Front Cover
 Front Matter
 Title Page
 Table of Contents
 Elements of areawide planning
 Training administrators for areawide...
 The delineation of a region
 Priority areas as a strategy in...
 Feasibility of areawide planni...
 Program evaluation and monitoring...
 Federal relationships to planning...
 Presidential messages on aging:...
 Summary of discussion groups
 Question and answer session
 Workshop: Community contact: Its...
 Cooperating agencies
 Back Cover

Group Title: Center for Gerontological Studies and Programs series, v. 22
Title: Areawide planning for independent living for older people
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00086052/00001
 Material Information
Title: Areawide planning for independent living for older people proceedings
Series Title: Center for Gerontological Studies and Programs series, v. 22
Physical Description: ix, 142 p. : illus. ; 23 cm.
Language: English
Creator: Southern Conference on Gerontology, 1973
Osterbind, Carter Clarke ( ed )
Publisher: Published for the Center for Gerontological Studies and Programs by the University of Florida Press,
Published for the Center for Gerontological Studies and Programs by the University of Florida Press
Place of Publication: Gainesville
Publication Date: 1973
Copyright Date: 1973
Subject: Older people -- Congresses -- United States   ( lcsh )
Old age -- Congresses -- United States   ( lcsh )
Personnes âgées -- Congrès -- États-Unis   ( rvm )
Vieillesse -- Congrès   ( rvm )
Genre: bibliography   ( marcgt )
conference publication   ( marcgt )
non-fiction   ( marcgt )
Bibliography: Includes bibliographical references.
Statement of Responsibility: Edited by Carter C. Osterbind.
 Record Information
Bibliographic ID: UF00086052
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 00640925
lccn - 73008869
isbn - 0813003962

Table of Contents
    Front Cover
        Front Cover 1
        Front Cover 2
    Front Matter
        Page i
        Page ii
    Title Page
        Page iii
        Page iv
    Table of Contents
        Page v
        Page vi
        Page vii
        Page viii
        Page ix
        Page x
    Elements of areawide planning
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
    Training administrators for areawide planning
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
        Page 25
    The delineation of a region
        Page 26
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
    Priority areas as a strategy in arewide planning under the Older Americans Act
        Page 44
        Page 45
        Page 46
        Page 47
        Page 48
        Page 49
        Page 50
        Page 51
    Feasibility of areawide planning
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
        Page 59
        Page 60
        Page 61
        Page 62
        Page 63
    Program evaluation and monitoring for areawide programs in aging
        Page 64
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
        Page 73
        Page 74
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
    Federal relationships to planning at regional and state levels
        Page 82
        Page 83
        Page 84
        Page 85
        Page 86
        Page 87
        Page 88
        Page 89
        Page 90
        Page 91
        Page 92
        Page 93
    Presidential messages on aging: Historical analysis and projection
        Page 94
        Page 95
        Page 96
        Page 97
        Page 98
        Page 99
        Page 100
        Page 101
        Page 102
        Page 103
        Page 104
        Page 105
        Page 106
        Page 107
    Summary of discussion groups
        Page 108
        Page 109
        Page 110
    Question and answer session
        Page 111
        Page 112
        Page 113
        Page 114
        Page 115
        Page 116
        Page 117
        Page 118
        Page 119
        Page 120
        Page 121
    Workshop: Community contact: Its value and feasibility
        Page 122
        Page 123
        Page 124
        Page 125
        Page 126
        Page 127
        Page 128
        Page 129
        Page 130
        Page 131
        Page 132
        Page 133
        Page 134
        Page 135
        Page 136
        Page 137
        Page 138
        Page 139
        Page 140
    Cooperating agencies
        Page 141
        Page 142
    Back Cover
        Page 143
        Page 144
Full Text

The Southern Conference

on Gerontology


(Communications relating to gerontology at the University of Flor-
ida should be addressed to the Center for Gerontological Studies
and Programs, 221 Matherly Hall, University of Florida, Gainesville,
Florida 32601. This publication and all previous publications of the
Center for Gerontological Studies and Programs, formerly the In-
stitute of Gerontology, may be obtained from the University of
Florida Press, Gainesville, Florida.)

Center for Gerontological Studies and Programs

Vol. 1-Problems of America's Aging Population, 1951
Edited by T. Lynn Smith
Vol. 2-Living in the Later Years, 1952
Edited by T. Lynn Smith
Vol. 3-Health in the Later Years, 1953
Edited by John M. Maclachlan
Vol. 4-Economic Problems of Retirement, 1954
Edited by George B. Hurff
Vol. 5-Aging and Retirement, 1955
Edited by Irving L. Webber
Vol. 6-Aging: A Current Appraisal, 1965
Edited by Irving L. Webber
Vol. 7-Services for the Aging, 1957
Edited by Irving L. Webber
Vol. 8-Organized Religion and the Older Person, 1958
Edited by Delton L. Scudder
Vol. 9-Society and the Health of Older People, 1959
Edited by Irving L. Webber
Vol. 10-Aging: A Regional Appraisal, 1961
Edited by Carter C. Osterbind
Vol. 11-Aging in a Changing Society, 1962
Edited by Ruth E. Albrecht
Vol. 12-Continuing Education in the Later Years, 1963
Edited by J. C. Dixon
Vol. 13-Social Change and Aging in the Twentieth Century, 1964
Edited by D. E. Alleger
Vol. 14-Maintaining High Level Wellness in Older Years, 1965
Edited by Lois N. Knowles
Vol. 15-Medical Care under Social Security, 1966
Edited by Irving L. Webber
Vol. 16-Income in Retirement, 1967
Edited by Carter C. Osterbind
Vol. 17-Potentialities for Later Living, 1968
Edited by O. Bruce Thomason
Vol. 18-Feasible Planning for Social Change
in the Field of Aging, 1969
Edited by Carter C. Osterbind
Vol. 19-Health Care Services for the Aged, 1970
Edited by Carter C. Osterbind
Vol. 20-New Careers for Older People, 1971
Edited by Carter C. Osterbind
Vol. 21-Independent Living for Older People, 1972
Edited by Carter C. Osterbind
Vol. 22-Areawide Planning for Independent Living for Older People, 1973
Edited by Carter C. Osterbind

Areawrid Planning

for Independent Living

-oHOdr eol

Edited by
Carter C. Osterbind

Published for the
Center for Gerontological Studies
and Programs
by the
University of Florida Press
Gainesville, 1973

A University of Florida Press Book

Library of Congress Cataloging in Publication Data

Southern Conference on Gerontology, 22d, University
of Florida, 1973.
Areawide planning for independent living for
older people.

(Center for Gerontological Studies and Programs
series, v. 22)
Includes bibliographical references.
1. Aged-United States-Congresses. 2. Old
age-Congresses. I. Osterbind, Carter Clarke, ed.
II. Title. III. Series: Florida. University,
Gainesville. Center for Gerontological Studies
and Programs series, v. 22.
HV1461.S58 1973 362.6'0973 73-8869
ISBN 0-8130-0396-2



Preface vii
CARTER C. OSTERBIND, Editor of the Proceedings and
Director, Center for Gerontological Studies and
Programs, University of Florida
Elements of Areawide Planning 1
CARTER C. OSTERBIND, Research Professor, and
CHARLOTTE R. MENKE, Research Instructor, Univer-
sity of Florida
Training Administrators for Areawide Planning 14
WAYNE VASEY, Co-director, Institute of Gerontology,
University of Michigan-Wayne State University
The Delineation of a Region 26
RALPH B. THOMPSON, Professor of Marketing, Uni-
versity of Florida
Priority Areas as a Strategy in Areawide Planning under
the Older Americans Act 44
CHARLES E. WELLS, Director, Older Americans Ser-
vices Division, Administration on Aging, United
States Department of Health, Education, and

Feasibility of Areawide Planning 52
ROBERT H. BINSTOCK, Professor of Politics and Social
Welfare, Brandeis University
Program Evaluation and Monitoring for Areawide
Programs in Aging 64
VICTOR I. KUGAJEVSKY, Vice President, Booz-Allen
Public Administration Services, Inc.
Federal Relationships to Planning at Regional and State
Levels 82
FRANK NICHOLSON, Associate Regional Commissioner
on Aging, United States Department of Health,
Education, and Welfare
Presidential Messages on Aging: Historical Analysis and
Projection 94
ELIAS S. COHEN, Assistant Professor, School of Com-
munity Medicine, University of Pennsylvania
Summary of Discussion Groups 108
Question and Answer Session 111
Workshop: Community Contact: Its Value and Feasibility
for Nursing Home Residents 122
Project Coordinator: BARBARA HERZOC, Geronto-
logical Society
Chairman: TED KOFF, Director, Handmaker Jewish
Home for the Aged, Tucson, Arizona
Resource People: CHARLES W. PRUITT, JR., President,
Cathedral Foundation; BEN SCHUMACHER,
Executive Director, East Ridge; ROBERT PARRY,
Executive Director, Presbyterian Homes of
Synod of Florida; SIDNEY ENTMAN, Executive
Director, River Garden Hebrew Home for the
can Nurses Association; EDITH ROBINS, Acting
Deputy Chief, Office of Long-Term Care
Services, Department of Health, Education, and
Registrants 129
Cooperating Agencies 141



MANY of the nation's social welfare programs are
undergoing thoughtful evaluation as a result of strong public criti-
cism. This evaluation has stimulated a number of administrative in-
novations which bear directly on the quality of services delivered
and the number of people who receive them. Innovators have at-
tempted to consider proper resource utilization in order to achieve
sound economic control, develop a rational social and economic
philosophy, provide for proper administrative efficiency, and assure
meaningful consideration for the well-being of the consumers of the
Areawide planning is a process by which effective administrative
procedures can be developed. Through this planning, communities
can utilize existing area resources to help provide for new and ex-
panding needs, thus overcoming some of the problems related to
program implementation.
The quality of independent living for older people, with which
we are all concerned, may be affected by the results of areawide
planning. Therefore, we think it timely to look closely at "Areawide
Planning for Independent Living for Older People" and see what
impact this planning has had on programs for the aged population.
The stated goal for the areawide programs of the Administration

Areawide Planning for Independent Living
on Aging is to assist older persons throughout the nation to live inde-
pendent, meaningful, and dignified lives in their own homes or other
places of residence as long as possible, emphasizing the lessening of
isolation and the prevention of unnecessary institutionalization.
Areawide planning must provide solutions for social programs
rather than impede the pursuit of independent living for older per-
The program of the Twenty-second Annual Southern Conference
on Gerontology focuses on numerous aspects of areawide planning
and the goals toward which it is directed. The planners of the con-
ference hope that out of the ideas presented and the discussions by
various concerned groups there will come a better comprehension
of what areawide planning is, how it can be used, and the problems
which arise as it is used.
The Center for Gerontological Studies and Programs is indebted
to the people who participated in the program and in various ways
gave assistance and time to the conference.
Three supporting groups held meetings concurrently with the
conference, the Florida Bureau on Aging, the Florida Council on
Aging, and the American Nurses Association. Members of the latter
group participated in the conference workshop session and the
association held a workshop for its members immediately following
the conference.
An expression of appreciation is due also to the Gerontological
Society for cooperatively planning and supporting the workshop on
Community Contact-Its Value and Feasibility for Nursing. Bar-
bara Herzog of the Gerontological Society was the project coordi-
nator. The chairman was Ted Koff, director of the Handmaker Jew-
ish Home for the Aged, Tucson, Arizona. Resource people for the
workshop were Charles W. Pruitt, Jr., president of the Cathedral
Foundation; the Reverend Ben Schumacher, executive director of
the Lutheran Retirement Program at East Ridge; Sidney Entman,
executive director of the River Garden Hebrew Home for the Aged;
Robert Parry, executive director of the Retirement Homes of the
Synod of Florida; Eldonna Shields and Sally Buseck of the Ameri-
can Nurses Association; and Edith Robins of the Department of
Health, Education, and Welfare.
Special acknowledgment is made to Margaret Jacks, acting chief

of the Florida Bureau on Aging; Constance Walker, coordinator,
Project INSTEP; and E. Russell Jackson, Florida Council on Aging,
for assisting the center's committee in planning the program.
Strong support was received from the cooperating agencies listed
in the proceedings. The Center for Gerontological Studies and Pro-
grams wishes to express its appreciation to participants in the con-
ference other than those who have papers in this volume. Among
these are Charles W. Pruitt, past president, Florida Council on
Aging; Margaret Jacks, acting chief, Florida Bureau on Aging; Earl
M. Starnes, director, Division of State Planning; Hugh Gaston, chair-
man, Georgia Commission on Aging; Gordon Shaw, associate direc-
tor, Southern Regional Education Board; Jeanne Brock, consultant
for adult education, Florida Department of Education; Thomas A.
Rich, professor and dean of the College of Social and Behavioral
Sciences, University of South Florida; and Rowena E. Rogers,
president, Florida Council on Aging.
The center wishes also to thank the many individuals who par-
ticipated as group leaders, recorders, and resource persons for the
various discussion groups.
The center is grateful to the Division of Continuing Education,
the agency at the University of Florida that joins the center in the
overall administration of the conference. Betty T. Siegel, dean, W.
T. Coram, Jr., head, Department of Special Programs, and Richard
Palmer, continuing education coordinator, handled a broad range of
administrative details connected with plans and local arrangements.
Valuable assistance was given by members of the staff of the Bureau
of Economic and Business Research in a variety of assignments-
Jacquelyn Smoak, Merry Reid, Douglas Duncan, Dot Evans, and
Frances Terhune. Special acknowledgment is due Charlotte Menke
who worked out the arrangements for the discussion groups and
prepared a summary of the reports.

Elements of Areawide Planning


PLANNING by either public or private agencies cus-
tomarily has an areal perspective. Planning offices, especially those
concerned with physical planning, identify their plans with a given
area, usually a political entity or an area distinguished by certain
physical characteristics, such as a river basin or coastal plain. Thus,
when we speak of areawide or areal planning in a general sense, we
are concerned with planning that covers, or takes place within, a de-
fined geographic area. Quite frequently we identify areas only
loosely with programs. For example, we speak of national or state
plans to attain vague goals such as full employment, equal oppor-
tunity, and the elimination of poverty. The programs associated
with these goals may or may not be attached to designated small
areas of the country. The fact that a program takes place within the
nation does not necessarily signify that there is a clear areal dimen-
sion to the plan.
What is it that differentiates our concept of areawide programs
from the customary areal perspective of any type of planning or
from loose references to geographic areas? In many social pro-
grams, especially those under the Older Americans Act, specific
conditions relating to the areal aspects of planning are precedent to,
as well as a continuing part of, the development of plans. The lan-

Areawide Planning for Independent Living
guage used in the not yet approved Older Americans Comprehen-
sive Service Amendments of 1972 identifies clearly the areal
requirements for its programs.' "In order for a state to be eligible to
participate in the program of grants to states .. the state shall .
designate a state agency as the sole state agency ... to: develop the
state plan . administer the state plan within such state . be pri-
marily responsible for the coordination of all state activities related
to the purposes of this act... and divide the entire state into distinct
areas . after considering the geographical distribution of individ-
uals aged sixty and older in the state, the incidence of the need for
social services (including the numbers of older persons with low in-
comes residing in such areas), the distribution of resources available
to provide such services, the boundaries of existing areas within the
state which were drawn for the planning or administration of social
services programs, the location of units of general purpose local
government within the state, and any other relevant factors."

Given the specific requirements of a state plan, of planning areas,
criteria for the selection of areas, and the conditions under which
programs under the Older Americans Act are to be implemented,
what aspects of areawide planning will be central to our conference
As we work to improve the effectiveness of social programs, we
are challenged to maintain our perspective on the more essential re-
quirements for program improvements and on the goals we seek to
attain. The function of this paper is briefly to direct attention to the
scope of the papers and discussions at this conference and to iden-
tify additional elements that should be kept in mind.
The next paper deals with the training of administrators for area-
wide planning. The Administration on Aging, in its heroic efforts to
move quickly to implement areawide planning programs, has
drawn on several universities to develop short-term training to bet-
ter equip the people working in areawide planning. The factors
weighed in developing one of these training programs will be dis-
cussed so that we may better understand the objectives of the
The paper which follows will set forth conditions that may be

Elements of Planning-Osterbind and Menke
used to delineate geographic areas, such as communications, eco-
nomic activity, and governmental structure. This examination will
give us an analytical base from which to assess some of the factors
that need to be weighed in the shaping of areas for areawide
We will next give attention to the philosophy that has led the
Administration on Aging to areawide planning. The areawide ap-
proach will be examined in terms of its relationship to the broader
program developments of the federal government.
Experience in developing community programs has revealed how
important well-defined goals are to the program's achievements.
Such goals must be in keeping with the time period of a program
and with what may be reasonably expected. Insights into the
feasibility of areawide programs and the implications of appropri-
ate goals are scheduled for attention by one of our speakers.
In areawide planning we must examine the needs and social attri-
butes of the people in the areas and the effect of programs on the life
conditions of the program recipients. Therefore, monitoring and
evaluating of areawide programs which are fundamental to an as-
sessment of a program's achievements are the subjects of another
Moving from the broader national perspective to the subnational
level, considerations will be given to program coordination and in-
tegration for areawide planning at the multistate or regional level.
The transmission of a diverse collection of programs through re-
gional offices to states and communities requires important strate-
gies intended to effect communications and to achieve program
coordination and efficiency among governmental offices. The organ-
izational and administrative procedures designed to carry out the
strategies will be described and analyzed.
In dealing with as broad a topic as "Areawide Planning for Inde-
pendent Living for Older People" in the short time available to the
conference, it is necessary to be selective. Our procedure, designed
to provide flexibility in the content of the program and to draw on
the wide range of experience the participants bring to the con-
ference, is to divide the conference body into small discussion
groups and confront each group with three very broad questions
that can lead to discussion on a variety of subjects pertaining to area-

Areawide Planning for Independent Living
wide planning. These discussions have been planned to provide two
types of feedback-first, questions that may be directed to the
speakers when the conference participants reassemble from their
group meetings into a general session, and, second, the notes of the
group recorders which will be reviewed and summarized in the con-
ference proceedings. Even with this additional flexibility in the
program, there will be many important topics which cannot be
covered. The conference topic reaches into many disciplines and
professional fields, each of which could be dealt with in depth. It is
believed, nevertheless, that the exchange of ideas and the presenta-
tion of selected topics will provide some new perspectives concern-
ing the areawide planning activities in which we have a common
Knowing that these selected aspects of areawide planning will be
examined by subsequent speakers at this conference, it seems ap-
propriate for this paper to place the subject in the framework of
accepted national goals for older Americans. To do this, we shall
reassert a scheme of values, move back in time to the goals sug-
gested at the recent White House Conference on Aging, view briefly
some aspects of the planning strategy for programs under the Older
Americans Act, and suggest uncertainties which are difficult to con-
trol but important to program success.

