Transportation

DOCUMENT RESUME ED 072 346 AC 01* 188' TITLE To Ward a National Policy on Aging: .Volume Background, Organization, Program.Volume II. Conference Findings- and ReCorMaendatiOns frOm- the Sections and SpecialConcerns -Sessions. Final Report. INSTITUTION White _Hail Se C_ onferenCe- on Aging, Washington,D.C. PUB DATE 2' Dec, 7-1 NOTE 462p.; ,Proceedings of the White House Conferenceon Aging, *Washington; -D.C.,,, November 28-Dedember2, 1971 AVAILABLE FROMSuperintendent of boCuMents, U.. S. Government Printing Off ice, Washington,D'.C. 20402 (S/N 1762 -0069, ;6.75' set Oftwo volumes) vEpits- :PRICE MF$0.65 THC-116.4 DESCRIPTORS. Adult ,DeVelOpMent; *Adult -Education-ProgramS; *donterence 'Reports; *Federal_ Legislation-'Health' Minority Groups; *National -ProgramSt.*Older Adults ; .Psychological NeedS;SocioecoriOMic Influences-- IDENTIFIERS *White. Hciuse= Conference ori Aging 1971 ABSTRACT TheSe two volUMes coMpriSe the officitalproceedings of the second White House Conferenceon AgiOq,. held-NOyenibek 28=December _2, 1971. Volume includes an overview of the Conference plan--its' concepts, organization, and prOgraniming: It 'presents the cOntributiOnS made bySpeakers at the` General Sessions and-COnference Delegate inncheons.Volume II is devoted to reports.-of the work of tbe 14 SubjectArea sections= and the_ .17 Special 'COncernS SeSsionS, which resulted. in the ,formtilation: ofthe COnferende reboriithendatiOris. -TheSe recoMMenda'tiOnS-concern- the follOwing: EddCation;. EMO.oyMent and Retirement;- Physical and meotai Health;- Housing; Income; Nutrition; Retirement Rolesand Activities; Spiritual -Well- Being; Transportation; Facilities,Programs,- and S-eri.rices; Government and NOngoverriritentotqatazatitin; Planning; Research and .Demonstration; Training;iiealtb daie Strategies;= Disability, and Rehabilitation;The Rural and the :Poor Elderly; The Elderly' Among the MinoritieS; -ProtectiVe-andand Social SUpport; and Roles: -for Old and Young.(DB) U S DEPARTMENT OF HEALTH EDUCATION i1 WELFARE OFFICE OF EDUCATION THIS DOCUMENT HAS 6FE \ REPRO DUI.ED ExACTt, RELEtED FRom WE PERSON OR ORY. On OR} iNA TING IT PoiNTS ei OR OPiN IONS STATED 00 NU REPRESENT OFFICIAL OFFtcF OI TOO CATION PUSI-,ON OR POLICY OFFICERS AND STAFF DIRECTORS

Chairman: Director: ARTHUR S. FLEMMING JOHN B. MARTIN Vice Chairman: Executive Director: BERTHA S. ADKINS WEBSTER B. "row, JR.

Co-Directors of Technical Activities: WiLma DONAH6E, CLARK Timurrs Director of Regional and State Relations: RAY SCHWARTZ Director of National Organiiations: DOROTHY MCLEOD Director of Public Information and Public Affairs: JoHN EowARDs Administrative Officer: FLORENCE JONES Director of Logistics: JOHN CHRISTMAN Special Assistant to the Chairman: JULIE. ERICKSON Special- Assistant to the Executive Director: TINA FORRESTER

NATIONAL PLANNING BOARD

ARTHUR S. FLEMMING, Chairman BERTHA S. ADKINS, EARL G. WARREN, -INABEL B. LINDSAY Vice Chairmen t

TARP ADAMS JOHN W. EDELMAN ALFRED IL LAWTON SEBASTIAN RODRIGUEZ DAVID L. ALVARADO CARL EISDORFER MELINDA ANN LEE E.BONNY RUSSELL DECKER AN STROM EDWARD K. (DUKE) MARCELLE C. LEVY WILLIAM L. RUTHERFORD ELOISE HARDISON BANKS ELLINGTON ELIZABTH K. LiNc.co.x MARGARET C. ROBERT W. BARON FRANCES FAIRBANKS EDWARD J. LORENZE SCHWEINHAUT MARGARET BARTOSEK *THOMAS E. FIELDER RUBYE. STUTTS LYELLS *HESS T. SEARS ROSEMARY BAXTER RABBI Louts FINKELSTEIN JOHN W. MCCONNELL. DAVID C. SINGLER MARIETTA RUMBERG BENCE * WILLIAM C. FITCH LAURA.B. MCCOY ELEANOR-F. SLATER' JAMES S. BENNETT MYRTLE C. FONTENO WALTER C. MCKAIN WILLIAM E. Sxuccs *ROBERT D. BLUE JULIAN P. Fox, JR. JOHN B. MCPHERSON ARTHUR L. SPARKS FRANCES P. BOLTON DANNY FRANK *GEORGE MEANY MARY E. SWITZER WALTER L. BOND S. ROSS GREENWOOD *CARSON MEYER *CHARLES P. TAFT MAR J ORIE T. BORCHARDT *ALFRED M. GRUENTHER DAVID MII.I.ER ROBERT H. TAKEUCHI KATHLEEN MERRY A. WEBB HALE A. LUTHER MOI.BERG BRADLEY L. TAYLOR BRODERICK *CECIL M. HARDEN THOMAS C. MORRILL PETER E. TERZICK RICHARD P. BUTRICK A. BAIRD HASTIN :5 ROGER F. MURRAY J. FRANK TROY HERBERT R. CAIN, JR. *ROBERT J. HAVIGHURST NOVERRE MUSSON MARY ELLEN TuLLY BLUE A. CARSTEN SON AII.EE HENRY *BERNARDE. NASH *BERNARD S. VAN *CHARLES H. CHASKES ADELAIDE C. HILL MELVIN N. NEWQUIST RENSSELAER MARGUERITE STITT TIBOR HORANYI JAMES C. O'BRIEN CHURCH *THOMAS G. WALTERS *LUCIUS DUB. CLAY GRACE HOWARD CARTER C. OSTF.RBIND JESSE P. WARDERS W. FRED COTTRELI. *HOBERT C. JACKSON FRELL M. OWL DONALD M. WATKIN *NELSON H. CRUIKSHANK JoHN A. JACKSON OLLIE A. RANDALL PAUL DUDLEY WHITE CONSUELO CASTILLO DE RONALD L. JENSEN GEORGE G. READER GEORGE K. WYMAN BONZO CERNORIA D. JOHNSON PATRICIA ROBERTS CLARA YANEZ LOUEI.LA C. DIRK SEN VICTOR KASSEI. ROBERT B. ROBINSON STEVE ZUMBACH

Executive Committee: The Chairman, the Vice Chairmen, and members whosenames arc marked with an asterisk(*) 1971 Wirt 'HOUSE CONF.,ERENCE.ON AGING November 28 Dicenibee 2 Washington, V.

Background Organization Program

CONTENTS In VolumeI. Page Letter of Transmittal--Elliot- Richardson ForewordArthur S. Flemming vii PrefaceJohn B. Martin ix

PART 13ackgrOund, Concepts, Planning

The Need .for a Second White House Conference,on Aging 3 Legislative History 4 Appropriations 6 The -President's Proclamation, 6 The Conference Plan

The Three. Year CotiferetiPlan---._. ,.. PlanAn Overview 6 TPrincipal Task of the Conference-7-Policies for Aging 7 Subject Matter Content 8 The Conference -Planners- 11 The Conference Materials 14

PART 2 Actionat Community and State .Levels The State Agencyon Aging 21 Survey of the State's Older People Training for Community Forums andOnferences 22 Older American White House ,Forums 22 Community White House Conferences on Aging 25 State White House Conferenceson Aging 26 Activities of National Organizations 27 Regional White House Conference Hearings 28

PART 3 The National Conference in Preparation

Establishing a National- Climate of Action 33 Consolidation of Recommendations 34 Categories of Conference Participants 35 Conference Format General Sessions 38 Subject Area Sections and Subsections 38 Special Concerns Sessions 41 Selection and Training of Conference Leadership 41 Assignment and Preparation of Conference Participants 42 `it

PART 4The National"Confcrence in Action

. The °inference Setting - 45. Characterisiics of the Delegates 46 The- Conference- Program 51 The Opening General Session 53 The Open Forum 59 The Conference Luncheon Programs 83 The Closing General 'Session, 135

PART 5 In Summary

A-Delegate's View of the Conference -147

PART 6 Appendices

A.White House Confereikeon Aging Act 155 B.Officials and Staff 157 C.National Planning Board 158 D.State Planning Officials 159 E.Conference Participants State Delegates 160 National Organization Delegates 171 Invited Observers 181 F.Special, Committees : National Assn. of State Units On Aging LiaisonCommittee 183 Committee to Assist Disabled Delegates 183 Advisory Committee 'for the Multi-mediaPresentation______183 G.Government Agencies Providing Assistanceto the Conference 183 H.Rules of Order 184 I. Titles and Authors of "Background andIssues" Papers 185 J. OutstEnding Older Americans 186 K. Senior Portrait Contest 186

Recommendations of-the Sections and Special Concerns Sessions follow in Volume II

iv THE SECRETARY OF HEALTH, EDUCATION, AND WELFARE WASHINGTON, D.C. 20201

Dear Mr. President: It is my privilege to transmit to you this official' report of the Second White House Conferenceon Aging, held November 23 December 2, 1971, in Washington, D.C. The Conference included a number of unique features of special interest. First, it was conceived` not -asa single event, but as a process extending over A three-year -period during which important activities would take place-at local; State and .national levels in both the-Public and: private sectors. Second was a .strong focus, throughout the Conference, on a major 'involvement of a relatively large proportion.,of thenation's older people. Third the inClusion,of ,youth in planning and decision-niaking roles, and as delegates `to- the Conferehce. A fourth innovation was the initiation of. national policyrecommendations at the community- level, whichwere refined in State conferences and; after-'fur her Consideration and sharp= ening, offichlly adopted by the delegates at the National Conference. I have examined these recommendations and find them remarkably practical, and concerned withmany of the .same issues and objectives to which your Administrationis addressing itself. The Conference findings will bea continuing source of guidance in the immediate future, not only to the Federal goVernment but to States, local communities, and national organizations concerned with older people. In my .judgement, the Second White House Conferenceon Aging has made an outstanding contribution toour Nation's efforts to bring more security and greater meaningto the later years of every Older American. Respectfully,

Elliot L. Richardson Secretary .1w

e- s

411

4 FOREWORD

Old age has no fixed ,term, and one may fitly live in it so long as he can observe and discharge the duties of his station... DE SENECTtTE CICERO (106-42 B.C.)

he1971 White House Conference on Aging sought to crystalize in national policy the dimensions ,of a society in which older Americansmay "fitly live" while completing the adventure of life with fulfillment and serenity. By bringing together nearly 4,000 of America's citizens to explore the. circumstances of the nation's older population and to recommend.po!icies needed to improve those circumstances, the White House Conference on Aging has initiated a new era for the "noW, generation" of older people, as well as for the generations comin^ after. The Delegates came to the Conference in Washington keenly aware of the importance of their work. Well prepared by pr'vious participation in local, State, and other pre-Con- ference activities 'and through study of materials distributed prior to the Conference, they came with anticipatory enthusiasm and with the intention of makingevery moment count toward the achievement of their goal. As a result, the Conference produceda remarkable set of recommendations. The one overriding goal of all therecom- mendations was to assist the aging personto maintain his independence and to provide dignified protection and assistance for those unable to maintain full independence. Within the complex of the total population of the nation's elderly, the special handicaps and problems of older members of the racial-ethnic groups were examined in special sessions. Policies and programs tailored to accommodate their cultural patterns and relieve their particular deprivations were outlined in detail. Delegates who participated in these sessions took full advantage of the opportunity to presentto a national audience a cull statement of the financial health, and psychological needs

vii of their elderly populations. Asa result, in the'future, legislative programs, and national, State or local planning programscan be based on clear and far- reaching- statements of the requirements of the elderly among the minorities. As another one of its major accomplishments, the1971 White House Conferenceon Agin.; has, I believe, contributed to the process of bringing about a much needed change in attitude toward aging and toward older people.Large segmenti of the nation have been broughtto a heightened sensitivity to and a greater understanding of what itmeans to grow old in a society that has a tendency to put older persons oueof sight and out of mind; to growpoorer in a time of increasing prosperity. For all who participated, the Conference generated a determination that action shall be taken immediatelyto ensure that all.older Americans may "live fitly" until the end of their days. To every one of the nearly one millionpersons who helped forge the recommendations which finallyemerged at the National Conference, to the Conference Planning Board,to President Nixon for his leadeaip,to all theDepartments and agencies of the Federal Government which providedassistance and :'support, and to my colleagues, Bertha Adkins,the Con- ference Vice Chairman, John B-Martin; ConferenceDirector; Webster B. Todd, Conference Executive Director,Willis At- well, Coaference Coordinator, andto Wilma Donahue and Clark "P,:hi:itts, twb of the principal planners forthe- Confer- ence, and to the White House Conference staff, I wishto express my sincerest thanks for their dedication and efforts; the harvest of which cannot but bea better life for all olAtr Americans.

Arthur S. Flemmingd(-- Conference Chairman

viii PREFACE

any changes have taken place in this century, but scarcely any have been more significant than the '4f 4ach'evement of a long life formost Americans. Factors contributing to greater longevity have been the great discoveries of modern medicine which have dramatically reduced the death rateamong the young and middle- aged; technological advances that haverelieved workers of life-exhausting tabor; and greatly improved environmental conditions (not; ithstanding thecurrent concern about pollution). In consequence of theses advances, the populationgroup aged 65 years and over increased from 3.1 millionin 1900 to over 20 million in 1971, and,by the year 2000 it will number,- about 25 million. This achievement, while desired andwel- comed, nonetheless meant something ofa crisis for a society unprepared to accommodate sucha burgeiming of the group of older Americans. Two decades of progress, initiatc,l-by the 1950 first National Conference on Aging and accelerated by the 1961 firstWhite House Conference on Aging, have broughtmany changes in our social institutions whichhave greatly benefitted the elderly .population. The second White House Conferenceon Aging held November 28December 2, 1971, provided opportunity to capitalize on the experiences of the past 20 years and thus to move ahead with confidence to delineate national policies and action for immediate implementation. The official proceedingsan presented in two volumes. They cover a 2-year period during which older people thrmgh their Older Americans Forums made their needs and expectations known; communities and States through their WhiteHouse Conferences on Aging generated the first formulations ofa national policy on aging; and Delegatesto the National Con- ference refined and took actionon those proposals recommending policies and programs considered feasible in thefin- .mediate future.

ix Voluine I of the proceedings includet an overview of the Conference plan-74s background; -concepts, organization, and rogramming. It presents the contributions made by speakers at the General Sessions and Coriferente Delegate- luncheons. ktherebY provides-the framework which enabledthe Delegates to carry-oat their_assigned tasks. VOldme- II _is devoted to reports of the work .Of_the 14-' Subject Area "Sections and the 17- Special Concerns Sissions. 'Generated by :a delegate body 'spanning in ag0a full eight decades, theserecommend_ations deseiVe the clokist scrutiny by all branches and -levels of .government, by the -private and Voluntary sectors, and` by older people theniselyes.-It: isto be hoped: that the , retbnimendations will not be Aiewed- singly but will be studied.-for theit interrelatedness -and- their potential for yielding an:integrated:ter of guidelines for further action anrbehalf of older Ainericans. No- effoit of the magninide --of .-the -1971' White _House Conference- on Aging can --he-broughtto a successful ccinchi- 4 sioti without incurring a -heavy- debt -Of thanks owed to-.the Many thousands. of persons throughout the Nation who-labored to-achieve-the stated Oils. To-them, I acknowledge my,-personal thanks 'and- eitenct the gratitude, of all members of the White - House ,Conference Staff: It was of great ,good-:fOrtune that Dr. ArthurS. leinining made himself for the fuiltime chairmanship -of the Conference. In that role, he -bibbght a vitality-to -the -Con- ference best expressed in his inpatient callifOr `-!Action,NOtv!" With it, he started -kground augmented later- by the White House Conference on- Aging, which promhesto -carry forwird at every level of the Nation's life for years-to come. To my own statf--7--Willii Atwell, DorotheaLewis, Olivia Coulter, and their colleagues==-I,am-grateful' for their willingness 'to add to their arduous duties for the Administration on Aging, significant-contributions of -their -time and talent-to the White House Conference on Aging: kar&--- John B. Martin Conference Director

^,..,4 i ,.,. .+t ,,,,,,, 46s- tl-P.

4 The Need fora ,,Second White House Conference on Aging

-gingfirst came intonationalfocus was it 'called simply on the baiis of the 10-year when, ih1950; PreSident Harry S. tradition established by the White House Con- Truman directed the Federal- Security ferences on Children and Youth. Agency .to hold- a:national: conference on. aging to assess the problems emerging -as a Evaluation of the action taken during the last° .result of the extraordinary increase in the number decade reveals that,in spite of great strides, of -elderly persons in the population. The 816 progress was at beSt sporadic and its momentum, Citizens Who Were delegatesto that conference Slowihg. There was-Still no comprehensive set of took no action as .a'body,13iit each of the 11.sec- national policies on which all levels and parts of tions developed recommendations that became the gOvernment were working together to articulate. first guidelines for broadly conceived national Older people were increasingly disadvantaged, action. and at least a fifth were still in the desperate, life-destroying circumstances of dire poverty. The problerris persisted, however, and insome respects became more severe with time. By 1958, Inflation was continuing at such a rate that, their, magnitude and complexity reached-a point while money incomes of millions of older people which prompted-the Congress-toenact legiSlation wereraised, through' increasedSocialSecurity requesting President Dwight D. Eisenhowerto benefits, many persons were relativelypoorer. Call a White House Conferenceon Aging, which Employment opportunities, forretirees did not was held on January 9 -12, 1961, with 2800 Dele- materialize to enable them to earn additional in- gates, in attendance. come. Taxes, especially property takes, climbed to such levels that many older hOmeowners were Many of the proposed recommendationswere forced to sell and move into cheap..rentedquar- impleinented during the earlyor middle years of ters. Production of new housing for the elderly the .1960's. Among themwere Medicare and lagged. "Health services remained fragmented and Medicaid; increased Social SeCurity benefits; the uncoordinated, resulting in poor delivery ofserv- Older Americans Act which established the Ad- ices to the elderly. -Institutional care was increas- ministration on Aging and its counterpart State ingly allocated by public agenciesto the proprie- units on aging in every jurisdiction. Newpro- tary nursing homes, which admittedly needed grams were funded for research and demonstra- stronger regulatory measures to improve their tion in aging and for trainingmanpower to serve standards. older people. Other initiatives takenon behalf of the elderly included increased financialsupport Reorganization withintheDepartmentof for new programs in healthcare and related Health, Education, and Welfare (HEW) in the social services, housing,manpower training for late 1960's initiated whatwas generally inter- older workers, and new volunteer opportunities. preted as a downgrading of the Administration on Aging when it was made a component of an- With so many important actions taken,one other administrative unit of the Department. This may reasonably ask if there was a need fora belief was fixed even more firmly when two-thirds second White House Conferenceon Aging; or of its program responsibilitieswere gradually

3. transferred to other units and agencies, and when pointed a special task force to study the problems the appropriation requested by the Department Of older Americans. for aging programs was only a fraction of the In a different sphere, planning had become amount authorized by Congress. a key goal and activity of the Federal and other levels of governmentplanning designedto pro- At the same time that the circumstances of the mote the development of systems of service for all elderly and. action on their behalf seemedto be age groups, while allowing enough flexibility to deteriorating, -there were emerging certainnew accommodate the particular service needs of the emphases and developments whichgave great especially disadvantaged elderly. promise of bringing about changes which would With apparent deterioration in the situation of benefit the older segment'of the population. the aging population on the one hand, andnew potentials for bringing about significant planned The Congress continued to maintaina strong change on the' other, there was a conspicuous interest in the older citizens group andto be re- need, for -=a second- White House ConferenCeon sponsive to their clear needs. Presidential interest Aging. Under such circumstances, it was natural in the social and economic problems of the elderly and 'imperative that a concerned Congress should expressed by Presidents Eisenhower,Kennedy, and call for a -second White House Conferenceon Johnson was reaffirmed- and significantly expanded Aging to clarify and assess the current state- of by President Nixon during his campaign and affairs and to ,initiate anew effort to achieve again soon after his inauguration when heap- security and dignity- for America's old people.

Legislative History

Steps leading to the authorization and the senators, officials from 'Federal and State execu- calling of the 1971 White House Conferenceon tive agencies with programs in aging, representa- Aging were initiated by the Congress in 1968. tives of non-government. organizations, and other Enabling legislation took the form ofa Joint interested citizens. The Select Subcommitteeon Resolution, Public Law 90-526 (September 28, Education of the HouseH Committeeon Education 1968), which declared : and Labor also held hearings where,once again, ...that it be the sense of Congress thata the testimony demonstrated broad support for White House Conferenceon Aging be congressional authorization of the Conference. called by'the President of the United States -Warm approval of they intendedpurposes of a in 1971, to be planned and conducted by the second White House Conference on Aging did Secretary of Health, Education, and Wel- fare... not, however, rule out differences over its timing, funding, organization, and preparation. Asre- At all stages of the legislativeprocess, cul- ported out on May 1, 1968, by. the Committeeon minating in the adoption of the Joint Resolution, Labor and Public Welfare, Senate Joint Resolu- there was a strong and wide-rangingagreement tion 117 provided that: (1). the Conference be on the need and value of holding a second White held in 1970; (2)a total of $4,000,000 be House Conference on Aging. Bipartisansponsor- authorized for Conference expensesover a three ship for the legislation introduced in the Senate year period, beginning July 1, 1968;. (3) grants (S.J. Res. 117), and in the House (H.J. Res. ranging from $5,000 to $35,000 be made avail- 1371), augured a favorable reception bythe able to each' State' for Conference-related activi- Congress. At hearings conducted by the Special ties; and (4) technical advisory committees be Subcommittee on Aging of the Senate Committee on Labor and Public Welfare in early March The term "State" was defined for the purposes of the joint 1968, virtually all the participants endorsedthe resolution to include the District of Columbia, the Common- wealth of Puerto Rico, Guam, American Samoa, the Virgin proposed Conference. Those testifying included Islands, and the Trust Territory of the Pacific Islands.

4 ctablished _to_ advise and assist in planning and As described by the authorizing resolution, the wnducting the Conference. 197 -1 White House Conference on Aging was to be called by the President "in order to develop Subsequent action by the House Committee on recommendations for further research and action Education and Labor showed divergent positions in the field of aging, which will further the poll.' on these four points. On July 25, 1968, the Com- ciessetforthinthe preamble ofthisjoint mittee reported favorably on House Joint Resolu- 'resolution." The preamble declared that responsi- tion 1371 which (1) called for a Conference in bility for meeting the challenge and problems of 1971; (2) authorized $1,300,000 for Conference aging rests primarily with the States and com- expenses;(3) provided no special grants for munities, yet all levels of government are involved State activities in preparation for, or to cover and must share this responsibility. Therefore, the State delegation attendance at, the national Con- Federal Government shall work jointly with -the ference; and .(4) excludedany express provision States and their citizens to develop recommenda- for technical advisory committees. With these tions and plans for actions which will serve the substantive differences, -the Senate and House, purposes of: Joint Resolutions were passed by theft' respective bodies on May 6 and July 30, 1968: (1) assuring middle-aged and older persons equal opportunity- with others to engage in The initial- consideration of legislation by- sub- gainful employment which they are capable of committees -and then by, full coinmittee, and the perforMing; subsequent passage of the original resolutions (2) enabling retired persons to enjoy incomes just described, involved the active leadersh:.p of many senators and representatives. Several of sufficient .for health and for participation in family and community life as self-respecting them .shared the.further responsibility of develop- citizens; ing an amended, uniform version of theseparate Joint Resolutions which would gain the final (3) providing housing suited to the needs of approval of Congress. With the assistance of older 1.-,mons and at prices theycan afford to legislative staff and the consultation ofappro- pay; priate officials from the Department of Health, Education, and Welfare, a compromise Joint (4) assisting ,niddle-aged and olderpersons Resolution was cleared for passage by the Senate to make the preparation, develop skills and on September 9, by the House on September 12, interests, and find social contacts which will 1968. make. the gift of added years of lifea period of reward and satisfaction; With respect to the provisions at issue, the Joint Resolution called for a date sometime in (5) stepping up research designed to relieve 1971, thereby allowing ample lead time in plan- old age of its burdens of sickness, mental breakdown, and social ostracism; dnd ning and preparing for the Conference. Asum of $1,900,000 was authorized tocover, among (6) evaluating progress made since the last other things, "financial assistanceto the States in White House Conference on Aging, and ex- enabling them to organize and conduct confer- amining the changes which the next decade ences on aging prior to the White House Con- will bring in the character of the problems ference on Aging." According tostatements made confronting older persons. preceding the House vote on the Joint Resolution, the congressional intent was toreserve $6C0,000 As a capstone to these stated aims of the legis- of the $1,900,000 for State participation in the lation, the preamble added: It is essential that Conference. Also, the law authorized and directed in all programs developed for the aging, empha- the Secretary of Health, Education, and Welfare sis should be upon the right and obligation of to establish technical advisory committees and older persons to free choice and self-help in plan- to appoint their chairmen and members. ning their own futures."

5 Appropriations

A total of $1,900,000 was appropriated by 1971fiscalyear, plus the sum of $650,000 Congress for the White House Conference on provided under an amendment, cosponsored by Aging. The early stages of planning and prepa- Senator Williams (N.J.) and Senator Prouty ration- for the Conference were supported by (Vt.), to cover the travel and per diem expenses funds amounting to $250,000 as part of the Ad- of elderly and other delegates representing the ministration on Aging budget under the fiscal States. 1970 Labor-HEW Appropriations Act (Public Law 91-24). The major share of the appropria- In addition to the Conference activities financed tion was subsequently pfovided by the fiscal 1971 by theseappropiiations, support servicesand- Labor-HEW Appropriation Act (Public Law 91- technical staff were contributed by several Federal 667), which allocated an additional $1,650,000 executive- departments and agencies. For their for Conference expenses, including those incurred part, the States, many communities; several hun-. in the post-Conference period through June 30, dred national organizations, and countless indi- 1972. This appropriation included the $1,000,000 vidual citizens also devoted considerable resources originally budgeted for .the Conference for the to the Conference effort.

The President's Proclamation

In accordance with the Joint Resolution of the that it, will fully consider. .the many factors Congress, President Nixon issued a proclamation which 'have a special influence on the lives of on October 6, 1969, calling for the Second White the aging and that it will address precise recom- House Conference on Aging, in which he said mendations, not only to the Federal Govern- in part: ment, but also to government at other levels Today, I am issuing a formal call for the and to the private and voluntary sectors as second White House Conference on Aging to well. meet in Washington, D.C., in November of Members of the older generation have given 1971. With careful advance planning and much to their country. Through the White with broad, representative participation, this House Conference on Aging, a grateful Nation Conference can help develop a more adequate can recognize the goal of Making old age a national policy for older Americans. 1 hope time of contribution and satisfaction.

The Conference Plan

The Three Year Plan Planning the Conference over a 3-year period An Overview provided an opportunity to avoid some major shortcomings of the first White House Confer- Designed as much more than justa single ence on Aging. One oversight of that first con- event, the second White House Conference on ference was the failure to consult with older Aging was conceived as a 3-yearprocess directed people, at first hand, to learn what theycon- toward bringing about ,ubstantial changes in sidered to be their most urgent, unsatisfied needs. society's perception and treatment of its older For the 1971 Conference, however, therewas population. sufficient lead-time for the process to be initiated

6 by older people through the 1970 Older Amer- deCision-makers, and youth, in order that icans Forums -held in thousands of localcom- they may represent a broad and effective munities. consensus. Another deficiency of the 1961 conference To broaden theunderstanding, at com- plan was the failure to provide fora systematic munity and State levels, of the needs of and intensive follow-up of the conferencerecom- older people, and strengthen the willingness mendations at national, State, and local levels. In to act on the policy prciposals that will contrast, the three-year plan for the 1971 Con- emerge from the White House Conferences ference emphasized that 1972was to be a year on Aging at all levels. for follow-through on recommendations and for If these objectives are achieved, the Conference evaluation of resulting action. will have a great meaning for the 1970's for, it Thus, 1970 was viewed asa Prologue Year in will result in: which older persons would have the opportunity Broader public awareness of older people through Older Americans...Forumsto speak out on and their circumstances; their needs and to be heard not only- in thecom- A realisticnational policy regarding, the munities and States but also by the executive older population; and legislative organs of the Federalgovernment. Greater commitment by government,. volun- The second year, 1971,was seen as the Year tary agencies and the private sector to serv- of Conferences. Local and State conferencesand ing older people;. National Organization Task Forces wouldmeet Clearer and stronger roles for the Admin- to develop policy recommendations which, inturn, istration on Aging as the advocate for older would be consolidated by Technical Committees people and as a focus on their affairs; to become the substance for consideration by Stronger and more effective State agencies Delegates at the national conference in Novem- responsible for planning and servingthe ber-December. older population; The third year, 1972, was projectedas the More systematic planning andan expansion Year of Action. Because the National Conference and coordination of services for the elderly took place in a climate of actioninitiated bythe at the community level; Older American Forums, the community and Assumption by older people ofmore re- State conferences, the active participation ofna- sponsibility for meeting their needs and for tional organizations, and by the Federalexecutive contributing to community life; and and legislative branchestheprospects are high New legislation on behalf of older people for accelerated effortsto implement the recom- at. Federal and State levels taken with refer- mendations arrived at by the Delegates andthus ence to a set of national policies designed to to greatly improve the well-being of older Amer- improve the quality of life of America's old icans. people and their families.

OVERALL CONFERENCE OBJECTIVES Three specific objectiveswere drawn up for the Principal Task of the Conference 1971 White House Conferenceon Aging. Policies for Aging To initiatethe development of specific, thoughtful guides and recommendations for In keeping with the objectives, the Conference policies and actions in agingat community, effort at all levels was directed toward the formu- State, and national levels. lation of coherent principles and feasibleplans To draw these guides and recommendations which would lead towarda national policy on from cross-sections of older people,provid- aging. ers of services, specialists on aging, key Historically, conferences in the field of aging

46$-217 0 - 73 :2 have produced three types of recommendations: consistent with national goals and social (1) broadly stated, 'far reaching goals which giye values? expression to aspirations to achieve ideal situations possible to implement with present knowl- or states for the older segment of the population; edge and manpower? (2) more focused and, closely considered policy proposals to bring about more-immediate change; realistic in terms of cost? and (3) large numbers of specifically detailed likely to be supported by the general public? programs to provide services for the elderly or Would it: increase knowledge, about them. benefit the whole community or society as The relatively free proliferation of all three well as just older people? types of recommendations was necessary and useful in the early stages of discovery and explora- preserve the dignity, freedom and right of . tion of the problems and needs associated with choice of older people? aging. However, the gradual .accumulation ofsys- Does it: tematic knowledge and'evaluative tools, together with relevant experience gained over the last fix responsibility for action on a specific several decades, made it possible for the 1971 public or private agency or organization? White House Conference on Aging to take as its It was expected- that rigorous application of purpoie the more difficult task of formulating these criteria would facilitate the selection of proposals for public policies leading to defined those policies most likely to elicit immediateac -' actions to meet clearly stated short range objection, to gain public acceptance, andto find a tives. readiness on the part of society tosee them implemented. To establish a common understanding of the purpose underlying the formulation of policies for the aging, as distinct from goals and froth Subject Matter Content of the Conference program recommendations, the following definitions were adopted for thepurposes of the Con- The legislationforthf...1971 White House ference. Conference on Aging directed that attention be given to employment, income, and housing of GoalsLong range objectives or targets stated older Americans. It also pointed out the need for in broad general terms. These are useful-as educational programs for middle-aged and older affirmations of social values or aspirations and persons to prepare them "to make the gift of as guides to the development of social policies. added years of life a period of reward and satisfaction." Policies r; set of focused, strategically feasible principies and plans for actionto provide Research and evaluation of progress, andan direction for program supportive of long-range examination of the effects that theprojected goals. changes of the 1970's will have on older people, were also included among the purposes the Con- Program RecommendationsProposals for gress believed the Conference should serve. specific action designed to implement policies and to move toward goals. SUBJECT AREAS In addition to defining the various types of Working from this basis, a careful study and ft recommendations as guides to policy formulation, evaluation of the circumstances of today's older the following set of criteriawas established for people and the problems which plague them, judging the feasibility of a policy proposal. even after 20 or more years of effort to improve their conditions, resulted in the selection of 14 Is it: areas in which it appeared therewas need for a based on known needs of older people? more effective set of national policies.

8 Of the 14, 9 represent Needs Areas within people, and to ensure that policy andaction rec- which policy and action are required if Ameri- ommendations would reflect recognition ofthese can societyisto be satisfiedthatitsolder differences, five principal variableswere identified citizens are to enjoy healthy, active, and meaning- for consideration in relationto each of the Needs ful lives. The other 5 areas, designatedas Needs and Needs Meeting Areas. ThesewereStage Meeting Areas,identify theprincipal means of Later Life, Level of Wellness(or Health), Em- ,through which action can be brought about.Fig- ployment-Retirement Stitus, Urban-Rural Resi- ure 1 lists the Needs and Needs Meeting Areas dence, and Maximum Freedom of Choice. and illustrates the relationship between them. Figure 2 illustrates the characteristic changesin The 5 Needs Meeting Areasare the avenues to health and employmentstatus as the individual action for each of the Needs, although in Figure moves from middle-age (45-59) through later 1 the relationship is illustrated for onlyone Need. maturity (60-74) and oldage (75 and over).

Figure 1. Schematic Representation of the Relationshipof Needs Areas to Needs Meeting Area

Needs Areas `Needs Meeting Areas Income -- Planning ... 1,0440 Health and Mental Health Inf-- 4.4 . 44 .44 . Training

.44. .... Housing and Environment .mow Research and Demonstration

Nutrition Services, Programs, and Facilities

Education Government and Non-government Organization Employment and Retirement

Retirement Roles and Activities

Transportation

4 Spiritual Wellbeing

Older people, of course,vary among themselves It also calls attention to the need in the same way other to consider age groups do. In fact, whether an aging person lives inan urban area because of the effects of aging iselfand of certain I. where resources are generallymore available or social practices, older people tendto change more rapidly and to be calledupon to make more major in sparsely settled rural environments. Andat adjustments in their lives thanat any other time every stage of life, and with reference to all Needs except childhood. and Needs Meeting Areas, the individualshould' be assured the rightthe freedomof In order to emphasize these making enormous varia- his own choices among available solutions-to his tions in the nature andcircumstances of older problems and needs.

9 Figure 2. Schematic Representation of Needs and Needs Meeting.Areas and Significant Variables

Needs Areas Stages of Later Life Needs 'Middle Age Later Maturity Old Age Meeting Areas 45-59 60-74 75+ Income Planning Health and F Mental Health ;R E 4. Housing and Training E of 4 D Environment ey., 0 _ tt 0 ir. M Nutrition o Research and Demonstration Education e 0 It 9. F Employment and Services, Programs, C Retirement and Facilities H 0 Retirement Roles and Activities C E Transportation Government and Non-government Spiritual Organization Wellbeing Urban-Rural Residence

The chart emphasizes the fact that no single problems of minority and other specially dis- solution in any area is static and fixed, but that advantaged groups. Although the requestswere change and accommodation must be features of all made too late to include them in the community planning and programs for older people whose and State conferences, arrangements could be life circumstances are changing as they grow made to hold the following 17 Special Concerns older and older. Sessions as a part of the national program

SPECIAL CONCERNS SESSIONS Long-Term Care of Older People The 14 subject areas becime the substantive Mental Health Care Strategies part of the Conference which was dealt with in the community and State conferences. National Homemaker-Home Health Aide Services Aging and ,Blindness organizations considered the Needs Areas erpe- cially, but also provided some comment on the Spanish Speaking Elderly Needs Meeting Areas. The Elderly Indian As the Conference planning progressed, re- The Older Family quests were received from various organized The Religious Community and the Aged groups for an expansion of the program to pro- Physical and Vocational Rehabilitation vide opportunity for consideration of the special Rural Older People

10 The Poor Elderly The Special Concerns Seseonsnot only en- Aging and Aged Blacks larged the ,progjam, but enriched itsoutput and Asian American Elderly gave visibility to many special groups and prob- The Elderly Consumer lems of the elderly that might otherwise have Legal Aid and Urban Aged failed to receive the focused attention ofthe Na- tional Conference. Volunteer Roles for Older People Youth and Age

The Conference Planners

The complex nature of the overall plan of THE NATIONAL ADVISORY COMMITTEE- the 1971 White House Conferenceon Aging called for extensive planningat local, State, and The Joint Resolution called fora National national levels. It required extensive involvement Advisory Council of professional and publicmem- in the planning fun ::ion by older Americansas bers of which a substantial numberwere to be consumers, specialistsinaging, planners and 55 Or more years of age. Secretary Richardson decision-makers, providers of services,representa- formed the committee in early 1970 by appoint- tives of minorities and other special problem ing 28 distinguished older Americans. Thiscom- groups and of organizations, the private sector, mitteel-ecame the core of a larger working board. and the generally concerned citizenry. The planning groups 'ascribed below reflect these requirements throughout.' THE CONFERENCE PLANNING BOARD

In order to share the duties of planningamong THE WHITE HOUSE CONFERENCESTAFF more personi and representative groups, a Con- A staff was assembled in early 1970 underthe ference Planning Board was named. Its member- leadership of John B. Martin, Commissioneron ship included representation of the, following Aging, whom the President had namedto direct groups: the Conference. Willis W. Atwell, Deputy Com- White House Conference on Aging missioner on Aging, became the Conference Co- National Advisory Committee 28 ordinator. At a later date, Arthur S.Flemming was appointed by the President to be the full- Advisory Committee on Older Americans13 time Chairman of the Conference. WebsterB. National Organizations of Older People 10 Todd Jr. joined Mr. Flemming and servedas the National Association of State Unitson Executive Director of the Conference.Other. Aging 10 components of the staff included: Youth Participation Committee 14 Administrative Office Consultants on Minority Problems 10 Public Information Technical Committee Chairmen 14 State and Regional Relations National Organization Relations The Chairman and the Director of the Con- Delegate Relations ference served. as Co-chairmen of the Board. An Technical Planning Executive Committee of 17 members of the. Board transacted the Board's business between Logistics Office full meetings. The Chairman also had thecon- tinuing advice of an ad hoc committee of those ' Rosters of the various planninggrouts appear as Appen- Board members whowere the representatives of dices to this document. national organizations of old people.

11 The responsibilities assigned the Board were: people as consumers. Supplementing each Techni- To assist the White House Conference staff cal Committee was 'a Secretariat made up of gov- Federal in arriving at broad plans and procedures;, ernment personnel from appropriate agencies. As the Committee's staff, the Secretariat 0, To insure coordination of the Conference provided assistance and acted in an advisory activities with the ongoing Federal and capacity. State programs in aging; The Technical Committees were assigned the To accommodate the considerable interest among National Organizations of Older 'prime responsibility of evaluating developments in their respective subject areas, and then focusing Persons; and attention on what they .perceived to be the major To represent the views of the providers of issues requiring resolution as a basis for formu- services, specialists, and scientists. lating a set of national policies on aging. For To carry out these responsibilities, the Con- this purpose, an issue was defined as follows: ference Board met three timesOctober 17-18, 1970, March 27, 1971 and September 24, 1971. An issue ica questionresolvable in two or At its October meeting, the Board established five more waysformulated for the purpose of de- committees: Information and Publications, Re- termining what broad policy or action should gional and State Planning, National Organiza- be taken to move toward a specific, goal- oriented objective. tions, Conference Programs and Procedures, Issues and Policies. At their initial meeting, the committees first These committees met and made recommenda- reyic-ved the drafts of background pipers, which tions to the Board which, after discussion and had beer prepared by specialists in their fields, amendment as needed, voted upon their adoption. for the purpose of ensuring that the papers were Similar procedures were followed at the subse- comprehensive, complete, and authoritative. On quent meetings of the Board. the basis of the background papers and their own Among the most important decisions made knowledge of the field, the. Committers set forth were those which approved the overall 3-year several salient questions or issues relative to the Conference plan, the subject areas, the topics of steps they believed were required to improve the Special Concerns Sessions, the criteria for Dele- circumstances of the older population. These gate nomination, and the rules and regulations stated issues became the focal point., for discussion governing the proceedings, voting and conduct and the basis of the first formulations of recom- of the meeting, including the restriction of voting mendations by the community and State confer- to the delegate bodies of the Subject Area Sec- ences an_ d by the National Organization Task Forces. tions and Special Concerns Sessions.' At the second meeting of the Technical Com- TECHNICAL COMMITTEES mittees in the summer of 1971, they consolidated the recommendations which were responsive to In accordance with the joint resolution author- the issues along with others generated at the izing the Conference, the Secretary of Health, State Conferences and the National Organization Education, and Welfare established a Technical Task Force meetings. These consolidated recom- Committee for each of the 14 Needs and Needs mendations were reproduced in the Delegate Meeting Areas. Membership of each of the com- Work Books for use at the National Conference. mittees included persons with special training and proven competence in their respective fields, representatives of minority groups, and older PLANNING COMMITTEES FOR SPECIAL CONCERNS SESSIONS 'The full text of the rules and regulations governing the conduct of the Conference work sessions can be found as A planning committee, consisting of represen- Appendix H. tatives from the organizations requesting the

12 session and other related organizations, was dians, and Spanish Speakingwereappoiate..1 to established for each of the 17 Special Concerns the citizen Planning Board of theConference as Sessions. The committeeswere assisted by. Federal special consultantson minority problems. Fol- agencies and the White House Conferencestaff, lowing is a brief summary of the provisions but had full responsibility for the made Sessions. for the participation of minorityrepresentatives The function of each committee includedde- in the various phases of the Conference. termining the content and format of theSession Number of Minority Representatives programs,identifyingandinviting program Securing an adequate number ofrepresenta- participants, conducting the Session in accordance tives of the various minority with the same rules of order which governed groups in the the Conference Delegate bodywas one of the Subject Area Sections, and preparinga report of principal aims of the Confcience the recommendations adopted planners. At Session meetings The Planning Board, for inclusion in thereport of the Conference at its first meeting, took proceedlitss. action requesting that special attentionbe given to the inclusion of minoritygroups in GOVERNMENT AGENCY LIAISON all aspects of the Conference.The Board continued to call attention andto take ac- The legislation authorized the Secretary of tion on behalf of the minorities suchas ap- Health, Education, and Welfareto request the proving the inclusion of Special Concerns cooperation and assistance of such other Federal Sessions on their problems in the Conference departments and agenciesas might be appiopriate plan. in carr7ing out the provisions of the Joint Resolu- States were urged, and they in tion. In order toopen these channels, each De- turn re- partment and 21 independent government quested local communities,to include rep- agen- resentatives of the minority cies were invited toname a member of their groups within organization to serve their populations in Conferenceactivities as a liaison with the White The Secretary's letter House Conference on Aging. This provided to the Governors also easy requested that in the naming of access to personnel and otherresources of the State Dele- gates attention be given to adequaterepre- government and afforded a means of distributing sentation of minority information about the Conference. groups. And, to make certain that a reasonable balance ofthe NATIONAT ASSOCIATION OP STATEUNITS minorities from the various sections ofthe ON AGING LIAISON COMMITTEE country were named, a category of Dele- A special committee gates-at-Large was establishedto be used by was named by the Na- the President to overcome tional Association of State Units any obvious un- on Aging to take derrepresentation. part in the initial planning of the Conference. This committee, along with theAssociate Re- Various organizationsthat represented gional Commissioners for Aging,was the first minority groups were also alive inensuring group convened (March 8-9, 1970) bythe representation in relative proportionto their White House Conferenceon Aging to review and numbers in the general population.The Na- advise on the initial Conferenceplans. tional Caucus on the Black Aged,represen- tativecommitteesofvariousAmerican MINORITY REPRESENTATION Indianorganizations,of Asian-American From the beginning, the plannersof the 1971 groups from the mainland and territories, White House Conferenceon Aging were con- and of the Spanish speaking,including cerned that the minorities havethe opportunity Puerto Rican and Cubangroups, worked to with the Conference Chairman share in the responsil :`tiesof decision-making to establish and achieving thegot. 's of the Conference. criteria for determiningan adequate representation of their groups. As a first step, 10 representatives of minority As a result of all these ;Eons, the groupsBlacks, Asian-Americans, number American In: of minority Delegates namedfar exceeded 13 their representation in either the 1950 Na. As National Conference Leaders tional Conference on Aging or the 1961 The 28 member White House Con- White House Conference on Aging and was roughly in proportion to their number in ference on Aging Advisory Committee included minority representatives. the general population. The Planning Board provided oppor- Roles of the Minoritiei in the Conference tunity for additional minority represen- As Participants in State and Communi- tation in a decision-making role of the ty Activities Conference planning. All the Technical COmmittees, which Many of the Older Americans White were largely responsible for deciding House Conference Forums, held in upon the technical content and focus September 1970, were lotated pur- of= the 1971 Conferences (local, State, posely in places where there are con- and national), included representatives centrations of minorities, such as the of some of the minority groups. center cities and certain geographical area's of the country. Reports received Special attention was given to the ap- from the Forum organizerS indicate propriate reprekntation of. minorities that, in many instances, a minority in the selection of- Section and Subsec- tion leadership. group constituted- the largest proportion of the participants. As Delegates States were careful to include minority In constituting the membership of the group members on their State White various Subsections, adjustments were House Conference on Aging planning made so, that all Subsections inclUded Committees and urged communities to reprdentation of the major minority do likewise for the planning commit- groups. In instances where the actual tees of local White House Conferences number of minorities in a Section was on Aging. AlSo, minority group per- too small to provide representation in tons participated as Delegates in the all groups, the Chairman was advised State and local Conferences of 1971. to raise for discussion the problems of In naming-Delegates to the National the minority groups. Conference, every Governor selected When the minority representation was members from the leading minority found lacking in particular skills (nurs- groups in their respective States. (As ing, community planning, health, etc.), mentioned earlier, where disparities re- recommendations were made to persons mained, the Delegates-at-Large cate- appointing the minority Delegates-at- gory was used to achieve a more appro- Large to include individuals with these priate balance in representation.) special skills, if possible. 1 Conference Materials Background and Issues Papers To establish the foundations for informed Con- research, and to organize and draft topical mater- ference discussion and resolution of the vital ial, applicable to their assigned subjectarea. The issues of policy affecting olderpersons, Back- paper for Health was in two parts, one concerned ground and Issues paperswere prepared covering with physical health, the other with mental each of the 14 subject-matter Needs and Needs health. Similarly, the Research paperwas pre- Meeting Areas. Under a grant made in 1970.by pared by two authors, one writing on biological the White House Conferenceto Brandeis Univer- and medical research, the otheron behavioral and sity, recognized authorities in the field ofaging social science research. In addition, the subject of were commissioned to undertake the necessary Employment and Retirement was covered in

14 separate papers, again each by a different author. of Work Books. This taskwas undertaken during The entire backgroundpaper project, involving January-March 1971. the preparation of some 17 documents,was directed by Dr. James H. Schulz of BrandeisUni- Part One of each Work Book containeda sum- versity.' mary of the corresponding Background Paper sections on the needs, goals, available knowledge, In most cases, the Background and Issues papers and present situation in thatarea of aging. Its followed a common outlined comprised offive parts. The first four sections covered relevant purpose was to add to the information of Dele- gates whose Conference section would be discuss- background material:an introduction to the particular Needs Area or Needs Meeting ing and adopting recommendations in thesubject Area; a area covered by the Work Book. statement of well-established, long-range goals (set by previous conferences, commissions,and In Part Two of the Work Book, severalques- legislative goals);a review of existing knowledge tions or issues were presented, accompanied by in the area; and a description ofthe nature and back-up discussion of their policyimplications. scope, together with the gaps and shortcomings, This part of the Work Book, with only minor of present policies andprograms. Each author had editorial changes, was arestatement of the Issues final responsibility for thecontents of these four Section of the Background Papers developed by sections, and assisted in the-preparationof the each of the Technical Committees.Thus, first fifth, Issues, section of thepaper. the community and then the State WhiteHouse Conference on Aging were asked The drafting of the Issues section foreach to address them- Background Paperwas the responsibility of the selves, in common, to certain major unresolved problems posed either by the identified respective Technical Committee forthat subject issues, or area. This portion of the paper set forth certain by other questions of importance. major questions or issues for considerationand In addition to the Background and Issues resolution by Conference Sections,leading to a papers and the Work Books, described above, comprehensive national policyon aging. several other documentswere published by the White House Conferenceon Aging. This series of guides-related training materials, Work Books for Community and and other relevant documents was prepared by the National State White House Conferenceson Aging 'Conference staff to assist in carryingout integral parts of the Conference process at community, Background information and discussionma- State, and national levels. In approximate _eriai, covering each of the 14subject-matter order areas, was prepared in a series of Work Books of their publication, the documentsare described below. for the use of participants incommunity and State White House Conferenceson Aging. The Work Books were regardedas a practical substitute for the full Background and Issuespapers, Self-Guide for Groups Organizing which could not be reproducedreasonably in the Older Americans White HouseForums quantity necessaryto accommodate the many thousands of Delegatesto the community and The Self-Guide was distributedto backstop the efforts of State agencies State conferences, Moreover, thelength and, in on aging and community .-.some cases, the technical nature of the Back- groups responsible for organizing the Older Amer- ground and Issuespapers made it doubly advis- icans Forums held in September 1970 and the able to produce summarized versionsin the form months following. The Self-Guide explained the importance of the Forums as ameans for older people themselves to voice their needs and de- ' A complete index of the Backgroundand Issues papers and sires; proposed methods of organizing, staffing, their authors can be foundas Appendix 1. The papers are available through the Superintendentof Documents, U.S. and conducting the Forums; andset forth the Government Printing Office, Washington,D.C. 20402. essentials of reporting their results.

15 Technical Guide for Community and State Leadership Training Guide White House Conferences on Aging in Policy Formulation The Technical Guide was prepared primarily The Leadership Training Guide, also printed for the use of State agencies on aging and Federal in December 1970, was part of a kit of materials regional units on aging. Distribution began in d4velOped for training sessionson the complex November 1970, and continued over the next procesi of policy formulation. This document was several months. for use by State agencies on aging in training lead- This basic work was presented in three parts. ers of community conferences, and adaptable to Part One dealt with the overall objectives, sub- their subsequent .use in training State conference ject-matter, and structure of the White House staff. Conference, and with State activities and responsibilities related to the Conference plan. Part Two was concernecr with community White House "So You Are To Be A Participant Conference activity, and Part Three, in similar In A Community White House fashion, with the preparation and program of Conference on Aging* State conferences. pain_phlet was printed in January 1971 to be used in conjunction with the Work Books which, as described earlier, provided participants Handbook for Community Conferences with background information and issues for dis- The Handbook, a supplement to the Techni- cussion and resolution. This pamphlet was de- cal Guide, was also distributed during the winter signed to explain clearly and succinctly how use and early spring of 1971. While the Handbook of the Work Books would equip each participant drew extensively from the materials presented in for an effective role in the Conference process the Technical Guide, it was more specifically of formulating national policies on aging. addressed to the tasks involved in organizing and conducting the first round of conferencesat the community level. The Handbook was provided Roster of Participating National to assist community conference leaders and plan- Organizations with Programs ning committees in the careful preparation and in the Field of Aging skillful execution of this nationwide effort. The expectation was that as many hundreds of com- Released in November 1971, just before the munity White House Conferences as werecom- national White House Conference on Aging, patible with time and resources would bespon- the roster of participating organizations identified sored by the States. the more than three hundred national organizations that took part in Conference activities.

Technical Guide for National Organizations National Conference Delegate Work Books A companion piece to the two previouslymen- tioned works, the Technical Guide for National A Delegate Work Book was prepared for each Organizations also set forth theconcept of the of the 14 subject matter areas of the Conference. total Conference effort. It then suggested several Each National Conference participant received ways in which national organizations and their a Work Book appropriate to the subject-matter Section to which he was assigned. constituents could contribute to that effort,especially through the formulation and support of These Work Books were structured in three a set of national poliCies on aging. This Technical parts. Part One provided Delegates with an over- Guide was published in December 1970. view of the organization and program of the

16 National Conference. Part Two servedto orient housing for the elderly, and then stimulating participants to their Conference task. Parts One the discussions, deliberations, and evaluative and Two were the same in all the Work Books. factors involved in resolving that example issue Part three contained a summary of selected to arrive at a feasible policy proposal. As a clear portions of the Background Paper in therespec- presentation of the precepts of the policy formu- tive subject area. It set forth the recognized needs lation process followed at successive levels of in the area, the long-range goals to be achieved, the 1971 Conferences, the film has enduring and a statement of the major issues and questions. value. It also contained the recommendations consoli- This film was prepared in November 1970, dated from the reports of the State conferences Willis W. Atwell, Deputy Commissioneron and the national organization task forces, and Aging and Coordinator of the Conference, relevant Technical Committee comments. served as narrator.

A Guide for Section and Trigger Films Subsection 7onference Leaders A series of five brief dramatizations of situ- Prepared in October 1971 for distributionto ations common to older peoplewere designed the Chairmen and Recorders of Sections and Sub- to provoke (trigger) thoughtful discussion. The sections at the National-Conference, the guide for films are in color and- vary in length from 1 these leaders dealt extensively with thestructure, minute 4 seconds to 4 minutes 10 seconds' procedures, and leadership roles planned for the Each State agency on aging was supplied with November 28December 2 meeting in Wash- a print of these films along with a suggestion ington, D. C. that they be used at the Opening session of the State White House Conference on Aging. FILMS: Multi -Media Presentation The Three-Year Conference Plan Produced especially for the White House Con- The Three-Year Plan,was made in August ference on .Aging, a multi-media presentation, of .1970 for viewing by White House Confer- in a series of dramatic sequences interspersed with ence planning groups at all levels. John B. film, slides, and music, depicted the problem of Martin, Commissioner on Aging and Director being old in a young society.' Some successful' of the Conference, outlined the plannedse- and some unsuccessful attempts at resolving the quence of Conference events for the three, problems of older people were shown with the 1970-1971 period; the roles projected for the intent of providing an overview of agingas a several sets of participants; and the flow of backdrop against which the work of the Sections recommendations and actions expected through- would take place. The presentation was produced out the course of the Conference process. by Eli Productions and The Design Center, Wash- This film, as well as the one described below, ington, D.C., with the assistance of an Advisory was prepared by the University of Michigan Committee made up of representatives of the Television Center,incooperation with the Department of Health, Education, and Welfare White House Conference staff. and the White House Conferenceon Aging staff.' The Policy Proposal' The Policy Proposal was designed primarily The Tripper Films can be purchased from the University of Michiean TelevisionCenter, 310 Maynard Street, Ann for the training of Conference leaders andper- Arbor, Michigan 48108. sonnel in the process of policy formulation.The 'Five films from the MultiMedia Presentationare available basic concepts underlying the development for loan or purchase through the General Services Administra- of tion. National Archives and Records Center, National Audio- policy recommendationswere explained by visual Center, Washington, D.C. 20409. 'The persons who served on the Advisory Committeeare identifying a majorissueinthefieldof identified in Appendix F.

17 Materials Prepared by Health in the Later Years of Life, U.S. Depart- Federal Department for the ment of Health, Education, and Welfare, Public White House Conference on Aging HealthService,HealthServicesandMental HealthAdministration,NationalCenterfor The Employment Problems of Older Workers,. Health Statistics, Washington, D. C.: Superin- U.S. Department of Labor, Bureau of Labor tendent of Documents, Government Printing Statistics, Washington, D.C.: Superintendent of Office. Documents, Government Printing Office. 1971 White House Conference on Aging First Housing: 1971White House Conference on Reader: Plan and Schedule for a Three-year Con- Aging, U.S. Department of Housing and Urban ference on Aging, U.S. Department of Health, Development, Washington, D.C.: Superintendent Education, and Welfare, Social and Rehabilitation of Documents, Government Printing Office. Service, Administration on Aging, Washington, D.C. AoA Publication No. 147. Facts and Figures on Older Americans: An Over- view for the Delegates to the White House Con- 1971 White House Conference on Aging Second ference on Aging,. 1971r U.S. Department of Reader: Invitation to Design a World, U.S. De- Health, Education, and Welfare, Social and Re- partment of Health, Education, and Welfare, habilitation Service, Administration" on- Aging, -Social and Rehabilitation Service, Administration Washington, D.C.: U.S. Department of Health, on Aging, Washington, D.C. AoA Publication Education, and Welfare, Social and Rehabilitation No. 148winner, First Prize, Federal Editors Service, Publication 72-20005. Blue Pencil Award.

Z trm The State Agencyon Aging

"t the time of the first White House House Conference activities within his jurisdic- Conference on Aging in 1961, few tion. In all instances the "State unitson aging State Offices on Aging had. beenestab- were asked to take on this responsibility. lished. In 1971, largelyas a result of the passage of the Older AmericansAct, each of the 50 States, as welas the District of Columbia, The State had four major responsibilitiesin American Samoa, Guam, Puerto Rico,the Virgin preparation for the White House Conferenceon Islands, and the Pacific TrustTerritories, had Aging:(1)surveying the jurisdiction's older Offices on Aging.' population,(2)trainingleadershipforthe Forums and for the community' andState confer- These State agencies playeda major role in ences, (3) organizing community conferences the preparation for the 1971 on White House Con- aging, and (4) holdingstate conferences. Al- ference on Aging. The ChiefExecutive of each though the manner and of the 56 jurisdictions extent of preparation for was informed of the overthe different conference activities varied all Conference plan and the job among that the public the jurisdiction, each of the 56was successful sector at the State level would be expectedto in holding both Older American undertake. He was asked Forums and to designate an agency community conferenceson aging; and 54 jurisdic- within the Stategovernment to coordinate White tions held State conferences.

Survey of the State's OlderPeople

The 1969 amendmentsto the Older Americans Act gave the States specific comprehensive study of the income, health,hous- responsibility for ing, social, and other significant conditionsof its statewide planning, coordination,and evaluation older population. of the variousprograms and services available within their respective Statesfor their older citi- Many States completed their studies intime for zens. the findings to becomean important source of information for participants in Under the plans for implementation the State confer- of this ences. Equipped with this type of factual infor- amendment, each State was required to make a mation, the States were ableto formulate realistic proposals for their own immediate action ' For purposes of thisreport, alljurisdictions (State, the as well District of Columbia. and the territorialunits) will generally as recommendations for needed policiesto be im- be reterred to as States. plemented at the national level.

21 Training for Community Forums and Conferences

Citizen leadership was to bear the responsi- on explaining the nature of the policy formulation bility for planning and conducting the Older process upon which the substantive output of the American Forums, and the community White conference would be based. If the recommenda- House Conferences. They were also to take major tions coming from hundreds of community con- roles in conducting the State conferences. Careful ferences (and later from State conferences) were training of these leaders, most of whom were not to be successfully consolidated, it was necessary professionals in aging, was therefore an essential to have a common understraiding of the process part of the preparatory phases of the work of the and to follow the same method of formulating State agencies on aging. policy recomniendations in all conferences. To prepare the State Agencies on Aging for The training materials therefore directed at- their responsibilitiesin planning the Forums, tention to: the rationale for focusing on major regional briefing meetings were held to cover: policy recommendations, as distinguished from (1) the organization and conduct of the Forums; narrow program refinements or distant, idealized (2) the enlistment of. local public and private goals; the process of arriving at policy proposals agencies in organizing and staffing the Forums; through the weighing of alternative resolutions to and (3) the essentials of reporting to the States those issues identified by the Technical Committee the findings and results. The State agencies then or considered by the Conference Sections on their formed and trained local community committees own initiative; and the need to evaluate each to take, leadership roles in implementing the plans recommended policy against such criteria as its for Forums. relevance, feasibility,clarity, salience, prospects Training for the community and State White for adoption; and consistency with social values. House Conferences on Aging was provided at two levels7-Arthe first level, the White Houk The agenda of all the training sessions devoted Conference on Aging staff held training meetings, the morning to an overall look at the conference arranged by the Federal regional offices on aging, process, the afternoon to a simulation exercise in for the personnel of State agencies on aging. The developing a policy proposal in the area of retire- agencies, in turn, trained the local committees ment by a model conference work group. This responsible for the community White House Con- extensive training prograni was an important fac- ferences on Aging. tor in achieving the consistency and efficiency required for the broad involvement which char- The training sessions for both the State agency acterizes the three year effort of the White Nouse directors and community committees concentrated Conference on Aging.

Older Americans White House Forums

More than 6,000 Older Americans White more and more communities asked to be involved House Forums, with over 500,000 participants, in the White House Conference activity. were held in communities in 50 States and several Each community electing to sponsor an Older of the Territories. In order to achievea maximum Americans Forum so notified the Stare agency. A impact, most of the meetings were scheduled dur- local community was then established and the ing the week of September 20; yet by year's end, leadership given appropriate training for their Forums were stiii being held in some States as roles as described in the previous section.

22 Two objectives guided the planning and the newspapers all sizes. Reports also showed good conduct of the Older Americans Forums. coverage by both commercial and educational (1) To form a national network ofcommun- radio and television. This was important inac- ity meetings, where older citizens would quainting the general public with the needs of have the opportunity to speakout and be older people and with the 1971 Conference. heard on what they considered their basic Since the Forums were regarded as the founda- needs, and on what oughtto be done to tion for community, State, and national White meet those needs. House Conferences, it was necessary to register (2) To increase publicawareness of the prob- how older persons taking part perceived them- lems faced by older people, and thepo- selves and their needs. Two principal methods tential they possess to tackle those prob- were used. One method was implicit in the very lems if given the means. concept of the Forum, namely, older persons were provided the opportunity to voice their con- Participation in the Forums depended, ofcourse, cerns during the work group discussion and to upon whether one had the time, means, and in- vote on their most pressing needs at the final clination to attend. Nonetheless, the participants plenary session. Arrangements were made for did represent a widearray of racial; ethnic, eco- Forum recorders to note the major points of the nomic, and religious 'groups and theycame from discussions and to report the voting on important all types of urban, suburban, and rural settings. needs in order of priority to State agencies for further use. Through this form of hearings and The Forums were of varied size. Manywere and testimony, older Americans issuesa clarian held on a neighborhood basis andwere attended by small numbers of people. Others call for major policy advances in such critical were con- areas as income, health, care, housing, and trans- ducted for larger areas suchas counties or legislative districts. portation. The locale of individual Forams The second, and more systematic,way of regis- was equally tering older persons' opinionswas through a varied. Meetings were held in seniorcenters, civic auditoriums, fraternal and service clubs buildings, questionnaire addressed to their specific needs. By filling out the questionnaire, participantswere churches and synagogues, individual homes,professional office suites, public housing projects, able to express their concerns whetheror not they joined in the Forum discussions. Written in nursing homes, retirement villages, tribal houses on Indian reservations and schools. both English and Spanish, the questionnairewas prepared by the Institute for Interdisciplinary The typical Forum agenda consisted of:an in- Studies, Minneapolis, Minnesota. troductory plenary session; the delivery ofa short questionnaire to each olderperson which asked The questionnaire included itemson transpor- about his or her needs in severalareas; workshop tation, legal, medical, and financial problems; discussion directed towarda panel of "listeners" living conditions; food; geographical location; who were in a position to initiate responsiveac- social activities; and life satisfaction. tion, i.e., local, State, and national legislators, Information was also collectedon age, sex, executive officials, providers of services, and other education, and income in order to providea basis community leaders; and a final plenary sessionto for assessing the relationships of needs and prob- choose priorities among theconcerns expressed lems to these characteristics of the elderly. by older people. At the close of the Forums,report of the findings were filed with the State The Institute for-Interdisciplinary Studiesproc- agencies. essed and analyzed a total of 194,000 questionnaires, additional thousands have been received An important part of the Forum activitywas too late for inclusion in the sample. A prelimi- local media coverage. Clippingssent in by com- nary report was made in April 1971 and became munities and States indicated broadcoverage in available to States for use in planning their White

468.217 0 - 73 - 3 House Conferences on Aging. The Institute also them. Nearly half of the respondents had in- prepared a final report, Older Americans Speak curred medical expenses during the previous To The Nation, a summary of which was dis- month and twelve percent had incurred dental tributed to Delegates attending the White House expenses. Conference on Aging.' Social Activities. Less than one-half of the The major results of the questionnaire as respondents used a senior citizen center. Of those analyzed and presented by the Institute are re- who did not, slightly less than half wanted to use ported here because of their importance in shaping one. Similar response rates were shown for indi- the thinking of Delegates to the State and Na- viduals belonging to or desiring to belong to an tional Conference.' organization for retired persons.

QUESTIONNAIRE RESULTS Life Satisfaction. Twenty-two percent of the respondents felt unwanted and -17 percent felt Living Situation. The majority of the elderly that they had nothing left to live for. The ma- respondents either lived alone or with their jority of respondents were happy in the neigh- spouse, although a disproportionately high per- borhood where they lived. centage in relation to the number in the general population lived in a retirement or nursing home. Food. The majority of respondents felt that they Half of the respondents owned the place where had enough -money to buy the food they liked, they lived and were thus responsible for mainte- although one-third felt that food is packed .in too nance of the premises. large amounts for their use. The majority of respondents cooked for themselves, and slightly Financial. Slightly mote than half of the re- more than one-third ate alone. spondents had difficulty in making ends meet. While more than one-third had difficulty in pay- Transportation. Nearly one-third of the responding for their housing. Nearly two-thirds of the ents indicated that they had transNaation diffi- respondents did not have- sufficient means for culties; primarily because of lack of public trans- "little extras." portation, or of a car or inability to drive. Retirement and Employment. The majority of Legal. Less than 20 percent of the respondents respOndents were retired. Of those individuals not needed legal assistance in the previous year. The retired, nearly one-half said.they would like to be. majority of respondents, however, felt that the Eighteen percent of the respondents were working elderly generally need legal advice about making either full- or part-time. Of those individuals not and probating a will. Slightly less than half felt working, slightly more than one- quarter would that the elderly need legal advice about guardian- have liked to be working. ship. Six percent of the respondents perceived themselves as having been victims of consumer Medical-Dental. One-quarter of the respondents fraud in the previous year. felt that they bad an unattended health problem. About a fourth felt that they could not receive There was scarcely a problem or concern re- medical or dental services whenever they needed ported by older people at their Forums, or revealed by the questionnaire, that was not re- ' In its report, the Institute of Interdisciplinary Studies ack- nowledges some limitations inherent in the data. Perhaps the sponded to by recommendations made by com- major difficulty was that: "The responses to the survey are no munity, State, and the national conferences. This based upon a random sample of elderly throughout the nation, which makes generalization of responses as encompassing per- process of calling upon the older people to pro- ceptions of all elderly somewhat tenuous. While the sample of duce these important components of the 1971 individuals over 65 years of age was representative of all elderly by age, 24% of all respondents were under 65 year: of White House Conference on Aging, coupled with age. The sample was betty. educated than the general popula- their continuing involvement in every stage of tion of elderly, yet it had a lower level of income. Additionally, the same represented a disproportionate number of females, the Conference, infused Conference discussi,:s people living in institutions, and people living alone." with meaning and timeliness, and provideda 'Copies of the full report can be obtained from the Institute forInterdisciplinaryStudies, 123 East Grant Street, Min- touchstone for action on Conference policy recom- neapolis, Minnesota 55403. mendatiom.

24 Community White House Conferenceson Aging

From February through April 1971, the 56 Book for Participants in Community WhiteHouse State jurisdictions held more than 500 localcon- Conferences on Aging in the subjectarea to which ferences on :Ting. As was The case with the Older each was assigned. American Forums, any communityso wishing could, by notifying the Stateagency on Aging, It was suggested that theprogram of the com- hold a White House ,Conferenceon Aging. Some munity conferences include registration, followed chapters of national organizations of older people by an opening plenary sessionat which the con- were also authorized by the State agenciesto ference task was explained and emphasisplaced hold community conferences. on the fact that the position the participants took would become the gristout of which a national The community conferenceswere planned by policy on aging wouldemerge. local committees which included communitylead- t ers who representedlocalorganizations and The participants would then assemblein work ( senior citizens groups, as wellas program plan- sessions according to their subjectarea assign- ners or lay persons interested in the problems of ments to formulate position statements orrecom- the aged. mendations on each issue. A final plenary session was to be held for the purpoSe of hearing the In most cases these committees, had already recommendations proposed by each of the work conducted the earlier Forums and,therefore, sessions. had some of thenecessary experience to perform the many difficult conference tasks.Other A final report of each of the communitycon- members were added to the committeesas needed ferences was to be preparedon special forms pro- to guarantee that a sufficient number of knowl- vided for that purpose. The finalreports were to edgeable persons were included foras many of be transmitted to the Stateagency on Aging where the subject-matter areas as possible. the recommendations wereto be organized for use at the State conference. The community conference committeeswere In order to convert these responsible for setting the date of the localcon- raw materials from ference, enlisting and training leaders, inviting the community conferences into usable formfor participants and assigning themto subject-matter the State conferences, each Stateagency on aging work sessions' accordingto interest and expertise. organized task forces of specialists for each ofthe nine Needs Areas. Here, as in all other aspects of conferenceac- tivity, substantial effort was madeto include The task forces reviewed all of the policyrecom- persons of all income levels, and of racial, ethnic, mendations in a particular subjectarea received and religious groups. from the various community conferences,consolidated recommendations thatwere not sub- In order that participants couldprepare for stantially different, while carefully preservingnew their tasks in the community conferences,two or creative ideas, and worded the policyrecom- pieces of literature were distributedto them, if mendations to be considered by the participants possible, before the date of each conference.One in the State conference. was a leaflet titled, "So You Are To Be A Par- ticipant In A Community White House Con- Thus, the development ofa national policy on ference on Aging," which providedrelevant back- aging, as was appropriate, beganat the grassroots ground information; the otherwas the Work level. The community conferencesoriginated most of the policy recommenditions which bear ' Most Community Conferences dealt only with thenine the stamp of the 1971 WhiteHouse Conference Needs Areas. on Aging.

25 State White House Conferenceson Aging

By early spring, 1971, the preparation for the Responsibility for organizing and holding the State White House Conferences on Aging was State Conferences was given to the State agencies completed. As Aaron M. Wiesen, Chairman of the on aging. The meetings were scheduled in the Ohio State Conference, told the Ohio conferees, period April to July 1971 in orderto conform to "Part of the race has been runmeaning, of the overall preparation plans for the national course, the-numerous White House Community meeting in November. Forums held throughout the State last September, the Community Conferences held in selected re- The Governors were asked to appoint thepar- gions this spring, and the work of the 17 Task ticipants to the State conferences accordingto the Forceswritingpreliminaryrecommendations. following formula proposed by the National Now comes the 'moment of truth': final prepara- Conference Planning Board. tion of the recommendations which the Ohio Delegates will take to Washington, D.C., as our Middle-aged and older people...45% State's contribution to the White House Con- Providers of services 35% Specialists in aging ference on Aging...Not only will our ideas be 10% Decision - :rakers useful at the White House Conferenceon Aging, 5% they will also be heard throughout the Statein Youth 5% the press, at all levels of local government, and Many of the State Conferences included ob-' in the State Legislature. For certainlynoall servers as well as the officially appointed partici- problems can be solved at the national level... pants. . Through this[State]meeting,the needs of Ohio's 'one million strong' will be articulated." The leadership for each Conference was ap: pointed and trained by the State agencies. Copies Mr. Wiesen thus summarized the preparatory of the materials prepared by task forces and the phases and emphasized the extraordinary im- Work Book, containing the issues identified by portance of the State White House Conferences the technical committees, were also distributed to on Aging. He reflected the sentiments of all the participants by the State Agencies: Whenever States. and projected what could be anticipated as possible, these materials were sent to the partici- continuing State involvement in improving the pants prior to the conference so that they might quality of life of their older citizens. be prepared.

Tod& 1

NUMBER OF STATES REPORTING RECOMMENDATIONS BY SUBJECT MATTER AREA

(P4 = S4 Jurisdictions)

Number of States Numbir 9 Needs Areas Included Omitted 5 Needs-Meeting Amos Included OmItted Education 52 2 Facilities, Programs, and Services 32 22 Employment/Retirement 53 1 Government/Non-Govt. Organization 35 19 Physical and Mental Health 54 0 Planning 35 19 Housing 53 1 Research and Demonstration 35 19 Income 53 1 Training 37 17 Nutrition 54 0 Retirement Roles and Activities 52 2 Spiritual We II-geing 51 3 Transportation 54 0 "28 jurisdictions included all 14 subject areas 49 jurisdictions included MI 9 needs areas 2 jurisdictions included o'l 13 subject areas 1 jurisdiction included all $ needs areas 2 jurisdictions included all 12 subject areas 3 jurisdictions included all 7 needs areas 5 jurisdictions included all 11 subject areas 1 jurisdiction included all 6 needs areas 5 jurisdictions included all 10 subject areas

26 The programs of the State conferencesgener- it was adopted. They were also asked to indicate ally, but not always, consisted of plenary sessions the extent of the support that each proposalre- and small work -group sections organized around ceived (majority or minority proposal) andto the subject areas. The States gave primarycon- which issue the proposal was addressed. sideration to the nine Needs Areas but,most also The State conference reports were to be re- included one or more of the five Needs Meeting ceived at the National Conference office within Areas as shown in Table 1. 10 working days after the close of the conference. Many of the States went beyond discussion of The recommendations of 54 jurisdictionswere thi issues of national policy andgave attention submitted in time to be included in the technical to what action could be taken immediately by committees' consolidation of State conference and their communities, the State, and variousorgan- National Organization Task Force reports. izations to improve the situation of their elderly Altogether, 38,297 persons were reported by populations. 53 jurisdictions to have attended the Statecon- In the small work groups, each of the issues ferences. Of this number, 57.4 percent were in the and recommendations in a particular subjectarea middle and older aged group as comparedto the was handled singly. A work group reviewed the 45 percent recommended by the National Con- various proposals that responded to one issue and, ference Board. The size and active involvement through discussion and ballot, determinedits of this consumer group gives further credenceto recommendation for a national policy before the responsiveness of the State conferencerecom- moving to a second issue. This processwas re- mendations to the needs and wishes of older peated until ell of the identified issues had been people. considered and both majority and minority positions recorded. With this portion of their work completed, the participants turned their attention Table 2 to issues other than those identified by the techni- STATE CONFERENCE PARTICIPANTS cal committees or to proposals forprogram recommendations. 53 JURISDICTIONS The programs ended with a general sessionat Participant Groups Number Percent which the recommendations developed by each Middle Aged sod Older People 21,992 57.4 conference work groupwere reported to the total Providers ,si Services, Specialists, Decision-Makers 14,993 39.1 participant body, and put to a vote for adoption. Youth 1,312 3.4 In some instances reports were votedon in work group sections but not by the full conference. Total 31,297 99.9 These three groups are combined because some jurisdictions The States were asked to submiton a special did net report them separately. form each proposal in the exact working in which

Activities of National Organizations

The 1971 White House Conferenceon Aging port for translating such proposals into action. was instructed to address its recommendations The national organizations with a concern for not only to government at all levels but to the aging had been a vital part of the 1961 White private and voluntary sectors as well. Their active House Conference on Aging, but they hadnot involvement in the Conferenceprocess would be had opportunity to participate inan organized instrumental to the development of sound policy fashion in providing content for that conference. proposals, and to generating broad publicsup- To make. possible their active participation in

27 the pre-conference planning for the 1971 Con- Needs Areas. .A National Organization Task ference; the leaders of 300 national organiza- Force was set up for each area. Altogether, 543 tions were invited to a planning meeting which persons representing 293 national organizations was held in Washington, July 1970. were distributed among the nine task forces. These organizations were widely representative To assist the task forces in their work, and to of the following groups:. insure that their recommendations were prepared Membership organizations-of older people in the same form. as those generated by State Professional and scientific associations conferences, they were provided copies of a Tech- nical Guide for National Organizations and the Business, consumer, and labor organizations appropriate Background and Issues paper. Religious, fraternal; social, service, and community action organizations At 2-day meetings in May 1971, the task forces approved sets of policy proposals which National Association of State Units on Aging were subsequently forwarded to Washington for More than 200 persons attended the Washing- consolidation with the State recomn.-ndations by ton meeting. They pledged themselves to assist the technical committees. Representatives of the the Conference in three major ways by: task forces met with the technical committees to 1. Providing lists of regional and State leaders ensure that full consideration was given to the for involvement in State and community recommendations of the National Organization conferences Task Forces. In addition, the organizations themselves were asked to comment on the task force 2. Submitting position papers for use of Tech- findings and submit any additional materials rele- nical Committees and authors of the Back- vant to the subject. ground and Issues. papers. 3. Establishing task forces to recommend pro- The national organization participation in the posals for developing a national policy in 1971 White House Conference continued with aging in the nine Needs Areas. the involvement of more than 700 representatives named by them to be Delegates to the Na- The major contribution of the participating tional Conference. They constituted a significant national organizations to the preparation for the proportion of the professionals among the Dele- National Conference was the development of gate body. They were assigned to both the Needs policy recommendations for each of the nine and Needs Meeting Sections.

Regional White House Conferenceon Aging Hearings

In October 1970, John Martin, Director of government at the regional, State and local the Conference, invited the chairman of each of levels. the 10 Federal Regional Councils to sponsora Regional Hearing on Aging in his respective To give greater visibility on the regional region. The invitations were accepted and plans level to the needs of older persons. were made for the hearings to be held during the To provide an extra dimension of available early months of 1971. . data for the Technical Committees preparing background information for the White Three purposes of the hearings were definedas House Conference on Aging in November follows: 1971. To provide an opportunity for input into the Flexibility was allowed each region to select White House Conference on Aging from the topic considered most appropriate for the representativesof government and non- region. Those selected were:

28 s

Region I (Boston) "Health ServicesInter- Region IX (SanFrancisco)Report from mediate and Long-Term Care" States Region H (New York) "How to Meet the Region X (Seattle) Report from States. Needs of the Elderly in a Variety of Housing Mr. Martin or Mr. Atwell opened each hearing Situations" with a "Report to the Region" which related the Region III (Philadelphia) "Methods to Im- programs of the White House Conference on prove the Income of Older Minority Groups" Aging across the Nation to the region in which the hearing was being held. Testimonywas heard Region IV (Atlanta) "Roles and Activities by the members of the Regional Federal Council. of Older Persons" It was given by officials of regional, State, and local government and representatives from vari- Region V -(Chicago) "Health Maintenance" ous organizations and agencies concerned with Region VI (Dallas) "Needs and Problems of older people. This testimony, along with written Older Mexican-Americans" testimony submitted by others, became the official record of the hearing. These constitutedii Region VII (Kansas City) "Rural Transpor- portant background materials for the National tation" Conference as well as providing opportunityto examine in depth some of the unique problems Region VIII (Denver) "Education for the foUnd by elderly persons in variousparts of the Elderly" country.

Conference Flow Chart Flow chart, pages 88-89, providesa sum- the involvement of a broad representation of mary and time scale of these elements which went citizensin various action-taking meetings, the into the making of the 1971 White House Con- Conference preparation culminated in thesummer ference on Aging. of 1971 with the consolidation of therecommen- dations from all sources for use of the Delegates Beginning with the older people speakingout, at the National Conference in November-De- followed by the mobilization of specialists and cember.

Establishing a National Climate ofAction

y January 1971, the preparatory phases ence plans. To this end, the President named of planning, appointment of commit- Arthur S. Flemming as Conference Chairman. tees, development of background papers and instructional materials had been Without changing the main Conference pur- completed. What remainedto be done at the pose of moving toward the development of a national level during the 11 months preceding national 'policy on aging, Mr. Flemming moved the Conference wasto implement the plans and quickly to bring about a greater understanding of prepare the details of the National Conference. the Conference anditsgoalof formulating policies for immediate feasible actionthe defini- When the Conference planning beganin early tion of a policy already adopted for theuse of the 1970, there was a publicconcern that aging was ConferenCe. no longer a Federal government priority. This strongly held belief heightened the sensitivities of Stne and regional groups across thecountry were urged to expand existing programs and to national organizations of older people,professional groups and responsible public initiate new ones without waiting for the final bodies lead- decisions of the Conference. It ing them to question whether indeed theWhite was important for House Conference on Agingwas a sincere effort the National Conference Delegates to feel that to improve the circumstances of the older they were participating ina movement already popu- well underway and to have the need for action lation. As a result of the widespreaddissatisfac- tion, criticism of the Conferencewas quick to uppermost in their minds when they spelled out generate. Thee critical of the Conference main- their hopes and aspirations in formulatingrecom- tained that it was being used forpolitical pur- mendations for national policy and in planning poses, that the Conference outcomewas being the implementation of them. controlled through rigid structuring ofits subject By October, when States reported what actions matter, and that there was little evidence of in- had been stimulated, theywere able to give dozens tent to seek action in time to benefit thepresent of examples, such as an increased variety ofserv- generation of old people. ices to the elderly, the formation ofmany new community councils and commission-on aging, Such a chill climate gave small promisethat the enactment of various legislative a great national meeting intended to advance the measures that were in line with the State Conferencerecom- quality of life for all olderAmericans would reach a full and fruitful maturity. mendations, new starts on housing for the elderly, What was and special transportationprograms tailored to needed was a change in the climatefrom one of the needs of the elderly. negative reaction toone of positive action action already underway beforethe Delegates To stimulate additional pre-Conferenceaction convened in Washington in November. and to identify any weaknesses in theNational Conference effort, a series oftet. regional meet- The immediate need was to augment the White ings were held. In each region the meetingin- House Conference on Aging staff with a fulltime cluded the members of the FederalRegional chairman who would work closely with the Con- Council, the chairmen of the State conferenceson ference director in carrying forward the Confer- aging, the directors of the State unitson aging,

33 and members of the national organizations of gional, and Federal levels, Mr. Flemming re- older people. sponded to the mutually expressed wishes of the During the late spring and summer of 1971 voluntary organizations and governmental agen- several important steps were taken to initiate cies for the post-Conference continuation of the close working relationship that had been gene- action within the Executive Branch of the Federal Government. The President named a Cabinet- rated through their cooperative preparation for level Committee on Aging within the Domestic the White House Conference bn Aging. "A Plan Council. In doing so he pointed out the "need to for Action" was launched at a meeting of repre- develop a comprehensive national policy with sentatives of 175 national organizations in the fall specific action to provide greater opportunities for of 1971. Primed for action, this group had, by this nation's 20 million older people to improve the time of the National Conference in Novem- the quality, dignity and productivity of their ber, already taken steps to establish an ongoing life." organization and had launched its first program, the ultimate goal of which is to make home serv- The Department of Health, Education, and ices available and accessible as needed to older Welfare appointed a special assistant on nursing people wherever they live. homes and began a vigorous program to improve the substandard nursing homes of the Nation. In Although only a small fracoon of the nearly May, the Secretary, in anticipation of increased one million persons who had a "piece of the government responsibilitiesin aging following action" in preparing for the White House Con- the Conference, asked that a citizen task force ference on Aging, could attendthenational be named to examine alternative plans of govern- meeting, they were already busy in their own mental organization for aging and to prepare an spheres and preparedto put into immediate interim report ofits recommendations for the action the recommendations of the national Dele- Delegates to the White House Conference on gates. And, because the Delegates returned home with copies of all the proposals made at the na- Aging. tional meeting, post-conference action at the local, Having stirred pre-Conference action and new State, and regional levels proceeded without a enthusiasm for aging at community, State, re- break in time or even a hesitation.

Consolidation of Recommendations

During July and August of 1971, the 14 Tech- mendation. Proposals addressed to matters other nical Committees were each convened for a second than those represented by the issues which had meeting. The purpose was to prepare a clear, suc- been developed by the Technical Committee were cinct consolidation of the policy recommendations also to be synthesized and reported for the consid- which had been produced by State White House eration of Delegates to the National Conference. Conferences on Aging and by the National Or- To be reported, however, such proposals were to ganization Task Forces. have been given majority approval by five or more States or by fewer than five if such States com- To assist the Technical Committees, the Sec- prised 10 or more percent of the 65 and over retariat for each Committee undertook a pre- population. Exceptions to this rule were made in liminary consolidation of the State and task force cases where proposals were particularly striking proposals following the guidelines adopted by the or innovative in nature. Conference Planning Board. To facilitate the use of the consolidated recom- The Technical Committees were asked to report mendations as a working tool for Delegates, the significant refinements or variations of any recom- Technical Committees often included with the

34 recommendations comments which theycon- Having anal responsibility for the consolidation sidered pertinent to discussions of theissues of the recommendations, the Technical Commit- involved. In some cases, for example, the Techni- tees sought to develop statements which were as cal Committee concluded that the original issue faithful as possible to the expression and intent had not been well phrased and suggesteda re- of the States and national organization task forces. statement to clarifyit. In other instances, the Technical Committee suggested additional issues or points it believed should be considered by the Observers named by the national organization Delegates. task forces and the National Association of State Units on Aging attended the meetings of the To assist Delegates in their task,program Technical Committees to ensure that equalcon- suggestions included in the recommendations of sideration was accorded to all recommendations. the States and national organizationswere also When the consolidated proposalstatements were reported when such proposalsset forth action agreed upon, they were incorporated withinthe steps which might be taken to implement pro- Delegate Work Books whichwere to be used at posed policies. the National Conference.

Categories of Conference Participants

In addition to preparing materials and finaliz- DELEGATES ing the organizational plans and procedures for the National Conference, during the several Nearly 3,600 Delegates were expectedto at- months prior to the 1971 White House Confer- tend the national meeting, including: ence on Aging, the Conference staff was actively Conference Planners 324 engaged in the process of identifying whatwas the essential Conference ingredientparticipants. State Delegates 1,750 Youth Delegates These participants, in all numberingover 4,500, 112 included: State Agency on Aging Representatives 99 National Organization Delegates 737 Delegates, nominated by severalsources, who Office of Economic Opportunity Advisory were the only Conference participants to hold Committee Members voting privileges. 15 Delegates-at-large 537 Observers, representatives from varioussectors identified as holdingsome special interest in work and objectives of the Conference.Ob- Conference Planners. Persons named by the Sec- servers participated with the same rights and retary of Health, Education, and Welfare to serve privileges of Delegates except they lackedthe on the Conference Planning Board or as members right to vote. of the Technical Committees, automaticallyas- Guests included all Governors and Members of sumed Delegate status. Such statuswas granted Congress, ortheir personalrepresentatives. to authors of the Background and Issues papers, Also invited as Guestswere decision-makers in consultants to the Technical Committees, andto the Executive Branch of the FederalGovern- Section Co-Chairmen who did not alreadypossess ment, and special persons invited by the Con- Delegate credentials. All thesepersons were classi- ference. fi ed as representing the States in which theyre- Staff consisted of the White HouseConference sided, but they did no count against the Stare on Aging personnel, complemented by Federal quotas. personnel drawn from the various departments State Delegates. Each State, Territory, and the and agencies involved inprograms for the District of Columbia was allotted a minimum of aging. 14 and a maximum of 125 Delegates, basedon

35 the size of their respective older populations in metropolitan areas and from all age groups, the 1970 census.' especially older persons. At the request of the Secretary of Health, Edu- That the delegation from each State should, cation, and Welfare, Governors of the States and insofar as feasible, include persons assigned Territories,andtheMayor-Commissionerof to a Section within each of the suNect matter Washington, D.C., nominated Delegates. Each groups, in order that the State may have Governor was asked to name his State quota, and broad coverage at the Conference. to provide a list of alternates equal to one-half That persons with a professional identifica- of the quota, to be drawn from in cases of dupli- tion in the field of aging should not exceed cate nominations or declinations of the President's one out of every four Delegates appointed invitation. by the States. Persons may be regarded as In their Delegate selection,the Governors "professionally identified" with the field of were requested to consider the following criteria aging if more than 50 percent of time for adopted by the Planning Board: which they receive compensation is devoted to programs or services to the aging. Tnat the diversity of population in each State be reflected in the composition of the Youth Delegates. Each Governor was invited to State Delegates, and that due recognition be name two Youth Delegates. To guide the selection given to ethnic, minority, and economically of these youths severalspecificcriteria were disadvantaged groups of older persons in offered. each State population. That the Youth Delegates be within the ages of 17 and 24 years at the time of the Con- That Delegates be selected on the basis of ference. demonstrated interest, personal effectiveness and leadership in the field of aging, with That attention be given to including youth special weight being given those who par- from ethnic, minor4 and economically dis- ticipatedinlocaland State conferences, advantaged groups. studies, and other activities preparatory to That formal affiliation with a national youth the White House Conference on Aging, and organizationnot bearequirementfor who best represent the points of view of the nomination. participants in those preparatory activities in the States. State Agency on Aging Representatives. Each State agency on aging was allotted two Delegate That a wide interest in programs for persons positions, one each for the executive director of be favored over specialized or exclusive in- the agency and its chairman. These Delegate slots terests. were utilized if the individuals involved did not That the individual's capacity to undertake already have Delegate status under some other followup action in his State and community, category. subsequent to the National Conference and National Organization Delegates. A total of his leadership potential be given weight. In- 347 national organizations named Delegates to sofar as possible, State legislators with re- attend the Conference. Organizations which had sponsibility for matters affecting the aged participated in the preparatory work of the Na- should be considered. tional Organization Task Forces, were each al- That the delegation asa whole provide lotted two Delegates. Organizations which had representation from rural, small town, and expressed interest in the Conference, but which had not participated in the task forces, were allowed to name one Delegate. Nine membership ' The 56 jurisdictions which named State Delegates includ- organizations of older people were granted 10 ing the 50 States, the District of Columbia, American Samoa, Guam, the Commonwealth of Puerto Rico, the Trust Terri- additional Delegates positions. The four largest tories of the Pacific, and the Virgin Islands. nationalorganizationsofolder personsthe

36 American Association of Retired Persons.the Rehabilitation Service (Department of Health, National Retired Teachers Association, the Na- Education, and Welfare) and the Gerontological tional Council of Senior Citizens, and the National Society to participate in an International Geron- Association of Retired Federal Employeeswere tology Research Symposium. The White House each invited to name an additional 14. G nference and the Research Symposiumwere Formal criteria were not established for Na- scheduled concurrently and participation in the tional Organization Delegates, although itwas Conference was part of the Symposiumprogram. assumed that persons nominated wouldpossess Ad,litional Foreign Observers invitedto partici- some specialized knowledge, skill, or interest in pate in the Conference included persons interna- the subject area Section to which the namingor- tionally active in the field of aging and profes- ganizationrequested assignment. Organizations sionals invited at the special request of their which were presented the opportunityto name governments. additional Delegates were asked to give special Faculty-Student Observers. Teachers andstu- attention to ethnic, minority, and economically dents of aging, representing over 50programs disadvantaged groups of older persons. offering training in gerontology, were invitedto 0E0 Advisory Committee. Members of the attend the Conference. Older Persons Advisory Committeeto the Office of Economic Opportunity, who Aging Program Directors. Twoprograms offer- were notac- ing community service employment opportunities credited as Delegates in other categories,were granted special Delegate status. to older persons were invited to name Observers. The Foster Grandparent Program sent its project Delegates-at-large. It was recognized that with directors. The Senior Aides, operating underan the quotas prescribed for Delegate seleCtion,some agreement between the National Council of Sen- particularly qualified individuals wouldnot be ior Citizens, Inc., and the Department of Labor, named. To make compensation for this, andto designated directors of itsprograms to attend. insure that there would beamong the Delegates appropriate representation from special popula- Federal-RegionalPersonnel.TheRegional tion groups, the President designated Delegates- Commissioners of the Social and Rehabilitation at-large. These Delegateswere not named, how- Service and the members of the Federal Regional ever, until all other Delegate appointments had Councils were invited Observers. The Federal been completed and analyzed. Regional Councils embody an inter-departmental approach to ameliorating social problems andare OBSERVERS composed of representatives from the Depart- ments of Housing and Urban Development, Foreign Observers. The majority of the Foreign Transportation, Labor, and Health, Education, and Observers were persons invited by the Social and Welfare, and the Office of Economic Opportunity.

Conference Format

Responsibility for the format of theNational groupings of them; and two types of work sessions Conference rested with staff, guided by the actions Subject Area Sections and Subsections forpar- of the Conference Board and itsCommittee on Program and Procedures. ticipants assigned to them and Special Concerns Sessions which participants could attendas they The adopted format included GeneralSessions chose. Chart 1 sets forth the events scheduledover for all Conference participantsor for special the 41 /2-day Conference period.

37 Chad 1

CONFERENCE FORMAT

MORNING AFTERNOON EVENING

SUNDAY Registration Registration General Session Opening the Conference MONDAY Section Meetings 1 Subsection Meetings 2 Open Forum (Orientation) Subsection Meetings 1

TUESDAY Subsection Meetings 3 Subsection Meetings 4 Subsection Meetings 5 (if needed) and Policy Draining Committee Meetings

WEDNESDAYSpecial Concerns Sessions Section Meetings II Section Meetings II and (Adoption of (Continued if needed) Policy Coordinating Recommendations) and ComMittee Meetings Preparation of Final Report

THURSDAY General Session. Closing the Conference

GENERAL SESSIONS The Closing Session of the Conference was intended to bring together all the Conference par- There were three general sessions planned for ticipants to hear an address by the President of all Conference participants. The Opening Session the United States and a challenge to post-Con- was designed to provide opportunity to welcome ference action by the Conference Chairman. In the Delegates and to instruct them in their Con- addition to these general sessions for all Dele- ference tasks. For this Session, a multi-media pre- gates, Conference Luncheon Meetings were or- sentation was developed to present a vivid illus- ganized for groups of Sections to provide oppor- tration of the circumstances of today's older people tunity for Delegates to hear firsthand the views of and of the various attitudes society holds toward major Federal officials and members of Congress them. on current problems of older people and pending The second generalsessionwas an Open legislative thrusts on their behalf. 1 Forum. Convened in the evening of the first full day of the Conference, this sessionwas arranged SUBJECT AREA SECTIONS AND SUBSECTIONS to give special groups and organizations a forum The Sections. The Conference program was or- from which to present their points of view early ganized into 14 working Sections according to the enough in the Conference period to influence the nine Needs Areas and five Needs Meeting Areas. deliberations of the Delegates in their working Each Section met twice in plenary sessions. The sessions. first meeting allowed for a task-setting orientation

38 before the Section divided into Subsections where gates assigned to each. A deliberate effort was it was that recommendations would be developed. made to keep every Subsection small in order to In its second gathering (two and one-half days insure that each Delegate would have full and later) the Section took formal actionon the Sub- sufficient opportunity to participate and offer his section recommendations. particular contribution. The 14 subject-area Sections were all organized Each Subsection, independent of the others, in the same manner, with Co-Chairmen. Onewas formulated its policy proposals. Each of the Sub- designated the Presiding Officer; the otherwas sections considered all issues and proposals pre- the Technical Co-Chairman who worked with the sented within the appropriate Delegate Work Delegates in developing Section procedures and Book. in setting the goals to be achieved during the Subsection sessions. All 95 Subsections were organized according to the same pattern. Each Subsection had a desig- Each Section had an official Recorder whowas responsible for keeping a record of the actions nated Chairman who presided throughout the of the Sections, and preparing the final several sessions of the Subsections. At the begin- report of ning of its meeting, each Subsection elected a the recommendations approved by the Sectionat its final meeting. Vice Chairman who assisted the Chairman and presided in his absence, or upon his request. A A Section Policy Coordinating Committee Recorder was assigned to each Subsection to keep was responsible for the final version of the Sec- an official record of all actions taken. tion recommendations whichwere reported to the Section for discussion and voting. Membership of There was a Subsequent Policy Drafting Com- the Committee consisted of the Section Co-Chair- mittee composed of the Subsection Chairman, men, Recorder, and all Subsection Officers. The Vice-Chairman, and Recorder. They prepared a presiding Section Co-Chairman chaired the Com- report of the recommendations of the Subsection mittee. for transmission to the Section Drafting Commit- tee. They also served as members of the Section A Section Policy Drafting Committeecon- Policy Coordinating Committee. solidated the policy recommendations from the Federal agency Resource Personnel and other various Subsections and transmitted themto the Section Policy Coordinating Committee for final Consultants were assigned to assist each of the Subsections during their work periods. review. Membership for this Committee included the Section Co-Chairmen, Recorder and the Sub- The flow of work between the Sections and section Recorders. The Technical Co-Chairman Subsections over the 3-day period was to lead presidedat meetings of this smaller working to the adoption by each Section of a set of recom- Committee. mendations. Chart 2 shows the structure and Sections hadavailableResource Personnel schedule of the meetings of the Sections and Sub- from the Federal agencies andother Consultants sections and the task which was to be carried on at to provide whatever technical informationwas each of them. needed during the discussions. Not shown by the chart is the process of pro- The Directors of the Secretariatsto the Techni- viding the Interim Report of the Sections to all cal Committees servedas the Section Managers Delegates at the Closing Session of the Confer- during the Conference. ence. The Section Reporters, with the assistance of the other Section officials, were to prepare a The Subsections. Each Sectionwas divided into 1500 word report for their respective Sections Subsections of approximately 35 Delegateswhich consisting of a short preamble and the recom- met for a total of 10 to 13 hours. There wasa mendations approved by the Delegates at the final total of 95 Subsections, apportionedamong the Section meetings. These were to be filed for repro- various Sections according to the number of Dele- duction and inclusion in the Interim Report.

46e -217 0-73 .4 Chart 2.

SECTION AND SUBSECTION STRUCTURE ANDTASK

Schedule Task MONDAY 9:00 AM- SECTIONS {Orientation 10:00 AM All Section Delegates Instruction

MONDAY 10:00 AM- Formulation 5:00 PM Subsections Subsections Subsections of Policies 35 Delegates 35 De legates 35 Delegates TUESDAY each each each Preliminary 9:00 AM- Vote 5:00 PM

MONDAY and Subsection Subsection Subsection Prepare TUESDAY Drafting Drafting Drafting Subsection 5:00 PM- Committees Committees Committees Reports 7:00 PM

TUESDAY Consolidate Section Drafting Committees 7:30 PM Subsection Reports

WEDNESDAY Review 8:00 AM- Section Policy Coordinating Committees Section 10:00 PM Draft Report

WEDNESDAY Consider SECTIONS 2:00 PM- and Vote on All Section Delegates 5:00 PM I Section I {Report

40 SPECIAL CONCERNS SESSIONS whom they wished to directly present theirrec- Planning the 17 Special Concerns Sessionswas ommendations. the responsibility of their respective organizing committees. The White House Conference staff Some of the planning committees were able and other government personnel served the to arrange meetings of constituent groups prior com- to the Conference for the purpose of developing mittees only in the capacity of expeditingcom- mittee plans. a platform for consideration and adoption at. the SpecialConcernsSessions.Some corarnittees, The committees met in sessionsover several especially those planning the Sessionson the months. Each sought to adopta program format elderly minority groups, fashioned theirprograms which would ensure productive discussionand to cover some or all of the 14 subject areas of the practical recommendations. Intheir programs, Conference. This allowed the Delegatesan oppor- a number of the committees included "listening tunity to speak to the common needs of all older panels" which were madeup of persons from people and to the additional, particular problems Congress and the various Federal departmentsto imposed by racial considerations.

Selection and Training ofConference Leadership Selection. An attemptwas made to select Section The Vice-Chairman for each of the 95 Sub- and Subsection leadership fromamong those Dele- sections, by action of the Planning Board, was gates most broadly informed about the problems elected at its first meeting from among the Dele- of older people, and those whowere judged to gates within the Subsection. possess an appreciation of the policies and actions needed to achieve a meaningful andhealthful life Rounding out the leadership of the Conference for the older segment of thepopulation. Sections and Subsections were expert non-government consultants and Federal personnel. The Responsibility for naming Sectionand Sub- Federal personnel were not voting delegates, but section leaders, except SubseCtiOn Vice-Chairmen, were to supply the staff support and resource nec- rested with the Executive Committeeof the Plan- essary for effective work. ning Board which Committee namedan ad hoc Sub-Committee to preparea slate of candidates A Section Management Officer, whowas also for each of the Sections and Subsections.The Sub- director of the Technical Committee Secretariat, Committee solicited suggestions ofpersons for was designated the principal government staff these leadership roles from various3ources, in- person for each Section. They in turn arranged cluding national organizations,minority groups, for the other government personnel who served State units on aging, and the membersof the at the Conference. Persons working in the re- technical committees, and the PlanningBoard. gional and central offices of the Administration on Aging provided additional staff assistance. The Sub-Committee reviewed thecredentials of all persons suggested whichwere received prior Training the Leadership. The orderly develop- to the time of its meeting and prepared alternative ment of recommendations by nearly 3600 persons slates of nominees for each position.The Execu- required that the leaders particularly be well tive Committee made the selections from among versed in the nature of the task and theprocess the potential candidates payingspecial attention to be followed. All leaders had instruction pro- to the inclusion of older people,women, and vided in various written materials andmany had minority representatives. Also, inlight of the very gained experience in leadership rolesat their sparse representation among previously named cz-nmunity and State conferences. As further in- Conference leadership ofpersons from nearly surance that the Conference objectives would be two-thirds of the States, weightedconsideration achieved, the Section and Subsection leadership was given to achieving a balanced geographical was provided with some additional training in two distribution. orientation sessions.

41 The first orientation and training meeting was The second training session was held for Sub- held in mid-November. It brought together the section Chairmen and Recorders on the day pre- Section Co-Chairmen, Recorders, and the Section ceding the opening of the National Conference. Management Officers. A Guide for Section and Special instruction on effective Conference record- Subsection Conference Leaders was distributed and ing was provided those who were to perform that reviewed. This publication set forth the Con- role in the work of the Conference. ference plans and procedures, including: Conference structures and organization, format Opportunity was also presented the leadership and schedule of each Section and its Subsections to meet to- Tasks of the Conference leaders gether and prepare for achieving their common Recommendation reporting procedures' goalthe develop.tient and refinement of quality Rules of order governing the conduct of the recommend,..tions over an extremely short period Conference working sessions. of time.

Assignment and Preparation of Conference Participants Assignments. All Delegates were to work within Preparation really began at the community one Section and one Subsection of that Section dur- level where many of the persons who would evening the entire Conference period. Section prefer- tually be named as Delegates to the nat+onal ences for the State Delegates, youth Delegates and meeting took part in community conferences. National Organization Delegates, based on known Here leaders, trained earlier by State agency per- interests and skills, were indicated by the source sonnel, explained the task of policy formulation, of the nomination. For State Delegates an attempt aided by a work book especially prepared for the was made to insure the widest possible represen- community conferenceparticipants. The State tation of the State among the 14 Conference conferences provided a second learning experi- Sections. Observers and guests were asked to indi- ence which closely resembled the task that the cate their choice of Section assignments. Delegatesto the National Conference would Assignments to Subsections were essentially undertake. randomly determined. Except that a special attempt was made to make certain that within every To prepare the Delegates in the specific plans Subsection, as within each Section, there was rep- and for effective participation in the national resentation from the various minority population meeting, the appropriate Delegate Work Book, groups. Background and Issues Paper, and other reference materials were forwarded to participants some To facilitate Conference registration and the weeks before the Conference began. This made it collection of demographic data, each Delegate possible for the Delegates to "study the recom- was asked prior to the Conference to complete an mendations upon which they were to build at the Advance Registration Form. At the time, each was Conference. It also gave them an oppoqunity to informed of his Section assignment, and was given identify gaps and problems for which they could, an opportunity to choose which, if any, special if they wished, propose additional recommenda- Concerns Session he wished to attend. tiors for consideration at the national meeting. Preparation. To achieve in the development of broad, feasible plans for national action, the Dele- As a final step in the preparation of the Dele- gates needed to be knowledgeable in the subject gates, most States convened their State delegations matter areas .and familiar with the plans and to provide them a firsthand orientation for the procedures of the Conference and the roles they National Conference and to review its significance were expected to carry out. and relationship to future action at the State level.

42 PART 4

The National Conference in Action

November 28December 2

The Conference Setting

he Conference was housedinfour profit organizations touched on a broad range of Washington Hotelsthe Washington issues and resources.relating to aging. Hilton, the Statler Hilton, the Sheraton Park, and the Shoreham. The Confer- The press room was also located in the Wash- ence headquarters was located in the Washington ington Hilton Hotel. A portion of the press room Hilton. The other hotels were used mainly for the was set aside for the press conferences which were smaller group meetings. to be held two or more times a day. Mr. Flemming and Commissioner Martin jointly met with the Although the Conference didnot open officially press each day to keep them informed of the Con- until Sunday evening, most of the Delegatesar- ference's progresS. rived either the day beforeor early in the day on Sunday with the result thatmany were on hand By mid-afternoon Sunday the number of Dele- for Registration when it openedat 10:00 A.M. gates had noticeably increased and the amount of Having registered and received their Conference Conference activity had risen sharply. State dele- materials, they were free to visit andto explore gations and special interest groups were caucusing the resources of the Conference. and planning their activities for the next 4 days. Get-acquainted meetingsand receptions were One of the areas that drew the attention ofthe quickly organized. Delegates was the Senior Portrait Exhibitionat the Conference headquarters. The exhibitwas Among the Delegates were the "47 Outstand- ing Older Americans." These persons, many of made up of those works that had been citedin the nationwide contest for original portraits ofan whom were in their 70's and 80's, had been aged subject completed bypersons who were designated by their Governors and honored at their State conferences for the contributions that themselves old. The show contained the 24win- ners of the State contests that were submitted for they have made to the aged and to society.' the national competition. For those Delegates who wished to attend, a The winning entry, "Patriarch of theMoun- special ecumenical service was held at the Wash- ington Cathedral. The ecumenical service was tain," was painted by Bernard C. Bonder,age 73, of Mountain Home, Arkansas,' whowas to be sponsored by the District of Columbia Advisory Committee on Aging. recognized in person at the ConferenceClosing Conference Chairman Session. Flemming and Dr. Inabel. Lindsay, a Vice Chair- man of the Conference, participated in the Service, Adjacent to the Senior Portrait Exhibitwas the as did Dr. Benjamin Mays, Georgia's Outstanding Reading and Document Room. Literatureon the Older American. problems of andprograms for the elderly had been placed there so that Delegates mighthave In such a setting began 4 days of effort to access to the most current information available. articulate policies and suggest programs which, if These reports and statements from the Federal implemented, could change society's attitudes and materially improve the status of America's older departments and public agencies and privatenon- citizens.

' See Appendix K for additional informationon the Senior Portrait Contest. 'See Appendix J for additional information on the Out- standing Older Americans.

45 Characteristics of the Delegates

The Presidential proclamation of 1969 called one presently finds a ratio of 139 women per 100 for broad representation; the Delegates who par- men. Women were underrepresentedin every ticipated in the Conference reflected the variety age category of the Delegate body except for the of background and diversity of interest that the range of under age 25. President sought to obtain. A total of 3,675 persons were invited by the President to be Delegates at the White House Table 3 Conference on Aging. Of the 3,574 who were able DELEGATE SEX DISTRIBUTION, BY AGE to accept, all but 427 persons filled in a pre- Conference Registration Form which included (percent) questions designed to provide information about Age Sex the characteristics of the Delegate body respon- Male Female Total siblefor the recommendations adopted at the Conference. Under 25 1.7 1.6 3.3 25 -44 12.1 4.6 16.7 45 -54 13.5 6.7 20.2 Not all Delegates replied to all questions; thus, 55 -64 14.6 9.8 24.4 the number of replies reported varies in several 65-74 16.4 10.0 26.4 of the tables presented below. over 75 5.9 3.1 9.0 Total 64.2 35.8 100.0 The "No Information" entry in the tables reflects the number for whom information was not * Percentages based on the number of Delegates for whom available, either because they did not answer the age information was available nr 3,)20 persons. question on which the table is based, or because the Registration Forms were not received. MINORITY GROUP REPRESENTATION AGE AND SEX The special efforts of the Conference and minority groups to insure adequate minority represen- In the Act authorizing the Conference, the tation among the Delegates were successful to Congress pointed out that a significant proportion the point that four major minority groups in the of the participants should be older people. The population constituted almost 20 percent of the Conference Planning Board took action recom- Delegate body. mending to the States that no less than 45 percent of the participants involved in the State Con- ferences should be in the older age category. Table 4

Although the proportion of older Delegates to MINORITY GROUP REPRESENTATION the National Conferences was not stipulated, of the 3,120 Delegates for whom data are available, AMONG THE DELEGATES 60 percent were aged 55 yearsor over. Only 20 percent of the group were younger than middle- Group Percent* aged (less than 45 years of age). More than 35 Blacks 10.3 percent were in the retirement age bracket of 65 Spanish Speaking 5.4 American Indians 2.7 or over. Asian - Americans 1.2 Only one of every three Delegateswas female. All 19.6 This contrasts sharply with the ratio ofwomen * Based on total Delegate body or 3,574 persons. in the over 65-age groupa category in which

, RESIDENCE ber as a basis for computing the percentage dis- Just over half (50.6 percent) of the Delegates tribution,itisfound that approximately one- resided in nine States and the District of Columbia. quarter (24.4 percent) of the Delegates reside These same jurisdictions contain 50.6 percent of in areas and communities with a population under the Nation's older people. 25,000, about a third (31.2 percent) live in cities of 500,000 or more, and the remainder (43.4 percent) live in smaller urban areas. Table 5 THE TEN MOST HEAVILY REPRESENTED . EMPLOYMENT STATUS JURISDICTIONS AMONG THE DELEGATE BODY Just over two-thirds (67.7 percent)of the Delegates, who indicated that they are not retired,

Jurisdiction Percent reported that they are employed either in fullor parttime jobs, 6.5 percent said that they are not New York 9.5 District of Columbia 7.6 now gainfully employed. Nearly 26 percent indi- 1 California 6.5 cated that they were retired from their regular Pennsylvania 5.3 Illinois 4.6 occupations, but many of these added that they Ohio 4.0 continue to work either parttime or as voltinteers. Florida 3.6 Texas 3.5 Michigan 3.1 MAJOR ACTIVITY OR OCCUPATION Maryland 2.9 Total 50.6 Delegates were asked to check among a list of occupational categories, the one in which their The relatively large number of Delegates from major work or activity would be classified. The the District of Columbia, Maryland, and New retired workers were instructed to indicate the York is accounted for in part by the fact that category representing the major occupation from a which they had retired. Out of large proportion of the Delegates named byna- a total of the 3,754 Delegates, 3,050 identified their tional organizations reside in these threejuris- occupa- dictions. tion or activity. Table 7 shows a larger proportion of the Dele- SIZE OF COMMUNITY gates checked education (17.3 percent) and social Of the 3,574 Delegates, 3,104 indicatedthe size of their home communities. Using thisnum- Table 7 MAJOR ACTIVITY OR OCCUPATION OF DELEGATES

(Present or, if Retired, Most Recent Occupation) Table 6 Occupational SIZE OF COMMUNITY WHERE DELEGATESLIVE Number of Category DelegatesPercent* (Number and Percent) Agriculture 131 4.3 Business, Manufacturing, Trade, and Community Size Number Percent* Transportation 400 13.1 Education Rural Areas 527 17.3 185 6.0 Health Services 325 Under 10,000 10.7 271 8.7 Homemaker 81 2.7 10,000 - 24,999 300 9.7 Labor Organization 25,000 - 99,999 124 4.1 712 22.9 Recreation 56 100,000 - 499,999 1.8 668 21.5 Religious Service 141 4.6 500,000 and over 968 31.2 Social Services No Information 502 16.4 470 Student 61 2.0 Other . Total 3574 702 23.0 100.0 No Information 524 -- *The percentage distributionis based on thenumber of Total 3,574 100.0 Delegates for whom community size informationwas available or 3,104 persons. * Percent of those reportinga maior activity or occupation or 3,050 persons.

47 services (16.4 percent) than any of the other INCOME occupational categories, except that nearlyone- fourth checked "other" indicating that their oc- One goal of the 1971 White House Confer- cupational group was not included in the list ence on Aging was to include among the Dele- provided. gates elderly consumers who were experiencing the problems to which the Conference' was ad- In view of the importance of leisure activities dressed. In order to ensure that the low income to older people, it appears that the inclusion of elderly could attend the Conference, Congress only 56 workers (1.8 percent) in the Delegate appropriated funds to underwrite the cost of body from the field of recreationwas something travel and living expenses of Delegates except of an underrepresentation of this professional those Delegates named by the national organiza- group. tions.

WORKING TIME IN FIELD OF AGING The income data are somewhat less complete than other data for the Delegates because only Of the 2,151 Delegates reporting that theyare 2,902 persons (exclusive of the youth group who employed either full- or part-time, 903 indicated were largely students) reported their annual cash that 50 percent or more of their working time is incomes. There is no information available to spert in serving older people or in some other show whether or not the 2,902 reporting are rep- phase of aging. This represents 28.4 percent of all resentative of the entire Delegate body, but they Delegates for whom information is available. do indicate the range of income. With these limi-

Table 8 LEVEL OF ANNUAL INCOME OF DELEGATES BY AGE AND SIZE OF HOUSEHOLD *

(Number and Percent) Household Size-1 Person Only

Annual Income Det.gates 65 or over Delegates under 65 Number Percent Number Percent

Under $1500 19 7.4 6 2.6 1500-2499 42 16.3 18 7.9 2500 - 3499 32 12.4 9 4.0 3500 - 4999 45 17.4 10 4.4 5000 - 9999 73 28.3 48 21.2 10,000 or Over 47 18.2 136 59.9

Total 258 100.0 227 100.0

Household Size-2 or More Persons

Under $1500 6 .7 4 .3 1500 - 2499 23 2.8 16 1.0 2500 - 3499 42 5.2 18 3500 -4999 1.1 83 10.3 111 1.1 5000 - 9999 252 31.1 137 8.5 10,000 or Over 404 49.9 1414 88.0 Total $10 100.0 1607 100.0 All Households

Under $1500 25 2.3 10 1500 -2499 .5 65 6.1 34 1.9 2300 - 3499 74 6.9 27 3500 -4999 1.5 1211 12.0 2$ 1.5 5000 -9999 325 30.4 185 10,000 or Over 10.1 451 42.2 1550 84.5 Total 1068 99.9 1834 100.0 Table doss not include the income data reported by 96Delegates under age 25 who supplied information.

48 tations in mind, the income data availableare incomes of $10,000 or more is a reflection of the presented in Table 8. The data are reportedsepa- high rate of employment among them. rately for one person and two-or-moreperson households. The two are combined in a thirdsec- These income data make it clear that thepro- tion of the table to show the income levels for all rision by Congress of travel funds for Delegates households. enabled the States to name manypersons who would not otherwise have been financially ableto The Delegates recording income data whowere attend. aged 65 and over and living alone numbered 258 persons. Of these, nearly one-fourth (23.7 per- The data reported thus far relate to the char- cent)reported annual incomes under $2500; acteristics of the Delegate bod) asa whole. When more than a third receive less than $3,500 per the data are arranged according to the 14 subject- year. Of the 810 Delegates 65 years of age and area Sections, differences in the composition of the over reporting income and living in households Section groupings become apparent. of 2 or more persons, only 3.5percent had comes of less than $2500, 8.7 percent less than SIZE OF SECTIONS AND SUBSECTIONS $3500. The number of Delegates assigned to partici- Similar data for the 1834 Delegates under 65 pate in different Sections varied from 93 (Re- years of age who reported their income, show that search and Demonstration) to 487 (Physical and the proportion living in a one-person household Mental Health). Nine of the groupswere com- and receiving less than $2500 annually is 10.5 posed of 200 or more Delegates each. percent, less than half the percentage of single The number of Delegates assigned toa Section older Delegates in this low incomecategory. For does not necessarily represent the extent of interest two-or-more person households, only 1.3 percent in a particular subject area because the States and of the younger Delegategroup have annual in- national organizations indicated the Sectionsto comes of less than $2500 but 3.5 percent of the which they wished their delegates to be assigned, older group have incomes in this low bracket. The and may or may not have consulted the Delegate relatively large number of Delegates reporting about his preferences. When Delegates requested

Table 9

SIZE OF CONFERENCE SECTIONS AND SUB-SECTIONS

Number of Average Number Delegates Number of of Delegates per Section Per Section Sub-Sections Sub -Section Education 269 $ 34 Employment and Retirement 337 9 37 Physical and Mental Health 437 14 35 Housing 3$2 9 42 Income 304 9 Nutrition 34 127 4 32 Retirement Roles and Activities 312 9 35 Spiritual Well-Being 204 6 34 Transportation 174 5 35 Facilities, Fresno: and Services 240 6 dowerment 40 and Nongovernment Organization 221 6 37 Planning 164 4 41 Research and Demonstration 93 3 Training 31 112 3 37 Total 3,426 95 36

* Based on Pre-conference Section Assignments of Delegatesfor whom nomination forms were available.

49 a different Section assignment, however, arrangements were made with Governors for the change. Table 11 SEX DISTRIBUTION OF DELEGATES BY SECTION AGE DISTRIBUTION BY SECTION (percent) N = 3120 One striking dissimilarity among the Sections Sex was the difference in the age distribution of the Section Male Female Delegates. Older people (65 and over), for ex- Education 59.6 40.4 Employment and Retirement 72.5 27.5 ample, were proportionately more numerous in Physical and Mental Health 71.9 28.1 the Sections on Income (41.8 percent), Retire- Housing 72.4 27.6 ment Roles and Activities (44.7 percent), Educa- Income 69.1 30.9 Nutrition 27.4 72.6 cation (45.0 percent) and Employment and Re- Retirement Roles and Activities 51.9 48.1 Spiritual Well-Being 63.6 36.4 tirement (51.2 percent). The Sections in which Transportation 66.9 33.1 they were less well represented were Facilities, Facilities, Programs and Services 49.1 50.9 Programs, and Services (25.0 percent); Health Government and Nongovernment Organization74.5 25.5 Planning 67.7 32.3 (24.0 percent); Research and Demonstration Research and Demonstration 70.1 29.9 (23.0 percent); and Training (22.0 percent). Training 55.0 45.0 These differences may be traced to the Delegate's own preferences and to the preferences ascribed to them by their nominators. RETIREES AND PROFESSIONAL WORKERS IN AGING BY SECTION Women Delegates, only about a third of the delegate body, tended to be underrepresented in The numbers of. retired persons in each Section comparison to men in most Sections. varied considerably, with the proportions corresponding, as one might expect, in part to the age distribution of Delegates by Section. The largest Table 10 AGE DISTRIBUTION OF DELEGATES BY SECTION

(percent)

Age* Table 12 Section Under 25-45.55-65-Over 25 44 B4 64 74 75 SELECTED EMPLOYMENT CHARACTERISTICS Education 5.810.819.219.234.610.4 OF DELEGATES BY SECTION Employment and Retirement 1.910.711.025.236.614.6 (Percent) Physical anel Mental Health 2.522.626.324.516.0 8.0 N = 3176 Housing 3.312.622.527.924.98.7 Income 2.615.517.722.330.910.9 Retired Professionals Nutrition 4.315.419.723.929.96.8 Section PeopleWorking in Aging* Retirement Roles and Activities3.814.116.820.633.711.0 Education Spiritual Well -Being 1.612.019.031.526.1 9.8 32.4 13.8 Employment and Retirement Transportation 4.123.714.222.526.68.9 35.9 23.2 Facilities, Programs, and Services 5.821.419.228.519.65.4 Physical and Mental Health 13.1 33.6 Government and Nongovemment Housing 25.1 31.4 Income Organization 3.021.021.023.525.07.5 29.6 22.8 Planning 1.920.626.520.628.41.9 Nutrition 23.9 20.2 Research and Demonstration 2.320.728.725.313.89.2 Retirement Roles and Activities 34.0 29.1 Spiritual Well-Being Training 3.719.329.425.715.66.4 20.1 23.9 Transportation 32.8 24.7 Facilities, Programs, and Services 20.8 46.5 * Totals by Section may not add to 100.0 percent because of Government and Nongovernment rounding. Based on 3,120 Delegates for whom oge data were Organization 20.8 available. 22.3 Planning 15.2 36.7 Research and Demonstration 16.4 34.1 Training 17.3 38.3 However, in five Sections women constituted All Sections 25.8 28.4 40 percent or more of the Delegates-Education; * Persons were counted in this category if they indicated 50 Training; Spiritual Well Being; Facilities, Pro- percent or more of their time in the field of aging. grams, and Services; and Nutrition.

50 percentages of retirPec were found in the Sections and Demonstration; and Facilities, Programs, and on Employment and Retirement (35.9 percent), Servicesthe retirees made up less than 20 per- Retirement Roles and Activities (34.0 percent), cent of the Delegates. For whatever the reason, Transportation(32.8 percent), and Education more retirees were included in the Sections con- (32.4 percent). cerned with activities for older people than in the In Sections with a relatively high proportion Sections concerned with the instrumentalities (30 to 40 percent) of Delegates whowere pro- planning, research, manpowerrequired to professional workersTraining; Planning; Research vide the opportunities for the activities.

The Conference Program

Sunday, November 28 T'uesday, November 30 10:00 A.M.Registration Opens 9:00 A.M. Subsection-Meetings 4:00 P.M.Ecumenical Service, 12:15 P.M. Conference Luncheons The Washington Cathedral 2:00 P.M. Subsection Meetings 7:30 P.M.Opening General Session 7:00 P.M. Section Drafting (International Ballroom) Committee Meetings Q11toOrder=--A-rthurS:Flemming; Chairiirair InvocationCynthia Wedel, President Wednesday, December 1 National Council of Churches 8:00 A.M. Special Concerns Sessions, and IntroductionsArthur S. Flemming Section Policy Coordinating GreetingsHonorable Walter E. Washington, Committee Meetings Mayor-Commissioner, District of Columbia 12:15 P.M. Conference Luncheons Message from President Nixon 2:00 P.M. Section Meetings AddressJohn B. Martin, Conference Director Adoption of Recommendations 7:00 P.M. Visit to the White House by Invita- AddressArthur S. Flemming tion of President and Mrs. Nixon Multi-Media IntroductionWebster B. Todd, Jr.8:00 P.M. Reception for Executive Director of Conference Conference Participants 10:30 P.M. Adjournment Hosts:Arthur S. Flemming, Bertha Adkins, and John B. Martin Monday, November 29 Thursday, December 2 9:00 A.M. Section Orientation Meetings 10:30 A.M. Subsection Meetings 9:00 A.M. Closing General Session 12:15 P.M. Conference Luncheons Arthur S. Flemming, presiding 2:00 P.M. Subsection Meetings MusicUnited States Marine Band 7:30 P.M. General SessionThe Open InvocationRight Reverend Forum (International Ballroom) Raymond J. Gallagher PresidingHonorable Earl G. Warren, Post-Conference Year Arthur S. Flemming Chief Justice cf the Supreme Court of the AddressHonorable Richard M. Nixon, United States, Retired President of the United States BenedictionRabbi Abraham J. Feldman Statements on AgingThe Delegates 12:00 Noon Conference Adjournment 11:30 P.M. Adjournment

The Opening General Session

The Second White House Conferenceon Aging You have my very best wishes fora most officially began at 7:30 P.M. November 28, 1971, productive Conference. with an Opening Session held in the International Ballroom of the Washington Hilton Hotel.Chair- Both Chairman Flemming and John B. Martin, man Arthur S. Flemming called the Sessionto Conference Director and Commissioner of the Ad- order and Dr. Cynthia Wedel offeredthe Invoca- ministration on Aging, addressed the Conference tion. and provided an orientation for the work of the Delegates on the ensuing days. The Honorable Walter E. Washington,Mayor- The Session closed with a multi-mediapresen- Commissioner of the District of Columbia, wel- tation, especially prepared for the Conference, comed the Con:::rence Delegatesto the city and which reflected by film and drama thecurrent wished them success in their effortson behalf of situation of the Nation's older people. all older Americans. Special Prayer Prepared for Following Mayor Washington's remarks,Mr. Flemming read the followingmessage of welcome The White House Conferenceon Aging to the Conference from President Nixon. Al-mighty G-d, who in your infinite wisdom It is a great pleasure forme to welcome to have decreed that man honor father and mother Washington all of you whoare participating in that man rise before an elderlyperson and that the second White House Conferenceon Aging. he honor the contenance of the aged,Al-mighty G-d, bless this convocation that has gatheredto It was 10 years ago that President Eisen- find ways and means to best fulfillyour decrees. hower addressed the opening sessionof the first White House Conferenceon Aging. He em- Bless this assemblage that has harkenedto the phasized then his feeling that thekey tt.a plea of the aged: "Cast usnot away at the time profitable conferencewas ensuring that every of our old age." opinion be fully aired. I know thatyour gather- Al-mighty G-d, bless the esteemed President of ing this week will meet that standard. Thereis the United States, Richard Milhaus Nixon, who a second key to a profitable meeting which I has convened this convocation ofconcern, bless stressed when I called this Conferencemore the chairman, consultants and staff and bless the than two years ago. I referred thento the need delegates, observers and guests whoare about to for "careful, advance planning and...broad, return to their respective cities, states, countries representative participation." Over the lasttwo and homes to implement the good resolutions of years, thousands of Americans, allacross the this second White House Conferenceon Aging. country, have worked to provide these critical ingredients. I know thatyour deliberations this Crown the efforts of this convocation withsuc- week will be all themore valuable as a result. cesssuccess that will in the words of your prophet Malachi, "Return the hearts of theparents Just as this Conference has beena focal point to their children and the hearts of the childrento for so much thought andenergy over the past their parents." two years, so it can now provide gie momentum Amen. for a great wave of reform and renewalin the Rabbi Noah Bernstein way our society treats its older citizens in the Spiritual leader and Director future. I am eager to learn the results ofyour Chaplaincy and Social Services deliberations and I look forwardto meeting Merkos Lubavitch Organization personally with you later in the week. Minnesota Branch

53 GREETINGS by government, from the lowest to the highest office, Mayor Walter E. Washington be committed to the betterment of the economic and social well-being of the elderly. Chairman Flemming, Mr. Martin, and all other The urgency of our times also demands that participants in this Conference. It is a pleasure to community leaders and individual citizens of all welcome each of you to the Opening Session of ages make the same commitment. the 1971 White House Conference on Aging. A Persian proverb says: "Four things come not This is a great and important occasion. It has back; the spoken word, the sped arrow, the past significant meaning to us in the District of Colum- life, and the neglected opportunity." bia because we had the unique opportunity of We here tonight must not let it be said that working very closely with the planning staff for this Conference. we neglected the opportunity to help bring about a more humane and responsible society for our When President Nixon called fora second elderly citizens or to protect those rights which White House Conference on Aging ina procla- are inherently theirs. mation in 1969, he gave to all of us the charge to help in the development of a more adequate national policy for older Americans. We here in the District of Columbiaas Iam ADDRESS by sure that each of you didtook the President's The Honorable John B. Martin proclamation very seriously. During the pastyear, we have been moving forward on many fronts. Ladies and GentlemenIt is good to be with you tonight. When I accepted my responsibilities Community forums and neighborhoodmeet- more than two years ago to administer the Older ings were held in each of our 9 serviceareas. Americans Act, the White House Conference on Over 1,000 concerned citizens met with District Aging seemed far away. Then it was only a brief officials and civic leaders in workgroups and dis- Congressional resolution on the bones of which cussion .sessions to identify problems and issues much flesh was needed. and make recommendations for changes inopr Since that time we have been working steadily programs and projects. to perfect a Conference which would give all This gave us a blue print for action and helped Older Americans a voice and a program for today design a viable and useful program forour older and tomorrow. citizens. These efforts culminated in an inspiring Tonight, another major step in that process Ecumenical Dedication Service held this afternoon begins. at the Washington Cathedral. But I would stress that this high point which The goals now before us are clearly defined: we now reach and have long anticipated, is itself creation of a greater awareness of the olderpopu- a beginning. lation; development of proposals fora comprehensive national policy on aging and thensup- This is the climactic period of our prepara- porting it; and strengthening themeans of older tion, but in a sense it is also mid-point inour people for independent living and active partici- work. For after this Conference, the task of pation in the life of the Nation. implementation begins. I see a year of action aheadexecutive action, legislative action, volun- These goals will not be attainable without the tary actionat Federal, State, and local levels. continued support and efforts of each ofyou here today. I am particularly pleased and heartened by the fact that as Delegates youare -k) varied a group, The urgency of our times demands thatour for older Americans are diverse and individual.

54 You include young people who must take the care or nutrition or transportation. Theseare long view toward what surely now seems a very urgent questions that require answers assoon as distant future. we can possibly get them. You include men andwomen already in their So for the duration of yourstay here you will later years, happy and successfulthere. And you be forging this national policy. I neednot try to include also those to whom theseyears are diffi- impress you with the importance of cult and sad. your task. You would not be here ifyou did not already understand that. You include representatives of differentraces and ethnic groupssome burdened bydiscrimi- What does need to be said, however, is that nations additional to those of t. age. You include you can help those who have to legislateor men and women of middle years who have been execute the many elements of this policy by giv- long devoted to the service of the elderly and now ing attention to priorities. Not everythingcan be approach that period of life themselves. done at once. It will be helpfulto know, among Together, it seems tome, you can move moun- the many recommendationsyou may have, the tains. Surely theyare there to be moved. .order of importance in whichyou place them what ought to take precedence ifone need must Most important, youcan move the hearts of be satisfied before another. men, for you come equipped to speakto all our people. And that is appropriate and goodbecause And let me make another suggestion because you will be speaking for all of themthosenow you represent 20 million other Americans who young as well as the old. It is with everyone's can't be here. Put yourself in their shoes... tomorrows we are concerned. think new... think forward ... theworld has changedis changing beforeour very eyes. The theme of this Conference is"Toward a National Policy on Aging." I have been askedon As far as you can tell what will it be like? occasion what that thememeans. "Don't the re- And how wouldyou like to have it be, so far ports of the 1961 Conference or the broad goals as the lives of older people are concerned? I hope of the Older Americans Act providesuch a pol- that you will not think little thoughts. Youare icy?" I am asked. And theanswer is "Yes in part designing a new worlda world thatmost older they do." people in our country today havenever known. But what is missing isa clarity of attitude and It should be a world free from fear of being a level of commitment whichassures our older forgotten, of being left out, isolated, and ignored, people that America and Americansare deter- unplanned for, unwelcomed, and unneeded. mined to treat the elderly of thisnation fairly and It is a world whose designing calls for vision, to guarantee them opportunity to share equitably fr): imagination, for innovation, becausewe don't in the saisfactions of life availableto other parts have to be content with what of our populationnot in we have. In this the far future but today. great and affluent country, we can afford to dream For many of our oldest Americansthe future dreams. must be nowthey cannot wait. This is theurgency of this conference. We can afford to have whatwe want to have. We can have an adequate retirement income, It is true, for example, that in such matters as strengthened and comprehensive healthcare, improvements in private pensionsystems, the results of our action more and better housing, chances for useful and may only be felt with the constructive employment, andan array of needed passage of time. But the question of whether an social services. Wecan have them, that is, if as a older personcan remain in his own home or, lack- Nation we want them badly enough. Whatis ing supportive services,must enter a nursing home needed is that we attach requires an answer a high enough priority now, not tomorrow. The same to our objectives and provide a commitment is true of many other needs to in the areas of health follow through.

468.217 0 . 13 5 I speak for the Administration on Aging in These attitudes will change only as we, and saying that I will not shirk any task, leave any increasing numbers of our fellow human beings, avenue unexplored, in efforts to bring the hopes are willing to recognize and obey the Command- of this Conference to reality.. I believe that we ment, "Thou shall love thy neighbor as thyself." have laid the basis for a breakthrough. We can This-Commandment does not place upon us an push back the walls, open a new view of our obligation to approve of what our neighbor says, responsibilities to our older citizens and a new or does, or even to like our neighbor. It does place understanding of the contribution they can make upon us, however, a common responsibility to to our national life. never pass up an opportunity to help our neighbor I speak for the President when I say: "The without regard to his race, color, creed, sex or time has come for a new attitude toward old age ageachieve his highest potential. When this in America. The time has come to close the gap Commandment is violated,it contributes to a between our older citizens and those who are not breakdown in the life of the lawbreaker and in the society of which he or she is a part. The per- old... to stopregarding older Americans as a burden and start regarding them as a resource for son who, for example, has passed up an oppor- America." tunity to help an older person achieve his highest potential is not at peace With himself. As Delegates to this great Conference, you The indefensible conditions confronting many bring impressive credentialsyears of life, ex- of the older persons in our society are the direct perience and adaptation in a changing world result of our failure as a society to use the knowl- high achievement in fields of health, finance, ad- edge, time, and resources that are available to us ministration, research, education, and service. For to help them achieve their highest potential. We the next few days you will be applying your cannot just resolve to obey this Commandment. knowledge and experience to the building of the We need the insight, the vision, the courage and future. the strength that comes from fellowship with the That is a tremendous assignment. I am certain God and Father of us all. you are capable of it. The hopes of all older And so, as this Conference begins, it is my hope Americans are with you. that we will do two things. I hope that we will pray for strength to apply this Commandment in our own lives, throughout our deliberations, and ADDRESS by in the days, months, and years that lie ahead and I hope that we will pray for the strength that will The Honorable Arthur S. Flemming enable us to bring others to the place where they will put love of neighbor above every other con- As this Conference opens, there isone point on sideration. In this spirit, let us consider some of which there is agreement: Society's attitudesto- the opportunities that will confront us in the next ward older persons must change. Fartoo often 4 days. society accords them an inferior or secondary position; turns its back on their needs with the We are confronted with the opportunity to de- comment, "0 well, they won't be around much velop, to quote from the Delegates Work Books, longer"; deprives them of the freedomto make "policy proposals that will lead to defined action their own decisions relative to theirown lives; to meet clearly stated short-range objectives." bars them from further involvement in life; and These policy proposals are to be distinguished robs them of their dignity. from long-range objectives that are stated in broad, general terms. We believe that the discus- The older people within minoritygroups, more- sions at this Conference can proceed on the as- over, must deal with all of these attitudes in addi- sumption that there is a recognition and accept, don to bearing the knowledge that society has ante of those long-range goals which have been failed to accord equality of opportunityto their stated and restated many time. (I like the follow- groups. ing comment in the Work Books relative to the

56 statement of long-range objectives. "Since they other to cultivate the soil and raise the crop. The are seldom formulated in terms of commitment policy proposals and the programs for action to immediate action, they ordinarily find ready which we recommend constitute the seed that will acceptance.") Let's make sure that the policy probe sown as a result of this Conference. Let's focus posals which emerge from this Conference call also on how we can cultivate the soil and raise for commitments to immediate action. This is our the crop. most important task; this is what the Nation ex- pects us to do. If we live up to the expectations Over 35 years ago, the writer of a book re- of our fellow citizens, they will respond to our view in the British publication, The Spectator, leadership. Let's carry on our work in the belief said: that this can happen. If we do, we will cherish 'The cry raised by all of the world's greatest every minute that has been provided us in this literature is Read me, do not write about Conference to work on designing and improving me, do not even talk about me, but read me!" statements of policy. The cry of older persons throughout our Na- The Work Books constitute the agendas for tion is, "Act, do not write about me, do not even the discussion of policies. They are not closed talk about me, but act!" It is in that spirit that agendas. We are free to add to them. Whenwe the executives of six national organizations have propose new policies, however, let's make sure addressed a message to the delegates to this Con- that they meet this test: Are they proposals that ference. The following have signed the message: call for commitments to immediate action? Bernard-E. Nash (Executive Director, Amer- We are confronted with the opportunity to ican Association of Retired Persons and Na- formulate programs for action. A policy proposal tional Retired Teachers Association) that calls for commitment to immediate action Thomas G. Walters (President, National As- sociation of Retired Federal Employees) quickly results in the identification ofprograms for action. Some of these programs for action have Hobart C. Jackson(Chairman, National been identified by State conferences and the task Caucus on the Black Aged) forces of national organizations. They have been William C. Fitch (Director, National Council made a part of our Work Books: Here again, these on the Aging) are not closed agendas; we are free to introduce Nelson H. Cruikshank (President, National new proposed programs for action. Council of Senior Citizens, Inc.) Miscellaneous action programs in the field of The message is as follows: aging, unrelated to carefully thought through Our members have investedsubstantial policies; can oftentimes be classified accuratelyas amounts of time and resources in the prepara- tokenism. Policy proposals in the field of aging, tions for the White House Conference on that are not backed by sound programs for action, Aging. are nothing more than sounding brass. We have Their futures are linked in a very real way the opportunity to bring the two together in the to what happens at the Conference and, above reports that will be formulated in sectional and all, to what happens after the Conference. special concerns meetings. We also have theopportunity to underline in thesereports the im- it is our hope, therefore, that the discussions portance of provisions for periodic evaluations of that take place and the conclusions thatare the programs for action thatwe recommend in reached will contribute to justone objective. order to find out whether theyare really moving That objective is: The enlistment of widespread us in the direction of the policies that we have support from all social, economic, religious and recommended. political groups in behalf of action programs that will make available to older persons in- Finally, we are confronted with theoppor- creased resources, services and opportunities tunity to develop strategies that will resulte.in and that will remove existing inequities ethnic action. It is one thing to sow the seed; itis an- and other minority groups have had to bear.

57 Our most serious problem is a lack of com- In the statement to the Delegates from theexec- mitment to action in the field of aging within utives of the six national organizations there was all of our social, economic, religious and politi- included this statement: cal groups. The White House Conference must devote itself to this problem. We must not We join all who have planned this Conference drive persons within these groups apart as they in the desire to open it up to full, uninhibited confront issues in the field of aging. instead, discussions of issues even where there may be we must seek a clear agreement on goals and sharp differences of opinion. a unity of purpose which is reflected by commitments from them to increase resources, This is our desire. There are no closed agendas services and opportunities for older persons and for discussions in Subsections, Sections, or Special to remove existing inequities which ethnic and Concern 'Sessions. Minority views will be incor- other minority groups have had to bear. porated in reports whenever theyare supported We join all who have planned this Con- by at least fifteen percent of the voting group. ference in the desire to open it up to full, un- There will be an Open Forum on Monday evening inhibited discussion of issues even where there where the retired Chief Justice of the United may be sharp differences of opinion. Any at- States, Earl Warren, will preside. You have been tempt to utilize the Conference for partisan provided with the rules from the Forum that have political advantage will be a violation of the been drawn up by a steering committee under the spirit which has permeated the planning of ,the chairmanship of Dr. Charles Schottland, the President of Brandeis University. Conference. I welcome that message. We must broaden the In the statement to the Delegates by theexecu- base of support for programs for older persons tives of the six national organizations, the word within all of our social, -conoznic, religious and "commitment" appears a number of times. I hope political groups. In the .hort run and the long tht this word will be uppermost in the minds of run,thesuccess ofthisConference will be all of us throughout this Conference. Everyk,ne in measured by its contributions to this objective. this mow has been guilty of passing upan oppor- This is why the closing general session of the tunity to help an older person achieve his highest Conference on Thursday morning will be devoted potential. In the book of Revelations, lukewarm- entirely to the Post-Conference Year. It would ness is clearly identified as a sin. We have all been certainly be appropriate for the written reports guilty at one time or another of lukewarmness in from the Sections and Special Concerns Sessions out approach to issues in the field of aging. The that you will receive at this final session to con- only way in which we can compensate foryester- tain brief references to strategies that you believe day's sins of omission is to make a commitment would broaden the base of support for the poll- to rake advantage of today's and tomorrow's opportunities to serve older persons. des and action programs you will be recommending. In addition, we hope to listen to reportson I hope that we will not spend very much time commitments to action in the Post-Conference at this Conference dwelling on our own, or other Year from various seg, ents of both the private persons', or groups' sins of omission. Rather, I and public sectors that are representedat this hope that our emphasis will be on makinga per- Conference. We hope that thisslosing session will sonal commitment to action and to doingour best make it clear to the older persons of this nation to persuade individuals and groups within both that "action now" will be the primary andcon- the public and private sectors to do likewise. If trolling objective of the delegates to this Con- we do, then we will truly become instruments of ference. In this way, and only in thisway, can this His peace through helping to replace despair Conference become a part of a significanton- with hope in the lives of millions of olderper- going process and avoid becoming just another sons. This is what I hope, and what I know that meering Char produces reports to goon shelves cc you hope, will happen as a resulr of our four days collect dust. together.

58 The Open Forum

"The purpose of the Open Forum," according Attitudes Toward Aging and the Aged to Arthur S. Flemming, Chairman of the Con- Retirement and Roles for Older People ference, "isto make certain that information The Family available to the Delegateson all the issues is as complete as possible. Economic Security in Old Age A. Assuring an adequate income "We must not overlook anygroup or organiza- B. Control of inflation tion in our society that wants to be heard,or any C. Tax relief point of view that needs to be expressed." Problems of Aging Among Minorities To develop the ground rules for the Open Services for the Elderly Forum, a steering committeewas drawn from the Conference National Planning Board andwas A. Facilities chaired by Dr. Charles I. Schott land, President of B. Health services Brandeis University, Walthani, Massachusetts. C. Protection Manpower and Training All Delegates who wished to speak at the Open Government Organization for Aging Forum were asked to submit theirrequest to the steering committee before 5:00p.m., Monday, Impressions of the Conference November 29. Delegates were permittedto speak c Call for Post Conference Action on any topic relating to the field of aging as long Various (addressed to several topics) as they did nor endorse a commercial productor service, did not speak to pending legislation, and kept within the three-minute time limit. Introduction by The Open Forum was convenedon the evening The Honorable Earl G. Warren of the first full day of the Conferencein the Chief Justice of the Supreme Court International Ballroom 'of the Washington Hilton of the United States. Retired Hotel. The Forum was presidedover by the Hon- This is a happy assignment for me. To preside orable Earl G. 'Warren, Retired ChiefJustice of over an Open Forum for the purpose of defining the United States. After opening remarks by the elements of a great American problem, and Justice Warren, the order ofappearance of the placing them ii context with our nationalre- speakers was determined by lot. sponsibility for making the "Pursuit of Happiness" a reality for all our people, is a great honor. Par- The Open Forum lasted for 4 hours and heard ticularly isit so when the Open Forum consists 3-minute presentations from more than 70 Dele- of 1,000 concerned people from everypart of the gates. All Delegates who spoke to the Open Nation who have studied the problem, not just Forum. were invited to submit their statemens in as an academic exercise but in life as it is lived in 250 words or less, within 60 days after theclose America. of the Conference. The Forum is an integral part of the White Fifty-seven of the personswho spoke at the House Conference on Aging. Markyou, itis Forum submitted statementsfor publication in properly defined as "the Conferenceon Aging," the Conference proceedings. and not a "Conference on the Aging." There is a real difference between the two. The latter im- These have been arrangedaccording to the plies that it is the problem of those in the aging general topics to -which theywere addressed, as group; the former implies that itis the aging follows: process which starts from youth.

59 People over 65 are often referred to as one of because life is an individual process. But all of the largest minority groups of Americans. There these facets converge into a few simple elements are now 20 million over that age, and their num- of living that are the heritage of all Americans ber and percentage of the population are increas- dignity, usefulness, physical comfort, and partici- ing every year. If they can be considered a minor- pation in the main channels of American life. It ity group, it is the only minority group I have is these things that give -Americans of any age or ever known of which every living person hopes to station in life the happiness which we have debe a member of some day, jnel in the absence of clared to be our goal. It is the achievement of adversity will be. How this segment of our society these things that this Open Forum is designed to is to be treated is, therefore, the problem of all further. Americans. There are at least asmany facets to the problem as there are persons in the group Let us begin.

Summaries of Statements by Delegates ATTITUDES TOWARD AGING AND THE AGED

Rabbi Noah Bernstein genuine concern, their children will learn from Director of Chaplaincy and Social Services. their example and show more respect for them. for Merkos Lubavitch in Minnesota, Duluth, Minnesota Funds for adequate programs must be. made available in the public and private schools as well We have gathered here in Washington because as through all media to educate the masses as to we realize that the attitude of society toward the how to respect, help and relate to the aging. aging must chamge. This will then reverse the trend of the utter disregard of children for parents and society for We can change the attitude by teaching chil- the aging and help build a society where one can dren while still young of the existence of G-d and age with dignity and where the aging will become that morals and ethics emanate from G-d. Chil- the moral and ethical guides for the younger dren taught respect for G-d, the creator of the generation. world, who sustains the world andcares about our well -being will be taught G-d's commandto respect parents and the agednot only on Mother's The Honorable Walter W. Sackett, Jr., M.D. Member, Florida House of Representatives, Day and Father's Day but throughout the year. Tallahassee, Florida We should strive to give children the maxi- John, elderly, wanted death with dignitythe mum religious education, .but at the very least health department wanted him to die in good there should be a non-denominationalprayer health so he underwent periodic medical check- where one is taught of the existence of G-d and ups. John, subsequently, slipped off one night our reliance upon Him for our daily sustenance quietly and peacefully. (From syndicated news and well-being. article) Children are influenced by personal example. Too long, medicine concerned itself with the If parents treat their parents withrespect and quantity of life rather than its quality. It is high

60- time that we contemplate the terminaion of life, action is societal prejudice,not on the Conference not confining ourselves to a one-sided heroic effort agenda. Few of us take growing oldfor granted to prolong life, but rather to makean inevitable until we reach later life. Research into death process more comfortable and personal dignified. opinion about age shows stereotypedapathy or General hospitals, nursing homes or state facili- rejection by young and middle-aged.This trend ties with their panorama of bottles, tubes, pipes, would doubtless be greater had therespondents resuscitators, respirators, pacemakers, bloodtrans- not been subject to embarrassment like that which fusions, etc., impress an individual with thisneces- a man feels when he is asked if he has stopped sity. Witness a patient 85-years-old witha ter- beating his wife. minal blood condition, three transfusions daily,to a total Of 65, with six emergency resuscitation A survey by New York StateUniversity indi- calls sounded before hewas allowed to die. Imag- cates that 40 percent of our population ismore ine the family's emotional turmoil, itseconomic or less afflicted with a mild neurosis calledgeren- bankruptcy; yes, bankruptcyat all levels of gov- tophobiadread of oldage. Senior citizens are ernment from millions of such episodes. jostled through a door marked"This Way Out" into whatisspeciously termed the "Golden Prolongation of meaningless life through mod- Years." For those inpoverty or pain, time goes ern medicine is more inhumane thana peaceful round a circle: each day is like natural end. Physicians every other. Joys are noncommittalwhile of spring are past and harvesttimerewards are nurses and the elderly (both so much closerto the few. dying patient) are heartily in accord. Thelatter fear more the senseless prolongationof the death A new era for oldage involves crashing the process than death itself. Pope Pius XII refuted major roadblock to publicacceptancegeronto- charges of euthanasia, stating in suchcases heroic phobia. Stereotypescan be replaced with under- measures are unnecessary. standing empathy bygovernmentalinitiative. Senior power also requires skilled,rational leader- Recalling Carl Sandburg's thoughts,"Death, ship. Old age won't be redeemedif our grand- like birth, can be glorious,"give me dignified parents use rabid dissent, stay sitting in their death as pictured in the deathbedscenes of Lincoln rockers, or, like oldcrows, scold from the tree and Washington. tops. R. 0. Beckman When will we no longer thrusta crown of Senior Service Foundation in Miami,Florida, thorns on the brow of oldage and crucify it on a and writer of 'The Vintage Years",syndicated cross of scorn and cynicism? A task force ofbe- newspaper column. havioral scientists, public officialsand communications media should indicateefficacious ways of Lodged at thevery heart of getting Conference abating popular bias.

