Spiritual -Well- Being; Transportation; Facilities, Programs,- and

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- theSections and Special Concerns -Sessions. FinalReport.

INSTITUTION White _Hail Se C_ onferenCe- on Aging, Washington, D.C.PUB DATE 2' Dec, 7-1NOTE 462p.; ,Proceedings of the White House Conference on

Aging, *Washington; -D.C.,,, November 28-Dedember 2,1971

AVAILABLE FROM Superintendent of boCuMents, U.. S. GovernmentPrinting Off ice, Washington, D'.C. 20402 (S/N1762 -0069, ;6.75' set Of two volumes)

vEpits- :PRICE MF$0.65 THC-116.4DESCRIPTORS. Adult ,DeVelOpMent; *Adult -Education- ProgramS;

*donterence 'Reports; *Federal_ Legislation- 'Health'Minority Groups; *National -ProgramSt. *Older

Adults ; .Psychological NeedS; SocioecoriOMicInfluences--

IDENTIFIERS *White. Hciuse = Conference ori Aging 1971

ABSTRACTTheSe two volUMes coMpriSe the officital proceedingsof the second White House Conference on AgiOq,. held-NOyenibek

28=December _2, 1971. Volume includes an overview of the Conferenceplan--its' concepts, organization, and prOgraniming: It'presents the cOntributiOnS made by Speakers at the` General Sessionsand-COnference Delegate inncheons. Volume II is devoted to reports.-ofthe work of tbe 14 Subject Area sections= and the_ .17 Special 'COncernSSeSsionS, which resulted. in the ,formtilation: of the COnferendereboriithendatiOris. -TheSe recoMMenda'tiOnS -concern- the follOwing:EddCation;. EMO.oyMent and Retirement; - Physical and meotai Health;-Housing; Income; Nutrition; Retirement Roles and Activities;Spiritual -Well- Being; Transportation; Facilities, Programs,- andS-eri.rices; Government and NOngoverriritent otqatazatitin; Planning;Research and .Demonstration; Training; iiealtb daie Strategies;=Disability, and Rehabilitation; The Rural and the :Poor Elderly; TheElderly' Among the MinoritieS; -ProtectiVe and-and Social SUpport; andRoles: -for Old and Young. (DB)

U S DEPARTMENT OF HEALTHEDUCATION i1 WELFAREOFFICE OF EDUCATION

THIS DOCUMENT HAS 6FE \ REPRODUI.ED ExACTt, RELEtED FRomWE PERSON OR ORY. On OR}iNA TING IT PoiNTS ei OR OPiNIONS STATED 00 NUREPRESENT OFFICIAL OFFtcF OI TOOCATION PUSI-,ON OR POLICY

OFFICERS AND STAFF DIRECTORS

Chairman:ARTHUR S. FLEMMING

Vice Chairman:BERTHA S. ADKINS

Director:JOHN B. MARTIN

Executive Director:WEBSTER B. "row, JR.

Co-Directors of Technical Activities: WiLma DONAH6E, CLARK Timurrs

Director of Regional and State Relations: RAY SCHWARTZDirector of National Organiiations: DOROTHY MCLEOD

Director of Public Information and Public Affairs: JoHN EowARDsAdministrative 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, ChairmanBERTHA S. ADKINS, EARL G. WARREN, -INABEL B. LINDSAY

Vice Chairmen

t

TARP ADAMS JOHN W. EDELMAN ALFRED IL LAWTON SEBASTIAN RODRIGUEZDAVID L. ALVARADO CARL EISDORFER MELINDA ANN LEE E.BONNY RUSSELLDECKER AN STROM EDWARD K. (DUKE) MARCELLE C. LEVY WILLIAM L. RUTHERFORDELOISE HARDISON BANKS ELLINGTON ELIZABTH K. LiNc.co.x MARGARET C.ROBERT W. BARON FRANCES FAIRBANKS EDWARD J. LORENZE SCHWEINHAUTMARGARET BARTOSEK *THOMAS E. FIELDER RUBY E. STUTTS LYELLS *HESS T. SEARSROSEMARY BAXTER RABBI Louts FINKELSTEIN JOHN W. MCCONNELL. DAVID C. SINGLERMARIETTA 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. SWITZERWALTER L. BOND S. ROSS GREENWOOD *CARSON MEYER *CHARLES P. TAFTMAR J ORIE T. BORCHARDT *ALFRED M. GRUENTHER DAVID MII.I.ER ROBERT H. TAKEUCHIKATHLEEN MERRY A. WEBB HALE A. LUTHER MOI.BERG BRADLEY L. TAYLOR

BRODERICK *CECIL M. HARDEN THOMAS C. MORRILL PETER E. TERZICKRICHARD P. BUTRICK A. BAIRD HASTIN :5 ROGER F. MURRAY J. FRANK TROYHERBERT R. CAIN, JR. *ROBERT J. HAVIGHURST NOVERRE MUSSON MARY ELLEN TuLLYBLUE A. CARSTEN SON

*BERNARDAII.EE HENRY E. NASH *BERNARD S. VAN*CHARLES H. CHASKES

ADELAIDE C. HILL MELVIN N. NEWQUIST RENSSELAERMARGUERITE STITTTIBOR HORANYI JAMES C. O'BRIEN *THOMAS G. WALTERSCHURCH

*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. WYMANBONZO 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 whose names arc marked with an asterisk(*)

1971 Wirt 'HOUSE CONF.,ERENCE. ON AGINGNovember 28 Dicenibee 2

Washington, V.

BackgroundOrganizationProgram

CONTENTS In Volume I. Page

Letter of Transmittal--Elliot- Richardson

ForewordArthur S. Flemming viiPrefaceJohn B. Martin ix

PART 13ackgrOund, Concepts, Planning

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

The Three Year CotiferetiPlan---PlanAn Overview 6. . _ . ,..

TPrincipal Task of the Conference-7-Policies for Aging 7Subject Matter Content 8

The Conference -Planners- 11The Conference Materials 14

PART 2 Action at Community and State .Levels

The State Agency on Aging 21Survey of the State's Older PeopleTraining for Community Forums and Onferences 22Older American White House ,Forums 22Community White House Conferences on Aging 25State White House Conferences on Aging 26Activities of National Organizations 27Regional White House Conference Hearings 28

PART 3 The National Conference in Preparation

Establishing a National- Climate of Action 33Consolidation of Recommendations 34Categories of Conference Participants 35Conference Format

General Sessions 38Subject Area Sections and Subsections 38Special Concerns Sessions 41

Selection and Training of Conference Leadership 41Assignment and Preparation of Conference Participants 42

ìt

PART 4The National"Confcrence in Action. The °inference Setting - 45.

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

PART 5 In Summary

A-Delegate's View of the Conference- 147

PART 6 Appendices

A. White House Confereike on Aging Act 155B. Officials and Staff 157C. National Planning Board 158D. State Planning Officials 159E. Conference Participants

State Delegates 160National Organization Delegates 171Invited Observers 181

F. Special, Committees :National Assn. of State Units On Aging Liaison Committee 183Committee to Assist Disabled Delegates 183Advisory Committee 'for the Multi-media Presentation _________ 183

G. Government Agencies Providing Assistance to the Conference 183H. Rules of Order 184I. Titles and Authors of "Background and Issues" Papers 185J. OutstEnding Older Americans 186K. Senior Portrait Contest 186

Recommendations of-the Sections and SpecialConcerns Sessions follow in Volume II

iv

THE SECRETARY OF HEALTH, EDUCATION, AND WELFAREWASHINGTON, D.C. 20201

Dear Mr. President:

It is my privilege to transmit to you this official' reportof the Second White House Conference on Aging, heldNovember 23 December 2, 1971, in Washington, D.C.

The Conference included a number of unique features ofspecial interest. First, it was conceived` not -as a single event,but as a process extending over A three-year -period duringwhich important activities would take place-at local; State and

.national levels in both the-Public and: private sectors. Secondwas a .strong focus, throughout the Conference, on a major'involvement of a relatively large proportion.,of thenation'solder people. Third the inClusion,of ,youth in planning anddecision-niaking roles, and as delegates `to- the Conferehce. Afourth innovation was the initiation of. national policy recom-mendations at the communitylevel, which were refined inState conferences and; after-'fur her Consideration and sharp=ening, offichlly adopted by the delegates at the NationalConference.

I have examined these recommendations and find themremarkably practical, and concerned with many of the .sameissues and objectives to which your Administration is ad-dressing itself. The Conference findings will be a continuingsource of guidance in the immediate future, not only to theFederal goVernment but to States, local communities, andnational organizations concerned with older people.

In my .judgement, the Second White House Conference onAging has made an outstanding contribution to our Nation'sefforts to bring more security and greater meaning to the lateryears of every Older American.

Respectfully,

Elliot L. RichardsonSecretary

.1w

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411

ty

e-s

FOREWORD

Old age has no fixed ,term, and one may fitly live init so long as he can observe and discharge the dutiesof his station.. .

DE SENECTtTECICERO (106-42 B.C.)

he 1971 White House Conference on Agingsought to crystalize in national policy the dimen-sions ,of a society in which older Americans may"fitly live" while completing the adventure of life

with fulfillment and serenity. By bringing together nearly4,000 of America's citizens to explore the. circumstances ofthe nation's older population and to recommend.po!icies neededto improve those circumstances, the White House Conferenceon Aging has initiated a new era for the "noW, generation" ofolder people, as well as for the generations comin^ after.

The Delegates came to the Conference in Washingtonkeenly aware of the importance of their work. Well preparedby pr'vious participation in local, State, and other pre-Con-ference activities 'and through study of materials distributedprior to the Conference, they came with anticipatory enthusiasmand with the intention of making every moment count towardthe achievement of their goal.

As a result, the Conference produced a remarkable set ofrecommendations. The one overriding goal of all the recom-mendations was to assist the aging person to maintain hisindependence and to provide dignified protection and assistancefor those unable to maintain full independence.

Within the complex of the total population of the nation'selderly, the special handicaps and problems of older membersof the racial-ethnic groups were examined in special sessions.Policies and programs tailored to accommodate their culturalpatterns and relieve their particular deprivations were outlinedin detail. Delegates who participated in these sessions took fulladvantage of the opportunity to present to a national audiencea cull statement of the financial health, and psychological needs

vii

of their elderly populations. As a result, in the'future, legislativeprograms, and national, State or local planning programs canbe based on clear and far- reaching- statements of the require-ments of the elderly among the minorities.

As another one of its major accomplishments, the 1971White House Conference on Agin.; has, I believe, contributedto the process of bringing about a much needed change inattitude toward aging and toward older people. Large segmentiof the nation have been brought to a heightened sensitivity toand a greater understanding of what it means to grow old ina society that has a tendency to put older persons oueof sightand out of mind; to grow poorer in a time of increasingprosperity. For all who participated, the Conference generateda determination that action shall be taken immediately toensure that all.older Americans may "live fitly" until the endof their days.

To every one of the nearly one million persons who helpedforge the recommendations which finally emerged at theNational Conference, to the Conference Planning Board, toPresident Nixon for his leadeaip, to all theDepartments andagencies of the Federal Government which provided assistanceand :'support, and to my colleagues, Bertha Adkins, the Con-ference Vice Chairman, John B-Martin; Conference Director;Webster B. Todd, Conference Executive Director, Willis At-well, Coaference Coordinator, and to Wilma Donahue andClark "P,:hi:itts, twb of the principal planners for the- Confer-ence, and to the White House Conference staff, I wish to ex-press my sincerest thanks for their dedication and efforts; theharvest of which cannot but be a better life for all olAtrAmericans.

viii

Arthur S. Flemming d(--Conference Chairman

'4f 4

PREFACE

any changes have taken place in this century, butscarcely any have been more significant than theach'evement of a long life for most Americans.Factors contributing to greater longevity have been

the great discoveries of modern medicine which have dramati-cally reduced the death rate among the young and middle-aged; technological advances that have relieved workers oflife-exhausting tabor; and greatly improved environmentalconditions (not; ithstanding the current concern about pollu-tion). In consequence of theses advances, the population groupaged 65 years and over increased from 3.1 million in 1900 toover 20 million in 1971, and,by the year 2000 it will number,-about 25 million. This achievement, while desired and wel-comed, nonetheless meant something of a crisis for a societyunprepared to accommodate such a burgeiming of the group ofolder Americans.

Two decades of progress, initiatc,l-by the 1950 first NationalConference on Aging and accelerated by the 1961 first WhiteHouse Conference on Aging, have brought many changes inour social institutions whichhave greatly benefitted the elderly

. population. The second White House Conference on Agingheld November 28December 2, 1971, provided opportunityto capitalize on the experiences of the past 20 years and thusto move ahead with confidence to delineate national policiesand action for immediate implementation.

The official proceedings an presented in two volumes. Theycover a 2-year period during which older people thrmgh theirOlder Americans Forums made their needs and expectationsknown; communities and States through their White HouseConferences on Aging generated the first formulations of anational policy on aging; and Delegates to the National Con-ference refined and took action on those proposals recom-mending policies and programs considered feasible in the fin-.mediate future.

ix

Voluine I of the proceedings includet an overview of theConference plan-74s background; -concepts, organization, androgramming. It presents the contributions made by speakersat the General Sessions and Coriferente Delegate- luncheons.ktherebY provides-the framework which enabled the Delegatesto 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 ag0 a full eightdecades, these recommend_ations deseiVe the clokist scrutiny byall branches and -levels of .government, by the -private andVoluntary sectors, and` by older people theniselyes.-It: is to behoped: that the , retbnimendations will not be Aiewed- singly butwill be studied.-for theit inter- relatedness -andtheir potentialfor yielding an:integrated:ter of guidelines for further actionanrbehalf of older Ainericans.

No- effoit of the magninide --of .-the -1971' White _HouseConference- on Aging can --he-brought to a successful ccinchi-sioti without incurring a -heavy- debt -Of thanks owed to-.theMany thousands. of persons throughout the Nation who-laboredto-achieve-the stated Oils. To-them, I acknowledge my,-per-sonal thanks 'and- eitenct the gratitude, of all members of theWhite - House ,Conference Staff:

It was of great ,good-:fOrtune that Dr. Arthur S. leininingmade himself for the fuiltime chairmanship -of theConference. 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 theWhite House Conference on- Aging, which promhes to -carryforwird at every level of the Nation's life for years- to come.

To my own statf--7--Willii Atwell, Dorothea Lewis, OliviaCoulter, and their colleagues==-I,am-grateful' for their willing-ness 'to add to their arduous duties for the Administration onAging, significant-contributions of -their -time and talent-to theWhite House Conference on Aging:

kar&---John B. Martin

Conference Director

4

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,,,,,,,46s-

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4

The Need for a ,,Second White House

Conference on Aging

-ging first came into national focuswhen, ih 1950; PreSident Harry S.Truman directed the Federal- SecurityAgency .to hold- a:national: conference

on. aging to assess the problems emerging -as a.result of the extraordinary increase in the numberof -elderly persons in the population. The 816Citizens Who Were delegates to that conferencetook no action as .a'body,13iit each of the 11. sec-tions developed recommendations that became thefirst guidelines for broadly conceived nationalaction.

The problerris persisted, however, and in somerespects became more severe with time. By 1958,their, magnitude and complexity reached- a pointwhich prompted-the Congress-to enact legiSlationrequesting President Dwight D. Eisenhower toCall a White House Conference on Aging, whichwas held on January 9 -12, 1961, with 2800 Dele-gates, in attendance.

Many of the proposed recommendations wereimpleinented during the early or middle years ofthe .1960's. Among them were Medicare andMedicaid; increased Social SeCurity benefits; theOlder Americans Act which established the Ad-ministration on Aging and its counterpart Stateunits on aging in every jurisdiction. New pro-grams were funded for research and demonstra-tion in aging and for training manpower to serveolder people. Other initiatives taken on behalfof the elderly included increased financial supportfor new programs in health care and relatedsocial services, housing, manpower training forolder workers, and new volunteer opportunities.

With so many important actions taken, onemay reasonably ask if there was a need for asecond White House Conference on Aging; or

was it 'called simply on the baiis of the 10-yeartradition established by the White House Con-ferences on Children and Youth.

Evaluation of the action taken during the last°decade reveals that, in spite of great strides,progress was at beSt sporadic and its momentum,Slowihg. There was-Still no comprehensive set ofnational policies on which all levels and parts ofgOvernment were working together to articulate.Older people were increasingly disadvantaged,and at least a fifth were still in the desperate,life-destroying circumstances of dire poverty.

Inflation was continuing at such a rate that,while money incomes of millions of older peoplewere raised, through' increased Social Securitybenefits, many persons were relatively poorer.Employment opportunities, for retirees did notmaterialize to enable them to earn additional in-come. Taxes, especially property takes, climbedto such levels that many older hOmeowners wereforced to sell and move into cheap..rented quar-ters. Production of new housing for the elderlylagged. "Health services remained fragmented anduncoordinated, resulting in poor delivery of serv-ices to the elderly. -Institutional care was increas-ingly allocated by public agencies to the proprie-tary nursing homes, which admittedly neededstronger regulatory measures to improve theirstandards.

Reorganization within the Department ofHealth, Education, and Welfare (HEW) in thelate 1960's initiated what was generally inter-preted as a downgrading of the Administrationon Aging when it was made a component of an-other administrative unit of the Department. Thisbelief was fixed even more firmly when two-thirdsof its program responsibilities were gradually

3.

transferred to other units and agencies, and whenthe appropriation requested by the Departmentfor aging programs was only a fraction of theamount authorized by Congress.

At the same time that the circumstances of theelderly and. action on their behalf seemed to bedeteriorating, -there were emerging certain newemphases and developments which gave greatpromise of bringing about changes which wouldbenefit the older segment'of the population.

The Congress continued to maintain a stronginterest in the older citizens group and to be re-sponsive to their clear needs. Presidential interestin the social and economic problems of the elderlyexpressed by Presidents Eisenhower,Kennedy, andJohnson was reaffirmed- and significantly expandedby President Nixon during his campaign andagain soon after his inauguration when he ap-

pointed a special task force to study the problemsOf older Americans.

In a different sphere, planning had become akey goal and activity of the Federal and otherlevels of governmentplanning designed to pro-mote the development of systems of service for allage groups, while allowing enough flexibility toaccommodate the particular service needs of theespecially disadvantaged elderly.

With apparent deterioration in the situation ofthe aging population on the one hand, and newpotentials for bringing about significant plannedchange on the' other, there was a conspicuousneed, for -=a second- White House ConferenCe onAging. Under such circumstances, it was naturaland 'imperative that a concerned Congress shouldcall for a -second White House Conference onAging to clarify and assess the current state- ofaffairs and to ,initiate a new effort to achievesecurity and dignity- for America's old people.

Legislative HistorySteps leading to the authorization and the

calling of the 1971 White House Conference onAging were initiated by the Congress in 1968.Enabling legislation took the form of a JointResolution, Public Law 90-526 (September 28,1968) , which declared :

. . . that it be the sense of Congress that aWhite House Conference on Aging becalled by'the President of the United Statesin 1971, to be planned and conducted by theSecretary of Health, Education, and Wel-fare...

At all stages of the legislative process, cul-minating in the adoption of the Joint Resolution,there was a strong and wide-ranging agreementon the need and value of holding a second WhiteHouse Conference on Aging. Bipartisan sponsor-ship for the legislation introduced in the Senate(S.J. Res. 117), and in the House (H.J. Res.1371), augured a favorable reception by theCongress. At hearings conducted by the SpecialSubcommittee on Aging of the Senate Committeeon Labor and Public Welfare in early March1968, virtually all the participants endorsed theproposed Conference. Those testifying included

4

senators, officials from 'Federal and State execu-tive agencies with programs in aging, representa-tives of non-government. organizations, and otherinterested citizens. The Select Subcommittee on

HEducation of the House Committee on Educationand Labor also held hearings where, once again,the testimony demonstrated broad support forcongressional authorization of the Conference.

-Warm approval of they intended purposes of asecond White House Conference on Aging didnot, however, rule out differences over its timing,funding, organization, and preparation. As re-ported out on May 1, 1968, by. the Committee onLabor and Public Welfare, Senate Joint Resolu-tion 117 provided that: (1). the Conference beheld in 1970; (2) a total of $4,000,000 beauthorized for Conference expenses over a threeyear period, beginning July 1, 1968;. (3) grantsranging from $5,000 to $35,000 be made avail-able to each' State' for Conference-related activi-ties; and (4) technical advisory committees be

The term "State" was defined for the purposes of the jointresolution to include the District of Columbia, the Common-wealth of Puerto Rico, Guam, American Samoa, the VirginIslands, and the Trust Territory of the Pacific Islands.

ctablished _to_ advise and assist in planning andwnducting the Conference.

Subsequent action by the House Committee onEducation and Labor showed divergent positionson these four points. On July 25, 1968, the Com-mittee reported favorably on House Joint Resolu-tion 1371 which (1) called for a Conference in1971; (2) authorized $1,300,000 for Conferenceexpenses; (3) provided no special grants forState activities in preparation for, or to coverState delegation attendance at, the national Con-ference; and .(4) excluded any express provisionfor technical advisory committees. With thesesubstantive differences, -the Senate and House,Joint Resolutions were passed by theft' respectivebodies on May 6 and July 30, 1968:

The initial- consideration of legislation by- sub-committees -and then by, full coinmittee, and thesubsequent passage of the original resolutionsjust described, involved the active leadersh:.p ofmany senators and representatives. Several ofthem .shared the.further responsibility of develop-ing an amended, uniform version of the separateJoint Resolutions which would gain the finalapproval of Congress. With the assistance oflegislative staff and the consultation of appro-priate officials from the Department of Health,Education, and Welfare, a compromise JointResolution was cleared for passage by the Senateon September 9, by the House on September 12,1968.

With respect to the provisions at issue, theJoint Resolution called for a date sometime in1971, thereby allowing ample lead time in plan-ning and preparing for the Conference. A sumof $1,900,000 was authorized to cover, amongother things, "financial assistance to the States inenabling them to organize and conduct confer-ences on aging prior to the White House Con-ference on Aging." According to statements madepreceding the House vote on the Joint Resolution,the congressional intent was to reserve $6C0,000of the $1,900,000 for State participation in theConference. Also, the law authorized and directedthe Secretary of Health, Education, and Welfareto establish technical advisory committees andto appoint their chairmen and members.

5

As described by the authorizing resolution, the197 -1 White House Conference on Aging was tobe called by the President "in order to developrecommendations for further research and actionin the field of aging, which will further the poll.'cies set forth in the preamble of this joint

'resolution." The preamble declared that responsi-bility for meeting the challenge and problems ofaging rests primarily with the States and com-munities, yet all levels of government are involvedand must share this responsibility. Therefore, theFederal Government shall work jointly with -theStates and their citizens to develop recommenda-tions and plans for actions which will serve thepurposes of:

(1) assuring middle-aged and older personsequal opportunity- with others to engage ingainful employment which they are capable ofperforMing;

(2) enabling retired persons to enjoy incomessufficient .for health and for participation infamily and community life as self-respectingcitizens;

(3) providing housing suited to the needs ofolder 1.-,mons and at prices they can afford topay;

(4) assisting ,niddle-aged and older personsto make the preparation, develop skills andinterests, and find social contacts which willmake. the gift of added years of life a periodof reward and satisfaction;

(5) stepping up research designed to relieveold age of its burdens of sickness, mentalbreakdown, and social ostracism; dnd

(6) evaluating progress made since the lastWhite House Conference on Aging, and ex-amining the changes which the next decadewill bring in the character of the problemsconfronting older persons.

As a capstone to these stated aims of the legis-lation, the preamble added: It is essential thatin all programs developed for the aging, empha-sis should be upon the right and obligation ofolder persons to free choice and self-help in plan-ning their own futures."

Appropriations

A total of $1,900,000 was appropriated byCongress for the White House Conference onAging. The early stages of planning and prepa-ration- for the Conference were supported byfunds amounting to $250,000 as part of the Ad-ministration on Aging budget under the fiscal1970 Labor-HEW Appropriations Act (PublicLaw 91-24). The major share of the appropria-tion was subsequently pfovided by the fiscal 1971Labor-HEW Appropriation Act (Public Law 91-667), which allocated an additional $1,650,000for Conference expenses, including those incurredin the post-Conference period through June 30,1972. This appropriation included the $1,000,000originally budgeted for .the Conference for the

1971 fiscal year, plus the sum of $650,000provided under an amendment, cosponsored bySenator Williams (N.J.) and Senator Prouty(Vt.), to cover the travel and per diem expensesof elderly and other delegates representing theStates.

In addition to the Conference activities financedby these appropiiations, support services and-technical staff were contributed by several Federalexecutive- departments and agencies. For theirpart, the States, many communities; several hun-.dred national organizations, and countless indi-vidual citizens also devoted considerable resourcesto the Conference effort.

The President's Proclamation

In accordance with the Joint Resolution of theCongress, President Nixon issued a proclamationon October 6, 1969, calling for the Second WhiteHouse Conference on Aging, in which he saidin part:

Today, I am issuing a formal call for thesecond White House Conference on Aging tomeet in Washington, D.C., in November of1971. With careful advance planning andwith broad, representative participation, thisConference can help develop a more adequatenational policy for older Americans. 1 hope

The Three Year PlanAn Overview

that it, will fully consider. .the many factorswhich 'have a special influence on the lives ofthe aging and that it will address precise recom-mendations, not only to the Federal Govern-ment, but also to government at other levelsand to the private and voluntary sectors aswell.

Members of the older generation have givenmuch to their country. Through the WhiteHouse Conference on Aging, a grateful Nationcan recognize the goal of Making old age atime of contribution and satisfaction.

The Conference Plan

Designed as much more than just a singleevent, the second White House Conference onAging was conceived as a 3-year process directedtoward bringing about ,ubstantial changes insociety's perception and treatment of its olderpopulation.

6

Planning the Conference over a 3-year periodprovided an opportunity to avoid some majorshortcomings of the first White House Confer-ence on Aging. One oversight of that first con-ference was the failure to consult with olderpeople, at first hand, to learn what they con-sidered to be their most urgent, unsatisfied needs.For the 1971 Conference, however, there wassufficient lead-time for the process to be initiated

by older people through the 1970 Older Amer-icans Forums -held in thousands of local com-munities.

Another deficiency of the 1961 conferenceplan was the failure to provide for a systematicand intensive follow-up of the conference recom-mendations at national, State, and local levels. Incontrast, the three-year plan for the 1971 Con-ference emphasized that 1972 was to be a yearfor follow-through on recommendations and forevaluation of resulting action.

Thus, 1970 was viewed as a Prologue Year inwhich older persons would have the opportunitythrough Older Americans...Forums to speak out ontheir needs and to be heard not only- in the com-munities and States but also by the executiveand legislative organs of the Federal government.

The second year, 1971, was seen as the Yearof Conferences. Local and State conferences andNational Organization Task Forces would meetto develop policy recommendations which, in turn,would be consolidated by Technical Committeesto become the substance for consideration byDelegates at the national conference in Novem-ber-December.

The third year, 1972, was projected as theYear of Action. Because the National Conferencetook place in a climate of actioninitiated by theOlder American Forums, the community andState conferences, the active participation of na-tional organizations, and by the Federal executiveand legislative branchesthe prospects are highfor accelerated efforts to implement the recom-mendations arrived at by the Delegates and thusto greatly improve the well-being of older Amer-icans.

OVERALL CONFERENCE OBJECTIVES

Three specific objectives were drawn up for the1971 White House Conference on Aging.

To initiate the development of specific,thoughtful guides and recommendations forpolicies and actions in aging at community,State, and national levels.

To draw these guides and recommendationsfrom cross-sections of older people, provid-ers of services, specialists on aging, key

46$-217 0 - 73 :2

7

deCision-makers, and youth, in order thatthey may represent a broad and effectiveconsensus.

To broaden the understanding, at com-munity and State levels, of the needs ofolder people, and strengthen the willingnessto act on the policy prciposals that willemerge from the White House Conferenceson Aging at all levels.

If these objectives are achieved, the Conferencewill have a great meaning for the 1970's for, itwill result in:

Broader public awareness of older peopleand their circumstances;

A realistic national policy regarding, theolder population;

Greater commitment by government,. volun-tary agencies and the private sector to serv-ing older people;.

Clearer and stronger roles for the Admin-istration on Aging as the advocate for olderpeople and as a focus on their affairs;

Stronger and more effective State agenciesresponsible for planning and serving theolder population;

More systematic planning and an expansionand coordination of services for the elderlyat the community level;

Assumption by older people of more re-sponsibility for meeting their needs and forcontributing to community life; and

New legislation on behalf of older peopleat. Federal and State levels taken with refer-ence to a set of national policies designed toimprove the quality of life of America's oldpeople and their families.

Principal Task of the ConferencePolicies for Aging

In keeping with the objectives, the Conferenceeffort at all levels was directed toward the formu-lation of coherent principles and feasible planswhich would lead toward a national policy onaging.

Historically, conferences in the field of aging

have produced three types of recommendations:(1) broadly stated, 'far reaching goals which giyeexpression to aspirations to achieve ideal situationsor states for the older segment of the population;(2) more focused and, closely considered policyproposals to bring about more-immediate change;and (3) large numbers of specifically detailedprograms to provide services for the elderly orincrease knowledge, about them.

The relatively free proliferation of all threetypes of recommendations was necessary and use-ful in the early stages of discovery and explora-

. tion of the problems and needs associated withaging. However, the gradual .accumulation of sys-tematic knowledge and'evaluative tools, togetherwith relevant experience gained over the lastseveral decades, made it possible for the 1971White House Conference on Aging to take as itspurpoie the more difficult task of formulatingproposals for public policies leading to definedactions to meet clearly stated short range objec-tives.

To establish a common understanding of thepurpose underlying the formulation of policiesfor the aging, as distinct from goals and frothprogram recommendations, the following defini-tions were adopted for the purposes of the Con-ference.

GoalsLong range objectives or targets statedin broad general terms. These are useful- asaffirmations of social values or aspirations andas guides to the development of social policies.

Policies r; set of focused, strategically feas-ible principies and plans for action to providedirection for program supportive of long-rangegoals.

Program RecommendationsProposals forspecific action designed to implement policiesand to move toward goals.

In addition to defining the various types ofrecommendations as guides to policy formulation,the following set of criteria was established forjudging the feasibility of a policy proposal.

Is it:based on known needs of older people?

8

consistent with national goals and socialvalues?

possible to implement with present knowl-edge and manpower?

realistic in terms of cost?

likely to be supported by the general public?

Would it:

benefit the whole community or society aswell as just older people?

preserve the dignity, freedom and right ofchoice of older people?

Does it:

fix responsibility for action on a specificpublic or private agency or organization?

It was expected- that rigorous application ofthese criteria would facilitate the selection ofthose policies most likely to elicit immediate ac -'tion, to gain public acceptance, and to find areadiness on the part of society to see them im-plemented.

Subject Matter Content of the Conference

The legislation for thf... 1971 White HouseConference on Aging directed that attention begiven to employment, income, and housing ofolder Americans. It also pointed out the need foreducational programs for middle-aged and olderpersons to prepare them "to make the gift ofadded years of life a period of reward and satis-faction."

Research and evaluation of progress, and anexamination of the effects that the projectedchanges of the 1970's will have on older people,were also included among the purposes the Con-gress believed the Conference should serve.

SUBJECT AREAS

Working from this basis, a careful study andevaluation of the circumstances of today's olderpeople and the problems which plague them,even after 20 or more years of effort to improvetheir conditions, resulted in the selection of 14areas in which it appeared there was need for amore effective set of national policies.

ft

I.

4

Of the 14, 9 represent Needs Areas withinwhich policy and action are required if Ameri-can society is to be satisfied that its oldercitizens are to enjoy healthy, active, and meaning-ful lives. The other 5 areas, designated as NeedsMeeting Areas, identify the principal means,through which action can be brought about. Fig-ure 1 lists the Needs and Needs Meeting Areasand illustrates the relationship between them.The 5 Needs Meeting Areas are the avenues toaction for each of the Needs, although in Figure1 the relationship is illustrated for only one Need.

people, and to ensure that policy and action rec-ommendations would reflect recognition of thesedifferences, five principal variables were identifiedfor consideration in relation to each of the Needsand Needs Meeting Areas. These wereStageof Later Life, Level of Wellness (or Health), Em-ployment-Retirement Stitus, Urban-Rural Resi-dence, and Maximum Freedom of Choice.

Figure 2 illustrates the characteristic changes inhealth and employment status as the individualmoves from middle-age (45-59) through latermaturity (60-74) and old age (75 and over).

Figure 1.

Schematic Representation of the Relationship ofNeeds Areas to Needs Meeting Area

Needs Areas `Needs Meeting AreasIncome

Health and Mental Health Inf--4.4

Housing and Environment

Nutrition

Education

Employment and Retirement

Retirement Roles and Activities

Transportation

Spiritual Wellbeing

1,0440... -- Planning

. 44 .44 . Training.....44. .mow Research and Demonstration

Services, Programs, and Facilities

Government and Non-governmentOrganization

Older people, of course, vary among themselvesin the same way other age groups do. In fact,because of the effects of aging iself and of certainsocial practices, older people tend to change morerapidly and to be called upon to make more majoradjustments in their lives than at any other timeexcept childhood.

In order to emphasize these enormous varia-tions in the nature and circumstances of older

9

It also calls attention to the need to considerwhether an aging person lives in an urban areawhere resources are generally more available orin sparsely settled rural environments. And atevery stage of life, and with reference to all Needsand Needs Meeting Areas, the individual should'be assured the rightthe freedomof makinghis own choices among available solutions- to hisproblems and needs.

Figure 2.

Schematic Representation of Needs and Needs Meeting.Areasand Significant Variables

Needs Areas Stages of Later Life NeedsMeeting Areas'Middle Age

45-59Later Maturity

60-74Old Age

75+Income

Health andMental Health

Housing andEnvironment

_

Nutrition

Education

Employment andRetirement

Retirement Rolesand Activities

Transportation

SpiritualWellbeing

4.of

ey.,

ir. o

It 9.e

tt4

0

Planning

Training

Research andDemonstration

Services, Programs,and Facilities

Government andNon-governmentOrganization

Urban-Rural Residence

F;R

EED0M

0F

CH0

CE

The chart emphasizes the fact that no singlesolution in any area is static and fixed, but thatchange and accommodation must be features of allplanning and programs for older people whoselife circumstances are changing as they growolder and older.

SPECIAL CONCERNS SESSIONS

The 14 subject areas becime the substantivepart of the Conference which was dealt with inthe community and State conferences. Nationalorganizations considered the Needs Areas erpe-cially, but also provided some comment on theNeeds Meeting Areas.

As the Conference planning progressed, re-quests were received from various organizedgroups for an expansion of the program to pro-vide opportunity for consideration of the special

10

problems of minority and other specially dis-advantaged groups. Although the requests weremade too late to include them in the communityand State conferences, arrangements could bemade to hold the following 17 Special ConcernsSessions as a part of the national program

Long-Term Care of Older PeopleMental Health Care StrategiesHomemaker-Home Health Aide ServicesAging and ,BlindnessSpanish Speaking ElderlyThe Elderly IndianThe Older FamilyThe Religious Community and the AgedPhysical and Vocational RehabilitationRural Older People

The Poor ElderlyAging and Aged BlacksAsian American ElderlyThe Elderly ConsumerLegal Aid and Urban AgedVolunteer Roles for Older PeopleYouth and Age

The Special Concerns Seseons not only en-larged the ,progjam, but enriched its output andgave visibility to many special groups and prob-lems of the elderly that might otherwise havefailed to receive the focused attention of the Na-tional Conference.

The Conference Planners

The complex nature of the overall plan ofthe 1971 White House Conference on Agingcalled for extensive planning at local, State, andnational levels. It required extensive involvementin the planning fun ::ion by older Americans asconsumers, specialists in aging, planners anddecision-makers, providers of services, representa-tives of minorities and other special problemgroups and of organizations, the private sector,and the generally concerned citizenry. The plan-ning groups 'ascribed below reflect these require-ments throughout.'

THE WHITE HOUSE CONFERENCE STAFF

A staff was assembled in early 1970 under theleadership of John B. Martin, Commissioner onAging, whom the President had named to directthe Conference. Willis W. Atwell, Deputy Com-missioner on Aging, became the Conference Co-ordinator. At a later date, Arthur S. Flemmingwas appointed by the President to be the full-time Chairman of the Conference. Webster B.Todd Jr. joined Mr. Flemming and served as theExecutive Director of the Conference. Other.components of the staff included:

Administrative OfficePublic InformationState and Regional RelationsNational Organization RelationsDelegate RelationsTechnical PlanningLogistics Office

' Rosters of the various planning grouts appear as Appen-dices to this document.

11

THE NATIONAL ADVISORY COMMITTEE-

The Joint Resolution called for a NationalAdvisory Council of professional and public mem-bers of which a substantial number were to be55 Or more years of age. Secretary Richardsonformed the committee in early 1970 by appoint-ing 28 distinguished older Americans. This com-mitteel-ecame the core of a larger working board.

THE CONFERENCE PLANNING BOARD

In order to share the duties of planning amongmore personi and representative groups, a Con-ference Planning Board was named. Its member-ship included representation of the, followinggroups:

White House Conference on AgingNational Advisory Committee 28

Advisory Committee on Older Americans 13National Organizations of Older People 10National Association of State Units on

Aging 10Youth Participation Committee 14Consultants on Minority Problems 10Technical Committee Chairmen 14

The Chairman and the Director of the Con-ference served. as Co-chairmen of the Board. AnExecutive Committee of 17 members of the .Board transacted the Board's business betweenfull meetings. The Chairman also had the con-tinuing advice of an ad hoc committee of thoseBoard members who were the representatives ofnational organizations of old people.

The responsibilities assigned the Board were:

To assist the White House Conference staffin arriving at broad plans and procedures; ,

0, To insure coordination of the Conferenceactivities with the ongoing Federal andState programs in aging;

To accommodate the considerable interestamong National Organizations of OlderPersons; and

To represent the views of the providers ofservices, specialists, and scientists.

To carry out these responsibilities, the Con-ference Board met three timesOctober 17-18,1970, March 27, 1971 and September 24, 1971.At its October meeting, the Board established fivecommittees: Information and Publications, Re-gional and State Planning, National Organiza-tions, Conference Programs and Procedures, Issuesand Policies.

These committees met and made recommenda-tions to the Board which, after discussion andamendment as needed, voted upon their adoption.Similar procedures were followed at the subse-quent meetings of the Board.

Among the most important decisions madewere those which approved the overall 3-yearConference plan, the subject areas, the topics ofSpecial Concerns Sessions, the criteria for Dele-gate nomination, and the rules and regulationsgoverning the proceedings, voting and conductof the meeting, including the restriction of votingto the delegate bodies of the Subject Area Sec-tions and Special Concerns Sessions.'

TECHNICAL COMMITTEES

In accordance with the joint resolution author-izing the Conference, the Secretary of Health,Education, and Welfare established a TechnicalCommittee for each of the 14 Needs and NeedsMeeting Areas. Membership of each of the com-mittees included persons with special trainingand proven competence in their respective fields,representatives of minority groups, and older

'The full text of the rules and regulations governing theconduct of the Conference work sessions can be found asAppendix H.

12

people as consumers. Supplementing each Techni-cal Committee was 'a Secretariat made up of gov-ernment personnel from appropriate Federalagencies. As the Committee's staff, the Secretariatprovided assistance and acted in an advisorycapacity.

The Technical Committees were assigned the'prime responsibility of evaluating developmentsin their respective subject areas, and then focusingattention on what they .perceived to be the majorissues requiring resolution as a basis for formu-lating a set of national policies on aging. Forthis purpose, an issue was defined as follows:

An issue ica questionresolvable in two ormore waysformulated for the purpose of de-termining what broad policy or action shouldbe taken to move toward a specific, goal-oriented objective.

At their initial meeting, the committees firstreyic-ved the drafts of background pipers, whichhad beer prepared by specialists in their fields,for the purpose of ensuring that the papers werecomprehensive, complete, and authoritative. Onthe basis of the background papers and their ownknowledge of the field, the. Committers set forthseveral salient questions or issues relative to thesteps they believed were required to improve thecircumstances of the older population. Thesestated issues became the focal point., for discussionand the basis of the first formulations of recom-mendations by the community and State confer-ences an_ d by the National Organization TaskForces.

At the second meeting of the Technical Com-mittees in the summer of 1971, they consolidatedthe recommendations which were responsive tothe issues along with others generated at theState Conferences and the National OrganizationTask Force meetings. These consolidated recom-mendations were reproduced in the DelegateWork Books for use at the National Conference.

PLANNING COMMITTEES FORSPECIAL CONCERNS SESSIONS

A planning committee, consisting of represen-tatives from the organizations requesting the

session and other related organizations, wasestablished for each of the 17 Special ConcernsSessions. The committees were assisted by. Federalagencies and the White House Conference staff,but had full responsibility for the Sessions.

The function of each committee included de-termining the content and format of the Sessionprograms, identifying and inviting programparticipants, conducting the Session in accordancewith the same rules of order which governed theSubject Area Sections, and preparing a report ofthe recommendations adopted At Session meetingsfor inclusion in the report of the Conferenceproceedlitss.

GOVERNMENT AGENCY LIAISON

The legislation authorized the Secretary ofHealth, Education, and Welfare to request thecooperation and assistance of such other Federaldepartments and agencies as might be appiopriatein carr7ing out the provisions of the Joint Resolu-tion. In order to open these channels, each De-partment and 21 independent government agen-cies were invited to name a member of theirorganization to serve as a liaison with the WhiteHouse Conference on Aging. This provided easyaccess to personnel and other resources of thegovernment and afforded a means of distributinginformation about the Conference.

NATIONAT ASSOCIATION OP STATE UNITSON AGING LIAISON COMMITTEE

A special committee was named by the Na-tional Association of State Units on Aging to takepart in the initial planning of the Conference.This committee, along with the Associate Re-gional Commissioners for Aging, was the firstgroup convened (March 8-9, 1970) by theWhite House Conference on Aging to review andadvise on the initial Conference plans.

MINORITY REPRESENTATION

From the beginning, the planners of the 1971White House Conference on Aging were con-cerned that the minorities have the opportunity toshare in the responsil :`ties of decision-makingand achieving the got. 's of the Conference.

As a first step, 10 representatives of minoritygroupsBlacks, Asian-Americans, American In:

13

dians, and Spanish Speakingwere appoiate..1 tothe citizen Planning Board of the Conference asspecial consultants on minority problems. Fol-lowing is a brief summary of the provisions madefor the participation of minority representativesin the various phases of the Conference.Number of Minority Representatives

Securing an adequate number of representa-tives of the various minority groups in theConference Delegate body was one of theprincipal aims of the Confcience planners.The Planning Board, at its first meeting, tookaction requesting that special attention begiven to the inclusion of minority groups inall aspects of the Conference. The Boardcontinued to call attention and to take ac-tion on behalf of the minorities such as ap-proving the inclusion of Special ConcernsSessions on their problems in the Conferenceplan.

States were urged, and they in turn re-quested local communities, to include rep-resentatives of the minority groups withintheir populations in Conference activitiesThe Secretary's letter to the Governors alsorequested that in the naming of State Dele-gates attention be given to adequate repre-sentation of minority groups. And, to makecertain that a reasonable balance of theminorities from the various sections of thecountry were named, a category of Dele-gates-at-Large was established to be used bythe President to overcome any obvious un-derrepresentation.

Various organizations that representedminority groups were also alive in ensuringrepresentation in relative proportion to theirnumbers in the general population. The Na-tional Caucus on the Black Aged, represen-tative committees of various AmericanIndian organizations, of Asian-Americangroups from the mainland and territories,and of the Spanish speaking, includingPuerto Rican and Cuban groups, workedwith the Conference Chairman to establishcriteria for determining an adequate repre-sentation of their groups.

As a result of all these ;Eons, the numberof minority Delegates named far exceeded

their representation in either the 1950 Na.tional Conference on Aging or the 1961White House Conference on Aging and wasroughly in proportion to their number inthe general population.

Roles of the Minoritiei in the Conference

As Participants in State and Communi-ty Activities

Many of the Older Americans WhiteHouse Conference Forums, held inSeptember 1970, were lotated pur-posely in places where there are con-centrations of minorities, such as thecenter cities and certain geographicalarea's of the country. Reports receivedfrom the Forum organizerS indicatethat, in many instances, a minoritygroup constituted- the largest propor-tion of the participants.States were careful to include minoritygroup members on their State WhiteHouse Conference on Aging planningCommittees and urged communities todo likewise for the planning commit-tees of local White House Conferenceson Aging. AlSo, minority group per-tons participated as Delegates in theState and local Conferences of 1971.In naming-Delegates to the NationalConference, every Governor selectedmembers from the leading minoritygroups in their respective States. (Asmentioned earlier, where disparities re-mained, the Delegates-at-Large cate-gory was used to achieve a more appro-priate balance in representation.)

As National Conference LeadersThe 28 member White House Con-ference on Aging Advisory Committeeincluded minority representatives.The Planning Board provided oppor-tunity for additional minority represen-tation in a decision-making role of theConference planning.All the Technical COmmittees, whichwere largely responsible for decidingupon the technical content and focusof= the 1971 Conferences (local, State,and national), included representativesof some of the minority groups.Special attention was given to the ap-propriate reprekntation of. minoritiesin the selection of- Section and Subsec-tion leadership.

As DelegatesIn constituting the membership of thevarious Subsections, adjustments weremade so, that all Subsections inclUdedreprdentation of the major minoritygroups. In instances where the actualnumber of minorities in a Section wastoo small to provide representation inall groups, the Chairman was advisedto raise for discussion the problems ofthe minority groups.When the minority representation wasfound lacking in particular skills (nurs-ing, community planning, health, etc.),recommendations were made to personsappointing the minority Delegates-at-Large to include individuals with thesespecial skills, if possible.

Conference MaterialsBackground and Issues Papers

To establish the foundations for informed Con-ference discussion and resolution of the vitalissues of policy affecting older persons, Back-ground and Issues papers were prepared coveringeach of the 14 subject-matter Needs and NeedsMeeting Areas. Under a grant made in 1970.bythe White House Conference to Brandeis Univer-sity, recognized authorities in the field of agingwere commissioned to undertake the necessary

14

research, and to organize and draft topical mater-ial, applicable to their assigned subject area. Thepaper for Health was in two parts, one concernedwith physical health, the other with mentalhealth. Similarly, the Research paper was pre-pared by two authors, one writing on biologicaland medical research, the other on behavioral andsocial science research. In addition, the subject ofEmployment and Retirement was covered in

1

separate papers, again each by a different author.The entire background paper project, involvingthe preparation of some 17 documents, was di-rected by Dr. James H. Schulz of Brandeis Uni-versity.'

In most cases, the Background and Issues papersfollowed a common outlined comprised of fiveparts. The first four sections covered relevantbackground material: an introduction to the par-ticular Needs Area or Needs Meeting Area; astatement of well-established, long-range goals(set by previous conferences, commissions, andlegislative goals); a review of existing knowledgein the area; and a description of the nature andscope, together with the gaps and shortcomings,of present policies and programs. Each author hadfinal responsibility for the contents of these foursections, and assisted in the-preparation of thefifth, Issues, section of the paper.

The drafting of the Issues section for eachBackground Paper was the responsibility of therespective Technical Committee for that subjectarea. This portion of the paper set forth certainmajor questions or issues for consideration andresolution by Conference Sections, leading to acomprehensive national policy on aging.

Work Books for Community andState White House Conferences on Aging

Background information and discussion ma-_eriai, covering each of the 14 subject-matterareas, was prepared in a series of Work Booksfor the use of participants in community andState White House Conferences on Aging. TheWork Books were regarded as a practical substi-tute for the full Background and Issues papers,which could not be reproduced reasonably in thequantity necessary to accommodate the manythousands of Delegates to the community andState conferences, Moreover, the length and, in

.-.some cases, the technical nature of the Back-ground and Issues papers made it doubly advis-able to produce summarized versions in the form

' A complete index of the Background and Issues papers andtheir authors can be found as Appendix 1. The papers areavailable through the Superintendent of Documents, U.S.Government Printing Office, Washington, D.C. 20402.

15

of Work Books. This task was undertaken duringJanuary-March 1971.

Part One of each Work Book contained a sum-mary of the corresponding Background Papersections on the needs, goals, available knowledge,and present situation in that area of aging. Itspurpose was to add to the information of Dele-gates whose Conference section would be discuss-ing and adopting recommendations in the subjectarea covered by the Work Book.

In Part Two of the Work Book, several ques-tions or issues were presented, accompanied byback-up discussion of their policy implications.This part of the Work Book, with only minoreditorial changes, was a restatement of the IssuesSection of the Background Papers developed byeach of the Technical Committees. Thus, firstthe community and then the State White HouseConference on Aging were asked to address them-selves, in common, to certain major unresolvedproblems posed either by the identified issues, orby other questions of importance.

In addition to the Background and Issuespapers and the Work Books, described above,several other documents were published by theWhite House Conference on Aging. This seriesof guides-related training materials, and otherrelevant documents was prepared by the National

'Conference staff to assist in carrying out integralparts of the Conference process at community,State, and national levels. In approximate orderof their publication, the documents are describedbelow.

Self-Guide for Groups OrganizingOlder Americans White House Forums

The Self-Guide was distributed to backstop theefforts of State agencies on aging and communitygroups responsible for organizing the Older Amer-icans Forums held in September 1970 and themonths following. The Self-Guide explained theimportance of the Forums as a means for olderpeople themselves to voice their needs and de-sires; proposed methods of organizing, staffing,and conducting the Forums; and set forth theessentials of reporting their results.

Technical Guide for Community and StateWhite House Conferences on Aging

The Technical Guide was prepared primarilyfor the use of State agencies on aging and Federalregional units on aging. Distribution began inNovember 1970, and continued over the nextseveral months.

This basic work was presented in three parts.Part One dealt with the overall objectives, sub-ject-matter, and structure of the White HouseConference, and with State activities and responsi-bilities related to the Conference plan. Part Twowas concernecr with community White HouseConference activity, and Part Three, in similarfashion, with the preparation and program ofState conferences.

Handbook for Community Conferences

The Handbook, a supplement to the Techni-cal Guide, was also distributed during the winterand early spring of 1971. While the Handbookdrew extensively from the materials presented inthe Technical Guide, it was more specificallyaddressed to the tasks involved in organizing andconducting the first round of conferences at thecommunity level. The Handbook was providedto assist community conference leaders and plan-ning committees in the careful preparation andskillful execution of this nationwide effort. Theexpectation was that as many hundreds of com-munity White House Conferences as were com-patible with time and resources would be spon-sored by the States.

Technical Guide forNational Organizations

A companion piece to the two previously men-tioned works, the Technical Guide for NationalOrganizations also set forth the concept of thetotal Conference effort. It then suggested severalways in which national organizations and theirconstituents could contribute to that effort, espe-cially through the formulation and support ofa set of national poliCies on aging. This TechnicalGuide was published in December 1970.

Leadership Training Guidein Policy Formulation

The Leadership Training Guide, also printedin December 1970, was part of a kit of materialsd4velOped for training sessions on the complexprocesi of policy formulation. This document wasfor use by State agencies on aging in training lead-ers of community conferences, and adaptable totheir subsequent .use in training State conferencestaff.

"So You Are To Be A ParticipantIn A Community White HouseConference on Aging*

pain_phlet was printed in January 1971 tobe used in conjunction with the Work Bookswhich, as described earlier, provided participantswith background information and issues for dis-cussion and resolution. This pamphlet was de-signed to explain clearly and succinctly how useof the Work Books would equip each participantfor an effective role in the Conference processof formulating national policies on aging.

Roster of Participating NationalOrganizations with Programsin the Field of Aging

Released in November 1971, just before thenational White House Conference on Aging,the roster of participating organizations identifiedthe more than three hundred national organiza-tions that took part in Conference activities.

National ConferenceDelegate Work Books

A Delegate Work Book was prepared for eachof the 14 subject matter areas of the Conference.Each National Conference participant receiveda Work Book appropriate to the subject-matterSection to which he was assigned.

These Work Books were structured in threeparts. Part One provided Delegates with an over-view of the organization and program of the

16

National Conference. Part Two served to orientparticipants to their Conference task. Parts Oneand Two were the same in all the Work Books.

Part three contained a summary of selectedportions of the Background Paper in the respec-tive subject area. It set forth the recognized needsin the area, the long-range goals to be achieved,and a statement of the major issues and questions.It also contained the recommendations consoli-dated from the reports of the State conferencesand the national organization task forces, andrelevant Technical Committee comments.

A Guide for Section andSubsection 7onference Leaders

Prepared in October 1971 for distribution tothe Chairmen and Recorders of Sections and Sub-sections at the National-Conference, the guide forthese leaders dealt extensively with the structure,procedures, and leadership roles planned for theNovember 28December 2 meeting in Wash-ington, D. C.

FILMS:

The Three-Year Conference Plan

The Three-Year Plan, was made in Augustof .1970 for viewing by White House Confer-ence planning groups at all levels. John B.Martin, Commissioner on Aging and Directorof the Conference, outlined the planned se-quence of Conference events for the three,1970-1971 period; the roles projected for theseveral sets of participants; and the flow ofrecommendations and actions expected through-out the course of the Conference process.

This film, as well as the one described below,was prepared by the University of MichiganTelevision Center, in cooperation with theWhite House Conference staff.

The Policy Proposal'

The Policy Proposal was designed primarilyfor the training of Conference leaders and per-sonnel in the process of policy formulation. Thebasic concepts underlying the development ofpolicy recommendations were explained byidentifying a major issue in the field of

17

housing for the elderly, and then stimulatingthe discussions, deliberations, and evaluativefactors involved in resolving that example issueto arrive at a feasible policy proposal. As a clearpresentation of the precepts of the policy formu-lation process followed at successive levels ofthe 1971 Conferences, the film has enduringvalue.

This film was prepared in November 1970,Willis W. Atwell, Deputy Commissioner onAging and Coordinator of the Conference,served as narrator.

Trigger Films

A series of five brief dramatizations of situ-ations common to older peoplewere designedto provoke (trigger) thoughtful discussion. Thefilms are in color and- vary in length from 1minute 4 seconds to 4 minutes 10 seconds'Each State agency on aging was supplied witha print of these films along with a suggestionthat they be used at the Opening session of theState White House Conference on Aging.

Multi -Media Presentation

Produced especially for the White House Con-ference on .Aging, a multi-media presentation,in a series of dramatic sequences interspersed withfilm, slides, and music, depicted the problem ofbeing old in a young society.' Some successful'and some unsuccessful attempts at resolving theproblems of older people were shown with theintent of providing an overview of aging as abackdrop against which the work of the Sectionswould take place. The presentation was producedby Eli Productions and The Design Center, Wash-ington, D.C., with the assistance of an AdvisoryCommittee made up of representatives of theDepartment of Health, Education, and Welfareand the White House Conference on Agingstaff.'

The Tripper Films can be purchased from the Universityof Michiean Television Center, 310 Maynard Street, AnnArbor, Michigan 48108.

'Five films from the MultiMedia Presentation are availablefor loan or purchase through the General Services Administra-tion. National Archives and Records Center, National Audio-visual Center, Washington, D.C. 20409.

'The persons who served on the Advisory Committee areidentified in Appendix F.

Materials Prepared byFederal Department for theWhite House Conference on Aging

The Employment Problems of Older Workers,.U.S. Department of Labor, Bureau of LaborStatistics, Washington, D.C.: Superintendent ofDocuments, Government Printing Office.

Housing: 1971 White House Conference onAging, U.S. Department of Housing and UrbanDevelopment, Washington, D.C.: Superintendentof Documents, Government Printing Office.

Facts and Figures on Older Americans: An Over-view for the Delegates to the White House Con-ference on Aging,. 1971r U.S. Department ofHealth, Education, and Welfare, Social and Re-habilitation Service, Administration" on- Aging,Washington, D.C.: U.S. Department of Health,Education, and Welfare, Social and RehabilitationService, Publication 72-20005.

Health in the Later Years of Life, U.S. Depart-ment of Health, Education, and Welfare, PublicHealth Service, Health Services and MentalHealth Administration, National Center forHealth Statistics, Washington, D. C.: Superin-tendent of Documents, Government PrintingOffice.

1971 White House Conference on Aging FirstReader: Plan and Schedule for a Three-year Con-ference on Aging, U.S. Department of Health,Education, and Welfare, Social and RehabilitationService, Administration on Aging, Washington,D.C. AoA Publication No. 147.

1971 White House Conference on Aging SecondReader: Invitation to Design a World, U.S. De-partment of Health, Education, and Welfare,

-Social and Rehabilitation Service, Administrationon Aging, Washington, D.C. AoA PublicationNo. 148winner, First Prize, Federal EditorsBlue Pencil Award.

18

Ztrm

The State Agency on Aging

"t the time of the first White HouseConference on Aging in 1961, fewState Offices on Aging had. been estab-lished. In 1971, largely as a result of

the passage of the Older Americans Act, each ofthe 50 States, as wel as the District of Columbia,American Samoa, Guam, Puerto Rico, the VirginIslands, and the Pacific Trust Territories, hadOffices on Aging.'

These State agencies played a major role inthe preparation for the 1971 White House Con-ference on Aging. The Chief Executive of eachof the 56 jurisdictions was informed of the overall Conference plan and the job that the publicsector at the State level would be expected toundertake. He was asked to designate an agencywithin the State government to coordinate White

House Conference activities within his jurisdic-tion. In all instances the "State units on agingwere asked to take on this responsibility.

The State had four major responsibilities inpreparation for the White House Conference onAging: (1) surveying the jurisdiction's olderpopulation, (2) training leadership for theForums and for the community' and State confer-ences, (3) organizing community conferences onaging, and (4) holding state conferences. Al-though the manner and extent of preparation forthe different conference activities varied amongthe jurisdiction, each of the 56 was successfulin holding both Older American Forums andcommunity conferences on aging; and 54 jurisdic-tions held State conferences.

Survey of the State's Older People

The 1969 amendments to the Older AmericansAct gave the States specific responsibility forstatewide planning, coordination, and evaluationof the various programs and services availablewithin their respective States for their older citi-zens.

Under the plans for implementation of thisamendment, each State was required to make a

' For purposes of this report, all jurisdictions (State, theDistrict of Columbia. and the territorial units) will generallybe reterred to as States.

21

comprehensive study of the income, health, hous-ing, social, and other significant conditions of itsolder population.

Many States completed their studies in time forthe findings to become an important source of in-formation for participants in the State confer-ences. Equipped with this type of factual infor-mation, the States were able to formulate realisticproposals for their own immediate action as wellas recommendations for needed policies to be im-plemented at the national level.

Training for Community Forums and Conferences

Citizen leadership was to bear the responsi-bility for planning and conducting the OlderAmerican Forums, and the community WhiteHouse Conferences. They were also to take majorroles in conducting the State conferences. Carefultraining of these leaders, most of whom were notprofessionals in aging, was therefore an essentialpart of the preparatory phases of the work of theState agencies on aging.

To prepare the State Agencies on Aging fortheir responsibilities in planning the Forums,regional briefing meetings were held to cover:(1) the organization and conduct of the Forums;(2) the enlistment of. local public and privateagencies in organizing and staffing the Forums;and (3) the essentials of reporting to the Statesthe findings and results. The State agencies thenformed and trained local community committeesto take, leadership roles in implementing the plansfor Forums.

Training for the community and State WhiteHouse Conferences on Aging was provided attwo levels7-Arthe first level, the White HoukConference on Aging staff held training meetings,arranged by the Federal regional offices on aging,for the personnel of State agencies on aging. Theagencies, in turn, trained the local committeesresponsible for the community White House Con-ferences on Aging.

The training sessions for both the State agencydirectors and community committees concentrated

on explaining the nature of the policy formulationprocess upon which the substantive output of theconference would be based. If the recommenda-tions coming from hundreds of community con-ferences (and later from State conferences) wereto be successfully consolidated, it was necessaryto have a common understraiding of the processand to follow the same method of formulatingpolicy recomniendations in all conferences.

The training materials therefore directed at-tention to: the rationale for focusing on majorpolicy recommendations, as distinguished fromnarrow program refinements or distant, idealizedgoals; the process of arriving at policy proposalsthrough the weighing of alternative resolutions tothose issues identified by the Technical Committeeor considered by the Conference Sections on theirown initiative; and the need to evaluate eachrecommended policy against such criteria as itsrelevance, feasibility, clarity, salience, prospectsfor adoption; and consistency with social values.

The agenda of all the training sessions devotedthe morning to an overall look at the conferenceprocess, the afternoon to a simulation exercise indeveloping a policy proposal in the area of retire-ment by a model conference work group. Thisextensive training prograni was an important fac-tor in achieving the consistency and efficiencyrequired for the broad involvement which char-acterizes the three year effort of the White NouseConference on Aging.

Older Americans White House Forums

More than 6,000 Older Americans WhiteHouse Forums, with over 500,000 participants,were held in communities in 50 States and severalof the Territories. In order to achieve a maximumimpact, most of the meetings were scheduled dur-ing the week of September 20; yet by year's end,Forums were stiii being held in some States as

22

more and more communities asked to be involvedin the White House Conference activity.

Each community electing to sponsor an OlderAmericans Forum so notified the Stare agency. Alocal community was then established and theleadership given appropriate training for theirroles as described in the previous section.

Two objectives guided the planning and theconduct of the Older Americans Forums.

(1) To form a national network of commun-ity meetings, where older citizens wouldhave the opportunity to speak out and beheard on what they considered their basicneeds, and on what ought to be done tomeet those needs.

(2) To increase public awareness of the prob-lems faced by older people, and the po-tential they possess to tackle those prob-lems if given the means.

Participation in the Forums depended, of course,upon whether one had the time, means, and in-clination to attend. Nonetheless, the participantsdid represent a wide array of racial; ethnic, eco-nomic, and religious 'groups and they came fromall types of urban, suburban, and rural settings.

The Forums were of varied size. Many wereheld on a neighborhood basis and were attendedby small numbers of people. Others were con-ducted for larger areas such as counties or legis-lative districts.

The locale of individual Forams was equallyvaried. Meetings were held in senior centers, civicauditoriums, fraternal and service clubs buildings,churches and synagogues, individual homes, pro-fessional office suites, public housing projects,nursing homes, retirement villages, tribal houseson Indian reservations and schools.

The typical Forum agenda consisted of: an in-troductory plenary session; the delivery of a shortquestionnaire to each older person which askedabout his or her needs in several areas; workshopdiscussion directed toward a panel of "listeners"who were in a position to initiate responsive ac-tion, i.e., local, State, and national legislators,executive officials, providers of services, and othercommunity leaders; and a final plenary session tochoose priorities among the concerns expressedby older people. At the close of the Forums, re-port of the findings were filed with the Stateagencies.

An important part of the Forum activity waslocal media coverage. Clippings sent in by com-munities and States indicated broad coverage in

468.217 0 - 73 - 3

23

newspapers all sizes. Reports also showed goodcoverage by both commercial and educationalradio and television. This was important in ac-quainting the general public with the needs ofolder people and with the 1971 Conference.

Since the Forums were regarded as the founda-tion for community, State, and national WhiteHouse Conferences, it was necessary to registerhow older persons taking part perceived them-selves and their needs. Two principal methodswere used. One method was implicit in the veryconcept of the Forum, namely, older personswere provided the opportunity to voice their con-cerns during the work group discussion and tovote on their most pressing needs at the finalplenary session. Arrangements were made forForum recorders to note the major points of thediscussions and to report the voting on importantneeds in order of priority to State agencies forfurther use. Through this form of hearings andand testimony, older Americans issues a clariancall for major policy advances in such criticalareas as income, health, care, housing, and trans-portation.

The second, and more systematic, way of regis-tering older persons' opinions was through aquestionnaire addressed to their specific needs.By filling out the questionnaire, participants wereable to express their concerns whether or notthey joined in the Forum discussions. Written inboth English and Spanish, the questionnaire wasprepared by the Institute for InterdisciplinaryStudies, Minneapolis, Minnesota.

The questionnaire included items on transpor-tation, legal, medical, and financial problems;living conditions; food; geographical location;social activities; and life satisfaction.

Information was also collected on age, sex,education, and income in order to provide a basisfor assessing the relationships of needs and prob-lems to these characteristics of the elderly.

The Institute for-Interdisciplinary Studies proc-essed and analyzed a total of 194,000 question-naires, additional thousands have been receivedtoo late for inclusion in the sample. A prelimi-nary report was made in April 1971 and becameavailable to States for use in planning their White

House Conferences on Aging. The Institute alsoprepared a final report, Older Americans SpeakTo The Nation, a summary of which was dis-tributed to Delegates attending the White HouseConference on Aging.'

The major results of the questionnaire asanalyzed and presented by the Institute are re-ported here because of their importance in shapingthe thinking of Delegates to the State and Na-tional Conference.'

QUESTIONNAIRE RESULTS

Living Situation. The majority of the elderlyrespondents either lived alone or with theirspouse, although a disproportionately high per-centage in relation to the number in the generalpopulation lived in a retirement or nursing home.Half of the respondents owned the place wherethey lived and were thus responsible for mainte-nance of the premises.

Financial. Slightly mote than half of the re-spondents had difficulty in making ends meet.While more than one-third had difficulty in pay-ing for their housing. Nearly two-thirds of therespondents did not havesufficient means for"little extras."

Retirement and Employment. The majority ofrespOndents were retired. Of those individuals notretired, nearly one-half said.they would like to be.Eighteen percent of the respondents were workingeither full- or part-time. Of those individuals notworking, slightly more than one- quarter wouldhave liked to be working.

Medical-Dental. One-quarter of the respondentsfelt that they bad an unattended health problem.About a fourth felt that they could not receivemedical or dental services whenever they needed

' In its report, the Institute of Interdisciplinary Studies ack-nowledges some limitations inherent in the data. Perhaps themajor difficulty was that: "The responses to the survey are nobased upon a random sample of elderly throughout the nation,which makes generalization of responses as encompassing per-ceptions of all elderly somewhat tenuous. While the sample ofindividuals over 65 years of age was representative of allelderly by age, 24% of all respondents were under 65 year: ofage. The sample was betty. educated than the general popula-tion of elderly, yet it had a lower level of income. Additionally,the same represented a disproportionate number of females,people living in institutions, and people living alone."

'Copies of the full report can be obtained from the Institutefor Interdisciplinary Studies, 123 East Grant Street, Min-neapolis, Minnesota 55403.

24

them. Nearly half of the respondents had in-curred medical expenses during the previousmonth and twelve percent had incurred dentalexpenses.

Social Activities. Less than one-half of therespondents used a senior citizen center. Of thosewho did not, slightly less than half wanted to useone. Similar response rates were shown for indi-viduals belonging to or desiring to belong to anorganization for retired persons.

Life Satisfaction. Twenty-two percent of therespondents felt unwanted and -17 percent feltthat they had nothing left to live for. The ma-jority of respondents were happy in the neigh-borhood where they lived.

Food. The majority of respondents felt that theyhad enough -money to buy the food they liked,although one-third felt that food is packed .in toolarge amounts for their use. The majority ofrespondents cooked for themselves, and slightlymore than one-third ate alone.

Transportation. Nearly one-third of the respond-ents indicated that they had transNaation diffi-culties; primarily because of lack of public trans-portation, or of a car or inability to drive.

Legal. Less than 20 percent of the respondentsneeded legal assistance in the previous year. Themajority of respondents, however, felt that theelderly generally need legal advice about makingand probating a will. Slightly less than half feltthat the elderly need legal advice about guardian-ship. Six percent of the respondents perceivedthemselves as having been victims of consumerfraud in the previous year.

There was scarcely a problem or concern re-ported by older people at their Forums, or re-vealed by the questionnaire, that was not re-sponded to by recommendations made by com-munity, State, and the national conferences. Thisprocess of calling upon the older people to pro-duce these important components of the 1971White House Conference on Aging, coupled withtheir continuing involvement in every stage ofthe Conference, infused Conference discussi,:swith meaning and timeliness, and provided atouchstone for action on Conference policy recom-mendatiom.

Community White House Conferences on Aging

From February through April 1971, the 56State jurisdictions held more than 500 local con-ferences on :Ting. As was The case with the OlderAmerican Forums, any community so wishingcould, by notifying the State agency on Aging,hold a White House ,Conference on Aging. Somechapters of national organizations of older peoplewere also authorized by the State agencies tohold community conferences.

The community conferences were planned bylocal committees which included community lead-ers who represented local organizations andsenior citizens groups, as well as program plan-ners or lay persons interested in the problems ofthe aged.

In most cases these committees, had alreadyconducted the earlier Forums and, therefore,had some of the necessary experience to per-form the many difficult conference tasks. Othermembers were added to the committees as neededto guarantee that a sufficient number of knowl-edgeable persons were included for as many ofthe subject-matter areas as possible.

The community conference committees wereresponsible for setting the date of the local con-ference, enlisting and training leaders, invitingparticipants and assigning them to subject-matterwork sessions' according to interest and expertise.Here, as in all other aspects of conference ac-tivity, substantial effort was made to includepersons of all income levels, and of racial, ethnic,and religious groups.

In order that participants could prepare fortheir tasks in the community conferences, twopieces of literature were distributed to them, ifpossible, before the date of each conference. Onewas a leaflet titled, "So You Are To Be A Par-ticipant In A Community White House Con-ference on Aging," which provided relevant back-ground information; the other was the Work

' Most Community Conferences dealt only with the nineNeeds Areas.

25

Book for Participants in Community White HouseConferences on Aging in the subject area to whicheach was assigned.

It was suggested that the program of the com-munity conferences include registration, followedby an opening plenary session at which the con-ference task was explained and emphasis placedon the fact that the position the participants tookwould become the grist out of which a nationalpolicy on aging would emerge.

The participants would then assemble in worksessions according to their subject area assign-ments to formulate position statements or recom-mendations on each issue. A final plenary sessionwas to be held for the purpoSe of hearing therecommendations proposed by each of the worksessions.

A final report of each of the community con-ferences was to be prepared on special forms pro-vided for that purpose. The final reports were tobe transmitted to the State agency on Aging wherethe recommendations were to be organized foruse at the State conference.

In order to convert these raw materials fromthe community conferences into usable form forthe State conferences, each State agency on agingorganized task forces of specialists for each of thenine Needs Areas.

The task forces reviewed all of the policy recom-mendations in a particular subject area receivedfrom the various community conferences, con-solidated recommendations that were not sub-stantially different, while carefully preserving newor creative ideas, and worded the policy recom-mendations to be considered by the participantsin the State conference.

Thus, the development of a national policy onaging, as was appropriate, began at the grassrootslevel. The community conferences originatedmost of the policy recommenditions which bearthe stamp of the 1971 White House Conferenceon Aging.

t(

State White House Conferences on AgingBy early spring, 1971, the preparation for the

State White House Conferences on Aging wascompleted. As Aaron M. Wiesen, Chairman of theOhio State Conference, told the Ohio conferees,"Part of the race has been runmeaning, ofcourse, the-numerous White House CommunityForums held throughout the State last September,the Community Conferences held in selected re-gions this spring, and the work of the 17 TaskForces writing preliminary recommendations.Now comes the 'moment of truth': final prepara-tion of the recommendations which the OhioDelegates will take to Washington, D.C., as ourState's contribution to the White House Con-ference on Aging. . . Not only will our ideas beuseful at the White House Conference on Aging,they will also be heard throughout the Stateinthe press, at all levels of local government, andin the State Legislature. For certainly no allproblems can be solved at the national level.. .

Through this [State] meeting, the needs ofOhio's 'one million strong' will be articulated."

Mr. Wiesen thus summarized the preparatoryphases and emphasized the extraordinary im-portance of the State White House Conferenceson Aging. He reflected the sentiments of allStates. and projected what could be anticipated ascontinuing State involvement in improving thequality of life of their older citizens.

Responsibility for organizing and holding theState Conferences was given to the State agencieson aging. The meetings were scheduled in theperiod April to July 1971 in order to conform tothe overall preparation plans for the nationalmeeting in November.

The Governors were asked to appoint the par-ticipants to the State conferences according to thefollowing formula proposed by the NationalConference Planning Board.

Middle-aged and older people ... 45%Providers of services 35%Specialists in aging 10%Decision - :rakers 5%Youth 5%

Many of the State Conferences included ob-'servers as well as the officially appointed partici-pants. .

The leadership for each Conference was ap:pointed and trained by the State agencies. Copiesof the materials prepared by task forces and theWork Book, containing the issues identified bythe technical committees, were also distributed tothe participants by the State Agencies: Wheneverpossible, these materials were sent to the partici-pants prior to the conference so that they mightbe prepared.

Tod& 1

NUMBER OF STATES REPORTING RECOMMENDATIONS BY SUBJECT MATTER AREA

(P4 = S4 Jurisdictions)

9 Needs AreasNumber of States

Included Omitted 5 Needs-Meeting AmosNumbir

Included OmIttedEducation 52 2 Facilities, Programs, and Services 32 22Employment/Retirement 53 1 Government/Non-Govt. Organization 35 19Physical and Mental Health 54 0 Planning 35 19Housing 53 1 Research and Demonstration 35 19IncomeNutrition

5354

1

0Training 37 17

Retirement Roles and Activities 52 2Spiritual We II-geingTransportation

5154

30

"28 jurisdictions included all 14 subject areas2 jurisdictions included o'l 13 subject areas2 jurisdictions included all 12 subject areas5 jurisdictions included all 11 subject areas5 jurisdictions included all 10 subject areas

49 jurisdictions included MI 9 needs areas1 jurisdiction included all $ needs areas3 jurisdictions included all 7 needs areas1 jurisdiction included all 6 needs areas

26

The programs of the State conferences gener-ally, but not always, consisted of plenary sessionsand small work -group sections organized aroundthe subject areas. The States gave primary con-sideration to the nine Needs Areas but, most alsoincluded one or more of the five Needs MeetingAreas as shown in Table 1.

Many of the States went beyond discussion ofthi issues of national policy and gave attentionto what action could be taken immediately bytheir communities, the State, and various organ-izations to improve the situation of their elderlypopulations.

In the small work groups, each of the issuesand recommendations in a particular subject areawas handled singly. A work group reviewed thevarious proposals that responded to one issue and,through discussion and ballot, determined itsrecommendation for a national policy beforemoving to a second issue. This process was re-peated until ell of the identified issues had beenconsidered and both majority and minority posi-tions recorded. With this portion of their workcompleted, the participants turned their attentionto issues other than those identified by the techni-cal committees or to proposals for program recom-mendations.

The programs ended with a general session atwhich the recommendations developed by eachconference work group were reported to the totalparticipant body, and put to a vote for adoption.In some instances reports were voted on in workgroup sections but not by the full conference.

The States were asked to submit on a specialform each proposal in the exact working in which

it was adopted. They were also asked to indicatethe extent of the support that each proposal re-ceived (majority or minority proposal) and towhich issue the proposal was addressed.

The State conference reports were to be re-ceived at the National Conference office within10 working days after the close of the conference.The recommendations of 54 jurisdictions weresubmitted in time to be included in the technicalcommittees' consolidation of State conference andNational Organization Task Force reports.

Altogether, 38,297 persons were reported by53 jurisdictions to have attended the State con-ferences. Of this number, 57.4 percent were in themiddle and older aged group as compared to the45 percent recommended by the National Con-ference Board. The size and active involvementof this consumer group gives further credence tothe responsiveness of the State conference recom-mendations to the needs and wishes of olderpeople.

Table 2

STATE CONFERENCE PARTICIPANTS

53 JURISDICTIONS

Participant Groups Number Percent

Middle Aged sod Older People 21,992 57.4Providers ,si Services, Specialists,

Decision-Makers 14,993 39.1Youth 1,312 3.4

Total 31,297 99.9

These three groups are combined because some jurisdictionsdid net report them separately.

Activities of National Organizations

The 1971 White House Conference on Agingwas instructed to address its recommendationsnot only to government at all levels but to theprivate and voluntary sectors as well. Their activeinvolvement in the Conference process would beinstrumental to the development of sound policyproposals, and to generating broad public sup-

27

port for translating such proposals into action.The national organizations with a concern for

aging had been a vital part of the 1961 WhiteHouse Conference on Aging, but they had nothad opportunity to participate in an organizedfashion in providing content for that conference.To make. possible their active participation in

the pre-conference planning for the 1971 Con-ference; the leaders of 300 national organiza-tions were invited to a planning meeting whichwas held in Washington, July 1970.

These organizations were widely representativeof the following groups:.

Membership organizations-of older people

Professional and scientific associations

Business, consumer, and labor organizations

Religious, fraternal; social, service, and com-munity action organizations

National Association of State Units on Aging

More than 200 persons attended the Washing-ton meeting. They pledged themselves to assistthe Conference in three major ways by:

1. Providing lists of regional and State leadersfor involvement in State and communityconferences

2. Submitting position papers for use of Tech-nical Committees and authors of the Back-ground and Issues. papers.

3. Establishing task forces to recommend pro-posals for developing a national policy inaging in the nine Needs Areas.

The major contribution of the participatingnational organizations to the preparation for theNational Conference was the development ofpolicy recommendations for each of the nine

Needs Areas. .A National Organization TaskForce was set up for each area. Altogether, 543persons representing 293 national organizationswere distributed among the nine task forces.

To assist the task forces in their work, and toinsure that their recommendations were preparedin the same form. as those generated by Stateconferences, they were provided copies of a Tech-nical Guide for National Organizations and theappropriate Background and Issues paper.

At 2-day meetings in May 1971, the taskforces approved sets of policy proposals whichwere subsequently forwarded to Washington forconsolidation with the State recomn.-ndations bythe technical committees. Representatives of thetask forces met with the technical committees toensure that full consideration was given to therecommendations of the National OrganizationTask Forces. In addition, the organizations them-selves were asked to comment on the task forcefindings and submit any additional materials rele-vant to the subject.

The national organization participation in the1971 White House Conference continued withthe involvement of more than 700 representa-tives named by them to be Delegates to the Na-tional Conference. They constituted a significantproportion of the professionals among the Dele-gate body. They were assigned to both the Needsand Needs Meeting Sections.

Regional White House Conference on Aging HearingsIn October 1970, John Martin, Director of

the Conference, invited the chairman of each ofthe 10 Federal Regional Councils to sponsor aRegional Hearing on Aging in his respectiveregion. The invitations were accepted and planswere made for the hearings to be held during theearly months of 1971. .

Three purposes of the hearings were defined asfollows:

To provide an opportunity for input into theWhite House Conference on Aging fromrepresentatives of government and non-

28

government at the regional, State and locallevels.

To give greater visibility on the regionallevel to the needs of older persons.

To provide an extra dimension of availabledata for the Technical Committees prepar-ing background information for the WhiteHouse Conference on Aging in November1971.

Flexibility was allowed each region to selectthe topic considered most appropriate for theregion. Those selected were:

s

Region I (Boston) "Health ServicesInter-mediate and Long-Term Care"

Region H (New York) "How to Meet theNeeds of the Elderly in a Variety of HousingSituations"

Region III (Philadelphia) "Methods to Im-prove the Income of Older Minority Groups"

Region IV (Atlanta) "Roles and Activitiesof Older Persons"

Region V -(Chicago) "Health Maintenance"

Region VI (Dallas) "Needs and Problems ofOlder Mexican-Americans"

Region VII (Kansas City) "Rural Transpor-tation"

Region VIII (Denver) "Education for theElderly"

Region IX (San Francisco) Report fromStates

Region X (Seattle) Report from States.

Mr. Martin or Mr. Atwell opened each hearingwith a "Report to the Region" which related theprograms of the White House Conference onAging across the Nation to the region in whichthe hearing was being held. Testimony was heardby the members of the Regional Federal Council.It was given by officials of regional, State, andlocal government and representatives from vari-ous organizations and agencies concerned witholder people. This testimony, along with writtentestimony submitted by others, became the officialrecord of the hearing. These constituted ii

portant background materials for the NationalConference as well as providing opportunity toexamine in depth some of the unique problemsfoUnd by elderly persons in various parts of thecountry.

Conference Flow ChartFlow chart, pages 88-89, provides a sum-

mary and time scale of these elements which wentinto the making of the 1971 White House Con-ference on Aging.

Beginning with the older people speaking out,followed by the mobilization of specialists and

29

the involvement of a broad representation ofcitizens in various action-taking meetings, theConference preparation culminated in the summerof 1971 with the consolidation of the recommen-dations from all sources for use of the Delegatesat the National Conference in November-De-cember.

Establishing a National Climate of Action

y January 1971, the preparatory phasesof planning, appointment of commit-tees, development of background papersand instructional materials had been

completed. What remained to be done at thenational level during the 11 months precedingthe Conference was to implement the plans andprepare the details of the National Conference.

When the Conference planning began in early1970, there was a public concern that aging wasno longer a Federal government priority. Thisstrongly held belief heightened the sensitivities ofnational organizations of older people, profes-sional groups and responsible public bodies lead-ing them to question whether indeed the WhiteHouse Conference on Aging was a sincere effortto improve the circumstances of the older popu-lation. As a result of the widespread dissatisfac-tion, criticism of the Conference was quick togenerate. Thee critical of the Conference main-tained that it was being used for political pur-poses, that the Conference outcome was beingcontrolled through rigid structuring of its subjectmatter, and that there was little evidence of in-tent to seek action in time to benefit the presentgeneration of old people.

Such a chill climate gave small promise thata great national meeting intended to advance thequality of life for all older Americans wouldreach a full and fruitful maturity. What wasneeded was a change in the climate from one ofnegative reaction to one of positive actionaction already underway before the Delegatesconvened in Washington in November.

The immediate need was to augment the WhiteHouse Conference on Aging staff with a fulltimechairman who would work closely with the Con-ference director in carrying forward the Confer-

33

ence plans. To this end, the President namedArthur S. Flemming as Conference Chairman.

Without changing the main Conference pur-pose of moving toward the development of anational 'policy on aging, Mr. Flemming movedquickly to bring about a greater understanding ofthe Conference and its goal of formulatingpolicies for immediate feasible actionthe defini-tion of a policy already adopted for the use of theConferenCe.

Stne and regional groups across the countrywere urged to expand existing programs and toinitiate new ones without waiting for the finaldecisions of the Conference. It was important forthe National Conference Delegates to feel thatthey were participating in a movement alreadywell underway and to have the need for actionuppermost in their minds when they spelled outtheir hopes and aspirations in formulating recom-mendations for national policy and in planningthe implementation of them.

By October, when States reported what actionshad been stimulated, they were able to give dozensof examples, such as an increased variety of serv-ices to the elderly, the formation of many newcommunity councils and commissionon aging,the enactment of various legislative measuresthat were in line with the State Conference recom-mendations, new starts on housing for the elderly,and special transportation programs tailored tothe needs of the elderly.

To stimulate additional pre-Conference actionand to identify any weaknesses in the NationalConference effort, a series of tet. regional meet-ings were held. In each region the meeting in-cluded the members of the Federal RegionalCouncil, the chairmen of the State conferences onaging, the directors of the State units on aging,

and members of the national organizations ofolder people.

During the late spring and summer of 1971several important steps were taken to initiateaction within the Executive Branch of the FederalGovernment. The President named a Cabinet-level Committee on Aging within the DomesticCouncil. In doing so he pointed out the "need todevelop a comprehensive national policy withspecific action to provide greater opportunities forthis nation's 20 million older people to improvethe quality, dignity and productivity of theirlife."

The Department of Health, Education, andWelfare appointed a special assistant on nursinghomes and began a vigorous program to improvethe substandard nursing homes of the Nation. InMay, the Secretary, in anticipation of increasedgovernment responsibilities in aging followingthe Conference, asked that a citizen task forcebe named to examine alternative plans of govern-mental organization for aging and to prepare aninterim report of its recommendations for theDelegates to the White House Conference onAging.

Having stirred pre-Conference action and newenthusiasm for aging at community, State, re-

gional, and Federal levels, Mr. Flemming re-sponded to the mutually expressed wishes of thevoluntary organizations and governmental agen-cies for the post-Conference continuation of theclose working relationship that had been gene-rated through their cooperative preparation forthe White House Conference bn Aging. "A Planfor Action" was launched at a meeting of repre-sentatives of 175 national organizations in the fallof 1971. Primed for action, this group had, bythe time of the National Conference in Novem-ber, already taken steps to establish an ongoingorganization and had launched its first program,the ultimate goal of which is to make home serv-ices available and accessible as needed to olderpeople wherever they live.

Although only a small fracoon of the nearlyone million persons who had a "piece of theaction" in preparing for the White House Con-ference on Aging, could attend the nationalmeeting, they were already busy in their ownspheres and prepared to put into immediateaction the recommendations of the national Dele-gates. And, because the Delegates returned homewith copies of all the proposals made at the na-tional meeting, post-conference action at the local,State, and regional levels proceeded without abreak in time or even a hesitation.

Consolidation of Recommendations

During July and August of 1971, the 14 Tech-nical Committees were each convened for a secondmeeting. The purpose was to prepare a clear, suc-cinct consolidation of the policy recommendationswhich had been produced by State White HouseConferences on Aging and by the National Or-ganization Task Forces.

To assist the Technical Committees, the Sec-retariat for each Committee undertook a pre-liminary consolidation of the State and task forceproposals following the guidelines adopted by theConference Planning Board.

The Technical Committees were asked to reportsignificant refinements or variations of any recom-

34

mendation. Proposals addressed to matters otherthan those represented by the issues which hadbeen developed by the Technical Committee werealso to be synthesized and reported for the consid-eration of Delegates to the National Conference.To be reported, however, such proposals were tohave been given majority approval by five or moreStates or by fewer than five if such States com-prised 10 or more percent of the 65 and overpopulation. Exceptions to this rule were made incases where proposals were particularly strikingor innovative in nature.

To facilitate the use of the consolidated recom-mendations as a working tool for Delegates, theTechnical Committees often included with the

recommendations comments which they con-sidered pertinent to discussions of the issuesinvolved. In some cases, for example, the Techni-cal Committee concluded that the original issuehad not been well phrased and suggested a re-statement to clarify it. In other instances, theTechnical Committee suggested additional issuesor points it believed should be considered by theDelegates.

To assist Delegates in their task, programsuggestions included in the recommendations ofthe States and national organizations were alsoreported when such proposals set forth actionsteps which might be taken to implement pro-posed policies.

Having anal responsibility for the consolidationof the recommendations, the Technical Commit-tees sought to develop statements which were asfaithful as possible to the expression and intentof the States and national organization task forces.

Observers named by the national organizationtask forces and the National Association of StateUnits on Aging attended the meetings of theTechnical Committees to ensure that equal con-sideration was accorded to all recommendations.When the consolidated proposal statements wereagreed upon, they were incorporated within theDelegate Work Books which were to be used atthe National Conference.

Categories of Conference Participants

In addition to preparing materials and finaliz-ing the organizational plans and procedures forthe National Conference, during the severalmonths prior to the 1971 White House Confer-ence on Aging, the Conference staff was activelyengaged in the process of identifying what wasthe essential Conference ingredientparticipants.These participants, in all numbering over 4,500,included:

Delegates, nominated by several sources, whowere the only Conference participants to holdvoting privileges.

Observers, representatives from various sectorsidentified as holding some special interest inwork and objectives of the Conference. Ob-servers participated with the same rights andprivileges of Delegates except they lacked theright to vote.

Guests included all Governors and Members ofCongress, or their personal representatives.Also invited as Guests were decision-makers inthe Executive Branch of the Federal Govern-ment, and special persons invited by the Con-ference.

Staff consisted of the White House Conferenceon Aging personnel, complemented by Federalpersonnel drawn from the various departmentsand agencies involved in programs for theaging.

35

DELEGATES

Nearly 3,600 Delegates were expected to at-tend the national meeting, including:

Conference Planners 324State Delegates 1,750Youth Delegates 112State Agency on Aging Representatives 99National Organization Delegates 737Office of Economic Opportunity Advisory

Committee Members 15Delegates-at-large 537

Conference Planners. Persons named by the Sec-retary of Health, Education, and Welfare to serveon the Conference Planning Board or as membersof the Technical Committees, automatically as-sumed Delegate status. Such status was grantedto authors of the Background and Issues papers,consultants to the Technical Committees, and toSection Co-Chairmen who did not already possessDelegate credentials. All these persons were classi-fi ed as representing the States in which they re-sided, but they did no count against the Starequotas.

State Delegates. Each State, Territory, and theDistrict of Columbia was allotted a minimum of14 and a maximum of 125 Delegates, based on

the size of their respective older populations inthe 1970 census.'

At the request of the Secretary of Health, Edu-cation, and Welfare, Governors of the States andTerritories, and the Mayor-Commissioner ofWashington, D.C., nominated Delegates. EachGovernor was asked to name his State quota, andto provide a list of alternates equal to one-halfof the quota, to be drawn from in cases of dupli-cate nominations or declinations of the President'sinvitation.

In their Delegate selection, the Governorswere requested to consider the following criteriaadopted by the Planning Board:

Tnat the diversity of population in eachState be reflected in the composition of theState Delegates, and that due recognition begiven to ethnic, minority, and economicallydisadvantaged groups of older persons ineach State population.

That Delegates be selected on the basis ofdemonstrated interest, personal effectivenessand leadership in the field of aging, withspecial weight being given those who par-ticipated in local and State conferences,studies, and other activities preparatory tothe White House Conference on Aging, andwho best represent the points of view of theparticipants in those preparatory activitiesin the States.

That a wide interest in programs for personsbe favored over specialized or exclusive in-terests.

That the individual's capacity to undertakefollowup action in his State and community,subsequent to the National Conference andhis leadership potential be given weight. In-sofar as possible, State legislators with re-sponsibility for matters affecting the agedshould be considered.

That the delegation as a whole providerepresentation from rural, small town, and

' The 56 jurisdictions which named State Delegates includ-ing the 50 States, the District of Columbia, American Samoa,Guam, the Commonwealth of Puerto Rico, the Trust Terri-tories of the Pacific, and the Virgin Islands.

36

metropolitan areas and from all age groups,especially older persons.

That the delegation from each State should,insofar as feasible, include persons assignedto a Section within each of the suNect mattergroups, in order that the State may havebroad coverage at the Conference.

That persons with a professional identifica-tion in the field of aging should not exceedone out of every four Delegates appointedby the States. Persons may be regarded as"professionally identified" with the field ofaging if more than 50 percent of time forwhich they receive compensation is devotedto programs or services to the aging.

Youth Delegates. Each Governor was invited toname two Youth Delegates. To guide the selectionof these youths several specific criteria wereoffered.

That the Youth Delegates be within the agesof 17 and 24 years at the time of the Con-ference.

That attention be given to including youthfrom ethnic, minor4 and economically dis-advantaged groups.

That formal affiliation with a national youthorganization not be a requirement fornomination.

State Agency on Aging Representatives. EachState agency on aging was allotted two Delegatepositions, one each for the executive director ofthe agency and its chairman. These Delegate slotswere utilized if the individuals involved did notalready have Delegate status under some othercategory.

National Organization Delegates. A total of347 national organizations named Delegates toattend the Conference. Organizations which hadparticipated in the preparatory work of the Na-tional Organization Task Forces, were each al-lotted two Delegates. Organizations which hadexpressed interest in the Conference, but whichhad not participated in the task forces, wereallowed to name one Delegate. Nine membershiporganizations of older people were granted 10additional Delegates positions. The four largestnational organizations of older personsthe

American Association of Retired Persons. theNational Retired Teachers Association, the Na-tional Council of Senior Citizens, and the NationalAssociation of Retired Federal Employeeswereeach invited to name an additional 14.

Formal criteria were not established for Na-tional Organization Delegates, although it wasassumed that persons nominated would possesssome specialized knowledge, skill, or interest inthe subject area Section to which the naming or-ganization requested assignment. Organizationswhich were presented the opportunity to nameadditional Delegates were asked to give specialattention to ethnic, minority, and economicallydisadvantaged groups of older persons.

0E0 Advisory Committee. Members of theOlder Persons Advisory Committee to the Officeof Economic Opportunity, who were not ac-credited as Delegates in other categories, weregranted special Delegate status.

Delegates-at-large. It was recognized that withthe quotas prescribed for Delegate seleCtion, someparticularly qualified individuals would not benamed. To make compensation for this, and toinsure that there would be among the Delegatesappropriate representation from special popula-tion groups, the President designated Delegates-at-large. These Delegates were not named, how-ever, until all other Delegate appointments hadbeen completed and analyzed.

OBSERVERS

Foreign Observers. The majority of the ForeignObservers were persons invited by the Social and

Rehabilitation Service (Department of Health,Education, and Welfare) and the GerontologicalSociety to participate in an International Geron-tology Research Symposium. The White HouseG nference and the Research Symposium werescheduled concurrently and participation in theConference was part of the Symposium program.Ad,litional Foreign Observers invited to partici-pate in the Conference included persons interna-tionally active in the field of aging and profes-sionals invited at the special request of theirgovernments.

Faculty-Student Observers. Teachers and stu-dents of aging, representing over 50 programsoffering training in gerontology, were invited toattend the Conference.

Aging Program Directors. Two programs offer-ing community service employment opportunitiesto older persons were invited to name Observers.The Foster Grandparent Program sent its projectdirectors. The Senior Aides, operating under anagreement between the National Council of Sen-ior Citizens, Inc., and the Department of Labor,designated directors of its programs to attend.

Federal-Regional Personnel. The RegionalCommissioners of the Social and RehabilitationService and the members of the Federal RegionalCouncils were invited Observers. The FederalRegional Councils embody an inter-departmentalapproach to ameliorating social problems and arecomposed of representatives from the Depart-ments of Housing and Urban Development,Transportation, Labor, and Health, Education, andWelfare, and the Office of Economic Opportunity.

Conference FormatResponsibility for the format of the National

Conference rested with staff, guided by the actionsof the Conference Board and its Committee onProgram and Procedures.

The adopted format included General Sessionsfor all Conference participants or for special

37

groupings of them; and two types of work sessionsSubject Area Sections and Subsections for par-ticipants assigned to them and Special ConcernsSessions which participants could attend as theychose. Chart 1 sets forth the events scheduled overthe 41 /2-day Conference period.

Chad 1

CONFERENCE FORMAT

MORNING AFTERNOON EVENING

SUNDAY Registration Registration General Session

Opening the ConferenceMONDAY Section Meetings 1

(Orientation)

Subsection Meetings 1

Subsection Meetings 2 Open Forum

TUESDAY Subsection Meetings 3 Subsection Meetings 4 Subsection Meetings 5(if needed)andPolicy DrainingCommittee Meetings

WEDNESDAY Special Concerns SessionsandPolicy CoordinatingComMittee Meetings

Section Meetings II(Adoption ofRecommendations)

Section Meetings II(Continued if needed)andPreparation of Final Report

THURSDAY General Session .

Closing the Conference

GENERAL SESSIONS

There were three general sessions planned forall Conference participants. The Opening Sessionwas designed to provide opportunity to welcomethe Delegates and to instruct them in their Con-ference tasks. For this Session, a multi-media pre-sentation was developed to present a vivid illus-tration of the circumstances of today's older peopleand of the various attitudes society holds towardthem.

The second general session was an OpenForum. Convened in the evening of the first fullday of the Conference, this session was arrangedto give special groups and organizations a forumfrom which to present their points of view earlyenough in the Conference period to influence thedeliberations of the Delegates in their workingsessions.

38

The Closing Session of the Conference was in-tended to bring together all the Conference par-ticipants to hear an address by the President ofthe United States and a challenge to post-Con-ference action by the Conference Chairman. Inaddition to these general sessions for all Dele-gates, Conference Luncheon Meetings were or-ganized for groups of Sections to provide oppor-tunity for Delegates to hear firsthand the views ofmajor Federal officials and members of Congresson current problems of older people and pendinglegislative thrusts on their behalf.

SUBJECT AREA SECTIONS AND SUBSECTIONS

The Sections. The Conference program was or-ganized into 14 working Sections according to thenine Needs Areas and five Needs Meeting Areas.Each Section met twice in plenary sessions. Thefirst meeting allowed for a task-setting orientation

1

before the Section divided into Subsections whereit was that recommendations would be developed.In its second gathering (two and one-half dayslater) the Section took formal action on the Sub-section recommendations.

The 14 subject-area Sections were all organizedin the same manner, with Co-Chairmen. One wasdesignated the Presiding Officer; the other wasthe Technical Co-Chairman who worked with theDelegates in developing Section procedures andin setting the goals to be achieved during theSubsection sessions.

Each Section had an official Recorder who wasresponsible for keeping a record of the actionsof the Sections, and preparing the final report ofthe recommendations approved by the Section atits final meeting.

A Section Policy Coordinating Committeewas responsible for the final version of the Sec-tion recommendations which were reported to theSection for discussion and voting. Membership ofthe Committee consisted of the Section Co-Chair-men, Recorder, and all Subsection Officers. Thepresiding Section Co-Chairman chaired the Com-mittee.

A Section Policy Drafting Committee con-solidated the policy recommendations from thevarious Subsections and transmitted them to theSection Policy Coordinating Committee for finalreview. Membership for this Committee includedthe Section Co-Chairmen, Recorder and the Sub-section Recorders. The Technical Co-Chairmanpresided at meetings of this smaller workingCommittee.

Sections had available Resource Personnelfrom the Federal agencies and other Consultantsto provide whatever technical information wasneeded during the discussions.

The Directors of the Secretariats to the Techni-cal Committees served as the Section Managersduring the Conference.

The Subsections. Each Section was divided intoSubsections of approximately 35 Delegates whichmet for a total of 10 to 13 hours. There was atotal of 95 Subsections, apportioned among thevarious Sections according to the number of Dele-

39

46e -217 0-73 .4

gates assigned to each. A deliberate effort wasmade to keep every Subsection small in order toinsure that each Delegate would have full andsufficient opportunity to participate and offer hisparticular contribution.

Each Subsection, independent of the others,formulated its policy proposals. Each of the Sub-sections considered all issues and proposals pre-sented within the appropriate Delegate WorkBook.

All 95 Subsections were organized accordingto the same pattern. Each Subsection had a desig-nated Chairman who presided throughout theseveral sessions of the Subsections. At the begin-ning of its meeting, each Subsection elected aVice Chairman who assisted the Chairman andpresided in his absence, or upon his request. ARecorder was assigned to each Subsection to keepan official record of all actions taken.

There was a Subsequent Policy Drafting Com-mittee composed of the Subsection Chairman,Vice-Chairman, and Recorder. They prepared areport of the recommendations of the Subsectionfor transmission to the Section Drafting Commit-tee. They also served as members of the SectionPolicy Coordinating Committee.

Federal agency Resource Personnel and otherConsultants were assigned to assist each of theSubsections during their work periods.

The flow of work between the Sections andSubsections over the 3-day period was to leadto the adoption by each Section of a set of recom-mendations. Chart 2 shows the structure andschedule of the meetings of the Sections and Sub-sections and the task which was to be carried on ateach of them.

Not shown by the chart is the process of pro-viding the Interim Report of the Sections to allDelegates at the Closing Session of the Confer-ence. The Section Reporters, with the assistanceof the other Section officials, were to prepare a1500 word report for their respective Sectionsconsisting of a short preamble and the recom-mendations approved by the Delegates at the finalSection meetings. These were to be filed for repro-duction and inclusion in the Interim Report.

Schedule

MONDAY9:00 AM-10:00 AM

MONDAY10:00 AM-5:00 PM

TUESDAY9:00 AM-5:00 PM

MONDAYand

TUESDAY5:00 PM-7:00 PM

TUESDAY7:30 PM

WEDNESDAY8:00 AM-10:00 PM

WEDNESDAY2:00 PM-5:00 PM

Chart 2.

SECTION AND SUBSECTION STRUCTURE AND TASK

Subsections35 Delegates

each

SubsectionDrafting

Committees

SECTIONSAll Section Delegates

Subsections35 De legates

each

SubsectionDrafting

Committees

Subsections35 Delegates

each

SubsectionDrafting

Committees

Section Drafting Committees

Section Policy Coordinating Committees

Task

{OrientationInstruction

I I {SECTIONS

All Section Delegates

Formulationof Policies

PreliminaryVote

PrepareSubsectionReports

ConsolidateSubsectionReports

ReviewSectionDraftReport

Considerand Vote onSectionReport

40

SPECIAL CONCERNS SESSIONS

Planning the 17 Special Concerns Sessions wasthe responsibility of their respective organizingcommittees. The White House Conference staffand other government personnel served the com-mittees only in the capacity of expediting com-mittee plans.

The committees met in sessions over severalmonths. Each sought to adopt a program formatwhich would ensure productive discussion andpractical recommendations. In their programs,a number of the committees included "listeningpanels" which were made up of persons fromCongress and the various Federal departments to

whom they wished to directly present their rec-ommendations.

Some of the planning committees were ableto arrange meetings of constituent groups priorto the Conference for the purpose of developinga platform for consideration and adoption at. theSpecial Concerns Sessions. Some corarnittees,especially those planning the Sessions on theelderly minority groups, fashioned their programsto cover some or all of the 14 subject areas of theConference. This allowed the Delegates an oppor-tunity to speak to the common needs of all olderpeople and to the additional, particular problemsimposed by racial considerations.

Selection and Training of Conference LeadershipSelection. An attempt was made to select Sectionand Subsection leadership from among those Dele-gates most broadly informed about the problemsof older people, and those who were judged topossess an appreciation of the policies and actionsneeded to achieve a meaningful and healthful lifefor the older segment of the population.

Responsibility for naming Section and Sub-section leaders, except SubseCtiOn Vice-Chairmen,rested with the Executive Committee of the Plan-ning Board which Committee named an ad hocSub-Committee to prepare a slate of candidatesfor each of the Sections and Subsections. The Sub-Committee solicited suggestions of persons forthese leadership roles from various 3ources, in-cluding national organizations, minority groups,State units on aging, and the members of thetechnical committees, and the Planning Board.

The Sub-Committee reviewed the credentialsof all persons suggested which were received priorto the time of its meeting and prepared alternativeslates of nominees for each position. The Execu-tive Committee made the selections from amongthe potential candidates paying special attentionto the inclusion of older people, women, andminority representatives. Also, in light of the verysparse representation among previously namedConference leadership of persons from nearlytwo-thirds of the States, weighted considerationwas given to achieving a balanced geographicaldistribution.

41

The Vice-Chairman for each of the 95 Sub-sections, by action of the Planning Board, waselected at its first meeting from among the Dele-gates within the Subsection.

Rounding out the leadership of the ConferenceSections and Subsections were expert non-govern-ment consultants and Federal personnel. TheFederal personnel were not voting delegates, butwere to supply the staff support and resource nec-essary for effective work.

A Section Management Officer, who was alsodirector of the Technical Committee Secretariat,was designated the principal government staffperson for each Section. They in turn arrangedfor the other government personnel who servedat the Conference. Persons working in the re-gional and central offices of the Administrationon Aging provided additional staff assistance.

Training the Leadership. The orderly develop-ment of recommendations by nearly 3600 personsrequired that the leaders particularly be wellversed in the nature of the task and the processto be followed. All leaders had instruction pro-vided in various written materials and many hadgained experience in leadership roles at theircz-nmunity and State conferences. As further in-surance that the Conference objectives would beachieved, the Section and Subsection leadershipwas provided with some additional training in twoorientation sessions.

The first orientation and training meeting washeld in mid-November. It brought together theSection Co-Chairmen, Recorders, and the SectionManagement Officers. A Guide for Section andSubsection Conference Leaders was distributed andreviewed. This publication set forth the Con-ference plans and procedures, including:

Conference structures and organization, formatand schedule

Tasks of the Conference leadersRecommendation reporting procedures'Rules of order governing the conduct of the

Conference working sessions.

The second training session was held for Sub-section Chairmen and Recorders on the day pre-ceding the opening of the National Conference.Special instruction on effective Conference record-ing was provided those who were to perform thatrole in the work of the Conference.

Opportunity was also presented the leadershipof each Section and its Subsections to meet to-gether and prepare for achieving their commongoalthe develop.tient and refinement of qualityrecommend,..tions over an extremely short periodof time.

Assignment and Preparation of Conference Participants

Assignments. All Delegates were to work withinone Section and one Subsection of that Section dur-ing the entire Conference period. Section prefer-ences for the State Delegates, youth Delegates andNational Organization Delegates, based on knowninterests and skills, were indicated by the sourceof the nomination. For State Delegates an attemptwas made to insure the widest possible represen-tation of the State among the 14 ConferenceSections. Observers and guests were asked to indi-cate their choice of Section assignments.

Assignments to Subsections were essentiallyrandomly determined. Except that a special at-tempt was made to make certain that within everySubsection, as within each Section, there was rep-resentation from the various minority populationgroups.

To facilitate Conference registration and thecollection of demographic data, each Delegatewas asked prior to the Conference to complete anAdvance Registration Form. At the time, each wasinformed of his Section assignment, and was givenan opportunity to choose which, if any, specialConcerns Session he wished to attend.

Preparation. To achieve in the development ofbroad, feasible plans for national action, the Dele-gates needed to be knowledgeable in the subjectmatter areas .and familiar with the plans andprocedures of the Conference and the roles theywere expected to carry out.

42

Preparation really began at the communitylevel where many of the persons who would even-tually be named as Delegates to the nat+onalmeeting took part in community conferences.Here leaders, trained earlier by State agency per-sonnel, explained the task of policy formulation,aided by a work book especially prepared for thecommunity conference participants. The Stateconferences provided a second learning experi-ence which closely resembled the task that theDelegates to the National Conference wouldundertake.

To prepare the Delegates in the specific plansand for effective participation in the nationalmeeting, the appropriate Delegate Work Book,Background and Issues Paper, and other referencematerials were forwarded to participants someweeks before the Conference began. This made itpossible for the Delegates to "study the recom-mendations upon which they were to build at theConference. It also gave them an oppoqunity toidentify gaps and problems for which they could,if they wished, propose additional recommenda-tiors for consideration at the national meeting.

As a final step in the preparation of the Dele-gates, most States convened their State delegationsto provide them a firsthand orientation for theNational Conference and to review its significanceand relationship to future action at the State level.

PART 4

The National Conference

in Action

November 28December 2

The Conference Settinghe Conference was housed in fourWashington Hotelsthe WashingtonHilton, the Statler Hilton, the SheratonPark, and the Shoreham. The Confer-

ence headquarters was located in the WashingtonHilton. The other hotels were used mainly for thesmaller group meetings.

Although the Conference did not open officiallyuntil Sunday evening, most of the Delegates ar-rived either the day before or early in the day onSunday with the result that many were on handfor Registration when it opened at 10:00 A.M.Having registered and received their Conferencematerials, they were free to visit and to explorethe resources of the Conference.

One of the areas that drew the attention of theDelegates was the Senior Portrait Exhibition atthe Conference headquarters. The exhibit wasmade up of those works that had been cited inthe nationwide contest for original portraits of anaged subject completed by persons who werethemselves old. The show contained the 24 win-ners of the State contests that were submitted forthe national competition.

The winning entry, "Patriarch of the Moun-tain," was painted by Bernard C. Bonder, age 73,of Mountain Home, Arkansas,' who was to berecognized in person at the Conference ClosingSession.

Adjacent to the Senior Portrait Exhibit was theReading and Document Room. Literature on theproblems of and programs for the elderly hadbeen placed there so that Delegates might haveaccess to the most current information available.These reports and statements from the Federaldepartments and public agencies and private non-

' See Appendix K for additional information on the SeniorPortrait Contest.

45

profit organizations touched on a broad range ofissues and resources.relating to aging.

The press room was also located in the Wash-ington Hilton Hotel. A portion of the press roomwas set aside for the press conferences which wereto be held two or more times a day. Mr. Flemmingand Commissioner Martin jointly met with thepress each day to keep them informed of the Con-ference's progresS.

By mid-afternoon Sunday the number of Dele-gates had noticeably increased and the amount ofConference activity had risen sharply. State dele-gations and special interest groups were caucusingand planning their activities for the next 4 days.Get-acquainted meetings and receptions werequickly organized.

Among the Delegates were the "47 Outstand-ing Older Americans." These persons, many ofwhom were in their 70's and 80's, had beendesignated by their Governors and honored attheir State conferences for the contributions thatthey have made to the aged and to society.'

For those Delegates who wished to attend, aspecial ecumenical service was held at the Wash-ington Cathedral. The ecumenical service wassponsored by the District of Columbia AdvisoryCommittee on Aging. Conference ChairmanFlemming and Dr. Inabel. Lindsay, a Vice Chair-man of the Conference, participated in the Service,as did Dr. Benjamin Mays, Georgia's OutstandingOlder American.

In such a setting began 4 days of effort toarticulate policies and suggest programs which, ifimplemented, could change society's attitudes andmaterially improve the status of America's oldercitizens.

'See Appendix J for additional information on the Out-standing Older Americans.

Characteristics of the Delegates

The Presidential proclamation of 1969 calledfor broad representation; the Delegates who par-ticipated in the Conference reflected the varietyof background and diversity of interest that thePresident sought to obtain.

A total of 3,675 persons were invited by thePresident to be Delegates at the White HouseConference on Aging. Of the 3,574 who were ableto accept, all but 427 persons filled in a pre-Conference Registration Form which includedquestions designed to provide information aboutthe characteristics of the Delegate body respon-sible for the recommendations adopted at theConference.

Not all Delegates replied to all questions; thus,the number of replies reported varies in severalof the tables presented below.

The "No Information" entry in the tables re-flects the number for whom information was notavailable, either because they did not answer thequestion on which the table is based, or becausethe Registration Forms were not received.

AGE AND SEX

In the Act authorizing the Conference, theCongress pointed out that a significant proportionof the participants should be older people. TheConference Planning Board took action recom-mending to the States that no less than 45 percentof the participants involved in the State Con-ferences should be in the older age category.

Although the proportion of older Delegates tothe National Conferences was not stipulated, ofthe 3,120 Delegates for whom data are available,60 percent were aged 55 years or over. Only 20percent of the group were younger than middle-aged (less than 45 years of age). More than 35percent were in the retirement age bracket of 65or over.

Only one of every three Delegates was female.This contrasts sharply with the ratio of womenin the over 65-age groupa category in which

46

one presently finds a ratio of 139 women per 100men. Women were underrepresented in everyage category of the Delegate body except for therange of under age 25.

Table 3

DELEGATE SEX DISTRIBUTION, BY AGE

(percent)

Age Sex

Male Female Total

Under 25 1.7 1.6 3.325 -44 12.1 4.6 16.745 -54 13.5 6.7 20.255 -64 14.6 9.8 24.465-74 16.4 10.0 26.4over 75 5.9 3.1 9.0

Total 64.2 35.8 100.0

* Percentages based on the number of Delegates for whomage information was available nr 3,)20 persons.

MINORITY GROUP REPRESENTATION

The special efforts of the Conference and minor-ity groups to insure adequate minority represen-tation among the Delegates were successful tothe point that four major minority groups in thepopulation constituted almost 20 percent of theDelegate body.

Table 4

MINORITY GROUP REPRESENTATION

AMONG THE DELEGATES

Group Percent*

Blacks 10.3Spanish Speaking 5.4American Indians 2.7Asian - Americans 1.2

All 19.6

* Based on total Delegate body or 3,574 persons.

,

RESIDENCE

Just over half (50.6 percent) of the Delegatesresided in nine States and the District of Columbia.These same jurisdictions contain 50.6 percent ofthe Nation's older people.

Table 5

THE TEN MOST HEAVILY REPRESENTED

JURISDICTIONS AMONG THE DELEGATE BODY

Jurisdiction Percent

New YorkDistrict of ColumbiaCaliforniaPennsylvaniaIllinoisOhioFloridaTexasMichiganMaryland

9.57.66.55.34.64.03.63.53.12.9

Total 50.6

The relatively large number of Delegates fromthe District of Columbia, Maryland, and NewYork is accounted for in part by the fact that alarge proportion of the Delegates named by na-tional organizations reside in these three juris-dictions.

SIZE OF COMMUNITY

Of the 3,574 Delegates, 3,104 indicated thesize of their home communities. Using this num-

Table 6

SIZE OF COMMUNITY WHERE DELEGATES LIVE

(Number and Percent)

Community Size Number Percent*

Rural Areas 185 6.0Under 10,000 271 8.7

10,000 - 24,999 300 9.725,000 - 99,999 712 22.9

100,000 - 499,999 668 21.5500,000 and over 968 31.2No Information 470

. Total 3574 100.0

*The percentage distribution is based on the number ofDelegates for whom community size information was availableor 3,104 persons.

47

ber as a basis for computing the percentage dis-tribution, it is found that approximately one-quarter (24.4 percent) of the Delegates residein areas and communities with a population under25,000, about a third (31.2 percent) live in citiesof 500,000 or more, and the remainder (43.4percent) live in smaller urban areas.

. EMPLOYMENT STATUS

Just over two-thirds (67.7 percent) of theDelegates, who indicated that they are not retired,reported that they are employed either in full orparttime jobs, 6.5 percent said that they are notnow gainfully employed. Nearly 26 percent indi-cated that they were retired from their regularoccupations, but many of these added that theycontinue to work either parttime or as voltinteers.

MAJOR ACTIVITY OR OCCUPATION

Delegates were asked to check among a list ofoccupational categories, the one in which theirmajor work or activity would be classified. Theretired workers were instructed to indicate thecategory representing the major occupation fromwhich they had retired. Out of a total of the3,754 Delegates, 3,050 identified their occupa-tion or activity.

Table 7 shows a larger proportion of the Dele-gates checked education (17.3 percent) and social

Table 7

MAJOR ACTIVITY OR OCCUPATION OF DELEGATES

(Present or, if Retired, Most Recent Occupation)

OccupationalCategory

Number ofDelegates Percent*

Agriculture 131 4.3Business, Manufacturing, Trade, and

Transportation 400 13.1Education 527 17.3Health Services 325 10.7Homemaker 81 2.7Labor Organization 124 4.1Recreation 56 1.8Religious Service 141 4.6Social Services 502 16.4Student 61 2.0Other 702 23.0No Information 524 --

Total 3,574 100.0

* Percent of those reporting a maior activity or occupation or3,050 persons.

1

services (16.4 percent) than any of the otheroccupational categories, except that nearly one-fourth checked "other" indicating that their oc-cupational group was not included in the listprovided.

In view of the importance of leisure activitiesto older people, it appears that the inclusion ofonly 56 workers (1.8 percent) in the Delegatebody from the field of recreation was somethingof an underrepresentation of this professionalgroup.

WORKING TIME IN FIELD OF AGING

Of the 2,151 Delegates reporting that they areemployed either full- or part-time, 903 indicatedthat 50 percent or more of their working time isspert in serving older people or in some otherphase of aging. This represents 28.4 percent of allDelegates for whom information is available.

INCOME

One goal of the 1971 White House Confer-ence on Aging was to include among the Dele-gates elderly consumers who were experiencingthe problems to which the Conference' was ad-dressed. In order to ensure that the low incomeelderly could attend the Conference, Congressappropriated funds to underwrite the cost oftravel and living expenses of Delegates exceptthose Delegates named by the national organiza-tions.

The income data are somewhat less completethan other data for the Delegates because only2,902 persons (exclusive of the youth group whowere largely students) reported their annual cashincomes. There is no information available toshow whether or not the 2,902 reporting are rep-resentative of the entire Delegate body, but theydo 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 65Number Percent Number Percent

Under $1500 19 7.4 6 2.61500-2499 42 16.3 18 7.92500 - 3499 32 12.4 9 4.03500 - 4999 45 17.4 10 4.45000 - 9999 73 28.3 48 21.210,000 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 .31500 - 2499 23 2.8 16 1.02500 - 3499 42 5.2 18 1.13500 -4999 83 10.3 111 1.15000 - 9999 252 31.1 137 8.510,000 or Over 404 49.9 1414 88.0

Total $10 100.0 1607 100.0

All Households

Under $1500 25 2.3 10 .51500 -2499 65 6.1 34 1.92300 - 3499 74 6.9 27 1.53500 -4999 1211 12.0 2$ 1.55000 -9999 325 30.4 185 10.110,000 or Over 451 42.2 1550 84.5Total 1068 99.9 1834 100.0

Table doss not include the income data reported by 96 Delegates under age 25 who supplied information.

48

tations in mind, the income data available arepresented in Table 8. The data are reported sepa-rately for one person and two-or-more personhouseholds. The two are combined in a third sec-tion of the table to show the income levels for allhouseholds.

The Delegates recording income data who wereaged 65 and over and living alone numbered 258persons. Of these, nearly one-fourth (23.7 per-cent) reported annual incomes under $2500;more than a third receive less than $3,500 peryear. Of the 810 Delegates 65 years of age andover reporting income and living in householdsof 2 or more persons, only 3.5 percent hadcomes of less than $2500, 8.7 percent less than$3500.

Similar data for the 1834 Delegates under 65years of age who reported their income, show thatthe proportion living in a one-person householdand receiving less than $2500 annually is 10.5percent, less than half the percentage of singleolder Delegates in this low income category. Fortwo-or-more person households, only 1.3 percentof the younger Delegate group have annual in-comes of less than $2500 but 3.5 percent of theolder group have incomes in this low bracket. Therelatively large number of Delegates reporting

incomes of $10,000 or more is a reflection of thehigh rate of employment among them.

These income data make it clear that the pro-rision by Congress of travel funds for Delegatesenabled the States to name many persons whowould not otherwise have been financially able toattend.

The data reported thus far relate to the char-acteristics of the Delegate bod) as a whole. Whenthe data are arranged according to the 14 subject-area Sections, differences in the composition of theSection groupings become apparent.

SIZE OF SECTIONS AND SUBSECTIONS

The number of Delegates assigned to partici-pate in different Sections varied from 93 (Re-search and Demonstration) to 487 (Physical andMental Health). Nine of the groups were com-posed of 200 or more Delegates each.

The number of Delegates assigned to a Sectiondoes not necessarily represent the extent of interestin a particular subject area because the States andnational organizations indicated the Sections towhich they wished their delegates to be assigned,and may or may not have consulted the Delegateabout his preferences. When Delegates requested

Table 9

SIZE OF CONFERENCE SECTIONS AND SUB-SECTIONS

Section

Number ofDelegates

Per SectionNumber of

Sub-Sections

Average Numberof Delegates per

Sub -Section

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

Total 3,426 95 36

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

49

a different Section assignment, however, arrange-ments were made with Governors for the change.

AGE DISTRIBUTION BY SECTION

One striking dissimilarity among the Sectionswas the difference in the age distribution of theDelegates. Older people (65 and over), for ex-ample, were proportionately more numerous inthe Sections on Income (41.8 percent), Retire-ment Roles and Activities (44.7 percent), Educa-cation (45.0 percent) and Employment and Re-tirement (51.2 percent). The Sections in whichthey were less well represented were Facilities,Programs, and Services (25.0 percent); Health(24.0 percent); Research and Demonstration(23.0 percent); and Training (22.0 percent).

These differences may be traced to the Delegate'sown preferences and to the preferences ascribed tothem by their nominators.

Women Delegates, only about a third of thedelegate body, tended to be underrepresented incomparison to men in most Sections.

Table 10

AGE DISTRIBUTION OF DELEGATES BY SECTION

(percent)

Age*Section Under 25-

25 4445.B4

55-64

65-74

Over75

Education 5.8 10.8 19.2 19.2 34.6 10.4Employment and Retirement 1.9 10.7 11.0 25.2 36.6 14.6Physical anel Mental Health 2.5 22.6 26.3 24.5 16.0 8.0Housing 3.3 12.6 22.5 27.9 24.9 8.7Income 2.6 15.5 17.7 22.3 30.9 10.9Nutrition 4.3 15.4 19.7 23.9 29.9 6.8Retirement Roles and Activities 3.8 14.1 16.8 20.6 33.7 11.0Spiritual Well -Being 1.6 12.0 19.0 31.5 26.1 9.8Transportation 4.1 23.7 14.2 22.5 26.6 8.9Facilities, Programs, and Services 5.8 21.4 19.2 28.5 19.6 5.4Government and Nongovemment

Organization 3.0 21.0 21.0 23.5 25.0 7.5Planning 1.9 20.6 26.5 20.6 28.4 1.9Research and Demonstration 2.3 20.7 28.7 25.3 13.8 9.2Training 3.7 19.3 29.4 25.7 15.6 6.4

* Totals by Section may not add to 100.0 percent because ofrounding. Based on 3,120 Delegates for whom oge data wereavailable.

However, in five Sections women constituted40 percent or more of the Delegates-Education;Training; Spiritual Well Being; Facilities, Pro-grams, and Services; and Nutrition.

50

Table 11

SEX DISTRIBUTION OF DELEGATES BY SECTION(percent)

Section

N = 3120Sex

Male Female

Education 59.6 40.4Employment and Retirement 72.5 27.5Physical and Mental Health 71.9 28.1Housing 72.4 27.6Income 69.1 30.9Nutrition 27.4 72.6Retirement Roles and Activities 51.9 48.1Spiritual Well-Being 63.6 36.4Transportation 66.9 33.1Facilities, Programs and Services 49.1 50.9Government and Nongovernment Organization 74.5 25.5Planning 67.7 32.3Research and Demonstration 70.1 29.9Training 55.0 45.0

RETIREES AND PROFESSIONAL WORKERSIN AGING BY SECTION

The numbers of. retired persons in each Sectionvaried considerably, with the proportions corre-sponding, as one might expect, in part to the agedistribution of Delegates by Section. The largest

Table 12

SELECTED EMPLOYMENT CHARACTERISTICS

OF DELEGATES BY SECTION(Percent)

Section

N = 3176

RetiredPeople

ProfessionalsWorking in Aging*

Education 32.4 13.8Employment and Retirement 35.9 23.2Physical and Mental Health 13.1 33.6Housing 25.1 31.4Income 29.6 22.8Nutrition 23.9 20.2Retirement Roles and Activities 34.0 29.1Spiritual Well-Being 20.1 23.9Transportation 32.8 24.7Facilities, Programs, and Services 20.8 46.5Government and Nongovernment

Organization 20.8 22.3Planning 15.2 36.7Research and Demonstration 16.4 34.1Training 17.3 38.3

All Sections 25.8 28.4

* Persons were counted in this category if they indicated 50percent or more of their time in the field of aging.

percentages of retirPec were found in the Sectionson Employment and Retirement (35.9 percent),Retirement Roles and Activities (34.0 percent),Transportation (32.8 percent), and Education(32.4 percent).

In Sections with a relatively high proportion(30 to 40 percent) of Delegates who were pro-fessional workersTraining; Planning; Research

and Demonstration; and Facilities, Programs, andServicesthe retirees made up less than 20 per-cent of the Delegates. For whatever the reason,more retirees were included in the Sections con-cerned with activities for older people than in theSections concerned with the instrumentalitiesplanning, research, manpowerrequired to pro-vide the opportunities for the activities.

The Conference ProgramSunday, November 28

10:00 A.M. Registration Opens4:00 P.M. Ecumenical Service,

The Washington Cathedral7:30 P.M. Opening General Session

(International Ballroom)

Q11toOrder=--A-rthurS:Flemming; ChairiirairInvocationCynthia Wedel, President

National Council of ChurchesIntroductionsArthur S. FlemmingGreetingsHonorable Walter E. Washington,

Mayor-Commissioner, District of Columbia

Message from President Nixon

AddressJohn B. Martin, Conference Director

AddressArthur S. FlemmingMulti-Media IntroductionWebster B. Todd, Jr.

Executive Director of Conference

10:30 P.M. Adjournment

9:00 A.M.12:15 P.M.2:00 P.M.7:00 P.M.

T'uesday, November 30Subsection-MeetingsConference LuncheonsSubsection MeetingsSection DraftingCommittee Meetings

Wednesday, December 18:00 A.M. Special Concerns Sessions, and

Section Policy CoordinatingCommittee MeetingsConference LuncheonsSection MeetingsAdoption of Recommendations

7:00 P.M. Visit to the White House by Invita-tion of President and Mrs. Nixon

8:00 P.M. Reception forConference Participants

Hosts: Arthur S. Flemming, Bertha Adkins,and John B. Martin

12:15 P.M.2:00 P.M.

9:00 A.M.10:30 A.M.12:15 P.M.2:00 P.M.7:30 P.M.

Monday, November 29Section Orientation MeetingsSubsection MeetingsConference LuncheonsSubsection MeetingsGeneral SessionThe OpenForum (International Ballroom)

PresidingHonorable Earl G. Warren,Chief Justice cf the Supreme Court of theUnited States, Retired

Statements on AgingThe Delegates11:30 P.M. Adjournment

Thursday, December 29:00 A.M. Closing General SessionArthur S. Flemming, presidingMusicUnited States Marine BandInvocationRight Reverend

Raymond J. GallagherPost-Conference Year Arthur S. FlemmingAddressHonorable Richard M. Nixon,

President of the United StatesBenedictionRabbi Abraham J. Feldman

12:00 Noon Conference Adjournment

51

The Opening General Session

The Second White House Conference on Agingofficially began at 7:30 P.M. November 28, 1971,with an Opening Session held in the InternationalBallroom of the Washington Hilton Hotel. Chair-man Arthur S. Flemming called the Session toorder and Dr. Cynthia Wedel offered the Invoca-tion.

The Honorable Walter E. Washington, Mayor-Commissioner of the District of Columbia, wel-comed the Con:::rence Delegates to the city andwished them success in their efforts on behalf ofall older Americans.

Following Mayor Washington's remarks, Mr.Flemming read the following message of welcometo the Conference from President Nixon.

It is a great pleasure for me to welcome toWashington all of you who are participating inthe second White House Conference on Aging.

It was 10 years ago that President Eisen-hower addressed the opening session of the firstWhite House Conference on Aging. He em-phasized then his feeling that the key tt. aprofitable conference was ensuring that everyopinion be fully aired. I know that your gather-ing this week will meet that standard. There isa second key to a profitable meeting which Istressed when I called this Conference morethan two years ago. I referred then to the needfor "careful, advance planning and . . . broad,representative participation." Over the last twoyears, thousands of Americans, all across thecountry, have worked to provide these criticalingredients. I know that your deliberations thisweek will be all the more valuable as a result.

Just as this Conference has been a focal pointfor so much thought and energy over the pasttwo years, so it can now provide gie momentumfor a great wave of reform and renewal in theway our society treats its older citizens in thefuture. I am eager to learn the results of yourdeliberations and I look forward to meetingpersonally with you later in the week.

53

You have my very best wishes for a mostproductive Conference.

Both Chairman Flemming and John B. Martin,Conference Director and Commissioner of the Ad-ministration on Aging, addressed the Conferenceand provided an orientation for the work of theDelegates on the ensuing days.

The Session closed with a multi-media presen-tation, especially prepared for the Conference,which reflected by film and drama the currentsituation of the Nation's older people.

Special Prayer Prepared forThe White House Conference on Aging

Al-mighty G-d, who in your infinite wisdomhave decreed that man honor father and motherthat man rise before an elderly person and thathe honor the contenance of the aged,Al-mightyG-d, bless this convocation that has gathered tofind ways and means to best fulfill your decrees.

Bless this assemblage that has harkened to theplea of the aged: "Cast us not away at the timeof our old age."

Al-mighty G-d, bless the esteemed President ofthe United States, Richard Milhaus Nixon, whohas convened this convocation of concern, blessthe chairman, consultants and staff and bless thedelegates, observers and guests who are about toreturn to their respective cities, states, countriesand homes to implement the good resolutions ofthis second White House Conference on Aging.

Crown the efforts of this convocation with suc-cesssuccess that will in the words of your pro-phet Malachi, "Return the hearts of the parentsto their children and the hearts of the children totheir parents."

Amen.Rabbi Noah Bernstein

Spiritual leader and DirectorChaplaincy and Social ServicesMerkos Lubavitch OrganizationMinnesota Branch

GREETINGS by

Mayor Walter E. Washington

Chairman Flemming, Mr. Martin, and all otherparticipants in this Conference. It is a pleasure towelcome each of you to the Opening Session ofthe 1971 White House Conference on Aging.

This is a great and important occasion. It hassignificant meaning to us in the District of Colum-bia because we had the unique opportunity ofworking very closely with the planning staff forthis Conference.

When President Nixon called for a secondWhite House Conference on Aging in a procla-mation in 1969, he gave to all of us the chargeto help in the development of a more adequatenational policy for older Americans.

We here in the District of Columbiaas I amsure that each of you didtook the President'sproclamation very seriously. During the past year,we have been moving forward on many fronts.

Community forums and neighborhood meet-ings were held in each of our 9 service areas.

Over 1,000 concerned citizens met with Districtofficials and civic leaders in work groups and dis-cussion .sessions to identify problems and issuesand make recommendations for changes in oprprograms and projects.

This gave us a blue print for action and helpeddesign a viable and useful program for our oldercitizens. These efforts culminated in an inspiringEcumenical Dedication Service held this afternoonat the Washington Cathedral.

The goals now before us are clearly defined:creation of a greater awareness of the older popu-lation; development of proposals for a compre-hensive national policy on aging and then sup-porting it; and strengthening the means of olderpeople for independent living and active partici-pation in the life of the Nation.

These goals will not be attainable without thecontinued support and efforts of each of you heretoday.

The urgency of our times demands that our

54

government, from the lowest to the highest office,be committed to the betterment of the economicand social well-being of the elderly.

The urgency of our times also demands thatcommunity leaders and individual citizens of allages make the same commitment.

A Persian proverb says: "Four things come notback; the spoken word, the sped arrow, the pastlife, and the neglected opportunity."

We here tonight must not let it be said thatwe neglected the opportunity to help bring abouta more humane and responsible society for ourelderly citizens or to protect those rights whichare inherently theirs.

ADDRESS byThe Honorable John B. Martin

Ladies and GentlemenIt is good to be withyou tonight. When I accepted my responsibilitiesmore than two years ago to administer the OlderAmericans Act, the White House Conference onAging seemed far away. Then it was only a briefCongressional resolution on the bones of whichmuch flesh was needed.

Since that time we have been working steadilyto perfect a Conference which would give allOlder Americans a voice and a program for todayand tomorrow.

Tonight, another major step in that processbegins.

But I would stress that this high point whichwe now reach and have long anticipated, is itselfa beginning.

