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proportion of the 1974 Title III funds were allocated to administration and what proportion were allocated to coordinating the delivery of existing services and pooling available but untapped resources from the public and private sectors. We will be able to provide this information about March 15.
Q. 8. This would leave -% for services? Do you think this is the best mix?
A. As stated in response to question 7, coordination and pooling of available but untapped resources have been identified as social services activities and are accounted for under funds to support social services.
We favor maximum utilization of Title III funds to support the expansion and coordination of the delivery of social services to older persons. This is why we support the current fifteen percent limitation on the use of funds allocated to the States for administration of area agencies.
Q. 9. Do you think the need of Area Agencies on Aging for more administration, planning, and coordination funds—the relatively small proportion of Title III funds going for actual services-indicates a need for a higher total budget for the area planning and social service program?
A. As I indicated in response to question 8, we support the fifteen percent limitation on the use of the funds allocated to the States for administration of area agencies, and we believe that the existence of this limitation does not lead to the conclusion that a higher total budget for the area planning and social service program is needed.
Q. 10. Can you give us a breakdown of the kinds of services being funded at the local levels, and some indication of the number of persons served and the extent of these services?
A. The services activities supported under area plans on aging include the following: coordination, pooling, information and referral, outreach, escort, transportation, counselling, health, homemaker, legal services, employment, housing, day care, chore services, continuing education, friendly visiting, telephone reassurance, protective services, recreation, nutrition, and senior centers.
We do not have information about the number of older persons served under each service category. As to the extent of the services supported, based on 336 approved area plans, the following indicates the percentage of area plans which included each service listed :
100 Pooling untapped resources,
100 Information and referral...
16 Nutrition (other than title VII).
10 Chore services.--
5 Senior centers..
9 Continuing education.
13 Legal services Employment
5 Day Care
4 Protective services.
3 Telepone reassurance
6 Friendly visiting--
3 Other services--
Q. 11. We have heard comments, that it is difficult for some AAA's to build the nutrition program into their area plans because the nutrition projects are often funded through a separate mechanism. (a) Can you describe to us the extent to which nutrition projects are included in AAA plans? (0) What are your views as to whether there should be closer coordination between these two prorams?
A. It is true in many cases that nutrition projects under Title VII are often funded through a mechanism other than the area agency on aging. However, thirty-seven percent of the nutrition projects are included in area plans.
Title III regulations on this point note that the area plan shall provide that the area agency, in conjunction with the State agency, shall take the initiative in endeavoring to develop arrangements with recipients of grants or contracts for nutrition projects under Title VII whereby, subject to mutual agreement of both parties, such projects shall be made part of the coordinated and comprehensive system of services for older persons to be established under the area plan. These regulations are consistent with the statutory provisions of Title VII. We believe that existing law and regulations will contribute to the achievement of the objective set forth in the law and regulations. We are not, at this time, recommending any changes in the law.
Q. 12. Do you think the extension of the Title III Program should continue the general prohibition against the provision of direct services by Area Agencies on Aging?
A. Section 305 (a) (8) of the Older Americans Act of 1965, as amended, provides that no social services will be directly provided by the State Agency or an area agency on aging, except where, in the judgment of the State agency, provision of such service by the State agency or an area agency on aging is necessary to assure an adequate supply of such services.
The intent of the Congress on this matter was set forth in the Report of the Senate Committee on Labor and Public Welfare which accompanied the Older Americans Comprehensive Services Amendments :
"... It is not intended, however, that the area agencies on aging shall be primary providers of services. In many communities existing organizations may already be engaged in providing services and the entry of area agencies is likely to result in duplication and overlap. Their primary concern must be to coordinate existing services and to stimulate the expansion of such services and the introduction of new services by other providers ... State and area agencies alike are authorized to provide services, though when it is determined, in the judgment of the State agencies, that such action is necessary to assure an adequate supply of services."
"Thus, the area agencies will function largely to close the gaps between the needs of older persons within the planning and service area and the services available to meet those needs; to continue to improve the linkages of services into a comprehensive, coordinated network; and to act as an ongoing advocate for the needs of older persons within the area."
The Title III regulations proscribe the direct delivery of social services by area agencies except under circumstances where the area agency was providing social services prior to its designation, or no other agency can or will deliver the social service in question.
We concur with the reasoning expressed in the Senate Report in 1973 and would favor continuation of the current general prohibition against directly delivery of services by area agencies.
Q. 13. Your regulations specify a general limit of 3 years on the funding of any social service under an Area Plan.
(a) Do you have any indications as to how feasible it will be for communities to pick up the costs of these programs?
(b) Do you have data on the average cost of a social service program funded under an Area Plan?
(c) As you know, communities generally were not able to take over the full cost of projects under the older Title III Program after the third year. How would this experience relate to your expectations for the current program?
