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OHI0 COMMISSION ON AGING On the renewal of the Older American Act of 1975 before the House Subcommittee on Labor of the House Labor and Education Committee, January 31, 1975.

Chairman Brademas and member of the Committee, I appreciate the opportunity to present to you some comments, thoughts, and recommendations concerning the Older Americans Act from my perspective as an executive of a state unit on aging.

I would like to begin my testimony by saying emphatically that Ohio endorses the philosophy and goals of the Older Americans Act. The concept that permits the triple layer approach to administration planning coordination and advocacy at the federal, state, and community level enhances the possibilities of broadening the political base for the program while raising the public consciousness about both the problems and potentials of the elderly.

While the program functioning under its present strategy has been in operation barely a year, it is clear that the first important steps have been taken and that results are direct and tangible. The members of this Committee who have in the past fought hard for improved services for the elderly and the new members should be made aware of some of these results. I would like to enumerate some accomplishments of the Ohio Commission on Aging-not that Ohio is necessarily a leader in the field, we have a lon way to go. However I thi the efforts in Ohio might not be uncommon. I cite these points because they are examples of what can be accomplished when the public awareness of an issue has been raised and more importantly when the elderly themselves are involved in implementing programs.

(1) For the first time Ohio has appropriated state funds for reduced fare on public transit for the elderly.

(2) A coalition of ten state-wide elderly organizations has been formed and as preparing to deal with the tremendous increases in the cost of utility bills as its tirst major project.

(3) Significant liberalizing amendments and administrative changes were made in the Supplemental Security Income program as a result of concerted political action by Ohio's elderly and the elderly from across the nation.

(+) For the first time both the Ohio House of Representatives and the Ohio Senate have permanent standing committees on aging.

(5) A fourteen agency State Interdepartmental Committee on Aging has been created to insure coordination and maximum services to the aged from these fourteen state agencies.

(6) The Commission has been able to serve as a resource to members of the Ohio Congressional delegation by providing research and background information for their deliberations and use.

Dr. Flemming's leadership has been positive and powerful. At times we have screamed that he was acting too powerfully. However, I have no question that Dr. Flemming and his staff at both the national and regional level are concerned and committed to improving the quality of life for older Americans.

You will hear if you have not already heard that there are in some states conflicts between Area Agencies on Aging (AAA) and the State Units (SU). That is to be expected and a certain level of creative tension can be helpful. However some unnecessary debilitating conflicts can be avoided by more clearly spelling out the various roles and responsibilities of the AAA and SU. Both need to be strong. Neither makes maximum impact unless both are strong and clear as to the respective roles. I would suggest the following:

(1) Allou a hidher percentage of the state's allocation to be spent of AAA ar ministration.--While some may argue that less money instead of more should go to AAA administration, it should be borne in mind that advocacy is an important element of the LIA functioning. Ohio has 14 AAA's. All save one are multicounty agencies. It takes this initial investment in planning and advocacy in AAA to insure that even more services for older people become available through other sources of funds.

(2) Strengthen consumer input.-AS AAA in itself does not insure maximum level of consumer involvement, an openness to consumer input and a bona fide effort to develop it must be characteristic of the AAA. Increased administrative funds will help this process by providing training and personal expenses for advisory councils and specifically the low income members.

(3) Reduce the intricacies and frustrations of the planning procc88.-We at the state level feel AAA has been compulsive in requiring a planning process

that is unrealistic and unnecessary. Since the problems of the aged are of such magnitude and will take years to address, it seems reasonable that states should be required to provide long range planning perhaps once every three years with annual less extensive revisions as objectives change. If this is done, states can be placed on a rotating schedule for submission of their long range plans and consequently receive more rational technical assistance from AAA.

(4) Determine either that coordinator and pooling of resources are administrative functions and should be funded at a 75/25 ratio or are services under Part B and eligible for the 90/10 ratio.

(5) Prevent OHD from raiding AAA staff particularly in the regional offices.

(6) Take steps to prevent the A95 process from becoming a gun-at-the-head-of the State Agency on AAA as happened with the A95 review of the FY 1975 plans.

(7) Allow a waiver to Title III and Title VII to secure financial information on certain participants in order to determine eligibility for Title XX funding thus increasing financial support for services offered under both Title III and Title VII.

(8) Take steps to allow Revenue Sharing monies to be used as local match for programs under the Older Americans Act. In view, of the fact that Older Americans have been substantially excluded from the benefits of Revenue Sharing and that some rural areas of the country find it almost impossible to raise local match. I feel this recommendation should be taken seriously.

(9) Transfer RSVP, FGP, and senior companions to AAA to be administered through state units on aging.

(10) Allocate $200,000,000 for programs under the Older Americans Act including Senior Citizens Centers, Section 309 (transportation) and services specifically designed to allow elderly to remain in their own homes and avoid institutionalization.

