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CONTENTS

MEMBERS' OPENING STATEMENTS

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Chairman Edward R. Roybal..
Chairman Matthew G. Martinez.
Harris H. Fawell..
James H. Bilbray ........
Bill Barrett ...................
Bill Richardson ..........
Dick Nichols..............
Nita M. Lowey ..................
David L. Hobson ..........
Thomas J. Downey ......
Sherwood L. Boehlert..
Rosa L. DeLauro.....
Gary A. Franks...
Louise M. Slaughter.
Wayne Owens ..
Jerry F. Costello.
John Paul Hammerschmidt..
Constance A. Morella ......................................................................
Olympia J. Snowe ..........

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CHRONOLOGICAL LIST OF WITNESSES
Joyce T. Berry, Ph.D., U.S. Commissioner on Aging, Administration on Aging.
William D. Bechill, School of Social Work, University of Maryland .........
Michael Mangano, Deputy Inspector General, Department of Health and

Human Services............
Robert L. York, Acting Director for Program Evaluation in Human Service

Areas, U.S. General Accounting Office, Program Evaluation and Methodolo
gy Division ....

......

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APPENDIX
Additional material received for the record:

Letter from Canyon County Organization on Aging, Inc., Cadwell, Idaho,

Margaret Langan, Executive Director...............
Testimony of The American Association of Homes for the Aging, Inc.,
Washington, DC..........

PROPOSED CHANGES TO THE OLDER AMERICANS ACT: IMPACT ON PARTICIPATION AND SERVICE DELIVERY

THURSDAY, APRIL 25, 1991

U.S. HOUSE OF REPRESENTATIVES, SELECT COMMITTEE ON
AGING, JOINT WITHSUBCOMMITTEE ON HUMAN RE-
SOURCES, COMMITTEE ON EDUCATION AND LABOR,

Washington, DC. The joint hearing met, pursuant to call, at 9:30 a.m., in Room 2175, Rayburn House Office Building, Hon. Edward R. Roybal (chairman of the Select Committee on Aging) and Hon. Matthew J. Martinez (chairman of the Subcommittee on Human Resources of the Committee on Education an Labor) presiding.

Members present: Select Committee on Aging: Representatives Roybal, Downey, Richardson, Stallings, Bilbray, Pallone, DeLauro, Snowe, Boehlert, Fawell, Morella, Franks, Hobson, Nichols, Nussle, Barrett. Subcommittee on Human Resources: Martinez, Lowey.

Staff present: Select Committee on Aging: Richard Veloz, Staff Director; Paul Ceja, Counsel; Mary Hanlon and Jose Vazquez, Professional Staff Members; Kathy Desmond, Staff Assistant. Subcommittee on Human Resources: Eric Jensen, Staff Director; Dan Adcock, Legislative Assistant; Roger McClellan, Legislative Assistant; Jennifer Amstutz, Staff Assistant. Minority Staff present: Mary Ann Chaffee, Professional Staff Member.

OPENING STATEMENT OF CHAIRMAN EDWARD R. ROYBAL Chairman ROYBAL. The committee will come to order. Ladies and gentlemen, this is a joint hearing of the Education and Labor Subcommittee on Human Resources and the Select Committee on Aging. I am joined today by the Chairman of that subcommittee, Mr. Martinez, as well as two past commissioners, one of them a former secretary of HEW.

Today's hearing, will focus on a very important subject, the reauthorization of the Older Americans Act, and we will examine some of the major issues facing reauthorization. We will have a very qualified group of witnesses including the present Commissioner on Aging and the first Commissioner on Aging. The comments of these individuals who know the Act so well, and who understand the history and intent of the Act, should not only prove interesting but very beneficial.

As we enter the last decade of the 20th century, we are very much aware of the fact that the elderly population is growing rapidly. This understanding, however, in many areas is not translated

into action, and that is what we would like to examine in this hearing: Why is it not being translated into real action?

Whatever we provide at the present time is done in a fashion which promotes independence and dignity to the elderly with the respect for all they have continued to do for our society.

Unfortunately, the Older Americans Act, in my opinion, is sorely underfunded, leaving many elderly in their homes, isolated and often in life-threatening situations. It has been shown over and over again what a difference the Older Americans Act program can make in the lives of many senior citizens. This translates into a reduction at the present time of 27 percent of real dollars since 1980. In other words, the funding that has been available under the Older Americans Act continues to be at the same level, and if you translate that into what it means in 1980 dollars, it means a reduction of 27 percent.

Today as we focus on the reauthorization of the Act, we are interested in developing ways and means to better serve the elderly: to serve more elderly and to enhance the services and the programs provided in the Act.

To this end, we will discuss the needs, and then we will go on and discuss the ability of the Act to successfully accomplish its legislative mandate of serving the elderly in the best manner. Ladies and gentlemen, this is going to be a very interesting hearing, but may I say that without the testimony that we will hear today, we would be unable to make the proper recommendations.

The experts who will appear today and the members of the committee that know this Act so well will work together to bring about a better atmosphere. We hope that what is recommended, will be passed by the Congress of the United States and signed by the President. That signature by the President is the most important thing that one can get in any Act passed by the Congress. May I now yield to my co-chairman, Mr. Martinez.

[The prepared statement of Mr. Roybal follows:]

OPENING STATEMENT OF CONGRESSMAN ROYBAL

"Proposed changes to the older Americans Act:
Impact on Participation and Service Delivery"

Thursday, April 25, 1991, 9:30 a.m.