In 1960, Jefferson B. Fordham, dean of the University of Pennsylva-
nia Law School, said, "It is not enough to identify goals or objec-
tives of planning without reference to any scheme of values."2 He
then went on to say, "The ultimate unit in society is the individual,
and it is with him that I associate the highest value. As an organized
society, we can provide conditions designed to enable the individ-
ual to develop and to find his own best expression. The values that
I consider most basic here are liberty and equality of opportunity."3
Dean Fordham had a special wish, a dozen years ago, that our value
system on which planning is based be anchored in our concern for
the individual who must look to society for liberty and equality of
Over and over, as we plan social programs for older people, we
are confronted with the question of whether what we do preserves

Elements of Planning-Osterbind and Menke
the dignity, individuality, and fundamental rights of the person
being served. Over the past several decades, rapid social changes
have continually confronted us with the need to reaffirm the value
system to which Dean Fordham referred and to which we generally
claim allegiance.

In planning the 1971 White House Conference on Aging, a great
deal of attention was devoted to the importance of setting well-
defined goals that could serve as a basis for social planning in the
field of aging. In these discussions, the goals specified in the Older
Americans Act were frequently mentioned and, on occasion, re-
ferred to as long-term goals. It was agreed that long-term goals
were laudable, but there was a need to develop short-term or im-
mediate goals that were concrete and more amenable to legislative
response. Thus, the planners for the conference sought to make
these temporal distinctions and to offer recommendations for a na-
tional policy which could be implemented under a "reasonable"
legislative program.
There was an awareness that the recommended policies in the
field of aging should take into account the feasibility of the program
proposals in light of the existing resources and the existing pro-
grams. This meant that it was necessary to think in terms of guide-
lines and criteria. Given the present institutional arrangements and
commitments of resources, our short-term or intermediate goals
can be quite different from our long-range goals. Apparently this
kind of thinking underlies the philosophy of areawide planning
under the Older Americans Act. In effect, the administrators of the
programs are saying, "Because the resources are far less than our
long-range goals call for, we should seek to utilize these resources as
best we can."
As a nation, we must remember that, when we agree to pursue
such short-term goals, we have not reordered our priorities so that
we may attain our long-range goals; we have foregone our long-
range goals because of our unwillingness to alter the status quo to
the required extent. We must also not lose sight of the ultimate test
of any program-the commitment of the resources in the way that
provides the maximum benefit to the individual, given all of the

Areawide Planning for Independent Living
alternative uses of the resources available for this purpose. Dean
Fordham's criteria of freedom and equity, repeated at the begin-
ning of this paper, should not be overlooked in areawide planning.

The term "areawide planning" seems to have chameleon-like ability
to adapt itself to the particular geographic aspects of a number of
different planning conditions. In the process, its meaning changes
radically, leaving only the common base of attention to the area in
which a program will operate.
Areawide planning may indicate that the total geographic area of
the nation and of states is subdivided, and all subdivisions, as well as
all qualified clients of each subdivision, are served by the program.
It may indicate only that all qualified clients of high-priority subdivi-
sions are served, or areawide planning may be confined within a
high-priority subdivision to a "target population" which is essen-
tially locational in character. A project directed toward a ghetto
population-urban or rural-assumes this demeanor. If such an
areawide project is also designed to suggest new techniques and ap-
proaches for service delivery, its resemblance to a demonstration
project may be so close that it defies definition.
The usual understanding of an areawide program, however, is
that of a comprehensive system of allocating resources which does
not exclude any member of a specified class of clients located within
a geographic area from access to the services provided by the pro-
gram. In contrast to the inequities frequently inherent in demonstra-
tion projects, equity in services provided appears to be fundamental
to the concept of areawide planning.
Areawide planning is also assumed to offer more efficient adminis-
tration of a project since it aims to make the best use of existing
organizations, facilities, and other resources in an area. Other ad-
vantages include standardized planning formats and instruments,
single integrated points of entry for needy clients into an assortment
of social and economic services, and a centralized focus of activities
within an area for volunteer efforts and community funding.
It may be deduced that an areawide planning program is princi-
pally a vehicle for the pursuit of short-term goals. The goals may be
classified as short term because they depend almost entirely upon a

Elements of Planning-Osterbind and Menke
reorganization and redirection of what resources presently exist in a
particular area. Much less emphasis is placed either on the introduc-
tion of new service programs or on the extension of programs to
low-priority areas now doing without the services. Moreover, since
the emphasis is on extant activities within an area of a state, area-
wide planning as now interpreted by the Administration on Aging,
for instance, does not incorporate deep review or change in basic
national programs and goals.

In its proposed strategy for implementing the Older Americans Act,
the Administration on Aging recognizes that the barriers to inde-
pendent living are not confined to poor elderly or to the elderly of
any race or place.4 However, the lack of income can be a very effec-
tive barrier to mobility, good health, social activity, and the like.
The strategy statement also mentions that the elderly, particularly
the isolated elderly, may not be aware of where assistance may be
found, even if they possess the means to travel to it. If the passing of
time severs a person's ties with relatives, friends, and even organiza-
tions of a community, he is effectively deprived of the ability to live
alone when his own resources fail.
To quote from the statement, "the Administration on Aging be-
lieves that community resources do exist that can be made to work
for the elderly, and that the community institutions can be made
more responsive to the unique and growing problems of their el-
derly citizens."5 The goal of the areawide program of the Adminis-
tration on Aging, therefore, encompasses the problems of the iso-
lated elderly unrestricted by the income, race, or rural or urban
place of residence of the older person who requires help.
Unfortunately, even so admirable a goal must find its achieve-
ment through the funding accorded it. An early planning document
anticipates this onslaught of reality on ideal goals and the necessity
of channeling available funds by some selected criteria for areas and
populations served. Where isolation is accompanied by lack of
adequate income, housing, nutrition, health care, and the like, inde-
pendent living tends to be especially threatened and institutionaliza-
tion most imminent. Therefore, the "target population" for an area-

Areawide Planning for Independent Living
wide planning project under the Administration on Aging is defined
more narrowly than knowledge of the existing need for services
might suggest.
Factors Affecting Success.-State units on aging administer the
programs in each state under guidelines and directives which may
be expected to affect the success of a program in providing services
for the selected target population. First, according to the Guide for
Implementation of Areawide Model Projects issued by the Adminis-
tration on Aging, it must be possible to identify the problems which
endanger the independence of a substantial number of older people
in an area.6 Second, existing organizations and agencies with pro-
grams related to the identified problems must give some indication
of willingness to coordinate their services to achieve the broad goals
and functional purposes of the areawide program. The guide em-
phasizes that the outcome of this planning-the plan itself-must
offer a reasonable hope of achieving improvement in the conditions
of life of older people.
As Robert Morris and Robert H. Binstock note in Feasible Plan-
ning for Social Change, predictors for program achievement are
hard to come by, and feasibility does not necessarily equal success.7
In fact, it may be less than clear that reaching a goal successfully
would bring about any measurable improvements in life for an
area's elderly. The measures for evaluating accomplishments which
accompany a program may not be able to weigh a program in this
light. Not only are program monitoring and evaluation procedures
undergoing dramatic change, but the basic information about an
area's population, organizations, facilities, and other resources may
be obtainable only at considerable cost. Such shortages in informa-
tion may affect both the planning and the evaluation of a program.
Priority Areas.-Areawide programs of the Administration on
Aging are prescribed at present only for high-priority areas. These
are areas having "identifiable populations of older persons having
priority needs consistent with the national goal established for the
program," "at least 5,000 older persons 65 years of age or older or at
least 3 percent of the total older population of the state," and "suffi-
cient resources within the area for the incremental development or
expansion of an array of services .. necessary to achieve the goals
established for the Older Americans Act."8 The statement from

Elements of Planning-Osterbind and Menke
which these quotations are drawn also suggests that "Such services
must be available and accessible to older persons throughout the
Planning and Service Areas selected as a priority."9 The purpose of
funneling available funds in this manner is to apply scarce resources,
mainly money, to the areas where they are most urgently needed
and where the cost of providing services is lowest. The effects of this
program allocation are to reinforce present funding flows and to in-
crease any geographic imbalance that may exist.
This state of affairs suggests that areawide planning may be a
mixed blessing. The examination of the proper size of an area for
planning and carrying out programs is already helping to stimulate
states to study and simplify their planning subdivisions. The goal of
efficient delivery of services to the consumers is certainly an admira-
ble goal which has many aspects besides the particular concerns of
areawide planning; if areawide planning can assist in the goal's
achievement, the needy elderly will certainly benefit. If it can chan-
nel less-than-optimum funding to the elderly who need it most, that
also is to be desired.
Among the risks associated with areawide planning, the most
obvious is surely the heavy focus on currently operating programs.
The present condition of social and economic programs is under
severe scrutiny, and a further program whose major aim is to shore
up and extend them may be termed by critics at best a holding
operation until a major policy revision occurs. It may be argued that
so long as the distance between this diminished goal and the ex-
pressed long-term goal is clearly understood, the present areawide
programs may be regarded as constructive.
If we allow our program purposes to relate only to short-term
goals, the price in neglect of human needs may be of major con-
sequence. We can never go back and change the miserable life con-
ditions which some of our citizens have experienced, and the man-
power lost through past unemployment is never recaptured. As we
seek to effectively deliver services to the poor, we should always
remember that if poverty were eliminated or greatly reduced,
people would be able to purchase most of the services they need
and to make choices according to their preferences. We should con-
tinually weigh the reasons for not providing services, income, em-
ployment, or anything else. The fact that we have not discovered

Areawide Planning for Independent Living
the best way to make services available is not sufficient reason to re-
fuse to provide adequate services by the means we now have.

Even if areawide planning is carefully conceived, our goals reason-
able and clearly defined, our areas skillfully chosen, we should not
assume that we have eliminated uncertainties. Even the concepts
we use have different meanings. As we look back to the concept of
independent living which was the topic of last year's conference, we
will recall that a keystone to independence is the privilege of an
individual to exercise choices in his style of living.10 However, we
are aware that each of us defines independence in terms of his cul-
tural roots and life experiences which influence his understanding of
independence. For instance, we insist on providing the goods and
services themselves to needy people, and we refuse to provide
people with the income to allow them to purchase these services
themselves, or we place them in subsidized housing. Thus, some
would argue that we obligate them to dependence.
Not only do the very concepts we use lead to uncertainties or
differences in understanding, but the control that we exert over our
programs means control quite frequently of a very small part of the
community activities or the environment in which we work. Obvi-
ously, this environment can be dynamic and changing.
There will be quite different viewpoints about the degrees of effi-
ciency or inefficiency in service delivery. While we believe, without
making a systematic inquiry, that there are wasteful and duplicative
efforts in both the public and private sectors of the community in
service to older people, the measurement of this or any critical as-
sessment of the situation produces differing viewpoints.
We know also that we confront uncertainties not just because of
differences in our understanding of concepts but because of ideolog-
ical differences about the proper approaches to social improve-
ment. Because of deep convictions concerning the desirable types
of social organization, we reach widely different conclusions con-
cerning the most desirable way to improve social conditions and the
desired quality of life for older people which serves as the goal.
Changes in national policy (which may be abrupt) may in a sense
reflect a collision in planning and require not only quick adjustments

Elements of Planning-Osterbind and Menke
in program plans but also searching re-examination concerning the
best way to attain short-term objectives and to blend them with
long-term goals. We know, for example, that the recent efforts to
control inflation have immediately brought controversy concerning
the effects of the efforts of these policy decisions on social programs.
While all of us favor strong efforts to curb inflation, we reach dif-
ferent conclusions concerning the types of efforts that should be

We believe that those working in areawide programs will provide
much useful information and will make accurate assessments of the
successes and improvements as well as the deficiencies in their serv-
ice programs. Welfare and other programs in the United States
have indeed chalked up many achievements. Social workers are
almost without exception keenly sensitive to the life situations of
disadvantaged people and are strong advocates of the need to re-
order social priorities to improve greatly the quality of life among
such people. With the renewed efforts to assess need more accu-
rately and to monitor and evaluate programs more systematically,
we believe that those working in areawide programs will be able to
communicate more effectively with the general public and with the
leaders who shape social policy in the United States.
Looking back to the beginning of the 1960s, Joseph L. Fisher,
president of Resources for the Future, stated, "At the national level
there are the separate functional plans for highways, for urban re-
newal and public housing, for water development, for soil conserva-
tion, and so on. Each of these is articulated principally within the
confines of its own activities and rarely with the other separate func-
tional plans. In nearly every case in which federal money is involved
without being accompanied by complete federal planning and de-
velopment, the states, local governments, or private groups are held
to certain standards of planning and performance, and frequently to
a financial contribution also; but such standards are often loosely set
out and more loosely enforced, allowing wide variations in actual-
ity. This permits adaptability to all kinds of situations, but inevitably
results in what is a hodgepodge from the broad national view-

Areawide Planning for Independent Living
Has there been sufficient change in our federal legislation as we
look to the 1970s to avoid a hodgepodge from the broad national
viewpoint? This question should be carefully considered. Secretary
Richardson recently said, "We must, first of all, create a process of
rational decisionmaking that is both open and honest. The choices
must be made clear and understandable, their advantages and dis-
advantages fully stated, and the alternatives brought into the
We do not want to demean our expectations nor to understate
what we can do. It is important that we have a reasonable match
between short-run expectations and short-run resources and the
same balance between long-run expectations and resources.
Almost certain failure can be anticipated in the Administration on
Aging's areawide programs if planners and implementors assume a
negative attitude toward the achievements that the programs are
capable of producing. It is equally true that the probability of fail-
ure is high if the planning and implementation of these programs are
assumed to be easy tasks. Therefore, it is important to examine real-
istically the barriers to successful accomplishment. If organizational
resistance to the program in an area is astutely observed and an ef-
fective strategy is evolved, feasible objectives may be developed
that focus on action planning, that recognize that our present unco-
ordinated programs do offer opportunities for greater efficiency,
and that envision the need to integrate programs so that more ef-
fective and meaningful services reach the service recipient.
The Administration on Aging's guide to the implementation of
areawide projects affirms that the resources available to its program
will be utilized to develop tests and design innovative solutions to
the problems associated with independent living and active engage-
ment by older people in community life.
This goal, to which most people can subscribe, can be consistent
with the value system we referred to in the beginning of our discus-
sion-"to enable the individual to find his own best expression."
Such an objective can lead us in attaining long-term goals that are
consistent with this value system. However, we should not lose sight
of the fact that such a program may be inconsistent, or may come to
be inconsistent, with long-term goals if a reordering of priorities and
an adequate commitment of resources to accomplish the long-term

Elements of Planning-Osterbind and Menke

goals does not occur. Without such a thoughtful review of our na-
tional goals, our programs can be at variance with the value system
that must underlie long-term planning.

1. United States Senate, Legislative History of the Older Americans Compre-
hensive Services Amendments of 1972, Report No. 92-1287, 92d Cong., 2d sess., De-
cember 1972, pp. 10-11.
2. Jefferson B. Fordham, "Planning for the Realization of Human Values," in
Planning 1960 (Chicago: American Society of Planning Officials, 1960), p. 2.
3. Ibid., p. 4.
4. Administration on Aging, "Proposed Strategy for Implementing the State and
Area Programs of the Administration on Aging Under the Older Americans Act in FY
1973 and Beyond," March 1972 (a draft for internal use by the agency).
5. Ibid., p. 8.
6. Administration on Aging, "Guide for Implementation of Areawide Model
Projects," June 1971 (a guide issued to state agencies for the administration of area-
wide model projects under the Older Americans Act).
7. (New York: Columbia University Press, 1966), pp. 140-41.
8. Administration on Aging, "Proposed Criteria for Selecting Planning Areas and
Agencies for Older Americans Act Programming," March 1972 (a paper drafted for
internal use), pp. 1-2.
9. Ibid., p. 2.
10. Carter C. Osterbind, ed., Independent Living for Older People (Gainesville:
University of Florida Press, 1972), p. ix
11. Joseph L. Fisher, "National Plans: United and Divided," in Planning 1960, p.
12. Elliot L. Richardson, Responsibility and Responsiveness, U.S. Department of
Health, Education, and Welfare Publication no. (OS) 72-19 (1972), p. 6.

Training Administrators for Areawide Planning


DURING THE past several months, we at the Univer-
sity of Michigan have been developing a program, curriculum, and
materials for training administrators of areawide services for the
aging. As we pursued this task, we have faced over and over the
question of what kind of educational package for planning can be
developed to help prepare for this function and responsibility. I
know that a high level of competence will be required to function
successfully in a planning role, unless services and programs for the
elderly or for other constituencies are more tractable and simple
than they have been in the past.
We have no model of success, no campaign strategy from past or
present experience that gives us a curriculum and program design
which might be simply adapted to a new and different terrain.
There are many lessons from experience which almost certainly
would be useful, but it is a most complex task to sort out and adapt
such experience. But in the field of aging, dissatisfaction with a lack
of planning and concerted decision-making in past experience
under the Older Americans Act has led to a determination to de-
velop an administrative competence in planning. However imper-
fect the process, it is considered unacceptable, if not intolerable, to
proceed without planning.

