Mr. Chairman and members of the Subcommittee:
Thank you for the opportunity to testify at your first hearing as Chairman of the
Subcommittee on Aging. We appreciate your leadership and commitment to working in a
bipartisan manner toward reauthorization of the Older Americans Act. I am pleased to be joined
by my colleague, Assistant Secretary Bramucci, from the Department of Labor's Employment
and Training Administration.
As we stand on the cusp of the 21st century, a time when there will be more older
Americans, more caregivers and greater diversity among generational cohorts, the need to
reauthorize the Older Americans Act has never been more evident. A strong Older Americans
Act will ensure that the new American century will be one in which elders and their families,
who deserve nothing less, are able to enjoy a good quality of life, optimal health and access to
critical supportive services as we together meet the challenges and opportunities of longevity.
I come before you today to provide an overview of the current activities of the
Administration on Aging (AoA), describe our new initiatives and future directions and talk
briefly about the Administration's proposal to reauthorize the Older Americans Act, which we
will formally transmit to Congress later this month.
Today, one in every six Americans, or 45 million people, is 60 years of age or older.
While most older Americans are active, productive members of their families and communities,
many are at risk of losing their independence. These include four million Americans age 85 and
older, and persons who are frail and living alone without a caregiver. The Administration on
Aging is dedicated exclusively to policy planning and development, and the delivery of
supportive home and community-based services to our nation's diverse population of older
Americans and their caregivers. Through the Older Americans Act, the Administration on Aging
also provides critical information and assistance and programs that protect the rights of
vulnerable, at-risk older persons.
Working in close partnership with its sister agencies in the Department of Health and
Human Services and throughout the federal government, AoA proudly leads a national aging
network which includes AoA's central and regional offices, 57 state units on aging, more than
655 area agencies on aging, 223 tribal organizations representing 300 tribes, and thousands of
service providers, senior centers, caregivers and volunteers.
Home and community-based services include access services (information and assistance,
outreach, transportation, and case management); in-home services (home-delivered meals,
chores, home repair, modifications and rehabilitation, homemaker/home health aides, and
personal care); community services (congregate meals, senior center activities, adult day care,
nursing home ombudsman services, elder abuse prevention, legal services, employment and
pension counseling, health promotion, and fitness programs); and caregiver services (respite,
adult day care, counseling and education). AoA also works to assist older persons with
Alzheimer's disease and supports their caregivers.
A critical component of AoA's consumer information and protection role is empowering
older persons and their family members through their life course through education and
information. The aging network works directly with older persons to enable them to make
informed choices about their own health, financial and long-term care needs. Additionally, AoA-funded programs provide opportunities for older persons to enhance their health. The Eldercare
Locator, a national toll-free service, puts callers in touch with necessary services and resources in
their own communities or across the country. The Insurance, Benefits and Pension Counseling
Programs, administered through the aging network, assist older Americans in accessing their
pensions and choosing among insurance and health care options. AoA also has an award-winning website with information for older persons, their families, professionals and
organizations involved in aging programs, which is widely used by the general public.
Central to the advocacy role mandated by the Older Americans Act is AoA's elder rights
protection programs which include many of the programs mentioned previously, and the
National Long-Term Care Ombudsman Program, which investigates and resolves complaints
made by or on behalf of residents of nursing, board and care, and similar adult care homes. AoA
provides funding to train thousands of paid and volunteer long-term care ombudsmen, insurance
counselors, and other professionals to identify and report fraud and abuse, along with programs
that recruit and train retired professionals, such as doctors, nurses, attorneys, accountants and law
enforcement personnel to serve as health care "fraud busters." Just last week, the Administration
on Aging joined forces with other federal agencies and the aging community to expand a national
government-led community outreach initiative to enlist more Medicare beneficiaries in
identifying and reporting Medicare waste, fraud and abuse. You may be interested to know that
Congress' support has enabled AoA to announce the availability of funds to train even more
retired persons to serve in their communities in this matter. We are very pleased to be working
with the Ohio Department of Aging on a statewide level on this initiative.
Native Americans
To assist older American Indians, Alaskan Natives and Native Hawaiians, the
Administration on Aging awards funds to 223 tribal organizations, representing more than 300
tribes across the United States
. Native Americans in general, and older Native Americans in
particular, are among the most disadvantaged groups in the country. AoA's support provides
home and community-based services in keeping with the cultural heritage and specific needs of
each person receiving assistance.
New Direction
The Administration on Aging is playing a lead role in preparing America for longevity,
and in constructing policies and programs which are essential to meeting the challenges and
opportunities posed by a longer-living society. 76 million baby boomers born between 1946 and
1964 will soon join the ranks of older Americans. According to the Census Bureau, one of every
nine baby boomers will live to at least 90 years of age. This generational cohort will present our
nation with a unique set of challenges. To that end, we are re-focusing our work in partnership
with the aging network to ensure that present and future generations of older Americans have the
opportunity for independent, productive, healthy and secure lives.
