[House Hearing, 109 Congress]
[From the U.S. Government Publishing Office]
THE OLDER AMERICANS ACT: STRENGTHENING
COMMUNITIES TO SUPPORT THE NEXT
GENERATION OF OLDER AMERICANS
=======================================================================
FIELD HEARING
before the
SUBCOMMITTEE ON SELECT EDUCATION
of the
COMMITTEE ON EDUCATION
AND THE WORKFORCE
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED NINTH CONGRESS
SECOND SESSION
__________
April 3, 2006, in Edinburg, Texas
__________
Serial No. 109-33
__________
Printed for the use of the Committee on Education and the Workforce
Available via the World Wide Web: http://www.access.gpo.gov/congress/
house
or
Committee address: http://edworkforce.house.gov
______
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WASHINGTON : 2006
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COMMITTEE ON EDUCATION AND THE WORKFORCE
HOWARD P. ``BUCK'' McKEON, California, Chairman
Thomas E. Petri, Wisconsin, Vice George Miller, California,
Chairman Ranking Minority Member
Michael N. Castle, Delaware Dale E. Kildee, Michigan
Sam Johnson, Texas Major R. Owens, New York
Mark E. Souder, Indiana Donald M. Payne, New Jersey
Charlie Norwood, Georgia Robert E. Andrews, New Jersey
Vernon J. Ehlers, Michigan Robert C. Scott, Virginia
Judy Biggert, Illinois Lynn C. Woolsey, California
Todd Russell Platts, Pennsylvania Ruben Hinojosa, Texas
Patrick J. Tiberi, Ohio Carolyn McCarthy, New York
Ric Keller, Florida John F. Tierney, Massachusetts
Tom Osborne, Nebraska Ron Kind, Wisconsin
Joe Wilson, South Carolina Dennis J. Kucinich, Ohio
Jon C. Porter, Nevada David Wu, Oregon
John Kline, Minnesota Rush D. Holt, New Jersey
Marilyn N. Musgrave, Colorado Susan A. Davis, California
Bob Inglis, South Carolina Betty McCollum, Minnesota
Cathy McMorris, Washington Danny K. Davis, Illinois
Kenny Marchant, Texas Raul M. Grijalva, Arizona
Tom Price, Georgia Chris Van Hollen, Maryland
Luis G. Fortuno, Puerto Rico Tim Ryan, Ohio
Bobby Jindal, Louisiana Timothy H. Bishop, New York
Charles W. Boustany, Jr., Louisiana [Vacancy]
Virginia Foxx, North Carolina
Thelma D. Drake, Virginia
John R. ``Randy'' Kuhl, Jr., New
York
[Vacancy]
Vic Klatt, Staff Director
Mark Zuckerman, Minority Staff Director, General Counsel
------
SUBCOMMITTEE ON SELECT EDUCATION
PATRICK J. TIBERI, Ohio, Chairman
Cathy McMorris, Washington Vice Ruben Hinojosa, Texas
Chairman Ranking Minority Member
Mark E. Souder, Indiana Danny K. Davis, Illinois
Jon C. Porter, Nevada Chris Van Hollen, Maryland
Bob Inglis, South Carolina Tim Ryan, Ohio
Luis P. Fortuno, Puerto Rico George Miller, California, ex
Howard P. ``Buck'' McKeon, officio
California,
ex officio
C O N T E N T S
----------
Page
Hearing held on April 3, 2006.................................... 1
Statement of Members:
Hinojosa, Hon. Ruben, Ranking Minority Member, Subcommittee
on Select Education, Committee on Education and the
Workforce.................................................. 3
Prepared statement of.................................... 5
Tiberi, Hon. Patrick J., Chairman, Subcommittee on Select
Education, Committee on Education and the Workforce........ 1
Prepared statement of.................................... 3
Statement of Witnesses:
Anzaldua, Rosa, program participant, Amigos del Valle,
prepared statement......................................... 6
Dominguez, Armando, Assistant Director, Center on Aging and
Health, University of Texas-Pan America.................... 13
Prepared statement of.................................... 15
Gonzalez, Joe, Director, Area Agency on Aging of the Lower
Rio Grande Valley, prepared statement...................... 31
Perez, Jose T., Executive Director, Senior Community Outreach
Services, Inc.............................................. 20
Prepared statement of.................................... 22
Additional testimony submitted........................... 35
Sullivan, Marlon, Senior Director of Staffing, the Home Depot 16
Prepared statement of.................................... 19
Urban, Karl, Manager, Policy Analysis and Support, Texas
Department of Aging and Disability Services................ 7
Prepared statement of.................................... 9
THE OLDER AMERICANS ACT:
STRENGTHENING COMMUNITIES
TO SUPPORT THE NEXT GENERATION
OF OLDER AMERICANS
----------
Monday, April 3, 2006
U.S. House of Representatives
Subcommittee on Select Education
Committee on Education and the Workforce
Edinburg, TX
----------
The subcommittee met, pursuant to call, at 8:45 a.m., in
room 1.102, International Trade and Technology Building, the
University of Texas-Pan American, 1201 West University Drive,
Edinburg, Texas, Hon. Patrick Tiberi [chairman of the
subcommittee] presiding.
Present: Representatives Tiberi and Hinojosa.
Staff Present: Ricardo Martinez, Legislative Assistant;
Moira Lenehan-Razzuri, Legislative Assistant; Kate Houston,
Legislative Assistant; Angela Klemack, Legislative Assistant;
Lucy House, Legislative Assistant.
Chairman Tiberi. Good morning. A quorum being present, the
Subcommittee on Select Education of the Committee on Education
and the Workforce will come to order.
We are meeting today to hear testimony on ``The Older
Americans Act: Strengthening Communities to Support the Next
Generation of Older Americans.''
I ask the members to consent for the hearing record to
remain open for 14 days to allow Members' statements and other
extraneous material referenced during the hearing to be
submitted to the official hearing record.
[Pause.]
Without objection, so ordered.
Good morning. Thank you all for joining us for this hearing
on the Select Education Subcommittee of the Committee on
Education and the Workforce. I want to extend my thanks to the
University of Texas-Pan American and the University's staff for
so graciously hosting this hearing and the breakfast this
morning, which was outstanding. I also want to thank my friend
and my colleague, Mr. Hinojosa, for welcoming me once again to
the 15th district in the great state of Texas. You have been
very accommodating and it's been a very warm visit.
I must also congratulate my friend and his alma mater,
University of Texas, on their NCAA Football Championship, with,
of course, the ``help'' of my alma mater, Ohio State, for
making that all possible. I do hope that UT will ``return the
favor'' in September. Hopefully you will be as accommodating as
we were this past year.
It is great to be back here in Edinburg and McAllen, and,
Mr. Hinojosa, you and your staff have been so gracious to the
committee staff and my staff and myself. It's been a great
visit. I look forward to coming back again for a future hearing
somewhere in the 15th district, preferably right here. It's
been a great place to come visit.
This is the first of two field hearings we are going to
have on the Older Americans Act. Field hearings offer Members
of Congress a unique opportunity to listen to witnesses who can
give us a local perspective on an issue. Field hearings are an
important part of this reauthorization process because we often
gain valuable insights that would be otherwise missed. It is
with particular interest that I have traveled here to Texas
where the ideas and challenges shared can be different than
those expressed by my constituents in Ohio.
Indifferent to residence in Texas or Ohio, the Older
Americans Act recognizes the specialized needs of all seniors.
These needs may include meals and nutrition, transportation,
employment, recreational activities and social services,
information about prescription drug benefits or long term care,
just to name a few. We are fortunate that the United States has
a sound infrastructure to support these needs. In fact, our
robust aging network includes 655 local and 56 state agencies
on aging. This year, the federal government invested nearly
$1.8 billion to support the delivery of these services.
Today, supporting the needs of older Americans is as
important as ever. It is estimated more than 36 million people
in the U.S. are over the age of 65, making it the fastest
growing group in our country. According to the U.S. Census
Bureau, by the year 2050, persons over age 65 will reach 90
million and comprise almost a quarter of the total U.S.
population. These astounding statistics make the upcoming
reauthorization of the Older Americans Act all the more
important.
Over the course of the following months, this Subcommittee
will be examining the current program, learning about evolving
issues facing older Americans, listening to seniors in their
own words, and laying out a plan for strengthening services to
seniors that are authorized by this Act and relied upon by
millions of aging Americans each year. We will work with
President Bush, and we will work with you and other senior
advocates, to ensure that the federal government is making the
most out of the taxpayers' investment in the programs
authorized by the Act.
I am pleased to have with us a distinguished panel of
experts to help us frame the issues for this hearing. I look
forward to hearing your recommendations on issues and actions
for the Subcommittee's deliberation. Before I introduce our
witnesses, I will yield to my colleague, Mr. Hinojosa, for his
opening statement.
[The prepared statement of Mr. Tiberi follows:]
Prepared Statement of Hon. Patrick J. Tiberi, Chairman, Subcommittee on
Select Education, Committee on Education and the Workforce
Good morning. Thank you for joining us for this hearing of the
Select Education Subcommittee of the Committee on Education and the
Workforce. I want to extend my thanks to the University of Texas-Pan
American and the University's staff for so graciously hosting this
hearing. I also want to thank my friend and colleague, Mr. Hinojosa,
for welcoming me once again to the 15th district in the great state of
Texas! He and his staff deserve much of the credit for organizing
today's hearing.
I am pleased to be here for the first of two field hearings on the
Older Americans Act, which this Subcommittee is scheduled to consider
this Spring. Field hearings offer Members of Congress a unique
opportunity to listen to witnesses who can give us a local perspective
on an issue. Field hearings are an important part of this
reauthorization process because we often gain valuable insights that
would be otherwise missed. It is with particular interest that I have
traveled here to Texas where the ideas and challenges shared can be
different than those expressed by my constituents in Ohio.
Indifferent to residence in Texas or Ohio, the Older Americans Act
recognizes the specialized needs of all seniors. These needs may
include meals and nutrition, transportation, employment, recreational
activities and social services, information about prescription drug
benefits or long term care-to name a few. We are fortunate that the
United States has a sound infrastructure to support these needs. In
fact, our robust aging network includes 56 state and 655 local agencies
on aging. This year, the federal government invested nearly $1.8
billion to support the delivery of these services.
Today, supporting the needs of older Americans is as important as
ever. It is estimated that more than 36 million people in the United
States are over the age of 65, making it the fastest growing age group
in our country. According to the U.S. Census Bureau, by the year 2050,
persons over age 65 will reach nearly 90 million and comprise almost a
quarter of the total U.S. population. These astounding statistics make
the upcoming reauthorization of the Older Americans Act all the more
important.
Over the course of the following months, this Subcommittee will be
examining the current program, learning about the evolving issues
facing older Americans, listening to seniors in their own words, and
laying out a plan for strengthening the services to seniors that are
authorized by this Act and relied upon by millions of aging Americans
each year. We will work with President Bush, and we will work with you
and other senior advocates, to ensure that the federal government is
making the most out of the taxpayer's investment in the programs
authorized by the Act.
I'm pleased to have with us a distinguished panel of experts to
help us frame the issues for this hearing. I look forward to hearing
your recommendations on issues and actions for this Subcommittee's
consideration. Before I introduce our witnesses, I will yield to my
colleague, Mr. Hinojosa, for his opening statement.
______
Mr. Hinojosa. Thank you very much, Mr. Chairman. I
appreciate so much your opening remarks, and I want to also say
that I am going to be switching from dark glasses to light-
colored glasses because I broke my prescription glasses
yesterday, and I can't read without them. But my staff said
that if I tried to substitute with these, these other glasses,
that I won't look as conspicuous, but these are really the
strong magnification that I can certainly read it much, much
better, so forgive me if I switch back and forth.
I have been to the Chairman's University of Ohio State,
Ohio State University, and their courtesies and their
hospitality and everything that has been shown both to me and
my staff has been outstanding, so I'm glad that we are able to
return that same hospitality and to show you how much we
appreciate the times that you have come to the Rio Grande
Valley and been able to see the potential in our area,
potential in our people, and that all we need is for the
federal government to continue to invest in human capital, in
higher education, in infrastructure and those things that we
have seen the last ten years that I have been in Congress.
Your support on what happened last week on the passage of
the Higher Education Act has, in that large piece of
legislation, a program that was extremely important, as you
learned back a year ago when you came for one of the hearings
that postgraduate studies of master's and doctoral programs are
something that will benefit this area a great deal.
Raising the level of education attainment has made a
significant difference over the last ten years in our area,
where we've seen unemployment drop from 22 percent down to 6
percent.
And, again, your presence and your support in Washington
for all of these programs that we've made you aware as being
very important to us has been very beneficial, and again I
wanted to publicly thank you for that.
Chairman Tiberi. Thank you.
Mr. Hinojosa. I would also like to thank the University of
Texas-Pan American for hosting us again today. This is the
Select Education Subcommittee's home here in this South Texas
area. The University plays a vital role in our community and is
a central player in improving the quality of life across the
region. I am always proud to bring my colleagues as our
chairman to this area so that they can visit and see that there
is great potential.
Most of all, I would like to thank the witnesses and all of
the members of our community for joining us today. This hearing
on the reauthorization of Older Americans Act is of critical
importance. Our local aging network, our state agency and
national organizations are vital links in our web of support
for older Americans. This region is known for its dynamic
growth and its youth. However, we also have a growing
population of older Americans. As with the Hispanic population
across the nation, many of our seniors are low income and rely
on their families for their primary care.
Many are more comfortable in Spanish than they are in
English and need assistance navigating our health and social
service systems.
The Older Americans Act of 1965 is the landmark legislation
that articulated our core values as a nation. The Act begins
with a declaration of objectives, which includes the following:
``Retirement in health, honor and dignity--after years of
contribution to the economy.''
This is a statement of our national obligation to older
Americans.
The Older Americans Act represents our commitment to
meeting that obligation. This law provides for supportive
services, as the Chairman read, that includes so many things;
especially transportation, housekeeping and personal care. It
provides nutrition services both at home and in community
settings, and it provides preventative health services and
supports family members.
