recommendations regarding transportation services that affect older individuals and to provide coordination of such services. Requires the Commissioner on Aging to submit a report regarding transportation services provided under the Act. Introduced April 23, 1991. Referred to Committee on Education and Labor. H.R. 2022 (Snowe) Outreach, Information, and Referral Older Americans Amendments of 1991. Amends Title III to require State and area agencies to give special emphasis to information and referral and outreach services to isolated older persons and those who are victims of Alzheimer's disease and related disorders, and their caregivers. Introduced April 23, 1991. Referred to Committee on Education and Labor. H.R. 2023 (Snowe) Older Americans Guardianship Assistance Amendments of 1991. Amends Title III to authorize services relating to the appointment and monitoring of guardians and representative payees of older individuals. Introduced April 23, 1991. Referred to Committee on Education and Labor. H.R. 2024 (Snowe) White House Conference on Aging Act of 1991. Requires the President to call a White House Conference on Aging in 1993. Introduced April 23, 1991. Referred to Committee on Education and Labor. H.R. 2025 (Snowe) Older Americans Act Eldercare Amendments of 1991. Amends Title III to require bates to expand State and community involvement in order to promote cooperative efforts to provide communitybased long-term care services to elderly persons including related services for their caregivers. Introduced April 23, 1991. Referred to Committee on Education and Labor. H.R. 2026 (Snowe) Caregivers Supportive Services Amendments of 1991. Amends Title III to provide supportive services to informal caregivers who assist older individuals in need of long-term care to remain in their homes. Introduced April 23, 1991. Referred to Committee on Education and Labor. H.R. 2391 (Saxton/Hughes) In-Home Care Encouragement Amendment. Amends Title III to authorize States to transfer to Part D not more than 50 percent of the funds allotted for Parts B and C. Introduced May 20, 1991. Referred to Committee on Education and Labor. H.R. 2392 (Saxton/Hughes) Consumer Protection Demonstration Projects Projects Amendment. Amends Title III to authorize appropriations for fiscal years 1992 and 1993 for consumer protection demonstration projects. Intro duced May 20, 1991. Referred to Committee on Education and Labor. H.R. 2393 (Hughes/Saxton) Older Americans Health Promotion and Disease Prevention Act. Amends Title III to expand the preventive health services program to include disease prevention and health promotion services. Introduced May 20, 1991. Referred to Committee on Education and Labor. H.R. 2653 (Smith) Requires the Commissioner on Aging to carry out model volunteer service credit projects. Introduced June 13, 1991. Referred to Committee on Education and Labor. H.R. 2780 (Roybal) National Older Americans Advocacy and Protection Amendments of 1991. Increases the authority of the Commissioner; establishes the Office of Long-Term Care Ombudsman Programs and provide for the appointment of an Associate Commissioner for Ombudsman Services; enhances the State long-term care ombudsman programs; provides financial assistance for programs relating to elder abuse, exploitation, or neglect; and for other purposes. Introduced June 26, 1991. Referred to Committees on Education and Labor and Ways and Means. APPENDIX D-Aging Advocacy Organizations' 1991 Reauthorization Recommendations AMERICAN ASSOCIATION OF RETIRED PERSONS The American Association of Retired Persons (AARP) appreciates this opportunity to outline what we regard as the major issues of the 1991 reauthorization of the Older Americans Act (OAA). The Association strongly supports the OAA programs, which constitute the major vehicle for the provision of social services to older persons in this country. For many years, however, AARP has been concerned about the effectiveness with which these programs are being targeted to the most vulnerable older persons, the accuracy and quality of program data, and the effectiveness of the Administration on Aging (AoA) in providing guidance and technical assistance to the states, as they execute the mission of the Act. RECOMMENDATIONS Implement better data collection procedures, in order to monitor the effectiveness of targeting efforts; include the intrastate funding formula as part of the state plan and make it subject to approval by AoA; require AoA to monitor each state plan and funding formula for possible discriminatory effects on minorities; require any intrastate funding formula that does not specifically include the incidence of low-income and minority individuals in the state to explain why inclusion of these factors is unnecessary; develop a standard definition of "rural", and require the intrastate funding formula to include a rural factor, or explain why this factor is unnecessary; mandate AoA to provide technical assistance to states on how to improve minority participation and require states to provide technical assistance to minority service providers; require state and area agencies on aging to (a) establish specific action plans to ensure increased service provision to low-income minority individuals in each planning and service area, and (b) evaluate the effectiveness of service delivery to low-income minority individuals in each planning and service area, including quantitative data on types of services received and intensity of services received; request the U.S. Commission on Civil Rights to conduct a follow-up study on the adequacy of OAA services to minority individuals; strengthen requirements for improved coordination between Titles VI and III, and increase funding for both Titles; direct a portion of Title III services to persons residing in assisted housing; exempt the SSI/Food Stamp/Medicaid Outreach Demonstration from the 105% funding "trigger" and extend the outreach demonstration throughout the next reauthorization period; require AoA, when awarding national grants, to give priority to projects that target low-income minorities; state units on aging also should emphasize service to low-income minorities, where they are given grant-making authority; and require competitive awarding of all grants under Title IV of the Act unless special circumstances dictate sole source contracts; require public dissemination of research and demonstration results funded by Title IV; and require periodic evaluation of all Title IV multi-year grantees with public dissemination of evaluation results. The Association stands ready to work with the Congress during the reauthorization process to achieve the important goals of improving administration of the Act and