This is the climactic period of our prepara-tion, but in a sense it is also mid-point in ourwork. For after this Conference, the task ofimplementation begins. I see a year of actionaheadexecutive action, legislative action, volun-tary actionat Federal, State, and local levels.

I am particularly pleased and heartened by thefact that as Delegates you are -k) varied a group,for older Americans are diverse and individual.

t.

You include young people who must take thelong view toward what surely now seems a verydistant future.

You include men and women already in theirlater years, happy and successful there. And youinclude also those to whom these years are diffi-cult and sad.

You include representatives of different racesand ethnic groupssome burdened by discrimi-nations additional to those of age. You includemen and women of middle years who have beenlong devoted to the service of the elderly and nowapproach that period of life themselves.

Together, it seems to me, you can move moun-tains. Surely they are there to be moved.

Most important, you can move the hearts ofmen, for you come equipped to speak to all ourpeople. And that is appropriate and good becauseyou will be speaking for all of themthose nowyoung as well as the old. It is with everyone'stomorrows we are concerned.

The theme of this Conference is "Toward aNational Policy on Aging." I have been asked onoccasion what that theme means. "Don't the re-ports of the 1961 Conference or the broad goalsof the Older Americans Act provide such a pol-icy?" I am asked. And the answer is "Yes in partthey do."

But what is missing is a clarity of attitude anda level of commitment which assures our olderpeople that America and Americans are deter-mined to treat the elderly of this nation fairly andto guarantee them opportunity to share equitablyin the saisfactions of life available to other partsof our populationnot in the far future but today.For many of our oldest Americans the futuremust be nowthey cannot wait. This is the ur-gency of this conference.

It is true, for example, that in such matters asimprovements in private pension systems, the re-sults of our action may only be felt with thepassage of time. But the question of whether anolder person can remain in his own home or, lack-ing supportive services, must enter a nursing homerequires an answer now, not tomorrow. The sameis true of many other needs in the areas of health

55

468.217 0 . 13 5

care or nutrition or transportation. These areurgent questions that require answers as soon aswe can possibly get them.

So for the duration of your stay here you willbe forging this national policy. I need not try toimpress you with the importance of your task.You would not be here if you did not alreadyunderstand that.

What does need to be said, however, is thatyou can help those who have to legislate orexecute the many elements of this policy by giv-ing attention to priorities. Not everything can bedone at once. It will be helpful to know, amongthe many recommendations you may have, the.order of importance in which you place themwhat ought to take precedence if one need mustbe satisfied before another.

And let me make another suggestion becauseyou represent 20 million other Americans whocan't be here. Put yourself in their shoes . . .think new . . . think forward . . . the world haschangedis changing before our very eyes.

As far as you can tell what will it be like?And how would you like to have it be, so faras the lives of older people are concerned? I hopethat you will not think little thoughts. You aredesigning a new worlda world that most olderpeople in our country today have never known.

It should be a world free from fear of beingforgotten, of being left out, isolated, and ignored,unplanned for, unwelcomed, and unneeded.

It is a world whose designing calls for vision,fr): imagination, for innovation, because we don'thave to be content with what we have. In thisgreat and affluent country, we can afford to dreamdreams.

We can afford to have what we want to have.We can have an adequate retirement income,strengthened and comprehensive health care,more and better housing, chances for useful andconstructive employment, and an array of neededsocial services. We can have them, that is, if as aNation we want them badly enough. What isneeded is that we attach a high enough priorityto our objectives and provide a commitment tofollow through.

I speak for the Administration on Aging insaying that I will not shirk any task, leave anyavenue unexplored, in efforts to bring the hopesof this Conference to reality.. I believe that wehave laid the basis for a breakthrough. We canpush back the walls, open a new view of ourresponsibilities to our older citizens and a newunderstanding of the contribution they can maketo our national life.

I speak for the President when I say: "Thetime has come for a new attitude toward old agein America. The time has come to close the gapbetween our older citizens and those who are notold . . . to stop regarding older Americans as aburden and start regarding them as a resource forAmerica."

As Delegates to this great Conference, youbring impressive credentialsyears of life, ex-perience and adaptation in a changing worldhigh achievement in fields of health, finance, ad-ministration, research, education, and service. Forthe next few days you will be applying yourknowledge and experience to the building of thefuture.

That is a tremendous assignment. I am certainyou are capable of it. The hopes of all olderAmericans are with you.

ADDRESS byThe Honorable Arthur S. Flemming

As this Conference opens, there is one point onwhich there is agreement: Society's attitudes to-ward older persons must change. Far too oftensociety accords them an inferior or secondaryposition; turns its back on their needs with thecomment, "0 well, they won't be around muchlonger"; deprives them of the freedom to maketheir own decisions relative to their own lives;bars them from further involvement in life; androbs them of their dignity.

The older people within minority groups, more-over, must deal with all of these attitudes in addi-don to bearing the knowledge that society hasfailed to accord equality of opportunity to theirgroups.

56

These attitudes will change only as we, andincreasing numbers of our fellow human beings,are willing to recognize and obey the Command-ment, "Thou shall love thy neighbor as thyself."This-Commandment does not place upon us anobligation to approve of what our neighbor says,or does, or even to like our neighbor. It does placeupon us, however, a common responsibility tonever pass up an opportunity to help our neighborwithout regard to his race, color, creed, sex orageachieve his highest potential. When thisCommandment is violated, it contributes to abreakdown in the life of the lawbreaker and inthe society of which he or she is a part. The per-son who, for example, has passed up an oppor-tunity to help an older person achieve his highestpotential is not at peace With himself.

The indefensible conditions confronting manyof the older persons in our society are the directresult of our failure as a society to use the knowl-edge, time, and resources that are available to usto help them achieve their highest potential. Wecannot just resolve to obey this Commandment.We need the insight, the vision, the courage andthe strength that comes from fellowship with theGod and Father of us all.

And so, as this Conference begins, it is my hopethat we will do two things. I hope that we willpray for strength to apply this Commandment inour own lives, throughout our deliberations, andin the days, months, and years that lie ahead andI hope that we will pray for the strength that willenable us to bring others to the place where theywill put love of neighbor above every other con-sideration. In this spirit, let us consider some ofthe opportunities that will confront us in the next4 days.

We are confronted with the opportunity to de-velop, to quote from the Delegates Work Books,"policy proposals that will lead to defined actionto meet clearly stated short-range objectives."These policy proposals are to be distinguishedfrom long-range objectives that are stated inbroad, general terms. We believe that the discus-sions at this Conference can proceed on the as-sumption that there is a recognition and accept,ante of those long-range goals which have beenstated and restated many time. (I like the follow-ing comment in the Work Books relative to the

statement of long-range objectives. "Since theyare seldom formulated in terms of commitmentto immediate action, they ordinarily find readyacceptance.") Let's make sure that the policy pro-posals which emerge from this Conference callfor commitments to immediate action. This is ourmost important task; this is what the Nation ex-pects us to do. If we live up to the expectationsof our fellow citizens, they will respond to ourleadership. Let's carry on our work in the beliefthat this can happen. If we do, we will cherishevery minute that has been provided us in thisConference to work on designing and improvingstatements of policy.

The Work Books constitute the agendas forthe discussion of policies. They are not closedagendas. We are free to add to them. When wepropose new policies, however, let's make surethat they meet this test: Are they proposals thatcall for commitments to immediate action?

We are confronted with the opportunity toformulate programs for action. A policy proposalthat calls for commitment to immediate actionquickly results in the identification of programsfor action. Some of these programs for action havebeen identified by State conferences and the taskforces of national organizations. They have beenmade a part of our Work Books: Here again, theseare not closed agendas; we are free to introducenew proposed programs for action.

Miscellaneous action programs in the field ofaging, unrelated to carefully thought throughpolicies; can oftentimes be classified accurately astokenism. Policy proposals in the field of aging,that are not backed by sound programs for action,are nothing more than sounding brass. We havethe opportunity to bring the two together in thereports that will be formulated in sectional andspecial concerns meetings. We also have the op-portunity to underline in these reports the im-portance of provisions for periodic evaluations ofthe programs for action that we recommend inorder to find out whether they are really movingus in the direction of the policies that we haverecommended.

Finally, we are confronted with the oppor-tunity to develop strategies that will resulte.inaction. It is one thing to sow the seed; it is an-

57

other to cultivate the soil and raise the crop. Thepolicy proposals and the programs for actionwhich we recommend constitute the seed that willbe sown as a result of this Conference. Let's focusalso on how we can cultivate the soil and raisethe crop.

Over 35 years ago, the writer of a book re-view in the British publication, The Spectator,said:

'The cry raised by all of the world's greatestliterature is Read me, do not write aboutme, do not even talk about me, but read me!"

The cry of older persons throughout our Na-tion is, "Act, do not write about me, do not eventalk about me, but act!" It is in that spirit thatthe executives of six national organizations haveaddressed a message to the delegates to this Con-ference. The following have signed the message:

Bernard-E. Nash (Executive Director, Amer-ican Association of Retired Persons and Na-tional Retired Teachers Association)Thomas G. Walters (President, National As-sociation of Retired Federal Employees)Hobart C. Jackson (Chairman, NationalCaucus on the Black Aged)William C. Fitch (Director, National Councilon the Aging)Nelson H. Cruikshank (President, NationalCouncil of Senior Citizens, Inc.)

The message is as follows:

Our members have invested substantialamounts of time and resources in the prepara-tions for the White House Conference onAging.

Their futures are linked in a very real wayto what happens at the Conference and, aboveall, to what happens after the Conference.

it is our hope, therefore, that the discussionsthat take place and the conclusions that arereached will contribute to just one objective.That objective is: The enlistment of widespreadsupport from all social, economic, religious andpolitical groups in behalf of action programsthat will make available to older persons in-creased resources, services and opportunitiesand that will remove existing inequities ethnicand other minority groups have had to bear.

Our most serious problem is a lack of com-mitment to action in the field of aging withinall of our social, economic, religious and politi-cal groups. The White House Conference mustdevote itself to this problem. We must notdrive persons within these groups apart as theyconfront issues in the field of aging. instead,we must seek a clear agreement on goals anda unity of purpose which is reflected by com-mitments from them to increase resources,services and opportunities for older persons andto remove existing inequities which ethnic andother minority groups have had to bear.

We join all who have planned this Con-ference in the desire to open it up to full, un-inhibited discussion of issues even where theremay be sharp differences of opinion. Any at-tempt to utilize the Conference for partisanpolitical advantage will be a violation of thespirit which has permeated the planning of ,theConference.

I welcome that message. We must broaden thebase of support for programs for older personswithin all of our social, -conoznic, religious andpolitical groups. In the .hort run and the longrun, the success of this Conference will bemeasured by its contributions to this objective.

This is why the closing general session of theConference on Thursday morning will be devotedentirely to the Post-Conference Year. It wouldcertainly be appropriate for the written reportsfrom the Sections and Special Concerns Sessionsthat you will receive at this final session to con-tain brief references to strategies that you believewould broaden the base of support for the poll-des and action programs you will be recommend-ing. In addition, we hope to listen to reports oncommitments to action in the Post-ConferenceYear from various seg, ents of both the privateand public sectors that are represented at thisConference. We hope that thisslosing session willmake it clear to the older persons of this nationthat "action now" will be the primary and con-trolling objective of the delegates to this Con-ference. In this way, and only in this way, can thisConference become a part of a significant on-going process and avoid becoming just anothermeering Char produces reports to go on shelves cccollect dust.

58

In the statement to the Delegates from the exec-utives of the six national organizations there wasincluded this statement:

We join all who have planned this Conferencein the desire to open it up to full, uninhibiteddiscussions of issues even where there may besharp differences of opinion.

This is our desire. There are no closed agendasfor discussions in Subsections, Sections, or SpecialConcern 'Sessions. Minority views will be incor-porated in reports whenever they are supportedby at least fifteen percent of the voting group.There will be an Open Forum on Monday eveningwhere the retired Chief Justice of the UnitedStates, Earl Warren, will preside. You have beenprovided with the rules from the Forum that havebeen drawn up by a steering committee under thechairmanship of Dr. Charles Schottland, thePresident of Brandeis University.

In the statement to the Delegates by the execu-tives of the six national organizations, the word"commitment" appears a number of times. I hopetht this word will be uppermost in the minds ofall of us throughout this Conference. Everyk,ne inthis mow has been guilty of passing up an oppor-tunity to help an older person achieve his highestpotential. In the book of Revelations, lukewarm-ness is clearly identified as a sin. We have all beenguilty at one time or another of lukewarmness inout approach to issues in the field of aging. Theonly way in which we can compensate for yester-day's sins of omission is to make a commitmentto rake advantage of today's and tomorrow's op-portunities to serve older persons.

I hope that we will not spend very much timeat this Conference dwelling on our own, or otherpersons', or groups' sins of omission. Rather, Ihope that our emphasis will be on making a per-sonal commitment to action and to doing our bestto persuade individuals and groups within boththe public and private sectors to do likewise. Ifwe do, then we will truly become instruments ofHis peace through helping to replace despairwith hope in the lives of millions of older per-sons. This is what I hope, and what I know thatyou hope, will happen as a resulr of our four daystogether.

The Open Forum

"The purpose of the Open Forum," accordingto Arthur S. Flemming, Chairman of the Con-ference, "is to make certain that informationavailable to the Delegates on all the issues is ascomplete as possible.

"We must not overlook any group or organiza-tion in our society that wants to be heard, or anypoint of view that needs to be expressed."

To develop the ground rules for the OpenForum, a steering committee was drawn from theConference National Planning Board and waschaired by Dr. Charles I. Schott land, President ofBrandeis University, Walthani, Massachusetts.

All Delegates who wished to speak at the OpenForum were asked to submit their request to thesteering committee before 5:00 p.m., Monday,November 29. Delegates were permitted to speakon any topic relating to the field of aging as longas they did nor endorse a commercial product orservice, did not speak to pending legislation, andkept within the three-minute time limit.

The Open Forum was convened on the eveningof the first full day of the Conference in theInternational Ballroom 'of the Washington HiltonHotel. The Forum was presided over by the Hon-orable Earl G. 'Warren, Retired Chief Justice ofthe United States. After opening remarks byJustice Warren, the order of appearance of thespeakers was determined by lot.

The Open Forum lasted for 4 hours and heard3-minute presentations from more than 70 Dele-gates. All Delegates who spoke to the OpenForum. were invited to submit their statemens in250 words or less, within 60 days after the closeof the Conference.

Fifty-seven of the personsForum submitted statementsthe Conference proceedings.

These have been arrangedgeneral topics to -which theyfollows:

who spoke at thefor publication in

according to thewere addressed, as

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Attitudes Toward Aging and the AgedRetirement and Roles for Older PeopleThe FamilyEconomic Security in Old Age

A. Assuring an adequate incomeB. Control of inflationC. Tax relief

Problems of Aging Among MinoritiesServices for the Elderly

A. FacilitiesB. Health servicesC. Protection

Manpower and TrainingGovernment Organization for AgingImpressions of the Conference

c Call for Post Conference ActionVarious (addressed to several topics)

Introduction byThe Honorable Earl G. WarrenChief Justice of the Supreme Courtof the United States. Retired

This is a happy assignment for me. To presideover an Open Forum for the purpose of definingthe elements of a great American problem, andplacing them ii context with our national re-sponsibility for making the "Pursuit of Happiness"a reality for all our people, is a great honor. Par-ticularly is it so when the Open Forum consistsof 1,000 concerned people from every part of theNation who have studied the problem, not justas an academic exercise but in life as it is lived inAmerica.

The Forum is an integral part of the WhiteHouse Conference on Aging. Mark you, it isproperly defined as "the Conference on Aging,"and not a "Conference on the Aging." There isa real difference between the two. The latter im-plies that it is the problem of those in the aginggroup; the former implies that it is the agingprocess which starts from youth.

People over 65 are often referred to as one ofthe largest minority groups of Americans. Thereare now 20 million over that age, and their num-ber and percentage of the population are increas-ing every year. If they can be considered a minor-ity group, it is the only minority group I haveever known of which every living person hopes tobe a member of some day, jnel in the absence ofadversity will be. How this segment of our societyis to be treated is, therefore, the problem of allAmericans. There are at least as many facets tothe problem as there are persons in the group

because life is an individual process. But all ofthese facets converge into a few simple elementsof living that are the heritage of all Americansdignity, usefulness, physical comfort, and partici-pation in the main channels of American life. Itis these things that give -Americans of any age orstation in life the happiness which we have de-clared to be our goal. It is the achievement ofthese things that this Open Forum is designed tofurther.

Let us begin.

Summaries of Statements by Delegates

ATTITUDES TOWARD AGING AND THE AGED

Rabbi Noah BernsteinDirector of Chaplaincy and Social Services.for Merkos Lubavitch in Minnesota,Duluth, Minnesota

We have gathered here in Washington becausewe realize that the attitude of society toward theaging must chamge.

We can change the attitude by teaching chil-dren while still young of the existence of G-d andthat morals and ethics emanate from G-d. Chil-dren taught respect for G-d, the creator of theworld, who sustains the world and cares about ourwell -being will be taught G-d's command to re-spect parents and the agednot only on Mother'sDay and Father's Day but throughout the year.

We should strive to give children the maxi-mum religious education, .but at the very leastthere should be a non-denominational prayerwhere one is taught of the existence of G-d andour reliance upon Him for our daily sustenanceand well-being.

Children are influenced by personal example.If parents treat their parents with respect and

genuine concern, their children will learn fromtheir example and show more respect for them.

Funds for adequate programs must be. madeavailable in the public and private schools as wellas through all media to educate the masses as tohow to respect, help and relate to the aging.

This will then reverse the trend of the utterdisregard of children for parents and society forthe aging and help build a society where one canage with dignity and where the aging will becomethe moral and ethical guides for the youngergeneration.

The Honorable Walter W. Sackett, Jr., M.D.Member, Florida House of Representatives,Tallahassee, Florida

John, elderly, wanted death with dignitythehealth department wanted him to die in goodhealth so he underwent periodic medical check-ups. John, subsequently, slipped off one nightquietly and peacefully. (From syndicated newsarticle)

Too long, medicine concerned itself with thequantity of life rather than its quality. It is high

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time that we contemplate the terminaion of life,not confining ourselves to a one-sided heroic effortto prolong life, but rather to make an inevitabledeath process more comfortable and dignified.General hospitals, nursing homes or state facili-ties with their panorama of bottles, tubes, pipes,resuscitators, respirators, pacemakers, blood trans-fusions, etc., impress an individual with this neces-sity. Witness a patient 85-years-old with a ter-minal blood condition, three transfusions daily, toa total Of 65, with six emergency resuscitationcalls sounded before he was allowed to die. Imag-ine the family's emotional turmoil, its economicbankruptcy; yes, bankruptcy at all levels of gov-ernment from millions of such episodes.

Prolongation of meaningless life through mod-ern medicine is more inhumane than a peacefulnatural end. Physicians are noncommittalwhilenurses and the elderly (both so much closer to thedying patient) are heartily in accord. The latterfear more the senseless prolongation of the deathprocess than death itself. Pope Pius XII refutedcharges of euthanasia, stating in such cases heroicmeasures are unnecessary.

Recalling Carl Sandburg's thoughts, "Death,like birth, can be glorious," give me dignifieddeath as pictured in the deathbed scenes of Lincolnand Washington.

R. 0. BeckmanSenior Service Foundation in Miami, Florida,and writer of 'The Vintage Years", syndicatednewspaper column.

Lodged at the very heart of getting Conference

action is societal prejudice, not on the Conferenceagenda. Few of us take growing old for granteduntil we reach later life. Research into personalopinion about age shows stereotyped apathy orrejection by young and middle-aged. This trendwould doubtless be greater had the respondentsnot been subject to embarrassment like that whicha man feels when he is asked if he has stoppedbeating his wife.

A survey by New York State University indi-cates that 40 percent of our population is moreor less afflicted with a mild neurosis called geren-tophobiadread of old age. Senior citizens arejostled through a door marked "This Way Out"into what is speciously termed the "GoldenYears." For those in poverty or pain, time goesround a circle: each day is like every other. Joysof spring are past and harvesttime rewards arefew.

A new era for old age involves crashing themajor roadblock to public acceptancegeronto-phobia. Stereotypes can be replaced with under-standing empathy by governmental initiative.Senior power also requires skilled, rational leader-ship. Old age won't be redeemed if our grand-parents use rabid dissent, stay sitting in theirrockers, or, like old crows, scold from the treetops.

When will we no longer thrust a crown ofthorns on the brow of old age and crucify it on across of scorn and cynicism? A task force of be-havioral scientists, public officials and communi-cations media should indicate efficacious ways ofabating popular bias.

RETIREMENT AND ROLES FOR OLDER PEOPLE

James F. ConnerEl Paso, Texas

Mr. Chairman, it's an honor to be Delegate-at-Large to this Conference by Presidential invita-tion. As such, my commitment is to the silentmajority of senior citizens rather than to theorganized minority. It speaks well for our gov-ernment and this Conference that all are repre-sented.

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Most aspects of retirement have been experi-enced by this Delegate. This has taught: (1) wecannot run away from ourselves; (2) we can re-gain community identity and esteem by sharingour talents with the present and future, foregoingself indulgence. These are not idle words; theyrefer to achievements without government sub-sidy or recognition for a self-help program byolder Americans.

Before we seek to share the fruits of today'sworkers, we should first separate our wants fromour needs. At the same time make sure the olderneedy have their needs. Then we will be in aposition to collect the presumed debt owed us bysociety but only after we have deducted our obli-gations to society.

Social Security increases, to which we have notcontributed, should be allotted in a manner as togive the lowest income group the greatest num-ber of new dollars. To do less than this wouldcast a shadow of insincerity upon our efforts.

The main source of well-being comes fromwithin ourselves as we strive to fill our cup oflife, not from sitting on the curbstone of timewaiting for others to fill our cup. Dare we meetthis challenge.

Raymond Wing, M.D.Easton, Pennsylvania

It is obvious that many of our older personsare second-class citizens. The reasons for this aremixed--some stem from failures of the individ-uals themselves, but others result from forces overwhich they have no control.

Any physician in active practice caring for olderpersons sees case after case in which mandatoryretirement serves as a shock resulting in a feelingof inferiority not only to the retiree, but to hisspouse and others of his family as well. In con-trast, retirement for disability or from choice doesnot seem to result in the psychological state thatproduces the feeling of second-class citizenship.

Much is said today about youth orientation inour society. Any observer can note that many ofthe young and relatively young have little pa-tience with the lack of productivity on the partof too many able older persons. The feeling isthat the aged consume, but younger persons pay.Perhaps no one should complain where this isnecessary. but one wonders if a system wherebyable older persons are offered incentives to do'useful work, and also penalties if they do not,would help to resurrect older persons fromsecond-class citizenship and put them back in themain stream of life. Able older persons should bekept in the producer class. There is no question

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in the minds of many that this alone could domuch to improve both paysical and mental healthfor older persons.

Ale-..mder Reid Martin, M.D.Psy,..;iiatrist, Old Lyme, Connecticut

I urge your sustained interest in Issue III ofour committee which reads: "Should society adopta policy of preparation for retirement and edu-cation for life off the job?"

Forty-two states unequivocally endorsed thisissue, many recommending such education to be-gin in childhood and continue throughout life.

This mandate is a fitting response to the latePresident Hoover's warning: "Our civilization'sfuture will not depend upon what man does onthe job, but what he does in his life off the job."

For generations, our education has preparedus, almost exclusively, for life on the job. All ourvalues, philosophies, our yardsticks and our atti-tudes towards social issues, the young and the,aging, are strongly conditioned by such education.Consequently, the shorter work-week, work-year,the lengthening of retirement establishes a newworld for which we are educationally unprepared.Because of this, the vast creative resources of ourretirement population remain virtually untapped.

Thus, we face a serious social condition, thesymptoms of which are the immediate concern ofthis Conference.

Issue III, however, aims to eradicate this under-lying social condition, i.e., a grossly unbalanceddevelopment of our inner resources because wehave only prepared ourselves for a work-a-dayworld. Now we must also prepare for a free-timeworld.

Education for life off the job must complementeducation for life on the job.

This calls for a whole new concept of educa-tionNOW. This calls for actionNOW.

E. S. Christoffersen,Mayor, City of Turlock, California

There is nothing as stimulating to a person asinvolvement. In Turlock we needed sewer ex-pansion involving a $2 million bond issue. By

involving the aging in this issue, they became ourbest supporters.

Let me relate what happened in Turlock, acommunity of 14,500. Through fund-raisingactivities, the aging raised approximately $65,000.An aging committee came before the city fathersasking for property and landscaping for thestructure. This was granted. A successful com-munity drive raised the balance of the money.

April 1971, we dedicated this beautiful, versa-tile Turlock Senior Center. Various uses of thebuilding are administered by the Recreation De-partment and owned by the City of Turlock.

May I suggest that every community not hav-ing an aging organization organize ,one immedi-ately and initiate projects for raising funds for anassembly hall.

The Seniors of Turlock are so proud of thisnew beautiful building. They could not have hadthat personal pride had it been built by Federalor State grants.

The Pilgrims were seeking a country wherethere would be total freedom of worship andspeech. They so dedicated themselves to God,allowing nothing to hinder these goals. This iswhy we have a wonderful America.

One cannot overemphasize the importance ofmaking God first in every undertaking whetherindividual or problems of our Nation. There isno problem too big for our God. The weaknessis that too many lack faith and worship of ourforefathers. Let's return to our country's founda-tionworshipping our God.

Walter J. Porowski, Jr.National Ombudsmen's InstituteUnionville, Connecticut

WHEREAS, the career of ombudsman has beenspreading since 1967 throughout the Nation toinvestigate complaints for the little man, in doz-ens of different kinds of government and com-munity agencies, such as health, education, hous-ing, drug abuse, youth, minorities, etc.;

WHEREAS, The White House Conference onYouth this year voted to establish Youth Ombuds-men and women for all youth problems;

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WHEREAS, such a red-tape cutter is especiallyneeded for older citizens to help prevent wrong-doing by public officials or abuse of power;

WHEREAS, the State of Florida has alreadypiloted Senior Citizen ombudsmen for counties inFlorida;

WHEREAS, New York State WHCoA dele-gates called for ombudsmen for aged citizens(also delegates of other states);

WHEREAS, eighty-seven percent of WHCoAdelegates polled agreed an ombudsman-advocatewould be an important breakthrough for the aged;

WHEREAS, Dr. Flemming and many leadersof national associations for the aged have gone onrecord approving this new role for the aged;

WHEREAS, rural and city aging, well-to-do orpoor, could benefit from a national corps of seniorcitizen ombudsmen, for local, State or Federalagencies, for health, education, housing, poverty,minority, transportation, nutrition, employment,recreation and other problems;

BE IT RESOLVED THAT, The White HouseConference on Aging go on record as recom-mending that new careers of ombudswoman orombudsman-advocate for the aging be consideredwhen preparing a national policy.

The White House Conference on Aging (onDecember 1, 1971) recommended such a nationalpolicy.

Alfred H. FoxcroftPresident, Leisure World Stars, Inc.Laguna Hills, California

Retirement may be a pleasant anticipation or adread of the future.

It is generally agreed by authorities in geron-tology that stimulating physical exercise is neces-sary to maintain good health, and it is equallyimportant that one should exercise his mentalprocesses to avoid senility and other health prob-lems.

Many people, when reaching the recognizedretirement age of 65, are not prepared for the

shock of sudden mental and physical inactivityand the feeling of not being wanted or needed.This transition could be accomplished much moreefficiently and gracefully through a tapering-offprocess.

It is my suggestion that labor and managementbe encouraged to adopt a policy in respect to re-tirement, which would accommodate those desir-ing early retirement, as well as those both ment-ally and physically able to continue working andwishing to do so. This plan could be an arrange-.ment, on a voluntary basis, calling for gradualreduction in working hours with correspondingreduction in income.

As a basis for discussion, I would suggest, aschedule along the following lines: Salary to bebased on 100 per cent prior to age 55 and a40-hour. week. Beginning at the age of 55, 35hours per week and salary to be 87.5 percent ofbase pay, with corresponding reduction in hoursand wages each 5-year period thereafter. Underthis arrangement, a need for additional helpwould be created, thereby improving the unem-ployment situation.

Varying conditions in industry would requiresome flexibility, but the basic plan could remainthe same.

Robert SharpAmerican Federation of Senior Citizens,Dade County Chapter, Inc.Nora. Miami Beach, Florida

There is a vast amount of land that is ownedby many cities, counties, also by many States.Some of this land could be used to build imusingfor our elderly in many States in our Nation.There could be communities built in some areas.Programs could be initiated as our older peoplehave millions of hours of talent that they wouldoffer. We would not be a burden to anyone.This plan wo' help the States' and Nation'seconomy; at Lie same time this would help theproblems of our older people.

Speaking for our older people, we should con-sider this recommendation and try to work outthis problem with our city, county and stategovernment. In this way we can live in dignity,contentment and happiness.

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I do hope some of our city, county and Stateofficials can see eye-to-eye with us and help usand More people have compassion for us anddo not deny us our rights that we well deserve.

Domingo DelgadoSenior C.tizens Recreation Specialist,County of Los Angeles,Department of Parks and Recreation,Los Angeles, California

Premise

The California Committee on Recreation be-lieves that the White House Conference on Ag-ing has failed to recognize the importance leisuretime plays in the lives of senior citizens.

Justification

Today our thoughts should turn to what rec-reation really means, since the word has manymeanings. Recreation, in whatever form it takes,is a basic human need, and its value to humanitycannot be too strongly emphasized.

Recreation as a worthy use of leisure time isespecially rewarding, and participation of seniorcitizens in wholesome programs stimulates betterphysical and mental health, and increases longev-ity. It requires well-planned programs to getseniors to participatetaking more interest incommunity affairs, accepting volunteer assign-ments or part-time jobs in recreation, and othermeaningful pursuits. These programs give theelderly a feeling of "belonging"that someonecares about them.

Proposal

Recognizing the value and importance recrea-tion plays in the lives of senior citizens every-where, this conference should concern itself withsetting up governmental policies on aging forthe Seventies that will bring the recreation fieldinto national focus. Early retirement and a_shorterwork-week has expanded the need for recreationalprograms.

This committee further proposes that theWhite House Conference develop a Special Con-cern Session on Recreation for the Elderly, andset guidelines that will give a positive directionalpolicy on recreation.

/

THE FAMILY AND AGING

John. R. DevittAssistant Corporation Counsel,Milwaukee County, Milwaukee, Wisconsin

WHEREAS, The mobility of modern societyand consequent loosening of family ties has hadan adverse effect on elder Americans, for manyof whom there is no longer a place in the homesof their children; and

WHEREAS, There is a growing need in ourtime to place new. emphasis on, and to re-affirmour dedication to, the cause of strengthening na-tional family values; and

WHEREAS, A beginning step inthis directionwould be to set aside one week in each year tofocus the Nation's attention on family needs andconcerns; and

WHEREAS, The period surrounding the na-tional observance of Thanksgiving in Novemberof each year is traditionally a time for familygatherings and reunions and is a suitable occa-sion for calling attention to the importance ofhome and family ideals; therefore, be it

RESOLVED, That the Congress and President4 the United States be requested to enact appro-priate legislation to declare that the week in whichThanksgiving is celebrated each year under Actof Congress be officially designated as AmericanHome and Family Week and that the Sunday ofsuch week be designated as Family Sunday-U.S.A.;and be it

FURTHER RESOLVED, That all citizens be urged

to observe these dates with serious reflectionand to realize that the principles of family re-sponsibility to spouses, children and parents, aswell as the importance of the stability of marriageand the home for our future well-being, requirerenewed allegiance and every-day implementation.

Stephen T. SzilagyiPhilippus United Church of Christ,Cincinnati, Ohio

Introduction

Present day realities for grandparents and forfamilies are that grandparents are the unrecog-nized victims of the 50 percent divorce rate. Be-cause of the personal problems of the parents andthe circumstances of the breakup of a family,grandparents find themselves cut off from per-sonal contact with their grandchildren. For thegrandparent whose child has custody there is notthe same situation as that of the grandparentwhose child has an obligation of support andvisitation but not custody.

What to Do

It is recommended that the Conference speakout on this problem. If it is possible to supportlegislation at the national or State level whichwould grant visitation privileges to grandparents,it may be that the courts will act to support thisnational human need. Only two jurisdictions havespoken out in statutes on this subject. This privi-lege would be a valuable addition to the rightsof senior citizens in all jurisdictions.

ECONOMIC SECURITY IN OLD AGE ASSURING AN ADEQUATE INCOME

Thomas G. WaltersPresident,National Association of Retired FederalEmployees, Washington, D. C.

I am Thomas G. Walters, President of the Na-tional Association of Retired Federal Employeeson whose behalf I am appearing. The National

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Association of Retired Federal Employees isfifty-year-old, non-profit, association.

The main objective of the Association is tosecure beneficial legislation for improving thegeneral welfare of Civil Service annuitants andcorrecting present inequities in the Civil ServiceRetirement Law. Its legislative accomplishments

in the past have more than justified its existence,by achieving liberalizations in the RetirementLaw, various increases in annuities, the establish-ment and increases in survivor benefits, and theestablishment of health coverage for Federal re-tirees. Tax benefits (local, State and Federal) andadditional veterans' compensation applicable toFederal retirees have also been achieved throughNARFE's efforts.

Our major concern at present is to securefinancial relief for retirees who have been forcedinto poverty-level existence through no fault oftheir own, and to have adequate health care madeavailable to the elderly.

As spokesman for a large number of SeniorCitizens, the Association is greatly interested inproblems of the aged and aging and is intenselyactive in pre-retirement counseling throughout theGovernment service.

Richard P. ButrickDelegate Representing the Diplomaticand Consular Officers, Retired,Washington, D. C.

I am Richard Butrick, senior delegate fromDiplomatic and Consular Officers, Retired.

Most retirees of the diplomatic and consularservices fall within the middle-income group,that vast group of Americans comprising not onlyourselves but most Federal, State, county, andmunicipal employees, the plumber, the carpenter,the mason, the transportation workerthe butch-er, the baker, the candlestick maker. Thisgroup participates fully in the life of the Nation,sends its children to college at no small expense,

. pays the bulk of taxes, either directly or in-directly. Because self-reliant, it is easily dis-missed from our 1.ughts and considerations. Itdeserves better!

The middle-income. American usually hassomething saved for his old age bur, as oursociety is presently constituted, one serious illnesscan wipe out his entire life savings. This shouldnot and must not be, and this Conference mus::address itself to the problem.

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How must the middle-income American beassured of a satisfactory old age? He must havefull protection against the exhorbitant cost of ill-ness. In considering such matters as housing, trans-portation, and nursing homes, he must be in-cluded. He must be protected against inflationeither by increasing his income or by reducingtaxes. While this great Nation must make ade-quate provisions for the needy elderly, it shouldnot and this Conference must see that it does notdisregard the middle-income American who, infact, has built and supported this Nation through-out its history and continues so to do.

Dewey AuchterSenior Citizen Area Council,Baker, Union, Wallowa CountiesLa Grande, Oregon

The greatest and most urgent senior citizen'sneeds is adequate income. Low earnings in ourproductive years has put our generation at a dis-tinct disadvantage in today's affluent society. Weare caught in a tight squeeze of an inflationaryeconomy. Our seventy-five cents an hour averageearnings, and savings have accrued through theseearnings, are not competitive on today's marketfor goods and services. We cannot pay sevendollars an hour for carpenters or plumbers; norcan we hope to use professional services withoutsoon depleting our meager savings (if there areany) before becoming destitute and a prospectfor welfare.

We are a proud and deserving people and thestipulation to be thus recognized by our Nation'shighest authorities becomes urgentis logical andpertinent. Therefore, the Administration and theCongress should proceed at once to enact lawsthat will do away with discrepancies, prejudicesand discriminating practices now so evident. In-come is an extremely important determinate ofthe elderly individual's sense of well-being. Onlywith adequate income can our aged lead meaning-ful self-respecting and independent lives. Mini-mum income under Social Security needs to bebrought up to Bureau of Labor moderate livingincome standards and corrected each year to meetprice index fluctuations.

Cost of program. to be shared through em-ployer, employee payroll tax deductions and gen-eral revenue sharing. We have earned our keep.The challenge is yours to pay this debt!

Tom RileyState Senator, Des Moines, Iowa

As a member of the Iowa 'State Commission onthe Aging and delegate to this White house Con-ference, I conducted regional conferences of sen-ior citizens in Cedar Rapids and Clinton, Iowa,prior to this national Conference.

These two local conferences gave area elderlythe opportunity to voice their opinions to me so I,in turn, could better relay their views to youtoday.

Through these local conferences and the addi-tional forum of direct mail questionnaires, theopinions of some 2,000 eastern Iowa elderly werereceived.

Forty-two percent of these people believed the"high cost of health care" was the most seriousproblem facing Iowa elderly. Thirty percent ofthe people marked "property taxes" as the mostserious problem.

Based on the 2,000 opinions I received, I makethe following recommendations:

1. Old Age Assistance payments should not bereduced when Social Security benefits are raised.

2. Social Security benefits should be increasedto minimum of $200 monthly.

3. Social Security benefits should increaseautomatically with the cost of living.

4. Legislation should be enacted to restrictmandatory retirement laws.

On the subject of mandatory retirement laws,let me' add that it is a tragic human waste toarbitrarily force retirement at a given age. Thosepersons who prefer to continue at their jobsshould be entitled to do so.

Senior employees bring experience, 'reliabilityand loyalty to their work. Harsh, indiscriminateindustry practices should not frustrate those de-siring to continue working at age 60 or 65.

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Robert J. MyersProfessor of Actuarial Science,Temple UniversityPhiladelphia, Pennsylvania

Governmental action in providing economicsecurity for persons at the older ages should belimited to the establishment of (a) a social in-surance plan which gives an economic floor ofprotection upon which the individual (along withhis employer) can and should build and (b) asupplementary public assistance program whichwill take care of the residual economic needs ofthe small proportion of persons whose incomefrom social insurance and their own efforts arcnot sufficient for a reasonable standard of living.

Conversely, social insurance should not by itselfalone provide income which is sufficient to takecare of the economic-security needs in full of thevast majority of the people. To do so would beunwise and undesirable becatise of the resultanttransfer of all individual responsibilities in theeconomic area to the government. This wouldresult in the dimunition of individual freedom ofchoice and initiative, as well as having otherserious effects on the national economy.

Specifically, if all pensions are provided undergovernmental plans, the private savings areawould be dried up. This would have a catas-trophic effect on the growth and development ofprivate industry.

The present level of Social Security benefitsmeets the test of adequacy as a floor of protection,since less than 10 percent of all beneficiaries overage 65 require cash public assistance to meet theirday-by-day needs. Therefore, the level of benefitsshould not be increased in the future, except toreflect changes in the cost of living.

John Doyle ElliottTownsend Plan National LobbyHyattsville. Alaryland

This Conference is not gathered because all iswell with Social Security and misnamed. Welfarebut because very much is wrong. All our poli-cies and programspublic and private combinedso far employed have failed to correct the pun-ishing lack of money-income, the very license tolive, of the aged.

We must have prosperity-sharing retirementfor every American as an inherent right, insteadof impoverishing retirement for most. Without iteconomic failure and dependency must remainlife's final rewards for multitudeswith futilitymocking all our other achievements. Our countrycan't know the social harmony, happiness success-fully pursued, necessary to fulfill America'spromise of peace with justice and ever-growingfreedom for mankind.

Prosperity-sharing retirement requires a mini-mum Social Security benefit for all persons alike,covering all business and all occupations all thetime. It must be money enough to assure pros-perity-sharing retirement even for those caughtwith no other resource; and with all others havingtheir other assets on top of their Social Securitybenefits. Nothing else is just to both beneficiariesand contributors.

This will not take a dollar out.of our country,economy, or out of any honest interest, or life. Itwill all be money circulating in every community,fully and prosperously functioning.

There are only bad reasons for not having thisincomparable boon, not a single good one.

Prosperity-sharing retirement for all Amer-icans indiscriminantly should be this Conference'sprimary policy-recommendation.

Richard P. BrownExecutive Director,Home Health Services of Louisiana, Inc.New Orleans, Louisiana

We heard many words at the opening sessionabout this Nation's concern for the well-being ofits elderly.

I suggest that one does not express true socialconcern by providing health insurance programswith fine print that is administratively changedto meet the current problems of the budget.

Under the present Medicare program, we essen-tially say to the elderly person who is ill, "Well,I see you are sick, you have worked hard for manyyears and contauted to the wealth of our Nation,so we might pay parr of your acute health carebill if you can find your own way to the services,and as long as you don't require more than 100home visits, or use up your lifetime hospital re-serve days. Our concern is limited to the extentof your Medicare benefits."

Insurance is a poor way to fund health care forthe elderly. Besides the fact that, in its presentform it meets only partial needs, it also creates alarge and expensive burden.

It is time that we stopped forcing the elderlyinto institutions so they can qualify for the benefitsto be measured out in coffee spoons.

Kay McGovern.Irving Park YMCA, Chicago, Illinois

Concern: This Conference concerned with the"quality of life" issues of older Americans shouldas its first priority strengthen the financial baseof all. Let us recommend that we starr by elimin-ating legislation that now discriminates againstthose who stay in the job market. The limitationon earnings that allows unearned income but re-duces Social Security benefits on earned income islegislation that inhibits, frightens and discouragesthe older American.

CONTROL OF INFLATIONThomas G. Walters.National Association of Retired FederalEmployees Representing Citizens for aNew Prosperity, Washington, D. C.

I am here on behalf of a group of concernedcitizens who have organized a committee knownas "Citizens for a New Prosperity." This is a non-partisan, nationwide organization composed of

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men and women from all walks of life who be-lieve that the far-reaching objectives of the Na-tion's new economic policies are in the interest ofall Americans. These objectives are: stopping in-flation, creating full employmenr, and makingAmerican products and services competitivearound the world.

We all recognize that economic progress can-

not be achieved through decision and action inthe executive and legislative branches of the gov-ernment alone. Economic stability depends greatlyupon what individual citizens feel, believe, andwant to do.

We have suffered too long with an inflationpsychology. We have assumed too long that theonly direction for prices to go is up; our indiffer-ence and lack of concern has permitted inflationby default.

If ever one segment of our population neededa voice raised in its behalf, it is the retired andelderly whose meager average income is stretchedto the breaking point.

What can you do to help? Encourage yourfriends and community leaders to stand againstpressures and activities which perpetuate thevicious cycle on inflation. Distribute materialswhich are available from Citizens for a New Pros-perity, 1627 K Street, Washington, D. C. Samplesare displayed in the auditorium along with infor-mation on the Committee.

We all can contribute to strengthening publicconfidence in the health and stability of America.

Martin K. BareLancaster, Pennsylvania

Our Lancaster, Pennsylvania, delegation waspledged to present to the White House Confer-ence the issue of number one importance to Lan-caster senior citizens, and of paramount im-portance to older citizens everywhere, namely, theelimination of inflation.

Inflation is the number one enemy of personson relatively fixed incomes, and ranks above in-come (except for a floor providing food, shelter,clothing) improvement of Medicare, property taxrelief, etc., is the number one senior citizen con-cern.

For far too long our government (both execu-tive and legislative) has contributed to inflationby imbalanced budgets. Unions have participatedby demanding wage increases far exceeding pro-ductivity, and business has shared by grantingthese increases, .z.nd passing the costs on to theconsumer.

Senior citizens must c,rganize to halt this in-

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flationary spiral. A non-partisan, lobbying effortmust be organized, not to promote senior citizensspending programs, but to control and educeoverall spending by government, supported bylabor leaders.

A fair question is, "How can our friends whovote for economy be identified?" A very goodguide is the pamphlet issued as "National Asso-ciated BusinessmenEconomy Voting Record."This lists the record of each senator and repre-sentative on 12 important bills directly showingwhether they are economy or spending advocates,and rates their percentare in support of economy.

It is essential that we keep in office those legis-lators who vote for economy, regardless of party,and replace those voting for spending. It is oursenior citizens' best method to kill our worstenemyin flat ion.

Sam ShawMoundsville, West Virginia

One of the most vital measures needed for im-provement of the lot of the next crop of elderlyis to stop INFLATION. Inflation trims a person'sretirement buying power to about half of what heprojected in his early working years.

It is time to get the general public to quitenjoying the things it wants that are inflationary:

A uniform minimum wage law, same in thehigh-cost-of-living cities as in economical ruralareas, is a "guaranteed inflation" law.

When Congress orders the postal v orker inMoundsville, W. Va., to get the same pay as theNew York City postal worker, it fans inflation.

When the government requires highwaycontractors to pay what is actually the highestwage scale to be found in each community, thatinflates.

When Congress tries to cut employmentbelow six percent, that is inflationary. Perhapsthree percent of ople are the kind who justdon't work until inflation-producing prosperityis waved at them.

These are just a few items in the long cata-logue of inflationary luxuries.

TAX

Kenneth E. DunlapFormer National Editor,Armed Forces ComptrollerArlington, Virginia

Congress recognizes that the Federal Govern-ment has an obligation to State and local govern-ments for depriving them of substantial revenuesin the form of real estate property taxes onproperty owned, in many instances occupied, andcontrolled by it.

The purpose of this recommendation is to pro-vide property tax relief to elderly homeownersand renters by providing the making of fair andequitable payments by the Federal government inlieu of property taxes to State and local govern-ments which will compensate in part for the re-sultant loss in tax revenue.

On the other side of the ledger- and in orderto meet these needs, I, as an editor, auditor andretired government contract negotiator, submita plan, which if approved by Congress, Will pro-vide substantial revenue to offset this proposed

PROBLEMS OF AGING

Hobart C. JacksonChairman,National Caucus on the Black AgedPhiladelphia, Pennsylvania

Jt seems appropriate that I should summarizea few of the general concerns of the members ofthe National Caucus on the Black Aged.

These general concerns are in addition to ourvery special concerns about improving the dis-graceful plight of the Black elderly and theelderly bf other minority groupsa plight that sodesperately and urgently needs improving.

Many of us view the special problems asso-ciated with aging as simply a microcosm of theoverall problems of the Nation and we wish todirect attention to the need for changing as ex-

RELIEF

Federal payment by the reduction of certain de-fense costs. I am including this as a major part ofmy recommendation for review by an appropriatecommittee of Congress.

I ask for your prayerful consideration of mytwo-fOld recommendation. It's high time wealleviate the many problems of our elderly,realizing full well that we fall tremendouslyshort of matching, dollar for dollar, the foreignaid program.

Jerry P. JohnsonArlington, Texas

The Federal Government should suggest to allStates that homestead taxes to persons over 65years of age be proportionate to their income atthe time of retirement and their retirement in-come, e.g.:

Person at time of retirement has income of$20,000.

Paying total ad valorem taxes of $800.00, re-tirees with income of $5,000 will pay $200.00.

AMONG THE MINORITIES

70

peditiously as possible our national goals andpriorities to give much more consideration toalleviating human need.

According to the Kerner Commission reportissued several years ago, the major domestic prob-lems which we face are racism and poverty. Oursystems and institutions have utterly failed toirradicate either and the situation, tends to getworse and is compounded by this senseless warin which we are engaged.

There seems to be absolutely no sense ofurgency by our leadership about this problem.

We must move in the direction of developingone human services system.

Perhaps the most devastating aspects of ournonsystem shows up in the lives of those persons

.>

1

who are Black, poor, aged, disabled, and handi-capped, in the multiple jeopardy they encounterin their daily lives.

We must devise a single system that will alle-viate the needs of all, otherwise we'll alwayshave this dual and fragmented approach and adual and fragmented delivery.

Henry Tanaka,President-Elect,National Japanese American Citizens LeagueCleveland, Ohio

I r:present the only national organization forJapanese Americans.

I speak -.n behalf of 1.5 million highly visible,but neglected and forgotten group of AsianAmericans.

There is a myth that Asian Americans have noprobleml- because of strong family ties. Thisstereotyping has been reinforced by certain cul-tural traitspride, honor, perseverance, and fam-ily loyalty and control. .

Asian Americans have been .victims of racialdiscrimination and unlawful' treatment for 120years, dramatized by the incarceration of JaPanesein America's concentration camps. The plight oftoday's elderly Japanese Americans can be attri-buted to -that despicable event. Sociologists tell usthat the greatest harm resulting from this experi-ence was -the separation from close family ties.

5' -t.s 50 percent of the elderly Japanese Amer-icans in Los Angeles are public assistance clients:Many are receiving Social Security benefits, butsubstantially lower than what they might haveearned because of disrupted employment duringtheir detention.

A recent survey revealed that 34 percent of theelderly Japanese Americans have not had dentalor medical examinations for tears, that suiciderates among Chinese Americans are three timesthose of other elderly Americans.

Most elderly Asian Americans cannot speakEnglish. The lack of bilingual, bicultural workersin public agencies has created a major problem ofcommunication.

468-217 0 . 73 - 6

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Elderly Asian Americans are accustomed to adiet of rice, dried seafoods, and pickled radisheswhich cannot be purchased with food stamps.

During the past biennium the Federal Govern-ment spent $3.2 million to identify the needs ofthe elderly; none on Asian Americans.

Rosa J. VasquezExecutive Director,Accion Community CenterMiami, Florida

We represent the Cuban elderly and "LosViejos Utiles" ( the useful aged), Cuban group ofelders who want to be useful, but feel that theyhave been set aside by the system. In the Miamiarea there are around 400,000 Spanish-speakingpeople.

We are requesting parity in all programs thatexist now for the elderly, taking into considerationthe language and cultural barriers that can beovercome by the use of bilingual and biculturalprograms. These programs should be organizedby the aged themselves with the appropriatedesign and delivery of services according to theirway of living and culture. Therefore, it is im-portant that the planning, the budget allocation,the program designs and development should bein the hands of the bilingual, so needs can be metmore efficiently.

We Cubans, refugees, residents, and citizenspay taxes in the same fashion as the communityat large. We expect our tax return in servicesthat take into consideration our cultural needs.

The day care for the elderly, the homes for theaged should consider the bicultural and bilingualneeds. The training and staffing of these pro-grams should consider this group and make useof it.

We formAlly request that action be taken at alllevels of governmentFederal, State, regional orlocaland on private funds, so parity is exertedfor the benfit of the elderly Cubans. Our elderlycannot survive in a system they minor under-stand. Let them live properly once you allowthem to come to this country.

4

SERVICES FOR THE ELDERLY

FACILITIES

James L. MacKaySan Antonio, Texas

The recipient of service is an individual. Thenormal environment of an individual is his home.This home may be with members of one's family,in a congenial foster home, in a residence for theelderly, or living alone. When we have a home,we are living as independently as our conditionpermits; we take part in making decisions; webelong.

Adequate housing, nutrition, activities andhealth care are functions of the home. The homeis part of a neighborhood as are the church, theshopping center, and the adjuncts- of health careshould be. An active neighborhood eliminatesmuch of the need of transportation.

While problems of income, Medicare, etc., areawaiting national action, the adequate use ofavailable facilities will provide more services arless cost than the present hodgepodge system.Therefore, I present two n.commendations:

1. The AoA be funded to ssist local communi-ties to inventory their present facilities for caringfor the aging and to establish a central office forstoring, updating and distributing these data.

2. The AoA be funded to help local communitiesestablish neighborhood centers for maintainingactivities and counseling facilities and for co-ordinating health and other facilities.

Joyce LeanseConsultant on Senior Centers,The National Council on The Aging, inc.Waibington, D. C.

A major goal emerging for the Conference isthe provision of services which will permit olderpersons to continue living independently in thecommunity, avoiding institutionalization.

The National Institute of Senior Centers, aprogram of the National Council on the Aging,urges government support for the developmentof multipurpose senior centers to be used as avehicle for the delivery of these essential services.

Senior Centers have demonstrated their abilityto effectively provide services, activities and avariety of opportunities for older people. Unlikemost other service agencies, Centers are asso-ciated with wellness and the prevention of illness.By providing an e .;ly identified site, and an at-mosphere conducive to involvement, they makeavailable a range of programs which promoteindependent living and enhance social function-ing.

Properly financed and operating as an ongoinggovernment service, Centers could become thefoundation for any such additional services as thevarious levels of government and the voluntarysector wanted to provide.

We recommend that the Federal Governmentmake a commitment to develop a delivery systemfor programs and services designed for and witholder persons, available and accessible in everycommunity. To support the concept of ActionNow we believe that the senior centers currentlyoperating provide a foundation from which acomprehensive, nationwide system can develop.To help realize the potential, o: the senior centerand to assure the availability of accessible focalpoints for these services, we further urge federalsupport for the development, makntenance, andoperation of multipurpose senior centers.

Monseigneur Lawrence J. CorcoranSecretary of the NationalConference of Catholic CharitiesWashington, D. C.

We have been pleased with the emphasis onspiritual values which Dr. Arthur Flemming,Chairman of the White House Conference, hasgiven to this gathering. We join with our fellowDelegates in pressing for more adequate income,housing, health care, and other services andfacilities for the aged population. We accentuateas strongly as possible the importance of spiritualand religious considerations to the elderly. Theirspiritual needs must be recognized, and the meet-ing of these needs accorded the highest priority.This should be a major resolve of the White

72

House Conference and a major challenge to thecitizens of America.

Further, we wish to raise a question pertainingto the cost of the delivery of human services, in-chiding services to the elderly. The cost of theseservices is constantly increasing, and there is greatdifficulty in finding funds to finance them. At thesame time, we note the increasing amount of profitbeing made on these services: We questionwhether the elderly, and others in need of humanservices, should be burdened with this added cost,the cost of profit for the entrepreneur. We ques-tion whether the hard-to-get tax funds should bespent for the profit, or excessively high salaries,of those providing human services.

We think that this question must be raisedand examined. We have serious reservationsabout making profit, or receiving excessively highincome, from the delivery of human services.This White House Conference on Aging shouldexamine this question as it relates to the pro-vision of services and care for the elderly.

Lois OliverWarren, Oregon

Old age brings new problems. Thoughts andmovements become slow; once simple matters ofkeeping house and taking care of oneself gradu-ally become too" much. At such a time, a personneeds place to live where he can feel at home,where he can do as much as he is able eventhough he may be slow, to be cared for only whenhe is unable to care for himself, to do things thathave meaning and interest, and to be able to dosomething for someone elsenot just sit and beentertained! He needs to keep in touch withfriends and relatives and with his church andlodge or club, to find new interests when oldones are lost, and to have companionship withpeople his own age.

The assumption is that he will go throughsuccessive srges: home, a small apartment, inter-mediate home, then possibly, a nursing home.

This intermediate home must be a place wherehe can have some of his belongings about him.He can be independent and a whole person with

73

a comfortable home, good food, recreation andcompanionship, where he can live in dignity at areasonable cost.

With such a home, the trip to the nursinghome can often be postponed for years.

These homes are desperately needed across theentire country.

HEALTH SERVICES

William KesselmanSickroom Service, Inc.Milwaukee, Wisconsin

I have been a licensed health professional forover forty-three years. As a neighborhood phar-macist, I see the consumer of health services morefrequently than other health speCialists.

Today, those in need of therapeutic aids fromtraction equipment to breathing machines findthe pharmacist prepared.

However, surrounding the pharmacist arehealth organizations operating under two magicphrases: "voluntary agency" or "not-foi-profit or-ganization." They cannot deliver services moreefficiently because their unit cost is higher. In-stead of contributing to the tax base, these or-ganizations use tax dollars, either directly withmatching funds, or as charitable dollars con-tributed to the organization rather than the U. S.Treasury.

I plead for health services as the criteria in-stead of the type of sponsoring organization.

For a half-century, the neighborhood pharma-cist has been practicing clinical pharmacy, knownthen as counter prescribing. We can still saveboth the doctor's time and cost of hospital beds.

Assigned to the Training Section of this Cou-ference, I brought with me, as requested, copiesof our Sickroom Service Training Program. Thisprogram helps the neighborhood pharmacist, incooperation with the Home Health Agency, totrain and supervise the paraprofessional in theuse of therapeutic equipment. So let's use theneighborhood pharmacist, with special training

in utilization of convalescent aids, in an exten-sive Home Care Service to not only save taxdollars but to deliver excellent and efficient healthservices at HOME.

I strongly urge that any health care policyinclude home care.

Arthur Elfenbasim, D.D.S.Chicago, Illinois

The mouth is an integral -art of the body en-tity, and any disorder in it may be correlated witha disturbance in any other pan of the body. Aninfected tooth may be the cause of a heart failure,and bleeding gums may be the effect of a general-ized blood disease. Only a dentist is qualified todetermine the relationship and to recognize it inits earliest stage. Dentistry is a health service;-andno health program can be called comprehensiveunless it considers oral health.

In addition to being the mouth physician, thedentist is also the expert in mechanical and cos-metic orai rehabilitation. It is not always essen-tial to provide a person with an extensive andexpensive oral rehabilitation to enable him toenjoy the pleasure of eating, speaking. moreplainly, and presenting a more pleasing facialexpression. Possible sources of infection must beremoved from the mouth, the remaining teeth, ifany, must be restored, and the patient must beprovided with a sufficient and efficient chewingmechanism.

With the rapid increase in the number ofelderly people in our population (3 million in1900; 20 million today ), their oral health is themain concern of the American Society for Geri-atric Dentistry, especially if they cannot affordthe services of a private practitioner. We haveenough dedicated dentists who are willing toprovide the necessary geriatric dental service forthose who need and want it, but the cooperationof local, state and Federal public health agenciesis essential.

Edward C. Carney,Executive DirectorCouncil of Organizations Serving the DeafWashington. D. C.

Can you hear me? Over 500,000 profoundly

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deaf elderly Americans could not hear-me if theywere here. Fifty thousand of these persons alwayshave been unable to hear. They deserve a fewminutes use of your ears.

You are convened to plan for improved serv-ices to elderly Americans. The benefits of many ofthese services will be denied to deaf persons un-less there is more awareness of the communicationproblem. Deaf pesons experience difficulties inlearning about available services, and in under-standing and making lemselves understoodwhen attempting to secure their rights. Theirrights are all they ask for!

Elderly deaf persons have not been articulate.They are doubly burdened by the general indif-ference of society to this invisible handicap. Thelast White House Conference on Aging made nospecific provisions for aged deaf persons. TheAdministration has no program designed to alle-viate the joint problems of aging and deafness.

Deaf people want to participate in decisionsaffecting their lives. Regardless of lip-readingskills, no :leaf person can follow and participatein a group discussion without an interpreter. Weask this Conference to adopt a policy insuringcommunication support for aged deaf persons dur-ing information dissemination, at points of serv-ice, and in group discussion.

You are urged to read and support the recom-mended policies and procedures to meet needsof the deaf community contained in Services forthe Elderly Deaf Persons.'

Elderly d. of persons need your help. Do notlet them continue to be forgotten. Lend them yourears.

V. Eugene McCraryAmerican Optometric SocietyCollege Park, Maryland

Nearly 100 percent of all persons -aged 65 andover have some sort of visiou problem. Yet, lessthan 20 percent of these people are receivingadequate care. One of the major reasons for this

' Deafness Research and Training Center. Services for theElderly Deaf Pertont. New York University School of Edinsi-tion, New York, N.Y.

situation is Medicare's failure to adequately pro-vide coverage for optometric services. Indeed,only a fraction of all public funds is allocated tothe coverage of elderly vision care. As such, anolder person, with half the income of those underage 65, is paying for almost 60 percent of hishealth bill.

Recommendations

The American Optometric Association believesthat the final report of the 1971 White HouseConference on Aging should contain a separatesection on vision care for the elderly. This sectionshould recommend that Medicare be amended toprovide recipients with: -( 1) a complete visionexamination upon enrollment into the programand every two years thereafter; (2) the servicesof the optometrist delivering this care; and (3)payment for prescription eyeglass frame:- andlenses.

In addition, we recommeid that there be anincreased emphasis on the provision of visioncare in nursing and private homes, through theutilization of house calls and/or mobile clinics.

Optometry, with over 18,000 professionals in6,239 municipalities delivering over 70 percentof this Nation's vision care, stands ready to do itsfull share in providing the comprehdisive careso urgently needed by older Americans.

Sidney E. Chapin, M.D.Medical Director,Home Care Program of Metropolitan Detroit,Dearborn, Michigan

Physicians are disturbed about the penny-wise-pound-foolish posture of the Social Security Ad-ministration (SSA) regarding Home Health Care.

Home Health Care is the !lust economicalmethod of caring for the sick. Yet, this small(1.5 percent) part of the total health budget isunder attack.

Impractical interpretations by the SSA aredenying senior citizen patients needed care. Ex-planations and documentations add iintrieasur-ably to the paper work for physicians.

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Originally, Medicare promised traditionalVisiting Nursing services. Now, SSA reinterpreta-tions have eliminated many patients from eligi-bility. Decisions completely ignore the moral sup-port patients need to facilitate economical treat-ment at home.

The patient not completely homebound, orwho does not need physical or speech th;:rapy,or "skilled nursing care" is denied services. Yet,patients need other kinds of help to maintainhealth, prevent complications, promote rehabili-tation, and prevent hospitalization. For example:

there are more reasons why a diabetic needshelp in learning to take insulin than poten-tial blindness or senility.

If a physician is concerned about his pa-tient's response to digitalis, the nurse'sskilled services in checking vital signs arenot paid for unless the patient has an acuteepisode.

To have a nurse determine if he is followinga diet correctly is not a paid-for benefit evenwhen language difficulty is present.

The fiscal intermediary will pay for theHome Care patient's commode or bedpanonly if the physician specifically forbids himfrom using his outdoor privy.

The elderly spinster living alone is deprivedof service for a necessary enema even thoughthere is no relative or neighbor available toassist her.

When a patient's wife cannot learn to carefor his indwelling catheter in one lesson,SSA still rules a nurse's service unreimburs-able.

SSA completely ignores the majority of pa-tients' diagnoses and medical situations encoun-tered among senior citizens requiring homehealth services.

Home Health agencies find themselves ham-pered in efforts to deliver services. They have beenforced into financial straits with payments forservices already delivered denied. Physicians arefrustrated and discouraged.

Rosalyn L. Switzen,Director,National Education Ombudsmen's AssociationUnionville, Connecticut

OMBUDSMAN: Swedish word meaning "rep-resentative." The ombudsman is hired to representthe "little man" who is helplessly caught in abureaucracy and needs help to overcome abuseof power.

He functions to service complaints, has Cloutwhen he investigates, and can expose informationquickly,

H_ e is, above all, a red-tape cutter when thereare unnecessary snafus. -Since 1807, he has beenan intervener, or citizen protector, different frompublic defender or ordinary complaint or investi,gation bureau.

In the past two decades, nine countries haveadopted thii-new career. In the United States, thefirst" ombudsman appeared in Minneela, LongIsland, in. 1967. Since then, thousands of new jobshave appeared on high school and college cam-puses and in many agencies in the Nation, allacting for the "underdog" as overseer and over-sight officer.

Health, Education, and Welfare has just Setup ombudsman units to service complaints innursing homes.

The elderly especially need a powerful inter-vener to cut through bureaucratic snafus andtransmit information better for more effectivedelivery of services.

The skills of older citizens have not beenackquatcly used to benefit the communities or theaged. An advocate is an important role for seniorcitizens, able to be combined successfully with-the ombudsman role, for even greater clout andefficiency, if proper ombudsmanship training isprovided in one-day institutes.

There is an important new career that canopen up to aged citizens- immediately for fivedifferent kinds of ombudsman or ombudswomanjobs.

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PROTECTION

Robert L. Lauretig,Executive DirectorSeniors of OhioCleveland, Ohio

Until a national effort is made to provide mini-mum ancillary supportive social services to theelderly in public housing there can be no sense ofsecurity.

There is a growing recognition of this prob-lem. On January 22, 1971, Congressman JamesH. Scheuer of New York submitted H. R. -447,a bill to amend the U. S. Housing Act of 1937.The purpose of this bill was "to finance securityarrangements = designed _to prevent crimes andotherWise insure the safety and well-being of low-rent housing tenants."

The Ohio Division of Administration on Agingadded safety and security to an already-crowdedState agenda for the "Governor's Conference onAging" in Columbus, Ohio. The ClevelandChapter, Seniors of Ohio, first identified the safetyand security problems of the elderly in 1970. Thisculminated in the formation of a county-wideTask Force on Safety and Security Problems of theElderly.

Guided by a county-wide Task Force SteeringCommittee, the elderly were directly involved inreporting crimes and safety complaints. Theelderly took responsibility for developing guide-lines so better services could be secured. For thefirst time, the elderly organized and conductedtheir own safety-security inspection teams of pub-lic housing units serving older adults.

A conclusion reached by our Task Force that,once on the streets, the elderly cannot' be r :.o-tected by municipal or specialized police forces.Housing and Urban Development must stop justgiving lip service. It must finance a comprehensivesocial service delivery plan for residents of publichousing units.

7

t

or

or

MANPOWER AND TRAINING IN AGING

Clyde W. Briggs,Personnel Officer,The University of MichiganAnn Arbor, Michigan

I would like to propose the establishment of a_scholarship fund to be awarded over the next fiveyears to prepare a m;nority work force of 15,000in the areas of geriatrics and gerontology.

Beginning in September, 1972, a scholarshipwould be awarded to 1,000 graduate studentsfor a one-semester workshop experience.

Such scholarships awarded annually over thenext five years would produce a well qualifiedprofessional and paraprofessional work force of15,000 by June, 1977. It should be imperativethat the awardees attend institutions with wellesablished curriculums in geriatrics and geron-tology, and not schools of social work.

Richard L. D. Morse,Delegate Representing the AmericanHome Economics Association,Manhattan, Kansas

'WHEREAS, independent home living is pre-ferred to institutionalized living, many elderlypersons .find this style of living increasingly diffi-cult to maintain with the departure of familymembers, relatives and friends who cared for theelderly, and the failure of communities to providesubstitute supportive servicesparticularly home-maker/home health aide service;

WHEREAS, America has an abundance of under-utilized womenpower among its mature womenwho are dependents and are potential welfareclients but with training could become contribut-ing members of society as homemaker /homehealth aides to their own satisfaction and thosewhom they serve;

WHEREAS, education and training requires fi-nancing, such expenditures should be viewed asan investment in human capital which, accordingto results of the experimental and demonstration

77

project at Kansas State University, can repaysociety for this investment in training in less thanone year;

WHEREAS, America i. on the brink of recog-nizing how this service can enable the elderly,the handicapped and the family in crisis to con-tinue to live at homeunfortunately, this recog-nition may bring such a surge in demand as tocause and stimulate the creation of de facto or"instant" staff who are not suitably trained tofulfill. the expectations for service which theelderly and the handicapped have a right to ex-pect;

THEREFORE, it is recommended that qualitytraining programs be initiated NOW to pace thesupply of needed homemaker/home health aidesand exemplify the standards of service whichAmerica's older and handicapped persons havea right to expect.

Erich M. HelbigKnoxville, Tennessee

May I say a word for some seemingly unmen-tioned resources for any attack on the problemsconfronted by the chronologically aged. They arethe various' engineering professions and the trulytechnical innovators or inventors within society.

I missed any reference to utilizing or solicitingthese segments of our society, bo.h in this Con-ference's opening remarks and in the statementsprepared for our consideration at this Conference.

The "Action Now" demands that have beenmade here may well find the "hard science" en-gineers and the pragmatic inventors unexpectedsources of assistance.

Note that Ben Franklin gave us the bifocals, ortwo-lens eyeglasses, that most all of us mustuse after age 40-45--they are the product of in-ventionand still the best, 200-year-old, solu-tion available. It now seems desirable that per-haps some new invention and technical schemereplace the glasses over our eyes, I would suggest.

Perhaps an example, in another area, for usingpresent engineering and inventive talents can bethe small, personal, radio-frequency, tone-trans-mitter issued to each chronologically aged person,who desires a means to summon help or assistance.Then a local area monitoring station or receivermay be operated by church groups, fire depart-

Fern C. TrullWeiser, Idaho

ments, or even some of the social service agencies.

I would askpleadpray that an orti mindbe kept to proposed problem solutions and con-cepts from the inventive, engineering, and indus-trial productive capacities of the Nation. They canprcvide the independence and dignity so muchdesired.

GOVERNMENT ORGANIZATION FOR AGING

We, the official Delegates representing . theState of Idaho, support the U. S. Senate SpecialCommittee on Aging Advisory Council recom-mendation dated October 1971 which reads:

"That an independent agency for the agingdirected by the Assistant on Aging to the Presi-dentbe established within the Office of thePresident with the authority and funding levelsand fulltime staff needed to formulate andminister policy, coordinate, and monitor pro-grams within and among those departments whichhave a direct concern in matters relating to aging,that this agency be served by an advisory council,and that it be required to make an accurate andcomprehensive report each year on the progressmade during the year in resolving problems andin meeting goals specified in the prior annualreport, and that this report be issued early enoughin the year to have an impact upon the budgetaryprocess for the following year.

"This White House-level office for the agingshould have enough prestige and resources to as-sure thatas part of its advocacy functionitwill encourage development of parallel units atthe State and community levels. And it would,when the Assistant on Aging to the Presidentdeems it necessary, provide funds for innovativeprograms to appropriate Federal departments oragencies. It would itself, in certain cases, whendeemed necessary by the Assistant to the Presi-dent, initiate and administer such programs untiltheir value is demonstrated sufficiently to dele-gate to the existing agencies."

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John M. Lally,Associate Director,Cardinal Ritter InstituteSt. Louis, Missouri

We recommend the establishment in the rouseof Representatives of a Committee on Aging simi-lar to that already established in the Senate. LastMarch we had the privilege of testifying before ajoint hearing of the United States Senate SpccialCommittee on Aging and the .Sub-Committee onAging of the Senate Labor and Public WelfareCommittee. We testified on behalf of the OlderAmericans Act and, in particular, on behalf of theFoster Grandparent Program and Title III grantprograms. The Cardinal Ritter Institute operatesa Foster Grandparent Program and a seniorcenter which is funded by a Title III grant throughthe Missouri Office of Aging.

You will recall that last year severe fundingcutbacks were proposed for the Administrationon Aging. However, as a result of the hearingsof the Senate Special Committee on Aging andthe Sub-committee on Aging, the proposed budgetcuts were reversed and funds were not only re-stored, but increased for the Title III grant p. o-grams, the Foster Grandparent Program and re-search and training activities, This would neverhave happened without such Congressional com-mittees. The Senate Special Committee on Agingfocuses the Nation's attention on the needs ofolder people and has been a very effective mecha-nism in seeing that Congress addressed itself tosome of these needs. We need a similar com-rr Nee in. the House of Representatives. Westrongly urge our delegation to bring to the WhiteHouse Conference on Aging a recommendationthat such a committee be established.

Blanche DuncanMember of Governor's Committeeon Aging, Wyoming

If you need a doctor, you call a local physician.If you need your house repaired, you call a localcontractor.

To expect the Federal Government to take careof the needs of the elderly at an enormous distance

from your home is like putting in a long-distancecall to a stranger. Eventually you may receive helpafter a long delay.

I would like to recommend to the Conferencethat as many of the issues as possible be imple-mented at the State and local level with thefinancial and technical assistance from the FederalGovernment through revenue sharing.

IMPRESSIONS OF THE CONFERENCE

The Rev. Paul A. Boriack,Pastor Emeritus,St. John's Evangelical Lutheran Church,Rome, New York

The Honorable Earl Warren, retired Justiceof the Supreme Court of the United States,moderator; the esteemed Glairman of the WhiteHouse Conference, Dr. Arthur S. Flemming, andrespected Delegates of the Conference. Upon re-quest to make a statement about my impressionsof the Conference, especially in relationship tothe Spiritual DevelopmentSection, may I say:

In my evaluation of the total package of theConference, one word would give the concept"COMPASSION" "feeling your hurts in myheart," on all levels, in all areas of life. And to-gether we are there to do our best to alleviatethese hurts.

As soon as I was registered as a New YorkState Delegate for the Conference, I briefed HisHoliness the Pope Paul VI, of Rome, Italy, onthe purpose of the Conference, including religiousmaterials, resolutions, and pictures. His responseI would like to read to you now.

FROM THE VATICAN, SEPTEMBER 23, 1971

The Secretariat of State is directed by thHoly Father to acknowledge the letter and en-closure recently sefa to him by the ReverendPaul Boriack and to express his appreciationof the sentiments which prompted it.

His Holiness invokes on the Reverend

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Boriack and upon those he serves abundantblessings from God.

At tomorrow's session I will distribute andsubmit a Resolution on "Illegitimate (born outof wedlock) Children." We hope this will bringabout discussions to help heal deep hurts. I deeplyappreciate your kind attention. God bless andkeep us well.

Terrie WetlePortland, Oregon

As both a Delegate and as one who caresabout the elderly, I am distressed.

I am distressed by the evangelical rhetoric thatmarked the opening of this Conference.

I am distressed that a con;erence dedicated toconcern for the elderly could be so insensitive asto schedule an incredibly taxing program, stretch-ing from 8:00 a.m. to 10:00 p.m: and uses buseswith impossibly high steps for anyone with evena minor ambulatory handicap.

I am distressed by preconference meetings, inwhich delegates were called upon to ratify pre-set issues, not to present original recommendationsor policy statements.

I am distressed by an anti-research, anti-long-term planning attitude. Short terzii action isneeded, but it can't effectively provide a minimumincome on a projected basis, nor can't providelong-term medical care, nor can it begin to solvethe numerous mysteries of aging.

If the short-term, action program beclmes theonly norm, then we will always be saddled withpatch-work, band-aid programs, never finding

solutions or methods of avoiding the many prob-lems associated with aging.

Finally, I would like to observe that out ofapproximately 20 million elderly, 11 million arefemale and 60 percent of these women arewidows. In that this group has received so specific

attention at this Conference, every Delegateshould make certain that the special need ofwomen are carefully considered. I state this bothas a member of the only minority group with anumerical k majority and also one who hopes tosomeday be an elderly woman.

CALL FOR POST CONFERENCE ACTION

Edwin- Shelley,President,National Council on the Aging, Inc.Washington, D. C.

The needs of older people, particularly theelderly poor, are well known. We have haddecades of studies, pilot projects and debate. Nowwe must have immediate action on a massivescale to meet those needs.

The worth of societies is measured in large,'part by the quality of their treatment of olderpeople. We have the resources, we have an un-derstanding of the need, and we have the-knowl-edge of what to do. Lacking is the national willto assign a high priority to improving the qualityof life for the elderly.

The White House Conference can and must bethe catalyst for a rising public demand for actionto provide all _older Americans with a decentstiindard of living. The Conference must force-fully bring the present deplorable conditions tothe attention of the public, and propose bold solu-tions on a scale that will grip public imagination.And ultimately, for the Conference to succeed,the Delegates to the Conference and the or-ganizations they represent must rot allow therecommendations to die on the shelves of book-cases They must lead a determined campaign toinsure that the recommendations become publicpolicy and are effectively implemented.

To this end, the National Council on the Aginginvites all organizations participating in the Con-ference to join with us in a series of regionalmeetings and a national conference in April, 1972to review the progress made in implementing therecommendations and to plan fOr concerted actionin any areas that have been neglected.

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Robert N. Butler, M.D.Psychiatrist,Washington, D. C.

True tests of our cultural sensitivity towardour Nation's elderly and of the success of thisConference are action, money and power.

Some of us are deeply concerned about pre-mature self-congratulation, the bland carefulorchestration of this Conference. There will bethe aura vssociated with the visit of the President.He will probably talk about k'l) an income flockfor the aged, (2) a gerater role for the Admin-istration on Aging- (or some similar Federalstructure) and of influence in the White House,and (3) the 8-point nursing home plan he an-nounced that he has yet to be implemented. (SeeWashington Star, November 28, article by MalSchechter.) Moreover, however important stand-ards are, the President's approach perpetuatescommercialism in the care of the elderly.

We must test all promises, including Presi-dential promises.

I propose, first, that this Conference itself serveas a continuing committee cf the wholeeach ofus an individuals woald responsibly monitor therecommendations of this Conference. Second, Ipropose convening representatives from this Con-ference to meet in June 1972 in Washington for:

1. Postmortem of the Administration's andCongress' implementation of the Recommenda-tions.

2. Review of the 1973 Federal Fiscal Budgetan acid test of commitment.

3. Ask Presidential aspirants to spell out theirprograms on behalf of America's elderly.

To participate in the audit should be Dr.Flemming; Rep. David Pryor, Ralph Nader, Sen-ators Williams, Church, Moss and others deeplyconcerned with the life and problems of oldpeople.

I counsel healthy suspicion of ourselves, thisConference, and the Administration and Congresswhere the power to act reside.

Leo MilmanFlemington, New Jersey

In his address to the opening session of theWhite House Conference on Aging on November28, 1971, Dr. Arthur S. Flemming expressedhis hope for periodic evaluation of the progressmade-by our government, Congress and the pub-lic sector toward carrying out the recommenda-tions of ff.'s Conference, so that they would not,in his words, "go on shelves to collect dust." Thisis also my own and, I'm sure, every delegate'sdesire, for the success of these derberations willultimately depend on how the final proposals aretranslated into effective action.

At this Open Forum, therefore, I should liketo suggest that each delegation to this Confer-ence elect or appoint. three delegates (a totalof about 150 people), who would form a Com-

VARIOUSHelen LynchIllinois Citizenship CouncilChicago, Illinois

I wish to suggest the following to be actedupon:

1. That pensions $5,000 or below annually forsingle persons and $6,000 for couples be exemptfrom income taxes.

2. That all buildings be required to haveramps for handicapped persons and that thisbuilding code be enforced.

3. That the elderly in homes, or elsewhere,be treated as human beings and that nongovern-mental agencies feel their responsibility towardthe elderly.

of

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mittee on Progress. This Commin& should meetevery two years to hear reports from appropriaterepresentatives of Government and the Congresson the progress being made toward implementingthe recommendations of this Conference. Mem-bers of the Committee would then communicatethe information to their respective jurisdictionsand organizations for whatever action, positionor recommendations they may deem necessary toachieve our stated goala national policy onaging.

This proposal is intended to provide an effec-tive follow-up to this Conference.

William GilsonChicago, Illinois

The private organizations (NRTA, AARP,Sr. Citizens, etc.), Messrs. Martin, Flemming, etal., have stressed the fact that action is thecritical objective of the Conferince. Sena&Eagleton stated today that we could producevolumes of literature, of resolutions, but if noaction is taken we are just "hatching an egg,"just a collector's item. Problem: Who, how, andwhat will be done to execute the objectives de-termined?

TOPICS

4. That it be mandatory to have pre-retirementeducation.

5. That hot meals be served to the elderly andthe handicapped.

Gertrude LowellWilmington, Delaware

1. Social Security benefits for widows shouldbe uniform, without making exception of thosewhose husbands died before 65. Benefits shouldbe full amount of husband's act.

2. Social Security payments should be in-creased in view of inflation and low income ofmany recipients.

''. Means test should be removed from Vet-

erans of World War I, as law was originallypassed, inasmuch as many veterans did not haveproper physical examination and service-con-nected disabilities did not appear. The countriesthey gave their young lives to protect us againsthave been helped more than the veterans whofought in these wars.

4. Jobs for elderly should be provided by usingparttime employees for peak loads instead ofpaying time and a half to young people. Many ofthese people have status and could easily be usedto the advantage of government agencies (SocialSecurity, Veterans, etc.} at a saving to the gov-ernment.

5. Housing. A decent place to Hie is a mustfor the elderly. Not only buildings where theycan keep house at a cost within their means, butresidences where they can live family-style at amode-rate cost. The States should utilize their ownunused land and Federal Government providebuilding costs so that one-story units for six oreight people in clusters under supervision of R.N.and Social Workers where elderly can help eachother.

Rosslyn S. KleemanActing Director,Women's Action Program,Department of Health, Education, and WelfareWashington, D. C.

Although we know little about aging in womenspecificallyfew texts and guides on aging de-vote special at ention to womenthere is evi-dence that women and men react differently tothe aging process.

The 1970 Census counts more than 20 millionpeople over 65 in the United States-11.6 womenand 8.4 million men and the number of older

.women as compared to older ram has increasedsteadily: 139 women per 100 men in 1970, com-pared to 120 women per 100 men ten yearsbefore.

-Because men generally die earlier than womenin America, more women are left alone with thecomplex problems of aging, complicated by'real-istic fears of a changing world beset with differ-

ing ,es, and economic pressures. It is a time of. great uncertainty for many. The cumulative effect

of negative social attitudes about women cometo fruition in an almost acceptable disregard fccontributions that could be made by the olderwoman.

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A recent report of the HEW Women's ActionProgram focuses on special problems of olderwomen: widowhood, income and social services,employment, leisure time and continuing educa-tion, legal services, and consumer protection.Recommendations directed toward HEW aid tothe older woman include: expansion of HEWsupport for education and career opportunities,increased direction of consumer information andprotection activities, attention to problems ofcommunication and mobility in the provisions ofsocial services, and working with other Federalagencies in areas such as improving legal services.

Katherine TurnerDirector,American Board of LearningExperience for Community Education,Farmington, Connecticut

There is a task force throughn.it the country. . . of behavioral scientists including sociologists,psychologists, educators and legislators at a na-tional and State level who are now working onthe idea of omhudsmanship training, throughsetting up a State Education Ombudsman officeby law.

It is predicted that within less than five yearsthere will be over a million new jobs where full-time paid Ombudsmen will be working as red-tape cutters in all kinds of fields such as govern-ment, housing, education, dentistry, medicine,transportation, even for tourists. Perhaps sixhundred thousand education ombudsmen will becutting red tape in schools, at least one student,one parent and one 'teacher ombudsman trainedfor each school.

A poll of principals and superintendents ofschools in April of 1970 indicated that 51 per-cent wanted a state education ombudsman im-mediately. Three out of ten educational adminis-

trators in that poll, admitted they had never heardof an ombudsman. When briefed, two-thirds ofthis latter group wanted a state education om-budsman immediately.

Alice M. Brophy,Director,New York City Office for the AgingNew York, New York

New York City has the larger: concentrationof elderly in the country. One million residents,5 percent of Americans over 65, live in our fiveboroughs. 25 percent of the Nation's elderly livebelow the poverty level, 50 percent of our elderlysubsist at that level: Most elderly own their homesmortgage free; 70 percent of our city's elderlyare renters without assets. They are poorer todaybecause they have been poor all their lives.

Fifty percent of New York City's povertystricken elderly spend more than 35 percent oftheir income on rent. The .Federal Governmenthas admitted to its responsibility for tenants inpublic housing who now pay no more than 25percent of their income for rent.

But our elderly live in the older rent-controlledhousing of the city without subsidy. This year

they will pay a 221/2 percent increase in rent.This year's Social S:curity increase has beenturned over to the landlords.

A massive Federal rent subsidy program mustbe endorsed by this White House Conference andpassed by Congress.

In New York City's half-fare transit programfor the elderly over 600,000 older New Yorkerssigned up for their passes, 50 percent "get aroundmore," and 67 percent plan their day to travelin nonrush hours when the fare is reduced. Thisprogram means physical mobility and incomesupplementation.

But New York City is at the breaking point.The program costs 15 million dollars a year ofcity tax levy monies. There must be Federal sub-sidies for operating expenses of mass transit pro-grams for senior citizens.

Ronald H. WilsonAsbury Methodist Home for the Aged, Inc..Gaithersburg, Maryland

The American Protestant Hospital Associationurgesa11 White House Conference on the AgingDelegates to actively support efforts being made toobtain tax exemptions for all nonprofit homes forthe aging.

Luncheon ProgramsNovember 29 and 30, December 1

Conference luncheons were held for all Dele-gates on each of 3 days. Since no single hotelcould accommodate the entire Delegate body,the Sections were divided among four differenthotels.

Luncheons were held simultaneously for thegroups meeting in each of the four hotels, withone exception: on December 1, two groups ofSections were combined.

At each luncheon there were two speakers

83

chosen from Congressional Committees and Ex-ecutive Departments dealing with problems ofaging.

The presiding officers of the luncheons weremembers of the National Planning Board ofthe White House Conference on Aging. All in-vocations were given by persons who were Dele-gates to the Conference.

The following programs were presented bySection for the 3 days.

C

- .

LuhcheonProgiainfor Sec:tit:0i

-

HEALTHINCOMENUTRITIONtiwpwywNI ittiRESENT

Washington Hi1toñ Hotel:

Monday, 14ailemlIft 29

,

OgNjAmiryCESenumn_ GER.Speakers :- Seitite-,FinanCe_Ortiriitiee_

THE-- HONORABLEUSSE-4_ 0.40Ne..

tHE:HoNORABLEtiVALLACE:FAEIsiNETi;

eSday, November 36'siding: MR. ROBERT TAicgoeirn

irivoCation: 'MRS. EDITH WALSH

'Speakers: THE HONORABLEJANIES'a-HancSbigSecretary of Libor

THE' HONORABLERO_BERT M.-BALL

Cornmistiantr of Social Security

Wednesday, . December 1:ifriresidinge WS. MARGUERITE STITT CHURCH

DR. BENJAMIN E. MAYS

Speakers: Senate Special Committee on Aging

THE HONORABLEFRANK CHURCH'

THE HONORABLEHIRAM L FONG

84

,LUNCHEON ADDRESSES

Before the Ifealthdtigoittei'Employment. eiti4TR1 ts'eeittetit Sections

'November 29

The flanoreiblerRniSeltLongCommittee

'I ,oi-,prc-otd- ,io -60 here.-to- discuss= -with yousome of-T-the,majoi-legtilative,deVelciOtnents conceriting_,tbe eldetlk,-Ukhoyi that:y04,:are awarethat the,COintitittee-on Ftnãnce hasbilny in the :Se:hafe for a-large-shake-of the,legit-latiOn--,thWvoiy drectly effect :Or -elderlir

First and foremost, the Social Security fOrnaiPfilli'*ithin:the---jarojeijo,4 the Conitnittee:on-Finance, and o er the years I thinicji:4 'fair, to-,*_;fthar=,the'Ctirnntittee:has-'beekinsi:djiigeririn-_making heoleir improvements :;_ in Ate-.;soCiali:Seettr-ityjpingtaiii. The Coriibined-at icitt-tiie;boatd-berie=fit- increases- in7197-67iild i 97,11faVe -totaled: 27½percent.

We now have pending_ in the Committee onFinance a major Social Security bill that has

-p*e_d-Ahe-.1ion§e-ot_ReprOsentatives-Afid:on whichwe plan to move just as soon at.-aetion,on thePresidents -tax bill has been completed:, In. fact,most of the provisions of this -bill would havebeen signed'intolaw.ayear_agolf,it had not beenfoi the.contioVertial- and, in My_ opinion; ill=advised:welfare expansion -proposed_ by the PieSi=

-dent.

Here are :sortie of the features of the Housebill:

provides a five percent across-the-boardSocial Security increase with a $74 minimumbenefit..

It provides a special minimum benefit forking-term low-wage workers equal to $5for each year of covered 'employment up to30 years.

It would provide for automatic benefit in-cteaseS as the cost of living riSes if the Con-gress fails to act. I, might mention that theCongress over the years has increased bene-fits by more than the increase in the cost of

4

tt

.

.living,,- but_ this..ptOvi*iii,Would, -ptcivide_an *Ready approved- an- ainendthent. -to:- raise, theadditional -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-,hetwOi fikreak Of:Sentibri prehabIY-Wish-;io'in04.teprovide a-21' percent increase for iliote-thaii---the 'five percent in the

=. ,

forfuture,be _baiecrot_the-dinibinecu_eariiing.- of t46-eckoge*'thuit'bO"scen:-__iik

husband-, and wife in the context of how w can py for the.,beriefirs.limit on taxable -Wageslot that year. through increased taxes I think this issueis-particularly criçical since there have been

. _-6, newspapers abon,spine-ine*

ideasAo,fiike Security/on.(a. completelypy as-you-go basis without buildthg up rese.ves

-fot4nnite-13eneficiariet.:LhaVe_an,OPeri;initid:On>this believe the Committee on 'Fi=e_

any '$*4 43.0150P.V*.:e0'carefully to eiisurè that we are not opporrunistKlyfObblitg,,l_the:tnist to payfor ifn&ite:beitefitsjUSt for the.=§alte--,-=of..16Weting

ineturn -tothe--area,1_4-: *elate.

-'Añoilier tha jar provision Oento disiegard three 400641 -years Of j63ii-eirnini* -in- calcOatiag,. theaVetage-,*ages,-on whiCh-.-b-enefitseate--;biSetracted, men will be-accOrded the same-treat-

.it7401,44)131*****-Persons would be allowed to disregard one

additional year-Of low earnings for each 15years of employment iinclet,'_SOCiat:SOCOrityrinad-ctilatingiaVetage_Wages Which-bone,.

are base&Benefits for persons --_ delaying retirement be-yood_ age _65 *Old increased ionepettent Welfare-has very controversial issuefor each year peison-dia not receive bent, iii.--botti,:the.-..CountrY.-:ai*whOle.arideitie-Oinkie0hetause he was voiking. . particulat. -The- Administration . has proposeThe Social Velfate,expaniOnjegislifion=iliat wouldwould 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,

wards able-bodied pOrt,iiiiS,::fot doing: nothing andthen cuts their -nêfit if they work My positionis that we should t1iiin who supportshis children by **Jog,. even at -a :IOW: Wagerather -thair.the man Who_-deSertt 'r-iii.§--fainity -or-ne.Vet iitarcieSrthe:ddtko _of'-his-.Childten in thefirst place.

earned above 42,000.._

impottantpithisiOns O(the-billi*Ould,tedUCe-the-waitiogperiod-fOudiiability bene-fits; extend Medicare to disabled Social Se-curity -beneficiaries; and make number ofsignificant improvements 4;:bnitiistra,.tion: of the-Medicare piogratii.

All in-,all, this adds up to $5.4 billion-in in,creaserbenefits for 28 million-persOnt: in the 'first .year._ _

Let ine give you my thoughts about what islikely-to happen in the -Sedate. Based' on- tny ex-perience, I would predict that the Senate willmove in the direction of raising benefits above theHouse bill. For example, the Senate in the pasthas. taken the position that the SocialSecurity benefit should be $100. The Senate has

85

This cOnuoVeitial, ptoblem the -Co- nunitteeon -Finance will hive try-grapple-With early nextyear But there is -rid cOntiMietsy-SurroundingttheprOgratn.of aid to the aged, and I belieii,thit the92nd : Congress will legislate to _guarantee "a pa,tiOnal-minimum-inconie standard- for theaged.

Last yeat,- the Finance Committee accepted myaniendment to guarantee a minimum intotiie of

for each individual 65- ears Or older, witha .$200 --guarantee_ foran -aged couple. This provi.sign was in last- years 'Social Setirrity bill Whichpassed-the Senate by an-81 to ,0 unanimous vote.

.

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Unfoitunatery;the House, of _Representativesrefused to even talk to'us.abone.thatibilrbecauSeit did not contain the Administration T Welfare

:expansion -- prograin farm' -lies'

The Houk- bilLipassed=this year proVidestot..a.guaranteed minimum intoMefot-the aged of -$130for an individual and $195; for a cattPle incteaS,Trig -within two years to $150 fOr- an individualand- enapic..1;ini--Corifideht -thatitheSenate *ill- sUpportthek

Tax legislation that -passed the Senate juSt. lastWeek will provide _a _Significant -tmeasure of taxrelief for those -persons- 65, and over who p-a.Y-

staxe*.

the ;Senate bill.-WOUld,-intreaie the per-sonal exemption in 1972 from $700 to $800 Inaddition, thc minimum standard deduction will be(fideaiett:i0-i't91'2,-fiotti41;00(Y:(6-$006:::Paean_elderly person, _ this means 4560:1eSS of *able

this: xñeâñsintoifie, and fot _an eldeily Couple,.$106 leis- of taxable- intoine.

-

_ In another attiotv-the=Senateaddedlinment to the tax bill to -ease. burden

elderly low income persons- with :respect to theproperty taxeson -their _residence or the. tent they

;pay for living quarters:

These actions, I believe, .demOnStrate a coñ-tinuing awareness in the Senate-of the -needs ofthe elderly. In own opinion, however, the mostimportant -single need of the elderly is foi betterand less expensive healthcare than we have today.It is a sad but true fact that the elderly Makegreater use of our 'health facilities thanany Othersegment of out population. It is-also sad but truethathealth care costs have: tigeti disproportionatelyto other costs in this periodof inflation.. Thesething costs, coupled with the- decline- of earningpower of the elderly, as they reach tetirethent _age-and leave the work force catch them in a viciouseconomic scissors grip from whith there is noescape.

We have been doing what we can in the Fi-nance Committee to stop abuses of the Medicareand Medicaid programs so that we can conserveimportant and badly needed dollars to pay for

-more -and- improved benefits. AdMiniSttatiVe at,i-tiOriS, taken, by the Department of Health, Eduta-,tiOn; and.*elfatein the :past year or , so at ourinsistence-an& urging-. Seen! to be navinKackiir-=41e:404;i:64 it is enough:

.Thejiresideries announcement that :Phase of

his economic plan would include tonitOlqof-health-care- coStS,is-also:_a;_gOod-,anct badly needed step,bitt:aS?-61'noW these Phase II controls are littleittore-thati;?papet ,tigers.Tho;:ave,.., no body and-they-have-no:Meaning.-Thededitatitin.witlyWhith.tite-.Adininistration_aPproathes:thi*impOrtant,part:of its ;Phase tiitoiedL in %the-consumer's Jpocketbook. If it is successful, thehealth care dollars of the aged will go further, ifit s unsucessful, then perhaps it will belip to theCongress to seek a way tostabilize health- caretOStt:so

economic _ circumstances over

Oi-Obisoritble Wallace I3oinett-S enerte_fiiiiinceoriztifitiee,

I certainly appreciate br. ,Flemming 's kintlr, invitation-to visit with you-this afternoon andI,Shate--my;:thOughtS concerning the activities of the Fihalite Cortnittee-4ith---respeet to improving thewell-being and capacity for independent living of

-our Millions Of Older AtheritanS.

-Of course, the Committee on Finante- shareyour interest and concern in matters of -it-Iconicmaintenance and health andf-welfateas they affect()Met peolpleA -Might add, parenthetically, as thesenior Republican member ,of, the Banking and'currency ComMittee, I also am involved with thequestion of housingfor the elderly.

Those of us who serve on the Committee onFinance are Confronted in the area of _Social Se-curity with a somewhat unique situation in. devel-()ping acceptable answers. to- what are Offenhighly-insistent and polititally-appealing calls forimmediate broad-scale and definitive solution.

The Finance committee is unique(in that itnot Only approves and authorizes programs underthe Social Security Act, but it also has the respon-

86

Sibilityr-of approving thetaitet:ttqUired to financenew --programs and 'benefit, :chango.,_ Thar; myfriearlsi,*'a heavy responsibility and one whichgives an addect-dithentiOWtO our work in 'eviliat-ing thelnerits.of iegitiatiYeproposalt.

It:itnot'coldhlo-ocied at all fOt,,ine tixsay.thatwe have to look,at:the -price tag on aprOposal.The needs of the aged -compete fOr--prioritt-with,other legitimate and-Worthwhile-,needt; -such as-4tication,-ilotising; health, defense and Lso, onLegislators, _an the one _hand,.- can be accused bytoinefo(7,;'nbr racing to respond in meeting a neeaOn the other 41014; if ---theyvnte:_to meet the need,others, will -contend that their ,rakes-Creased'UnneCettark thelieve that the FinanceCommittee, however, 1)4,- almost always

deVelop-2-_a:reasOnable-;balanCe-:betWeen-t4e, obvimoly---,deSitable:aticithemtly, the Committee - CannOt-ibe=aCCUted,,Of ignor-ing devoting titffitietit attentinrytb- Olderpeople: -At least six people on -ttaff Of the-Corilialiteet=intladiag all, orthe bulk of -their time concerned with our -workon Medicare, Medicaid, Social Security Cash, bene-fits and bid ageassistance..4 :kW- short years -*gowe had only ,one - staff Merribet--devtiting.,jUSt partof hitiiinetb-all'Otthote iinpOrtanr_areaS.

During recent years the-CO Minittee has,:been-deYotingiari inordinate amount of time and effortto the problems in the Medicare and MediCaid,ptogtams. Our -toncern. has been that =those pro-grams be run with far 'greater_ efficiency,economy and equity than has been ManifestelPlease don't mistake my meaningMedicare ishere tO:tray. Our interest is-to inaniporate-Changestieceitary-in enable it to do abettei"joil of:servingthe people for whom it was Established.

As -you know; we have .deYeloped inany im-provements iii Medicare-and-Medicaid whith wereincluded -in last year's Social Security, bill, H.R.17550.- -At a result of the legislative 'logjam atthe end-Of the last Congress, the Senate vertion- ofthe bili4as not considered the House of Rep.resentatiVet. I am pleased, nonetheless, that theHouse saw fit to take many of those Senate Fi-nande Committee amendments and incorporatethem into H.R. 1, which is now pending beforethe Committee.

Sortie -Of -those_ amendments we developed, forHR 17550 are major and have received a

relatively yminor, but they are important and 1- thoughtmight call some of.theM to your attention today

:Periodically, there. ,seems to be public outcryover -COndirions_iii._dojno-hpmes and the needto clean them up., tInfOrtntiately all too -often,_after r brief flurry of attiiiity, the matter diesdown and the situatiOn is essentially as it wsbefore : The Tinante, Committee :belieVed; it .*cirtii.While,;to:deYeitip,,somehaticalmott sOfipolitiog-=-proviA*.io,riie- law with respect to !Mir-Sing'

homes In this regard, we approved an amend_-,Ment,-WhiCh reqUire,,toblie disclosure ofany ,-.04Jstanii444cieneiei in a_ ;nursing homewhich, *ere: .teireai4. _duting,a- Medicare surveyand' Y;There ithete':'defiCientietivefe, ,nOt,CdtreCtedwithin 90 days A you can appreciate, regularand discloiure should serve to generatepressure within a community _' -for--Upgradifig -Oftare- in a deficient facility Along similar lines, wevoted-Tib establish as a-Federarcrime.the makingOr -inducing of a false-statement of Material,. faitNvithreitiett:sto-=_4ie .conditions and operation of =ahealth facility- for purposes of:teen-ring Medicare

approval.

We-,_aito; voted_ to conform the 'bask Medicareand -Mediatid-StandaratqOr L skilled nursing-- homes

that,and,,ektended-e4ic,_-ikiliiii with theproVisor. _

if one program -established a higher standardthan the -other; , the ,higher standard would _ applyto =both. We approVed. another Medicaid amend-ment , designed' to virtually eliminate the problemof retroactive denial of coverage for care intended: Care_ facilities. Additionally; we furtherspelled out; in. no-_utiCertain terms, the Congres-sionalAntetit- that every_ older patient in a -skillednursing home or mental hospital- must be thesubject of regular; independent medical audit toatiure that he is receiving the right care in therighrplacat the right time.

We included' comparable independent audit re-quirements with respect to patients in intermedi-ate- care facilities. -Quite simply, the intent of theFinance committee and the Senate is unmistak-ably dearolder people shOuld, not be ware-housed and indiscriminately- placed in facilities;

87

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theyinay. not be conveniently forgotten and keptfor years in -settings_ where "iliey inapprOpti-atelY treated. I hope the ,achninistrators-bf thegrog-rains -.,nd the _facilities --get- the ithettage.

A ,mast important amehdinent-z=atid5hOpefully.I Say, this with reasonable ModettyWatzthe,COM-mittee,approval, as well as that of thefulSenate;of my amendment Which would establish 'Proiet--siOnaVStandards Review -OrgattilatiOnt- through-out the Cotintry

Under theaMenciment, organizations of physiciatis*oulti- be responsible, on 0.-- fully accountablebasis, for evaluating, the -Medical, ,necessity ofcare and services,-whether, the Cate ;prOViClect.meett,professional standards, _and, *here Medically- ap,,propriate, encouraging the attending _phySician toilselest-cottlymOdet sites of-treatment..

The- PSRO. ,amendm'ent WasAetigned to .fixresponsibility With-physiCiantfor -comprehensivereview Of all care and services provided to pa-tients under _Medicare and Medicaid; It was de-signed to the :fragmented, piecemeal in-effettiVei,:arbitiary and inequitable methods beingemployed today. It was designed with -kafeguardstOProtect patientt and/practitiOnert and, to avoidpro fortnaleVietv.

PrOperly, mOtivated_ and implemented, -psitocan work. For-example, in New Mexico, the NewMexico 'Medical Foundation; composed Of hunidreds of practicing physicians, assumed -completeietponsibility for ,comprehensive review -of thecare-provided under Medicaid. Among the resultsthtit, far, of the active and Vigorous' -pingram inthat State, ika finding that tome 35-Tercent of theelderlY in nursing hornet' in New .MeXicO did notneed institutional care. Additionally; they are turn-ing down, as medically unnecessary, a_ substantialproportion of mittens by doctors to do electiVesurgery.

In Colorado, where another PSRO-type orga-nization was established, and took over responsi-bility- for Medicaid review at the beginning ofthis year, they have reduced the average lengthof hospital stay by more than one day and de-creased hospital admissions by about 10 percent.Similar beneficial results are also being experi-

90

enced-by the Medicare.prograM- in Colorado, ,ac-cording to my infOrrtiatiOn

To thy knowledge, _no, one hat:Indicated. thatany of this -hard and tanttructive., effort has .re-stiliedLin a deterioration in the quality of medicalCare. In fact; all of -tit can :agree that avoidanceof unnecessary surgery obviously improves thequality Of-cate.

SRO offers tremendous potentiaL :for getting,a handle on the -Costs and riittality..00Care providedunder Medicare and Medicaid : "Obviously, it willhave to be pragmatically, reipOnsihly and sensitiVekiMplementecr it-it is to .realiie:thai potential.

'However, , with effective -retie*: MechanisMs.the Congress - can then consider,, with clett,',00F0=hension :than at present, ,propOsaiT clesigneoi to,liberalize ; and expand. Medicare and Medicaid$0*§:-

SettatOr'qx,ng., and -i=.ilicleect-,teeshare a common -desire to establish reasonable minimum income levels for the aged, blindand disabled tinder welfare . and for those depend=ent -upon Social z SetttritY. I',think our record isclear in that regard and, for that -reason, willnot stress out work to raise the Socialminimum henefitand to estoblith_minimitrivbene!fits under welfare for the -aged, blind and, dis-abled:

, .My_ concluding thoughts reflect, I suppOse, my

Mormon -background when I .0ay, that in our com-mon concern for the well being of older Amer-icans we should seek to avoid usurping the roleand responsibility of families. Obviously therehive been changes in those relationships, andoften they are non-existent, but, where they doexist, certainly we wouldnot want to do anythingto impair the sense of family unity which commonconcern and caring, brings;. Our society is morethan sufficiently -fragmented today without fur-ther solidifying lines of demarkation betweenyoung, Old and middle-aged.

In this regard, with respect to the needs ofolder people, I think that the proper role of theCongress and, in -fact, of all Americans should beresponsible, responsive, but not obsessive.

Thank you again for this opportunity to visitand good luck in your efforts.

November 30

The lionorabkja;:oer 1.-Iodgion-

Secretary of Labor

Good afternoon, Delegates to the White HouseCOnfetenecon. Aging.

On behalf Of the .-Adifilinstration; may I firstexpress our appreciation : -for the .work you aredoing to help us deire'-:)- a national-poliey,towardMaking, the -lives of -our older -people more productive to society_ and more perSOnally-retVarding..One of the tests of '-any: SOeiety is how well ittreats those whO-haVe:gest*h;old;i0 ith-Setviee,%Onthis test ont,o*n.-sikiety- does not IlWayi get thehighest marks. Perhaps is .of y.ourcueions :here we Wil r be able _to ben*.

'Let =Say, at :the- OutSet° I know it-is not 'un-common for :public officials, speaking :before -spe-cial grotipS like- this one, to paint in _glOiVingterms alt'fne measures they are _undertaking intheir fields of interest It would be easy for me todo this._ I cOüld dwell at length upOn my .OWO-Departnient's efforts to _abolish- job cliSerithitia-thin against older workerS.-I &nil& point to themore than- 0,000- compliance 'congaed' We = madelast year, with age discrithinatien barriers re-moved-from 100,000 jobs I Could -talk. about ourmanpower--training prograMs and thelion We-are- spending this year on_ jó b _trainingfor thOse Whb are 45 and _over. I could note werequire that at least half of the participants-in-our

-Operation 'Mainstream shallbe 45 or Older. Icould remind you we insist pee* over 45 -begiven special consideration in filling public jobsunder the recent $1 billion Emergency -EniplOy-ment Act. ,

But this kind of self-congratulatory listing con-tributes little. Whatever the program, whateverthe group being helped, we know the need al*aysseems to outrun available resources. So today Iwould like to strike out in another direction, onethat I think might be more helpful. I would liketo confine my discussion to the role of work infilling some of the needs of the older person.And I would like to hazard an observation or twoon strategy to realize these needs.

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What areithe Work -needs of the-older :perion?*ell, of course, :these needs vary with the indi-vidual; with-the situation, and with age. It's diffi-cult- to Jurnp,them all in one bigcpot.Still, 1-thinkwe can inakei few general Observations.

Pirst_we-shouldippreeiate that work may oftenMean something different to the .older,perSon--,-both something more and something lessthanto the-younger-one.

Some cornmori. worker- needs are not alwayspresent among Older `-workersfor example,, theneed'to cleVelop', a skill, to ibnildi career, to feed

_a:groing family, ancl-to on Income, Of en'uise, isimportant to any worker: ,Butrincorrie for theolder- worker may often be -needed is,,tnUch- tosustain -dignity as to Maintain- li,fing, standards;So ,-psychological : rneeds MifSt, be coupled _ withrecognition of .economic -need. The neat to be

JO be part of :something, to contributesomething worthwhile, to .itay, in the lmain stream

psychological needs are -often part, ofthe-,drivitieforce_; that keeps the older person _inthe workfoice. -the$, Aotil&ticit--be ignived.

A second_-need--relates to- unernployinent prob-lems of the -older worker: While they may notbe-broad, they ire,,in instances whérè'theexist,'very-deep:We know geographic poked of severeunemployment exist among older workers. Weknow whole industries -pass from the scene, _leiy-ing a residue-qf stranded older-Ws:irked. *le knowjob skills of some specific older occupationalgroups have become dunnocied. And we know thatwhen Older workers-do experience -a job-10- theyOften have anicutely-serious-prObletn in- findinganother job. Last fell., forinstance, even-thoughthe- rate Of unemployment for the older workerwas quite low, the duration Of uneniployment forthose who did lose their jobs was more than twicethe national average. Every plant closing we havestudied Yreveals thesame patternOlder =Workersare. the -ones who experience. serious _problems inbecoming re-employed. The_ pattern is evident. Theyoung move with job opportunity; the olderworker often does not. Community and familyties lessen geographic mobility. Reduced incentiveto acquire new 'Skills limits occupational mobility.This shoüL be understood as fact rather thanmerely deplored.

So=here we have .two major work -needsthe_psychological-_ needs that jobs' supply and-the spe-cialized eMployability_ problems of those _olderWorkers who find' themselves out -of jobs. Theseare needs that differentiate the older from theyoUnger or even middy: -aged Worker:

Now,, how do -we go about seeing that theseneeds are recognized arid, filled? Here tbelieVe ashift-in strategy might_help.

I have spent a; lifetime 'in what_ I call the"peOple businese=lhat is, dealing with-problemsof-people. A- compassionate person-Who deals withpeople problems cannot'but be touched and evenoverwhelmed by the-ththet needs of the aging, inour society: So one who obSerVes,,ancl-works atthese problems- wants to make sure they are un-derstood and presenter', in a way ,and,at a-,placeWhere they. ,ate, apt to receive 'amountand kind' of attention they-4*i*. It my ith=-pretsiotr. this is not now being -clone as effectivelyat,--it could be becauseshe speciat-needs of _olderworkers are not being pointed- up: Instead,- theplight of the :Older worker -in general' has =teen'the.:foctis- of the attention. ThiS,pligbt, L believe,,has -been well- drathatized-and _well. presented. Buta more sharply tailored- approach May now be-more=

Let's start with an examination of groupsrepresenting, the older worker are up-against whenthey -attempt to get recognition-for' his _unernploy-ment problem in Federal legislation. They ate-tip'againsi,two major things. First, limited resources=unhappily-resources are always_ limited. Second,they face strong competition for the -resourcesthat do exist. So when,one .attemptS to drar.)acizethe unemployment ;problem of older workers inthe traditional sense=that is, in terms of the num-ber -of proportion of his groupthat ,are unem-ployedthere are some facts that make the effortan uphill struggle.

Remember, I noted that many groups are com-peting for whatever resources are available. Let'slook-At the claims that can be made for some ofthese groups. Though there are several, I willtouch on only three--the young, Blacks andOther minorities, and veterans. First, let's look atthe young. Here are the most recent unemploy-ment figuresthose supplied by the Bureau ofLabor -Statistics for October of this year.

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For the age group 1649. unemployment is 16.4percent; for those age- 20-29, unemployment is72 percent; for those age 30-55, it is-3.6 percent;--for those 55 and over, it is 2.9 percent.

Not a strong argument -for giving extra atten-tion to-theolder group, is it? And. yet to- the oldergroup-that knows full viell_inany of its membersoften= hpve serious unemplOyment,problems, theseovii-a/rtigureS proVide little comfort.

Now -look at figures ,for, the- two other grOups-that Compete for attention., The ciirrentAinemploy=-thent rate. for Blacks- and, other, minorities- is: 9.5:_perterit. ,And Tduring!thepast fear the: uneMploy-ment rate-for ouVietnaih_veterans have averaged9,-PCkceiit;

Sohere obserVe -what. can-13e -called' the-- coniPetiii3;e_ dimension* of the problem._ In.termsof 'pteitiortiOns-,=the_ raditional measure--of theunemployment- probleth -in -this ilation=other.gioupS have -an awesome competitive edge. Un,employment:rates:forthese groUpi are from threeto .fiVe times is ,great as-for- the-older age group.In- fact, theolder. -age group -figure -is only halfthe _national average.

So if -the aging attempt =to compete for- atten-tion in Congress .on a traditional basis that is,on the amount of unemployment --they findthemselves *swimming upstreani against a strongcurrent. But here it is important to understandtht_ quantitative figutet tell a limited story. Theyconceal-4-lot Of clikouragement, wasted talent, andacute hunian misery.

What then can be done? It seems to me twoapproaches should be emphasized. One of theseapproaches is to emphasize the specialized needsthat I have spoken of earlier. I suggest that thosewho champion the cause of the older worker shifttheir sights somewhat frOm a generalized concernfor levels of unemployment to a diffetenta focuS concentrating on the special need of theolder worker who is 'without a job and the com-panion psychological needs of the older worker.This may mean specialized help for unemploy-ment problems. And it may, mean specializedkinds of manpower programs to meet special jobneeds.

And, while we_ are talking about strategy, itMay mean something else. It may mean more con-centration on the .local government- level than -inthe past.

In a-big country, Federal legislators are apt toconcentrate on the big---picture. Special needs ofspecial -groups, 'particularly needs that' often varyWidely-by situation and.community, have difficultS,competing for attention.

This circumstance, prompts me to wonder -aboutthe wisdom of promoting categorical- programsfor the Older worker at the Federal level: Suchprogianis face the -most, demanding competition.from, other groups who_ contend :they-have a-_su-periorehtim.. We-must recognize that work-needsfor the agiag..differ by -age- -and" circumstance.Those WhO 'are-familiar witli-categorieal_:'funcling,knOW- how difficult it is to recognize -properly'such -differences- in- Fed_ eral: ptogramtiOn.

Thete- are clearly ,areas in -this Nation Where-needs' of older workers are preeminent-rural"areas retirement communities; many suburbs,'areasof declining induStriat employment, etc.- Ifmore funds Were ayailable -with-localized controlin these communities, -the needs- Of the olderworker- would no _doubt -get a- better bleak thinthey do now. For all its .t-orteomitigi, City Hallis still _More accessible and-more attuned to _loCalneeds -th-ari a &ant Federal bureaucracy. Untilnow, hoWever, at City-Hall and other localleVelsa shOitage of funds has limited-the extent of helpfor needy-citizens.

This condition is, of course, what-presidentNixon -sought to remedy with his revenue shar-ing concepta concept that permits local govern-ments to respond to the needs of their own citi-zens without being constrained by the ill-fittingregulations of a remote Federal agency. Certainlythe Manpower Revenue Sharing bill proposed bythe Administration would be a big step forward inachieving this objective. Thus, as a matter ofstrategy, perhaps local government levels shouldbe the subject of increased attention among olderworkers.

Well, I hilve offered these suggestions as: afriend of the older worker and a student of his

needs. But I don't -want to leave you with -theidea that you discontinue your effOrts on theFedeial level. Not- do I want to-suggest that welit-the Labor Department aren't developing_ someof our recipes to give the older worker a betterbreak-in the future.

One of these is our, Senior Community ServiceProject involving a_$1.6 milliOn _grant= to the Na,tional Council on the-Aging: We and the Council-have joined- in providing special_ work experienceand training help to hundreds of- a -special group-- chronically unemployed older-workers:Thoughtheprograiv still -has nearly, a-year to run, we areabout -i-aady-to, pronounte it to success. It will nodoubt be- continued- and it's ;a good' candidate forexpansion.

Down in Abe -good .,city of LotdsVille -we haveanother_ fascinating_ experimental- project underway; Here the, Employment Service and-the,SeniorHouseA of toUiSville _provide -a- unique type ofscrvice_to help- retirees set either full or parttime,jobs thiough use of older Voiker volunteers.These- Volunteers :are- used' to uncover suitable- jobopenings. EVen=at this- tidy -stage_Of _the effort wefind a high:percentage_of -those seeking thii;terv-ice are being 0144 in Obi. ACcordingly; -I amdirecting expansion of the -program _by bringingin representative older worker service otganiza,tionsAn -order to make use oftheir resources andknow=how as well as those of .the EmploymentService.

Then up in Minneapolis we have somethingunderway that really has eiciting promise. Herethe Department working with the State and theMinneapolis Aehabilitation- Center bas-developeda comprehensive package covering training, fortall phases of service needed by older workerswho ire seeking _jobs. This approach has workedso favorably in Minnesota that I _have directed itbe.extended Ito eight other States within sixty day's.If the program continues its present promise, itwill be extended nationwide.

There-is a bundle of related subjects that con-sume our interest down at the Labor Department.New pension protection and liberalization mea-sures, the popular Green Thumb program we runwith farm organizations, fascinating findings anddevelopments with regard' to second careers for

93

Older workers, the additional funds we are devot-ing each year to manpower programs and howthe amount of money available would, take aquantum leap forward-under- the Administration'sManpower Revenue Sharing Billthese are-partof a veritabIe laundry list of'items that-might beof interest to this Conference. But I shalPhave toforego .their discussion today.

In closing, let, me say this. From a- study- ofadvance Conference reports, I notice, things' likeincome, health, housing- and transportation= may-rate-higher priority among -the interest -of theaging than-do problems of employment. We -inthe Department of Labor, -however, :believe theeemployment needs of-the older' workers are oftenacute, that they -- deserve specialized- attentiOni =andthat we should- play a role in :providing -that.

We will continue -to do so. Thank youvery-much.

the Honorable Robert M BallCommissioner of Social Security

I, appreciate the opportunity to speak -(b- -youtoddy about the Social Security and Medicare pro-grams, about their role in providing economicsecurity, and about how we hope to further? im-prove these programs.

Social Security Today

Since its modest beginning in 1935, the Social.Security program has grown until today it pro-vides retirement, survivors, and disabiik protec-tion for almost)all Americans, and health insur-ance protection for nearly all those aged 65 andover. The Social Security program touches thelives of practically 'everyone in the-Nation.-Overnine out of every ten people in paid' employmentand self-employment are covered or eligible forcoverage under the program. Almost 27 millionpeopleone out of every eight Americansarereceiving about $3 billion a month in benefits.And 171/2 million of these benficiaries are oursenior citizens.

Of the more than 20 million people in thisCountry who have reached aged 65, over 9Q- per-

94

cent are getting monthly cash-benefits, will-beable to gekthem-when-ihey of their spouseszretire._Moreover, almost all-of the 20 million are pro-tected-by the hospital-insurance part of. the Medi-care program, and about 191/2 'million havechosen the protection of the supplementary medi-cal insurance-part -of the program. Medicare pay-ments for hospital, and-doctors' care account forover -twe-thirds of expenditUris" fOr hospital anddoctors' -services that the aged receive.

People sometimes forget -that Sociil Securityis not -just siletirement: 'program, but those ofUS who are parents and grandparents `ran appre-ciate the important, tole this, program- plays inthe security of -young families, too. As you . mayrecall, Wehave bn-Our.-benefit -tolls _persons-iYhoare'- totally -disabled- at yOUnger ages and their de-penilentl, and Surylvdn_of deceased' -workerswidows witlizfeging-childret) and-youngpeople inschool-all, of whith -add. up -tO. almost -another10-million.benefi'ciaries.

In short, the Social' eectirity program is, isPresident Nixon hat described- it, ran establishedand. Jnportarit American institution, a foundationOn which-millions are able to build a more com-fortable life,than Wouldotheryzise beipossitsleafter -their retirement theeveriof- aisabilityor deathof s'-)efattill, earner:"

Improverients Nied5d.,%, .

.The AdMinistration realized, though, that de--spite the significant rOle-that. the-Social Securityand Medicare pi6grams play in providing eco,nornic security- fsit.-: the aggd, the' potectionafforded by -these:progiarns should be fuither im-prOved...And 1-, she Social Security andwelfare-reform bill that passed the House Of ltep-retehtatives last spring and is nowpending thethe -Senate, contains many recommendations ofthe PriSident designed- to naive. us significantlycloser to the",goal of providing economic Securityin old age for all Americans. ,

H.R. -1 will bring Social Security benefits up todate with the increase in.:he -cost of living that -'has occurred since the last ger4ial benefit-.ircrease.H.R. 1 will make sure that benefits-stay up*toatewith future increases in the cost,of living, thusprotecting beneficiaries against the ravages of, in-

nation. H.R. I will raise the amount of moneythat Social Security beneficiaries who want to con-tinue to be useful, productive members of societyand are able to do so can earn before having anyof their social security benefits withheld and will'remove from the law the disincentives to workthat now.ow exist under the present earnings test.And H.R. I will increase and improve the pro-tection afforded by the Social Security programin a number of other ways.

Cash Benefit Changes under 1

The most important of the changes whichH.R. 1 would make in the Social Security cashbenefits program is the provision -for automaticadjustment of Social Security benefits wheneverthe cost of living rises by at least 3 perce / in ayear. This would make benefits "inflation proof"by assuring that they will at least bekept abreastof increases-in the cost of iiving. While benefitincreases legislated by Congress over the yearshave more than kept benefits up to date with in-creases in prices when measured against the levelof benefits set many years ago, time-lags havefrequently occurred during which the purchasingpower of a person's Social Secuiity benefits havebeen seriously eroded. And, of course, later ad-justment in benefits can't make up for the depriva-tion that people have suffered during the time thebenefits were inadequate. The automatic adjust-ment provision would assure that long lags be-tween price increases and benefit increases willnot occur as they sometimes have in the past.

Before the automatic adjustment provision goesinto effect, benefits would be increased across theboard by five percent effective with benefits forJune 1972. This increase is on top of the tenpercent general benefit increase that was effectivefor January 1971, and the 15 percent increasethat was effective for January 1970, and willmean chat for June 1972 benefits will be one-third higher than they were for January 1970,just 21/2 years earlier.

Concerning the provision of the law known asthe retirement test, it is possible under the presentprovision for a person to actually have less in-come (that is, Social Security benefits plus earn-ings after taxes) if he works at certain earnings

95

levels than he would if he earned less. At present,there is a -$1 reduction in benefits for ea:h $2 ofearnings from $1,680 to $2,880, and a $1 reduc-tion in benefits for earnings above $2880. Under.H.R. 1, only SI in ben_ its would be withheld foreach $2 Of earnings above $2,000 regardless ofhow high the earnings might be; there is no SIfor $1 reduction at any point. Thus, it will alwaysbe advantageous for people who can to work andearn more.

Increased benefits for some 31/2 million agedwidows are provided by the bill. Under presentlaw, an aged wdow's- benefit is equal to 821/2percent of the benefit that her husband wouldhave received =starting at age 65. Under the= billa person who- becomes widowed after age 65would get, benefit equal -to what her husbandwould be getting if he were still living.

The method of computing retirement benefitsfor men would be changed to make it the sameas that- for women. This change will -allow mento drop out of their benefit computation threeadditional years of low musings, and will en-able men retiring in the future to get higherbenefits.

Higher benefits would be provided for many"long-term, low-paid workers. Low-income workerswho have worked for many years under SocialSecurity would be eligible for a special minimumbenefit equal to $5 multiplied by the number ofyears under social security, up to a maximum of30 years, providing them with a special minimumbenefit of up to $150 a month.

As a result of all of the H.R. I changes in thecash benefits program, average cash benefits willincrease significantly. The average monthly cashbenefit for all old-age beneficiaries will increasefrom $131 to $142; for aged couples the increasewill be from $222 to $234; for aged widows,average monthly benefits will go up from $114to $133. The automatic adjustment provisionwill, of course, increase these benefits more inthe future as prices rise.

Medicare Changes under H.R. 1

Health insurance protection under Medicareboth hospital insurance and supplementary medi-cal insurancewould be extended to persons en-

titled to monthly cash benefits under the socialSecurity-and railroad retirement programs becausethey are disabled after they hive -been entitled-todisability- benefits; for at least 2 years. If enacted,this-,provision wouldmake about 1.-5 million .dis=.abled- beneficiaries eligible for hospital benefitsand physician coverage .undet Medicare: This isa'-sigtiificant-provisiOn for older _peOple for al-thoigh social security disability beneficiaries areunder age 65, alinost twothirds of them are over-

-age 50.

there are othei -important provisions in H.R.that would =make a number of..Chariges

Cite, _intluding-many- Which_ would- 'improve theoperating effectiveness of the 05grani. There isnot enough -tithe for =me to discuSs these, thanges

-here, except to mention-' briefly; that -the .Adinitv.*racier' is counting on one fprOisicinthAf Whiehwould- encourage. theeXpanSion arid 1-USe- of -healthmaintenance rganiiationt=to -help _control 'the-

:demand for health services andsupport the best=Use Of theirsUpply.

.As --many of you are aware, one of, the princi--pal-desires of -the-President -is to improve cOndi,,tiOns- in nursing homes, where Over 900,00Americans over 65 live, -and.sto -help assure thatnursing -home patients ate treated ivith-dignityandconsideration: The MediCare -prOgrirn -has done-,Muth to help achieve these-goals. Since Meditare-began, almoSt 100 million days ofcare in ex-tended care _facilities=mniing homes which pro-vide skilled nursing care to- Medicare beneficiarieswho no longer need intensiyehotpiral care--haVe

:been:paid for under the-rograiii. The quality ofthii care has been upgraded under Federalstandards and Federal-State inspection proceduresthat are unparalleled in the nursing home field-.

Over the last 12 months alone, more than4,000 surveys of nursing homes were made todetermine whether these homes meet Medicarestandards. One result of these surveys, and the8,000 visits made to nursing _homes during thattime to assist them in correcting deficiencies, hasbeen that many hundreds-of nursing homes haveimproved their services and corrected their de-ficiencies so as to be able to continue to partici-pate- in the Medicare program. Since Medicarebegan; about 100 extended care facilities have had

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their -Medicare approval terminated because theyfailed to meet health and safety standards, andiinanY` More have voluntarily dropped out-of -theprogram when they were -unable to. meet thestandards.

While many nursing hothes do provide- out-.standing- care to our older citizens, we are allaware that some do not. At this- moment, theAdministration is engaged- in many- activities. thatwill' help- assUre:thatnurSing home- Care providedto the _aged is unproved. TheSe activities- takeMany :forms; _including :better -enforcement ofStandards for 'participation ,in'Federal programs;improving: the training and professional tthupe-

iente-OCthese- engaged in seeing ,that -,stanClardsare -Met;-;inCreaseillimcling of:State,:health depart-inept services. tonnected, -With.,ithproVennerit ofnursing home -facilities, terminatingt the :pat:tiCi:-pitiOn, 'Federal .programs of _nursingthat fail- to-meet standards: and regular -reviews-Of State =health - department 'profeisional certifica-tions of nursing -hones.

Secretary- Richardson recently designated So-cial Security, district offices; WhiCh- are in 850-communities throughout the country; _ to serve aslocal "nursing home listening posts." _People- whohave: information- -about instances- of odor -.qualitycare, neglect; unsanitary or. unsafe Conditions- ina purSing -hothecairgiVe this- information to ,theirlocaLSoCial Security office on a-Confidential basisand the-Social 'SeCwity office will see that thecomplaint 'gets to the 'proper Federal, State, orlocal authority for investigation.

One very-important provision of H.R. 1 whichwill benefit the aged concerns those who arereceiving institutional care that is not at theskilled nursing care level. This type Of care isnow provided in several thousand "intermediatecare faeilitieS." -There are, however, no uniformnational standards of quality of care and safetyfor these facilities and no assurancethat the- levelof care and the conditions under which it is pro-vided are of. the highest postible quality. UnderH.R. 1, these institutions would for the first timebe required to meet prescribed Federal standardsrelated to quality of care and the safety of theinstitution.

Welfare - Reform Proposals Affecting the Aged

In addition to provisions for improvements inSocialSecurity,_411. 1 also provides for a major._

new approach to public assistance for olderpeople. H.R. 1 would replace the State-adthin-istered programs of assistance to the aged, theblind, and; the disabled with a new national pro-gram financed by the 'Federal GovernMent andadministered br the Social Security Administra-tion.

The-new program represents.a watershed pointin the-hiStory of public Welfare in this country.Eligibility requirehients would be uniform

the-country and adininistration,hy-theSocial, SectritY Administration;. -Would-be ton=sistenr nation Wide._ The new prograin when_ fullyeffective, will help= abouti-21/2 1timeS aS iinanrolderpeople as now receive- assistance under presentprograMS, and older people will he-able-to,haveone-stop service in their quest-for economic secur-ity, applying for both Social Security and supple,mentarypublie assistance at the same time.

The new Federal-program, when fully effective(July 1974 under H.R. 1), would provide assist-ance standards Of $150 a month for aged, blind,or diSabled individuals-- and $200 A_ month forcouples. These Federal payment standards arehigher than the corresponding standards in overhalf of the States. These standards establish as agoal of the program a situation in -which noolder person- will need to live on income that is.below the poverty level..

States --may establish a higher standard than thefiederal :assistance standard if they choose to doso in their State and pay the difference in colt.Under such circumstances, the program couldstill be administered in that 'State by the' Social:-,Security Administration as a single program.

Under the new program, people will qualifyif they have assets that do not exceed $1,500, but.the home, household goods and personal effectswill not be counted within. the $1,500 limitation.Face value of life insurance of up to $1,500 per

iperson will also be excluded in counting resources.Resource limitations are much lower than this inthe preSent assistance programs of some States,and it has been a common practice in State pro-

97

grams AO place liens on homes as a condition ofeligibility for assistance.

_

_ An older person's or couple's eligibility forassistance under the new program will be deter-mined on the batisnlhis or-their own need with-out regard -to the income or assets of relatives.Relative4esponsibility rules will not be a part ofthe new program for--,the aged. People will ntirbedisqualified or have their assistance payments re-duced -because of the income or assets of theirrelatives.

Conclusion

Too -often our seniorcitizens have the rightto feel that--they= are the fOrgotten;.SegmentTofoiff _society Ve are on the move to correct thesituations., that- lead to thiSi feeling. For tiltmore adeqUate'Soeial_SeCuritYbenefitS-Avill-beTprO-Vided- and those benefi is:- Will- -be made --inflation-proof. As a _reshlt_of =a- variety of ilistini-tiotial care for the Aged- is _being iniproVed andH.R.1 will bring for the first time the -great bulkof nursing homes under Federal standards. In-centiVes-to work and continue to be active will begreatly improved under pending legislation. And,finally, through the Welfare reform proposals anew program of national assistance will be ad-Ministered as a supplement to Social Securitybenefits with the goal of making sure that noolder person has to live in thil land of abundancebelow the level of minimum poverty establishedby the Government.

But obviously a floor of protecticrti against direpoverty is not enough. Through Social Securityand the improvement of private pension plans andthe opportunity to work we must move forWardto the goal of adequateincome for all.

December 1

The Honorable Hiram L. FongSenate Special Committee on Aging

May I extend to each and" every one of you thewarmest greeting I know: Aloha!

Aloha is that endearing word meaning so very

much . . . love . . . friendship . . . brotherhoodall the feelings of goodwill which we cherish andwhich we want to dominate this White HouseConference.

Speaking of dominating, when I. received theletter giving details on this luncheon, I noticedthat thename of Church dominates the occasionMrs. Marguerite church, former CorigresSwoman from Illinois, is presiding and' my_ .col-league, _Senator Church, is one of the speakers. Ibegan to wonder how a fellow .named Tong -wasinvited to attend!

Whatever -our -narneS, we are all engaged in acommon Cause. (Or, a ;group of Americans- forwhom we share a common concern, our agingbrethren.

May- I take-'this= Otcation.-05-:cominend -all- ofyOU-_'for your yeoman --work on -theSe concernswhich :fated' the 1971 White House -- Conferenceon_ Aging. YOU are making history" -here, arid' Iknow this will lead- to _Mr-titer progress for ourNation.

It is an honor and a great pleasure to breakbread with you today- and to share the speakers'platform -with the distinguished Chairman of theSenate Special Committee on -Aging, SenatorChurch of Idaho.

Although he is the youngest member of OurCommitteeyoungest in years, but-long in serv-ice-- Senator Church haS earned- his spurs. asChairman by reason of his deep empathy forAmerica's, 20 million older Americans. He sharesWith all-members of the-Committee-a strong com-mitment to improving the future of our Nation'solder generations.

You know, the Chinese have a saying, "onekind of rice, a thousand kinds of people." Inother words, we all eat the same ricer. but we'reall different. So it is with our older population.They are all aging, but they have different needs,different' problems, different aspirations.