Finally, it protects the rights of vulnerable older
Americans by combating consumer fraud and protecting seniors
from abuse. That is something very important to us in South
Texas.
Your testimony today will help us understand how the
programs in the Older Americans Act programs are working in
this community. This region is a model for best practices on
how to serve older Hispanic Americans. We will be looking for
your suggestions and recommendations about how we can make
improvements and expand the reach of these programs during the
upcoming reauthorization.
As we prepare for that, it is my hope that the chairman and
I will continue the Select Education Subcommittee's tradition
of bipartisanship. Together, Chairman Tiberi and I can work in
ways that will strengthen and improve the programs that provide
critical support to older Americans.
Thank you, Mr. Chairman. I am looking forward to today's
hearings and working with you to see that we come up with a
reauthorization that will take us the next five to six years
and be able to strengthen our support and the work that we do
together.
Thank you.
[The prepared statement of Mr. Hinojosa follows:]
Prepared Statement of Hon. Ruben Hinojosa, Ranking Minority Member,
Subcommittee on Select Education, Committee on Education and the
Workforce
Good Morning. I would like to welcome Chairman Tiberi to South
Texas again and thank him for calling this hearing.
I would also like to thank the University of Texas Pan American for
hosting us again. This is the Select Education Subcommittee's home in
the Rio Grande Valley. The university plays a vital role in our
community and is a central player in improving the quality of life
across the region. I am always proud to bring my colleagues here to
visit.
Most of all I would like to thank the witnesses and all of the
members of our community for joining us today. This hearing on the
reauthorization of the Older Americans Act is of critical importance.
Our local aging network, our state agency, and national organizations
are vital links in our web of support for older Americans.
This region is known for its dynamic growth and its youth. However,
we also have a growing population of older Americans. As with the
Hispanic population across the nation, many of our seniors are low-
income and rely on their families for the primary care. Many are more
comfortable in Spanish than English and need assistance navigating our
health and social service systems.
The Older Americans Act of 1965 is the landmark legislation that
articulated our core values as a nation. The Act begins with a
declaration of objectives, which includes the following:
``Retirement in health, honor, dignity--after years of contribution
to the economy.''
This is a statement of our national obligation to older Americans.
The Older Americans Act represents our commitment to meeting that
obligation. This law provides for supportive services, such as
transportation, housekeeping, and personal care. It provides nutrition
services, both in the home and in community settings. It provides
preventative health services and supports family caregivers. Finally,
it protects the rights of older vulnerable older Americans by combating
consumer fraud and protecting seniors from abuse.
Your testimony today will help us understand how the programs in
the Older Americans Act programs are working in this community. This
region is a model for best practices on how to serve older Hispanic
Americans. We will be looking for your suggestions and recommendations
about how we can make improvements and expand the reach of these
programs.
As we prepare for the reauthorization of the Older Americans Act,
it is my hope that the Chairman and I will continue the Select
Education Subcommittee's tradition of bipartisanship. Together, we can
work together to strengthen and improve the programs that provide
critical support to older Americans.
Thank you, Mr. Chairman. I am looking forward to today's hearing.
______
Chairman Tiberi. Thank you, Mr. Hinojosa. You do look good
in those dark glasses.
We have a very distinguished panel with us today, and
before I ask them to give their testimony, let me introduce all
four of them who are with us.
Mr. Karl Urban is Manager of Policy Analysis and Support at
the Texas Department of Aging and Disability Services. Before
assuming his current position, Mr. Urban served in a variety of
capacities with the state government, including as Deputy
Director of the Texas Department on Aging, where he oversaw
implementation of the state's Aging Texas Well initiative. Mr.
Urban also held posts in the Texas Governor's Office and the
Texas Health and Human Services Commission.
Mr. Armando Dominguez is Assistant Director of the Center
on Aging and Health at the University of Texas-Pan American. In
this capacity, he oversees NIH-sponsored research on
communities and the elderly. In addition, Mr. Dominguez is a
lecturer on sociology and the sociology of health. He earned a
master's degree in sociology from the University of Texas-Pan
American.
Mr. Marlon Sullivan is the Senior Director of Staffing at
the corporate office of Home Depot in Atlanta, Georgia. In this
capacity, he oversees enterprise-wide staffing operations
encompassing all domestic and international retail stores,
distribution centers, call centers, and the U.S.-based Home
Depot headquarters. Mr. Sullivan has been involved in Home
Depot's innovative partnership with SER-Jobs for Progress, a
nonprofit organization providing job training and employment
assistance to seniors through the Senior Community Service
Employment Program.
Mr. Jose T. Perez is the Executive Director of Senior
Community Outreach Services, Inc., and has the been the
director of the Senior Companion Program for more than 30
years. His mission as an advocate for older Americans and as
Director is to ensure that individuals age with dignity,
purpose and security in an elderly friendly environment. Mr.
Perez earned a degree in Community Services from the University
of Texas-Pan American and holds several certificates on issues
affecting the elderly.
And, finally, our last witness was unable to join us due to
a family emergency, Ms. Rosa Anzaldua is unable to be with us.
Her testimony will be entered into the record.
[The statement of Ms. Anzaldua follows:]
Prepared Statement of Ms. Rosa Anzaldua, Program Participant, Amigos
del Valle
My name is Rosa Anzaldua, I am presently a resident at a property
that Amigos Del Valle Inc. manages it is Villas Residencial/Casa #7 in
Mercedes Texas, I moved into this property on October 6, 1999. I was
born on March 8, 1934 in Mercedes and I am the 5th child of 10
children. I have volunteer in different organization to assist other
people, I volunteered in the Head Start Program, the food bank, I am a
volunteer Circus Clown and I would visit the children, I visit the
surrounding nursing homes and visit with the people that are sick, I am
also a committee member for my church, in 2004 I was in film named
Harvest of Redemption our screenwriter and director was Mr. Eddie
Howell.
I am currently an active participant with Amigos Del Valle; I
participate in their meals program and live in their housing project.
We have about 43 elderly people living in Villas Residencial/Casa #7
and we also have participants that are provided transportation and the
other participants drive themselves to the Center, we gather everyday
at the center and we socialize and we have different kinds of
activities, we also have presentations on programs that are available
to us. Our meals are a well balance meal and our donation is 25 cents
if we have them if we do not have the 25 cents then we can still have
our meal. The meal program has helped a lot of our elders because they
do deliver meals to their participants that can not make it to the
center. If more funding was available for this type of programs more
monies should be given to Amigos Del Valle to serve more clients.
Amigos Del Valle has vehicles to transport our participants from and to
the center if additional monies could be given to Amigos Del Valle more
services would be provided to us to keep us active. Every day we also
come to the center to talk and keep each other company we also play
different kind of games. All Amigos Del Valle Centers are unique in
their own way. Help Amigos continue to provide us with more services.
I am very comfortable and happy in Villas Residencial/Casa #7 I
have my own apartment and I feel very independent I feel good in being
able to decide what I am going to do each day I feel safe living in
Villas Residencial/Casa #7 and when ever we have a problem in our
apartment the staff that is available here is very helpful, they attend
to us and they make sure we are comfortable and happy, they fix
whatever problems we have in our apartments even after hours. The staff
is very knowledgeable in their work.
Amigos Del Valle has 8 different properties around the valley and
the assistance that is given to us is a great help because being in a
fix income we need to be careful with our monies we are in a tied
budget. Amigos Del Valle has help us in having a safe place to live.
______
Chairman Tiberi. Before the panel begins, I would ask that
each of our witnesses please limit their statements to five
minutes. Your entire written testimony will be included in the
official hearing record. With that, I will recognize Mr. Urban.
STATEMENT OF KARL URBAN, MANAGER, POLICY ANALYSIS AND SUPPORT,
TEXAS DEPARTMENT OF AGING AND DISABILITY
Mr. Urban. Thank you. Good morning, Mr. Chairman Tiberi,
Mr. Hinojosa.
Chairman Tiberi. Good morning.
Mr. Urban. My name is Karl Urban, and I am from the Texas
Department of Aging and Disability Services. It is nice to be
here in the Rio Grande Valley where my good friend Joe Gonzalez
is the area Agency on Aging Director, and Dr. Elena Gonzalez is
here, who is a former board member of the Texas Department on
Aging, so it is always nice to be down here in the Valley to
see my friends.
The Texas Department of Aging and Disability Services was
created in September of 2004 as part of the major
reorganization of the Health and Human Services delivery system
in Texas, and that has given us a great opportunity to kind of
be a role model for a lot of the things that I think we want to
think about in the reauthorization of the Older Americans Act.
The Older Americans Act has served this nation very well,
and Texas is a great example of that with our response to the
hurricanes this past summer. When thousands and hundreds of
thousands of evacuees came to Texas, they were met by an Aging
Network that was on the ground in local communities, able to
meet their particular needs; the fact that there was this
network in place, not only in Texas but across the country,
that allowed the response to be so effective and so quick to
this particular crisis.
That is perhaps the greatest strength of the Older
Americans Act, is that it has created in local communities this
network that has a flexible system of supports and services
that's responsive to local needs and that is, in fact, driven
by local decision-making.
The State Unit on Aging, which I serve in, and the AAA,
serve as a vital voice in ensuring that our communities prepare
for the rapidly aging population that you mentioned a minute
ago. And so this growth in the older population sets the
framework for three things that I would like to mention this
morning.
The first thing is that the Older Americans Act should
continue to allow states and local communities to address the
particular needs of local communities. In Texas, and as we sit
here in the Valley, those concerns are the rural nature of our
state, as well as the predominant Hispanic population.
The second thing is, the Older Americans Act should to
enhance the ability of states to best meet the long-term
service and support needs of older Texans and all persons with
disabilities.
And, finally, the Older Americans Act should empower state
and local communities to plan and prepare for this rapidly
growing aging population.
First let me talk a little bit about the unique population
needs.
Texas is a state of great the diversity, and I think the
lower Rio Grande Valley epitomizes this diversity. Three things
are important: One, it's predominantly Hispanic; two, there are
very rural areas in this part of the state; and, three, there
are still despite the economic of growth that we see around us,
areas of poverty that need to be addressed.
Given this diversity, the fact that the Older Americans Act
allows states and local communities to target populations is a
very good thing. As part of our Aging Texas Well initiative, we
conducted some forums across the state to ask what's going on
in rural communities and how we can better serve those
communities, and we learned several things.
One, there is a great pride in local communities in their
ability to, within that community, take care of themselves, but
this is made more difficult by a number of different factors,
and these include in some communities of Texas an eroding local
economic base to support social services, a confusion about
where to go to get information about services, and then just
some just natural barriers such as great distances. And these
create unique challenges for the Area Agencies on Aging that
have to serve these areas. These forums also pointed out that
social isolation is a significant problem in a lot of these
communities.
The second thing I'd like to talk about is the ability of
states to integrate services. This has become a growing
priority, not just in the State of Texas, where we think in the
creation of this we have somewhat of a model that would work,
but it's also a priority in Washington, from what I understand.
And so as states try to rebalance their long-term care systems,
as persons with mental retardation and developmental
disabilities continue to grow older, this need to integrate
services across population groups becomes ever more important,
and I think there are a number of proposals that have been
reported related to the Older Americans Act that would allow us
to continue both at the federal level and at the state and
local level to integrate services and better meet needs of all
of our populations.
The final thing I would like to talk about is the idea of
empowering local communities to plan and prepare for an aging
population.
In 1997, Texas created an initiative called Aging Texas
Well. Both Mr. Hinojosa and Chairman Tiberi mentioned the
declaration of objectives from the Older Americans Act. We kind
of take our mantra and our model for looking at Aging Texas
Well from this declaration of objectives.
As you said, it speaks to a number of different areas of
life. It's a very holistic overview of the well-being of older
Texans, and we have modeled our Aging Texas Well initiative to
look at the policy issues in all of those areas of life to
improve the lives of older Texans, and both NAAAA and the
National Association of State Units on Aging as well as the
White House Conference on Aging have said that within the
concept of the Older Americans Act we need to do more to help
states and local communities to do the planning and the
preparation that they need to do for this rapidly increasing
older population.
I don't think it's any accident that Texas, New York, and
Florida have all established very specific initiatives within
their states to help local communities prepare for the aging of
the population. This is probably a model that needs to be
replicated around the country.
In conclusion, as you know I'm sure by now, the Older
Americans Act was the number one priority of the delegates at
the recent White House Conference on Aging. When the Texas
delegation was talking about priorities, it was one of their
top priorities, as well, and I think that reflects on the fact
that the Older Americans Act has served this nation very well,
both in times of crisis and on a day-to-day basis. And, as we
look to the future, it should be a mechanism for helping us
plan and prepare for a future in which we're going to be a much
older state, a much older nation.
With that, I would be glad to answer any questions.
[The statement of Mr. Urban follows:]
Prepared Statement of Karl Urban, Manager, Policy Analysis and Support,
Texas Department of Aging and Disability Services
Good Morning Chairman Tiberi, Ranking Minority Member Hinojosa and
members of the subcommittee. On behalf of the Texas Department of Aging
and Disability Services, thank you for the opportunity to be here, in
the home district of Representative Hinojosa, to discuss the
reauthorization of the Older Americans Act (OAA).
My name is Karl Urban. I am the manager of Policy Analysis and
Support at the Texas Department of Aging and Disability Services
(DADS), which serves as the State Unit on Aging in Texas . DADS was
established in September 2004 as part of a major reorganization of the
health and human services delivery system. I have been the manager of
the Aging Texas Well initiative for many years. I will discuss both the
creation of DADS and the Aging Texas Well initiative as they relate to
the reauthorization of the OAA in a few moments.
The OAA has served this nation well. There is no better example of
this than our recent experience in Texas with Hurricanes Rita and
Katrina. When hundreds of thousands of evacuees from the Gulf Coast
fled to Texas, they were met with open arms. More than that, those over
the age of 60 were met by an Aging Network that quickly mobilized to
provide them with needed services. From the Harris County Area Agency
on Aging (AAA) Director, who practically lived at the Astrodome, to AAA
Directors in all the major cities and along the Gulf Coast, the people
of the Aging Network worked with DADS and their communities to meet the
needs of current and new older Texans. At DADS, we commend AAA
Directors Charlene Hunter James, Curtis Cooper, Holly Anderson, Colleen
Halliburton, Claude Andrews, Glenda Rogers, and Debbie Billa, among
others, for serving older Americans so well.
