Title II-Administration on Aging

Establishment of the Administration on Aging.—The Administration on Aging is established within the Office of the Secretary of Health, Education, and Welfare as the principal agency for carrying out the purposes of the Older Americans Act and administering most of the grant programs authorized under the act. The agency is directed by a U.S. Commissioner on Aging who is appointed by the President and confirmed by the Senate, and who is responsible directly to the Office of the Secretary of Health, Education, and Welfare. As envisioned by Congress, the Administration on Aging is to have high visibility within the executive branch of the Government so it may serve effectively as a "Federal focal point" on all activities and matters related to the field of aging.

Background. Since conception of the Administration on Aging in 1962, its appropriate placement within the Federal framework has been questioned. The original sponsors conceived of placing such an agency at the White House level so it would not be subordinate to any one agency or department, but an independent agency able to carry out its interdepartmental functions. This placement, however, was strongly opposed by officials of the executive branch, therefore, the sponsors turned to a compromise position to expedite passage of the act. The Administration on Aging, was placed in 1965 within the Department of Health, Education, and Welfare and not as an independent agency.

Over the years, many policymakers have questioned whether the agency can carry out its interdepartmental functions and serve as a Federal coordinator, spokesman, and advocate for the elderly as well as impact on Federal programs and policies when it is placed within a Federal department.

During consideration of the 1978 amendments, discussion continued about the appropriate placement of the Administration on Aging. Sentiment ranged from placing the Administration as an independent office at the White House level to retaining the agency in its current position. The amendments, however, did not change prior law.

The Administration on Aging currently is placed within the Secretary's Office of Human Development Services (OHDS) along with service programs for other special groups such as low-income families. In support of this placement, the 1978 Senate bill report stated that

The committee believes that there is some benefit in having the Commissioner on Aging within OHDS for purposes of coordinating programs under the Administration on Aging with those programs administered by the Public Services Administration, the Developmental Disabilities Office, the Office of Child Development, the Office of Youth Development, and the Rehabilitation Services Administration. The committee believes that bringing these programs together fosters increased coordination and cooperation, and gives the Commissioner on Aging greater insight into overall policy development and program interface. Thus, while no new action with respect to AOA's placement in ŎHDS was taken in connection with this bill, it is a matter of continuing interest to the committee.7

The conference committee considering the 1978 Amendments retained the existing placement language, but noted that Congress will closely monitor the power and recognition accorded the Commissioner

6 U.S. House. Committee on Education and Labor. Hearings on Administration on Aging, H.R. 7957 and Similar Bills. 88th Congress. 1st Session, Sept. 17, 1963: 16.

7 U.S. Senate. Committee on Human Resources. Older Americans Act Amendments of 1978. Committee Rep. No. 95-855. May 15, 1978: 5.

on Aging and his ability to serve as a focal point for all Federal programs for the aging from his present organizational position."

Functions of the Administration on Aging.-The Act directs officials of the Administration on Aging to carry out the following functions: 1. Serve as the effective and visible advocate for the elderly within HEW and agencies and departments of the Federal Government by maintaining active review and overview responsibilities of all Federal policies affecting the elderly;

2. Serve as a clearinghouse for information;

3. Administer grants;

4. Develop plans, conduct and arrange for research in the field of aging;

5. Assist the Secretary of Health, Education, and Welfare with problems and matters pertaining to the aged;

6. Provide technical assistance and consultation services to States and localities;

7. Prepare, publish, and disseminate materials;

8. Gather statistics;

9. Stimulate more effective use of resources and services;

10. Develop policies and set priorities with regard to programs and activities under the act;

11. Coordinate Federal programs and activities;

12. Coordinate and assist in planning and development by public and private nonprofit organizations to establish a nationwide newtork of comprehensive services;

13. Hold conferences of public and nonprofit private organizational officials;

14. Develop and operate programs providing services and opportunities not otherwise provided by existing programs;

15. Continually evaluate programs and activities, paying particular attention to medicare, medicaid, Age Discrimination Act of 1967, as amended, and the National Housing Act;

16. Provide information and assistance to private nonprofit organizations; and

17. Develop plans for education and training, and in consultation with the Director of ACTION, encourage the participation of voluntary groups including youth organizations to serve the elderly.

