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service provision for older persons with developmental disabilities with the state mental retardation/developmental disabilities agency.

Renumber the following paragraphs previously designated
"(17)" as "(19)", "(18)" as "(20)", '(19)" as '(21)",
"(20)" as "(22)", and "(21)" as "(23)".

8.

That Section 321(b), Part B

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Supportive Services and

9.

Senior Centers, be amended to include reference to mental health services and encourage interagency agreements to improve mental health services for the elderly. The amendment would read as follows:

a.

b.

Amend Section 321(a)(1) by inserting after "health" the following: "(including mental health)".

Amend Section 321 by redesignating subsection "(b)" as
"(c)" and inserting immediately antecedent the following
new subsection: "(b) the Commissioner shall encourage
Area Agencies on Aging to enter into interagency or
other formal agreements with public or private nonprofit
entities providing mental health services to ensure a
coordinated approach in meeting the mental health and
psychosocial needs of the elderly."

Insert a separate section within Title III for the nursing
home ombudsman program which would specify the purpose,
authority function and authorization for the program. This
separate section should assure that the ombudsman program:
(a) is conflict free in order to most effectively monitor
conditions in nursing homes including independence from ser-
vice providers and (b) has the ability to pursue legal,
administrative and other appropriate remedies. This section
should also require cooperation with the protection and
advocacy system for the developmentally disabled and men-
tally ill and provide demonstration monies to enhance that
relationship.

10. That Section 401, Statement of Purpose, be amended to include a reference to older persons with special needs. The amendment would read as follows:

11.

12.

13.

Amend Section 401(3) by adding the following new paragraph: "(3) collaborative projects joining aging with professions specializing in providing treatment and services to those with disabilities and mental disorders (including Alzheimer's disease and related disorders)."

Renumber the following paragraphs previously designated
"(3)" as "(4)", and "(4)" as "(5)".

That Section 411(a)(1), Grants and Contracts, be amended to include mental health care and include the use of the more accurate terminology "Alzheimer's disease and related disorders."

b.

a. Amend Section 411(a)(1) by inserting after "health
care, "the following: "(including mental health care)".
Amend Section 411(c) by deleting "Alzheimer's disease
and other neurological and organic brain disorders of
the Alzheimer's type" and inserting the following:
"Alzheimer's disease and related disorders with neurolo-
gical and organic brain dysfunction".

That Section 412(a), Multidisciplinary Centers of
Gerontology, be amended to include mental health services as
an emphasis. The amendment would read as follows:

Amend Section 412(a) by inserting the following after
"health": "(including mental health)".

That Section 413 be created to enable the Commissioner to enter into cooperative agreements with the Commissioner of the Administration on Developmental Disabilities in order to establish education and training programs in aging and developmental disabilities, and to authorize joint grants to public and private nonprofit agencies, organizations, and institutions for the support of multidisciplinary centers that would train personnel to work with older individuals with mental retardation and developmental disabilities. amendment would read as follows:

The

14.

15..

16.

17.

Amend Title IV, Part A by adding the following new sec-
tion: "Multidisciplinary Centers for the Mentally
Retarded and Developmentally Disabled

Section 413. The Commissioner in conjunction and
agreement with the Commissioner of the Administration on
Developmental Disabilities may make grants to private
and public nonprofit agencies, organizations, and insti-
tutions of higher education for the purpose of
establishing multidisciplinary centers in aging and
developmental disabilities. Such centers shall conduct
research and policy analysis, provide for the training
of personnel, serve as a technical resource at the State
level for State agencies, State developmental disabili-
ties planning councils, State mental retardation/
developmental disabilities agencies and service provi-
ders and at the national level, to the Commissioners and
the Congress, and provide for other functions deemed
necessary by the Commissioner. Such centers on aging
and developmental disabilities shall --

(1) develop and provide education programs for the training of personnel working with older developmentally disabled individuals;

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(3) provide technical assistance to State and area agencies providing for older individuals with developmental disabilities; and

(4) serve as repositories of technical information."

That Section 414 be created to improve mental health training for aging services providers. The amendment would read as follows:

Amend Title IV, Part A by adding the following new sec-
tion: "Special Population Training Section 414. The
Commissioner may make grants to any public or private
nonprofit entity and may enter into contracts with any
public or private nonprofit entity to develop and pro-
vide training programs to Title III service providers
and nursing home care providers to meet the special ser-
vice needs of elderly with: (a) mental, emotional or
behavioral disorders; or (b) physical, and sensory disa-
bilities, who are residing either in the community or in
nursing care facilities."

That Section 422, Demonstration Projects, be amended to include the location of older severely mentally ill persons who are increasingly living into old age. The amendment would read as follows:

Amend Section 422(b)(2)(A) by inserting after "mental health services" the following: "or who are severely mentally impaired".

That Section 422(b)(2) be amended by adding the following subsections:

(E) the identification and provision of services to
elderly individuals (including individuals who
experience lifelong or extended disabilities) with
disorders of speech, language and/or hearing that inter-
fere with their ability to function socially or indepen-
dently; and

(F) the provision of rehabilitation services, and com-
munication aids and devices to assist individuals
(including individuals who experience lifelong or
extended disabilities) with severe speech, language and
hearing disorders.

That Section 423, Special Projects in Comprehensive
Long-Term Care, be amended to include allowing grants for
the development of programs to address the needs of the
estimated 50% or more of nursing home residents who have
severe mental impairment. The amendment would read as
follows:

Amend Section 423(a)(3) by inserting after "geriatric
health maintenance organizations" the following:
"services to the severely mentally impaired residing in
nursing homes;".

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Throughout the country there are hard-working, non-lawyer advocates helping older persons with law-related problems. But for these advocates, many problems which older persons experience would go unaddressed. Many of these advocates are a part of the Older Americans Act network the aging network. It is these lay advocates which are the focus of our concern at this time of reauthorization.

