solidates the funds available. Each community would receive its total formula allotment of funds as at present. But, working through its area agency, each community would be required to make a priority decision for using those funds, in order to have a substantial impact upon the most extreme problem confronted by older persons in that community. The legislation would not provide restrictions as to categories of priority other than the extensive agenda of legitimate general concerns that has already been elaborated. Rather it would provide that most of the funds available, somewhere between 80 and 90 percent, be expended by each area for a priority program in accordance with its perception of the most pressing local concern related to the needs of older persons.

Senator EAGLETON. You would let this decisionmaking process be made on the community level?

Dr. BINSTOCK. Yes, indeed.

I have generally found that when people are in severe enough condition to need governmental help, and I am sure you have found this, too, they do not have much trouble sorting out their priorities, whether it is starvation, blizzards, or whatnot.

Senator EAGLETON. Let us use Boston.

Dr. BINSTOCK. All right.

Senator EAGLETON. You would send a bag of money to Boston, to the mayor and the city council of Boston. Who would receive the bag?

Dr. BINSTOCK. In this particular case, because Commissioner Fleming approved it this way, that would be to the area agency of that community, which is the mayor's Commission on Elderly Affairs.

Senator EAGLETON. That is a committee appointed by the mayor, I will take your word for it

Dr. BINSTOCK. Agency run by the mayor. He calls it the MOBMayor's Office of Older Bostonians.

Senator EAGLETON. Is it fairly representative-that is, are poor people on that, minorities and so forth?

Dr. BINSTOCK. The consumers are there for participation as window dressing, but what I am saying is, let us revise the act to make sure they make the decisions. OK? They are there, and as long as they are going through the motions, why do we not use them for genuine decisions? In some communities they might choose legal services, figuring that is the way to get leverage and mileage through class action suits.

Let me give you a concrete example. Under medicare and medicaid you cannot really get reimbursed for these wonderful home health services we are all talking about, unless they have skilled nursing components in them. Yet there are a great many things to be done that do not require skilled nursing components. It could be very well through legal challenge that we might find that this is perhaps because of the way people in Mr. Califano's office are interpreting the legislation, and we could open up billions and billions of dollars to home visits that would not involve skilled nursing; a class action suit would be good.

Senator EAGLETON. I hate to interrupt you, but let us assume by some formula-let us assume it is going to be $50 million that is going to Boston.

Dr. BINSTOCK. Right.

Senator EAGLETON. Do we give any guidelines as to how that should be spent? Do we have a nonbinding, but a statement of purpose saying to help America's senior citizens, to help their health, their nutrition, their transportation? Do we have at least certain objectives?

Dr. BINSTOCK. I would take the ones you have legitimated through various transformations of the Older Americans Act. Say it has to be one of those objectives, but spend it on the one you think is your problem.

Senator EAGLETON. On the statements of purpose-I will put the statements of purpose in the record. I think this is not an exhaustive list but here are statements of purpose out of title III. We have model projects, and they have a bunch of statements of purpose. Title III: Transportation, in-home service-homemaker servicelegal services and counseling; residential repair; assist in meeting special housing needs of the elderly; provide continuing education for the elderly; provide free retirement education services; provide services to meet the needs of physically, mentally impaired elderly; meet the special needs of low-income, limited English-speaking elderly; and develop and establish day care centers for the elderly.

I am sure if I look around I can find several more statements of purpose. Let us suppose we put all of those together. Woodrow Wilson had 14 points. Let us assume we narrowed it down to 14, and say-all right, Boston, the mayor's Council on the Elderly, you have $10 million, $30 million, whatever you want within reason. Let us say a pretty nice piece of change. You have a go at it and given these statements of purpose, it is up to you. Is that about, in rough form, how you do it?

Dr. BINSTOCK. I would, and I will tell you why. Because if I picked it or you picked it, and we narrowed down that list, and I would have no trouble telling you what my No. 1 priority would

be

Senator EAGLETON. What would it be?

Dr. BINSTOCK. My No. 1, if it were not legal services because of the multiplier effect of class action, would be very specific things to help supplement the family's desire to take care of its older relatives, such as day boarding services, housekeeping services, somebody to mind mom or dad while you are out earning a paycheck that keeps the roof over your head.