In FY 1975 Ohio will receive approximately $3.00 per year for each person age 60 and over from the Older Americans appropriations. We are requesting that this amount be doubled. In the meanwhile we are asking the Ohio legislature to allocate a 200% increase in state funds of Older Ohioans.

I am grateful for the opportunity to have appeared before this Committee to present my suggestions and to request your continued aid, in fact, increased support for our nation's elderly. I have not dwelled on the many problems our elderly face. This committee is well aware of them. I have emphasized instead some positive steps that have taken place in this initial phase. There are many more of these positive steps that have to be taken. Let's do that today.



(The result of a discussion anticipating the December meeting in

Washington, D.C.) After one year's experience, the State units on aging basically support the AAA approach. However, there are still major questions about roles and relationships. There is need for greater flexibility in approaches. Since there is yet no perfect model for either the States Unit on Aging or the AAA, we need that flexibility.

There need to be clearer definitions of the roles of the States, the AAAs, and AOA worked out jointly.

The States and AAAs are spending so much of their time responding to administrative details, requests, special requests for information, information memos, or directives, phone requests generated by AOA that the States and AAAs cannot do the basic job of planning, coordination and carrying out their plans.

A0A has too often come out with program instructions, guidelines, information memos, and directives after the fact. The States and AAAs have innovatively moved ahead where there has been no federal policy and AoA unilaterally sends out detailed instructions changing everything and causing the States and AAA to have to undo work, thereby injuring their credibility and effectiveness.

The food of information memos, program directives or instructions are being rigidly interpreted as law by AoA staff (particularly the regional staff).

Because many of these are or seem to be unclear, ambiguous, or conflict with the law, regulations or other HEW and AoA policies or pronouncements, AOA


should take greater care and do more consultation in preparing these papers. The States and AAAs cannot be held accountable when AoA directives, memos, and guidelines regulation, and statements are in conflict or ambiguous. Too often information memos and podium policies seem inconsistent with the law and regulations.

Present law, and particularly AoA policy, does not permit the flexibility for the states or AAAs to work cooperatively with integrated services or program efforts which causes conflict with other federal and State policies and priorities. The States and AAAs are restricted in contraction, sharing staff, and integrating efforts or projects.

The States and AAAs cannot be held accountable when AoA directives and memos give inadequate time for planning and implementation (for example 75-11, Affirmative Action).

AOA should be giving more leadership in policy formation and less in detailed administration. There is currently “over detailed” AoA administrative direction in such areas as Information and Referral, escort S.S.I. and energy.

There are important national policy areas that are seemingly neglected by AA including maintenance of effort, prevention of problems, pension planning. eraluation, long range financing (after 3 years) of projects, interfacing Older American Program efforts with human resources and services integration programs, SSI, SSA, COG and district planning councils.

The 15% limitation on planning and administrative funds for AAAS is imreal and creates administrative headaches and should be removed as well as the percentage of funds going to AAAs. The States and AAAs must realistically face the difficult task of how much to invest in administration, planning, and coordination with a simple administrative process which can be justified to the public. Calling “coordination” and “tapping untapped resources" direct services is unreal. The single area plan States need approximately 8% for the additional administrative and program costs involved in carrying out the area plan.

The States should clearly have the right to determine the criteria for the selection of AAA over and above the federal laws and official regulation,

AOA and/or the Federal Council should set an example of advocacy at the federal level. The States and AAAs have trouble with the advocacy role when AoA is silent on critical aging issues at the federal level and isn't providing leadership on legislation.

Regardless of the formula for State allocations in the 1975 Older American Act, the law, the regulations, and policy statements should clearly spell out that the mission of the Older American Act is to serve all older people on an equitable basis.

The State administrative funds should be in one budget and not separate line items for each program it has to administer and should be increased in proportion to the funds under all Titles it must administer.

The States find that the system of monthly “draw down" of A0A funds is unrealistic not allowing sufficient turn around time and strongly urge return to the "quarterly draw down". The administrative and program cost is disruption not worth the interest lost to the Federal Government.

The States need to take a greater role in Older American Act policy formation and the States and AoA should do more to insure better communication and consultation before policies are established.

I. The states are supportive of substate planning and administration of the
Older Americans Act. This process las contributed to improved policies and
services for older citizens through:

The more active involvement of older citizens in policy development.
The increased involvement and support of local elected officials.

The development of a broader policy and leadership role for state agencies on aging. In order to further strengthen this process. AOA should develop policies to provide the state increased flexibility in the designation of AAA's to meet particular state needs. Specific attention should be given to amending Sec. 903.66 to permit AAA's to purchase planning and other functions, when they are available from established multi-purpose agencies.

II. In order to provide state and area agencies with an opportunity to know and to reflect national policy for services to older citizens, prior to the initiation of each fiscal year, the AOA should develop a federal plan including three (3) to five (5) year's goals and one (1) year measurable operational objectives. This plan should be transmitted to state agencies for review and comment. In addition the Federal Council on the Aging should hold public hearings on the annual plan within each federal region.