Our commitment is most visibly demonstrated in our FY 2000 budget request, which was
submitted to Congress last month. I would like to spend just a few moments talking about our
budget which presents some of the components of our strategy for the new century. Our budget
request of $1,048,055,000 represents the first Older Americans Act budget for the new
millennium. At the very heart of our budget proposal is our National Family Caregiver Support
Program, which we believe is a modest yet compassionate response to an issue of concern to
nearly all Americans families--long-term care. This issue will become even more compelling in
the 21st century, when more families will be caring for their older relatives. We know that
families and friends care for 95 percent of disabled older persons who need assistance to remain
independent and living in their communities. Caregivers, most of whom are women, many older
and vulnerable, or workers with multiple responsibilities are the sole source of assistance for
two-thirds of older persons. The National Family Caregiver Support Program would be
established by amending the Older Americans Act to create an unprecedented infrastructure for
caregiver support, counseling, information, education and services and much needed respite for
caregivers. This program is a critical component of the President's long-term care initiative that
also includes a new long-term care tax credit, long-term care education, long-term care insurance
for federal employees, and expanded Medicaid eligibility for individuals with long-term care
needs living in community settings. As Secretary Shalala said recently, "This is the beginning of
a new direction toward a more rational national long-term strategy for long-term care."
Recognizing America's diverse aging population, the Administration on Aging is
working in partnership with its sister agencies and its national aging network to target resources
and services to those individuals in the greatest social and economic need, with particular
attention to low-income minority elders. There is a proposal in the FY 2000 budget for a $4
million innovative grants program to be funded under title IV of the Older Americans Act to help
reach the Surgeon General's goal of reducing health disparities among minority populations. If
funded, AoA will work in partnership with the public health and aging networks to address the
higher incidence of preventable, costly chronic disease and disabilities in minority elders.
As Ohio's lieutenant governor, you became familiar with the home-delivered meals
programs for older Ohioans. Our budget proposal contains a modest but essential increase for
home-delivered meals, which are an important component of our home and community-based
long-term care system. Home-delivered meals enable older adults with multiple chronic diseases
and disabilities to remain in their homes and communities. This proposal will fund 27 million
additional meals for homebound elders.
We all recognize that reauthorizing appropriations under the Older Americans Act is our
paramount objective. Our proposal also proposes changes to existing programs that will result in
more effective service for older Americans, in particular those who are frail and at risk, and their
families. We will propose to streamline the operation of state programs; enhance state and local
flexibility by eliminating unnecessary federal requirements; target services to those in the
greatest social and economic need, with particular attention to low-income minorities; allow
states the option of instituting cost sharing for certain services, with the exception of critical
access, protective and nutrition services; and streamline title IV state and local innovations to
better address the dramatic demographic changes anticipated early in the next century.
To modernize aging services and programs, and to increase the accessibility of
information and tools that multiple generations of older Americans need, it is essential that we
pursue rigorous testing to identify and measure effective program interventions and their costs.
We must also determine the specific outcomes that can contribute to a comprehensive strategy
for meeting life course needs which result from increases in longevity, and which can be
replicated in states and local communities throughout the nation. I look forward to working with
you and the Subcommittee members to complete the bipartisan reauthorization of the Older
Americans Act. We must not let differences over specific details prevent us from achieving that
goal.
I want to take this opportunity to share with you some information on other activities we
are vigorously pursuing at the Administration on Aging. We are pleased to be hosting a
symposia series entitled "Honor the Past, Imagine the Future: Towards a Society for All Ages"
which will begin later this month in Baltimore, Maryland. Our first symposium will focus on the
implications of human longevity upon our nation's policies, programs and service delivery
mechanisms for older Americans and their families. This symposia series will provide an
opportunity for participants to gain access to state of the art research and information in the areas
of economic security, long-term care, health, caregiving, productive aging, information and
technology, consumer protection and diversity.
In recognition of the promise which the longevity revolution holds for social, economic,
cultural and spiritual development in the next century, the United Nations General Assembly
designated 1999 as the International Year of Older Persons. The Administration on Aging
serves as the focal point and convenor of agencies within the federal government for
collaborative efforts to advance an aging policy and program agenda for the new millennium.
We are pleased to have more than 40 federal agencies and departments involved in this initiative.
In June of this year, we will be hosting a government-wide symposium on the International Year
of Older Persons to further explore the policy course for the next century for Americans and their
families.
Technology is rapidly transforming our economy and our lives in ways that are both
sweeping and profound. Appropriate and elder-friendly technology can significantly improve
access to resources and information to assist those who are frail and vulnerable, and reduce
isolation among those living in rural or hard to reach areas of our country. The Administration
on Aging, other federal departments and agencies and the national aging network are exploring
the use of technology to more effectively serve the diverse needs of older Americans and their
caregivers.
The Administration on Aging is poised to take on the challenges older Americans will
face in the 21st century. We strongly believe that durable incomes for seniors living longer lives,
access to quality health care, secure places to live, and transportation that accommodates decline
in mobility are preconditions for active, productive aging. We look forward to continued work
with you and your staff to meet these challenges and to reauthorize the Older Americans Act.
I would be happy to respond to any questions you and the members of the Subcommittee
have.