But no matter what their individual needs ortheir individual problems or their individual as-pirations, I believe all want opportunity, all wanthope.

I believe it is imperative that the last three

98

decades of this century must offer opporunity inage.

I hope Delegates -to this Conference will unitein saying, "America, hold. open the doors of op-portunity in age."

The record is clear. More and more older Amer-icans have greater capacity for involvement inlife's affairs. Their children have left the nest,and the -parents- are free to follow new pursuits.Thanks to-medical and scientific advances, peopleare -living longer and are . healthier. Their desireto,enjoy life, to serve their .ifellow man, and tobe a vital part of society'st Mainstream growsapace.

Where _in' the past we counted our _elders inteni..of thouSands,;..we-fiow---haVe....unllioris. Let 'usmake :sure 'that:: all enjoy -the benefits, the oppor=tithitieS, and hope of ,age.

Henry- Wadsworth Longfellow_ well under=stood the values Of ;age. After reminding us thatthe Greek dramatist; Sophodes, wrote his greatplay, "Oedipus", after 80; that Germany's giant,Goeth, coinpleted "Faust" after four score years,and that England's ,thaucer wrote "The Canter-bury Tales" at 60, Lon-t--- said:

For age is opportunity no lessThan youth itself, though in another dreis,And as the evening twilight- fades away,The sky is filled with stars invisible by day.

Longfellow's contemporary, Dr. Oliver Wen-dell Holmes, -reemphasized by deed Longfellow'spoint that age can be opportunity. His famous"Over the Teacups ", written at 80, showed noreduction in wit and no-flagging of spirit.

His son, Oliver Wendell Holmes, Jr., madegreat contributions until he was -over 90. Hisdistinguished service of over -30 years on theSupreme Court began when he was 61.

History is replete with magnificent contribu-tions by persons in their seventies and eighties.Michelangelo was at work on The Last Judg-ment", Rome's most famous painting, after 80.Others who made great contributions late in lifewere Benjamin Franklin during the Americanrevolutionary period, and more recently in thefield -of science, George Washington Carver andThomas A. Edison.

A list of political powers in our time adds tothe testimony of values in age. Churchill's wholeplace of historical greatness was earned after 65.To his name must be added De Gaulle, whoseeleven years'of rule in France ended at 78;'ChiahgKai-Sbek who still prevails at 84; Adenauer, whostepped down as head of Germany's governmentat 87.

In our-ownUnited States Senate, Senator AllenEllender, Chairman of the Appropriations Com-mittee, was 81 in September and he'S still goingstrong! Senator _Strom ThurMond, incidentally,married his beauty- queen bride two years agowhen-he was 66 years_ young.

Other 'famous persons offer _similar- 'stories ofvigor and: -Vitality- in age. The peerless;, pianist,Art& kubinitein; still- enthralls- atidieheeS in theconcert ha_ ll-,today at 82. Picasso ,reigns -over -theworld Of art- at 90. The recently deceased "RubeGoldberg -retired from creating cartoons only topursue a Seeond- career of distinction as a serioussculptor at a level Which may bring _him evenmore laSting fame. Nor should-we fail to mentiona member of this Conference's planning' beard,Mr. Edward K. Ellington. Now 72; it seems thatthe incomparable Duke just on and on bring-ing joy and happiness to millionsof peoplethroughout the world by hiS great music.

Clinton Rickard, a lifetime Grand Presidentof the Indian Defense Leagne, Of America, wasstill chief,,of the Tuscarora nation when he dieda few weeks ago at the age of 89. He workedmany years building understanding and com-munication between people, on both sides, of theCanadian-United States-border. When he died, hewas taping and recording the Tuscarora languageso his people would retain this part of their heri-tage.

A. Philip Randolph, past 80, is the elderstatesman of Negro labor leaders. At 74, he wasone of the organizers and leaders of the famous1963 March on Washington.

Many of our distinguished elders have beenfamous throughout their lives. But for others,such as Grandma Moses, fame comes only forwork they have done late in life. Incidentally, if

99

you wonder why the only woman I mention isGrandma Moses, it is out of deference to the eter-nal-right of the ladies to "keep their ages to theM-selves. When-Grandma Moses passed her centurymark; of course, different, rules applied.

Nor is fame. really important. Thousands,hundreds of thousands, of older Americans in the +4

quiet pursuit of their daily lives demonstrate that"Age is opportunity no less:"

The dream we have for all older Americans issuch a dream Of opportunity=one- in which, asLongfellow says, "the sky is filted With-stars."

The_ record .shoWS -What:older persons CAN doif ,given, a -chance. isnt, as you ,know; for manyolder- Americans. there rio opportunity:

You do -not: have to _be reminded that too oftenincom opportunities for older_ persons; are-_totallyinadequate.

You do not have to be reminded of the short-comings in our health services for the elderly.

You do not have to be told that jobs are fore-closed- becausebecause of age . . ..and doors are shut onvigorous, capable, willing older Americans whoi

Want to ,participate in family, community -arid'national life:

Too often society says, indeed even the familytoo often says, "You old folks are through. Youhave had- your day. You belong on the shelf."

Over 20 million older Americans know this tobe a great lie. They know that they have capaci-ties, appetites, and-a zest for, living which a decentnational conscience insists musi i.:e met.

It is time you and I, and all citizens of ourNation, face up to our responsibilities in seeingthat these legitimate demands are met. Govern-ment alone cannot do the job.

Together, we must do everything necessary tosee that this 20th Century age of opportunity inwhich we live offers full opportunity in age.

This is what the work of the Senate SpecialCommittee on Aging is all about.

This is what this White House Conference onAging is all about.

You have labored long and strenuously toward.this grand objective. You have worked in thecommunities, in State conferences, and now arenearing completion of your immediate efforts atthis Conference in the Nation's Capital.

I have confidence that your labor will makegreat contributions to the new era of aging, whichscientific and social progress in this century hasopened to millions of Americans.

I trust that your section reports, will empha-size, in their _several- ways, :that:thit age of oppor-.tunity niust offe full opportunity olderple=- full opportunity in age.

Opportunity .for decent incomes; opportunityfor necessary health services; opportunity for ade-quate housing; opportunity for satisfying, readilyaccessible recreation in leisure hours; Opportunityfor mobilityand no one doubts the iinpottanceof better transportation to eliminate isolation andloneliness; opportunity' for learningso that allwho wish may expand their own personal hori-zons; opportunity for second that can Meanso much; opportunity for social interchange, forenriched participation in community activities,for involvement in life's mainstream.

Just give our millions of older Americans theirfull measure of opportunity and, with their wealthof experience, know-how, and talent, watch themrise to new heights of achievement, success andservice!-

How to open the doors of opportunitythisis the question with which you are grappling.

At this time, I would not presume to spell outmy own specific ideas. Instead, I await with deepinterest your recommendations, and with them nodoubt I shall modify at least some of my proposalsin behalf of older Americans.

In the meantime, let us pledge to work togetherand persevere together to the goals we hold dear.

Only so, can we be sure that for all olderAmericans, "Age,is opportunity no less than youthitself, though in another dress."

The lives of all older Americans should besuch that "The sky is filled with stars."

Thank you, my friends, and aloha.

The Honorable Frank CburcbSenate Special. Committee on Aging

Soine of you here today may remember whatJohn F. Fogarty said just before the 1961 WhiteHouse Conference:

Even though it was his legislation that calledfor the "Conference, CongteiSman Fogarty. wasworried.

What good would the Conference be, he asked,if it resulted in little more than an increase inthe output of words?

Well, you already are inundated with words.I understand many of you have just come from16 different Special Concerns Sessions wherefor four hoursyou tackled problems as variedas long-term care, the elderly blind, minoritygroup needs, and consumer interests.

I have more words for you, but only 15 minutesworth. The planners of this particular part of theConference must have sensed that this would bea good dme for a short talk.

And this is good because it encourages me toline up my thoughts and to choose those key factsthat may fit in here just before you write yourrecommendations.

What, then, is my major message today? Ithink it can be summed up very readily.

To put it bluntly, I think we are falling behindnot advancing at allin our national effort toassure genuine security and fulfillment in retire-ment.

100

That may be a shocking statement, but it is

based u;-- a hard facts of today and foreseeablefacts of the future.

My first hard fact is that the Congress has hadto fight Pill year to prevent a retreat in key areasrelated to aging. When the Administration sub-mitted a budget request for the Older AmericansAct that was actually lower than for the previousyear, members of the 'COmmittee on Aging-7Republicans and Democrati aliketook up thefight, restored' the proposed cuts, and actually in-creased the appropriation to almost 45 milliondollars.'

Lest you-think- that I regaid that sum as lushlargesse,--however, let me remind you that itielessthan hallas much as:we'll Contribute year tothe Gieek Army. It is a. gfeit deaFleat,than:juitthe flight dedt -Of that billion dollir -aircraft -Cat-rier the-Pentagon isttalkitigabout. _

Once the budget for the AoA had been settled,my COnitnittee and Tom Eagleton's ,Subcornniitteton Aging,. conducted hearings on the conduct ofthis White House ConferenCe. I'M happy to reportthat hearings do have an effect: just a few daysbefore the first one, Arthur Fleinming was ap-pointed fulltime chairman of this Conference, andlater Secretary Richardson reversed his policy onabandonment of motethan 20 nutrition programs.But the biggest dividend of those hearings wasgood, honest analysis of the impossible positionof the AoA as it now stands. I appointed an Ad-visory Council to make proposals for improvingthe AoA or replacing it, when the present lawexpires.

Congress and the Administration have hadother disagreements on aging in the last year orso.

On Capitol Hill, for example, many of usagree on the need for a, cost-of-living adjustmentmechanism for Social Security, but we can't seewhy the Administration has been.willing to settle

1 1971 FY Funding; $32 million; for FY 1972 initialAdministration, request $29.5 million, amended to $39.5millicn; final FY 1972 appropriation $44.75 million.

Note to footnote. Two days after Senator Church deliveredhis speech, the Senate added an additional $55 million supple.mental to bring the final FY 1972 budget to $100 million.

for such a low base on which to build the esca-lator.

. 'My own personal goal is to end povery amongolder- Americans. And I have sponsored a pro--posal calling for the use of the 'Social Securitysystem as the elevator for lifting nearly five mil-lion elderly persont-out of poverty. No old-age re-tirement-is worthy of the name, which leavesfullY a fourth of the elderly on incomes below thegOyernment's owpoverty line!

I've described_ just a few conflicts between.Congress _and the ExeCutiVe Branchnot in thename of partisanship-7butto help explain -why. Ithink our present _national- effort is lagging. Ibelieve that the :tecontrecent' AdminiStra-tiOns-7-deSPite Medicare and -the Older 'Americans

_Act--,:faileds. to go -far enough and must -shtietheir; part of the responsibility for -today's inade-quaciei. The time 4.ripe, for coalition action 'bymembers of both .partiti dlitingithelO's. On thatpoint, I. might refer you to-the minority views ex-pressed in our latest pre-White House Conferencereport and in our most recent annual report. Onall-key pointi, as .tenatbaong has told you, thereis fundamental agreement on goals. When itcornet to aging, there is really no room- for°a"game:plan" based upon shortrange political. tac-tics Seeking' narrow partisan advantage.

It's already !nuch too late to play games, or tostall, or to explain why this or that hasn't beendoneor cantcantt'be done--,--for older Americans to-day and tomorrow.

I mentioned hard facts before. Let me give youmore now

101

Our Nation, in the Older Americans Act of1965, said that one of its goals was an adequateincome for the elderly. And yet in the past twoyears, 100,000 more elderly persons -throughoutthis land slipped below the poverty level. Oneout of four potions past age 65 is poor.

Our Nation, in the Housing Act of 1968, madeproud statements about good shelter for all Amer-icans within a very few years. And yet, as far asthe elderly are concerned, there is ample reasonto fear that we are falling behind. The 'Commit-

tee estimates that 6 million older. Americans Jivein unsatisfactory quarters. Only about 350,000Federally-supported units have been built in thelast 10 years. How do we catch up? And what dowe do about property tax increases that are driv-ing many elderly honieowners to despair?

Our Nation, in the Employment Act of 1946,declared that it would no longer tolerate wide-spread joblessness. And yet today, at this verymoment, among the millions of Americans nowwithout work are 1 million ,persons past age 45;the so-called "older workers." Their unemploy-ment will be far longer than for younger persons.Their pension benefits and Social Security' of thefuture will be far less than might have been: TheComMittee tayi .that a- new :generation of elderlypootmay-be in the making. What do we do aboutthem?

Our Nation, in passing Medicare, pledged itselfto adequate medical treatment for the elderly.And yet, within the past two years, Medicare iscosting more and providing less. Cost control isone thing, but widespread abandonmbnt of re-sponsibility is another. Here again, we are losingground.

As fOr transportation, in rural and urbanAmerica alike, it is becoming harder, instead ofeasier, to get from one place to another:

Consider the trend. It is backward, not forward.And if our overall national effort is beingswamped by the needs of today, consider what isin store for us in the years ahead.

Between now and the turn of the centuryjust 29 years awaybetween 45 and 50 millionof today's middle-aged persons will enter the 65years-and-up age bracket. Think of that: tens ofmillions of persons entering a retirement way oflife which is already strained for most and bitterfor many.

Will today's failures be deepened, or will thepressures of sheer numbers and sheer need finallyforce adequate response?

I think you know my answer to that question.Despair never solved anything. Game plans, if

they merely stall action, add only deception to-despair. But when it comes to. aging, I_ think wehave passed befond, either deception or despair., z,

.I mentioned before "that" I: believe that coali-

tions for action are essential during the 1970's.

What I mean is that Republicans and Demo-crats alike should, use the momentum of an elec-tion. year to make certain that the recomnienda-dons of this Conference are implemented-in theearly part of the 1970's.

What I mean, too, is that we should be un-afraid to question even: our most .self-satisfiedassumptions, ranging fak---beyond the fielcts- of the

-aging; far beyond even' such questions as new-directions for Social Security, new- ways,of provia-,ing and paying for health care, and other- suchvital policy matters.

What I mean, fundamentally, is that this Na-don is ready to question and discard many sacredcows that have already lived too long.

We have questioned a foolish, futile war, andthough its termination is slow, it is now inevit-able.

102

A few weeks ago, . the Senate questionedwhether foreign aid is really serving our Nationand others in the ways that it should, and we havegone back to the drawing -boards in march ofneeded change.

'We are questioning our attitudes toward racialminorities and we are finding much to questionin our use of our land, our water, and our air.

Now we must ask questions about the veryhealth of our Nation and the well-being of. eachand every citizen of our laid.

Our treaunen: of the elderly certainly tells us .

whether we are sound or sick as a Nation. if. we--0are indifferent toward the last years of life, wediminish the dreams of all, our people.

So let us respond to the dynamics of this Con:ference and to the needs,opes, and just demandsof those who built this country; her senior citizens.

Luncheon Prograin

for Sections on

TRAININGEDUCATIONHOUSING--PLANNING

Sheraton Park Hotel.

Monday, November 29

Presiding: MRS: CERNORIA JOHNSON

Invocation: THE REVEREND KIRK M. DEWEY

SPeakeri: Senate Labor 'and 'PublicWelfare Committee

THE 'HONORABLEJACOB K jams

THE HONORABLETHOMAS F. EAGLETON

Tuesday, November 30

ML THOMAS E. FIELDER

Invocation: RABBI IRVING LEHRMAN

Speakers: THE HONORABLEELLIOT L RICHARDSON,Secretary of Health,Education, and Welfare

THE HONORABLEGEORGE ROMNEY,

Secretary of Housing andUrban Development

Wednesday, Dicember 1The Training, Education, Housing, and PlanningSections joined the Health, Income, Employmentand Retirement, and Nutrition 'Sections forLuncheon to hear Senators Frank Church andHiram L Fong. See pages 97 and 100 for theiraddresses.

46a- 1170 - 73 II

LUNCHEON ADDRESSES

Before the Training Education,Housing and Planning Sections

Midnday, November 291

The Honorable Jacob K. JavitsMember, U.S. Senate Labor andPublic Welfare Committee

There are now approximately 26 million people65 years of age and over in this country. A quarterof these. Americans live below the, poverty level;

.many do not become poor- untl they reach oldage. .

Because of this circumstance, the United Statesis rapidly appMaching a critical juncture in its ex-perience with provisions of income ,assurance tothe aged. Some of the accepted principles thatheretofore have governed the design of SocialSecurity and private pension programs are nowunder serious attack.

The underlying problemassuring adequateincome for the agedis notew; not is the UnitedStates alone in experiencing increased pressuresfor adopting more effective strategies to deal withthe issue. In recent years, Belgium, Canada, GreatBritain, Germany and Switzerlandto name afewhave, been compelled to reexamine the ade-quacy of 'their retirement systems. Still othercountriesnotably Francehave succeeded infashioning an elaborate and sophisticated integra-tion of public and private retirement systems soas to insure an adequate old-age income. for itsworkers.

Foreign models and proposals for change varywidely and reflect the specific historical, political,economic and social conditions of the countries in-volved.

It is natural and desirable for experts inence-in order to develop perspectives from whichto evaluate Social Security and private pension

103

1 Text of speech of Senator Thomas F. Eagleton was notavailable.

f"-

programs in the U.S. In the last analysis, however,the future direction of our "dual retirement sys-tem" will come from the unique complex of needsand interests of the American people. Therefore,primary attention must focus on our nationalconcerns.

Problems of Social Security

Since its inception, Social Security has beenconceived as furnishing a minimum floor of re-tirement protectiOn for almost. the entire workforce. Private initiatives, i.e., principally grouppension plans, have been cast in the role of pro-Viding a "supplement" to the retirement incomedelivered by Social SeCurity.

However, -the scope and level of benefits underSocial Seturity, Or What is meant by providing a"minimum floor of protection," has never beenfirmly decided. This deficiency -has -grown Moreacute as persistent inflationary preisures haveeroded the purchasing power of the retirementdollars provided by social security.

Most authorities agree that the wage-replace-ment ratio or social securitybetween 19 percentto 29 percentis very low. The median socialsecurity benefit paid in 196i to a retired couplethe latest year for which this data is availablewas $129 a month. $241 is the minimummonthly income required to sustain a retiredurban couple, as reported by the Bureau of LaborStatistics in January 1970.

Despite recent and proposed increases in SocialSecurity, and despite the likely enactment ofmeasures to guard against lois of social securitypurchasing power, the continuing inadequacy ofsocial security remains a stony fact. The evidenceto date strongly suggests that a concerted effortbe made to improve the Social Security benefitformula so that it will result in a higher and morerealistic wage-replacement ratio. -1

To accomplish this requires some meaningfulconsensus as to what the long-range floor protec-tion ought to be and to gear the system to pro-vide that level of protection. At the sine time,care must be taken to insure that private initia-

rives and responsibility for participating in secur-ing old-age financial security are not discouragedor diminished. This- would occur if we were toestablish a level of social securitybenefits whichwould cost so much that employers; unions andindividuals no longer perceived -the desirabilityor the feasibility of providing supplementary-pen-sion programs. The advantages of maintainingand encouraging private initiatives are too im-portant to sacrifice, and, it would not be in thebest interests of workers or our economy to im-pose such a sacrifice in order to obtain such ahigh deget of social security protection.

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Problems of Private Pensions

Because Social - Security benefit levels seldomhave been satisfactory,,priyate -pension programshaire grown to filLthe gapand they have en-joyed aspectaCular growth.

In 1950, private pension plans covered 9.8million workers, 22 percent of the 'work force; by1971, private plans covered in excess of 30 mil:lion workers, roughly 50 'percent of the workforce:

In 1950, pension plan assets totaled $12.1billion; in 1971, these assets exceeded $130 bil-lion, growing at the rate of $10 billion annuallyand expected to reach over 4200 billion by 1980.

Undeniably, these programs have become amajor factor in the economic life of this countryand in the minds of workers everywhere. Em-ployeesrealizing the inadequacy of Social Se-curityrely heavily, on their private pension planto provide the income necessary to maintain adecent standard Of living in their retirement years.

The spectacular growth of private pensionplans has been accompanied, however, by .equally-spectacular problems. At the center of these prob-lems is a cancerous phenomenon: The' averageemployee covered by a private pension planandI emphasize the word "average"cannot counton getting anything from that plan.

It is this absence of employee security in privatepension plans which has led me to advocate their

basic reform under law. If we are going to operateon the theory that our national interests are bestserved by a partnership between public and privateretirement programsand I strongly believe thisto be truethen we must see to it that the part-nership is an effective one for delivering adequateretirement income.

To accomplish this it is essential that the de-sign of private pension plans be reconciled withthe freedom of labor mobility which we as apeople value so highly and which=together withrapid economic and technological changenowconstitutes the most prominent feature of modemindustrial life.

The pension reform bill I have authored, S-2,now± pending before the Senate Labor Subcommit-tee, would make this reconciliation .a matter ofdeliberate national policy. It would protect em-ployees against loss oftheir pension. benefits whenthey lose or change their jobs, or when their em-ployer goes- out- of business or moves awayandit would establish a new S.E.C.-type commissionto supervise pension plans to insure that they areproperly managed in the workers' interests..

The importance of enacting this legislation can-not be emphasized enough. By assuring the aver-,age worker that he will get more than one pen-sion at his retirementone from Social Securityand one or more from private retirement pro-gramswe will have taken a major step forwardin securing the goal of adequate income to theaged.

Public interest in reform of private plans hasgrown steadily, and now it is an idea whose timehas come. In my judgment, 1972 will be the de-cisive yearthe year when the Congress willdecide whether private pension plans are to be afull-fledged and responsible partner in our dualretirement system, or whether they will remain,a spectacular but uncertain experiment, destinedfor ultimate obsolescence and replacement.

Conclusion

It is said we are, as a Nation, experiencing asickness of spiritan erosion of motivation-

particularly among the young, which has, as oneof its aspects, a loss of confidence in the ability ofour industrial system to develop adequate eco-nomic justice.

105

We must ask ourselves whyin the most afflu-ent country in the world; in the Mint advancedindustrial society, so lege a proportion of the agedmust suffer economically.

Could it be that we have shaped art industrialsystem so obsessed with productivity and techno-logical superiority, that when an individual's in-dustrial life -is exhausted, our system' can imper-sonally discard- him!

4 think not, and I believe that our Social Se-curity and private pension programs are clearevidence of thisnation's moral- commitment toprovide for the economic well-being of the indi-vidual at the end of his productive years.

But also believe that to the extent our dualretitement system fails to provide the means fora decent standard of living in old age, it directlycontributes to the alienation and isolation of theaged from the mainstream of society, andequally importantreinforces the impressionamong active Workers, espeCially the young ones,that the end of a working career is almost equiva-lent to the end of life itself.

As long as this impression has currency, it willcontribute significantly to the erosion of workermotivation, because what is the point-of workinghard if at the end there is so little?

We must, therefore, give great priority tostrengthening and improving our public and pri-vate retirement programs so that they will providean adequate income to the elderlyand I believeit should and can be done along the lines I havesuggested:

Perhaps then we can state with convict:it:T.the famous lines from Robert Browning:

Grow old along with me! .

The best is yet to be,The last of life, for which the first was made.

Tuesday, November 30

The Honorable Elliot L RichardsonSecretary of Health, Education, and Welfare

The President, last July, declared that stepswould be taken to improVe the deficiencies char-acteristic of many nursing homes. Re asked thatthe Department of nealth, Education, and Wel-fare take steps to this end.

Subsequently, a study was made by the Depart-ment of the skilled nursing ,home certificationprocess in 38 States under Medicaid. Since Medic -aid is a Federal grant-in-aid program, administeredby States in accordance With Federal regulations,State Medicaid agencies are responsible to theDepartment of Health, Education, and Welfarefor, making sure that State programs are in ac-cordance with all Federal regulations as well aswith State and local rules. .

A State can give the Department assurancethat this is so only if it demonstrates that homesare .inspected, that standards are enforced, andthat only homes that meet Federal, State, andlocal standards are "certified" to participate in theMedicaid program and receive Medicaid funds.

In all the 38 States surveyed, substantial Je-ficiencies were found in their nursing home cer-tification process. The deficiencies related to inter-agency agreements, certification procedures, andprovider agreements--deficiencies serious enoughto. requith significant iinprovements. Today, there-fore, I have notified the appropriate officials in all3g States and advised that they will have untilFebruary 1, 1972, to significantly improve theirMedicaid processes.

The States have also been informed that theDepartthent of Health, Education, and Welfarestands ready to assist them, in any way the Depart-ment can, in upgrading their procedures. If theStates fail to validate improvements by the Feb-

'The full text of Secretary Richardson's address is notavailable, but a summary of the major points of his addressate presented herewith.

106

ruary 1 target date, the Department intends toinitiate a noncompliance procedure that couldultimately result in withholding all FederalMedicaid funds from any or every one of the 38States.

Finally, all States and territories receivingFederal Medicaid funds have been given untilJuly 1, 1972, to inspect every participating skillednursing home to insure that such homes are in ,coinpliance or in substantial compliance- with theMedicaid certification procedure that the Statesmust have in place by- February 1, 1972. For anyStates, not in compliance by the July 1 date, theDepartment -of Health, Education, and Welfarewill have no choice but to initiate conformityhearings.

am- hopeful: that such- strong -Federal actionWillzbe- unnecessary. I believe-that no".e of the 38States face insurmountable difficulties in, meetingthe February target date. But let there be no mis-take about it, the President has said Federal fundswill no longer be used to subsidize nursing homesthat are little more than warehouses for theelderly . . . dumping grounds for the dying . . .

and I mean to enforce that Presidential directive.

The Honorable George RomneySecretary of Housing and Urban Development

All of us here have at least one thing in com-mon. We'll all be a day older tomorrow. Manyof us are already old enough to be called seniorcitizens. In fact, my 16 grandchildren alreadyhave reason to call me one. So you can under-stand I'm particularly honored to address theSecond White House Conference on Aging.

Now I'm acutely aware of the severe and variedhousing needs of many of our senior citizens.Many of these problems reflect the high incidenceof elderly poverty, which is nearly double thenational poverty rate. Poverty forces many elderlyto pay a disproportionate percentage of their in-come for housingleaving too little to supportother critical needs.

Given the relatively fixed nature of elderlyincomes, this problem has been.greatly aggravatedin recent years by the rapid rise in housing costs.For example, between. 1965 and 1970, the costof buying and maintaining a new home increasedby nearly 80 percent while the median income ofelderly Americans rose by about 40 percent.Property tax increases have been a major factorin this housing cost escalation; rising during thesame period an average of nearly 85 percent.

An equally serious problem involves the largenumber of elderly living in substandard housing.While this problem has improved significantlyduring the 1960's, it remains severe. For ex-ample, over, 1.6 million elderly Americans livein housing whith lacks basic plumbing facilities.

A third problem relates to the large, large num-ber of elderly wholive in deteriorating or isolatedurban and rural areas. The inaccesibility of serv-ices in these areas is particularly serious for thoseelderly who are limited in mobility because ofchronic health conditions or lack of money to payfor transportation.

Finally, as described by the President in hisAugust statement on nursing homes, the plight ofthe institutionalized elderly is particularly grave.Almost five percent of the elderlynearly onemillion people--live in expensive and often sub-standard long-term care institutions. This figurehas increased from under four percent in 1960.Many have been institutionalized prematurely.There's no question that better alternatives mustbe developed. Fortunately, a majority of elderlyAmericans are mobile, are healthy and are cap-able of a more meaningful role.

A great variety of elderly housing is needed.Many elderly citizens require housing that is spe-cially designed to promote safety, facilitate move-ment, and encourage socialization with people ofall age groups. Others, while requiring housingassistance, are well served by general-purposeunits. Some need congregate housing and inter-mediate- or even long-term care institutions.

The provision of shelter must be integratedwith the effective delivery of nutritional, health,

107

transportation, training and other essentit:". serv-ices. At the lame time, incomes must be at a satis-factory level and opportunities must exist foremployment, recreation and other forms of com-munity participation.

During the decade since the first White HouseConference on Aging some housing progress hasbeen made. Publid housing occupied by the elderlyincreased during that time from about 80,000 to32n,000 units-400 percent. Within that total,specially designed elderly` housing increased fom3,500 units to approximately 160,000 units. As aresult, by the end of 1970 almost 40 percent ofall pUblie housing units were occupied by elderlyfamilies and individuals.

Elderly occupancy -in our other housing assist:ance programs also increased rapidly. We estimatethat Well over one-third of all Other HUDAtbsi-dized housing units were occupied by the elderlyat the beginning of this year. And as one moreexample of progress, nursing home beds underthe SeCtion -232 program numbered only 1,330in 1961. That figure isinow 57,000 beds.

While the figures in this history of progress areimpressive, greater progress is essential.

As you may know, this Administration in-herited the Congressional decision to phase outthe Section 202 program under which nonprofitsponsors of rental housing for the, elderly re-ceived direct three percent Federal loans. TheSection 236 program, which subsidizes intereston mortgages to as low as one percent, was en-acted to replace the 202 program.

The 236 Program has four key advantagesover 202higher rtoduction levels, lower rentlevels, more varied sponsorship, and greaterdiversity of tenant age and income. A more de-tailed description of the last three advantages iscontained in your HUD fact sheet. Let me com-ment on the firsthigher production levels.

Out of a 35,000 unit Section 202 pipeline ofpending applications and proposals, HUD hasapproved, under Section 236, projects including

over 33,000 unitsa funding rate four timesgreater than that achieved under Section 202. Inthree fiscal years--1970 to 1972HUD willfund under Section 236 more specially-designeddwellings for older Americans than were fundedduring the entire ten-year history of the 202 pro-gram

During this fiscal year we will allocate $35millionover 17 percent of our entire Section236 authorityto hoe 3 for the elderly. Thatwill permit between 41,000 and 44,000 units tobe approved=almost as many as the total numberof units approved during the entire ten-year his-tory of the 202 program. And to make the pri--gram more effective, our Department-is presentlypreparing a separate circular for Section 236elderly housing.

Nonprofit sponsors did an excellent job withinthe 202 program. We want to help them do thesame with Section 236. Two - thirds of all pendingapplications to build housing for the elderly underSection 236 have been submitted by non-profitsponsors.

Many of these sponsors need both technicaland financial assistance to get projects started andcompleted. A specific HUD program is directlygeared to assist themSection 106 (b) . It pro-vides interest-free loans to get projects from thedrawing board construction. At times repaymentof these loans is waived when the sponsor runs-into financial straits. We have already approvedloans of $5 million during the first three yearsof operation. Last year they were $2.7 million.This fiscal, year we expect such loans to be over$7 million.

Today I am announcing the beginning of anew program that should be of great assistance tononprofit sponsors. Authorized by Section 106(a)of the National Housing Act, this is a $1 milliongrant program. And under it HUD will contractWith experienced public and private non-profitorganizations to provide a variety of technical as-sistance and information to inexperienced non-profit sponsors of low- and moderate-income hous-ing.

Public Housing and Rent Supplement pro-

108

grams are also extremely important for the largenumber of elderly who are poor or near poor.For this reason, our Department has set a targetlevel of one-third of ell fiscal year 1972 publichousing contract authority' to be used for speciallydesigned housing kit the aged.

Now, the high levels of subsidized elderly hous-ing production reflect the success, we have had instimulating volume production of total subsidizedhousing. During fikal year 1971 the volume ofHUD-subsidized homing starts reached about400,000 units. We expect that total to reachover 500,000 units this year. This contrasts witha volume of about 150,000 subsidized housing.starts in- FY 1969.

HUD activity has also stimulated total housingproduction. We expect at least 2.5 million units incalendar year 1971.-----971an all-time record.

At the same time,-other HUD programs assistthe elderly. nearly 80 percent of reporting ModelCities were wing supplemental Model Citiesfunds for elderly programs. An additional- fivepercent are currently planning such programs.The number and scope of these programs willundoubtedly increaseduring FY 1972especiallyunder the continued funding of the HUD /HEWcontract with the National Council on Aging,which specifically encourages such programs.

Nursing homes under our Section 232 pro-gram will increase by an estimated 11 percentduring FY 1972 to an annual- production figureof 14,500 beds. The-HUD nursing home programrecently amended to cover intermediate-carefacilitieshas been responsible for significantrecent improvements in nursing home standards.

Congregate housing can also play a more im=portant role. Because many elderly persons withadequate nutritional and other supportive servicescould avoid expensive and often premature place-ment in institutions, we are planning to issue newcongregate regulations for both our public hous-ing and Section 236 programs within the verynear future.

Now, more research related to the elderly is

a.

needed in HUD program areas. Topics presentlythe subject of HUD - sponsored research relate tocauses of home accidents, use of home equity forannuities, architectural barriers, and two elderlyhousing program studies being conducted by theUrbar Institute. Because we need a higher level ofelderly-related research, we solicit meaningfulproposals. Please send them to Harold Finger, As-sistant Secretary for Research and Technology.

The public and consumers require regular 'in-formation about elderly housing needs and pro-grams. The statistical handbook we provided youis such an effort.

I understand you also have copies of our 1-qr-chure describing all HUD programs for , theelderly, "A Guide to Elderly Housing"; : descrip-tion ofour filmstrip on housing for the elderly,"A Stranger Just Once"; and a copy of the No-vember "Housing for the Elderly" edition ofChallenge magazine.

Now, let me turn directly to the problems fac-ing elderly homeownersa group representingnearly 70 percent of all elderly. Over 80 pt tentof their homes are owned mortgage free. Butmany of these owners are "house poor," becauseproperty taxes and other housing costs are gener-ally rising faster than incomes. Moreover, manyof these homes were built for younger and largerfamilies and as a result, they imposc: severefinancial and maintenance problem for the elderlyhomeowner. Many older people would like tomove out- of these homes into new, smaller, moreappropriately designed units, but rising costsoften lock them into their present quarters.

HUD has a homeownership programSection235that can be used to redixe intermit paymentson new homes to as low as one percent. Up tonow, elderly participation in this subsidized hous-ing program has been, minimal. But 'our Depart-ment is presently considering administrativechanges that would enable Section 235 to pro-vide elderly with the option ry move into newunits. In some cases, participati' . by local housingauthorities may be necessary to facilitate the saleof elderly-owned homes and to enable larger low-income families to afford .these vacated units.

109

We also recognize the importance of assistingthe elderly who wish to continue living in theirown homes. Property tax increases are a majorproblem. The President's General and SpecialRevenue Sharing Recommendations will signifi-cantly retard property tax increases and thusgreatly aid the elderly homeowner and renter.

Other activities of this Administration alsobenefit the elderly. The Cost of Living Councilowes its very existence to the Administration'sattempts to curtail the spiraling inflation that haspinched the pocketbooks of all Americans, buthas had even a more severe effect on those withfixed- incomes such as-the elderly.

In our own Department, Operation Break-through attacks the general problem of risinghousing costs by developing ways to breakthrough the specific barriers to volume housingproduction and marketing, such as outdated build-ing codes and zoning laws, antiquated methods,outmoded materials and high labor costs. Also thePresident's proposals for broad welfair reformand increased social security benefits would helpelderly homeowners.

Government programs are important, but I be-lieve we must rely heavily upon private programs.Dr. Arthur S. Flemming's proposal for increasedvoluntary action to provide services to the elderlyis an excellent example of what we need.

Self-help is vital. The search by older personsfor new meaning, new jobs and roles is essentialto their living independently and happily.

Finally, I believe the younger generations mustreassess their obligations to older parents and rela-tives, rather than leaving most problems of . theelderly for the government or private third-partysolution. At no time in history has the cominggeneration been in greater deed of the wisdomand affection of their living forbears. I hope thisConference will identify ways in which your ex-perience and empathy can be more fully em-ployed in saving the nation from the consequencesof indifference to those who made the very exis-tence of coming generations possible.

Thank you very much.

Luncheon Programfor Sections on

TRANSPORTATION

GOVERNMENTNON-GOVERNMENT

ORGANIZATIONFACILITIES, PROGRAMS

AND SERVICESShoreham Hotel

Monday, November 29Presiding: DR: INABEL LINDSAY

ifiVOCatiOn: REVEREND ANTHONY ROCHA

Speakers: -House Interstate andForeign Commerce Committee

THE HONORABLEWILLIAM L SPRINGER

THE HONORABLE

PAUL ROGERS

Tuesday, November 30Presiding: MR. FRELL OWL

Invocation: MRS. FRED WEISER

Speakers: THE HONORABLEJOHN A. VOLPESecretary of TransportationTHE HONORABLEVIRGINIA H. KNAUERSpecial Assistant to thePresident for Consumer Affairs

Wednesday, December 1Presiding: MRS. GRACE HOWARD

Invocation: LIEUTENANT COLONELOLAF D. LINDGREN

Speakers: House GovernmentOperations Committee

THE HONORABLEWILLIAM J. RANDALL

THE HONORABLEOGDEN R. REID

110

LUNCHEON ADDRESSES

Before the Transportation, Government andNon-government Organization, and Facilities,

Programs, and Services Sections

November 29

The Honorable William L. SpringerMember, House Interstate andForeign Commerce Committee

Knowing that this group has given much timeeffort and knowledge to the study and deep con-sideration of the aging process, I shall- not presumeto inform you on the iisueSwhich are to be faced.Although I have given a great deal -of attentionto this field in the last few years, I know thatmany of you might call me a Johnny-come-latelyto the effortand in comparison with your dedi-cation you would undoubtedly be justified.

Since my attention has been turned to thesubject, I have found, as I know you have, thatthe most dangerous thing to do with any 'broadsocially oriented subject is to generalize toogreatly and to categorize. There is a tendency incertain parts of our society to picture the elderlyin our population in a stereotyped way which isneither accurate nor fair. The picture brings tomind an aged man sitting dejectedly on the frontporch of a board shack, staring vacantly intospace while leaning on a homemade cane. Thestereotype conveys the idea that all of the aged arebeyond recall and redemption mentally andphysically and that the only question which shouldconcern society is when to institutionalize them.Unfortunately, some of this false picture is fos-tered by well-meaning people who only mean tofocus attention upon the most pressing of theproblems in the field.

Certainly not all of those 20 million folks over65 are poor. Many have sufficient means to meettheir needs and more besides. It would be sur-prising, however, if any large number can roamthe world at their whim and winter on theRiviera. What percentage of the people at theheight of their productive years can do so? Thestatistics with which we are all familiar indicate

that about five million of that twenty are actuallybelow the recognized poverty line. What hurtsis that many of these are in such straits becauseof circumstances which overtook them and notlack of foresight or a life history of poverty. Butapparently only one percent of the group findthemselves limited to social security for income.

Fortunately for the individuals involved andfor our beleagured health delivery system not allof them are sick. Most suffer from some kind ofchronic condition. But many of these ills are suchthat activity 'need not cease or even that enjoy-ment of activity be impaired.

I know that much attention is given to theproblems attendant upon helping the aged whofind themselves in the heart of a fast moving,changing metropolitan area. They do have specialproblems. And I would have thought a few yearsago that growing old in a small, closely knitcommunity with long time friends would be ideal.Now I know that advanced age in a decaying areaor in a spread out rural area can be most difficultwhen the time comes that old cronies cannot drivearound to see each other and public transportationis apt to be non-existent.

I suppose what I am trying to say is that I nowrecognize, and people like you recognize, that theproblems of the aged and aging are as diverse asthose which afflict all of society. They cannot betagged and thrown in a bin with the proper signo:. it. They cannot be solved solely by a few legalor administrative devices. Neither should they beleft to fester while we wait until we know every-thing there is to know about the matter. Thatmay be never. Like all such things, developmentsseem to keep striding ahead of solutions.

It was with these things in mind that I spon-sored a bill to create a National Institute ofGerontology. At the same time I introduced abill to promote an intensive five year program ofbiological research on aging. The first of thesebills was assigned to the Committee on Interstateand Foreign Commerce on which I serve and thesecond one went to the Committee on Educationand Labor. Our committee has not as yet heldhearings on the Institute for Gerontology bill forreasons which I will discuss in a moment, but asimilar bill in the Senate was the subject of three

days of hearings last June. It is my hope that thecommittee calendar will allow us to get to my billearly in the next session. I am particularly anxiousfor this to be done because I will not be returningto Congress after next year. I would like veryMuch to see the Institute provided for and set upbefore I leave.

Recognizing that health is only a piece of thepuzzle, we can easily see that the most immediate

problems and the greatest tragedy are to be foundhere. Whether or not money is a problem, manyolder persons need extensive health care whichmay not be available to the individual for variousreasons or. may not be available in the communityat all

Which brings me to the reason, or at least areason, why the Subcommittee on Public Healthand Environment has not been able to move onthe Institute for Gerontology bill this session.Lack of health manpower and the uneven distri-bution of that manpower affects every citizenwhatever his age. The renewal of the MedicalEducation Act, now called the Health ManpowerAct; and the Nurse Training Act were of par-amount importance in this first session .of the92nd Congress. This legislation, which carries aprice tag of well over 3 billion dollars for the nextthree year period, 400 million in 1972, 500 in1973, 600'in 1974, is designed to step up evenfurther the development of medical and otherhealth professional Schools and the capacity ofthose schools. Since the first act of this kind, therehas been a provision which requires increases inenrollment if schools are to qualify for funds.Extra funds are provided if larger increases canbe accomplished. In addition to the so-calledcapitation grants, the act includes special projectMoney, start-up money for new schools, initiativegrants for better curricula and some reserve moneyto help those medical schools which meet financialreverses. Student loans and scholarships have beenliberalized to attract students who are more likelyto practice in the shortage areas and forgivenessfeatures were expanded to encourage the samething. Family practice is encouraged and assistedin every way possible. All of this applies in mostrespects the same for nursing students. Whateverresults from the Health Manpower Act, and wecertainly hope it will significantly affect the supply

111

and distribution of health professionals, is boundto favorably affect the health problems of theaged.

Another bill which as received attention bythe committee is the bill to beef up the fightagainst cancer. At present the measure has passedboth houses and must be hammered out in con-ference. This will start on Wednesday. Stream-lining the organization to attack cancer, with theexpressed interest of the President and a simplifiedbudgeting process, is bound to pay off in researchbenefits and accelerated time schedules. Extrasums of money are already pumped into the effortand more will come. Since cancer is in fact amajor cause of illness among older citizens and isalso the source of widespread worry and dread inthe same group, the priority given -to this legis-latiod is fully justified from any angle.

Now I know that many of you are interestedin other aspects of this subject and would like toknow something about activities of the CommerceCommittee in fields other than health. That wouldbring us around to transportation which is oneof the major items included within our jurisdic-tion. As peculiar as it may seem to those notentirely familiar with the system, our committeedoes not handle legislation which covers urbanmass transit. That subject falls within the purviewof the ComMittee on Banking and Currency be-cause of its connection with housing.

There are a few bills all basically the same inour committee which would provide half or par-tial fares for senior citizens. Nothing has hap-pened to these as yet. This may be because of thepreoccupation with attempting to save the rail-roads and salvaging the remnants of the passengerservice. It has had to wait also for several actionsby Congress to avert nationwide railroad strikes.No doubt other emergency matters could be citedas reason for no actionbut for whatever cause,no action has occurred. I think I can assure youthat these bills will receive a high priority, in 1972and I think we can move them.

Without trying to make policy for anothercommittee, but only to explain my own view, Iwould like to point out that the matter of partialor reduced fares in urban transportation systems

112

seems more pertinent than for interstate or inter-national travel. The ability to get around thecommunity would seem to me to .be more im-portant to large numbers of older citizens thanthe possibility of traveling around the country.And, of course, the whole subject of special faresis a touchy one which has been bothering theCivil Aeronautics Board and the Interstati Com-merce Commission for quite awhile. As long astransportation units have excess capacity, as atpresent, it can be argued that it is sensible to usethe space at reduced fares for some return to thecarrier. Older citizens who are healthy and finan-cially secure should need no subsidy, unless it isto be our policy to keep us old folks moving, likePhilip Nolan or the Flying Dutchman. But thetruly needy need this. nowreduced fares is oneof the things the marginal elderly desire most. Inthe next 'session there will be some respite fromemergencies and a chance to consider some meas-ures of this type. Certainly these are of enoughimportance to justify committee consideration.We realize old people need this relief.

Other kinds of legislation affecting the agedespecially are not apt to reach our committee.Many of the other things we deal with will havea far-reaching affect on them however. There are,for example, the consumer bills which touch uponwarranties and product safety. Packaging, labelingand control of hazardous substances have beenthe subject of legislation and are being furtherconsidered. Communications, particularly televi-sion and cable television, have great implicationsfor older citizens. Proposals on these and manymore will be hammered out and in the course ofcreating such legislation the special problems andspecial needs of our increasing older populationwill be taken into account.

The work of this conference, the informationobtained, the thought, discussion and recommen-dations worked out here will be invaluable toCongress as it considers present, and future legis-lation directly and indirectly touching upon theaged. We hope that in addition to forwardingyour recommendations on the elderly to the Presi-dent you will let us in the Congress also havethem as well. If any legislation is needed, it willhave to start with the Congresswith us whoenact the law in the first instance.

The Honorable Paul RogersCh;sirman, House Public Health and Environ-ment Committee; Member, House Interstateand Foreign Commerce Committee'

Every story, every statistic which has emanatedas a result of this Conference implies needs ofthe elderly as though this segment of our popula-tion is somehow separate from our society. Theimplication is that our elderly citizens have specialneeds and are some how divorced from. the. restof society.

But this is true of every age group. Education,by and large, is ' need and problem of the young.Just as employment is a need and problem forthose between youth and age 60. But we do notconsider these people on the outside. And- ourelderly should not be considered outside either.

We constantly speak of the needs of our elderlybut seldom speak of their contributions, abilityand potential for contributing to society, and thisis totally shortsighted.

The income problems of the elderly are notbeing properly considered and existing lawsshould be changed to be more -flexible and re-sponsive to the elderly.

It is almost un- American to tell a man orwoman who wants to work that he cannot do sobecause of the age of his birth. Yet the laws wenow have in fact prohibit a man from earning acertain amount or he is penalized. For millionsof our older citizens, this means a life of minimalexistence.

One of every four elderly citizens has an in-come below the poverty level.

I would hope that the President would tellyou at the close of this Conference that he in-tends to give the problems of the aging a nationalpriority.

I plan to introduce legislation in the very nearfuture to create a National Institute on Aging.

'The full text of Congressman Rogers address is not avail-able, but a summary of the major points of his address arepresented herewith.

This institute would bring the Nation's resourcestogether to find answers to many of the physicalproblems involved in the aging process.

November 30

The Honorable Jain A. VolpeSecretary of Transportation

I am delighted to be hereto participate andto pledge the continuing support and commitmentof my Department to the goals of this COnference.

Travel today is often a trying experience forthe young and able; as you are well aware, it canbe an ordeal for the aged or infirm. The agedmust be afforded the same opportunities as otherpersons to use public facilities and services, and totake part in the affairs of community life.

The Department of Transportation has beengiven the responsibility for improving transporta-tion methodology through research and demon-strations to improve mobility for all Americansand specifically the elderly of this country. Wegladly accept this as our role.

Yet the challenge is intensified by a numberof factorsnot the least of which is the fact thatone-half of the 20 million Americans over 65live at the near-poverty level. They have littlediscretionary income. In most cases the incomesof the elderly have not kept pace with the risingcosts of goods and services. 'What may have ap-peared 10 or 20 or 30 years ago to be a com-fortable retirement income could be hopelesslyinadequate today.

And I would be negligent if I did not note thatPresident Nixon's anti-inflation program is work-ing to relieve that situation. By exercising re-straint over wages and prices, the President'sprogram is especially helpful to those on fixedincomes, those who are frequently caught on theshort end of the wage-price cycle. At the sametime, we are working with all diligence to providean alternative to the expensive proposition ofowning and operating a car.

We want to make public transportation eco-nomically accessible to all. President Nixon,

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when he took office, directed that transportationbe improved for all the people of our land. Un-precedented legislation, providing for pro-gressive long-range developments in air, highway,railroad, and urban mass transportation, has beenenacted. We are on our way to a better brand,a better blend, and a better balance of transporta-tion services for all who travel.

Every plank in our broad platform of trans-portation reforms has provisions for the elderlyand the handicapped. We intend to overlooknothing that might make transportation morerespectful of our elders.

There are two approaches we are taking. Onthe one hand, we are conducting demonstrationprograms designed specifically with the transpor-tation needs of the elderly in view. At the sametime, we make certain that every transportationprogram we sponsor or support involves due con-sideration for the circumstances of the seniortraveler.

Section 16 of the Urban Mass TransportationAct, for example, requires that localities give spe-cial attention to the needs of the elderly and thehandicapped when planning and designing urbanmass transportation facilities and equipment.This means what it says. I have personally in-sisted that no grant be approved until the appli-cant shows that this stipulation has been met.There simply is no longer any place in this coun-try for transportation initiatives that fail to con-sider 20 million of our citizens.

A case in point is the new subwayor "Metro"system now under construction here in theWashington area. We insist that it be accessibleto alland that is why we worked with themetro planners to provide for the installation ofelevators to the train platforms, recognizing thatescalators alone would not suffice.

But let's look at the larger picture, of interestto all Americans.

I should like first to tell you what we havedone and then I shall discuss our program forthe future.

We have a number of demonstration projectsunderway or on tap that put the transportation

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needs of the elderly and the handicapped fore-most.

For example, in the lower Naugatuck Valleyin Connecticut, where 10 percent of the popula- .

tion is of retirement, age, our Urban Mass Trans-portation Administration (we call it "UMTA")is funding a unique transportation demonstration.Bus service to and from the community's healthand medical facilities will be furnished, on afixed-route basis, andexperimentallyon ademand-responsive basis as well. That means, thebus will make house calls even when the doctorcan't.

In Helena, Montana, where there is no publicbus system, UMTA had made a grant to the localtaxi company to provide reduced-rate service tosenior citizens on a "will call" basis.

One innovative program we have particularlyhigh hopes for is the "dial-a-ride" demonstrationproject to be tried in Haddonfield, New Jersey.The intent here is to operate a flexible, semi-automated system, enabling residents to dial fora bus when they need one. The buses have beenpurchaser, the equipment is being installed, andwe hope to be underway in February.

Any or all of these demonstration projectscould become the model for better door-to-doormunicipal transit systems to come.

As another example of transit developmentswith built-in "people saver" provisions, the newBay Area Rapid Transit System in San Franciscowhich opens this springwill feature elevatorsto transport passengers from street level to thetrain. The system will make extensive use ofloudspeakers and super-visible signs, and willhave special gates and fare-collection proceduresto ease the way for older passengers.

The "people-mover" demonstration project inMorgantown, West Virginia, is designed to meetthe needs of its passengers more than half way.There will be no more "waiting for the bus"another "people-mover" will be along in a mat-ter of minutes. Aisles will be spacious, doors wide,the cars clean and comfortable, and no trickysteps or high curbs to contend with.

While other new rail and subway systems arebeginning to sprout in cities across the country,

buses still promise to be the mainstay of publictransportation for some time to come.

Not bus systems as we have known them, butbus systems as they should be.

'Buses themselves. can stand improvement.UMTA's Office of Research, Development andDemonstrations is putting the finishing toucheson a new set of bus specifications that includelower bus floors; special doors, lower steps; infact, an experimental bus has been designed thatactually kneels down to the curb after it pulls upto the bus stop!

I might also mention that we are experimentingwith iv- low-emission engines, and even withsteam-powered and natural gas-powered buses,prototypes of which are now in operation, as ameans of cutting down on air pollution. Andthat's good news for everybody, young and oldalike.

While urban transit is often the most immedi-ate of the elderly's transportation needs, it is notthe only one. The aged have "long distance"travel problems, too.

The National Rail Passenger Act (Amtrak)was proposed by President Nixon and passed byCongress as a means of rescuing and revitalizingpassenger rail service in the U.S. I know thatmany older people prefer to travel by train. Am-trak is trying to enlarge that frame of preferenceby making rail travel more attractive to morepeople. It is a difficult job, but I am confident thetrainespecially on routes up to 400 milescanbe restored as a popular and viable form of inter-city transportation.

For those able and willing to travel by air, themost difficult obstacles are the terminals and thetrip to and from them. But help is on the way.Air terminals today are being designed to mini-mize walking, baggage handling, and passengerprocessingand airport access plays a vital partin all airport planning.

On the highways, we have launched a nation-wide program of driver control which, :amongother things, is intended to help our elder citi-zens cultivate better driving and pedestrianhabits. We are deeply concerned that while the

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elderly comprise about 10 percent of the popu-lation, they account for 28 percent of pedestrianfatalities.

I think it's important to point out that while wehope to make elderly pedestrians more safetyconscious, we are working equally hard to makeall drivers more aware of Their responsibilitiesbehind the wheel.

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Also regarding highway transportation we arewell aware that our highway responsibilities in-clude housing relocation. While some forms ofrelocation assistance have long been available,theyon occasionhave been impersonal and in-considerate. .It has long been my policyand theCongress has now approved it as a national polkythat suitable replacement housing must be pro-vided before any resident's life is disrupted by ahighway project.

It doesn't make any sense to kick someone outin the street just to build another street! And infar too many cases the people being displacedwere elderly peoplefor whom the disruptionwas particularly harsh. The way the policy readsnow, no Federally-financed construction projectgets our approval unless and until adequate re-placement housing is found, or if need be, built.Period.

There is another area of vital concern to theelderly. I touched upon it a moment ago whilementioning fixed incomes, and the like. We recog-nize full well that the cost of public transporta-tion is crucial, and we are inspecting very care-fully the possibility of government supported re-duced fares for the elderly. Already, in a numberof cities, experimental programs are underway foroff-peak hours on bus and subway lines. But howabout reduced fares on trains? And on planes andon other modes? We are watching all the experi-ments closely, and if such an approach is foundto be sensible and produces measurable results,government at .all levels should be ready totackle the problem on a nationwide basis. This iscertainly an area worthy of full attention; it notonly answers a need, it also gives local communi-ties and the states an opportunity to help the Fed-eral government provide answers to that need.

Our sensitivities to the needs of the elderly are

by no means confined to the few programs I havementioned here today. We are exploring a greathost of possibilities, including such things as theuse of school buses during off-hours, in an effortto bring the means of mobility to more of theelderly.

We don't question the suitability of schoolbuses for trips to concerts, parks, ball games, medi-cal facilities, shopping excursions, sightseeingtrips, or what-have-you. Indeed, a perliminarystudy being funded by our Federal Highway Ad-ministration is even looking toward the possibleuse of off:duty mail trucks!

I will be realistic, however, and point out atleast one problem communities are having withthe use of such vehicles. The matter of liabilitycoverage for public as well as privately-ownedschool buses used to transport the elderly seems,to many communities, to be an insurmountableproblem. In this regard, we are now working ona program that will provide liability coveragefor those school districts and private companiesthat want to participate.

We feel that this is certainly a worthwhilefunction of a government that cares about itssenior citizens. Nothing is insurmountable whenyou really want to do it.

We are committed to all the research it takesand to whatever programs will do the job best. Iassure you we welcome and solicit your sugges-tions and recommendations.

Our motives are not entirely free of self-interest.Old age is not something that happens only to thefew or the unfortunate.. The good Lord willing,we shall all come to know the rewards as wellas the trials of old age.

By 1985, the over-65 population in our coun-try will number 25 million; 30 million before theyear 2000. We would be foolish to deprive ourNation of the great contributions which ourelderly- citizens, by -virtue of their maturity andexperience, can make to our society and to theworld. Yet, without adequate transportation, thosecontributions could be severely curtailed.

We cannot arrest the flight of time. But we

can make the journey as comfortable and as ful-filling and' as fruitful as possible. For transporta-tion to be a good and faithful servant, it must be

.the servant to all.

Thank you for inviting me to be with ,youtoday.

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The Honorable Virginia I-L KnauerSpecial Assistant' to thePresident for -Consumer Affairs

We owe our elderly, our senior citizens, much.They fought in World War I, in World Warthey gave their sons' to wars. They raised us, theyfed us,. they: clothed; us, they sent us- to school,they packed our, lunches. They lived through thedepression, and after they suffered through thewars, they struggled to give us a better life, abetter government, a better educational system, abetter marketplace,' a better world. They did allthis. Yes, they made mistakes, and they had faults,but they gave, and they gave much, and we owethem much. They are our parent's, and one daysoon we shall all stand in their shoes.

We cannot .look away from their special prob-lems and we should not look away, and that iswhy this White House Conference on the Agingis so important: Through this Conference, we canshow America the problems of the elderly. Wecan show Atherica what should be done and whathad to be done; and by arousing the combinedefforts of government, of business, and of theprivate sector, we can act, and act wisely.

We know that a major problem of the elderlyis economic. In 1970, half of the 7.2 millionfamilies with heads 65 years or older had in-comes of less than $5,053. Almost a quarter ofthe older families had incomes of less than $3,000.

Of 5.8 million older persons living alone orwith non-relatives, half had incomes of less than$1,951. A third of unrelated individuals had in-comes of less than $1,500.

There has been some help;

Due to the increase in Social Security paymentsin 1970, the median income of families with

heads 65 or over rose 5.2 percent from 44,803in 1969 to $5,053 in 1970. But as ironic as itmay seem, the increase in Social Security benefitsin some States has led to the loss of other benefits.I am sure that those of you who read the WallStreet Journal story last Friday were dismayed atthe reports of senior citizens who tried to give theincrease back to the government, but couldn't. Wemust take steps to see that such inequities do notoccur again.

We have known the chilling effect of inflationon senior citizens and others on fixed incomes.Unchecked, unharnessed inflation hurts everyone,but especially those who can't look forward to araise in their wages.

And inflation has a marked effect on the pricesthe elderly have to pay for health care.

Just the other day, I received a letter from aretired gentleman in Philadelphia, my home city.He writes about the soaring costs of calciumgluconate. Twelve years ago, he paid 75 cents apound for it. Now he pays $4.75 a pound. Hewants to know why.

The sharp upturn in medical costs started in1966. The Consumer Price Index shows that across-section of medical goods and services thatcould be bought for about $80 in 1960 costjust over $10 more in 1965. But between 1965and 1970 the cost of diesame services went up by$30, three times as much. And the September1971 cost was $10 above the 1970 average.

These cost increases are highlysome describethem as wildlyinflationary.

The impact such inflationary pressures can haveon the elderly can be readily comprehended whenwe understand that where the per capita healthcare expenditures for individuals under 65 are$225 annually, for those 65 and over the figureis more than three times as much$790. For-tunately, over half the amount paid for healthcare for those over 65 comes from governmentalprograms. Still, the burden of inflationary healthcosts on our elderly is significant.

President Nixon has understood the problemsthat inflation has caused consumers generally andthe elderly specifically. And so on August 15 he

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instituted a new economic policy. We had thewage and price freeze and now we are into Phase'I.

I think it can be said categorically that thusfar this New Policy is working. The WholesalePrice Index dropped 0.3 percent in September, andanother 0.1 percent last month.

The Consumer Price Index rose only 0.1 per-cent in October and only 0.2 percent in Septem-ber. This compares with an average monthly in-crease of 0.4 percent in the six months prior toSeptember. Longer-term trends also show thatinflation is slowing down. For the year ending thispast October, prices rose a total of 3.8 percentcompared with a 5.8 percent increase in the yearending October 1970.

Theie figures have great meaning for theelderly and those on fixed incomes. Translated,they mean that the inflationary rate has declinedconsiderably, and that not only the elderly, butall consumers, can look fOrward to a more stablecurrency: The Damoclian sword of lower andlower standards of living should not be a con-stant nightmare for our senior citizens.

In the specific matter of drug prices and healthcare costs, the President has established a Com-mittee on the Health Services Industry, which isheaded by Mrs. Barbara Dunn, Commissioner ofthe Department of Consumer Protection for Con-necticut., This committee will advise the Cost ofLiving Council, of which I am a member, onmethods to reduce the escalating costs of medicalservice without reducing its quality.

Still another burden facing our senior citizensis the matter of rent costs. Statistics from the Bu-reau of Labor show that citizens over 65 pay about30 percent of their income for housing costs, com-pared to 23.4 percent for those under 65. In short,when costs go up in rent, the impact on theelderly is considerable.

An important part of Phase II will 'be theaction of the Rent Advisory Board. This Boardwill provide advice to the Price Commission onspecial considerations involved in the stabilizationof rents. Last week, the President announced theappointment of 14 persons to this Board, and fourof them represent consumer interests. One of these

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four, Mrs. Mary Elizabeth C. Sowards, serves as amember of the President's Consumer AdvisoryCouncil which advises the President and my office.Another member, Robert D. Blue, serves as amember of the Older Am lican Advisory Com-mittee to the Secretary of Health, Education, andWelfare. Another member, Mrs. Rossetta Wylie,Chairman of the National Tenants Organization,will look after the problems of the low-incomehousing residents. I can assure you that the sub-ject of rent costs for the elderly will not be over-looked by the Advisory Board.

Still much more-needs to be done.

President Nixon's Social Security and AdultAssistance proposals now before Congress addsignificant new benefits to Social Security andintroduce improved income .assistance provisionsfor those with low incomes. This legislationestablishes two primary goals for the elderlyfirst, the establishment of an income floor for poorolder Americans, and second, the guarantee ofinflation-proof Social Security benefits. In fact,additional Social Security cash benefits payableunder this bill total $3 billion and additionalMedicare benefits total $1.7 billion. We must seethat H.R. 1 passes.

Another area in which we need to take actionto protect the elderly in the future is in pensionplanning. The major problem is that only halfthe work force in the United States has the secur-ity that pension plans provide; the other halfdoesn't. Another problem is the injustice causedto workers, who, through no fault of their own,lose their pensions to which they have contributedall their lives because they leave their employ-ment shortly before retirement. While the numberof such losses is very small, the loss to the affectedworkers is immense.

The Administration is now working on a com-prehensive legislative package to deal with theseproblems, and we expect that it will be ready tosend to the Congress very soon. We hope, too,that Congress will take swift action on these pro-posals.

For some time now, I have been concernedabout the problems caused to the elderly by theget-rich schemes offered by a rmber of multi-

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level distributorships. Knowing that the elderlyare anxious to supplement their limited income,some of these outfits promise rich returns onpyramid sales tactics.

The majority of the companies using the multi-level distributorship scheme require the individualto purchase certain amounts of the product theysell in order to become part of the organization.Each person buying into the organization pays afee to become a "distributor." And that's wherethe razzle-dazzle comes in. The emphasis is placedon the glowing picture of the earning potential ofbecoming a distributor by signing up other peopleas "distributors".

They appeal. to the Horatio Alger dream in theAmerican mind. Too few of the investors havehad any business experience. But to the "go, go,go" chant of the pitchmen they convince them-selves that they can recruit friends, acquaintancesand neighbors to become distributors, too.

But the bubble burstsjust like the old chainletter. The problem with the scheme, of course, isthat within a mathematically short period of time,one runs out of people. Two carried to the 29thpower equals the approximate population of theUnited States. The people who buy in on the firstlevels may get their money back, or even make aprofit. But the people who buy in at the end ofthe schemeat the saturation pointstand tolose their money.

The National Association of Attorneys Generalwas so concerned about the effect these tacticswere having on the States and on consumersthat at its convention last June it urged action onthe Federal level. I have been in frequent com-munication with the various regulatory agenciesconcerned with this problem, and I am pleasedto announce that the Securities and ExchangeCommission has taken action today to requiremulti-level distributorships and pyramid salesplans to adhere to the securities laws. What thismeans is that henceforth, any multi-level distribu-torship found giving false or deceptive informa-tion to prospective purchasers can be ptosecutedby the SEC. These firms are now on notice thatthe full force of the SEC injunctive civil andcriminal powers will be used against them. These

predators are unlikely to continue their question-able operations.

How much money this action by the SEC willsave consumers and the elderly nobody knows.But just to give you an estimate, in Pennsylvaniaalone, the Consumer Protection Agency re-covered $350,000 in refunds for individuals whowere victimized by one firm. This figure repre-sented only .45 cents.on the dollar invested, andjust to thoue individuals who came into the con-sumer protection office and complained that theyhad been defrauded.

Further, this problem has spread from Stateto State, causing losses in each State, and in somecases requiring action by 15 to 20 states to bringseparate action against the same firm.

I want to congratulate SEC Chairman WilliamJ. Casey for taking such expeditious action on thismatter. This action by the SEC will protect thesavings and the pension plan benefits of many ofour senior citizens.

,I am, of course, concerned about other con-sumer problems which affect the elderly. TheFedetal-State Relations Division within my officehas found through its contacts with the Statesthat the major complaints of senior citizens aredoor-to-door sales; the unavailability of suitablefoods or goods; I,ealth frauds; the unavailabilityof automobile insurance renewals; and the rise inhealth insurance and utility rates.

Where appropriate, we have taken action onthe Federal level to resolve these problems. TheFederal Trade Commission has proposed a rulewhich would require a three business day "coolingoff" period before a contract becomes final; theFood and Drug Administration has been vigorousin moving against medical quackery; and we be-lieve that the adoption of no-fault insurance sys-tems by the States will help alleviate renewalproblems faced by the elderly.

The President has sent to the Congress a seriesof consumer legislation proposals which, if passedby the Congress, will certainly benefit the elderly.

These include legislation to strengthen theFTC in enforcing the laws against fraud and de-ception, a warranty bill to make warranties mean-

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ingful; a Consumer Product Safety Act whichwould give the Secretary of Health, Education,and Welfare authority to remove unreasonablyhazardous products from the market; and a DrugIdentification Act which would require the identi-fication coding of drug tablets and capsules, sothat proper action can be taken for a patient whenoverdosage or accidental ingestion occurs.

These are some of the solutions to the prob-lems that we have devised. Yet, there still remainsmuch more to do.

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We know, for instance, that most States havelaws that prohibit, or severely restrict, the adver-tising of prescription drug priCes or even postingthem in a store. And when consumers do. notcompare prices, prices tend not to be competitive.One New York study found that the 'price of agiven quantity of one drug ranged from $0.79to $7.45. Another sold from $1.25 to $11.50 fora prescription.

One drug store chain, OscO Drug, Inc., a mem-ber of Jewel Companies, is breaking the tradi-tional secrecy surrounding prescription drug pric-ing. Just last month the company announcedthat it would post its prices for the 100 mostfrequently filled prescriptions. The prices areprominently displayed in Osco stores and consum-ers may ask for the prices of unposted drugs.

Osco Drug may face a court challenge, butthe principles of its policy have the backing ofthe Department of Justice and the Departmentof Health, Education, and Welfare. The De-partment of Justice wrote Osco that the agencyfeels that many, if not most, restrictions on theadverising of prescripion drugs are unjustifiedon any grounds. As a result of the lack of priceinformation, the Department said, many con-sumers are forced to make needlessly high ex-penditures for drugs. Further, the Justice Depart-ment has also served civil investigative demandson the American Pharmaceutical Association andthe Michigan State Pharmaceutical Associationas part of an investigation as to whether those.associations may be parties to an agreement tosuppress price competition in the retail medicinemarket.

The States can take the initiative not only

in this area but in many others. The enforcementof laws against fraud and deception, the initia-tive of new laws to cope with new schemes, andthe removal of laws which tend to limit compe-tition are just a few measures states can taketo help the elderly.

In Wisconsin, a pilot project for statewideinformation and a referral program rot seniorcitizens has just been started. In Nassau County,New York, the consumer office has contactedsenior citizen groups to establish liaison anddeal with particular needs. In MontgomeryCounty,' the Maryland Commission on Aginghai issued ID cards to persons over 65 whichentitle the bearer to certain discounts in businessestablishments.

I believe business can do more than it is.

Forbes Magazine has wondered out loud whybusiness is generally ignoring what amounts toa $40 billion market. I wonder, too. Why can'tclothing manufacturers design special clothes forthe elderly? It is easy for a young woman tounzip 'her -dress in the back, but it is agonyfor an 80-year old woman whose hands arecrippled by arthritis.

In short, to solve the manifold pioblems ofthe elderly, manifold efforts need to be under-taken. Combined action by the public, business,local, State, and Federal governments is neededif we are to succeed in giving our elderly whatthey have earned--=that their last years be yearsof hope instead of years of agony.

' There are now more problems than .there aresolutions.

This Conference can provide us with the in-sight, the recommendations, the solutions. Thoseof us who have the honor of serving in thisAdministration are here to listen to you andto take appropriate action. We want others tolisten, too. Everyone in this country should listen.

This Conference must awaken America, itmust show America these problems. It must letAmerica know that it can look away. It mustlet America know that when we act for theelderly, we act for ourselves, that the elderlyare our faces in the mirror.

Thank you.

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December 1

The Honorable William I RandallChairman, Special Studies Subcommittee,House Committee on Government Operation!

The twentieth century has been an age ofmagnificent change. In the fields of science, tech-nocracy and social consciousness greater progresshas been made in the past 70 years than in allthe years since the birth of our country. Whowould have believed at the dawn of this centuryback in 1900 that within a few years womenwould not only be given the right to vote, butmany would also hold high public office. Whowould have believed that in the same time re-quired in 1900- to travel from New York toWashington we would, by 1971, be able to spanthe continent or even cross the Atlantic Ocean.

Yet, what a shame it isand I say it is anational shamethat in this age of change wehave come to the last quarter of this mostprogressive century before starting to take posi-tive action on the serious problems that confrontone-tenth of the people in our countryouraging Americans.

We should not forget that those people whocomprise our elderly popufation today helpedto pay for two great wars and, yes, two so-calledlesser ones. Some of that generation are notwith us today because they gave their liveson the-battlefields. The sons of many of our oldercitizens also died in the cause of our country'sfreedom. The senior citizens of 1971 enduredthe greatest economic depression in the historyof our Nation; they helped buy trips to the moonfor our astronaum These people have spent theirlives in helping to respond to the problems ofour Nation. But until now the Nation's responseto their problems has been to talk only about"national policy."

Now the time has come to implement thatpolicy with action. And I believe that is whatthis White House Conference is all about.

It may be well, before proceeding furtheiin my remarks, to tell you a little about theSpecial Studies Subcommittee, of which I amChairman. We -e a subcommittee of the HouseCommittee on Government Operations. The

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Government Operations Committee, under thevery able Chairmanship of Congressman ChetHolifield of California; has oversight responsi-bilities with respect to the economy and. effi-ciency of operations of every Department andevery Agency of the Federal Government. TheGovernment Operations Committee also hasjurisdiction over any reorganization within theGovernment. So, if a new department or agencywere to be created in the Federal structure, in-cluding any special office or department a) dealwith the problem of the aging, it is most likelythat the Government Operations Committeewould handle the reorganization legislation.

Early in the 92nd Congress I enthusiasticallyco-sponsored legislation to create a Select Com-mittee in the House of Representatives to studyproblems of the aging. But there are already176 Committees and Subcommittees, repeating176, on the House side of the Capitol. The spacesituation is so critical that we now have legisla-tive subcommittees housed in storage rooms, inthe basement garage, and, in at least one case, aCommittee has no office at all.

I doubt if there is a Member of either Houseof Congress who is not sensitive to the plight ofour senior citizens; I doubt if there is a vote iv.either House against creating a Special Commit-tee to consider this plight, if there were no otherway to focus upon it. The House leadership,certainly, is aware of the need for action at theearliest possible time. That is why, instead ofwaiting perhaps yens, one, two, three or moreyears, until more space becomes available, theHouse Leadership asked the Special Studies Sub-committee to function as a Committee on theaged. It seemed like a practical or logical solution,particularly for this year. We already had a staffand office facilities and assigned hearing rooms.And, I hope you recall that I mentioned a momentago that the Government Operations Committee,parent group of the Special Studies Subcommittee,has oversight jurisdiction in the case of all federalgovernment departments and agencies. That, ofcourse, includes the dozen or so offices chargedwith administering different programs for theaged, and including those which might or couldbecome responsible for any new programs thatwill be proposed and enacted.

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Since September 15, the Special Studies Sub-committee has held 20 days of hearings on prob-lems of the aging. Seventeen of these hearingswere in Washington; two in Chicago, and onewas in Baltimore.

Our staff has isolated nearly 50 separate prob-lem areas of special application to the aged. Theseclosely parallel the enumerations which you havemade under the 14 sections of study associatedwith this While House Conference on Aging.Our hearings have already touched upon severalof these. Before we finish our study and file ourlegislative recommendations sometime next year,we will have had expert testimony on every oneof these subjects. The Subcominittee and its staffwill have inspected as many of the various kindsof facilities across the United States as we needto see.in Order to have a- comprehensive view ofall the 'problems confronting the aged. Beforethe end of 1972 we will have researched everymajor authoritative work on various aspects ofbeing old and growing old. I think you mayagree this is a major project. I can report it isbeing undertaken by a group of hardworking com-mittee colleagues who hive shown they are will-ing to find and give as much time to the task asit may require.

As our hearings on problems of the agingprogress, I realize more and more that determin-ing how to meet the needs of our senior citizensis a greater challenge to the subcommittee thansimply learning what those needs are. The WhiteHouse Conference on the Aging which was heldten years ago, in 1961, clearly identified theneeds. I, along with three other members of theSpecial Studies Subcommittee, was in Congresswhen that Conference was held. We were awareof the recommendations that came out of the 1961Conference. The importance and correctness ofthose recommendations have been more indeliblyimpresssd upon each of us with the passing oftime. We supported passage of the Older Ameri-cans Act, the creation of the Administration onAging, and the Medicare-Medicaid legislationwhich had their genesisat least in parr in the1961 White House Conference. Each of us havevoted for adequate funding for activities underthose acts.

But more needs to be done. Much *on.

In many camindeed, in most casestheStates and local communities have moved morequickly and more positively than has the Federalgovernment, to answer the pleas of the aged forspecial consideration of their special needs. ButI feel it necessary to digress for just a momentto call attention to one glaring failure on theparts of the states and local governments. Irefer, of course, to the matter of safety standardsand inspection practices as they apply to nursinghomes and other facilities for caring for the dis-abled and homeless aged.

I completely disassociate myself from thosewho, seem willing to issue a blanket indictmentagainst all nursing homes as an evil institution.

The members and the staff of the subcommit-tee have inspected many nursing homes. Wehave seen some very good ones. True, and un-fortunately, we have also seen some bad ones.I dislike saying it, but in most, if not all thecases of substandard conditions and deficienciesof service we have observed, studied or investi-gated, blame was traceable to varying degrees ofinadequacies on the parts of local units of govern-ment in their setting of standards and supervisorypractices. In many cases we have observed di-verse and divergent regulations on the parts ofcity, county and State goierning bodies withinthe same general area. Where Federal funds areinvolved, as in Medicare patients, or in construe-tin loans, then Federal standards and require-ments may encourage more orderly regulationat the local level. But many nursing homes andother health care facilities for the aged are notrecipients of Federal funds and are, therefore,outside the reach of Federal regulatory bodies.

This was the case with the Pennsylvania nurs-ing home in which the most recent tragic fireoccurred. This home was in fastidious conformitywith all State and local regulations respectingconstruction, fire prevention requirements andnumber of attendants on duty per patient. Yet,15 elderly lives were lost in a few tragic minutesbecause in all respects these regulations were notsufficient to keep a wooden building with no fire

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or smoke warning devices, or sprinkler systems,from quickly going up in flames.

But let us talk about the positive.

The. most frequent recommendation by wit-nesses before the Special Studies Subcommitteehas been that better protection be afforded retiredpersons' incomes. This protection could take manyforms, one of which is the opportunity to earnadditional money within the limits prescribed forrecipients of social security benefits. A variety ofself-help programs have been devised by .31un-tary groups in some communities through whichelderly persons are afforded the opportunity torender needed, worthwhile services on a part-timebasis. We need more of these programs. Buttwo things are needed from the Federal, Govern-ment. One, there must be -a more realistic limitplaced upon outside earnings before reductionsare made in social security payments. I have longrecognized this need and have introduced legisla-tion to raise thee limits. Modest increases weremade in the Social Security Amendments whichpassed the House in 1970, but failed to becomelaw, and again in H.R. 1, which passed theHouse last May. I am hopeful the other legisla-tive body on the north side of the Capitol willact on this bill in timely fashion during thissession of- Congress.

Another thing the Congress can do now is toprovide more liberal funding of the Older Amer-icans Act to permit an expansion of existingactivities, such as Green Thumb and FosterGrandparents programs.

Another income protection device that hasbeen extended to the elderly by State and localgovernments has been in different kinds of con-cessions made on real estate and other taxes dueat those levels. I strongly be. ;eve those effortsshould be matched by the Federal Governmentin the form of more realistic tax treatment of theincomes of the elderly.

Health care is second in frequency of requestsour subcommittee hears as necessary to meet theneeds of the elderly. Here again, there ar manyavenues of relief. My limited time will permitidentification of only the most recent case oflocal effort I ha-re observed along this line. In

a visit to Mac Neal Memorial Hospital in a Chi-cago suburb last week the Administrator toldus what they are doing. This hospital is freeingbeds for other patients needing geriatric care byearly releases of those patients who have homesand can live in them if only they can have a mini-mum amount of care. That hospital is preparingmeals for patients released under this plan. Mei lsare delivered -to patients by church and othervolunteer groups, which also provide certainhome-making services. b-r

This one plan operated by a single hospital isof course just a little thing, or a small beginning.But, when and if multiplied by the communityand individual efforts in hundreds of cities in allof our Stores, then thousands of aged persons withlimited abilities to care for themselves would beenabled to stay in their own homes where I be-lieve they prefer to be. And for each of theseindividuals freed from hospital or other institu-tional care, space is made available for someoneelse who is even less able to care for himself.

Of course, we need better institutions for thecare of the elderly. But I am satisfied that thepopulations of these institutions could be reducedby 12 percent to 15 percent or more if voluntaryprograms of home care could be expanded tomeet the food requirements, minor therapeuticand medicinal needs of some of our older citizens.

My final point to be made in this brief sum-mary of cur subcommittee's study of problems ofthe aging to date, really encompasses a vital ele-ment that threads its way through all the cate-gories of needs felt by the elderly: human dignity.The dignity of remaining a useful member of thecommunity even though the calendar may indi-cate the age of usefulness is past. The dignity ofcollecting for the services the elderly have al-.ready paid for by a lifetime of contributions totheir national and local communities withouthaving these collections branded as "welfare,"as seems to be the tendency by lumping togetheror making into one package badly needed andlong overdue social security reforms with meas-ures heavily directed to, and called, "welfarereform." The dignity of being able to board apublic transportation conveyance without the ath-

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letic exertion that can be expected of the muchyounger generation for whom these buses_ trainsand planes seem to have been designed. Thedignity of being able to apply for and get em-ploymentor to be able to keep a job on thebasis of ability to perform, rather than beingrejected solely and only on the basis of the daceof birth. The dignity of having all these needsand the special health, dietary and other personaland spiritual requirements met, without endur-ing the impatience and intolerance of those whocannot or prefer not to understand that all ofthese are the needs of those citizens who havesupported this nation for three score or moreyears.

I realize that in the time allotted to me todayit was possible to discuss only the broadestgeneralities. The two major points which I triedto makeI will attempt to summarize as fo:-lows:

1. State Agencies and voluntary groups at thelocal level have done and are doing a com-mendable job in delivering to the aged the bene-fits intended by the various laws Congress haspassed for making the golden years more pleasantand more secure. These financially hard-pressedstate and local governments, when taken in re-lation to their ability to perform, are doing abetter job than the Federal Government in pro-viding benefits for their elderly citizens.

2. The pipelines through which Federal pro-grams are delivered to the states must be clearedof the obstructions created by ambiguity andunnecessary complexities. To avoid red tape orto cut through it, there should be a high-leveloffice for the agingnot in HEW or HUD orDOT or elsewherebut in the Executive Office ofthe President.

Perhaps a third point should be made, andthis one is directed toward my -own branch ofgovernment. the United Stuis Congress. Theprograms that have already been authorized forthe elderly, the ones now on the books, shouldbe backed by sufficient appropriations to maketheir benefits more universally available. I be-lieve it is better to make self-help opportunitiesmore generally available to all classes of needy

citizens, and especially the elderly needy, that itis to provide alternative methods of caring forthose who cannot care for themselves.

In meeting the needs stressed in this thirdpoint, Members of Congress themselves may haveto relax some of their long and tightly heldjealousies of prerogatives. 'Whether there is everestablished a special or,select committee in theHouse of .Representatives to deal with problemsof the aging or not, there will remain some stum-bling blocks both in the House as well as inthe Senate. In my judgment, it would be a par-liamentary impossibility, touched by Constitu-tional overtones, to create a legislative committeeon problems of the aging. Therefore, recommen-dations for legislation coming from any selector special committee studying problems of theaging would have to be considered by the legis-.lative committee having jurisdiction over the spe-cific recommendation. On the Senate side thisjurisdictional authority is spread among 13 ofthe 17 standing committees. On the House side,14 of the 21 standing committees have jurisdic-tion to consider various proposals to benefit theaging.

It is my devout hope that when recommenda-tions are made in the House or the Senate byany committee working and dedicated to ease theprocess of growing old or being old, the appro-priate jurisdictional committees will receive andconsider these recommendations without prejudiceand without regard to the fact that they origi-nated in another committee.

Changing America's attitude toward our agedcitizens and meeting the needs of these very spe-cial people require a partnership_ that includesthe good will and the sincee efforts of everybranch of this government and the cooperationof State, Local and voluntary groups. With sucha team, we can meet the challenge to overcomeall the past years of neglect of our aged. We canno longer afford to waste the valuable contribu-tions older Americans can continue to make toour society. Existing programs must be fundedand new programs created under which futuregenerations of our elderly citizens will be treatedwith compassion 'and appreciation.

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Tk Honorable Ogden R. ReidMember, House Committeeon Government Operations'

Senior citizens is the only group of Americansin which poverty is still growing rapidly. Whatis needed is a comprehensive and coherent na-tional committment to the Nation's elderlymatched by adequate funds.

Our Nation's elderly have been caught in an.intolerable squeeze between fixed income andrapid inflation.

Older Americans have one-half the income ofthose under 65 and must pay twice as muci. forhealth care. One-quarter of our citizens over 65live below the poverty line, and over six millionof them live in substandard living quarters. Wehave done little to ease their burden.

The Administration must address itself to thebasic needs of the elderlyincome maintenance,health services, housing, and geriatric research.

A first priority should be the removal of anyincome limit on those receiving Social Securitybenefits. Currently, a single person earning over$1680 annually loses half of his Social Securitybenefits if his earnings do not exceed $2000 andall of his benefits if his earnings exceed $2880.

We are not meeting the growing needs of theelderly in housing. The 69,000 housing unitsbeing built annually are not nearly enough. Itis high time we provided adequate housing forall senior citizens.

The substandard conditions in many nursinghomes is an area of major concern. There areover 23,000 nursing homes in the United Stateswith over 900,000 people living in them. Manyof the homes are firetraps, provide inadequatemedical services and substandard care. We mustallocate funds to rehabilitate existing nursinghomes, construct new ones, and develop area-wide programs for senior citizens.

Let's talk about a national committment thatmeans a life of dignity, not a life of mere starva-tion, for our elderly.

Full text of Congressman Reid's address is not available.Excerpts of the major points are presented herewith.

Luncheon Program

for Sections on

RETIREMENT ROLESand ACTIVITIES

SPIRITUAL WELL-BEING

RESEARCH and DEMONSTRATIONScat ler Hilton Hotel

Monday, November 29Presiding: DR. PAUL DUDLEY WHITE

Invocation: RABBI STANLEY S. RABINOWITZ

Speakers: House Ways andMeans Committees

THE HONORABLEJACKSON E. BETTS

THE HONORABLEAL ULMAN

Tuesday, November 30Presiding: MRS. FRANCIS FAIRBANKS

Invocation: BISHOP RAYMOND J. GALLAGHER

Speakers: THE HONORABLEJOHN ERLICHMAN. Assistant tothe President for Domestic Affairs

THE HONORABLELEONARD GARMENT,Special Consultant to the President

Wednesday, December 1Presiding: MRS. ELIZABETH LINCOLN

Invocation: THE REVEREND A. L CARTER

Speakers: House Committee onEducation and Labor

THE HONORABLECARI. D. PERKINS

THE HONORABLEALBERT H. QUIE .,

LUNCHEON ADDRESSES

Before the Retirement Roles and Activities,Spiritnal We II-Being and Research and

Demonstration Sections

November 29

The Honorable Jackson E. BettsMember, House Ways and Means Committee

I am delighted to be here to talk with youtoday about some legislative actionboth takenand contemplatedwhich has particular importfor Senior Americans.

We hear.a great deal these days about youngAmericansand rightly so! It is true that theirnumbers are vast and the role they play inour national way of life is vital indeed. RecentCensus Bureau figures, for example, show thatyoung people aged 18 to 21 total some 11 million,or about 51/2 per cent of the population.

But I am a member of a Congressional Com-mittee which is concerned as much, if not more,with the role of another substantial minoritygroup, in which all of us here today have morethan a passing interest.

Census statistics also show that Americansaged 65 and older number in excess of 20 mil-lion, or some 10 percent of the total population.And it is universally conceded, I believe, thatthe contribution which senior Americans make toour national life is so great as to be virtuallyinestimable.

The Ways and Means Committee has, as youknow, jurisdiction over broad areas of legislationdirectly affecting this 65 and older populationgroup.

Social Security is just one of those legislativeareas, but it is an extremely large one. About 201 ":ln persons now receive checks each monthui.,,,.. this 36-year-old program. Not all of themare 65 or older, but most of them, 13.7 millionare retirees; 2.7 million are dependent wives orhusbands, 550,000 are dependent children; and3.3 million are widows or widowers of retiredworkers.

I might add that although benefits under this

program certainly are not as high as the recipientswould like for them to be, they nevertheless havebeen increased substantially during the yearsby147 percent over the past two decades and, morerecently, by 25 percent within the past two years.And further increases are in prospect, as I willdiscuss shortly.

But I would like to concentrate briefly nowon just two pieces of legislation under the juris-diction of our Committee. Both were stimulatedby Administration proposals and inspired byPresident Nixon's messages to Congress. Andeach is of immense importance not only to thosewho already have attained senior status, but toall those who will become se. nior Americansasfar into the future as it is possible to foresee oreven imagine today.

One of these is H.R. 1, the Social SecurityAmendments of 1971, which was approved by theWays and Means Committee in May, and passedby the House in June. It has been pending beforethe Senate Finance Committee since then.

The other piece of legislation has not yet beendeveloped. It is national health insurance, whichwill have an obvious and direct effect on thelives of all Americans, junior as well as senior.But before speculating on this bill of the future,let me discuss the one which is present, real, andvery much alive, despite the fact it has not beenkicking lately.

Dormant though H.R. 1 may be at themoment, I firmly believe that its Social Securityprovisions at least eventually will be enacted. Thislegislation is simply too strong to keep downforever.

I doubt very seriously that there has been anylegislationsince the original Social Security Actitselfwhich included more important improve-ments-in the laws affecting senior Americans.

These provisions are so broad in scope andso broadly significant that it is difficult to selectany of them as more worthy of emphasis thanthe rest.

I do, however, think that five of these pro-visions perhaps have not been given the publicattention which they merit. So I will take thisopportunity to put the spotlight on them.

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I am sure you are all familiar with the fivepercent across-the board increase in cash benefits.This is assuredly an important provision. But farmore important in the long run, I believe, is theprovision for automatically increasing social se-curity benefits following increases in the cost ofliving.

Under this provision, after the Consumer PriceIndex had increased by at least three percent,commensurate increases in benefits automaticallywould be triggered, provided that legislation toincrease benefits had not been enacted or takeneffect in the preceding year.

This provision not only would serve to takebenefit increases out of the political arena, itwould assure beneficiaries that they no longerwould have to bear the brunt of inflation, as theyhave had to do so often in the past.

I strongly feel that this one provision, whichthe President personally put forward, could havea more beneficial effect on the lives of socialsecurity retirees than any now contemplated.

The other four provisions which warrant spe-cial emphasis are these.

One is a special minimum benefit for thosewho have worked for years under Social Security,but at such low covered wages that the benefitpayment is relatively slight. This special benefitwould be equal to $5 multiplied by the numberof years of coverage between 15 and 30. About300,000 persons would get increased benefits,totaling $30 million under this provision in thefirst full year.

Second is an increase in benefits for widowsand widowers, assuring them of receiving at least100 percent of the amounts their insured spouseswould have received had they lived to apply.Under present law, a widow applying for benefitsat age 65 or older gets a maximum of only 821/2percent of her deceased husband's primaryamount. About 3.4 million widows and widowerswould receive a total of $764 million in addi-tional benefits the first year under this provision.

Third is an increase in benefits for those whoare covered by Social Security but delay theirretirement. Under present law, people who need

or want to continue working are penalized, in asense, because they continue paying Social Securitytaxes, but do not draw benefits immediately uponentitlement. This provision would increase bene-fits one percent per year of delayed retirement,affecting about 400,000 persons who would re-ceive $11 million in first-year additional benefits.

Fourth is a liberalization of the retirement test.This, too, would be of particular help to thosewho continue working past 65. As some of youprobably know only too well, present law per-mits a beneficiary to earn a maximum of $1,680per year without having benefits reduced. H.R. 1would increase this exempt amount to $2,000,and would liberalize benefit reductions above thatsum.

In addition to these purely Social Security pro-visons, there are other elements of H.R. 1 whichI believe deserve special mention now. One wouldenable all those senior Americans whofor onereason or anotherhave not been able to enrollin MedicarePart A, to do so simply by signingup and agreeing to pay the basic cost of protec-tion. Another would provide, under the Old AgeAssistance program, a basic monthly income of$150 for each eligible single person and $200for each eligible couple by 1975. A third wouldupdate and substantially liberalize the so-calledretirement income credit, boosting it from a maxi-mum of $229 to $375a gain of $146 or 68percent.

These are, as I indicated at the outset, onlya few of the farreaching improvements calledfor in H.R. 1, and I am sure you join with mein a fervent hope that they soon will resumetheir progress toward enactment into law.

Now to national health insurance, on whichthe Committee just ten days ago completed four-and-a-half weeks of public hearings.

This legislation, of course, can only beguessed at now. There are 12 major proposalsbefore the Committee, ranging all the way froma plan to replace our present, pluralistic systemwith a monolithic and mandatory program paidfor by Federal taxpayers, to a plan to covercatastrophic illness only.

President Nixon, in his Health Message to the

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Congress earlier in the year, declared: "We musttry to see to it that oar approach to health prob-lems is a balanced approach." I certainly agreewith that, and I believe the Administration'shealth insurance plan follows his guideline verywell indeed. It is right down the middle of therange of pending proposals.

Called the National Health Partnership Act,it would require employers to provide protectionfor employees and their families and it wouldestablish a Federally financed program of protec-tion for the poor families whose breadwinner isunemployed.

I favor the thrust of this approach, and I hopethe Committee will use it as the foundation onwhich to build its own legislation.

Whatever kind of bill is created, of two thingsI am virtually certain: It will provide adequatelyfor the poor, and it will be a long time in themaking.

As H. L. Mencken once said: "For every hu-man problem there is a solution which is simple,neat and wrong." And we obviously do not Wantto reach a wrong conclusion here.

The Committee will not begin actual prepara-tion of a bill until next year. House action couldcome some time in 1972, but in trying to antici-pate the further course of such legislationthrough the Congress, it must be borne in mindthat once a bill has cleared the House, it stillmust face the Senate. And judging by past per-formances on House-passed bills, such as H.R. 1,I would have to say that a crystal ball would beas reliable a source as any to use in guessing thefate of national health insurance after it leavesthe House.

Despite what may appear to be a rather gloomytimetable, I can give you a rosier outlook onprobable content of the eventual bill. As far ascoverage of senior Americans is concerned, Ithink it is safe to assume that this is unlikelyto be cut back and is more likely to be expanded.Existing programs such as Medicare and Medi-caid will be reviewed thoroughly, and are likelyto be either replaced by more effective programsor substantially strengthened.

Spokesmen for various organizations represent-

,

ing senior Americans appeared before the Com-mittee during the hearings, and articulated .force-fully the provisions which their members feltshould be included in whatever legislation isdeveloped. I can assure you that the Committeewas very attentive to these presentations and willremember them when the actual mark-up of thebill takes place.

One of the witnesses during the hearings, whoimpressed the entire Committee very favorably,was speaking in behalf of strong preventive healthprovisions, which I am confident the bill willinclude.

A good preventive health program, he said,should be designed to "help make man die youngbut as late as possible."

And that is one of the things we are certainlygoing to try to do with national health insurance.

Note: The speeches of The Honorable Al Ulman,Member, House Ways and Means Committee,delivered on November 29; The Honorable johnEhrlichman, Assistant to the President for Do-mestic Affairs, and The Honorable Leonard Gar-ment, Special Consultant to the President, deliv-ered November 30, are not available.

December 1

The Honorable Carl D. PerkinsMember, House Committeeon Education and Labor

Mrs. Lincoln, distinguished guests and friends.It is a greet pleasure to be with you at this mostimportant and timely Conference. As you know,the bill calling for the 1971 White House Con-ference on the Aging originated in the Commit-tee on Education and Labor and thus, I had theprivilege of being associated with it as it travelledthrough the legislative process.

Your invitation to be here today has specialsignificance for me as a result. But more thanthat, you have provided me with an opoprtunityto meet with and discuss the problem of a group

of Americans for whom I have the deepestfeeling. Much of my legislative career has beendirected to the very problems and issues beforethis Conferencethose related to the elderly. Letus initially examine our roles.

If it would serve any useful purpose, I thinkI would ask the Library of Congress to give mea catalog of all of the reports and recommenda-tions filed by White House Conferences in themore thari two decades since I first came to Con-gress,

I can recall conferences that have describedin brilliant detail some of the most pressingneeds of American society in the Twentieth Cen-tury. And I can recall recommendations whichpointed the way toward a national effort to meetthose needs.

Unfortunately, I am being only half facetiouswhen I tell you that one of our greatest resourcesis a warehouse full of unacted upon recommenda-tions.

Now, I sincerely hope that the recommenda-tions of the White House Conference on Aging1971 will not join all of those other fine blue-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 wise person said "Allthat is necessary for the triumph of evil is forgood men to do nothing."

To paraphrase that distilled truth, all that is-necessary for the report of the White HouseConference on Aging 1971 to wind up on theshelf is for you to submit it, and then go homeand forget it.

If you were not aware of it before you cameto Washington this week, you must now beconvinced of the overwhelming importance ofyour mission.

The needs of the aging in this country areacute, and they cannot much longer be relegatedto the low-priority rank to which they are pres-ently assigned by the Federal Government andby the various states.

Now, we all know that those needs are im-

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ponant, and we really do intend to do somethingabout them.

We will do that just as soon as:1. All our national defense needs are met;2. All our space goals are accomplished;

3. All our educational problems are overcome;4. All our international commitments are

eased somewhat;

5. Inflation is brought under control;6. Our environmental needs are met; and7. Our cities are made safe.

No doubt there are other pressing needs thatwill make themselves known as we go along.

The point I am trying to make in this recitalof our priorities is that, no matter how well-meaning or how noble our intentions, the prob-lems of the aging are not going to be tackledin any massive, meaningful way unless the coun-try rises up on its hind legs and demands it.

You who are participating in this White HouseConference will have to go home as missionaries,and make sure that the voice of the people isheard above the hoopla raised by more vocalbut less worthy interests.

And this will be no easy task. For to some ob-servers we are farthe. away from a meaningfulnational policy and commitment to the elderlythan ever before.

During my years in Congress the rhetoric onthe national scene concerning the elderly hasfar too often outdistanced the action.

Let me share with you some examples.

One of the brighter spots in our endeavor toprovide adequate services and opportunities forolder people was the bipartisan effort in 1965which resulted in the establishment of the Ad-ministration on Aging.

The Congress intended that the new agencywould provide our older population with mean-ingful representation in the upper echelons of theFederal Government. The Administration onAging was to be an agency which could devotefull attention to the development of solutions for

many social and economic problems facing theelderly. It was intended to be the focal point forthe older persons of this Nation within the. Fed-eral Government.

This was the rhetoric that we heard in 1965many promises which never have been fulfilled.Time after time, and in a variety of ways, thisCongressional intent has been thwarted.

Programs authorized by the 1965 Act asamended and administered by the Administrationon Aging have never been funded at a realisticlevel. Consider the following. The original FiscalYear 1972 budget submission called for reducedfunding of programs such as the Faster Grand-parents Program, the grant program for state andcommunity projects for the elderly, and researchand training of personnel concerned with theaging.

When these curtailments were announced, theCommittee on Education and Labor convened ahearing and subsequently, through pressures fromboth sides of the aisle of our Committee, theoriginal budget submission was amended so asto bring these programs up to the Fiscal Year1971 level.

Nevertheless, for Fiscal Year 1972, $25,000,-000 is authorized for the Foster Grandparentsprogram but only one-half$12,700,000willbe available. To obtain this much the Congresshad to add $2,200,000 to the President's budgetrequest.

Consider also that $15,000,000 is authorizedfor the Retired Senior Volunteer Program, butonly $5,000,000 will be available. $30,000,000is authorized for grants for state and communityprograms on agingless than one-half, ,nly$12,000,000, will be availableand this is $3,-000,000 over what the President requested.

In total, $85,000,000 is authorized in FiscalYear 1972 for the Older Americans Act. Only$38,700,000or 45 percent of what is author-izedwill be available for programs carried onunder the Act. To give this added perspective, Imight mention that the amount we spent forone aircraft carrier (above one billion dollars)would fully fund the Older Americans Act atits present level for the next ten years. Ourfinancial outlay for one destroyer would enable

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us to fund fully the community programs onaging for three years. Moreover, this could pro-vide an estimated 2,500 additional projects tomeet the special needs of the elderly.

Largely because of the totally inadequate fund-ing of many of the programs I have just men-tioned, the Foster Grandparents Program standsout as the most successful and beneficial programadministered by the Administration on Aging.Yr.tt, this agency, which was intended to be thefocal point in government for older persons, hashad the Foster Grandparents Program . takenfrom its responsibility. That action to deprive theAgent.7 of its most successful program will in myjudgment further hamper and impede the de-velopment of the Agency into (-le high levelagency of power and responsibility which wasintended by the Congrets.

As if this were not enough, the Administra-tion on Aging has been deprived of another mostsuccessful programthe Retired Senior Volun-teer Program. This program, along with theFoster Grandparents Program, is now placed ina new agency which is not chiefly concerned withthe problems of the elderlyan action which con-stitutes yet another step from the elderly, theirneeds and problemsin search of an objectivewhich in my judgment is of much lesser priority.Members of the Committee on Education andLabor made a strong effort to stop these trans-fers but unfortunately, we were not in the ma-jority.

But consider also that the research functionof the Administration on Aging has been trans-ferred away and into the Social and RehabilitationService.

Perhaps you now understand why there aresome who say we are farther away from a na-tional commitment to the elderly than ever before.

Let me cite other =cent matters which are ofequal concern.

During House debate on legislation to amendand extend the Economic Opportunity Act, Isupported an amendment designed, according toits sponsor, "to remedy a problem that has be-come endemic in this country in connection with

the poverty program, the failure to adequatelyserve our senior citizens."

The amendment would have added $50 mil-lion of additional funding authority for povertyprograms designed for elderly people. The billon the floorauthorizing two billion dollars an-nuallyprovided a meager $12,000,000 annual-ly for programs focusing exclusively on the elderly.

I have always felt the elderly were shortchangedin the War on Poverty. Listening to the debatethat afternoon reinforced my feelings. It wasbrought out that out of appropriations of cpproxi-mately $2 billion dollars last year, only $6,000,-000 was spent on programs exclusively for theelderly poor.

Yet, the elderly poor Lcmprise 20 percent ofour poverty population. They should, in all fair-ness, receive something like a four or five hundredmillion dollar appropriation.

I regret to inform you the amendment wasdefeated.

Not all is as bleak as I have suggested. Thebill I have just mentioned, the Economic Oppor-tunity Act extension, carried with it an amend-ment which I sponsored that will in my judgmenthave a great and beneficial impact for the elderlyand isolated in rural America.

Those friends of mine here today from ruralAmerica know the condition in the shortage ofdecent housing available to low-income familiesin rural areas is one of the most critical mattersfacing the country. It is also one of the mostneglected, because the homes of the rural poorare too often isolated up in the mountain hollows,or screened by the woods or the mesquite, andfar away from the affluent corridors served bythe interstates and the expressways. Public hous-ing is not the answer to this particular problem,because these people are country folk. They likethe elbow room afforded by their remote resi-dence. To them the concept of wall-to-wall orgable-to-gable urban living is both alien and in-tolerable.

There is genuine need for new housing, andfor the rehabilitation or repair of old.

We do not intend that this will be a major

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new housing program. The modest $10,000,000suggested for it is the best guarantee of that. Thisis a modest rural program aimed at a specialhousing problem in which existing housing legis-lation simply has not proved effective. It is con-fined to the rural areas and limited to rural hous-ing development. We felt it should have specialidentity.

There are other aspects of this legislationwhich are also, as you know, of significant benefitto elderly Americans. The bill provides for theextension of Operation Mainstreamof theGreenthumb projectsand of community actionprograms, many of which but certainly not en-ough, provide help to the elderly.

Tomorrow on the floor of the House of Repre-sentatives we will debate the final version of thislegislation. At stake will be the continuation ofso many of the programs which have meant somuch to our elderly. At stake will be the estab-lishment of the new housing program for therural poor and the new Comprehensive ChildDevelopment Program.

One of the more valuable benefits of WhiteHouse Conferences such as this is that partici-pants have an opportunity to bring grass rootsreactions to our elected; officials: As we. near thisvery crucial vote on the Economic OpportunityAct Amendments, I know that my colleagueshave benefitted, as I have benefitted, from theinsights you have shared and will share with themthis week.

As we look farther ahead, I am quite optimis-tic. In the immediate future, the Committee onEducation and Labor will be considering legisla-tion of tremendous importance to the elderly. Iwould like to mention very briefly some of theprograms and issues the Committee will turn toduring the Second Session of the 92nd Congress.

As you all know, the Older Americans Actexpires on June 30, 1972, less than seven monthsfrom now. Already one of our Subcommittees,chaired by my able and distinguished colleaguefrom Indiana, John Brademas, has begun over-sight and exploratory hearings.

At this time we have pending before theCommittee legislation which I believe will make

significant additions to the Administration onAging. I have joined with my colleague fromFlorida, Congressman Claude Pepper, in the spon-sorship of a bill to establish a nutritional pro-gram for the elderly. This legislation is in linewith recommendations from the White HouseConference on Food, Nutrition and Health heldin 1969 and of the President's Task Force onAging in April of 1970. It is an important andnecessary proposal, but I caution you that alreadyopposition has been voiced to its enactment.

We haVe legislation directed at a major prob-leM which afflicts many middle-aged and elderlypersonsthe lack of employment opportunities.There is pending before the Committee the pro-posed "Older Americans Community Service Em-ployment Act," which would help assure a chancefor useful and 'constructive jobs. But I cautionyou again that already opposition has been voicedto this proposal also.

It is my hope that as we continue with ourscheduled hearings, we will developand I amconfident that we will with your helpa compre-hensive piece of legislation which will includeprovisions attacking the frequently mentionedtransportation problems facing the elderly, assur-ing adequate nutrition for aged citizens and de-veloping new systems of food delivery, betteringhousing conditions for the elderly, and provisionsdesigned to guarantee that the Administration onAging becomes what the Congress has clearlyintended; that is, an office of power and respon-sibility within the Federal system.

We have also begun hearings on comprehen-sive manpower legislation. There are two majorversions of this legislation which are being con-sidered. In an effort to consolidate similar typeprograms both bills call for the abolishment ofthe categorical approach to manpower programsfound in present law. One of the bills goes so faras to consolidate all separately identified cate-gorical manpower programs, whereas the othersponsored by the distinguished Chairman of oneof our Labor Subcommittees, Dominick Danielsof New Jerseywould consolidate certain cate-gorical programs, but preserve others. The under-lying philosophy of this approach is that there arecertain areas of need which are of such great

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importance and so much in the Federal interestthat their separate identity must be preserved. Isupport this latter approach and I am pleasedto advise you that in this bill the interest of theelderly would not be merged with all other in-terests, but would stand apart as a special Federalinterest and concern which is accorded special andseparate funding.

At the end of the current fiscal year, programsauthorized by the Vocational Rehabilitation Actwill expire. Here, too, we will have extensionand revision legislation of an Act and programswhich have made substantial contributions tomany of the problems being discussed in thisWhite House Conference. We will conduct acomprehensive evaluation of existing law in aneffort to strengthen and expand existing programsand to identify still unmet needs.

During our work and deliberations, some ofthe issues may receive national attention andsome will not. You must be aware of both. Anexamplethe ComMittee will have to make adecision on whether we will merge the interestsof the elderly in our comprehensive manpowerprogram or whether we will provide for a sepa-rate authorization. Your guidance and recom-mendations will be weighed very carefully notonly in this debate, but also in the many otherdebates which will undoubtedly occur during thenext twelve months on legislation directly af-fecting the elderly.

I am confident that with your continued in-terest, support and cooperation, we will be ableto seize upon these opportunities and to takesignificant steps toward creating at the Federallevel a genuine awareness and commitment bothto programs and to money in the field of theaging.

The Honorable Albert H Quit,Member, House Committeeon Education and Labor

Thank you for your kind invitation to appearhere with Chairman Perkins. There are, as youhave been informed, numerous bills before Con-gress dealing with the problems and opportuni-ties of older Americans. A number of them will

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be considered by our Committee on Educationand Labor. Although the jurisdiction of our Com-mittee is somewhat limited in the many fieldsof interest to this White House Conference, weare proud to have originated the Older AmericansAct of 1965 which created the Administrationon Aging, and the 1968 legislation which estab-lished this White House Conference on Aging.

This legislation was enacted on a completelybipartisan basis, and that is the only proper ap-proach to the problems of the aging. An Ameri-can statesman of those difficult days just preced-ing World War II remarked that "politics shouldstop at the water's edge where foreign policybegins". I think that politics should stop in theconsideration of how government may best servethe aging, because it is an issue that concernsall of us. I think it was Mark Twain who re-marked that he hated to think about growing old,but that there was only one alternative and hedidn't want to think about that at all! Sat everycitizen, in a very personal way, is involved in theprocess of aging. One of the tasks of this Con-ference is to help make every citizen more awareof that personal involvement, so that it can betranslated into informed concern which leads toeffective action.

We do urgently need a better informed publicbecause many of the problems of elderly personsare increasing at the same time their numbers inour society are growing, both in terms of aggre-gate numbers and percentage of the total popu-lation. Twenty million Americans are now 65years of age or older. In the past decade this agegroup increased by 22.1 percent, or nearly doublethe increase (12.5 percent) of the total popula-tion. The population aged 75 and older greweven faster, an astonishing 37.1 percent in asingle decade.

I know that many, perhaps all of you, haveheard these statistics repeatedly, but it still amazesmost people to learn that in the past hundredyears, while our total population has increasedfive times, our middle-aged population is ninetimes larger and our older population has in-creased 17 times.

We must now meet the challenge of matchingthe progress in longevity brought about by medical

and nutritional advances with progress towardachieving an acceptable standard in the qualityof life for all of our older citizens.

This is a difficult challenge and in my judgmentthere are no easy ways to meet it. Governmenthas an important, and even crucial role in thistask, but we cannot expect to achieve our goalsthrough governmental action alone. Somehowwe must stimulate far greater private concernand action. Somehow we must make far moreeffective use of the "people to people" approachwhich is often so vital to the success of ourefforts for older people, just as it is for thevery young.

When we talk about the problems of olderAmericans we are not discussing needs whichare foreign to other groups in the population.We are talking about income maintenance, ade-quate housing, adequate nutrition, safety in ourhomes and streets, education and social services,a decent standard of medical care, and so forth.The major difference is that all of these concernstend to be far more acute for the older American.And too often other really critical differencesare not well understood by the rest of us.

Consider for example a fundamental problemfor millions of our elderlyloneliness and isola-tion from the rest of the community. This basicproblemwhich can be the most devastating ofall in human terms and often makes worse suchproblems as inadequate nutrition or medical careis compounded by the fact that America'selderly are not concentrated in model communi-ties in warm climates. That is the fiction. Thefact is, for example, that New York City withfive percent of the Nation's total population has12 percent of our elderly population. A largerpercentage of th6 population of Massachusetts(11.4 percent) is aged 65 or older than ofArizona (8.3 percent). My own State of Minne-sota, with 13 percent of its population in thisage group, is right behind Florida with 13.3 per-cent. The Fact is that nearly two-thirds of Ameri-ca's elderly live in metropolitan areas and fullyone-third live in the central cities.

Thus the problems of older persons are mostoften aggravated by the problems of our cities.Crime in the streets is not a political issue or an

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abstract concern for millions of our elderlyitis a daily and very real fear which in turn is amajor cause of loneliness and isolation.

In New York City, Jules Sugarman, the directorof the city's Human Resources Administration,told our subcommittee which handles the olderAmericans legislation, that there had been a recentupsurge of attacks on elderly persons by juvenilesaged 10 to 15. He said that many evening pro-grams for the elderly were closing down andthat even programs during the day often requireescort services.

I have singled out this particular concern, forwhich our Committee has some jurisdiction interms of ou'r responsibility for the Juvenile De-linquent), Prevention and Co'ntrol Act, to try toshow the interrelation of some of these problems.Loneliness and isolation can be vastly increasedby street crime. It can also be a product of poorlyplanned housing which takes into account neitherthe older person's need for physical safety nor theneed to feel and be a part of the larger commu-nity. And social services which do not take intoaccount either of these needs simply do not servethe elderly.

Some day, hopefully, we shall have solved thecomplex problem of street crime. But older peoplecannot wait for that day. Meanwhile, we mustdesign our programs in housing, transportation,and social services in such a way that it is over-come or minimized.

Our task as legislators is to design legislationwhich, as well as legislation can, will promotegenuinely effective programs for the elderly. Thistask is complicated by the limited jurisdiction ofCongressional committees which deal with piecesof the problemincome maintenance in our com-mittee, housing in another, transportation in stillanother, and nutrition and health split betweenseveral. The same difficulty is found in the Execu-tive Branch where these matters are dealt within different agencies. I personally doubt thateither in the Congress or in the Execut;ve Branchcould we change all of these jurisdictional lines,but I do feel that we can cut through them.

That is why I think President Nixon is to becommended for establishing a cabinet-level Com-mittee on Aging within the Domestic Council,

which can and will provide high-level.considera-don of these issues and the coordination of Fed-eral programs. The Committee is under theChairmanship of the Secretary of Health, Educa-tion, and Welfare, Elliot Richardson. I know ofno man in American public life who has a keenerintellect or who has more desire to solve socialproblems than Secretary Richardson.

Within the Congressional Branch it may wellbe that we should take some similar step, such asa Joint Committee on Aging. Perhaps this Con-ference will come forward with helpful recom-mendations for us. I know that our Committeeon Education and Labor has the immediate taskof considering extension and possible modificationof the Older Americans Act, and that we shallcarefully consider the views expressed at this Con-ference concerning the status and programs ofthe Administration on Aging. Year by*year thebudget of that agency has been increased (from$23 million in fiscal 1969 to $38.9 million infiscal 1972). Actually, the comparable 1972figure is nearly $45 million, since almost $6 mil-lion for research and personnel training in thefield of the aged is budgeted under the parentSocial and Rehabilitation Service of HEW.

However, I think all of us need to considerways in which we can further strengthen theAdministration on Aging. I know that recentprogram transfers have raised some issues, butthese were made for the purpose of strengtheningthe programs themselves and I think we shouldnot prejudge the question of whether they harmthe agency. The important point is that we mustimprove the .overall effectiveness of governmentin helping the older American.

We have made significant progress in terms oftotal Federal outlays for programs affecting olderAmericans: from $25 billion in 1967 to $34.1billion in 1969, to $46.4 billion in fiscal 1972.These sums, as you all will recognize includeoutlays for Social Security and similar trust funds.The Federal expenditures for discretionary pro-gra..as for the agedthat is, for those programsin which expenditures were not mandatedaremore revealing. These rose from S457 million in1967 to $687 million in 1969 to 51.2 billionin fiscal 1972. This is not a record of expendi-tures which suggests neglect. Yet in the final

analysis, it is not how much money we spendbut what happens to and for people that reallymatters. We should never allow ourselves theluxury of believing that if we have passed a law,appropriated the funds, and expended money forprograms, we automatically have solved a prob-lem.

One could discuss at length, as this Conferenceundoubtedly shall consider at length, the effectof this or that income policy for the elderly. Ihappen to believe that the President's welfarereform recommendations, as embodied in H.R. 1together with suggested improvements in theSocial Security program, represent a major stepforward to assuring a more adequate income forthe elderly poor. Certainly the success of effortsbeing made to control inflation and thus to sta-bilize the value of income is also a vital necessityif we are going to see any income policy work.

But I do not believe that sufficient inamewhile it may be the fundamental need of allolder Americans, is the complete answer to allof their problems. i know that it is something ofa cliché, but the great human need of every per-sonthe need to be needed by othersis par-ticularly acute for the elderly. This need can befufilled for a foster grandparent on a very smallincome and totally unmet in the case of an olderperson of considerable wealth. We are misusingand losing a large part of one of our greatesthuman resourcesthe knowledge, experience,and judgment of older citizens. It is this resourcethat we need to find out how to really use to themutual benefit of the older citizen and our society.I think we have barely begun to examine waysof doing this, and that we are doing far less thanwe should to implement ways we have shown tobe successful.

In accomplishing this fundamental and in-creasingly urgent social goalthe constructiveuse of the capacities of our older citizensweshall need a strong combination of governmentaland private efforts. I pledge to do my best bothas a Representative in the Congress and as aprivate citizen in helping to bring this about. .

We are all looking to this Conference forguidance as to how best to carry out that sortof pledge.

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...

The Closing General Session

December 2, 1971

The Conference closed with a General Sessionheld in the International Ballroom of the Wash-ington Hilton Hotel. The United States Marine.Band, under the direction of Col. Albert F.Schoepper, provided music while the audienceassembled and again when President and Mrs.Nixon joined the Conference.

Arthur S. Flemming called the Session to orderand asked Bishop Raymond J. Gallagher to offerthe Invocation. Following introductions, Mr.Flemming addressed the Delegates on the "Post-Conference Year." President Nixon closed theConference with an address which also lookedforward to a better world for the Nation's oldercitizens. Rabbi Abraham J. Feldman pronouncedthe Conference Benediction.

Copies of the 1971 White House ConferenceRecommendationsA Report to the Delegatesfrom the Conference Sections and Special Con-cerns Sessions were distributed to all participantsat the close of the Session.

ADDRESS byThe Honorable Arthur S Flemming

While we had the pleasure of greeting manyof you at the reception last evening, you werevery gracious in your comments relative to themanner in which the Conference has been con-ducted. Many persons have contributed to thisresult. When the first one of the longer reportsof the Conference is issued, it will be accompa-nied by an introduction that will endeavor toidentify both individuals and groups to whomall of us are deeply indebted.

Almost without exception last evening yousaid, "Now I hope we can get action." You knowthat I share that hope. Briefly, this morning, Iwant to identify some of the initial steps we willtake.

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At the outset, we will seek to obtain informationrelative to what actions individuals and groupsof individuals are planning to take. Wide dis-semination of actions that are being taken at thebeginning of the Post-Conference Year willstimulate the development of new action pro-grams early in the year. Once this informationhas been assembled, it will be possible for leaderiin both the public and private sectors to identifygaps and then to try to do something aboutclosing the gaps.

First, we would like to obtain informationrelative to the individual commitments that theDelegates to this Conference plan to make. Youhave been provided with a form which, if youSO desire, can be used for this purpose. You cancheck the items on the forms or you can stateyour commitment in your own way. If you dofill out the form, or if you communicate withus in some other way; we, in turn, will want tokeep in touch with you in the hope that you willshare your experiences with us. Making a com-mitment of this kind is not a part of your re-sponsibilities as a Delegate. We offer this in thebelief that some of you might like to begin thePost-Conference Yesr in this manner.

Next, we will endeavor to obtain informationfrom the national organizations that have partici-pated in the White House Conference. Many ofthese organizations will take formal positionson the findings and recommendations of the Con-ference. We will seek to determine when thesepositions are to be taken. We will also seek todetermine whether the organization in questionplans to take a position on all of the recommenda:tions or only on those contained in certain Sec-tions and Special Concerns reports.

Many organizations will develop plans for ob-taining support for the recommendations they de-cide to endorse. Where a recommendation sup-ported by an organization calls for involvementon the part of the private sector, we will seekto determine what plans the organization has

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for bringing about the involvement of its mem-bership. Where a recommendation supported byan organization calls for action on the part ofFederal, State or local governments, we will seekto determine what plans, if any, the organizationmay have to develop citizen support for therecommendation. In both instances, we will askwhether or not the organization has plans forcooperating with other organizations.

We will endeavor to obtain information frompublic agencies at all levels of government. Wewill call their attention to recommendations ad-dressed to their part of the public sector. Wewill ask them for their reactions to these recom-mendations. If they have a favorable reaction, wewill seek to ascertain whether they plan to im-plement the recommendations immediately orfeel that they must postpone action. If they feelthat they must postpone action, we will seek toascertain their reasons for this conclusion.

Once this information has been obtained, wewill bring together representatives from boththe private and public sectors who have partici-pated in this Conference to determine how, in thelight of this information, strategies for action canbe developed.

'Finally, we will develop a reporting systemreflecting progress or lack of progress.

In my opening address on Sunday evening Iread a message to the delegates from six nationalorganizations. The signators to this statement werein alphabetical order by name of organizationas follows:

Bernard E. Nash, Executive Director, Ameri-can Association of Retired Persons and Na-tional Retired Teachers Association

Thomas G. Walters, President, National As-sociation of Retired Federal Employees

Hobart C. Jackson, Chairman, NationalCaucus on the Black Aged

William C. Fitch, Director, National Coun-cil on the Aging

Nelson H. Cruikshank, President, NationalCouncil of Senior Citizens, Inc.

I have discussed with these signators the plansI have outlined for obtaining information to use as

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a basis for the Post-Conference Year of Action.As a result, they have decided to address thefollowing message to the delegates.

"In a message to the Delegates at the openingof this Conference, we stated that it was ourhope that the discussions and the conclusionsreached would contribute to just one objective.That objective is: The enlistment of widespreadsupport from all social, economic, :eligious, andpolitical groups in behalf of action programsthat will make available to older persons increased'resources, services and opportunities and that willremove existing inequities which ethnic and otherminority groups have had to bear.

"We believe that the discussions and the con-clusions reached by the delegates could set inmotion forces that can lead to the achievementof this objective.

"What is now required are commitments toaction.

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The Chairman has reviewed with us the plansfor sending a communication to the national or-ganizations that have participated in this Confer-ence. We believe that an approach of this kindwould help to provide an opportunity to makemeaningful commitments for action. We also be-lieve, however, that it should be made clear thatparticipation by voluntary organizations in thePost-Conference Year can be meaningful onlyif there is commitment of substantial resourcesand leadership by government at all levels.

"Our organizations will take advantage of thisopportunity. We hope that hundreds of otherorganizations will do likewise.

"In responding to this communication, we in-tend to underline the following points in con-nection with those specific Conference recom-mendations with which each of our organizationsfind itself in agreement:

1. We will monitor on a continuous basis whatis happening to those recommendations ad-dressed to i'le public sector at all levels, butespecially those which are addressed to theFederal Government, and will speak out in nouncertain terms when actions do not keeppace with rhetoric.

2. We will do everything possible to developstrong political backing at all levels of govern-ment for such recommendations.

3. We will take seriously the recommendationsaddressed to the private sector and will makesignificant investments of time, energy andresources in order to implement them.

"The Chairman advises us that he recognizes theimportance of commitments for action from thepublic sector to parallel those he is seeking fromthe private sector. He is going to urge publicagencies at all levels to make their own com-mitments.

"We are convinced that an immediate andvigorous effort is going to be made to determinejust where we are in terms of a willingness onthe part of public and private organizations tofollowup on the White House Conference recom-mendations. We are convinced further that oncethis information is available, it will provide thebasis for developing strategies for actionstrat-egies that could produce unprecedented actionsin behalf of older persons on the part of allsegments of our society during the Post-Confer-ence Year.

"The millions of older persons we representwill be satisfied with nothing less. We are confi-dent that the delegates to this Conference willbe satisfied with nothing less."

ADDRESS byThe Honorable Richard M. NixonPresident of the United States

Dr. Flemming, Chief Justice Warren, all of thedistinguished guests on the platform and all ofthe distinguished delegates to this Conference:

First, I want you to know how very delightedwe were to have you-2,700 I understandasguests last night at the White House. As I camein by helicopter from Chicago, after speaking toa 4-H Convention there, I saw many in the win-dows looking out. I only wish I could have comedown; but I realized if I shook hands with 2,700

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persons, it would take more than the four hoursthat Chief Justice Warren took at the OpenForum on Monday night, and I wanted to be herethis morning. I wish I could have welcomed allof you from all of the States in this Nation, allof you with your deep commitment.

Now I want to talk about this Conference, theWhite House Conference. I want to talk aboutit very candidly, in terms not of the past or thepresent, the resolutions that you will present, butin terms of the future.

Down in the Library of Congress there is awhole floor with many, many stacks of volumes of .

the records of White House Conferences, con-ferences on aging, conferences on young people,conferences on health. On almost any subject youcan imagine, there has been a White House Con-ference, and every President has participated inthem. Every President opens them or closes them,as the case may be.

Those volumes, very many of them, when Ihave seen them down there, just gathered dust,and you wonder what happened. Was it worth it?And all of you, as you come to the end of thisConference, must wonder, after all the work youhave done, after all the recommendations youhave made: Is it going to end here, or is this abeginning?

That is what I want to talk about. I would beless than candid if I were not to say that manyWhite House conferences are more cosmetics thanthe real thing. They talk about the problem, givepeople an outlet, and, of course, that is a goodthing; but recommendations usually are not putinto practice as often as they should be.

When this Conference was called, as JohnMartin and Arthur Flemming will tell you, Itold them I wanted to know what we could do.In preparing my remarks today, I wanted to speakspecifically to the things that you recommended,and to speak also to how we could follow up.

I do not want the volumesand there willbe volume:. on this Conferencesimply to gatherdust in the Library of Congress or in the Officeof the President. As long as I am here, 1 sill goover and shake off the dust myself to find outwhat was said. But Dr. Flemming told me before

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I came in here just what he said to you when heintroduced me: that each one of you has madea very important pledge this morning, a specificcommitment to action in the post-Conference year.I am here to join you in that pledge.

This means that I am going to give my close,personal attention to the recommendations of thisConference. I have asked Dr. Flemming to stayon. We really cannot afford him, but he comesreally as a volunteer. He is not only going to beChairman of the Conference in the followupperiod; but also as a Special Consultant on Aging,so that I can take up these matters personallywith him, as well as John Martin, who, as youknow, is my Special Assistant on Aging.

Now, Dr. Flemming is known to you fromhaving presided over this Conference. He is alsoknown as a great educator. I knew him as amember of the Cabinet. Beneath that very genteelexterior is one of the most tenacious men I haveknown. So you have a good representative therespeaking up for your problems.

The second step I have taken is that I havedirected that your recommendations be put at thetop of the agenda of our Cabinet-level Commit-tee on Aging, in which Dr. Flemming also playsa leading role.

Finally, I have asked Dr. Flemming to createa post-Conference board to act as your agent infollowing up on your proposals. When mattersthat affect the interests of older Americans arebeing discussed in the White House, I am de-termined that the voice of older Americans willbe heard. That is my commitment to you.

Now, as we consider your suggestions, we willbe guided by this conviction: Any action whichenhances the dignity of older Americans enhancesthe dignity of all Americans, for unless the Ameri-can dream comes true for our older generation,it cannot be complete for any generation.

This is true, first, because we all grow old.The younger generation today will be the oldergeneration tomorrow. But more than that, theentire Nation has a high stake in a better lifefor its older citizens simply because we need you.We need the resources which you alone canoffer.

We are speaking, after all, of a proven gen-eration, one that has brought this country throughthe most turbulent period in human history. Yourskills, your wisdom, your values and your faiththese are among the most valuable resources thisNation possesses.

This country will have to be at its best ifwe are to meet the challenge of competition inthe world of the 70's, and we cannot be at ourbest if we keep our most ex,..sienced players onthe bench. I am not speaking of the WashingtonRedskins, either. Yet, in recent years all of usknow a gulf has been opening between olderAmericans and the rest of our people. This gulfis the product of a great social revolution whichhas weakened the traditional bonds of family,neighborhood and community. For millions ofolder Americans, the result has been a growingsense of isolation and insecurity.

We have to change that. Younger and olderAmericans need one another. We must find waysto bring the generations together again.

In addressing the challenges before us, let usbegin where most of you beginthat is theproblem of inadequate income. We have to beginthere because if we move this front, all theother battles will be easier, and if we fail, tomove in the income front, the other battlesandthere are many others that I will discuss in myremarks this morningwill be impossible.

That is why it is so important that the Con-gress approve one of the most important bills tocome before it in many yearsthe bill knownas H.R. 1. Now, let me talk to you a bit aboutH.R. 1.

It is generally known as welfare reform. Ipresented it to the country in a radio-televisionaddress almost two and a half years ago. Inthat period, since it was presented to the country,it has been debated and talked about, passedone House, and still ianguishes in the Senatenoprospect for this session, and apparently not toomuch prospect even for the next session, unlesssomething happens in terms of waking the Con-gress up to the fact that the American peoplewant it.

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Let me tell you what H.R. 1 does. You hear

about welfare reform. Well, believe me, weneed it. We have a system at the present in thiscountry, a system in which, under our presentwelfare rules, in many States it makes it moreprofitable for a man not to work than to work,and it rewards a man for leaving his family,rather than staying with his family. When youhave that kind of a system, you ought to abolishit and get something else. .

So our new program provides for work in-centives and work requirements. It also providesfor needy children and provides for those needychildren without the effect of the present welfareprogram, which is so degrading on those childrenand mars them for life.

But what is in it for older people? I think wehave forgotten many of those things. Let me tellyou how much is at stake for older citizens inH.R. 1 and why it must be a top priority.

For the first time in our history, it would puta national floor under the annual income ofevery oPer American. Now, some may say itought to be higher, some may say it ought to beearlier; but the point is, it will be done. We needa national floor under the income of every olderAmerican. H.R. 1 does that.

Second, for the first time in our history, itwould make Social Security benefits inflation-proof. This is something that I have always be-lieved in. It does not make sense to have SocialSecurity benefits constantly behind inflation. Ifwe have inflation, the benefits should go up withit, and H.R. 1 provides for that.

It would allow Social Security recipients toearn more money from their own work:It wouldraise benefit levels, especially for widows. I havealso asked the Congress to include in H.R. 1 aproposal for eliminating the $5.60 monthly feenow charged for Part B of Medicare.

Now let me get into the numbers. These num-bers are so big that they may not, of course, bevery impressive when we think of $200 billionbudgets; and I am going to be working on thatbudget over this next weekend. But H.R. 1, as itnow stands, would provide five and a half billiondollars in additional Federal benefits for olderAmerica.Jfive and a half billion dollars more.

Let me point out something: If they hadpassed it two years ago, we would have hadit then. You can see why the Congress needs toquit talking and staat acting on H.R. 1. Thiswould be three billion dollars in 'increased SocialSecurity benefits, and when it is fully effective,another two and a half billion dollars in newbenefits to persons with lower incomes. And aproposal to eliminate the monthly Medicare feewould enrich the five and a half billion dollarpackage by an additional one and one-fourth bil-lion dollars, so that is the equivalent of an addi-tional five percent increase in social security.

So you can see how much is at stake in thisone proposal which has been there for over twoyear?, which has not been acted upon, and whichneeds to be acted upon.

I have made a commitment to you. We needyour help. Let your Congressman, let your Senator,know that before the next election you wantaction on H.R. 1. I think we ought to have it.

Now I would like to go to a second subjectwhich is related to income. It is on the otherside of the coin. That is the subject of taxes. Weare supporting a series of tax reform proposalswhich would enable a single person aged 65 orolder, to receive up to $5,100 of tax-free income.A married couple, both of whom are 65 or older,would receive over $8,000 in tax-free income.

Howeverand now I come to one that willbe very close, I rtm sure, to the hearts of mostof the people here, because when I met withrepresentatives of this group before this confer-ence was convened, this subject was raised by everyone of those present. That is the property tax. Iti not related to income, but it is a tax whichkeeps going up and up and up; whereas, an olderperson's income may be even going down.

Property tax collections have increased by 40percent in the last five years alone. Now, here iswhere older Americans come in. We have checkedand found that 70 percent of older Americansown their own homes. For many, these homes rep-resent a lifetime of careful saving, and yet, be-cause of property taxes, the same home which hasbeen a symbol of their independence often be-comes the cause of their impoverishment.

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Take the 30 percent who do not own theirhomes. Those who rent their homes often bearan unfair burden because property tax increasesare often passed along in the form of higherrents.

The inequity of the property tax is often thegreater because it takes money from those whohave already educated their own children, anduses it largely for the education of other children.

I received a letter recently from a womenwhose parents brought her and five other childrento this country from Switzerland many years ago.They settled in California as homesteaders. Theywere full of hope and pride. Over the years thatfollowed, they made their dreams come true.But today, many, many years later, things havechanged so much that Mrs. Ewing begins herletter to me by saying, "Was it just an emptydream after all?"

_Her father, at 72, is too ill, too tired to work.

His family is grown and scattered. To meet hisreal estate taxes, he is now being forced to sellthe prci-,:rty for which he worked so hard andso long. Then she goes on to say, "If this isreally the country I grew up believing it to be,these inhumane property tax laws must bechanged."

She is right and they should be changed. Thatis why we need a complete overhaul of ourproperty taxes and of our whole system of fi-

nancing public education because the property tax,as you know, in California as well as in many otherStates, is the primary tax which can and must beused at this time for financing public education.

Our revenue sharing proposals which weremade a year ago, and which still have not beenacted upon, can help relieve the pressure onproperty taxes, and older Americans have a largestake in enacting those proposals. But I believewe have to move in another front, more directlyon the problem of property taxes. I am, therefore,working with our Domestic Council and workingspecifically with Secretary of the Treasury Con-nally in preparing specific proposals to ease thecrushing burden of property taxes for older Ameri-cans and for all Americans.