Not to discount the importance of individuals, the fact that there
was a network in place was critical. This network was able to include
work with all the providers of long-term services and supports partners
across the state as a direct result of the recent creation of DADS.
Indeed, this is perhaps the most important aspect of the programs of
the OAA--having in place in local communities a flexible system of
services and supports that is responsive to local needs and driven by
local decision-making. This network covers the entire country and was
supportive during our time in need. For example, the National
Association of Area Agencies on Aging worked to send assistance from
other AAAs across the country when we were working in the aftermath of
the hurricanes last summer.
In addition to service provision, the State Unit on Aging and AAAs
serve as a vital voice in ensuring our communities prepare and plan for
a rapidly growing aging population. Even though Texas is a relatively
young state, the older population will grow by over 50 percent over the
next 15 years. This growth sets the framework for three important
issues that we would like to highlight in our testimony:
1. The OAA should continue to allow Texas to address the unique
population needs of our state, particularly those in rural areas and of
Hispanics.
2. The OAA should continue to allow and, in fact, enhance the
ability of states to integrate services to best meet the long-term
service and support needs of older Texans and all persons with
disabilities.
3. The OAA should further empower states and local communities to
plan and prepare for an aging population.
I would like to briefly address each of these three points.
1. The OAA should continue to allow Texas to address the unique
population needs of our state, particularly those in rural areas and of
Hispanics.
Texas is a state of great diversity. Texas recently passed a
demographic milestone in which the combined minority populations became
the majority in our state. While it will be a number of years before
this is the same for the older population of Texas, minority
populations are growing at a much faster rate than Anglo populations
among those over age 60. The Lower Rio Grande Valley epitomizes this
diversity. In the Valley at least three different factors affect the
delivery of OAA services to older Texans: 1) the population is
predominantly Hispanic; 2) there are highly rural areas with less
infrastructure to support delivery of services; and 3) there are great
pockets of poverty, which increase the need for services.
According to Census data, the absolute size, ethnic and racial
diversity, and poverty rate distinguish older Texans from the national
population. Texas has the fourth largest population of older adults
(3.1 million) in the nation, and has the second largest older Hispanic
population in the nation (604,963). Among the over 60 population,
Hispanics are one of the fastest growing groups. They currently make up
about 19 percent of the older population but are expected to make up 25
percent by 2020. In the 14 counties along the Texas/Mexico border,
older Hispanics account for nearly 71 percent of the older population.
Economic conditions along the border have not kept up with the rest
of the state. Estimates from the U.S. Bureau of Labor Statistics show
that for border counties, especially rural border counties,
unemployment is generally substantially higher than that of non-border
areas. Only 19 percent of older Hispanics have a high school diploma
(versus 70 percent for Anglos). Older Hispanics report a median income
of $8,400--about 50 percent less than African Americans and nearly 120
percent less than elderly Anglos. Twenty-five percent of older
Hispanics are uninsured. With the prevalence of conditions such as
diabetes 80 percent higher among Hispanics than in the rest of the
population, OAA initiatives such as disease management services and
health promotion and nutrition programs are critical for this
population. Older Hispanics are also more likely to be caregivers of
young children than are their counterparts. Nearly 50 percent report
living with grandchildren, with 30 percent serving as the primary
caregiver of those children. The National Family Caregiver Support
program, especially with its inclusion of grandparents, is an important
program for this population.
Along the Texas-Mexico border, nearly half a million people live in
substandard conditions known as ``colonias''. Though colonias exist in
other parts of the state--such as rural East Texas--their prevalence
along the border presents a great need for services. Residents are
predominantly Hispanic, young, and untrained. Most have very low
incomes, inadequate health care, and live in unsound or unsafe housing.
Despite the commonalities among colonias, there is great variability in
areas such as population density and level of development. There is no
single prescription for addressing all of the problems in a given area.
In recent years, Texas has made progress in improving conditions
along the border. The Texas Health and Human Services Commission (HHSC)
implemented a Colonias Initiative in September of 2000 to create a
coordinated, interagency system for providing services and training to
colonia residents. The initiative included partnerships with other HHSC
agencies and service organizations, such as DADS and AAAs, to enhance
the infrastructure of services and supports. Working with Community
Resource Centers in these regions, AAAs are able to provide information
and assistance to help residents obtain much needed services. AAAs have
also taken part in coordinated efforts to increase enrollment among
residents in programs such as Medicaid and Medicare. These efforts can
be particularly challenging given the geographical diversity, low
population density, cultural and language barriers in these regions.
However, the outreach efforts and the development of local partnerships
lay the groundwork for future efforts to strengthen needed
infrastructure in these regions.
The last reauthorization of the OAA included rural within the
definition of target populations. Texas contains many rural counties in
which over 30 percent of the total population is over the age of 60. As
part of our Aging Texas Well initiative, we recently conducted a series
of forums in rural communities across Texas. We learned several things.
First, there is great pride in these communities in their ability to
care for one another. However, a number of factors limit the ability of
communities to support older Texans. These include an eroding local
economic base to support social services, confusion and lack of
information about where to go to get services, and natural barriers
such as great distances. These barriers create unique challenges for
AAAs that serve these areas. For example, the cost of providing home
delivered meals, personal attendant or caregiver services often are
higher due to lack of economies of scale and the cost--both time and
monetary--involved in traveling great distances. In some areas, it is
more difficult to find traditional providers and, when they exist, to
find workers. One way we have addressed these problems, for example,
was by implementing a voucher system for respite services under the
National Family Caregiver Support program.
The rural forums also pointed out that social isolation is a
significant problem among older Texans. The need for socialization and
social contact is a critical factor in successful aging. Older adults
who engage in social activities are more likely to remain mentally and
physically stimulated, thereby maintaining better overall health and
quality of life. Texas recently conducted an Aging Texas Well
Indicators Survey, with 26 percent of the respondents indicating
loneliness is a problem. Four to five percent of the respondents said
they talked or spent time with family members, friends or neighbors
only on a monthly basis; 25 percent reported that they did not have
daily contact with family members, friends or neighbors. (See Texas
Department of Aging and Disability Services, Aging Texas Well:
Indicator Survey Results, 2005, found at http://www.dads.state.tx.us/
news--info/publications/studies/atw--results--report.pdf.) OAA programs
such as telephone reassurance, nutrition programs and Senior Centers
remain a valuable way to combat social isolation.
Given the challenges presented by these unique population
characteristics, the targeting provisions of the OAA provide AAAs the
flexibility to be responsive to these unique population needs without
being overly prescriptive.
2. The OAA should continue to allow and, in fact, enhance the
ability of states to integrate services to best meet the long-term
service and support needs of older Texans and all persons with
disabilities.
In anticipation of the growing number of older Americans that may
need long-term services and supports, there is a growing desire around
the country to ``re-balance'' long-term care systems. Texas was at the
forefront of this movement, particularly for aging persons and persons
with physical disabilities. For example:
In the early 1980s, Texas began offering home and community-based
services as an alternative to institutionalization. Since then, while
home and community-based services have grown significantly, there has
been no growth in nursing facility utilization despite a significant
growth in the older population.
In the late 1990s, Texas was the first state to develop the Money
Follows the Person concept, which has now been written into federal law
in the most recent Deficit Reduction Act. In Texas, we have used the
Money Follows the Person concept to move over 10,000 people out of
nursing facilities and into the community. AAAs, particularly through
the nursing facility ombudsman program, have played a role in this
effort.
Texas was one of the first states to apply innovative thinking to
integrating access to services across populations. Texas applied for
and received funds in the first round of Real Choice System Change
grants to test a system navigation function. The purpose of these
grants, which were administered through AAAs, was to help individuals
and their families ``navigate'' the often confusing system of services
that are available to persons who are aging or have disabilities. In
both areas where it was implemented, the results supported development
of an Aging and Disability Resource Center (ADRC) model even before
specific grants were available for ADRCs.
Texas was also one of the first states to test the concept of
managed care for long-term care through the Star-Plus program in
Houston, which is now being expanded to more areas of the state.
In Texas, home and community based Medicaid services are not
delivered through the Aging Network. However, the Aging Network
provides a crucial role in the system of long-term services and
supports. Through access and assistance services, including benefits
counseling, AAAs help individuals and their families understand public
and private benefits. Through care coordination services, AAAs assist
in obtaining those benefits. In addition, OAA services help fill in
gaps in services caused by the more rigorous rules of Medicaid and for
individuals waiting eligibility determination. AAAs have also taken a
lead role in community planning to improve local systems of access,
with the goal of creating a seamless system of services.
In September 2004, Texas created DADS as the sole state agency
focused on delivering long-term services and supports to persons who
are aging and have disabilities. The agency serves as the State Unit on
Aging and administers institutional and community based Medicaid
services to persons with physical and cognitive disabilities. DADS has
a functional, not population-based, administrative structure to ensure
the continued integration of services to persons who are aging and have
disabilities.
I would like to discuss one example of why this matters. One of the
realities of an aging population is the increasing number of persons
with cognitive and physical disabilities who are living longer lives.
Testimony at a White House Conference on Aging Listening Session
indicates ``the mean age at death for persons with MR/DD rose from 19
years in the 1930's to 66 years in 1993, an increase of 247 percent.''
The number of adults with MR/DD age 60 or older in the United States is
expected to be 1.2 million by 2030, twice what it was estimated for
2000.'' (See Aging with a Developmental Disability 2005 White House
Conference on Aging Listening Session Testimony 12/8/2004, Chicago
Illinois.) The aging of persons with cognitive disabilities, in
particular, creates new challenges for the Aging Network. The
challenges of integrating new populations into the aging network
include having the right mix of home and community based services so
that individuals can age in place, and overcoming issues such as
``turfism'', lack of proper training, and the lack of knowledge among
the disability community about services available through the Aging
Network.
In creating DADS, our desire is overcome these challenges. The OAA
recognizes these same challenges. The Administration's proposal to
create Aging and Disability Resource Centers, consumer directed options
and more choice in its programs are philosophically consistent with the
functional design of DADS and the integration of services in Texas. In
doing so, we believe states need to have the flexibility to design
service delivery systems at the local level that are responsive to
needs and desires of the local community.
3. The OAA should further empower states and local communities to
plan and prepare for an aging population.
In 1997, Texas began an initiative called Aging Texas Well.
Administered by the State Unit on Aging, under the general advocacy and
planning provisions of the OAA, the purpose of Aging Texas Well is to
ensure Texans prepare for aging in all aspects of life and that state
and local social infrastructure facilitates aging well throughout the
lifespan. The importance of the initiative has been further recognized
by passage of a resolution by the Texas Legislature (SCR 36, 75th Texas
Legislature) and, most recently, by an executive order by Governor Rick
Perry (RP 42).
The Declaration of Objectives of the OAA provides the conceptual
framework for Aging Texas Well. When the original OAA was passed, these
Objectives, which are related to employment, housing, health and other
life areas, were ahead of their time in recognizing the importance of a
holistic approach to the wellness of older persons. A second key
element of Aging Texas Well is its focus on individuals taking
responsibility to prepare for aging and on communities supporting that
preparation. A final critical element is the recognition that aging
well requires a lifespan approach focused on long-term living.
Aging Texas Well seeks to ensure state policy is responsive to the
needs of older Texans, consistent with the mandates of the OAA to
review state policy. It also drives efforts to work with local
communities to strengthen capacity to support older Americans, again
consistent with the mandates of the OAA. (More information is available
at www.agingtexaswell.org.)
For example, one of the great successes of Aging Texas Well has
been our internationally recognized Texercise program. Texercise uses
evidence-based practices through partnerships with the private and non-
profit sectors to create locally based programs to improve the
nutritional and physical activity habits of older adults. AAAs
participate in these programs as part of their mandate under the health
promotion provisions of the OAA. (More information about Texercise is
available at www.texercise.com.)
One of the strengths of the OAA is the implicit mandate to the
Aging Network to take a proactive role in preparing our communities for
the aging of the population. This mandate could be made more explicit
in the Act. The need for this type of proactive planning has been
acknowledged by the delegates at the recent White House Conference on
Aging, by the National Association of Area Agencies on Aging and by the
National Association of State Units on Aging. New York (Project 2015),
Texas (Aging Texas Well) and Florida (Communities for a Lifetime) have
all begun projects to plan and prepare states and communities for the
realities of an aging population. The OAA could dedicate resources and
provide encouragement for other states to do the same.
In conclusion, as you may be aware, reauthorization of the OAA was
the highest ranked resolution of the White House Conference on Aging.
It was also one of the top priorities of the Texas delegation to the
Conference. This reflects the fact that the OAA has served this country
well by creating at the local level a system of services to respond on
a day-to-day basis, and in times of crisis, to the needs of older
Americans, their families and caregivers. It has been successful
because of its emphasis on developing community participation and
resources.
On behalf of the Texas Department of Aging and Disability Services,
thank you for this opportunity to testify. I will be glad to answer any
questions.
______
Chairman Tiberi. Thank you. We're going to go ahead and
hear from the other three witnesses, and then we'll ask
questions.
Mr. Dominguez?
STATEMENT OF ARMANDO DOMINGUEZ, ASSISTANT DIRECTOR, CENTER ON
AGING AND HEALTH, UNIVERSITY OF TEXAS-PAN AMERICA
Mr. Dominguez. Thank you, sir.
Chairman Tiberi, Congressman Hinojosa, welcome to the
University of Texas, where the Center on Aging and Health has
over 15 years experience conducting basic and applied research
with a goal of advancing the quality of life of our area
seniors. With this in mind, we strongly suggest transformation
as a major impetus underlying the process for reauthorization
of the Older Americans Act. The new century challenges us to
think well beyond the demographics and socioeconomic realities
of the 1960s which figured heavily in formulating the first
Older Americans Act and subsequent reauthorizations.
In reauthorizing the Older Americans Act, we should seek a
collective synergy in making possible its transformation.