Training Administrators for Planning-Vasey
What is this process called planning? I know that others have
dealt at this conference with the subject of what it is, so I will not
risk redundancy. I sometimes think, as I look at the varying ap-
proaches to this subject, of Bertrand Russell's reference to the
nature of electricity. It is, he declared, better known for what it does
than for what it is. I find it useful, however, to put this statement in
perspective by a definition by Edward Banfield, who described and
in a sense defined planning in these terms: "Planning is generally
regarded as a method for delineating goals and ways of achieving
them. There is no agreement, however, as to the precise nature of
this method."'
Planning proceeds from policy, and in a sense, policy also pro-
ceeds from planning. In an interview with Marvin Kalb on CBS,
Henry Kissinger made a comment on policy and its uses which has
more than a little relevance to the subject of this meeting. While his
focus was on questions of foreign policy, he somehow moved with
the interviewer into a general discussion of policy, including domes-
tic. In effect, he stated that any assumption that policy can be
planned and prescribed with such precision and prescience that it
can then simply be followed is at best naive. He went on to say that
actors in the realm of administration do not consult policy planners
when action is required. It is more likely that these planners, how-
ever impressive their credentials and intellectual abilities, are likely
to be relegated to a relatively impotent role, occupying a corner of
the organization, writing statements on abstract questions, but
having little to say about the vital day-by-day decisions of adminis-
Yet, he went on to say, it would be equally wrong to go to the op-
posite extreme and to become obsessed with tactics to the point that
the administrators are encouraged to forget what they are working
for. Efficiency, skill in dealing with others, the ability to persuade
and to influence, are important attributes. They are not, however,
ends in themselves, but rather means to the end of achieving some
This, in a sense, is like the distinction someone once made be-
tween a statesman and a politician-the politician thinks about the
next election and the statesman about the next generation.
One point is obvious. Whatever our skepticism about the effec-

Areawide Planning for Independent Living
tiveness of prior planning, we cannot rely on inspired planlessness,
on improvisation on the spot, as the only way to provide community
services to older people. If a priori planning cannot provide a com-
plete, impeccable blueprint for action, and if we also cannot rely
completely on the judgement of the program operators to provide
a decent system of services, what is the best approach?
Some years ago, when speaking of the fear that many have of the
frailties of inspired planlessness and complete reliance on impro-
vised solutions, I recounted my experience as the director of a local
urban antipoverty program. Those early days of the war on pov-
erty were an agonizing period for the administrator of a local plan-
ning agency. He found himself beset by pressures from many sides.
Local people were expecting miracles. The publicity with which the
program had been launched had been tremendous. The proclama-
tions of intent were coming from all sides. Unexpended money for
the programs, which was never close to adequate for the announced
objectives, was piling up. Wanting to do what should be done with
wisdom and good judgement, but not being permitted the luxury of
waiting until I felt reasonably sure of the outcome before approving
a project or a plan, I decided to find solace in coining a new term-
retroactive preplanning. It didn't solve my problems, but it made
me feel better. At least I had the process labeled.
The poverty programs are now history and, like many other ven-
tures of that period, are part of an experience which many now are
apparently willing to write off as an unqualified failure. As I listen to
this constantly repeated theme of failure, I try to remember whether
anyone ever really defined success. So far my memory has failed
me. So I am compelled to assume that all of these governmental
programs fail to do whatever it was that they were supposed to do
without knowing what that was. I shall have to go on listening to the
dismal theme of the alleged failure of housing for the elderly, for ex-
ample, without having any perspective provided on how it is or was
to have done any good at all, including provision of some decent
places for many of our elderly citizens.
Frankly, I think that the protestations of failure, like the promises
of success, are so overstated that planning for anything in the future
is extremely difficult. We have so little faith in what has been done,
and so much need to get something accomplished, that we are in

Training Administrators for Planning-Vasey
danger of resorting to sweeping new measures which in time will
run their course and perhaps lead also to inevitable bitter disillusion-
ment. We have scaled down our lofty rhetoric, but I don't find too
much comfort in the implicit promises of the lexicon of business
management. I am referring to the language of "management by
objectives" and the whole battery of technologies which are now
being offered. It is true that the road we are traveling has been
paved with the unfulfilled good intentions of the past ten or twenty
years. But like these other methods and approaches, the one cur-
rently popular may also suffer the fate of having its outcomes
measured against grossly overstated prospects. I believe that there
was a ritual of service developed around input measures and that it
was falsely assumed that, if this ritual of service were faithfully fol-
lowed, good must inevitably result. Insufficient attention was given
to the determination of whether measurable or comparable results
were attained. I believe also that the substitution of a ritual of man-
agement for a ritual of service will not solve the problem and that
management also must be concerned with substantive content of
program and with service outcomes. It must also take into account
those factors which cannot be measured. I hope that we will not
succumb to a disposition to assume that that which is not precisely
measurable is ipso facto not good. This would result in a distortion
at least as bad as that which has characterized our efforts in the past
several years.
Whatever the design for planning, the significance must be related
to the importance and feasibility of its goals. Abraham Kaplan has
described a plan as "a configuration of goals" which are presented as
consistent with each other and as grounded in the facts of the case
and specified in a sequence of actions. He sees planning as particu-
larly a function of determining jointly ends and means. "Without
this reciprocal determination," he states, "action is directed to lim-
ited objectives having no significance beyond themselves, while
aspiration drifts into fantasy, without purchase in the real world."2
The point of this statement is the reciprocal nature of ends and
means, of goals and actions. Anyone engaged in the administration
of a planning agency soon learns that he invites disastrous drift if he
starts without a plan, but it is foolish to refuse to modify objectives
in the light of experience. We are really speaking of the policy of

Areawide Planning for Independent Living
planning as it relates to the politics of execution. As Roland Warren
has observed, English speaking people have been both helped and
hindered by having available two words-politics and policy. The
position of these two words permits a distinction between broad
guidelines for action and the processes that determine them. But
having separated the two words, we seem to have trouble getting
them back together. Many languages have only one word (the
French politique, the German politik to denote the what and the
how) but, states Warren, users of the English language must make
that special effort to fuse the two. "To neglect the what is oppor-
tunism. To neglect the how is utopianism."3
As we consider today the need for competence in this complex
and demanding process of planning, and as we are confronted by
the present prospect of initiation of areawide plans, what may we
say about training? It seems quite clear to me that it is wise to put
the emphasis on developing the abilities of people who will be en-
gaged in the process, rather than on the process itself. In the many
and varied circumstances which will confront the areawide plan-
ners, it seems to me that it would be ridiculous to assume that any
formula or method could be provided which would make unneces-
sary the development of the personal skills and abilities of the area
planning personnel. It would be nice if we could have a pro-
grammed approach which could be pursued with robotlike consis-
tency, but we must face the fact that it is the actions and reactions
of the planner-his human characteristics, his responses to the pres-
sures which are brought to bear on him, the threats and blandish-
ments of circumstances which cannot be anticipated in advance-
that will largely determine his success or failure.
Having suggested all this by way of background, I shall now ask
two questions: What can be imparted through formal training, or
conversely, how much can be learned only through direct ex-
perience? And what components that can be taught may effectively
be presented in a training program, particularly short-term training?
The importance and urgency of these questions is obvious.
We are going to be confronted very soon with a substantial job, and
we shall be asked to do it before we can have any certainty that we
are prepared with a design and technology for area services to older
people. There is nothing new about this. Seldom do we time our

Training Administrators for Planning-Vasey
programs of human services to coincide with the availability of
qualified and competent manpower. We seem almost inevitably to
be caught in a situation in which we have to muster our forces to
catch up with the demand, to meet what is or is about to be over-
whelmingly upon us. This has been true of every program with
which I have been associated or which I have observed in the past
thirty years or more, from the earlier, stirring calls to arms of the
New Deal and the Great Society to the White House Conference on
Aging in 1971. The demand for competent administrators and
planners will anticipate the supply of such people and the pressures
to get them on the job with the ability to do something at least fairly
well will be no less intense than in the past. Training, it would seem,
must always be stuck with helping people to catch up with com-
mitments, but training must be undertaken with a sense of its limits
as well as of its potential contributions.
At the beginning, an effort should be made to establish guidelines
on goals and objectives. The hope for planning depends largely on
an understanding of what we are planning for. If it is specifically
program related, we will be that much more on target. It may be
that there are galloping generalists who can develop an abstract
process to a point of effectiveness which will apply in all circum-
stances. Certainly general goals should be promulgated, but we
should also be aware that at a sufficiently high level of abstraction all
can agree. Such agreement is largely meaningless. I am sure that
almost everyone could subscribe to a goal of "providing a high
quality of life for our older people." There probably would be little
quarrel with the stated objective of improving the opportunities of
older people for independent living, but when we get to the point of
determining the means to be followed to achieve these broad ends
-or even before that, to the more specific objectives of particular
programs-we find that agreement does not come so easily.
The definition of goals may reflect the predilections and prefer-
ences of the planners. In the material which has been developed at
the University of Michigan for the training program for area plan-
ning, we have suggested a number of task definitions or objectives of
areawide services which have been presented in hypothetical form
to illustrate the different views which might be taken.
One planner might see the objective of a planning agency as that

Areawide Planning for Independent Living
of providing a funnel through which money should go and that it
should probably go where the need is greatest and the services are
scarcest. A second might see the primary objective as elimination of
duplication, waste, and inefficiency. A third might perceive the
objective as getting older people to start talking up in their own
behalf, then getting other people to advocate for them. A fourth
might see the task as providing a decent information service to
which all agencies and their constituencies could relate. Another
might perceive the objective as providing a cement to bind people
together in an effort to serve older people. A sixth might see it as
providing a balance between long-term goals and short-term vic-
As we get into the process of training, we must perceive that all of
these are probably valid objectives and that the task of training is to
learn to identify common threads among these various valid objec-
tives in the apparently tangled skein of differing mission statements.
The challenge is not only to identify those threads but to help peo-
ple learn to weave them into a pattern. This pattern must be tailored
to the differing needs of specific communities. I believe it is not
overstating the case to say that the pressure for areawide planning
has come from the lack of a statewide or national objective or set of
objectives. Perhaps there has been too much yielding to the impor-
tunities of local pressures and too much opportunism. Nevertheless,
it would be a mistake of serious proportion to disregard variations
and to fail to help people being trained for planning to perceive the
importance of fitting the garment to the local frame. Training can-
not provide a person with this ability, but it can alert him to the
need to develop it.
This brings me to what I think is an important distinction between
what can be taught specifically as a skill or technology and what
cannot be taught in this way. We can teach certain technologies:
budget and fiscal controls, grant writing (this is a fine skill which
should be preserved for future use when there may be grants avail-
able), information exchanges, the development of planning in-
formation and its uses. It is important to learn service program eval-
uation, and I hope that my skepticism regarding the risks of
domination by such technologies has not given the impression that I
think that they have no great value. Service programs do pose eval-

Training Administrators for Planning-Vasey
uative difficulties. Such qualities as dignity, independence, equality,
and personal security do not yield easily, if at all, to mathematical
analysis. Yet I think we have an obligation to try to evaluate output
instead of continuing to be preoccupied with internal or input
measures. I suppose that I am really suggesting that there is a danger
that the instrument may set its own goals and that the medium will
become the message. One might say that if you can't measure the
progress toward the goals, don't change the method, change the
goals. I am sure that some day we shall develop the capability to use
our evaluation and monitoring technologies in a way that sustains
our effort to develop processes consistent with established goals..
One of the most important technologies among those listed is in-
formation development for planning purposes. It is important,
particularly with all the varied local situations, to determine whether
prior judgements about the mission are appropriate to that local
It is relatively simple, however, to identify the tools and tech-
nologies which a person must learn. It is much more difficult to
decide how much expertise the learner needs as an administrator-
planner in order to utilize these technologies effectively. Some might
even say that there is some risk in his becoming too steeped in these
technologies, to the point that he becomes an expert. One is re-
minded of the observation made by the famous British writer
Harold Laski years ago in his essay on the "Limitations of the Ex-
pert." He declared that the expert sacrifices the insight of common
sense to the intensity of his experience. This is a concern and a fear
which has been felt by many over the years with reference to the
technician or professional whose training requires an intensity of
knowledge and involvement.
Frankly, I don't think that we have resolved the question of how
much a person needs to know about something in order to make
good use of it. What do we mean by minimum mastery for adminis-
trative purposes? Obviously the planner is not going to be the evalu-
ator, monitor, information developer, accountant, and fiscal expert.
He may be any one of these things before he gets into an organiza-
tion, but he must develop a broader range of vision than intense pre-
occupation with any one area permits him. Yet a little knowledge
can be a dangerous thing with reference to these various tech-

Areawide Planning for Independent Living
nologies, and I think that one of the challenges we face in training_
for areawide planning is that of ascertaining how much one really
needs to know about any and all of these techniques in order to
make good use of them.
There is also a personal and psychological payoff to the learner in
mastering a body of knowledge and information. It gives him not
only useful tools but a sense of mastery, of confidence and identi-
fication with his program. Knowing that there is an objective body
of knowledge and a system of operation will give him greater con-
fidence in relating his judgment and his skills to the planning and
administering process.
We should not forget that planning is essentially an administrative
and political process, not a technical one. This is where the problem
of training becomes more acute. We are now speaking of a process
which requires a degree of sagacity that can be learned only by
direct personal experience. Area planning and coordination require
the ability to mobilize other people and a high degree of skill in
working with them. It is a kind of ability which comes with the per-
son and cannot be imparted as a political technology. A good plan-
ner is essentially a good administrator, not an Olympian figure
swiveling on his pinnacle of sapience. His style and his personality,
no less than his techniques, must be adapted to what the program
In essence, the training process can help alert the person to the
realities he will face and to make him conscious of what, for want of
a better term, we might call the political and human relations as-
pects of his job. By alerting him to that reality and by helping him
develop a sense of appropriateness of his actions in relation to the
program, the training process can make a definite contribution.
What are some of these teachable components or factors to which
the potential planner-administrator must be alerted? First, the limits
of power should be part of the subject matter to be taught to poten-
tial planners. They can define needs and problems and can sustain
and accelerate an existing momentum, but it is highly questionable
whether the planner has the power to reverse the direction of pro-
Planners can be alerted to the importance of understanding the
possibility, or even probability, of unanticipated consequences. If

Training Administrators for Planning-Vasey
they assume that outcomes can be predicted with any degree of
precision, they are in for serious disillusionment.
Planners can be helped to understand dilemmas. Many policy
issues do not have unequivocally right or wrong answers. This is an
important aspect of knowledge. It helps provide a perspective on
successes or failures. Accomplishments are valued for what they are
rather than for what they fail to be.
The politics of the interorganizational field should be understood
by the person who would be engaged in planning. The problems of
achieving domain consensus are formidable. The fight for turf, how-
ever disguised in polite rhetoric, can be savage and relentless. It
helps the planner if he understands this phenomenon and if he is
aware of the possibilities of transformation of what was meant to be
a structure of collaboration into an arena for conflict.
The planner needs to be alert to the tendency toward satisfying
behavior on the part of agencies, namely, fulfilling the purposes of
the organization rather than the needs of a constituency served.
A perspective should be provided also on participation by the
elderly population. It isn't so much a question of techniques of ad-
vocacy and involvement, although these are important, as it is one
of developing a view of the elderly as people with capacity to make
responsible decisions respecting their needs and their wants. Per-
haps in the distinction between these two terms we find a clue.
Margaret Blenkner, from her experience in research in protective
services and other programs for the elderly, has made this distinc-
tion in a way that should be understood by people who will be
engaged in planning. Needs are often defined by others. Such defi-
nition may be legitimate, but the level of wants should also be con-
sidered, that is, services and programs desired by the elderly and
evaluated on their terms. I think that we have evolved over the years
a view of constituency served which creates problems of perspec-
tive. As we have spoken traditionally of "clientele," we have by such
usage imputed to the people served a dependent role. Whatever the
realities of the life circumstances of the elderly, there is no reason to
assume that simply by reason of becoming sixty or sixty-five years
of age, they no longer have the capacity for citizenship.
Planners need to be acquainted with informal as well as formal
service delivery systems. Frequently it is the informal network of

Areawide Planning for Independent Living
services that will best meet the older people's needs and fulfill their
wants. Friends, relatives, people to whom they customarily turn,
members of their own age group, should all be regarded by the
planner as important factors in human services for the elderly.
Another area of learning I think must be included in a training
program for planners of services for older people is the phenome-
non of aging in American society. How the planner regards this phe-
nomenon and the degree of understanding he has of its nature will
have an impact on his decisions as a planner and on his negotiations
with the various forces with which he must work. For this reason we
have included in our training package a substantial volume called
"Aging in American Society." I do not believe that we can teach
planning in a vacuum. We must teach it not only in relation to the ex-
pectations of a program but also in relation to the phenomena with
which it is designed to deal. How people feel about aging and the
elderly will have much to do with the way they behave as adminis-
trators and planners. A pessimistic view of aging as a decremental
process will lead to overemphasis on custody and humane care
rather than on opportunities for positive interaction with the elderly.
The goal of increasing the opportunities for independent living will
be fostered only if the people involved in the program believe it
possible for older people to have such capacity. A view of old age
as pathology and decrement must have a distorting effect on priori-
ties for service and allocation of resources. I believe that the
planners need to know as much as they can be taught about the
demography of age and the economic circumstances of the elderly
so that they will have a better understanding of the conditions with
which they are confronted.
How much of all this can be taught in a short-term training pro-
gram? Probably little can be imparted in such a framework unless
the process is related to the ongoing activities of the administrator-
planner and unless there is a continuing process of interaction be-
tween experience and training. It seems to me that this must be built
into the training program from the beginning and must be sustained.
All processes have limits, and learning is a process of development
through experience, fostered by initial and continuing education. It
is my hope that this will be the pattern as our national program of
areawide services for aging develops throughout the country and in

Training Administrators for Planning-Vasey

the various regions within the states. It is hoped that experience will
provide an arena for learning as well as doing, and that training and
operation will be integrally related. Perhaps over time we shall
master this complex and demanding process.


1. A Dictionary of the Social Sciences, eds. Julius Gould and William L. Kolb
(Free Press, 1964), p. 503.
2. Abraham Kaplan, The Conduct of Inquiry (San Francisco: Chandler, 1964),
p. 404.
3. Roland Warren, The Politics of the Ghetto (New York: Atherton, 1969), p. 12.

The Delineation of a Region


IF AREAWIDE planning is to be accomplished, there
must be agreement on the boundaries of the areas in which, or for
which, the plans are made. Agreement on area delineation has not
yet been attained and developing a uniformly acceptable system of
areas is not a simple task.
I will first suggest some variations in areal delineation that now
exist. Then I will briefly supply some of the principles that underlie
the process of determining regions scientifically and suggest some
procedures for future use.
I will use the state of Florida as an example because I have made
a considerable study of the areas of Florida and because many of
you are familiar with this state's geography. I suspect that those
from other states will be able to apply the generalizations-though
not the details-to their situations.
In the table which groups the counties in Florida according to the
regional system devised by the Florida Department of Adminis-
tration, the number which designates the region to which any one
county is assigned is listed in column 2; the regions bear the same
numbers on the accompanying map. The present regional system
used by the Florida Department of Health and Rehabilitative Serv-
ices is represented in column 3.

Delineation of a Region-Thompson

The numbers in column 4 indicate the regional planning organiza-
tion, if any, to which each county belongs. Many counties belong to
no planning district. The districts that do exist are, in almost every
case, composed of combinations of counties different from the ad-
ministration districts in column 2. These examples in the variation
among schemes for making an areal division of the state can be
multiplied many times as we consider road districts, congressional
and legislative districts, and others.
The question, then, is how one can divide a large area such as a
state or nation into smaller areas or regions for planning, administra-
tive, or data-gathering purposes.