The President's Commission on School Finance,

which I appointed last year, has been carefullystudying a range of possible remedies. Theseremedies will involve large sums of money. Butwe are prepared, however, to make the harddecisions we are going to have to make to provideproperty tax relief.

The time has come, in this subject as in others,to stop talking about the impact of property taxeson older Americans and to act in their behalfand in behalf of other citizens in similar circum-stances.

Now, I want to go to another matter that Iknow has had consideration here, and one which1fiii-cl very fundamental agreement with yourconclusions. That is the inadequacy of privatepension plans. One-half of our work force isnot even enrolled in such a plan and many ofthose who are enrolled have inadequate or un-reliable coverage.

I will, therefore, propose to the Congress a newprogram to reform our private pension systems. .

Here are some of the reforms: They will includemeasures designed to expand pension coverage,to ensure that pension funds are soundly managed,and also I will recommend new laws to requirethe investing of pensions so that an individualwho works in a job, has money invested in apension, and then moves from that job doesn'tlose what he has put in. lie is entitled to that andhe should get it.

Now, there is one other item where I amgoing to talk about something that involves notwhat the Congress and what the Administrationcan do for older Americans, but what you cando for the country and for yourselves.

I am sure you:have-been reading and hearingin your newspapers and on television and radioa lot about our new economic policy; with thefreeze on wages and prices for 90 days, Phase II,some of the arguments that have taken place withregard to what the application should be. Let mesay that as far as this program is concerned, itsprimary design is to stop the rise in the cost ofliving. As far as this program is concerned, it isinevitable that anything that we do is going tocause some sacrifice on the part of some Ameri-cans.

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For example, some labor leaders, not all, butsome of them object to the fact that labor in-creases and wage increases cannot be as high asthey would like. Some business leaders are ob-jecting to the fact that we have laid down regu-lations in which their profit margins are notallowed to be as high as they would like. Somestockholders are objecting to the fact that we havelaid on regulations where their dividend pay-ments cannot be as high as they would like.

Let me say, I would like to have a programthat would satisfy them all, because it is not pleas-ant to have any segment of the population objectto a program that we have adopted. But let melay it right on the line. Where a wage increase ora profit increase or a dividend increase can becontrolled and the result will be stopping the risein the cost of living for all Americans, that isworth doing, and that is what we plan to do.

The support for that program has been strongerperhaps, among older Americans, according toall the polls, than all the others. On the otherhand, 70 percent of Americans do support it andwe ask your continued support, because no matterhow much the pensions may be, no matter howmuch the Social Security payments may go up, ifthe cost of living continues to go up it doesn'tmake any difference. That is why those who areretired and living on fixed incomes have thebiggest stake of all Americans, and we hope thatyou will continue to support it right to the hilt.

Now, I have been talking about income andtaxes and how we control prices, but even withhigher income, we all know that many olderAmericans face problems beyond their individualcontrol. I am going to talk for a moment aboutthe one million Americans who live in nursinghomes.

I can talk with great feeling about this becausemy mother was in a nursing home. She was veryill and had a stroke during the last two yearsof her life. It was a very good nursing home andI will always be thankful that the nurses theretreated her just as I would have wanted to treather, if I could have been there. Many of thesenursing homes, like the one my mother was inand like the one my 91-year-old Aunt Edith isin out in Riverside, California, are ones where

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they receive excellent care from people who careabout them. But many do not. There are somebad nursing homes, some inadequate ones. Thereis little that the people who are in them can doabout it.

Partially, it is a question of money, being ableto afford the payments, and partially it is a ques-tion of regulation. Where it is a question of regu-lation, we certainly can do something about it.That is why I announced last summer an eight-point program for improving our nation's nursinghomes, for cutting off funds to those which re-main substandard.

Our primary objective is the upgrading ofnursing homes, but we are not going to hesitateto cut off funds from those which are hopelesslysubstandard.

Furthermore, we will take the initiative tomake sure that public and private resources areavailable to provide alternative arrangements forthe victims of such homes; to cut off the fundsfor the substandard ones and just let the peopleout, that is no answer. We must find an alterna-tive and we are planning to do that.

But when we speak of the million who live innursing homes, we want it realized that for everyperson in a nursing home, we have twenty timesas many older people who are not in nursinghomes. The greatest need is to help more olderAmericans to go on living in their own homes.Income programs, such as- H.R. 1, tax reforms,they can help achieve this, because if the indi-viduals have the funds, then they can retain theirown homes. But so can a number of other addi-tional decisions which we have already made.

We want to begin by increasing the presentbudget of the Administration on Aging nearlyfive-fold--to 100 million dollars. Now, you maywonder where I got that number. I must say, Iheard from a number of you and I heard fromArthur Flemming. He didn't know about thenumber until this morning because it was 80million dollars last night, and I decided, why not100 million dollars. One hundred million dollarsis needed for reasons that I am going to indicateas to what I expect from this.

But let me put it in another context. Let us

put it in terms of priorities. The Congress, forexample, at the present time, has, under consider-ation a tax bill. It is a tax bill that has somevery good provisions in it. It has one in whichthere is disagreement, honest disagreement, onewhere I take a different position from some

-others. But there is one provision in that billthat provides for between 50 and 100 milliondollars to go for the purpose of paying the cam-paign expenses of an individual who is runningas the nominee of his party for the Presidencyof the United States. Now, my friends, just letme say this: It is very important that campaignsbe adequately financed, but I say, rather thanto have the taxpayers' money used for the pur-pose of financing a candidate's campaign for elec-tion, that money should be used for the purposeof allowing the elected President to keep his cam-paign promises once he gets into office.

Now, let's see what this 100 million dollarsis going to do. We can give special emphasis toservices that will help people live decent anddignified lives in their own homes, services suchas home health aides, homemaker and nutritionalservices, home-delivered meals, transportation as-sistance. Much of this new money will be usedto help marshall existing and expanding resourcesmore effectively at the local level.

Toward this end, I will direct the Social Se-curity Administration to provide an informationcenter in each of its 889 district and branchoffices to help explain all Federal programs whichaid the elderly. These offices will, of course, sup-plement the State offices which already are doinga very fine job in this respect.

Then, there are two additional administrativedecisions which will help older Americans remainin their own homes. The first will make housingmoney more readily available to older citizensto purchase homes in a variety of settings, in-cluding condominiums and retirement communi-ties. Secretary Romney, who is also a very tena-cious, evangelistic man in our Cabinet, is goingto see that that is done, I can assure you.

The second will require that Federal grantsprovide services for older persons and also pro-vide for the transportation they need to take ad-vantage of these services.

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Now I turn to another subject, and if I seemto be moving from place to place, believe me,you moved from place to place throughout thisConference and I am trying to cover most of themajor subjects in which you expressed an interest.Some of the best service programs for olderAmericans are those that give older Americans achance to serve. Thousands of older Americanshave found that their work in hospitals, churches,parks and schools gives them a new sense ofpride and purpose even as it contributes to thelives of others.

Federal programs to provide such opportunitieshave proved remarkably successful at the demon-stration level, but that is all they have been upto this point. We are going to change them.We are going to move from demonstration toestablish these programs on a broader nationalbasis. Therefore, I am going to request that theRetired Senior Volunteers Prograin be tripled for15 million dollars, so that an additional 50,000volunteers can be involved. I have directed thatthe Foster Grandparent Program be doubled to25 million dollars, and I will ask that this programbe altered so that Foster Grandparents can workwith older persons as well as with children.

I have also ordered that our jobs programfor older persons with low incomes be doubled to26 million dollars. Under this program, projectssuch as Green Thumb and Senior Aides havedemonstrated that older Americans can makevaluable contributions in health, education, andcommunity service projects even as they earnadditional income.

Let me say: Every older American can beproud that you have made these programs workin recent years. That is why we can double thisone, triple that one, make a permanent programout of what was previously a trial or demonstra-tion one. These decisions mean that you will beable to work in more places and for more people.

Now I have spoken this morning about someof the immediate steps that I am taking as partof my commitment, with your commitment, toaction. We are proud of hese initiatives, but weare not content to rest on them. We are goingto build on-them. That is why I have outlined

a mechanism for following up on this Conference,one which will allow us to take the fullest ad-vantage of the excellent work which you havedone.

Any discussion of the recommendations fordealing with the problems of the aged would notbe complete without recognizing the strong sup-port expressed at this Conference for extendingMedicare coverage to include prescription drugs,and for accelerating the rate at which the incomefloor comes into effect under H.R. 1.

Now as you know, these programs involvevery, very substantial budget problems for theAdministration. Therefore, they are ones thatwill need a great deal of consideration and study.Because of the interest which you have expressedin these programs, I have directed the DomesticCouncil, under John Ehrlichman, who has alreadyaddressed you, to carefully consider both proposalsand to make recommendations to me at an earlydate.

Your work is not yet over. You have a messageto take home with you from this Conference, amessage which must now be heard in every com-munity in this land. Let me tell you what it is.

We need a new, national attitude toward olderpeople in this country, and that attitude must beone which recognizes that America, whatever itdoes for its older citizens, fully appreciates whatour older citizens can do for America.

Only a new national attitude toward aging canend the throwaway psychology which I under-stand was so graphically demonstrated in thefilm you saw Sunday night. Only a new attitudetoward aging can reopen the doors of opportunitywhich have too often been closing on older menand women.

To borrow another phrase from your multi-media presentationonly a new attitude towardaging can keep older Americans from "slippingthrough the cracks."

We are entering a period when people will beretiring even earlier from their regular jobs, andwhen it will, therefore, be more important thanever to recognize that retirement from work doesnot mean retirement from life. This concept must

be at the heart of our new, national attitudetoward aging.

I see a great number of people in the WhiteHouse, young people, middle-aged, older people,not nearly as many as I would like to see, butevery day some come through to receive anaward or recognition, and some just want tocome in and see the President for some reason.A few months ago I met with a remarkable man.His name was George Black. For more than 80years, this man has been making bricks by handin Winston-Salem, North Carolina, his own spe-cial way of doing it. He is a master craftsman.

When he came in to see me, he didn't lookit but he told me he was 93 years old. But hisproductive years were not over. So our Govern-ment, under one of the prorgams that we for-tunately had, sent this remarkable man to a coun-try that needed to learn about that almost for-gotten skill of making bricks by hand. GeorgeBlack went to Guyana, in South America, sothat he could share his skills with the people ofthat less developed country.

When I asked him about his trip, this is whathe said: "I have always asked the Lord to letmy last days be my best days. I feel like Heis answering my prayers."

George Black'i prayer is the prayer of millionsof Americans"to let my last days be my bestdays." And for them, as for him, its answerdepends not only on what they are given, but onwhat they continue to give.

Older Americans have much to give to thiscountry. The best thing this country can give tothem is the chance to be a part of it, a chanceto play a continuing role in the great Americanadventure.

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In a real sense, therefore, this Conference isjust beginning, for all of us are going home withpromises to keep. As we keep those promises,as we fulfill our commitments to action, wewill make this Conference the great, new begin-ning that you have talked about this week. Letus make the last days the best days for allAmericans.

A Delegate's View Of The Conference On Aginghe official report of the Conferencespeaks for itself in most ways. It doesnot, however, give account of the Dele-gates' personal views of the human

experience of being a part of the White HouseConference on Aging. For this reason, we askedMrs. David M. Levitt for permission to reprint,as a part of the proceedings, the report of the

Conference which she prepared for the NationalFederation of Sisterhoods', for which she serveda Delegate.

It will give an overview of the Conference atwork for those who could not participate person-ally, and it will hopefully revive the dynamic qual-ity of the Conference for all those who attend.

AgingA Burden or An HonorA Report by Mrs. David M. Levitt

"My 94-year-old mother was failing," said ablack womyi from Jackson, Mississippi, herselfone of the 20 million Americans over 65 yearsof age designated as elderly. "Mama talked tome of the burden of old age. To help myself Iread the Bible, and I happened on Psalm 91. Iwent intomy mother's room to comfort her andread to her what God says, 'I will be with himin trouble; I will deliver him, and honor him.With long life I satisfy him.' And do you know,it changed her spirit. Next day, she was up andwalking."

To the White House Conference on Aging, inWashington, D.C., November 28 - December 2,1971, came approximately 3,500 Delegates andseveral hundred who -were observers, guests fromGovernment, visitors from foreign countries, aswell as leaders of training programs in gerontology. They came to discuss the problems, andsituation of aging, and particularly the twentymillion elderly who comprise the fastest growingminority in the United States, a quarter of whomlive beloW the poverty level.

Dr. Arthur S. Flemming, ConferenCe Chairman

' Those portions of the rerart specifically directed to the. Sisterhood have been omitted.

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and former Secretary of Health, Education, andWelfare in the Eisenhower Administration, whoalso presided over the first White House Con-ference on Aging in 1961 stressed: "The timefor action is now." People had come to Wash-ington from every part of the United States andfrom overseas. The oldest delegate was 95, theyoungest 17. Represented were many ethnicgroups: Blacks, Spanish-speaking people, Ameri-can Indians, Asian Americans. Special interestsessions were planned for these groups, as wellas `ror rural and urban aged, for poor elderly, forblind and deaf aging, for youth and age and forthose of the middle years who devote themselvesin service to the aging.

A Three-Year ProcessThe Conference was an important mountain

peak in a three year process. It was authorized byCongress on September 12, 1968, and called byPresident Nixon's proclamation of October 6,1969, which directed that it develop "a more ade-quate national -policy for older Americans." Dur-ing 1970, over 6000 local meetings were helJ onthe problems of the elderly, meetings on com-munity, State, regional and national levels, alloriented toward the Conference. In this three year

process, a year of action will follow the Con-ference to bring to Government, communities,agencies and organizations new policies and pro-grams.

Weeks and months ahead of arrival, Delegateshad received assignments to subject sections oftheir choice, along with a continuing supply ofmaterials to read. Among these materials werebackground papers developed by Technical Com-mittees of citizens and work books listing issueswhich had been developed by citizens at local,State and regional meetings.

Briefing for Leaders

Over 200 Chairmen and Recorders convenedfor briefing sessions late in the afternoon andevening of Saturday, November 27, the day be-fore the White House Conference officiallyopened. Dr. Flemming greeted the leaders; hespoke of the necessity for follow-through on theConference and action in the post-Conferenceyears. He stressed that there must be specialattention and concern for minority groups, eth-nic, rural, the poor, the disabled. Dr. Flemmingsaid: "The elderly are barred from further mean-ingful involvement in life. Society's attitudes to-ward older persons must change. Out of the &in-ference we hope will come both a national policyon aging, and clearly stated specific action pro-grams related to policy to meet short term goals."

The Conference procedure had been developedby Dr. Clark Tibbitts who had written a guidebook for Conference Chairmen and Recorderswho would be responsible for leading groups anddrafting policy. Dr. Tibbitts reviewed both theprocedure and structure at this pre-Conferencebriefing. As a final stage in preparation forthe formulation of policy proposali, confereeshad been assigned, as previously noted, toone of 14 subject areas: Education, Employmentand Retirement; Health; Housing; Income; Nu-trition; Retirement Roles and Activities; SpiritualWell-Being; Transportation; Facilities, Programsand Services; Government and Non-GovernmentOrganizations; Planning; Research and Demon-stration; Training. Each Section was divided intoSubsections. In addition, Special Concerns Sessionsweer scheduled for Wednesday morning, Decem-ber 1. There were 95 subsections.

On Sunday morning, briefing continued in the14 separate Sections. I was a recorder in theSection on Spiritual Well-Being. Hess Sears, Sec-retary of the Equitable Life Insurance Companyof Iowa, co-chairman of the Section, introducedco-chairman Monsignor Lawrence J. Corcoran,Secretary of the National Conference of CatholicCharities. The leaders present had read the schol-arly background paper by Dr. David 0. Moberg,and we started to discuss: What is our subject?What is the distinction between "spiritual" and"religious"? What is the relation between "mate-rial" and "spiritual" needs? Is housing for theelderly a part of this subject? If it is a responsi-bility of the religious institutions and communityto provide housing, would this dimension beneglected in the Section on Housing? Hess Searssaid that he had felt that it was important tohave this Section, which had been only inferredin 1961, on the agenda of the Conference. Thisdiscussion of definition of the nature of personsspiritual, physical, emotional, socialand of ful-filling needs through actioncontinued in meet-ings throughout the Conference. I paraphrasedthe famous statement of Rabbi Hillel, "If notfood, health and shelter, how will I live? But ifonly food, health and shelter, is life worth living?And if not now, when?"

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Sunday EveningThe OpeningThe White House Conference on Aging op-

ened officially on Sunday evening, November 28,at 7:30 p.m., in the International Ballroom ofthe Washington Hilton Hotel, the Conferenceheadquarters. Delegates carried handsome blackbriefcases provided by the National RetiredTeachers' Association and the American Associa-tion of Retired Persons. Among the many paperswas a Program Book, on the cover of which wasreproduced the winning painting in the nation-wide Senior Portrait Contest. On pillars outsidethe Ballroom were signs: "Spanish SpeakingCaucus, Jefferson Room;" "Black Caucus Meeting,moved to Lincoln Room;" "ComingSeniorCitizens Ombudsman Advocate." The confereeswere addressed by John Martin, Commissioneron Aging, and by Dr. Flemming. A multi-mediapresentation followed, interspersing live dramawith films and slide-sound programs. Two titles

poignantly told the stories of fear and loneliness:"Let's Find Poppa a Nice Place to Live"; andreferring to old people in our youth-orientedsociety, "Throw Away Culture."

Subsection and Section Meetings

On Monday morning, after a short orientationin this section, Delegates met in their Subsec-tions in which approximately 35 people wouldmeet together for 101/2 hours through Mondayand Tuesday. Through these 101/2 hours theywould deal with many difficult concerns andneeds: adequate income, Government funding to.nake action possible, health services, unjust re-duction in social security payments for low in-come earners, unfair discrimination for employ-ment and various types of license, training ofcounselors for the aged, protection of old peoplein the streets, continuing education for growth andwell-being in all stages of life..

Through all the discussions, there was theoverriding concern that we in the United Stateshave denied the fact of aging, have pushed asidethe elderly, ignored and demeaned them. In aland of abundant material resources we havethrown away our human resources, and havecaused millions to live in physical, emotional,and spiritual deprivation. The old are isolated.How do we change a nation's attitude?

I was in subsection No. 5 of the section onSpiritual Well-Being. Thirty of us metyoungand old, black and white, men and women,Catholic priests, Methodist minister, Baptistpreacher, Evangelical worker, rabbi, Unitarianlay leaders, retired teacher, psychiatrist, Episcopalsister, director of a Canadian home for the elderly----where the minimum age of admission is 85people from Hawaii, Alaska and throughout conti-nental United States.

At first we were careful, proper and estranged.We worked through Monday and Tuesday. Whatwas our output? First we discussed, changed andvoted on four policy issues which had been de-veloped through State and regional meetings.

Issue No. 1. The Government should co-operate with religious bodies and private agenciesto help meet the spiritual needs of the elderly, but

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in doing so should observe the principle of separa-tion of Church and State.

Issue No. 2. Efforts should be made to meetthe spiritual needs of the aging by ministeringto them in conjunction with people of all ages,as well as in groups with special needs. It wasnoted that special attention should be given toallowing older persons to share in the plant ingand implementation of all programs related tothem.

Issue No. 3. Since man is a whole being withinterrelated and interdependent needs, religiousorganizations should be actively concerned withspiritual, personal and social needs.

Issue No. 4. Religious bodies have tradition-ally and properly developed their own philoso-phies. We recommend that they work togetherwith the elderly and coordinate their efforts withother groups to develop and declare an affirma-tion of rights for the elderly. These rights shouldinclude the basic values of all while ensuringthe basic right of freedom of religion.

Then we compiled a list of program imple-mentation, bearing in mind the mandate forpossible action. Lastly, we wrote an openingstatement to help define the meaning of SpiritualWell-Being.

By Tuesday afternoon, 101/2 hours later, a senseof pride permeated "our group" and there waseasy laughter even on serious differences. OnWednesday morning when we no longer met insubsections, we eagerly greeted members of "ourgroup" in halls, at lunch, and in the ocean of peo-ple at the general meeting.

As recorder for our subsection, it was my re-sponsibility not only to take notes on the pro-posals, but also to be a member of the wholeSection Drafting Committee, in which we at-tempted to synthesize the work of the six sub-sections. This task was done through dinner hours,and on into the evenings. These combined pro-posals were then brought to a final meeting ofall the subsections of the entire section, whereagain the issues were discussed and voted in thedemocratic process which had been started onlocal and regional levels and was now carried tofinality at the national Conference level.

Luncheons and an Open Forum

Alternating with small subsections were largegatherings. The Conference provided luncheonsin four Washington hotels on Monday, Tuesday,and Wednesday for all conferees. Speakers fromgovernment offices and from Congress addressedeach luncheon.

On Monday evening an Open Forum, chairedby Earl Warren, retired Chief Justice of theUnited States Supreme Court, gave opportunitiesfor individuals or representatives of organizationsto speak on any subject related to the generalfield of aging for from three to five minutes.Requests for time were accepted by a SteeringCommittee and the order of appearance was de-termined by lot. More than 80 persons spokeduring four hours. Said Dr. Flemming, "We mustnot overlook any group in our society that wantsto be heard."

Special Concerns

On Wednesday morning there were held Spe-cial Concerns Sessions: Aging and Blindness;Aging and Aged Blacks; Asian American Elderly;the Elderly Consumer; Mental Health CareStrategies and Aging; The Older Family; Home-maker-Home Health Aide Services; Older In-dians; Legal Aid and the Urban Aged; Long.Term Care for Older People; The Poor Elderly;Rural Older People; The Spanish Speaking El-derly; The Religious Community and the Aged;Physical and Vocational Rehabilitation of OlderPeople; Voluntec . Roles for Older People; Youthand Age.

I attended the Session on Youth and Age, runby youth delegates. Heartening interest produceda position statement that young and old are one,both deserving respect; and that since all are con-cerned with the quality of life, there is a needto reorder national priorities. In a discussion ofeducation and awareness, young people expressedthe need to become aware of the aging process,the need for trained teachers, text books,.sharedcourses with older persons. Many action projectsinvolving youth were listed, from transportationteams to youth advocates for local and Stateprograms for the elderly.

At the close of the Session, a visiting sociolo-gist from India asked to speak. He said, "In theUnited States the old are isolated from theirfamilies. The young need to stop feeling likethe 'in' group. You should tear down your walls,return to your elders."

The White House and President Nixon

On Wednesday evening, the citizens and for-eign guests visited the White House, slowlytouring the rooms and studying portraits of UnitedStates Presidents. A marine band played and ChiefLittle Wolf, an elderly American Indian in hand-some red and white feather headdress and fullwhite Indian regalia, asked a woman to dance.

Next morning, Thursday, December 2, thefinal general meeting convened. The MarineCorps Band played as the thousands of confereestook their seats in the International Ballroom. Allthe short reports from all Sections, which hadbeen duplicated overnight, were distributed. Inthe vast crowd, one now saw many familiar faces.

Dr. Flemming addressed the Conference. Hepledged a post-Conference year of action, withearly steps to attain information about what ac-tions individuals and groups take, and to sharehese experiences so that the early new actionswill stimulate others. He said, "I have beenlistening to older persons and they want to bein a position to make decisions about their life.They want to be involved in life. And they wantto be treated with dignity."

Exactly at 10:30 A.M., as the Marine CorpsBand played "Hail to the Chief," President andMrs. Nixon walked on to the platform to thun-derous applause.

"Any action which enhances the dignity ofthe older generation enhances the dignity of allgenerations," said President Nixon. He spoke ofthe benefits which would follow the passage ofH.R. 1 (Welfare Reform Bill) in establishinga national floor under the income of every olderAmerican, of allowing Social Security recipients toearn more money from their own work, ofeliminating the monthly fees for Part B of Medi-care. He spoke also of the need fot tax reform

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to provide property tax relief; of new programsto protect workers under private penSion plans;of the need for regulation of nursing homes; ofthe need for Federal grants to provide servicesfor older people. And he stressed the need fora new national attitude of appreciation for whatolder citizens can do for America, to change the"throw away" psychology.

Dr. Flemming closed the Second White'HouseConference on Aging, telling a story about hischildren during a power shortage. The youngestcomplained of the dark, while the older oneslooked for candles. He said, "Mature people de-termine to find candles and to light them to dispeldarkness."

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The White House Conference on Aging, inits long process through more than 6,000 meet-ings, involving two million people, has focusedattention on and increased understanding of thesituation and needs of older persons. The greatquestion is: What action wilt we take followingthe Conference, individually and in our groups?We can help twenty million people to a betterlifeto provide necessary material goods andservices, to help to release the inexhaustible boun-ty of spirit, to help our nation to benefit from thepeople who have contributed life-long work. Byour actions, we have the answer: Agingnot aburden 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 the sense of Congressthat a White House Conference on Aging, becalled by the President of the United Statesin'1971, to be planned and conducted by theSecretary of Health, Education, and Welfare,and for related purposes.

Whereas, the primary responsibility for meetingthe challenge and problems of aging is that ofthe States and communities, all levels of govern-ment are involved and must necessarily share re-sponsibility; and it is therefore the policy of theCongress that the Federal Government shall workjointly with the States and their citizens, to de-velop recommendations and plans for action, con-sistent with the objectives of this joint resolution,which will serve the purposes of(1) assuring middle-aged and older personsequal opportunity with others to engage in gainfulemployment which they are capable of perform-ing; and

(2) enabling retired persons to enjoy incomessufficient for health and for participation in fam-ily and community life as self-respecting citizens;and

(3) providing housing suited to the needs ofolder persons and at prices they can -afford topay; and

(4) assisting middle-aged and older persons tomake the preparation, develop skills and interests,

468.217 0 - 73 - 12

155

i

and find social contacts which will make the giftof added years of life a period of reward andsatisfaction; and

(5) stepping up research designed to relieve oldage of its burdens of sickness, mental breakdown,and social ostracism; and

(6) evaluating progress made since the lastWhite House Conference on Aging, and exam-ining the changes which the next decade willbring in the character of the problems confront-ing older persons; and

Whereas, it is essential that in all programs de-veloped for the aging, emphasis should be uponthe right and obligation of older persons to freechoice and self-help in planning their own fu-tures: Now, therefore, be it

Resolved by the Senate and House of Represent-atives of thR United States of America in Congressassembled, That

(a) The President of the United States is author-ized to call a White House "Conference on Agingin 1971 in order to develop recommendatiohs forfurther research and action in the field of aging,which will further the policies, set forth in thepreamble of this joint resolution, shall be plannedand conducted' under the direction of the Secre-tary who shall have the cooperation and assistanceof such other Federal departments and agencies,including the assignment of personnel, as may beappropriate;

( b) For the purpose of arriving at facts andrecommendations concerning the utilization ofskills, experience, ard energies and the improve-ment of the conditions of our older people, theconference shall bring together representatives ofFederal, State, and local governments, professionaland lay people who are workilg in the field ofaging, and of the general public, including olderpersons themselves;

(c) A final report of the White House Confer-ence on Aging shall be submitted to the Presi-dent not later than one hundred and twenty daysfollowing the date on which the Conference iscalled and the findings and recommendations in-cluded therein shall be immediately made avail-able to the public. The Secretary of Health, Edu-cation, and Welfare shall, within ninety daysafter the submission of such final report, transmitto the President and the Congress his recommen-dations for the administrative action and the legis-lation necessary to implement the recommenda-tions contained in such report.

ADMINISTRATION

Sec. 2. In administering this joint resolution, theSecretary shall:

(a) request the cooperation and assistance ofsuch other Federal departments and agencies asmay be appropriate in carrying out the provisionsof this joint resolution;

(b) render all reasonable assistance, includingfinancial assistance, to the States in enabling themto organize and conduct conferences on agingprior to the White House Conference on Aging;

(c) prepare and make available backgroundmaterials for the use of delegates to the WhiteHouse Conference as he may deem necessary andshall prepare and distribute such report or reportsof the Conference as may be indicated; and

(d) in carrying out the provisions of this jointresolution, engage such additional personnel asmay be necessary without regard to the provisions

of title 5, United States Code, governing ap-pointments in the competitive civil service, andwithout regard to chapter 57 and subchapter 111of chapter 53 of such title relating to classifica-tion and General Schedule pay rates.

ADVISORY COMMITTEES .

Sec. 3. The Secretary is authorized and directedto establish an Advisory Committee to the WhiteHouse Conference on Aging composed of notmore than twenty-eight professional and publicmembers, a substantial number of whom shall befifty-five years of age or older, and, as necessary,to establish technical advisory committees io ad-vise and assist in planning and conducting theConference. The Secretary shall designate one ofthe appointed members as Chairman. Members ofany committee appointed pursuant to this section,who are not officers or employees of the UnitedStates, while attending conferences or meetingsof their committees or otherwise serving at therequest of the Secretary, shall be entitled to receive

:Compensation at a rate to be fixed by the Secretarybut not exceeding $75 per diem, including travel-time, and while away from their homes or regularplaces of business they may be allowed travelexpenses, including per diem in lieu of subsistence,as authorized under section 5703 of title 5 ofthe United States Code for persons in the Govern-ment service employed intermittently. The Com-missioner on Aging shall act as Executive Secretarycf the Committee.

DEFINITIONS

Sec. 4. For the purposes of this joint resolution(1) the term "Secretary" means the Secretary ofHealth, Education, and Welfare; and(2) the term "State" includes the District ofColumbia, the Commonwealth of Puerto Rico,Guam, American Samoa, the Virgin Islands, andthe Trust Territory of the Pacific Islands.

Sec. 5. There is authorized to be appropriated tocarry out this joint resolution the sum of $1,900,000.Approved September 28, 1968.

156

Arthur S. FlemmingChairman

Bertha S. AdkinsVice Chairman

John B. MartinDirector

TECHNICAL ACTIVITIES

Wilma DonahueCo-Director

Clark TibbittsCo-Director

Alfred E. Duncker

Joanne HogueGeorge Thomas BeallJuanita WillsSteven KrasnerFrank StewartHannah NathansonStaff Assistant

Vivian Fitz-RoyStaff Assistant

LOGISTICS

John ChristmanDirector

Dennis CondieAssociate Director

James MillsCarol CamelioShelia StayteAnne AndersonSecretary

Appendix B

Officials and Staff

OFFICERS

Webster B. Todd, Jr. .

Executive Director

Florence J. JonesAdministrative Officer

Julie EricksonSpecial Assistant to the Chairman

STAFF

REGIONAL AND STATERELATIONS

Ray L. SchwartzDirector

Patrick Twohig.Donald JacksonSuzanne SmithSecretary

NATIONAL ORGANIZATIONRELATIONS

Dorothy S. MacLeaodDirector

Cora ThayerHelen AndersonSecretary

157

Marguerite ThomasSecretary to the Chairman

Dorothy WhitenerSecretary to the Director

Pauline SedlakSecretary to the Executive Director

DELEGATE RELATIONS

Tina ForresterDirector

Joanne F. LawsonValerie Brown

PUBLIC INFORMATION

John EdwardsDirector

Patsy KinserSecretary

Mary YouryHelene MelzerLee Lawrence Ansberry

Barbara HildrethSecretary

ADMINISTRATIVE STAFF

Cherie L. CozinAssistant to

Administrative Officer

Grace BehmAmelia MadrakThomasine HollisCecilia PilkertonRosa JohnsonHarry Lark

ChairmanArthur S. Flemming

Vice Chairmen

Bertha S. AdkinsInabel B. LindsayEarl G. Warren

Members

Tary Adams

David L. AlvaradoDecker AnstromEloise Hardison BanksRobert W. BaronMargaret BartosekRosemary BaxterMarietta Rumberg BengeJames S. BennettRobert D. Bloe*Frances P. BoltonWalter L. BondMarjorie 'T. BorchardtKathleen Merry BroderickRichard ButrickHerbert R. Cain, Jr.Blue A. CarstensonCharles H. Chaskes*Marguerite Stitt Church

Appendix C

The National Planninr; BoardNote: The Executive Committee included the Chairman, ViceChairmen and members whose names are marked with anasterisk (*).

Lucius DuB. Clay*W. Fred CottrellNelson H. Cruikshank*Cons (lel° Castillo de BonzoLouella C. DirksenJohn W. EdelmanCarl Eisdorfer

Edward K.(Duke) EllingtonFrances FairbanksThomas E. Fielders*Rabbi Louis FinkelsteinWilliam C. Fitch*Myrtle C. FontenoJulian P. Fox, Jr.Danny FrankS. Ross GreenwoodAlfred M. Gruenther*A. Webb HaleCecil M. Harden*A. Baird Hastings*Robert J. Havighurst*Ai le HenryAdelaide C. HillTibor HoranyiGrace HowardHobert C. Jackson*John A. Jackson

Ronald L. JensenCernoria D. JohnsonVictor KasselAlfred H. LawtonMelinda Ann LeeMarcel le G. LevyElizabeth K. LincolnEdward J. LorenzeRuby E. Stutz LyellsJohn W. McConnellLaura B. McCoyWalter C. McKainJohn B. McPhersonGeorge Meany*Garson Meyer*David MillerA. Luther MolbergThomas C. MorrillRoger F. MurrayNoverre MussonBernard E. Nash*Melvin N. NewquistJames C. O'BrienCarter C. OsterbindFrell M. Owl011ie A. RandallGeorge G. Reader

158

Patricia Roberts

Robert B. Robinson

Sebastian Rodriguez

E. Bonny Russell

William L. RutherfordMargaret C. Schweinhaut

Hess T. Sears*David C. Sing ler

Eleanor F. Slater

William E. SnuggsArthur L. SparksMary E. SwitzerCharles P. Taft*Robert H. TakeughiBradley L. TaylorPeter E. TerzickJ. Frank TroyMary Ellen TullyBernard S. Van Rensselaer*Thomas G. Walters*Jesse P. WardersDonald M. WatkinPaul Dudley WhiteGeorge K. WymanClara YanezSteve Zumbach

Note:

Appendix D

State Planning OfficialsAll persons listed were in charge of the State unit on aging

in their respective states at the time of the Conference.

AlabamaEmmett EatonAlaskaHenry A. HarmonArizonaThomas TracyArkansasJ. R. JonesCaliforniaDavid BaxterColoradoRobert B. RobinsonConnecticutSholom BloomDelawarePreston LeeDistrict of ColumbiaRoberta B. BrownFloridaOliver JerniganGeorgiaHarold ParkerGuamEufrosina S. LujanHawaiiRenji GotoIdahoKay PellIllinoisElizabeth BreckenridgeIndianaGeorge E. DavisIowa Earl V. NelsonKansasLauren HarrodKentuckyDon ValentineLouisianaArchie E. RobinsonMaineRichard W. MichaudMaryland Harry WalkerMassachusettsDonald StrongMichiganCharles H. ChaskesMinnesotaGerald BloedowMississippiDoug Kenna, Sr.MissouriEarl R. WeltyMontanaLyle Downing

159

NebraskaRonald L. JensenNevadaJack HerreraNew HampshireElizabeth K. LincolnNew Jersey--Edward L. DonohueNew MexicoK. Rose WoodNew YorkJames O'MalleyNorth CarolinaJames E. BrownNorth DiikotaMarion ConnollyOhioRose PapierOklahomaJohn J. HoppisOregonMrs. Edward L. HughesPennsylvaniaHerman M. MelitzerPuerto RicoAlicia RamirezRhode IslandEleanor F. SlaterSamoaW. H. ScrubsSouth Carolina Harry BryanSouth DakotaHerbert SchumacherTennesseePatty BuchannanTexasMrs. Carter CloptonTrust Territory William Allen(Ttah Melvin WhiteVermontJack LearyVirginiaJulian P. Fox, Jr.Virgin IslandsGloria M. KingWashingtonJohn B. McPhersonWest VirginiaLouise B. GerrardWisconsinDuane WilladsenWyomingStan Torvik

ALABAMA

Carrie B. AllenMary Abby BergRev. James G. BerryDuke M. BradfordEleanbr BrantleyM. P. CoprichErman CrewRei. Sylvester Croom, Sr.Sylvester Croom, Jr.Phillip CrunkMary M. DarnerEmmett W. EatonWilliam F. ElliottHoly 0. Fa.quharEddie FletcherLucille FletcherJames C. FolsomJames Hoyt GayC. G. Gomil lionRubin M. HananWilbur S. HartDavid A. HemphillBelcher HobsonNita HoggW. Gene KerlinBuford LachreyGanta N. LovellFred H. PumphreyJohnnie Dean RiversBill Roberts, Jr.Beatrice SalsburyMrs. J. W. ScarbroughMrs. Robbie Fritts SmithW. E. SnuggsJesse T. ToddEdith UpchurchMildred Van De MarkDoreen VarnerE. 0. Williams

ALASKA

Leah BoydDavid B. CarlsonJesse CoodayFrank DegnanFrank D. EatonKathryn L FialaBuddy GomezHenry A. HarmonSteven V. NotchZetta HoytJames Hu,ntington, Sr.Samuel KithMsgr. J. A. LunneyFrederick P. McginnisBessie Moses

Note:Health,

Appendix E

Conference Participants

STATE DELEGATES

Delegates named by the President, the Secretary ofEducation, and Welfare, and the State Governors

James Peter OlsenFrank PeratrovichVernon I.. PerryTitus PeterMrs. Allan L PetersenMrs. Frank M. Reed, Sr.Lorena ShowersA. Doris SouthallEdward SpencerMrs. Ed SweeneyMargaret ThomasHomer ThompsonWilliam C. Wiggins

ARIZONA

Marie AllenEloise BanksJane C. BecentiElinor J. BarnesHarry BrownEsther 0. CarsonAmparo CarrilloLenora CollinsLouva DahozyMsgr. Robert J. DonahueR. Alice Drought

\ Edison Evans`Ted EvansGarry M. FingarRev. William M. JacksRaymond KaneJohn LinkMarian LupuEverett B. LutherPeter McDonaldHoward McKinleyClinton MellorWinona E. MontgomeryRonald MooreDorothy NolanGraciela OlivarezGlenn D. OvermanRev. Scott RedhouseElwood J. SaganeyRodger H. SandovalGrace J. SchellAgnes SavillaHarry SloanCharles Still, Jr.Sophie ThompsonDebra Lynn ToyThomas TracyGrey ValentineJoan Van WinkleKarl E. VoldengWilliam WelshClara Yanez

ARKANSAS

Stanley ApplegateCharlotte BaileyJennie B. BatesMalcolm R. BeanFranklin CollierWesley K. GeeDavis W. GoldsteinFannie HardyBeverly J. HolcombPeggy HudsonJ. R. JonesMrs. Charles KayserLetcher LangfordChester LauckMrs. E. S. LeonardMark LesterLillian McGillicuddyLonnie MeachumLuther MillerHarry MooreLucy MuldrowKenneth P. NewfieldAlex T. PerdueChristine PoindexterVirginia RobinsonFloyd SextonVada SheidRuth SiesickiBonnie L. StanleyGordon Perry StoneMildred B. WilliamsSadie J. WilliamsGlenn B. WinstonLucy WrightAnnie Zachary

CALIFORNIA

Achille AlbouzeFrances AlbrierBaltis Allen, Jr.Jack AndersonLupe AnguianoHelen AntoniakAubrey E. Austin, Jr.Jose BaldivinoMilton B. BallRoscoe B. BancroftWilliam S. BanowskyE. Richard BarnesDavid E. BaxterMalcolm R. BeanJames BeldaPeggy BestJames E. Birren

160

Kay BixbyLouis BoldenMarjorie T. BorchardtSam BozzoGeorge M. BriggcBarbara BrightRobert BrownRoy BrownWat W. BrownGlen BurchHelen R. BurnsMrs. Francis X. BushmanLovella CarlingFrances M. CarpVincent P. CarrollElsa CarrowRoberto CaruajalJack CaryPeter R. ChaconYung-Ping ChenMarshall C. CheneyLarry ChriscoEnoch ChristoffersonMargaret M. ClarkPaul CowgillEarle P. CrandallW. Earl CranshawRobert B. CummingsEvelyn Roeding CuttleMother Frances DanzKarl L. DavisConsuelo Castillo DebonzoMargaret DebowEugene DegabrielleDomingo DelgadoDavid DemarchePatti DewittAndrew DieppaIsmael DieppaSteven DoiWilliam E. DorseyPatti DuroWilliam Edisor.Dorothy E. ElliottJulie EllisTed EllsworthJules EshnerEleanor FaitAlbert FeldmanMaureen ForsbergRobert A. ForstAlfred H. FoxcroftSidney FriedmanSuzie P. GainesJoselyn V. GeagaLouis E. GelwicksNathaniel N. GeorgeMorris Gibbs

Ralph Goldman Frank Nelson Frances Fairbanks Carolyn D. RiceLu Greenberg Leon Nicolai Tim G. Flores Mona ScottEleanor Guilford Sergei Nutkiewicz janies Fresquez Margaret SeitzA. Webb Hale Mary O'Day Corine Garcis Alfred R. Stands, Jr.Gertrude Hall Glenn Oloane Augusts Bulbis Melvin A. SlawikJ. Tillman Hall Cecilia O'Neil Harriet Hall Jacob H. WagnerLloyd W. Halvorson Martin Ortiz Idell Harrison Leon N. WeinerLois Hamer Father Joe Otte Stephen H. Hart Rep. Daniel E. WeissDearie Hampton Rev. E. L. Peet Rev. Leland Hoyer Donald L. WoodallCleo Hardin Edith Quinn H. Harper Kerr Roy ZerbyDonald C. Harrington Auturo Raya Rev. Wendell LigginsEthel Harris Dean Renfro Delphine LuceroA. Baird Hastings H. R. Richardson Mrs. Robert Morris DISTRICT OF COLUMBIALeonard Hayf lick Rev, William H. Robertson Alfred C. NelsonHubert L. Hems ley Earl Rodda Clarence Quinlan Lewis Marco AnthonyGrace K. Hennington Mrs. Armando Rodriquez Robert B. Robinson Encarnacion ArmasEvelyn Herrmann Sister Olga Rossi Paco Sanchez Willis AtwellKathryn Higgins Harvey Roth Keith Sanders The Rev, Bishop Zolton BeckyNei land H. Hines Edwin Rounds Gary Stay Frances P. BoltonW. C. Hohmann Chris Roybal Sue Taoka Kathleen Merry BroderickL HollomanHarold Holmes

Leah RuizeA. M. G. Russell

Rev. Richard WaggyJudith Lund Wood

Roberta B. BrownRobert N. Butler

Thomas Hsieh John. Ryan Homer Morris Woods Richard P. ButrickDavid Hurford Ed Ryken Juan Luis CardenseMary JackJohn A. Jackson

Ruth SayreBea Schiffman

CONNECTICUT Blue A. CarstensonArdoin D. Casgrain

Maurice Jackson Vera Schultz Douglas Beals William ChinLeeE. Gartly Jaco Bernard Schussel Mary Ann Beres Annette ChurchEdna Johnsen Mary Lee Schuster Sister Marjorie Beyer Ewan ClagueBurton E. Jones Jerome Seliger Sholom Bloom Kathleen ClardySam Kalb Mequmi Shinoda Anna H. L. Brinton Leo J. CoadyRichard Kalish Alexander Simon Howard W. Buckley Ben CortezRobert H. Kelley Leila Smith Cyril Cross Nelson H. CruikshankThomas Kiddie Lenore Smith Mother Bernadette De Lourdes Donald DavisStanley J. Kilcoyne Vera Soderstrom Edward Dodek Steven H. DewhurstArcher R. Kirkpatrick Mel Stein Barbara, Dunn J. Martin EmersonSam 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 FaassenRev. Peter Kwon Loy F. Teo John S. Gallagher Marcello FernandezMargaret Larpenter Jessie Terry Mary Claire Granata William C. FitchLoic Lazovich Prescott W. Thompson Harry Hale Ernest Giddings

Ida Ann Lee Richard Thompson Anne G. Heffernan Elma L. GrieselMa,.uel B. Leon Arturo Tirado Edward Lang Harriet F. GriswoldAlice K. Leopold Kazue Togasaki Sister Joseph Mary Gen. Alfred M. GruentherDavid Littaver Rev. Howard N. Toriumi Laura B. McCoy Philip GuarinoDolores Lipka Tsutomu Uchida Walter C. McKain Tony GutierrezHenry Lopez David M. Val lo Emerson Parker Thomas HanniganPaul H. Lorham Isabel Van Frank Edward Peavy Helen HayesLyllis Lundkuist Jean Von Ezdorf Kurt Pe lz Barbara HealthJohn Y. Maeno John T. Walker Thomas J. Quinn Blanca HernandezThe.Most Reverend Leo T. Maher Rewa Walsh John E. Rogers Merci HernandezEd Malan Laughlin E. Waters Howard A. Rosencranz Robert HillMarion Marshall Roy W. Waters Stuart A. Smith Lorenzo IriarteRuth Mattsson Delma Webb Martha Stengel Fannie P. JeffreyJean Maxwell Ruth Weg Clifford L. Sterrett David JeffreysHorace Mays Luna Wessell Noel E. Tomas A. Elaine JenkinsWilliam McColl James Whetmore Rep. Ruth Truex Cemoria Dolores JohnsonRebecca Mcenespy Cliff Whitman W. Homer Turner Sam Jack KaufmanJack McKay Mary Wiley Jacob Wagner Loren E. KenaGeorge McLain, Jr. Lawrence Willis Helen Walsh Michael KerleyHelen McLendon Lawrence B. Wilson William J. Who lean Josephine H. KylesRev. Martin McManus Diana Woodruff Crettie LeeRobert Medina Royal Younger DELAWARE Robert F. LenhartKeith Merrill Sam Yuen Inabel B. LindsayClifford E. Miller Sylvia Yuster Andrew Ballantine, Jr. Daniel LopezRobert Mintie Arthur H. Brandenburg Joseph MadisonEmmitt L. Mitchell COLORADO Herbert R. Butts Erlina S. ManzanaresJim Y. Miyano Dan Camera David H. MarlinNinette Morales Marietta Rumberg Benge Zenas R. Clark John E. MartinAlberto Moya Gladyce F. Call William H. Duncan David M. MartinezTom Murphy Sen. Roger Cisneros Raymond Evans Dick MartinezLucy MyersHerb Nalibow

Oliver DiggsLt. Col. Jack L. Dignum

Rev. C. Luther Fulmer, Jr.Francis C. B. McCann, Sr.

Mike MasokaDorothy F. McCamman

Edward R. Neill Julian F. Ebersold Joseph Mraz George Meany

161

Jesus MelandezHerbert J. MillerJoe E. MontoyaPhilomena M. MulladyGloria MuquerzaSusie MunozJames M. Nabrit,Bernard E. NashWesley OlerAntonia PantotaMae PhillipsFrank PohlhausAntonia PantojaMaria PoinsettLorenzo RamirezRalph E. RechelVictor ResendezJoseph S. RevisThomas RiversHenry RobinsonAntonony RochaRoy RodriquezEffie RoebuckJane A. RollinsJames RussoSanto RuizHector Santa AnnaIsabelle R. SchaffnerPaul T. SchulerPaul Sedillo, Jr.Bert SeidmanHarold L. SheppardRudolph SobernheimGeorge SoloyainsArthur L. SparksRuth Spur lockEsther StamatsC. Joseph StellerSister Mary Barbara SullivanSur lo G. SwansonCharles P. TaftMabel TaylorPeter TerzickVirginia TiinmonsMary TovarMrs. John TwinameBernard S. VanrensslaerThomas G. WaltersEarl WarrenPaul WeissMinnie WoodenVicente XimenesDiosdado M. Yap

FLORIDA

Antonio Mendez AnayaL. Dewey AndersonLcree AtkinsonFelix.BarardoEmily BarefieldCharles R. BeberAllen BechetR. 0. BeckmanWilliam G. BellCarlene J. BennettAllen BurkettCarlos CajigaHarry CareySister Jean CassidyJoseph F. Chapman, IIINat CooperS. W. CurtisFranklyn S. Cuyler

Jr.

Leota DavisCarlota De LermaCarmela S. de RegaladoHelen Kaechele DryleLeon EarlsSideny EntmanGeorge FerreeTheresa N. FicarrottaCharles FichtnerCatherine C. FinniganJames FlingClinita FordEdmond M. FortuneWilliam FowlerFlorence FoxMax FriedsonAnna GayleMrs. William L GibsonE. Verner GoodmanMrs. Henry GilmanLiza GorhamCharles GreinerFred HallerHelene HarringtonHoward HarrisPreston C. HaynesAnn HeffernanAndreiv HendricksonNicomedes HernandezMattie B. HicksArdeth W. HighleymanSelden G. HillLawrence HowbertMargaret JacksArchibald B. JAcksonE. Russell JacksonBeth JohnsonSen. Beth J. JohnsonR. W. JohnsonBetty Mae JumperEnrique JovaRudolph KadanskyMildred KaufmanMax KaplanJoseph KerriganJoe L KershawFrances KleinmanDavid C. LaneHenry C. LaneAlfred H. LawtonAaron LipmanMrs. Carl E. MayMarian Hafner McMannLouis MeethAntonio MendezVon D. MizellJorge Garcia MontesVerne B. MorrisonRay MoudryJ. Wertz NeaseIt 1 N. NewquistEt NixonJai 1V. NobleEthel J. OdomCarter C. OsterbindAdriano PadronBarbara PalmerRobert PalmerAlbert PaulFern PenceJean J. PerdueRobert M. PerkinsCharles W. Pruitt, Jr.C. Dallas Reach

Larry H. ReaganMrs. Justo G. RegaladoJusto RegaladoRobert P. RenfrowThomas A. RichHenry RichardsLillian S. RoebuckWalter W. SackettLuis SanjenisSue SaxonlRev. Benjimin F. SchumacherKenneth M. ShaverStanley SilvernG. Ballard SimmonsCharles U. SmithFred SmithSylvester SmithCharles J. SpellMildred SterlingGrace A. StevensGrace H. StewartIrene K. ThresherCharles F. TrumbullRosa VasquezByron J. VillwockConstance G. WalkerHoward WeberEarth M. WhiteAlbert J. E. WilsonWade K. WisslerGeorge WolpertJesse G. WrightMarguerite W. Zapoleon

GUAM

Dolores Cruz CamachoRicardo C. CamachoFather Zoilo L. G. CamachoRichard L. G. CastroJoaquin San Nicolas DiegoEutrosina LyonCarmen Tanaka MatiasLucas L. San NicolasVeronica S. A. PerezJesus Santiago QuinataTeresa T. SablanJesus L. SalasFrank SanchezJose B. SudoBrigidia S. TerlajeSinforoso C. TolentinoGregorio UntalanPedro Q. Untalan

HAWAII

Paul AkamaNorman AkitaCharles BadeAlfred BarrosStella BelknapAnne J. BennerGladys SowellJ. 0. CayabanFoo Lin ChingMargaret FayeEllen Y. FongRenji GotoPatrick J. HoganDruzella G. LytleWilliam NuganumaChristian NV kamaDavid L. Pang

162

Clara Y. SetoGeorge SugaiDianne YasuiRobert Yokoyama

IDAHO

Joseph BaileyDorothy BakerClarence W. CharitonLouise EdmoHomer GrahamHorton HaightLouella HartenbowerKenneth HillDoris KellyManuel LopezLaurine MortonEdna Belle OslundWill E. OvergaardKay PellGerald ReedMrs. Francis RileyCecil SandbergHannah SessionsPerry SwisherJames SymeFern TrullCarolyn Watts

ILLINOIS

Robert J. AhrensMadeline ArmbrustJohn H. BallardFlorence L. BaltzH. Robert Bartell, Jr.Howard H. BedeJohn H. BellC. Felix BengtsonRev. Wilbert BensonMurray BergHa BougeoisElizabeth L BreckinridgeDeton J. Brooks, Jr.Edward W. CannadyWilliam L. ChapinManuel H. ChavezMarguerite S. ChurchMilton CohenJane F. ConnollyRuth CookeEulalia 0. CorbinAgnes CzachorJ. A. DavidsonKurt DreifussGeorge DrysdaleJulia L. DubinMabel Y. DureyRobert L. EmmonsLovelyn J. EvansEsther FainAllan FilekRalph FrancisJane GarretsonDave Gasper, Sr.Neil L. GaynesWilliam GellmanJohn GianopolusJoseph L. GidwitzWilliam nilsonJacob GoldJames GrayJoseph Grittani

Edward F. GurneyJerome HammermanJames G. HaughtonRobert J. HauighurstJ. R. HaynesEdith HeideRabbi Morris M. HershmanEdwin S. HewittThe Very Rev. Msgr. T. J. HolbrookMarshall M. HollebEdward P. HopperCyril 0. HouleCharles J. JanecekJohn Louis JevitzMichael K. JonesGuy R. JustisEunice KellyMrs. Voldemars KorstsStephen KuropasMrs. Fred KushmerAnna LangfordGeorge LangevinHelen LaneBenjamin LeyensonEdythe LevyClarence Lipman1. S. LowenbergThe Rev. Stuart T. LundahlHelen G. LynchDavid M. MageeEve ManzardoCharles V. MartinAloysius A. MazewskiRobert MaysHenry L. McCarthyRobert McCleeryEdward M. McGeheeKay McGovernPaul 0. McKeownAndrew R. McKillopJean J. McVeetyRichard M. MichaelsSen. Howard R. MohrThomas C. MorrillSister M. Paulita MorrisBertram MossLola MuckerBronius NainysHerman J. NebelBernice L. NeugartenFrank B. NorburyMajor Roy B. NordheimerPeter PerreconeCarolyn RadebaughClarence A. ReardonJohn RicePaul S. RhoadsRobert RummenieWilliam L. RutherfordLeonard SchramRalph F. SchroederMrs. Willard C. ScrivnerThe Rev. Herman SeinwerthRep. Joseph G. SevcikEthel ShanasRudolph SobernheimJames StampsGordon F. StreibDavid R. SturgesMargaret SummersPeter TarrellSheldon S. TobinWilliam TudorClyde VedderEugene Verdu

Fern WatsonRonald WeismehlMrs. Wilson WestDonald H. WilliamsEdgar F. WitteChief Little Wolf

INDIANA

Tary AdamsCarl W. AllenMarcile AllenWarren AndrewsMason AtwoodRobert H. BalesMrs. C. A. BanksC. L. Flossie BecknellChester BlubaughJack L. BottenfieldGeraldine 0. BradfordLeonard BreenErnest Brundehler, Sr.Stanley Chernish .Lulu M. ChickadaunceWilliam C. ChristyJames F. ConoverJohn R. CraddockF. Benjamin DavisGeorge E. DavisJesse L. DickinsonValjean DickinsonScott DoupLawrence E. FooteLester J. FoxBishop Raymond J. GallagherMrs. Cecil M. HardenGrover L. HartmanSimon HeemstraRuth HeinsC. W. HemmerJeffrey Allen HurstEmma 0. JohnsonMaurice L. JohnsonAlbert KellyWilliam Marcus KendallByron E. K luteRonald H. McCloudArnold McFarland'Janet McLeanDonald T. NelsonPaul L. PhillippeMargaret Moore PostHomer K. RiceJoel SalonNathan L. SalonGus SamoraCharles SappenfieldSen. John F. ShawleyRabbi Albert M. ShulmanLu H. StoverWallace Van Den SoschHarry TharpKatherine TollClemens A. WarnAllan H. WarneRobert 0. WeirichMax F. WrightGus Zamora

IOWA

Freda BandeIves BartlettDarlene BettsRobert D. Blue

163

Mrs. Delbert CampbellEthel M. CarltonMichael CarterAnn Marie EckertLouise Den n lerTom DoughertyJeanne Schram FortnerWalter W. FoxJames N. GillmanAlden R. GodwinVirginia GriffinAdeline M. HoffmanClarence JohnsonMrs. Thelma KassHarry G. KobesEnfred E. LinderJune McClureFred E. MillerPaul A. MorrisEarl V. NelsonTom RileyMarilyn RussellE. Georgia SamonsHess T. SearsJohn F. SchmidtLeif SchreinerDorcas SpeerGwendolyn R. SpeerHarold TempletrarHarold T. Trupp, Sr.Bass Van GilstRev. Alvin F. VoileMrs. Charles E. WebbSteve Zumbach

KANSAS

Tessie AganJoy ArmknechtFred A. BauschElvora BelcherMary Elsie BorderMildred BoyersmithHarlow BrownMrs. Clifton C, CalvinC. Donald CloseMary CongerArthur B. DennisRev. Armour H. EvansMrs. C. Louden FrazierMary GearhartLauren W. HarrodJean E. HaysAilee HenryCarlos HernandezJohn HolzhuterRonald Johnson .

Stephen P. KralikRobert A. MaxwellSister M. Charles McGrathRussell W. MillerWilliam D. MorelandNellie NavarroLinda Tittle PelzerMargaret A. PennySia SadriEarl H. SayreMrs. Harry L. SmithAddie SpicherMsgr. Arthur TonneWilliam F. TurrentineFay H. WilliamsMamie L. WilliamsRalph E. WilsonMable WrightJames M. Young

KENTUCKY

William BurkettMary Ellen CurtinMary E. EllisJohn H. Ewing, Jr.Dorothy EzelleThomas E FielderNell FlorenceMrs. James Fog:eChloe GiffordMrs. Charles HornadayNaomi HouriganDan HowardEarl KauffmanMrs. J. Murray KinsmanMayor William LayneRev. William P. LivesayHenrietta LoweJohn W. MaharHarold L. MannMildred NeffEarl OliverBlanche PatrickNell Regain.Harold RiesRev. E. Arthur RussellCalvin SchneiderClifford W. SeatonDebbie TrimbleArthur UrlageDon H. ValentineJohn VanderwierRoy WaltersJesse P. WardersWilliam Woodson

LOUISIANA

James W. AilorLawrence J. BallardRebecca E. BoseEmile J. Bourg, Sr.Meredith BradyRichard P. BrownC. S. CadwalladerFrancis M. CarsonDell S. Durand, Jr.Zola A. ErnestFrank P. ForwoodAlbert A. FredericksFlora S. GallowayGrace A. GoldsmithClayton A. GravesRobert S. GreenHelen McBride HiltonTheodore IsraelAnnie H. JonesJ. H. JonesSam Houston JonesBenjamin J. KaplanElliott J. KeyesHeyman C. KornElizabeth M. McGowanMae Dee MooreAlton Ochsner, Sr.Jackson M. Powell, Jr.Archie E. RobinsonEstella SchwarzeFranklin B. StaggAlbert Tate, Sr.Alice TeddlieDavid J. TerrioHorace G. White

MAINE

Laurence P. BagleyMalcolm BrownHarold CollinsGary CookHarriet FoggMary FortierRobert A. FratesKathleen GoodwinMilton HallCharles A. JacobsMrs. Harold JonesJane C. KilroyGerald B. KinneyTheodore E LewinJackson P. LibbyMrs. Philip MarstonJohn L MartinJames F. McMichaelRuth P. McNamaraRichard W. MichaudMrs. Irving PerkinsLeora PrentissHerman D. SahagianJoseph F. SandersFloyd G. ScammonGov. John W. StevensHarold StevensMary G. Worth Icy

MARYLAND

Sen. Rosalie Silber AbramsBertha S. AdkinsLois Kahl BaldwinPeter W. Bauman, Sr.Kathy BaysMrs. Stacy BrooksLeo J. CoadyEdward S. ColbyLou CordovaAlicia CoraLionel H. De MontignyRobert F. DoveJoseph ExcndineThomas C. FetherstonSammuel N. FoxTed GonzalezG. Bartow HarrisJean M. HartmanEarle T. HawkinsWilliam E. HenryFranklyn C. HochreiterJames T. HortonWilliam C. NudelsonWilliam M. HuntGeorge E. JohnsonMrs. Courtney JonesM. Shakman KatzAbiva KaufmanCol. Harold D. KehmAbraham KostickNoemi LabradaJane MattinglyMary McGowanMrs. Courtney Jones McKeldinMable PattersonHilda PawlingEdwardo Pena, Jr.Ida May PettyHazel L. RickerNorman C. RutherHenry RuttingerMargaret C. SchweinhautGertrude W. Shockley

Antonio SuarezJacqueline T. SunderlandMrs. J. Arthur ThroneL. P. ThorntonRichard TrudellIshmael ValdezHarry F. WalkerAlice WestVicar Richard WilliamsLynn WillisWright WilliamsonLadymarie WiseWilliam T. WolfreyLeon M. Woolf

MASSACHUSETTS

Fannie L AllenKen ArvedonDavid M. BanenSolomon BarkinRep. Robert A. BelmonteRobert BinstockSol S. BoskindJames BreagyMelnea A. CassLouise ClarkJames W. CoughlanWalter CrossGeorge L. CulbertCharles F. Doo lingEdward V. DriscollRev. William DuvallRaymon ldridgeDonald C. ExfordDennis FargasLouis FilliosJ. Leslie FirthLevin FosterHenry FredetteHarvey FriedmanW. Rankin FureyFernando Torres GilLillian L. BlickmanJack GouldOrville F. GrahameDavid GreerJohn GuarinoSamuel HarmonFritz HeinemannMyra L. HerrickAdelaide C. HillThomas HoullahanEdna HughesVirginia JefferyHervert JerauldMadeline Dugger KellyJack LeffLouis Lowyr.o.her LymanLouis M. LyonsFrank J. Mtto.ningNorman P. MasonJean MayerRichard McDowellRoss A. McFarlandMadlyn McNiffJanet McNulkyManuel MelloEdward MichaudCharles MooreIsadore MorantzRobert MorrisBernard O'NeillIsabelle M. Parker

Osier PetersonFrederick PicardRuth RobinsonRev. Anthony RochaSolomon RosenbaumMargaret L RossJoyce W. RovelliDante RussoSherman G. SassGenevieve H, SchiffmacherDorothy SchoonmakerCharles I. Schott landJames H. SchultzRoberta SenchkowskiF. Marott SinexFrederick John StareDonald H. StrongRev. Donald A. ThompsonDee TobbenNoel E: TomasDonald M. WatkinWilliam D. WeeksMildred WestoverPaul Dudley White,Dorathca WillgooseConstance WilliamsEurysc WrightBrad Yoncoka

MICHIGAN

Cordon J. AldridgeJ. Kenneth Alt landSolomon J. AxelrodMargaret BartosekClark H. BeirigerBeryle BluespruceClyde W. BriggsNathaniel BrooksAndrew W. L. BrownLowell BusierPhyllis M. BussaRuth ButlerLawrence Gox CalahanDena CederquistSidney W. ChapinCharles H. ChaskesArthur ChildsWilbur J. CohenWalter CoeDorothy H. CoonsHelen CooverJune CronkH. David DekkerErnest C. FacklerLeonard GernantFreida GorrechtLeo A. HaakMilton J. HagelbergJoe N. HamTheodore J. HaskellPeggy F. HincheyRev. James A. HoodClark HopkinsMargaret A. HossackC. Edwin HowardWoodrow W. HunterPauline JacksonHelen G. JacobsMildred M. JeffreyAlberta K. JohnsonLloyd R. JohnsonMyra JohnsonHarold JulianMitchell I. Kafarski

164

Mary E. KastcadRobert KastenbaumEarl KennedyKurt R. KeydelKarl M. KeyesDoris KirklandDaniel H. KrugerMichalene D. LcwandowskiDaniel S. LingJames A. LivingtonMargheritta S. LoudSamuel MacketyLuz Martinc.:Joseph MashHoward Y. McCluskyDavid MillerJohn W. MoffatRose Ila H. NeumannPhilip K. NumincnRoland A. OuelletteMarvin PahlJudge M. Robert PayantDavid A. PetersonEleanor PotterRuth E. PrestonA. Hazen PriceRay R. PurdinJ. Alfred Right IcyHazel B. RobinsonN:ck RohanJack F. SandersLeo ShafferVirginia SolbergWilliam M. SpreitzerMel SteinMonsignor Wilbur F. SuedcampFrederick C. SwartzJohn S. TaylorEdward H. TerryCharles A. ThompsonMrs. Lester TiscorniaVirginia Rogers VancoeveringV. K. VolkRoscoe A. WaltersRobert S. WilliamsCharles L YoungsCharles Younglove

MINNESOTA

Mrs. Ernest R. AndersonDecker AnstromLeonard L. BakerMae BarnessKarl A. BeilkeJane BelauOscar BergstromRabbi Noah BernsteinGerald A. BloedowWin BordenJ. Richard BurtonEnds G. ButenuthCy CarpenterFather Denzil A. CartyInga CraggJohn CrowleyLinda CuttingJudy Anne DwyerRev. Norris ErdalGrace FasslerWilliam G. FisherRichard FlesherGeorge C. CouldSam GraisJames A. Green

Myrtle E. GriffinLlyal M. HansonReuben L HillVirginia M. HinikerTim HowardBea KerstenWilliam KirdmerCharles KrusellMrs. B. C. LeadholmRay I. LemkeConstance J. LindahlTheodor J. LitmanElaine LoucksJames LydayMrs. John LynchBlanche McIntoshClaire N. McRostieRev. Willard J. Merrill, Sr.Rhoda E. MillerRabbi Albert G. MindaAllen Luther MolbergMary Ann MurphyRichard NolanStephen S. OberThomas L. OlsonPhil PaddenW. Dennis PedersonHosea PerryWilliam J. PikeMae D. RogersEtta SaloshinLyall A. SchwarzkopfMrs. Ralph SchwichtenbergMrs. Arthur SehlinKarla SkahenLeo J. SkardaWendell M. SwensonIrene VizenorRegina WeberBarbara R. WehrLeslie E. WestinMarion Williams

MISSISSIPPI

John D. BoydB. Hayden CampbellNora Welch DalyMrs. John A. DonaldsonNoel J. DuquesnayIkie E. EthridgeKay L. FerrymanClay GibsonGwen H. GollotteMrs. Surry A. GraftonJack L. HarrisNorman Weber HillikerMary HouseJeanette JenningsAlice L JohnsonEdgar D. KeimaRuby E. Stutts Lye llsHulette J. MassieTravis McCharenJulius V. MillerLouise Moss MontgomeryLeslie NewcombJohn D. ParishWilliam PoweVelma RogersVardaman J. RunnelsJoseph ThomasVirginia Thomas

James H. WhiteReginald WhiteCharles E. WilliamsLeo la G. Williams

MISSOURI

Angie AkerIcae AlgeoRussell ArmentroutDorothy BakerQuinnie BentonJudge Robert Berry, IIIHerman T. BlumenthalViola BolandCharles BraithwaitMargaret CareyDonald CowgillBina S. DavisCecil N. DavisIda W. DeniningerHarold DicksonAlma G. EfgertIra F. EhrlichRobert H. FelixWilliam R. FortneyGrace L HartClara C. Hem_plemannJudge Mark D. HendersonJudge William A. Honeycutt, Jr.Roy Stokes HowellAlbert G. Incani.Sylvene JamesBen F. JutziJoe KeilholzGregory LefeverMargaret M. LloydPhyllis Kitty MadesonRev. John E. MathewsPearl B. MatthewsDean MoneymakerMrs. Curtis MorganH. Azell MorrisMyrtle MowbrayMargaret A. PennyStanley C. PetersonWarren PetersonC. T. PihlbladMary QuarlesMarion E. RamseyGeorge F. Reeves, Sr.Lela E. ReevesElaine M. ReiterF. E. Buck RobinsonJamesetta RobisonGuy S. RuffinJohn G. RuhlMarie E. SchindlerNita SchwabeEdward G. SeiterLouis SolomonArchie E. StarcherCharles StiverJohn W. StoneBetty ThomasHenry C. TomlinsonNellie Ir. UtzRuth A. WainscottMajor Marjorie A. WeberEarl R. WeltyJoseph 0. WrightMildred WrightMarie Wylie

MONTANAJ. Hugo AronsonDavid Andrew BraatenMarie BradleyElizabeth CashenBill ChristiansenJohn Coey, Jr.Barclay CraigheadKirk M. DeweyLyle DowningDorothy EdsonWilla EvansWilliam D. (Slotty) JamesNorma F. KeilE. F. MacGilvraWilliam A. MacMillanCatherine Calk McCarthyDelude Ann McLaughlinThomas H. MahanDolly PageEffie PentzEarl Old PersonColin W. RaffAnna Pearl SherrickFrank TakesGunMrs. Berrie Weiloff

NEBRASKA

Aubrey AllenAlit; AndersonAngela Little BeaverRuth BlankenshipAnna CameronIsabelle B. CraigSally DittmarIrwin EllestadRobert GibsonRobert D. HarrisonMajor Harry C. HealdHans JensenRonald L. JensenJoe J. JuarezEdwin R. KentGrace LeeCharles MartinJill McMasterMary Maxine MillerHattie MooreVern PangbornWilliam A. PeterEverett P. PhillipsMike RichardsonPaul SchneiderAdelaide H. StubblefieldDorothy SwitzerLola UllstromPhilip VogtAsa Wolfe

NEVADA

Edythe M. AbingtonVirginia B. AkinsClara BaileyHelen jean BrumettMaurice CassAlbert V. GibbonsHeather HindDawn HoltonTed JamesMary Gayle JensenDorothy B. JohnsonMary Johnson

Belma JonesNick B. LauriJack McCloskeyWilliam D. McColloughDorothy MillerRev. j. L. SimmonsAlice L SmithKate St. ClaireRae Van DornumMary Wild

NEW HAMPSHIRE

Arthur S. AdamsRobert P. BurroughsNeal CobleighMargaret CoteElizabeth J. DonovanRichard DowneyRemi L Gendro..JRebecca HallMadelene HaynesRay KippJames LagiosElizabeth K. LincolnHarlan LoganJames R. MackayPhyllis MorrillMother M. Therese PatriciaRichard VitaglinoEmily WilsonRalph W. Wilson

NEW JERSEY

Charles E. ArchbaldJack BelfiNancy BladesJoan M. BrumbcrgJane BrysonEdward CarrFrank J. CouryFanny CowellGeorge DareHarry DecampDoris DealamanRev. Purd E. DeitzEdward L. DonohueGeorge DownsWilliam EdwardsWalter G. EvansMrs. Lee FagioniAnn FinlawEvelyn FrankHarry M. FrankelAdeline FranzelSolomon GeldGeorge GilbertGeorge GoodfellowCharles HansburyEone HargerMildred HaywoodStanley IaconoJohn L. KaufmanWilliam E. 'CayesJohn T. KellyRalph K.mballRev. Robert F. KirchgessnerMelba KostMildred KrasnowDorothy LarsenAnn MacFarlaneSimon F. Mankiewicz

Sister Rita MargaretLouis MazzochiAnnetta McCordAnn McFarlaneJohn McLaughlinConstance MidkiffLeon MilmanDesiree M. MittelstaedtJack H. MohrJohn MooreheadBirger MyksvollIlmar PleerMarion E. PurbeckMildred RadcliffeAnna M. RhineschmidtJohn T. RiceMrs. Bernard RichmanJean RindlaubPatricia. RobertsA. Bruce RobertsonElizabeth RothMaria SalazarMayolyn SaundersRev. Cornelius SchoonejongenAdolph SiegalJoseph SlavinSampson G. SmithAnnabelle StoryCharles TarsiCol. Robert L. TarverMrs. Jack VolosinConrad VuocoloArthur WackerRev. Howard W. WashburnVera WeindlandtWilliam WilliamsAnn Zahora

NEW MEXICO

Col. Cruz AlverezRafael Pablo Ciddioy AbeytaLura Bennett*!rs. C. R. BlockerWilliam L BoyleMarcella A. CiddioLenora CollinsFernando C. de BacaTheodore EvansEdythe FranksJohn D. GallegosBoles lo GarciaR. R. Garner, Sr.Jchn M. HaberlAnn HortonGladys LongSantiago MarquezTheodore F. MartinezDoris MawsonLewis W. McClellandDave MontoyaMarie OblitasBob RevelesNick ReyesGwen RobbinsJesus SantanaAmerande SilbaHenry V. TrujilloAlbert ValleiosHubert VeliideClifford, WhitingK. Rose WoodGeraldine Young

NEW YORK

Albert J. AbramsCharles AbruscatoClifford A. AllansonMother M. AloysiusFernando E. AlverezGertrude L. AmmermanEvelina AntonettyRaymond W. ArnoldAdelaide AttardBela P. BachkaiFrank C. BarlowIrene B. BarnesPeter S. Battaglia,Walter M. Beattie, Jr.John W. BeckmanLouis L. BennettBernard BerggenMildred BerkLawrence BestGeorge F. BerlingerMerritt BidwellEdmund G. BillRev. Paul A. BpriackRev. Leonard BraamRev. P. Arthur BrindisiHarold BrodyAliê M. BrophyHerbert R. BrownEve line M. BurnsEdna E. ButlerRev. Robert H. CalvertPaul C. CardamOneLuis CardonaVirginia W. ChorltonEdwin S. ClareWilliam A. ClermontAlice ColeLester L. ColemanWilliam T. ConklinTimothy W. CostelloR. Eugene CurryMichael M. DacsoGertrude R. DavisMalinda J. DavisMargaret DeadyErwin di CyanMaurice D. DolphinMrs. Milton DorfmanJohn A. .DormiRobert R. DouglassEdward H. DuganWalter DushnyckFaye B. EaglesRhea M. EckelKenneth H. EckhertGrace L. EgelstonRichard A. EstepRev. Charles J. FaheyRalph A. FalcoGerard E. FaheyMurrae A. FeingoldRabbi Louis FinkelsteinGerald M. FlynnMary Alice FlynnEvelyn H. FormanWilliam L. FournierDanny FrankMalcolm J. FreebornE. Corrine B. GalvinArthur GarsonLilyan W. GartnerRev. Stanley P. Gasek

Sol GoldschmidtDonald GorhamPaul C. GouldinRabbi Ronald GreenwaldJose GutierrezTony GuzmanGuinivere B. HallLeon HanLeon HarrisStanley I. Hayes, Sr.Catherine L. Harwood?..Zost Rev. Edward D. HeadGoldie Merle HermanJohn HickeyChief Marcel lus High HawkHyman HirschLouis HongTiber HofanyiJames B. HoverGrace HowardSister Mary Rosari HughesLois HuntingtonHollis S. IngrahamAbraham J. IssermanLissy R. JarvikMuriel -E. JenkinsArnold B. JeromeGou la JohnidesJesse JohnsonRobert F. KatzJohn P. Keith .Herman F. KenneyG. Gwendolyn Kingsland.Loucile M. KinneRabbi I. Usher KirshblumFred W. KleemfierWalter E. KlintBorys KobrynskiRuth E. KocherKalin KoicheffMoonray KojimaErnest K. Kr"_rJoseph A. KuncelikSimon I. KonovitchFred F. KrokenbergerSamuel KuhnAbraham R. KushnerMae LauferElinor LeDrewLouis L. LevineGustave L. LevyMarcelle G. LevyWarren T. LinguistEdward G. LindseyEdward J. LorenzoCarol LucasNellie Pagan LugoLena M. LynkGoeffrey E. MaclayJulian M. MajorRaphael B. MalsinSteven L. MarkovskiHoward C. Mai shaAlexander R. MartinGeneva MathiasenMadge L. MatthewsBaldwin Maul!Stephen MayMother M. Aloysius McBrideKevin McCarthyMarian Ft McChesneyFrancis P. McCloskeyJohn W. McConnellHoward A. McConville

Rev. Robert J. McCuneHelen L. McGovernJohn W. McGrathGrace B. McHenryJohn MedinaSister Regis MellonFaith Dale MeyerGarson MeyerAlan D. MillerIrma MingesNorman S. MooreMartha J. MorganLouise Fisher MorrisJoseph MosarraNeal L. MoylanRoger F. MurrayLucille NakamuraWalter R. NewburgherSanoma De Beal NixonJoseph A. OberMuriel F. OberlederRobert F. O'Connell

'James J. O'MalleyA. Holly PattersonElizabeth PerkinsEdith A. PoddRobert L. PopperErsa H. PostonRobert PriceEmma A. Rainbow011ie RandallAlma E. RangelGeorge G. ReaderLillian ReevesHarold W. ReischVincent A. RiccioIra S. RobbinsAnn S. L. RobinsonRev. Anthony RochaCarmen A. RodriquezHector RodriquezSebastian RudriquezManuel RodsteinWilliam T. RogersEli H. RudinHugo A. RuizJack M. Sabi e

Y Janet S. SainerDaniel SambolWilliam M. SauterMrs. Raymond SchneiderDoris R. Schwartzhenry SegalRabbi Solomon ShannonMost Rev. Fulton J. SheenJerry A. ShroderCharles Edward SigetyHarry SilvermanDavid C. SinglerSigmund J. SluszkaEdward J. StaffordCharles StantonDorothy Goldman SteinfeldWilliam TaggartMrs. Robert TahamutMrs. Alan V. TishmanMary Ellen TullyW. Homer TurnerAndrew TurnipseedJane TurnerCharles J. UrstadtJuan E. VallecilloRev. Rene A. ValeroBella Van Bark

166

Paul G. VanbuskirkHelen Bull VandervortHector 1. VasquezWilliam VazquezHenry Viscardi, Jr.Mitchell M. WaifeGeorge M. WarnerWilliam W. WarrenBenjamin W. WatkinsJoseph D. WeissMax M. WisemanRobert 1. WishnickMyra E. WorkmanGeorge K. WymanRev. William C. Zenns

NORTH CAROLINA

Mrs. Dan M. AllisonPeter B. AuerbachRoy Andersor.Earl D. BarkerPortia BeamonSen. Hargrove BowlesJ. Eddie BrownHarold CarrickEdith B. ChanceEloise CoferThomas H. CollinsWilliam R. CollinsJames CurrieMrs. Albert J. DeforestClement D. Dow lerFaye EaglesCarl EisdorferRalph G. FaulknerFrancis A. FayEva K. GerstelIsa C. GrantJulia HarrisLuther C. HodgesAlbert HuntJacquelyne J. JacksonAnn M. JohnsonSamuel Lawson JohnsonMadeline A. JonesPhillip KellyBuford KiddJuanita M. KrepsSamuel LawsonLouise Lo,George Maddox, Jr.R. Powell MajorsJ. H. McCombsCharles A. McLeanMrs. William R. MullerInez--MylesFannie NewsomePhillip S. OgilvieFre 11 OwlAnnie May PembertonMarguerite F. RoysterMarie SandersCecil ShepsCarter SmithBen SpenceMartha C. StackVirginia StoneJohn SyriaMrs. Charles Zell Taylor, Jr.Mrs. M. B. TaylorHarold TriggSamuel S. WileyMarcia E. WilkinsEllen WinstonNathan H. Yelton

NORTH DAKOTAFrancis BarthHerman J. BischofGladys BlackArthur G. BunkerMarion ConnollyBernhard G. GustafsonRobert E. HansonBrynhild liauglandJack HoevenGeorge KtaftonMrs. Ray LawWalter LoomerDonald McArthurRobert McLaughlinAlvin M. PaulsonBea PetersonNels PorsborgMyrtle SharpWalter ShermanHerman StemDaine StrommeKenneth Urdahl, Sr.Herman WeissAnthony Zukowsky

OHIOMax AmdurThomas S. AndrewsStanley BadynaRaymond J. BalesterDe Are G. BartonElmer BarthelRoy BeverMartin E. BlumMargarer BoganErnest J. BohnRev. L Venchael BoothMarie BrooksAnna BrownMatthew BrownRonald BrownPhilip M. BurgessRobert BurnsL Earle BushAnthony a CalabreseB. Bernard CaplanRichard F. CelesteAlbina R. CermakPhilip ChelnickHoward CheslerKenneth W. ClementAlbert S. CloseMayor Stanley A. CmichGerald CohnJohn H. CooperFred CottrellDorothy CraigHenry CrawfordWilliam F. CrowleyMrs. George CurtisLois S. DaleDolores I: B. DavisWilliam DejonckheereJohn De VitoPaul DingledyLeonard DittmanStephen DoughertyLeo-1DuganMrs. Carl EngelJames FalveyEdward FireT. Lyston FultzAugust B. Garner

Catherine GillieRuth GlickMrs. John F. GottronJoseph G. GrundaKay GundersheimerAlice HairstonEd HellkampMary HemmyErnest L. HenesSister Mary ImmaculateRev. Monsignor Michael B.Henry S. JenkinsMartha JonesJerome KaplanMilton KleinMarie Kathryn KiumpeHelen West KnightGo ldie LakeDorothy LangleyNathaniel C. LeeVivian LewisRuth M. LindesmithWendell LotzRichard LungJustin J. MackertAlex MaravichJoyce McDowellKirk McGeeGoldie McGillSister Anne MarieRuth MelvinMonsignor Paul MetzgerC. A. Charlie Mick leWillard E. MooreRep. Norman A. MurdockNoverre MussonLela MyersRose PapierRalph PerkMarguerite .ParrishJackson -PerryWalter PieperVelma PikkojaEverett PoeS. Donald PollittSam PollockMary PowellHoward RiegerHenry RobinsonHelen RussellHarold SchneidermanA. J. ScolasticeJoseph SediveLouis SeltzerWilliam P. SheehanGary ShepherdM. R. SimpsonMildred. SindellJoseph StocklenLucetia StoicaMarvin B. SussmanRev. Stephen T. SzilagyiCharles P. TaftHenry T. TanakaFrank TateGuy TaylorMrs. Murtis TaylorRichard TaylorFrederick ThalerLouise ThomasFrank Si TroyFrank ValentaRev. Paul WardJesse E. WaughAaron WiesenWilliam Wiggenhorn

McMaus

167

Ivanko

I

OKLAHOMA

Major Howard BeaneWilliam L BrockCeceila BrooksBruce G. CarterThomas S. CunninghamVera J. Da. isBetty L DefriendJohn W. DevoreEileen ElliottKate FrankCol. Leonard H. FullerDee E Gambrel,Lucille T. GeraldMrs. Arthur GermanEldridge Gordon, Jr.Albert Thomas HardinJohn M. HoppisDale KirkR. B. KnightC. A. MarkeyBeth MastersLewis J. McCoyLee MotahLela. P. NashRev. Donald 0. NewbyJune NewmanGladys NunnPansy PriceLloyd E. Rader, Sr.Lloyd C. RoachA. 0. H. SetzepfandtRev. Joseph T. ShackfordWilson D. SteenMrs. Jessy SullivanMike SynarRobert TompkinsLennie-Marie P. TolliverJames B. TownsendRobert N. WallA. Kurt WeissRalph WilliamsJosephus Younger

OREGON

Dewey AuchterJames S. BennettElsie 3loomerBarbara BretzRalph H. CakeDave CameronAntonio CastrejonPaul ElliottEdna R. GildeEleanor GriffittsRobert HoldridgeMarion R. HughesEdgar JacksonWalter G. KlopferHelen ManningTom MarshWalter J. McGettiganArt MotanicMrs. Ray NelsonLois OliverMrs. Ted SaxVada ScottE.M. SheldonClayton ShepherdMrs. John ShepherdMildred WhippleMrs. Terrie C. Wetle

of

PENNSYLVANIA

Peter G. AlapasE. W. AllisonSarah A. AndersonJeanne BaderMary BaltimoreMartin K. BareSylvia BargMary D. BarnesRobert W. BaronMrs. George BarrieFrederick H. BarthCharles BatesMargaret BaynesSarah BellGenevieve BlattWalter L BondThurmond BookerRev. Wesley W. BowdenMrs. Sol BrayBishop John D. BrightLouise Brookins

Elizabeth BrownEleanor H. BryantHarriett BuryRev. A. L. CaesarHerbert R. Cain, Jr.Louis Caplet laSylvia CarothersCharles F. Craver, Jr.David ChittisterWalter J. ClaytonElias S. CohenJacob CohenRuth CohenEllen ConnellFrancis J. CosgroveVincent J. CristofaloMrs. William CrittendenFrank D. CroopMrs. Lagree DanielsFather Del RealMrs. Russell W. DixonMrs. Clarence EbbertMrs. Roy W. EngleGwendolyn FarmerEloise- FarrowJuan Silva FernandezAlbert A. FiokHarry W. FisherJeane FisherJames W. FordSamuel W. FrankTheodore F. FreedHenry FreemanSamuel GranickPatrick GreeneElizabeth Ann GroffHerbert J. GrubbChauncey GundcrmanFrank HendersonMargaret HippeyWilbur HobbsGertrude S. HoistJohn HorneHobart C. JacksonFannie JeffersonSamuel P. KatzManuel KaufmanEllis 0. KellerLeona KellyDonald P. KentMrs. Herman KerberCharles B. Killinger

Edith B. KingGeorge A. KotichFannie G. KrevskyM. Powell LawtonFred J. LeeElizabeth LehmanHarvey LevinGeraldine LewisJimmy LittleturtleDominic LynchGuy MacocciJohanne Zerby MartzRalph McGrawFather James J. Mc HaleMrs. David MeadeMrs David MeasurollHerman M. MelitzerShirley _MooseRiy MorganKenneth MoserJames R. NeelyJohn NicholsWilliam NyeClarence J. 011endikeDean OlewilerMargaret O'NeillJoan OwensJulia PararellaMrs. Forrest L. ParrVictorina PeraltaAlex T. PowellJames B. PrestonThomas S. QuinnJoy Spaulding RabinTheda 1.Hobson ReynoldsMargaret Young RichardsHelen Newbury RiddingtonRichard RifeKatherine Rob 'sonClayton RockAl RojohnDonald J. RosatoArthur RoseFrank RuckJohn A.,SabolMrs. P. SalnerWilliam F. SchlogWilliam SchrumJuan SilvaMrs. Edward SmithRichard A. SnyderLonora SolomonJohn SpadacinnoJ. Flinton SpellerMargaret B. SpencerCecile SpringerDaniel StoneWilbur H. StricklandNathan SussmanCharles TaylorDorothy TaylorJoseph ThompsonRev. Alva TompkinsJohn C. VoermanSen. George N. WadeBeatrice WardC. Clifford WashingtonThe Rev. Shelton B. WatersUlysses WatsonBenjamin F. WeaverRev. Paul WhiteDonald WielandDelores T. WilliamsRaymond Wing

Stephen WisyanskiLula Mays WitherowHelene Wohigemuth

PUERTO RICO

Betty Mabel DeBien AcostaJuan Alemanylag. Emilio CanalsWendy ColonRafael Correa CoronasAlejc DiazInes E. de SalcaFrancisca GonzalezHeyda GonzalezMariano HernandezHector L Rodriguez MuncoJaime Tow PerezMargarita Pietri De PiquetModesto RiveraRenato RoyoEfrain SantiagoAlicia Ramirez SuarezMiguel VasquezEddie Zavala Vazquez

RHODE ISLAND

Robert S. Burgess.John W. CornettMildred DeanAdeline N. DerensisVictor GagnonAmelia GelfusoSidney GoldsteinPaula L GregoireBernard A. HeslinMargaret HollandRichard J. KraemerAlbert V. LeesHelen C. McLeishWilliam A. PellitierEdgar J. PeloquinRose ShockettEleanor F. SlaterMabel Constance SneedVirginia StoneBev TavaresDel ThebergeLillian TurnerAgnes VigeantJames N. WilliamsRichard Zambarano

SOUTH CAROLINA

W. T. C. BatesW. T. BoltRosa monde R. BoydAlton G. BrownHarry R. BryanEmma DavisJames D. DubsR. Archie EllisJim FlintMary HeriotCharles G. HeronMary E. HiteW. T. HoltLeonidas JamesAnna D. KellyRev. Grant LeveretsIsadore LourieWilliam MarettRev. Ted R. Morton,S. White Rhyne

168

Jr.

Chaplain James E. RogersLarry SextonSherry ShealyGertrude ThurmondW. Fulmer WellsMarjorie WhetstoneBennie L WilliamsJohn R. Woff

SOUTH DAKOTA

Eunice AndersonEvelyn BergenFrancis ColeFrank D. Ducheneaux, Sr.Sister Alicia DumphyGerry EisenbraumCarl FisherDelia GreeneMyrle G. HansonRobert H. HayesPeter B. JohansenRussell E JonasPeg M. LamontJoan LiebigRev. C Elliott MeansLillian NacePatrick A. NormanMartin OsterhausI Tech J. Schumacheral.s. Harold ThomasRev James W. TorbertLloyd T. Uecker

TENNESSEE

Alfred BallingerMary Sue BetheaCol. Leroy B. BibleRichard BlockDavid BowBetsy BowmanRalph BrayPatty Rae BuchananGlen BusheyHenry CannonMrs. Frank CheneyWilliam E. ColeMrs. Alfred N. CostnerLee DabneyMurray FlatsRobert FortThomas F. Frist, FirstThomas F. Frist, Sr.H. M. FryeNancy Ir.ill FulmerGrahan FunderbrukPearl GilliamRobert GlennMrs. Walter GoforthJohn GriesbaumRoy HallT. J. Harrison, Jr.Erich HelbigMildred HurleyTom JensenRudolph H. HampmeierJames J. KellyThomas P. Kennedy, Jr.Taknski MakipodanSart McCalebA. U. MooreT. G. MurphreeVirginia W. PowerRev. Walter I.. Russell

at:

Dan J. ScottIna Fulton ShumakerRebecca SmithHenry A. TillerSebastian TineE. Neige TodhunterErshell VaughnEthely H. VensonRev. Kenneth C. VerranPaul WellsLeah Rose WerthanRev. Henry G. WestMrs. Malcolm Whit.Earle L WhittingtonCharles Edwin Williams

TEXAS

Mrs. C L AbernethyRomaon S. AcostaFred J. AgnichDavid AlvardoGerald (Jerry) AvilaDonna Beardajudge Ernest BelcherMinnie BellCarlos BesinaizZeronoa S. BlackHoward BlomquistBillie BolinFred Brinkley, Jr.Henry Allen BullockAlvin A. BurgerDorothy ByrdAti lano CalderonJohn CamposManual GinoLois CarlisleE R. CarverMrs. Carter M. aoptonJ. H. ClouserJames F. ConnerThomas CraddickMrs. V. W. CrumpMrs. Howard DavisonRudy DavilaNadine C. DensonHarry Dieu. tArt DilleyFratis L DuffMrs. Printis EllisElmo FischerSwan FisherStanley A. FishierMyrtle FontenoStuart FosjerH. J. FriedsamCharles M. GaitzClotilde GarciaConsuelo L GarciaMrs. John GarciaBernard GoldsteinMcChesney Goodall, Jr.Ross GreenwoodTito GuerreroBurton G. HackneyHugh HackneyJohn H. HannahRuth HarperRoy HarringtonAlan W. HastingsMargaret M. HendersonBill HernandezMrs. Jackson HindsMrs. R. M. Hix

Bert HolmesRev. William HolmesRoy Stokes HowellMrs. Lynn HubbertEdna JagoeEvelyn JeffersonInez JefferyLois JenkinsMary Louise JohnsDonna JohnsonR. L JonesJohn T. KingOlga LepereCarl D. LevyArden I. LewisBen W. LinsaySam LongMrs. Ernest MaciverJames L. MackayCora MartinHomer MartinezLouise MasseyMrs. Charlie MatlockJack MatthewsMrs. Fred McCleskeyMrs. Ray MillilcanDorothy E. MoodMargaret MurrayMarie OrtegaOlga OrtizSaul ParedesRev. Billy Mack PanesonAda PenaGante PenaFelix Perez, Sr.Robert S. PoolLeola PrellHarold PriceRobert E. PughJuanita QuinterosDorothy RakerAlbert RandallBernard RapportDan ReynaMrs. A. W. ReynoldsRamon RomeroMeledo SanchezRev. Rudi SanchezRovers R. SandersEugene P. Schoodi, Jr.James SherryHerbert ShoreMrs. Martin D. SiegelMrs. Bert Kruger SmithRev. Albert StaffordBradley TaylorLena TaylorMrs. Terry ThomasMike TitanIsrael ValdezL G. (Bill) VawterEdwina WhiteJay E. Wilkins, Jr.Norma WilkinsMabel WilliamsMary Williams

TRUST TERRITORY OFTHE PACIFIC ISLANDS

Olympio T. SoriaEd-vard CapelleChief Alper DomsinDwight Heine

Kintoki JosephChief Reklai Ngirasechedui LChief Francisco LuktunEskiel MosesNamaru NakamuruChief Ibcdul NgoriaklHenry S. PangelinanChief Andrew J. RobomanBenign SablanHenry SamuelBen SchermesJoab SigrahNorman SkillingKakwe TelinejRosendo T. TongaFrancisco B. TudelaSabi William

UTAH

Donald C. CapfallJessie CrowderOrin CrumpIrene C. CuchHorace DotyMary M. HansonGeorge HenryVictor KasselStella La RoseSimona MansJames A. McMurrinMike MelendezHarry NelsonFerdinand E. PetersonThomas M. PhillipsWayne PrinceMignon RichmondDeborah RobertsGlezi SnowHyrum TooneAlberta WestMelvin A. WhiteDouglas 0. WoodruffNaomi WooleyJohn Zupko

VERMONTHenry P. AlbarelliLeonard BlackTheresa BrungardtCyril CartyJoyce CorningAlfred CoutureFrank DumasScotty GrigatJune E. HolmesMrs. Herbert IngramAline JohnsonJohn M. LearyMarguerite LillicrapMrs. Lou MaginnElizabeth lficklejohnWalttr J. ReganDavid H. RosenGeorge SloanMabel SullivanJulia E. TuckerMaurice WalshMargaret B. Whitticsey

THE VIRGIN ISLANDS

Clarice BournneFather Julian M. Clarke

169

Theodora Dunbavinomisang Florence Hill

Arturo JamesRuth H. JonesPastor Roger KimballGloria M. KingMrs. Bert PaiewonskyAlice PetersenElaine SprauveClarice ThomasJane TuittConsuelo VantcrpoolBetty WatlingtonFitzroy. WilliamsPatrick WilliamsSylvia C. Young

VIRGINIA

Belle Boore BeardRaleigh CambellAustin B. ChinnHoward C. CobbsJohn CullA. Ray DawsonLouella C DirksenMrs. Norvleate DowningKenneth E. DunlapJohn W. EdeltnanJames H. Elam, Jr.Mrs. W. H.-EllifritsWilliam H. Emory, Jr.

-.0.c Julian P. Fox, Jr.Anna GoverMrs. C L GregsonGeorge H. HillHarold H. HopperAline JohnsonFannie JonesR. L LacyHenry 0. LampeMrs. Virgil F. LawsJ. Franklin Little, Jr.Sandra H. McNairJames E. MontgomeryKey. Charles E. NealAdriano P. PadronMaria PornsettH. Stewart Potterjanipher W. RobinsonM. Leigh RookeDorothy RoweBurton RudyNeil RyanByron C. SarvisCot Wilfred SmithHerbert H. SouthallRev. John StantonJulia E. TuckerSen. James C. TurkDavid Evan UshioStanley WilcoxEdwin L. WoodHobie Wright

WASHINGTON

Mrs. Jose AguilarNora BarkerLyle DaverinVine DeloriaRoland DietmeicrJames B. Dixon

Arthur FarberConrad() FloresLaura FoltzJoe GarciaThomas GardnerRichard A. GrantClarence HartRaymond HiflyardLillian HodinChisato KawakoriFred KellyRudolph KnaackHarry LoftSister Lois MarieCatherine MayJohn B. McPhersonMrs. Florence Myers

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WEST VIRGINIA

Glen ArmstrongRev. Arnold BelcherWinifred M. BoothWylene DialEdward W. DrichorscMargaret EmeryMrs. G. Thomas EvansLouise B. GerrardRobert Goodrich, Jr.Al lie GorrellG. E. JordanYvonne KnauffW. J. MartinMrs. Marion McQuadeRonald M. Nestor

170

Larkin OursF. Ray PowerEmma C. RobinsonMartha ScottSam ShawJulia Woodruff

THE TERRITORY OFAMERICAN SAMOA

Asuemu U. FuimaonoBen SchirmerFiataualoca D. SomaSinatoga Wan li

NATIONAL ORGAN! ZATION DELEGATES

ADULT EDUCATION1 ASSOCIATION OF THE U.S.A.

Dr. Earl Kauffmani Dr. Mary C. Mulvey

APL-CIO, INDUSTRIALUNION DEPARTMENT

Marvin CaplanJacob Clayman

AFRICAN METHODISTEPISCOPAL CHURCH

W. E. RossRev. Andrew White

ALTRUSA INTERNATIONAL,INCORPORATED

Ethel J. BoyleDorothy E. Kueldhora

AMALGAMATED CLOTHINGOFWORKERS OF AMERICA

William ElkusHoward D. Samuel

AMALGAMATED MEATCUTTERS AND BUTCHERSWORKMEN OF NORTH AMERICA

Leon B. SchachterIrving Stern

AMERICAN ACADEMYOF OPTOMETRY

Dr. Frank A. BrazeltonDr. Donald C. Exford

AMERICAN ACADEMYOF PHYSICAL MEDICINEAND REHABILITATION

Dr. Leonard F. Bender

AMERICAN AGINGASSOCIATION, INC.

Dr. Denham HarmanDr. Morris Rockstein

AMERICAN ASSOCIATIONOF EMERITI

Dr. George R. LukeDr. Phi (omens MarquardtMullady

AMERICAN ASSOCIATIONFOR HEALTH, PHYSICALEDUCATION, ANDRECREATION

Laura Mae BrownDr. Barbara E. Forker

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AMERICAN ASSOCIATIONOF HOMES FOR THE AGING

Eugene T. HacklerFrank G. Zelenka

AMERICAN ASSOCIATIONON MENTAL DEFICIENCY

Natalie TwardzickiMargaret M. Wright

AMERICAN ASSOCIATIONOF OPHTHALMOLOGY .

Dr. Abraham L. KornzweigDr. David H. Scott

AMERICAN ASSOCIATIONOF RETIRED PERSONS

Olivia C. AlanizCyril F. BrickfieldBertha ByrdsongMamie- R. CapellenRev. Otho CobbiasLeonard DavisIyy_Demps_eyRuby M. ElliotJar les M. FarrisKatie FlanaganEdward E. FrederickGar P. FryerJosephine M. GustafsonMilton JacksonJerry P. JohnsonVictor A. LindstromTsunao MiyamotoNicholas H. ModinosPaul F. NewellArthur J. SchuettnerChester A. Smith_Charles R. StultzAlice Van LandinghamDr. Harry WeinermanDouglas 0. Woodruff

AMERICAN BAPTISTCONVENTION

Miriam R. CorbettRev. Ray L Schroder

AMERICAN BAPTISTHOME MISSION SOCIETIES

Rev. Donald H. CrosbyDr. Charles A. Oehrig. Jr.

AMERICAN BAPTIST WOMENAlonzo H. HartwigViolet E. Rudd

AMERICAN BAR ASSOCIATIONNorman J. KaicheimRalph J. Podell

AMERICAN BIBLE SOCIETYDr. Gordon ClarkeDr. James Z. Nettinga

AMERICAN CAMPING

AMERICAN ASSOCIATIONOF STATE AND TERRITORIALDENTAL DIRECTORS

Dr. Norman C. Rutter, Jr.

AMERICAN ASSOCIATIONOF UNIVERSITY WOMEN

Alice L. EeemanMartha S. Luck

AMERICAN ASSOCIATIONOF WORKERS FOR THEBLIND, INCORPORATED

J. Kenneth CozierPater J. Salmon

AMERICAN BANKERSASSOCIATION

Richard W. DrakeThomas R. Wirsing, Jr.

171

ASSOCIATION, INC.Fred D. Carl

AMERICAN CANCERSOCIETY, INCORPORATED

Joseph W. Leverenz

AMERICAN COLLEGEOF NURSING HOMEADMINISTRATORS

Lynn W. Norris

AMERICAN COLLEGEOF PHYSICIANS

Dr. Wesley M. Oler IIIDr. Edward C. Rosenow, Jr.

AMERICAN CONGRESS OFREHABILITATION MEDICINE

Dr. Margaret Kenrick

AMERICAN DENTALASSOCIATION

Dr. Dayton KrajicekDr. Frank L Shuford, Jr.

AMERICAN DIABETESASSOCIATION, INC.

Dr. Louis K. AlpertDr. Herbert Pollack

THE AMERICANDIETETIC ASSOCIATION

Marjorie M. DonnellyMildred Randall

AMERICAN FEDERATIONOF GOVERNMENTEMPLOYEES, AFL-CIO

Laura H. HarrisJoseph B. Resins

AMERICAN FEDERATION OFLABOR AND CONGRESS OFINDUSTRIAL ORGANIZATIONS

Walter DavisClinton FairPage GrotonPeter Mc GavinFrederick O'NealWilliam E. PollardJulius Roth-manJoseph RoukeMichael SampsonBoris ShishLawrence T. SmedlyStanton Smith

AMERICAN FEDERATION OPTATE, COUNTY, MUNICIPALEMPLOYEES, AFL-CIO

Robert D. BolandJohn E. Martin

AMERICAN FEDERATIONOF TEACHERS

Sylvia R. LetinsonCarl J. Megel

AMERICAN FOUNDATIONFOR THE BLIND, INC.

Dorothy DembyMarion V. blunter

AMERICAN GERIATRICSSOCIETY

Dr. Theodore C. KraussDr. William Reichel

AMERICAN HOMEECONOMICS ASSOCIATION

Dr. Richard L D. MorseIrene IL Wolgamot

AMERICAN HOSPITALASSOCIATION

Regina KulysMonroe Mitchel

AMERICAN INSTITUTEOF ARCHITECTS

Olin Boese, Jr.Eugene D. Sternberg

AMERICAN INSTITUTEOF PLANNERS

Harland BartholomewAlvin Zelver

AMERICAN INSTITUTEFOR PSYCHOANALYSIS

Dr. Bela S. Van Bark

AMERICAN JEWISH CONGRESSNaomi B. Levine

THE AMERICAN LEGIONMilton S. ApplebaumJoseph Holzka

AMERICAN LIBRARYASSOCIATION

Ira PhillipsLesiyn Mary Schmidt

AMERICAN LIFE CONVENTIONRichard E. VernorEdwin J. Faulkner

AMERICAN LUTHERANCHURCH, SOCIAL SERVICEDIVISION

James V. AndersonRev. John M. Mason

AMERICAN MEDICALASSOCIATION

Dr. David EcksteinDr. Pierre Salmon

AMERICAN MEDICALWOMEN'S ASSOCIATION INC.

Dr. Elizabeth S. ICahlerDr. Margaret J. Schneider

AMERICAN MOTHERSCOMMITTEE. INC.

Dorothy M. Lewis

THE AMERICANNATIONAL RED CROSS

Mrs. Francis E. HildebrandBarbara K. Williamson

AMERICAN NURSES'ASSOCIATION, INC.

Sister M. Loyola SchwabMii-k E. Stiatighitesii

AMERICAN NURSINGHOME ASSOCIATION

David R. MosherFrank J. Ritiehait

AMERICAN OCCUPATIONALTHERAPY ASSOCIATION, INC.

Betty R. CoxAlice L. Shafer

AMERICAN OPTOMETRTCASSOCIATION

Dr. V. Eugene McCraryDr. Douglas W. Redmond

AMERICAN ORTHOPSYCHIATRICASSOCIATION, INC.

Dr. Jean K. BoekSimon H. Tulchin

172

AMERICAN OSTEOPATHICASSOCIATION

Dr. F. L. ReedDr. Richard F. Siehl

AMERICAN PATIENTSASSOCIATION

M. Daniel TatkinMarilyn Wisoff

AMERICAN PERSONNEL ANDGUIDANCE ASSOCIATION

Leonard M. MillerDr. Frank L. Sievers

AMERICAN PHARMACEUTICALASSOCIATION

Mr. James D. HawkinsCharles A. Schreiber

AMERICAN PHYSICALTHERAPY ASSOCIATION

William F. LangPaul G. Otoittior

AMERICAN PODIATRYASSOCIATION

Dr. Daniel A. RietzDr. Edward L. Tarara

AMERICAN PROTESTANTHOSPITAL ASSOCIATION

Charles D. Phillips

Ronald H. WisonAMERICAN PYCHIATRICASSOCIATION

Dr. Alvin I. GoldfarbDr. Jack Weinberg

AMERICAN PSYCHOANALYTICASSOCIATION

Dr. Hugh T. CarmichaelDr. Ralph J. Kahana

AMERICAN PSYCHOLOGICALASSOCIATION

Jack BotwinickLeonard Gotteiman

AMERICAN PUBLIC HEALTHASSOCIATION, INC.

Henry C. DanielsGladys H. Mathewson

AMERICAN PUBLICWELFARE ASSOCIATION

George K. Wyman

AMERICAN SCHIZOPHRENIAASSOCIATION

Mel Mendelssohn

AMERICAN SOCIETY OFCONSULTANT PHARMACISTS

Richard S. BermanDr. Allen M. Kratz

THE AMERICAN SOCIETYFOR GERIATRIC DENTISTRY

Dr. Arthur ElfenbaumDr. Walter A. Hall, Jr.

AMERICAN SOCIETY OFHOSPITAL PHARMACISTS

Dr. Carl T. De MarcoDr. Dwight R. Tousignant

AMERICAN SOCIETY OFOF INTERNAL MEDICINE

Dr. Robert H. Barnes

AMERICAN SOCIETY FORPERSONNEL ADMINISTRATION

L R. BriceMark Staley

AMERICAN SOCIETY OFPHYSICIANS IN CHRONIC

DISEASE-FACILITIES -

Or. Raymond T. BenackDr. J. Raymond Gladue

AMERICAN SOCIOLOGICALASSOCIATION

Ethel Shanas

AMERICAN SPEECH ANDHEARING ASSOCIATION

Dr. Norman S. BarnesDr. Henry E. Spuehler

AMERICAN TRANSITASSOCIATION

Stanley H. Gates, Jr.

AMERICAN VETERANSCOMMITTEE

Chester C. ShoreRudolf Sobernheim

AMERICAN VOCATIONALASSOCIATION, INC.

H. Dean Griffin

ARROW, INC.Virgil I.. Kirk, Sr.

THE ARTHRITISFOUNDATION

David D. Shobe

ASSOCIATION OFADMINISTRATORS OFMH-MR FACILITIES

Stephen CaulfieldSidney R. Katz

ASSOCIATION OFJEWISH CENTER WORKERS

Stanley FerdmanRobert H. Weiner

ASSOCIATION OF LADIESOF CHARITY OF THEUNITED STATES

Mrs. Willard M. JacksonAnny May Moynihan

ASSOCIATION OF MEDICALREHABILITAION DIRECTORSAND COORDINATORS, INC.

Mary C. Van Benschoten

ASSOCIATION OF PRIVATEPENSION ANDAND WELFARE PLANS, INC

James A. CurtisJoseph P. Leary

ASSOCIATION OF SCHOOLSOF PUBLIC HEALTH, INC.

B'NAI B'RITH WOMENHelen DiamondMrs. Frederick Solomon

BOY SCOUTS OF AMERICAArthur K. Weiner

BROTHERHOOD OF RAILWAY,AIRLINE AND STEAMSHIPCLERKS, FREIGHT HANDLERS,EXPRESS AND STATIONEMPLOYES

J. J. KennedyE J. Neal

CATHOLIC DAUGHTERSOF AMERICA

.Annie Schipp Shields

CATHOLIC HOSPITALASSOCIATION

John T. JamesSister Mary Maurita Sengelaub

CAUCUS OF BLACKDr. John A. Scharffenberg

THE ASSOCIATIONOF SOCIAL ANDBEHAVIORAL SCIENTISTS

Dr. Jesse E. GlosterDr. Hubert B. Ross

ASSOCIATION OF STATEAND TERRITORIALHEALTH OFFICERS

Dr. Hollis S. Ingraham.

BAKERY AND

CONFECTIONARY WORKERS'INTERNATIONAL UNIONOF AMERICA

Vaughn a BallAlbert K. Her ling

BLACK, PSYCHIATRISTSOF AMERICA

Dr. Gail AllenDr. Dorothea Simmons

BLACK WOMEN'S COMMUNITYDEVELOPMENT FOUNDATION

Sarah W. Herbin

BLUE CROSS ASSOCIATIONHada G. PearceJohn E. Svenson

B'NAI B'RITHRaynard I. JamesonAviva Kaufman

173

SOCIOLOGISTSDr. James E.BlackwellDr. Stanley Smith

CENTRAL CONFERENCEOF AMERICAN RABBIS

Rabbi Bernard H. Mehlman

CHRISTIAN CHURCH,DEPARTMENT OF CHURCHIN SOCIETY

Loisanne BuchananDonald F. Clingan

CHRISTIAN CHURCH,THE NATIONALBENEVOLENT ASSOCIATION

Dr. William T. Gibb e

CHRISTIAN FAMILYMOVEMENT

William J. Fitzgerald

CHRISTIAN REFORMEDCHURCH

Jack W. Stoepker

CHURCH OF THE BRETHRENOlin J. MasonLarry K. Ulrich

CHURCH OF GODRobert 0. Dulin, Jr.Dr. William E. Reed

CHURCH OF THE NAZARENE, Rev. Earl Wolf

A

CHURCH WOMEN UNITEDCamella J. BarnesGrace Loucks Elliot

COMMITTEE FORECONOM IC DEVELOPMENT

Robert F. LenhartJohn A. Perkins

COMMUNICATIONSWORKERS OF AMERICA

John T. MorganWilliam J. Walsh

CONFERENCE OF MAJORSUPERIORS OF WOMEN

Sister M. Madeleine Adamczyk

CONSUMER FEDERATIONOF AMERICA

Dr. W. Palmer DearingWilliam R. Hutton

CONSUMERS UNION

Dr. Edivard Reich

COOPERATIVE LEAGUEOF THE U.S.A.- Eugene R. Clifford

Dressel

COUNCIL OF JEWISHFEDERATIONS ANDWELFARE FUNDS, INC.

Sophie B. EngelMrs. Jack H. Pearistone

COUNCIL OF ORGANIZATIONSSERVING THE DEAF

Edward C. Carney

COUNCIL OF STATECHAMBERS OF COMMERCE_

Paul P. HenkelThomas M. Welch

CUNA INTERNATIONAL, INC.George R. LaChappelleEvert S. Thomas, Jr.

DAUGHTERS OF ISABELLAMarie HeyerAnna C. Walsh

THE DELTA KAPPAGAMMA SOCIETY

Avis Dunn Whitlow

DELTA SIGMA THETA, INC.Cassie CookeVera Foster

DIPLOMATIC AND CONSULAROFFICERS, RETIRED, INC.

William C. Affeld, Jr.Theodore J. HadrabaFrederick D. Leatherman

DISABLED AMERICANVETERANS

Robert F. Dove

THE ELDER CRAFTSMENINCORPORATED

Samuel L. Kuhn

"'ti' EPISCOPAL CHURCH,tYISCUPAL SOCIETY FORMINISTRY TOTHE AGING, INC.

Rev. Herbert LazenbyRev. Gregory D. M. Maletta

THE EPISCOPAL CHURCH,EXECUTIVE COUNCIL

Woodrow W. CarterJarifes E. Dumas

THE EVANGELICAL COVENANTCHURCH OF AMERICA

Nils G. AxelsonRev. Milton B. EngAretson

EVANGELICAL LUTHERANGOOD SAMARITAN SOCIETY

August J. Hoeger, Jr.

FAMILY SERVICEASSOCIATION OF AMERICA

Francis M. BainLeonore Rivesman

THE FIRST CHURCHOF CHRIST, SCIENTIST

C. Ross Cunningham01,:e A. LaRoche

FOUNDATION FORCOOPERATIVE HOUSING

C. Franklin Daniels

FRATERNAL ORDER OF EAGLESSteven V. Thomas

FREE METHODIST CHURCHOF NORTH AMERICA

Bishop Edward C. JohnRev. Harold S. Schwab

FRIENDS COMMITTEE ONNATIONAL LEGISLATION

Stephen L. Angell, Jr.Robert Mills

174

FRIENDS UNITED MEETINGHerbert Pettengill, Jr.Katherine Toll

FUTURE FARMERSOF AMERICA

Kevin RAIErnest E. Towell, Jr.

FUTURE HOMEMAKERSOF AMERICA

Margaret Louisa Lindell

GENERAL COUNCILOF ASSEMBLIES OF GOD

Rev. Stanley. MichaelRev. Charles W. H. Scott

GENERAL FEDERATIONOF WOMENS' CLUBS

Katherine AbbotEmogene K. Baxter

GERONTOLOGICAL SOCIETYDr. Jerome KaplanDr. Ivan N. Mensh

GOLDEN RING COUNCIL OFSENIOR CITIZENS CLUBS

Moe Diamond

GOLDEN YEARSFOUNDATION, INC.

Dr. Bernard LanderMorris Zelditch

GREEK ORTHODOXARCHDIOCESE OF NORTHAND SOUTH AMERICA

_Penelope ConstantinePagona Maroulis

GUILD OF PRESCRIPTIONOPTICIANS OF AMERICA, INC.

Jerome A. MillerAlfred D. Teunia

HEALTH INSURANCEASSOCIATION OF AMERICA

Arthur M. BrowningRichard H. Hoffman

HEARING AIDINDUSTRY CONFERENCE

James P. InceRobert E. Winslow

HOME ECONOMICSEDUCATION ASSOCIATION,N.E.A.

Dr. Mary Lee HurtBertha G. King

INSTITUTE OFLIFE INSURANCE

Willard W. PeckJohn W. Riley, Jr.

INTERNATIONAL ASSOCIATIONOF FIRE FIGHTERS

Raymond L. PerryJack A. Waller

INTERNATIONAL ASSOCIATIONOF MACHINISTS ANDAEROSPACE WORKERS

Robert G. RoddenJoycelyn A. Thompson

INTERNATIONALBROTHERHOOD OFELECTRICAL WORKERS

Thomas A. HanniganHarold G. Tate

INTERNATIONAL--------- BROTHERHOOD OF

INTERNATIONALUNIONOF UNITED BREWERY, FLOUR,CEREAL SOFT DRINK ANDDISTILLERY WORKERS OFAMERICA

Arthur P. Gildea

INTERSTATE ASSOCIATIONOF COMMISSIONS ON THESTATUS OF WOMEN

Jessie H. Roy

IOTA PHI LAMBDA

SORORITY, INC.Belle Butler'Bessie Coston

JAPANESE-AMERICANCITIZENS LEAGUE

Mike M. Masaoka

PAINTERS AND ALLIED TRADESJohn J. Pecoraro

INTERNATIONALEXECUTIVE SERVICE CORPS.

William L FingerHarold F. Stebbins

INTERNATIONAL LADIES'GARMENT WORKERS' UNION

Evelyn DubrowMatthew Schoenwald

INTERNATIONALREADING ASSOCIATION

Dr. Lester M. Emans

INTERNATIONAL SENIORCITIZENS ASSOCIATION, INC.

Ted EllsworthGrace Sawyer

INTERNATIONALUNION OF ELECTRICAL,RADIO AND MACHINEWORKERS, AFL-CIO-CLC

Edward J. CarlsonWilliam S. Gray

INTERNATIONALUNIONOF OPERATING ENGINEERS

Howard B. Mundorf

JEWISH LABOR COMMITTEEIcing BarshopBella Hyman

JEWISH OCCUPATIONALCOUNCIL

Roland BaxtBeatrice Novick

JOINT STRATEGY ANDACTION COMMITTEE

Rev. Norman E. Dewire

KAPPA ALPHA PSIDr. William Thomas Carter

KIWANIS INTERNATIONALPercy H. Shue

LABORERS' INTERNATIONALUNION OF NORTH AMERICA

James R. Sheets

LEAGUE OF UNITEr LATINAMERICAN CITIZENS

Angelo DeSotoJulia S. Zozaya

LEGISLATIVE COUNCILFOR OLDER AMERICANS, INC.

Miriam CainesFrank Holiver

LIFE INSURANCEASSOCIATIONOF AMERICA

Alan E. PinadoJ. Darrison Sillesky

LIONS INTERNATIONALWilliam B. Hix

175

LITTLE SISTERSOF THE POOR

Sister CecilMother Mary James

LUTHERAN CHURCHIN AMERICA

Rueben T. JessopRev. Harold W. Reisch

THE LUTHERAN CHURCHMISSOURI SYNOD

Alfred Y. ArmsteadDr. Weslie F. Weber

LUTHERAN COUNCIL IN THEUNITED STATES OF AMERICA

Rev. Norman C. HeinWill C. Rasmussen

THE LUTHERANLAYMEN'S LEAGUE

Ben F. Jutzi

LUTHERAN RESOURCESCOMMISSION

Dr. Henry En dressWilson M. Matthews

MENNONITE BOARD OFMISSIONS AND CHARITIES

Arnold W. CressmanTilman R. Smith

MEXICAN-AMERICANLEGAL DEFENSE ANDEDUCATIONAL FUND

Mario G. Obledo

MEXICAN-AMERICANOPPORTUNITY FOUNDATION

Dionicio Morales

THE MILITARY ORDEROF THE WORLD WARS

Col. Harold D. Kehm

MOBILE HOMESMANUFACTURERSASSOCIATION

Ronald K. Jones

THE NATIONAL ASSEMBLYFOR SOCIAL POLICYAND DEVELOPMENT, INC.

C. F. McNeil

NATIONAL ASSOCIATIONFOR THE ADVANCEMENTOF COLORED PEOPLE

Warran HowardKivie Kaplan

NATIONAL ASSOCIATION

OF BLACK SOCIAL WORKERSJay Chun

NATIONAL ASSOCIATIONOF BLUE SHIELD PLANS

Hugh E. DeFazioDenwood N. Kelly .

THE NATIONAL CATHOLICEDUCATIONAL ASSOCIATION

Sister Mary Barbara Sullivan

NATIONAL ASSOCIATIONOF COLORED WOMEN'SCLUBS, INC.

Georgia C. AndersonMyrtle 011ison

NATIONAL ASSOCIATIONOF COORDINATORS OF STATEPROGRAMS FOR THEMENTALLY RETARDED, INC.

Robert M. Gettings

NATIONAL ASSOCIATIONOr COUNTIES

Max A. BarczakGeorge Otlowski

NATIONAL ASSOCIATIONOF THE DEAF

James T. FloodDr. Jerome D. Schein

NATIONAL ASSOCIATIONOF EVANGELICALS

Floyd Robertson

NATIONAL ASSOCIATION OFEXTENSION HOMEECONOMISTS/

Alfretta E. DickinsonBetty Parks Strutin

NATIONAL ASSOCIATION OFHEARING AND SPEECHAGENCIES

Susan F. SegrestAlice H. Suter

NATIONAL ASSOCIATIONOF HOUSING ANDREDEVELOPMENT OFFICIALS

John D. LangeHugh Denman

NATIONAL ASSOCIATION OFJEWISH FAMILY, CHILDREN'S,AND HEALTH SERVICES

Benjamin IL Sprafkin

NATIONAL ASSOCIA1 TON OFJEWISH HOMESFOR THE AGED

Jacob ReingoldDr. Herbert aore

NATIONAL ASSOCIATIONOF LIFE U/:DERWRITERS

Michael L. KerleyMarvin A. Kobel

NATIONAL ASSOCIATIONOF-NEGRO BUSINESSAND PROFESSIONALWOMEN'S CLUBS, INC.

Marion E BryantRuth M. Tucker

NATIONAL ASSOCIATIONFOR NON-PROFITRETIREMENT HOUSING

Stanley B. AxlrodRev. Virgil Mabry

Tv

NATIONAL ASSOCIATIONFOR PRACTICAL NURSEEDUCATION AND SERVICE

Rose G. MartinMildred H. Smith

NATIONAL ASSOCIATIONFOR THE PREVENTIONOF ADDICTION TO NARCOTICS

Harold AlksneLeroy H. Jones

NATIONAL ASSOCIATIONFOR THE PREVENTIONOF PSYCHIATRICHOSPITALIZATION

Wright WilliamsonDr. Herbert Winston

NATIONAL ASSOCIATIONOF PRIVATEPSYCHIATRIC HOSPITALS

Melvin HermanDr. Maurice E. Linden

NATIONAL ASSOCIATIONFOR PUBLIC CONTINUINGAND ADULT EDUCATION

Dr. Monroe C. NeffRose Mary Pattison

THE NATIONAL ASSOCIATIONOF RETATT TIRT TnelISTS

Willard B. SimmonsWilliam E. Woods

176

NATIONAL ASSOCIATIONOF RETIRED FEDERALEMPLOYEES

Mae R. AndersonRichard Z. BrownSamuel BullockWebster FryeGus GehlbachJoseph F. GoreErnesto GuzmanWilliam F. HallVirginia B. HernandezMiriam HoffmanThelma HoneyJames A. JohnsonChauncey LeeLou1/4 J. MancusoRobert L. MerrittCarl L SchopperRobert SolomonMaur%e S. SpauldingA!.-xander F. SwickardP!,:::p H. C TamClarence M. TarrWv.-.mint; WiP:amsInt.o I Wardena Irt:a D Y-.ncy

Raymond A. r. Young

NATIONAL ASSOCIATION OFSOCIAL WORKERS, INC.

Elaine M. B ladyCamille Jeffrrs

NATIONAL ASSOCIATION OFSTATE MENTAL HEALTHPROGRAM DIRECTORS

Dr. William AllertonHarry C. Schnibbe

NATIONAL ASSOCIATION FORSTATEWIDE HEALTH ANDWELFARE

Theresa MacMillan

NATIONAL CANCERFOUNDATION

Irene G. Buckley

THE NATIONAL CATHOLICEDUCATIONAL ASSOCIATION

Sister Mary Barbara Sullivan

NATIONAL CAUCUS ONTHE BLACK AGED

Eddie W. GibbsDr. Jacquelyne J. Jackson

NATIONAL CIVIL LIBERTIESCLEARING HOUSE

Mary Alice BaldingerLuise B. Kiefer

NATIONAL COMMITTEEOF BLACK CHURCHMEN

Rev. Timothy P. Mitchell

1

NATIONAL CONFERENCEOF CATHOLIC CHARITIES

Sister Made GaffneyLawrence Lawson

NATIONAL CONFERENCEON PUBLIC EMPLOYEERETIREMENT SYSTEMS

Westford RobbinsBerthe E. West

NATIONAL CONFERENCEON SOCIAL WELFARE

R.: R. Hoffer

NATIONAL CONFERENCEOF UREAN MENTALHEALTH PROGRAMS

Dr. Charles W. LandisDr. H. G. Whittington

NATIONAL CONGRESSOF AMERICAN INDIANS

Adam T. Mandan

NATIONAL CONSUMERSLEAGUE

Lavinia EngleBeatrice McConnell

THE NATIONAL COUNCILON THE AGING, INC.

Dr. David G. SaltenEdwin F. Shelley

NATIONAL COUNCILOF CATHOLIC WOMEN

I -rgaret A. CassidyC-.herine Jsrboe

NATIONAL COUNCILOF THE CHURCHESOF CHRIST IN THE U.S.A.

John McDowellRobert J. Myers

NATIONAL COUNCILOF COMMUNITY MENTAL14PAT.TH CENTERS

Dr. John B. CarverDr. Donald Weston

NATIONAL COUNCILON FAMILY RELATIONS

Dr. Felix BerardoRuth H. Jewson

NATIONAL COUNCILOF HEALTH CARE SERVICES

Berkeley V. BennettPatrick J. Callihan

NATIONAL COUNCIL FORHOMEMAKER-HOME HEALTHAIDE SERVICES, INC.

Hadley D. HallFlorence M. Moore

THE NATIONAL COUNCIL ONHUNGER AND MALNUTRITIONIN THE UNITED STATES

John R. KramerDr. Sadie Brenner Sklarsky

NATIONAL COUNCILOF JEWISH WOMEN

Adrienne PicardHenrietta Weiser

NATIONAL COUNCILOF NEGRO WOMEN, INC.

Leota P. BrownMrs. Beecher Cassells

NATIONAL COUNCILOF_SENIOR-CITIZENS

Charles A!varezRoger R. AndrewsJames CarbrayWalter CassidyRoy C. ColeRudolph T. DanstedtMatthew De MorePaul F. DuganHarry DunhamVirginia FerrachoWilliam H. HolstenArthur KlingGeorge Mc CourtMartin J. McNamaraDavid McSweeneyEdviin W. MurphyRose NathensonEdward PeetIrvin RyanDora N. SchatzMax SerchukEbert SharpStanley E. SpraguePhilip StearnsLucille ThornburghJoseph Walsh

NATIONAL COUNCILOF WOMEN OF THEUNITED STATES, INC.

Daisy S. GeorgeMana S. Jennings

NATIONAL DAIRY COUNCILLa Rose M. KetterlingDr. Elwood W. Speckmann

NATIONAL DENTALASSOCIATION, INC.

Dr. Theodore A. ShellDr. Harvey Webb, Jr.

177

NATIONAL EASTER SEALSOCIETY FOR CRIPPLEDCHILDREN AND ADULTS

Dr. Woodroe W. ElliotClare D. Rejahl

NATIONAL EDUCATIONASSOCIATION

Vivian PowellW. Jack Tennant

NATIONAL EXTENSIONHOMEMAKERS COUNCIL

Shirlee S. Blackner

NATIONAL FARMERS UNIONWeldon B. BartonArchie BaumannElton L. BerckLewis J. JohnsonSam LipetzWillie MorrisonJames G. PattonLimns PhillipsGilbert C. Rohde-Justus T. StevensArlo G. SwansonEllen Dean Wern

NATIONAL FEDERATION OFBUSINESS AND PROFESSIONALWOMEN'S CLUBS

Fanny HaidyCynthia E. Marano

NATIONAL FEDERATIONOF FEDERAL EMPLOYEES

Grace P. NoldaHenry No Ida

NATIONAL FEDERATION OFJEWISH MEN'S CLUBS, INC.

Max M. GoldbergSidney J. Goldstein

NATIONAL FEDERATIONOF LICENSED PRACTICALNURSES,' INCORPORATED

Teresa M. CrowleyEtta B. Schmidt

NATIONAL FEDERATIONOF SETTLEMENTS ANDNEIGT-7BORHOOD CENTERS

Miriam W. Wasserman

NATIONAL FEDERATIONOF TEMPLE SISTERHOODS

Mrs. Paul J. BasingerMrs. David M. Levitt

NATIONAL FOUNDATIONOF HEALTH, WELFARE ANDPENSION PLANS, INC.

R. C. GallyonClaude Kordus

NATIONAL GERIATRICSSOCIETY

Rev. Carl A. BeckerDr. W. Dean Mason

THE NATIONAL GRANGEConstance R. Seay

NATIONAL HEALTH COUNCILDr. Clarence BookbinderDr. Jay H. Eshleman

THE NATIONAL HEARINGAID SOCIETY

Dona'd E. GallowaySheva Kotok

NATIONAL INSTITUTEOF SENIOR CENTERS

William R. Pothier

NATIONAL INSTITUTESON REHABILITATIONAND HEALTH SERVICES

Dr. Bruce GrynbaumDr. Samuel Sverlick

NATIONAL .JEWISHWELFARE BOARD

Harold AxlerodMyron Mayer

NATIONAL LEAGUE OF CITIESCarter L. Dunlop

NATIONAL LEAGUEFOR NURSING, INC,

Ruth AddamsJanina Lapniewska

NATIO1AL LEGAL AID ANDDEFENDER ASSOCIATION

Barbara J. CampbellFrank N. Jones

NATIONAL MEDICALASSOCIATION

Dr. Louis C. Brown

NATIONALMEDICAL ASSOCIATIONFOUNDATION, INC.

Dr. Jean L. HarrisH. Peter Solomon

NATIONAL PHARMACEUTICALASSOCIATION, INC.

Aaron E. HenryFloyd L. White

NATIONAL RECREATIONAND PARK ASSOCIATION

Ira J. Hutchison, Jr.Janet R. MacLean

NATIONAL RETIREDTEACHERS ASSOCIATION

Raymond J. AstAnita B. BlakeBeyan BundyLawrence CarlsonFrederick J. FerrisJoseph A. FitzgeraldLois GrayMaude H. HainesOlga A. HellbeckFrank HughesMargaret H. KizerFlorence KriegerRuth LanaHerman MillerMary MullenC. B. MurrayKatherine PearceSelma RichardsonMabel I. RobbinsAdelino SanchezGeorge W. Schluderberg

_Minnie-0.-SledgeMarion SmithCharles L. Steel-John E. ThomasMary E. Titus

NATIONAL RURAL ELECTRICCOOPERATIVE ASSOCIATION

H. Louis CusterWilliam E. Murray

NATIONAL SAFETY COUNCILHarry W. EcklundHans R. Grigo

NATIONALSHARECROPPERS FUND

John A. Wilson

NATIONAL SOCIETYFOR THE PREVENTIONOF BLINDNESS, INC.

Virginia S. BoyceDr. Wilfred D. David

NATIONAL THERAPEUTICRECREATION SOCIETY

David C. ParkJean R. Tague

NATIONAL UNION OFHOSPITAL AND NURSINGHOME EMPLOYEES

Edward GarrinsAnne Shore

NATIONAL UNIVERSITYEXTENSION ASSOCIATION

Floyd B. FischerRobert J. Pitchell

178

THE NATIONAL URBANCOALITION

'Herbert M. Franklin. Leonard W. Stern

NATIONAL URBAN LEAGUEBarbara A. CowanJeweldean Jones Londa

NATIONAL WELFARERIGHTS ORGANIZATION

Louise SingletonLoucinda Walker

OLDER AMERICANS RESOURCESAND SERVICES PROGRAM

Dr. Eric Pfeiffer

OMEGA PSI PHIFRATERNITY, INC.

Samuel C. Coleman

PHARMACEUTICALMANUFACTURERSASSOCIATION

Dr. John 0. Adams

PHI BETA SIGMAFRATERNITY, INC.