Federal Agency Cooperation.-Programs under the jurisdiction of the Administration on Aging are to be coordinated with programs of other Federal agencies impacting on the lives of the elderly. The law cites specifically, programs under the Department of Labor, Social Security Administration, Department of Housing and Urban Development, and Community Services Administration, and Department of Transportation. It is intended that department heads will advise, consult and cooperate with one another to develop programs consistent with meeting the needs of the elderly.

Background.-Congress amended the Older Americans Act in 1973 to require Federal agency cooperation, and with the 1978 amendments strengthened this requirement. Unlike the 1973 law where responsibility for interagency coordination was placed solely on those agencies intending to establish programs related to the purposes of the Older

8 U.S. House. Committee of Conference. Comprehensive Older Americans Act Amendments of 1978. Rep. No. 95-1618. Sept. 22, 1978: 54.

Americans Act, the 1978 amendments placed responsibility for coordination on both the Commissioner on Aging and the directors of the other agencies concerned. Federal agency cooperation stems from duplication of effort and fragmentation of resources among public programs.

The National Information and Resource Clearinghouse for the Aging. As contemplated by the act, a national clearinghouse within the Administration on Aging is established to provide information directly or through State information and referral sources on a wide range of subjects relating to the needs and interests of older people and professionals in the field of aging.

The Federal Council on the Aging.-The 1973 amendments authorized the establishment of a Federal Council on Aging to consist of 15 members appointed by the President, with the advise and consent of the Senate for terms of 3 years, for the purposes of advising the President on the needs of Older Americans and assisting the Commissioner in appraising the need for personnel in the field of aging. In addition to advising the President and the Commissioner, the Federal Council on Aging has extensive duties relating to review and evaluation of policy and programs affecting older people, serving as a spokesman for the elderly, informing the public, and providing forums for discussing and publicizing problems. Not later than March 31 of each year, the Council is required to submit a report to the President, who is required to furnish a copy to Congress, on its findings and recommendations.

The council is required to conduct a study of the effectiveness of all programs conducted under the Older Americans Act, including an examination of the fundamental purposes and effectiveness of these programs; an identification of the numbers of low-income and minority elderly participating in the programs; alternative methods of allocating funds under the act; an analysis of the need for area agencies on aging to provide direct services; and an analysis of the number of nonelderly handicapped in need of home-delivered meals.

Administration of the Act.-In carrying out the purposes of this act, the Commissioner on Aging is authorized to:

(1) Provide consultative services and technical assistance to public or nonprofit private agencies and organizations;

(2) Provide short-term training and technical instruction;

(3) Conduct research and demonstrations;

(4) Collect, prepare, publish, and disseminate special educational or informational materials; and

(5) Prepare a report by September 30, 1980 on the effectiveness of legal services funded under the title III program of grants for State and community programs; and an analysis of the need for a separate program of legal services under the Act, including factors which may prohibit AoA funding of legal services projects without such a separate program.

Title III—Grants for State and community programs on Aging

Summary.-Title III authorizes grants to State agencies on aging for developing a comprehensive and coordinated delivery system of social services, nutrition services and multipurpose senior center facilities. To qualify for funds, the State agency must divide the State into separate geographic areas, known as planning and service areas,

and establish when feasible, area agencies on aging for developing a comparable delivery system within specified geographic boundaries. As part of the delivery system, area agencies coordinate existing resources and foster the expansion and development of community services for the elderly. They only fund directly those services not already available in the community. Area agencies also serve as advocates for the elderly.

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The title III organizational structure is intended to form a "network on aging” linking the Administration on Aging, State and area agencies on aging, other public and private agencies, and social service providers. This network is intended to help older persons in need of support care remain independently in their homes. It also is intended to provide a continuum of services as well as social and economic opportunities for older persons.