RETIREMENT AND ROLES FOR OLDERPEOPLE

James F. Conner Most aspects of retirement have been El Paso, Texas experienced by this Delegate. This hastaught: (1) we Mr. Chairman, it'san honor to be Delegate-at- cannot run away from ourselves; (2)we can re- Large to this Conference by Presidentialinvita- gain community identity andesteem by sharing tion. As such, my commitmentis to the silent our talents with the present and future, foregoing majority of senior citizens rather than to the self indulgence. Theseare not idle words; they organized minority. It speaks well for our gov- refer to achievements withoutgovernment sub- ernment and this Conference that allare repre- sidy or recognition for sented. a self-help program by older Americans.

61 Before we seek to share the fruits of today's in the minds of many that this alone could do workers, we should first separate our wants from much to improve both paysical and mental health our needs. At the same time make sure the older for older persons. needy have their needs. Then we will be in a position to collect the presumed debt owed us by Ale-..mder Reid Martin, M.D. society but only after we have deducted our obli- Psy,..;iiatrist, Old Lyme, Connecticut gations to society. I urge your sustained interest in Issue III of Social Security increases, to which we have not our committee which reads: "Should society adopt contributed, should be allotted in a manner as to a policy of preparation for retirement and edu- give the lowest income group the greatest num- cation for life off the job?" ber of new dollars. To do less than this would this cast a shadow of insincerity upon our efforts. Forty-two states unequivocally endorsed issue, many recommending such education to be- The main source of well-being comes from gin in childhood and continue throughout life. within ourselves as we strive to fill our cup of life, not from sitting on the curbstone of time This mandate is a fitting response to the late waiting for others to fill our cup. Dare we meet President Hoover's warning: "Our civilization's this challenge. future will not depend upon what man does on the job, but what he does in his life off the job." Raymond Wing, M.D. For generations, our education has prepared Easton, Pennsylvania us, almost exclusively, for life on the job. All our values, philosophies, our yardsticks and our atti- It is obvious that many of our older persons tudes towards social issues, the young and the, are second-class citizens. The reasons for this are aging, are strongly conditioned by such education. mixed--some stem from failures of the individ- Consequently, the shorter work-week, work-year, uals themselves, but others result from forces over the lengthening of retirement establishes a new which they have no control. world for which we are educationally unprepared. Any physician in active practice caring for older Because of this, the vast creative resources of our persons sees case after case in which mandatory retirement population remain virtually untapped. retirement serves as a shock resulting in a feeling Thus, we face a serious social condition, the of inferiority not only to the retiree, but to his symptoms of which are the immediate concern of spouse and others of his family as well. In con- this Conference. trast, retirement for disability or from choice does not seem to result in the psychological state that Issue III, however, aims to eradicate this under- produces the feeling of second-class citizenship. lying social condition, i.e., a grossly unbalanced development of our inner resources because we Much is said today about youth orientation in have only prepared ourselves for a work-a-day our society. Any observer can note that many of world. Now we must also prepare for a free-time the young and relatively young have little pa- world. tience with the lack of productivity on the part Education for life off the job must complement of too many able older persons. The feeling is education for life on the job. that the aged consume, but younger persons pay. Perhaps no one should complain where this is This calls for a whole new concept of educa- necessary. but one wonders if a system whereby tionNOW. This calls for actionNOW. able older persons are offered incentives to do 'useful work, and also penalties if they donot, E. S. Christoffersen, would helptoresurrect olderpersons from Mayor, City of Turlock, California second-class citizenship and put them back in the There is nothing as stimulating to a person as main stream of life. Able older persons should be involvement. In Turlock we needed sewer ex- kept in the producer class. There isno question pansion involving a $2 million bond issue. By

62 involving the aging in this issue, they became our WHEREAS, such a red-tape cutter is especially best supporters. needed for older citizens to help preventwrong- Let me relate what happened in Turlock, a doing by public officials or abuse ofpower; community of14,500. Throughfund-raising WHEREAS, the State of Florida has already activities, the aging raised approximately $65,000. piloted Senior Citizen ombudsmen for counties in An aging committee came before the city fathers Florida; asking for property and landscaping for the structure. This was granted. A successful com- WHEREAS, New York State WHCoA dele- munity drive raised the balance of the money. gates called for ombudsmen for aged citizens April 1971, we dedicated this beautiful, versa- (also delegates of other states); tile Turlock Senior Center. Various uses of the WHEREAS, eighty-seven percent of WHCoA building are administered by the Recreation De- delegates polled agreedan ombudsman-advocate partment and owned by the City of Turlock. would be an important breakthrough for the aged; May I suggest that every community not hav- WHEREAS, Dr. Flemming and many leaders ing an aging organization organize ,one immedi- of national associations for the aged havegone on ately and initiate projects for raising funds foran record approving this new role for the aged; assembly hall. WHEREAS, rural and city aging, well-to-door The Seniors of Turlock are so proud of this poor, could benefit from a national corps of senior new beautiful building. They could not have had citizen ombudsmen, for local, Stateor Federal that personal pride had it been built by Federal agencies, for health, education, housing,poverty, or State grants. minority, transportation, nutrition, employment, The Pilgrims were seeking a country where recreation and other problems; there would be total freedom of worship and BE IT RESOLVED THAT, The White House speech. They so dedicated themselves to God, Conference on Aging goon record as recom- allowing nothing to hinder these goals. This is mending that new careers of ombudswomanor why we have a wonderful America. ombudsman-advocate for the aging be considered One cannot overemphasize the importance of when preparing a national policy. making God first in every undertaking whether The White House Conferenceon Aging (on individual or problems of our Nation. There is December 1, 1971) recommended sucha national no problem too big for our God. The weakness policy. is that too many lack faith and worship ofour forefathers. Let's return to our country's founda- tionworshipping our God. Alfred H. Foxcroft President, Leisure World Stars, Inc. Walter J. Porowski, Jr. Laguna Hills, California National Ombudsmen's Institute Unionville, Connecticut Retirement may be a pleasant anticipationor a WHEREAS, the career of ombudsman has been dread of the future. spreading since 1967 throughout the Nationto It is generally agreed by authorities ingeron- investigate complaints for the littleman, in doz- tology that stimulating physical exercise isneces- ens of different kinds of government and com- sary to maintain good health, and it is equally munity agencies, such as health, education, hous- important that one should exercise his mental ing, drug abuse, youth, minorities,etc.; processes to avoid senility and other health prob- WHEREAS, The White House Conferenceon lems. Youth this year voted to establish Youth Ombuds- Many people, when reaching the recognized men and women for all youth problems; retirement age of 65, arenot prepared for the

63 shock of sudden mental and physical inactivity I do hope some of our city, county and State and the feeling of not being wanted or needed. officials can see eye-to-eye with us and help us This transition could be accomplished much more and More people have compassion for us and efficiently and gracefully through a tapering-off do not deny us our rights that we well deserve. process. It is my suggestion that labor and management Domingo Delgado be encouraged to adopt a policy in respect to re- Senior C.tizens Recreation Specialist, tirement, which would accommodate those desir- County of Los Angeles, ing early retirement, as well as those both ment- Department of Parks and Recreation, ally and physically able to continue working and Los Angeles, California wishing to do so. This plan could be an arrange-. ment, on a voluntary basis, calling for gradual Premise reduction in working hours with corresponding The California Committee on Recreation be- reduction in income. lieves that the White House Conference on Ag- As a basis for discussion, I would suggest, a ing has failed to recognize the importance leisure schedule along the following lines: Salary to be time plays in the lives of senior citizens. based on 100 per cent prior to age 55 and a Justification 40-hour. week. Beginning at the age of 55, 35 Today our thoughts should turn to what rec- hours per week and salary to be 87.5 percent of reation really means, since the word has many base pay, with corresponding reduction in hours meanings. Recreation, in whatever form it takes, and wages each 5-year period thereafter. Under is a basic human need, and its value to humanity thisarrangement, a need for additional help cannot be too strongly emphasized. would be created, thereby improving the unemployment situation. Recreation as a worthy use of leisure time is Varying conditions in industry would require especially rewarding, and participation of senior some flexibility, but the basic plan could remain citizens in wholesome programs stimulates better the same. physical and mental health, and increases longevity.Itrequires well-planned programs toget Robert Sharp seniors to participatetaking more interest in American Federation of Senior Citizens, communityaffairs,accepting volunteer assign- Dade County Chapter, Inc. ments or part-time jobs in recreation, and other Nora. Miami Beach, Florida meaningful pursuits. These programs give the elderly a feeling of "belonging"that someone There is a vast amount of land that is owned cares about them. by many cities, counties, also by many States. Some of this land could be used to build imusing Proposal for our elderly in many States in our Nation. Recognizing the value and importance recrea- There could be communities built in some areas. tion plays in the lives of senior citizens every- Programs could be initiated as our older people where, this conference should concern itself with have millions of hours of talent that they would setting up governmental policies on aging for offer. We would not be a burden to anyone. the Seventies that will bring the recreation field This plan wo' help the States' and Nation's into national focus. Early retirement and a_shorter economy; at Lie same time this would help the work-week has expanded the need for recreational problems of our older people. programs. Speaking for our older people, we should con- Thiscommitteefurtherproposesthatthe sider this recommendation and try to work out White House Conference develop a Special Con- this problem with ourcity,county and state cern Session on Recreation for the Elderly, and government. In this way we can live in dignity, set guidelines that will give a positive directional contentment and happiness. policy on recreation.

64 /

THE FAMILY AND AGING

John. R. Devitt to observe these dates withseriousreflection Assistant Corporation Counsel, and to realize that the principles of familyre- Milwaukee County, Milwaukee, Wisconsin sponsibility to spouses, children andparents, as WHEREAS, The mobility of modern society well as the importance of the stability of marriage and consequent loosening of family ties has had and the home for our future well-being, require an adverse effect on elder Americans, for many renewed allegiance and every-day implementation. of whom there is no longer a place in the homes of their children; and Stephen T. Szilagyi Philippus United Church of Christ, WHEREAS, There is a growing need in our Cincinnati, Ohio time to place new. emphasis on, and to re-affirm our dedication to, the cause of strengthening na- Introduction tional family values; and Present day realities for grandparents and for WHEREAS, A beginning step inthis direction families are that grandparents are the unrecog- would be to set aside one week in each year to nized victims of the 50 percent divorcerate. Be- focus the Nation's attention on family needs and cause of the personal problems of the parents and concerns; and the circumstances of the breakup ofa family, grandparents find themselves cut off fromper- WHEREAS, The period surrounding thena- sonal contact with their grandchildren. For the tional observance of Thanksgiving in November grandparent whose child has custody there isnot of each year is traditionally a time for family the same situation as that of the grandparent gatherings and reunions and is a suitable occa- whose child has an obligation of support and sion for calling attention to the importance of visitation but not custody. home and family ideals; therefore, be it What to Do RESOLVED, That the Congress and President 4 the United States be requested to enactappro- It is recommended that the Conference speak priate legislation to declare that the week in which out on this problem. If it is possible to support Thanksgiving is celebrated each year under Act legislation at the national or State level which of Congress be officially designated as American would grant visitation privilegesto grandparents, Home and Family Week and that the Sunday of it may be that the courts will act tosupport this such week be designated as Family Sunday-U.S.A.; national human need. Only two jurisdictions have and be it spoken out in statutes on this subject. This privilege would be a valuable additionto the rights FURTHER RESOLVED, That all citizens be urged of senior citizens in all jurisdictions.

ECONOMIC SECURITY IN OLD AGE ASSURINGAN ADEQUATE INCOME

Thomas G. Walters Association of Retired Federal Employees is President, fifty-year-old, non-profit, association. National Association of Retired Federal Employees, Washington, D. C. The main objective of the Associationis to secure beneficiallegislation for improving the I am Thomas G. Walters, President of the Na- general welfare of Civil Service annuitants and tional Association of Retired Federal Employees correcting present inequities in the Civil Service on whose behalf I am appearing. The National Retirement Law. Its legislative accomplishments

65 in the past have more than justified its existence, How must the middle-income American be by achieving liberalizations in the Retirement assured of a satisfactory old age? He must have Law, various increases in annuities, the establish- full protection against the exhorbitant cost of ill- ment and increases in survivor benefits, and the ness. In considering such matters as housing, trans- establishment of health coverage for Federalre- portation, and nursing homes, he must be in- tirees. Tax benefits (local, State and Federal) and cluded. He must be protected against inflation additional veterans' compensation applicable to either by increasing his income or by reducing Federal retirees have also been achieved through taxes. While this great Nation must make ade- NARFE's efforts. quate provisions for the needy elderly, it should Our major concern at presentis to secure not and this Conference must see that it does not financial relief for retirees who have been forced disregard the middle-income American who, in fact, has built and supported this Nation through- into poverty-level existence through no fault of out its history and continues so to do. their own, and to have adequate health care made available to the elderly. As spokesman for a large number of Senior Citizens, the Association is greatly interested in Dewey Auchter problems of the aged and aging and is intensely Senior Citizen Area Council, active in pre-retirement counseling throughout the Baker, Union, Wallowa Counties Government service. La Grande, Oregon The greatest and most urgent senior citizen's needs is adequate income. Low earnings in our Richard P. Butrick productive years has put our generation at a dis- Delegate Representing the Diplomatic tinct disadvantage in today's affluent society. We and Consular Officers, Retired, are caught in a tight squeeze of an inflationary Washington, D. C. economy. Our seventy-five cents an hour average earnings, and savings have accrued through these I am Richard Butrick, senior delegate from earnings, are not competitive on today's market Diplomatic and Consular Officers, Retired. for goods and services. We cannot pay seven dollars an hour for carpenters or plumbers; nor Most retirees of the diplomatic and consular can we hope to use professional services without servicesfallwithin the middle-income group, soon depleting our meager savings (if there are that vast group of Americans comprisingnot only any) before becoming destitute and a prospect ourselves but most Federal, State,county, and for welfare. municipal employees, the plumber, thecarpenter, the mason, the transportation workerthe butch- We are a proud and deserving people and the er,thebaker,thecandlestickmaker. This stipulation to be thus recognized by our Nation's group participates fully in the life of the Nation, highest authorities becomes urgentis logical and sends its children to college atno small expense, pertinent. Therefore, the Administration and the . paysthe bulk of taxes, either directly or in- Congress should proceed at once to enact laws directly. Because self-reliant, it is easily dis- that will do away with discrepancies, prejudices missed from our 1.ughts and considerations. It and discriminating practicesnow so evident. In- deserves better! come is an extremely important determinate of the elderly individual's sense of well-being. Only The middle-income. Americanusuallyhas with adequate income can our aged lead meaning- something saved for his oldage bur,as our ful self-respecting and independent lives. Mini- society is presently constituted,one serious illness mum income under Social Security needs to be can wipe out his entire life savings. This should brought up to Bureau of Labor moderate living not and must not be, and this Conference mus:: income standards and corrected eachyear to meet address itself to the problem. price index fluctuations.

66 Cost of program. to be shared through em- Robert J. Myers ployer, employee payroll tax deductions and gen- Professor of Actuarial Science, eral revenue sharing. We have earned our keep. Temple University The challenge is yours to pay this debt! Philadelphia, Pennsylvania Governmental actionin providing economic Tom Riley security for persons at the older ages should be State Senator, Des Moines, Iowa limited to the establishment of (a) a social in- As a member of the Iowa 'State Commission on surance plan which gives an economic floor of the Aging and delegate to this White house Con- protection upon which the individual (along with ference, I conducted regional conferences of sen- his employer) can and should build and (b) a ior citizens in Cedar Rapids and Clinton, Iowa, supplementary public assistance program which prior to this national Conference. will take care of the residual economic needs of the small proportion of persons whose income These two local conferences gave area elderly from social insurance and their own effortsarc the opportunity to voice their opinions to me so I, not sufficient for a reasonable standard of living. in turn, could better relay their views to you today. Conversely, social insurance should not by itself alone provide income which is sufficient to take Through these local conferences and the addi- care of the economic-security needs in full of the tional forum of direct mail questionnaires, the vast majority of the people. To do so would be opinions of some 2,000 eastern Iowa elderly were unwise and undesirable becatise of the resultant received. transfer of all individual responsibilities in the Forty-two percent of these people believed the economic area to the government. This would "high cost of health care" was the most serious result in the dimunition of individual freedom of problem facing Iowa elderly. Thirty percent of choice and initiative, as wellas having other the people marked "property taxes" as the most serious effects on the national economy. serious problem. Specifically, if all pensions are provided under governmentalplans,theprivate savingsarea Based on the 2,000 opinions I received, I make would be dried up. This would have the following recommendations: a catastrophic effect on the growth and development of 1. Old Age Assistance payments should not be private industry. reduced when Social Security benefitsare raised. The present level of Social Security benefits 2. Social Security benefits should be increased meets the test of adequacy as a floor of protection, to minimum of $200 monthly. since less than 10 percent of all beneficiariesover age 65 require cash public assistance to meet their 3. SocialSecuritybenefitsshouldincrease day-by-day needs. Therefore, the level of benefits automatically with the cost of living. should not be increased in the future, exceptto 4. Legislation should be enactedtorestrict reflect changes in the cost of living. mandatory retirement laws. John Doyle Elliott On the subject of mandatory retirement laws, Townsend Plan National Lobby let me' add that itis a tragic human waste to Hyattsville. Alaryland arbitrarily force retirement ata given age. Those persons who prefer to continue attheirjobs This Conference is not gathered because all is should be entitled to doso. well with Social Security and misnamed. Welfare but because very much is wrong. Allour poli- Senior employees bring experience, 'reliability cies and programspublic and private combined and loyalty to their work. Harsh, indiscriminate so far employed have failed to correct the pun- industry practices should not frustrate thosede- ishing lack of money-income, thevery license to siring to continue workingat age 60 or 65. live, of the aged.

67 We must have prosperity-sharing retirement I suggest that one does not express true social for every American as an inherent right, instead concern by providing health insurance programs of impoverishing retirement for most. Without it with fine print that is administratively changed economic failure and dependency must remain to meet the current problems of the budget. life's final rewards for multitudeswith futility mocking all our other achievements. Our country Under the present Medicare program, we essen- can't know the social harmony, happiness success- tially say to the elderly person who is ill, "Well, fullypursued,necessarytofulfillAmerica's I see you are sick, you have worked hard for many promise of peace with justice and ever-growing years and contauted to the wealth of our Nation, freedom for mankind. so we might pay parr of your acute health care Prosperity-sharing retirement requires a mini- bill if you can find your own way to the services, mum Social Security benefit for all persons alike, and as long as you don't require more than 100 covering all business and all occupations all the home visits, or use up your lifetime hospital re- time. It must be money enough to assure pros- serve days. Our concern is limited to the extent perity-sharing retirement even for those caught of your Medicare benefits." with no other resource; and with all others having their other assets on top of their Social Security Insurance is a poor way to fund health care for benefits. Nothing else is just to both beneficiaries the elderly. Besides the fact that, in its present and contributors. form it meets only partial needs, it also creates a large and expensive burden. This will not take a dollar out.of our country, economy, or out of any honest interest, or life. It It is time that we stopped forcing the elderly will all be money circulating in every community, into institutions so they can qualify for the benefits fully and prosperously functioning. to be measured out in coffee spoons. There are only bad reasons for not having this incomparable boon, not a single goodone. Kay McGovern. Prosperity-sharing retirementforall Amer- Irving Park YMCA, Chicago, Illinois icans indiscriminantly should be this Conference's primary policy-recommendation. Concern: This Conference concerned with the "quality of life" issues of older Americans should Richard P. Brown as its first priority strengthen the financial base Executive Director, of all. Let us recommend that we starr by elimin- Home Health Services of Louisiana, Inc. ating legislation that now discriminates against New Orleans, Louisiana those who stay in the job market. The limitation on earnings that allows unearned income but re- We heard many words at the opening session duces Social Security benefits on earned income is about this Nation's concern for the well-being of legislation that inhibits, frightens and discourages its elderly. the older American.

CONTROL OF INFLATION Thomas G. Walters. men and women from all walks of life who be- National Association of Retired Federal lieve that the far-reaching objectives of the Na- Employees Representing Citizens fora tion's new economic policies are in the interest of New Prosperity, Washington, D. C. all Americans. These objectives are: stopping in- I am here on behalf of a group of concerned flation, creating full employmenr, and making citizens who have organized a committee known Americanproductsandservicescompetitive as "Citizens for a New Prosperity." This is a non- around the world. partisan, nationwide organization composed of We all recognize that economic progress can-

68 not be achieved through decision and action in flationary spiral. A non-partisan, lobbyingeffort the executive and legislative branches of thegov- must be organized, not to promote senior citizens ernment alone. Economic stability depends greatly spending programs, butto control and educe upon what individual citizens feel, believe, and overall spending bygovernment, supported by want to do. labor leaders. We have suffered too long withan inflation A fair question is, "Howcan our friends who psychology. We have assumed too long that the vote for economy be identified?" Avery good only direction for prices to go is up; our indiffer- guide is the pamphlet issuedas "National Asso- ence and lack of concern has permitted inflation ciated BusinessmenEconomy Voting by default. Record." This lists the record of eachsenator and repre- If ever one segment ofour population needed sentative on 12 important bills directlyshowing a voice raised in its behalf, itis the retired and whether they are economyor spending advocates, elderly whose meager average income is stretched and rates theirpercentare in support of economy. to the breaking point. It is essential that we keep in officethose legis- What can you do to help? Encourageyour lators who vote for economy, regardless ofparty, friends and community leadersto stand against and replace those voting for spending.It is our pressures andactivitieswhich perpetuatethe senior citizens' best methodto kill our worst vicious cycle on inflation. Distributematerials enemyin flat ion. which are available from Citizens fora New Pros- perity, 1627 K Street, Washington, D.C. Samples Sam Shaw are displayed in the auditorium along with infor- Moundsville, West Virginia mation on the Committee. One of the most vital We all can contribute measures needed for im- to strengthening public provement of the lot of the next crop of elderly confidence in the health and stability of America. is to stop INFLATION. Inflation trimsa person's Martin K. Bare retirement buying power to about half ofwhat he projected in his early working Lancaster, Pennsylvania years. It Our Lancaster, Pennsylvania, delegationwas is time to get the general publicto quit pledged to presentto the White House Confer- enjoying the things itwants that are inflationary: ence the issue of number one importance to Lan- A uniform minimumwage law, same in the caster senior citizens, and of paramount im- high-cost-of-living cities as in economical rural portance to older citizens everywhere, namely, the areas, is a "guaranteed inflation" law. elimination of inflation. When Congress orders the postal v orker in Inflation is the number one enemy of persons Moundsville, W. Va., to get thesame pay as the on relatively fixed incomes, and ranks above in- New York City postal worker, it fans inflation. come (except for a floor providing food, shelter, clothing) improvement of Medicare,property tax When the governmentrequires highway relief, etc., is the numberone senior citizen con- contractors to pay what is actually the highest cern. wage scale to be found in each community, that inflates. For far too longour government (both executive and legislative) has contributedto inflation When Congress tries to cut employment by imbalanced budgets. Unions haveparticipated below six percent, that is inflationary.Perhaps by demandingwage increases far exceeding pro- three percent of opleare the kind who just ductivity, and business has sharedby granting don't work until inflation-producing prosperity these increases, .z.nd passing thecosts on to the is waved at them. consumer. These are just a few items in the longcata- Senior citizens must c,rganizeto halt this in- logue of inflationary luxuries.

69 TAXRELIEF

Kenneth E. Dunlap Federal payment by the reduction of certain de- Former National Editor, fense costs. I am including this as a major part of Armed Forces Comptroller my recommendation for review by an appropriate Arlington, Virginia committee of Congress. Congress recognizes that the Federal Govern- I ask for your prayerful consideration of my ment has an obligation to State and local govern- two-fOldrecommendation.It'shigh time we ments for depriving them of substantial revenues alleviatethe many problems of our elderly, in the form of real estate property taxes on realizingfull well that we fall tremendously property owned, in many instances occupied, and short of matching, dollar for dollar, the foreign controlled by it. aid program. The purpose of this recommendation is to pro- Jerry P. Johnson vide property tax relief to elderly homeowners Arlington, Texas and renters by providing the making of fair and equitable payments by the Federal government in The Federal Government should suggest to all lieu of property taxes to State and local govern- States that homestead taxes to persons over 65 ments which will compensate in part for the re- years of age be proportionate to their income at sultant loss in tax revenue. the time of retirement and their retirement income, e.g.: On the other side of the ledger- and in order to meet these needs, I, as an editor, auditor and Person at time of retirement has income of retired government contract negotiator, submit $20,000. a plan, which if approved by Congress, Will pro- Paying total ad valorem taxes of $800.00, re- vide substantial revenue to offset this proposed tirees with income of $5,000 will pay $200.00.

PROBLEMS OF AGINGAMONG THE MINORITIES

Hobart C. Jackson peditiously as possible our national goals and Chairman, priorities to give much more consideration to National Caucus on the Black Aged alleviating human need. Philadelphia, Pennsylvania According to the Kerner Commission report Jt seems appropriate that I should summarize issued several years ago, the major domestic prob- a few of the general concerns of the members of lems which we face are racism and poverty. Our the National Caucus on the Black Aged. systems and institutions have utterly failed to irradicate either and the situation, tends to get 1 These general concerns are in addition to our worse and is compounded by this senseless war very special concerns about improving the dis- in which we are engaged. graceful plight of the Black elderly and the elderly bf other minority groupsa plight that so There seems to be absolutely no sense of desperately and urgently needs improving. urgency by our leadership about this problem. Many of us view the special problems asso- We must move in the direction of developing ciated with aging as simply a microcosm of the one human services system. overall problems of the Nation and we wish to Perhaps the most devastating aspects of our direct attention to the need for changing as ex- nonsystem shows up in the lives of those persons .> 70 who are Black, poor, aged, disabled, andhandi- capped, in the multiple Elderly Asian Americansare accustomed to a jeopardy theyencounter diet of rice, dried in their daily lives. seafoods, and pickledradishes which cannot be purchasedwith foodstamps. We must devisea single system that will viate the needs of alle- During the past biennium all, otherwise we'llalways the Federal Govern- have this dual and ment spent $3.2 millionto identify the needs of fragmented approachand a the elderly; dual and fragmenteddelivery. none on Asian Americans.

Henry Tanaka, President-Elect, Rosa J. Vasquez National Japanese Executive Director, American CitizensLeague Cleveland, Ohio Accion CommunityCenter Miami, Florida I r:present the only nationalorganization for Japanese Americans. We represent theCuban elderly and "Los Viejos Utiles" ( the useful aged),Cuban group of I speak -.n behalf of elders who 1.5 million highlyvisible, want to be useful, but feel thatthey but neglected andforgottengroup of Asian have been set aside by Americans. the system. In the Miami area there are around 400,000Spanish-speaking There is a myth that people. Asian Americans haveno probleml- because of strong familyties. This We are requesting parityin all programs that stereotyping has beenreinforced by certain exist now for the elderly, tural traitspride, cul- taking into consideration honor, perseverance,and fam- the language andcultural barriers thatcan be ily loyalty andcontrol. . overcome by the use of bilingualand bicultural Asian Americans programs. These programs should 4 have been .victimsof racial by the aged be organized discrimination andunlawful' themselves with theappropriate treatment for 120 design and delivery of years, dramatized by theincarceration of JaPanese services accordingto their in America'sconcentration way of living and culture.Therefore, it is im- camps. The plight of portant that the planning, the today's elderlyJapanese Americanscan be attri- budget allocation, buted to -that despicable the program designsand development event. Sociologists tellus should be that the in the hands of thebilingual, so needs greatest harm resulting fromthis experi- can be met ence was -the separation more efficiently. from close familyties. 5' -t.s 50percent of the elderly Japanese We Cubans, refugees,residents, and citizens Amer- pay taxes in the same fashion icans in Los Angelesare public assistance clients: as the community Many are receiving at large. We expectour tax return in services Social Security benefits,but that take into consideration substantially lowerthan what theymight have our cultural needs. earned because ofdisrupted employment The day care for the their detention. during elderly, the homes forthe aged should considerthe bicultural and bilingual A recent needs. The training survey revealed that 34percent of the and staffing of thesepro- elderly Japanese grams should consider thisgroup and make use Americans havenot had dental of it. or medical examinationsfor tears, that suicide rates among Chinese Americansare three times We formAllyrequest that action be takenat all those of otherelderly Americans. levels of governmentFederal, State, regionalor Most elderly Asian localand on privatefunds, so parity isexerted Americanscannot speak for the benfit of English. The lack ofbilingual, bicultural the elderly Cubans.Our elderly in public agencies workers cannot survive in a has createda major problem of system they minor under- communication. stand. Let them liveproperly onceyou allow them to cometo this country. 71

468-217 0 . 73 - 6 SERVICES FOR THE ELDERLY

FACILITIES Senior Centers have demonstrated their ability to effectively provide services, activities and a James L. MacKay variety of opportunities for older people. Unlike San Antonio, Texas most other service agencies, Centers are asso- The recipient of service is an individual. The ciated with wellness and the prevention of illness. normal environment of an individual is his home. By providing an e .;ly identified site, and an at- This home may be with members of one's family, mosphere conducive to involvement, they make in a congenial foster home, in a residence for the available a range of programs which promote elderly, or living alone. When we have a home, independent living and enhance social function- we are living as independently as our condition ing. permits; we take part in making decisions; we Properly financed and operating as an ongoing belong. government service, Centers could become the Adequate housing,nutrition,activitiesand foundation for any such additional services as the health care are functions of the home. The home various levels of government and the voluntary is part of a neighborhood as are the church, the sector wanted to provide. shopping center, and the adjuncts- of health care We recommend that the Federal Government should be. An active neighborhood eliminates make a commitment to develop a delivery system much of the need of transportation. for programs and services designed for and with While problems of income, Medicare, etc., are older persons, available and accessible in every awaiting nationalaction, the adequate use of community. To support the concept of Action available facilities will provide more services ar Now we believe that the senior centers currently less cost than the present hodgepodge system. operating provide a foundation from which a Therefore, I present two n.commendations: comprehensive, nationwide system can develop. 1. The AoA be funded tossist local communi- To help realize the potential, o: the senior center ties to inventory their present facilities for caring and to assure the availability of accessible focal for the aging and to establish a central office for points for these services, we further urge federal storing, updating and distributing these data. support for the development, makntenance, and operation of multipurpose senior centers. 2. The AoA be funded to help local communities establish neighborhood centers for maintaining activities and counseling facilities and for co- Monseigneur Lawrence J. Corcoran ordinating health and other facilities. Secretary of the National Conference of Catholic Charities Joyce Leanse Washington, D. C. Consultant on Senior Centers, The National Council on The Aging, inc. We have been pleased with the emphasis on Waibington, D. C. spiritual values which Dr. Arthur Flemming, A major goal emerging for the Conference is Chairman of the White House Conference, has the provision of services which will permit older given to this gathering. We join with our fellow persons to continue living independently in the Delegates in pressing for more adequate income, community, avoiding institutionalization. housing, health care, and other services and facilities for the aged population. We accentuate The National Institute of Senior Centers, a as strongly as possible the importance of spiritual program of the National Council on the Aging, and religious considerations to the elderly. Their urges government support for the development spiritual needs must be recognized, and the meet- of multipurpose senior centers to be used as a ing of these needs accorded the highest priority. vehicle for the delivery of these essential services. This should be a major resolve of the White

72 House Conference and a major challengeto the a comfortable home, good food, recreation and citizens of America. companionship, where he can live in dignityat a Further, we wish to raise a question pertaining reasonable cost. to the cost of the delivery of human services, in- With such a home, the tripto the nursing chiding services to the elderly. Thecost of these home can often be postponed foryears. services is constantly increasing, and there isgreat difficulty in finding funds to finance them. Atthe These homes are desperately neededacross the same time, we note the increasing amount of profit entire country. being made on these services: Wequestion whether the elderly, and others in need ofhuman services, should be burdened with this addedcost, the cost of profit for theentrepreneur. We ques- HEALTH SERVICES tion whether the hard-to-gettax funds should be spent for the profit, or excessively high salaries, William Kesselman of those providing human services. Sickroom Service, Inc. Milwaukee, Wisconsin We think that this questionmust be raised and examined. We have seriousreservations I have been a licensed health professional for about making profit,or receiving excessively high over forty-three years. As a neighborhood phar- income, from the delivery of humanservices. macist, I see the consumer of health servicesmore This White House Conferenceon Aging should frequently than other health speCialists. examine this question as it relates to the pro- Today, those in need of therapeutic aids from vision of services and care for the elderly. traction equipment to breathing machines find the pharmacist prepared. However, surroundingthepharmacistare Lois Oliver health organizations operating under Warren, Oregon two magic phrases: "voluntary agency"or "not-foi-profit or- Old age brings new problems.Thoughts and ganization." They cannot deliver servicesmore movements become slow; once simplematters of efficiently because their unitcost is higher. In- keeping house and takingcare of oneself gradu- stead of contributing to thetax base, these or- ally become too" much. Atsuch a time, a person ganizations use tax dollars, either directly with needsplace to live where hecan feel at home, matching funds, or as charitable dollarscon- where he can doas much as he is able even tributed to the organization rather thanthe U. S. though he may be slow,to be cared for only when Treasury. he is unable to care for himself, to do things that I plead for health servicesas the criteria in- have meaning and interest, andto be able to do stead of the type of sponsoring organization. something for someone elsenotjust sit and be entertained! He needsto keep in touch with For a half-century, the neighborhood pharma- friends and relatives andwith his church and cist has been practicing clinical pharmacy, known lodge or club, to findnew interests when old then as counter prescribing. Wecan still save ones are lost, and to have companionshipwith both the doctor's time andcost of hospital beds. people his own age. Assigned to the Training Section of this Cou- The assumption is that hewill go through ference, I brought withme, as requested, copies successive srges: home,a small apartment, inter- of our Sickroom Service Training Program.This mediate home, then possibly,a nursing home. program helps the neighborhood pharmacist, in cooperation with the Home Health Agency,to This intermediate homemust be a place where train and supervise the paraprofessional inthe he can have some of his belongingsabout him. He can be independent and use of therapeutic equipment. So let'suse the a whole person with neighborhood pharmacist, with specialtraining 73 in utilization of convalescent aids, in an exten- deaf elderly Americans could not hear-me if they sive Home Care Service to not only save tax were here. Fifty thousand of these persons always dollars but to deliver excellent and efficient health have been unable to hear. They deserve a few services at HOME. minutes use of your ears. I strongly urge that any health care policy You are convened to plan for improved serv- include home care. ices to elderly Americans. The benefits of many of these services will be denied to deaf persons un- Arthur Elfenbasim, D.D.S. less there is more awareness of the communication Chicago, Illinois problem. Deaf pesons experience difficulties in The mouth is an integral -art of the body en- learning about available services, and in under- tity, and any disorder in it may be correlated with standing and making lemselvesunderstood a disturbance in any other pan of the body. An when attempting to secure their rights. Their infected tooth may be the cause of a heart failure, rights are all they ask for! and bleeding gums may be the effect of a general- Elderly deaf persons have not been articulate. ized blood disease. Only a dentist is qualified to They are doubly burdened by the general indif- determine the relationship and to recognize it in ference of society to this invisible handicap. The its earliest stage. Dentistry is a health service;-and last White House Conference on Aging made no no health program can be called comprehensive specific provisions for aged deaf persons. The unless it considers oral health. Administration has no program designed to alle- In addition to being the mouth physician, the viate the joint problems of aging and deafness. dentist is also the expert in mechanical and cos- Deaf people want to participate in decisions metic orai rehabilitation. It is not always essen- affecting theirlives. Regardless of lip-reading tial to provide a person with an extensive and skills, no :leaf person can follow and participate expensive oral rehabilitation to enable him to in a group discussion without an interpreter. We enjoy the pleasure of eating, speaking. more ask this Conference to adopt a policy insuring plainly, and presenting a more pleasing facial communication support for aged deaf persons dur- expression. Possible sources of infection must be ing information dissemination, at points of serv- removed from the mouth, the remaining teeth, if ice, and in group discussion. any, must be restored, and the patient must be provided with a sufficient and efficient chewing You are urged to read and support the recom- mechanism. mended policies and procedures to meet needs of the deaf community contained in Services for With the rapid increase in the number of the Elderly Deaf Persons.' elderly people in our population (3 million in 1900; 20 million today ), their oral health is the Elderly d. of persons need your help. Do not main concern of the American Society for Geri- let them continue to be forgotten. Lend them your atric Dentistry, especially if they cannot afford ears. the services of a private practitioner. We have enough dedicated dentists who are willing to V. Eugene McCrary provide the necessary geriatric dental service for American Optometric Society those who need and want it, but the cooperation College Park, Maryland of local, state and Federal public health agencies is essential. Nearly 100 percent of all persons -aged 65 and over have some sort of visiou problem. Yet, less Edward C. Carney, than 20 percent of these peopleare receiving Executive Director adequate care. One of the major reasons for this Council of Organizations Serving the Deaf Washington. D. C. ' Deafness Research and Training Center.Services for the Elderly Deaf Pertont.New York University School of Edinsi- Can you hear me? Over 500,000 profoundly tion, New York, N.Y.

74 situation is Medicare's failure to adequatelypro- Originally,Medicare promisedtraditional vide coverage for optometric services. Indeed, Visiting Nursing services. Now, SSA reinterpreta- only a fraction of all public funds is allocatedto tions have eliminatedmany patients from eligi- the coverage of elderly vision care. As such,an bility. Decisions completely ignore the moralsup- older person, with half the income of those under port patients need to facilitate economical treat- age 65, is paying for almost 60 percent of his ment at home. health bill. The patient not completely homebound,or Recommendations who does not need physicalor speech th;:rapy, or "skilled nursing care" is denied services. Yet, The American Optometric Association believes patients need other kinds of helpto maintain that the final report of the 1971 WhiteHouse health, prevent complications,promote rehabili- Conference on Aging should containa separate tation, and prevent hospitalization. For example: section on vision care for the elderly. This section should recommend that Medicare be amended to thereare more reasons why a diabetic needs provide recipients with: -( 1)a complete vision help in learning to take insulin thanpoten- examination upon enrollment into theprogram tial blindness or senility. and every two years thereafter; (2) theservices of the optometrist delivering thiscare; and (3) If a physician is concerned about hispa- payment for prescriptioneyeglass frame:- and tient'sresponse todigitalis,thenurse's lenses. skilled services in checking vital signsare not paid for unless the patient has an acute In addition, we recommeid that there bean episode. increased emphasis on the provision of vision care in nursing and private homes, through the To have a nurse determine if he is following utilization of house calls and/or mobile clinics. a diet correctly is not a paid-for benefit even when language difficulty ispresent. Optometry, with over 18,000 professionals in 6,239 municipalities deliveringover 70 percent The fiscal intermediary willpay for the of this Nation's visioncare, stands ready to do its Home Care patient's commodeor bedpan only if the physician specifically forbids him full share in providing the comprehdisivecare so urgently needed by older Americans. from using his outdoor privy. The elderly spinster living alone is deprived of service for anecessary enema even though Sidney E. Chapin,M.D. there is no relative or neighbor availableto Medical Director, assist her. Home Care Program of MetropolitanDetroit, When a patient's wife cannot learnto care Dearborn, Michigan for his indwelling catheter inone lesson, SSA still rules a nurse's service unreimburs- Physicians are disturbed about the penny-wise- able. pound-foolish posture of the SocialSecurity Ad- ministration (SSA) regarding Home HealthCare. SSA completely ignores the majority ofpa- Home Health Care is the!lust economical tients' diagnoses and medical situationsencoun- method of caring for the sick.Yet, this small teredamong seniorcitizensrequiring home (1.5 percent) part of the total healthbudget is health services. under attack. Home Health agencies find themselves ham- Impractical interpretations by the SSAare pered in efforts to deliver services. Theyhave been denying senior citizen patients neededcare. Ex- forced into financial straits withpayments for planations and documentations add iintrieasur- services already delivered denied. Physiciansare ably to the paper work for physicians. frustrated and discouraged.

75 Rosalyn L. Switzen, PROTECTION Director, National Education Ombudsmen's Association Unionville, Connecticut Robert L. Lauretig, Executive Director OMBUDSMAN: Swedish word meaning "rep- Seniors of Ohio resentative." The ombudsman is hired to represent Cleveland, Ohio the "little man" who is helplessly caught in a bureaucracy and needs help to overcome abuse Until a national effort is made to provide mini- of power. mum ancillary supportive social services to the elderly in public housing there can be no sense of He functions to service complaints, has Clout security. when he investigates, and can expose information quickly, There is a growing recognition of this prob- H_ e is, above all, a red-tape cutter when there lem. On January 22, 1971, Congressman James are unnecessary snafus. -Since 1807, he has been H. Scheuer of New York submitted H. R. -447, an intervener, or citizen protector, different from a bill to amend the U. S. Housing Act of 1937. public defender or ordinary complaint or investi, The purpose of this bill was "to finance security gation bureau. arrangements = designed _to prevent crimes and otherWise insure the safety and well-being of low- In the past two decades, nine countries have rent housing tenants." adopted thii-new career. In the United States, the first" ombudsman appeared in Minneela, Long The Ohio Division of Administration on Aging Island, in. 1967. Since then, thousands of new jobs added safety and security to an already-crowded have appeared on high school and college cam- State agenda for the "Governor's Conference on puses and in many agencies in the Nation, all Aging"inColumbus, Ohio. The Cleveland acting for the "underdog" as overseer and over- Chapter, Seniors of Ohio, first identified the safety sight officer. and security problems of the elderly in 1970. This culminated in the formation of a county-wide Health, Education, and Welfare has justSet up ombudsman units to service complaints in Task Force on Safety and Security Problems of the nursing homes. Elderly.

The elderly especially need a powerful inter- Guided by a county-wide Task Force Steering vener to cut through bureaucratic snafus and Committee, the elderly were directly involved in or transmit information better for more effective reporting crimes andsafetycomplaints. The delivery of services. elderly took responsibility for developing guide- The skills of older citizens have not been lines so better services could be secured. For the first time, the elderly organized and conducted ackquatcly used to benefit the communities or the their own safety-security inspection teams of pub- aged. An advocate is an important role for senior lic housing units serving older adults. citizens, able to be combined successfully with -the ombudsman role, for even greater clout and 7 efficiency, if proper ombudsmanship training is A conclusion reached by our Task Force that, provided in one-day institutes. once on the streets, the elderly cannot' be r :.o- tected by municipal or specialized police forces. There is an important new career that can Housing and Urban Development must stop just open up to aged citizens- immediately for five giving lip service. It must finance a comprehensive different kinds of ombudsman or ombudswoman social service delivery plan for residents of public jobs. housing units. t 76 MANPOWER AND TRAINING IN AGING

Clyde W. Briggs, project at Kansas State University, canrepay Personnel Officer, society for this investment in training in less than The University of Michigan one year; Ann Arbor, Michigan WHEREAS, America i. on the brink of recog- I would like to propose the establishment ofa nizing how this service can enable the elderly, _scholarship fund to be awardedover the next five the handicapped and the family in crisisto con- years to prepare a m;nority work force of 15,000 tinue to live at homeunfortunately, thisrecog- in the areas of geriatrics and gerontology. nition may bring such a surge in demandas to Beginning in September, 1972,a scholarship cause and stimulate the creation of de facto or would be awarded to 1,000 graduate students "instant" staff who are not suitably trainedto for a one-semester workshop experience. fulfill. the expectations for service which the elderly and the handicapped havea right to ex- Such scholarships awarded annuallyover the pect; next five years would produce a well qualified professional and paraprofessional work force of THEREFORE, itis recommended that quality 15,000 by June, 1977. It should be imperative training programs be initiated NOW to pace the that the awardees attend institutions with well supply of needed homemaker/home health aides esablished curriculums in geriatrics andgeron- and exemplify the standards of service which tology, and not schools of social work. America's older and handicappedpersons have a right to expect.

Richard L. D. Morse, Delegate Representing the American Erich M. Helbig Home Economics Association, Knoxville, Tennessee Manhattan, Kansas May I say a word for some seeminglyunmen- 'WHEREAS, independent home living ispre- tioned resources for any attackon the problems ferred to institutionalized living,many elderly confronted by the chronologically aged. Theyare persons .find this style of living increasingly diffi- the various' engineering professions and the truly cult to maintain with the departure of family technical innovators or inventors within society. or members, relatives and friends who cared for the I missed any reference to utilizing or soliciting elderly, and the failure of communitiesto provide these segments of our society, bo.h in this Con- substitute supportive servicesparticularlyhome- ference's opening remarks and in thestatements maker/home health aide service; prepared for our considerationat this Conference. WHEREAS, America has an abundance of under- The "Action Now" demands that have been utilized womenpower among its mature women made here may well find the "hard science"en- who are dependents andare potential welfare gineers and the pragmatic inventors unexpected clients but with training could become contribut- sources of assistance. ing members of societyas homemaker /home health aides to theirown satisfaction and those Note that Ben Franklin gave us the bifocals,or whom they serve; two-lens eyeglasses, that most all ofus must use after age 40-45--they are the product of in- WHEREAS, education and training requires fi- ventionand still the best, 200-year-old,solu- nancing, such expenditures should be viewedas tion available. It nowseems desirable that per- an investment in human capital which, according haps some new invention and technical to results of the experimental and demonstration scheme replace the glasses over oureyes, I would suggest.

77 Perhaps an example, in another area, for using ments, or even some of the social service agencies. present engineering and inventive talents can be I would askpleadpray that an orti mind the small, personal, radio-frequency, tone-trans- be kept to proposed problem solutions and con- mitter issued to each chronologically aged person, cepts from the inventive, engineering, and indus- who desires a means to summon help or assistance. trial productive capacities of the Nation. They can Then a local area monitoring station or receiver prcvide the independence and dignity so much may be operated by church groups, fire depart- desired.

GOVERNMENT ORGANIZATION FOR AGING

Fern C. Trull John M. Lally, Weiser, Idaho Associate Director, Cardinal Ritter Institute St. Louis, Missouri We, the official Delegates representing.the State of Idaho, support the U. S. Senate Special We recommend the establishment in the rouse Committee on Aging Advisory Council recom- of Representatives of a Committee on Aging simi- mendation dated October 1971 which reads: lar to that already established in the Senate. Last March we had the privilege of testifying before a "That an independent agency for the aging joint hearing of the United States Senate Spccial directed by the Assistant on Aging to the Presi- Committee on Aging and the .Sub-Committee on dentbe established within the Office of the Aging of the Senate Labor and Public Welfare President with the authority and funding levels Committee. We testified on behalf of the Older and fulltime staff needed to formulate and Americans Act and, in particular, on behalf of the minister policy,coordinate, and monitor pro- Foster Grandparent Program and Title III grant grams within and among those departments which programs. The Cardinal Ritter Institute operates have a direct concern in matters relating to aging, a Foster Grandparent Program and a senior that this agency be served by an advisory council, center which is funded by a Title III grant through and that it be required to make an accurate and the Missouri Office of Aging. comprehensive report each year on the progress made during the year in resolving problems and You will recall that last year severe funding in meeting goals specified in the prior annual cutbacks were proposed for the Administration report, and that this report be issued early enough on Aging. However, as a result of the hearings in the year to have an impact upon the budgetary of the Senate Special Committee on Aging and process for the following year. the Sub-committee on Aging, the proposed budget cuts were reversed and funds were not only re- "This White House-level office for the aging stored, but increased for the Title III grant p. o- should have enough prestige and resources to as- grams, the Foster Grandparent Program and re- sure thatas part of its advocacy functionit search and training activities, This would never will encourage development of parallel units at have happened without such Congressional com- the State and community levels. And it would, mittees. The Senate Special Committee on Aging when the Assistant on Aging to the President focuses the Nation's attention on the needs of deems it necessary, provide funds for innovative older people and has been a very effective mecha- programs to appropriate Federal departments or nism in seeing that Congress addressed itself to agencies. It would itself, in certain cases, when some of these needs. We need a similar com- deemed necessary by the Assistant to the Presi- rr Nee in. the House of Representatives. We dent, initiate and administer such programs until strongly urge our delegation to bring to the White their value is demonstrated sufficiently to dele- House Conference on Aging a recommendation gate to the existing agencies." that such a committee be established.

78 Blanche Duncan from your home is like putting ina long-distance Member of Governor's Committee call to a stranger. Eventuallyyou may receive help on Aging, Wyoming after a long delay. If you need a doctor,you call a local physician. If you need your house repaired,you call a local I would like to recommendto the Conference contractor. that as many of the issues as possible be implemented at the State and local level with the To expect the Federal Governmentto take care financial and technical assistance from the Federal of the needs of the elderlyat an enormous distance Government through revenue sharing.

IMPRESSIONS OF THE CONFERENCE

The Rev. Paul A. Boriack, Boriack and upon those he serves abundant Pastor Emeritus, blessings from God. St. John's Evangelical Lutheran Church, Rome, New York At tomorrow's session I will distribute and submit a Resolution on "Illegitimate (bornout The Honorable Earl Warren, retiredJustice of wedlock) Children." We hope this will bring of the Supreme Court of theUnited States, about discussions to help heal deep hurts. I deeply moderator; the esteemed Glairman ofthe White appreciate your kind attention. God bless and House Conference, Dr. Arthur S. Flemming,and keep us well. respected Delegates of the Conference.Upon request to make a statement about my impressions Terrie Wetle of the Conference, especially inrelationship to Portland, Oregon the Spiritual DevelopmentSection,may I say: As both a Delegate and as one whocares about the elderly, I am distressed. In my evaluation of the total packageof the Conference, one word would give theconcept I am distressed by the evangelical rhetoric that "COMPASSION" "feelingyourhurtsin my marked the opening of this Conference. heart," on all levels, in allareas of life. And to- I am distressed that a con;erence dedicated to gether we are there to doour best to alleviate concern for the elderly could be so insensitive as these hurts. to schedule an incredibly taxing program, stretch- As soon as I was registeredas a New York ing from 8:00 a.m. to 10:00p.m: and uses buses State Delegate for the Conference,I briefed His with impossibly high steps foranyone with even Holiness the Pope Paul VI, ofRome, Italy, on a minor ambulatory handicap. the purpose of the Conference, includingreligious I am distressed by preconference meetings, in materials, resolutions, and pictures. Hisresponse which delegates were called upon to ratifypre- I would like to readto you now. set issues, not to present original recommendations or policy statements. I am distressed by an anti-research, anti-long- FROM THE VATICAN, SEPTEMBER 23,1971 term planning attitude. Shortterziiactionis needed, but it can't effectively providea minimum The Secretariat of State is directedby th income on a projected basis, nor can't provide Holy Father to acknowledge the letterand en- closure recently sefa to him by the long-term medical care, nor can it beginto solve Reverend the numerous mysteries of aging. Paul Boriack and toexpress his appreciation of the sentiments which promptedit. If the short-term, actionprogram beclmes the only norm, then we will always be saddled with His Holiness invokes on theReverend patch-work, band-aidprograms, neverfinding 79 solutions or methods of avoiding the many prob- attentionatthisConference, every Delegate lems associated with aging. should make certain that the special need of Finally, I would like to observe that out of women are carefully considered. I state this both approximately 20 million elderly, 11 million are as a member of the only minority group with a female and 60 percent of these women are numerical k majority and also one who hopes to widows. In that this group has received so specific someday be an elderly woman.

CALL FOR POST CONFERENCE ACTION

Edwin- Shelley, Robert N. Butler, M.D. President, Psychiatrist, National Council on the Aging, Inc. Washington, D. C. Washington, D. C. True tests of our cultural sensitivity toward The needs of older people, particularly the our Nation's elderly and of the success of this elderly poor, are well known. We have had Conference are action, money and power. decades of studies, pilot projects and debate. Now we must have immediate action on a massive Some of us are deeply concerned about pre- scale to meet those needs. mature self-congratulation,the blandcareful orchestration of this Conference. There will be The worth of societiesis measured in large,'the aura vssociated with the visit of the President. part by the quality of their treatment of older He will probably talk about k'l) an income flock people. We have the resources, we have an unfor the aged, (2) a gerater role for the Admin- derstanding of the need, and we have the-knowl- istration on Aging- (or some similar Federal edge of what to do. Lacking is the national will structure) and of influence in the White House, to assign a high priority to improving the quality and (3) the 8-point nursing home plan he an- of life for the elderly. nounced that he has yet to be implemented. (See The White House Conference can and must be Washington Star, November 28, article by Mal the catalyst for a rising public demand for action Schechter.) Moreover, however important stand- to provide all _older Americans with a decent ards are, the President's approach perpetuates stiindard of living. The Conference must force- commercialism in the care of the elderly. fully bring the present deplorable conditions to We must test all promises, including Presi- the attention of the public, and propose bold solu- dential promises. tions on a scale that will grip public imagination. And ultimately, for the Conference to succeed, I propose, first, that this Conference itself serve the Delegates to the Conference and the oras a continuing committee cf the wholeeach of ganizations they represent must rot allow the us an individuals woald responsibly monitor the recommendations to die on the shelves of book- recommendations of this Conference. Second, I cases They must lead a determined campaign to propose convening representatives from this Con- insure that the recommendations become public ference to meet in June 1972 in Washington for: policy and are effectively implemented. 1. Postmortem of the Administration's and To this end, the National Council on the Aging Congress' implementation of the Recommenda- invites all organizations participating in the Con- tions. ference to join with us in a series of regional meetings and a national conference in April, 1972 2. Review of the 1973 Federal Fiscal Budget to review the progress made in implementing the an acid test of commitment. recommendations and to plan fOr concerted action 3. Ask Presidential aspirants to spell out their in any areas that have been neglected. programs on behalf of America's elderly.

80 /

To participate in the audit should be Dr. mittee on Progress. This Commin& shouldmeet Flemming; Rep. David Pryor, RalphNader, Sen- every two years to hear reports from appropriate ators Williams, Church, Moss and others deeply representatives of Government and theCongress concerned with the life and problemsof old on the progress being made toward implementing people. the recommendations of this Conference.Mem- I counsel healthy suspicion ofourselves, this bers of the Committee would thencommunicate Conference, and the Administration andCongress the information to their respective jurisdictions where the power toact reside. and organizations for whatever action,position or recommendations they may deemnecessary to Leo Milman achieve our stated goala national policyon Flemington, New Jersey aging. In his address to the openingsession of the This proposal is intendedto provide an effec- White House Conferenceon Aging on November tive follow-up to this Conference. 28, 1971, Dr. Arthur S.Flemming expressed his hope for periodic evaluationof the progress made-by our government, Congressand the pub- William Gilson lic sector toward carryingout the recommenda- Chicago, Illinois tions of ff.'s Conference,so that they would not, in his words, "goon shelves to collect dust." This The private organizations (NRTA, AARP, is also my own and, I'msure, every delegate's Sr. Citizens, etc.), Messrs. Martin, Flemming,et desire, for thesuccess of these derberations will al., have stressed the fact thatactionis the ultimately dependon how the final proposals are criticalobjective oftheConferince. Sena& translated into effective action. Eagleton statedtoday that we could produce volumes of literature, of resolutions, but ifno At this Open Forum, therefore,I should like action is taken we are just "hatching to suggest that each delegation an egg," to this Confer- just a collector's item. Problem: Who, how,and ence elect or appoint. three delegates (atotal what will be done to execute the objectives de- of about 150 people), who wouldform a Com- termined?

VARIOUSTOPICS Helen Lynch 4. That it be mandatoryto have pre-retirement Illinois Citizenship Council education. Chicago, Illinois 5. That hot meals be servedto the elderly and I wish to suggest the followingto be acted the handicapped. upon:

1. That pensions $5,000or below annually for Gertrude Lowell single persons and $6,000 forcouples be exempt Wilmington, Delaware from incometaxes. 1. Social Security benefits for widows should 2. That allbuildings be requiredto have be uniform, without making exception ofthose ramps for handicapped persons andthat this whose husbands died before 65. Benefits should building code be enforced. be full amount of husband'sact. 3. That the elderly in homes,or elsewhere, 2. SocialSecurity payments should be in- be treated as human beingsand that nongovern- creased in view of inflation and low incomeof mental agencies feel their responsibilitytoward many recipients. the elderly. ''. Means test should be removed from Vet- of erans of World War I, as law was originally ing ,es, and economic pressures. It is a time of passed, inasmuch as many veterans did not have. great uncertainty for many. Thecumulative effect properphysicalexaminationandservice-con- of negative social attitudes about women come nected disabilities did not appear. The countries to fruition in an almost acceptable disregard fc they gave their young lives to protect us against contributions that could be made by the older have been helped more than the veterans who woman. fought in these wars. A recent report of the HEW Women's Action 4. Jobs for elderly should be provided by using Program focuses on special problems of older parttime employees for peak loads instead of women: widowhood, income and social services, paying time and a half to young people. Many of employment, leisure time and continuing educa- these people have status and could easily be used tion,legalservices, and consumer protection. to the advantage of government agencies (Social Recommendations directed toward HEW aid to Security, Veterans, etc.} at a saving to the gov- the older woman include: expansion of HEW ernment. support for education and career opportunities, 5. Housing. A decent place to Hie is a must increased direction of consumer information and for the elderly. Not only buildings where they protectionactivities,attention to problems of can keep house at a cost within their means, but communication and mobility in the provisions of residences where theycan live family-style at a social services, and working with other Federal mode-rate cost. The States should utilize their own agencies in areas such as improving legal services. unused land and Federal Government provide building costs so that one-story units for six or eight people in clusters under supervision of R.N. and Social Workers where elderly can help each Katherine Turner other. Director, American Board of Learning Experience for Community Education, Farmington, Connecticut Rosslyn S. Kleeman Acting Director, There is a task force throughn.it the country Women's Action Program, ...of behavioral scientists including sociologists, Department of Health, Education, and Welfare psychologists, educators and legislators at a na- Washington, D. C. tional and State level who are now working on the idea of omhudsmanship training, through Although we know little about aging in women setting up a State Education Ombudsman office specificallyfew texts and guides on aging de- by law. vote special at ention to womenthere is evidence that women and men react differently to It is predicted that within less than five years the aging process. there will be over a million new jobs where fulltime paid Ombudsmen will be working as red- The 1970 Census counts more than 20 million tape cutters in all kinds of fields such as govern- people over 65 in the United States-11.6 women ment, housing, education,dentistry,medicine, and 8.4 million men and the number of older transportation, even fortourists.Perhapssix .women as compared to older ram has increased hundred thousand education ombudsmen will be steadily: 139 women per 100 men in 1970, com- cutting red tape in schools, at least one student, pared to 120 women per 100 men ten years one parent and one 'teacher ombudsman trained before. for each school. -Because men generally die earlier than women A poll of principals and superintendents of in America, more women are left alone with the schools in April of 1970 indicated that 51 per- complex problems of aging, complicated by'real- cent wanted a state education ombudsman im- istic fears of a changing world beset with differ- mediately. Three out of ten educational adminis-

82 trators in that poll, admitted they had never heard they will pay a 221/2 percent increase inrent. of an ombudsman. When briefed, two-thirds of This year's Social S:curity increase has been this latter group wanteda state education om- turned over to the landlords. budsman immediately. A massive Federal rent subsidyprogram must be endorsed by this White House Conference and passed by Congress. Alice M. Brophy, Director, In New York City's half-fare transitprogram New York City Office for the Aging for the elderly over 600,000 older New Yorkers New York, New York signed up for theirpasses, 50 percent "get around more," and 67 percent plan their dayto travel New York City has the larger: concentration in nonrush hours when the fare is reduced. This of elderly in the country. One million residents, program means physical mobility and income 5 percent of Americans over 65, live inour five supplementation. boroughs. 25 percent of the Nation's elderly live below the poverty level, 50 percent ofour elderly But New York City is at the breaking point. subsist at that level: Most elderlyown their homes The program costs 15 million dollarsa year of mortgage free; 70 percent of our city's elderly city tax levy monies. Theremust be Federal sub- are renters without assets. They are poorer today sidies for operating expenses ofmass transit pro- because they have been poor all their lives. grams for senior citizens. Fifty percent of New York City'spoverty Ronald H. Wilson stricken elderly spend more than 35percent of Asbury Methodist Home for the Aged,Inc.. their income on rent. The .FederalGovernment Gaithersburg, Maryland has admitted to its responsibility fortenants in public housing whonow pay no more than 25 The American Protestant Hospital Association percent of their income for rent. urgesa11 White House Conferenceon the Aging Delegates to actively support efforts being madeto But our elderly live in the older rent-controlled obtain tax exemptions for all nonprofit homes for housing of the city without subsidy. Thisyear the aging.

Luncheon Programs November 29 and 30, December 1

Conference luncheonswere held for all Dele- chosen from Congressional Committees and Ex- gates on each of 3 days. Since no single hotel ecutive Departments dealing with problems of could accommodate the entire Delegate body, aging. the Sections were divided among four different hotels. The presiding officers of theluncheons were members of the National Planning Boardof Luncheons were held simultaneously for the the White House Conferenceon Aging. All in- groups meeting in each of the four hotels, with vocations were given by persons whowere Dele- one exception: on December 1, two groups of gates to the Conference. Sections were combined. The following programswere presented by At each luncheon therewere two speakers Section for the 3 days.

83 - . ,LUNCHEON ADDRESSES Before the Ifealthdtigoittei C 'Employment. eiti4TR1 ts'eeittetit LuhcheonProgiain Sections

for Sec:tit:0i - 'November 29 The flanoreiblerRniSeltLong HEALTHINCOMENUTRITION Committee tiwpwywNIittiRESENT 'I ,oi-,prc-otd- ,io -60here.-to- discuss= -with you Washington Hi1toñ Hotel: some of-T-the,majoi-legtilative,deVelciOtnentscon ceriting_,tbe eldetlk,-Ukhoyithat:y04,:areaware that the,COintitittee-on Ftnãnce has Monday, 14ailemlIft29 bilny in the :Se:hafe fora-large-shake-of the,legit- latiOn--,thWvoiy drectly effect:Or -elderlir

, First and foremost, the Social SecurityfOrnaiP OgNjAmiryCESenumn_ GER. filli'*ithin:the---jarojeijo,4the Conitnittee:on- Speakers :- Seitite-,FinanCe_Ortiriitiee_ Finance, and o er theyears I thinicji:4 'fair, to- THE-- HONORABLE ,*_;fthar=,the'Ctirnntittee:has-'beekinsi:djiigeririn-_ USSE-4_ 0.40Ne.. making heoleirimprovements :;_ in Ate-.;soCiali:Seettr- tHE:HoNORABLE ityjpingtaiii. The Coriibined-at icitt-tiie;boatd-berie= tiVALLACE:FAEIsiNETi; fit- increases- in7197-67iild i97,11faVe -totaled: 27½ percent. eSday, November 36 We now have pending_ inthe Committee on Finance a major SocialSecurity bill that has 'siding:MR. ROBERT TAicgoeirn -p*e_d-Ahe-.1ion§e-ot_ReprOsentatives-Afid:onwhich irivoCation: 'MRS.EDITH WALSH we plan to move just as soonat.-aetion,on the 'Speakers: THE HONORABLE Presidents -tax bill has been completed:,In. fact, JANIES'a-HancSbig most of the provisions of this -billwould have Secretary of Libor been signed'intolaw.ayear_agolf,it had not been THE' HONORABLE foi the.contioVertial- and,in My_ opinion; ill= RO_BERT M.-BALL advised:welfare expansion-proposed_ by the PieSi= Cornmistiantr of Social Security -dent. Here are :sortie of the featuresof the House bill: Wednesday,. December 1: provides a fivepercent across-the-board ifriresidinge WS. MARGUERITE STITT CHURCH Social Security increase witha $74 minimum DR. BENJAMIN E. MAYS benefit.. Speakers: Senate Special Committeeon Aging It provides a specialminimum benefit for 4 king-term low-wage workers THE HONORABLE equal to $5 FRANK CHURCH' for each year of covered'employment up to 30 years. THE HONORABLE HIRAM L FONG It would provide forautomatic benefit in- cteaseS as the cost of living riSesif the Con- gress fails to act. I, might mentionthat the Congress over theyears has increased benefits by more than theincrease in the cost of 84 .

.living,,- but_ this..ptOvi*iii,Would, -ptcivide_an *Ready approved- an- ainendthent.-to:- raise, the additional -rneatUre-olseCurity-fOtthefuture Sotial";Settrity-eainingi $2;400,--a . .7r.--kiviclOW's- benefits sr-would ; be -..eated, froth; rather than-, the $2,000 in the Honse, bill, 821/2-16-10 *Cent; of her deCiasedl---Inis-- and I- detec!elebriinel# Senate to raise : the -banclia- _benefit. This-provision :$2;4Q0-- figure. AyolL.the -fiVe.pertrent-,hetwOifikreak Of:Sentibri prehabIY-Wish-;io'in04.te provide a-21' percentincrease for iliote-thaii---the 'five percentin the . , for = future,be _baiecrot_the-dinibinecu_eariiing.- of t46-eckoge*'thuit'bO"scen:-__iik husband-, and wife in the context of howw can py for the limit on taxable -Wageslot that. _ year. .,beriefirs.through increased taxes I think thisissue -'Añoilier tha jar provision Oen is-particularly criçical since there have been to disiegard three 400641-years Of j63ii- -6, newspapers abon,spine-ine* eirnini* -in- calcOatiag,. theaVetage-,*ages,- ideasAo,fiike Security/on.(a. completely on whiCh-.-b-enefitseate--;biSetr py as-you-go basis without buildthg up rese.ves acted, men will be-accOrded thesame-treat- -fot4nnite-13eneficiariet.:LhaVe_an,OPeri;initid:On .it7401,44)131*****- >this believe the_ Committeeon 'Fi=e Persons would be allowed any '$*4 43.0150P.V*.:e0' to disregard one carefully to eiisurè that additional year-Of lowearnings for each 15 we are not opporrunistKly years of employment iinclet,'_SOCiat:SOCOrityr fObblitg,,l_the:tnist to pay for ifn&ite:beitefitsjUSt for inad-ctilatingiaVetage_Wages Which-bone,. the.=§alte--,-=of..16Weting are base& Benefits forpersons --_ delaying retirement be- ineturn -tothe--area,1_4-: *elate. yood_ age _65 *Old increased ionepettent Welfare-has very controversial issue for each year peison-dia not receive bent, iii.--botti,:the.-..CountrY.-:ai*whOle.arideitie-Oinkie0 hetause he was voiking.. . tt particulat. -The- Administrationhas propose The Social Velfate,expaniOnjegislifion=iliat would . would be raised 41;680 to double:the:410_00p on Wel= With a -Jr .1;inefit for :each: 42- 000.0.04--, to Which_ te,

earned above 42,000.. _ wards able-bodied pOrt,iiiiS,::fot doing: nothingand then cuts their-nêfitif they work My position impottantpithisiOns O(the-billi*Ould is that we should ,tedUCe-the-waitiogperiod-fOudiiabilitybene- t1iiin who supports fits; extend Medicare to disabled Social Se- his children by **Jog,.even at -a :IOW: Wage rather -thair.the man Who_-deSertt 'r-iii.§--fainity curity -beneficiaries; and make number of -or- ne.Vet iitarcieSrthe:ddtko _of'-his-.Childten significant improvements 4;:bnitiistra, in the .tion: of the-Medicare piogratii. first place. This cOnuoVeitial, ptoblem the -Co- nunittee All in-,all, this adds upto $5.4 billion-in in, on -Finance will hive try-grapple-With early next year But there is -rid cOntiMietsy-Surroundingtthe creaserbenefits for 28 million-persOnt: in the 'first. year._ _ prOgratn.of aidto the aged, and I belieii,thit the 92nd : Congress will legislateto _guarantee "a pa, Let ine give youmy thoughts about what is tiOnal-minimum-inconie standard- for theaged. likely-to happen inthe -Sedate. Based' on-tny ex- Last yeat,- the Finance Committeeaccepted my perience, I would predict thatthe Senate will aniendment to guarantee move in the direction of raising benefits above a minimum intotiie of the for each individual 65-ears Or older, with House bill. For example, the Senatein the past has. taken the position a .$200 --guarantee_ foran -aged couple. This provi. that the Social sign was in last- years 'Social Security benefit should be $100. The Setirrity bill Which Senate has passed-the Senate by an-81to ,0 unanimous vote. 85 Unfoitunatery;the House, of _Representatives -more -and- improved benefits. AdMiniSttatiVe at,i- refused to even talk to'us.abone.thatibilrbecauSe tiOriS, taken, by the Department of Health, Eduta- it did not contain the Administration T Welfare ,tiOn; and.*elfatein the :past year or, so at our :expansion -- prograin farm' -lies' insistence-an& urging-. Seen! to be navinKackiir- =41e:404;i:64 it is enough: The Houk- bilLipassed=this year proVidestot..a. . guaranteed minimum intoMefot-the aged of -$130 Thejiresideries announcement that :Phase of for an individual and $195; for a cattPle incteaS, his economic plan would include tonitOlqof-health- Trig -within two years to $150 fOr-an individual care- coStS,is-also:_a;_gOod-,anct badly needed step, and- enapic..1;ini--Corifideht -thatithe bitt:aS?-61'noW these Phase II controls are little Senate *ill- sUpportthek ittore-thati;?papet ,tigers.Tho;:ave,.., no body and -they-have-no:Meaning.-Thededitatitin.witlyWhith. Tax legislation that -passed the Senate juSt. last tite-.Adininistration_aPproathes:thi*impOrtant,part: Week will provide _a _Significant -tmeasure of tax of its ;Phase tiitoiedL in %the- relief for those -persons-65, and over who p-a.Y- consumer's Jpocketbook. If itis successful, the staxe*. health care dollars of the aged will go further, if it s unsucessful, then perhaps it will belip to the the ;Senate bill.-WOUld,-intreaie the per- Congress to seek a way tostabilize healthcare sonal exemption in 1972 from $700 to $800 In tOStt:so addition, thc minimum standard deduction will be economic _ circumstances over (fideaiett:i0-i't91'2,-fiotti41;00(Y:(6-$006:::Paean_ elderly person,_ this means 4560:1eSS of *able intoifie, and fot _an eldeily Couple,.this: xñeâñs - $106 leis- of taxable- intoine. Oi-Obisoritble Wallace I3oinett- _ In another attiotv-the=Senateaddedlin S enerte_fiiiiinceoriztifitiee, ment to the tax bill to -ease. burden elderly low income persons- with :respect to the I certainly appreciate br. ,Flemming 's kintlr, in property taxes- on -their _residence or the. tentthey vitation-to visit with you-this afternoon andI,Shate- ;pay for living quarters: -my;:thOughtS concerning the activities of the Fi halite Cortnittee-4ith---respeet to improving the These actions, I believe, .demOnStrate acoñ- well-being and capacity for independent living of tinuing awareness in the Senate-of the -needs of -our Millions Of Older AtheritanS. the elderly. In own opinion, however, the most important -single need of the elderly is foi better -Of course, the Committee on Finante- share and less expensive healthcare than we have today. your interest and concern in matters of -it-Iconic It is a sad but true fact that the elderly Make maintenance and health andf-welfateas they affect greater use of our 'health facilities thanany Other ()Met peolpleA -Might add, parenthetically, as the segment of out population. It is-also sad but true senior Republican member ,of, the Banking and' thathealth care costs have: tigeti disproportionately currency ComMittee, I also am involved with the to other costs in this period- of inflation.. These question of housing- for the elderly. thing costs, coupled with the- decline- of earning Those of us who serve on the Committee on power of the elderly, as they reach tetirethent _age Finance are Confronted in the area of _Social Se- -and leave the work force catch them in a vicious curity with a somewhat unique situation in. devel- economic scissors grip from whith thereis no ()pingacceptable answers. to- what are Offen escape. highly-insistent and polititally-appealing calls for immediate broad-scale and definitive solution. We have been doing what we can in the Fi- nance Committee to stop abuses of the Medicare The Finance committee is unique(in that it and Medicaid programs so that we can conserve not Only approves and authorizes programs under important and badly needed dollars to pay for the Social Security Act, but it also has the respon-

86 / Sibilityr-of approving thetaitet:ttqUired to finance Sortie -Of -those_ amendments we developed, for new --programs and 'benefit, :chango.,_ Thar; my HR 17550 are major and have received a friearlsi,*'a heavy responsibility andone which relatively y gives an addect-dithentiOWtOour work in 'eviliat- minor, but they are important and 1- thought ing thelnerits.of iegitiatiYeproposalt. might call some of.theM to your attention today It:itnot'coldhlo-ociedat all fOt,,ine tixsay.that :Periodically, there. ,seems to be public outcry we have to look,at:the -price tag on aprOposal. over -COndirions_iii._dojno-hpmes and the need The needs of the aged-compete fOr--prioritt-with, to clean them up., tInfOrtntiately all too -often,_ other legitimate and-Worthwhile-,needt; -suchas afterr brief flurry of attiiiity, the matter dies -4tication,-ilotising; health, defense andLso, on down and the situatiOn is essentially as it ws Legislators,_an the one _hand,.- can be accused by before : The Tinante, Committee :belieVed; it .*cirtii. toinefo(7,;'nbrracing to respond in meeting a neea While,;to:deYeitip,,somehaticalmott sOfipolitiog On the other 41014; if ---theyvnte:_tomeet the need, -=-proviA*.io,riie- law withrespect to !Mir-Sing' others, will -contend that their ,rakes- homes In this regard, we approved an amend Creased'UnneCettark thelieve thatthe Finance _-,Ment,-WhiCh reqUire,,toblie disclosure of Committee, however, 1)4,- almost always any ,-.04Jstanii444cieneiei in a_ ;nursing home deVelop-2-_a:reasOnable-;balanCe-:betWeen- which, *ere: .teireai4. _duting,a- Medicare survey t4e, obvimoly---,deSitable:aticithe and' Y;There ithete':'defiCientietivefe, ,nOt,CdtreCted mtly, the Committee-CannOt-ibe=aCCUted,,Ofignor- within 90 days A you can appreciate, regular ing devoting titffitietit attentinrytb- Older and discloiure should serve to generate people: -At least six people on -ttaff Of the pressure within a community _' -for--Upgradifig -Of -Corilialiteet=intladiag all, or tare- in a deficient facility Along similar lines, we the bulk of -their time concerned withour -work voted-Tib establish as a-Federarcrime.the making on Medicare, Medicaid, Social Security Cash, bene- Or -inducing of a false-statement of Material,. fait fits and bid ageassistance..4 :kW- shortyears -*go Nvithreitiett:sto-=_4ie .conditions andoperation of =a we had only ,one - staff Merribet--devtiting.,jUSt part health facility- forpurposes of:teen-ring Medicare of hitiiinetb-all'Otthote iinpOrtanr_areaS. approval.

During recent years the-CO Minittee has,:been- We-,_aito; voted_to conform the 'bask Medicare deYotingiari inordinate amount of time and effort and -Mediatid-StandaratqOrL skilled nursing-- homes to the problems in the Medicare and MediCaid, and,,ektended-e4ic,_-ikiliiii. with_ theproVisorthat, ptogtams. Our -toncern. has been that =thosepro- if one program -establisheda higher standard grams be run with far 'greater_ efficiency, - , than theother;the ,higher standard would_apply economy and equity than has been Manifestel to =both. We approVed. another Medicaid amend- Please don't mistake my meaningMedicareis ment , designed' to virtually eliminate the problem here tO:tray. Our interest is-to inaniporate-Changes of retroactive denial ofcoverage for care in tieceitary-in enable it to do abettei"joil of:serving tended: Care_ facilities. Additionally;we further the people for whom it was Established. spelled out; in. no-_utiCertain terms, the Congres- As -you know; we have .deYeloped inany im- sionalAntetit- that every_ older patient ina -skilled provements iii Medicare-and-Medicaid whith were nursing home or mental hospital- must be the included -in last year's Social Security, bill, H.R. subject of regular; independent medical audit to 17550.- -At a result of the legislative 'logjamat atiure that he is receiving the right care in the the end-Of the last Congress, the Senate vertion- of righrplacat the right time. the bili4as not considered the House of Rep. We included' comparable independent auditre- resentatiVet. I am pleased, nonetheless, that the quirements with respect to patients in intermedi- House saw fit to take many of those Senate Fi- ate- care facilities. -Quite simply, the intent of the nande Committee amendments and incorporate Finance committee and the Senate is unmistak- them into H.R. 1, which isnow pending before ably dearolder people shOuld,not be ware- the Committee. housed and indiscriminately- placed in facilities;

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''",;;; " "4," 'o' theyinay. not be conveniently forgotten and kept enced-by the Medicare.prograM- in Colorado, ,ac- for years in -settings_ where "iliey inapprOpti- cording to my infOrrtiatiOn atelY treated. I hope the ,achninistrators-bf the grog-rains -.,nd the _facilities --get- the ithettage. To thy knowledge, _no, one hat:Indicated. that any of this -hard and tanttructive., effort has .re- A ,mast important amehdinent-z=atid5hOpefully. stiliedLin a deterioration in the quality of medical I Say, this with reasonable ModettyWatzthe,COM- Care. In fact; all of -tit can :agree that avoidance mittee,approval, as wellas that of thefulSenate; of unnecessary surgery obviously improves the of my amendment Which would establish 'Proiet- quality Of-cate. -siOnaVStandards Review -OrgattilatiOnt-through- SRO offers tremendous potentiaL :for getting, out the Cotintry a handle on the -Costs and riittality..00Care provided under Medicare and Medicaid : "Obviously, it will Under theaMenciment, organizations of physi have to be pragmatically, reipOnsihly and sensi ciatis*oulti- be responsible, on 0.-- fully accountable tiVekiMplementecr it-it is to .realiie:thai potential. basis, forevaluating, the -Medical, ,necessity of

care and services,-whether,the Cate ;prOViClect.meett, 'However,, with effective -retie*: MechanisMs. professional standards, _and, *here Medically-ap,, the Congress- can then consider,, with clett,',00F0= propriate, encouraging the attending _phySicianto hension :than at present, ,propOsaiT clesigneoi to ilselest-cottlymOdet sites of-treatment.. ,liberalize ; and expand. Medicare and Medicaid $0*§:- The- PSRO. ,amendm'ent WasAetignedto .fix responsibility With-physiCiantfor -comprehensive SettatOr'qx,ng., and -i=.ilicleect-, review Of all care and services providedto pa- teeshare a common -desire to establish reason able minimum income levels for the aged, blind tients under _Medicare and Medicaid; Itwas de- and disabled tinder welfare.and for those depend= signed to the :fragmented, piecemealin ent -upon Social z SetttritY. I',think our record is -effettiVei,:arbitiary and inequitable methodsbeing employed today. It was designed with -kafeguards clear in that regard and, for that -reason, will not stress out work to raise the Social tOProtect patientt and/practitiOnert and,to avoid pro fortnaleVietv. minimum henefitand to estoblith_minimitrivbene! fits under welfare for the -aged, blind and, dis- PrOperly, mOtivated_ and implemented,-psito abled: , . can work. For-example, in New Mexico, the New My_ concluding thoughts reflect, I suppOse, my Mexico 'Medical Foundation; composedOf huni Mormon -background when I .0ay, that in ourcom- dreds of practicing physicians,assumed -complete mon concern for the well being of older Amer- ietponsibility for ,comprehensivereview -of the icans we should seek to avoid usurping the role care-provided under Medicaid. Among theresults and responsibility of families. Obviously there thtit, far, of the active and Vigorous'-pingram in hive been changes in those relationships, and that State, ika finding that tome35-Tercent of the often they are non-existent, but, where they do elderlY in nursing hornet' in New.MeXicO did not exist, certainly we wouldnot want to do anything need institutionalcare. Additionally; they are turn- to impair the sense of family unity which common ing down, as medically unnecessary,a_ substantial concern and caring, brings;. Our society is more proportion of mittens by doctorsto do electiVe than sufficiently -fragmented today without fur- surgery. ther solidifying lines of demarkation between young, Old and middle-aged. In Colorado, where anotherPSRO-type organization was established, and tookover responsi- In this regard, with respect to the needs of bility- for Medicaid reviewat the beginning of older people, I think that the proper role of the this year, they have reduced theaverage length Congress and, in -fact, of all Americans should be of hospital stay bymore than one day and de- responsible, responsive, but not obsessive. creased hospital admissions by about10 percent. Thank you again for this opportunity to visit Similar beneficial results are also beingexperi- and good luck in your efforts.

90 November 30 What areithe Work -needs of the-older :perion? *ell, of course, :these needsvary with the indi- The lionorabkja;:oer 1.-Iodgion- vidual; with-the situation, and withage. It's diffi- Secretary of Labor cult- to Jurnp,them all in one bigcpot.Still, 1-think we can inakei few general Observations. Good afternoon, Delegates to the White House Pirst_we-shouldippreeiate that workmay often COnfetenecon. Aging. Mean something different to the .older,perSon--, -both something more and something lessthan On behalf Of the .-Adifilinstration; may I first to the-younger-one. express our appreciation : -for the .work you are doing to help us deire'-:)- a national-poliey,toward Some cornmori. worker- needs are not always Making, the -lives of -our older -peoplemore pro present among Older `-workersfor example,, the ductive to society_ and more perSOnally-retVarding.. need'to cleVelop', a skill, to ibnildi career, to feed One of the tests of '-any: SOeiety is how well it _a:groing family, ancl-to on Income, Of en'uise, is treats those whO-haVe:gest*h;old;i0 ith-Setviee,%On important to any worker: ,Butrincorrie for the this test ont,o*n.-sikiety- does not IlWayiget the older- worker may often be -needed is,,tnUch- to highest marks. Perhaps is .of y.our sustain -dignity as to Maintain- li,fing, standards;

cueions :here we Wil r be able _to ben*. So ,-psychological : rneeds MifSt, be coupled_ with recognition of .economic -need. The neat to be 'Let =Say, at :the- OutSet° I know it-is not 'un- JO be part of :something, to contribute common for :public officials, speaking :before -spe- something worthwhile, to .itay, in the lmain stream cial grotipS like- this one, to paint in _glOiVing psychological needs are -often part, of terms alt'fne measures they are _undertaking in the-,drivitieforce_; that keeps the older person _in their fields of interest It would be easy forme to the workfoice. -the$, Aotil&ticit--be ignived. do this._ I cOüld dwell at length upOnmy .OWO- Departnient's efforts to _abolish- job cliSerithitia- A second_-need--relates to- unernployinent prob- thin against older workerS.-I &nil& pointto the lems of the -older worker: While they may not more than- 0,000- compliance 'congaed' We = made be-broad, they ire,,in instances whérè'theexist, last year, with age discrithinatien barriers re- 'very-deep:We know geographic poked of severe moved-from 100,000 jobs I Could -talk. aboutour unemployment exist among older workers. We manpower--training prograMs and the know whole industries -pass from the scene, _leiy- lion We-are- spending thisyear on_ jó b _training ing a residue-qf stranded older-Ws:irked. *le know for thOse Whb are 45 and_over. I could note we job skills of some specific older occupational require that at least half of the participants-in-our groups have become dunnocied. And we know that -Operation 'Mainstream shall- be 45or Older. I when Older workers-do experience -a job-10- they could remind you we insist pee* over 45 -be Often have anicutely-serious-prObletn in- finding given special consideration in filling public jobs another job. Last fell., for- instance, even-though under the recent $1 billion Emergency -EniplOy- the- rate Of unemployment for the older worker ment Act., was quite low, the duration Of uneniployment for those who did lose their jobs was more than twice But this kind of self-congratulatory listingcon- the national average. Every plant closing we have tributes little. Whatever theprogram, whatever studied Yreveals thesame patternOlder =Workers the group being helped,we know the need al*ays are. the -ones who experience. serious _problems in seems to outrun available resources. So today I becoming re-employed. The_ pattern is evident. The would like to strikeout in another direction, one young move with job opportunity; the older that I think might bemore helpful. I would like worker often does not. Community and family to confine my discussion to the role of work in ties lessen geographic mobility. Reduced incentive filling some of the needs of theolder person. to acquire new 'Skills limits occupational mobility. And I would like to hazardan observation or two This shoüL be understood as fact rather than on strategy to realize these needs. merely deplored.

91 So=here we have .two major work -needsthe For the age group 1649. unemployment is 16.4 _psychological-_ needs that jobs' supply and-thespe- percent; for those age- 20-29, unemployment is cialized eMployability_ problems of those _older 72 percent; for those age 30-55, it is-3.6 percent;- Workers who find' themselves out -of jobs. These -for those 55 and over, it is 2.9 percent. are needs that differentiate the older from the yoUnger or even middy: -aged Worker: Not a strong argument -for giving extra atten- Now,, how do -we go about seeing that these tion to-theolder group, is it? And. yetto- the older needs are recognized arid, filled? Here tbelieVe a group-that knows full viell_inany of its members shift-in strategy might_help. often= hpve serious unemplOyment,problems, these I have spent a; lifetime 'in what_ I call the ovii-a/rtigureS proVide little comfort. "peOple businese=lhat is, dealing with-problems Now -look at figures ,for, the- two other grOups- of-people. A- compassionate person-Who deals with that Compete for attention., The ciirrentAinemploy= people problems cannot'but be touched and even -thent rate. for Blacks- and, other, minorities- is: 9.5 overwhelmed by the-ththet needs of the aging, in our society: So one who obSerVes,,ancl-works at :_perterit. ,And Tduring!thepast fear the: uneMploy- these problems- wants to make sure they are un- ment rate-for ouVietnaih_veterans have averaged derstood and presenter', in a way ,and,at a-,place 9,-PCkceiit; Where they. ,ate, apt to receive 'amount Sohere obserVe -what. can-13e -called' the- and kind' of attention they-4*i*. It my ith= -coniPetiii3;e_ dimension* of the problem._ In.terms -pretsiotr. this is not now being -clone as effectively of 'pteitiortiOns-,=the_ raditional measure--ofthe at,--it could be becauseshe speciat-needs of _older unemployment- probleth -in -this ilation=other. workers are not being pointed- up: Instead,- the gioupS have -an awesome competitive edge. Un, plight of the :Older worker -in general' has =teen' employment:rates:for- these groUpi are from three the.:foctis- of the attention. ThiS,pligbt, L believe,, to .fiVe times is ,great as-for- the-older age group. has -been well- drathatized-and _well. presented. But In- fact, theolder. -age group -figure -is only half a more sharply tailored- approach May now be the _national average. -more= Let's start with an examination of groups So if -the aging attempt =to compete for-atten- representing, the older worker are up-against when tion in Congress .on a traditional basis that is, they -attempt to get recognition-for' his _unernploy- on the amount of unemployment --they find ment problem in Federal legislation. They ate-tip' themselves *swimming upstreani againsta strong againsi,two major things. First, limited resources current. But here it is important to understand =unhappily-resources are always_ limited. Second, tht_ quantitative figutet tell a limited story. They they face strong competition for the -resources conceal-4-lot Of clikouragement, wasted talent, and that do exist. So when,one .attemptS to drar.)acize acute hunian misery. the unemployment ;problem of older workers in What then can be done? It seemsto me two the traditional sense=that is, in terms of the num- approaches should be emphasized. One of these ber -of proportion of his group- that,are unem- approaches is to emphasize the specialized needs ployedthere are some facts that make the effort that I have spoken of earlier. I suggest that those an uphill struggle. who champion the cause of the older worker shift Remember, I noted that many groups arecom- their sights somewhat frOm a generalizedconcern peting for whatever resourcesare available. Let's for levels of unemployment toa diffetent look-At the claims thatcan be made for some of a focuS concentrating on the special need of the these groups. Though thereare several, I will older worker who is 'withouta job and the com- touch on only three--theyoung, Blacks and panion psychological needs of the older worker. Other minorities, and veterans. First, let's lookat This may mean specialized help for unemploy- the young. Here are the mostrecent unemployment problems. And it may, mean specialized ment figuresthose supplied by the Bureau of kinds of manpower programs tomeet special job Labor -Statistics for October of thisyear. needs.

92 And, while we_ are talking about strategy, it needs. But I don't-want to leave you with -the May mean something else. It may mean more con- idea that you discontinue youreffOrts on the centration on the .local government- level than-in Fedeial level. Not- do I the past. want to-suggest that we lit-the Labor Department aren'tdeveloping_ some of our recipes In a-big country, Federal legislatorsare apt to to give the older worker a better break-in the future. concentrate on the big---picture. Special needs of special -groups, 'particularly needsthat' often vary One of these is our, SeniorCommunity Service Widely-by situation and.community, havedifficultS, Project involving a_$1.6milliOn _grant= to the Na, competing for attention. tional Council on the-Aging:We and the Council -have joined- in providing special_ This circumstance, work experience prompts me to wonder -about and training help the wisdom of promoting categorical- to hundreds of- a -specialgroup programs -- chronically unemployed older-workers:Though for the Older workerat the Federal level: Such theprograiv still -has nearly,a-year to run, we are progianis face the -most, demandingcompetition. about -i-aady-to, pronounte itto success. It will no from, other groups who_ contend :they-havea-_su- doubt be- continued- and it's;a good' candidate for periorehtim.. We-must recognize that work-needs expansion. for the agiag..differ by -age- -and" circumstance. Those WhO 'are-familiar witli-categorieal_:'funcling, Down in Abe -good .,city ofLotdsVille -we have knOW- how difficult itis to recognize -properly another_ fascinating_experimental- project under 'such -differences- in- Fed_ eral:ptogram way; Here the, Employment Service and-the,Senior tiOn. HouseA of toUiSville _provide-a- unique type of scrvice_to help- retirees set either fullor parttime, Thete- are clearly ,areasin -this Nation Where- jobs thiough needs' of older workers use of older Voiker volunteers. are preeminent-rural" These- Volunteers :are- used' to areasretirement communities; uncover suitable- job 'many suburbs, openings. EVen=at this- tidy -stage_Of_the effort we areasof declining induStriatemployment, etc.- If find a high:percentage_of more funds Were ayailable -with-localized -those seeking thii;terv- control ice are being 0144 in Obi.ACcordingly; -I am in these communities, -theneeds- Of the older directing expansion of the-program _by bringing worker- wouldno _doubt -get a- better bleak thin in representative older workerservice otganiza, they do now. For all its.t-orteomitigi, City Hall tionsAn -order to make is still _More accessible and use oftheir resources and -more attuned to _loCal know=how as wellas those of .the Employment needs -th-ari a &ant Federal bureaucracy.Until Service. now, hoWever, at City-Hall and otherlocalleVels a shOitage of funds has limited-theextent of help Then up in Minneapoliswe have something for needy-citizens. underway that reallyhas eiciting promise. Here the Department working with This conditionis, of course, what-president the State and the Minneapolis Aehabilitation-Center bas-developed Nixon -sought to remedy withhis revenue sharing concepta a comprehensive package coveringtraining, fort concept that permits local govern- all phases of service needed ments to respond to the needs of their by older workers own citi- who ire seeking _jobs. Thisapproach has worked zens without being constrained by theill-fitting regulations of a so favorably in Minnesota that I _havedirected it remote Federal agency. Certainly be.extended Ito eight other States the Manpower Revenue within sixty day's. Sharing bill proposed by If the program continuesits present promise, it the Administration would bea big step forward in will be extended nationwide. achieving this objective. Thus,as a matter of strategy, perhaps localgovernment levels should There-is a bundle of relatedsubjects that con- be the subject of increasedattention among older sume our interest down at the LaborDepartment. workers. New pension protection andliberalization measures, the popular Green Thumbprogram we run Well, I hilve offered thesesuggestions as: a with farm organizations, friend of the older workerand a student of his fascinating findings and developments with regard'to second careers for 93 Older workers, the additional funds we are devot- cent are getting monthly cash-benefits, will-be ing each year to manpower programs and how able to gekthem-when-ihey of their spouseszretire._ the amount of money available would, take a Moreover, almost all-of the 20 million are pro- quantum leap forward-under- the Administration's tected-by the hospital-insurance part of. the Medi- Manpower Revenue Sharing Billthese are-part care program, and about 191/2 'million have of a veritabIe laundry list of'items that-might be chosen the protection of the supplementary medi- of interest to this Conference. But I shalPhave to cal insurance-part -of the program. Medicare pay- forego .their discussion today. ments for hospital, and-doctors' care account for In closing, let, me say this. From a- study- of over -twe-thirds of expenditUris" fOr hospital and advance Conference reports, I notice, things' like doctors' -services that the aged receive. income, health, housing- and transportation= may- People sometimes forget -that Sociil Security rate-higher priority among -the interest -of the is not -just siletirement: 'program, but those of aging than-do problems of employment. We -in US who are parents and grandparents `ran appre- the Department of Labor, -however, :believe theeciate the important, tole this, program- plays in employment needs of-the older' workers are often the security of -young families, too. As you. may acute, that they -- deserve specialized- attentiOni =and recall, Wehave bn-Our.-benefit -tolls _persons-iYho that we should- play a role in :providing -that. are'- totally-disabled- at yOUnger ages and their de- We will continue -to do so. Thank you penilentl, and Surylvdn_of deceased' -workers very-much. widows witlizfeging-childret) and-young- people in school-all, of whith -add. up -tO. almost -another 10-million.benefi'ciaries. the Honorable Robert M Ball In short, the Social' eectirity program is, is President Nixon hat described- it, ran established Commissioner of Social Security and. Jnportarit American institution, a foundation On which-millions are able to build a more com- I, appreciate the opportunity to speak -(b- -you fortable life,than Wouldotheryzise beipossitsle toddy about the Social Security and Medicare pro- after -their retirement theeveriof- aisability grams, about their role in providing economic or deathof s'-)efattill, earner:" security, and about how we hope to further? improve these programs. Improverients Nied5d. ,%, . Social Security Today .The AdMinistration realized, though, that de- -spite the significant rOle-that. the-Social Security Since its modest beginning in 1935, the Social. and Medicare pi6grams play in providing eco, Security program has grown until today it pro- nornicsecurity- fsit.-: the aggd,the' potection vides retirement, survivors, and disabiik protec- afforded by -these:progiarns should be fuither im- tion for almost)all Americans, and health insur- prOved...And 1-, she Social Security and ance protection for nearly all those aged 65 and welfare-reform bill that passed the House Of ltep- over. The Social Security program touches the retehtatives last spring and isnow- pending the lives of practically 'everyone in the-Nation.-Over the -Senate, contains many recommendations of nine out of every ten people in paid' employment the PriSident designed- to naive. us significantly and self-employment are covered or eligible for closer to the",goal of providing economic Security coverage under the program. Almost 27 million in old age for all Americans., peopleone out of every eight Americansare receiving about $3 billion a month in benefits. H.R. -1 will bring Social Security benefits up to And 171/2 million of these benficiaries are our date with the increase in.:he -cost of living that -' senior citizens. has occurred since the last ger4ial benefit-.ircrease. H.R. 1 will make sure that benefits-stay up*toate Of the more than 20 million people in this with future increases in the cost,of living, thus Country who have reached aged 65, over 9Q- per- protecting beneficiaries against the ravages of, in-

94 nation. H.R. I will raise theamount of money levels than he would if he earned less.At present, that Social Security beneficiaries whowant to con- there isa -$1 reduction in benefits for ea:h $2 of tinue to be useful, productive members of society earnings from $1,680 to $2,880, anda $1 reduc- and are able to do socan earn before having any tion in benefits for earnings above $2880. Under. of their social security benefits withheldand will' H.R. 1, only SI in ben_ its would be withheld for remove from the law the disincentives to work each $2 Of earnings above $2,000 regardless of that now. ow exist under the present earnings test. how high the earnings might be;there is no SI And H.R. I will increase and improve the pro- for $1 reduction atany point. Thus, it will always tection afforded by the Social Securityprogram be advantageous for people whocan to work and in a number of other ways. earn more. Increased benefits for some 31/2 million aged Cash Benefit Changes under 1 widows are provided by the bill. Underpresent The most important of the changes which law, an aged wdow's- benefit is equalto 821/2 H.R. 1 would make in the Social Security cash percent of the benefit that her husband would benefits program is the provision -for automatic have received=starting at age 65. Under the= bill adjustment of Social Security benefits whenever a person who- becomes widowed after age 65 the cost of living rises byat least 3 perce / in a would get,benefit equal -to what her husband year. This would make benefits "inflation proof" would be getting if hewere still living. by assuring that they willat least be- kept abreast The method of computing retirement benefits of increases-in thecost of iiving. While benefit for men would be changedto make it the same increases legislated by Congressover the years as that- for women. This change will -allow men have more than kept benefitsup to date with in- to drop out of their benefit computation three creases in prices when measured against the level additional years of low musings, and willen- of benefits setmany years ago, time-lags have able men retiring in the futureto get higher frequently occurred during which the purchasing benefits. power of a person's Social Secuiity benefits have Higher benefits would be provided for many" been seriously eroded. And, ofcourse, later ad- long-term, low-paid workers. Low-income workers justment in benefits can't makeup for the depriva- who have worked formany years under Social tion that people have suffered during thetime the Security would be eligible fora special minimum benefits were inadequate. The automaticadjust- benefit equal to $5 multiplied by the number of ment provision would assure that long lags be- years under social security, up to a maximum of tween price increases and benefit increases will 30 years, providing them witha special minimum not occur as they sometimes have in thepast. benefit of up to $150 a month. Before the automatic adjustment provisiongoes As a result of all of the H.R. I changes in the into effect, benefits would be increasedacross the cash benefits program, average cash benefits will board by five percent effective withbenefits for increase significantly. The average monthly cash June 1972. This increase ison top of the ten benefit for all old-age beneficiaries will increase percent general benefit increase thatwas effective from $131 to $142; for aged couples the increase for January 1971, and the 15percent increase will be from $222 to $234; for aged widows, that was effective for January 1970,and will average monthly benefits will go up from $114 mean chat for June 1972 benefits will beone- to $133. The automatic adjustment provision third higher than theywere for January 1970, will, of course, increase these benefitsmore in just 21/2 years earlier. the future as prices rise. Concerning the provision of the law knownas the retirement test, it is possible under thepresent Medicare Changes under H.R. 1 provision for a personto actually have less in- Health insurance protection under Medicare come (that is, Social Security benefits plusearn- both hospital insurance and supplementary medi- ings after taxes) if he worksat certain earnings cal insurancewould be extendedto persons en-

95 titled to monthly cash benefits under the social their -Medicare approval terminated because they Security-and railroad retirement programs because failed to meet health and safety standards, and they are disabled after they hive -been entitled-to iinanY` More have voluntarily dropped out-of -the disability- benefits; for at least 2 years. If enacted, program when they were -unable to. meet the this-,provision would- make about 1.-5 million .dis=. standards. abled- beneficiaries eligible for hospital benefits and physician coverage .undet Medicare: This is While many nursing hothes do provide-out-. a'-sigtiificant-provisiOn for older _peOple for al- standing- care to our older citizens, we are all thoigh social security disability beneficiariesare aware that some do not. At this- moment, the under age 65, alinost twothirds of them are over- Administration is engaged- in many- activities. that -age 50. will' help- assUre:thatnurSing home- Care provided to the _aged is unproved. TheSe activities- take there are othei -important provisions in H.R. Many :forms; _including :better -enforcement of that would =make a number of..Chariges Standards for 'participation ,in'Federal programs; Cite, _intluding-many- Which_ would- 'improve the improving: the training and professional tthupe- operating effectiveness of the 05grani. There is iente-OCthese- engaged in seeing ,that -,stanClards not enough -tithe for =me to discuSs these, thanges are -Met;-;inCreaseillimcling of:State,:health depart- -here, except to mention-' briefly; that -the .Adinitv. inept services. tonnected, -With.,ithproVennerit of *racier' is counting on one fprOisicinthAf Whieh nursing home-facilities, terminatingt the :pat:tiCi:- would- encourage. theeXpanSion arid 1-USe- of -health pitiOn, 'Federal .programs of _nursing maintenance rganiiationt=to -help _control 'the- that fail- to-meet standards: and regular -reviews- :demand for health services and- support the best Of State =health- department 'profeisional certifica- =Use Of theirsUpply. tions of nursing -hones. .As --many of you are aware, one of, the princi- -pal-desires of -the-President -is to improve cOndi,, Secretary- Richardson recently designated So- tiOns- in nursing homes, where Over 900,00 cial Security, district offices; WhiCh- are in 850- Americans over 65 live, -and.sto -help assure that communities throughout the country;_ to serve as nursing -home patients ate treated ivith-dignityand local "nursing home listening posts." _People- who consideration: The MediCare -prOgrirn -has done-, have: information- -about instances- of odor -.quality Muth to help achieve these-goals. Since Meditare care, neglect; unsanitary or. unsafe Conditions- in -began, almoSt 100 million days of-care in ex- a purSing -hothecairgiVe this- information to ,their tended care _facilities=mniing homes whichpro- locaLSoCial Security office on a-Confidential basis vide skilled nursingcare to- Medicare beneficiaries and the-Social 'SeCwity office will see that the who no longer need intensiyehotpiral care--haVe complaint 'gets to the 'proper Federal, State, or :been:paid for under the-rograiii. Thequality of local authority for investigation. thiicarehasbeen upgradedunderFederal standards and Federal-State inspection procedures One very-important provision of H.R. 1 which that are unparalleled in the nursing home field-. will benefit the aged concerns those who are receiving institutional care that is not at the Over the last 12 months alone, more than skilled nursing care level. This type Of care is 4,000 surveys of nursing homeswere made to now provided in several thousand "intermediate determine whether these homesmeet Medicare care faeilitieS." -There are, however, no uniform standards. One result of thesesurveys, and the national standards of quality of care and safety 8,000 visits made to nursing _homes during that for these facilities and no assurance- that thelevel time to assist them in correcting deficiencies, has of care and the conditions under which it is pro- been that many hundreds-of nursing homes have vided are of. the highest postible quality. Under improved their services and corrected their de- H.R. 1, these institutions would for the first time ficiencies so as to be able to continueto partici- be required to meet prescribed Federal standards pate- in the Medicare program. Since Medicare related to quality of care and the safety of the began; about 100 extendedcare facilities have had institution.

96 Welfare - Reform Proposals Affecting the Aged grams AO place liens on homes as a condition of eligibility for assistance. In addition to provisions for improvements in _

SocialSecurity,_411._ 1 also provides for a major. _An older person's or couple's eligibility for new approach to public assistancefor older assistance under the new program will be deter- people. H.R. 1 would replace the State-adthin- mined on the batisnlhis or-their own need with- istered programs of assistanceto the aged, the out regard -to the income or assets of relatives. blind, and; the disabled with anew national pro- Relative4esponsibility rules will not be a part of gram financed by the 'Federal GovernMent and the new program for--,the aged. People will ntirbe administered br the Social Security Administra- disqualified or have their assistance payments re- tion. duced -because of the income or assets of their relatives. The-new program represents.a watershed point in the-hiStory of public Welfare in this country. Conclusion Eligibilityrequirehientswouldbeuniform the-country and adininistration,hy-the Too -often our seniorcitizens have the right Social, SectritY Administration;. -Would-beton= to feelthat--they=are the fOrgotten;.SegmentTof sistenr nation Wide._ The new prograin when_ fully oiff _society Ve are on the move to correct the effective, will help= abouti-21/2 1timeSaS iinanrolder situations., that- lead to thiSi feeling. For tilt people as now receive- assistance under present more adeqUate'Soeial_SeCuritYbenefitS-Avill-beTprO- prograMS, and older people will he-able-to,have Vided- and those benefi is:- Will- -be made --inflation- one-stop service in their quest-for economic secur- proof. As a _reshlt_of =a- variety of ilistini- ity, applying for both Social Security and supple, tiotial care for the Aged- is _being iniproVed and mentarypublie assistance at thesame time. H.R.1 will bring for the first time the -great bulk of nursing homes under Federal standards. In- The new Federal-program, when fully effective centiVes-to work and continue to be active will be (July 1974 under H.R. 1), would provide assist- greatly improved under pending legislation. And, ance standards Of $150a month for aged, blind, finally, through the Welfare reform proposalsa or diSabled individuals-- and $200 A_ month for new program of national assistance will be ad- couples. These Federal payment standardsare Ministered as a supplement to Social Security higher than the corresponding standards inover benefits with the goal of making sure thatno half of the States. These standards establishas a older person has to live in thil land of abundance goal of the program a situation in -whichno below the level of minimum poverty established older person- will need to liveon income that is. by the Government. below the poverty level.. But obviously a floor of protecticrti against dire States --may establish a higher standard than the poverty is not enough. Through Social Security fiederal :assistance standard if theychoose to do and the improvement of private pension plans and so in their State and pay the difference in colt. the opportunity to work we mustmove forWard Under such circumstances, theprogram couldto the goal of adequateincome for all. still be administered in that 'State by the' Social:-, Security Administration as a singleprogram. Under the new program, people will qualify if they have assets that donot exceed $1,500, but. December 1 the home, household goods and personal effects will not be counted within. the $1,500 limitation. The Honorable Hiram L. Fong Face value of life insurance ofup to $1,500 per Senate Special Committee on Aging person will also be excluded iin counting resources. Resource limitations are much lower than this in May I extend to each and" every one ofyou the the preSent assistanceprograms of some States, warmest greeting I know: Aloha! and it has been a common practice in Statepro- Aloha is that endearing word meaningso very

97 much...love...friendship...brotherhood decades of this century must offer opporunity in all the feelings of goodwill which we cherish and age. which we want to dominate this White House I hope Delegates -to this Conference will unite Conference. in saying, "America, hold. open the doors of op- Speaking of dominating, when I. received the portunity in age." letter giving details on this luncheon, I noticed The record is clear. More and more older Amer- that thename of Church dominates the occasion Mrs. Marguerite church, former CorigresS icans have greater capacity for involvement in life's affairs. Their children have left the nest, woman from Illinois, is presiding and' my_ .col- and the -parents- are free to follow new pursuits. league, _Senator Church, is one of the speakers. I Thanks to-medical and scientific advances, people began to wonder how a fellow .named Tong -was are -living longer and are . healthier. Their desire invited to attend! to,enjoy life, to serve their .ifellow man, and to Whatever -our -narneS, we are all engaged in a be a vital part of society'st Mainstream grows common Cause. (Or, a ;group of Americans- for apace. whom we share a common concern, our aging Where _in' the past we counted our _elders in brethren. teni..of thouSands,;..we-fiow---haVe....unllioris. Let 'us May- I take-'this= Otcation.-05-:cominend -all- of make :sure 'that:: all enjoy -the benefits, the oppor= yOU-_'for your yeoman --work on -theSe concerns tithitieS, and hope of ,age. which :fated' the 1971 White House -- Conference Henry- Wadsworth Longfellow_ well under= on_ Aging. YOU are making history" -here, arid' I stood the values Of ;age. After reminding us that know this will lead- to _Mr-titer progress for our the Greek dramatist; Sophodes, wrote his great Nation. play, "Oedipus", after 80; that Germany's giant, It is an honor and a great pleasure to break Goeth, coinpleted "Faust" after four score years, bread with you today- and to share the speakers' and that England's ,thaucer wrote "The Canter- platform -with the distinguished Chairman of the bury Tales" at 60, Lon-t--- said: Senate Special Committee on -Aging, Senator For age is opportunity no less Church of Idaho. Than youth itself, though in another dreis, Although he is the youngest member of Our And as the evening twilight- fades away, Committeeyoungest in years, but-long in serv- The sky is filled with stars invisible by day. ice-- Senator Church haS earned- his spurs. as Longfellow's contemporary, Dr. Oliver Wen- Chairman by reason of his deep empathy for dell Holmes, -reemphasized by deed Longfellow's America's, 20 million older Americans. He shares point that age can be opportunity. His famous With all-members of the-Committee-a strong com- "Over the Teacups ", written at 80, showed no mitment to improving the future of our Nation's reduction in wit and no-flagging of spirit. older generations. His son, Oliver Wendell Holmes, Jr., made You know, the Chinese have a saying, "one great contributions until he was -over 90. His kind of rice, a thousand kinds of people." In distinguished service of over -30 years on the other words, we all eat the same ricer. but we're Supreme Court began when he was 61. all different. So it is with our older population. History is replete with magnificent contribu- They are all aging, but they have different needs, tions by persons in their seventies and eighties. different' problems, different aspirations. Michelangelo was at work on The Last Judg- But no matter what their individual needs or ment", Rome's most famous painting, after 80. their individual problems or their individual as- Others who made great contributions late in life pirations, I believe all want opportunity, all want were Benjamin Franklin during the American hope. revolutionary period, and more recently in the field -of science, George Washington Carver and I believe it is imperative that the last three Thomas A. Edison.

98 A list of political powers in our time addsto you wonder why the only woman I mention is the testimony of values in age. Churchill's whole Grandma Moses, it is out of deferenceto the eter- place of historical greatness was earned after 65. nal-right of the ladies to "keep theirages to theM- To his name must be added De Gaulle, whose selves. When-Grandma Moses passed hercentury eleven years'of rule in France ended at 78;'Chiahg mark; of course, different, rules applied. Kai-Sbek who still prevails at 84; Adenauer, who stepped down as head of Germany'sgovernment Nor isfame. really important. Thousands, at 87. hundreds of thousands, of older Americans in the+4 quiet pursuit of their daily lives demonstrate that In our-ownUnited States Senate, Senator Allen "Age is opportunity no less:" Ellender, Chairman of the Appropriations Com- mittee, was 81 in September and he'S still going The dream we have for all older Americans is strong! Senator _Strom ThurMond, incidentally, such a dream Of opportunity=one- in which, as married his beauty- queen bride two yearsago Longfellow says, "the sky is filted With-stars." when-he was 66 years_ young. The_ record .shoWS -What:older persons CANdo Other 'famous persons offer _similar- 'stories of if ,given, a -chance. isnt, as you ,know; formany vigor and: -Vitality- in age. The peerless;, pianist, older- Americans. thererio opportunity: Art& kubinitein; still- enthralls- atidieheeS in the concertha_ll-,today at 82. Picasso ,reigns -over -the You do -not: have to _be reminded that too often world Of art- at 90. The recently deceased "Rube incom opportunities for older_ persons; are-_totally Goldberg -retired from creatingcartoons only to inadequate. pursue a Seeond- career of distinction as a serious sculptor at a level Which may bring _him even You do not have to be reminded of the short- more laSting fame. Nor should-we fail to mention comings in our health services for the elderly. a member of this Conference's planning' beard, You do not have to be told that jobsare fore- Mr. Edward K. Ellington. Now 72; it seems that closed- because of age....and doors are shut on the incomparable Duke just on and on bring- ingjoy and happiness to vigorous, capable, willing older Americans whoi millions- of people Want to ,participate in family, community -arid' throughout the world by hiS great music. national life: Clinton Rickard, a lifetime Grand President Too often society says, indeed of the Indian Defense Leagne, Of America, even the family was too often says, "You old folks are through. You still chief,,of the Tuscarora nation when he died a few weeks ago at the age of 89. He worked have had- your day. You belongon the shelf." many years building understanding and com- Over 20 million older Americans know thisto munication between people, on both sides, of the be a great lie. They know that they have capaci- Canadian-United States-border. When he died, he ties, appetites, and-a zest for, living whicha decent was taping and recording the Tuscarora language national conscience insists musi i.:emet. so his people would retain this part of their heritage. It is time you and I, and all citizens ofour Nation, face up to our responsibilities in seeing A. Philip Randolph, past 80, is the elder that these legitimate demandsare met. Govern- statesman of Negro labor leaders. At 74, he was ment alone cannot do the job. one of the organizers and leaders of the famous 1963 March on Washington. Together, we must do everythingnecessary to see that this 20th Century age of opportunity in Many of our distinguished elders have been which we live offers full opportunity inage. famous throughout their lives. But forothers, such as Grandma Moses, famecomes only for This is what the work of the Senate Special work they have done late in life. Incidentally, if Committee on Aging is all about.

99 This is what this White House Conference on Only so, can we be sure that for all older Aging is all about. Americans, "Age,is opportunity no less than youth itself, though in another dress." You have labored long and strenuously toward. The lives of all older Americans should be this grand objective. You have worked in the such that "The sky is filled with stars." communities, in State conferences, and now are nearing completion of your immediate efforts at Thank you, my friends, and aloha. this Conference in the Nation's Capital.

I have confidence that your labor will make The Honorable Frank Cburcb great contributions to the new era of aging, which Senate Special. Committee on Aging scientific and social progress in this century has opened to millions of Americans. Soine of you here today may remember what John F. Fogarty said just before the 1961 White I trust that your section reports, will empha- House Conference: size, in their _several- ways, :that:thit age of oppor-. tunity niust offe full opportunity older Even though it was his legislation that called ple=- full opportunity in age. for the "Conference, CongteiSman Fogarty. was worried. Opportunity .for decent incomes; opportunity for necessary health services; opportunity for ade- What good would the Conference be, he asked, quate housing; opportunity for satisfying, readily if it resulted in little more than an increase in accessible recreation in leisure hours; Opportunity the output of words? for mobilityand no one doubts the iinpottance of better transportation to eliminate isolation and Well, you already are inundated with words. loneliness; opportunity' for learningso that all I understand many of you have just come from who wish may expand their own personal hori- 16 different Special Concerns Sessions where zons; opportunity for second that can Mean for four hoursyou tackled problems as varied so much; opportunity for social interchange, for as long-term care, the elderly blind, minority enriched participation in community activities, group needs, and consumer interests. for involvement in life's mainstream. I have more words for you, but only 15 minutes Just give our millions of older Americans their worth. The planners of this particular part of the full measure of opportunity and, with their wealth Conference must have sensed that this would be of experience, know-how, and talent, watch them a good dme for a short talk. rise to new heights of achievement, success and service!- And this is good because it encourages me to line up my thoughts and to choose those key facts How to open the doors of opportunitythis that may fit in here just before you write your is the question with which you are grappling. recommendations. What, then, is my major message today? I At this time, I would not presume to spell out think it can be summed up very readily. my own specific ideas. Instead, I await with deep interest your recommendations, and with them no To put it bluntly, I think we are falling behind doubt I shall modify at least some of my proposals not advancing at allin our national effort to in behalf of older Americans. assure genuine security and fulfillment in retirement. In the meantime, let us pledge to work together and persevere together to the goals we hold dear. That may be a shocking statement, but it is

100 based u;-- a hard facts of today and foreseeable for such a low base on whichto build the esca- facts of the future. lator. My first hard fact is that the Congress has had . 'My own personal goal is to end poveryamong to fight Pill year to prevent a retreat in key areas older- Americans. And I have sponsoreda pro-- related to aging. When the Administration sub- posal calling for the use of the 'Social Security mitted a budget request for the Older Americans system as the elevator for lifting nearly five mil- Act that was actually lower than for the previous lion elderly persont-out ofpoverty. No old-age re- year, members of the 'COmmittee on Aging-7 tirement-is worthy of thename, which leaves Republicans and Democrati aliketookup the fullY a fourth of the elderly on incomes below the fight, restored' the proposed cuts, and actually in- gOyernment's owpoverty line! creased the appropriation to almost 45 million dollars.' I've described_ just a few conflicts between. Congress _and the ExeCutiVe Branch Lest you-think- that I regaid that sum as lush not in the name of partisanship-7butto help explain -why. I largesse,--however, let me remind you that itieless think our present _national-effort is lagging. I than hallas much as:we'll Contribute year to believe that the :tecont the Gieek Army. It is a. gfeit deaFleat,than:juit recent' AdminiStra- tiOns-7-deSPite Medicare and -the Older 'Americans the flight dedt -Of that billion dollir -aircraft -Cat- _Act--,:faileds. to go -far enough andmust -shtie rier the-Pentagon isttalkitigabout. _ their; part of the responsibility for -today's inade- Once the budget for the AoA had been settled, quaciei. The time 4.ripe, for coalition action 'by my COnitnittee and Tom Eagleton's ,Subcornniittet members of both .partiti dlitingithelO's. On that on Aging,. conducted hearings on the conduct of point, I. might refer you to-the minority viewsex- this White House ConferenCe. I'M happy to report pressed in our latest pre-White House Conference that hearings do have an effect: just a few days report and in our most recent annual report. On before the first one, Arthur Fleinmingwas ap- all-key pointi, as .tenatbaong has toldyou, there pointed fulltime chairman of this Conference, and is fundamental agreement on goals. When it later Secretary Richardson reversed his policyon cornet to aging, there is really no room- for°a abandonment of motethan 20 nutrition programs. "game:plan" based upon shortrangepolitical. tac- But the biggest dividend of those hearingswas tics Seeking' narrow partisan advantage. good, honest analysis of the impossible position of the AoA as it now stands. I appointedan Ad- It's already !nuch too lateto play games, or to visory Council to make proposals for improving stall, or to explain why thisor that hasn't been the AoA or replacing it, when the present law doneor cantcantt'be done--,--for older Americansto- expires. day and tomorrow. Congress and the Administration have had I mentioned hard facts before. Letme give you other disagreements on aging in the lastyear or more now so. Our Nation, in the Older Americans Act of On Capitol Hill, for example,many of us 1965, said that one of its goalswas an adequate agree on the need for a, cost-of-living adjustment income for the elderly. And yet in thepast two mechanism for Social Security, butwe can't see years, 100,000 more elderly persons -throughout why the Administration has been.willingto settle this land slipped below thepoverty level. One out of four potionspast age 65 is poor. Our Nation, in the Housing Act of 1968, made 1 1971 FY Funding; $32 million;for FY 1972 initial Administration, request$29.5million, amendedto$39.5 proud statements about good shelter for all Amer- millicn; final FY 1972 appropriation $44.75 million. icans within a very few Note to footnote. Two days after Senator Church delivered years. And yet, as far as his speech, the Senate added an additional $55million supple. the elderly are concerned, there is amplereason mental to bring the final FY 1972 budgetto $100 million. to fear that we are falling behind. The 'Commit-

101 tee estimates that 6 million older. Americans Jive they merely stall action, add only deception toin unsatisfactory quarters. Only about 350,000 despair. But when it comes to. aging, I_ think we Federally-supported units have been built in the have passed befond, either deception or despair., z, last 10 years. How do we catch up? And what do . we do about property tax increases that are driv- I mentioned before "that" I: believe that coali- ing many elderly honieowners to despair? tions for action are essential during the 1970's.

Our Nation, in the Employment Act of 1946, What I mean is that Republicans and Demo- declared that it would no longer tolerate wide- crats alike should, use the momentum of an elec- spread joblessness. And yet today, at this very tion. year to make certain that the recomnienda- moment, among the millions of Americans now dons of this Conference are implemented-in the without work are 1 million ,persons past age 45; early part of the 1970's. the so-called "older workers." Their unemployment will be far longer than for younger persons. What I mean, too, is that we should be un- Their pension benefits and Social Security' of the afraid to question even: our most .self-satisfied future will be far less than might have been: The assumptions, ranging fak---beyond the fielcts- of the ComMittee tayi .that a- new :generation of elderly -aging; far beyond even' such questions as new pootmay-be in the making. What do we do about -directions for Social Security, new- ways,of provia-, them? ing and paying for health care, and other- such vital policy matters. Our Nation, in passing Medicare, pledged itself to adequate medical treatment for the elderly. What I mean, fundamentally, is that this Na- And yet, within the past two years, Medicare is don is ready to question and discard many sacred costing more and providing less. Cost control is cows that have already lived too long. one thing, but widespread abandonmbnt of responsibility is another. Here again, we are losing We have questioned a foolish, futile war, and ground. though its termination is slow, it is now inevitable. As fOr transportation, in rural and urban America alike, it is becoming harder, instead of A few weeks ago,.theSenate questioned easier, to get from one place to another: whether foreign aid is really serving our Nation and others in the ways that it should, and we have Consider the trend. It is backward, not forward. gone back to the drawing -boards in march of Andifour overallnationaleffortisbeing needed change. swamped by the needs of today, consider what is in store for us in the years ahead. 'We are questioning our attitudes toward racial minorities and we are finding much to question Between now and the turn of the century in our use of our land, our water, and our air. just 29 years awaybetween 45 and 50 million of today's middle-aged persons will enter the 65 Now we must ask questions about the very years-and-up age bracket. Think of that: tens of health of our Nation and the well-being of. each millions of persons entering a retirement way of and every citizen of our laid. life which is already strained for most and bitter for many. Our treaunen: of the elderly certainly tells us. whether we are sound or sick as a Nation. if. we--0 Will today's failures be deepened, or will the are indifferent toward the last years of life, we pressures of sheer numbers and sheer need finally diminish the dreams of all, our people. force adequate response? So let us respond to the dynamics of this Con: I think you know my answer to that question. ference and to the needs,opes, and just demands Despair never solved anything. Game plans, if of those who built this country; her senior citizens.

102 LUNCHEON ADDRESSES Before the Training Education, Luncheon Prograin Housing and Planning Sections for Sections on TRAININGEDUCATION Midnday, November 291 HOUSING--PLANNING The Honorable Jacob K. Javits Sheraton Park Hotel. Member, U.S. Senate Labor and Public Welfare Committee Monday, November 29

Presiding: MRS: CERNORIA JOHNSON There are now approximately 26 million people Invocation: THE REVEREND KIRK M. DEWEY 65 years of age and over in thiscountry. A quarter of these. Americans live below the,poverty level; SPeakeri: Senate Labor 'and 'Public .many do not become poor- untl they reach old Welfare Committee age. . THE 'HONORABLE JACOB K jams Because of this circumstance, the United States is rapidly appMaching a critical juncture in itsex- THE HONORABLE perience with provisions of income,assurance to THOMAS F. EAGLETON the aged. Some of the accepted principles that heretofore have governed the design of Social Security and private pension programsare now Tuesday, November 30 under serious attack. ML THOMAS E. FIELDER The underlying problemassuring adequate Invocation:RABBI IRVING LEHRMAN income for the agedis notew; not is the United States alone in experiencing increased pressures Speakers: THE HONORABLE for adopting more effective strategies ELLIOT L RICHARDSON, to deal with Secretary of Health, the issue. In recent years, Belgium, Canada, Great Education, and Welfare Britain, Germany and Switzerlandtoname a fewhave, been compelled to reexamine the ade- THE HONORABLE quacy of 'theirretirement systems. Still other GEORGE ROMNEY, countriesnotably Francehave succeeded in Secretary of Housing and fashioning an elaborate and sophisticated integra- Urban Development tion of public and private retirementsystems so as to insure an adequate old-age income. for its workers. Wednesday, Dicember 1 Foreign models and proposals for changevary The Training, Education, Housing, and Planning widely and reflect the specific historical, political, Sections joined the Health, Income, Employment economic and social conditions of the countries in- and Retirement, and Nutrition'Sectionsfor volved. Luncheon to hear Senators Frank Church and Hiram L Fong. See pages 97 and 100 for their Itisnaturaland desirable for experts in addresses. ence-in order to develop perspectives from which to evaluate Social Security and private pension

1 Text of speech of Senator Thomas F. Eagletonwas not available.

103

46a- 1170 - 73II f"-

programs in the U.S. In the last analysis, however, rives and responsibility for participating in secur- the future direction of our "dual retirement sys- ing old-age financial security are not discouraged tem" will come from the unique complex of needs or diminished. This- would occur if we were to and interests of the American people. Therefore, establish a level of social securitybenefits which primary attention must focus on our national would cost so much that employers; unions and concerns. individuals no longer perceived -the desirability or the feasibility of providing supplementary-pension programs. The advantages of maintaining and encouraging private initiatives are too im- Problems of Social Security portant to sacrifice, and, it would not be in the best interests of workers or our economy to im- Since its inception, Social Security has been pose such a sacrifice in order to obtain such a conceived as furnishing a minimum floor of re- high deget of social security protection. tirement protectiOn for almost. the entire work force. Private initiatives,i.e., principally group pension plans, have been cast in the role of pro- Problems of Private Pensions Viding a "supplement" to the retirement income delivered by Social SeCurity. However, -the scope and level of benefits under Because Social-Security benefit levels seldom Social Seturity, Or What is meant by providing a have been satisfactory,,priyate -pension programs "minimum floor of protection," has never been haire grown to filLthe gapand they have en- firmly decided. This deficiency -has -grown More joyed aspectaCular growth. acute as persistent inflationary preisures have In 1950, private pension plans covered 9.8 eroded the purchasing power of the retirement million workers, 22 percent of the 'work force; by dollars provided by social security. 1971, private plans covered in excess of 30 mil: Most authorities agree that the wage-replace- lion workers, roughly 50 'percent of the work ment ratio or social securitybetween 19 percent force: to 29 percentis very low. The median social In 1950, pension plan assets totaled $12.1 security benefit paid in 196i to a retired couple billion; in 1971, these assets exceeded $130 bil- the latest year for which this data is available lion, growing at the rate of $10 billion annually was $129 a month. $241isthe minimum and expected to reach over 4200 billion by 1980. monthly income required to sustain a retired urban couple, as reported by the Bureau of Labor Undeniably, these programs have become a Statistics in January 1970. major factor in the economic life of this country and in the minds of workers everywhere. Em- Despite recent and proposed increases in Social Security, and despite the likely enactment of ployeesrealizing the inadequacy of Social Se- measures to guard against lois of social security curityrely heavily, on their private pension plan purchasing power, the continuing inadequacy of to provide the income necessary to maintain a decent standard Of living in their retirement years. social security remains a stony fact. The evidence to date strongly suggests that a concerted effort The spectacular growth of private pension be made to improve the Social Security benefit plans has been accompanied, however, by .equally- formula so that it will result in a higher andmore spectacular problems. At the center of these prob- realistic wage-replacement ratio. -1 lems is a cancerous phenomenon: The' average To accomplish this requiressome meaningful employee covered by a private pension planand consensus as to what the long-range floor protec- I emphasize the word "average"cannot count tion ought to be and to gear thesystem to pro- on getting anything from that plan. vide that level of protection. At the sinetime, It is this absence of employee security in private care must be taken to insure that private initia- pension plans which has led me to advocate their

104 basic reform under law. If we are goingto operate particularly among the young, which has,as one on the theory that our national interests are best of its aspects, a loss of confidence in the ability of served by a partnership between public and private our industrial system to develop adequate eco- retirement programsand I strongly believe this nomic justice. to be truethen we must see to it that the partnership is an effective one for delivering adequate We must ask ourselves whyin the most afflu- retirement income. ent country in the world; in the Mint advanced To accomplish this it is essential that the de- industrial society, so lege a proportion of the aged must suffer economically. sign of private pension plans be reconciled with the freedom of labor mobility whichwe as a people value so highly and which=together with Could it be that we have shaped art industrial rapid economic and technological changenow system so obsessed with productivity and techno- constitutes the most prominent feature of modem logical superiority, that whenan individual's in- industrial life. dustrial life -is exhausted,our system' can imper- sonally discard- him! The pension reform bill I have authored, S-2, now± pending before the Senate LaborSubcommit- 4 think not, and I believe that our Social Se- tee, would make this reconciliation .a matter of curity and private pension programsare clear deliberate national policy. It wouldprotect em- evidence of thisnation's moral- commitment to ployees against loss oftheir pension. benefits when provide for the economic well-being of the indi- they lose or change their jobs,or when their em- vidual at the end of his productive years. ployer goes- out- of business ormoves awayand it would establish a new S.E.C.-type commission Butalso believe that to the extentour dual to supervise pension plans to insure that they are retitement system fails to provide themeans for properly managed in the workers' interests.. a decent standard of living in old age, it directly contributes to the alienation and isolation of the The importance of enacting this legislationcan- aged from the mainstream of society, and not be emphasized enough. By assuring the aver-, equallyimportantreinforcestheimpression age worker that he will get more than one pen- among active Workers, espeCially theyoung ones, sion at his retirementone from Social Security that the end of a working career is almost equiva- and one or more from private retirementpro- lent to the end of life itself. gramswe will have taken a major step forward in securing the goal of adequate incometo the As long as this impression hascurrency, it will aged. contribute significantly to the erosion of worker motivation, because what is the point-of working Public interest in reform of private plans has hard if at the end there isso little? grown steadily, and now it is an idea whose time has come. In my judgment, 1972 will be the de- We must, therefore, give great priorityto cisive yearthe year when the Congress will strengthening and improvingour public and pri- decide whether private pension plansare to be a vate retirement programs so that they will provide full-fledged and responsible partner inour dual an adequate income to the elderlyand I believe retirement system, or whether they will remain, it should and can be done along the lines I have a spectacular but uncertain experiment, destined suggested: for ultimate obsolescence and replacement. Perhaps then we can state with convict:it:T. the famous lines from Robert Browning: Conclusion Grow old along with me! . It is said we are, as a Nation, experiencinga The best is yet to be, sickness of spiritan erosion of motivation- The last of life, for which the firstwas made.

105 Tuesday, November 30 ruary 1 target date, the Department intends to initiate a noncompliance procedure that could The Honorable Elliot L Richardson ultimatelyresultinwithholdingallFederal Medicaid funds from any or every one of the 38 Secretary of Health, Education, and Welfare States.

The President, last July, declared that steps Finally, all States andterritoriesreceiving would be taken to improVe the deficiencies char- Federal Medicaid funds have been given until acteristic of many nursing homes. Re asked that July 1, 1972, to inspect every participating skilled the Department of nealth, Education, and Wel- nursing home to insure that such homes are in, fare take steps to this end. coinpliance or in substantial compliance- with the Medicaid certification procedure that the States Subsequently, a study was made by the Depart- must have in place by- February 1, 1972. For any ment of the skilled nursing ,home certification States, not in compliance by the July 1 date, the process in 38 States under Medicaid. Since Medic - Department -of Health, Education, and Welfare aid is a Federal grant-in-aid program, administered will have no choice but to initiate conformity by States in accordance With Federal regulations, hearings. State Medicaid agencies are responsible to the Department of Health, Education, and Welfare am- hopeful: that such- strong -Federal action for, making sure that State programs are in ac- Willzbe- unnecessary. I believe-that no".e of the 38 cordance with all Federal regulations as well as States face insurmountable difficulties in, meeting with State and local rules. . the February target date. But let there be no mistake about it, the President has said Federal funds A State can give the Department assurance will no longer be used to subsidize nursing homes that this is so only if it demonstrates that homes that arelittle more than warehouses for the are .inspected, that standards are enforced, and elderly...dumping grounds for the dying... that only homes that meet Federal, State, and and I mean to enforce that Presidential directive. local standards are "certified" to participate in the Medicaid program and receive Medicaid funds.

In all the 38 States surveyed, substantial Je- ficiencies were found in their nursing home cer- The Honorable George Romney tification process. The deficiencies related to inter- Secretary of Housing and Urban Development agency agreements, certification procedures, and provider agreements--deficiencies serious enough All of us here have at least one thing in com- to. requith significant iinprovements. Today, there- mon. We'll all be a day older tomorrow. Many fore, I have notified the appropriate officials in all of us are already old enough to be called senior 3g States and advised that they will have until citizens. In fact, my 16 grandchildren already February 1, 1972, to significantly improve their have reason to call me one. So you can under- Medicaid processes. stand I'm particularly honored to address the Second White House Conference on Aging. The States have also been informed that the Departthent of Health, Education, and Welfare Now I'm acutely aware of the severe and varied stands ready to assist them, in anyway the Depart- housing needs of many of our senior citizens. ment can, in upgrading their procedures. If the Many of these problems reflect the high incidence States fail to validate improvements by the Feb- of elderly poverty, which is nearly double the national poverty rate. Poverty forces many elderly to pay a disproportionate percentage of their in- 'The full text of SecretaryRichardson's addressis not available, but a summary of the major points of his address come for housingleaving too little to support ate presented herewith. other critical needs.

106 Given the relatively fixed nature of elderly transportation, training and other essentit:".serv- incomes, this problem has been.greatly aggravated ices. At the lame time, incomes must beat a satis- in recent years by the rapid rise in housing costs. factory level and opportunitiesmust exist for For example, between. 1965 and 1970, the cost employment, recreation and other forms ofcom- of buying and maintaining a new home increased munity participation. by nearly 80 percent while the median income of elderly Americans rose by about 40 percent. Property tax increases have been a major factor During the decade since the first White House in this housing cost escalation; rising during the Conference on Aging some housingprogress has same period an average of nearly 85 percent. been made. Publid housing occupied by the elderly increased during that time from about 80,000to An equally serious problem involves the large 32n,000 units-400 percent. Within that total, number of elderly living in substandard housing. specially designed elderly` housing increased fom While this problem has improved significantly 3,500 units to approximately 160,000 units. Asa result, by the end of 1970 almost 40percent of during the 1960's, it remains severe. Forex- ample, over, 1.6 million elderly Americans live all pUblie housing units were occupied by elderly families and individuals. in housing whith lacks basic plumbing facilities.

A third problem relates to the large, largenum- Elderly occupancy -in our other housing assist: ber of elderly wholive in deterioratingor isolated ance programs also increased rapidly. We estimate urban and rural areas. The inaccesibility ofserv- that Well over one-third of all Other HUDAtbsi- ices in these areas is particularly serious for those dized housing units were occupied by the elderly elderly who are limited in mobility because of at the beginning of this year. And as one more chronic health conditions or lack of moneyto pay example of progress, nursing home beds under for transportation. the SeCtion -232 program numbered only 1,330 in 1961. That figure isinow 57,000 beds. Finally, as described by the President in his August statement on nursing homes, the plight of While the figures in this history ofprogress are the institutionalized elderly is particularlygrave. impressive, greater progress is essential. Almost five percent of the elderlynearlyone million people--live in expensive and often sub- As you may know, this Administration in- standard long-term care institutions. This figure herited the Congressional decisionto phase out has increased from under fourpercent in 1960. the Section 202 program under which nonprofit Many have been institutionalized prematurely. sponsors of rental housing for the, elderly re- There's no question that better alternativesmust ceived direct three percent Federal loans. The be developed. Fortunately,a majority of elderly Section 236 program, which subsidizes interest Americans are mobile, are healthy andare cap- on mortgages to as low as one percent, was enable of a more meaningful role. acted to replace the 202program.

A great variety of elderly housing is needed. The 236 Program has four keyadvantages Many elderly citizens require housing thatis spe- over 202higher rtoduction levels, lowerrent cially designed topromote safety, facilitate move- levels, more variedsponsorship, and greater ment, and encourage socialization with people of diversity of tenant age and income. Amore de- all age groups. Others, while requiringhousing tailed description of the last three advantagesis assistance, are well served by general-purpose contained in your HUD fact sheet. Letme com- units. Some need congregate housing andinter- ment on the firsthigher production levels. mediate- or even long-termcare institutions. Out of a 35,000 unit Section 202 pipeline of The provision of shelter must be integrated pending applications and proposals, HUDhas with the effective delivery of nutritional,health, approved, under Section 236, projects including

107 over 33,000 unitsa funding rate four times grams are also extremely important for the large greater than that achieved under Section 202. In number of elderly who are poor or near poor. three fiscal years--1970 to 1972HUD will For this reason, our Department has set a target fund under Section 236 more specially-designed level of one-third of ell fiscal year 1972 public dwellings for older Americans than were funded housing contract authority' to be used for specially during the entire ten-year history of the 202 pro- designed housing kit the aged. gram Now, the high levels of subsidized elderly hous- During this fiscal year we will allocate $35 ing production reflect the success, we have had in millionover 17 percent of our entire Section stimulating volume production of total subsidized 236 authorityto hoe3for the elderly. That housing. During fikal year 1971 the volume of will permit between 41,000 and 44,000 units to HUD-subsidized homing startsreached about be approved=almost as many as the total number 400,000 units. We expect that total to reach of units approved during the entire ten-year his- over 500,000 units this year. This contrasts with tory of the 202 program. And to make the pri-- a volume of about 150,000 subsidized housing. gram more effective, our Department-is presently starts in- FY 1969. preparing a separate circular for Section 236 elderly housing. HUD activity has also stimulated total housing production. We expect at least 2.5 million units in Nonprofit sponsors did an excellent job within calendar year 1971.-----971an all-time record. the 202 program. We want to help them do the same with Section 236. Two - thirds of all pending At the same time,-other HUD programs assist applications to build housing for the elderly under the elderly. nearly 80 percent of reporting Model Section 236 have been submitted by non-profit Cities were wing supplemental Model Cities sponsors. funds for elderly programs. An additional- five Many of these sponsors need both technical percent are currently planning such programs. and financial assistance to get projects started and The number and scope of these programs will completed. A specific HUD program is directly undoubtedly increaseduring FY 1972especially under the continued funding of the HUD /HEW geared to assist themSection 106 (b).It provides interest-free loans to get projects from the contract with the National Council on Aging, drawing board construction. At times repayment which specifically encourages such programs. of these loans is waived when the sponsor runs -into financial straits. We have already approved Nursing homes under our Section 232 pro- loans of $5 million during the first three years gram will increase by an estimated 11 percent of operation. Last year they were $2.7 million. during FY 1972 to an annual- production figure This fiscal, year we expect such loans to be over of 14,500 beds. The-HUD nursing home program $7 million. recently amended to cover intermediate-care facilitieshas been responsible forsignificant Today I am announcing the beginning of a recent improvements in nursing home standards. new program that should be of great assistance to nonprofit sponsors. Authorized by Section 106(a) Congregate housing can also play a more im= of the National Housing Act, this is a $1 million portant role. Because many elderly persons with grant program. And under it HUD will contract adequate nutritional and other supportive services With experienced public and private non-profit could avoid expensive and often premature place- organizations to provide a variety of technical as- ment in institutions, we are planning to issue new sistance and information to inexperienced non- congregate regulations for both our public hous- profit sponsors of low- and moderate-income housing and Section 236 programs within the very ing. near future. Public Housing and Rent Supplement pro- Now, more research related to the elderly is

108 a.

needed in HUD program areas. Topics presently We also recognize the importance of assisting the subject of HUD - sponsored research relate to the elderly who wish to continue living in their causes of home accidents, use of home equity for own homes. Property tax increases are a major annuities, architectural barriers, and two elderly problem. The President's General and Special housing program studies being conducted by the Revenue Sharing Recommendations will signifi- Urbar Institute. Because we need a higher level of cantly retard property tax increases and thus elderly-relatedresearch, we solicit meaningful greatly aid the elderly homeowner and renter. proposals. Please send them to Harold Finger, As- sistant Secretary for Research and Technology. Other activities of this Administration also benefit the elderly. The Cost of Living Council The public and consumers require regular 'in- owes its very existence to the Administration's formation about elderly housing needs and pro- attempts to curtail the spiraling inflation that has grams. The statistical handbook we provided you pinched the pocketbooks of all Americans, but is such an effort. has had even a more severe effecton those with fixed- incomes such as-the elderly. I understand you also have copies of our 1-qr- chure describing all HUD programs for,the In our own Department, Operation Break- elderly, "A Guide to Elderly Housing"; : descrip- through attacks the general problem of rising tion ofour filmstrip on housing for the elderly, housing costs by developing ways to break "A Stranger Just Once"; and a copy of the No- through the specific barriers to volume housing vember "Housing for the Elderly" edition of production and marketing, such as outdated build- Challenge magazine. ing codes and zoning laws, antiquated methods, outmoded materials and high laborcosts. Also the Now, let me turn directly to the problems fac- President's proposals for broad welfair reform ing elderly homeownersa group representing and increased social security benefits would help nearly 70 percent of all elderly. Over 80pt tent elderly homeowners. of their homes are ownedmortgage free. But many of these owners are "house poor," because Government programs are important, but I be- property taxes and other housing costs are gener- lieve we must rely heavily upon privateprograms. ally rising faster than incomes. Moreover,many Dr. Arthur S. Flemming's proposal for increased of these homes were built foryounger and larger voluntary action to provide servicesto the elderly families and as a result, they imposc: severe is an excellent example of whatwe need. financial and maintenance problem for the elderly homeowner. Many older people would liketo Self-help is vital. The search by olderpersons move out- of these homes into new, smaller, more for new meaning, new jobs and roles is essential appropriately designedunits, but risingcosts to their living independently and happily. often lock them into theirpresent quarters. Finally, I believe the younger generationsmust HUD has a homeownership programSection reassess their obligations to older parents and relatives, rather than leaving 235that can be used to redixe intermitpayments most problems of.the on new homes to as low as one percent. Up to elderly for the governmentor private third-party now, elderly participation in this subsidized hous- solution. At no time in history has the coming ing program has been, minimal. But 'our Depart- generation been in greater deed of the wisdom and affection of their living forbears. I mentispresentlyconsideringadministrative hope this changes that would enable Section 235to pro- Conference will identifyways in which your experience and empathy vide elderly with the optionry move into new can be more fully em- units. In some cases, participati'. by local housing ployed in saving the nation from theconsequences authorities may be necessary to facilitate the sale of indifference to those who madethe very existence of coming generations possible. of elderly-owned homes andto enable larger low- income families to afford .these vacated units. Thank you very much.

109 LUNCHEON ADDRESSES Luncheon Program Before the Transportation, Government and for Sections on Non-government Organization, and Facilities, Programs, and Services Sections TRANSPORTATION GOVERNMENT NON-GOVERNMENT November 29 ORGANIZATION FACILITIES, PROGRAMS The Honorable William L. Springer AND SERVICES Member, House Interstate and Foreign Commerce Committee Shoreham Hotel Knowing that this group has given much time Monday, November 29 effort and knowledge to the study and deepcon- Presiding: DR: INABEL LINDSAY sideration of the aging process, I shall- not presume to inform you on the iisueSwhich are to be faced. ifiVOCatiOn: REVEREND ANTHONY ROCHA Although I have given a great deal -of attention Speakers: -House Interstate and to this field in the last few years, I know that Foreign Commerce Committee many of you might call me a Johnny-come-lately THE HONORABLE to the effortand in comparison with your dedi- WILLIAM L SPRINGER cation you would undoubtedly be justified. THE HONORABLE Since my attention has been turned to the PAUL ROGERS subject, I have found, as I know you have, that the most dangerous thing to do with any 'broad Tuesday, November 30 socially oriented subjectisto generalize too Presiding: MR. FRELL OWL greatly and to categorize. There is a tendency in Invocation: MRS. FRED WEISER certain parts of our society to picture the elderly in our population in a stereotyped way which is Speakers: THE HONORABLE neither accurate nor fair. The picture brings to JOHN A. VOLPE Secretary of Transportation mind an aged man sitting dejectedlyon the front porch of a board shack, staring vacantly into THE HONORABLE space while leaning on a homemade cane. The VIRGINIA H. KNAUER Special Assistant to the stereotype conveys the idea that all of the aged are beyond President for Consumer Affairs recallandredemption mentally and physically and that the only question which should Wednesday, December 1 concern society is when to institutionalize them. Unfortunately, some of this false picture is fos- Presiding: MRS. GRACE HOWARD tered by well-meaning people who onlymean to Invocation:LIEUTENANT COLONEL focus attention upon the most pressing of the OLAF D. LINDGREN problems in the field. Speakers: HouseGovernment Certainly not all of those 20 million folksover Operations Committee 65 are poor. Many have sufficientmeans to meet THE HONORABLE their needs and more besides. It would besur- WILLIAM J. RANDALL prising, however, if any large numbercan roam THE HONORABLE the world at their whim and winteron the OGDEN R. REID Riviera. What percentage of the peopleat the height of their productive yearscan do so? The statistics with which we are all familiar indicate

110 that about five million of that twenty are actually days of hearings last June. It is my hope that the below the recognized poverty line. What hurts committee calendar will allow us to get to my bill is that many of these are in such straits because early in the next session. I am particularly anxious of circumstances which overtook them andnot for this to be done because I will not be returning lack of foresight or a life history of poverty. But to Congress after next year. I would like very apparently only one percent of the group find Much to see the Institute provided for and set up themselves limited to social security for income. before I leave. Fortunately for the individuals involved and Recognizing that health is only a piece of the for our beleagured health delivery system not all puzzle, we can easily see that the most immediate of them are sick. Most suffer from some kind of problems and the greatest tragedyare to be found chronic condition. But many of these illsare such here. Whether or not money is a problem,many that activity 'need not cease or even that enjoy- older persons need extensive healthcare which ment of activity be impaired. may not be available to the individual for various I know that much attention is givento the reasons or. may not be available in the community problems attendant upon helping the aged who at all find themselves in the heart ofa fast moving, Which brings me to the reason, or at leasta changing metropolitan area. They do have special reason, why the Subcommittee on Public Health problems. And I would have thoughta few years and Environment has not been able tomove on ago that growing old in a small, closely knit the Institute for Gerontology bill this session. community with long time friends would be ideal. Lack of health manpower and the uneven distri- Now I know that advanced age ina decaying area bution of that manpower affects every citizen or in a spread out rural area can be most difficult whatever his age. The renewal of the Medical when the time comes that old cronies cannot drive Education Act, now called the Health Manpower around to see each other and public transportation Act; and the Nurse Training Actwere of par- is apt to be non-existent. amount importance in this first session .of the I suppose what I am trying to say is that Inow 92nd Congress. This legislation, which carriesa recognize, and people like you recognize, that the price tag of well over 3 billion dollars for the next problems of the aged and agingare as diverse as three year period, 400 million in 1972, 500 in those which afflict all of society. Theycannot be 1973, 600'in 1974, is designed to stepup even tagged and thrown in a bin with the proper sign further the development of medical and other o:. it. They cannot be solved solely by a few legal health professional Schools and the capacity of or administrative devices. Neither should they be those schools. Since the first act of this kind, there left to fester while we wait untilwe know every- has been a provision which requires increases in thing there is to know about thematter. That enrollment if schools are to qualify for funds. may be never. Like all such things, developments Extra funds are provided if larger increasescan seem to keep striding ahead of solutions. be accomplished. In additionto the so-called capitation grants, the act includes special project It was with these things in mind that Ispon- Money, start-up money for new schools, initiative sored a billto create a National Institute of grants for better curricula and some reserve money Gerontology. At the same time I introduceda to help those medical schools which meet financial bill to promote an intensive fiveyear program of reverses. Student loans and scholarships have been biological research on aging. The first of these liberalized to attract students who aremore likely bills was assigned to the Committeeon Interstate to practice in the shortage areas and forgiveness and Foreign Commerceon which I serve and the features were expanded to encourage thesame second one went to the Committeeon Education thing. Family practice is encouraged and assisted and Labor. Our committee hasnot as yet held in every way possible. All of this applies inmost hearings on the Institute for Gerontology bill for respects the same for nursing students. Whatever reasons which I will discuss in a moment, but a results from the Health Manpower Act, andwe similar bill in the Senate was the subject of three certainly hope it will significantly affect the supply

111 and distribution of health professionals, is bound seems more pertinent than for interstate or inter- to favorably affect the health problems of the national travel. The ability to get around the aged. community would seem to me to .be more important to large numbers of older citizens than Another bill which as received attention by the possibility of traveling around the country. the committee is the bill to beef up the fight And, of course, the whole subject of special fares against cancer. At present the measure has passed is a touchy one which has been bothering the both houses and must be hammered out in con- Civil Aeronautics Board and the Interstati Com- ference. This will start on Wednesday. Stream- merce Commission for quite awhile. As long as lining the organization to attack cancer, with the transportation units have excess capacity, as at expressed interest of the President and a simplified present, it can be argued that it is sensible to use budgeting process, is bound to pay off in research the space at reduced fares for some return to the benefits and accelerated time schedules. Extra carrier. Older citizens who are healthy and finan- sums of money are already pumped into the effort cially secure should need no subsidy, unless it is and more will come. Since cancer is in fact a to be our policy to keep us old folks moving, like major cause of illness among older citizens and is Philip Nolan or the Flying Dutchman. But the also the source of widespread worry and dread in truly needy need this. nowreduced fares is one the same group, the priority given -to this legis- of the things the marginal elderly desire most. In latiod is fully justified from any angle. the next 'session there will be some respite from emergencies and a chance to consider some meas- Now I know that many of you are interested ures of this type. Certainly these are of enough in other aspects of this subject and would like to importance tojustify committee consideration. know something about activities of the Commerce We realize old people need this relief. Committee in fields other than health. That would bring us around to transportation which is one Other kinds of legislation affecting the aged of the major items included within our jurisdic- especially are not apt to reach our committee. tion. As peculiar as it may seem to those not Many of the other things we deal with will have entirely familiar with the system, our committee a far-reaching affect on them however. There are, does not handle legislation which covers urban for example, the consumer bills which touch upon mass transit. That subject falls within the purview warranties and product safety. Packaging, labeling of the ComMittee on Banking and Currency be- and control of hazardous substances have been cause of its connection with housing. the subject of legislation and are being further considered. Communications, particularly televi- There are a few bills all basically the same in sion and cable television, have great implications our committee which would provide half or par- for older citizens. Proposals on these and many tial fares for senior citizens. Nothing has hap- more will be hammered out and in the course of pened to these as yet. This may be because of the creating such legislation the special problems and preoccupation with attempting to save the rail- special needs of our increasing older population roads and salvaging the remnants of the passenger will be taken into account. service. It has had to wait also for several actions by Congress to avert nationwide railroad strikes. The work of this conference, the information No doubt other emergency matters could be cited obtained, the thought, discussion and recommen- as reason for no actionbut for whatever cause, dations worked out here will be invaluable to no action has occurred. I think I can assure you Congress as it considers present, and future legis- that these bills will receive a high priority, in 1972 lation directly and indirectly touching upon the and I think we can move them. aged. We hope that in addition to forwarding your recommendations on the elderly to the Presi- Without trying to make policy for another dent you will let us in the Congress also have committee, but only to explain my own view, I them as well. If any legislation is needed, it will would like to point out that the matter of partial have to start with the Congresswith us who or reduced fares in urban transportation systems enact the law in the first instance.

