Senate Standing Committee on Aging Public Hearing
2011 Reauthorization of the Older Americans Act
Statement of the New York
State Office for the Aging (NYSOFA)
Presented by
Greg Olsen
Deputy Director
Division of Policy, Research and Legislative Affairs
Friday, April 9, 2010
250 Broadway, New York City
Senate Hearing Room, 19th Floor
Thank you Senator Diaz for holding this important public hearing and inviting NYSOFA to outline our priorities for the 2011 Older Americans Act Reathorization. I want to also extend thanks to you for your leadership and for your passion for serving New York’s older population and their caregivers. My name is Greg Olsen, I am Deputy Director of the New York State Office for the Aging, and I am representing Director Michael J. Burgess today. Director Burgess is unable to attend due to a prior commitment but sends his regards.
This testimony will focus on six broad areas that we believe need to be strengthened, institutionalized within the Act and funded. Although funding for the Act is a separate process, the issues pertaining to reauthorization of the OAA and funding are intertwined. However, first I wish to provide some context in terms of New York State (NYS). While NYS is frequently viewed as being an urban state because of New York City, Buffalo, Rochester, Syracuse and Yonkers, the State is extraordinarily rural and also suburban. Forty-three of New York State’s sixty-two counties are designated by statute as being rural. There are over 3.5 million older New Yorkers. The challenges and opportunities we face as a state are many and they vary greatly based on geography, population and income distribution.
The Older Americans Act reauthorization comes at a particularly critical juncture. There are several generations comprised within the sixty plus cohort. Over the next five years, the “baby boom” generation, as well as an increasingly ethnically diverse population, will be swelling the ranks of the older population. The aging services community will need to serve these multiple and diverse generations with a myriad of services and strategies. Simultaneously, there exists tremendous opportunities to utilize older adults in the workforce and as volunteers. Since these remarks are primarily focused on needs, I will just mention that harnessing the opportunities through employment or re-employment of older adults as well their civic engagement in their communities can significantly support the goals of the Older Americans Act.
Your leadership can be very helpful as we go forward. It is very important that together we educate our members of Congress about the challenges and opportunities that we face now and will face in the future and encourage their strong advocacy through the reauthorization process. Their engagement during this process will be critically important.
It is also very important to point out that New York State has been a leader in providing supplemental funding for services because the funding support we have received through the Administration on Aging by Congress has long been inadequate. Over the past decade, not counting recent stimulus funding for congregate and home delivered meals and the Title V employment program, New York received an increase of about $5 million. Over the same period of time, the Governor and the Legislature allocated $44 million in new money for services and the counties are providing over $32 million above what they are required to provide to meet their match. This does not count Title XX discretionary funds, town program budgets, contributions from recipients, cost-sharing in the EISEP program or other fundraising strategies employed locally to meet needs.
New York and municipalities have done a tremendous amount to serve its most vulnerable and during this fiscal crisis, the message that needs to be communicated is that it is time for the federal government to help New York State and other states by adequately funding the programs and services authorized by the Older Americans Act.
On behalf of Director Burgess, I will now turn to the six areas we will be advocating for over the next year and half.
- Increase core funding for Older Americans Act in order to adequately expand the infrastructure of non-medical home and community-based services to help older adults
cost-effectively remain in their communities. The OAA plays a critical role in communities to
deliver services to help older adults age in place, support caregivers, provide legal services
and test new approaches to care. In order to ensure that older adults can maintain their
independence and prevent higher cost care in hospitals and nursing homes, the infrastructure
must be invested in, both in terms of service dollars and incentives to increase the
availability of trained workers.
As part of core services, NYSOFA would like to see statutory language added within the Act and provision of demonstration dollars to states to provide seed
funding to local communities to develop livable community plans. The seed funding would help to
organize a variety of local interests to understand the demographics of their communities and
develop a plan that will address the needs of older adults but also to utilize them as part of
the solution. Livable community planning grants should be used for either the development of a
community based plan or implementing successful aging in place initiatives that support aging in the community. Some communities throughout the state have begun to develop and/or implement
plans. New York City, the City of Rochester, Chemung and Broome Counties are just a few.
Incentives to develop local plans are important to help identify needs, bring a wide variety of
stakeholders together, build political support for action and most importantly, it encourages
action at the level where people live, not relying on the state to solve the problem. These
self-help strategies work and should be expanded in every county.
- The Aging and Disability and Resource Center (ADRC) and Evidence Based Programming
(EBI) demonstration programs need to cease to be demonstrations and need to be
institutionalized within the Act. Further, ADRC and EBI programming needs to be embedded in the
national agenda that focuses efforts on prevention and wellness. The demonstrations have been
effective in seeding these initiatives. However, in order to effectuate national and state
systems change and sustain these changes, federal leadership and funding is key or all the gains achieved in recent years may be lost; particularly in these times of shrinking state and local
resources.
