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At the same time, the IV-E program will be directed toward establishing and supporting multidisciplinary gerontological centers that concentrate their activities on a particularly significant issue of serious concern to older people. The principal type of special emphasis center to be established under IV-E authority would focus on services for the chronically impaired aged person. Briefly characterized, the proposed long term care gerontology centers would serve as:

1) effective demonstrations of a full range of integrated
health and social services geared specifically to the
chronically impaired elderly.

2) ideal sites for training future health and social services
professionals as members of multidisciplinary teams.

3) centers of excellence in continuing education for service
providers currently working with impaired elderly.

4) research sites uniquely suited to social and health service
research, especially policy-oriented research on the delivery
and effectiveness of services to chronically impaired older persons.
5) authoritative and resourceful providers to consumers and
policy makers of up-to-date scientifically-based informa-
tion concerning health maintenance and health policy issues.

6) accessible and available providers of technical assistance
to service agencies in the governmental and voluntary sector.

It is recognized that applicants may be at various stages in the complex task of developing such centers. During the first year of IV-E funding, grants will be made available in the range of $60,000 to $100,000 for the support of the center's developmental activities. In subsequent years, it is proposed that at least one center per region would be chosen for multi-year funding ranging from $200,00 the first year, to $350,000 to $400,000 in subsequent years. Eligible applicants would include individual universities, consortia, collaborations between universities and service providing organizations. An essential component of all applications is the active participation of a university medical school. For the first year of this program initiative, AoA will support a technical assistance contractor to help in the development of the centers.

While the Administration on Aging will provide "core" support for these centers through IV-E funds, it is intended that other sources of support will be sought as well. These might include: grants from other federal agencies such as DHUD, NIMH, NIA; collaborative arrangements with the V.A.; Title XIX waivers where appropriate; and other grants under AOA's discretionary programs and special long term care demonstration authority. The activities of these Title IV-E centers will be appropriately coordi nated with the regional education and training program, as well as the activities of bi-regional advocacy assistance back-up centers.

Proposed FY 79 Funding: $1.8 million--new grant awards

(Detailed information on this program is given in Part II, Subpart: C).

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There is a recognized need for trained professional and paraprofessional persons who can deliver health services to older persons. A key meinber of the health care team is the physician, knowledgeable in geriatric: medicine. With rare exception, undergraduate and postgraduate training of today's primary care physicians do not include adequate exposure to and competence in the growing body of knowledge concerning clinical and case management problems that frequently occur with older patients. There are a few new efforts across the country to interest future heal'th professionals in geriatric medicine. The Veterans Administration, thr ough both its GRECC program as well as Geriatric Fellowships, is beginning to train geriatric practitioners. However, there remains a need for facui ty persons who have an interest in geriatric medicine and who will influen ce up-coming students and current professionals in this field of research, practice, teaching.

To address this need for faculty with a geriatric interest, the geriatric fellowship program will award grants to support the development of multiyear programs to train physicians for faculty roles in geriatric medicine. The focus of the program will be to provide graduate physicians with the additional clinical and teaching experience necessary and appropriate to qualify them to serve on the faculty of existing geriatric programs or to aid in the development of new academic programs in geriatrics.

Each award will be for a period of five years during which time it is expected that three physicians, at a minimum, will have completed the following three year sequence; one year of specialized residency training in geriatrics and a two year faculty appointment during which time the physician will assume full time geriatric teaching and clinical responsibilities.

Proposed FY 79 Funding: $.25 million - new grant awards.

(Detailed information on this program is given in Part II, Subpart D).

B-3. Minority Research Associate and Minority Recruitment Programs

The Administration on Aging will initiate under Title IV-A of the Older Americans Act two special programs in FY '1979 to address the shortage of minority researchers in the field of aging and the lack of personnel trained to meet the community service needs of racial and ethnic minority elderly Asian/Pacific Americans, Blacks, Hispanics, and Native Americans.

Both the Minority Research Associate Program and the Minority Recruitment Program are initiated in response to the 1978 Amendments to the Older Americans Act which authorize the Commissioner on Aging through either grant or contract:

"to assess future national personnel needs, including the
nered for training of advocates, with respect to the elderly
with special emphasis on the needs of elderly minority group
in divicluals and the need for the training of minority group
individuals to meet such needs." (01der Americans Act:
Title IV, Part A Training, Section 404 (a) 6).

Minority Research Associate Program

Training persons effectively to plan, manage, and deliver services responsive to the needs of minority elderly initially depends upon the extent of available information concerning the special circumstances of minority elder ly and the range of policies and programs which impact on their well-being. The Administration on Aging recognizes that the base of knowledge concerning minority aging has long lagged measureably behind other fields of gerontology both quantitatively and qualitatively. The lack of such a knowledge base not only attests to a shortage of research rescurces among minority groups but also accounts, to some degree, for t'he unserved and underserved among the minority elderly.

