Mr. EAGLETON, from the Committee on Labor and Public Welfare, submitted the following

REPORT

Together With

SUPPLEMENTAL VIEWS

[To accompany S. 4044]

The Committee on Labor and Public Welfare, to which was referred the bill (S. 4044) to strengthen and improve the Older Americans Act of 1965, and for other purposes, having considered the same, reports favorably thereon without amendment and recommends that the bill do pass.

SUMMARY

This legislation extends and expands the Older Americans Act of 1965 to enlarge the scope of the services provided therein; it improves the organizational structure at the federal, state and local level of the agencies having responsibility for the delivery of such services; and it creates new programs to meet the demonstrated needs of older Americans. In addition, the bill creates an advocate for older persons to act on their behalf with all departments and agencies of the federal government whose policies and programs relate to or affect the particular problems and needs of the aging. More specifically, S. 4044 contains the following provisions:

(1) The Older Americans Advocacy Commission is created, composed of six members serving on a part-time basis and appointed by the President with the advice and consent of the Senate, no more than three of whom may be members of the same political party. The Commission is to

(145)

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Act as an advocate for the aging throughout the Federal government with respect to policies and programs relating to their particular needs and problems;

Evaluate existing programs intended to benefit the aging;

Make recomendations to the President, Congress, and to the heads of Federal departments and agencies regarding policies and programs affecting the aging;

By means of hearings, studies, publications, etc. inform the public about the problems and needs of the aging and activities of the Federal government designed to meet these problems and needs.

(2) The Administration on Aging is reorganized within the Department of Health, Education, and Welfare by removing it from its present location in the Social and Rehabilitation Service-which is oriented primarily toward income maintenance programs and placing it in the Office of the Secretary of Health, Education, and Welfare and assigning primary responsibility for carrying out the Act to the Commissioner on Aging. In addition to his other duties, the Commissioner is directed to establish and operate a National Older Americans Information Clearinghouse to collect, maintain and disseminate information relating to the needs and interest of older persons and to render technical assistance to similar clearinghouse operations operated by state and local governments for the purpose of providing information and referral services related to the needs and interests of the aging in their respective jurisdictions.

(3) The existing program of formula grants to the states is substantially expanded and reorganized to provide that funds shall be granted the states to provide a range of social services to the aging in accordance with approved state plans. The legislation provides further that the delivery of such services shall be accomplished primarily by area planning and service agencies to be designated by the state agencies and operated in accordance with area plans approved by the state agencies. State agencies are required to designate those area agencies of highest priority, in order to concentrate limited resources, and in such priority areas 90% Federal funding is provided while 75% Federal funding is authorized for projects in non-priority areas. Area agencies are intended, primarily, to coordinate and fund existing service providers rather than to establish themselves as new providers of services to the aging.

(4) In addition to formula grants to states, funds are authorized for direct grants by the Commissioner on Aging to model projects which will expand or improve social services for the aging. In making such grants, the Commissioner is directed to give priority consideration to projects in the areas of housing, transportation, continuing education, pre-retirement training and services to the physically and mentally handicapped elderly.

(5) The Commissioner is authorized to make grants and contracts to conduct research in the field of aging and for training personnel for programs for the aging, including the establishment of multidisciplinary centers of gerontology. A special program of grants and contracts is authorized for the conduct of special demonstration programs for meeting the transportation needs of older Americans.

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(6) Funds are authorized to make grants to pay up to 75% of the cost of acquiring or renovating facilities for use as multi-purpose senior centers. Also authorized is Federal loan insurance and interest subsidies to assist in such acquisition or renovation, and funds are authorized for initial staffing grants for the operation of such centers,

(7) The authorization for the Foster Grandparent and RSVP programs previously conducted by the Administration on Aging and since transferred to the ACTION agency—is extended for an additional three years and a new program is established to permit the provision of services to individuals other than children.

