have termed its first phase, over the past dozen years. First, there is no doubt that the programs of the Older Americans Act directly help many older persons through the provision of a variety of health and social services, free meals, and opportunities to make useful contributions to community life. Second, the Act directly sustains hundreds of public and voluntary service and planning organizations, as well as research and education programs, devoted to concerns of older persons. Without sustenance from the Older Americans programs, many of these operations would not exist or would be devoting their attention and efforts to other matters than aging. Third, the elaboration of a so-called "national network on aging," anchored by more than 500 Area Agencies on Aging, generates ongoing support for the Act and its programs. Almost every Congressional District is served by an Area Agency and has within it some older persons who are benefiting from specific services provided through Older Americans Act programs. Fourth, the extensive range of programs initiated and supported through the Act has set forth a tremendous agenda of American society's responsibilities toward its older citizens, beyond those undertaken through the Social Security Act. Through a dozen years of legislation and implementation, the Older Americans Act has brought to the fore as legitimate public concerns the need for: home care services, transportation, nutrition, leisure programs, protection against crime, legal services, 31-813-79-22 - 3 regulatory ombudsmen, and a variety of other health care and supportive services. This process of programmatic elaboration has provided important leadership in directing attention to the issues of aging. And there is little doubt that American society has become more conscious of these issues. Unfortunately, these strengths of the Older Americans Act go hand-in-hand with a series of weaknesses. First, the extensive range of programmatic responsibilities has been elaborated without much sense of priority. Consequently, the available funds are distributed relatively thinly among many objectives and are far from sufficient to make a substantial impact on any given problem. A second and related weakness is that the programmatic agenda and the bureaucratic network have been developed in a fashion that may create an illusion that a variety of problems can eventually be solved through funding and implementation under the Older Americans Act. We can appreciate the extent to which this is an illusion if we consider that no one problem of the many toward which the Act's programs are directed could be solved through the present pattern even if funding were drastically increased. For example, according to recent testimony by the Director of New York City's Office on Aging, the Title VII Nutrition Program is meeting about one percent of the national need. Are we looking toward an appropriation of over $20 billion to fund the nutrition programs throughout the country? And tens of billions for each of the other programmatic needs? Certainly not! Yet our failure to confront the illusion that the Older Americans Act presents solutions to any of the problems on its agenda lets us ignore the challenges of making priority choices, and the challenges of looking to local priorities and resources. A third weakness is that the bureaucratic components of the network the public and voluntary service agencies and the universities and colleges have quite understandably become preoccupied with sustaining and expanding the different, thinly-funded program elements with which they are directly involved. Each program element has a corresponding set of bureaucratic or educational mechanisms, and each of these sets has developed its own professional organization or association. As a consequence, one finds a great deal of attention given to the apportionment of Older Americans Act funds earmarked for each of the bureaucratic domains in the network, but little, if any, attention to how a given problem confronting older persons is to be solved. In my own state of Massachusetts, for example, we have continuing conflict among statewide associations for area agencies, for nutrition projects, for home care corporations, for senior centers, and for municipal councils on aging. Last summer this conflict became so intense, and so unrelated to older persons and their problems, that the Governor's Citizens Advisory Committee felt impelled to convene a statewide meeting at which these five state associations were charged to straighten out their bureaucratic differences and come to some settlements about their division of the territory and its resources. In Massachusetts, as elsewhere, these settlements are not made with an - - 5 eye to solving the problems of older persons so much as with an eye to entrenching firmly the role of the bureaucratic components. - There are additional problems that we might discuss, but perhaps those I have already addressed are sufficient to convey my basic point namely, that the Older Americans Act and its programs are not well structured for solving or even for making a substantial impact upon the problems of aging in our society. The legislation and its programs have been effective for some essential first-phase purposes, particularly in spelling out an agenda of issues affecting older persons. And the Act's programs have been well designed for helping each Congressman or Congresswoman know how many constituents in his or her district have been served a meal or provided with some other form of assistance. It is now time, however, to address the larger issue of how, if at all, the Act might help solve or have a substantial impact upon one or more problems affecting older persons. I believe that one possible way to shift to a problem-solving orientation would be through a strategic departure a legislative approach that eliminates the compartments separating the various titled programs of the Act - area planning and services, training, research gerontology centers, senior centers, and nutrition the funds available. and consolidates 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 2 - 6 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. Perhaps this general approach would make it possible to have an impact upon at least one problem of importance in each community. It would certainly be better than the current situation in which only a very little effort is put into a great many problem areas, and a tremendous amount of energy is being expended upon issues of professional and industrial domain and stature. Such an approach would also be far better than persisting with the peculiar assumption that effective community services can be developed and implemented from our nation's capital, in a country that has 80,000 distinct units of government. The history of our country shows rather clearly that effective community services such as profes sional fire protection services, police services, sanitation services have been developed in response to a locally experienced sense of crisis which transcends the fragmentation of governmental authority. Similarly, the approach I am suggesting today might enable services to the aging to develop as a concentrated response to the priority crises experienced by older persons in the many different communities in which they live, rather than as minimum, token coverage of a large range of possibilities identified by professionals. To be sure, few if any professionals in the field of aging would be happy with the approach have briefly outlined. Presumably, however, |