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WE HOPE THAT THE SUBCOMMITTEE ON AGING WILL EXPLORE
THIS SITUATION IN AN EFFORT TO FIND A WORKABLE SOLUTION.
SERVICES IN RURAL AREAS
LAST NOVEMBER I CHAIRED THREE HEARINGS IN NEW MEXICO
EMERGED FROM THESE HEARINGS:
(1) THE COST OF DELIVERING
SERVICES IN RURAL AREAS IS EXCESSIVE AND (2) SERVICES
IN RURAL AREAS TEND TO BE FAR LESS READILY AVAILABLE THAN
IN MORE DENSELY POPULATED AREAS. THERE IS GENUINE CONCERN
DELIVER COMPREHENSIVE SERVICES TO OLDER PERSONS IN RURAL
AREAS WITHOUT AN ADDITIONAL SOURCE OF FUNDS.
I WOULD URGE
THIS SUBCOMMITTEE TO EXPLORE THIS PROBLEM AND WE WILL CONTINUE
TO DO LIKEWISE IN THE HOPE THAT WORKABLE APPROACHES CAN BE
FOUND THAT MAY BE INCORPORATED INTO THE 1978 AMENDMENTS TO
MR. CHAIRMAN, IN CLOSING LET ME SAY THAT WE HAVE MADE
PROGRESS IN RECENT YEARS IN OUR EFFORTS TO PROVIDE SOCIAL
AND NUTRITIONAL SERVICES TO OLDER AMERICANS. WE STILL HAVE
A LONG WAY TO GO IF WE ARE TO FULLY MEET THE NEEDS OF THIS
STEADILY INCREASING SEGMENT OF OUR POPULATION.
I HOPE THAT THE SUBCOMMITTEE ON AGING WILL EXTEND AND EXPAND THE OLDER AMERICANS ACT SO THAT IT CAN MOVE TOWARDS
A TRUE COMPREHENSIVE, COHERENT SYSTEM OF SERVICE DELIVERY.
Senator EAGLETON. I don't want to repeat the thrust of an hour or so of testimony that we had here this morning, but let me try to capsulize a proposal to you. Suppose we go further than some of your suggestions you would merge title III with title V, and other valuable suggestions—suppose we merged everything, take out the Social Security Act, we could put that aside, and let's stay in the righthand column; let's consolidate everything under the Older Americans Act, everything under Community Services Administration, and everything under ACTION. The red figures—that's the Carter budget for that-would total something in the neighborhood of $850 million. Suppose we make it a billion dollars and almost make it an entitlement so that we could guarantee that considerably more money is going to be spent in the overall area of aging. We could do away with these subcategories—for instance, as you know, we have a home repair clause, and it gets $8 million nationwide for home repair; you would need that in Albuquerque, wouldn't you, maybe Santa Fe could spend that. We would follow your suggestion and Albuquerque would become a region unto itself. Let's say that based on a formula that we work out we just give Albuquerque $10 million, and we have a council on aging out there and let them decide. And we set a whole bunch of statements of purpose-you know, we put all that in—legal services, nutrition, housing, and so on and so forth, transportation. And we also say but you have got to spend 70 percent or so of that on one item. You guys pick out what item it is—if out your way it's home repair, fine; if out your way it's nutrition, fine; if out your way it's homemaker services, fine. You have got to try to do one job fairly thoroughly.
What would you think of that? You used to be mayor of Albuquerque.
Senator DOMENICI. Well, I guess, if I were the mayor of a city I would say that's great. I guess the only part of it that bothers me is the nutrition program. I am concerned that there is so much need there. I am not saying local officials wouldn't find that need also; they may agree that nutrition should be the 70-percent priority. But generally speaking I don't think I would have any serious objection to an approach that gives State and local governments greater flexibility. I would like to think about it, but I really think the thrust you are talking about is moving in the right direction. We just have to eventually, as a national legislature, develop the notion that we can trust local units of government. If we don't we are going to continue to be besieged with the kind of problems you and I are finding everyday. Problems such as arbitrariness-because we try to make too many decisions at the national level. We are not meeting the right need and the tail is wagging the dog. We make them do things they wouldn't give high priority to.
