![](media/image1.png){width="1.2083333333333333in"
height="1.0833333333333333in"}**National Rural Development Council**

Monday, May 10, 2004

**1:30 PM-3:30 PM ET**

***Senior Citizens Issues in Rural America***

*Meeting location:*

Washington Council of Agencies

1666 K Street, NW, Suite 440

Washington, DC

*[14 Participants]{.underline} [14 Agencies &
Organizations]{.underline}*

Tom Goldsmith, Chair\* Rural Community Assistance Program

Smith Covey USDA Natural Resources Conservation Service

Beth Denniston\* American Public Works Association

Beverly Nykwest\* National Association of Regional Councils

Mary Kusler\* American Association of School Administrators

Steve Rhodeside\* US Dept of Housing and Urban Development

Conley Chaney\^ USDA/ Office of Community Development

Adrienne Dern National Association of Area Agencies on Aging

Jane Hardin Community Transportation Association of America

Pat John USDA Rural Information Center

Jenna Musselman DOT/ Office of the Asst Secretary for Trans Policy

Rick Reeder USDA Economic Research Service

Lori Stalbaum HHS Administration on Aging

Shelly Ten Napel National Rural Health Association

\*Denotes NRDC Steering Committee Member

\^Denotes NRDC Staff

I.  Introductions by NRDC Chair Tom Goldsmith

II. Monthly Updates

    a.  **NRDP at USDA-RD Office of Community Development:**

        i.  Regarding SRDCs:

            1.  Overwhelming majority of Funding Cooperative Agreements
                have been put into place.

            2.  Federal Recognition Status:

                a.  Mississippi Rural Development Councils is well on
                    its way to achieving Full Recognition Status.

                b.  South Carolina and Rhode Island Rural Development
                    Councils will likely be progressing from Provisional
                    to Full Recognition Status in the coming weeks.

                c.  Currently 24 states have a fully-recognized
                    SRDC---this is up from 18 states in November 2003.
                    Additionally 12 states have a
                    provisionally-recognized council.

        ii. 2004 National Rural Development Partnership Annual
            Leadership Conference

            1.  August 29 -- September 2, 2004

            2.  Oklahoma City, Oklahoma at the Cox Convention Center

            3.  Organized by USDA-RD, NRDP, and the Oklahoma Rural
                Development Council

        iii. [NRDP Website](http://www.rurdev.usda.gov/nrdp/):

             1.  The SRDC Success Story database is down temporarily
                 while USDA-RD transfers these pages to from NRDP's
                 former internet server.

             2.  For information about specific Councils

                 a.  Please use [online
                     map](http://www.rurdev.usda.gov/nrdp/statemap.html)
                     to find contact information for individual State
                     Councils, or

                 b.  Direct detailed inquiries to [Rick
                     Wetherill](mailto:rick@ocdx.usda.gov), Director of
                     Empowerment Programs Division, USDA-RD Office of
                     Community Development.

        iv. USDA-RD staff have received copies of April 9, 2004 letters
            to Ranking members of the Senate Appropriations Subcommittee
            on Agriculture, Rural Development and Related Agencies
            requesting that \$4 million be allocated in the fiscal year
            2005Agriculture Appriations Bill for the NRDP and SRDCs.
            Twenty-nine Senators had signed the letter as of May 5.

    b.  **Update: NRDP Task Forces & Rural Policy Fellows Program**

        i.  On June 1, 2004, several new faces will take over the Rural
            Policy Fellows Program. Outgoing Fellows will remain for
            various lengths to complete projects and handoff staff
            assignments for task forces, inter-agency projects, NRDC,
            and the Rural Policy Fellows Program.

        ii. NRDC Fellow:

            1.  Conley will continue working with the Steering Committee
                to set up the June 14, and July 12 meetings. As of the
                July 12 meeting, 1 of the 3 new Fellows at OCD will
                assume this role: Jen Larson (ND), Beth Peck (CO), or
                Nate Watson (GA).

        iii. NRDP Health Care Task Force

             1.  Deanna Durrett (KY), new Truman Fellow at HHS Office of
                 Rural Health Policy will step in for outgoing Fellow
                 Craig Williamson in June/July.