2175 Rayburn HOB

AS CHAIRMAN OF THE SELECT COMMITTEE ON AGING, I AM PLEASED TO HOLD THIS IMPORTANT HEARING ON THE REAUTHORIZATION OF THE OLDER AMERICANS ACT. TODAY WE WILL EXAMINE SOME OF THE MAJOR ISSUES FACING REAUTHORIZATION. WE HAVE A VERY QUALIFIED GROUP OF WITNESSES INCLUDING THE PRESENT COMMISSIONER ON AGING, THE FIRST COMMISSIONER ON AGING, AND A WITNESS WHO HAS BEEN BOTH SECRETARY OF HEALTH, EDUCATION AND WELFARE AND COMMISSIONER ON AGING. THE COMMENTS OF THESE INDIVIDUALS WHO KNOW THE ACT SO WELL, AND WHO UNDERSTAND THE HISTORY AND INTENT OF THE ACT, SHOULD PROVE TO BE VERY INTERESTING.

AS WE ENTER THE LAST DECADE OF THE TWENTIETH (20TH CENTURY, WE ARE VERY AWARE OF THE GROWING ELDERLY POPULATION. THE ELDERLY ARE THE FASTEST GROWING SEGMENT OF THE POPULATION. THIS UNDERSTANDING HOWEVER IN MANY AREAS IS NOT TRANSLATING INTO ACTION.

THE OLDER AMERICANS ACT IS OUR PRIMARY VEHICLE FOR SERVICES TO THE ELDERLY TO PROVIDE MEALS, IN-HOME SERVICES, AND JOBS FOR LOW-INCOME ELDERLY.

ALL OF THIS IS DONE IN A FASHION WHICH PROMOTES THE INDEPENDENCE, AND DIGNITY OF THE ELDERLY, WITH THE RESPECT FOR ALL THEY HAVE CONTRIBUTED TO OUR SOCIETY. THESE PROGRAMS BECOME AN INTEGRAL AND FULFILLING PART OF THEIR LIVES AND MANY TIMES BECOME THE VEHICLE FOR THEIR CONTINUED SERVICE TO SOCIETY.

UNFORTUNATELY, THE OLDER AMERICANS ACT IS SORELY UNDER-FUNDED LEAVING MANY ELDERLY IN THEIR HOMES, ISOLATED, AND OFTEN IN LIFE THREATENING SITUATIONS. IT HAS BEEN SHOWN OVER AND OVER AGAIN WHAT A DIFFERENCE THE OLDER AMERICANS ACT PROGRAMS CAN MAKE. HOWEVER, THE ACT HAS RECEIVED LEVEL FUNDING THROUGHOUT THE EIGHTIES. THIS TRANSLATES INTO A 27% REDUCTION IN REAL DOLLARS SINCE 1980. SO, AS OUR ELDERLY POPULATION GROWS, THEIR UNMET NEEDS GROW, THEY BECOME OLDER AND MORE FRAIL, BUT THE SERVICES WE ARE MAKING AVAILABLE TO THEM ARE DECREASING!

TODAY AS WE FOCUS ON THE REAUTHORIZATION OF THE ACT, WE ARE INTERESTED IN DEVELOPING WAYS TO BETTER SERVE THE ELDERLY. TO SERVE MORE ELDERLY AND TO ENHANCE THE SERVICES AND THE PROGRAMS PROVIDED FOR IN THE ACT.

TO THIS END, WE WILL DISCUSS:

* FIRST, THE NEEDS AND THE ABILITY OF THE ACT TO SUCCESSFULLY ACCOMPLISH ITS LEGISLATIVE MANDATE OF SERVING THOSE MOST IN NEED -THE LOW-INCOME AND MINORITY ELDERLY. WHILE SOME AREAS ARE DOING WELL AT SERVING THE MOST NEEDY, OTHERS ARE NOT. SEVERAL ISSUES SUCH AS TARGETING DATA COLLECTION, AND TECHNICAL ASSISTANCE WILL BE EXAMINED TO UNDERSTAND HOW BEST TO IMPROVE THE ABILITY OF THE ACT TO SERVE THOSE MOST IN NEED.

SECOND, WE WILL REVIEW THE ADMINISTRATION OF THE ACT. REAUTHORIZATION PROVIDES US WITH AN OPPORTUNITY TO EXAMINE THE CURRENT STRUCTURE AND ORGANIZATION OF THE ADMINISTRATION. PERHAPS LIGHT CAN BE SHED ON THE SIGNIFICANT CHANGES WHICH WERE RECENTLY MADE BY THE SECRETARY OF HEALTH AND HUMAN SERVICES (HHS). ADDITIONALLY, WE NEED TO LOOK CLOSELY AT THE FEDERAL PARTICIPATION IN ADMINISTERING THE PROGRAMS UNDER THE ACT, AND FOLLOWING UP ON HOW WELL THE PROGRAMS ARE MEETING THE NEEDS OF THE OLDER AMERICANS:

FINALLY, SOME PROPOSALS HAVE CALLED INTO QUESTION THE ENTIRE CHARACTER OF THE ACT. WE WILL EXAMINE THE FUNDING NEEDS OF THE ACT AND THE FUTURE STRUCTURE FOR MEETING THE NEEDS OF THE ELDERLY, ESPECIALLY THE LOW-INCOME AND MINORITY ELDERLY.

I LOOK FORWARD TO HEARING FROM TODAY'S WITNESSES. IT IS MY HOPE THAT TODAY'S HEARING WILL PROVIDE A VALUABLE CONTRIBUTION TO THE REAUTHORIZATION PROCESS, AND LEAD TO A STRONGER OLDER AMERICANS ACT IN THE FUTURE.

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