112 The Honorable Paul Rogers This institute would bring theNation's resources Ch;sirman, House Public Healthand Environ- together to findanswers to many of the physical ment Committee; Member, HouseInterstate problems involved in theaging process. and Foreign Commerce Committee'

Every story, every statistic which has emanated November 30 as a result of this Conference implies needs of the elderly as though thissegment of our popula- The Honorable Jain A. Volpe tion is somehow separate fromour society. The Secretary of Transportation implication is thatour elderly citizens have special needs and are some how divorced from. the. rest I am delighted to be hereto participateand of society. to pledge the continuing support and commitment of my Department But this is true of everyage group. Education, to the goals of this COnference. by and large, is' need and problem of the young. Travel today is oftena trying experience for Just as employment isa need and problem for the young and able;as you are well aware, it can those between youth and age 60. Butwe do not be an ordeal for the agedor infirm. The aged consider these people on the outside. And- our must be afforded the same opportunitiesas other elderly should not be considered outside either. persons to use public facilities and services, andto take part in the affairs of community We constantly speak of the needs ofour elderly life. but seldom speak of their contributions,ability The Department of Transportation hasbeen and potential for contributingto society, and this given the responsibility for improvingtransporta- is totally shortsighted. tion methodology through research anddemon- strations to improve mobility for allAmericans The income problems of the elderlyare not and specifically the elderly of being properly considered and this country. We existing laws gladly accept this asour role. should be changed to bemore -flexible and responsive to the elderly. Yet the challenge is intensified bya number of factorsnot the least of whichis the fact that It is almost un- American to tell a man or one-half of the 20 million Americansover 65 woman who wants to work that he cannot doso live at the near-poverty level. Theyhave little because of the age of his birth.Yet the laws we discretionary income. Inmost cases the incomes now have in fact prohibit a man from earninga of the elderly havenot kept pace with the rising certain amount or he is penalized. For millions costs of goods and services. 'What may haveap- of our older citizens, thismeans a life of minimal peared 10 or 20or 30 years ago to be a com- existence. fortable retirement income could behopelessly inadequate today. One of every four elderly citizens hasan income below the poverty level. And I would be negligent if I didnot note that I would hope that the President President Nixon's anti-inflationprogram is work- would tell ing to relieve that situation. By you at the close of this Conference that he in- exercising re- straint over wages and prices, the tends to give the problems of theaging a national President's priority. program is especially helpful to thoseon fixed incomes, those whoare frequently caught on the I plan to introduce legislation in thevery near short end of the wage-price cycle.At the same future to create a National Instituteon Aging. time, we are working with all diligenceto provide an alternative to the expensive proposition of owning and operatinga car. 'The full text of Congressman Rogersaddress is not available, but a summary of the major pointsof his address are We want to make public transportationeco- presented herewith. nomicallyaccessibletoall.President Nixon, 113 when he took office, directed that transportation needs of the elderly and the handicapped fore- be improved for all the people of our land. Un- most. precedentedlegislation,providingforpro- For example, in the lower Naugatuck Valley gressive long-range developments in air, highway, in Connecticut, where 10 percent of the popula- . railroad, and urban mass transportation, has been enacted. We are on our way to a better brand, tion is of retirement, age, our Urban Mass Trans- portation Administration (we call it "UMTA") a better blend, and a better balance of transporta- is funding a unique transportation demonstration. tion services for all who travel. Bus service to and from the community's health Every plank in our broad platform of trans- and medical facilities will be furnished, on a portation reforms has provisions for the elderly fixed-routebasis,andexperimentallyon a and the handicapped. We intend to overlook demand-responsive basis as well. That means, the nothing that might make transportation more bus will make house calls even when the doctor respectful of our elders. can't. There are two approaches we are taking. On In Helena, Montana, where there is no public the one hand, we are conducting demonstration bus system, UMTA had made a grant to the local programs designed specifically with the transpor- taxi company to provide reduced-rate service to tation needs of the elderly in view. At the same senior citizens on a "will call" basis. time, we make certain that every transportation One innovative program we have particularly program we sponsor or support involves due con- high hopes for is the "dial-a-ride" demonstration sideration for the circumstances of the senior project to be tried in Haddonfield, New Jersey. traveler. The intent here is to operate a flexible, semi- automated system, enabling residents to dial for Section 16 of the Urban Mass Transportation a bus when they need one. The buses have been Act, for example, requires that localities give spe- purchaser, the equipment is being installed, and cial attention to the needs of the elderly and the we hope to be underway in February. handicapped when planning and designing urban mass transportationfacilitiesand equipment. Any or all of these demonstration projects This means what it says. I have personally in- could become the model for better door-to-door sisted that no grant be approved until the appli- municipal transit systems to come. cant shows that this stipulation has been met. As another example of transit developments There simply is no longer any place in this coun- with built-in "people saver" provisions, the new try for transportation initiatives that fail to con- Bay Area Rapid Transit System in San Francisco sider 20 million of our citizens. which opens this springwill feature elevators A case in point is the new subwayor "Metro" to transport passengers from street level to the system now under construction here in the train. The system will make extensive use of Washington area. We insist that it be accessible loudspeakers and super-visiblesigns, and will to alland thatis why we worked with the have special gates and fare-collection procedures metro planners to provide for the installation of to ease the way for older passengers. elevators to the train platforms, recognizing that The "people-mover" demonstration project in escalators alone would not suffice. Morgantown, West Virginia, is designed to meet But let's look at the larger picture, of interest the needs of its passengers more than half way. to all Americans. There will be no more "waiting for the bus" another "people-mover" will be along in a mat- I should like first to tell you what we have ter of minutes. Aisles will be spacious, doors wide, done and then I shall discuss our program for the cars clean and comfortable, and no tricky the future. steps or high curbs to contend with. We have a number of demonstration projects While other new rail and subway systems are underway or on tap that put the transportation beginning to sprout in cities across the country,

114 -,*

buses still promise to be the mainstay of public elderly comprise about 10 percent of thepopu- transportation for some time to come. lation, they account for 28 percent of pedestrian fatalities. Not bus systems as we have known them, but bus systems as they should be. I think it's important to point out that whilewe 'Busesthemselves. canstandimprovement. hope to make elderly pedestrians more safety UMTA's Office of Research, Development and conscious, we are working equally hard to make Demonstrations is putting the finishing touches all drivers more aware of Their responsibilities on a new set of bus specifications that include behind the wheel. lower bus floors; special doors, lower steps; in Also regarding highway transportationwe are fact, an experimental bus has been designed that well aware that our highway responsibilities in- actually kneels down to the curb after it pullsup clude housing relocation. While some forms of to the bus stop! relocation assistance have long been available, I might also mention that we are experimenting theyon occasionhave been impersonal and in- with iv- low-emission engines, and even with considerate. .It has long been my policyand the steam-powered and natural gas-powered buses, Congress has now approved itas a national polky prototypes of which are now in operation, as a that suitable replacement housingmust be pro- means of cutting down on air pollution. And vided before any resident's life is disrupted bya that's good news for everybody, young and old highway project. alike. It doesn't make any sense to kicksomeone out While urban transit is often the most immedi- in the street just to build another street! And in ate of the elderly's transportation needs, it is not far too many cases the people being displaced the only one. The aged have "long distance" were elderly peoplefor whom the disruption travel problems, too. was particularly harsh. The way the policy reads now, no Federally-financed construction project The National Rail Passenger Act (Amtrak) gets our approval unless and until adequate re- was proposed by President Nixon and passed by placement housing is found, or if need be, built. Congress as a means of rescuing and revitalizing Period. passenger rail service in the U.S. I know that many older people prefer to travel by train. Am- There is another area of vitalconcern to the trak is trying to enlarge that frame of preference elderly. I touched upon ita moment ago while by making rail travelmore attractive to more mentioning fixed incomes, and the like. Werecog- people. It is a difficult job, but Iam confident the nize full well that the cost of publictransporta- trainespecially on routes upto 400 milescan tion is crucial, and weare inspecting very care- be restored as a popular and viable form ofinter- fully the possibility ofgovernment supported re- city transportation. duced fares for the elderly. Already, ina number of cities, experimentalprograms are underway for For those able and willing to travel by air, the off-peak hours on bus and subway lines. Buthow most difficult obstacles are the terminals and the about reduced fares on trains? Andon planes and trip to and from them. But help ison the way. on other modes? We are watching all the experi- Air terminals today are being designedto mini- ments closely, and if such an approach is found mize walking, baggage handling, andpassenger to be sensible and produces measurable results, processingand airport access playsa vital part government at .alllevels should be ready to in all airport planning. tackle the problem on a nationwide basis. This is On the highways, we have launcheda nation- certainly an area worthy of full attention; itnot wide program of driver control which,:among only answers a need, it also gives local communi- other things, is intendedto help our elder citi- ties and the states an opportunityto help the Fed- zenscultivatebetterdriving and pedestrian eral government provideanswers to that need. habits. We are deeply concerned that while the Our sensitivities to the needs of the elderlyare 115 by no means confined to the few programs I have can make the journey as comfortable and as ful- mentioned here today. We are exploring a great filling and' as fruitful as possible. For transporta- host of possibilities, including such things as the tion to be a good and faithful servant, it must be use of school buses during off-hours, in an effort .the servant to all. to bring the means of mobility to more of the elderly. Thank you for inviting me to be with ,you today. We don't question the suitability of school buses for trips to concerts, parks, ball games, medi- calfacilities,shopping excursions, sightseeing trips, or what-have-you. Indeed, a perliminary The Honorable Virginia I-L Knauer study being funded by our Federal Highway Ad- Special Assistant' to the ministration is even looking toward the possible President for -Consumer Affairs use of off:duty mail trucks! We owe our elderly, our senior citizens, much. I will be realistic, however, and point out at They fought in World War I, in World War least one problem communities are having with they gave their sons' to wars. They raised us, they the use of such vehicles. The matter of liability fed us,. they: clothed; us, they sent us- to school, coverage for public as well as privately-owned they packed our, lunches. They lived through the school buses used to transport the elderly seems, depression, and after they suffered through the to many communities, to be an insurmountable wars, they struggled to give us a better life, a problem. In this regard, we are now workingon better government, a better educational system, a a program that will provide liability coverage better marketplace,' a better world. They did all for those school districts and private companies this. Yes, they made mistakes, and they had faults, that want to participate. but they gave, and they gave much, and we owe We feel that thisis certainly a worthwhile them much. They are our parent's, and one day function of a government thatcares about its soon we shall all stand in their shoes. senior citizens. Nothing is insurmountable when We cannot .look away from their special prob- you really want to do it. lems and we should not look away, and that is We are committed to all the research it takes why this White House Conference on the Aging and to whatever programs will do the job best. I is so important: Through this Conference, we can assure you we welcome and solicit your sugges- show America the problems of the elderly. We tions and recommendations. can show Atherica what should be done and what had to be done; and by arousing the combined Our motives are not entirely free of self-interest. efforts of government, of business, and of the Old age is not something that happens only to the private sector, we can act, and act wisely. few or the unfortunate.. The good Lord willing, We know that a major problem of the elderly we shall all come to know the rewards as well is economic. In 1970, half of the 7.2 million as the trials of old age. families with heads 65 years or older had incomes of less than $5,053. Almost a quarter of By 1985, the over-65 population in ourcoun- the older families had incomes of less than $3,000. try will number 25 million; 30 million before the year 2000. We would be foolish to deprive our Of 5.8 million older persons living alone or Nation of the great contributions which our with non-relatives, half had incomes of less than elderly- citizens, by -virtue of their maturity and $1,951. A third of unrelated individuals had in- experience, can make to our society and to the comes of less than $1,500. world. Yet, without adequate transportation, those There has been some help; contributions could be severely curtailed. Due to the increase in Social Security payments We cannot arrest the flight of time. But we in 1970, the median income of families with

116 heads 65 or over rose 5.2percent from 44,803 instituted a new economic policy. We had the in 1969 to $5,053 in 1970. Butas ironic as it wage and price freeze and now we are into Phase may seem, the increase in Social Security benefits 'I. in some States has led to the loss of other benefits. I am sure that those ofyou who read the Wall I think it can be said categorically that thus Street Journal story last Fridaywere dismayed at far this New Policy is working. TheWholesale the reports of senior citizens who triedto give the Price Index dropped 0.3percent in September, and increase back to the government, but couldn't.We another 0.1 percent last month. must take steps to see that such inequities do not The Consumer Price Indexrose only 0.1 per- occur again. cent in October and only 0.2 percent in Septem- ber. This compares with We have known the chilling effect of inflation an average monthly in- on senior citizens and others on fixed incomes. crease of 0.4 percent in the six months prior to Unchecked, unharnessed inflation hurtseveryone, September. Longer-term trends also showthat but especially those who can't look forwardto a inflation is slowing down. For theyear ending this raise in their wages. past October, prices rose a total of 3.8 percent compared with a 5.8 percent increase in theyear And inflation has a marked effecton the prices ending October 1970. the elderly have to pay for healthcare. Theie figures have great meaning for the Just the other day, I receiveda letter from a elderly and those on fixed incomes. Translated, retired gentleman in Philadelphia,my home city. they mean that the inflationaryrate has declined He writes about the soaringcosts of calcium considerably, and that not only the elderly,but gluconate. Twelve years ago, he paid 75cents a all consumers,can look fOrward to a more stable pound for it. Now he pays $4.75a pound. He currency: The Damoclian sword of lower and wants to know why. lower standards of living shouldnot be a con- stant nightmare for our senior citizens. The sharp upturn in medicalcosts started in 1966. The Consumer Price Index showsthat a In the specific matter of drug prices and health cross-section of medical goods and services that care costs, the President has establisheda Com- could be bought for about $80 in 1960cost mittee on the Health Services Industry,which is just over $10 more in 1965. But between 1965 headed by Mrs. Barbara Dunn,Commissioner of and 1970 the cost of diesame services went up by the Department of Consumer Protectionfor Con- $30, three timesas much. And the September necticut., This committee will advise theCost of 1971 cost was $10 above the 1970average. Living Council, of which Iam a member, on methods to reduce the escalatingcosts of medical These cost increases are highlysome describe service without reducing its quality. them as wildlyinflationary. Still another burden facingour senior citizens The impact such inflationary pressures can have is the matter of rentcosts. Statistics from the Bu- on the elderly can be readily comprehended when reau of Labor show that citizens over 65pay about we understand that where the per capita health 30 percent of their income for housingcosts, com- care expenditures for individuals under 65are pared to 23.4 percent for those under65. In short, $225 annually, for those 65 andover the figure when costs go up inrent, the impact on the is more than three timesas much$790. For- elderly is considerable. tunately, over half theamount paid for health care for those over 65 comes from governmental An important part of Phase II will'be the programs. Still, the burden of inflationary health action of the Rent Advisory Board.This Board costs on our elderly is significant. will provide adviceto the Price Commission on special considerations involved inthe stabilization President Nixon has understood theproblems of rents. Last week, the President that inflation has caused announced the consumers generally and appointment of 14persons to this Board, and four the elderly specifically. And so on August 15 he of them representconsumer interests. One of these .-r 117 16

four, Mrs. Mary Elizabeth C. Sowards, serves as a level distributorships. Knowing that the elderly member of the President's Consumer Advisory are anxious to supplement their limited income, Council which advises the President and my office. some of these outfits promise rich returns on Another member, Robert D. Blue, serves as a pyramid sales tactics. member of the Older Am lican Advisory Com- mittee to the Secretary of Health, Education, and The majority of the companies using the multi- Welfare. Another member, Mrs. Rossetta Wylie, level distributorship scheme require the individual Chairman of the National Tenants Organization, to purchase certain amounts of the product they will look after the problems of the low-income sell in order to become part of the organization. housing residents. I can assure you that the sub- Each person buying into the organization pays a ject of rent costs for the elderly will not be over- fee to become a "distributor." And that's where 1 looked by the Advisory Board. the razzle-dazzle comes in. The emphasis is placed on the glowing picture of the earning potential of Still much more-needs to be done. becoming a distributor by signing up other people President Nixon's Social Security and Adult as "distributors". Assistance proposals now before Congress add They appeal. to the Horatio Alger dream in the significant new benefits to Social Security and American mind. Too few of the investors have introduce improved income .assistance provisions had any business experience. But to the "go, go, for those with low incomes. Thislegislation go" chant of the pitchmen they convince them- establishes two primary goals for the elderly selves that they can recruit friends, acquaintances first, the establishment of an income floor for poor and neighbors to become distributors, too. older Americans, and second, the guarantee of inflation-proof Social Security benefits. In fact, But the bubble burstsjust like the old chain additional Social Security cash benefits payable letter. The problem with the scheme, of course, is under this bill total $3 billion and additional that within a mathematically short period of time, Medicare benefits total $1.7 billion. We must see one runs out of people. Two carried to the 29th that H.R. 1 passes. power equals the approximate population of the United States. The people who buy in on the first Another area in which we need to take action levels may get their money back, or even make a to protect the elderly in the future is in pension profit. But the people who buy in at the end of planning. The major problem is that only half the schemeat the saturation pointstand to the work force in the United States has the secur- lose their money. ity that pension plans provide; the other half

ti doesn't. Another problem is the injustice caused The National Association of Attorneys General to workers, who, through no fault of their own, was so concerned about the effect these tactics lose their pensions to which they have contributed were having on the States and on consumers all their lives because they leave their employ- that at its convention last June it urged action on ment shortly before retirement. While the number the Federal level. I have been in frequent com- of such losses is very small, the loss to the affected munication with the various regulatory agencies workers is immense. concerned with this problem, and I am pleased The Administration is now working on a com- to announce that the Securities and Exchange prehensive legislative package to deal with these Commission has taken action today to require multi-level problems, and we expect that it will be ready to distributorshipsand pyramidsales send to the Congress very soon. We hope, too, plans to adhere to the securities laws. What this that Congress will take swift action on these pro- means is that henceforth, any multi-level distribu- posals. torship found giving false or deceptive information to prospective purchasers can be ptosecuted For some time now, I have been concerned by the SEC. These firms are now on notice that about the problems caused to the elderly by the the full force of the SEC injunctive civil and get-rich schemes offered by a rmber of multi- criminal powers will be used against them. These

118 predators are unlikelyto continue their question- ingful; a Consumer Product Safety Act which able operations. would give the Secretary of Health, Education, How much money this action by the SEC will and Welfare authority to remove unreasonably save consumers and the elderly nobody knows. hazardous products from the market; anda Drug But just to give youan estimate, in Pennsylvania Identification Act which would require the identification coding of drug tablets and capsules, alone,the Consumer Protection Agencyre- so covered $350,000 in refunds for individuals who that proper action can be taken fora patient when overdosage or accidental ingestion were victimized by one firm. This figurerepre- occurs. sented only .45 cents.on the dollar invested,and These are some of the solutionsto the prob- just to thoue individuals whocame into the con- lems that we have devised. Yet, there still remains sumer protection office and complained that they much more to do. had been defrauded. We know, for instance, that most States have Further, this problem has spread from State laws that prohibit, or severely restrict, the adver- to State, causing losses in each State, and insome tising of prescription drug priCes oreven posting cases requiring action by 15 to 20 states to bring them in a store. And whenconsumers do. not separate action against the same firm. compare prices, prices tend not to be competitive. I want to congratulate SEC Chairman William One New York study found that the 'price ofa given quantity of one drug ranged from $0.79 J. Casey for taking such expeditious actionon this matter. This action by the SEC will protect the to $7.45. Another sold from $1.25 to $11.50 for a prescription. savings and the pension plan benefits ofmany of our senior citizens. One drug store chain, OscO Drug, Inc.,a mem- ,I am, of course, concerned about othercon- ber of Jewel Companies, is breaking the tradi- sumer problems which affect the elderly. The tional secrecy surrounding prescription drug pric- Fedetal-State Relations Division withinmy office ing. Just last month thecompany announced has found through its contacts with the States that it would post its prices for the 100most that the major complaints of senior citizensare frequently filledprescriptions. The prices are door-to-door sales; the unavailability of suitable prominently displayed in Oscostores and consum- foods or goods; I,ealth frauds; the unavailability ers may ask for the prices of unposted drugs. of automobile insurance renewals; and the rise in Osco Drug may face a court challenge, but health insurance and utilityrates. the principles of its policy have the backing of Where appropriate, we have taken actionon the Department of Justice and the Department the Federal level to resolve these problems. The of Health, Education, and Welfare. TheDe- Federal Trade Commission has proposeda rule partment of Justice wrote Osco that the agency which would require a three business day "cooling feels that many, if notmost, restrictions on the off" period before acontract becomes final; the adverising of prescripion drugsare unjustified Food and Drug Administration has been vigorous on any grounds. As a result of the lack of price in moving against medical quackery; andwe be- information, the Department said,many con- lieve that the adoption of no-fault insurancesys- sumers are forced to make needlessly high ex- tems by the States will help alleviate renewal penditures for drugs. Further, the Justice Depart- problems faced by the elderly. ment has also served civil investigative demands on the American Pharmaceutical Association and The President has sent to the Congressa series the Michigan State Pharmaceutical Association of consumer legislation proposals which, if passed as part of an investigation as to whether those. by the Congress, will certainly benefit the elderly. associations may be parties toan agreement to These includelegislation to strengthen the suppress price competition in the retail medicine FTC in enforcing the laws against fraud and de- market. ception, a warranty bill to make warrantiesmean- The States can take the initiativenot only

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468-2no73' 9 in this area but in many others. The enforcement December 1 of laws against fraud and deception, the initia- The Honorable William I Randall tive of new laws to cope with new schemes, and the removal of laws which tend to limit compe- Chairman, Special Studies Subcommittee, tition are just a few measures states can take House Committee on Government Operation! to help the elderly. The twentieth century has been an age of In Wisconsin, a pilot project for statewide magnificent change. In the fields of science, tech- information and a referral program rot senior nocracy and social consciousness greater progress citizens has just been started. In Nassau County, has been made in the past 70 years than in all New York, the consumer office has contacted the years since the birth of our country. Who would have believed at the dawn of this centuryI senior citizen groups to establishliaison and 4 dealwithparticularneeds.InMontgomery back in 1900 that within a few years women County,' the Maryland Commission on Aging would not only be given the right to vote, but hai issued ID cards to persons over 65 which many would also hold high public office. Who 1 entitle the bearer to certain discounts in business would have believed that in the same time re- establishments. quiredin 1900- to travel from New York to Washington we would, by 1971, be able to span I believe business can do more thanitis. the continent or even cross the Atlantic Ocean. Forbes Magazine has wondered out loud why business is generally ignoring what amounts to Yet, what a shame it isand I say itis a a $40 billion market. I wonder, too. Why can't national shamethat in this age of change we clothing manufacturers design special clothes for have come tothelast quarter of this most the elderly? Itis easy for a young woman to progressive century before starting to take posi- unzip 'her -dress in the back, but itis agony tive action on the serious problems that confront for an 80-year old woman whose hands are one-tenth of the people in our countryour crippled by arthritis. aging Americans. In short, to solve the manifold pioblems of We should not forget that those people who the elderly, manifold efforts need to be under- comprise our elderly popufation today helped taken. Combined action by the public, business, to pay for two great wars and, yes, two so-called local, State, and Federal governments is needed lesser ones. Some of that generation are not if we are to succeed in givingour elderly what with us today becausethey gave theirlives they have earned--=that their last years be years on the-battlefields. The sons of many of our older of hope instead of years of agony. citizens also died in the cause of our country's freedom. The senior citizens of 1971 endured 'There are now more problems than .there are the greatest economic depression in the history solutions. of our Nation; they helped buy trips to themoon This Conference can provide us with the infor our astronaum These people have spent their sight, the recommendations, the solutions. Those lives in helping to respond to the problems of of us who have the honor of serving in this our Nation. But until now the Nation's response Administration are here to listen to you and to their problems has been to talk only about to take appropriate action. We want others to "national policy." listen, too. Everyone in this country should listen. Now the time has come to implement that This Conference must awaken America,it policy with action. And I believe that is what must show America these problems. It must let this White House Conference is all about. America know that it canlook away. It must let America know that when we act for the It may be well, before proceeding furthei elderly, we act for ourselves, that the elderly in my remarks, to tell youa little about the are our faces in the mirror. Special Studies Subcommittee, of which Iam Chairman. We -e a subcommittee of the House Thank you. Committee on Government Operations. The

120 Government Operations Committee, under the Since September 15, the Special Studies Sub- very able Chairmanship of Congressman Chet committee has held 20 days of hearings on prob- Holifield of California; has oversight responsi- lems of the aging. Seventeen of these hearings bilities with respect to the economy and. effi- were in Washington; two in Chicago, and one ciency of operations of every Department and was in Baltimore. every Agency of the Federal Government. The Government Operations Committeealsohas Our staff has isolated nearly 50 separate prob- jurisdiction over any reorganization within the lem areas of special application to the aged. These Government. So, if a new department or agency closely parallel the enumerations which you have were to be created in the Federal structure, in- made under the 14 sections of study associated cluding any special office or department a) deal with this While House Conference on Aging. with the problem of the aging, it is most likely Our hearings have already touched upon several that the Government Operations Committee of these. Before we finish our study and file our would handle the reorganization legislation. legislative recommendations sometime next year, Early in the 92nd Congress I enthusiastically we will have had expert testimony on every one co-sponsored legislation to create a Select Com- of these subjects. The Subcominittee and its staff mittee in the House of Representatives to study will have inspected as many of the various kinds problems of the aging. But there are already of facilities across the United States aswe need 176 Committees and Subcommittees, repeating to see.in Order to have a- comprehensive view of 176, on the House side of the Capitol. The space all the 'problems confronting the aged. Before situation is so critical that we now have legisla- the end of 1972 we will have researched every tive subcommittees housed in storage rooms, in major authoritative work on various aspects of the basement garage, and, in at least one case, a being old and growing old. I think youmay Committee has no office at all. agree this is a major project. I can report it is being undertaken by a group of hardworkingcom- I doubt if there is a Member of either House mittee colleagues who hive shown they are will- of Congress who is not sensitive to the plight of ing to find and give as much time to the task as our senior citizens; I doubt if there is a vote iv. it may require. either House against creating a Special Commit- tee to consider this plight, if there were no other As our hearings on problems of the aging way to focus upon it. The House leadership, progress, I realize more and more that determin- certainly, is aware of the need for action at the ing how to meet the needs ofour senior citizens earliest possible time. That is why, instead of is a greater challenge to the subcommittee than waiting perhaps yens, one, two, three or more simply learning what those needs are. The White years, until more space becomes available, the House Conference on the Aging which was held House Leadership asked the Special Studies Sub- ten years ago, in 1961, clearly identified the committee to function as a Committee on the needs. I, along with three other members of the aged. It seemed like a practical or logical solution, Special Studies Subcommittee, was in Congress particularly for this year. We already hada staff when that Conference was held. We wereaware and office facilities and assigned hearingrooms. of the recommendations thatcame out of the 1961 And, I hope you recall that I mentioneda moment Conference. The importance and correctness of ago that the Government Operations Committee, those recommendations have beenmore indelibly parent group of the Special Studies Subcommittee, impresssd upon each of us with the passing of has oversight jurisdiction in thecase of all federal time. We supported passage of the Older Ameri- government departments and agencies. That, of cans Act, the creation of the Administration on course, includes the dozen or so offices charged Aging, andtheMedicare-Medicaidlegislation with administering differentprograms for the which had their genesisat least in parr in the aged, and including those which mightor could 1961 White House Conference. Each ofus have become responsible forany new programs that voted for adequate funding for activities under will be proposed and enacted. those acts.

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468. 217 0 - 78 - 10 But more needs to be done. Much *on. or smoke warning devices, or sprinkler systems, from quickly going up in flames. In many camindeed, in most casesthe States and local communities have moved more But let us talk about the positive. quickly and more positively than has the Federal The. most frequent recommendation by wit- government, to answer the pleas of the aged for nesses before the Special Studies Subcommittee special consideration of their special needs. But has been that better protection be afforded retired I feel it necessary to digress for just a moment to call attention to one glaring failure on the persons' incomes. This protection could take many parts of the states and local governments. I forms, one of which is the opportunity to earn additional money within the limits prescribed for refer, of course, to the matter of safety standards recipients of social security benefits. A variety of and inspection practices as they apply to nursing self-help programs have been devised by .31un- homes and other facilities for caring for the dis- tary groups in some communities through which abled and homeless aged. elderly persons are afforded the opportunityto render needed, worthwhile services on a part-time I completely disassociate myself from those basis. We need more of these programs. But who, seem willing to issue a blanket indictment against all nursing homes as an evil institution. two things are needed from the Federal, Govern- ment. One, there must be -a more realistic limit placed upon outside earnings before reductions The members and the staff of the subcommittee have inspected many nursing homes. We are made in social security payments. I have long recognized this need and have introduced legisla- have seen some very good ones. True, and un- tion to raise thee limits. Modest increases fortunately, we have also seen some bad ones. were I dislike saying it, but in most, if not all the made in the Social Security Amendments which passed the House in 1970, but failed cases of substandard conditions and deficiencies to become of service we have observed, studied law, and again in H.R. 1, which passed the or investi- House last May. I am hopeful the other legisla- gated, blame was traceable to varying degrees of tive body on the north side of the Capitol will inadequacies on the parts of local units of govern- act on this bill ment in their setting of standards and supervisory in timely fashion during this session of- Congress. practices. In many cases we have observed diverse and divergent regulations on the parts of Another thing the Congress can donow is to city, county and State goierning bodies within provide more liberal funding of the Older Amer- the same general area. Where Federal fundsare icans Act to permitan expansion of existing involved, as in Medicare patients,or in construe- activities, such as Green Thumb and Foster tin loans, then Federal standards and require- Grandparents programs. ments may encourage more orderly regulation at the local level. But many nursing homes and Another income protection device that has other health care facilities for the agedare not been extended to the elderly by State andlocal recipients of Federal funds andare, therefore, governments has been in different kinds of con- outside the reach of Federal regulatory bodies. cessions made on realestate and other taxes due at those levels. I strongly be. ;eve those efforts This was the case with the Pennsylvanianurs- should be matched by the Federal Government ing home in which themost recent tragic fire in the form of more realistictax treatment of the occurred. This home was in fastidious conformity incomes of the elderly. with all State and local regulations respecting Health care is second in frequency ofrequests construction, fire prevention requirements and our subcommittee hears as necessary to meet the number of attendants on duty per patient. Yet, needs of the elderly. Here again, therear many 15 elderly lives were lost ina few tragic minutes avenues of relief. My limited time will permit because in all respects these regulationswere not identification of only themost recent case of sufficient to keepa wooden building with no fire local effort I ha-re observed along this line. In 122 a visit to Mac Neal Memorial Hospital in a Chi- letic exertion that can be expected of the much cago suburb last week the Administrator told younger generation for whom these buses_ trains us what they are doing. This hospital is freeing and planes seem to have been designed. The beds for other patients needing geriatriccare by dignity of being able to apply for andget em- early releases of those patients who have homes ploymentor to be able to keep a job on the and can live in them if only they can have a mini- basis of ability to perform, rather than being mum amount of care. That hospital is preparing rejected solely and only on the basis of the dace meals for patients released under this plan. Mei ls of birth. The dignity of having all these needs are delivered -to patients by church and other and the special health, dietary and other personal volunteer groups, which also provide certain and spiritual requirements met, without endur- home-making services. b-r ing the impatience and intolerance of those who cannot or prefer not to understand that all of This one plan operated by a single hospital is these are the needs of those citizens who have of course just a little thing, or a small beginning. supported this nation for three score or more But, when and if multiplied by the community years. and individual efforts in hundreds of cities in all of our Stores, then thousands of agedpersons with I realize that in the time allotted to me today limited abilities to care for themselves would be it was possible to discuss only the broadest enabled to stay in their own homes where I be- generalities. The two major points which I tried lieve they prefer to be. And for each of these to makeI will attempt to summarize as fo:- individuals freed from hospitalor other institu- lows: tional care, space is made available forsomeone else who is even less able to care for himself. 1. State Agencies and voluntary groups at the local level have done and are doing a com- Of course, we need better institutions for the mendable job in delivering to the aged the bene- care of the elderly. But I am satisfied that the fits intended by the various laws Congress has populations of these institutions could be reduced passed for making the golden years more pleasant by 12 percent to 15 percent ormore if voluntary and more secure. These financially hard-pressed programs of home care could be expanded to state and local governments, when taken in re- meet the food requirements, minor therapeutic lation to their ability to perform, are doing a and medicinal needs of some of our older citizens. better job than the Federal Government inpro- viding benefits for their elderly citizens. My final point to be made in this briefsum- mary of cur subcommittee's study of problems of 2. The pipelines through which Federal programs are delivered to the states must be cleared the aging to date, really encompasses a vital element that threads its way through all the cate- of the obstructions created by ambiguity and gories of needs felt by the elderly: human dignity. unnecessary complexities. To avoid red tape or to cut through it, there should be a high-level The dignity of remaining a useful member of the office for the agingnot in HEW community even though the calendar may indi- or HUD or cate the age of usefulness is past. The dignity of DOT or elsewherebut in the Executive Office of the President. collecting for the services the elderly have al-. ready paid for by a lifetime of contributionsto Perhaps a third point should be made, and their national and local communities without this one is directed towardmy -own branch of having these collections brandedas "welfare," government. the United Stuis Congress. The as seems to be the tendency by lumping together programs that have already been authorized for or making into one package badly needed and the elderly, the ones now on the books, should long overdue social security reforms withmeas- be backed by sufficient appropriationsto make ures heavily directed to, and called, "welfare their benefits more universally available. I be- reform." The dignity of being ableto board a lieve it is better to make self-help opportunities public transportation conveyance without the ath- more generally available to all classes of needy

123 citizens, and especially the elderly needy, thatit Tk Honorable Ogden R. Reid is to provide alternative methods of caring for Member, House Committee those who cannot care for themselves. on Government Operations'

In meeting the needs stressed in this third Senior citizens is the only group of Americans point, Members of Congress themselves may have in which poverty is still growing rapidly. What to relax some of their long and tightly held is needed is a comprehensive and coherent na- jealousies of prerogatives. 'Whether there is ever tionalcommittment totheNation's elderly established a special or,select committee in the matched by adequate funds. House of .Representatives to deal with problems of the aging or not, there will remain some stum- Our Nation's elderly have been caught in an. bling blocks both in the House as well as in intolerable squeeze between fixed income and the Senate. In my judgment, it would be a par- rapid inflation. liamentary impossibility, touched by Constitu- Older Americans have one-half the income of tional overtones, to create a legislative committee those under 65 and must pay twice as muci. for on problems of the aging. Therefore, recommen- health care. One-quarter of our citizens over 65 dations for legislation coming from any select live below the poverty line, and over six million or special committee studying problems of the of them live in substandard living quarters. We aging would have to be considered by the legis-. have done little to ease their burden. lative committee having jurisdiction over the specific recommendation. On the Senate side this The Administration must address itself to the jurisdictional authority is spread among 13 of basic needs of the elderlyincome maintenance, the 17 standing committees. On the House side, health services, housing, and geriatric research. 14 of the 21 standing committees have jurisdic- A first priority should be the removal of any tion to consider various proposals to benefit the income limit on those receiving Social Security aging. benefits. Currently, a single person earning over $1680 annually loses half of his Social Security It is my devout hope that when recommenda- benefits if his earnings do not exceed $2000 and tions are made in the House or the Senate by all of his benefits if his earnings exceed $2880. any committee working and dedicated to ease the process of growing old or being old, the appro- We are not meeting the growing needs of the priate jurisdictional committees will receive and elderly in housing. The 69,000 housing units consider these recommendations without prejudice being built annually are not nearly enough. It and without regard to the fact that they origi- is high time we provided adequate housing for nated in another committee. all senior citizens. The substandard conditions in many nursing Changing America's attitude toward our aged homes is an area of major concern. There are citizens and meeting the needs of thesevery spe- over 23,000 nursing homes in the United States cial people require a partnership_ that includes with over 900,000 people living in them. Many the good will and the sincee efforts ofevery of the homes are firetraps, provide inadequate branch of this government and the cooperation medical services and substandard care. We must of State, Local and voluntarygroups. With such allocate funds to rehabilitate existing nursing a team, we can meet the challenge to overcome homes, construct new ones, and develop area- all the past years of neglect ofour aged. We can wide programs for senior citizens. no longer afford to waste the valuable contributions older Americans can continueto make to Let's talk about a national committment that our society. Existing programs must be funded means a life of dignity, not a life of mere starva- and new programs created under which future tion, for our elderly. generations of our elderly citizens will be treated Full text of Congressman Reid's address is not available. with compassion 'and appreciation. Excerpts of the major points are presented herewith.

124 LUNCHEON ADDRESSES Before the Retirement Roles and Activities, Spiritnal We II-Being and Research and Luncheon Program Demonstration Sections for Sections on RETIREMENT ROLES November 29 and ACTIVITIES The Honorable Jackson E. Betts SPIRITUAL WELL-BEING Member, House Ways and Means Committee RESEARCH and DEMONSTRATION I am delighted to be here to talk with you Scat ler Hilton Hotel today about some legislative actionboth taken and contemplatedwhich has particular import for Senior Americans. Monday, November 29 We hear.a great deal these days about young Americansand rightly so! It is true that their Presiding: DR. PAUL DUDLEY WHITE numbers are vast and the role they play in Invocation:RABBI STANLEY S. RABINOWITZ our national way of life is vital indeed. Recent Speakers: House Ways and Census Bureau figures, for example, show that Means Committees young people aged 18 to 21 total some 11 million, THE HONORABLE or about 51/2 per cent of the population. JACKSON E. BETTS But I am a member of a Congressional Com- THE HONORABLE mittee which is concerned as much, if not more, AL ULMAN with the role of another substantial minority group, in which all of us here today have more Tuesday, November 30 than a passing interest. Presiding: MRS. FRANCIS FAIRBANKS Census statisticsalso show that Americans aged 65 and older number in excess of 20 mil- Invocation:BISHOP RAYMOND J. GALLAGHER lion, or some 10 percent of the total population. Speakers: THE HONORABLE And itis universally conceded, Ibelieve, that JOHN ERLICHMAN.Assistantto the contribution which senior Americans make to the President for Domestic Affairs our national lifeis so great as to be virtually THE HONORABLE inestimable. LEONARD GARMENT, Special Consultant to the President The Ways and Means Committee has, as you know, jurisdiction over broad areas of legislation directly affecting this 65 and older population Wednesday, December 1 group. Presiding: MRS. ELIZABETH LINCOLN Social Security is just one of those legislative Invocation: THE REVEREND A. L CARTER areas, but it is an extremely large one. About 20 Speakers: House Committee on 1 ":ln persons now receive checks each month Education and Labor ui.,,,.. this 36-year-old program. Not all of them THE HONORABLE are 65 or older, but most of them, 13.7 million CARI. D. PERKINS are retirees; 2.7 million are dependent wives or THE HONORABLE husbands, 550,000 are dependent children; and

ALBERT H. QUIE ., 3.3 million are widows or widowers of retired workers. I might add that although benefits under this program certainly are not as high as the recipients I am sure you are all familiar with the five would like for them to be, they nevertheless have percent across-the board increase in cash benefits. been increased substantially during the yearsby This is assuredly an important provision. But far 147 percent over the pasttwo decades and, more more important in the long run, I believe, is the recently, by 25 percent within the past twoyears. provision for automatically increasing socialse- And further increases are in prospect,as I will curity benefits following increases in the cost of discuss shortly. living. But I would like to concentrate brieflynow Under this provision, after the Consumer Price on just two pieces of legislation under the juris- Index had increased by at least threepercent, diction of our Committee. Bothwere stimulated commensurate increases in benefits automatically by Administration proposals and inspiredby would be triggered, provided that legislationto President Nixon's messages to Congress. And increase benefits had not been enacted or taken each is of immense importance not onlyto those effect in the preceding year. who already have attained seniorstatus, but to all those who will become se. nior Americansas This provision not only would serve to take far into the future as it is possibleto foresee or benefit increases out of the political arena, it even imagine today. would assure beneficiaries that theyno longer One of these is H.R. 1, the Social Security would have to bear the brunt of inflation,as they have had to do so often in the past. Amendments of 1971, whichwas approved by the Ways and Means Committee in May, and passed I strongly feel that this one provision, which by the House in June. It has been pending before the President personally put forward, could have the Senate Finance Committee since then. a more beneficial effect on the lives of social The other piece of legislation hasnot yet been security retirees than any now contemplated. developed. It is national health insurance, which The other four provisions which warrant spe- will have an obvious and direct effecton the cial emphasis are these. lives of all Americans, junioras well as senior. But before speculating on this bill of the future, One is a special minimum benefit for those let me discuss the one which ispresent, real, and who have worked for years under Social Security, very much alive, despite the fact it hasnot been but at such low covered wages that the benefit kicking lately. payment is relatively slight. This special benefit would be equal to $5 multiplied by the number Dormant though H.R. 1 may beat the of years of coverage between 15 and 30. About moment, I firmly believe that its Social Security 300,000 persons would get increasedbenefits, provisions at least eventually will be enacted.This totaling $30 million under this provision in the legislationis simply too strong to keep down first full year. forever. Second is an increase in benefits for widows I doubt very seriously that there has been any and widowers, assuring them of receiving at least legislationsince the original Social SecurityAct itselfwhich included 100 percent of the amounts their insured spouses more important improve- would have received had they livedto apply. ments-in the laws affecting senior Americans. Under present law, a widow applying for benefits These provisions areso broad in scope and at age 65 or older gets a maximum of only 821/2 so broadly significant that it is difficultto select percentofherdeceasedhusband'sprimary any of them as more worthy of emphasis than amount. About 3.4 million widows and widowers the rest. would receive a total of $764 million in addi- I do, however, think that five of thesepro- tional benefits the first year under this provision. visions perhaps havenot been given the public Third is an increase in benefits for those who attention which they merit. So I will takethis are covered by Social Security but delay their opportunity to put the spotlighton them. retirement. Under present law, people who need

126 or want to continue working are penalized, in a Congress earlier in the year, declared: "We must sense, because they continue paying Social Security try to see to it that oar approach to health prob- , taxes, but do not draw benefits immediately upon lems is a balanced approach." I certainly agree entitlement. This provision would increase bene- with that, and Ibelieve the Administration's fits one percent per year of delayed retirement, health insurance plan follows his guideline very affecting about 400,000 persons who would re- well indeed. It is right down the middle of the ceive $11 million in first-year additional benefits. range of pending proposals. Fourth is a liberalization of the retirement test. Called the National Health Partnership Act, This, too, would be of particular help to those it would require employers to provide protection who continue working past 65. As some of you for employees and their families and it would probably know only too well, present law per- establish a Federally financed program of protec- mits a beneficiary to earn a maximum of $1,680 tion for the poor families whose breadwinner is per year without having benefits reduced. H.R. 1 unemployed. would increase this exempt amount to $2,000, I favor the thrust of this approach, and I hope and would liberalize benefit reductions above that the Committee will use it as the foundation on sum. which to build its own legislation. In addition to these purely Social Security pro- Whatever kind of bill is created, of two things visons, there are other elements of H.R. 1 which I am virtually certain: It will provide adequately I believe deserve special mention now. One would for the poor, and it will be a long time in the enable all those senior Americans whofor one making. reason or anotherhave not been able to enroll in MedicarePart A, to do so simply by signing As H. L. Mencken once said: "For every hu- up and agreeing to pay the basic cost of protec- man problem there is a solution which is simple, tion. Another would provide, under the Old Age neat and wrong." And we obviously do not Want Assistance program, a basic monthly income of to reach a wrong conclusion here. $150 for each eligible single person and $200 The Committee will not begin actual prepara- for each eligible couple by 1975. A third would tion of a bill until next year. House action could update and substantially liberalize the so-called come some time in 1972, but in trying to antici- retirement income credit, boosting it from a maxi- pate thefurthercourseofsuchlegislation mum of $229 to $375a gain of $146 or 68 through the Congress, it must be borne in mind percent. that once a bill has cleared the House, it still These are, as I indicated at the outset, only must face the Senate. And judging by past per- a few of the farreaching improvements called formances on House-passed bills, such as H.R. 1, for in H.R. 1, and I am sure you join with me I would have to say that a crystal ball would be in a fervent hope that they soon will resume as reliable a source as any to use in guessing the their progress toward enactment into law. fate of national health insurance after it leaves the House. Now to national health insurance, on which the Committee just ten days ago completed four- Despite what may appear to be a rather gloomy and-a-half weeks of public hearings. timetable, I can give you a rosier outlook on probable content of the eventual bill. As far as Thislegislation,ofcourse,canonlybe coverage of senior Americans is concerned, I guessed at now. There are 12 major proposals think it is safe to assume that this is unlikely before the Committee, ranging all the way from to be cut back and is more likely to be expanded. a plan to replace our present, pluralistic system Existing programs such as Medicare and Medi- with a monolithic and mandatory program paid caid will be reviewed thoroughly, and are likely for by Federal taxpayers, to a plan to cover to be either replaced by more effective programs catastrophic illness only. or substantially strengthened. President Nixon, in his Health Message to the Spokesmen for various organizations represent-

127 ing senior Americans appeared before the Com- of Americans for whom Ihave the deepest mittee during the hearings, and articulated .force- feeling. Much of my legislativecareer has been fully the provisions which their members felt directed to the very problems and issues before should be included in whatever legislationis this Conferencethose relatedto the elderly. Let developed. I can assure you that the Committee us initially examine our roles. was very attentive to these presentations and will remember them when the actual mark-up of the If it would serve any usefulpurpose, I think bill takes place. I would ask the Library of Congressto give me a catalog of all of the reports and recommenda- One of the witnesses during the hearings, who tions filed by White House Conferences in the impressed the entire Committee very favorably, more thari two decades since I first came to Con- was speaking in behalf of strong preventive health gress, provisions, which I am confident the bill will include. I can recall conferences that have described inbrilliant detail some of themost pressing A good preventive health program, he said, needs of American society in the Twentieth Cen- should be designed to "help make man die young tury. And I can recall recommendations which but as late as possible." pointed the way towarda national effort to meet And that is one of the things we are certainly those needs. going to try to do with national health insurance. Unfortunately, I am being only half facetious when I tell you that one of our greatestresources Note: The speeches of The Honorable Al Ulman, is a warehouse full of unactedupon recommenda- Member, House Ways and Means Committee, tions. delivered on November 29; The Honorable john Ehrlichman, Assistant to the President for Do- Now, I sincerely hope that the recommenda- mestic Affairs, and The Honorable Leonard Gar- tions of the White House Conferenceon Aging ment, Special Consultant to the President, deliv- 1971 will not join all of those other fine blue- ered November 30, are not available. prints to a better life in some Executive Depart- ment file, or on some library shelf. But you must be alert to that danger. A long time ago, some wiseperson said "All December 1 that is necessary for the triumph of evil is for good men to do nothing." The Honorable Carl D. Perkins To paraphrase that distilled truth, all that is- Member, House Committee necessary for the report of the White House on Education and Labor Conference on Aging 1971to wind up on the shelf is for you to submit it, and thengo home Mrs. Lincoln, distinguished guests and friends. and forget it. It is a greet pleasure to be withyou at this most important and timely Conference. Asyou know, If you were not aware of it beforeyou came the bill calling for the 1971 White House Con- to Washington this week, you must now be ference on the Aging originated in the Commit- convinced of the overwhelming importance of tee on Education and Labor and thus, I had the your mission. privilege of being associated with itas it travelled The needs of the aging in this countryare through the legislative process. acute, and they cannot much longer be relegated Your invitation to be here today has special to the low-priority rank to which they are pres- significance for me as a result. Butmore than ently assigned by the Federal Government and that, you have provided me withan opoprtunity by the various states. to meet with and discuss the problem of a group Now, we all know that those needsare im-

128 ponant, and we really do intend to do something many social and economic problems facing the about them. elderly. It was intended to be the focal point for We will do that just as soon as: the older persons of this Nation within the. Fed- eral Government. 1. All our national defense needs are met; This was the rhetoric that we heard in 1965 2. All our space goals are accomplished; many promises which never have been fulfilled. 3. All our educational problems are overcome; Time after time, and in a variety of ways, this 4. All ourinternational commitments are Congressional intent has been thwarted. eased somewhat; Programs authorized by the 1965 Act as 5. Inflation is brought under control; amended and administered by the Administration on Aging have never been funded at a realistic 6. Our environmental needs are met; and level. Consider the following. The original Fiscal 7. Our cities are made safe. Year 1972 budget submission called for reduced funding of programs such as the Faster Grand- No doubt there are other pressing needs that parents Program, the grant program for state and will make themselves known as we go along. community projects for the elderly, and research The point I am trying to make in this recital and training of personnel concerned with the of our priorities is that, nomatter how well- aging. meaning or how noble our intentions, the prob- When these curtailments were announced, the lems of the aging are not going to be tackled Committee on Education and Labor convened a in any massive, meaningful way unless thecoun- hearing and subsequently, through pressures from try rises up on its hind legs and demands it. both sides of the aisle of our Committee, the You who are participating in this White House original budget submission was amended so as Conference will have to go home as missionaries, to bring these programs up to the Fiscal Year and make sure that the voice of the people is 1971 level. heard above the hoopla raised bymore vocal Nevertheless, for Fiscal Year 1972, $25,000,- but less worthy interests. 000 is authorized for the Foster Grandparents And this will be no easy task. For to some ob- program but only one-half$12,700,000will servers we are farthe. away from a meaningful be available. To obtain this much the Congress national policy and commitment to the elderly had to add $2,200,000 to the President's budget than ever before. request. Consider also that $15,000,000 is authorized During my years in Congress the rhetoric on for the Retired Senior Volunteer Program, but the national scene concerning the elderly has only $5,000,000 will be available. $30,000,000 far too often outdistanced the action. is authorized for grants for state and community Let me share with you some examples. programs on agingless than one-half,,nly $12,000,000, will be availableand this is $3,- One of the brighter spots inour endeavor to 000,000 over what the President requested. provide adequate services and opportunities for older people was the bipartisan effort in 1965 In total, $85,000,000 is authorized in Fiscal which resulted in the establishment of the Ad- Year 1972 for the Older Americans Act. Only ministration on Aging. $38,700,000or 45 percent of what is author- izedwill be available for programs carried on The Congress intended that thenew agency under the Act. To give this added perspective, I would provide our older population withmean- might mention that the amount we spent for ingful representation in theupper echelons of the one aircraft carrier (above one billion dollars) Federal Government. The Administrationon would fully fund the Older Americans Actat Aging was to be an agency which could devote itspresent level for the next ten years. Our full attention to the development of solutions for financial outlay for one destroyer would enable

129 us to fund fully the community programson the poverty program, the failureto adequately aging for three years. Moreover, this couldpro- serve our senior citizens." vide an estimated 2,500 additional projectsto meet the special needs of the elderly. The amendment would have added $50 million of additional funding authority forpoverty Largely because of the totally inadequate fund- programs designed for elderly people. The bill ing of many of the programs I have justmen- on the floorauthorizing two billion dollars an- tioned, the Foster Grandparents Program stands nuallyprovided a meager $12,000,000 annual- out as the most successful and beneficial program ly for programs focusing exclusivelyon the elderly. administered by the Administrationon Aging. Yr.tt, this agency, which I have always felt the elderlywere shortchanged was intended to be the in the War on Poverty. Listening focal point in government for olderpersons, has to the debate that afternoon reinforcedmy feelings.It was had the Foster Grandparents Program.taken brought out that out of appropriations of cpproxi- from its responsibility. That actionto deprive the mately $2 billion dollars last year, only $6,000,- Agent.7 of its most successfulprogram will in my 000 was spent on programs exclusively for the judgment further hamper and impedethe development of the Agency into(-le high level elderly poor. agency of power and responsibility which was Yet, the elderly poor Lcmprise 20percent of intended by the Congrets. our poverty population. They should, in all fairness, receive something like a four or five hundred As if this were not enough, the Administra- million dollar appropriation. tion on Aging has been deprived of anothermost successful programthe Retired Senior Volun- I regret to inform you the amendmentwas teer Program. This program, along with the defeated. Foster Grandparents Program, isnow placed in Not all is as bleak as I have suggested. The a new agency which is not chiefly concerned with bill I have just mentioned, the Economic the problems of the elderlyan action Oppor- which con- tunity Act extension, carried with itan amend- stitutes yet another step from the elderly, their ment which I sponsored that will in my judgment needs and problemsin search ofan objective have a great and beneficial impact forthe elderly which in my judgment is of much lesserpriority. and isolated in rural America. Members of the Committeeon Education and Labor made a strong effortto stop these trans- Those friends of mine here today from rural fers but unfortunately,we were not in the ma- America know the condition in the shortage of jority. decent housing available to low-income families in rural areas is one of themost critical matters But consider also that the research function facing the country. It is also of the Administration one of the most on Aging has been trans- neglected, because the homes of the ruralpoor ferred away and into the Social andRehabilitation are too often isolated up in the mountain hollows, Service. or screened by the woods or the mesquite, and Perhaps you now understand whythere are far away from the affluent corridors served by some who say we are farther away froma na- the interstates and the expressways. Public housing is not the answer to this particular problem, tional commitment to the elderly thanever before. because these peopleare country folk. They like Let me cite other =centmatters which are of the elbow room afforded by theirremote resi- equal concern. dence. To them the concept of wall-to-wallor gable-to-gable urban living is both alien andin- During House debateon legislation to amend tolerable. and extend the EconomicOpportunity Act, I supported an amendment designed,according to There is genuine need fornew housing, and its sponsor, "to remedya problem that has be- for the rehabilitationor repair of old. come endemic in this country in connection with We do not intend that this will bea major 130 new housing program. The modest $10,000,000 significant additions to the Administration on suggested for it is the best guarantee of that. This Aging. I have joined with my colleague from is a modest rural program aimed at a special Florida, Congressman Claude Pepper, in the spon- housing problem in which existing housing legis- sorship of a bill to establish a nutritionalpro- lation simply has not proved effective. It iscon- gram for the elderly. This legislation is in line fined to the rural areas and limited to rural hous- with recommendations from the White House ing development. We felt it should have special Conference on Food, Nutrition and Health held identity. in 1969 and of the President's Task Force on There are other aspects of thislegislation Aging in April of 1970. It is an important and which are also, as you know, of significant benefit necessary proposal, but I caution you that already to elderly Americans. The bill provides for the opposition has been voiced to its enactment. extensionofOperation Mainstreamof the We haVe legislation directed at a major prob- Greenthumb projectsand of community action leM which afflicts many middle-aged and elderly programs, many of which but certainly not en- personsthe lack of employment opportunities. ough, provide help to the elderly. There is pending before the Committee the pro- Tomorrow on the floor of the House of Repre- posed "Older Americans Community Service Em- sentatives we will debate the final version of this ployment Act," which would help assure a chance legislation. At stake will be the continuation of for useful and 'constructive jobs. But I caution so many of the programs which have meant so you again that already opposition has been voiced much to our elderly. At stake will be the estab- to this proposal also. lishment of the new housingprogram for the rural poor and the new Comprehensive Child It is my hope that as we continue with our Development Program. scheduled hearings, we will developand I am confident that we will with your helpa compre- One of the more valuable benefits of White hensive piece of legislation which will include House Conferences such as this isthat partici- provisions attacking the frequently mentioned pants have an opportunity to bring grass roots transportation problems facing the elderly, assur- reactions to our elected; officials: As we.near this ing adequate nutrition for aged citizens and de- very crucial vote on the Economic Opportunity veloping new systems of food delivery, bettering Act Amendments, I know that my colleagues housing conditions for the elderly, and provisions have benefitted, as I have benefitted, from the designed to guarantee that the Administration on insights you have shared and will share with them Aging becomes what the Congress has clearly this week. intended; that is, an office of power and responsibility within the Federal system. As we look farther ahead, I am quite optimistic. In the immediate future, the Committeeon We have also begun hearings on comprehen- Education and Labor will be considering legisla- sive manpower legislation. There are two major tion of tremendous importance to the elderly. I versions of this legislation which are being con- would like to mention very brieflysome of the sidered. In an effort to consolidate similar type programs and issues the Committee will turn to programs both bills call for the abolishment of during the Second Session of the 92nd Congress. the categorical approach to manpower programs As you all know, the Older Americans Act found in present law. One of the bills goes so far expires on June 30, 1972, less thanseven months as to consolidate all separately identified cate- from now. Already one ofour Subcommittees, gorical manpower programs, whereas the other chaired by my able and distinguished colleague sponsored by the distinguished Chairman of one from Indiana, John Brademas, has begunover- of our Labor Subcommittees, Dominick Daniels sight and exploratory hearings. of New Jerseywould consolidate certaincate- gorical programs, but preserve others. The under- At this time we have pending before the lying philosophy of this approach is that there are Committee legislation which I believe will make certain areas of need which are of such great

131 importance and so much in the Federal interest be considered by our Committee on Education that their separate identity must be preserved. I and Labor. Although the jurisdiction ofour Com- support this latter approach and I am pleased mittee is somewhat limited in the many fields to advise you that in this bill the interest of the of interest to this White House Conference,we elderly would not be merged with all other in- are proud to have originated the Older Americans terests, but would stand apart as a special Federal Act of 1965 which created the Administration interest and concern which is accorded special and on Aging, and the 1968 legislation which estab- separate funding. lished this White House Conferenceon Aging. At the end of the current fiscalyear, programs This legislation was enacted on a completely authorized by the Vocational Rehabilitation Act bipartisan basis, and that is the only properap- will expire. Here, too, we will have extension proach to the problems of the aging. An Ameri- and revision legislation ofan Act and programs can statesman of those difficult days just preced- which have made substantial contributionsto ing World War II remarked that "politics should many of the problems being discussed in this stop at the water's edge where foreign policy White House Conference. We will conducta begins". I think that politics shouldstop in the comprehensive evaluation of existing law inan consideration of how government may bestserve effort to strengthen and expand existingprograms the aging, because it is an issue thatconcerns and to identify still unmet needs. all of us. I think it was Mark Twain whore- During our work and deliberations,some of marked that he hated to think about growing old, the issues may receive national attention and but that there was only one alternative and he some will not. You must be aware of both. An didn't want to think about that at all! Satevery examplethe ComMittee will haveto make a citizen, in a very personal way, is involved in the decision on whether we will merge the interests process of aging. One of the tasks of this Con- of the elderly inour comprehensive manpower ference is to help make every citizenmore aware program or whether we will provide for a sepa- of that personal involvement,so that it can be rate authorization. Your guidance and recom- translated into informedconcern which leads to mendations will be weighedvery carefully not effective action. only in this debate, but also in themany other We do urgently need a better informed public debates which will undoubtedlyoccur during the because many of the problems of elderly persons next twelve months on legislation directly af- are increasing at the same time their numbers in fecting the elderly. our society are growing, both in terms of aggre- I am confident that with your continued in- gate numbers and percentage of the total popu- terest, support and cooperation, we will be able lation. Twenty million Americansare now 65 to seize upon these opportunities and to take years of age or older. In the past decade this age significant steps toward creatingat the Federal group increased by 22.1 percent, or nearly double level a genuine awareness and commitment both the increase (12.5 percent) of the total popula- to programs and to money in the field of the tion. The population aged 75 and older grew aging. even faster, an astonishing 37.1 percent in a single decade. The Honorable Albert H Quit, I know that many, perhaps all ofyou, have Member, House Committee heard these statistics repeatedly, but it stillamazes on Education and Labor most people to learn that in the past hundred years, while our total population has increased Thank you for your kind invitation toappear five times, our middle-aged population is nine here with Chairman Perkins. Thereare, as you times larger and our older population has in- have been informed, numerous bills before Con- creased 17 times. gress dealing with the problems and opportuni- We must now meet the challenge of matching ties of older Americans. A number of them will the progress in longevity brought about by medical

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L and nutritional advances with progress toward abstract concern for millions of our elderlyit achieving an acceptable standard in the quality is a daily and very real fear which in turn is a of life for all of our older citizens. major cause of loneliness and isolation. This is a difficult challenge and in my judgment In New York City, Jules Sugarman, the director there are no easy ways to meet it. Government of the city's Human Resources Administration, has an important, and even crucial role in this told our subcommittee which handles the older task, but we cannot expect to achieve our goals Americans legislation, that there had been a recent through governmental action alone. Somehow upsurge of attacks on elderly persons by juveniles we must stimulate far greater private concern aged 10 to 15. He said that many evening pro- and action. Somehow we must make far more grams for the elderly were closing down and effective use of the "people to people" approach that even programs during the day often require which is often so vitalto the success of our escort services. efforts for older people,just asitisfor the very young. I have singled out this particular concern, for which our Committee has some jurisdictionin When we talk about the problems of older terms of ou'r responsibility for the Juvenile De- Americans we are not discussing needs which linquent), Prevention and Co'ntrol Act, to try to are foreign to other groups in the population. show the interrelation of some of these problems. We are talking about income maintenance, ade- Loneliness and isolation can be vastly increased quate housing, adequate nutrition, safety in our by street crime. It can also be a product of poorly homes and streets, education and social services, planned housing which takes into account neither a decent standard of medical care, and so forth. the older person's need for physical safety nor the The major difference is that all of these concerns need to feel and be a part of the larger commu- tend to be far more acute for the older American. nity. And social services which do not take into And too often other really critical differences account either of these needs simply do not serve are not well understood by the rest of us. the elderly. Consider for example a fundamental problem Some day, hopefully, we shall have solved the for millions of our elderlyloneliness and isola- complex problem of street crime. But older people tion from the rest of the community. This basic cannot wait for that day. Meanwhile, we must problemwhich can be the most devastating of design our programs in housing, transportation, all in human terms and often makes worse such and social services in such a way that it is over- problems as inadequate nutritionor medical care come or minimized. is compounded by the fact that America's Our task as legislators is to design legislation elderly are not concentrated in model communi- which, as well as legislation can, will promote ties in warm climates. That is the fiction. The genuinely effective programs for the elderly. This fact is, for example, that New York City with task is complicated by the limited jurisdiction of five percent of the Nation's total population has Congressional committees which deal with pieces 12 percent of our elderly population. A larger of the problemincome maintenance in our com- percentage of th6 population of Massachusetts mittee, housing in another, transportation in still (11.4 percent)isaged 65 or older than of another, and nutrition and health split between Arizona (8.3 percent). My own State of Minne- several. The same difficulty is found in the Execu- sota, with 13 percent of its population in this tive Branch where these matters are dealt with age group, is right behind Florida with 13.3 per- indifferent agencies.Ipersonally doubt that cent. The Fact is that nearly two-thirds of Ameri- either in the Congress or in the Execut;ve Branch ca's elderly live in metropolitan areas and fully could we change all of these jurisdictional lines, one-third live in the central cities. but I do feel that we can cut through them. Thus the problems of older persons are most That is why I think President Nixon is to be often aggravated by the problems ofour cities. commended for establishing a cabinet-level Com- Crime in the streets is not a political issueor an mittee on Aging within the Domestic Council,

133 which can and will provide high-level.considera- analysis, it is not how much money we spend don of these issues and the coordination of Fed- but what happens to and for people that really eral programs. The Committee isunder the matters. We should never allow ourselves the Chairmanship of the Secretary of Health, Educa- luxury of believing that if we have passeda law, tion, and Welfare, Elliot Richardson. I know of appropriated the funds, and expendedmoney for no man in American public life who has a keener programs, we automatically have solved a prob- intellect or who has more desire to solve social lem. problems than Secretary Richardson. One could discuss at length, as this Conference Within the Congressional Branch it may well undoubtedly shall consider at length, the effect be that we should take some similar step, such as of this or that income policy for the elderly. I a Joint Committee on Aging. Perhaps this Con- happen to believe that the President's welfare ference will come forward with helpful recom- reform recommendations,as embodied in H.R. 1 mendations for us. I know that our Committee together with suggested improvements in on Education and Labor has the immediate task the Social Security program, represent a majorstep of considering extension and possible modification forward to assuring a more adequate income for of the Older Americans Act, and that we shall the elderly poor. Certainly the success of efforts carefully consider the views expressed at this Con- being made to control inflation and thus tosta- ference concerning the status and programs of bilize the value of income is also a vital necessity the Administration on Aging. Year by*year the if we are going to see any income policy work. budget of that agency has been increased (from $23 million in fiscal 1969to $38.9 million in But I do not believe that sufficient iname fiscal1972). Actually, the comparable 1972 while it may be the fundamental need of all figure is nearly $45 million, since almost $6 mil- older Americans, is the completeanswer to all lion for research and personnel training in the of their problems. i know that it is something of field of the aged is budgeted under theparent a cliché, but the great human need of every per- Social and Rehabilitation Service of HEW. sonthe need to be needed by othersispar- However, I think all of us need to consider ticularly acute for the elderly. This needcan be ways in which we can further strengthen the fufilled for a foster grandparenton a very small Administration on Aging.I know that recent income and totally unmet in the case ofan older program transfers have raised some issues, but person of considerable wealth. We are misusing these were made for the purpose of strengthening and losing a large part of one ofour greatest the programs themselves and I thinkwe should human resourcesthe knowledge,experience, not prejudge the question of whether they harm and judgment of older citizens. It is thisresource the agency. The important point is thatwe must that we need to find out how to reallyuse to the improve the .overall effectiveness of government mutual benefit of the older citizen andour society. in helping the older American. I think we have barely begun to examineways of doing this, and thatwe are doing far less than We have made significant progress interms of we should to implement ways we have shown to total Federal outlays for programs affecting older be successful. Americans: from $25 billion in 1967 to $34.1 billion in 1969, to $46.4 billion in fiscal 1972. In accomplishing this fundamental andin- These sums, as you all will recognize include creasingly urgent social goalthe constructive outlays for Social Security and similar trust funds. use of the capacities of our older citizenswe The Federal expenditures for discretionarypro- shall need a strong combination of governmental gra..as for the agedthat is, for those programs and private efforts. I pledge to domy best both in which expenditures were not mandatedare as a Representative in the Congress and as a more revealing. These rose from S457 million in private citizen in helping to bring this about. . 1967 to $687 million in 1969to 51.2 billion We are alllooking to this Conference for in fiscal 1972. This is not a record of expendi- guidance as to how best to carry out thatsort tures which suggests neglect. Yet in the final of pledge.

134 ...

The Closing General Session 1 December 2, 1971

The Conference closed with a General Session At the outset, we will seek to obtain information held in the International Ballroom of the Wash- relative to what actions individuals and groups . ington Hilton Hotel. The United States Marine of individuals are planning to take. Wide dis- Band, under the direction of Col. Albert F. semination of actions that are being taken at the Schoepper, provided music while the audience beginning ofthePost-Conference Year will assembled and again when President and Mrs. stimulate the development of new action pro- Nixon joined the Conference. grams early in the year. Once this information Arthur S. Flemming called the Session to order has been assembled, it will be possible for leaderi and asked Bishop Raymond J. Gallagher to offer in both the public and private sectors to identify the Invocation.Followingintroductions,Mr. gaps and then to try to do something about Flemming addressed the Delegates on the "Post- closing the gaps. Conference Year." President Nixon closed the First, we would like to obtain information Conference with an address which also looked relative to the individual commitments that the forward to a better world for the Nation's older Delegates to this Conference plan to make. You citizens. Rabbi Abraham J. Feldman pronounced have been provided with a form which, if you the Conference Benediction. SO desire, can be used for this purpose. You can Copies of the 1971 White House Conference check the items on the forms or you can state RecommendationsA Report to the Delegates your commitment in your own way. If you do from the Conference Sections and Special Con- fill out the form, or if you communicate with cerns Sessions were distributed to all participants us in some other way; we, in turn, will want to at the close of the Session. keep in touch with you in the hope that you will share your experiences with us. Making a commitment of this kind is not a part of your responsibilities as a Delegate. We offer this in the belief that some of you might like to begin the ADDRESS by Post-Conference Yesr in this manner. The Honorable Arthur S Flemming Next, we will endeavor to obtain information from the national organizations that have partici- While we had the pleasure of greeting many pated in the White House Conference. Many of of you at the reception last evening,you were these organizations will take formal positions very gracious in your comments relative to the on the findings and recommendations of the Con- manner in which the Conference has been conference. We will seek to determine when these ducted. Many persons have contributedto this positions are to be taken. We will also seek to result. When the first one of the longerreports determine whether the organization in question of the Conference is issued, it will beaccompa- plans to take a position on all of the recommenda: nied by an introduction that will endeavorto tions or only on those contained in certain Sec- Y identify both individuals and groups to whom tions and Special Concerns reports. all of us are deeply indebted. Many organizations will develop plans for ob- Almost without exception last evening you taining support for the recommendations they de- said, "Now I hope we can get action." You know cide to endorse. Where a recommendationsup- that I share that hope. Briefly, this morning, I ported by an organization calls for involvement want to identify some of the initial steps we will on the part of the private sector, we will seek take. to determine what plans the organization has

135 i"

for bringing about the involvement of itsmem- a basis for the Post-Conference Year of Action. bership. Where a recommendation supported by As a result, they have decided to address the an organization calls for action on the part of following message to the delegates. Federal, State or local governments,we will seek to determine what plans, if any, the organization "In a message to the Delegates at the opening may have to develop citizen support for the of this Conference, we stated thatit was our recommendation. In both instances,we will ask hope that the discussions and the conclusions whether or not the organization has plans for reached would contributeto just one objective. cooperating with other organizations. That objective is: The enlistment of widespread support from all social, economic, :eligious, and We will endeavor to obtain information from political groups in behalf of actionprograms public agencies at all levels of government. We that will make available to older persons increased' will call their attentionto recommendations addressed to their part of the public resources, services and opportunities and that will sector. We remove existing inequities which ethnic and other will ask them for their reactions to these recom- minority groups have had to bear. mendations. If they have a favorable reaction,we will seek to ascertain whether they planto im- "We believe that the discussions and thecon- plement the recommendations immediatelyor clusions reached by the delegates could set in feel that they must postpone action. If they feel motion forces that can lead to the achievement that they must postpone action, we will seekto of this objective. ascertain their reasons for this conclusion. "What is now required are commitments to Once this information has been obtained,we action. will bring together representatives from both the private and public sectors who have partici- The Chairman has reviewed with us the plans pated in this Conferenceto determine how, in the for sending a communication to the nationalor- light of this information, strategies for actioncan ganizations that have participated in this Confer- be developed. ence. We believe that an approach of this kind would help to provide an opportunityto make 'Finally, we will develop a reporting system meaningful commitments for action. We also be- reflecting progress or lack of progress. lieve, however, that it should be made clear that In my opening addresson Sunday evening I participation by voluntary organizations in the read a message to the delegates from six national Post-Conference Year can be meaningful only organizations. The signators to thisstatement were if there is commitment of substantialresources in alphabetical order byname of organization and leadership by government at all levels. as follows: "Our organizations will take advantage of this Bernard E. Nash, Executive Director, Ameri- opportunity. We hope that hundreds of other can Association of Retired Persons and Na- organizations will do likewise. tional Retired Teachers Association "In responding to this communication,we in- Thomas G. Walters, President, National As- tend to underline the following points incon- sociation of Retired Federal Employees nection with those specific Conferencerecom- Hobart C. Jackson, Chairman, National mendations with which each of our organizations Caucus on the Black Aged find itself in agreement: William C. Fitch, Director, National Coun- 1. We will monitor on a continuous basis what cil on the Aging is happening to those recommendations ad- Nelson H. Cruikshank,President, National dressed to i'le public sector at all levels, but Council of Senior Citizens, Inc. especially those which are addressedto the Federal Government, and will speakout in no I have discussed with these signators the plans uncertain terms when actions do not keep I have outlined for obtaining informationto use as pace with rhetoric.

136 2. We will do everything possible to develop persons, it would take more than the four hours strong political backing at all levels of govern- that Chief Justice Warren tookat the Open ment for such recommendations. Forum on Monday night, and I wanted to be here 3. We will take seriously the recommendations this morning. I wish I could have welcomed all addressed to the private sector and will make of you from all of the States in this Nation, all significant investments of time, energy and of you with your deep commitment. resources in order to implement them. Now I want to talk about this Conference, the "The Chairman advises us that he recognizes the White House Conference. I want to talk about importance of commitments for action from the it very candidly, in terms not of thepast or the public sector to parallel those he is seeking from present, the resolutions that you will present, but the private sector. He is going to urge public in terms of the future. agencies at all levels to make their owncom- mitments. Down in the Library of Congress there is a whole floor with many, many stacks of volumes of. "We are convinced that an immediate and the records of White House Conferences, con- vigorous effort is going to be made to determine ferences on aging, conferences on young people, just where we are in terms of a willingnesson conferences on health. On almost any subjectyou the part of public and private organizations to can imagine, there has been a White House Con- followup on the White House Conferencerecom- ference, and every President has participated in mendations. We are convinced further thatonce them. Every President opens them or closes them, this information is available, it will provide the as the case may be. basis for developing strategies for actionstrat- egies that could produce unprecedented actions Those volumes, very many of them, when I in behalf of older personson the part of all have seen them down there, just gathered dust, segments of our society during the Post-Confer- and you wonder what happened. Was it worth it? ence Year. And all of you, as you come to the end of this Conference, must wonder, after all the workyou "The millions of older persons werepresent have done, after all the recommendationsyou will be satisfied with nothing less. Weare confi- have made: Is it going to end here,or is this a dent that the delegates to this Conference will beginning? be satisfied with nothing less." That is what I want to talk about. I would be less than candid if I were not to say thatmany White House conferences are more cosmetics than the real thing. They talk about the problem, give people an outlet, and, of course, that isa good ADDRESS by thing; but recommendations usuallyare not put The Honorable Richard M. Nixon into practice as often as they should be. President of the United States When this Conference was called, as John Martin and Arthur Flemming will tellyou, I Dr. Flemming, Chief Justice Warren, all of the told them I wanted to know whatwe could do. distinguished guests on the platform and all of In preparing my remarks today, I wanted to speak the distinguished delegates to this Conference: specifically to the things that you recommended, First, I want you to know how very delighted and to speak also to how we could followup. we were to have you-2,700 I understandas I do not want the volumesand there will guests last night at the White House. As I came be volume:. on this Conferencesimplyto gather in by helicopter from Chicago, after speakingto dust in the Library of Congress or in the Office a 4-H Convention there, I saw many in the win- of the President. As long as Iam here, 1 sill go dows looking out. I only wish I could havecome over and shake off the dust myself to find out down; but I realized if I shook hands with 2,700 what was said. But Dr. Flemming toldme before

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468:217 0 73 - 11 I came in here just what he said to you when he We are speaking, after all, of a proven gen- introduced me: that each one of you has made eration, one that has brought this country through a very important pledge this morning, a specific the most turbulent period in human history. Your commitment to action in the post-Conference year. skills, your wisdom, your values and your faith I am here to join you in that pledge. these are among the most valuable resources this This means that I am going to give my close, Nation possesses. personal attention to the recommendations of this This country will have to be at its bestif Conference. I have asked Dr. Flemming to stay we are to meet the challenge of competition in on. We really cannot afford him, but he comes the world of the 70's, and we cannot be at our really as a volunteer. He is not only going to be best if we keep our most ex,..sienced players on Chairman of the Conference inthe followup the bench. I am not speaking of the Washington period; but also as a Special Consultant on Aging, Redskins, either. Yet, in recent years all of us so that I can take up these matters personally know a gulf has been opening between older with him, as well as John Martin, who, as you Americans and the rest of our people. This gulf know, is my Special Assistant on Aging. is the product of a great social revolution which Now, Dr. Flemming is known to you from has weakened the traditional bonds of family, having presided over this Conference. He is also neighborhood and community. For millions of known as a great educator. I knew him as a older Americans, the result has been a growing member of the Cabinet. Beneath that very genteel sense of isolation and insecurity. exterior is one of the most tenacious men I have We have to change that. Younger and older known. So you have a good representative there Americans need one another. We must find ways speaking up for your problems. to bring the generations together again. The second step I have taken is that I have In addressing the challenges before us, let us directed that your recommendations be put at the begin where most of you beginthat isthe top of the agenda of our Cabinet-level Commit- problem of inadequate income. We have to begin tee on Aging, in which Dr. Flemming also plays there because if we move this front, all the a leading role. other battles will be easier, and if we fail, to move in the income front, the other battlesand Finally, I have asked Dr. Flemming to create there are many others that I will discuss in my a post-Conference board to act as your agent in remarks this morningwill be impossible. following up on your proposals. When matters that affect the interests of older Americans are That is why it is so important that the Con- being discussed in the White House, Iam de- gress approve one of the most important bills to termined that the voice of older Americans will come before it in many yearsthe bill known be heard. That is my commitment to you. as H.R. 1. Now, let me talk to you a bit about Now, as we consider your suggestions, we will H.R. 1. be guided by this conviction: Any action which Itis generally known as welfare reform. I enhances the dignity of older Americans enhances presented it to the country in a radio-television the dignity of all Americans, for unless the Ameri- address almost two and a half years ago. In can dream comes true for our older generation, that period, since it was presented to the country, it cannot be complete for any generation. ithas been debated and talked about, passed This is true, first, because we all grow old. one House, and still ianguishes in the Senateno The younger generation today will be the older prospect for this session, and apparently not too generation tomorrow. But more than that, the much prospect even for the next session, unless entire Nation has a high stake ina better life something happens in terms of waking the Con- for its older citizens simply becausewe need you. gress up to the fact that the American people We need the resources which you alone can want it. offer. Let me tell you what H.R. 1 does. You hear

138 about welfare reform. Well, believeme, we Let me point out something: If they had need it. We have a system at the present in this passedit two years ago, we would have had country, a system in which, under our present it then. You can see why the Congress needs to welfare rules, in many States it makes itmore quit talking and staat acting on H.R. 1. This profitable for a man not to work than to work, would be three billion dollars in 'increased Social and it rewards a man for leaving his family, Security benefits, and when it is fully effective, rather than staying with his family. Whenyou another two and a half billion dollars in new have that kind of a system, you oughtto abolish benefits to persons with lower incomes. And a it and get something else. . proposal to eliminate the monthly Medicare fee So our new program provides for work in- would enrich the five and a half billion dollar centives and work requirements. It also provides package by an additional one and one-fourth bil- for needy children and provides for those needy lion dollars, so that is the equivalent of an addi- children without the effect of the present welfare tional five percent increase in social security. program, which is so degrading on those children So you can see how much is at stake in this and mars them for life. one proposal which has been there for over two But what is in it for older people? I thinkwe year?, which has not been acted upon, and which have forgotten many of those things. Letme tell needs to be acted upon. you how much is at stake for older citizens in H.R. 1 and why it must be a top priority. I have made a commitment to you. We need your help. Let your Congressman, let your Senator, For the first time in our history, it wouldput know that before the next electionyou want a national floor under the annual income of action on H.R. 1. I think we ought to have it. every oPer American. Now, some may say it ought to be higher, some maysay it ought to be Now I would like to go to a second subject earlier; but the point is, it will be done. We need which is related to income. It is on the other a national floor under the income of every older side of the coin. That is the subject oftaxes. We American. H.R. 1 does that. are supporting a series of tax reform proposals which would enable a single person aged 65or Second, for the first time inour history,it older, to receive up to $5,100 of tax-free income. would make SocialSecurity benefitsinflation- A married couple, both of whom are 65or older, proof. This is something that I have always be- would receive over $8,000 in tax-free income. lieved in. It does not makesense to have Social Security benefits constantly behind inflation. If Howeverand now I come to one that will we have inflation, the benefits should goup with be very close, I rtm sure, to the hearts ofmost it, and H.R. 1 provides for that. of the people here, because when Imet with representatives of this group before this confer- It would allow Social Security recipientsto ence was convened, this subject was raised by every earn more money from their own work:It would one of those present. That is the property tax. It raise benefit levels, especially for widows.I have inot related to income, but itis a tax which also asked the Congress to include in H.R. 1 a keeps going up and up and up; whereas,an older proposal for eliminating the $5.60 monthly fee person's income may be even going down. now charged for Part B of Medicare. Property tax collections have increased by 40 Now let me get into the numbers. Thesenum- percent in the last five years alone. Now, here is bers are so big that theymay not, of course, be where older Americans come in. We have checked very impressive when we think of $200 billion and found that 70 percent of older Americans budgets; and I am goingto be working on that own their own homes. For many, these homes rep- budget over this next weekend. But H.R.1, as it resent a lifetime of careful saving, and yet, be- now stands, would provide five anda half billion cause of property taxes, the same home which has dollars in additional Federal benefits forolder been a symbol of their independence often be- America.Jfive and a half billion dollarsmore. comes the cause of their impoverishment.

139 Take the 30 percent who do not own their which I appointed last year, has been carefully homes. Those who rent their homes often bear studying a range of possible remedies. These an unfair burden because property tax increases remedies will involve large sums of money. But are often passed along in the form of higher we are prepared, however, to make the hard rents. decisions we are going to have to make to provide property tax relief. The inequity of the property tax is often the greater because it takes money from those who The time has come, in this subject as in others, have already educated their own children, and to stop talking about the impact of property taxes uses it largely for the education of other children. on older Americans and to act in their behalf and in behalf of other citizens in similar circum- I received a letter recently from a women stances. whose parents brought her and five other children to this country from Switzerland many years ago. Now, I want to go to another matter that I They settled in California as homesteaders. They know has had consideration here, andone which were full of hope and pride. Over the years that 1fiii-cl very fundamental agreement withyour followed, they made their dreams come true. conclusions. That is the inadequacy of private But today, many, many years later, things have pension plans. One-half of our work force is changed so much that Mrs. Ewing begins her not even enrolled in such a plan and many of letter to me by saying, "Was_ it just an empty those who are enrolled have inadequate or un- dream after all?" reliable coverage.

Her father, at 72, is too ill, too tired to work. I will, therefore, propose to the Congress anew His family is grown and scattered. To meet his program to reform our private pension systems.. real estate taxes, he is now being forced to sell Here are some of the reforms: They will include the prci-,:rty for which he worked so hard and measures designed to expand pension coverage, so long. Then she goes on to say, "If this is to ensure that pension funds are soundly managed, really the country I grew up believing itto be, and also I will recommend new laws to require these inhumane property taxlaws must be the investing of pensions so that an individual changed." who works in a job, has money invested in a She is right and they should be changed. That pension, and then moves from that job doesn't is why we need a complete overhaul ofour lose what he has put in. lie is entitled to that and he should get it. property taxes and of our whole system offi- nancing public education because the property tax, Now, there is one other item where I am as you know, in California as well as in many other going to talk about something that involves not States, is the primary tax which can and must be what the Congress and what the Administration used at this time for financing public education. can do for older Americans, but what you can Our revenue sharing proposals which were do for the country and for yourselves. made a year ago, and which still have not been I am sure you:have-been reading and hearing acted upon, can help relieve the pressure on in your newspapers and on television and radio property taxes, and older Americans have a large a lot about our new economic policy; with the stake in enacting those proposals. But I believe freeze on wages and prices for 90 days, Phase II, we have to move in another front, more directly some of the arguments that have taken place with on the problem of property taxes. I am, therefore, regard to what the application should be. Let me working with our Domestic Council and working say that as far as this program is concerned, its specifically with Secretary of the Treasury Con- primary design is to stop the rise in the cost of nally in preparing specific proposals to ease the living. As far as this program is concerned, it is crushing burden of property taxes for older Ameri- inevitable that anything that we do is goingto cans and for all Americans. cause some sacrifice on the part of some Ameri- The President's Commission on School Finance, cans.

140 For example, some labor leaders,not all, but they receive excellent care from people whocare some of them object to the fact that labor in- about them. But many donot. There are some creases and wage increases cannot be as high as bad nursing homes, some inadequateones. There they would like. Some business leadersare ob- is little that the people whoare in them can do jecting to the fact that we have laid downregu- about it. lations in which their profit marginsare not allowed to be as highas they would like. Some Partially, it is a question of money, being able stockholders are objectingto the fact that we have to afford the payments, and partially it is a ques- laid on regulations where their dividendpay- tion of regulation. Where it isa question of regu- ments cannot be as high as they would like. lation, we certainly can do something about it. That is why I announced last summeran eight- a- Let me say, I would like to havea program point program for improvingour nation's nursing that would satisfy them all, because it isnot pleas- homes, for cutting off funds to those whichre- ant to have any segment of the population object main substandard. to a program that we have adopted. But let me lay it right on the line. Wherea wage increase or Our primary objectiveisthe upgrading of a profit increase or a dividend increase can be nursing homes, but we are not goingto hesitate controlled and the result will be stopping the rise to cut off funds from those which are hopelessly in the cost of living for all Americans,that is substandard. worth doing, and that is whatwe plan to do. Furthermore, we will take theinitiativeto The support for thatprogram has been stronger make sure that public and privateresources are perhaps, among older Americans, accordingto available to provide alternativearrangements for all the polls, than all the others. Onthe other the victims of such homes;to cut off the funds hand, 70 percent of Americans dosupport it and for the substandard ones and just let the people we ask your continued support, because nomatter out, that is no answer. We must find an alterna- how much the pensions may be,no matter how tive and we are planningto do that. much the Social Securitypayments may go up, if But when we speak of the million who live in the cost of living continues to go up it doesn't nursing homes, we want it realized that forevery make any difference. That is whythose who are person in a nursing home, we have twenty times retired and living on fixed incomes havethe as many older people who are not in nursing biggest stake of all Americans, andwe hope that homes. The greatest need isto help more older you will continue to support it right to the hilt. Americans to go on living in theirown homes. Now, I have been talking about income and Income programs, such as- H.R. 1,tax reforms, taxes and how we control prices, but even with they can help achieve this, because if the indi- higher income, we all know thatmany older viduals have the funds, then theycan retain their Americans face problems beyond their individual own homes. But so can a number of other addi- control. I am going to talk fora moment about tional decisions which we have already made. the one million Americans who live in nursing We want to begin by increasing thepresent homes. budget of the Administrationon Aging nearly I can talk with great feeling about this because five-fold--to 100 million dollars. Now,you may my mother was in a nursing home. She wasvery wonder where I got that number. Imust say, I ill and had a stroke during the lasttwo years heard from a number ofyou and I heard from of her life. It wasa very good nursing home and Arthur Flemming. He didn't know aboutthe I will always be thankful that thenurses there number until this morning because itwas 80 treated her just as I would have wantedto treat million dollars last night, and I decided, whynot her, if I could have been there. Many ofthese 100 million dollars. One hundred milliondollars nursing homes, like theone my mother was in is needed for reasons that Iam going to indicate and like the one my 91-year-old Aunt Edithis as to what I expect from this. in out in Riverside, California, are ones where But let me put it in another context. Letus

141 put it in terms of priorities. The Congress, for Now I turn to another subject, and if I seem example, at the present time, has, under consider- to be moving from place to place, believe me, ation a tax bill. It is a tax bill that has some you moved from place to place throughout this very good provisions in it. It has one in which Conference and I am trying to cover most of the there is disagreement, honest disagreement, one major subjects in which you expressed an interest. where Itake a different position from some Some of the best service programs for older -others. But there is one provision in that bill Americans are those that give older Americans a that provides for between 50 and 100 million chance to serve. Thousands of older Americans dollars to go for the purpose of paying the cam- have found that their work in hospitals, churches, paign expenses of an individual who is running parks and schools gives them a new sense of as the nominee of his party for the Presidency pride and purpose even as it contributes to the of the United States. Now, my friends, just let lives of others. me say this: It is very important that campaigns be adequately financed, but Isay, rather than Federal programs to provide such opportunities to have the taxpayers' money used for the pur- have proved remarkably successful at the demon- pose of financing a candidate's campaign for elec- stration level, but that is all they have been up tion, that money should be used for the purpose to this point. We are going to change them. of allowing the elected President to keep hiscam- We are going to move from demonstration to paign promises once he gets into office. establish these programs on a broader national basis. Therefore, I am going to request that the Now, let's see what this 100 million dollars Retired Senior Volunteers Prograin be tripled for is going to do. We can give special emphasis to 15 million dollars, so that an additional 50,000 services that will help people live decent and volunteers can be involved. I have directed that dignified lives in their own homes, services such the Foster Grandparent Program be doubled to as home health aides, homemaker and nutritional 25 million dollars, and I will ask that this program services, home-delivered meals, transportationas- be altered so that Foster Grandparents can work sistance. Much of this new money will be used with older persons as well as with children. to help marshall existing and expanding resources more effectively at the local level. I have also ordered that our jobs program Toward this end, I will direct the Social Se- for older persons with low incomes be doubled to curity Administration to provide an information 26 million dollars. Under this program, projects center in each of its 889 district and branch such as Green Thumb and Senior Aides have offices to help explain all Federal programs which demonstrated that older Americans can make aid the elderly. These offices will, ofcourse, sup- valuable contributions in health, education, and plement the State offices which already are doing community service projects even as they earn a very fine job in this respect. additional income. Then, there are two additional administrative Let me say: Every older American can be decisions which will help older Americans remain proud that you have made these programs work in their own homes. The first will make housing in recent years. That is why we can double this money more readily available to older citizens one, triple that one, make a permanent program to purchase homes in a variety of settings, in- out of what was previously a trial or demonstra- cluding condominiums and retirement communi- tion one. These decisions mean that you will be ties. Secretary Romney, who is alsoa very tena- able to work in more places and for more people. cious, evangelistic man in our Cabinet, is going to see that that is done, I can assure you. Now I have spoken this morning about some of the immediate steps that I am taking as part The second will require that Federal grants of my commitment, with your commitment,to provide services for older persons and alsopro- action. We are proud of hese initiatives, but we vide for the transportation they needto take ad- are not content to rest on them. We are going vantage of these services. to build on-them. That is why I have outlined

142 a mechanism for following up on this Conference, be at the heart ofour new, national attitude one which will allow us to take the fullest ad- toward aging. vantage of the excellent work which you have done. I see a great number of people in the White Any discussion of the recommendations for House, young people, middle-aged, older people, not nearly as many as I would like to see, but dealing with the problems of the aged wouldnot be complete without recognizing thestrong sup- every day some come through to receive an port expressed at this Conference for extending award or recognition, and some justwant to Medicare coverage to include prescription drugs, come in and see the President for some reason. and for accelerating the rate at which the income A few months ago I met witha remarkable man. floor comes into effect under H.R. 1. His name was George Black. Formore than 80 years, this man has been making bricks by hand Now as you know, these programs involve in Winston-Salem, North Carolina, hisown spe- very, very substantial budget problems for the cial way of doing it. He isa master craftsman. Administration. Therefore, theyare ones that will need a great deal of consideration and study. When he came in to see me, he didn't look Because of the interest which you have expressed it but he told me he was 93years old. But his in these programs, I have directed the Domestic productive years werenot over. So our Govern- Council, under John Ehrlichman, who has already ment, under one of the prorgams that we for- addressed you, to carefully consider both proposals tunately had, sent this remarkableman to a coun- and to make recommendations tome at an early try that needed to learn about that almost for- date. gotten skill of making bricks by hand. George Black went to Guyana, in South America,so Your work is not yet over. You havea message that he could share his skills with the people of to take home with you from this Conference,a that less developed country. message which must now be heard in every community in this land. Let me tellyou what it is. When I asked him about his trip, this is what We need a new, national attitude toward older he said: "I have always asked the Lordto let people in this country, and that attitudemust be my last days be my best days. I feel like He one which recognizes that America, whatever it is answering my prayers." does for its older citizens, fully appreciates what George Black'i prayer is the prayer of millions our older citizens can do for America. of Americans"to letmy last days be my best Only a new national attitude toward agingcan days." And for them,as for him, its answer end the throwaway psychology which I under- depends not only on what theyare given, but on stand was so graphically demonstratedin the what they continue to give. film you saw Sunday night. Onlya new attitude Older Americans have much toward aging can reopen the doors ofopportunity to give to this country. The best thing this country can give to which have too often been closingon older men and women. them is the chance to be apart of it, a chance to play a continuing role in the great American To borrow another phrase fromyour multi- adventure. media presentationonlya new attitude toward aging can keep older Americans from "slipping In a real sense, therefore, this Conference is through the cracks." just beginning, for all ofus are going home with promises to keep. Aswe keep those promises, We are entering a period when people will be as we fulfill our commitments to action, we retiring even earlier from their regular jobs,and will make this Conference thegreat, new begin- when it will, therefore, be more important than ning that you have talked about this week.Let ever to recognize that retirement from work does us make the last days the best days for all not mean retirement from life. This conceptmust Americans.

143

A Delegate's View Of The ConferenceOn Aging he officialreport of the Conference Conference which she prepared for the National speaks for itself in most ways. It does Federation of Sisterhoods', for which she served not, however, give account of the Dele- a Delegate. gates' personal views of the human experience of being a part of the White House It will give an overview of the Conference at Conference on Aging. For this reason,we asked work for those who could not participateperson- Mrs. David M. Levitt for permissionto reprint, ally, and it will hopefully revive the dynamic qual- as a part of the proceedings, the report of the ity of the Conference for all those who attend.

AgingA Burdenor An Honor A Report by Mrs. David M. Levitt

"My 94-year-old mother was failing," saida and former Secretary of Health, Education, and black womyi from Jackson, Mississippi, herself Welfare in the Eisenhower Administration, who one of the 20 million Americans over 65 years also presided over the first White House Con- of age designated as elderly. "Mama talkedto ference on Aging in 1961 stressed: "The time me of the burden of old age. To help myself I for action is now." People had come to Wash- read the Bible, and I happenedon Psalm 91. I ington from every part of the United States and went intomy mother's room to comfort her and from overseas. The oldest delegate was 95, the read to her what Godsays, 'I will be with him youngest17.Represented were many ethnic in trouble; I will deliver him, and honor him. groups: Blacks, Spanish-speaking people, Ameri- With long life I satisfy him.' And doyou know, can Indians, Asian Americans. Special interest it changed her spirit. Next day, shewas up and sessions were planned for these groups, as well walking." as `ror rural and urban aged, for poor elderly, for To the White House Conferenceon Aging, in blind and deaf aging, for youth andage and for Washington, D.C., November 28- December 2, those of the middle years who devote themselves 1971, came approximately 3,500 Delegates and in service to the aging. several hundred who -were observers,guests from Government, visitors from foreign countries,as A Three-Year Process well as leaders of trainingprograms in geron tology. They came to discuss the problems, and The Conference was an important mountain situation of aging, and particularly thetwenty peak in a three year process. It was authorized by million elderly who comprise the fastest growing Congress on September 12, 1968, and called by minority in the United States,a quarter of whom President Nixon's proclamation of October 6, live beloW the poverty level. 1969, which directed that it develop "amore adequate national -policy for older Americans." Dur- Dr. Arthur S. Flemming, ConferenCe Chairman ing 1970, over 6000 local meetings were helJon the problems of the elderly, meetingson com- ' Those portions of the rerart specifically directedto the munity, State, regional and national levels, all . Sisterhood have been omitted. oriented toward the Conference. In this threeyear

147 process, a year of action will follow the Con- On Sunday morning, briefing continued in the ference to bring to Government, communities, 14 separate Sections. I was a recorder in the agencies and organizations new policies and pro- Section on Spiritual Well-Being. Hess Sears, Sec- grams. retary of the Equitable Life Insurance Company Weeks and months ahead of arrival, Delegates of Iowa, co-chairman of the Section, introduced had received assignments to subject sections of co-chairman Monsignor Lawrence J. Corcoran, their choice, along with a continuing supply of Secretary of the National Conference of Catholic materials to read. Among these materials were Charities. The leaders present had read the schol- background papers developed by Technical Com- arly background paper by Dr. David 0. Moberg, mittees of citizens and work books listing issues and we started to discuss: What is our subject? which had been developed by citizens at local, What is the distinction between "spiritual" and State and regional meetings. "religious"? What is the relation between "material" and "spiritual" needs? Is housing for the Briefing for Leaders elderly a part of this subject? If it is a responsi- Over 200 Chairmen and Recorders convened bility of the religious institutions and community for briefing sessions late in the afternoon and to provide housing, would this dimension be evening of Saturday, November 27, the day be- neglected in the Section on Housing? Hess Sears forethe White House Conferenceofficially said that he had felt that it was important to opened. Dr. Flemming greeted the leaders; he have this Section, which had been only inferred spoke of the necessity for follow-through on the in 1961, on the agenda of the Conference. This Conference and action in the post-Conference discussion of definition of the nature of persons years. He stressed that there must be special spiritual, physical, emotional, socialand of ful- attention and concern for minority groups, eth- filling needs through actioncontinued in meet- nic, rural, the poor, the disabled. Dr. Flemming ings throughout the Conference. I paraphrased said: "The elderly are barred from further mean- the famous statement of Rabbi Hillel, "If not ingful involvement in life. Society's attitudes to- food, health and shelter, how will I live? But if ward older persons must change. Out of the &in- only food, health and shelter, is life worth living? ference we hope will come both a national policy And if not now, when?" on aging, and clearly stated specific action programs related to policy to meet short term goals." Sunday EveningThe Opening The Conference procedure had been developed The White House Conference on Aging op- by Dr. Clark Tibbitts who had written a guide ened officially on Sunday evening, November 28, book for Conference Chairmen and Recorders at 7:30 p.m., in the International Ballroom of who would be responsible for leading groups and the Washington Hilton Hotel, the Conference drafting policy. Dr. Tibbitts reviewed both the headquarters. Delegates carried handsome black procedure and structure atthis pre-Conference briefcasesprovidedby the NationalRetired briefing. As a finalstagein preparation for Teachers' Association and the American Associa- the formulation of policy proposali, conferees tion of Retired Persons. Among the many papers hadbeenassigned,aspreviouslynoted,to was a Program Book, on the cover of which was one of 14 subject areas: Education, Employment reproduced the winning painting in the nation- and Retirement; Health; Housing; Income; Nu- wide Senior Portrait Contest. On pillars outside trition; Retirement Roles and Activities; Spiritual the Ballroom were signs:"Spanish Speaking Well-Being; Transportation; Facilities, Programs Caucus, Jefferson Room;" "Black Caucus Meeting, and Services; Government and Non-Government moved toLincoln Room;" "ComingSenior Organizations; Planning; Research and Demon- Citizens Ombudsman Advocate." The conferees stration; Training. Each Section was divided into were addressed by John Martin, Commissioner Subsections. In addition, Special Concerns Sessions on Aging, and by Dr. Flemming. A multi-media weer scheduled for Wednesday morning, Decem- presentation followed, interspersing live drama ber 1. There were 95 subsections. with films and slide-sound programs. Two titles

148 poignantly told the stories of fear and loneliness: in doing so should observe theprinciple of separa- "Let's Find Poppaa Nice Place to Live"; and tion of Church and State. referring to old people inour youth-oriented society, "Throw Away Culture." Issue No. 2. Efforts should be madeto meet the spiritual needs of the agingby ministering Subsection and Section Meetings to them in conjunction with people of allages, as well as in groups with special needs.It was On Monday morning, aftera short orientation noted that special attention shouldbe given to in this section, Delegatesmet in their Subsec- allowing older personsto share in the plant ing tions in which approximately35 people would and implementation of allprograms related to meet together for 101/2 hours through Monday them. and Tuesday. Through these101/2 hours they would deal withmany difficult concerns and Issue No. 3. Sinceman is a whole being with needs: adequate income, Governmentfunding to interrelated and interdependentneeds, religious .nake action possible, healthservices, unjust re- organizations should be activelyconcerned with duction in social securitypayments for low in- spiritual, personal and social needs. come earners, unfair discrimination for employ- Issue No. 4. Religious bodies havetradition- ment and various types of license, training of ally and properly developedtheir own philoso- counselors for the aged, protection of old people phies. We recommend that theywork together in the streets, continuing education for growth and with the elderly and coordinatetheir efforts with well-being in all stages of life.. other groups to develop anddeclare an affirma- Through all the discussions,there was the tion of rights for the elderly.These rights should overriding concern thatwe in the United States include the basic values ofall while ensuring the basic right of freedom of have denied the fact of aging,have pushed aside religion. the elderly, ignored anddemeaned them. Ina Then we compileda list of program imple- land of abundant material resources we have mentation, bearing in mindthe mandate for thrown away our humanresources, and have possible action. Lastly,we wrote an opening caused millions to live in physical, emotional, statement to help define the meaningof Spiritual and spiritual deprivation. Theold are isolated. Well-Being. How do we changea nation's attitude? By Tuesday afternoon, 101/2 I was in subsection No. hours later, a sense 5 of the sectionon of pride permeated "ourgroup" and therewas Spiritual Well-Being. Thirty ofus metyoung easy laughter even on serious differences.On and old, black andwhite, men andwomen, Wednesday morning whenwe no longer met in Catholic priests,Methodistminister,Baptist subsections, we eagerly greetedmembers of "our preacher, Evangelical worker, rabbi, Unitarian group" in halls, at lunch, andin the ocean ofpeo- lay leaders, retired teacher,psychiatrist, Episcopal ple at the general meeting. sister, director ofa Canadian home for the elderly ----where the minimum As recorder for our subsection,it was my re- age of admission is 85 sponsibility not only people from Hawaii, Alaskaand throughout conti- to take notes on the pro- nental United States. posals, but also to bea member of the whole Section Drafting Committee, At first we in which we at- were careful, proper and estranged. tempted to synthesize thework of the six sub- We worked through Mondayand Tuesday. What sections. This taskwas done through dinner hours, was our output? First we discussed, changed and and on into the evenings.These combinedpro- voted on four policyissues which had been de- posals were then broughtto a final meeting of veloped through Stateand regional meetings. all the subsections ofthe entire section, where again the issues Issue No. 1.The Governmentshould co- were discussed and voted in the operate with religious bodies and democraticprocess which had been startedon private agencies local and regional levels to help meet the spiritual needsof the elderly, but and was now carriedto finality at the nationalConference level. 149 Luncheons and an Open Forum At the close of the Session, a visiting sociolo- gist from India asked to speak. He said, "In the Alternating with small subsections were large United States the old are isolated from their gatherings. The Conference provided luncheons families. The young need to stop feeling like in four Washington hotels on Monday, Tuesday, the 'in' group. You should tear down your walls, and Wednesday for all conferees. Speakers from return to your elders." government offices and from Congress addressed each luncheon. On Monday evening an Open Forum, chaired The White House and President Nixon by Earl Warren, retired Chief Justice of the United States Supreme Court, gave opportunities On Wednesday evening, the citizens and for- for individuals or representatives of organizations eign guests visitedthe White House, slowly to speak on any subject related to the general touring the rooms and studying portraits of United field of aging for from three to five minutes. States Presidents. A marine band played and Chief Requests for time were accepted by a Steering Little Wolf, an elderly American Indian in hand- Committee and the order of appearance was de- some red and white feather headdress and full termined by lot. More than 80 persons spoke white Indian regalia, asked a woman to dance. during four hours. Said Dr. Flemming, "We must Next morning, Thursday, December 2, the not overlook any group in our society that wants finalgeneral meeting convened. The Marine to be heard." Corps Band played as the thousands of conferees took their seats in the International Ballroom. All Special Concerns the short reports from all Sections, which had been duplicated overnight, were distributed. In On Wednesday morning there were held Spe- the vast crowd, one now saw many familiar faces. cial Concerns Sessions: Aging and Blindness; Aging and Aged Blacks; Asian American Elderly; Dr. Flemming addressed the Conference. He theElderly Consumer; MentalHealthCare pledged a post-Conference year of action, with Strategies and Aging; The Older Family; Home- early steps to attain information about what ac- maker-Home Health Aide Services; Older In- tions individuals and groups take, and to share dians; Legal Aid and the Urban Aged; Long. hese experiences so that the early new actions Term Care for Older People; The Poor Elderly; will stimulate others. He said, "I have been Rural Older People; The Spanish Speaking El- listening to older persons and they want to be derly; The Religious Community and the Aged; in a position to make decisions about their life. Physical and Vocational Rehabilitation of Older They want to be involved in life. And they want to be treated with dignity." People; Voluntec.Roles for Older People; Youth and Age. Exactly at 10:30 A.M., as the Marine Corps I attended the Session on Youth and Age, run Band played "Hail to the Chief," President and by youth delegates. Heartening interest produced Mrs. Nixon walked on to the platform to thun- a position statement that young and old are one, derous applause. both deserving respect; and that since all are con- "Any action which enhances the dignity of cerned with the quality of life, there is a need the older generation enhances the dignity of all to reorder national priorities. In a discussion of generations," said President Nixon. He spoke of education and awareness, young people expressed the benefits which would follow the passage of the need to become aware of the aging process, H.R. 1(Welfare Reform Bill)in establishing the need for trained teachers, text books,.shared a national floor under the income of every older courses with older persons. Many action projects American, of allowing Social Security recipients to involving youth were listed, from transportation earn more money from their own work, of teams to youth advocates for local and State eliminating the monthly fees for Part B of Medi- programs for the elderly. care. He spoke also of the need fot tax reform

150 to provide property tax relief; of new programs The White House Conferenceon Aging, in to protect workers under private penSion plans; its long process throughmore than 6,000 meet- of the need for regulation of nursing homes; of the need for Federal grants to provide services ings, involving two million people, has focused for older people. And he stressed the need for attention on and increased understanding of the a new national attitude of appreciation for what situation and needs of olderpersons. The great older citizens can do for America,to change the question is: What action wiltwe take following "throw away" psychology. the Conference, individually and inour groups? Dr. Flemming closed the Second White'House We can help twenty million peopleto a better Conference on Aging, tellinga story about his lifeto provide necessary material goodsand children during a power shortage. Theyoungest services, to help to release the inexhaustible boun- complained of the dark, while the olderones ty of spirit, to help our nation to benefit from the looked for candles. He said, "Mature people de- people who have contributed life-long work. By termine to find candles andto light them to dispel our actions, we have the answer: Agingnota darkness." burden but an honor.

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Appendix A

White House Conference on Aging Act Public Law 90-526 90th Congress, H.J. Res. 1371 September 28, 1968

Joint Resolution

To provide that it be thesense of Congress and find social contacts which will make the gift that a White House Conferenceon Aging, be of added years of life a period of reward and called by the President of the United States satisfaction; and in'1971, to be planned and conducted by the Secretary of Health, Education, and Welfare, (5) stepping up research designed to relieve old and for related purposes. age of its burdens of sickness, mental breakdown, and social ostracism; and (6) evaluating progress made sincethelast White House Conference on Aging, and exam- Whereas, the primary responsibility for meeting ining the changes which the next decade will the challenge and problems of aging is that of bring in the character of the problems confront- the States and communities, all levels of governing older persons; and ment are involved and must necessarily share re- Whereas, it is essential that in all programs de- sponsibility; and it is therefore the policy of the veloped for the aging, emphasis should be upon Congress that the Federal Government shall work the right and obligation of older persons to free jointly with the States and their citizens,to de- choice and self-help in planning their own fu- velop recommendations and plans for action,con- tures: Now, therefore, be it sistent with the objectives of this joint resolution, which will serve the purposes of Resolved by the Senate and House of Represent- (1) assuringmiddle-agedand olderpersons atives of thR United States of America in Congress equal opportunity with others to engage in gainful assembled, That employment which they are capable of performing; and (a) The President of the United States is author- (2) enabling retired personsto enjoy incomes ized to call a White House "Conferenceon Aging sufficient for health and for participation in fam- in 1971 in order to develop recommendatiohs for ily and community lifeas self-respecting citizens; further research and action in the field of aging, and which will further the policies,set forth in the (3) providing housing suited to the needs of preamble of this joint resolution, shall be planned older persons and at prices theycan -afford to and conducted' under the direction of the Secre- pay; and tary who shall have the cooperation and assistance of such other Federal departments andagencies, (4) assisting middle-aged and olderpersons to including the assignment of personnel,as may be make the preparation, develop skills andinterests, appropriate;

155

468.217 0 - 73 - 12 ( b) For the purpose of arriving at facts and of title5, United States Code, governing ap- recommendations concerning the utilization of pointments in the competitive civil service, and skills, experience, ard energies and the improve- without regard to chapter 57 and subchapter 111 ment of the conditions of our older people, the of chapter 53 of such title relating to classifica- conference shall bring together representatives of tion and General Schedule pay rates. Federal, State, and local governments, professional and lay people who are workilg in the field of aging, and of the general public, including older persons themselves; ADVISORY COMMITTEES .

(c) A final report of the White House Confer- Sec. 3. The Secretary is authorized and directed ence on Aging shall be submitted to the Presi- to establish an Advisory Committee to the White dent not later than one hundred and twenty days House Conference on Aging composed of not following the date on which the Conference is more than twenty-eight professional and public called and the findings and recommendations in- members, a substantial number of whom shall be cluded therein shall be immediately made avail- fifty-five years of age or older, and,as necessary, able to the public. The Secretary of Health, Edu- to establish technical advisory committees io ad- cation, and Welfare shall, within ninety days vise and assist in planning and conducting the after the submission of such final report, transmit Conference. The Secretary shall designateone of to the President and the Congress his recommen- the appointed members as Chairman. Members of dations for the administrative action and the legis- any committee appointed pursuant to this section, lation necessary to implement the recommenda- who are not officers or employees of the United tions contained in such report. States, while attending conferences or meetings of their committees or otherwise servingat the request of the Secretary, shall be entitled to receive :Compensation at a rate to be fixed by the Secretary ADMINISTRATION but not exceeding $75 per diem, including travel- time, and while away from their homes or regular Sec. 2. In administering this joint resolution, the places of business they may be allowed travel Secretary shall: expenses, including per diem in lieu of subsistence, as authorized under section 5703 of title 5 of (a) request the cooperation and assistance of the United States Code for persons in the Govern- such other Federal departments and agenciesas ment service employed intermittently. The Com- may be appropriate in carrying out the provisions missioner on Aging shall act as Executive Secretary of this joint resolution; cf the Committee. (b) render all reasonable assistance, including financial assistance, to the States in enabling them to organize and conduct conferences on aging DEFINITIONS prior to the White House Conference on Aging; Sec. 4. For the purposes of this joint resolution (c) prepare and make available background (1) the term "Secretary" means the Secretary of materials for the use of delegates to the White Health, Education, and Welfare; and House Conference as he may deem necessary and (2) the term "State" includes the District of shall prepare and distribute such reportor reports Columbia, the Commonwealth of Puerto Rico, of the Conference as may be indicated; and Guam, American Samoa, the Virgin Islands, and the Trust Territory of the Pacific Islands. (d) in carrying out the provisions of this joint Sec. 5. There is authorized to be appropriatedto resolution, engage such additional personnelas carry out this joint resolution the sum of $1,900, may be necessary without regard to the provisions 000.Approved September 28, 1968.

156 Appendix B

Officials and Staff

OFFICERS

Arthur S. Flemming Webster B. Todd, Jr. . Marguerite Thomas Chairman Executive Director Secretary to the Chairman Bertha S. Adkins Florence J. Jones Dorothy Whitener Vice Chairman Administrative Officer Secretary to the Director John B. Martin Julie Erickson Pauline Sedlak Director Special Assistant to the Chairman Secretary to the Executive Director

STAFF

TECHNICAL ACTIVITIES REGIONAL AND STATE DELEGATE RELATIONS RELATIONS Wilma Donahue Tina Forrester Co-Director Ray L. Schwartz Director Director Joanne F. Lawson Clark Tibbitts Co-Director Patrick Twohig. Valerie Brown Donald Jackson Alfred E. Duncker Suzanne Smith PUBLIC INFORMATION Joanne Hogue Secretary John Edwards George Thomas Beall Director Juanita Wills NATIONAL ORGANIZATION Patsy Kinser Steven Krasner RELATIONS Secretary Frank Stewart Dorothy S. MacLeaod Mary Youry Hannah Nathanson Director Helene Melzer Staff Assistant Cora Thayer Lee Lawrence Ansberry Vivian Fitz-Roy Helen Anderson Barbara Hildreth Staff Assistant Secretary Secretary

LOGISTICS ADMINISTRATIVE STAFF John Christman Cherie L. Cozin Director Assistant to Administrative Officer Dennis Condie Associate Director Grace Behm James Mills Amelia Madrak Carol Camelio Thomasine Hollis Shelia Stayte Cecilia Pilkerton Anne Anderson Rosa Johnson Secretary Harry Lark

157 Appendix C

The National Planninr; Board Note: The Executive Committee included the Chairman, Vice Chairmen and members whose names are marked with an asterisk (*).

Chairman Lucius DuB. Clay* Ronald L. Jensen Patricia Roberts Arthur S. Flemming W. Fred Cottrell Cernoria D. Johnson Robert B. Robinson Nelson H. Cruikshank* Victor Kassel Vice Chairmen Sebastian Rodriguez Cons (lel° Castillo de BonzoAlfred H. Lawton Bertha S. Adkins E. Bonny Russell Louella C. Dirksen Melinda Ann Lee Inabel B. Lindsay William L. Rutherford Earl G. Warren John W. Edelman Marcel le G. Levy Carl Eisdorfer Elizabeth K. Lincoln Margaret C. Schweinhaut Members Edward K.(Duke) EllingtonEdward J. Lorenze Hess T. Sears* Tary Adams Frances Fairbanks Ruby E. Stutz Lyells David C. Sing ler David L. Alvarado Thomas E. Fielders* John W. McConnell Eleanor F. Slater Decker Anstrom Rabbi Louis Finkelstein Laura B. McCoy William E. Snuggs Eloise Hardison Banks William C. Fitch* Walter C. McKain Arthur L. Sparks Robert W. Baron Myrtle C. Fonteno John B. McPherson Mary E. Switzer Margaret Bartosek Julian P. Fox, Jr. George Meany* Charles P. Taft* Rosemary Baxter Danny Frank Garson Meyer* Robert H. Takeughi Marietta Rumberg BengeS. Ross Greenwood David Miller Bradley L. Taylor James S. Bennett Alfred M. Gruenther* A. Luther Molberg Peter E. Terzick Robert D. Bloe* A. Webb Hale Thomas C. Morrill J. Frank Troy Frances P. Bolton Cecil M. Harden* Roger F. Murray Mary Ellen Tully Walter L. Bond A. Baird Hastings* Noverre Musson Bernard S. Van Rensselaer* Marjorie 'T. Borchardt Robert J. Havighurst* Bernard E. Nash* Thomas G. Walters* Kathleen Merry BroderickAi le Henry Melvin N. Newquist Jesse P. Warders Richard Butrick Adelaide C. Hill James C. O'Brien Donald M. Watkin Herbert R. Cain, Jr. Tibor Horanyi Carter C. Osterbind Paul Dudley White Blue A. Carstenson Grace Howard Frell M. Owl George K. Wyman Charles H. Chaskes* Hobert C. Jackson* 011ie A. Randall Clara Yanez Marguerite Stitt ChurchJohn A. Jackson George G. Reader Steve Zumbach

158 Appendix D

State Planning Officials Note:All persons listed were in charge of the State unit on aging in their respective states at the time of the Conference.

AlabamaEmmett Eaton NebraskaRonald L. Jensen AlaskaHenry A. Harmon NevadaJack Herrera ArizonaThomas Tracy New HampshireElizabeth K. Lincoln ArkansasJ. R. Jones New Jersey--Edward L. Donohue CaliforniaDavid Baxter New MexicoK. Rose Wood ColoradoRobert B. Robinson New YorkJames O'Malley ConnecticutSholom Bloom North CarolinaJames E. Brown DelawarePreston Lee North DiikotaMarion Connolly District of ColumbiaRoberta B. Brown OhioRose Papier FloridaOliver Jernigan OklahomaJohn J. Hoppis GeorgiaHarold Parker OregonMrs. Edward L. Hughes GuamEufrosina S. Lujan PennsylvaniaHerman M. Melitzer HawaiiRenji Goto Puerto RicoAlicia Ramirez IdahoKay Pell Rhode IslandEleanor F. Slater IllinoisElizabeth Breckenridge SamoaW. H. Scrubs IndianaGeorge E. Davis South Carolina Harry Bryan Iowa Earl V. Nelson South DakotaHerbert Schumacher KansasLauren Harrod TennesseePatty Buchannan KentuckyDon Valentine TexasMrs. Carter Clopton LouisianaArchie E. Robinson Trust Territory William Allen MaineRichard W. Michaud (Ttah Melvin White Maryland Harry Walker VermontJack Leary MassachusettsDonald Strong VirginiaJulian P. Fox, Jr. MichiganCharles H. Chaskes Virgin IslandsGloria M. King MinnesotaGerald Bloedow WashingtonJohn B. McPherson MississippiDoug Kenna, Sr. West VirginiaLouise B. Gerrard MissouriEarl R. Welty WisconsinDuane Willadsen MontanaLyle Downing WyomingStan Torvik

159 Appendix E

Conference Participants STATE DELEGATES

Note:Delegates named by the President, the Secretary of Health,Education, and Welfare, and the State Governors

ALABAMA James Peter Olsen ARKANSAS Kay Bixby Frank Peratrovich Louis Bolden Carrie B. Allen Vernon I.. Perry Stanley Applegate Marjorie T. Borchardt Mary Abby Berg Titus Peter Rev. James G. Berry Charlotte Bailey Sam Bozzo Mrs. Allan L Petersen Jennie B. Bates George M. Briggc Duke M. Bradford Mrs. Frank M. Reed, Sr. Eleanbr Brantley Malcolm R. Bean Barbara Bright Lorena Showers Franklin Collier Robert Brown M. P. Coprich A. Doris Southall Wesley K. Gee Erman Crew Roy Brown Edward Spencer Davis W. Goldstein Wat W. Brown Rei. Sylvester Croom, Sr.Mrs. Ed Sweeney Fannie Hardy Sylvester Croom, Jr. Margaret Thomas Beverly J. Holcomb Glen Burch Phillip Crunk Homer Thompson Peggy Hudson Helen R. Burns Mary M. Darner William C. Wiggins J. R. Jones Mrs. Francis X. Bushman Emmett W. Eaton Mrs. Charles Kayser Lovella Carling William F. Elliott Letcher Langford Frances M. Carp Holy 0. Fa.quhar ARIZONA Chester Lauck Vincent P. Carroll Eddie Fletcher Mrs. E. S. Leonard Elsa Carrow Lucille Fletcher Marie Allen Mark Lester Roberto Caruajal James C. Folsom Eloise Banks Lillian McGillicuddy Jack Cary James Hoyt Gay Jane C. Becenti Peter R. Chacon Elinor J. Barnes Lonnie Meachum C. G. Gomil lion Luther Miller Yung-Ping Chen Rubin M. Hanan Harry Brown Harry Moore Marshall C. Cheney Wilbur S. Hart Esther 0. Carson Lucy Muldrow Larry Chrisco David A. Hemphill Amparo Carrillo Kenneth P. Newfield Enoch Christofferson Belcher Hobson Lenora Collins Alex T. Perdue Margaret M. Clark Nita Hogg Louva Dahozy Christine Poindexter Paul Cowgill W. Gene Kerlin Msgr. Robert J. Donahue Virginia Robinson Earle P. Crandall Buford Lachrey R. Alice Drought W. Earl Cranshaw \ Edison Evans Floyd Sexton Ganta N. Lovell Vada Sheid Robert B. Cummings Fred H. Pumphrey `Ted Evans Evelyn Roeding Cuttle Garry M. Fingar Ruth Siesicki Johnnie Dean Rivers Bonnie L. Stanley Mother Frances Danz Bill Roberts, Jr. Rev. William M. Jacks Karl L. Davis Raymond Kane Gordon Perry Stone Beatrice Salsbury Mildred B. Williams Consuelo Castillo Debonzo Mrs. J. W. Scarbrough John Link Sadie J. Williams Margaret Debow Mrs. Robbie Fritts Smith Marian Lupu Eugene Degabrielle Everett B. Luther Glenn B. Winston W. E. Snuggs Lucy Wright Domingo Delgado Jesse T. Todd Peter McDonald Annie Zachary David Demarche Edith Upchurch Howard McKinley Patti Dewitt Mildred Van De Mark Clinton Mellor Andrew Dieppa Doreen Varner Winona E. Montgomery Ismael Dieppa E. 0. Williams Ronald Moore CALIFORNIA Steven Doi Dorothy Nolan William E. Dorsey ALASKA Graciela Olivarez Achille Albouze Patti Duro Glenn D. Overman Frances Albrier William Edisor. Leah Boyd Rev. Scott Redhouse Baltis Allen, Jr. Dorothy E. Elliott David B. Carlson Elwood J. Saganey Jack Anderson Julie Ellis Jesse Cooday Rodger H. Sandoval Lupe Anguiano Ted Ellsworth Frank Degnan Grace J. Schell Helen Antoniak Jules Eshner Frank D. Eaton Agnes Savilla Aubrey E. Austin, Jr. Eleanor Fait Kathryn L Fiala Harry Sloan Jose Baldivino Albert Feldman Buddy Gomez Charles Still, Jr. Milton B. Ball Maureen Forsberg Henry A. Harmon Sophie Thompson Roscoe B. Bancroft Robert A. Forst Steven V. Notch Debra Lynn Toy William S. Banowsky Alfred H. Foxcroft Zetta Hoyt Thomas Tracy E. Richard Barnes Sidney Friedman James Hu,ntington, Sr. Grey Valentine David E. Baxter Suzie P. Gaines Samuel Kith Joan Van Winkle Malcolm R. Bean Joselyn V. Geaga Msgr. J. A. Lunney Karl E. Voldeng James Belda Louis E. Gelwicks Frederick P. Mcginnis William Welsh Peggy Best Nathaniel N. George Bessie Moses Clara Yanez James E. Birren Morris Gibbs

160 Ralph Goldman Frank Nelson Frances Fairbanks Carolyn D. Rice Lu Greenberg Leon Nicolai Tim G. Flores Mona Scott Eleanor Guilford Sergei Nutkiewicz janies Fresquez Margaret Seitz A. Webb Hale Mary O'Day Corine Garcis Alfred R. Stands, Jr. Gertrude Hall Glenn Oloane Augusts Bulbis Melvin A. Slawik J. Tillman Hall Cecilia O'Neil Harriet Hall Jacob H. Wagner Lloyd W. Halvorson Martin Ortiz Idell Harrison Leon N. Weiner Lois Hamer Father Joe Otte Stephen H. Hart Rep. Daniel E. Weiss Dearie Hampton Rev. E. L. Peet Rev. Leland Hoyer Donald L. Woodall Cleo Hardin Edith Quinn H. Harper Kerr Roy Zerby Donald C. Harrington Auturo Raya Rev. Wendell Liggins Ethel Harris Dean Renfro Delphine Lucero A. Baird Hastings H. R. Richardson Mrs. Robert Morris DISTRICT OF COLUMBIA Leonard Hayf lick Rev, William H. RobertsonAlfred C. Nelson Hubert L. Hems ley Earl Rodda Clarence Quinlan Lewis Marco Anthony Grace K. Hennington Mrs. Armando Rodriquez Robert B. Robinson Encarnacion Armas Evelyn Herrmann Sister Olga Rossi Paco Sanchez Willis Atwell Kathryn Higgins Harvey Roth Keith Sanders The Rev, Bishop Zolton Becky Nei land H. Hines Edwin Rounds Gary Stay Frances P. Bolton W. C. Hohmann Chris Roybal Sue Taoka Kathleen Merry Broderick L Holloman Leah Ruize Rev. Richard Waggy Roberta B. Brown Harold Holmes A. M. G. Russell Judith Lund Wood Robert N. Butler Thomas Hsieh John. Ryan Homer Morris Woods Richard P. Butrick David Hurford Ed Ryken Juan Luis Cardense Mary Jack Ruth Sayre CONNECTICUT Blue A. Carstenson John A. Jackson Bea Schiffman Ardoin D. Casgrain Maurice Jackson Vera Schultz Douglas Beals William ChinLee E. Gartly Jaco Bernard Schussel Mary Ann Beres Annette Church Edna Johnsen Mary Lee Schuster Sister Marjorie Beyer Ewan Clague Burton E. Jones Jerome Seliger Sholom Bloom Kathleen Clardy Sam Kalb Mequmi Shinoda Anna H. L. Brinton Leo J. Coady Richard Kalish Alexander Simon Howard W. Buckley Ben Cortez Robert H. Kelley Leila Smith Cyril Cross Nelson H. Cruikshank Thomas Kiddie Lenore Smith Mother Bernadette De LourdesDonald Davis Stanley J. Kilcoyne Vera Soderstrom Edward Dodek Steven H. Dewhurst Archer R. Kirkpatrick Mel Stein Barbara, Dunn J. Martin Emerson Sam Kolb Bernard Strehler Rabbi Abraham J. Feldman Edwin D. Etherington. Carl Kunze Michio Suzuki Major Ruth Flinn William R. Ewald, Jr. Louis Kuplan Robert Takeuchi Bernard Friedman Fred Faassen Rev. Peter Kwon Loy F. Teo John S. Gallagher Marcello Fernandez Margaret Larpenter Jessie Terry Mary Claire Granata William C. Fitch Loic Lazovich Prescott W. Thompson Harry Hale Ernest Giddings Ida Ann Lee Richard Thompson Anne G. Heffernan Elma L. Griesel Ma,.uel B. Leon Arturo Tirado Edward Lang Harriet F. Griswold Alice K. Leopold Kazue Togasaki Sister Joseph Mary Gen. Alfred M. Gruenther David Littaver Rev. Howard N. Toriumi Laura B. McCoy Philip Guarino Dolores Lipka Tsutomu Uchida Walter C. McKain Tony Gutierrez Henry Lopez David M. Val lo Emerson Parker Thomas Hannigan Paul H. Lorham Isabel Van Frank Edward Peavy Helen Hayes Lyllis Lundkuist Jean Von Ezdorf Kurt Pe lz Barbara Health John Y. Maeno John T. Walker Thomas J. Quinn Blanca Hernandez The.Most Reverend Leo T. Maher Rewa Walsh John E. Rogers Merci Hernandez Ed Malan Laughlin E. Waters Howard A. Rosencranz Robert Hill Marion Marshall Roy W. Waters Stuart A. Smith Lorenzo Iriarte Ruth Mattsson Delma Webb Martha Stengel Fannie P. Jeffrey Jean Maxwell Ruth Weg Clifford L. Sterrett David Jeffreys Horace Mays Luna Wessell Noel E. Tomas A. Elaine Jenkins William McColl James Whetmore Rep. Ruth Truex Cemoria Dolores Johnson Rebecca Mcenespy Cliff Whitman W. Homer Turner Sam Jack Kaufman Jack McKay Mary Wiley Jacob Wagner Loren E. Kena George McLain, Jr. Lawrence Willis Helen Walsh Michael Kerley Helen McLendon Lawrence B. Wilson William J. Who lean Josephine H. Kyles Rev. Martin McManus Diana Woodruff Crettie Lee Robert Medina Royal Younger DELAWARE Robert F. Lenhart Keith Merrill Sam Yuen Inabel B. Lindsay Clifford E. Miller Sylvia Yuster Andrew Ballantine, Jr. Daniel Lopez Robert Mintie Arthur H. Brandenburg Joseph Madison Emmitt L. Mitchell COLORADO Herbert R. Butts Erlina S. Manzanares Jim Y. Miyano Dan Camera David H. Marlin Ninette Morales Marietta Rumberg Benge Zenas R. Clark John E. Martin Alberto Moya Gladyce F. Call William H. Duncan David M. Martinez Tom Murphy Sen. Roger Cisneros Raymond Evans Dick Martinez Lucy Myers Oliver Diggs Rev. C. Luther Fulmer, Jr. Mike Masoka Herb Nalibow Lt. Col. Jack L. Dignum Francis C. B. McCann, Sr. Dorothy F. McCamman Edward R. Neill Julian F. Ebersold Joseph Mraz George Meany

161 Jesus Melandez Leota Davis Larry H. Reagan Clara Y. Seto Herbert J. Miller Carlota De Lerma Mrs. Justo G. Regalado George Sugai Joe E. Montoya Carmela S. de Regalado Justo Regalado Dianne Yasui Philomena M. Mullady Helen Kaechele Dryle Robert P. Renfrow Robert Yokoyama Gloria Muquerza Leon Earls Thomas A. Rich Susie Munoz Sideny Entman Henry Richards IDAHO James M. Nabrit,Jr. George Ferree Lillian S. Roebuck Bernard E. Nash Theresa N. Ficarrotta Walter W. Sackett Joseph Bailey Wesley Oler Charles Fichtner Luis Sanjenis Dorothy Baker Antonia Pantota Catherine C. Finnigan Sue Saxonl Clarence W. Chariton Mae Phillips James Fling Rev. Benjimin F. Schumacher Louise Edmo Frank Pohlhaus Clinita Ford Kenneth M. Shaver Homer Graham Antonia Pantoja Edmond M. Fortune Stanley Silvern Horton Haight Maria Poinsett William Fowler G. Ballard Simmons Louella Hartenbower Lorenzo Ramirez Florence Fox Charles U. Smith Kenneth Hill Ralph E. Rechel Max Friedson Fred Smith Doris Kelly Victor Resendez Anna Gayle Sylvester Smith Manuel Lopez Joseph S. Revis Mrs. William L Gibson Charles J. Spell Laurine Morton Thomas Rivers E. Verner Goodman Mildred Sterling Edna Belle Oslund Henry Robinson Mrs. Henry Gilman Grace A. Stevens Will E. Overgaard Antonony Rocha Liza Gorham Grace H. Stewart Kay Pell Roy Rodriquez Charles Greiner Irene K. Thresher Gerald Reed Effie Roebuck Fred Haller Charles F. Trumbull Mrs. Francis Riley Jane A. Rollins Helene Harrington Rosa Vasquez Cecil Sandberg James Russo Howard Harris Byron J. Villwock Hannah Sessions Santo Ruiz Preston C. Haynes Constance G. Walker Perry Swisher Hector Santa Anna Ann Heffernan Howard Weber James Syme Isabelle R. Schaffner Andreiv Hendrickson Earth M. White Fern Trull Paul T. Schuler Nicomedes Hernandez Albert J. E. Wilson Carolyn Watts Paul Sedillo, Jr. Mattie B. Hicks Wade K. Wissler Bert Seidman Ardeth W. Highleyman George Wolpert Harold L. Sheppard Selden G. Hill Jesse G. Wright ILLINOIS Rudolph Sobernheim Lawrence Howbert Marguerite W. Zapoleon Margaret Jacks Robert J. Ahrens George Soloyains Madeline Armbrust Arthur L. Sparks Archibald B. JAckson GUAM John H. Ballard Ruth Spur lock E. Russell Jackson Florence L. Baltz Esther Stamats Beth Johnson Dolores Cruz Camacho H. Robert Bartell, Jr. C. Joseph Steller Sen. Beth J. Johnson Ricardo C. Camacho Howard H. Bede Sister Mary Barbara SullivanR. W. Johnson Father Zoilo L. G. Camacho John H. Bell Sur lo G. Swanson Betty Mae Jumper Richard L. G. Castro C. Felix Bengtson Charles P. Taft Enrique Jova Joaquin San Nicolas Diego Rev. Wilbert Benson Mabel Taylor Rudolph Kadansky Eutrosina Lyon Murray Berg Peter Terzick Mildred Kaufman Carmen Tanaka Matias Ha Bougeois Virginia Tiinmons Max Kaplan Lucas L. San Nicolas Elizabeth L Breckinridge Mary Tovar Joseph Kerrigan Veronica S. A. Perez Deton J. Brooks, Jr. Mrs. John Twiname Joe L Kershaw Jesus Santiago Quinata Edward W. Cannady Bernard S. Vanrensslaer Frances Kleinman Teresa T. Sablan William L. Chapin Thomas G. Walters David C. Lane Jesus L. Salas Manuel H. Chavez Earl Warren Henry C. Lane Frank Sanchez Marguerite S. Church Paul Weiss Alfred H. Lawton Jose B. Sudo Milton Cohen Minnie Wooden Aaron Lipman Brigidia S. Terlaje Jane F. Connolly Vicente Ximenes Mrs. Carl E. May Sinforoso C. Tolentino Ruth Cooke Diosdado M. Yap Marian Hafner McMann Gregorio Untalan Eulalia 0. Corbin Louis Meeth Pedro Q. Untalan FLORIDA Antonio Mendez Agnes Czachor Von D. Mizell J. A. Davidson Antonio Mendez Anaya Jorge Garcia Montes HAWAII Kurt Dreifuss L. Dewey Anderson Verne B. Morrison George Drysdale Lcree Atkinson Ray Moudry Paul Akama Julia L. Dubin Felix.Barardo J. Wertz Nease Norman Akita Mabel Y. Durey Emily Barefield Charles Bade Robert L. Emmons It 1 N. Newquist Alfred Barros Lovelyn J. Evans Charles R. Beber Et Nixon Allen Bechet Jai 1V. Noble Stella Belknap Esther Fain R. 0. Beckman Ethel J. Odom Anne J. Benner Allan Filek William G. Bell Carter C. Osterbind Gladys Sowell Ralph Francis Carlene J. Bennett Adriano Padron J. 0. Cayaban Jane Garretson Allen Burkett Barbara Palmer Foo Lin Ching Dave Gasper, Sr. Carlos Cajiga Robert Palmer Margaret Faye Neil L. Gaynes Harry Carey Albert Paul Ellen Y. Fong William Gellman Sister Jean Cassidy Fern Pence Renji Goto John Gianopolus Joseph F. Chapman, III Jean J. Perdue Patrick J. Hogan Joseph L. Gidwitz Nat Cooper Robert M. Perkins Druzella G. Lytle William nilson S. W. Curtis Charles W. Pruitt, Jr. William Nuganuma Jacob Gold Franklyn S. Cuyler Christian NV kama James Gray C. Dallas Reach David L. Pang Joseph Grittani

162 Edward F. Gurney Fern Watson Mrs. Delbert Campbell KENTUCKY Jerome Hammerman Ronald Weismehl Ethel M. Carlton James G. Haughton Mrs. Wilson West Michael Carter Robert J. Hauighurst Donald H. Williams Ann Marie Eckert William Burkett J. R. Haynes Edgar F. Witte Louise Den n ler Mary Ellen Curtin Edith Heide Chief Little Wolf Tom Dougherty Mary E. Ellis Rabbi Morris M. Hershman Jeanne Schram Fortner John H. Ewing, Jr. Edwin S. Hewitt INDIANA Walter W. Fox Dorothy Ezelle The Very Rev. Msgr. T. J. Holbrook James N. Gillman Thomas E Fielder Marshall M. Holleb Tary Adams Alden R. Godwin Nell Florence Edward P. Hopper Carl W. Allen Virginia Griffin Mrs. James Fog:e Cyril 0. Houle Marcile Allen Adeline M. Hoffman Chloe Gifford Charles J. Janecek Warren Andrews Clarence Johnson Mrs. Charles Hornaday John Louis Jevitz Mason Atwood Mrs. Thelma Kass Naomi Hourigan Michael K. Jones Robert H. Bales Harry G. Kobes Dan Howard Guy R. Justis Mrs. C. A. Banks Enfred E. Linder Earl Kauffman Eunice Kelly C. L. Flossie Becknell June McClure Mrs. J. Murray Kinsman Mrs. Voldemars Korsts Chester Blubaugh Fred E. Miller Mayor William Layne Stephen Kuropas Jack L. Bottenfield Paul A. Morris Rev. William P. Livesay Mrs. Fred Kushmer Geraldine 0. Bradford Earl V. Nelson Henrietta Lowe Anna Langford Leonard Breen Tom Riley John W. Mahar George Langevin Harold L. Mann Ernest Brundehler, Sr. Marilyn Russell Mildred Neff Helen Lane Stanley Chernish . E. Georgia Samons Earl Oliver Benjamin Leyenson Lulu M. Chickadaunce Hess T. Sears Blanche Patrick Edythe Levy William C. Christy John F. Schmidt Nell Regain. Clarence Lipman James F. Conover Leif Schreiner Harold Ries 1. S. Lowenberg John R. Craddock Dorcas Speer Rev. E. Arthur Russell The Rev. Stuart T. Lundahl F. Benjamin Davis Gwendolyn R. Speer Calvin Schneider Helen G. Lynch George E. Davis Harold Templetrar Clifford W. Seaton David M. Magee Jesse L. Dickinson Harold T. Trupp, Sr. Debbie Trimble Eve Manzardo Valjean Dickinson Bass Van Gilst Arthur Urlage Charles V. Martin Scott Doup Rev. Alvin F. Voile Don H. Valentine Aloysius A. Mazewski Lawrence E. Foote Mrs. Charles E. Webb John Vanderwier Robert Mays Lester J. Fox Steve Zumbach Roy Walters Henry L. McCarthy Bishop Raymond J. Gallagher Jesse P. Warders Robert McCleery Mrs. Cecil M. Harden KANSAS William Woodson Edward M. McGehee Grover L. Hartman Kay McGovern Simon Heemstra Tessie Agan Paul 0. McKeown Ruth Heins Joy Armknecht LOUISIANA Andrew R. McKillop C. W. Hemmer Fred A. Bausch Jean J. McVeety Jeffrey Allen Hurst Elvora Belcher Richard M. Michaels Emma 0. Johnson Mary Elsie Border James W. Ailor Sen. Howard R. Mohr Maurice L. Johnson Mildred Boyersmith Lawrence J. Ballard Thomas C. Morrill Albert Kelly Harlow Brown Rebecca E. Bose Sister M. Paulita Morris William Marcus Kendall Mrs. Clifton C, Calvin Emile J. Bourg, Sr. Bertram Moss C. Donald Close Meredith Brady Byron E. K lute Mary Conger Lola Mucker Ronald H. McCloud Richard P. Brown Bronius Nainys Arnold McFarland' Arthur B. Dennis C. S. Cadwallader Herman J. Nebel Janet McLean Rev. Armour H. Evans Francis M. Carson Bernice L. Neugarten Mrs. C. Louden Frazier Dell S. Durand, Jr. Donald T. Nelson Mary Gearhart Zola A. Ernest Frank B. Norbury Paul L. Phillippe Lauren W. Harrod Frank P. Forwood Major Roy B. Nordheimer Margaret Moore Post Jean E. Hays Albert A. Fredericks Peter Perrecone Homer K. Rice Ailee Henry Flora S. Galloway Carolyn Radebaugh Joel Salon Carlos Hernandez Grace A. Goldsmith Clarence A. Reardon Nathan L. Salon John Holzhuter John Rice Gus Samora Clayton A. Graves Ronald Johnson . Robert S. Green Paul S. Rhoads Charles Sappenfield Stephen P. Kralik Helen McBride Hilton Robert Rummenie Sen. John F. Shawley Robert A. Maxwell Theodore Israel William L. Rutherford Rabbi Albert M. Shulman Sister M. Charles McGrath Annie H. Jones Leonard Schram Lu H. Stover Russell W. Miller J. H. Jones Ralph F. Schroeder Wallace Van Den Sosch William D. Moreland Sam Houston Jones Mrs. Willard C. Scrivner Harry Tharp Nellie Navarro Benjamin J. Kaplan The Rev. Herman Seinwerth Katherine Toll Linda Tittle Pelzer Elliott J. Keyes Rep. Joseph G. Sevcik Clemens A. Warn Margaret A. Penny Heyman C. Korn Ethel Shanas Allan H. Warne Sia Sadri Elizabeth M. McGowan Rudolph Sobernheim Robert 0. Weirich Earl H. Sayre Mae Dee Moore James Stamps Max F. Wright Mrs. Harry L. Smith Alton Ochsner, Sr. Gordon F. Streib Gus Zamora Addie Spicher Jackson M. Powell, Jr. David R. Sturges Msgr. Arthur Tonne Archie E. Robinson Margaret Summers IOWA William F. Turrentine Estella Schwarze Peter Tarrell Fay H. Williams FranklinB.Stagg Sheldon S. Tobin Freda Bande Mamie L. Williams Albert Tate, Sr. William Tudor Ives Bartlett Ralph E. Wilson Alice Teddlie Clyde Vedder Darlene Betts Mable Wright David J. Terrio Eugene Verdu Robert D. Blue James M. Young Horace G. White

163 MAINE Antonio Suarez Osier Peterson Mary E. Kastcad Jacqueline T. SunderlandFrederick Picard Robert Kastenbaum Laurence P. Bagley Mrs. J. Arthur Throne Ruth Robinson Earl Kennedy Malcolm Brown L. P. Thornton Rev. Anthony Rocha Kurt R. Keydel Harold Collins Richard Trudell Solomon Rosenbaum Karl M. Keyes Gary Cook Ishmael Valdez Margaret L Ross Doris Kirkland Harriet Fogg Harry F. Walker Joyce W. Rovelli Daniel H. Kruger Mary Fortier Alice West Dante Russo Michalene D. Lcwandowski Robert A. Frates Vicar Richard Williams Sherman G. Sass Daniel S. Ling Kathleen Goodwin Lynn Willis Genevieve H, SchiffmacherJames A. Livington Milton Hall Wright Williamson Dorothy Schoonmaker Margheritta S. Loud Charles A. Jacobs Ladymarie Wise Charles I. Schott land Samuel Mackety Mrs. Harold Jones William T. Wolfrey James H. Schultz Luz Martinc.: Jane C. Kilroy Leon M. Woolf Roberta Senchkowski Joseph Mash Gerald B. Kinney F. Marott Sinex Howard Y. McClusky Theodore E Lewin Frederick John Stare David Miller Jackson P. Libby MASSACHUSETTS Donald H. Strong John W. Moffat Mrs. Philip Marston Rev. Donald A. Thompson John L Martin Fannie L Allen Rose Ila H. Neumann Ken Arvedon Dee Tobben Philip K. Numincn James F. McMichael Noel E: Tomas Roland A. Ouellette Ruth P. McNamara David M. Banen Donald M. Watkin Richard W. Michaud Solomon Barkin Marvin Pahl Rep. Robert A. BelmonteWilliam D. Weeks Judge M. Robert Payant Mrs. Irving Perkins Mildred Westover David A. Peterson Leora Prentiss Robert Binstock Paul Dudley White, Herman D. Sahagian Sol S. Boskind Eleanor Potter James Breagy Dorathca Willgoose Ruth E. Preston Joseph F. Sanders Constance Williams A. Hazen Price Floyd G. Scammon Melnea A. Cass Eurysc Wright Ray R. Purdin Gov. John W. Stevens Louise Clark James W. Coughlan Brad Yoncoka J. Alfred Right Icy Harold Stevens Hazel B. Robinson Mary G. Worth Icy Walter Cross George L.Culbert MICHIGAN N:ck Rohan MARYLAND Charles F. Doo ling Jack F. Sanders Edward V. Driscoll Cordon J. Aldridge Leo Shaffer Sen. Rosalie Silber Abrams Rev. William Duvall J. Kenneth Alt land Virginia Solberg Bertha S. Adkins Raymon ldridge Solomon J. Axelrod William M. Spreitzer Lois Kahl Baldwin Donald C. Exford Margaret Bartosek Mel Stein Peter W. Bauman, Sr. Dennis Fargas Clark H. Beiriger Monsignor Wilbur F. Suedcamp Kathy Bays Louis Fillios Beryle Bluespruce Frederick C. Swartz Mrs. Stacy Brooks J. Leslie Firth Clyde W. Briggs John S. Taylor Leo J. Coady Levin Foster Nathaniel Brooks Edward H. Terry Edward S. Colby Henry Fredette Andrew W. L. Brown Charles A. Thompson Lou Cordova Harvey Friedman Lowell Busier Mrs. Lester Tiscornia Alicia Cora W. Rankin Furey Phyllis M. Bussa Virginia Rogers Vancoevering Lionel H. De Montigny Fernando Torres Gil Ruth Butler V. K. Volk Robert F. Dove Lillian L. Blickman Lawrence Gox Calahan Roscoe A. Walters Joseph Excndine Jack Gould Dena Cederquist Robert S. Williams Thomas C. Fetherston Orville F. Grahame Sidney W. Chapin Charles L Youngs Sammuel N. Fox David Greer Charles H. Chaskes Charles Younglove Ted Gonzalez John Guarino Arthur Childs G. Bartow Harris Samuel Harmon Wilbur J. Cohen MINNESOTA Jean M. Hartman Fritz Heinemann Walter Coe Earle T. Hawkins Myra L. Herrick Dorothy H. Coons Mrs. Ernest R. Anderson William E. Henry Adelaide C. Hill Helen Coover Decker Anstrom Franklyn C. Hochreiter Thomas Houllahan June Cronk Leonard L. Baker James T. Horton Edna Hughes H. David Dekker Mae Barness William C. Nudelson Virginia Jeffery Ernest C. Fackler Karl A. Beilke William M. Hunt Hervert Jerauld Leonard Gernant Jane Belau George E. Johnson Madeline Dugger Kelly Freida Gorrecht Oscar Bergstrom Mrs. Courtney Jones Jack Leff Leo A. Haak Rabbi Noah Bernstein M. Shakman Katz Louis Lowy Milton J. Hagelberg Gerald A. Bloedow Abiva Kaufman r.o.her Lyman Joe N. Ham Win Borden Col. Harold D. Kehm Louis M. Lyons Theodore J. Haskell J. Richard Burton Abraham Kostick Frank J. Mtto.ning Peggy F. Hinchey Ends G. Butenuth Noemi Labrada Norman P. Mason Rev. James A. Hood Cy Carpenter Jane Mattingly Jean Mayer Clark Hopkins Father Denzil A. Carty Mary McGowan Richard McDowell Margaret A. Hossack Inga Cragg Mrs. Courtney Jones McKeldin Ross A. McFarland C. Edwin Howard John Crowley Mable Patterson Madlyn McNiff Woodrow W. Hunter Linda Cutting Hilda Pawling Janet McNulky Pauline Jackson Judy Anne Dwyer Edwardo Pena, Jr. Manuel Mello Helen G. Jacobs Rev. Norris Erdal Ida May Petty Edward Michaud Mildred M. Jeffrey Grace Fassler Hazel L. Ricker Charles Moore Alberta K. Johnson William G. Fisher Norman C. Ruther Isadore Morantz Lloyd R. Johnson Richard Flesher Henry Ruttinger Robert Morris Myra Johnson George C. Could Margaret C. Schweinhaut Bernard O'Neill Harold Julian Sam Grais Gertrude W. Shockley Isabelle M. Parker MitchellI. Kafarski James A. Green

