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Unmet Needs That Represent Serious concerns

We also asked state unit officials to identify which of their unmet needs for overall technical assistance represent regulations pertaining to targeting, this issue has been a major focus of recent amendments to older Americans Act and AOA

serious concerns for them.

The respondents most frequently

identified technical assistance for targeting, with 32 percent

of the state unit officials identifying targeting issues. Specifically, they indicated a need for more technical assistance on outreach initiatives to low income and minority

elders, on demographic data, and on how to perform needs


Another unmet need that represented a serious concern,

was for technical assistance regarding data collection.

Twenty-eight percent of the state unit officials specifically

identified this unmet need.

In addition, some expressed a

specific need for technical assistance on how to develop and/or implement computerized data collection systems. As I mentioned earlier, without accurate data on participation in older Americans Act programs, it is not possible to determine the effectiveness of targeting initiatives.

Sixteen percent of the state unit officials indicated that

they have a serious unmet need for technical assistance in

interpreting legislation, policies, and regulations.

While the

respondents did not necessarily specify legislation and


Finally, 10 percent of the state unit officials noted a

serious unmet need for technical assistance in monitoring plans

and contracts, and assuring compliance with laws and

regulations by area agencies and service providers.

They also

mentioned a need for regional offices to provide more monitoring. Again, while they did not specifically mention monitoring of targeting mandates, we believe this unmet need is relevant to targeting. It is in their plans that area agencies

specify how they intend to meet the needs of those elderly individuals they have identified for targeting. State units

that are able to monitor the area plans effectively can provide

more technical assistance on targeting to those area agencies

that are not meeting their targeting goals.

Although it is evident that state units on aging have unmet needs for technical assistance on targeting, some of which represent serious concerns, we recognize that an obstacle to the provision of technical assistance is the paucity of staff at AOA's regional offices. Regional offices have approximately 7 to 8 staff, with limited funds for training. This means that regional office personnel are constrained in their ability to develop the necessary expertise for the provision of technical assistance.

Moreover, AOA has

limited travel funds to allow regional office staff to visit

states and provide hands-on technical assistance.



You also asked us to examine the ability of AOA to

administer Older Americans Act programs under the current

organizational structure within the office of Human Development

Services of the Department of Health and Human Services. As you know, the Department of Health and Human Services recently announced that it is merging most programs administered by the

Office of Human Development Services into the new

Administration for Children and Families, but that AOA will not

be included in this reorganization. Rather, the Commissioner

on Aging will report directly to the Secretary. Because we do not yet know the precise nature of this arrangement, it would be premature for us to comment on this development at today's



As a result of our study of the technical assistance that

AOA provides to state units on aging, we have focused on

several issues.

First, in order for state units and area

agencies on aging to evaluate the effectiveness of their

targeting strategies, they must have a sound methodology to ensure that they can collect accurate data on the participation

rates of targeted populations in older American Act programs. However, as I have already noted, there are major unresolved problems in AOA's data collection methodology. Therefore, AOA cannot currently assess the effectiveness of targeting initiatives.

Second, for state units to identify the number of elderly persons with the greatest social or economic needs, as well as

elderly minorities, they must have access to census data on the geographic distribution of elderly persons in their state or planning and service areas. Currently, such information is

neither readily accessible to state units and area agencies nor

is it up-to-date.

As many state unit officials indicated in

our survey, they continue to have unmet needs for such


Third, in order to develop methods to target those elderly

persons with the greatest social or economic needs and minority elderly persons, our survey indicated that many state units

need more technical assistance.

Specifically, state unit

officials noted serious concerns about their unmet needs for

technical assistance in the areas of needs assessments, outreach initiatives, federal laws and regulations, and the

monitoring of area plans and service providers. These needs exist in spite of the fact that most of the regional offices and the national resource centers reported that they provide a

great or very great deal of technical assistance for targeting.

Fourth, despite the manifest need, AOA appears to lack adequate staff, as well as travel and training funds, to provide such

technical assistance.


Based on the results of our ongoing work (and as we stated in our previous testimony), we recommend that the Commissioner on Aging take steps to (1) modify the current data collection instrument and methodology to ensure accurate participation data related to programs and services authorized under the older Americans Act, and (2) develop specific standards for the data input to computer systems currently being used or

contemplated by the states so that the information generated

can be compared across states.

We also recommend the

Commissioner on Aging take steps to (3) acquire from the U.S.

Census Bureau the necessary demographic/census information to

be used by the state units and area agencies to identify and

target elderly populations in their respective geographic

areas, and (4) identify those state units that continue to have

serious unmet needs for technical assistance for targeting, and

then provide those agencies with the necessary assistance.

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