State and area agencies on aging stimulate the development, at the community level, of comprehensive, coordinated services for older persons through more effective use of all existing resources. Desired goal outcomes of.-Increased awareness of the needs of older persons and identification of resources that could be used to assist them at the Federal level in order to stimulate greater utilization and coordination of resources for development and maintenance of comprehensive and coordinated services for older persons at the State and local level. To implement this basic strategy, AOA has pursued the following approach: Negotiate signed, working agreements with Federal agencies. These agreements serve to focus the attention of the Federal agency on the service and other needs of the elderly. These agreements call for specific action items designed to bring into play the leadership and technical assistance roles a Federal agency can assume with respect to its State and local counterparts, thereby focusing their attention on the field of aging. Some of the areas typically covered by Federal agreements include: -General descriptions of the programs and resources of the agencies entering into agreements, including a description of the kind of coordination that is possible; -Agreement to establish a mechanism for identification and resolution of policy and administrative barriers to coordinated planning, development, and provision of services to older persons; -Commitments to prepare joint policy issuances and technical assistance -Exchange of relevant research and demonstration and evaluation findings; -Presentation of actions that could be undertaken to achieve coordination. The Administration on Aging had negotiated and signed twenty formal working agreements with other Federal departments and agencies by the end of fiscal year 1976. A brief summary of some of these follows. See list of working agreements negotiated by the Administration on Aging. Health The Administration on Aging is working with the Public Health Service and with the Medical Services Administration-the two Federal agencies that control health care resources-to insure that available health resources are directed toward meeting the needs of older persons, and that development and implementation of programs is coordinated to the maximum extent possible. Progress has been made in coordinating the resources available under the Public Health Service for long-term (institutional and noninstitutional) care and home health care. (These areas were made the priority areas for coordination because of AOA's emphasis on maintaining older persons in their own homes as long as possible and because of the congressional investigations of nursing homes that highlighted the need for immediate Federal actions and intervention in this area.) The Administration on Aging participates on an interagency advisory group on long-term care. Regional Offices have formed aging councils that are comprised of representatives of health and health-related programs and aging programs. These councils have assessed how to better coordinate health and healthrelated activities, have identified barriers to coordination in the area of longterm care, and have provided technical assistance to the States through a task force approach. LIST OF WORKING AGREEMENTS NEGOTIATED BY THE ADMINISTRATION ON AGING Affirmative action (Civil Service Commission). Community action programs (Community Services Administration). Community development (Department of Housing and Urban Development). Crime and victimization (Law Enforcement Assistance Administration). Disaster assistance (Federal Disaster Assistance Administration/HUD). Energy Conservation/Home Winterization (Federal Energy Administration, Community Services Administration-OEO, Department of Agriculture, Department of Labor, Department of Housing and Urban Development, ACTION, Public Services Administration). Health Services (Public Health Service). Information and referral: (a) Social Security Administration and the Social and Rehabilitation Service, (b) Federal Interagency Task Force on Information and Referral. Medicaid (Medical Services Administration). Native Americans (Office of Native American Programs, Indian Health Service, Office of Indian Education, Public Services Administration, Department of Transportation). Nutrition Sites in Public Housing (Department of Housing and Urban Rehabilitation Services (Rehabilitation Services Administration). (Department of Housing and Urban Transportation (Department of Transportation). Use of school buses (Department of Transportation and Office of Education). Volunteer programs (ACTION). AoA staff are participating on the Interagency Task Force on Home Health Services, which will prepare technical assistance materials for distribution to agencies at the State and local levels. In addition, the Administration on Aging has discussed joint activities with the National Institute for Mental Health, and with the National Institute on Aging. These discussions are to be the basis for agreements in the areas of mental health and biomedical research on aging. Housing/environment The Administration on Aging has begun to coordinate its resources with those of the Department of Agriculture Extension Service and Farmers Home Administration, Department of Housing and Urban Development, Department of Labor, ACTION, the Federal Energy Administration, and the Community Services Administration to weatherize and otherwise repair and upgrade the homes of low-income and older persons. The program was originally begun as an effort to winterize homes to lessen the impact of fuel shortages on the elderly. ACTION volunteers and persons employed under the CETA and title IX public services employment programs have provided the labor to make repairs and insulate homes across the Nation, and have learned carpentry and other skills and received income in the process. State and area agencies on aging locate older persons who need this service. Other agencies provide funding for the cost of supplies. About half the States now operate such programs. It is estimated that over 60 percent of all homes repaired or weatherized under this program were homes of older persons. The Administration on Aging has taken steps to insure that consideration is given to the needs of older persons in determining how title I Community Development Block Grant funds will be used. A memorandum of understanding was developed between HUD and the Administration on Aging providing for collaboration between the area agencies on aging and community development program sponsors to insure that funds under the HUD program were used for support of services that would benefit older persons, such as: Acquisition, construction, reconstruction, or installation of neighborhood facilities, senior