The objective of the Minority Research Associate Program is to provide opportunities to strengthen the interest, participation, and productivity of minority scholars in the field of aging research, particularly studies related to service provision and delivery to minority elderly. By catalyzing increased efforts to expand the base of knowledge concerning minority aging, the Program will contribute to advances in public policies and programs to serve the minority aging.

The Minority Research Associate Program is designed to attract qualified minority social scientists to the field of aging by supporting their participation as research associates in gerontology institutes, centers, or programs of study which in turn, are distinguished by their capacity for scholarship, research, and education in the field of aging. Grants will be made to institutions with sufficient program resources to:

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effectively recruit qualified minority social scientists;

provide extensive opportunities for education and research
in gerontology;

foster research activity focused on improvement of services
or service delivery, changes in Federal programs, or new
policy recommendations benefiting minority elderly.

Proposed FY 1980 Funding: $480,000 - new grant awards.

(Detailed information on this program is given in Part II, Subpart B).

Minority Recruitment Program

The purpose of this program is, by increasing recruitment, training, and placement of minority students, to improve the personnel resources and services, both quantitative and qualitative, of the minority groups, who have historically been under-represented. The program is both career - and service-oriented. Participants, graduates or undergraduates, will not only have a career focus in their academic training but also render services upon completion of their training relating to aging. Thus the program will benefit minority elderly, directly or indirectly, with services provided by well trained minority professionals.

The program will be set up in two phases: planning and operational. In
the 6 month planning phase, AoA will award a contract to design and develop
the program. The contractor will perform the following tasks:

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At the end of the planning phase, assuming satisfactory progress, the contract will be renewed for a multi-year period to operate the program. The contract, beginning in FY 1980, will be funded at an approximate $300,000 annual level. Assuming satisfactory project performance and the availability of sufficient funds, the contract will be renewed for up to three (3) years during the operational phase of the program.

Proposed FY 1979 Funding: $200,000 - contract awards under the Small Business Administration's Section 8(a) Minority Business Firm Program.

C-1. IV-E National Centers: Aging Policy Study Centers

Complementing development of the long term care gerontology centers will be
AoA support of national aging policy study centers. Each national center
will focus on a unique subject or problem area affecting the field of
aging. As prescribed by the IV-E legislation, centers will be engaged
in multifunctional, as well as multidisciplinary activities, including
research, development of educational and instructional programs, technical
assistance and training. The center's subject area focus should meet three
criteria:

0 Salience to the AoA mission and its major programs

o Appropriateness of establishing a center in this
particular problem area given the current knowledge.
and sophistication of policy applications in the area.

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Need and priorities expressed by the Congress, the
Commissioner on Aging, the Federal Council on Aging,
and by other appropriate entities.

National Centers will be supported in two phases. In FY 1980, AoA will award 15 month cooperative agreements for establishment and development of a national center in each of several selected priority areas. Phase II, scheduled to begin in FY 1981, will consist of long-term cooperative agreements, up to 3 years, following an assessment of the center's progress and its proposed long-term plans. Comprehensive reviews and site visits will precede the award of Phase I as well as Phase II cooperative agreements. AoA support for each center is expected to range from $200,000 to $250,000 per year. Eligible applicants include universities, research institutes, and other appropriate non-profit organizations.

Program content and the disciplinary focus of individual centers will vary in accordance with the topical mission, but all will be expected to engage in the full range of functions specified by the IV-E legislation. The Administration on Aging has identified several priority subject areas for the development of national aging policy study centers. These are listed below. Applicants may elect to propose the establishment and support of centers in subject areas other than (by way of addition, combination, or substitution) those identified by AoA. In such cases, the applicant must demonstrate convincingly that the proposed center has equal or greater salience than those set forth by AoA. Based on current estimates of the Title IV-E appropriation for FY 1980, sufficient funds are available to establish national centers in only five (5) of the several subject areas. Up to five (5) more national centers will be started in FY 1981 given the availability of additional funds.

Applications to establish national centers will be solicited in the following areas:

1) Income Maintenance

2) Housing and Living Arrangements

3) Employment and Retirement

4)

5)

Education, Leisure, and Continuing Opportunities for Older Persons
Health

6) Family and Community Support Systems

7) Aging in the Future Society

8) Older Women

9) Aging and Attitudes, Values, and Ethics

Where appropriate, both a minorities and an inner-city/rural elderly component will be incorporated in the subject area focus of the national center. Proposed FY 1980 Funding: $1.0 million - new cooperative - agreement awards (Detailed information on this program is given in Part II, Subpart F).

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