A. (a) No. (b) No.
(c) The Title III regulations provide that an individual social service activity supported under an area plan may not be funded beyond a three-year period unless, after obtaining the views of the State agency, I approve funding beyond that period. This provision was included in the regulations as an incentive to area agencies to find other resources to support services for older persons. If the area agency makes good faith efforts to secure other funding and these prove unsuccessful, it can request the State Agency to recommend that I approve continued funding, and I would in turn support the State Agency's recommendation,
Q. 14. (a) What kind of statistics do you have on the socio-economic status of persons benefitting from the AAA programs? (6) Do you know for example the extent to which low income persons are benefitting? (c) Are the low income elderly actually receiving priority in all States?
A. We have not collected this information relative to the operations of the Title III program. We are now putting in place a new reporting system which will provide us with information on the number of low income older persons benefitting from the Program. We expect the first report yielding this information will be available by March 15.
Although we do not have this information relative to Title III activity, we do have information on Title VII Program operations. The report for the second quarter of the present Fiscal Year shows that nationwide sixty-seven percent of the meals being provided are to those older recipients from the low income groups. Attached is a chart which shows by State the percentage of meals served to low income older persons as reported by the State Agencies.
Percent of participants served below poverty
67 | Region V-Continued
68 Connecticut 54 Wisconsin
51 Maine 61 Region VI.
83 Massachusetts 64 Arkansas
88 New Hampshire 70 Louisiana
81 Rhode Island 71 New Mexico
76 Vermont 43 Oklahoma
86 Region II. 75 Texas
81 New Jersey 58 Region VII.
58 New York 51 Iowa
47 Puerto Rico 95 Kansas
62 Virgin Islands
49 Missouri Region III.--
71 Nebraska Delaware 71 Region VIII.
68 Dist. of Col.
39 Colorado Maryland
75 Pennsylvania 73 North Dakota
76 Virginia 69 South Dakota...
79 West Virginia 72 Utah
50 Region IV77 Wyoming
33 Alabama 75 Region IX.-
74 Florida 73 American Samoa
91 Georgia 83 Arizona
78 Kentucky 72 California
67 Mississippi 85 Guam
84 North Carolina 79 Hawaii
71 South Carolina 87 Nevada
69 Tennessee 78 Trust Territory.
90 Region V59 Region X.-
52 Illinois 55 Alaska
52 Michigan 66 Oregon
Q. 15. (a) What is the relationship between Information and Referral (I&R) services provided by the State Agencies and by the Area Agencies on Aging?
A. The 1973 Amendments to the Older Americans Act assign to Area Agencies the responsibility for providing for the establishment and maintenance of I&R services. The responsibility is placed with State agencies with respect to planning and services areas without approved area plans, or where the State Agency finds an existing I&R service to be inadequate in areas with approved area plans.
(b) I know the regulations require that information and referral service provided under this Act be coordinated with information and referral services provided by social security district offices. What is the relationship with other community information and referral services?
The legislative mandate concerning I&R for State and Area Agencies on Aging makes it essential that existing I&R resources be utilized maximally. The overall objective is to strengthen or develop at the local level a system of coordinated and comprehensive services for older persons. This provision for the establishment or maintenance of I&R services is an important link in the network or coordinated comprehensive services. Information and referral services can serve two complementary functions:
(1) the assemblage and provision of information to link older people with the opportunities, services, and resources designed to help meet their particular problems and needs, and
(2) the collection and reporting of information about the needs of older people and the adequacy of resources available to them as aids to the evaluation, planning, coordination and resource development efforts required of State and Area Agencies. Thus any Area Agencies on Aging, to carry out these functions, must become involved and assure coordination with other community I&R services.
(c) What do you think of information and referral services which serve the total population? How well do these meet the needs of the elderly? For example, how well is the comprehensive Georgia information and referral project working for older persons ?
AOA is supporting several research projects to explore the efficiency, effectiveness, and cost benefit relationships between age-integrated and age-segregated I&R services. Results of this research are not yet available.
The Georgia comprehensive information and referral project has only been in operation for eight months. It is too early to make any definitive judgments as to how well the project is meeting the needs of older persons. A concerted effort is being made by the project to expand outreach and publicity efforts in order to inform older people about the availability of this service.
16. MODEL PROJECTS
The model projects were funded through two channels in Fiscal Year 1974: (1) the Administration on Aging's Division of Research Applications and Demonstrations (and referred to as National Model Projects), and (2) the State Agencies on Aging (referred to as State Model Projects). The questions are answered for each of these two separately.
Of the $16.0 million approximately $4.0 was used for the National and $12.0 million for the State projects.
I NATIONAL MODEL PROJECTS
2. 16. (a) Can you give us a brief rundown of the types of model projects that have been funded under Section 308 of the Act?