Transformation calls for identifying new possibilities for
partnering, no longer limited to the young and the old or
public and private, but for partnering between senior and
senior, old and old. What do we mean by this proposed
partnership between senior and senior? It means that we need to
draw in the well-educated, economically secure and physically
able baby boomer to partner with another senior not as lucky in
benefiting from the options made possible by our society. This
is particularly the case for our current minority population,
but especially for our future population of boomers who,
although not quite seniors yet, will be soon entering their
rank.
We are at the threshold of having a recognizable number of
well-educated professionals and small business owners who were
able to advance with the passage of the Civil Rights Act of
1964 which opened doors previously closed for most, if not all,
of us. Yet, just as the existence of this group is made quite
explicit in our research, we are also painfully aware of
another group of seniors who, because of adverse circumstances,
which I will not go into at this time, have not equally
benefited from these options.
Still today, the largest number of Valley seniors are
barely making it, if that, with the very minimum combination of
SSI Social Security disbursed in Texas, which is less than
$7,000 a year. These were hardworking people, they struggled
all of their lives, yet for a myriad of reasons, agricultural
work, unprincipled employers who did not contribute to the
Social Security fund, find themselves barely surviving with
practically no options in their lives.
Our research indicates that this parallel demographic and
socioeconomic trend will continue in our communities for quite
a long time. What is different is that while seniors, poor in
resources and education, will continue to be very much part of
our horizon, we have another group that is not. This is the
synergy that we call for. How to use the human capital of the
accomplished in partnering with those who are not? Thus we call
for a new approach, we need to revitalize by understanding this
new population dynamic which is happening throughout the
country and amongst most ethic and racial groups.
In transforming our thinking about seniors and the services
they need, let us not forget that research indicates that we do
not stop learning because we have grown old. On the contrary,
we continue and are capable of learning throughout life. Let us
revitalize by acknowledging this fact and address the learning
potential of seniors. Another key word here after partnering is
learning potential. Seniors, regardless of income and
education, can learn. And we have substantial proof that
indicates that our Valley seniors with little education and
resources succeeded in learning the basics of using a computer
and communicating with others through the web. We successfully
trained over 60 Valley seniors with an average of five years of
education to use the computer and search the web for health-
related information. This process yielded other intangible
benefits like building their self-esteem, and, even more
importantly, it has a major impact on their relationships with
their children and their grandchildren. It opened whole new
communication channel between generations and advanced the
position of the elderly within their families.
Underscoring the need for transformation is the shift from
acute illnesses of the latter half of the past century to
present chronic illnesses such as cardiovascular disease,
cancer, and of course diabetes. Medicine does not have a magic
bullet for chronic illness as it developed for acute illness.
Medicine does not have a cure for chronic diseases, it provides
care. Present and future services for the elderly must be
revitalized to reflect this medical reality.
Within this medical reality, there is also a shift that
demands a better-educated patient. This is why partnering and
learning potential are key words in revitalizing the act.
Better educated seniors can mentor those with low health
literacy to become better informed, to understand management of
their diseases, health prevention, and, as important, to become
better health care consumers, and by doing so save Medicare
dollars from unnecessary medical procedures and waste.
The well-educated senior can mentor other seniors in
reaching out and modifying behaviors that may adversely affect
their health, and in particular for Mexican-Americans of our
area who many times subscribe to cultural norms toward external
locus of control, fatalism, dependence on the medical delivery
system for their care, and overall low health literacy.
Finally, by transformation we mean the need not only to
reform but to change the infrastructure to empower our own to
make informed choices. Our own research at the Center on Aging
and Health shows that through culturally sensitive approaches,
older Mexican-Americans can learn to use a computer, eat
healthier, exercise often, drink five glasses of water daily,
and altogether modify their behaviors in ways that advanced not
only their physical but mental health. Many doubted this could
be achieved, but our outcomes have demonstrated time and again
the success of our best practice models. This is why the new
reauthorization needs to become an effort in transformation by
emphasizing the learning potential of our seniors, of all races
and ethnicities and socioeconomic classes, through a senior
technology program, empowerment training, health literacy and
consumerism, prevention and management of disease, and most
importantly, by building partnerships between senior and
senior. This is no longer a choice as we ready ourselves for
the largest wave of seniors ever in our history, since baby
boomers will soon enter this stage, this latter stage of life.
Thank you.
[The statement of Mr. Dominguez follows:]
Prepared Statement of Armando Dominguez, Assistant Director, Center on
Aging and Health, University of Texas-Pan America
Reauthorization of Older American's Act
The Center on Aging and Health has over 15 years experience
conducting basic and applied research with the goal of advancing the
quality of life of our area's seniors. With this in mind, we strongly
suggest transformation as a major impetus underlying the process for
reauthorization of the Older American's Act. The new century challenges
us to think well beyond the demographics and socio-economic realities
of the 60s which figured heavily in formulating the first Older
American's Act and subsequent re-authorizations.
In re-authorizing the Older American's Act we should seek a
collective synergy in making possible its transformation.
Transformation calls for identifying new possibilities for partnering,
no longer limited to the young and the old or public and private, but
for partnering between senior and senior, old and old. What do we mean
by this proposed partnership between senior and senior? It means that
we need to draw in the well educated, economically secure and
physically able baby boomer to partner with another senior not as lucky
in benefiting from the options made possible by our society. This is
particularly the case for our current minority population, but
especially for our future population of boomers who although not quite
seniors yet, will be soon entering their rank.
We are at the threshold of having a recognizable number of well
educated professionals and small business owners who were able to
advance with the passage of the Civil Rights Act of 1964 which opened
doors previously closed for most, if not all, of us. Yet, just as the
existence of this group is made quite explicit in our research, we are
also painfully aware of another group of seniors who because of adverse
circumstances, which I will not take the time to list, have not equally
benefited from these options. Still, today the largest number of Valley
seniors are barely making it, if that, with the very minimum
combination of SSI Social Security dispersed in Texas which is less
than $7000 a year. These were hard working people, they struggled all
of their lives, yet for a myriad of reasons, agricultural work,
unprincipled employers who did not contribute to the Social Security
fund, find themselves barely surviving with practically no options in
their lives. Our research indicates that this parallel demographic and
socio-economic trend will continue in our communities for quite a long
time. What is different is that while seniors, poor in resources and
education, will continue to be very much part of our horizon, we now
have another group that is not. This is the synergy that we call for.
How to use the human capital of the accomplished in partnering with
those who are not? Thus we call for a new approach, we need to
revitalize by understanding this new population dynamic which is
happening throughout the country and among most ethnic and racial
groups.
In transforming our thinking about seniors and the services they
need, let us not forget that research indicates that we do not stop
learning because we have grown old. On the contrary, we continue and
are capable of learning throughout life. Let us revitalize by
acknowledging this fact and address the learning potential of seniors.
Another key word here after partnering is learning potential, seniors
regardless of income and education can learn. And we have substantial
proof that indicates that our Valley seniors with little formal
education and resources succeeded in learning the basics of using a
computer and communicating with others through the web.
We successfully trained over 60 Valley seniors with an average of 5
years of education to use the computer and search the web for health
related information. This process yielded other intangible benefits
like building their self esteem and, even more importantly, it had a
major impact on their relationships with children and grandchildren. It
opened a whole new communication channel between generations and
advanced the position of the elderly within their families.
Underscoring the need for transformation is the shift from acute
illnesses of the latter half of the past century to present chronic
illnesses such as cardiovascular disease, cancer, and of course
diabetes. Medicine does not have a magic bullet for chronic illness as
it developed for acute illness. Medicine does not have a cure for
chronic diseases, it provides care. Present and future services for the
elderly must be revitalized to reflect this medical reality.
Within this medical reality there is also a shift that demands a
better-educated patient. This is why partnering and learning potential
are key words in revitalizing the act. Better educated seniors can
mentor those with low health literacy to become better informed, to
understand management of their diseases, health prevention and as
important to become better health care consumers. And by doing so save
Medicare dollars from unnecessary medical procedures and waste. The
well educated senior can mentor other seniors in reaching out and
modifying behaviors that may adversely affect their health, and in
particular for Mexican-Americans of our area who many times subscribe
to cultural norms toward external locus of control, fatalism,
dependence on the medical delivery system for their care, and overall
low health literacy.
Finally, by transformation we mean the need not only to reform, but
to change the infrastructure to empower our own to make informed
choices. Our own research at the Center on Aging and Health shows that
through culturally sensitive approaches older Mexican Americans can
learn to use a computer, eat healthier, exercise often, drink 5 glasses
of water daily and altogether modify their behaviors in ways that
advanced not only their physical but mental health. Many doubted this
could be achieved, but our outcomes have demonstrated time and again
the success of our best practice models. This is why the new re-
authorization needs to become an effort in transformation by
emphasizing the learning potential of our seniors, of all races and
ethnicities, and socio-economic classes through a senior technology
program, empowerment training, health literacy and consumerism,
prevention and management of disease, and most importantly, by building
partnerships between senior and senior. This is no longer a choice as
we ready ourselves for the largest wave of seniors ever in our history,
since baby boomers will soon enter this stage of life.
______
Chairman Tiberi. Thank you, Mr. Dominguez.
Mr. Sullivan?
STATEMENT OF MARLON SULLIVAN, SENIOR DIRECTOR OF STAFFING FOR
THE HOME DEPOT
Mr. Sullivan. Mr. Chairman and members of the subcommittee:
I am pleased to have the opportunity to testify before you
today and to represent The Home Depot. As mentioned earlier, my
name is Marlon Sullivan. I am the Senior Director of Staffing
for The Home Depot.
As many of you here may know, Home Depot was founded in
1978 in Atlanta, Georgia, and is currently the world's number
one home improvement retailer, operating more than 2,000 stores
across North America. Today, Home Depot is a Fortune 13
company, which caters to both do-it-yourselfers and
professional customers who serve the home improvement,
construction and building and maintenance market segments.
The Home Depot currently operates in roughly all 50 U.S.
states, the District of Columbia, nine Canadian provinces,
Mexico, Puerto Rico, as well as most recently two sourcing
offices that were opened in China. The Home Depot family of
companies includes the Home Depot proper, which we call back at
the home office ``The Orange Box,'' in addition to our EXPO
design centers and The Home Depot Supply.
Over the years it's become very clear to us that one of our
competitive advantages is that of our associates, and in
particular its diversity of thought and cultural background
that they bring. We really fundamentally believe that to build
a workforce that reflects its community is the key to success.
We also believe that diversity is the catalyst for innovative
thinking, entrepreneurial spirit, and also for ways of building
our communities.
As a sign of our commitment, The Home Depot has joined
forces starting back in 2002 with a number of national
nonprofit and government agencies to develop key hiring
partnerships. Just to name a few today, we have launched hiring
partnerships with the following organizations and/or agencies,
including, but not limited to: The Department of Labor, the
AARP, the Department of Defense, Labor and Veterans Affairs,
and four of the nation's leading nonprofit Hispanic
associations, which include ASPIRA; HACU, the Hispanic
Association of Colleges and Universities; the National Council
of La Raza, and obviously SER--Jobs for Progress National.
These partnerships allow us to not only reach out to the
communities, but also provide us with a broad range of
qualified candidates with diverse backgrounds, and they also
provide a unique pipeline for us that will aid us in hiring the
nearly 20,000 net new jobs we will create in fiscal year 2006.
And today I am particularly excited to talk about the
hiring partnership with SER--Jobs for Progress National. It was
launched back in February 2005 in approximately 40 markets. The
scope of the partnership is fairly large, including more than
60 SER affiliates in five states, each of which are operating
One Stops. As many of you know, One Stops today offer services
not only to employers, but then also services to their job
seekers, providing skill sets and training regarding job
matching, career counseling, and et cetera.
The success of the hiring partnership to date has enabled
us to develop an active workforce of qualified associates with
diverse backgrounds, but that is only one aspect of the
partnership. An equally as impressive aspect of the partnership
is SER operating as a SCSEP grantee of the U.S. Department of
Labor, which affords us the opportunity to leverage the 26
SCSEP sites that currently exist through SER in 16 states.
At each of these offices, the SER staff provide candidates
who have an interest in applying online with hands-on training.
They also provide them with the option to go to our Home Depot
stores where they can apply via the kiosks, and then they also
have the opportunity to apply out of their homes. The
partnership also brings both SER and The Home Depot the
opportunity to provide jobs on each of our web sites as well as
provide promotional materials that are available to each of the
candidates.
We have had a number of successes through SCSEP, and I will
share with you one in particular that I think you will find
interesting. The SER affiliate in Cleveland has developed a
customized program with a nearby Home Depot store there, and,
in essence, a co-partnership led to the job preparation
curriculum that provides each of the interested candidates with
clear instructions for how to apply and ensuring they have the
skill sets available. This particular partnership and the
development, co-development of this curriculum, has been so
successful that efforts are currently being made to expand and
replicate the program statewide first, and potentially
nationwide.
The partnership is not only important in terms of
increasing our ability to reflect our community, but it
provides us with the ability to provide regular unsubsidized
employment opportunities to many SCSEP participants, thus
allowing us to mirror the changing U.S. demographics. A number
of our panelists have already mentioned some of the 2000 census
statistics, which include numbers such as the current
population of 281 million people in the U.S., of which 12
percent, some 35 million people, are 65 years of age or older,
and the projection that by 2030, 20 percent of all Americans
will have passed their 65th birthday, representing 70 million
people.
At The Home Depot, we believe knowledge, experience and
passion never retires. We fundamentally know that mature
workforce brings honed talent, sound judgment and solid
experience. We will also know from our customers who have said
on numerous occasions that senior workers for us has been very
knowledgeable and customer-service oriented. Our research also
points to the fact that the retention rate for those in the 50-
plus sector is very strong; in fact, higher than the retail
norms.
Given the success of the SER hiring partnership in the
first six months, we recently agreed to a partnership expansion
back in October 2005 involving the participation in SER's
502(e) project, which is a federally funded Older Worker
Employment Training Program. This program allows the provision
of technical skills training in preparation for unsubsidized
employment in the private sector and targets high growth
industry, thus The Home Depot interest in being a partner from
the retail industry.
