Images de page
PDF
ePub

that goes from the Hospital of Saint Raphael into the community in a station somewhere, and they are actually really almost going door to door looking for people. What kinds of processes are you talking about?

Ms. BERRY. Well, State Agencies are to provide an assurance that preference will be given to those with the greatest economic and social need with particular attention to the low-income minority. MS. DELAURO. Yes.

MS. BERRY. The States, as they try to implement this provision of the Act, have been innovative in their procedures. The Administration on Aging has funded four national aging minority organizations over a number of years to provide technical assistance.

We also have a resource center on minority aging that is providing technical assistance, offering information in terms of targeting of services; but I think we do have to pay more attention to the Title III intrastate funding formula. As the dollars go out to communities in the State, we have to make sure that those dollars are, in fact, going to the places where there are greatest concentrations of minority individuals and those who are economically and socially needy as well.

MS. DELAURO. Pardon me, maybe it is a naive question: In terms of your own jurisdiction over that intrastate funding and monitoring, just tell me what that is?

Ms. BERRY. At the moment I have review and comment authority on Title III intra-state formulas.

MS. DELAURO. Okay.

Ms. BERRY. And many of our forum participants clearly expressed the interest in the Commission on Aging having actual approval authority over the intra-state formulas.

MS. DELAURO. Okay. Thank you.

Chairman ROYBAL. Mr. Nichols.

Mr. NICHOLS. Madam Commissioner, I would like to ask you a question a little different, but I think it is something you have an interest, I have heard. We are always looking for money; and when I dealt with these issues at the state level, one of the things I found was that about 30 to 40 percent of the people, sometimes higher, that they were putting in the nursing homes didn't really need to be there; and after they were in there about four months, they got public assistance generally because all their assets were gone, and so we picked them up.

And we tried to start a program called Elder Care with Options which is more of an in-home health care that would attempt to try to keep people more cost effectively in an environment that they are healthier in at a less cost by providing some of these services to them in that environment. But when you look at these proposals, do you have any studies going on that could impact this type of Older Americans Act with that type of program in encouraging states to conserve resources by doing it because these generally are middle income people that we force into poverty and force under the public rolls which cost us even more? Do you share that concern, and how do we work with that?

MS. BERRY. Yes. You have touched on an issue that is critical in the provision of services to older people. It is probably one of the most important issues in the field of aging right now. That is how

do we provide services to the growing numbers of older people who are at risk of becoming totally dependent. Furthermore, we know that older people want to stay in the community.

We have funded six long-term care resource centers that are looking at a number of issues related to the whole matter of the provision of services in the community. We have a center that is trying to link our network with hospitals and residential long-term care facilities. We are trying at another center to improve some of the decisions that are made by families that impact on the care provided to seniors.

We also have another center that is looking at how we can shore up our community-based systems of care. I agree with you wholeheartedly. I think that the whole matter of in-home and community-based services is key to the Act. We have a clear mandate to keep older people in the community for as long as possible. I think, quite frankly, that the whole notion of doing business differently will help us in reaching out to some of the institutions that traditionally have not been involved in helping provide some of that

care.

For example, some of the religious institutions, have offered to provide care, as well as some of the voluntary organizations, such as the Red Cross and the Salvation Army. I am asking the network to be more creative and to step up its efforts to link up with some of these organizations to address home and community-based care needs.

We know that the home-delivered meals program is critical. There are many transfers of resources from the congregate program to the home-delivered program. In fiscal year 1990 a total of $36 million was transferred to the home-delivered meals program from congregate meals. These transfers increased home delivered meals resources by 41 percent.

Mr. NICHOLS. If I may, do you have any idea why there has been a reluctance for states to move more rapidly into this area? It would seem to me that it is much more cost effective, it is much healthier, but there has been a resistance to providing the network.

MS. BERRY. Well, actually, the States have taken a leadership role in trying to set up creative financing mechanisms to keep older people in the home and in the community. The State of Pennsylvania, for example, has a State lottery which, in fact, is targeted to help the vulnerable elderly. There are many other creative programs across the country where the State directors have set up measures to prevent institutionalization of older people. I think it is to the State's credit that less than 5 percent of our seniors are in institutions.

