Plans for the future direction of the Nutrition Program are contingent upon what unfortunately are a series of outside factors that will impact on any changes made in the Older Americans Act itself, including the restructuring of the emphasis on the kinds and methods of services delivery.

In addition, there is discussion regarding what funding mechanism will be used for OAA Programs. Any changes in which would greatly impact on how dollars would be made available for such services, with consequent changes in the mandates of how such services would be provided, at both the state and local level. The concern from the Nutrition Services perspective is that there be retained the level of Nutrition Services presently existing, with appropriate consideration allowing for future growth, both in terms of numbers of participants to be served, as well as the funding levels specifically awarded for the financial support of said services.

There must also be a protection built in to assure the historic, philosophic and congressional intent of the Nutrition Program for the Elderly is not lost, reduced or fragmented.

As the number of older persons in the country continues to increase both in terms of total numbers, and in the percentage of the total population, we will be faced with even greater demands for elderly services.

The Nutrition Services should continue to be that integral part of any services plan, be it for keeping well people well, as part of a continuum of care, or as a component in a long term care dimension of service systems delivery.

An extremely complex, demanding challenging task is at hand. With limited resources, limited facilities, limited staff, meeting the increased needs will require new, innovative solutions to be found in places not yet explored.

In terms of the specific issues to be considered, the following positions have been developed:

1. Position of the Commissioner and the Administration on Aging within the Dept. of Health and Human Services. (See attachment.)

2. Position on reauthorization of the Older American Act. (See attachment.) 3. Additionally, the following concerns regarding consolidation and the reauthorization need to be considered:

Continuance of a protection provision for existing service providers.

Transfer allowance of supportive services, particularly transportation, back to Title III-C of the Act.

Reduction of paperwork, as called for by the Act and the regulations, as compared to the actual increase that has in fact occurred.

Specific designation of nutrition centers as focal point, assuming criteria is met. Over emphasis on long term care as proposed by the recent FCOA position paper, combined with the proposed age irrelevant approach to aging programs which we believe would be counter-productive and contrary to the historical and congressional intent of the Act itself.

Disagreement with the Committee's futures report that would split the older community into two groups; the "older" old, 75 plus and the 60 to 75 yr. group or elderly persons, which would fragment the Older Americans Act Programs, rather than bringing about a truly consolidated approach as called for in the 1978 Amendments to the Act.

There is confusion regarding the apparent de-emphasis on the well elderly in terms of services delivery as a truly preventative approach to programming.

The potential for Block Grant Funding of Older Americans Act Programs is of great concern to the organization and at this point in time have taken a position against such a funding mechanism, due primarily to the Administration's current position, that Block Grant Funded Programs, in all likelihood, would be cut by 20 percent. Additionally, program components within the Older Americans Act itself would lose their identity, or be diluted from their original purpose and intent. As indicated, a full written response to all of the issues will be submitted to the Committee upon final review by the Association Board of Directors to ascertain and reflect their views.

Mr. BLANCATO. Well, I can't believe that this actually finished faster than I thought it would, considering we've been behind all day. Let me acknowledge-wonderful. Your timing is outstanding. Last words were just spoken. Just a second.

Mr. BIAGGI. All I can say is we've come to the end of a long, long hearing, and I wanted to thank you for your contribution, and just talking to Dr. Marr, and I can only tell you that it's been a very pro

ductive hearing as far as the committee is concerned. There are some suggestions that we will pursue and we hope that won't cost any money and we want-the question of not costing money, the idea of implementing them is more probable. If it costs money, then, we'll have to try a little bit harder, but not all hearings produce notions for legislative changes. This one has produced several, several such notions, and we're grateful to all of those responsible for the hearing and, of course, those witnesses who made it successful.

Thank you very much.

[Whereupon, at 1:15 p.m., the hearing was adjorned.]

APPENDIX

PREPARED STATEMENT OF MICHAEL COOLEY, EXECUTIVE DIRECTOR, COHOES MULTI-SERVICE SENIOR CITIZENS CENTER, INC., AND VICE PRESIDENT, THE NEW YORK STATE CONFERENCE ON AGING

I would like to address my remarks this morning to two areas of concern in the 1978 Older Americans Act Amendments: the elimination of the separate category for multipurpose senior centers (old Title V); and the targeting of the act toward seniors in need, especially the "elders". I introduce my remarks with the briefest of preambles to the effect that senior centers are the oldest part of the aging service network and in the opinion of many have proven to be the most effective. In a state where the State Office for Aging Commissioner claims that programs are reaching 3 percent of the older adult population, most communities where senior centers exist are serving 50 percent and more of the age-eligible population. In my own community of Cohoes for instance we have an enrolled membership of over 3,000 seniors out of a total population of approximately 18,000, almost 30 percent of whom are older Americans.

The consolidation of old Title V into the revised Title III-B of the Act has in effect meant the elimination of funding for multipurpose centers at least in New York State. Although the amount of money available was not large and the long delay in putting the title into effect meant that there were only two opportunities to use it before it was eliminated, those in the field of senior centers throughout the state felt it was serving the very important function of calling local governments attention to the importance of senior centers. In many areas throughout this state, especially in the under-served rural communities it brought senior services to people who never had access to them before. You need only trace the history of any of the multipurpose centers throughout the state to know that once a senior center has been developed and a community made aware of the needs of the older adult population the full range of access and other support services begin to develop. Communities apparently need this visible focus for their efforts in order to move on the development of ways to respond to their "elders".

