STATEMENT OF BLUE CARSTENSON, PRESIDENT, CARSTENSON & ASSOCIATES, AND THE AMERICAN MANPOWER AND AGING ADVISORY SERVICE, ACCOMPANIED BY DAVID C. CROWLEY, EXECUTIVE DIRECTOR, OHIO COMMISSION ON AGING

Mr. CARSTENSON. Miss Slater was not able to be with us.

I appreciate the chance to appear before you.

Mr. BRADEMAS. Go ahead. If you can summarize your statement it will be helpful.

Mr. CARSTENSON. Since it is about 37 pages, I would like to submit it for the record. I also would like to submit Eleanor Slater's statement for the record. She did indicate a number of points she would like to touch upon and a few points I would like to touch upon. I know your schedule is tight with witnesses. I appreciate the chance to appear early.

[Prepared statements submitted by Mr. Carstenson follow:]

PREPARED STATEMENT OF DR. BLUE CARSTENSON, PRESIDENT OF CARSTENSON & ASSOCIATES AND AMERICAN MANPOWER AND AGING ADVISORY SERVICE

I am pleased to be asked to testify before this Committee since you have heard me so many times in the past. I have been involved with the formulation of this law since I worked with the Senate Committee on Aging Staff in 1960 writing the report on the problems of Federal Organization of Programs in the field of Aging. I am currently working in the field of aging as consultant to 4 states, Rhode Island, South Dakota, Minnesota and Ohio, and through the American Manpower and Aging Advisory Service we are working with the Retired Workers Committee of the United Steelworkers of America, we have also directed the evaluation of RSVP for ACTION and have worked as consultant for other agencies such as the state units on aging of the states of Wisconsin and Connecticut and Green Thumb and the National Council of Senior Citizens. Previously I served as the national executive director and originator of the latter two groups.

The Congress and all of the people who over the years have been associated with the Older Americans Act can be proud of the results of your efforts despite the anguished cries by OMB planners that catagorical programs such as these are ineffective, inefficient, and somehow immoral. This program has achieved what you set out to achieve. Initially, every time you have changed the law the Administration has been opposed regardless of who has been Secretary, but you have gone ahead and used your judgment to improve this program, and I know that you will do this again this year.

What is most remarkable about the Older Americans program is that it has generated many new services and programs at the local level which are funded on an on-going basis at the local level after the three years of funding by Title III. No other Federal program has had such a good record of initiating services and programs through initial federal funding for three years and letting local funds come in on an increasing basis to support these programs. However, because of economic and other factors there is need to modify some of this approach.

By giving the states and communities freedom to create new approaches and programs, this program has created a system of senior citizen centers across this country with more and more of them becoming multipurpose senior citizen centers. Many new programs of social service, recreation, transportation, and other creative programs have been created in concort with other local efforts and with cooperation and coordination not seen in other federal programs. It works through existing agencies except where the local agencies and people feel that there is need to create new structures. The programs are locally planned, geared to local ideas and pocketbooks.

These services and programs are touching the lives of millions of older people. With relatively few federal dollars, what federal program has created so many

permanent local program services? There is in all likelihood, over a billion dollars a year of local programs and services for the aged that have been initiated or stimulated by initial federal dollars that are now being funded by local sources. In summary, over the years Title III has achieved a record of which you can be proud.

1. The percentage of programs that have been designed and developed through community initiative.

2. The percentage of programs that survive after federal funding.

3. The extent to which the programs make sense locally.

4. The extent to which the client group-older people take active roles in policy formation and implementation.

5. The acceptance of the program by the local communities.

6. The general lack of rip offs and fraud and corruption (except the OHD Rip Off).

7. The success of Title IX, senior citizen community service employment programs (Senior Aides and Green Thumb programs).

However, there are some problems. Most of these came as a result of compromises in the Older Americans Act of 1973 and the failure of the Administration to follow through with the agreements and commitments that it made at the time of the passage of the Act.

Specifically,

1. The administration (the Domestic Council staff acting for President Nixon) made the commitment that Title III, VII, and IX would be funded at the authorized level for FY 1974 as realistic levels of funding, including the funding of Title IX at 90 million dollars.