The concern is that there are many seniors who are in their homes who do need home repair, who entered public housing facilities at 60 and are now 80 and who do need the support of services. At the national level, I personally can exercise my authority under Title II of the Older Americans Act by trying to get other Federal agencies, like the Department of Housing and Urban Development, to work with aging network officials as they try to strengthen the community-based system of services.

Mr. NICHOLS. While I have you, I will ask one last question. I hope that someday we can figure out a way for the middle income

family in diseases such as Alzheimer's that we don't destroy that family by taking all their assets before we will help that family either at a state level or a Federal level; and to date, as far as I can tell, we don't have that, and I think that is a big problem. The catastrophic problems such as that when you have to tell someone who has been married for 40, 50 years that the only way they can preserve any assets between that family is to get a divorce when there is an Alzheimer's patient in there is not in the best interests of this society and mine. You and I hope someday we can find that solution. Thank you. Thank you.

Chairman ROYBAL. Thank you. The Chair now recognizes Ms. Morella.

STATEMENT OF REPRESENTATIVE CONSTANCE A. MORELLA Ms. MORELLA. Thank you, Mr. Chairman. I appreciate your calling for this meeting, Chairman Roybal, and I appreciate the chairman of the Subcommittee on Human Resources of the Committee on Education and Labor, Chairman Martinez, for calling for it. I think it is very important.

Dr. Berry, it is always great to have you before us as an expert, and we appreciate your commitment to the aging. Mr. Chairman, may I ask unanimous consent that my opening statement be put into the record?

Chairman ROYBAL. Without objection, it will be ordered. [The prepared statement of Ms. Morella follows:]

Opening Statement, Joint Hearing on the Reauthorization of the Older

Americans Act

April 25, 1991

The Honorable Constance A. Morella

Mr. Chairman, I want to thank you and the Chairman of the Subcommittee on Human Resources of the Committee on Education and Labor, Mr. Martinez, for convening this morning's hearing on the crucial subject of the future of the Older Americans Act. As we prepare to reauthorize what is truly a landmark piece of legislation, it is fitting that we pause to examine ways in which we can build upon the Act's accomplishments and strengthen its services for millions of older Americans.

Several issues are of special interest to me as we discuss possible revisions in the Older Americans Act. In particular, I am pleased to see that our committees will be focusing on the scope of minority participation in services offered by the Act. It is believed that minority participation suffered a significant decrease in the mid 1980s, although it has apparently taken an upturn in recent years. It is vital that we in the Congress examine the reasons for which this reduction occurred, and adjust the Act so as to insure that minority seniors continue to be served according to their needs. With this in mind, we need to review and possibly refine minority targeting programs under the Act so that African-Americans, Hispanic-Americans, Native-Americans, and other receive the OAA benefits to which they are entitled.

The issue of minority participation is closely linked to the problem of

data collection. Without an accurate accounting of who is being served under the Act, it is extremely difficult to fashion effective improvements in the law. Of course, there are significant logistical difficulties involved in mass data collection, and Congress must do whatever it can to assist the Administration on Aging in the performance of this crucial function. I look forward to hearing Dr. Berry's suggestions in this regard.

Finally, the idea of cost-sharing is one which has received a great deal

of attention in recent months, and one which will certainly be discussed by our witnesses this morning. It is my belief that any proposals in this area must respect the fundamental and critical goal of the Act that of providing vital nutritional, vocational, and other assistance for any older American who needs them. If cost-sharing significantly compromises the quality and breadth of services available under the Older Americans Act, its implementation could be a disservice to our nation's elderly.

On this and a variety of issues, I look forward to hearing the views of our distinguished guests, Mr. Flemming, Dr. Berry, Mr. Kusserow, Mr. York, and Mr. Bechill. Your input is very valuable as we tackle the reauthorization of the Older Americans Act, and I thank both distinguished Chairmen for providing us with the opportunity to discuss the Act with you this morning.

« PrécédentContinuer »