164 Myrtle E. Griffin James H. White MONTANA Belma Jones Llyal M. Hanson Reginald White Nick B. Lauri Reuben L Hill Charles E. Williams J. Hugo Aronson Jack McCloskey Virginia M. Hiniker Leo la G. Williams David Andrew Braaten William D. McCollough Tim Howard Marie Bradley DorothyMiller Bea Kersten Elizabeth Cashen Rev. j. L. Simmons William Kirdmer Bill Christiansen Alice L Smith Charles Krusell MISSOURI John Coey, Jr. Kate St. Claire Mrs. B. C. Leadholm Barclay Craighead Rae Van Dornum Ray I. Lemke Angie Aker Kirk M. Dewey Mary Wild Constance J. Lindahl Icae Algeo Lyle Downing Theodor J. Litman Russell Armentrout Dorothy Edson Elaine Loucks Dorothy Baker Willa Evans NEW HAMPSHIRE James Lyday Quinnie Benton William D. (Slotty) James Mrs. John Lynch Judge Robert Berry, III Norma F. Keil Arthur S. Adams Blanche McIntosh Herman T. Blumenthal E. F. MacGilvra Robert P. Burroughs Claire N. McRostie Viola Boland William A. MacMillan Neal Cobleigh Rev. Willard J. Merrill, Sr. Charles Braithwait Catherine Calk McCarthy Rhoda E. Miller Margaret Cote Margaret Carey Delude Ann McLaughlinElizabeth J. Donovan Rabbi Albert G. Minda Donald Cowgill Thomas H. Mahan Richard Downey Allen Luther Molberg Bina S. Davis Dolly Page Remi L Gendro..J Mary Ann Murphy Cecil N. Davis Effie Pentz Rebecca Hall Richard Nolan Ida W. Denininger Earl Old Person Madelene Haynes Stephen S. Ober Harold Dickson Colin W. Raff Thomas L. Olson Ray Kipp Alma G. Efgert Anna Pearl Sherrick James Lagios Phil Padden Ira F. Ehrlich Frank TakesGun Elizabeth K. Lincoln W. Dennis Pederson Robert H. Felix Mrs. Berrie Weiloff Hosea Perry Harlan Logan William J. Pike William R. Fortney James R. Mackay Mae D. Rogers Grace L Hart NEBRASKA Phyllis Morrill Clara C. Hem_plemann Mother M. Therese Patricia Etta Saloshin Judge Mark D. Henderson Aubrey Allen Richard Vitaglino Lyall A. Schwarzkopf Judge William A. Honeycutt, Jr.Alit; Anderson Emily Wilson Mrs. Ralph SchwichtenbergRoy Stokes Howell Angela Little Beaver Ralph W. Wilson Mrs. Arthur Sehlin Albert G. Incani. Ruth Blankenship Karla Skahen Sylvene James Anna Cameron Leo J. Skarda Ben F. Jutzi Isabelle B. Craig NEW JERSEY Wendell M. Swenson Joe Keilholz Sally Dittmar Irene Vizenor Gregory Lefever Regina Weber Irwin Ellestad Charles E. Archbald Barbara R. Wehr Margaret M. Lloyd Robert Gibson Jack Belfi PhyllisKittyMadeson Robert D. Harrison Nancy Blades Leslie E. Westin Rev. John E. Mathews Major Harry C. Heald Joan M. Brumbcrg Marion Williams Pearl B. Matthews Hans Jensen Jane Bryson Dean Moneymaker Ronald L. Jensen Edward Carr Mrs. Curtis Morgan Joe J. Juarez Frank J. Coury MISSISSIPPI H. Azell Morris Edwin R. Kent Fanny Cowell Myrtle Mowbray Grace Lee George Dare Margaret A. Penny Charles Martin Harry Decamp John D. Boyd Stanley C. Peterson Jill McMaster Doris Dealaman B. Hayden Campbell Warren Peterson Mary Maxine Miller Rev. Purd E. Deitz Nora Welch Daly C. T. Pihlblad Hattie Moore Edward L. Donohue Mrs. John A. Donaldson Mary Quarles Vern Pangborn George Downs Noel J. Duquesnay Marion E. Ramsey William A. Peter William Edwards Ikie E. Ethridge George F. Reeves, Sr. Everett P. Phillips Walter G. Evans Kay L. Ferryman Lela E. Reeves Mike Richardson Mrs. Lee Fagioni Clay Gibson Elaine M. Reiter Paul Schneider Ann Finlaw Gwen H. Gollotte F. E.Buck Robinson Adelaide H. Stubblefield Evelyn Frank Mrs. Surry A. Grafton Jamesetta Robison Dorothy Switzer Harry M. Frankel Jack L. Harris Guy S. Ruffin Lola Ullstrom Adeline Franzel Norman Weber Hilliker John G. Ruhl Philip Vogt Solomon Geld Mary House Marie E. Schindler Asa Wolfe George Gilbert Jeanette Jennings Nita Schwabe George Goodfellow Alice L Johnson Edward G. Seiter NEVADA Charles Hansbury Edgar D. Keima Louis Solomon Eone Harger Ruby E. Stutts Lye lls Archie E. Starcher Edythe M. Abington Mildred Haywood Hulette J. Massie Charles Stiver Virginia B. Akins Stanley Iacono Travis McCharen John W. Stone Clara Bailey John L. Kaufman Julius V. Miller Betty Thomas Helen jean Brumett William E. 'Cayes Louise Moss Montgomery Henry C. Tomlinson Maurice Cass John T. Kelly Leslie Newcomb Nellie Ir. Utz Albert V. Gibbons Ralph K.mball John D. Parish Ruth A. Wainscott Heather Hind Rev. Robert F.Kirchgessner William Powe Major Marjorie A. Weber Dawn Holton Melba Kost Velma Rogers Earl R. Welty Ted James Mildred Krasnow Vardaman J. Runnels Joseph 0. Wright Mary Gayle Jensen Dorothy Larsen Joseph Thomas Mildred Wright Dorothy B. Johnson Ann MacFarlane Virginia Thomas Marie Wylie Mary Johnson Simon F. Mankiewicz Sister Rita Margaret NEW YORK Sol Goldschmidt Rev. Robert J. McCune Louis Mazzochi Donald Gorham Annetta McCord Helen L. McGovern Ann McFarlane Albert J. Abrams Paul C. Gouldin John W. McGrath John McLaughlin Charles Abruscato Rabbi Ronald Greenwald Grace B. McHenry Constance Midkiff Clifford A. Allanson Jose Gutierrez John Medina Leon Milman Tony Guzman Desiree M. Mittelstaedt Mother M. Aloysius Sister Regis Mellon Jack H. Mohr FernandoE. Alverez Guinivere B. Hall Faith Dale Meyer John Moorehead Gertrude L. Ammerman Leon Han Garson Meyer Evelina Antonetty Leon Harris Birger Myksvoll Alan D. Miller Ilmar Pleer Raymond W. Arnold Stanley I. Hayes, Sr. Marion E. Purbeck Adelaide Attard Catherine L. Harwood Irma Minges Mildred Radcliffe Bela P. Bachkai ?..Zost Rev. Edward D. Head Norman S. Moore Anna M. Rhineschmidt Frank C. Barlow Goldie Merle Herman Martha J. Morgan John T. Rice Irene B. Barnes John Hickey Louise Fisher Morris Mrs. Bernard Richman Peter S.Battaglia, Chief Marcel lus High Hawk Joseph Mosarra Jean Rindlaub Walter M. Beattie, Jr. Hyman Hirsch Neal L. Moylan Patricia. Roberts John W. Beckman Louis Hong Roger F. Murray A. Bruce Robertson Louis L. Bennett Tiber Hofanyi Lucille Nakamura Elizabeth Roth Bernard Berggen James B. Hover Walter R. Newburgher Maria Salazar Mildred Berk Grace Howard Sanoma De Beal Nixon Mayolyn Saunders Lawrence Best Sister Mary Rosari Hughes Joseph A. Ober Rev. Cornelius Schoonejongen George F. Berlinger Lois Huntington Muriel F. Oberleder Adolph Siegal Merritt Bidwell Hollis S. Ingraham Robert F. O'Connell Joseph Slavin Edmund G. Bill Abraham J. Isserman 'James J. O'Malley Sampson G. Smith Rev. Paul A. Bpriack Lissy R. Jarvik A. Holly Patterson Annabelle Story Rev. Leonard Braam Muriel -E. Jenkins Elizabeth Perkins Charles Tarsi Rev. P. Arthur Brindisi Arnold B. Jerome Edith A. Podd Col. Robert L. Tarver Harold Brody Gou la Johnides Robert L. Popper Mrs. Jack Volosin Ali^e M. Brophy Jesse Johnson Ersa H. Poston Conrad Vuocolo Herbert R. Brown Robert F. Katz Robert Price Arthur Wacker Eve line M. Burns John P. Keith. Emma A. Rainbow Rev. Howard W. Washburn Edna E. Butler Herman F. Kenney 011ie Randall Vera Weindlandt Rev. Robert H. Calvert G. Gwendolyn Kingsland. Alma E. Rangel William Williams Paul C. CardamOne Loucile M. Kinne George G. Reader Ann Zahora Luis Cardona Rabbi I. Usher Kirshblum Lillian Reeves Virginia W. Chorlton Fred W. Kleemfier Harold W. Reisch Edwin S. Clare Walter E. Klint Vincent A. Riccio William A. Clermont Borys Kobrynski Ira S. Robbins NEW MEXICO Alice Cole Ruth E. Kocher Ann S. L. Robinson Lester L. Coleman Kalin Koicheff Rev. Anthony Rocha William T. Conklin Moonray Kojima Carmen A. Rodriquez Col. Cruz Alverez Timothy W. Costello Ernest K. Kr"_r Hector Rodriquez Rafael Pablo Ciddioy Abeyta R. Eugene Curry Joseph A. Kuncelik Sebastian Rudriquez Lura Bennett Michael M. Dacso Simon I. Konovitch Manuel Rodstein *!rs. C. R. Blocker Gertrude R. Davis Fred F. Krokenberger William T. Rogers William L Boyle Malinda J. Davis Samuel Kuhn Eli H. Rudin Marcella A. Ciddio Margaret Deady Abraham R. Kushner Hugo A. Ruiz Lenora Collins Erwin di Cyan Mae Laufer Jack M. Sabi e Fernando C. de Baca Maurice D. Dolphin Elinor LeDrew Y Janet S. Sainer Theodore Evans Mrs. Milton Dorfman Louis L. Levine Daniel Sambol Edythe Franks John A. .Dormi Gustave L. Levy William M. Sauter John D. Gallegos Robert R. Douglass Marcelle G. Levy Mrs. Raymond Schneider Boles lo Garcia Edward H. Dugan Warren T. Linguist Doris R. Schwartz R. R. Garner, Sr. Walter Dushnyck Edward G. Lindsey henry Segal Jchn M. Haberl Faye B. Eagles Edward J. Lorenzo Rabbi Solomon Shannon Ann Horton Rhea M. Eckel Carol Lucas Most Rev. Fulton J. Sheen Gladys Long Kenneth H. Eckhert Nellie Pagan Lugo Jerry A. Shroder Santiago Marquez Grace L.Egelston Lena M. Lynk Charles Edward Sigety Theodore F. Martinez Richard A. Estep Goeffrey E. Maclay Harry Silverman Doris Mawson Rev. Charles J. Fahey Julian M. Major David C. Singler Lewis W. McClelland Ralph A. Falco Raphael B. Malsin Sigmund J. Sluszka Dave Montoya Gerard E. Fahey Steven L. Markovski Edward J. Stafford Marie Oblitas Murrae A. Feingold Howard C. Mai sha Charles Stanton Bob Reveles Rabbi Louis Finkelstein Alexander R. Martin Dorothy Goldman Steinfeld Nick Reyes Gerald M. Flynn Geneva Mathiasen William Taggart Gwen Robbins Mary Alice Flynn Madge L. Matthews Mrs. Robert Tahamut Jesus Santana Evelyn H. Forman Baldwin Maul! Mrs. Alan V. Tishman Amerande Silba William L. Fournier Stephen May Mary Ellen Tully Henry V. Trujillo Danny Frank Mother M. Aloysius McBride W. Homer Turner Albert Valleios Malcolm J. Freeborn Kevin McCarthy Andrew Turnipseed Hubert Veliide E. Corrine B. Galvin Marian Ft McChesney Jane Turner Clifford, Whiting Arthur Garson Francis P. McCloskey Charles J. Urstadt K. Rose Wood Lilyan W. Gartner John W. McConnell Juan E. Vallecillo Geraldine Young Rev. Stanley P. Gasek Howard A. McConville Rev. Rene A. Valero Bella Van Bark 166 I

Paul G. Vanbuskirk NORTH DAKOTA Catherine Gillie Helen Bull Vandervort Ruth Glick OKLAHOMA Hector 1. Vasquez Francis Barth Mrs. John F. Gottron William Vazquez Herman J. Bischof Joseph G. Grunda Major Howard Beane Henry Viscardi, Jr. Gladys Black Kay Gundersheimer William L Brock Mitchell M. Waife Arthur G. Bunker Alice Hairston Ceceila Brooks George M. Warner Marion Connolly Ed Hellkamp Bruce G. Carter William W. Warren Bernhard G. Gustafson Mary Hemmy Thomas S. Cunningham Benjamin W. Watkins Robert E. Hanson Ernest L. Henes Vera J. Da. is Joseph D. Weiss Brynhild liaugland Sister Mary Immaculate Betty L Defriend Max M. Wiseman Jack Hoeven Rev. Monsignor Michael B.IvankoJohn W. Devore Robert 1. Wishnick George Ktafton Henry S. Jenkins Eileen Elliott Myra E. Workman Mrs. Ray Law Martha Jones Kate Frank George K. Wyman Walter Loomer Jerome Kaplan Col. Leonard H. Fuller Rev. William C. Zenns Donald McArthur Milton Klein Dee E Gambrel, Robert McLaughlin Marie Kathryn Kiumpe Lucille T. Gerald NORTH CAROLINA Alvin M. Paulson Helen West Knight Mrs. Arthur German Bea Peterson Go ldie Lake Eldridge Gordon, Jr. Mrs. Dan M. Allison Nels Porsborg Dorothy Langley Albert Thomas Hardin Peter B. Auerbach Myrtle Sharp Nathaniel C. Lee John M. Hoppis Roy Andersor. Walter Sherman Vivian Lewis Dale Kirk Earl D. Barker Herman Stem Ruth M. Lindesmith R. B. Knight Portia Beamon Daine Stromme Wendell Lotz C. A. Markey Sen. Hargrove Bowles Kenneth Urdahl, Sr. Richard Lung Beth Masters J. Eddie Brown Herman Weiss Justin J. Mackert Lewis J. McCoy Harold Carrick Anthony Zukowsky Alex Maravich Lee Motah Edith B. Chance Joyce McDowell Lela. P. Nash Eloise Cofer OHIO Kirk McGee Rev. Donald 0. Newby Thomas H. Collins Goldie McGill June Newman William R. Collins Max Amdur Sister Anne MarieMcMaus Gladys Nunn James Currie Thomas S. Andrews Ruth Melvin Pansy Price Mrs. Albert J. Deforest Stanley Badyna Monsignor Paul Metzger Lloyd E. Rader, Sr. Clement D. Dow ler Raymond J. Balester C. A. Charlie Mick le Lloyd C. Roach Faye Eagles De Are G. Barton Willard E. Moore A. 0. H. Setzepfandt Carl Eisdorfer Elmer Barthel Rep. Norman A. Murdock Rev. Joseph T. Shackford Ralph G. Faulkner Roy Bever Noverre Musson Wilson D. Steen Francis A. Fay Martin E. Blum Lela Myers Mrs. Jessy Sullivan Eva K. Gerstel Margarer Bogan Rose Papier Mike Synar Isa C. Grant Ernest J. Bohn Ralph Perk Robert Tompkins Julia Harris Rev. L Venchael Booth Marguerite .Parrish Lennie-Marie P. Tolliver Luther C. Hodges Marie Brooks Jackson -Perry James B. Townsend Albert Hunt Anna Brown Walter Pieper Robert N. Wall Jacquelyne J. Jackson Matthew Brown Velma Pikkoja A. Kurt Weiss Ann M. Johnson Ronald Brown Everett Poe Ralph Williams Samuel Lawson Johnson Philip M. Burgess S. Donald Pollitt Josephus Younger Madeline A. Jones Robert Burns Sam Pollock Phillip Kelly L Earle Bush Mary Powell Buford Kidd Anthony a Calabrese Howard Rieger OREGON Juanita M. Kreps B. Bernard Caplan Henry Robinson Samuel Lawson Richard F. Celeste Helen Russell Dewey Auchter Louise Lo, Albina R. Cermak Harold Schneiderman James S. Bennett George Maddox, Jr. Philip Chelnick A. J. Scolastice R. Powell Majors Elsie 3loomer Howard Chesler Joseph Sedive Barbara Bretz J. H. McCombs Louis Seltzer Charles A. McLean Kenneth W. Clement Ralph H. Cake Albert S. Close William P. Sheehan Dave Cameron Mrs. William R. Muller Mayor Stanley A. CmichGary Shepherd Antonio Castrejon Inez--Myles Gerald Cohn M. R. Simpson Paul Elliott Fannie Newsome John H. Cooper Mildred. Sindell Phillip S. Ogilvie Edna R. Gilde FredCottrell Joseph Stocklen Eleanor Griffitts Fre 11 Owl Dorothy Craig Lucetia Stoica Robert Holdridge Annie May Pemberton Henry Crawford Marvin B. Sussman Marguerite F. Royster Marion R. Hughes William F. Crowley Rev. Stephen T. Szilagyi Edgar Jackson Marie Sanders Mrs. George Curtis Charles P. Taft Walter G. Klopfer Cecil Sheps Lois S. Dale Henry T. Tanaka Helen Manning Carter Smith Dolores I: B. Davis Frank Tate Tom Marsh Ben Spence William Dejonckheere Guy Taylor Walter J. McGettigan Martha C. Stack John De Vito Mrs. Murtis Taylor Art Motanic Virginia Stone Paul Dingledy Richard Taylor Mrs. Ray Nelson John Syria Leonard Dittman Frederick Thaler Lois Oliver Mrs. Charles Zell Taylor, Jr. Stephen Dougherty Louise Thomas Mrs. M. B. Taylor Mrs. Ted Sax Harold Trigg Leo-1Dugan Frank Si Troy Vada Scott Mrs. Carl Engel Frank Valenta E.M. Sheldon Samuel S. Wiley James Falvey Rev. Paul Ward Clayton Shepherd Marcia E. Wilkins Edward Fire Jesse E. Waugh Mrs. John Shepherd Ellen Winston T. Lyston Fultz Aaron Wiesen Mildred Whipple Nathan H. Yelton August B. Garner William Wiggenhorn Mrs. Terrie C. Wetle

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PENNSYLVANIA Edith B. King Stephen Wisyanski Chaplain James E. Rogers George A. Kotich Lula Mays Witherow Larry Sexton Peter G. Alapas Fannie G. Krevsky Helene Wohigemuth Sherry Shealy E. W. Allison M. Powell Lawton Gertrude Thurmond Sarah A. Anderson Fred J. Lee PUERTO RICO W. Fulmer Wells Jeanne Bader Elizabeth Lehman Marjorie Whetstone Mary Baltimore Harvey Levin Betty Mabel DeBien Acosta Bennie L Williams Martin K. Bare Geraldine Lewis Juan Alemany John R. Woff Sylvia Barg Jimmy Littleturtle lag. Emilio Canals Mary D. Barnes Dominic Lynch Wendy Colon SOUTH DAKOTA Robert W. Baron Guy Macocci Rafael Correa Coronas Mrs. George Barrie Johanne Zerby Martz Alejc Diaz Eunice Anderson Frederick H. Barth Ralph McGraw Ines E. de Salca Evelyn Bergen Charles Bates Father James J. Mc Hale Francisca Gonzalez Francis Cole Margaret Baynes Mrs. David Meade Heyda Gonzalez Frank D. Ducheneaux, Sr. Sarah Bell Mrs David Measuroll Mariano Hernandez Sister Alicia Dumphy Genevieve Blatt Herman M. Melitzer Hector L Rodriguez MuncoGerry Eisenbraum Walter L Bond Shirley _Moose Jaime Tow Perez Carl Fisher Thurmond Booker Riy Morgan Margarita Pietri De PiquetDelia Greene Rev. Wesley W. BowdenKenneth Moser Modesto Rivera Myrle G. Hanson Mrs. Sol Bray James R. Neely Renato Royo Robert H. Hayes Bishop John D. Bright John Nichols Efrain Santiago Peter B. Johansen Louise Brookins William Nye Alicia Ramirez Suarez Russell E Jonas Elizabeth Brown Clarence J. 011endike Miguel Vasquez Peg M. Lamont Eleanor H. Bryant Dean Olewiler Eddie Zavala Vazquez Joan Liebig Harriett Bury Margaret O'Neill Rev. C Elliott Means Rev. A. L. Caesar Joan Owens RHODE ISLAND Lillian Nace Herbert R. Cain, Jr. Julia Pararella Patrick A. Norman Mrs. Forrest L. Parr Robert S. Burgess Louis Caplet la .John W. Cornett Martin Osterhaus Sylvia Carothers Victorina Peralta I Tech J. Schumacher Alex T. Powell Mildred Dean Charles F. Craver, Jr. Adeline N. Derensis al.s. Harold Thomas David Chittister James B. Preston Rev James W. Torbert Thomas S. Quinn Victor Gagnon Walter J. Clayton Amelia Gelfuso Lloyd T. Uecker Elias S. Cohen Joy Spaulding Rabin Jacob Cohen Theda 1. Sidney Goldstein Hobson Reynolds Paula L Gregoire TENNESSEE Ruth Cohen Bernard A. Heslin Ellen Connell Margaret Young Richards Helen Newbury RiddingtonMargaret Holland Alfred Ballinger Francis J. Cosgrove Richard J. Kraemer Mary Sue Bethea Vincent J. Cristofalo Richard Rife Katherine Rob 'son Albert V. Lees Col. Leroy B. Bible Mrs. William Crittenden Helen C. McLeish Richard Block Frank D. Croop Clayton Rock David Bow Mrs. Lagree Daniels Al Rojohn William A. Pellitier Donald J. Rosato Edgar J. Peloquin Betsy Bowman Father Del Real Rose Shockett Ralph Bray Mrs. Russell W. Dixon Arthur Rose Frank Ruck Eleanor F. Slater Patty Rae Buchanan Mrs. Clarence Ebbert Mabel Constance Sneed Glen Bushey Mrs. Roy W. Engle John A.,Sabol Mrs. P. Salner Virginia Stone Henry Cannon Gwendolyn Farmer Bev Tavares Mrs. Frank Cheney Eloise- Farrow William F. Schlog Del Theberge William E. Cole Juan Silva Fernandez William Schrum Juan Silva Lillian Turner Mrs. Alfred N. Costner Albert A. Fiok Agnes Vigeant Lee Dabney Harry W. Fisher Mrs. Edward Smith Richard A. Snyder James N. Williams Murray Flats Jeane Fisher Richard Zambarano Robert Fort James W. Ford Lonora Solomon Thomas F. Frist, First Samuel W. Frank John Spadacinno SOUTH CAROLINA Thomas F. Frist, Sr. Theodore F. Freed J. Flinton Speller H. M. Frye Henry Freeman Margaret B. Spencer W. T. C. Bates Nancy Ir.ill Fulmer Samuel Granick Cecile Springer W. T. Bolt Grahan Funderbruk Patrick Greene Daniel Stone Rosa monde R. Boyd Pearl Gilliam Elizabeth Ann Groff Wilbur H. Strickland Alton G. Brown Robert Glenn Herbert J. Grubb Nathan Sussman Harry R. Bryan Mrs. Walter Goforth Chauncey Gundcrman Charles Taylor Emma Davis John Griesbaum Frank Henderson Dorothy Taylor James D. Dubs Roy Hall Margaret Hippey Joseph Thompson R. Archie Ellis T. J. Harrison, Jr. Wilbur Hobbs Rev. Alva Tompkins Jim Flint Erich Helbig Gertrude S. Hoist John C. Voerman Mary Heriot Mildred Hurley John Horne Sen. George N. Wade Charles G. Heron Tom Jensen Hobart C. Jackson Beatrice Ward Mary E. Hite Rudolph H. Hampmeier Fannie Jefferson C. Clifford Washington W. T. Holt James J. Kelly Samuel P. Katz The Rev. Shelton B. WatersLeonidas James Thomas P. Kennedy, Jr. Manuel Kaufman Ulysses Watson Anna D. Kelly Taknski Makipodan Ellis 0. Keller Benjamin F. Weaver Rev. Grant Leverets Sart McCaleb Leona Kelly Rev. Paul White Isadore Lourie A. U. Moore Donald P. Kent Donald Wieland William Marett T. G. Murphree Mrs. Herman Kerber Delores T. Williams Rev. Ted R. Morton,Jr. Virginia W. Power Charles B. Killinger Raymond Wing S. White Rhyne Rev. Walter I.. Russell

168 Dan J. Scott Bert Holmes Kintoki Joseph Theodora Dunbavin Ina Fulton Shumaker Rev. William Holmes Chief Reklai Ngirasechedui Lomisang Florence Hill Rebecca Smith Roy Stokes Howell Chief Francisco Luktun Arturo James Henry A. Tiller Mrs. Lynn Hubbert Eskiel Moses Ruth H. Jones Sebastian Tine Edna Jagoe Namaru Nakamuru Pastor Roger Kimball E. Neige Todhunter Evelyn Jefferson Chief Ibcdul Ngoriakl Gloria M. King Ershell Vaughn Inez Jeffery Henry S. Pangelinan Mrs. Bert Paiewonsky Ethely H. Venson Lois Jenkins Chief Andrew J. Roboman Alice Petersen Rev. Kenneth C. VerranMary Louise Johns Benign Sablan Elaine Sprauve Paul Wells Donna Johnson Henry Samuel Clarice Thomas Leah Rose Werthan R. L Jones Ben Schermes Jane Tuitt Rev. Henry G. West John T. King Joab Sigrah Consuelo Vantcrpool Mrs. Malcolm Whit. Olga Lepere Norman Skilling Betty Watlington Earle L Whittington Carl D. Levy Kakwe Telinej Fitzroy. Williams Charles Edwin WilliamsArden I. Lewis Rosendo T. Tonga Patrick Williams Ben W. Linsay Francisco B. Tudela Sylvia C. Young Sam Long Sabi William TEXAS Mrs. Ernest Maciver James L. Mackay UTAH VIRGINIA Mrs. C L Abernethy Cora Martin Romaon S. Acosta Homer Martinez Donald C. Capfall Belle Boore Beard Fred J. Agnich Louise Massey Jessie Crowder Raleigh Cambell David Alvardo Mrs. Charlie Matlock Orin Crump Austin B. Chinn Gerald (Jerry) Avila Jack Matthews Irene C. Cuch Howard C. Cobbs Donna Bearda Mrs. Fred McCleskey Horace Doty John Cull judge Ernest Belcher Mrs. Ray Millilcan Mary M. Hanson A. Ray Dawson Minnie Bell Dorothy E. Mood George Henry Louella C Dirksen Carlos Besinaiz Margaret Murray Victor Kassel Mrs. Norvleate Downing Zeronoa S. Black Marie Ortega Stella La Rose Kenneth E. Dunlap Howard Blomquist Olga Ortiz Simona Mans John W. Edeltnan Billie Bolin Saul Paredes James A. McMurrin James H. Elam, Jr. Fred Brinkley, Jr. Rev. Billy Mack Paneson Mike Melendez Mrs. W. H.-Ellifrits Henry Allen Bullock Ada Pena Harry Nelson William H. Emory, Jr. Alvin A. Burger Gante Pena Ferdinand E. Peterson -.0.c Julian P. Fox, Jr. Dorothy Byrd Felix Perez, Sr. Thomas M. Phillips Anna Gover Ati lano Calderon Robert S. Pool Wayne Prince Mrs. C L Gregson John Campos Leola Prell Mignon Richmond George H. Hill Manual Gino Harold Price Deborah Roberts Harold H. Hopper Lois Carlisle Robert E. Pugh Glezi Snow Aline Johnson E R. Carver Juanita Quinteros Hyrum Toone Fannie Jones Mrs. Carter M. aopton Dorothy Raker Alberta West R. L Lacy J. H. Clouser Albert Randall Melvin A. White Henry 0. Lampe James F. Conner Bernard Rapport Douglas 0. Woodruff Mrs. Virgil F. Laws Thomas Craddick Dan Reyna Naomi Wooley J. Franklin Little, Jr. Mrs. V. W. Crump Mrs. A. W. Reynolds John Zupko Sandra H. McNair Mrs. Howard Davison Ramon Romero James E. Montgomery Rudy Davila Meledo Sanchez VERMONT Key. Charles E. Neal Nadine C. Denson Rev. Rudi Sanchez Adriano P. Padron Harry Dieu. t Rovers R. Sanders Henry P. Albarelli Maria Pornsett Art Dilley Eugene P. Schoodi, Jr. Leonard Black H. Stewart Potter Fratis L Duff James Sherry Theresa Brungardt janipher W. Robinson Mrs. Printis Ellis Herbert Shore Cyril Carty M. Leigh Rooke Elmo Fischer Mrs. Martin D. Siegel Joyce Corning Dorothy Rowe Swan Fisher Mrs. Bert Kruger Smith Alfred Couture Burton Rudy Stanley A. Fishier Rev. Albert Stafford Frank Dumas Neil Ryan Myrtle Fonteno Bradley Taylor Scotty Grigat Byron C. Sarvis Stuart Fosjer Lena Taylor June E. Holmes Cot Wilfred Smith H. J. Friedsam Mrs. Terry Thomas Mrs. Herbert Ingram Herbert H. Southall Charles M. Gaitz Mike Titan Aline Johnson Rev. John Stanton Clotilde Garcia Israel Valdez John M. Leary Julia E. Tucker Consuelo L Garcia L G. (Bill) Vawter Marguerite Lillicrap Sen. James C. Turk Mrs. John Garcia Edwina White Mrs. Lou Maginn David Evan Ushio Bernard Goldstein Jay E. Wilkins, Jr. Elizabeth lficklejohn Stanley Wilcox McChesney Goodall, Jr. Norma Wilkins Walttr J. Regan Edwin L. Wood Ross Greenwood Mabel Williams David H. Rosen Hobie Wright Tito Guerrero Mary Williams George Sloan Burton G. Hackney Mabel Sullivan Hugh Hackney Julia E. Tucker WASHINGTON John H. Hannah TRUST TERRITORY OFMaurice Walsh Ruth Harper Margaret B. Whitticsey Mrs. Jose Aguilar Roy Harrington THE PACIFIC ISLANDS Nora Barker Alan W. Hastings Lyle Daverin Margaret M. Henderson Olympio T. Soria THE VIRGIN ISLANDS Vine Deloria Bill Hernandez Ed-vard Capelle Roland Dietmeicr Mrs. Jackson Hinds Chief Alper Domsin Clarice Bournne James B. Dixon Mrs. R. M. Hix Dwight Heine Father Julian M. Clarke

169 at: Arthur Farber riieirePYrIZET WEST VIRGINIA Larkin Ours Conrad() Flores DeWitt TalMadge Pennington F. Ray Power Laura Foltz Kryn Polinder Glen Armstrong Emma C. Robinson Joe Garcia Joseph E. Primeau Rev. Arnold Belcher Martha Scott Thomas Gardner Robert Santos Winifred M. Booth Sam Shaw Richard A. Grant Robert Sarvis Wylene Dial Julia Woodruff Clarence Hart Gladys Schmidt Edward W. Drichorsc Raymond Hiflyard Morton A. Schwabacher Margaret Emery Lillian Hodin Theoda Smith Mrs. G. Thomas Evans Chisato Kawakori Jess B. Speilholz Louise B. Gerrard THE TERRITORY OF Fred Kelly Helen Stafford Robert Goodrich, Jr. Rudolph Knaack Deanna Stamsos Al lie Gorrell AMERICAN SAMOA Harry Loft Donna Stuteville G. E. Jordan Sister Lois Marie Gladys Taitte Yvonne Knauff Asuemu U. Fuimaono Catherine May Richard Toepper W. J. Martin Ben Schirmer John B. McPherson Thomas Villinu va Mrs. Marion McQuade Fiataualoca D. Soma Mrs. Florence Myers Sally Wren Ronald M. Nestor Sinatoga Wan li

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170 NATIONAL ORGAN! ZATION DELEGATES

ADULT EDUCATION AMERICAN ASSOCIATION AMERICAN BAPTIST 1 ASSOCIATION OF THE U.S.A. OF HOMES FOR THE AGING CONVENTION Dr. Earl Kauffman Eugene T. Hackler Miriam R. Corbett i Dr. Mary C. Mulvey Frank G. Zelenka Rev. Ray L Schroder

APL-CIO, INDUSTRIAL AMERICAN ASSOCIATION AMERICAN BAPTIST UNION DEPARTMENT ON MENTAL DEFICIENCY HOME MISSION SOCIETIES Marvin Caplan Natalie Twardzicki Rev. Donald H. Crosby Jacob Clayman Margaret M. Wright Dr. Charles A. Oehrig. Jr.

AFRICAN METHODIST AMERICAN ASSOCIATION AMERICAN BAPTIST WOMEN EPISCOPAL CHURCH OF OPHTHALMOLOGY . Alonzo H. Hartwig W. E. Ross Dr. Abraham L. Kornzweig Violet E. Rudd Rev. Andrew White Dr. David H. Scott AMERICAN BAR ASSOCIATION ALTRUSA INTERNATIONAL, AMERICAN ASSOCIATION Norman J. Kaicheim INCORPORATED OF RETIRED PERSONS Ralph J. Podell Ethel J. Boyle Olivia C. Alaniz Dorothy E. Kueldhora Cyril F. Brickfield AMERICAN BIBLE SOCIETY Bertha Byrdsong Dr. Gordon Clarke Mamie- R. Capellen Dr. James Z. Nettinga AMALGAMATED CLOTHING Rev. Otho Cobbias WORKERS OF AMERICA Leonard Davis AMERICAN CAMPING William Elkus Iyy_Demps_ey Ruby M. Elliot ASSOCIATION, INC. Howard D. Samuel Jar les M. Farris Katie Flanagan Fred D. Carl AMALGAMATED MEAT Edward E. Frederick CUTTERS AND BUTCHERS Gar P. Fryer AMERICAN CANCER Josephine M. Gustafson WORKMEN OF NORTH AMERICA Milton Jackson SOCIETY, INCORPORATED Leon B. Schachter Jerry P. Johnson Joseph W. Leverenz Irving Stern Victor A. Lindstrom Tsunao Miyamoto AMERICAN COLLEGE Nicholas H. Modinos AMERICAN ACADEMY Paul F. Newell OF NURSING HOME OF OPTOMETRY Arthur J. Schuettner ADMINISTRATORS Dr. Frank A. Brazelton Chester A. Smith Lynn W. Norris Dr. Donald C. Exford _Charles R. Stultz Alice Van Landingham Dr. Harry Weinerman AMERICAN COLLEGE AMERICAN ACADEMY Douglas 0. Woodruff OF PHYSICIANS OF PHYSICAL MEDICINE AMERICAN ASSOCIATION Dr. Wesley M. Oler III AND REHABILITATION Dr. Edward C. Rosenow, Jr. Dr. Leonard F. Bender OF STATE AND TERRITORIAL DENTAL DIRECTORS AMERICAN CONGRESS OF AMERICAN AGING Dr. Norman C. Rutter, Jr. REHABILITATION MEDICINE ASSOCIATION, INC. Dr. Margaret Kenrick Dr. Denham Harman AMERICAN ASSOCIATION Dr. Morris Rockstein OF UNIVERSITY WOMEN AMERICAN DENTAL AMERICAN ASSOCIATION Alice L. Eeeman ASSOCIATION Martha S. Luck OF EMERITI Dr. Dayton Krajicek Dr. George R. Luke AMERICAN ASSOCIATION Dr. Frank L Shuford, Jr. Dr. Phi (omens Marquardt OF WORKERS FOR THE Mullady AMERICAN DIABETES BLIND, INCORPORATED ASSOCIATION, INC. AMERICAN ASSOCIATION J. Kenneth Cozier Dr. Louis K. Alpert FOR HEALTH, PHYSICAL Pater J. Salmon Dr. Herbert Pollack EDUCATION, AND AMERICAN BANKERS THE AMERICAN RECREATION ASSOCIATION DIETETIC ASSOCIATION Laura Mae Brown Richard W. Drake Marjorie M. Donnelly Dr. Barbara E. Forker Thomas R. Wirsing, Jr. Mildred Randall

171

h. 468-217 0 t3 - 13 AMERICAN FEDERATION AMERICAN JEWISH CONGRESS AMERICAN OSTEOPATHIC OF GOVERNMENT Naomi B. Levine ASSOCIATION EMPLOYEES, AFL-CIO Dr. F. L. Reed Laura H. Harris THE AMERICAN LEGION Dr. Richard F. Siehl Joseph B. Resins Milton S. Applebaum Joseph Holzka AMERICAN PATIENTS AMERICAN FEDERATION OF ASSOCIATION LABOR AND CONGRESS OF AMERICAN LIBRARY M. Daniel Tatkin INDUSTRIAL ORGANIZATIONS ASSOCIATION Marilyn Wisoff Walter Davis Ira Phillips Clinton Fair Lesiyn Mary Schmidt AMERICAN PERSONNEL AND Page Groton Peter Mc Gavin AMERICAN LIFE CONVENTION GUIDANCE ASSOCIATION Frederick O'Neal Richard E. Vernor Leonard M. Miller William E. Pollard Edwin J. Faulkner Dr. Frank L. Sievers Julius Roth-man Joseph Rouke AMERICAN LUTHERAN AMERICAN PHARMACEUTICAL Michael Sampson Boris Shish CHURCH, SOCIAL SERVICE ASSOCIATION Lawrence T. Smedly DIVISION Mr. James D. Hawkins Stanton Smith James V. Anderson CharlesA. Schreiber AMERICAN FEDERATION OP Rev. John M. Mason AMERICAN PHYSICAL TATE, COUNTY, MUNICIPAL AMERICAN MEDICAL THERAPY ASSOCIATION EMPLOYEES, AFL-CIO ASSOCIATION William F. Lang Robert D. Boland Dr. David Eckstein Paul G. Otoittior John E. Martin Dr. Pierre Salmon AMERICAN FEDERATION AMERICAN MEDICAL AMERICAN PODIATRY OF TEACHERS WOMEN'S ASSOCIATION INC. ASSOCIATION Sylvia R. Letinson Dr. Elizabeth S. ICahler Dr. Daniel A. Rietz Carl J. Megel Dr. Margaret J. Schneider Dr. Edward L. Tarara AMERICAN FOUNDATION AMERICAN MOTHERS AMERICAN PROTESTANT FOR THE BLIND, INC. COMMITTEE. INC. HOSPITAL ASSOCIATION Dorothy Demby Dorothy M. Lewis Charles D. Phillips Marion V. blunter THE AMERICAN Ronald H. Wison AMERICAN GERIATRICS NATIONAL RED CROSS AMERICAN PYCHIATRIC SOCIETY Mrs. Francis E. Hildebrand ASSOCIATION Dr. Theodore C. Krauss Barbara K. Williamson Dr. Alvin I. Goldfarb Dr. William Reichel Dr. Jack Weinberg AMERICAN NURSES' AMERICAN HOME ASSOCIATION, INC. AMERICAN PSYCHOANALYTIC ECONOMICS ASSOCIATION Sister M. Loyola Schwab ASSOCIATION Dr. Richard L D. Morse Mii-k E. Stiatighitesii Irene IL Wolgamot Dr. Hugh T. Carmichael AMERICAN NURSING Dr. Ralph J. Kahana AMERICAN HOSPITAL HOME ASSOCIATION AMERICAN PSYCHOLOGICAL ASSOCIATION David R. Mosher ASSOCIATION Regina Kulys Frank J. Ritiehait Monroe Mitchel Jack Botwinick AMERICAN OCCUPATIONAL Leonard Gotteiman AMERICAN INSTITUTE THERAPY ASSOCIATION, INC. OF ARCHITECTS AMERICAN PUBLIC HEALTH Betty R. Cox Olin Boese, Jr. Alice L. Shafer ASSOCIATION, INC. Eugene D. Sternberg Henry C. Daniels AMERICAN OPTOMETRTC Gladys H. Mathewson AMERICAN INSTITUTE ASSOCIATION OF PLANNERS AMERICAN PUBLIC Dr. V. Eugene McCrary Harland Bartholomew Dr. Douglas W. Redmond WELFARE ASSOCIATION Alvin Zelver George K. Wyman AMERICAN ORTHOPSYCHIATRIC AMERICAN INSTITUTE ASSOCIATION, INC. AMERICAN SCHIZOPHRENIA FOR PSYCHOANALYSIS Dr. Jean K. Boek ASSOCIATION Dr. Bela S. Van Bark Simon H. Tulchin Mel Mendelssohn

172 AMERICAN SOCIETY OF ASSOCIATION OF B'NAI B'RITH WOMEN CONSULTANT PHARMACISTS JEWISH CENTER WORKERS Helen Diamond Richard S. Berman Stanley Ferdman Mrs. Frederick Solomon Dr. Allen M. Kratz Robert H. Weiner BOY SCOUTS OF AMERICA THE AMERICAN SOCIETY ASSOCIATION OF LADIES Arthur K. Weiner FOR GERIATRIC DENTISTRY OF CHARITY OF THE Dr. Arthur Elfenbaum BROTHERHOOD OF RAILWAY, Dr. Walter A. Hall, Jr. UNITED STATES AIRLINE AND STEAMSHIP Mrs. Willard M. Jackson AMERICAN SOCIETY OF Anny May Moynihan CLERKS, FREIGHT HANDLERS, HOSPITAL PHARMACISTS EXPRESS AND STATION Dr. Carl T. De Marco ASSOCIATION OF MEDICAL EMPLOYES Dr. Dwight R. Tousignant REHABILITAION DIRECTORS J. J. Kennedy E J. Neal AMERICAN SOCIETY OF AND COORDINATORS, INC. OF INTERNAL MEDICINE Mary C. Van Benschoten CATHOLIC DAUGHTERS Dr. Robert H. Barnes OF AMERICA ASSOCIATION OF PRIVATE .Annie Schipp Shields AMERICAN SOCIETY FOR PENSION AND PERSONNEL ADMINISTRATION AND WELFARE PLANS, INC CATHOLIC HOSPITAL L R. Brice James A. Curtis ASSOCIATION Mark Staley Joseph P. Leary John T. James Sister Mary Maurita Sengelaub AMERICAN SOCIETY OF ASSOCIATION OF SCHOOLS PHYSICIANS IN CHRONIC OF PUBLIC HEALTH, INC. CAUCUS OF BLACK DISEASE-FACILITIES- Dr. John A. Scharffenberg SOCIOLOGISTS Or. Raymond T. Benack Dr. James E.Blackwell Dr. J. Raymond Gladue THE ASSOCIATION Dr. Stanley Smith AMERICAN SOCIOLOGICAL OF SOCIAL AND CENTRAL CONFERENCE ASSOCIATION BEHAVIORAL SCIENTISTS Ethel Shanas Dr. Jesse E. Gloster OF AMERICAN RABBIS Dr. Hubert B. Ross Rabbi Bernard H. Mehlman AMERICAN SPEECH AND HEARING ASSOCIATION ASSOCIATION OF STATE CHRISTIAN CHURCH, Dr. Norman S. Barnes AND TERRITORIAL DEPARTMENT OF CHURCH Dr. Henry E. Spuehler HEALTH OFFICERS IN SOCIETY AMERICAN TRANSIT Dr. Hollis S. Ingraham. Loisanne Buchanan Donald F. Clingan ASSOCIATION BAKERY AND Stanley H. Gates, Jr. CHRISTIAN CHURCH, CONFECTIONARY WORKERS' AMERICAN VETERANS INTERNATIONAL UNION THE NATIONAL COMMITTEE OF AMERICA BENEVOLENT ASSOCIATION Chester C. Shore Vaughn a Ball Dr. William T. Gibb e Rudolf Sobernheim Albert K. Her ling CHRISTIAN FAMILY AMERICAN VOCATIONAL BLACK, PSYCHIATRISTS MOVEMENT ASSOCIATION, INC. OF AMERICA William J. Fitzgerald H. Dean Griffin Dr. Gail Allen CHRISTIAN REFORMED ARROW, INC. Dr. Dorothea Simmons Virgil I.. Kirk, Sr. CHURCH BLACK WOMEN'S COMMUNITY Jack W. Stoepker THE ARTHRITIS DEVELOPMENT FOUNDATION CHURCH OF THE BRETHREN FOUNDATION Sarah W. Herbin Olin J. Mason David D. Shobe BLUE CROSS ASSOCIATION Larry K. Ulrich ASSOCIATION OF Hada G. Pearce CHURCH OF GOD ADMINISTRATORS OF John E. Svenson Robert 0. Dulin, Jr. MH-MR FACILITIES B'NAI B'RITH Dr. William E. Reed Stephen Caulfield Raynard I. Jameson CHURCH OF THE NAZARENE Sidney R. Katz Aviva Kaufman , Rev. Earl Wolf

173 A

CHURCH WOMEN UNITED DIPLOMATIC AND CONSULAR FRIENDS UNITED MEETING CamellaJ.Barnes OFFICERS, RETIRED, INC. Herbert Pettengill, Jr. Grace Loucks Elliot William C. Affeld, Jr. Katherine Toll Theodore J. Hadraba COMMITTEE FOR Frederick D. Leatherman FUTURE FARMERS ECONOM IC DEVELOPMENT OF AMERICA Robert F. Lenhart DISABLED AMERICAN Kevin RAI John A. Perkins VETERANS Ernest E. Towell, Jr. Robert F. Dove COMMUNICATIONS FUTURE HOMEMAKERS OF AMERICA WORKERS OF AMERICA THE ELDER CRAFTSMEN Margaret Louisa Lindell John T. Morgan INCORPORATED William J. Walsh Samuel L. Kuhn GENERAL COUNCIL CONFERENCE OF MAJOR OF ASSEMBLIES OF GOD "'ti' EPISCOPAL CHURCH, SUPERIORS OF WOMEN Rev. Stanley. Michael tYISCUPAL SOCIETY FOR Rev. Charles W. H. Scott Sister M. Madeleine Adamczyk MINISTRY TO GENERAL FEDERATION CONSUMER FEDERATION THE AGING, INC. OF WOMENS' CLUBS OF AMERICA Rev. Herbert Lazenby Katherine Abbot Dr. W. Palmer Dearing Rev. Gregory D. M. Maletta Emogene K. Baxter William R. Hutton THE EPISCOPAL CHURCH, GERONTOLOGICAL SOCIETY CONSUMERS UNION EXECUTIVE COUNCIL Dr. Jerome Kaplan Woodrow W. Carter Dr. Ivan N. Mensh Dr. Edivard Reich Jarifes E. Dumas GOLDEN RING COUNCIL OF THE EVANGELICAL COVENANT COOPERATIVE LEAGUE SENIOR CITIZENS CLUBS OF THE U.S.A. CHURCH OF AMERICA Moe Diamond - Eugene R. Clifford Nils G. Axelson Dressel Rev. Milton B. EngAretson GOLDEN YEARS EVANGELICAL LUTHERAN FOUNDATION, INC. COUNCIL OF JEWISH Dr. Bernard Lander FEDERATIONS AND GOOD SAMARITAN SOCIETY Morris Zelditch August J. Hoeger, Jr. WELFARE FUNDS, INC. GREEK ORTHODOX Sophie B. Engel FAMILY SERVICE Mrs. Jack H. Pearistone ARCHDIOCESE OF NORTH ASSOCIATION OF AMERICA AND SOUTH AMERICA COUNCIL OF ORGANIZATIONS Francis M. Bain Leonore Rivesman _Penelope Constantine SERVING THE DEAF Pagona Maroulis Edward C. Carney THE FIRST CHURCH GUILD OF PRESCRIPTION OF CHRIST, SCIENTIST COUNCIL OF STATE OPTICIANS OF AMERICA, INC. C. Ross Cunningham CHAMBERS OF COMMERCE_ 01,:e A. LaRoche Jerome A. Miller Paul P. Henkel Alfred D. Teunia Thomas M. Welch FOUNDATION FOR HEALTH INSURANCE CUNA INTERNATIONAL, INC. COOPERATIVE HOUSING C. Franklin Daniels ASSOCIATION OF AMERICA George R. LaChappelle Arthur M. Browning Evert S. Thomas, Jr. FRATERNAL ORDER OF EAGLES Richard H. Hoffman DAUGHTERS OF ISABELLA Steven V. Thomas HEARING AID Marie Heyer Anna C. Walsh FREE METHODIST CHURCH INDUSTRY CONFERENCE OF NORTH AMERICA James P. Ince Robert E. Winslow THE DELTA KAPPA Bishop Edward C. John GAMMA SOCIETY Rev. Harold S. Schwab HOME ECONOMICS Avis Dunn Whitlow FRIENDS COMMITTEE ON EDUCATION ASSOCIATION, DELTA SIGMA THETA, INC. NATIONAL LEGISLATION N.E.A. Cassie Cooke Stephen L. Angell, Jr. Dr. Mary Lee Hurt Vera Foster Robert Mills Bertha G. King

174 INSTITUTE OF INTERNATIONAL LITTLE SISTERS LIFE INSURANCE UNION OF THE POOR Willard W. Peck John W. Riley, Jr. OF UNITED BREWERY, FLOUR, Sister Cecil CEREAL SOFT DRINK AND Mother Mary James INTERNATIONAL ASSOCIATION DISTILLERY WORKERS OF LUTHERAN CHURCH OF FIRE FIGHTERS AMERICA IN AMERICA Raymond L. Perry Arthur P. Gildea Rueben T. Jessop Jack A. Waller Rev. Harold W. Reisch INTERSTATE ASSOCIATION INTERNATIONAL ASSOCIATION OF COMMISSIONS ON THE THE LUTHERAN CHURCH OF MACHINISTS AND STATUS OF WOMEN MISSOURI SYNOD Jessie H. Roy Alfred Y. Armstead AEROSPACE WORKERS Dr. Weslie F. Weber Robert G. Rodden IOTA PHI LAMBDA Joycelyn A. Thompson LUTHERAN COUNCIL IN THE SORORITY, INC. UNITED STATES OF AMERICA INTERNATIONAL Belle Butler' Bessie Coston Rev. Norman C. Hein BROTHERHOOD OF Will C. Rasmussen ELECTRICAL WORKERS JAPANESE-AMERICAN THE LUTHERAN Thomas A. Hannigan CITIZENS LEAGUE Harold G. Tate LAYMEN'S LEAGUE Mike M. Masaoka Ben F. Jutzi INTERNATIONAL JEWISH LABOR COMMITTEE LUTHERAN RESOURCES ------BROTHERHOOD OF Icing Barshop Bella Hyman COMMISSION PAINTERS AND ALLIED TRADES Dr. Henry En dress John J. Pecoraro JEWISH OCCUPATIONAL Wilson M. Matthews COUNCIL INTERNATIONAL MENNONITE BOARD OF Roland Baxt MISSIONS AND CHARITIES EXECUTIVE SERVICE CORPS. Beatrice Novick Arnold W. Cressman William L Finger Tilman R. Smith Harold F. Stebbins JOINT STRATEGY AND ACTION COMMITTEE MEXICAN-AMERICAN INTERNATIONAL LADIES' Rev. Norman E. Dewire LEGAL DEFENSE AND GARMENT WORKERS' UNION KAPPA ALPHA PSI EDUCATIONAL FUND Evelyn Dubrow Mario G. Obledo Matthew Schoenwald Dr. William Thomas Carter KIWANIS INTERNATIONAL MEXICAN-AMERICAN INTERNATIONAL Percy H. Shue OPPORTUNITY FOUNDATION READING ASSOCIATION DionicioMorales Dr. Lester M. Emans LABORERS' INTERNATIONAL UNION OF NORTH AMERICA THE MILITARY ORDER INTERNATIONAL SENIOR James R. Sheets OF THE WORLD WARS Col. Harold D. Kehm CITIZENS ASSOCIATION,INC. LEAGUE OF UNITEr LATIN Ted Ellsworth MOBILE HOMES Grace Sawyer AMERICAN CITIZENS Angelo DeSoto MANUFACTURERS INTERNATIONAL Julia S. Zozaya ASSOCIATION UNION OF ELECTRICAL, LEGISLATIVE COUNCIL Ronald K. Jones RADIO AND MACHINE FOR OLDER AMERICANS, INC. THE NATIONAL ASSEMBLY WORKERS, AFL-CIO-CLC Miriam Caines FOR SOCIAL POLICY Frank Holiver Edward J. Carlson AND DEVELOPMENT, INC. William S. Gray LIFE INSURANCE C. F. McNeil ASSOCIATIONOF AMERICA INTERNATIONAL NATIONAL ASSOCIATION Alan E. Pinado UNION J. Darrison Sillesky FOR THE ADVANCEMENT OF COLORED PEOPLE OF OPERATING ENGINEERS LIONS INTERNATIONAL Howard B. Mundorf Warran Howard William B. Hix Kivie Kaplan

175 NATIONAL ASSOCIATION NATIONAL ASSOCIA1 TON OF NATIONAL ASSOCIATION OF BLACK SOCIAL WORKERS JEWISH HOMES OF RETIRED FEDERAL Jay Chun FOR THE AGED EMPLOYEES NATIONAL ASSOCIATION Jacob Reingold Mae R. Anderson Dr. Herbert aore Richard Z. Brown OF BLUE SHIELD PLANS Samuel Bullock Hugh E. DeFazio NATIONAL ASSOCIATION Webster Frye Denwood N. Kelly . Gus Gehlbach OF LIFE U/:DERWRITERS Joseph F. Gore THE NATIONAL CATHOLIC Michael L. Kerley Ernesto Guzman Marvin A. Kobel William F. Hall EDUCATIONAL ASSOCIATION Virginia B. Hernandez Sister Mary Barbara Sullivan Miriam Hoffman NATIONAL ASSOCIATION Thelma Honey NATIONAL ASSOCIATION OF-NEGRO BUSINESS James A. Johnson Chauncey Lee OF COLORED WOMEN'S AND PROFESSIONAL Lou1/4J. Mancuso CLUBS, INC. WOMEN'S CLUBS, INC. Robert L. Merritt Carl L Schopper Georgia C. Anderson Marion E Bryant Robert Solomon Myrtle 011ison Ruth M. Tucker Maur%e S.Spaulding A!.-xander F. Swickard NATIONAL ASSOCIATION NATIONAL ASSOCIATION P!,:::p H. C Tam Clarence M. Tarr OF COORDINATORS OF STATE FOR NON-PROFIT Wv.-.mint; WiP:ams PROGRAMS FOR THE RETIREMENT HOUSING Int.o I Warden MENTALLY RETARDED, INC. Stanley B. Axlrod a Irt:a D Y-.ncy Rev. Virgil Mabry Raymond A. r. Young Robert M. Gettings Tv NATIONAL ASSOCIATION OF NATIONAL ASSOCIATION NATIONAL ASSOCIATION SOCIAL WORKERS, INC. Or COUNTIES FOR PRACTICAL NURSE Elaine M. B lady Max A. Barczak EDUCATION AND SERVICE Camille Jeffrrs George Otlowski Rose G. Martin Mildred H. Smith NATIONAL ASSOCIATION OF NATIONAL ASSOCIATION STATE MENTAL HEALTH OF THE DEAF NATIONAL ASSOCIATION PROGRAM DIRECTORS James T. Flood FOR THE PREVENTION Dr. Jerome D. Schein Dr. William Allerton OF ADDICTION TO NARCOTICS Harry C. Schnibbe NATIONAL ASSOCIATION Harold Alksne OF EVANGELICALS Leroy H. Jones NATIONAL ASSOCIATION FOR STATEWIDE HEALTH AND Floyd Robertson NATIONAL ASSOCIATION WELFARE NATIONAL ASSOCIATION OF FOR THE PREVENTION Theresa MacMillan EXTENSION HOME OF PSYCHIATRIC ECONOMISTS/ HOSPITALIZATION NATIONAL CANCER Alfretta E. Dickinson Wright Williamson FOUNDATION Betty Parks Strutin Dr. Herbert Winston Irene G. Buckley NATIONAL ASSOCIATION OF NATIONAL ASSOCIATION THE NATIONAL CATHOLIC HEARING AND SPEECH OF PRIVATE EDUCATIONAL ASSOCIATION AGENCIES PSYCHIATRIC HOSPITALS Sister Mary Barbara Sullivan Susan F. Segrest Melvin Herman NATIONAL CAUCUS ON Alice H. Suter Dr. Maurice E. Linden THE BLACK AGED NATIONAL ASSOCIATION NATIONAL ASSOCIATION Eddie W. Gibbs 1 OF HOUSING AND FOR PUBLIC CONTINUING Dr. Jacquelyne J. Jackson REDEVELOPMENT OFFICIALS AND ADULT EDUCATION NATIONAL CIVIL LIBERTIES John D. Lange Dr. Monroe C. Neff CLEARING HOUSE Hugh Denman Rose Mary Pattison Mary Alice Baldinger NATIONAL ASSOCIATION OF Luise B. Kiefer THE NATIONAL ASSOCIATION JEWISH FAMILY, CHILDREN'S, OF RETATT TIRT TnelISTS NATIONAL COMMITTEE AND HEALTH SERVICES Willard B. Simmons OF BLACK CHURCHMEN Benjamin IL Sprafkin William E. Woods Rev. Timothy P. Mitchell

176 NATIONAL CONFERENCE NATIONAL COUNCIL FOR NATIONAL EASTER SEAL OF CATHOLIC CHARITIES HOMEMAKER-HOME HEALTH SOCIETY FOR CRIPPLED Sister Made Gaffney AIDE SERVICES, INC. Lawrence Lawson CHILDREN AND ADULTS Hadley D. Hall Dr. Woodroe W. Elliot NATIONAL CONFERENCE Florence M. Moore Clare D. Rejahl ON PUBLIC EMPLOYEE THE NATIONAL COUNCIL ON NATIONAL EDUCATION RETIREMENT SYSTEMS HUNGER AND MALNUTRITION Westford Robbins ASSOCIATION Berthe E. West IN THE UNITED STATES Vivian Powell John R. Kramer W. Jack Tennant NATIONAL CONFERENCE Dr. Sadie Brenner Sklarsky ON SOCIAL WELFARE NATIONAL EXTENSION R.: R. Hoffer NATIONAL COUNCIL HOMEMAKERS COUNCIL OF JEWISH WOMEN Shirlee S. Blackner NATIONAL CONFERENCE Adrienne Picard OF UREAN MENTAL Henrietta Weiser NATIONAL FARMERS UNION HEALTH PROGRAMS Weldon B. Barton NATIONAL COUNCIL Archie Baumann Dr. Charles W. Landis OF NEGRO WOMEN, INC. Elton L. Berck Dr. H. G. Whittington Lewis J. Johnson Leota P. Brown Sam Lipetz NATIONAL CONGRESS Mrs. Beecher Cassells Willie Morrison OF AMERICAN INDIANS James G. Patton NATIONAL COUNCIL Limns Phillips Adam T. Mandan Gilbert C. Rohde OF_SENIOR-CITIZENS -Justus T. Stevens NATIONAL CONSUMERS Charles A!varez Arlo G. Swanson Roger R. Andrews Ellen Dean Wern LEAGUE James Carbray Lavinia Engle Walter Cassidy Beatrice McConnell Roy C. Cole NATIONAL FEDERATION OF Rudolph T. Danstedt BUSINESS AND PROFESSIONAL THE NATIONAL COUNCIL Matthew De More ON THE AGING, INC. PaulF. Dugan WOMEN'S CLUBS Harry Dunham Fanny Haidy Dr. David G. Salten Virginia Ferracho Cynthia E. Marano Edwin F. Shelley William H. Holsten Arthur Kling NATIONAL COUNCIL George Mc Court NATIONAL FEDERATION OF CATHOLIC WOMEN Martin J. McNamara OF FEDERAL EMPLOYEES David McSweeney I-rgaret A. Cassidy Edviin W. Murphy Grace P. Nolda C-.herine Jsrboe Rose Nathenson Henry No Ida Edward Peet NATIONAL COUNCIL Irvin Ryan NATIONAL FEDERATION OF Dora N. Schatz OF THE CHURCHES Max Serchuk JEWISH MEN'S CLUBS, INC. OF CHRIST IN THE U.S.A. Ebert Sharp Max M. Goldberg John McDowell Stanley E. Sprague Sidney J. Goldstein Robert J. Myers Philip Stearns Lucille Thornburgh NATIONAL FEDERATION NATIONAL COUNCIL Joseph Walsh OF LICENSED PRACTICAL OF COMMUNITY MENTAL NATIONAL COUNCIL NURSES,' INCORPORATED 14PAT.TH CENTERS OF WOMEN OF THE Teresa M. Crowley Dr. John B. Carver Etta B. Schmidt Dr. Donald Weston UNITED STATES, INC. Daisy S. George NATIONAL COUNCIL Mana S. Jennings NATIONAL FEDERATION ON FAMILY RELATIONS OF SETTLEMENTS AND NATIONAL DAIRY COUNCIL Dr. Felix Berardo La Rose M. Ketterling NEIGT-7BORHOOD CENTERS Ruth H. Jewson Dr. Elwood W. Speckmann Miriam W. Wasserman

NATIONAL COUNCIL NATIONAL DENTAL NATIONAL FEDERATION OF HEALTH CARE SERVICES ASSOCIATION, INC. OF TEMPLE SISTERHOODS Berkeley V. Bennett Dr. Theodore A. Shell Mrs. Paul J. Basinger Patrick J. Callihan Dr. Harvey Webb, Jr. Mrs. David M. Levitt

177 NATIONAL FOUNDATION NATIONAL RECREATION THE NATIONAL URBAN OF HEALTH, WELFARE AND AND PARK ASSOCIATION COALITION PENSION PLANS, INC. Ira J. Hutchison, Jr. 'Herbert M. Franklin R. C. Gallyon Janet R. MacLean . Leonard W. Stern Claude Kordus NATIONAL RETIRED NATIONAL URBAN LEAGUE NATIONAL GERIATRICS TEACHERS ASSOCIATION Barbara A. Cowan SOCIETY Raymond J. Ast Jeweldean Jones Londa Rev. Carl A. Becker Anita B. Blake Dr. W. Dean Mason Beyan Bundy NATIONAL WELFARE Lawrence Carlson THE NATIONAL GRANGE Frederick J. Ferris RIGHTS ORGANIZATION Joseph A. Fitzgerald Louise Singleton Constance R. Seay Lois Gray Loucinda Walker NATIONAL HEALTH COUNCIL Maude H. Haines Olga A. Hellbeck Dr. Clarence Bookbinder Frank Hughes OLDER AMERICANS RESOURCES Dr. Jay H. Eshleman Margaret H. Kizer AND SERVICES PROGRAM Florence Krieger Dr. Eric Pfeiffer THE NATIONAL HEARING Ruth Lana AID SOCIETY Herman Miller OMEGA PSI PHI Dona'd E. Galloway Mary Mullen Sheva Kotok C. B. Murray FRATERNITY, INC. Katherine Pearce Samuel C. Coleman NATIONAL INSTITUTE Selma Richardson Mabel I. Robbins OF SENIOR CENTERS Adelino Sanchez PHARMACEUTICAL William R. Pothier George W. Schluderberg _Minnie-0.-Sledge MANUFACTURERS NATIONAL INSTITUTES Marion Smith ASSOCIATION Charles L. Steel ON REHABILITATION -John E. Thomas Dr. John 0. Adams AND HEALTH SERVICES Mary E. Titus PHI BETA SIGMA Dr. Bruce Grynbaum NATIONAL RURAL ELECTRIC Dr. Samuel Sverlick FRATERNITY, INC. COOPERATIVE ASSOCIATION James T. Horton NATIONAL .JEWISH H. Louis Custer Dr. Parlett L. Moore WELFARE BOARD William E. Murray PHI DELTA KAPPA Harold Axlerod NATIONAL SAFETY COUNCIL Myron Mayer Harry W. Ecklund Ruby S. Couche Hans R. Grigo NATIONAL LEAGUE OF CITIES PILOT CLUB INTERNATIONAL Carter L. Dunlop NATIONAL Frances B. Keever NATIONAL LEAGUE SHARECROPPERS FUND Minnie Walker FOR NURSING, INC, John A. Wilson PRESBYTERIAN CHURCH IN Ruth Addams NATIONAL SOCIETY THE U.S., BOARD OF Janina Lapniewska FOR THE PREVENTION WOMEN'S WORK NATIO1AL LEGAL AID AND OF BLINDNESS, INC. Lucy R. Hestir DEFENDER ASSOCIATION Virginia S. Boyce Edith J. Walsh Barbara J. Campbell Dr. Wilfred D. David Frank N. Jones PSYCHIATRIC OUTPATIENT NATIONAL THERAPEUTIC CENTERS OF AMERICA NATIONAL MEDICAL RECREATION SOCIETY Mildred E. Berl ASSOCIATION David C. Park Richard W. Loring Dr. Louis C. Brown Jean R. Tague QUOTA INTERNATIONAL INC. NATIONAL NATIONAL UNION OF Charlotte Shaffer MEDICAL ASSOCIATION HOSPITAL AND NURSING FOUNDATION, INC. HOME EMPLOYEES THE 'RABBINICAL ASSEMBLY Dr. Jean L. Harris Edward Garrins Rabbi Stanley S. Rabinowitz H. Peter Solomon Anne Shore Rabbi Herbert A. Seltzer NATIONAL PHARMACEUTICAL NATIONAL UNIVERSITY REFORMED CHURCH ASSOCIATION, INC. EXTENSION ASSOCIATION IN AMERICA, Aaron E. Henry Floyd B. Fischer THE BOARD OF PENSIONS Floyd L. White Robert J. Pitchell Rev. Theodore F. Zandstra 178 REORGANIZED CHURCH SOUTHERN BAPTIST UNITED CHURCH OF CHRIST, OF JESUS CHRIST OF CONVENTION, THE CHRISTIAN DIVISION OF LATTER DAY SAINTS LIFE COMMISSION CHRISTIAN EDUCATION Dr. Frederick A. Kunz William P. Harris Chasie Ortiz Bishop Homer D. Spiers W. L Howse, HI Carlos Rios RETAIL CLERKS SOUTHERN UNITED CHURCH OF CHRIST, INTERNATIONAL REGIONAL COUNCIL DIVISION OF ASSOCIATION James N. Wood HEALTH AND WELFARE Douglas Coutee SOUTHWEST COUNCIL Walter L. Davis OF LA RAZA Dr. Hobart A. Burch The Rev. Carroll J. Olm .00 RETIRED PROFESSIONALS' Charles J. Garcia Alex Zermano ACTION GROUP UNITED HEALTH Elma L. Griesel SYNAGOGUE COUNCIL OF FOUNDATIONS, INC. Edmond L. Kanwit AMERICA Bertram Loeb THE SALVATION ARMY Rabbi Irving Lehrman Rabbi Solomon ). Sharfman THE UNITED METHODIST Lt. Col. Olof Lundgren Mrs. Col. Lloyd Robb TELEPHONE PIONEERS CHURCH, BOARD OF OF AMERICA CHRISTIAN SOCIAL CONCERNS SERBIAN EASTERN Mrs. Leslie E. Barnhardt Lawrence N. Jensen Dr. Luther E. Tyson ORTHODOX DIOCESE James 0. Parker MONASTERY OF THE MOST Joseph P. Sheridan THE UNITED METHODIST HOLY MOTHER OF GOD TOWNSEND PLAN CHURCH, BOARD OF HEALTH RtRev:Bishop lriney' -NATIONAL LOBBY" AND WELFARE Ari Kovacevich John Doyle Elliott M. Joe Helms .ERVICi CORPS OF Ruth Bowdey Elliott John A. Murdock RETIRED EXECUTIVES TRAVELERS AID ASSOCIATION Walter H. Channing OF AMERICA THE UNITED METHODIST Julius Davidson Ruth F. Spur lock CHURCH, BOARD OF MISSIONS SERVICE EMPLOYEES UNION OF ORTHODOX Harry Greenberg Betty J. Letzig INTERNATIONAL JEWISH CONGREGATIONS UNION Rabbi Elkanah Schwartz THE UNITED METHODIST Richard E. Murphy Dr. Samson R. Weiss CHURCH, DIVISION OF SEVENTHDAY ADVENTISTS, UNITARIAN UNIVERSALIST CURRICULUM RESOURCES GENERAL CONFERENCE WOMEN'S FEDERATION Daisy Dozier Warren Dr. Ralph F. Waddell Ruth P. Mendelsohn Harriett Oulton THE UNITED METHODIST SEX INFORMATION UNITED AUTO WORKERS CHURCH, DIVISION OF AND EDUCATION COUNCIL John Allard THE LOCAL CHURCH OF THE U.S. Stanley Badyna Rev. Roy H. Ryan Dr. Mary S. Calderone Gwendolyn Edwards Virginia K. Stafford Nelson J. Edwards SHEET METAL WORKERS Charles Enos, Jr. UNITED MINE WORKERS Douglas A. Fraser OF AMERICA INTERNATIONAL ASSOCIATION Marcellius Ivory J. W. O'Brien Kenneth Johnston Bedford W. Bird C. A., Darnell Oiga Madar Dr. Lorin E. Kerr Hardy Merrill SIGMA KAPPA SORORITY Florence Peterson UNITED MINE WORKERS Mrs. Swift M. Lowry Rudy Vaughn OF AMERICA, WELFARE SOCIETY OF ST. VINCENT DE UNITED BROTHERHOOD OF AND RETIREMENT FUND PAUL, SUPERI07. COUNCIL CARPENTERS AND JOINERS Dr. John Newdorp Kenneth E. Pohlmann OF THE UNITED STATES OF AMERICA Dudley L. Baker Paul H. Connelley UNITED PRESBYTERIAN Martin J. Loftus Donald D. Danielson CHURCH IN THE UNITED SOROPTIMIST FEDERATION UNITED CEREBRAL STATES OF AMERICA, OF THE AMERICAS, INC PALSY ASSOCIATION BOARD OF PENSIONS Valerie F. Levitan Dr. Elsie D. Helsel Rev. Winton H. Halsted Virginia Timmons Charles T. Mitchell, Jr. Rev. W. Eugene Houston

179 _UNITED PRESBYTERIAN UNITED - SYNAGOGUE VETERANS-CIF WORLD WART HEALTH, EDUCATION AND OF:AMERICA; NATIONAL oP THE WELFARE ASSOCIATION, WOMEN'S LEAGUE Pftiyd *E. Milder-ion BOARD OF NATIONALWISSIONS Zelda:Dick J.-B. Koch-- Harvey M. Luce Mrs. Herbert Quint ,Rev. H. Kris `Ronnow THE VOLUNTEEBS'OFAMERICA' UNITED=TRANSPOR;TATION Lt-Col. Belle "Leach. jis:CATHOLIC CONFERENCE UNION- General John, F. -McMahon Rev. Mstr.:Lawrence Corcoran Luna-, = Msgt Hariold-J: Murray WOMEN'S AUXILIARY THE UNITED ,STATES JAYCEES UNITED WAY OF *ERICA- TO- 'AMERICAN' Ardith -Hithleyinan -Gary R. McNaughi, MEDICAL ASSOCIATION,INC- Raymond -W. Roper Mrs. 'Manna- Betimes uniciLsimiums Jack 'Le*,

-.UNITED STEELWORKERS_ INTERNATIONAL -UNION- AMERICA- OrNoitrki,4mEtiek Robert Baron - yotirid'MENDS-CHRISTIAN- Buike- theory _Gilman Mamie =.10 Giilispie oF- Abrahani, 'NATIONAL COUNCIL: Larry Killer- Hoinier,'W. ;Bressler- ,Anthony,-,S..Luelielt "VETERANS: -OF= 'Frank McKee ;FOREIGN WARS--OF .Alek- T. ,`Powell; _Jr: - Larry THg UNItEDStkiES- Herman , Stissfuith Norman13:Joiies- -ZONTA--.IMEERNATIONAL Etigene Verdu Dr: -RiyineticFW. Murray _Jane Rollins -

. 180 4.-

INVITEll OBSERVERS NOte: Observers -Were -prictiiiied- to take full pan in the 'Conference except-for -official ,voting.

01. 'CONGRESSIONAL STAFF

Kathy Adana- Jay Cutler _ Elizabeth P.hottill Kenneth Schlosiberg David Affeldt Ken ,Daiiceiori William Laiighlin ::Paul,Skarbut Nattey Amidei ,LeRoy;Geoldrican- -Eugene Middelman, jcidah_C.-"Sommer William "Bechtel- Michael = Gordon Roy Millen:ion, Erlitine.,Stewart. Patricia C.artee-- James -X.:Gnirk James, Murphy Jacob N: -Wasserman Gerald ;Cassidi- -Val- Halarnandaris Mario Noto -Becijaniitt Yamigata Boren Chertkov Judy: With- John

.FEDERAL-REGIONAL ,COUNCIL REPRESENTATIVES

Aguirre -grin Doresius Bernard`, -Kelly _ Pierce A :Quinlan. 'John -A. Dyer, Astor- ICiik Rainaltec Rbbert-Bliida Rear Adsic: Benjancitt"-Er-mei-Kenneth ; Kugel:. Angel "Williastt T. -Bailey Norman Er1ie William B.*:LeWis Theodoie ,Ntiormarrflinton- arOlcr Bailin: _ Sheridan Lawrence W.-- Rogers _JaineSJ: Barry-_ -Ect: Foreinatt ,Sainuel'Maitiicei :Robeit C tRoienheiin, Theodore=N.:Mc1 swell - - -Richard Friedrn3n 6oriihU"SaCniiiiitaa- -Edit:gird:M. :Bator- ei! Robert E Ft lron- `John -MCGiiider; :Harry;F:::Shiricite: -Howard'D::McMaha_n George:I: = Smith' Goihini I.. :Black, -Jr. RulOn .Garfiel George S.Akttvling Green Margin- deriege J; vVavouiis Lowell: Briaion James -Griffith' Willian Verduin Ray B: Chambers Frank -J: Groschelle Oscar Pedeittin Rittiell-,ILWaesche -Robert-Co*, Hairs- - Clayton J. :Cottrell David-W. "Hifi Harold = Putnanc Etta -Lou Wilkinson

-SOCIAL AND-REHASILITATIOICSERVICE :REGIONAL- REPRESENTATIVES,- DEPARTMENT OF HEALT0,4iiIICATION,_ AND -WELFARE

Janes Burress - Robert L. ;Davis Clarence '14; Lanibright Virginia: M._ Smith Barb* C Coughlan Neil P.,,Xallori Simpson Francis L Warren -Gerald; W: Green' Ebner W. Smith

FOSTER GRANDPARENT PROGRAM DIRECTORS;,ACTION, tkECUTIVE OFFICE OF THE PRESIDENT

Jean Akin .. Joan_A: Dui.Can William/ .McCey Susan Rosen Clinton: Atterbury Elizabeth Finnigan Barry McLaughlin Gladyi 'RUOff- Phyllis Bandy Mich Fraiii Dale Medearis Joan_ Sena Faith Belleiny- James -Gee Dana Meilen' John Shaffer Ricliaid Bonnet, Wally Gursch Evelyn -B.=--Metritt J. Anthony Smith Charles _Bostwick Mari -Hale Betty S. Millie Samuel:Sosnoviick Joan Breland Julia Yociii&-HaWkins Georgie- 0:-Miller Robert_Swanson_ Martha J; Bienneinan_ Bette Hillhouse Rene Nalcaritt Charlotte Turner James Byrnes. Robert -Hodges Merle larding. Stan Vaiiiant Ruth ConrOvi: Kay 'Nov:tell E. W: -Ratkard- Viiginia Van-Pelt Mary C. -Crum Barbara P. Janes C. ,Howard Parks Carolyn: Whitlock Vim Dahlheimer Rita KatZinin- Joseph H. _Pierre Thomai Gilda IL De: Acosta Izella 'Kendrick BObbi- Roberti Janie Wiinberly Charles -J. Dearing James Lieder Nancy Robinson Henry -D. Woitman Edith Zayas De Capo Raine Mahaffey Charles G: Rogers Valiant Yates Lea 13: Dwain . Louada -Markusen

181 Yv

SENIORAIDES'pRojECT'DIRECTORS, _NATIONAL ObNCOLOV-.#Di!bit,OitIZEii;

Jean Campbell; 4La-Mar :Hirriion, dertrude!,-knuio Charles L. -Pray Elizabeth' Curley Wilma -Jackson. -Rev.:Nathaniel L_ iiiiie Shirley Davis Marguerite E Schivarzinan Walter Janes_ _C.; -MeLoild Simon W:.-Scott Jane Hardin JosephtB: Kerria.sey- Juditk Paulus- kobertfH. _Tennant Wilnier Wilion;_ Jr.

-Pearl Abramson- -.GloriaiS.;H:aerther Paltiel'=E Mitchell Ilene G .Siegier Jo -Ann _Al Rose_.Halrnan Mari-Moreira= john _IL Skinner Diane R. ,Beeson. :CYtithisi;-Haintiton- Mnore Leonard-.D. Cain, -Jr. Anita Harbert-. J. Emory` Smith= WilliIni4Pc-Hawkinson -, ;Nehrlie- Donald .Spence'. --Genevieve M._:Casey "Edward R::Heriderson" -Robert -Newcoiner JSpide-r= John- Cole& Syheseei GeOrgiiSPringer -Mary 'Waid,ttiai: Steven M. ;Horvath Termite Corrine:Nideggef- Beverly "V:-r,Stein- `Sandra' C: Ycilifide, C.-70Wens- - Patricia-L.:Steirier Tied IL -Hyatt' _Brit ;Pnwleit 'Sean :Merrill 4:".E.lisit Joyce, Anita Jarrett. -ManfrecIPeachIce- BeVerlee HO war& rV. Epstein Janice-:Sue Jones. Otin --Pollaik- Natalie P.' Trager .EdWaid=f2oiiera -Thin* Tyler Dwight Frankfather Keisdniet- Eileen. Lindy : Rabb =Wayne, Yasek, Sharon- -Kristine _k: Krenke. MaryReese_ _` -Gerald:.1» =Van-than -.CarorA.; -FUMY- Lloyd Kaufman Ronald- W2.- Geason _ Betty.-}L,RObeiti-- Reiseinar-YAL-Wide _ _ Anthony Karen - Rothenberg Marcella;. Weiner-- De. Douglai.Glis-gcnv Daniel-;Rubenstein Thelma S. Weiss ChirleiL:ZA. _GlesSing- James Joseph .Lirides. Robert Jam es ;Ruby Sterling H::Whitener :Megan Gordon' K. Weinei-Sdiiie Blundell Wiggins_ ` 'Annie B,,_Marrin Mark- Mary Opal-Wolanin Barbaraz=.,Grossinaii Williarii Grant: Mayfield= Friiicei; G. 'Stir* -ROsalie:.--S. Wolf Mildred Guberniaii Joan -xt..McMiirdci Shaw-

FOREIGNOBSERVERS

Belgisiin- Eric Pergiatix 44Y ) Scotland Di. Monique. Asiel Dr-. Michel Philibert M. B. -Sachs Professor F. M. Antonini Dr. R. -A. Robinson Brazil- Sweden Professor 'Allies GinsbergGhana Yelban Peter Bouitedt. Make _Apt Dr. S.- Kinoshita- Simi 0. HYderi Canada Mrs. Chiyo OmaChi LavirencerCrowford -Torizo 'Watanabe Switzerland Dr. David-Sherinsin Greece Dr. A. Braim Dr. A. -E:Da-vid"Sch John tirras Alexiiider Betiirdy Dr. J. W. Willard Malta Christina Codcburn Lola Wilson- Professor Salvino Busuttil Itsdia- Dr Arviel Pardo Denniarh S. D. Gokhole United-Nations P. N. Iyner 'Dr; Tarek M: Shuman Dr. O. Z. Daigaard Netherlands Iran Professor J. -M. A. MunnichsWelt Germany England- Dr. Barbara- Fulgroff Dr. Sheila Chown Dr. Ahmad Ashraf Dr. Mini Thoiriiie David Holiman Norway Israel Eva Beverfelt 'West Pakiitan France Simon Bergman Mazhar Huisain Dr. AntieMarie GuillemardHilde Kahn Dr. J. A. Huet Di. Charism Rappaport Poland Yugoslavia Dr. Paul Paillat Hannah Weihl Adatii Kurzynowski Dr. Nada Smolic-Krhovic

182 Appendix F-

Committees

NATIONAL ASSOCIATION _OP-STATE -UNITS-ON- AGING.'LIAISON COMMITTEE- ' Charleiii.Chiskei, Chairman- 'ibis 'GieensioOd, Carter C..- osterbitid Eliancir_"Mater Julian P.- FOx, -Jr. Ronald L Jensen -Robert 'a Robinson -Herb -Whitivorth.. _Maicelle-,... G.- Levy: -E. Scinaie:Rusiell

COMMITTEE TO ASSIST DISABLED DELEGATES

Ws. Eiiiiii:.N."-GriswOht-Chairman Mii. jtilian-Difinii- Mrs: tioniici,kMariiir Mrs., oSel:2 dSitterti,*1;ite, MM. Freidi:Aith.: .Mri.11iri-m.Fong, -Mrs:"--L--7Jaek Martin Miss -Mary-"--E-;Ssiiiier,*- MrsJohn:W....BYfites 1161M;;Divicl'Giinbieil_ Mii.-Richaid,MeLaren_ 'Mri:_Wiltei-E.:WisitingtOn. WS...Richard' W. tan Mis:Villiasii,T. Gannon" Mai.-- Thcimai: Meloyz. -Wt. Nfillany Willi: bfrif-T.-Ti-,Haines -Mrs:-Egiiiiigicin.:D.;Plikei -MM.:Frank Mis.-Shiiii,ICashinra-, "Mri."Williim:Rehitcluiit . Mrs'. Jan*: r.s.-c4Fir- :-Mrs: Williinf;E: MicOniber, WI:Elliot L. Richardion= ,, ,Mrs...-SidneiP::- Wilanil,.11::::Mrs. giiiiin_--;W.Romnek- *--"Deceased'

ADVISORY COMMITTEEPo. THE MULTI=MEPIA: PRESENTATION

DePirtnieisi..-of Health, Social'and White -House Admilistriseion-an-Akitig Education, ad Welfare RkiabilitatiOnS Conference-on Aging Office di- thi Sect'etary lohii Maitin _ John -O. Twiname Webster B. TOdd,_ jr. ,pcnotheit Rinsell'Eyeis Jatiiei _John Edwards: RusielFRaycroft Marvin .Taxes. -Ger-ontolo,0611,Soci'ety Tom -Joe: Robert_Wilson- Echiraid-Kaskiiiaritz-

AppenFlix G GoVerrunent AgenciesProviding Assistance: to the Conference Department of Agriculture DepartMent of COMmeree. CONFERENCE ON Department of Defense V) DepartMent of Health, Education, 0 and Welfare DepartMent of Housing and Urban Affairs U.S.POSTAGE8c Department of Lab& Department of Transportation The U. S. POstal- Serrikeon October 2, 197-1, Department of Treasury issued an -8 -cent Stamped envelope witha Veterans, Administration specially designed eMbOised stamp.to com- memorate the 1971 White Ildisie ConferenCe Office of. Economic Opportunity on Aging.

183 Appendix H Rules of Order Governing Section, Subsection and Special Concerns Sessions Meetings

The-hi:es of otder to govern=thexonduCt.-ofthe 8. The : Section poliCy- -CoOidinating Committee SeCtion and Subsection :SeSsionS., and-- Special- Con- may-edit and combine siinilat:-reCommendationS cerns .Sessions -'of' the 1971 White .1-Icnse Con;' Without -Making:-Substantive changes: la Cate- of ference,on Aging- aie :Set. fOtth Wow. These riles .a- direct -cOtOict in the retoMmendationS,OE the were adopied-_-brihe ,COnfetenCe Planning -Board different eachAvill be'presentedto the to assist, :-Conference ,leaders= "Condrictin,Orderly' Section. and- effectiVe Work sessions. 9; 14teientatiOri. of synthesized_ SiihSeCtioh, policy 040: of .order-. as :adOpted ,by- the -tOntetenCe, recommendations,. in the 'SectiOn, SO= Planning Board -. > -0*-0-ptoCedore and fotmal- liOnS iineeting, onWednesday-:.afternoon.- Action- aCtions' all sessions of the Conietence, and taken Jo*: on,,--recoinineridatiOns Originat= *here:,ti*sc-ClO not apply Roberts' '.rileSt.of 'Circlet Ing, in the Subsection o'cr:presentect,by the' SeCtif..4 or :Speci4i Concerns ,tepOtt along. 21.'SeCtioir and. Special= Concerns= SesSionS be debate,recommendation be cpieStiooed by responsible for- CrinfereriCe -freCOinineildatiOnS. NO lb- perCerie- of the Delegates. The exact .vote on voting will t*e__plate at:-gerieraL'ieSsions., -every issue Will-b&:recordect_tio-,SlibsianCe_Of the Minority point_ of view of at.-least 156 percent. of 3. The Chairman -of each Section -and `Subsection those "vOting-Must be"tecordea.and-reptoduted in and-of each Special' Concerns .SesSion_ willMk the Sedion Concerns report -along out of order any- prOpciial not n' specifically related With tbo -point of VieW,_of. the Majority. fA.;lesSet to -_the purpose of the-Confeiente oa-serrnahe may file its point of- iew_ with the 'Re= to -the subject- matter -before the_stOup. Corar'!i_ but- it will not ,be -,reportedto _the Confer- 4 SuhseCtioni will ,have- as the basle-tobjectfoi ence. discussion the synthesized_ policy recotnifienda- tioni submitted- by the States and N_ ational- Or- 10. Proxy votes -are not permissible in voting at ganizations, while the Section -will have as the any Section,-Subsection or Special Concerns Meet- 'basic subjeCt,for,*digaission the syntheSized ing. tecOitinienda6ns ,oi the StibkCtiOtis. 11. Pertons eligible to vote are the conference 5:- The official recorder ior -each-Settion or Sub, Delegates who are designated members of the section and Special Concerns SeisiOns: shall be a Conference Section or' Special Concerns Session Delegate. involved. 6.: Each discussant in being_ recognized by the 12. All voting shall- be by ,voice except in cases Chair shall give for_the record hisname and-the in whith the Chairman is in doubt or where a State or organization represented. Upon the standing vote is demanded. quest of any Delegate a discussant Maybe asked= either before or -at the conclusion of his remarks 13. The forthula for obtaining a vote on all to state the interest with which he is identified. recommendations will be the same for all Section; Subsection's and Special Concerns Sessions as fol- 7. A ,participant from_ the floor or any Section or lows:- Subsection will be-permitted to speak not more than three minutes on any one subject except by A. The recommendation will be read and its Unanimous consent. Where there is a matter of adoption moved. some controversy, the first speaker of either side B. Voting By Acclamation Will be allowed five minutes. 1. The Chair will say, "You have heard the

184 recommendation. Isthere- any Objettioti- - not will those _favorsay (Pause) If _not, -without objection (pause) -(A7i18) ''ThciSe opposed;. NAY." _(NAYS) the recommendationisapproved. utiani- (Count): If the-vote is clOse,enough-so.that **sly." it is estimated that -percent are-opposed= ease of Objection arid: a- request is. made for .Stibrnission,_:ofa 1: The Chair_ will ky, "You haVeheard Minority 'rePori,= the- Chairman; will ask -th6se stand and be counted: If 10 Tem* object opposed= to stand -and be counted: (Ride 9), debate 'Shall- be -,operied. D' In Debate _ Alter:the Chair ha.0 opened'--discussion- :a 4. ILan,arnendinent is offered,. it MUST be lunit will. be set for clebite..'T4e ChairMan: ,preSented;,to the .Chair- in written form_ be,

. Willrecognize ,alternately those favoring faire, any action -can:be taken_on it. and thok bpPositia,a _position.< The Chairman of :th&-ConfereriCe Planning these "have "polten- the Chair Will -BOard will review or ,adjUdiCate- any -proCedural: .4; "Has -anyone -anything NEW tiy.--add: questions during theTpetiod:9(44e,'Cotter-eti:ce, Appendix.- I Tides and Authors -of Background andIssues Papers'

EDUCATION RETIREMENT -ROLES-AND ACTIVITIES HoWiairt_ Y. McChisky, Professor Emeritus of EducatiOn, Gordon kF.Streib, Profeashi, Department of Sociology, Unisi,,eriity of Michigan Cornell _UniversiO EMPLOYMENT- SPIRITUAL WELL-BEING_ , Sobel, Prof ettor -andChairnian, Departmentof David -0:-/sioioerk, Profeitor and .Chairman, Department -of ECOnomics, Florida'State University SoCiologY and AnthrOpologY, Maitnette University RETIREMENT TRANSPORTATION janies ;H: Astotiate professor -of -Welfare Ito, Joseph -S.- Revis, Consulting Assticate, Institute of Public noniici, Heller School, Brandeis Universiiy- Administration PHYSICAL AND MENTAL. HEALTH: FACILITIES, :PROGRAMS, AND SERVICES Robert,Morrii, _Professor Of SOCial Planning; and Director, PHYSICAL HEALTH -Levinson GerOntologiCal_ Inititute, HellerSchool, Austin -B.Chirin, Former Chief, Gerontology -Branch, Brandeis UnWersity Division, of Chronic Diseases, Public Health Service GOVERNMENT- AND NONGOVERNMENT Edward, S. Colby, Evaluation Officer, CommunityHealth Service,Health -Services and Mental Health Adininistration,, ORGANIZATION Public Health Service W. Fred-Cottrell, -Professor of Government, and Director, SciiPps, Foundation for. Population Research, Miami Uni- Edith G. Robins, Coordinator for health of the Aging, versity, Ohio Community HealthService, Health ServiCes and Mental Health-Administration, Public Health 'Service PLANNING. MENTAL HEALTH Robert H. Binstock, Associate Protestor of Politics and AleXander 'Simon, M.D., Professorand Chairman, De- Soda! 'Welfare, Heller School; Brandeis University partment of Psychiatry, School of Medicine, Uniyeriityof California, Berkeley RESEARCH AND DEMONSTRATION George L. Maddox, Professor of Sociology and Medical HOUSING THE ELDERLY Sociology, Departmenti of Sociology and Psychiatry, Duke Universiti Ira 'S. Robbins, Hou'sing Consultant, Former ViceChair- men, New York City Housing Authority TRAINING INCOME James E. Birren, Professor of Psychology, and Director, Gerontology Center, University of Southern California Yung-Ping Chen,AssociateProfessor,, Departmentof Economics,-University of California, Los Angeles NUTRITION ' These papers are available for purchase from the E. Neige TOdhunter, Professor of Nutrition,Vanderbilt Superin- University tendentof Documents, U.S. Government Printing Office. Washington, D.C. 20402.

185 Appendix Outstanding Older Americans

Named by- theirrespective Slatesinresponse to an invitation -froth the White HouseConfeience on Aging.

Alabama: Mildred Hutto Massachusetts: Frank J. Manning Oregon: Helen _Manning Alaska: Dora Sweeney Michigan: HazerG. Robinson Pennsylluinia: Ellen.Connell Ari,iona: Winona Montgomery Minnesota: Puerto Rico: Juan Alethany Silva Caity Aykatisas: Maniie -Kayser Rhode island: John W.; Cornett TO:6SMcCharen -California :' Isabel Vail; Prank " :Missouri: CeCil-N.*Davis South Carolina: Hoinei*: Woods Malaria: Jefferson BoOne Aiken dOnneetleut: -EdWa'id''Peavy Catherine Caik:McCarty Sotitg 'Dakota:. iiiiseil`E..Jonas Affredk.,$ilands Asa:WOlfe Tenneisee:_, District of:Colitinbia:d?kulVeNi. N. Yirginia,Aikens, -Rudolph II:kanipnieiet Neu Hampshire;- -Elijabeth Florida:Eartha4M.M: White Alyin ArthurBurger DOnovaii-&Ithily WilsonW_ 'bah: thoinaS'Phillips deOgia: Benjamin ] :Mays -New Jersey: Arthur-A.=Wacker .Vermont: theresa'Brufigardt Minas: Howard H. 'Bede -New 'Mkrcelle G:-Levy Virginia: Belle R6one Beard Indiana: George-E. Da-Nis North Carolina: Ellen Winston Washington: Rudolph Kilaack kentutky: Albert Christen North Dakota: NelS Porsborg Wiseoniin: Marie: PloYd Scammon OhiO: TiedjCottrell- 'Margaret Hardy Noble Maryland: Mabel-Patterson Oklakoma: Lloyd C. Roach Wyoming: Robert Rhode Appendix K Senior Portrait Contest

THE WINNING PAINTING Leonard Herbert, 67, of Lihue, Kauai, Hawaii, for "Glory," 'oil. "Patriarch of the Mountain," oil, by Bernard C. Blonder, 73, of Mountain Home, Arkansas: Mr. Mrs. Vera Macbeth, 85,, of St. Thomas, Virgin Bro-nder'spainting,executedinyellows and Islands, for "John of St. Thomas," oil. browns, won the national White House Con- Jeff Madden, 70, of McKeesport, Pennsylvania, ference portrait contest and was reproduced on for "Overcoat Sam," oil. the cover of the Conference Program. Edmund Yaghjian,67,of Columbia, South Carolina, for "It's Brighter Today," polymer. TIONORXELE MENTION CONTEST JUDGES. Mrs. Esther Andresen, 74, of Fairmount, North Charles Parkhurst, Assistant Director, The Na- .;;;Dakot f: ;z113.!iThe Golden Years," charcoal. tional Gallery of Art. Mrs, Katharine A., Cawgill, 81, Silver Spring, Dr. Marvin'S. Sadik, Director, The National Mirilaild;'fer the Cobbler," oil Portrait Gallery. -.:Virgi1414eitech, 72, of Holgate, Ohio, for Dr. Joshua C. Taylor, Director, The National "Master Carver," oil. Collection of Fine Arts.

U.S. GOVERNMENT PRINTING OFFICE 1973 0-468-217 186 *it

?y. Bernard 'C: Broitder; - ofMountai Honie, Ark`arsas;:

the: Arkansas entry, and=itational'Winner_

For sale by the SuOrintencierit of Ockunierite,-0,S:doyeininent.Frintiag,01tre Washington, D.C. 20402 = Price46.76 per 2-V61414:set: -Stock Nuniber 1762:069-

Co-Directors of Technical Activities:Wm:" DoNAnuE, CLARKTuturn.s Director of Regional and State. Relations: RAY SCHWARTZ Director of National Organizations: DoRonty Niclx.cn) Director of Public Information and Public 'Wails: JotuI.:DwARDs Administrative Officer: FLoRENci.. Jork:F.s Director-of Logistics: JOHN' CHRISTMAN Special Assistant to the Chairman: JULIE ERICKSON Special Assistant .to the Executive Director: TINA 'FORRESTER

NA1 IONAL PLANNING BOARD

ARTHUR S. FiEldNiING, Chairman BERTHA S. AINC:,:s,BART. C. WARREN, NADEL. B. LINDSAY Vice Chairmen

TARY ADAMS JOHN W. EDELMAN ALFRED H. LAWTON SEBASTIAN RODRIGUEZ DAVID L. ALVARADO CARL EISDOR r ER MELINDA ANN LEE E. BONNY RI;sSEI.1. DECKER ANSTROM EDWARD K. (DUKE) MARcEw: G. LEVY WILLIAM L. RUTHERFORD ELOISE HARDISON BANKS ELLINGToN ELIZAIITH K. LINCOLN MARGARET C. ROBERT W. BARON FRANCES FAIRBANKS EDWARD J. LORENZ): SCHWEINIIACT MARGARET BARTOSEK *THOMAS E. FIELDER RUBY E. STUT LELLS *liEss T. SEALS ROSEMARY BAXTER RABBI LOG'S FINKELSTF.IN JOHN W. McCoNNE1.1. DAVID C. SINGLER MARIETTA RUMBF.RG BrNoF. *WILLIAM C. FITCII LACRA B. McCoy ELEANORF. JAMES S. BENNErr SLATER MYRTLE C. FONTENO WALT1:RC. MCKAIN VILLIAM E. SNuoos R011F.RT D. BLUE JULIAN P. Fox, JR. JOHN B. McPtIERsoN ARTII UR L. SPARKS FRANCES P. Boucot: DANNY FRANK *GEORGE MEANY MARY E. SWIT;.ER WA LTF:R L. BONI) S. Ross GREENWOOD *CARSON MEYER CIIARLF.q P. TAFT MM JORIF. T. BORCHARDr ALFRED M. GRunNTIIER DAVID MILLER ROBERT H. 'I'm:Et:cif: KATHLEEN MERRY A. WEBB HALE A. Lurtir.R MoLue.Ro BRADLEY L. TAN.I.oR BRODERICK *CFCII. M. HARDEN THOMAS C. MORRILL PETER E. TERZICK RICHARDI'.BUTRICK A. BAIRD HASTINGS ROGER F. MURRAY HERBERTR.CAIN, JR. J. FRANK TROY *ROBERTI HAVIGHURST NOMBRE NIESSON A. CARSTENSON MARY ELLEN TULLY Att.Ec HENRY *CHARLES H. CIIASKEs *BERNARD E. NAS II *BEHNARD S. VAN ADELAIDE C. HILL :.'1ARGUEIUTE STITT MELVIN N. NsAVVIST RENSSEI.AER TutoR HORANyi CHURCH JAMES C. 0.BRIEN *THOMAS G. WAITERS GRACE HOWARD Lucius DUB. CLAY CAR7::It C. OSTERBIND JESSE P. WARHERs *HOBERT C. JACKSON W. FRED COTTRELL FRF.I.L M. OWL DONALD M. WRTitts JOHN A. JACKSON *NEI.SON H. CRUIKSIIANK 01.1.11: A. RANDALL PAul. DUDLEY WHITE RONALD L. JF.NSEN CONSUELo CASTILLO DE GEORGE G. READER GEORGE: K. WYMAN BONZO CERNORIA D. JOHNSON PATRICIA ROBERTS CI.ARA 1.ANEZ Lour.I.LA C. DIRKsF.N VICTOR KASSF.I. ROBERT B. ROBINSON STEVE ZUMBACII

Executive Committee: The Chairman, the Vice Chairmen, and members whose Dames are marked withan asterisk () Toward A National Policy On Aging

Prvteedingi of:the- 1971 WHITE HOUSE CONFERENCEON AGING November 28Preneber 2 Washington, D.-C

Volume II Conference Findings and Recommendations from the Sections and Special Concerns Sessions

CONTENTS In Volume-II. Pegs Introduction PART 1--Seciion-iteconincendationS

-Edutition = 1 Employment- and Retirement 11

Phyikal and MentaLHe.alth. 19 Housing' 29 hitothe, 37 Nutrition 43 Retirement Roles,andActivities- -- 49 -Spikftualltfre11:Being 57 0.:;PlOr*klY 63 Fa0.40.0,).?-f08400,-* 0jee$ 71 ..... 79 -87 ROO' and De*Oatratielti._ 93 T_ ing- . , 97

PART 2=-.,SfieCialt.MiCern*SessionsAecOMEnentioriS

Health--.'4re Strategies - tong,Terin'taie,for Older-:People 7, 105 Mental 'Health :care .Stiategies- and Aging- .111 lioineniake-HO-Me Health Aide -seokos_ 115 pisaboty-404-Achabilitotioo- 44 and BlindneSs- - .123- -Phisice.1:4fia- VocationaLlehabilitation of Older People 129 Agicig, aac Deafness~ 135 .The_RUral: and--the- Poor- Elderly -Rival: Older-PeOple -- 145 The Nor Elderly 151 The _Elderly Among the Minorities The Asian American Elderly ...... 159 The Spanish Speaking Elderly 165 The Aging-and Aged Blacks 17 The Elderly Indian 197 Protective and Social Support ' The Older Family 205 The Religious Community and the Aging 219 Tile Elderly Consumer .225 Legal Aid and the Urban Aged 233 Roles for Old and Young Volunteer Roles for Older People .239 Youth and Age 243

iii t.

1:4. 1.444'144A s X* AN, INTRODUCTION

-41 he White House Conferenceon Aging was organized into 14 subject-matter Sections -Technical COM- mitteei were appointedIfor each byAke Secretary of Health, -Education,: and Welfare, 'Elliot Richardson, who charged, theni with the responsibility for planning the work of their respeCtiveSeCtiOns. With -the- assistance- of:a:Secretariat; ;Madeup of lepresenta,

tives of appropriate Government agencies,the Technical = Committees identified What they believed to be the -Major' issues requiring ret_olUtion,iti:orderth., ithieVei-lOrwardloOk- :ins, consistent national policy in aging andto bring about immediate .aCtion27Theie;itsues were COnsiderti,sinOdified;iand -added- to by local and ',State- White= 1-itaise.-:-.Conferences ---and IstatiOnabOrganliatiOn'`Tatit,POrees2. '_From *these-, deliberations there. emerged the core .subject matter :Whick-waa:Considered:hy the Delegates to the various Sections of the National CAM- ference.. The Conference Sections- each --mettwice .during the Con-- ference, but most of the workwas done.by the Delegates working in small-aubiection,,groUnings of fropi, 35:to persons . Thus, every Delegate had opportunity to participate in the 2 days of subsection and to take_ an active part in the formulation of recommendations to be actedupon by the:full Section.. The recoininehdations-(triajority-and Minority). approved- by the -SithseetiOnt were prepared for transmittal to the Section Drafting Committee by the -Subsection :Chairman, ViCe;-Chair- man, and Recorder._ The _Section Drafting Committee, which included the Section Co-Chairman and Recorders and the Subsection _Recorders, collated the recommendations _from- the Subsections for the review of the Policy Coordinating 'Coin= mittees. These Committees, each of which consisted- of all Section and Subsection Officers, determined the statethent of the majority and' minority recommendationsto be presented for action at the -final meeting ofthe Sections. Those recom- inendations that -received support Of the majority of .the Dele- gates attending the meeting,-together with approved minority recommendations, became the officiaLaction report of .the Section. The separate reports of the 14 subject-matter Sections,are presented in Volume 1 of the Conference Proceedings: The recommendations reported are those thatwere adopted at the final Section plenary meeting. They included majority

.v recommendations, those Supported bymore than -half Of the voting Delegates; and minority recommendations, those Sup- ported--by- from 15 t6'.50-Percent-oftheSectiOn.Delegates. Eadi of the 'following_ &Won- reportSii preceded,bya brief introductory profile of conferencegroup that -develOped the recommendations. -Theieintroductory statementsare presented to *Vide the reader with additional information relevant -. to a better understanding of the -policy :kecommenda- tiptis.

In response to the request: of a.number of national organizations, the program 197.1 =White House Conference on Agibg**eipabdecrio include 17 =Solos ontopics of 43_001- coriceitlii-thoie organizations The purpose of these -Special Concerns Sesions was to provide for indeptiir.dit---CuSiiOn, of specific aspects aging or of the circumstances of particular giblipi--bilhe Older tpopulation : The Sessions, lifcestheiiibject, inatteil.$ections;were committed to developing and ,reconi- mending _policies .thar. could lead46, immediate -action for iniproVing- thequality of fife Of Older people. These Special Concerni'S*HOns were organizedby planning committees made up of .representatives -frOin-',-tfiose national organizations requesting, the-.SeiSion-- and frOm related groups. Each of the planning cointhitteesNai4isistett:14 representatives from appropriate Federal agencies The:Cominitties,-had; _ responsibility for determining the content of the-program of theSessions and foridentifying, andinvitingprOgram participants, The 17 Special CotiiernsSeisions Were-held siinultanionily from 8:00rAlif. until 12:00 -NOon oir-Wednesday, 'December 1. Each Delegate chose Which, if any; Session he wishedto attend. The recommendations from the Sessionsare -presented in Volume 11Part 2 Of the Conference Proceedings. The 'Spec' Jai Concerns Session?. recommendations tendto less policy focused thin the Section prOposals. They givemore attention to programs and services_ heeded to alleiriate-thevery difficult circumstances many older people face today. Session reports that foals ona general concern have been grouped together to allow, the reader to reviewmore easily those Subjects that are significantly interrelated. Inmany instances the reader will also want to read the recommendations made by-Sections (Volume IIPart 1) whichare related to the general topic under which the Session reportsare assembled.

vi SECTION ON EDUCATION

receive special attention; what -types of INTRODUCTION -serviCesi-Shouid'be deVelOped; -What are-iorrie,Ways wo hundred sixty -nine Delegates of effectively providing these-, services.. it -iS:shOpecl to the 1071 *White HouseConference that,theie,ieCothruenCiation.§-Wili:provide. direction" Aging were named to die '410= for _Substantially iniproVing:the-quality;,_prodik- don:Section: -Thete nelegatei included tivity; and dignity Of the Lives of older people. .administrators andinstructors- in elementary, secondary; and higher education, College- andl university students, doctori, lawyers, -religiouslead- SECTION REPORT ers, soda' -Workers, _public offiCials;labor leaders, The initial "Section - plenary meeting was called and prOfessiOnals in the field of aging. to Order by Walter G.Davis, Director of the Department Of EduCation of the AFL -CIO; who This veep of Delegates was. uniquely quali- Served as presiding co- chairman. After introduc- fied to develop -policy recommendations in -educa- ing himself and the other Sectionleaders, Mr. tion for Older, people. The belegatei in the Edu- Davis called- on co-Chairman- Howard Y. Mc- cation Section included: (1.) substantial represen- Clusky, Professor Emeritus, University of Mich- tation of older people themselves (approximately igan, toprovide the DelegateS with additional 32A percent were retired persons); (2) represen- background for the 2.. days of discussion that tation Of the major ethnic minority groups Were to follow. (American Indian; 'Afro- American,Man Airier- In his address, Di. McClusky' , the author of the ican, and- Spanish American); (3) representation of professionals in the fields of education and Background and 'blues Paper on Education and aging, (4) representation from each Of the 50 Aging, establiihed the gravity and scope of the States, Puerto Rieb, the Virgin Islands, Guam, need for education for aging. He mentioned, recent developments in the structure of theAMer- and the Pacific Islands. ican education system "which show substantial The thinking and desires of the State and promise of superior achievement is education for local White House Conferences on Aging and the aging." earlier Older Americans Forums formed the basis for the recommendationsproduce_d by this able Co-Chairman's Statement and experienced group, The dominant theme of much of the discussion The Education Section produced 23 recom- about, older persons is essentially pessimistic in mendations which speak to several issues includ- character. We do not have to wander very far ing: what basis should be used in allocating fi- to discover why thisis so. In the first place, nancial and manpower resources for education older persons are confronted with threats to their and aging; what populations among the aged health that frequently occur with advancing years.

4. In the second plaCe, the great majority of older advantage of the opportunitiet which change persons are subject to substantial reductions in product* education must now be thought of as income without an 'equalizing decrease in their being. as continuous _as- change itself and must continuing need for financial resources. In the also be programmed solhat all persons, regardless third place; retirement usually leads to a decline of age, inaylake.part in learning throughout the in poSition with --a collateral -reduction in status .length of their years: and influence affecting not only the retiree,_ but also many of those to whom he is Significantly The implications of this new outlook for edu- related. cation as a- whole can scarcely be exaggerated. hit In other wards, great numbers of older persons implications for the education of olderpersons are covertly,- if-not overtly, engage:a -In a running is especially far-reaching, and urgent. For' in the battle :for survival; with their attention given case of. the' Older, person, -change has- a double- and primarily to devising strategics for recovering uniquely -aggravating dimension. -First there is from actual lostes, or strategies designed to -cir- -the change, in -the- enviiraning society. But -Second, cumvent anticipated.. losses or It is not itur there_ are changes hr.the,life situation-of the per, -priting,:theiefore,- toclittOVer- that Much of the son -4-'he_grtrars older .HenCe,.for_perSOUS in the discussiOn :about .older personsover .the: media, later years; change :gives rise -ra.a "doubles -jeopardy" That is, the -4anges- in the .society= in conferences, and .the', lay and professional literature it :more likely : -to -deal with_ the rounding the individUal COmpoUnd; the readjuSt- rather than -the opportunities 'Ofpersons_'in the Mend indUCed: bytheage-related-changes later years. Occurring Within the-.individual: -Tlids, if. editCa.; don isTto -be-relevant for the unique situation of- But wheditve turn to education we find amore the Older person and, moreover, if it is- -to -be optimistic domain. Inz fact, education is itself es- effective, it must without compromise deal -with sentially an affirmative enterprise. --For instance, the multiple-impact-of- change inherent in the life education -tole older persons is based on the- as= stage -whichOlder people occupy. -Such an en- sumption that it will lead to somethirg better counter -should- generate- an ,edtitational program in the liveS_ of those participating. it -also -pro- Markedly different from -that associated with the ceeds on the Collateral assumption that older "Credential syttetn" of fornial education. persons are capable of a constructive response_ to educational atiin-ulation.Thus,_ because" ofits But, however _inappropriate the standard in- faith in the learning ability of older_ persons and, struction of the elementary and secondary schools because ofits confidence in the improVement that inight_be for persons-in-their later years, the 'fact results from-learning, education, in contrast with remains that ,older persons were once young and other areas_ in the field ofaging, can be -invested_ that the-schooling they received in their childhOod with a climate of optimism which is highly attrac- and, youth-constitutes -a basic foundation for what- tive to those_Who may be involved in its operation. ever learning they may pursue is adults. What From an educational viewpoint the impressive then do the results of research show about the and distinguishing feature of Our times is the fact amount of schooling which the present genera- that we are living in a "learning society." Within tion of older persont have received in their earlier recent decades, and at an ever increasing rate, we years? have been arriving at a stage where learning has become an essential condition for participating The evidence indicates.that the level of formal and advancing in the world about us and equally schooling attained by older persons is far below mandatory for personal development. This new the national average for all portions of the popu- condition is largely the result of profound and lation. One-fifth of persons over 65 are regarded accelerating change. In fact, change is now trans- as functionally illiterate; only one-third of those forming all aspects of living for all people of all over 65 haVe continued beyond the eighth grade. ages. This process has become so pervasive that in In any random sample of the population, the in order to cope with the dislocations, and take oldest are the most poorly educated.

2 The Situation becomes even more serious when hypothesis that, in general, older persons do not we examine, The probable quality and relevance perceive education as having any relevance for of the instruction they received. For example, their interests and needs. This point was re- since they went to school from-60 to 80 or more peatedly, confirmed in theco_mMunity discussion years ago, it is ,plausible to expect, that teachers groups- held, throughout the country in prepara- then were less qualified than they are today, that tionifor- the White House Conference meeting in instruCtional" materials and facilities were leis-ade- .Washington, D.C., during the period November quate than they are today, and that the subject 28 to- Decenibei 2. AssriMing this to be a valid matter they studied would today_ be _regaided as assessment, what does it mean for the education clearly,out -OE ,dite. of older persons? The implications of this deficit might be eased In attempting -to answer this _question, we if older persons compensate- fortheir lack of should be reminded that older .persons apparently schooling -'by taking part in activities designed- regard education -as sornething separate and diifer- specifically ,for :their instruction. -But,. here again, ent.froin,the progranis.ot other serVice.areas-with the data ;give-Ali little cause foe-celebration. For which .they, are more familiar. There are health instance, reseirCh_ indicates that ,persoris, over. 50 Set-vices,- finanCia 1 servi ces, legal- setV ices, housing ire-underrepresented in adUlt_eduCational.activitiei services, etc., and more or less as a..postsCript,_ And that the degree ,of: underiepresentatiOn 'there are echicatiOnalservices; MOrtover,., the creases, with the adVance.iri,years: Thisis especially _educationall,inaiie=_o( older ,persont based= on true for - adult :batic education: where- the -need- of the.,Memory of the -sChOolitig_.they-- received- in older persons is greatest. childhOod: and youth-,---in iniage.that-,beitS little But is this-low level of schooling-and partici- resemblance to the -urgentiei of the situation in pation paralleled with an equally low leVet of which theY currently find theMselves. It is not mental ability? Is it possible that in this deficit stirpriSing thattheir' typicalresponseto -any of educational. achievement we also hav a deficit queries about education= is often "Why do. I. in the ability to achieve? The answer is. an em- any inOre-education? *hat.can it do for me? It is phatic NO! ReSearch presents. no eviderice that too late _for that," etc. after a person enters his years of adulthood age, Such an attitude obviously -imposes severe limi- per se, iS a barrier, ,to learning. On the contrary, tations on the-potential of-older- pettons to cope in many cases age may be an advantage in learn- effectively -with their survival needs, as well as ing. Thris, we are on solid empirical grounds in _their ability to- increase the significance of their saying that we can teach an old dog new tricks;. continuing development. Instead of thinking of in fact, there are probably some tricks an old dog education. as a_thing apart or as a decorative op- can better tion, it should be regarded' as a principal com- The picture suggested so far by our discussion ponent of all the) services de-Signed to meet the is a mixed one and not as optitnistic as our intro- necessities of living. ductory comments might lead us to expect. On the one hand, we find older persons gravely de More specifically: echwationsshould play an im- ficient in formal schooling and participating little portant role in di? prcichiaion, maintenance and in adult educational activities. On the other hand, protection of health and income. It should also we find older persons fully capable of learning, be a basic element in solving, problems of housing, in a world of dramatic change when learning is the use of legal services, in the adjustment to so important and when the rewards of learning change of relationships in the family, community are potentially great. How can we more nearly organizations, etc. In short, education should be Match their need to learn with a better perform- regarded as a program category to which all other ance in learning? aspects of living in the later years should be related. In this sense, it would become an "um- The answer tothis question probablylies brella" for working in and comprehending the somewhete in the realm of motivation. It is our field of aging as a whole.

3 But the full scope of the field is even more for-older persons gives society a reason lot_looking comprehensive than that suggested by our 'anal- at the complete life-spati as a-whole. Technically ogy ofshe "umbrella." In a more fundamental at;d speaking; aging-begins with-the-beginning of life; generic sense, education foraging -shotild:be rtle- while this fact -may appear to_ be a. far cry from vant lot persons of all ages and not merely for the problems -exacerbated by the survival- needs those in the -later years. of older persons, it reminds us that _any point in one's- total -life line has a significance which .In- order- to clarify this point, let us first look is a product of -both its past and future. In at persons in the mainstream of productive adUlt- other words, a pertoir has a-, relation to- the time hood. In at least two respects they have an im- dimension of his- life with hich he must come portant stake in education for aging. They need to terms if he -is to f_ulfill the promise of his instruction 'abodt-- the :problems and- opportunities potential. of liVing in the period :beginning- with-age .65; first,.: because they *ill- need .tO provide :the favor- At this point, -the biological view of the life able -Climate 'of, support, aecepumee- and...under- span as - a - rise -for grotOth; a- iplateau for mainte- standing ityWhicprograins for_oldetTersonsmay nance, anddecline -for regression gives- us only develop; and 4second, because they will :need- to -part of:the picture. kit propoied-here that a-more begin- to think Construe:direly ,about retirement complete- pieture maY-' -detivect:froin sonie- of for themselves; preferably as erlyas age- 45 and -the developmental -.dieories- of personality. To il- at least 'by -age:,55. let. look =, at._ the '4econd =of -luttrate,. let us- -look at Edition's theory of the the two preceding points in greater_ (wed-. matuking- The- basis for inaking a case for ptetetiretnent -To summarize his potition, he pOstulates that education is a sound -one. An early -introduction there. are -eight developmental stagei from the to the decisions- that an- adult will be compelled beginning' to the-end of life. In-infancy we begin to make as he or she makes the -transition -from a with -the-achieveinent of --trust;- in early childhood working to:a nonworking Style of life will:enable we -.tontinde with the achievement, successively, the -individual to anticipate the hazards and the Of autonomy- and initiative. In .middle childhood oppoitunities of the later years. By so- doing, he we accidite-the skills of industry-and work; andin willbe'able to- regulate his performance in ad- adOleseente asente of:identity. Building -on -these vance, so that when _the hazards appear they will five stages of childhood' and youth, the first task be defused and the opportunities exploited. of .the -adult is to develop -a-'sense -of intimacy; In a youth-oriented society, the problem of next, he mustinoVe into-the stage-of generativity; and finally, as-a admination to life-long develop- persdading a middle-aged person to admk that ment, he- must achieve a softie of ego integritY. someday he, too; will be an older -person and In other words, the Erikson forthulation.proposes should therefore take some rational measures in a stage -by -stage progression toward fulfillment in anticipation thereof, often gives rise to diffictiltieS of motivation which are extremely frustrating. maturity.1 But the need for developing procedures for re- There are risks in presenting such a compre- solving these difficultiesis an additional and hensive theory-in such an abbreviated form. But compelling argument for the relevance of thinking We-have done so in order to support the view that of education for aging, as applying not only to more than the current biological-and psychometric those in the years' 65 and _beiOnd, but also those picture of -the-life spin is necessary in order to who are not yet "older", but are irreversibly on formulate a fundamental and comprehensive pro- their way to becoming so. gram of education for life-long fulfillment. In an optimal and operational sense, the last stages of There is yet another respect in which education for aging is more than education for older persons. This is perhaps the. most comprehensive of I Elkind, David, "Erilcson's Eight Stages of Man," New York Tinsel Magazine, January 1970; and Erikson, E. H., Child- the categories we have proposed. We refer to hood and Society, Revised Edition, New York, W. W. Norton education for life-long development. Education and Company.

4 life should be a guide for education in all the and television broadcasting witha sharp lookout sequences and at all the stages leading thereto. To for cable television that is just emerging. qualify as a complete and fundamental view,we must then regard education for' older persons as In the case of all these agencies, education for designed not only to help them cope with the aging should appear as an explicit and separate requirements for survival, but also by usingex- commitment, in both statements of purpose and as pressive, contributive and influential activities to a line item in budgets. It should not be allowed assist them in achieving their potential. In short, to become buried in the amorphous terrain of we are proposing that it takes a lifetime to develop general funds, or lost in general expressions. of a complete self. Education should aid in 'this pious intent. This point is particularly relevant process. at the Federal. level. Nowhere does the Federal Government take specific and primary responsi- As a postscript to the above discussion, let bility for leadership in the field of education for us i return to our initial theme of education AS. an agingneither in the Administration on Aging "accent-on the positive." At this pointwe' neecha nor in the OfEce of Education:This deficit is a remind ourselves that edneation for Older_persons scandal and should be liquidated= in the immediate will realistically,- and for the foreseeable future, future. constitute the Principal -part Of education for .aging and that, for immediate and: operational Btit, to coinplete this section-on a more positive note, We should,_report two developments_ which purposes,- the bulk of education- for =Older perions show substantial-promise of superior achievement will be devoted'th helping them cope with threats in education for aging. One of thesemay be ob- to their-survival and autonomy as Well as insults served in the phenomenal-growth of the to their-integrity: But for more fundamental and community college. The bails for -this optimism is ultimate purposes, society's stake in the education 'contained in the fact that the new breed of of older persons is that of helping them become community Colleges is, by franchise and by budget a more effective resource for the improvement and allocations, designed to make community services enrichment of society itself. and adult education a principal part of its overall In the context of this'view, education for older program and to make these activities coordinate persons is an investment by society in resource in status_ith that of the more traditional transfer development. It is based on 'the assumption that programs of credit instruction. Already there is older persons hive experiente and specialassets evidence that community colleges are beginning which the society needs for the cultivation -of its to take seriously their responsibility for providing health and well,being. Society still lags gravely educational services for elder persons. At this in recognizing the validity of this view. -Its full stage only a beginning has been made, but the acceptance and implementation with understand- potential of the community college to serve the ing is one of the major tasks of education. elderly is there and could soon be realized. Where will we find the agencies to develop the Another promising development is the wide- programs envisaged in the preceding discussion? spread development of the community school. Stimulated to a large extent by the example of the All- agencies with education asa part-time or public schools of Flint, Michigan, and inpart full-time objective should be regardedas poten- encouraged by subsidies from the Mott Founda- tial contributors to education for aging. In the tion, the Flint type community school is being informal domain, we would include organizations adopted as a part of the regular schoolsystem in of older persons, churches, synagogues,, labor all parts of the country. The essence of thecom- unions, farm and business organizations, civic munity school idea is that of service to .all people associations, libraries, museums, communitycen- of all ages in terms of their needs and preferences, ters, etc. In the formal domain, we would include often as a,result of their participation inprogram private and public schools from the kindergarten development. Apparently the community school through host-graduate and professional education. is more responsive to the educational needs of Above all, we would welcome the realm of'radio older persons than the traditional K-12 institu-

5 tion. It is quite possible that the community sc.htial non-English speaking elderly pertaining either alone, or_ in combination with toin- the commun- structions relating to the requirements of ity 'college, will beeome the Federal, most feasible, re- State, and local government agencies,i.e., gaining sponsive and certainly themost universal vehicle for providing educational citizenship, applying forSocial Security, housing, servicesfor older applications, etc. persons. In conclusion, education foraging should have RECOMMENDATION III. a* much highei priority in. :thepiograms of the Access to Educational Opportunities educational enterprise than it now has. It should Education for older persons should be an instrument for helping-deliverthe services be conducted set up to meet the survival needs of older either apart froinor integrated with other groups persons. according to theirspecific needs and choices. It should also upgrade the talentsof:older persons as a resource in nurturing the *ell-being of Where- feasible -and desirable, the agedmust be granted' the opportunityto take advantage of society. It should aid in the progressiveattainment i)yindividuals of life-long, existing programa withboth oldand young- fulfillment and, inso learning from -each ..other. HoWever, doing, constitutea principal pan of the education e alternatives- of petsons at all ages. must- be litovided- Which emphasize- the felt- needs- of the.aged ;at -their particularstage. inthe life The opportunities for thedevelopment of at- cycle. tractive and highly_ functionalprograms of education for agingare unlitnited. The exploitation of RECOMMENDATION IV these opportunities will requirenew resoutces, Expansion of Adult EducationalPrograms commitment, and creative leadership. The expansiorrof adult educationalprograms having a demonstrated record_ of_success shouldre- Recortsmendations ceive higher_ priority with due consideration-being Education is a basic right of allpersons of all given to experimental andinnovative programs. age groups. It is continuous and henceforthone of the ways of enabling olderpeople to have a RECOMMENDATION V full and meaningful life, andas a means of help- Educational Opportunities ing them develop their potentialas a resource for for all Older Persons the betterment of society. Educational opportunitiesmust be afforded all RECOMMENDATION I persons, with special efforts madeto reach those Involvevsent of Special Populations who because of low income,poor health, social in Program Planning' circumstances, or ethnicstatus- are less likely to respond voluntarily. Outreachprograms should All issues and "recommendations which will affect use all appropriate channels and deliverysystems. or serve linguistically/culturally different populations must enlist thenecessary linguistically/cul- RECOMMENDATION VI turally different qualified expertisein the develop- Eliminating Barriers ment processes of such proposals,so as to insure to Educational Services that all programs designed forthe elderly will result in maximum utilizationand participation For older personsto participate in educational of the constituents in question. programs, agencies, organizations, andgovern- ment must provide incentives. Theseincentives RECOMMENDATION II should be aimed at eliminatingspecific barriers to Education of Non-English SpeakingElderly the availability and accessibilityof educational services for olderpersons including transporta- Particularly urgent are Federal,State, and local tion, free attendance, subsistence, funds for bilingual/biculturaleducation to the auditing privileges, relaxed admissionrequirements,flexible- 6 hours, convenient locations, subsidiesto sponsors, tinuing, vocational education and training about and removal of legal barriers. needs for better use of services, culturalenrich- ment, and more successful adjustment to aging. RECOMMENDATION VII Public Libraries RECOMMENDATION XII Public Support for -Educatton A Gum:unity Learning Resource Public libraries serve to support the cultural, in- Public expenditures for education of olderper- formational and recreational aspirations of all sons must be increased and directly related to the residenti at many community levels. Since older proportion of older persons within the population. adults are increasingly advocating and participat- These expenditures should relate to the needs ingjn lifetime education, we recommend -that the articulated by all segments of the population of public library, because of its nearby neighborhood older persons, including rural and ethnic minorities, or by the organizations that character, be strengthened and usedas a primary represent older persons. community resource. Adequate and specific funding' for this purpose must be:forthcoming from all levels of government and,most important, from RECOMMENDATION XIII private philanthropy. Need its a-Basis for Funding AvAable facilities, manpower and fundsmust be RECOMMENDATION VIII used for educational programs- designed and of- Library Services fered on the basis 'of the assessed needs and in- We recommend further that the Library Services terests of older persons. The initiative may be and Construction Act be amended to includean taken by many sources, but the design andcur- additional title to provide library services for older riculum must include active participation byolder persons. persons. RECOMMENDATION IX RECOMMENDATION XIV Use of Leisure Funding Priority for Educational Programs Emphasis should be given at every level of edu- The Federal Government must consider the con- cation to implement and expand the expressed cerns of educational programs of older persons in educational objective of "worthy use of leisure." a greater equity of allotment and on a higher Education must be directed toward an acceptance priority basis when allocating funds for educa- of the dignity and worth of non-work pursuitsas tional programs. well as development of leisure skills and apprecia- tions. RECOMMENDATION XV Elimination of Matching Funds RECOMMENDATION X Allocation of Money and Manpower Where matching funds are required for Federal education programs aimed to assist older persons, Money and manpower for educational opportuni- it is recommended that the lifelong contributions ties must have high priority thrOughout all serv- toward building this country by the now elderly ices offered to order persons by any approved be considered as suitable compensation in lieu public or private agency, or organization, in order of "matching funds. " to assure continued, meaningful living. RECOMMENDATION XVI RECOMMENDATION XI Education for Political Action Scope of Educational Opportunities Education should place emphasis on instruction Educational opportunities must include'basic, con- to help the older persons understand issues, pro-

7 cedures and action in regard to political processes ration of those who will and are workir.g with to enable them to meet more effectively and older persons (law, medicine, social wcsk, home quickly their special needs as individuals oras a economics, recreation, education, etc.). More at- group. tention must also be given to workshops, institutes, and inservice 'education for those who now RECOMIVIENI5ATION XVII work with older adults. Materials; Method.; and Curricula RECOMMENDATION XXII Appropriate materials and methods about all aspects of aging must be developed and intro- Government Organization for Aging duced in the curricula at all levels of education T..) implement the educational policies growing from preschool thiough higher education. out of the 1971 White House Conference on Aging, the Administration on Agingmust be RECOMMENDATION XVIII accorded status and financing appropriateto the Tonard a National Understanding of Aging task and man be 'madean independent agency within the Department of Health, Education, and A national awareness campaign must be initiated 'Welfare as provided for in the Older. Americans through mass media and through educational Act of 1965. systemsto promote better understanding by society of the nature of the aging process, the RECOMMENDATION XXIII needs and interests of older people, and the -positive contributions and potentially untapped re- Division of Education for Aging sources of older persons. in tlx Office of Education Primary responsibility for the initiation,support RECOMMENDATION XIX and conduct of education programs for olderper- Use of Educational Resources sons must be vested in the existing educational system, Federal, State and local with the active All educational resources must be pressed into participationandcooperation service for the needed leadership in the prepara- ofspecialized tion and implementation of: agencies. A Division of Education for Aging (a)leadership should be established in the Office of Education training, (b) teacher training, (c) curricula, and immediately, to initiate supportive educational (d) needs of the older persons in America. services for the aging. Similarly, all State Depart- RECOMMENDATION XX inents of Education should designate full-time responsibility to key staff for the development and Preretirement Education implementation of programs in education for Preretirement education programs must be estab- aging. lished to help those approaching retirement age to achieve greater satisfaction and fulfillment in SECTION LEADERSHIP later years. Preretirement education must be the Spas will permit listireg of tide awl n1- primary responsibility of the public education dress only the Jinn time a some appears- sector in cooperation with relevant community The Technical Committee organizations in the areas of industry, labor, all for Education levelsof goveniment, voluntary service and Chairman private associations. John W. McConnell, President Emeritus, University of New Hampshire, Trumansbtug, New York RECOMMENDATION XXI Consultants Inservia Education for Professionals Hyman Hirsh, Director, Institute for Retired Professionals, New School for Social Research, New York, NewYork We urge that institutions of higher learning pro, Woodrow W. Hunter, Research Associate. Institute ofGeron tology, University of Michigan-Wayne State University,Ann vide opportunities for special profesSional prepa- Arbor, Michigan

8 tr,

Members Vice Chairman Glen Burch, Director of Extension Services, University of Myra L. Herrick, Regional Representative, National Retired a California at Davis, Davis, California Teachers Association, Reading, Massachusetts Lovelyn J. Evans, Former Employee Counselor, Chicago, Illi- Recorder nois Rhea M. Eckel, President Emeritus, Cazenovia College, Syn. Leonard Gernant, Director of Academic Servicvs, Western ruse, New York Michigan University, Kalamazoo, Michigan Bernhard G. Gustafson, Coordinator for Research and De- Subsection 2 velopment, Division of Continuing Education, University of North Dakota, Grand Forks, North Dakota Chairman EdWard M. McGehee Cyril 0. Houle, Professor of Education, The University of go. Chicago, Illinois vice Chairman mice Elaine Jenkins, President, Oni-Ametica, Washington, W. Dean Mason, Executive Administrator, Kennedy Memorial D. C ..istiuism Home, Maninsville, Indiana t Ev,lyn Greenman, Director, Brookline MultiService Senior Recorder Ce,,ter, Brookline, Massachusetts A. L, Johnson, President, Prentiss Institute, Prentiss, Islis6s- Philip J. Kelly, Chairman, Committee on Aging and Retire- F'Ppi mont, Sales F'S* r-stive Club of New York, Hendersonville, North Carolina Ei:biection 3 Sister Mary Wake, OSE, Director., Health Services for the Chairman Aging, The Catholic Hospital Assocsation, St. Louis, Missouri Janet-R. MacLean, Professor,Department of Recreation and Druzella G.Lide,-Former Family Editor, Honolulu Ativet Park Administration, UniversityofIndians, Bloomington, riser, Horrolulu,_Hawaii Indiana- Edward M. McGelsee, Director, Retirement Studies, Indus- Vice Ch_ airman trialRelations -Center, The University of Chicago, Chicago, Robert J. Burns, Professor, Department of Psychology, Uni. Illinois versity of Toledo, Toledo, Ohio Katsuma Mukaeda, Attorney, Los Angeles, California Weiorder Lawirence 0. Carlson, Associate Dean, The Institute of Life. time Learning. National Retired Teachers AssociationA-Medan The Secretariat Association of Retired Persons, Washington, D. C Director Subsection 4 Frank M. Stewart, Technical Staff Assistant, White House Conference on Aging, Washington, D. C. Chairman Maurice Braginsky, Administration on Aging Gerontology Earle T. Hawkins, insiders* Emeritus, Towson State College, Trainee. University of Arizona, Tucson, Arizona Towson, Maryland Vice Chairman, Section Officers Marcell:us Ivory, Executive Board Member, United Auto CoChairinen Workers, Detroit, Michigan Walter G. Davis, Director, Departmint of Education, AFL- Recorder CIO, Washington, D. C. Sister Mary Laurie. Howard Y. McClusky, Professor Emeritus, Educational Psy. chology and Adult Education, University of Michigan, Ann Subsection S Arbor. Michigan Chairman Consultants Earl Kauffman, Director, Council on University of Woodrow W. Hunter and Hyman Hirsh Kentucky, Lexington, .Kentucky Recorder Vice Chairman Alice Eliine Jenkins Mrs. Marion Marshall, Specialist in Gerontology Los Angeles Unified School District, Los Angeles, California Assistant Recorder Chisato Kawabori, Associate Regional Commissioner for Recorder Aging, Social and Rehabilitation Service, U.S. Department Eileen laNiedertneier, Program Chairman, Center for Wom- of Health, Education, and Welfare, Seattle, Washington en's and Family Living Education, University of Wisconsin Management Offices Subsection 6 Frank M. Stewart Chairman Subsection Officers Adelaide C. Hill, Director, Afro-Amerian Studies Center, Boston University, Boston, Massachusetts Subsection I Vice Chairman Chairman Rudy S. Conche, Deputy to the Superintendent for Curricu- lum, School District of Springfield Gardens, Springfield Gar- Woodrow W. Hunter dens, New York

10 SECTION ON EMPLOYMENT ANDRETIREMENT

INTRODUCTION. upon the knowledge and resourcefulness of a complex and_sophitiicated delegate body. More- here were 337 Delegates namedto Over,,a large nuniber- of the =Delegates were them- the Section on Employment and Re-, selves, retired and could speak -first hand of the iirement._ Informationavailablefor employment and retirement problems faced by _ some 310 of them itidicate.that 36per- older persons. Their prefereficei guided the de- Cent -.Were retired. Approximately one-sixthwere liberations of the Secdon as did the desires and members of one of the minoritygroups. thinking- conveyed by the State and local White The Delegatesto the Section on Employment Honse Conferences on Aging, the earlier Older and, Retirement representeda wide array of Americans Forums, and National Organizations groups, both public and private. Aged member- Task- Forces. ship organizations were strongly representedas Altogether, the Section approved 17recom- were religious, voluntary, State and local organiza- mendations addressed in general toward ensuring tions with programs-in such fieldsas Manpower older Americans a real choke between working and training services, and retirement preparation as long as one can and will, or retiring on ade- ;-.e. and education. Participants with interests related quate income with opportunities to pursue other to thesematters included officials from farm, 'rewarding activities. Specific proposalscover such labor and business organizations, the lattertwo important areas as: the fundinr and operation of groups having also named persons specializing in manpower programs; steps to eliminate age, dis- pension and annuity plans. An equally diverse crimination in employment, opportunities for number of professional and technical personnel public service employmenr, reforms of public and were represented. Among them were lawyers, private pension plans and of the Social Security phyticians, educators, industrial economists and system; and the determination of responsibility sociologists,legislative and executiveofficials, for policies to provide employment for older librarians, social workers, job placement andcoun- workers or, alternatively, toprepare persons for a seling officers, and consultantson aging. secure and meaningful retirement. In formulating its recommendations,' the Sec- tion on Employment and Retirement thus drew SECTION REPORT Preamble ' This report of the recommendations of the Employment and Retirement Sections follows, for themost part, the text "Freedom, independence and the free exercise printed in the blue-cover Conference Report distributedat the last day of the Conference. It does add, however,certain of individual initiative in planning and managing recommendations and statements that had been approved by their own lives" was declaredan objective for the Section, but which were necessarily omittedfrom the earlier, shorterreport because of limitations of time and older Americans in the 1965 Older Americans spacle. Act. This includes freedom to choose in their

463-213 0 73 - 2 later years between retiring on an adequate in- vance our Nation toward our long established come or continuing in employment, full time or goals relating to the employment and retirement part time, if they are able to do so. This free of older Americans. choice however, isstill denied to most older citizens, 'although the same Act included among Employment of older workers is a vitalpart other goals for them equal opportunity to enjoy: of our national problem of attaining full employment. Older workers are especially disadvantaged Opportunity for employment with no in competition for jobs in the labor market. Their discriminatory personnel practices because problems -cannot be met adequatelyat the State of agc and local level or through the financial instru- Retirement in health, honor, dignity ment of revenue sharing. Strong Federal leader- after years of contribution to the economy. ship and financing are required. Adequate income in retirement in accordance with the American standard of living.' Recotrtmendations Many barriers hamper older Americans in exercising this choice in- alloting- their titne- and RECOMMENDATION I talents and deprive our Nation of the highest use EartnarkedManponer Fun& of-their knowledge, skills, anal potentialities. They The Nation's present manpower programs fail include: compulsory retirement on reachinga to take adequate account of the uneinploYnient particular birthday, regardless of their ability to problems -of Older people. Experienceproves that work; lack of information and counselingon re- adequate funds must be earmarked to improve tirement problenis and job opportunities; lack of employment opportunities for older workers. placement and counseling personnel equipped to deal with their special problems; underrepresen- In order to- achieve a more equitable distribution ration in education, training, rehabilitation, and of services to all age groups, Federal, State and other manpower programs; continuing discrimi- local manpower programs should expand their nation in employment practices despite Federal services and provide more job recruitment, train- and State legislation; and enforced retirement ing, counseling, and placement services for older resulting from long unemployment as an increas- workers. :ng number of workers lose their jobs in their It is imperative that adequate funds basedon fifties when plant shutdowns or technological population ratio, needs, and special circumstances changes make their skills obsolete. This results in be earmarked for special employmentprograms their being undercounted among the unemployed.' for older people. Aggressive efforts should be The unemployment and underemployment of made to monitor effectively the use of suchear- workers in the age grotip 45-65 seriously jeop- marked funds. ardize their retirement prospects. For this reason, consideration of the present employment and RECOMMENDATION II future retirement problems of this age group, as Steps to End Age Discrimination well as those over 65, was included in arriving at our policy recommendations. These are offered We now have legislation designed to eliminate in the hope that they will lead to actions that ad- discrimination in employment on account of age. But there is question as to whether this legislation 'For these three goals and the opening paragraph there were substitutedin the shorter report the following lines: is vigorously enforced and as to whether further "Our long established goal in employment and retirement efforts are needed to expand employment oppor- policy is to create a climate of free choice between continuing in employment as long as one wishes and is able,or retiring tunities for older workers.' on adequate income with opportunities for meaningful activities." 'This paragraph is a fuller version ofthat presented in the 'This sentence was cut from the Introduction to the short short report, which reads: "We nowhave legislationde- sectionreport with the understandingthatitwould be signed to eliminate age discriminationin employment, but included here in the final report. more vigorous enforcement is needed.'

12 Federal, State, and localgovernments should chronological age rather than with abilityto per- strictly ,enforce protective and antidiscriminatory form the job. laws and policies regarding employment oppor- Chronological age should not be the sole criterion tunities, with the elimination of theage limit of for retirement. A flexible 65 in age discrimination legislation. The Age policyshouldbe adopted based upon the worker's desires and needs Discrimination Act of 1967 should be expanded and upon his to cover all employees in both private and public physical and mentalcapacity. sectors. Policies and prograths that provide employment opportunities after age 65 must be made available. There should be a governmentally-sponsored pub- Realistic opportunities for retirement earlier than lic relations and educational effort designedto inage 65 must be provided. EMployerS should be duce employers voluntarily to hiremore older workers.' encouraged to adopt flexible policies, suchas gradual or trial retirement. RECOMMENDATION III RECOMMENDATION V Public Service Employment Policies,to Protect Older 'Workers Even unproved manpower policiesmay- not result Existing policies fail to protect the worker who is forced to retire prematurely- in adeqnate opportunities for-those,persont will- or whci is unprotected ing and'able to work' State and local governments by a pension plan. are hard pressed to finance the public services New national policies and 'publicly and privately that are so badly needed by our communities today supported programs are neededto help workers and that are so appropriate for the employment who are forced to retire before the normalretire- of older people. ment age because of health problems, or job displacement caused by technological changes, It is the responsibility of the governmentto as- or sume the role of "employer of last resort" to jobs requiring early-age retirement. Newprograms should be vested generally in existing agencies provide meaningful and socially needed employ- that. have responsibility for dealing with theie ment opportunitiet for those older workers willing problems. and able to work, if all otherprograms fail to produce such results. There should be created a continuously funded program by the Federal Government especially A minority favored expanded and innovative pro- designedtomaintain economic securityfor grams to meet employment needs of older per- middle-aged andolder workers duringtheir sons, but questioned the concept of government period of transition from prematurely forceddis- serving as "employer of last resort" employment into suitable employmentor retirement. During this period, a major objective would RECOMMENDATION IV be to retrain and educate the disemployedto Flexible Retirement Age assure reemployability, or to assist in mobilizing resources to assure a meaningful retirement. Our society presently equates employability with other (non-contract) employers to hiremore workers. ' The Section on Employment and Retirement agreed that Recommend that the Child Care Centersto be created the following proposals be included with Recommendation H. nationwide be preferentiallystaffedby adequately trained Time limitations, however, precluded a formal voteon any elderly persons, resorting to reverse discrimination, if need of these matters. The recommendations are reproduced here be, by-declaring such job opportunitiesa special reserve for exactly as they were reported to the Section. the elderly. Furthermore, that such childcarefacilities be Recommend that chronological age discrimination in firing incorporated where practical as adjunctsto senior centers, be made as illegal as age discrimination in hiring. Further in order to counteract the present segregation and inward recommend that the Federal Government take the initiative orientation of these centers and attempt, instead,to involve the and set a national example by promoting the employment of aged members, through visual contact and prciximity, in the older persons and eliminating mandatory retirement provisions laughter and activities of littlechildren as well as in the based solely on an age criterion. workday problems of their young parents. Employers who have Federal, State, or local government Recommend that "Employ the Older Worker Week" be contracts should be required to implement affirmative action moved from the month of May to September and that it be- programs and/or quota system to assure the hiring of older come a true community effort. workersin addition tostrict enforcement of existing laws Involuntary unemployment is not an acceptable condition and policies regarding employment opportunities to induce of the American way of life.

13 All workers should be guaranteed a retirement RECOMMENDATION IX income adequate to maintain a decent standard Government Organization for Aging of living above the poverty level. Legislation must be enacted as soon as possible requiring A major overriding problem connected with the early vesting, adequate funding and portability administration of employment and retirement of pensions and to provide for Federal insurance policies is the lack of fixed responsibility by any pensions. single agency and lack of coordination by any single agency. The President should establish an RECOMMENDATION VI Office on Aging within his Executive Office by Eicecutive Order until Congress amends the Older Preretirement Preparation Americans ACt of 1965 to create a Department of Too many individuals fail to plan for retirement Aging at cabinet level status. In addition, there or plan too late. Preretirement education and shall be appointed an Assistant Secretary of Labor counseling shoulcL be provided locally throughout for Older Workers until a Department of Aging the, nation by trained instructors, starting at least is established.' five years before normaLretireinent age.:Informa- tionon ,problems and opportunities involved -in- RECOMMENDATION X retirement-should be included in family living A- National Pension Commission andother pertinent courses at all educational levels. A nationaL pension commission with a governing Government at all levels, employers, unions, and board of management, labor, and public iepre- educational institutions (especially through adult sentatives-should be established to study ways of education agencies and the use of television) encouraging the expansion and the improvement should encourage and promote preretirement of private and public pension plans with particu- counseling by trained instructors. Special. courses lar reference to: flexible retirement ages, liberal for those nearing retirement are urgently' needed. (early) vesting and portability, adequate funding, more general coverage; job redesign, and Federal RECOMMENDATION VII insurance of pensions.' Retirement Teo RECOMMENDATION XI The earnings test that results in withholding of A National Yob Bank" SocialSecuritybenefitsconstitutes a financial hardship for older people. A national "job bank" should be computerized by The Retirement Test should allow persons to the Department of Labor to meet employerre- receive Social Security benefits without reduction quirements. The "job bank" now being com- up to the point where the total of Social Security puterized should include job opportunities for plus earnings equals $5,000 a year. In no case retirees (including those in rural and smallcom- should benefits be reduced for persons earning munities) who should be encouraged to register under $1,680. with the U.S. Employment Service. RECOMMENDATION VIII Increasing Social Security 'This recommendation appeared in the short report without the additional proposal calling for an Assistant Secretary of An immediate 25 percent increase in Social Se- labor for Older Workers. curity benefits was recommended with a $150 'A somewhat altered version of this recommendation was minimum per month, to be financed, in part, by printed as part of the shorter report, namely: "A National Pension Commission with a governing board of management, general revenue.' labor and publicrepresentatives shouldbe establishedto encouragethe expansion and the improvement of pension ' This recommendation appeared in the short report without plans with particular reference to:flexible retirement ages, the provision for general revenue financing of partof the liberal(early)vesting and portability, adequate funding, costs of S::cial Security benefits. more general coverage, and job 'redesign."

14 RECOMMENDATION XII sion or retirement income plans with retirement 1 Work Related Centers for Older People counseling programs, such as counselingprograms to be submitted to the Internal Revenue Service The Federal Government shall develop a program for, and provide financing for, the establishment at the time the pension program is submitted. of local centers for the purpose of locating and Both program content and costs for counseling programs would be a pan of the total pension bringing together older persons and potentialem- ployers on both fulltime and Parttime basis. Fed- package that requires the approval of the Internal eral funds will be channeled through the various Revenue Service.' State administrations on aging which will be responsible for approving applications for the RECOMMENDATION XVI establishment and financing of such centers by Tax Incentives and Exemptions public and private agencies, and the supervision and Retirement Plans of their operation. . It is recommended that the Federal Government For the dual purpose of prothoting job oppor- and particularly the President encourage and tunities for elderly workers and meetinga crucial support legislation which would exempt from need for help in the private hOmes of other current Federal taxation, employee contributions elderly= persons, Federal funding for employment to retirement funds; and provkle increased tax inprograms through public or voluntary agencies centives- to employers (particularly smallem- should offer counseling, training, and placement ployers) to establish and maintain adequatere- for "companions for elderly persons living in tirement plans. private homes." RECOMMENDATION XVII RECOMMENDATION XIII Quadrennial White House Conferenas Mariana Man& on Aging For the Mariana Islands a study should be made It is recommended that each of the 50 States hold of the aged and how to alleviate their problems, a White House Conference on Aging at least especially of employment. A vocational instructor every four years in their respective States. It is in a workshop to train older persons innature further recommended that a White House Con- crafts for sale to tourists is needed. ference on Aging be held in Washington, D.C. every four years, 18 months before Presidential 'RECOMMENDATION XIV elections, so that senior Citizens can make each Portable Pension Plan President accountable for senior citizens'prn- grams. It is further recommended that funds for For all minorities, rural residents, migrants, and the White House Conference on Agingcome employees of small business, Congress should from Federal general revenue funds. enact a compulsory, universal and national portable pension plan administered through Social Security, (with tax advantages for the employer SECTION LEADERSHIP and the self-employed) to provide for those not Space will permit listingof titleand ad- normally covered by other pension plans. iiress.only the kit tins a sans* appoint. RECOMMENDATION XV The Technical Committee Pension Programs with Counseling for Employment and Retirement Employers should be required to supplement pen- Chairman A. Webb Hale, Director, Recreation Center, Space Division, ' This second paragraph was approved as a companion North American Rockwell Corporation, Downey, California recommendation tothat presentedinthefirstparagraph, which had been adopted earlier by the Section and which Recommendations XV, XVI, and XVII were not included appears alone in the short report. in the short report because of space limitations.