The initial 502(e) markets include six geographies, three
of which are located in Texas; that being San Antonio, Houston,
Fort Worth; and then also Miami, Cleveland, and Los Angeles. In
each of these locations, there are roughly 23 participants who
receive a two week pre-employment training, roughly 80 hours in
total of training, and, of those numbers, we will totally have
about 140 total applicants who are currently part of this
program applying for jobs at The Home Depot today for
opportunities not limited to but including Lot Associates,
Cashiers, Sales Associates, Sales Specialists and Management
positions.
In conclusion, we fundamentally believe a partnership with
SER and a number of our existing hiring partners provides us
with a competitive advantage, a highly qualified and diverse
workforce. We also are honored to enable for the ongoing
regular and unsubsidized employment of our SCSEP participants,
and also are very proud to be an active proponent of lifelong
retooling and upgrading of the nation's workforce.
Thank you.
[The statement of Mr. Sullivan follows:]
Prepared Statement of Marlon Sullivan, Senior Director of Staffing, the
Home Depot
Mr. Chairman and Members of the Subcommittee, I am pleased to have
the opportunity to testify before you today and represent The Home
Depot, Inc. My name is Marlon Sullivan, and I am the Senior Director of
Staffing for the Home Depot. In this capacity, I oversee enterprise-
wide staffing operations, encompassing all domestic and international
retail stores, distribution centers, call centers, and the US based
Home Depot headquarters, also known as the Store Support Center. My
team's responsibilities include policy design, practices development,
operational improvement, technological innovations, strategic workforce
planning, field implementation, and strategy development for the
Staffing function.
The Home Depot, founded in 1978 in Atlanta, Georgia, is the world's
#1 home improvement retailer, operating more than 2,000 stores across
North America. Today, Home Depot is a Fortune 13 company, which caters
to both do-it-yourselfers and professional customers who serve the home
improvement, construction and building maintenance market segments. The
Home Depot currently operates in 50 U.S. states and in the District of
Columbia, nine Canadian provinces, Mexico, and Puerto Rico as well as
two sourcing offices in China. The Home Depot family of companies
includes The Home Depot, EXPO Design Centers and The Home Depot Supply.
Over the years it has become clear that one of our key competitive
advantages is our associates and the diversity of thought and cultural
background they bring to the workplace. That withstanding, the Home
Depot seeks to build a workforce that reflects its communities. We
believe that diversity is the catalyst for innovative thinking,
entrepreneurial spirit and new ways of building our communities. We are
convinced the greater the diversity of our people, the greater our
ability to serve our customers and communities.
As a sign of our commitment, The Home Depot has joined forces with
national nonprofits and government agencies to develop key hiring
initiatives. To date, The Home Depot has hiring partnerships with the
following organizations and agencies: Department of Labor, the AARP,
the Department of Defense, Labor and Veterans Affairs, and four of the
nation's leading non-profit Hispanic organizations, including the
ASPIRA Association, the Hispanic Association of Colleges and
Universities (HACU), the National Council of La Raza (NCLR), and SER--
Jobs for Progress National. These partnerships allow us to reach out to
the communities in which we operate, and provide our company with a
broad range of qualified candidates with diverse backgrounds. In
addition, these hiring partnerships provide The Home Depot with a
unique pipeline to assist the company in its hiring for the nearly
20,000 net new jobs it will create in 2006.
Today I am here today to talk about our hiring partnership with
SER--Jobs for Progress National, which was launched in February 2005 in
approximately 40 markets. The scope of the hiring partnership is very
board, as it includes more than 60 SER affiliate One Stops nationwide.
The success of the hiring partnership to date has enabled us to develop
an active workforce of qualified associates with diverse backgrounds.
As a Senior Community Service Employment Program (SCSEP) grantee of
the US Department of Labor, SER's partnership also affords us the use
of its 26 SCSEP project sites in 16 states. This aspect of the hiring
partnership enables us to provide regular, unsubsidized employment
opportunities to many SCSEP participants, thus building an employment
base that mirrors the changing US demographics.
According to the 2000 census, the U.S. population is more than 281
million. Of that, the 65 and older population makes up about 12% of our
country's citizens, roughly 35 million people. In essence, Baby Boomers
are maturing at twice the rate of the rest of the population. In fact,
demographic projections show that by 2030, that population will more
than double, with 20% of all Americans, or about 70 million people,
having passed their 65th birthday.
At The Home Depot, we believe knowledge, experience and passion
never retires. We know that a mature workforce brings with it honed
talent, sound judgment and solid experience--precisely the skills and
attributes we value in our talent pool. Our research indicates that our
customers feel that mature workers are very knowledgeable and customer-
service oriented. It also points to the fact that the retention rate
with the 50+ sector is very strong--higher than the retail norms.
Given the success of the SER hiring partnership in its first 6
months, The Home Depot agreed to a partnership expansion in October of
2005 involving participation in SER's ``502(e)'' project, a federally
funded older worker employment training program. The initial 502(e)
markets include: San Antonio, Houston, Fort Worth, Miami, Cleveland and
Los Angeles. As part of SER National's 502(e) On the Job Training
Program (OJT), 23 participants in each of the 6 markets underwent 2
weeks of pre-employment training. The 80 hours of training included
skills such as computer basics, customer service, interview best
practices and preparing for the Home Depot application. Having recently
completed training, the 138 total applicants are currently applying on
line for Home Depot opportunities, which include but are not limited to
Lot Associate, Cashier, Sales Associate and Sales Specialist.
In conclusion, the success of the hiring partnership with SER--Jobs
for Hire National enables Home Depot to enhance its competitive
advantage by developing a highly qualified, diverse workforce. In turn,
we are able to provide regular, unsubsidized employment opportunities
to many SCSEP participants. Meanwhile, the recent expansion of the SER
hiring partnership to include the 502 (e) OJT further empowers the Home
Depot to positively impact our communities by playing an active role in
promoting lifelong retooling and upgrading of the nation's workforce.
______
Chairman Tiberi. Thank you.
Mr. Perez?
STATEMENT OF JOSE T. PEREZ, EXECUTIVE DIRECTOR, SENIOR
COMMUNITY OUTREACH SERVICES, INC.
Mr. Perez. Good morning. I want to thank the Committee
Chairman, Congressman Tiberi, and Congressman Ruben Hinojosa
for allowing me this opportunity to testify before the House
Subcommittee on Select Education.
My name is Jose Perez, Executive Director of Senior
Community Outreach from Alamo. I also serve as vice president
of the National Association For Senior Companion Project
Directors, and I also served as a delegate for the 2005 White
House Conference on Aging.
Senior Community Outreach Services is a nonprofit
organization whose mission statement is to establish a
comprehensive system of community services that would respond
to the talent and everyday needs of older persons and to see
senior citizens of our community have the opportunity to live
independently, meaningful and dignified lives in their own home
and community.
People are living longer, and the family support system
they once counted on to help them as they age is not always
there now. Families live miles apart due to economics, while
adult daughters, who were the primary source of care for
elderly parents, are now working to support their immediate
families. However, care is still needed for a much longer time
than before, due to the increasing longevity of today's
seniors. The answer for some of these long-term care needs can
be provided by in-home service provider agencies and the
utilization of volunteers.
For the elderly, the absence of in-home support care often
makes a difference between living independently at home or
premature placement in a care facility, and may place their
family caregiver at significant risk of being overextended,
take a toll on family earnings, workplace productivity, and the
loss of quality of family life.
The Senior Companion--I work for the Senior Companion
Program, which is a wonderful and compassionate program. The
Senior Companion Program currently administered through the
Corporation for National and Community Service has been
serviced in the Rio Grande Valley for the past 30 years.
Congress established the Senior Companion Program in 1973 to
utilize low income volunteers to serve and provide assistance
to home-bound elderly and enable them to continue living
independently as long as possible. At the same time, the
program offered healthy seniors age 60 and older the
opportunity to serve their community by volunteering.
Today, the Senior Companion Program has 16,000 volunteers,
providing over 15 million hours of service to 80,000 clients,
over 227 projects across the country and Puerto Rico. Senior
companions serve 20 hours per week and receive a small tax-free
stipend which, by law, does not affect any other benefits they
may be receiving. Companions also receive liability insurance,
a meal, and travel allowance while in service.
Services of the Senior Companion Program are flexible
enough to meet the needs of the older person. For example, a
senior companion through a care plan can provide assistance in
personal care, meaning dressing, grooming, bathing, toiletry
and exercising, or provide assistance in home management,
preparing a meal, light house keeping, escort service,
shopping, tidying, dusting and cleaning, provide protective
services, oversee and overlooking or looking in on a
individual's physical or mental well-being, seeing that there's
no abuse or neglect of those elderly living alone, providing
information or referrals or arrange services from the
community, respite care services for family caregivers by
providing relief from the constant demands of ongoing caring,
provide an opportunity to take a well-deserved nap, bathe, or
go shopping or just take a short vacation.
The cost of having a Senior Companion Program volunteer in
the Rio Grande Valley is 5,475 per year. We have 110 volunteers
servicing the Rio Grande Valley. These companions service 330
clients, for a total of 114,840 hours. The total of the project
cost is 602,250 per year. This same service outside the
program, there's an estimated cost of 1,952,280 per year.
The Senior Companion Program has demonstrated the cost
effectiveness of providing in-home care support services to the
family caring for loved ones at home and to frail, isolated
elderlies striving to maintain independence. In anticipation of
the baby boomer population coupled with the current growth of
elderly already in need of support services, to continue to
live independently, the expansion of the Senior Companion
Program and other volunteer-modeled programs is imperative.
My recommendation is the funds should be made available to
programs that engage senior volunteers to serve as support
resource to frail older persons still living at home. In doing
so, we can prevent early institutionalization and save the
government and families the expensive of institutional care.
One idea is to amend the Title 3(e) of the Older Americans Act
Family Caregiver Support Program to establish subprograms of
volunteer organizations to conduct family caregiver activities
in order to promote independent living and the lay
institutional placement for older individuals through the use
of volunteers, including low income volunteers. Grants should
be awarded on a competitive basis to use and employ the use of
volunteers to help older persons requiring long-term care.
Also, my recommendation is to encourage, enable and
facilitate collaboration and partnerships among national, state
and local organizations of government that currently provide
volunteer and paid work opportunities for people of retirement
age, in terms of retirement age from all economic backgrounds,
and to generate more resources to support elders as volunteers
and to attract baby boomers by expanding and realigning their
portfolio to include more informal time limit, episodic and
project-based volunteer service opportunities, as well as full-
time, part-time and episodic pay work opportunities, especially
in the area of community services, intergenerational
involvement, independent living and long-term care.
Another recommendation is to combat ageism by encouraging
the federal government to provide education and public
awareness that emphasizes elders as givers of service instead
of consumers of service, to publicize the positive contribution
older adults make to their community every day, and that
focuses on the value of volunteering for people's well-being,
physical and mental health, independence and self-esteem.
The 2005 White House Conference on Aging delegates voted
and made recommendations on the top ten resolutions, and
reauthorizing the Older Americans Act was number one.
The second was to develop a coordinated, comprehensive
long-term care strategy by supporting public and private sector
initiatives that address financing, choice, quality service
delivery and the paid and unpaid work force.
Thank you for this opportunity.
[The statement of Mr. Perez follows:]
Prepared Statement of Jose Perez, Executive Director, Senior Community
Outreach Services, Inc.
Good Morning Ladies and Gentlemen, I want to thank the committee
Chairman Congressman Patrick Tiberi and Congressman Ruben Hinojosa for
allowing me this opportunity to testify before the subcommittee on
Select Education.
Today, I am going to testify on the services provided by Senior
Community Outreach Services; Specifically, the Senior Companion Program
with the hope of making recommendations to the committee on how to
strengthen communities and improve programs and services for seniors.
My name is Jose T. Perez, Executive Director of Senior Community
Outreach Services, Inc. We are a non-profit organization whose mission
statement is to establish a comprehensive system of community services
that would respond to the talents and every day needs of the older
person and to see all senior citizens of our community have the
opportunity to live independent, meaningful, and dignified lives in
their own homes and community.
Statement
People are living longer, yet the family support system they once
counted on to help them as they age is not always there now. Families
live miles apart due to economics, while adult daughters who were the
primary source of care for elderly parents are now working to support
there immediate families, However care is still needed and for a much
longer time than before due to the increasing longevity of today's
seniors. The answer for some of these long-term care needs can be
provided by in-home service agencies and the utilization of volunteers
through the Senior Companion Program.
There is a growing need for long term care and independent living
services for the aged and infirm older persons. It is estimated that
80% of the care given to the frail older person comes from informal
sources such as, relatives or friends who assumes the burden of
providing around the clock care. According to the U.S. censes, by 2020
the 65+ population will increase from 33 million or 12.7% to 53
million.
Substantial portions of the elderly, especially the very old,
requires assistance with necessary daily activities such as dressing,
bathing, shopping, or meal preparation. Most frail older persons
currently living in the community rely primarily on family members and
friends for personal care, household assistance, transportation, help
with medications and emotional support. At present, there are more than
11 million health impaired Americans who experience difficulty in
performing activities of daily living, 5 million or 50% are elderly,
while the remainder are the severely disabled and children. For these
individuals institutionalization can be avoided only by having some
source of support for their personal care. Because family caregivers
undergo great sacrifice, studies have shown that a breakdown in the
physical and/or emotional health of a caregiver can precipitate
institutionalization for the impaired individual.
For the elderly the absence of in-home support care often makes the
difference between living independently at home or premature placement
into a care facility and/or may place the family caregiver in
significant risk of being over extended, taking toll on family
earnings, workplace productivity, and the lose of quality of family
life.
Senior Companion Program
The Senior Companion Program currently administered through the
Corporation for National and Community Service has been servicing the
Rio Grande Valley for the past 30 years. Congress established the
Senior Companion Program in 1973 to utilize low-income volunteers to
serve and provide assistance to homebound elderly, and enable them to
continue living independently as long as possible. At the same time,
the program offers healthy seniors age 60 and older the opportunity to
serve their community by volunteering. Today in 2006 the Senior
Companion Program has over 16,000 volunteers providing over 15,000,000
hours of service to over 80,000 clients in over 221 projects across the
country and in Puerto Rico.
