For example, Yolanda Jeselnick tells me she knows of many cases in which older persons stood outside for hours waiting for a bus that never came. Backup buses and replacement drivers often are not provided in adequate numbers to insure reliable service. The cost of maintaining and operating buses in isolated rural areas is staggering. Services provided by different agencies are usually not coordinated. School buses are idle during most of the day, when they could be used to transport many of the rural elderly. When funds are allocated uniformly on a per capita basis, rural areas are often placed in double jeopardy. First, the funds are usually inadequate because of the high cost of providing services in lowdensity areas. Second, essential services are often simply nonexistent. In her five-county area, for example, Mrs. Jeselnick tells me there is not even one Social Security Office. She told me that while the Farmers Home Administration does provide an excellent loan program that could help many elderly persons in her area to obtain better housing, the FmHA offices in the area are so understaffed that a huge backlog of loan applications have built up; and she says most elderly people in her area do not even know the program exists. She knows of many rural elderly who live more than 30 miles from the nearest hospital, with no public transportation available. These are only a few of the problems faced by the rural elderly. I wish to commend this committee for giving explicit attention to the problems encountered in providing essential services to elderly persons in rural areas. Hopefully, your deliberations will include hearings in some rural areas. If so, you are cordially invited to Pennsylvania. Senator CLARK. Thank you very much. We certainly are going to consider that invitation. We are going to be going into some rural areas. The plane has arrived so Elizabeth Myers is here. I am going to ask her to speak. She is the director of the Georgia Mountains Area Program on Aging, in Gainesville, Ga. Ms. MYERS. The weather and the airlines apologize. STATEMENT OF ELIZABETH MYERS, DIRECTOR, GEORGIA MOUNTAINS AREA PROGRAM ON AGING, GAINESVILLE, GA. Ms. MYERS. The programs for the aging established under the Older Americans Act of 1965 have probably done more for the rural elderly than any other Federal program with the possible exception of those administered under the various titles of the Social Security Act. Their popularity among all segments of the rural population cannot be denied and is attested to repeatedly in letters we receive from family members of the participants, from written comments that we get at public hearings, and from the program participants themselves. You asked to focus on the program impact in our area. I can be statistically accurate only with regard to the Georgia Mountains Aging Program but from conversations with other area agency on aging directors, I gather that the impact of the program in our area is repeated over and over in other rural areas. The 13 counties of the Georgia Mountains Planning and Development Commission, the designated area agency on aging in that region, lie in the northeastern part of the State. All or parts of the seven northernmost counties are located in the Blue Ridge Mountains. The terrain is rugged and well-paved roads are relatively sparse. On the east and south, the region is on Georgia's Upper Piedmont which ranges in elevation from 1,800 feet at the base of the mountains to less than 1,200 feet in the rolling land farther south. There, too, paved roads are sparse. The population of approximately 200,000 is thinly scattered over 3,500 square miles and only one town in the region has a population of over 10,000-four other towns having over 2,500. The rest of the area live in smaller communities or in completely rural settings. Thirteen percent of the population-26,000-falls in the 60-andover age range and 40 percent of these are below poverty level. Another 30 to 40 percent live at near-poverty level. Another 30 to 40 percent live at near-poverty or low-moderate income levels. TITLE VII NUTRITION PROJECT As the result of a needy survey of the elderly in the area, numerous meetings with social agency personnel and with the help of a large task force, a program was initiated in October 1973 that encompassed a title VII nutrition project with at least one meal site in each county, home delivered meals supplemented with title III moneys, areawide supporting services which include a strong outreach, information, referral and counseling component, and transportation in 12 passenger vans and by a corps of volunteer drivers. Homemaker and home health services are the major gap-filling services to date. In the 18 months of the program implementation, over 3,000-11.5 percent of the older people in the area have participated in one way or another, at a cost, under our present funding, of just under $200 per person per year. I have no idea how that cost compares with other urban areas. The total funding under titles III and VII of the Older Americans Act and title VI of the Social Security Act has brought $500,315 into the area in the form of salaries for 47 people hired to work in the program, van purchase, gasoline, insurance, volunteer and advisory council