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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 AAAs.
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 reed 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 Con"ess 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 shoulil 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 state's shonld 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 orner agencies program, it would give them the right and responsibility
to review, study, and make recommendations on other programs including the right to look at the budgets of other programs where federal funds were involved and to ask questions concerning the impact of those programs on older people. It might also help some of the agencies on aging to be broader in some than just a grants management agency for Title III and VII funds.
16. The language of the law and report on Title III should stress the federal government in setting policy not detailed instructions on program operations. It should re-enforce the idea that the federal government should hold the states and AAA accountable for reaching the goals that the states and AAA set for themselves in the state and area plans. The federal government should be providing more technical assistance of high quality. More technical assistance and resources could be obtained without additional funds or slots simply by the elimination of the useless layer of bureaucracy called OHD. It is my belief that 040 eats up about 1/4 of the present federal administrative dollars under the Older Americans Act with little or no benefits to state and local programs in aging. Only when Congress sat on OHD and AOA with a GAO audit, were additional AOA staff provided at the regional and national level which began immediately to provide improved technical assistance and review project and program. The states noticed the improvement of quantity of staff services available to them. I know that AOA wants to improve and increase the level of technical assistance.
17. The amount of money for state administration has to be increased. The small and middle sized states are both underfinanced to do a decent job.
I strongly recommend that:
(b) The total for state administration be raised to $20 million per year and that if Congress and the Administration assign planning, administrative, and program responsibility for more than $200 million dollars of program funds under the Older Americans Act that the state may use 10% of such funds for administrative purposes and any unused portion may revert to program use within the state. If the state does not use any portion of the $20 million it may be reallocated to other states for administrative use.
The present Older Americans Act is the only program in the federal government where the states have been asked to administer additional federal programs monies (of any size without any additional federal funds according to the director of the National Governors Conference. Today you are asking the states to administer the Nutrition program without the funds originally provided for state administration. AOA is requiring that the state provide a nutritionists and other staff without providing funds to do it with.
Inadequate staffing too often means poor programming and in the case of the Older Americans Act the lark of adequate staffing for planning and administration and technical assistance will mean that a number of the Title III programs will not he sustained at the local level after the third year. What may be gained in short term savings of administrative funds has resulted in the lack of careful early planning to assure continued survival of Title III programs.
As we add more monies for Title III to go after the limited local and state funding sources, better the programs must be to survive with state or local funding. State and local funding sources will only take over programs that are really good. Many local and state governments are looking very warely about easy short term federal program dollars that they will have to take over in three or five years. During this period of economic crisis it will be even more true than when state and local dollars were in easier supply. Title III is a great bargain for the federal government but unless carefully administered it will not remain the popular, successful program that it is today.
is. There is a need for more short term training for Title III and VII staff and Commissioner Flemming actions and directions in this regard should be encouraged in Title V.
19. Unless the middle aged and older worker program is adopted, it would be very important to give Title III permissive authority to carry out employment and training programs for older workers which it now lacks. There should be permissive language to allow Title III to carry out the activities in Title VIII if it is dropped.
SENIOR CITIZEN TRANSPORTATION With the current rates of poverty and near poverty among older people there are many people who are having to forgo the car as the sources of transportation. The number of small “ma and pa” stores that are closing is alarming in my home community of Minneapolis. These are the little shops in the city where large numbers of older people would walk to the store for groceries have the groceries delivered. Some sources have indicated that over half of these small stores especially the “ma and pa" food stores have closed within the last five years. The large suburban shopping centers are difficult to get to for older people without a car.
The doctors have moved in droves from the big office buildings downtown to small suburban offices often off of bus routes. Large numbers of older people still live in inner parts of the city. In Sioux Falls, S.D., a majority of the older people and the majority of the doctors were within a 15 block radius of downtown and most within 10 blocks 5 years ago. Today all but one doctor has moved their offices to the suburban areas. The public transit, what there is of it, doesn't go in those directions. In cities, like Newport, Rhode Island, cabs run high with the meter registering one dollar when you get in the cab, and $8 is not unusual for a round trip to the doctor.
But in rural areas, these are critical problems caused by doctors locating in the major towns and cities and stores that close in the smaller towns cause critical problems because gas and car costs are so great that the friendly neighbor who would ride the older person to town isn't likely to want to take older neighbors to the city for regular doctor visits and treatments. The little isolated towns without services or stores, no longer served by the intert own buses and an increasing number of older people without cars and neighbors and relatives who could drive them to the county seat or major shopping center.
We have seen the emergence of reduced fares during off hours on urban mass transit systems, which now Congress has made public policy and a requirement for receiving federal funds. DOT is now seriously talking of requiring that all public transit vehicles have where chair access. There must be a better and more economical way that will provide for transportation for the handicapped and the elderly.
About 13 of the elderly are “handicapped" and about half the "handicapped are elderly.” During the past three years well over 1,000 senior citizens special transportation systems and projects have been established. A number of areas are developing specialized transportation for the handicapped and/or elderly.
