duce to the Subcommittee the Honorable Edward DiPrete, Governor of the State of Rhode Island. Governor DiPrete comes before us today with a wealth of experience and leadership in making government work for all of our people, including our senior citizens, and his public service dates back to 1971, when he was first elected as a member of the City of Cranston School Committee. Cranston is one of our State's largest cities and Ed DiPrete served the citizens well and became member of the City Council and then Mayor. Mayor DiPrete soon gained a reputation as a man of great integrity, and his abilities and reputation led to his election as our Governor in 1984. Governor DiPrete has brought to his new office the same work ethic and energy that served him so well as Mayor. He was reelected to a second term as Governor this past November by a large majority. As a Member of the National Governors Association's Committee on Human Resources, Governor DiPrete is well versed in the problems facing our Nation's elderly population. Governor DiPrete and the other Governors on the Human Resources Committee of the National Governors Association have put together a position paper on the Older Americans Act that I for one believe is a hundred percent on target. It emphasizes reauthorization and two changes, inhome services for the functionally impaired seniors and a defined structure of preventive services. I look forward to hearing Governor DiPrete's testimony today and I am very glad to join you, Mr. Chairman, in welcoming him here. Governor DiPrete. Governor DIPRETE. Thank you, Senator Pell. Thank you, Mr. Chairman. Senator MATSUNAGA. Governor, we would be happy to hear from you. As I understand it, you are testifying here in behalf of the National Governors' Association? Governor DIPRETE. That is correct, Mr. Chairman. The remarks that I will be making are on behalf of the National Governors' Association. Senator MATSUNAGA. We would be happy to hear from you. STATEMENT OF HON. EDWARD D. DiPRETE, GOVERNOR OF RHODE ISLAND, ON BEHALF OF THE NATIONAL GOVERNORS' ASSOCIATION Governor DIPRETE. I certainly appreciate the opportunity to testify on behalf of my colleagues, and I might say I am particularly delighted to be testifying on the Older Americans Act, because former Congressman John Fogarty, from Rhode Island, was one of its principal sponsors when it was first enacted in the year 1965. I might say to begin with that the National Governors' Association strongly supports reauthorization of the Older Americans Act. Over the past decades, the Act has helped to create a network of people and organizations which provide invaluable assistance to America's elderly. The Governors believe, however, that the Older Americans Act must change as America's elderly population increases as a propor tion of the total population. While many of the new elderly may be healthy, a growing number, particularly those over 85, will need more help with activities of daily living. In addition, then, to continuing the provisions of the current Act, the Nation's Governors are proposing several major amendments which would help meet essential and growing needs of the elderly population. The first change is in direct response to the increasing age of our elderly population. We propose a new authorization in Title III of the Act to strength State efforts to provide in-home services. We suggest this new authorization take into account factors such as the number of elderly over age 75 and over age 85, the estimated number suffering from Alzheimer's and related diseases, the number of elderly who are impaired in three or more activities of daily living, and the number of elderly who are minorities. We commend Senator Metzenbaum for his proposal in S. 81 to provide home and community-based services to the frail elderly with Alzheimer's and related dimentia. It is very similar to our own proposal. However, a new authorization for in-home services should be broad enough to allow services, regardless of the cause of that need. Many elderly need assistance as a result of heart or muscle diseases, in addition to dimentia. Further, our proposal would require the same 15 percent State match required in other Title III programs, whereas S. 81 would require a State match that could be as high as 40 percent. Now, my written testimony filed with the Subcommittee details three compelling reasons to increase support of in-home services to the frail elderly. The reasons can be summarized as follows: The increasing age of our elderly population: By the year 2010, there are expected to be 7.1 million more elderly over the age of 75. That includes 3.9 million over the age of 85, compared to 1985. The shorter hospital stays that are resulting from the new Medicare prospective payment system and the increase in the number of senior citizens with functional impairments are currently estimated at 4.6 million elderly people. Secondly, the Governors urge you to increase Older Americans Act support for preventive health services. We are convinced that reducing the need for intensive health care is not only cost effective, but it is compassionate. Title VII of the Act could be funded and restructured to provide Federal matching funds to States for preventive health services. A specific package of preventive services addressing leading health problems that cause functional impairments in daily living, such as arthritis, hypertensive disease, hearing, and other problems, is envisioned. The Governors' third major proposal is to permit State initiatives to develop new resources for elderly programs. Those with high incomes can share in the cost of services they receive. States could then use the increased revenue to serve more elderly. States should be permitted to develop cost sharing approaches for services other than nutrition programs. These arrangements should be on a sliding scale based on the ability to pay. Rhode Island, for example, has an excellent record in soliciting voluntary contributions for the senior nutrition program. During fiscal 1986, older persons contributed an average of 90 cents for every meal served. In addition to these new initiatives, the Governors want to maintain and/or strengthen the current services and research funded through Titles III, IV, and V of the Act. A summary of our specific recommendations are as follows: To retain the Governors' responsibility to structure the long-term care ombudsman program to assure its independence and integrity; To maintain the State responsibility for coordination and integration of community-based, long-term care services; we particularly oppose eliminating State authority to decide whether or not to authorize Area Agencies on Aging; We require that the national contractors and State agencies operating Title V community service employment programs develop a Statewide plan, to be approved by the Governor; To require State input into federally financed research and demonstration projects funded through Title IV. We believe that research and demonstration projects should support innovative approaches to services and encourage new approaches to intergovernmental activities that better integrate the elderly into our society. Mr. Chairman and Senator, I want to thank you again for inviting me to testify on behalf of the National Governors' Association before you today. We look forward to working with you to find solutions to the long-term care of America's growing elderly population. The Governors believe that a vibrant aging network, with new authority for in-home and preventive health services, and authority to secure new resources in a reauthorized Older Americans Act is an excellent first step. We as an association offer our help and assistance with this reauthorization effort. Thank you, Mr. Chairman. [The prepared statement of Governor DiPrete follows:] Mr. Chairman and Members of the Subcommittee, I very much appreciate the opportunity to testify on behalf of the nation's Governors regarding the Older Americans Act (OAA). I am particularly delighted to be testifying on the Older Americans Act because Rep. John Fogarty of Rhode Island was one of its principal sponsors when it was enacted in 1965. The National Governors' Association strongly supports reauthorization of the Older Americans Act. While other federal programs serve the elderly, NGA believes that the Older Americans Act is essential in the continuum of services for the elderly. The Governors therefore are pleased to see a general consensus that the basic OAA programs for social services, nutrition and employment should be continued at least at current levels of funding. The Governors believe, however, that the Older Americans Act must change as America's elderly population increases as a proportion of the population, particularly with larger numbers over age 85. While many of the new elderly may be healthy, a growing number, particularly those over 85, will need more help with activities of daily living. To respond to the needs of this growing group, the Governors have called for a new authorization in Title III of the act to strengthen state efforts to provide in-home services to the elderly. To complement this suggestion, NGA believes that the Older Americans Act should increase support to prevent the problems that lead to functional impairment. Finally, we ask for the authority to develop cost-sharing arrangements with those elderly who are able to pay for services. There are three compelling reasons to increase OAA support for in-home services to the frail elderly: First, in the year 2010, there are expected to be 7.1 million more elderly over age 75, including 3.9 million over age 85, than in 1985. Moreover, in 2010, the life expectancy at age 65 is expected to be 86.1 for females and 81.1 for males. The elderly population will increase to about 21 percent of the population in the year 2030, up from 12 percent in 1985. About 16 percent of the elderly will be over age 85, up from 9 percent in 1985. |