Senator EAGLETON. You would realize that reasonable people disagree. I like the nutrition program. You like that program.

Dr. BINSTOCK. Right. It may very well be that in a rural community what I am talking about would be impossible, and in an urban area they may find that the most important thing to do.

There is no way somebody sitting here in Washington should tell the 80,000 governments that we have in this country how to do it, and say we are going to administer from here a comprehensive coordinated system, coordinating 80,000 governments. That is absurd. All right, if we are putting out the money, and nobody wants to be

the bad guy and pull it back then let us stop the nonsense of elaborating the agenda. Let's say, we found that there are great things to do but you folks, you have got to decide and spend up to 80 or 90 percent on that one category of thing you choose. The list of categories could be 14, it could be 20, it could be 8. A reasonable number of the things that have been legitimated up to now. That is what I would do.

Senator EAGLETON. You would require that 80 percent of the money would go for one item?

Dr. BINSTOCK. Right, 80 to 90 percent.

Senator EAGLETON. Make a substantial concentration in one area, whatever that local group wanted to make the No. 1 target problem? Dr. BINSTOCK. Certainly. In Boston right now, Senator, to give you a concrete example, we have title IV-A, the training thing. Now the State office on aging lays off the allotment to the Boston Area Agency on Aging. They put out a request for proposals and they decide ahead of time that maybe they are going to give 20 grants so they will keep 20 organizations happy. You call up and you find out that, well, there is going to be $2,500 worth of grant to each person who gets them. At this point anybody who really is interested in doing a job that might be useful says: Are you kidding? We are not in this just to say we got some. We cannot do a job with that. I am saying let us leave the money in lumps where at least one job can be done, rather than distribute it in little lumps that say, everybody is happy and loves each other and is going along and getting along.

Senator EAGLETON. You would make the money available directly to the local agency? Would you have the money at all pass through the capital city-Boston happens to be a capital-let us move to Missouri-would that money filter through Jefferson City before it goes to St. Louis?

Dr. BINSTOCK. At this point I would. If I were redesigning this thing to begin with, I would not set it up with what we got. We discussed this in 1973, if I remember correctly, when this area agency thing came into play. But given what we have got, what I would do is try to pull together the State units and the area agencies and the network that is out there, not attack and eliminate anybody who is there but try and show everyone how we can all benefit from pulling together and starting to solve problems, rather than seeing how we can build up domains.

I would work with the people we have. I would not create enemies within the family, so to speak. I would try to get them to see through some leadership, administratively, as well as legislatively, that if we do not all begin to turn our attention to solving problems of older persons, rather than those of the industries in the field of aging, the whole think is going to go away.

Senator EAGLETON. Let me try this on you for size. This just popped into my head. It is sort of an impulse thought because I do not want to go down in history as the guy who canceled home repair for the elderly or legal services for the elderly. If I cancel one of those sections, then they will say Eagleton killed it; he isn't for old folks fixing up their homes.

Could I accommodate to that? Suppose I put in the Older Americans Act a bottom line for the 1979 budget of $700 or $800 million, and with action down there, a total of about $840 million. Suppose I create a $1 billion entitlement, a mandatory spending of $1 billion for all of it. I can say I pulled out some of these other things but I increased the actual money by $100 or so million to protect me politically. How would that strike you?

Dr. BINSTOCK. I think that would be exactly the way to do it. The way to do it would be to say, OK, we are tearing down the walls. Nobody is cutting back and saying you cannot do home repairs, nobody is cutting back on money. What we are saying is, OK, you have had professional and Washington leadership in setting an agenda, but we do not know if Montana's agenda is the same as Jefferson City's. So you would have all these targets as being permissible ways to spend it. But you would require that 80 percent, or you might back that up to 70 percent, would be a massive or very substantial concentration in trying to do at least one program reasonably well. And report to us what is your one problem you are solving with this sizable lump we are giving you.

