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is tremendous diversity in this country, as you are well awareState to State, area to area, and within the areas. And there is tremendous diversity in the need of older persons.

And I am a bit concerned that, first blush, though we will want to look further at it—at the single-priority or two-priority approach, The reason for that is that—it bears on the question that you asked Dr. Binstock, which was something along the lines of what about the people who may not be heard in this, or what about the people with very severe needs that may not fit into the single category or the two categories that get selected.

And that is a very considerable concern to me.

The principle on which the current title 3 of the Older Americans Act is based is really this one of local analysis of needs—the whole range of needs; local analysis of services available; and a combination of working with the other agencies to try and bring them together and get them to commit more for the elderly, and spotshot the money that the area agency has under the Older Americans Act to fill the priority gaps.

I submit that the one- or two-priority way to go has a certain attractiveness to it, and it is a lot easier to get your hands on what is happening as a result of the program.

But if you believe, as I do, that it is possible to get most of the area agencies doing a serious job of priority setting, then I think it may be premature to go that way. And I am struck by the fact that individual older persons have problems that relate to them as individuals. You can aggregate problems to a considerable degreebut most problems aren't dealt with by a single service; in effect, most problems have to be dealt with, ideally, by a package of services. If you focus on a single service, you are meeting part of the need of many people—perhaps a greater volume of people—but you are not meeting the package of needs of people that I would be particularly concerned about, the severely impaired elderly, for example.

So that's an initial reaction.
Senator EAGLETON. Well, that's a worthy observation.
[The prepared statement of Mr. Reilly follows:]

31-813 0 - 79 - 24

TESTIMONY

by

Donald F. Reilly Deputy Comissioner on Aging Evaluations of the Area Planning and

Social Services Program

February 1, 1978

- 3

needs of older persons; and

.

Advocating for provisions to meet needs of older persons

on such issues as tax celief, special housing, medical

and mental-health secvices, and public transportation,

to county and city government, Councils of Governments and

Economic Development Districts.

The planning cole, plus the managerial and program development cole

with regard to service delivery development with AOA funds could take

up all of the time of Area Agencies.

The advocacy cole is challenging

because of the wide cange of specialized issues to be dealt with.

Per2.

suading other agencies to change policies, change their funding

patterns, and to give up some degree of autonomy in order to improve

the coordination of services delivery to older persons is pechaps the

most difficult cole of all, for the Area Agency, which has a limited

number of tools available.

Since amounts of money larger than those

provided under the Older Americans Act flow through other systems

which could benefit older persons moce than they do, this lattec cole

is of critical importance.

Part II

Two Studies

The informacion I will be sharing with you for the cemainder of this

testimony was obtained primarily from two major studies.

on Aging to foster the development of comprehensive, coordinated service

delivery systems to meet the needs of older persons within designated

areas of the State.

The Area Agencies are charged with becoming a focal point on aging

for their geogcaphic portion of the State; a group of counties, a

single county, or a city.

This involves difficult and diverse coles:

Development of the annual acea plan, for movement

toward a comprehensive, coordinated service delivery

system to meet the needs of older persons in the area;

Funding secvice provider agencies to fill gaps in

priority service areas such as information and ceferral,

legal and other counseling, transportation, home serve

ices and home cepair, providing training and technical

assistance to such agencies and monitoring their pec

formance;

Persuading other public and private agencies at the area,

county, city, and neighbochood level to make greates

cesource commitments to services for older persons, to

make policy changes to better-serve older people, and to

coordinate with the Acea Agency and other service providers

so that services for older persons become more comp ce

hensive, moce coordinated and more oriented to the special

. 3

needs of older persons; and

Advocating for provisions to meet needs of older persons

on such issues as tax celief, special housing, medical

and mental-health services, and public transportation,

to county and city government, Councils of Governments and

Economic Development Districts.

The planning cole, plus the managerial

and program development cole

with regard to service delivery development with AOA funds could take

up all of the time of Area Agencies.

The advocacy cole is challenging

because of the wide range of specialized issues to be dealt with.

Per

suading other agencies to change policies, change their funding

patterns, and to give up some degree of autonomy in order to improve

the coordination of services delivery to older persons is perhaps the

most difficult cole of all, for the Area Agency, which has a limited

Number of tools available.

Since amounts of money larger than those

provided under the oldec Americans Act flow through other systems

which could benefit older persons moce than they do, this latter cole

is of critical importance.

Part II

Two Studies

The informacion I will be sharing with you for the cemainder of this

testimony was obtained primarily from two major studies.

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