James T. HortonDr. Parlett L. Moore

PHI DELTA KAPPARuby S. Couche

PILOT CLUB INTERNATIONALFrances B. KeeverMinnie Walker

PRESBYTERIAN CHURCH INTHE U.S., BOARD OFWOMEN'S WORK

Lucy R. HestirEdith J. Walsh

PSYCHIATRIC OUTPATIENTCENTERS OF AMERICA

Mildred E. BerlRichard W. Loring

QUOTA INTERNATIONAL INC.Charlotte Shaffer

THE 'RABBINICAL ASSEMBLYRabbi Stanley S. RabinowitzRabbi Herbert A. Seltzer

REFORMED CHURCHIN AMERICA,THE BOARD OF PENSIONS

Rev. Theodore F. Zandstra

REORGANIZED CHURCHOF JESUS CHRIST OFLATTER DAY SAINTS

Dr. Frederick A. KunzBishop Homer D. Spiers

RETAIL CLERKS

INTERNATIONALASSOCIATION

Douglas CouteeWalter L. Davis

RETIRED PROFESSIONALS'ACTION GROUP

Elma L. GrieselEdmond L. Kanwit

THE SALVATION ARMYLt. Col. Olof LundgrenMrs. Col. Lloyd Robb

SERBIAN EASTERNORTHODOX DIOCESEMONASTERY OF THE MOSTHOLY MOTHER OF GOD

Rt Rev: Bishop lriney'Ari Kovacevich

.ERVICi CORPS OFRETIRED EXECUTIVES

Walter H. ChanningJulius Davidson

SERVICE EMPLOYEESINTERNATIONALUNION

Richard E. Murphy

SEVENTHDAY ADVENTISTS,GENERAL CONFERENCE

Dr. Ralph F. WaddellSEX INFORMATIONAND EDUCATION COUNCILOF THE U.S.

Dr. Mary S. CalderoneSHEET METAL WORKERSINTERNATIONAL ASSOCIATION

J. W. O'BrienC. A., Darnell

SIGMA KAPPA SORORITYMrs. Swift M. Lowry

SOCIETY OF ST. VINCENT DEPAUL, SUPERI07. COUNCILOF THE UNITED STATES

Dudley L. BakerMartin J. Loftus

SOROPTIMIST FEDERATIONOF THE AMERICAS, INC

Valerie F. LevitanVirginia Timmons

SOUTHERN BAPTISTCONVENTION, THE CHRISTIANLIFE COMMISSION

William P. HarrisW. L Howse, HI

SOUTHERNREGIONAL COUNCIL

James N. WoodSOUTHWEST COUNCILOF LA RAZA

Charles J. GarciaAlex Zermano

SYNAGOGUE COUNCIL OFAMERICA

Rabbi Irving LehrmanRabbi Solomon ). Sharfman

TELEPHONE PIONEERSOF AMERICA

Lawrence N. JensenJames 0. ParkerJoseph P. Sheridan

TOWNSEND PLAN-NATIONAL LOBBY"

John Doyle ElliottRuth Bowdey Elliott

TRAVELERS AID ASSOCIATIONOF AMERICA

Ruth F. Spur lockUNION OF ORTHODOXJEWISH CONGREGATIONS

Rabbi Elkanah SchwartzDr. Samson R. Weiss

UNITARIAN UNIVERSALISTWOMEN'S FEDERATION

Ruth P. MendelsohnHarriett Oulton

UNITED AUTO WORKERSJohn AllardStanley BadynaGwendolyn EdwardsNelson J. EdwardsCharles Enos, Jr.Douglas A. FraserMarcellius IvoryKenneth JohnstonOiga MadarHardy MerrillFlorence PetersonRudy Vaughn

UNITED BROTHERHOOD OFCARPENTERS AND JOINERSOF AMERICA

Paul H. ConnelleyDonald D. Danielson

UNITED CEREBRALPALSY ASSOCIATION

Dr. Elsie D. HelselCharles T. Mitchell, Jr.

179

UNITED CHURCH OF CHRIST,DIVISION OFCHRISTIAN EDUCATION

Chasie OrtizCarlos Rios

UNITED CHURCH OF CHRIST,DIVISION OFHEALTH AND WELFARE

Dr. Hobart A. BurchThe Rev. Carroll J. Olm

UNITED HEALTHFOUNDATIONS, INC.

Bertram Loeb

.00

THE UNITED METHODISTCHURCH, BOARD OFCHRISTIAN SOCIAL CONCERNS

Mrs. Leslie E. BarnhardtDr. Luther E. Tyson

THE UNITED METHODISTCHURCH, BOARD OF HEALTHAND WELFARE

M. Joe HelmsJohn A. Murdock

THE UNITED METHODISTCHURCH, BOARD OF MISSIONS

Harry GreenbergBetty J. Letzig

THE UNITED METHODISTCHURCH, DIVISION OFCURRICULUM RESOURCES

Daisy Dozier Warren

THE UNITED METHODISTCHURCH, DIVISION OFTHE LOCAL CHURCH

Rev. Roy H. RyanVirginia K. Stafford

UNITED MINE WORKERSOF AMERICA

Bedford W. BirdDr. Lorin E. Kerr

UNITED MINE WORKERSOF AMERICA, WELFAREAND RETIREMENT FUND

Dr. John NewdorpKenneth E. Pohlmann

UNITED PRESBYTERIANCHURCH IN THE UNITEDSTATES OF AMERICA,BOARD OF PENSIONS

Rev. Winton H. HalstedRev. W. Eugene Houston

_UNITED PRESBYTERIANHEALTH, EDUCATION ANDWELFARE ASSOCIATION,BOARD OF NATIONALWISSIONS

Harvey M. Luce,Rev. H. Kris `Ronnow

jis:CATHOLIC CONFERENCERev. Mstr.:Lawrence Corcoran

= Msgt Hariold-J: Murray

THE UNITED ,STATES JAYCEES-Gary R. McNaughi,Raymond -W. Roper

-.UNITED STEELWORKERS_

AMERICA-Robert Baron -

Buike-theory _GilmanAbrahani,Larry Killer-

, Anthony,-,S..Luelielt'Frank McKee.Alek- T. ,`Powell; _Jr:LarryHerman , StissfuithEtigene Verdu

UNITED - SYNAGOGUE

OF:AMERICA; NATIONALWOMEN'S LEAGUE

Zelda:DickMrs. Herbert Quint

UNITED=TRANSPOR;TATIONUNION-

Luna-,

UNITED WAY OF *ERICA-Ardith -Hithleyinan

uniciLsimiumsINTERNATIONAL -UNION-

OrNoitrki,4mEtiek

Mamie =.10 Giilispie

"VETERANS: -OF=

;FOREIGN WARS--OF-

THg UNItEDStkiES-Norman13:Joiies-Dr: -RiyineticFW. Murray

. 180

VETERANS-CIF WORLD WARToP THE

Pftiyd *E. Milder-ionJ.-B. Koch--

THE VOLUNTEEBS'OFAMERICA'Lt-Col. Belle "Leach.GeneralGeneral John, F. -McMahon

WOMEN'S AUXILIARYTO- 'AMERICAN'MEDICAL ASSOCIATION,INC-

Mrs. 'Manna- BetimesJack 'Le*,

yotirid 'MENDS- CHRISTIAN-oF-

'NATIONAL COUNCIL:Hoinier,'W. ;Bressler-

-ZONTA--.IMEERNATIONAL_Jane Rollins -

INVITEll OBSERVERSNOte: Observers -Were -prictiiiied- to take fullpan in the 'Conference except-for -official ,voting.

01.

'CONGRESSIONAL STAFF

Kathy Adana-David Affeldt

Jay CutlerKen ,Daiiceiori

_ Elizabeth P. hottillWilliam Laiighlin

Kenneth Schlosiberg::Paul,Skarbut

Nattey Amidei ,LeRoy;Geoldrican- -Eugene Middelman, jcidah_C.-"SommerWilliam "Bechtel- Michael = Gordon Roy Millen:ion, Erlitine.,Stewart.Patricia C.artee-- James -X.:Gnirk James, Murphy Jacob N: -WassermanGerald ;Cassidi- -Val- Halarnandaris Mario Noto -Becijaniitt YamigataBoren Chertkov Judy: With- John

Aguirre

Rbbert-Bliida"Williastt T. -BaileyarOlcr Bailin: __JaineSJ: Barry-_

-

-Edit:gird:M. :Bator- ei!

Goihini I.. :Black, -Jr.George S.AkttvlingLowell: BriaionRay B: Chambers

-Robert-Co*,Clayton J. :Cottrell

.FEDERAL-REGIONAL ,COUNCIL REPRESENTATIVES

-grin Doresius'John -A. Dyer,Rear Adsic: BenjancittNorman Er1ieSheridan-Ect: Foreinatt-Richard Friedrn3nRobert E Ft lron-RulOn .Garfiel

GreenJames -Griffith'Frank -J: Groschelle

Hairs- -David-W. "Hifi

Bernard`, -Kelly _

Astor- ICiik"-Er-mei-Kenneth ; Kugel:.

William B.*:LeWis,Ntiormarrflinton-,Sainuel'MaitiiceiTheodore=N.:Mc1 swell -

`John -MCGiiider;-Howard' D::McMaha_n

Margin-WillianOscar Pedeittin

Harold = Putnanc

Pierce A :Quinlan.Rainaltec

AngelTheodoieLawrence W.-- Rogers:Robeit C tRoienheiin,6oriihU"SaCniiiiitaa-:Harry;F:::Shiricite:George:I: = Smith'deriege J; vVavouiis

VerduinRittiell-,ILWaesche

Etta -Lou Wilkinson

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

Janes Burress - Robert L. ;Davis Clarence '14; Lanibright Virginia: M._ SmithBarb* 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 RosenClinton: Atterbury Elizabeth Finnigan Barry McLaughlin Gladyi 'RUOff-Phyllis Bandy Mich Fraiii Dale Medearis Joan _ SenaFaith Belleiny- James -Gee Dana Meilen' John ShafferRicliaid Bonnet, Wally Gursch Evelyn -B.=--Metritt J. Anthony SmithCharles _Bostwick Mari -Hale Betty S. Millie Samuel:SosnoviickJoan Breland Julia Yociii&-HaWkins Georgie- 0:-Miller Robert_Swanson_Martha J; Bienneinan_ Bette Hillhouse Rene Nalcaritt Charlotte TurnerJames Byrnes . Robert -Hodges Merle larding. Stan VaiiiantRuth ConrOvi: Kay 'Nov:tell E. W: -Ratkard- Viiginia Van-PeltMary C. -Crum Barbara P. Janes C. ,Howard Parks Carolyn: WhitlockVim Dahlheimer Rita KatZinin- Joseph H. _Pierre ThomaiGilda IL De: Acosta Izella 'Kendrick BObbi- Roberti Janie WiinberlyCharles -J. Dearing James Lieder Nancy Robinson Henry -D. WoitmanEdith Zayas De Capo Raine Mahaffey Charles G: Rogers Valiant YatesLea 13: Dwain . Louada -Markusen

181

4.-

Yv

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

Jean Campbell; 4La-Mar :Hirriion, dertrude!,-knuio Charles L. -PrayElizabeth' Curley Wilma -Jackson. -Rev.:Nathaniel L_ iiiiie Marguerite E SchivarzinanShirley Davis Walter Janes_ _C.; -MeLoild Simon W:.-ScottJane Hardin JosephtB: Kerria.sey- Juditk Paulus- kobertfH. _TennantWilnier Wilion;_ Jr.

-Pearl Abramson- -.GloriaiS.;H:aerther Paltiel' =E Mitchell Ilene G .SiegierJo -Ann _Al Rose_. Halrnan Mari-Moreira= john _IL SkinnerDiane R. ,Beeson. :CYtithisi;-Haintiton- MnoreLeonard-.D. Cain, -Jr. Anita Harbert-. J. Emory` Smith=

--Genevieve M._:CaseyJohn- Cole&-Mary 'Waid,ttiai:TermiteTied IL

WilliIni4Pc- Hawkinson -,"Edward R::Heriderson"SyheseeiSteven M. ;Horvath`Sandra' C:

-Hyatt'

;Nehrlie--Robert -Newcoiner

Corrine:Nideggef-Ycilifide, C.-70Wens-_Brit ;Pnwleit

Donald . Spence'.JSpide-r=

GeOrgiiSPringerBeverly "V:-r,Stein-- Patricia -L.:Steirier'Sean

:Merrill 4:".E.lisitHO war& rV. Epstein

Joyce, Anita Jarrett.Janice - :Sue Jones.

-ManfrecIPeachIce-Otin --Pollaik-

BeVerleeNatalie P.' Trager

.EdWaid=f2oiiera -Thin* TylerDwight Frankfather Keisdniet- Eileen. Lindy : Rabb =Wayne, Yasek,Sharon- -Kristine _k: Krenke. MaryReese_ _` -Gerald:.1» =Van-than-.CarorA.; -FUMY- Lloyd KaufmanRonald- W2.- Geason _ Betty.-}L,RObeiti-- Reiseinar-YAL-Wide

_ _ Anthony Karen - Rothenberg Marcella;. Weiner--De. Douglai.Glis-gcnv Daniel-;Rubenstein Thelma S. WeissChirleiL: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-WolaninBarbaraz=.,Grossinaii Williarii Grant: Mayfield= Friiicei; G. 'Stir* -ROsalie:.--S. WolfMildred Guberniaii Joan -xt..McMiirdci Shaw-

FOREIGN OBSERVERS

Belgisiin-Di. Monique. Asiel

Brazil-Professor 'Allies Ginsberg

CanadaLavirencerCrowfordDr. David-SherinsinDr. A. -E:Da-vid"SchDr. J. W. WillardLola Wilson-

DenniarhDr. O. Z. Daigaard

England-Dr. Sheila ChownDavid Holiman

FranceDr. AntieMarie GuillemardDr. J. A. HuetDr. Paul Paillat

Eric PergiatixDr-. Michel PhilibertM. B. -Sachs

GhanaMake _Apt

GreeceJohn tirras

Itsdia-S. D. GokholeP. N. Iyner

IranDr. Ahmad Ashraf

IsraelSimon BergmanHilde KahnDi. Charism RappaportHannah Weihl

44Y ) ScotlandProfessor F. M. Antonini Dr. R. -A. Robinson

SwedenYelban Peter Bouitedt.Dr. S.- Kinoshita- Simi 0. HYderiMrs. Chiyo OmaChi-Torizo 'Watanabe Switzerland

Dr. A. BraimAlexiiider BetiirdyMalta Christina CodcburnProfessor Salvino Busuttil

Dr Arviel Pardo United-Nations'Dr; Tarek M: Shuman

Netherlands Welt GermanyProfessor J. -M. A. MunnichsDr. Barbara- FulgroffDr. Mini Thoiriiie

NorwayEva Beverfelt 'West Pakiitan

Mazhar Huisain

Poland YugoslaviaAdatii 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_"MaterJulian P.- FOx, -Jr. Ronald L Jensen -Robert 'a Robinson -Herb -Whitivorth_Maicelle- G.- Levy: -E. Scinaie:Rusiell ..

,...

Ws. Eiiiiii:.N."-GriswOht-MM. Freidi:Aith.:Mrs John: W....BYfitesWS...Richard' W. tan

-MM.:FrankMrs'. Jan*: r.s.-c4Fir-

COMMITTEE TO ASSIST DISABLED DELEGATES

Chairman Mii. jtilian-Difinii- Mrs: tioniici,kMariiir Mrs., oSel:2 dSitterti,*1;ite,.Mri.11iri-m.Fong, -Mrs:"--L--7Jaek Martin Miss -Mary-"--E-;Ssiiiier,*-1161M;;Divicl'Giinbieil_ Mii.-Richaid,MeLaren_ 'Mri:_Wiltei-E.:WisitingtOn.Mis:Villiasii,T. Gannon" Mai.-- Thcimai: Meloyz. -Wt. Nfillany Willi:bfrif-T.-Ti-,Haines -Mrs:-Egiiiiigicin.:D.;PlikeiMis.-Shiiii,ICashinra-, "Mri."Williim:Rehitcluiit .

:-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,Education, ad WelfareOffice di- thi Sect'etary

Rinsell'EyeisRusielFRaycroftTom -Joe:

Social'and White -HouseRkiabilitatiOnS Conference-on Aging

Webster B. TOdd, jr._

_John Edwards:_ John -O. Twiname

JatiieiMarvin .Taxes.Robert_Wilson-

GoVerrunent AgenciesDepartment of AgricultureDepartMent of COMmeree.Department of DefenseDepartMent of Health, Education,and WelfareDepartMent of Housingand Urban AffairsDepartment of Lab&Department of TransportationDepartment of TreasuryVeterans, AdministrationOffice of. Economic Opportunity

Admilistriseion-an-Akitiglohii Maitin,pcnotheit

-Ger-ontolo,0611,Soci'etyEchiraid-Kaskiiiaritz-

AppenFlix GProviding Assistance: to the Conference

CONFERENCE ON

V)

0

U.S.POSTAGE 8c

The U. S. POstal- Serrikeon October 2, 197-1,issued an -8 -cent Stamped envelope with aspecially designed eMbOised stamp .to com-memorate the 1971 White Ildisie ConferenCeon Aging.

183

Appendix HRules of Order Governing Section, Subsection

and Special Concerns Sessions Meetings

The-hi:es of otder to govern=thexonduCt.-oftheSeCtion and Subsection :SeSsionS., and-- Special- Con-cerns .Sessions -'of' the 1971 White .1-Icnse Con;'ference,on Aging- aie :Set. fOtth Wow. These rileswere adopied-_-brihe ,COnfetenCe Planning -Boardto assist :-Conference ,leaders= "Condrictin,Orderly',and- effectiVe Work sessions.

040: of .order-. as :adOpted ,by- the -tOntetenCe,Planning Board -0*-0-ptoCedore and fotmal-aCtions' all sessions of the Conietence, and*here:,ti*sc-ClO not apply Roberts' '.rileSt.of 'Circlet

21.'SeCtioir and. Special= Concerns= SesSionS beresponsible for- CrinfereriCe -freCOinineildatiOnS. NOvoting will t*e__plate at:-gerieraL'ieSsions.,

3. The Chairman -of each Section -and `Subsectionand-of each Special' Concerns .SesSion_ will Mkout of order any- prOpciial notn' specifically relatedto -_the purpose of the-Confeiente oa-serrnaheto -the subject- matter -before the_stOup.

4 SuhseCtioni will ,have- as the basle-tobjectfoidiscussion the synthesized_ policy recotnifienda-tioni submitted- by the States and N_ ational- Or-ganizations, while the Section -will have as the'basic subjeCt,for,*digaission the syntheSizedtecOitinienda6ns ,oi the StibkCtiOtis.

5:- The official recorder ior -each-Settion or Sub,section and Special Concerns SeisiOns: shall be aDelegate.

6.: Each discussant in being_ recognized by theChair shall give for_the record his name and-theState or organization represented. Upon thequest of any Delegate a discussant Maybe asked=either before or -at the conclusion of his remarksto state the interest with which he is identified.

7. A ,participant from_ the floor or any Section orSubsection will be-permitted to speak not morethan three minutes on any one subject except byUnanimous consent. Where there is a matter ofsome controversy, the first speaker of either sideWill be allowed five minutes.

8. The : Section poliCy- -CoOidinating Committeemay-edit and combine siinilat:-reCommendationSWithout -Making:-Substantive changes: la Cate- of

.a- direct -cOtOict in the retoMmendationS,OE thedifferent eachAvill be'presented to theSection.

9; 14teientatiOri. of synthesized_ SiihSeCtioh, policyrecommendations in the 'SectiOn, SO=,. -.

>

liOnS iineeting, on Wednesday- :.afternoon.- Action-taken Jo*: on,,--recoinineridatiOns Originat=

Ing, in the Subsection o'cr:presentect,bythe' SeCtif..4 or :Speci4i Concerns ,tepOtt along.debate, recommendation be cpieStiooed bylb- perCerie- of the Delegates. The exact .vote on

-every issue Will-b&:recordect_tio-,SlibsianCe_Of theMinority point_ of view of at.-least 156 percent. ofthose "vOting-Must be"tecordea.and-reptoduted inthe Sedion Concerns report -alongWith tbo -point of VieW,_of. the Majority. fA.;lesSet

may file its point of- iew_ with the 'Re=Corar'!i_ butit will not ,be -,reported to _the Confer-ence.

10. Proxy votes -are not permissible in voting atany Section,-Subsection or Special Concerns Meet-ing.

11. Pertons eligible to vote are the conferenceDelegates who are designated members of theConference Section or' Special Concerns Sessioninvolved.

12. All voting shallbe by ,voice except in casesin whith the Chairman is in doubt or where astanding vote is demanded.

13. The forthula for obtaining a vote on allrecommendations will be the same for all Section;Subsection's and Special Concerns Sessions as fol-lows:-

A. The recommendation will be read and itsadoption moved.

B. Voting By Acclamation1. The Chair will say, "You have heard the

184

recommendation. Is there- any Objettioti-(Pause) If _not, -without objection (pause)the recommendation is approved. utiani-**sly."

ease of Objection1: The Chair_ will ky, "You haVeheardstand and be counted: If 10 Tem* object(Ride 9), debate 'Shall- be -,operied.

Alter:the Chair ha.0 opened'--discussion- :a

lunit will. be set for clebite..'T4e ChairMan:Will . recognize ,alternately those favoringand thok bpPositia,a _position.<

these "have "polten- the Chair Will.4; "Has -anyone -anything NEW tiy.--add:

- not will those _favor say-(A7i18) ''ThciSe opposed;. NAY." _(NAYS)(Count): If the-vote is clOse,enough-so.that

it is estimated that -percent are-opposed=arid: a- request is. made for .Stibrnission,_:of aMinority 'rePori,= the- Chairman; will ask -th6seopposed= to stand -and be counted:

D' In Debate_

4. ILan,arnendinent is offered,. it MUST be,preSented;,to the .Chair- in written form_ be,faire, any action -can:be taken _ on it.

The Chairman of :th&-ConfereriCe Planning-BOard will review or ,adjUdiCate- any -proCedural:questions during theTpetiod:9(44e,'Cotter-eti:ce,

Appendix.- ITides and Authors -of Background and Issues Papers'

EDUCATIONHoWiairt_ Y. McChisky, Professor Emeritus of EducatiOn,Unisi,,eriity of Michigan

EMPLOYMENT-Sobel, Prof ettor -and Chairnian, Department

ECOnomics, Florida'State University

RETIREMENTjanies ;H: Astotiate professor -of -Welfare Ito,noniici, Heller School, Brandeis Universiiy-

RETIREMENT -ROLES-AND ACTIVITIESGordon kF. Streib, Profeashi, Department of Sociology,Cornell _UniversiO

SPIRITUAL WELL-BEING_ ,

of David -0:-/sioioerk, Profeitor and .Chairman, Department -ofSoCiologY and AnthrOpologY, Maitnette University

PHYSICAL AND MENTAL. HEALTH:

PHYSICAL HEALTHAustin -B. Chirin, Former Chief, Gerontology -Branch,Division, of Chronic Diseases, Public Health Service

Edward, S. Colby, Evaluation Officer, Community HealthService, Health -Services and Mental Health Adininistration,,Public Health Service

Edith G. Robins, Coordinator for health of the Aging,Community Health Service, Health ServiCes and MentalHealth - Administration, Public Health 'Service

MENTAL HEALTHAleXander 'Simon, M.D., Professor and Chairman, De-partment of Psychiatry, School of Medicine, Uniyeriity ofCalifornia, Berkeley

HOUSING THE ELDERLYIra 'S. Robbins, Hou'sing Consultant, Former Vice Chair-men, New York City Housing Authority

INCOMEYung-Ping Chen, Associate Professor,, Department ofEconomics,-University of California, Los Angeles

NUTRITIONE. Neige TOdhunter, Professor of Nutrition, VanderbiltUniversity

TRANSPORTATIONJoseph -S.- Revis, Consulting Assticate, Institute of PublicAdministration

FACILITIES, :PROGRAMS, AND SERVICESRobert,Morrii, _Professor Of SOCial Planning; and Director,-Levinson GerOntologiCal_ Inititute, Heller School,Brandeis UnWersity

GOVERNMENT- AND NONGOVERNMENTORGANIZATION

W. Fred-Cottrell, -Professor of Government, and Director,SciiPps, Foundation for. Population Research, Miami Uni-versity, Ohio

PLANNING.Robert H. Binstock, Associate Protestor of Politics andSoda! 'Welfare, Heller School; Brandeis University

RESEARCH AND DEMONSTRATIONGeorge L. Maddox, Professor of Sociology and MedicalSociology, Departmenti of Sociology and Psychiatry, DukeUniversiti

TRAININGJames E. Birren, Professor of Psychology, and Director,Gerontology Center, University of Southern California

185

' These papers are available for purchase from the Superin-tendent of Documents, U.S. Government Printing Office.Washington, D.C. 20402.

f:

AppendixOutstanding Older AmericansNamed bytheir respective Slates in response to aninvitation -froth the White HouseConfeience on Aging.

Alabama: Mildred HuttoAlaska: Dora SweeneyAri,iona: Winona MontgomeryAykatisas: Maniie -Kayser

-California :' Isabel Vail; Prank "

Hoinei*: WoodsdOnneetleut: -EdWa'id''Peavy

Affredk.,$ilandsDistrict of:Colitinbia:d?kulVeNi.Florida: Eartha4M. M: WhitedeOgia: Benjamin ] :MaysMinas: Howard H. 'BedeIndiana: George-E. Da-Nis

kentutky: Albert ChristenMarie: PloYd ScammonMaryland: Mabel-Patterson

Massachusetts: Frank J. ManningMichigan: HazerG. RobinsonMinnesota:

CaityTO:6S nMcChare

:Missouri: CeCil-N.*DavisMalaria:

Catherine Caik:McCartyAsa:WOlfe

N. Yirginia,Aikens,Neu Hampshire;- -Elijabeth

DOnovaii-&Ithily WilsonW_-New Jersey: Arthur-A.=Wacker-New 'Mkrcelle G:-LevyNorth Carolina: Ellen WinstonNorth Dakota: NelS PorsborgOhiO: TiedjCottrell-Oklakoma: Lloyd C. Roach

Appendix KSenior Portrait Contest

THE WINNING PAINTING

"Patriarch of the Mountain," oil, by Bernard C.Blonder, 73, of Mountain Home, Arkansas: Mr.Bro-nder's painting, executed in yellows andbrowns, won the national White House Con-ference portrait contest and was reproduced onthe cover of the Conference Program.

TIONORXELE MENTION

Mrs. Esther Andresen, 74, of Fairmount, North.;;;Dakot ;z113.!iThe Golden Years," charcoal.

Mrs, Katharine A., Cawgill, 81, Silver Spring,Mirilaild;'fer the Cobbler," oil

-.:Virgi1414eitech, 72, of Holgate, Ohio, for"Master Carver," oil.

186

Oregon: Helen _ManningPennsylluinia: Ellen.ConnellPuerto Rico: Juan Alethany SilvaRhode island: John W.; CornettSouth Carolina:

Jefferson BoOne AikenSotitg 'Dakota:. iiiiseilÈ..JonasTenneisee:_,

-Rudolph II:kanipnieietAlyin ArthurBurger

'bah: thoinaS'Phillips.Vermont: theresa'BrufigardtVirginia: Belle R6one BeardWashington: Rudolph KilaackWiseoniin:

'Margaret Hardy NobleWyoming: Robert Rhode

Leonard Herbert, 67, of Lihue, Kauai, Hawaii,for "Glory," 'oil.

Mrs. Vera Macbeth, 85,, of St. Thomas, VirginIslands, for "John of St. Thomas," oil.

Jeff Madden, 70, of McKeesport, Pennsylvania,for "Overcoat Sam," oil.

Edmund Yaghjian, 67, of Columbia, SouthCarolina, for "It's Brighter Today," polymer.

CONTEST JUDGES.

Charles Parkhurst, Assistant Director, The Na-tional Gallery of Art.

Dr. Marvin'S. Sadik, Director, The NationalPortrait Gallery.

Dr. Joshua C. Taylor, Director, The NationalCollection of Fine Arts.

U.S. GOVERNMENT PRINTING OFFICE 1973 0-468-217

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?y. Bernard 'C: Broitder; - ofMountai Honie, Arkàrsas;:the: Arkansas entry, and =itational'Winner_

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072

34'6

OFFICERS AND STAFF DIREC'T'ORS

Chairman:ARTHUR S. FLEMMING

Nice Chairman:BERTHA S. ADKINS

Co-Directors of Technical Activities:

Director:JOHN B. MARTIN

Executive Director:IVEMSTER B. TODD, JR

Wm:" DoNAnuE, CLARK Tuturn.sDirector of Regional and State. Relations: RAY SCHWARTZ

Director of National Organizations: DoRonty Niclx.cn)Director of Public Information and Public 'Wails: Jotu I.: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, ChairmanBERTHA S. AINC:,:s, BART. C. WARREN, NADEL. B. LINDSAY

Vice Chairmen

TARY ADAMS JOHN W. EDELMAN ALFRED H. LAWTON SEBASTIAN RODRIGUEZDAVID L. ALVARADO CARL EISDOR r ER MELINDA ANN LEE E. BONNY RI;sSEI.1.DECKER ANSTROM EDWARD K. (DUKE) MARcEw: G. LEVY WILLIAM L. RUTHERFORDELOISE HARDISON BANKS ELLINGToN ELIZAIITH K. LINCOLN MARGARET C.ROBERT W. BARON FRANCES FAIRBANKS EDWARD J. LORENZ): SCHWEINIIACTMARGARET BARTOSEK *THOMAS E. FIELDER RUBY E. STUT LELLS *liEss T. SEALSROSEMARY BAXTER RABBI LOG'S FINKELSTF.IN JOHN W. McCoNNE1.1. DAVID C. SINGLERMARIETTA RUMBF.RG BrNoF. *WILLIAM C. FITCII LACRA B. McCoy ELEANOR F. SLATERJAMES S. BENNErr MYRTLE C. FONTENO WALT1:RC. MCKAIN VILLIAM E. SNuoos

R011F.RT D. BLUE JULIAN P. Fox, JR. JOHN B. McPtIERsoN ARTII UR L. SPARKSFRANCES P. Boucot: DANNY FRANK *GEORGE MEANY MARY E. SWIT;.ERWA LTF:R L. BONI) S. Ross GREENWOOD *CARSON MEYER CIIARLF.q P. TAFTMM 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.oRBRODERICK *CFCII. M. HARDEN THOMAS C. MORRILL PETER E. TERZICKRICHARD I'. BUTRICK A. BAIRD HASTINGS ROGER F. MURRAY J. FRANK TROYHERBERT R. CAIN, JR.

*ROBERTI HAVIGHURST NOMBRE NIESSON MARY ELLEN TULLYA. CARSTENSONAtt.Ec HENRY *BERNARD E. NAS II *BEHNARD S. VAN*CHARLES H. CIIASKEsADELAIDE C. HILL MELVIN N. NsAVVIST RENSSEI.AER:.'1ARGUEIUTE STITTTutoR HORANyi JAMES C. 0.BRIEN *THOMAS G. WAITERSCHURCH

Lucius DUB. CLAY GRACE HOWARD CAR7::It C. OSTERBIND JESSE P. WARHERsW. FRED COTTRELL *HOBERT C. JACKSON FRF.I.L M. OWL DONALD M. WRTitts

*NEI.SON H. CRUIKSIIANK JOHN A. JACKSON 01.1.11: A. RANDALL PAul. DUDLEY WHITECONSUELo CASTILLO DE RONALD L. JF.NSEN GEORGE G. READER GEORGE: K. WYMAN

BONZO CERNORIA D. JOHNSON PATRICIA ROBERTS CI.ARA 1.ANEZLour.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 with an asterisk ()

Toward ANational Policy

On Aging

Prvteedingi of:the-

1971 WHITE HOUSE CONFERENCE ON AGINGNovember 28Preneber 2

Washington, D.-C

Volume II

Conference Findingsand Recommendationsfrom the Sections andSpecial Concerns Sessions

c

CONTENTS In Volume-II .

IntroductionPegs

1

1119293743

PART 1--Seciion-iteconincendationS-Edutition =

Employment- and RetirementPhyikal and MentaLHe.alth.

Housing'hitothe,NutritionRetirement Roles,andActivities- -- 49-Spikftualltfre11:Being 57

0.:;PlOr*klY 63Fa0.40.0,).?-f08400,-* 0jee$ 71

..... 79-87

ROO' and De*Oatratielti._ 93T_ ing- . , 97

PART 2=-.,SfieCialt.MiCern*SessionsAecOMEnen tioriSHealth--.'4re Strategies -

tong,Terin'taie,for Older-:People 7, 105Mental 'Health :care .Stiategies- and Aging- .111lioineniake-HO-Me Health Aide -seokos_ 115

pisaboty-404-Achabilitotioo-44 and BlindneSs- -

.123--Phisice.1:4fia- VocationaLlehabilitation of Older People 129Agicig, aac Deafness~ 135

.The_RUral: and--the- Poor- Elderly-Rival: Older-PeOple -- 145The Nor Elderly 151

The _Elderly Among the MinoritiesThe Asian American Elderly ...... . 159The Spanish Speaking Elderly 165The Aging-and Aged Blacks 17The Elderly Indian 197

Protective and Social Support 'The Older Family 205The Religious Community and the Aging 219Tile Elderly Consumer .225Legal Aid and the Urban Aged 233

Roles for Old and YoungVolunteer Roles for Older People .239Youth and Age 243

iii

1:4. 1.444'144As

X*A

N,

t.

INTRODUCTION-41 he White House Conference on Aging was organized

into 14 subject-matter Sections -Technical COM-mitteei were appointedIfor each byAke Secretary ofHealth, -Education,: and Welfare, 'Elliot Richardson,

who charged, theni with the responsibility for planning thework of their respeCtiveSeCtiOns.

With -the- assistance- of:a:Secretariat; ;Made up of lepresenta,tives of appropriate Government agencies, the TechnicalCommittees identified What they believed to be the -Major'issues requiring ret_olUtion,iti:orderth., ithieVei-lOrwardloOk-

:ins, consistent national policy in aging and to bring aboutimmediate .aCtion27Theie;itsues were COnsiderti,sinOdified;iand

-added- to by local and ',State- White= 1-itaise. -:-.Conferences ---andIstatiOnabOrganliatiOn'`Tatit,POrees2. '_From *these-, deliberationsthere. emerged the core .subject matter :Whick-waa:Considered:hythe Delegates to the various Sections of the National CAM-ference..

The Conference Sections- each --met twice .during the Con--ference, but most of the work was done . by the Delegatesworking in small-aubiection,,groUnings of fropi, 35: topersons . Thus, every Delegate had opportunity to participatein the 2 days of subsection and to take_ an activepart in the formulation of recommendations to be acted uponby the:full Section..

The recoininehdations-(triajority-and Minority). approved- bythe -SithseetiOnt were prepared for transmittal to the SectionDrafting Committee by the -Subsection :Chairman, ViCe;-Chair-man, and Recorder._ The _Section Drafting Committee, whichincluded the Section Co-Chairman and Recorders and theSubsection _Recorders, collated the recommendations _from- theSubsections for the review of the Policy Coordinating 'Coin=mittees. These Committees, each of which consisted- of allSection and Subsection Officers, determined the statethent ofthe majority and' minority recommendations to be presentedfor action at the -final meeting of the Sections. Those recom-inendations that -received support Of the majority of .the Dele-gates attending the meeting,-together with approved minorityrecommendations, became the officiaLaction report of .theSection.

The separate reports of the 14 subject-matter Sections, arepresented in Volume 1 of the Conference Proceedings:The recommendations reported are those that were adopted atthe final Section plenary meeting. They included majority

.v

=

recommendations, those Supported by more than -half Of thevoting Delegates; and minority recommendations, those Sup-ported--by- from 15 t6'.50-Percent-of theSectiOn.Delegates.

Eadi of the 'following_ &Won- reportSii preceded,by a briefintroductory profile of conference group that -develOpedthe recommendations. -Theieintroductory statements are pre-sented to *Vide the reader with additional informationrelevant -. to a better understanding of the -policy :kecommenda-tiptis.

In response to the request: of a . number of national organiza-tions, the program 197.1 =White House Conference onAgibg**eipabdecrio include 17 =Solos on topics of 43_001-coriceitlii-thoie organizations The purpose of these -SpecialConcerns Sesions was to provide for indeptiir.dit---CuSiiOn, ofspecific aspects aging or of the circumstances of particulargiblipi--bilhe Older tpopulation : The Sessions, lifcestheiiibject,inatteil.$ections; were committed to developing and ,reconi-mending _policies .thar. could lead 46, immediate -action foriniproVing- thequality of fife Of Older people.

These Special Concerni'S*HOns were organized by planningcommittees made up of .representatives -frOin-',-tfiose nationalorganizations requesting, the-.SeiSion-- and frOm related groups.Each of the planning cointhitteesNai4isistett:14 representativesfrom appropriate Federal agencies The:Cominitties,-had;

_

responsibility for determining the content of the -program ofthe Sessions and for identifying, and inviting prOgramparticipants,

The 17 Special CotiiernsSeisions Were-held siinultanionilyfrom 8:00rAlif. until 12:00 -NOon oir-Wednesday, 'December1. Each Delegate chose Which, if any; Session he wished toattend. The recommendations from the Sessions are -presentedin Volume 11Part 2 Of the Conference Proceedings.

The 'Spec' Jai Concerns Session?. recommendations tend toless policy focused thin the Section prOposals. They give moreattention to programs and services_ heeded to alleiriate-the verydifficult circumstances many older people face today.

Session reports that foals on a general concern have beengrouped together to allow, the reader to review more easilythose Subjects that are significantly interrelated. In manyinstances the reader will also want to read the recommenda-tions made by-Sections (Volume IIPart 1) which are re-lated to the general topic under which the Session reports areassembled.

vi

INTRODUCTION

SECTION ON

EDUCATION

wo hundred sixty -nine Delegatesto the 1071 *White House Conference

Aging were named to die '410=don:Section: -Thete nelegatei included

.administrators and instructors- in elementary,secondary; and higher education, College- andl uni-versity students, doctori, lawyers, -religious lead-ers, soda' -Workers, _public offiCials; labor leaders,and prOfessiOnals in the field of aging.

This veep of Delegates was. uniquely quali-fied to develop -policy recommendations in -educa-tion for Older, people. The belegatei in the Edu-cation Section included: (1.) substantial represen-tation of older people themselves (approximately32A percent were retired persons); (2) represen-tation Of the major ethnic minority groups(American Indian; 'Afro- American, Man Airier-ican, and- Spanish American); (3) representationof professionals in the fields of education andaging, (4) representation from each Of the 50States, Puerto Rieb, the Virgin Islands, Guam,and the Pacific Islands.

The thinking and desires of the State andlocal White House Conferences on Aging and theearlier Older Americans Forums formed the basisfor the recommendations produce_d by this ableand experienced group,

The Education Section produced 23 recom-mendations which speak to several issues includ-ing: what basis should be used in allocating fi-nancial and manpower resources for educationand aging; what populations among the aged

4.

1

receive special attention; what -types of-serviCesi-Shouid'be deVelOped; -What are-iorrie,Waysof effectively providing these-, services.. it -iS:shOpeclthat,theie,ieCothruenCiation.§-Wili:provide. direction"for _Substantially iniproVing:the-quality;,_prodik-tivity; and dignity Of the Lives of older people.

SECTION REPORTThe initial "Section - plenary meeting was called

to Order by Walter G. Davis, Director of theDepartment Of EduCation of the AFL -CIO; whoServed as presiding cochairman. After introduc-ing himself and the other Section leaders, Mr.Davis called- on co-Chairman- Howard Y. Mc-Clusky, Professor Emeritus, University of Mich-igan, toprovide the DelegateS with additionalbackground for the 2.. days of discussion thatWere to follow.

In his address, Di. McClusky' , the author of theBackground and 'blues Paper on Education andAging, establiihed the gravity and scope of theneed for education for aging. He mentioned, re-cent developments in the structure of the AMer-ican education system "which show substantialpromise of superior achievement is education foraging."

Co-Chairman's StatementThe dominant theme of much of the discussion

about, older persons is essentially pessimistic incharacter. We do not have to wander very farto discover why this is so. In the first place,older persons are confronted with threats to theirhealth that frequently occur with advancing years.

In the second plaCe, the great majority of olderpersons are subject to substantial reductions inincome without an 'equalizing decrease in theircontinuing need for financial resources. In thethird place; retirement usually leads to a declinein poSition with --a collateral -reduction in statusand influence affecting not only the retiree,_ butalso many of those to whom he is Significantlyrelated.

In other wards, great numbers of older personsare covertly,- if-not overtly, engage:a -In a runningbattle :for survival; with their attention givenprimarily to devising strategics for recoveringfrom actual lostes, or strategies designed to -cir-cumvent anticipated.. losses or It is not itur-priting,:theiefore,- toclittOVer- that Much of thediscussiOn :about .older persons- over .the: media,in conferences, and .the' , lay and professionalliterature it :more likely : -to -deal with_ therather than -the opportunities 'Of persons_ 'in thelater years.

But wheditve turn to education we find amoreoptimistic domain. Inz fact, education is itself es-sentially an affirmative enterprise. --For instance,education -tole older persons is based on the- as=sumption that it will lead to somethirg betterin the liveS_ of those participating. it -also -pro-ceeds on the Collateral assumption that olderpersons are capable of a constructive response_ toeducational atiin-ulation. Thus,_ because" of itsfaith in the learning ability of older_ persons and,because ofits confidence in the improVement thatresults from-learning, education, in contrast withother areas_ in the field ofaging, can be -invested_with a climate of optimism which is highly attrac-tive to those_Who may be involved in its operation.

From an educational viewpoint the impressiveand distinguishing feature of Our times is the factthat we are living in a "learning society." Withinrecent decades, and at an ever increasing rate, wehave been arriving at a stage where learning hasbecome an essential condition for participatingand advancing in the world about us and equallymandatory for personal development. This newcondition is largely the result of profound andaccelerating change. In fact, change is now trans-forming all aspects of living for all people of allages. This process has become so pervasive that inin order to cope with the dislocations, and take

2

advantage of the opportunitiet which changeproduct* education must now be thought of asbeing. as continuous _as- change itself and mustalso be programmed solhat all persons, regardlessof age, inaylake.part in learning throughout the.length of their years:

The implications of this new outlook for edu-cation as a- whole can scarcely be exaggerated. hitimplications for the education of older personsis especially far-reaching, and urgent. For' in thecase of. the' Older, person, -change has- a double- anduniquely -aggravating dimension. -First there is-the change, in -the- enviiraning society. But -Second,there_ are changes hr.the,life situation-of the per,son -4-'he_grtrars older .HenCe,.for_perSOUS in thelater years; change :gives rise -ra.a "doubles -jeop-ardy" That is, the -4anges- in the .society=rounding the individUal COmpoUnd; the readjuSt-Mend indUCed: by the age-related- changesOccurring Within the-.individual: -Tlids, if. editCa.;don isTto -be-relevant for the unique situation of-the Older person and, moreover, if it is- -to -beeffective, it must without compromise deal -withthe multiple-impact-of- change inherent in the lifestage -whichOlder people occupy. -Such an en-counter -should- generate- an ,edtitational programMarkedly different from -that associated with the"Credential syttetn" of fornial education.

But, however _inappropriate the standard in-struction of the elementary and secondary schoolsinight_be for persons-in-their later years, the 'factremains that ,older persons were once young andthat the-schooling they received in their childhOodand, youth-constitutes -a basic foundation for what-ever learning they may pursue is adults. Whatthen do the results of research show about theamount of schooling which the present genera-tion of older persont have received in their earlieryears?

The evidence indicates.that the level of formalschooling attained by older persons is far belowthe national average for all portions of the popu-lation. One-fifth of persons over 65 are regardedas functionally illiterate; only one-third of thoseover 65 haVe continued beyond the eighth grade.In any random sample of the population, theoldest are the most poorly educated.

The Situation becomes even more serious whenwe examine, The probable quality and relevanceof the instruction they received. For example,since they went to school from-60 to 80 or moreyears ago, it is ,plausible to expect, that teachersthen were less qualified than they are today, thatinstruCtional" materials and facilities were leis-ade-quate than they are today, and that the subjectmatter they studied would today_ be _regaided asclearly,out -OE ,dite.

The implications of this deficit might be easedif older persons compensate- for their lack ofschooling -'by taking part in activities designed-specifically ,for :their instruction. -But,. here again,the data ;give-Ali little cause foe-celebration. Forinstance, reseirCh_ indicates that ,persoris, over. 50ire-underrepresented in adUlt_eduCational.activitieiAnd that the degree ,of: underiepresentatiOncreases, with the adVance.iri,years: Thisis especiallytrue for - adult :batic education: where- the -need- ofolder persons is greatest.

But is this-low level of schooling-and partici-pation paralleled with an equally low leVet ofmental ability? Is it possible that in this deficitof educational. achievement we also hav a deficitin the ability to achieve? The answer is. an em-phatic NO! ReSearch presents. no eviderice thatafter a person enters his years of adulthood age,per se, iS a barrier, ,to learning. On the contrary,in many cases age may be an advantage in learn-ing. Thris, we are on solid empirical grounds insaying that we can teach an old dog new tricks;.in fact, there are probably some tricks an old dogcan better

The picture suggested so far by our discussionis a mixed one and not as optitnistic as our intro-ductory comments might lead us to expect. Onthe one hand, we find older persons gravely deficient in formal schooling and participating littlein adult educational activities. On the other hand,we find older persons fully capable of learning,in a world of dramatic change when learning isso important and when the rewards of learningare potentially great. How can we more nearlyMatch their need to learn with a better perform-ance in learning?

The answer to this question probably liessomewhete in the realm of motivation. It is our

3

hypothesis that, in general, older persons do notperceive education as having any relevance fortheir interests and needs. This point was re-peatedly, confirmed in the co_mMunity discussiongroups- held, throughout the country in prepara-tionifor- the White House Conference meeting in

.Washington, D.C., during the period November28 to- Decenibei 2. AssriMing this to be a validassessment, what does it mean for the educationof older persons?

In attempting -to answer this _question, weshould be reminded that older .persons apparentlyregard education -as sornething separate and diifer-ent.froin,the progranis.ot other serVice.areas-withwhich .they, are more familiar. There are healthSet-vices,- finanCia 1 servi ces, legal- setV ices, housingservices, etc., and more or less as a..postsCript,_'there are echicatiOnal services; MOrtover,., the_educationall,inaiie=_o( older ,persont based= onthe.,Memory of the -sChOolitig_.they-- received- inchildhOod: and youth-,---in iniage.that-,beitS littleresemblance to the -urgentiei of the situation inwhich theY currently find theMselves. It is notstirpriSing that their' typical response to -anyqueries about education= is often "Why do. I.any inOre-education? *hat.can it do for me? It istoo late _for that," etc.

Such an attitude obviously -imposes severe limi-tations on the-potential of-older- pettons to copeeffectively -with their survival needs, as well as_their ability toincrease the significance of theircontinuing development. Instead of thinking ofeducation. as a_thing apart or as a decorative op-tion, it should be regarded' as a principal com-ponent of all the) services de-Signed to meet thenecessities of living.

More specifically: echwationsshould play an im-portant role in di? prcichiaion, maintenance andprotection of health and income. It should alsobe a basic element in solving, problems of housing,the use of legal services, in the adjustment tochange of relationships in the family, communityorganizations, etc. In short, education should beregarded as a program category to which all otheraspects of living in the later years should berelated. In this sense, it would become an "um-brella" for working in and comprehending thefield of aging as a whole.

But the full scope of the field is even morecomprehensive than that suggested by our 'anal-ogy ofshe "umbrella." In a more fundamental at;dgeneric sense, education foraging -shotild:be rtle-vant lot persons of all ages and not merely forthose in the -later years.

. In- order- to clarify this point, let us first lookat persons in the mainstream of productive adUlt-hood. In at least two respects they have an im-portant stake in education for aging. They needinstruction 'abodt-- the :problems and- opportunitiesof liVing in the period :beginning- with-age .65;first,.: because they *ill- need .tO provide :the favor-able -Climate 'of, support, aecepumee- and...under-standing ityWhicprograins for_oldetTersonsmaydevelop; and 4second, because they will :need- tobegin- to think Construe:direly ,about retirementfor themselves; preferably as erlyas age- 45 andat least 'by -age:,55. let. look =, at._ the '4econd =of

the two preceding points in greater_ (wed-.

The- basis for inaking a case for ptetetiretnenteducation is a sound -one. An early -introductionto the decisions- that an- adult will be compelledto make as he or she makes the - transition -from aworking to:a nonworking Style of life will:enablethe -individual to anticipate the hazards and theoppoitunities of the later years. By sodoing, hewill be' able to- regulate his performance in ad-vance, so that when _the hazards appear they willbe defused and the opportunities exploited.

In a youth-oriented society, the problem ofpersdading a middle-aged person to admk thatsomeday he, too; will be an older -person andshould therefore take some rational measures inanticipation thereof, often gives rise to diffictiltieSof motivation which are extremely frustrating.But the need for developing procedures for re-solving these difficulties is an additional andcompelling argument for the relevance of thinkingof education for aging, as applying not only tothose in the years' 65 and _beiOnd, but also thosewho are not yet "older", but are irreversibly ontheir way to becoming so.

There is yet another respect in which educationfor aging is more than education for older per-sons. This is perhaps the. most comprehensive ofthe categories we have proposed. We refer toeducation for life-long development. Education

4

for-older persons gives society a reason lot_lookingat the complete life-spati as a-whole. Technicallyspeaking; aging-begins with-the-beginning of life;while this fact -may appear to_ be a. far cry fromthe problems -exacerbated by the survival- needsof older persons, it reminds us that _any pointin one's- total -life line has a significance whichis a product of -both its past and future. Inother words, a pertoir has a-, relation to- the timedimension of his- life with hich he must cometo terms if he -is to f_ulfill the promise of hispotential.

At this point, -the biological view of the lifespan as - a - rise -for grotOth; a- iplateau for mainte-nance, and decline -for regression gives- us only-part of:the picture. kit propoied-here that a-morecomplete- pieture maY-' -detivect:froin sonie- of-the developmental -.dieories- of personality. To il--luttrate,. let us- -look at Edition's theory of thematuking-

-To summarize his potition, he pOstulates thatthere. are -eight developmental stagei from thebeginning' to the-end of life. In-infancy we beginwith -the-achieveinent of --trust;- in early childhoodwe -.tontinde with the achievement, successively,Of autonomy- and initiative. In .middle childhoodwe accidite-the skills of industry-and work; andinadOleseente asente of:identity. Building -on -thesefive stages of childhood' and youth, the first taskof .the -adult is to develop -a-'sense -of intimacy;next, he mustinoVe into-the stage-of generativity;and finally, as-a admination to life-long develop-ment, he- must achieve a softie of ego integritY.In other words, the Erikson forthulation.proposesa stage -by -stage progression toward fulfillment inmaturity.1

There are risks in presenting such a compre-hensive theory-in such an abbreviated form. ButWe-have done so in order to support the view thatmore than the current biological-and psychometricpicture of -the-life spin is necessary in order toformulate a fundamental and comprehensive pro-

gram of education for life-long fulfillment. In anoptimal and operational sense, the last stages of

I Elkind, David, "Erilcson's Eight Stages of Man," New YorkTinsel Magazine, January 1970; and Erikson, E. H., Child-hood and Society, Revised Edition, New York, W. W. Nortonand Company.

life should be a guide for education in all thesequences and at all the stages leading thereto. Toqualify as a complete and fundamental view, wemust then regard education for' older persons asdesigned not only to help them cope with therequirements for survival, but also by using ex-pressive, contributive and influential activities toassist them in achieving their potential. In short,we are proposing that it takes a lifetime to developa complete self. Education should aid in 'thisprocess.

As a postscript to the above discussion, let usreturn to our initial theme of education AS. an"accent-on the positive." At this point we' neecharemind ourselves that edneation for Older _personswill realistically,- and for the foreseeable future,constitute the Principal -part Of education for.aging and that, for immediate and: operationalpurposes,- the bulk of educationfor =Older perionswill be devoted'th helping them cope with threatsto their-survival and autonomy as Well as insultsto their-integrity: But for more fundamental andultimate purposes, society's stake in the educationof older persons is that of helping them becomea more effective resource for the improvement andenrichment of society itself.

In the context of this'view, education for olderpersons is an investment by society in resourcedevelopment. It is based on 'the assumption thatolder persons hive experiente and special assetswhich the society needs for the cultivation -of itshealth and well,being. Society still lags gravelyin recognizing the validity of this view. -Its fullacceptance and implementation with understand-ing is one of the major tasks of education.

Where will we find the agencies to develop theprograms envisaged in the preceding discussion?

All- agencies with education as a part-time orfull-time objective should be regarded as poten-tial contributors to education for aging. In theinformal domain, we would include organizationsof older persons, churches, synagogues,, laborunions, farm and business organizations, civicassociations, libraries, museums, community cen-ters, etc. In the formal domain, we would includeprivate and public schools from the kindergartenthrough host-graduate and professional education.Above all, we would welcome the realm of'radio

5

and television broadcasting with a sharp lookoutfor cable television that is just emerging.

In the case of all these agencies, education foraging should appear as an explicit and separatecommitment, in both statements of purpose and asa line item in budgets. It should not be allowedto become buried in the amorphous terrain ofgeneral funds, or lost in general expressions. ofpious intent. This point is particularly relevantat the Federal. level. Nowhere does the FederalGovernment take specific and primary responsi-bility for leadership in the field of education foragingneither in the Administration on Agingnor in the OfEce of Education:This deficit is ascandal and should be liquidated= in the immediatefuture.

Btit, to coinplete this section-on a more positivenote, We should,_report two developments_ whichshow substantial-promise of superior achievementin education for aging. One of these may be ob-served in the phenomenal-growth of the com-munity college. The bails for -this optimism is'contained in the fact that the new breed of com-munity Colleges is, by franchise and by budgetallocations, designed to make community servicesand adult education a principal part of its overallprogram and to make these activities coordinatein status_ ith that of the more traditional transferprograms of credit instruction. Already there isevidence that community colleges are beginningto take seriously their responsibility for providingeducational services for elder persons. At thisstage only a beginning has been made, but thepotential of the community college to serve theelderly is there and could soon be realized.

Another promising development is the wide-spread development of the community school.Stimulated to a large extent by the example of thepublic schools of Flint, Michigan, and in partencouraged by subsidies from the Mott Founda-tion, the Flint type community school is beingadopted as a part of the regular school system inall parts of the country. The essence of the com-munity school idea is that of service to .all peopleof all ages in terms of their needs and preferences,often as a,result of their participation in programdevelopment. Apparently the community schoolis more responsive to the educational needs ofolder persons than the traditional K-12 institu-

i

tion. It is quite possible that the community sc.htialeither alone, or_ in combination with the commun-ity 'college, will beeome the most feasible, re-sponsive and certainly the most universal vehiclefor providing educational services for olderpersons.

In conclusion, education for aging should havea* much highei priority in. :the piograms of theeducational enterprise than it now has. It shouldbe an instrument for helping-deliver the servicesset up to meet the survival needs of older persons.It should also upgrade the talents of:older personsas a resource in nurturing the *ell-being ofsociety. It should aid in the progressive attainmenti)yindividuals of life-long, fulfillment and, in sodoing, constitute a principal pan of the educationof petsons at all ages.

The opportunities for the development of at-tractive and highly_ functional programs of educa-tion for aging are unlitnited. The exploitation ofthese opportunities will require new resoutces,commitment, and creative leadership.

RecortsmendationsEducation is a basic right of all persons of all

age groups. It is continuous and henceforth oneof the ways of enabling older people to have afull and meaningful life, and as a means of help-ing them develop their potential as a resource forthe betterment of society.

RECOMMENDATION IInvolvevsent of Special Populationsin Program Planning'

All issues and "recommendations which will affector serve linguistically/culturally different popula-tions must enlist the necessary linguistically/cul-turally different qualified expertise in the develop-ment processes of such proposals, so as to insurethat all programs designed for the elderly willresult in maximum utilization and participationof the constituents in question.

RECOMMENDATION IIEducation of Non-English Speaking Elderly

Particularly urgent are Federal, State, and localfunds for bilingual/bicultural education to the

6

non-English speaking elderly pertaining to in-structions relating to the requirements of Federal,State, and local government agencies, i.e., gainingcitizenship, applying for Social Security, housing,applications, etc.

RECOMMENDATION III.Access to Educational Opportunities

Education for older persons should be conductedeither apart froin or integrated with other groupsaccording to their specific needs and choices.Where- feasible -and desirable, the aged must begranted' the opportunity to take advantage ofexisting programa withboth old and young-learning from -each ..other. HoWever, e alternatives-mustbe litovided- Which emphasize- the felt- needs-of the . aged ;at -their particular- stage. in the lifecycle.

RECOMMENDATION IVExpansion of Adult EducationalPrograms

The expansiorrof adult educational programs hav-ing a demonstrated record_ of _success should re-ceive higher_ priority with due consideration- beinggiven to experimental and innovative programs.

RECOMMENDATION VEducational Opportunitiesfor all Older Persons

Educational opportunities must be afforded allpersons, with special efforts made to reach thosewho because of low income, poor health, socialcircumstances, or ethnic status- are less likely torespond voluntarily. Outreach programs shoulduse all appropriate channels and delivery systems.

RECOMMENDATION VIEliminating Barriersto Educational Services

For older persons to participate in educationalprograms, agencies, organizations, and govern-ment must provide incentives. These incentivesshould be aimed at eliminating specific barriers tothe availability and accessibility of educationalservices for older persons including transporta-tion, free attendance, subsistence, auditing privi-leges, relaxed admission requirements, flexible-

hours, convenient locations, subsidies to sponsors,and removal of legal barriers.

RECOMMENDATION VIIPublic LibrariesA Gum:unity Learning Resource

Public libraries serve to support the cultural, in-formational and recreational aspirations of allresidenti at many community levels. Since olderadults are increasingly advocating and participat-ingjn lifetime education, we recommend -that thepublic library, because of its nearby neighborhoodcharacter, be strengthened and used as a primarycommunity resource. Adequate and specific fund-ing' for this purpose must be:forthcoming from alllevels of government and, most important, fromprivate philanthropy.

RECOMMENDATION VIIILibrary Services

We recommend further that the Library Servicesand Construction Act be amended to include anadditional title to provide library services for olderpersons.

RECOMMENDATION IXUse of Leisure

Emphasis should be given at every level of edu-cation to implement and expand the expressededucational objective of "worthy use of leisure."Education must be directed toward an acceptanceof the dignity and worth of non-work pursuits aswell as development of leisure skills and apprecia-tions.

RECOMMENDATION XAllocation of Money and Manpower

Money and manpower for educational opportuni-ties must have high priority thrOughout all serv-ices offered to order persons by any approvedpublic or private agency, or organization, in orderto assure continued, meaningful living.

RECOMMENDATION XIScope of Educational Opportunities

Educational opportunities must include'basic, con-

7

tinuing, vocational education and training aboutneeds for better use of services, cultural enrich-ment, and more successful adjustment to aging.

RECOMMENDATION XIIPublic Support for -Educatton

Public expenditures for education of older per-sons must be increased and directly related to theproportion of older persons within the population.These expenditures should relate to the needsarticulated by all segments of the population ofolder persons, including rural and ethnic minori-ties, or by the organizations that represent olderpersons.

RECOMMENDATION XIIINeed its a-Basis for Funding

AvAable facilities, manpower and funds must beused for educational programs- designed and of-fered on the basis 'of the assessed needs and in-terests of older persons. The initiative may betaken by many sources, but the design and cur-riculum must include active participation by olderpersons.

RECOMMENDATION XIVFunding Priority for Educational Programs

The Federal Government must consider the con-cerns of educational programs of older persons ina greater equity of allotment and on a higherpriority basis when allocating funds for educa-tional programs.

RECOMMENDATION XVElimination of Matching Funds

Where matching funds are required for Federaleducation programs aimed to assist older persons,it is recommended that the lifelong contributionstoward building this country by the now elderlybe considered as suitable compensation in lieuof "matching funds. "

RECOMMENDATION XVIEducation for Political Action

Education should place emphasis on instructionto help the older persons understand issues, pro-

cedures and action in regard to political processesto enable them to meet more effectively andquickly their special needs as individuals or as agroup.

RECOMIVIENI5ATION XVIIMaterials; Method.; and Curricula

Appropriate materials and methods about allaspects of aging must be developed and intro-duced in the curricula at all levels of educationfrom preschool thiough higher education.

RECOMMENDATION XVIIITonard a National Understanding of Aging

A national awareness campaign must be initiatedthrough mass media and through educationalsystems to promote better understanding bysociety of the nature of the aging process, theneeds and interests of older people, and the -posi-tive contributions and potentially untapped re-sources of older persons.

RECOMMENDATION XIXUse of Educational Resources

All educational resources must be pressed intoservice for the needed leadership in the prepara-tion and implementation of: (a) leadershiptraining, (b) teacher training, (c) curricula, and(d) needs of the older persons in America.

RECOMMENDATION XXPreretirement Education

Preretirement education programs must be estab-lished to help those approaching retirement ageto achieve greater satisfaction and fulfillment inlater years. Preretirement education must be theprimary responsibility of the public educationsector in cooperation with relevant communityorganizations in the areas of industry, labor, alllevels of goveniment, voluntary service andprivate associations.

RECOMMENDATION XXIInservia Education for Professionals

We urge that institutions of higher learning pro,vide opportunities for special profesSional prepa-

8

ration of those who will and are workir.g witholder persons (law, medicine, social wcsk, homeeconomics, recreation, education, etc.). More at-tention must also be given to workshops, insti-tutes, and inservice 'education for those who nowwork with older adults.

RECOMMENDATION XXIIGovernment Organization for Aging

T..) implement the educational policies growingout of the 1971 White House Conference onAging, the Administration on Aging must beaccorded status and financing appropriate to thetask and man be 'made an independent agencywithin the Department of Health, Education, and'Welfare as provided for in the Older. AmericansAct of 1965.

RECOMMENDATION XXIIIDivision of Education for Agingin tlx Office of Education

Primary responsibility for the initiation, supportand conduct of education programs for older per-sons must be vested in the existing educationalsystem, Federal, State and local with the activeparticipation and cooperation of specializedagencies. A Division of Education for Agingshould be established in the Office of Educationimmediately, to initiate supportive educationalservices for the aging. Similarly, all State Depart-inents of Education should designate full-timeresponsibility to key staff for the development andimplementation of programs in education foraging.

SECTION LEADERSHIPSpas will permit listireg of tide awl n1-dress only the Jinn time a some appears-

The Technical Committeefor EducationChairman

John W. McConnell, President Emeritus, University of NewHampshire, Trumansbtug, New York

Consultants

Hyman Hirsh, Director, Institute for Retired Professionals,New School for Social Research, New York, New YorkWoodrow W. Hunter, Research Associate. Institute of Gerontology, University of Michigan-Wayne State University, AnnArbor, Michigan

tr,

Members

Glen Burch, Director of Extension Services, University ofCalifornia at Davis, Davis, CaliforniaLovelyn J. Evans, Former Employee Counselor, Chicago, Illi-nois

Leonard Gernant, Director of Academic Servicvs, WesternMichigan University, Kalamazoo, Michigan

Bernhard G. Gustafson, Coordinator for Research and De-velopment, Division of Continuing Education, University ofNorth Dakota, Grand Forks, North DakotaCyril 0. Houle, Professor of Education, The University of

go. Chicago, Illinoismice Elaine Jenkins, President, Oni-Ametica, Washington,D. CEv,lyn Greenman, Director, Brookline MultiService SeniorCe,,ter, Brookline, Massachusetts

Philip J. Kelly, Chairman, Committee on Aging and Retire-mont, Sales F'S* r-stive Club of New York, Hendersonville,North Carolina

Sister Mary Wake, OSE, Director., Health Services for theAging, The Catholic Hospital Assocsation, St. Louis, Missouri

Druzella G.Lide,-Former Family Editor, Honolulu Ativetriser, Horrolulu,_Hawaii

Edward M. McGelsee, Director, Retirement Studies, Indus-trial Relations -Center, The University of Chicago, Chicago,Illinois

Katsuma Mukaeda, Attorney, Los Angeles, California

The SecretariatDirector

Frank M. Stewart, Technical Staff Assistant, White HouseConference on Aging, Washington, D. C.Maurice Braginsky, Administration on Aging GerontologyTrainee. University of Arizona, Tucson, Arizona

Section OfficersCoChairinenWalter G. Davis, Director, Departmint of Education, AFL-CIO, Washington, D. C.Howard Y. McClusky, Professor Emeritus, Educational Psy.chology and Adult Education, University of Michigan, AnnArbor. Michigan

Consultants

Woodrow W. Hunter and Hyman HirshRecorderAlice Eliine JenkinsAssistant RecorderChisato Kawabori, Associate Regional Commissioner forAging, Social and Rehabilitation Service, U.S. Departmentof Health, Education, and Welfare, Seattle, WashingtonManagement OfficesFrank M. Stewart

Subsection OfficersSubsection I

ChairmanWoodrow W. Hunter

9

Vice ChairmanMyra L. Herrick, Regional Representative, National RetiredTeachers Association, Reading, MassachusettsRecorderRhea M. Eckel, President Emeritus, Cazenovia College, Syn.ruse, New York

Subsection 2

ChairmanEdWard M. McGeheevice ChairmanW. Dean Mason, Executive Administrator, Kennedy Memorial..istiuism Home, Maninsville, IndianaRecorderA. L, Johnson, President, Prentiss Institute, Prentiss, Islis6s-F'Ppi

Ei:biection 3

Chairman

Janet-R. MacLean, Professor,Department of Recreation andPark Administration, University of Indians, Bloomington,Indiana-

Vice Ch_ airmanRobert J. Burns, Professor, Department of Psychology, Uni.versity of Toledo, Toledo, OhioWeiorderLawirence 0. Carlson, Associate Dean, The Institute of Life.time Learning. National Retired Teachers AssociationA-MedanAssociation of Retired Persons, Washington, D. C

Subsection 4

Chairman

Earle T. Hawkins, insiders* Emeritus, Towson State College,Towson, Maryland

Vice Chairman,Marcell:us Ivory, Executive Board Member, United AutoWorkers, Detroit, MichiganRecorderSister Mary Laurie.

Subsection S

ChairmanEarl Kauffman, Director, Council on University ofKentucky, Lexington, .KentuckyVice ChairmanMrs. Marion Marshall, Specialist in Gerontology Los AngelesUnified School District, Los Angeles, CaliforniaRecorderEileen laNiedertneier, Program Chairman, Center for Wom-en's and Family Living Education, University of Wisconsin

Subsection 6

ChairmanAdelaide C. Hill, Director, Afro-Amerian Studies Center,Boston University, Boston, MassachusettsVice ChairmanRudy S. Conche, Deputy to the Superintendent for Curricu-lum, School District of Springfield Gardens, Springfield Gar-dens, New York

a

t

RecorderBecjunin J. Kaplan, Godchaux Professor of Sociology, Mi.versity of Southwestern Louisiana, Lafayetw, Louisiana

Subsection 7

Chairman

William E. Cole, Professor, Department of Sociology, Uni-versiti of Tennessee, Knoxville, TennesseeVice ChairmanJames IL Fling, Administrator, Adult and Veteran Education,Department of Education, Tallahassee, FloridaRecorierLeonard Gernant

Subsection 8

Chairman

Mary C. Mulvey, Adult Education Supervisor, ProvidencePublic Smoot:, Providence, Rhode IslandVice ChairinatiMildred S: Hurley, Tennessee State University, Nuhville,Tennessee

RecoiderMargaret Eriery, Director, Rural Manpower Research sadTraining Project, West Virginia University, Morgantown,West Virginia

Federal Resource PersonnelDavid Berkman, Education Program Specialist, Division ofEducational Technology, Office of Education, Department ofHealth, Education, and Welfare, Washington, D.C.James Botches, Assistant to the Director for Leadership Drvelopment and Training, Division of Adult, Vocational andTechnical Education, Bureau of -Adult, Vocational and Techni-cal Education, Office of Education, Department of Health.Education and Welfate, Washington, D. CMaurice BrainskyPamella Christoffel, Program Analyst, Office of Education,Department of Health, Education, and 'Welfare, Washington,D. CBayard Clark, Special Assistant to the Director, Division ofAdult Education Programs, Bureau of Adult, Vocational andTechnical Education Office of Education, Department ofHealth, Education, and Welfare, Washington, D. C.Eleanor Dolan, Regional Coordinator, Graduate AcademicProgram, Division of Universities Programs, Office of &Mo-tion, Department of Health, Education, and Welfare, Wash-ington, D. CJohn Donahue, Educative Program Specialist, Bureau ofHigher Education, Office of Education, Department of Health,Education, and Welfare, Washington, D. CHenry Drennan, Senior Program Officer, Researth and De-velopment Branch. Division of Library Programs, Bureau ofLibraries and Education Technology. Office of Education,Department of Health, Education, and Welfare, Washington,D. C

Russell Eallonos, Special Assistant to the Secretary 0Ifioe ofthe Secretary, Depot:meat of.Heidth, Education, sad Welfare.Washington, D. C

William Floyd, Program Specialist, Office of Regional Co.ordination, Office of Education, Department of Heald*. Eau-catioa, and Welfate, Washings" D. C

Margaret Franck, Office of Special Concerns, Office of Edu-ced." Department of Health, Education, and Welfare,Washington, D., C.

David Groton, Legislative Assistant. Office of Legislation,Office of Education, Department of Health, Eduatioa, andWelfare, Washington, D.

Ann Nullifier, Program-Analyst, Office of Education, Depart.meet of Health, Education, and Welfare, Washingtoo, D. C.

Sherron Ritmo, Program. Analyst, Adniinisastion onAging, Social and R -thados Services, Department refBealtb,.Education, sad Welfare, Washington. D. C.Gayle Jones, Secretary, Administration oa Aging. Bridal andRehsbilitatiost-Services. Department of Health, Educatioa, andWelfare, Washington. D.C.Martin Reamer, director of Higher N....=tion Planning.Office of the -Assistant Secretary for Planning and Evaluation,Office of the Secretary, Department oft Health, Eduasion, andWelfare, Washinntoo,-D.David Landis, Contract, Opentioos Specialist, Bureau ofHealth Insurance, Social' Scattily Adatinisuatsoo, Depatimentof Health, Education,,and -Welfare. Washington, D. C.Ann Pastier*, Student Wan, Beloit College, Beloit. Wis.consin

Edward Ramer, System Analyst Office of Prow= Planingand Evaluation, Office of Educalson. Department of Health,Education, and Welfare,. Washington, D. C.Frances Riot, Admitiistiitive Aide, Division of Adminituadon, Administration- on Asing. Social and RehotilititionService, Department of Health, Education, and Welfare, Wash-ington, D.CRoy area, EducationProgram Assistant, Office forSpznishimg Americans' Affairs, Office of Education,Deparu.sent of Heslth; Education, and Welfare, Washington,D. CRichard Schloss, Anima to the Commissioner, Administra-tion on Aging, Social and Rehabilitation Service, Devilmentof Health, Education, and Welfare, Washington, D. C.Jean Anne South, Research and Development Branch, Di-vision of Library Programs, Bureau, of Library Programs andEducational Technology. Office of Education. Department ofHealth, EducatiOn, and Welfare, Washington, D. CFred Teal, Budget Officer, Division of Administration, Ad.Ministration on Aging. Social and Rehabilitation Services,DDepsnment

C of Health, !doodah and Welfare, Washintnon.

Betty Ward, Assistant to the Director, Office of African.American Main, Department of Health, Education, and Welfore, Washingtos, D. C.

. Howard White, Budget Officer, Division of Administration,Administration on Aging, Social and Rehabilitation &Moe.Department of Health, Education, and Welfare, Washington,. C

10

SECTION ON

EMPLOYMENT AND RETIREMENT

INTRODUCTION .

here were 337 Delegates named tothe Section on Employment and Re-,iirement._ Information available for

_ some 310 of them itidicate.that 36 per-Cent -.Were retired. Approximately one-sixth weremembers of one of the minority groups.

The Delegates to the Section on Employmentand, Retirement represented a wide array ofgroups, both public and private. Aged member-ship organizations were strongly represented aswere religious, voluntary, State and local organiza-tions with programs-in such fields as Manpowerand training services, and retirement preparation

;-.e. and education. Participants with interests relatedto these matters included officials from farm,labor and business organizations, the latter twogroups having also named persons specializing inpension and annuity plans. An equally diversenumber of professional and technical personnelwere represented. Among them were lawyers,phyticians, educators, industrial economists andsociologists, legislative and executive officials,librarians, social workers, job placement and coun-seling officers, and consultants on aging.

In formulating its recommendations,' the Sec-tion on Employment and Retirement thus drew

' This report of the recommendations of the Employmentand Retirement Sections follows, for the most part, the textprinted in the blue-cover Conference Report distributed atthe last day of the Conference. It does add, however, certainrecommendations and statements that had been approved bythe Section, but which were necessarily omitted from theearlier, shorter report because of limitations of time andspacle.

11

463-213 0 73 - 2

upon the knowledge and resourcefulness of acomplex and_sophitiicated delegate body. More-Over,,a large nuniber- of the =Delegates were them-selves, retired and could speak -first hand of theemployment and retirement problems faced byolder persons. Their prefereficei guided the de-liberations of the Secdon as did the desires andthinking- conveyed by the State and local WhiteHonse Conferences on Aging, the earlier OlderAmericans Forums, and National OrganizationsTask- Forces.

Altogether, the Section approved 17 recom-mendations addressed in general toward ensuringolder Americans a real choke between workingas long as one can and will, or retiring on ade-quate income with opportunities to pursue other'rewarding activities. Specific proposals cover suchimportant areas as: the fundinr and operation ofmanpower programs; steps to eliminate age, dis-crimination in employment, opportunities forpublic service employmenr, reforms of public andprivate pension plans and of the Social Securitysystem; and the determination of responsibilityfor policies to provide employment for olderworkers or, alternatively, to prepare persons for asecure and meaningful retirement.

SECTION REPORTPreamble

"Freedom, independence and the free exerciseof individual initiative in planning and managingtheir own lives" was declared an objective forolder Americans in the 1965 Older AmericansAct. This includes freedom to choose in their

later years between retiring on an adequate in-come or continuing in employment, full time orpart time, if they are able to do so. This freechoice however, is still denied to most oldercitizens, 'although the same Act included amongother goals for them equal opportunity to enjoy:

Opportunity for employment with nodiscriminatory personnel practices becauseof agc

Retirement in health, honor, dignityafter years of contribution to the economy.

Adequate income in retirement in accord-ance with the American standard of liv-ing.'

Many barriers hamper older Americans inexercising this choice in- alloting- their titne- andtalents and deprive our Nation of the highest useof-their knowledge, skills, anal potentialities. Theyinclude: compulsory retirement on reaching aparticular birthday, regardless of their ability towork; lack of information and counseling on re-tirement problenis and job opportunities; lack ofplacement and counseling personnel equipped todeal with their special problems; underrepresen-ration in education, training, rehabilitation, andother manpower programs; continuing discrimi-nation in employment practices despite Federaland State legislation; and enforced retirementresulting from long unemployment as an increas-:ng number of workers lose their jobs in theirfifties when plant shutdowns or technologicalchanges make their skills obsolete. This results intheir being undercounted among the unemployed.'

The unemployment and underemployment ofworkers in the age grotip 45-65 seriously jeop-ardize their retirement prospects. For this reason,consideration of the present employment andfuture retirement problems of this age group, aswell as those over 65, was included in arrivingat our policy recommendations. These are offeredin the hope that they will lead to actions that ad-

'For these three goals and the opening paragraph therewere substituted in the shorter report the following lines:"Our long established goal in employment and retirementpolicy is to create a climate of free choice between continuingin employment as long as one wishes and is able, or retiringon adequate income with opportunities for meaningful activi-ties."

'This sentence was cut from the Introduction to the shortsection report with the understanding that it would beincluded here in the final report.

12

vance our Nation toward our long establishedgoals relating to the employment and retirementof older Americans.

Employment of older workers is a vital partof our national problem of attaining full employ-ment. Older workers are especially disadvantagedin competition for jobs in the labor market. Theirproblems -cannot be met adequately at the Stateand local level or through the financial instru-ment of revenue sharing. Strong Federal leader-ship and financing are required.

Recotrtmendations

RECOMMENDATION IEartnarkedManponer Fun&

The Nation's present manpower programs failto take adequate account of the uneinploYnientproblems -of Older people. Experience proves thatadequate funds must be earmarked to improveemployment opportunities for older workers.

In order toachieve a more equitable distributionof services to all age groups, Federal, State andlocal manpower programs should expand theirservices and provide more job recruitment, train-ing, counseling, and placement services for olderworkers.

It is imperative that adequate funds based onpopulation ratio, needs, and special circumstancesbe earmarked for special employment programsfor older people. Aggressive efforts should bemade to monitor effectively the use of such ear-marked funds.

RECOMMENDATION IISteps to End Age Discrimination

We now have legislation designed to eliminatediscrimination in employment on account of age.But there is question as to whether this legislationis vigorously enforced and as to whether furtherefforts are needed to expand employment oppor-tunities for older workers.'

'This paragraph is a fuller version ofshort report, which reads: "We nowsigned to eliminate age discriminationmore vigorous enforcement is needed.'

that presented in thehave legislation de-in employment, but

Federal, State, and local governments shouldstrictly ,enforce protective and antidiscriminatorylaws and policies regarding employment oppor-tunities, with the elimination of the age limit of65 in age discrimination legislation. The AgeDiscrimination Act of 1967 should be expandedto cover all employees in both private and publicsectors.

There should be a governmentally-sponsored pub-lic relations and educational effort designed to in-duce employers voluntarily to hire more olderworkers.'

RECOMMENDATION IIIPublic Service Employment

Even unproved manpower policies may- not resultin adeqnate opportunities forthose, persont will-ing and'able to work' State and local governmentsare hard pressed to finance the public servicesthat are so badly needed by our communities todayand that are so appropriate for the employmentof older people.

It is the responsibility of the government to as-sume the role of "employer of last resort" toprovide meaningful and socially needed employ-ment opportunitiet for those older workers willingand able to work, if all other programs fail toproduce such results.

A minority favored expanded and innovative pro-grams to meet employment needs of older per-sons, but questioned the concept of governmentserving as "employer of last resort"

RECOMMENDATION IVFlexible Retirement Age

Our society presently equates employability with

' The Section on Employment and Retirement agreed thatthe following proposals be included with Recommendation H.Time limitations, however, precluded a formal vote on anyof these matters. The recommendations are reproduced hereexactly as they were reported to the Section.Recommend that chronological age discrimination in firingbe made as illegal as age discrimination in hiring. Furtherrecommend that the Federal Government take the initiativeand set a national example by promoting the employment ofolder persons and eliminating mandatory retirement provisionsbased solely on an age criterion.Employers who have Federal, State, or local governmentcontracts should be required to implement affirmative actionprograms and/or quota system to assure the hiring of olderworkersin addition to strict enforcement of existing lawsand policies regarding employment opportunities to induce

13

chronological age rather than with ability to per-form the job.

Chronological age should not be the sole criterionfor retirement. A flexible policy should beadopted based upon the worker's desires and needsand upon his physical and mental capacity.Policies and prograths that provide employmentopportunities after age 65 must be made available.

Realistic opportunities for retirement earlier thanage 65 must be provided. EMployerS should beencouraged to adopt flexible policies, such asgradual or trial retirement.

RECOMMENDATION VPolicies,to Protect Older 'WorkersExisting policies fail to protect the worker who isforced to retire prematurely- or whci is unprotectedby a pension plan.New national policies and 'publicly and privatelysupported programs are needed to help workerswho are forced to retire before the normal retire-ment age because of health problems, or job dis-placement caused by technological changes, orjobs requiring early-age retirement. New programsshould be vested generally in existing agenciesthat. have responsibility for dealing with theieproblems.

There should be created a continuously fundedprogram by the Federal Government especiallydesigned to maintain economic security formiddle-aged and older workers during theirperiod of transition from prematurely forced dis-employment into suitable employment or retire-ment. During this period, a major objective wouldbe to retrain and educate the disemployed toassure reemployability, or to assist in mobilizingresources to assure a meaningful retirement.

other (non-contract) employers to hire more workers.Recommend that the Child Care Centers to be creatednationwide be preferentially staffed by adequately trainedelderly persons, resorting to reverse discrimination, if needbe, by-declaring such job opportunities a special reserve forthe elderly. Furthermore, that such child care facilities beincorporated where practical as adjuncts to senior centers,in order to counteract the present segregation and inwardorientation of these centers and attempt, instead, to involve theaged members, through visual contact and prciximity, in thelaughter and activities of little children as well as in theworkday problems of their young parents.Recommend that "Employ the Older Worker Week" bemoved from the month of May to September and that it be-come a true community effort.Involuntary unemployment is not an acceptable conditionof the American way of life.

All workers should be guaranteed a retirementincome adequate to maintain a decent standardof living above the poverty level. Legislationmust be enacted as soon as possible requiringearly vesting, adequate funding and portabilityof pensions and to provide for Federal insurancepensions.

RECOMMENDATION VIPreretirement Preparation

Too many individuals fail to plan for retirementor plan too late. Preretirement education andcounseling shoulcL be provided locally throughoutthe, nation by trained instructors, starting at leastfive years before normaLretireinent age.:Informa-tionon ,problems and opportunities involved -in-retirement-should be included in family livingand- other pertinent courses at all educationallevels.

Government at all levels, employers, unions, andeducational institutions (especially through adulteducation agencies and the use of television)should encourage and promote preretirementcounseling by trained instructors. Special. coursesfor those nearing retirement are urgently' needed.

RECOMMENDATION VIIRetirement Teo

The earnings test that results in withholding ofSocial Security benefits constitutes a financialhardship for older people.

The Retirement Test should allow persons toreceive Social Security benefits without reductionup to the point where the total of Social Securityplus earnings equals $5,000 a year. In no caseshould benefits be reduced for persons earningunder $1,680.

RECOMMENDATION VIIIIncreasing Social Security

An immediate 25 percent increase in Social Se-curity benefits was recommended with a $150minimum per month, to be financed, in part, bygeneral revenue.'

' This recommendation appeared in the short report withoutthe provision for general revenue financing of part of thecosts of S::cial Security benefits.

14

RECOMMENDATION IXGovernment Organization for Aging

A major overriding problem connected with theadministration of employment and retirementpolicies is the lack of fixed responsibility by anysingle agency and lack of coordination by anysingle agency. The President should establish anOffice on Aging within his Executive Office byEicecutive Order until Congress amends the OlderAmericans ACt of 1965 to create a Department ofAging at cabinet level status. In addition, thereshall be appointed an Assistant Secretary of Laborfor Older Workers until a Department of Agingis established.'

RECOMMENDATION XA- National Pension Commission

A nationaL pension commission with a governingboard of management, labor, and public iepre-sentatives-should be established to study ways ofencouraging the expansion and the improvementof private and public pension plans with particu-lar reference to: flexible retirement ages, liberal(early) vesting and portability, adequate funding,more general coverage; job redesign, and Federalinsurance of pensions.'

RECOMMENDATION XIA National Yob Bank"

A national "job bank" should be computerized bythe Department of Labor to meet employer re-quirements. The "job bank" now being com-puterized should include job opportunities forretirees (including those in rural and small com-munities) who should be encouraged to registerwith the U.S. Employment Service.

'This recommendation appeared in the short report withoutthe additional proposal calling for an Assistant Secretary oflabor for Older Workers.

'A somewhat altered version of this recommendation wasprinted as part of the shorter report, namely: "A NationalPension Commission with a governing board of management,labor and public representatives should be established toencourage the expansion and the improvement of pensionplans with particular reference to: flexible retirement ages,liberal (early) vesting and portability, adequate funding,more general coverage, and job 'redesign."

1

RECOMMENDATION XIIWork Related Centers for Older People

The Federal Government shall develop a programfor, and provide financing for, the establishmentof local centers for the purpose of locating andbringing together older persons and potential em-ployers on both fulltime and Parttime basis. Fed-eral funds will be channeled through the variousState administrations on aging which will beresponsible for approving applications for theestablishment and financing of such centers bypublic and private agencies, and the supervisionof their operation. .

For the dual purpose of prothoting job oppor-tunities for elderly workers and meeting a crucialneed for help in the private hOmes of otherelderly= persons, Federal funding for employmentprograms through public or voluntary agenciesshould offer counseling, training, and placementfor "companions for elderly persons living inprivate homes."

RECOMMENDATION XIIIMariana Man&

For the Mariana Islands a study should be madeof the aged and how to alleviate their problems,especially of employment. A vocational instructorin a workshop to train older persons in naturecrafts for sale to tourists is needed.

'RECOMMENDATION XIVPortable Pension Plan

For all minorities, rural residents, migrants, andemployees of small business, Congress shouldenact a compulsory, universal and national port-able pension plan administered through SocialSecurity, (with tax advantages for the employerand the self-employed) to provide for those notnormally covered by other pension plans.

RECOMMENDATION XVPension Programs with Counseling

Employers should be required to supplement pen-

' This second paragraph was approved as a companionrecommendation to that presented in the first paragraph,which had been adopted earlier by the Section and whichappears alone in the short report.

15

sion or retirement income plans with retirementcounseling programs, such as counseling programsto be submitted to the Internal Revenue Serviceat the time the pension program is submitted.Both program content and costs for counselingprograms would be a pan of the total pensionpackage that requires the approval of the InternalRevenue Service.'

RECOMMENDATION XVITax Incentives and Exemptionsand Retirement Plans

It is recommended that the Federal Governmentand particularly the President encourage andsupport legislation which would exempt fromcurrent Federal taxation, employee contributionsto retirement funds; and provkle increased tax in-centives- to employers (particularly small em-ployers) to establish and maintain adequate re-tirement plans.

RECOMMENDATION XVIIQuadrennial White House Conferenason Aging

It is recommended that each of the 50 States holda White House Conference on Aging at leastevery four years in their respective States. It isfurther recommended that a White House Con-ference on Aging be held in Washington, D.C.every four years, 18 months before Presidentialelections, so that senior Citizens can make eachPresident accountable for senior citizens' prn-grams. It is further recommended that funds forthe White House Conference on Aging comefrom Federal general revenue funds.

SECTION LEADERSHIPSpace will permit listing of title and ad-iiress.only the kit tins a sans* appoint.

The Technical Committeefor Employment and RetirementChairman

A. Webb Hale, Director, Recreation Center, Space Division,North American Rockwell Corporation, Downey, California

Recommendations XV, XVI, and XVII were not includedin the short report because of space limitations.

Consultant

Geneva Mathiasen, retired Executive Director, National Coun-cil on the Aging, Inc., Woodside, New York

Members

Robert B. Burroughs, Designer of Pension Plans, Manchester,New Hampshire

Ewan Clague, Economist, Washington, D. C.

Murrae A. Feingold, Chairman, Town of Hempstead OlderAmerican Volunteers Committee, Hempstead, New YorkAlice K. Leopold, former Assistant to the Secretary of Labor,San Francisco, California

Ross Armstrong McFarland, Professor, Guggenheim Center,School of Public Health, Harvard University, Boston, Massa-chusetts

James F. McMichael, Director, Experimental MarketingProject, Union Mutual Life- Insurance Company, Portland,Maine

Charles V. Martin, Chairman, Carson Pixie Scott Company,Chicago, Illinois

Lawrence A. Oxley, Director of Special Projects, NationalCouncil.of Senior Citizens, Inc., Washington, D. C.Lowell W. Perry, Manager, Section B, Chrysler CorporationLabor Relations, Detroit, Michigan

Harold L Sheppard, Staff Social Scientist, W. E. UpjohnInstitute for Empicvaunt Research, Washington, D. C.Gerald G. Somers, Professor of Economics and Director, In-dustrial Relations Research Institute, University of Wisconsin,Madison, Wisconsin

Frederick C. Swartz, Physician, Lansing, Michigan

Marguerite Wykoff Zapoleon, Consultant on Labor Econom-ics and Vocational Guidance, Ft. Lauderdale, Florida

The Secretariat

DirectorRoland G. Ross, Chief, Departmental Management System,Manpower Administration, Department of Labor

Members

Anna Boyd, Program Analyst, Program Analysis Division,Office of Comptroller, Office of Economic Opportunity

Roberta Church, Consultant on Aging, Division of Disabili-ties Services, Rehabilitation Services Administration, Socialand Rehabilitation Service, Department of Health, Education,and Welfare, Washington, D. C.

Lewis Denton, Policy Specialist, Bureau of Retirement andSurvivors Insurance, Social Security Administration, Depart-ment of Health, Education, and Welfare, Baltimore, MarylandRobert Glasgow, Assistant Chief, Human Resources Branch,Economic Research Service, Economic Development Division,Department of Agriculture, Washington, D. C.Bates Johnson, Assistant Chief, National Programs and Serv-ices Branch, Division of Vocational and Technical Education,Office of Education, Department of Health, Education, andWelfare, Washington, D. C.Zachary Metz, Chief, Publication Division, Economic De-velopment Administration, Department of Commerce, Wash-ington, D. C.

Craig Pettibone, Legislative and Technical Assistant, Legisla-tion and Policy Division, Civil Service Commission, Washing.ton, D. C.

Milton Salzburg, Legal Consultant Compensation and PensionReview, Department of Veterans Benefits, Veterans Admin-istration, Washington, D. C.

Section OfficersCo-Chairmen

Dorothy F. McCamman, Consultant on Retirement Incomeand Health Economics, Washington,-D. C., and A. Webb Hale

ConsultantGeneva .MathiasenRecorderMarguerite W: ZapoleonAssistant RecorderJames C. Hunt, Associate Regional Commissioner for Aging,Social and Rehabilitation Service, Department of Health, Edu-cation, and Welfare, Boston, MassachusettsManagement OfficerRoland G. Ross, Chief, Departmental Management Systems,Manpower Administration, Department of- Labor, Washington,D. C

16

Subsection OfficersSubsection 1

ChairmanRonald Brown, Management Consultant, Cleveland Heights,Ohio.

Vice ChairmanSimon Heemstra, Specialist Program Coordination and De-velopment, Indiana Commission of Aging, Indianapolis, In-diana.

Recorder

Emogene Baxter, founder, Over.60 Counseling EmploymentService, Montgomery County Federation of Women's Clubs,Inc., Bethesda, Maryland

Subsection 2

ChairmanHarold L. Sheppard

Vice ChairmanJoseph F. Gore, Secretary, Chapter No. 6, National Associa-tion of Retired Federal Employees, Chicago, Illinois

Recorder

Jacqueline T. Sunderland, President, Metropolitan SeniorCitizens Center, Baltimore, Maryland

Subsection 3

Chairman

James H. Schultz, Associate Professor of Welfare Economics,Florence E. Heller Graduate School for Advanced Studies inSocial Welfare, Brandeis University, Waltham, Massachusetts

Vice Chairman

Mrs. Lee M. Fagioni, Director of Personnel, Permacel Com-pany Division, Johnson & Johnson, Metuchen, New Jersey

Recorder

Oliver Diggs, Assistant Director, Freedom House Job Place-ment Center, Denver, Colorado

Subsection 4

ChairmanEwan Clague

Vice Chairman

W. Eugene Houston, Minister, Springfield Gardens, NewYork

Recorder

Dorothy Switzer, former Managing Editor, The Journal ofIndustrial Gerontology, University of Nebraska, Lincoln, Ne-braska

Subsection 5

ChairmanGeneva Mathiasen

Vice Chairman

Leonard 'M. Miller, retired specialist in Counseling Tech-niques, U.S. Officer of Education, Bowie, Maryland

Recorder

Stanley J. Gregory, Assistant Director, Region 10, UnitedAuto Workers of America, Milwaukee, Wisconsin

Subsection 6

Chairman

Leon B. Schachter, International Vice President, Amalga-mated Meat Cutters and Butcher Workmen of North America,Washington, D. C.

Vice Chairman

Frederick D. Leatherman, Retired Foreign Service Officer,Bethesda, Maryland.

Recorder

Gwen Robbins, Teacher, Roiwell, New Mexico

Subsection 7

Chairman

E. W. Christiansen, State Representative, Hartin, Montana

Vice Chairman

Harry Walker, Executive Director, Maryland Commission onAging, Baltimore, Maryland

Recorder

William J. Wholean, Executive Director, Connecticut Catho-lic Conference, Hartford, Connecticut

Subsection 8.

Chairman

Mrs. Joshua D. Shubin, volunteer, Golden Age EmploymentService, and National Board Member, National Council ofJewish Women, Atlanta, Georgia

Vice Chairman

Hargrove Bowles, State Sen,cor, Greensboro, North CarolinaRecorderJames F. McMichael

17

Subsection 9Chairman

Wiliam Gellman, Director, Jewish Vocational Services andNational Easter Seal Society of Crippled Children and Adults,Chicago, Illinois

Vice Chairman

jack Gould, Director, New Bedford Council on Aging, NewBedford, Connecticut

RecorderWilliam Dorsey, Consultant, California Commission onAging, Sacramento, California

Federal Resource PersonnelAnna Boyd

Dale Chismore, Specialist, Education Records and Reports,National Center for Education Statistics, Office of Education,Department of Health, Education, and Welfare, Washington,D. C.

Roberta ChurchLewis Denton

Ann Donovan, Deputy Director, Division of Manpower Developnient and Training, Office of Education, Department ofHealth, Education, and Welfare, Washington, D. C.Anthony Fantaci, Chief, Division of Counseling, Testing andSpecial Workers Service, U.S. Training and EmploymentService, Manpower Administration, Department of Labor,Washington, D. C.

Robert Granakis, Special Assistant to Deputy Associate Man-power Administrator, U.S. Training and Employment Service,Manpower Administration, Department of Labor, Washington,D. C.

Roger Grant, Special Assistant to Director of Program Opera-tions and Services, Occupational Safety and Health Admin-istration, Department of Labor, Washington, D. C.Gerald Gunderson, Program Analyst, Office of Planning andEvaluation, Manpower Administration, Department of Labor,Washington, D. C.

Helen Hamer, Chief, Program Development Branch SelfSupport Program Division, Community Services Administra-tion, Social and Rehabilitation Service, Department of Health,Education, and Welfar4:, Washington, D. C.Joseph Hickey, Chief, Program Policies and LegislativeBranch, Unemployment Insurance Service, Manpower Ad-ministration, Department of Labor, Silver Springs, MarylandBates JohnsonZachary MetzMerlin A. Myers, Program Analyst, Division of ResourcePlanning and Review, Manpower Administration, Departmentof Labor, Washington, D. C.Janet Pease, Manpower Development Specialist, OperationMainstream, U.S. Employment and Training Service, Man-power Adminiration, Department of Labor, Washington,D. C.Craig PettiboneMilton Salzburg

Avis Smith, Manpower Development Specialist, U.S. Trainingand Employment Service, Manpower Administration, Depart-ment of Labor, Washington, D. C.Arnold Strasser, DirectorAnnual Earnings and EmployeeBenefits Projects, Bureau of Labor Statistics, Department ofLabor, Washington, D. C.

James F. Taylor, Director, Planning and Evaluation Staff,Bureau of International Labor Affairs, Department of Labor.Wasnington, D. C.

Rose Ter lin, Chief Special Projects, Womens Bureau, Wageand Labor Standards Administration, Department of Labor,Washington, D. C.

r

c

Robert Turner, Labor Economist, Office of Planning andEvaluation, Manpower Administration, Department of Labor,Washington, D. C.

Helene White, Writer and Editor, Office of Labor, Manage-ment and Welfare Pension Reports, LaborManagement Serveices Administration, Department of Labor, Silver Springs,Maryland

dp -sh\, .

'4.0srot

18

NNY.

1/111.".."11114/

SECTION ON

PHYSICAL AND MENTAL HEALTH

"Compulsory health-Care inevitably resultsin poor quality health care."

SECTION ON HEALTH AND MEDICAL CARE,.1961 WHITE HOUSE CONFERENCE ON AGING

"11 is distressing to be told . . . that the qualityof care the individual physician renders willbe influenced by: the source of payment. We donot believe this is so."

MINORITY REPORT, SECTION ON HEALTH ANDMEDICAL CARE, 1961 WHITE HOUSE CONFER-ENCE ON AGING

INTRODUCTION

he report of the first (1961) WhiteHouse Conference on Aging, The Na-tion and Its Older People, clearly re-veals the debate at that meeting which

raged over the provision and financing of healthcare to the elderly.

Now, ten years later, it is possible to point todemonstrable outcomes of that debate, namelythe evolution of vast change in the whole realmof health care and public policy. At the same time,however, long-recognized deficiencies in the tra-ditional system of health care remain. And, pro-grams adopted to make the system more respon-sive to the circumstances of those most disadvan-taged within itthe elderly and the poorfashioned in controversy, remain under intensecritical review. Medicare and Medicaid, recognizedfor their strengths, are equally noted for theirdeficiencies. Attention is now being focused on the

19

adoption of a comprehensive national health plan,but there is concern about the alterations its adop!don might bring about in the quality and deliveryof health services to the elderly.

Over 480 Delegates to the 1971 White HouseConference on Aging were named to participatein the deliberations of the Section on Physicaland Mental Health, the largest of any of the 14Conference Sections. Among the Section partici-pants were over 100 physicians, including spe-cialists in such areas as geriatrics and psychiatry;over 50 association executives working in health,social welfare, and related fields, including the in-surance industry; over 35 administrators of hos-pitals, extended-care facilities, nursing homes,mental health 'clinics and outpatient centers, orother such health facilities. Nurses, optometrists,podiatrists, psychologists, pharmacists and reha-bilitation workers serving the blind, the deaf, andother physically disabled, were members of theSection. So, too, were researchers and professorsof medicine, nursing, sociology, health care ad-ministration, and persons serving within healthand welfare agencies at local and State levels.

By virtue of their age, over 13 percent of theSection body could speak directly to the varioushealth services still out of reach for a large shareof elderly persons, largely because of costs, lackof facilities, and the fragmentation of health caredelivery systems.

In offering nine major proposals, these Dele-gates, sensitive to what has passed and what re-mains to be done, addressed such topics as: theneed for separate health services for the elderly;the coordination and delivery of health services;Medicare, Medicaid, and the alternatives offered

i

through adoption of a national health insuranceprogram; a national program of education aboutspecific health changes and diseases associatedwith aging; the adequacy of the supply and train-ing of health manpower; and the balance to beachieved among expenditures for research, train-ing, and services.

SECTION REPORTConvened in an initial orientation session, Dele-

gates to the Section on Physical and MentalHealth heard Co-chairman Edward J. Lorenze setforth the parameters for the work of the Sectionand its Subsections over the course of the nextseveral days. At the request of presiding Co-chairmen James G. Haughton, Dr. Lorenze offeredhis remarks highlighting the topical areas whichwould likely be a major concern to the Delegatesin their deliberations.

Co-Chairman's Statement

It gives me great pleasure to welcome the Dele-gates to the Physical and Mental Health Sectionof the 1971 White House Conference on Aging.As you may know, you number over 400 dele-gates and constitute the largest Section of theConference. This fact, as well as the responsesin the State and regional White House Con-ferences, indicates that health care in its broadaspects, including both physical and mental health,continues to be a major concern of the Americanpeople.

This concern is not limited to those at or nearthe arbitrary age of 65 years, but involves theentire population. This concern continues for theelderly, despite the fact that since the 1961 WhiteHouse Conference on Aging, major public policydecisions Shave been made in regard to the TitleXVIII and Title XIX programs of Medicare andMedicaid which have profoundly affected thedelivery of health care services to the elderly forthe better. Indeed, among some, it has been feltthat programs for the payment of health serviceshave made those over 65 a privileged group.Progress has been made, but much remains tobe accomplished.

The issues which were developed by, the Tech-nical Committee on Health, which I had the honorto chair, were developed to stimulate discussionin a number of broad areas concerning the de-livery of quality health services. They were de-signed not to limit the areas to be considered,- butto provoke discussion and difference of opinionand recommendations from a broad segment ofthe population, involving the consumer, the de-liverers of health services, laymen and profes-sionals, individuals and national organizationswith a particular concern in this area. The issuequestions have been discussed at the White HouseConferences of the several States and by localconferences within the States, as well as by thenational organizations.

The program recommendations which havecome out of these deliberations have been tabu-lated and integrated, and appear in your WorkBooks under each of the issue questions. Thus, theWork Book contains the results of national dis-cussion. The issue questions and the recommenda-tions of these groups, plus your own contributions,are the subject matter for this Conference whichwe are about to begin.

You will be divided up into 13 groups, eachof which will consider all the health and mental

. health issues, and determine the recommendationswhich you feel appropriate. We anticipate that therecommendations coming from this process willprovide guidelines which are an expression of thewill and the wisdom of people on all levels, andfrom which will be developed .a blueprint whichwill have profound effect upon the health, caredelivery system and the quality of care which willbe provided.

As I have thought over the issues and possiblerecommendations, the, following areas seem tome to be of major concern in your deliberations.

1. A recognition of the fact that, while manyhealth services are provided to the older segmentof the population, obvious gaps and deficienciesexist. The identification of these gaps and incon-sistencies will be a major concern. It should berecognized that a coordinated system of compre-hensive health services is the objective, not inde-

20

It

pendent and fragmented services without provi-sion for continuity of care.

2. The goal of comprehensve health servicesis difficult to achieve without a coordinated systemfor 'a variety of reasons, incuding ignorance ofone's needs, financial or geographical considera-tions which limit access to services which areavailable, lack of facilities and personnel to de-liver the services. The quality of care providedwill also be dependent upon the supply of man-power and the ever improving results of research.We should be aware that the product the deliverysystem brings to us must be a continually', improv-ing one. The medical care of 1900 is not themedical care of 1970 and the medical care of1970 will not be the care of 1980. The necessityfor continued research to improve .the product isself-evident. We might be able to get along withthe 1930 automobile, but no one would acceptthe quality of medical care of 1930, which wasthen available to the most privileged in oursociety.

3. The elderly, despite gains in the area ofFederal programs for payment of health services,continue to require special attention to theirneeds because of their particular social and eco-nomic vulnerability, as well as the fact that in theolder age group, the incidence of disease, disabilityand need for health care services of all kinds is sogreat. We must examine the special needs withinthis group of\those who are impoverished andthose who, because of racial and ethnic origin,have been particularly isolated from the mainstream of the existing health care delivery system.The rural and urban ghetto areas, particularly,have had limited resources in terms of facilitiesand personnel needed lo meet their health carerequirements. The distribution of these servicesmust be reconsidered and new and innovativeways must be developed to provide for them. Therole of regional health facility planning and, in-deed, health personnel distribution, must bedeveloped and expanded on a national basis ifthe goal of comprehensive health care is to beachieved. This must include provisions for healtheducation and preventive services, diagnostic andtherapeutic services, rehabilitative services andprograms for long-term care with alternate m,' h-ods to institutional care.

21

4. Consideration must be given to the fact that,while the achievement of these services for theelderly is our immediate and primary concern, ina larger sense we recognize that. such a programmust be available to all of our people, whateverthe age. It is not conceivable that a system of thiskind can be developed for the elderly to theneglect of other age groups. Our network offacilities, including physicians' offices, health carecenters, clinics, hoipitals, rehabilitation centers,long-term care facilities and home care programs,must all be of high quality- in providing both forthe old and the young. It would-be difficult toconceive that separate facilities, such as generalhospitals, would be developed only for the elderly,but should continue to provide for all age groups.Howeimr, it may be some time until such a systembecomes an actuality and the aged might well beconsidered a trial group for which this type ofcomprehensive health care program could beworked out, and would provide the experimentalbasis on which developments for the other seg-ments of the population would come about.

5. A variety of national health care plans havebeen suggested. These have primarily dealt withfinancing of such care for our population. Prob-ably nothing that could be considered a trulysatisfactory comprehensive health care system hasbeen outlined, nor have the details been spelledout. It may well be that it will be a considerabletime before a comprehensive program for a na-tional health plan will be developed.

In our deliberations, we must stress the natureof the program that we would like to see de-veloped. We should take care that our recom-mendations do not work adversely to the interestof the elderly or that gains which have alreadybeen made are lost. The attitudes toward thedeficiencies in Medicare and Medicaid should bereviewed in the light of expanding the legislationand financing and not provide the opportunityfor cutbacks and limitation.

6. We must remember that in this country wedo have a system of delivery of health care serv-ices which, although failing to meet all of theneeds of all of the people all of the time, has,nevertheless, provided tremendously effectiveservice to a large population. It is the imperfec-

tions in this system which we are stressing, but

one would have difficulty in finding examples ofcountries which have provided a quality of careon the scale which we have achieved. We wantimprovement, but we should not be ashamed orapologetic of the achievements to date.

7. There are many States ir. this country wherethe provisions under Medicaid have been quitebroad for the elderly. The question to be examinedis why there are inequalities in the level of servicesprovided across the Nation, and would bring us toask why the quality of care and extent of servicescovered should not be national in scope and notvary from State to State. It would appear onlyright that the minimal standards of care accept-able should be national in scope and provision.Likewise, regional' planning for health facilities

and services should have a similar national scope

as should the regulations and supervision of theseservices, so that the amount and quality wouldnot vary from one area of the country to another

8. Another matter to be considered is whether

access to comprehensive health services should bea matter of right to all elderly people, regardlessof ability to pay. A major criticism of the Medicaidprogram, even in the States in which a broadspectrum of services are available, is the fact thatit is not a right available to all elderly personsbut is based on a means test. The Medicate pro-

gram and the services provided by it are a matterof right and not limited by economic need. These

are financial and philosophical questions whichwill require considerable thought' before satisfac-

tory solutions are determined. One would haveto consider whether health care, like public edu-cation, is a basic ingredient to the continuation ofa successful free society such as we havedeveloped.

9. I would particularly stress that we not lose

sight of the problems in mental health. There aremany Who feel that lip service is given to this area,but that it is frequently then overlooked. It isclear that our concern is with the total healthneeds of the individual and that the physical andmental aspects cannot be separated in or programdevelopment, just as they cannot be separated in

the individual human being.

In conclusion, we are embarked on a voyage of

22

major importance. The policy recommendationswhich you will develop will, undoubtedly, haveprofound effects on the course which our societywill follow in the next ten years. I am sure thatchanges will occur between this and the nextWhite House Conference on Aging which willfar surpass the changes . which have occurredsince the Conference of 1961. I wish you well in

your deliberations and' I feel secure that you willprovide clear guidance to those who will becharged with the development of the health caresystem of the future.

PreambleWe, the Delegates to the Physical and Mental

Health Section of- the 1971 White House Con-

ference on Aging, assert that the United Statesof America must guarantee to all its older peoplehealth care as a basic right and a quality of lifeconsistent with that in which our Nation should

assure to this group who have made invaluablecontributions to its development. In order to as-sure that quality of life, a basic requirement isthe availability of a comprehensive system ofappropriate health care.

A comprehensive system of appropriate healthcare requires that full spectrum of presentlyknown services be readily accessible. These mustbe of high quality and be delivered in the appro-priate setting and at the appropriate time, withconcern for .the dignity and choice of the indi-vidual, and within a framework which guaranteescoordination among the various levels of care,continuity of care over time, and the efficiency andeffectiveness which will assure supportable costs.

To be comprehensive and systematic, this

health care must provide:

a. Assessment of healthb. Education to preserve healthc. Appropriate preventive and outreach serv-

icesd. All physical, mental, social, and supportive

services necessary to maintain or restorehealth

e. Rehabilitationf. Maintenance and long-term care when dis-

ability occurs

To be specifically responsive to the needs ofthe elderly, special attention must be given to theavailability and quality of long-term care and tothe development of adequate, appropriate alter-natives to institutional care.

Community and consumer participation in theplanning and delivery of such a system oserviceswill tend to assure the responsiveness of the sys-tem to locally defined community need and theappropriate use of health manpower, facilities andfinancing.

The Health Section recognizes that althoughthe aged.represent a minority, within this minoritythere are special problems experienced by racialand ethnic groups. Within the special concernexpressed Car the problems of the, aged, particularattention must be accorded to make sure thatthese minorities are not doubly jeopardized.

In support of these basic premises the Physicaland Mental Health Section submits the followingpolicy proposals.

Recommendations

RECOMMENDATION ISpecial Health Care

Health care for the aging must be provided asan integral part of a coordinated system that 'pro-vides comprehensive health services to the totalpopulation, but immediate and special considera-tion and emphasis must be given to the problemsof, and services for, the aging.

RECOMMENDATION IICoordinated Health Services. Delivery System

A coordinated delivery system for comprehensivehealth services must be developed, legislated, andfinanced to ensure continuity of both short- andlong-term care for the aged.

RECOMMENDATION IIINational Health Insurance and Medicare

A comprehensive health care plan for all personsshould be legislated and financed through a na-tional health plan. Pending the achievement of

23

such a national health plan, the complete rangeof health care services for the elderly must beprovided by expanding the legislation and financ-ing of Medicare.' Such expanded financing shouldbe accomplished by means of a combination ofSocial Security trust funds with a greatly expandeduse of general revenues. Such expansion of Medi-care should include elimination of deductibles,co-insurance and co-payment, and all provisionsdiscriminatory to the mentally ill, as well as theestablishment of congruent ages for Medicare andSocial Security benefit eligibility. Both the im-mediate expansion of the current program anda future national health plan shouldprovide fora public-private partnership in the 'delivery ofservices and for Federal financing and qualitycontrols in order to assure uniform benefits anduniform application of thestandards of quality.Centralized responsibility for standards and con-trols over health facilities and services must becombined with protection, for the patient andprovider, from arbitrary, capricious, and varied'application and interpretation of existing as wellas new standards.

Minority RecommendationThe fiscal aspects of the Medicare programshould be administered by the Federal gov-ernment rather than by the private insurancecarriers as intermediaries.

RECOMMENDATION IVHealth Education for All Ages

A continuing national program for education ofall persons should be provided about the specificphysical, mental, and social aspects of aging. Edu-cational programs should be addressed to all agesand should include all stages of development sothat the different age groups will better under-stand each other. Information on all aspects ofaging should be included in educational coursesat all levels. The aged themselves should beamong those recruited, trained, and utilized incarrying out these programs.

' A minority opposed the Section's action eliminating thecombination of Medicate and Medicaid expansion (throughlegislation and financing) as an alternative to the expansionof Medicare alone in order to achieve a comprehensive healthcare plan.

ti

RECOMMENDATION VTraining in Aging for Health Manpouer

Emphasis shOuld Iv placed on including curriculaor course contents on physical, mental and socialaspects of aging in secondary schools, undergradu-ate professional education, and in inservice train-ing and continuing education of health personnel.The development of specialists in the care of theelderly should also receive emphasis, especiallywith the view of developing professional, alliedhealth professional, and other health personnelselected and trained to give, compassionate andexpert care to the aged. Funds must be iprovidedto ensure the development of such programs aswell as increase the supply of health manpower ofall kinds.

RECOMMENDATION VIFunding for Research, Service, and Education

The aging will best be served if available fundsare divided among service, research, and educa-don. Emphasis should be placed on funding ofdirect services but not to the exclusion of researchand education, which should receive a reasonableproportion of total resources available. Researchfindings now available should be assembled, co-ordinated, and incorporated into service programs.

Specific attention should be given to increasingthe funds available for basic research and foroperational research with a strong suggestion thata gerontological institute be established withinthe National Institutes of Health to provide theessential coordination of training and researchactivities.

RECOMMENDATION VIINational Mental Health Center for Aging

A center for aging should be established in theNational Institute of Mental Health to meet theresponsibilities for more research and training inthe field of mental health of the elderly.

RECOMMENDATION VIIIPresidential Commission on Aging

The President and Congress should authorize theappointment of a commission on aging, includinga committee on mental health of the elderly,

comprised of representatives from concernedFederal agencies, national organizations, Congress,and the Judiciary, and private citizens to study,evaluate, and recommend a comprehensive set ofpolicies for the Federal government, the severalStates, and locai communities to pursue in thisvital area.

RECOMMENDATION IXProtection of Iirdividual Rigbtr

Congress should appoint a nationwide interdis-ciplinary committee to determine the scope andtype .of intervention procedures and protectiveservices that would clearly protect the rights ofthe individual with health, mental health, andemotional problems requiring care. The rights ofhis immediate family and other close associatesshould be considered. This committee should in-chide representatives of the religious, civil rights,civil liberties, legal, health and social servicescommunities. Congress should appropriate suffi-cient funds to assure an indepth study of allaspects of the individual's rights in relation tohis needs for health services and thv administra-tion of his affairs until he can resume responsi-bility.

Intervention procedures and protective servicesalso should assure for elderly individuals theirrights of self-determination in their use of healthfacilities and services.

In order to promote and encourage the establish-ment of ombudsman services, the nationwide in-terdisciplinary committee, or other suitable means,should be used to study and define the functionsand roles of ombudsmen as separate and distinct,conceptually and in practice, from other protec-tive services and from convmer participation inhealth and other matters affecting the elderly.Subsequent promotion of ombudsman servicesshould include financial support for their activi-ties, as well as programs to assure that their func-tions andfindings are given full visibility at local,Stare, and national levels, and in both the publicand private semis!

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'A minority requested the Section to substitute the words"physical and mental health" for the amended word "health".

'A minority requested the Section to eliminate the lastparagraph referring to mho, man services.

S

I

I

I

SE CTION LEADERSHIPSpace will permit listing of title and ad-dress only the first time a name appears.

The Technical Committeefor Physical and Mental HealthChairmanEdward J. Lorenze, Medical Director, Burke RehabilitationCenter, White Plains, New York

ConsultantCecil G. Sheps, Director, Center for Health Services Research,University of North Carolina, Chapel Hill, North Carolina

Members

James C. Bennett, Chairman, Department of Gerondontology,University of Oregon Dental School, Portland, OregonLester Breslow, Chief, Division of Preventive and SocialMedicine, School of Medicine, University of California, LosAngeles, California

Michael M. Dacso, Dean, Institute of Health Sciences, HunterCollege, New York, New York

Horace Doty, Physician, Salt Like City, UtahReverend William T. Eggers, Administrator, Home for AgedLutherans, Wauwatosa, Wisconsin

Ernest C. Fackler, Management Consultant, Taylor, MichiganReverend Charles J. Fahey, Chairman, Commission on'Aging National Conference of Catholic Charities, Syracuse,New York

Robert H. Felix, Dean, School of Medicine, St. -Louis Univer-sity, St. Louis, Missouri

Walter W. Fox, Superintendent, Mental Health Institute,Mount Pleasant, Iowa

Charles M. Gaitz, Gerontology Research Section, TexasResearch Institute of Mental Sciences, State Department ofMental Health and Mental Retardation, Houson, TexasRalph Goldman, Professor of Medicine, The Center for theHealth Sciences, University of California, Los Angeles, Cali-fornia

Samuel Granick, Clinical Psychologist and Director of Re-search, Philadelphia Psychiatric Center, Philadelphia, Pennsyl-vania

E..Gartly jaco, Professor Department of Sociology, Universityof California, Riverside, CaliforniaDavid Littauer, Executive Director, Cedars-Sinai MedicalCenter, Los Angeles, California

Manuel Rodstein, Chief of Medical Services, The JewishHome and Hospital for the Aged, New York, New YorkDoris R. Schwartz, Associate Professor of Public Health Nurs-ing, Cornell University-New York Hospital School of Nursing,New York, Ncw York

Lyall A. Schwarzkopf, Member, State House of Representa-tives, Minneapolis, Minnesota

Megumi Shinoda, Physician, Los Angeles, California

Virginia Stone, Professor of Nursing and Director of Grad-uate Studies, Duke University School of Nursing, Durham,North Carolina

Wilbur H. Strickland, Specialist in Internal Medicine, Phila-delphia, Pennsylvania

George M. Warner, Director, Bureau of Long-Term Care,Division of Hospital Agents, New York State Departmentof Health, Albany, New York

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Austin B. Chinn, Consultant, Community Health Service,Health Services and Mental Health Administration. PublicHealth Service, Department of Health, Education, and Welfare;Rockville, Maryland

Special Assistant to the Director

Edith Robins, Coordinator for Health of the Aging, Com-munity Health Service, Health Services and Mental HealthAdministration, Public Health Service, Department of Health,Education, and Welfare, Rockville, Maryland

Members

Thomas E. Anderson, Chief, Section on Mental Health of theAging, National Institute of Mental Health, Health Servicesaid Mental Health Administration, Public Health Service,De,l meat of Health, Education, and Welfare, Rockville,Maryla...!

Sarah A. Butts, Social Work Program Specialist, Divisionof Services to the Aged and Handicapped, Community ServicesAdministration, Social and Rehabilitation Service, Depart-ment of Health. Education, and Welfare, Washington, D. C.Davi3 Callagy, Project Director, Program Operations Branch,Comprehensive Health Services, Offices of Economic Oppor-tunity, Washington, D. C.Edward S. Colby, Evaluation Officer, Community HealthService, Health Services and Mental Health Administration,Public Health Service, Department of Health, Education, andWelfare, Rockville, MarylandLeroy E. Duncan, jr., Director, Adult Development andAging Branch, National Institute of Child Health and HumanDevelopment, Public Health Service, Department of Health,Education, and Welfare, Bethesda, MarylandEdward Dunner, Special Assistant to the Assistant ChiefMedical Director for Research and Education in Medicine,Veterans Administration, Washington, D. C.Hans Falck, Consultant, Mental Health Care and ServiceFinancing Branch, National Institute of Mental Health, HealthServices and Mental Health Administration, Public HealthService, Department of Health, Education, and Welfare,Rockville, Maryland

Evelyn Flook, Special Assistant to the Director, NationalCenter for Health Services Research and Development, HealthServices and Mental Health Administration, Public HealthService, Department of Health, Education, and Welfare,Rockville, Maryland

Frank C. Frantz, Special Assistant to the Associate Commis-sioner, Medical Services Administration, Social and Rehabilita-tion Service, Department of Health, Education and Welfare,Washington, D. C.

Claudia B. Galiher, Interim Chief, Community AssistanceBranch, National Health Service Corps, Health Services andMental Health Administration, Public Health Service, De-partment of Health, Education, and Welfare, Rockville, Mary-land

James R. Gussenhoven, Program Analyst, ExperimentalHealth Services Delivery gystems, Health Services and MentalHealth Administration, Public Health Service, Departmentof Health, Education, and Welfare, Rockville, Maryland

Paul A. Haber, Deputy for Clinical Services, Departmentof Medicine and Surgery, Veterans Administration, Washing-ton, D. CHelen Holt, Special Assistant for Nursing Homes and Re-lated Facilities, Federal Housing Administration, Departmentof Housing and Urban Development, Washington, D. C.

1

Patricia P. Hunter, Assistant Director, Community ProfileData Center, Community Health Service, Health Services andMental Health Administration, Public Health Service, De-partment of Health, Education, and Welfare, Rockville, Mary-land

Wallace F. Janssen, Information Officer, Food and DrugAdministration, Public Health Service, Department of Health,Education, and Welfare, Washington, D. C.Ruth I. Knee, Chief, Mental Health Care AdministrationBranch, National Institute of Mental Health, Health Servicesand Mental Health Administration, Public Health Set.% Ice,Department of Health, Education, and Welfare, Rockville,Maryland

Marilyn Lammers, Consultant, Community Health Service,Health Services and Meantal Health Administration, PublicHealth Service, Department of Health, Education, and Welfare,Rockville, Maryland

Benjamin Lau, Management Consultant, Nursing HomeBranch, Community Health Service. Health Services andMental Health Administration, Public Health Service, De-partment of Health, Education, and Welfare, Rockville,Maryland

Dorothy E. Lawson, Chief, Social Service Branch, IndianHealth Service, Health Services and Mental Health Admin-istration, Public Health Service, Department of Health, Edu-cation, and Welfare, Rockville, MarylandEileen E. Lester, Interim Chief, Financing and ReimbursementBranch, Division of Health Care Services, Community HealthService, Health Services and Mental Health Administration,Public Health Service, Department of Health, Education, andWelfare, Rockville, Maryland

David Lit, Technical Advisor to Assistant Bureau Director,Bureau of Health Insurance, Social Security Administration,Department of Health, Education, and Welfare, Baltimore,Maryland

Ruth B. Logsdon, Public Health Advisor, Director of Medi-cal Care Standards, Community Health Service, Health Servicesand Mental Health Administration, Public Health Service,Department of Health, Education, and Welfare, Rockville,Maryland

William C. Loring, Research Director, Bureau of CommunityEnvironmental Management, Public Health Service, Depart-ment of Health, Education, and Welfare, Rockville, MarylandStanley Lotzkar, Associate Director, Resources and ManpowerDevelopment, Division of Dental Health, Bureau of HealthProfessions Education and Manpower Training, NationalInstitutes of Health, Public Health Service, Departmentof Health, Education, and Welfare, Bethesda, MarylandAnne Martin, Resource Consultant, Division of MentalHealth Service Programs, National Institute of Mental Health,Health Services and Mental Health Administration, PublicHealth Service, Department of Health, Education, and Welfare,Rockville, Maryland

John Powell, Program Specialist, Office of Health Affairs,Comprehensive Health Services Division, Office of EconomicOpportunity, Washington, D. C.Gruine Robins, ')irector of Information, Health CareFacilities Services. . ilth Services and Mental Health Ad-ministration, Public Health Service, Department of Health,Education, and Welfare, Rockville, Maryland'Luther Robinson, Acting Director and Superintendent, St.Elizabeth's Hospital, National Institute of Mental Health,Health Services and Mental Health Administration, PublicHealth Services, Department of Health, Education, and Welfare,Washington, D. C.Claire Ryder, Chief, Home Health Branch, Division ofHealth Resources, Community Health Service, Health Servicesand Mental Health Administration, Public Health Service,

Department of Health, Education, and Welfare, Rockville,Maryland

Margaret Sheehan, Chief, Institutional Nursing Branch, Di-vision of Nursing, Bureau of Health Professions Educationand Manpower Training, National Institutes of Health, PublicHealth Service, Department of Health, Education, and Welfare,Bethesda, Maryland

Nathan Sloate, Special Assistant to the Director, NationalInstitute of Mental Health, Health Services and Mental HealthAdministration, Public Health Service, Department of Health,Education, and Welfare, Rockville, Maryland

Stephanie B. Stevens, Specialist on Aging, Administration onAging, Social and Rehabilitation Service, Department ofHealth, Education, and Welfare, Washington, D. C.

Section OfficersCo-ChairmanJames G. Haughton, Executive Director of Health andHospitals, Govcri ng Commission of Cook County, Chicago,Illinois, and Ech.1rd J. Lorenze

ConsultantCecil G. Sheps

RecorderGeorge M. Warner

Assistant RecorderEleonor Morris, Associate Regional Commissioner for Aging,Social and Rehabilita :on Service, Department of Health,Education, and Welfare, New York, New York

Management OfficerEdith Robins


ChairmanEmily Wilson, Director, Geriatric Direct Services Project,White Mountain Community Services, Littleton, New Hamp-shire

Vice ChairmanRaymond T. Benack, Physician, Wheaton, Maryland

RecorderWilson D. Steen, Associate Dean, School of Health, Univer-sity of Oklahoma Medical Center, Oklahoma City, Oklahoma

' Subsection 2

ChairmanAlexander Simon, Professor and .Chairman, Department ofPsychiatry, University of California, San Francisco, California

Vice ChairmanDouglas W. Redmond, Special Assistant to the Director forResearch and Development, American Optometric Association,Washington, D. C.

RecorderHubert B. Ross, Professor of Anthropology, Atlanta University, Atlanta, Georgia

Subsection 3

ChairmanRenato M. Royo, Assistant Dean for Studies, Schools of PublicHealth, University of Puerto Rico, San Juan, Puerto Rico

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5

Vice Chairman

Weldon V. Barton, Legislative Representative, The NationalFarmers Union, Washington, D. C.

RecorderJames S. Bennett

Subsection 4

Chairman

W. Palmer Dearing, Medical Consultant, Group Health Asso-ciation of America, Inc., Washington, D. C.

Vice ChairmanFrank G. Zelenka, Associate Executive, American Associationof Homes for the Aging, Washington, D. C.Recorder

David Lee Pang, Physician, Nuuanu Clinic, Honolulu, HawaiiSubsection 5

ChairmanJames C. Folsom, Deputy Commissioner for Hospitals, StateDepartment of Mental Health, Tuscaloosa, Alabama

Vice Chairman

Samuel P. Katz, Member, State House of Representatives,Harrisburg, Pennsylvania

Recorder

Margheritta S. Loud, Director, Senior Center Inc., Detroit,Michigan

Subsection 6

ChairmanCharles M. Gaitz

Vice Chairman

Jerome Hammerman, Assistant Professor, School of SocialServices Administration, University of Chicago, Chicago, Illi-nois

Recorder

Edward L Tarara, Chief, Podiatry Section, Department ofOrthopedics, Mayo Clinic, Rochester, Minnesota

Subsection 7

Chairman

Stephen Caulfield, Assistant Dean for Allied Health Man-power, Albert Einstein College of Medicine, New York, NewYork

Vice ChairmanLyall A. Schwarzkopf

RecorderRuth B. Robinson, Staff Consultant, Massachusetts Commis-sion on Aging, Newton Centre, Massachusetts

Subsection 8

ChairmanHarvey Webb, Jr., Chairman, Legislation Committee, Na-tional Dental Association, Baltimore, Maryland

Vice ChairmanGail Allen, Psychiatrist, Riverdale, New York

RecorderLeonard F. Bender, Professor, Department of Physical Medi-

468.218 0 73 3

tine and Rehabilitation, University of Michigan Medical Cen-ter, Ann Arbor, Michigan

Subsection 9

Chairman

Edward C. Rosenow, Jr., Executive Vice President, Ameri-can College of Physicians, Philadelphia, Pennsylvania

Vice Chairman

Bishop Edward A. Head, Executive Director, Catholic Chari-ties of the Archdiocese of New York, New York, New York

Recorder

Jean K. Boek, Director, Special Education, National GraduateUniversity, Washington, D. C.

Subsection 10

Chairman

John A. Scharffenberg, Assistant Professor, Department ofPreventive Care School, of Health, Loma Linda, University,Loma Linda, California

Vice Chairman

Leory H. Jones, Executive Director, Bensonville Home So-ciety, Bensonville, Illinois

RecorderDoris R. Schwartz

Subsection 11

ChairmanRalph Goldman

Vice ChairmanWalter M. Cassidy, Southwestern Michigan Representative,United Auto Workers, and Member of the Board, NationalCouncil of Senior Citizens, Inc., Dearborn, Michigan

Re Corder

Doris Kelly, Professor of Nursing, Boise State College, Boise,Idaho

Subsection 12

ChairmanVictor Kassel, Geriatrician, Salt Lake City, Utah

Vice ChairmanAndrew R. McKillop, Administrator, Rehabilitation Instituteof Chicago, Chicago, Illinois

RecorderManuel Rodstein

Subsection 13

ChairmanKurt Pe lz, Director, Masonic Home and Hospital, Walling-ford, Connecticut

Vice ChairmanBenjamin W. Watkins, Director of Podiatry Service, NewYork City Department of Health, New York, New YorkRecorderAlbert G. Incani, Executive Director, Swope Ridge NursingHome, Kansas City, Missouri

Subsection 14

ChairmanReverend Charles J. Fahey

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Vice Chairman

Rosalie A. Abrams, Member, State Senate, Baltimore, Mary-land

Recorder

Bennie L Williams, Chief Psychologist,Hospital, Columbia, South Carolina

Federal Resource Personnel

Crafts Farrow State

Dorothy Aird, Nurse Consultant, Division of Medical CareStandards, Community Health Service, Health Services andMenial Health Administration, Public Health Service, Depart-ment of Health, Education, and Welware, Rockville, MarylandThomas M. Antone, Hospital Administrator, Division ofMedical Care Standards, Community Health Service, HealthServices and Mental Health, Administration, Public HealthService, Department of Health, Education, and Welfare,Rockville, Maryland

Clifford Becker, Social Worker Consultant, Division ofMedical Care Standards, Community Health Service, HealthServices and Mental Health, Administration, Public HealthService, Department of Health, Education, and Welfare,Region X, Seattle, Washington

Judish Brown, Professional Relations Advisor, Social SicurityAdministration, Department of Health, Education, and Wel-fare, Baltimore, Maryland

William Byrd, Acting Special Assistant to the Director forProfessional Relations, Social Security Administration, Depart.ment of Health, Education, and Welfare, Baltimore, Maryland

Joseph Coakley, Professional Relations Specialist, Social Se-curity Administration, Department of Health, Education, andWelfare, Baltimore, Maryland

Dorothy Collard, Mental Health Nurse Consultant, NationalInstitute of Mental Health, Health Services and MentalHealth Administration, Public Health Service, .Department ofHealth, Education, and Welfare," Rockville, Maryland.

Elizabeth S. Cornelius, Occupational Therapy Consultant,Division of Health Resources, Community Health Service,Health Services and Mental Health Administration, PublicHealth Service, Department of Health, Education, and Wel-fare, Rockville, Maryland

Judith Culver, Special Assistant to Regional Health Director,Department of Health, Education, and Welfare, Region IX,San Francisco, California

Doll Cutler, Legislative and Program Analyst, Administra-tion on Aging, Social and Rehabilitation Service, Departmentof Health, Education, and Welfare, Washington, D. C.Bruce Edemy, State Agency Operations Analyst, Social Se-curity Administration, Department of Health, Education, andWelfare, Baltimore, Maryland

Albert Fox, Director, Division of Direct Reimbursement,Social Security Administration, Department of Health, Edu-cation, and Welfare, Baltimore, Maryland

Frank C. FrancsRenee Gallop, Senior Economist, Office of Business Researchand Analysis, Bureau of Domestic Commerce, Department ofCommerce, Washington, D. C.