centers, parks, walkways, and recreational facilities; the removal of architectural barriers in public and private buildings and access areas; services supportive of other community development activities. Technical assistance material on the possible uses of the community development block grant program was transmitted to the State and area agencies on aging. In an effort to facilitate coordination between the Administration on Aging (AOA) title III and title VII program and the Department of Housing and 83-524 O-77-7 Urban Development (HUD) section 202 and section 8 programs, AOA and HUD signed a joint working agreement in July of 1976. The agreement, which has been disseminated to the respective networks of HUD and AOA, focuses on strengthening the linkage of services provided under title III and VII of the Older Americans Act with facilities assisted under HUD's sections 202/8 programs. Another attempt to improve environments in which older persons find themselves is being made through the development of an interagency agreement with the Law Enforcement Assistance Administration. This agreement is to encourage cooperation between State agencies on aging and law enforcement, State planning agencies in developing programs intended to reduce the extent of victimization of older persons and to increase public awareness of and citizen involvement in efforts to reduce circumstances of crime against older persons. It has been transmitted to the State agencies on aging and their State law enforcement counterparts. Employment/Retirement The Administration on Aging has attempted to influence allocation of resources for public employment under the CETA program, through provision of technical assistance to State and area agencies on aging. They have been informed about the process for obtaining funding under CETA, and for influencing priority-setting relative to population groups to whom jobs will be targeted. In addition, staff of the Administration on Aging and the Department of Labor have worked together on program issues regarding the title IX senior community services employment program-a categorical jobs program for lowincome older persons (55 and over)-and on development of program materials for transmittal to State agencies on aging and to CETA manpower prime sponsors and national contractors under the title IX program. More extensive coordination of title IX program activities will now take place as a result of recently passed amendments to the Older Americans Act. Nutrition The Administration on Aging has also negotiated agreements with both HUD and the Office of Education to promote the development of congregate meal sites in public housing for the elderly and handicapped, and in existing school facilities. The Department of HUD has agreed to encourage both the use of space in current housing, and the design of space for nutrition programs as part of any new construction of elderly and handicapped housing. The Office of Education has also encouraged public school boards to establish nutrition sites in public school facilities. AOA staff have met with State representatives regarding utilization of these facilities for nutrition programs, and a number of sites are now located in public schools. In addition, ACTION has provided volunteers for assistance at congregate meal sites. They help with serving and preparation of meals as well as providing social services and assistance to older participants at the congregate site. Finally, the social services program supported under title XX of the Social Security Act can be a resource for the support of congregate meals, or for the provision of social services at title VII sites. Joint efforts between the State and area agencies on aging and the title XX State and local counterparts to support expanded nutrition programs or provision of social services at nutrition sites have been encouraged at the Federal level, by AOA and PSA, SRS. Many States have used title XX funds to support expansion of title VII programs. This has been difficult because of different income and reporting requirements of title XX and title VII. Additional efforts will be necessary to resolve the policy and administrative barriers that these different requirements pose. Transportation As part of a broader joint working agreement, AOA and DOT have agreed to support joint research, demonstration, and technical assistance activities to promote efficient and effective provision of transportation services to older persons. A first step in this coordination was taken with the joint AoA/DOT planning, development and conduct of biregional conferences on transportation for the elderly and handicapped. These Conferences were held in the early fall of 1976. More than 200 persons attended each of these Conferences. Participants consisted of local social service providers, local transit planners, and State aging and transportation personnel. AOA will participate in an OHD-directed and DOT-assisted coordinated transportation initiative which has as its goal the development, demonstration, and evaluation of coordinated or consolidated transportation systems to serve Office of Human Development target populations. During fiscal year 1976 and 1977, up to five sites will be selected for demonstrations of such coordinated systems, the sites being in areas where there are existing transportation services supported under Office of Human Development programs (e.g., The Older Americans Act, The Rehabilitation Act, Head Start, Office of Rural Development, Office of Native American Programs, Developmental Disabilities Act) but operating in a noncoordinated fashion. State and area agencies on aging have been encouraged to develop agreements at the State and local levels with State departments of transportation or highways, local transit authorities and other State or local service agencies concerned with meeting the transportation needs of older persons. Currently 25 agreements exist between State agencies on aging and State departments of transportation. State agencies on aging are encouraged to work closely with the area agencies on aging to assist them in developing local-level transportation agreements with other social service agencies, local transit authorities and with private paratransit operators (e.g. taxis) in the planning, pooling and coordination of aging-related transportation services. Working together, in cooperation with these various agencies and organizations, area agencies on aging can take advantage of the opportunity to assist in the development of applications for funds and transit development programs that will provide the elderly and the handicapped with effective, coordinated transportation systems that meet their special needs. Many States and local areas currently operate diverse transportation projects ranging from the relatively inexpensive, informal use of volunteer drivers in small towns and rural areas to the use of sophisticated demand-responsive or regularly scheduled transit vehicles, often designed to meet their patrons' special needs. Free or reduced fares on public transportation vehicles are enabling the elderly in many parts of the country to travel during midday, night, and weekend hours. Many areas which permit older people to ride free during off-peak transit hours also offer reduced (but not free) fares during rush hours. Social services Action.