             2.  The April 21, 2004 conference call focused on HUD's 242
                 program for critical access hospitals, and featured:

                 a.  Chris Boesen, Director of the Office of Insured
                     Health Care Facilities (OIHCF), HUD Federal Housing
                     Administration

                 b.  Charles Davis, OIHCF

                 c.  Bob Murray, CEO of the Fulton County Medical Center
                     (Fulton County, Pennsylvania)

             3.  There will be no conference call in May.

             4.  A June call has been tentatively scheduled to discuss
                 the Rural EMS Agenda for the Future. Please contact
                 [Craig Williamson](mailto:cwilliamson@hrsa.gov) for
                 more information.

        iv. NRDP Livable Rural Communities Taskforce

            1.  David Angeles (NC), new Truman Fellow at DOT Office of
                the Under Secretary for Transportation Policy, will step
                in for outgoing Fellow Jenna Musselman

            2.  LRC Task Force membership has been loosing interest and
                momentum.

                a.  David may help transform this into a new Rural
                    Transportation Task Force. No meetings are scheduled
                    at this time.

                b.  Please contact [Jenna
                    Musselman](mailto:jenna.musselman@ost.dot.gov) to if
                    you are interested in participating on either the
                    Livable Rural Communities Task Force, or the
                    proposed Rural Transportation Task Force.

    c.  **NRDC Member Updates:**

        i.  The deadline for [Rural Housing & Economic Development
            (RHED)
            grants](http://www.rurdev.usda.gov/nrdp/taskforce.html) from
            the U.S. Department of Housing and Urban Development is May
            24, 2004. \[Stephen Rhodeside (HUD)\]

III. NRDC Business

     a.  **Call for nominations for Chair and members of NRDC Steering
         Committee**.

         i.  To submit a nomination, please email your nomination to
             [Conley Chaney](mailto:cchaney@ocdx.usda.gov) before
             Monday, June 14, 2004.

         ii. Self-nominations and re-nominations are permissible.

         iii. NRDC members will vote on the nominations at the June
              14^th^ NRDC meeting---location to be announced.

IV. **[Featured Discussion: Senior Citizens Issues in Rural
    America]{.underline}**

    a.  **Introduction to HHS Administration on Aging**

> Presented by Lori Stalbaum, MSW, HHS Administration on Aging
> (AoA)---Center for Wellness and Community-Based Service

i.  AoA: Background

    1.  One of the nation's largest providers of home and
        community-based care for older persons and their caregivers

    2.  Created in 1965 with the passage of the Older Americans Act
        (OAA)

    3.  AoA is the lead agency for the Aging Network

ii. Mission

    1.  To promote the dignity and independence of older people and help
        society prepare for an aging population.

iii. Focus

     1.  Vulnerable elderly who are at risk of losing their independence

     2.  As worded in the OAA, AoA programs target services to "older
         individuals with greatest economic need...with particular
         attention to low-income minority individuals and older
         individuals residing in rural areas."

iv. Core Services Funded by OAA & Provided by Aging Network

    1.  Supportive Services

    2.  Nutrition Services

    3.  Preventive Health Services

    4.  National Family Caregiver Support Program (NFCSP)

    5.  Services that protect the rights of vulnerable older persons

    6.  Services to Native Americans

v.  Serving the Rural Elderly

    1.  Currently, 25% of all elderly (age 65 and older) live in rural
        areas

    2.  Rural elderly are becoming more isolated---scattered across 80%
        of the nation's land.

    3.  Rural elderly are more likely to own their own home than urban
        elderly

    4.  Rural elderly are more likely to live in poverty than their
        urban counterparts

    5.  Older rural residents more likely to have poorer health and
        certain chronic conditions than their urban counterparts

    6.  Rural elders face many of the same challenges in their efforts
        to --

        a.  Gain access to services

        b.  Live independent lives

    7.  Demographic & Socio-economic challenges inherent in the rural
        population, make these challenges more difficult to overcome

    8.  Number of rural elderly participating in OAA programs is
        declining

        a.  FY1998 -- 33.5% were rural

        b.  FY 2000 -- 32.9% were rural

        c.  FY 2001 -- 30.4% were rural

    9.  One of AoA's goals in our five year strategic plan \-\-\--
        increase the percentage of service to clients who live in rural
        areas to 35% by FY 2007.