mileage reimbursement-most of these people are over 60-office supplies, rent, food, and other necessary items. All personnel live in the area and most of them live in the counties in which they work. The geographic barriers of mountainous terrain is exacerbated by the largely unpaved back roads where many of the participants live, and that red Georgia earth becomes a slippery quagmire in the rain and occasional snow. So far, we have been able to reach many of the most poverty stricken-those who live on the back roads-but it has taken some creative driving and intricate arrangements to reach some of these people who live on roads no van and few passenger cars can maneuver. There are still some parts of the region where physical accessibility is so difficult and costly in time and money and where few telephones are in service, that potential participants have not been contacted. INFLATION'S IMPACT Inflation is having a growing impact on the aging program, not only in the obvious areas of increases in gasoline and food prices, but in more subtle ways, too. Many participants have gone back to relying on fireplaces and wood stoves to help heat their homes and save fuel costs. This poses a very real fire threat and we find that during cold weather the people leave the meal sites earlier and often cancel needed medical and other appointments in order to forestall fires. Inflation has also put an onerous burden on rural towns and counties. These political jurisdictions are mandated to provide solid waste disposal, sewer and water systems, police and fire protection, schools and transportation to the schools, and jails and health facilities that meet certain minimum standards. Only two counties in our area meet the minimum standards of the National Fire Protection Agency and too many towns and counties are already operating on deficit budgets. Increases in utility rates are straining county and city budgets beyond their ability to meet necessary costs. One county commissioner has stated the problem well when he said: "You can't run a county for 7,000 people nowadays." It is unrealistic to expect local jurisdictions to show local financial support by picking up aging program costs, especially in light of the larger local matching requirements for non-title III funding. It is urgently recommended, by all that I have talked to in rural areas throughout the Nation, that title III funding to established area agencies on aging be sustained at a level commensurate with the financial facts of our existence. There are other problems we come across in rural areas and, I imagine, in the more metropolitan areas, too. The Administration on Aging requires that program components be contracted to minority owned and/or operated businesses or agencies in proportion to the percentage of the minority population in the area. This is posing a very serious problem, whether there is a lowminority population as in the Georgia Mountains area-8 percentand the program is implemented through only six contracts, or where there is a high-minority population with few minority businesses available. What is happening as a result of this requirement is that title III moneys are being spent to set up minority corporations rather than for the social services defined in section 302 of title III. This is a clear instance where there is a conflict between two valid values. We feel that a priority must be set which more closely carries out the intent of the Older Americans Act in providing services to the elderly. BARRIERS TO COORDINATING SERVICES Coordination of services is part of the function of the area agencies on aging. However, the barriers to effecting such coordination are often due to conflicting regulations and guidelines between programs at the Federal level. A step that can be taken to alleviate at least some of this problem would be that all titles of the Older Americans Act be administered by the Administration on Aging and that all appropriate titles be administered through State and area agencies on aging to insure that such programs come under a comprehensive and coordinated plan. This would include such programs as the retired senior volunteer program, foster grandparents, and the woefully underfunded senior companions program. Prior to the proposed title VIII legislation, the language in House bill 3922 relative to the funding and administration of title VIII pro grams is unclear. In addition, it seems that the services under parts B, C, D, and E are already defined as either supporting or gap-filling services under title III. The services are certainly needed, but do we need a new title to provide these services? It is always easy to find problems and pick at faults in any program. I do not want what I perceive as problems to overshadow the vast good that aging programs are doing in rural areas. I would like to quote part of a conversation I overheard at one of the meal sites in our area to underscore the valuable impact of the program: I'm a widow woman and I'm almost blind, so I can't see to read or sew any more. I used to be a nurse and the doctor says I have worn down the cartilage in my knees from so much walking on hard floors. I can't walk much or garden at all any more. I didn't care if I lived or died until I heard about this