According to one dictionary, a region is "a major indefinite division
of inanimate creation." These words imply that there are regions
which exist without any effort of man and without any definite
natural limits. When one begins to define the limits of such regions,
one must select which natural phenomena are to be considered and
ignore the others. Hence, geographer Derwent Whittelsy could
write, "A region is not an object self-determined or nature given. It
is an intellectual concept . created by the selection of certain
features that are relevant to an areal interest or problem and by dis-
regard of all features that are considered to be irrelevant."'
One type of region based on definitions of natural phenomena is
a drainage area such as the Ohio-Mississippi-Missouri valley or inte-
rior basin. Florida is part of two drainage areas-Atlantic coastal
and Gulf coastal, the dividing line between them being the water-
shed which runs down the center of the peninsula and separates
streams that eventually flow into the Gulf or Atlantic. People in New
York have a fairly clear idea of the area meant by the term "Hudson
Valley." In Pennsylvania the natives are aware of the differences
between the Conestoga Valley and the Susquehanna Valley. In
Florida such natural divisions are not as commonly referred to,
despite the efforts of conservationists to set aside the Suwannee
River basin as part of the wild rivers program.
More fundamentally the Florida Department of Natural Re-
sources has set up five water management districts following the
boundaries of river basins of Florida. State Senator Robert Graham


(1) (2) (3) (4) (5) (6) (7) (8) (9)
Florida Florida Department of Regional Census state Number of Census Publication Bureau
Department of Health and planning economic persons aged county center of dominant of Economic and
County Administration Rehabilitative Services organizations areas (1950) 65 years & over group (1970) metropolitan newspaper Business Research
(Numbers or letters refer to the region or group to which the county is assigned.)
Escambia 1 1 1 1 1 35 P P
Okaloosa 1 1 1 1 35 P P
Santa Rosa 1 1 1 1 1 35 P P

Bay 2 1 2 1 2 34 L P
Calhoun 2 2 2 1 2 34 TY P
Franklin 2 2 2 1 3 34 TY TY
Gadsden 2 2 3 3 34 TY TY
Gulf 2 1 2 1 2 34 TY P
Holmes 2 1 2 3 2 34 P P
Jackson 2 2 2 3 2 34 P P
Jefferson 2 2 3 3 34 TY TY
Leon 2 2 3 3 3 34 TY TY
Liberty 2 2 2 1 3 34 TY TY
Wakulla 2 2 2 1 3 34 TY TY
Walton 2 1 2 1 2 35 P P
Washington 2 1 2 1 2 34 P P

Alachua 3 3 5 3 4 31-2 G G
Bradford 3 3 2 4 31-3 J J
Columbia 3 3 3 4 31-3 J J
Dixie 3 3 2 4 31-2 J G
Gilchrist 3 3 3 4 31-3 G G
Hamilton 3 3 3 4 31-3 J J
Lafayette 3 3 3 4 31-3 J J


St. Johns


Indian River


3 2 3 3 34 TY TY
3 3 3 4 31-3 J J
3 2 2 3 34 TY TY
3 3 3 4 31-3 J J

4 4 4 3 5 31-3 J J
4 4 4 2 5 31-3 J J
4 4 4 2 5 31-1 J J
4 4 4 7 32-3 D O
4 4 4 2 5 31-3 J J
4 3 2 4 31-2 J J
4 4 4 2 5 31-2 J J

5 6 5 6 33-6 TA TSP
5 6 5 6 33-6 TA TSP
5 3 2 4 31-3 G G
5 3 5 4 31-2 L G
5 6 5 6 32-3 TA O

6 5 6 4 7 32-2 O O
6 8 6 4 9 33-8 M M
6 5 6 5 7 32-3 O O
6 5 6 5 7 32-1 O O
6 5 6 5 7 32-2 O O
6 5 6 5 7 32-1 O O
6 5 4 7 32-3 D O

7 9 5 8 33-7 TA TSP
7 9 5 6 33-7 TA TSP
7 9 5 6 33-8 TA M
7 8 6 9 33-8 M M

(1) (2) (3)

(4) (5) (6) (7)

(8) (9)

(1) (2) (3)



Palm Beach
St. Lucie

(4) (5) (6) (7)

- 5 6 33-6

(8) (9)



a. Serving 20 per cent or more of the households in the county.
- County is omitted from coverage.

Letters in last two columns refer to Florida cities:
D, Daytona G, Gainesville
FL, Ft. Lauderdale J, Jacksonville
FM, Ft. Myers L, Local paper

NOTE: See map of planning areas on page 32.

M, Miami
O, Orlando
P, Pensacola

SA. Sarasota
SP, St. Petersburg
TA, Tampa

TSP, Tampa-St. Petersburg
TY, Tallahassee
WP, West Palm Beach

Delineation of a Region-Thompson
is quoted by the press as telling Governor Askew that these basins
should be used in determining planning regions in Florida because
"water is the key to Florida's future." Secretary of Administration
Kenneth Ireland was reported to be unimpressed. He indicated he
would not split counties in determining planning areas. One cannot
quarrel with this because planning basically involves people, and
people want water or any other natural resource to be their servant,
not their master. People have chosen to organize themselves into
political units-hence the search for rational areal delineation next
turns to political subdivisions.

A political region can be defined as an area subject to common
governmental structure. Its homogeneity is, therefore, basically an
imposed one. In this country, state boundaries were laid out without
much regard for the location of different types of resources which
have led to the development of economic activities over the years.
Rivers have often been used as boundaries of states or counties,
despite the fact that the people who lived on each bank carried on
economic activities, farming, for example, which gave them more in
common with each other than with other people in the same polit-
ical unit who live in the uplands beyond the valley.
Since counties are smaller than states, they might be expected to
be more homogeneous economically, but this is not necessarily true.
Dade County has the second largest number of workers employed
in agriculture of all counties in Florida, and the largest number of
nonagricultural employees of any Florida county. Unsatisfactory as
they are, however, counties must be used as the basic unit of geo-
graphical economic analysis for two reasons: data are not generally
available for smaller political units, and counties are a fundamental
part of the political administrative structure of the state.
On the other hand, areas that are larger then counties but smaller
than states have been created to deal with problems which extend
beyond previously determined boundaries. As suggested, adminis-
trative and planning regions are composed of one or more counties.
Traditionally, legislative and congressional districts were also
composed of groups of counties until strict adherence to the one-
man-one-vote principle made it necessary to split counties.

Planning areas established for Florida by the Department of Administration, 1973

Total population Population aged
Region (1970) 65 and over (1970)
1 331,262 18,467
2 333,458 29,560
3 215,142 17,790
4 662,263 53,840
5 132,825 21,089
6 958,060 118,370
7 295,911 39,209
8 1,306,077 292,910
9 186,343 35,936
10 2,368,102. 362,195

NOTE: The Department of Administration in May 1973 added an eleventh region
composed of the counties of Palm Beach, Martin, St. Lucie, Indian River, and

Delineation of a Region-Thompson
Anyone who has made a cursory study of the economic conditions
within political subdivisions is aware of the lack of homogeneity.
While the common interest that influenced the original delineation
of state, county, and municipal boundaries probably included
economic and social considerations, these seem to have been sub-
ordinated to political factors or simply to convenience.
In 1950, the Bureau of the Census defined an economic area as a
relatively homogeneous subdivision of a state, consisting of single
counties or groups of counties which have similar economic and
social characteristics. The Bureau of the Census established a na-
tionwide system of economic areas, such that each economic area
had certain significant characteristics which distinguished it from
the other areas which it adjoined. Factors considered in establishing
these areas were industrial and commercial activities and demo-
graphic, climatic, physiographic, and cultural factors. Standard
metropolitan areas of 100,000 population or more were considered
to be a special class of economic area because the nonagricultural
economy of such an area is "a closely integrated unit and distinctly
different from the economy of the areas which lie outside the orbit
of close contact with the metropolis."2 Column 5 shows the assign-
ment of counties to the state economic areas for Florida.
This effort to delineate economic areas was described by Rutledge
Vining as one whose objective was to prepare "an optimal set of
geographic areas for the purposes served by the Census Bureau."3
He concluded that the bureau was proceeding on the theory that
there was such a thing as a natural area unit, each one of which
could be considered an operating unit. Vining did not accept this
concept. He believed that, for each research worker who was seek-
ing to describe economic phenomena or test some hypothesis, there
might well be an optimum set of areas, but these would differ from
each other. To study society or the economy, one must approach it
as a system and this can be done without reference to any particular
set of geographic subareas. Vining preferred an approach based on
density of population and economic activities of the type of central-
place system rather than the homogeneity of economic activities
within geographical areas.

Areawide Planning for Independent Living
To follow Vining's suggestion for developing economic areas, one
starts with "economizing units" which are engaged in production,
distribution, exchange, or consumption. These may be individuals,
families, farms, business firms, or other types of organizations. The
center of interest is not the behavior of the individual unit but of the
system of units which are devoted to some defined specialized task.
One begins by locating each unit on some system of spatial coordi-
nates, and then finds that the units tend to cluster in certain areas.
Ideally, the spatial coordinates would be a grid that could be
readily identified from a map of the area. The township system that
was developed in many of the midwestern states or the block sys-
tem in most of our newer cities are examples of such grids. By
plotting the number of incidents of some phenomenon with refer-
ence to the nearest intersection of the grids, the density of that phe-
nomenon would become evident. If one uses his imagination and
thinks of the phenomenon as having thickness as well as length and
breadth, one can envision a relief map with lines of relative density
not unlike contour lines of elevation of relief maps.
For example, suppose one were measuring the extent of farming.
A number of different units of measure might be selected: the num-
ber of persons engaged in agriculture, the number or proportion of
acres under cultivation, or the value of crops harvested. The meas-
ure of any one of these variables at Main and Bay streets in Jack-
sonville is zero, but at the intersection of two grid lines in the heart
of the citrus country near Clermont, the value might be quite high.
Similarily, one could prepare contour maps for other economic
activities such as fishing, forestry, manufacturing, or retailing. No
two of these would look alike. Concentration would occur in differ-
ent places or at least in different relative densities. Contours of mini-
mum density would also follow different patterns. But in each case
there would be contours of minimum density surrounding each
peak of concentration. One could then delineate regions by marking
these contours more heavily than the others. So the economic areas
are born without regard to rivers, soils, climate, or other "natural"
But there is no such grid. In Florida and other southern states

Delineation of a Region-Thompson
there is no system of six-mile-square townships. There is a system of
counties and these form the grid, however imperfect, which can be
used as a practical basis for constructing contour maps of economic
Note, however, that emphasis has been shifted from that de-
scribed before. The Bureau of the Census attempted to construct
its system of economic areas in 1950 by determining the dominant
economic activity in each county and considering each one to be
more or less homogeneous. When using the density principle,
counties are used merely as a means of aggregating information.
Heterogeneity is recognized to be rampant. A different system of
regions is developed for each phenomenon studied. We are no
nearer a goal of determining a basic system of economic areas.

One approach to creating areawide planning programs for older
people would be to develop planning districts using this density
principle and employing the number of persons 65 and over as the
variable of interest. For this discussion, let us assume that all of
Florida's counties are the same size. The centers of these districts
might be the counties having 10,000 or more population 65 and over
in 1970. Areas to be delineated around them would consist of coun-
ties with decreasing numbers of such persons.
There are sixteen counties having more than 10,000 persons 65
years of age and over. Of these, all but three are Standard Metro-
politan Statistical Areas (SMSAs) or parts of SMSAs. Of the four-
teen SMSAs in Florida, all but two have 10,000 or more elderly per-
sons. These two are Gainesville and Tallahassee. Bay County
(Panama City) has almost as many persons 65 and over as does
Leon, and Marion County has more than Alachua. By somewhat
arbitrary assignment of counties with small numbers of senior
citizens, areas could be developed similar to those indicated in
column 6. Every such area except region 2 has at least one SMSA.
Region 2 has as a central city Panama City which has over 5,000 per-
sons 65 and over.
To delineate areas for the administration of programs for the
aged is to make the assumption that their needs are unique. While to
some extent they are, many are shared with people of other age

Areawide Planning for Independent Living
groups. For example, the census provides data for 1969 on the
number of persons living in families with incomes of less than the
poverty level. The percentage of these persons who are also 65 and
over is fairly high, particularly in counties with large numbers of
older people. In Dade County, 23 per cent of those at the poverty
level are over 65, in Broward 26 per cent, and in Pinellas 42 per cent.
It is doubtful that programs designed to aid the poor would dis-
criminate against people of different age groups. In a recent issue of
Economic Leaflets, it was stated that there are a great many "fed-
eral, state and local programs relating to health and rehabilitation
services, hospital planning, education, recreation, flood control, cor-
rection and probation, transportation, sewage treatment and land
management." Older people are, to a greater or lesser extent, the
beneficiaries of all these programs. Separate planning, or planning
by separate agencies, for senior citizens may not be necessary or
desirable in many of these programs. What is needed, then, as the
authors point out, is "a beneficial geographic substructure that will
be the result of combining expertise from government, business,
economics, geography, political science, sociology"4 and so on.
Kenneth Ireland, secretary of the Florida Department of Admin-
istration, is reported in a newspaper article to have established a
new set of regional planning districts to be used in coordinating all
planning, from highways to hospitals, by local, state, and, he hopes,
federal governments. He declared that regions should be so
designed as not to cut across established patterns for transportation,
communication, employment, consumption of goods and services,
and other activities. I agree with this, but I would be more specific
and state that areas delineated in terms of the movement of people
into and out from the major centers of population should be utilized
for planning and administration in a way similar to that by which
they are utilized for economic analysis, marketing, finance, and

At the Bureau of Economic and Business Research we collect and
publish a great deal of economic, demographic, and business infor-
mation. We have been seeking to describe a geographical unit larger
than an SMSA or county, but smaller than the state, for aggregating

Delineation of a Region-Thompson
these data. The results of our search to date are published in two
articles in Economic Leaflets.5
Briefly, these are the processes used in arriving at these areas. It is
my contention that for the consumption of goods, entertainment,
health services, sports, or government services, the elderly travel to
the same centers as everyone else. At the same time the dissemina-
tion of information by newspapers, television, radio, and personal
contact flows from the major central places to people within its area
of dominance, regardless of the ages of the recipients.
The first step in the delineation of general communication or mar-
ket areas is to select the central cities where the places of concentra-
tion of activities occur. People who engage in production or distri-
bution'or government or private service organizations, as well as
children and retired persons, have at least one common character-
istic: they all consume and, in order to do so, they patronize retail
stores. Brian J. L. Berry, a geographer at the University of Chicago,
writes that retail and service businesses are "at the end of the chain
of production and the beginning of the process of consumption."
For this reason, he claims it is in the geography of retail and service
businesses that we find the "vital equilibrating interface between
the geography of production and the geography of consumption."6
Furthermore, the density of retailing follows closely that of popula-
tion in general and that of persons 65 years of age and over.
For example, 35 per cent of the total population, 33 per cent of
those 65 and over, and 31 per cent of retail sales in Florida are con-
centrated in three counties. If we list all the counties having 1.0 per
cent of the state's population or more, they account for 86 per cent
of the total. They also include 89 per cent of persons 65 and over
and 90 per cent of retail sales. Retail sales do seem to represent an
equilibrating force. Hence, the population centers can be selected
as central cities for delineating market areas. For this purpose we
shall use the major standard metropolitan statistical areas which,
according to the Bureau of the Budget, are recognized as integrated
economic and social units. They have not only extensive facilities
for retail and service trades, but also for professional and health
services, entertainment, sports, and governmental and legal agen-
cies. Most important, from our viewpoint, they are centers for the
media, principally newspapers and television stations, by which in-

Areawide Planning for Independent Living
formation is dispersed to the public and which through their notices
and advertisements draw people into the center from the hinterland.
Once centers have been selected, the problem is again one of
determining the breaking points between the areas within the orbit
of one center and those surrounding it.
We can utilize the concept of peaks and valleys. Almost any phe-
nomenon has the highest measure at the point of the central city.
We have already noted that retail sales volume is distributed in a
manner that parallels population. Research shows that other meas-
ures-wholesale sales, recreation and educational facilities, pro-
fessional and health facilities-by and large parallel population, too.
It seems to me that older people will follow generally the same
patterns of shopping and attending functions of all kinds as does the
general public. Those who wish to communicate with persons over
65 will find the principal media-newspapers and television-the
most useful means of doing so. Those engaged in social planning will
need information from the area. It behooves all of them to use, if
possible, the areal breakdown that most closely represents the
homogeneity of interest and behavior of the people involved.
As suggested, the problem is not one of selecting the peaks but of
determining the limits of the influence of each central place. That is,
we wish to locate the troughs which separate the area dominated,
for all these purposes, by one center from those dominated by other
Are the limits of each area not determined by perception as much
as by anything else? One may think he lives in a place that is in the
orbit of Orlando rather than that of Tampa, even though Tampa
may be closer in actual mileage than Orlando and larger in popula-
tion or volume of retail sales. The best way to determine such per-
ception would be to conduct attitude research with samples of
people throughout the country and establish the limits of trade areas
by finding out what people think them to be. This procedure would
be costly and time-consuming. It would have to be repeated at
frequent intervals to allow for the dynamic changes in many areas,
particularly in Florida. Some means of indirectly measuring peo-
ple's attitudes is desired.

Delineation of a Region-Thompson

Several methods have been attempted to determine the attitudes
of people toward trade centers by examining records of behavior.
Studies of the location of samples of charge account customers of
department and other shopping goods stores have developed statis-
tics on the ratio of such account holders to total households through-
out the areas in and adjacent to metropolitan areas. Flows of bank
checks and location of bank accounts or loans, and analysis of li-
cense plates in shopping-center parking lots, can be used in what has
sometimes been called "social physics" to measure the impact of
one place upon another.

In the mid-1960s; a study was undertaken by the Committee on
Areas for Social and Economic Statistics of the Social Science Re-
search Council, in cooperation with the Bureau of the Census. One
of its stated purposes was to "classify the entire United States into a
hierarchy of urban, metropolitan, and consolidated areas using
criteria of size and of the linkage between places of work, places of
residence, and places of shopping."7
SCommuting fields for each center were found to have the familiar
cone-like characteristics, with the commuting rate declining regu-
larly with distance. Fields were mapped for every SMSA central
city, for urban centers in the 25,000-50,000 population range lying
outside the SMSAs, and for many small places.

The contour lines of commuting frequency do not necessarily follow
political boundaries, so the researchers developed the concept of
the functional economic area. This is defined as all those counties
within a labor market for which the proportion of resident workers
commuting to a given central county exceeds the proportion com-
muting to alternative central counties.
The principal researcher for this study wrote that the evidence
suggested that regions with less than 250,000 population are not self-
sustaining parts of the national economic system. Hence, these, plus
unallocated counties, should be "shared among the larger nodes on
the basis of contiguity, plus external data such as wholesale relation-

Areawide Planning for Independent Living
ships, or a gravity formulation (shown many times to be good proxy
for total social and economic interdependence) . ."8
These functional areas were used by the Bureau of the Census as
a basis for determining sample areas for utilizing data from the 1970
census. It has prepared public use samples of the records of sample
questionnaires on computer tapes. The primary sample size is one-in-
a-hundred. There are such samples of the more detailed question-
naires asked from 15 per cent of all respondents and of those asked
from 5 per cent of all respondents. For each of these divisions there
are samples drawn from county groups. For this purpose the nation
is divided into areas and subareas. Every SMSA of 25,000 or more is
identified as a subarea. Functional areas of the Bureau of Analysis
serve as subareas except that, where necessary to meet the 250,000
minimum, they may be combined.
An advantage in developing regions using these census county
groupings as building blocks would be the ready availability, from
computer printouts, of all important population and housing charac-
teristics. It would seem that those who are engaged in regional plan-
ning would find these samples particularly useful for obtaining a
wide variety of data about the area of interest. Incidentally, one ad-
vantage of these samples is the wide variety of cross-tabulations that
are obtainable. The areas designated by the Census Bureau as
County Groups (CG) are shown in column 7. The numbers shown
are those assigned by the Census Bureau, and indicate both major
areas and subareas. In northwest Florida there are only major areas.

Newspapers and television are major sources of information, not
only on the assortments of goods offered by retailers, but also the
availability of sporting events, other types of entertainment, legal
and political services, health facilities, financial services, investment
opportunities, and other economic goods and services. They are a
means by which planning and administrative agencies can com-
municate with their patrons. One assumption, of course, is that
people trade in the city whose newspaper they read regularly. Thus,
it is to a considerable extent that newspapers and other media are
important factors in drawing together elements of supply and de-
mand within the areas they serve.