15 Consultant Milton Salzburg, Legal Consultant Compensation and Pension Geneva Mathiasen, retired Executive Director, National Coun- Review, Department of Veterans Benefits, Veterans Admin- cil on the Aging, Inc., Woodside, New York istration, Washington, D. C. Members Robert B. Burroughs, Designer of Pension Plans, Manchester, New Hampshire Section Officers Ewan Clague, Economist, Washington, D. C. Co-Chairmen Murrae A. Feingold, Chairman, Town of Hempstead Older American Volunteers Committee, Hempstead, New York Dorothy F. McCamman, Consultant on Retirement Income and Health Economics, Washington,-D. C., and A. Webb Hale Alice K. Leopold, former Assistant to the Secretary of Labor, San Francisco, California Consultant Ross Armstrong McFarland, Professor, Guggenheim Center, Geneva .Mathiasen School of Public Health, Harvard University, Boston, Massa- chusetts Recorder Marguerite W: Zapoleon JamesF.McMichael,Director,ExperimentalMarketing Project, Union Mutual Life- Insurance Company, Portland, Assistant Recorder Maine James C. Hunt, Associate Regional Commissioner for Aging, Charles V. Martin, Chairman, Carson Pixie Scott Company, Social and Rehabilitation Service, Department of Health, Edu- Chicago, Illinois cation, and Welfare, Boston, Massachusetts Lawrence A. Oxley, Director of SpecialProjects, National Management Officer Council.of Senior Citizens, Inc., Washington, D. C. Roland G. Ross, Chief, Departmental Management Systems, Lowell W. Perry, Manager, Section B, Chrysler Corporation Manpower Administration, Department of- Labor, Washington, Labor Relations, Detroit, Michigan D. C Harold L Sheppard, Staff Social Scientist, W. E. Upjohn Institute for Empicvaunt Research, Washington, D. C. Gerald G. Somers, Professor of Economics and Director, In- dustrial Relations Research Institute, University of Wisconsin, Subsection Officers Madison, Wisconsin Frederick C. Swartz, Physician, Lansing, Michigan Subsection 1 Marguerite Wykoff Zapoleon, Consultant on Labor Econom- Chairman ics and Vocational Guidance, Ft. Lauderdale, Florida Ronald Brown, Management Consultant, Cleveland Heights, Ohio. Vice Chairman The Secretariat Simon Heemstra, Specialist Program Coordination and De- velopment, Indiana Commission of Aging, Indianapolis, In- Director diana. Roland G. Ross, Chief, Departmental Management System, Recorder Manpower Administration, Department of Labor Emogene Baxter, founder, Over.60 Counseling Employment Members Service, Montgomery County Federation of Women's Clubs, Anna Boyd, Program Analyst, Program Analysis Division, Inc., Bethesda, Maryland Office of Comptroller, Office of Economic Opportunity Subsection 2 Roberta Church, Consultant on Aging, Division of Disabili- Chairman tiesServices,RehabilitationServices Administration, Social and Rehabilitation Service, Department of Health, Education, Harold L. Sheppard and Welfare, Washington, D. C. Vice Chairman Lewis Denton, Policy Specialist, Bureau of Retirement and Survivors Insurance, Social Security Administration,Depart- Joseph F. Gore, Secretary, Chapter No. 6, National Associa- ment of Health, Education, and Welfare, Baltimore, Maryland tion of Retired Federal Employees, Chicago, Illinois Robert Glasgow, Assistant Chief, Human ResourcesBranch, Recorder Economic Research Service, Economic Development Division, Department of Agriculture, Washington, D. C. Jacqueline T. Sunderland, President, Metropolitan Senior Citizens Center, Baltimore, Maryland Bates Johnson, Assistant Chief, National Programs andServ- ices Branch, Division of Vocational and Technical Education, Subsection 3 Office of Education, Department of Health, Education, and Welfare, Washington, D. C. Chairman Zachary Metz, Chief, Publication Division, Economic De- James H. Schultz, Associate Professor of Welfare Economics, velopment Administration, Department of Commerce, Wash- Florence E. Heller Graduate School for Advanced Studies in ington, D. C. Social Welfare, Brandeis University, Waltham, Massachusetts Craig Pettibone, Legislative and Technical Assistant,Legisla- Vice Chairman tion and Policy Division, Civil Service Commission,Washing. ton, D. C. Mrs. Lee M. Fagioni, Director of Personnel, Permacel Com- pany Division, Johnson & Johnson, Metuchen, New Jersey

16 Recorder Subsection 9 Oliver Diggs, Assistant Director, Freedom House Job Place- Chairman ment Center, Denver, Colorado Wiliam Gellman, Director, Jewish Vocational Services and Subsection 4 National Easter Seal Society of Crippled Children and Adults, Chicago, Illinois Chairman Vice Chairman Ewan Clague jack Gould, Director, New Bedford Councilon Aging, New Vice Chairman Bedford, Connecticut W. Eugene Houston, Minister, Springfield Gardens,New Recorder York WilliamDorsey,Consultant,CaliforniaCommission on Recorder Aging, Sacramento, California Dorothy Switzer, former Managing Editor, The Journal of Industrial Gerontology, University of Nebraska, Lincoln, Ne- braska Federal Resource Personnel Anna Boyd Subsection 5 Dale Chismore, Specialist, Education Records andReports, Chairman National Center for Education Statistics, Office ofEducation, Department of Health, Education, and Welfare, Washington, Geneva Mathiasen D. C. Vice Chairman Roberta Church Leonard 'M. Miller, retired specialist in Counseling Tech- Lewis Denton niques, U.S. Officer of Education, Bowie, Maryland Ann Donovan, Deputy Director, Division ofManpower De Recorder velopnient and Training, Office of Education,Department of Health, Education, and Welfare, Washington, D. C. Stanley J. Gregory, Assistant Director, Region 10, United Auto Workers of America, Milwaukee, Wisconsin Anthony Fantaci, Chief, Division of Counseling, Testingand Special Workers Service,U.S.Training and Employment Service, Manpower Administration, Department ofLabor, Subsection 6 Washington, D. C. Chairman Robert Granakis, Special Assistant to Deputy AssociateMan- Leon B. Schachter, International Vice President, Amalga- power Administrator, U.S. Training and Employment Service, mated Meat Cutters and Butcher Workmen of North America, Manpower Administration, Department of Labor,Washington, Washington, D. C. D. C. Vice Chairman Roger Grant, Special Assistant to Director of ProgramOpera- tions and Services, Occupational Safety and HealthAdmin- Frederick D. Leatherman, Retired Foreign Service Officer, istration, Department of Labor, Washington, D. C. Bethesda, Maryland. Gerald Gunderson, Program Analyst, Officeof Planning and Recorder Evaluation, Manpower Administration, Department of Labor, Washington, D. C. Gwen Robbins, Teacher, Roiwell, New Mexico Helen Hamer, Chief, Program Development BranchSelf Subsection 7 Support Program Division, Community Services Administra- tion, Social and Rehabilitation Service, Departmentof Health, Chairman Education, and Welfar4:, Washington, D. C. E. W. Christiansen, State Representative, Hartin, Montana Joseph Hickey, Chief, ProgramPoliciesand Legislative Branch, Unemployment InsuranceService, Manpower Ad- Vice Chairman ministration, Department of Labor, Silver Springs,Maryland Harry Walker, Executive Director, Maryland Commissionon Bates Johnson Aging, Baltimore, Maryland Zachary Metz Recorder Merlin A. Myers, Program Analyst, Divisionof Resource William J. Wholean, Executive Director, ConnecticutCatho- Planning and Review, Manpower Administration,Department lic Conference, Hartford, Connecticut of Labor, Washington, D. C. Janet Pease, Manpower Development Subsection 8. Specialist, Operation Mainstream, U.S. Employment and TrainingService, Man- power Adminiration, Department ofLabor, Washington, Chairman D. C. Mrs. Joshua D. Shubin, volunteer, Golden AgeEmployment Craig Pettibone Service, and National Board Member, NationalCouncil of Jewish Women, Atlanta, Georgia Milton Salzburg Vice Chairman Avis Smith, Manpower Development Specialist,U.S. Training and Employment Service, ManpowerAdministration, Depart- Hargrove Bowles, State Sen,cor, Greensboro,North Carolina ment of Labor, Washington, D. C. Recorder Arnold Strasser, DirectorAnnualEarnings and Employee James F. McMichael Benefits Projects, Bureau of Labor Statistics,Department of Labor, Washington, D. C.

17 James F. Taylor, Director, Planning and Evaluation Staff, Robert Turner, Labor Economist, Office of Planning and Bureau of International Labor Affairs, Department of Labor. Evaluation, Manpower Administration, Department of Labor, Wasnington, D. C. Washington, D. C. Helene White, Writer and Editor, Office of Labor, Manage- Rose Ter lin, Chief Special Projects, Womens Bureau, Wage ment and Welfare Pension Reports, LaborManagement Serve and Labor Standards Administration, Department of Labor, icesAdministration, Department of Labor, Silver Springs, Washington, D. C. Maryland

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18 SECTION ON PHYSICAL AND MENTALHEALTH

"Compulsory health-Care inevitably results adoption of a comprehensive national health plan, in poor quality health care." but there is concern about the alterations its adop! SECTION ON HEALTH AND MEDICAL CARE,. don might bring about in the quality and delivery 1961 WHITE HOUSE CONFERENCE ON AGING of health services to the elderly. Over 480 Delegates to the 1971 White House "11 is distressing to be told.. . that the quality Conference on Aging were named to participate of care the individual physician renders will in the deliberations of the Section on Physical be influenced by: the source of payment. We do and Mental Health, the largest of any of the 14 not believe this is so." Conference Sections. Among the Section partici- MINORITY REPORT, SECTION ON HEALTH AND pants were over 100 physicians, including spe- MEDICAL CARE, 1961 WHITE HOUSE CONFER- cialists in such areas as geriatrics and psychiatry; ENCE ON AGING over 50 association executives working in health, social welfare, and related fields, including the insurance industry; over 35 administrators of hospitals, extended-carefacilities, nursing homes, INTRODUCTION mental health 'clinics and outpatient centers, or other such health facilities. Nurses, optometrists, podiatrists, psychologists, pharmacists and reha- he report of the first (1961) White bilitation workers serving the blind, the deaf, and House Conference on Aging, The Na- other physically disabled, were members of the tion and Its Older People, clearly re- Section. So, too,were researchers and professors veals the debate at that meeting which of medicine, nursing, sociology, health care ad- raged over the provision and financing of health ministration, and persons serving within health care to the elderly. and welfare agencies at local and State levels. Now, ten years later, it is possible to point to By virtue of their age, over 13 percent of the demonstrable outcomes of that debate, namely Section body could speak directly to the various the evolution of vast change in the whole realm health services still out of reach for a large share of health care and public policy. At the same time, of elderly persons, largely because of costs, lack however, long-recognized deficiencies in the tra- of facilities, and the fragmentation of health care ditional system of health care remain. And, pro- delivery systems. grams adopted to make the system more responsive to the circumstances of those most disadvan- In offering nine major proposals, these Dele- taged within itthe elderly and the poor gates, sensitive to what has passed and what re- fashioned in controversy, remain under intense mains to be done, addressed such topics as: the critical review. Medicare and Medicaid, recognized need for separate health services for the elderly; for their strengths, are equally noted for their the coordination and delivery of health services; deficiencies. Attention is now being focusedon the Medicare, Medicaid, and the alternatives offered

19 through adoption of a national health insurance The issues which were developed by, the Tech- program; a national program of education about nical Committee on Health, which I had the honor specific health changes and diseases associated to chair, were developed to stimulate discussion with aging; the adequacy of the supply and train- in a number of broad areas concerning the de- ing of health manpower; and the balanceto be livery of quality health services. Theywere de- achieved among expenditures for research, train- signed not to limit the areas to be considered,- but ing, and services. to provoke discussion and difference of opinion and recommendations from a broadsegment of the population, involving the consumer, the de- SECTION REPORT liverers of health services, laymen and professionals,individuals and national organizations Convened in an initial orientation session, Dele- It gates to the Section on Physical and Mental with a particular concern in thisarea. The issue Health heard Co-chairman Edward J. Lorenze set questions have been discussed at the White House forth the parameters for the work of the Section Conferences of the several States and by local and its Subsections over the course of the next conferences within the States,as well as by the several days. At the request of presiding Co- national organizations. chairmen James G. Haughton, Dr. Lorenze offered his remarks highlighting the topical areas which The program recommendations which have would likely be a major concern to the Delegates come out of these deliberations have been tabu- in their deliberations. lated and integrated, and appear inyour Work Books under each of the issue questions. Thus,the Work Book contains the results of national dis- Co-Chairman's Statement cussion. The issue questions and the recommendations of these groups, plus your own contributions, It gives me great pleasure to welcome the Dele- are the subject matter for this Conference which gates to the Physical and Mental Health Section we are about to begin. of the 1971 White House Conferenceon Aging. As you may know, you numberover 400 dele- You will be divided up into 13groups, each gates and constitute the largest Section of the of which will consider all the health and mental i Conference. This fact, as well as theresponses .health issues, and determine the recommendations in the State and regional White House Con- which you feel appropriate. We anticipate thatthe ferences, indicates that health care in its broad recommendations coming from thisprocess will aspects, including both physical and mental health, provide guidelines which arean expression of the continues to be a major concern of the American will and the wisdom of peopleon all levels, and people. from which will be developed.a blueprint which will have profound effectupon the health, care This concern is not limitedto those at or near delivery system and the quality ofcare which will the arbitrary age of 65 years, but involves the be provided. entire population. This concern continues for the elderly, despite the fact that since the 1961 White As I have thoughtover the issues and possible House Conference on Aging, major public policy recommendations, the, followingareas seem to decisions Shave been made in regardto the Title me to be of major concern in your deliberations. XVIII and Title XIX programs of Medicare and Medicaid which have profoundly affectedthe 1. A recognition of the fact that, whilemany delivery of health care servicesto the elderly for health services are provided the better. Indeed, among to the older segment some, it has been felt of the population, obviousgaps and deficiencies that programs for the payment of health services exist. The identification of these have made those over 65 gaps and incon- a privileged group. sistencies will be a majorconcern. It should be Progress has been made, but much remainsto recognized that a coordinated be accomplished. system of comprehensive health services is the objective,not inde- 20 pendent and fragmented services withoutprovi- 4. Consideration must be givento the fact that, sion for continuity ofcare. while the achievement of these services for the elderly is our immediate and primary 2. The goal of comprehensve healthservices concern, in is difficult to achieve withouta coordinated system a larger sense we recognize that. such a program for 'a variety ofreasons, incuding ignorance of must be available to all of our people, whatever one's needs, financial or geographical considera- the age. It is not conceivable thata system of this tions which limit access kind can be developed for the elderlyto the to services which are neglect of other age available, lack of facilities and personnelto de- groups. Our network of facilities, including physicians' offices, liver the services. The quality ofcare provided health care will also be dependentupon the supply of man- centers, clinics, hoipitals, rehabilitation centers, power and the ever improving results of research. long-term care facilities and homecare programs, must all be of high quality- in providing both for We should be aware that the product thedelivery system brings to us must be a continually', improv- the old and the young. It would-be difficultto ing one. The medicalcare of 1900 is not the conceive that separate facilities, suchas general medical care of 1970 and the medical hospitals, would be developed only for the elderly, care of but should continue to provide for all 1970 will not be the care of 1980. Thenecessity age groups. for continued researchto improve .the product is Howeimr, it may be some time until sucha system self-evident. We might be ableto get along with becomes an actuality and the aged might well be the 1930 automobile, butno one would accept considered a trial group for which thistype of comprehensive health care the quality of medicalcare of 1930, which was program could be then available to themost privilegedin our worked out, and would provide theexperimental society. basis on which developments for the otherseg- ments of the population would come about. 3. The elderly, despite gains in thearea of Federal programs forpayment of health services, 5. A variety of national healthcare plans have continue to require special attentiontotheir been suggested. These have primarily dealt with needs because of their particular socialand eco- financing of such care forour population. Prob- nomic vulnerability, as wellas the fact that in the ably nothing that could be considereda truly older age group, the incidence ofdisease, disability satisfactory comprehensive healthcare system has and need for healthcare services of all kinds is so been outlined, nor have the details been spelled great. We must examine the special needs within out. It may well be that it will be a considerable this group of\those whoare impoverished and time before a comprehensiveprogram for a na- those who, because of racial and ethnicorigin, tional health plan will be developed. have been particularly isolatedfrom the main In our deliberations, stream of the existing health care deliverysystem. we must stress the nature The rural and urban ghettoareas, particularly, of the program thatwe would like to see de- have had limitedresources in terms of facilities veloped. We should takecare that our recom- and personnel needed lomeet their health care mendations do not work adverselyto the interest of the elderly or that gains which requirements. The distribution of theseservices have already must be reconsidered and new and innovative been made are lost. The attitudestoward the ways must be developed to provide for them. The deficiencies in Medicare and Medicaid shouldbe role of regional health facility planningand, in- reviewed in the light of expanding thelegislation deed,health personneldistribution, must be and financing and not provide theopportunity developed and expandedon a national basis if for cutbacks and limitation. the goal of comprehensive health care is to be 6. We must remember thatin this country we achieved. This must include provisions for health do have a system of delivery of healthcare serv- education and preventive services,diagnostic and ices which, although failing therapeutic services, rehabilitative to meet all of the services and needs of all of the people all of thetime, has, programs for long-term care with alternatem,' h- nevertheless,provided ods to institutional tremendouslyeffective care. service to a large population. It is the imperfec-

21 tions in this system which we arestressing, but major importance. The policyrecommendations have one would havedifficulty in finding examples of which you will develop will, undoubtedly, countries which have provided a quality of care profound effects on the course which oursociety that on the scale which wehave achieved. We want will follow in the next ten years. I am sure improvement, but we should not be ashamed or changes will occur between this andthe next which will apologetic of the achievements to date. White House Conference on Aging far surpass the changes . whichhave occurred 7. There are many States ir. this countrywhere since the Conference of 1961. I wish youwell in the provisions under Medicaid havebeen quite your deliberationsand' I feel secure that you will broad for the elderly. The question tobe examined provide clear guidance to those whowill be is why there are inequalities in thelevel of services charged with the development of thehealth care provided across the Nation, and wouldbring us to system of the future. ask why the quality of care and extentof services covered should not be national in scopeand not vary from State toState. It would appear only Preamble right that the minimal standards of care accept- We, the Delegates to thePhysical and Mental able should be national in scopeand provision. Health Section of- the 1971 White HouseCon- Likewise, regional' planning for healthfacilities ference on Aging, assert that theUnited States national scope and services should have a similar of America must guarantee to all its olderpeople as should the regulationsand supervision of these of life quality would health care as a basic right and a quality services, so that the amount and consistent with that in which our Nationshould not vary from one areaof the country to another assure to this group whohave made invaluable 8. Another matter to be consideredis whether contributions to its development. In order to as- access to comprehensivehealth services should be sure that quality oflife, a basic requirement is a matter of right toall elderly people, regardless the availability of a comprehensive systemof of ability to pay. A major criticismof the Medicaid appropriate health care. program, even in theStates in which a broad A comprehensive system of appropriatehealth spectrum of services areavailable, is the fact that full spectrum of presently all elderly persons care requires that it is not a right available to known services be readily accessible. These must Medicate pro- but is based on a means test. The be of high quality and be delivered inthe appro- gram and the servicesprovided by it are a matter priate setting and at the appropriatetime, with of right and not limited by economicneed. These and choice of the indi- philosophical questions which concern for .the dignity are financial and vidual, and within a framework which guarantees will require considerable thought'before satisfac- coordination among the various levelsof care, determined. One would have tory solutions are continuity of care over time, and theefficiency and health care, like public edu- to consider whether effectiveness which will assure supportable costs. cation, is a basic ingredient tothe continuation of this asuccessfulfreesocietysuchaswe have To be comprehensive andsystematic, developed. health care must provide: 9. I would particularly stress that we notlose a. Assessment of health sight of the problems in mentalhealth. There are b. Education to preserve health many Who feel thatlip service is given to this area, c. Appropriate preventiveand outreach serv- but that it is frequently thenoverlooked. It is ices clear that our concern is with thetotal health d. All physical, mental, social, andsupportive needs of the individual and that thephysical and services necessary to maintain or restore mental aspects cannot be separated in or program health development, just as they cannot be separatedin e. Rehabilitation the individual human being. f.Maintenance and long-term care whendis- In conclusion, we are embarked on a voyageof ability occurs 22 To be specifically responsiveto the needs of such a national health plan, the completerange the elderly, special attention must be given to the of health care services for the elderlymust be availability and quality of long-termcare and to provided by expanding the legislation and financ- the development of adequate, appropriate alter- ing of Medicare.' Such expanded financing should natives to institutional care. be accomplished by means ofa combination of Community and consumer participation in the Social Security trust funds witha greatly expanded planning and delivery of such a system oservices use of general revenues. Such expansion of Medi- will tend to assure the responsiveness of thesys- care should include elimination of deductibles, tem to locally defined community need and the co-insurance and co-payment, and all provisions appropriate use of health manpower, facilities and discriminatory to the mentally ill,as well as the financing. establishment of congruent ages for Medicare and Social Security benefit eligibility. Both the im- The Health Section recognizes that although mediate expansion of thecurrent program and ti the aged.represent a minority, within this minority a future national health plan shouldprovide for there are special problems experienced by racial a public-private partnership in the 'delivery of and ethnic groups. Within the specialconcern services and for Federal financing and quality expressed Car the problems of the, aged, particular controls in order to assure uniform benefits and attention must be accorded to makesure that uniform application of the- standards of quality. these minorities are not doubly jeopardized. Centralized responsibility for standards and con- In support of these basic premises the Physical trols over health facilities and servicesmust be and Mental Health Section submits the following combined with protection, for the patient and policy proposals. provider, from arbitrary, capricious, and varied' application and interpretation of existingas well as new standards. Recommendations Minority Recommendation The fiscal aspects of the Medicareprogram RECOMMENDATION I should be administered by the Federalgov- Special Health Care ernment rather than by the private insurance carriers as intermediaries. Health care for the aging must be providedas an integral part of a coordinated system that 'provides comprehensive health servicesto the total RECOMMENDATION IV population, but immediate and special considera- Health Education for All Ages tion and emphasis must be givento the problems of, and services for, the aging. A continuing nationalprogram for education of all persons should be provided about the specific RECOMMENDATION II physical, mental, and social aspects of aging. Edu- Coordinated Health Services. Delivery System cational programs should be addressedto all ages and should include allstages of development so A coordinated deliverysystem for comprehensive that the different age groups will better under- health services must be developed, legislated, and stand each other. Informationon all aspects of financed to ensure continuity of both short- and aging should be included in educationalcourses long-term care for the aged. at alllevels. The aged themselves should be among those recruited, trained, and utilized in RECOMMENDATION III carrying out these programs. National Health Insurance and Medicare A comprehensive health ' A minority opposed the Section's action eliminatingthe care plan for all persons combination of Medicate and Medicaid expansion (through should be legislated and financed througha na- legislation and financing) as an alternativeto the expansion of Medicare alone in order to achievea comprehensive health tional health plan. Pending theachievement of care plan.

23 RECOMMENDATION V comprised of representativesfrom concerned Training in Aging for Health Manpouer Federal agencies, national organizations, Congress, and the Judiciary, and private citizens to study, S Emphasis shOuld Iv placed on including curricula evaluate, and recommend a comprehensive set of or course contents on physical, mental and social policies for the Federal government, the several aspects of aging in secondary schools, undergradu- States, and locai communities to pursue in this ate professional education, and in inservice train- vital area. ing and continuing education of health personnel. The development of specialists in the care of the elderly should also receive emphasis, especially RECOMMENDATION IX with the view of developing professional, allied Protection of Iirdividual Rigbtr health professional, and other health personnel Congress should appoint a nationwide interdis- selected and trained to give, compassionate and ciplinary committee to determine the scope and expert care to the aged. Funds must be iprovided type .of intervention procedures and protective to ensure the development of such programs as services that would clearly protect the rights of well as increase the supply of health manpower of the individual with health, mental health, and I all kinds. emotional problems requiring care. The rights of RECOMMENDATION VI his immediate family and other close associates should be considered. This committee should in- Funding for Research, Service, and Education chide representatives of the religious, civil rights, The aging will best be served if available funds civilliberties, legal, health and social services are divided among service, research, and educa- communities. Congress should appropriate suffi- don. Emphasis should be placed on funding of cient funds to assure an indepth study of all direct services but not to the exclusion of research aspects of the individual's rights in relation to and education, which should receive a reasonable his needs for health services and thv administra- proportion of total resources available. Research tion of his affairs until he can resume responsi- findings now available should be assembled, co- bility. ordinated, and incorporated into service programs. Intervention procedures and protective services Specific attention should be given to increasing also should assure for elderly individuals their the funds available for basic research and for rights of self-determination in their use of health operational research with a strong suggestion that facilities and services. a gerontological institute be established within In order to promote and encourage the establish- the National Institutes of Health to provide the ment of ombudsman services, the nationwide in- essential coordination of training and research terdisciplinary committee, or other suitable means, activities. should be used to study and define the functions I RECOMMENDATION VII and roles of ombudsmen as separate and distinct, conceptually and in practice, from other protec- I National Mental Health Center for Aging tive services and from convmer participation in A center for aging should be established in the health and other matters affecting the elderly. National Institute of Mental Health to meet the Subsequent promotion of ombudsman services responsibilities for more research and training in should include financial support for their activi- the field of mental health of the elderly. ties, as well as programs to assure that their functions andfindings are given full visibility at local, RECOMMENDATION VIII Stare, and national levels, and in both the public Presidential Commissionon Aging and private semis!

The President and Congress should authorize the 'A minority requested the Section to substitute the words appointment of a commissionon aging, including "physical and mental health" for the amended word "health". 'A minority requested the Section to eliminate the last a committee on mental health of the elderly, paragraph referring to mho, man services. 24 SE CTION LEADERSHIP The Secretariat Space will permit listing of title and address only the first time a name appears. Director Austin B. Chinn, Consultant, Community Health Service, The Technical Committee Health Services and Mental Health Administration. Public for Physical and Mental Health Health Service, Department of Health, Education, and Welfare; Rockville, Maryland Chairman Special Assistant to the Director Edward J. Lorenze, Medical Director, Burke Rehabilitation Center, White Plains, New York Edith Robins, Coordinator for Health of the Aging, Com- munity Health Service, Health Services and Mental Health Consultant Administration, Public Health Service, Department of Health, Cecil G. Sheps, Director, Center for Health Services Research, Education, and Welfare, Rockville, Maryland University of North Carolina, Chapel Hill, North Carolina Members Members Thomas E. Anderson, Chief, Section on Mental Health of the James C. Bennett, Chairman, Department of Gerondontology, Aging, National Institute of Mental Health, Health Services University of Oregon Dental School, Portland, Oregon aid Mental Health Administration, Public Health Service, Lester Breslow, Chief, Division of Preventive and Social De,l meat of Health, Education, and Welfare, Rockville, Medicine, School of Medicine, University of California, Los Maryla...! Angeles, California Sarah A. Butts, Social Work Program Specialist, Division Michael M. Dacso, Dean, Institute of Health Sciences, Hunter of Services to the Aged and Handicapped, Community Services College, New York, New York Administration, Social and Rehabilitation Service, Depart- ment of Health. Education, and Welfare, Washington, D. C. Horace Doty, Physician, Salt Like City, Utah Davi3 Callagy, Project Director, Program Operations Branch, Reverend William T. Eggers, Administrator, Home for Aged Comprehensive Health Services, Offices of Economic Oppor- Lutherans, Wauwatosa, Wisconsin tunity, Washington, D. C. Ernest C. Fackler, Management Consultant, Taylor, Michigan Edward S. Colby, Evaluation Officer, Community Health Reverend CharlesJ.Fahey, Chairman, Commission on Service, Health Services and Mental Health Administration, 'Aging National Conference of Catholic Charities, Syracuse, Public Health Service, Department of Health, Education, and New York Welfare, Rockville, Maryland Robert H. Felix, Dean, School of Medicine, St. -Louis Univer- Leroy E. Duncan, jr.,Director, Adult Development and sity,St. Louis, Missouri Aging Branch, National Institute of Child Health and Human Development, Public Health Service, Department of Health, Walter W. Fox, Superintendent, Mental Health Institute, Education, and Welfare, Bethesda, Maryland Mount Pleasant, Iowa Edward Dunner, Special Assistant to the Assistant Chief Charles M. Gaitz, Gerontology ResearchSection, Texas Medical Director for Research and Education in Medicine, Research Institute of Mental Sciences, State Department of Veterans Administration, Washington, D. C. Mental Health and Mental Retardation, Houson, Texas Hans Falck, Consultant, Mental Health Care and Service Ralph Goldman, Professor of Medicine, The Center for the Financing Branch, National Institute of Mental Health, Health Health Sciences, University of California, Los Angeles, Cali- Services and Mental Health Administration, Public Health fornia Service, DepartmentofHealth,Education, and Welfare, Samuel Granick, Clinical Psychologist and Director of Re- Rockville, Maryland search, Philadelphia Psychiatric Center, Philadelphia, Pennsyl- Evelyn Flook, Special Assistant to the Director, National vania Center for Health Services Research and Development, Health E..Gartly jaco, Professor Department of Sociology, University Services and Mental Health Administration, Public Health of California, Riverside, California Service, Department ofHealth,Education, and Welfare, Rockville, Maryland David Littauer,ExecutiveDirector,Cedars-SinaiMedical Center, Los Angeles, California Frank C. Frantz, Special Assistant to the Associate Commis- sioner, Medical Services Administration, Social and Rehabilita- Manuel Rodstein, Chief of Medical Services, The Jewish tion Service, Department of Health, Education and Welfare, Home and Hospital for the Aged, New York, New York Washington, D. C. Doris R. Schwartz, Associate Professor of Public Health Nurs- Claudia B. Galiher, Interim Chief, Community Assistance ing, Cornell University-New York Hospital School of Nursing, Branch, National Health Service Corps, Health Services and New York, Ncw York Mental Health Administration, Public HealthService, De- Lyall A. Schwarzkopf, Member, State House of Representa- partment of Health, Education, and Welfare, Rockville, Mary- tives, Minneapolis, Minnesota land Megumi Shinoda, Physician, Los Angeles, California James R. Gussenhoven, ProgramAnalyst,Experimental Health Services Delivery gystems, Health Services and Mental Virginia Stone, Professor of Nursing and Director of Grad- HealthAdministration, Public Health Service, Department uate Studies, Duke University School of Nursing, Durham, of Health, Education, and Welfare, Rockville, Maryland North Carolina Paul A. Haber, Deputy for Clinical Services, Department Wilbur H. Strickland, Specialist in Internal Medicine, Phila- of Medicine and Surgery, Veterans Administration, Washing- delphia, Pennsylvania ton, D. C George M. Warner, Director, Bureau of Long-Term Care, Helen Holt, Special Assistant for Nursing Homes and Re- Division of Hospital Agents, New York State Department lated Facilities, Federal Housing Administration, Department of Health, Albany, New York of Housing and Urban Development, Washington, D. C.

26 Vice Chairman tine and Rehabilitation, University of Michigan Medical Cen- Weldon V. Barton, Legislative Representative,The National ter, Ann Arbor, Michigan Farmers Union, Washington, D. C. Subsection 9 Recorder James S. Bennett Chairman Edward C. Rosenow, Jr., Executive Vice President, Ameri- Subsection 4 can College of Physicians, Philadelphia, Pennsylvania Chairman Vice Chairman W. Palmer Dearing, Medical Consultant,Group Health Asso- Bishop Edward A. Head, Executive Director, Catholic Chari- ciation of America, Inc., Washington, D. C. ties of the Archdiocese of New York, New York, New York Vice Chairman Recorder Frank G. Zelenka, Associate Executive,American Association Jean K. Boek, Director, Special Education, National Graduate of Homes for the Aging, Washington,D. C. University, Washington, D. C. Recorder Subsection 10 David Lee Pang, Physician, Nuuanu Clinic,Honolulu, Hawaii Chairman Subsection 5 John A. Scharffenberg, Assistant Professor, Department of Preventive Care School, of Health, Loma Linda, University, Chairman Loma Linda, California James C. Folsom, Deputy Commissionerfor Hospitals, State Department of Mental Health, Tuscaloosa, Alabama Vice Chairman Leory H. Jones, Executive Director, Bensonville Home So- Vice Chairman ciety, Bensonville, Illinois Samuel P. Katz, Member, State House ofRepresentatives, Harrisburg, Pennsylvania Recorder Doris R. Schwartz Recorder Subsection 11 Margheritta S. Loud, Director, Senior CenterInc., Detroit, Michigan Chairman Subsection 6 Ralph Goldman Chairman Vice Chairman Charles M. Gaitz Walter M. Cassidy, Southwestern Michigan Representative, United Auto Workers, and Member of the Board, National Vice Chairman Council of Senior Citizens, Inc., Dearborn, Michigan Jerome Hammerman, Assistant Professor,School of Social Re Corder Services Administration, University of Chicago,Chicago, Illi- nois Doris Kelly, Professor of Nursing, Boise State College,Boise, Idaho Recorder Subsection 12 Edward L Tarara, Chief, PodiatrySection, Department of Orthopedics, Mayo Clinic, Rochester, Minnesota Chairman Subsection 7 Victor Kassel, Geriatrician, Salt Lake City, Utah Vice Chairman Chairman Andrew R. McKillop, Administrator, RehabilitationInstitute Stephen Caulfield, Assistant Dean for AlliedHealth Man- of Chicago, Chicago, Illinois power, Albert Einstein College of Medicine, New York, York New Recorder Manuel Rodstein Vice Chairman Lyall A. Schwarzkopf Subsection 13 Recorder Chairman Kurt Pe lz, Director, Masonic Home and Hospital, Ruth B. Robinson, Staff Consultant,Massachusetts Commis- Walling- sion on Aging, Newton Centre, Massachusetts ford, Connecticut Subsection 8 Vice Chairman Benjamin W. Watkins, Director of PodiatryService, New Chairman York City Department of Health, New York,New York Harvey Webb, Jr., Chairman, LegislationCommittee, Na- Recorder tional Dental Association, Baltimore, Maryland Albert G. Incani, Executive Director, Swope RidgeNursing Vice Chairman Home, Kansas City, Missouri Gail Allen, Psychiatrist, Riverdale, New York Subsection 14 Recorder Chairman Leonard F. Bender, Professor, Department ofPhysical Medi- Reverend Charles J. Fahey

28 SECTION ON HOUSING

INTRODUCTION mend ations addressed to such critical policy questions as the funding of elderly housing, eligibility here were 382 Delegates .named to the for occupancy of publicly assisted housing, types Housing Section. Some 327 of these of housing needed to meet the diversified and filled out an advanced registration form, changing needs of aging persons, financial aid and of these, 25 percent indicated that programs for homeowners and renters, standards, they were already retired. Approximately a fifth and research and manpower needs to insure qual- of the registrants of the Section were members ity of facilities and of their management. of one of the minority groups. Within these recommendations will be found The various professional and technical groups policy guidelines for feasible action in the area of concerned with different aspects of housing the housing which, if implemented at national, State elderly were represented by highly experienced and local levels, by public and private resources, persons. The most numerous of these were ad- will not only increase the quantity of housing ministrators of old-age or retirement homes. available to older people, but concomitantly will Others were public housing authorities and di- improve the quality of their lives. rectors, architects, builders, realtors,legislators, model cities personnel, bankers and brokers;nursing home administrators, housing planners and SECTION REPORT consultants. The object of the first meeting of the Section Interested organizations were also stronglyrep- was to provide an orientation for the two days of resented. Among them were unions, religious Subsection discussions and formulation of recom- groups, associations of homes for the aged, coop- mendations which were to follow. For this pur- eratives, nursing homes, boarding homes, and pose, Co-chairman Noverre Musson was requested resident care homes. Delegates whowere pro- by the presiding Co-chairman, Abraham J. Isser- viders of services related to housing included man, to present a statement on the significance of dietitians, social workers, physicians and nurses, housing to the elderly and society. religious leaders, and environmental planners. CO-Chairmans Statement The recommendations produced by thiscom- plex and sophisticated group of Delegates, guided Our three days' work in this Section isto deal by the preferences expressed by the older people with the question of housing for older Americans among them, reflect the desires and thinking ini- and we must attempt to do it in the broadest,most tiated in the State and local White House Con- comprehensive sense. Now it will bevery easy in ferences on Aging, the earlier Older American our deliberations to drift into discussions of tan- Forums, and National Organization Task Forces. gential subjects which seem to be importantto housing, such as income, transportation, and the Altogether, the Section approved 25 recom- like. This we must not do. Thereare 13 other 29 large sections besides ours, each assigned to a to have a measure of total minimum income to subject such as Nutrition, Health, Services, Em- maintain a decent existence. Thus without our ployment, etc., including Income. Our job is to needing here to spell anything out in dollars and stick specifically to the subject of housingbut, cents, the whole equation becomes apparent and as I said, in its broadest connotation. measurable when stated this way. If we consider I believe that if we are able to spell out per- housing an important structuring mechanism for ceptively the full meaning of housing to older satisfying the need for independence, thenwe -can people, we will find it to be a framework for also begin to spell out what kind it should be, how it should be designed, and where it should discussing many of their other problems, and a be located. foundation from which to attack them. To be good, housing must face squarely the I have long maintained that if we were to solve question of security. How can one have any feeling for our society the problem of housingin its of security if he dare not go out on the street broadest significancewe would go a long way which can be just as much a matter of how his toward solving most of the other problems ofour housing relates to the onslaught of traffic as a people. And there is no one for whom this is matter of purse-snatthing. Security is as much a more true than the elderly. But to do so we must matter of how one gets from his bedroom to his understand fully all that housing includes. bathroom in the night, as whether his home. is What does housing mean to the elderly? Aside one-story or two. It is a matter of how accessible from his spouse, housing is probably the single counseling and good advice are, or how available most important element in the life of an older help is. for yard work and housework, as how far person. This can be good; it can be bad. Most of one lives from the nearesrhospital. his satisfactions are house oriented. He spends I said housing was an important factor in a more time in his home than almost anyone else person's sense of identity, his evaluation of his over the age of five. And just as more and more own personal worth. If housing is to be a positive of his satisfactionsare bound up in his sense of factor in self-identity, then the personmust have home, so more and more of his problemsare house generated. a choice of environments and having made a choice it must be an environment he can take Let me spell out for you some ofmy thoughts satisfaction in and be proud of. Freedomto make on the significance of housing to older people. one's own decisions is important to self-evalu- Housing, to be good, must deal with the indi- ation. vidual's need for independence, his need forsecur- Identity can be jeopardized when a person ity, for identity, for well-being: Ifwe are going falls on loneliness. Fear of being leftout, fear of to ask this measure of capability of housing, we being neglected, forgotten, do more damage than are asking for considerably more than shelter, most of the more diagnosable ailments of the good temperature controls, anda safe bathtub. We elderly, .i in fact not inducing them. Housing are talking, as a matter of fact, about aesthetics, can help solve the problem of loneliness, or it economics, community planning, city administra- can aggravate it. Housing which isolates the older tion, the structuring of a neighborhood, and the person from family, friends, church, entertain- character of a community. ment, the golden age center, or the neighborhood For example, if we put, housing togetherso as pub is bad housing. Even TVthat fantasy sub- to deal with the need for independenceon the stitute for companionshipis better if shared part of the elderly, we begin at once to confront with someone else. the question of economics. To maintaina measure Independence, security, a sense of personal iden- of independence the elderlymust have housing tity go hand-in-hand with personal well-being. It they can afford. Housing should take its fair is greatly enhanced if housing is comfortable, share of their income, butnot all of it. So if we convenient, and considered. attractive inside and can say what that housing will cost, then we begin out. It helps a great deal if rooms are big enough

30 to house your possessions and you can still get programs be put together to fit the people they around in them, and if the house isnot so large will serve, be designed for he people who need that housekeeping is a burden; if the yard is them, rather than the people who will administer attractive, yet manageable. It helps immeasur- them. ably if shops, a supermarket,a bank, and a post office are minutes away. To be ableto walk to At the Federal level: the library, a -restaurant, a movie house, a drug Many departments and agencies have programs store, or a health clinic 'would be greatly sustain- now. In many cases they overlap; they leave big ing to many older people. To have good public gaps; they are too narrow and specialized. We transportation at your door would stimulateac- must urge that these programs be reorganized tivity. To have an active, welcoming church in around the people's needs, across administrative the next block would supply a whole gamut of boundaries, and expanded to fill the satisfactions. present deficiencies. So you see why I say when I talk about housing At the State and county level: I am talking about a lotmore than buildings. I am talking about &esthetics and about how door- Funding programs must be dertloped. knobs work; about society's responsibilitiesto the Tax inequities must be eliminated. elderly and about the values itcan find in them; Reluctant communities must be prodded. about a workable house plan and about how Local jurisdictions must be educated to their neighborhoods and citiesare put together. This responsibilities. They must be encouraged and is what I mean by housing in the largestsense enabled to shoulder these responsibilities will- and to be satisfied with part of the package and ingly. not the whole is to settle for something less than At the local community level: housing. The needs must be documents;;. So what is to be done? Housing sponsors must be found, ak1, and in- spired to act In general: Services must be inventoried. Agencies and volunteer organizations must be First, we must develop this overall view of what helped to cooperate and to innovate where needs the housing needs of the elderlyall elderly are not being met. are. We must not concentrate on one segment Local responsibilities must be recognized as well of the elderly population and be blindto others. as those that are State and Federal. We must spell out the basic human needs of all elderly. And then wecan identify what elements In summary: are missing and where. We must delineate the We must reveal the whole picture; we must whole picture. tell the whole need; and we must not becontent Next we must take a look at what has been to discuss half-measures or be put off with crumbs done and test it againstour criteria for the total from the tablesuch as reduced-rate movies, need. This will showup the gaps, and perhaps reduced bus fare, reduced real estate taxes for indicate how they can be filled, and by whom. elderly homeowners, but no help for elderly renters. Then we must let whoever that is know about it. Good housing is primary to the good life. Aspiring to the good life for our people will be We must take a look at how existingprograms fruitless unless the full significance of housing is for housing have been constructed. I thinkwe understood. And there is no part of the popula- will find that up to nowprograms have been tion that would benefit more from a comprehen- conceived and put together to fit the convenience sive, fully knowledgeable attack on the present and procedures of specific existing agencies and deficiencies of housing than the elderly. It could administrative jurisdictions. Letus now insist that remake their lives and remake our society.

31 Preamble needs. Recipients having incomes abovean established minimum level shall pay for benefitson a A national policy on housing for the elderly sliding scale related to their income. worthy of this Nation must enjoy a high priority and must embrace not only shelter, but needed services of quality that extend the span of inde- RECOMMENDATION III pendent living in comfort and dignity, in and outside of institutions, as a right wherever the Housing Production Basedon Need elderly live or choose to live. The Federal Government shall ensure that State, Of particular concern and priority are the poor, regional, and local governments and private non- the minority -groups, the disabled, and the aged profit groups produce suitable housing for the located in isolated rural areas. elderly on the basis of documented need. The Federal Government shall encourage production Availability of housing in great variety is im- through the uniform application and use ofap,, perative. Such housing should respond to health propriate incentives. and income needs and provide a choice of living arrangements. It should include sales and rental housing, new and rehabilitated housing, large RECOMMENDATION IV and small concentrations. It should be produced by public agencies and by private profit and non- Variety of flowing with Related Services profit sponsors, with incentives to encourage such A variety of living arrangements shall be made housing in all communities. available to meet changing needs of the elderly. Funds to support a massive and varied housing Such arrangements shallincluderesidentially program and mechanisms forassuring appro- oriented settings for those who need different priate services are imperative to the well-being of levels of assistance in daily living. The range the elderly of this Nation. A decent and safe liv- shall include long-term care facilities for the sick; ing environment is an inherent right of all elderly facilities with limited medical, food and home- citizens.It should become an actualityat the maker services; congregate housing with food and earliest possible time. personal services and housing for independent living and recreational and activity programs.

RECOMMENDATION V Recommendations Supportive and Outreach Services RECOMMENDATION I Supportive services are essential in the total com- Earmarked Funds for Elderly Housing munity and in congregate housing. Emphasis shall be given to providing more congregate hous- A fixed proportion of all government funds ing for the elderly, which shall include the serv- Federal, State, and localallocated to housing ices needed by residents and provide outreach and related services, shall be earmarked for hous- services to the elderly living in adjacent neigh- ing for the elderly, with a minimum production borhoods when needed to help older people re- of 120,000 units per year. main in their own homes.

RECOMMENDATION II RECOMMENDATION VI New Eligibility Criterion Property Tax Relief Eligibility for the benefits of publicly assisted low The State or Federal Government shall provide and moderate income housing and related serv- mechanisms to make possible local property tax ices shall be based on economic, social and health relief for the elderly homeowner and renter.

32 RECOMMENDATION VII preservation of neighborhoods of special character Elimination of Procedural Delays through rehabilitation, and selective replacement of substandard dwellings with new dwellings, Every effort shall. be made to.eliminate red tape with full provision for the elderly of thearea to and procedural delay in the production of housing remain in their familiar environment. for the elderly. RECOMMENDATION XIV RECOMMENDATION VIII Direct Loan Housing Program Allocation of Housing to Minority Groups Housing funds now impounded by the Admin- Particular attention shall be given to the needs istration should be released and the highly effec- of all minority groups and the hardcore poor tive Section 202 of the Housing Act with its elderly. At least 25 percent 'of the elderly housing special guidelines related to space, design, con- shall be for the hardcore poor elderly, those with struction, and particularly favorable financing, incomes at the poverty level or less per year. restored. RECOMMENDATION IX New Section 202 projects should be established by recirculating monies now being sent to the Multidisciplinary Review Teams United States Treasury from mortgage payments All Federal agencies dealing with housing for the and Section 202 conversions to Section 236 or like elderly 'shall be required to establish multidiscip- programs. Such conversions of current Section linary teams to formulate guidelines for achitec- 202's should be encouraged by establishing in- tural standards based on the needs of the elderly. centives. The multidisciplinary teamsshallalsohave The Senior Housing Loan Section 202 admin- authority to review and approve innovative pro- istrative component of the Department of Hous- posals. ing and Urban Development should have man- a Bement audit responsibility for all Section 202 RECOMMENDATION X projects and all Section 236 elderly projects. Development of Housing by Minority Groups RECOMMENDATION XV Minority nonprofit groups shall be encouraged Rent Supplement and assisted in developing housing for the elderly. The rent supplement program shall be increased RECOMMENDATION XI in dollars and eligibility. Relocation and Replacement RECOMMENDATION XVI When housing units for the elderly are eliminated for any reason, adequate replacement units must Housing and Related Services be available and relocation programs provided Financial incentives shall be available to families before such persons are displaced. providing housing and related care in their own 1 homes, or in appropriate accommodations, for RECOMMENDATION XII their elderly relatives. New Definition of Family Needed Congress should revise the definition of a family RECOMMENDATION XVII in the National Housing Act to include single Property Tax Exemption persons 55. and over. for Non-Profit Housing Sponsors RECOMMENDATION XIII The Federal Government shall provide financial incentives to State and local governments to en- Preservation of Neighborhoods courage property tax exemption of voluntary, The Federal Government shall encourage the nonprofit sponsored elderly housing projects.

33 RECOMMENDATION XXIII tive programs to meet the unique needs of rural Assistance for Home Maintenance elderly Americans, including those on Indian reservations. The inability of the elderly to financially maintain their homes because of high maintenance cost and RECOMMENDATION XXIV increasing taxes resulted in the recommendation that interest-free, nonamortized loans be made Housing Standards available, the amount of the loan to be related to Standards for physical and environmental secur- income, with repayment either upon the death of ity should be developed and applied as an inte- the borrower or the transfer of the property. gral and basic element of all housing projects As an additional element of national policy, it is serving the elderly. proposed that ways or mechanisms be researched to enable older homeowners to voluntarily utilize RECOMMENDATION XXV the equities in their homes to increase their dis- Housing Research and Training cretionary income while remaining in their own homes. Competent service to the elderly in housing requires sound research widely disseminated and utilized, covering many aspects of their living RECOMMENDATIONS XIX, XX, XXI arrangements. Such research shall be undertaken Government Organization for Housing to cover the health, physical, psychological, and social aspects of environment in urban and rural (XIX) Congressional action shall be taken to areas; to delineate the needs of elderly over 80 establish within the Department of Housing and years of age; to determine the needs of transient Urban Development an Office of Assistant Sec- elderly; to establish the importance of selecting retary of Housing for Elderly. This office shall appropriate locations; and to provide safe and have statutory authority and adequate funding a- adequateconstruction.Particularattentionis provide overall direction toward the implementa- directed to the consequences to vulnerable older tion of a national policy and the production of people of improper sales methods and inadequate housing for the elderly. housing arrangements. There also shall be under- (XX) Executive action shall be taken to create taken a well-conceived and well-financed program an Executive Office on Aging within the Office of of training for professional and semiprofessional the President. staff to develop efficient and competent management in developments for the elderly. (XXI) Congressional action shall be taken to create a Special Committee on Aging in the House of Representatives. SECTION LEADERSHIP RECOMMENDATION XXII Space will permit listing of title and ad- Protection for Elderly Homeowner dress only the first time a name appears. The Congress shall enact legislation to safeguard the elderly property owner or purchaser from The Technical Committee unscrupulous real estate developers and/or pro- for Housing moters. Chairman Noverre Musson, F.A.I.A., Tibbais, Crumley, and Musson Architezts, Columbus, Ohio RECOMMENDATION XXIII Members Housing for Rural and Indian Elderly Alice M. Brophy, Director, New York Office for the A-in :. New York, N. Y. The Congress shall enact legislation providing Robert Cummings, Housing Consultant, Pasadena, California special funds for adequate housing and suppor- John W. DeVore, Internist, Oklahoma C ty, Oklahoma

34 Louis E. Gelwicks, FellowinArchitecture, Institutefor Environmental Management, Public Health Service,Depart- Study of Retirement and Aging, Universityof Southern ment of Health, Education, and Welfare, Washington, D. C. California, Los Angeles, California Louis D. Malotsky, Director, Rural Housing Loan Division, Hobart C. Jackson, Administrator, Stephen Smith Home, Farmers Home Administration, Department ofAgriculture, Philadelphia, Pennsylvania Washington, D. C. M. Powell Lawton, Research Psychologist, Philadelphia Geri- George I. Mishtowt, Deputy Assistant Secretary forMedical atric Center, Philade:phia, Pennsylvania Services, Department of State, Washington, D. C. Warren T. Lindquist, Rockefeller r.nd Associates, New York, Robert E. Ryan, Chief, Statistical Unit, Office of N.Y. Data Systems . . and Statistics, Department of Housing and Urban Development, Everett B. Luther, Administrator, The Beatitudes Retirement Washington, D. C. Home, Phoenix, Arizona Lewis I. Schwartz, Deputy Director, Office of DataSystems John Y. Maeno, Attorney-at-Law, Los Angelos, California and Statistics, Department of Housing and UrbanDevelop- ment, Washington, D. C. Ethyl H. Venson, Vicc Chairman, Board of Commissioners, Memphis Housing Authority, Memphis, Tennessee Leonard Shaw, RecreationMarket Analyst,Divisionof Technical Assistance, Bureau of Outdoor Recreation,Depart- Joseph D. Weiss, Architect, Weiss Whelan Edelbaum Web- ment of Interior, Washington, D. C. ster, New York, N.Y. Candace Sullivan, Housing Specialist, Office ofProgram De- Leon N. Wiener, Builder, Leon N. Weiner Associates, Wil- velopment,OfficeofEconomic Opportunity, Washington, mington, Delaware D. C. Arthur F. Young, Chief, Housing Division,Bureau of the The Secretariat Census, Department of Commerce, Washington, D.C. Director Marie McGuire, Program Advisor, Problems of the Elderly Section Officers and Handicapped, Department of Housing and Urban De- Co-Chairmen velopment, Washington, D. C. Abraham J. Isserman, Consultanton Housing Programs, New Members York, New York, and Noverre Musson Kathaleen C. Arneson, Special Assistant to the Commissioner, Consultant Rehabilitation Services Administration, Social and Rehabilita- tion Service, Department of Health, Education, and Welfare, Herbert Shore, Executive Director, Golden Acres,Dallas, Washington, D. C. Home and Hospital for the Aged, Dallas, Texas Ronald Bird, Chief, Community and Facilities Branch, Eco- Recorder nomic Research Service, Department of Agriculture, Wash- ington, D. C. John D. Lange, Retired Executive Director, NationalAsso- ciation of Housing and Redevelopment Officials, Alexandria, Paul Conn, Multiple Housing Loan Officer, Rural Housing Virginia Loan Division Farmers, Home Administration, Department of Agriculture, Washington, D. C. Assistant Recorder Wesley Davies, Member Administrator's Advisory Council, Harold Geldon, Associate Regional Commissioner forAging, Veterans Administration, Washington, D. C. Social and Rehabilitation Service U.S. Department of Health, Education, and Welfare, Dallas, Texas Mary Fairbanks, Stag Assistant, Housing forthe Elderly and Handicapped, Department of Housing and Urban De- Management Officer velopment, Washington, D. C. Marie C. McGuire Perry J. Fliakas, Director for Housing Programs, Department of Defense, Washington, D. C. Leslie N. Gay, Jr., Chief, Branch of Tribal Government, Subsection Officers Bureau of Indian Affairs, Department of Interior, Washington, Subsection I D. C. Chairman A. Robert Granakis, Special Assistant to the Director, Office ofSystemsSupport,TrainingandEmploymentService, John W. Devore Department of Labor, Washington, D. C. Vice Chairman Enid C.Hairston,Housing ServicesProgramSpecialist, Special Unitfor Housing and Community Improvement, John A. Jackson, Executive Director, Stovall Foundationand Community Services Administration, Social and Rehabilitation Stovall Development Corporation, Los Angeles, California Service,DepartmentofHealth,Education, andWelfare, Recorder Washington, D. C. Thomas A. Hannigan, Director of Research andEducation, William D. Hughes, Chief,ElderlyHousingAssistance International Brotherhood of Electrical Workers, Washington, Branch,FederalHousingAdministration,Departmentof D. C. Housing and Urban Development, Washington, D. C. John Hutchinson, Program Analyst, Older Persons Program, Subsection 2 Office of Economy Opportunity, Washington, D. C. Chairman Morton H. Leeds, Deputy Director, Office of Program De- Robert B. Cummings velopment, Department of Housing and Urban Development, Washington, D. C. Vice Chairman Dorothy Taylor, Director, Special Home ServicesProgram William Loring, Research Director, Bureau of Community of the Episcopal Church Homes, Pittsburgh, Pennsylvania

35 Recorder Recorder Gary Stay, Assail* Superintendent, PresbyterianMedical Center, Denver, Colorado E. Russell Jackson, Health Program Specialist, State Depart- ment of Health and RehabilitationServices,Jacksonville, Subsection 3 Florida Chair: tan Subsection 9 Margaret Faye, Executive,Kauai County Committee on Chairman Aging, Lihue, Kauai, Hawaii Hugh W. Gaston, Architect and Chairman, Georgia Commis- Vice Chairman sion on Aging, Albany, Georgia John Lindoerfer, Housing Consultant, Division on Aging, Madison, Wisconsin Vice Chairman Recorder Gwendolyn Kingsland, Member of the Board of Directors, State Council of Churches, Syracuse, New York Louis Gelwicks C Subsection 4 Recorder Chairman Olin J. Mason, Home Administrator, Florida Brethren Homes, Inc., Sebring, Florida Herbert Shore Vice Chairman Edith B. King, Planning Associate, HWA of Allegheny Coun- ty, Pittsburgh, Pennsylvania Federal Resource Personnel Recoider C G. GOMIlli00, Professor Emeritus, TuskegeeInstitute, Kathaleen C Arneson Tuskegee, Alabama Ronald Bird Subsection S Wester Davies Chairman Jesse L. Dickinson, Executive Director, Housing Authority, Mary Fairbanks South Bend, Indiana Leslie N. Gay, Jr. Vice Chairman Moses J. Gozonsky, Housing Specialist, Multifamily Housing Assistance Branch, Department of Housing and Urban De- Lawrence B. Wilson, Director, Urban Affairs, Los Angeles, velopment, Washington, D. C. California Recorder William D. Hughes Everett Luther John Hutchinson William Laughlin, Staff, Senate Committee on Aging, Wash- Subsections 6 ington, D. C Chairman Morton IL Leeds Julia S. Zozaye, National Vice-President, League of United Latin American Citizens, Phoenix, Arizona Tenn Lumtkins, Housing Specialist, Office of Economic Op- portunity, Washington, D. C. Vice Chairman Louis bialotaky Gerald B. Kinney, Directoi, Methodist Conference Home, Rockland, Maine Sharon B. Mizell, Program Administrative Assistant, Elderly Housing Assistance Branch, Department of Housing and Ur- Recorder ban Develoment, Washington, D. C Archille Alhoure, Personnel Consultant, Sacramento, Cali. Ashot Mnatralusnian, Architectural Consultant, Division of fornia Develomental Disability, Rehabilitation Services Administra- tion, Social and Rehabilitation Service, Deartment of Health, Subsection 7 Education, and Welfare, Washington, D. C. Chairman James F. Neville, Assistant Administrator, Rural Housing, Leah Rose Werthan, President, Board of Trustees, Knowles Department of Agriculture, Washington, D. C. Senior Citizens Center, Nashville, Tennessee . Vincent Piper, Housing Management Specialist, Office of Field Support, Department of Housing and Urban Development, Vice Chairman Washington, D. C Aaron E. Henry, Pharmacist, Clarksdale, Mississippi Philip E. Ryan, Senior Housing Specialist, Department of Recorder Housing and Urban Development, Washington, D. C. Reverend Monsignor Michael B. Ivanko, Pastor,Sacred Robert E. Ryan, Chief, Statistical Unit, Office of Data Sys- Heart Parish, Oberlin, Ohio tems and Statistics, Departmtnt of Housing and Urban De- velopment, Washington, D. C. Subsection 8 Chairman Lewis L Schwartz Stephen May, Mayor, Rochester, New York Leonard Shaw, Recreation Market Analyst, Department of the Interior, Washington, D. C. Vice Chairman Roger Waller, Deputy Chief, Elderly HousingAssistance Mrs. C. A. Banks, Associate Professor, Department of Home Branch, Department of Housing and Urban Development, Economics, Indiana State University, Terre Haute, Indiana Washington, D. C. 36 SECTION ON INCOME

INTRODUCTION mendations, 'addressed to such vital policy mat- here were 304 Delegates named to the ters as ensuring the elderly adequate and secure Income Section. Information available income, funding of the Social Security system, re- for some 287 of theie indicate that 30 forms in private and public pension plans, financ- percent were retired. Almost one-fifth ing of health care for the aging, property tax were members of one of the minority groups. relief, and changes in the Social Security retirement test. Action along these lines will not only The Delegates to the Section on Incomerep- significantly advance the material welfare of older resented a broad range of interests andorganiza- people, but will also help to overcome the sense tions. National aged membership groups and of isolation, anxiety, and deprivation felt bymany other organizations, both governmental andnon- of the elderly. governmental, directly serving the elderly at State and local levels ranked highest in numbers of Delegates. Also strongly representedwere labor SECTION REPORT unions, insurance and other business companies, Preamble religious and lay, social and health servicegroups, There is no substitute for income 'if people are agricultural and rural organizations, and theaca- to be free to exercise choices in their style of demic community. A partial list of thetypes of living. professional andtechnical personnelincludes The income of elderly people in thepast left economists, accountants, bankers, union andman- the greater number of them with insufficient agement officers, legislative and executive officials, means for decent, dignified living. During the community project directors, lawyers, social work- Sixties, the elderly as a whole enjoyed improve- ers, and financial and other consultants. ments through greater employment opportunities Throughout its deliberations, the Sectionon and better old age security and other public and Income thus had the benefit ofa diverse, knowl- private benefits. The last two years have witnessed edgeable, and experienced setof participants. the reversal of these trends toward improvement Guided by the preferences expressed first-hand by as inflation continued to erode the purchasing older and retired personsamong the Delegate power of fixed incomes, and rising unemployment body, the Section's recommendations also reflect reduced job opportunities for older workers. The the desires and thinking initiated in the State and economic situation of the elderly, if past experi- local White House Conferenceson Aging, the ence is repeated, will improve more slowly than earlier Older American Forums, and National that of younger groups even with an upturn in Organization Task Forces. the national economy. Immediate action to increase the income of the elderly is urgent and Altogether, the Section approved 12recom- imperative. 37 t. Recommendations Elimination of thetest would cost an additional $3 billion, and thereare more urgent needs to RECOMMENDATION I which this sum could be applied Income Adequacy than paying benefits to persons whoare still employed at more than the exempt levels. The immediate goal for olderpeople is that they should have total cashincome in accordance with the "American standard ofliving." We, therefore, RECOMMENDATION IV recommend the adoption now, as the)inimum Widow's Benefits standard of income adequacy,of the intermediate budget foran elderly couple pre1 ared by the Increasing numbers ofwomen without dependent Bureau of Labor Statistics(nationally averaging children who havenot been regularly employed about $4,500a year in Spring 1970). This level are becoming widowed beforeage 60. We recom- must be adjusted annually for changesin both mend that they be eligibleto receive widow's the cost of living and risingnational standards of benefits starting atage 50 to help fill the income living. For single individualsthe minimuman- gap until they are eligible at the laterage to re- rual total income should besufficient to maintain ceive their Social Security benefit. the same standard of livingas for couples (not less than 75percent of the couple's budget). For RECOMMENDATION V the elderly handicapped,with higher livingex- penses, the budget should be appropriatelyad- "Special Age-72" Benefits justed. Certain residents of theCommonwealth of Puerto RECOMMENDATION II Rico, Samoa, the Virgin Islands,and Guam are presently excluded from special Providing a Floor of Income benefits which are otherwise applicableto persons over the age of vs The basic floor of incomefor older people should 72 who reside in the UnitedStates. be provided througha combination of payments We recommend that the 1965amendments to the from the Social Securitysystem and payments Social Security Act, providingfor special benefits from general taxrevenues. to all persons 72 years of age and oldernot other- This proposal would retainthe basic features of wise receiving benefits, beapplied without dis- the Social Securityprogram. In addition, there crimination to all residents ofPuerto Rico and the territories and possessions of should be a supplementarypayment system based the United States. on an income test to bring incomesup to the minimum, financed entirely fromFederal Gov- RECOMMENDATION VI ernment general revenues and includedin a single Disadvantaged Groups under SocialSecurity check from the Social SecurityAdministration. Studies should be madeto determine whether RECOMMENDATION III there are disadvantagedgroups within the popula- Liberalizing the RetirementTest tion whose age ac retirement,or benefits under the Social Securitysystem, may be inequitable Many older persons workin order to supplement because of shorter life their retirement income. The expectancy due to social exempt amount of and economic conditionsor racial discrimination. earnings under the SocialSecurity retirementtc',t should be increasedto not less than $3,000 ayear (adjusted periodicallyto char.; es in the general RECOMMENDATION VII level of wages). Financing Social Security The offset forMula of $1reduction in benefits for each $2 of earning should The financing of the SocialSecurity system should apply to all earnings include a contribution from in excess of theexempt amount. general revenues. The whole structure of payrolltaxes should be re- I 38 viewed to lightenthis burden on low-income ployers and individuals. There should beno workers. deductibles, co-payments, or co-insurance. Until such a system is established, the benefits of RECOMMENDATION VIII Medicare-Medicaid should be increased immedi- Private Pensions ately to include, at a minimum, out-of-hospital drugs, care of the eyes, ears, teeth, and feet, (in- Social Security benefits provide a basic protection cluding eyeglasses, hearing-aids, dentures, etc.), which should continue to be improved but which and improved services for long-term care, and can be augmented through private pension plans. expanded and broadened services in the home and The Federal Government should take action to other alternatives to institutional care. Here, too, encourage broader coverage under private pension there should be no deductibles, co- payments, or plans and ensure receipt of benefits LI workers co-insurance. and their survivors. It should require early vesting Government should assume responsibilityfor and/or portability, survivor benefits, and com- assuring an adequate supply of health manpower plete disclosure to beneficiaries of eligibility and and essential facilities and for improving theor- benefit provisions of the plans. In addition, Fed- ganization and deEvery of health services. eral requirements should assure fiduciary responsibility, minimum funding requirements and pro- RECOMMENDATION XI tection, through reinsurance and other measures, of the promised benefits. U.S. House of Representatives Special Commitke on Aging RECOMMENDATION IX We support the establishment of a specialcom- Remission of Property Taxes mittee of the House of Representatives which will It is desirable that older persons be enabled to devote its attention to all social and economic problems of the aged, including income, health, live in their homes. States and localities should be encouraged to remit part or all of the resi- housing, and other needs areas reflected in the dential property taxes on housing occupied by organization of this Conference. older persons as owners or tenants who qualify on the basis of an appropriate measure of income RECOMMENDATION XII and assets. Remission is to be achieved by Federal Reordering National Priorities and State grant programs to State and local taxing authorities to compensate for reduced reve- Our Nation has the resources to effectivelycarry nues. out the proposals made by this Section provided there is a reordering of national priorities. RECOMMENDATION X National Health Security Program This Nation can never attain a reasonable goal SECTION LEADERSHIP Space will permit listing of title and ad- of income security so long as heavy and unpre- dress only the first time a name appears. dictable health costs threaten incomes of the aged. Priority consideration should be given to the estab- The Technical Committee lishment of a comprehensive national health se- for Income curity program which would include the aged as Chairman _ well as the rest of the population. Financing the Roger F. Murray, S. Sloan Colt Professor of Banking and Finance, Graduate School of Business, Columbia University, program solely through wage and payroll taxes New York, New York and contributions from Federal general revenues Consultant would ensure that health care expenses would be Solomon Barkin, Professor of Economics, University of Massa- a shared responsibility of the government, em- chusetts, Amherst, Massachusetts

39 Members Recorder Theodore M. Alexander, Sr., President, Alexander and Corn- Carter C. Osterbind, Chairman, Institute of Gerontology, pany. General Insurance Agency, Atlanta. Georgia University of Florida, Gainesville, Florida Solomon J. Axelrod, Professor of Medical Care Organiza- Assistant Recorder tion, School of Public Health, The University of Michigan. Ann Arbor, Michigan Clinton Hess, Associate Regional Commissioner for Aging, Social and Rehabilitation Service, Department of Health, Edu- H. Robert Bartell, Jr., Commissioner of Banks and Trust cation, and Welfare, Denver, Colorado Companies, State of Illinois, Chicago, Illinois Management Officer W. Rankin Furey, Board Member, Berkshire Life Insurance Company, Pittsfield, Massachusetts Patience Lauriat August B. Garner, Budget Analyst, Wright-PattersonAir Force Base, Xenia, Ohio Subsection Officers Sidney Goldstein, Professor, Department of Sociology, Brown University, Providence, Rhode Islas Subsection 1 Orville F. Grahame, Chairman of the Law Committee, Paul Chairman Revere Corporation, Worcester, Massachusetts Wilbur J. Cohen, Dean, School of Education, University of Edwin S. Hewitt, President, Hewitt Associates, Libertyville, Michigan, Ann Arbor, Michigan Illinois Vice Chairman George E. Johnson, Consultant, Variable Annuities, Gaithers- Thomas S. Quinn, President, Community Council, Cornwall, burg, Maryland Pennsylvania Walter E.Klint,Director, Employee BenefitPrograms, Recorder Continental Can Comr.uy, Inc., New York, New York Eleanor W. Griffins, Director, SeniorOpportunities and Juanita M. Kreps, Professor of Economics and Dean, The Services, Community Aftion Agency, Inc., Salem, Oregon Women's College, Duke University, Durham, North Carolina Ben Seidman, Director, SocialSecurity Department, AFL- Subsection 2 CIO, Washington, D. C. Chairman Tsutomu Uchida, Partner, EquiVestAssociates,Pasadena, Sally Ybarra Din:mar, Field Office Coordinator, Nebraska California Panhandle Community Actions Agency, Gering, Nebraska Vice Chairman Ben W. Lindsay, Governor's Assistant, Austin, Texas Recorder The Secretariat H. Robert Bartell, Jr. Subsection 3 Directors Patience Lauriat, Acting Director, Division on Retirement Chairman and Survivors Studies, Office of Research and Statistics, Social Solomon Bstrkin SecurityAdministration, Department of Health, Education, Vice Chairman and Welfare, Washington, D. C. Fannie Jefferson, President of Senior Citizens Clubs, Wash- Elizabeth G. Sanders, Director, Division of Retirement and ingtonPennsylvania Survivors Benefits, Office of Program Evaluation and Plan- ning, Social Security Administration, Department of Health, Recorder Education, and Welfare, Washington, D. C. Julia W. Harris, President, Coordinating Council for Senior Citizens, Durham, North Carolina Members Subsection 4 Helen Lama le, Chief, Division of Living Condition Studies, Bureau of Labor Statistics, Department of Labor, Washington. Frank J: Manning, President, Legislative Council for Older D. C. Americans, Inc., Boston, Massachusetts Helen Nicol, EconomLt, Division of IntramuralResearch. Vice Chairman Social and RehabilitationService, Department of Health, Mary E. Titus, Retired Teacher, Huntington, West Virginia Education, and Welfare, Washington, D. C. Recorder Marie Bradley, Director, Butte-Silver Bow County Senior Citizens Activity Center, Butte, Montana Subsection 5 Section Officers Chairman Jeweldean Londa, AssociateDirectorofSocialWelfare, Co-Chairmen National Urban League, Inc., New York, New York Eve line M. Burns, Professor Emeritus, Columbia University, Vice Chairman and Consultant Economist, Community Service Society, New William L Brock, Attorney, Norman, Oklahoma York, New York and Roger F. Murray Recorder Consultant Beatrice C. Schiffman, Regional Representative, the National Solomon J. Barkin Council on the Aging, Inc., San Francisco, California

41 Alfred M. Skolnik, Chief, Interprogram Studies, Division Research and Statistics, Social Security Administration, De- of Economics and Long-Range Studies, Office of Research and partment of Health, Education, and Welfare, Washington, Statistics,SocialSecurityAdministration,Department Of D. C. Health, Education, and Welfare, Washington, D. C. Saul Waldman, Social Insurance Research Analyst, Division John A. Snee, Legislative Reference Officer, Office of Pro- of Health Insurance Studies, Office of Research and Statistics, gram Evaluation and Planning, Social Security Administration, Social Security Administration, Department of Health, Edu- Department of Health, Education, and Welfare, Baltimore, Maryland cation, and Welfare, Washington, D. C. Joseph Zisman, Statistician, Bureau of Retirement and In- Tom G. Staples, Social Insurance Research Advisor, Office of surance, Civil Service Commission, Washington, D. C. Research and Statistics, Social Security Administration, De- partment ofHealth, Education, and Welfare, Washington, Carol Zuckert, Social Science Research Analyst, Division of D. C. Retirement and SurvivorStudies,Officeof Research and Statistics,SocialSecurityAdministration,Departmentof Marilyn Thomas, Writer-Editor, Publication Staff, Office of Health, Education, and Welfare, Washington, D. C.

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42 SECTION ON NUTRITION

INTRODUCTION The Section produced six recommendations of he first White House Conferenceon several parts-each calling for action which would Aging in 1961 devotedone recom- meet the nutrition and related health needs of mendation of five words to "nutrition." elderly people. The Delegates clearly pointedout Itstatedthat"Nutritionprograms the need for societythrough concerted action by should be established." And taken broadly,that Federal, State, and local governmentsto make recommendation was implemented, because dur- more efficient use of existing programs and to ing the ensuing decade the foodstamp and food develop new ones in providing better servicesto distribution programs became widely available the aging. to the poor elderly. However, theseprograms The Delegates also stressed theurgency for were inadequate in meeting the needs of special increasing the range of facilities and servicesto or unique groups of the elderlythe shut-ins, serve the entire segment of the elderly population, the very poor, the disabled, the lonelyisolates, thus underscoring the recommendations of the and those with ethnic food preferences. By1971 1969 White House Conferenceon Food, Nutri- the situation was critical. With 20percent too tion, and Health, and the need for the legislation poor to 'buy the necessities of life including nutri- being considered by Congressat that moment tious food, it was imperative that nutrition be which would establish a far-reaching nutritional' accorded the importance of beingone of the 14 program for the elderly. - subject-areas of the second White House Con- ference on Aging. SECTION REPORT There were 127 Delegates namedto the Nutri- tion Section. The group was composed ofa rep- Preamble resentative number of professional and layper- We take it for granted that all older Ameri- sons from most of the States and Territories and cans should be provided with the means to insure from variousnational organizations.Minority that they, too, can enjoy life, liberty, and the persons constituted approximately one-fifth of the pursuit of happiness. Adequate nutrition is ob- Delegates to the Section. viously basic to the enjoyment of these rights. Among the participants were practicing nutri- Food is more than a source of essential nutri- tionists and dieticians, nutrition researchers and entit can be an enjoyable interlude inan other- teachers, physicians, public health personnel,ex- wise drab existence. Thus, provision should be tension specialists, food specialists, homeecono- made to meet the socialas well as the nutritional mists, State agency executives, legislators, direc- needs of older people. A factor that adds dignity tors of senior citizens centers and activities, and and significance to the life of the aged is the feel- elderly persons themselves. ing that they,too,are useful and important. 43

468.218 0 73 4 Assistance should be provided to make possible RECOMMENDATION II preparation of meals for themselves and others. Standards for Food Community meals, however, should bean alternative. Volunteer groups can be involved in such and Nutrition Services services as transportation, shopping, and distribu- The Federal Government should establishand tion of hot meals. Young people should beenmore strictly enforce high standards with specific couraged to participate in these services andto regulations for the food and nutrition services join the elderly in meals. provided by institutions and home-care agenciesthat All nutrition programs should be supplemented receive any direct or indirect Federal funds,re- by appropriate educationalmeasures. Older people quire a high level of performance fromState should be protected from food quackery andun- government enforcementagencies,and when founded nutritionalclaims. Lack of research, necessary, provide financial assistance to bring evaluation and communication leadsto failure of non-profit organizationsup to standard. These otherwise good programs and to the perpetuation standards should include such importantareas as of poor programs. The search formore efficient quality and nutritive value of food, methods of and better means of providing for the good nutri- handling, preparing and serving foods, the special tion, health, and happiness of older people should dietary needs of individuals, and the availability be a continuous process. of and accessibility to nutritional counseling. All recommendations regarding the nutrition Itis recommended that nutrition services and of aging Americans should clearly include the nutrition counseling be a requiredcomponent of elderly in small towns, rural and isolatedareas, all health delivery systems, including such plans and the elderly in minoritygroups. Special cog- as Medicare, Medicaid, health maintenance or- nizance must be taken of the long neglected needs ganizations, home health services, extendedcare of older Indians and other non-English speaking facilities, and preventionprograms. groups. RECOMMENDATION III Consumer Education in Nutrition Recommendations Governmentresourcesallocatedtonutrition should be concentrated on providing food assist- RECOMMENDATION I ance to those in need. However, a significant por- Funding Programs and Research tion of these resources should be designated for nutrition education of all consumers, especially It is recommended that the Federal Government the aged, and to the education by qualified nutri- allocate the major portion of funds for action tionists of those who serve theconsumer, includ- programs to rehabilitate the malnourished aged ing teachers in elementary and secondary schools, and to prevent malnutritionamong those approaching old doctors, dentists, nurses, and other health workers. age. However, adequate funds This can be accomplished immediately by increas- should be allocated for a major effort in research ing personnel and funds in existing agencies and on the influence of nutrition on the aging process institutions. and diseases during old age in order to givemean- ing and impact to the actionprograms. Appro- priate research findings must be made available RECOMMENDATION IV to all action programs. Food Services in Elderly Housing Projects Since approximately one-half to one-third of the Federal Government policy must offer the older health problems of the elderlyare believed to be person a variety of options for meals, but should 'related to nutrition, we recommend that pilot stress the favorable psychological values and the programs be set up for evaluation of the nutri- economies inherent in group feeding. The policy tional status of the elderly. should require all Federally assisted housing de-

44 velopments to include services or to insure that couraged and facilitated by providing the first services are available for the feeding of elderly food stamp allotment without costto the recipi- residents and for elderly persons to whom the ent, by permitting more frequent purchases and development is accessible. Where a meal is pro- by distributing stamps at senior citizencenters. vided, it should meet at least 1/3 of the nutrient The approximately 1,000 counties in the needs of the individual. The policy should also United States still using the commodity program require the provision of facilities (including trans- must switch by December 31, 1972, to the food portation) for food purchase and meal preparation stamp program for the individual feeding of the within each household of the development. In elderly. Until this is accomplished, the Federal addition, Federal policy should encourage and donated food should be made nutritionally appro- support community agencies to provide facilities priate, in packages of suitable size, and at readily and services for food purchase, meal preparation, accessible places. and home-delivered meals (often called Meals-on- Wheels) for eligible persons living outside hous- B.It is recommended that the equivalent ofa ing developments or in isolated areas. National School Lunch Program be established for senior citizens, not be limitedto school facili- RECOMMENDATION V ties or to low income persons. Basic components of the program should be: Elimination of Hunger and Malnutrition All United States Department of Agriculture It is recommended that the Federal Government commodities should-be fully-available on the same assume the responsibility for making adequate basis as the school lunch program. nutrition available to all elderly persons of the Funding should provide for adequate staff, United States and its possessions. food supplies, equipment. and transportation. A.Minimum adequate income (at least $3,000 Elderly people should be employed insofar per single person and $4,500 per couple) must as pOssible. be made available to all elderly. Until money Auxiliary services should be built in, includ- payments are increased above the minimum level, ing recreational and counseling programs. existing food programs should be strengthened, including nutrition education, to meet the needs C.It is recommended that nutrition specialists al- of the elderly. Therefore, it is recommended that: ready in the field direct the recruitment of volun- I- n addition to store purchases of food, food teers and/or paid part-time aides from among the stamps be used for the purchase of meals in par- elderly and train them to teach sound nutritional ticipating restaurants,schoolsand community practices to older people in groups and in their settings, and any approved home delivery systems. homes. Qualified social workers should be utilized in getting client acceptance of the services being The food stamp program must be-structured made available. to conform to the United States Department of Agriculture low-cost food plan at no increase in the cost of food stamps to the recipient. RECOMMENDATION VI A- s long as low income Social Security recipients are on fixed incomes, they should be Responsibility for Food Safety eligible for self-certification for food stamps and/ and Wholesomeness or public assistance cash grants. The responsibility for producing quality food Food stamp applications should be mailed rests with the food industry. However, it is the with Social Security checks and stamps sent to responsibility of the Federal Government to estab- older persons through the mail or by some other lish and enforce such standards as are necessary efficient,practicalanddignifieddistribution to insure the safety and wholesomeness of our method. national food supply, as well as improve nutri- The purchase of food stamps should be en- tive value. To do this requires more personnel and

45 funding. State requirements thatmeet or exceed Members Federal standards must be established, imple- Patsy Graves, Family Service Specialist, Division of Farmers Home Administration, Department of Agriculture, Washing. mented and monitored with Federalsupport. Par- ton, D. C. ticular attention should be given to both nutrient MargaretE.Heap, NutritionConsultant,SocialService and ingredient labeling of food productsas a Branch, St. Elizabeths Hospital, Washington, D. C. means of achieving greater consumer understand- Kathleen E. Lloyd, Medical Officer, Rehabilitation Services Administration, Department of Health, Education, and Wel- ing. An inclusive list of the ingredients inany fare, Washington, D. C. processed food should be made available by the Mary Ann Moss, Head, Nutrition Service Section, Depart- manufacturer to the consumer onrequest. ment of Agriculture, Washington, D. C. Louise Page, Nutrition Analyst, Research Division, Depart- ment of Agriculture, Washington, D. C. Jeannette P. Pelcovits, Nutritionist, AdministrationonAging, Social and Rehabilitation Service, Department of Health, Edu- SECTION LEADERSHIP cation, and Welfare, Washington, D. C. Geraldine Piper, Acting Chief, Allied Health Training Sec- Spa:e will permit listing of title and ad- tion, Division of Allied Health Manpower, Bureau of Health dress only the first time a name appears. Manpower Education, National Institutes of Health, Depart- ment of Health, Education, and Welfare, Washington, D. C. The Technical Committee Gladys Royal, Principal BioChemist, Food Science Programs, Cooperative State Research Service, Department of Agriculture, for Nutrition Washington, D. C Chairman Andromach Sismanidis, Nutrition Consultant, Maternal and Child Health Service, Division of Health Services and_Menral Analcl_n_Watldn,ActingChief,-SpinalCord-iniusy-Cente, Veterans Administration Hospital, West Roxbury, Massachu- Health Administration, Department of Health, Education, and setts Welfare, Rockville, Maryland Consultant Charlotte E. Smith, Nutrition Consultant, Nursing Home Branch, Division of Health Services and Mental Health Ad- Jack Weinberg, Clinical Director, Illinois StatePsychiatric ministration, Department of Health, Education, and Welfare, Institute, Chicago, Illinois Rockville, Maryland Members Dorothy M. Youland, Nutrition Consultant,Divisionof Health Examination Statistics,National Center for Health Tessie Agan, Emeritus Professor of Family Economics, Man- Statistics, Division of Health Services and Mental Health Ad- hattan, Kansas ministration, Department of Health, Education, and Welfare, GeorgeBriggs,ProfessorofNutrition,Departmentof Rockville, Maryland Nutritional Sciences, University of California, Berkeley, Cali- fornia Grace A. Goldsmith, Professor of Medicine, Tulane Univer- Section Officers sity, New Orleans, Louisiana Co-Chairman Adeline M. Hoffman, Professor of Home Economics, Uni- Jean Mayer, Professor of Nutrition, School of Public Health, versity of Iowa, Iowa City, Iowa Harvard University, Boston, Massachusetts - Ruth E. Kocher, Regional Public Health Nutritionist, New Louis Fillios, Professor of Biochemistry, Boston University, York State Department of Health, Buffalo, New York Boston, Massachusetts Vivian F. Lewis, Chairman, Department of Health, Physical Consultant Education, and Recreation, Central State University, Wilber- Jack Weinberg force, Ohio Recorder Donald J. Rosato, Chief, Section of Adult Health andProj- Dena D. Cedarquist, Professor, Department of Food Science ect Supervisor for Preventitest, Department of Public Health. and Human Nutrition, Michigan State University, East Lan- Division of Chronic Disease Control, Philadelphia, Pennsyl- sing, Michigan vania Assistant Recorder Margaret L. Ross, Nutritionist and Professor of Nutrition, Emeritus, Simmons College, Waltham, Massachusetts Verna Due, Associate Regional Commissioner forAging, SocialandRehabilitationService, DepartmentofHealth,' Frederick J. Stare, Professor and Chairman,Department of Education, and Welfare, Chicago, Illinois Nutrition, School of Public Health, Harvard Medical School, Boston, Massachusetts Management Officer Evelyn B. Spindler Annie Zachary, Farm Proprietor, Marvell, Arkansas The Secretariat Subsection Officers Director Subsection 1 Chairman Evelyn B. Spindler, Extension Nutritionist, Division of Home Marcile Allen, Extension Specialist, Foods and Nutrition De- Economics, Department of Agriculture, Washington, D. C. partment, Purdue University, Purdue, Indiana 46 Vice Chairman .ViceVice Chairman Conrad Vuocolo, Director, Tenant Relations, JerseyCity Edison, Supervisor, County Association of Senior Af- Housing Authority, Jersey City, New Jersey fairs, San Bernardino, California Recorder Recorder Marjorie M. Donnelly, President, American Dietetic Asso. Irene H. Wolgamot, Retired, Former Assistant to the Di- ciation, Raleigh, North Carolina rector, Consumer and Food Economic ResearchDivision, AgriculturalResearchService, Department ofAgriculture, Subsection 2 Arlington, Virginia Chairman Jack Weinberg Federal. Resource Personnel Vice Chairman Francisca Gonzalez, Director, Local Office of Social Services, Sandra Beckwith, Secretary, Division of Home Economics, Mayaguez, Puerto Rico Department of Agriculture, Washington, D. C. Recorder Evelyn H. Johnson, Food and Nutrition Specialist, Depart- ment of Agriculture, Washington, D. C. Margaret L. Ross Mary Ann Moss Subsection 3 Louise Page Chairman Jeannette P. Pelcovits, Milo K. Swanton, Chairman, Wisconsin Councilon Aging, Madison, Wisconsin Geraldine Piper, Vice Chairman Nade Poole, Home Economist, Food and Nutrition Service, Department of Agriculture, Washington, D. C. Rudolph H: Kampmeier, ProfessorEmeritus, Department of Medicine, Vanderbilt University, Nashville, Tennessee Gladys Royal Recorder Marvin M. Sandstrom, Assistant Deputy Administrator, Food "SadieB- , and-Nutrition-Service,-DePatuttertt-of-Agriculturer-Washing utrit-SIEsu cant, atF)naion Council ton, D. C. or, Hunger and Malnutrition in the United States, Arlington, Virginia Charlotte E. Smith Subsection 4 Margaret Stewart, Editor, Nutrition Program News, Agricul- tural Research Service, Department of Agriculture, Washing. Chairman ton, D. C. Ruth E. Kocher Dorothy M. Yonland

47 s- ftv SECTION ON RETIREMENT ROLES ANDACTIVITIES

INTRODUCTION order the first Section plenary meeting and intro- ducing himself and the other Section leaders, he he proportion of older persons named called on Dr. Margaret M. Clark to deliveran as Delegates to the Retirement Roles opening address to the Section Delegates. and Activities Section was somewhat higher than for most other Sections; of Dr. Clark, Senior Research Anthropologist the 306 Delegates for whom information is avail- with the Langley-Porter Neuropsychiatric Insti- tute of San Francisco, California, served as the able, better than 34 percentwere retired persons. The representation from minoritygroups was, on other Cochairman of the Section. In herstate- the other hand, lower than inmany of the other ment to the Delegates, Dr. Clark described the Sections. problems of social roles for older peopleas less basic than the survival areas of income, health In addition to the large number of elderly care and housing but in some ways even more Delegates participating in the Section, therewere fundamental and complex. not only practitioners with long experience as directors of senior citizen activitycenters, of vol- Co- Chairman's Statement unteer service 'programs (such as Foster Grand- parents Program), and of information and refer- The work of this Section is to formulatena- ral centers, but also professional personnel in- tional policy regarding roles and activities ofretired people in our society. In cluding social workers, gerentologists, sociologists, some ways our topic is less basic than those of some of the other anthropologists, and educators. The fifteenrecom- sec- mendations produced by the group give testimony tionswe would all agree that provision of income, health care, and livable housing are re- to an appreciation of older persons as an important component in society, and of the society's respon- quired for the simple survival of older people. In sibility for providing the social and economic certain other ways, however, our topic iseven milieu necessary to maintain older people more fundamental than these. We are being at an asked to look at some deeper and optimum level of functioning throughout the life more complex span. issueswe are being called upon toanswer questions such as these: Does our society need its older citizens at all? What are they good for? Do SECTION REPORT they have a right to a place in our social order? What are older people to do with therest of their Preamble lives after they are no longer working? Doesour Nation have any responsibility for helping the Mr. SebastianTine, Executive Director of elderly to find greater meaning and personal Senior Citizens, Inc., of Nashville, Tennessee,was satisfaction in the later years? the presiding Co-chairman of the Sectionon Re- In speaking to you today, I haveno choice but tirement Roles and Activities. After callingto to speak from my own background as an anthro- 49 pologist. From this point of viewthat ofa stu- physical anthropologists have spent so much time dent of human culturesthe most startling fact describing aggression, protective cooperation, mat- about aging today is that so largea proportion ing, nurturance of the young, and other kinds of of our population is over theage of sixty. This is social behavior among lower primates, but have a novel circumstance in the history of the human never described the changes that occur in rela- species. Never before in all the long millennia tionships as members of the band grow old. He of mankind, from his earliest origins in the dawn said, "That's very simplethere aren'tany old of time, have so many people livedso long. Those monkeys in natural environments. Asnoon as of us who are in the field of aging have heard their teeth wear out, they starve to death." He this statement so often that it scarcely registers went on to remind me that it has been only re- any more. But if we look at the historical meaning cently that we have discoveredmenopause in of this imple fact, it becomesan engaging phe- monkeysthose that have been sheltered in nomenon. In terms of human history, it means humanly controlledlaboratoryenvironments. simply that when primitiveman took charge of From observations made in the field,no one his physical environment through the develop- thought the menopause existed in femalemon- ment of tools, and then experienced that even keys; but now we know that they simply didn't greater miraclethe creation of a symbolic world survive long enough to undergo this change. throughtheinventionoflanguagethere emerged a totally new relationship between the The human species, then, is theone that keeps generations. Simple animal evolution beganto its old alive. Why? Because, with the discovery of give way. Many of us still cling, atavistically,to language, knowledge could be accumulated that the idea that human historycan be explained in promoted survivalnot just for the single indi- terms of the survival of the fittest. And, indeed, vidual, but for his whole group. The old could on the streets of our cities today, it sometimes remember the year of the great drought, when seems as if the law of the jungle still prevails; the only water to be hadwas at such-and-such a but it does not. We mustnever for a moment spring; or the lean years when thegame had to forget what characterizes humanas opposed to be tracked far to the north. They remembered non-human nature is man's capacity for caring how to treat wounds to prevent infection, how about others, and his desireto aid in the survival to improve the chances of survival of a newborn of all those he cares aboutthe weakas well as or a new mother by observing certain taboos. the strong, the elder as wellas the infant. And, perhaps most important of all, theywere When I first became interested in the role of the links between past and future. The oldest the aged in human societies, the full meaning of man or woman of a tribe, by definition, had lived the riddle of the Sphinx cameto me. As the an- during years when no one else in thegroup had cients tell the tale, Oedipus,on his travels, was been alive or could remember. In the absence asked this riddle by the Sphinx: "What isit that of records, these old peoplewere the sole links walks first upon four legs, thenupon two, and with the pastthe only windows through which finally upon three?" Theanswer, of course, is mankind could glimpse the long hazy corridors of man; as an infant he first crawls upon all four, his ancestors, the world thatwas before. Small then stands on two feet, and, in decliningyears, wonder that the few ancients who survivedwere leans upon his staff. It occurred tome that this viewed with such awe and wonder by theiryoung cycle is, indeed, the essence of humanity, for inno kinsmen. We really can't blame Methuselah for other animal species are the old fed and cared for stretching the facts a bit about hisage; it gave by the young who can still hunt, fish, andgather him a few extra points, and who elsewas count- food. ing? Old age has always been regardedas a magical time of lifesometimes, insome places, In talking with a colleague of mine recently as potentially evil. (And this is a more unfor- aphysicalanthropologist whosespecialtyis tunate human trait: to fear too much knowledge primate behavior (the observation ofapes and and sometimes to destroy that which is feared.) monkeys in their natural habitats) --I askedwhy More often, however, the magic of oldage was 50 regarded as benevolent, andgreat awe and respect Loren Eisley, who has just written these words paid to the ancients and thepower of their lore. on this subject: Now, let me pause here to explain why I have "Man," he writes, "escapes definitioneven as given you this somewhat pedantic and round- the modern phantoms in militarist garb proclaim about discourse on humannature. It is to lead up as I have heard them dothat man will fight to this: from one side of the solar systemto the other, and Man's nature is not fixedneither in hiscon- beyond. The danger, of course, is truly there, but trol of the physical environmentnor in his ca- itis a danger which, while itlies partially in pacity for changing and shaping the socialenvi- what man is, lies much more closeto what he ronment. We have the capacity, as we know, for chooses to believe about himself. Man's whole t. creating the kind of worldwe want to live in, if history is one of transcendence and self-examina- we can keep the sources of power out of the hands tion, which has led him to angelic heights of of demagogues andwarmongers. But, beyond our sacrifice as well as into the bleakest regions of ability to shape the world aroundus, there is despair. The futureis not truly fixed but the another enormous, andeven more important world arena is smoking with the cauldrons of human capacity, and that is man's abilityto form those who could create tomorrow by evoking, conceptions of himselfto build images, raise rather than exorcising, the stalking ghost of the phantoms, have visions of what he is and what past."' he might be. And then. ..and this is the true In turning to our work hereat this conference, magic.. . man has the capacity to become what I hope we can keep withinour vision the theme he conceives. of becoming. We shall become that whichwe There are many people in the world who fail dream. Let us remember that atany point in to grasp the significance of this creativity, who human history we could have lookedat ourselves keep thinking of human beingsas bird-brains in and our society and said, "Well, then, thisis a box or naked apes. And, while the ape is al- realitythis is human society." And for that day, ways somewhere within mankind, the ape-nature that time, the statement would have beentrue cannot contain mankind. With the birth ofmean- during the sack of Rome, during thegreat plagues ing, somethingtotally new has enteredour of the Dark Ages, in the holds of slave ships, in planet. We escaped from thetrap of the past; the the ovens of Buchenwald. Present is no longer what itwas for our primitive But it doesn't have to be like that. Nowhere is ancestorsa reliving, over and over again, gene- it written that the young have done andcan do no ration after generation, of a life cycle, invariable more for humanity than the old. Nor do the old for thousands of years. have to eat crumbs, wear rags, and have their There are people today whotempt us to keep bodies shaken with untended coughs and fevers. defining ourselves, and our relationships to each Nor do the old have to lea..: the tanks of the other, within the frozen, crystallizedstructures of the past. Don't be tempted into believing living, the assemblies and enterprises of mankind, that a quarter century before they die. Again, from it is "human nature" to kill,to destroy, to abandon the elders, to be "tough." The whole history of Eisley: "The terror that confrontsour age is our own conception of ourselves." .. the species gives the lieto these fallacies. It is only by caring, by a kind of tenderness, thatwe What can we do here to break our elders, and have survived as a species. How else couldwe ourselves as we age, out of that frozenpast that have done it, without fangsor claws, with our we so often invoke? As Commissioner Martin weak jaws and our thin hides? Andwe must not said last night, we are asking of ourselves thatwe be tempted into, that furthertrap of believing not be bound in our planning by the restraints that humanity can never be other than it has that our society now imposesuponitsolder already been. ' Eisley, Loren. TheNight County.New York, Charles Scrib Let me quote an eminent colleague, Professor net's Sons, 1971.

11. members. We must transcend this place, this time, differences in language and ethnicity, and limi- and this evil. We must strive fornew conceptions tation because of disability or level of income. of later life, what itcan mean, how it can be enhanced. The lives. of Americans of allages will be enriched as the Nation provides opportunities for But there is a problem that all of us face when developing and utilizing the untappedresources we sit down and try to have new ideas. They're of the elderly. not that easy to have. How does one think creatively? I wish I knew. I can offer only one RECOMMENDATION I suggestion from my own experienceas an anthropologist that may help. Wewere taught as stu- Meeting Role Needs dents that if we hope to see ourselves andour Societythrough government, private industry, own culture in a new and revealing way, we labor, voluntary organizations, religious institu- could begin by looking at othergroups of people tions, families and older individualsmust and the ways in which they live and exer- pattern their cise its responsibility to createa public awareness lives. This, our teachers said, would provideus of changing life styles and commitmentsin a with a great mirror in whichwe could see our- continuous life cycle. Together they should dis- selves reflected and perhaps improve on whatwe cover and implement social innovations as ve- saw. hicles for older persons to continue in,return to, We are here a very diverse group of people. or assume roles of their choice. These innovations We come from many backgrounds. We have shouldprovide meaningfulparticipationand different experiences, knowledge, persuasions.Per- leadership in government, cultural activities, in- haps the key to creative visionis in our own dustry,labor, welfare, education, religiousor- diversity as z people. Let ustry to listen and ganizations, recreation and all aspects of volunteer learn from each other. That might helpa little. services. Implementation: Programs atFederal,State andlocal levels which provide opportunities forcom- Recommendations munity service by older persons should be strengthened and expanded. As we grow older, we continueto need to occupy roles that are meaningful to society anci Mechanisms should be developed forcon- satisfying to us as individuals. However,we em- tinuing the work of successful demonstration phasize the primacy of such basic necessitiesas programs, until such programs become un- income, health, and housing and these needs necessary or self-sustaining. must be adequately met. - -Older people should not be further iso- Twenty million older people with talents, lated. Attention must be paidto making oppor- skills, experience and timeare an inexhaustible tunities for community service accessibleas resource in our society. We represent all segments well as available to all older persons. of the population; our abilities,our education, our occupational skills, and our cultural backgrounds RECOMMENDATION II are as diverse as America itself. Priorities in Meeting Role Needs Given proper resources, opportunities and moti- Program efforts to meet role problems andto vation, older persons can make a valuable contri- create new role opportunities should be designed bution. We are also capable of being effective to serve all segments of the older population. advocates of our own cause and should be in- Priorities should be determined accordingto cluded in planning, in decision-making and in local and individual needs; special effortmust be the implementation of programs. Choice roles made to include persons who might otherwise must be available t" each older person despite be excludedthe impoverished, the socially iso- 52 lated, the ethnic minorities, the disabled and the and local communities as well as State orga- disad.antaged. nizations. The availability of such services should RECOMMENDATION III be made known through a program of public Preparation for Life Off the Job information. Society should adopt a policy of preparation for retirement, leisure, and education for life off the RECOMMENDATION V job. The private and public sectors should adopt [Inviting Older People and expand programs to prepare persons to under- Public policy should encourage and promote op- stand and benefit from the changes produced by retirement. Programs should be developed with portunities for greater involvement of older peo- government at all levels, educational systems, re- ple in community and civic affairs, and for their ligious institutions, recreation departments, busi- participation in formulating goals and policies ness and labor to provide opportunities for the on their own behalf as a basis for making the acquisition, of the necessary attitudes, skills and transition from work to leisureroles. Society should reappraise the current life style sequence knowledge to assure successful living. Retirement and leisure time planning begins with the early of student/worker/retiree roles,and promote years and continues through life. role flexibility. Implementation: RECOMMENDATION VI While retirement preparation is both an Reordering National Priorities individual and total community responsibility, every employer has a major responsibility for We recognize that many problems of aging providing preparation-for-retirement programs Americans are problems for all Americans and during the working hours. we urge the Conference to request the reordering of the Nation's priorities. The function of Social Security district offices should be expanded to include the addi- All citizens will benefit from elimination of pov- tional role of offering individual pre-retirement erty, preservation of the environment, more ade- counseling. quate health care services, better housing, transportation and the control of disease and physical RECOMMENDATION IV disability. Responsibility for Supportive Services Therefore, we recommend that the Chairman of the 1971 White House Conference on Aging Social policy should encourage families to assume appoint a select committee of Delegates to pre- the responsibility for providing supportive serv- pare a preamble for action which calls for a ices to older family members; however, society reordering of our Nation's priorities, and that must insure the availability through government recognizes that the strength and success of Amer- and community organizations to all older people ica will be judged on how well the needs of its of comprehensive supportive services which they own people are served. are unable to provide independently. Implementation: RECOMMENDATION VII The Federal Government should move Government Organization for Aging immediately to develop models for a network We recommend that the President and the Con- of supportive services for all elderly citizens. gress, either by Executive Order or by Congres- Implementation should be the ultimatere- sionalaction, give immediate priority to the sponsibility of the local community. restructuring of the Administration on Aging and In funding supportive services, Federal its establishment of a visible, effective advocate funds should be provided to applicant agencies agency for the elderly at the highest level of

53 government so that it will directly relate to the at six-month intervals, on action taken on the Executive Office of the President. recommendations of the1971 White House Conference on Aging. RECOMMENDATION VIII Gnegorical Support for the Aged RECOMMENDATION XIII Aging in Training Curriculum Since older persons have special needs,we recommend that public programs specifically designed Training and research agencies, including uni- for the elderly should receive categoricalsupport versity programs which relate to recreation and for the elderly, rather than compelling the aged leisure, should be encouraged toconcern them- to compete for services, activities, and facilities selves with the needs of olderpersons as an in- intended for the general population. tegral part of their training curriculum.

RECOMMENDATION IX RECOMMENDATION XIV Multiservice Senior Centers Physical Fitness jor Older People It should be the responsibility of the Federal We endorse a program looking toward continu- Government, in cooperation with other levels of ing physical fitness of men andwomen before and government, to provide funds for the establish- during the years of retirement. Sucha program ment, construction and operation of community- should be implemented by governmentalsupport oriented multiservice centers designed for older in cooperation with voluntary agencies which have citizens. Industry, labor, voluntary and religious a long history of experience in this field. organizations should assist in the planning and implementation. RECOMMENDATION XV Use of Older Professionals RECOMMENDATION X Work Means (Retirement) Ten Because reciprocity often does not permit the full use of elderly professionals whose services are In order to encourage further activityon the part badly needed, we urge the National Conference of older Americans, it is recommended that the of Commissioners on Uniform State Laws, inco- work means test be modifiedso as to allow un- operation with the professions, to develop and limited earnings without the reduction of Social promulgate a minimum national standard for Security benefits. admission to the medical, dental, legal and other professions, which standard permits qualitypro- RECOMMENDATION XI fessional practice, and that each State adopt such Use of Information Media a uniform standard of professional practice. The information media areso important in the formation of public attitudes that it isrecom- mended that special attention be givento en- SECTION LEADERSHIP Space will permit listing of tide and ad- hancing the image of olderpersons, and to dis- dress only the first time a name appears seminating the recommendations of the 1971 White House Conference on Aging and its follow- The Technical Committee up activities. for Retirement Roles and Activities Chairman RECOMMENDATION XII Walter C. McKain, Professor of Sociology, University of Follow-up Conference Reports Connecticut, Storrs, Connecticut The Administration on Aging shouldarrange for Members Melnea A. Cass, Vice President, Council of Elders, Roxbury, the publication of statusreports to the Delegates, Massachusetts

54 4-

Margaret M. Clark, Senior Research Anthropologist, Adult Recorder Development Research Program, Langley-Porter Neuropsychi- atric Institute, San Francisco, California Janet S. Sainer, Director, SERVE Projects, Community Service Society, New York, New York Delores I. B. Davis, Craftsman and Artist, Lorain, Ohio Assistant Recorder Nathaniel N. George, Retired High Schoolteacher, Los Angeles, California Morris Cohen, Chief, Community Services Branch, Older American Services Division, Administration on Aging, Social Max Kaplan, Director, Center for Studies of Leisure,Uni- and Rehabilitation Service, Department of Health, Education, versity of South Florida, Tampa, Florida and Welfare, Washington, D. C. Alexander R. Martin, Psychiatrist, New York, New York Management Officer William C. McColl, State Director, Allied Senior Citizens Anne C. Johnson Clubs, Inc., Los Angeles, California Lennie-Marie P. Tolliver, Professor of Social Work, Uni- versity of Oklahoma, Norman, Oklahoma Subsection Officers C. T. Pihlblad, Professor of Sociology, University of Missouri, Subsection I Columbia, Missouri Chairman Janet S. Sainer, Director, SERVE projects, Community Serv- ice Society, New York, New York Max Kaplan Gordon F. Streib, Committee on Human Development, Uni- Vice Chairman versity of Chicago, Chicago, Illinois Kathleen Broderick, ProgramIntern, American National Red Cross, Washington, D. C. Wendell M. Swenson, Clinical Psychologist and Associate Professor, Mayo Graduate School of Medicine, University of Recorder Minnesota, Rochester, Minnesota Sai Sadri, Superintendent of Recreation, Johnson County Park Howard H. Weber, Republican State Executive Committee and Recreation District, Shawnee Mission, Kansas of Florida, Pompano Beach, Florida Subsection 2 Chairman C. Loudell Frazier, Retired Director, Kansas Division of The Secretariat Services for the Aging, and Area VI Vice-President, American Association of Retired Persons, Topeka, Kansas Director Vice Chairman Walter Moeller, Program Analyst, Administrationon Aging, Stanley Sprague, Board of Directors,Special Council of Socialand Rehabilitation Service, Department of Health, Senior Citizens, Belleville, Illinois Education, and Welfare, Washington, D. C. Recorder Members Sister Marie Gaffney, M.S.B.T., Consultant, National Con- Lawrence D. Davis, Retirement Training Advisor, Bureau ference of Catholic Charities, Washington, D. C. of Retirement Insurance and Occupational Health, Civil Service Commission, Washington, D. C. Subsection 3 Bernard Gaudy, Contract Specialist, Office of Policy, Evalua- Chairman tion, and Research, Manpower Administration, Department Gordon F. Streib of Labor, Washington, D. C. Vice Chairman Anne C. Johnson, Chief, Foster Grandparent Program, Older Joe N. Ham, Program Director, Oakland County Commission Americans Volunteer Programs, ACTION, Executive Office on Economic Opportunity, Pontiac, Michigan of the President, Washington, D. C. Recorder Velma Linford, Recruitment Resource Specialist, ACTION, Executive Office of the President, Washington, D. C. Mary Sue Bethea, Executive Director, Senior Neighbors of Chattanooga, Inc., Chattanooga, Tennessee John Guy Miller, Minority Staff Director, Senate Special Committee on Aging, Washington, D. C. Subsection 4 Jeanne PriesteProgram Leader, Home Economics Extension Chairman Service, Department of Agriculture, Washington, D. C. Theresa S. Brungardt, Chairman, Governor's Advisory Com- mittee on Aging, Brattleboro, Vermont Vice Chairman Section Officers Martin McNamara, Attorney, Washington, D. C. Recorder Co-Chair' man Margaret Hossacic; SeniorCitizen Program Coordinator, Sebastian Tine, Executive Director, Senior Citizens,Inc., Mayor's Senior Citizen Council, Detroit, Michigan Nashville, Tennessee Subsection 5 Margaret M. Clark, Senior Research Anthropologist, Adult Development Research Program, Langley-Porter Neuropsy- Chairman chiatric Institute, San Francisco, California H. Etta Saloshin, Professor, School of Social Work, University Consultant of Minnesota, Minneapolis, Minnesota Mother It Bernadette De Lourdes, 0. Carm., Administrator, Vice Chairman St. Joseph's Manor, Trumbull, Connecticut Mabel Robbins, Retired, Des Moines, Iowa

55 Recorder Federal Resource. Personnel Alice L. Schafer, Assistant Professor, Division of Occupa- tional Therapy, Sargent College of Allied Health Professions, Bea Alford, Volunteer Representative, Western Region, Peace Boston University, Boston, Massachusetts Corps, Los Angeles, California Subsection 6 John Calhoun, Special Assistant to the Director, Office of Chairman Public Affairs, ACTION, Executive Office of the President, Washington, D. C. Constance Lindahi, Director, Wilder Senior Citizens Center, St. Paul, Minnesota Nick DiMichaels, Program Analyst, Retired Senior Volunteer Program, ACTION, Executive Office of the President, Wash- Vice Chairman ington, D. C. Reverend Amour Evans, Minister, Newton, Kansas Dorothy Doherty, VISTA Volunteer, Volunteer in Service Recorder To America, Regional Office, Denver, Colorado. Mary McGowan, Director, Anne Arundel County Senior James Dotson, ssistant Chief, Division of Child Welfare, Citizens Center, Annapolis, Maryland Research and Demonstration, Social and Rehabilitation Serv- ice, Department of Health, Education, and Welfare, Washing- Subsection 7 ton, D. C. Chairman Tom Dunleavy, Program Specialist, Foster Grandparent Pro- Jerome D. Schein, Director, Deafness Research and Training gram, ACTION, Executive Office of the President, Washing- Center, New York University, New York, New York ton, D. C. Vice Chairman Suzanne Fahy, Program Analyst, Foster Grandparent Pro- John Marros, Administrator, State Agency on Aging, Chey- gram, ACTION, Executive Office of the President, Washing. enne, Wyoming ton, D. C. Recorder Sandra S. Fisher, Program Development Specialist, Retired Reverend Herbert C. Lazenby, Executive Director, Senior Senior Volunteer Programs, Older Americans Volunteer Pro- Center, Inc., Seattle, Washington grams, ACTION, Executive Office of the President, Washing- ton, D. C. Subsection 8 Fraser Lang, Domestic Coordinator for School Partnership Chairman Programs, ACTION, Executive Office of the President, Wash- Freida E. Gorrecht, Executive Director, United Auto Workers, ington, D. C. Retired Workers Center of Detroit, Inc., Detroit, Michigan Alfred Larsen, Chief,Retired Senior Volunteer Program, Vice Chairman ACTION, Executive Office of the President, Washington, D. C. Robert F. Katz, Management Consultant, Huntington, New Velma Linford, Recruitment Resource Specialist, ACTION, York Executive Office of the President, Washington, D. C. Recorder Lois Rafferty, VISTA Volunteer, Volunteer In Service To America, Diocesan Human-Relations Committee, Grand Rapids, Winston Borden, State Senator, Brainerd, Minnesota Michigan Subsection 9 John Rafferty, VISTA Volunteer, Volunteer In Service To Chairman America, Diocesan Human-Relations Committee, Grand Rap- Monroe C. Neff, Director, Division of Continuing Education, ids, Michigan State Education Department, Albany, New York Leo Scott, Director of Volunteer Services, Veterans Hospital, Vice Chairman Veterans Administration, Washington, D. C. Tom Murphy, Director, Recreation Program for Older People, Sarah Sheets, Secretary, ACTION, Executive Office of the Los Angeles Recreation Department, Los Angeles, California President, Washington, D. C. Recorder Dorothy Van Ess, Program Officer for Social Services, VISTA, Bonnie L.Stanley,Director, KITS (Keep In Touch), ACTION, Executive Office of the President, Washington, D. C. Jonesboro, Arkansas Josba Wiener, College Student, Bethesda, Maryland

56 SECTION ON SPIRITUAL WELL -BEING

INTRODUCTION life entirely by artificialmeans as opposed to legalization and sanctioning of the right of old people to choose to die naturally and in dignity. he Section on theSpiritual Well- Being of the elderly involvedover 200 Delegates. Although many of thepar- SECTION REPORT ticipants in the Sectionwere religious The work of the Spiritual Well-Being Section leaders, a number of other professionaland tech- began with an orientation meeting of all Section nical occupations were represented.Among them Delegates. The Section meetingwas called to were educators, legislators, social workers, busi- order by The Reverend MonsignorLawrence j. ness people, consultants, volunteer workers,serv- Corcoran of the National Conference of Catholic ice agency administrators, andyoung people. Charities, the presiding Co-chairman. Reverend Corcoran introduced the other Section leaders The work of the Sectionwas guided in part and invited Hess T. Sears, SectionCo-chairman by the thought and experienceof many of the and Chairman of the Technical Committeefor group who were themselves elderly. Of the Dele- Spiritual Well-Being, to address the Section. gates named to the Section, one-fifth listed them- Mr. Sears provided background information selves as retired. The breadth and depthof and the role that Delegatesto the Spiritual discussion was also enhanced by theparticipation Well-Being Section were to play in developing of a substantialgroup of minority persons (18 recommendations for a national policyon aging. percent were Black, Asian American, American Indian, or Spanish American). Preamble The recommendations of this Seaion encom- Spiritual Well-Being relatesto all areas of pass some of the most significant trends of the human activity. In referringto man's spiritual day among religious bodies.Changes in attitudes well-being, we consider thoseaspects of life ". . pertaining to man's inner are reflected in recommendations stressingecu- resources, especially menism and interfaith responsibilities.New rela- his ultimate concern, the basic valuearound which tionshipsbetween government and all other values are focused, the centralphiloso- religious phy of lifewhether religious, organizations are envisaged, with thereligious anit-religious, or community having a muchgreater role in com- non-religious--which guidesa person's conduct, munity service to the elderly. Andfinally, the the supernatural and non-material dimensionsof Section Delegates had thecourage to take up a human nature."' problem that is becoming one of the most con- ' Moberg, David 0.,.Background and IssuesPaper on troversial of the day. That is, the Spiritual Well.Being,1971 White House Conferenceon Aging, prolongation of P. 3.

57 Whether rich or poor, advantagedordis- spiritual needs of the elderly, but in doingso advantaged, every person hasa right to achieve a should observe the principle of separation of sense of spiritual well-being. "We believe that Church and State. something is wrong with any society in which every age level is not clearly of meaning and of value to that society. The spiritual needs of the RECOMMENDATION II aging really are those of everyperson, writ large: Training in Spiritual Well-Being the need for identity, meaning, love, and wis- The government should cooperate with religious dom." organizations and concerned social and educational agencies to provide research and professional As Delegates to the White House Conference training in matters of spiritual well-beingto those on Aging in the Section concerned with spiritual who deliver services to the aging. well-being, we call attention to this fact of life: to ignore, or to attempt to separate the need to fulfill the spiritual well-being ofman from at- RECOMMENDATION III tempts to satisfy his physical, material, and social Funding Professional Training needs is to fail to understand both the meaning of God and the meaning of It is recommended that thegovernment provide man. financial assistance for the training of clergy, Whether it be the concerns for education, em- professional workers, and volunteersto develop ployment, health, housing, income, nutrition,re- special understanding andcompetency in satisfy- tirement roles, or transportation,a proper solution ing the spiritual needs of the aging. involves personal identification, socialacceptance, and human dignity. Thesecome fully only when RECOMMENDATION IV man has wholesome relationships with both fel- Chaplaincy Services lowman and God. It is recommended that all licensingagencies in The concerns apply to allages. Basic needs the State require that institutions caring for do not necessarily change with the age, but they often aged must provide adequate chaplaincy are intensified. services. In certain instances in which cooperating church Therefore, the White House Conferenceon organizations cannot obtain financialsupport for Aging states that all policies,programs, and ac- such service, government should be empowered tivities recommended in a national policyon aging to supply it upon the recommendations of the should be so developed that the spiritual well- State commission of agingor other appropriate being of all citizens should be fulfilled. agencies. In this context, the Sectionon Spiritual Well- Being of the White House Conferenceon Aging RECOMMENDATION V makes the following policy recommendations. Evaluating Programs for the Elderly It is recommended that the Federal Government should establish a continuingsystem of evalua- Recommendations- tion of present and proposed government-funded RECOMMENDATION I programs serving the elderly. One of the functions of such a system would bea determination of a Religious and Governmental Cooperation program's effect upon the spiritual well-being of The government shouldcooperate with religious the elderly. bodies and private agenciesto help mea the RECOMMENDATION VI ' Bollinger, Thomas E., "Spiritual Needsof the Aging, The Need for a Specific Ministry to the Aged,Southern Pines, Acquainting the Elderly with Services N.C.: Bishop Edwin A. Penick MemorialHome, 1969, pp. 50.51. It is recommended thata much greater, more 58 diverse information flow is necessary to acquaint RECOMMENDATION XI the elderly with all the services which are avail- Religious Bodies as Advocates able tothem. SocialSecurity Administration should be required to disseminate adequately the Religious bodies should exercise a strong advo- information necessary to acquaint the elderly with cacy role in meeting the needs of the elderly, all the services which are available to them, such working for programs, both public and private, as by enclosing information with Social Security that contribute to the well-being of the elderly and checks. protecting them from those who would victimize or demean them. RECOMMENDATION VII Elderly in Age-Integrated Programs RECOMMENDATION XII Protecting the Rights of the Elderly Efforts should be made to meet the spiritual needs of the aging by ministering to them in conjunc- Religious bodies have traditionally and properly tion with people of all ages, as well as in groups developed their own philosophies. We recommend with special needs. It is noted that special atten- that they work together with the elderly and co- tion should be given to allowing older persons ordinate their efforts with other groups to develop to share in the planning and implementations of and declare an affirmation of rights for the elderly. all programs related to them. These rights should include the basic values of all while insuring the basic right of freedom of RECOMMENDATION VIII religion. Home Delivery of Spiritual Consultation RECOMMENDATION XIII As a part of total programming for older persons, communities should make available religious Inter-Faith Community Programs or other spiritual consultation to the aged in their It should be the national policy that religious own homes, using the clergy and other trained bodies and other private agencies make it their persons. Special emphasis shall be given to assist concern to bring together the services of the and utilize personnel of those religious bodies entire community toprovide opportunity for lackingfinancialresourcesoftenavailable to interfaith broad-based community programs for larger groups. the aged through multipurpose community centers. RECOMMENDATION IX Concern for Man as a Whole Being RECOMMENDATION XIV Since man is a whole being with interrelated and The Right to Die With Dignity interdependentneeds,religiousorganizations Religious bodies and government should affirm should be actively concerned with spiritual, per- the right to, and reverence for life and recognize sonal and social needs. the individual's right to die with dignity. RECOMMENDATION X Religious Bodies as Referral Agencies SECTION LEADERSHIP Space .will permit listing of title and ad. Religious organizations must be aware of agencies dress only the first time a name appears. and services, other than their own, which can provide a complete ministry to older persons. The Technical Committee Other organizations designed for the benefit of for Spiritual Well-Being older persons should develop, as a part of their services, channels to persons and agencies who Chairman Hess T. Sears, Secretary, Equitable Life Insurance Company can help in spiritual problems. of Iowa, Des Moines, Iowa

/ g SECTION ON TRANSPORTATION

INTRODUCTION any modes of transportation in their communities. here were 174 Delegates named to the However, it was emphaized over andover again Transportation Section. In addition, a that the problem of transportation exists for all numberofobserversrepresenting older people, whatever their place of residence. Federal Government agencies,State The Section on Transportation produced 21 government, institutions of higher education, and recommendations which call for Federal, State, foreign countriesattended the Section. and local action to provide increased availability Participants represented a wide range of occu- of transportation services to older citizens. Broadly concerned with the dignity and well-being of old pational fields and interests. Among themwere people, Delegates recognized that the ability researchers, insurance executives, legislators, State to provide for one's needs and the ability agency executives, health and social services work- to function within society-at-large is significantly dependent ers, attorneys, union representatives, and experts upon one's access to adequate transportation. In- intheareaof transportationtransportation deed, the solutions to tie problems oftransporta- economists and plannerswho assisted in guiding tion for the elderly may be the sine the discussion toward the development of feasible qua non for and realistic policies. ameliorating many of the other 'problems faced by older people. A third of the Delegates named to the Trans- portation Section were retired. They added addi- SECTION REPORT tional relevance to the discussion by making the Section fully aware of the elderly's particular Co-chairman Walter J. Bierwagen opened the transportation needs. This was the first time that work ofthesessionby asking Co-chairman such an intermix of elderly people and practition- Thomas C. Morrill to make an openingstatement ers have had the opportunity to speak together which would introduce the Section Delegatesto ab keeping older people mobile. The subject their task. wa. ,t considered as a major topic at the 1961 White House Conference on Aging. Co-Chairman's Statement Beginning with the Older Americanscom- I am pleased to join my Co-chairman, Walter munity forums, State White House Conferences Bierwagen, in welcoming you to the opening on Aging, and continuing through the National meeting of the Transportation Section of the Conference,participantsspoke franklyabout White House Conference on Aging. transportation needs peculiar to their owncom- As you know the planning for this significant munities. Rural participants expressed particular event has been in progress for about two years concern regarding the virtual non-existence of and many of you have been quite actively in-

63 volved in the community forums, State and re- Travel today can be an ordeal for the agedand gional conferences leadingup to this time. infirm, but if theyare to take part in the affairs It is well said that weare today a society on of community life, theymust have available some wheels. In the lifetimes ofmany of us at this convenient and economical mode oftransporta- Conference, the automobile has moved instatus tion. And this, of course, is whywe are here today. from a luxury for the affluentto the common Our mission during thenext three days is to come property of almost every household. up with policy proposals on transportation which will lead to administrative and legislativeaction Motor vehicle transportation is today theover- on behalf of senior citizens. whelming mode of personal travel. Bysome estimates, 94 percent of allpassenger miles are As Mr. Joseph Revis has stated in theBack- traveled by car or bus. Asa people, we buy eight ground and Issues Paperon Transportation, the to nine million cars a year, drivea hundred mil- transportation problems of the elderlyare most lion miles that glut the cities, pollutethe air, kill acute in three areas: (1) lack of money fortrans- 55,000 people and injureusinunbelievable portation; (2) lack of available serviceto places numbers. In the process,we destroyby neglect they need and want togo, and (3) problems of and misusemuch ofour mass transportation safety, comfort, and convenienceassociated with service. the various transportationsystems used by them: Then, with the passage of time, much ofour These three problemareas have served as the older population reachesa point where, for either basis for the issues whichyou have been dealing economic reasons or costor physical reasons, the with during the past twoyears and which we will private means of transportationon which they be discussing. It ismy sincere hope that we will have relied for most of their lives isno longer deal with the issues as they have beenpresented available. They find that alternativeways to get in the Work Book and thatwe will develop mean- where they want to go eitherno longer exist or ingful policy proposals which willlead toward are oriented toward other transportation needs the elimination ofmany of the transportation to and from work, rather than to and from shop- problems which weas senior citizens face in our ping areas, medical and socialservices, or human day-to-day existence. contacts with friends and relatives. The older population thenmay also find that other forms of transportationare also expansive Preamble or too challenging for declining physical skills. Even as pedestrians, the "WalkDon'tWalk" It has been unanimously agreed bythe State signs turn on and off with threateningspeed, the and Territorial conferences,the National Or- curbs are too high, the driversinconsiderate. ganization Task Force, the TechnicalCommittee on Transportation and the Delegates of the Trans- It is concerns of this kind .which maketrans- portation Section of this Conference that portation for the aging meeting a serious issue. The prob- the transportation needs of the elderlyis a problem is common, although itmay take different lem of vital concern. For forms for those who live many of the elderly the on farms than for those lack of transportation itself isthe problem; for who live in cities or towns, and forthose with and others, it is the lack of without alternatives to the money for bus fares, the s motor car. la4 of available servicesto places they want and In the two years of preparation forthis Con- need to reach, the design and service featuresof ference, thousands of older peoplehave under- our transportation systems. These problems inter- scored for us their worries abouttransportation. act with one another and in doingso further aug- During the community forums whichwere held ment the transportation difficulties of the elderly. throughout the country, transportationsurfaced For example, their low incomes often in many communitiesas the third force prob- them to live in poor transit serviceareas and pre- lem of the elderly, after income andandhealth. vent them from owning private automobiles.

64 Rising Awes and reduced service of financially Recommendations declining transit companies restrict their travel. Even where transit is available, design features RECOMMENDATION I and the lack of directional informationmay pre- dude access to available part-time work which Transportation Subsidies might improve their incomes. The Federal Governmer,t shall immediately adopt a policy of increasing transportation services for The elderly, like everyone in society, must de- the rural and urban elderly. The policy should be pend upon the ability to travel for acquiring the flexible, encompassing various alternatives. Both basic necessities of food, clothing and shelter as syszcin subsidies and payments to elderly individ- well as employment and medical care. The ability uals may be needed, the choice dependingupon to travel is also necessary for their participation in the availability and usability of public and private spiritual, cultural, recreational and other social transportation. activities. To the extent the aged are denied transportation services they are denied full participation Subsidies should be made available not only for in meaningful community life. existing systems, but also for the development of flexible and innovative systems, especially where It is essential that the needs of all the elderly there are no existing facilities. be considered. In the establishment and operation Financial support should be directed toward ac- of the transportation systems and services pro- complishing program purposes such as: posed in the policy recommendations, provision must be made to serve the ethnic and cultural Reduced or no fare transit for elderly . people. needs of minority groups. In addition, because the transportation needs of the rural elderly are Operating and capital subsidies. critical, they must be assured of receiving all the benefits associated with the recommendations of RECOMMENDATION II this Conference. Transportation For All Users The implications of the failure of our trans- The Federal Government shell act immediately portation network to meet the needs of the elderly to increase support for the development of trans- have received widespread attention and study by portation for all users, with special consideration Congressional committees, advisory boards, the given to the needs of the elderly, the handicapped, President's Task Force on Aging, and numerous rural people, the poor and youth. other goal-generating sources. They have repeatedly affirmed that the opportunity for a widerange RECOMMENDATION III of life choices is a basic right of the elderly, that Transportation Coordination mobility is a necessary precondition for free and dignified choice, and that miximization of choice Publicly-funded programs for the elderly shall be through programs to increase the mobility of the designed so that transportation will be required aged ought to be the overall goal of public policy as an integral part of these programs, whether for the older citizen. transportation is provided directly by the programs or through other community resources. The Delegates of the Tiansportation Section Public policy shall require coordination of exist- are in agreement with these goals. However, the ing transportation and/or new planned transpor- transportation needs of the elderly cannot wait for tation with publicly funded programs for the more studies. Immediate action is needed. The elderly. transportation policy recommendations are a call for action now. The order of presentation of rec- RECOMMENDATION IV ommendations in this report shall not be considered as an ordering of the priority of the Transportation Coordination of Vehicles recommendations. To assure maximum use of vehicles and coordi-

65 nation, all government passenger vehicles (such to State and local governments to assist in the de- as school buses, vans and other vehicles) inuse velopment of imprc ed ancillary services, such by Federal, regional, State,county and city pro- as: terminal design, shelters, centralized transit grams shall be made available interchangeably information, traffic control, and crosswalk mark- among agencies for the provision of transporta- ings. Where appropriate, symbols, multilingual tion to senior citizens for their respectivepro- signs, and other devices will be usedto facilitate grams. The use of these vehicles shall be avail- movement of all users. able without prejudice toserve all disadvantaged elderly. RECOMMENDATION VIII An area clearinghouse should be establishedso that all local transportationresources are used Reduced Fares efficiently to meet the transportation needs of the Appropriate legislation at all levels ofgovernment elderly. i.ould provide that the elderly and handicapped / be allowed to travelat half fares or less on a RECOMMENDATION V space available basis on all modes of public transportation. Individualized Transportation The Federal Government shall provide leadership and financial support for the development of indi- RECOMMENDATION IX vidualized, flexible transportation for the elderly, Transportation Fund which provides increased access to health care The FederilGovernment shouldmove immedi- facilities, shopping, religious, social, recreational, ately to adopt a policy which will both increase and cultural activities. Programs should be imple- the level of funding availableto the development mented by local and Stategovernments, private and improvement of transportation services and enterprise, and voluntary community action. also foster the coordination of all forms oftransportation, public and private, at Federal, State, RECOMMENDATION VI regional and local levels or responsibility. Design and Safety Standards The Federal Government, in cooperation with RECOMMENDATION X State and local governments and otheragen- Revision of Highway Trust Fund cies, shall set minimum standards for the design The Congress of the United States is urgedto of equipment and facilities and shall develop pro- immediately adopt legislation toconvert the High- grams to assure the safety, comfort, and conveni- way Trust Fund ;nto a General Transportation ence of the elderly as pedestrians, drivers, and Fund to be utilized for all modes oftransporta- users of transportation services. Implementation tion. and enforcement of these standards should be by local and State governments unless preempted A portion of the General Transportation Fund by the Federal Government. shall be made available for the development of new transportation services and the improvement of existing transportation services for the RECOMMENDATION VII elderly. Barrier-Free Design RECOMMENDATION XI Transportation systems and servicesdeveloped Driver Licensing or subsidized by public funds shall be designed in an architecturally barrier-free manner in orderto A nationwide set of driver's licensing standards provide accessibility for all people. shall be established that donot discriminate against the elderlyon the basis of chronological The Federal Government shall provideguidelines age alone.

66 RECOMMENDATION XII the various States which would further the Volunteer Driver Insurance development of better. insurance programs, shall be encouraged. In designing new, flexible transportation services, the Federal Government should establish a na- RECOMMENDATION XVII tional policy for guaranteed liability insurance to cover volunteer drivers. Transportation for Rural Elderly All levels of government shall take immediate RECOMMENDATION XIII steps to correct the present lack of provisions for EncOuragement for Volunteer Driven- the basic transportation needs of the rural elderly. Federal laws shall be amended to include specific Individuals should be encouraged to serve as vol- definitions of responsibility for rural transporta- unteer drivers for the elderly and be compensated tion by the Department of Transportation. in one or more of the following ways: reimbursement for out-of-pocket cost of services rendered; RECOMMENDATION XVIII a tax break; use of publicly owned vehicles; or assistance with insurance and maintenance of Transporation and Federal Action vehicles. In the absence of State or local response to the transportation needs of all users, especially the RECOMMENDATION XIV elderly, handicapped, rural, poor and youth, the Governmental-Organization-for-TransportationFederal-Government-shall-be-empowered-to-act unilaterally in their interest. An elderly person knowledgeable in the affairs of the elderly shall be appointed as an assistant RECOMMENDATION. XIX reporting directly to the Secretary of Transporta- tion to represent the needs of the elderly and work Private Housing Transporation Near toward implementation of their transportation Individualized and/or public transportation shall .programs. be incorporated in the planning of all privately funded senior housing projects to meet the needs RECOMMENDATION XV of the elderly. Insurance Cancellation RECOMMENDATION XX The Federal Government and/or State governments should pass legislation prohibiting insur- Jurisdictional Coverage ance companies from increasing auto insurance All policies adopted as a result of the recoinmen- premiums or cancelling policies on the basis of dations of this Conference shall be applicable to age alone. all of the United States, the Commonwealth of Puerto Rico and all other territories asscmated RECOMMENDATION XVI with the United States. No-Fault Insurance Exploration of the concept of no-fault insurance RECOMMENDATION XXI and the possibility of government-or arated insur- Reservation Indians ance programs. and operimentation now under- Because American Indian reservations are con- way in the various States which would further sidered to be outside of State jurisdiction, Amer- the development of better insurance programs, ican reservation Indians are not eligible for exist- shall be encouraged. ing or proposed State-funded transportation serv- Minority Recommendation ices. Exporation of the concept of no-fault insur- The Federal Government should recognize the ance and experimentation now underway in unique transportation problems of American re-

67 serv:, tion Indians, and shall immediately provide Roland A. Ouellette, Assistant Director, Highway 'and Traffic through subsidies new transportation services that Safety, General Motors Corporation, Detroit, Michigan' Ralph E Rachel, Transportation Economist,Institute of assure American reservation Indians transporta- Public Administration, Washington, D. C. tion to health care, educational, social, religious, Morton A. Schwabadier, President, Council on Aging for recreational, cultural, and shopping facilities. Seattle and King County, Seattle, Washington Sigmund J. SInszka, Teacher, Sewanhaka High School, Floral RECOMMENDATION XXII Park, New York Post-Conference Action It is proposed that the 1971 White House Con- The Secretariat ference on Aging, and subsequent followup of Director this Conference, can benefit by including in their Ira Laster, Jr., Program Coordinator, Office of the Assistant structured deliberations a special sectionor work- Secretary for Environment and Urban Systems, Department shop having a kind of free-wheeling assignment of Transportation, Washington, D. C. to offer new and- creative ideas. Such a section Members would not be bound by structured issues. It would Kathaleen C Arneson, SpecialAssistant to the Commis-' sioner, Rehabilitation Services Administration, Social and Re- be composed of leaders from the elderly anda habilitation Service, Department of Health, Education, and cross-section of all of the major fields of society. Welfare, Washington, D. C. It would examine the issues and underlying value Joseph S. Ain, Policy Analyst, Federal Aviation Administra- tion, Department of Transportation, Washington, D. C. systems which limit self-determination and inhibit James E. Huddleston, Acting Director, Child arid Family the-elderly-persons'--opportunity-to-be-productive. Services,CommunityServicesAdministratkn- -Socialand This section would suggest new basic RehabilitationService, Departmentof Health, Edution,ca and concepts Welfare,Washington, not now explored in the field of aging. Said con- Ira Kaye, Chief, Community Development Division, Office cepts would go beyond our basic view of the of Program Development, Office of Economic Opportunity, elderly persons role in society. Washington, D. C. Ferree Kolodner, Social Insurance Specialist, Office of the Commissioner, SocialSecurityAdministration, Department of Hmslth, Education, and Welfare, Washington, D. C. Edmond J. Leonard, Director of Information, The Presidenis Committee on Employment of the Handicapped, Washington, SECTION LEADERSHIP D. C. Spate will permit lining of tide and ad- Ryland Swain, Specialist in Aging, Office of Research and dress only the first time a name appears. Demonstration, Social and Rehabilitation Service, Department of Health, Education, and Welfare, Washington, D. C. The Technical Committee Floyd L Thiel, Chief, Socio-Economic Studies Division, Fed- for 'Transportation eral Highway Administration, Department of Transportation Washington, D. C. Chairman Thomas C. Morrill, Vice President, State Farm Mutual Auto- mobile InsUrance Company, Bloomington, Illinois Members Section Officers Fernando E. Alvarez-President, Spanish-American Translation Co-Chairmen Bureau, New York, New York Walter J. !Henriksen, Director of Public Affairs, Amalgamated Francis M. Carp, -Research Psychologist, Institute of Urban Transit Union, Washington, D. C., and Thomas C. Morrill and Regional Development, University of California, San Fran- cisco, $alifornia Consultant Robert J. Ahrens, Director, Division of Senior Citizens, Chi- Sherman G. Irinesilver, Judge, District Court, State of Colo- cago, Department of Human Resources, Chicago, Illinois rado, Denver, Colorado Recorder Kalin Koicheff, Caseworker, Tremont Social Service Center, Joseph S. Revis, Consulting Associate, Institute of Public Ad- Bronx, New York ministration, Washington, D. C. Marion E. Martin, Commissioner, Labor and Industry, State Assistant Recorder of Maine, Augusta, ;Maine PaulErtel, AssociateRegional Commissioner forAging, Earl Kennedy, President, Interamerican Travel Agents Society, Social and Rehabilitation Service, U.S. Department of Health, Detroit, Michigsn Education, and Welfare, Kansas City, Missouri. Richard M. Michaels, Director of Research, Transportation Management Officer Center, Northwestern University, Evanston, Illinois Ira Laster, Jr.

68 Subsection Officers Recorder Francis Barth, State Senator. So len, North Dakota Subsection 1 Chairman Robert J. Ahrens Federal Resource Personnel Vice Chairman Juanita H. Quinteros, Director, Project Brevo. Senior Citizen Program, El Paso, Texas. Joseph Asin Recorder Robert H. Bruton, Urban Planner, Office of Policy and Plans Development, Office of Assistant Secretary for Policy and Mamie Cape nen, Area VIII Vice-President, American Asso- International Affairs, Department of Transportation, Washing- ciation of Retired Persons, Blackfoot, Idaho. ton, D. C. Subsection 2 Patricia Cass, Special Assistant to Deputy Administrator, Urban Mass Transportation Administration, Department of Chairman Transportation, Washington, D. C. James B. Townsend, State Representative, Shawnee. Okla- hoina Marilee B. Cavender, Consumer Affairs Specialist, Office of Consumer Affairs, Office of the Assistant Secretary for Safety Vice Chairman and Consumer Affairs, Department of Transportation, Wash- William Rasmussen, Director, Division of Care of the Aged, ington, D. C. Chicago, Illinois Michael Finkelstein, Acting Chief, Highway and Mass Transit Recorder Programs Division, Office of Planning and Program Review, Cynthia Marano, Writer, National Federation of Business Department of Transportation, Washington. D. C. and Professional Women's Clubs, Washington, D. C. Marion W. Forrester, International Economist, Officeof TransportationPolicy and International Affairs, Office of Subsection 3 Assistant Secretary for Policy" and International Affairs, De- Chairman partment of Transportation, Wrshington, D. C. Williamrld..Spreitzer,-Head, Transportation-Research-Depart--- Donakt_IL_Haines,_AttorneyAdvisor, -Office-of -Assistant meat, Research laboratories, General Motors Corporation, Secretary for Legislation, General Counsel, Department of Warren, Michigan. Transportation, Washington, D. C. Vice Chairman Eric H. Hanson, Intergovernmental Coordinator,Federal William K. Fowler, Chief, Bureau of Research and Develop- RailroadAdministration,DepartmentofTransportation, ment, Division of Mass Transit Operations, Department of Washington, D. C. Transportation, Tallahassee, Florida. Thomas Henry, Economist, Socio-Economic Studies Division. Recorder Federal Highway Administration: Department of Transporta- tion, Washington., D. C. Marion E. van; Executive Officer, National Association of Negro Businc., and Professional Women's Clubs, Inc, Pitts- Ira Kaye burgh, Penntylvania Edmond J. Leonard Subsection 4 Father Anthony Rods, Consultant to the Secretary, Office of Chairman the Assistant Secretary for Environment and Urban Systems, Department of Transportation, Washington, D. C. Leota G. Davis, Retired, Jacksonville, Florida Beverly Silverberg, Information Specialist, Office of Public Vice Chairman Affairs, Department of Transportation, Washington, D. C. Edward Ryken, Executive Director, Martin Senior Coordi- Cynthia Straker, Attorney Advisor, Office of General Counsel, nating Council, Inc San Rafael, California Department of Transportation, Washington, D. C. Recorder Ryland Swain Jean Von Ezdorf, Executive Director, Little House, Menlo Park, California Floyd L Thiel Margaret E. A. Tuttle, Program Analyst, Office of Program Subsection 5 Development, Office of Economic Oppoltunity, Washingtnn, Chairman D.C. Frances M. Carp Jim F. Young, Chief, Service Development Division, Office Vice Chairman of Civil Rights and Service Development, Urban Mass Trans- portationAdministration,Department ofTransportation, Earl Kennedy Washington, D. C.

69 4.1:r:*4' ejiit Xpo,t, 4.r$.41°, {` '

4". Not ,

i SECTION ON FACILITIES, PROGRAMS, ANDSERVICES

INTRODUCTION SECTION REPORT wo hunched and forty Delegates were named to the Section on Facilities, Pro- Preamble grams, and Services. Of this total, some National policy should guaranteeto all older _____50.persons_(21-percent)-indicated-that-_persons_real-choices_as-to-how-they-shall- spend they were retired. A comparable number;45 Dele- their later years. Older persons should be enabled gates (18 percent), were from non-white minor- to maintain their independence and their useful- ity groups. ness at the highest possible levels. They must have the opportunity for continued growth, develop- The Delegates represented a complex of ad- ment and self-fulfillment, and for expanded con- vocacy and service organizations in the field of tributions to a variety of community activities. aging. A partial listing would includeat the State and local levelsgovernment officeson ag- In addition to adequate income,an effective ing, departments of social services, community network of facilities, programs, and servicesmust welfare organizations, homes for the aged, and be readily available and accessibleto permit them senior citizen centers. Delegates from national to exercise a wide range of options, regardless of organizations included representatives o5 several their individual circumstances or where they hap- aged membershipgroups, voluntary associations, pen to live. Such facilities, programs, and services and advocates ofconsumer interests. Among other must be available whether the need for them is participants in the Section's weakwere legislators, short-term or long-term. Theymay be under pub- lawyers, clergymen, union and business officials, lic or voluntary auspices. social workers, and members of the academic Attention must be given now to identify and community. provide those services which make it possible for The Section on Facilities, Programs, andServ- Older persons to remain in,or return to, their ices adopted 28 recommendations for policyin own homes or other places of residence. Whatever the broad yet criticalareas of program develop- the type of resource requiredto assist them in ment and operation, community facilities, social maintaining the living arrangements oftheir services, and consumer and legal protection. The choice, whether institutional or community based, policy guidelines and actions proposed bythe Sec- appropriate standards for thoseresources must be tion are regarded as essentialto the accomplish- established and strictly enforced. ments of an overriding purpose: that olderper- Action is riv.ecIed in forginga national social sons will be able to maintain their iiiclgpendence, policy on protection of the older person'srights their self-worth, their dignity, and theircontinu- and choices that will be reflected inpovision of a ing contribution to our society. wide range of facilities,programs, and services, 71 whether preventive, protective, rehabilitative,sup- RECOMMENDATION III portive or developmental in their focus. To this Structuring Government to Serve the Elderly end there must be strategies for achieving action now, including Federal fiscal support to imple- Primary responsibility for planning and coordina- ment the policies which follow. tion of health, welfare and other services for the older population should be placed in a public service agency with divisions at the Federal, State and local levelich strong administrative authority and funding controls and the capability of Recommendations functioningacrossdepartmentallines.There should be extensive involvement of older people RECOMMENDATION I and independent agencies and organizations in the making of policies and in all aspects of plan- Range of Living Arrangements ning. Tax funds should be more equitably allocated to maximize the likelihood that older persons will RECOMMENDATION IV continue to live independently and to help assure that older persons will have a choice of living Participation in Policy Making arrangements. 7o achieve this, a full range of Aiiage groups should be involved in the deter- supportive community services, public and private, mination of policies and standards for facilities must be adequately financed. Public funds must and services for the older population and older he allocated in sufficient magnitude to assure such persons themselves certainly must have a role. quality institutional care, from minimal to maxi- mal, as may be needed at various stages in an older person's life. The level and quality. of care RECOMMENDATION V and services shall be provided without regard to Criteria for Program Staffing source of payment. Qualifications other than age should be the determining factors in stall employment in facilities RECOMMENDATION II and programs for the elderly, but special effort Responsibility for Providing Services should be made to use older persons in staffing such facilities and programs. Servicesto older people should be provided through a combination of governmental, private nonprofit, and commercial agencies. The Federal RECOMMENDATION VI Government should be responsible for financing Specialized Services a minimum floor for all services. These services may be procured from private nonprofit and/or Older persons should be served by an integrated commercial sources at the election of local and system, sharing equitably with other age groups State governments. those facilities, programs and services suitable and appropriate to the needs of the general popu- Minority Recommendation lation, but they should also have the benefit of specialized facilities, programs, and services based Services to older people should be provided on their distinctive needs. through a combination of governmental, private nonprofit, and commercial agencies. The Federal Government should be respons- RECOMMENDATION VII ible for financing a minimum floor for all Responsibility for Consumer Protection services. These services may be procured from private .rionprofit and/or commercial Government controls as a primary means for as- sources. suring consumer protection should be substan-

72 tially augmented by the participation of consum- standards and guidelines. Such standards and ers, industry, business, and the professions. guidelines shall clearly specify requiremcnts regarding staff qualifications and training and the RECOMMENDATION VIII quality of facilities, programs, and services. A Federal Consumer Agency RECOMMENDATION XII A central consumer agency should be established Legal Services for the Elderly at the Federal level to better coordinate and strengthen the powers and responsibilities of Government funded legal service shall be avail- existing Federal agencies engaged in consumer able to older persons in all communities. To en- protection to ensure that the interests of elderly sure this: consumers arc better served. The Federal Goveminent should earmark adequate funds so that older persons will have RECOMMENDATION IX a guaranteed full range of legal services, including advocacy, administrative reform, -liti- Protective Set-vices gation and legislation. The funds provided Older persons shall be free to manage their own should be a fair proportion of all legal service affairs. ShOizicl public intaireiition-be rieeded, due funding. to hazardous circumstances or situations in which Bar associations, private law firms, law they-may-be-involved,theremust-be lull-protec- -schools; anduniversity-researchinstitutes- tion of their legal rights as individuals. There should be encouraged to provide legal assist- should be development of protective services for ance and research findings to older persons. those older persons in the community who are Lay people and older paraprofessionals unable to Manage their affairs because their mental should be used to perform advocacy roles that and/or physical functioning is seriously impaired. advance the legal concerns of older people. Congress should establish an independent RECOMMENDATION X legalservicecorporationinwhicholder 4g1:- q.afftr4 'Mk ?OW persons will have a fair share of direction, that Age alone may be an appropriate criterion in will provide free services for those who cannot afford them (including rights and property of establishing policy for certri3 programs, such as older homeowners), will charge a reasonable eligibility for Social Security retirement benefits fee for those persons whose incomes permit a and property tax relief. It is an inappropriate cri- modest payment, and whose services will be terion when used to disCiiininateagainst the accessible wherever older people live. elderly in determining /eligibility for insurance, employment and credit, for example. Any cri- Funds should be made available for re- terion based solely on age should be analyzed to search into the legal problems of older persons. determine whether it is appropriate for a particular age. RECOMMENDATION XIII 11. Adequate Income RECOMMENDATION XI Standard Setting While the need for greatly expanded facilities, programs, and services is urgeir, services are not Federal legislation shall provide minimum quality a substitute for sufficient income to maintain in- standards and guidelinesto provide uniforrn serv- dependent living in dignity and healthOlder ices and care for the elderly in all Federally ad- peisons require no less than the moderate standard ministered programs and in grant-in-aid programs of living defined by the Bureau of Labor Statistics offered to the States, stippletherwed by legislation and no limit should be placed on earnings of on the State and local levels conforming to such Social Security beneficiaries.

73 RECOMMENDATION XIV establish a continuing body of Delegatesto make Police Protection recommendations for State and Federallegisla- tion as part of the post-Conferenceaction year. Police protection of the elderly should becomea top priority. A portion of Federal funds for the Minority Recommendation prevention of crime allocatedto the States or local The White House Conferenceon Aging communities should be earmarked for thispur- should continue the participation ofcurrent pose. Particular attention should be paid to the delegatesto make recommendations needs of minority groups. for State and Federal legislationas part of the post-Conference action. Financing forthis RECOMMENDATION XV work should be continued by theFederal Government. Cross-Generational Ties Involvement between young people and older RECOMMENDATION XIX people should be encouragedat all levels of com- Government Organization for Aging munity life. Young people can gain knowledge of the process of aging and become involved with There should be established immediatelya Federal elderly people through the educationsystem, na- Department of Elder Affairs headed by a Secretary tional youth organizations, and volunteer roles. of Elder Affairs who shall bea member of the President's cabinet. Such departmentshall be broadly -responsible fosttheplaiiiiink-,coordina- RECOMMENDATION XVI tion, and funding of health, welfare, andother Communications about services for older people. Public Policy in Aging From the date of establishment, thete shall bea two-year period in which the Secretary shall pre- A policy affecting the elderly will only be useful if pare the plan for the transfer of appropriate it is written clearly, is publicized broadly, and is operating functions from other Federalagencies. completely understandable bypersons with differ- During this period, the Administration ing cultural and linguistic backgrounds. Forex- on Aging ample, the Social Security Administration could should be immediately strengthened in orderthat enclose with the monthly check notification ofen- its original functions as provided inthe Older Americans Act of 1965 titlements and programs availableto beneficiaries. can be more effectively realized.