2. That the commissioner would report to the Secretary through an Assistant Secretary that there would not be a big layer of bureaucracy over AOA.

3. That there would be no delegation of authority or funds to people not under the jurisdiction of the Commissioner.

4. That an effort would be made to encourage the Labor Department to treat older workers without discrimination in the manpower program in exchange for the dropping of Title X of The Middle-aged and Older Worker Program. The Administration actively fought funding of Title IX at full funding and has tried in every way to make the program vanish.

The Commissioner and his regional representatives have had to report through a mass of bureaucracy called the Office of Human Development. Except for a few speeches by Assistant Secretary Thomas and some administrative process of such things as travel, etc., I have yet to find a single person in the state units on aging or in the Administration on Aging staff who can name a single concrete thing that the Office of Human Development has done which has positively improved the life of one older person or helped a single local program. Perhaps you can find some reason for the approximately one quarter of the AOA staff positions in the national and regional offices that has been used by the Office of Human Development. I can't. OHD may be of some help to the other agencies. I urge that the Congress return to their original position that the Commissioner of Aging report directly to the Secretary of HEW and not through any sub unit of the Department or through any sub official or assistant. If the Administration says that this can't be done then I urge that an Assistant Secretary for Aging be created so that it can be done. This committee has been frustrated long enough. You were right and should remain adamant in your position even if it means a veto. The Commissioner or Assistant Secretary for Aging should be able to directly delegate responsibility to the regional representatives or directors on aging. Regional OHD staff have been a waste of the taxpayers money as far as senior citizens are concerned.

TITLE III COMMUNITY PROGRAMS

The Older Americans Act of 1973 mandated a new approach to Title III which cause to be created Area Agencies on Aging throughout the country. The Commissioner, Dr. Flemming has been aggressive if a bit heavy-handed task master. He wants action now. The people in the field of aging generally respect and admire Dr. Flemming. However, at the December AOA meeting with the state directors and directors of AAA directors showed the high levels of frustration and problems which existed. At least part of these problems and tensions were resolved successfully by the meeting. We commend Dr. Flemming and his staff

for the willingness to change some of the unclear, restrictive or frustrating policies and directives.

I am submitting papers on the recommendations made by an Ohio Seminar for state executives on aging which I staffed and later adopted by the National Association of State Units on Aging. My recommendations are in part based upon these papers and upon consultation with the states with whom I am a consultant. We have seen a number of exciting new directions in Title III.

First there has been the development of over 1000 senior citizen transportation programs. Using the small mini-bus these programs have been effective in creating new very essential services for older people. There has been the emergency of some new home repair and winterizing programs. There have been a major new effort in information and referral at least some of which is really good, but much of which is just getting started. There is a major push to get senior citizen centers to be on local funding except to expand their range of services so that they are truly multi-purpose centers rather than just recreation programs. There is increasingly a focus upon alternatives to nursing home and institutional care. There is a major increase in the active involvement of older people themselves in the policy making and in the staffing of programs.

I want to convey a strong feeling among most state and area agency directors that they are not desirous of taking over Title IX programs. They know that the national contractors are generally doing a fine job except for the old "Experienced Americans" contract. They do not want the Congress to be strong in your battle to force the Labor Department to carry out the intent of Congress and allow the Green Thumb and Senior Aides programs to continue.

The state directors are not coveting the FGP and RSVP program but are concerned about the good health of both programs. They would like to be kept informed about the older worker and volunteer programs in their areas and have a chance to make comment upon them. While there are a few who would like to have these programs most of them are new and do not know the history of the development of these programs and do not have good relationships with the major organizations in the field of aging. Having talked to over a hundred state and area agency directors, I believe that statements concerning the mandatory funding of these programs through the state or area agencies does not reflect the views of the majority of people or groups or agencies in the field of aging.

It may have sounded like the program is full of mistakes and problems but in fact it is not in serious difficulty. Quite the contrary. With a few modifications, the program can be brought forward in fine shape.

