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eligibility criteria. Eligibility criteria applied in programs <br /> designed to address health needs of older adults are too restrictive <br /> within programs !and often conflict across the various programs. For <br /> example. a program might apply eligibility criteria to determine if <br /> persons are eligible for health services and another program might <br /> apply a different set of eligibility criteria to determine if they are <br /> eligible for sociial support services. The persons may need both health <br /> and social support services in order to maintain functional <br /> independence inItheir own homes. Further, criteria within discrete <br /> programs are oftlen too restrictive. For example, under the Medicaid <br /> program. in order for a person not eligible for Aid to Families with <br /> Dependent Children (AFDC) to become medically needy to receive home and <br /> community-based (long-term care. that person has to spend-down to an <br /> income allowance! of $175 a month or a total of $1050 for six months. <br /> Out of this income allowance a person would have to pay for rent. food, <br /> utilities and other types of subsistence. This specific criterion <br /> makes it almost impossible for a person to become eligible under the <br /> medically needy category. <br /> 52modacsis_Qf_cACS <br /> To insure an adequate quality of services. uniform standards of <br /> care are needed across and within the continuum of long-term health <br /> care. There areimany facets, ranging from standards for nursing homes <br /> to adult day care. Currently, no entity exists at the state or local <br /> level to insure that even higher than minimal standards are maintained <br /> in all programs and services contributing to the health care of older <br /> adults, <br /> f 014A91/ASS_ICAD OCIMIisQ1__A-@ UCitt-I2-ACQ22s_i9-CAt! <br /> The handicapping conditions experienced by many older persons have <br /> already been described. At the same time that these conditions <br /> increase older adults' needs for services. they often restrict their <br /> mobility and access to the ordinary sources of transportation. <br /> Frequently, inadequate transportation becomes the most severe barrier <br /> to meeting other needs. By limiting access to critical necessities <br /> such as nutritionally sound meals or health care. inadequate <br /> transportation can speed the deterioration of older persons and <br /> necessitate their reliance on substantially higher and more expensive <br /> levels of care. <br /> ZURORCi_fAC-EAAilsA <br /> Families are; the primary care givers for older parsons, supplying <br /> some 80 percent of all their supportive care. It should not be the aim <br /> {or the unintended outcome) of social programs to silo( ,3uag other <br /> sources of care when families can adequately provide it. However, <br /> families often do, need support in order to adequately meet the needs of <br /> their older members. To reduce the financial burden involved, several <br /> states have implemented, and others are considering, programs which <br /> 1 <br /> 9 <br />