RECOMMENDATION XVII RECOMMENDATION XX "Tbe War Must Stop!" Increased Social Security Benefits Delegates from every part of our Nation call We older Americans, and representatives ofolder upon the President to end the United States in- Americans, meeting in Washington, D.C.,at the volvement in the war in Southeast Asia. Weare invitation of the President, have studied acutely aware of the human propos- costs resulting from als, programs, schemes and strategiesto make life that tragic war includingwar- related spiralling for older Americansmore than simply bearable. inflation and the unfortunatewaste of our resources in so-called defense appropriations. We However, we are cf one mind when wedeclare declare urgently and simply: The War Must Stop! the primary need for older Americansintruth, for all Americansis adequateincome. We ask for action now from The White Houseto increase RECOMMENDATION XVIII Social Security benefits toa level at which people Post-Conference Action may live in dignity; specifically, we recommend a benefit level of at least $3,000 per year foran The White House Conference oti Agingshould individual and $4,500 fora married couple. 74 RECOMMENDATION XXI from neglect and exploitation by 'datives, friends, the aged individual himself, and the "Special Age-72" Benefits community. Service would be directed toward Although they are United States citizens and the older persons with limited mental func- contributors to the Social Security Trust Fund tioning due to mental deterioration, emotional through payroll deductions, certain residents of disturbance, or extreme informity, and would Puerto Rico, Guam and the Virgin Islands are focus on their inability to manage their own ineligible to receive OASDI benefits under the affairs in such areas as providing for personal Prouty Amendment. This discriminatorytreat- and physicalneeds, planning and decision- ment should be changed so that benefits are avail- making and handling of finances. able to them on the same basis as they ase to Maximum involvement of the elderly in policy other persons. making, staff and volunteer roles, should be encouraged. RECOMMENDATION XXII Multipurpose Senior Centers RECOMMENDATION XXIII Implementation of Titles I and XVI In every community and neighborhood, as appropriate, there should be a multi-purpose senior Social Security Act center to provide basic social services, as well as States are urged to fully implement the service _link_ alLolder_persons_ to appropriate _sources of -provisions-Of-Titles-I and-XVI-of the- Socia'- Se- help, including home-delivered services. curity Act The basic services, in clearly identifiable sites, i.e., It is inconsistent to acknowledge the need for seniorcenters,actioncenters,department of greatly expanded social services for adults under social services, etc., financed as an on-going gov- the Social Security Act and then propose to fore- ernment program, could be the foundation for close this possibility by limiting funding under such additional services as various levels of gov- Welfare Reform. Therefore, it is recommended ernment and the voluntary sector, including or- that funding of social services remain open-ended. ganizations of the aged, would desire and sponsor. Basic social services that would enhance the RECOMMENDATION XXIV ability of the elderly to retain independence The Food Stamp and Commodity Programs should be made available. These may include but are not necessarily limited to: Procedures and arrangements for the certification and distribution of food stamps and commodities Supportive Services which aid the older should be convenient and protect the dignity of person to remain in hic familiar environment individuals utilizing the programs. or to retain his usual living arrangement when this is no longer possible through his own ef- Minority Recommendation forts. Specific serv;ces would include homemaker-housekeeping services, organized home Procedures and arrangements for the certification and distribution of food stamps and care, chore services, home-meal services, and commodities should be convenient and pro- escort services. tect the dignity of individuals utilizing the Preventive Services which prevent the programs. It is strongly urged that States do breakdown of the capacity of the older person not have Departments of Public Welfare to function physiologically, 'psychologically, or administer the programs. socially through detection and through social intervention prior to old age or prior to a crisis RECOMMENDATION XXV in old age. Reforming Public Assistance Laws Protective Services which protect the civil rights and personal welfare of older persons Restictive Federal and State public assistance laws

468-218 0 - 13 - 6 and regulations which in effect deny benefits and RECOMMENDATION XXVIII services to otherwise eligible older people should be abolished. It is recommended that: (1) public Comprehensive Care in Various Settings assistance benefits be based on need without re- Tax funds should be more equitably allocated to gard to residence or citizenship; (2) minimum maximize the likelihood that older persons will standards for benefits should be set at the Feder- continue to live independently and to helpensure ally-defined poverty level; (3)a simple declara- that older persons have a choice of living arrange- tion of need should be the basis for determining ments. To achieve this, a full range of supportive eligibility; and (4) both lien laws and relative services must be adequately financed. These serv- responsibility provisions should be abolished. ives would include visiting nursing, homemaking programs, home-delivered meals, transportation RECOMMENDATION XXVI for essential services and all other seasonably Improving Title II, Social Security Act necessary services. The following recommendations for improvement of Title II of the Social Security Act are made: Tax funds should also be used to support institutional care and construct facilities. A full range Substantial increasein SocialSecurity of serviceshorn minimum to maximumcare NOW and to add funds from the general reve- recognizing cultural differences, should be avail- nue. Senior citizens (62 and up) should be able in institutions. given a guaranteed income of at least $3,000 rer-person-and $4;500 per couple; Ter-year, A personal care benefit is proposed payable to eligible older persons to enable them plus an automatic cost of living increase. to purchase such required services from provider organiza- No ceilings be placed on earnings for tions in each community which includes multi- those persons receiving Social Security benefits. purpose service centers. Basic to the ability to Widows or widowers eligible for Social 'continue to live independently is the availability Security benefits shall be entitled to receive the of a national health security program providing full benefits based on their spouse's earnings comprehensive health care services. rather than a reduced portion as a result of their being widows or widowers. Persons who have earned Social Security benefits independently, then marry, should be allowed to retain their separate benefits until SECTION LEADERSHIP such time as Congress enacts legislation to in- Space will permit listing of title and ad- crease benefits for married couples. dress only the first time a name appears. That Social Security funds from payroll The Technical Committee taxes be supplemented by general revenue funds for Facilities, Programs and Seririces in order to provide adequate benefits and keep Chairman race with changes in the standard of living. George K. Wyman, Commissioner, New York State Depart- Retroactive denial of Medicare benefits ment of Social Services, Albany, New York should be abolished. Consultants Jerome KaplanExecutiveDirector,MansfieldMemorial That home care services under Medicare Homes, Mansfield, Ohio be broadened. W. W. Morris, Associate Dean, College of Medicine, Univer- sity of Iowa, Iowa City, Iowa RECOMMENDATION XXVII Members Trained Personnel in Aging Margaret Blenkn, Professor and Director, Regional Insti- tute of Social Welfwe Research, University of Georgia, Athens, There should be adequate training of personnel Georgia to implement proposals in the area of facilities, Andrew W. L. Brown, Assistant Director, Community Serv- ices and Retired Workers Department, United Automobile programs, and services. Workers, Detroit, Michigan

76 Leon Barks, Businessman, Miami, Florida Consultants Jeanette Jennings, Professor, Social Work Program, Hume Jerome Kaplan and W. W. Morris Hall, University of Mississippi, University, Mississippi Fannie G. Krevsky, Public Information Director, Bureau of Recorder Human Resources, State of Pennsylvania, Harrisburg, Penn- Mary L. Henlmy, Director, Benjamin Rose Institute, Cleve- sylvania land, Ohio Edward G. Lindsey, Director, Health Services, State Com- Assistant Recorder munities Aid Association, Buffalo, New York Mel Spear, Associate Regional Commissioner for Airing, Social Reverend Martin McManus, Holy Spirit Parish, San Diego, and Rehabilitation Service, Department of Health, Education, California and Welfare, San Francisco, California David H. Marlin, Director, Legal Research and Services for Management Officer the Elderly Project, National Council of Senior Citizens, Inc., Washington, D. C. James J. Burr Joseph Mash, Executive Director, Grosse Point Nursing Home, Farmington, Michigan Subsection Officers Norman P. Mason, 'lousing Consultact, South Harwich, Subsection 1 Massachusetts Chairman Ethel Shanas, Professor of Sociology, University of Illinois Efrain Santiago, Secretary, Department of SocialServices, at Chicago Circle, Chicago, Illinois San Juan, Puerto Rico C. Joseph Steller, 'President, Pharmaceutical Manufacturers Vice Chairman Association, Washington, D. C. Harvey Roth, Associate Professor, Department of Recreation, Chico State College, Paradise, California The Secretariat Recorder -Director- Sylvia Barg, Executive Director, Senior Wheels East, Model Cities, Philadelphia, Pennsylvania James JBurr, Director, Division of Services to the Aged and Hark.,capped, Community Services Administration, Social Subsection 2 and Rehabilitation Service, Department of Health, Education, Ch unman and Welfare, Washington, D. C. W. W. Morris Members Vice Chairman Irving Etreim, Director, Services for the Elderly, Office of Donna Bearden, Public Information Officer, Governor's Com- Economic Opportunity, Washington, D. C mission on Aging, Austin, Texas Herbert Kamsky, Social Work Program Specialist, Division Recorder of Services to the Aged and Handicapped, Community Serv- Margaret M. Jones, Member, State Technical Review Com- icesAdministration, Social and Rehabilitation Service, De- mittee to the Older Americans Act, Portland, Maine partment of Health, Education, and Welfare, Washington, D. C. Subsection 3 Philip Grossman, Research and Demonstration Specialist, Chairman Community Services Administration, Social and Rehabilita- David H. Marlin tion Service, Department of Health, Education, and Welfare, Vice Chairman Washington, D. C. Charles W. Pruitt, Jr., Executive Director, Cathedral Founda- Thomas Prather, Program Specialist, Division of Develop- tion, Jacksonville, Florida mentalDisabilities,RehabilitationServicesAdministration, SocialandRehabilitationService, Department ofHealth, Recorder Education, and Welfare, Washington, D. C Anna D. Kelly,Director,Foster Grandparent Program, Charleston, South Carolina Stephanie B. Stevens, Aging Specialist, Older American Serv- ices Division, Community Services Branch, Administration on Subsection 4 Aging,Social and RehabilitationService, Department of Health, Education, and Welfare, Washington-, D. C. Chairman Fran Wersells, Community Services Specialist, Division of Jane Garretson, Director, Services to the Aged, Family Service Services to the Aged and Handicapped, Community Services Bureau, Unilted Charities of Chicago, Chicago, Illinois Administration, Social and Rehabilitation Service, Department Vice Chairman of Health, Education, and Welfare, Washington, D. C. Clara- Bailey, Senior Citizens Organizer, Economic Oppor- Ruth White, Social Insurance Specialist, Community Plan- tunity Board, Clark County, Las Vegas, Nevada .aning Staff, Office of the Commissioner, Social Security Ad- Recorder ministration, Department of Health, Education, and Welfare, Hazel L. Ricker, Executive Director, Howard County Com- Baltimore, Maryland mission on the Aging, Columbia, Maryland Section Officers Subsection 5 Chairman Co-C ntirmen Peg Lamont, Chairman, South Dakota Governor's Advisory Ellen Winston, ?resident, National Council for Homemaker- Council on Aging, Aberdeen, South Dakota. Home-Health Aide Services, Inc., Raleigh, North Carolina, Vice Chairman and George K. Wyman James Sykes, County Board, Madison, Wisconsin

77 V ,

a Recorder Service, Department of Health, Education, and Welfare,Wash- Rodger H. Sandoval, Director, Local CommunityDevelop- ington, D. C. ment Program, Office of Navajo Economic Opportunity, Nava- jo, New Mexico Herbert Kamsky Subsection 6 Gladys Lawson, Acting Homemaker Services Specialist,Com- munityServices Administration,SocialandRehabilitation Chairman Service,DepartmentofHealth,Education,and Welfare, Fannie L. Allen, Directorof Servicesfor Older Adults, Washington, D. C. United South End Settlements, Boston, Massachusetts De Vera Lynn, Student Intern, HowardUniversity, Washing- Vice Chairman ton, D. C. Bernard E. Nash, Executive Director, AmericanAssociation of Diane O'Heir, Student Intern, NationalAssociation of Social Retired Persons, National Retired TeachersAssociation, Wash. Work, Washington, D. C. ington, D. C. Thomas Prather Recorder George Roby, Chief, Division of Adult Services,Department Margaret Blenkner of Human Resources, Washington,D. C. Stephanie B. Stevens Federal Resource Personnel Virginia Tanner, Acting Chief, TrainingUnit, Office of Service Delivery, Community Services Administration, Roberta Brown, Chief, Office of Servicesto the Aged, De- Social and Rehabilitation Service, Department' ofHealth, Education, partment of Human Resources, Washington, D. C. and Welfare, Washington, D. C. Sarah Butts, Adult Services Specialist, Division of Service to the Aged and Handicapped, Community Services Admin- Cleonice Tavani, Older, PersonsCoordinator, Office of Eco- nomic Opportunity, Washington, D. C. istration,Social and RehabilitationService, Department of Health, Education, and Welfare, Washington, D. C. William Tuttle, Community ServicesSpecialist, Communit Services Irving Etreim Adrr.inistration,Social and RehabilitationService, Department of Health, Education, and Welfare,Washington Evelyn Green,..Staff_Development-Specialist,-,Office of Service D.C. Delivery, rommunity Services 'Administration;Socialand Fran Wersells Rehabilitation Service, Department of Health, Education, and Welfare, Washington, D. C. Charles Yates, Student Intern, Division ofServices to the Aged and Handkapped, Community Services ViVian Griffin, Supervisor, Division of Self-Support Administration, Services, Social and Rehabilitation Service, Departmentof Health, Edu- Community Services Administration, Social and Rehabilitation cation, and Welfare, Washington, D. C.

78 SECTION ON GOVERNMENT AND NONGOVERNMENT ORGANIZATION

INTRODUCTION don's older people have little chance of adoption, much less implementation. The following set of total of 221 Delegates was named to recommendations are directed toward building the the Section on Government and Non- organizational base for action, now and over the government Organization. Information coming decade. available from their nomination forms indicate that some 21 percent were retired, and 11- percent were members of one of the minority SECTION REPORT 7 groups. Co-chairman Timothy W. Costello opened the The majority of Delegates represented orga- Section meeting. He introduced the officials of nizations whose activities involve the aging di- the Section and invited Co-chairman Fred W. Cot- rectly, if not exclusively.. Governmental units on trell to provide the Section Delegates with back- aging at the State and local levels were heavily ground and orientation for their work of the represented, as were higher level dpartments, ensuing three days. -chief executive officers, and legislative bodies with broad responsibilities for loCal and State programs Co- Chairman's Statement in aging. Other prominent participants in the In this Section we concentrate on means by Section's work included leaders of national, State, which older people can secure what they need. and community voluntary organizations, many of We particularly deal with the kinds of organiza- them free. aged membership groups. Serving tion that are required, as contrasted with such also as Delegates were business and labor officials, things as changes in the values of individual educators, lawyers, and physicians. older people. At times it seems as if we are faced In formulating a total of 12 policy recom- with the same dilemma that confronteda moun- mendations, the Delegates to the Section on Gov- taineer who was asked the way to a place on a ernment and Nongovernment Organization were neighboring mountain; after several false starts guided by the preferences expressed by State and at giving the information, he finally said, "Mister, local White House Conferences on Aging, and you can't get there from here." by the earlier Older American Forms. Discussion The multiplicity of organizations, the differ- centered ton the paramount problems of develop- ences between the constituences they were set up ing and sustaining strong and .effective organiza- to serve, the differences in priority among values tion for and by the aging. Lacking this support assigned by different sets of clients, the relative structure, policies to meet the needs of the Na- power older people have in determining what will

79 be done in different parts ofgovernment, and in I ow new policies, and if supported in your sub- differentnongovernmental agencies,make .a section and at Section levels, these willgo into single rational or logical planseem unattainable. the Section report. Perhaps the best we can do isto arrange things so that more of the things that older peoplewant The most important thing to remember is that can be secured in an order that reflects theirown if too many of our proposals conflictwith one priorities than has' been possible in thepast. another, or are contradictoryto those which will be coming out of other Sections,we are not likely The effort to do this required thatwe find out to be persuasive. What we must do istry :3 find something about their needs and their priorities, the greatest common groundon which we can all and the way existing organizations work. Asa stand. This may mean thata position held to be writer of the workbook used in this Section, I of very great significance bya particular minority had to sample whatwas going on in all the will not be supported by enough rolesto get into States, at the national level, incounty and local the Section report. Those who loseon this issue governments, and among at least the leading can take satisfaction in the gains they make on nongovernmental organizations. Iwas helped by others. the fact that since the 1961 Conferencewe have, through research and demonstration, been learn- Organization is a difficult subjectto deal with. ing more and more about theprograms and there Those who think of it interms of structure put are now many more knowledgeable people than great emphasis on locating an agency that deals in any previous times. Later,as Chairman of the with their concerns highup in the hierarchy of Technical Committee, Iwas also made aware of authority. Another point of view holds that itis the -fad that both older people andexperts are political "clout" that givespower to aiiy agency. far from being in agreementas to what is wanted, So if somebody in office doesn't havea strong what is being done, how well it is being done, and political support inour society at large he can't what changes in organization should be made. It get much done, no matter where he is located is no wonder then thatyou may find it hard to on a chart, or what title he is given. Some of the discover clear lines to be recommendedon the matters you will have to decide on relateto these basis of adequate evidence thatone rather than two somewhat different ideas about what makes another cause will serve all older people better. an organization work. Most of the organizations that dealwith the In preparing for the Conference,we were try- problems of older people ing to cite for you the evidence that led were developed to deal one with problems that the aging sharewith other group to support one kind of organization and age groups. So, for example, health organizations that which would cause another to take a different are built up around the means toprevent or cure track. We wanted to focus your attention on a disease.Similarly, much public housingwas limited number of issues so thatwe would be developed for low income people, without refer- able to get some action, rather than makeso many ence to whether they are young or old. Organi- statements that nobody who was trying to help zations were not createdso that one agency would older people could findout what they most deal with the health of older people, housing wanted. Becausewe limited the topics we pre- for older people, transportation for older sented to you, some people suspected people, that by and all other concerns of older people.The struc- pointing to these proposals wewere also trying ture of government in Washington became what to prevent discussion of, or resolutions on,a num- itis under the influence of these ber of other topics of "functional" greater interest to them. organizations. Here wemust decide whether to This is not so. In the subsections it will be possible devise means to increase emphasis on for any of you to propose the needs new topics. Dr. Cos- of older people in each of theseorganizations, tello has discussed the rules under whichwe will or try to create a special structure to coordinate operate. I am sure you will agree that they give work for the aging independently ofthe existing ample opportunity toanyone who wishes to pro- departments, divisions or offices.

80 While-we are-doing-this inour Section it -approval of. Title -111-_prograMs_ which arerun will Undoubtedly- be true that other Sections of -by, State-agenties, _though there waSa _great. deal the -Conference, dealing With substantive needs,, Of complaint, Mo. You willagain need M.iecog- will also be recommending changes that they nize_ that many other -Sections of -the- Conference I. -diinktepretent the -best WaYS.--ito solve- the,-prob- will be making -_-recommendationson this issue, :laps> they are dealing With:. SO ifyou decide and in the ,Post-conference-era- you will -have: to -on_-one---approach, yOU::ate--iiko1yto be supported take their support or antagonism to.-yOur-position by those whowant "functional" autonomy,_and -into acrOunt. will be opposed by these groups ifyou .try- to :control all ierviCes -for--ihefaging_in a tingle, 4e- -PerhapsI ha-fie:said enough -about-the,com- 43#tilient. The conflict will thoWup not only in plexity Of' the problems Wefate.:-Ii-_:haS:been the the -reports of the White .416uSe:. Conference,: but genius of the Americio,systerri- that over- also at hearings r, befOre the tongrest, andin State come odds. In spite of the lack and Tocar. government. Theseare .the-lcinds of of -ra-map or --blueprint,, I :atti-7inie.:that-you will considerations we were trying toget you to thin help, find_ a way to getfrom Where- we are to -iiiiefesvi--want. to go.-

--In the:firit-White 'Honk Conferencewe Were divided Over--the-Oegree to which _older 'people: should demandAirthereihOnid be n-stiong_advO- cite --_ of their interests within -government itself 'the-19'71.- White -ilonse-COnference-On Aging_ 0ierything_:-thar_I- learned "from- studies for the has been diVidedinto-14 Sections, 95 Subsections, ;Workbook from reactions- of the Technical:: Com- and several Special Concerns Sessions, allton- mittees --anrFfroM:6 rimMialty_=inrl''State Confer- Sideting-a-staggerititirtaq'OUtirOblerhs:aniLneedi ences, supported almost unanimously the :idea of our Nation's older population. Whatever their

decisions,_ thar-the-riMe- hascome forjGovennthent.-tosup- and/or :proposals,_ plf advocacy of the-interests_ -of- they rultimately euir become theconcern and the aging. This ispciSition- you may wish to sup- -responsibility of the -Section-- Oti.GoVerninent-and

Tort or Iti'question: But the -decision aVto---hdigr- Nongovernment Organization,.if they-_ are to be .sttongly-7govertinient is to -advocate the eldeibeS iinpkuiented.

Conceal: will have a_bearing on all of the subte-- -Thi Sëcozi:;iecognizesthat the -problems- of_ quentdecisions--thatyou thake. the -aging, are statewide andr: nationwide; they There is a general issue facing- the.county require multiple solutions, they must -first have -as-to -Whether we are to continue to -centralize local identification, they cannot- and willnot be decision-making in Washington,_ with a -copte- Met- successfully without the involvement -of all tment_inkteate in the_ pOwer of -the central ;govern- -government and nOrigoverrinient- agencies -con, ..ment tti=dittribute the wealth- and other resources ternertviith7the aging; they -clenand-a- coopetatiVe, Of the -Nation. One aspect -of this zit the Way correlated approach *kith= extends neededservices service for older people is to be provided Shall- tO=ail older-persons; and_ they-must-13eunderWrit- there --be,ati increase in the power sarirt_fmictions ton-'beyond,Speeches, proposals and laws, bycorn- of, Sayi,the-Sotial_Socotity--systetk which Isrun mitinents of ManpOwer and sufficient funds. almott,withonereferenceto-State-Or local -g-oiern, Further, this Section recognizes that both-gov- menu- ormongovenunental. agencies? Or, -on- the ernmental and nongovernmental agencies-must Other hand, Should: there- be 'devolution" with .iet, as advocates' for the elderly -,and- be heldac- -many more resources being placed in the hands countable kith lor what they do and for what of--organizations that can inunediarely get -feed- they do not do, to- advance the interest Of older back =Which shows them- Audiare and which people. are not successful programs? Whatever organizational patternsare estab- _1n-the research I did, I found very widespread lished and/or modified must now include focal

81 pointt-of-authority :and responsibility_ateach level levels and full-dine staff -neededto-forMulatc of government: and =administer policy,-1-andthould'"be -assisted:by an advisory council, '_and- should-,be required- to Finally; this Section_ =introduces- -its _own pro - Make._ an acturate-_and-comprehensive -anktiat posals -with the recognition that society has grown port on --its- progress -in resolving problems and ,so increasingly- complex and interdependent -no Meeting _gOals. This -White 'House 'level office individuaklperson_and no individual-lagency can thOuld-. have enough -prestige and- resources to as, provide -for- the need_ s, Of peOple'through- sure, that it will encouragethe. development Of pendent efforts. The time has come--to =develop,. -parallel; units- at the State and community levels. support, and enhance an-, improved and -itrength= erred moving organizational forte Whic will lead' to strong - reforms- .and a_ction-'whereby every RECOMMENDATION 'III- .older person in our land shall:-be privileged to IntogaiernnientatRelii tionibipu iife in decenty antr-With _a sense' of _personal _Worth. RelationshipshetWeen_agericiet imaging °arid other= :publicagencies-should-be tharacteiized-byfthittitial adjuttmer4S- antL:Cooperation:. at all sgOVerninentat Recommendations leirelsand- by durable joint .agreernents tpontibility-fot teteatch, CompiebensiVe,:planning;_ RECOMMENDATION= I. .and-proyision of" serVites-and shOuld .Adrotacyby Public and--Volitntary,Agencio be-'-bated: -teiponsive- td-older

Americans_' opinions ,incl'detirei at_thefgtait -roots" PubliciagenCies shouldbe empowered, anthrolun- tail- agencies encouraged, to -undertake = and /or leVels._ pursue more vigothusly the -adijocaey of Older interests,_ -Mote. diteCt RECOMMENDATION_ communication with, and participation -by, the qayeimnenitilfzinding_ and Standard Setting elderly-and/at their- organizations and-the:general public. GOvermiaentaltespOnsibility,..particularly fur pro, viding- funds -- and establishing standards, must be RECOMMENDATIONII- emphasizedAt thetieCessatjitaCilities and services are to -be, Made available to-older _people; The Government Organiz'ation- for Aging delivery of services shOuld Make itakinium use At all. levels of gOvenunent,_:a- central office on of Voluntary and ptivate organizations which can aging: should be e_ ttablithed- in the OffiCe of the meet the-standards established-by gOierninent in Chief -Executive, with responsibility for coordi- consultation With consumers and -the providers, of nating- all programs and activities 'dealing with service. the aging, fostering coordination betWeen governmental- -and nongovernmental programs directly RECOMMENDATION V andinditectly engaged in the provision of services;, Coordination and Support-Policies and ior:planning, monitoring -and eva-luatingserv, ices and programs. Eath- operating department Overall agency activitiesin aging should be should' establish the post of Assistant Secretary. planned- and organized to provide coordination for Aging. with _responsibility for maximizing:the and support in both vertical and horizontal di- department's impaCt in relation to- the -needs Of mensions. Lotal agencies thould,_participatein- the the Older perton. A coordinating: council should formulation of State plans; State agencies should be established in each central Office of aging to participate in the formulation -of comprehensive be chaired by the director of the office, and should plans:and national policies. Such interrelatedness include-the several department assistants on aging. should include governmental and nongovern- At the Tederal level, this central office should be mental organizatiOni, private and voluntary agen- implemented with the authority and funding cies, and representatives of the elderly.

82 . RECOMMENDATION VI thtinieation: with State-units on =aging to ;provide advance- Private and Voluntary Efforts _- of direct' Federal -giantsto individuali organizations and agencies; -GOVernment at :should encourage -and foster the. partitipation of private - enterprise and -RECOMMENDATION Voluntary orgariiiations, including, those. whose membership.- is _drawn --frond .amOrtk: the SuChr-eiforts -10 meet-the 'needs-Aif _peOple -SpOritConisisittee, on- Aging= should. :pilot research :-.and deMonStration projects, direct service .proiams,_.,Sell-beip 2.pra ial-coniniittee the -aging4hould ,:be ~et= grams, -informational;. -educational` and --referral House -Of Repfe ierviceS,:ilariiiiiig Arid' triin prOiraini. sentatives, functioning in 'At coinpaiahle-lole to that of the .United 'States-"Senate Special Corn- -RECOMMENDATION'APII- Entitlententiftulenikei, RECOMMENDATION' XI: -Basic faCihties and serViCes.ShOuld`_be proVidecLas iteorileringAlatiottarPrioritils: rights-to. "irhich-.741 Older '.-people'are_-erititied and- National priorities= must :he-Atorderecl-iio,.ai the oppotrunitiTto-- Share theie facilities and sere= ,APotate:a..ijreater,-Shati-of onr'Vation's-.resources ices ought` to _be-available_ older :people; to-Meetthe rip* otitsfoldef-ddios: adVeisely:cittniiiiianted :niust:be entitled to- special- consideration. RECOMMENDATION XII RECOMMENDATION- VIII Poi-Confetinie_ Action Rights of Older People -Means, should' be- fonnd =for a continuing "Con- fere-nee"- on:the_ aging to aid --in= the -"follow -up- of All efforts-- to Meet the needs _of. -Older =peOple the -recthrithendations,ol_this--tniie--lion.Se-COn- whetber, goVerninental-Or- private and =voluntary feience on Aging, WhiCh-- also-- :WM] Id- &tend be= -agencieS,7sh6uld be consittene_With:i (a).- the:First lond the announced ftAlow,op=year.of 1972 and Amendment freedoms of association and expres- even-Until the next- White:HOUse:-.COnferenCe on sion; -(b)---the righutO:participate.iii- goVernment- Aging. sponsored--progranit-free-ifrOin- :religious, -racial, ethnic-andage discrimination; -and -(e) protection of one'siperson- and -prOPerty, particularly in institutional-Settings. SECTIONLEADERSHIP RECOMMENDATION' IX sp;ice will permit lilting of title .and ad: drat only the firo time a name dppqrs. Accountability for Policieson Aging The integration of governmental `activities -in the Tech_ tii41 Conunittet for GoVernment field of aging_shOuld be -unproved by the Federal and NotigoVqnment Organization agencies, showing greater- appreciation of the _fact Chairman that the-- principle of accountability- applies -from W. Fred Cottrell; ,Professor, Departments of-Political Science and Sociology, and Director, Siripps-FoundatiOn for Popula the Federal _to the State- level; as well as-froth. the tion Research, Miami University; 03tford, Ohio' States to the Federal adminisration.- Federal ac, countability to the -StateS shOuld.provide sufficient COnsultants William D. Bechill,,Chairman, Social Administration COneen. lead time when Federal policy and administrative tration,Schoolof Social Work, University of Maryland, changes are to be announced, as well as prior Baltimore, Maryland consultation regarding changes-in appropriations. Ewald W. Busse, Executive Chairman and Professor of .Psy- chiatry, Duke University Medical. Center, Durham, Mirth Federal agencies also should improve theircorm. Carolina

83 -Members Consultants John- H. -Billard.--Executive_birei-tol, Welfare Council -of William=D-Beehill and Ewild W.,Bussi Metropolitan (4,410,-.aaialso, Illinois -Recorder Frederic H. Barth, President Philadelphia College Ogee-- pithic Medicine, Philidelphiii Pennsylvania Lloyd- W. fialioribisi Director of Membership Services,. American Adociation. Of -Homes-for-the Aging, Washington, Robert Neil bider, Psychiatrist, Washingttiti;-D.,,C. D._ C. Steven 60, President, Maivel Enterprises, San Francisco, Anistant Recorder- Fred- Faassen,. President, A*eikair Association Of .Retired Priee,,Associite-*Regionaltoininissioner for Aging, Pe_rsons, Social .-aad, RehabilitationService, ;Detriment -of- -Health, EdUcition, and Welfire;:.Philidelphii,',',Pennsyliania Herbert. -Miller, Fedeialt Mint Counselin, Wishington, Management;Ofiter--:. . iird-T:Surgeon;_ Fort.Ladder : Aifred.E.,Oundrir, dale, Florida Anhui -HE ;MO-ley, Pres-idol-4 'Parade Puhlishitit ComPiny, I nc.-,-.IsIeW Yoik;NeVt- TO& S-Obiection- Officers

James 14. Nabnt, Former President, Howard -University. a. r- -Sirldectixi- Itoberr,-PriCe,.'Preiident,Price ,CapitalCorporation ;- ;Nei!, chaunian Cernoria D Johnson, Directid, -3-Washington Bureau, National drains-1 .Schadliand, :President, BrandeiS University -Mil. thetzi,:Maisithirsidts- ice 'Millman Irene K. Thresher, .-.Prilident,,- Brevard County Council on §tOleTY SilVeni,-Engineei,,tfiliii, -Florida, Aging -COcoe:Beatli;;Flotida Rector-din- Josephus Younger; Superintendent. of MailsState Depict- leierind 'Janke. G. -Ben*, ,Dirittor, Opportini it* nient.-Of- Agrictilture-Oklihomi- City; Oklahoma -Prog,rani..forthe Elderly, -}ItininillerAlahnid SubsettiOn .2. The Secretariat thaininit Clinton -Mellor, R ither,ElgiO, Arizona 154fcm- Nike Chailinin Alfred E. Dundier Technical Stiff Assistant, White /louse Jitdie"-Williim A.Honeycutt, Jr., City Court, Kansas City, Ctififereri..t Agini,_ Washington,=D:. C /Ansonia' _ - Steinhart Reander- John Doyle, _:Planiiiiig Specildiii--in_Aging, Older Americans John- if. Ballard Services Division, Administration_cin,Aging, Soda! add Reha- Subseciiidi -3 bilitatiOnService;.Departnient of Health, Education, and- Wel- fare,-Washington, D. C. Chairman- Allan:H. Wane,- Chairman, Task -Forte on Aging, Greater John _Guy Miller, Stiff- Director; Senate SpeCial. IndianapOlia-Progress On's-nine on Agin, Washington, D. C . Conisiiihee,_ Indianapolis, Indiana Vite-Cheinnan Idwience Miller,. AJthiflistratie Officer,Executive Office, Community Services. Adini-nistration, Social and -Rehabilita- Leslie Newcomb, Executive Director, Southern .Mississippi tion lervice-Deparinient- Of Health, Education, and- Welfare, Planning and -DeveloPment District, Hattiesburg, Mississippi Washington, D. C. Reander Charles Odell, Depink Assothite ifinPowerfAdthinittratin for Irene K. Thresher U.S. Training and -Em-plciyment Service, Manpower Adininis-. Subsection 4 trationrDepartment of Labor, WaShington, D. C. ..- William E. 0001, ,Staff-birector; Senate Special Committee Chairman . on Aging, Washington, D. C. Alvin A.-Burger, _Retired "Executive Director, Texas Research league,. Austin, Texas Nancy Tide, Program Analyst, Office of Program Review, Office of Economic Opportunity; Washington, D. C. Vice Chairman CleoniceTavani,OlderPersonsCoordinator,Officeof Robert B. Robinson, Executive Director, Division of Services Economic Opportunity, Washington, D. C. for the-Aging, State Department, of Social Services, Denver, Colorado Recorder Harlan Logan, Former Edited of life, Meriden, New Hamp- Section Officers shire Co-Chairmen Subsection 5 -Timothy W. Costello, Deputy Mayor-CityAdministrator, Chairman New York New York Jack Leff, Executive Director, Council of Elders; Malden, W. Fred Cottrell- Massachtuetta

84 _ - -

Vice Chairman 'Robin .Hemphill,- Management- Analyst, :Office Thoniii Gardner, Special Assistant to the of the teue- Governor ,Olympia', tity;,Depiriment of Health, Education; and Welfare;"Wash- Washington Ingtok;-D:-C. keeorder -Ceril.-Hoitimini Assistant -to'Ithe Assistant :SeCretary for VadirSheid, State 1:epresentatiire, Prograni Deirelopnient,' Department 'of_the' Inierioi, Washing- Mountain HOme Arkintai c.. Asiistint Recorder -Wtine Kong, sSiStant,:13rOfeiso' Oeparttneni- of Ferti,,Pence;Supervisoi, Division of Family-Services; -15epaCt- Work, and Rehabilitatkin; SoCial tnentf Of.:Meatay,Heilth and Rehabilitation`, Services, Jackson= , - Federal_ City_. _College, 'Washingnin, ville, D. C: -. ,DonaldAindiy, F.cOnomitt, -*tread' of-Libor be- Sub-section6. of=' Labor, Washington; D. thaitinin- Phu GOY- Miller Anne- j. Berier; Member Hawaii toinniiniaa-On Agiag,- William j...Nor Honaluln,,H1Waii .Administration on- .Sociaf_ incl : Rehabilitation', SeriiCe,- Department- of Vice Health', Education, ma- Welfare, -Washitignin,;D:'C Weeks;- Attorney; Coluiset Massachusetts Records' Willi** E. O_rioL `Anon, ,Brown MiyOr's- quiiniisiion- Directo -Of Resource ,Agingicleieliad, Ohio lkiliiation;.:O:fiCe_ CoMiiiiinity,:DelieloPifietii; 'DePartMent _ of-Hotilink llibitir-DeirelOPmeiteirWiihingroni- D. C.. Sol Sherman; Secrion,ithief;;:DiviciOnof _Stine Operations, Bureau:of,:Health Insurance; Social -Stkiirityz ,Depiiiiinetie, :He-14h, '.Eduattii* Baltimore; 'Maryland. Pederalite*St#0, Personnel. . Delbrali .Cooke, S,:Creinit .Offici; of DegC:iiietit ofHousing=and' UrbanDevelOPinent;_-Washingron,. IV_ -Eleanor. Tompkins, Program AnalystTrainee: Older_ Amer- John-Moyle AdthitiiitritiOn Aguig; Side and- Rehibiliratione,Servite;,DePiiiiiiiiiii of -Health,Edurinion.4.1id JessieGertnazn,..Deputy,Director, =of ..Office, of- Planning, Reiearth, and Triining; SocialnudiRehabilitation g Odessa:MC*44- CdraniitilitY,Action--Program--Specielist; SerVicei, Department of: `Health; Education; and--Welfare,. Older Washington, Persons:Divisioti,,,Office;Ofi-`Eintiomit Opportunity,Wishing-

TION ON PLANNING

INOcolIcznoNT attivirle -golo4a.s4,iF.EiliCeci, on the. totat,of164-'-Delegateg WO. named``-,to importance-OVgiVing=ipecialCOniideratiOn,fo. the the :SeCtion 04 ;Planning: Information probleinSs of racial and inOritie*=/plati nomination:, forms. serve-- the .older. population:. -Underlying; theSe . ihdicateS.shat ,some 15= percent, Were- recommendations retired; anci.ltpertehiWere-metnbers-OfMinority insistence that plan- groups: iinilergirded .=byf COMPrehensiVe:'research and professional tfairiing Piogr**, a. Vital'. ThenThe participants in _the- Planning .Settion'repre-. :merit-,for aetigiOns sentett.a *We: range-of ,otfoleSSional,_ancilteChnittal- that -*ill have lasting and significantbenefit for ocCUpations. AppinkiMately,One-sixth: of, the ,gates` .held _OoikinS associated the -field or Planning.. Attong- them-we-re--11101114 ,SECTIONREPORT 'poRT berg of community -=and -State--,planning,',COUtitilg;, Preamble:- SpecialiSts::itt!prOgrath.tleVelopmen(and.CoOrdirta7, -Many:AineriCatiSIOVe ;f0Und, their-later years_ don; directors: of areaWide-._Planning -*gratis, ro be:,- a dine. of new opportunity,-fulfillmentand ettiplOyed-.irrAfie, area growth 'it is:the :kielief.- ofthe :Settionrorf-Planning of services- and research, development that thorOiigh ,and sound :planningin aging is consultants, anct,profesgois-of community most important -old- 4,0 for most affairg;:and_ social- :Welfare. tecauSe_ of its technical 4theriCans isto beCothe a reality. knowledge and:Operience,'thisgroup Was..4.rell- 'inahning in_ aging is prepared ; guide discussion totvard= the ceVelop- a. protess. through WhiCh nierit and fornailation of recommendations our - society must determine those: stepS tobe taken to in achieving the :goals; 'oa::,objectives of hOrh achieve- long -range CbiriptehenSive planning.in the field of aging; -614er. persOns- andr-stliose :who willone Cky-be elderly. Planning, forthe, future is the -real means Other ,participants in the Section Wereleaders of -changing the conditiOns ofold:_age for the of senior cit4en... groups, -Staterepresentatives, better: Plannitw. 'botir.the forMing social Workers; attorneys,_ professorS,gerOntolo- of goals. and a.-.'weighing of theadvantages- and giSts,_ executives repregenting,State and local-gov- disadvantages 'of any plan -of action. Goodplan- ernmental units, anclelderlYpersons themSelves. ning -sequires knowledge of needs,resources and priorities. Infoririation_ baSed- oil solid research The Section on Planning adopted- 12recom- is a basic tool-iivgOod`platining. mendations, The recommendations -call for action Too_much of our planning foragiiig has been which Will focus responsibilityfor planning at on a short-range batis==going frothcrisisto all levels, of the public and _privatesectors, as crisis. While some movement toviarchlon,glange well-ag -provide for the coordination of planning planning has been made bya number Of bOth 87 goverilMental and:priliate4ronpS,--inany, feet. that- ,RetOtiMiclulltio:tts Short-terdc_patchWork --planning' has- characterized planning: efforts: RECOMMENDATIONT Governmental Pkitin in-Aging Planning, which aims it the Tong -range -needs, of the elderly arid' attempts to -lOok into the To be reSpOnsive; planning:_MuSt involve inputs -future to anticipate -needi' which" Mak-arise in from many segments and":-Sectors ,off,Our society: To-;be.effetti*e,,,this: planning-inust -be compre years --toy come; 'it' needed: Many of the needs V./ of our _present older citizens will be:the-sairie_ as tie istit.--an& COordinated; -The iplatinning efforts -of the needs of Am who are "now government =should- dintinue. to -constitut the tivh6 they ate- older, some ,neects-may 'be, differ- basiC Mei nS f.throdgh:' Whien7ihe_ Nation ;,pla ent Great social- changes;. which may take yeari, aging. *e. must recommend that goVerrithent to accomplish, may be" needed. OVer-, all- = levels-lie regtdred it?-_proycjide opportunity croading,POPUlationgrOaiih,-,etiliirOnMental,-Cdti- for signikint the tio0oyern= arict.iotviil,:government, sector and: consumers' in the deCiSion- the lessened, ability, of an citizen to .MakingAiroteSS, plan for the future' thakei,:piatining; needed -today, tomorrow;, anti-:for -yeark,',:to,Cotie:; ItECOMKIENOATtOST 'It 1 4:014niiing-,,iritist not ,be_tOntd.Sed,;viitlidelayi ;It Ait :Picea-Jaw office:, on: Aging never -be.-used as an:- excuse for We.-must _understand =that '.action-:noi-e is not A separate.,entity- should' be 'created the contrary tothe -need' for long -range Executive-office-,-61 'the President through Jegis,_ Instead,. the --fun& Spent -Ori mean lation and :charged' with the-;ieSponSibility_ for that the - programs which are developed are'tnean- comprehensive planning: and ad*oticy- in aging. ingful; well thoughtout, and truly effective. MOre; This entity_ShOuldrhaile.'resbdices -(e.g., authority, rather tharrless, -time .andinoney- may = be needed ;. funds; staff).adequate to. meet thil:respensibility. The Adthinistratioir Ori :Aging Aoul& be- retained= Our Nation_is constantly-setting,goals 'for,itself Within the,Pepartinenttif.Health,_Fdticationi and in all-areas of national- 'Concern. In-,the rfield- of Welfare,- htitit-.019-0111-:6e- raised to the ,statds of aging. as in-other -areai.of COnceini:the,priOritiei an independent, agency within the pepartMent, whith: we as a Nation -set, are most mportant. -reporting.- directly the .Secretary:- Indeed, the very place_ that we giit to the needs of our present older citizens- will' be ,the same as There should: be an interdepartmental committee deterthinett by the action -We ,takenow Planning With-:-representation:,_ at the-: Secretarial level= to be withodt_ action Would- .be.,a,crUel- hoax. _Action- -chaired= 4 the senior Federal ,official -on -aging. without planning would be.an- apensive exercise. RECOMMENDATION *f. The following policy proposals -repretent feelings and attitudes of Delegates representing Planning--Unitrin Aging all sections of AMerica.:Eideily -Americans, plan= There _Was -recogriltiorr of the urgent need' for a ners, Citizens: involved in 'both- the _planning and commitment- within- each State government to deliVery. of Services, to the elderlY- were 'rePre- provide conaprehentNe -planning in aging. sewed in each Section of the Conference. Plan- ning to identify and state-the needs of the elderly, It:is-recommended-that _this (build beat be realized planning- to develop _Methods of meeting _those by- the establishment of a separate entity dedicated to comprehensive_ planning in aging within each needs, planning to -finct the Means- -to generate SuppOrt and-galvanize-the Nation-actiou- -each State gOsiernment. step of the way needs,clear guidelintS. The policy The leadership planning mechanism at State and propOsals herein may assist in finding our way. local levels'should, to the extent posiible, parallel

88 the, mechanism at the Federal leyel. Where:ap- provide coordination of. _Nanning: activities_ .10 propriate, Stich:planningat- the local should, aging at-all three levels of_ gciverninent: and across be undertaken on a.-Iegional, multi-countY- department lines: TheSe should- regiona! basis. forums ,organiied't;y: the. FederalRegional* Coun, CornprehentiVe_ planning at the local levelshould and' systematic Federal and State-evaluation be encouraged, but the ineChanism leftto- focal of planning:in option. This .effort should eMbraCe a:partnership In order-to-allow. maxiMum-fieicibilitYat the_State between_ the governmental and voluntarysectors and 10'61 levels for innovation, :Federal funds- of our SciCiety: in .the-forni of 'grants without ,restrictiOn should be. set aside for4ong-terin-planning in aging. RECOMMENDATION: IV . ,Tecbasical AsiinanceforNon4tatelnriiiikdons RECOMMENDATION' VI Adequate technical=aisistatice-.and Consultation .mq04;$er-Pici,Peograilis-AforeResporyive planning,for, meeting the needsof the,elderlY . shall be provided, possessions and: The-platining mechanisms that been,detret- other. -nOnstateiurisdictions Of- the:VnitedStates; -,oped- coninitinitiei ,and. ,it the State and_. na- tionaf:letrels:Should":increase_their- efforts.to, make *ECONIWNDATION mnitigenerationaJ_ -prograini, and; 'services: more

respOnSiVe to the concerns -Of_ -Coordinated -Conkrebeniive;Planning- Orions and= m ore effective = in 7:Meeting their, OeedS. 'In, instances PlannifitiCtivities- in aging:of, thethree levels of in -which inidtigenerational3progranisand services, governMent shOuld be -related ',,tO each-other,and Cannotbe ,Made. responsive enough to -Meet the planning- -at -- State and local levels should.receitio needs of older persons,_ new-Or expanded- pro- - -financialsupport frOM the-'Federal- government. -grams :planned -specially for the eldeily ShOuld be- developed: In order_ to insure, that. comprehensive planning functions-at :State and, national' levels- are meaningful: nd "effective,' - priorities :andierV! RECOMMENDATION ice needs -should -be identified-, at the locallevel. Criteria-forPkinning,Stafflor Aging Federal -hinds should be -provided' for -local -planning in aging- and be channeled -throughState Planning -.inaging- should be basedupon experi- -units On-aging which in turn will alloCate-fundS eriC'e -and*-_expertise of professional -and .parapio- to regional-,and local planning .bodies -for this feSsional- personnel and specialistsin -aging with purpose. the-total involvement-oivan-early and continuous basis of a majoritrrepresentation-Of the Federal- agencieS should be directed elderly, to assure that including-racialf and edinic ritinOrity any Federal planning-grants -Which have iinpliei- _groups. This dons for human services, whether made involvement should be guaranteed in- cilf to States ning for:,,the elderly at- the -Federal, Saxe and or localities,, -Shalt require specific planning, for local levels._ Age-alone should not be the the special -needs of the aging.During- all plan- ruling ning stages; die development of the factor -in- =planning; -thus, Middle-aged andyoung plan shall persons shouldbe included. be coordinated-with the Stateagency on aging. There should be basic mechaniSms-esfablishedto ,RECOMMENDATION VIII Elderly under Revenue Staring A minority report Med upon a vote of 37.32on this para The Section expressed graph provided for conclusion- of the paragraphas follows: grave concern about how "planning agencies at all levels must be responsiveto needs the elderly might fare underrevenue sharing and priorities identified at the local level. In general,Federal arrangements. However, if Federal revenue shar= funds should be provided for local planning in agingand channeled through State-units on aging, which inturn will ing is enacted, enabling legislation should provide allocate funds to regional and local planning bodies." for protection of the interests of theelderly. 89 --RECOMMENDATION_IX All planning shouldinclude theuse of exist- Prioritiii for Minority ing private resources, body proprietary andnon- Racial and ethnic profit. discrimination and ica-attendant consequences have condemned- substantial ,num- -RECOMMENDATION XI bets of -minorityelderly-to loiv. levelS -of income -.and inadequite'healthand-hOusing prOvisions: Too Planning-:and theBudgetary-Process often, these minoritygrOnps,of the-elderly have not had the resources Planning:should be -linked'to the budget-process or capacity -to stand up:for and, therefore, their- rights; nor have we recommend that copy of governmental agencies- and the planning and:priority-strategies, for the- elder- citizens' organizations.. adequately terVed-iiidy0= lybe submitted cates for them. Therefore,_ to the elected andexectuivepublic planning ',for _aging officials- who-have -a- direct -role inthe_budgeting Must- take priority -cogni4:,Mteof:the- aboVe--ijroh: and appropriations lems and ieek-ro processes.- correct-,ind_eliminatethetn!. While we_inutt- improve- the quality_ of;life for -all RECOMMENDATION-XII the-404; our toppriority _Must ;-geto those--Who suffer. ReoidtiiitgcNittiOtatPribritiu- Most..Ainerici-miiit_ addresiAtselffirst to the needs ofthe elderly poor.- In- the Anal=arialysis,,planitingin behalf of stems -from_ the :batic values society, those -val. -ate_ translated. into-goals, objectiVis ind 1 tiesAs. planning- RECOMMENDATIONX_ for agingliroceedsiit !be. neCessarylo -address these ReltiOnsiklitx_Atanintabiliti,_-12erponsivenos Vilues- and priorities. In Tplanning:-the=.illoCationof resOurces,:*e If- planning is 'urge to be more than an-exercise in that the aging .receivea _fair shire of national rhetork, it= isiinpetative wealth: Thit -should-r.he that there be ippropiiate, accomplished through_a authority, responsibility_ and accountability;,and- reordering_ of prioritiesat -all leVelt to -increase that there be the commitment of- linking those who:plait:pro- _national resources-to--Meet grams, those Who- administer_programs,_ and the hunian needs. consumer. To these- ends-we-reCoMinerid---thit: The -Federal plinninglqganization Must- an- SECTION nually review and LEADERSHIP publicly- reporton its _pro- SPIN* will point= listingof title aid posals; dress; only the first timea teams *Mars The 'Federal, planningorganization -shallre- The-Technical Committee view propoied_ legislationand executive-activi=, for Planning ties to evaluite their- potsible effects-upOn the Chairman status of elderly --persons; Williim L. Rutherford, Administrative Vice President, Park Foultdation, Peoria,-Illinois Po= Administrative agenciei.annually evaluate Conitiliant and report on theeffectiveness- of theit pro- Eone Harger, formeriiirector,New Jersey Division`on grams; Annandale, New Jersey Aging, Members Federal agencies beempowered to takesteps to insure that Federal Albert J. Abrahams,Secretary, State of New programs adinitiistered Albany. New York York Senate, at the Stare and localley& are in conformity Winans R. Ewald, Jr., with .stated guidelines ton, D. C. Development Consultant,Washing- and objectives ofpro, grams; Robert .D. raptly,Jr., Assistant Director, Advanced Study The Center for in organization Science,eniville, Wisconsin E. Corinne B. Gilvin, A minority report based College, -Ithaca, New YorkAssociate Professor ofSociology, Ithaca paragraph provides for upon a vote of ,22.19 on this planning deletion of the sentence:-Therefore, Lloyd R. JoIsnion, President, ... and eliminate them." and inclusion ofa substitute Whitehall ConvalescentHomes, sentence reading: 'Therefore,planning for aging Inc., Ypsilanti, Michigan special cognizance of must take Guy R. Juana, Public institutionalized prejudice' Welfare Administrator,American lac Welfare Association,Chicago, Illinois 90 Donald P. Kea; Chairman, Department of Sociology and Subeectioa 2 Andiro *on, Pennsylvania State University, University Park. Pennsylvania Chairmen Dew* 1 ; Holcomb, &calico Specialist-Gerontology, Agri- John C. McKintiey, Professor of Sociology, Duke University, cultural Extension Service, University of Arkansas, Little Rock, Durham, North Carolina Arkaniss Paul 6, Van Buskirk, Lecturer -and Coordinator, Urban En- vironmental Studies Program, RennselaeuPolytechnk Institute, Vice 'Chairman Troy, New York HinvartL-Bloisenquist, Management Service Associates, Inc., Auitin, Texas Recirdet The Secretariat Nathaniel Brooks, Director,= Division of Health, Education, Director and Community Services, New DetivicInc., Detroit, Michigan *eon D. Gold, Director, Division of Program and Legis- Subsection:3 lative Analysis; Administration on Aging, Social and Re- habilitation Service, Department of Health, Education, and Chile:ma Welfare; Washington, D. C. V. Robeir Payout, District judge, Iron Mountain, Members Sharon L. House, grief,, -State Agency.- Operations Branch, Vice dais:man Older American Services -Achn anima tioti, on .7- Aging, Lloyd Itjohisine Social Aid-Rehabilitation Silvice, Department of Heskh,l Edu- Recorder cation, andMelfare,--Washington,D. C. Zola A. Ernest, Professor and- Pro)act Director on Aging Mart, E. Laid, Program Development Specialist;:oftice of GnmblineCtillege, Grumbling; Louisiana Management,-- Of of the Secretary,. Department of Health, Education; and Welfare, WaAington, 'D.-- C itsbeection4 -Richard' L "Schulie, -Urban Anaiyir, Spicier Research-4nd'. Cbairiens. Demonstration -Projects-1Division, Healtli-lervice, 'De- Connie Laws, Acting Project Coordinator, Ariawide Model, mean* of Health, Education, -And_ Welfair., -Washington, ,Healtb, Welfare, Recreation-Planning Countil, :Norfolk, Vie-

Cleoake Tivani,"_Older Persons _Coordinator, Of -Vita Chairman sank- Opportunity, -Washingtoti;-_ =C. Schein W.,,Mtirphy, Assistant- Editor., Senior Citizens News, Daniel _ A. Whalen, cStudent-Assistant, GirontolOgy Training National Council of Senior- Citizens, WishitigtOn, D. C. Program, University of Minnesota, Minneapolis, -Miwnesixa_ Riaidet ,Philip stitasaineis-State Agency-Staff. Michigan-Commis sioa_os,A,gisg, Section Officers Lansing,. Michigan CoCheirmen Federal, Resource Personnel Elias S.- Cohen,- ASSistinc Profess-or ot' Social = Administrition, Helen t _Burr, COnakihant,-Office of Services- to the Aged, School-,61-Medicine,,Univitfity of Pennsylvania,-Philadelphia,- _Deputessent of -Human Resources, Washington, D. C. PantiO,ania.-and L.- Rutherford Sbaies _Holies Counties* iseis A. Kelley, ,Iseislativeltefereace Analyst, Division of lione-Nigger and Legislative Analysis, Administration on Aging, -ltecorder .sad Rehabilitation Service, Depatunenr of Health, r;dis cation, and,Welfate, Washington, D. =C. Seanky_ IL- Smith, Dean, Fisk University, Nashville, Ten_ nesiee Lawreace Lewin, C.Onsultint, Committee on Aging, Domenic Animist_ Rik:ceder Council,'OSte of the President, Washington, D. C. Innis Levitz, Assiltazt to thessociate- Regional C.onu.sis- Maly :11i Los& skitter for, Aging, Social-and nabilitation Service, U.S. De-- panrk ment Of Health, Education, and Welfare, New York, New Fraalrlia D; -Marks, Adnsinistritive Assistant, Division of Yo Adrignistrition, Administration on Aging, Socialand Re' whebiliaistetatiOr4astlerriceisisto,n,Depact Citment of Health, FrlucatiOn, and WAottinewat Of6cer BYron-D.-Gold Daibuis:11. Moffett, Mansectvot Intern, Bureau of Higher Education,-Office of Education,-Department of' Health, Edo- wimps-sad Welfare, Washington, 1); C. Subsection Officers Donald P. -Reilly, Deputy Administrator, -Priority Progrises, Social and Sesvice,- IDeperuneni of Subsection 1 Health ,- Education, and Welfare, Washington, D. C Chairmen Illaabedi-D. Shield*. Secretary, Diiision of Program and Robert Medias, Executive Director, Los Angeles County De- Legislative Analysis, -Administration on Aging, Social and putinent of Senior Citizens Affairs, Ins Angeles, California WRelerfbijeatii:shrigivtonice: -DDepartm. ent of Health, Education, and Vice Chairman Elisabeth K. Lincoln, Director, State Council on Aging, Richard_ L Schulze Concord, New Hampshire Eileen Stowe, Social Science Analyst, Program,Statistics. and Data Sfitems, National Center for Social Statistics, De- Recorder c of_ Education, and Welfare, Washington, Harold Schneiderman, Associate Professor, School of Social num Work, Ohio State University, Columbus, Ohio Daniel A.11Visalen

. 91

445201 0 - 737 -r;

3 L. SECTION ON RESEARC AND DEMONSTRATION

INTRODUCTION *die- the- p-reserVation of- .a -meaningful way of life, throughout age. ;ging; it:-,One.cirtMriStarice- *hich.:affeat _ . everY':indiyidnaLaritt.grOWing-old4ilf _ 13e-the fate -of,,alt,-_"thote..4i3riVilegea_JO, SECTION-REPORT -N= =live at-100g se-Von: or -More- decades: Ritgitlbk. hi view .,of 'chit- universality of the aging:proceSt -cope with -the : problems of ',older persons antl,the certainty of _its eventual Ontcoine;_it is "Mr, we ,mnst understand- the nature of_ the difficulties -priSing, that a, major research_ effort p ferret out its they face, as. well as the nature of the aging process nature -and its personal and societal, COnteqiienCet in itsovariUs-biological=and- social-behavioral di- has not 'been made =a national pritirity. ItiSteaci; mensions. Research, deinonstration; and _evalua- edeial: support for research-on _aging...has been tion- are bitic-_-tbols by Which -a society- produces relatively. minimal in comparison t9-thar-ptovided the knowledge_ii_requirei to deal, With-the ,prob- for .conditions to which only-- a -limited segment leins of its :people and to improve the quality of of the4:optilation will succumb.,Most.of-the funds individual have .beeh, allotted, tomedical and health-related- stUdiet,,While-suPport for the social- behavioral and- -Industry- has long recognized the .importance biOlogi,Cal ,components' of aging lias 'been -very of research and has typically allocated froin-.two minimal" indeed. Under these circumstances, re- to ten- percent of itsindustrial"operating budgets Search-, scientists= have not generally -eleeted to to -research and develOpment.. governmental _invest :their time and- skills in investigationsce- prograMS, just as inindustry,research-, is-,required. -lated -to to -achieve accountabilitYi. costfeffiCietitY, in quality, and control. To ,achieVe these, Objec- 4t,is knowledge of these facts whichis. dyes, substantial. research is- necessary, in aging the eight recommendations -formulated by the as in other areas,..Yet government researclt'in the SectiOn on. Research. Among the 93 .Delegares, aging- area remains- at in inipoverithed namecfle:the Sectionwere representatiVei3Of the several- gerontological research The principal reasons for this:criticalstate of centers and: indi, affairs appear to be: Vidual investigators from-fattilties of universities and - independent research organizations. Thus, the A long history Of governmental and-so- Section paiticipants were well qualified for formu- cietal neglect of its responsibility toward the lating -a set Of consistent research policies whiCh, elderly. :if adequately .funded, would significantly increase An inadequate level- of funding for im- Our knowledge and control of the aging process, mediate and long-range programs to improve andiat the same time could guide social action to the quality of life for older Americans.

93 ---,An inadequate administrative structure to Recommendations advocate, coordinate, implement, and administer ;research prograins involving aging and RECOMMENDATION I the aged. A National Institute of Gerontology Recognizing this pin neglect and. urgent cur- -It is- recommended that a National Institute of rent needs, we- affirm that the time -hat -come to' Gerontology be established- immediately tosup- accelerate research efforts aimed at understand- port and conduct research -'and training in the ing -the basic process 01 aging and :alletiatirig biomedical-and social-behavioral aspects of aging. the suffering of- 'those who =encounter difficulty The Institute -Should' include study sections with in adapting to this-- phase of life. For the aboie equitable representation of the variousareas in- reasont, the total- .Federalresearch and -deinon= volVed in aging-research and training. stration expenditure on pioblomt of the aging must be increased. -Research -and demonstration. serve a role, and we ad_Vocate -a greatly _ RECOMMENDATION- expanded funding..base for-th-- piirpOte. on.ieiging important is .the development=of anjroyerall;,irate- grated, Consittent funding ifoingrionittr will. or; It is -recOMMeOclect -that the ptesidentpropose mit tne-,-probleint,OL,akingto-be_ addrestedi ina-, and that the -Congress: create potition."Within balanced- and coordinated "manner encompassing- the:Executive _Branch -With--tuffident:'thpport,and- both -the biomedical =and sociat-behaViOral- itiencet. atithOrityxto-- develop ,and,Coordinate,at- all -levet We cannot separate the impraVeinent_Ofthequal-- of the -goVerninent; programsfor the aged;in-- .try Of life frOiti the understanding Of the-'bio- chiding research and dethonStrationprograms, and medital and "social-behavioral Orig.* of agitg_and- to oversee-their-translation into action. theaging process. in -additiOn, diereibuit VisitiOn- for theoretiCaL research Whith- will pie= pare us foi-aging in the future: RECOMMENDATION III Federal Funding of Research Research .and demonstration on _problems of and Training the aged must -take into account the fact that It is_ recommended thata- major increase in Fed:. significant differences in -aging -prOcestis exist eral- :funds- _iesearc.h, research- training, and withitiran -individual, between individuals of- the demonstration be appropriated and allocated..4- tame- age, and between various _aged groups. We proliriation general -revenues- for programsin should` give SpeCial consideration to the unmet the interests of older persons should tontain,addi- needs-of older ArneriCans who belong_to minority tionallfundi-aniounting in_ the averageM no -less .groupsrand *dote with special- problems, eg:,. the than, 35 percent of such expenditures,these ad-, impoverished, the rural; the isolated; and- The ditional -funds -to be- allocate& forresearch, dem- mentally- ill. Retired technical and- scientificper- onstration, and evaluation. Federal-support of sonnel -should be utilized in research. -While research and _training inseparate departments or women are not a numerical minority, theyare schools within universities andseparate research underrepresented in high -level research and-aca- agencies should be- continued and Multidiscipli- demie' positions and should be- given representa- nary and muiti-inititUtional programs should be tion at decision-making levels in research and fostered. demonstration. .

In an effort to give greater visibility, impact, RECOMMENDATION IV and opportunity for practical implementation-of these research principles, the Delegatesto the Funding Minority Research and Training White House Conference on Aging Section on It is recommended that funds forresearch, train- Research and Demonstration recommend the fol- ing for research, and deMonstrations, lowing policy proposals. should be allocated in the aggregate in sucha manner that 94 the above activities (Recommendation -III) rele- SECTION LEADERSHIP vant to aging and the aged in racial and ethnic Space will permit listingtitle and ad- Minority groups, be funded in an amount-not-less dress only the first -time a name appears. than their proportion ofthe total population. At- tention should be given to the recruitment arid The Technicil Comthittee training of minority group students to /become for Research and. Demonstration competent researchers in gerontology. Minority groups would include but not be limited to the -Chaiiinan Alfred M. Lawton,,Intemiit, Bay Pines Veterans Administra- following: Bladcs, Spanish-language Americans, tion Hospital;,Outpatient Clifiie, St. Petersburg, Florida American Indians, and Aiian-AmericanS. ConsUliagir Jacqtielyne J. Jackson, Assistant -Professor of Medical Soci- ology, Center- for the Study of Aging and Human Develop- RECOMMENDATION V ment, Duke University Medical Center, Durham, North Caro- Ricnritment and Training of Women lina Members High priority should be given-to the recruitment., James-IL_Austin,,Professor and-Mead, Division ollsieuitilogy,. and _training of capable women and i-the -repreten-' -University-,of CdoradO Medical:-Ceitter,,Denver, Colorado- "Miry aD. ,Barnes, NeMber, -Pennsylvania. State Civil "Seriice ration -of -such women in bodies-which_ =have Commission, : Pittsburgh, Pennsylvania _responsibility for allocatiOn- of training _and Walter M r and Dein` orSchool_Of -.Social search- funds. Syracuse- yfiik Harold BrOdY;.-PirofessOr_OrAna---tomy.; State:Univers- ity of-New York, School Medicine; -Buffalo, Ne* York RECOMMENDATION VI Buigess,, Associate Professor of Political Science, Clearinghouse for Research -Findings Ohio State University, Columbus, Ohio Jolui IL Cooper, -Associate Professor of Biology, Central State University, Wilberforce, Ohio The Administration on Aging, -or otherappro- Vincentj. Cristofalo, Associate Member, Wistar Institute of priate Clearinghouse, should -be charged- with and Afiatoniy and Biology, Philadelphia, PenniYlVania allocated adequate resources for collecting and 'Walter T Lecturer, Brooklyn, New York. diSseminating current research findings in the Cart Eisdorfer, Professor of Psychiatry and- DifeCtor, Center field of the aging and for making these findings for:the Study- of -Aging-and Huniair-DevelopMein, -Duke Uni, relevant and available to practitiniters. versify- Medical C.enter,.Durham,_Ncirth Carolina McChesney GaAs% Jr., PrOfessof of Stugery and Physiology, Univeriiry of Texas Medical Blanch, Galveston, Texas RECOMMENDATION VII Lissy F. Jarvik, Psychiatrist II (Research),-New York-State Psychiatric Institute; Associate- Professor of- Clinical Piychiatry; Prompt Allocation of College- of Physicians and -Surgeoni, Columbia University, New York New York Appropriated Federal Funds Bernice L Neugarten, Professor and Chairman, Committee on 'Marian Development, The University of Chicago, Chicago, AppropriatedFederalresearch, demonstration, Illinois and training funds should be apportioned and F. Marott -Sinex, Professor and Chairman, Depirtment of Biochemistry, Boston University School of Medicine, Boston, allocated prOmptly; and programs for which such Massachuietts funds are appropriated, whether- intramuralor extramural, should be implemented with 'adequate staff without delay. The Secretariat Director RECOMMENDATION VIII Shirley- P. Bagley, Health ScientistAdministrator, Adult Development and Aging Branch, National Institute of Child Federally-Funded Demonstrations Health and Human Development, NationalInstitutesof Health, Public Health Service, Defartment of Health, Educa- More adequate procedures should be developed tion, and Welfare, Bethesda, Maryland within the Federal Government to assure the Members continued operation and funding of those Federal- Thomas E. Anderson, Medical Officer, National Institute of lyfunded demonstration projects which have Mental Health, Health Service and Mental Health Administra- tion, Public Health Service, Department of Health, Educa- been proven successful after evaluation. tion, and Welfare, Rockville, Maryland

95 t Henry P. Brehm, Chief, Office of Research and Statistics, So- Vice Chairman, cial Security- Administration, Department of Health, Educa- tion, andWelfaie, Washington, D. C. kernian T. Blumenthal, Research -Professor ofGerontology, Washington University, Frontenac, Missouri H. D. Bruner, Assistant Director, Division of Biology and Medicine, Atomic Energy Commission, Washington, D. Recorder John H;Cdoper, Associate Piofessor of BiolOgy, Central State Edward Dunne', Special Assistint,-Research and Education_ in University, Wilberforce, Ohio Medicine, Veterans Adininistration,. Washington, D. C. -Sharon -Fitz-William, Social- Science Analyst, Office Of Plan- Subsection 2 ning, Research, and EViluation, Office- of Econinnic -Oppor- Chairman tunity, Washington, D. C. Bernard -L Strehler, Professor of Biology, University of Evelyn Flook,-Associate Director, National Center for Health Southern California, Los-Angeles, California Services Research and Development, Health- Services and Mental Health Administration; -Public Health Service,-Depart- Vice Chaiiman went of -Health, Eleanor Potter, Center Director, Ishpeming Senior Center, Education,and Welfare, -Rockville, Maryland Ishpeming, Michigan john Mehl; Deputy Division Directot, Biological and-Medical Sciences, National Science Foundation, Washington,-1). C. likorder Mary D. Barnes, Member, Pennsylvania State Civil Service :John- A. Noble,, Special Assistant to the- Commissioner, Re- Cominission, Pittsburgh, Pennsylva-nia habilitation Seivices Administration, Social' -and Rehabilitation _Services, Department -of -Health,Education, and Welfare, Subsection 3- Washington, Et C.

Nathan_ Shock,, Chief, GerontologyAesearch Center, Na- Carl 'Eisdorfee, tional -Institute dr-Child ;Health _incl,,Fluinah.-=Deieloninent, Baltithoit City tidnitals; BaltinjOie''Matyland- Vice: Chairman Bettrani B. kosi, Chief -of Geriatric -Medicine; OakForest btraivin. J. Tives,,Chief;'1:iivision on Aging; Office of 'Research Hospital;n0ak Forest, Illinois '"and "Demonstration, -Social-arid Alehabilitation -ServiCe;_:DePare- 'meat of Health, Education, and Welfaie,:Washinithri;13; Reenider Kenneth -P: Associate Professor, Graduate School of SoCial -Work, Univeisity of Arkansas, Little Rock, Arkansas Section Officers Co-Chairmen Federal Resource Personnel Raymond C. -Monts, Professor, School of Soda( Work, Uni- Thomas E. Anderion versity of Wisconsin, Madison,_ Wisconsin Reuben Andres:, Deputy Chief, Gerontology Research Center, Alfred H. Lawton National Institute of _Child Health and Human Development, Consultant. National Inititutes of Health, Department of Health, Edticit- Jacquelyrie J. Jackson, -tion, and Welfare, Bethesda, Maryland Recorder Henry. P. Brehm Aaron Lipman, Professor,of Sociology, University of Miami, H. D. Bruner Miami, Florida Dennis Beutan, National Library of Medicine, National In- Assistant Recorder stitutes of Health, Department of Health, Education, and Wel- Herman B. Brotman, Assistant tothe Commissioner for fare, Bethesda, Maryland Statistics and Analyils, Administrationon Aging, Social and Edward. Dunner Rehabilitation Seriice, Department ofHealth; Education, and Eirelyn Flook Welfare, Washington, D. C. Don Gibson, Health Science Administrator, National Insti- Management Officer tute of Child _Health and _Huinan Development, National In- Shirley P. Bagley stitutesof- Health, Departnient of Health,_ Ethication, and Welfare, Bethesda, Maryland Darlene Levenson, Technical inforination Specialist, Program Subsection Officers Statistics and Analysis Branch, National Institute of Child Health and Hunian Deiftlopment,NationalInstitutes of Subsection 1 Health,Department ofHealth,Education,andWelfare, Chairman Bethesda, Maryland Arthur S. Adams, Consultant, New England Center for Con- Nathan W. Shock tinuing Education, Durham, New Hampshire Marvin J. Taves

96 SECTION ON TRAINENG

INTRODUCTION gave attention to the .manpower- Shortages and outlined policies. and- strategies:lot: increasing the he SectiOn-on Training; was_cOnceined number and range., of" training- opportunities: in wit-the-preparation of :personnel to aging :SpeCialeniphasii was placed on Alie:par- =work-in service,- research;, andi- teaching tkolar, need for -training; =-Oinot4 personnel to ,positions -f ity the- field of it was Serve the elderlyi of their Own racial or ethruc not concerned-With:the- educatiOn-Of alder people groilps. themselves except as they are included= among those preparing -for work in aging. The Delegates to the Section- on Training were SECTION REPORT well aware that_ if -the pOlicies and programs be- The Section was called to order by Co-chairman ing proposed by the other Conference Sections Hirtnan F_ riedsatn whO introduced the Section were to be iniplemented, there- would be need for leaders. He then. calledupon CO,Chairmaii_ Dr. the immediate recruitment and training of new George. Reader to prOVide 'background for the personnel at all leveli. And,-cotiOthitantly, there work of the Delegatei over the ensuing three day wouldbe requited a significant increase in the period. number of educational institutions, offering training in aging. Distission of The Section; therefore, Dr. Reader reviewed the basic characteristics focused on how best -to bring about the necessary of the older segment of the. population and point- expansions in manpower and in training oppor- ed-out the impliCations of aging in America.1 He tunities In aging and related fields. stressed- the fact that if such a large population group is to be.well served, it is necessary to train Although the Delegates named to -the Train- a large cadre Of technicians and professional working Section numbered only 111, they included ers to plan, research and provide the assistance representatives of practicallyall the country's needed. The .rapidly expanding -social concern major research and training centers inaging. for older people, and increased Federal, State and These educators, together with the practitioners local support of programs to save them, is result- serving the older population, constituted a group ing in a manpower shortage which promisee to that was well qualified to delineate policies re- be of crisisproportions. For this reason, Dr. quired to meet urgent manpower needs, including Reader emphasized the particular opportunity the the inservice training of persons already employed Delegates in the Training Section had to propOse in the field of aging. policies designed to help overcome the manpower The Section On Training adopted 12 recom- shortages. mendations, but almost all the other Conference I See Reader, George G. Implications of Aging in America, Sections and the Special Concerns Sessions also Medical News Service: Geriatrics, 1971.

97 Preamble Crucial to the national effort to provide training at all levels is the development and implementa, Older persons continue to increase in numbers. tion of programs to train the trainers. Research Their needs havenot been met because we have now proVides a base of understanding and learn, failed to act. There is, therefore, an immediate ing which makes it possible to develop meaning- urgency to deal with these matters. The resolution ful, specifically designedprograms for further . _of these significant human problenis requiresa training in aging. large cadre of personnel trained in and committed to the field of aging. What is necessary is the The following are' the recommendations and development of innovative and creative programs policy proposals emanating from the Sectionon to provide training for the _total range of octupa Training of the 1971 White House Conference tions providing services to older persons, and on Aging. .Specifically for profetsional and scholarlypro- grams preparing peopleto work in the field- of Recommendations aging. As- new-service delivery "systeiris, are de- velOped, ,neW Modei of training ,_and:new types -of RECOMMENDATION: I pospiinel required. Level of Putsding of Training :Programs In considering the training -requirements _for A_ fully developed training _pOlicy must ifoois_ on. SerViCe rorlie ofder.pciptilatiOti,_*e are still inind, bOth the immediate needs of thepresent :aged- ful of the that adequate incoine maintenance pOpulatiOn- and-the 'future- needs of the aging; and sufficient healthcare are basic necessities. through innovation -of -fat- reaching policietand There is 'a need for a minimum income level ptogiams. To accomplish the tiainingof needed which will lift all older peOple out cof poverty. personnel, the present levels of funding in all Furthermore, we are also convinced there ispres- government agencies- concerned with -aging-must ent urgent and massive need for expansion of be substantially increased immediately in order prograMs which will provide employment- oppor- to increase the supply of all types of manpower: tunities for the elderly in constructive activities. technicians, paraprofessionals, professionals, plan- nets, researchers, teachers and volunteers. Train- At. present there is little training and education in the field of aging. During the 1970's the-task ing must be conducted-in appropriate settings both facing those who are responsible for training is within and outsideTof educational institutions. one of substantially increasing the amount of RECOMMENDATION II training available. While there his beensome progress and there are high quality programs in New Federal Agency for Aging. a few locations, most States, do not have any Given that training in .aging it lagging seriously appreciable amount of training ofany type re- behind the ptoven need, there is consensus that lated to problems of aging. responsibility for the development ofa vigorous The need for training exists at different levels national plan and continuing monitoring oftrain- for many types of persons and formany types of- ing of manpower in aging should .be lodged in subject matter. Retired persons, mature adults, a new Federal agency for aging adequately fi- students making career choices, volunteers, and nanced and with the powerto coordinate Fed- members of minority groups must be recruited erally supported trainingprograms in aging.' to -work in aging and trained for this work. The decade of the 1970's is the decade in which major RECOMMENDATION III plans for training must be put into effect. Alterna- Planning Bodies for the New Agency k tives must be evaluated so that the following In discharging its responsibilities, the decades will be marked by a notably higher level new Federal' of training and consequent improvement ofpro- Misority Position: One third of those voting believed,that there should be a single but not necessarilynew Federal grams for the aged. agency for aging.

98 agency should include representatiVei of training disadvantagedt funds should be earmarked at all organizations,private.non - profitfoundations, levels of training and research for Blacks, Chica- scientific and professional organizations, organi- -nos, Pima°. Ricans, Asiahs, Indians, and other iations of older retired persohs, and other con- disadvantagedgroups. Alltrainingprograms cerned groups in all planning bodies which for- funded on Federal, State and community- leVels mulate policies on training: should actively recruit faculty and trainees from thele groups. RECOMMENDATION IV Training Centers in Aging RECOMMENDATION VIII Curricula in Aging Multidisciplinary research and training centers of excellence in gerontology with a -relatiOnihip to In order to develop adequately trained persons in service- delivery- systems should be cieVelopoi, -and health, allied health, anct.other professional fields -research and- training shotildhe fostered ina wide such as- law, archifecture, socialwork, -etc., sul- -range of colleges; - universities and other institu- ject 'matter on aging *sr be 'inserted -into :pre-- tions.Innovative and experimental- .efforts serViCe _and inservice_ curricula of professional: training must= be encouraged:--Each Center should schools immediately. In,addtion, empbasilisbould developnetwork of effective relationtitipi with be plaCed, on the deVelOpment, of community col- other- edticatiOnal;ancL seririce4genciei.- todissemi- lege- -level -certificate and degree programs and nate information andiproinote implementation of programs. -in vocational -and- technicalinstitutes activities in aging: as well as other lbcal program:slot personnel who deliver services to the older population. Teacher RECOMMENDATION V training programs should include positive concepts regarding _the aging process and the older person Support for Manpower Training in Aging for incorporation into elementary` and secondary In additiontoincreased Federal support for school curricula. training prOgranis in aging there should be an acceleration of support for training in aging from RECOMMENDATION IX State appropriations, foundation grants, private A National Institute-of Gerontology donations, and regular agency budgets. All service programs for older people should contain ear- We urge the creation of an adequately funded Na- inaikra funds for the training of-personnel. tional Institute Of derontology for training and research. A. substantial portion of the funds -allocated to it Should be earmarked for training. RECOMMENDATION VI .Recruitment for Training in Aging RECOMMENDATION X Funds for recruitment and support of personnel A National Data Bank to be trained in aging should be allocated without A national data bank and retrieval system similar priority based on sex or age. Special inducements to, or parallel with, the education research in- traineeships, scholarships, tuition grants, loans should be offered in order to recruit personnel formation center (ERIC) should be established' (particularly those from ethnic and minority to convert, translate, interpret, and make available groups) into careers in aging. all research knowledge and curriculum materials in aging to all training and research and demonstration programs. RECOMMENDATION VII Funding Training for Minorities RECOMMENDATION XI Because of the needs and problems that exist Determining Manponer Need among the aging of the economically and socially Recruitment and training will be to no avail if

99 there is no corresponding increase in services. Sheldon S. Tobin,. AssistantProfessor,.School of Social Serv- ice Administration and Committee -on HuMan Development, Therefore, recruiting should be related to useful The University of Chicago, Chicago, Illinois job opportunities: Financial support for-new serv- Henry .Viscardi, Jr., President, Abilities, Inc., Long Island, ice positions should be provided in balance with New York support of training prOgrams.1

RECOMMENDATION XII The Secretariat Reordering National Priorities Director Marian H. Miller, Specialist on Aging, Training Grant Pro- To insure the dedication of.-the_Federal Govern- gram, Administration on Aging; Social' and Rehabilitation Service, Department of Health, Education,,and Welfare, Wash- ment and. our country in this period of life as ington;p. C opposed to death, we strongly urge Congress to Associate Director reorder its priorities .and divert funds from the Walter Spieth, Executive Director, ,Adult .Development. and military -to human 'needs.' Aging Research' and Training Conimittee; National Institute of:Child' Health Wand- Human-,DeieloPment; Department of Health, Ecication, and Welfare,-Bethesda,Maryland. MeMberi MieleL. Blank, Social- Work- Consultant, SittioSection SECTION LEADERSHIP Health- Of` the, Aging;. National -Institute- Of 'Mental; Health; A.s.% HealthflerVices- and- Mental-Health -Administration; Space will permit listing -iitk Mod ad= Merit "of Health,-Edtiattion; ind dress only the first time a name appears ;Welfare, _Rockville;Maryland Maigatet F. Clark,,Tiaining -Corisultatit.DiVision of Mail. power, Development; -RehabilitationServiCe AdMinistration; The Technical Committee Deparinient-of Health, Education and Welfare,- Washington, for Training D. C Samuel Hammerman, Specialist on Aging, Training. Grant Chairman Program, AdministratiOn on Aging, Social and Rehabilitation ServiCe, IDePartinentof ,Health;Education; 'and- Welfare; George G. Reader, Professor of Medicine, The New York Washington,-D. C. Hospital, Cornell Medical Center, New York, New York James M. Hoeven, Graittse Management Specialist, Health Consultant Manpower_ Education,.- National Institutes of Health, Depart Warren A. Petersen, Director, Midwest Council for Social meat of Health,-Edlicition, and Welfare, Bethesda, Maryland Research for the Aging, .Kansas City, Missouri -Donald L. Lacey, Student AsSistant, Gerontology Training Program, 'The Institute of Gerontology, The UniverSity of Members Michigan-Wayne State. University, Detroit, Michigan Elinor J. Barnes, Chairniin, Graduate Committee on Geron- E. Percil Stanford, Regional Office --Represetitative,Office of tology, Retirement HousingAdministration,College of Busi- Field -Opeuitioni; Social .and Rehabilitation Service, Depart- ness and Public Administration, University of Arizona, Tucson, ment of- Health,:Edutation, and -Welfaie, 'Washington; D.- C. Arizona Milton. Wittniiiii Chief, Social Work Training- Branch, De- Jean Shinoda Bolen, PhySician and Assistant Professor, Un partment of Health, Education, and Welfare, Washington, Versitft of California, School of Medicine, San Francisco, Cali- D. C. fornia Francis A. Fay, Assistant Professor of Education and Co ordinator, Graduate Training Program in Aging, University of North Carolina, Chapel Hill, North Carolina Section Officers Harrier F. Griswold, Retired, Author, Lecturer, Civic Worker, Washington, D. C. Co-Chairmen Andrew Hendrickson, Professor, Adult Education, Florida Hiram J. Friedsam, Director, Center for Studies in Aging, State University, Tallahassee, Florida North Texas State University, Denton, Texas, and George Walter G. Klopfer, Professor of Psycbol'igy, 2ortland State G. Reader University, Portland, Oregon Constxhant Thomas A.. Rich, Associate Dean of Liberal Arti and Direc- Warren A. Petersen tor of The Institute on Aging, University of South Florida, Recorder Tampa, Florida Leonard 7.. Breen, Professor and Chairman Department of Marvin B. Sussman, Professor and Chairman, Department of Sociology, Vuidue University, Lafayette; Indiana Sociology and Anthropology, Western ReserveUniversity, Cleveland, Ohio Assistant Recorder Franklin Nicholson, Associate Regional Commissioner for ' Minority Position: One-fifth of those Delegates voting were Aging, Social and Rehabilitation Service, U.S. Department of opposed to this recommendation for a variety of reasons. Health, Education, and Welfire, Atlanta, Georgia 'Minority Position: One-fourth of those Delegates voting Management Officer were opposed to this recommendation. Marian H. Miler

100 Subsection Officers Federal- Resource Personnel

StibsectiOn 1 Helen Asf)esligh, Adniinistnitive -Officer, Administration on Aging,Social andRehabilitation -Service;Department of Chairman Health, Education, end Welfare, -Washington, D. C. Rosamondi R. Boyd, Chairman, South Carolina Commission Marie L Blank on Aging, Colunibia, South Carolina Eileen P. :Bradley,: Chief, Program Administration Branch, Vice Chairinan Division of Older Asheriatns Service, Administration on Aging; Joyce Lowry, Specialistin Rehabilitation, Recreation, and Social Sid- RehabilitationService,Department ofHealth, Aging, Milwaukee, Wisconsin EduCation, and Welfare, Washington,-D. C. Kenneth "Durind, Student' Assistint, Training Grant, Pro- Recorder -grim, Administration on Aging; Social- and Rehabilitation A Kurt Weiss,'Professor, Department of Physiology, Univer- Service, Department ofHealth;Education,andWelfare, sity of Oklahoma Medical Center, Oklahoma City, Oklahoma Washington, James-hi .HOeven- Subsectiob 2 .Lonella C Johnson, Secretary, Training Grant Program, Ad- Chairman_ -ininiitration on Aging, Social- and =Rehabilitation Service, -De- Aitliur S. Farber, Professor, School of Social Work, Univer- partment of :Health, Education, and Welfare, Washington, sity of Wishington, Seattle, Washington D.C. _Lily P._ Litz,, Grants Management',officer, Administration on Vicett aiiMan :Aging,, Social -and- Rehabilitation :Service,Department of David L Levine,= Director of -the Learning-Service Center, Health; Education, and Welfare,-Washington,'D.,C. University of Georgia, Athens, Georgia Wiltex_- Spaeth Recorder L Penn- Rtinford Warr- en A. Petersen Joimillitoibbeb,-,Chief,'MaispowerResOinces_lninchi Divi: -don of 'Manpower Development ,,and_ -Training; SOciaLtuid Subiection 3 Rehabilitition Service,_ Department of Health, Education, and Chairman Welfare:- Washington; D. Sheldon S. Tobin Sue Whitman, Personnel' Officer, The Department of State, Vice Chairman "VhshOski,..;P: C. Milton Wittman Erich Helbig, Knoxville, Tennessee CorinnelL *one, Deputy_ Assistant Adminiitrator for Man- Recorder power Development- for, Training,;-Social and Rehabilitation Glenn D; Overman, Dean, College of Business Adsninistra- -Service, -Department of Health,Education, and Welfare, don, Arizona State University, Tempe; Arizona Washington, -D. C. .

Ow.

101

.Reports of the Special Concerns Sessionson HEALTH ARE STRATEGIES , ::=.1Tr

//41ripe. _ 'A.47-11)4111.4.-2Z1.sx-A4'; LONG-TERM CARE FOR OLDER PEOPLE

-dequate long-term. care has become a persons preregistered the Sessionmaking it A priority need for older pc.Ople. The de- the largest of any ofof the Conference. 17 Special 'Aland for supportive,_ preventive, and Concerns Sessions. Still many other Delegates and rehabilitative"services has :long: ex= observers Joined, them during:the +hour:meeting. ceeded the ability of". the health delivery system In order to provide for greater involvement of to elect it. At present, long-term-care-facilities participants in- the =discussions, -the Sessionwas and services ate in short supply :and- :Many ire subdivided intci: six relatively small groupings of

of substandard- quality. To encourage .Delegates from approximately GO to 75persons. . to consider these critical problems indto propose Participants in the Session included policies designed:: to solve them,a request was persons re- made by. the National Association of; Jewish :ponsible for planning, Standard setting, andregu- Honiet for the Aged for inclusion ofa :Spetial lating-various types of long-term care facilities. In Concerns Session "on Long-Term Care for Older addition, there was a large component of those People in the Conference program. actively- engaged in the delivery of health services and others who, because ofage, had special in- Joining the National- Association of Jewish terest in the availability and quality Of such services. Homes for the Aged as inernbers of.the planning committee were representatives of the American The Program anNOP," oaNON, pate) Association of Homes for the Aged, Anierican Association of Retired Persons- National ._Retired To provide Delegates with some background Teachers Association, American .Lutheran Church, of the present situation in long-term care for older American Medical- AssociatiOn, American Nursing people,. the American- Association of Retired Per- Home Association, Evangelical Lutheran Good sonvNational Retired Teithers Associationput to- Samaritan Society, National Conference of Cath- gether three case histories which dramatized the olic Charities, National Council of Health Care plight of the sick, socially dependent elderly seek- Services, National Council of Senior Citizens, ing admission to long-term care facilities. The Presbyterian Church of the United States, -and the Delegates were also provided with summary sheets United Methodist Church.' which briefly Outlined present programsparticu- The planning committeewas assisted by Sev- larly Federal programsfor long-term facil- eral Federal agencies within the Departments of ities. Health, Education, and Welfare, and Housing and Urban Development. Prior to the Session meeting, the planning -committee developed five basic topics toserve as an outline for the discussion. This made it The Participants possible for each of the subgroups to consider This Special Concerns Session attracteda sub- the same subject areas in developing theirrec- stantial number of Delegates. More than 450 ommendations. The five topical areas, listed below, s See Roster of Phoning Cominittee, psge 109. were designed to include consideration of both in-

105 stitutional and non-institutional care: (1) Scope of improving and expanding long-termcare facil- Etznefits, Services, and Facilities, (2) Eligibility, ities and services for older Americans. (3) Financing, (4) Monitoring and Accountabil- The Session formulated ity, and (5) Implications for National Policy and 20 recommendations, two of which were defeated but are reported here Programs. A panel of listeneis selected' from both to provide a clear picture of all of the basicques- the public and private sectors was invited to react tions considered by the Delegates to the Special to the recommendations and to urge their respec- Concerns Session on Long-Term Care foi Older tive agencies and organizations to take a lead in People.

1971 WHFfE'HOUSF CONFERENCE ON AGING PETER KARPOFF, Consultant, (Health Econom- ics), -Health Services and-Mental'Health Adminis- PROGRAM tration,Public Health Service, Department of Health, Education, and Welfare; Rodcville, Mary, LONG-TERM. CARE land FOR OLDER PEOPLE JACK KLEH, Director of Professional Services, C Village; Washington, D. C. Chairman RUTH KNEE, -Chief, Mental- Health Care and CHARLES J. FAHEY, Chairman, Commission on Services Financing-- Branch, Division of Mental Aging, National Conference of Catholic Charities, Syracuse, New York Health- Seriice Programs, National -institute of Mental Health, HWth Serviies and Mc 'tat Health Vice Chairman Administration, Public Health Service, Department HERB'rs:T SHORE, Executive Director, Golden of Health, Education, and Welfare, Rockville, Acre;, t)allas Home and Hospital for the Aged, Maryland Dallas, Texas HOWARD NEWMAN, Commissioner, Medical Summarizer: Services Administration, Social and Rehabilitation Service, Department of Health_,Education, and JEROME HAMMERMAN, Professor, University Welfare, Washington, D. C. of Chicago, School of Social Servici Administra- tion, Chicago, Illinois THOMAS M. TIERNEY, Director, Bureau of klIZABETH CONNELL. Director of Public Re- Health Insurance, Social Security Administration, lations,National Council of Health Care Services, Department of. Health, Education, and Welfare, Washington, D. C. Washington, D. C Panel of Listeners ROBERT VAN HOEK Deputy Administrator for FAYE G. ABDELLAH, Chief Nurse Officer, Health, Servicei Delivery, ,Health Services and Public Health Service, Department of Health, Mental Health Administration,Public Health Education, and Welfare, Rockville, Maryland Service, Department of Health, Education, and ELAINE M. BRODY, Director, Department of Welfare, Rockville, Maryland Social Work, Philadelphia Geriatric Center, Pennsylvania MARIECALLENDER, Special Assistant for Nuts- AGENDA ing Home Affairs to the Assistant Secretary for .Health andScientific. Affairs,Department of 8:00 A.M. Introduction Health, Education, and Welfare, Washington, D. C 8:15 A.M. Case Histories ERWIN HYTNER, Director, Division of Health 8:45 A.M. Perspectives and Ground Rules Insurance, Office of Program Evaluation and Plan- 9:00 A.M. Discussion of Issues and Voting ning, Social Security Administration, Department of Health, Education, and Welfare, Washington, 11:45 A.M. Summary D.C. 12:00 Noon Adjournment

106 THE SESSION REPORT

Preamble proper incentives to encourage the providing of good patient care. The Special Session on Long-Term Care for Older People is concerned about the develop- 3. It is recommended that the problems and ment of a National Policy on Long- Term -Care. feasibility of transferring the long-term institu- We meet within the context of a growing national tional care aspects of the Medicaid program to the involvement in this area Medicare program be intensively studied. It was only in the 1930's that the Federal Gov- 4. It is recommended that the Department of ernthent'became deeply involved in human serv- Health, Education, and Welfare work to change ices. We_theet within'the context of disclosures in the primary emphasis in nursing home inspections thatiy:eitiet of inadequate nursing home care. We from physical plant standards to direct patient are'_aisiate of Ralph Nader, Congressman David care. Pryor;_ and now the views Of Health, ,Education, andWelfare Seeretary-Elliot Richardson; We hope 5. It is recommended-that a national policy on that the commitment of the Administration to long-term care needs must have mechanisnis for standardi will be matched by a-concomitant com- being implemented and financed; that supple- initment.to adequate funding of long-term care. mentary resources are needed to be allocated to means of financing alternate care; that this is a We recognize that long -term care involves not reason for loW standards of care in many long- only -inpatient care but also services to people in term care institutions; that we need a change in their own homes as well. national priorities to human needs; and that we Our- focus should be upon the individual and call upon the government to change our national making the right to adequate long-term care a priorities, shifting some of our resources from de- reality. fense, foreign assistance, and space priorities to the needs of our elderly citizens to implement a national policy on long-term care. Recommendations 6. It is recommended that a Presidential Com- 1. It is recommended that all long-term institu- mission on Mental Health and Illness of the El- tional care aspects of the Title XIX (Medicaid) derly be established. program be completely federalized. By federaliza- tion is meant funding shall come from Federal 7. It is recommended that any national health general tax revenues; that a uniform minimum insurance program which is adopted should meet level of benefits be set on a national level; and that the needs of those who require catastrophic, long- standards be uniform nationally. term physical and mental health care and social It is further recommended that payment to in- services both within and outside of institutions. Aitutional providers of long-term care be made 8. It is recommended that, to encourage the on such basis as to cover the cost of providing physician to accept responsibility for the medical that care, and, in the case of proprietary facilities, care of patients in long-term care facilities, the to-allow a fair return on investment. Payment to coverage limitation of one physician visit per pa- facilities is not necessarily to be the same in dol- tient per month in nursing homes be eliminated lar amounts, but is to be computed using the and that physicians be allowed to see patients as same formula nationwide. often as is deemed necessary by the professional 2. It is recommended that Medicare-type cost staff as the patient's condition warrants. reimbursement be specifically discouraged and It is further recommended that the physician be that prospective rate setting be encouraged with reimbursed at his reasonable established fee level

107

468.218 - 73 - $ without reduction for seeing several patients dur- supported health care programs includea require- ing one visit in extended care, skilled nursing, and ment" that inspectors and surveyors of nursing nursing facilities. homes hold currently valid licensesas nursing 9. Itis recommended that more registered home administrators in the States in which they nurses be placed in leadership positions in all pro- work, plus special preparation in inspection of grams involving health care of the elderly at all long-term care facilities, was defeated. governmental levels. 16. It is recommended that there should .be 10. It is recornr-ided that preventive and Federal financing available for the construction of restorative dental care benefits be made available nursing homes and health facilities. It is further for all persons over age 65, and that those bene- suggested that this financing take the form ofa fits be fully funded by the Federal Government 40- to 50-year loan witha three to five percent for those who cannot afford topay for such care. interest rate or a guaranteed loansystem. H. It is recommended that an appropriateex- 17. -It is recommended that in the interests of pression of appreciation be "made -to Dr. Arthur the patient, standards and guidelines whichcar- Flemming, Chairman of the 1971 White House riers use in making their decisionson coverage Conference on Aging, for his efforts in making be readily available to professionals helpingto the Special Session on Lorig-Term Care possible. effect their care. 12. It is recommended that the provision of 18. A proposed recommendation that the ele- care and services for the aged be removed from ment of profit be eliminated from the care ofper- Title XIX (Medicaid) and Title XI, and that all sons and that the profit factor be confined to a health care for the aged be provided underan ex- limited return on equity capital, meaninga profit panded Title XVIII (Medicare)program. It- is in the form- of rental of land, buildings, improve- further moved that health care be providedto all ments and furnishings, over and above the actual aged as a matter of entitlement; allpersons cost of the care and services provided, was should be covered andmeans tests presently in defeated.' use under Title XIX be abolished.' 19. It is recommended that appropriate Fed- 13. It is recommended that the Secretary of eral and State regulatory bodies andconsumer Health, Education, and Welfare study the feasi- protection agencies be urged to take appropriate bility of health facilities (i.e., hospitals, nursing action to protect the public by curbing the mis- homes, extended care facilities, etc.), including leading and exaggeratedmass media solicitation long-term care facilities, becOming public utilities and advertisement of voluntary health insurance and that his report be submitted as part of the post- programs to. the elderly and the general public. White House Conference on Aging report by De- cember 31,1972! 20. It was recommended that the Department of Health, Education, and Welfare considerthe - 14. It is recommended that social services,as feasibility of national certification for consultant part of the team approach, arc important toguar- antee quality care of the elderly in long-term pharmacist to separate the "paper" consultant institutional care and should be supported by leg- from the bonafide consultant pharmacist andthat islative action. the Department also explore the possibilitiesfor reasonable reimbursement of consultant pharma- 15. A proposed recommendation that Federal cists for consulting services. requirements for State participation in Federally 3 The minority view holds that the Senator Percy hearings a The Session was divided on this motion because of some highlighted the fact that nursing home patientsare not receiv- deep-seated reservations about the suitability of the Medicare ing quality, comprehensive programs ofcare. This is most program as a vehicle for meeting total health care needs for the significant, in the minority's view, since most nursing home elderly. patients are public aid recipients. The minority feels that the 2 The Session was divided on this issue becausesome Dele- taking of profits from the delivery of care additionally and gates have serious reservations regarding the concept of making substantially reduces the number of dollars available to provide health facilities into a public utility. the care needed.

108 Roster of Planning Committee

Nongovernment Frank Rinehart, Acting Executive Vice-President, American Nursing Home Association, Washington, Herbert Shore, (Chairman), Executive Director, D. C. Golden Acres, Dallas Home and Hospital for the Aged,. and Executive Vice-President, National Asso- Randolph Thornton, Program Development Special- ciation of Jewish Homes for the Aged, Dallas, Texas ist on Church Programs, American Association of Retired Persons- National Retired Teachers Association, Berkeley Bennett, Executive Vice-President, National Washington, D. C Council of Health Care Services, Washington, D.. C Frank Zelenka, Associate Director and Director of Elizabeth Connell, Director of Public Relations, Na- Public Affairs, American Association of Homes for tional Council of Health Care Services, Washington, the Aging, Washington, D. C. D. C. Charles Fahey, Chairman, Commission on Aging, National Conference of CatholicCharities,,Syracuse, Government New York James Burr, Director, Division of Services to the Herman Gruber, Secretary, Committee on Aging, Aging and-Handicapped, Community Services Admin- American Medical Association, Chicago, Illinois istration; Soda' and Rehabilitation Service, Depart- Eugene Hackler, Attorney-at-Law, Hadder, Ander- ment of Health, EducatiOn, and Welfare, Washington, son, Londerholm, Speer and Voder, Olathe, Kansas D. C. Jerome Hammerman, Professor, University of Chi- Mary Jo Gibson, Program Management Advisor, cago School of Social Service Administration, Chicago, Office of Program Innovation, Medical Services Ad- Illinois ministration, Social and Rehabilitation Service, De- partment of Health, Education, and Welfare, Wash- Gordon Hanson, Secretary, Division of Christian ington, D. C. Social Service, Board of National Ministries, Presby- terian Church of the U. S., Atlanta, Georgia Helen Holt, Special Assistant for Nursing Homes and Related Facilities, Federal Housing Administra- William Hutton, Executive Director and Director of tion, Department of Housing and Urban Development, Information, National Council of Senior Citizens, Inc., Washington, D. C. Washington, D. C. David Lit, Technical Advisor, Bureau of Health Milton Jackson, Associate Director for National Insurance, Social Security Administration, Department Affairs, American Association of Retired Persons- of Health, Education, and Welfare, Washington, D. C. National Retired Teachers Association, Washington, Helen Martz, Medical Care Planning Specialist, Office D. C. of Program Innovation, Medical Services Administra- Maurice Kramer, Congressional Liaison Assistant, tion, Social and Rehabilitation Service, Department of American Nursing Home Association, Washington, Health, Education, and Welfare, Washington, D. C. D.C. Edith Robins, Coordinator for Health of the Aging, Dorothy McCamman, Consultant on Retirement In- Corr.munityHealthService,HealthServices and come and Health Economics, Washington, D. C. Mental Health Administration, Public Health Service, Department of Health, Education, and Welfare, Rock- Dan Ozelis, Administrator, Methodist Home, United ville, Maryland Methodist Church, Chicago, Illinois Nathsa Sloate, Special Assistant to the Director, Na- Charles Peterson, Regional Director,Evangelic A tional Institute of Mental Health; Public Health Serv- Lutheran Good Samaritan Society, Sioux Falls, South ice, Department of Health, Education, and Welfare, Dakota Rockville, Maryland

109

MENTAL HEALTH CARE STRATEGIES AND AGING

he Special Concerns Session on Mental the participants were experts in mental. health Health Care Strategies and Aging care, and, therefore, contributed substantially to was requested by the American Psy- the discussion and formulation of recommenda- chiatric Association. Members of var- tions needed to improve the circumstances of el- ious -othermentalhealth. organizationsthe derly mental patients. American- Psychological Association TaSk FOrCe on Aging, GrOup for the Advancement of- Psy- chiatry, National Association for Mental Health, The Program National Association of Private Psychiatric Hos- In order to provide Delegates with background pitals,National Association of State Mental information, each participant in the Sessionre- Health Program Directors, and the National Com- ceived a copy of Cost and Delivery of HealthServ- mittee Against Mental Illnessparticipated in ices to Older Americans, a report of hearings be- planning the Session. Assisting the group was the fore the Subcommittee on Health of the Elderly of National Institute of Mental Health, Health Serv- the United States Senate Special Committee On ices and Mental Health Administration, Depart- Aging. ment of Health, Education, and Welfare.1 The Chairman of the Session pointedout to In view of the general lack of publicconcern the Delegates- some of the various strategies of and the lack of available informationon the care mental health care so that they could consider of aged mental patients, itwas deemed impor- several alternatives while discussing and formu- tant to give special attention to what strategies lating recommendations. The Session adopted16 could be employed to increase publicawareness recommendations which call fora wide range of of mental disorders experienced by agingper- mental health care services to meet the needs of sons; to point ouL some of the critical changes in older people. life patterns which sometimes leadto functional disorders; and to providean opportunity to recommend action whichcan be taken to expand 1971 WHITE HOUSE CONFERENCE ON AGING mental health care services for the elderly andto realize fully their rehabilitation potential. PROGRAM MENTAL HEALTH CARE The Participants STRATEGIES AND AGING Chairman Approximately 242 Delegates preregistered for ALVIN I. GOLDFARB, Associate Clinical Pro- the Special Concerns Sessionon Mental Health fessor of Psychiatry, Mt. Sinai School of Medicine, Care Strategies and Aging. Thisgroup was joined City University of New York, New York by other Delegates, observers, andguests upon 8:00 A.M. Presentation of Mental Health opening its 4-hour meeting. A large number of Care Strategies by the Chairman 10:30 A.M. Resolutions and Voting I See Roster of Planning Committee, page 113. 12:00 Noon Adjournment

111 THE SESSION REPORT

Introduction 3. It is recommended that theie be recognition and support of each older individual's rightto care It is agreed that the aged are a heterogeneous and treatment in any one of the widerange of group. Large numbers of them need a wide variety alternative mental health services now existing,or of comprehensive health care. Mental impairment those that will be developed. and a wide variety of functional disorders arecom- mon. Depressive reaction to the changes in role, 4. It is recommended that there be universal status, appearance, and to decrements of function prepaid, comprehensive health insurance including or ill healthis prevalent. Consequently, there coverage for mental illness and health. should be recognition of, and response to, the 5. It is recommended that inequities and dis- elderly person's need for mental health care and crimination with respect to the financing of mental psychiatric care wherever he may be and whatever health services should be eliminated from Medi- his age or condition. All institutions, including care and Medicaid. There should be prompt elimi- mental hospitals and centers, should have the nation of deductible and co-insurance features; and obligation and the facilities to diagnose, treator inclusion of drugs, currently excluded dentalcare to safely provide for transfer to a more adequate and prosthetics under Medicare. site for care, all applicants for admission in crisis. Differences in financing patterns, geography, 6. Itis recommended that Medicaid funds transportation facilities and population distribu- should be properly used as legally prescribed; this tion may make for different patterns of intermedi- should be guaranteed by adequate Federal supervision and enforcement. ate and long-term care in differentlocalities. Financial, social, and technical matters should not 7. It is recommended that all funds allocated interfere with ease of admission to and discharge by the Congress for research, training andservices from inpatient care facilitiesor return home to for the elderly should be released and distributed functional status in the community. Also, readmis- promptly both now and in the future, with speedy sions and transfer to more suitable loci ofcare cooperation of the Executive Branch of the gov- should be easy and free of financialor legal ernment where required. (See recommendation on obstructions. the appointment of a Presidential Commission.) 8. It is recommended that efforts should be made at Federal, State, and local levels to develop Recommendations options to institutional care. 1. It is recommended that at an early date, 9. It is recommended that adequately staffed there be established a Presidential Commissionon and programmed comprehensive mental health Mental Illness and the Elderly, with responsi- diagnostic and treatment centers be developed in bility for implementing recommendations made at neighborhood health centers, community mental the White House Conference on Aging. Itsmem- health centers, hospitals and other appropriate bers' should be appointed by the President, subject local, geographically accessible settings; special to the advice and consent of the Congress. attention to adequate funding is of prime import- 2. It is recommended that a Center for the ance. MentalHealth of the Aged be established within 10. It is recommended that properly staffed the National Institute of Mental Health, with the inpatient or residential facilities with proper pro- authority and funds for research, training, and grams should be available in adequate number; innovative programs for older people in the com- all of these should have available methods of munity and in hospitals. supervising, caring for, and protecting persons in

112 their own homes for as long a periodas medically professionals is urgently indicated. Such health and socially possible for the patient. manpower must be increased in number as well as 11. It is recommended that more attention be quality. Agaiii, adequate funding isa necessity. given to the development of innovative therapeutic 15. We are aware that there is a large body of services to currently institutionalized olderpersons, factual and technical data on aging and the practi- and for the future care ofpersons in need of pro- cal treatment of the disorders in the elderly which tective environments as inpatientsor residents in is not generally available and known. 'Therefore, congregate settings. it is recommended that material describing the 12. It is recommended that research monies for best comprehensive care methods ina variety of studies of aging and the elderly, from basic bio- settings should be prepared, widely distributed and logical processes to social and psychological phe- their availability made known. nomena, be greatly increased. 16. It is recommended that the proposed Presi- 13. It is recommended that all mental health dential Commission,, or another appropriategov- programs-for the elderly be open to all, withouta einment agency, look into the methods of purchase "means test." This mandates adequate funding. and provision of mental healthcare currently undertaken by Federal, State, and localgovern- 14. it is recommended that there be recognition mend, in order to advise as to what ismost eco- that training and education of thenecessary health noMical- and effective.

Roster of Planning Committee

Nongovernment Charles Gaitz, Chief, Gerontology Research Section, Texas_ Institute of Mental Sciences, Texas Department Alvin I. Goldfarb, (Chairman), Associate Clinical of Mental Health and Mental Retardation, Houston, Professor of Psychiatry, Mt. Sinai School of Medicine, Texas City University of New York, New York Wendel Swenson, Chief of Psychology, Mayo Clinic, James Bitten, Director, Gerontology Center, Univer- University of Minnesota, Rochester, Minnesota sity of Southern California, Los Angeles, California Prescott Thompson, Psychiatrist, Samaritan Medical Ewald Busse, Chairman, Department of Psychiatry, Center, San Jose, California Duke University, Durham, North Carolina Jack Weinberg, ClinicalDirector,IllinoisState Robert Butler, Psychiatrist, Washington School of Psychiatric Institute, Chicago, Illinois Psychiatry, Washington, D. C. Government Robert Doveninueble, Executive Director, Dallas County Mental Health and Mental Retardation Center, Thomas Anderson, Chief, Section on Mental Health Dallas, Texas of the Aging, National Institute of Mental Health, Carl Eisdorfer, Professor of Psychiatry and Director, Health Services and Mental Health Administration, Center for the Study of Aging and Human Develop. Public Health Service, Department of Health, Educa- tion, and Welfare, Rockville, Maryland ment, Duke University Medical Center, Durham, North, Carolina Nathan Sloate, Special Assistant to the Director, Na- tional Institute of Mental Health, Health Services and Albert Feldman, Associate Director for Community Mental, Health Administration, Public Health Serv- Centers, Gerontology Center, University of Southern ice, Department of Health, Education, and Welfare, California, Los Angeles, California Rockville, Maryland

113 .,- y,,..'Citt r, HOMEMAKER-HOME HEALTH AIDE SERVICES

uring the several months preceding the ante. Yet, it recognized a vast group of aging peo- 1971 White House Conference onple living deprived and isolated lives who find Aging, the Federal Government made that the assistance they need to remain independ- a forceful effort to meet the challenges' ent is not available. presented by substandard nursing homes. Presi- dent Nixon in two major addressesChkago, Through a Special Concerns Session,one addi- Illinois, -on June 25, 1971, and Nashua, New tional step was to be taken to insure the availa- Hampshire, on August 6emphasized his con- bility of the service as ,a resource for all elderly cern with the level of such care being offered people who desire to remain in their own homei the elderly and presented a plan of action for and who could do so, provided they received the the government to pursue. necessary community assistance. The National Council on HomemakerHome Health Aide Serv- This thrust, taken with the attention presentlyices was invited to initiate the planning of the being paid to the soaring costs of institutional care Session. It sought the assistance of interested na- and proposed alterations in the traditional system tional, State, and local organizations and agencies. of health care delivery, has served to strengthen The National League for Nursing, the Home- interest in developing alternatives to institutional- makerHome Health Aide Association of New ization. For many older people especially, more York State, the Visiting Nurse Service of New adequate support services in the home would pre- York,' and the Homemaker Services Bureau of vent, shorten, or postpone hospitalization. For Greater New Haven, Connecticut, joined with it most older people, care in the home would repre- in planning the Session. sent a less traumatic solution to certain of their health and social problems. Given the high costs The Department of Health, Education, and of medical care, it would appear to be more eco- Welfare, through the Social Security Administra- nomically desirable. And, by allowing more per- tion,the Health Services and Mental Health sons to remain in their own residences, such serv- Administration, and the Community Services Ad- ives could decrease the demands made upon those ministration and the Administration on Aging of delivering care within institutions, thereby increas- the Social and Rehabilitation Service, provided ing the responsiveness of institutional care to those Federal resource and assistance.' in greatest need. The National Council on HomemakerHome The Participants Health Aide Services, in a position paper prepared Each Delegate attending the Session did so for the Conference, conveyed the importance after 2 full days of .discussion within one of the which should be attached to "accelerating and 14 major Conference Sections. Perhaps indicative strengthening the hitherto sporadic and faltering of the broad interest generated by the topic of in- efforts in this country in developinga continuum home services and alternatives to institutional care, of health and social services to people in their own each of the Sections was represented among the homes." The Council noted that Medicare pro- HomemakerHome Health Aide Session partici- vides funds for home health care of some older pants. people and that homemaker services have been mandated for the c4clerly receiving public assist- 1 See Roster of Planning Committee, page 120.

115 The participants in the Session had the opportu- Service who could speak with firsthand knowledge nity to shape recommendations directed at devel- of the approaches the Federal Government has oping homemakerhome health aide services as a taken to provide in-home services. A representative resource in every community throughout the Na- from the Department of Labor could discuss the tion. It is significant, therefore, that among the unique training and employment opportunities nearly 200 Delegates who had expressed interest offered those who deliver in-home health and in attending the Session, over 40 States and Ter- social services. Persons working to insure the ritories were represented. availability and adequacy of such services through Each person present, despite a participant mix State and' local agencies, as well as those repre- of age, occupation, income, and residence, realized senting interested national organizations such as that at some time, he or someone he knows might the American National Red Cross, had theop- need a homemakerhome health aide service. portunity to contribute their particular insights.

The Program 1971 WHITE HOUSE CONFERENCE ON AGING The program was designed to fulfill two purposes. The.first was to make participants aware of PROGRAM the present situationwhere it is -that the pro- HOMEMAKER-HOME HEALTH vision of homemakerhome health aide services' stands in the spectrum. of health and social care . AIDE SERVICES available today.2 A second and. overriding purpose Presiding wit to direct attention toward realizing the poten- ELLEN WINSTON, President, National Council tial such services hold!' Thi, culminated in the for Homemaker-Home Health Aide Services, Inc. naming of a drafting committee from among the Delegates present and the framing of the Session's AGENDA recommendations. In addition to the challenge to action contained 8:00 A.M. Focus of the Session DR. ELLEN WINSTON within the keynote address,' a number of special consultants contributed to the substantive discus- Introduction of Special Consul- tants sion within the Session. There to listen as wellas to inform, these consultants were drawn from Address among persons actively involved in the develop- .Meeting the Needs of Older Peo- ment and provision of in-home services. Among plethroughHomemaker-Home HealthAide Services MRS. them were representatives from the Social Security THEODORE WEDEL, Associate Administration and the Social and Rehabilitation Director, Center for a Voluntary Society 1 In keeping with the Session's educational purpose. Delegates were provided with selected publications on the development of Discussion of Major Issues homemakerhome health aide services. These and other publica- "What We Have; What We Need" tions, at cost, and further information, can be obtained from the National Council on HomemakerHome Health Aide Services, Appointment of a Committee to 1740 Broadway, New York, New York 10019 Draft Recommendations a proceedings of the White House Conferenceon Aging underscored the many problems of the aging in America today. Summary of Earlier Discussion It is perhaps meaningful to note how frequently proposed solu- and Continuation of Discussion tions to these problems focused 'on t!.:t need for the development of adequate services to maintain the aging in their own homes. with Emphasis on Development The reader is encouraged to refer !I the reports of the Sections and Expansion of Services on Physical and Mental Health, awl Facilities, Programs, and Services, as well as to those of other Conference Sections and Consideration and Adoption of Special Concerns Sessions, to note the frequency with which Recommendations reference was made to inhome alternatives to inappropriate, institutional care of the elderly. Excerpts from the Address given by Mrs. Theodore Wedel 12:00 Noon Adjournment are appended to this report of the Session.

116 THE SESSION REPORT

Introduction doubly from this service as previously unemployed individuals become self-sustaining. Homemakerhome health aide service helps families to remain together in their own homes Homemakerhome health aide services provide when a health and/or social problem strikesor to many older persons the choice of maintaining in- return to their homes after specialized care. The dependent living. homemakerhome health aide carries cut assigned tasks in the family's place of reSidence, working under the supervision of the professional Recommendations person who also assesses the need for the service 1. Homemakerhome health aide servicesare and implements the plan of care. basic to continued independent living for older A national approval system has been developed individuals in their own homesor in other places of residence considered as home; which provides agencies, whether under voluntary, or the return to ti government or proprietary auspices, help to assure independent living of a large proportion of older the quality of homemakerhome health aide people. They must be required in those health and services throughout the country. This program for welfare programs for older people, with broadened approving agencies will be implemented in 1972. definition for greater flexibility and eligibility for services, in which the Federal Government partici- Despite the demonstrated need, it is estimated pates financially. They must be required services that there are only 30,000 homemakerhome available throughout each State. These services health aides in the entire United States, serving all must be well publicized, including frequent use of categories of social and health needs: the ill, aged, mass media. disabled, children, and others with social and/or health problems. At a minimum, homemaker Federal legislation for both health and welfare home health aide agencies should have available progiams should specifically identify and require that homemakerhome health aide servicesare 300,000 homemakerhome health aides orone available to every community, with appropriations homemakerhome health aide per every 1,000 of Federal funds making it possibleto establish persons in our total population. For older persons; them. the ratio should be approximately oneper 100 as a minimum. The expansion of these services will require additional funds, but it should be recognized that Professional personnel is in short supply and it they also open up and offer new opportunities for is expensive. Paraprofessional or allied profes- employment and careers for many maturewomen sional help must be utilized where and when and men. appropriate from the standpoint of safe and effective care. Homemakerhome health aide service 2. Since homemakerhome health aide services is an exemplary utilization of paraprofessional may be needed in any family, rich or poor, at some personnel. time, they should be available free;or on a sliding scale of fees, to the recipientor through third To meet established national standards, home- party payments, or other financial sources. Experi- makerhome health aides must be carefully mentation with new and different methods of fi- selected, trained, and supervised, but they donot nancing should be explored. Federal and State require an extensive educational background and, legislation should be enacted to provide adequate therefore, this vocation is proving to bea realistic on-going public funding to make it possible to choice for many educationally disadvantaged but provide homemakerhome health aide services capable individuals. Often theseare middle-aged for all older persons to live in theirown homes or or older women. The community stands to gain other places of residence.

117 3. Since at the time of need for homemaker families are to be servedas effectively as possible. home health aide services the individual or family Any in-home service must be provided is in a vulnerable situation, theremust be a require- only ment that any agency providing such services, when it is the choice of theperson or persons to be served with their full knowledge of whether public, voluntary,or commercial, meet alternatives. nationally established standardsto protect the 5. Homemakerhomehealthaideservices quality of the services rendered. Such .standards must be available as supportive, protective, and call for a team approach, using bothprofessionals preventive services on a flexible basis foras long and paraprofessionals. . as needed, whether full-time or a few hoursper week, whether on a continuing supportivebasis or 4. The necessary resources of other relatedin- for only a temporary period of time.The arrange- home services such as friendly visitors, meals-on- ments in each case should provide the olderper- wheels, chore services, shopping and transporta- son the option of remaining in hisown home or tion, as well as other in-home professionalservices, place of residence, as longas it is feasible and must be available when needed if individuals and possible to do so with dignity and safety.

118 MEETING NEEDS OF OLDER PEOPLE Excerpts from me Address gives by Mrs. Theodore Weal, AssochstiDirector, Canter for a Volmatary Society

We are here today to discuss the role of home- may also be far more costly than being thakerhome health aide services to the aging, maintained in their own homes. Scarce, but this service will benefit many other groups in expensive hospital beds 1.re often occupied the population as wellchildren whose mother is by aging persons who do not really need ill, the chronically ill, physically and mentally dis- hospital care, but for whom there is no abled or severely handicapped ofany age, and dis- alternative. The construction of enough advantaged mothers who need help in child rearing hospitals,- nursing homes, and retirement or home management. Therefore, as we discuss homes to take all the aging would cost the benefits for the aging portion of our popula- untold millions of dollars, even before any tion, we can realize that this is not speCial pleading service was provided. There is an unfortu- for one group at the expense of others. We want nate tendency at the moment to tie health the service available for all. insurance payments to hospital or other First, let's just note some facts. institutional area subject on which some of us need to take legislative action. 1. Today there are at least 20 million over 65 in this country. 7. There is a shortage of the professional personnel who can meet the needs of the 2. A very tiny proportion of this group have agingdoctors, nurses, social workers and sufficient financial resources to buy needed others. services or care. 8. There are thousands of able-bodied, ex- 3. The vast majority of the 20 million face perience women in this country who major health and social problems, yet in would welcome the opportunity to work our mobile society few can be cared for for a recognized agency, receive training by members of their families. and be challenged by the role of home- 4. Home is for many an aging person or makerhome health aide. couple theost important factor in maintaining dignity, self assurance, and con- These facts add up to just one thing for human- tentment. itarian and for financial reasons, it is essential that every community in this country provide home- 5. Many communities provide only institu- maker 'come health aide services. tional care for the aging, in hospitals, nursing homes, homes for the aged or I hope we will face this question soberlywhat retirement homes. This will be the best can we do to wake up our communities and the plan for some, but for as many as 10 mil- Federal Government to the fact that there h a lion of our aging citizens, institutional good and workable solution to the inappropriate care is ,inappropriate, inadequate, and un- institutionalization of the aging. It is found in wanted. Every one in thisroom will face quality homemakerhome health aide services this situation personallyfor yourselfor services that meet nationally established standards. someone you lovein the not too far distant future. What can you and I do? 6. Not only is institutional care not welcome 1. We as citizens with knowledge can have a or congenial to many older people, but it lot of influence on Federal legislation and 119 regulations. Learn the facts;talk and write with enthusiasm If publicor private health insurance to your Congress- provide can be man; demand that aging to pay for home healthcare and home- persons be. given makerhome health aide the choice of staying intheir own homes; services as part ofthat become aware of the care, it will do much toprovide more humane Federal programs often more adequate and that tie benefits only care for the aging, and in to institutional care. long run will result the Medicare, for example, in great savings ifwe can restricts inordi- stop building additional, nately payments for home unnecessary, expensive health services. institutions. 2. Federal financial helpis needed, but State and 1,4a1 communities must also be in- There may be timesand places whenwe who volved. There is need forlocal voluntary are enthusiasts for thisservice will find, it wise action and a broadened stress dollar and zo base of funding cents values. But I hopeyou feel because a largegroup of the aged who Is I do, thateven if homemakerhome most need these services aide services health are not the very, cost more s thaninstitutional care, it very poor who might be would still be served by a public worth the cost. If--by whatwe do welfare program, but they here todaywe are the middle- can assure happiness, betterhealth, income -aged living on and the dignity Of pensions who are independence to ourbeloved badly hit by inflation.There are evensome elders, this will bea day well spent indeed. quite well-to-do olderpeople who need the service and couldpay for it, were it available.

Roster of PlanningCommittee liongovernment Government Ellen Winston (Chairman), President,National Albert Fox, Director, Division Council for HomemakerHomeHealth Aide Serv- of Direct Reimburse- ices, Inc., Raleigh, NorthCarolina ment, Bureau of HealthInsurance, Social Security Helen Cusuck, Assistant Administration, Department ofHealth, Education, and Director, Nursing Services, Welfare, Washington,D. C. Visiting Nurse Service,New York, New York Bernice C. Harper, SocialWork Consultant, Divi- Leah Hoenig, Director,Department of Home Health sion of Health Resources, Agencies, National Leaguefor Nursing, New York, Community Health Service, New York Health Services and MentalHealth Administration, Public Health Service,Department of Health, Educa- Florence Moore, ExecutiveDirector, National Coun- tion, and Welfare, Rockville,Maryland 61 for HomemakerHomeHealth Aide Services, Inc., New York New York Gladys Lawson, Specialiston Homemaker Service, Division of Child andFamily Service, Community Janet Starr, Executive Director,HomemakerHome- Services Administration,Social and Rehabilitation Health Aide Association ofNew York State, Syracuse, Service, Department ofHealth, Education, and:Wel- New York fare,;Washington, D. C. William Voltam, ExecutiveDirector,' Homemaker Stephanie B. Stevens, HomemakerS. rvice Specialist, Services Bureau of Greater NewHaven, New Haven, Administration on Aging, Connecticut Social and Rehabilitation Service, Department ofHealth, Education, and Wel- Mary Walsh, Program Consultant,National Council fare/Washington, D. C. for HomemakerHomeHealth Aide Services,Inc., New York, New York

120 Reports of the Special Concerns Sessiowon DISABILITY AND REHABILITATION

AGING ANDBLINDNESS 4 evere visual impairment is increasinglyThe Participants a problem affecting older persons. The Special Concerns Session on Aging A small group of about 40 Delegates with some specialpersonal interest or professional and Blindness was designed to focus competence in the area of visual health chose to national attention the special needs of the one million older Americans in this group and on pre-register for the Session on Aging and Blind- ways of meeting those needs. ness. Among those indicating their intent to attend this Session were Delegates representing pro- The prevention and treatment of blindness was fessional organizations in the area of visual care initially identified as a special Conference concern and blindness, gerontologists and researchers in in the work. of the National Organization Task the field of aging, rehabilitation workers serving Force on Physical and Mental Health. Included in the blind and the handicapped, and older persons the recommendations of that group was "Among themselves, including the elderly blind among the the complex needs for the aged, priority should Delegate body. be given to the prevention and treatment of blindness." In addition to regular Conference Delegates and observers, at the request of the Session Plan- This expression of concern, together with the ning Committee, a number of special guests were efforts of several individuals and national organi- invited. These special guests included the full zations, served to heighten the sensitivity of the membership of the National Task Force on Ger- Conference planners to the special circumstances iatric Blindness and the Liaison Committee on of the elderly blind and resulted in the establish- Geriatric Blindness, and other persons working ment of the Session on Special Concerns. with the blind within both governmental and The National Task Force on Geriatric Blind- nongovernmental units. Although theie special ness of the American Foundation for the Blind, guests did not hold voting privileges, they con- Inc., initiated the planning of the Session. Joining tributed substantially to discussion within the Ses- them as members of the Planning Committee sion. were representatives from the Liaison Committee on Geriatric Blindnesswhich functions on behalf of the Foundation and the American Geria- The Program trics Societyand the National Society for the The program of the Special Concerns Session Prevention of Blindness, Inc. In all, more than 25 on Aging and Blindness allowed a panel of ex- organizations were represented among the Session planning committee members and program partic- perts in the areas of income maintenance, medicine and health,rehabilitation, ipants.( See Roster of Planning Committee, transportation, page 129..) and home health services to outline major problems and present specific recommendations for Providing Federal resource and assistance in consideration and vote by the Delegates attending the planning and program activities were the Na- the Session. tional Eye Institute and the Division for the Blind and Visually Handicapped, within the Re- Panel members sought to address the challenge habilitation Service Administration of the Social presented them in the address of the Session Key- and Rehabilitation Service, U.S. Department of note Speaker, the Honorable Jennings Randolph, Health, Education, and Welfare. United States Senator from West 'Virginia, who

123

468.218 0 - 73.9 t:,

urged the forging of "policy recommendations mendations of the Session speakers. Includedin which willfirmly and forcefullyinbed in the this group of Reactors were several olderblind public conscience the need fora national policy people themselves and representatives from on aging and blindness." two organizations serving the blind whichwere not Plior to discussion and voting, an invited panel otherwise active in the Session program. of Reactors responded to the remarks andrecom-

1971 WHITE HOUSE CONFERENCE ON AGING FoundationofBlind,American PROGRAM Geriatrics Society, New York, N.Y. Rehabilitation DR. DOUGLAS C. MacFAR- LAND, Director,Officeforthe AGING AND BLINDNESS Blind and Visually Handicapped, Social and RehabilitationService, GARSON MEYER, Presiding U. S. Department of Health, Educa- tion,andWelfare,Washington, 8:00 A.M. OPENING REMARKS D. C. DR. PETER J. SALMON, Trustee, Transportation American Foundation for the Blind, WILLIAM C. FITCH, Executive Inc., New York, N.Y. Director, National Council on the DR. ROBERT MORRISGAR- Aging, Washington, D. C. SON MEYER, Co-Chairmen of the Home Help Service National Task Force on Geriatric DR. ROBERT MORRIS, Director, Blindness, American Foundation of Max Levinson Gerontological Policy the Blind Institute, and Professor of Social DR. WILFRED D. DAVID, Exec- Planning, the Florence .Heller Grad- uate School for Advanced Studies utive Director, National Society for the Prevention of Blindness, Inc. in Social Welfare, Brandeis Univer- sity, Waltham, Massachusetts. DR. ROBERT A. RESNIK, Chief, Office of Program Planning, Na- 10:40 A.M.Discussion of Policy Recommen- tional Eye Institute, Bethesda, Mary dations land An invited group of elderly blind persons and special personnel will 8:30 A.M. SPEAKER serve as reactors during this period. SENATOR JENNINGSRAN- Invited Reactors DOLPH, West Virginia,Special WILLIAM EDWARDS, Washing- Committee on Aging, U.S. Senate, ton, D.C.; MILTON KLEIN, Co- Special Needs of the Aging Blind lumbus, Ohio; HAZEL LEMKE, Population Rochester, New York; APARICIO 9:00 A.M. PANEL G. RANGHLE, Washington, D.C.; Policy and Platform Statement in DURKWARD K.McDANIEL, Behalf of the Elderly Blind Popula- National Representative, American tion in the U.S. Council of the Blind, Washington, D.C.; and JOHN F. NAGLE, Chief, Income Maintenance Washington Office, National Fed- DR. JUANITA M. KREPS, Profes- eration of the Blind. sor of Economics, and Dean, The Women's College. Duke University, 11:00 A.M.Adoption of Policy and Platform Durham, North Carolina Statements By floor vote for final recommenda- Medicine and Health tions in the White House Confer- DR. A. L. KORNZWEIG, Chair- ence Report. man, Liaison Committee American 12:00 NoonAdjournment

124 The Program Content Dr. Kreps recommended that OASDI and the adult public assistance categories (Old Age As- The grist from which the recommendations of sistance, Aid to the Blind, and Aid to the Perma- the Session on Aging and Blindness evolved was nently and Totally Disabled) be increased to the detailed in the notes of the Session maintained by intermediate level recommended by the Bureau of members ofthePlanning Committee. High- Labor Statistics, that the public assistance catego- lighted below are the remarks of some of the Ses- ries be federalized, and that Social Security bene- sion participants as drawn from these notes. fits not be considered in determining eligilibity Dr. Robert A. Resnik spoke of the necessity for for public assistance. research on cause of blindness incident to the aging process and called for a concentrated ef- Dr. A. L. Kornzweig elaborated upon several areas in which improvement is necessary. Among fort to reduce blindness from glaucoma through them: increased use of low vision aids, periodic drugs, screenings, etc. He pointed to research cur- eye examinations for people over 40, glaucoma rently being done to treat cataracts medically as education and screening programs, more research well as through the improvement of surgical re- on diabetic retinopathy, and prevention of acci- moval techniques and he set forth the following dents of the eye. needs: an increase in the number of researchers, better public education and awareness of blinding Dr. Kornzweig made several concrete sugges- eye diseases, and the clinical application of re- tions: (1) that diabetic retinopathy be given high search findings. priority in research both by the National Eye In- stitute and by other research groups; (2) that The Honorable Jennings Randolph noted there be periodic eye examinations in nursing the continuing need for treatment and prevention homes and other homes for the aged in order to of blindness and the need to provide older blind detect -and treat preventable blindness; (3) that personswithrehabilitationservices.Inthis the National Eye Institute and others establish a connection, he mentioned a bill which he had in- research program on diseases of the macula; (4) troduced which provides such services without that there be increased financial support for re- regard to the ability of the rehabilitant to join the search on cataract, glaucoma, and vascular dis- work force. The Senator also identified the need eases which affect the eye; (5) that there be a for more trained personnel and researchers in the community screening program, possibly using mo- area of rehabilitation. bile units, to reach and treat aged patients who Senator Randolph discussed another bill which suffer from blinding eye diseases; and (6) that he had introduced in Congress which would ex- there be an educational center established to dis- paad employment opportunities for blind persons, seminate information about preventable eye dis- induding older blind persons, as operators of ease. vending stands in Federal buildings. Dr. Douglas C. MacFarland told of the need Dr. Juanita M. Kreps indicated the need for for comprehensive social services leading to inde- a guaranteed minimum income based on need pendent living, integration of the blind with the with automatic increases based on increases in the sightedpopulation,counsellingwithnewly- cost-of-living and recognized that welfare reform blinded persons and their families, and private legislationcurrently pending inthe Congress agencies to purchase necessary services which are would take a large step in this direction by feder- otherwise unavailable. He also noted the need for alizing the adult public assistance categories and better recreation opportunities for the blind per- establishing eventually a minimum payment of son and for widespread mobility instruction. $150 per month. (Thirty-seven states were cited as currently having public assistance payments He affirmed the goal of rehabilitation to be in- below this level.) She noted that another good dependence of the blind person, freeing other feature of the welfare reform legislation is that it members of the family from the burden of con- requires separation of income maintenance and stant care, and, if the blind person is in a nursing the provision of social services. home or extended-care-facility, freeing staff for

125 g

other purposes and allowing the blind person to tion, rehabilitation, and personal care and home live in such facilities without having to pay for help services, and called for the development ofa extra care. nationwide network of personalcare organiza- Dr. MacFarland projected a move away from tions to assist elderly persons to remain in their providing direct services through State agencies to own homes as long as they desire to do so. The more use of private agencies with which State organizations should provide whatever services agencies can contract for services. He also looks the clients request, even if it isa request for a for increased use of volunteers in the rehabilita- simple non-skilled type of service. tion process and a specialized type of workshop Dr. Morris suggested that financing of these where older blind persons can work on a part-time personal care services should be through Social or occasional basis. Security and that they should be availableto all Dr. MacFarland made the followingrecom- those needing them as a matter of right. Thepur- mendations: (1) the Rehabilitation Services Ad- chase of such services .could be by voucheror by ministration (RSA) should be urged to develop direct cash benefits and the amount of benefit demonstration programs in rural areas and the should be based on the severity of the handicap. data so developed should be widely circulated; Dr. Morris recommended the reallocation of (2) RSA should fund construction and staffing of resources form the provision of custodial care to at least one workshop for older persons of the the provision of home care service. 1 kind mentioned above; (3) the Social and Reha- bilitation Service, of which RSA is part, should give a high priority to the training of paraprofes- Delegates and the Panel of Reactors: sional workers to make rehabilitationservices Expressed support of the legislative initia- available to all older blind persons within the tives made by Senator Randolph. next five years. Spoke of the need for provision of social The RSA should also make a study of volun- services and vocational rehabilitation servicesto teer programs now in operation and develop older blind persons as a matter of right without guidelines for recruitment, training, and supervi- restriction based on the age or financial ability of sion of volunteers. An attempt should also be the applicant and in support of amending the made to double the number of volunteers and in- Civil Rights Act of 1964 to prohibit discrimina- erase the number of hours they work; (4) reha- tion against blind persons solely byreason of bilitation adjustment training, mobility instruc- their blindness. tion, etc., should be made available to all persons who need or request them, and not only those Encouraged the consideration of a broader who are employable. spectrum of employment possibilitiesforthe blind, as well as directing efforts at traininga The Congress should enact legislationnow blind person in line with his interests. pending in Congress which would implement this recommendation; (5) there is a continuing need Reiterated the need `or a more adequate infor research and demonstration and training of come and training directed at useful activities professional personnel. which would keep the older blind person in the community rather than having him shut off from William C. Fitch recognized the urgent need it. for adequate transportation for the elderly and Spoke against segregated housing for the particularly the elderly blind, and recommended blind and for more adequate medicalcare person- that the group adopt a resolution calling for the nel and more community workers and volunteers. provision of adequate transportation services particularly to elderly blind and handicappedper- Supported (1) the use of the professional services of optometrists in vision screening; (2) sons. . the amending of the Medicare legislationto in- Dr. Robert Morris outlined three needs of the clude payment for low vision aids when the need elderly blind persons: medical care and preven- is certified by an ophthalmologistor optometrist

126 c

specializing in low vision treatment; and (3) in- And, in floor discussion following the adop- creasing the number of low vision centers, and tion of the Session recommendations, proposed having such centers manned under the supervision and adopted the following motion: That we rec- of an opthalmologist or qualified optometrist. ommend to Congress a nationally recognized identification card similar to a driver's license Identified support for a system of redu'Od which blind persons could use for identification in fares on airplanes and municipal transportation the same manner in which sighted people now for blind persons of all ages. use a driver's license.

THE SESSION REPORT

Introduction

Since the American Foundation for the Blind, dividualswill become beneficiaries of thy- rap- participated actively in the 1961 White House idly expanc.;:rig programs and services for older Conference on Aging, we have a deep apprecia-persons in such fields as health, nutrition, hous- tion of its constructive impact in generating ining, recreation, employment, continuing educa- creased public awareness and concern for the tion, etc. It often takes little if any adaptation to unmet needs of our aging population and in stim- implementthisconcept,butunfortunatelyit ulating a larger use of our Nation'sresources in rarely occurs automatically, i. e., without continu- meeting these needs. ing interpretation, education, and planning. We, in collaboration with other national, State, In summary, we urge that the 1971 White and local organizations of and for the blind, do House Conference give a high priority to if appreciate an opportunity to share with youour question of how handicapped persons, especially special concerns. As reported by the National So- those who are visually handicapped, can be more ciety for the Prevention of Blindness, approxi- effectively integrated and served by the ever-in- mately half of the estimated 500,000 legally blind creasing number of special programs for older persons in the United 'States are 65 years of age persons. As Senator Jennings Randolph of West or older while two-thirds are past middle age. Virginia stated in his keynote address to the Spe- Moreover, the majority of all new cases of blind- cial Concerns Session on Aging and Blindness, "It ness each year fall within the same age brackets. is clear that we must change attitudes toward the Despite these facts, most of our efforts, in both blind. We must provide opportunities for normal the governmental and private sectors, have been living in society; not charity, but a chance. I fear directed to blind children and to blind adults of that there is widespread misconception about the employable age. Only recently have we begun to abilities and aspirations of elderly blind persons." consider the needs of the older blind person. Another aspect of our special concern stems Findings and from our philosophical belief in the desirability Recommendations of helping blind persons to achieve their fullest potential and integrated members of their com- RECOMMENDATION 1 munity. It is recommended that Congress increase old age, While this belief in no way contradicts the survivors and disability insurance and the adult need for specialized and often separate services public assistance categories to the intermediate for persons who are visually handicapped, there is level of living recommended by the Bureau of an equal need to insure the availability of general Labor Statistics (at least $2,297 for a singie per- community services. Within this context, our hope son and $4,185 for a married couple) and further is that blind personsin fact all handicapped inthat the adult categories of public assistance be 127 federalized and that Social Security benefits not RECOMMENDATION 3 be deducted from public assistance payments. It is recommended that the Vocational Rehabilita- tion Act be broadened to make rehabilitation RECOMMENDATION 2 services available to blind persons without regard It is recommended that the National Eye Institute to age or economic need and that Congress be and other interested organizations on a national urged to enact legislation to amend the Voca- and local level combine their efforts in a urgent tional Rehabilitation Act to provide rehabilitation overall program to prevent or alleviate diabetic services for older blind persons, and to amend the retinopathy; establish a center for the study of Randolph-Sheppard Act to accomplish these pur- diseases of the macula, and increase research ef- poses. i forts in the fields of cataract, glaucoma, and vascular diseases of the eye; establish screening ef- fortsespeciallyathospitals,medicalcenters, RECOMMENDATION 4 homes for the aged, nursing homes, and extended carefacilitiesto find aged patients who have It is recommended that the elderly, including the blinding eye diseases which can be helped by blind and handicapped, must have access to all medical or surgical means and low vision aids. modes of mobility and transportation for obtain- Such efforts should be made by interested philan- ing the essentials of daily living and the cultural thropic organizations and implemented if neces- and social benefits of modern society. sary by legislative action; It is further recommended that the National Eye Institute be required to develop better statis- RECOMMENDATION 5 tics on incidence, prevalence, and etiology of It is recommended that the Administration and blinding eye conditions:that Congress amend Congress develop a network of personal care ben- Titles XVIII and XIX of the Social Security Act efits for 'individuals with a certain level of func- to cover low vision aids when the need is certified tional disability to enable the older person to pur- by an ophthalmologist or an optometrist specializ- chase whatever services are necessary to help him ing in low vision treatment; and that the number remain in his own home if he so wishes; such of low. vision centers be increased and that the benefit is to be in addition to basic minimum in- centers be staffed under the supervision of an op- come and assure a financial basis for local com- thalmologist or a qualified optometrist. munity service providers.

Roster of Formal Planning Committee

A. L. Kornzweig, Planning Committee Chair- Robert Morris, Co-Chairman man,Liaison Committee, American Geria .. National Task Force on Geriatric Blindness, tricsSociety, New York, N.Y. Waltham, Mass. Dorothy Demby, Staff Associate Harold G. Roberts, Associate Director National Task Force on Geriatric Blindness, American Foundation for the Blind, Inc., New York, N.Y. New York, N.Y. Wilfred D. David, Executive Director Robert Robinson, Research Associate National Society for the Prevention of Blind- AmeriL in Foundation for the Blind, Inc., ness, Inc., New York, N.Y. New York, N.Y. Garson Meyer, Co-Chairman Irvin P. Schloss, Legislative Analyst National Task Force on Geriatric Blindness, American Foundation for the Blind, Inc. Rochester, N.Y. Washington, D.C.

128

1 PHYSICAL AND VOCATIONAL REHABILITATION OF OLDERPEOPLE

bsence of formal plansto develop systematic vocational rehabilitation inputs for the 1971 'White House Con- 1971 WHITE HOUSE CONFERENCE 1. ference on Aging ledthe Federal ON AGING Guidance and Employment Service to conduct a broad-based pre-White House Conference on this subjectat Arlington,Virginia, on September 14-16, 1971. PROGRAM Attended by more than 100 leaders in the field SPECIAL CONCERN SESSION of vocational rehabilitation, this Conference was supported by a grant from the Rehabilitation on Services Administration, Social and Rehabilitation Service, United States Department of Health, Ed- PHYSICAL and VOCATIONAL ucation, and Welfare, and received extensive cooperation from a -wide spectrum of rehabilitation REHABILITATION groups and agencies. A Policyand Platform OF OLDER PEOPLE Statement emerged from the Conference with the understanding that it would be presented to the 8:00 A.M.OPENING REMARKS: .White House Conference on Aging as an expres- DR. EDWARD NEWMAN, sion of the recommendations of the vocational re- Commissioner, Rehabilitation Serv- habilitation movement. icesAdministration, Department of Health, Education, Welfare The Participants 8:30 A.M.PRESENTATION OF The Special Concerns Session on the Physical PROPOSALS FOR DISCUSSION and Vocational Rehabilitation of Older People at- AND ADOPTION tracted a pre-registration of 211 Delegates. In addition to these, a distinguished list of guests, in- PANEL MEMBERS cluding members of Congress known to be W. SCOTT ALLAN, Assistant especially concerned with the problems of the el- Vice President, Liberty Mutual In- derly population and with the rehabilitation of the surance Company handicapped, were _invited to attend the meeting CHARLES ROBERTS, Executive Vice President, International As- of the Session. sociation of Rehabilitation Facil-

ities . . The Program LAWRENCE SMEDLEY, Assist- The major part of the Session program was de- ant Director, Department of Social voted to a discu3sion of the Policy and Platform Security, AFL-CIO Statement developed at the September Confer- E. B. WHITTEN, Director, Na- ence. A panel of specialistscommented upon the tional Rehabilitation Association recommendations presented, and the Delegates 12 Noon Adjournment unanimously endorsed, without change, the document as presented.

129 THE SESSION REPORT

Preamble undercurrent of skepticism and detachment marks the American attitude toward olderdisabled workers and is manifested in such phenomenaas Although strong social pressures impingeupon arbitrary retirement age levels, inadequate reha- unemployed disabled persons 55 years ofage and bilitation services, and employer disinclinationto over to disengage themselves from the labor mar- hire older persons. ket, some 15 to 20 percent of them persist in their desire to continue working. Employer resistance, The pre-White House Conferenceon the Vo- community apathy, and inadequate rehabilitation cational Rehabilitation of the Older Disabled resources combine to frustrate the employment Person was developed to give visibilityto the aspirations of the members of this group. Yet,re- legitimate needs and concerns of vocationally- search conducted at Federation Employment and motivated older, disabled persons and to bring to Guidance Service and elsewhere clearly indicates the White House Conference and to the publicat that almost all vocationally-motivated older disa- large an awareness of the critical needs of this bled persons retain surprisingly high degrees of group. The Platform that follows, an out-growth potential employability and respond positively to of the pre-White House Conferenceon the Voca- vocational rehabilitation measures. In study after tional Rehabilitation Older Disabled Persons,pre- study,olderdisabled vocationalrehabilitation sents the views of a cross-section of American clients in all sections of the United States have leadership concerned with agingpersons. Each demonstrated that they can make a contribution plank was presented to the preliminary conference to the welfare of their families, their communi- as a whole, for study, review, amendment, and ties, and the country at large, if provided with pass: se. It represents the combined interest, in- , suitable rehabilitation and employment opportuni- sight, and skill of more than 100 delegates. As ties. such, it may serve to focus the attention of the American people upon a group that currently is The benefits derived by this group from partici- being grossly neglected despite their interest in, pation in vocational rehabilitation often is stated and readiness for, rehabilitation and employment. in economic terms. Indeed, their nost-rehabilitation earnings usually spell the difference between The Special Concerns Session on Physical and living in poverty and living in comfort. Beyond Vocational Rehabilitation at the White House this, however, their psychic gains are no less sub- Conference on Aging endorsed this Policy and stantial.Vocationally-motivatedolderdisabled Platform Statement, presented here in shortened persons who reenter employment usually feel bet- form.' ter,acquire enhanced self-regard, and assume meaningful roles in the family and thecommu- Recommendations and Comment nity. Psychologically, the disengagement process usually is reversed and mental health problems Some 15 to 20 percent of all unemployed dis- are ameliorated. Case evidence as well as statisti- abled persons 55 years of age andover elect to cal findings support the conclusion that participa- continue in the labor market, despitesevere limitation in remunerative work is closely associated tions, and the lack of encouragement from the with the achievement of a satisfying and useful community. life style among employment-oriented older disa- Vocational rehabilitation services for themem- bled persons. Notwithstanding the bright promise of voca- I A full statement of the Platform and Policy Statement has tional rehabilitation for such individuals, services been published by the Federation Employment and Guidance for this group remain largely undeveloped. An Service, 215 Park Avenue, South, New York, N. Y. 10003. 130 hers of this group are lacking or are highly inade- Non-discrimination in employment throughout quate in most sections Of the United States. This the United States at all geographic levels. neglect reflects the general apathy of Americans, even those who work with older persons, toward the vocational aspirations of older persons. Even 2. The Community the 1971 White House Conference on Aging, in The community should: its preparatory stages, made no plans for a con- Pay particular attention to disadvantaged sub- ference section on rehabilitation (as it had done in 1961). groups among the aging. Establish general and/or specialized 'Programs In face of this extensive lack of concern for the for the aging. vocationally-motivated older disabled person, the Be educated to the vocational rehabilitation po- objective of the pre-White House Conference tential of the aging. meeting was to recommend policies and programs that should be instituted to meet the needs of this Develop comprehensive service programs for group in the 1970's. the aging containing strong vocational components. Develop organized gm:4.s of aging persons, SPECIFIC RECOMMENDATIONS that, among other activities, support vocational components. 1.Legislation Through its rehabilitation agencies and workers, function as an advocate of the aging. A. Current legislation should be amended or ad- Develop improved community transportation ministered so as to provide for: facilities in cooperation with United States De- Positive enforcement of existing anti-discrimi- partment of Transportation. nation legislation.

Improved Social Security benefits. 3. Organizations and Programs Modification of the Social Security earnings A. Alltypesof agenciesinthe community limitation. should: Inclusion of rehabilitation incentives in welfare Open their general community facilities and legislation. programs to the aging on the same priority basis as other groups. A rise in the level of Social Security Trust Funds available for payment for vocational Reach out to currently "underserved" subgroups of aging persons. rehabilitation services. Consider rehabilitation of the aging as a spe- Earmarking of specific anti-poverty funds for cialized rehabilitation subfield. the aging. Include vocationalrehabilitationservicesin Inclusion of vocational rehabilitation services their multifunction programs for the aging. under Medicare and Medicaid and proposed comprehensive care programs. Adopt service procedures that enable the aging toenter vocationalrehabilitationprograms without delay. B. New legislation is needed to achieve: Public agency financial support for long-term Make provisionfor the aging to serve on workshop employment programs. boards and committees which formulate agency The use of Federal funds to create new jobs policies and programs. for the aging in private industry and govern- Encourage institutions for the aging to set up ment-sponsored public service activities. vocational programs for their residents.

131 Establish experimental rehabilitation residences Offer comprehensive vocational rehabilitation for the aging. programs. Be given responsibility for continuity Develop regional and State vocational rehabili- of care. tation centers for the aging. a't Set up special programs for homebound and D. Private enterprise should: neighborhood-bound older agencies. Be encouraged to participate in the vocational Establish linkages between agencies for the rehabilitation of older disabled persons. aging and other agencies. Assume responsibility for preventing andame- Designate a national group to serve as a forum liorating vocational handicaps in their aging and a clearing-house for those concerned with employees. the vocational rehabilitation of older persons. Be assisted in these functions by comultation Expect rehabilitation agencies serving the aging from specializedrehabilitation agencies and to conform to commonly-accepted service stand- personnel. ards.

