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agencies are not compromised by any elder care initiatives.
These public-private partnerships will need to be carefully monitored by both the Administration on Aging and through Congressional oversight. There is, as some have expressed, the possibility that the area agencies on aging, in their efforts to develop such income-producing partnerships, will lose sight of the needs of the low-income and minority older populations.
There are two new initiatives which have been made recently by national organizations in the field of aging that have considerable appeal.
The first is the proposal of the National Association of State Units on Aging for a new Title VII-Grant for Elder Rights Programs. Its actual provisions may need some careful drafting since the new title would cover somewhat diverse programs, ranging from the State Long Term Care Ombudsman program, the Prevention of Elderly Abuse program, and a permanent outreach program regarding the Supplemental Security Income, Medicaid, and related programs. There should be particular interest by the Congress in strengthening the State Long Term Care Ombudsman program by complimenting it with one for in-home services as well.
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. The proposal is one that has been proposed by the National Council on the Aging and Its National Institute of Sentor Centers. Its nucleus is already contained in section 361(a) of the Act. This would be a major prevention health services and education program. There are over 12,000 senior centers in the nation, and several of these would be appropriate sites for such a
Mr. Chairman, this concludes my testimony. Thank you again for Inviting me here today. I would be glad to provide additional information on any part of my testimony.
Chairman ROYBAL. The Chair now recognizes Mr. Mangano.
STATEMENT OF MICHAEL MANGANO, DEPUTY INSPECTOR GENERAL, DEPARTMENT OF HEALTH AND HUMAN SERVICES
Mr. MANGANO. Thank you very much, Mr. Chairman. I have with me here today Jack Ferris who is the Assistant Inspector General for Human, Family, and Departmental Services Audits. You have asked us to testify on several of the studies that we have undertaken regarding the Older Americans Act. We are prepared to talk this morning about four of our more important studies.
The Inspector General has overall responsibility for reporting the deficiencies of specific programs within the Department. Consequently, our reports usually contain reviews illustrating problems or potential problems within certain areas. Even though the AoA is deficient in certain areas as highlighted by our testimony, we also believe that overall the AOA has come a long way towards achieving the ideals of its originating legislation under the guidance of Dr. Joyce Berry.
During the past several years, the OIG has evaluated and issued, approximately, 165 audit reports on Older American programs. As a result of this work, we have recommended financial adjustment/ savings of, approximately, $26 million.
Now, I would like to devote the rest of our testimony to 4 of the specific reports in 3 areas that I know are of interest to the subcommittee.
In 1989, we undertook an audit of the reversionary interest of the United States Government in multipurpose senior centers. The Older Americans Act entitles AoA to obtain their financial share of federally funded property when no longer used for intended purposes. We examined three states to determine whether appropriate procedures were in place to protect our investment interest in these properties.
We found that an inadequate management information systems hinders the ability of AoA to ensure that the Federal Government will receive its fair share, that is, the original investment and its share on the increased value, in the event that properties are sold or ceased to be used to provide services to senior citizens.
None of these states had adequate procedures to ensure that our financial interest was fully protected. AoA agreed with our assessment and has issued guidance to the states requiring them to have a system to recover funds when appropriate. Additionally, AOA has instructed its regional offices to ensure required inventories are maintained.
Now, I would like to turn to the topic of discretionary grants. We assessed this process from the perspective of awarding and monitoring. We found that AOA was not always adhering to established policies and procedures for monitoring discretionary grants.
The AoA agreed and has developed a corrective action plan which includes monitoring grantee performance through ongoing evaluation of progress and financial reports submitted quarterly by grantees.
We are also examining the topic of discretionary grants from the perspective of whether successful grant results are effectively being disseminated to other persons in the field as mandated by Title IV.
Our initial findings illustrate that successful grants are not getting out to others in the field. One of the distinguishing characteristics of AoA's discretionary funds program is the wide variety of grantees. The capabilities of these organizations to carry out effective dissemination varies.
The value AoA assigns to dissemination activities has declined, but the requirements on dissemination have become more substantial. Respondents in our study noted a number of problems. Congress withdrew authorization for the agency's own information clearinghouse in 1982, and AOA has not had a staff devoted to dissemination since then. Funding for the Title IV program has been reduced from a high of $54 million in 1980 to $26 million this year.
AoA has tried to maintain a wide range of dissemination activities. However, we believe greater emphasis needs to be given to this function since the dissemination of good, efficient, and effective programs benefits everyone in the long run.
Before closing, I would like to present our findings on a fourth report we believe is of interest to the committee. 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 interviewed over 160 recipients who are currently cost-sharing for their in-home and adult care services. Nearly 90 percent of the recipients considered it fair that they have to pay something for the services they receive, and 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 recipient share based on self-declared income of the recipient. State and local officials we interviewed from cost-sharing states say money from recipients of the adult day care and in-home services helps expand their programs to serve more recipients. More than three quarters feel positively about the cost-sharing feature of community service programs funded by their states.
Ninety percent support cost-sharing for adult day care and inhome services under Title III, and 73 percent support cost-sharing for other Title III services such as transportation, legal services, and home-delivered meals. Even state and local officials in the noncost-sharing states we sampled share this view.
Before concluding, we would like to say that our work plan includes items for future years like a study we have underway for the ombudsman program and other studies that will look at, nutrition and elderly abuse, integration of departmental services, services provided by Area Agencies on Aging, and Area Agencies on Aging coordination with hospital discharge planners.
Thank you very much, Mr. Chairman, and that concludes my testimony. Whenever appropriate, we will be happy to answer any questions.
Chairman ROYBAL. Thank you.
GOOD MORNING, MR. CHAIRMAN AND MEMBERS OF THE SUBCOMMITTEE, I AM MICHAEL MANGANO, DEPUTY INSPECTOR GENERAL FOR THE DEPARTMENT OF HEALTH AND
HUMAN SERVICES. WITH ME TODAY, IS JACK FERRIS, ASSISTANT INSPECTOR GENERAL
FOR HUMAN, FAMILY AND DEPARTMENT SERVICES AUDITS WITHIN THE OFFICE OF INSPECTOR GENERAL YOU HAVE ASKED US TO TESTIFY ON SEVERAL STUDIES WE HAVE UNDERTAKEN WITH REGARD TO THE OLDER AMERICANS ACT WHICH IS NOW UP FOR
REAUTHORIZATION. WE HAVE DONE REPORTS ON SEVERAL ASPECTS OF THIS PROGRAM,
BUT TODAY, WE WOULD LIKE TO PRESENT TO YOU POUR OF OUR MOST IMPORTANT
THE MISSION OF THE OFFICE OF INSPECTOR GENERAL (OIG) IS TO PROVIDE ASSISTANCE TO THE VARIOUS DIVISIONS OF THE DEPARTMENT, INCLUDING THE ADMINISTRATION ON AGING (AOA). IN THIS CAPACITY, WE
0 CONDUCT AND SUPERVISE AUDITS, INVESTIGATIONS AND
FINANCIAL INTEGRITY ACT (FMFIA) WHICH REQUIRES THAT