To use Cohoes once again as an example the growth of the Center from an initial 5 to its present 3,000-plus is proof both of the need for the services it provides and the communities continued willingness to support them. The Center was started in 1967 under a start-up grant from Title III after a communitywide social needs assessment identified senior supports as a community priority, and today almost half of its operational budget comes from the participants themselves both from program related contributions and direct fund raising support. This together with the Centers reliance on a strongly motivated core of member volunteers is proof of the viability of the concept of the Older American as a community resource.

Now a word about the "elder" in the older adult population and their special needs. Once again I will be speaking from the bias that senior centers are already beginning to address these needs and are the logical place to support these efforts. I would like to describe for you a phenomenon that is occurring in Cohoes and that I know from my travels throughout the state is being repeated elsewhere. As I mentioned, the Cohoes Center was begun in 1967 and this June looks forward to celebrating its Fourteenth anniversary. A fair number of seniors are still with us who started with the Center and have grown old along with it. I would say as many as 10 percent of our seniors are in the 75-plus category. This carries over percentagewise in the number who are using the Center and its resources on a daily or at least frequent basis, so the concern for the older, older adult that is just a statistic for many is a reality for us. Each day we transport to the Center a number of 75-plus seniors who are handicapped or multiply handicapped, and in our Congregate Dining program we serve approximately 25 seniors in this category seven days a week. All of these people are pre-seated and hand served, some of them assisted with feeding.

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On any given day the approximately 60 people a day we bring Home Delivered Meals to are about 75 percent in the 75-plus category. No consideration is given in the funding structure of either of these programs to the extra supports needed by these "elder" recipients and the staffing patterns needed to make them available. In many places the creation of a whole new Day Care structure would be an unnecessary and costly duplication of efforts if the Centers that are already delivering these services could have their service capacity enriched through increased funding. This has to be cost-effective as the structures, both physical and administrative already exist and at most would only have to be expanded, not developed from nothing. A strong belief in the preventive care aspect of the senior center programs that already exist, makes it necessary to emphasize that this must be done through the infusion of new monies and not the targeting of existing funds to a narrower and more closely defined population. I have watched the older adult community in Cohoes take on responsibility for their "elders" at home, in the Center, and in local institutions. They are the resource we must look to to make this new program work, and in order to do that we must sustain the programs that provide for them and keep them a viable force in the community.

PREPARED STATEMENT OF ANN CORTESE, PRESIDENT, NEW YORK STATE ASSOCIATION OF AREA AGENCIES ON AGING; AND DIRECTOR, ORANGE COUNTY OFFICE FOR THE AGING, GOSHEN, N.Y.

Congressman Biaggi, honored guests, ladies and gentlemen, my name is Ann Cortese. I am President of The New York State Association of Area Agencies on Aging and Director of the Orange County Office for The Aging. My remarks will carry the perspective of some 7 years experience as director of an area agency on aging and the perspective of member agencies of the Association.

Congressman Biaggi has requested that this hearing address issues relating to the Older Americans Act Reauthorization and to this end has posed specific questions. I will speak to several of the questions and make additional suggestions. A major consideration of the reauthorization facing Congress is the question, "How long a period of time should the reauthorization extend?". My recommendation is to extend the reauthorization for 3 years. There are two reasons back of this recommendation.

First, the varied time lags to both the governmental process and to field implementation of programs. As you know, extensive amendments to the Older Americans Act were signed into law during October of 1978. The final regulations spawned by the 1978 amendments were not completed until March of 1980. The orderly process of translating the intent of Congress into the mechanics of administration took the time of a full year and one half before completion. This leaves a year and a half in the life of the 1978 law for field experience, or less than two funding cycles to learn the strengths and weaknesses of the 1978 law.

These several time lags have important implications at the Federal level and at the county level. If it requires a full year and half at the federal level to develop administrative rules and regulations pursuant to fundamental changes in a law, then consideration should be given to making the working span of a law longer. If Congress conceives of a law such as the Older Americans Act, being operationally intact from the moment the law is signed, it is deluding itself. I do not believe Congress is deluding itself in this fashion and recognizes that laws of the type in question require time, both in the Government and, later, in the field to become effectively implemented.

Another consideration entering into the question of time is what role will the forthcoming White House Conference on Aging have in future laws. How rapidly can the findings of the conference be understood? How rapidly can they be interpreted into the language of law?

It is very likely that the findings of the White House Conference will call for major changes of law. Given study time that will have to be devoted prior to recommending changes, and given the time required to write and pass laws, it seems reasonable to assume a time span of at least 2 years. This suggests that if the proposed reauthorization extends for 3 years, that is to say until October 1984, there will be ample time to carefully consider both the findings of the White House Conference and the language the law of 1984 should take.

A second reason for extending the reauthorization for a 3 year period is the reality of the law when applied in the field. Area Agencies are required by the Older Americans Act to build a service network based on needs assessments. By law, much of the network comprises subcontracted services. We are just now approach