program. Coming here, seeing and talking to people again, going on trips-all this has made me want to live again. Senator CLARK. Very good. Let's see if there are questions by members of the panel here. Senator Domenici or Senator Chiles? Senator DOMENICI. I have a couple of questions to direct to Mr. Bryan. First, you did not have any prepared testimony, did you? Senator DOMENICI. Can I talk to you about two things that you have mentioned? You have mentioned mandating transportation as an ingredient to the program and then the remodeling of buildings. I am impressed with both of those. Let's talk about the second one first. OLD BUILDINGS RENOVATION I find that the remodeling of old buildings to serve as communitytype buildings is very intriguing. I have been through some of our rural areas and they are having a great deal of difficulty finding sites. No one is suggesting that you should build a brand new community center for an area that serves 90 people. There are all kinds of facilities. They may have an old church rectory in one instance. They may have a very old public school that they have acquired the temporary occupancy rights under and have done a little remodeling on it. Could you address yourself to the fact that, if we were to broaden this so that remodeling funds were made available under the act, how would you take care of the great diversity in ownership of the buildings that they can acquire? Some borrow from a church; some borrow from a public school; some borrow from a county courthouse facility. Is this presently a problem in your mind? Mr. BRYAN. I see the problem you raise and I understand the examples you have given. That is certainly what I was recommending in these rural areas. I feel that with appropriate stipulations, but I am somewhat at a loss as to how those stipulations should be written into the regulations that would prevent any undue gain coming to the actual owner, it would work out all right. Perhaps you could get a commitment on the part of the owner to make the facility available for a long period of time. In our State, Senator, most of these facilities would be made available by governmental bodies and municipalities, but they are small and they have a hard time coming up with the dollars to provide the renovations. I think title V of the act, if this were funded, would be very helpful in the rural areas. Again, as you said, we are not talking about fancy senior centers, but some place where the rural people can walk to, near their homes, for meals and other programs. Senator DOMENICI. I am not as worried about a gain going to the owner-lessor as I am in what the regulatory body would do in terms of adopting regulations or in terms of what kind of occupancy rights a senior citizen group would have to have. But to me it seems that if you are going to take a building that is not very usable and spend $4,000, $5,000 or $6,000 to remodel it, you ought not be required to have a 50-year lease or an ownership. It seems to me there has got to be some real flexibility here in letting them do it, based upon reasonable judgment, that they are going to get good use out of it. Mr. BRYAN. Yes, I agree with that. Senator DOMENICI. I have seen so much legislation where we thought we did that. But then when the little local agency applies, they want the lease to be for a 12-year duration or a 25-year duration. We are spending Federal dollars very meticulously. I suggest that this is a serious problem. I do agree that we ought to broaden its scope in funding. I want to share that concern with you. Mr. BRYAN. Your point brings to mind the comment by Ray Scott, from Arkansas, that we can be overregulated. We have to be aware of this; in some instances I think we have been overregulated. I think that is what you are referring to and I certainly agree. There has to be some flexibility. Let the States handle it. TRANSPORTATION MONEY CONTROL Senator DOMENICI. The other one that concerns me, and everyone has spoken about it to some extent so I will not direct the question only at you-you have pinpointed the matter very precisely with regard to transportation. For instance, there is no doubt but that senior citizen activity is run by different basic umbrella agencies depending on where you are. In parts of my State, CAP runs most activities. In another part of the State there is a new nonprofit corporation that was formed and things fit into it. As you know, they allocated some money for transportation and it is administered through the Department of Transportation. You know what they did? They sent it on to the highway commissions of each State. And then the highway commission had to make a decision with regard to the best administratively manageable program, what kind of entity could apply for the money to run the buses or vans or whatever. We ran into some immediate problems because the highway department chose the easiest route and said that municipalities know how to buy insurance, they know how to plan in advance for reserve drivers, and the like. So the few thousand dollars we got in New Mexico, for example, were spent by the highway department on only municipally owned entities or government entities as a valid applicant. It does appear to me that this was not our intent. 55-714-75-4 |