Senior Companions serve 20 hours per week and receive a small tax-
free stipend, which by law does not affect any of the benefits they may
be receiving. Companions also receive liability insurance, a meal, and
travel allowance while in service.
Services Senior Companion Program are flexible enough to meet the
needs of the a signed orlder person for example:
1. Provide assistance in personal care; dressing, grooming,
bathing, toiletry, and exercising
2. Provide assisstance in home management, preparing meals, light
house keeping, escort services, shopping, tidying, dusting, cleaning,
washing dishes, sweeping, laundering and more.
3. Providing protective services, over seeing or looking in on the
individual's mental and physical well being. Seeing that there is no
abuse or neglect of those elderly living along.
4. Provide information and referral or arrange services from the
community, such as, arranging transportation to the doctor or shopping,
food stamps, etc.
5. Respite care services for family caregivers by provide relief
from the constant demands of ongoing caring. Provide an opportunity to
take a well deserve nap, bath, go shopping, or just take a short
vacation.
The Alliance on aging research estimates that annually, the United
States spends $27 billion more in health care cost for seniors who lose
their ability to live independently than if they had maintained their
ability to live on their own.
The Senior Companion Program is the most compassionate Program ever
put out by the federal government, it is cost effective and it is a
program where every body wins. The client wins because they have
someone taking care of their needs, the family wins because they do not
have to worry anymore for their love one is being care for, and the tax
payers do not have pay for their care in an expensive facility, and the
volunteer wins because of the opportunity to help someone in need and
rip the rewards of appreciation of the clients.
The cost of having a Senior Companion volunteer is $5,475 here in
the Rio Grande Valley we have 110 volunteers in service. These Senior
Companion services 330 Clients for a total of 114,840 hours per year.
The total for this project is $ 602,250 per year. This same service
provided by a for profit business is estimated to be at a cost of
$1,952,280 per year.
Seniors as volunteers are a viable and untapped resource with 77
million baby boomers ready to retire, an abundance of seniors will be
ready to volunteer if asked.
The Senior Companion Program has demonstrated the cost
effectiveness of providing in-home care support services to the
families caring for loved ones at home and to the frail isolated
elderly striving to maintain independence. In anticipation of the baby
boom population, coupled with the current growth of the elderly already
in need of supportive services to continue to live independently, the
expansion of the Senior Companion Program and other volunteer model
programs is imperative.
Recommendation
More Federal Agency Collaboration
Funds should be made available to programs that engage senior
volunteers to serve as a support resource to frail older persons still
living at home. In doing so, we can prevent early institutionalization
and save the government and families the expense of institutional care.
One idea is to amend the Title III-E of the Older American Act/
Family Caregiver Program to establish subprograms of volunteer
organizations to conduct family caregiver activities in order to
promote independent living and delay institutional placement for older
individuals through the use of volunteers, including low income
volunteers. Grants can be awarded on a competitive basis to use and
employ the use of volunteers to help older persons requiring long-term
care, including those receiving home health care and nursing care. (
Justification and recommendations are attached as provided by the
National Association for Senior Companion Project Directors NASCPD)
Encourage, enable, and facilitate, collaborations and partnerships
among national, state and local organizations that currently provide
volunteer and paid work opportunities for people of retirement age from
all economic backgrounds to generate more resources to support elders
as volunteers and to attract Baby Boomers by expanding and re-aligning
their portfolios to include more informal, time-limited, episodic and
project-based volunteer service opportunities as well as full-time,
part-time, and episodic paid work opportunities, especially in the
areas of community services, intergenerational involvement, independent
living and long term care.
Combat ageism by encouraging the Federal Government to provide
education and public awareness that emphasizes elders as givers of
services instead of consumers of services, that publicizes the positive
contributions older adults make to their community every day, and that
focuses on the value of volunteering for people's well-being, physical
and mental health, independence, and self esteem
Again, Thank you for this great opportunity.
______
Chairman Tiberi. Thank you, Mr. Perez.
I'm going to ask one question. I would like to remind
everybody that your entire testimony is going to be submitted
in the record. I'm going to ask one question and then I will
turn it over to my colleague, Mr. Hinojosa.
Mr. Urban, I read in fact everybody's testimony on the
plane ride down here, so thank you very much for your time in
preparing the testimony. But something struck me in your
testimony that I would like you to expand on a little bit.
In your written testimony, you talked or you wrote a little
bit about several initiatives that Texas undertook to modernize
delivery of your Aging Network, and a couple of them kind of
stuck out, and I want you to just touch on those. One was your
Consumer-Directed Care Initiative that you wrote about. Another
one was Money Following the Person. Can you touch on those two
a little bit and how they've worked in Texas?
Mr. Urban. Gladly, and I'll start first with consumer-
directed services.
A number of states have implemented, and I think Arkansas
is perhaps the most famous, what are known as Cash and
Counseling Programs to improve, particularly in their Medicaid
waiver programs, how individuals are empowered to make more
choices and have more control over the services that they
receive. We implemented a program that was similar in concept
in Texas, in fact we got a Real Choice Grant to look at a
Service Responsibility Option, is what we call it, model for
helping empower consumers or clients to direct how their
services go. So we have done that through our Medicaid
programs, we've also done that in our Aging Network programs.
When the National Family Caregiver Support Program was
funded in Texas, in a number of our rural communities in
particular, there are not that many providers, which my written
testimony talks a little bit more about. And so we're striving
to figure out how to empower these consumers to help, A, find
providers to help them with services such as respite, and one
of the ways we were able to do that is through the voucher
program in which we were able to give the client the cash to go
out and recruit and hire and control their own provider of
respite services to help them meet the needs of the person that
they are providing care-giving to.
In terms of Money Follows the Person, Texas was the first
state to implement such a program, and it actually came through
a rider to the appropriations bill in our legislative process,
I think probably three sessions ago, and the basic concept was,
when an individual is in an institution but could be served in
a community, to take the individual when they transition from
the institution back to the community and have that money from
the institutional side of the budget follow the person to the
community to ensure that there is funding in the community for
the individual.
About the same time that we adopted that rider to our
appropriations bill, we implemented our Promoting Independence
Plan, and our Promoting Independence Plan was directly in
response to the Olmstead Supreme Court case. And so we had this
very focused, focused initiative at the state level to try to
reach into institutions and those individuals that would prefer
services in the community to give them the support, services,
and the transition assistance that they need in the community.
So we would fill in the gaps with housing, the Aging Network
would come in with supportive services that they might need in
the transition period, the ombudsman would work with the
individual along with other transition specialists to help move
the individual to the community, and then, if they're a
Medicaid client, that money follows them into the community so
we ensured that there were slots in the waiver programs for the
individual.
Chairman Tiberi. How does that work? How are seniors
responding.
Mr. Urban. We have moved over 10,000 people out of
institutions into the community across our state, and while it
is often the case that the younger disabled community
stakeholders and advocates are pushing very strongly for
deinstitutionalization, what we have found in Texas is that
many, many people that are over the age of 60 have made the
move from the institution, from the nursing facility in
particular, back into the community.
So we applaud what Congress has done in the most recent
Deficit Reduction Act to put in a very specific Money Follows
the Person program. We think that we have learned a lot in
Texas about how that works with our experience to do that, and
we look forward to enhancing our efforts with the additional
funding that will be available through the DRA.
Chairman Tiberi. I will have someone from Ohio call you.
Mr. Urban. Please do so.
Chairman Tiberi. Thank you.
Mr. Urban. And I will direct them to the person that can
really help them with that particular program, as well.
Chairman Tiberi. Great. Thank you.
Mr. Hinojosa.
Mr. Hinojosa. Thank you, Mr. Chairman.
I have questions for each of the panelists, and I'm going
to start with the last presenter, Mr. Perez.
My question was, it begs the question when I heard you say
that the cost of having a senior volunteer is a little over
$5,000 here in South Texas, and that we have 110 volunteers in
service. You further said that the senior companion service is
330 clients for a total of 114,840 hours, cost of about
$600,000 per year, and that the same service provided by a for-
profit business would cost 2 million dollars.
It reminds me of a hearing that we had in Mission, Texas,
three weeks ago with 50 farmers who farm in the dry land up
around McCook, just north of Edinburg, and they were showing us
that if they planted their seed, that there was--because of the
drought, there was little probability of it actually taking
root and yielding what they were expecting from their sorghum
crop, and their accountants were able to show us that by not
planting this year, they would save the government some $500
million in agriculture for those that were suffering from the
drought in the State of Texas.
What I hear you say is that if we expanded our senior
companion volunteer here in Texas it would save the government
right here one and a half million dollars.
It also reminds me of the impact that NAFTA had when this
area displaced approximately 7,500 garment workers when they
closed down Levis, Haggars, Fruit of the Loom, Dickies, and
many of these garment workers had worked there for 20 years or
longer, and trying to give them retraining has not been very
successful with those with the lowest level of education. It
seems to me that a program like this could help those displaced
workers and that many, because of their age, would be wonderful
senior companion volunteers, and $100 a week, $5,000 a year
would be a win-win situation for those families and for the
elderly who need this type of assistance.
So I want to ask you, Mr. Perez, possibly you and your
organization can counsel us as to how much more we should
request from our appropriations committee in this very tight
budget environment. Do you have any suggestions.
Mr. Perez. We had our meeting last week at the National
Association for Senior Companion Project Directors Staff, and
we came up with a number----
Mr. Hinojosa. Can you put the speaker closer to you, so
folks can hear you in the back? Thank you.
Mr. Perez. Okay. I just came back from a meeting with the
National Association for Senior Companion Project Directors,
and considering the deficit that this country is in, we are
asking for $10 million for 2007, and that is just to expand it
and keep up with a portion of the growth of the needs here in
the Valley and elsewhere in the nation.
Mr. Hinojosa. Thank you.
Dr. Armando Dominguez, I congratulate you and the Valley
for establishing the Center on Aging and Health. Now more than
ever we need the teaching and research that those efforts have
provided.
Did the project on training, the 60 Valley seniors you
mentioned in your statement training in computer literacy,
include any of the senior-to-senior partnerships you mentioned.
Mr. Dominguez. Not at that time. We took computers from the
university warehouse surplus, refurbished them a little bit,
placed them in senior centers throughout the three-county area,
and there was a bit of that at the beginning. I can tell you
that subsequently at one of the centers I get feedback of the
strength of having computers hooked up to the Internet in these
senior centers. There is an individual who walks up to me each
time to thank me for that process, and she says that by going
on the Internet she was able to help her son find medical help
way out at the Mayo Clinic, because they're from up north, and
that she did it by going on the Internet, something she was
afraid of. She had fear of computers, which we experience area-
wide. And then she says a year later she used the computer yet
one more time and was able to save herself money for auto
insurance.
And in this way, we see the beginning. We see how, and we
come to then the conclusion that, indeed, by placing the
computers at the senior, centers we see the beginning of this
process where now she is able to help those less informed in
this process, and thus we get this notion of growing this
concept, of partnering between old and old; those who are
capable and literate, help those who are less literate,
especially with low health literacy.
There is a great deal of information in Spanish about
health care that was not available five years ago.
Mr. Hinojosa. Well, I can relate to that story, because I
have a relative who is in his middle 70s, and he was diagnosed
with leukemia. He is a cancer survivor, and he didn't know how
to use the computer. And about, I guess, eight years ago one of
his children bought a computer for him, and they worked with
him, and he says that as a result of that he's been able to
research all of the best hospitals in the country--MD Anderson,
where he has already been to once, and the Mayo Clinic and
others--and found everything he possibly can researching on
leukemia, and your story is something that is very, very true,
if we could just make the tools available and some assistance.
I want to ask you one other question. With my experience on
financial services, I work a great deal on financial literacy
education programs. I was interested in your comments of trying
to establish health literacy for seniors. Could you elaborate
more on that idea?
Mr. Dominguez. Certainly. Another research project we
conducted had to do with nutrition and education for those with
low health literacy. That came about and was conducted in the
primary language of many of us. At home, we speak Spanish. So
we conducted these series of health education classes.
Each class had a specific topic that was linked to a
specific menu dealing with that health topic. And this time of
the year, as you know through our little breakfast this
morning, we also include nopalitos. Nopalitos are the baby
cactus leaf that is included--it's in season right now, but in
particular in our culture, it is a cultural identity food item
for Lent.
So the project was linked with school public health at the
University Autonoma de Monterrey. The students came in and
conducted these health studies, health topics. One of the
topics this time of year was a juice made with the cactus and
grapefruit and pineapple. To the day, they still ask me about
the possibility of continuing that particular research project,
and they ask about that particular menu. ``Do you remember the
portions I tried,'' and et cetera.
Again, from our research, we see here the potential for
improving health literacy in this model that turned out to be a
best practice model that was evaluated out of a research outfit
out of Washington. They found us on the Internet, called us up,
and they ranked us number two in the country for this type of
activity. It's called the Academy for Educational Development
out of Washington, D.C., who was at that point under contract
with the USDA. And here in our research we find the best
practice model for improving health literacy among those that
are not quite as fluent in English.
Mr. Hinojosa. Thank you for sharing those thoughts. After
this is over, I would like to maybe visit with you on how in
the last year we've created a caucus on the Financial Literacy
Education Program that now has 67 members of Congress.
Chairman Tiberi. Including me.
Mr. Hinojosa. Including our Chairman.
Chairman Tiberi. That's where you're going with this.
Mr. Hinojosa. And I can tell you that it's moving so
rapidly because of the number of banks and federal agencies--
actually, they're not federal agencies; they're federally-
sponsored agencies like Freddie Mac and Fannie Mae. It's
really, really moving forward, so I want to discuss this with
you, because maybe the Chairman and I could start health caucus
in Washington, and I would like to back to the Chairman so that
he can ask some more questions.
Mr. Dominguez. We welcome the opportunity.
Chairman Tiberi. Thank you.
Mr. Sullivan, let me ask you a question that you've
probably been asked before. What can we do to encourage more
employers to hire and retain older workers? Much as you have
been a leader, Home Depot has been a leader in that; what can
we do to encourage others to follow your lead?