vi. Strategic Priorities

    1.  Improve access to integrated systems of health and social
        supports

    2.  Help older people stay active & healthy

    3.  Support families in their efforts to care for loved ones at home
        & in the community

    4.  Ensure rights of older people

vii. Current Activities to Support the Rural Elderly

     1.  Alzheimer's grants in 39 states -- 47% target needs of rural
         families

     2.  Aging & Disability Resource Centers (ADRCs) -- now funded in 24
         states

     3.  Participating in HHS Rural Task Force & National Advisory
         Committee on Rural HHS

     4.  Participating in *United We Ride* -- DOT, in cooperation with
         HHS

         a.  Five-part initiative that focuses on transportation needs
             for human services

         b.  For more info on *United We Ride* see
             <http://www.fta.dot.gov/CCAM/United_We_Ride.html>, and the
             February 9 [NRDC
             minutes](http://www.rurdev.usda.gov/nrdp/nrdc.html) at

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b.  **Introduction to the National Association of Area Agencies on Aging
    (N4A) and the AAA's**

> Presented by Adrienne Dern, Deputy Director of N4A

i.  N4A's relationship to AoA:

    1.  N4A is a the trade association of Area Agencies on Aging, also
        known as Triple A's (AAA).

    2.  AAA's are supported by State Agencies on Aging, which are
        supported by AoA.

ii. Current focus:

    1.  Reauthorization of the Older Americans Act

    2.  Technical assistance and training for AAA's

    3.  Providing important information

    4.  Advocacy -- Rural Special Interest Group meets regularly

        a.  Issues

            i.  Transportation

            ii. Access to Health Care

iii. Area Agencies on Aging (AAA)---"Triple A's"

     1.  AAA's are not always known as "Area Agencies on Aging". Many
         AAA's are county/city agencies or centers.

     2.  About 2/3 are government affiliated, and 1/3 are non-profit
         organizations

     3.  Services to Seniors:

         a.  Adult day care services

             i.  Mobile respite care van

         b.  Transportation

         c.  Telecommunications at some seniors centers.

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c.  **Discusion:**

> Ms. Stalbaum and Ms. Dern answered questions from the group as we
> explored some of the issues seniors face in utilizing the services of
> AoA and the issues that AoA and N4A face in delivering these services.

i.  Currently about 30% of rural seniors utilize the services of AoA.

ii. What structural barriers exist? Are there problems of geo-political
    overlaps in programs and services, or is it more a problem of total
    funding?

    1.  Funding is an issue simply because these are tremendously
        expensive need to service.

    2.  Seniors are living longer and in these later years require more
        care.

    3.  Seniors in rural areas are more expensive to serve do to the
        greater distances and isolation.

iii. AoA is funded at about \$1 Billion annually.

iv. Limitted staff resources at national, state, and local Agencies on
    Aging dramatically hinder the ability of increase the visibility and
    public awareness of the services available.

    1.  State agencies need to develop more effective methods to pool
        information.

    2.  N4A call centers provide outreach and visibility

    3.  211 services are now serving roughly 80% of the country

v.  6-8 states have no AAA's, but do operate State Agencies on Aging.

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V.  Next Meeting: Monday, June 14, 2004 (Location to be announced)

    a.  NRDC elections: Steering committee members and Chair

    b.  Presentation & Discussion: Mapping Rural: Policy, Programs,
        Advocates, and Impacts

## APPENDIX: Rural Factoids

### There area over twenty seven different definitions of "rural"

# [Demographics]{.underline}[^1]

-   20% of the population lives in the rural United States

-   75% of all counties in the United States are "rural"

-   The 75% of counties represent over 83% of the nations land mass

-   74% of the counties in the U.S. have populations of less than 50,000

-   24% of the counties in the U.S. have populations of less than 10,000

# [Poverty]{.underline}[^2]

-   In 1999, 457 rural counties have had a poverty rate of 20% or more,
    and of these 80% have held that rate since 1959.

-   The poverty rate of rural elders is 2.7% percent greater (12.2%)
    than the elderly living in a metropolitan area (9.5%)

# [Transportation]{.underline}

-   Forty percent of rural Americans live in areas with no form of
    public transportation.

-   Nearly 80% of rural counties have no public bus service.

-   57% of the rural poor do not own a car

**Housing**

-   Rural elders are more likely to own their own homes than urban
    elders. The fact that their homes are more likely to be in poorer
    conditions has important implications for safe "aging in place"
    (Ricketts, 1999 Rogers 1999, W.K. Kellogg Foundation 1995)

-   The elderly occupy on-third of the rural households in this country
    without indoor plumbing: almost two-thirds of these homes are in the
    South. (W.K. Kellogg Foundation 1995)

[^1]:
    > Rural Policy Research Institute, 2002)

[^2]:
    > USDA Economic Research Service 2003