So, philosophically, it sounds very good. Senator EAGLETON. I am sure it has a lot of pitfalls, but Dr. Binstock and I have been discussing this this morning, and I am sure there are many objections that one could very legitimately raise to it. But I think, as I said earlier—well, Dr. Binstock used the word "hoax"; I use the word "deception,” both words of approximately the same meaning. When we say nationwide, we have a program on home repairs for the elderly, and we can write all our constituents that we have a home repair for the elderly program and spend $8 million on it nationwide; that is sort of deceptive. It is pretty much of a hoax.
We just put into the record a survey out of Rhode Island from their aging commission. The No. 1 priority, if they were picking the priorities in Rhode Island-residential repair and renovation; that's the lowest priority on our list, that's the smallest thing I've been able to see nationwide—it's $8 million. Yet in Rhode Island that's what they would like to do first.
Yet we, by our appropriating process—we put it last. You see, some people think that, well, when we list all these priorities, we are not playing favorites. We think legal services is as good as nutrition is as good as health care, homemaker services—because we've got them all on our statement of purpose. But we then put varying amounts of dollars into these.
So we say what we think is the most important by the dollars that we appropriate, and we have said—the Congress of the United States has said—that home repair for the elderly is the least meritorious program in our arsenal. Yet in Rhode Island they think that ought to be first, you see.
Senator DOMENICÍ. Let me suggest, Mr. Chairman—and I don't mean to be presumptuous in this statement-but I think it would be very relevant in discussing an issue like home repair, if your committee would compile from current law and all the various legislation that's floating around here—all the programs that relate to home repair for the poor people and for the aging.
Senator EAGLETON. Yes, in the agriculture bill, we got a hunk of that in there now.
Senator DOMENICI. In the CETA bill, if it was followed literally, there is $115 million for what its sponsors thought would be small public works projects where you would put people to work doing home repair for the poor. We don't even know how well that's working—but that's a lot of money.
In the Energy Conservation bills there is a goal to insulate every home in America by a certain date, and there is a large grant program for insulation and repairs. But think a minute here. If that bill is enacted and implemented with a set of guidelines that says here is what "insulation” means, here is what "energy conserration" means—and it turns out that it will do only certain types of repair, and they don't have a livable house because they don't have a water faucet in it, they will get insulation; but then they will look to another program and it won't have enough money in it to bring water service into the house. Someway we have to pull those programs together, where while you insulate you do the other repairs that need to be done.
I believe, in parts of my State home repair including insulation, would probably-from the people's standpoint meet an important need. Nutrition sites, meals-on-wheels, and senior centers have a lot of boosters of their own programs.
Senator EAGLETON. Sure.
Senator DOMENICI. Some program people out there may say let's renovate homes for the next 3 years and forget about everything else. I don't know how we can draft workable legislation that would pool all services together, but we sure ought to give such an approach very careful consideration.
Incidentally, at one point in time, Mr. Chairman, we had at least three programs for home insulation. They all had different guidelines for who qualified—and all three were run by different agencies. That is a mess for anybody trying to explain to people
Senator EAGLETON. It sure is. Thank you, Senator, very much.
Our final witnesses are Mr. Donald Reilly, Deputy Commissioner on Aging; Mr. Steve Dietz, Mr. Ray Steinberg, and Mr. Howard White.
Good morning, gentlemen. Mr. Reilly? Could you give us a highlight summary of your 16-page statement?
STATEMENT OF DONALD F. REILLY, DEPUTY COMMISSIONER ON
AGING, ACCOMPANED BY STEVE DIETZ, WESTAT STUDY; RAY. MOND M. STEINBERG, STEINBERG STUDY; AND HOWARD WHITE, CHIEF OF EVALUATION, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
Mr. REILLY. Yes, Mr. Chairman, I would be glad to. I will submit my full statement for inclusion in the record at the end of my testimony.
