Title XX and the elderly

Sanford F. Schram, MA, is Director of Research and Richard Hurley, MA, is Director of Policy Analysis, Aging Research Coordination Project, State University of New York at Albany. The authors wish to thank Daniel F. Herring, Hilda LaSalle, Joseph F. Zimmerman, Thomas Don ovan, and Sol Zalcgendler for their assistance in the preparation of this article. title xx was added to the Social Se1970 census of the United States.2) curity Act of 1934 on January 4, 1975, Consolidated under Title XX are and provision for services under it social service authorizations previously began on October 1, 1975. It consolprovided under Titles I, IV-A, VI, X, idates into one block grant federal soXIV, and XVI of the Social Security cial services grants that were formerly Act. Gathered under Title XX pro separate and establishes a planning grams are such services as the follow process in which states and localities set ing: day care, foster care, and protec their own priorities among noncash tive services for children; foster care, benefit programs. This new planning social group services, and protective process allows local groups to compete services for adults; housekeeping for influence in determining local soand homemaker assistance programs; cial services expenditure patterns. In housing improvement programs; pre some ways, the process makes the conventive services; transportation ser cept of special revenue sharing relevant vices; and information and referral to social services, and its implications services.3 Several of these service cat for the provision and distribution of soegories are vitally important to the el cial services are far-reaching and proderly, many of whom have come to found.1 rely on the regular provision of one This article attempts to assess the or several of them, adequacy of the Title XX planning In most states, the services now process in responding to the needs of included under Title XX were tradi older persons. A description of Title tionally seen as services exclusively for XX and some of its operational probthose persons with low income who lems will be followed by a review of were eligible for or already receiving New York State's Title XX implemencash assistance. The transition to Ti tation plan. Before analyzing New tie XX guidelines has meant that ser York State's planning data for 1975vices now under Title XX are no 76, however, the authors will examine longer designed to serve cash benefi the circumstances and problems surciaries only. New income-based eli rounding the inclusion under Title XX gibility requirements have made it pos of the noncash benefit programs of the sible to include those not receiving Social Security Act. These circumcash benefits as recipients of services stances and their concomitant proband, therefore, to increase the potential lems affect the ability of Title XX proservice population, grams in many states to provide needed The elderly and other groups not services to the elderly. The analysis of necessarily receiving cash assistance New York's planning data will examare now likely to participate in the ine whether older persons are effecnew Title XX planning process in the tively influencing the local planning hope that they will be able to influence process in that state and are thereby budgetary decisions. For example, receiving their fair share of funds. then, states having fiscal flexibility or What constitutes a "fair" share of powerful senior citizen organizations funds can be plausibly defined. It is may see an increase in Title XX expen important in service planning that alditures on services to the elderly. Con locations be determined by indicators versely, states having little fiscal flexi of the extant needs of different groups bility or few powerful senior citizen within a planning area. If a group reorganizations may continue serving ceives Title XX service funding progroups other than the elderly and may portionate to its size within a given not increase expenditures on ser population, it may be said that the vices for older persons, allocation has been based on an in dicator of need and that a fair share of funds is being received. (The ini tial indicator of need among the elIn recent years, changes in the fed derly used in the analysis appearing in eral system in this country have meant this article is the percentage of poor greater flexibility for state and local over the age of 65, as defined by the governments regarding the use of SPECIAL REVENUE SHARING