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In addition,

The constitutional responsibility of the States is specifically directed at the general health and welfare of their residents. the major delivery mechanisms are based in the authority of State Legislation.

Any substantial system of services to adults, must be developed within the context of existing authorities, or it will require specific legislation to create and provide authority for a new delivery mechanism. The point we are making here is that only the State has the necessary authority and machinery for the development and delivery of comprehensive health and social services, and all States already have existing State agencies to perform these functions.

We are please to note that S-3391 incorporates this concept of Federal, State and local relationship.

any state is

While it is tempting again to contemplate the possibility of contracts and other arrangements between the federal government and a variety of parties, public and private, we believe that the result would be chaos and confusion in the fair name of pluralism. The primary vehicle for the expression of preference for goods and services within vested in the state legislative process. If the preferences of the aging and the elderly are to take on meaning, basic policy decisions must be made, and basic mechanisms for the provision of services must be developed within the context of that authority. If the primary responsibility is

vested in the private delivery mechanism, or if it is left to federal

regulation, or if it is fragmented and buried in a wide range of state and

Federal agencies, the opportunity for a National policy on aging which is responsive to their preferences and needs will be lost.

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11

We believe that the Federal government should hold the states

accountable for a level of services commensurate with national standards,

and that the pattern of organization should be negotiated, rather than left

entirely to state.

The bills now under consideration make provision for federal

organization.

One bill, S 3181, provides for the establishment of an

Office for the Aging in the Executive Office of the President. This

follows a recommendation offered by a distinguished committee of specialists

in Gerentology

arguments

to the U. S. Senate Special Committee on Aging. The

for visibility for the aged, the evidence of short shrift given the problems of older people when their concerns compete for attention and support in multi-service and multi-clientele structures, provide an impressive supporting base for this recommendation. We have some concerns about this recommendation, and recognize that such a location will only have value as long as the interest of the President is high, and he has confidence in and provides direct access by the individual in charge of

the program.

The alternatives of an interdepartmental committee, or an independent office such as the Office of Economic Opportunity present their own problems.

Other proposals have been forthcoming from all sources that the Administration on Aging should return to its original status of reporting directly to the Secretary of Health, Education and Welfare. This has received widespread support and was one of the major recommendations from the White House Conference on Aging. We believe that this proposal has merit.

We have appreciated this opportunity to present our views. With all the specific concerns which we have expressed, we want to be sure that we have made the point that we are encouraged by the fact that national policy for the aged is at the level of constructive choices of alternatives for meeting effectively the needs of our older people. We welcome the opportunity to respond to any questions which the members of the Committee may wish to direct to us.

U.S. SENATE,

SUBCOMMITTEE ON AGING OF THE

COMMITTEE ON LABOR AND PUBLIC WELFARE,

Washington, D.C.

The subcommittee met, pursuant to notice, at 10:10 a.m. in room 6226, New Senate Office Building, Senator Thomas J. Eagleton (chairman of the subcommittee) presiding.

Present: Senator Eagleton.

Committee staff members present: James J. Murphy, counsel. Senator EAGLETON. Let us officially begin the hearing. Good morning, ladies and gentlemen, the Senate Subcommittee on Aging of the Senate Committee on Labor and Public Welfare is in session to continue its hearing on the Older Americans Act.

Our first witness this morning is Mrs. Elaine Brody, director, Department of Social Work, Philadelphia Geriatric Center for the Gerontological Society.

Mrs. Brody, we welcome you. You may proceed as you desire.

STATEMENT OF MRS. ELAINE BRODY, DIRECTOR, DEPARTMENT OF SOCIAL WORK, PHILADELPHIA GERIATRIC CENTER FOR THE GERONTOLOGICAL SOCIETY

Mrs. BRODY. Thank you, Senator. My name is Elaine Brody. I represent the American Gerontological Society, which is a multidisciplinary organization of research investigators, educators, and practitioners. Our national membership includes physicians, nurses, biologists, biochemists, social workers, psychologists, sociologists, anthropologists, administrators, economists, and many others. Our interests are in scientific research, communication among scientists, practitioners, and educators, and the application of research to practice and public policy. I am director of the department of social work at the Philadelphia Geriatric Center, and principal investigator of several research studies funded by the National Institute of Mental Health and the Administration on Aging.

We wish to thank the committee for its leadership and efforts on behalf of our 20 million elderly citizens.

With respect to the organization arrangements outlined in the Church bill-S. 3181-and the Hartke bill-S. 3076-ordinarily organizational issues such as where aging is placed in the Federal structure are not a major concern of the Gerontological Society. Whatever the administrative arrangements, the more important issue is basic commitment and support of the needs of the elderly as ex