Mary Jo Gibson, Program Management Advisor, MedicalServices Administration, Social and Rehabilitation Service,Department of Health, Education, and Welfare, Washington,D. C.Paul A. HaberJames Haden, Medical Care Administrator, Division of Medi-cal Care Standards, Community Health Service, Health Servicesand Mental Health Administration, Public Health Service,

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Department of Health, Education, and Welfare, Rockville,Maryland

Richard A. Hall, Director, Health Resources and Standards,Community Health Service, Health Services and Mental HealthAdministration, Public Health Service, Department of Health,Education, and Welfare, Region V, Chicago, IllinoisBernice C. Harper, Social Work Consultant, Division ofHealth Resources, Community Health Service, Health Servicesand Mental Health Administration. Public Health Service,Department of Health, Education, and Welfare, Rockville,Maryland

Esther E. Horde, Special Assistant to the Associate Com-missioner for Policy, Medical Services Administration, Socialand Rehabilitation Service, Department of Health, Education,and Welfare, Washington, D. C.Helen HoltFrances B. Kaplan, Director, Office of Information, MedicalServices Administration, Social and Rehabilitation Service,Department of Health, Education, and Welfare, Washington,D. C.Marilyn LammertBenjamin LanDavid LitRuth B. LogsdonCaro E. Luhrs, Medical Advisor to the Secretary, Departmentof Agriculture, Washington, D. C.Anne MartinHelen E. Martz, Medical Care Planning Specialist, MedicalServices Administration, Social and Rehabilitation ServiceDepartment of Health, Education, and Welfare, Washington,D. C.

Virginia B. Maxwell, Consultant, Health Services andMental Health Administration, Public Health Service, Depart-ment of Health, Education, and Welfare, Rockville, MarylandRita McGrath, Social Research Analyst, Social Security Ad-ministration, Department of Health, Education, and Welfare,Baltimore, Maryland

Alvin A. Pearis, Field Liaison Assistant, Bureau of HealthInsurance, Social Security Administration, Department ofHealth, Education, and Welfare, Baltimore, MarylandJohn R. Percy, Social Insurance Advisor, Social SecurityAdministration, Department of Health, Education, and Wel-fare, Baltimore, Maryland

Max E. Perlman, Acting Director, Advisory Groups Staff,Bureau of Health Insurance, Social Security Administration,Department of Health, Education, and Welfare, Baltimore,Maryland

John PowellGruine RobinsonJon Robinson, Regional Program Director, Community HealthService, Health Services and Mental Health Administration,Public Health Service, Department of Health, Education, andWelfare, Region VII, Kansas City, MissouriMargaret SheehanNathan SloneJerry A. Solon, Chief, Health Services Organization andDelivery, Health Services and Mental Health Administration,Public Health Service, Department of Health, Education, andWelfare, Rockville, Maryland

Carleton B. White, Medical Officer, Community HealthService, Health Services and Mental Health Administration,Public Health Service, Department of Health, Education, andWelfare, Region VIII, Denver, Colorado

INTRODUCTIONhere were 382 Delegates .named to theHousing Section. Some 327 of thesefilled out an advanced registration form,and of these, 25 percent indicated that

they were already retired. Approximately a fifthof the registrants of the Section were membersof one of the minority groups.

The various professional and technical groupsconcerned with different aspects of housing theelderly were represented by highly experiencedpersons. The most numerous of these were ad-ministrators of old-age or retirement homes.Others were public housing authorities and di-rectors, architects, builders, realtors, legislators,model cities personnel, bankers and brokers; nurs-ing home administrators, housing planners andconsultants.

Interested organizations were also strongly rep-resented. Among them were unions, religiousgroups, associations of homes for the aged, coop-eratives, nursing homes, boarding homes, andresident care homes. Delegates who were pro-viders of services related to housing includeddietitians, social workers, physicians and nurses,religious leaders, and environmental planners.

The recommendations produced by this com-plex and sophisticated group of Delegates, guidedby the preferences expressed by the older peopleamong them, reflect the desires and thinking ini-tiated in the State and local White House Con-ferences on Aging, the earlier Older AmericanForums, and National Organization Task Forces.

Altogether, the Section approved 25 recom-

SECTION ON

HOUSING

29

mend ations addressed to such critical policy ques-tions as the funding of elderly housing, eligibilityfor occupancy of publicly assisted housing, typesof housing needed to meet the diversified andchanging needs of aging persons, financial aidprograms for homeowners and renters, standards,and research and manpower needs to insure qual-ity of facilities and of their management.

Within these recommendations will be foundpolicy guidelines for feasible action in the area ofhousing which, if implemented at national, Stateand local levels, by public and private resources,will not only increase the quantity of housingavailable to older people, but concomitantly willimprove the quality of their lives.

SECTION REPORTThe object of the first meeting of the Section

was to provide an orientation for the two days ofSubsection discussions and formulation of recom-mendations which were to follow. For this pur-pose, Co-chairman Noverre Musson was requestedby the presiding Co-chairman, Abraham J. Isser-man, to present a statement on the significance ofhousing to the elderly and society.

CO- Chairmans StatementOur three days' work in this Section is to deal

with the question of housing for older Americansand we must attempt to do it in the broadest, mostcomprehensive sense. Now it will be very easy inour deliberations to drift into discussions of tan-gential subjects which seem to be important tohousing, such as income, transportation, and thelike. This we must not do. There are 13 other

large sections besides ours, each assigned to asubject such as Nutrition, Health, Services, Em-ployment, etc., including Income. Our job is tostick specifically to the subject of housingbut,as I said, in its broadest connotation.

I believe that if we are able to spell out per-ceptively the full meaning of housing to olderpeople, we will find it to be a framework fordiscussing many of their other problems, and afoundation from which to attack them.

I have long maintained that if we were to solvefor our society the problem of housingin itsbroadest significancewe would go a long waytoward solving most of the other problems of ourpeople. And there is no one for whom this ismore true than the elderly. But to do so we mustunderstand fully all that housing includes.

What does housing mean to the elderly? Asidefrom his spouse, housing is probably the singlemost important element in the life of an olderperson. This can be good; it can be bad. Most ofhis satisfactions are house oriented. He spendsmore time in his home than almost anyone elseover the age of five. And just as more and moreof his satisfactions are bound up in his sense ofhome, so more and more of his problems arehouse generated.

Let me spell out for you some of my thoughtson the significance of housing to older people.Housing, to be good, must deal with the indi-vidual's need for independence, his need for secur-ity, for identity, for well-being: If we are goingto ask this measure of capability of housing, weare asking for considerably more than shelter,good temperature controls, and a safe bathtub. Weare talking, as a matter of fact, about aesthetics,economics, community planning, city administra-tion, the structuring of a neighborhood, and thecharacter of a community.

For example, if we put, housing together so asto deal with the need for independence on thepart of the elderly, we begin at once to confrontthe question of economics. To maintain a measureof independence the elderly must have housingthey can afford. Housing should take its fairshare of their income, but not all of it. So if wecan say what that housing will cost, then we begin

30

to have a measure of total minimum income tomaintain a decent existence. Thus without ourneeding here to spell anything out in dollars andcents, the whole equation becomes apparent andmeasurable when stated this way. If we considerhousing an important structuring mechanism forsatisfying the need for independence, then we -canalso begin to spell out what kind it should be,how it should be designed, and where it shouldbe located.

To be good, housing must face squarely thequestion of security. How can one have any feelingof security if he dare not go out on the streetwhich can be just as much a matter of how hishousing relates to the onslaught of traffic as amatter of purse-snatthing. Security is as much amatter of how one gets from his bedroom to hisbathroom in the night, as whether his home. isone-story or two. It is a matter of how accessiblecounseling and good advice are, or how availablehelp is. for yard work and housework, as how farone lives from the nearesrhospital.

I said housing was an important factor in aperson's sense of identity, his evaluation of hisown personal worth. If housing is to be a positivefactor in self-identity, then the person must havea choice of environments and having made achoice it must be an environment he can takesatisfaction in and be proud of. Freedom to makeone's own decisions is important to self-evalu-ation.

Identity can be jeopardized when a personfalls on loneliness. Fear of being left out, fear ofbeing neglected, forgotten, do more damage thanmost of the more diagnosable ailments of theelderly, .i in fact not inducing them. Housingcan help solve the problem of loneliness, or itcan aggravate it. Housing which isolates the olderperson from family, friends, church, entertain-ment, the golden age center, or the neighborhoodpub is bad housing. Even TVthat fantasy sub-stitute for companionshipis better if sharedwith someone else.

Independence, security, a sense of personal iden-tity go hand-in-hand with personal well-being. Itis greatly enhanced if housing is comfortable,convenient, and considered. attractive inside andout. It helps a great deal if rooms are big enough

to house your possessions and you can still getaround in them, and if the house is not so largethat housekeeping is a burden; if the yard isattractive, yet manageable. It helps immeasur-ably if shops, a supermarket, a bank, and a postoffice are minutes away. To be able to walk tothe library, a -restaurant, a movie house, a drugstore, or a health clinic 'would be greatly sustain-ing to many older people. To have good publictransportation at your door would stimulate ac-tivity. To have an active, welcoming church inthe next block would supply a whole gamut ofsatisfactions.

So you see why I say when I talk about housingI am talking about a lot more than buildings. Iam talking about &esthetics and about how door-knobs work; about society's responsibilities to theelderly and about the values it can find in them;about a workable house plan and about howneighborhoods and cities are put together. Thisis what I mean by housing in the largest senseand to be satisfied with part of the package andnot the whole is to settle for something less thanhousing.

So what is to be done?

In general:

First, we must develop this overall view of whatthe housing needs of the elderlyall elderlyare. We must not concentrate on one segmentof the elderly population and be blind to others.We must spell out the basic human needs of allelderly. And then we can identify what elementsare missing and where. We must delineate thewhole picture.

Next we must take a look at what has beendone and test it against our criteria for the totalneed. This will show up the gaps, and perhapsindicate how they can be filled, and by whom.

Then we must let whoever that is know aboutit.

We must take a look at how existing programsfor housing have been constructed. I think wewill find that up to now programs have beenconceived and put together to fit the convenienceand procedures of specific existing agencies andadministrative jurisdictions. Let us now insist that

31

programs be put together to fit the people theywill serve, be designed for he people who needthem, rather than the people who will administerthem.

At the Federal level:

Many departments and agencies have programsnow. In many cases they overlap; they leave biggaps; they are too narrow and specialized. Wemust urge that these programs be reorganizedaround the people's needs, across administrativeboundaries, and expanded to fill the present de-ficiencies.

At the State and county level:

Funding programs must be dertloped.Tax inequities must be eliminated.Reluctant communities must be prodded.Local jurisdictions must be educated to their

responsibilities. They must be encouraged andenabled to shoulder these responsibilities will-ingly.

At the local community level:

The needs must be documents;;.Housing sponsors must be found, ak 1, and in-

spired to actServices must be inventoried.Agencies and volunteer organizations must be

helped to cooperate and to innovate where needsare not being met.

Local responsibilities must be recognized as wellas those that are State and Federal.

In summary:

We must reveal the whole picture; we musttell the whole need; and we must not be contentto discuss half-measures or be put off with crumbsfrom the tablesuch as reduced-rate movies,reduced bus fare, reduced real estate taxes forelderly homeowners, but no help for elderlyrenters.

Good housing is primary to the good life.Aspiring to the good life for our people will befruitless unless the full significance of housing isunderstood. And there is no part of the popula-tion that would benefit more from a comprehen-sive, fully knowledgeable attack on the presentdeficiencies of housing than the elderly. It couldremake their lives and remake our society.

PreambleA national policy on housing for the elderly

worthy of this Nation must enjoy a high priorityand must embrace not only shelter, but neededservices of quality that extend the span of inde-pendent living in comfort and dignity, in andoutside of institutions, as a right wherever theelderly live or choose to live.

Of particular concern and priority are the poor,the minority -groups, the disabled, and the agedlocated in isolated rural areas.

Availability of housing in great variety is im-perative. Such housing should respond to healthand income needs and provide a choice of livingarrangements. It should include sales and rentalhousing, new and rehabilitated housing, largeand small concentrations. It should be producedby public agencies and by private profit and non-profit sponsors, with incentives to encourage suchhousing in all communities.

Funds to support a massive and varied housingprogram and mechanisms for assuring appro-priate services are imperative to the well-being ofthe elderly of this Nation. A decent and safe liv-ing environment is an inherent right of all elderlycitizens. It should become an actuality at theearliest possible time.

Recommendations

RECOMMENDATION IEarmarked Funds for Elderly Housing

A fixed proportion of all government fundsFederal, State, and localallocated to housingand related services, shall be earmarked for hous-ing for the elderly, with a minimum productionof 120,000 units per year.

RECOMMENDATION IINew Eligibility Criterion

Eligibility for the benefits of publicly assisted lowand moderate income housing and related serv-ices shall be based on economic, social and health

32

needs. Recipients having incomes above an estab-lished minimum level shall pay for benefits on asliding scale related to their income.

RECOMMENDATION IIIHousing Production Based on Need

The Federal Government shall ensure that State,regional, and local governments and private non-profit groups produce suitable housing for theelderly on the basis of documented need. TheFederal Government shall encourage productionthrough the uniform application and use of ap,,propriate incentives.

RECOMMENDATION IVVariety of flowing with Related Services

A variety of living arrangements shall be madeavailable to meet changing needs of the elderly.Such arrangements shall include residentiallyoriented settings for those who need differentlevels of assistance in daily living. The rangeshall include long-term care facilities for the sick;facilities with limited medical, food and home-maker services; congregate housing with food andpersonal services and housing for independentliving and recreational and activity programs.

RECOMMENDATION VSupportive and Outreach Services

Supportive services are essential in the total com-munity and in congregate housing. Emphasisshall be given to providing more congregate hous-ing for the elderly, which shall include the serv-ices needed by residents and provide outreachservices to the elderly living in adjacent neigh-borhoods when needed to help older people re-main in their own homes.

RECOMMENDATION VIProperty Tax Relief

The State or Federal Government shall providemechanisms to make possible local property taxrelief for the elderly homeowner and renter.

RECOMMENDATION VIIElimination of Procedural Delays

Every effort shall. be made to.eliminate red tapeand procedural delay in the production of housingfor the elderly.

RECOMMENDATION VIIIAllocation of Housing to Minority Groups

Particular attention shall be given to the needsof all minority groups and the hardcore poorelderly. At least 25 percent 'of the elderly housingshall be for the hardcore poor elderly, those withincomes at the poverty level or less per year.

RECOMMENDATION IXMultidisciplinary Review Teams

All Federal agencies dealing with housing for theelderly 'shall be required to establish multidiscip-linary teams to formulate guidelines for achitec-tural standards based on the needs of the elderly.The multidisciplinary teams shall also haveauthority to review and approve innovative pro-posals.

RECOMMENDATION XDevelopment of Housing by Minority Groups

Minority nonprofit groups shall be encouragedand assisted in developing housing for the elderly.

RECOMMENDATION XIRelocation and Replacement

When housing units for the elderly are eliminatedfor any reason, adequate replacement units mustbe available and relocation programs providedbefore such persons are displaced.

RECOMMENDATION XIINew Definition of Family Needed

Congress should revise the definition of a familyin the National Housing Act to include singlepersons 55. and over.

RECOMMENDATION XIIIPreservation of Neighborhoods

The Federal Government shall encourage the

33

preservation of neighborhoods of special characterthrough rehabilitation, and selective replacementof substandard dwellings with new dwellings,with full provision for the elderly of the area toremain in their familiar environment.

RECOMMENDATION XIVDirect Loan Housing Program

Housing funds now impounded by the Admin-istration should be released and the highly effec-tive Section 202 of the Housing Act with itsspecial guidelines related to space, design, con-struction, and particularly favorable financing,restored.

New Section 202 projects should be establishedby recirculating monies now being sent to theUnited States Treasury from mortgage paymentsand Section 202 conversions to Section 236 or likeprograms. Such conversions of current Section202's should be encouraged by establishing in-centives.

The Senior Housing Loan Section 202 admin-istrative component of the Department of Hous-ing and Urban Development should have man-a Bement audit responsibility for all Section 202projects and all Section 236 elderly projects.

RECOMMENDATION XVRent Supplement

The rent supplement program shall be increasedin dollars and eligibility.

RECOMMENDATION XVIHousing and Related Services

Financial incentives shall be available to familiesproviding housing and related care in their ownhomes, or in appropriate accommodations, fortheir elderly relatives.

RECOMMENDATION XVIIProperty Tax Exemptionfor Non-Profit Housing Sponsors

The Federal Government shall provide financialincentives to State and local governments to en-courage property tax exemption of voluntary,nonprofit sponsored elderly housing projects.

1

RECOMMENDATION XXIIIAssistance for Home Maintenance

The inability of the elderly to financially maintaintheir homes because of high maintenance cost andincreasing taxes resulted in the recommendationthat interest-free, nonamortized loans be madeavailable, the amount of the loan to be related toincome, with repayment either upon the death ofthe borrower or the transfer of the property.

As an additional element of national policy, it isproposed that ways or mechanisms be researchedto enable older homeowners to voluntarily utilizethe equities in their homes to increase their dis-cretionary income while remaining in their ownhomes.

RECOMMENDATIONS XIX, XX, XXIGovernment Organization for Housing

(XIX) Congressional action shall be taken toestablish within the Department of Housing andUrban Development an Office of Assistant Sec-retary of Housing for Elderly. This office shallhave statutory authority and adequate funding a-provide overall direction toward the implementa-tion of a national policy and the production ofhousing for the elderly.

(XX) Executive action shall be taken to createan Executive Office on Aging within the Office ofthe President.

(XXI) Congressional action shall be taken tocreate a Special Committee on Aging in theHouse of Representatives.

RECOMMENDATION XXIIProtection for Elderly Homeowner

The Congress shall enact legislation to safeguardthe elderly property owner or purchaser fromunscrupulous real estate developers and/or pro-moters.

RECOMMENDATION XXIIIHousing for Rural and Indian Elderly

The Congress shall enact legislation providingspecial funds for adequate housing and suppor-

34

tive programs to meet the unique needs of ruralelderly Americans, including those on Indianreservations.

RECOMMENDATION XXIVHousing Standards

Standards for physical and environmental secur-ity should be developed and applied as an inte-gral and basic element of all housing projectsserving the elderly.

RECOMMENDATION XXVHousing Research and Training

Competent service to the elderly in housing re-quires sound research widely disseminated andutilized, covering many aspects of their livingarrangements. Such research shall be undertakento cover the health, physical, psychological, andsocial aspects of environment in urban and ruralareas; to delineate the needs of elderly over 80years of age; to determine the needs of transientelderly; to establish the importance of selectingappropriate locations; and to provide safe andadequate construction. Particular attention isdirected to the consequences to vulnerable olderpeople of improper sales methods and inadequatehousing arrangements. There also shall be under-taken a well-conceived and well-financed programof training for professional and semiprofessionalstaff to develop efficient and competent manage-ment in developments for the elderly.

SECTION LEADERSHIPSpace will permit listing of title and ad-dress only the first time a name appears.

The Technical Committeefor HousingChairmanNoverre Musson, F.A.I.A., Tibbais, Crumley, and MussonArchitezts, Columbus, Ohio

MembersAlice M. Brophy, Director, New York Office for the A-in :.New York, N. Y.Robert Cummings, Housing Consultant, Pasadena, CaliforniaJohn W. DeVore, Internist, Oklahoma C ty, Oklahoma

Louis E. Gelwicks, Fellow in Architecture, Institute forStudy of Retirement and Aging, University of SouthernCalifornia, Los Angeles, California

Hobart C. Jackson, Administrator, Stephen Smith Home,Philadelphia, Pennsylvania

M. Powell Lawton, Research Psychologist, Philadelphia Geri-atric Center, Philade:phia, Pennsylvania

Warren T. Lindquist, Rockefeller r.nd Associates, New York,N.Y.

. .

Everett B. Luther, Administrator, The Beatitudes RetirementHome, Phoenix, Arizona

John Y. Maeno, Attorney-at-Law, Los Angelos, CaliforniaEthyl H. Venson, Vicc Chairman, Board of Commissioners,Memphis Housing Authority, Memphis, Tennessee

Joseph D. Weiss, Architect, Weiss Whelan Edelbaum Web-ster, New York, N.Y.Leon N. Wiener, Builder, Leon N. Weiner Associates, Wil-mington, Delaware


Marie McGuire, Program Advisor, Problems of the Elderlyand Handicapped, Department of Housing and Urban De-velopment, Washington, D. C.

Members

Kathaleen C. Arneson, Special Assistant to the Commissioner,Rehabilitation Services Administration, Social and Rehabilita-tion Service, Department of Health, Education, and Welfare,Washington, D. C.

Ronald Bird, Chief, Community and Facilities Branch, Eco-nomic Research Service, Department of Agriculture, Wash-ington, D. C.

Paul Conn, Multiple Housing Loan Officer, Rural HousingLoan Division Farmers, Home Administration, Departmentof Agriculture, Washington, D. C.Wesley Davies, Member Administrator's Advisory Council,Veterans Administration, Washington, D. C.Mary Fairbanks, Stag Assistant, Housing for the Elderlyand Handicapped, Department of Housing and Urban De-velopment, Washington, D. C.Perry J. Fliakas, Director for Housing Programs, Departmentof Defense, Washington, D. C.Leslie N. Gay, Jr., Chief, Branch of Tribal Government,Bureau of Indian Affairs, Department of Interior, Washington,D. C.

A. Robert Granakis, Special Assistant to the Director, Officeof Systems Support, Training and Employment Service,Department of Labor, Washington, D. C.Enid C. Hairston, Housing Services Program Specialist,Special Unit for Housing and Community Improvement,Community Services Administration, Social and RehabilitationService, Department of Health, Education, and Welfare,Washington, D. C.William D. Hughes, Chief, Elderly Housing AssistanceBranch, Federal Housing Administration, Department ofHousing and Urban Development, Washington, D. C.John Hutchinson, Program Analyst, Older Persons Program,Office of Economy Opportunity, Washington, D. C.Morton H. Leeds, Deputy Director, Office of Program De-velopment, Department of Housing and Urban Development,Washington, D. C.

William Loring, Research Director, Bureau of Community

35

Environmental Management, Public Health Service, Depart-ment of Health, Education, and Welfare, Washington, D. C.Louis D. Malotsky, Director, Rural Housing Loan Division,Farmers Home Administration, Department of Agriculture,Washington, D. C.

George I. Mishtowt, Deputy Assistant Secretary for MedicalServices, Department of State, Washington, D. C.Robert E. Ryan, Chief, Statistical Unit, Office of Data Systemsand Statistics, Department of Housing and Urban Development,Washington, D. C.

Lewis I. Schwartz, Deputy Director, Office of Data Systemsand Statistics, Department of Housing and Urban Develop-ment, Washington, D. C.Leonard Shaw, Recreation Market Analyst, Division ofTechnical Assistance, Bureau of Outdoor Recreation, Depart-ment of Interior, Washington, D. C.

Candace Sullivan, Housing Specialist, Office of Program De-velopment, Office of Economic Opportunity, Washington,D. C.

Arthur F. Young, Chief, Housing Division, Bureau of theCensus, Department of Commerce, Washington, D. C.

Section OfficersCo-Chairmen

Abraham J. Isserman, Consultant on Housing Programs, NewYork, New York, and Noverre Musson

Consultant

Herbert Shore, Executive Director, Golden Acres, Dallas,Home and Hospital for the Aged, Dallas, Texas

Recorder

John D. Lange, Retired Executive Director, National Asso-ciation of Housing and Redevelopment Officials, Alexandria,Virginia

Assistant Recorder

Harold Geldon, Associate Regional Commissioner for Aging,Social and Rehabilitation Service U.S. Department of Health,Education, and Welfare, Dallas, Texas

Management OfficerMarie C. McGuire

Subsection OfficersSubsection IChairmanJohn W. Devore

Vice Chairman

John A. Jackson, Executive Director, Stovall Foundation andStovall Development Corporation, Los Angeles, California

Recorder

Thomas A. Hannigan, Director of Research and Education,International Brotherhood of Electrical Workers, Washington,D. C.

Subsection 2ChairmanRobert B. Cummings

Vice ChairmanDorothy Taylor, Director, Special Home Services Programof the Episcopal Church Homes, Pittsburgh, Pennsylvania

C

RecorderGary Stay, Assail* Superintendent, Presbyterian MedicalCenter, Denver, Colorado

Subsection 3

Chair: tan

Margaret Faye, Executive, Kauai County Committee onAging, Lihue, Kauai, HawaiiVice ChairmanJohn Lindoerfer, Housing Consultant, Division on Aging,Madison, WisconsinRecorderLouis Gelwicks

Subsection 4ChairmanHerbert ShoreVice ChairmanEdith B. King, Planning Associate, HWA of Allegheny Coun-ty, Pittsburgh, PennsylvaniaRecoiderC G. GOMIlli00, Professor Emeritus, Tuskegee Institute,Tuskegee, Alabama

Subsection SChairmanJesse L. Dickinson, Executive Director, Housing Authority,South Bend, Indiana

Vice Chairman

Lawrence B. Wilson, Director, Urban Affairs, Los Angeles,California

RecorderEverett Luther

Subsections 6ChairmanJulia S. Zozaye, National Vice-President, League of UnitedLatin American Citizens, Phoenix, Arizona

Vice Chairman

Gerald B. Kinney, Directoi, Methodist Conference Home,Rockland, Maine

Recorder

Archille Alhoure, Personnel Consultant, Sacramento, Cali.fornia

Subsection 7

ChairmanLeah Rose Werthan, President, Board of Trustees, KnowlesSenior Citizens Center, Nashville, Tennessee .

Vice ChairmanAaron E. Henry, Pharmacist, Clarksdale, Mississippi

RecorderReverend Monsignor Michael B. Ivanko, Pastor, SacredHeart Parish, Oberlin, Ohio

Subsection 8ChairmanStephen May, Mayor, Rochester, New York

Vice ChairmanMrs. C. A. Banks, Associate Professor, Department of HomeEconomics, Indiana State University, Terre Haute, Indiana

36

RecorderE. Russell Jackson, Health Program Specialist, State Depart-ment of Health and Rehabilitation Services, Jacksonville,Florida

Subsection 9Chairman

Hugh W. Gaston, Architect and Chairman, Georgia Commis-sion on Aging, Albany, Georgia

Vice Chairman

Gwendolyn Kingsland, Member of the Board of Directors,State Council of Churches, Syracuse, New York

RecorderOlin J. Mason, Home Administrator, Florida Brethren Homes,Inc., Sebring, Florida


Kathaleen C ArnesonRonald BirdWester DaviesMary FairbanksLeslie N. Gay, Jr.Moses J. Gozonsky, Housing Specialist, Multifamily HousingAssistance Branch, Department of Housing and Urban De-velopment, Washington, D. C.

William D. HughesJohn HutchinsonWilliam Laughlin, Staff, Senate Committee on Aging, Wash-ington, D. CMorton IL LeedsTenn Lumtkins, Housing Specialist, Office of Economic Op-portunity, Washington, D. C.Louis bialotakySharon B. Mizell, Program Administrative Assistant, ElderlyHousing Assistance Branch, Department of Housing and Ur-ban Develoment, Washington, D. CAshot Mnatralusnian, Architectural Consultant, Division ofDevelomental Disability, Rehabilitation Services Administra-tion, Social and Rehabilitation Service, Deartment of Health,Education, and Welfare, Washington, D. C.James F. Neville, Assistant Administrator, Rural Housing,Department of Agriculture, Washington, D. C.Vincent Piper, Housing Management Specialist, Office of FieldSupport, Department of Housing and Urban Development,Washington, D. CPhilip E. Ryan, Senior Housing Specialist, Department ofHousing and Urban Development, Washington, D. C.Robert E. Ryan, Chief, Statistical Unit, Office of Data Sys-tems and Statistics, Departmtnt of Housing and Urban De-velopment, Washington, D. C.Lewis L SchwartzLeonard Shaw, Recreation Market Analyst, Department ofthe Interior, Washington, D. C.Roger Waller, Deputy Chief, Elderly Housing AssistanceBranch, Department of Housing and Urban Development,Washington, D. C.

INTRODUCTIONhere were 304 Delegates named to theIncome Section. Information availablefor some 287 of theie indicate that 30percent were retired. Almost one-fifth

were members of one of the minority groups.

The Delegates to the Section on Income rep-resented a broad range of interests and organiza-tions. National aged membership groups andother organizations, both governmental and non-governmental, directly serving the elderly at Stateand local levels ranked highest in numbers ofDelegates. Also strongly represented were laborunions, insurance and other business companies,religious and lay, social and health service groups,agricultural and rural organizations, and the aca-demic community. A partial list of the types ofprofessional and technical personnel includeseconomists, accountants, bankers, union and man-agement officers, legislative and executive officials,community project directors, lawyers, social work-ers, and financial and other consultants.

Throughout its deliberations, the Section onIncome thus had the benefit of a diverse, knowl-edgeable, and experienced set of participants.Guided by the preferences expressed first-hand byolder and retired persons among the Delegatebody, the Section's recommendations also reflectthe desires and thinking initiated in the State andlocal White House Conferences on Aging, theearlier Older American Forums, and NationalOrganization Task Forces.

Altogether, the Section approved 12 recom-

SECTION ONINCOME

37

mendations, 'addressed to such vital policy mat-ters as ensuring the elderly adequate and secureincome, funding of the Social Security system, re-forms in private and public pension plans, financ-ing of health care for the aging, property taxrelief, and changes in the Social Security retire-ment test. Action along these lines will not onlysignificantly advance the material welfare of olderpeople, but will also help to overcome the senseof isolation, anxiety, and deprivation felt by manyof the elderly.


There is no substitute for income 'if people areto be free to exercise choices in their style ofliving.

The income of elderly people in the past leftthe greater number of them with insufficientmeans for decent, dignified living. During theSixties, the elderly as a whole enjoyed improve-ments through greater employment opportunitiesand better old age security and other public andprivate benefits. The last two years have witnessedthe reversal of these trends toward improvementas inflation continued to erode the purchasingpower of fixed incomes, and rising unemploymentreduced job opportunities for older workers. Theeconomic situation of the elderly, if past experi-ence is repeated, will improve more slowly thanthat of younger groups even with an upturn inthe national economy. Immediate action to in-crease the income of the elderly is urgent andimperative.

t.

Recommendations

RECOMMENDATION IIncome Adequacy

The immediate goal for older people is that theyshould have total cash income in accordance withthe "American standard of living." We, therefore,recommend the adoption now, as the )inimumstandard of income adequacy, of the intermediatebudget for an elderly couple pre1 ared by theBureau of Labor Statistics (nationally averagingabout $4,500 a year in Spring 1970). This levelmust be adjusted annually for changes in boththe cost of living and rising national standards ofliving. For single individuals the minimum an-rual total income should be sufficient to maintainthe same standard of living as for couples (notless than 75 percent of the couple's budget). Forthe elderly handicapped, with higher living ex-penses, the budget should be appropriately ad-justed.

RECOMMENDATION IIProviding a Floor of Income

The basic floor of income for older people shouldbe provided through a combination of paymentsfrom the Social Security system and paymentsfrom general tax revenues.

This proposal would retain the basic features ofthe Social Security program. In addition, thereshould be a supplementary payment system basedon an income test to bring incomes up to theminimum, financed entirely from Federal Gov-ernment general revenues and included in a singlecheck from the Social Security Administration.

RECOMMENDATION IIILiberalizing the Retirement Test

Many older persons work in order to supplementtheir retirement income. The exempt amount ofearnings under the Social Security retirement tc',tshould be increased to not less than $3,000 a year(adjusted periodically to char.; es in the generallevel of wages).

The offset forMula of $1 reduction in benefits foreach $2 of earning should apply to all earningsin excess of the exempt amount.

38

Elimination of the test would cost an additional$3 billion, and there are more urgent needs towhich this sum could be applied than payingbenefits to persons who are still employed at morethan the exempt levels.

RECOMMENDATION IVWidow's Benefits

Increasing numbers of women without dependentchildren who have not been regularly employedare becoming widowed before age 60. We recom-mend that they be eligible to receive widow'sbenefits starting at age 50 to help fill the incomegap until they are eligible at the later age to re-ceive their Social Security benefit.

RECOMMENDATION V"Special Age-72" Benefits

Certain residents of the Commonwealth of PuertoRico, Samoa, the Virgin Islands, and Guam arepresently excluded from special benefits which areotherwise applicable to persons over the age of72 who reside in the United States.

We recommend that the 1965 amendments to theSocial Security Act, providing for special benefitsto all persons 72 years of age and older not other-wise receiving benefits, be applied without dis-crimination to all residents of Puerto Rico andthe territories and possessions of the United States.

RECOMMENDATION VIDisadvantaged Groups under Social Security

Studies should be made to determine whetherthere are disadvantaged groups within the popula-tion whose age ac retirement, or benefits underthe Social Security system, may be inequitablebecause of shorter life expectancy due to socialand economic conditions or racial discrimination.

RECOMMENDATION VIIFinancing Social Security

The financing of the Social Security system shouldinclude a contribution from general revenues. Thewhole structure of payroll taxes should be re-

vs

I

viewed to lighten this burden on low-incomeworkers.

RECOMMENDATION VIIIPrivate Pensions

Social Security benefits provide a basic protectionwhich should continue to be improved but whichcan be augmented through private pension plans.

The Federal Government should take action toencourage broader coverage under private pensionplans and ensure receipt of benefits LI workersand their survivors. It should require early vestingand/or portability, survivor benefits, and com-plete disclosure to beneficiaries of eligibility andbenefit provisions of the plans. In addition, Fed-eral requirements should assure fiduciary respon-sibility, minimum funding requirements and pro-tection, through reinsurance and other measures,of the promised benefits.

RECOMMENDATION IXRemission of Property Taxes

It is desirable that older persons be enabled tolive in their homes. States and localities shouldbe encouraged to remit part or all of the resi-dential property taxes on housing occupied byolder persons as owners or tenants who qualifyon the basis of an appropriate measure of incomeand assets. Remission is to be achieved by Federaland State grant programs to State and local tax-ing authorities to compensate for reduced reve-nues.

RECOMMENDATION XNational Health Security Program

This Nation can never attain a reasonable goalof income security so long as heavy and unpre-dictable health costs threaten incomes of the aged.

Priority consideration should be given to the estab-lishment of a comprehensive national health se-curity program which would include the aged aswell as the rest of the population. Financing theprogram solely through wage and payroll taxesand contributions from Federal general revenueswould ensure that health care expenses would bea shared responsibility of the government, em-

39

ployers and individuals. There should be nodeductibles, co-payments, or co-insurance.

Until such a system is established, the benefits ofMedicare-Medicaid should be increased immedi-ately to include, at a minimum, out-of-hospitaldrugs, care of the eyes, ears, teeth, and feet, (in-cluding eyeglasses, hearing-aids, dentures, etc.),and improved services for long-term care, andexpanded and broadened services in the home andother alternatives to institutional care. Here, too,there should be no deductibles, co- payments, orco-insurance.

Government should assume responsibility forassuring an adequate supply of health manpowerand essential facilities and for improving the or-ganization and deEvery of health services.

RECOMMENDATION XIU.S. House of Representatives

Special Commitke on Aging

We support the establishment of a special com-mittee of the House of Representatives which willdevote its attention to all social and economicproblems of the aged, including income, health,housing, and other needs areas reflected in theorganization of this Conference.

RECOMMENDATION XIIReordering National Priorities

Our Nation has the resources to effectively carryout the proposals made by this Section providedthere is a reordering of national priorities.


The Technical Committeefor IncomeChairman _Roger F. Murray, S. Sloan Colt Professor of Banking andFinance, Graduate School of Business, Columbia University,New York, New York

Consultant

Solomon Barkin, Professor of Economics, University of Massa-chusetts, Amherst, Massachusetts

Members

Theodore M. Alexander, Sr., President, Alexander and Corn-pany. General Insurance Agency, Atlanta. GeorgiaSolomon J. Axelrod, Professor of Medical Care Organiza-tion, School of Public Health, The University of Michigan.Ann Arbor, Michigan

H. Robert Bartell, Jr., Commissioner of Banks and TrustCompanies, State of Illinois, Chicago, IllinoisW. Rankin Furey, Board Member, Berkshire Life InsuranceCompany, Pittsfield, Massachusetts

August B. Garner, Budget Analyst, Wright-Patterson AirForce Base, Xenia, Ohio

Sidney Goldstein, Professor, Department of Sociology, BrownUniversity, Providence, Rhode Islas

Orville F. Grahame, Chairman of the Law Committee, PaulRevere Corporation, Worcester, MassachusettsEdwin S. Hewitt, President, Hewitt Associates, Libertyville,Illinois

George E. Johnson, Consultant, Variable Annuities, Gaithers-burg, Maryland

Walter E. Klint, Director, Employee Benefit Programs,Continental Can Comr.uy, Inc., New York, New YorkJuanita M. Kreps, Professor of Economics and Dean, TheWomen's College, Duke University, Durham, North CarolinaBen Seidman, Director, Social Security Department, AFL-CIO, Washington, D. C.Tsutomu Uchida, Partner, EquiVest Associates, Pasadena,California

The Secretariat

Directors

Patience Lauriat, Acting Director, Division on Retirementand Survivors Studies, Office of Research and Statistics, SocialSecurity Administration, Department of Health, Education,and Welfare, Washington, D. C.Elizabeth G. Sanders, Director, Division of Retirement andSurvivors Benefits, Office of Program Evaluation and Plan-ning, Social Security Administration, Department of Health,Education, and Welfare, Washington, D. C.

Members

Helen Lama le, Chief, Division of Living Condition Studies,Bureau of Labor Statistics, Department of Labor, Washington.D. C.Helen Nicol, EconomLt, Division of Intramural Research.Social and Rehabilitation Service, Department of Health,Education, and Welfare, Washington, D. C.

Section Officers

Co-ChairmenEve line M. Burns, Professor Emeritus, Columbia University,and Consultant Economist, Community Service Society, NewYork, New York and Roger F. MurrayConsultantSolomon J. Barkin

40

RecorderCarter C. Osterbind, Chairman, Institute of Gerontology,University of Florida, Gainesville, Florida

Assistant RecorderClinton Hess, Associate Regional Commissioner for Aging,Social and Rehabilitation Service, Department of Health, Edu-cation, and Welfare, Denver, Colorado

Management OfficerPatience Lauriat

Subsection Officers

Subsection 1ChairmanWilbur J. Cohen, Dean, School of Education, University ofMichigan, Ann Arbor, MichiganVice ChairmanThomas S. Quinn, President, Community Council, Cornwall,Pennsylvania

RecorderEleanor W. Griffins, Director, Senior Opportunities andServices, Community Aftion Agency, Inc., Salem, Oregon

Subsection 2

ChairmanSally Ybarra Din:mar, Field Office Coordinator, NebraskaPanhandle Community Actions Agency, Gering, NebraskaVice ChairmanBen W. Lindsay, Governor's Assistant, Austin, TexasRecorderH. Robert Bartell, Jr.

Subsection 3

ChairmanSolomon BstrkinVice ChairmanFannie Jefferson, President of Senior Citizens Clubs, Wash-ingtonPennsylvaniaRecorderJulia W. Harris, President, Coordinating Council for SeniorCitizens, Durham, North Carolina

Subsection 4

Frank J: Manning, President, Legislative Council for OlderAmericans, Inc., Boston, MassachusettsVice ChairmanMary E. Titus, Retired Teacher, Huntington, West VirginiaRecorderMarie Bradley, Director, Butte-Silver Bow County SeniorCitizens Activity Center, Butte, Montana

Subsection 5ChairmanJeweldean Londa, Associate Director of Social Welfare,National Urban League, Inc., New York, New YorkVice ChairmanWilliam L Brock, Attorney, Norman, OklahomaRecorderBeatrice C. Schiffman, Regional Representative, the NationalCouncil on the Aging, Inc., San Francisco, California

Subsection 6

ChairmanSolomon J. AxelrodVice ChairmanKenneth Johnston, Executive, National Council of SeniorCitizens, Peoria, Illinois

RecorderRuth Jones, Chairman, State White House ConferenceAging, St. Thomas, Virgin Islands

Subsection 7

ChairmanCharles Braithwait, Executive Director, West Central Mis-souri Rutal Development Corporation, Appleton City, Mis-souri

Vice ChairmanThomas C. Fetherston, Chairman, Dorchester County Com-mission on Aging, Cambridge, MarylandRecorderKen Arvedon, Field Representative, National Council ofSenior Citizens, Inc., Boston, Massachusetts

Subsection 8

ChairmanRichard F. Celeste, State Representative, Cleveland, OhioVice ChairmanMyron Mayer, Associate Treasurer, National Jewish WelfareBoard. New York, New YorkRecorderCharles W. Smith, Chairman, Department of Sociology, Flor-ida Agticultutal and Mechanical University, Tallahassee,Florida

Alan Fox, Economist, Division of Retirement and SurvivorStudies, Office of Research and Statistics, Social Security Ad-ministration, Department of Health, Education, and Welfare,Washington, D. C.

Ronald Hansen, Staff Officer, Seattle Regional Office, SocialSecurity Administration, Department of Health, Education, andWelfare, Seattle, Washington

Mary Hass, Economist, Division of Living Costs, Bureau ofon Labor Statistics, Department of Labor, Washington, D. C.

Janice Hedges, Labor Economist, Bureau of Labor Statistics,Department of Labor, Washington, D.. C.

Edward Hinson, Social Security Administration Fellow, SocialSecurity Administration, Department of Health, Education,and Welfare, Washington, D. C.

Harry Holland, Manager, Phoenix District Office, SocialSecurity Administration, Phoenix, Arizona

Paul Horowitz, Social Science Research Analyst, Division ofRetirement and Survivor Studies, Office of Research andStatistics, Social Security Administration, Department ofHealth, Educatio,t and Welfare, Washington, D. C.

Irene Jaworski, Technical Publications Writer-Editor, Di-vision of Technical Assistance, Office of Labor-Management,Welfare-Pension Reports, Department of Labor, Washington,D. C.

Pamela Kacser, Advisor on Socio-Economic Research, Bu-reau of Labor Statistics, Department of Labor, Washington,D. C.Walter W. Kolodrubetz, Economist, Employee-Benefit Studies,Division of Economic and Long-Range Studies, Office ofResearch and Statistics, Social Security Administration, De-partment of Health, Education, and Welfare, Washington,D. CHelen Lamale, Chief, Division of Living Condition Studies,Bureau of Labor Statistics, Department of Labor, Washington,D. C.Phyllis A. Marbrey, Secretary, Division of Retirement andSurvivor Studies. Office of Research and Statistics, SocialSecurity Administration, Department of Health, Education,and Welfare, Washington, D. C.Trent Mitchell, Writer-Editor, Publication Staff, Office ofResearch and Statistics, Social security Administration, De-partment of Health, Education, and Welfare, Washington,D. C.Dena K. Motley, Social Science Analyst, Division of Retire.ment and Survivor Studies, Office of Research and Statistics,Social Security Administration, Department of Health, Educa-tion, and Welfare, Washington, D. C.Helen NicolMollie Orshansky, Economist, Division of Economic andLong-Range Studies, Office of Research and Statistics, SocialSecurity Administration, Department of Health, Education,and Welfare, Washington, D. C.Sharon Puma, Specialist in Aging, Older Americans ServiceDivision, Administration on Aging, Social and RehabilitationServce, Department of Health, Education, and Welfare, Wash-ington, D. CShirley Queen, Writer-Editor, Publication Staff, Office ofResearch and Statistics, Social Security Administration, De-partment of Health, Education, and Welfare, Washington,D. C.Mary Ross, Deputy Director, Division of Retirement andSurvivors Benefits, Office of Program Evaluation and PlanningSocial Security Administration, Department of Health, Educa-tion, and Welfare, Washington, D. C.

Subsection 9

ChairmanGilbert C. Rohde, President, Wisconsin Farmer's Union,Gteenwood, WisconsinVice ChairmanWilliam R. Hutton, Executive Director, National Council forSenior Citizens, Washington, D. C.RecorderDan Reyna, Director, Cameron County Community Projects,Inc., Brownsville, Texas

Assistant Recorder

Anita Harbert, Youth Delegate, University of Massachusetts,Amherst, Massachusetts


Olivia Birdsall, Social Science Research Analyst, Division ofRetirement and Survivor Studies, Office of Research andStatistics, Social Security Administration, Department ofHealth, Education, and Welfare, Washington, D. C.

William C Birdsall, Economist, Division of Economic andLong-Range Studies, Office of Research and Statistics, SocialSecurity Administration, Department of Health, Education, andWelfare, Washington, D. CJames C Callison, Social Insurance Research Advisor, Officeof Research and Statistics, Social Security Administration, De-partment of Health, Education, ar,J Welfare, Washington,D. C.

41

Alfred M. Skolnik, Chief, Interprogram Studies, Divisionof Economics and Long-Range Studies, Office of Research andStatistics, Social Security Administration, Department OfHealth, Education, and Welfare, Washington, D. C.John A. Snee, Legislative Reference Officer, Office of Pro-gram Evaluation and Planning, Social Security Administration,Department of Health, Education, and Welfare, Baltimore,Maryland

Tom G. Staples, Social Insurance Research Advisor, Office ofResearch and Statistics, Social Security Administration, De-partment of Health, Education, and Welfare, Washington,D. C.

Marilyn Thomas, Writer-Editor, Publication Staff, Office of

-e

10f.r.74;

Research and Statistics, Social Security Administration, De-partment of Health, Education, and Welfare, Washington,D. C.

Saul Waldman, Social Insurance Research Analyst, Divisionof Health Insurance Studies, Office of Research and Statistics,Social Security Administration, Department of Health, Edu-cation, and Welfare, Washington, D. C.Joseph Zisman, Statistician, Bureau of Retirement and In-surance, Civil Service Commission, Washington, D. C.Carol Zuckert, Social Science Research Analyst, Division ofRetirement and Survivor Studies, Office of Research andStatistics, Social Security Administration, Department ofHealth, Education, and Welfare, Washington, D. C.

42

ti

t

4.,,r vow

INTRODUCTIONhe first White House Conference onAging in 1961 devoted one recom-mendation of five words to "nutrition."It stated that "Nutrition programs

should be established." And taken broadly, thatrecommendation was implemented, because dur-ing the ensuing decade the food stamp and fooddistribution programs became widely availableto the poor elderly. However, these programswere inadequate in meeting the needs of specialor unique groups of the elderlythe shut-ins,the very poor, the disabled, the lonely isolates,and those with ethnic food preferences. By 1971the situation was critical. With 20 percent toopoor to 'buy the necessities of life including nutri-tious food, it was imperative that nutrition beaccorded the importance of being one of the 14subject-areas of the second White House Con-ference on Aging.

There were 127 Delegates named to the Nutri-tion Section. The group was composed of a rep-resentative number of professional and lay per-sons from most of the States and Territories andfrom various national organizations. Minoritypersons constituted approximately one-fifth of theDelegates to the Section.

Among the participants were practicing nutri-tionists and dieticians, nutrition researchers andteachers, physicians, public health personnel, ex-tension specialists, food specialists, home econo-mists, State agency executives, legislators, direc-tors of senior citizens centers and activities, andelderly persons themselves.

SECTION ON

NUTRITION

468.218 0 73 4

43

The Section produced six recommendations ofseveral parts-each calling for action which wouldmeet the nutrition and related health needs ofelderly people. The Delegates clearly pointed outthe need for societythrough concerted action byFederal, State, and local governmentsto makemore efficient use of existing programs and todevelop new ones in providing better services tothe aging.

The Delegates also stressed the urgency forincreasing the range of facilities and services toserve the entire segment of the elderly population,thus underscoring the recommendations of the1969 White House Conference on Food, Nutri-tion, and Health, and the need for the legislationbeing considered by Congress at that momentwhich would establish a far-reaching nutritional'program for the elderly. -


We take it for granted that all older Ameri-cans should be provided with the means to insurethat they, too, can enjoy life, liberty, and thepursuit of happiness. Adequate nutrition is ob-viously basic to the enjoyment of these rights.

Food is more than a source of essential nutri-entit can be an enjoyable interlude in an other-wise drab existence. Thus, provision should bemade to meet the social as well as the nutritionalneeds of older people. A factor that adds dignityand significance to the life of the aged is the feel-ing that they, too, are useful and important.

Assistance should be provided to make possiblepreparation of meals for themselves and others.Community meals, however, should be an alter-native. Volunteer groups can be involved in suchservices as transportation, shopping, and distribu-tion of hot meals. Young people should be en-couraged to participate in these services and tojoin the elderly in meals.

All nutrition programs should be supplementedby appropriate educational measures. Older peopleshould be protected from food quackery and un-founded nutritional claims. Lack of research,evaluation and communication leads to failure ofotherwise good programs and to the perpetuationof poor programs. The search for more efficientand better means of providing for the good nutri-tion, health, and happiness of older people shouldbe a continuous process.

All recommendations regarding the nutritionof aging Americans should clearly include theelderly in small towns, rural and isolated areas,and the elderly in minority groups. Special cog-nizance must be taken of the long neglected needsof older Indians and other non-English speakinggroups.

Recommendations

RECOMMENDATION IFunding Programs and Research

It is recommended that the Federal Governmentallocate the major portion of funds for actionprograms to rehabilitate the malnourished agedand to prevent malnutrition among those ap-proaching old age. However, adequate fundsshould be allocated for a major effort in researchon the influence of nutrition on the aging processand diseases during old age in order to give mean-ing and impact to the action programs. Appro-priate research findings must be made availableto all action programs.

Since approximately one-half to one-third of thehealth problems of the elderly are believed to be

'related to nutrition, we recommend that pilotprograms be set up for evaluation of the nutri-tional status of the elderly.

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RECOMMENDATION IIStandards for Foodand Nutrition Services

The Federal Government should establish andmore strictly enforce high standards with specificregulations for the food and nutrition services pro-vided by institutions and home-care agencies thatreceive any direct or indirect Federal funds, re-quire a high level of performance from Stategovernment enforcement agencies, and whennecessary, provide financial assistance to bringnon-profit organizations up to standard. Thesestandards should include such important areas asquality and nutritive value of food, methods ofhandling, preparing and serving foods, the specialdietary needs of individuals, and the availabilityof and accessibility to nutritional counseling.

It is recommended that nutrition services andnutrition counseling be a required component ofall health delivery systems, including such plansas Medicare, Medicaid, health maintenance or-ganizations, home health services, extended carefacilities, and prevention programs.

RECOMMENDATION IIIConsumer Education in Nutrition

Government resources allocated to nutritionshould be concentrated on providing food assist-ance to those in need. However, a significant por-tion of these resources should be designated fornutrition education of all consumers, especiallythe aged, and to the education by qualified nutri-tionists of those who serve the consumer, includ-ing teachers in elementary and secondary schools,doctors, dentists, nurses, and other health workers.This can be accomplished immediately by increas-ing personnel and funds in existing agencies andinstitutions.

RECOMMENDATION IVFood Services in Elderly Housing Projects

Federal Government policy must offer the olderperson a variety of options for meals, but shouldstress the favorable psychological values and theeconomies inherent in group feeding. The policyshould require all Federally assisted housing de-

velopments to include services or to insure thatservices are available for the feeding of elderlyresidents and for elderly persons to whom thedevelopment is accessible. Where a meal is pro-vided, it should meet at least 1/3 of the nutrientneeds of the individual. The policy should alsorequire the provision of facilities (including trans-portation) for food purchase and meal preparationwithin each household of the development. Inaddition, Federal policy should encourage andsupport community agencies to provide facilitiesand services for food purchase, meal preparation,and home-delivered meals (often called Meals-on-Wheels) for eligible persons living outside hous-ing developments or in isolated areas.

RECOMMENDATION VElimination of Hunger and Malnutrition

It is recommended that the Federal Governmentassume the responsibility for making adequatenutrition available to all elderly persons of theUnited States and its possessions.

A. Minimum adequate income (at least $3,000per single person and $4,500 per couple) mustbe made available to all elderly. Until moneypayments are increased above the minimum level,existing food programs should be strengthened,including nutrition education, to meet the needsof the elderly. Therefore, it is recommended that:

I- n addition to store purchases of food, foodstamps be used for the purchase of meals in par-ticipating restaurants, schools and communitysettings, and any approved home delivery systems.

The food stamp program must be-structuredto conform to the United States Department ofAgriculture low-cost food plan at no increase inthe cost of food stamps to the recipient.

A- s long as low income Social Security re-cipients are on fixed incomes, they should beeligible for self-certification for food stamps and/or public assistance cash grants.

Food stamp applications should be mailedwith Social Security checks and stamps sent toolder persons through the mail or by some otherefficient, practical and dignified distributionmethod.

The purchase of food stamps should be en-

45

couraged and facilitated by providing the firstfood stamp allotment without cost to the recipi-ent, by permitting more frequent purchases andby distributing stamps at senior citizen centers.

The approximately 1,000 counties in theUnited States still using the commodity programmust switch by December 31, 1972, to the foodstamp program for the individual feeding of theelderly. Until this is accomplished, the Federaldonated food should be made nutritionally appro-priate, in packages of suitable size, and at readilyaccessible places.

B. It is recommended that the equivalent of aNational School Lunch Program be establishedfor senior citizens, not be limited to school facili-ties or to low income persons. Basic componentsof the program should be:

All United States Department of Agriculturecommodities should-be fully-available on the samebasis as the school lunch program.

Funding should provide for adequate staff,food supplies, equipment. and transportation.

Elderly people should be employed insofaras pOssible.

Auxiliary services should be built in, includ-ing recreational and counseling programs.

C. It is recommended that nutrition specialists al-ready in the field direct the recruitment of volun-teers and/or paid part-time aides from among theelderly and train them to teach sound nutritionalpractices to older people in groups and in theirhomes. Qualified social workers should be utilizedin getting client acceptance of the services beingmade available.

RECOMMENDATION VIResponsibility for Food Safety

and Wholesomeness

The responsibility for producing quality foodrests with the food industry. However, it is theresponsibility of the Federal Government to estab-lish and enforce such standards as are necessaryto insure the safety and wholesomeness of ournational food supply, as well as improve nutri-tive value. To do this requires more personnel and

funding. State requirements that meet or exceedFederal standards must be established, imple-mented and monitored with Federal support. Par-ticular attention should be given to both nutrientand ingredient labeling of food products as ameans of achieving greater consumer understand-ing. An inclusive list of the ingredients in anyprocessed food should be made available by themanufacturer to the consumer on request.

SECTION LEADERSHIPSpa:e will permit listing of title and ad-dress only the first time a name appears.

The Technical Committeefor NutritionChairman

Analcl_n_Watldn,ActingChief,-SpinalCord-iniusy-Cente ,Veterans Administration Hospital, West Roxbury, Massachu-setts

Consultant

Jack Weinberg, Clinical Director, Illinois State PsychiatricInstitute, Chicago, Illinois

Members

Tessie Agan, Emeritus Professor of Family Economics, Man-hattan, Kansas

George Briggs, Professor of Nutrition, Department ofNutritional Sciences, University of California, Berkeley, Cali-fornia

Grace A. Goldsmith, Professor of Medicine, Tulane Univer-sity, New Orleans, Louisiana

Adeline M. Hoffman, Professor of Home Economics, Uni-versity of Iowa, Iowa City, IowaRuth E. Kocher, Regional Public Health Nutritionist, NewYork State Department of Health, Buffalo, New YorkVivian F. Lewis, Chairman, Department of Health, PhysicalEducation, and Recreation, Central State University, Wilber-force, Ohio

Donald J. Rosato, Chief, Section of Adult Health and Proj-ect Supervisor for Preventitest, Department of Public Health.Division of Chronic Disease Control, Philadelphia, Pennsyl-vania

Margaret L. Ross, Nutritionist and Professor of Nutrition,Emeritus, Simmons College, Waltham, MassachusettsFrederick J. Stare, Professor and Chairman, Department ofNutrition, School of Public Health, Harvard Medical School,Boston, Massachusetts

Annie Zachary, Farm Proprietor, Marvell, Arkansas


Evelyn B. Spindler, Extension Nutritionist, Division of HomeEconomics, Department of Agriculture, Washington, D. C.

46

Members

Patsy Graves, Family Service Specialist, Division of FarmersHome Administration, Department of Agriculture, Washing.ton, D. C.Margaret E. Heap, Nutrition Consultant, Social ServiceBranch, St. Elizabeths Hospital, Washington, D. C.Kathleen E. Lloyd, Medical Officer, Rehabilitation ServicesAdministration, Department of Health, Education, and Wel-fare, Washington, D. C.Mary Ann Moss, Head, Nutrition Service Section, Depart-ment of Agriculture, Washington, D. C.Louise Page, Nutrition Analyst, Research Division, Depart-ment of Agriculture, Washington, D. C.Jeannette P. Pelcovits, Nutritionist, Administration on Aging,Social and Rehabilitation Service, Department of Health, Edu-cation, and Welfare, Washington, D. C.Geraldine Piper, Acting Chief, Allied Health Training Sec-tion, Division of Allied Health Manpower, Bureau of HealthManpower Education, National Institutes of Health, Depart-ment of Health, Education, and Welfare, Washington, D. C.Gladys Royal, Principal BioChemist, Food Science Programs,Cooperative State Research Service, Department of Agriculture,Washington, D. CAndromach Sismanidis, Nutrition Consultant, Maternal andChild Health Service, Division of Health Services and_MenralHealth Administration, Department of Health, Education, andWelfare, Rockville, Maryland

Charlotte E. Smith, Nutrition Consultant, Nursing HomeBranch, Division of Health Services and Mental Health Ad-ministration, Department of Health, Education, and Welfare,Rockville, Maryland

Dorothy M. Youland, Nutrition Consultant, Division ofHealth Examination Statistics, National Center for HealthStatistics, Division of Health Services and Mental Health Ad-ministration, Department of Health, Education, and Welfare,Rockville, Maryland

Section OfficersCo-ChairmanJean Mayer, Professor of Nutrition, School of Public Health,Harvard University, Boston, Massachusetts -Louis Fillios, Professor of Biochemistry, Boston University,Boston, Massachusetts

ConsultantJack WeinbergRecorderDena D. Cedarquist, Professor, Department of Food Scienceand Human Nutrition, Michigan State University, East Lan-sing, Michigan

Assistant RecorderVerna Due, Associate Regional Commissioner for Aging,Social and Rehabilitation Service, Department of Health,'Education, and Welfare, Chicago, Illinois

Management OfficerEvelyn B. Spindler

Subsection OfficersSubsection 1ChairmanMarcile Allen, Extension Specialist, Foods and Nutrition De-partment, Purdue University, Purdue, Indiana

Vice ChairmanConrad Vuocolo, Director, Tenant Relations, Jersey CityHousing Authority, Jersey City, New JerseyRecorderMarjorie M. Donnelly, President, American Dietetic Asso.ciation, Raleigh, North Carolina

Subsection 2ChairmanJack WeinbergVice ChairmanFrancisca Gonzalez, Director, Local Office of Social Services,Mayaguez, Puerto RicoRecorderMargaret L. Ross

Subsection 3ChairmanMilo K. Swanton, Chairman, Wisconsin Council on Aging,Madison, WisconsinVice ChairmanRudolph H: Kampmeier, Professor Emeritus, Departmentof Medicine, Vanderbilt University, Nashville, TennesseeRecorder"SadieB- , utrit-SIEsu cant, atF) ionna Councilor, Hunger and Malnutrition in the United States, Arlington,Virginia

Subsection 4ChairmanRuth E. Kocher

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Vice Chairman.Vice

Edison, Supervisor, County Association of Senior Af-fairs, San Bernardino, CaliforniaRecorderIrene H. Wolgamot, Retired, Former Assistant to the Di-rector, Consumer and Food Economic Research Division,Agricultural Research Service, Department of Agriculture,Arlington, Virginia

Federal . Resource PersonnelSandra Beckwith, Secretary, Division of Home Economics,Department of Agriculture, Washington, D. C.Evelyn H. Johnson, Food and Nutrition Specialist, Depart-ment of Agriculture, Washington, D. C.Mary Ann MossLouise PageJeannette P. Pelcovits,Geraldine Piper,

Nade Poole, Home Economist, Food and Nutrition Service,Department of Agriculture, Washington, D. C.Gladys RoyalMarvin M. Sandstrom, Assistant Deputy Administrator, Foodand-Nutrition-Service,-DePatuttertt-of-Agriculturer-Washington, D. C.Charlotte E. SmithMargaret Stewart, Editor, Nutrition Program News, Agricul-tural Research Service, Department of Agriculture, Washing.ton, D. C.Dorothy M. Yonland

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SECTION ONRETIREMENT ROLES AND ACTIVITIES

INTRODUCTIONhe proportion of older persons namedas Delegates to the Retirement Rolesand Activities Section was somewhathigher than for most other Sections; of

the 306 Delegates for whom information is avail-able, better than 34 percent were retired persons.The representation from minority groups was, onthe other hand, lower than in many of the otherSections.

In addition to the large number of elderlyDelegates participating in the Section, there werenot only practitioners with long experience asdirectors of senior citizen activity centers, of vol-unteer service 'programs (such as Foster Grand-parents Program), and of information and refer-ral centers, but also professional personnel in-cluding social workers, gerentologists, sociologists,anthropologists, and educators. The fifteen recom-mendations produced by the group give testimonyto an appreciation of older persons as an importantcomponent in society, and of the society's respon-sibility for providing the social and economicmilieu necessary to maintain older people at anoptimum level of functioning throughout the lifespan.


Mr. Sebastian Tine, Executive Director ofSenior Citizens, Inc., of Nashville, Tennessee, wasthe presiding Co-chairman of the Section on Re-tirement Roles and Activities. After calling to

49

order the first Section plenary meeting and intro-ducing himself and the other Section leaders, hecalled on Dr. Margaret M. Clark to deliver anopening address to the Section Delegates.

Dr. Clark, Senior Research Anthropologistwith the Langley-Porter Neuropsychiatric Insti-tute of San Francisco, California, served as theother Cochairman of the Section. In her state-ment to the Delegates, Dr. Clark described theproblems of social roles for older people as lessbasic than the survival areas of income, healthcare and housing but in some ways even morefundamental and complex.

Co- Chairman's StatementThe work of this Section is to formulate na-

tional policy regarding roles and activities of re-tired people in our society. In some ways our topicis less basic than those of some of the other sec-tionswe would all agree that provision of in-come, health care, and livable housing are re-quired for the simple survival of older people. Incertain other ways, however, our topic is evenmore fundamental than these. We are beingasked to look at some deeper and more complexissueswe are being called upon to answer ques-tions such as these: Does our society need itsolder citizens at all? What are they good for? Dothey have a right to a place in our social order?What are older people to do with the rest of theirlives after they are no longer working? Does ourNation have any responsibility for helping theelderly to find greater meaning and personalsatisfaction in the later years?

In speaking to you today, I have no choice butto speak from my own background as an anthro-

pologist. From this point of viewthat of a stu-dent of human culturesthe most startling factabout aging today is that so large a proportionof our population is over the age of sixty. This isa novel circumstance in the history of the humanspecies. Never before in all the long millenniaof mankind, from his earliest origins in the dawnof time, have so many people lived so long. Thoseof us who are in the field of aging have heardthis statement so often that it scarcely registersany more. But if we look at the historical meaningof this imple fact, it becomes an engaging phe-nomenon. In terms of human history, it meanssimply that when primitive man took charge ofhis physical environment through the develop-ment of tools, and then experienced that evengreater miraclethe creation of a symbolic worldthrough the invention of languagethereemerged a totally new relationship between thegenerations. Simple animal evolution began togive way. Many of us still cling, atavistically, tothe idea that human history can be explained interms of the survival of the fittest. And, indeed,on the streets of our cities today, it sometimesseems as if the law of the jungle still prevails;but it does not. We must never for a momentforget what characterizes human as opposed tonon-human nature is man's capacity for caringabout others, and his desire to aid in the survivalof all those he cares aboutthe weak as well asthe strong, the elder as well as the infant.

When I first became interested in the role ofthe aged in human societies, the full meaning ofthe riddle of the Sphinx came to me. As the an-cients tell the tale, Oedipus, on his travels, wasasked this riddle by the Sphinx: "What is it thatwalks first upon four legs, then upon two, andfinally upon three?" The answer, of course, isman; as an infant he first crawls upon all four,then stands on two feet, and, in declining years,leans upon his staff. It occurred to me that thiscycle is, indeed, the essence of humanity, for in noother animal species are the old fed and cared forby the young who can still hunt, fish, and gatherfood.

In talking with a colleague of mine recentlya physical anthropologist whose specialty isprimate behavior (the observation of apes andmonkeys in their natural habitats) --I asked why

50

physical anthropologists have spent so much timedescribing aggression, protective cooperation, mat-ing, nurturance of the young, and other kinds ofsocial behavior among lower primates, but havenever described the changes that occur in rela-tionships as members of the band grow old. Hesaid, "That's very simplethere aren't any oldmonkeys in natural environments. As noon astheir teeth wear out, they starve to death." Hewent on to remind me that it has been only re-cently that we have discovered menopause inmonkeysthose that have been sheltered inhumanly controlled laboratory environments.From observations made in the field, no onethought the menopause existed in female mon-keys; but now we know that they simply didn'tsurvive long enough to undergo this change.

The human species, then, is the one that keepsits old alive. Why? Because, with the discovery oflanguage, knowledge could be accumulated thatpromoted survivalnot just for the single indi-vidual, but for his whole group. The old couldremember the year of the great drought, whenthe only water to be had was at such-and-such aspring; or the lean years when the game had tobe tracked far to the north. They rememberedhow to treat wounds to prevent infection, howto improve the chances of survival of a newbornor a new mother by observing certain taboos.And, perhaps most important of all, they werethe links between past and future. The oldestman or woman of a tribe, by definition, had livedduring years when no one else in the group hadbeen alive or could remember. In the absenceof records, these old people were the sole linkswith the pastthe only windows through whichmankind could glimpse the long hazy corridors ofhis ancestors, the world that was before. Smallwonder that the few ancients who survived wereviewed with such awe and wonder by their youngkinsmen. We really can't blame Methuselah forstretching the facts a bit about his age; it gavehim a few extra points, and who else was count-ing? Old age has always been regarded as amagical time of lifesometimes, in some places,as potentially evil. (And this is a more unfor-tunate human trait: to fear too much knowledgeand sometimes to destroy that which is feared.)More often, however, the magic of old age was

t.

regarded as benevolent, and great awe and respectpaid to the ancients and the power of their lore.

Now, let me pause here to explain why I havegiven you this somewhat pedantic and round-about discourse on human nature. It is to lead upto this:

Man's nature is not fixedneither in his con-trol of the physical environment nor in his ca-pacity for changing and shaping the social envi-ronment. We have the capacity, as we know, forcreating the kind of world we want to live in, ifwe can keep the sources of power out of the handsof demagogues and warmongers. But, beyond ourability to shape the world around us, there isanother enormous, and even more importanthuman capacity, and that is man's ability to formconceptions of himselfto build images, raisephantoms, have visions of what he is and whathe might be. And then . . . and this is the truemagic . . . man has the capacity to become whathe conceives.

There are many people in the world who failto grasp the significance of this creativity, whokeep thinking of human beings as bird-brains ina box or naked apes. And, while the ape is al-ways somewhere within mankind, the ape-naturecannot contain mankind. With the birth of mean-ing, something totally new has entered ourplanet. We escaped from the trap of the past; thePresent is no longer what it was for our primitiveancestorsa reliving, over and over again, gene-ration after generation, of a life cycle, invariablefor thousands of years.

There are people today who tempt us to keepdefining ourselves, and our relationships to eachother, within the frozen, crystallized structuresof the past. Don't be tempted into believing thatit is "human nature" to kill, to destroy, to abandonthe elders, to be "tough." The whole history ofthe species gives the lie to these fallacies. It isonly by caring, by a kind of tenderness, that wehave survived as a species. How else could wehave done it, without fangs or claws, with ourweak jaws and our thin hides? And we must notbe tempted into, that further trap of believingthat humanity can never be other than it hasalready been.

Let me quote an eminent colleague, Professor

Loren Eisley, who has just written these wordson this subject:

"Man," he writes, "escapes definition even asthe modern phantoms in militarist garb proclaimas I have heard them dothat man will fightfrom one side of the solar system to the other, andbeyond. The danger, of course, is truly there, butit is a danger which, while it lies partially inwhat man is, lies much more close to what hechooses to believe about himself. Man's wholehistory is one of transcendence and self-examina-tion, which has led him to angelic heights ofsacrifice as well as into the bleakest regions ofdespair. The future is not truly fixed but theworld arena is smoking with the cauldrons ofthose who could create tomorrow by evoking,rather than exorcising, the stalking ghost of thepast."'

In turning to our work here at this conference,I hope we can keep within our vision the themeof becoming. We shall become that which wedream. Let us remember that at any point inhuman history we could have looked at ourselvesand our society and said, "Well, then, this isrealitythis is human society." And for that day,that time, the statement would have been trueduring the sack of Rome, during the great plaguesof the Dark Ages, in the holds of slave ships, inthe ovens of Buchenwald.

But it doesn't have to be like that. Nowhere isit written that the young have done and can do nomore for humanity than the old. Nor do the oldhave to eat crumbs, wear rags, and have theirbodies shaken with untended coughs and fevers.

Nor do the old have to lea..: the tanks of theliving, the assemblies and enterprises of mankind,a quarter century before they die. Again, fromEisley: "The terror that confronts our age is ourown conception of ourselves." ..

What can we do here to break our elders, andourselves as we age, out of that frozen past thatwe so often invoke? As Commissioner Martinsaid last night, we are asking of ourselves that wenot be bound in our planning by the restraintsthat our society now imposes upon its older

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' Eisley, Loren. The Night County. New York, Charles Scribnet's Sons, 1971.

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11.

members. We must transcend this place, this time,and this evil. We must strive for new conceptionsof later life, what it can mean, how it can beenhanced.

But there is a problem that all of us face whenwe sit down and try to have new ideas. They'renot that easy to have. How does one thinkcreatively? I wish I knew. I can offer only onesuggestion from my own experience as an anthro-pologist that may help. We were taught as stu-dents that if we hope to see ourselves and ourown culture in a new and revealing way, wecould begin by looking at other groups of peopleand the ways in which they live and pattern theirlives. This, our teachers said, would provide uswith a great mirror in which we could see our-selves reflected and perhaps improve on what wesaw.

We are here a very diverse group of people.We come from many backgrounds. We havedifferent experiences, knowledge, persuasions. Per-haps the key to creative vision is in our owndiversity as z people. Let us try to listen andlearn from each other. That might help a little.

RecommendationsAs we grow older, we continue to need to oc-

cupy roles that are meaningful to society ancisatisfying to us as individuals. However, we em-phasize the primacy of such basic necessities asincome, health, and housing and these needsmust be adequately met.

Twenty million older people with talents,skills, experience and time are an inexhaustibleresource in our society. We represent all segmentsof the population; our abilities, our education, ouroccupational skills, and our cultural backgroundsare as diverse as America itself.

Given proper resources, opportunities and moti-vation, older persons can make a valuable contri-bution. We are also capable of being effectiveadvocates of our own cause and should be in-cluded in planning, in decision-making and inthe implementation of programs. Choice rolesmust be available t" each older person despite

differences in language and ethnicity, and limi-tation because of disability or level of income.

The lives. of Americans of all ages will be en-riched as the Nation provides opportunities fordeveloping and utilizing the untapped resourcesof the elderly.

RECOMMENDATION IMeeting Role Needs

Societythrough government, private industry,labor, voluntary organizations, religious institu-tions, families and older individualsmust exer-cise its responsibility to create a public awarenessof changing life styles and commitments in acontinuous life cycle. Together they should dis-cover and implement social innovations as ve-hicles for older persons to continue in, return to,or assume roles of their choice. These innovationsshould provide meaningful participation andleadership in government, cultural activities, in-dustry, labor, welfare, education, religious or-ganizations, recreation and all aspects of volunteerservices.

Implementation:

Programs at Federal, State and locallevels which provide opportunities for com-munity service by older persons should bestrengthened and expanded.

Mechanisms should be developed for con-tinuing the work of successful demonstrationprograms, until such programs become un-necessary or self-sustaining.

- -Older people should not be further iso-lated. Attention must be paid to making oppor-tunities for community service accessible aswell as available to all older persons.

RECOMMENDATION IIPriorities in Meeting Role Needs

Program efforts to meet role problems and tocreate new role opportunities should be designedto serve all segments of the older population.Priorities should be determined according tolocal and individual needs; special effort must bemade to include persons who might otherwisebe excludedthe impoverished, the socially iso-

52

lated, the ethnic minorities, the disabled and thedisad . antaged.

RECOMMENDATION IIIPreparation for Life Off the Job

Society should adopt a policy of preparation forretirement, leisure, and education for life off thejob. The private and public sectors should adoptand expand programs to prepare persons to under-stand and benefit from the changes produced byretirement. Programs should be developed withgovernment at all levels, educational systems, re-ligious institutions, recreation departments, busi-ness and labor to provide opportunities for theacquisition, of the necessary attitudes, skills andknowledge to assure successful living. Retirementand leisure time planning begins with the earlyyears and continues through life.

Implementation:

While retirement preparation is both anindividual and total community responsibility,every employer has a major responsibility forproviding preparation-for-retirement programsduring the working hours.

The function of Social Security districtoffices should be expanded to include the addi-tional role of offering individual pre-retirementcounseling.

RECOMMENDATION IVResponsibility for Supportive Services

Social policy should encourage families to assumethe responsibility for providing supportive serv-ices to older family members; however, societymust insure the availability through governmentand community organizations to all older peopleof comprehensive supportive services which theyare unable to provide independently.Implementation:

The Federal Government should moveimmediately to develop models for a networkof supportive services for all elderly citizens.Implementation should be the ultimate re-sponsibility of the local community.

In funding supportive services, Federalfunds should be provided to applicant agencies

53

and local communities as well as State orga-nizations.

The availability of such services shouldbe made known through a program of publicinformation.

RECOMMENDATION V[Inviting Older People

Public policy should encourage and promote op-portunities for greater involvement of older peo-ple in community and civic affairs, and for theirparticipation in formulating goals and policieson their own behalf as a basis for making thetransition from work to leisure roles. Societyshould reappraise the current life style sequenceof student/worker/retiree roles, and promoterole flexibility.

RECOMMENDATION VIReordering National Priorities

We recognize that many problems of agingAmericans are problems for all Americans andwe urge the Conference to request the reorderingof the Nation's priorities.

All citizens will benefit from elimination of pov-erty, preservation of the environment, more ade-quate health care services, better housing, trans-portation and the control of disease and physicaldisability.

Therefore, we recommend that the Chairman ofthe 1971 White House Conference on Agingappoint a select committee of Delegates to pre-pare a preamble for action which calls for areordering of our Nation's priorities, and thatrecognizes that the strength and success of Amer-ica will be judged on how well the needs of itsown people are served.

RECOMMENDATION VIIGovernment Organization for Aging

We recommend that the President and the Con-gress, either by Executive Order or by Congres-sional action, give immediate priority to therestructuring of the Administration on Aging andits establishment of a visible, effective advocateagency for the elderly at the highest level of

government so that it will directly relate to theExecutive Office of the President.

RECOMMENDATION VIIIGnegorical Support for the Aged

Since older persons have special needs, we recom-mend that public programs specifically designedfor the elderly should receive categorical supportfor the elderly, rather than compelling the agedto compete for services, activities, and facilitiesintended for the general population.

RECOMMENDATION IXMultiservice Senior Centers

It should be the responsibility of the FederalGovernment, in cooperation with other levels ofgovernment, to provide funds for the establish-ment, construction and operation of community-oriented multiservice centers designed for oldercitizens. Industry, labor, voluntary and religiousorganizations should assist in the planning andimplementation.

RECOMMENDATION XWork Means (Retirement) Ten

In order to encourage further activity on the partof older Americans, it is recommended that thework means test be modified so as to allow un-limited earnings without the reduction of SocialSecurity benefits.

RECOMMENDATION XIUse of Information Media

The information media are so important in theformation of public attitudes that it is recom-mended that special attention be given to en-hancing the image of older persons, and to dis-seminating the recommendations of the 1971White House Conference on Aging and its follow-up activities.

RECOMMENDATION XIIFollow-up Conference Reports

The Administration on Aging should arrange forthe publication of status reports to the Delegates,

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at six-month intervals, on action taken on therecommendations of the 1971 White HouseConference on Aging.

RECOMMENDATION XIIIAging in Training Curriculum

Training and research agencies, including uni-versity programs which relate to recreation andleisure, should be encouraged to concern them-selves with the needs of older persons as an in-tegral part of their training curriculum.

RECOMMENDATION XIVPhysical Fitness jor Older People

We endorse a program looking toward continu-ing physical fitness of men and women before andduring the years of retirement. Such a programshould be implemented by governmental supportin cooperation with voluntary agencies which havea long history of experience in this field.

RECOMMENDATION XVUse of Older Professionals

Because reciprocity often does not permit the fulluse of elderly professionals whose services arebadly needed, we urge the National Conferenceof Commissioners on Uniform State Laws, in co-operation with the professions, to develop andpromulgate a minimum national standard foradmission to the medical, dental, legal and otherprofessions, which standard permits quality pro-fessional practice, and that each State adopt sucha uniform standard of professional practice.

SECTION LEADERSHIPSpace will permit listing of tide and ad-dress only the first time a name appears

The Technical Committeefor Retirement Roles and ActivitiesChairmanWalter C. McKain, Professor of Sociology, University ofConnecticut, Storrs, Connecticut

Members

Melnea A. Cass, Vice President, Council of Elders, Roxbury,Massachusetts

4-

Margaret M. Clark, Senior Research Anthropologist, AdultDevelopment Research Program, Langley-Porter Neuropsychi-atric Institute, San Francisco, California

Delores I. B. Davis, Craftsman and Artist, Lorain, OhioNathaniel N. George, Retired High School teacher, LosAngeles, California

Max Kaplan, Director, Center for Studies of Leisure, Uni-versity of South Florida, Tampa, Florida

Alexander R. Martin, Psychiatrist, New York, New YorkWilliam C. McColl, State Director, Allied Senior CitizensClubs, Inc., Los Angeles, California

Lennie-Marie P. Tolliver, Professor of Social Work, Uni-versity of Oklahoma, Norman, OklahomaC. T. Pihlblad, Professor of Sociology, University of Missouri,Columbia, Missouri

Janet S. Sainer, Director, SERVE projects, Community Serv-ice Society, New York, New York

Gordon F. Streib, Committee on Human Development, Uni-versity of Chicago, Chicago, Illinois

Wendell M. Swenson, Clinical Psychologist and AssociateProfessor, Mayo Graduate School of Medicine, University ofMinnesota, Rochester, Minnesota

Howard H. Weber, Republican State Executive Committeeof Florida, Pompano Beach, Florida

The Secretariat

DirectorWalter Moeller, Program Analyst, Administration on Aging,Social and Rehabilitation Service, Department of Health,Education, and Welfare, Washington, D. C.

Members

Lawrence D. Davis, Retirement Training Advisor, Bureauof Retirement Insurance and Occupational Health, Civil ServiceCommission, Washington, D. C.

Bernard Gaudy, Contract Specialist, Office of Policy, Evalua-tion, and Research, Manpower Administration, Departmentof Labor, Washington, D. C.Anne C. Johnson, Chief, Foster Grandparent Program, OlderAmericans Volunteer Programs, ACTION, Executive Officeof the President, Washington, D. C.

Velma Linford, Recruitment Resource Specialist, ACTION,Executive Office of the President, Washington, D. C.John Guy Miller, Minority Staff Director, Senate SpecialCommittee on Aging, Washington, D. C.Jeanne Prieste Program Leader, Home Economics ExtensionService, Department of Agriculture, Washington, D. C.

Section Officers

Co-Chair' man

Sebastian Tine, Executive Director, Senior Citizens, Inc.,Nashville, Tennessee

Margaret M. Clark, Senior Research Anthropologist, AdultDevelopment Research Program, Langley-Porter Neuropsy-chiatric Institute, San Francisco, CaliforniaConsultantMother It Bernadette De Lourdes, 0. Carm., Administrator,St. Joseph's Manor, Trumbull, Connecticut

RecorderJanet S. Sainer, Director, SERVE Projects, Community ServiceSociety, New York, New York

Assistant Recorder

Morris Cohen, Chief, Community Services Branch, OlderAmerican Services Division, Administration on Aging, Socialand Rehabilitation Service, Department of Health, Education,and Welfare, Washington, D. C.Management OfficerAnne C. Johnson


ChairmanMax KaplanVice ChairmanKathleen Broderick, Program Intern, American NationalRed Cross, Washington, D. C.RecorderSai Sadri, Superintendent of Recreation, Johnson County Parkand Recreation District, Shawnee Mission, Kansas

Subsection 2

ChairmanC. Loudell Frazier, Retired Director, Kansas Division ofServices for the Aging, and Area VI Vice-President, AmericanAssociation of Retired Persons, Topeka, Kansas

Vice ChairmanStanley Sprague, Board of Directors, Special Council ofSenior Citizens, Belleville, IllinoisRecorderSister Marie Gaffney, M.S.B.T., Consultant, National Con-ference of Catholic Charities, Washington, D. C.

Subsection 3

ChairmanGordon F. StreibVice ChairmanJoe N. Ham, Program Director, Oakland County Commissionon Economic Opportunity, Pontiac, MichiganRecorder

Mary Sue Bethea, Executive Director, Senior Neighbors ofChattanooga, Inc., Chattanooga, Tennessee

Subsection 4

ChairmanTheresa S. Brungardt, Chairman, Governor's Advisory Com-mittee on Aging, Brattleboro, VermontVice ChairmanMartin McNamara, Attorney, Washington, D. C.RecorderMargaret Hossacic; Senior Citizen Program Coordinator,Mayor's Senior Citizen Council, Detroit, Michigan

Subsection 5

ChairmanH. Etta Saloshin, Professor, School of Social Work, Universityof Minnesota, Minneapolis, MinnesotaVice ChairmanMabel Robbins, Retired, Des Moines, Iowa

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RecorderAlice L. Schafer, Assistant Professor, Division of Occupa-tional Therapy, Sargent College of Allied Health Professions,Boston University, Boston, Massachusetts

Subsection 6ChairmanConstance Lindahi, Director, Wilder Senior Citizens Center,St. Paul, MinnesotaVice ChairmanReverend Amour Evans, Minister, Newton, KansasRecorderMary McGowan, Director, Anne Arundel County SeniorCitizens Center, Annapolis, Maryland

Subsection 7ChairmanJerome D. Schein, Director, Deafness Research and TrainingCenter, New York University, New York, New YorkVice ChairmanJohn Marros, Administrator, State Agency on Aging, Chey-enne, Wyoming

RecorderReverend Herbert C. Lazenby, Executive Director, SeniorCenter, Inc., Seattle, Washington

Subsection 8ChairmanFreida E. Gorrecht, Executive Director, United Auto Workers,Retired Workers Center of Detroit, Inc., Detroit, MichiganVice ChairmanRobert F. Katz, Management Consultant, Huntington, NewYork

RecorderWinston Borden, State Senator, Brainerd, Minnesota

Subsection 9ChairmanMonroe C. Neff, Director, Division of Continuing Education,State Education Department, Albany, New YorkVice ChairmanTom Murphy, Director, Recreation Program for Older People,Los Angeles Recreation Department, Los Angeles, CaliforniaRecorderBonnie L. Stanley, Director, KITS (Keep In Touch),Jonesboro, Arkansas

Federal Resource. PersonnelBea Alford, Volunteer Representative, Western Region, PeaceCorps, Los Angeles, California

John Calhoun, Special Assistant to the Director, Office ofPublic Affairs, ACTION, Executive Office of the President,Washington, D. C.Nick DiMichaels, Program Analyst, Retired Senior VolunteerProgram, ACTION, Executive Office of the President, Wash-ington, D. C.Dorothy Doherty, VISTA Volunteer, Volunteer in ServiceTo America, Regional Office, Denver, Colorado.James Dotson, ssistant Chief, Division of Child Welfare,Research and Demonstration, Social and Rehabilitation Serv-ice, Department of Health, Education, and Welfare, Washing-ton, D. C.Tom Dunleavy, Program Specialist, Foster Grandparent Pro-gram, ACTION, Executive Office of the President, Washing-ton, D. C.Suzanne Fahy, Program Analyst, Foster Grandparent Pro-gram, ACTION, Executive Office of the President, Washing.ton, D. C.Sandra S. Fisher, Program Development Specialist, RetiredSenior Volunteer Programs, Older Americans Volunteer Pro-grams, ACTION, Executive Office of the President, Washing-ton, D. C.Fraser Lang, Domestic Coordinator for School PartnershipPrograms, ACTION, Executive Office of the President, Wash-ington, D. C.Alfred Larsen, Chief, Retired Senior Volunteer Program,ACTION, Executive Office of the President, Washington, D. C.Velma Linford, Recruitment Resource Specialist, ACTION,Executive Office of the President, Washington, D. C.Lois Rafferty, VISTA Volunteer, Volunteer In Service ToAmerica, Diocesan Human-Relations Committee, Grand Rapids,Michigan

John Rafferty, VISTA Volunteer, Volunteer In Service ToAmerica, Diocesan Human-Relations Committee, Grand Rap-ids, Michigan

Leo Scott, Director of Volunteer Services, Veterans Hospital,Veterans Administration, Washington, D. C.

Sarah Sheets, Secretary, ACTION, Executive Office of thePresident, Washington, D. C.Dorothy Van Ess, Program Officer for Social Services, VISTA,ACTION, Executive Office of the President, Washington, D. C.

Josba Wiener, College Student, Bethesda, Maryland

56

SECTION ON

SPIRITUAL WELL -BEING

INTRODUCTION

he Section on the Spiritual Well-Being of the elderly involved over 200Delegates. Although many of the par-ticipants in the Section were religious

leaders, a number of other professional and tech-nical occupations were represented. Among themwere educators, legislators, social workers, busi-ness people, consultants, volunteer workers, serv-ice agency administrators, and young people.

The work of the Section was guided in partby the thought and experience of many of thegroup who were themselves elderly. Of the Dele-gates named to the Section, one-fifth listed them-selves as retired. The breadth and depth ofdiscussion was also enhanced by the participationof a substantial group of minority persons (18percent were Black, Asian American, AmericanIndian, or Spanish American).

The recommendations of this Sea ion encom-pass some of the most significant trends of theday among religious bodies. Changes in attitudesare reflected in recommendations stressing ecu-menism and interfaith responsibilities. New rela-tionships between government and religiousorganizations are envisaged, with the religiouscommunity having a much greater role in com-munity service to the elderly. And finally, theSection Delegates had the courage to take up aproblem that is becoming one of the most con-troversial of the day. That is, the prolongation of

57

life entirely by artificial means as opposed tolegalization and sanctioning of the right of oldpeople to choose to die naturally and in dignity.

SECTION REPORTThe work of the Spiritual Well-Being Section

began with an orientation meeting of all SectionDelegates. The Section meeting was called toorder by The Reverend Monsignor Lawrence j.Corcoran of the National Conference of CatholicCharities, the presiding Co-chairman. ReverendCorcoran introduced the other Section leadersand invited Hess T. Sears, Section Co-chairmanand Chairman of the Technical Committee forSpiritual Well-Being, to address the Section.

Mr. Sears provided background informationand the role that Delegates to the SpiritualWell-Being Section were to play in developingrecommendations for a national policy on aging.

PreambleSpiritual Well-Being relates to all areas of

human activity. In referring to man's spiritualwell-being, we consider those aspects of life ". .

pertaining to man's inner resources, especiallyhis ultimate concern, the basic value around whichall other values are focused, the central philoso-phy of lifewhether religious, anit-religious, ornon-religious--which guides a person's conduct,the supernatural and non-material dimensions ofhuman nature."'

' Moberg, David 0., . Background and Issues Paper onSpiritual Well.Being, 1971 White House Conference on Aging,P. 3.

Whether rich or poor, advantaged or dis-advantaged, every person has a right to achieve asense of spiritual well-being. "We believe thatsomething is wrong with any society in whichevery age level is not clearly of meaning and ofvalue to that society. The spiritual needs of theaging really are those of every person, writ large:the need for identity, meaning, love, and wis-dom."

As Delegates to the White House Conferenceon Aging in the Section concerned with spiritualwell-being, we call attention to this fact of life:to ignore, or to attempt to separate the need tofulfill the spiritual well-being of man from at-tempts to satisfy his physical, material, and socialneeds is to fail to understand both the meaning ofGod and the meaning of man.

Whether it be the concerns for education, em-ployment, health, housing, income, nutrition, re-tirement roles, or transportation, a proper solutioninvolves personal identification, social acceptance,and human dignity. These come fully only whenman has wholesome relationships with both fel-lowman and God.

The concerns apply to all ages. Basic needsdo not necessarily change with age, but they oftenare intensified.

Therefore, the White House Conference onAging states that all policies, programs, and ac-tivities recommended in a national policy on agingshould be so developed that the spiritual well-being of all citizens should be fulfilled.

In this context, the Section on Spiritual Well-Being of the White House Conference on Agingmakes the following policy recommendations.

Recommendations-

RECOMMENDATION IReligious and Governmental Cooperation

The government should cooperate with religiousbodies and private agencies to help mea the

' Bollinger, Thomas E., "Spiritual Needs of the Aging,The Need for a Specific Ministry to the Aged, Southern Pines,N.C.: Bishop Edwin A. Penick Memorial Home, 1969, pp.50.51.

58

spiritual needs of the elderly, but in doing soshould observe the principle of separation ofChurch and State.

RECOMMENDATION IITraining in Spiritual Well-Being

The government should cooperate with religiousorganizations and concerned social and educationalagencies to provide research and professionaltraining in matters of spiritual well-being to thosewho deliver services to the aging.

RECOMMENDATION IIIFunding Professional Training

It is recommended that the government providefinancial assistance for the training of clergy,professional workers, and volunteers to developspecial understanding and competency in satisfy-ing the spiritual needs of the aging.

RECOMMENDATION IVChaplaincy Services

It is recommended that all licensing agencies inthe State require that institutions caring for theaged must provide adequate chaplaincy services.In certain instances in which cooperating churchorganizations cannot obtain financial support forsuch service, government should be empoweredto supply it upon the recommendations of theState commission of aging or other appropriateagencies.

RECOMMENDATION VEvaluating Programs for the Elderly

It is recommended that the Federal Governmentshould establish a continuing system of evalua-tion of present and proposed government-fundedprograms serving the elderly. One of the functionsof such a system would be a determination of aprogram's effect upon the spiritual well-being ofthe elderly.

RECOMMENDATION VIAcquainting the Elderly with Services

It is recommended that a much greater, more

diverse information flow is necessary to acquaintthe elderly with all the services which are avail-able to them. Social Security Administrationshould be required to disseminate adequately theinformation necessary to acquaint the elderly withall the services which are available to them, suchas by enclosing information with Social Securitychecks.

RECOMMENDATION VIIElderly in Age-Integrated Programs

Efforts should be made to meet the spiritual needsof the aging by ministering to them in conjunc-tion with people of all ages, as well as in groupswith special needs. It is noted that special atten-tion should be given to allowing older personsto share in the planning and implementations ofall programs related to them.

RECOMMENDATION VIIIHome Delivery of Spiritual Consultation

As a part of total programming for older per-sons, communities should make available religiousor other spiritual consultation to the aged in theirown homes, using the clergy and other trainedpersons. Special emphasis shall be given to assistand utilize personnel of those religious bodieslacking financial resources often available tolarger groups.

RECOMMENDATION IXConcern for Man as a Whole Being

Since man is a whole being with interrelated andinterdependent needs, religious organizationsshould be actively concerned with spiritual, per-sonal and social needs.

RECOMMENDATION XReligious Bodies as Referral Agencies

Religious organizations must be aware of agenciesand services, other than their own, which canprovide a complete ministry to older persons.Other organizations designed for the benefit ofolder persons should develop, as a part of theirservices, channels to persons and agencies whocan help in spiritual problems.

468-318 0 - 73 - 5

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RECOMMENDATION XIReligious Bodies as Advocates

Religious bodies should exercise a strong advo-cacy role in meeting the needs of the elderly,working for programs, both public and private,that contribute to the well-being of the elderly andprotecting them from those who would victimizeor demean them.

RECOMMENDATION XIIProtecting the Rights of the Elderly

Religious bodies have traditionally and properlydeveloped their own philosophies. We recommendthat they work together with the elderly and co-ordinate their efforts with other groups to developand declare an affirmation of rights for the elderly.These rights should include the basic values of allwhile insuring the basic right of freedom ofreligion.

RECOMMENDATION XIIIInter-Faith Community Programs

It should be the national policy that religiousbodies and other private agencies make it theirconcern to bring together the services of theentire community to provide opportunity forinterfaith broad-based community programs forthe aged through multipurpose community cen-ters.

RECOMMENDATION XIVThe Right to Die With Dignity

Religious bodies and government should affirmthe right to, and reverence for life and recognizethe individual's right to die with dignity.

SECTION LEADERSHIPSpace .will permit listing of title and ad.dress only the first time a name appears.

The Technical Committeefor Spiritual Well-BeingChairmanHess T. Sears, Secretary, Equitable Life Insurance Companyof Iowa, Des Moines, Iowa

Consultant

Charles Taylor, Professor of Human Development and Psy-chology, Pennsylvania State University, University Park, Penn-sylvania

Members

William S. Banowsky, Chancellor, Pepperdine College atMalibu, Los Angeles, California

Annette Church, Retired, Washington, D. C.Reuben L Hill, Professor of Sociology, University of Minne-sota, Minneapolis, Minnesota

Leland Hoyer, Chaplain, Lutheran Hospital and Medical Cen-ter, Wheat Ridge, Colorado

Helen G. Jacobs, Member, Michigat. Commission on Aging,Traverse City, Michigan

Josephine H. Kyles, Consultant, Council of Churches ofGreater Washington, Washington, D. C.Rabbi Albert G. Minda, Minneapolis, MinnesotaPaul S. Rhoads, Professor of Medicine, Northwestern Medi-cal School, Evanston, Illinois

Anthony Rocha, Professor, Institute of Gerontology, StateUniversity of New York, Albany, New York

jessy Sullivan, Owner, Title and Abstract Company, Sapulpa,Oklahoma

Prescott W. Thompson, Physician, San Jose, CaliforniaLaughlin E. Waters, Attorney, Nossaman, Waters, Scott,Krueger and Riordan, Los Angeles, CaliforniaRev. Richard Williams, Vicar, Holy Cross Episcopal Mission,Bethesda, Maryland

The Secretariat

Director

Henry C. Shadeberg, Special Assistant to the Secretary, De-partment of Defense, Washington, D. C.

Consultants

Lawrence j. Corcoran, Secretary, National Conference ofCatholic Charities, Washington, D. C.Arthur Seeger, Director, Division of Social Services, -Ameri-can Lutheran Church, Minneapolis, Minnesota

Esther Stamats, American Association of Retired Persons,Washington, D. C,

Albert Wildman, Minister, Chevy Chase Presbyterian Church,Washington, D. C.

Members

John F. Albert, Deputy Chief of Chaplains, Department ofthe Air Force, Department of Defense, Washington, D. C.Raymar E Bobber, Director, Veterans Administration Chap-lain Service, Washington, D. C.Gerhardt W. Hyatt, Chief of Chaplains, Department of theArmy, Department of Defense, Washington, D. C.Alice A. McFadden, Liaison Officer, Private Sector Division,Office of Economic Opportunity, vilz,...hington, D. C.Ed Pope, Family Life Specialist, Exteusion Service, Depart-ment of Agriculture, Washington, D. C.Roy M. Terry, Chief of Chaplains, DepartmeNt of the AirForce, Department of Defense, Washington, D. C,

Section OfficersCo-ChairmenLawrence J. Corcoran and Hess T. SearsConsultantCharles TaylorRecorderHoward W. Washburn, Executive Director, Methodist Homesof New Jersey, Ocean Grove, New jerseyAssistant RecorderRuth Ward, Associate Regional Commissioner for Aging, So-cial and Rehabilitation Service, Department of Health, Educa-tion, and Welfare, Seattle, WashingtonManagement OfficerHenry C. Schadeberg

Subsection OfficersSubsection 1

ChairmanMartin McManus, Holy Spirit Parish, San Diego,California

Vice ChairmanTed R. Morton, Administrator, Greenwood Methodist Home,Greenwood, South CarolinaRecorderViolet E. Rudd, Executive Director, American Baptist Home,Greenwood, South Carolina

Subsection 2ChairmanRaymond J. Gallagher, Bishop, Diocese of Lafayette-in-Indi-ana, Lafayette, Indiana

ViceChairmanRudi Sanchez, Minister, Dallas, TexasRecorderJosephine H. KylesSubsection 3ChairmanRabbi Abraham J. Feldman, West Hartford, ConnecticutVice ChairmanEleanor Guilford, Director, Catholic Program for Aging, SanFrancisco, CaliforniaRecorderCharles TaylorSubsection 4ChairmanGrace Loucks Elliott, Retired National Executive, YoungWomen'. (..nrwian Association, New York, New YorkVice Chairman-'David 0. Moberg, Chairman, Department of Sociology andAnthropology, Marquette University, Milwaukee, WisconsinRecordersJ. L Simmons, Pastor, St James Baptist Church, Las Vegas,Nevada; Reverend Purd E. Deity Retired, Bloomfield, NewJersey

Subsection 5ChairmanFloyd Robertson, Assistant to the General Director, Na-tional Association of Evangelicals, Washington, D. C.Vice ChairmanJames A. Hood, Pastor, Boulevard Temple Methodist Church,Detroit, Michigan

60

l

I

/

RecorderNorma Uttal Levitt, President, National Federation of TempleSisterhoods, Great Neck, New York

Subsection 6Chairman.Virginia Stafford. Director of Ministries with Older Adultsand Homebound, Board of Education, United Methodist Church,Nashville, Tennessee

Vice ChairmanRuth Blankenship, Director of Diversionary ActiN:ties, Doug-las County Hospital and Annex, Omaha, Nebraska

RecorderThe Reverend Monsignor Arthur J. Tonne, St. John Nep-Pilsen, Marion, Nebraska

Federal Resource PersonnelRaymar E. BobberGloria Bray, Personnel Assistant, Personnel Services Office,Department of the Navy, Department of Defense, Washington,D. C.Katherine Doyle, Clerk-Typist, Labor and Employee RelationsDivision, Office of Civilian Manpower Management, Depart-ment of the Navy, Department of Defense, Washington, D. C

61

Joyce Fitzhugh, Secretary, Special Action Section, CivilianPersonnel Division, Office of the Chief of Staff, Departmentof the Army, Department of Defense, Washington, D. C.

Mary Ann Garrett, Employee Relations Specialist, DefenseSupply Agency, Department of Defense, Washington, D. C.

Joan M. Henry, Clerk-Typist, Civilian Personnel Division,Office of the Chief of Staff, Department of the Army, De-partment of Defense, Washington, D. C.

Orris E. Kelly, Director of Plans, Programs and Policies, Officeof the Chief of Chaplains, Department of the Army, Depart-ment of Defense, Washington, D. C.Barbara Matthews, Secretary, Office of International RelationsAdvisors, Department of the Army, Department of Defense,Washington, D. C.

Alice A. McFaddenSally E. O'Donnell, Clerical Assistant-Stenographer, CentralClearance Group, Headquarters, Department of the Air Force,Department of Defense, Washington, D. C.Dorris W. Rivers, Deputy Assistant Administrator for RuralDevelopment, Extension Service, Department of Agriculture,Washington, D. CGail M. Testa, Clerk-Typist, Graphic Arts Division, °fact ofthe Director of Administration, Department of the Air Force,Department of Defense, Washington, D. C.

g

SECTION ON

TRANSPORTATION

INTRODUCTIONhere were 174 Delegates named to theTransportation Section. In addition, anumber of observersrepresentingFederal Government agencies, State

government, institutions of higher education, andforeign countriesattended the Section.

Participants represented a wide range of occu-pational fields and interests. Among them wereresearchers, insurance executives, legislators, Stateagency executives, health and social services work-ers, attorneys, union representatives, and expertsin the area of transportationtransportationeconomists and plannerswho assisted in guidingthe discussion toward the development of feasibleand realistic policies.

A third of the Delegates named to the Trans-portation Section were retired. They added addi-tional relevance to the discussion by making theSection fully aware of the elderly's particulartransportation needs. This was the first time thatsuch an intermix of elderly people and practition-ers have had the opportunity to speak togetherab keeping older people mobile. The subjectwa. ,t considered as a major topic at the 1961White House Conference on Aging.

Beginning with the Older Americans com-munity forums, State White House Conferenceson Aging, and continuing through the NationalConference, participants spoke frankly abouttransportation needs peculiar to their own com-munities. Rural participants expressed particularconcern regarding the virtual non-existence of

63

any modes of transportation in their communities.However, it was emphaized over and over againthat the problem of transportation exists for allolder people, whatever their place of residence.

The Section on Transportation produced 21recommendations which call for Federal, State,and local action to provide increased availabilityof transportation services to older citizens. Broadlyconcerned with the dignity and well-being of oldpeople, Delegates recognized that the ability toprovide for one's needs and the ability to functionwithin society-at-large is significantly dependentupon one's access to adequate transportation. In-deed, the solutions to tie problems of transporta-tion for the elderly may be the sine qua non forameliorating many of the other 'problems facedby older people.

SECTION REPORTCo-chairman Walter J. Bierwagen opened the

work of the session by asking Co-chairmanThomas C. Morrill to make an opening statementwhich would introduce the Section Delegates totheir task.

Co-Chairman's StatementI am pleased to join my Co-chairman, Walter

Bierwagen, in welcoming you to the openingmeeting of the Transportation Section of theWhite House Conference on Aging.

As you know the planning for this significantevent has been in progress for about two yearsand many of you have been quite actively in-

volved in the community forums, State and re-gional conferences leading up to this time.

It is well said that we are today a society onwheels. In the lifetimes of many of us at thisConference, the automobile has moved in statusfrom a luxury for the affluent to the commonproperty of almost every household.

Motor vehicle transportation is today the over-whelming mode of personal travel. By some esti-mates, 94 percent of all passenger miles aretraveled by car or bus. As a people, we buy eightto nine million cars a year, drive a hundred mil-lion miles that glut the cities, pollute the air, kill55,000 people and injure us in unbelievablenumbers. In the process, we destroyby neglectand misusemuch of our mass transportationservice.

Then, with the passage of time, much of ourolder population reaches a point where, for eithereconomic reasons or cost or physical reasons, theprivate means of transportation on which theyhave relied for most of their lives is no longeravailable. They find that alternative ways to getwhere they want to go either no longer exist orare oriented toward other transportation needsto and from work, rather than to and from shop-ping areas, medical and social services, or humancontacts with friends and relatives.

The older population then may also find thatother forms of transportation are also expansiveor too challenging for declining physical skills.Even as pedestrians, the "WalkDon't Walk"signs turn on and off with threatening speed, thecurbs are too high, the drivers inconsiderate.

It is concerns of this kind .which make trans-portation for the aging a serious issue. The prob-lem is common, although it may take differentforms for those who live on farms than for thosewho live in cities or towns, and for those with andwithout alternatives to the motor car.s

In the two years of preparation for this Con-ference, thousands of older people have under-scored for us their worries about transportation.

During the community forums which were heldthroughout the country, transportation surfacedin many communities as the third

andprob-

lem of the elderly, after income and health.

Travel today can be an ordeal for the aged andinfirm, but if they are to take part in the affairsof community life, they must have available someconvenient and economical mode of transporta-tion. And this, of course, is why we are here today.Our mission during the next three days is to comeup with policy proposals on transportation whichwill lead to administrative and legislative actionon behalf of senior citizens.

As Mr. Joseph Revis has stated in the Back-ground and Issues Paper on Transportation, thetransportation problems of the elderly are mostacute in three areas: (1) lack of money for trans-portation; (2) lack of available service to placesthey need and want to go, and (3) problems ofsafety, comfort, and convenience associated withthe various transportation systems used by them:

These three problem areas have served as thebasis for the issues which you have been dealingwith during the past two years and which we willbe discussing. It is my sincere hope that we willdeal with the issues as they have been presentedin the Work Book and that we will develop mean-ingful policy proposals which will lead towardthe elimination of many of the transportationproblems which we as senior citizens face in ourday-to-day existence.

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PreambleIt has been unanimously agreed by the State

and Territorial conferences, the National Or-ganization Task Force, the Technical Committeeon Transportation and the Delegates of the Trans-portation Section of this Conference that meetingthe transportation needs of the elderly is a prob-lem of vital concern. For many of the elderly thelack of transportation itself is the problem; forothers, it is the lack of money for bus fares, thela4 of available services to places they want andneed to reach, the design and service features ofour transportation systems. These problems inter-act with one another and in doing so further aug-ment the transportation difficulties of the elderly.

For example, their low incomes often forcethem to live in poor transit service areas and pre-vent them from owning private automobiles.

Rising Awes and reduced service of financiallydeclining transit companies restrict their travel.Even where transit is available, design featuresand the lack of directional information may pre-dude access to available part-time work whichmight improve their incomes.

The elderly, like everyone in society, must de-pend upon the ability to travel for acquiring thebasic necessities of food, clothing and shelter aswell as employment and medical care. The abilityto travel is also necessary for their participation inspiritual, cultural, recreational and other socialactivities. To the extent the aged are denied trans-portation services they are denied full participationin meaningful community life.

It is essential that the needs of all the elderlybe considered. In the establishment and operationof the transportation systems and services pro-posed in the policy recommendations, provisionmust be made to serve the ethnic and culturalneeds of minority groups. In addition, becausethe transportation needs of the rural elderly arecritical, they must be assured of receiving all thebenefits associated with the recommendations ofthis Conference.

The implications of the failure of our trans-portation network to meet the needs of the elderlyhave received widespread attention and study byCongressional committees, advisory boards, thePresident's Task Force on Aging, and numerousother goal-generating sources. They have repeat-edly affirmed that the opportunity for a wide rangeof life choices is a basic right of the elderly, thatmobility is a necessary precondition for free anddignified choice, and that miximization of choicethrough programs to increase the mobility of theaged ought to be the overall goal of public policyfor the older citizen.

The Delegates of the Tiansportation Sectionare in agreement with these goals. However, thetransportation needs of the elderly cannot wait formore studies. Immediate action is needed. Thetransportation policy recommendations are a callfor action now. The order of presentation of rec-ommendations in this report shall not be con-sidered as an ordering of the priority of therecommendations.

65

Recommendations

RECOMMENDATION ITransportation Subsidies

The Federal Governmer,t shall immediately adopta policy of increasing transportation services forthe rural and urban elderly. The policy should beflexible, encompassing various alternatives. Bothsyszcin subsidies and payments to elderly individ-uals may be needed, the choice depending uponthe availability and usability of public and privatetransportation.

Subsidies should be made available not only forexisting systems, but also for the development offlexible and innovative systems, especially wherethere are no existing facilities.

Financial support should be directed toward ac-complishing program purposes such as:

Reduced or no fare transit for elderly. people.

Operating and capital subsidies.

RECOMMENDATION IITransportation For All Users

The Federal Government shell act immediatelyto increase support for the development of trans-portation for all users, with special considerationgiven to the needs of the elderly, the handicapped,rural people, the poor and youth.

RECOMMENDATION IIITransportation Coordination

Publicly-funded programs for the elderly shall bedesigned so that transportation will be requiredas an integral part of these programs, whethertransportation is provided directly by the programsor through other community resources.

Public policy shall require coordination of exist-ing transportation and/or new planned transpor-tation with publicly funded programs for theelderly.

RECOMMENDATION IVTransportation Coordination of Vehicles

To assure maximum use of vehicles and coordi-

nation, all government passenger vehicles (suchas school buses, vans and other vehicles) in useby Federal, regional, State, county and city pro-grams shall be made available interchangeablyamong agencies for the provision of transporta-tion to senior citizens for their respective pro-grams. The use of these vehicles shall be avail-able without prejudice to serve all disadvantagedelderly.

An area clearinghouse should be established sothat all local transportation resources are usedefficiently to meet the transportation needs of theelderly. /RECOMMENDATION VIndividualized Transportation

The Federal Government shall provide leadershipand financial support for the development of indi-vidualized, flexible transportation for the elderly,which provides increased access to health carefacilities, shopping, religious, social, recreational,and cultural activities. Programs should be imple-mented by local and State governments, privateenterprise, and voluntary community action.

RECOMMENDATION VIDesign and Safety Standards

The Federal Government, in cooperation withState and local governments and other agen-cies, shall set minimum standards for the designof equipment and facilities and shall develop pro-grams to assure the safety, comfort, and conveni-ence of the elderly as pedestrians, drivers, andusers of transportation services. Implementationand enforcement of these standards should beby local and State governments unless preemptedby the Federal Government.

RECOMMENDATION VIIBarrier-Free Design

Transportation systems and services developedor subsidized by public funds shall be designed inan architecturally barrier-free manner in order toprovide accessibility for all people.

The Federal Government shall provide guidelines

66

to State and local governments to assist in the de-velopment of imprc ed ancillary services, suchas: terminal design, shelters, centralized transitinformation, traffic control, and crosswalk mark-ings. Where appropriate, symbols, multilingualsigns, and other devices will be used to facilitatemovement of all users.

RECOMMENDATION VIIIReduced Fares

Appropriate legislation at all levels of governmenti.ould provide that the elderly and handicappedbe allowed to travel at half fares or less on aspace available basis on all modes of public trans-portation.

RECOMMENDATION IXTransportation Fund

The FederilGovernment should move immedi-ately to adopt a policy which will both increasethe level of funding available to the developmentand improvement of transportation services andalso foster the coordination of all forms of trans-portation, public and private, at Federal, State,regional and local levels or responsibility.

RECOMMENDATION XRevision of Highway Trust Fund

The Congress of the United States is urged toimmediately adopt legislation to convert the High-way Trust Fund ;nto a General TransportationFund to be utilized for all modes of transporta-tion.

A portion of the General Transportation Fundshall be made available for the development ofnew transportation services and the improvementof existing transportation services for the elderly.

RECOMMENDATION XIDriver Licensing

A nationwide set of driver's licensing standardsshall be established that do not discriminateagainst the elderly on the basis of chronologicalage alone.

RECOMMENDATION XIIVolunteer Driver Insurance

In designing new, flexible transportation services,the Federal Government should establish a na-tional policy for guaranteed liability insurance tocover volunteer drivers.

RECOMMENDATION XIIIEncOuragement for Volunteer Driven-

Individuals should be encouraged to serve as vol-unteer drivers for the elderly and be compensatedin one or more of the following ways: reimburse-ment for out-of-pocket cost of services rendered;a tax break; use of publicly owned vehicles; orassistance with insurance and maintenance ofvehicles.

RECOMMENDATION XIVGovernmental-Organization-for-Transportation

An elderly person knowledgeable in the affairsof the elderly shall be appointed as an assistantreporting directly to the Secretary of Transporta-tion to represent the needs of the elderly and worktoward implementation of their transportation.programs.

RECOMMENDATION XVInsurance Cancellation

The Federal Government and/or State govern-ments should pass legislation prohibiting insur-ance companies from increasing auto insurancepremiums or cancelling policies on the basis ofage alone.

RECOMMENDATION XVINo-Fault Insurance

Exploration of the concept of no-fault insuranceand the possibility of government-or arated insur-ance programs. and operimentation now under-way in the various States which would furtherthe development of better insurance programs,shall be encouraged.

Minority RecommendationExporation of the concept of no-fault insur-ance and experimentation now underway in

the various States which would further thedevelopment of better. insurance programs,shall be encouraged.

RECOMMENDATION XVIITransportation for Rural Elderly

All levels of government shall take immediatesteps to correct the present lack of provisions forthe basic transportation needs of the rural elderly.Federal laws shall be amended to include specificdefinitions of responsibility for rural transporta-tion by the Department of Transportation.

RECOMMENDATION XVIIITransporation and Federal Action

In the absence of State or local response to thetransportation needs of all users, especially theelderly, handicapped, rural, poor and youth, the

Federal-Government-shall-be-empowered-to-actunilaterally in their interest.

67

RECOMMENDATION. XIXPrivate Housing Transporation Near

Individualized and/or public transportation shallbe incorporated in the planning of all privatelyfunded senior housing projects to meet the needsof the elderly.

RECOMMENDATION XXJurisdictional Coverage

All policies adopted as a result of the recoinmen-dations of this Conference shall be applicable toall of the United States, the Commonwealth ofPuerto Rico and all other territories asscmatedwith the United States.

RECOMMENDATION XXIReservation Indians

Because American Indian reservations are con-sidered to be outside of State jurisdiction, Amer-ican reservation Indians are not eligible for exist-ing or proposed State-funded transportation serv-ices.

The Federal Government should recognize theunique transportation problems of American re-

serv:, tion Indians, and shall immediately providethrough subsidies new transportation services thatassure American reservation Indians transporta-tion to health care, educational, social, religious,recreational, cultural, and shopping facilities.

RECOMMENDATION XXIIPost-Conference Action

It is proposed that the 1971 White House Con-ference on Aging, and subsequent followup ofthis Conference, can benefit by including in theirstructured deliberations a special section or work-shop having a kind of free-wheeling assignmentto offer new and- creative ideas. Such a sectionwould not be bound by structured issues. It wouldbe composed of leaders from the elderly and across-section of all of the major fields of society.It would examine the issues and underlying valuesystems which limit self-determination and inhibitthe-elderly-persons'--opportunity-to-be-productive.This section would suggest new basic conceptsnot now explored in the field of aging. Said con-cepts would go beyond our basic view of theelderly persons role in society.

SECTION LEADERSHIPSpate will permit lining of tide and ad-dress only the first time a name appears.

The Technical Committeefor 'TransportationChairmanThomas C. Morrill, Vice President, State Farm Mutual Auto-mobile InsUrance Company, Bloomington, Illinois

Members

Fernando E. Alvarez-President, Spanish-American TranslationBureau, New York, New YorkFrancis M. Carp, -Research Psychologist, Institute of Urbanand Regional Development, University of California, San Fran-cisco, $alifornia

Sherman G. Irinesilver, Judge, District Court, State of Colo-rado, Denver, Colorado

Kalin Koicheff, Caseworker, Tremont Social Service Center,Bronx, New York

Marion E. Martin, Commissioner, Labor and Industry, Stateof Maine, Augusta, ;Maine

Earl Kennedy, President, Interamerican Travel Agents Society,Detroit, Michigsn

Richard M. Michaels, Director of Research, TransportationCenter, Northwestern University, Evanston, Illinois

68

Roland A. Ouellette, Assistant Director, Highway 'and TrafficSafety, General Motors Corporation, Detroit, Michigan'Ralph E Rachel, Transportation Economist, Institute ofPublic Administration, Washington, D. C.Morton A. Schwabadier, President, Council on Aging forSeattle and King County, Seattle, Washington

Sigmund J. SInszka, Teacher, Sewanhaka High School, FloralPark, New York


Ira Laster, Jr., Program Coordinator, Office of the AssistantSecretary for Environment and Urban Systems, Departmentof Transportation, Washington, D. C.

Members

Kathaleen C Arneson, Special Assistant to the Commis-'sioner, Rehabilitation Services Administration, Social and Re-habilitation Service, Department of Health, Education, andWelfare, Washington, D. C.Joseph S. Ain, Policy Analyst, Federal Aviation Administra-tion, Department of Transportation, Washington, D. C.James E. Huddleston, Acting Director, Child arid FamilyServices,CommunityServicesAdministratkn- -SocialandRehabilitation

Washington,Service, Department caof Health, Edution, and

Welfare,

Ira Kaye, Chief, Community Development Division, Officeof Program Development, Office of Economic Opportunity,Washington, D. C.Ferree Kolodner, Social Insurance Specialist, Office of theCommissioner, Social Security Administration, Departmentof Hmslth, Education, and Welfare, Washington, D. C.Edmond J. Leonard, Director of Information, The PresidenisCommittee on Employment of the Handicapped, Washington,D. C.Ryland Swain, Specialist in Aging, Office of Research andDemonstration, Social and Rehabilitation Service, Departmentof Health, Education, and Welfare, Washington, D. C.Floyd L Thiel, Chief, Socio-Economic Studies Division, Fed-eral Highway Administration, Department of TransportationWashington, D. C.

Section OfficersCo-ChairmenWalter J. !Henriksen, Director of Public Affairs, AmalgamatedTransit Union, Washington, D. C., and Thomas C. MorrillConsultantRobert J. Ahrens, Director, Division of Senior Citizens, Chi-cago, Department of Human Resources, Chicago, IllinoisRecorderJoseph S. Revis, Consulting Associate, Institute of Public Ad-ministration, Washington, D. C.Assistant RecorderPaul Ertel, Associate Regional Commissioner for Aging,Social and Rehabilitation Service, U.S. Department of Health,Education, and Welfare, Kansas City, Missouri.Management OfficerIra Laster, Jr.

Subsection OfficersSubsection 1ChairmanRobert J. AhrensVice ChairmanJuanita H. Quinteros, Director, Project Brevo. Senior CitizenProgram, El Paso, Texas.RecorderMamie Cape nen, Area VIII Vice-President, American Asso-ciation of Retired Persons, Blackfoot, Idaho.

Subsection 2ChairmanJames B. Townsend, State Representative, Shawnee. Okla-hoinaVice ChairmanWilliam Rasmussen, Director, Division of Care of the Aged,Chicago, IllinoisRecorderCynthia Marano, Writer, National Federation of Businessand Professional Women's Clubs, Washington, D. C.

Subsection 3ChairmanWilliamrld..Spreitzer,-Head, Transportation-Research-Depart---meat, Research laboratories, General Motors Corporation,Warren, Michigan.

Vice ChairmanWilliam K. Fowler, Chief, Bureau of Research and Develop-ment, Division of Mass Transit Operations, Department ofTransportation, Tallahassee, Florida.RecorderMarion E. van; Executive Officer, National Association ofNegro Businc., and Professional Women's Clubs, Inc, Pitts-burgh, Penntylvania

Subsection 4ChairmanLeota G. Davis, Retired, Jacksonville, FloridaVice ChairmanEdward Ryken, Executive Director, Martin Senior Coordi-nating Council, Inc San Rafael, CaliforniaRecorderJean Von Ezdorf, Executive Director, Little House, MenloPark, California

Subsection 5ChairmanFrances M. CarpVice ChairmanEarl Kennedy

69

RecorderFrancis Barth, State Senator. So len, North Dakota


Joseph AsinRobert H. Bruton, Urban Planner, Office of Policy and PlansDevelopment, Office of Assistant Secretary for Policy andInternational Affairs, Department of Transportation, Washing-ton, D. C.

Patricia Cass, Special Assistant to Deputy Administrator,Urban Mass Transportation Administration, Department ofTransportation, Washington, D. C.

Marilee B. Cavender, Consumer Affairs Specialist, Office ofConsumer Affairs, Office of the Assistant Secretary for Safetyand Consumer Affairs, Department of Transportation, Wash-ington, D. C.

Michael Finkelstein, Acting Chief, Highway and Mass TransitPrograms Division, Office of Planning and Program Review,Department of Transportation, Washington. D. C.Marion W. Forrester, International Economist, Office ofTransportation Policy and International Affairs, Office ofAssistant Secretary for Policy" and International Affairs, De-partment of Transportation, Wrshington, D. C.Donakt_IL_Haines,_AttorneyAdvisor, -Office-of -AssistantSecretary for Legislation, General Counsel, Department ofTransportation, Washington, D. C.Eric H. Hanson, Intergovernmental Coordinator, FederalRailroad Administration, Department of Transportation,Washington, D. C.Thomas Henry, Economist, Socio-Economic Studies Division.Federal Highway Administration: Department of Transporta-tion, Washington., D. C.Ira KayeEdmond J. LeonardFather Anthony Rods, Consultant to the Secretary, Office ofthe Assistant Secretary for Environment and Urban Systems,Department of Transportation, Washington, D. C.Beverly Silverberg, Information Specialist, Office of PublicAffairs, Department of Transportation, Washington, D. C.Cynthia Straker, Attorney Advisor, Office of General Counsel,Department of Transportation, Washington, D. C.Ryland SwainFloyd L ThielMargaret E. A. Tuttle, Program Analyst, Office of ProgramDevelopment, Office of Economic Oppoltunity, Washingtnn,D. C.

Jim F. Young, Chief, Service Development Division, Officeof Civil Rights and Service Development, Urban Mass Trans-portation Administration, Department of Transportation,Washington, D. C.

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SECTION ON

FACILITIES, PROGRAMS, AND SERVICES

INTRODUCTION SECTION REPORTwo hunched and forty Delegates werenamed to the Section on Facilities, Pro-grams, and Services. Of this total, some

_____50.persons_(21-percent)-indicated-that-_they were retired. A comparable number;45 Dele-gates (18 percent), were from non-white minor-ity groups.

The Delegates represented a complex of ad-vocacy and service organizations in the field ofaging. A partial listing would includeat theState and local levelsgovernment offices on ag-ing, departments of social services, communitywelfare organizations, homes for the aged, andsenior citizen centers. Delegates from nationalorganizations included representatives o5 severalaged membership groups, voluntary associations,and advocates of consumer interests. Among otherparticipants in the Section's weak were legislators,lawyers, clergymen, union and business officials,social workers, and members of the academiccommunity.

PreambleNational policy should guarantee to all older

persons_real-choices_as-to-how-they-shall- spendtheir later years. Older persons should be enabledto maintain their independence and their useful-ness at the highest possible levels. They must havethe opportunity for continued growth, develop-ment and self-fulfillment, and for expanded con-tributions to a variety of community activities.

In addition to adequate income, an effectivenetwork of facilities, programs, and services mustbe readily available and accessible to permit themto exercise a wide range of options, regardless oftheir individual circumstances or where they hap-pen to live. Such facilities, programs, and servicesmust be available whether the need for them isshort-term or long-term. They may be under pub-lic or voluntary auspices.

Attention must be given now to identify andprovide those services which make it possible forOlder persons to remain in, or return to, theirown homes or other places of residence. Whateverthe type of resource required to assist them inmaintaining the living arrangements of theirchoice, whether institutional or community based,appropriate standards for those resources must beestablished and strictly enforced.

Action is riv.ecIed in forging a national socialpolicy on protection of the older person's rightsand choices that will be reflected in povision of awide range of facilities, programs, and services,

The Section on Facilities, Programs, and Serv-ices adopted 28 recommendations for policy inthe broad yet critical areas of program develop-ment and operation, community facilities, socialservices, and consumer and legal protection. Thepolicy guidelines and actions proposed by the Sec-tion are regarded as essential to the accomplish-ments of an overriding purpose: that older per-sons will be able to maintain their iiiclgpendence,their self-worth, their dignity, and their continu-ing contribution to our society.

71

whether preventive, protective, rehabilitative, sup-portive or developmental in their focus. To thisend there must be strategies for achieving actionnow, including Federal fiscal support to imple-ment the policies which follow.

Recommendations

RECOMMENDATION IRange of Living Arrangements

Tax funds should be more equitably allocated tomaximize the likelihood that older persons willcontinue to live independently and to help assurethat older persons will have a choice of livingarrangements. 7o achieve this, a full range ofsupportive community services, public and private,must be adequately financed. Public funds musthe allocated in sufficient magnitude to assure suchquality institutional care, from minimal to maxi-mal, as may be needed at various stages in anolder person's life. The level and quality. of careand services shall be provided without regard tosource of payment.

RECOMMENDATION IIResponsibility for Providing Services

Services to older people should be providedthrough a combination of governmental, privatenonprofit, and commercial agencies. The FederalGovernment should be responsible for financinga minimum floor for all services. These servicesmay be procured from private nonprofit and/orcommercial sources at the election of local andState governments.

Minority Recommendation

Services to older people should be providedthrough a combination of governmental,private nonprofit, and commercial agencies.The Federal Government should be respons-ible for financing a minimum floor for allservices. These services may be procuredfrom private .rionprofit and/or commercialsources.

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RECOMMENDATION IIIStructuring Government to Serve the Elderly

Primary responsibility for planning and coordina-tion of health, welfare and other services for theolder population should be placed in a publicservice agency with divisions at the Federal, Stateand local level ich strong administrative author-ity and funding controls and the capability offunctioning across departmental lines. Thereshould be extensive involvement of older peopleand independent agencies and organizations inthe making of policies and in all aspects of plan-ning.

RECOMMENDATION IVParticipation in Policy Making

Aii age groups should be involved in the deter-mination of policies and standards for facilitiesand services for the older population and olderpersons themselves certainly must have a role.

RECOMMENDATION VCriteria for Program Staffing

Qualifications other than age should be the deter-mining factors in stall employment in facilitiesand programs for the elderly, but special effortshould be made to use older persons in staffingsuch facilities and programs.

RECOMMENDATION VISpecialized Services

Older persons should be served by an integratedsystem, sharing equitably with other age groupsthose facilities, programs and services suitableand appropriate to the needs of the general popu-lation, but they should also have the benefit ofspecialized facilities, programs, and services basedon their distinctive needs.

RECOMMENDATION VIIResponsibility for Consumer Protection

Government controls as a primary means for as-suring consumer protection should be substan-

tially augmented by the participation of consum-ers, industry, business, and the professions.

RECOMMENDATION VIIIA Federal Consumer Agency

A central consumer agency should be establishedat the Federal level to better coordinate andstrengthen the powers and responsibilities ofexisting Federal agencies engaged in consumerprotection to ensure that the interests of elderlyconsumers arc better served.

RECOMMENDATION IXProtective Set-vices

Older persons shall be free to manage their ownaffairs. ShOizicl public intaireiition-be rieeded, dueto hazardous circumstances or situations in whichthey-may-be-involved,theremust-be lull-protec-tion of their legal rights as individuals. Thereshould be development of protective services forthose older persons in the community who areunable to Manage their affairs because their mentaland/or physical functioning is seriously impaired.

RECOMMENDATION X4g1:- q.afftr4 'Mk ?OWAge alone may be an appropriate criterion inestablishing policy for certri3 programs, such aseligibility for Social Security retirement benefitsand property tax relief. It is an inappropriate cri-terion when used to disCiiininate against theelderly in determining /eligibility for insurance,employment and credit, for example. Any cri-terion based solely on age should be analyzed todetermine whether it is appropriate for a particu-lar age.

RECOMMENDATION XIStandard Setting

Federal legislation shall provide minimum qualitystandards and guidelines to provide uniforrn serv-ices and care for the elderly in all Federally ad-ministered programs and in grant-in-aid programsoffered to the States, stippletherwed by legislationon the State and local levels conforming to such

73

standards and guidelines. Such standards andguidelines shall clearly specify requiremcnts re-garding staff qualifications and training and thequality of facilities, programs, and services.

RECOMMENDATION XIILegal Services for the Elderly

Government funded legal service shall be avail-able to older persons in all communities. To en-sure this:

The Federal Goveminent should earmarkadequate funds so that older persons will havea guaranteed full range of legal services, in-cluding advocacy, administrative reform, -liti-gation and legislation. The funds providedshould be a fair proportion of all legal servicefunding.

Bar associations, private law firms, law-schools; and university- research institutes-should be encouraged to provide legal assist-ance and research findings to older persons.

Lay people and older paraprofessionalsshould be used to perform advocacy roles thatadvance the legal concerns of older people.

Congress should establish an independentlegal service corporation in which olderpersons will have a fair share of direction, thatwill provide free services for those who cannotafford them (including rights and property ofolder homeowners), will charge a reasonablefee for those persons whose incomes permit amodest payment, and whose services will beaccessible wherever older people live.

Funds should be made available for re-search into the legal problems of older persons.

RECOMMENDATION XIIIAdequate Income

While the need for greatly expanded facilities,programs, and services is urgeir, services are nota substitute for sufficient income to maintain in-dependent living in dignity and health Olderpeisons require no less than the moderate standardof living defined by the Bureau of Labor Statisticsand no limit should be placed on earnings ofSocial Security beneficiaries.

11.

RECOMMENDATION XIVPolice Protection

Police protection of the elderly should become atop priority. A portion of Federal funds for theprevention of crime allocated to the States or localcommunities should be earmarked for this pur-pose. Particular attention should be paid to theneeds of minority groups.

RECOMMENDATION XVCross-Generational Ties

Involvement between young people and olderpeople should be encouraged at all levels of com-munity life. Young people can gain knowledge ofthe process of aging and become involved withelderly people through the education system, na-tional youth organizations, and volunteer roles.

RECOMMENDATION XVICommunications aboutPublic Policy in Aging

A policy affecting the elderly will only be useful ifit is written clearly, is publicized broadly, and iscompletely understandable by persons with differ-ing cultural and linguistic backgrounds. For ex-ample, the Social Security Administration couldenclose with the monthly check notification of en-titlements and programs available to beneficiaries.

RECOMMENDATION XVII"Tbe War Must Stop!"

Delegates from every part of our Nation callupon the President to end the United States in-volvement in the war in Southeast Asia. We areacutely aware of the human costs resulting fromthat tragic war including war- related spirallinginflation and the unfortunate waste of our re-sources in so-called defense appropriations. Wedeclare urgently and simply: The War Must Stop!

RECOMMENDATION XVIIIPost-Conference Action

The White House Conference oti Aging should

74

establish a continuing body of Delegates to makerecommendations for State and Federal legisla-tion as part of the post-Conference action year.

Minority RecommendationThe White House Conference on Agingshould continue the participation of currentdelegates to make recommendations forState and Federal legislation as part of thepost-Conference action. Financing for thiswork should be continued by the FederalGovernment.

RECOMMENDATION XIXGovernment Organization for Aging

There should be established immediately a FederalDepartment of Elder Affairs headed by a Secretaryof Elder Affairs who shall be a member of thePresident's cabinet. Such department shall bebroadly -responsible fosttheplaiiiiink-, coordina-tion, and funding of health, welfare, and otherservices for older people.

From the date of establishment, thete shall be atwo-year period in which the Secretary shall pre-pare the plan for the transfer of appropriateoperating functions from other Federal agencies.During this period, the Administration on Agingshould be immediately strengthened in order thatits original functions as provided in the OlderAmericans Act of 1965 can be more effectivelyrealized.

RECOMMENDATION XXIncreased Social Security Benefits

We older Americans, and representatives of olderAmericans, meeting in Washington, D.C., at theinvitation of the President, have studied propos-als, programs, schemes and strategies to make lifefor older Americans more than simply bearable.However, we are cf one mind when we declarethe primary need for older Americansin truth,for all Americansis adequate income. We askfor action now from The White House to increaseSocial Security benefits to a level at which peoplemay live in dignity; specifically, we recommenda benefit level of at least $3,000 per year for anindividual and $4,500 for a married couple.

