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Mr. BRADEMAS. Thank you for a very impressive statement. I just have one or two questions.
There have been a number of programs that have operated with Federal funds based on concepts of the AAA, for example, comprehensive health planning and model cities. I think there is agreement that those have not been universally successful. Why do you think the AAA program will be different!
Mr. GONIA. The AAA program, of course, has many different expressions in different areas of the country. In one particular region it is identified with a regional planning and service area, usually a regional council of governments. This has given it entry into the local governments and built it into the structure, the governmental structure, which I think is more firmly into the services delivery system.
Mr. BRADEMAS. Do you think that the extension of the title III program should continue the general prohibition against the provision of direct services by the area agencies?
Mr. GONIA. In some cases I think it is necessary for the area agency to deliver the services until an organization that is capable can carry it out. I would hate to see a definite prohibition continued. In general, I think it is good to contract for services to other agencies.
Mr. BRADEMAS. Thank you very much.
Mr. CORNELL. I was struck by one statement you made, that one of the greatest needs we have is for funds to provide transportation for older persons in a more efficient manner.
You probably noted that I referred before to the request of the administration that the section 309 be allowed to expire. I presume, therefore, that you do not agree with that proposal?
Mr. GONIA. No, sir.
Mr. CORNELL. In a kind of hypothetical case, I noted you presented a list. You presented in the order of priority based on a survey that you took, the greatest needs were for additional income, better health care, transportation, nutrition, and socialization. Is that the order in which you found the response of what the greatest needs were for the elderly?
Mr. GONIA. In our area, yes, sir. That was the order of priority that our advisory council gave these needs.
Mr. BRADEMAS. Mr. Beard.
In calling on Mr. Beard, the Chair would just like to observe what he had planned to say earlier. I think it is encouraging that we have Mr. Beard on this subcommittee because he represents a seat long held in the House by one of the great legislators of this century, the late John Fogarty, who was a great champion of programs in the fields of health and the elderly and the handicapped.
I think it is quite appropriate that someone with that same dedication should have sought a seat on this subcommittee.
Mr. BEARD. I thank the chairman for his kind remarks.
Mr. GONIA, In our area the elderly population is 39,400 approximately.
Mr. BEARD. Out of the 39,000 approximately what percentage is being serviced in any capacity as far as programs for the elderly?
Mr. GONIA. Under our title VII program which becomes a focal point for our services we serve 3,000 people in one quarter which is a very small percentage, about 10 percent.
Mr. BEARD. Do you feel the funds you are presently receiving are sufficient?
Mr. Gonia. No, sir.
Tell the people back home to write to the President and tell him to take some of that $300 million earmarked for Vietnam and $250 million for Cambodia and transfer it to the communities.
Mr. GONIA. We have been constantly doing this. We see one of our major tasks is to create a sensitivity on the part of the communities to the needs of the elderly and to recognize the role of the Congress.
Mr. BEARD. Thank you.
In your remarks you talk about the question of advocacy and that the seniors ought to be their own advocates, speaking with their own voice and with a sense of pride and dignity. I would like to have you comment on what you think the role of your agency is in being an advocate for the needs of senior citizens. It is a very active role in terms of confronting the Federal agencies to provide programs, whether it is a continuation of this program or others or is it simply one of administration of those programs which come on behalf of the senior citizens?
Mr. Gonia. No; we take this role very seriously. We have published newspaper articles. Every newspaper in our area has covered these articles regularly. We see ourselves as advocate of other agencies, service agencies, with the local government and creating an awareness of the needs of the elderly in the area, also in our State and in our national and political processes.
There are limits to what an organization within the Regional Council of Governments can do in the sense of high pressure tactics.
We feel that there is great value in the older persons being able to advocate for their own rights. One of our major objectives is to create retired organizations in which they can become more actively involved and speak for themselves in the local governmental settings. We have been able to be very effective in moderating sometimes between very active local groups and the government, mediators.
Mr. BRADEMAS. Thank you.
I understand Mr. Carstenson has a plane to catch shortly, so we will ask him to come up next.
Mr. Carstenson is the president of Carstenson & Associates. He is accompanied by Dave Crowley from the Ohio Commission on Aging.
STATEMENT OF BLUE CARSTENSON, PRESIDENT, CARSTENSON &
ASSOCIATES, AND THE AMERICAN MANPOWER AND AGING AD-
Mr. BRADEMAS. Go ahead. If you can summarize your statement it will be helpful.
Mr. CARSTENSOx. 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 Old 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 comproinises 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.
1. The administration (the Domestic Council staff acting for President Nixon) made the commitment that Title III, III, 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 Allministration 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 Comunissioner 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 Conmissioner, Dr. Flemming has been aggressive if a bit hea ry-handed task master, He wants action now. The people in the field of aging generally respect and admire Dr. Flemming. Ilowever, 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 covering 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.