Mr. Sullivan. I think there are a couple of things. The
first is what you guys have done today I think is a very
important step, which is to be able to document in the public
record the successes that a hiring partnership with a nonprofit
and a for-profit can have, not just for both of those entities,
but, more importantly, for the community, as well.
I think the second is giving some thought potentially to
the creation of a corporate council which sits with government
to talk about the changes in U.S. demographics that is visible
in the 2000 census. Inevitably, corporate leaders either now or
later will realize that these demographics will ultimately
change their customer base, will change how their operating
their business, and if their employee base doesn't mirror the
community, they're going to be at a competitive disadvantage.
Having those conversations, again, in an open forum with the
data I think will also start to overcome some of the hesitancy
that some of the corporations are having in making that change.
I think, thirdly, there are things that corporations can
do, like The Home Depot. Recently I presented at a functional
presentation, nationwide HR conference, and talked about the
hiring partnership. The responses that I received after that
were phenomenal. Many of the folks within retail, even those
that are not in retail, were very, very interested, and we were
excited to be able to share the lists of the partners we
currently have and encourage our peers to get involved, whether
it be SER or any other hiring partner, to get involved.
So those are just a few that we thought through.
Chairman Tiberi. Thank you. Thank you for your input.
Mr. Dominguez, obviously a lot of people in this room agree
that disease prevention is preferable to disease treatment,
whether it be physical activity, whether it be healthy
nutrition, whether it be training someone on a computer.
I think of my own mother and father, both of whom were
immigrants to America, both self-taught. Both my parents now
use the computer, both self-taught on the computer, and that's
one of the good things they've done, but for my mother to try
to get my father out of the house for physical activity is,
well, you might as well forget it.
How do we as a society try to encourage seniors to break,
in many cases, a lifelong habit of not doing things right?
Whether it be eating right, whether it be lack of physical
activity, what do we do to solve that dilemma?
Mr. Dominguez. Behavior modification is, indeed, very
troublesome. The way that we did it was, in its research, is
adding a parenthetical phrase to a sentence, so it's very small
steps. One of the techniques that we utilized for increasing
water intake that proved to be successful was for the
individual to label a container with his or her name and pour,
in the morning, the amount of water that is prescribed; five
glasses of water. And, again, through research we see the
benefits when we go into the senior centers and they say, ``Oh,
I still remember and I still have my jar with my name on it. I
tell my children not to drink from it.'' That way, at the end
of the day we don't say, ``Well, was it three or was that four
glasses that I had?'' We know the amount that that individual
consumed.
And, as you point out, women are the caregivers primarily,
the caretakers in the family. So through our training, through
our research and these classes that we have, it was the women,
and then they would invite the husband.
``But look, it's so simple.'' And then the exercises that
we did were designed through our kinesiology department for an
aging population, exercise and plays with the stretch band, and
we have a video of that. So when they see their image projected
as part of what we consider best practices, then the husband
wants to come in for the next taping to be part of that.
Chairman Tiberi. Thank you.
Mr. Hinojosa.
Mr. Hinojosa. Mr. Sullivan, I'm so glad that you came,
because I want to share a story with you.
About a month ago, maybe six weeks ago, I broke bread with
the president of Home Depot in Atlanta, Georgia. We were having
a Congressional Hispanic Caucus Institute Retreat, and he
agreed to have breakfast with us, and I happened to sit next to
him, and I heard some stories of how Home Depot is partnering,
as in your presentation, as it applies to health. But I like
the fact that you-all are involving folks 50, 55 years and
older in ways that are innovative and very, very helpful that
could help us continue to drive the unemployment rate down in
this region where we've experienced for over 30 years double
digit unemployment.
So I mentioned to him that we have a region called the
Delta, and that we, with the help of the Department of
Commerce, Secretary Gutierrez gave us money to write a
strategic plan for the Delta Revitalization Project. They had a
15 percent unemployment, so you can understand my concern as
their Congressman. And they agreed to look at what I presented
and ask for assistance, and I need a follow-up.
Maybe you would be the ambassador for the Delta Region, an
area that has great potential.
I want to tell you that some of my friends in Congress
wanted to know if Edcouch-Elsa was a private high school, and I
said, ``Well, how come you're asking?'' He says, ``Well, we've
heard of all these high school graduates that are at Yale, at
Harvard, at Stanford, at Princeton, at Boston College''----
Chairman Tiberi. Ohio State.
[Laughter.]
Mr. Hinojosa.--in international studies. And I laughed, and
I said, ``It is the second poorest school district in the whole
State of Texas out of 1,050 school districts.''
So there is great potential, but a brain drain. They go and
they get recruited by big corporations.
So after this program is over, I would like to sit down
with you and see if we can have a follow-up of that meeting
with the President and see if maybe we can involve Home Depot
in a project that now has the support of Secretary Gutierrez,
who will be here in the Delta Region, I believe April the 21st.
And every one of the successful projects that I have been
involved in that are regional in scope always involve corporate
partners. The Boy's Club, what we call the high school magnet
or the magnet high school program we have here on allied
health, the community college, University of Texas, HESTEC,
others, all have corporate partners, and I would like to invite
Home Depot to help us in this one so that we can drive the
unemployment to look like the rest of Hidalgo County, which is
6 percent.
Mr. Sullivan. We would be--well, first, I guess we pride
ourselves in being a forerunner, and we love challenges, and
this is one that I think we will be more than happy to explore
with you and work through.
Mr. Hinojosa. Well, we have the seed money. We have the
seed money to launch it. We just need to start off with some
strong partner like you, Home Depot. And, believe me, we're
going to incorporate home health and the programs that we have
been hearing from the presenters, because that's an area that
has many displaced farm workers, and it has many displaced
garment workers.
Mr. Sullivan. We're very excited to explore those, would be
more than happy to do so.
Mr. Hinojosa. Wonderful. I would welcome your help.
And the last part here I wanted to ask is, the program you
mentioned has the 80-hour on-the-job training, and I would ask,
is this period sufficient or do you provide some follow-up
training? I believe that's what I heard you say in your
presentation.
Mr. Sullivan. Uh-huh. The training is actually conducted by
SER as part of the 502(e) project, and it is a total of 80
hours. What's most impressive about the 80 hours is there is a
portion of it that's focused on technology training, so getting
our seniors up to speed on being more comfortable with the
Internet, understanding how to work through the application
process and applying online. And typically what we do is once
our associate is on board, we will do more than a million hours
of learning and training within The Home Depot.
So, absolutely, when they're on board, we're training them
in the department that we brought them into. So we have what's
called ``Before the Apron'' which is kind of the fundamentals
of the trade, but then based on their performance we also go
into very specifics so they can develop an expertise, increase
their compensation overall and add more value to their
community.
Mr. Hinojosa. That's interesting. Approximately what would
be the estimate that you-all spend per trainee.
Mr. Sullivan. That, I don't know, unfortunately. It is
significant investment, though. We have about 345,000
associates in total, and I do know that we will generate about
a million hours in learning, so the quick math is that's a
significant amount of learning per associate that we're
bringing on.
Mr. Hinojosa. I wouldn't be surprised if you-all are
spending over $1,000 per trainee, and that is very significant.
I find that this hearing has been very interesting, because
each one of you has brought forward some information that we
want to see how we can incorporate into the reauthorization
that's coming up.
I also want to take this opportunity to recognize and thank
a few people who have volunteered to submit written testimony
that the Chairman and I can take back to Washington. I want to
acknowledge Rachanna Rodriguez, who is with the Family
Caregiver Program, as well as Joe Gonzalez of the Area Agency
on Aging.
[The statement of Mr. Gonzalez follows:]
Prepared Statement of Joe Gonzalez, Director, Area Agency on Aging of
the Lower Rio Grande Valley
Reauthorize the OAA--Care and Prepare for an Aging America
Since it was enacted in 1965, the Older Americans Act (OAA) has
served as the legislative vehicle and guiding force behind efforts to
help older Americans age in their homes and communities safely and with
maximum dignity and independence for as long as possible. As the baby
boom generation ages, ensuring that the necessary supports are in place
to promote healthy and productive aging has never been more important.
The OAA offers an extensive range of options for older adults,
including, but not limited to homecare services, transportation,
ombudsman, case management, advocacy and assistance. The breadth and
depth of OAA programs and services provide essential support to older
adults who wish to age in place.
One of the reasons the OAA is so successful is that it is based on
an effective and efficient system--the national Aging Network--which
serves as the infrastructure for aging service delivery at the federal,
state and local level. The OAA binds together all 650 Area Agencies on
Aging (AAAs) and 240 Title VI Native American aging programs across the
country, providing a support structure for planning, service
coordination, oversight, and advocacy on programs and services that
reach more than eight million older Americans every year. AAAs serve as
the focal point at the community level to link seniors and their family
caregivers to a myriad of services.
AAAs serve as a single point of entry for the complex and
fragmented range of home and community-based services for older adults
and their caregivers, including congregate and home-delivered meals,
other in-home services for the vulnerable seniors (such as personal
care and chore services), elder abuse prevention and protections, the
nursing home ombudsman program, senior centers, transportation,
consumer information, education and counseling and senior employment.
AAAs and Title VI agencies leverage federal dollars with other
federal, state, local and private funds to meet the needs and provide a
better quality of life for millions of older adults. According to a
quote from the Administration on Aging: ``In FY 2003 state and local
communities leveraged approximately $2 from other sources for every $1
of federal funding; for intensive in-home services, the ratio was
closer to $3 to $1.''
The OAA offers an extensive range of options for older adults,
including, but not limited to homecare services, transportation,
ombudsman, case management, advocacy and assistance. The breadth and
depth of OAA programs and services provide essential support to older
adults who wish to age in place.
One of the reasons the OAA is so successful is that it is based on
an effective and efficient system--the national Aging Network--which
serves as the infrastructure for aging service delivery at the federal,
state and local level. The OAA binds together all 650 AAAs and 240
Title VI Native American aging programs across the country, providing a
support structure for planning, service coordination, oversight, and
advocacy on programs and services that reach more than eight million
older Americans every year. AAAs serve as the focal point at the
community level to link seniors and their family caregivers to a myriad
of services.
AAAs serve as a single point of entry for the complex and
fragmented range of home and community-based services for older adults
and their caregivers, including congregate and home-delivered meals,
other in-home services for the vulnerable seniors (such as personal
care and chore services), elder abuse prevention and protections, the
nursing home ombudsman program, senior centers, transportation,
consumer information, education and counseling and senior employment.
AAAs and Title VI agencies leverage federal dollars with other
federal, state, local and private funds to meet the needs and provide a
better quality of life for millions of older adults. According to AoA:
``In FY 2003 * * * state and local communities leveraged approximately
$2 from other sources for every $1 of federal funding; for intensive
in-home services, the ratio was closer to $3 to $1.''
Many AAAs manage or receive funding from a variety of sources in
addition to the OAA, including Medicaid waivers for home and community-
based care, social service block grants, transportation funds, and
state-funded in-home service programs. AAAs have demonstrated an
extraordinary record of achievement in stretching limited federal
resources to help hundreds of thousands of older people avoid costly
nursing home placement and remain independent. OAA funds make it
possible for AAAs to leverage millions of non-federal dollars from
local governments, foundations, the private sector, and participant and
volunteer contributions.
This year, the first baby boomers are turning 60, the age of
eligibility for OAA services. Over the course of the next three
decades, the aging of the baby boomers will have a direct and dramatic
impact on national, state and local policies, programs and services.
With the first of the 77 million baby boomers approaching retirement
age, and the current senior population experiencing a ``longevity
boom'' of unprecedented proportions, now is the time for individuals,
families, communities and the nation as a whole to plan and prepare for
this coming demographic explosion.
To balance the current and future needs of the older adult
population, n4a believes that legislative changes are needed to improve
the accessibility and quality of OAA programs, while meeting rising
demand.
As such, the following are recommendations to be considered for the
OAA Re-authorization:
1. Help Communities Prepare to Meet Demographic Challenges
The increase in the numbers of aging citizens will impact the
social, physical and fiscal fabric of our nation's cities and counties,
directly and dramatically affecting local aging, health, human
services, land use, housing, transportation, public safety, workforce
development, economic development, recreation, education/lifelong
learning, and volunteerism/civic engagement policies and services.
Given their mandated role under the OAA to create multi-year plans
for the development of comprehensive, community-based services which
meet the needs of older adults, AAAs and Title VI Native American aging
programs are in a unique position to help communities prepare to
address the challenges and opportunities posed by the growing numbers
of older adults.
New language should be included in the OAA to authorize State Units
on Aging, Area Agencies on Aging and Title VI Native American aging
programs to help communities prepare for the aging of the baby boomers.
New funds will be needed to support this expanded role, which would
support a full or part-time planning staff position in every AAA. This
professional planner would offer the Aging Network's expertise to help
state agencies, local city and county elected officials, local
government agencies, tribal councils, and private and nonprofit
organizations to develop policies, programs and services to foster
livable communities for all ages. In addition we recommend that:
Funding be non-formula based, with a minimum level of
funding and additional formula-based funding to increase resources to
more heavily populated service areas, and have a 25 percent non-federal
match requirement.
It includes non-formula based funding to State Units on
Aging to coordinate state-level preparedness planning.
A national resource center on aging in place be
established to provide the necessary guidance, training and technical
assistance to SUAs, AAAs and Title VI Native American aging programs in
their efforts to help communities become livable communities for all
ages.
The new provision be evaluated and sunsetted in 10 years.
2. Strengthen the Aging Network as a Single Point of Entry
The OAA reauthorization should permanently establish authorized
Aging and Disability Resource Center (ADRCs) within every service area
in the nation, with AAAs given the right of first refusal to be
designated as the ADRC within their service areas. The ADRC program,
part of the President's New Freedom Initiative, and spearheaded by the
U.S. Administration on Aging and Centers for Medicare and Medicaid
Services, has helped 43 states integrate their long-term support
programs for the elderly and people with disabilities into a single
coordinated system.
The OAA and the Aging Network comprise the nation's non-Medicaid
long-term care system, and many AAAs manage Medicaid home and
community-based long-term care services. In order to structure a system
that is easily accessible to all who need long-term care, AAAs and
Title VI Native American aging programs should be the single point of
entry for both Medicaid and non-Medicaid long-term care services.
