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Statement on the Reauthorization of the Older Americans Act by Jeanette C. Takamura
Assistant Secretary for Aging
U.S. Department of Health and Human Services

Before the Senate Committee on Health, Education, Labor and Pensions, Subcommittee on Aging
March 3, 1999

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.

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