Delineation of a Region-Thompson
Newspapers publish circulation data in various places as an aid to
advertisers. In column 8 the counties of Florida are grouped accord-
ing to the ratio of daily newspaper circulation to households. These
data were compiled by the Standard Rate and Data Service. Coun-
ties are assigned to areas where the circulation of a daily newspaper
is at least equal to 20 per cent of the households. Where two papers
each have over 20 per cent of the households, the county is assigned
to the area of the newspaper having the larger percentage. Regions
are not completely unambiguous.
There are a few counties in which no newspaper published in a
Standard Metropolitan Statistical Area reaches at least 20 per cent of
the households. Newspaper circulation in some counties, such as
Marion, has a ratio of over 20 per cent penetration for newspapers
from a metropolitan center, in this case Orlando, yet the major daily
newspaper is the Ocala Star-Banner.
The American Research Bureau has developed what it designates
as areas of dominant influence, similar to newspaper areas al-
though somewhat different. We have not included the television
regions on the table, but we have used them as an input in develop-
ing delineation of market areas.

By taking into consideration all these and other variables, the
Bureau of Economic and Business Research has developed a set of
areas for Florida, to be utilized in assembling and publishing statis-
tical information. The criteria for establishing these market areas are
relevant also to the planning and administering of social programs.
These areas represent as well as possible the spheres of influence of
the various metropolitan centers as they are perceived by persons
who buy newspapers, watch television, or commute to and from
The plan consists of two types of county groupings: regions and
areas. A region will be defined as a major geographical division of a
state which is served by one or more of the larger SMSAs and which
differs in terms of economic behavior from other regions. An area is
a group of counties related in terms of economic behavior to an
SMSA and which, by 1980, can be expected to have at least 250,000

Areawide Planning for Independent Living
population. Only these areas are shown in column 9 of the table.
Furthermore, all these areas meet another criterion of regional via-
bility-their population must be within a two-hour commuting time
of the central city.
Market areas can overlap state lines. Holmes and Jackson coun-
ties fall into the economic orbit of Dothan, Alabama, and certain
counties in Georgia are really part of the market areas of Tallahassee
and Jacksonville. But where political units are involved, such over-
lappings are irrelevant.

The basic idea here is that areas are defined by systems of behavior
and attitudes that can be identified by reference to the peaks and
valleys of various demographic, economic, or social attributes of
people or organizations and can be plotted on a map. Areas deter-
mined by examination of different variables tend to overlap because
the greatest incidence of most of these phenomena occur in the
same central cities and they decline in intensity in all directions until
a similar contour of minimum occurrence is reached. Beyond these
minimum contours, intensity of the variables increases toward the
next central place.
The attitudes of those who are going to utilize the areas for plan-
ning and action should be mentioned. Human institutions, once
established, tend to perpetuate themselves. Thus, in developing a
new set of planning district boundaries for Florida, the Division of
State Planning included among its criteria such factors as existing
regional planning councils, strong local preference, and existing
state service delivery regions.9
In Georgia, boundary determination for area planning and devel-
opment commissions became state law in 1970. The right of any unit
of local government to petition for amending or changing bound-
aries was reserved. Furthermore, one criterion used in organizing
planning districts in Georgia is "the will to work together on prob-
lems of mutual interest."10
In both states, some districts seem to have been created so that
the more rural counties are separated from urban-oriented ones. It
seems likely that the administrators of the programs in these rural
areas may have felt that they could deal with their problems more

Delineation of a Region-Thompson

effectively without any "big city bias" interfering, even if this feeling
is purely subjective. Furthermore, the aged, ill, or poor individuals
in isolated communities may be located more readily and served
more helpfully than if the area's plans flowed from a metropolitan
In the last analysis, delineation of areas for any purpose is not a
perfect science. There is and always will be room for disagreement
as well as the need to allow for change over time as people move
about and change their behavior and attitudes.


1. "The Regional Concept and the Regional Method," in American Geography-
Inventory and Prospect (Syracuse: University of Syracuse Press, 1954), p. 30.
2. Donald J. Bogue, State Economic Areas (Washington: U.S. Bureau of the
Census, 1951), p. 2.
3. "Delineation of Economic Areas," American Statistical Association Journal 48
(1953): 48.
4. Carter C. Osterbind and Charlotte Menke, "Areawide Planning of Services for
Older People," Economic Leaflets, December 1972.
5. Ralph Thompson, "Delineating Economic or Market Areas for Florida,"
Economic Leaflets, October-November 1972.
6. Geography of Market Centers and Retail Distribution (Englewood Cliffs, N.J.:
Prentice-Hall, 1967), p. 2.
7. U.S. Bureau of the Census, Metropolitan Area Definition: A Re-Evaluation of
Concept and Statistical Practice (Washington: Bureau of the Census Working Paper
no. 28, 1968), p. iii.
8. Ibid., p. 25.
9. Letter from Don L. Spicer, Chief, Bureau of Intergovernmental Relations,
February 20, 1973.
10. Ernest L. Melvin, "The Multi-County Regional Commission in Georgia,"
Journal of the Community Development Society (Spring 1972), p. 23.

Priority Areas as a Strategy in Areawide Planning
under the Older Americans Act


THE TOPIC of the conference, "Areawide Planning
for Independent Living for Older People," is a particularly appro-
priate subject for discussion from the point of view of the kinds of
activity which must be undertaken if we are to give older persons an
opportunity to pursue an independent and dignified life in retire-
ment years. But the topic is also very appropriate in light of the new
program thrusts that are underway, and on the drawing board,
under the Older Americans Act.
I am sure you are aware of the areawide planning programs ini-
tiated in recent months under Title III of the act. The southeast
region has the largest number of such programs of any region in the
country. They were initiated as a pilot effort to determine if measur-
able progress could be made toward expanding the opportunities
for independent living for elderly citizens if a major effort were
devoted to program planning and development on an areawide
basis. The Administration on Aging has just completed a nationwide
assessment of these programs and hopes to have a better estimate
shortly as to whether or not such comprehensive programming
really makes a difference.
The areawide programs are very important to the Administration

Priority Areas as a Strategy-Wells
on Aging for another reason. A major new program strategy has
been proposed for the community program efforts of the Older
Americans Act; the areawide program experiences will definitely in-
fluence our preparation for implementation of this new strategy.
I will present a brief overview of the proposed program strategy
in relationship to the use of priority areas in program planning and
implementation. I hope this information will give a better perspec-
tive in which to review and relate the information discussed in all
the conference sessions.
All too often in our ivory tower in Washington we do not, for a
variety of reasons, always provide for adequate input from the
practitioners in the field and from those who will be on the receiving
end of such strategies. The Administration on Aging welcomes your
views, and I hope that through this kind of discussion we can assure
that our plans for the future have a real relationship to the program
realities that exist at the local level.

Before discussing where we are going, or more correctly, where we
hope to go, it is important to know where we are. The programs
administered by the Administration on Aging are authorized under
the Older Americans Act of 1965, as amended in 1969 and 1972.
However, the authorization of this act, with the exception of the
new Title VII Nutrition Program, expired on June 30, 1972. Since
that time, our programs have been operating under a Joint Con-
tinuing Resolution of Congress.
At the recent White House Conference on Aging, President Nixon
announced his strong commitment to expanding the impact of the
state and community programs authorized under the Older Amer-
icans Act. His budget sent to the Congress for these programs in
fiscal year 1973 contains a request for $200 million, a significant pro-
posed expansion of the program over the previous fiscal year.
Since that time, a great deal has happened. Following passage by
the Congress of the Comprehensive Older Americans Act Amend-
ments of 1972 (H.R. 15657), those amendments were vetoed by
President Nixon. The reasons for this veto were complex and need
not be discussed at this time. It is important to note, however, that
President Nixon did support the plans proposed for the operation of

Areawide Planning for Independent Living
the state and community programs, Titles III and VII, as set forth in
H.R. 15657.
Several bills to amend the act have already been introduced in the
new Congress. They all vary from each other to some degree, but
what is important is that the strategy proposed for the future con-
duct of the state and community programs remains virtually un-
changed from the bill enacted last year. It is this strategy that I
would like to discuss.

By way of an overview, there are three principal elements of the
new strategy. First, major emphasis will be placed on utilizing the
resources available under the act in a planned manner in keeping
with clearly defined national and state priorities. Second, the strate-
gists have proposed the concentration of these resources in such
manner to better assure a measurable impact on the specific pro-
grams and target populations of the older persons identified. And,
finally, we hope to see the maximum effective use of all available
federal, state, and local resources which are concentrated on those
programs identified as priorities for the elderly.

Under the proposed strategy, as in the past, the community pro-
grams authorized under the Older Americans Act will be formula
grant programs, with the amount of moneys received by a state
being determined by the number of elderly (sixty years of age and
over) in the state in relation to the numbers in all other states.
However, there are some noticeable changes in the manner in
which the programs would be operated. Principally, the Commis-
sioner on Aging will have the authority to establish national priori-
ties for the program as well as standards for any specific services
and activities undertaken. Up to this time, this authority has rested
solely with individual states. The proposed act sets forth an over-
riding national goal for the program, and it reads:

Sec. 301. It is the purpose of this title to encourage and assist
state and local agencies to concentrate resources in order to
develop greater capacity and foster the development of com-

Priority Areas as a Strategy-Wells
prehensive and coordinated services systems to serve older
persons by entering into new cooperative arrangements with
each other and with providers of social services for planning
for the provision of, and providing, social services and, where
necessary, to reorganize or reassign functions, in order to: (1)
secure and maintain maximum independence and dignity in a
home environment for older persons capable of self-care with
appropriate supportive services; and (2) remove individual
and social barriers to economic and personal independence for
older persons.

Moneys would be available to the states in two principal cate-
gories-for state agency operations and community programs
activities. For state agency activities, the goal is, as it has always
been, to expand significantly the leadership and program capacity
of the state agencies on aging. The new strategy makes the resources
available for significant gains in this important area.
Moneys for the community program activities will be available
for three separate and distinct activities. They are: for meeting 75
per cent of the ongoing costs of operating substate agencies on
aging; for meeting 90 per cent of the ongoing costs of needed serv-
ices planned and developed by such substate agencies; and for
meeting 75 per cent of the costs of services initiated not as part of a
program planned by the substate agencies. In addition, moneys will
be available to meet 90 per cent of the costs of local nutrition pro-
grams under Title VII of the Older Americans Act.

The first and one of the most important steps is the development of
an annual state operating plan by the state agency. Such a plan will
identify specific output oriented objectives against which the re-
sources of the agency would be directed each fiscal year. In addi-
tion, specific geographic areas in the state will be identified to re-
ceive priority attention.
The second step, actually indistinguishable from the first, is the
determination of priority geographic areas in the state in which the
program will be concentrated. Before this can be done, and as pre-
scribed in the act, the state agency must divide the entire state into
planning and service areas. This division is to be accomplished with

Areawide Planning for Independent Living
five considerations: the distribution of older persons; the need for
social services-especially among the low-income elderly; the avail-
ability of resources in the area; the boundaries of areas already
drawn in the state; and the location of units of general purpose gov-
ernment in the state. The identification of possible criteria for this
selection will be discussed later.
Following the identification of the priority areas, the next step is
designating an agency to be responsible for the aged in the area,
to be known as the Area Agency on Aging. Such an agency must be
either an established Office on Aging, a unit of general purpose gov-
ernment, an agency designated to act on behalf of local general
purpose government, or any public or nonprofit private agency
under the supervision or direction of the state agency. These area
agencies will have a major mission and extensive responsibilities:
they will be responsible for ongoing leadership, advocacy, data col-
lection and analysis, program development, and evaluation activi-
ties in aging throughout the planning and service area. An overriding
responsibility will be the development for the area of a plan on
aging which seeks to develop a comprehensive and coordinated sys-
tem for the delivery of social services for the elderly throughout the
planning and service area.
The implementation of this plan could then be financed at 90 per
cent matching by the state agency. However, 80 per cent of the total
resources available to the state agency would have to be utilized in
keeping with the comprehensive social service plans developed by
the area agencies on aging. I should add that states are urged to uti-
lize their nutrition program resources in concert with the plans
developed for the planning and service areas. Also, only a small por-
tion of their total allotment (20 per cent) would be available for pro-
gram development outside of the priority planning and service
areas mentioned.
As you can see, this strategy is a considerable change, for our cur-
rent program is characterized by relatively small projects, widely
distributed over the state. The experience gained in the areawide
model programs and the social services and nutrition projects will
be of great importance. The strategy proposed for the areawide
program is certainly similar to the areawide models, but no current
areawide program is operating at the scope it proposes.

Priority Areas as a Strategy-Wells

The determination of high priority areas, or of which high priority
areas to program, is a problem of great magnitude for the state
agencies as they approach areawide planning and program imple-
mentation. The proposed strategy certainly anticipates the selection
of some areas over others and does not anticipate the designation of
the entire state as a priority area. Limited resources will make the
selection of high priority areas a necessity.
The proposed act itself does not prescribe criteria for the selec-
tion of priority areas. The act only declares that once the state has
been divided into areas, the state agency should "determine for
which planning and service areas a plan will be developed . ."
However, from the broad expectations prescribed for the program,
certain criteria are automatically suggested. No criteria have yet
been developed in Washington, even in draft form, so discussion is
strictly theoretical. Specifically, it appears that these kinds of factors
would have to be considered by the state agency in its selection
Concentrations of older persons.-Does a planning and service
area under consideration have a major concentration of older per-
sons which meet the national and state priorities that have been es-
tablished? Such individuals might include those with low income,
without mobility, with handicaps, members of minority groups, the
homebound-those who are threatened with the loss of their in-
dependence if services are not provided. One might also ask if this
elderly population is concentrated in such a manner so as to make
effective service delivery feasible.
Organization for aging program.-Is there an existing agency
within the area with the capacity and willingness to be designated as
an area agency on aging? The capacity of the agency would include
the potential and authority for these factors: providing ongoing
leadership and advocacy in aging; developing and implementing an
areawide plan on aging; planning on a continuing basis with pro-
viders of services; collecting ongoing data on needs of residents
and analyzing existing programs; providing technical assistance to
providers of services; receiving and disbursing funds, and entering
into contractural arrangements for the purchase of services; and

Areawide Planning for Independent Living
seeking the most efficient use of resources through coordinating
activities with providers of services.
The Administration on Aging has been concerned about the esti-
mated annual operating costs for an area agency having these opera-
tional capacities. Some preliminary estimates given by outside
sources suggest that for an area having a total population of 750,000
(or 75,000 older persons), it would be necessary to pay from
$250,000 to $400,000 annually for the effective operation of such an
agency. This is only an estimate, and we have no way of making a
more accurate appraisal at this time.
Leadership and staff potential.-Is there the potential of high
quality leadership and the availability of trained staff to carry out a
comprehensive program of the extent proposed?
Availability of resources.-Does the area have the potential for
the full development of a "comprehensive system" for the delivery
of social services to the elderly? A "comprehensive system" is de-
fined in the Older Americans Act as one which provides for all
necessary social services in a manner designed to facilitate the use of
all social services, make most efficient use of social services, and
eliminate duplication to the maximum extent possible. Here we
would ask, are existing services available in the area, in adequate
amount, to make an impact on the problems identified? Are the
service agencies of the area, both public and private, willing to work
together toward common goals on behalf of the elderly?
The criteria suggested propose a very tall order for everyone con-
cerned. Many of the criteria are nonquantifiable or are of a subjective
nature, but these are the factors that often determine how successful
a program will be. It is also important to point out that some of the
criteria I have mentioned as reasons for selecting one area over
another may in your minds be adequate reasons to do just the op-
posite. For example, the area with a limited number of elderly is
probably a rural area. You may feel the rural elderly need services
most, or that the area without services is where we should seek to
develop services first!
There is no question that, whatever criteria are finally established,
the selection process will pose an enormous challenge for the state
agency. In this light, there will be a new level of leadership de-
manded of a state agency on aging. The decision-making process

Priority Areas as a Strategy-Wells
concerning priority areas and the determination of statewide goals
and priorities will require a new level of expertise for state execu-
tives and their staffs. We know that a major element in the success
of this strategy will be the degree to which we can assure the
strengthening of the state agency. This is why this goal has such a
high priority with the Administration on Aging. A companion con-
cern is the availability of qualified manpower, especially at the sub-
state and local levels. This is a high priority item which is also a
suitable subject of a future discussion.

The program strategy I have outlined is still in the proposal stage.
However, we are doing our best to begin analyzing the impact that
such a strategy would have on the program operations of the Ad-
ministration on Aging.
We do not underestimate the challenge and problems that the
program will pose. We do not feel we have all the answers. That is
one reason I am happy for the opportunity to discuss the strategy. I
am sure we will learn a great deal from your comments and reac-
In spite of the problems and obstacles facing us, we are confident
the strategy for areawide programs has great potential. The devel-
opment of strong local leadership and planning agencies in aging,
the utilization of resources from many sources in keeping with
jointly established goals, and the significant expansion of program
operations under the Older Americans Act that the strategy repre-
sents, all represent a major development to the field of aging. Now is
the time for us to take a major step forward.