RECOMMENDATION XXI"Special Age-72" Benefits

Although they are United States citizens andcontributors to the Social Security Trust Fundthrough payroll deductions, certain residents ofPuerto Rico, Guam and the Virgin Islands areineligible to receive OASDI benefits under theProuty Amendment. This discriminatory treat-ment should be changed so that benefits are avail-able to them on the same basis as they ase toother persons.

RECOMMENDATION XXIIMultipurpose Senior Centers

In every community and neighborhood, as appro-priate, there should be a multi-purpose seniorcenter to provide basic social services, as well as_link_ alLolder_persons_ to appropriate _sources ofhelp, including home-delivered services.

The basic services, in clearly identifiable sites, i.e.,senior centers, action centers, department ofsocial services, etc., financed as an on-going gov-ernment program, could be the foundation forsuch additional services as various levels of gov-ernment and the voluntary sector, including or-ganizations of the aged, would desire and sponsor.

Basic social services that would enhance theability of the elderly to retain independenceshould be made available. These may include butare not necessarily limited to:

Supportive Services which aid the olderperson to remain in hic familiar environmentor to retain his usual living arrangement whenthis is no longer possible through his own ef-forts. Specific serv;ces would include home-maker-housekeeping services, organized homecare, chore services, home-meal services, andescort services.

Preventive Services which prevent thebreakdown of the capacity of the older personto function physiologically, 'psychologically, orsocially through detection and through socialintervention prior to old age or prior to a crisisin old age.

Protective Services which protect the civilrights and personal welfare of older persons

468-218 0 - 13 - 6

75

from neglect and exploitation by 'datives,friends, the aged individual himself, and thecommunity. Service would be directed towardthe older persons with limited mental func-tioning due to mental deterioration, emotionaldisturbance, or extreme informity, and wouldfocus on their inability to manage their ownaffairs in such areas as providing for personaland physical needs, planning and decision-making and handling of finances.

Maximum involvement of the elderly in policymaking, staff and volunteer roles, should be en-couraged.

RECOMMENDATION XXIIIImplementation of Titles I and XVISocial Security Act

States are urged to fully implement the service-provisions-Of-Titles-I and-XVI-of the- Socia'- Se-curity ActIt is inconsistent to acknowledge the need forgreatly expanded social services for adults underthe Social Security Act and then propose to fore-close this possibility by limiting funding underWelfare Reform. Therefore, it is recommendedthat funding of social services remain open-ended.

RECOMMENDATION XXIVThe Food Stamp and Commodity Programs

Procedures and arrangements for the certificationand distribution of food stamps and commoditiesshould be convenient and protect the dignity ofindividuals utilizing the programs.

Minority RecommendationProcedures and arrangements for the certifi-cation and distribution of food stamps andcommodities should be convenient and pro-tect the dignity of individuals utilizing theprograms. It is strongly urged that States donot have Departments of Public Welfareadminister the programs.

RECOMMENDATION XXVReforming Public Assistance Laws

Restictive Federal and State public assistance laws

and regulations which in effect deny benefits andservices to otherwise eligible older people shouldbe abolished. It is recommended that: (1) publicassistance benefits be based on need without re-gard to residence or citizenship; (2) minimumstandards for benefits should be set at the Feder-ally-defined poverty level; (3) a simple declara-tion of need should be the basis for determiningeligibility; and (4) both lien laws and relativeresponsibility provisions should be abolished.

RECOMMENDATION XXVIImproving Title II, Social Security Act

The following recommendations for improvementof Title II of the Social Security Act are made:

Substantial increase in Social SecurityNOW and to add funds from the general reve-nue. Senior citizens (62 and up) should begiven a guaranteed income of at least $3,000rer-person-and $4;500 per couple; Ter-year,plus an automatic cost of living increase.

No ceilings be placed on earnings forthose persons receiving Social Security benefits.

Widows or widowers eligible for SocialSecurity benefits shall be entitled to receive thefull benefits based on their spouse's earningsrather than a reduced portion as a result oftheir being widows or widowers.

Persons who have earned Social Securitybenefits independently, then marry, should beallowed to retain their separate benefits untilsuch time as Congress enacts legislation to in-crease benefits for married couples.

That Social Security funds from payrolltaxes be supplemented by general revenue fundsin order to provide adequate benefits and keeprace with changes in the standard of living.Retroactive denial of Medicare benefitsshould be abolished.

That home care services under Medicarebe broadened.

RECOMMENDATION XXVIITrained Personnel in Aging

There should be adequate training of personnelto implement proposals in the area of facilities,programs, and services.

76

RECOMMENDATION XXVIIIComprehensive Care in Various Settings

Tax funds should be more equitably allocated tomaximize the likelihood that older persons willcontinue to live independently and to help ensurethat older persons have a choice of living arrange-ments. To achieve this, a full range of supportiveservices must be adequately financed. These serv-ives would include visiting nursing, homemakingprograms, home-delivered meals, transportationfor essential services and all other seasonablynecessary services.

Tax funds should also be used to support institu-tional care and construct facilities. A full rangeof serviceshorn minimum to maximum carerecognizing cultural differences, should be avail-able in institutions.

A personal care benefit is proposed payable toeligible older persons to enable them to purchasesuch required services from provider organiza-tions in each community which includes multi-purpose service centers. Basic to the ability to

'continue to live independently is the availabilityof a national health security program providingcomprehensive health care services.


The Technical Committeefor Facilities, Programs and SeriricesChairman

George K. Wyman, Commissioner, New York State Depart-ment of Social Services, Albany, New York

ConsultantsJerome Kaplan Executive Director, Mansfield MemorialHomes, Mansfield, Ohio

W. W. Morris, Associate Dean, College of Medicine, Univer-sity of Iowa, Iowa City, Iowa

Members

Margaret Blenkn, Professor and Director, Regional Insti-tute of Social Welfwe Research, University of Georgia, Athens,Georgia

Andrew W. L. Brown, Assistant Director, Community Serv-ices and Retired Workers Department, United AutomobileWorkers, Detroit, Michigan

Leon Barks, Businessman, Miami, Florida

Jeanette Jennings, Professor, Social Work Program, HumeHall, University of Mississippi, University, Mississippi

Fannie G. Krevsky, Public Information Director, Bureau ofHuman Resources, State of Pennsylvania, Harrisburg, Penn-sylvania

Edward G. Lindsey, Director, Health Services, State Com-munities Aid Association, Buffalo, New YorkReverend Martin McManus, Holy Spirit Parish, San Diego,California

David H. Marlin, Director, Legal Research and Services forthe Elderly Project, National Council of Senior Citizens, Inc.,Washington, D. C.Joseph Mash, Executive Director, Grosse Point Nursing Home,Farmington, Michigan

Norman P. Mason, 'lousing Consultact, South Harwich,Massachusetts

Ethel Shanas, Professor of Sociology, University of Illinoisat Chicago Circle, Chicago, IllinoisC. Joseph Steller, 'President, Pharmaceutical ManufacturersAssociation, Washington, D. C.

The Secretariat-Director-James J Burr, Director, Division of Services to the Agedand Hark.,capped, Community Services Administration, Socialand Rehabilitation Service, Department of Health, Education,and Welfare, Washington, D. C.

Members

Irving Etreim, Director, Services for the Elderly, Office ofEconomic Opportunity, Washington, D. CHerbert Kamsky, Social Work Program Specialist, Divisionof Services to the Aged and Handicapped, Community Serv-ices Administration, Social and Rehabilitation Service, De-partment of Health, Education, and Welfare, Washington,D. C.

Philip Grossman, Research and Demonstration Specialist,Community Services Administration, Social and Rehabilita-tion Service, Department of Health, Education, and Welfare,Washington, D. C.Thomas Prather, Program Specialist, Division of Develop-mental Disabilities, Rehabilitation Services Administration,Social and Rehabilitation Service, Department of Health,Education, and Welfare, Washington, D. CStephanie B. Stevens, Aging Specialist, Older American Serv-ices Division, Community Services Branch, Administration onAging, Social and Rehabilitation Service, Department ofHealth, Education, and Welfare, Washington-, D. C.Fran Wersells, Community Services Specialist, Division ofServices to the Aged and Handicapped, Community ServicesAdministration, Social and Rehabilitation Service, Departmentof Health, Education, and Welfare, Washington, D. C.Ruth White, Social Insurance Specialist, Community Plan-

.aning Staff, Office of the Commissioner, Social Security Ad-ministration, Department of Health, Education, and Welfare,Baltimore, Maryland

Section OfficersCo-C ntirmen

Ellen Winston, ?resident, National Council for Homemaker-Home-Health Aide Services, Inc., Raleigh, North Carolina,and George K. Wyman

77

ConsultantsJerome Kaplan and W. W. Morris

Recorder

Mary L. Henlmy, Director, Benjamin Rose Institute, Cleve-land, Ohio

Assistant Recorder

Mel Spear, Associate Regional Commissioner for Airing, Socialand Rehabilitation Service, Department of Health, Education,and Welfare, San Francisco, California

Management OfficerJames J. Burr

Subsection OfficersSubsection 1ChairmanEfrain Santiago, Secretary, Department of Social Services,San Juan, Puerto RicoVice ChairmanHarvey Roth, Associate Professor, Department of Recreation,Chico State College, Paradise, CaliforniaRecorderSylvia Barg, Executive Director, Senior Wheels East, ModelCities, Philadelphia, Pennsylvania

Subsection 2Ch unmanW. W. MorrisVice ChairmanDonna Bearden, Public Information Officer, Governor's Com-mission on Aging, Austin, Texas

RecorderMargaret M. Jones, Member, State Technical Review Com-mittee to the Older Americans Act, Portland, Maine

Subsection 3ChairmanDavid H. MarlinVice ChairmanCharles W. Pruitt, Jr., Executive Director, Cathedral Founda-tion, Jacksonville, FloridaRecorderAnna D. Kelly, Director, Foster Grandparent Program,Charleston, South Carolina

Subsection 4ChairmanJane Garretson, Director, Services to the Aged, Family ServiceBureau, Unilted Charities of Chicago, Chicago, IllinoisVice ChairmanClara- Bailey, Senior Citizens Organizer, Economic Oppor-tunity Board, Clark County, Las Vegas, Nevada

RecorderHazel L. Ricker, Executive Director, Howard County Com-mission on the Aging, Columbia, Maryland

Subsection 5

ChairmanPeg Lamont, Chairman, South Dakota Governor's AdvisoryCouncil on Aging, Aberdeen, South Dakota.Vice ChairmanJames Sykes, County Board, Madison, Wisconsin

,V

a

RecorderRodger H. Sandoval, Director, Local Community Develop-ment Program, Office of Navajo Economic Opportunity, Nava-jo, New Mexico

Subsection 6ChairmanFannie L. Allen, Director of Services for Older Adults,United South End Settlements, Boston, MassachusettsVice ChairmanBernard E. Nash, Executive Director, American Association ofRetired Persons, National Retired Teachers Association, Wash.ington, D. C.RecorderMargaret Blenkner

Federal Resource PersonnelRoberta Brown, Chief, Office of Services to the Aged, De-partment of Human Resources, Washington, D. C.Sarah Butts, Adult Services Specialist, Division of Serviceto the Aged and Handicapped, Community Services Admin-istration, Social and Rehabilitation Service, Department ofHealth, Education, and Welfare, Washington, D. C.Irving Etreim

Evelyn Green,..Staff_Development-Specialist,-,Office of ServiceDelivery, rommunity Services 'Administration; Social andRehabilitation Service, Department of Health, Education, andWelfare, Washington, D. C.ViVian Griffin, Supervisor, Division of Self-Support Services,Community Services Administration, Social and Rehabilitation

78

Service, Department of Health, Education, and Welfare, Wash-ington, D. C.Herbert Kamsky

Gladys Lawson, Acting Homemaker Services Specialist, Com-munity Services Administration, Social and RehabilitationService, Department of Health, Education, and Welfare,Washington, D. C.De Vera Lynn, Student Intern, Howard University, Washing-ton, D. C.

Diane O'Heir, Student Intern, National Association of SocialWork, Washington, D. C.Thomas PratherGeorge Roby, Chief, Division of Adult Services, Departmentof Human Resources, Washington, D. C.Stephanie B. StevensVirginia Tanner, Acting Chief, Training Unit, Office ofService Delivery, Community Services Administration, Socialand Rehabilitation Service, Department' of Health, Education,and Welfare, Washington, D. C.Cleonice Tavani, Older, Persons Coordinator, Office of Eco-nomic Opportunity, Washington, D. C.William Tuttle, Community Services Specialist, CommunitServices Adrr.inistration, Social and Rehabilitation Service,Department of Health, Education, and Welfare, WashingtonD.C.Fran Wersells

Charles Yates, Student Intern, Division of Services to theAged and Handkapped, Community Services Administration,Social and Rehabilitation Service, Department of Health, Edu-cation, and Welfare, Washington, D. C.

4

7

SECTION ONGOVERNMENT AND NONGOVERNMENT

ORGANIZATION

INTRODUCTIONtotal of 221 Delegates was named tothe Section on Government and Non-government Organization. Informationavailable from their nomination forms

indicate that some 21 percent were retired, and11- percent were members of one of the minoritygroups.

The majority of Delegates represented orga-nizations whose activities involve the aging di-rectly, if not exclusively.. Governmental units onaging at the State and local levels were heavilyrepresented, as were higher level dpartments,-chief executive officers, and legislative bodies withbroad responsibilities for loCal and State programsin aging. Other prominent participants in theSection's work included leaders of national, State,and community voluntary organizations, many ofthem free. aged membership groups. Servingalso as Delegates were business and labor officials,educators, lawyers, and physicians.

In formulating a total of 12 policy recom-mendations, the Delegates to the Section on Gov-ernment and Nongovernment Organization wereguided by the preferences expressed by State andlocal White House Conferences on Aging, andby the earlier Older American Forms. Discussioncentered ton the paramount problems of develop-ing and sustaining strong and .effective organiza-tion for and by the aging. Lacking this supportstructure, policies to meet the needs of the Na-

79

don's older people have little chance of adoption,much less implementation. The following set ofrecommendations are directed toward building theorganizational base for action, now and over thecoming decade.

SECTION REPORTCo-chairman Timothy W. Costello opened the

Section meeting. He introduced the officials ofthe Section and invited Co-chairman Fred W. Cot-trell to provide the Section Delegates with back-ground and orientation for their work of theensuing three days.

Co- Chairman's StatementIn this Section we concentrate on means by

which older people can secure what they need.We particularly deal with the kinds of organiza-tion that are required, as contrasted with suchthings as changes in the values of individualolder people. At times it seems as if we are facedwith the same dilemma that confronted a moun-taineer who was asked the way to a place on aneighboring mountain; after several false startsat giving the information, he finally said, "Mister,you can't get there from here."

The multiplicity of organizations, the differ-ences between the constituences they were set upto serve, the differences in priority among valuesassigned by different sets of clients, the relativepower older people have in determining what will

be done in different parts of government, and indifferent nongovernmental agencies, make .asingle rational or logical plan seem unattainable.Perhaps the best we can do is to arrange thingsso that more of the things that older people wantcan be secured in an order that reflects their ownpriorities than has' been possible in the past.

The effort to do this required that we find outsomething about their needs and their priorities,and the way existing organizations work. As awriter of the workbook used in this Section, Ihad to sample what was going on in all theStates, at the national level, in county and localgovernments, and among at least the leadingnongovernmental organizations. I was helped bythe fact that since the 1961 Conference we have,through research and demonstration, been learn-ing more and more about the programs and thereare now many more knowledgeable people thanin any previous times. Later, as Chairman of theTechnical Committee, I was also made aware ofthe -fad that both older people and experts arefar from being in agreement as to what is wanted,what is being done, how well it is being done, andwhat changes in organization should be made. Itis no wonder then that you may find it hard todiscover clear lines to be recommended on thebasis of adequate evidence that one rather thananother cause will serve all older people better.

In preparing for the Conference, we were try-ing to cite for you the evidence that led onegroup to support one kind of organization andthat which would cause another to take a differenttrack. We wanted to focus your attention on alimited number of issues so that we would beable to get some action, rather than make so manystatements that nobody who was trying to helpolder people could find out what they mostwanted. Because we limited the topics we pre-sented to you, some people suspected that bypointing to these proposals we were also tryingto prevent discussion of, or resolutions on, a num-ber of other topics of greater interest to them.This is not so. In the subsections it will be possiblefor any of you to propose new topics. Dr. Cos-tello has discussed the rules under which we willoperate. I am sure you will agree that they giveample opportunity to anyone who wishes to pro-

80

I ow new policies, and if supported in your sub-section and at Section levels, these will go intothe Section report.

The most important thing to remember is thatif too many of our proposals conflict with oneanother, or are contradictory to those which willbe coming out of other Sections, we are not likelyto be persuasive. What we must do is try :3 findthe greatest common ground on which we can allstand. This may mean that a position held to beof very great significance by a particular minoritywill not be supported by enough roles to get intothe Section report. Those who lose on this issuecan take satisfaction in the gains they make onothers.

Organization is a difficult subject to deal with.Those who think of it in terms of structure putgreat emphasis on locating an agency that dealswith their concerns high up in the hierarchy ofauthority. Another point of view holds that it ispolitical "clout" that gives power to aiiy agency.So if somebody in office doesn't have a strongpolitical support in our society at large he can'tget much done, no matter where he is locatedon a chart, or what title he is given. Some of thematters you will have to decide on relate to thesetwo somewhat different ideas about what makesan organization work.

Most of the organizations that deal with theproblems of older people were developed to dealwith problems that the aging share with otherage groups. So, for example, health organizationsare built up around the means to prevent or curedisease. Similarly, much public housing wasdeveloped for low income people, without refer-ence to whether they are young or old. Organi-zations were not created so that one agency woulddeal with the health of older people, housingfor older people, transportation for older people,and all other concerns of older people. The struc-ture of government in Washington became whatit is under the influence of these "functional"organizations. Here we must decide whether todevise means to increase emphasis on the needsof older people in each of these organizations,or try to create a special structure to coordinatework for the aging independently of the existingdepartments, divisions or offices.

While-we are-doing-this in our Section itwill Undoubtedly- be true that other Sections of

the -Conference, dealing With substantive needs,,will also be recommending changes that they

-diinktepretent the -best WaYS.--ito solve- the,-prob-:laps> they are dealing With:. SO if you decide-on_-one---approach, yOU::ate--iiko1y to be supportedby those who want "functional" autonomy, _ andwill be opposed by these groups if you .try- to:control all ierviCes -for--ihefaging_ in a tingle, 4e-43#tilient. The conflict will thoW up not only inthe -reports of the White .416uSe:. Conference,: butalso at hearings r, befOre the tongrest, and in Stateand Tocar. government. These are .the-lcinds ofconsiderations we were trying to get you to thin

-- In the:firit-White 'Honk Conference we Weredivided Over--the-Oegree to which _older 'people:should demandAirthereihOnid be n-stiong_advO-cite --_ of their interests within -government itself0ierything_:-thar_I- learned "from- studies for the

;Workbook from reactionsof the Technical:: Com-mittees --anrFfroM:6 rimMialty_=inrl''State Confer-ences, supported almost unanimously the :ideathar-the-riMe- has come forjGovennthent.-to sup-plf advocacy of the -interests_ -of-the aging. This is pciSition- you may wish to sup-Tort or Iti'question: But the -decision aVto---hdigr-.sttongly-7govertinient is to -advocate the eldeibeSConceal: will have a _ bearing on all of the subte--quentdecisions--that you thake.

There is a general issue facing- the .county-as-to -Whether we are to continue to -centralizedecision-making in Washington,_ with a -copte-tment_inkteate in the_ pOwer of -the central ;govern-

..ment tti=dittribute the wealth- and other resourcesOf the -Nation. One aspect -of this zit the Wayservice for older people is to be provided Shall-there --be,ati increase in the power sarirt_fmictionsof, Sayi,the-Sotial_Socotity--systetk which Is runalmott,withonereferenceto-State-Or local -g-oiern,menu- ormongovenunental. agencies? Or, -on- theOther hand, Should: there- be 'devolution" with-many more resources being placed in the handsof--organizations that can inunediarely get -feed-back =Which shows them- Audi are and whichare not successful programs?

_1n-the research I did, I found very widespread

81

-approval of. Title -111-_prograMs_ which are run-by, State-agenties, _though there waS a _great. dealOf complaint, Mo. You will again need M.iecog-nize_ that many other -Sections of -the- Conferencewill be making -_-recommendations on this issue,and in the ,Post-conference- era- you will -have: totake their support or antagonism to.-yOur-position-into acrOunt.

-PerhapsI ha-fie:said enough -about-the, com-plexity Of' the problems Wefate.:-Ii-_:haS:been thegenius of the Americio,systerri- that over-come odds. In spite of the lackof -ra-map or --blueprint,, I :atti-7inie.:that -you willhelp, find _ a way to get from Where- we are to-iiiiefesvi--want. to go.-

'the-19'71.- White -ilonse-COnference -On Aging_has been diVidedinto-14 Sections, 95 Subsections,and several Special Concerns Sessions, all ton-Sideting-a-staggerititirtaq'OUtirOblerhs:aniLneediof our Nation's older population. Whatever theirdecisions, _ and/or :proposals, _

they rultimately euir become the concern and-responsibility of the -Section-- Oti.GoVerninent-andNongovernment Organization, . if they-_ are to beiinpkuiented.

-Thi Sëcozi:;iecognizesthat the -problems- of_the -aging, are statewide andr: nationwide; theyrequire multiple solutions, they must -first havelocal identification, they cannot- and will not beMet- successfully without the involvement -of all-government and nOrigoverrinient- agencies -con,ternertviith7the aging; they -clenand-a- coopetatiVe,correlated approach *kith= extends needed servicestO=ail older-persons; and_ they-must-13e underWrit-ton-'beyond,Speeches, proposals and laws, by corn-mitinents of ManpOwer and sufficient funds.

Further, this Section recognizes that both-gov-ernmental and nongovernmental agencies- must.iet, as advocates' for the elderly -,and- be held ac-countable kith lor what they do and for whatthey do not do, to- advance the interest Of olderpeople.

Whatever organizational patterns are estab-lished and/or modified must now include focal

I.

pointt-of-authority :and responsibility_ateach levelof government:

Finally; this Section_ =introduces- -its _own pro -posals -with the recognition that society has grown,so increasingly- complex and interdependent -noindividuakl person_ and no individual-lagency canprovide -for- the need_ s, Of peOple'through-pendent efforts. The time has come--to =develop,.support, and enhance an-, improved and -itrength=erred moving organizational forte Whic will lead'to strong - reforms- .and a_ction-'whereby every

.older person in our land shall:-be privileged toiife in decenty antr-With _a sense'

of _personal _Worth.

RecommendationsRECOMMENDATION= I..Adrotacyby Public and--Volitntary,Agencio

PubliciagenCies shouldbe empowered, anthrolun-tail- agencies encouraged, to -undertake = and /orpursue more vigothusly the -adijocaey of Older

interests,_ -Mote. diteCtcommunication with, and participation -by, theelderly-and/at their- organizations and-the:generalpublic.

RECOMMENDATION II-

Government Organiz'ation- for Aging

At all. levels of gOvenunent,_:a- central office onaging: should be e_ ttablithed- in the OffiCe of theChief -Executive, with responsibility for coordi-nating- all programs and activities 'dealing withthe aging, fostering coordination betWeen govern-mental- -and nongovernmental programs directlyandinditectly engaged in the provision of services;,and ior:planning, monitoring -and eva-luatingserv,ices and programs. Eath- operating departmentshould' establish the post of Assistant Secretary.for Aging. with _responsibility for maximizing:thedepartment's impaCt in relation to- the -needs Ofthe Older perton. A coordinating: council shouldbe established in each central Office of aging tobe chaired by the director of the office, and shouldinclude-the several department assistants on aging.

At the Tederal level, this central office should beimplemented with the authority and funding

levels and full-dine staff -needed to -forMulatcand =administer policy,-1-andthould'"be -assisted:byan advisory council, '_and- should-,be required- toMake._ an acturate-_and-comprehensive -anktiatport on --its- progress -in resolving problems andMeeting _gOals. This -White 'House 'level officethOuld-. have enough -prestige andresources to as,sure, that it will encourage the. development Of-parallel; units- at the State and community levels.

RECOMMENDATION 'III-IntogaiernnientatRelii tionibipu

RelationshipshetWeen_agericiet imaging °arid other=:public agencies-should-be tharacteiized-byfthittitialadjuttmer4S- antL:Cooperation:. at all sgOVerninentatleirelsand- by durable joint .agreernentstpontibility-fot teteatch, CompiebensiVe,:planning;_.and-proyision of" serVites-and shOuldbe-'-bated: -teiponsive- td- olderAmericans_' opinions ,incl'detirei at _thefgtait -roots"leVels._

RECOMMENDATION_qayeimnenitilfzinding_ and Standard Setting

GOvermiaentaltespOnsibility,..particularly fur pro,viding- funds -- and establishing standards, must beemphasizedAt thetieCessatjitaCilities and servicesare to -be, Made available to-older _people; Thedelivery of services shOuld Make itakinium useof Voluntary and ptivate organizations which canmeet the-standards established-by gOierninent inconsultation With consumers and -the providers, ofservice.

RECOMMENDATION VCoordination and Support-Policies

Overall agency activities in aging should beplanned- and organized to provide coordinationand support in both vertical and horizontal di-mensions. Lotal agencies thould,_participatein- theformulation of State plans; State agencies shouldparticipate in the formulation -of comprehensiveplans:and national policies. Such interrelatednessshould include governmental and nongovern-mental organizatiOni, private and voluntary agen-cies, and representatives of the elderly.

82

RECOMMENDATION VIPrivate and Voluntary Efforts

-GOVernment at :should encourage -andfoster the. partitipation of private - enterprise andVoluntary orgariiiations, including, those. whosemembership.- is _drawn --frond .amOrtk: theSuChr-eiforts -10 meet-the 'needs-Aif _peOpleshould. :pilot research :-.and deMonStrationprojects, direct service .proiams,_.,Sell-beip 2.pragrams, -informational;. -educational` and --referralierviceS,:ilariiiiiig Arid' triin prOiraini.

-RECOMMENDATION'APII-Entitlententiftulenikei,

-Basic faCihties and serViCes.ShOuld`_be proVidecLasrights-to. "irhich-.741 Older '.-people'are_-erititied and-the oppotrunitiTto-- Share theie facilities and sere=ices ought` to _be-available_ older :people;

adVeisely:cittniiiiianted :niust:be entitledto- special- consideration.

RECOMMENDATION- VIIIRights of Older People

All efforts-- to Meet the needs _of. -Older =peOplewhetber, goVerninental-Or- private and =voluntary-agencieS,7sh6uld be consittene_With:i (a).- the:FirstAmendment freedoms of association and expres-sion; -(b)---the righutO:participate.iii- goVernment-sponsored--progranit-free-ifrOin- :religious, -racial,ethnic-andage discrimination; -and -(e) protectionof one'siperson- and -prOPerty, particularly in in-stitutional-Settings.

RECOMMENDATION' IXAccountability for Policies on Aging

The integration of governmental àctivities -in thefield of aging_shOuld be -unproved by the Federalagencies, showing greater- appreciation of the _factthat the-- principle of accountability- applies -fromthe Federal _to the State- level; as well as-froth. the

States to the Federal adminisration.- Federal ac,countability to the -StateS shOuld.provide sufficientlead time when Federal policy and administrativechanges are to be announced, as well as priorconsultation regarding changes-in appropriations.Federal agencies also should improve their corm.

.thtinieation: with State-units on =aging to ;provideadvance- of direct' Federal -giants to

_ -

individuali organizations and agencies;

-RECOMMENDATION

-SpOritConisisittee, on- Aging=

ial-coniniittee the -aging4hould ,:be ~et=House -Of Repfe

sentatives, functioning in 'At coinpaiahle-lole tothat of the .United 'States-"Senate Special Corn-

RECOMMENDATION' XI:iteorileringAlatiottarPrioritils:

National priorities= must :he-Atorderecl-iio,.ai,APotate:a..ijreater,-Shati-of onr'Vation's-.resourcesto-Meetthe rip* otitsfoldef-ddios:

RECOMMENDATION XIIPoi-Confetinie_ Action

-Means, should' be- fonnd =for a continuing "Con-fere-nee"- on:the_ aging to aid --in= the -"follow -up- ofthe -recthrithendations,ol_this--tniie--lion.Se-COn-feience on Aging, WhiCh-- also-- :WM] Id- &tend be=

lond the announced ftAlow,op=year.of 1972 andeven-Until the next- White:HOUse:-.COnferenCe onAging.

83

SECTION LEADERSHIPsp;ice will permit lilting of title .and ad:drat only the firo time a name dppqrs.

Tech_ tii41 Conunittet for GoVernmentand NotigoVqnment OrganizationChairman

W. Fred Cottrell; ,Professor, Departments of-Political Scienceand Sociology, and Director, Siripps-FoundatiOn for Population Research, Miami University; 03tford, Ohio'

COnsultants

William D. Bechill,,Chairman, Social Administration COneen.tration, School of Social Work, University of Maryland,Baltimore, Maryland

Ewald W. Busse, Executive Chairman and Professor of .Psy-chiatry, Duke University Medical. Center, Durham, MirthCarolina

-Members

John- H. -Billard.--Executive_birei-tol, Welfare Council -ofMetropolitan (4,410,-.aaialso, IllinoisFrederic H. Barth, President Philadelphia College Ogee--pithic Medicine, Philidelphiii PennsylvaniaRobert Neil bider, Psychiatrist, Washingttiti;-D.,,C.Steven 60, President, Maivel Enterprises, San Francisco,

Fred- Faassen,. President, A*eikair Association Of .RetiredPe_rsons,

Herbert. -Miller, Fedeialt Mint Counselin, Wishington,

iird-T:Surgeon;_ Fort.Ladder :dale, Florida

Anhui -HE ;MO-ley, Pres-idol-4 'Parade Puhlishitit ComPiny,I nc.-,-.IsIeW Yoik;NeVt- TO&

James 14. Nabnt, Former President, Howard -University.r-

Itoberr,-PriCe,.'Preiident, Price ,Capital Corporation ;- ;Nei!,

drains-1 .Schadliand, :President, BrandeiS University -Mil.thetzi,:Maisithirsidts-

Irene K. Thresher, .-.Prilident,,- Brevard County Council onAging -COcoe:Beatli;;FlotidaJosephus Younger; Superintendent. of Mails State Depict-nient.-Of- Agrictilture-Oklihomi- City; Oklahoma

The Secretariat

154fcm-Alfred E. Dundier Technical Stiff Assistant, White /louseCtififereri..t Agini,_ Washington,=D:. C

_ -

SteinhartJohn Doyle, _:Planiiiiig Specildiii--in_Aging, Older AmericansServices Division, Administration_cin,Aging, Soda! add Reha-bilitatiOnService;.Departnient of Health, Education, and- Wel-fare,-Washington, D. C.

John _Guy Miller, Stiff- Director; Senate SpeCial.On's-nine on Agin, Washington, D. CIdwience Miller,. AJthiflistratie Officer, Executive Office,Community Services. Adini-nistration, Social and -Rehabilita-tion lervice-Deparinient- Of Health, Education, and- Welfare,Washington, D. C.Charles Odell, Depink Assothite ifinPowerfAdthinittratin forU.S. Training and -Em-plciyment Service, Manpower Adininis-.trationrDepartment of Labor, WaShington, D. C.William E. 0001, ,Staff-birector; Senate Special Committeeon Aging, Washington, D. C.Nancy Tide, Program Analyst, Office of Program Review,Office of Economic Opportunity; Washington, D. C.Cleonice Tavani, Older Persons Coordinator, Office ofEconomic Opportunity, Washington, D. C.

Section OfficersCo-Chairmen-Timothy W. Costello, Deputy Mayor-CityNew York New YorkW. Fred Cottrell-

Administrator,

Consultants

William=D-Beehill and Ewild W.,Bussi

-Recorder

Lloyd- W. fialioribisi Director of Membership Services, .

American Adociation. Of -Homes-for-the Aging, Washington,D._ C.

Anistant Recorder-Priee,,Associite-*Regionaltoininissioner for Aging,

Social .-aad, Rehabilitation Service, ;Detriment -of- -Health,EdUcition, and Welfire;:.Philidelphii,',',Pennsyliania

Management;Ofiter--:. .

Aifred.E.,Oundrir,

S-Obiection- Officers

-Sirldectixi -

chaunianCernoria D Johnson, Directid, -3-Washington Bureau, National

ice 'Millman§tOleTY SilVeni,-Engineei,,tfiliii, -Florida,

Rector-din-leierind 'Janke. G. -Ben*, ,Dirittor, Opportini it*-Prog,rani..forthe Elderly, -}ItininillerAlahnid

SubsettiOn .2.thaininitClinton -Mellor, R ither,ElgiO, ArizonaNike ChailininJitdie"-Williim A./Ansonia'

Reander-John- if. Ballard

Subseciiidi -3

Chairman-Allan:H. Wane,- Chairman, Task -Forte on Aging, GreaterIndianapOlia-Progress . Conisiiihee,_ Indianapolis, Indiana

Vite-CheinnanLeslie Newcomb, Executive Director, Southern .MississippiPlanning and -DeveloPment District, Hattiesburg, MississippiReanderIrene K. Thresher

Subsection 4..-

Chairman .

Alvin A.-Burger, _Retired "Executive Director, Texas Researchleague,. Austin, Texas

Vice ChairmanRobert B. Robinson, Executive Director, Division of Servicesfor the-Aging, State Department, of Social Services, Denver,Colorado

RecorderHarlan Logan, Former Edited of life, Meriden, New Hamp-shire

Subsection 5ChairmanJack Leff, Executive Director, Council of Elders; Malden,Massachtuetta

84

Honeycutt, Jr., City Court, Kansas City,

a.

Vice ChairmanThoniii Gardner, Special Assistant to the Governor , ,Olympia'Washington

keeorderVadirSheid, State 1:epresentatiire, Mountain HOme ArkintaiAsiistint RecorderFerti,,Pence;Supervisoi, Division of Family-Services; -15epaCt-tnentf Of.:Meatay,Heilth and Rehabilitation`, Services, Jackson=ville,

Sub-section 6.thaitinin-Anne- j. Berier; Member Hawaii toinniiniaa -On Agiag,-Honaluln,,H1WaiiVice

Weeks;- Attorney; Coluiset MassachusettsRecords'Ànon, ,Brown MiyOr's- quiiniisiion-,Agingicleieliad, Ohio

Pederalite*St#0, Personnel.Delbrali .Cooke, S,:Creinit .Offici; of DegC:iiietitofHousing=and' UrbanDevelOPinent;_-Washingron,. IV_John-MoyleJessie Gertnazn,..Deputy, Director, =of ..Office,of- Planning, Reiearth, and Triining; SocialnudiRehabilitationSerVicei, Department of: `Health; Education; and- -Welfare,.Washington,

'Robin .Hemphill,- Management- Analyst, :Office of the teue-tity;,Depiriment of Health, Education; and Welfare; "Wash-Ingtok;-D:-C.

-Ceril.-Hoitimini Assistant -to'Ithe Assistant :SeCretary forPrograni Deirelopnient,' Department 'of_ the' Inierioi, Washing-c..

-Wtine Kong, sSiStant,:13rOfeiso' Oeparttneni- of SoCialWork, and Rehabilitatkin;- Federal City _College, 'Washingnin,D. C: -. , _ _.

85

,DonaldAindiy, F.cOnomitt, -*tread' of-Libor be-of=' Labor, Washington; D.Phu GOY- MillerWilliam j...Nor .Administration on-

.Sociaf_ incl : Rehabilitation', SeriiCe, - Department- ofHealth', Education, ma- Welfare, -Washitignin,;D:'C

Willi** E. O_rioL

Directo -Of Resourcelkiliiation;.:O:fiCe_ CoMiiiiinity,:DelieloPifietii; 'DePartMent _of-Hotilink llibitir-DeirelOPmeiteirWiihingroni- D. C..Sol Sherman; Secrion,ithief;;:DiviciOn of _Stine Operations,Bureau: of,:Health Insurance; Social -Stkiirityz,Depiiiiinetie, :He-14h, '.Eduattii* Baltimore;'Maryland..

-Eleanor. Tompkins, Program Analyst Trainee: Older_ Amer-AdthitiiitritiOn Aguig; Side and-

Rehibiliratione,Servite;,DePiiiiiiiiiii of -Health, Edurinion.4.1idg

Odessa:MC*44- CdraniitilitY,Action--Program--Specielist; OlderPersons:Divisioti,,,Office;Ofi-Èintiomit Opportunity, Wishing-

_ - -

INOcolIcznoNTtotat,of164-'-Delegateg WO. named` -̀,tothe :SeCtion 04 ;Planning: Information

nomination:, forms.. ihdicateS.shat ,some 15 = percent, Were-

retired; anci.ltpertehiWere-metnbers-Of Minoritygroups:

TheThen participants in _the- Planning .Settion'repre-.sentett.a *We: range-of ,otfoleSSional,_ancilteChnittal-ocCUpations. AppinkiMately,One-sixth: of,,gates` .held _OoikinS associatedthe -field or Planning.. Attong- them- we-re--11101114berg of community -=and -State--,planning,',COUtitilg;,

SpecialiSts::itt!prOgrath.tleVelopmen(and.CoOrdirta7,don; directors: of areaWide-._Planning -*gratis,

ettiplOyed-.irrAfie, areaof services- and research, developmentconsultants, anct,profesgois-of communityaffairg;:and_ social- :Welfare. tecauSe_ of its technicalknowledge and:Operience, 'thisgroup Was..4.rell-prepared ; guide discussion totvard = the ceVelop-nierit and fornailation of recommendations toachieve- long -range CbiriptehenSive planning. inthe field of aging;

Other ,participants in the Section Were leadersof senior cit4en... groups, -State representatives,social Workers; attorneys,_ professorS, gerOntolo-giSts,_ executives repregenting,State and local -gov-ernmental units, anclelderlY persons themSelves.

The Section on Planning adopted- 12 recom-mendations, The recommendations -call for actionwhich Will focus responsibilityfor planning atall levels, of the public and _private sectors, aswell-ag -provide for the coordination of planning

TION ONPLANNING

87

attivirle -golo4a.s4,iF.EiliCeci, on the.importance-OVgiVing=ipecialCOniideratiOn,fo. theprobleinSs of racial and inOritie*= /plati

serve-- the .older. population:. -Underlying; theSerecommendations insistence that plan-

iinilergirded .=byf COMPrehensiVe:' research andprofessional tfairiing Piogr**, a. Vital'.:merit-,for aetigiOnsthat -*ill have lasting and significant benefit forthe

REPORT,SECTION 'poRTPreamble:-

-Many:AineriCatiSIOVe ;f0Und, their -later years_ro be:,- a dine. of new opportunity,-fulfillment andgrowth 'it is:the :kielief.- ofthe :Settionrorf-Planningthat thorOiigh ,and sound :planning in aging ismost important -old- 4,0 for most4theriCans is to beCothe a reality.

'inahning in_ aging is a. protess. through WhiChour - society must determine those: stepS tobe takenin achieving the :goals; 'oa::,objectives of hOrh

-614er. persOns- andr-stliose :who will one Cky- beelderly. Planning, for the, future is the -real meansof -changing the conditiOns of old:_age for thebetter: Plannitw. 'botir.the forMingof goals. and a.-.'weighing of the advantages- anddisadvantages 'of any plan -of action. Good plan-ning -sequires knowledge of needs, resources andpriorities. Infoririation_ baSed- oil solid researchis a basic tool-iivgOod`platining.

Too_much of our planning for agiiig has beenon a short-range batis==going froth crisis tocrisis. While some movement toviarchlon,glangeplanning has been made by a number Of bOth

goverilMental and:priliate4ronpS,--inany, feet. that-Short-terdc_patchWork --planning' has- characterizedplanning: efforts:

Planning, which aims it the Tong -range -needs,of the elderly arid' attempts to -lOok into the-future to anticipate -needi' which" Mak-arise inyears --toy come; 'it' needed: Many of the needsof our _present older citizens will be:the-sairie_ asthe needs of Am who are "nowtivh6 they ate- older, some ,neects-may 'be, differ-ent Great social- changes;. which may take yeari,to accomplish, may be" needed. OVer-,croading,POPUlationgrOaiih,-,etiliirOnMental,-Cdti-

arict.iotviil, :government,the lessened, ability, of an citizen toplan for the future' thakei,:piatining; needed-today, tomorrow;, anti-:for -yeark,',:to,Cotie:;

4:014niiing-,,iritist not ,be_tOntd.Sed,;viitlidelayi ;Itnever -be.-used as an:- excuse for

We.-must _understand =that '.action-:noi-e is notcontrary to the -need' for long -rangeInstead,. the --fun& Spent -Ori meanthat the - programs which are developed are'tnean-ingful; well thoughtout, and truly effective. MOre;rather tharrless, -time .andinoney- may = be needed ;.

Our Nation_is constantly-setting,goals 'for,itselfin all-areas of national- 'Concern. In-,the rfield- ofaging. as in-other -areai.of COnceini:the,priOritieiwhith: we as a Nation -set, are most mportant.Indeed, the very place_ that we giit to the needsof our present older citizens- will' be ,the same asdeterthinett by the action -We ,take now Planningwithodt_ action Would- .be.,a,crUel- hoax. _Action-without planning would be.an- apensive exercise.

*f. The following policy proposals -repretentfeelings and attitudes of Delegates representingall sections of AMerica.:Eideily -Americans, plan=ners, Citizens: involved in 'both- the _planning anddeliVery. of Services, to the elderlY- were 'rePre-sewed in each Section of the Conference. Plan-ning to identify and state-the needs of the elderly,planning- to develop _Methods of meeting _thoseneeds, planning to -finct the Means- -to generateSuppOrt and-galvanize-the Nation- actiou- -eachstep of the way needs,clear guidelintS. The policypropOsals herein may assist in finding our way.

88

,RetOtiMiclulltio:tts

RECOMMENDATIONTGovernmental Pkitin in-Aging

To be reSpOnsive; planning:_MuSt involve inputsfrom many segments and":-Sectors ,off,Our society:To-;be.effetti*e,,,this: planning-inust -be compretie istit.--an& COordinated; -The iplatinning efforts -ofgovernment =should- dintinue. to -constitut thebasiC Mei nS f.throdgh:' Whien7ihe_ Nation ;,plaaging. *e. must recommend that goVerrithentall- = levels -lie regtdred it?-_proycjide opportunityfor signikint the tio0oyern=

sector and: consumers' in the deCiSion-.MakingAiroteSS,

ItECOMKIENOATtOST 'It 1Ait :Picea-Jaw office:, on: Aging

A separate.,entity- should' be 'created theExecutive-office-,-61 'the President through Jegis,_lation and :charged' with the-;ieSponSibility_ forcomprehensive planning: and ad*oticy- in aging.

This entity_ShOuldrhaile.'resbdices -(e.g., authority,funds; staff). adequate to. meet thil:respensibility.The Adthinistratioir Ori :Aging Aoul& be- retained=Within the,Pepartinenttif.Health,_Fdticationi andWelfare,- htitit-.019-0111-:6e- raised to the ,statds ofan independent, agency within the pepartMent,

-reporting.- directly the .Secretary:-

There should: be an interdepartmental committeeWith-:-representation:,_ at the-: Secretarial level= to be

-chaired= 4 the senior Federal ,official -on -aging.

RECOMMENDATIONPlanning--Unitrin Aging

There _Was -recogriltiorr of the urgent need' for acommitment- within- each State government toprovide conaprehentNe -planning in aging.

It:is-recommended-that _this (build beat be realizedby- the establishment of a separate entity dedicatedto comprehensive_ planning in aging within eachState gOsiernment.

The leadership planning mechanism at State andlocal levels'should, to the extent posiible, parallel

V./

the, mechanism at the Federal leyel. Where :ap-propriate, Stich:planning at- the local should,be undertaken on a.-Iegional, multi-countY-basis.

CornprehentiVe_ planning at the local level shouldbe encouraged, but the ineChanism left to- focaloption. This .effort should eMbraCe a:partnershipbetween_ the governmental and voluntary sectorsof our SciCiety:

RECOMMENDATION: IV .

,Tecbasical AsiinanceforNon4tatelnriiiikdons

Adequate technical=aisistatice-.and Consultationplanning,for, meeting the needsof the ,elderlYshall be provided, possessions and:other. -nOnstateiurisdictions Of- the:Vnited States;

*ECONIWNDATION-Coordinated -Conkrebeniive;Planning-

PlannifitiCtivities- in aging:of, the three levels ofgovernMent shOuld be -related ',,tO each-other, andplanning- -at -- State and local levels should .receitio

- -financialsupport frOM the-'Federal- government.

In order_ to insure, that. comprehensiveplanning functions- at :State and, national' levels-are meaningful: nd "effective,' - priorities :and ierV!ice needs -should -be identified-, at the local level.Federal -hinds should be -provided' for -local -plan-ning in aging- and be channeled -through State

-units On-aging which in turn will alloCate-fundSto regional-,and local planning .bodies -for thispurpose.

Federal- agencieS should be directed to assure thatany Federal planning-grants -Which have iinpliei-dons for human services, whether made to Statesor localities,, -Shalt require specific planning, forthe special -needs of the aging. During- all plan-ning stages; die development of the plan shallbe coordinated-with the State agency on aging.

There should be basic mechaniSms-esfablished to

A minority report Med upon a vote of 37.32 on this paragraph provided for conclusion- of the paragraph as follows:"planning agencies at all levels must be responsive to needsand priorities identified at the local level. In general, Federalfunds should be provided for local planning in aging andchanneled through State-units on aging, which in turn willallocate funds to regional and local planning bodies."

provide coordination of. _Nanning: activities_ .10aging at-all three levels of_ gciverninent: and acrossdepartment lines: TheSe should- regiona!forums ,organiied't;y: the. Federal Regional* Coun,

and' systematic Federal and State-evaluationof planning:in

In order-to-allow. maxiMum-fieicibilitY at the_Stateand 10'61 levels for innovation, :Federal fundsin.the-forni of 'grants without ,restrictiOn shouldbe. set aside for4ong-terin-planning in aging.

RECOMMENDATION' VI.mq04;$er-Pici,Peograilis-AforeResporyive

.

The-platining mechanisms that been,detret--,oped- coninitinitiei ,and. ,it the State and_ . na-tionaf:letrels:Should":increase_their- efforts .to, makemnitigenerationaJ_ -prograini, and; 'services: morerespOnSiVe to the concerns -Of _ Orions and=m ore effective = in 7:Meeting their, OeedS. 'In, instancesin -which inidtigenerational3progranis and services,Cannotbe ,Made. responsive enough to -Meet theneeds of older persons,_ new -Or expanded- pro--grams :planned -specially for the eldeily ShOuldbe- developed:

89

RECOMMENDATIONCriteria-forPkinning,Stafflor Aging

Planning -.inaging- should be based upon experi-eriC'e -and*-_expertise of professional -and .parapio-feSsional- personnel and specialists in -aging withthe-total involvement-oivan-early and continuousbasis of a majoritrrepresentation-Of the elderly,including-racialf and edinic ritinOrity _groups. Thisinvolvement should be guaranteed in- cilfning for:,,the elderly at- the -Federal, Saxe andlocal levels._ Age-alone should not be the rulingfactor -in- =planning; -thus, Middle-aged and youngpersons shouldbe included.

,RECOMMENDATION VIIIElderly under Revenue Staring

The Section expressed grave concern about howthe elderly might fare under revenue sharingarrangements. However, if Federal revenue shar=ing is enacted, enabling legislation should providefor protection of the interests of the elderly.

--RECOMMENDATION_ IXPrioritiii for Minority

Racial and ethnic discrimination and ica-attendantconsequences have condemned- substantial ,num-bets of -minority elderly-to loiv. levelS -of income

-.and inadequite'health and-hOusing prOvisions: Toooften, these minority grOnps,of the-elderly havenot had the resources or capacity -to stand up:fortheir- rights; nor have governmental agencies- andcitizens' organizations.. adequately terVed-iiidy0=cates for them. Therefore,_ planning ',for _agingMust- take priority -cogni4:,Mte of:the- aboVe--ijroh:lems and ieek-ro correct-,ind_eliminatethetn!.While we_inutt-improve- the quality_ of ;life for -allthe-404; our top priority _Must ;-ge to those--Whosuffer. Most..Ainerici-miiit_ addresiAtself first tothe needs of the elderly poor.-

RECOMMENDATION X_

ReltiOnsiklitx_Atanintabiliti,_-12erponsivenosIf- planning is to be more than an- exercise inrhetork, it= isiinpetative that there be ippropiiate,authority, responsibility_ and accountability;, and-that there be linking those who:plait:pro-grams, those Who- administer_ programs,_ and theconsumer. To these- ends-we-reCoMinerid---thit:

The -Federal plinninglqganization Must- an-nually review and publicly- report on its _pro-posals;

The 'Federal, planning organization -shall re-view propoied_ legislation and executive-activi=,ties to evaluite their-potsible effects- upOn thestatus of elderly --persons;

Administrative agenciei. annually evaluateand report on the effectiveness- of theit pro-grams;

Federal agencies be empowered to take stepsto insure that Federal programs adinitiisteredat the Stare and local ley& are in conformitywith .stated guidelines and objectives of pro,grams;

A minority report based upon a vote of ,22.19 on thisparagraph provides for deletion of the sentence: -Therefore,planning ... and eliminate them." and inclusion of a substitutesentence reading: 'Therefore, planning for aging must takespecial cognizance of institutionalized prejudice'

All planning should include the use of exist-ing private resources, body proprietary and non-profit.

-RECOMMENDATION XIPlanning-:and the Budgetary-Process

Planning:should be -linked' to the budget-processand, therefore, we recommend that copy ofthe planning and:priority-strategies, for the- elder-lybe submitted to the elected andexectuive publicofficials- who-have -a- direct -role in the_budgetingand appropriations processes. -

RECOMMENDATION -XIIReoidtiiitgcNittiOtatPribritiu-In- the Anal=arialysis,,planiting in behalf ofstems -from_ the :batic values society, those -val.

-ate_ translated. into -goals, objectiVis indtiesAs. planning- for agingliroceedsi it !be.neCessarylo -address these Vilues- and priorities.In Tplanning:-the=.illoCation of resOurces,:*e 'urgethat the aging .receive a _fair shire of nationalwealth: Thit -should-r.he accomplished through_ areordering_ of priorities at -all leVelt to -increasethe commitment of-_national resources- to--Meethunian needs.

90

SECTION LEADERSHIPSPIN* will point= listing of title aiddress; only the first time a teams *Mars

The-Technical Committeefor PlanningChairmanWilliim L. Rutherford,

Administrative Vice President, Po=Park Foultdation, Peoria,- IllinoisConitiliantEone Harger, formeriiirector, New Jersey Divisionòn Aging,Annandale, New Jersey

MembersAlbert J. Abrahams, Secretary, State of New York Senate,Albany. New YorkWinans R. Ewald, Jr., Development Consultant, Washing-ton, D. C.Robert .D. raptly, Jr., Assistant Director, The Center forAdvanced Study in organization Science, eniville, WisconsinE. Corinne B. Gilvin, Associate Professor of Sociology, IthacaCollege, -Ithaca, New YorkLloyd R. JoIsnion, President, Whitehall Convalescent Homes,Inc., Ypsilanti, MichiganGuy R. Juana, Public Welfare Administrator, Americanlac Welfare Association, Chicago, Illinois

1

Donald P. Kea; Chairman, Department of Sociology andAndiro *on, Pennsylvania State University, University Park.Pennsylvania

John C. McKintiey, Professor of Sociology, Duke University,Durham, North Carolina

Paul 6, Van Buskirk, Lecturer -and Coordinator, Urban En-vironmental Studies Program, RennselaeuPolytechnk Institute,Troy, New York

The SecretariatDirector*eon D. Gold, Director, Division of Program and Legis-lative Analysis; Administration on Aging, Social and Re-habilitation Service, Department of Health, Education, andWelfare; Washington, D. C.MembersSharon L. House, grief,, -State Agency.- Operations Branch,Older American Services -Achn anima tioti , on .7- Aging,Social Aid-Rehabilitation Silvice, Department of Heskh,l Edu-cation, and Melfare,--Washington, D. C.Mart, E. Laid, Program Development Specialist;:oftice ofManagement,-- Of of the Secretary,. Department of Health,Education; and Welfare, WaAington, 'D.-- C

-Richard' L "Schulie, -Urban Anaiyir, Spicier Research-4nd'.Demonstration -Projects-1Division, Healtli-lervice, 'De-mean* of Health, Education, -And_ Welfair., -Washington,

Cleoake Tivani,"_Older Persons _Coordinator, Ofsank- Opportunity, -Washingtoti;-_ =C.

Daniel _ A. Whalen, cStudent-Assistant, GirontolOgy TrainingProgram, University of Minnesota, Minneapolis, -Miwnesixa_

Section OfficersCoCheirmenElias S.- Cohen,- ASSistinc Profess-or ot' Social = Administrition,School-,61-Medicine,,Univitfity of Pennsylvania,-Philadelphia,-PantiO,ania.-and L.- RutherfordCounties*lione-Nigger

-ltecorderSeanky_ IL- Smith, Dean, Fisk University, Nashville, Ten_ nesiee

Animist_ Rik:cederInnis Levitz, Assiltazt to the ssociate- Regional C.onu.sis-skitter for, Aging, Social-and nabilitation Service, U.S. De--panrk ment Of Health, Education, and Welfare, New York, NewYo

WAottinewat Of6cerBYron-D.-Gold

Subsection OfficersSubsection 1ChairmenRobert Medias, Executive Director, Los Angeles County De-putinent of Senior Citizens Affairs, Ins Angeles, CaliforniaVice ChairmanElisabeth K. Lincoln, Director, State Council on Aging,Concord, New HampshireRecorderHarold Schneiderman, Associate Professor, School of SocialWork, Ohio State University, Columbus, Ohio

Subeectioa 2ChairmenDew* 1 ; Holcomb, &calico Specialist-Gerontology, Agri-cultural Extension Service, University of Arkansas, Little Rock,Arkaniss

Vice 'ChairmanHinvartL-Bloisenquist, Management Service Associates, Inc.,Auitin, Texas

RecirdetNathaniel Brooks, Director,= Division of Health, Education,and Community Services, New DetivicInc., Detroit, Michigan

Subsection:3Chile:ma

V. Robeir Payout, District judge, Iron Mountain,

Vice dais:manLloyd ItjohisineRecorderZola A. Ernest, Professor and- Pro)act Director on AgingGnmblineCtillege, Grumbling; Louisiana

itsbeection4Cbairiens.Connie Laws, Acting Project Coordinator, Ariawide Model,,Healtb, Welfare, Recreation-Planning Countil, :Norfolk, Vie-

-Vita ChairmanSchein W.,,Mtirphy, Assistant- Editor., Senior Citizens News,National Council of Senior- Citizens, WishitigtOn, D. C.Riaidet,Philip stitasaineis-State Agency-Staff. Michigan-Commissioa_ os,A,gisg, Lansing,. Michigan

Federal, Resource PersonnelHelen t _Burr, COnakihant,-Office of Services- to the Aged,_Deputessent of -Human Resources, Washington, D. C.Sbaies _Holiesiseis A. Kelley, ,Iseislativeltefereace Analyst, Division of

and Legislative Analysis, Administration on Aging,.sad Rehabilitation Service, Depatunenr of Health, r;dis

cation, and,Welfate, Washington, D. =C.Lawreace Lewin, C.Onsultint, Committee on Aging, DomenicCouncil,'OSte of the President, Washington, D. C.Maly :11i Los&Fraalrlia D; -Marks, Adnsinistritive Assistant, Division ofAdrignistrition, Administration on Aging, Social and Re'whebiliaistetatiOr4astlerriceisisto,n,Depact Citment of Health, FrlucatiOn, and

Daibuis:11. Moffett, Mansectvot Intern, Bureau of HigherEducation,-Office of Education,-Department of' Health, Edo-wimps-sad Welfare, Washington, 1); C.Donald P. -Reilly, Deputy Administrator, -PriorityProgrises, Social and Sesvice,- IDeperuneni ofHealth ,- Education, and Welfare, Washington, D. CIllaabedi-D. Shield*. Secretary, Diiision of Program andLegislative Analysis, -Administration on Aging, Social andWRelerfbijeatii:shrigivtonice: -DDepartm. ent of Health, Education, and

Richard_ L SchulzeEileen Stowe, Social Science Analyst, Program, Statistics.and Data Sfitems, National Center for Social Statistics, De-

c of_ Education, and Welfare, Washington,numDaniel A.11Visalen

. 91

445201 0 - 73 7

-r;

L.

3

RESEARC

INTRODUCTION

SECTION ON

AND DEMONSTRATION

;ging; it:-,One.cirtMriStarice- *hich.:affeateverY':indiyidnaLaritt.grOWing-old4ilf13e-the fate -of,,alt,-_"thote..4i3riVilegea_JO,

-N= =live at-100g se-Von: or -More- decades:hi view .,of 'chit- universality of the aging:proceStantl,the certainty of _its eventual Ontcoine; _ it is "Mr,-priSing, that a, major research_ effort p ferret out itsnature -and its personal and societal, COnteqiienCethas not 'been made =a national pritirity. ItiSteaci;

edeial: support for research-on _aging...has beenrelatively. minimal in comparison t9-thar-ptovidedfor .conditions to which only-- a -limited segmentof the4:optilation will succumb.,Most.of-the fundshave .beeh, allotted , to medical and health-related-stUdiet,,While-suPport for the social- behavioral and-biOlogi,Cal ,components' of aging lias 'been -veryminimal" indeed. Under these circumstances, re-Search-, scientists= have not generally -eleeted to_invest :their time and- skills in investigations ce--lated -to

4t,is knowledge of these facts whichis.the eight recommendations -formulated by the

SectiOn on. Research. Among the 93 .Delegares,namecfle:the Section were representatiVei3Of theseveral- gerontological research centers and: indi,Vidual investigators from-fattilties of universitiesand - independent research organizations. Thus, theSection paiticipants were well qualified for formu-lating -a set Of consistent research policies whiCh,

:if adequately .funded, would significantly increaseOur knowledge and control of the aging process,andiat the same time could guide social action to

93

*die- the- p-reserVation of- .a -meaningful way oflife, throughout age.

._ _SECTION-REPORTRitgitlbk.

-cope with -the : problems of ',older personswe ,mnst understand- the nature of_ the difficultiesthey face, as. well as the nature of the aging processin itsovariUs- biological= andsocial-behavioral di-mensions. Research, deinonstration; and _evalua-tion- are bitic-_-tbols by Which -a society- producesthe knowledge_ii_requirei to deal, With-the ,prob-leins of its :people and to improve the quality ofindividual

-Industry- has long recognized the .importanceof research and has typically allocated froin-.twoto tenpercent of its industrial" operating budgetsto -research and develOpment.. governmentalprograMS, just as in industry, research-, is-,required.to -achieve accountabilitYi. costfeffiCietitY, in quality,and control. To ,achieVe these, Objec-dyes, substantial. research isnecessary, in agingas in other areas,..Yet government researclt'in theaging- area remains- at in inipoverithed

The principal reasons for this:critical state ofaffairs appear to be:

A long history Of governmental andso-cietal neglect of its responsibility toward theelderly.

An inadequate levelof funding for im-mediate and long-range programs to improvethe quality of life for older Americans.

---,An inadequate administrative structure toadvocate, coordinate, implement, and admin-ister ;research prograins involving aging andthe aged.

Recognizing this pin neglect and. urgent cur-rent needs, we- affirm that the time -hat -come to'accelerate research efforts aimed at understand-ing -the basic process 01 aging and :alletiatirigthe suffering of- 'those who =encounter difficultyin adapting to this-- phase of life. For the aboiereasont, the total - .Federal research and -deinon=stration expenditure on pioblomt of the agingmust be increased. -Research -and demonstration.serve a role, and we ad_Vocate -a greatlyexpanded funding..base for-th -- piirpOte.important is .the development=of anjroyerall;,irate-grated, Consittent funding ifoingrionittr will. or;mit tne-,-probleint,OL,akingto-be_ addrestedi in a-,

balanced- and coordinated "manner encompassing-both -the biomedical =and sociat-behaViOral- itiencet.We cannot separate the impraVeinent_Ofthequal--.try Of life frOiti the understanding Of the-'bio-medital and "social-behavioral Orig.* of agitg_and-theaging process. in -additiOn, diereibuitVisitiOn- for theoretiCaL research Whith- will pie=pare us foi-aging in the future:

Research .and demonstration on _problems ofthe aged must -take into account the fact thatsignificant differences in -aging -prOcestis existwithitiran -individual, between individuals of- thetame- age, and between various _aged groups. Weshould` give SpeCial consideration to the unmetneeds-of older ArneriCans who belong_to minority

. groupsrand *dote with specialproblems, eg:,. theimpoverished, the rural; the isolated; and- Thementally- ill. Retired technical and- scientific per-sonnel -should be utilized in research. -Whilewomen are not a numerical minority, they areunderrepresented in high -level research and- aca-demie' positions and should begiven representa-tion at decision-making levels in research anddemonstration. .

In an effort to give greater visibility, impact,and opportunity for practical implementation- ofthese research principles, the Delegates to theWhite House Conference on Aging Section onResearch and Demonstration recommend the fol-lowing policy proposals.

RecommendationsRECOMMENDATION IA National Institute of Gerontology

-It is- recommended that a National Institute ofGerontology be established- immediately to sup-port and conduct research -'and training in thebiomedical-and social-behavioral aspects of aging.The Institute -Should' include study sections withequitable representation of the various areas in-volVed in aging-research and training.

_ RECOMMENDATION-on.ieiging

It is -recOMMeOclect -that the ptesident proposeand that the -Congress: create potition."Withinthe:Executive _Branch -With--tuffident:'thpport, and-atithOrityxto-- develop ,and,Coordinate, atall -levetof the -goVerninent; programsfor the aged; in--chiding research and dethonStration programs, andto oversee-their-translation into action.

94

RECOMMENDATION IIIFederal Funding of Researchand TrainingIt is_ recommended that a- major increase in Fed:.eral- :funds- _iesearc.h, research- training, anddemonstration be appropriated and allocated. .4-proliriation general -revenues- for programs inthe interests of older persons should tontain,addi-tionallfundi-aniounting in_ the average M no -lessthan, 35 percent of such expenditures, these ad-,ditional -funds -to be- allocate& for research, dem-onstration, and evaluation. Federal- support ofresearch and _training in separate departments orschools within universities and separate researchagencies should be- continued and Multidiscipli-nary and muiti-inititUtional programs should befostered.

RECOMMENDATION IVFunding Minority Research and Training

It is recommended that funds for research, train-ing for research, and deMonstrations, should beallocated in the aggregate in such a manner that

the above activities (Recommendation -III) rele-vant to aging and the aged in racial and ethnicMinority groups, be funded in an amount-not-lessthan their proportion ofthe total population. At-tention should be given to the recruitment aridtraining of minority group students to /becomecompetent researchers in gerontology. Minoritygroups would include but not be limited to thefollowing: Bladcs, Spanish-language Americans,American Indians, and Aiian-AmericanS.

RECOMMENDATION VRicnritment and Training of Women

High priority should be given- to the recruitment.,and _training of capable women and i-the -repreten-'ration -of -such women in bodies -which_ =have_responsibility for allocatiOn- of training _andsearch- funds.

RECOMMENDATION VIClearinghouse for Research -Findings

The Administration on Aging, -or other appro-priate Clearinghouse, should -be chargedwith andallocated adequate resources for collecting anddiSseminating current research findings in thefield of the aging and for making these findingsrelevant and available to practitiniters.

RECOMMENDATION VIIPrompt Allocation ofAppropriated Federal Funds

Appropriated Federal research, demonstration,and training funds should be apportioned andallocated prOmptly; and programs for which suchfunds are appropriated, whether- intramural orextramural, should be implemented with 'adequatestaff without delay.

RECOMMENDATION VIIIFederally-Funded Demonstrations

More adequate procedures should be developedwithin the Federal Government to assure thecontinued operation and funding of those Federal-ly funded demonstration projects which havebeen proven successful after evaluation.

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SECTION LEADERSHIPSpace will permit listing title and ad-dress only the first -time a name appears.

The Technicil Comthitteefor Research and. Demonstration

-ChaiiinanAlfred M. Lawton,,Intemiit, Bay Pines Veterans Administra-tion Hospital;,Outpatient Clifiie, St. Petersburg, Florida

ConsUliagirJacqtielyne J. Jackson, Assistant -Professor of Medical Soci-ology, Center- for the Study of Aging and Human Develop-ment, Duke University Medical Center, Durham, North Caro-lina

MembersJames-IL_Austin,,Professor and-Mead, Division ollsieuitilogy,.

-University-,of CdoradO Medical:-Ceitter,,Denver, Colorado-

"Miry aD. ,Barnes, NeMber, -Pennsylvania. State Civil "SeriiceCommission, : Pittsburgh, Pennsylvania

Walter M r and Dein` or School_ Of -.SocialSyracuse- yfiik

Harold BrOdY;.-PirofessOr_OrAna---tomy.; State:Univers- ity of-NewYork, School Medicine; -Buffalo, Ne* York

Buigess,, Associate Professor of Political Science,Ohio State University, Columbus, OhioJolui IL Cooper, -Associate Professor of Biology, CentralState University, Wilberforce, OhioVincentj. Cristofalo, Associate Member, Wistar Institute ofAfiatoniy and Biology, Philadelphia, PenniYlVania

'Walter T Lecturer, Brooklyn, New York.Cart Eisdorfer, Professor of Psychiatry and- DifeCtor, Centerfor:the Study- of -Aging-and Huniair-DevelopMein, -Duke Uni,versify- Medical C.enter,.Durham,_Ncirth Carolina

McChesney GaAs% Jr., PrOfessof of Stugery and Physiology,Univeriiry of Texas Medical Blanch, Galveston, TexasLissy F. Jarvik, Psychiatrist II (Research),-New York-StatePsychiatric Institute; Associate- Professor of- Clinical Piychiatry;College- of Physicians and -Surgeoni, Columbia University,New York New YorkBernice L Neugarten, Professor and Chairman, Committeeon 'Marian Development, The University of Chicago, Chicago,Illinois

F. Marott -Sinex, Professor and Chairman, Depirtment ofBiochemistry, Boston University School of Medicine, Boston,Massachuietts

The SecretariatDirectorShirley- P. Bagley, Health Scientist Administrator, AdultDevelopment and Aging Branch, National Institute of ChildHealth and Human Development, National Institutes ofHealth, Public Health Service, Defartment of Health, Educa-tion, and Welfare, Bethesda, Maryland

MembersThomas E. Anderson, Medical Officer, National Institute ofMental Health, Health Service and Mental Health Administra-tion, Public Health Service, Department of Health, Educa-tion, and Welfare, Rockville, Maryland

t

Henry P. Brehm, Chief, Office of Research and Statistics, So-cial Security- Administration, Department of Health, Educa-tion, andWelfaie, Washington, D. C.H. D. Bruner, Assistant Director, Division of Biology andMedicine, Atomic Energy Commission, Washington, D.

Edward Dunne', Special Assistint,-Research and Education_ inMedicine, Veterans Adininistration,. Washington, D. C.-Sharon -Fitz-William, Social- Science Analyst, Office Of Plan-ning, Research, and EViluation, Office- of Econinnic -Oppor-tunity, Washington, D. C.

Evelyn Flook,-Associate Director, National Center for HealthServices Research and Development, Health- Services andMental Health Administration; -Public Health Service,-Depart-went of -Health, Education, and Welfare, -Rockville, Marylandjohn Mehl; Deputy Division Directot, Biological and-MedicalSciences, National Science Foundation, Washington,-1). C.:John- A. Noble,, Special Assistant to the- Commissioner, Re-habilitation Seivices Administration, Social' -and Rehabilitation_Services, Department -of -Health, Education, and Welfare,Washington, Et C.Nathan _ Shock,, Chief, GerontologyAesearch Center, Na-tional -Institute dr-Child ;Health _incl,,Fluinah.-=Deieloninent,Baltithoit City tidnitals; BaltinjOie''Matyland-

btraivin. J. Tives,,Chief;'1:iivision on Aging; Office of 'Research'"and "Demonstration, -Social-arid Alehabilitation -ServiCe;_:DePare-'meat of Health, Education, and Welfaie,:Washinithri;13;

Section OfficersCo-ChairmenRaymond C. -Monts, Professor, School of Soda( Work, Uni-versity of Wisconsin, Madison,_ Wisconsin

Alfred H. LawtonConsultant.Jacquelyrie J. Jackson,RecorderAaron Lipman, Professor,of SociologyMiami, Florida

Assistant RecorderHerman B. Brotman, Assistant toStatistics and Analyils, AdministrationRehabilitation Seriice, Department ofWelfare, Washington, D. C.Management OfficerShirley P. Bagley

, University of Miami,

the Commissioner foron Aging, Social and

Health; Education, and

Subsection OfficersSubsection 1ChairmanArthur S. Adams, Consultant, New England Center for Con-tinuing Education, Durham, New Hampshire

Vice Chairman,kernian T. Blumenthal, Research -Professor of Gerontology,Washington University, Frontenac, MissouriRecorderJohn H;Cdoper, Associate Piofessor of BiolOgy, Central StateUniversity, Wilberforce, Ohio

Subsection 2ChairmanBernard -L Strehler, Professor of Biology, University ofSouthern California, Los-Angeles, CaliforniaVice ChaiimanEleanor Potter, Center Director, Ishpeming Senior Center,Ishpeming, Michigan

likorderMary D. Barnes, Member, Pennsylvania State Civil ServiceCominission, Pittsburgh, Pennsylva-nia

Subsection 3-

Carl 'Eisdorfee,Vice: ChairmanBettrani B. kosi, Chief -of Geriatric -Medicine; Oak ForestHospital;n0ak Forest, IllinoisReeniderKenneth -P: Associate Professor, Graduate Schoolof SoCial -Work, Univeisity of Arkansas, Little Rock, Arkansas

Federal Resource PersonnelThomas E. AnderionReuben Andres:, Deputy Chief, Gerontology Research Center,National Institute of _Child Health and Human Development,National Inititutes of Health, Department of Health, Edticit--tion, and Welfare, Bethesda, MarylandHenry. P. BrehmH. D. Bruner

Dennis Beutan, National Library of Medicine, National In-stitutes of Health, Department of Health, Education, and Wel-fare, Bethesda, MarylandEdward. DunnerEirelyn Flook

Don Gibson, Health Science Administrator, National Insti-tute of Child _Health and _Huinan Development, National In-stitutes of- Health, Departnient of Health,_ Ethication, andWelfare, Bethesda, Maryland

Darlene Levenson, Technical inforination Specialist, ProgramStatistics and Analysis Branch, National Institute of ChildHealth and Hunian Deiftlopment, National Institutes ofHealth, Department of Health, Education, and Welfare,Bethesda, Maryland

Nathan W. ShockMarvin J. Taves

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INTRODUCTION

he SectiOn-on Training; was_cOnceinedwit-the-preparation of :personnel to=work-in service,- research;, andi- teaching,positions -f ity thefield of it was

not concerned-With:the- educatiOn-Of alder peoplethemselves except as they are included= amongthose preparing -for work in aging.

The Delegates to the Section- on Training werewell aware that_ if -the pOlicies and programs be-ing proposed by the other Conference Sectionswere to be iniplemented, therewould be need forthe immediate recruitment and training of newpersonnel at all leveli. And,-cotiOthitantly, therewould- be requited a significant increase in thenumber of educational institutions, offering train-ing in aging. Distission of The Section; therefore,focused on how best -to bring about the necessaryexpansions in manpower and in training oppor-tunities In aging and related fields.

Although the Delegates named to -the Train-ing Section numbered only 111, they includedrepresentatives of practically all the country'smajor research and training centers in aging.These educators, together with the practitionersserving the older population, constituted a groupthat was well qualified to delineate policies re-quired to meet urgent manpower needs, includingthe inservice training of persons already employedin the field of aging.

The Section On Training adopted 12 recom-mendations, but almost all the other ConferenceSections and the Special Concerns Sessions also

SECTION ONTRAINENG

97

gave attention to the .manpower- Shortages andoutlined policies. and- strategies:lot: increasing thenumber and range., of" training- opportunities: inaging :SpeCialeniphasii was placed on Alie:par-tkolar, need for -training; =-Oinot4 personnel toServe the elderlyi of their Own racial or ethrucgroilps.

SECTION REPORTThe Section was called to order by Co-chairman

Hirtnan F_ riedsatn whO introduced the Sectionleaders. He then. called- upon CO,Chairmaii_ Dr.George. Reader to prOVide 'background for thework of the Delegatei over the ensuing three dayperiod.

Dr. Reader reviewed the basic characteristicsof the older segment of the. population and point-ed-out the impliCations of aging in America.1 Hestressed- the fact that if such a large populationgroup is to be.well served, it is necessary to traina large cadre Of technicians and professional work-ers to plan, research and provide the assistanceneeded. The .rapidly expanding -social concernfor older people, and increased Federal, State andlocal support of programs to save them, is result-ing in a manpower shortage which promisee tobe of crisis proportions. For this reason, Dr.Reader emphasized the particular opportunity theDelegates in the Training Section had to propOsepolicies designed to help overcome the manpowershortages.

I See Reader, George G. Implications of Aging in America,Medical News Service: Geriatrics, 1971.

Preamble

Older persons continue to increase in numbers.Their needs have not been met because we havefailed to act. There is, therefore, an immediateurgency to deal with these matters. The resolutionof these significant human problenis requires a. _

large cadre of personnel trained in and committedto the field of aging. What is necessary is thedevelopment of innovative and creative programsto provide training for the _total range of octupations providing services to older persons, and.Specifically for profetsional and scholarly pro-grams preparing people to work in the field- ofaging. As- new - service delivery "systeiris, are de-velOped, ,neW Modei of training ,_and: new types -ofpospiinel required.

In considering the training -requirements _forSerViCe rorlie ofder.pciptilatiOti,_*e are still inind,ful of the that adequate incoine maintenanceand sufficient health care are basic necessities.There is 'a need for a minimum income levelwhich will lift all older peOple out cof poverty.Furthermore, we are also convinced there is pres-ent urgent and massive need for expansion ofprograMs which will provide employment- oppor-tunities for the elderly in constructive activities.

At present there is little training and education.

in the field of aging. During the 1970's the-taskfacing those who are responsible for training isone of substantially increasing the amount oftraining available. While there his been someprogress and there are high quality programs ina few locations, most States, do not have anyappreciable amount of training of any type re-lated to problems of aging.

The need for training exists at different levelsfor many types of persons and for many types of-subject matter. Retired persons, mature adults,students making career choices, volunteers, andmembers of minority groups must be recruitedto -work in aging and trained for this work. Thedecade of the 1970's is the decade in which majorplans for training must be put into effect. Alterna-tives must be evaluated so that the followingdecades will be marked by a notably higher levelof training and consequent improvement of pro-grams for the aged.

Crucial to the national effort to provide trainingat all levels is the development and implementa,tion of programs to train the trainers. Researchnow proVides a base of understanding and learn,

ing which makes it possible to develop meaning-ful, specifically designed programs for furthertraining in aging.

The following are' the recommendations andpolicy proposals emanating from the Section onTraining of the 1971 White House Conferenceon Aging.

Recommendations

RECOMMENDATION: ILevel of Putsding of Training :Programs

A_ fully developed training _pOlicy must ifoois_ on.bOth the immediate needs of the present :aged-pOpulatiOn- and-the 'future- needs of the aging;through innovation -of -fat- reaching policiet andptogiams. To accomplish the tiainingof neededpersonnel, the present levels of funding in allgovernment agenciesconcerned with -aging -mustbe substantially increased immediately in orderto increase the supply of all types of manpower:technicians, paraprofessionals, professionals, plan-nets, researchers, teachers and volunteers. Train-ing must be conducted-in appropriate settings bothwithin and outsideTof educational institutions.

RECOMMENDATION IINew Federal Agency for Aging.

Given that training in .aging it lagging seriouslybehind the ptoven need, there is consensus thatresponsibility for the development of a vigorousnational plan and continuing monitoring of train-ing of manpower in aging should .be lodged ina new Federal agency for aging adequately fi-nanced and with the power to coordinate Fed-erally supported training programs in aging.'

RECOMMENDATION IIIPlanning Bodies for the New Agency k

In discharging its responsibilities, the new Federal'

Misority Position: One third of those voting believed,thatthere should be a single but not necessarily new Federalagency for aging.

98

agency should include representatiVei of trainingorganizations, private .non - profit foundations,scientific and professional organizations, organi-iations of older retired persohs, and other con-cerned groups in all planning bodies which for-mulate policies on training:

RECOMMENDATION IVTraining Centers in Aging

Multidisciplinary research and training centers ofexcellence in gerontology with a -relatiOnihip toservice- delivery- systems should be cieVelopoi, -and

-research and- training shotildhe fostered in a wide-range of colleges; - universities and other institu-tions. Innovative and experimental- .effortstraining must= be encouraged:--Each Center shoulddevelop network of effective relationtitipi withother- edticatiOnal;ancL seririce4genciei.- to dissemi-nate information andiproinote implementation ofactivities in aging:

RECOMMENDATION VSupport for Manpower Training in Aging

In addition to increased Federal support fortraining prOgranis in aging there should be anacceleration of support for training in aging fromState appropriations, foundation grants, privatedonations, and regular agency budgets. All serviceprograms for older people should contain ear-inaikra funds for the training of-personnel.

RECOMMENDATION VI.Recruitment for Training in Aging

Funds for recruitment and support of personnelto be trained in aging should be allocated withoutpriority based on sex or age. Special inducementstraineeships, scholarships, tuition grants, loansshould be offered in order to recruit personnel(particularly those from ethnic and minoritygroups) into careers in aging.

RECOMMENDATION VIIFunding Training for Minorities

Because of the needs and problems that existamong the aging of the economically and socially

disadvantagedt funds should be earmarked at alllevels of training and research for Blacks, Chica-

-nos, Pima°. Ricans, Asiahs, Indians, and otherdisadvantaged groups. All training programsfunded on Federal, State and community- leVelsshould actively recruit faculty and trainees fromthele groups.

RECOMMENDATION VIIICurricula in Aging

99

In order to develop adequately trained persons inhealth, allied health, anct.other professional fieldssuch as- law, archifecture, socialwork, -etc., sul-ject 'matter on aging *sr be 'inserted -into :pre--serViCe _and inservice_ curricula of professional:schools immediately. In,addtion, empbasilisbouldbe plaCed, on the deVelOpment, of community col-lege- -level -certificate and degree programs andprograms. -in vocational -andtechnical institutesas well as other lbcal program:slot personnel whodeliver services to the older population. Teachertraining programs should include positive conceptsregarding _the aging process and the older personfor incorporation into elementary` and secondaryschool curricula.

RECOMMENDATION IXA National Institute-of Gerontology

We urge the creation of an adequately funded Na-tional Institute Of derontology for training andresearch. A. substantial portion of the funds -allo-cated to it Should be earmarked for training.

RECOMMENDATION XA National Data Bank

A national data bank and retrieval system similarto, or parallel with, the education research in-formation center (ERIC) should be established'to convert, translate, interpret, and make availableall research knowledge and curriculum materialsin aging to all training and research and demon-stration programs.

RECOMMENDATION XIDetermining Manponer Need

Recruitment and training will be to no avail if

there is no corresponding increase in services.Therefore, recruiting should be related to usefuljob opportunities: Financial support for-new serv-ice positions should be provided in balance withsupport of training prOgrams.1

RECOMMENDATION XIIReordering National Priorities

To insure the dedication of.-the_Federal Govern-ment and. our country in this period of life asopposed to death, we strongly urge Congress toreorder its priorities .and divert funds from themilitary -to human 'needs.'

SECTION LEADERSHIPA.s.%

Space will permit listing -iitk Mod ad=dress only the first time a name appears

The Technical Committeefor TrainingChairman

George G. Reader, Professor of Medicine, The New YorkHospital, Cornell Medical Center, New York, New York

Consultant

Warren A. Petersen, Director, Midwest Council for SocialResearch for the Aging, .Kansas City, Missouri

Members

Elinor J. Barnes, Chairniin, Graduate Committee on Geron-tology, Retirement Housing Administration, College of Busi-ness and Public Administration, University of Arizona, Tucson,Arizona

Jean Shinoda Bolen, PhySician and Assistant Professor, UnVersitft of California, School of Medicine, San Francisco, Cali-fornia

Francis A. Fay, Assistant Professor of Education and Coordinator, Graduate Training Program in Aging, University ofNorth Carolina, Chapel Hill, North CarolinaHarrier F. Griswold, Retired, Author, Lecturer, Civic Worker,Washington, D. C.Andrew Hendrickson, Professor, Adult Education, FloridaState University, Tallahassee, Florida

Walter G. Klopfer, Professor of Psycbol'igy, 2ortland StateUniversity, Portland, Oregon

Thomas A.. Rich, Associate Dean of Liberal Arti and Direc-tor of The Institute on Aging, University of South Florida,Tampa, Florida

Marvin B. Sussman, Professor and Chairman, Department ofSociology and Anthropology, Western Reserve University,Cleveland, Ohio

' Minority Position: One-fifth of those Delegates voting wereopposed to this recommendation for a variety of reasons.

'Minority Position: One-fourth of those Delegates votingwere opposed to this recommendation.

Sheldon S. Tobin,. Assistant Professor,. School of Social Serv-ice Administration and Committee -on HuMan Development,The University of Chicago, Chicago, Illinois

Henry .Viscardi, Jr., President, Abilities, Inc., Long Island,New York

The SecretariatDirectorMarian H. Miller, Specialist on Aging, Training Grant Pro-gram, Administration on Aging; Social' and RehabilitationService, Department of Health, Education,,and Welfare, Wash-ington;p. CAssociate DirectorWalter Spieth, Executive Director, ,Adult .Development. andAging Research' and Training Conimittee; National Instituteof:Child' Health Wand- Human-,DeieloPment; Department ofHealth, Ecication, and Welfare,- Bethesda, Maryland.MeMberiMiele . Blank, Social- Work- Consultant, SittioSectionLHealth- Of` the, Aging;. National -Institute- Of 'Mental; Health;HealthflerVices- and- Mental-Health -Administration;Merit "of Health,-Edtiattion; ind ;Welfare, _Rockville; MarylandMaigatet F. Clark,,Tiaining -Corisultatit.DiVision of Mail.power, Development; -Rehabilitation ServiCe AdMinistration;Deparinient-of Health, Education and Welfare,- Washington,D. CSamuel Hammerman, Specialist on Aging, Training. GrantProgram, AdministratiOn on Aging, Social and RehabilitationServiCe, IDePartinent of ,Health; Education; 'and- Welfare;Washington,-D. C.

James M. Hoeven, Graittse Management Specialist, HealthManpower_ Education,.- National Institutes of Health, Departmeat of Health,-Edlicition, and Welfare, Bethesda, Maryland

-Donald L. Lacey, Student AsSistant, Gerontology TrainingProgram, 'The Institute of Gerontology, The UniverSity ofMichigan-Wayne State. University, Detroit, MichiganE. Percil Stanford, Regional Office --Represetitative,Office ofField -Opeuitioni; Social .and Rehabilitation Service, Depart-ment of- Health,:Edutation, and -Welfaie, 'Washington; D.- C.Milton. Wittniiiii Chief, Social Work Training- Branch, De-partment of Health, Education, and Welfare, Washington,D. C.

Section OfficersCo-ChairmenHiram J. Friedsam, Director, Center for Studies in Aging,North Texas State University, Denton, Texas, and GeorgeG. ReaderConstxhantWarren A. PetersenRecorderLeonard 7.. Breen, Professor and Chairman Department ofSociology, Vuidue University, Lafayette; IndianaAssistant RecorderFranklin Nicholson, Associate Regional Commissioner forAging, Social and Rehabilitation Service, U.S. Department ofHealth, Education, and Welfire, Atlanta, GeorgiaManagement OfficerMarian H. Miler

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Subsection Officers

StibsectiOn 1

ChairmanRosamondi R. Boyd, Chairman, South Carolina Commissionon Aging, Colunibia, South Carolina

Vice ChairinanJoyce Lowry, Specialist in Rehabilitation, Recreation, andAging, Milwaukee, Wisconsin

RecorderA Kurt Weiss,'Professor, Department of Physiology, Univer-sity of Oklahoma Medical Center, Oklahoma City, Oklahoma

Subsectiob 2

Chairman_Aitliur S. Farber, Professor, School of Social Work, Univer-sity of Wishington, Seattle, Washington

Vicett aiiManDavid L Levine,= Director of -the Learning-Service Center,University of Georgia, Athens, Georgia

RecorderWarr- en A. Petersen

Subiection 3ChairmanSheldon S. TobinVice ChairmanErich Helbig, Knoxville, TennesseeRecorderGlenn D; Overman, Dean, College of Business Adsninistra-don, Arizona State University, Tempe; Arizona

Federal- Resource PersonnelHelen Asf)esligh, Adniinistnitive -Officer, Administration onAging, Social and Rehabilitation -Service; Department ofHealth, Education, end Welfare, -Washington, D. C.Marie L BlankEileen P. :Bradley,: Chief, Program Administration Branch,Division of Older Asheriatns Service, Administration on Aging;Social Sid- Rehabilitation Service, Department of Health,EduCation, and Welfare, Washington,-D. C.

Kenneth "Durind, Student' Assistint, Training Grant, Pro--grim, Administration on Aging; Social- and RehabilitationService, Department of Health; Education, and Welfare,Washington,

James-hi .HOeven-

.Lonella C Johnson, Secretary, Training Grant Program, Ad--ininiitration on Aging, Social- and =Rehabilitation Service, -De-partment of :Health, Education, and Welfare, Washington,D.C._Lily P._ Litz, , Grants Management ',officer, Administration on:Aging,, Social -and- Rehabilitation :Service, Department ofHealth; Education, and Welfare,-Washington,'D.,C.Wiltex_- Spaeth

L Penn- RtinfordJoimillitoibbeb,-,Chief,'MaispowerResOinces_lninchi Divi:-don of 'Manpower Development ,,and_ -Training; SOciaLtuidRehabilitition Service,_ Department of Health, Education, andWelfare:- Washington; D.

Sue Whitman, Personnel' Officer, The Department of State,"VhshOski,..;P: C.Milton WittmanCorinnelL *one, Deputy_ Assistant Adminiitrator for Man-power Development- for, Training,;-Social and Rehabilitation-Service, -Department of Health, Education, and Welfare,Washington, -D. C. .

101

Ow.

.Reports of the

Special Concerns Sessions on

HEALTH ARESTRATEGIES

, ::=.1Tr

//41ripe. _

)4111.4.-2Z1.'A.47-11 sx-A4';

LONG-TERM CARE

FOR OLDER PEOPLE-dequate long-term. care has become a

A priority need for older pc.Ople. The de-'Aland for supportive,_ preventive, andrehabilitative "services has :long: ex=

ceeded the ability of". the health delivery systemto elect it. At present, long-term-care-facilitiesand services ate in short supply :and- :Many ireof substandard- quality. To encourage .Delegatesto consider these critical problems indto proposepolicies designed:: to solve them, a request wasmade by. the National Association of; JewishHoniet for the Aged for inclusion of a :SpetialConcerns Session "on Long-Term Care for OlderPeople in the Conference program.

Joining the National- Association of JewishHomes for the Aged as inernbers of.the planningcommittee were representatives of the AmericanAssociation of Homes for the Aged, AniericanAssociation of Retired Persons- National ._RetiredTeachers Association, American .Lutheran Church,American Medical- AssociatiOn, American NursingHome Association, Evangelical Lutheran GoodSamaritan Society, National Conference of Cath-olic Charities, National Council of Health CareServices, National Council of Senior Citizens,Presbyterian Church of the United States, -and theUnited Methodist Church.'

The planning committee was assisted by Sev-eral Federal agencies within the Departments ofHealth, Education, and Welfare, and Housingand Urban Development.

The Participants

This Special Concerns Session attracted a sub-stantial number of Delegates. More than 450

s See Roster of Phoning Cominittee, psge 109.

persons preregisteredof

the Sessionmaking itthe largest of any of the Conference. 17 SpecialConcerns Sessions. Still many other Delegates andobservers Joined, them during:the +hour:meeting.In order to provide for greater involvement ofparticipants in- the =discussions, -the Session wassubdivided intci: six relatively small groupings offrom approximately GO to 75 persons. .

Participants in the Session included persons re-:ponsible for planning, Standard setting, and regu-lating-various types of long-term care facilities. Inaddition, there was a large component of thoseactively- engaged in the delivery of health servicesand others who, because of age, had special in-terest in the availability and quality Of such services.

The Program an NOP," oa NON, pate)

To provide Delegates with some backgroundof the present situation in long-term care for olderpeople,. the American- Association of Retired Per-sonvNational Retired Teithers Association put to-gether three case histories which dramatized theplight of the sick, socially dependent elderly seek-ing admission to long-term care facilities. TheDelegates were also provided with summary sheetswhich briefly Outlined present programsparticu-larly Federal programsfor long-term facil-ities.

Prior to the Session meeting, the planning-committee developed five basic topics to serveas an outline for the discussion. This made itpossible for each of the subgroups to considerthe same subject areas in developing their rec-ommendations. The five topical areas, listed below,were designed to include consideration of both in-

105

stitutional and non-institutional care: (1) Scope ofEtznefits, Services, and Facilities, (2) Eligibility,(3) Financing, (4) Monitoring and Accountabil-ity, and (5) Implications for National Policy andPrograms. A panel of listeneis selected' from boththe public and private sectors was invited to reactto the recommendations and to urge their respec-tive agencies and organizations to take a lead in

improving and expanding long-term care facil-ities and services for older Americans.

The Session formulated 20 recommendations,two of which were defeated but are reported hereto provide a clear picture of all of the basic ques-tions considered by the Delegates to the SpecialConcerns Session on Long-Term Care foi OlderPeople.

1971 WHFfE'HOUSF CONFERENCE ON AGING

PROGRAMLONG-TERM. CARE

FOR OLDER PEOPLE

ChairmanCHARLES J. FAHEY, Chairman, Commission onAging, National Conference of Catholic Charities,Syracuse, New York

Vice ChairmanHERB'rs:T SHORE, Executive Director, GoldenAcre;, t)allas Home and Hospital for the Aged,Dallas, Texas

Summarizer:JEROME HAMMERMAN, Professor, Universityof Chicago, School of Social Servici Administra-tion, Chicago, Illinois

klIZABETH CONNELL. Director of Public Re-lations,National Council of Health Care Services,Washington, D. C.Panel of ListenersFAYE G. ABDELLAH, Chief Nurse Officer,Public Health Service, Department of Health,Education, and Welfare, Rockville, Maryland

ELAINE M. BRODY, Director, Department ofSocial Work, Philadelphia Geriatric Center,

Pennsylvania

MARIECALLENDER, Special Assistant for Nuts-ing Home Affairs to the Assistant Secretary for

.Health and Scientific. Affairs, Department ofHealth, Education, and Welfare, Washington,D. CERWIN HYTNER, Director, Division of HealthInsurance, Office of Program Evaluation and Plan-ning, Social Security Administration, Departmentof Health, Education, and Welfare, Washington,D.C.

PETER KARPOFF, Consultant, (Health Econom-ics), -Health Services and-Mental'Health Adminis-tration, Public Health Service, Department ofHealth, Education, and Welfare; Rodcville, Mary,land

JACK KLEH, Director of Professional Services,C Village; Washington, D. C.

RUTH KNEE, -Chief, Mental- Health Care andServices Financing-- Branch, Division of MentalHealth- Seriice Programs, National -institute ofMental Health, HWth Serviies and Mc 'tat HealthAdministration, Public Health Service, Departmentof Health, Education, and Welfare, Rockville,Maryland

HOWARD NEWMAN, Commissioner, MedicalServices Administration, Social and RehabilitationService, Department of Health_, Education, andWelfare, Washington, D. C.

THOMAS M. TIERNEY, Director, Bureau ofHealth Insurance, Social Security Administration,Department of. Health, Education, and Welfare,Washington, D. C

ROBERT VAN HOEK Deputy Administrator forHealth, Servicei Delivery, ,Health Services andMental Health Administration, Public HealthService, Department of Health, Education, andWelfare, Rockville, Maryland

AGENDA

8:00 A.M. Introduction8:15 A.M. Case Histories8:45 A.M. Perspectives and Ground Rules9:00 A.M. Discussion of Issues and Voting

11:45 A.M. Summary12:00 Noon Adjournment

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THE SESSION REPORTPreamble

The Special Session on Long-Term Care forOlder People is concerned about the develop-ment of a National Policy on Long- Term -Care.We meet within the context of a growing nationalinvolvement in this area

It was only in the 1930's that the Federal Gov-ernthent'became deeply involved in human serv-ices. We_theet within'the context of disclosures inthatiy:eitiet of inadequate nursing home care. Weare'_aisiate of Ralph Nader, Congressman DavidPryor;_ and now the views Of Health, ,Education,andWelfare Seeretary-Elliot Richardson; We hopethat the commitment of the Administration tostandardi will be matched by a-concomitant com-initment.to adequate funding of long-term care.

We recognize that long -term care involves notonly -inpatient care but also services to people intheir own homes as well.

Our- focus should be upon the individual andmaking the right to adequate long-term care areality.

Recommendations1. It is recommended that all long-term institu-

tional care aspects of the Title XIX (Medicaid)program be completely federalized. By federaliza-tion is meant funding shall come from Federalgeneral tax revenues; that a uniform minimumlevel of benefits be set on a national level; and thatstandards be uniform nationally.

It is further recommended that payment to in-Aitutional providers of long-term care be madeon such basis as to cover the cost of providingthat care, and, in the case of proprietary facilities,to-allow a fair return on investment. Payment tofacilities is not necessarily to be the same in dol-lar amounts, but is to be computed using thesame formula nationwide.

2. It is recommended that Medicare-type costreimbursement be specifically discouraged andthat prospective rate setting be encouraged with

468.218 - 73 - $

proper incentives to encourage the providing ofgood patient care.

3. It is recommended that the problems andfeasibility of transferring the long-term institu-tional care aspects of the Medicaid program to theMedicare program be intensively studied.

4. It is recommended that the Department ofHealth, Education, and Welfare work to changethe primary emphasis in nursing home inspectionsfrom physical plant standards to direct patientcare.

5. It is recommended-that a national policy onlong-term care needs must have mechanisnis forbeing implemented and financed; that supple-mentary resources are needed to be allocated tomeans of financing alternate care; that this is areason for loW standards of care in many long-term care institutions; that we need a change innational priorities to human needs; and that wecall upon the government to change our nationalpriorities, shifting some of our resources from de-fense, foreign assistance, and space priorities tothe needs of our elderly citizens to implement anational policy on long-term care.

6. It is recommended that a Presidential Com-mission on Mental Health and Illness of the El-derly be established.

7. It is recommended that any national healthinsurance program which is adopted should meetthe needs of those who require catastrophic, long-term physical and mental health care and socialservices both within and outside of institutions.

8. It is recommended that, to encourage thephysician to accept responsibility for the medicalcare of patients in long-term care facilities, thecoverage limitation of one physician visit per pa-tient per month in nursing homes be eliminatedand that physicians be allowed to see patients asoften as is deemed necessary by the professionalstaff as the patient's condition warrants.

It is further recommended that the physician bereimbursed at his reasonable established fee level

107

without reduction for seeing several patients dur-ing one visit in extended care, skilled nursing, andnursing facilities.

9. It is recommended that more registerednurses be placed in leadership positions in all pro-grams involving health care of the elderly at allgovernmental levels.

10. It is recornr -ided that preventive andrestorative dental care benefits be made availablefor all persons over age 65, and that those bene-fits be fully funded by the Federal Governmentfor those who cannot afford to pay for such care.

H. It is recommended that an appropriate ex-pression of appreciation be "made -to Dr. ArthurFlemming, Chairman of the 1971 White HouseConference on Aging, for his efforts in makingthe Special Session on Lorig-Term Care possible.

12. It is recommended that the provision ofcare and services for the aged be removed fromTitle XIX (Medicaid) and Title XI, and that allhealth care for the aged be provided under an ex-panded Title XVIII (Medicare) program. It- isfurther moved that health care be provided to allaged as a matter of entitlement; all personsshould be covered and means tests presently inuse under Title XIX be abolished.'

13. It is recommended that the Secretary ofHealth, Education, and Welfare study the feasi-bility of health facilities (i.e., hospitals, nursinghomes, extended care facilities, etc.), includinglong-term care facilities, becOming public utilitiesand that his report be submitted as part of the post-White House Conference on Aging report by De-cember 31,1972!

- 14. It is recommended that social services, aspart of the team approach, arc important to guar-antee quality care of the elderly in long-terminstitutional care and should be supported by leg-islative action.

15. A proposed recommendation that Federalrequirements for State participation in Federally

a The Session was divided on this motion because of somedeep-seated reservations about the suitability of the Medicareprogram as a vehicle for meeting total health care needs for theelderly.

2 The Session was divided on this issue because some Dele-gates have serious reservations regarding the concept of makinghealth facilities into a public utility.

supported health care programs include a require-ment" that inspectors and surveyors of nursinghomes hold currently valid licenses as nursinghome administrators in the States in which theywork, plus special preparation in inspection oflong-term care facilities, was defeated.

16. It is recommended that there should .beFederal financing available for the construction ofnursing homes and health facilities. It is furthersuggested that this financing take the form of a40- to 50-year loan with a three to five percentinterest rate or a guaranteed loan system.

17. -It is recommended that in the interests ofthe patient, standards and guidelines which car-riers use in making their decisions on coveragebe readily available to professionals helping toeffect their care.

18. A proposed recommendation that the ele-ment of profit be eliminated from the care of per-sons and that the profit factor be confined to alimited return on equity capital, meaning a profitin the form- of rental of land, buildings, improve-ments and furnishings, over and above the actualcost of the care and services provided, wasdefeated.'

19. It is recommended that appropriate Fed-eral and State regulatory bodies and consumerprotection agencies be urged to take appropriateaction to protect the public by curbing the mis-leading and exaggerated mass media solicitationand advertisement of voluntary health insuranceprograms to. the elderly and the general public.

20. It was recommended that the Departmentof Health, Education, and Welfare consider thefeasibility of national certification for consultantpharmacist to separate the "paper" consultantfrom the bonafide consultant pharmacist and thatthe Department also explore the possibilities forreasonable reimbursement of consultant pharma-cists for consulting services.

3 The minority view holds that the Senator Percy hearingshighlighted the fact that nursing home patients are not receiv-ing quality, comprehensive programs of care. This is mostsignificant, in the minority's view, since most nursing homepatients are public aid recipients. The minority feels that thetaking of profits from the delivery of care additionally andsubstantially reduces the number of dollars available to providethe care needed.

108

Roster of Planning Committee

NongovernmentHerbert Shore, (Chairman), Executive Director,Golden Acres, Dallas Home and Hospital for theAged,. and Executive Vice-President, National Asso-ciation of Jewish Homes for the Aged, Dallas, TexasBerkeley Bennett, Executive Vice-President, NationalCouncil of Health Care Services, Washington, D.. C

Elizabeth Connell, Director of Public Relations, Na-tional Council of Health Care Services, Washington,D. C.

Charles Fahey, Chairman, Commission on Aging,National Conference of Catholic Charities,, Syracuse,New York

Herman Gruber, Secretary, Committee on Aging,American Medical Association, Chicago, Illinois

Eugene Hackler, Attorney-at-Law, Hadder, Ander-son, Londerholm, Speer and Voder, Olathe, Kansas

Jerome Hammerman, Professor, University of Chi-cago School of Social Service Administration, Chicago,Illinois

Gordon Hanson, Secretary, Division of ChristianSocial Service, Board of National Ministries, Presby-terian Church of the U. S., Atlanta, Georgia

William Hutton, Executive Director and Director ofInformation, National Council of Senior Citizens, Inc.,Washington, D. C.

Milton Jackson, Associate Director for NationalAffairs, American Association of Retired Persons-National Retired Teachers Association, Washington,D. C.

Maurice Kramer, Congressional Liaison Assistant,American Nursing Home Association, Washington,D.C.Dorothy McCamman, Consultant on Retirement In-come and Health Economics, Washington, D. C.

Dan Ozelis, Administrator, Methodist Home, UnitedMethodist Church, Chicago, Illinois

Charles Peterson, Regional Director, Evangelic ALutheran Good Samaritan Society, Sioux Falls, SouthDakota

109

Frank Rinehart, Acting Executive Vice-President,American Nursing Home Association, Washington,D. C.

Randolph Thornton, Program Development Special-ist on Church Programs, American Association ofRetired Persons - National Retired Teachers Association,Washington, D. CFrank Zelenka, Associate Director and Director ofPublic Affairs, American Association of Homes forthe Aging, Washington, D. C.

Government

James Burr, Director, Division of Services to theAging and-Handicapped, Community Services Admin-istration; Soda' and Rehabilitation Service, Depart-ment of Health, EducatiOn, and Welfare, Washington,D. C.

Mary Jo Gibson, Program Management Advisor,Office of Program Innovation, Medical Services Ad-ministration, Social and Rehabilitation Service, De-partment of Health, Education, and Welfare, Wash-ington, D. C.Helen Holt, Special Assistant for Nursing Homesand Related Facilities, Federal Housing Administra-tion, Department of Housing and Urban Development,Washington, D. C.

David Lit, Technical Advisor, Bureau of HealthInsurance, Social Security Administration, Departmentof Health, Education, and Welfare, Washington, D. C.Helen Martz, Medical Care Planning Specialist, Officeof Program Innovation, Medical Services Administra-tion, Social and Rehabilitation Service, Department ofHealth, Education, and Welfare, Washington, D. C.Edith Robins, Coordinator for Health of the Aging,Corr.munity Health Service, Health Services andMental Health Administration, Public Health Service,Department of Health, Education, and Welfare, Rock-ville, Maryland

Nathsa Sloate, Special Assistant to the Director, Na-tional Institute of Mental Health; Public Health Serv-ice, Department of Health, Education, and Welfare,Rockville, Maryland

MENTAL HEALTH CARE

STRATEGIES AND AGINGhe Special Concerns Session on MentalHealth Care Strategies and Agingwas requested by the American Psy-chiatric Association. Members of var-

ious -other mental health. organizationstheAmerican- Psychological Association TaSk FOrCeon Aging, GrOup for the Advancement of- Psy-chiatry, National Association for Mental Health,National Association of Private Psychiatric Hos-pitals, National Association of State MentalHealth Program Directors, and the National Com-mittee Against Mental Illnessparticipated inplanning the Session. Assisting the group was theNational Institute of Mental Health, Health Serv-ices and Mental Health Administration, Depart-ment of Health, Education, and Welfare.1

In view of the general lack of public concernand the lack of available information on the careof aged mental patients, it was deemed impor-tant to give special attention to what strategiescould be employed to increase public awarenessof mental disorders experienced by aging per-sons; to point ouL some of the critical changes inlife patterns which sometimes lead to functionaldisorders; and to provide an opportunity to rec-ommend action which can be taken to expandmental health care services for the elderly and torealize fully their rehabilitation potential.

The Participants

Approximately 242 Delegates preregistered forthe Special Concerns Session on Mental HealthCare Strategies and Aging. This group was joinedby other Delegates, observers, and guests uponopening its 4-hour meeting. A large number of

I See Roster of Planning Committee, page 113.

the participants were experts in mental. healthcare, and, therefore, contributed substantially tothe discussion and formulation of recommenda-tions needed to improve the circumstances of el-derly mental patients.

The Program

In order to provide Delegates with backgroundinformation, each participant in the Session re-ceived a copy of Cost and Delivery of Health Serv-ices to Older Americans, a report of hearings be-fore the Subcommittee on Health of the Elderly ofthe United States Senate Special Committee OnAging.

The Chairman of the Session pointed out tothe Delegates- some of the various strategies ofmental health care so that they could considerseveral alternatives while discussing and formu-lating recommendations. The Session adopted 16recommendations which call for a wide range ofmental health care services to meet the needs ofolder people.

111

1971 WHITE HOUSE CONFERENCE ON AGING

PROGRAMMENTAL HEALTH CARE

STRATEGIES AND AGINGChairmanALVIN I. GOLDFARB, Associate Clinical Pro-fessor of Psychiatry, Mt. Sinai School of Medicine,City University of New York, New York

8:00 A.M. Presentation of Mental HealthCare Strategies by the Chairman

10:30 A.M. Resolutions and Voting12:00 Noon Adjournment

THE SESSION REPORT

IntroductionIt is agreed that the aged are a heterogeneous

group. Large numbers of them need a wide varietyof comprehensive health care. Mental impairmentand a wide variety of functional disorders are com-mon. Depressive reaction to the changes in role,status, appearance, and to decrements of functionor ill health is prevalent. Consequently, thereshould be recognition of, and response to, theelderly person's need for mental health care andpsychiatric care wherever he may be and whateverhis age or condition. All institutions, includingmental hospitals and centers, should have theobligation and the facilities to diagnose, treat orto safely provide for transfer to a more adequatesite for care, all applicants for admission in crisis.

Differences in financing patterns, geography,transportation facilities and population distribu-tion may make for different patterns of intermedi-ate and long-term care in different localities.Financial, social, and technical matters should notinterfere with ease of admission to and dischargefrom inpatient care facilities or return home tofunctional status in the community. Also, readmis-sions and transfer to more suitable loci of careshould be easy and free of financial or legalobstructions.

Recommendations1. It is recommended that at an early date,

there be established a Presidential Commission onMental Illness and the Elderly, with responsi-bility for implementing recommendations made atthe White House Conference on Aging. Its mem-bers' should be appointed by the President, subjectto the advice and consent of the Congress.

2. It is recommended that a Center for theMentalHealth of the Aged be established withinthe National Institute of Mental Health, with theauthority and funds for research, training, andinnovative programs for older people in the com-munity and in hospitals.

3. It is recommended that theie be recognitionand support of each older individual's right to careand treatment in any one of the wide range ofalternative mental health services now existing, orthose that will be developed.

4. It is recommended that there be universalprepaid, comprehensive health insurance includingcoverage for mental illness and health.

5. It is recommended that inequities and dis-crimination with respect to the financing of mentalhealth services should be eliminated from Medi-care and Medicaid. There should be prompt elimi-nation of deductible and co-insurance features; andinclusion of drugs, currently excluded dental careand prosthetics under Medicare.

6. It is recommended that Medicaid fundsshould be properly used as legally prescribed; thisshould be guaranteed by adequate Federal super-vision and enforcement.

112

7. It is recommended that all funds allocatedby the Congress for research, training andservicesfor the elderly should be released and distributedpromptly both now and in the future, with speedycooperation of the Executive Branch of the gov-ernment where required. (See recommendation onthe appointment of a Presidential Commission.)

8. It is recommended that efforts should bemade at Federal, State, and local levels to developoptions to institutional care.

9. It is recommended that adequately staffedand programmed comprehensive mental healthdiagnostic and treatment centers be developed inneighborhood health centers, community mentalhealth centers, hospitals and other appropriatelocal, geographically accessible settings; specialattention to adequate funding is of prime import-ance.

10. It is recommended that properly staffedinpatient or residential facilities with proper pro-grams should be available in adequate number;all of these should have available methods ofsupervising, caring for, and protecting persons in

their own homes for as long a period as medicallyand socially possible for the patient.

11. It is recommended that more attention begiven to the development of innovative therapeuticservices to currently institutionalized older persons,and for the future care of persons in need of pro-tective environments as inpatients or residents incongregate settings.

12. It is recommended that research monies forstudies of aging and the elderly, from basic bio-logical processes to social and psychological phe-nomena, be greatly increased.

13. It is recommended that all mental healthprograms-for the elderly be open to all, without a"means test." This mandates adequate funding.

14. it is recommended that there be recognitionthat training and education of the necessary health

professionals is urgently indicated. Such healthmanpower must be increased in number as well asquality. Agaiii, adequate funding is a necessity.

15. We are aware that there is a large body offactual and technical data on aging and the practi-cal treatment of the disorders in the elderly whichis not generally available and known. 'Therefore,it is recommended that material describing thebest comprehensive care methods in a variety ofsettings should be prepared, widely distributed andtheir availability made known.

16. It is recommended that the proposed Presi-dential Commission,, or another appropriategov-einment agency, look into the methods of purchaseand provision of mental health care currentlyundertaken by Federal, State, and local govern-mend, in order to advise as to what is most eco-noMical- and effective.


Nongovernment

Alvin I. Goldfarb, (Chairman), Associate ClinicalProfessor of Psychiatry, Mt. Sinai School of Medicine,City University of New York, New York

James Bitten, Director, Gerontology Center, Univer-sity of Southern California, Los Angeles, California

Ewald Busse, Chairman, Department of Psychiatry,Duke University, Durham, North Carolina

Robert Butler, Psychiatrist, Washington School ofPsychiatry, Washington, D. C.

Robert Doveninueble, Executive Director, DallasCounty Mental Health and Mental Retardation Center,Dallas, Texas

Carl Eisdorfer, Professor of Psychiatry and Director,Center for the Study of Aging and Human Develop.ment, Duke University Medical Center, Durham, North,Carolina

Albert Feldman, Associate Director for CommunityCenters, Gerontology Center, University of SouthernCalifornia, Los Angeles, California

113

Charles Gaitz, Chief, Gerontology Research Section,Texas_ Institute of Mental Sciences, Texas Departmentof Mental Health and Mental Retardation, Houston,Texas

Wendel Swenson, Chief of Psychology, Mayo Clinic,University of Minnesota, Rochester, Minnesota

Prescott Thompson, Psychiatrist, Samaritan MedicalCenter, San Jose, California

Jack Weinberg, Clinical Director, Illinois StatePsychiatric Institute, Chicago, Illinois

Government

Thomas Anderson, Chief, Section on Mental Healthof the Aging, National Institute of Mental Health,Health Services and Mental Health Administration,Public Health Service, Department of Health, Educa-tion, and Welfare, Rockville, MarylandNathan Sloate, Special Assistant to the Director, Na-tional Institute of Mental Health, Health Services andMental, Health Administration, Public Health Serv-ice, Department of Health, Education, and Welfare,Rockville, Maryland

.,- y,,..'Citt r,

HOMEMAKER-HOMEHEALTH AIDE SERVICES

uring the several months preceding the1971 White House Conference onAging, the Federal Government madea forceful effort to meet the challenges

presented by substandard nursing homes. Presi-dent Nixon in two major addressesChkago,Illinois, -on June 25, 1971, and Nashua, NewHampshire, on August 6emphasized his con-cern with the level of such care being offeredthe elderly and presented a plan of action forthe government to pursue.

This thrust, taken with the attention presentlybeing paid to the soaring costs of institutional careand proposed alterations in the traditional systemof health care delivery, has served to strengtheninterest in developing alternatives to institutional-ization. For many older people especially, moreadequate support services in the home would pre-vent, shorten, or postpone hospitalization. Formost older people, care in the home would repre-sent a less traumatic solution to certain of theirhealth and social problems. Given the high costsof medical care, it would appear to be more eco-nomically desirable. And, by allowing more per-sons to remain in their own residences, such serv-ives could decrease the demands made upon thosedelivering care within institutions, thereby increas-ing the responsiveness of institutional care to thosein greatest need.

The National Council on HomemakerHomeHealth Aide Services, in a position paper preparedfor the Conference, conveyed the importancewhich should be attached to "accelerating andstrengthening the hitherto sporadic and falteringefforts in this country in developing a continuumof health and social services to people in their ownhomes." The Council noted that Medicare pro-vides funds for home health care of some olderpeople and that homemaker services have beenmandated for the c4clerly receiving public assist-

ante. Yet, it recognized a vast group of aging peo-ple living deprived and isolated lives who findthat the assistance they need to remain independ-

' ent is not available.

Through a Special Concerns Session, one addi-tional step was to be taken to insure the availa-bility of the service as ,a resource for all elderlypeople who desire to remain in their own homeiand who could do so, provided they received thenecessary community assistance. The NationalCouncil on HomemakerHome Health Aide Serv-ices was invited to initiate the planning of theSession. It sought the assistance of interested na-tional, State, and local organizations and agencies.The National League for Nursing, the Home-makerHome Health Aide Association of NewYork State, the Visiting Nurse Service of NewYork,' and the Homemaker Services Bureau ofGreater New Haven, Connecticut, joined with itin planning the Session.

The Department of Health, Education, andWelfare, through the Social Security Administra-tion, the Health Services and Mental HealthAdministration, and the Community Services Ad-ministration and the Administration on Aging ofthe Social and Rehabilitation Service, providedFederal resource and assistance.'

The Participants

Each Delegate attending the Session did soafter 2 full days of .discussion within one of the14 major Conference Sections. Perhaps indicativeof the broad interest generated by the topic of in-home services and alternatives to institutional care,each of the Sections was represented among theHomemakerHome Health Aide Session partici-pants.

115

1 See Roster of Planning Committee, page 120.

The participants in the Session had the opportu-nity to shape recommendations directed at devel-oping homemakerhome health aide services as aresource in every community throughout the Na-tion. It is significant, therefore, that among thenearly 200 Delegates who had expressed interestin attending the Session, over 40 States and Ter-ritories were represented.

Each person present, despite a participant mixof age, occupation, income, and residence, realizedthat at some time, he or someone he knows mightneed a homemakerhome health aide service.

The Program

The program was designed to fulfill two pur-poses. The.first was to make participants aware ofthe present situationwhere it is -that the pro-vision of homemakerhome health aide services'stands in the spectrum. of health and social careavailable today.2 A second and. overriding purposewit to direct attention toward realizing the poten-tial such services hold!' Thi, culminated in thenaming of a drafting committee from among theDelegates present and the framing of the Session'srecommendations.

In addition to the challenge to action containedwithin the keynote address,' a number of specialconsultants contributed to the substantive discus-sion within the Session. There to listen as well asto inform, these consultants were drawn fromamong persons actively involved in the develop-ment and provision of in-home services. Amongthem were representatives from the Social SecurityAdministration and the Social and Rehabilitation

1 In keeping with the Session's educational purpose. Delegateswere provided with selected publications on the development ofhomemakerhome health aide services. These and other publica-tions, at cost, and further information, can be obtained from theNational Council on HomemakerHome Health Aide Services,1740 Broadway, New York, New York 10019

a proceedings of the White House Conference on Agingunderscored the many problems of the aging in America today.It is perhaps meaningful to note how frequently proposed solu-tions to these problems focused 'on t!.:t need for the developmentof adequate services to maintain the aging in their own homes.The reader is encouraged to refer !I the reports of the Sectionson Physical and Mental Health, awl Facilities, Programs, andServices, as well as to those of other Conference Sections andSpecial Concerns Sessions, to note the frequency with whichreference was made to inhome alternatives to inappropriate,institutional care of the elderly.

Excerpts from the Address given by Mrs. Theodore Wedelare appended to this report of the Session.

Service who could speak with firsthand knowledgeof the approaches the Federal Government hastaken to provide in-home services. A representativefrom the Department of Labor could discuss theunique training and employment opportunitiesoffered those who deliver in-home health andsocial services. Persons working to insure theavailability and adequacy of such services throughState and' local agencies, as well as those repre-senting interested national organizations such asthe American National Red Cross, had the op-portunity to contribute their particular insights.

116


PROGRAM

HOMEMAKER-HOME HEALTH. AIDE SERVICES

PresidingELLEN WINSTON, President, National Councilfor Homemaker-Home Health Aide Services, Inc.

AGENDA

8:00 A.M. Focus of the SessionDR. ELLEN WINSTON

Introduction of Special Consul-tants

Address.Meeting the Needs of Older Peo-ple through Homemaker-HomeHealth Aide Services MRS.THEODORE WEDEL, AssociateDirector, Center for a VoluntarySociety

Discussion of Major Issues"What We Have; What We Need"

Appointment of a Committee toDraft Recommendations

Summary of Earlier Discussionand Continuation of Discussionwith Emphasis on Developmentand Expansion of Services

Consideration and Adoption ofRecommendations

12:00 Noon Adjournment

THE SESSION REPORT

IntroductionHomemakerhome health aide service helps

families to remain together in their own homeswhen a health and/or social problem strikes or toreturn to their homes after specialized care. Thehomemakerhome health aide carries cut as-signed tasks in the family's place of reSidence,working under the supervision of the professionalperson who also assesses the need for the serviceand implements the plan of care.

A national approval system has been developedwhich provides agencies, whether under voluntary,government or proprietary auspices, help to assurethe quality of homemakerhome health aideservices throughout the country. This program forapproving agencies will be implemented in 1972.

Despite the demonstrated need, it is estimatedthat there are only 30,000 homemakerhomehealth aides in the entire United States, serving allcategories of social and health needs: the ill, aged,disabled, children, and others with social and/orhealth problems. At a minimum, homemakerhome health aide agencies should have available300,000 homemakerhome health aides or onehomemakerhome health aide per every 1,000persons in our total population. For older persons;the ratio should be approximately one per 100 asa minimum.

Professional personnel is in short supply and itis expensive. Paraprofessional or allied profes-sional help must be utilized where and whenappropriate from the standpoint of safe and effec-tive care. Homemakerhome health aide serviceis an exemplary utilization of paraprofessionalpersonnel.

To meet established national standards, home-makerhome health aides must be carefullyselected, trained, and supervised, but they do notrequire an extensive educational background and,therefore, this vocation is proving to be a realisticchoice for many educationally disadvantaged butcapable individuals. Often these are middle-agedor older women. The community stands to gain

doubly from this service as previously unemployedindividuals become self-sustaining.

Homemakerhome health aide services providemany older persons the choice of maintaining in-dependent living.

Recommendations1. Homemakerhome health aide services are

basic to continued independent living for olderindividuals in their own homes or in other placesof residence considered as home; or the return toindependent living of a large proportion of olderpeople. They must be required in those health andwelfare programs for older people, with broadeneddefinition for greater flexibility and eligibility forservices, in which the Federal Government partici-pates financially. They must be required servicesavailable throughout each State. These servicesmust be well publicized, including frequent use ofmass media.

Federal legislation for both health and welfareprogiams should specifically identify and requirethat homemakerhome health aide services areavailable to every community, with appropriationsof Federal funds making it possible to establishthem.

The expansion of these services will requireadditional funds, but it should be recognized thatthey also open up and offer new opportunities foremployment and careers for many mature womenand men.

2. Since homemakerhome health aide servicesmay be needed in any family, rich or poor, at sometime, they should be available free; or on a slidingscale of fees, to the recipient or through thirdparty payments, or other financial sources. Experi-mentation with new and different methods of fi-nancing should be explored. Federal and Statelegislation should be enacted to provide adequateon-going public funding to make it possible toprovide homemakerhome health aide servicesfor all older persons to live in their own homes orother places of residence.

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3. Since at the time of need for homemakerhome health aide services the individual or familyis in a vulnerable situation, there must be a require-ment that any agency providing such services,whether public, voluntary, or commercial, meetnationally established standards to protect thequality of the services rendered. Such .standardscall for a team approach, using both professionalsand paraprofessionals. .

4. The necessary resources of other related in-home services such as friendly visitors, meals-on-wheels, chore services, shopping and transporta-tion, as well as other in-home professional services,must be available when needed if individuals and

families are to be served as effectively as possible.Any in-home service must be provided only

when it is the choice of the person or persons to beserved with their full knowledge of alternatives.

5. Homemakerhome health aide servicesmust be available as supportive, protective, andpreventive services on a flexible basis for as longas needed, whether full-time or a few hours perweek, whether on a continuing supportive basis orfor only a temporary period of time. The arrange-ments in each case should provide the older per-son the option of remaining in his own home orplace of residence, as long as it is feasible andpossible to do so with dignity and safety.

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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-thakerhome health aide services to the aging,but this service will benefit many other groups inthe population as wellchildren whose mother isill, the chronically ill, physically and mentally dis-abled or severely handicapped of any age, and dis-advantaged mothers who need help in child rearingor home management. Therefore, as we discussthe benefits for the aging portion of our popula-tion, we can realize that this is not speCial pleadingfor one group at the expense of others. We wantthe service available for all.

First, let's just note some facts.

1. Today there are at least 20 million over65 in this country.

2. A very tiny proportion of this group havesufficient financial resources to buy neededservices or care.

3. The vast majority of the 20 million facemajor health and social problems, yet inour mobile society few can be cared forby members of their families.

4. Home is for many an aging person orcouple theost important factor in main-taining dignity, self assurance, and con-tentment.

5. Many communities provide only institu-tional care for the aging, in hospitals,nursing homes, homes for the aged orretirement homes. This will be the bestplan for some, but for as many as 10 mil-lion of our aging citizens, institutional

care is ,inappropriate, inadequate, and un-wanted. Every one in this room will facethis situation personallyfor yourself orsomeone you lovein the not too fardistant future.

6. Not only is institutional care not welcomeor congenial to many older people, but it

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may also be far more costly than beingmaintained in their own homes. Scarce,expensive hospital beds 1.re often occupiedby aging persons who do not really needhospital care, but for whom there is noalternative. The construction of enoughhospitals,- nursing homes, and retirementhomes to take all the aging would costuntold millions of dollars, even before anyservice was provided. There is an unfortu-nate tendency at the moment to tie healthinsurance payments to hospital or otherinstitutional area subject on whichsome of us need to take legislative action.

7. There is a shortage of the professionalpersonnel who can meet the needs of theagingdoctors, nurses, social workers andothers.

8. There are thousands of able-bodied, ex-perience women in this country whowould welcome the opportunity to workfor a recognized agency, receive trainingand be challenged by the role of home-makerhome health aide.

These facts add up to just one thing for human-itarian and for financial reasons, it is essential thatevery community in this country provide home-maker 'come health aide services.

I hope we will face this question soberlywhatcan we do to wake up our communities and theFederal Government to the fact that there h agood and workable solution to the inappropriateinstitutionalization of the aging. It is found inquality homemakerhome health aide servicesservices that meet nationally established standards.

What can you and I do?

1. We as citizens with knowledge can have alot of influence on Federal legislation and

regulations. Learn the facts; talk andwrite with enthusiasm to your Congress-man; demand that aging persons be. giventhe choice of staying in their own homes;become aware of the Federal programsthat tie benefits only to institutional care.Medicare, for example, restricts inordi-nately payments for home health services.

2. Federal financial help is needed, but Stateand 1,4a1 communities must also be in-volved. There is need for local voluntaryaction and a broadened base of fundingbecause a large group of the aged whomost need these services are not the very,very poor who might be served by a publicwelfare program, but they are the middle-income -aged living on pensions who arebadly hit by inflation. There are even somequite well-to-do older people who needthe service and could pay for it, were itavailable.

If public or private health insurance can beprovide to pay for home health care and home-makerhome health aide services as part of thatcare, it will do much to provide more humane andoften more adequate care for the aging, and in thelong run will result in great savings if we canstop building additional, unnecessary, expensiveinstitutions.

There may be times and places when we whoare enthusiasts for this service will find, it wise zostress dollar and cents values. But I hope you feelIs I do, that even if homemakerhome healthaide services cost more s than institutional care, itwould still be worth the cost. If--by what we dohere todaywe can assure happiness, better health,and the dignity Of independence to our belovedelders, this will be a day well spent indeed.

Roster of Planning Committeeliongovernment

Ellen Winston (Chairman), President, NationalCouncil for HomemakerHome Health Aide Serv-ices, Inc., Raleigh, North CarolinaHelen Cusuck, Assistant Director, Nursing Services,Visiting Nurse Service, New York, New York

Leah Hoenig, Director, Department of Home HealthAgencies, National League for Nursing, New York,New York

Florence Moore, Executive Director, National Coun-61 for HomemakerHome Health Aide Services, Inc.,New York New YorkJanet Starr, Executive Director, HomemakerHome-Health Aide Association of New York State, Syracuse,New York

William Voltam, Executive Director,' HomemakerServices Bureau of Greater New Haven, New Haven,Connecticut

Mary Walsh, Program Consultant, National Councilfor HomemakerHome Health Aide Services, Inc.,New York, New York

GovernmentAlbert Fox, Director, Division of Direct Reimburse-ment, Bureau of Health Insurance, Social SecurityAdministration, Department of Health, Education, andWelfare, Washington, D. C.Bernice C. Harper, Social Work Consultant, Divi-sion of Health Resources, Community Health Service,

Health Services and Mental Health Administration,Public Health Service, Department of Health, Educa-tion, and Welfare, Rockville, MarylandGladys Lawson, Specialist on Homemaker Service,Division of Child and Family Service, CommunityServices Administration, Social and RehabilitationService, Department of Health, Education, and:Wel-fare,;Washington, D. C.Stephanie B. Stevens, Homemaker S. rvice Specialist,Administration on Aging, Social and RehabilitationService, Department of Health, Education, and Wel-fare/Washington, D. C.

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Reports of the

Special Concerns Sessiow on

DISABILITY ANDREHABILITATION

AGING ANDevere visual impairment is increasinglya problem affecting older persons. TheSpecial Concerns Session on Agingand Blindness was designed to focus

national attention the special needs of the onemillion older Americans in this group and onways of meeting those needs.

The prevention and treatment of blindness wasinitially identified as a special Conference concernin the work. of the National Organization TaskForce on Physical and Mental Health. Included inthe recommendations of that group was "Amongthe complex needs for the aged, priority shouldbe given to the prevention and treatment ofblindness."

This expression of concern, together with theefforts of several individuals and national organi-zations, served to heighten the sensitivity of theConference planners to the special circumstancesof the elderly blind and resulted in the establish-ment of the Session on Special Concerns.

The National Task Force on Geriatric Blind-ness of the American Foundation for the Blind,Inc., initiated the planning of the Session. Joiningthem as members of the Planning Committeewere representatives from the Liaison Committeeon Geriatric Blindnesswhich functions on be-half of the Foundation and the American Geria-trics Societyand the National Society for thePrevention of Blindness, Inc. In all, more than 25organizations were represented among the Sessionplanning committee members and program partic-ipants. ( See Roster of Planning Committee, page 129..)

Providing Federal resource and assistance inthe planning and program activities were the Na-tional Eye Institute and the Division for theBlind and Visually Handicapped, within the Re-habilitation Service Administration of the Socialand Rehabilitation Service, U.S. Department ofHealth, Education, and Welfare.

468.218 0 - 73.9

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BLINDNESSThe Participants

A small group of about 40 Delegates withsome special personal interest or professionalcompetence in the area of visual health chose topre-register for the Session on Aging and Blind-ness. Among those indicating their intent to at-tend this Session were Delegates representing pro-fessional organizations in the area of visual careand blindness, gerontologists and researchers inthe field of aging, rehabilitation workers servingthe blind and the handicapped, and older personsthemselves, including the elderly blind among theDelegate body.

In addition to regular Conference Delegatesand observers, at the request of the Session Plan-ning Committee, a number of special guests wereinvited. These special guests included the fullmembership of the National Task Force on Ger-iatric Blindness and the Liaison Committee onGeriatric Blindness, and other persons workingwith the blind within both governmental andnongovernmental units. Although theie specialguests did not hold voting privileges, they con-tributed substantially to discussion within the Ses-sion.

The Program

The program of the Special Concerns Sessionon Aging and Blindness allowed a panel of ex-perts in the areas of income maintenance, medi-cine and health, rehabilitation, transportation,and home health services to outline major prob-lems and present specific recommendations forconsideration and vote by the Delegates attendingthe Session.

Panel members sought to address the challengepresented them in the address of the Session Key-note Speaker, the Honorable Jennings Randolph,United States Senator from West 'Virginia, who

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urged the forging of "policy recommendationswhich willfirmly and forcefullyinbed in thepublic conscience the need for a national policyon aging and blindness."

Plior to discussion and voting, an invited panelof Reactors responded to the remarks and recom-

mendations of the Session speakers. Included inthis group of Reactors were several older blindpeople themselves and representatives from twoorganizations serving the blind which were nototherwise active in the Session program.


PROGRAM

AGING AND BLINDNESS

GARSON MEYER, Presiding

8:00 A.M. OPENING REMARKSDR. PETER J. SALMON, Trustee,

American Foundation for the Blind,Inc., New York, N.Y.

DR. ROBERT MORRISGAR-SON MEYER, Co-Chairmen of theNational Task Force on GeriatricBlindness, American Foundation ofthe Blind

DR. WILFRED D. DAVID, Exec-utive Director, National Society forthe Prevention of Blindness, Inc.

DR. ROBERT A. RESNIK, Chief,Office of Program Planning, Na-tional Eye Institute, Bethesda, Maryland

8:30 A.M. SPEAKERSENATOR JENNINGS RAN-

DOLPH, West Virginia, SpecialCommittee on Aging, U.S. Senate,Special Needs of the Aging BlindPopulation

9:00 A.M. PANELPolicy and Platform Statement inBehalf of the Elderly Blind Popula-tion in the U.S.

Income MaintenanceDR. JUANITA M. KREPS, Profes-sor of Economics, and Dean, TheWomen's College. Duke University,Durham, North Carolina

Medicine and HealthDR. A. L. KORNZWEIG, Chair-man, Liaison Committee American

Foundation of Blind, AmericanGeriatrics Society, New York, N.Y.

RehabilitationDR. DOUGLAS C. MacFAR-LAND, Director, Office for theBlind and Visually Handicapped,Social and Rehabilitation Service,U. S. Department of Health, Educa-tion, and Welfare, Washington,D. C.

TransportationWILLIAM C. FITCH, ExecutiveDirector, National Council on theAging, Washington, D. C.

Home Help ServiceDR. ROBERT MORRIS, Director,Max Levinson Gerontological PolicyInstitute, and Professor of SocialPlanning, the Florence .Heller Grad-uate School for Advanced Studiesin Social Welfare, Brandeis Univer-sity, Waltham, Massachusetts.

10:40 A.M.Discussion of Policy Recommen-dationsAn invited group of elderly blindpersons and special personnel willserve as reactors during this period.