A. Of the 40 Model Projects funded in FY '74, all were concerned with im. proving the quality and scope of services, or improving the delivery of services. For example:
The International Center for Social Gerontology is developing a clearing house on Housing and Environments so that organizations concerned with housing for the elderly in the U.S. may draw upon a breath of knowledge and experience world-wide.
Triangle J. Council of Government/Area Agency on Aging is developing approaches to assist older persons with their housing problems, utilizing current resources for loans and home repair.
In Minnesota, a consortium of colleges and universities is developing an intergenerational-Living-Learning Community. This project is experimenting with new approaches in education for the older person, including residential opportunities for older persons on college campuses, and the involvement of the older person as “teacher" as well as student.
The Georgia Center for Continuing Education is developing a Multi-Media approach to pre-retirement education.
The New York City Office for the Aging is conducting a project designed to better meet the needs of the mentally frail elderly. This project is jointly funded by AoA and NIMH.
A project to involve voluntary organizations nationwide, in helping older persons to remain in their own homes is being conducted by the National Council on the Aging. This project is known as Operation Independence.
Several projects are in progress in Indian communities related primarily to home-health services.
Four projects were funded to assist older persons in disasters. These projects were funded in Alabama, Kentucky, Tennessee and Indiana. Information already gained from these projects is being used in the development of AoA policy in this area, and for inclusion of the special needs of older persons in state disaster plans.
A special information service through TV Programming is being conducted in New York City, to demonstrate the use of TV making older persons aware of services and how to receive them, with specific relationships to information and referral systems.
(6) How many of these fall within the four priority areas set forth in the law?
All of the projects funded relate to one or more of the four priorities; 22 deal exclusively with one of the four priority areas.
(c) How did you determine your priorities?
During FY '74 the four principle priorities already listed were taken directly from Section 308 of the Older Americans Act: housing, pre and post retirement education and counseling, and services for the physically and mentally impaired. Priorities were also funded in two other areas and identified as (1) information and referral, and (2) disasters of National concern.
In the two information and referral projects one provides opportunity to explore the role of TV in such programs and the other encourages a national effort among voluntary agencies to organize for more effective "retirement employment” opportunities to supplement retirement income. These projects will help carry out better the larger information and referral program called for in other portions of the act.
Four projects each provided a state agency on aging funds to help insure appropriate attention to the aging under disaster relief programs in areas hit by tornadoes. This proved to be an important asset to both the agencies and the elderly who are more prone than others to view such tragedies fatalistically or without hope of recovery.
These priorities were arrived at by noting the statutory requirements, the Congressional intent and the pressing program and human needs within the scope of Section 308.
(d) Which of these, or other, priorities do you think are most important?
All of these are important; some may be more pressing or provide greater opportunity for successful action at the time. For FY '75 special importance is being given to the first and last of the four priorities specified in Section 308 : "special housing” needs and “services to assist in meeting the particular needs of the physically and mentally impaired older persons."
Should catastrophies of national concern, such as a devastating hurricane, tornado or earthquake again strike, projects to provide advocacy for the rights and benefits of the aging should again be considered.
Other priorities which could merit special attention for Model Project support include: (1) improved advocacy for older persons but especially the impaired whether at home or in an institutional setting; (2) transportation, over and above that of concern to public service transport systems (especially the study and development of mutual assistance and volunteer arrangements) ; (3) problems of death and dying ; (4) the special problems of recession and inflation for older Americans, and (5) preventive outreach to reduce unanticipated emergencies.
II STATE MODEL PROJECTS Q. 16. (a1) Types of projects funded?
A. In concert with the overall thrust of the Title III program to enhance the capacity of State and Area Agencies to develop coordinated and comprehensive service systems for older persons, four program areas were set forth as priorities for use of model project funds: (1) Information and Referral Sources; (2) Project SSI-Alert; (3) To assist in phasing in the Areawide Model Projects to the new Title III program ; and (4) Other Programs for Special Consideration, including special housing needs, continuing education, pre-retirement education, special services to physically and mentally handicapped elderly and assistance to older persons in national disasters. Over $3 million, or approximately twentyfive percent, of the $12 million was earmarked by 29 States to support activities to ensure that all older persons have reasonably convenient access to infor-, mation and referral sources by the end of Fiscal Year 1975. Twenty-four States used somewhat over $1 million for SSI-Alert to inform older persons of their potential eligibility for participation in the SSI program. Seven States used about $600,000 to assist in phasing in Areawide Model Projects to the new Title III program, Twenty-four States used approximately $2.8 million to expand social service activities, including transportation, homemaker, housing, health care, education, legal, day care, and employment services.
16. (61) How many fall within the four priority areas set forth in the law? See material under (al) above.