Feasibility of Areawide Planning


LIKE MOST presentations at this conference, my re-
marks are addressed to elements that make areawide planning suc-
cessful or effective. Before discussing these elements, however, it is
advisable to identify explicitly several interpretations of effective
planning that I will not be considering. For instance, judging from
the actual behavior of many planners,' we might fairly infer the
definition of effective planning to be to use up planning funds with-
in the proper budgetary period without causing a scandal. While it
is safe to assume that I am excluding this frivolous (though realistic)
interpretation of effectiveness, it should be emphasized that I am
also excluding the most significant, ultimate criterion of effective
planning: whether planning efforts truly result in greater well-being
for human beings, in this case, better prospects for independent
living by older persons. One reason to exclude this criterion is that
it cannot be operationalized; there is not sufficient evidence to show
that specific programs, services, and facilities truly enhance the
capacity of older persons for independent living.2 Moreover, even if
such evidence were available, we would still need to confront the
intermediate issues that I want to consider here.
The kind of effectiveness I want to discuss is the achievement of
areawide planning goals. That is not simply the development of a

Feasibility of Areawide Planning-Binstock
good plan on paper, but the realization of efforts to modify the
quality, the accessibility, the range, and the configuration of serv-
ices, goods, and facilities provided for older persons.
The seeds of success or failure in areawide planning are sown in
the particular ways that the goals are formulated. Many planning
goals are unfeasible the moment they are stated. And yet, through
careful understanding of the elements involved in successful plan-
ning, alternative goals, which have good prospects for being real-
ized, can be formulated and achieved. Moreover, replacing un-
feasible goals with feasible goals does not necessarily require a
reduction in the merit of what can be accomplished. We are not
interested in planning that is successful in terms of extremely limited
goals with little promise for helping older persons, even if achieved.
In talking about the difference between successful and unsuccessful
areawide planning, I want to focus on goals involving substantial
policy, program, and service changes in the local community.
Probably the most common situation encountered by an areawide
planning agency could be outlined.3 The planner (whether staff pro-
fessional, a consumer board, council, or committee, a combination
of these, or the total areawide agency) is an actor with limited in-
fluence. The planner's goal typically embodies a proposal for one or
more target organizations to make a policy change. It might be the
extension of a home care service to a neglected region of the com-
munity by the visiting nurse association, or the allocation of a
greater proportion of a municipal or county budget to a recreational
program for the elderly. In these terms the situation seems simple
enough. We can assume, on the basis of widespread and longstand-
ing experience, that the target organization will initially resist the
proposed change. The only issue would seem to be if the areawide
planner has sufficient influence to overcome the target organiza-
tion's resistance to the proposed change in its policy. Influence is
simply "the ability to get others to act, think, or feel as one in-
But it is in this deceptively simple formulation of the situation that
most efforts at effective planning founder. Both the exercise of in-
fluence and organizational resistance to planning goals are complex
phenomena. Most of us are willing to recognize and acknowledge
these complexities in our nonprofessional, day-to-day activities, but

Areawide Planning for Independent Living
for some reason we tend to ignore them when functioning as profes-
sional planners. Areawide planning will be much more effective if
planners will consciously distinguish among different types of in-
fluence and different types of organizational resistance to proposed
policy changes, and be willing to exercise the appropriate type of
influence for overcoming a specific organization's resistance to a
planning goal.
It is worth remembering that influence works in a number of dif-
ferent ways.5 Perhaps the most familiar way is through inducement,
that is, changing the behavior alternatives open to the target in such
a way that he selects the alternative preferred by the planner. A
similar but distinct kind of influence is coercion, in which the target
is strictly precluded from behaving in a fashion undesirable to the
planner. Using coercion and inducement requires the ability to
change the actual options open to the target. But influence also
works without changing behavioral alternatives. It can be exercised
through rational persuasion, changing the target's perception of the
alternatives open to him by improving his logic or information. This
can be usefully distinguished from other means of changing the
target's perception of the options such as selling, or suggestion,
fraud, and deception. Another kind of influence, which might be
termed friendship, relies upon the desire of the target to gratify the
influence. And finally, it is important to take note of authority, in-
fluence which depends upon the target's sense of obligation, legal or
otherwise. All of these-inducement, coercion, rational persuasion,
selling, friendship, and authority-are distinctly different ways in
which influence works.
While these distinctions may seem obvious and rather elementary
once they are called to attention, it is amazing how frequently they
are ignored in efforts to implement planning goals. Perhaps the most
common case is that of the planner who tries to exercise influence
through rational persuasion by supplying information and logic to
support his goal, when the target of his efforts is basing its resistance
on factors that have nothing to do with the information and logic
provided. One familiar example of such a target is the boards of
directors of many hospitals. As Clark and Wilson have pointed out,
"Among the trustees and directors of ... hospitals . the personal
prestige which membership provides is often a strong incentive.

Feasibility of Areawide Planning-Binstock
Board members not only contribute prestige to such boards, but
their own prestige is enhanced through association with other high-
status community figures and with the institutions themselves."6
Board members, as targets for influence, will most likely be respon-
sive to proposals which enhance the hospital's prestige and stature,
thereby enhancing their own opportunities for recognition. To
them, there may be no effective relevance in facts about the number
of persons needing home health care and logical arguments about
the efficient coordination that might be achieved through a joint out-
reach program carried out by the hospital and the visiting nurse as-
Organizations do not tend to resist innovation because their mem-
bers are ignorant of facts or because they are illogical. Rather, they
are predisposed to resist changes embodied in planning goals re-
gardless of the facts. As Herbert Siriron, perhaps the country's lead-
ing student of organizational behavior, has expressed it, the "exist-
ing pattern of organizational behavior has qualities of persistence; it
is valuable in some way or it would not be maintained."7 An orga-
nization's members do not search for or consider alternatives to the
existent course.of action unless that course is in some sense unsatis-
Areawide planning goals, however, will not be formulated pri-
marily to solve unsatisfactory conditions within a hospital, a nursing
home, or some other target organization, at least not conditions that
are regarded as unsatisfactory by the target. On the contrary, the
planner directs his major attention to finding a solution to an unsatis-
factory community condition that may have little or nothing to do
with the target organization's operative incentives. Target organiza-
tions are rarely selected with attention to the current states of their
internal affairs. And even if the organization finds its own state to be
unsatisfactory in some sense, it is unlikely that the policy change
presented by a planning goal for the elderly will be perceived by
the organization as a solution to its own problems. It should not be
surprising, then, that planning goals are frequently resisted by target
Unfortunately, most planners confronted with the fact of organ-
izational resistance to a planning goal do little to devise a strategy
that could overcome this resistance. Some are unwilling to do more

Areawide Planning for Independent Living
than berate and condemn the recalcitrant target organization, taking
comfort in the notion that their planning goals represent a blueprint
for more extensive and higher quality living for older persons. Other
planners will unsuccessfully invest a great deal of time and energy in
trying to sell or to persuade the target that it should change its
The effective planners seem to be those who tailor a specific strat-
egy, with a relatively intimate knowledge of the pertinent organiza-
tions and the incentives that maintain them. How can a planner gain
this knowledge of target organizations? The history of each organ-
ization's previous responses to proposals for policy change can
help. But at best this is a rough guide, since, from the viewpoint of
the organization, the current proposal for change may differ impor-
tantly from past proposals in ways not readily apparent to the
planner, an outsider. Similarly, decision criteria within the organiza-
tion may alter over time, often in ways so subtle that even key indi-
viduals in organizational operations may not have recognized the
change. The planner may also be able to read day-to-day clues indi-
cating that an organization considers its situation unsatisfactory in
some sense and may consequently be predisposed to accept innova-
But the planner cannot really grasp the phenomena of organiza-
tional resistance by viewing an organization as if it were a single
entrepreneur calculating the value of various courses of action. Each
of the many types of roles performed in complex organizations is
defined by a different set of constraints, each set having some effect
upon organizational policy. It is safe to say, however, that most in-
novative proposals presented to an organization are tested against a
set of constraints which is widely shared within the organization;
moreover, this set has its strongest roots in the major concerns of
those persons who are in dominant organizational roles. The critical
considerations for the planner are who plays the dominant roles in
the organization's decision-making, and, in their organizational
roles, what are their primary concerns?
A planner who cannot do a reasonably good job of answering
these questions stands little chance of being effective. The type of
influence needed to overcome the resistance of an executive, who
may be preoccupied with organizational maintenance and enhance-

Feasibility of Areawide Planning-Binstock
ment and his desire for career recognition, may be quite different
from that needed to influence a board of directors interested in
prestige, sociability, and the discharge of traditional obligations.
The need to be sensitive to such considerations has always been
evident to more sophisticated and effective planners. But, increas-
ingly, even they will need to take a new look at their traditional and
time-honored assumptions about dominant factions and incentives
in state and local health and welfare organizations. In the late 1960s
and early 1970s, when the power bases of so many health, educa-
tion, and welfare organizations were challenged through direct
social and political action,9 the leadership factions of many public
and quasipublic organizations have undergone substantial change.
Many boards of directors and executives have come to share ever
greater portions of their power with consumers and staff members,
and, in turn, the incentive systems of executives and boards have
been modified.
These distinctions between types of influence and the character-
istics of organizational behavior may seem elementary, but the ap-
palling truth is that they are virtually ignored in the conduct of
planning. Most of the recorded cases of community planning for the
aging provide ample opportunity for the "Monday-morning
quarterback." Sometimes the policy change embodied in a planning
goal totally violates the primary concerns of a target organization,
the fundamental viability of its organizational life as interpreted by
the dominant faction. In such cases, the prospects for goal achieve-
ment are nil. A more frequent case involves a target organization
that is susceptible to being influenced to make the desired policy
change. Over and over, planners can be observed using a type of in-
fluence to which the target organization is unlikely to be responsive.
Most typically, the planner tries to influence through rational per-
suasion and selling in circumstances in which the target organization
is most unlikely to be influenced in this fashion.
One simple, though typical, case took place some years ago in San
Francisco when a health planner attempted to establish a multi-
phasic screening program for older persons living independently
and not in regular contact with a physician. One of the target organi-
zations from which a policy change was sought was the local
medical society, which was asked to endorse and help organize the

Areawide Planning for Independent Living
screening program. At the time, the leaders of the medical society
were deeply embroiled in a public campaign of opposition to medi-
care, arguing that the existent private system of medical care for the
aged was more than adequate. The planner's proposal, in itself,
clearly implied that the existing system of private medical care in
San Francisco was inadequate for meeting the health needs of many
older persons; indeed, it was developed by the planner because he
thought that system to be inadequate. In this instance, of course, it
would have been easy enough to predict the intransigent resistance
of the medical society to the planning goal. Yet the planner's
strategy for achieving his goal was to try to change the view of the
society's directors by marshaling evidence of the gaps in medical
care received by indigent older persons and of the likely effective-
ness of a public health screening program in coping with these defi-
ciencies. Needless to say, this effort was not effective in any sense.
This incident presents a pathetically obvious example of ineffec-
tive planning, but it is substantially representative, in principle, of a
great many less obvious, more complicated planning situations. In
virtually every case of ineffective community planning, it is possible
to find substantial evidence of inattention to the relations among the
planning goal, the primary concerns of the target organization from
which a policy change is sought, and the kind of influence that the
planner attempts to exercise. On the other hand, examinations of the
relatively few successful planning efforts, in this and other fields, in-
dicates that attention to these factors not only leads to selection and
employment of the relevant kinds of influence, but also tends to
increase a planner's general effectiveness in a number of other ways.
At the very least, attention to these factors can enable a planner to
avoid the waste of his precious resources for exercising influence,
either by alerting him to situations in which he will be expending his
resources in a hopeless cause or by indicating situations in which he
will need little influence and can avoid an excessive use of resources
in accomplishing an essentially simple task. More important, in
helping him to identify hopelessly unfeasible goals, it can redirect
his focus to other approaches for achieving his larger objectives for
improving community health. Often, a minor change in the content
of a goal, an alteration in the scale of a goal, or the redirection of the
goal toward a different target can lead to a potentially more ef-

Feasibility of Areawide Planning-Binstock
fective planning situation in which the nature of organizational re-
sistance may be changed and/or the planner is able to acquire a
fuller range of resources for exercising influence. Such alterations
can often transform an unfeasible planning effort into a feasible one,
without sacrificing the merit of the larger community objectives for
older persons that the planner may have in mind.
A common situation of unfeasibility is one in which the planner's
goal violates the primary concerns and interests of the target organi-
zation's dominant faction. The planner's application of any kind of
influence resources for overcoming resistance will be fruitless. How-
ever, it may be possible to eliminate the sense of violation by substi-
tuting an entirely different type of innovation that will accomplish
the same ultimate social objective as originally intended. A goal
revised in this fashion may not be resisted at all. But even if it is,
some means of effective influence may be open to the planner be-
cause the substitute goal can be formulated so as to not violate the
target's primary concerns. A good illustration is provided by the
case of the hospital affiliated with a university medical school. It
rarely admitted elderly patients who needed hospitalization be-
cause of diagnoses such as incipient diabetes, because such cases are
sufficiently common to be of little interest for teaching purposes.
Elderly patients were referred to nursing homes where, instead of
receiving effective treatment and a short-term release, many dete-
riorated and remained there the rest of their lives. One goal formu-
lated by the planners in this instance was to seek a change in admis-
sions policy by the hospital. This proposition got nowhere, because
the hospital would not begin to consider cutting into the number of
beds it used for "interesting" teaching cases. But the substitute goal
eventually proposed-to have the hospital undertake the operation
of a home health care program for the elderly in the community-
was implemented because it complemented the teaching concerns
of the hospital.
Another possible response to an unfeasible goal situation is to
redirect the initial goal to another target organization which may not
find the proposed innovations so repugnant. In one community, for
example, a municipal housing authority was totally unresponsive to
a planner's attempt to get a multiservice center for the aging located
in a public housing project. He redirected his sights to the YWCA as

Areawide Planning for Independent Living
a promising target for the same goal. Although the Y did offer some
resistance, it was responsive to the kinds of resources for-influence
that the planner was able to mobilize, and the multiservice center
was established in a desirable location.
Some goals are unfeasible-not because the target is unalterably
opposed, but because the kinds of influence that are available to the
planner have little or no leverage on the target. For example, the
target may be susceptible to inducements, but the planner may have
none to offer. While he may have expert knowledge or moral stand-
ing, these may be of no interest whatsoever to the target. If the
planner wishes to make his goal feasible, he can modify it so as to
make the target susceptible to his influence resources, or he must
acquire for his use resources that can be used in relation to the orig-
inal goals.
The options of substitution and redirection are still useful in this
type of situation. But here, by simply altering the scale of his goal,
the planner may be able to achieve feasibility without changing the
basic character of the policy innovations sought or without redirec-
ting his efforts towards a new target. Reduction in the scale of a goal
is probably the most obvious adjustment for eliciting responsiveness
from a target organization. Typically, a request for five home health
aides may be scaled down to two. Increases in scale, however, can
be equally effective for this purpose. Unfortunately, planners
usually attempt decreases rather than increases, preferring to ask for
less in the hope that the size of their proposition is what accounts for
resistance. It is because of this that goal adjustments to attain feasi-
bility have so often been regarded as sins of accommodation which
compromise the integrity of planners as social reformers.
And yet target organizations are often unresponsive to a planner's
goal because of indifference. The target does not reject the goal ex-
plicitly, but simply does not find it sufficiently significant to be
worthy of serious attention. An increase in the size or scale of a pro-
posal may convert it into a possible solution for a community
problem of pressing importance and thereby attract favorable in-
terest from the target organization. Even if the goal is not intrin-
sically interesting to the target as a community health or welfare
measure, its transformation into a major undertaking which captures
the interest of other parties in the community may make if diffi-

Feasibility of Areawide Planning-Binstock
cult for the initial target to remain indifferent. When a simple pro-
gram or service proposition can be transformed into a bold, innova-
tive, community-wide goal, perhaps capturing the imagination of
the governor or the mayor, the original target organization, which
had been recalcitrant and aloof, may scramble to be included. The
target organization becomes afraid that it will be left out of some-
thing important, lose some of its community-serving legitimacy, and
miss an opportunity for gaining a piece of pie and a share of glory.
In the process of increasing the scale of a goal in this way, the
planner may not only be able to influence resisting organizations,
but also achieve a plan of much greater scope and significance for
the older people than contemplated in the original goal.
We have been considering the elements that make for feasible
goals, and how unfeasible goals can be revised to make success pos-
sible. But even if a planner can establish a sound, practical goal, he
still needs to operate skillfully to overcome organizational resistance
to his goal.
The dimensions of feasibility in any situation will clearly indicate
the major strategy to be employed. If the planner needs to use re-
sources for inducement, offering commodities that the target organ-
ization would like to acquire, then his basic strategy will be to
bargain. A relatively stable relationship for negotiation is required
so that the two parties can communicate effectively about the terms
of the exchange. The planner's skill in these negotiations will de-
termine how much of the desired goal he will obtain at the price he
is able to offer. Often, the planner expends far more influence than
needed to achieve his goal, and thereby wastes resources that could
be used to achieve additional goals.
When the areawide planner and the target organization are
seeking virtually the same ends, the basic strategy, of course, is co-
operation. The two parties search for a means of pooling resources
to achieve mutually satisfactory objectives. The danger to avoid is
pretending that the planner and the target share the same goals of
community welfare. Countless so-called cooperative meetings take
place when the parties involved are not even close to a genuine set
of shared or even parallel objectives. Such meetings often set a fine
public record of cooperative intent, but rarely lead to concrete

Areawide Planning for Independent Living

When the planner and the target have conflicting ends, it is usually
better to drop the pretense of cooperation and undertake conflict.
Planners in the health and welfare field generally try to avoid con-
flict strategy, but this is often the only viable approach for those
interested in achievement. As many consumer advocacy groups
have demonstrated in recent years, even a weak planning organi-
zation can increase its power for winning conflicts by making a
nuisance of itself. If a target organization is sufficiently bothered, it
may make concessions to the planner in order to obtain cessation of
the nuisance.
In this and other planning strategies outlined, there are a number
of hazards as well as opportunities. There are the hazards of making
enemies, of uncertainty in remaining flexible enough to reformulate
goals and strategies, of failure to achieve ambitious and significant
areawide goals.
But in my view, these are insignificant compared with the hazards
of neglecting the feasibility of planning goals and the requisite
strategic skills for achieving them. Countless examples of com-
munity and statewide planning for the elderly show that achieve-
ment of results depends upon objectives and actions that are care-
fully formulated in accordance with the realities of the planning
agency's influence and the target organization's concerns. Without
attention to such matters, areawide planning agencies will probably
be able to hold countless seemingly worthwhile meetings, and
expend their planning funds in each fiscal year, without causing
major scandals. But achievement of results that will have substantial
benefit for older people in the community will require sustained at-
tention to the feasibility of goals and strategies for implementing


1. See, for example, Governor's Special Planning Commission on Elderly Af-
fairs [Commonwealth of Massachusetts], Report on State Government Planning in
Aging (Commonwealth of Massachusetts, 1971).
2. Robert H. Binstock, "Some Deficiencies of Gerontological Research in Social
Welfare," Journal of Gerontology 21 (April 1966):157-60.
3. Much of this conceptual outline is adapted from Robert Morris and Robert H.
Binstock, Feasible Planning for Social Change (Columbia University Press, 1966).
4. Edward C. Banfield, Political Influence (The Free Press, 1961), p. 3.

Feasibility of Areawide Planning-Binstock

5. The distinctions among the ways in which influence works, presented in this
paper, are adapted from a formulation by Banfield, ibid., pp. 4-5.
6. Peter B. Clark and James Q. Wilson, "Incentive Systems: A Theory of Organ-
izations," Administrative Science Quarterly 6 (1961):141.
7. Herbert A. Simon, Donald W. Smithburg, and Victor A. Thompson, Public Ad-
ministration (Alfred A. Knopf, 1961), p. 453.
8. James G. March and Herbert A. Simon, Organizations (John Wiley & Sons,
1958), esp. p. 173.
9. See, for example, Nick Kotz, Let Them Eat Promises: The Politics of Hunger
in America (Prentice-Hall, Inc., 1969), esp. pp. 154-91.

