THE NATION'S RURAL ELDERLY HEARING BEFORE THE SPECIAL COMMITTEE ON AGING UNITED STATES SENATE NINETY-FOURTH CONGRESS SECOND SESSION PART 1-WINTERSET, IOWA AUGUST 16, 1976 Printed for the use of the Special Committee on Aging U.S. GOVERNMENT PRINTING OFFICE 80-319 WASHINGTON: 1977 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 -Price $1.90 SPECIAL COMMITTEE ON AGING FRANK CHURCH, Idaho, Chairman HARRISON A. WILLIAMS, JR., New Jersey HIRAM L. FONG, Hawaii JENNINGS RANDOLPH, West Virginia CLIFFORD P. HANSEN, Wyoming EDMUND S. MUSKIE, Maine EDWARD W. BROOKE, Massachusetts FRANK E. MOSS, Utah CHARLES H. PERCY, Illinois EDWARD M. KENNEDY, Massachusetts ROBERT T. STAFFORD, Vermont WALTER F. MONDALE, Minnesota J. GLENN BEALL, JR., Maryland VANCE HARTKE, Indiana PETE V. DOMENICI, New Mexico CLAIBORNE PELL, Rhode Island BILL BROCK, Tennessee THOMAS F. EAGLETON, Missouri DEWEY F. BARTLETT, Oklahoma JOHN V. TUNNEY, California LAWTON CHILES, Florida DICK CLARK, Iowa JOHN A. DURKIN, New Hampshire WILLIAM E. ORIOL, Staff Director DAVID A. AFFFLDT, Chief Counsel VAL J. HALAMANDARIS, Associate Counsel JOHN GuY MILLER, Minority Staff Director PATRICIA G. ORIOL, Chief Clerk The Nation's Rural Elderly: Part 1. Winterset, Iowa, August 16, 1976. Part 2. Ottumwa, Iowa, August 16, 1976. Part 3. Gretna, Nebr., August 17, 1976. Part 4. Ida Grove, Iowa, August 17, 1976. Part 5& Sioux Falls, S. Dak., August 18, 1976. Part 6. Rockford, Iowa, August 18, 1976. Part 7. Denver, Colo., March 23, 1977. (Additional hearings anticipated but not scheduled at time of this printing) (II) CONTENTS Page Opening statement by Senator Dick Clark, presiding - _- _- ___ 1 Statement of Hon. Thomas R. Harkin, a Representative in Congress from the State of Iowa -_-------- __-- 32 CHRONOLOGICAL LIST OF WITNESSES Orr, George W., executive director, Iowa Commission on Aging, Des Moines, Iowa - _------ 4 Goeldner, L. R., chairman, Central Iowa Area Agency on Aging, Earlham, Iowa - _----------- 7 Stroeber, Hazel, Macksburg, Iowa -__-_-_-_- 8 Anderson, Lucille, Melcher, Iowa - _--- - -_- _ 10 Sprunger, Willis, Winterset, Iowa _-_-_-_-_-12 Morris, Dr. Woodrow, associate dean, College of Medicine, University of Iowa, Iowa City, Iowa - 18 Pals, Joe J., former executive director of Matura Action Corp., Orient, Iowa,- 23 Forsyth, Louise, director, Madison County Multipurpose Center, Winter- set, Iowa - 27 Fickel, Dr. Jack, medical director, Family Care Center, Red Oak, Iowa- 34 APPENDIXES Appendix 1. Material submitted by witnesses: Item 1. Magazine article and brochure submitted by L. R. Goeldner-_ 39 Item 2. Additional information submitted by Louise Forsyth - 43 Appendix 2. Letters from U.S. departments and agencies: Item 1. Letter from William B. Prendergast, Assistant Director for Congressional Affairs, ACTION, Washington, D.C.; to Senator Dick Clark, dated July 27, 1976 - 48 Item 2. Letter from Frank B. Elliott, Administrator, Farmers Home Administration, Washington, D.C.; to Senator Dick Clark, dated July 15, 1976 - 51 Item 3. Letter and enclosure from William H. Walker III, Assistant Secretary, Department of Agriculture; to Senator Dick Clark, dated August 3, 1976 - 53 Item 4. Letter from Samuel R. Martinez Director Community Services Administration, Washington, A.C.; to Senator Dick Clark, dated August 10, 1976 -_ 55 Item 5. Letter and enclosure from Faye G. Abdellah, special assistant to the Under Secretary, HEW; to Senator Dick Clark, dated July 16, 1976 - -- --------- 56 Item 6. Letter and enclosure from Arthur S. Flemming, Commissioner on Aging, HEW; to Senator Dick Clark, dated July 17, 1976- 58 Item 7. Letter and enclosure from M. Keith Weikel, Commissioner, Social and Rehabilitation Service, HEW; to Senator Dick Clark, dated July 27, 1976 - 60 Item 8. Letter from Robert Fulton, Administrator, Social and Re- habilitation Service, HEW; to Senator Dick Clark, dated July 28, 1976 -_-------------- 61 Item 9. Letter from Louis M. Hellman, Administrator, Health Serv- ices Administration, HEW; to Senator Dick Clark, dated August 11, 1976 - 62 Item 10. Letter and enclosures from James B. Cardwell, Commissioner of Social Security; to Senator Dick Clark, dated August 27, 1976-. 64 (m) IV Page Item 11. Letter from James L. Young, Assistant Secretary, Depart- ment of Housing and Urban Development; to Senator Dick Clark, dated July 13, 1976 - --------------------------------- 68 Item 12. Letter and enclosures from James L. Young, Assistant Secretary, HUD; to Senator Dick Clark, dated July 15, 1976_ 68 Item 13. Letter from Richard W. Velde, Administrator, Law Enforce- ment Assistance Administration; to Senator Dick Clark, dated July 16, 1976 -_ --------- 71 Item 14. Letter from Jeanna D.