Background. În 1965, title III authorized Federal grants to State agencies on aging for funding directly social service providers serving the elderly. State agencies basically were dispensers of Federal funds rather than service planners, and some tended to dispense limited resources thinly over too many services and duplicate efforts of other public agencies. As a result, Congress revised the program in 1969 to give State agencies responsibility and funding for statewide planning, coordination and evaluation of programs which serve the elderly. Congress also continued the program's primary purpose of direct funding to social service providers.

With the 1973 amendments, planning efforts again were strengthened. State agencies on aging were changed from primarily a dispenser of Federal funds to basically planners of a comprehensive and coordinated social service delivery system for the elderly. In addition, the area agency on aging structure was created to perform a somewhat parallel role at the community level.

As to functions that might properly be performed by area agencies, the following comment extracted from the report of the Senate committee report is illustrative:

It is not intended 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 the area agencies into the position of providing services 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.9

In addition, State and area agencies were directed to provide greater leadership in identifying gaps and weaknesses in the delivery of services as well as fostering the expansion of services for the elderly.

The 1973 amendments also authorized grants for multipurpose senior center facilities for providing a central locale for the delivery of services.

Moreover, the title VII national nutrition program, created under the act in 1972, became increasingly part of the social services program with a growing number of area agencies on aging administering nutrition funds. Steps leading to integration of the nutrition and social services program began with the 1973 amendments which provided that

U.S. House. Committee on Education and Labor. The Older Americans Comprehensive Services Amendments of 1973. Rep. No. 93-19. Feb. 14, 1973: 9.

funds allotted for State administrative costs may cover both the social services program and nutrition program.

Insight into the purpose of this latter provision can be obtained from the following committee comment:

It is the Committee's intent that by having wherever possible only one planning authority for such funding, title VII funds can be used for providing additional nutritional services.10

Another provision of the 1973 amendments permitted nutrition projects to be made a part of the title III social services system when mutually agreed upon by area agencies and those receiving nutrition grants. In explaining the purpose of the amendment, the following comment appears in the House Committee Report:

It is not the intention of the committee to remove the special identity that the title VII programs have already achieved, although we do encourage the integration of such projects with the comprehensive title III programs.11

In order to further strengthen planning efforts and coordination of services for the elderly, the 1978 amendments placed the grant program for social services, multipurpose senior center facilities and nutrition services under the State and area agency on aging administrative structure. The amendments aim toward providing a more efficient service delivery system as a result of the funding and operation of programs through the area agency on aging.

State organization and State plans.-The Governor-designated State agency on aging is required to develop a 3-year plan for providing a comprehensive and coordinated social services delivery system. The plan must include provisions for social services, congregate meal programs, home-delivered meals, multipurpose senior center facilities, the division of the State into planning and service areas, and the establishment of area agencies on aging. The plan also must include provisions for a statewide ombudsman program for protecting the rights of residents of nursing homes and other long-term care facilities.

The 3-year plan must be approved, first by the Governor and then by the U.S. Commissioner on Aging. Once approved, a Federal grant is awarded to the State based on the State's proportionate share of the Nation's age 60 and older population.

More specifically, the State plan must provide that the State agency will

(1) Analyze the needs and characteristics of the State's elderly population and provide assurances that preference will be given to providing services to older individuals with the greatest economic need;

(2) Identify and analyze available resources;

(3) Establish and/or maintain information and referral services if otherwise unavailable to assure that all older persons have reasonable convenient access to such sources;

(4) Assure that area agencies will not provide services directly unless a service otherwise cannot be provided adequately;

(5) Coordinate all State activities relating to the field of aging. (6) Develop an intra-State formula for distributing funds throughout the State taking into account the State's geographical distribution of the age 60 and older population;

10 U.S. House. Committee on Education and Labor. The Older Americans Comprehensive Services Amendments of 1973. Rept. No. 93-43. Mar. 2, 1973: 24. 11 Ibid.