Program Evaluation and Monitoring
for Areawide Programs in Aging


IN A RECENT memorandum to heads of executive
departments and agencies, President Nixon stated, "Program evalu-
ation is one of your most important responsibilities ... as the Presi-
dent's Advisory Committee on Executive Organization has empha-
sized, each agency must continually evaluate its own programs."1
In this paper, I will examine how the Administration on Aging and
its local partners, area agencies on aging, can meet this responsi-
bility. I will also review some alternative evaluation systems for
areawide aging programs. My purpose is to establish in the aging
program administrator's thinking the need to plan for, introduce,
and support an evaluation and monitoring system for every major
program for which he is responsible.
Program evaluation and monitoring are necessary for improving
program performance and accountability for results. AoA and its
state and local partners are faced with four basic issues, each of
which can be met more successfully with the use of planned and
soundly administered program evaluation and monitoring systems.
These are (1) to identify the more important goals which need to be
addressed in order to improve the status of the elderly in this nation;
(2) to design programs and activities which are most likely to bring
about desired changes; (3) to administer these programs and activi-

Program Evaluation-Kugajevsky
ties as efficiently as possible; and (4) to account to the public, the
Congress, and other legislative bodies for the results of these pro-
grams in terms of the money spent on them.
The likelihood of greatly increased funding for programs for the
aging reinforces the need for developing evaluation and monitoring
systems. In the past, programs which provide social and rehabilita-
tive services to the elderly have not been funded or operated on a
grand scale. Recently, this situation has changed dramatically. Over
$1.3 billion have been requested for AoA programs in the next three
years. This request is part of the bill recently passed by Congress
for renewing the Older Americans Act. It is now awaiting the Presi-
dent's approval. Public administrators of such programs have the
responsibility to account for the accomplishments of such pro-
grams, not only because of the inevitable scarcity of public re-
sources and need for accountability, but also because of the genu-
inely harmful consequences that can result to older persons from
poorly administered programs. In programs which provide health,
nutrition, and preventive personal care services, the damage caused
by misconceived or inadequate services is often irremediable. It
may be too late for the elderly victims of poorly planned or in-
competently administered service programs to have deficiencies
corrected. Indeed, the failure of community-based home care social
service programs for the aged is perhaps the single largest cause
of the scandalously unnecessary institutionalization of the elderly.
There is growing evidence that the vast majority of elderly confined
to nursing homes need not be there. Provision of minimal home-
maker and home health care services and alternatives (group homes,
cooperative apartments care arrangements) would allow close to
60 per cent of the older people who are or will need to be institu-
tionalized to return to or remain in the community. This would be
less expensive and more beneficial to the elderly people. Yet, many
programs continue on the recreation and leisure or counseling syn-
drome rather than providing these other more vital services.2
Program evaluation and monitoring have been given insufficient
priority in aging programs. Since the Older Americans Act was
passed in 1965, AoA has spent slightly over $130 million on services
programs for the elderly. Of this, $110 million was spent through
Title III. Yet, the total spent on evaluating the results achieved by

Areawide Planning for Independent Living
Title III programs since 1965 amounts to less than $300,000-a sum
that is clearly inadequate to assess properly the degree to which the
1,500 Title III projects have met their objectives.
In the near future, program evaluation and monitoring must be
given greater priority and integrated into the program planning and
implementation process. In a moment of frustration, one can char-
acterize AoA as having a twenty-year job with a one-year appro-
priation, one-half year plan, and no provision for evaluation. While
this is a somewhat harsh characterization, it is clearly incumbent on
AoA and its state and local partners to make the best possible use of
their resources at all times. It should be equally clear that program
evaluation plays a key part in this effort, provided the evaluation
findings are applied to planning or replanning the use of resources.
If used properly, evaluation results should permit AoA and state and
local agencies to improve materially the quality of their program
performance; if not so used, evaluation and monitoring are not
worth the effort.3
Program evaluation should be viewed as a vital part of good pro-
gram management. Ideally, it should be thought of and funded as
an integral part of every program. It should be viewed as that part
of the program that provides feedback information to the program
administrator and to the staff that actually delivers the services.
Thus, program evaluation is good program management.
The basic components of program management consist of three
steps which look to be-but are not always-as easy as pie: P: plan-
ning-deciding what and how much to do and how to do it; I:
implementing-doing it; E: evaluating-appraising the actual re-
sults in order to determine effectiveness, significance, and efficiency.
Program evaluation provides the factual information about what
happened, and thus becomes a key management tool for improving
planning and implementation of new and ongoing programs.
There appears to be relatively little disagreement concerning the
definitions of planning and implementation. However, a review of
the literature reveals a variety of definitions of evaluation.4 Some
say it means measuring progress toward a target. Others say it is
analyzing reasons for the outcome. Still others say that there is no
evaluation unless we look at the significance of a project, at link-
ages, at relationships to sectors, to economic development, to civic

Program Evaluation-Kugajevsky

participation, to something bigger than the project. Some say evalu-
ation is a Project Appraisal Report-a PAR. And others say, that an
evaluation which produces only a PAR is PARalysis.
A possible conclusion: evaluation can be many things. It can be
ascertaining the answers to such questions as these: Is one meeting
program objectives and, if not, why not? Should one do more of the
same? Should one change? Should one quit? Do the objectives
make sense? Or, to use a somewhat more formal definition,
program evaluation can be described as a systematic assessment of
actions in order to improve planning or implementation of current
and future activities.5 It is the key aspect of the intertwined program
management cycle consisting of planning, implementation, and
Program monitoring also should be thought of as a vital part of
good program management. However, to clarify its role in effective
program management, it will be useful to indicate how evaluation
differs from monitoring.6 The latter is generally designed to appraise
operations in order to determine compliance with management con-
trols and regulations. As such, program monitoring does not, as a
rule, challenge the choice of objectives. Evaluation, on the other
hand, questions the relevance of a project, challenges all aspects of
project design, examines performance of inputs and implementing
agents, measures progress toward objectives, and may well result in
the redesign and replanning of actions. Program monitoring may
uncover inefficiencies in implementation or lack of clarity in goals
which concern the planner and manager. Hence, evaluators must be
informed of monitoring results and avoid duplication of work in
looking at project effectiveness and efficiency. Thus, a good moni-
toring system will make program evaluation easier but is no sub-
stitute for it. Since the design and use of monitoring systems are rel-
atively straightforward, no further attention will be devoted to
them. Instead, the focus of the remainder of this paper will be on
the much more difficult task of the design, implementation, and use
of program evaluation systems for areawide programs.

Like unpleasant tasting medicine, program evaluation and moni-
toring are seldom given an enthusiastic welcome by program ad-

Areawide Planning for Independent Living
ministrators. Many of them have been "socialized" into taking the
worthwhileness of their activities for granted and are naturally
resistant to having these activities and their underlying assumptions
challenged. Furthermore, many of them are sincerely convinced
that evaluative research is not really scientific and cannot be relied
upon to produce reliable and valid results. Others are too caught up
in the daily demands of providing necessary services to take the
time for research, especially if this requires an interruption or modi-
fication of services or the reallocation of limited resources.7
Administrative resistance may also result from a possibility of
conflict between the goals or objectives of field programs and the
goals and objectives of the parent organization itself. As an example,
for years AoA's Title III projects were charged with the mission of
providing services to the nation's elderly. Concurrently, AoA had
neither the money nor the administrative support to follow through
on this mission. As a result, there was little desire to see an evalu-
ation done which would document just how great the disparity was
between the stated goals of AoA's Title III program and the actual
performance of Title III projects. One might conclude additionally
that whenever the expected results of an evaluation could embar-
rass or weaken the sponsoring organization, such an evaluation will
be resisted. Other impediments to routine inclusion of program
evaluation systems in the program management process include
skepticism of the administrators about the value of evaluation; mis-
understanding by administrators concerning the aspects of the proj-
ect that need to be evaluated (when something is wrong, most ad-
ministrators focus on symptoms rather than causes, hence evaluators
evaluate the wrong problem or spend time redefining it); scarcity of
resources (few administrators will spend money on evaluation
when there is a forced trade-off between evaluation and service
delivery to a needy clientele); inability of administrators to apply
evaluation results in replanning and reprogramming efforts; incom-
petence of persons doing evaluations resulting in the use of poor
evaluation designs and inadequate data to support sweeping con-
Some of these general problems can be illustrated with a recent
evaluation of the Title III program. The Title III program repre-
sented, until the advent of Title VII, AoA's largest program for the

Program Evaluation-Kugajevsky
elderly. Last year, AoA contracted for an outside evaluation of the
Title III program and its 1,500 community projects. This was a
nationwide evaluation which included a survey of a sample of 100
projects (80 active, 20 defunct); a survey of 36 state agencies, and a
survey of 2,000 elderly (1,000 service recipients and 1,000 nonre-
The main purposes of this study were to assess the effectiveness of
Title III projects in reducing unmet needs among the elderly and to
provide a management evaluation of the program. These were the
principal findings of the study: services provided had no measurable
impact in reducing the unmet needs of the recipients; projects did
not serve enough of the older people in minority groups or of iso-
lated elderly people; services were not well matched to the recipi-
ents' expressed needs; services reached only a tiny fraction of the
elderly; and projects were badly underfunded which led to poor
planning and service delivery design, poor management, and inade-
quate staffing.
Notwithstanding these findings, the results of the evaluation were
not uniformly informative. In some areas, findings simply cor-
roborated what was already known. In other areas, however, key
questions could not be adequately answered due to the absence of
required data such as the unduplicated number of elderly provided
with services, costs of services, units of services delivered, needs of
elderly to which services were targeted, and follow-up data on
elderly participants in Title III projects.
More often than not, local projects had no records on which an
evaluation could be based. Consequently, it was impossible to pro-
duce an accurate figure on such a basic statistic as the aggregate
number of elderly people served by Title III programs. Instead, a
guess estimate of between 1,000,000 and 700,000 was produced.
Needless to say, data on service cost, service cost-effectiveness, and
service impacts were equally imprecise.
The result was that an important evaluation was conducted on
AoA's major program for the elderly with little hope that infor-
mation obtained about Title III projects would answer any impor-
tant questions. The data were simply too poor to permit better
results. Not surprisingly, the wisdom of having done the evaluation
was questioned. The results were not beyond doubt. The basic

Areawide Planning for Independent Living
questions of program administrators, of the Department of Health,
Education, and Welfare, Office of Management and Budget,
Congress, and especially of the Senate Subcommittee on Aging
were not adequately answered. In all, it was yet another example of
a less than ideal evaluation.
The lesson in this is that good program evaluation or monitoring
cannot be done without adequate prior preparation of a system to
produce program data. These data, in turn, are not a natural out-
growth of project operation.' They must be planned for and con-
sciously collected. A data collection and monitoring system requires
planning, implementation, and conscientious upkeep of the system
for the duration of the program. In short, administrators must
become as equally committed to evaluating the outcome of services
as they are to providing the services.

There are several alternatives from which the most suitable pro-
gram evaluation and monitoring system (PEMS) may be chosen.
Before this choice is made, however, one must know at what pro-
gram level they will operate.
Recent trends are toward areawide or nationwide program
evaluations. In most past cases, program evaluation has focused
upon a single particular program service. Increasingly, however, the
providers of funds are requesting evaluation on a national or area-
wide basis. For example, the Administration on Aging has been in-
terested in an evaluation of all the nutrition programs they have
funded across the country or in certain regions. But the decision still
has to be made as to the factors to be evaluated. Does one focus on
a single service operation, different operations with the same or sim-
ilar services on a comparative basis, or on the entire target popula-
tion? For example, all older people in a given city needing nutri-
tional supplementation might be selected whether or not they
received any direct service. Or, on a still broader scale, all service
programs could be evaluated as to their impact on the quality of life
of the total aging population. Any and all of these levels of concern
are legitimate and necessary fields of inquiry. Evaluation is needed
at every step in the process of providing services. Fortunately, in-

Program Evaluation-Kugajevsky
terest in evaluation is increasingly being centered on the outcome of
programs as represented by these questions: does the service meet
the expressed social need? does it remedy the unacceptable social
condition? does it have other, more general effects upon the lives of
the elderly?
The point is that services can satisfy some needs, solve some
problems, and have a significant impact upon the quality of life of

Evaluation and Monitoring System

Fig. 1

some aspect of the situations of elderly persons beyond the stated
need and problem dimensions. On the other hand, a service may be
meeting few if any of the ends for which it was established. Even
worse, it may be intensifying the social need, creating other social
needs, creating a greater problem, creating different problems, or
lowering the quality of life in some way.
The most appropriate level at which these questions can be an-

Program Evaluation

* Program efficiency

* Program effectiveness

* Program performance

* Program adequacy

* Program preventive

* Planning

* Policy setting

Program Operations
Monitoring and Documentation

* Management procedures

* Fiscal accounting

* Staff and personnel
procedures and systems

* Facilities planning and

* Organizational design
and procedures

* Inter-agency coordination
and procedures

Areawide Planning for Independent Living
swered is at the areawide, regional, or national level. Hence, there
are sound reasons for focusing on these levels and devising program
evaluation and monitoring systems appropriate to use at the area-
wide, regional, or even national level.
A program evaluation and monitoring system appropriate to area-
wide or regional levels needs to be developed from the local pro-
gram upwards. The basic building block for an areawide PEMS is
the local program and the program evaluation and monitoring sys-
tem appropriate to it. The essential structure can be thought of as
resting on two footings as depicted in figure 1.
Most local programs have well-developed program operations
monitoring and documentation systems. Typically, program oper-
ations monitoring and documentation is the most highly developed
component of local service systems. This is not surprising, since it
insures program survival, at least for the short run. This component
assembles and provides data on how money is used, what staff
members are hired, what they work at, and what activities or serv-
ices are being produced. These are all requirements laid down by
funding sources. Indeed, the funding sources for most programs
prescribe in elaborate detail all the procedures and stipulations for
operations monitoring and documentation. Thus, this component of
an evaluation and monitoring system is normally handed over to
local project administrators in a uniformly prepackaged form, e.g.,
Title III Manual of Policies and Procedures; Title VII Manual of
Policies and Procedures.
However, the program monitoring and evaluation component is
seldom so well developed. Here, program administrators are more
frequently left to their own devices. What are their choices? Pro-
gram evaluation can be divided into three broad techniques: pro-
cess evaluation, impact evaluation, and systems evaluation.10
Process evaluation focuses on how efficiently a service program
operates. It is based on the assumption that to the extent that there
is organization efficiency, there will be something valuable coming
out of the program. Impact evaluation is concerned with assessing
changes in recipients of services. It is premised on the assumption
that the impact of service is measurable and can be identified
separately from the influence of other factors. Systems evaluation
takes a holistic view of a program including the degree to which

Program Evaluation-Kugajevsky
objectives are achieved, recipients impacted, and the totality of a
problem affected by the program. It is premised on the assumption
that a balanced, comprehensive view of a program is possible and
the required parameters are measurable."
Most program evaluation systems to date have concentrated on
process evaluation. Besides being technically less demanding and
less expensive, process evaluation with its concern for administra-
tive detail is usually considered more useful by program adminis-
tration. In addition, program funders, and the general public, are
usually more suspicious about management and accountability,
rarely doubting the program's effect on the people served. There is a
general assumption that social services for the elderly accomplish
their stated goals-at least for those who do get the service-and
that if people get the service they benefit from it.
Impact evaluations have been avoided because of their greater
technical difficulty and the still extant problems of developing ade-
quate indicators that measure the impact of social services upon the
needs of the elderly. For example, how does one measure the im-
pact of recreation and leisure upon isolation?12
Systems evaluation is preferred for areawide program evaluation
because of its multiperspective approach. This approach is selected
because every program on aging has limited resources and resource
allocation decisions must be made; these then become the focal
points of an effectiveness evaluation. For example, an areawide
program might devote the bulk of its resources to outreach and re-
cruitment in an attempt to serve as many elderly as possible;
another might concentrate on delivering or offering a maximum
diversity of services to its clients; a third may emphasize the pro-
vision of only the most intensely needed services; while a fourth
might focus on serving the "totality" of needs of its clients. Clearly,
areawide service programs will have different emphases and cor-
respondingly different resource allocation patterns. Under these cir-
cumstances, a meaningful program evaluation methodology must
be capable of assessing each program from a multiplicity of man-
agement perspectives.
For these reasons, the recommended systems model for evalua-
tion of areawide programs is seen in terms of these four types of

Areawide Planning for Independent Living
Efficiency.-The measurement of the amount of effort, activity,
services, products being produced for given amounts of input of
resources (money, manpower, and so on). The main question here:
are there more efficient ways of achieving the same results?
Effectiveness.-The measurement of the results, impact, benefit
of the effort itself. The main question here: did the program output
produce a desired change-did the recipient of a service benefit
from it, and did his status improve?
Adequacy.-The measurement of the degree to which the pro-
gram covers the total amount of need. The main question here: how
adequate is the program in terms of total need, and what percentage
of those who should be touched by the program really are being
Preventive impact.-The measurement of the extent to which a
particular problem is being controlled; for instance, how many
elderly persons is the program preventing from being institutional-
ized by doing something now to avoid something from occurring
These four indicators can be further specified: efficiency-the
cost per unit of output of services provided to older persons; effec-
tiveness-the extent to which needs or problems of the elderly are
reduced or solved by receipt of services; adequacy-the extent to
which the program has an impact on the total number of elderly
persons in need of its services; preventive impact-the extent to
which the number of elderly persons who are vulnerable to institu-
tionalization is reduced. Relationships between these different types
of indicators are depicted in figure 2.
This systems model for program evaluation shows various com-
binations of areawide program resources (manpower, facilities, and
so on) that are transformed through the program operating process
into service outputs. Service outputs are units such as hours of coun-
seling, appointments, and client visits. The "efficiency" measure
describes the relationship between program resource inputs and
their corresponding service outputs. This relationship is usually
measured in terms of cost per unit of output. It says nothing about
the impact of such services on the clients in terms of results or prob-
lem-solving. The "effectiveness" indicator is employed for this
purpose and measures the extent to which service outputs are in fact

Program Evaluation-Kugajevsky

successful in reducing needs or problems. The effectiveness of social
services is then measured in terms of need or problem reduction
rather than simply in the quantity and amount of services provided.
The model is thus oriented to results.


I1 P1 01 -- E -

12 2 02 E2

In -- Pn On En


Fig. 2

The third measure relates to the "adequacy" of areawide pro-
gram performance in terms of unmet need. This measure requires a
needs analysis and represents the ratio between that proportion of
the service population for which needs are reduced and the total
number with needs. This is a very important measure in that it gives
management an indication of relative program performance. A
program with limited resources may be very effective for the few
elderly persons it serves but grossly inadequate in terms of the total
number with needs in the program area.
The fourth measure, preventive impact, is the change (presum-
ably a reduction) in the growth rate of the "population at risk" that
can be attributed to social services that are preventive in nature.14
For example, home care services should reduce the incidence of
unnecessary institutionalization of people receiving these services.
Although difficult to measure, preventive impacts must be consid-
ered along with other measures of social service effectiveness.
The four indicators are the essential components of a sound local
areawide program evaluation system. Once translated into quaritita-



- 0


- 100

--- 0


- 100

-- 0

- 100

Composite index for
-.. 0 program evaluation

Fig. 3. Composite index for program evaluation

Preventive impact

- 100

-- 0

Program Evaluation-Kugajevsky
tive measures, they can be consolidated with some appropriate
weighting scheme into a single, combined areawide program eval-
uation system. The underlying concept of such a consolidated pro-
gram evaluation system is illustrated in figure 3.15 While clearly sim-
plistic, the development of such a summary program evaluation
index is useful and necessary for transforming massive amounts of
data about areawide programs into useful information for making
management decisions.
The systems model approach to evaluation is a vital part of an
areawide strategy for programs in aging. It levies some very spe-
cific data requirements: comprehensive analysis of needs of the
elderly (for measuring adequacy and preventive impact); client
tracking system across agency lines; in-depth assessment of pro-
gram participant needs; client follow-up (to assess service effective-
ness); service cost documentation; and service objective docu-
mentation. These are the minimal information requirements for
implementing and using the systems model for areawide program
evaluation and monitoring.1'
For the most part, programs in aging across the nation have not
systematically collected this sort of information. The reasons are
clear when one considers the cost, effort, and technical difficulties of
such an undertaking. Yet, if the areawide planning and programing
effort is to be launched, it must begin with a comprehensive plan-
ning effort which in turn must include a comprehensive (probably
multicounty) analysis of the needs of the elderly. This analysis of
needs must then be translated into a resource allocation plan, an
example of which is shown in figure 4. The multicounty resource
allocation plan then becomes the basic data document which shows
those needs that are extant and identified for programing, the
number of elderly persons that have these needs, the number that
will be served, and the number and cost of service units they will
The resource allocation plan is also the baseline from which the
system model begins measurement of program effectiveness. The
plan represents the task to be done. As the plan is transformed into
an operating program, the application of the system model to the
plan baselines will tell program managers how well or how poorly
they are doing.