I have been conducting studies for the RI Division on Aging on the development of their senior citizen transportation system which now provides statewide service to all seniors on a reserve-a-ride, demand-response radio-dispatched system using some 39 mini-buses or vans. Delaware and Missouri (81 counties) have statewide systems and states including Michigan, Massachusetts, Florida, Minnesota, South Dakota, and North Carolina have major areas of their state covered by systems. They are a mixture of fixed-route and reserve-a-ride systems most of them use the Dodge or Ford van or minibus or small corporation bus or modifications of those vehicles which are not yet really accepted by DOT. DOT is still fighting hard for the big bus with adaptions and lifts made for the handicapped and elderly but fixed route. I hope and believe that there will be a change in that policy. I am a member of the newly established National Commission for the Transportation Disadvantaged and have visited with the President, Steve Polodarus, Director of the Senior Citizen Transportation Inc. of Rhode Island. This group presenting both the elderly, the handicapped and providers of transportation services for this group is concerned that the Older Americans Act does contain the McGovern-Schweiker Senior Transportation Section 309 program of the Older Americans Act enacted by Congress this past fall. It is essential if many of the present services are to survive and we hope that it will be on a sustaining basis. I hope that DOT will begin to function in this area of specialized transportation some including more than capital grants. We can't expect to provide services of this type without continuing federal assistance. Many of the services that the federal government now provides requires transportation if you expect the older people to use them including food stamps, medicare, medicaid. SSI, Social Security Nutrition, and federal-aided housing. Without transportation a majority of older people can not use these services. The federal government must be concerned with giving older people access to these federally financial services.
The administration report to Congress on senior citizen transportation is well worth your reading.
Reduced bus fares for seniors during off hours is now federal law if bus service receives federal support. In the Twin Cities in Minnesota we have free fares for off hours. Even with modifications, many can't get on or ride the bus, find carrying food bags on the bus impossible, can't get to the bus stop, can't stand that long at the stop and the buses don't go from their home to medical and social services.
The cost of most of these services run from about a $0.80 to $3.50 per passenger trip depending upon distance, density, number of riders, degree of handicap, etc.
Most require advanced reservations even on the fixed route operations. A number, such as Racine, Wisconsin use volunteer drivers. A number of other systems supplement with cars with volunteer drivers. Perhaps 14 use radio dispatch and most phone reservation dispatch from a community, senior, or nutrition centers. In some places there are contracts with cab or bus services but most all are either a separate non-profit agency or a part of a larger community service non-profit agency.
By and large, most public transit systems are a "hands off" system with drivers instructed not to give help and assistance to passengers on boarding and movement. The senior transportation systems are a “hands-on” system with drivers usually instructed to give assistance in boarding and with packages. The most common reason for transportation trips in some of the projects we have studied are to medical services, shopping for groceries, trips to the nutrition and senior citizen center programs, trips to social and goverument agencies, and trips to get medication and drugs.
It is probably the fastest developing area in aging. Major issues are going to develop our bus design, what is the relation to transit authorities, unions and cab companies and relation to efforts for transportation for the handicapped.
The recently released report on Senior Transportation to the Congress and this Committee is good survey of the transportation problems and programs of older people. The Committee will be making major policy on transportation for seniors and handicapped in this law.
I urge that the McGovern-Schweiker Title 309 Senior Transportation section be continued at the rate of $45 million for fiscal year 1976. I would suggest maximum flexibility as Commissioner Flemming and their staff is working hard to work out cooperative relations with DOT so that these programs are properly coordinated. I would like to suggest one amendment that would "provide for limited use of these funds in cooperative efforts to provide for transportation for younger handicapped persons as well as those people over age 60 at the discretion of the administration on aging.
The Title III decision process is a most democratic one with great participation by the older people themselves. For a major decision it involves tens of thousands of people at the local organization and agency level, agency and community agencies, area agencies on aging, state units on aging.
What we have happening in over 1000 different areas of the country is a decision to fund separate senior citizen transportation reserve-a-ride mini bus systems with some variation. This was not a federal policy or directive, but collective community decision making at its best. Because of the need for community matching funds (mostly at 75–25% match) and the prospect of community funding in 3 years, this decision is not lightly reached.
Commissioner Fleming plans to hold 4 hearings on transportation in the near future but recommendations which involve funds are not likely to come forth from the OMB at this time, Congress will have to unite action. I hope the Congress will review the McGovern-Schweiker Section 309 Senior Transportation program.
I would like to make a special plea for the Indian transportation programs. In many Indian cultures the grandparents are responsible for the very young children. They would like for permission to allow pre school age grandchildren who are in the charge of persons over age 60 to use the senior citizen transportation services and nutrition programs on Indian reservations at the discretion of the administration on aging.
I would urge that this Committee request the new House Committee on Aging when it is formed to undertake hearings and study on the whole range of transportation problems. ouer Tolunteer Programs
The Foster Grandparent program and RSVP were a part of the Administration and a part of the Older Americans Act. The study of RSVP indicated the importance of the technical assistance received for the RSVP specialists in the state unit on aging furnished under contract. The situation of the older volunteer programs in ACTION is not good and the continuing lack of understanding and proper staffing at the regional level for these programs as the programs have been regionalized and decentralized by Action has hurt the programs. The staff of the Older Americans Volunteer programs have been ignored in many areas of policy making by the regional offices.