featured the involvement of all levels of government. Since the milestone 1973 Amendments to the Act especially, there has been the emergence of an "aging network" that involves all levels of government, literally hundreds of community agencies and organizations, representing older persons, the various professions, and voluntary organizations who have interests in the needs and interests of the older population. The "network" is visible. It includes the various state units on aging, area agencies on aging, thousands of senior centers, thousands of nutrition sites, and the programs and services carried in behalf of Native Americans and the excellent Title V employment program for low-income older persons.

This 1991 reauthorization will be a critical one. Various committees of the House and Senate have been collecting data and studying various issues and matters of concern regarding the present operations of the Act. This seems to be especially the case with the title II functions regarding the role of the Commissioner on Aging, the Title III grant program, and the Title IV research and training grant program. In the time given to me today, I would 11ke to briefly comment on some of these issues. I hope these remarks will be helpful to you in your work on the 1991 reauthorization.

A. Extension of the Act

I strongly support the reauthorization of the Act and all of its titles for either a three year or four year period. If major changes are made in the Act, a three year reauthorization might be in order. Either a three year or four year authorization would symbolize the strong support of the Congress for the Older Americans Act program.

B. Role of the Commissioner and the Administration on Aging

The recent decision by HHS Secretary Sullivan to make the Administration on Aging an independent agency again in the office of the Secretary is a most important one. But, I would urge the Congress to add to it by including a provision in Title II of the Act that would require the Commissioner on Aging to have the control over the budget and personnel of the Administration on Aging clearly and unequivocally. In addition, it is time to support a major strengthening of the staff and resources of the Administration on Aging if it is to function as a strong advocate for older people and as a source of technical assistance and direction to all of the public and private agencies involved in the administration of the Older Americans Act programs.

The field of aging is very fortunate to have Dr. Joyce Berry as the Commissioner on Aging. She is extremely competent, but Commissioner Berry needs more help to carry out fully all the functions assigned to the Commissioner under the Act's Title II provisions.

Increased Authorizations and Funding for Title III

The Title III grant program should have greatly increased authorizations and funding if it is to meet the growing demands being placed upon it to meet the

needs of an increasing older population. As presently constituted, Title III has become the major delivery system in the nation for the provision of many social and nutrition services for older persons. As the result of both past Congressional mandates in previous amendments to the Older Americans Act and the present stringent budget situation, the Title III grant program 1s under extreme pressure. There is competition for its funds from those interested in supportive services and senior centers, from those interested in congregate and homedelivered nutrition services, from those concerned with legal services for the aging, and, from those concerned with the needs of the developmentally disabled aging, the minority aging, and with such serious problems as elder abuse and neglect. I believe the scarcity of funding, especially at the area and state level, is what is behind the interest, almost the preoccupation 1t seemed, with such proposals as mandatory cost-sharing and the publ1c-private partnerships put forward by the Administration on Aging.

Increasing Minority Participation

Mr. Chairman, the General Accounting Office has just completed a comprehensive report on minority participation in the act. The GAO made several constructive recommendations, most notably the development of a more adequate data base for the collection of information on minority participation in the Title III program.

But, other steps are needed to help the aging "network" reach the objectives in the Act for the participation of the low income minority population. Either by regulation or by language in the Act, state units on aging and area agencies on aging should be required to provide technical assistance to minority service providers, utilize the services of HBCUs and other minority agencies in the field

of aging in the development of area and state plans for various Title III services and carry out continuing outreach programs to low income minority populations as part of an approved area and state plan of services.

Both the National Association of Area Agencies on Aging and the National Caucus and Center on Black Aged have produced excellent reports and recommendations in this area that should be consulted in the development of any new targeting provisions.

Mandatory Cost-Sharing

Once again, mandatory cost sharing for Title III Supportive and Nutrition Services has been proposed by the National Association of State Units on Aging. This 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 care of the frail elderly and declining budgets at the state level, the States should have the option of implementing a mandatory cost-sharing program for Title III of the Act. It is argued that this approach would permit much eater coordination of Title III programs with the Title XX Social Service block grant program and Medicaid as well as with other programs serving older persons which are means-tested. Those advocating this approach also argue that mandatory costsharing would result in improved targeting of the low income 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 cost-sharing is not just a significant new way to raise funds in the title III program. It also implies a shift in OAA programs to

a highly residual and selective models in which services are basically for certain sub-groups of older persons. The widespread use of income eligibility forms and assessment will stigmatize the program in the eyes of older people. And this will result, in my opinion, in reduced participation rates not only among middle-class older persons, but low-income seniors as well.

It is interesting to note the strong opposition to mandatory cost-sharing 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.

The Older Americans Act has worked well with voluntary contributions. I am un impressed 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 ili grant would convert it eventually to a traditional "welfare"


Public-Private Partnerships

The public-private partnerships being carried out by the "aging network" with private non-profit organizations requires careful attention by the Congress.

I do feel that there is considerable potential here. The "elder-care" initiative started recently by the Administration on Aging is an interesting innovation, and one that clearly is designed to increase the involvement and participation of the private for profit sector in developing various "elder-care" programs. Also, the Administration on Aging has issued guidelines that are designed to assure that the major statutory missions of the state and area

« PrécédentContinuer »