Fig. 4. Resource allocation plan

Program Evaluation-Kugajevsky
Specifically, the systems model will begin systematic monitoring
and evaluation of the performance, effectiveness, and adequacy of
the areawide program. Hence, the model is vital to good manage-
ment of areawide programs. It will provide program managers with
information to monitor the progress of the areawide program, to
institute corrective action while it still can have some effect, and to
reprogram resources to areas of highest payoff.
If the systems model is used in areawide programs, it will repre-
sent a giant leap towards effective management of programs for the
aging and better benefits and accountability to the elderly persons.
The areawide programs could then become models of effective
social programing.

It is the rare program administrator who looks at program evalua-
tion and monitoring systems in terms of the elementary economics
of information.17 The logical function of PEMS is to provide the
areawide program administrator with information that will reduce
the likelihood of his making an expensive mistake. Therefore, the
amount which should be invested in areawide PEMS should be con-
trolled by the potential costliness of making a mistake or bad pro-
gramatic decision. This method for deciding the level at which an
areawide PEMS should be funded and operated is a mistake-mini-
mizing strategy.
Habitually, most program administrators underestimate the need
and value of PEMS before making an irrevocable program decision.
They have a natural incentive to de-emphasize PEMS because set-
ting one up and operating it is usually expensive. For example,
many administrators will balk at spending $50,000-$100,000 to de-
velop a PEMS, even though they are making program decisions in-
volving $5 to $10 million. Yet, a mistake causing the misprograming
of just 2 per cent of funds would represent a waste of $100,000-
$200,000. In addition to the waste created by directly mispro-
gramed funds, there is a powerful indirect cost multiplier. For
example, elderly persons who, because of misprograming of serv-
ices, fail to receive home care services and are therefore unneces-
sarily institutionalized create an added and unnecessary cost to the
public treasury of $5,000 per person. This is in addition to the harm

Areawide Planning for Independent Living

that unneeded institutionalization wreaks on the elderly.'8 One
could search the records of the Title III program and discover nu-
merous examples where the absence of an operating PEMS led to
costly and irrevocable mistakes-mistakes that involved planning
for the wrong service, no reprograming when needs of the elderly
changed, or simply delivering the wrong service. Such errors be-
come rife when "seat-of-the-pants" judgments are used to assess the
worth and effectiveness of a program rather than using a PEMS to
systematically document program effectiveness (or lack of it).
The areawide program can become victimized by the same short-
sightedness which omitted developing a good PEMS for the Title
III program. We must hope that areawide program administrators
will recognize the importance of establishing a PEMS as an integral
part of the areawide strategy. If they do, their foresight will save
them from repeating some of the fatal mistakes made in the past.
Their reward for implementing a viable PEMS will be a recogniz-
ably better managed program and demonstrably better results in
meeting the needs of the elderly.


1. Message of the President on Reorganization of the Executive Branch, March
12, 1970.
2. For elaboration of this point, see Alternatives to Nursing Home Care, Report
by the Special Committee on Aging, U.S. Senate, October 1971.
3. On this, see Donald P. Kent, Research Planning and Action for the Elderly: The
Power and Potential of Social Service (New York: Behavioral Publications, 1972),
and M. W. Riley and M. Fouer, Aging and Society (New York: Russell Sage Founda-
tion, 1968).
4. See, for example, F. G. Caro, ed., Readings in Evaluation Research (New York:
Russell Sage Foundation, 1971), and E. A. Suchman, Evaluative Research (New
York: Russell Sage Foundation, 1967). Suchman's book is probably the best treat-
ment of the conduct and design of evaluative research of social programs.
5. See Suchman.
6. A good discussion of the differences between monitoring and evaluation is
found in John Hannah, ed., Evaluation Handbook (Washington: AID Office of Pro-
gram Evaluation, 1972), pp. 2-5.
7. For further discussion of obstacles to performing evaluation, see John Mann,
"Technical and Social Difficulties in the Conduct of Evaluative Research," in Caro,
pp. 175-84; see also Suchman, pp. 151-62.
8. Copies of the report of this evaluation may be requested from AoA, Public
Information Office.
9. Operations people seldom understand what data are needed for evaluation and
evaluators seldom communicate these needs at an early enough stage of program
design to have any effect. This situation clearly argues for getting the operations per-
sons together with researchers from the start of any project. See S. Donna Lind and


Program Evaluation-Kugajevsky

John E. O'Brien, "The General Problem of Program Evaluation: The Researchers'
Perspective," The Gerontologist (Winter, part 2, 1971).
10. For further discussion of major types of evaluations, see Suchman.
11. For further discussion of these and other types of evaluation, see B. G.
Greenberg, "Evaluation of Social Programs," in Caro, pp. 155-74.
12. A classic example of the difficulty of developing impact indicators is the
Social Indicators in the Aged project (Institute for Interdisciplinary Studies, Minne-
sota). AoA too tried, through this project, to develop indicators that measure the
status of the elderly in such areas as health, housing, social contact, and so on, and the
impact of programs on these. To date, the indicators have failed to satisfy anyone as
to their adequacy and are being extensively refined.
13. Suchman discusses the first three indicators in detail. The fourth indicator is
described in R. Kandle, "Evaluation in Public Health," Public Health 12 (1953): 14-
14. For further discussion of the "population of risk" concept, see "Measurement
of Social Service Effectiveness," study prepared by Booz, Allen for the Social and
Rehabilitation Service, HEW, Report no. 078-72.
15. Obviously this consolidated program evaluation system would need to weigh
each of the component indicators according to their relative importance. These
"weights" would be developed subjectively by what administrators thought were
appropriate weighting-or objectively by the volume of resources going to each in-
dicator area or by its impact on solving problems of the elderly. For a discussion of
possible weighting systems, see M. T. Hannah, Problemed Aggregation and Dis-
aggregation in Sociological Research (Chapel Hill: Institute for Social Research,
16. The ideal vehicle for handling these sets of data would be a computerized
"Gerontological Data Book" or GDB. This GDB would contain, on an up-dated
basis, information on the total elderly population in an areawide program area, its
needs, the services being provided, the changes in needs over time, and the programs
associated with these changes. This GDB would then permit rapid evaluation of
efficiency, effectiveness, adequacy, and preventive impact on a longitudinal basis,
thus revealing cause-effect relationship. It would be a powerful planning and pro-
gram management tool. It is, however, initially very expensive and difficult to
establish such a data bank.
17. For an economist's view, see Anthony Downs, "Some Thoughts on Giving
People Economic Advice," American Behavioral Scientist 9 (September 1965): 30-32.
18. See "Penny Wise and Pound Foolish, the Relative Costs of Homebound
Versus Custodial Care," G. W. Wagner mimeograph paper Director Cafe Co-op
Project, Hudson Guild Center (New York, 1972).

Federal Relationships to Planning
at Regional and State Levels


PRESIDENT NIXON, in his address to the 1971 White
House Conference on Aging, referred to his intended plans to give
special emphasis to services that will help older people live decent
and dignified lives in their homes. The President's recently sub-
mitted budget for 1973-74 proposes $196 million for special pro-
grams related to this thrust, including approximately $100 million
for a broad range of nutrition services.
The national goal, as reflected through the Administration on
Aging, is "to assist older persons throughout the nation to live inde-
pendent, meaningful, and dignified lives in their own homes or other
places of residence as long as possible, emphasizing the lessening of
isolation and the prevention of unnecessary institutionalization."
There are three key objectives related to this goal. Institutional
reform will eliminate barriers which prevent the elderly from lead-
ing independent lives, as measured by changes in laws, policies, and
practices of the institutions of the community which contribute to
such barriers. A comprehensive services system will strengthen
existing service systems for assuring the provision of comprehensive
and coordinated services necessary to enable older persons to live
independent lives in the retirement years as long as possible. Ser-
vices integration will make maximum effective utilization of existing

Federal Relationships to Planning-Nicholson

public and private community resources through joint and coopera-
tive planning, funding, delivery, and evaluation of services neces-
sary to enable older persons to live independent lives.
This goal and these objectives were first announced about a year
ago at a meeting of state units on aging in Washington. The Admin-
istration on Aging's proposed strategies for 1973-78 continue to re-
flect this direction. The area planning strategy is intended to be the
vehicle through which we pursue this goal and these objectives. This
strategy is reflected in the amendments to the Older Americans Act
now before the Congress.
Because of financial limitations of the program, the intent is to use
the state resources of the Older Americans Act primarily in carefully
selected, high impact areas of the states. Each state would be
divided into planning and service areas, from which the high impact
areas would be selected by state officials. No area selected for pro-
graming could be smaller than a county but it could embrace
several political jurisdictions. Programs could be developed in-
crementally in these high impact areas, with future efforts directed
toward program coverage throughout the entire planning-service
The strategies call for area agencies on aging to be established in
the high impact areas to serve as catalysts in the development of
effective programs on behalf of the elderly-not as operators of
service programs. Primary emphasis will be devoted to getting serv-
ices to older persons who are in need of but are not being served by
the existing service delivery systems. The basic responsibilities of
the area agency on aging relate to the planning, coordination, and
evaluation of services for older people.
A careful observer might note that these new directions run some-
what counter to certain existing themes, and consequently problems
may arise if we pursue our course. And yet in each problem there is
an opportunity. Three areas come to mind in which these problems
may occur.
Our focus on the aged and efforts to mobilize resources on their
behalf is contrary to the high priority placed on services to youth.
The opportunity we have is to expand and increase public aware-
ness and support of programs for the elderly, but not necessarily at
the expense of services to the young. And we are well aware of the

Areawide Planning for Independent Living
possibilities that efforts may be devised to render services to both in
a blending way, i.e., the Foster Grandparents Program (FGP).
Second, the incentives and rewards in our system have tradition-
ally been toward the institutionalizing of older people. The goal of
independent living is referred to by some as an alternative to institu-
tional care. This phraseology causes some to think the intent is to do
away with institutions. This is not the case. We need and want first-
class institutional programs. We now want to provide options,
choices, and other alternatives through community and in-home
services. As such options are created, professional staff in and out of
institutional settings will be forced to reconsider existing criteria for
service eligibility to assure that appropriate services are provided to
the consumer when and where needed.
A third thrust, running counter to much of the system, is the con-
cept of the community in area planning. Such planning, I believe,
should be community and people oriented-not agency oriented.
The delivery systems should be viewed from the standpoint of the
consumer. We want to make the system more responsive to the
people rather than fitting the people into the system. There will be
many points at which community and agency interests are the same.
But we must also recognize there will at times be disagreement,
conflict, and controversy. I would point out that honest people may
disagree. Let us hope it will be creative conflict.
Problems can be opportunities. As Charles Kettering once said,
"problems are the price of progress. Don't bring me anything but
trouble. Good news weakens me." The pursuit of our goal and
objectives provides many potential linkages with public and vol-
untary agencies and other organized groups. A planning strategy
should make it a reality.
A partnership effort is required too among the local, state, and
regional efforts. The approved authority for funds for various pro-
grams or projects will vary considerably, sometimes requiring co-
ordination among the different levels of government to implement a
particular program. This is the vertical relationship which our
regional office has with states and communities. In the aging pro-
gram, our main point of contact in the state is the state unit on aging.
Our purpose is to assist state units to build their capacity through
technical assistance, consultation, and monitoring. We seek to

Federal Relationships to Planning-Nicholson
complement, not duplicate, their endeavors. State units on aging
have a similar responsibility to local committees. "Partnership for
Older Americans," by the way, is the theme for the forthcoming
Senior Citizens Month.
The Administration on Aging's Social and Rehabilitative Services
is our focal point in the central office. We work within the goals,
objectives, and priorities established by the Department of Health,
Education, and Welfare, SRS, and AoA. Our aging strategy is
closely related to the proposed allied services programs and to other
efforts in the department to de-emphasize institutional care through
increased support of community care, i.e., mental health, nursing
homes, and institutions for retarded. We now have an annual plan-
ning cycle in HEW which meshes program priorities, management
objectives, long-range planning and budgeting, development of
legislation, evaluation and research, and operational planning. The
process moves from the long-range to the immediate, from the
general to the particular, and from the imprecise to the measurable.
The Operational Planning System, an innovation in managing social
programs, is a key element in this effort. Through this method we
establish specific goals and set deadlines. Management conferences
are conducted to review progress toward these goals. This is a con-
tinuous but flexible process and strategies can be changed.
To complete the frame of reference within which our regional
office operates, we have a set of relationships to other regional fed-
eral and nonfederal programs. These are our horizontal relation-
ships. Our Regional Office on Aging Services has recently expanded
its professional staff from three to ten. We expect to improve the
quality and volume of our work. Our primary purpose is to provide
technical assistance and consultation to state units on aging and to
monitor their activities as related to Title III of the Older Americans
Act. We want to build the capacity of the states and, through them,
communities. Our authority over funds is very limited and is cur-
rently related to continuation grants for training and areawide pro-
grams. Our state units on aging, through formula grant funds, have
the bulk of the money in the aging program and are responsible for
allocating, administering, and monitoring these funds.
We and our state units on aging are expected to carry out certain
responsibilities under the Older Americans Act. But one must still

Areawide Planning for Independent Living
take legislation and regulations, written on a piece of paper, and
make them viable.
The 1969 amendments to the Older Americans Act first pointed
our program in the direction of statewide planning, coordination,
and evaluation of services for older people. Shortly after, activities
were begun in preparation for the White House Conference on
Aging. In Region IV, we saw this as an opportunity to begin estab-
lishing a base for planning, through the involvement of citizens and
providers of service in our activities. In concert with our state units
on aging, we set an objective to have at least one community forum
in every county in the region, a total of 736. In the regional office, we
mobilized the resources of regional, federal, and voluntary agencies
to complement state efforts. We had 1,056 forums-about 20 per
cent of the total of those conducted across the country.
We then proceeded to area conferences, which we agreed to
organize around the substate planning districts which were begin-
ning to evolve. A total of eighty-six such conferences were con-
ducted. Local and state agencies were encouraged to participate in
the community and state conferences by regional counterparts.
To provide for the active participation of regional representa-
tives, two regional hearings were conducted before the South-
eastern Federal Regional Council. At the last such hearing, testi-
mony was received from the chairmen of the state White House
conferences on aging. A common theme was concern about the lack
of options for older people to institutional care.
The Federal Regional Council is comprised of the director of
several regional agencies, including the Department of Housing and
Urban Development, Office of Economic Opportunity, Depart-
ment of Transportation, and the Department of Commerce. The
council's purpose is to coordinate federal programs so they are more
responsive to state and local needs. Because of their involvement in
the regional hearings, the council readily responded when a pro-
posal was submitted to them to create a regional planning resource
committee on aging. The purpose of the committee is to serve as
a focal point for planning and coordination of resources for older
people. Representatives are on the committee from HEW, HUD,
OEO, DOT, Department of Labor, Community Action Program,
and the Department of Agriculture.

Federal Relationships to Planning-Nicholson
In February 1971, following the announcement by AoA of the
goal of independent living and the areawide strategy, our regional
committee, in concert with our state units on aging, adopted the
goal and agreed to a cooperative partnership effort to achieve it. In
March 1971, our regional committee and state units on aging jointly
sponsored a regional meeting in Atlanta, on the theme of independ-
ent living. Approximately 175 selected representatives were in-
vited from regional and state agencies concerned with welfare, the
blind, mental health, OEO, labor, and so forth. We wanted these
agencies to be involved from the beginning and so we continued to
strengthen the linkages we had begun to create with the activities of
the White House Conference on Aging. Some states followed up
with state level meetings.
When the Administration on Aging began to release special
project funds for area planning grants for the new direction re-
flected in the proposed amendments to the Older Americans Act,
we were generally prepared to take advantage of it. For each such
project funded by central office moneys, our state units on aging
agreed to fund one with a Title III community grant. Our objective
was forty such grants by June 30, 1973.
Much has been said about dividing the state into planning and
service areas or into substate planning districts. You have heard of
the recent action taken in Florida. Let us look at a larger perspec-
tive. About three years ago, the President, by executive order, estab-
lished ten regions in the nation and mandated that certain federal
agencies reorganize their territories to be consistent with these
regions. Today, therefore, the regional offices of HEW, OEO, DOT,
HUD, and DOL all embrace the same eight southeastern states.
Prior to that time, for example, HEW covered only six states.
The idea of uniform substate planning districts just came about in
Georgia. All the southeastern states have now officially made these
designations of substate planning districts, either by an executive
order of the governor or by state legislation. These eight states, a
total of 736 counties, have been divided into about 86 planning and
service areas.
It is my understanding that selected federal programs are now
being asked to relate to the substate districts established by the
states. In addition, over time, various state programs may also have

Areawide Planning for Independent Living
to be structured in this way. It would be difficult, if not impossible,
for a state program on aging to divorce itself from such trends.
When the state units on aging in Region IV were faced with the
decisions of dividing the states into substate districts for the funding
of area planning grants, our regional office encouraged them to
consult carefully with state planning bureaus, the governors' offices,
and other state agencies in making that decision and in identifying
the high impact areas in the state for area planning purposes. The
states decided to tie into the trends already under development.
To date, we have forty area planning grants in place in the region
in high impact areas as defined by the states. The central office has
funded twenty-one of these and the states have funded nineteen, for
Title III community grant funds. We expect another four to be
funded. Of the 736 counties in Region IV, 293 are now embraced in
the current area planning grants, or 39.8 per cent. There are
4,620,284 persons age 60 plus in the region; 1,889,252, or 40.9 per
cent, live in the high impact areas.
The planning grants, with three exceptions, are operating through
area district organizations which were established by the partici-
pating counties. While such agencies have been primarily involved,
to date, in physical planning, we note some movements toward area
public housing authorities and comprehensive health planning.
These agencies are sometimes referred to as "the clearinghouse"
agency for the Office of Management and Budget according to its
circular A-95, a process requiring organizations in the locality which
seek federal funds to clear the request through the planning body.
In September 1971, our regional office, with participation by
other federal agencies, conducted an orientation session with repre-
sentatives of state and area agencies on aging. Again, all the plan-
ning grants in the high impact areas are related to the goal of
independent living. And so we have local, state, and regional
agencies focused on a common goal.
In addition to the key objectives of removal of barriers to inde-
pendent living, there are other objectives involved in our work plan.
Public affairs.-Aside from the usual public information activities
embraced at the regional level, we are attempting to identify
various regional conferences conducted by other agencies and are
asking to be placed on the program. In this regard, I have spoken to

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