In terms of ADRCs, the objectives of creating: 1) consumer friendly, seamless
access to information, assistance and services regardless of funding source and 2) to coordinate aging, disability, Medicaid and other systems to utilize resources more effectively and
intervene earlier are working. There does need to be recognition that the work of the ADRCs is
staff intensive to be successful. Creating a seamless service system does not reduce the need
for funding to support the work of staff as they provide information, assistance, options
counseling and other functions. There is need for federal support to embed ADRCs across all
states rather than in pockets. New York Connects, our states ADRC which is in its fourth of year of implementation, has been very successful throughout the state. There are over 1,600
participants in local long-term care councils that are working on local systems change, cross
training, better resource management and being recognized as an objective source of information
on long-term care options. What is important to note is that new funding at the national level
is being offered to the states through grants. States/counties that do not have an ADRC cannot
access these funds.
Additionally, we recommend amending the OAA to establish clear statutory
authority for State Units on Aging and area agencies on aging to work in partnership with the
variety of partners including health, labor and transportation.
- Transportation continues to be a top priority with insufficient funding to
address the unique needs of urban, rural and suburban areas. The aging network provides quality services that help older adults maintain their independence but if the older adult is unable to
access programs, utilize transportation to be engaged in community life and reduce social
isolation, shop for groceries or get to medical appointments, their quality of life and their
health status deteriorates. Adequately funding transportation is paramount to the success of
the older adult aging in the community and to service providers. We also hope that AoA will be
at the table for the reauthorization of SAFETY-LU as a means to address critical transportation
needs of older adults. We also support innovative programs like the Independent Transportation
Network (ITN) model out of the state of Maine that focuses on a community solution to
transportation, is a public-private partnership, is not reliant on limited public
transportation, and offers transportation access on a 24/7 basis.
- There is tremendous need for assistance from AoA in developing an operational
web-based data reporting and analysis system tying local, state and federal reporting
together in order to effectively measure program and performance outcomes. The development of a data collection and reporting systems employing current technologies should be supported, e.g.
Web-based client and provider data systems for local and State units on Aging.
Currently, a
variety of computerized systems are used by those administering programs authorized under OAA.
Licensing and training for all providers are costly to implement system-wide. Those providers
who do not use the same system may not be able to provide complete and consistent client and
service data. To achieve and improve reporting, Web-based systems should be used at all levels
in the administration of OAA programs. The benefits of such Web-base reporting systems are:
- Timeliness in reporting would be increased.
- Cost savings in licensing and training.
- Gaps in reported data would be minimized (Missing Data).
- Possible reduction or elimination of duplicative tasks.
- Monitoring and Evaluation of programs and service delivery would be enhanced.
- Custom reports for administrative and other needs could be developed with less effort.
- Greater coordination would be achievable at various program and service delivery.
- Legal services are a critical component of Elder Rights and Justice, but
have not been given the same attention as other core services nor are they adequately funded.
Providing access to legal services for older adults is a high need. Landlord-tenant and other
housing related issues, financial exploitation and scams, as well as elder abuse are just some
of the areas that require competent legal services. Economic distress coupled with major
advancements in technology has created a “perfect storm”. Older adults are increasingly
susceptible to a myriad of scams and abuse, with financial exploitation being the fastest
growing form of elder abuse.
Support for elder abuse mitigation and legal services need to be
invested in and need to be a prominent part of the Older Americans Act.
- Staff training is a critical on-going need. Other human services systems
emphasize and receive federal funding for staff training; however, this is not the case for
delivery of aging services outside the health system. Further, if we are to succeed in changing
the system paradigm to be truly individually centered and achieve real consumer choice then it
requires staff training in the new paradigm. The aging network since its inception has focused
on the individual, valued consumer choice, and seeks to maximize the individual’s strengths and
informal supports. However, attaining an individual centered system is more than assessing needs and providing options; it is asking and starting with what are the individual’s goals and
objectives. This is a different approach and a paradigm shift for which staff need to be trained in order to achieve the desired outcomes.
The issues described above are broad in nature. Our specific recommendations will be provided to you in the very near future after we have completed them and include addressing:
- Daily Money Management
- Senior Centers
- Nutrition Programs
- End of Life Support Programs
- Workforce development
- Long-term care reform
- Caregiver support and respite
- Volunteerism
- Prevention
- Economic Security
- Long Term Care Ombudsman Program
- Elder Abuse and
- Agency Infrastructure.
While it has been known for some time now that New York and other northeast states did not fare well when the funding formula was revised, we do not want to engage in this discussion at the national level. Advocating for reopening the funding formula places us at risk for further loss. There are other ways to ensure that we receive our fair share.
The network of aging professionals has been providing long-term care services for over 40 years. We can play a much bigger role in meeting state and national goals around long-term care restructuring and rebalancing, health and long-term care costs savings, and improving older adults and caregivers quality of life.
We look forward to working with you and your staff and I again want to thank you for understanding how important this reauthorization is and seeking feedback from those who are providing services everyday.
I would be happy to answer any questions at this time.
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