-Under the Older Americans Act and the Domestic Volunteer Service Act of 1973, AOA and ACTION have developed a joint working agreement. This called for the establishment of at least one ACTION program in each aging planning and service area and the placement of older volunteers in the title III and title VII aging programs. These volunteers contribute significantly to the capacity of the area agencies and nutrition projects in providing better services to older persons with emphasis on the homebound and the handicapped. These services include information and referral, escort, home visiting, outreach, and telephone reassurance. Although the agreement focused on the ACTION retired senior volunteer program, the foster grandparent program, and the senior companion program, many of the State aging agencies and ACTION's State offices have developed activities which also involve the ACTION cooperative volunteer program and the VISTA program. Under the agreement ACTION designates an "aging resource specialist" in each of its State offices. The primary responsibility of the specialist is to support programs carried out under title II of the Domestic Volunteer Service Act and to coordinate those programs with the title III and Title VII programs of the Older Americans Act. The aging resource specialists were trained in 1975 and the list of these specialists was transmitted to the State agencies on aging and the local aging network in March 1976. As a result of the coordinated activities between Older Americans Act programs and ACTION programs more and better services can be provided to older persons. Title XX-The joint working agreement between AOA and the Public Services Administration, SRS, negotiated during fiscal year 1976 established a basis for a cooperative relationship and coordinated activities between title III and title VII Older Americans Act programs and the title XX social services program. Under this agreement AOA and PSA have designated staff members to work together for the joint resolution of policy and administrative barriers to coordinated planning and integrated provision of services to older persons. To strengthen State level coordination, AOA required that each State agency on aging have a formal written agreement with the State agency administering title XX as a condition for the approval of its fiscal year 1977 State plan. All States met this requirement. AOA Goal III: Federal capacity (title I, national objectives) Goal statement.-Increase the Federal capacity to contribute to the realization of the national objectives set forth in title I of the Older Americans Act, as amended. Desired outcome of goal III.-The desired outcome of goal III is the development, dissemination, and utilization of knowledge which will impact on the formulation and implementation of Federal policies which will lead to realization of the national objectives for older persons (as defined in title I of the Older Americans Act). Accomplishments Toward the accomplishment of this goal, the Administration on Aging was engaged in three significant information development activities during fiscal year 1976: (1) Identification of policy issues related to the title I objectives; (2) Identification of research issues related to the title I objectives; and (3) Technical support to the Federal Council on Aging in its activities related to the title I objectives. (1) Policy issue identification: AOA awarded four grants in fiscal year 1976 for the purpose of performing intensive exploration of each of the substantive policy areas of income, housing, employment, and community services. The first phase of this exploration will focus on a comprehensive identification of issues associated with each of the policy areas as they relate to older persons which need to be addressed in order to achieve the national objective in that area. In the area of income, for example, one of the policy issues identified might be: What should the Federal role be in assuring an adequate income for older persons? (2) Research issue identification: The second phase of the grants will focus on identifying and explicating policy research and disciplinary research issues associated with each of the four policy areas. The findings of these studies will form a basis upon which to develop a research program designed to answer policy-related research questions that need to be answered in order to progress toward achievement of those title I objectives related to the four policy areas. (3) Support to Federal Council on Aging: During fiscal year 1976 the Administration on Aging provided technical support to the Federal Council on Aging in the development of three major reports which the Council submitted to the White House and to Congress: -The impact of the tax structure on the elderly, -The interrelationships of benefit programs for the elderly, and -A Bicentennial charter for older Americans. These reports provide information which further clarifies issues related to some of the title I objectives. Other Federal Coordination Activities Besides the negotiation and implementation of interagency agreements discussed under goal II in the previous section, the Administration on Aging was engaged in other Federal coordination activities during fiscal year 1976. These activities are discussed below. Federal Regional Councils.-The Federal Regional Councils (FRCS) have established committees on aging in order to support the Federal government's Aging program of developing State and local programs for the elderly. The committees which are made up of the Regional Directors of several Departments seek to coordinate interdepartmental planning and program development with the view of identifying obstacles and assisting State and local officials to improve program delivery to the elderly. Some of the committees also include voluntary organizations such as the American Red Cross, the American Association of Retired Persons and others. Examples of objectives which the FRCs are focusing on include the following: (a) Providing retirement planning for Federal employees; (b) Working with State agencies on aging and area agencies on aging in the development, modification, and implementation of Interdepartmental Agreements promulgated by the Administration on Aging; |