-Tully, Director, Office of Revenue Sharing, Department of the Treasury; to Senator Dick Clark, dated July 23, 1976 -_- - ----------- 72 Item 15. Letter from Odell W. Vaughn, Deputy Administrator, Veterans' Administration; to Senator Dick Clark, dated July .15, 1976 ------ 73 Appendix 3. Letters from individuals and organizations: Item 1. Letter and enclosure from Joyce Leanse, director, National Institute of Senior Centers; to Senator Dick Clark, dated July 15, 1976 _---7-_-7-- - Item 2. Letter and enclosure from Judith Assmus Riggs, director, Office of Government Relations, Legal Services Corp.; to Senator Dick Clark, dated July 19, 1976 ___- _-_-_-_-_-_-_-79 Item 3. Letter from Harvey C. Davis, acting director, Matura Action Corp.; to Senator Dick Clark, dated August 12, 1976 -_-_-__-_-_ 82 Item 4. Letter and enclosures from David L. Adams, human aging- coordinator, Drake University, Des Moines, Iowa; to Senator Dick Clark, dated August 30, 1976 -_-_-_ -_-_-__83 Appendix 4. Statements submitted by the hearing audience: Burger, Opal, Winterset, Iowa - __---- __-_-_-__-_-_-_-_ 90 Drorbaugh, Majorie, Creston, Iowa -_-__-_-_- _-___-_-_-_-_ 90 Fee, Vernon R., St. Charles, Iowa -___-__- ___-_-___-_-_-_ 90 Higens, Verne M., Winterset, Iowa - _-_-_-_-___-_-_-_-_ 90 McKinney, Alma, Winterset, Iowa - __- ___-_-_-__-_-_-_-___ 91 Saville, Mrs. Wilbur, Mt. Ayr, Iowa -__-_-_-_-_____-_-__-_-_ 91 Wilson, Yvette, Winterset, Iowa _ __ __ _ ___ _ _ _-_ 92 Woods, Opal, Truro, Iowa-_ _ ___ _ ___-_-_- ___-___ - 92 Young, Marion W., Des Moines, Iowa - _-_-_-_- ____-__ 93 THE NATION'S RURAL ELDERLY MONDAY, AUGUST 16, 1976 U.S. SENATE, SPECIAL COMMrTrEE ON AGING. Winterset, Iowa. The committee met at 9:45 a.m., pursuant to notice, in the Madison County Multipurpose Center, 114 North Second Street, Winterset, Iowa, Hon. Dick Clark, presiding. Present: Senator Clark and Representative Thomas R. Harkin. Also present: William E. Oriol, staff director; Deborah K. Kilmer, professional staff member; David Harf, legislative assistant to Sena- tor Clark; John Guy Miller, minority staff director; and Alison Case, assistant clerk. OPENING STATEMENT BY SENATOR DICK CLARK, PRESIDING Senator CLARK. The meeting will now come to order. Let me welcome all of you here this morning; I am particularly pleased that you came by. This is, of course, a hearing of the Senate Committee on Aging. I want to start off by particularly thanking the Hillbilly Band. You were great. [Applause.] We are very pleased that you came. I also want to thank the people who made the arrangements for the facilities of the center for us to use. We have a number of witnesses- actually, panels of witnesses-today. We were scheduled to start at 9 :30, but we are a little bit past that, so I think we will go right ahead. I want to make a brief opening statement and then we are going to hear from Mr. George Orr, executive director of the Iowa Commis- sion on Aging. Today the Senate Committee on Aging is represented here in Win- terset at the start of a major inquiry into the problems and way of life of the Nation's rural elderly. In other words, we are emphasizing in these hearings, not just problems of the elderly, but, more specifically, problems of older people who live in small towns and in rural areas generally. I asked that we meet in this community in order to set a tone of grassroots participation in all or most of the hearings that follow. Our subject-or group of subjects-is best seen up close. We cannot hope to know what's happening in rural America if we simply stav in Wash- insrton, D.C., and that is why these hearings are being held here. I have been a member of the Senate committee since January 1975. Last year, when the Older Americans Act was up for extension, I suggested to our committee chairman, Senator Frank Church of Idaho, (1) 2 that the committee hold a hearing to determine whether older Ameri- cans in rural areas were receiving their fair share of attention and help under that act. He agreed, and I chaired that hearing. I was very glad to have the opportunity to do so. The witnesses made a great case for flexibility and responsiveness in Federal requirements. As a result of the hearings, I attempted to ad- vance legislation to achieve those purposes. We didn't achieve all that we wanted to, I must say, but I will certainly be offering legislation again in the next session as well. FEDERAL PROCRAMIS FOR RURAL ELDERLY Federal policy on the rural elderly is not expressed solely through the Older Americans Act that you are familiar with. There are, of course, many other programs that affect older people. There are pro- grams like the medicare program. It is supposed to provide equitable benefits to all older Americans throughout the Nation, but if, as in many parts of Iowa and other States, the older persons can't get to a doctor or if they have no doctor to get to, then one wonders how effec- tive such programs are.