Senator EAGLETON. And not that we want to put anything in concrete, but if you care to comment on some of the observations that have been made here this morning by the witnesses or myself or Senator Kennedy, we would appreciate having that, too.
Mr. REILLY. Well, it's obvious right at the outset that there is going to be no shortage of interesting ideas relative to amending the Older Americans Act, and the Administration on Aging expects, when the Commissioner-designate gets officially in office, that the administration bill will be put together in final form, and we think we may have some rather exciting suggestions, too.
A couple of comments perhaps. One, the discussion about home repair here, in terms of congressional priorities, putting it lowest is not really, I think, the correct context to look at it in. In effect, that ranking of home repair on the list of services which get Older Americans Act money is the result of the addition of decisions made by all of the area agencies across the country, prodded by the four congressionally established priorities.
Senator EAGLETON. But when Congress got around to appropriating money-we appropriated 172 million for title 3; then when they got around to handling the money out there, they sort of some of those out there sort of put home repair lower down on their list.
Mr. REILLY. That's correct.
Mr. REILLY. Right. Well, I would make two points in relation to that, that I think bears considerably on the two studies that we are here to talk about today. One is that these decisions that are made at the local level by the area agencies are based on inputs from the older people in the community; they are also based on the judgments made by those area agencies in terms of what other organizations, which have funds to invest, are putting funds into particular areas, so there is in effect sort of a cross-rift between what the complex of agencies that are funding into various service areas are doing, and then the area agency—the ones that are functioning well—attempting to get them to do more, which is what the studies focus on, relative to success in that in the first 2 years.
And then investing their own funds where there are gaps left by other agencies.
Senator EAGLETON. Let me see if we can do this, Mr. Reilly—and you have been very patient, I think you have been here all' morning Mr. REILLY. It's been instructive.
Senator EAGLETON. Well, we hope you have enjoyed it. Why don't we do this because your statement is certainly worthy of more careful analysis than we would be able to give it right away. Let me pursue with you some of these sort of general philosophical ideas, and let's conclude today's hearing, for the moment—but set another day for you
and your associates to come, so that we can go through these things in greater specificity, because your recommendations are too valuable and too important to us than to just sort of gloss over them. And I know you put a lot of work into preparing this—and you don't just want it filed somewhere never for me to hear it or to see the words. I think that would be treating you too summarily.
But why don't we philosophize for a few minutes on some of these—we have Dr. Binstock here--just general observations, and then we will set up a full morning for you so we can go into this in some depth. I think that's fairer to you and will be more educational and informative for me.
Mr. REILLY. That's fine, Mr. Chairman. I would just like to put one thing out front on the record, and that is that since we are still working on the administration bill and sorting out options within the administration, there may be some things I may not feel at liberty to comment on. If so, I will say so.
Senator EAGLETON. Yes, that's understandable. Without picking a specific hour and a specific day, give me a rough estimate as to when we can expect the administration's bill? Are we talking 4, 5, 6 weeks or what?
Mr. REILLY. The third or fourth week in February.
Senator EAGLETON. Well, that would be fine. If it takes you another week-not that we want you to delay it, that would be seceptable. We don't want a hasty concoction; you don't want to submit such to us. So that is fully understandable.
Well, let me propound to you this nagging lingering doubt that I have expressed repeatedly today—and you have heard it-spreading too little money doing too little rather than having more money better targeted and trying to do more of an in-depth job on an important area, or two important areas. And I think Dr. Binstock even went so far as to say we should earmark 80 percent-let Albaquerque target 80 percent, or make it 70 percent-I don't know.
Just ruminate with us—we won't make this binding on the administration.
Mr. Reilly. Well, I come at this maybe through a somewhat different lens—and I would put it back to you this way, that there