I have left out many suggestions and changes which can be and are being administratively. There are quite a number listed by the state directors and the directors of the AAA's at their meeting in December with AOA. However, it appears that the AOA is taking these suggestions seriously and are making these changes and to Commissioner Flemming's credit and the credit of the staff, the agency appears to have "heard the problems" and are moving without being overly defensive to correct the problems.

There are areas that need legislative adjustment and improvements, if the state and area agencies on aging are to do a good job.

There are several problems in the Older Americans Title III law and program: 1. There is a lack of effective tools for the state agency on aging to have significant impact on many state programs.

2. The use of unreal "buzz words" in the Washington memos, directives regulations, and law is not good for the program including such phrases as tapping "un-tapped resources," "pooling" activities, and calling "coordination" a "direct service."

3. There are unrealistic community funding expectations for supportive services, mandated services and for all programs during this period of economic recession-depression.

4. The relationships between the state unit on aging, the state planning department, the AAA and planning district or COG, are unclear and have caused problems. Several state planning and district planning agencies have used the delay of the A-95 as a tactic to pressure the state agency on aging to gain contracts for themselves.

5. With the increased federal directives, mandates, and requirements, the reporting and planning requirements, and the breath of the legislative mandates, administrative funds are inadequate for the AAS and the states.

6. The lack of success at any level for the older Americans Act programs in having any meaningful relationship to the federal manpower programs (other than Title IX) needs Congressional attention.

7. The pre-occupation with managing the AOA grant monies in projects have limited the effectiveness of some state units on aging and the AAĀS.

8. The pre-occupation with federal requirements for planning and reports has meant that some agencies have barely got around to implementing the plan.

9. There has been an over-extention of the federal authority and detailed instructions to the state and AAAS which is unrealistic and self defeating in terms of gaining continuing local funding.

10. The words in the law stress the development of a delivery system have been construed to mean that there should be a separate permanent delivery system of services funded out of AOA funds separate apare from other major delivery systems. There has been a temptation to build empires rather than trying to effect other systems so that they can affect older people.

11. The Older Americans programs have had limited success in getting substantial local revenue sharing funds partly because of the face that Revenue sharing can't be effectively used until the 4 year of the project when it has been already accepted.

12. It is unrealisitc to expect that senior citizen transportation programs can be self-supporting. Even regular urban mass transit programs all need large subsidies.

13. The 15% limitation on administrative money for the AAA is unrealistic and the act of calling coordination a direct service so that the budget of the AAA is large enough to actually operate is not giving a true picture of the costs of the AAA and is causing extra trouble, waste and problems in budgeting, and bookkeeping. The AAA re required to keep two sets of books, one for planning and administration activities and one for coordination and activities to tap untapped resources.

14. The allocation of 80% of the Title III program to the AAA is causing serious planning and administrative problems and needs to be eliminated to allow greater flexibility. Its arbitraizing and inflexible level would effectively prohibit temporary defunding of an AAA if problems arise and still being able to sustain local projects while a new AAA was developed. It also means that certain areas where there is great need but no way to effectively form an AAA can not be given a fair share of programs.

15. There are some thinly populated rural areas where there is difficulty in applying the AAA format and some state that have a mix of areas where the AAA system is suitable and some that are not.

16. There is a tendency to take the provision of the law calling for serving all older persons including the poor and minority and making that the primary mission of the Older Americans Act.

On the basis of close association with the program and discussion with the three state executives of Minnesota, Ohio, Rhode Island and South Dakota and other states, I recommend the following:

1. To increase the effectiveness of the states in impacting other programs that they better serve older people, the states should be given authority to spend up to 5% of their funds states allocation for contracts and grants with state and federal agencies providing there is the specific approval of the Commissioner of AOA to prevent "rip-offs" by hungry state budget managers.

2. The Administration on Aging should be given authority to spend unto half of its special model projects money in contracts with or jointly with other federal agencies to develop new methods or approaches in programs and agencies so that they better reach or serve older people. With the approval of the Federal Council who shall report periodically to the Congress on the success or failures in the efforts to affect other federal programs and agencies.