(8) Title VII of the Older Americans Act, which provides nutrition services for the elderly, is amended to expand the range of surplus commodities available for the use in such programs, and to consolidate the state administration of Title VII and Title III programs.

(9) The Commissioner is authorized to make grants to the states for special library and education programs for the elderly.

(10) New programs are created in the Department of Labor to provide for the employment of individuals 55 and older in community service activities, and to provide special counseling and training programs for middle-aged and older workers.

BACKGROUND

The Older Americans Act was first enacted by the 89th Congress in 1965 and, thereafter, was amended in 1967 and 1969. Since its enactment, virtually all of the states and territories have created state offices of aging and, in addition, a total of 1,215 local agencies have been created to deal with the problems of the elderly. Of these, 283 are funded under Title III of the Act and another 932 are funded from other sources.

From small beginnings in 1965, programs under the Older Americans Act have expanded substantially. The following table shows the appropriation history:

Total Appropriations Under the Older Americans Act-Fiscal Years 1966-73 Fiscal year:

1966

1967

1968

1969

1970

1971

1972 Annual

1972 Supplemental

$7,500, 000 10, 275, 000

18, 450, 000

23, 000, 000

28, 360, 000

33, 650, 000

46, 450, 000

55, 250, 000

101, 700, 000

Total fiscal year 1972. 1973 Request

257, 000, 000

The principal focus of activity under the Act has been through community programs conducted under Title III to provide services to older Americans. Last year more than 800,000 older persons were served by 1,721 projects funded under Title III.

Services for independent living were offered in 235 community programs during 1971. These programs were designed to maintain independent living arrangements for the elderly and assisted in reaching a large portion of elderly shut-ins. These in-home and out-of-home

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services made it possible for the elderly to maintain a sense of dignity and independence in their own familiar community environment.

There were 416 community programs on aging which involved older volunteers. These volunteers assisted in such services as visiting, telephone reassurances, transportation, teaching adult education courses to other older persons, preparation and delivery of meals, and were involved in the planning of community activities and services for the elderly.

Group meals and home-delivered meals were provided to 24,913 older persons to help solve nutritional problems of the elderly. Many older persons unable to pay received this service without cost. In many programs, these meals were prepared and delivered by older persons. Senior centers and other community and neighborhood facilities were used for preparing and serving these meals. Many persons were served at least two nutritional meals, 5 days a week. Those elderly who were isolated have benefited from the delivery of meals to their homes on a daily basis.

There were 247 projects with transportation as a component or a sole service of the program. Many programs had one or two minibuses which were radio-equipped; cars and other vehicles were used as well. This service enabled older persons to keep doctors appointments, to go to health clinics and food stamp offices, to make trips at a distance, and visits to senior centers for other significant activities and services.

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There were 160 projects which offered health and health-related services to older persons providing visiting nurses and in-home health aides for the home-bound elderly. Other health-related services offered were health education, geriatric screening and referral, immunization programs, and homemaker services. These programs included the promotion of prevention techniques for accidents through education, and activities which provided the means to alleviate other particular emotional or physiological health problems of the elderly. A number of programs gave particular attention to the handicapped older person such as the blind or deaf, or those reaching these stages because of age, by counseling the older person in readjustment to their surroundings and homes. Often other older persons with similar handicaps provided this assistance.

There is a total of 1,215 local agencies on aging, with 283 of these directly supported by Title III funds and the remaining 932 funded through other auspices. Over 75 percent of these agencies received start-up financial assistance from the State Agencies on Aging under the Title III Community Programs. These local agencies on aging were the focal point for planning, developing, and coordinating services for older persons in local communities.

With assistance under Title III, State agencies provided support for 474 senior centers which were located in public low-rent housing, churches, public and private buildings and some institutions. These senior centers have satellite centers located in neighborhoods where the elderly reside. The satellite centers provided and delivered services tailored to meet the special needs of the elderly in the community. These senior centers also trained 2,434 elderly for employment and provided opportunities for participation and active engagement in community life.