Many individuals with disabilities, whether age-onset or life-long,
need information on and access to basic supportive services that will
enable them to become or remain active and contributing members of the
community. Over the last 30 years, AAAs and Title VI Native American
aging programs have developed the infrastructure that coordinates a
host of programs that provide information on, access to and choices for
individuals who seek such services.
AAAs have become the first and most trusted source for older
Americans and their caregivers who are seeking information on home and
community based services, both public and private, anywhere in the
nation. The rising numbers of aging baby boomers will bring a
corresponding increase in the need and demand for a ``one stop'' source
of information as well as a single point of entry into the aging
services system.
3. Enhance the Aging Network's Role in Health Promotion and Disease
Prevention
To enhance the ability of AAAs to carry out health promotion and
disease prevention efforts, an authorization level of $50 million for
the Title III-D program and $10 million of the appropriation be set
aside to pilot, through the AAAs, a community-based collaborative
between local aging and healthcare providers to promote disease
prevention services.
Although only funded at $21 million in prior years and eliminated
in the President's FY 2007 budget, Title III-D of the OAA has played a
pivotal role in disease prevention and health promotion services for
seniors in communities across America. This program has become
increasingly invaluable as recent evidence-based research continues to
prove that health promotion and disease prevention not only contribute
significantly to an individual's quality of life, but also are a cost-
effective means of reducing, or in some cases eliminating, acute or
chronic care costs.
As the coordinators and providers of home and community-based
services at the local level, AAAs and Title VI agencies have long
recognized the critical importance of health promotion and disease
prevention. With limited Title III-D funding, these agencies have
developed innovative programs that improve the physical and mental
well-being of older adults, while reducing the need for more intensive
chronic and acute care services. To enable older adults to remain in
their homes and communities for as long as possible, one critical
element is engaging in activities that promote healthy living.
4. Increase Authorization Levels to Enhance Home and Community-Based
Services
AAAs, as part of the larger Aging Network, have the ideal
structure, the established reputation, and the expertise to engage in
community planning, to serve as the ADRC, and to manage health
promotion and disease prevention programs. What they lack are adequate
financial resources.
The OAA has provided vital community-based supports to millions of
older adults for forty years. Since 1980, however, there has been a
substantial loss in the OAA's capacity to provide services to older
Americans due to rising costs, an increasing number of older adults in
need of services in general, and the need to provide more extensive
services to larger numbers of vulnerable older persons living into
their 80s, 90s and beyond.
To illustrate how the cost of providing services has risen over the
last five years, we'd like to share examples of a few situations in
Texas.
In many areas of Texas, especially the more rural areas, a pattern
that holds up across the country, transportation is one of the most
requested services by older adults. It is also one of the most under-
funded and suffers from the most rapidly rising costs. Lack of funding
has forced the Lower Rio Grande Valley Area Agency on Aging to seek
alternatives to provide transportation that may need to fewer trips.
Besides the oft-recognized increases in fuel costs, vehicle maintenance
and insurance costs have also risen dramatically.
Food prices have also risen in recent years, driving up the cost of
home-delivered and congregate meal programs that are funded under OAA
Title III. The Area Agency on Aging is expecting an 11% increase in the
Congregate Meal rate and will be expecting a similar increase in the
home-delivered meal cost. The Lower Rio Grande Valley Area Agency on
Aging has funded a breakfast home delivered meal for the last four
years. Due to the increase cost, the current meal provider is
contemplating discontinuing this needed service.
Unfortunately, appropriations for OAA programs over the past five
years have not reflected these and other increased costs. As a result,
they have not kept up with demand.
Another factor also needs consideration. In Texas and nationwide
this year, the roll-out of the new Medicare Part D prescription drug
plan has placed additional responsibilities on AAAs, largely without
additional funding. Older adults and their families have turned to AAAs
and Title VI programs en masse during the 2005-2006 enrollment
campaign. Yet only a small number of local aging programs received new
resources from states or national pilot projects to support their one-
on-one counseling and enrollment assistance efforts.
To respond to the overwhelming demand for Medicare Rx assistance,
AAA staff were often shifted from other responsibilities to help with
Medicare Part D enrollment, making this level of effort unsustainable.
Even when the initial enrollment period ends, the public will continue
to turn to AAAs and Title VI aging programs. Millions of seniors will
continue to need counseling and enrollment assistance every year, as
they become newly eligible for Medicare or seek to change their
prescription drug plans.
In order for AAAs and Title VI Native American aging programs to
continue the tremendous amount of work that Medicare Rx enrollment
assistance has generated, they will need new funding to support and
sustain their efforts.
In conclusion, to compensate for inflation and the rising costs of
providing services, it is necessary to raise the authorized funding
levels of all the titles of the OAA by at least 25 percent above the FY
2006 appropriated funding level, except for Title III-E which should be
authorized at $250 million. The increased authorization levels will
ensure the Aging Network has the necessary resources to adequately
serve the projected growth in the numbers of older adults, particularly
the growing ranks of the 85 and older population who are the most
vulnerable and in the greatest need for aging supportive services. The
need also exists to allow program income to be used as match.
Conclusion
The Lower Rio Grande Valley Area Agency on Aging appreciates the
opportunity to present suggestions for modernizing and strengthening
the Older Americans Act. We look forward to working with the Lower Rio
Grande Valley Congressional Delegation to reauthorize the OAA in a way
that respects the needs of today's older adults and their caregivers,
recognizes and rewards the cost-effectiveness of home and community-
based care vs. institutional care, and prepares adequately and
responsibly for the aging boom.
______
Mr. Hinojosa. Joe, thank you for the great leadership that
you have shown in this area.
And I also wish to acknowledge Martha Balboa Rochelle of
the AARP.
Those three individuals, thank you for agreeing to submit
written testimony.
The chairman is running on a very close and tight schedule
because he has to be on board the airplane by 11:00 to be able
to speak this afternoon in Ohio, and I can only say that if
there had been time, we would have had these presentations also
in a second panel, but we're just fortunate to have gotten him
and his staff.
By the way, I want to give all his staff, both of the
majority and minority party, a big round of applause, because
they have been on this together.
[Applause.]
Mr. Hinojosa. We couldn't possibly get these things done
without the formidable work that they have done in advancing
this project. And, again, I never get tired of thanking the
University of Texas, Dr. Bambi Cardenas, the president, and her
very competent special assistant Carol Roche. Thank you, Carol,
for all that you and the staff have done to make this possible.
And other members who are here, I am very, very appreciative of
how this has been prepared and conducted.
I yield back, Mr. Chairman.
Chairman Tiberi. Thank you again, Mr. Hinojosa. Again, it's
been a pleasure to be down here once again. The people of the
15th District of Texas are awfully lucky to have someone of
this man's quality. I enjoy working with you, and will continue
to work with you as we work through this process.
I really thank the witnesses for their valuable time and
their input, as well. It will be very helpful as we work toward
the reauthorization. I would like to thank everyone who came,
and again thank the staff, as well, for their time and
commitment to making this possible.
With that, if there is no further business, the
subcommittee is adjourned.
[Whereupon, the subcommittee was adjourned.]
[Additional materials supplied:]
Additional Testimony of Jose Perez
My name is Jose Perez and I serve as Executive Director of Senior
Community Outreach Services, Inc. in Donna, Texas. I also serve as Vice
President of the National Association of Senior Companion Project
Directors representing 16,500 volunteers in 227 projects nationwide
serving the needs of over 57,700 homebound clients.
The Senior Companion Program is part of the Corporation for
National and Community Service Senior Corps. While the Senior Companion
Program is authorized under another law under the Committee's
jurisdiction (the Domestic Volunteer Service Act and national service
laws), our work and that of our sister National Senior Service Corps
programs (RSVP and Foster Grandparent Program) is interrelated with
that authorized and supported by the Older Americans Act.
Through grants and other resources-including the energy and efforts
of citizens age 55 and over-Senior Corps helps meet the needs and
challenges of America's communities through three special programs.
Why are senior volunteers and the programs of the National Senior
Service Corps relevant to your discussion of Older Americans Act
reauthorization? Because we are part of the answer to the nation's
growing long term care challenges and a conduit for bringing senior
volunteers to the cause of senior services authorized and coordinated
under the Older Americans Act. And we are educators and advisers in
getting the word out on programs such as the new Medicare Part D
option, and can be particularly helpful in communities traditionally
overlooked in outreach efforts, including language minorities. Senior
facilitators, resource counselors and Promotoras help individuals
seeking long-term care support avoid and minimize confusion, enhance
individual choices and support informed decision making. But we can and
must do more.
The first of 77 million baby boomers turn 60 in 2006. These new
``sexagenarians'' are the tip of the iceberg of the largest,
healthiest, best educated population of older Americans in our history.
They are pioneers in a new stage spanning the decades between middle
and late life and represent an extraordinary pool of social and human
capital. And, in large numbers, they want to do work that serves a
greater good.
Our new seniors were in their formative years when President
Kennedy issued his call to ``ask not what your country can do for you,
ask what you can do for your country.'' Millions of our new older
Americans are determined to apply their experience of a lifetime to
make a difference for others. Some are able to do so as unpaid
volunteers. Others, like the low-income seniors enrolled as volunteers
in the Senior Companion and Foster Grandparent Programs, may need
incentives to offset the cost of volunteering.
Too often, seniors looking for services to keep them vital in the
community are stymied by policies and practices that discourage their
sharing of experience. As a result, this growing number of Americans
represents a largely untapped resource in a nation with many unmet
needs.
The reauthorization of the Older Americans Act can serve to sound
the call that seniors are not just recipients of service and a
potential drain on our economy. Older Americans are the nation's
fastest growing and most valuable asset.
As but one example of the importance of collaboration between
programs of government, Senior Companions throughout the country are an
integral part of the ``new'' Family Caregiver Support Program. Our
grantees subcontract with area agencies on aging and others to deliver
home services and respite services for kin of homebound seniors. But
much as we are an integral part of senior services administered by the
Administration on Aging through the Older Americans Act, more needs to
be done to forge a partnership between federal laws and federal
agencies--in much the same way as we deliver on the ground in
communities through the country.
Do not look at your reauthorization of the Older Americans Act as
simply renewing critical programs for the nation's seniors. Look to
this year's legislation as a way to boldly respond to an historic
chapter in our nation's growth.
I and my colleagues on the Board and among the membership of the
National Association of Senior Companion Project Directors and program
directors in all streams of senior service believe this year's
reauthorization of the Older Americans Act presents a golden
opportunity to harness the assets of experience, particularly as the
Baby Boom Generation nears retirement and our truly golden years.
We support modifications in the Older Americans Act that would
amplify the intended role of the Assistant Secretary on Aging as a
repository of opportunity, service, and information for all older
Americans. The Administration on Aging is uniquely positioned to take a
leadership role in coordinating not only the activities of the Federal
Government as they relate to seniors. AoA can foster cooperation and
collaboration by example.
The nation's aging demographic demands that we tap older adults as
a source of social capital and foster the growth of promising practices
and program models that develop volunteerism to address critical human
and community needs especially those of frail, vulnerable populations
and of overburdened family caregivers.
Recognizing that this is a tough time of limited tax resources to
support domestic initiatives, I urge the Subcommittee to recognize the
cost-effective resources we have at hand. It is critical that you look
toward program integration and the dissemination of best practices
among the larger aging network.
Senior Corps directors and their staff have the experience
necessary to inform those who deliver services through the aging
network, even as they deliver services and recruit and train others to
deliver services themselves. In line with that asset, I urge the
Subcommittee to include modifications to the Older Americans Act that
would, at a minimum, encourage and, preferably require, specific
formalized training and technical assistance from qualified national,
state, and local organizations to state units on aging and area
agencies on aging in the recruitment, retention, and training of
volunteers to assist in operations of the Family Caregiver Support
Program. Consistent with this initiative, I urge the Subcommittee to
consider augmenting the Family Caregiver Support Program through
authority for the designation of a national grantee to share best
practices to the field of family caregivers.
I also ask that the committee consider an initiative first proposed
by President Bush and introduced on a bipartisan basis by Congresswoman
Nydia Velasquez (D-NY) in prior Congresses calling for a valuable
incentive for senior service. I speak of the Silver Scholarship
program. Under the Senior Scholarship initiative, older Americans who
dedicate at least 600 hours per year in service to their communities,
in areas such a family caregiver services or literacy training for
youngsters, would receive an ``education award'' of $1,000 for use in
helping to defray the cost of higher education. The award would be
transferable to a family member or other youngster in need. While the
President's original proposal envisioned the initiative as an amendment
to national service laws, I encourage the Subcommittee to consider this
initiative in the context of the Older Americans Act as a formal
partnership between the Administration on Aging and the Corporation for
National and Community Service.
Finally, I ask the Subcommittee's indulgence on a matter not
strictly germane to the reauthorization of the Older Americans Act.
That is the minor but badly needed changes which we have promoted in
the authorization for Senior Corps programs under the national service
laws, and specifically the Domestic Volunteer Service Act within the
Committee's jurisdiction.
I urge the Subcommittee to consider embracing changing the age of
eligibility for participation in the Senior Companion Program and the
Foster Grandparent Program from the current age 60 to age 55, as is
currently the law for participation in the Retired and Senior Volunteer
Program (RSVP). In addition, I ask that the Committee consider
increasing the income eligibility for participation in the means-tested
programs of the Senior Corps (SCP and FGP) from the current law 125% of
poverty to 200% of poverty, in recognition of the need to grow
volunteer opportunities for low-income seniors. Taken together, these
modest changes, which have been endorsed by all three National Senior
Service Corps Directors Associations, would go far toward meeting the
desire of senior to serve and the needs of communities who need their
service. Given the uncertainty of reauthorization of national service
laws under the Committee's jurisdiction, your action in the context of
legislation aimed at addressing the Federal Government's role in
meeting the needs of our greatest natural resource--our seniors--would
make great sense.
I, and the Board of Directors of the National Association of Senior
Companion Project Directors, are available to provide our wealth of
technical and substantive expertise in support of your reauthorization
efforts.
Thank you for this opportunity and I welcome your questions.