Senator EAGLETON. Let us suppose this Boston Council, they meet and meet and meet, and let us say there are 15 members of that council, 4 of them agree with you that it is-what did you wantlegal services?

Dr. BINSTOCK. Either that or some way to help keep the family going.

Senator EAGLETON. About four of them want nutrition, three of them want transportation, and a couple want something else, no really clear concensus coming out of that meeting. What happens? Dr. BINSTOCK. I think like many of the rest of the spots in our democracy, you have to go with the majority. Sometimes we have split decisions.

Senator EAGLETON. You have all these permissible things in the act; in any one city it is going to be pretty hard to get a clear majority for concentration. I like that idea of concentration.

Dr. BINSTOCK. That is up to the Commissioner. Presumably he will be saying, hey, if you folks-and he will tell the regional offices-if you folks cannot come to a decision, you are going to commit the most grievous error known in the business which is not expending your money before the fiscal year is out, because we are taking it back from you. That is a question of good administration. Senator EAGLETON. Let us say that works in Boston, and in Springfield, and Worcester and what have you. What do you do in Amherst, Mass., where I went to college? Well, it is a bigger town, now. Let us say Williamstown, Mass., a town of about 800, where Williams College is, and let us say we have a percentage for mula. You have to have that, because Senator Stafford from Ver mont is not going to take his chances competing against New York City and St. Louis. He has got to have an earmarked amount for the small States. We understand the politics of that. What are you going to do if let us say in Amherst the formula comes out to $20. 000 or in Williamstown, what are they going to do with $20.000? Dr. BINSTOCK. It would not come to that because fortunately, so far, the aging network has not elaborated to the point where the

area agencies are so numerous that the funds would get that small. It is true, if we get down to the point where every municipality is an area agency on aging, we would have that problem. At the moment you have Amherst lumped in with Holyoke and maybe Springfield and a couple others, and they would have to sit down and say, OK, we have to live with this in our area.

There are certain similarities here in terms of transportation, population, and if we cannot learn to live together on this, money is going to be taken away from us. They will have far more than $20,000 to play around with. There are only something like six area agencies in all of Massachusetts. There are millions of dollars going in. It will be bigger sums.

Senator EAGLETON. We have 1 agency in Missouri that has 11 counties, and geographically our counties are fairly big. It is a pretty thin population, so they lumped about 11 counties together. I do not know what they are spending in terms of dollars there but it is a lot of cities in those counties that have 500 to 600 or 1,100 people, but very thin. How do we deal with it?

Dr. BINSTOCK. I do not know if you have county managers or elected commissioners.

Senator EAGLETON. Commissioners.

Dr. BINSTOCK. They are enough attuned politically, I would think, to know they could sit down in a room together and say, hey, we have X number of dollars to go with; what can we get the most mileage out of here? Is it a transportation project that could bring together all 11 of our counties, and whatever other hospitals and other services we have. How can we best do it, keep everybody happy here, and feel satisfied we have used Federal dollars best? I think they have got that capability. I think they have got the capability better than the bureaucrats, with all due respect, down at Independence Avenue for understanding how to do that.

Senator EAGLETON. That may be so, although let me put a little cautionary footnote to your last statement. I heard from the very first day that I came to the Senate, from State legislators and others back in my home State:

You know what? We know what the people's needs are better than you do, Eagleton. You are now miles away and each year you get more remote because you have been away longer. We in Jefferson City, we are close to the people. Our State legislators come home every week. Give us the money and we will do the job.

Some of the most venal legislators in the world are around-I am not ready to surrender to that rubric that everybody out there is going to be well taken care of vis-a-vis the faceless bureaucrat in Washington. I am not a lobbyist for faceless bureaucrats. Let us not get carried away that all wisdom is out there or up here. There is some wisdom-and inept thinking, too-in all of us.

Dr. BINSTOCK. I certainly agree with you. Perhaps that gives me an opening to bring in a comment on the point you raised before, the question of representation on the Federal Council on Aging. It is a conventional concern, that the National Council on the Aging, the National Council of Senior Citizens, AARP, and so on, be represented. I do not know if you are aware that at the moment there is a postal service investigation going on of AARP in which

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