targeting services to the most vulnerable older Americans. (102) NATIONAL ASSOCIATION OF STATE UNITS ON AGING, The Honorable David Pryor Chairman, Senate Special Committee on Aging SD-G31 Dirksen Senate Office Building Washington, D.C. 20510-6400 Dear Senator Pryor, May 15, 1991. The National Association of State Units on Aging is pleased to have this opportunity to highlight our recommendations for the 1991 reauthorization of the Older Americans Act. At the same time we want to applaud the participatory process you used during the past year to receive ideas and suggestions from all actors in the field of aging. NASUA has developed a comprehensive set of specific recommendation for changes in the OAA. We believe that these changes I would continue to strengthen the capacity of the OAA network to be responsive to the changing circumstances, needs and preferences of the nation's elderly. These policy recommendations include: elevating the rank and status of the Administration on Aging and the U.S. Commissioner on Aging a new set of targeting requirements for state plans, area plans and service provider contracts a cost sharing proposal for certain services provided under the Act to enhance coordination, ensure equity, encourage targeting and generate new resources a new Title VII-Grants to States for Elder Rights Programs-to consolidate and underscore the advocacy responsibilities of the aging network-ombudsman, elder abuse, legal services development and benefits counseling new provisions to underscore the "public purpose" mission of network agencies while encouraging appropriate public/private partnerships maintaining state leadership and flexibility in the administration of the Act a set of new provisions to enhance coordination between Titles VI and III, and to underscore the responsibilities of the aging network to older native Americans Thank you for this opportunity to present NASUA's views on the OAA reauthorization and thank you for your continued advocacy and concern for older Ameri cans. Sincerely, DANIEL A. QUIRK, Executive Director. NATIONAL ASSOCIATION OF AREA AGENCIES ON AGING RECOMMENDATIONS FOR THE 1991 OLDER AMERICANS ACT REAUTHORIZATION I. Increasing Access to Services Enhancing targeting efforts to low-income minority, frail, and rural elders through changes in intrastate funding formulas, having state formulas reviewed and approved/disapproved by the Commissioner on Aging, having Area Plans contain specific targeting objectives, and by other means. Improving the data collection system so that it is consistent across states and allows an accurate assessment of service utilization, minority participation, and unmet needs. Strengthening transportation funding, services, and coordination. Increasing the link between Area Agencies and public/low income housing. II. Elder Protection Strengthening the Long-Term Care Ombudsman program. III. Strengthening the Aging Network Elevating the position of the U.S. Commissioner on Aging to the rank and status of the head of an operating division within the Department of Health and Human Services. Utilize the existing network of Area Agencies on Aging to coordinate federal programs for older persons at the local level, including SSI outreach, Medicaid, housing, and food stamps. Promoting a lead role for State and Area Agencies in a national community-based long-term care system. IV. Enhancing Resources/Resource Allocation for the Aging Network Increasing the authorization/appropriations levels for Older Americans Act pro grams. Supporting Public-Private partnerships, while insuring that the public mission of Area Agencies is maintained. Voluntary cost-sharing to defray the expense of costly in-home services. New responsibilities or special mandates must be accompanied by additional funding. As new tribes are added to Title VI, current grantees should be held harmless. V. Operational Issues of Concern to Area Agencies on Aging Area Agencies on Aging having the authority to directly provide outreach and information and referral services and care/case management. Establishing "due process" procedures for states to follow in the dedesignation/ redesignation processes of Area Agencies and planning and service areas. Restore the provision that prohibits State Units from requiring prior approval of grants and/or contracts entered into by Area Agencies Area Agencies are not agents or employees of the state. THE NATIONAL COUNCIL ON THE AGING, INC. POSITION STATEMENT SUMMARY ON THE OLDER AMERICANS ACT 1991 REAUTHORIZATION Long-term care and the OAA The National Council on the Aging (NCOA) believes that the major focus of the Older Americans Act (OAA) is to promote and maintain health and foster independence through the delineated social and nutrition services of Title III of the Act. NCOA holds that long-term care services addressing chronic health problems should not be provided under the Older Americans Act. While standards for inhome, case management, and other long-term care services may appropriately be developed under the OAA, implementation of such standards and provision of such services must be part of a national health or long-term care program much a program based on health care needs, not age, should have adequate appropriations and be located in agencies that can effectively carry out the administration of such services. Cost sharing NCOA rejects the concepts of means-testing and mandatory cost-sharing for OAA services. The real issue hidden behind cost sharing is the fact that federal funding has not kept pace with need. Congress must authorize and appropriate an adequate budget for an adequate budget for an Act that enhances the quality of life of millions of older people. Title V NCOA recommends funding for the Senior Community Service Employment Program (SCSEP) be increased by at least 11.3 percent. NCOA also recommends dual eligibility for the Title V and Job Training Partnership Act programs. Changes in OAA titles NCOA believes that transportation services provided under the OAA could best be improved by transferring administration of those services to the Department of Transportation. NCOA recommends moving the legal assistance, ombudsman, and elder abuse prevention services under a new "legal and protective services" title. These services are to ensure access. They do not include enforcement of laws protecting rights; that function belongs to other agencies. Public-private partnerships NCOA believes that public-private partnerships may present a potential for conflict of interest and abuse on the part of State and area agencies on aging and their stated mission of serving those with the greatest social and economic need, and therefore recommends close scrutiny of such arrangements. |