B. Federal and State RehabilitationAgencies 4. Employment should: Vocational rehabilitation should emphasize ca- Take leadershipin developing servicesfor reers, not merely jobs, for older disabled persons. older disabled persons, preferably through spe- Public and private hiring practices which bar older cially-designated organizational sections or divi- disabled _persons from employment should be sioss. altered. Earmark special funds for the aging. Employers should be educated to see the values of Be strengthened, in general, in funding, pro- hiring older disabled workers. gramming, and administration. Vocational benefits offered to other disability Assignresponsibilityfor programs forthe groups in employment should be opened to the older disabled person to special personnel. aging. Stipulate clearly that age, per se, is not a dis- Flexible working hours should be adopted in in- qualification for entry into vocational rehabili- dustry. Additional part-time employment oppor- tation service. tunities should be created. Employment should not be discontinued on the C. Voluntary Agencies should: basis of an arbitrary maximum age. Employment opportunities in community service Be given a major role in the vocational rehabil- should be fully explored. itation of older disabled persons. Demonstration new careers program. s should be Engage, along with otheragencies, in launched. innovation research and demonstration activities. Attempt to reach as many older disabled per- 5. Personnel Training and Research sons as possible through decentralized catch- Rehabilitation personnel should be trainedin ment area programs. service to the aging through specially-funded programs. Along with State agencies, assume responsibility for the conduct of long-term workshop employ- Grant applications for research and demonstra- ment programs with the aid of public agency tion projects for the older disabled person should funding. be given a high priority.

132 National research and demonstration and/or re- Federal funds for medical research should be in- search and training .centers on the vocational creased. rehabilitation of the aging should be established. Additional Federal financial assistance should be Fundamental and applied research relating to the provided for, the training of medical and allied older disabled worker should be supported by personnel. public funding. The Federal Government should sharply increase Application of modern technology to the prob- the funds allocated for the construction,expan- lems of the aging should be explored. sion, and alteration of rehabilitationfacilities under the Hill-Burton Program and the Voca- tional Rehabilitation Act.

1. 6. Medical Medicare and Medicaid legislation should be adopted which strengthens the rehabilitationcom- Medicare-funded rehabilitation services should be ponent and which enables patients to receive extended to persons receiving Social Security Dis- medical rehabilitation service in conjunction with ability benefits through rehibilitationas well as their hospitalization. other health facilities.

(

133

AGING AND DEAFNESS

cting on a suggestion made by Dr. fromthe generalaged population. Deafness Boyce R. Williams 1 and Dr. Jerome makes communication between them and most Schein,Director, Deafness and Re- people very d:ilcult. The ordinary use of radio, search Training Center, New York televisi n, and telephones is denied them. They University organized a national conferenceon cannot hear a doorbell nor a shouted warning. "Services for the Elderly Deaf Persons" heldin When aging combines with deafness, the result- Columbus, Ohio.2 ing disability can be massive, though it need not The committee 3 planning the program antici- be. pated that the outcome of the meeting would be included as one of the special concerns of the As will be seen, communication is not the only difficulty aged deaf persons have in contrast to 1971WhiteHouseConferenceonAging. Through a series of circumstances, this expecta- other aged persons. Their deafness has been a large factor in their educational, occupational, and tion did not become clear until it was too late to social development. Now in their declining years, organize such a session. their deafness continues to confront them with The outcomes of the Columbus Conference, problems demanding special efforts to yield satis- which were published on July 9, 19714are of factory solutions. such national importance that arrangements have Being a small group relative to the general been made to include this summary of the find- population and having an "invisible" disability, ings as a part of the report of the White House deaf people are easily overlooked in planning for Conference on Aging. The following material is the general welfare. The 1961 White House Con- quoted, with Dr Schein's permission, from Serv- ference on Aging, for example, makes no specific ices for Elderly Deaf Persons. references to the elderly deaf population. Further- more, little has been written about this group and almost no formal research has been conducted rel- Columbus evant to them. In order to correct this unhappy state of affairs, a conference was held to bring to- Conference Report gether deaf community leaders and geriatric experts, who worked together to expose the issues Preamble and to recommend appropriate policies and programs. Because they cannot hearand have not heard for all or almost all of their lives--deaf To assist the conferees to work effectively to- persons face their later life with different needs gether despite their diverse backgrounds and the limited time available to them, a series of back- 1 Chief,Communication Disorders Branch,Rehabilitation ground papers were prepared and sent out in ad- Services Administration. Social and Rehabilitation Services, De- partment of Health, Education, and Welfare. vance of the conference. Following a brief orien- 2 Supported, in part, by a grant from the Social and Re- tation to the conference, the participants met in habilitation Service, Department of Health, Education, and Welfare. small discussion groups. Each discussion group 3 See Roster of Planning Committee, page 141. then presented its conclusions to the full assem- 4 Copies of the full report are available from the Deafness bly, at which time differences were resolved and Research and Training Center, New York University, 80 Wash- ington Square East, New York, N. Y. 10003. the policies and programs adopted unanimously.

135 p-

The conference participants were chosen be- gram more properly falls under one or another cause of their interest in and knowledge about heading. Some cross-referencing 'has been doneto the problems of aging and deafness. The majority aid the reader whd may not find what he wishes of them are themselves deaf. However, because in the expected place below. of limited funds, it was realized from the outset that a group representing all organizations of In deliberating on aging and deafness, thecon- deaf people in all parts of the United States ferees were not trying to fill in the blankson a could not be assembled, The participants, there- prepared schedule of items. Rather, theysaw fore,directedthattheirrecommendations be their mission as twofold: (a) determining the given the widest possible circulation in the deaf needs and desires of aged deafpersons and (b) community, so that any disagreements withor presenting these as clearly as possible to those who omissions from the policies and programs can be can assist them to solve their problems and satisfy noted before the forthcoming White House Con- their needs. ference on Aging. The emphasis and omissions, therefore, should reflect the special orientation of the deafcommu- nity toward aging. Recommendations Issues, Policies, Programs Income The following policies and programs were Because of their deafness, which may have lim- unanimously adopted by the participants in the ited their lifetime earnings and consequentlyre- Conference on Services for Aged Deaf Persons, duced their retirement benefits, many elderly deaf held in Columbus, Ohio, June 15-17, 1971. The persons face their declining years with inadequate issues dealt with below were also agreed upon financial resources. without disient, though only after extensive dis- Policy: Aged deaf persons, no less than any cussion. Only those issues were considered and citizen, should have sufficient income to live with only those recommendations were made whiches- pecially concerned the aged deaf population. dignity. The deaf community should join with all General issues for all elderly people were not other groups in implementing this policy. taken up as such. The conferees felt that these Program A: The Social Security Administra- problems will be adequately discussed at the tion should educate and inform those who are forthcoming White House Conference on Aging. entitled to, but are not receiving, benefits about Issues of income, employment, health, housing how to file for them. In order to more effec- and so forth, then, are all presented here in the tively do this, the Social Security Administration context of the special needs of the elderly deaf should appoint, as has already been done in community. the Bureau of Education of the Handicapped and the Rehabilitation Services Administration, The order of the topic follows th .t in the Invi- program specialists with responsibility for at- tation to Design a World...Second Reader, tending to the special needs of deaf persons. prepared for the 1971 White House Conference These educational efforts should be made with on Aging, distributed by the Administration on adequate provisions for the communication lim- Aging, Social and Rehabilitation Service, U.S. De- itations of deaf persons. (Also see Education.) partment of Health, Education, and Welfare. In accordance with the plan of presentation for the Program B: Increase vocational training pro- Conference, the sections first discuss issues, then grams and employment opportunities for deaf suggest policies, and finally recommend programs, workers. (Also see Employment.) as appropriate. There is some overlap between Program C: Reduce costs of transportation, the broad categories, and there may besome dis- communication, housing, and medical care, so agreement as to whether an issue, policy, or pro- that aged deaf persons' present resources will

136

; i cover a larger portion of their living expenses. taining knowledge about correct diets. In both in- (AlsoseeTransportation, Housingand stances, deafness is a potential barrier. Health.) Health Employment The health needs of aged deaf persons are dif- Programs that could and should assist elderly ficult to meet, because of the lack of medical deaf people in securing employment after retire- and paramedical personnel able to communicate ment do not appear to be doing so. The special- with deaf persons. ized approaches necessary to finding work for those aged persons who cannot hear are not pres- Policy. In providing for the health of elderly ently included in programs of vocational rehabili- deaf persons, particular attention must be given tation for elderly people. to their communication problems and their social needs. Policy: Aged deaf persons who can and who Program A. Existing health legislation for the wish to continue in productive service to society aged population, such as Medicaid and Medi- should be given every opportunity to do so. care, should be amended to take note of the Program A. Ensure the provision of counsel- special needs of deaf people. Such legislation ing and rehabilitation services to aged deaf per- should provide funds for interpreters whenever sons by encouraging them to use existing facil- they would be needed to permit deaf persons itiesand,atthe same time,adaptingthe to take full advantage of the health facility. existing facilities to meet the aged deaf per- Program B. The American Medical Associa- son's needs. tion and the American Hospital Association Program B. Educate the public to the value of should encourage some doctors and nurses to the elderly deaf worker. learn how to communicate with deaf persons. Program C. Make certain that government, The AMA should be urged to develop central- government-sponsored, and private programs ized services providing information on avail- for employment of elderly personsfor exam- able doctorsskilledat communicating with ple, Senior Community Service Aides. Foster deaf persons. When appropriate, hospitals and Grandparents, Operation Mainstreamsuitably nursing homes should arrange'for each nursing provide for the inclusion of aged deaf persons. shift to have at least one nurse available who is Program D. Develop volunteer programs for skilled at communicating with deaf persons. health-carepersonnel those elderly deaf persons not in need or desir- Physiciansand other should be informed about the availability and ous of paid employment. Such programs may be instituted in cooperation with local church use of interpreters for deaf patients. and community organizations, State associations Program C. Health education programs espe- of the deaf, and the divisions of the National cially designed for elderly deaf persons should Fraternal Society of the Deaf. It would also be be implemented at once. (Also see Education.) helpful to develop guidelines which local agen- Program D. Existing and new nursing homes cies could use in planning for the assistance of should make suitable provisions for some of these aged deaf volunteers. (Also see Retire- the aged deaf population, taking account of ment Roles and Functions.) their special social and environmental needs. (Also see Housing.) Nutrition Program E. Community health centers and home-care services should become aware of the No special issues pertaining to aged deaf persons were raised. However, some of the issues special problems of deaf persons and establish under Income, Health, and Education are relevant a focal point for services to aged deaf persons. to this topic, insofar as these beat upon having Program F. Third-party payers under medical sufficient funds to purchase proper foods and ob- insurance plans should meet the costs incurred

137 in providing an interpreter for deaf persons. should offer all levels from completely inde- during consultations and other medical services. pendent living to nursing-home care. The facility should have a policy and admissions' board Housing which is representative of the deaf community in general as well as the elderly deaf popula- When circumstances cause an aged deaf person tion. to seek group living arrangements, he often finds his choices limited and many, or ali of them, unsatisfactory. Transportation Policies. The housing needs of aged deaf per- Many elderly deaf persons have more difficulty sons should be given greater attention, with the traveling than elderly hearing persons because of object of providing the widest possible choice of their communication problem. The deaf commu- facilities through rent supplements, housing subsi- nity joins with the general aged public in seeking dies, low-interest loans, etc. Funding should be the cooperation of private and governmental available to groups of deaf people alone or to agencies to improve transportation for the elderly mixed groups of hearing and deaf people. and to reduce its costs. Aging deaf people are not uncommonly placed Retirement Roles in a variety of institutions without consideration of the fact that they are deaf. Long-term commit- and Activities ment of deaf people should be in institutions Aged deaf persons, due to their communication where a deaf population is provided for in par- problems, have available to them few of the so- ticular. This policy is necessary due to the basic cial, recreational, and civic opportunities that are problems of communication and isolation which available to those of the general aged population. could be alleviated by special social and recrea- Consequently, their later years are often spent in tional opportunities for aged deaf persons. extreme loneliness, boredom, and unproductivity. Program A. Housing guidelines should be Policies and programs to overcome these offenses prepared for use by all groups interested in of aging are presented in the sections headed Em- serving aged deaf persons. ployment, Housing, and Education, Clearly, all steps aimed atalleviating the communication Program B.Supportive servicessuchas problems imposed by deafness will aid the deaf "meals-on-wheels,"transportation,or home nursingshould be provided to enable the person in his daily living, at home or on the job. aged deaf person to continue to live in his own home whenever possible. Education Program C. Wherever appropriate, units for Inadequate perparation is given for old age. It aged deaf persons should be provided in exist- is often the case that deaf people reach their re- ing or new facilities serving the general aged tirement time without an adequate understanding population, and services should be included to of Social Security benefits, health-care programs, meet the special needs imposed by deafness. and other benefits to which they are entitled. Program D. Encourage organizations of and Many enter their later life without recreational, for the deafnational, state, and localto social and civic knowledge that would permit sponsor housing facilities for aging deaf per- them to make productive use of their time. Fur- sons under existing laws. ther, many are not prepared psychologically for Program E. Conduct a study of the feasibility their old age. of establishing for aged deaf persons a Feder- Policy. Educational programs for aged deaf ally supported model retirement community. It persons and their families should be prepared and should be comprehensive, providing forall widely distributed in a form and manner specifi- ranges of servicehealth, nursing care, recrea- cally designed to interest and be understood by a tional, and social facilities. The housing, itself, deaf audience.

138 Program A. Increase educational programs for search and Demonstration and Government and the improved use and enjoyment by older deaf Nongovernment Organizations. persons of their leisure time. Program B. Develop rehabilitation programs to sharpen their marketable skills. Facilities, Programs and Services Program C.. Disseminate more effectively to deaf persons information vital to their func- There are special problems of integrating deaf tioning; e.g., health information, Social Security persons into many appropriate existing services. changes. There is lack of coordination between the different governmental departments responsible for provid- Program D. Educational and counseling pro- ing services to all aged people. grams should be developed to prepare deaf persons for the readjustment problems they Policies. Existing services should bear in mind will meet on retirement. Suchprograms should the special needs of disabilitygroups, such as the utilize all methods of communication suitable crippled and deaf populations. In particular,it to deaf audiences and should be administered should be noted that the deaf person's communi- through national and local organizations of the cation handicap and his lack of hearing placesse- deaf. vere limitations on the use of mass media and the Program E. Preretirement programs to assist telephone. There should bea permanent Presi- in preparing deaf people for their retirement dential Commission on 'Aging with appropriate years should be established. representation for different groups of the aged population, including the deaf population. Program F. Adult education programs should become more flexible in an effort to meet the Program A. The National Association of adult education needs and desires of deafpeo- Homes for Aged Deaf (NAHAD) should be ple, even to the point of suspending certainre- linked to the National Association of Homes quirements,inparticularthoserelatedto for the Aged (NAHA) and should drawupon teacher qualifications and class size. general community resources in orderto pro.. Program G. Senior citizen centers should be vide a more efficient and effective service. encouraged (a) to develop programs whichcan accommodate deaf senior citizens withincenter Training programs or (b) to establish satellite centers for deaf people and make provision for having There are not enough professional andpara- people in the programs whoare able to com- professional persons qualified toserve the deaf municate and work effectively with deafpeo- community. Aside from education in the disci- ple. pline he practices, a person working with deaf people must be skilled in communicating with Spiritual Well-Being them. Possibly as critical, is the need for professional counseling for the families of aged deaf No specific policies or programs directed at the persons. religious needs of elderly deafpersons were suggested. A great many denominations make special Policy. Establish training programs and create provisions for their deaf congregants. A few also educational materials to prepare professional and arrange to serve their older deaf members in ways paraprofessional personnel to work with aged suitable to their condition; for example, through deaf persons and their families. home visits and special services. Program A. Establish specialized education Planning and Evaluation and training programs in Social Work, Reli- gion, Nursing, Guidance and Counseling which The policies and programs relating to this topic would develop personnel who could effectively are largely discussed under the headings of Re- work with aged deaf persons and their families.

139

468.218 0 79 - 10 Program B. Provide training programs in aspects would include explaining what to do Total Communication for professionals and when hearing is decreasing and where togo paraprofessionals who wish to work in the deaf for assistance, evaluation, etc. Corps members community. would also assist in counseling, guidance, teach- Program C. Develop recruiting programs to ing new communications skills, giving informa- interest professional and paraprofessional per- tion about such devices as lights in place of sonnel in the problems of aged deaf persons. doorbells and alarmclocks, describing thecap- These programs should be sufficiently funded tioned Films for the Deaf program, and refer- to attract well-qualified persons. ring to Vocational Rehabilitation services when indicated. Research and Demonstration Program D. Research should be conducted on ways to overcome unfavorable attitudes, to the There is a need for increased knowledge of the extent they exist, toward aged deaf persons. problems, needs and desires of aged deaf persons. There is also a need for further development and refinement of service techniques for meeting these needs. Government and Nongovernment Organization Policy. Studies of the aged deaf population are needed in order for service programsisLinaose Local, State, and national programs for deaf their effectiveness. The findings of such studies persons are often ineffective or achieve only mini- should be published, disseminated, and applied as mal impact due to the lack of involvement of rapidly as possible. deaf persons in policy making, administration, and provision of services. Program A. As a development of the Na- tional Census of the Deaf a continuing demo- Policy. Programs for aged deaf persons at the graphic study of the aged deaf population local, State and national levels should involve should be instituted and this should make pro- deaf persons in the policy making, administration, vision for the evaluation of existing services and provision of services. and needs. Program A. Amend all legislation relevant to Program B. Services to aged deaf persons aged deaf persons to designate them as spe- should be evaluated regularly in order to foster cial-needs group and to incorporate provisions maximum effectiveness and proper program de- for special services for this group. velopment, and the results of these evaluations should be given to all concernedagencies, Program B. Interpreting service should. be consumers, and other interested groups. available as need for service, rather than providing services only at times when interpreting Program C. Establish a Volunteer Workers service is available. This provision also applies Corps of aged deaf people who could provide to interpreters at meetings deaf people should service assistance to recently deafened people. attend to express their views and lend their as- The recently deafened group would probably sistance. Availability of interpreters for the include any adult, but concentration would be deaf, under such circumstances, should be an with the older age group. Some of the service acknowledged right.

140 Roster of Ad Hoc Planning Committee

Leon Auerbach, Chairman of Department of Augustine Gentile, Director, Office of Demo- Mathematics, Gallaudet College, Washington, graphicStudies,GallaudetCollege,Silver D.C. Spring, Maryland C. Orin Cornett, Vice President, Gallaudet Col- Glen T. Lloyd.. Editor of Journal of Rehabilita- lege, Washington, D.C. tion of Deaf, College of Education, University Alan B. Crammattee, Associate Professor of of Tennessee, Knoxville, Tennessee Business Administration, Gallaudet College, Jerome D. Schein, Director, Deafness Research Washington, D.C., Adelphia, Maryland and Training Center, New York University, Thomas H. Fay, Deafness Research and Train- School of Education, New York, N.Y. ing Center, New York University, School of Frederick C. Schreiber, Executive Secretary, Na- Education, New York, N.Y. tional Association of the Deaf, Silver Spring, James T. Flood, President of National Associa- Maryland tion of Homes for Aged Deaf, Columbus, Ohio Francis J. Guttas, Program Specialist, Bureau of Vocational- Rehabilitation,-Columbus, -Ohio

. t )

141

Reports of the Special Concerns Sessionson THE RURAL AND THE POOR ELDERLY

RURAL OLDER PEOPLE he Special Concerns Session on Rural giving attention to a group of older Americans Older People was requested by Green who might otherwise have received scant atten- Thumb, Inc., of the National Farmers tion. The recommendations from this Special Ses- Union. Accepting invitations" to mem- sion are, therefore, a major addition to the out- bership on the Planning Committee for the Ses- come of the Conference as a whole. sion were the National Grange, the Coalition for Rural America, and the National Association of Counties. Federal agencies naming representatives The Participants to the Planning Committee were the Departments of Agriculture, Labor, and Health, Education, and Approximately 162 Delegates pre-registered for Welfare; the Office of Economic Opportunity, and the Session but they were joined by many other the Appalachian-Regional Commission.1 Delegates and observers sothat the meeting room provided standing room only throughout The 14 subject-area Sections of the Conference the morning. Participants were prepared for the were largely focused on the needs and problems session through the distribution of a leaflet be- of the older urban population. The Special Session fore the Session convened which provided the on the Rural Older People afforded a means of following informati about older Americans in rural areas and small towns. I See Roster of Planning Committee, page 150.

OLDER AMERICANS IN RURAL AREAS AND SMALL TOWNS

How Many People Are We Talking About? There are nearly nine million Americans aged 65 and over living outside of our cities. They are 41 percent of U.S. population in this age group.

How Do They Fare on Income? Nearly a 'third of the men have less than $2,000 annual income; fewer than five percent have $10,000 or more. About 70 percent of the women have less than $2,000 annual income; less than 1 percent have $10,000 or more. One-third of all elderly persons in rural areas live in poverty, compared with 25 percent in central cities and 17 percent in suburban areas. (continued next page)

145 AreMen 65and Liketheir Over work city Employed? after cousins,only age 65. abouta Moreover, quarter workers present continue lived andruralmanpower to in areas; programs 45 only24 neglect or oldernonmetropolitanin percent both 1970. areasand ofall older HowDo only4 enrollees Rural percentwere ManyruralPeopleGet cause of elderly poor are Around? or both. roads isolatedfrom few Lackof or lackof their services private neighbors inruraltransportation or public be- How areas. hamperstheir vehicles GoodIs use ofthe Sixty Their percentofHousing? metropolitan the areas;substandard rural about housing Nine elderly. unitsare in out of one-fourthare non- the 10 of occupied povertylevel. these by occupantshave How incomes Healthy below Rural Are people Older and 65and Rural limitations olderhaveAmericans? Disabled on their more scarcity rural activities chronic of elderlyare thanthe conditions facility. doctorsand doubly urban Ifthey lackof aged. neglected. are also poor,transportationdisadvantagedby health to a needs medical tendto be

.The Program The Planning Committee informcommunication wanted was as methodsin touse introduced also many ofthe orderto various were bythe wishedto interest of followedby reachthose havetheaudienceas and thelife a vivid,Arkansas persons voices possible. of Fiddlers. wouldbe in and ofthe It presentation theruralaudio-visual They Delegatesresponsive out of audience ment of which elderlyin portrayal would to the was make. governmentwho In Agriculture. producedbyAmerica;a To recommendations order the achievethe the the toreach Depart- former Planning theears of objective, sons tobe the the a "panelCommittee concerned program ofinviteda numberpersons, Delegates listeners" of commenting formulate whoalso per- 146 uponthe helped variousrecommendations proposals. by 1971 WHITE HOUSE CONFERENCE ON AGING Recorders: BLUE CARSTENSON, Director of Citizenship Activities, Senior Member PROGRAM Council, National Farmers Union JEANNETTE WEDEL, Associate Di- RURAL OLDER PEOPLE rector for Administration, Coalition for Rural America Chairman:C. E. BISHOP, Chancellor, University of Maryland. Audio-Visual Program: Panel of Listeners: Honorable JOHN D. EHRLICHMAN, RUSSELL T. FORTE, Information Assistant to thi President for Domestic Specialist, Office of Information, De- Affairs partment of Agriculture Honorable CLIFFORD M. HARDIN, Secretary, Department of Agriculture AGENDA Honorable HUBERT H. HUMPHREY, Member, United States Senate 7:55 A.M.Arkansas Green Thumb Fiddlers DR. JUANITA M. KREPS, Professor of Economics and Dean, The Women's Opening Remarks by Chairman College, Duke University Bishop Honorable GEORGE H. MAHON, Member, United States Home of Rep- Slide Presentation of the Prob- resentatives lems and Resources of Rural Older People Honorable ARCH A. MOORE, JR., Governor of West Virginia Floor Discussion Honorable JAMES B. PEARSON, Member, United States Senate 9:15 A.M.Comments by the Panel ofLii- Honorable ALBERT H. QUIE, Mem- teners ber, United States House of Represent. atives 10:00 A.M.Deliberation and Adoptionof Recommendations STANLEY SMOOT, Vice President. National Association of Counties 12 NoonAdjournment

f :;7.:%er,

147 THE SESSION REPORT

Preamble areas have one-third of the poverty in this country, yet they get only 16 percent of Federal manpower Growing older in rural America presents special funds. and unique problems to whichwe call the attention of the 1971 White 'House Conferenceon National programs designed to providepart- Aging and the general public. Sheer distance be- time community service work for older ruralpeo-, tween people, and between people and services, ple, such as Green Thumb and Green Light is the most obvious aspect in which ruralareas (funded under Operation Mainstream), have differ from urban ones. Distance complicatesthe found that the opportunity toserve and also earn delivery of any service to rural older people; the is eagerly welcomed by rural older folk. expense of maintaining private cars and lack of Programs established to meet the needs of the public transportation bar older people fromcorn- elderly in rural areas and small ing to the services. Many people, in rural towns should be areas, designed to fit their way of living. Most rural are isolated by a more basic lack of roads. Rural people have been very self-reliant all their lives. transportation prOblems must be solved before They were their own mechanics, plumbers, there can be effective solutions to rural health, in- car- penters, doctorsbecause there often wereno come, employment, or housing problems. others. When crises came, neighbors quietly Another unique aspect of growing olderin chipped in, often without being asked. Age has rural America is thata large proportion of the now stripped them of their resources but not their neighbors are also old. Nationally,one out of traditions. Many refuse to take advantage ofthe every ten of our citizens is old; in rural counties few services whichare available because they that ratio is often one in five. As theyounger don't know how to take the initiative indealing people are forced to leave to find jobs, theyleave with "government officials" and they feela strong a shrinking tax base and a growing scarcity of sense of shame and failure if they try. Programs services. Rising property and sales taxes in rural must be designed to seek out deeds, not merely areas are becoming increasingly oppressive to respond to demand. They must deal withthe older rural people. rural elderly in ways whichare not frightening or foreign to them. Older people need to be in- Retirement income is lower in ruralareas, ton. Few workers in rural areas volved in designing, planning, and implementing are covered by privatt: these programs. pension plans. Income in their lateryears must come from Social Security, from savings, from continued employment,or from welfare. Since most rural people became eligible for Social Se- curity relatively recently when agricultural workers and the self-employed were included, they have had fewer years of covered earningsand Recommendations thus their benefits are lower. Although older rural peopleare accustomed to working, there is a critical shortage of paidjobs Transportation for those who wish to work. Manyurgently need 1. A broad program to develop people-delivery work because of low income, yetpresent Federal systems in rural areas should be undertaken, such programs discriminate against rural areas. Rural as those by the Federal and State governments,

148 based on demonstration projects by theOffice of comes through employment, craft cooperatives, Economic )pportunity, the Appalachian Regional and similar arrangements should be removed. Commission, Green Light, and others. 8. State and local governments should reduce 2. Legislation should br: passed enabling and or alleviate the disproportionately heavy property requiring public, social, health, and employment taxes on retired persons on limited incomes. services in rural areas to help providetranspor- tation and outreach; remove legal barriers suchas taxi rates and car, taxi, and school bus insurance Housing restrictions to such transportation services, and 9. Legislation establishing and fundinga major finance such services for older people inrural home repair program for older people in rural areas. areas should be passed. It should include home repair loan and grant programs under the Farm- 3. Older people in rural and farm communities ers Home Administration (currently authorized must be provided legal and protective services in .., but not provided); larger home repairgrants for order to assure adequate voice and assistanceon welfare recipients with less State matching funds all issues which involve possible encroachmenton than at present; authorization to their rights and property. use Federal din- power training programs to perform the work, and adequate staff to administer theseprograms efficiently. Employment 10. More new housing should be provided for 4. Community service employmentprograms older people in rural areas. A majornew rural for older people, suchas Foster Grandparents, housing program must be developed to meet the Green Thumb, Project FIND, Extension Service, needs of the rural elderly. Public housingpro- Homemaker Aides, and Senior Aides, must be grams should be expanded in rural areas. The expanded into every rural county. Federal Government should aggressivelyencour- 5. Public job assistance, training, and place- age local government and/or private non-profit ment programs, currently-required to give priority organizations to implement theseprograms. to youth and minority groups, should be modified and expanded to includea higher proportion of Health older workers. Such programs should havean 11. In the design of a national health service equitable rural-urban distribution corresponding delivery system which provides for facilities,per- to the distribution of poverty. sonnel, and payment for services, the unique characteristics of rural areas must be considered and special delivery systems developed. Transporta-. Income tion, outreach, and home-care services should be integral parts of all health services in ruralareas. 6. In reforming the Social Securitysystem, we The use of mobile health units for multiphasic urge increases in the level of earnings allowed screening should be greatly expanded. and increases in the minimum benefit in addition to across-the-board percentage increases witha 12. Health and nutrition educationprograms basic floor for adequate living (BLS) andwith should be greatly expanded. Public Health, Voca- automatic cost-of-living provisions. tional Education, Exte -sion Services, and other such community action programs have found that 7. Present legislative and regulatory impedi- poor nutrition practices are a major health prob- ments to older people supplementing their in- lem of the rural elderly.

149 Roster of Planning Committee

Nongovernment Sandra S. Gruschin, Special Assistant to the Fed- eral Co-Chairman, and Project Coordinator, Appala- Blue Carstenson, (Chairman), Director of Citizen- chian Regional Commission shipActivities, Senior Member Council, National- Farmers Union, Washington, D.C. Amy Hardy, Editor, Journal "Appalachia", Appa- lachian Regional Commission W. J. Brake, Lecturer, The National Grange, Wash- ington, D.C. Maurice L Hill, Assistant Director, Office of Rural Mark Freeman, Executive Director, Coalition for Program Development,Rural Manpower Service, Rural America, Washington, D.C. Department of.Labor Ty lee S. Smith, Assistant for Program Analysis, John G. Hutchinson, Program Officer, Older Per- Green Thumb, Inc., Washington, D.C. sons Programs, Office of Economic Opportunity Ralph Tabor, Director of Federal Affairs, National Helen W. Johnson,. Assistant to the Director, Eco- Association of Counties, Washington, D.C. nomic Development Division,Economic Research Service, Department of Agriculture Jeannette Wedel, Associate Director for Adminis- tration, Coalition for Rural America, Washington, Orville H. Lurch, Alternate Federal Co-Chairman, D.C. Appalachian Regional Commission Dr. Karl Munson, Program Leader, Extension Serv- ice, Department of Agriculture Ruth Rothman, Manpower Development Specialist, Government Rural Manpower Service, Department of Labor Gerald F. Combs, Food Safety Coordinator, Science Nancy Tate, Program Analyst, Office of Program and Education, Office of the Secretary, Department of Review, Office of Economic Opportunity Agriculture Marvin Taves, Chief, Divisior. on Aging, Office of Dr. Lynn Daft, Assistant Deputy Administrator, Research and Demonstration, Social and Rehabilita- Economic Research Service, Department of Agricul- tion Service, Department of Health, Education, and ture Welfare Russell T. Forte, Information Specialist, Office of Jane A. Taylor, Special Assistant, Science and Edu- Information, Department of Agriculture cation, Office of the Secretary, Department of Agri- culture Jessie S. Gertman, Deputy Chief, Division on Aging, Office of Research and Demonstration, Social and Margaret Tuttle, Pre.g,ram Analyst, Community De- Rehabilitation Service, Department of Health, Edu- velopment Branch, Office of Program Development, cation, and Welfare Office of Economic Opportunity

150 THE POOR ELDERLY

"I he Special Concerns Sessions on The 1971 WHITE HOUSE CONFERENCE ON AGING Poor Elderly was requested first by the National Council on the Aging, PROGRAM Inc. The Council had made a study THE POOR ELDERLY of impoverished elderly people in various com- Chaitnaan:OLLIE RANDALL, Board Member, munities throughout the country. Distressed by Older Persons Advisory Committee, magnitude of the problem and -the dire circum- Office of Economic Opportunity stances of the poor aged, it was natural that the Speaker:DR. WALTER M. BEATTIE, Dean, Council should seek to bring this deprived group School of Social Work, Syracuse Uni- to national attention at the White House Con- versity ference on Aging. Commentators: ANNA CHAPMAN, Neighborhood Following the Council's request for the Special Worker,Friendship House Project Concerns Session, several other national organiza- Link, Washington, D. C. tions having a special concetfor the economic SAM COLB, Mission Indian Tribal and social welfare of the pow aged were invited Conference, Los Angeles, California to join the Council in sponsoring the Session. A LUTHER J. CONLEY, Big Sandy Planning Committee was established with mem- Area Community ActionProgram, Paintsv i I I e, Kentucky bership representing the National Council on the ORIN CRUMP, Project Green Thumb, Aging, Inc., the National Council of Senior Citi- Draper, Utah zens, Inc., the National Consumer's League, and BOLESLO GARCIA, Director, Home the Older Persons Advisory Committee of the Education livelihood Program, Albu- Office of Economic Opportunity. The Committee querque, New Mexico was assisted by personnel from the Departments MARY POWEI.L, President, Spring- Of Health, Education, and Welfare, Labor, Hous- field Township (Ohio) Community Action Council, Akron, Ohio ing and Urban Development, and the Office of Presentation of Draft Recommendation: Economic Opportunity.2 MARY LOUISE JOHNS, President, Foster Grandparents of Bexar County, THE PROGRAM San Antonio, Texas The Planning Committee assembled a program RUDOLF J. DANSTEDT, Assistant to the President, National Council of which would provide Delegates accessto the Senior Citizens knowledge and experience of. persons who work Discussion Leader: ' directly with tse poor among minority and other JACK OSSOFSKY, Deputy Director, especially deprived groups of the elderly, thus in- National Council on the Aging suring the relevance of policies and programs Recorder: DANIEL J. SCI-IULDER, Assistant prepared by the Session. Director, Federal Relations Branch, Re- sourceUtilization.Division, Depart- I The National Council on the Aging.The Golden YearsA ment of Housing and Urban Develop- Tarnished Myth,Washington, D. C., 1970. ment ;Continued next page) 2 See Roster of Planning Committee. page 156.

151 Technical Resource Panel: CLEONICE TAVANI, Older Persons ALPHONSO ANDERSON, Director, Coordinator, Office of Economic Op- 0E0 Project, National Council on the . portunity Aging ALVIN M. DAVID, Assistant Com- AGENDA missioner for Program Evaluation and Planning, Social Security Administra- 8:00 A.M.Opening Remarks by Chairman tion, Department of Health, Education, Randall and Welfare MONROE DOWLING, Special As- 8:15 A.M.Address by Dean Beattie, "The sistant, Manpower Administration- Nature and Facts of Poverty USTES, Department of Labor Among the Elderly" MILDRED K. HOADLEY, Chief, Di- 8:40 A.M.Comments by Panel vision of Program Payment Standards, Assistance Payments Administration, 9:10 A.M.Presentation of Draft Recommen- SRS, Department of Health, Education, dations and Welfare 9:30 A.M.Deliberations and Adoption of MARIE A. OBLff AS, Program Ana- Policy Recommendations lyst, Migrant Division, Office of Eco- nomic Opportunity 12 NoonAdjournment

152 THE SESSION REPORT

dated housing, and remain isolated and hidden The Special Concerns sessionwas attended by some 200 Delegates, guests and observers. Dr. from the mainstream of American life. Many Walter M. Beattie, Dean of the. School of Social elderlypoor and richare robbed of their dignity as human beings by a now-oriented society Work, Syracuse University, addressed thegroup on the challenges of poverty among older Ameri- which too easily forgets the contributionspast cans. A panel of commentators composed of older and presentof its aged population. persons active, in community action programsre- We canwe mustwe will do better! sponded to the address. While we must improve the quality of life for all the aged, our top priority mustgo to those Several commentators emphasized the needto direct attention to rural areas and such who suffer most. America must address itselffirst groups as to the needs of the elderly poor. the Spanish-speaking migrant farm workers. All called for_immediate action, best characterized by Our goals must equal our nationalgreatness. the words of Mrs. Mary Powell of the Springfield Our action must meritour national pride. We Township (Ohio) Community Action Council must strive to provide more than mere subsistence; who said, "Do it now, I won't be around in10 we can and must provide the opportunities for years for the next Conference!" decent and meaningful living through all. the years of life. Mri Mary Louise John, President ofthe Foster Grandparents of Bexar County, San Antonio, In planning, we must recognize the continuity Texas, presented the group with the recommenda- of life. We must act immediately to lift thepres- tions of the Planning Committee after which ent aged from poverty. Even with adequate in- Rudolph Danstedt of the National Council of come, certain needed services cannot be purchased in the marketplace and must be provided. Within Senior Citizens provided commenton the recom- and between income and services mendations. In discussions chaired by Jack Ossof- programs, a full sky of the National Council range of options should be available for all aged oil the Aging, the Americans. Session agreed tothe following introductory . statement and the recommendations. To insure that future generations donot end their days in poverty and despair,we submit these recommendations to the White House Con- ference on Aging. Preamble Actiga Now Recommendations One out of every four Americansover the age of 65 lives in poverty. Andeven more live so and Comment close to poverty that its chilling effectshang over them. To the trials of old age are added the harsh burdens of poverty, mademore cruel Income by the fact that it need not be. It must be the national policy of theUnited No longer must American aged live in hunger, States that poverty be eliminatedas a concomitant suffer from lack of health care, exist in dilapi- of the older years. In this regard, prioritymust 153 be given to providing older Americans with an benefits. As a further step to make thisrecom- income to keep them from poverty and subse- mendation effective, the Old Age Assistance pro- quently to assure the aged an income foundation gram must be merged into the Social Security that will provide them with a comfortable exis- System, the ensuing additional costs to be financed tence. out of general revenue funds. 1. The establishment of an incume floor in the 4. That computation mechanisms be established social security and adult assistance programs to to periodically revise the benefit structures to re- provide all older persons with an income equal flect increases in the cost-of-living. to the "intermediate" standard of living estab- 5. To meet the increased financial burden of lished by the Bureau of Labor Statistics. This these recommendations the general revenues of would provide (as of Spring, 1970, the latest fig- the Federal Government be utilized to supple- ures available) at least $2,316 for a single older ment employer and employee contributions to the person, regardless of sex, and $4,489 for a couple Social Security System, and that the Adult As- headed by someone 60 years of age or older. We sistance programs be completely federalized. recommend that this be done now through legislation pending in the Congress. 6. With respect to private and public pensions plans, require that they contain provisions for Minority Recommendation 1 guaranteed vesting after the first year of employ- That for minority persons the age of quali- ment, for guaranteed portability of pension bene- fication for benefits be 7 years younger than fits, and for Federal insurance protection against the qualifying age for Whites and that any loss of pension benefits. Moreover, require that penalties in other benefits, because of benefit these pension entitlements and protections be increases, be outlawed. spelled out to all employees under a "truth in 2. As a follow -up in the progression of the pension" Federal statute. benefit floor, not later than 1974 the minimum 7. Enact immediately a Senior Emergency Em- income for Social Security and Adult Assistance ployment Act providing for one million full- and beneficiaries be upgraded to provide the elderly part-time jobs for persons 55 years old and over with the "comfortable" standard of living estab- who can and wish to work. lished by the Bureau of Labor Statistics. This would provide (as of the Spring of 1970), at Comment:. An additional recommendation, least $3,403 for a single older person, and $7,114 introduced from the floor,to immediately for an elderly couple. abolish the Social Security "earning test" was defeated with a substantial minority favoring Comment: During discussions on this recom- abolition. A number of Delegates expressed mendation it was emphasized by the dele- a heatedfrustration with the continuing gates that the "comfortable' BLS standard problems of reduced benefits associated with should set the level of future benefit pay- increases in Social Security payments (OAA, ments. food stamps, etc.). 3. Those elderly persons in the United States Services and territories not now covered or eligible to receive benefits under existing income maintenance Even when the income levels recommended programs be blanketed into the programs now above are reached, many older people, especially so that all elderly persons can be assured an in- poor older people, would face serious gaps in? come at the comfortable standard of living and available services to meet their needs. To fill these that there be no penalty or reduction in other gaps in health care, housing, and social services, we recommend:

I This recommendation was presented as a Comment in the A. Health interim report distributed at the Conference. It was, however, 1. The income and service restrictions imposed proposed and voted upon by the Session and won support of 15 percent or more of the Delegates present. on Medicaid and the shifting of the cost

154 of Medicare on to the backs of the elderly housing is located without regard to loca- through ceilings on length of benefit peri- tion in an. urban renewal area or other ods, increases in deductibles, and increases artificial geographic limitations. in Part B (doctor's care) premiums are seri- 3. The end to liens on homes of those eligible ously limiting health care for the elderly ,r Adult Assistance. and the poor. 4. The expansion of the Rent Supplement The time is now to eliminate the hodge- Program specially dirthed to older persons podge ofpartialhealth care programs. utilizing local organizations of older persons Medicaid and Medicare systems should be to promote its use. reformed now through the merger of these 5.Assuring that the planning of highways programs and a Federally administered sys- which dislocate thousands of low income tem covering all persons 65 and older estab- older and other persons is discontinued; lished. designing urban renewal and other physical 2. This Federally administered program should development programs so that residences have no co-insurance and deductible fea- and natural neighborhods are renewed and tures; it should provide for out-of-hospital not bull-dozed; assuring that there is full prescribed drugs, and afford, without limit, participation of older poor persons in the nursing home care in a facility owned or planning of all physical development' pro- operated by an accredited hospital or com- grams. prehensive health service organization. 6. Where homes and apartments are not cap- 3. While immediate reform of the Medicaid able of renovation, the expansion of Fed- and Medicare programs is essential, there erally-supported construction of new hous- must be early adoption of a national health ing units to house the elderly poor who system available to all, the young, the mid- have no other meanstosecure decent dle-aged and the elderly, with a full range housing. of health services financed out of payroll Comment: Passed unanimously. taxes and the general revenues with no ad- C. Social Services ditionalbillingtothe patient for these services. 1.It shall be the responsibility of the Federal Comment; A substantial minority opposed Government working in concert with other national health system primarily on the publk and voluntary agencies to establish question of costs. in each community a public senior service system as the primary means through which B. Housing the elderly receive services. Such services should include leisure time and cultural Where the homes and apartments of older per- programs but should extend also to preven- sons arc now adequate, or capable of renovation, tativehealth programs, information,re- the course of action is clear. Every effort must ferral, outreach, advocacy services, coun- be made to assure that the elderly keep or re- seling, legal aid, help with employment, claim a decent place to live in neighborhoods housing, securing benefits, etc. Such a public of their choice. To achieve these goals, it should senior service system must be responsive to be the policy of the United States to assure: -the aged themselves as participants in the '-1. The reduction of property taxes for lower decision-making processes determining what income elderly home owners, with propor- services are provided, through what means, tionate remissions for those older people and for what groups. who rent. 2.Public departments of social services need 2. The greatly expanded promotion of grants to become the primary agency for services to and low or no interest loans by HUD to the disabled and impaired elderly with serv- renovate unsuitable housing wherever such ices rendered through a consortium of pub-

155

46818 0 73 -Il lic and private agencies. Needed services Public and private agencies should motivateand should be available to all the aged without support the elderly to undertake self-helppro- any restrictions to financial status. Services grams and to engage in social action, articulating available through these resources should their needs and participating in the flow ofcom- provide a community health alternativeto munity life to create solutions to those needs. institutional care by offering such services as homemaker, home-health and chore serv- 3. Voluntary agencies and churchgroups, in particular, are called upon toserve as enablers ices, protective services, friendly visiting and for the elderly, to telephone reassurance, day care, home-de- encourage and assist them in developing new roles in self-help, social livered meals, special transportation,etc. action, and political action. Recognizing thatthe elderly 3. Special efforts must be made in the delivery have not fared well by relyingon others to act of services to assure that the olderpoor, in their behalf, the elderlyare urged to organize minority elderly and those most isolated themselves into active social action and political from the community are reached by the action groups to press for those policies,to sup- service systems, that bilingual outreach pro- port those candidates, and to ally with thoseor- grams are built into all programs. ganizations which will elevate their priority needs to national attention and action. (Accepted unani- Self-HelpSocial and Political Action mously.) 1. Older Americans including those whoare poor repr- sent a resource of experience and ability Other Concerns of the Session which can and must be utilized in dealingwith their problems and needs. Weurge that all agen- The Delegates accepted, withoutcomment, a cies and organizations which seek toserve the group of recommendations developed by the elderly use that resource and findways of involv- Spanish Speaking Caucus relatingto the needs ing the elderly on their policy-making boards,on of the Spanish speaking elderly. advisory committees, and on their staffs so that Also accepted was a resolution submitted by they play a full role in the planning and delivery of services. State Senator Samuel Harman of Massachusetts memorializing the Congress to immediatelyenact 2. The eicirly themselves need to take the legislation to remedy the inequitable loss of bene- initiative to develop and operateprograms and fits associated wtih increases in SocialSecurity services to meet their needsas they see them. payments. Roster of Planning Committee Nongovernment . Government Jack Ossofsky, (Chairman), Deputy Director,Na- tional Council on the Aging, Inc., Washington,D. C. James J. Burr, Director, Division of Servicesto the Aging ,and Handicapped, Community Services Anna M. Chapman, Neighborhood Worker, Ad- Friend- ministration, Social and Rehabilitation Service,De- ship House Project Link, Washington,D. C. partment of Health, Education, and Welfare Luther J. Conley, Big Sandy Area CommunityAc- Monroe D. Dowling, Special Assistant, Manpower tion Program, Paintsville, Kentucky Administration,U.S. Training and Employment Service, Department of Labor Rudolf J. Danstedt, Assistanttothe President, National Council of Senior Citizens,Inc., Washing- Robert Granakis, Special Assistant, ManpowerAd- ton, D. C. ministration, U.S. Training and EmploymentService, Department of Labor Elizabeth B. Herring, National ConsumersLeague, Marie A. Oblitas, Program Analyst, Migrant Divi- Washington, D. C. sion, Office of Economic Opportunity Mary Louise Johns, President, Foster Grandparents Daniel J. Schulder, Assistant Director, Federal Rela- of Bexar County, San Antonio, Texas tons Branch, Resource Utilization Division, Depart- ment of Housing and Urban Development Sarah H. Newman, General Secretary,National Consumers League, Washington, D. C. Cleonice Tavani, Older Persons Coordinator, Office of Economic Opportunity 156 Reports of the Special Concerns Sessions on THE ELDERLY AMONG THE MINORITIES

ASIAN AMERICANELDERLY

he Japanese American Citizens League The time was allocated in three parts to include: made a formal request that the Con- (1) an address on the Asian American problem; ference program includea Special Con- (2) comments and observations by representatives cerns Session on The Asian American of the various national groups; and (3) develop- Elderly. The League pointed out that most of ment and adoption of recommendations. today's elderly Asian citizensare foreign-born and, after migration, generally, continuedto fol- 1971 WHITE HOUSE CONFERENCE ON AGING low their awn cultural patterns and practices. The rapidly changing social structure and economic PROGRAM circumstances in the United States havenow created a crisisfor these elderly persons which ASIAN AMERICAN ELDERLY should command special consideration in the de- Presiding: DAVID E. USHIO, velopment of any national policyon aging. Assistant Washington Representative, Japanese American Citiiens League, The Asian American group is made up of vari- Washington, D. C. ousnationalitiesSamoans,Chinese,Filipino, Korean, Hawaiian, and Japanese. The League Background and Overview invited representatives of each of these groups to "ASIAN AMERICAN ELDERLY" membership on the Planning Committee for the SHARON FUJI!, Graduate GerontologyPro- Session. Although representing widely scattered gram, Florence Heller Graduate School forAd- vanced Studies in Social Welfare, BrandeisUni- Asian elderly populations, the Planning Commit- versity, Waltham, Massachusetts tee was, nevertheless, able to plan a program which encompassed their common interest in im- Comments and Observations proving the well-being of the elderly Asian Ameri- PANEL OF ASIAN AMERICANS can in the United Slates. Chinese American SAM YUEN, Director of Self-Help for the The Participants Elderly, San Francisco, California All Asian Americans named as Delegates to the Filipino American ROBERT SANTOS, Executive Director of Proj- Conference received a special invitation from the ect Caritas, Seattle, Washington Session Planning Committee to attend the Special Korean American Concerns Session on the Asian American Elderly. REVEREND PETER KWON. Korean Social, Altogether 44 Asian Delegates took part in the Health, and Education Society of Southern Cali- Session. They represented all the Asian groups fornia, Los Angeles, California mentioned above. Relatively few of the Delegates Samoan American were older or ' persons, a fact which indi- LOY F. TEO, Director of Samoan Center, Los Angeles, California cates that the leaf. ip for elderly Asian Ameri- Hawaiian cans are the young and middle-aged. CHRISTIAN S. NAKAMA, Executive Director, Honolulu County Committee on Aging, Hono- lulu, Hawaii The Program Japanese American The relatively small size of the Session made it MIKE SUZUKI, Chief of Social Service, Cali- possible for the group to engage inan informal fornia State Department of Social Welfare, discussion of the major problems for which itwas Vice President of General Operations, Japa- believed national policy should be formulatedto nese American Citizens League, Sacramento, give special attention to the older Asian American. California

159

gr. THE SESSIONREPORT

Preamble Asian aged. For example, in 1969-71some $32 million was appropriated forcommunity grant In the United States today, elderlyAsian Ameri- projects for the aged which includedinformational cans are suffering from unprecedented problems services, health care, and aged assistance(many that are devastating the lives of these agedpeople. of the areas that Asian Americanelderly need the In addition to the many critical problemsthat face most). Of this $32 million,not one dollar was the 20 million senior citizens in the UnitedStates, given to Asian American communitiesfor their Asian American elderlyare further confronted aged problems. Thereason, according to the with cultural barriers that exclude themfrom re- government officials, was Asian Americans don't ceiving their rightful benefits. have problems. Language problems created by lack ofbilingual So pervasive is this myth that theplanners of information systems and the lack ofbilingual serv- the White House Conferenceon Aging, the group ice workers deny Asian American agedeven the most knowledgeable in thearea of aging needs, knowledge of how to obtain suchbenefits. But failed to includea Special Concerns Session for most of all, the Asian American elderlyare se- Asian American elderlyas part of its original verely handicapped by the myth thatpervades the agenda. While the planning forother Special society at large and permeates the policydecisions Concerns Sessions had been inprocess for many of agencies and governmental entities that are months, the decision to holda Special Concerns charged with the responsibility of helpingall the Session for Asian Americans United States. was made only one month prior to the Conference and onlybecause a Thisemasculating myththatdiscriminates special request was made by concernedAsian against Asian American elderlyisthat Asian Americans. American aged do not have any problems, that This oversight is typical of Asian Americans are ableto take care of their the neglect that Asian American elderly face own, and that Asian American aged donot need on all fronts. Within or desire aid in any form. Such assertions, which the confines of the short time givento prepare for are generally accepted as valid by society,are this Conference, concerned AsianAmericans were false. A quick look at Asian Americancommuni- able to identify many specific and crucialneeds ties would verify that they do indeedhave prob- that are crippling the Asian Americanelderly. lems and the problems inmany respects are more The following policy recommendationsrepresent intense and complex than the problemsof the some examples of the myriad of problems thatare general senior citizen population. Whenthe Asian devastating Asian American elderly people. American aged suicide rate in certainareas is three times the national average, when 34per cent of Asian American Delegates support themany Asian American aged whowere studied have never recommendations that the Conferenceas a whole had a medical or dental examination,it should be has proposed for the benefit of all seniorcitizens. However, history has demonstriTecr obvious that the problems facing AsianAmerican again and again that Asian American elderly aged are overwhelming to the pointthat it is im- are among the people most neglected by possible for Asian American agedto look only to programs presumably their families for help. serving all elderly. We demand that the following policy recommendations be implementedto in- However, those who hold the responsibilityto sure that Asian American elderly receive their assist in these areas have turnedtheir backs on the rightful opportunities in this Nation. 160 all Asians are alike. In reality, the cultural dif- Recommendations ferences between the basic Asian American groups (Chinese, Filipino, Korea , Japanese, Samoan) are as different as the fiN ! different Research and Demonstrations languages they speak. It is unrealistic and wish- ful thinking to assume that thl small enclaves 1. Federal funds for research and demonstra- of Asian American elderly will be reached by tion projects to determine how older Asian Amer- massive grants to the county or State for all icans can be effectively assisted, based on their elderly persons. G:ants aimed at specific pock- needs, culturaldifferences, values, and desires, ets of ethnic groups would more likely reach should be expanded and should involve research- elderly Asians. ers of Asian background. Thefindings from such Program Issue: Federal, State, and local gov- efforts should be disseminated to policy makers, ernments in mutual cooperation with the Asian program planners, and service providers. community should establish and fund in those Rationale: Information on older Asian' Ameri- States and localities where Asian Americans are cans must be collected so that a national policy concentrated, outreach programs to provide in- on aging is truly responsive to, and representa- formation, referral, and advocacy services, in- tive of, all older Americans. cluding resource persons, transportation assistance, drop-in centersall of which reflect the Program Issues: Research and demonstration culturaldifferences and preferences of the projects should identify the older Asian Ameri- Asian American elderly. cans (i.e., where they reside, what their characteristics are) and should be supported by agencies such asthe Department of Commerce Services 3. Public and private agencies should provide (Bureau of the Census), the Department of (e.g., home Health, Education, and Welfare, and the De- older Asians with support services care assistance, transportation, health screening, partment of Labor. etc.) in their own communities which have been Special research and training services for th traditionally provided by the family. In doing so, investigation, study, and treatment of medical recognition should be made of family structure diseases peculiar to Asian American elderly and kinship networks among Asian ethnic groups (i.e., incidence of sickle cell anemia affecting for the purpose of building on these, rather than Samoans) should be conducted. imposing or allowing totally strange service de- Special research studies relating to the dispro- livery systems. portionate number of Asian elderly in mental Rationale: Traditionally, services such as trans- institutions should be initiated. portation, home care, financial support, and Demonstration grants should be provided for housing have been provided by the family of the training of researchers to deal with the the older Asian. Resulting from changes in problems of older Asian Americans. family structure and an increasing need for di- 2. Federalsuch as Department of Housing and verse services (e.g., health care, housing, etc.), Urban Development, Department of Labor, De- the Asian elderly cannot continue to look solely partment of Transportation, Statesuch as com- to their families to have needs met. missions on aging, public welfare, departments of 4. On-going service projects, such as senior citi- human resources, and local government and pri- zen centersand multipurposeservice centers vate organization grants which provide assistance which are designed to meet the special needs of for the elderly should reflect the diversity of the older Asian Americans, should be established in Asian American groups. communities of elderly Asian Americans, and Fed- Rationale: Because persons of Asian ancestry eral, State, and local assistance should be made are lumped under the heading of Asian Ameri- available to support these either in full or on a can or "Oriental", it is assumed by many that matching basis.

161 Program Issue: Programs should provide bi- 12. Federal, State, and local funds should be lingual, bicultural staffing; recreational, leisure- made available for establishing nursinghomes for time activities geared to cultural interests; in- elderly Asians which provide for bilingual,bicul- formation and referral services; direct social tural staffing, ethnic foods, family and individua: services; elderly self-help programs; youth and counseling services, and recreation andleisure elderly mutual assistanceprograms; and educa- activities which are culturally relatedto Asians. tional programs and services for the Asian el- Protective grouporresidentialarrangements derly and for training personnel to work with should be provided in the communitywhere Asian elderly. Asians are concentrated for those whocan continue to live independently. 5. Continued Federal support of existingprograms should be contingent on reexamination and revision to assure that theyare responsive to the Health needs of elderly Asian Americans through theuse of bilingual workers for outreach and advocacy 13. In the development ofa more complete services. range of health care (physical and mental)services for the .aging througha national health insurance program, specific provisions should be Housing established to meet the special needs ofelderly 6. The Department of Housing and UrbanDe- Asian Americans. velopment should acquire land in the Asian Amer- Rationale:ElderlyAsian Americans have ican communities, using condemnation procedures health problems similar to those of all older if necessary, and create housing programs for the persons, but they have borne Added burdens due Asian elderly with related life support serviceson to cultural and language differences which make a crash basis. access to health care services difficult.. 7. The Federal Government should provide Program Issues:Mobile medical outreach special funding to meet the needs of elderly Asian teams should be established to serve the Asian Americans for new housing by providing loans to elderly in the community. Such teams should be Asian American nonprofit organizationsto de- developed to relate to language andcultural velop housing with attention to cultural prefer- patterns of the elderly Asian. ences. Public and private funding should be provided 8. Department of Housing and Urban Devel- for health education of elderly Asiansby the opment should provide substitute housing to community through multiservicecentersnd Asian elderly, who live in 'substandardcongregate regularlyscheduled community information housing, in the same community to preventen- days. vironmental displacement.

9. The government should institute rentcon- Income trol and rent increase exemptions to Asian Ameri- 14. A Federal guaranteed annual incomepro, 444 can elderly. gram for the elderly must be established if this 10. All efforts should be made to maintain Nation is to meet the basic needs of elderlyAsian Americans who are denied benefits related Asian elderly in their own homes, if they wishto to remain there, with collateral life support services, "covered" employment (i.e., Social Security,pension programs) because of long-existing discrimi- rather than having them go toan institutional setting. natory employment patterns. Rationale: Limited and fixed income levels for 11. The Federal Government should initiatea older Asians as provided by standardsources substantial tax incentive to the younger generation (Social Security, pension funds, savings)have who can provide housing and/or other supportive- been inadequate to meet their needs, especially care for their Asian elderly relatives. health and housing costs. Furthermore,many 162 older Asians have no sources of income what- Rationale: Most non-Asian workers currently soever since they were employed in occupations serving the elderly are not aware of the needs (self-employed, domestic labor, or farming) and concerns of the Asian elderly. They are not which are not covered by Social Security or pri- able, therefore, to work effectively with them vate pensions. and Lave alienated the Asian elderly. Program Issues: The involuntary and enforced Program Issues: Opportunities for bicultural, period of time spent by Asian elderly (from the bilingual Asians to serve Asian elderly with Japanese community) in concentration camps special skills, understanding, and knowledge during World War II should be fully ac- should be provided. credited as accumulated time towards the re- Special training programs should be provided ceipt for full Social Security benefits as well as and conducted by Asian bilingual and bicultural other Federal benefits to which they are entitled. workers for public agencies serving the Asian All references to differential treatment of aliens elderly. with regard to public programs (i.e., public welfare programs) should be stricken. Education Newly arrived elderly Samoans should be guar- 17. Educational institutions (public and private anteed their Social Security benefits derived and at all governmental levels) should provide from work in American Samoa. special and continuing education courses for el- The unique income-saving plans of the Asian derly Asian Americans which will enable them-to elderly should be fully legitimized and safe- become more knowledgeable about services .and guarded (e.g., Tannomoshi, Kei) by financial programs- that exist for all- elderly- and-to learn systems. about their unique cultural heritage. Rationale: There should be a continuous effort made in all needs areas to educate the elderly, Employment and Training the public at large, and program and service 15. There should be continuation, expansion, personnel as to the differing needs and prob- and innovation of placement, training, and job lems of Asian elderly. assistance programs for Asian elderly throt .41 State employment programs and special Federal Nutrition programs for older people. Asian elderly should 18. Existing nutrition policies for older persons be employed as community workers to educate who receive Federal support should be reexamined others. They should also work in public agencies, and revised to include the cultural food prefer- community organizations such as funded by Social ences of the elderly Asian American. and Rehabilitation Service under the Older Amer- icans Act (Titles III and VI). Sheltered work- Rationale: Nutrition programs for the elderly shops for the Asian elderly should be developed. have failcsi to include special dietary and cultural preferences of older Asian Americans. Program Issue: The food stamp program as Training presently constituted excludes elderly Asians 16. A Federal policy should be created em- from purchasing ethnic foods. The food stamp phasizing training of Asians who will work wit; program should be revised to include provision older Asians. There should also btt provisions for for the purchase of ethnic foods. non-Asian workers to receive training which will Meals-on-wheels programsfortheelderly enable them to work effectively with Asian el- should be revised to meet the basic dietary pref- derly. As an illustration, support for training erences of older Asian Americans. Nutrition should he made available by the Social and Reha- education programs should be provided for bilitation Service of the Department of Health, older Asian Americans which will assist them Education, and Welfare under Title V of the to plan well-balanced diets using their own Older Americans Act.. ethnic foods.

163 ---

Transportation Cabinet Committee .for Asian American Affairs which would include among its priorities the 19. Free public transportation should be made needs of elderly Asian Americans. available to the Asian elderly which will enable full access to culturally preferred life support 21. In all political jurisdictions where Asian services both in and outside the community. Americans reside, the committees or commissions Rationale: The special needs of elderly Asians on aging shall include Asian American repre- for cultural and- life support servicescause sentation. All agencies which directly affect the transportation needs which currentlyare not elderly in such jurisdictions shall appoint staffor provided in public transportation systems. retain consultants of Asian background whoare knowledgeable about the needs and cultural pref- Program Issues: Public and private funding erences of Asian elderly. shall be made available on a local basisto insure that elderly Asians will obtain equal freedom of mobility as the rest of the elderly. Legal Public funding shall be provided to voluntary 22. In passing legislation and adopting regula- organizations which provide transportationto tions at all governmental levels affecting services the Asian elderly to meet their needs. to the elderly, no differentiation shall be made between aliens and citizens. Special Concerns Advocacy 23r Free bilingual legalassistance must be made available to Asian elderly who wishto be- 20. The Federal Government shall establisha come naturalized citizens.

Roster of Planning Committee

David E. Ushio, Chairman, Assistant Washington Rep- Reverend Peter Kwon, Korean Social, Health, and resentative, Japanese American Citizens League, Wash- Education Society of Southern California, Los Angeles, ington, D. C. California Jim Miyano, Director of Project Liaison, Los Angeles, California Toyo A. Biddle, Bureau of Educational Personnel Development, Office of Education, Department of Joselyn Geaga, Filipino American Community of Los Health, Education, and Welfare, Washington, D. C. Angeles, Los Angeles, California Robert Santos, Executive Director of Project Caritas, Loy F. Teo, Director of Samoan Center, Los Angeles, Seattle, Washington California Sharon Fujii, Graduate Gerontology Program, Florence Mike Suzuki, Chief of Social Service, California State Heller Graduate School for .Advanced Studies in Department of Social Welfare, and Vice President of Social Welfare,BrandeisUniversity,Waltham, GeneralOperations,JapaneseAmericanCitizens Massachusetts League, Sacramento, California

164 THE SPANISH SPEAKING ELDERLY

he several organizations servingthe The Program(See program on next page) Spanish speaking people thatco-sponsored and named member's ofthe In preparation for the Special Concerns Ses- Planning Committee for this Special sion, position papers in some of the acknowledged Concerns Session were the United areas of need induding Income, Employment, States Catholic Conference, thePuerto Rican Education, Training, and Housing of the Spanish Forum, Inc., the League of UnitedLatin Amer- speaking elderly, were prepared and made avail- ican _Citizens,. the_ CommunidadHiSpallit de able to the Delegates who had indicated that they Maryland, Interstate ResearchAssociation, and would attend this Session. These papers were de- the National Urban Coalition.Representatives of signed to provide an informational base for the the Office of Economic Opportunity,the Cabinet development and adoption of policy recommen- Committee on Opportunity for the SpanishSpeak dations. ing, the National Insf hate of Mental Health, the The Session program was developed around Office of Education, a, a ! the Office of the Secre- series of five discussion panels, each dealing with tary of Health, Education, and Welfare alsopar- one of the following: Income, Housing, Employ- ticipated in planning this Special Session. ment, Health, and Education. This format proved The Session focussed attentionon the plight of to be quite effective by stimulating productive the Spanish speaking elderly and broughtto light discussion, providing access to experts in thepar- those problems thatare particular to this popu- ticular field, and allowing the participantsto deal lation. The work of the Session, therefore,adds an substantively with the several essential areas. The important component for considerationin the result of these efforts is the followingset of delineation of a national policyon aging. recommendations which, if considered in future planning and action for the elderly, will aid in providing a better life for the elderly. Spanish The Participants speaking people of the Nation. Approximately 100 Delegates participatedin the Special Concerns Sessionon the Spanish speaking elderly. The participantscame from Introduction many parts of the Nation. Most of themwere either Mexican-American, Cuban, or Puerto Rican. The Spanish speaking agedcompose a particu- Many of the Delegates who participatedin this larly vulnerable class of needy Special Concerns Session persons within met on the first 2 days the already disadvantaged populationof elderly of the White House Conferenceto discuss ex- Americans. Due to linguistic and cultural periences in their home localities and bar- decide which .riers, physic.,1 isolation, and thedisadvantages of the problems of the Spanishspeaking elderly endemic to minority would be dealt with group status, the Spanish at the Special Session. "viejito" finds himself ineven more deplorable 165 circumstances than the majority of the American tween his ability to speak English and his lack elderly population. of awareness of thevery few servi,...s, activities, Poverty of such magnitude exists within this and programs to which he is entitled. group that is incomprehensible to the average citizen. It is a poverty that knowsno boundary Income: National economists would do well line as it affects the Spanish speaking elderly to learn how some of the Spanish speaking elderly equally as hard as in rural, urban, andmetro- are able to survive. Because of life-long poverty, politan areas. many have not been able to save toward retirement or collect adequate pension and Social Se- Perhaps the most pervasive handicap the Span- curity benefits. There are those who receiveno ish speaking elderly person has in this societyis public assistance and haveto depend on whatever his inability to speak and communicate in English help friends and familiescan provide. and his lack of understanding of the "System." Directly related to the lack ofawareness of Health: The mortalityrate of the Spanish health, housing, recreation, employment, social speaking elderly is above average. At 48years services, and benefits is the problem of communi- of age a Spanish speaking migrantcompares with cation. There is a high correlation existing bean Anglo of 65. This is because of the hardship

1971 WHITE HOUSE CONFERENCE ON AGING (HOUSINGContinued) GEORGE ROYBAL, Department of Hous- PROGRAM ing and Urban Development ISMAEL MELENDEZ, American G.I. Forum THE SPANISH SPEAKING of the United States ELDERLY Employment. ANTONIO GUTIERREZ, Chairman, Inter- Presiding. PABLO. SEDILLO, Jr., National Direc- state Research Associates tor, Spanish Speaking Vvision, U.S. Catholic Conference LUIS CARDONA, National Association. of 8:00 A.M.-8:15 A.M.---InttxxInctory Remarks Spanish Surnamed Americans HENRY RAMIREZ, Chairman, Cabinet JOE MO/s1TOYA, Director, Migrant Man- Committee on Opportunity for the Spanish power Unit, Department of Labor Speaking - EDUARDO PENA, League of United Latin 8:15 A.M.-12 Nc on----Panel Discussions and Pres- American Citizens entation of Major Policy Recommendations LORENZO RAMIREZ, Community Rela- for the Spanish Speaking Elderly tions Service, Department of Justice Income. Health. BLANCA HERNANDEZ, Chairman, The JUAN RAMOS, Co-Chairman,National National Urban Coalition Institutes of Mental Health CLEOTILDE GARCIA, Committeeon ENCARNATION ARMAS, Co-Chairman, Education and Aging of the American G.I. Eastern Regional Director, Office of Spanish Forum Speaking, United States Catholic Conference CARLOS BPSINAIZ, Consultant, Interstate Education. Research Associates ROY RODRIGUEZ, Chairman, Office for Spanish American Affairs, Department of Housing.. Health, Education, and Welfare BIRGELIO G. ROEL, Chairman, Director ANTONIO CASTREJON, Centro Chicano of Conciliation, Department of Housing Cultural and Urban Development RAFAEL PABLO CIDDIO Y ABEYTA, SANTOS RUIZ, National Association of Higher Education for Farmworkers Associa- Spanish Surnamed Americans tion

166 these individuals have had to endure. Medicare RECOMMENDATIONS and Medicaid provide relief, butsome cannot eat properly without dentures or communicate without hearing aids that they can't afford. Income and Transportation Transportation: In rural areas transportation 1. It is recommended that the Department of is unavailable most of the timeor else too ex- Transportation, the Department of Defense, and pensive. In metropolitan areas, where publictrans- the General Services Administration make avail- portation is available, many times it istoo ex- able all excess vehicles, in good condition, toany pensive and the Spanish speaking elderlycannot elderly-based organization in order thattrans- communicate with the drivers or understandroute portation services for the Spanish speaking and and time schedules. other elderly be made available in metropolitan, Nutrition: Inadequate nutrition affects all el- urban, or rural areas. derly Spanish speaking. Surplus commodities offer 2. It is recommended that all municipalities some assistance and although they are not de- with public transit systems provide free,or re- signed as a complete meal, formany they are. duced, fare during the non-peak hours for the Food stamps have to be boughtonce a month elderly and handicapped and demand that these and for the majority of the Spanish speaking same systems make literature available in Spanish elderly poor, they are too expensive to purchase. for the Spanish speaking elderly interms of Employment: The Spanish speaking elderly routes and schedules, and also that these systems need innovative programs for employmentop- request subsidized assistance from the Federal portunities without penalizing retirementor other Government. benefits. 3. It is recommended that research and study Housing: Many of our Spanish speaking el- be conducted by every agency involved inpro- derly poor own their own homes. For them own- grams for the elderly in order to determine an ing a home is a matter of pride and self-respect. age comparability and other important data in For the most part, these homes are below stand- regard to the different ethnic backgrounds of ard and do not have regular facilities. the elderly. The above are just a few of the many real 4. It is recommended thata minimum of guar- problems affecting the Spanish speaking elderly anteed income of between $430044500 (couple) today. They are mentioned to dramatize the fact be made immediately availableto all Spanish that the theme of the Conference is wrong. Many speaking elderly and 75 percent of that fora elderly and non-elderly here this weekare not single person. themselves poor and, therefore, cannot adequately represent the poor who were unable to attend. 5. It is strongly demanded that States amend their legislation to prevent the lowering of Old It is a myth to believe that action eminating Age Assistance benefits as Social Security benefits from this Conference will automatically benefit are increased. the Spanish speaking elderlypoor because this did not and has not happetted from the 1961 6. It is recommended that Spanish bicultural White House Conference. Had this Conference planners and consultants design and reevaluate concerned itself exclusively with the problems all programs and servicesto serve the Spanish of the elderly poor and minority poor then the speaking with the cooperation and participation reverse could be expected to happen. of the consumer to be affected by theseprograms. We strongly urge that a conference on AC- 7. It is recommended that all elderly legisla- TION for the elderly poor and minoritypoor tion regarding services benefits. andprograms of be developed as soon as feasible and possibleto any kind and in effect in the mainland United provide the action necessary that this Conference States be extended to cover all elderly in Puerto has failed to do. Rico.

167 8. It is recommended that employers, who con- of the demolition or the removal of homes by tract migrant elderly workers for any amount of programs such as Urban Renewal, Government work done, be required to make Social Security assistance at all three levels be given for the re- payments and that the farmer be defined as the habilitation and renovation of housing units employer and not the contractor or crew leader. owned by the Spanish speaking elderly. 9. It is recommended that piecemeal research 3. Whereas: The present Federal housing pro- and demonstration programs be funded on a jects are highly undesirable to the Spanish speaking national level and give special emphasis to the elderly, itis recommended that all subsequent employment of the Spanish speaking elderly. housing be constructed according to the Spanish 10. It is recommended that the Social Security speaking cultural considerations such as design, Administration compile a census on the Spanish cost, location, and size. speaking population receiving Social Security ben- 4. Whereas: It is recognized that the Spanish efits and that a projection be made of those who speaking elderly are not receiving a "fair-shake" will be receiving assistance in the next 10 years. of Federally subsidized housing, it is recommended that the Federal Government adopt a policy in Health housing utilizing a formula wherein those units that are authorized, built, or rehabilitated, be 1. That where applicable, representatives of reserved for the Spanish speaking elderly in direct elderly Spanish speaking and migrants .be_air___.proportion_.to_their_populationin_theirresmoive. pointed or all commissions, committees, councils, communities. and other bodies concerned with the planning, development, operation, and evaluation of com- 5. Whereas: It is a fact that there exists a re: prehensive health services systems funded by quirement forcing the Spanish speaking elderly Federal, Stare, or local governments. to give up their claim to "real property" in order to qualify for pro-grams of financial assistance, 2. That priority be given to bilingual, bicul- it is recommended that the above requirement, tural students being recruited for the health pro- being a prohibitive and unjust law, be eliminated fessions and for new careers or paraprofessional or amended as will meet the needs of the Spanish employment opportunities in the field of health speaking elderly. and geriatrics. 6. Whereas: It is a revered tradition that the 3. That -special college credit be made avail- Spanish speaking elderly person has a strong de- able for students in the medical and health fields sire to remain living within the family household, who are bilingual and bicultural. it is recommended (1) that a new program be adopted that would promote and protect this Housing opportunity for continued participation with the family, and contribute to the Spanish speaking 1. Whereas: It is of critical concern that the need for a sense of usefulness, and (2) that this needs of the Spanish speaking elderly have been new program would pay rent subsidies directly ignored by the Federal, State, and localgovern- to the elderly recipient residing within the familial ment bodies concerned with housing, it is recom- household. mended: (1) that staff of Spanish descentrespon- sive to the Spanish speaking be appointedto all three levels of government, and (2) that funds Spiritual Well-Being be sp,tcifically earmarked for the need in housing of our Spanish speaking elde:ly. 1. The Government should cooperate with religious bodies and private agencies to help meet 2. Whereas: Many of the Spanish speaking the spiritual needs of the elderly, but in doing elderly live in and own homes thatare deteriorat- so Should observe the principle of separation of ing and decaying, it is recommended that in lieu Church and State.

168 2, Spanish speaking elderly should be involved 6. It is recommended that the President estab- in the development of all programs which affect lish a National Coordinating Committee for the their spiritual well-being from the initial plan- Spanish speaking elderly whx11 insures consumer ning stage through implementation. participatidn, develops a national strategy to solve the problems of the elderly, tap Federal, State, 3. That all religious and/or private groups and local funds, and evaluates existing programs. open their eyes to the needs of the Spanish speaking elderly which are more than religious services and ceremonies and strive toward fulfilling the 7. It is recommended that due to the lack of needs of the total person among the Spanish statistics available on the Spanish speaking el- speaking elderly. derly, the Bureau of the Census conductan in- depth study which will evaluate theaccuracy of 4. The declaration of the rights of the elderly the number of Spanish speaking elderly in the should continue to be a responsibility of the United States. various religious bodies, but they should also 'recognize the value of coordinating their efforts 8. It is recommended that the Bureau of Labor with community groups. Statistics be required to havean ethnic breakdown on employment figures to make planning possible 5. All religious and/or private groups, particu- for those Spanish speaking who will become larly those with sizeable Spanish speakingmem- senior citizens in the near future. bership, must spend a fair and adequate share of their resources advocating assistance for the 9. Because of the lower lifeexpectancy of the Spanish-speaking elderly. Spanish speaking elderly, it is recommendedthat Federal legislation be passedto lower the retirement age to 55 for the urban Spanish speaking General Resolutions and to 45 for the migrant rural Spanish speaking worker. 1. It is recommended that a $5,000 tax exemption be granted to Spanish speaking senior i O. It citizens on real and personal property in all States.. is recommended that Federal, State, and local monies be set asideto research and 2. It is recommended that tik I be acted and study the specific problems of the Spanish speak- passed upon by Congress with a modification that ing elderly as a first step in the planning ofcom- the guaranteed minimum income of $2,400 be prehensive and relevantprograms to alleviate increased to $4,800 for all elderly people. the plight of the Spanish speaking elderly.

3. It is recommended that all resolutions passed 11. It is recommended that the Cabinet Com- at the Special Concerns Session for the elderly be mittee on Opportunities for the Spanish Speaking, applicable to the rural as well as the urban elderly. in cooperation with. the National Councilon 4. It is recommended that Congresspass a Aging, the National Institute of Industrial Geron- law to automatically grant citizenship without the tology, the National Institute of Senior Centers, requirement of. an examination to thosepersons and the National Council of Senior Citizenscreate who have been in the United States for 20years. a national organization for the Spanish speaking elderly to serve as an agent at municipal, State, 5. It is recommended that any organization, be and Federal levels. it private or public, which provides servicesto the Spanish speaking elderly be required to have 12. Itis recommended an inv: .igation be an adequate number of ,bilingual, bicultural staff, made into which States did not send Spanish speak- literature, and forms printed in Spanish, make ing delegates to the White House Conferenceon outreach efforts to Iziform the Spanish speaking Aging and letters be writtento their governors community', and utilize multimedia servicesto expressing our disappointment thatno Spanish this effect. speaking delegates represented their States.

169 Roster of Planning Committee'

Nongovernment Government Pablo Sedillo (Chairman), National Director, 'panish- Maurice Braginsky, Gerontology Trainee, Adminis- Speaking Division, United States Catholic Confer- tration on Aging, Departmeta of Health, Education, ence and Welfare Anthony Gutierrez, Senior Associate, Interstate Re- Guadalupe G. Garcia, Associate Director, Program search Associates , Division, Cabinet Committee on Opportunity for the Blanca Hernandez, Special Assistant to the Vice Presi- Spanish-Speaking dent ofField Operations, The National Urban Maria Poinsett, Management Intern, Office of Spanish Coalition Surnamed Americans, Office of Special Concerns, Eduardo Pena, Chairman of the Washington, D. C. Office of the Secretary, Department of Health, Edu- Cottnci. League of United Latin American Citizens cation, and Welfare Santo J. Ruiz, Member, American G.I. Forum of the Juan Ramos, Acting Chief of the Interagency Liaison Unitel States, Hyattsville, Maryland Branch, Office of Program Coordination, National Antoaia Suarea, President, Communidad Hispana de Institute of Mental Health, Department of Health, Mary- land, Silver Spring, Maryland Education, and Welfare, Rockville, Maryland Hector Vazquez, Executive Director, Puerto Rican For- Roy Rodriguez, Education Program Assistant, Office of um incorporated, New York, New York Spanish-American Affairs, Office of Education, De-, partment of Health, Education, and Welfare Hector Santo Anna, Deputy Associate Director for 'Unless otherwise indicated, location is Washington, D. C. Public Affairs, Office of Economic Opportunity

170 LOS ANCIANOSDEHABLA HISPANA

as diversas organizacionessirviendo a las personas hispanos como Ingresos, Empleo, Education,Entrenamien- que auspiciaron y to y Vivienda fueron presentados iipp nombraron miembros y puestos a la del Comit6 de disposition de los -Delegados planes para estaSesiOn de Asuntos que habian indicado que iban a asistir a esta SesiOn.Estos reportes Especiales fueron LaCo...... lencia Catolica de los fueron disefiadospara presentar una base de in- Estados Unidos, ElForo Puertorriquetio,Inc., la Lige de- Ciudadanos formacion para la adoptiony desarrollo de las Unidos Latino- americans, recomendaciones. InvestigacionesdelInteriorAssociadosy La CoaliciOn NacionalUrbana. Representatesde la El programa fue.desarrollado Oficina de Opportunidad alrededor deuna Economia:, El Comite serie de cinco discusiones,cada una acerca de lo del GabinetePresidential de Oportunidades siguiente: Ingreso, Vivienda, las Personas de para Empleo, Salud,y Habla Hispana, ElInstituto Education. Este formato prob6ser sumamente Nacional de Salud Mental, La Oficina deEduca- efectivo en estimular discusiones tion, y Bienestar, tarnbien produaivas, pro- participaron en planear porcionando accesoa expertos en los camposes- esta SesiOn Especial. peciales, y permitiendoa los participantes que La Sesi6n enfoco atencion negociarin en las areas demss necesidad. Elre- a los ancianos de !la- sultado de estos esfuerzos bia. hispana,y di6 luz a esos problemas que si es consideradoen los son planes y acciones, ayudara particulares a esta pohlaciOn. Eltrabajo de esta en el futuro a los ancianos hispanos auna vida de mss provecho. Sesion, por lo tanto, afiadeun componente impor- tante para considerar la delineaci6n delcurso de action national sobre el anciano La Seskin Report6 Los Participantes IntroducciOn Aproximadamente 100 Delegados participaron La poblacion anciana en la Sesion de Asuntos EspecialesPara los hispana constituyeuna Ancianos Hispanos. Los de las clases mss vulnerables&taro de la ya des- participantes vinieron de ventajada poblacion anciana muchas panes de la Nacion;mut.hos de ellos americana. La barre- eran ra cultural y del idioma, el aislamiento Puettorriquefios, Me:..konos-Ameri:anoso Cuba- fisico y el nos. Muchos de los Delegados pertenecer a un grupo minoritario, elviejitohis - se rrunieron en los pano se encuentra de por si primeros 2 dias de laConferencia de la Casa en una situation Inas Blanca para discutir experiencias deplorable que lamayora de la poblacion anciana en sus locali- zniericana. dades y decidir cual de lotproblemas concer- nientes a los ancianoshispanos se discutirianen Pobreza de esta magnitud la Sesion Especial. existe en realidady no es aceptada o comprendidapor el ciudadano de clase media. Esuna pobreza que no tiene limites ya que afecta El Programa igualmente a los viejitos de habla 11:1)ana de laszonal rurales, urbanasy En preparacionpara la Sesion de Asuntos Es- metropol itanas. peciales, reportes referentesa algunas ciertas ne- Quizas la mss terrible cesidades de la poblacionanciana de habla hispana desventaja que tienen los viejitos de hablahispana en esta sociedades 171

468-216 073 - 12 v

su inhabilidad para hablar y comunicarseen Vivienda: Muchos de nuestros ancianos son ingles y que no entienden el "Sistema."El desco- duenos de sus casas, puts para ellos es un simbolo nocimiento de los servicios de salud, viviendas, de respecto y honor. La mayoria de los veces estos recreation, empleo y servicios socialesestan di- hogares son mu" pobres y carecen de servicios rectamente relacionados con la falta de conoci- sanitarios adecuauv.. miento del idioma y del sistema. Existeuna alta correlaciOn entre la habilidad de hablaringles y Lo anteriormente mencionado es justamente su des conocimiento de los pocos servicios, acti- uno de los muchos problemas reales que afectan vidades y programasque tienen a su alcance. a los ancianos de habla hispana en la actualidad. Han sido comentados con la finalidad de exponer Ingresos EconOmicos: Economistas nacionales el hecho de que el espiritu que inspirO esta Con- pudieran aprender mucho si estudiarancomo es ferencia no ha sido implementado en la practica. que los ancianos pueden sostenerse con elpoco Muchos ancianos y jovenes que han participado dinero con que ellos sobreviven. Su largahistoria en esta Conferencia no son pobres y por lo tanto de pobreza no les ha permitido guardar para cuan- no pueden representar adecuadamente a los pobres t do el :es llega momento de retirarseo se recibir que desafortunada-mente no pudieron asistir a la pension adecuada o beneficios delSeguro Social. misma. Hay muchos que no reciben asistensia pablicay tienen que depender de loque les dan sus amigos Es un mito creer que las accionesque se deriven y familiares. de esta Conferencia beneficiarin automaticamente a los ancianos de habla hispana que se encuen- Saltid: La mortalidad en los ancianos de habla tran en la pobreza. Esto no sucedio como conse- hispana es mas alta que el termino medio.Cua- cuencia- de la Conferencia de la Casa Blanca del renta y ocho atios es la edad media de mortalidad afio 1961. Si esta Conferencia se hubieseconcre- entre migrantes comparable con 65 entre losan- tado exclusivamente a las problemas de los glos. Esto se debe a la vida dura an- que han tenido cianos y las minorfas pobres era deesperarse que que llevar toda su vida. Medicare y Medicaidpro- sucediera lo contrario, es decir, que los ancianos veen ayuda pero no se puede corner apropriada- no pobres se habrian beneficiado tambien. mente sin dentaduras artificiales ni comunicarse sin una buena audiciOno aparatos auditivos para Urgimos, energicamente, que una conferencia los que no tienen medios econOmicos. donde se tome action directa para el ancianopo- bre y las minbrias pobressea preparada tan pronto Transportation: En lasareas ru.ales los me- sI dios de transportation como sea T.t2sible a fin de desarrollar la action que son muy escasos y cuando en esta conferenc A no se ha logrado. existen son muy caros. En las ciudadesmetropo- .1itanas los servicios detransporte son caros los viejitos no pueden entendar lasrotas y los horarios por desconocer el idioma inglesy la carencia de servicios bilingues. Alimentacidn: La alimentaciOn inadecuada RECOMENDACIONES afecta a Dodos los ancianos de habla hispana.Pro- ductos alimenticios suplementarios ofrecenalguna Ingresos economicos y transporte ayuda y aunque no estansupuestos a ser alimentos basicos, por carecer de otrosrecursos muchos an- 1. Se recomienda que el Departmento de Trans- cianos los usan como tal. Las estampillaspara porte, el Departmento de Defensa, y la Ad- alimentos (food stamps)son a veces demasiado ministracion de Servicios Genera lespongan a la caras para nuestros ancianos. disposition de cualquiet organization de ancianos los vehiculos sobrantes, en buenas condiciones, de Empleo: Los ancianos de habla hispananecesi- manera que los ancionos de habla hispana y otros tan programas innovadores queno les prohiban ancianos de las mism..ks comunidades donde ellos recibir otras pensiones o beneficios que estan ob- viven puedan tener los servicios detransporte ne- teniendo. cessarios en las areas metropolitanas y/o urbanas.

172 2. Se recomienda que todas las municipalidaJes fasis especial a la cuestiOn de empleos para los que tengan sistemas de transporte publicos pro- ancianos de habla hispana. vean gratis o con tarifas reducidas pasajes para ancianos durante todo el dia con la exception de 10. Que la Administraci6n de Seguro Social las horas de entrada y salida de los empleosy de- (Social Security Administration) compile un cen- mandar de estos sistemas de transporteque publi- so sobre la poblacion de habla hispana que re- quen en espariol las rutas y horarios. Al mismo cibe beneficios del Seguro Social una proyeccion tiempo pedimos que estos sistemas de transit° a diez arios incluyendo los que se esperan que en soliciten del Gobierno Federal el subsidio deestos ese termino de tiempo puedan ser recipientes de programas. estos beneficios. 3. Se recomienda que investigacionesy estudios sean hechos por todas las agendas que este invo- lucradas en programas para los viejospara poder Salad determinar comparaciones basadas en la edad asi como otros datos importantes relacionados con los 1. Siempre que sea aplicable, se deberan nom- diferentes grupos etnicos de dichos viejos. brar representantes de los ancianos de habla hispana y migrantes en todas las comisiones, comites, 4. Se recomiendaque una minimo de ingresos consejos y otras organizaciones relacionadas con la entre $4,300 y $4,500 (por pareja) se haga in- planificacion, desarrollo, operation, y evaluation mediantamente una realidad para todos los viejos de servicios globales de salud, financiados por el de habla hispana yun 75% de esa cantidad para gobierno local, Estatal o Federal. cuando sea uno solo. 2. Dade prioridad a estudiantes y 5. Se demanda energicamente que los estados biculturales que puedan ser reclutadoL pra el enmienden su legislacion para prevenir la rebaja eseudio de las profesiones relacionadas con elcam- de beneficios de Asistencia Publica (Old Age po de la salud y para las "Nuevas Carreras" (New Assistance) para los ancianosa medida que vayan Careers Program) y oportunidades de empleos aumentando los beneficios del Seguro Social (So- ptra semiprofesionales en el campo de salud y cial Security benefits). g;:riatria. 6. Se recomienda que personas hispanas bicultu- 3. Creditos especiales sean otorgados por las rales organizadores y consultantes disefieny eva- universidades a estudiantes de medicinay el cam- Men todos los programasy servicios orientados a po de la salud que sean bilingiies y biculturales. servir los de habla hispana con la cooperationy participation de los consumidores deestos programas. .. Vivienda 7. Que toda la legislacion en relationcon servi- dos, beneficios y programas a los ancianosen los 1. Ya que los gobiernos municipales, Estatales Estados Unidos sean extendidosa los viejitos de y Federales han ignorado las necesidades de vi- la isla de Puerto Rico. vienda de los ancianos de habla hi (pana llegando estasa alcanzar dimensions criticas,sereco- 8: Que los empleadores que contratana los mienda (1) Que personal bilingiie y bicultural viejitos migrantes, cualquieraque sea el trabajo sea nombrado en los tres niveles gubernamentales, que realicen, contribuyan para los beneficios de y (2) Que fondos sean especificamente apropiados Seguro Sociales y que los duenos de fincassean para las necesidades de viviendas de nuestros an- definidos como empleadoresy no como contra- cianos de habla hispana. tistas o reclutadores de empleados. 2. Por cuanto muchos de los ancianos de habla 9. Que las investigaciones y programas en de- hispana son residentes o proprietarios decasas de- mostracion que se han estado haciendoa retazos terioradas, se recomienda (1) Que por motivos sean financiados a nivel nacional y se les de en- de las demolitions o remociones de casaspor los 173 programas del "Urban Renewal" se conceda asis de los ancianos sin que poreste motivo se olvide tencia Gubernamental en los tres nivels para la el principio de la separation de la Iglesiay el rehabilitation y renovation de edificiosde vivien- Estado. das cuyos proprietariossean ancianos de habla hispana. 2. Los ancianos de habla hispana deben partici- par en la redaction de los programas que afecten 3. Por cuanto el actual proyecto federal de vi- su vida espiritual desde su inicio hasta el momento viendas es altamente indeseablepara nuestros an- de comenzar su funcionamiento. cianos, se recomienda (1) Que todas las unidades de viviendas sean construidas de acuerdocon las 3. Que todos los grupos religiososy privados preferencias socio-culturales de loshispanos tales se den cuenta de cuales son las necesidades de los como disefio, costo, localization, tomafio. ancianos de habla hispana queno se limitan a servicios religiosos y otras cermoniasy que se es- 4. Por cuanto es por todos reconocido que los fuercen por satisfacer las necesidadeshumanas de ancianos de habla hispanano estan recibiendo la dichos ancianos. cuota proporcional de los programas Federales de 4. La declaration de derechos vivienda, se recomienda (1) Que elGobierno de los ancianos hispanos deben de continuar siendo Federal adopte una politica de 'viviendautilizando una responsa- una formula en la cual las unidades autorizadas bilidad de los distintosgrupos religiosos que ade- mas deberan reconocer el valor de coordinar para ser construidas o rehabilitadassean reserva- sus esfuerzos con los de los diversos das para ancianos hispanosen proporci6n directa grupos de la co- a la poblacion de sus respectivas comunidades. munidad. 5. Todos los grupos religiosos 5. Por cuanto es un hechoque existe un requi- y privados, espe- sito que fuerza a los ancianos hispanos cialmente los que cuentancon una cantidad con- a ceder sus siderable de miembros de habla hispana, rcrlamaciones a bienes raices,por ejemplo: tierras, deben fincas, etc.. a fin de calificar gastar una cantidad proporcional adecuada desus como recipientes para recursos para ayudar a los hispanos. programas de ayuda financiera, se recomiendaque (1) Los requisitos arriba mencionados,los cuales son legalmente injustos y prohibitivos,sean eli- Resoluciones Generales minados y enmendadosa fin de satisfacer las necesidades de los ancianoshispanos. 1. Se recomienda que se concedaa los ancianos hispanos una execucion de impuestos de $5,000 6. Por cuanto es una tradition altamente res- sobre la propiedad mueble y personalen todos los petada por las familias hispanasde que estos an- Estados de la Union. cianos tienen una fuertey \Tali& necesidad de 'permanecer viviendo en elseno familiar, se re- 2. Se recomienda que se active el dabate sobre comienda (1) Queun nuevo programa sea dise- el proyecto de la ley HR Iy que el Congreso fiado y adoptadopara promover y proteger esta apruebe, sin enmiendas, la leyque garantiza un ingreso minimo de $4,800 anuales oportunidad de una continu.t participhciondentro para los ancianos en lugar de los $2,400 del seno familiar, y conti 'huhpara responder al que se especificaban en dicho proyecto. deseo de los ancianos hispanospara mantener sus sentimientos de utilidqd social. (2)Este nuevo 3. Se recomienda qu§ todas las recoluciones programa pagaria la renta directmente a los aprobadas en la Sesion apliquena los ancianos de ancianos hispanos recipientes desubsidios econo- las zonas rurales y urbanas por igual. micos aunque estos vivan dentro del seno familiar. 4. Se recomiendaque el Congreso promulgue una ley por medio de la cual se otorgue la ciuda- Bienestar Espiritual dania sin el requisito delexamen de ingles a todos los que hubieran resididoen los Estados Unidos 1. El Gobierno debecooperar con los distintos durante 20 arios. grupos religiosos y organizaciones privadascon 5. Se recomienda que todas las organizations, objecto de satisfacer las neces;ladesespirituales publicas o privadas, que ofrezca serviciosa los 174

.4 ancianos de origen hispano cuentencon una can- de los ancianos hispanos a los 55 aiios de edad tidad proportional de empleados .bilingiiesy bi- para los que habitan en ciudades y a los 45 ailos culturales; y que el material y los modelosse im- para los obreros migrantes rurales. priman en espanol; y que mantengan informadas a las comunidades hispanas sobre todos sus servi- 10. Se recomienda que se voten fondos Fede- cios por medio de la prensa, radio y television. rales, Estatales y municipales para realizar investi- 6. Se recomienda al Presidente la' creation de gaciones y estudios de los problemas peculiares de un Comite Nacional de Coordination para los an- los ancianos de origen espatiol como paso previo cianos de habla hispana en el cual participen los en la planificaciOn de un programa global que consumidores; que redacte un programa nacional verdaderamente pueda aliviar la situation desespe- cuya estrategia permita resolver los problemas de rada de los ancianos de habla hispana. los ancianos; que utilice fondos Federales, Esta- 11. Se recomienda que el Comite del Gabinete tales y municipales, y que evalue losprogramas existentes. Presidential de Oportunidades para los Ciudada- nos de Habla Hispana con la cooperation del 7. Se recomienda que el Negociado de Censo Consejo Nacional para Ancianos, el Instituto Na- haga un estudio exhaustivo de los ancianos de cional de Gerontologia Industrial, el Consejo Na- habla hispana mediante el cualse llegue a una cional de Centros para Ancianos y la Asociacion cantidad exacta de los ancianos hispanos de los Nacional de Ciudadanos Ancianos creen una orga- Estados Unidos ya que las estadisticas existentes nizaciOn nacional de Ancianos de Habla Hispana son muy escasas. que sirva como agente de los mismos al nivel municipal, Estatal y Federal. 8. Se recomienda que se exija al Negociado de Estadfsticas* de Trabajo que ofrezcaen detalle, por grupos etnicos, la cantidad de empleados que en 12. Se recomienda que se investigue cuales un futuro proximo llegaran a los 65 Mies de edad fueron los estados que no enviaron Delegados de con cuyos datos se podran redectar programas para habla hispana a la Conferencia de la Casa Blanca los ancianos hispanos. Sobre la Ancianidad para escribirle al Gobernador expresandole el disgusto que la ausencia de dicha 9. Se recomienda que se promulgue una ley representation caus6 los asistentes a esta Con- mediante la cual se reduzca la edadpara el retiro ferencia.

175

THE AGING ANDAGED BLACKS

cadets of the black community, as well Many of the Delegates who attewled this Ses- asthoseofothermajorminority sion had participated in one or more of the pre- groups, were concerned because the paratory meetings held by the National Caucus on regular program of the White 'House the Black Aged on November 27 and 28 at the Conference on Aging made no visible provision Washington-Hiltcn Hotel. Other Delegates had for discussion of problems of the elderly among attended t,l National Conference on the Black the minorities. The National Caucus on the Black Aged held in Washington a few weeks prior to Aged proposed that a Special Concerns Session on the White House Conference. Still others (Dele- the Black Elderly be organized and a special effort gates) were familiar with the working paper, en- be made to involve a significant number of mem- titledThe Multiple Hazards of Age and Race," bers of the black community both as Delegates to which was Fepared by Dr. Isabel B. Lindsay for the White House Conference and guests at this the United States Senate Special Committee on Session. Aging. The Delegates who attended this Session The White House Conference on Aging is in- were thus aware of the problems that elderly debted to Mr. Hobart C. Jackson. a member of blacks face and were familiar with many of kbe the Executive Conimittee of the National Plan- latest proposals to remedy their situation. ning Board for the White House Conference on Aging. who served as Chairman of the Planning Committee for this Special Concerns Session, for 1971 WIIITE HOUSE CONFERENCE ON AGING his leade-ship in the planning, execution, and reporting of this Session on The Aging and Aged PROGRAM Blacks. Mr. Jackson interested outstanding black leaders in serving with him on the Session Plan- AGING and AGED BLACKS ning Committee. (see Roster. page 196) PresidingDR. BENJAMIN E. MAYS, Presi- The Participants nent-Emeritus. Morehouse College and President, Atlanta School Board of Education More than 200 Delegates to the 1971 White House Conference on Aging preregistered for the 8:00 A.M.-8:10 A.M.Opening Remarks Special Concerns Session on The Aging and Aged DR. BENJAMIN E. MAYS Blacks, and they were joined by so many other 8:10 A.M.-8:20 A.M.The Current Status of Delegates, observers, and invited guests that not Black Aged: A Demographic Profile. even standing room was available when the Ses- DR. ROBERT HILL, Associate Research sion began. Only official Delegates were permit- Director, National Urban League ted' to vote on recommendations. although the 8:20 A.M.-8:45 A.M.Toward aNational discussion of the recommendations was open to Policy for Black Aged. all who were present. HOBART C. JACKSON, Chairman. National Caucus on the Black Aged, and The majority of those Delegates who chose to Chairman, Advisory Council on Aging attend this Session were themselves black. They and Aged Blacks to the U.S. Senate came from every State and from the Virgin Is- Special Committee on Aging lands. They had participated in each of the needs and needs-meeting Sections, and some had been (Program eontmued on net! page) Section officers.

177 (Program Continued) 8:45 A.M.-9:45 A.M.Presentations of Major Research, Demon- tration and Train- Policy Recommendations for Aging and ingDR. JACQUELINEJ.JACK- Aged Blacks. SON, Associate Professor of Medical Education and LawDR. WILLIAM Sociology,DukeUniversityMedical T. CARTER, Director, Division of Pro- Center, Durham, North Carolina gram Resources, Bureau of Educational Retirement Roles and Activities Personnel, U.S. Office of Education, De- IRA HUTCHINSON, Assistant to the partmentofHealth,Education,and President, National Parks and Recreation Welfare Association, Washington, D.C. Employment, Retirement and Income Spiritual Well-Being DR. MAURICE JACKSON, Depart- FATHER DENZIL A. CARTY, Rector,Saint ment of Sociology, University of Cali- Philips Episcopal Church, St. Paul, Min- fornia at Riverside, Riverside, California nesota Facilities,Programs,Services and TransportationJOE HAM, Program 9:45 A.M.-10:00 A.M.Break Director, Oakland County Commission onEconomicOpportunity,Pontiac, 10:00 A.M.-10:45 A.M.Discussion of Policy Michigan Recommendations Government and Non-Government 10:45 A.M.-11:00 A.M.--Cmcensus Formation OrganizationJAMES A. JOHNSON, on Policy Recommendation and Estab- President,Local Chapter of the Na- lishment of Priorities tionalAssociation of RetiredFederal Civil Service Employees and President, 11:00 A.M.-11:15 A.M.Break Tuskegee Institute Federal Credit Union, Tuskegee Institute, Alabama 11:15 A.M.-11:55 I.M.Presentation of Pol- HealthDR. AARON HENRY, Phar- icy Concerns to Special Guests macist. Clarksdale, Mississippi HOBART C. JACKSON, Chairman, HousingALAN PINADO, Assistant National Caucus on the Black Aged and Vice - President, Life Insurance Associa- Chairman, Advisory Council on Aging tion of America, New York, New York and Aged Blacks to the U.S. Senate NutritionPEGGY BEST, Director, Special Committee on Aging State Nutrition Program for Older Per- Responses sons, Los Angeles, California PlanningWILLIAM T.ROGERS, 11:55 A.M.-12:00 NoonTowardsa National Field Representative, National Commit- Policy for Black Aged: A Follow-up tee Against Discrimination in Housing, Charge. New York, New York DR. BENJAMIN E. MAYS

178 THE SESSION REPORT

Introduction

Participants in the Special Concerns Session on blacks to ensure satisfactory black representation, Aging and Aged Blacks and The National Call- or black apathy, cannot provide sufficient explica- ars on the Black Aged were especially concerned tion, inasmuch as black effortsIt considerable about three major and related issues during the expense of time and money by blacks themselves 1971 White House Conference on Aging. One were purposively and constructively exerted. '11 was the insufficientand generally lack ofat- fact, black efforts probably far outweighted those tentiongiventominoritygroups,including of the other groups. Perhaps the most significant blacks, in the formation of issues presented in the factor accounting for differentialrepresentation background materials and the workbooks for dis- of minority groups may be sought in dominant re- cussion and policy recommendations at the Con- sponses to minority requests. If so, the need for ference, as well as the exclusion of any specific blacks to remain critically concerned about blacks references to minority groupsincluding blacks is yet extant, since we are those most likely to by major Conference speakers. The heavily continue to experience the most severe forms of jeopardizing status of being black and old and racial prejudice in the United States. often poor (and, frequently, female) deserved more explicit recognition. This black underrepresentation may also account for the feeling of some black Delegates A second was a general feeling of black under- that our numbers were too small to gain sufficient representation as Delegates and particularly so as strength in actual policy deliberation and forma- compared with other minority groups. A subse- tion. Hence, while we appreciate the cooperative quent examination of minority group delegate efforts which were received in enlarging our black representation to the White House Conferenceon representation, we may still be correct in believ- Aging revealed support for the latter fear. In ingthatthe "multiple jeopardy" confronting comparison with our proportionate representation many black aged necessitated a larger biack dele- in the total United States 1970 population, we gation to participate in forming a national policy were slightly underrepresented, Asian Americans on the aging, including aging blacks. equaled chance representation, American Indians and Spanish speaking persons were clearlyover- Insufficient time to prepare and insufficient represented space to present our preliminary report consti- We have estimated that there were 1.62 black tuted the third merriding issue. Sheer numbers of Delegates per every 100,000 blacks in the United black aged unduly victimized by race and poverty States in 1970. Correspondingly, Asian Americans, justify this concern. The 1970 United States popu- had 2.1 delegates per 100,000, Spanish speaking lation contained about 809,000 black females and persons 2.8 per 100,000, and American Indians, 608,000 black males 65 or more years of age. Lo- 12.4 per 100,000. cated in every State, twice as many black aged as white aged dwelled in poverty. Between 1959 This significant black underrepresentation can- and 1969, dollar income gaps between black and not be justified by purporting greater tribal or white aged actually widened. Thus, by comparison, ethnicdiversity among theAsianAmericans black aged were worse off than white aged in American Indians, or Spanish speaking Ameri- 1969 than in 1959. Currently one of every two cans, thereby negating the considerable hetero- black aged lives in poverty. Three of every four geneity among blacks.Inadequateeffortsby live in substandard housing. Policy recommenda-

179 tions for black aged required more time than that for black aged more than 100 years ago), he is provided for in the Conference. also Chairman, The National Caucus on the Actual time needed for such deliberations may Black Aged: Chairman, Advisory Council on have been reduced had more information on aged Aging and Aged Blacks to the U.S. Senate Special blacks been available. Scant data are even now Committee on Aging; and an active member of available. The National Caucus on the Black the Gerontological Society. The Presiding Chair- Aged was generally foiled in its attempts to ob- man of the Session was Dr. Benjamin E. Mays. tain relevant data from the 1970 Census, but President-Emeritus of Morehouse College (At- some recent breakthroughs have been made in lanta, Georgia). President of the Atlanta School this direction. The National Center for Health Board of Education, and the 1971 "Senior Citizen Statistics, to the extent possible, was quite co- of the Yeir" from Georgia. An eminent scholar, operative. That is, data from that source was made educator, administrator, and theologian, as well available to us. The chief problem was the lack of as an outstanding representative of aging individ- sufficient data collected by that agency. In the uals whose lifelong patterns of significant profes- future, and certainly before a possible 1981 White sional, civic, and community contributions persist House Conference on Aging, all relevant data over time, he is also a member of the Advisory should be on hand for adequate policy delibera- Council on Aging and Aged Blacks to the U.S. tions and implementations. Senate Special Committee on Aging. The Session Coordinator was Dr. Jacquelyne J. Jackson, Asso- These three points are important in any evalua- ciate Professor of Medical Sociology, Department tion of the Special Concerns Session on Aging of Psychiatry, Duke University Medical Center, and Aged Blacks. More important. they are criti- Durham, North Carolina, Secretary of The Na- cal for those sincerely concerned about improving tional Caucus on the Black Aged, and a member drastically the adverse plights of those blacks of the Advisory Council on Aging and Aged who are now old and those aging blacks who will Blacks to the U.S. Senate Speci:i Committee on become old. Aging and the Gerontological Society. She is also Two major purposes characterize this presenta- the author of the only three published reviews as- tion of our deliberations in the Special Concerns sessing the current status of gerontological litera- Session on Aging and Aged Blacks. The first is ture on black aged, which were partially sup- the presentation of all of the recommendations ported by the Nacional Institute of Child Health approved inthat Session, following insofar as and Human Development (Grant #HD 668) and the U.S. Public Health Service (Grant possible the actual language employed. Thoserec- ommendations are incorporated into Section One #MH16554). of thisfinalreport. The second purpose, con- Those persons specifically responsible for chair- tained in Section Two. is multifold. Thatpurpose isto provide background data, much of which ing selected task forces to aid in developing our was set forth or alluded to during our delibera- recommendations and whose tremendous efforts tions; to present several additional recommenda- in this direction, as well as their commitment to tions arising from discussions of asignificant black aged, cannot be overlooked include, in addition to those mentioned above, Ms. Peggy Best number of persons following the Session; andto provide additional informationon the reactions (Director, State Nutrition Program for Older of participants to the Session, in general, and to Persons, Los Angeles, California); Dr. William the White House Conference on Aging, in partic- T. Carter (U.S. Office of Education and then ular. These reactions were systematically compiled Grand Polemarch, Kappa Alpha Psi); Father and analyzed by Hobart C. Jackson. Denzil A. Carty (Episcopal Rector, St. Paul, Minnesota); Dr. Aaron Henry (Pharmacist and Hobart C. Jackson was Chairman of the Special State President of the National Association for Concerns Session on Aging and Aged Blacks. the Advancement of Colored People, Clarksdale, Head of the Stephen Smith Geriatric Center in Mississippi); Ira Hutchison, Jr. (Assistant to the Philadelphia, Pennsylvania (a home established President of the National Parks and Recreation

180 Association, Washington, D.C.); Maurice Jackson tion; Planning; Research and Demonstratic-, (then Associate Professor of Sociology, University and Training). Preferably at least one such black of California at Riverside, California, and now representative should be from The National Cau- Executive Associate, American Sociological Asso- cus on the Black Aged. ciation, Washington, D.C.); James A. Johnson (Pr-sident, Tuskegee Institute Federal Credit Un- 2. Above all, first priority should be given to ion and President, Local Chapter, National Asso- establishing a system providing at least a guaran- ciation of Retired Federal Civil Service Employees, teed, mode'ate income for all black aged. Income Tuskegee Institute, Alabama); Alan Pinado (As- needs excee.! all other priorities. sistant Vice-President, New York Life Insurance 3. When the President's Domestic Council (or Company, New York, New York); and William whatever agency makes final recommendations on T. Rogers, Jr.(Field Representative, National aging to the President) considers the various pol- Committee Against Discriminationin Housing, icy recommendations, that body should have at New York, New York). least proportionate black representation onits In addition, The National Caucus on the Black staff and as consultants. if Hobart C. Jackson is Aged and each participant in the Session were not properly included as a consultant, a copy of aided immeasurably by background data on black all action taken on all of our recommenaations aged provided by Dr. Robert L. Hill, Associate should be forwarded to him for his consideration within a reasonable time following the action ResearchDirector,NationalUrbanLeague (Washington, D.C.). Dr. Hill is also a member of taken, and prior to its presentation to the Presi- The National Caucus on the Black Aged and the dent, so that appropriate modifications can be Advisory Council on Aging and Aged Blacks to made. Those recommendations requiring Federal the U.S. Senate Special Committee on Aging. legislation should be forwarded to appropriate bodies for such consideration and every effort We welcome the opportunity to present in Sec- should be made toinvolve the Congressional tions One and Two below our recommendations Black Caucus. and selected background data, with the hope that they can be implemented to improve dramatically 4. Inasmuch as insufficient data are available the lives of aging and aged blacks and that the on aging and aged blacks from all Federal agen- spirit in which they were given will become the ciescollecting and interpretingsuchdata,it spirit of the Federal Government which can mo- should be mandatory that all such agencies be bilize their enactment. compelled to collect data from a sufficient sample size to ensure that multivariate analyses providing greater information on patterns and processes of aging among blacks can be undertaken. The Fed- SECTION ONE eral Government is urged to present a report on Recommendations Approved in Session aging and aged blacks at regular intervals during the years ahead, such as every 5 years, so we can General measure the changes, if any, occurring in their 1. All policy recommendations emanating from conditions. The Census should shift from a de- the Special Concerns Session on Aging and Aged cennial to a quinquennial format and should report data fully for blacks without including us in Blacks should receive appropriate follow-upas quickly as possible. At least one black representa- any category of "nonwhites." tive should participate in the preparation of the 5. The White House Conference on Aging final report from each Section(i.e., Education; should provide us with periodic reports for its Employment and Retirement; Physical and Men- fol!ow-up of our recommendations, with the first tal Health; Housing; Income; Nutrition; Retire- report to be presented in not less than 9 months ment Roles and Activities; Spiritual Well-Being; following the close of this Session and with re- Transportation; Facilities, Programs and Services; maining reports to be presented by the Federal GovernmentandNon-GovernmentOrganiza- agency or agencies having any responsibility for

181 the aged yearly following the initial report. This stitute for provisions of adequate income without report and all subsequent ones should include all any additional work in their old age. In other relevant data, including that on food from the words, while we strongly support efforts madeto U.S. Department of Agriculture, participation in provide meaningful employment for those who the labor force from the U.S. Department of are old and black who desire labor force partici- Labor, housing patterns from the U.S. Depart- pation for reasons "other than needed incomesup- ment of Housing and Urban Development, and plementation to ensure survival, we feel that old research, demonstration, and trainingas well as blacks who do not-desire to work shouldnot hare health care and Social Security data from the U.S. to engage in employment only to supplement in- Department of Health, Education, and Welfare. adequate incomes, but, as already recommended, Copies of such reports should be forwardedto all should have a guaranteed, moderate annual in- members of The National Caucuson the Black come. Aged, all State agencies of aging, and allother relevant organizations or agencies,as well as 10. The proposed National SeniorCitizens being made available at cost at the U.S. Govern- Community Service Program should be enacted ment Printing Office. From time to time, blacks and implemented, with sufficient consideration themselves should be consulted foran evaluation given to black participation and representationat of those reports and for policy formationand im- all levels, provided that no aged black is forced plementation. to participate in such a program. 11. The Federal Government should initiate guidelines and policies to govern and enforce ade- Education quate standards of private pension systems and 6. The Federal Government should provide, establish a mandatory pension portabilitysystem through appropriate trainingprograms, realistic for all workers. and effective opportunities for elderly blacksto 12. The Federal Government should require further, without cost to them, theireducational that all employers pay employees at least mini- goals. mum wages and minimum wage coverage should be extended to all workers, including domestics 7. The administration of the proposedpro- gram for effective education for elderly blacks and farm laborers. Fringe benefits should include should provide for funding supportto institutions adequate provisions for sick pay, annual leave, and life insurance which, in for such training projects,or stipend and tuition cases of employers costs to be paid directly to the elderly to enroll in with very few employees, could be accomplished courses or curricula of their choice wherever avail- through Federally sponsored programs requiring able. regular financial contribution.; by employers to employee coverage. 13. The Federal Government should take steps Employment and Retirement to reduce significantly high unemployment rates 8. Since income is the most serious problem typically found among blacks so thatno signifi- confronting many aging and aged blacks,significant differences will characterize black and white cant attention should be given to improving sub- unemployment rates. It should also remain cogni- stantially the income levels of all blacks. zant of those significant links between employment in the earlier years and retirement in the 9. Inasmuch as a significant proportion ofcon- later years so as to reduce current gaps adversely temporary black aged have been a part of the affecting aging and aged blacks. labor forceworking fulltime forpoverty wages and in menial jobs generally lackingadequate fringe benefits related to retirementitis recom- Physical and Mental Health mended strongly that employmentopportunities 14. Medicare coverage should be expanded for aged blacks should not be regardedas a sub- and improved to provide coverage for homecare, 182 long-term care and extended care without prior 21. Existing nursing homes and long-term care admission to an acute-care hospital, and ex- facilities. owned by blacknonprofitsponsors panded coverage for home care, -coverage for should be given grants and low-interest bearing out-of-hospital drugs, and removal of the 100-day loans for renovation and constructionto meet limit on skilled nursing home care for those pa- minimum state and Federal standards. tients who continue to need such care should be- 22. The archaic practice of static custodial care come a reality. in institutions where the elderly go "to lie and 15. Parts A and B of Medicare should be die" is self-defeating, inhuman, and economically merged andalldeductibles and co-payments unsound. We recommend its abolishment and, in should be eliminated.Servicespreviouslyex- its place, the development of a "Socio-Medical cluded, such as foot care, eyeglasses, eye refrac- Approach" utilizing progressive patient care tech- tions and examinations for eyeglasses, hearing niques (phased intensive, intermediate, minimum aids, false teeth and dental care, other prostheses, care, rehabilitation, resettlementall representing and out-patient psychiatric care should bein- joint health team efforts) integrated with com- cluded. munity support to maintain the elderly in their 16. Medicare coverage should expand to in- chosen environments, with those services includ- clude disabled Social Security beneficiaries. ing,but not being limitedto, home health services, occupational and physical therapy, recu- 17. Front-end financing from the Medicaid perative holidays, meals-on-wheels, day- centers, Trust Fund should be utilized to develop senior recreation clubs, and ambulances and other trans- citizen day-care centers and a full range of geriat- portation services. ric health service centers, including community health outreach workers, transportation, informa- 23. The following new 'trends inlong-term care should be researched and implemented wher- tion referral and advocacy services and suchcen- ters should be owned and operated by nonprofit ever feasible: holiday admissions (the voluntary indigenous community corporations. admissionto nursing homes/extended care or appropriate facilities during planned family vaca- 18. The Administration on Aging, or whatever tions); short-term admissions (providing for in- agency supercedes that'agency in assuming overall termitt'nt 2-week admissions of aged patients responsibility for all Federal programs related to every 4 months) and day hospital (utilizing a the aged, should identify and design and support unit combining medical and nursing care, physical opportunities for older persons to render services and occupational therapy, and a noon meal for to their communities. the aged). 19. The Administration on Aging (with the 24. The implementation of health care legisla- above qualification), and anyor all public and pri- tion should be uniform and mandatory and inde- vate agencies concerning themselves with the pendent of matching State funds or voluntary aging and the aged, should join together ina co- participation of individual States. operate effort to develop programs of technical 25. Wherever feasible within :black communi- andfinancialassistanceforlocalcommunity groups to provide daily meals to ambulatory older ties, comprehensive health services should be de- persons in group settings and to shut-ins at home. livered through a community health corporation composed of indigenous consumers and provid- 20. The $2 billion spent yearly by the Federal ers rather than the traditional approach (medical Government for private nursing home services schools, public-health departments, and medical should be diverted to nonprofit social utilities and associations, et cetera). This health corporation homes for the aged sponsored by religiousor be- should secure significant input from informed and nevolent organizations or community corporations relevant consultants within or without its com- with joint consumer control and equity bya rep- munity. Satisfactory implementation of this pro- resentative number of the elderly receivingserv- posal would net needed equity, cultural relevance, ices. Such homes should receive sufficient financial self-sufficiency, and self-respect in health-care for support to ensure their maintenance. blacks.

183 26. Research in experimental health delivery tent personnel with adequate knowledge and systems should be conducted to- determine the understanding of and respect for their-subcultural best method of financing comprehensive geriatric backgrounds. services. Arrangements might include front-end financing from Medicare Trust Fund, Medicaid 32. Governmental reimbursement to nursing appropriation for neighborhood healthcenters, or homes for the care of residents whosecareis a combination of social insurance and general tax financed with public funds should beat a level revenues for Health Maintenance Organizations. consistent with the actual cost of thiscare. 27. Restrictive provisions of H.R.1 (the "Fam- 33. Private and public nursing homes yetprac- ily Assistance Plan") pertainingto Medicare and ticing racial discrimination should be madeto Medicaid cutbacks should be opposed. Thosesec- conform to standards of compliance with nondis- tions pertaining to the aged should be separated criminatory policies pertaining to race. Enforced from those pe1,4ining to non-aged andincorpo- compliance wherever necessary is essential. rated into a separate bill. H.R.1 inits present 34. The greater problem for black aged is not form should be actively opposed by all- genuinely one-of remaining without but of getting intonurs- concerned about aging and aged blacks. ing hows. Thus, sufficient attention to reducing 28. The scarcity of black health professionals barriers preventing needed black admissionsto necessitates sufficient Federal allocations for train- nursing homes is urgently needed. ing black females and malesas physicians, nurses, pharmacists, dentists, technicians, social workers, Housing dieticians, and other relevant health professionals to increase dramatically available black health 35. The Federal Government should increase professionals in the next decade. Their training the supply of housing available to low and mod- curricula should include mandatory geriatric and erate income minority elderly through such meas- gerontological exposure. ures as providing seed monies and loans for creating and supporting nonprofit minority housing 29. The Federal Government should continue development organizations. Provisions should be to enforce racial desegregation in all medical fac- made for technical assistance and 100 percent ilitiesincluding nursing homescoming under financing to develop housing available for the its jurisdiction or using any Federal funds. Such elderly of all races. policies should apply to all administrators, staff, and patients. 36. Federal policy should require the provision for low and moderate income elderly housing in 30. The Federal Government should require all new cities or communities, planned unit devel- adequate hospital and other health insurancecov- opments, urban renewal and model-cities areas erage for alllabor force employeesincluding and other similar developments receiving Federal domestics and farm laborersor it shouldmove assistance. immediately towards othercoverage methods such as, in the opinion of some Session participants, 37. The Federal Government should fund a nationalized health systems. Irrespective ofsocio- system of fellowships and scholarships to low-in- economic status and geographical location (which ane students to provide education and inservice may necessitate greater medical services delivered training in -the development and management of via aeroplanes), all black aged shouldhave access nursing homes and other residentially-oriented fa- to good health care. cilities. Programs should include a representative number of trainees from allracial and ethnic groups. Nursing Homes

31. Sufficient attention should be given toes- Income tablishing nursing homes for black elderly need- 38, A minimum. guaranteed annual income of ing such facilities, with staff comprised ofcompe- $6,000 for a single aged person and $9,000 for

184 an aged couple should-be established, with appro- tion should concentrate on providing food assist- priatecost-of-livingindices attachedtothese ance to those in need. This food assistance pro- bases. This recommendationparticularly desira- gram must be improved whether by commodity ble for black aged who have experienced lifelong distribution or food stamps to make more com- povertycould be modified to restrict its benefici- modities available to senior adults in more acces- aries to those whose average earnings (singularly sible distribution centers with transportation for in cases of individuals bereft of spouses for at seniors to and from the centers. Commodity foods least W preceding years, and collectivelyfor must be packaged in smaller units for one and Married individuals) never exceeded $9,000 an- two person families to reduce spoiling and food nually during their working years. poisoning dangers.An adequate guaranteed in- 39. The minimum ageeligibility requirement come, however, should eliminate any need for the for primary beneficiaries of- Old Age, Survivors, above for older persons would not be in poverty Disability,andHealthInsurance_ (OASDHI and would be able to purchase "heir foods in the under Social Security) should be reduced by 8 modal American ma»ner. years for black males so as to erase existing racial inequities. Retirement Roles and Activities 40. Aged workers supplementing -their retire- 43. Inasmuch as retiroment roles and activities ment funds through work should not be penal- are influenced heavily by such variables asin- izedfor monies earned unless those earnings come, health, housing, and education, we recom- place their total income above the national me- mend strongly, sighificant improvements in these dian income during any taxable year, and, in ad- areas for aging and aged blacks, so that we will dition,thecategoryofOld-AgeAssistance be better able to engage in preretirement and (OAA) should be deleted from Social Security, retirement roles and activities, including leisure since a-majority of blacks receiving that aid- are usage of time. those who were denied sufficient participation in OASDHI and in the labor market in their work- 44. Better planning for recreation outlets for ing years. They should merely be eligible for black aged, based upon their needs and desires, OASDHI at a monthly minimum placing them should be encouraged, with aged blacks playing above the poverty level. All workers and their de- decisive rolesin developing and implementing pendent family members can and should be ade- those plans.. quately covered by -OASDHI, and- the aged do 45. Consideration should be given to the need not need to be stigmatized by coverage arising for improved transportation services at reasonable from OAA. Coverage under OASDHI should costs, better street lighting and police protection in continue until such time as that system is replaced predominantly black neighborhoods, and other by a more effective system. factors enhancing aged participation in desired roles and activities. Nutrition 46. Public housing designed for the elderly and especially for elderly blacksshould contain 41. The Federal Government must allocate temporary lodging provisions for their out-of-town substantial funds for comprehensive nutritionac- visiting relatives since the high costs of commer- tion programs to rehabilitate malnourished aged cial lodging available often prohibits or adversely and prevent malnourishment in those approaching affects these visiting patterns. retirement. These nutrition action programs must provide health-related components in additionto 47. All governmental and nongovernmental research components. Additionally, all nutrition agencies concerned with the aged should give health-related research must have a service action greater consideration to utilizing professional tal- component. ents and skills of aged blacks, who have a wealth of information and experience to share and who 42. Government resources allocated to nutri- can enrich the lives of all Americans.

185 48. All levels of public and private education under the the banner of spiritual well-being, con- should include training for leisure activities and certed action within all churches and the commu- continued adult education outlets should be made nity-at-large, working toward the understanding available for all older persons. of the monster of racism so as to eradicate it, in 49. Formalretirementactivitiesforaged the' name of God, Father of all mankind, from blacks should include both age-integrated and our society. age-segregated activities since some aged blacks prefer the former, some the latter, and some, Transportation both. 56. The Federal Government should establish 50. While greater emphasis upon developing or stbsidize transportation systems providing serv- voluntary roles and activities for aged blacks with ices at lower rates and operating on convenient adequate income is needed, greater emphasis must time schedules for aged blacks in all areas with be placed upon developing more salariedroles black aged residents. In addition to better bus and activities (which are meaningful and satisfac- service, subsidized taxi-cab service, et cetera, physi- tory to them) for those aged blacks without suffi- cal arrangements should be improved so as to re- cient income until such time as they also receive duce difficulties black aged may experience in adequate income. mounting unusually high steps, standing in un- 5L Existing recreational outlets, such as movie safe places, and waiting services in bad or cold theaters and restaurants, should be encouraged to weather. provide reasonable fares for the aged and to pro- 57. Needed transportation to medical facilities, vide servicesincluding entertainmentfavorable grocery and other shopping outlets, and business to the aged. places (such as food stamp'distribution centers at the present time) should be provided at tr,!;nimal Spiritual Well-Being costs to the participants.

52. The Federal Government should make it 58. Especial attentionisneeded inreducing possible for black churches to sponsor housing for transportation problems of rural black aged. black aged and should give them all the help and direction possible, including the use of black institutions for financing purposes. Facilities, Programs, and Services 53. All national church denominations should 59. In general, facilities, programs, and serv- broaden their interpretation of the Fatherhood of ices for black aged are woefully inadequate due God and the Brotherhood of Man, which is im- to a variety of reasons. An assessment of the cur- plied in spiritual well-being, by making certain rent status of black aged in existing programs that all nursing and rest homes and other living (including such Federally funded ones as Foster facilities for the aged under religious aegis reach Grandparents, and the training and effective use out toinclude minorities irrespective of race, of subprofessionals and volunteers in Titles I, IV, color, or creed. This isparticularly important X, XIV, and XIX under the Social Security Act, when such institutions use government funding. food stamp and food distribution programs under the U.S. Department of Agriculture, and Medi- 54. Sincespiritualwell-being and economic care under Social Security) should be made avail- well-being are significantly correlated ina variety of ways, the former may be improved by improv- able toThe National Caucus on the Black Aged for consideration and policy recommendations to ing the latter. Anything less thana moderate guaranteed alinual income would be meaningless appropriate agencies as quickly as possible. and simply prolong the suffering of those aged in unnecessary poverty. 60. All Federally funded demonstration programs should be required to evaluate themselves 55. The Federal Government should sponsor a and adequate funds must be built-in to provide consortium of black and white clergymen to seek, for independent evaluation by outsiders to deter-

186 mine progiam effectiveness and the need. ifany. Got.etwmeritNon-Got'ernmthil for program continuation. Oranizalion 61. Greater diversity insubstantive content 67. The Federal. State, and local governments and in geographical location is needed formost should become strong auvocates for aged blacks. facilities. programs. and services for black aged serving to identify their nerds. to promotepro and every (Mort should he made to extend such grams of public education and interpretation of diversity so that all black aged will have reasona- needs and how those needs may bemet. et cetera. ble access to these programs. 68. Government employees functioning as ad 62. Manv existing programs and servicesare vocal es for the aged must include individualsre- unduly hampered by insensitive and incompetent flecting the race and sex composition of theirre- personnel insofar as they relate to black aged. spective cachement areas. When black agedare One solution is greater employment of Mack:-- within the cachement areas.every consideration and especially of older blacksin suchprograms. should be given to weighting that employeecom- 63. Often information about existing facilities. position to reflect the "multiple jeopardy- affect- programs. and services is withheld from blacks in ing inany aged blacks. various ways. necessitating thereb a need to in- 69. All levels of government should provide crease information flow to blacks through prime financial resources to black organizations capable television-viewing hours for older blacks. churches. of pros Wing more efficient servicesto black aged and other existing andnew black communicative than thOSe they now receive. networks. 70. Greater emphasis should he placed upon 64. Considerableoutreachtomakeolder the responsibilities of the private sectors for meet- blacks feel comfortable in using facilities,pro- ing the needs of aged blacks. grams. and services from which they were. or 71. The Federal Government should act imme- would have been, excluded during most of their diately to bring about significant changes in unde- lives because of racial segregation is needed. Si- sirable housing conditions of aged-1)13(:s: and all multaneous efforts should he made to estabhsh fa- Federally-approved homing in which aged blacks cilities. programs. and services amidst the commu- reside should he equipped with necessary mecha- nities where black aged reside. nisms to ease their lives, including telephoneserve 65. The Federal Government, on continuing ice where their own incomes prevent the purchas- basis, should require all new and existing facili- ing of that service. ties for the aged. includ'ng housing. to report- the 77, More seed monies should be givento extent to which they will and actually are serving national and regional black organizations inter- minorities. Facilities with poor records should be ested in the aged so that they can develop viable required to implement meaningful affirmativeac- program networks. such organizations should in- tion programs or lose their Federal funding. clude. but not necessarily he limited to, The Na- 66. A majority of the rticipants were cogni- tional Caucm on the Black Aged. The National zant bodi of the need for facilities. programs. and Urban League (as is presently thecase with cer- services for aged blacks and the needto refrain tain fundings this organization has alreadyre- from unduly emphasizing thoseareas at the ex- ceived), black fraternities and societies (suchas pense of providing sufficient incomes to black t/0aKappa /1/pha Paz and Delta Sigma Theta). Na- aged who, in turn, could he effectiveconsumers llo,mal and Nursing Ilinnt limployeel. of available programs. services, and facilities. The Union and The Nationa1 Committee of tendency was that of emphasizing greater selectiv- Black Churchmen. ity or choice by aged blacks. as opposed to more 73, Information about existing granting pro- current practices where many aged blacks have grains and all new granting piograms should be almost no option other than that of beingat the mailed periodically to major black organizations mercy of those providing services. by the appropriate Federal agencies.

187

4. '1 Thc.Federal Go% eminent should ensure should he meaningfulh imoled in planning and that blacks arc adcquatclt icprcsentcd at all polic- planning implcmcntation. but they should nut be lecei And in Ali stall positions in al; of its agencies brought in merely to rubbcrstamp the plans of and inits counterpart State agencies (such as a others. The% should not he brought in after plan State agent% on aging). Black represent.nion in ning has been completed. They should nut be torle%el administration. on review committees. brought in without anauthorit) to participate in and as principal investigatOrs of research projects planning anditsimplementation. Th(rtdo.d or directors Of demonstration pat grams involving Girdawnew rind( rrtrit, linam:totc ughII any significant number of aging and aged blacks h ipat I( b thi,4tdr(L'tli- is imperative. t unduhhandl, apped when /num.)" (Pa- k,ipatIN! isrequin if Mon in tit, b ;tail-r'es :Is those leading to and including the \N'llite House Planning. Conference on Aging. Most black national orga- 75. Since planning is so critical. comprehensive nizations lack the necessary financial base to per- and wel.-integrated planning for aging and aged 1111: such participation. blacks atalllevelsis urgent. Aging and aged blacks must lw effectively involved as planners and as those who 'plan the planners." Such plan- Research. Downistration._and Training ning should be designed to reduce drastically rac- 79. At least 12 percent of .111 Federal funds al- ism. pmer'v. and ignorance and ant planning for located fur research. demonstratio_ and training as opposed to u h --blacks. Blacks must also in aging and in related fields (e.g.. medicine, den- be effectivel imol-zd in planning. planning im istr. sociology, psychology. social work. ph%siol plementation, and planning evaluation of a "Na- ctonomits. and religion) in .any and all fiscal tional Policy on the Aged." years during the next decade, and beginning with FiscalYear1972. should be specificallyear - 76. Older blacks should be significantlyin- oled inFederal- planning- of the delivery and marked for blacks. utilization of sort ices.including integrated ap. 80. Given the great difficulty often experienced roaches to community services and IISCA Of public in obtaining adequate data on aging and aged facilities. Federal -regulations pioviding gukidincs blacks. and especially those S5 years of age. for implementing Federal le,!islation should in- from Federal statistical sources such as the l'.S. chide rcquired guidelines for establishing and lo- Bureau of the Census of the National Center for cating programs, sei vices, and facilities in areas Health Statistics, those agencies should increase of ready access to black aged. substantially their sampling sizesinallfuture data collections from okler blacks. Such an in- 77. Since housingisacriticalproblem for many blacks. the Federal Government should en- ,:rease--at the very leastwould permit various force more fullyits anti.discrimination laws in multivariateanalysesofdatafurthering our housing. increase its efforts to provide standard knowledge and wide, standing of aging complexi- housing in all geographical areas. eliminate subtle ties (such as the social, psychological. and biolog- discriminatory realestate and other practices ad- ical processes) among blacks. Data about blacks versely affecting blacks as far as possible, and. should he reported in categories specifically con- above all. upgrade immediately the housing occu- fined to blacks as opposed to a customary practice of collapsing blacks and other nonwhites. Many pied by it )st aged blacks. similarities may characterize blacks and other non- 78. Planning and panningimplementation whites, but their differemr:s also deserve greater bask e upon this Session's rewminendations and recognition, such as the implications of recent emanating from the \X'hite House Confer- census data indicatingithigher median educa- ence on Aging and pertinentto aged blacks tional level among blacks than among Mexican- lhould be followed up with swift action in terms Americans, but a higher median income level ofshort-rangeandlong-rangegoals.Blacks among the latter than the former (w hich may be

188 partially explained by the greater concentration of United States, such as at Duke University, Uni- Mexican-Americans in the West and the generally versityof SouthernCalifornia,Universityof higher income level of that region as compared Michigan-Wayne State University, and Washing- with remaining U.S. regions, and particularly the ton University (St. Louis). South). 85, 'While we do not support the development 81. The paucity of adequate data on black of separated, isolated programs from the geronto- aged should be rectified by the development of ad- logical and geriatric mainstream, and while we do equate gerontological research on -black aged in support pluralistic incorporation of blacks at all basic and applied areas, including longitudinal re- levels in existing gerontological and geriatric pro- search. Hence, we support proposals to establish a grams of high calibre (where curriculum revisions National Institute of Gerontology (two of whose are needed to ensure training pertinent to various major functions would be basic research and aged subcultures), we also believe that certain graduate training support) provided that itcon- black colleges should be funded 'sufficientlyto tain a Division of Black Gerontology controlling trainstudents and, where needed,facultyin approximately 30 percent of the total Institute aging. Especially useful would be the integration funds. Failing that -we urge the establishment of a of aged curricula into existing curricula. Four FederallyfulitledNationalInstitute of Black such institutions which we feel should be funded Gerontology. Until such time as either of these should they so desireare Florida A. and M. two Institutes becomes a reality, we urge all exist- University, Tuskegee Institute, Texas Southern ing Federal and private agencies to provide basic University, and St.Augustine's College, since and applied research funds for black aged research. those institutions are strategically located with re- 82. Basic research is urgently needed to iden- spect to the aged and have, or can readily de- tify more satisfactorily variables inducing prema- velop, adequate resources -for such programs. We ture aging and death among black males, as seen do not believe that undergraduate majors should intheir significantlyshorterlifeexpectancies. specialize in gerontology, but that feasible Asso- This concern can be extended-to other vulnerable ciate of Arts degree programs could be developed minority groups, so we urge the initiation of stud- at the aforenamed institutions. ies designed to identify factors contributing to such vulnerability and practical action upon the 86. M this time, we strongly recommend that emergent findings. three black institutions should offer a master's degree program in gerontology or a disciplinary or 83. We recommend strongly a significant in- interdisciplinary-based program with a concentra- crease in trained professionals and paraprofes- tion in gerontology. These three institutions are sionals in gerontology and geriatrics as related to Atlanta University, Fisk University (where there black aged, which could be readily facilitated by is now an existing program funded by the Ad- allocating training funds at least proportionate to ministration on Aging as of 1971), and Howard our representation in the population to blacks for University, since all three are strategically located, these purposes, as suggested in #79 above, with with respect to facilities, personnel, resources, and the understanding that at least does not implya since a considerable portion of black aged fall quota system suggesting no less than, nor any within their immediate or long-range geographi- more than that entitled to by proportionate repre- cal arm. sentation. In other words, much more than 12 percent of allocated funds for training could be 87. We recommend that the Adult Aging and used to develop black professionals andparapro- Development Branch under the National Institute fessionals. of Child Health and Human Development notre- strict its training funds to doctoral programs, but 84. Students enteringprofessional programs under special circumstances, release training funds should be disciplinary based, and they should be on the master's degree level to Atlanta, Fisk, and encouraged to train in the best programs in the Howard Universities should they so desire.

189

468.218 0 73 14 88, We urge the Administration on Aging and SECTION TWO itsparent body, the Social and Rehabilitation Additional Recommendations Service under the Department of Health, Educa- tion, and Welfare, to reconsider the feasibility of and Background Information providing inadequate funds,.as was done in 1971, to -six black institutions for gerontological or ag- Additional Recommendations ing-oriented programs, since our careful analysis The following "additional recommendations" of that situation strongly suggests Federal partici- constitute those which were developed subsequent pation in "programming forfailure."Iithe to the Special Concerns Session on Aging and long-run, programming for quality instead of pro- Aged Blacks, but which have received sufficient gramming for quantity will be of greater value. support to warrant their inclusion in this report. Thus, we recommend careful consideration by the Administration on Aging in its funding patterns 92. A black Technical Advisory and Assistance in aging to black colleges and universities insuc- Team should be established to function as "link" ceeding years of its operation. agents in aiding blacks interested in developing programs, facilities, and services for blacks and in 89. Since we have not been able to obtain data aidingnonblacks concerned about developing on the precise nature and extent of black partici- such programs, facilities, and services. The Na- pationindemonstrationprogramsFederally tional Caucus on the Black Aged has no staff and funded, we urge that all Federal agenciesso in- has insufficient monies to handle effectively the volved, such as the Office of Economic Opportu- innumerable requestsit has received for assist- nity and the Administration on Aging, provideus ance. The Federal Government, with the advice with information about those programs withina of or through The National Caucus on the Black period of 3 months following the publication of Aged, could set up that team by underwriting its this final report. Desired data include thenum- financial support for an initial period of at least ber, nature, and locality of programs and thepro- 5 years. If this proposal is feasible to the Federal portion and roles of black administrators, staff Government, Federal assistance in developing and personnel, volunteers, clients, and other partici- funding proposals would be greatly appreciated. pants. We are especially concerned about the lack of evaluation of theseprograms and recom- 93. We strongly recommend that all such Con- mend strongly, outside independent evaluation. ferences include a specific and separate Session on The specific area of evaluation with which weare Aging and Aged Minorities within such Confer- concerned is the effectiveness of the programs for encesandpayespeciallycloseattentionto aged blacks. problems confronting persons over and above those merely associated with aging. The initial 90. We strongly recommend the establishment oversight in omitting a specific focus upon minor- of a single Federal agencyas an umbrella for all ity group aged should not be an oversightor de- Federal programs concerned with the aged, and liberate omissionin follow-up conferences and under which a National Institute of Gerontology action. At the very least, most State follow-up might be housed. Representative black participa- conferences should include a Section on Aging tion at all levels is a sine qua non. and Aged Minorities and a Section on Special 91. Certain current practices of various educa- Concerns from the remaining Special Concerns Sessions. tional institutions of higher learning, whereincon- sideration is given to lower-income black students 94. The National Caucus on the Black Aged or potential students at the expense of middle- wishes to express its appreciation to Dr. Arthur income students or potential students, shouldnol Flemming for his capable handling of many as- operate in selecting students for gerontological or pects of the White House Conference on Aging geriatric training. That is, the best qualified black and for the cooperation he extended to us in a students should be selected, irrespective of their variety of ways. His leadership and his sensitivity socioeconomic backgrounds. towards all aged were and are remarkable.

190

cs Background Information over the past decade. In general, increasing difficulties older blacks are experiencing in obtaining Considerable background information was in- and maintaining employment at evenyounger fused into deliberations leading up to and includ- years points towards at least the need to redefine ing the Special Concerns Session on Aging and old age for retirement benefits for blacks. Provi- Aged Blacks so as to facilitate policy develop- sions are needed both for adequate retirement in- ment already limited by insufficient available data comes for retired blacks and for employment op- on black aged. Since various responses may be portunities for those now forced to retire while made to our recommended policies by persons not they arestillemployable. Black heterogeneity having the opportunity to deliberate with us, se- should be considered in developing employment lected background information is presented below and retirement policies. Blacks need more prere- so as to provide greater insights about some of tirement programs and, of course, more adequate our critical concerns. retirement provisions. Education: Some elderly blacks denied sufficient access to formalized education intheir formative Physicaland MentalHealth:Widespread years who now wish to further their education awareness of racial discrimination in the area _of can benefit from additional education by continu- health precludes any need to document it anew in ing to improve their coping skills and techniques this report. Often, black medical and dental care for functioning in today's technologically chang- is negatively affected by such factors asrace, ing world. Any number of older blacks could socioeconomic status, scarce health personnel in well welcomemeaningfulcoursescentered black communities, and disrespect to blacks by around hobbies, death and dying, and wills and health-care personnel. Many blacksshunted off estate management. The educational needs of to the least prestigious health facilities (e.g., pub- aging blacks (i.e., those not yet old) should be lic clinics or public health departments largely de- emphasized by placing stress upon substantial pendent upon public health nurses) or to sub- qualitative and quantitative education available standard State mental institutionsreceive for younger blacks. Further, significant upgrading inferior health care. Black morbidity and mortal- ineducational"pay-offs"foryoungerblacks ity rates readily attest1,,racial discrimination. should occur -in occupation, employment, and in- Diseases dispror,,onately typical of blacks re- come, and especially so for many blad: females_so ceive considerably less research, curriculum, diag- as to reduce the significant amount of economic nostic, and treatment focuses than those typical of dependence now characteristic of old black fe- whites. Reduction ofracialdiscriminationin males without spouses. health care should result in improved health care for aging blacks, including greater availability of Employment and Retirement: Most aged blacks health professionals and greater access to medical have been active within the labor force, most consultations via telephone, as well as a decrease often in the lowest occupational levels at poverty- in black mental illness primarily induced by rac- level wages. Thus, many black aged have been ism. In the years ahead, much greater attention in poverty throughout their lives. Some remain in must be given to the health care needs of aged the labor force after age 65 years (in 1970, about blacks since it is quite likely that aged blacks in 24 percent of the males and 13 percent of the fe- the future may not be as healthy as aged blacks males were still in the labor force) primarily to in the past. In addition, blacks are increasingly re- supplement meager incomes or,less often, be- garding health care 73 a right and such an atti- cause they hold professional employment where tude is likely to he accompanied by a greater de- mandatory retirement occurs beyond 65years. A mand for service. number experience involuntary retirement atage 65 years or even earlier. Labor force participation Nursing Homes: Researchis needed on the by aged black females has increased slightly and availability and use of nursing homes among that of aged black males has decreased slightly blacks. More physically attractive, weli staffed,

191 and efficient nursing homes are needed for blacks. majority of the HUD tables, such as in the data The likelihood of greater prevalence of infirmities presented on institutionalization. Omitted from among black aged in the future suggests rising in- Table 4 was information about blacks occupying stitutionalized rates or at least the need for insti- owner and renter units, and subsequent tables tutionalization among them. Present planning is concerned with that variable were restricted pri- needed for those currently requiring but unable to marily to husband-wife families, although a large receive institutionalization and for those needing proportion of black aged no longer reside in hus- institutionalization in the years ahead. Among the band-wife families, due principally to the death manifest problems preventing adequate institu- of their spouses. tional facilities for black aged is the Federal Gov- ernment's failure to provide sufficient seed and Racial information on husband-wife occupied maintenance monies to black, nonprofit nursing housing units by plumbing facilities and persons homes, so that they can develop and maintain sat- per room was useful, but the omission of such isfactory physical, medical, and social services. data on spouseless household heads among blacks Governmental funding should make available was significant since substandard housing is prob- planning grants, 100 percent capital financing, ably more severe among the latter than the for- and operating costs on the basis of the fullcosts mer. That omission tended to mask the critical of care and services provided. housing conditions of many black aged. Housing: As already noted, substandard housing The failure to report income data by race in affects three out Of every four black aged. They Tables 9-11 was highly significant since, as afore- may not have hot water or bathrooms with stand- mentioned, racial gaps in aged income widened ard safety provisions for the aged. Theymay between 1959 and 1969. In all probability, many have drafty houses and broken steps, andso on. Conference Delegatesand especially those in Incomplete 1970 Census housing profileswere the Income and the Housing Sectionsmay not available at the time of this Conference, and ef- have been aware of those racial differences in forts by The National Caucuson the Black Aged income. If they had had available data, some of to obtain all relevant housing data from the 1970 their policy recommendations might have been Census-were largely unsuccessful. modified or structured differently. Ingeneral,the monograph on Population, Housing, and Income, and Federal Housing Data were not provided about Department of Programs (U.S. Department of Housing and Housing and Urban Development housing loans Urban Development) distributed to Conference to black nonprofit groups or about the extent to participants, was of scant help in providing which such groups had sought loans. Norwere we us given data about the total proportion of blacks in with a relevant profile of housingpatterns and, conditions among aged blacks and of changes each State'S aged population, so, as in Table 19, over the past decade. Without quibbling about we could not determine if aged blacks were underrepresented, equitably represented, or over- the failure to capitalize the propernoun Negro in represented in low-rent public housing. that report, we can point out severalgaps. Racial presentations of data should consider differential No racial breakdown was presented in Table group aging. Based upon that assumption, and 43 on monthly charges per beds for patients in since blacks become old atan earlier chronologi- FHA Nursing Homes by Type of Accommoda- cal timepoint than whites, dataon blacks 55 or tion. We could infer that very few blackswere more years of age would have been more useful accommodated since only about seven percent had than that merely on those 65-ormore years of monthly costs under $300, but we were not able age, as presented, e.g., in Table 1-S of the HUD to assess the validity of that assertion. Also, ra- report. Since there are sex differences among cial distributions by type of room (i.e., private, blacks (such as lower median incomesamong fe- semi-private, or ward) and locations in each State males than among males), presentation of data were omitted. Such data could aid in assessing use by race and -sex would have been useful in the of nursing homes by blacks.