3. That wherever possible “buzz words" or government zargon in the law should be replaced by English words that older people can understand.

4. We recommend that Congress should authorize $150,000,000 for Title III and $45,000,000 for Section 309 for senior citizen transportation for FY 1976. There should be $175 million for III and $55 million for FY 77 and $200 million for III and $70 million for Section 309 for FY 78.

5. There should be a one year freeze on the community or local matching or share for Title III because of the serious economic problems that most of the community find themselves in and which makes local match hard and the commissioner should be given encouragement to roll back the local matching provisions for very hard hit communities. This provision could be reviewed by Congress next year to see what the situation is at that time.

6. That for supportive services such as senior transportation, information and referral, and outreach should receive continuing federal funding at a level of 60% federal match, after the third year because these services are desirable from the federal viewpoint so that people can be reached and be served by such federal programs as Medicare, Medicaid, Social Security, SSI federally-aided senior citizen housing, Food Stamps, etc. It is unreasonable to expect senior citizen and handicapped transportation systems to be more successful in being self-sustaining than urban mass transit and since DOT is still hostile to specialized mini-bus transportation for senior citizens and the handicapped. The federal government has funded on-again, off-again outreach and information programs such as Medicare Alert, Find, SSI Alert over the past years and the start stop administration and program development is not as effective as a sustained effort using older persons in the outreach activities. To restrict federal administrative policy making tendencies, I urge that:

7. The amount authorized for the AAA should not be set at a flat 15% which in effect it is now doing, but at "the minimum necessary to do an effective job." This would eliminate necessity of having two budget and two bookkeeping activities for the AAAS, and would make for more rational and effective administration. AOA has no idea now of the real cost of AAA but I estimate that it runs about 22% of the Title III funds.

8. I strongly urge that the requirement at 80% of the funds should go to AAAS should be eliminated, as arbitrary, rigid, complicating.

9. In rural and thinly populated areas the states should be permitted to set up AAAS which are staffed by state personnel of the state unit on aging.

10. The language in the act should clearly indicate that the states should have a clear option as to whether they apply as a single state-wide area plan state or having multiple plans and AOA should not place a value judgment on the option.

11. We strongly urge that in the law that where a state assumes the full responsibilities for a single statewide area plan that up to 8% of the Title III funds allocated to it be available for the state to administer the programs (in lieu of the 15% to 25% for AAA costs). If the state unit is going to provide the same services as AAA for planning, administration and coordination, then additional funds are needed.

12. I urge that both in the preamble and in the language of title three that new emphasis be given to the language used in the earlier Older American Act calling for efforts to improve the well being and living for all older people and stressing prevention of problems and difficulties and working to improve existing services and programs in their delivery of services and programs for older people where possible and improving delivery systems rather than emphasizing the establishing of a separate delivery system for services for the elderly.

13. To encourage local communities and states to put revenue sharing funds into programs on aging, it is suggested that the Older Americans Act permit up to half of the non federal share or match for a Title III program can be revenue sharing funds if the local or state unit of government pledges that revenue sharing money is earmarked or indicates its content for continuing support of the project from revenue sharing funds following the end of the federal AOA financing at the end of 3 years. This is very different from other federal matching situations in that Title III provides very short term federal funding which is to act as seed money to start local projects. This would encourage rather than discourage local and state use of revenue sharing monies for programs in the field of aging, which is the current situation. Presently the increasing local share can not come from revenue sharing funds until federal funds have ended altogether.

14. The state and district or area agencies which provide A-95 review for the state and area plans should be prohibited from using that power to influence the designation of themselves or their local counterparts as AAA's or get contracts from the state or area agencies that the time for A-95 Review process be limited to 30 days from time of receipt of the plans.

15. We recommend that Title III language should clearly emphasize that the state unit on aging and area agency on aging should be devoting a significant portion of time to the study, review and action on all programs especially those involving federal funds to help insure that they are having a significant and beneficial impact upon older people. The mandate for such review and action is unclear especially when approaching other agencies for information. While this would not and should not give the state unit on aging and the AAA power over any crner agencies program, it would give them the right and responsibility