III. Item le of Commissioner Flemming's letter to Mr. David Crowley states that AOA regards program instructions as binding. Given this interpretation, clarification is needed on the following points :

A. What is the legal basis for the development of binding policies without using established procedures such as promulgation of rules?

B. What is the legal basis for developing policies which deviate from or extend beyond existing statistics and rules? (i.e., policy requiring the destruction of information and referral identifiable records after 30 days).

C. What is the process for state agencies to appeal policies transmitted by program instructions?

IV. The Older Americans Act assigns the AOA prime responsibility for advocating the needs of older citizens in federal administrative and legislative decisions. While it is recognized that some of the federal interagency agreements have been developed with the objective of improving services for older citizens from existing resources, it is important that the needs of older citizens be actively advocated in the development of new or revised legislative and administrative policies.

A. What is the AOA position on the proposed budget reductions in food stamps, Medicaid and Medicare? Has AOA prepared an analysis of the impact of these reductions on older citizens?

B. Has AOA prepared a budget request for Title V appropriations since 1973? llas there been an analysis of the need for Title V funds?

C. What was the initial AOA budget request to OMB for the 1974–75 Title VII appropriations?

D. Did AOA actively support the inclusion of half for seniors in the Transportation Assistance Act?

E. Has AOA taken a position on Title XX? Does the AOA analysis of Title XX propose any amendments to provide increased benefits for seniors ?

F. Are AOA legislative analyses available for distribution to state and area agencies?

Mr. CARSTENSON. During this past 2 years in implementing the Older Americans Act and particularly title III, a number of complaints have come to the fore as to things that need to be altered in the Older Americans Act in order to help the States function more effectively.

I work as a consultant to a number of States: Ohio, Rhode Island, South Dakota, and Minnesota. This testimony is based on experience in working with these States and trying to cope with a number of the problems that have emerged.

Certainly one of the things which has been touched upon by earlier witnesses today and yesterday is the need for some tools for the State unit on aging and the area agency on aging and the Federal Government, the Administration on Aging, to deal with other agencies, to help make it an effective tool in working with other State and Federal agencies.

For this reason I would like to suggest that there be some flexibility, limited flexibility to negotiate and work out agreements with other State and Federal agencies, to work on joint projects, that this would greatly strengthen the ability to work with agencies such as the SSI program, such as social security, such as the employment service, and other State and Federal agencies.

The suggested changes, specifically on title III, are spelled out on pages 8 and 9 and 10, on through 11. I would like to call attention to two points. One is the problem of the A-95 review. It is being abused in certain States and in certain planning districts to use to coerce States and area agencies into providing contracts or arrangements.

I would like to suggest that some safeguards be put into protect the area agencies and State units on aging from this coercion.

I would like to in general commend the Administration on Aging not only for moving ahead in putting into operation a nutrition program in title III. Commissioner Flemming is an aggressive forceful champion of older people even if he is a bit of a hard taskmaster for State agencies and local area agencies on aging to try to reach older people.

I have been discouraged from the reports I have heard on the budget about the administration systemmatically cutting every single program in the field of aging without exception, or perhaps without exception. I am not sure about the SSI program. But every program whether it is senior transportation, senior aids, green thumb, RSVP, foster grandparents, title III, title IV, title VII, social security, food stamps, housing, every single program that affects older people by the Federal Government has been cut in the proposed rescinding of the budget items.

I urge that the whole thing be thrown out and you ask the President to come up with a budget that is not going to cut back on programs and services for older people.

I would like to suggest that perhaps the location of the older American volunteer programs should be changed back to the way that this committee had originally set the program up, mainly in the Administration on Aging or in HEW. I would strongly urge that this not be put through the traditional area agency-State agency channel, but rather worked out on an individual contract basis with the States, because of the problem of disallocation and because, frankly, I think the area agencies have a lot to chew on and a lot to do and a lot of things to work out, and so I would urge that it be put over in a family and a cooperative arrangement and relationship developed as it did in the past when the foster grandparents was in the Administration on Iging.

One other major area I would like you to consider is the problem of realistic financing of the title III projects on an ongoing basis. First of all, I think that because of our current economic situation that a 1year freeze on reduction or increasing the local share should be undertaken. We are in a very difficult situation where many local programs will not be able to raise additional programs will not be able to raise additional funds this year, and I would like to suggest this:

I would also like to suggest that certain kinds of projects, transportation, outreach, and information referral, do have a difficult time in getting local funding. I would like to suggest that the 309, the MeGovern-Schweiker program, be continued, but that the program not go below 60 percent Federal funding on an ongoing basis.

I heard the testimony yesterday about the great skills of the Department of Transportation and I am afraid in terms of having worked a good deal in the area of transportation with Congressman Beard and others in Rhode Island, it was a great experience in working with their senior transportation program, but AOA has a lot more skill and ability in senior transportation than does the Department of Transportation.

I am afraid that we are going to see a situation in the next 2 weeks or so where the Department of Transportation is going to come out

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