192 Data omissions indicated above and similar whites and that blacks tended to define them- ones could be made available to us by the U.S. selves as being old at an earlier chronological Bureau of the Census and by Department of point than did whites, Jackson proposed that Housing and Urban Development. Amore sys- "The minimum ageeligibility for retirement ben- tematic review of that monograph may also result efits should be racially' differentiatedto reflect in more suggestions for future data collection, present racialdifferencesinlife expectancies." analysis, and interpretation fromus. The making The acquisition of additional supporting data, available of all pertinent housing data collected such as Robert Morgan's 1968 hypothesis that by Federal agencies on blacksas well as informa- body age proceeds ata faster rate among black tion on Federal housing programs for the aged to than among white adult males, led her to refine national black organizations, including churches, that proposal, and a petition signed bya number may be useful in stimulating greater black partici- of North Carolinians was forwardedto President pation in aged housing developments. Richard M. Nixon in December, 1970, requesting that consideration be given to modifying the min- Income: In listing their most critical needs, most imum age-eligibility requirements for OASDHI black aged cite income first, a priority validated retirement benefits through racial differentiation by income data on aged blacks, and particularly reflecting present racial differences in lifeexpect- so in the case of aged black females whose in- ancies, so as to reduce the discriminatory gaps in comes are generally even lower than that of aged earned benefits which now occur. black males. While many poor black aged display extraordinary functional skills in budgetmanage- Greater awareness of this proposal hasgener- ment, every effort should be made to improve ated issues pertaining to the historicalcoverage of their low incomes. black workers under social insurance and demographic factors related to black aged, the ethicity The proposal to reduce minimum age-eligibility and/or feasibility of excluding other significant requirements for black male primary beneficiaries minority groups from the initial proposal, the of OASDHI received overwhelming support in specific fact that black beneficiariesmay tend to the Special Concerns Session on Aging and Aged receive proportionately more benefits as compared Blacks, but the Income Section of the Conference with payments than do white beneficiaries, and failed to provide majority approval. Given the refinement of the specific proposal by includinga controversy this proposal may have aroused, some more precise specification of the methodology to background information on itmay be helpful in be employed in determining raciallydifferen- mobilizing additional support. tiated, minimum age-eligibility requirements. The background information presented below This proposal focuses upon social insurance to was extracted from Jacquelyne J. Jackson's "Aged which workers contribute payments throughpay- blacks: a potpourri in the direction of the reduc- roll deductions. Most blacks with inadequateor tion of inequities" (Ph/on, 32:260-280, 1971). with no coverage under OASDHIare those effec- In 1967, Herman Brotman notedanew that, on tively excluded by the Social Security Act of 1935, the average, nonwhites lived feweryears than which exempted especially agricultural and casual whites. For example, lifetable values at birth in laborers and private household domestics (occu- 1900-1902 showed that nonwhite males couldex- pations held by most employed blacks). In 1940, pect to live 15.7 years less than white males, and domestics employed in club, fraternity, andsoror- nonwhite females 16.0 years less than white fe- ity houses on college campuses were also specifi- males. Corresponding data for 1959-1961were cally exempted from coverage. The Acts of 1950 6.1years fewer for nonwhite than for white and 1954 finally extended coverage to most agri- males and 7.7 years less for nonwhite than for cultural laborers and domestic workers, withvary- white females. ing degrees of effective enforcement. Currently most employed blacks are covered by OASDHI, In 1968, based upon observations thataverage but a disproportionate number of old blacks must life expectancy was shorter for blacks than for yet rely upon Old Age Assistance, although had

193

.03-71n 0 73 1$ coverage been extended to them earlier, there ing minimumage-eligibilityrequirementsfor we been less relianceupon OAA. OASDHI recipients from 1972 through 1981; Relevant data reveal that significantly fewer 1920 data for 1982-1991; and so on. 'What is black than white males live to reach the present most critical is that differential age requirements minimum age requiredfor primary beneficiary by race shouldbe effected until such time as no status for OASDHI. In addition, the trend of de- significant life expectancy differences distinguish clininglaborforce participation among older blacks and whites. . black males especially points toward the need for A memorandum from Lawrence Alpern, Dep- establishing other income sources at earlierages. uty Chief Actuary, Social Security Administration, Clearly no significant decline in povertyamong dated 23 November 1971, to the Advisory Coun- black aged occurred over the past decade. Thus,_ cil on Aging and Aged Blacks to the U.S. Senate demographic data support the feasibility of the Special Committee on Aging, provided cost esti- proposal. mates for full-ratebenefitsfor OASDHI for black males, beginning at age 58 years. Assuming The overriding emphasis upon black malescan that the proposed change would apply to be justified on any number of grounds. While all- black males qualifiedas many gains sought by blacks accrue to other mi- retired workers, hus- nority groups as well, black demands for black bands, widowers, or parents, and to all dependents of insured black males 58-F years of age, that the aged should be regarded as legitimate demands in benefits of dependents and survivors eligible for their own rights. But this proposal could be readily expanded to include other minority males same would increase since average monthly earnings would be based on the terminal age of 58 whose racial statuses adversely affect their longev- years, and that the proposed change would apply ity. to beneficiaries cn the rolls as well as to future It is often assumed that black OASDHI pri- beneficiaries, "additional benefit payments in the mary beneficiaries tend to receive proportionately first full year are estimated- to total $400 million, more benefits (as compared with actual contribu- over and above benefit payments under present tions-to OASDHI) than do whites. The factsare law. Of this amount, an estimated $,I80 million otherwise. A significantly larger proportion of would be paid to persons receiving benefits for black male contributors to OASDHI die before the first time, and $220 million would be-paid to reaching the minimum age for receiving primary persons receiving benefits under present law." benefits than do their white counterparts. Thus, Even though this estimate-may be higher than ac- they are denied an equal probability of receiving tual costs required to implement the proposal, as benefits over time. More important is the fact compared with the income needs and unemploy- that, on the average, blacks pay proportionately ment rates of many older black males, the imple- more of their earnings -into OASDHI than do mentation coseis.relatively low. whites. Thus, this proposal can be supportedon the basis of greater proportionate contributions Nutrition: Many Session participants, enraged by among blacks and greater disproportionate receipt hunger among black aged and by degradation of primary benefits by blacks than whites. Racial they suffer in seeking food stamps and commodi- disparities can be reduced by utilizing raciallyap- ties when exposed to insensitive and inefficient propriate life expectancy data for blacks and for personnelin those programs, urged immediate whites. improvements in ending hunger or meager food supplies for those so affected. Preferably black While further methodological refinement of aged should have incomes permitting them to this proposal may be needed, the Federal Govern- purchase their own food, but until that goal is re- ment employs technicians capable of making such alized,theU.S.Department ofAgriculture refinements. The base for determining racial dif- should improve its distribution of food stamps ferences should be established at birth. Then and commodities and should provide The Na- 1910 racial life expectancy data at birth could be tional Caucus on the Black Aged with a detailed employed as the baseline standard for determin- report on- food distribution patterns to black aged

194

L "Ow no later than 3 -months following the publication Transportation,Programs,Facilities,and of the final report, with periodic reports thereaf- Services: Major factors hampering recommenda- ter on at least an annual -basis. Also needed are tions revolved around insufficient data about the research studies on dietary patterns of blacks and current statuses of aged blacks as personnel and their relationships to such factors as longevity. users in these areas. While geographical variations abound, transportation problems most often men- Retirement Roles and Activities: Scant data are tioned included no public, or inadequate public available, but, given widespread poverty among transportation. in a number of areas; inconvenient black aged, most of their retirement roles and ac- public transportation during the day, on holidays, tivities are probably centered around income sup- arid on week-ends; high fares and, in some cities, plementation, informalactivities withrelatives exact fares for public transits; and great distances and neighborhood friends, and sedentary activi- prohibiting walking between homes and site loca- ties requiring relatively little monetary expendi- tions of needed services, such as grocery and drug tures (e.g., television-viewing or "just sitting and stores. Other problems involved inordinate time thinking"). Church activities, typically attendance lapses between calling for and the arrival of taxi- at Sunday morning services, characterize some cabs in major cities, and particularly those where but not all. Those without well-established pat- some cabdrivers may be reluctant to work in cer- terns of church participation and those experienc- tain neighborhoods, which unfortunately may also ing difficulty in attending church (due to such be those neighborhoods in central cities with a factors as poor health or inadequate transporta- fairly high concentration of black aged. Use of tion) could be excluded. While many grandmoth- programs by many black aged is adversely af- ers. especially may enjoy babysitting with grand- fected by their inaccessibility, long waiting pe, children, most feel that child care should bea riods ("and come back tomorrow" philosophies), parental responsibility. Thus, greater support for et cetera. The National Caucus on the Black higher income levels and other factors permitting Aged urgently needs good data on these areas. less reliance upon older blacks for grandparental Federal agencies and State agencies could aid by care is needed. Opportunities for increased social making those needed data available. - interaction with others of varying ages would probably be welcomed. GovernmentNon-Government Organization: One factor contributing to extremely low black The greatest concern of many Session participants utilization of existing senior citizens centers is the was the failure of the White House Conference failure of those programs to meet their needs. on Aging to test the validity of what was, in fact, Many reject such centers. Critical program evalua- an invalid assumption: namely, that financial and tion of such centers may provide more important staffing resources of national black organizations rationalizations than those commonly proffered, equaled those of white organizations. Thus, most such as black ignorance, in explaining these low national black organizations had insufficient re- utilizationrates.In other words, many centers sources for participatingin- the White House need to reexamine carefully their programsso as Conference on Aging. Additionally, concern was to isolate program factors rejected by many black expressed by the significant omission of such aged. black national organizations as the National Med- icalAssociation, the National Dental Associa- Spiritual Well-Being: Major concern focused upon racial discrimination in religious facilities tion,the National Pharmaceutical Association, for the aged and in local religious programs for Kappa Alpha Psi Fraternity, Inc., Omega Psi Phi the aged. Emphasized was the need for increased Fraternity, Inc., Phi Beta Sigma Fraternity, Inc., Federal support to aid black churches in develop- the National Hospital and Nursing Home Em- ing programs and facilities for the aged. Anum- ployees Union #1199, and the National Associa- ber of instances of racial discrimination in reli- tion of Black Social Workers as invited partici- gious facilities and programs for the aged were pants until The National Caucus on the Black cited. Aged specifically pointed out these omissions and

195 urged the extending of invitations to them and explainable by the usual myth of the dearth of other national black organizations. qualified blacks for such positions, can be im- Great concern focused on inadequate black proved immediately by adding more blacksto staff and board representation on State agencies such agencies, with representative distribution on aging. This undesirable situation, not readily across the board.

Roster of the Planning Committee

7 Chairman: Hobart C. Jackson, Chairman, The Na- tionalCaucus on the Black Aged, Philadelphia, Nongovernment Pennsylvania Jay Chunn, Member, National Association of Black Social Workers, New York, New York Government Dr. Jacquelyn J. Jackson, Secretary, The National Shirley Bagley, Health Scientists Administrator, Adult Caucus on the Black Aged, Philadelphia, Pennsylvania Development and Aging Branch, National Institute Jeweldine Jones Londa, Associate Director for Social for Child Health and Human Development, National Welfare, National Urban League, New York, New Institutes of Health, Department of Health, Educa- York tion, and Welfare; Bethesda, Maryland Alfreda Hoeber, Office of Contract Compliance and Dr. James Ralph, Member, BlackPsychiatristsof Equal Employment Opportunity, Office of the Assist- America, Los Angeles, California ant Secretary for Equal Opportunity, Department of M. Wilhelmina Rolark, Assistant Secretary, National Housing and Urban Development, Washington, D. C. Bar Association, Washington, D. C. Calvin Nophlin, Project Coordinator, Project Evalua- tion by Summer Interns, Office of Special Concerns, Rev. J. Metz Rollins, Executive Director, National Office of the Secretary, Department of Health, Educa- Committee of Black Churchmen, New York, New tion, and Welfare, Washington, D. C. York Frank M. Stewart, Technical Staff Assistant, White Melvin Turner, DeputyDirectorfor Operations, House Conference on Aging, Washington, D. C. National Welfare Rights Organization, Washington, Fredricka Williams, Director, Office of Service Deliv- D. C. ery, Community Services Administration, Social and Dr. Robert D. Watkins, Executive Vice President for Rehabilitation Service, Department of Health, Educa- Administrative Affairs, National Medical Association, tion, and Welfare, Washington, D. C. Washington, D. C.

196 THE ELDERLY INDIAN

r°'°12 he Special Concerns Session on The Confederation, the Inter-Tribal Council of Cali- Elderly Indian was requested by the fornia, the Association on American Indian Af- f National Congress of AmericanIn- fairs,the National American Indian Women's dians. The Navajo Tribal Council, the Association, the National Indian Physicians' Asso- National Council on Indian Opportunity,the ciation, the Dallas American Indian Center, and American Indian Movement, and the National the National Indian Law Students' Association Tribal Chairmen's Association accepted invita- were some of the organizations that sent repre- tions to participate in planning this Session. Fed- sentatives to the Session; eral agencies that named representatives to the Planning Committee were: the Departments of Many of the Delegates who attended this Ses- Health, Education, and Welfare, Housing and sion had participated in one or more of the regional conferences on The Elderly Indian (confer- Urban Development, and Interior; the Office of Economic Opportunity, and the Senate Special ences were held for the Northwest, the Southwest, and the Southeast), and many of these Delegates Committee on Aging. were acquainted with the comprehensive report of Because of the desperate economic plight of the the Indian Advisory Council to the Senate Special American Indian and because there exists a-unique Committee on Aging. In short, many of these relationship between the Indians and the Federal Delegates came tothisSessionwithawell Government, it was felt that this Special Concerns grounded understanding ofthescope ofthe Session would be important ifthe Conference problems to be discussed and specific suggestions were to address itself to the needs of all segments about needed changes in national policy on aging of the older population. The recommendations and The Elderly Indian. presented can bean important component in our national policy on aging. The Program The-Participants In order to provide for maximum in-depth at- Eighty-two Delegates preregistered for the Ses- tention to several important areas of concern for sion on The Elderly Indian but they were joined elderly Indians, the small work group format was employed as an important part of the program. by other Delegates, observers, and invited guests, The Session was, essentially, divided into three so that the estimations of space had to be consid- parts. The opening part was organizational and erably altered and additional facilities made avail- was to serve as a very brief orientation to the able. Only official Delegates were permitted to Delegates' role for the Session. During the second vote on recommendations although the discussion part of the meeting, the Delegates were divided of the recommendations was open to all who were into five work groups which were asked to discuss present. and develop recommendations within the topical The majority of those Delegates who chose to area assigned to their group. The five groups dealt attend this Session were themselves American In- with (1) Housing and Related Facilities,(2) dians. Thcy were from several different Indian Legal Problems of the Elderly Indian, (3) Spe- Nations including Apache, Blackfoot, Cherokee, cial Health Problems of the Elderly Indian, (4) Choctaw, Comanche, Iroquois, Makah, Mohave, Spiritual Well-Being and Recreation, and (5) Navajo, Pueblo, Seminole, Sioux, Ute, and others. Income (including Employment, Retirement, Edu The Alaskan Federation of Natives, the Iroquois cation, and Training). 197 The third part of theprogram called for the to the entire Session for further discu4sion and work groups to present the results of their work adoption.

1971 WHITE HOUSE CONFERENCE ON AGING C. Special Health Problemsof Elderly PROGRAM Indians Chairman: JOE EXENDINE, ActingDirec- THE ELDERLY INDIAN tor,Office of Program Planning,Indian Health Service Presiding: FRELL OWL, Former Chairmanof Recorder: DAVID VALLO,Community Or- Planning Board for the Eastern Bandof Chero- ganization Specialist, Inter TribalCouncil of kee Indians; Member, National PlanningCommit- California tee of the White House Conferenceon Aging D. Spiritual Well-Being and 8:00 Recreation Opening Chairman: EARL OLD PERSON, President, Na- REVEREND SCOTT RED- HOUSE, Aging Committee, NavajoTribal tional Congress of American Indians Council 8:30Working Groups Begin Recorder: JAMES PETEROLSEN, Guber- natorial Delegate, State of Alaska A. Housing and Related Facilities E. Income Chairman: ROBERT McLAUGHLIN,De- velopmental Planner and Architect, Standing Chairman: CLAY GIBSON, Director,Choc- Rock Sioux Tribe taw Community Action Agency Recorder: IRENE CUCH, Member,Standing Recorder: RONALD MOORE,Assistant Di- Rock Tribal Council rector, Arizona Affiliated Tribes, Inc.

B. Legal Problems of ElderlyIndians 10:30-7Break Chairman: VIRGIL KIRK, ChiefJustice, Navajo Nation Judiciary 11:00---Presentation of Work Group Recorder: ELWOOD SAGANEY,Chairman, Reports for Discussion and Voting AlcoholismSubcommittee,NavajoTribal Council 12:00 NoonAdjournment THE SESSION REPORT

Introduction Recommendations The American Indian and Alaskan Native Dele- gates (hereafter referred to as American Indian) to this White House Conference on Aging, No- The Indian Delegates also identified the fol- vember 28December 2, 1971, appreciate the op- lowing issues and have made the followingrec- portunity we have been given to participate in ommendations. developing a national strategyin coping with problems of the .aging. Our elderly citizens face Income similar problems to those of other Americans. Issue: The elderly Indian citizen should have an However, due to the unique relationships between income which would permit him to live the rest our people and the-Federal Government, we also of his life in health, decency, and dignity. have unique problems. The Indian Delegates to this Conference support those issues and recom- Recommendations mendations which will ultimately benefit all older 1. Because of the past relationships between the Americans. Federal Government, through the Bureau of In- dian Affairs, and the Indians, most ofour people The Indian Delegates have outlined five gen- did' not participate in retirementprograms such eral areas where immediate action must be taken: as: company retirement plans, insurance plans, 1. The United States must reassure our elderly investing in- income propCrty and, inmany cases, citizens that the policy concerning termination Social Security. Therefore, the sole source of inis no longer a national policy. come for many of the elderly is welfare and for those fortunate enough to reach 72, Social Secur- 2. That an adequately staffed and funded In- ity at the very minimum level. The elderly Indians dian desk similar to Indian desks in other Fed- must be permitted to work and earn income for as eral agencies be established in the Administra- long as they want or are able. They should not be tion on Aging or its successor. This office would act as a central point for information and an required to forfeit parts of other benefits when continuing to earn. advocate for the needs of the Indian elderly. 3. That sections 303 Part (a) and section 612 2. That the elderly and middle-aged Indian should be assisted in obtaining job information, training, of the Older Americans Act of 1965,as amended counseling, placement, and other assistance which November 1970, be revised so that Indian tribes would permit him to continue employment. These no longer have to go through State agencies for steps would enable him to qualify for an increased funding. This is necessary because of the lack benefit when he becomes eligible to receive Social of sympathy by most States for their Indian Security. population. All funds for older Indian pro-. grams should be funded directlytoIndian 3. That there be an equitable form of tax relief tribes. for the elderly Indian. 4. That agencies serving elderly Indians in- 4. That retirement plans be worked out in sucha crease funding levels to Indian tribes so as to way that there is a guaranteed pension, that it be adequately serve their needs. vested and with portability. 5. That a thorough and complete research pro- 5. That there be a Social Security "ALERT" to gram be developed tosearch, evaluate, and assure that all eligibles receive their entitlements. cause to be amended, existing laws and policies 6. That a Federal policy be established which governing programs serving the elderly Indian. would state that judgment funds are not to be

199 considered as assets or windfall, butrather the Recommendations due allotment and recompense for misappropri- 1. That on-site paraprofessional ated lands and rights. That this policyhe binding service staff be to all-State and local welfare agencies. made available to assist theelderly Indian. 2. That sufficient funds he provided for 7. That State public assistance departments adequate cease care for Indian individuals in custodialor nursing to press the elderly Indian to sell individualal- homes. lotted lands on reservations to meet their own 3. A systemof advocacy be established and subsistence needs, in view of the Indians'desire to retain the tribal homeland intact for further maintained for elderlycare. use in accord with President Nixon's rejection of termination as a Federal policy. Issue-3: Indian Senior Citizens havetoo little to say about the design, location, andconstruction 8. That Social Security benefits be extendedto all of their homes and othertypes of living facilities. male and female elderlyupon reaching the age Recommendation of eligibility regardless of theirparticipation dur- That full local participation of ing previous periods of employment. elderly individuals and organizations be assuredin the designing. 9. That separate funds be made availablefor the location, and construction of elderlyIndian Hous- establishment of specialmanpower programs de- ing projects. signed by and for elderly Indians. Issue-4: The allocation and actualapplication of 10. That manpower programs be designedto refunds for homes and other tain the people on or living facilities per near the homelands of the year is not sufficient to meet the needs ofthe elderly Indian. people.Lines of communication, coordination, and flow of existing funds 11. That these manpowerprograms be adequately are poor. There is need for direct funding funded to meet the employmentneeds of the to Indian groups. Indian aged. Recommendations 1. Funds should be clearly identifiedfor the elderly and should be made availablein sufficient Housing amounts to meet the-housing needs of the elderly. Issue-1: A large percentage of elderly Indian 2. That all organizations dealing withelderly In- dian projects have adequate people do not have sufficientincome to cover representation of elderly Indians on their decision-making housing and utility costs of existingprograms boards. along with the other necessities oflife. 3. Changes in Indian housing policy shouldnot be accomplished without consultation withthe Indian Recommendation people. That program policies governinghousing not be restrictive but adaptableto the elderly housing Legal needs and the financial conditionof individual Issue: The elderly Indian peopleare not normally Indian people, and wherevernecessary, no cost provided with legal services, therefore.many older housing should be provided. Indians are taken advaMage of becausethey are not familiar with legal matters. Issue-2: Some elderly Indian peoplelive alone Recommendation and are too incapacitated to live in existing pri- That legal services be made availableto the el- vate dwellings regardless of whether thehome is derly for the purposes of obtaining adequate and modernized. rights to Old Existing nursing homes Age Assistance, writing of wills,etc. These serv- and related facilities havenot taken into consid- ices should be made available eration the social and emotional in the local area needs of the rather than some far removed largemetropolitan Indian people. area. 200 Nutrition Issue 2. Indian Health Services are not governed by State regulatims, and nursing homesor shel- Issue: Most older Indians arc malnourished. This tered care facilities arc similar innature to Indian is the result of both an inadequate nutritional Health Service hospitals. education program and lack of familiar and nutritional foods. Present Federal food programs are Recommendations not designed to meet the nutritional needs of the 1. Federal funds should be made available diiectly elderly Indians. to Indian tribes or organizations for the design. construction. and operation of these facilitieson Recommendations the local level. 1, The U.S. Department of Agriculture and Office of Economic Opportunity must assist Indian tribes Indian nursing homes or shelteredcare facil- in developing a food program utilizing existing ities on _reservations should not haveany State controls imposed on them, but Federal regulations programsit as: commodity foods. food stamps. supplemental food, emergency food, and medical should govern these facilities similar to the Indian services to fit the particular nutritional needs of Health Service Hospitals. the elderly Indian people. 2. All Federal funds presently being allocated to Transportation existing nutritional education 'programs must be Issue 1: Because of the lack of transportation. funded directly to Tribal groups or organizations the elderly American Indian cannot acquire those to carry out the function of nutritional education necessities which would assure hima normal to elderly Indians. and healthy life. This denies him the opportunity 3. That allnutritional programs be adequately io obtain medical services. food, and clothing funded to satisfy the nutritional needs of the which are available to other citizens in the United elderly Indian, States. In addition. poor road conditions. lack of communication systems. absence of publiccon- veyances. and isolation compound the problem. Nursing Homes Recommendation Issue 1. Nursing homes or sheltered care facilities Funds should be allocated to assure elderly Ameri- are urgently needed by Indian people. However. can Indians of their transportation needs. One of due to present funding systems for such facilities. the ways the problem could be alleviated is by Indian people have very little chance to obtain providing the vehicles deemednecessary to over- these facilities. The following examples pinpoint come the existing conditions cited above. How- some specific problem areas. ever. each Indian tribe or organization should define its own transportation requirements fit (a) Some States refuse tolicense nursing to its respective needs. homes on reservations due to a question of jurisdiction and at the same time Federal funds will not be authorized unless the facil- Education, Physical and Spiritual ity is licensed by the State. Well-Being (b) Hill-Burton Funds are only made avail- Issue I. The social, physical. and spiritual well: able to States for these projects. The States being is a very important aspect of the American in turn establish advisory groups which dic- Indian. There are no funds available to finance tate the use of such funds. Most advisory well-rounded social or culturally-oriented activities groups arc composed of urban non-Indians for elderly American Indians. with little or no sympathy for Indian projects, thereby making nursing homes or sheltered Recommendation care facilities almost impossible to obtain by That sufficient funds be allocated for the elderly Indian people. American Indian to develop and assure thecon-

201 tinuance of activities which he deems importantto Issue 2. Medical services for elderly Indians hisphysical, spiritual and cultural well-being. are at best inadequate to meet their needs.Severalrea- Such activities might include, butnot be limited sons for the above arc: insufficient staffing, inade- to: quate health facilities, and seeming lackof con- (a) Clubs. such as social, sewing,cooking, cern by the Administration, which is ina position arts and crafts, recreation, and gardening. to determine funding levels. for Indian Health These promote good health and keepthe Services. elderly from becoming lonely anddepressed. Issue 3. Thbre is a lack of Indian professional (b) In some cases. educationaltype sessions medical staff to assist in upgradingmedical serv- might be desirable to fulfill thoseactivities ices to elderly Indian people. selected by the elderly American Indian. Recommendations I. That all health facilities beimmediately up- Health graded to meet the specific standardsof the Joint Commission of Accreditation of Hospitals. Issue 1. Indian people generally sufferdeplorable health conditions when comparedwith other races 2. That sufficient funds be allocatedto finance all in this country. This situationis compounded for aspects of health services soas to provide com- the elderly Indian people. Theseconditions are plete-health coverage. further aggravated by the lack offunds for dental 3. That educational grants be providedto-encour- prosthetics. hearing aids. eyeglasses,psychological services, etc. age individual Indians who wish topursue and complete professional healthcareers.

Roster of PlanningCommittee

Nongovernmcnt Government Fre II Owl (Chairman). Former Chairmanof the Clare Jerdonc, Principal Child Welfare Specialist. Planning Board for She Eastern Band ofCherokee Division of Social Services, Bureau of Indian Af- Indians; Member. National Planning Committee of fairs,Department of theInterior, Washington, the White !louse Conferenceon Aging, Cherokee, D.C. North Carolina Reeves Nahwooksy, Special Assistant, Office ofthe Henry Garnenez, Department Head, Departmentof Assistant Secretary for Equal Opportunity,Depart. Animal Husbandry, Navajo communityCollege, ment of Housing and Urban Development, Wash- Window Rock, Arizona ington, D. C. Richard La Course, Reporter, National Congressof Mary Steers, Chief of Categories Payment and Eligi- American Indians, Washington. D.C. bilty Branch, Assistance Payments Administration, Sojal and Rehabilitation Service, Department of Ronald Moore, Assistant Director, ArizonaAffiliated Health, Education, and Welfare, Washington,D.C. Tribes, Inc., Phoenix, Arizona Frank M. Stewart, Technical Staff Assistant, White Rodger Sandoval, Member, Indian AdvisoryCouncil House Conference on Aging, Washington, D.C. to the Senate Special Committeeon Aging, Wash. ington, D.C. Benjamin Yamagata, Staff Member, &mate Special Committee on Aging, Washington, D.C.

202 Reports of the Special Concerns Sessionson PROTECTIVE AND SOCIAL SUPPORT witep,, THE OLDER FAMILY

ver a year before conferees met in the In meeting the familial, marital, and sexual 1971 White House Conference on needs of the aging, the psychological, Aging, emo- anintensive campaign was tional,social,physiological, and environ- mounted to insure that, in their delib- mental aspects must be considered. erations, Delegates would give explicit attention to the familial and marital problems of the Illustrative concerns of this nature might in- elderly. To assuage fears that sucha topic would clude the following: not receive proper stress, Conference planners acknowledged that the family unitwas an es- 1. Relationships with grown children, grand- sential ingredient to the understanding andreso- children,agingparents,intergenerational lution of many of the elderly's needs anda factor needs which could not be overlooked in the development 2. Marital health and happiness of a national plan to meet the needs of older people. To insure that adequate attentionwas 3, Intimate interpersonal relationship includ- paid their concern, those who had waged the ing sexual fulfillment campaign were urged to involve themselves in the many different levels of Conference activities. 4. Bereavement, grief, and social adjustment to loss This challenge to participate was heeded. Sev- 5. Remarriage eral family life educators, for example, prepared position papers for the Conferenceon aspects of When the Program and Procedures Committee aging and the family. Organizations active in var- of the Conference Planning Board votedto in- ious aspects of family life, counseling, and serv- clude in the program of the National Conferencea ices, named representatives to participate in the series of Sessions devoted to in-depth discussions deliberations of the National Organization Task of some specific aspects of aging, itwas inevitable Forces. These same organizations urged their that a Special Sessionon the Older Family memberships to become active in other Confer- should be among the first to'be considered. ence preparatory activities within their communities and States. The National Council of Family Relations, the A concrete result of such participationcan be Family Service Association of America, the Amer- seen, for example, in the recommendations ema- ican Association of Marriage and Family Counse- nating from the Minnesota State White House lors, and the American Home Economics Associa- Conference on Aging. Delegates to that Confer- tion joinedtogethertosponsor the Session. ence adopted the following resolution: Meeting with their representatives to plan the Session were Federal personnel from the Admin- In view of our increasing awareness of the istration on Aging, the National Institute of deep, yet often poorly met, familial, marital, Mental Health, and the 1970 White House Con- and sexual needs of the aging, it is urgently ference on Children. Also invited to assist the necessary for society to provide for older Planning Committee were two special consultants people more adequate social services of an with known interest in the problems of the elderly educational and counseling nature, and to family.' undertake the study and research needed to make these services effective. 1 Sec Roster of Planning Committee, page 208.

205 The Program 1971 WHITE HOUSE CONFERENCE ON ACING A small group of some 40 Delegateslistened and joined in discussion with Dr.Evelyn Millis PROGRAM Duvall, a recognized authorityon all facets of family living. The full text of herprovocative THE OLDER FAMILY address AgingFamily Members' Roles and Rela- Presiding=RUTH H. JEWSON, Executive Offi- tionshipsand its extensive bibliographyappears cer, National CounciLon Family Relations on pages 209-218. 8:00 A.M.Opening Remarks and Focusof the SessionMRS. RUTH H. JEWSON The sociodrama which openedthe Session served as an uniqueway in which to stimulate 8:10 A.M.--A Choice to Make,"a play por- traying family problems through the techniques program participants. By evoking participantre- of professional theatreWashington Area Plays sponse to a realistic portrayal of the problems forLiving. Inc.MRS. BARBARA MAT- faced by aging family members, "AChoice to THEWS, Executive Secretary Make" added to the liveliness of the Session. The 8:40 A.M:Discussion of "A Choiceto Make" play was drawn from the Plays for LivingDivi- Led by MRS. DORIS RIiIBER, Washington sion of the Family Service Association ofAmer- Area Plays for Living, Inc. ica, and was performed by volunteers living in 9:15 A.M.Keynote Address and Discussion the Washington, D.C., area. DR. EVELYN MILLIS DUVALL, Family Life Consultant, Sarasota, Florida 11:15 AM.Consideration and Adoption of Recommendations 12:00 NoonAdjournment

206 THE SESSION REPORT

Introduction to assure quality of life, rather than senselesspro- longation of the process of dying.

American families bear the brunt of allthe 7: Public and private agencies workingon be- care, economic, and emotional nurturance, and half of America's aging recognize the family sense of belonging that aging families need. Re- roles, relationships, and responsibilities implicit in search finds that it is, primarily, to their families the stage of family development represented by that older people turn for help. each older person served. 8. All possible steps be taken to make it possible for aging persons to live as longas possible Recommendations in their own homes and that kin families be able to carry out their responsibilities to older families. We therefore recommend that: 9. Housing and homesforaging persons should be so designed as to allow for private 1. A Department of Family Life be established with Cabinet status for its Secretary, quarters for couples wishing to share them. At- so that the tractive social centers should be provided where American family may be represented in all poli- older men and women could enjoy the formation cies affecting the many millions of families who of new friendships and relationships to take the now carry the chief responsibilities for their mem- place of those they have lost, and all personnel bers of all ages. should be taught to accord full respect and dig- 2. A National Institute on the Family be de- nity to these. veloped in which concerns of central importance Continent: We recommendthisbecause to families, and to the society of which families among the primary characteristics of aging are the core, be studied to serve as a basis for persons today are loneliness and emotional considered action. deprivation, and institutions and personnel 3. The President of the United States call and involved in caring for the aging should be convene a White House Conference on the Fam- orientedasrealistically and humanely as ily in the near future. possible to meet their deep-seated needs for companionship and human warmth. 4. Tax reductions be given for qualified family gifts and assistance, as they are 10. The Social Security laws be revisedto now given for make it possible for older families, charitable contributions. or for older persons wishing to take up family life through re- Comment: Family support and care of their marriage, to combine their incomes. The present aging members, without recognition or relief law provides that persons on Social Security who from tax burdens, save the government as marry find that their income decreases. The law well as private agencies many millions of should be changed to allow continued receipt of dollars, staff years, and expensive programs. Social Security without decrease in the amount. 5. Death education be widely encouraged and 11. A national program of family guaranteed implemented. income be established which would include the aged family. This is necessary in order to make it 6. Medical and legal priorities be established possible for the older family to have the financial

207 wherewithal to continue to existat a time in its Special Session on The Older Family be referred family life cycle when income is sharplyreduced. to the President of the United States, to the Ad- In addition, such a guaranteed income will make ministration on Aging, and to the Secretary ofthe it possible for families to continue-to carry out Department of Health, Education, and Welfare their responsibilities and roles in relationto older with the strongest possible recommendation families. that theinformationbestudiedandimplications 12. The Congress and the President of the drawn as a basis for planning, settingagency United States be requested to .enact appropriate priorities, etc.toward support through education legislation to proclaim that the weekin which and community resources. Thanksgiving is celebrated eachyear under Act of Congress be officially designatedas National 14. Courses on marriage and family living in- Home and Family Week, that the Sunday of such clude material on the older family. week be designated as Family Sunday-U.S.A.All citizens be urged to observe these dates with seri- 15. A Task Force be formed, representing this ous reflection and realization that the principles Conference and major national organizationsand of family responsibility tospouse, children and agencies concerned, to: (1) explore thepresent parents, as well as the importance of the stability status offamilylifeeducation inthe public of marriage and the home forour future well- schools of the United States, (.2) develop plans being, require renewed allegiance and everyday for strengthening suchprograms as now exist, implementation. and (3) encourage the development ofnew comprehensive programs of education forhome and 13. The paper presented by Dr. Evelyn Duvall family living as rapidly as possible,as an integral at the White House Conference on Aging, in the part of our American system of public education.

Roster of Planning Committee

Government Nongovernment Eileen Bradley, Specialiston Aging, Administration on Aging, Social and Rehabilitation Service, Depart- Ruth H. Jewson (Chairman), Executive Director, ment of Health, Education, and Welfare,Washing- National Council on Family Relations,Minneapolis, ton, D. C. Minnesota Barbara Chandler, Coordinator,Follow-up Unit, Clark Blackburn, General Director, Family 1970 White House Conferenceon Children, Wash- Service ington, D. C. Association of America, New York, New York Nathan Sloate, Special Assistant to the Director, Na- Leonore Rivesman, Social Worker, Family Service tional Institute of Mental Health, Health Services and Association of America, New York, New York Mental Health Administration, Department ofHealth, Education, and Welfare, Rockville, Maryland Edward Rydman, Executive Director, AmericanAs- sociation of Marriage and Family Counselors,Dallas, Texas Consultants Mrs.-Charles McCullough, Springfield, Virginia Irene H. Wolgamot, Retired, Representativeof the American Home Economics Association,Alexandria, Beryl Carter Rice, Washington, D. C. Virginia

208 AGING FAMILY MEMBERS' ROLES AND RELATIONSHIPS

An Address given by Evelyn Mills Duval, Ph.D., Sarasota, Florida Special Concerns Session on T he Older Family December 1, 1971

In a Conference devoted largely to the specific The lonely old lady in an institutional rocking interests of special groups of olderpersons, it is chair is not to be forgotten, at thesame time that appropriate that this one Session takea wide-angle we remember that she is not typical of her age view of aging members of typical older families group, or generation. According to November in the United States today. This is possible through 1971 data froth the U.S. Bureau of the Census, a review of current data from the U.S. Bureau of only 2.1 percent of the women 65-74 years old, Census, and numerous research studies appearing and 2.3 percent of themen between 65 and 74 in the professional literature inrecent years. These years of age were institutionalized in 1971. Even sources are alphabetically listed and numbered at among the very old, above 75 years of age, 8.1 the end of this booklet, and cited by number where percent of the women and 6.0 percent of the men they are referred to in the body of thetext. were in institutions of any kind in 1971. (46) Persons of all complexions and colorsblack, The great majority of personsover 65 years white, brown, red, and yelloware borninto of age-live in families. Fourout of five men (79.7 families where they establish the foundationsof percent), and 57.6 percent of allwomen over 65 their individual personalities withinthe homes in the United States are classifiedas family mem- their parents built. Rich andpoor, rural and urban, bers, according to a private communication, No- strong or weak, in the midstream or marginal in vember 1, 1971, from Paul C. Glick, Assistant community life, older persons find theiridentity Chief, Population Division, Bureau of the Census. as members of the families to which they belong, Most of these older men and women are married as they have throughout their lifetimes. Tosee and living with their spouses;some are making clearly the family roots, roles, and relationshipsof homes for their adult children; others are single the aging in America is of central importancefor women providing for their relatives, in many cases any who would become effective in meeting their their elderly parents. In 1971, 4,500,000 men needs and tapping their resources. (83.3 percent) and 4,274,000 women (62.3 percent) between 65 and 74 years of age were heads Most Are Family Members of families. (46, p.13) Most of America's aging are family members Many older persons of both sexes prefer to with the full complement of roles, relationships, maintain their own homes as long as they can. needs and challenges that belonging in families When they are physically and financially able to involves. According to recent nationwide studies, do so, older men and women enjoy the privacy, four our of five older Americansare members of freedom and independence that living in their own families. Only 20 percent ofmen and women over homes provides them. In 1971, some 15 percent 65 are virtually kinless in America today.(37)1 of the men and 36 percent of thewomen over 65 in the United States were maintaining theirown I See References starting on page 217. homes. Two out of every three older familiesown

209 their own homes, the great bulk of them free from studied had used help from outside their families indebtedness, with theirmortgages paid up. It is during the year of the study. (19) not unusual for spiralling propertytaxes, and higher costs of livingon fixed incomes to neces- There is evidence, too, that the principle of "to sitate giving up the homes olderpersons have each according to his need, and from each accord- spent lifetimes paying for, in order to cutexpenses. ing to his ability" is applicable to the mutual help Unfortunately, this robs the elderly oftheir hard given and received by family members. Parents earned independence, and insome instances makes of married children disproportionally givemore them a burden upon family members,or the com- both to the younger and the older generations; munity at large. while the grandparents, on retirement budgets and with diminishing strength, give less than they receive from -their grown children. Thus it is that Most Are in Touch with Families American families bear the major burden of the The stereotype of olderpersons being aban- care, emotional and economic support, and the doned by their families isnot borne out by the sense of belonging to families that older persons facts. Research findsa great deal of face-to-face need, and find primarily within theirown kin visiting, telephoning,letter writing and close network. association between middle-aged and agingparents When asked to respond, to the proposition, and their grown children. (2, 16,19, 30, 41, 42) "Children who move up in the world tendto A nationwide study finds 84percent of Americans neglect their parents," two-thirds of the members over 65 live less than one hour away fromat least of the older generations, and three-fourths of the one of their grown children; nine out ofterr have younger do NOT accept this generalization. The seen one of their children within the past month, great majority of the members of all three genera- 84 percent the past week. (37)Both horizontal tions (65 percent of both older generations, and and longitudinal studies of families findthe aging 74 percent of the married child generation)agree and middle-aged visiting and beingvisited by that "A young man has a real responsibility for family members at frequent intervals. (19,30, 41, keeping in touch with his parents-in-law." These 42) data suggest strongly that it is the youngestgenera- A two-directional, three-generationflow of emo- tion that is most opposed to each generation's going tional and financial support betweenolder parents its own way. (19, chap. 3) and grandparents and their grown children is found Adams reports, "The relations between young in many recent studies. (1, 2, 16,19, 40, 42) Parents generally help their adults and -their aging parents are ordinarily the grown children, and closest kintieattitudinally and residentially." the adult sons and daughters reciprocatein a wide (1, p. 589) While Hill sees the "kinkeeping variety of ways. Family help takes many forms: middle generation.. . as the lineage bridge across nursing in illness and accidents, shopping, child the generations, being most involved withits care, repairs, personal care, and financial assistance in direct gifts, loans, and help in adjacent generations bothinintergenerational emergencies. contacts in help exchanges." (19, p. 330) The poor look to their relatives forhelp and the more affluent get and give it in gifts and legacies a major theme in recent researchreports. (2, Family Roles Continue 19,37,42) Parent-childrelationshipsand grandparent- Itis to their families thatmost persons of grandchild roles continue as long as family mem- every age and generation turn for help, first of all, bers live. An ever increasing number of Americans when problems arise or trouble strikes. A three- live out their full life span within the web of generation study in Minneapolis found that 70 family living. The author's original studies find percent of the 3,781 instances of help in a one- young people confiding more intheir grand- year period of time were kinship exchanges. Less mothers than in any other persons, according to than one-fifth of the three- generation families their parents. Youth have much in common with

210 their grandparents, feel closer to them thanto A person is more clearly understood bystage other relatives, except their parents and siblings, of his or her family life cycle than by chronological and contrary to commonly heldstereotypes enjoy age alone, at any period in life. The story is told their associations with older family members. (12, of an attractive young woman standing beside 32) oldtimer at the Fountain of Youth. Herspon- Disengagement tends to be into rather thanout taneous comment was,. "Oh, to be 18 again." The of the family. As the olderperson selectively re- senior citizen asked, "How old are you?" Her reply tires from many active and time-consuming roles came back quickly, "21." The puzzled response of in the community, he or she tends characteristically the older tourist was, "But, what's the difference to enjoy more family contacts and activities. Fami- between 18 and 21?" To which theyoung woman lies remain the focus of the aging individual's answered, "Difference? I'll tellyou what the dif- social interaction and emotional satisfactionon ference is between being 18 and 21it'sone hus- into the latter years of life. (11, 18, 25) band and two children." Family member roles and relationships change Conceptual Framework throughout the entire family life cycle. From the of Family Development time the young married couple settle down in their first home, have their first baby, and learn It is by stage of the family life cycle rather than what it means to be parents,as they become re- chronological age that individuals are most clearly sponsible for guiding their children through-in- seen. As the aging are recognized as having roles fancy, preschool and school-age periods, andon and responsibilities at the particularstage of family into adolescence and young adulthood, theygo development that they occupy, their needs and through a series of fast-moving phases. Eachstage challenges are more sharply focused than when of the family life cycle has itsown problems and they are lumped together in age groupings. prom;ses, its challenges and rewards. Each well- Actually, 65-year-olds differ widely fromone lived prepares for the next,as family members and another. A personality tends to becomemore and the family as a whole satisfies the demands of the more unique over the years as differential experi- period. This is quiteas true for the later decades ences, attitudes, values, and commitments make of life as for the earlier years. Family roles andre- the individualincreasingly himself. We have lationships shift markedly throughout theyears learned to recognize individual differencesamong that follow the bearing, rearing, and releasing of children; even more is it essentialto respect each children. older person for himself,as the unique individual Aging, therefore, is seen most clearlyas a process he is. of development and decline through thelater years Family relationships and rolesare a better that stretch over several decades. The typical gauge of an older person's concerns, preoccupa- American couple go througha number of distinctly tions, and interests than is hisor her age alone. different stages in their life together during the Consider, for instance, the differencesto be ex- half of their lives. Each of thesestages has its own pected between newly-wed 70-year-olds happily demands and responsibilities, itsown roles and establishing their new home for theyears ahead to- relationships, and its own peculiar problems and gether; the old grandmother raisingyoung chil- possibilities. dren while their mother works; and the aging Through the use of current census data, and the parents launching their "fall crop" of late-born findings of recent studies of the agingprocess, we children now emancipating, themselves, long after are able to trace the process of development that their older siblings have left home. Inmany ways aging families experience. Thereare typically four these older persons are more like theircounter- well differentiated periods thatcan be distin- parts of younger ages at similar family life cycle guished one from another in the last fourdecades stages than they are like others of their age with of the life of a family: the launchingyoung adult roles and responsibilities more typical of the post- childrenstage,theempty-nestpreretirement retirement stage of life. period, the early retirementyears, and the final

211 phase of the aged terminated by the death ofone typical American woman in her forties and fifties after another of the original husband-wife pair. at this stage in her family history finds herself con- Characteristics of each of thesestages are outlined currently functioning as wife, mother, mother-infor typical American census families in the follow- law, grandmother, sister, sister-in-law, daughter of ing manner. aging parents, aunt, cousin, and bridgeto other members of the extended family through her roles Launching Young Adult Children as kin keeper, letter writer, gift giver, visitor, hostess,homemaker,shopper,chauffeur,etc. As children grow up and start to leave home, At the same Cme, theman of the family is in- a family begins to contract in size and in nature. volved in parallel relationshipsas husband, father, This stage of the family life cycle startsas the first father-in-law, grandfather, brother, brother -in -law, son or daughter leaves home for marriage, work, son of aging parents, uncle, cousin, and head of military service, or college and other post-high- the family as provider, partner in family activities, school educat'on and training. It ends with the father of the bride, companion, counselor, decision departure of the last child into a life of hisown. maker, investment counselor, buyer,property man- Husband and wife typically noware between45 ager, etc. In a three-child family at this stage of and54years of age. More than nine out of ten the famly life cycle there are some66possible men and women of this age group share their interpersonal relationships, each witha multitude homes with their marriage partner and/or their of roles and responsibilities. (12, Chart5-7; 47) grown children or other relativesin primary families.(46) Empty Nest Mothers of grown children being launchedare When the last child grows up and leaves home in menopause, typically. Nearly half of the wives the typical American parents still have half of their are working outside their homes, but their hus- marriage still ahead of them. As theyenter the bands remain the chief support of the family. This empty nest stage of their family they are in their is an expensive stage of the family -life cycle as fifties, on the average. They haveten or more years maturing young adult children costmore than before the husband's retirementto build a new life they did ^.t younger ages for education, clothing, for themselves now that their preoccupation with transportation, recreation, and marriage plans. rearing and releasing the:r children isover. The The married couple tends to be "quite satisfied great majofty of men(84percent) and women (65 with their marriage" at this stage.(15)Husband- percent) in this age group(55-64)live with wife relationships are calm and focusedon mutual their spouses in their own homes.(46) concerns for their children, whose choices and Most husbands in these preretirementyears are challenges in deciding on appropriate educational still working, as are one-third of their wives. This experiences, work possibilities, marriageprospects is the time of life when theyare financially better and opportunities, personality development, social off than they were in earlieryears when providing exposures, problems and promises are of deep con- a home base for their growing children drained cern to their parents at the time in life when young them financially. Now thatthechildrenare adults typically must make theirown decisions launched and on theirown, the middle-aged and learn to stand on their own feet, withouttoo couple now has a decadeor so in which to estab- great dependence on parental supervision and lish some security for theirown aging years that control. (12) lie ahead when the pinch of oldage comes. (12) Grandparenthood typically begins during this Middle-aged couples in theempty-nest stage of stage of the family life cycle as one of the sons the family life cycle are generous in helping their or daughters bears the first grandchild. This adds grown children get established. They are found to a whole new dimension to life for many a woman help their young marred sons and daughters with who now finds herself not just a mother anda gifts and loans to floata down-payment on a car, mother-in-law, but a grandmother as well. The a house, a baby, or a program of home and self-

212 improvement. Their help extends to many other has powerful personal and marital components goods and services for both their young adult that lie inherently in this stage of family life. children and their aging parents: gifts, repairing, Studies find disenchantment in the middle years shopping, personal care, nursing through illness of marriage among many of the couples studied. and accidents, child care and baby sitting, etc. (5, 10, 15, 29) One research of married couples (19, 41, 42) Hill's three-generation study of at various stages in the family life cycle finds that family development finds this middle generation the middle-aged couple value conjugal factors in serving in a patron-like status in that they give their lives highest now that companionship and more than they receive to both the younger and calmness tend to be characteristic of their marriage. the older generations in the family. (19, Chap. 3) (15) The middle-aged wife may go through an Disenchantment is often a problem for middle- identity crisis as she finds herself without the aged men and women, as well as for preretirement active roles she played when there were children couples. (29) In a sense, they feel they have done in the home and young adults to be released. In everything once, and that everything elseis a a sense her job of twenty or more years has packed repeat of the same old thing. By now they have its suitcase and left home, leaving her without a recognized one another's weaknesses, annoying focus for her energies and interests. Many a woman habits and tendencies. They each have hadto face at this stage of life holds a job, finds constructive their own problems in themselvesso often harder community work to do, or goes back to college to take than the other's faults. In the rough and to finish a degree and retool for the years that lie tumble of theiryears of marriage they have ahead. If such rechannelling of her energies is not wounded one another, said things that are difficult done, today's middle-aged woman, more vigorous to forget, and developed scar tissue over areas that and younger for her age than was her mother or are painful to think about and almost impossible grandmother before her, may become a meddle; to discuss with objectivity. Now they face the task some mother and mother-in-law, a too-doting of rebuilding their 'relationshipon a wholesome grandmother, or a nuisance to her husband now basis for the years that still lie ahead. at the peak of his career, and community roles. The number of family relationships increases Husband and wife as a pair may find these greatly at this stage of the family cycle. Ina three- middle years a chance to develop their resources. child family there are 153 probable interpersonal Financially they are better off than they have been relationships between a total of 18 differentper- before, or will be later on when they live on a re- sons now. (12, p. 128) The woman relates to tirement income. So, they may travel, rebuild their others in her family as wife, mother, mother-in- home for their own interests now that children law, grandmother, sister, sister-in-law, daughter have gone, and begin to devote themselves to the of aging parents, aunt, cousin, etc. Theman of the things and interests that mean most to them infamily has interpersonal relationshipsas husband, father, father-in-law, grandfather, brother-in-law, dividually and as a pair. (12) son of aging parents, uncle, cousin, etc. Some of One used to hear of a man's "dangerous years" these relationships are with more than one person; when younger women were a temptation, and as is the case when more than one of their chil- "being young, virile and active" were male pre- dren marries and brings additional in-laws into the family, or as the number of grandchildren increase occupations. This period is dangerous not only for over time. While the number of persons in the the marriage, but basically for the man himself. family increases arithmetically, the number of As his strength and vitality begin to observably possible interpersonal relationships increasesgeomet- decline, as the hair line recedes, and the abdominal rically. So, the more the family proliferates, the muscles failtc' restrain the swelling paunch, a more complex and complicated the intra-family man must find new meanings in his life beyond relationships become. Peek in on any familyre- his sheer masculinity and sex attractiveness. The union or holiday celebration for an illustration of disillusionment of the middle years of marriage what this means in family terms.

213 Early Retirement Years Men who have lost their wives tend to remarry Comes the time whena man retires from his in about three years; widows remarry in seven work, and a wholenew ballgame begins for both years, if at all. The discrepancy is accounted for in members of the pair. Hemay feel like a fifth a number of ways. Men marry younger mates, and wheel around the house wherehis wife has been so have a wider field of choice than do widows of in charge so long. Unlesshe has prepared well for the same age group. Scholars point out that the his retirement, hemay find that the leisure so benefits of remarriage are greater for the' man )ong anticipated whenhe would be freeto go than a woman. A man is better fed and cared for fi3hing and spendmore time at home fails to with a wife to look after him, and when he re- satisfy as fullyas he had dreamed it might. marries he has a housekeeper, hostess and companion for his remaining years. (27) The family income declinesrapidly after the husband's retirement,since Social Security and Although marital interaction is low at this stage, private pension plans rarelysatisfy even the basic there is a general feeling of peacefulness, and the needs of the couple. Lessthan 10 percent of the satisfaction with the marriage approaches that of wives are still workingafter their husband'sre- newlyweds. In fact, Feldman finds thisa "very tirement, which gives the,pair more time forone satisfying" period for most of the older couples another, but lessmoney to work with than they he studied. (15) Older couples after the man's have had before in theirmarriage, since their retirement talk a great deal about religion, health, earliest days together. home repairs. They rarely report "a gay time away The early retirementyears, when husband and from home," but appear to get their satisfaction wife are between 65 and 74 from the peace and quiet, and the lack ofstress typically, begin when in their lives. (15, 22, 27, 39) the man no longer has his daysfilled with his work. Three out of four (75.3percent) of themen Years ago a thick book was circulated with the are still living with their wivesat this stage. But title, Sex After Sixty. Its cover was attractive, the women are widowed inlarge numbersnow, format thick and imposing. But when one opened especially after theage of seventy. The differential the book there were only blank pages. This stereo- mortality rates formen and women combine with type of the cessation of all ,sexual activity in the the tendency formen to marry women younger later years is still prevalent in spite of evidence than themselvesto make the chances of being to the contrary. While it is true that sexual inter- widowed muchgreater for the woman than the course declines in frequency over the years, many man of the family. couples continue to enjoy it well into old age. The death of a life partner isa crisis for the (26, 35 and the Kinsey studies) As passion de- surviving member of the pair. (24) Studiesshow clines, expressive roles dominate the husband-wife that reactions vary with the individual, andthat relationship. Throughout the later years affection, there is a somewhat predictableprocess of bereave- interest, kindness, tenderness, intimacy and comment that starts with disbelief, proceeds to grief, panionship are of great importance to the older self-blame, depression, and finally intoa successful pair. (3, 20, and the work of Dentler, Epstein, and weathering of one's loss ina constructive channel- others) ling of the loss through memorials, and/or carry- Great- grandparenthocd is not unusual now, as ing out the mate's wishes and interestsas well as one can. (12, pages 468ff) grandchildren marry and have children of their own. The recent retiree and his wife may already Older widows are found to fare better than begin to feel at the apex of a pyramid with multi- women who lost their husbands at earlier ages. tudes of descendants arriving tocarry on the family One reason for this appears to be that whenan name and tradition. There are some older men and older woman is widowed thereare more friends women who relish their roles as grandparents, who her own age in the same predicament,so that she enjoy their children and grandchildren, and takean has new companions and relationshipsto tie to. active interest in them 'And their development. (23) Other grandparents are much more remote and 214 formal as older family members. (7, 28)Itis institutionalized for anyreason or type of care. generally agreed that young children are too noisy Again this fact blasts the alltoo common stereo- and tiring for the aging to enjoy as a steady diet. type that the aged are senile, helpless, andmust It is not unusual for grandparentsto be glad when be "put away." (46) their grandchildren and great-grandchildrencome to visit and to be quite as happy when they leave. Warm human interaction is stilla compelling need not easily Few aging men andwomen live met by those who have lost their inthree- life companion. The need generation homes, as the popular mythhas it. to be needed remains There is but a small minority of grandparents as long as life and ability last formost persons. who Many aging life with their married children inhomes where men and women maintain a full there are young grandchildren. Much repertoire of meaningful relationshipswith others more com- infamily, mon is the widowed father or mother, or an older friendshlp, church and community circles as well as in creative expression married pair, living witha middle-aged married of all kinds. Grandma Moses modelled for child whose own children have alreadyleft home. millions the joy Such middle-aged sons and daughters of painting in her lateryears. Pablo Casals and have an on- Leopold Stokowski became going interest in their agingparents, as already ever more gifted reviewed in research evidence above. Their musicians with the passing oftime. Jack Benny home was still 39 on his 75th birthday, when is established, and large enoughto accommodate on a an aging replacement of the recently launched nationwide television celebrationof it, he asked young adult sons and daughters. (36, 46) a young girl in the audience, "How old doyou think I am?" She lookedat him thoughtfully, The family relationships of aging memberscon- smiled and said, "Thirth-nine."He beamed, looked tinue to be numerous and complex. A possible153 a bit embarrassed and confessedto her that he interpersonalrelationshipsinathree-children actually was a little older than that.Gaining con- family have been charted, each witha plethora of fidence hecame back, "So, how old would you say roles and responsibilities. (12, Chart 5-7) The I really am?" She looked himstraight in the eye woman of the family possibly is now a wifeor and promptly replied, "75!"At this his face fell, widow, a mother, mother-in-law,grandmother, and he stared, and stared, andstaredin but a few great-grandmother, daughter of agingparents, sis- seconds emerging in the publiceye not as an old ter, sister-in-law, aunt, great-aunt, cousin, and elder 39, but a young 75. woman of the family clan. The husband hasa parallel number of interpersonal relationships, but The Kansas City Study of AdultLife finds one- tends to be less actively involved inthem than third of the oldpersons in their population mature, are the woman of the family. integrated, and functioning wellwith strong egos, a sense of mastery and control, witha feeling of self-worth and a willingnessto take on new roles Old Age Over 75 and responsibilitiesto replace those lost as their families have Even beyond the age of 75 nearly three-fourths grown and gone, and their employment no longer is so time-consuming. (18, of the men (73.2 percent) andmore than half of 28) These are no doubt the older the women are head of the family, often withrela- men and women activein tives living with them in theirown homes. By AARP, NRTA, SCORE,Green- this age, 58 percent of the aged husbands and Thumbers, Foster Grandparents, andother nation- 19.3 percent of the wives are living with their wide as wellas local programs. Such elderly per- spouses. Twice as many women (40 percent) as sons have become relaxed and mellow with the men (19 percent) over 75 live alone for at least passing of the years. Theyare relaxed rather than two reasons: old women are more able to take care combative in their relationships withothers. They of themselves, and are less likelyto remarry after use the wisdom they have accumulated increa- tively consti:Ictive they are widowed than are aging and agedmen. ways, and remain articulated into society as long Even at advanced ages over 75,a small minority as life lasts. (28, 31, 33, 34) of men (6 percent) and women (8 percent) are In time even the healthiest individualcomes to 215 the point where the possibility of hisor her death ment of tissue, for medical education and research must be faced. In recent years studies have been is now legally possible in all 50states under the made of the reactions of persons faced with the Uniform Anatomical Gift Act. A donorcard is likelihood of dying. Contrary to the common ex- carried in one's wallet specifying thepermission pectation that men and women facing death do not for posthumous transplants of bodytissue upon want to talk about it, the researchers found them one's death. Morticians have legal formsfor the willing and able to talk freely about how they felt living to file specifying thatupon one's death the about their own approaching death. A seriesof human material will be taken directlyto a nearby sequential reactions were found inmany cases medical teaching and researchcenter. In place of that began at the first recognition of the possibility the traditional funeral with theremains present, of dying with its denial, and rejection as a possibil- families and friendscome together for a memorial ity. Next came anger, with a possible overlay of service in which the departed lovedone's life is "Why me?" as a second phase in personal r) response remembered, celebrated, and openlymemorialized. to one's own demise. Bargaining followed with Th:s provides the rite ofpassage helpful in accept- attempts psychologically to trade good behavior ing the death ofa person whose life has been or good works for an extension of time. With the meaningful, with the positiveovertones for both recognition that the process of dying wouldnot the one who has died, leaving his bodyto benefit be stayed came depression; and lastly, forsome the living, and to his dearones who assemble to came the peace of acceptance of one's ownap- do him honor confident thathe has died as Lc proaching death. (21) lived, with grace and selflessness. Quite recent published works have explored the Death education is being advocatedwidely now positive ways of accepting life's final actthat of to remove the stigma and taboo from the finalact dying. One particularly articulate review of what of life. Public education,college and university it means to prepare for one's own death includes courses, as well as adult educationprograms now this statement: increasingly include the latter decadesof life, and its termination "Death is inextricably woven into all that makes as a part of their work in human development, family life education, life rich, noble and triumphant. To concealit and philosophy. Since every human being, is to cheat one's self of what might givemean- like all other forms of life, is mortal, and inevitablywill die, the end of ing to life. Indeed, one cannotaccept life with- life is a part of the whole, out knowing that it must end. Death is not and in a realsense, death education isseen as preparation for living. the scissors that cuts the thread ofour lives. It (17, 38) is rather one of the threads that iswoven into the design of existence." (13,p. 15) Family membership isa central factor in the life and death ofevery citizen of these United Family members recently have been urgingthat States. Therefore, itis fitting that consideration their loved ones be allowed to die naturally when be given to the social andpersonal policies thatre- their time comes, rather than be subjectedto the flect family roles and relationshipsin the economic, senseless prolongation of vegetativestates, or un- educational, emotional, health,housing, personal necessarily painful, agonizing final days, weeks, and public care of andconcern for the aging. At months, even years through medicalattempts to this point in history then, letpis turn ourselves to sustain life as long as possible. One physician ad- the recommendations that derive from thisreview vocating medical and legal policies that would of research, clinical andcensus evidence. Only as allow a person to executea document directing the later years of life can be made meaningfuland that he be allowed to die inpeace when his time rewarding will life makesense for old and young comes, points out that each end of life is a miracle, alike. For it is inexorablytrue that all age in time, "Death like birth is glorious, let itcome easy." and if being old is respected,appreciated, and admired, as a fitting climax of thegood life, then Donation of one's own body for surgical replace- life itself is to be valued--at every age. 216 References and Bibliography (23) Lopata, Helena Z., Role Changes in Widowhood. Mime- ographed, 1969. (1) Adams, Bert N.,"Isolation, Func Nn,and Beyond: American Kinship in the 1960's," 'journal of Marriage (24) Maddison, David and Agnes Viola, "The Health of and the Family 32: 575-597, 1970. Widows in the Year Following Bereavement," Journal of Psychosomatic Research 12(4): 297-306. (2) Aldous, Joan, "Intergenerational Visiting Patterns: Vari- (25) Maddox, George L., "Persistence of Life Style ation in Boundary Maintenance as an Explanation," Fam- among the ily Process 6(2): 235-251, 1967. Elderly: A Longitudinal Study of Patterns of Social Activity in Relationto Life Satisfaction,"in Bernice (3) Ballweg, John A., "Resolution of ConjugalRole Ad- Neugarten (ed.) Middle Age and Aging. Chicago: Uni- justment after Retirement," Journal of Marriage and versity of Chicago Press, 1968. the Family 29:(2); 277-281, 1967. (26) Masters, W. H. and Virginia E. Johnson, "Human (4) Bekker, L deMoyne and Charles Taylor,"Attitudes Sexual Response: the Aging Female and the Aging Toward the Aged in a MultiGenerationalSample," Male," in Bernice Neugarten (ed.) Mad': Age and Journal of Gerontology 21(1): 115-118, 1966. Aging. Chicago: University of Chicago Press, 1%8. (5) Blood, Robert 0. and Donald M. Wolfe,Husbands (27) McKain, W. C., Retirement Marriages. Storrs, CT: and Wives. New York: The Free Press, 1960. Agricultural Experiment Station Monograph *3, 1969. (6) Borke, Helen, "A Family OverThree Generations: The (28) Neugarten, Bernice (ed.), Middle Age and Aging. Chi- TransmissionofInteractingandRelatingPatterns," cago: Univ. of Chicago Press, 1968. Journal of Marriage and the Family 29(4):639-655, 1967: (29) Pineo, Peter, "Disenchantment in the Later Years of Marriage," in Bernice Neugarten (ed.) Middle Age and (i)Boyd, Rosamonde R., "The ValuedGrandparent: A Aging. Chicago: Univ. of Chimp Press, 1968. Changing Social Role," in Wilma Donahueet al. (eds.) (30) Reiss, Paul J., "Extended Kinship System: Correlates of Living in a Multigenerational Family. Ann Arbor:Insti- and Attitudes on Frequent, of Interaction," Marriage tute of Gerontology, 1969. and Family Living 24: 333 ,39. (8)Burgess, Ernest W., "Family Structure andRelation- (31.) Riley, Matilda, et al., Aging and Society, Vol. I, An ships," in Ernest W. Burgess (ed:) Aging inWestern Inventory of Research Findings. New York: Russell Sage Societies. Chicago: University of Chicago-Press, 1960. Foundation, 1968. (9) Clark, Margaret and Barbara G. Anderson,Culture (32) Robins, N. and Mirada Tomanec, "Closeness to and Aging. Springfield: Charles Thomas, 1967. Blood Relatives tt!ds the Immediate Family," Mar- (10) Cuber, John F. and Peggy Harroff,The Significant riage and Family Living 24: 330-346. Americans, New York: AppletonCentury-Crofts,1965. (33) Rose, Arnold M. and Warren A. Peterson, Older Peo- (11) Cumming, Elaine and William Henry, GrowingOld. ple and Their Social World. Philadelphia: F. A. Davis New York: Basic Books, 1961. Co., 1965. (12) Duvall, Evelyn Millis, Family Development,Fourth (34) Rosow, Irving, "Relationship of Older Personsto Fam- Edition, Philadelphia: J. B. Lippincott, 1971. ily and Friends," Welfare in Review 3(7): 15, 1965. (13) Elliot, Grace Loucks, To Come Full Circle: (35) Rubin, Isadore, "The 'Sexless Older Years'-A Socially Toward an Harmful Stereotype," Annals of the American Academy Understanding of Death, New York, 1971. of Social Sciences 376: 86-95, 1968. (14) Farber, Bernard,- Kinship and FamilyOrganization. New (36) Schorr, Alvin,Filial Responsibility in the Modern York: Wiley and Sons, 1966. American Family, Washington: Department of Health, (15) Feldman, Harold, Development ofthe Husband-Wife Education, and Welfare, 1960. Relationship, Research Report. Ithaca: CornellUniversity, (37) Shanas, Ethel, "Family Help Patterns and Social Class 1965. in Three Countries," Journal of Marriage and the Fam- ily 29(2): 257-266; see also, Shanas, Ethel and (16) Gibson, Geoffrey, "Kin FamilyNetwork: Overheralded Gordon Structure of Past Conceptualizations of F. Streib (eds.) Social Structure and the Family: Genera- Family Func- tional Relations. Englewood Cliffs, N.J.: PrenticeHall, tipning." Paper presented at AmericanSociological As- 1965. sociation, San Francisco, 1969. (38) Somerville, Rose M., "Death Educationas Part of Fam: (17) Green, Betty R. and Donald P. Irish,Death Educa- ily Life Education: Using Imaginative Literature for In- tion: Preparation foe Living. Cambridge,Mass.: Schenk- sightsintoFamily Crises," The Family Coordinator man Publishing Company, 1971. 20(3): 209-224, 1971. (18) Havighurst, Robert M., M. A. Munnicks,Thomas (39) Stinnett, Nick, Janet Collins and James E. Montgom- Joep, and Bernice Neugarten. Adjustmentto Retire- ery, "Maritial Need Satisfaction of Older Husbands and ment: A Cross-National Study, Assen, Netherlands:Van Wives," Journal of Marriage and the Family 32(3): Goscum, 1969. 428-434, 1970. (19) Hill, Reuben et al., Family Developmentin Three Gen- (40) Streib, Gordon F., "Intergenerational Relations:Per- erations. Cambridge, Mass.: Schenkman PublishingCom- sNctives of the Two Generations on the Older Parent," pany, 1970. Journal of Marriage and the Family 27(4): 469-476, 1965. (20) Kerckhoff, Alan C., "Family andRetirement," in Ada H. Simpson and John C. McKinney (eds.)Social As- (41) Sussman, Marvin B., "Intergenerational FamilyRela- pects of Aging, Durham, N.C.: Duke UniversityPress, tionships and Social Role Changes in Middle Age," 1966. Journal of Gerontology 15(1): 71-75, 1960. (21) Kublcr.Ross, Elisabeth, On Deathand Dying. New (42) Sussman, Marvin and Lee Burchinal, "KinFamily Net- York: Macmillan, 1969. work: Unheralded Structure in Current Conceptualiza- (22) Lipman, Aaron, "Role Conceptionsand Morale of tions of Family Functioning," Marriage and Family Liv- Couples in Retirement," Journal of Gerontology ing 24:231-240, 1962; see also, "Parental Aidto Married 267-271. 16(3) : Children: Implications for Family Functioning," Mar- riage and Family Living 24: 320-332, 1962. 217 (43) Tibbitts, Clark, Handbook of Soda! Gerontology. Chi- (46) U.S. Bureau of the Census. Current Population Reports, cago: University of Chicago Press, 1960. Series P.20, No. 225, "Marital Status and Living Ar- (44) Tibbitts, Clark, and Wilma Donahue (eds.), Social and rangements: March 1971,- U.S. Government Printing Psychological Aspectsof Aging. Aging Around the Office, Washington, D.C., November 1971. World. New York: Columbia University Press, 1962. (45) Troll, Lillian E., The Family of Later Life: A Decade (47) Vickery, Florence E.. Creatite Programming for Older Review," Journal of Marriage and the Family 33(2): Adults. New York: Association Press, In-Press. 263-290, 1971.

218 THE RELIGIOUS COMMUNITY AND THE AGING

"nli he Special Concerns Session on The The Program ReligiousCommunityandthe Aging was requested by the National In order to prepare the Delegates for formulat- CoUncil on the Aging, Inc. It was felt ing sound recommendations, the major part of that this Session was needed, in addition to the the program was devoted to presentations by key- Conference Section on Spiritual Well-Being, to note speakers who discussed some of the most develop recommendations directed specifically to frequently voiced criticisms of the religious com- the religious needs of older people. Other groups munity. The Planning Committee also invited a participating in the Planning Committee were number of representatives from the religious com- The National Conference of Catholic Charities, munity to respond and comment on the presenta- The National Presbyterian Center and The Relief tions. Society of the Church of Jesus Christ of Latter- Day Saints! 1971 WHITE HOUSE CONFERENCE ON AGING PROGRAM The Participants THE RELIGIOUS COMMUNITY During Conferencepreregistration, approxi- AND THE AGING mately 138 Delegates signed up for the Session. PresidingWILLIAM C. FITCH, Executive Di- Upon opening the Session, however, a number of rector, National Council on the Aging, Inc., Wash- ington, D. C. other Delegates, observers, and guests attended the 4-hour meeting. Only official Conference Del- 8:00 A.M.Opening Remarks egates were qualified to vote on the recommenda- 8:15 A.M."The Church and the Commu- tions. nity"DR. REX A. SKIDMORE, Dean, Graduate School of Sociology, University of Prior to the Session meeting, the Interreligious Utah, Salt Lake City, Utah Committee of General Secretaries prepared a 9:00 A.M."Practical Ecumenism"DR. statement relativeto the role of the religious ROBERT N. BUTLER, Chairman, District of ColumbiaAdvisory`CommitteeonAging, community in providing opportunities for older Washington, D. C. persons to enjoy the basic rights and freedoms 9:45 A.M."Church Facilities for Minority within their communities and to become fully in- GroupsPolicy versus Practice"HOBART volved in programs and services affecting their C. JACKSON, Chairman, National Caucus on well-being. This statement is reproduced in the the Black Aged, Philadelphia, Pennsylvania Appendix to provide information from which 10:30 .A.M."Ministering for and to the Delegates were able to draw upon in formulating Elderly"REVEREND HERBERT C. LAZENBY, Executive Director, Senior Citizens, recommendations. Inc., Seattle, Washington (Program continued on iext page) See Roster of Planning Committee. page 224.

219 (Program Continued) 11:15A.M.POLICY RECOMMENDATIONS AND ACTION -PLANS 1.Formal presentations will discuss some 3.Policy recommendations will be proof the most frequently Voiced criti- posed and acted on by the group. cisms of the religious community and the aging. 2.Representatives of the religious community will react or respond to the 4. Suggestions for statement of commit- presentations. ment for closing session.

THE SESSION REPORT

Recommendations 4. That church-related retirement facilities add to their staff (on a salaried and/or volunteer 1. That a National Conference on Spiritual basis) a retiree in the role of community ombudsman-advocate, working with older adults within Well-Being be held within the next two years, and the institution and the larger community, serving not later than five years, to review and evaluate as a representative with and for older adults. the recommendations in terms of achievements as a result of the 1971 White House Conference on 5, That religiously related educational institu- Aging. tions and religious laymen in any teaching situation, be urged to provide a knowledge base for 2. That it should be the national policy that an understanding of the processes of aging, the religious bodies and other private agencies make characteristics and needs of older persons, and the it their concern to bring together the services of implications of such knowledge for fields of com- the entire ,community to provide opportunity for munity practice. interfaith broad-based community programs for 6. Subscribing to the principle that responsibil- the aged through multipurpose community cen- ity for the care and affectional support of persons ters. of all ages rests with one's immediate family and kinsmen, we, therefore, recommend that (a) tax 3. That private institutions of religious and deductions, be given for qualified gifts and assist- charitable organizations which discriminate in the ance to aged persons, as are now authorized for admission of black persons and those of other charitable contributions, and (b) education be in- minority groups, and deny and abrogate the civil augurated for couples in their middle years for rights of such persons, have their tax exemption their tasks in bridging the snerations, including statuslifted. We urge that the U.S. Congress accepting death and preparation for the life of a enact appropriate legislation to bring this about. survivor.

220 A Message to the Religious Community '

A consideration of policies affecting the aging sense of fairness.' The religious community as- at the White House Conference should start with sists the older person to deepen his relationship recognition of the dignity of allpersons, specifi- to God and to accept the assurance of eternal cally the elderly. "You shall honoryour father life." and your mother," the scripturesays, and from this commandment flows the necessity for policy and program decisions. The Facts of Life As representatives of our respective religious We start from the premise that life for older organizations we address this open letter to the people, like that for all others, will bea mixture religious community of America on the occasion of pain and problems, of pleasures and richness. of the 1971 White House Conferenceon Aging. The broad policy issue is whether the difficulties can be lessened and the strengths enhanced. We remind you of the statement on the role of religion in the life of the older person in the Re- There are a number ofspecificnecessities port of the 1961. White House Conference on which we call to the attention of members of reli- Aging. gious organizations and ofDelegatestothe "Religion's concern with human dignity at White House Conferenceon Aging. Adequate every stage in the span of life derives from the medical care, an adequate standard of living,an fact that each individual is created in the imageopportunity for cultural enrichmentare necessary of God. As a consequence, religion seeks to for a full life. Particularly important is theop- build a living fellowship of believers in which portunity to communicate and cooperate with oth- the aging find and share the true benefits of ers, to live with others if this is the mutual de- being part of the household of God. It is this sire. Similarly, the right to live alone and in one's conviction which likewise demands a concern own home should be respected. Loneliness should for such matters as the maintenance of social be replaced by companionship, idleness by the welfare institutions by religious bodies and the opportunity toparticipate, isolation by involve- proper conduct of those sponsored by Govern- ment. ment or voluntary agencies in a manner conso- In earlier times when the extended family liv- nant with the nature of man and the sanctity of ing together was the life style, both physical existence. Similarly, it is the basis of a concern care for the right of every individual to a burial and social involvement of the agedperson was a benefiting human dignity. natural component of family life. The life style of today's nuclear family, not to mentionnewer "It has been suggested that 'man's potential for life styles appearing in the youth culture, donot change and growth is much greater than we are provide for the aged person's protection against willing to admit and that'old age be regardedsocial isolation and a sense of abandonment. In- not as the age of stagnation but as the-age ofstitutions other than the familyare looked to for opportunities for inner growth.' Inlight ofphysical care of the aged to a degree not true of this, congregations should recognize that their a half-century ago. elder members are often specially endowed with gifts of wisdom, serenity, and understand- Early retirement at the age of 65,or even ear- ing. To the aging person, religion extends an lier, has to be faced by many people, and not al- invitation to see the -later years of his life as ways on the basis of their own choice. In a society 'rich in possibilities to unlearn the _follies of a lifetime, to see through inbred self-deceptions, I Prepared by Bishop Joseph I.. Bernardm. General Secretary, to deepen understanding and compassion, to U.S. Catholic Conference; Dr. R. H. Espy, General Secretary, National Council of Churches; and Rabbi Henry Scigman. Ex. widen the horizon of honesty, to refine the ecuticc Vice President, Synagogue Council of America.

221 which places high value on those who can pro- The Role of Community duce goods or services which can be marketed in the ordinary workings of the economic system. As religious representatives we are, of course, compulsory retirement for those who cannot so primarily concerned with the spiritual well-being produce tends to be inevitable for too manypeo- of the community. But we also strongly affirm ple. This can destroy a _person's sense of worth that spiritual well-being cannot exist in a vacuum. and value. As the prophet Micah wrote, "What does the Lord require of you. but to do justice. and to love The knowledge, experience, wisdom and good kindness, and to walk humbly with your God?" judgment that so often accompany the older years (Micah 6:8) may still be of yak(' to society though not neces- sarilyto be contributed through the economic The human spirit cannot flourish ina society channels of theearlier career. Employers and which neglects. demeans, or tries men's souls be- older employees may mutually benefit from the yond endurance through the denial of basic rights exploration of second careers with production and freedoms, such as the right to worship God pressures and time schedules adapted to the ca- according to one's own conscience, to freelyas- pacities of older people. semble with others, and to petition one'sgovernment for redress of grievances. Apart from the economic employment, the voluntary assistance that can be provided to charita- The religious community by itself cannotpro- ble, educational, and public functions by older vide thesocialmilieu neededtosustainthe people drawing on their wide_experience with is- spiritual well-being of older people. sues and people could be invaluable. Many of Government on all levels, organizations in the those who retire today have much to contribute voluntary sector, the business community and the and there are many needs they could meet, but family, among others, must all play an appropri- toooftenthe person andthe need are not ate role in creating a society in which older per- brought together. sons can participate in full measure according to their abilities. Ability to contribute wisdom and experience to community life is not the possession of well-to-do We are mindful of the enormity and complex- or educated people only. People rich in experi- ity of the task confronting the community, and ence though limited in formal education, people that men of good will are faced by many impor- from minority racial and ethnic groups, as well as tant issues. from the majority are entitled to the satisfaction of having their talents valued and utilized by-the- Do our community_attitudes_reflecta_genu, larger community. ine concern for the aging and their families and our philosophical affirmation of the dignity of man and the richness of the golden The Fact of Death yearsor -do the needs of the aging need more attentionin our national andlocal One of the most important concerns of the priorities? aging person is the relative proximity of death. Is our vision of the aging clouded by ster- Death isan inexorable event that must be eotypes, and do we thus fail to see the tre- faced. It cannot be denied as a fact; it cannot be mendous variations in their aspirations, drive avoided as an issue. However, it cannot be has- for independence, abilities, interests, handi- tened by any positive act of any person. The fact caps, limitations, and dependency? Do we of death must be faced, but it should not be con- thus fail to consider whether we are provid- sidered as something within the determination of ing the full range of facilities and services any human being. Extraordinary means need not which they might utilize in maintaining opti- be taken to unduly postpone death, but no posi- mum independence during declining years? tive means can be used to bring it about. For example, are services suchas home 222 health aides,visiting homemakers, and the like hot meals, The concept available whenneeded? of thecongregation asa "fellowship of thefaithful" or "a How much ofa gap is there between can be applied in beloved community" judgment of our practicalways to alleviate the what constitutessocial justice loneliness and and what sense of isolationmany older peo- we actually do; betweenour stand- ple feel. ards andour practice; between and their social policies implementation? For 2. Be an advocateof older people. nursing homes example,are really required Not all theneeds of older an acceptable standard to operate at people can bemet of health andcom- through volunteerservices. Some fort? Are SocialSecurity in law, such require changes payments adequate as provision fortax exemptions when measuredagainst current new public facilities or of ing? Do escalating costs of liv- andprograms. Some require real estate changes inpractices and people out of the taxes force procedures ofagencies in home of theirchoice? the governmental, voluntary, orcommercialsec- Do we have tor, such as reducedbus fares, adequate mechanismsfor get- or provision ona ting the facts neighborhood basis.Senior citizens about our agingpopulation, should be able their problems to count on thesupport of social and ourprogress? Havewe actiongroups developed adequate within religiouscongregations in mechanisms forplan- their effortsto ning together, secure needed changesin community locally andnationally, and for services and sustaining practices. One of such advocacy comprehensive,well-coordinated to older peopl is to provide programs thatare adequate for e right to freechoice and self- range of need ? the full determination whi seek for all community. groups in the The religiouscommunity should The Role of to sensitize the do all itcan ReligiousCongregations conscience ofcommunities to spir- We propose itual and moral that congregations values implicitin policyissues serve as 'their spiritual and those who which must befaced with leaders give and rights of respect to theneeds consideration to thoughtful older people. the followingresponsibilities. 3. Provide spiritual 1. Include olderpeople fully in services to olderpeopl the religious Meeting the fellowship. spiritual needsof older people Retired poses some practicalproblems which persons and other peopleover 65 years characteristic of are not so are members of other agegroups. More are home- religious congregations.As such bound becauseof illness they expectopportunities to or infirmity, andwor- participate inpro- ship as wellas counseling services grams of worship,education, and in the home. must be offered with other service along Someare in homes for members of the nursing homes, the aged, they have interests congregation. Where or other extendedcare facilities. or needs peculiarto older peo- More thanever they want the ple, theyexpect to be able spiritual ministry to formgroups of which they havecome to expect. from their own and be he priest, the pastor, to organize activitiesof their rabbi, orminister, and from choice. Some oldermembers of the cerned membersof the con- may need services congregation other duties congregation. Pressureof that can be providedon a vol- must not causethem to be deprived unteer basis, such of comfort and as daily telephonecalls of support. surance, transportation as- to the h-Juse ofworship, Changes inphysical condition, visiting-shopper life style, and service,andthelike.These relationships to othermembers of the should be provided front the older family con- wherever possiblethrough ar- person with moral and rangements and plans questions that spiritual made bya responsible are not identicalwith those group in the congregation, other membersof the facing making fullestpossi- congregations. Inthe total ble use of otherelderly members conduct of parishlife and in all and volunteer as organizers programs, older aides. persons should be fullyinvolved and their needs considered. special

223

468-713 Q - 73- 16 Finally, churches and synagogues havean obli- the total community, the religious community gation to help the aged face the necessity of shares in a responsibility to provide for aging death, with all of its pain and grief. Through people the full opportunity for lives of dignity, group programs when appropriate and especially usefulness, and satisfaction which social justice through pastoral counseling, the elderly should be demands. helped to cope with the many problems surrounding death. More needs to be done through theo- logical education to equip ministers, priests, and Roster of the Planning Committee rabbis of all ages to provide the spiritual ministry especially needed by older people. Lawrence J. Corcoran, Secretary, National Conference of Catholic Charities, Washington, D. C. Lowell R. Ditzen, National Presbyterian Center, Wash- Conclusion ington, D. C. William C. Fitch, Executive Director, National Council The religious community has older as wellas on the Aging, Inc., Washington, D. C. younger members. Its concern must be genuine Belle S. Spafford, General President, The Relief Society for all its members, providing to all spiritual and of the Church of Jesus Christ of Latter-Day Saints, Salt social ministry attuned to their needs. As part of Lake City, Utah.

224 THE ELDERLY CONSUMER

ecognizing their long-standing interest sponsive to the rapidity of change characterizing in assuring that the elderly's consumer contemporary life, as a population group, the el- problems be designated an areafor derly easily fall prey to marketplace ills. Numer; special consideration in the 1971 White ous studies, surveys, research and demonstration House Conference on Aging,theConsumer projc:ts, other conferences, and Congressional Federation of America, the Consumers Union of hearings have documented the need and offered the United States, and the President's Consumer recommendations for the development of public Advisory Council were invited to initiate planning policies directed at assuring the older citizen his of the Special Concerns Session on The Elderly rights. Within such an atmosphere, the group Consumer. The National Association of Attor- convened to plan the Special Concerns Session neys General named arepresentativetothis recognized the opportunity they were presented. group, as did the National Council of Senior Citizens, which had also earlier tried to assure They began their work with the tacit acknowl- that consumer issues be treated among the Con- edgment that in both implicit and explicit inter- ference subject areas. Joining the planning group ests, the 1971 White House Conference on Aging were representatives of the American Association was a consumers' conference -for the elderly. In- of Retired Persons and the National Retired come, health, housing, transportation, and the Teachers Association,the. National Association other needs areas around which the Conference for the Advancement of Colored People, and the was structured, were regarded as topics which Retired Professionals' Action Group.' would be addressed in any comprehensive review of the older person as a consumer. In addition, Serving as consultants to this group were gov- through a Conference plan calling for the active participation. of older people themselves in Older ernmentrepresentativesfrom Federaldepart- ments and agencies actively involved in efforts to Americans Forums, community and State confer- assist the elderly consumer. These included the ences, and within the National Conference, a firm Office of Consumer Affairs within the Executive tenet of consumerismthe involvement of the consumer in pursuits in his interestwas upheld. Office of thePresident;the Departments of Transportation, and Health, Education, and Wel- The stage for recognition of the elderly con- fare; and the Federal Trade Commission. The sumer's interest was further set for the Planning United States Senate Special Committee on Aging Committee in the recognition which had been also participated in the planning activities. given consumer issues in the Conference subject Since the 1961 White House Conference on area of Facilities, Programs, and Services. Work- Aging, a Consumer Bill of Rights has been pro- ing with the Technical Committee in that area nounced and endorsed by three Presidents. Fre- was a Special Consultant Committee on Consumer que,,tly, however, the elderlyperhaps the most Services, which identified specific consumer con- disadvantaged in the modern marketplacehave cerns for the consideration of participantsin been identified as lacking opportunity- to secure White House Conferences on Aging at all levels. these rights.Beset by low income, increasing physical infirmity, and a life style frequently unre- These concerns centered around two questions: (1) What organizational setup at the Federal 1 See Roster of Planning Committee, page 232. level would best serve the interests of the elderly

225 consumers, and, (2) In assuring consumer protec- Listeningasthey addresssedthemselvesto tion, what balance should be sought among the adopting policies and programs which wouldas- consumer himself, business, and governmental sure all elderly persons of their consumer rights, controls? were decision makers from business and govern- Other Conference activities contributed to this ment. These official listeners, invited by the Ses- propitious climate of concern. Several States had sion Planning Committee, attended, not only to chosen to extend their considerations beyond the hear firsthand of the elderly's particulai consumer specific 14 Conference subject areas to the elder- problems, but to learn where it is that the Dele- ly's considerable array of marketplace problems. gates believed responsibility lies for implementing The KansasStateConference,forexample, solutions. sparked by a special edition of Probe, the news- Three teams of nongovernment members serv- letter of the Kansas Citizens Council on Aging, ing on the Planning Committee recorded theac- Inc., adopted an older citizens' consumer pro- tion of the Session. Each team held responsibility gram. Savings, investments, and credit, market for the discussion in one of the three broad sub- sales, consumer representation, protection from ject areas, drafting the specific recommendations deceptive home sales, legal rights, and insurance which had been made, a process completed dur- reform Were components of the Kansas consumer ing the ensuing discussion on another of the top- program which the Planning Committee consid- ics, and then presenting the formal recommenda- ered as it sought to hone the focus of the Session. tions to the Session foradoption. In this regard, the Committee also utilized the report of the Michigan State White House Confer- ence Task Force on Consumer Protection. A 1971 WHITE HOUSE CONFERENCE ON ACING comprehensive document, the Task Force Report heightened the Planning Committee's awareness PROGRAM of the elderly's concern with the organization of THE ELDERLY CONSUMER government to meet their consumer needs, protective services, insurance practices, consumer educa- Chairman tion, marketing, and legal rights. .1.1COB CLAYMAN, Administrative Director, In- dustrial Union Department, AFL-CIO, and Vice Fromthis wealth of materialchartingthe President, Consumer Federation of America. movement of consumerism among the elderly, the Purpose committee members developed a platform state- To explore solutions for problems of older ment to be used as a basis for discussion at the consumers and to develop an action program Special Concerns Session. They were adamant, to solve as many of the problems as possible however, in their belief that the Session should be and alleviate those that cannot be solved. so structured as to allow the older consumer him- Agenda self an opportunity to raise his voice and seek the Chairman opens Session, introduces official lis- changes necessary to the improvement of the mar- teners and explains their role, invites all delegates to participate and vote their convictions ketplace on his behalf. as they develop this action program for the older consumer. The Program Delegates discuss Consumer Platform, divided into three major areas of concern: As buyers, recipients of services, and victims of Consumer Education and Research frauds and marketplace abuses, over 225 Dele- Consumer Protection and Legislation gates, most of whom were older people, brought Consumer Advocacy and Representation their experiences to bear upon the proposals con- Delegates vote the action program they desire, tained within the suggested platform statement. (Planning Committee members will shape these The Delegates actively involved themselves in decisions into resolution form during the discus- modifying, deleting, and proposing additional sion). recommendations. (Program continued on next page)

226 Official Listeners Public Health Service, Department of Health, SUE BOE, Consumer Services Director, Pharma- Education, and Welfare ceutical Manufacturers Association MILES W. KIRKPATRICK, Chairman, Federal BARBARA BURNS, Deputy Assistant Secretary Trade Commission for Consumer Services,Office of the Assistant VIRGINIA KNAUER, Special Assistant to the Secretary for Community and Field Services, De- President, and Director, Office of Consumer Af- partment of Health, Education, and Welfare. fairs, Executive Office of the President NANCY CHASEN, Legislative Assistant, Office W. C. LAUDERDALE, Fraud Branch Manager, of Senator Thomas Eagleton of Missouri U. S. Postal Service BETTE CLEMENS, Director of Consumer Af- PHILIP OLSSON, Deputy AssistantSecretary, fairs, Council of Better Business Bureaus Department of Agriculture PHYLLIS CORBITI., Deputy Executive Assistant, THOMAS C. PERROT, Assistant Commissioner, Environmental Protection Agency SocialSecurityAdministration,Department of SAUL HOCH, Deputy Assistant Secretary, De- Health, Education, and Welfare partment of Labor CAROL SMITH, Deputy Assistant Director, Of- GREGG HOVENDEN, Chief of Consumer Af- fice of Special Concerns, Office of Education, De- fairs, Department of Justice partment of Health, Education, and Welfare JOHN JENNINGS, AssistantCommissioner, ANN UCCELLO, Director of Consumer Affairs, Medical Affairs, Food and Drug Administration, Department of Transportation.

THE SESSION REPORT Introduction These issues are: The Delegates of the Special Concerns Session I. Consumer Education and Research on The Elderly Consumer reaffirm the four II. Consumer Advocacy and Representation basic consumer rights of all citizens: III. Consumer Protection and Legislation The Right to Safety The Right to Be Informed Consumer Education and Research The Right to Be Heard The older consumer has the right to be in- The Right to Choose formed. In a country such as ours, where literacy In order to achieve and maintain these rights, is high and mechanisms for communication are the government and the private sector must effec- available and reasonably inexpensive, the most tively combine and direct their energies and re- important approach to consumer education and sources toward that goal. Although the majority research must be to impart to the older consumer of the recommendations from this Conference are information and methods which will alert him to directed to government and voluntary agencies the problems of the marketplace and enable him for their implementation, the consumer delegates to make realistic and prudent decisionsnot only are particularly concerned that business and in- learning what to buy, but how to buy. dustry cooperate with voluntary and government The following recommendations could help as- agencies to create an equitable, economical, acces- sure that the older consumer's rights are pro- sible, and attractive marketplace for the older tected. consumer. 1. Agencies of the Federal, State, and local The Special Concerns Session on the Elderly governments, incooperation with each other, Consumer stressedspecificissuesthat would should develop and administer curriculum guide- strengthen the older consumer's position in the lines for the education of older consumers. The marketplace and which had not been addressed following areas, among others, should be cov- directlyinothermajor ConferenceSections. ered: banking and lending institutions; budget-

227

168.213 0 73 - 17 ing; consumer fraud; door-to-door selling and tel- titular needs for education and protection,so ephonesoliciting;falseadvertising;funerals; effective educationprograms can be developed healthfrauds and quackery;insurance(auto, and remedial action suggested. health, home, and life); medicalcare and services;. nutrition; pricing practices _(particularly in lowin- 7. The results of product research and testing come areas); public assistance and services avail- by government and the privatesector should be able at little or no cost, including legalservices; translated into layman's language and madeac- purchasing of all consumer products; realestate; cessible to th olderconsumer. retirement planning; and safety. 8. Any consumer education and researchpro- 2. Consumer education efforts at the local level grams developed at the Federal, State, territorial should include the establishment ofconsumer in- and local levels can bemost effectively adminis- formation and referral centers with appropriate tered at the local level. emphasis on and provision for the olderconsumer. Consumer Advocacy and Representation 3. Any independent consumeragency estab lished within the Federalgovernment structure The older consumer must be assured that his should provide forconsumer information services voice will be heard and his wishesconsidered for the elderly. Theagency should gather infor- when decisions are made which affectthe quality mation from other Federal agencies and non-Fed- of his life. He must also be assuredthat his eral sources to disseminate to the public through concerns will be given necessary emphasis and priority. government-sponsoredextensionservicepro- grams, consumer-oriented seminars, institutes, and The Consumer Concerns Session votedto rec- other leadership and group participationpro- ommend that: grams. 1. A consumer agency should be established 4. :n communicating with the elderlycon- which would be a separate entity withinthe pres- sumer, there should be a maximum use of such of ent Federal Government structure and which the following methods as have been deemedto be would have the authorityto serve as an advocate effective: educational television, commercial of the consumer, bothas an individual and as a television, extension courses, other adult educa- class, in proceedings before Federal agencies, Fed- tion courses, radio, newspaper articles, brochures, eral officials, and Federal courts. Other functions local club and group activities, storefront offices, of this agency would include the authorityto con- and paraprofessionals. Special emphasis should be duct research and education, includingthe provi- placed on person-to-person contacts. sion of systematic and comparative information 5. The broadcasting industryincluding net- about consumer products. In addition,the agency works, local stations and educational television must be adequately financed to fulfil! its responsi- and radiois called upon touse its resources to bilities and to have sufficient monies for enforce- prepare and/or accept and to air informational ment. Money must be made available for grant- and educational programs on theconsumer needs in-aid programs to developconsumer protection of the aging. Special emphasis would be placed programs in individual States, jurisdictions, terri- on the problems of the' 5,000,000 elderly whose tories and possessions. income is below the poverty level and, whereap- 2. Consumers should have the right tosue as a propriate, the format of suchprograms should in- class (class action suits)in proceedings before volve the elderly themselves. State and Federal courts and agencies. 6. Research should be done by government at 3. Social seivice agencies and volunteer action all levels in cooperation with the privatesector, agencies at the Federal, State and locallevels universities, and nonprofit groupson the prob- must be vested with proper advocacypowers to lems of the older consumer, the behavior of the represent their clients when consumer -issuesare older person in the marketplace, -andon his par- involved.

228 4. Each State should retain its Delegates to this plementation of the legislative suggestions made Conference as advisory boards to represent older by the White House Conferenceson Aging. consumers at the State governmental level. CONSUM ER PRODUCT SAFETY LEGISLATION 5. A consumer representative should be added to the newly-established Cabinet-level committee We recommend the passage ofa consumer which now coordinates Federal policies for im product safety law which has undiluted responsi- proving the quality of life, dignity and productiv- bility for preventing consumers from beingex- ity of the Nation's older people. posed to unsafe goods, drugs, cosmetics and other consumer products, including: 6. The President's Office of Consumer Affairs should make a specific staff assignment to deal Establishment of a National Injury Information with the consumer problems of older people. Clearing House to monitor and report accidents resulting in injury, illness, or death, and iden- 7. The administrator of every State and local tify the agents producing such injury. governmental agency or office dealing with consumer affairs should designate aspecificstaff Establishment of a Consumer Safety Informa- member to deal with consumer problems of older tion Center to respond to written inquiries from people. consumers concerning consumer safety and to conduct consumer education programs to in- 8. Every State investigative team which is cre- form the public of safety hazards. ated to inspect health facilities which will provide Medicare and Medicaid services should include a Development of proposed product safety stand- consumer who is eligible for these services and ards based on continuous evaluations of inju- who lives in the community of the facility being ries. surveyed. Establishment of a mechanism for withdrawal Comment: The Delegates also expressed partic- of banned hazardous- consumer products from ular concern regarding fee schedules set by the market. physicians, attorneys, dentists, morticians, and Development of generic standards of safety ap- other feefor-service professionals. plicable to new and innovative consumer products. Consumer Protection and Legislation Prevention of stockpiling of products prior to Today's changing marketplace has become in- the establishment of a final standard of safety creasingly complex and impersonal. Because of for a consumer product. these characteristics and other factors which relate particularly to older people, such as fixed and low Petitioning of consumers to commence a pro- incomes, limited mobility, and poor health, a sig- ceeding for the issuance of a consumer product nificant number of older people have difficulties safety standard. as consumers. Action must be taken at the State, Refund of the purchase price by the manufac- local, territorial, possession and protectorate, as turer of a banned hazardous consumer product. well as-Federal levels, to see that the rights of all consumers are protected- and that particular prob- Recovery of the damages and cost of a suit for lems that relate to the older consumer receive sustaining an injury if the Act is violated. necessary and appropriate attention. INSURANCE LEGISLATION Delegates recognize the need to form consumer Health Insurance: We recommend passage of leg- organizations and to know their State and Federal islation requiring more stringent regulations re- legislators for the purpose of promoting the im- garding private health insurance (with particular - emphasis on health insurance which supplements 1 Included in this section are recommendations adopted at the Session, but not included in the initialReport To The Deli,. Medicare) including: gates From the Conference Sections and Special Concerns Ses slowissued on December 2, 1971. Increased disclosure of financialoperations,

229 particularly operating expenses and profit re- composed in the majority of odiologists andau- tention. diologists for hearing aids, similar trainedper- Assurance that these firms have sufficient cash sons for other devices, and public members. resources to avoid problems of insolvency and Requiring a proper audiometric testing and fit- to prevent fly-by-night operations from cashing ting before a hearing aidmay be fitted by a in on business generated by thegaps in the salesman or dealer. Medicare program. Assuring recovery of loss when Development of basic coverage requirements an aid or device is sold improperly. based on the most pressingareas of coverage needed to supplement Medicare. Prohibiting false and misleading advertising.

Clear disclosure by the companies of thistype Requiring short-term trainingcourses for com- of coverage, and any super-supplementalcover- mercial dispensers of hearing aids and them- age, in clear, easily-understandable terms. pettic devices and appliances to be certified by Oversight of rates for the required health-in- the State health department. surance package. Establishing a program for testing of hearing Assurance that duplicate coverage byone insur- aids, audiometers, physical therapeuticdevices ance company should not he used to deny and appliances and the publication ofthe re- claims pressed by a consumer against another sults of such tests by the National Bureau of company with which he holds a policy. Standards. Suchtesting shouldinclude the quality of construction and No-Fault /Minn/obi le Insurance: Despite the fact component parts and performance as compared that statistics prove that older people to the specifica- are involved tions published for the manufacturer by the in fewer accidents per capita, and, therefore, are National Bureau of Standards. Audiometers safer drivers as a class, they are generally as- should be tested in accordance with the stand- sumed to be more at fault and less desirable risks. ards of the International Standards The older person has a right to purchase insur- Organiza- tion and the International Electrical Engineer- ance at a reasonable fee which will safeguard and ing Organizations. indemnify him against losses.

We strongly urge that the Delegates return to MISCELLANEOUS ADMINISTRATIVE AND their States and work for thepassage of laws LEGISLATIVE PROPOSALS at the Federal and/or State level providing for Require packaged consumercommodities no -fault automobile insurance to replace the under the Fair Packaging and Labeling Actto be present inadequate auto reparations system. priced on a per unit basis, displayedon the package or shelf in print that is easily read and under- HEARING AIDS, PHYSICAL THERAPEUTIC DEVICES stood so prices can be compared. AND APPLIANCES LEGISLATION When an older person needs a hearing aid, Reform regulation of land salesto provide for elimination through legislation- of physical therapeutic devices and appliances, he is current ex- faced with high prices, confusion, and lack of emptions from the Interstate Land Sales Full Dis- safeguards. We, therefore, urge the Council of closure Act; better property report disclosure; and State Governments, the State Attorneys General, a 72-business hour cooling-off period in !awl sales con tracts. and the American Law Institute to draft andpro- mulgate uniform model laws regarding the dis- Provision should be made to allowconsum- pensing of hearing aids, physical therapeutic de- ers increased opportunities. for settle lent of small vices and appliances, including the following claims to eliminate lengthy court procedures. provisions: Standards of flammability should be up-dated Licensing of dealers and salesmen by the State and effective Federal regulations applied under the health department. The licensing board to be Flammable Fabrics Act Amendments of 1968.

230 Legislation should require thename and all derly to invest in savings free from the uncertain- activeingredientsinprescribed, and over-the- ties of inflation. counter drugs to be disclosedin standardized 'readable terminology on the label of the drugas Truth-in-Savings should be required, telling packaged for sale or delivery. consumers in standard terms the annual percentage rate, the conditions under which interest will No laws or trade practices should prohibit be and is paid, and any limitations on interestor the advertising of prescription drug prices. Fur- liquidity of funds. thermore, as a matter of public policy, complete information about the availability of pharmaceuti- Gasoline should be required to be labeled at cal services should be provided to allow informed the pump, giving the amount per gallon of those judgments as to the value of the products and standardized ingredients important to the func- services received by consumers. tioning of a car and 4-s, the control of pollution.

Legislation should require a 72-business hour Home appliances should be labeled witha (3-day) cooling-off period which would give the -tel-tag" such as has been proven to be used suc- buyer or borrowers, from a seller or lender who is cessfully in Europe, giving as standardized termi- operating away from his established place of busi- nology such base information as wattage, capac- ness (includes door-to-door selling) 72 business ity, size, and performance characteristics. hours to cancel a contract. Homestead tax exemptionshould be Provision for a simple, open-dating system provided the elderly to relieve them from being for all packaged foods should be required to indi- taxed out of their homes. cate when each item should be removed from the store shelf. Housing for the elderly shouldbe designed for the needs of the elderly, included in commu- T- he Food and Drug Administration shall re- nity planning so the elderly can participate in quire all manufacturers to print informationre- community activities, integrated with home health garding ingredient content by percentage, vitamin care facilities to facilitate the transition of being content, and caloric count on all packaged foods cared for by others. It should be economical, at- to be sold in this country. tractive, and should encourage the elderly to live Legislation should be passed to abolish hold- in a life style that allows for greater socialization er-in-due-course laws. and participation with others. Legislation should be passed to prevent the Cash customers should get the same discount denial of credit to older persons solely on the the banks get when they ,give cash to the mer- basis of age. chant. Federal safeguards against unrealistic raises Comment: The intent of The Older Citizens' in rent should be continued for the protection of Consumer Program," published by- the- Kan- consumers of shelter as long as we are in a period sas Citizens Council of Aging in Probe, Feb- of inflation. ruary 1971, was accepted as expressing the general opinion of the Delegates participating The Federal Government should establish a intheSpecial Concerns Session on The Senior Savings Bond program to enable the el- Elderly Consumer.

231 Roster of Planning Committee

Nongovernment ' stinting the National Association for the Advancement of Colored People) Erma Angevine, (Chairman), Executive Director, David Swankin, Director, Washington Office, Con- Consumer Federation of America, Washington, D. C. sumers Union of the United States, Inc., Washington, Elma Griesel, Staff Coordinator, Retired Profession- D. C. als* Action Group, Washington, D. C. Camille M. Haney, Consumer Affairs Coordinator, Government Wisconsin State Department of Justice, Madisor, Wis. consin (representing the National Association of At. Dorothy Burkhardt, Assistant for Community In- torneys General) volvement, Office of Consumer Affairs, Executive Of- fice of the President, Washington, D. C. Eunice -1):- Howe, Chairman, President's Consumer ):7 Advisory Council, Belmont, Massachusetts Barbara M. Burns, Deputy Assistant Secretary for Consumer Services, Office of the Assistant Secretary William Hutton, Executive Director. National Coun- for Community and Field Services, Department of cil of Senior Citizens, Inc., Washington, D. C. Health, Education, and Welfare, Washington, D. C. George A. Johnson, Member, President's Consume'. Marilee Cavender, Consumer Affairs Specialist, Of- Advisory Council, and Assistant Head Master, Boston fice of Consumer Affairs, Department of Transporta- English High School, Boston, Massachusetts tion, Washington, D.C. Ralph Leach, Consumer Information Program Co- Patricia Carter, Professional Staff Member, Special ordinator, American Association of Retired Persons Committee on Aging, United States Senate, Washing- National Retired Teachers Association, Washington, ton, D. C. D. C. Ezra Kohn, Director of Research, Office of Consumer Yvonne Price, Executive Assistant, Leadership Con- Affairs, Executive-Office of the President, Washing. ferenth on Civil Rights, Washington, D. C. (repre- ton, D. C. W. Byron Rumford, Assistant Director, Division of 1 Although not actively participating in the work of the Plan- Consumer Education,Federal Trade Commission, ning Committee, the American Council on Consumer Intere5ts Washington, D. C. and the Consumer Advisory Task Force of the American Asso- ciation of Emeriti accepted invitations to serve with the other Ann Uccello, Director, Office of Consumer Affairs,_ organizations as co-sponsors of the Session. Department of Transportation, Washington, D. C.

232 LEGAL AID AND THE URBAN AGED

tthe request of the American Bar on Aging of the United States Senate, was made Aisociation Family Law Section Com- available to the Delegates who attenued this Ses- mittee on Legal Problems of the Aging, sion. Some of the Delegateswere well acquainted and the Legal Research and Services with the document and were thus abletocontrib- to the Elderly Project of the National Council ute to the discussions from more thanI their own of Senior Citizens, this Special ConcernsSession experience. was provided. The Institute of Criminal Law and Procedure of the Georgetown UniversityLaw Center also accepted an invitationto membership The Program on the Planning Committee. These three co- sponsoring organizations were assisted byrepre- The program of the Special Concerns Session sentatives from the Office of Services to the Aged, on Legal Aid and the Urban Aged was presented the Public Defender Service of- the District of in two parts reflecting the two majorareas of Columbia, and Federal 'representatives from -the concern. Departments of Justice, and Health, Education, . . and Welfare, and the White House Conference The first part dealt with "The Elderlyas Vic- on Aging. tims of Crime." This part of theprogram concerned itself with the need for protective facilities- to deter "whitecollar crime," such as unfair business practices and fraud, as well as "crimes of Participants violence" such as assaults and robberies. Attention Nearly 100 Delegatesto the 1971 White was also given to ways to facilitate the participa- House Conference on Aging participatedin this tion of the elderly in the criminal justicesystem. Session. Many of them were lawyers and knew The second part of the Session was concerned first hand the problems to which this meetingwas with providing legal service to the aged; services addressed. Other Delegates had themselvesexpe- such as: representation in appeals togovernmen- rienced problems in getting legal service, and still tal agencies, conservatorships and guardianships, others were concerned about the high incidence administration ofestates,andfacilitationof of crime against the older citizens. A working model legislation. The suggestions presented in paper entitled "Legal Problems Affecting Older this report speak to the protection of self,prop- Americans, "' prepared for the Special Committee erty, and civil rights for older people. This area of concern and these suggestions must be given care- I Available from the Superintendent of Documents, United ful attention if the dignity of thelater years is to States Government Printing Office, Washington, D. C. 20102. become a reality. Price S.30. (See Program on next page) 233 1971 WHITE HOUSE CONFERENCE ON AGING

PROGRAM Resource Panel LEON JAWORSKI, President, American Bar LEGAL AID AND Association THE URBAN AGED JOHN DOUGLAS, Former President, National Presiding: Bruce Terris Legal Aid and Defender Association

ALFRED CONARD, President, Association of IT 8:00 A.M.Part I THE ELDERLY AS VICTIMS OF CRIME American Law School JAMES W. COBB, President, National Bar As- Speaker sociation SEYMOUR GLANZER, Fraud Division, Office of the District of Columbia MARVIN LEWIS, President, American Trial Lawyers Association Resource JEFFERY HALPRIN, General Counsel to Met- C. NORMAND POIRIER, President, Federal ropolitan Washington Police Department, Dis- Bar Association trict of Columbia NORMAND J. KALCHEIM, Chairman, Corn- PRESENTATION OF RESOLUTIONS mittee on Legal Problems of the Aging, Atheri- FOR DISCUSSION AND VOTING can Bar Association

9:45 A.M.Part II EDWIN VILLMOARE, Program Development LEGAL SERVICES FOR THE AGED and Training Division, Office of Legal Services, 0E0 Speakers DAVID H. MARLIN, Director of Legal Re- search and Services for the Elderly, National PRESENTATION OF RESOLUTIONS Council of Senior Citizens FOR DISCUSSION AND ADOPTION

DR. CLINTON BAMBURGER, President, Na- tional Legal Aid and Defender Association 12:00 NoonAdjournment

234 THE SESSION REPORT

Recommendations Law Enforcement Assistance Administration for personnel.of the criminal justice system. 1. The Law Enforcement Assistance Adminis- tration, the Department of Housing & Urban 4. The Federal Government should provide Development, and other Federal agencies should funds to allow consumer protection agencies, with provide funds for new methods to protect the el- staff, to be established or expanded by State, derly against crime. For example, special security county or city government in every locality to pro- measures should be included in 'all housing occu- tect the elderly from fraud. They should develop pied exclusively or largely by the elderly, suchas educational techniques to alert the elderly to the ways to call the police from each residence, high kinds of frauds frequently practiced and the need quality door and window locks, and extra guards. to consult a legal service or other attorney when Social Security and other government checkscan large purchases are being made. They should also be sent on varied dates instead of all atonce, and draft statutes needed to protect the elderly, such can be sent, with the consent of the elderly, dias allowing several days for recession from con- rectly to banks. tracts made with door-to-door salesmen of home improvements or various 'consumer goods. 2. Social services should be designated to work closely with-police departments so that all elderly 5. Fraud units should be established in Fed- persons who are victims of crime, or who report eral,State, and localpolice and prosecuting non-criminal problems to the police, can obtain offices. The personnel of these offices shouldre- all necessary assistance. Such agencies might be ceive thorough training in methods to detect and within or outside the police department itself. combat schemes used to deceive the elderly. The Emergencyassistanceshouldbeimmediately Federal Government, either directly or through available for persons who have suffered loss of the Law Enforcement Assistance Administration, checks or money, personal injury or other dam- should provide training and funds to enable such age. A single telephone number should be publi- programs to be established. cized so that the elderly can readily obtain these services. The Law Enforcement Assistance Ad- 6. TheFederalGovernment(throughthe ministration and other Federal agencies should Office of Economic Opportunity, any successor provide grants to agencies to provide these serv- legal service agency providing funds for legal ices. And the local Bar Association should de- services -to the poor, or other agency) should set velop programs to ensure that victims of fraud aside funds to be used -for special legal services to can obtain attorneys to represent them in suits serve the elderly which are at least proportionate seeking compensation for their losses. to the elderly's share of the total poor. These 3. The criminal justice system should give spe- services could be provided by existing legalserv- cial assistance to elderly persons who are victims ice programs or new -programs. A minimum of of crime or are witnesses in criminal cases. For $10,000,000 a year should therefore be set aside example, police officers, prosecutors, and defense forthispurpose immediately. Some of these attorneys should be especially trained to commu- funds should be available to allow organizations nicate with the elderly. Elderly witnesses may of the elderly to retain partial feesor prepaid need to be provided with transportation for court legal insurance for the elderly whose incomesare appearances. Trials may have to be conducted inadequate to pay full legal feesor the cost of more promptly to relieve the burden on the el- such insurance. derly from repeated and protracted court appear- 7. TheFederalGovernment(throughthe ances. The Federal Government should provide Office of Economic Opportunity, anysuccessor assistance to these efforts such as by including legal service gency, or other agency) shouldes- these ideas in training provided by funds- of the tablish a special center concerning legal rights of

235 the elderly comparable to its centers relating to or limit benefits. These fees should be adequate health,housing, consumer, migrant problems. to attract attorneys to provide service to elderly The center should do research, bring test cases, clients regardless of income. draft and work for model legislation, train legal service attorneys and legal aides, and have addi- 12. All Federal and State benefit 'programs tional funds to support demonstration and re- should explicitly notify in writing all elderlyper- search concerning the regal problems of -the el- sons whose benefits are denied, reduced or lim- derly. ited, that they have the right to representation by an attorney or trained lay advocate, the desirabil- 8. The Federal Government(throughthe irrof this representation through legal service Office of Economic Opportunity, anysuccessor programs, Bar Association referral committees, legal service agency, or other agency)- should pro- and other means. The Federal or State govern- vide funds to train elderly laymen as paid legal ment should provide for free counsel chosen by aides and to operate programs in which these the elderly if the elderly cannot otherwise obtain aides can act as advocates forthe.elderly before counsel. administrative agencieg. 13. The elderly should be provided free, com- 9. Legislationtoestablishalegalservices petent attorneys inallproceedings relating to agency to assume the responsibilities of the Office civil commitment, conservatorships, and other of Economic Opportunity relating to legalserv- proceedings brought to restrict their freedomor ices should assure that the elderly are represented other legal rights. Such legislation should allow on the agency's board of directors in approximate the elderly to pay for persons of their.own choos- proportion to their share of the poor. ing. 10. Legal service programs should themselves 14. The States should adopt legislation provid- develop or work closely with existing outreach ing public guardians, conservators, and adminis- programs to the elderly poor so that the elderly trators without cost to the elderly who cannot are fully aware of and have full accessibility to afford from modest assets to pay for theseserv- legal services. ices. Such legislation should allow the elderly to 11. All Federal and State benefit programs pay for persons of their own choosing. such as Medicare, Medicaid, and Old Age Assist- 15. A subcommittee of this Session should -con- anceshould provide for the payment ofattor- tinue to operate after the Session is concluded to neys' fees, which are not taken from the benefits work with the leadership, staff, and Delegates to to which the elderly are entitled, for all elderly theConference andwithothergovernment persons who challenge decisions to deny, reduce, officials to carry out the above recommendations. Roster Of Planning Committee Government Nongovernment Carlile Bolton-Smith, Assistanttothe- Director, Bureau of Hearings and Appeals, Social Security Ad- Bruce Terris,Chairman,Attorney, Washington, ministration, Department of Health, Education, and D. C. Welfare, Washington, D: C. Robert Brown, Associate Director, Legal Research Roberta Brown, Director, Office of Services to the and Services for the Elderly, National Council of Aged, Washington, D. C. Senior Citizens, Washington, D. C. Jane Comerford, Social Case Worker, Mental Health Division, Public Defender Service, Washington, D. C. Alan Hurst, Research Assistant, Institute of Criminal Law and Procedure, Georgetown University1.4w Axel Kleiboener, Attorney Advisor, Office of Crimi- Center, Washington, D. C. nal Justice, Office of the Deputy Attorney General, Department of Justice, Washington, D. C. David H. Marlin, Director, Legal Research and Serv- Frank M. Stewart, Technical Assistant, White House ices to the Elderly, National Council of Senior Citi- Conference on Aging, Washington, D. C. zens, Washington, D. C.

236 Reports of the Special Concerns Sessionson YOUTH AND AGE

VOLUNTEER ROLES FOR OLDER PEOPLE

he American National Red Cross, the B'nal I3'rith Women, the Community 1971 WHITE HOUSE CONFERENCE ON AGING ServiceSociety of New York,the Jewish Social Service Agency, and the National Center for Voluntary Action made up PROGRAM the membership of the Planning Committee for the Special Concerns Session on Volunteer Roles VOLUNTEER ROLES for Older People. The Foster Grandparent Pro- FOR OLDER PEOPLE gram and Retired Senior Volunteer Program of 2. ACTION also sent representatives to the Com- PresidingMRS. ALEXANDER RIPLEY, Presi- mittee. dent-Elect, National Conference on Social Welfare 8:00 A.M.-8:15 A.M.Welcome and Opening The Participants Remarks That older and retired persons want to put their 8:15 A.M.-9:15 A.M.Background for the For- mulation of Recommendations experience, skills, and time to the service of others Volunteering TodayMrs. ALEX- as volunteers intheir communities was clearly ANDER RIPLEY demonstrated by the participants in -this Special Volunteer RolesCHARLES ARCHI- Concerns Session. Approximately 400 delegates BALD, New Jersey Department of Insti- pre-registered for this Session; they were joined tutions by many other Delegates, observers, and invited --Factors Influencing Volunteering by guests. Of the17 SpecialConcerns Sessions, OlderPersons GWEN O'NEAL, the Session on Volunteer Roles for Older People American Association of Retired Persons had the second largest attendance. Official Dele- Value of Volunteering by Older Per- gates were the only persons at the Session who sonsHARRIET NAYLOR, National were permitted to vote on the recommendations. Center for Voluntary Action The participants came to the Session without 9:15A.M.- 9:30A.M. AssignmenttoSub- prior knowledge of the format or content of the groups program, but each brought his conviction and 9:30 A.M.-10:45 A.M.Preparation of Recom- dedication to the idea that older people could mendations fulfill themselves by giving. Discussion Leaders Subgroup No. 1CHARLES FREEMAN, The Program The New York Room Subgroup No. 2THOMAS TEWEY, The Session focused on the development of The Massachusetts Room policy and action recommendations that facilitate Subgroup No. 3ROBERT CURREY, volunteering by older persons. As background for The California Room the formulation of recommendations,some consid- Subgroup No. 4DENISE CAVENAUGH erations significant to volunteering by olderper- and RICHARD- SHAPIRO, The Con- sons were brought into focus in four brief presen- gressional Room tations. 11:00 A.M.-12:00 A.M.Concurrence -on Final Recommendations In her opening remarks, Mrs. Ripley noted 12:00 NoonAdjournment three major current trends in volunteering contri-

239 busing to the growing significance of the-volun- sible in his years of employment. The potential tary roles in our society: the great-expansion, both manpower inthe pool ofretired,olderper- in quantity and in variety, of opportunitiesfor sons presents both a resource and a challenge to volunteer involvement; the expandingresources volunteering. for volunteer recruitment (the olderperson and retiree being one of-the most significant of these); Following the presentations, four subgroups and the emergence of special professional leader- were organized to allow as generous an opportun- ship for voluntary effort at both local and national ity as possible for conferees toexpress their think- levels, under private as wellas governmental aus- ing. As a means of arriving at substantiverecom- pices. mendations in this broad subjectarea, each subgroup was asked to consider the need, and develop In volunteering, individuals have opportunity recommendations to meet the need inone of to fill many roles Mr. Archibald noted. "Volun- four areas. The Delegates were told thatrecom- teers" are frequently seenas those who give direct mendations could be developed regardingany service to others in regularly scheduledprograms. other aspect of volunteering by olderpersons as Attention was called to the importance ofthe ser- they saw the need, but that all recommendations vice of volunteers in policy and planningroles were required to receive the approval of the en- and in leadership of the activities ofothers as well tire Session. The four areas were: as in roles of stimulating participation in groups 1. Recommendations to agencies and organiza- that organized 'around special interests, including tions with respectto strengthening their groups that direct their volunteer efforts to mat- commitment to the involvement of older ters of concern to the well-being-of senior citizens persons as volunteers. themselves. 2. Recommendations With respect to how older Chief among the significant factors influencing persons can be encouraged to give volunteer volunteering by older personsare the attitudes and service, including recommendations toor- misconceptions of others regarding the capabilities ganizations whosemembership include of older persons. MissO'Neal pointed out that older persons. great variations in physical, emotional and mental 3. Recommendations with respect to meeting capacities exist at every age, and that the inclu- the individual's cost in volunteering (reim- sion of older persons in setting goals and in for- bursement and stipends). mulating plans and policy may well be the missing ingredient in achieving effective, fresh approaches. 4. Recommendations regarding special consid- The fact that some olderpersons cannot afford erations in the development of volunteer financially to volunteer isa factor to which at- participationthatwouldencourageor tention should be given, not in terms ofmoney strengthen the involvement of older persons. alone, but of fundamental convictions regarding Both the subject matter of this Special Concerns the values of volunteer services. Job designat Session and the small group discussion method every level is the key to sound planningbuilding which was used contributed to the participants the worth of the volunteer participation into the exchanging a great deal of information andex- organization's total plans. perience regarding the stimulation and development of volunteer participation by older persons, Volunteering by older persons has special values particularly in the areas of recruitment, guidance, to them as well as to the persons served. Assome and recognition of volunteers. Much 'of thiswas of these, Mrs. Naylor pointed out: opportunities not essentially in the nature of recommendations for the use of knowledge, skills, and judgement foraction; Recommendations accepted -by the acquired through life experience; time for thought- participants reassembled in a general session,as ful listening to persons and problems; theolder reported below, reflect the substance of the much person's need to fill roles- usefulto others; and more detailed and cowprehensive reports of the his greater freedom, to do and be thingsnot pos- discussion sub-groups.

240 Recommendations provide for adequate staff leadership andprepara- tion of staff to support volunteer involvement. 1. A national policy should be established to create awareness in the Nation at large about the 5. Jobs developed for older volunteers should- worth and talents of older -adultsas a national meet the needs of older persons, provide for pro- resource and to encourage older adults to volun- gressive levels of responsibility, and recognize the teer. In this connection, widest possible use should need for special job design for adults. be made of pre-retirement counseling as a- point of interpreting volunteer opportunities. 6. Budget planning in both government and ivoluntary agencies should provide for making 2. Existing national older adult volunteer pro- availabletoolder volunteers assistance, when grams should be expanded and funded at ade- needed, with transportation, incidentalexpenses, quate levels in order to serve extensive numbers and insuran.protection.' of older persons. 7. Appropriate interested organizations, agen- 3. There should be support for and strengthen- cies, and departments (governmental and volun- ing of national leadership (governmental and tary) should endeavor to developa workable def- voluntary) through which local organizations, de- inition of a Volunteer. partments, and agencies- can be encouraged and assisted in developing volunteer participation by Comment older persons. Discussion-of This recommendation indicated the diversity of views with respect to what is Cominent a volunteer. But there was concensus on the In discussion-of this recommendation,as il- need to provide the widest possiblerange lustrative of national leadership, reference of opportunities for olderpersons to be in- was made to the National Center for Volun- volved in the life of their communities, from tary Action,the Centerfor a Voluntary full-tiMe paid employment to part-timeun Society, Retired Senior Volunteer Program, remunerated service. and others. Concern was 'expressed regarding the need 4. Agencies and organizations (governmental to clarify, at local levels, the character of and. voluntary -at any level) should adapt their volunteer service in order to insure that_giv- programs to the use of older volunteers and pro- ing such service should not infringe- the vide adequately for their training, their -growth, rights Of older persons to receive publicas- and recognition of their accomplishments; should sistance or other public support. .

Roster of Planning Committee

Nongovernment Phoebe Steffey; Assistant Directoi, Office of Pro- gram Development, American National Red Cross, Ruth Breslow, Coordinator of Volunteers Services to Washington, D.C. the Aging, Jewish Social Service Agency, Rockville, Maryland Isolde Weinberg, Information Researcher, National Center for Voluntary Action, Washington,_ D.C. Mrs. John Byrnes, Volunteer; American National Red Cross, Washitigton, D.C. Helen Diamond, Director of Training & Develop- Government ment, B'nai B'rith Women, Washington, D.C. Anne C. Johnson, Chief, Foster Grandparent Pro- David Jeffries, Vice President for Administration, gram, ACTION, Washington, D.C. National Center for Voluntary Action, Washington, Alfred N. Larsen, Chief, Retired Senior Volunteer D.C. -Program, ACTION, Washington, D.C. Janet Sainer, Director, SERVE Projects, Community Frank Stewart, TechnicalStaff 'Assistant, White Service Society of New York, New York House Conference on Aging, Washington, D.C. 241 'I YOUTH AND AGE

hen the Planning Board of the 1971 gates, observers, and guests, were provided the op- White House Conference on Aging portunity to express themselves and to present wasinitiallyconstituted,no young their recommendations. people were named as members. Be- lieving that the social problems of aging are a concern of youth as well as adults, Elliot Rich- Development of the Session ardson, Secretary of Health, Education, and Wel- fare,directed Conference plannerstoinvolve Central to the planning of the Special Concerns members of the younger segment of the popula- Session was the notion that it should buildupon tion. the unique opportunity presented by havingyoung At its first meeting in the Fall of 1970, the Con- persons from across the country named to partic- ference Planning Board included youth represen- ipate in a conference on the problems of the tatives from eight national youth organizations. elderly. To this end, at the initiative of the Youth These youthful members of the Conference plan- Participation Committee, the White House Con- ning body sought to inswe the meaningful partic- ference on Aging sponsored a series of 4 oneday ipation of young people in all Conference activities regional youth meetings. During- October 1971, and arranged to meet again with the Conference Boston, Atlanta, Chicago, and-San Francisco each Director to discuss additional routes which this hosted meetings Df Conference Youth Delegates involvement might follow. from geographically proximal States and territories. Stemming from these two meetings, two youth delegate positions were allocated to each State The regional "youth think" sessions servedas an and territory which was to name Delegatesto the important preparatory activity for the Session it- Conference. In addition, the initial eight youth self. Lacking the specificity ofconcern and focus representatives*had their_number expanded td in- which might be thought to characterize otherspe- clude-representatives from various minority groups cialConference Sessions,itbecame possible, and_ from among youth not involved in organized through the mechanism of the regional discus- national activities. And, as the Youth Participa- sions for Youth Delegates to identify common tion Committee of the Planning Board, thegroup areas of concern to serve as the themes around was charged with the responsibility for devel- which substantive discussion and refinedrecom- oping plans for- youth participation in the Con- mendations- could be forthcoming in the length ference.' of the morning Session Ln Special Concerns.

Although desirous of having young Conference The Youth Delegateslargely students from Delegates participate with thesame rights and high schools and colleges, but including graduate privileges as other -Conference participants, the students and young professionals -working with Youth Participation Committee soughtto make the agedthrough their discussions with others it possible for Youth Delegates to meetas a group from their region, with members of the Youth during the Conference to develop proposalsre- Participation Committee, and with Conference flecting their distinctive attitudes and particular 'Chairman, Arthur S.Flemming, shaped their thoughts into a working document for interests. Through the Special Concerns Sessionon use at the Youth and Age, Youth Delegates to the Confer- Session: -Each regional grouping, drawingupon ence, joined by other interested Conference Dele- the discussions Of those meeting before it andupon the work of the Youth Participation Committee, worked to formulate the document attachedas an 1See Roster of Planning Committee, page 253. -Appendix to this report.

243

__! Reflecting the concerns of over 100 young peo- the morning Session was spent in small group dis ple between the ages of 17 and 25, this document cussions. Delegates chose to participate within one served to focus the program and recommendations of three work groups, each group considering one of the Special Concerns Session on Youth and Age of the three core-areas of concern identified by around: youth in their preparatory meetings. 1. Youths'overriding concernwithseveral major societal issues. To insure access to those who could implement their recommendations, the Session participants 2. A specificconcernwith young peoples' addressed their remarks to an invited listemng awareness, attitudes, and education directed panel. Persons working within national organiza- at understanding aging and the problems of tions, particularly those directly involved in youth the aged. and volunteeractivities, and representatives of of- 3. An interest in community service and vol- fices within the Federal Government with special untary action directed at ameliorating these interest in student and youth affairs, heard the problems. challenge to action presented by the young Dele- gates. Also there to listen, as well as to present The Program the keynote address,was WebsterB.Todd, As suggested in the following agenda, most of Executive Director of the Conference.

1971 wiirrE nous': coNnmuNci: ON AGING (Iniro.baionofListening P.sritl Coned) THOMAS MOONEY, Vice Presi- PROGRAM dent, National Students Association JACK TENNANT, Coordinator, YOUTH AND AGE Office of Teacher Retirement, Na- tional Education Association PresidingTHOMAS E. -FIELDER, Chairman, STANLEY B. THOMAS, -Deputy Youth Participation Committee, White Assistant Secretary for Youth and House Conference on Aging StudentAffairs,Departmentof 8:00 A.M.Welcome and Opening of the Health, Education, and Welfare Session, THOMAS E. FIELDER BARBARA WILLIAMS, Member, Introduction of Listening Panel Board of Governors, The American JOAN CATON, Special Assistant National Red Cross for Student Affairs, Office of the :ARTHUR WEINER, Urban/Sub- Secretary,Department of Health, urban Relationships Executive, Boy Education, and Welfare Scouts of America GEORGE FREEMAN,Director, Washington Bureau, Boy Scouts of 8:20 A.M.Address, WEBSTER B. TODD, America Jr., ExecutiveDirector,White MABEL HAMMERSMITH, Pro- House Conference on Aging gram Specialist, Girl Scouts of the States of America 8:35 A.M.Group Discussions SCOTT HUNT. Director,-Office of Youth Statement of Concerns Youth and Student Affairs, Office Youth Awareness and Aging of Education, Department of- Health, Education, and Welfare Youth and Voluntary Action ALEX MALESKI, Director, Spe- cial Services, Boys Clubiof America 10:30 A.M.Presentation of Group Recom- mendations for Discussion and Rat- MARGO MARUSI, Staff Member, ification Office of Robert H. Finch,, Coun- selor to the President, The White House 12:00 NoonAdjournment

244 THE SESSION REPORT

I. Concern 8. We urge that many more employmentop, Whereas, we recognize young and oldare one; portunities,includingpart-timejobs,be and both deserve dignity and respect; and together made available by government and by the are concerned with the quality of life in the fu- private sector for both youth and the aging, ture as well as the present; and in recognition of particularly those jobs which enable them the urgency of the situation;we therefore pro- to -work together _and relate to one another pose the following: for the betterment of themselves and _their communities. 1. A radical and immediate reordering ofour national spendingpolicies- and economic priorities to place human needs before the H. Awareness material needs of the military and thespace program. As citizens we are all entitledto full participation in the democratic 2. A wide range of accessible-services must be process. Therefore, we urge that public and privately-sponsored civic edu- provided in the areas of nutrition, health, cation programs be implemented for the aging housing. medical and social care. But the to inform them of their legal rights and political most crucial need is to provide all citizens privileges and toencourage them to exercise these a guaranteed adequate income enabling them rights and privileges collectively. to purchase goods and services of their. own choosing. Wherever appropriate, economic boycott,non- 3. That both young and old be represented in violentprotest and demonstration, and other the decision-making processes of all local, forms of political activity should be usedto pursue State, and national commissions and boards the goal )f a better life for all Americans. affecting the aging. In order to effectively implement the positions 4. That all persons, particularly the aging, be stated above, it is recognized thatawareness of given the legal right to choose to dienat- the continuation of life from conceptionthrough urally and in dignity, avoiding prolonged death is an essential aspect of education through- illness, pain, confinement, and degradation. out the life cycle.It is further recognized that 5.That we must bridge thegap of young and there will be many avenues of activity thatmust old by encouraging alternate forms of social be exploited and maximized. organization to supplement family structure We submit the following resolutions regarding from which young and oldare often with- education: drawn. 1.Federal, State, and community agenciesshall 6. That government-immediately provide -ade- earmarkfunds and appoint committees- quate and sufficient housing -for the aging within the year following the WhiteHouse including communal settings whereyoung families and the old can live together. Conference on Aging for the preparation, and utilization of curricular and educational 7. That society should adopt a policy of educa- materials for all school levels that deal with tion for life such as preparation for job, the biological, medical, psychological, social, family, retirement and use of leisure time. and environmental aspectS of thecontinua- This education should begin withyoung tion of life from conception through death. children developing a philosophy of life Further, this shall be implemented with in- and should be developed by consultation service training for teachers at all levels,as with government, business, labor, and edu- well as continuing education forpersons all cational institutions, through life.

245 It is particularly suggested that in allappro- HI. Action priate educational institutions,courses such as sociology, anthropology, etc., be offered One of the major aims of the WhiteHouse in which younger and olderpersons can Conference on Aging should beto harness the ac- both enroll on a credit or non-credit basis. tivity and energy of youth and link itto the solution of the problems confronting the aging. 3. Conference follow-up -shall include: Three areas of youth volunteer activity suggest them- a.Contact with student governments at selves for immediate action: everyavailableeducationallevel-to identify a vehicle for their contributions 1.Providing information to senior citizensre- towards the realizations of the policies garding existing social services and financial adopted at this Conference. resources. b. Contact withexisting and projected 2.Rendering direct service to senior citizens. Federal agencies with fundedprograms 3.Acting as advocates in behalf of the elderly. for youth opportunities' in community activities(e.g.ACTION,Domestic However, it is imperative that suchprograms Council, etc.)to identify aging as an involving youth and aging recognizea relationship urgent social issue. of reciprocal rewards. Additionally,young- people should be reimbursed forexpenses incurred in c.Contact with universities, State andcom- volunteer activities. munity colleges and community organizations to establish seminar and field Suggestions for immediate action include: experience coursesthatwillinvolve 1.. Providing information students in all disciplines. a. Undertake local projects to identifyex- 4. Wherever possible, educationalsystems at isting resources for and needs of aging all levels should utilize qualified olderper- Americans. sons as paraprofessionals._Formal credential b.Staff telephone information andcrisis requirements should be relaxed without the centers. relaxation of remuneration for theseservices. Funds should be- provided byan ap- c.Utilize the media to inform the aging propriate Federal agency for these services. about existing resources. 5. We think that without neglecting the incor- d. Guarantee that youth and aging berep- resented in all aging-related agencies. poration of preparation -for living into -the school system, it is urgent thatevery avail- 2.Rendering service able avenue for informal education bepo- tentiated. Priority (in the appropriation of a. Form transportation -teams to assist the elderly. funds) shall be given to the promotionof interaction between youth and aged outside b.Assist in home upkeep and maintenance. the formal school system, in voluntary-or- c.Establish friendly visitor programs. ganizations and other common activitiesas a conscious reflection of the need to change d.Utilize programs sponsored by ACTION current cultural attitudes and stereotypes of to provide needed staffing. all stages of life. e.Assist with programming activities in Senior Centers. 6.It is finally urged that the President ofthe United States include,as part of a national f.Provide -escortservices,especiallyat policy on aging, an emphasison achieving night. life cycle education as a mandatory compo- g-Provide activities that will- promoteso- nent of all educational institutions. cial and sexual interaction for the aging. 246 3.Acting as advocates -_(STEP)*, through the formation of local-steering a.Utilize existing advocacy groups on be- committees. National youth organizations and half of the elderly. State agencies should encourage their local affiliates to.begin creating these committees and _to pro- b. Form community-wide advocacy groups, vide the funding for training programs in the which will also serve as grievance-boards study of the aging. and community coordinating committees for volunteer activities related to aging. In-order to implement a program of young assisting the aging, means are needed to -mobilize * The STEP concept is discussed more fully in_ the document and coordinate community activities. This can be engendered by the Youth Delegates in their regional meetings. accomplishedby-ServicestoElderlyPeople-

247 Platform Statement of Youth Delegates' 1971 White House Conferenceon Aging

Introduction the percentage of the population they represent, particularly in terms Of Fed- In preparation for the Special Concerns Session eral funding and Stateagency spend- on'YouthandAge,Regionalmeetings of ing. Youth Delegates to the 1971 White House Con- ference on Aging were held to develop a compre- An investigation of national priorities hensive working statement of youth concerns and hi terms of defense and-space spending proposals regarding aging and society. as compared to domestic needs. The structure of this working document, which lent itself to adoption as the framework for the development of recommendations within the Ses- sion itself, includes a statement of overridingcon- Youth Awareness of Aging cern- and an elaboration upon the themes of education and voluntary action among youth. Aging is not a sudden occurrence-at 50or 65, but a developmental process proceeding ata rate From this working statement, the thought and unique to each individual. Too often, however, study whichits preparatiol.fostered, and the peopleand especially young people unique opportunity presentedyoung people to -- ignore the meet in a Special Session of the White House -developmental aspects of aging and, asa result. Conference on Aging, specific recommendations 'hold many- misconceptions about the agingprocess. A more realistic understanding-of others andwere framed and presented,to the Nation. a fuller acceptance of one's own developmental process would be gained if individuals were aware of the -potential -problems and disadvantagesex- Youth Statement of Concern citements and rewards -of -each stage of the life cycle from infancy to old-age. Such preparation The priorities- of this countryare not in for living should deal with the biological factors the best interest of the needs of the people of growth-and physical change, -the ensuingpsy- particularly the aging. We,as citizens of chological- needs and strengths, social environ- the United States of America, isolated and mental influences affecting personal-development, and the responsibilities of society in dealing-with- forgot the elderly after allowing them to the problems and concerns of individuals of dif- sacrifice their lifetimes to make it possible ferent age groups. for us to enjoy a high standard of living. Therefore, we, as Youth Delegates- to-the Awareness of the devel-opmcntal processcan be _gained- through association with others- of differ- 1971 White House Conference on Aging ent ages. Youth, for instance, can gain under- strongly support. standing and insight into the concerns of the -el- Equality for the aged. derly through involvement incommon activities -(the voluntary action -segment of this document A balance of spending hi proportion to deals more specifically with how face-to-face in-

Suhrnitted=for the consideration of Delegates to the Special volvement can be- attained). Rut knowledge of-the Concemc Session on Youth and A. developmental process and- the social conditions 248 that may affect individuals at different steps of the d. Develop adult education, community aides,. life cycle can be better gained through formal field placement, trainingprogram' for volun- learning. teers of all-ages and educational levels. The concept of preparation- for living could be 2. Pre-Elementary and Elementary School incorporated into the school system at all levels Levels to alert individuals to the feelings and experiences of others as well as how one's a. Utilize elderly persons as nursery school help- own feelings and ers -and day care-center supervisors. experiences fit into the Overall pattern of life. Such a program would also utilize theresources b." Encourage school administratorstoavail of various segments of the population inthe themselves of older persons as teacher aides, teaching process and tap the resources ofyoung reading tutors, etc. people in-alleviating some of the social problems c. -Provide situations for face-to-face_ interaction affecting older individuals while at thesame time between young children and older people. gaining valuable practical experience. d. Hold a National Poster Conteston the theme In this section, the following items will be dis- -Young and Old Together.- cussed:- 3. High Schools 1.Preparation for life at the elementary andpre- a. Provide options for relaxing school require. elementary school level. ments in order that young people may become 2. Continuing emphasis including career possibil- more involved in the community. ities and social problems. b. Discuss the problems of -the aged and of 3.Utilizing college students in alleviatingsome aging and implications for societyas part -of social problems. contemporary -American government, current issues, classes, etc. Also, provide optional- IDEAS OR DISCUSSION -field experience in social service agencies, senior DiscussionSjritithe regional meetings revolving citizens community centers, nursing homes, with around the -topic -of youthawareness produced= older- individuals, etc. severalideas and -suggestions forways youth knowledge and understanding of the agingTtoc= c. Encourage instructors in the social science css could be increased through the existing school fields_ :(psychology, sociology, etc.) and in- bi- ology-and health to incluch information system. kle-as which are general -in scope are listed on the mental, physical, and social aspects of aging, -first, followed by those pertainingto elementary and= high =schooi-s, and universities- d. In vocational- educationprograms, promote courses which will train yozing-peor h. to -work 1. General with older people in- healtil instit.reS suchas a. Update the educational system in -order to -nursing homes and hospi_als. Ltilize tetitedl -emphasize the individual-developnient-ofa life workers as resource_people>r part-time teachers- style and philosophy of life thatare dynamic in vocational educationcourses. i.e. accepting and adjusting to change in the. e. In home economics-programs, invite mobile larger-society and in one's physical and mental elderly from the community and nursing homes capabilities. (and provide transportation) to food service -b. -Expand the scope ofeducation to include classes where _meals -are prepared. --Wherepos- information and possibly training for youthon sible utilize older women in cooking, sewing,or -the constructive use of free time. other craft classes. c. As our society becomes more technological f. For school activities suchas plays, musicals, and industrialized, schools must hear majorre- and sports, set aside special accessible sections sponsibilityfor educating people of various ,for older: persons, both from the community and ages for second careers or for leisure-time activ- from nursing -homes. Arrange special _perfor- ities. mances and provide the transportation. 249 4. Colleges and Universities Conference on Aging follow-through staff,or by a. Emphasize research in gerontology. a representative from the Domestic Affairs Coun- b. Offer interdisciplinary courses de*aling with cil, or from the Department of Health, Education, the aging process. and Welfare's Office of Youth and Student Affairs with the National Education Association, National c. Organize more opportunities for field ex- Association of School Boards, and the National periences for credit. Associations of Elementary and Secondary School d. Emphasize flexibility, both in involvingvar- Principals to: ious disciplines and types of placement offered. Encourage the involvement of elderly peopleas PROPOSALS FOR IMPLEMENTATION class resources. In order to implement the ideas listed in the Expand the scope of education to include prep- previous section, several program ideasor mech- aration for living emphasis. anisms have been developed. It should be assumed Delevop community-oriented field experiences that the people who know the most about growing in the field of aging. old arc those who have actuallygone through the 3. A "National Poster Contest" could beor- process. Additionally, it can be assumed that those ganized by the State agencies who teach best are usually those who have done it on aging. Contests throughout their lives. If these two assumptions would be arranged on local level' inany way the are granted, then the following proposal should agencies see fit. Then schools, youth gm-ups, and enable us to have a significant impact local committees on aging would take part. Hope- on increas- fully, these posters would be distributed ing the awareness of the young about growing old. to local businesses, nursing homes, senior citizens' clubs, 1. The National Retired Teachers Association etc. for their use after the contests. (NRTA) should be contacted by the White 4. A means of reaching high school students is House Conference on Aging follow-through staff, through individual high school newspapers. News or a representative from the Domestic Council on releases or a series of them could be sentto the Aging, or from the Department of Health, Edu- schools. cation, and Welfare's Office of Youth and Student Affairs, -to develop a program and curricula that 5. Young people throughout the United States could be used in elementary schools throughout should be alerted to the needs, problems, and the country to achieve the goal ofawareness by contributions of older people. A vehicle which youth of the aging process. While the NRTA is reaches many young persons -is the college radio developing this program, the National Education station. A 15-minute program could be organized Association (NEA), the National Association of on the theme "Young and Old Together." Such a School- Boards, and the National Association of program could servetoinform,inspire, and Elementary School Principals could also becon- sensitize young people in the area of aging. The tacted to encourage -them- to initiate this-program program could include: in the elementary schools 'throughout the country. a. 1-,minute music (hopefully, specially com- Once this program has been developed and re- posed song) ceivedacceptance by the major organizations mentioned above, the NRTA could move to im- b. 1-minute introduction by host (well known plement it, in some cases using retired teachers to figure) teach the program, and, in others, using retired c. 30seconds of facts on aging teachers to tutor the teachers who would teach the d. 10-12 minute discussion betweensome Youth program. In 'addition to aiding the young, such a Delegates to the White House Conference on program would utilize a tremendous amount of Aging and perhaps some elderly persons on the talent by using retired teachers many- of whom topic-of youth-age cooperation and involvement. would enjoy becoming partially active. e. 30-seconds of music and "for further- infor- 2. Contact should be made by the White House mation.. 250 6. ACTION, a new Federal agency, has-pro- 3. Act- as advocates in behalf of the elderly vided_ funds. to colleges and universities for the purpose of locating and developing opportunities Specific projects designed to meet these goals for students to spend a year working-on an will vary to adjust to differentareas of the country, identified social-problem forone year of college but each goal can be fulfilled inany region. credit. ACTION, Department of Health, Educa- To marshal the efforts of young people in the tion, and Welfare Office of Youth and Student most effective yet immediate manner, several key -Affairs,:and the Domestic Council Committeeon assumptions must be made. First, though national Aging_should encourage utilization of these funds in scope, such a program can bestserve the needs forfield placement in aging by colleges and of the aging if implemented ona local, community universities. level. Second, while initiallysome youth may be 7. Conference follow up should include contact uninvolved, the most effective way to mobilize with universities in regard to settingup seminar- many young people immediately is through na- field experience courses. These should be fairly tional youth organizations. Consequently, in de- long-in duration to enable students to becomepro- veloping a volunteer youth program to assist the ficient in their-particular jobs as well as to provide elderly, both, the assumption that it should be Sometneasurt of continuity to the community. The implemented at the community level, and -that aim- of the -project is to involve students -from national youth organizationscan most effectively ,disciplines(medicine, social work, law, mobilize youth should be taken into consideration. health,Ionfe economics, etc.) to develop a-multipurpose community center in a senior citizens PROJECT IDEAS neighborhood. In--addition to Work in the field, A number ofprojects ideas that could be students would -be exposed to lecttires or-participate initiated at the community level originatedout of in seminars- dealing -with the problems andcon- the four regional meetings in October. Inmost cerns oEthe elderly,or other related topics. cases these ideas were not specifically developed, but they were the kinds of programs thatonce Voluntary Action suggested could better be formulated in respective The=concept of an action White House Con- communities across -the country to meet each locality's special needs. ference oil Aging in 1971can be nowhere better realized than in activity and interaction between Following is a compilation of those ideas-or- young and elderly Aniericans. On the one hand, ganized according to the priority goals they,are the elderly have a number of- pressing problems attempting to fulfill. Hopefully they will be-dis- that demand immediate action. On the other hand; cussed, expanded, and either acceptedor rejected. young people -have unlimited resources of energy 1.To- provide information- to senior citizensre- and idealism. Accordingly, one of the major aims garding existing social services and financial of the White House Conferenceon Aging should resources. :be -to harness=this youthful activity and link, itto a. Undertake a community- centered- project the Solution of the -problems confronting aging similar to Project FINDIto identify resources, citizens. needs, and those who are and whoare not re- Iri developing a _program of volunteer youth ceiving available resources. activity throughout-thelcountry to itSsist the elderly, Project FIND (Friendless. Isolated. Nerdy, Disibled)-7A three areas of involvement- provide immediate program of research and service was carried out in communities opportunities for service and thereby suggest them- in 12 different parts- of the country. The project soughtto lb. Cate -the elderly poor, to learn something of the source and selvo aaiigh prioritygoals: amount of their income, their state -of health, housing, needs- -for assistance of whatever kind; and to help themsecure the 1. Provide Information to senior citizens re- benefits of such services and resources as might be-available in garding existing social services and financial the-community; and when there-were no such services and re sources, to stimulate their development. It-also organized-direct resources. :personal help when necessary. (Supported-by a grant from thee Office of Economic Opportunity, -Project Find was conducted Renderdirect service to senior citizens -by the National Coo-kit on the Aging,-Inc.).

251 b. Provide- community telephone "call-in"cen- STEP (Services to Elderly People) ters with vital information to aging, anden- courage elderly to use these centers. 1. Proceeding from the assumption thata pro- c. Utilize the media, via public service advertis- gram will best serve older people if it iscom- munity-initiated, the key to STEP will bea local ing, to inform elderly citizens of existingserv- steering committee. ices. d. Insure that older citizens have input, by being a. The function of the local steeringcom- represented on advisory and planning commit- mittee will be to coordinate all volunteer activi- tees to social agencies that affect them, so that ties, recruit volunteers, and toact as both a better delivery and informational systems will grievance board and a clearinghouse for infor- be developed. mation. 2. To render direct service to senior citizens. b.. The committee would be composed of representatives from youth organizations, social-7 a. Form transportation teams toassist the service agencies, and other communitygroups. elderly in getting around to shop, for medical attention, to church, etc. 2. To initiate the formation of local committees, b.Assist in home upkeep similir to home- national youth organizations and Stateagencies maker service. on aging should be directed to encourage .their local affiliates-to begin creating the committees. c.Deliver meals to homes, similar tothe In meals-on-wheels program. this manner, young people can be easily contacted and mobilized and two forces would beworking d.E..tablish friendships with -senior citizens to develop and organize the community steering and visit them regularly. committees throughout the country. e. Utilizethe student placement program a. To contact the national youth organiza- sponsored by the new ACTIONagency to in- tions and the State agencieson- aging and then crease the staffs of agencies dealing with the to follow -up and insure that directives aging. are being delivered, one staff member duringthe 3. To act as advocates in behalf of the elderly. follow-up of the White House Conferenceon Aging will be needed. a.Utiliie existing advocacy groups suchas Urban League, Urban Coalition, public interest b. Each national youth organization should groups, and press them to advocate for senior assign a staff person to oversee their directives, citizens. . and to assist local units in initiating-theforma- b. Form a community group toact not only tion of steering committees. as advocate, but also as -a grievance body and c.Each State agency on aging should assign coordinator of volunteer activities. Includenot a staff person to oversee their directive- and to just youth, but also social service agency repre- assistlocal- units (whether aging boardsor sentatives (Welfare, Social Security) and people welfare departments) in initiating the forma- from organizations such as Jaycees,United Fund, tion of steering committees. Legal Aid, etc. 3. To facilitate the exchange of ideas between PROPOSALS FOR IMPLEMENTATION national youth organizations, a coordinating body should be formed- composed of the staffperson In order to implement a volunteer program of from each organization responsible for STEP. The young volunteers assisting the aging, means are staff person from the White House Conferenceon needed both to mobilize youth and coordinate Aging follow-up staff, or from the Domestic Colin= community, activities. Accordingly, the following cif Committee on- Aging, or the Department of proposal is presented for consideration inan- at- Health, Education, and Welfare's Office of Youth tempt to facilitate the initiation of an immediate and Student Affairs would also bea member of national action prograth. this body.

252 4. To facilitate the- exchange of information be- designated. Such a person would handle the day- tween community steering committees within, a to-day' STEP activities in his or her community. State, the State agency would act asa clearing- The funds, if required, to pay this director could house* for such information. This role would be be contributed by the participating youth organiza- filled by the STEP coordinator assigned by the tions and community groups. Ideally, this indi- State agency. vidual would be an elderly person. If funding is difficult, perhaps a local organizationor business 5. To enable the community steering committee could release an employee. for several hoursa to function most effectively, a director should be week to fill this position.

Roster of Youth Participation Committee

Tary Adams, Boys Club of 'America, Anderson, Indiana Danny Frank, Garden City, New York David Alvarado, San Antonio, Texas Melinda Ann Lee, Girl Scouts of the United States of America, Fresno, California Decker Anstrom, St. Paul, Minnesota Patricia Roberts, Lake Village, Arkansas Margaret Bartosek, 4-H Clubs of America, Rockledge, Florida Bradley Taylor, National Council of Young Mens' Christian Associations, Dallas, Texas Rosemary Baxter, Riverside, California - Sonya Toledo, Dorchester, Massachusetts Kathleen Broderick, The American National Red Mary Ellen Tully, Girls Club of America, New York, Cross; Harrisburg, Pennsylvania New York Thomas E: Fielder, (Chairman), Boy Scouts of Amer- Steve Zumbach, Future Farmers of America, Manches- ica, Paducah, Kentucky ter, Iowa

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U. S. GOVERNMENT MINTING OFFIC1:1 1973 04GB218 senior citizensmonth may 1972

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