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In the mid-1970's the Administration on Aging funded a number of legal assistance model projects around the country, certain of which were designed to promote law-related advocacy by nonlawyers. For the most part, the focus of these programs was nonlawyers who, themselves, were participants in the Older Americans Act network, e.g., outreach workers and information and referral specialists. These projects tested the thesis that advocates who were operating in the aging network could spot problems which were law-related; the realization was that lawyers and paralegals, while serving a valuable function, would rarely stumble across the most serious cases. These same projects also made the point that without the work of these non-lawyer advocates, a permanent class of underserved, frail elderly individuals, experiencing public benefits problems, would grow. NON-LAWYER ADVOCATES AND THE OLDER AMERICANS ACT

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lay persons

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This era of AOA model projects also demonstrated that it was the advocate in the community who could engender the trust of the older client. And because of the huge numbers of clients needing law-related assistance, the point was also demonstrated that community advocates could be taught the law of public benefits and taught how to use the law to advocate in the public benefits arena. Example: The outreach worker who found an older person living on catsup soup could not only obtain food from a church food closet; the worker could also advocate for the waiver of an SSI overpayment, this when the client was innocent of wrongdoing and the evidence of hardship was spelled out. As you know, federal law permits non-lawyers to represent clients with federal public benefits problems at all phases of their cases, short of judicial review. This includes representation at the administrative hearing, which is the most important step in public benefits advocacy since this is where the evidence (the record) is weighed.

In short, the Administration on Aging, with several years and several millions of dollars of model projects funding, and later with national advocacy assistance funding, has sought to insure that non-lawyers are at the heart of OAA "legal assistance". And on that point the Act, itself, is not silent. Rather, legal assistance is defined, in part, as:

"...assistance by a paralegal or law student
under the supervision of an attorney and
including counseling or representation by a
non-lawyer where permitted by law.

Notwithstanding the above statutory definition of legal assistance, and the Administration on Aging's own funding of pilot programs utilizing non-lawyer public benefits advocates, there apparently is still some confusion over whether or not such nonlawyer advocates come within the Act's definition of "legal assistance".

The American Bar Association has, through its Commission on Legal Problems of the Elderly, previously submitted a White Paper to your Subcommittee containing recommendations for reauthorization. A number of the suggestions are excellent. However, Recommendation 7 confuses the role of non-lawyer, public benefits advocates with the role of paralegal advocates. As you likely know, paralegals are persons who work directly under the supervision of attorneys. Indeed their work product belongs to the attorney.

The Report states that, "the statutory exception for 'representation' by a non lawyer where allowed by state law, does not create a broad exception allowing paralegals, unsupervised by attorneys, to provide legal assistance within the meaning of the current statutes." I agree. Again, a paralegal, by definition, is a person who is supervised by an attorney. The problem is that the Commission does not continue by explaining who can as nonlawyers advocate, without attorney supervision, i.e., non-lawyer public benefits advocates.

Please know that as an attorney I support the full continuum of legal advocacy, from lawyers engaged in impact litigation to nonlawyers engaged in public benefits advocacy. Each perform a critical service. For the most needy, particularly the frail elderly who suffer an inordinate degree of difficulty in dealing with public benefits problems, no person is more important than the volunteer or paid non-lawyer advocate operating within the Older Americans Act network the person who can cut through bureaucratic red tape, obtain eligibility where eligibilty has been denied and deal with post-elibibility crises.

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Please know that my staff and I are committed to assisting your efforts to perpetuate both in spirit and in express statutory language, the vital work non-lawyer advocates perform in the OAA network. We support the work of both paralegals (operating under the direct supervision of attorneys) and other non-lawyers, including Community Service Advisors, who operate in the public benefits arena without the direct supervision of any attorney. would, therefore, very much appreciate your assuring me at this time that it is your intention to keep this non-lawyer advocacy at the heart of any OAA statutory definition of legal assistance". I would also hope that any legislative history surrounding this year's reauthorization would reflect the belief that these nonlawyer advocates are, at least in part, exactly what the Act envisions as "legal assistance".

As I have indicated to your staff, I remain eager to assist your efforts at locating skilled non-lawyer advocates throughout the country who can testify before any hearings you might seek to schedule on this important subject.

Sincerely,

Best Buford

Albert D. Buford, III, Esq..

Executive Director

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Thank you for your letter of April 9 in which you describe the very valuable service performed by non-lawyer advocates in the Older Americans Act network.

I agree that these non-lawyer advocates are a valuable resource in addressing the plight of the underserved. As you point out, in the public benefits arena particularly, their advocacy often makes a dramatic difference in the quality of life for an older person. Because these non-lawyer advocates are usually persons operating in the community and have earned the trust and respect of the older clients, they are uniquely suited to represent older persons.

It is my belief that you are correct in stating that many public benefits problems older persons face would go unaddressed without their help. This is true primarily because 1) as you point out, most older persons do not perceive their public benefits problems as having a law related dimension, and 2) an increase in appropriations can not completely provide for the numbers of persons who need help. Operating a lawyer/paralegal service model only, at least in the public benefits arena, might constitute a narrow use of limited resources.

Please be assured that I have every intention of seeing that these non-lawyer advocates, particularly in the public benefits advocacy arena, remain a vital component of "legal assistance" within the Older Americans Act.

Finally, I would direct your attention to Federal law on this subject. Both at 20 CFR, Part 404. 1705 (b) and 20CFR, part 416.1515(b), there is ample evidence that the non-lawyer advocacy which you have described is, in fact, not only be permitted, bu to be encouraged.

Incerely,

Maggi

MARIO BAGGT

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