Invited ReactorsWILLIAM EDWARDS, Washing-ton, D.C.; MILTON KLEIN, Co-lumbus, Ohio; HAZEL LEMKE,Rochester, New York; APARICIOG. RANGHLE, Washington, D.C.;DURKWARD K. McDANIEL,National Representative, AmericanCouncil of the Blind, Washington,D.C.; and JOHN F. NAGLE, Chief,Washington Office, National Fed-eration of the Blind.

11:00 A.M.Adoption of Policy and PlatformStatementsBy floor vote for final recommenda-tions in the White House Confer-ence Report.

12:00 NoonAdjournment

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The Program Content

The grist from which the recommendations ofthe Session on Aging and Blindness evolved wasdetailed in the notes of the Session maintained bymembers of the Planning Committee. High-lighted below are the remarks of some of the Ses-sion participants as drawn from these notes.

Dr. Robert A. Resnik spoke of the necessity forresearch on cause of blindness incident to theaging process and called for a concentrated ef-fort to reduce blindness from glaucoma throughdrugs, screenings, etc. He pointed to research cur-rently being done to treat cataracts medically aswell as through the improvement of surgical re-moval techniques and he set forth the followingneeds: an increase in the number of researchers,better public education and awareness of blindingeye diseases, and the clinical application of re-search findings.

The Honorable Jennings Randolph notedthe continuing need for treatment and preventionof blindness and the need to provide older blindpersons with rehabilitation services. In thisconnection, he mentioned a bill which he had in-troduced which provides such services withoutregard to the ability of the rehabilitant to join thework force. The Senator also identified the needfor more trained personnel and researchers in thearea of rehabilitation.

Senator Randolph discussed another bill whichhe had introduced in Congress which would ex-paad employment opportunities for blind persons,induding older blind persons, as operators ofvending stands in Federal buildings.

Dr. Juanita M. Kreps indicated the need fora guaranteed minimum income based on needwith automatic increases based on increases in thecost-of-living and recognized that welfare reformlegislation currently pending in the Congresswould take a large step in this direction by feder-alizing the adult public assistance categories andestablishing eventually a minimum payment of$150 per month. (Thirty-seven states were citedas currently having public assistance paymentsbelow this level.) She noted that another goodfeature of the welfare reform legislation is that itrequires separation of income maintenance andthe provision of social services.

Dr. Kreps recommended that OASDI and theadult public assistance categories (Old Age As-sistance, Aid to the Blind, and Aid to the Perma-nently and Totally Disabled) be increased to theintermediate level recommended by the Bureau ofLabor Statistics, that the public assistance catego-ries be federalized, and that Social Security bene-fits not be considered in determining eligilibityfor public assistance.

Dr. A. L. Kornzweig elaborated upon severalareas in which improvement is necessary. Amongthem: increased use of low vision aids, periodiceye examinations for people over 40, glaucomaeducation and screening programs, more researchon diabetic retinopathy, and prevention of acci-dents of the eye.

Dr. Kornzweig made several concrete sugges-tions: (1) that diabetic retinopathy be given highpriority in research both by the National Eye In-stitute and by other research groups; (2) thatthere be periodic eye examinations in nursinghomes and other homes for the aged in order todetect -and treat preventable blindness; (3) thatthe National Eye Institute and others establish aresearch program on diseases of the macula; (4)that there be increased financial support for re-search on cataract, glaucoma, and vascular dis-eases which affect the eye; (5) that there be acommunity screening program, possibly using mo-bile units, to reach and treat aged patients whosuffer from blinding eye diseases; and (6) thatthere be an educational center established to dis-seminate information about preventable eye dis-ease.

Dr. Douglas C. MacFarland told of the needfor comprehensive social services leading to inde-pendent living, integration of the blind with thesighted population, counselling with newly-blinded persons and their families, and privateagencies to purchase necessary services which areotherwise unavailable. He also noted the need forbetter recreation opportunities for the blind per-son and for widespread mobility instruction.

He affirmed the goal of rehabilitation to be in-dependence of the blind person, freeing othermembers of the family from the burden of con-stant care, and, if the blind person is in a nursinghome or extended-care-facility, freeing staff for

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other purposes and allowing the blind person tolive in such facilities without having to pay forextra care.

Dr. MacFarland projected a move away fromproviding direct services through State agencies tomore use of private agencies with which Stateagencies can contract for services. He also looksfor increased use of volunteers in the rehabilita-tion process and a specialized type of workshopwhere older blind persons can work on a part-timeor occasional basis.

Dr. MacFarland made the following recom-mendations: (1) the Rehabilitation Services Ad-ministration (RSA) should be urged to developdemonstration programs in rural areas and thedata so developed should be widely circulated;(2) RSA should fund construction and staffing ofat least one workshop for older persons of thekind mentioned above; (3) the Social and Reha-bilitation Service, of which RSA is part, shouldgive a high priority to the training of paraprofes-sional workers to make rehabilitation servicesavailable to all older blind persons within thenext five years.

The RSA should also make a study of volun-teer programs now in operation and developguidelines for recruitment, training, and supervi-sion of volunteers. An attempt should also bemade to double the number of volunteers and in-erase the number of hours they work; (4) reha-bilitation adjustment training, mobility instruc-tion, etc., should be made available to all personswho need or request them, and not only thosewho are employable.

The Congress should enact legislation nowpending in Congress which would implement thisrecommendation; (5) there is a continuing needfor research and demonstration and training ofprofessional personnel.

William C. Fitch recognized the urgent needfor adequate transportation for the elderly andparticularly the elderly blind, and recommendedthat the group adopt a resolution calling for theprovision of adequate transportation services par-ticularly to elderly blind and handicapped per-sons. .

Dr. Robert Morris outlined three needs of theelderly blind persons: medical care and preven-

tion, rehabilitation, and personal care and homehelp services, and called for the development of anationwide network of personal care organiza-tions to assist elderly persons to remain in theirown homes as long as they desire to do so. Theorganizations should provide whatever servicesthe clients request, even if it is a request for asimple non-skilled type of service.

Dr. Morris suggested that financing of thesepersonal care services should be through SocialSecurity and that they should be available to allthose needing them as a matter of right. The pur-chase of such services .could be by voucher or bydirect cash benefits and the amount of benefitshould be based on the severity of the handicap.

Dr. Morris recommended the reallocation ofresources form the provision of custodial care tothe provision of home care service.

Delegates and the Panel of Reactors:Expressed support of the legislative initia-

tives made by Senator Randolph.

Spoke of the need for provision of socialservices and vocational rehabilitation services toolder blind persons as a matter of right withoutrestriction based on the age or financial ability ofthe applicant and in support of amending theCivil Rights Act of 1964 to prohibit discrimina-tion against blind persons solely by reason oftheir blindness.

Encouraged the consideration of a broaderspectrum of employment possibilities for theblind, as well as directing efforts at training ablind person in line with his interests.

Reiterated the need òr a more adequate in-come and training directed at useful activitieswhich would keep the older blind person in thecommunity rather than having him shut off fromit.

Spoke against segregated housing for theblind and for more adequate medical care person-nel and more community workers and volunteers.Supported (1) the use of the professionalservices of optometrists in vision screening; (2)the amending of the Medicare legislation to in-clude payment for low vision aids when the needis certified by an ophthalmologist or optometrist

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specializing in low vision treatment; and (3) in-creasing the number of low vision centers, andhaving such centers manned under the supervisionof an opthalmologist or qualified optometrist.

Identified support for a system of redu'Odfares on airplanes and municipal transportationfor blind persons of all ages.

And, in floor discussion following the adop-tion of the Session recommendations, proposedand adopted the following motion: That we rec-ommend to Congress a nationally recognizedidentification card similar to a driver's licensewhich blind persons could use for identification inthe same manner in which sighted people nowuse a driver's license.

THE SESSION REPORT

IntroductionSince the American Foundation for the Blind

participated actively in the 1961 White HouseConference on Aging, we have a deep apprecia-tion of its constructive impact in generating in-creased public awareness and concern for theunmet needs of our aging population and in stim-ulating a larger use of our Nation's resources inmeeting these needs.

We, in collaboration with other national, State,and local organizations of and for the blind, doappreciate an opportunity to share with you ourspecial concerns. As reported by the National So-ciety for the Prevention of Blindness, approxi-mately half of the estimated 500,000 legally blindpersons in the United 'States are 65 years of ageor older while two-thirds are past middle age.Moreover, the majority of all new cases of blind-ness each year fall within the same age brackets.Despite these facts, most of our efforts, in boththe governmental and private sectors, have beendirected to blind children and to blind adults ofemployable age. Only recently have we begun toconsider the needs of the older blind person.

Another aspect of our special concern stemsfrom our philosophical belief in the desirabilityof helping blind persons to achieve their fullestpotential and integrated members of their com-munity.

While this belief in no way contradicts theneed for specialized and often separate servicesfor persons who are visually handicapped, there isan equal need to insure the availability of generalcommunity services. Within this context, our hopeis that blind personsin fact all handicapped in-

dividualswill become beneficiaries of thy- rap-,

idly expanc.;:rig programs and services for olderpersons in such fields as health, nutrition, hous-ing, recreation, employment, continuing educa-tion, etc. It often takes little if any adaptation toimplement this concept, but unfortunately itrarely occurs automatically, i. e., without continu-ing interpretation, education, and planning.

In summary, we urge that the 1971 WhiteHouse Conference give a high priority to ifquestion of how handicapped persons, especiallythose who are visually handicapped, can be moreeffectively integrated and served by the ever-in-creasing number of special programs for olderpersons. As Senator Jennings Randolph of WestVirginia stated in his keynote address to the Spe-cial Concerns Session on Aging and Blindness, "Itis clear that we must change attitudes toward theblind. We must provide opportunities for normalliving in society; not charity, but a chance. I fearthat there is widespread misconception about theabilities and aspirations of elderly blind persons."

Findings andRecommendationsRECOMMENDATION 1It is recommended that Congress increase old age,survivors and disability insurance and the adultpublic assistance categories to the intermediatelevel of living recommended by the Bureau ofLabor Statistics (at least $2,297 for a singie per-son and $4,185 for a married couple) and furtherthat the adult categories of public assistance be

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federalized and that Social Security benefits notbe deducted from public assistance payments.

RECOMMENDATION 2It is recommended that the National Eye Instituteand other interested organizations on a nationaland local level combine their efforts in a urgentoverall program to prevent or alleviate diabeticretinopathy; establish a center for the study ofdiseases of the macula, and increase research ef-forts in the fields of cataract, glaucoma, and vas-cular diseases of the eye; establish screening ef-forts especially at hospitals, medical centers,homes for the aged, nursing homes, and extendedcare facilities to find aged patients who haveblinding eye diseases which can be helped bymedical or surgical means and low vision aids.Such efforts should be made by interested philan-thropic organizations and implemented if neces-sary by legislative action;

It is further recommended that the NationalEye Institute be required to develop better statis-tics on incidence, prevalence, and etiology ofblinding eye conditions: that Congress amendTitles XVIII and XIX of the Social Security Actto cover low vision aids when the need is certifiedby an ophthalmologist or an optometrist specializ-ing in low vision treatment; and that the numberof low. vision centers be increased and that thecenters be staffed under the supervision of an op-thalmologist or a qualified optometrist.

RECOMMENDATION 3It is recommended that the Vocational Rehabilita-tion Act be broadened to make rehabilitationservices available to blind persons without regardto age or economic need and that Congress beurged to enact legislation to amend the Voca-tional Rehabilitation Act to provide rehabilitationservices for older blind persons, and to amend theRandolph-Sheppard Act to accomplish these pur-poses.

RECOMMENDATION 4

It is recommended that the elderly, including theblind and handicapped, must have access to allmodes of mobility and transportation for obtain-ing the essentials of daily living and the culturaland social benefits of modern society.

RECOMMENDATION 5

It is recommended that the Administration andCongress develop a network of personal care ben-efits for 'individuals with a certain level of func-tional disability to enable the older person to pur-chase whatever services are necessary to help himremain in his own home if he so wishes; suchbenefit is to be in addition to basic minimum in-come and assure a financial basis for local com-munity service providers.

Roster of Formal Planning Committee

A. L. Kornzweig, Planning Committee Chair-man, Liaison Committee, American Geria ..trics Society, New York, N.Y.

Dorothy Demby, Staff AssociateNational Task Force on Geriatric Blindness,New York, N.Y.

Wilfred D. David, Executive DirectorNational Society for the Prevention of Blind-ness, Inc., New York, N.Y.

Garson Meyer, Co-ChairmanNational Task Force on Geriatric Blindness,Rochester, N.Y.

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Robert Morris, Co-ChairmanNational Task Force on Geriatric Blindness,Waltham, Mass.

Harold G. Roberts, Associate DirectorAmerican Foundation for the Blind, Inc.,New York, N.Y.

Robert Robinson, Research AssociateAmeriL in Foundation for the Blind, Inc.,New York, N.Y.

Irvin P. Schloss, Legislative AnalystAmerican Foundation for the Blind, Inc.Washington, D.C.

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PHYSICAL AND VOCATIONALREHABILITATION OF OLDER PEOPLE

bsence of formal plans to developsystematic vocational rehabilitation in-puts for the 1971 'White House Con-ference on Aging led the Federal

Guidance and Employment Service to conduct abroad-based pre-White House Conference on thissubject at Arlington, Virginia, on September14-16, 1971.

Attended by more than 100 leaders in the fieldof vocational rehabilitation, this Conference wassupported by a grant from the RehabilitationServices Administration, Social and RehabilitationService, United States Department of Health, Ed-ucation, and Welfare, and received extensive co-operation from a -wide spectrum of rehabilitationgroups and agencies. A Policy and PlatformStatement emerged from the Conference with theunderstanding that it would be presented to the.White House Conference on Aging as an expres-sion of the recommendations of the vocational re-habilitation movement.

The ParticipantsThe Special Concerns Session on the Physical

and Vocational Rehabilitation of Older People at-tracted a pre-registration of 211 Delegates. In ad-dition to these, a distinguished list of guests, in-cluding members of Congress known to beespecially concerned with the problems of the el-derly population and with the rehabilitation of thehandicapped, were _invited to attend the meetingof the Session.

The ProgramThe major part of the Session program was de-

voted to a discu3sion of the Policy and PlatformStatement developed at the September Confer-ence. A panel of specialists commented upon therecommendations presented, and the Delegatesunanimously endorsed, without change, the docu-ment as presented.

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1971 WHITE HOUSE CONFERENCEON AGING

PROGRAMSPECIAL CONCERN SESSION

on

PHYSICAL and VOCATIONAL

REHABILITATION

OF OLDER PEOPLE

8:00 A.M.OPENING REMARKS:DR. EDWARD NEWMAN,

Commissioner, Rehabilitation Serv-ices Administration, Departmentof Health, Education, Welfare

8:30 A.M.PRESENTATION OFPROPOSALS FOR DISCUSSIONAND ADOPTION

PANEL MEMBERSW. SCOTT ALLAN, Assistant

Vice President, Liberty Mutual In-surance Company

CHARLES ROBERTS, ExecutiveVice President, International As-sociation of Rehabilitation Facil-ities . .

LAWRENCE SMEDLEY, Assist-ant Director, Department of SocialSecurity, AFL-CIO

E. B. WHITTEN, Director, Na-tional Rehabilitation Association

12 Noon Adjournment

1.

THE SESSION REPORT

Preamble

Although strong social pressures impinge uponunemployed disabled persons 55 years of age andover to disengage themselves from the labor mar-ket, some 15 to 20 percent of them persist in theirdesire to continue working. Employer resistance,community apathy, and inadequate rehabilitationresources combine to frustrate the employmentaspirations of the members of this group. Yet, re-search conducted at Federation Employment andGuidance Service and elsewhere clearly indicatesthat almost all vocationally-motivated older disa-bled persons retain surprisingly high degrees ofpotential employability and respond positively tovocational rehabilitation measures. In study afterstudy, older disabled vocational rehabilitationclients in all sections of the United States havedemonstrated that they can make a contributionto the welfare of their families, their communi-ties, and the country at large, if provided with

, suitable rehabilitation and employment opportuni-ties.

The benefits derived by this group from partici-pation in vocational rehabilitation often is statedin economic terms. Indeed, their nost-rehabilita-tion earnings usually spell the difference betweenliving in poverty and living in comfort. Beyondthis, however, their psychic gains are no less sub-stantial. Vocationally-motivated older disabledpersons who reenter employment usually feel bet-ter, acquire enhanced self-regard, and assumemeaningful roles in the family and the commu-nity. Psychologically, the disengagement processusually is reversed and mental health problemsare ameliorated. Case evidence as well as statisti-cal findings support the conclusion that participa-tion in remunerative work is closely associatedwith the achievement of a satisfying and usefullife style among employment-oriented older disa-bled persons.

Notwithstanding the bright promise of voca-tional rehabilitation for such individuals, servicesfor this group remain largely undeveloped. An

undercurrent of skepticism and detachment marksthe American attitude toward older disabledworkers and is manifested in such phenomena asarbitrary retirement age levels, inadequate reha-bilitation services, and employer disinclination tohire older persons.

The pre-White House Conference on the Vo-cational Rehabilitation of the Older DisabledPerson was developed to give visibility to thelegitimate needs and concerns of vocationally-motivated older, disabled persons and to bring tothe White House Conference and to the public atlarge an awareness of the critical needs of thisgroup. The Platform that follows, an out-growthof the pre-White House Conference on the Voca-tional Rehabilitation Older Disabled Persons, pre-sents the views of a cross-section of Americanleadership concerned with aging persons. Eachplank was presented to the preliminary conferenceas a whole, for study, review, amendment, andpass: se. It represents the combined interest, in-sight, and skill of more than 100 delegates. Assuch, it may serve to focus the attention of theAmerican people upon a group that currently isbeing grossly neglected despite their interest in,and readiness for, rehabilitation and employment.

The Special Concerns Session on Physical andVocational Rehabilitation at the White HouseConference on Aging endorsed this Policy andPlatform Statement, presented here in shortenedform.'

Recommendations and CommentSome 15 to 20 percent of all unemployed dis-

abled persons 55 years of age and over elect tocontinue in the labor market, despite severe limita-tions, and the lack of encouragement from thecommunity.

Vocational rehabilitation services for the mem-

130

I A full statement of the Platform and Policy Statement hasbeen published by the Federation Employment and GuidanceService, 215 Park Avenue, South, New York, N. Y. 10003.

hers of this group are lacking or are highly inade-quate in most sections Of the United States. Thisneglect reflects the general apathy of Americans,even those who work with older persons, towardthe vocational aspirations of older persons. Eventhe 1971 White House Conference on Aging, inits preparatory stages, made no plans for a con-ference section on rehabilitation (as it had donein 1961).

In face of this extensive lack of concern for thevocationally-motivated older disabled person, theobjective of the pre-White House Conferencemeeting was to recommend policies and programsthat should be instituted to meet the needs of thisgroup in the 1970's.

SPECIFIC RECOMMENDATIONS

1. Legislation

A. Current legislation should be amended or ad-ministered so as to provide for:

Positive enforcement of existing anti-discrimi-nation legislation.

Improved Social Security benefits.

Modification of the Social Security earningslimitation.

Inclusion of rehabilitation incentives in welfarelegislation.

A rise in the level of Social Security TrustFunds available for payment for vocationalrehabilitation services.

Earmarking of specific anti-poverty funds forthe aging.

Inclusion of vocational rehabilitation servicesunder Medicare and Medicaid and proposedcomprehensive care programs.

B. New legislation is needed to achieve:

Public agency financial support for long-termworkshop employment programs.

The use of Federal funds to create new jobsfor the aging in private industry and govern-ment-sponsored public service activities.

131

Non-discrimination in employment throughoutthe United States at all geographic levels.

2. The Community

The community should:

Pay particular attention to disadvantaged sub-groups among the aging.Establish general and/or specialized 'Programsfor the aging.

Be educated to the vocational rehabilitation po-tential of the aging.

Develop comprehensive service programs forthe aging containing strong vocational compo-nents.

Develop organized gm:4.s of aging persons,that, among other activities, support vocationalcomponents.

Through its rehabilitation agencies and work-ers, function as an advocate of the aging.

Develop improved community transportationfacilities in cooperation with United States De-partment of Transportation.

3. Organizations and Programs

A. All types of agencies in the communityshould:

Open their general community facilities andprograms to the aging on the same prioritybasis as other groups.

Reach out to currently "underserved" subgroupsof aging persons.

Consider rehabilitation of the aging as a spe-cialized rehabilitation subfield.

Include vocational rehabilitation services intheir multifunction programs for the aging.

Adopt service procedures that enable the agingto enter vocational rehabilitation programswithout delay.

Make provision for the aging to serve onboards and committees which formulate agencypolicies and programs.

Encourage institutions for the aging to set upvocational programs for their residents.

Establish experimental rehabilitation residencesfor the aging.

Develop regional and State vocational rehabili-tation centers for the aging. a't

Set up special programs for homebound andneighborhood-bound older agencies.

Establish linkages between agencies for theaging and other agencies.

Designate a national group to serve as a forumand a clearing-house for those concerned withthe vocational rehabilitation of older persons.Expect rehabilitation agencies serving the agingto conform to commonly-accepted service stand-ards.

B. Federal and State Rehabilitation Agenciesshould:

Take leadership in developing services forolder disabled persons, preferably through spe-cially-designated organizational sections or divi-sioss.

Earmark special funds for the aging.

Be strengthened, in general, in funding, pro-gramming, and administration.Assign responsibility for programs for theolder disabled person to special personnel.

Stipulate clearly that age, per se, is not a dis-qualification for entry into vocational rehabili-tation service.

C. Voluntary Agencies should:

Be given a major role in the vocational rehabil-itation of older disabled persons.

Engage, along with other agencies, ininnovation research and demonstration activi-ties.

Attempt to reach as many older disabled per-sons as possible through decentralized catch-ment area programs.

Along with State agencies, assume responsibilityfor the conduct of long-term workshop employ-ment programs with the aid of public agencyfunding.

Offer comprehensive vocational rehabilitationprograms. Be given responsibility for continuityof care.

D. Private enterprise should:

Be encouraged to participate in the vocationalrehabilitation of older disabled persons.

Assume responsibility for preventing and ame-liorating vocational handicaps in their agingemployees.

Be assisted in these functions by comultationfrom specialized rehabilitation agencies andpersonnel.

4. Employment

Vocational rehabilitation should emphasize ca-reers, not merely jobs, for older disabled persons.

Public and private hiring practices which bar olderdisabled _persons from employment should bealtered.

Employers should be educated to see the values ofhiring older disabled workers.

Vocational benefits offered to other disabilitygroups in employment should be opened to theaging.

Flexible working hours should be adopted in in-dustry. Additional part-time employment oppor-tunities should be created.

Employment should not be discontinued on thebasis of an arbitrary maximum age.

Employment opportunities in community serviceshould be fully explored.

Demonstration new careers program. s should belaunched.

5. Personnel Training and Research

Rehabilitation personnel should be trained inservice to the aging through specially-funded pro-grams.

Grant applications for research and demonstra-tion projects for the older disabled person shouldbe given a high priority.

132

1.

National research and demonstration and/or re-search and training .centers on the vocationalrehabilitation of the aging should be established.

Fundamental and applied research relating to theolder disabled worker should be supported bypublic funding.

Application of modern technology to the prob-lems of the aging should be explored.

6. Medical

Medicare-funded rehabilitation services should beextended to persons receiving Social Security Dis-ability benefits through rehibilitation as well asother health facilities.

Federal funds for medical research should be in-creased.

Additional Federal financial assistance should beprovided for, the training of medical and alliedpersonnel.

The Federal Government should sharply increasethe funds allocated for the construction, expan-sion, and alteration of rehabilitation facilitiesunder the Hill-Burton Program and the Voca-tional Rehabilitation Act.

Medicare and Medicaid legislation should beadopted which strengthens the rehabilitation com-ponent and which enables patients to receivemedical rehabilitation service in conjunction withtheir hospitalization.

133

(

AGING AND DEAFNESScting on a suggestion made by Dr.Boyce R. Williams 1 and Dr. JeromeSchein, Director, Deafness and Re-search Training Center, New York

University organized a national conference on"Services for the Elderly Deaf Persons" held inColumbus, Ohio.2

The committee 3 planning the program antici-pated that the outcome of the meeting would beincluded as one of the special concerns of the1971 White House Conference on Aging.Through a series of circumstances, this expecta-tion did not become clear until it was too late toorganize such a session.

The outcomes of the Columbus Conference,which were published on July 9, 19714 are ofsuch national importance that arrangements havebeen made to include this summary of the find-ings as a part of the report of the White HouseConference on Aging. The following material isquoted, with Dr Schein's permission, from Serv-ices for Elderly Deaf Persons.

ColumbusConference ReportPreamble

Because they cannot hearand have notheard for all or almost all of their lives--deafpersons face their later life with different needs

1 Chief, Communication Disorders Branch, RehabilitationServices Administration. Social and Rehabilitation Services, De-partment of Health, Education, and Welfare.

2 Supported, in part, by a grant from the Social and Re-habilitation Service, Department of Health, Education, andWelfare.

3 See Roster of Planning Committee, page 141.4 Copies of the full report are available from the Deafness

Research and Training Center, New York University, 80 Wash-ington Square East, New York, N. Y. 10003.

from the general aged population. Deafnessmakes communication between them and mostpeople very d:ilcult. The ordinary use of radio,televisi n, and telephones is denied them. Theycannot hear a doorbell nor a shouted warning.When aging combines with deafness, the result-ing disability can be massive, though it need notbe.

As will be seen, communication is not the onlydifficulty aged deaf persons have in contrast toother aged persons. Their deafness has been alarge factor in their educational, occupational, andsocial development. Now in their declining years,their deafness continues to confront them withproblems demanding special efforts to yield satis-factory solutions.

Being a small group relative to the generalpopulation and having an "invisible" disability,deaf people are easily overlooked in planning forthe general welfare. The 1961 White House Con-ference on Aging, for example, makes no specificreferences to the elderly deaf population. Further-more, little has been written about this group andalmost no formal research has been conducted rel-evant to them. In order to correct this unhappystate of affairs, a conference was held to bring to-gether deaf community leaders and geriatric ex-perts, who worked together to expose the issuesand to recommend appropriate policies and pro-grams.

To assist the conferees to work effectively to-gether despite their diverse backgrounds and thelimited time available to them, a series of back-ground papers were prepared and sent out in ad-vance of the conference. Following a brief orien-tation to the conference, the participants met insmall discussion groups. Each discussion groupthen presented its conclusions to the full assem-bly, at which time differences were resolved andthe policies and programs adopted unanimously.

135

p-

The conference participants were chosen be-cause of their interest in and knowledge aboutthe problems of aging and deafness. The majorityof them are themselves deaf. However, becauseof limited funds, it was realized from the outsetthat a group representing all organizations ofdeaf people in all parts of the United Statescould not be assembled, The participants, there-fore, directed that their recommendations begiven the widest possible circulation in the deafcommunity, so that any disagreements with oromissions from the policies and programs can benoted before the forthcoming White House Con-ference on Aging.

RecommendationsIssues, Policies, Programs

The following policies and programs wereunanimously adopted by the participants in theConference on Services for Aged Deaf Persons,held in Columbus, Ohio, June 15-17, 1971. Theissues dealt with below were also agreed uponwithout disient, though only after extensive dis-cussion. Only those issues were considered andonly those recommendations were made which es-pecially concerned the aged deaf population.General issues for all elderly people were nottaken up as such. The conferees felt that theseproblems will be adequately discussed at theforthcoming White House Conference on Aging.Issues of income, employment, health, housingand so forth, then, are all presented here in thecontext of the special needs of the elderly deafcommunity.

The order of the topic follows th .t in the Invi-tation to Design a World . . . Second Reader,prepared for the 1971 White House Conferenceon Aging, distributed by the Administration onAging, Social and Rehabilitation Service, U.S. De-partment of Health, Education, and Welfare. Inaccordance with the plan of presentation for theConference, the sections first discuss issues, thensuggest policies, and finally recommend programs,as appropriate. There is some overlap betweenthe broad categories, and there may be some dis-agreement as to whether an issue, policy, or pro-

gram more properly falls under one or anotherheading. Some cross-referencing 'has been done toaid the reader whd may not find what he wishesin the expected place below.

In deliberating on aging and deafness, the con-ferees were not trying to fill in the blanks on aprepared schedule of items. Rather, they sawtheir mission as twofold: (a) determining theneeds and desires of aged deaf persons and (b)presenting these as clearly as possible to those whocan assist them to solve their problems and satisfytheir needs.

The emphasis and omissions, therefore, shouldreflect the special orientation of the deaf commu-nity toward aging.

Income

Because of their deafness, which may have lim-ited their lifetime earnings and consequently re-duced their retirement benefits, many elderly deafpersons face their declining years with inadequatefinancial resources.

Policy: Aged deaf persons, no less than anycitizen, should have sufficient income to live withdignity. The deaf community should join with allother groups in implementing this policy.

Program A: The Social Security Administra-tion should educate and inform those who areentitled to, but are not receiving, benefits abouthow to file for them. In order to more effec-tively do this, the Social Security Administrationshould appoint, as has already been done inthe Bureau of Education of the Handicappedand the Rehabilitation Services Administration,program specialists with responsibility for at-tending to the special needs of deaf persons.These educational efforts should be made withadequate provisions for the communication lim-itations of deaf persons. (Also see Education.)

Program B: Increase vocational training pro-grams and employment opportunities for deafworkers. (Also see Employment.)

Program C: Reduce costs of transportation,communication, housing, and medical care, sothat aged deaf persons' present resources will

136

;i

cover a larger portion of their living expenses.(Also see Transportation, Housing andHealth.)

EmploymentPrograms that could and should assist elderly

deaf people in securing employment after retire-ment do not appear to be doing so. The special-ized approaches necessary to finding work forthose aged persons who cannot hear are not pres-ently included in programs of vocational rehabili-tation for elderly people.

Policy: Aged deaf persons who can and whowish to continue in productive service to societyshould be given every opportunity to do so.

Program A. Ensure the provision of counsel-ing and rehabilitation services to aged deaf per-sons by encouraging them to use existing facil-ities and, at the same time, adapting theexisting facilities to meet the aged deaf per-son's needs.

Program B. Educate the public to the value ofthe elderly deaf worker.

Program C. Make certain that government,government-sponsored, and private programsfor employment of elderly personsfor exam-ple, Senior Community Service Aides. FosterGrandparents, Operation Mainstreamsuitablyprovide for the inclusion of aged deaf persons.

Program D. Develop volunteer programs forthose elderly deaf persons not in need or desir-ous of paid employment. Such programs maybe instituted in cooperation with local churchand community organizations, State associationsof the deaf, and the divisions of the NationalFraternal Society of the Deaf. It would also behelpful to develop guidelines which local agen-cies could use in planning for the assistance ofthese aged deaf volunteers. (Also see Retire-ment Roles and Functions.)

NutritionNo special issues pertaining to aged deaf per-

sons were raised. However, some of the issuesunder Income, Health, and Education are relevantto this topic, insofar as these beat upon havingsufficient funds to purchase proper foods and ob-

taining knowledge about correct diets. In both in-stances, deafness is a potential barrier.

HealthThe health needs of aged deaf persons are dif-

ficult to meet, because of the lack of medicaland paramedical personnel able to communicatewith deaf persons.

Policy. In providing for the health of elderlydeaf persons, particular attention must be givento their communication problems and their socialneeds.

Program A. Existing health legislation for theaged population, such as Medicaid and Medi-care, should be amended to take note of thespecial needs of deaf people. Such legislationshould provide funds for interpreters wheneverthey would be needed to permit deaf personsto take full advantage of the health facility.Program B. The American Medical Associa-tion and the American Hospital Associationshould encourage some doctors and nurses tolearn how to communicate with deaf persons.The AMA should be urged to develop central-ized services providing information on avail-able doctors skilled at communicating withdeaf persons. When appropriate, hospitals andnursing homes should arrange'for each nursingshift to have at least one nurse available who isskilled at communicating with deaf persons.Physicians and other health-care personnelshould be informed about the availability anduse of interpreters for deaf patients.

Program C. Health education programs espe-cially designed for elderly deaf persons shouldbe implemented at once. (Also see Education.)Program D. Existing and new nursing homesshould make suitable provisions for some ofthe aged deaf population, taking account oftheir special social and environmental needs.(Also see Housing.)

137

Program E. Community health centers andhome-care services should become aware of thespecial problems of deaf persons and establisha focal point for services to aged deaf persons.Program F. Third-party payers under medicalinsurance plans should meet the costs incurred

in providing an interpreter for deaf persons.during consultations and other medical services.

HousingWhen circumstances cause an aged deaf person

to seek group living arrangements, he often findshis choices limited and many, or ali of them, un-satisfactory.

Policies. The housing needs of aged deaf per-sons should be given greater attention, with theobject of providing the widest possible choice offacilities through rent supplements, housing subsi-dies, low-interest loans, etc. Funding should beavailable to groups of deaf people alone or tomixed groups of hearing and deaf people.

Aging deaf people are not uncommonly placedin a variety of institutions without considerationof the fact that they are deaf. Long-term commit-ment of deaf people should be in institutionswhere a deaf population is provided for in par-ticular. This policy is necessary due to the basicproblems of communication and isolation whichcould be alleviated by special social and recrea-tional opportunities for aged deaf persons.

Program A. Housing guidelines should beprepared for use by all groups interested inserving aged deaf persons.

Program B. Supportive servicessuch as"meals-on-wheels," transportation, or homenursingshould be provided to enable theaged deaf person to continue to live in his ownhome whenever possible.

Program C. Wherever appropriate, units foraged deaf persons should be provided in exist-ing or new facilities serving the general agedpopulation, and services should be included tomeet the special needs imposed by deafness.Program D. Encourage organizations of andfor the deafnational, state, and localtosponsor housing facilities for aging deaf per-sons under existing laws.

Program E. Conduct a study of the feasibilityof establishing for aged deaf persons a Feder-ally supported model retirement community. Itshould be comprehensive, providing for allranges of servicehealth, nursing care, recrea-tional, and social facilities. The housing, itself,

should offer all levels from completely inde-pendent living to nursing-home care. The facil-ity should have a policy and admissions' boardwhich is representative of the deaf communityin general as well as the elderly deaf popula-tion.

TransportationMany elderly deaf persons have more difficulty

traveling than elderly hearing persons because oftheir communication problem. The deaf commu-nity joins with the general aged public in seekingthe cooperation of private and governmentalagencies to improve transportation for the elderlyand to reduce its costs.

Retirement Rolesand Activities

Aged deaf persons, due to their communicationproblems, have available to them few of the so-cial, recreational, and civic opportunities that areavailable to those of the general aged population.Consequently, their later years are often spent inextreme loneliness, boredom, and unproductivity.Policies and programs to overcome these offensesof aging are presented in the sections headed Em-ployment, Housing, and Education, Clearly, allsteps aimed at alleviating the communicationproblems imposed by deafness will aid the deafperson in his daily living, at home or on the job.

138

Education

Inadequate perparation is given for old age. Itis often the case that deaf people reach their re-tirement time without an adequate understandingof Social Security benefits, health-care programs,and other benefits to which they are entitled.Many enter their later life without recreational,social and civic knowledge that would permitthem to make productive use of their time. Fur-ther, many are not prepared psychologically fortheir old age.

Policy. Educational programs for aged deafpersons and their families should be prepared andwidely distributed in a form and manner specifi-cally designed to interest and be understood by adeaf audience.

Program A. Increase educational programs forthe improved use and enjoyment by older deafpersons of their leisure time.

Program B. Develop rehabilitation programsto sharpen their marketable skills.

Program C.. Disseminate more effectively todeaf persons information vital to their func-tioning; e.g., health information, Social Securitychanges.

Program D. Educational and counseling pro-grams should be developed to prepare deafpersons for the readjustment problems theywill meet on retirement. Such programs shouldutilize all methods of communication suitableto deaf audiences and should be administeredthrough national and local organizations of thedeaf.

Program E. Preretirement programs to assistin preparing deaf people for their retirementyears should be established.

Program F. Adult education programs shouldbecome more flexible in an effort to meet theadult education needs and desires of deaf peo-ple, even to the point of suspending certain re-quirements, in particular those related toteacher qualifications and class size.

Program G. Senior citizen centers should beencouraged (a) to develop programs which canaccommodate deaf senior citizens within centerprograms or (b) to establish satellite centersfor deaf people and make provision for havingpeople in the programs who are able to com-municate and work effectively with deaf peo-ple.

Spiritual Well-BeingNo specific policies or programs directed at the

religious needs of elderly deaf persons were sug-gested. A great many denominations make specialprovisions for their deaf congregants. A few alsoarrange to serve their older deaf members in wayssuitable to their condition; for example, throughhome visits and special services.

Planning and EvaluationThe policies and programs relating to this topic

are largely discussed under the headings of Re-

468.218 0 79 - 10

search and Demonstration and Government andNongovernment Organizations.

Facilities, Programsand Services

There are special problems of integrating deafpersons into many appropriate existing services.There is lack of coordination between the differentgovernmental departments responsible for provid-ing services to all aged people.

Policies. Existing services should bear in mindthe special needs of disability groups, such as thecrippled and deaf populations. In particular, itshould be noted that the deaf person's communi-cation handicap and his lack of hearing places se-vere limitations on the use of mass media and thetelephone. There should be a permanent Presi-dential Commission on 'Aging with appropriaterepresentation for different groups of the agedpopulation, including the deaf population.

Program A. The National Association ofHomes for Aged Deaf (NAHAD) should belinked to the National Association of Homesfor the Aged (NAHA) and should draw upongeneral community resources in order to pro..vide a more efficient and effective service.

TrainingThere are not enough professional and para-

professional persons qualified to serve the deafcommunity. Aside from education in the disci-pline he practices, a person working with deafpeople must be skilled in communicating withthem. Possibly as critical, is the need for profes-sional counseling for the families of aged deafpersons.

Policy. Establish training programs and createeducational materials to prepare professional andparaprofessional personnel to work with ageddeaf persons and their families.

Program A. Establish specialized educationand training programs in Social Work, Reli-gion, Nursing, Guidance and Counseling whichwould develop personnel who could effectivelywork with aged deaf persons and their families.

139

Program B. Provide training programs inTotal Communication for professionals andparaprofessionals who wish to work in the deafcommunity.

Program C. Develop recruiting programs tointerest professional and paraprofessional per-sonnel in the problems of aged deaf persons.These programs should be sufficiently fundedto attract well-qualified persons.

Research and DemonstrationThere is a need for increased knowledge of the

problems, needs and desires of aged deaf persons.There is also a need for further development andrefinement of service techniques for meeting theseneeds.

Policy. Studies of the aged deaf population areneeded in order for service programsisLinaosetheir effectiveness. The findings of such studiesshould be published, disseminated, and applied asrapidly as possible.

Program A. As a development of the Na-tional Census of the Deaf a continuing demo-graphic study of the aged deaf populationshould be instituted and this should make pro-vision for the evaluation of existing servicesand needs.

Program B. Services to aged deaf personsshould be evaluated regularly in order to fostermaximum effectiveness and proper program de-velopment, and the results of these evaluationsshould be given to all concernedagencies,consumers, and other interested groups.

Program C. Establish a Volunteer WorkersCorps of aged deaf people who could provideservice assistance to recently deafened people.The recently deafened group would probablyinclude any adult, but concentration would bewith the older age group. Some of the service

140

aspects would include explaining what to dowhen hearing is decreasing and where to gofor assistance, evaluation, etc. Corps memberswould also assist in counseling, guidance, teach-ing new communications skills, giving informa-tion about such devices as lights in place ofdoorbells and alarmclocks, describing the cap-tioned Films for the Deaf program, and refer-ring to Vocational Rehabilitation services whenindicated.

Program D. Research should be conducted onways to overcome unfavorable attitudes, to theextent they exist, toward aged deaf persons.

Government and NongovernmentOrganization

Local, State, and national programs for deafpersons are often ineffective or achieve only mini-mal impact due to the lack of involvement ofdeaf persons in policy making, administration,and provision of services.

Policy. Programs for aged deaf persons at thelocal, State and national levels should involvedeaf persons in the policy making, administration,and provision of services.

Program A. Amend all legislation relevant toaged deaf persons to designate them as spe-cial-needs group and to incorporate provisionsfor special services for this group.

Program B. Interpreting service should. beavailable as need for service, rather than pro-viding services only at times when interpretingservice is available. This provision also appliesto interpreters at meetings deaf people shouldattend to express their views and lend their as-sistance. Availability of interpreters for thedeaf, under such circumstances, should be anacknowledged right.

)

Roster of Ad Hoc Planning CommitteeLeon Auerbach, Chairman of Department of

Mathematics, Gallaudet College, Washington,D.C.

C. Orin Cornett, Vice President, Gallaudet Col-lege, Washington, D.C.

Alan B. Crammattee, Associate Professor ofBusiness Administration, Gallaudet College,Washington, D.C., Adelphia, Maryland

Thomas H. Fay, Deafness Research and Train-ing Center, New York University, School ofEducation, New York, N.Y.

James T. Flood, President of National Associa-tion of Homes for Aged Deaf, Columbus, Ohio

Francis J. Guttas, Program Specialist, Bureau ofVocational- Rehabilitation, -Columbus, -Ohio

141

Augustine Gentile, Director, Office of Demo-graphic Studies, Gallaudet College, SilverSpring, Maryland

Glen T. Lloyd.. Editor of Journal of Rehabilita-tion of Deaf, College of Education, Universityof Tennessee, Knoxville, Tennessee

Jerome D. Schein, Director, Deafness Researchand Training Center, New York University,School of Education, New York, N.Y.

Frederick C. Schreiber, Executive Secretary, Na-tional Association of the Deaf, Silver Spring,Maryland

. t

Reports of the


THE RURAL ANDTHE POOR ELDERLY

RURAL OLDER PEOPLEhe Special Concerns Session on RuralOlder People was requested by GreenThumb, Inc., of the National FarmersUnion. Accepting invitations" to mem-

bership on the Planning Committee for the Ses-sion were the National Grange, the Coalition forRural America, and the National Association ofCounties. Federal agencies naming representativesto the Planning Committee were the Departmentsof Agriculture, Labor, and Health, Education, andWelfare; the Office of Economic Opportunity, andthe Appalachian-Regional Commission.1

The 14 subject-area Sections of the Conferencewere largely focused on the needs and problemsof the older urban population. The Special Sessionon the Rural Older People afforded a means of

I See Roster of Planning Committee, page 150.

giving attention to a group of older Americanswho might otherwise have received scant atten-tion. The recommendations from this Special Ses-sion are, therefore, a major addition to the out-come of the Conference as a whole.

The Participants

Approximately 162 Delegates pre-registered forthe Session but they were joined by many otherDelegates and observers so that the meetingroom provided standing room only throughoutthe morning. Participants were prepared for thesession through the distribution of a leaflet be-fore the Session convened which provided thefollowing informati about older Americans inrural areas and small towns.

OLDER AMERICANS INRURAL AREAS AND SMALL TOWNS

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

How Do They Fare on Income?Nearly a 'third of the men have less than $2,000 annualincome; fewer than five percent have $10,000 or more.About 70 percent of the women have less than $2,000annual income; less than 1 percent have $10,000 or more.One-third of all elderly persons in rural areas live inpoverty, compared with 25 percent in central cities and17 percent in suburban areas. (continued next page)

145

AreMen65and OverEmployed?

Like their citycousins, only about a

quartercontinue to

workafterage 65.Moreover,

presentmanpower

programsneglect both older

workers and rural areas; only 24percent of all

enrollees

lived innonmetropolitan areas and only 4

percent were

45 or olderin1970.HowDoRuralPeopleGet

Around?Many rural

elderly areisolated from their

neighbors be-

cause of poor roads or lack ofprivate or public

vehicles

or both.Lack of

transportationhampers their use of the

fewservices in rural areas.HowGood IsTheir

Housing?Sixty

percent ofsubstandard

housing units are in non-

metropolitanareas; about

one-fourth areoccupied by

the ruralelderly.Nine out of 10 of

theseoccupants have

incomes below

thepoverty level.

HowHealthyAreOlderRural

Americans?

Ruralpeople 65 and older have more

chronicconditions

andlimitations on their

activities than the urban aged.

Disabled ruralelderly are

doubly

disadvantagedby

scarcity ofdoctors and lack of

transportation to amedical

facility. If they are alsopoor, health needs tend to be

neglected.

.TheProgram

ThePlanning

Committeewanted to use

various

communicationmethods in order to

interest and

inform asmany of the

audience aspossible. It

alsowished to have the

voices of theaudience

reach thosepersons in and out of

governmentwho

would beresponsive to the

recommendations the

Delegates wouldmake.Toachieve the

formerobjective, the

program

wasintroduced by the

ArkansasFiddlers. They

werefollowed by a vivid,

audio-visualportrayal

of the life of the ruralelderly in

America; a

presentation which wasproduced by the

Depart-

ment ofAgriculture.In order to reachthe ears of

concernedpersons,

thePlanning

Committeeinvited a number of per-

sons to be a "panel oflisteners" who also helped

theDelegates

formulate

recommendations by

commenting upon thevarious

proposals.146


PROGRAM

RURAL OLDER PEOPLE

Chairman:C. E. BISHOP, Chancellor, Universityof Maryland.

Panel of Listeners:Honorable JOHN D. EHRLICHMAN,Assistant to thi President for DomesticAffairs

Honorable CLIFFORD M. HARDIN,Secretary, Department of Agriculture

Honorable HUBERT H. HUMPHREY,Member, United States Senate

DR. JUANITA M. KREPS, Professorof Economics and Dean, The Women'sCollege, Duke University

Honorable GEORGE H. MAHON,Member, United States Home of Rep-resentatives

Honorable ARCH A. MOORE, JR.,Governor of West Virginia

Honorable JAMES B. PEARSON,Member, United States Senate

Honorable ALBERT H. QUIE, Mem-ber, United States House of Represent.atives

STANLEY SMOOT, Vice President.National Association of Counties

Recorders: BLUE CARSTENSON, Director ofCitizenship Activities, Senior MemberCouncil, National Farmers Union

JEANNETTE WEDEL, Associate Di-rector for Administration, Coalition forRural America

Audio-Visual Program:

RUSSELL T. FORTE, InformationSpecialist, Office of Information, De-partment of Agriculture

AGENDA

7:55 A.M.Arkansas Green Thumb Fiddlers

Opening Remarks by ChairmanBishop

Slide Presentation of the Prob-lems and Resources of RuralOlder People

Floor Discussion

9:15 A.M.Comments by the Panel of Lii-teners

10:00 A.M.Deliberation and Adoption ofRecommendations

12 NoonAdjournment

f

:;7.:%er,

147

THE SESSION REPORT

Preamble

Growing older in rural America presents specialand unique problems to which we call the atten-tion of the 1971 White 'House Conference onAging and the general public. Sheer distance be-tween people, and between people and services,is the most obvious aspect in which rural areasdiffer from urban ones. Distance complicates thedelivery of any service to rural older people; theexpense of maintaining private cars and lack ofpublic transportation bar older people from corn-ing to the services. Many people, in rural areas,are isolated by a more basic lack of roads. Ruraltransportation prOblems must be solved beforethere can be effective solutions to rural health, in-come, employment, or housing problems.

Another unique aspect of growing older inrural America is that a large proportion of theneighbors are also old. Nationally, one out ofevery ten of our citizens is old; in rural countiesthat ratio is often one in five. As the youngerpeople are forced to leave to find jobs, they leavea shrinking tax base and a growing scarcity ofservices. Rising property and sales taxes in ruralareas are becoming increasingly oppressive toolder rural people.

Retirement income is lower in rural areas, ton.Few workers in rural areas are covered by privatt:pension plans. Income in their later years mustcome from Social Security, from savings, fromcontinued employment, or from welfare. Sincemost rural people became eligible for Social Se-curity relatively recently when agricultural work-ers and the self-employed were included, theyhave had fewer years of covered earnings andthus their benefits are lower.

Although older rural people are accustomed toworking, there is a critical shortage of paid jobsfor those who wish to work. Many urgently needwork because of low income, yet present Federalprograms discriminate against rural areas. Rural

areas have one-third of the poverty in this country,yet they get only 16 percent of Federal manpowerfunds.

National programs designed to provide part-time community service work for older rural peo-,ple, such as Green Thumb and Green Light(funded under Operation Mainstream), havefound that the opportunity to serve and also earnis eagerly welcomed by rural older folk.

Programs established to meet the needs of theelderly in rural areas and small towns should bedesigned to fit their way of living. Most ruralpeople have been very self-reliant all their lives.They were their own mechanics, plumbers, car-penters, doctorsbecause there often were noothers. When crises came, neighbors quietlychipped in, often without being asked. Age hasnow stripped them of their resources but not theirtraditions. Many refuse to take advantage of thefew services which are available because theydon't know how to take the initiative in dealingwith "government officials" and they feel a strongsense of shame and failure if they try. Programsmust be designed to seek out deeds, not merelyrespond to demand. They must deal with therural elderly in ways which are not frighteningor foreign to them. Older people need to be in-volved in designing, planning, and implementingthese programs.

148

Recommendations

Transportation1. A broad program to develop people-delivery

systems in rural areas should be undertaken, suchas those by the Federal and State governments,

based on demonstration projects by the Office ofEconomic )pportunity, the Appalachian RegionalCommission, Green Light, and others.

2. Legislation should br: passed enabling andrequiring public, social, health, and employmentservices in rural areas to help provide transpor-tation and outreach; remove legal barriers such astaxi rates and car, taxi, and school bus insurancerestrictions to such transportation services, andfinance such services for older people in ruralareas.

3. Older people in rural and farm communities.., must be provided legal and protective services in

order to assure adequate voice and assistance onall issues which involve possible encroachment ontheir rights and property.

Employment4. Community service employment programs

for older people, such as Foster Grandparents,Green Thumb, Project FIND, Extension Service,Homemaker Aides, and Senior Aides, must beexpanded into every rural county.

5. Public job assistance, training, and place-ment programs, currently-required to give priorityto youth and minority groups, should be modifiedand expanded to include a higher proportion ofolder workers. Such programs should have anequitable rural-urban distribution correspondingto the distribution of poverty.

Income6. In reforming the Social Security system, we

urge increases in the level of earnings allowedand increases in the minimum benefit in additionto across-the-board percentage increases with abasic floor for adequate living (BLS) and withautomatic cost-of-living provisions.

7. Present legislative and regulatory impedi-ments to older people supplementing their in-

comes through employment, craft cooperatives,and similar arrangements should be removed.

8. State and local governments should reduceor alleviate the disproportionately heavy propertytaxes on retired persons on limited incomes.

Housing9. Legislation establishing and funding a major

home repair program for older people in ruralareas should be passed. It should include homerepair loan and grant programs under the Farm-ers Home Administration (currently authorizedbut not provided); larger home repair grants forwelfare recipients with less State matching fundsthan at present; authorization to use Federal din-power training programs to perform the work, andadequate staff to administer these programs effi-ciently.

10. More new housing should be provided forolder people in rural areas. A major new ruralhousing program must be developed to meet theneeds of the rural elderly. Public housing pro-grams should be expanded in rural areas. TheFederal Government should aggressively encour-age local government and/or private non-profitorganizations to implement these programs.

149

Health11. In the design of a national health service

delivery system which provides for facilities, per-sonnel, and payment for services, the unique char-acteristics of rural areas must be considered andspecial delivery systems developed. Transporta-.tion, outreach, and home-care services should beintegral parts of all health services in rural areas.The use of mobile health units for multiphasicscreening should be greatly expanded.

12. Health and nutrition education programsshould be greatly expanded. Public Health, Voca-tional Education, Exte -sion Services, and othersuch community action programs have found thatpoor nutrition practices are a major health prob-lem of the rural elderly.


NongovernmentBlue Carstenson, (Chairman), Director of Citizen-ship Activities, Senior Member Council, National-Farmers Union, Washington, D.C.

W. J. Brake, Lecturer, The National Grange, Wash-ington, D.C.

Mark Freeman, Executive Director, Coalition forRural America, Washington, D.C.

Ty lee S. Smith, Assistant for Program Analysis,Green Thumb, Inc., Washington, D.C.

Ralph Tabor, Director of Federal Affairs, NationalAssociation of Counties, Washington, D.C.

Jeannette Wedel, Associate Director for Adminis-tration, Coalition for Rural America, Washington,D.C.

GovernmentGerald F. Combs, Food Safety Coordinator, Scienceand Education, Office of the Secretary, Department ofAgriculture

Dr. Lynn Daft, Assistant Deputy Administrator,Economic Research Service, Department of Agricul-ture

Russell T. Forte, Information Specialist, Office ofInformation, Department of Agriculture

Jessie S. Gertman, Deputy Chief, Division on Aging,Office of Research and Demonstration, Social andRehabilitation Service, Department of Health, Edu-cation, and Welfare

150

Sandra S. Gruschin, Special Assistant to the Fed-eral Co-Chairman, and Project Coordinator, Appala-chian Regional Commission

Amy Hardy, Editor, Journal "Appalachia", Appa-lachian Regional Commission

Maurice L Hill, Assistant Director, Office of RuralProgram Development, Rural Manpower Service,Department of.Labor

John G. Hutchinson, Program Officer, Older Per-sons Programs, Office of Economic Opportunity

Helen W. Johnson,. Assistant to the Director, Eco-nomic Development Division, Economic ResearchService, Department of Agriculture

Orville H. Lurch, Alternate Federal Co-Chairman,Appalachian Regional Commission

Dr. Karl Munson, Program Leader, Extension Serv-ice, Department of Agriculture

Ruth Rothman, Manpower Development Specialist,Rural Manpower Service, Department of Labor

Nancy Tate, Program Analyst, Office of ProgramReview, Office of Economic Opportunity

Marvin Taves, Chief, Divisior. on Aging, Office ofResearch and Demonstration, Social and Rehabilita-tion Service, Department of Health, Education, andWelfare

Jane A. Taylor, Special Assistant, Science and Edu-cation, Office of the Secretary, Department of Agri-culture

Margaret Tuttle, Pre.g,ram Analyst, Community De-velopment Branch, Office of Program Development,Office of Economic Opportunity

THE POOR ELDERLY"I he Special Concerns Sessions on The

Poor Elderly was requested first bythe National Council on the Aging,Inc. The Council had made a study

of impoverished elderly people in various com-munities throughout the country. Distressed bymagnitude of the problem and -the dire circum-stances of the poor aged, it was natural that theCouncil should seek to bring this deprived groupto national attention at the White House Con-ference on Aging.

Following the Council's request for the SpecialConcerns Session, several other national organiza-tions having a special concet for the economicand social welfare of the pow aged were invitedto join the Council in sponsoring the Session. APlanning Committee was established with mem-bership representing the National Council on theAging, Inc., the National Council of Senior Citi-zens, Inc., the National Consumer's League, andthe Older Persons Advisory Committee of theOffice of Economic Opportunity. The Committeewas assisted by personnel from the DepartmentsOf Health, Education, and Welfare, Labor, Hous-ing and Urban Development, and the Office ofEconomic Opportunity.2

THE PROGRAM

The Planning Committee assembled a programwhich would provide Delegates access to theknowledge and experience of. persons who workdirectly with tse poor among minority and otherespecially deprived groups of the elderly, thus in-suring the relevance of policies and programsprepared by the Session.

I The National Council on the Aging. The Golden YearsATarnished Myth, Washington, D. C., 1970.

2 See Roster of Planning Committee. page 156.

151


PROGRAMTHE POOR ELDERLY

Chaitnaan:OLLIE RANDALL, Board Member,Older Persons Advisory Committee,Office of Economic Opportunity

Speaker: DR. WALTER M. BEATTIE, Dean,School of Social Work, Syracuse Uni-versity

Commentators:ANNA CHAPMAN, NeighborhoodWorker, Friendship House ProjectLink, Washington, D. C.SAM COLB, Mission Indian TribalConference, Los Angeles, California

LUTHER J. CONLEY, Big SandyArea Community Action Program,Paintsv i I I e, Kentucky

ORIN CRUMP, Project Green Thumb,Draper, UtahBOLESLO GARCIA, Director, HomeEducation livelihood Program, Albu-querque, New Mexico

MARY POWEI.L, President, Spring-field Township (Ohio) CommunityAction Council, Akron, Ohio

Presentation of Draft Recommendation:MARY LOUISE JOHNS, President,Foster Grandparents of Bexar County,San Antonio, Texas

RUDOLF J. DANSTEDT, Assistantto the President, National Council ofSenior Citizens

Discussion Leader: 'JACK OSSOFSKY, Deputy Director,National Council on the Aging

Recorder: DANIEL J. SCI-IULDER, AssistantDirector, Federal Relations Branch, Re-source Utilization. Division, Depart-ment of Housing and Urban Develop-ment

;Continued next page)

Technical Resource Panel:ALPHONSO ANDERSON, Director,0E0 Project, National Council on theAging

ALVIN M. DAVID, Assistant Com-missioner for Program Evaluation andPlanning, Social Security Administra-tion, Department of Health, Education,and Welfare

MONROE DOWLING, Special As-sistant, Manpower Administration-USTES, Department of Labor

MILDRED K. HOADLEY, Chief, Di-vision of Program Payment Standards,Assistance Payments Administration,SRS, Department of Health, Education,and Welfare

MARIE A. OBLff AS, Program Ana-lyst, Migrant Division, Office of Eco-nomic Opportunity

CLEONICE TAVANI, Older PersonsCoordinator, Office of Economic Op-

. portunity

AGENDA

8:00 A.M.Opening Remarks by ChairmanRandall

8:15 A.M.Address by Dean Beattie, "TheNature and Facts of PovertyAmong the Elderly"

8:40 A.M.Comments by Panel

9:10 A.M.Presentation of Draft Recommen-dations

9:30 A.M.Deliberations and Adoption ofPolicy Recommendations

12 NoonAdjournment

152

THE SESSION REPORT

The Special Concerns session was attended bysome 200 Delegates, guests and observers. Dr.Walter M. Beattie, Dean of the. School of SocialWork, Syracuse University, addressed the groupon the challenges of poverty among older Ameri-cans. A panel of commentators composed of olderpersons active, in community action programs re-sponded to the address.

Several commentators emphasized the need todirect attention to rural areas and such groups asthe Spanish-speaking migrant farm workers. Allcalled for_immediate action, best characterized bythe words of Mrs. Mary Powell of the SpringfieldTownship (Ohio) Community Action Councilwho said, "Do it now, I won't be around in 10years for the next Conference!"

Mri Mary Louise John, President of the FosterGrandparents of Bexar County, San Antonio,Texas, presented the group with the recommenda-tions of the Planning Committee after whichRudolph Danstedt of the National Council ofSenior Citizens provided comment on the recom-mendations. In discussions chaired by Jack Ossof-sky of the National Council oil the Aging, theSession agreed to the following introductorystatement and the recommendations.

PreambleActiga Now

One out of every four Americans over the ageof 65 lives in poverty. And even more live soclose to poverty that its chilling effects hangover them. To the trials of old age are addedthe harsh burdens of poverty, made more cruelby the fact that it need not be.

No longer must American aged live in hunger,suffer from lack of health care, exist in dilapi-

dated housing, and remain isolated and hiddenfrom the mainstream of American life. Manyelderlypoor and richare robbed of their dig-nity as human beings by a now-oriented societywhich too easily forgets the contributionspastand presentof its aged population.

We canwe mustwe will do better!While we must improve the quality of life

for all the aged, our top priority must go to thosewho suffer most. America must address itself firstto the needs of the elderly poor.

Our goals must equal our national greatness.Our action must merit our national pride. Wemust strive to provide more than mere subsistence;we can and must provide the opportunities fordecent and meaningful living through all. theyears of life.

In planning, we must recognize the continuityof life. We must act immediately to lift the pres-ent aged from poverty. Even with adequate in-come, certain needed services cannot be purchasedin the marketplace and must be provided. Withinand between income and services programs, a fullrange of options should be available for all agedAmericans.

.

To insure that future generations do not endtheir days in poverty and despair, we submitthese recommendations to the White House Con-ference on Aging.

153

Recommendationsand Comment

IncomeIt must be the national policy of the United

States that poverty be eliminated as a concomitantof the older years. In this regard, priority must

be given to providing older Americans with anincome to keep them from poverty and subse-quently to assure the aged an income foundationthat will provide them with a comfortable exis-tence.

1. The establishment of an incume floor in thesocial security and adult assistance programs toprovide all older persons with an income equalto the "intermediate" standard of living estab-lished by the Bureau of Labor Statistics. Thiswould provide (as of Spring, 1970, the latest fig-ures available) at least $2,316 for a single olderperson, regardless of sex, and $4,489 for a coupleheaded by someone 60 years of age or older. Werecommend that this be done now through legisla-tion pending in the Congress.

Minority Recommendation 1That for minority persons the age of quali-fication for benefits be 7 years younger thanthe qualifying age for Whites and that anypenalties in other benefits, because of benefitincreases, be outlawed.

2. As a follow -up in the progression of thebenefit floor, not later than 1974 the minimumincome for Social Security and Adult Assistancebeneficiaries be upgraded to provide the elderlywith the "comfortable" standard of living estab-lished by the Bureau of Labor Statistics. Thiswould provide (as of the Spring of 1970), atleast $3,403 for a single older person, and $7,114for an elderly couple.

Comment: During discussions on this recom-mendation it was emphasized by the dele-gates that the "comfortable' BLS standardshould set the level of future benefit pay-ments.

3. Those elderly persons in the United Statesand territories not now covered or eligible to re-ceive benefits under existing income maintenanceprograms be blanketed into the programs nowso that all elderly persons can be assured an in-come at the comfortable standard of living andthat there be no penalty or reduction in other

I This recommendation was presented as a Comment in theinterim report distributed at the Conference. It was, however,proposed and voted upon by the Session and won support of15 percent or more of the Delegates present.

benefits. As a further step to make this recom-mendation effective, the Old Age Assistance pro-gram must be merged into the Social SecuritySystem, the ensuing additional costs to be financedout of general revenue funds.

4. That computation mechanisms be establishedto periodically revise the benefit structures to re-flect increases in the cost-of-living.

5. To meet the increased financial burden ofthese recommendations the general revenues ofthe Federal Government be utilized to supple-ment employer and employee contributions to theSocial Security System, and that the Adult As-sistance programs be completely federalized.

6. With respect to private and public pensionsplans, require that they contain provisions forguaranteed vesting after the first year of employ-ment, for guaranteed portability of pension bene-fits, and for Federal insurance protection againstloss of pension benefits. Moreover, require thatthese pension entitlements and protections bespelled out to all employees under a "truth inpension" Federal statute.

7. Enact immediately a Senior Emergency Em-ployment Act providing for one million full- andpart-time jobs for persons 55 years old and overwho can and wish to work.

Comment:. An additional recommendation,introduced from the floor, to immediatelyabolish the Social Security "earning test" wasdefeated with a substantial minority favoringabolition. A number of Delegates expresseda heated frustration with the continuingproblems of reduced benefits associated withincreases in Social Security payments (OAA,food stamps, etc.).

ServicesEven when the income levels recommended

above are reached, many older people, especiallypoor older people, would face serious gaps in?available services to meet their needs. To fill thesegaps in health care, housing, and social services,we recommend:

A. Health

154

1. The income and service restrictions imposedon Medicaid and the shifting of the cost

of Medicare on to the backs of the elderlythrough ceilings on length of benefit peri-ods, increases in deductibles, and increasesin Part B (doctor's care) premiums are seri-ously limiting health care for the elderlyand the poor.

The time is now to eliminate the hodge-podge of partial health care programs.Medicaid and Medicare systems should bereformed now through the merger of theseprograms and a Federally administered sys-tem covering all persons 65 and older estab-lished.

2. This Federally administered program shouldhave no co-insurance and deductible fea-tures; it should provide for out-of-hospitalprescribed drugs, and afford, without limit,nursing home care in a facility owned oroperated by an accredited hospital or com-prehensive health service organization.

3. While immediate reform of the Medicaidand Medicare programs is essential, theremust be early adoption of a national healthsystem available to all, the young, the mid-dle-aged and the elderly, with a full rangeof health services financed out of payrolltaxes and the general revenues with no ad-ditional billing to the patient for theseservices.

Comment; A substantial minority opposednational health system primarily on thequestion of costs.

B. Housing

Where the homes and apartments of older per-sons arc now adequate, or capable of renovation,the course of action is clear. Every effort mustbe made to assure that the elderly keep or re-claim a decent place to live in neighborhoodsof their choice. To achieve these goals, it shouldbe the policy of the United States to assure:

'- 1. The reduction of property taxes for lowerincome elderly home owners, with propor-tionate remissions for those older peoplewho rent.

2. The greatly expanded promotion of grantsand low or no interest loans by HUD torenovate unsuitable housing wherever such

46818 0 73 - Il

housing is located without regard to loca-tion in an. urban renewal area or otherartificial geographic limitations.

3. The end to liens on homes of those eligible,r Adult Assistance.

4. The expansion of the Rent SupplementProgram specially dirthed to older personsutilizing local organizations of older personsto promote its use.

5. Assuring that the planning of highwayswhich dislocate thousands of low incomeolder and other persons is discontinued;designing urban renewal and other physicaldevelopment programs so that residencesand natural neighborhods are renewed andnot bull-dozed; assuring that there is fullparticipation of older poor persons in theplanning of all physical development' pro-grams.

6. Where homes and apartments are not cap-able of renovation, the expansion of Fed-erally-supported construction of new hous-ing units to house the elderly poor whohave no other means to secure decenthousing.

Comment: Passed unanimously.

C. Social Services

1. It shall be the responsibility of the FederalGovernment working in concert with otherpublk and voluntary agencies to establishin each community a public senior servicesystem as the primary means through whichthe elderly receive services. Such servicesshould include leisure time and culturalprograms but should extend also to preven-tative health programs, information, re-ferral, outreach, advocacy services, coun-seling, legal aid, help with employment,housing, securing benefits, etc. Such a publicsenior service system must be responsive to-the aged themselves as participants in thedecision-making processes determining whatservices are provided, through what means,and for what groups.

2. Public departments of social services needto become the primary agency for services tothe disabled and impaired elderly with serv-ices rendered through a consortium of pub-

155

lic and private agencies. Needed servicesshould be available to all the aged withoutany restrictions to financial status. Servicesavailable through these resources shouldprovide a community health alternative toinstitutional care by offering such servicesas homemaker, home-health and chore serv-ices, protective services, friendly visiting andtelephone reassurance, day care, home-de-livered meals, special transportation, etc.

3. Special efforts must be made in the deliveryof services to assure that the older poor,minority elderly and those most isolatedfrom the community are reached by theservice systems, that bilingual outreach pro-grams are built into all programs.

Self-HelpSocial and Political Action1. Older Americans including those who are

poor repr- sent a resource of experience and abilitywhich can and must be utilized in dealing withtheir problems and needs. We urge that all agen-cies and organizations which seek to serve theelderly use that resource and find ways of involv-ing the elderly on their policy-making boards, onadvisory committees, and on their staffs so thatthey play a full role in the planning and deliveryof services.

2. The eicirly themselves need to take theinitiative to develop and operate programs andservices to meet their needs as they see them.

Public and private agencies should motivate andsupport the elderly to undertake self-help pro-grams and to engage in social action, articulatingtheir needs and participating in the flow of com-munity life to create solutions to those needs.

3. Voluntary agencies and church groups, inparticular, are called upon to serve as enablersfor the elderly, to encourage and assist them indeveloping new roles in self-help, social action,and political action. Recognizing that the elderlyhave not fared well by relying on others to actin their behalf, the elderly are urged to organizethemselves into active social action and politicalaction groups to press for those policies, to sup-port those candidates, and to ally with those or-ganizations which will elevate their priority needsto national attention and action. (Accepted unani-mously.)

Other Concerns of the Session

The Delegates accepted, without comment, agroup of recommendations developed by theSpanish Speaking Caucus relating to the needsof the Spanish speaking elderly.

Also accepted was a resolution submitted byState Senator Samuel Harman of Massachusettsmemorializing the Congress to immediately enactlegislation to remedy the inequitable loss of bene-fits associated wtih increases in Social Securitypayments.

Roster of Planning CommitteeNongovernment .

Jack Ossofsky, (Chairman), Deputy Director, Na-tional Council on the Aging, Inc., Washington, D. C.Anna M. Chapman, Neighborhood Worker, Friend-ship House Project Link, Washington, D. C.

Luther J. Conley, Big Sandy Area Community Ac-tion Program, Paintsville, Kentucky

Rudolf J. Danstedt, Assistant toNational Council of Senior Citizens,ton, D. C.

Elizabeth B. Herring, National Consumers League,Washington, D. C.

Mary Louise Johns, President, Foster Grandparentsof Bexar County, San Antonio, Texas

Sarah H. Newman, General Secretary, NationalConsumers League, Washington, D. C.

the President,Inc., Washing-

156

GovernmentJames J. Burr, Director, Division of Services to theAging ,and Handicapped, Community Services Ad-ministration, Social and Rehabilitation Service, De-partment of Health, Education, and WelfareMonroe D. Dowling, Special Assistant, ManpowerAdministration, U. S. Training and EmploymentService, Department of Labor

Robert Granakis, Special Assistant, Manpower Ad-ministration, U.S. Training and Employment Service,Department of Labor

Marie A. Oblitas, Program Analyst, Migrant Divi-sion, Office of Economic Opportunity

Daniel J. Schulder, Assistant Director, Federal Rela-tons Branch, Resource Utilization Division, Depart-ment of Housing and Urban DevelopmentCleonice Tavani, Older Persons Coordinator, Officeof Economic Opportunity

Reports of the


THE ELDERLY AMONGTHE MINORITIES

i

ASIAN AMERICAN ELDERLYhe Japanese American Citizens Leaguemade a formal request that the Con-ference program include a Special Con-cerns Session on The Asian American

Elderly. The League pointed out that most oftoday's elderly Asian citizens are foreign-bornand, after migration, generally, continued to fol-low their awn cultural patterns and practices. Therapidly changing social structure and economiccircumstances in the United States have now cre-ated a crisis for these elderly persons whichshould command special consideration in the de-velopment of any national policy on aging.

The Asian American group is made up of vari-ous nationalities Samoans, Chinese, Filipino,Korean, Hawaiian, and Japanese. The Leagueinvited representatives of each of these groups tomembership on the Planning Committee for theSession. Although representing widely scatteredAsian elderly populations, the Planning Commit-tee was, nevertheless, able to plan a programwhich encompassed their common interest in im-proving the well-being of the elderly Asian Ameri-can in the United Slates.

The ParticipantsAll Asian Americans named as Delegates to the

Conference received a special invitation from theSession Planning Committee to attend the SpecialConcerns Session on the Asian American Elderly.Altogether 44 Asian Delegates took part in theSession. They represented all the Asian groupsmentioned above. Relatively few of the Delegateswere older or ' persons, a fact which indi-cates that the leaf. ip for elderly Asian Ameri-cans are the young and middle-aged.

The ProgramThe relatively small size of the Session made it

possible for the group to engage in an informaldiscussion of the major problems for which it wasbelieved national policy should be formulated togive special attention to the older Asian American.

159

The time was allocated in three parts to include:(1) an address on the Asian American problem;(2) comments and observations by representativesof the various national groups; and (3) develop-ment and adoption of recommendations.


PROGRAMASIAN AMERICAN ELDERLY

Presiding: DAVID E. USHIO,Assistant Washington Representative,Japanese American Citiiens League,

Washington, D. C.

Background and Overview"ASIAN AMERICAN ELDERLY"

SHARON FUJI!, Graduate Gerontologygram, Florence Heller Graduate School forvanced Studies in Social Welfare, Brandeisversity, Waltham, Massachusetts

Pro-Ad-Uni-

Comments and ObservationsPANEL OF ASIAN AMERICANS

Chinese AmericanSAM YUEN, Director of Self-Help for theElderly, San Francisco, California

Filipino AmericanROBERT SANTOS, Executive Director of Proj-ect Caritas, Seattle, Washington

Korean AmericanREVEREND PETER KWON. Korean Social,Health, and Education Society of Southern Cali-fornia, Los Angeles, California

Samoan AmericanLOY F. TEO, Director of Samoan Center, LosAngeles, California

HawaiianCHRISTIAN S. NAKAMA, Executive Director,Honolulu County Committee on Aging, Hono-lulu, Hawaii

Japanese AmericanMIKE SUZUKI, Chief of Social Service, Cali-fornia State Department of Social Welfare,Vice President of General Operations, Japa-nese American Citizens League, Sacramento,California

gr.

THE SESSION REPORT

Preamble

In the United States today, elderly Asian Ameri-cans are suffering from unprecedented problemsthat are devastating the lives of these aged people.In addition to the many critical problems that facethe 20 million senior citizens in the United States,Asian American elderly are further confrontedwith cultural barriers that exclude them from re-ceiving their rightful benefits.

Language problems created by lack of bilingualinformation systems and the lack of bilingual serv-ice workers deny Asian American aged even theknowledge of how to obtain such benefits. Butmost of all, the Asian American elderly are se-verely handicapped by the myth that pervades thesociety at large and permeates the policy decisionsof agencies and governmental entities that arecharged with the responsibility of helping all theUnited States.

This emasculating myth that discriminatesagainst Asian American elderly is that AsianAmerican aged do not have any problems, thatAsian Americans are able to take care of theirown, and that Asian American aged do not needor desire aid in any form. Such assertions, whichare generally accepted as valid by society, arefalse. A quick look at Asian American communi-ties would verify that they do indeed have prob-lems and the problems in many respects are moreintense and complex than the problems of thegeneral senior citizen population. When the AsianAmerican aged suicide rate in certain areas is threetimes the national average, when 34 per cent ofAsian American aged who were studied have neverhad a medical or dental examination, it should beobvious that the problems facing Asian Americanaged are overwhelming to the point that it is im-possible for Asian American aged to look only totheir families for help.

However, those who hold the responsibility toassist in these areas have turned their backs on the

160

Asian aged. For example, in 1969-71 some $32million was appropriated for community grantprojects for the aged which included informationalservices, health care, and aged assistance (manyof the areas that Asian American elderly need themost). Of this $32 million, not one dollar wasgiven to Asian American communities for theiraged problems. The reason, according to thegovernment officials, was Asian Americans don'thave problems.

So pervasive is this myth that the planners ofthe White House Conference on Aging, the groupmost knowledgeable in the area of aging needs,failed to include a Special Concerns Session forAsian American elderly as part of its originalagenda. While the planning for other SpecialConcerns Sessions had been in process for manymonths, the decision to hold a Special ConcernsSession for Asian Americans was made only onemonth prior to the Conference and only because aspecial request was made by concerned AsianAmericans.

This oversight is typical of the neglect thatAsian American elderly face on all fronts. Withinthe confines of the short time given to prepare forthis Conference, concerned Asian Americans wereable to identify many specific and crucial needsthat are crippling the Asian American elderly.The following policy recommendations representsome examples of the myriad of problems that aredevastating Asian American elderly people.

Asian American Delegates support the manyrecommendations that the Conference as a wholehas proposed for the benefit of all senior citizens.However, history has demonstriTecr again andagain that Asian American elderly are among thepeople most neglected by programs presumablyserving all elderly. We demand that the followingpolicy recommendations be implemented to in-sure that Asian American elderly receive theirrightful opportunities in this Nation.

Recommendations

Research and Demonstrations

1. Federal funds for research and demonstra-tion projects to determine how older Asian Amer-icans can be effectively assisted, based on theirneeds, cultural differences, values, and desires,should be expanded and should involve research-ers of Asian background. The findings from suchefforts should be disseminated to policy makers,program planners, and service providers.

Rationale: Information on older Asian' Ameri-cans must be collected so that a national policyon aging is truly responsive to, and representa-tive of, all older Americans.Program Issues: Research and demonstrationprojects should identify the older Asian Ameri-cans (i.e., where they reside, what their charac-teristics are) and should be supported by agen-cies such as the Department of Commerce(Bureau of the Census), the Department ofHealth, Education, and Welfare, and the De-partment of Labor.Special research and training services for thinvestigation, study, and treatment of medicaldiseases peculiar to Asian American elderly(i.e., incidence of sickle cell anemia affectingSamoans) should be conducted.Special research studies relating to the dispro-portionate number of Asian elderly in mentalinstitutions should be initiated.Demonstration grants should be provided forthe training of researchers to deal with theproblems of older Asian Americans.

2. Federalsuch as Department of Housing andUrban Development, Department of Labor, De-partment of Transportation, Statesuch as com-missions on aging, public welfare, departments ofhuman resources, and local government and pri-vate organization grants which provide assistancefor the elderly should reflect the diversity of theAsian American groups.

Rationale: Because persons of Asian ancestryare lumped under the heading of Asian Ameri-can or "Oriental", it is assumed by many that

161

all Asians are alike. In reality, the cultural dif-ferences between the basic Asian Americangroups (Chinese, Filipino, Korea , Japanese,Samoan) are as different as the fiN ! differentlanguages they speak. It is unrealistic and wish-ful thinking to assume that thl small enclavesof Asian American elderly will be reached bymassive grants to the county or State for allelderly persons. G:ants aimed at specific pock-ets of ethnic groups would more likely reachelderly Asians.Program Issue: Federal, State, and local gov-ernments in mutual cooperation with the Asiancommunity should establish and fund in thoseStates and localities where Asian Americans areconcentrated, outreach programs to provide in-formation, referral, and advocacy services, in-cluding resource persons, transportation assist-ance, drop-in centersall of which reflect thecultural differences and preferences of theAsian American elderly.

Services3. Public and private agencies should provide

older Asians with support services (e.g., homecare assistance, transportation, health screening,etc.) in their own communities which have beentraditionally provided by the family. In doing so,recognition should be made of family structureand kinship networks among Asian ethnic groupsfor the purpose of building on these, rather thanimposing or allowing totally strange service de-livery systems.

Rationale: Traditionally, services such as trans-portation, home care, financial support, andhousing have been provided by the family ofthe older Asian. Resulting from changes infamily structure and an increasing need for di-verse services (e.g., health care, housing, etc.),the Asian elderly cannot continue to look solelyto their families to have needs met.

4. On-going service projects, such as senior citi-zen centers and multipurpose service centerswhich are designed to meet the special needs ofolder Asian Americans, should be established incommunities of elderly Asian Americans, and Fed-eral, State, and local assistance should be madeavailable to support these either in full or on amatching basis.

Program Issue: Programs should provide bi-lingual, bicultural staffing; recreational, leisure-time activities geared to cultural interests; in-formation and referral services; direct socialservices; elderly self-help programs; youth andelderly mutual assistance programs; and educa-tional programs and services for the Asian el-derly and for training personnel to work withAsian elderly.

5. Continued Federal support of existing pro-grams should be contingent on reexamination andrevision to assure that they are responsive to theneeds of elderly Asian Americans through the useof bilingual workers for outreach and advocacyservices.

Housing6. The Department of Housing and Urban De-

velopment should acquire land in the Asian Amer-ican communities, using condemnation proceduresif necessary, and create housing programs for theAsian elderly with related life support services ona crash basis.

7. The Federal Government should providespecial funding to meet the needs of elderly AsianAmericans for new housing by providing loans toAsian American nonprofit organizations to de-velop housing with attention to cultural prefer-ences.

8. Department of Housing and Urban Devel-opment should provide substitute housing toAsian elderly, who live in 'substandard congregatehousing, in the same community to prevent en-vironmental displacement.

9. The government should institute rent con-trol and rent increase exemptions to Asian Ameri-can elderly.

10. All efforts should be made to maintainAsian elderly in their own homes, if they wish toremain there, with collateral life support services,rather than having them go to an institutional set-ting.

11. The Federal Government should initiate asubstantial tax incentive to the younger generationwho can provide housing and/or other supportive-care for their Asian elderly relatives.

162

12. Federal, State, and local funds should bemade available for establishing nursing homes forelderly Asians which provide for bilingual, bicul-tural staffing, ethnic foods, family and individua:counseling services, and recreation and leisureactivities which are culturally related to Asians.Protective group or residential arrangementsshould be provided in the community whereAsians are concentrated for those who can con-tinue to live independently.

Health13. In the development of a more complete

range of health care (physical and mental) serv-ices for the .aging through a national health in-surance program, specific provisions should beestablished to meet the special needs of elderlyAsian Americans.

Rationale: Elderly Asian Americans havehealth problems similar to those of all olderpersons, but they have borne Added burdens dueto cultural and language differences which makeaccess to health care services difficult..

Program Issues: Mobile medical outreachteams should be established to serve the Asianelderly in the community. Such teams should bedeveloped to relate to language and culturalpatterns of the elderly Asian.

Public and private funding should be providedfor health education of elderly Asians by thecommunity through multiservice centers ndregularly scheduled community informationdays.

Income14. A Federal guaranteed annual income pro,

gram for the elderly must be established if thisNation is to meet the basic needs of elderly AsianAmericans who are denied benefits related to"covered" employment (i.e., Social Security, pen-sion programs) because of long-existing discrimi-natory employment patterns.

Rationale: Limited and fixed income levels forolder Asians as provided by standard sources(Social Security, pension funds, savings) havebeen inadequate to meet their needs, especiallyhealth and housing costs. Furthermore, many

444

older Asians have no sources of income what-soever since they were employed in occupations(self-employed, domestic labor, or farming)which are not covered by Social Security or pri-vate pensions.

Program Issues: The involuntary and enforcedperiod of time spent by Asian elderly (from theJapanese community) in concentration campsduring World War II should be fully ac-credited as accumulated time towards the re-ceipt for full Social Security benefits as well asother Federal benefits to which they are entitled.All references to differential treatment of alienswith regard to public programs (i.e., publicwelfare programs) should be stricken.

Newly arrived elderly Samoans should be guar-anteed their Social Security benefits derivedfrom work in American Samoa.

The unique income-saving plans of the Asianelderly should be fully legitimized and safe-guarded (e.g., Tannomoshi, Kei) by financialsystems.

Employment and Training15. There should be continuation, expansion,

and innovation of placement, training, and jobassistance programs for Asian elderly throt .41State employment programs and special Federalprograms for older people. Asian elderly shouldbe employed as community workers to educateothers. They should also work in public agencies,community organizations such as funded by Socialand Rehabilitation Service under the Older Amer-icans Act (Titles III and VI). Sheltered work-shops for the Asian elderly should be developed.

Training16. A Federal policy should be created em-

phasizing training of Asians who will work wit;older Asians. There should also btt provisions fornon-Asian workers to receive training which willenable them to work effectively with Asian el-derly. As an illustration, support for trainingshould he made available by the Social and Reha-bilitation Service of the Department of Health,Education, and Welfare under Title V of theOlder Americans Act..

163

Rationale: Most non-Asian workers currentlyserving the elderly are not aware of the needsand concerns of the Asian elderly. They are notable, therefore, to work effectively with themand Lave alienated the Asian elderly.

Program Issues: Opportunities for bicultural,bilingual Asians to serve Asian elderly withspecial skills, understanding, and knowledgeshould be provided.

Special training programs should be providedand conducted by Asian bilingual and biculturalworkers for public agencies serving the Asianelderly.

Education17. Educational institutions (public and private

and at all governmental levels) should providespecial and continuing education courses for el-derly Asian Americans which will enable them-tobecome more knowledgeable about services .andprograms- that exist for allelderly- and-to learnabout their unique cultural heritage.

Rationale: There should be a continuous effortmade in all needs areas to educate the elderly,the public at large, and program and servicepersonnel as to the differing needs and prob-lems of Asian elderly.

Nutrition18. Existing nutrition policies for older persons

who receive Federal support should be reexaminedand revised to include the cultural food prefer-ences of the elderly Asian American.

Rationale: Nutrition programs for the elderlyhave failcsi to include special dietary and cul-tural preferences of older Asian Americans.

Program Issue: The food stamp program aspresently constituted excludes elderly Asiansfrom purchasing ethnic foods. The food stampprogram should be revised to include provisionfor the purchase of ethnic foods.Meals-on-wheels programs for the elderlyshould be revised to meet the basic dietary pref-erences of older Asian Americans. Nutritioneducation programs should be provided forolder Asian Americans which will assist themto plan well-balanced diets using their ownethnic foods.

---

Transportation19. Free public transportation should be made

available to the Asian elderly which will enablefull access to culturally preferred life supportservices both in and outside the community.

Rationale: The special needs of elderly Asiansfor cultural and- life support services causetransportation needs which currently are notprovided in public transportation systems.

Program Issues: Public and private fundingshall be made available on a local basis to in-sure that elderly Asians will obtain equal free-dom of mobility as the rest of the elderly.Public funding shall be provided to voluntaryorganizations which provide transportation tothe Asian elderly to meet their needs.

Special Concerns Advocacy

20. The Federal Government shall establish a

Cabinet Committee .for Asian American Affairswhich would include among its priorities theneeds of elderly Asian Americans.

21. In all political jurisdictions where AsianAmericans reside, the committees or commissionson aging shall include Asian American repre-sentation. All agencies which directly affect theelderly in such jurisdictions shall appoint staff orretain consultants of Asian background who areknowledgeable about the needs and cultural pref-erences of Asian elderly.

Legal22. In passing legislation and adopting regula-

tions at all governmental levels affecting servicesto the elderly, no differentiation shall be madebetween aliens and citizens.

23r Free bilingual legal assistance must bemade available to Asian elderly who wish to be-come naturalized citizens.


David E. Ushio, Chairman, Assistant Washington Rep-resentative, Japanese American Citizens League, Wash-ington, D. C.

Jim Miyano, Director of Project Liaison, Los Angeles,California

Joselyn Geaga, Filipino American Community of LosAngeles, Los Angeles, California

Robert Santos, Executive Director of Project Caritas,Seattle, Washington

Sharon Fujii, Graduate Gerontology Program, FlorenceHeller Graduate School for .Advanced Studies inSocial Welfare, Brandeis University, Waltham,Massachusetts

164

Reverend Peter Kwon, Korean Social, Health, andEducation Society of Southern California, Los Angeles,California

Toyo A. Biddle, Bureau of Educational PersonnelDevelopment, Office of Education, Department ofHealth, Education, and Welfare, Washington, D. C.

Loy F. Teo, Director of Samoan Center, Los Angeles,California

Mike Suzuki, Chief of Social Service, California StateDepartment of Social Welfare, and Vice President ofGeneral Operations, Japanese American CitizensLeague, Sacramento, California

THE SPANISH SPEAKINGELDERLY

he several organizations serving theSpanish speaking people that co-spon-sored and named member's of thePlanning Committee for this SpecialConcerns Session were the United

States Catholic Conference, the Puerto RicanForum, Inc., the League of United Latin Amer-ican _Citizens,. the_ Communidad HiSpallit deMaryland, Interstate Research Association, andthe National Urban Coalition. Representatives ofthe Office of Economic Opportunity, the CabinetCommittee on Opportunity for the Spanish Speaking, the National Insf hate of Mental Health, theOffice of Education, a, ! the Office of the Secre-tary of Health, Education, and Welfare also par-ticipated in planning this Special Session.

The Session focussed attention on the plight ofthe Spanish speaking elderly and brought to lightthose problems that are particular to this popu-lation. The work of the Session, therefore, adds animportant component for consideration in thedelineation of a national policy on aging.

The Participants

Approximately 100 Delegates participated inthe Special Concerns Session on the Spanishspeaking elderly. The participants came frommany parts of the Nation. Most of them wereeither Mexican-American, Cuban, or Puerto Rican.Many of the Delegates who participated in thisSpecial Concerns Session met on the first 2 daysof the White House Conference to discuss ex-periences in their home localities and decide whichof the problems of the Spanish speaking elderlywould be dealt with at the Special Session.

The Program (See program on next page)

In preparation for the Special Concerns Ses-sion, position papers in some of the acknowledgedareas of need induding Income, Employment,Education, Training, and Housing of the Spanishspeaking elderly, were prepared and made avail-able to the Delegates who had indicated that theywould attend this Session. These papers were de-signed to provide an informational base for thedevelopment and adoption of policy recommen-dations.

The Session program was developed around aseries of five discussion panels, each dealing withone of the following: Income, Housing, Employ-ment, Health, and Education. This format provedto be quite effective by stimulating productivediscussion, providing access to experts in the par-ticular field, and allowing the participants to dealsubstantively with the several essential areas. Theresult of these efforts is the following set ofrecommendations which, if considered in futureplanning and action for the elderly, will aid inproviding a better life for the elderly. Spanishspeaking people of the Nation.

Introduction

The Spanish speaking aged compose a particu-larly vulnerable class of needy persons withinthe already disadvantaged population of elderlyAmericans. Due to linguistic and cultural bar-

. riers, physic.,1 isolation, and the disadvantagesendemic to minority group status, the Spanish"viejito" finds himself in even more deplorable

165

circumstances than the majority of the Americanelderly population.

Poverty of such magnitude exists within thisgroup that is incomprehensible to the averagecitizen. It is a poverty that knows no boundaryline as it affects the Spanish speaking elderlyequally as hard as in rural, urban, and metro-politan areas.

Perhaps the most pervasive handicap the Span-ish speaking elderly person has in this society ishis inability to speak and communicate in Englishand his lack of understanding of the "System."Directly related to the lack of awareness ofhealth, housing, recreation, employment, socialservices, and benefits is the problem of communi-cation. There is a high correlation existing be-

tween his ability to speak English and his lackof awareness of the very few servi,...s, activities,and programs to which he is entitled.

Income: National economists would do wellto learn how some of the Spanish speaking elderlyare able to survive. Because of life-long poverty,many have not been able to save toward retire-ment or collect adequate pension and Social Se-curity benefits. There are those who receive nopublic assistance and have to depend on whateverhelp friends and families can provide.

Health: The mortality rate of the Spanishspeaking elderly is above average. At 48 yearsof age a Spanish speaking migrant compares withan Anglo of 65. This is because of the hardship


PROGRAMTHE SPANISH SPEAKING

ELDERLY

Presiding. PABLO. SEDILLO, Jr., National Direc-tor, Spanish Speaking Vvision, U.S. Catholic Conference

8:00 A.M.-8:15 A.M.---InttxxInctory RemarksHENRY RAMIREZ, Chairman, Cabinet

Committee on Opportunity for the SpanishSpeaking

8:15 A.M.-12 Nc on----Panel Discussions and Pres-entation of Major Policy Recommendationsfor the Spanish Speaking ElderlyIncome.

BLANCA HERNANDEZ, Chairman, TheNational Urban CoalitionCLEOTILDE GARCIA, Committee onEducation and Aging of the American G.I.Forum

CARLOS BPSINAIZ, Consultant, InterstateResearch Associates

Housing..BIRGELIO G. ROEL, Chairman, Director

of Conciliation, Department of Housingand Urban Development

SANTOS RUIZ, National Association ofSpanish Surnamed Americans

(HOUSINGContinued)

GEORGE ROYBAL, Department of Hous-ing and Urban Development

ISMAEL MELENDEZ, American G.I. Forumof the United States

Employment.ANTONIO GUTIERREZ, Chairman, Inter-

state Research AssociatesLUIS CARDONA, National Association. of

Spanish Surnamed AmericansJOE MO/s1TOYA, Director, Migrant Man-

power Unit, Department of Labor- EDUARDO PENA, League of United Latin

American Citizens

LORENZO RAMIREZ, Community Rela-tions Service, Department of Justice

Health.JUAN RAMOS, Co-Chairman, National

Institutes of Mental HealthENCARNATION ARMAS, Co-Chairman,

Eastern Regional Director, Office of SpanishSpeaking, United States Catholic Conference

Education.ROY RODRIGUEZ, Chairman, Office for

Spanish American Affairs, Department ofHealth, Education, and Welfare

ANTONIO CASTREJON, Centro ChicanoCultural

RAFAEL PABLO CIDDIO Y ABEYTA,Higher Education for Farmworkers Associa-tion

166

these individuals have had to endure. Medicareand Medicaid provide relief, but some cannoteat properly without dentures or communicatewithout hearing aids that they can't afford.

Transportation: In rural areas transportationis unavailable most of the time or else too ex-pensive. In metropolitan areas, where public trans-portation is available, many times it is too ex-pensive and the Spanish speaking elderly cannotcommunicate with the drivers or understand routeand time schedules.

Nutrition: Inadequate nutrition affects all el-derly Spanish speaking. Surplus commodities offersome assistance and although they are not de-signed as a complete meal, for many they are.Food stamps have to be bought once a monthand for the majority of the Spanish speakingelderly poor, they are too expensive to purchase.

Employment: The Spanish speaking elderlyneed innovative programs for employment op-portunities without penalizing retirement or otherbenefits.

Housing: Many of our Spanish speaking el-derly poor own their own homes. For them own-ing a home is a matter of pride and self-respect.For the most part, these homes are below stand-ard and do not have regular facilities.

The above are just a few of the many realproblems affecting the Spanish speaking elderlytoday. They are mentioned to dramatize the factthat the theme of the Conference is wrong. Manyelderly and non-elderly here this week are notthemselves poor and, therefore, cannot adequatelyrepresent the poor who were unable to attend.

It is a myth to believe that action eminatingfrom this Conference will automatically benefitthe Spanish speaking elderly poor because thisdid not and has not happetted from the 1961White House Conference. Had this Conferenceconcerned itself exclusively with the problemsof the elderly poor and minority poor then thereverse could be expected to happen.

We strongly urge that a conference on AC-TION for the elderly poor and minority poorbe developed as soon as feasible and possible toprovide the action necessary that this Conferencehas failed to do.

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RECOMMENDATIONS

Income and Transportation

1. It is recommended that the Department ofTransportation, the Department of Defense, andthe General Services Administration make avail-able all excess vehicles, in good condition, to anyelderly-based organization in order that trans-portation services for the Spanish speaking andother elderly be made available in metropolitan,urban, or rural areas.

2. It is recommended that all municipalitieswith public transit systems provide free, or re-duced, fare during the non-peak hours for theelderly and handicapped and demand that thesesame systems make literature available in Spanishfor the Spanish speaking elderly in terms ofroutes and schedules, and also that these systemsrequest subsidized assistance from the FederalGovernment.

3. It is recommended that research and studybe conducted by every agency involved in pro-grams for the elderly in order to determine anage comparability and other important data inregard to the different ethnic backgrounds ofthe elderly.

4. It is recommended that a minimum of guar-anteed income of between $430044500 (couple)be made immediately available to all Spanishspeaking elderly and 75 percent of that for asingle person.

5. It is strongly demanded that States amendtheir legislation to prevent the lowering of OldAge Assistance benefits as Social Security benefitsare increased.

6. It is recommended that Spanish biculturalplanners and consultants design and reevaluateall programs and services to serve the Spanishspeaking with the cooperation and participationof the consumer to be affected by these programs.

7. It is recommended that all elderly legisla-tion regarding services benefits. and programs ofany kind and in effect in the mainland UnitedStates be extended to cover all elderly in PuertoRico.

8. It is recommended that employers, who con-tract migrant elderly workers for any amount ofwork done, be required to make Social Securitypayments and that the farmer be defined as theemployer and not the contractor or crew leader.

9. It is recommended that piecemeal researchand demonstration programs be funded on anational level and give special emphasis to theemployment of the Spanish speaking elderly.

10. It is recommended that the Social SecurityAdministration compile a census on the Spanishspeaking population receiving Social Security ben-efits and that a projection be made of those whowill be receiving assistance in the next 10 years.

Health

1. That where applicable, representatives ofelderly Spanish speaking and migrants .be_air___pointed or all commissions, committees, councils,and other bodies concerned with the planning,development, operation, and evaluation of com-prehensive health services systems funded byFederal, Stare, or local governments.

2. That priority be given to bilingual, bicul-tural students being recruited for the health pro-fessions and for new careers or paraprofessionalemployment opportunities in the field of healthand geriatrics.

3. That -special college credit be made avail-able for students in the medical and health fieldswho are bilingual and bicultural.

Housing

1. Whereas: It is of critical concern that theneeds of the Spanish speaking elderly have beenignored by the Federal, State, and local govern-ment bodies concerned with housing, it is recom-mended: (1) that staff of Spanish descent respon-sive to the Spanish speaking be appointed to allthree levels of government, and (2) that fundsbe sp,tcifically earmarked for the need in housingof our Spanish speaking elde:ly.

2. Whereas: Many of the Spanish speakingelderly live in and own homes that are deteriorat-ing and decaying, it is recommended that in lieu

168

of the demolition or the removal of homes byprograms such as Urban Renewal, Governmentassistance at all three levels be given for the re-habilitation and renovation of housing unitsowned by the Spanish speaking elderly.

3. Whereas: The present Federal housing pro-jects are highly undesirable to the Spanish speakingelderly, it is recommended that all subsequenthousing be constructed according to the Spanishspeaking cultural considerations such as design,cost, location, and size.

4. Whereas: It is recognized that the Spanishspeaking elderly are not receiving a "fair-shake"of Federally subsidized housing, it is recommendedthat the Federal Government adopt a policy inhousing utilizing a formula wherein those unitsthat are authorized, built, or rehabilitated, bereserved for the Spanish speaking elderly in direct.proportion_.to_their_populationin_theirresmoive.communities.

5. Whereas: It is a fact that there exists a re:quirement forcing the Spanish speaking elderlyto give up their claim to "real property" in orderto qualify for pro-grams of financial assistance,it is recommended that the above requirement,being a prohibitive and unjust law, be eliminatedor amended as will meet the needs of the Spanishspeaking elderly.

6. Whereas: It is a revered tradition that theSpanish speaking elderly person has a strong de-sire to remain living within the family household,it is recommended (1) that a new program beadopted that would promote and protect thisopportunity for continued participation with thefamily, and contribute to the Spanish speakingneed for a sense of usefulness, and (2) that thisnew program would pay rent subsidies directlyto the elderly recipient residing within the familialhousehold.

Spiritual Well-Being

1. The Government should cooperate with re-ligious bodies and private agencies to help meetthe spiritual needs of the elderly, but in doingso Should observe the principle of separation ofChurch and State.

2, Spanish speaking elderly should be involvedin the development of all programs which affecttheir spiritual well-being from the initial plan-ning stage through implementation.

3. That all religious and/or private groupsopen their eyes to the needs of the Spanish speak-ing elderly which are more than religious servicesand ceremonies and strive toward fulfilling theneeds of the total person among the Spanishspeaking elderly.

4. The declaration of the rights of the elderlyshould continue to be a responsibility of thevarious religious bodies, but they should also'recognize the value of coordinating their effortswith community groups.

5. All religious and/or private groups, particu-larly those with sizeable Spanish speaking mem-bership, must spend a fair and adequate shareof their resources advocating assistance for theSpanish-speaking elderly.

General Resolutions

1. It is recommended that a $5,000 tax ex-emption be granted to Spanish speaking seniorcitizens on real and personal property in all States..

2. It is recommended that tik I be acted andpassed upon by Congress with a modification thatthe guaranteed minimum income of $2,400 beincreased to $4,800 for all elderly people.

3. It is recommended that all resolutions passedat the Special Concerns Session for the elderly beapplicable to the rural as well as the urban elderly.

4. It is recommended that Congress pass alaw to automatically grant citizenship without therequirement of. an examination to those personswho have been in the United States for 20 years.

5. It is recommended that any organization, beit private or public, which provides services tothe Spanish speaking elderly be required to havean adequate number of ,bilingual, bicultural staff,literature, and forms printed in Spanish, makeoutreach efforts to Iziform the Spanish speakingcommunity', and utilize multimedia services tothis effect.

169

6. It is recommended that the President estab-lish a National Coordinating Committee for theSpanish speaking elderly whx11 insures consumerparticipatidn, develops a national strategy to solvethe problems of the elderly, tap Federal, State,and local funds, and evaluates existing programs.

7. It is recommended that due to the lack ofstatistics available on the Spanish speaking el-derly, the Bureau of the Census conduct an in-depth study which will evaluate the accuracy ofthe number of Spanish speaking elderly in theUnited States.

8. It is recommended that the Bureau of LaborStatistics be required to have an ethnic breakdownon employment figures to make planning possiblefor those Spanish speaking who will becomesenior citizens in the near future.

9. Because of the lower life expectancy of theSpanish speaking elderly, it is recommended thatFederal legislation be passed to lower the retire-ment age to 55 for the urban Spanish speakingand to 45 for the migrant rural Spanish speakingworker.

i O. It is recommended that Federal, State,and local monies be set aside to research andstudy the specific problems of the Spanish speak-ing elderly as a first step in the planning of com-prehensive and relevant programs to alleviatethe plight of the Spanish speaking elderly.

11. It is recommended that the Cabinet Com-mittee on Opportunities for the Spanish Speaking,in cooperation with. the National Council onAging, the National Institute of Industrial Geron-tology, the National Institute of Senior Centers,and the National Council of Senior Citizens createa national organization for the Spanish speakingelderly to serve as an agent at municipal, State,and Federal levels.

12. It is recommended an inv: .igation bemade into which States did not send Spanish speak-ing delegates to the White House Conference onAging and letters be written to their governorsexpressing our disappointment that no Spanishspeaking delegates represented their States.

Roster of Planning Committee'

Nongovernment

Pablo Sedillo (Chairman), National Director, 'panish-Speaking Division, United States Catholic Confer-ence

Anthony Gutierrez, Senior Associate, Interstate Re-search Associates

Blanca Hernandez, Special Assistant to the Vice Presi-dent of Field Operations, The National UrbanCoalition

Eduardo Pena, Chairman of the Washington, D. C.Cottnci. League of United Latin American Citizens

Santo J. Ruiz, Member, American G.I. Forum of theUnitel States, Hyattsville, Maryland

Antoaia Suarea, President, Communidad Hispana deMary- land, Silver Spring, Maryland

Hector Vazquez, Executive Director, Puerto Rican For-um incorporated, New York, New York

'Unless otherwise indicated, location is Washington, D. C.

Government

Maurice Braginsky, Gerontology Trainee, Adminis-tration on Aging, Departmeta of Health, Education,and Welfare

Guadalupe G. Garcia, Associate Director, Program, Division, Cabinet Committee on Opportunity for the

Spanish-Speaking

Maria Poinsett, Management Intern, Office of SpanishSurnamed Americans, Office of Special Concerns,Office of the Secretary, Department of Health, Edu-cation, and Welfare

Juan Ramos, Acting Chief of the Interagency LiaisonBranch, Office of Program Coordination, NationalInstitute of Mental Health, Department of Health,Education, and Welfare, Rockville, Maryland

Roy Rodriguez, Education Program Assistant, Office ofSpanish-American Affairs, Office of Education, De-,partment of Health, Education, and Welfare

Hector Santo Anna, Deputy Associate Director forPublic Affairs, Office of Economic Opportunity

170

LOS ANCIANOS DE

iipp

as diversas organizaciones sirviendo alas personas hispanos que auspiciaron ynombraron miembros del Comit6 deplanes para esta SesiOn de Asuntos

Especiales fueron La Co.......lencia Catolica de losEstados Unidos, El Foro Puertorriquetio, Inc., laLige de- Ciudadanos Unidos Latino- americans,Investigaciones del Interior Associados y LaCoaliciOn Nacional Urbana. Representates de laOficina de Opportunidad Economia:, El Comitedel Gabinete Presidential de Oportunidades paralas Personas de Habla Hispana, El InstitutoNacional de Salud Mental, La Oficina de Educa-tion, y Bienestar, tarnbien participaron en planearesta SesiOn Especial.

La Sesi6n enfoco atencion a los ancianos de !la-bia. hispana, y di6 luz a esos problemas que sonparticulares a esta pohlaciOn. El trabajo de estaSesion, por lo tanto, afiade un componente impor-tante para considerar la delineaci6n del curso deaction national sobre el anciano

Los Participantes

Aproximadamente 100 Delegados participaronen la Sesion de Asuntos Especiales Para losAncianos Hispanos. Los participantes vinieron demuchas panes de la Nacion; mut.hos de ellos eranPuettorriquefios, Me:..konos-Ameri:anos o Cuba-nos. Muchos de los Delegados se rrunieron en losprimeros 2 dias de la Conferencia de la CasaBlanca para discutir experiencias en sus locali-dades y decidir cual de lot problemas concer-nientes a los ancianos hispanos se discutirian enla Sesion Especial.

El Programa

En preparacion para la Sesion de Asuntos Es-peciales, reportes referentes a algunas ciertas ne-cesidades de la poblacion anciana de habla hispana

468-216 0 73 - 12

HABLA HISPANAcomo Ingresos, Empleo, Education, Entrenamien-to y Vivienda fueron presentados y puestos a ladisposition de los -Delegados que habian indicadoque iban a asistir a esta SesiOn. Estos reportesfueron disefiados para presentar una base de in-formacion para la adoption y desarrollo de lasrecomendaciones.

El programa fue.desarrollado alrededor de unaserie de cinco discusiones, cada una acerca de losiguiente: Ingreso, Vivienda, Empleo, Salud, yEducation. Este formato prob6 ser sumamenteefectivo en estimular discusiones produaivas, pro-porcionando acceso a expertos en los campos es-peciales, y permitiendo a los participantes quenegociarin en las areas de mss necesidad. El re-sultado de estos esfuerzos si es considerado en losplanes y acciones, ayudara en el futuro a los an-cianos hispanos a una vida de mss provecho.

171

La Seskin Report6

IntroducciOn

La poblacion anciana hispana constituye unade las clases mss vulnerables &taro de la ya des-ventajada poblacion anciana americana. La barre-ra cultural y del idioma, el aislamiento fisico y elpertenecer a un grupo minoritario, el viejito his -pano se encuentra de por si en una situation Inasdeplorable que la mayora de la poblacion ancianazniericana.

Pobreza de esta magnitud existe en realidad yno es aceptada o comprendida por el ciudadanode clase media. Es una pobreza que no tienelimites ya que afecta igualmente a los viejitos dehabla 11:1)ana de las zonal rurales, urbanas ymetropol itanas.

Quizas la mss terrible desventaja que tienenlos viejitos de habla hispana en esta sociedad es

su inhabilidad para hablar y comunicarse eningles y que no entienden el "Sistema." El desco-nocimiento de los servicios de salud, viviendas,recreation, empleo y servicios sociales estan di-rectamente relacionados con la falta de conoci-miento del idioma y del sistema. Existe una altacorrelaciOn entre la habilidad de hablar ingles ysu des conocimiento de los pocos servicios, acti-vidades y programas que tienen a su alcance.

Ingresos EconOmicos: Economistas nacionalespudieran aprender mucho si estudiaran como esque los ancianos pueden sostenerse con el pocodinero con que ellos sobreviven. Su larga historiade pobreza no les ha permitido guardar para cuan-do el :es llega momento de retirarse o se recibirpension adecuada o beneficios del Seguro Social.Hay muchos que no reciben asistensia pablica ytienen que depender de lo que les dan sus amigosy familiares.

Saltid: La mortalidad en los ancianos de hablahispana es mas alta que el termino medio. Cua-renta y ocho atios es la edad media de mortalidadentre migrantes comparable con 65 entre los an-glos. Esto se debe a la vida dura que han tenidoque llevar toda su vida. Medicare y Medicaid pro-veen ayuda pero no se puede corner apropriada-mente sin dentaduras artificiales ni comunicarsesin una buena audiciOn o aparatos auditivos paralos que no tienen medios econOmicos.

Transportation: En las areas ru.ales los me-dios de transportation son muy escasos y cuandoexisten son muy caros. En las ciudades metropo-

.1itanas los servicios de transporte son caros losviejitos no pueden entendar las rotas y los hora-rios por desconocer el idioma ingles y la carenciade servicios bilingues.

Alimentacidn: La alimentaciOn inadecuadaafecta a Dodos los ancianos de habla hispana. Pro-ductos alimenticios suplementarios ofrecen algunaayuda y aunque no estan supuestos a ser alimentosbasicos, por carecer de otros recursos muchos an-cianos los usan como tal. Las estampillas paraalimentos (food stamps) son a veces demasiadocaras para nuestros ancianos.

Empleo: Los ancianos de habla hispana necesi-tan programas innovadores que no les prohibanrecibir otras pensiones o beneficios que estan ob-teniendo.

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Vivienda: Muchos de nuestros ancianos sonduenos de sus casas, puts para ellos es un simbolode respecto y honor. La mayoria de los veces estoshogares son mu" pobres y carecen de serviciossanitarios adecuauv..

Lo anteriormente mencionado es justamenteuno de los muchos problemas reales que afectana los ancianos de habla hispana en la actualidad.Han sido comentados con la finalidad de exponerel hecho de que el espiritu que inspirO esta Con-ferencia no ha sido implementado en la practica.Muchos ancianos y jovenes que han participadoen esta Conferencia no son pobres y por lo tantono pueden representar adecuadamente a los pobresque desafortunada-mente no pudieron asistir a lamisma.

Es un mito creer que las acciones que se derivende esta Conferencia beneficiarin automaticamentea los ancianos de habla hispana que se encuen-tran en la pobreza. Esto no sucedio como conse-cuencia- de la Conferencia de la Casa Blanca delafio 1961. Si esta Conferencia se hubiese concre-tado exclusivamente a las problemas de los an-cianos y las minorfas pobres era de esperarse quesucediera lo contrario, es decir, que los ancianosno pobres se habrian beneficiado tambien.

Urgimos, energicamente, que una conferenciadonde se tome action directa para el anciano po-bre y las minbrias pobres sea preparada tan prontocomo sea T.t2sible a fin de desarrollar la action queen esta conferenc A no se ha logrado.

RECOMENDACIONES

Ingresos economicos y transporte1. Se recomienda que el Departmento de Trans-

porte, el Departmento de Defensa, y la Ad-ministracion de Servicios Genera les pongan a ladisposition de cualquiet organization de ancianoslos vehiculos sobrantes, en buenas condiciones, demanera que los ancionos de habla hispana y otrosancianos de las mism..ks comunidades donde ellosviven puedan tener los servicios de transporte ne-cessarios en las areas metropolitanas y/o urbanas.

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2. Se recomienda que todas las municipalidaJesque tengan sistemas de transporte publicos pro-vean gratis o con tarifas reducidas pasajes paraancianos durante todo el dia con la exception delas horas de entrada y salida de los empleos y de-mandar de estos sistemas de transporte que publi-quen en espariol las rutas y horarios. Al mismotiempo pedimos que estos sistemas de transit°soliciten del Gobierno Federal el subsidio de estosprogramas.

3. Se recomienda que investigaciones y estudiossean hechos por todas las agendas que este invo-lucradas en programas para los viejos para poderdeterminar comparaciones basadas en la edad asicomo otros datos importantes relacionados con losdiferentes grupos etnicos de dichos viejos.

4. Se recomienda que una minimo de ingresosentre $4,300 y $4,500 (por pareja) se haga in-mediantamente una realidad para todos los viejosde habla hispana y un 75% de esa cantidad paracuando sea uno solo.

5. Se demanda energicamente que los estadosenmienden su legislacion para prevenir la rebajade beneficios de Asistencia Publica (Old AgeAssistance) para los ancianos a medida que vayanaumentando los beneficios del Seguro Social (So-cial Security benefits).

6. Se recomienda que personas hispanas bicultu-rales organizadores y consultantes disefien y eva-Men todos los programas y servicios orientados aservir los de habla hispana con la cooperation yparticipation de los consumidores de estos pro-

..gramas.

7. Que toda la legislacion en relation con servi-dos, beneficios y programas a los ancianos en losEstados Unidos sean extendidos a los viejitos dela isla de Puerto Rico.

8: Que los empleadores que contratan a losviejitos migrantes, cualquiera que sea el trabajoque realicen, contribuyan para los beneficios deSeguro Sociales y que los duenos de fincas seandefinidos como empleadores y no como contra-tistas o reclutadores de empleados.

9. Que las investigaciones y programas en de-mostracion que se han estado haciendo a retazossean financiados a nivel nacional y se les de en-

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fasis especial a la cuestiOn de empleos para losancianos de habla hispana.

10. Que la Administraci6n de Seguro Social(Social Security Administration) compile un cen-so sobre la poblacion de habla hispana que re-cibe beneficios del Seguro Social una proyecciona diez arios incluyendo los que se esperan que enese termino de tiempo puedan ser recipientes deestos beneficios.

Salad

1. Siempre que sea aplicable, se deberan nom-brar representantes de los ancianos de habla his-pana y migrantes en todas las comisiones, comites,consejos y otras organizaciones relacionadas con laplanificacion, desarrollo, operation, y evaluationde servicios globales de salud, financiados por elgobierno local, Estatal o Federal.

2. Dade prioridad a estudiantes ybiculturales que puedan ser reclutadoL pra eleseudio de las profesiones relacionadas con el cam-po de la salud y para las "Nuevas Carreras" (NewCareers Program) y oportunidades de empleosptra semiprofesionales en el campo de salud yg;:riatria.

3. Creditos especiales sean otorgados por lasuniversidades a estudiantes de medicina y el cam-po de la salud que sean bilingiies y biculturales.

Vivienda

1. Ya que los gobiernos municipales, Estatalesy Federales han ignorado las necesidades de vi-vienda de los ancianos de habla hi (pana llegandoestas a alcanzar dimensions criticas, se reco-mienda (1) Que personal bilingiie y biculturalsea nombrado en los tres niveles gubernamentales,y (2) Que fondos sean especificamente apropiadospara las necesidades de viviendas de nuestros an-cianos de habla hispana.

2. Por cuanto muchos de los ancianos de hablahispana son residentes o proprietarios de casas de-terioradas, se recomienda (1) Que por motivosde las demolitions o remociones de casas por los

programas del "Urban Renewal" se conceda asistencia Gubernamental en los tres nivels para larehabilitation y renovation de edificios de vivien-das cuyos proprietarios sean ancianos de habla his-pana.

3. Por cuanto el actual proyecto federal de vi-viendas es altamente indeseable para nuestros an-cianos, se recomienda (1) Que todas las unidadesde viviendas sean construidas de acuerdo con laspreferencias socio-culturales de los hispanos talescomo disefio, costo, localization, tomafio.

4. Por cuanto es por todos reconocido que losancianos de habla hispana no estan recibiendo lacuota proporcional de los programas Federales devivienda, se recomienda (1) Que el GobiernoFederal adopte una politica de 'vivienda utilizandouna formula en la cual las unidades autorizadaspara ser construidas o rehabilitadas sean reserva-das para ancianos hispanos en proporci6n directaa la poblacion de sus respectivas comunidades.

5. Por cuanto es un hecho que existe un requi-sito que fuerza a los ancianos hispanos a ceder susrcrlamaciones a bienes raices, por ejemplo: tierras,fincas, etc.. a fin de calificar como recipientes paraprogramas de ayuda financiera, se recomienda que(1) Los requisitos arriba mencionados, los cualesson legalmente injustos y prohibitivos, sean eli-minados y enmendados a fin de satisfacer las ne-cesidades de los ancianos hispanos.

6. Por cuanto es una tradition altamente res-petada por las familias hispanas de que estos an-cianos tienen una fuerte y \Tali& necesidad de'permanecer viviendo en el seno familiar, se re-comienda (1) Que un nuevo programa sea dise-fiado y adoptado para promover y proteger estaoportunidad de una continu.t participhcion dentrodel seno familiar, y conti 'huh para responder aldeseo de los ancianos hispanos para mantener sussentimientos de utilidqd social. (2) Este nuevoprograma pagaria la renta direct mente a losancianos hispanos recipientes de subsidios econo-micos aunque estos vivan dentro del seno familiar.

Bienestar Espiritual

1. El Gobierno debe cooperar con los distintosgrupos religiosos y organizaciones privadas conobjecto de satisfacer las neces;lades espirituales

de los ancianos sin que por este motivo se olvideel principio de la separation de la Iglesia y elEstado.

2. Los ancianos de habla hispana deben partici-par en la redaction de los programas que afectensu vida espiritual desde su inicio hasta el momentode comenzar su funcionamiento.

3. Que todos los grupos religiosos y privadosse den cuenta de cuales son las necesidades de losancianos de habla hispana que no se limitan aservicios religiosos y otras cermonias y que se es-fuercen por satisfacer las necesidades humanas dedichos ancianos.

4. La declaration de derechos de los ancianoshispanos deben de continuar siendo una responsa-bilidad de los distintos grupos religiosos que ade-mas deberan reconocer el valor de coordinar susesfuerzos con los de los diversos grupos de la co-munidad.

5. Todos los grupos religiosos y privados, espe-cialmente los que cuentan con una cantidad con-siderable de miembros de habla hispana, debengastar una cantidad proporcional adecuada de susrecursos para ayudar a los hispanos.

Resoluciones Generales1. Se recomienda que se conceda a los ancianos

hispanos una execucion de impuestos de $5,000sobre la propiedad mueble y personal en todos losEstados de la Union.

2. Se recomienda que se active el dabate sobreel proyecto de la ley HR I y que el Congresoapruebe, sin enmiendas, la ley que garantiza uningreso minimo de $4,800 anuales para los an-cianos en lugar de los $2,400 que se especificabanen dicho proyecto.

3. Se recomienda qu§ todas las recolucionesaprobadas en la Sesion apliquen a los ancianos delas zonas rurales y urbanas por igual.

4. Se recomienda que el Congreso promulgueuna ley por medio de la cual se otorgue la ciuda-dania sin el requisito del examen de ingles a todoslos que hubieran residido en los Estados Unidosdurante 20 arios.

5. Se recomienda que todas las organizations,publicas o privadas, que ofrezca servicios a los

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ancianos de origen hispano cuenten con una can-tidad proportional de empleados .bilingiies y bi-culturales; y que el material y los modelos se im-priman en espanol; y que mantengan informadasa las comunidades hispanas sobre todos sus servi-cios por medio de la prensa, radio y television.

6. Se recomienda al Presidente la' creation deun Comite Nacional de Coordination para los an-cianos de habla hispana en el cual participen losconsumidores; que redacte un programa nacionalcuya estrategia permita resolver los problemas delos ancianos; que utilice fondos Federales, Esta-tales y municipales, y que evalue los programasexistentes.

7. Se recomienda que el Negociado de Censohaga un estudio exhaustivo de los ancianos dehabla hispana mediante el cual se llegue a unacantidad exacta de los ancianos hispanos de losEstados Unidos ya que las estadisticas existentesson muy escasas.

8. Se recomienda que se exija al Negociado deEstadfsticas* de Trabajo que ofrezca en detalle, porgrupos etnicos, la cantidad de empleados que enun futuro proximo llegaran a los 65 Mies de edadcon cuyos datos se podran redectar programas paralos ancianos hispanos.

9. Se recomienda que se promulgue una leymediante la cual se reduzca la edad para el retiro

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de los ancianos hispanos a los 55 aiios de edadpara los que habitan en ciudades y a los 45 ailospara los obreros migrantes rurales.

10. Se recomienda que se voten fondos Fede-rales, Estatales y municipales para realizar investi-gaciones y estudios de los problemas peculiares delos ancianos de origen espatiol como paso previoen la planificaciOn de un programa global queverdaderamente pueda aliviar la situation desespe-rada de los ancianos de habla hispana.

11. Se recomienda que el Comite del GabinetePresidential de Oportunidades para los Ciudada-nos de Habla Hispana con la cooperation delConsejo Nacional para Ancianos, el Instituto Na-cional de Gerontologia Industrial, el Consejo Na-cional de Centros para Ancianos y la AsociacionNacional de Ciudadanos Ancianos creen una orga-nizaciOn nacional de Ancianos de Habla Hispanaque sirva como agente de los mismos al nivelmunicipal, Estatal y Federal.

12. Se recomienda que se investigue cualesfueron los estados que no enviaron Delegados dehabla hispana a la Conferencia de la Casa BlancaSobre la Ancianidad para escribirle al Gobernadorexpresandole el disgusto que la ausencia de dicharepresentation caus6 los asistentes a esta Con-ferencia.

THE AGING ANDcadets of the black community, as wellas those of other major minoritygroups, were concerned because theregular program of the White 'House

Conference on Aging made no visible provisionfor discussion of problems of the elderly amongthe minorities. The National Caucus on the BlackAged proposed that a Special Concerns Session onthe Black Elderly be organized and a special effortbe made to involve a significant number of mem-bers of the black community both as Delegates tothe White House Conference and guests at thisSession.

The White House Conference on Aging is in-debted to Mr. Hobart C. Jackson. a member ofthe Executive Conimittee of the National Plan-ning Board for the White House Conference onAging. who served as Chairman of the PlanningCommittee for this Special Concerns Session, forhis leade-ship in the planning, execution, and re-porting of this Session on The Aging and AgedBlacks. Mr. Jackson interested outstanding blackleaders in serving with him on the Session Plan-ning Committee. (see Roster. page 196)

The ParticipantsMore than 200 Delegates to the 1971 White

House Conference on Aging preregistered for theSpecial Concerns Session on The Aging and AgedBlacks, and they were joined by so many otherDelegates, observers, and invited guests that noteven standing room was available when the Ses-sion began. Only official Delegates were permit-ted' to vote on recommendations. although thediscussion of the recommendations was open toall who were present.

The majority of those Delegates who chose toattend this Session were themselves black. Theycame from every State and from the Virgin Is-lands. They had participated in each of the needsand needs-meeting Sections, and some had beenSection officers.

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AGED BLACKSMany of the Delegates who attewled this Ses-

sion had participated in one or more of the pre-paratory meetings held by the National Caucus onthe Black Aged on November 27 and 28 at theWashington-Hiltcn Hotel. Other Delegates hadattended t,l National Conference on the BlackAged held in Washington a few weeks prior tothe White House Conference. Still others (Dele-gates) were familiar with the working paper, en-titled The Multiple Hazards of Age and Race,"which was Fepared by Dr. Isabel B. Lindsay forthe United States Senate Special Committee onAging. The Delegates who attended this Sessionwere thus aware of the problems that elderlyblacks face and were familiar with many of kbelatest proposals to remedy their situation.

1971 WIIITE HOUSE CONFERENCE ON AGING

PROGRAM

AGING and AGED BLACKS

PresidingDR. BENJAMIN E. MAYS, Presi-nent-Emeritus. Morehouse College and President,Atlanta School Board of Education

8:00 A.M.-8:10 A.M.Opening RemarksDR. BENJAMIN E. MAYS

8:10 A.M.-8:20 A.M.The Current Status ofBlack Aged: A Demographic Profile.DR. ROBERT HILL, Associate Research

Director, National Urban League

8:20 A.M.-8:45 A.M.Toward a NationalPolicy for Black Aged.HOBART C. JACKSON, Chairman.

National Caucus on the Black Aged, andChairman, Advisory Council on Agingand Aged Blacks to the U.S. SenateSpecial Committee on Aging

(Program eontmued on net! page)

(Program Continued)

8:45 A.M.-9:45 A.M.Presentations of MajorPolicy Recommendations for Aging andAged Blacks.

Education and LawDR. WILLIAMT. CARTER, Director, Division of Pro-gram Resources, Bureau of EducationalPersonnel, U.S. Office of Education, De-partment of Health, Education, andWelfare

Employment, Retirement and IncomeDR. MAURICE JACKSON, Depart-ment of Sociology, University of Cali-fornia at Riverside, Riverside, CaliforniaFacilities, Programs, Services andTransportationJOE HAM, ProgramDirector, Oakland County Commissionon Economic Opportunity, Pontiac,Michigan

Government and Non-GovernmentOrganizationJAMES A. JOHNSON,President, Local Chapter of the Na-tional Association of Retired FederalCivil Service Employees and President,Tuskegee Institute Federal Credit Union,Tuskegee Institute, Alabama

HealthDR. AARON HENRY, Phar-macist. Clarksdale, Mississippi

HousingALAN PINADO, AssistantVice - President, Life Insurance Associa-tion of America, New York, New YorkNutritionPEGGY BEST, Director,State Nutrition Program for Older Per-sons, Los Angeles, California

PlanningWILLIAM T. ROGERS,Field Representative, National Commit-tee Against Discrimination in Housing,New York, New York

Research, Demon- tration and Train-ingDR. JACQUELINE J. JACK-SON, Associate Professor of MedicalSociology, Duke University MedicalCenter, Durham, North Carolina

Retirement Roles and ActivitiesIRA HUTCHINSON, Assistant to thePresident, National Parks and RecreationAssociation, Washington, D.C.

Spiritual Well-Being FATHERDENZIL A. CARTY, Rector, SaintPhilips Episcopal Church, St. Paul, Min-nesota

9:45 A.M.-10:00 A.M.Break

10:00 A.M.-10:45 A.M.Discussion of PolicyRecommendations

10:45 A.M.-11:00 A.M.--Cmcensus Formationon Policy Recommendation and Estab-lishment of Priorities

11:00 A.M.-11:15 A.M.Break

11:15 A.M.-11:55 I.M.Presentation of Pol-icy Concerns to Special Guests

HOBART C. JACKSON, Chairman,National Caucus on the Black Aged andChairman, Advisory Council on Agingand Aged Blacks to the U.S. SenateSpecial Committee on Aging

Responses

11:55 A.M.-12:00 NoonTowards a NationalPolicy for Black Aged: A Follow-upCharge.

DR. BENJAMIN E. MAYS

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THE SESSION REPORT

Introduction

Participants in the Special Concerns Session onAging and Aged Blacks and The National Call-ars on the Black Aged were especially concernedabout three major and related issues during the1971 White House Conference on Aging. Onewas the insufficientand generally lack ofat-tention given to minority groups, includingblacks, in the formation of issues presented in thebackground materials and the workbooks for dis-cussion and policy recommendations at the Con-ference, as well as the exclusion of any specificreferences to minority groupsincluding blacksby major Conference speakers. The heavilyjeopardizing status of being black and old andoften poor (and, frequently, female) deservedmore explicit recognition.

A second was a general feeling of black under-representation as Delegates and particularly so ascompared with other minority groups. A subse-quent examination of minority group delegaterepresentation to the White House Conference onAging revealed support for the latter fear. Incomparison with our proportionate representationin the total United States 1970 population, wewere slightly underrepresented, Asian Americansequaled chance representation, American Indiansand Spanish speaking persons were clearly over-represented

We have estimated that there were 1.62 blackDelegates per every 100,000 blacks in the UnitedStates in 1970. Correspondingly, Asian Americans,had 2.1 delegates per 100,000, Spanish speakingpersons 2.8 per 100,000, and American Indians,12.4 per 100,000.

This significant black underrepresentation can-not be justified by purporting greater tribal orethnic diversity among the Asian AmericansAmerican Indians, or Spanish speaking Ameri-cans, thereby negating the considerable hetero-geneity among blacks. Inadequate efforts by

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blacks to ensure satisfactory black representation,or black apathy, cannot provide sufficient explica-tion, inasmuch as black effortsIt considerableexpense of time and money by blacks themselveswere purposively and constructively exerted. '11fact, black efforts probably far outweighted thoseof the other groups. Perhaps the most significantfactor accounting for differential representationof minority groups may be sought in dominant re-sponses to minority requests. If so, the need forblacks to remain critically concerned about blacksis yet extant, since we are those most likely tocontinue to experience the most severe forms ofracial prejudice in the United States.

This black underrepresentation may also ac-count for the feeling of some black Delegatesthat our numbers were too small to gain sufficientstrength in actual policy deliberation and forma-tion. Hence, while we appreciate the cooperativeefforts which were received in enlarging our blackrepresentation, we may still be correct in believ-ing that the "multiple jeopardy" confrontingmany black aged necessitated a larger biack dele-gation to participate in forming a national policyon the aging, including aging blacks.

Insufficient time to prepare and insufficientspace to present our preliminary report consti-tuted the third merriding issue. Sheer numbers ofblack aged unduly victimized by race and povertyjustify this concern. The 1970 United States popu-lation contained about 809,000 black females and608,000 black males 65 or more years of age. Lo-cated in every State, twice as many black aged aswhite aged dwelled in poverty. Between 1959and 1969, dollar income gaps between black andwhite aged actually widened. Thus, by comparison,black aged were worse off than white aged in1969 than in 1959. Currently one of every twoblack aged lives in poverty. Three of every fourlive in substandard housing. Policy recommenda-

tions for black aged required more time than thatprovided for in the Conference.

Actual time needed for such deliberations mayhave been reduced had more information on agedblacks been available. Scant data are even nowavailable. The National Caucus on the BlackAged was generally foiled in its attempts to ob-tain relevant data from the 1970 Census, butsome recent breakthroughs have been made inthis direction. The National Center for HealthStatistics, to the extent possible, was quite co-operative. That is, data from that source was madeavailable to us. The chief problem was the lack ofsufficient data collected by that agency. In thefuture, and certainly before a possible 1981 WhiteHouse Conference on Aging, all relevant datashould be on hand for adequate policy delibera-tions and implementations.

These three points are important in any evalua-tion of the Special Concerns Session on Agingand Aged Blacks. More important. they are criti-cal for those sincerely concerned about improvingdrastically the adverse plights of those blackswho are now old and those aging blacks who willbecome old.

Two major purposes characterize this presenta-tion of our deliberations in the Special ConcernsSession on Aging and Aged Blacks. The first isthe presentation of all of the recommendationsapproved in that Session, following insofar aspossible the actual language employed. Those rec-ommendations are incorporated into Section Oneof this final report. The second purpose, con-tained in Section Two. is multifold. That purposeis to provide background data, much of whichwas set forth or alluded to during our delibera-tions; to present several additional recommenda-tions arising from discussions of a significantnumber of persons following the Session; and toprovide additional information on the reactionsof participants to the Session, in general, and tothe White House Conference on Aging, in partic-ular. These reactions were systematically compiledand analyzed by Hobart C. Jackson.

Hobart C. Jackson was Chairman of the SpecialConcerns Session on Aging and Aged Blacks.Head of the Stephen Smith Geriatric Center inPhiladelphia, Pennsylvania (a home established

for black aged more than 100 years ago), he isalso Chairman, The National Caucus on theBlack Aged: Chairman, Advisory Council onAging and Aged Blacks to the U.S. Senate SpecialCommittee on Aging; and an active member ofthe Gerontological Society. The Presiding Chair-man of the Session was Dr. Benjamin E. Mays.President-Emeritus of Morehouse College (At-lanta, Georgia). President of the Atlanta SchoolBoard of Education, and the 1971 "Senior Citizenof the Yeir" from Georgia. An eminent scholar,educator, administrator, and theologian, as wellas an outstanding representative of aging individ-uals whose lifelong patterns of significant profes-sional, civic, and community contributions persistover time, he is also a member of the AdvisoryCouncil on Aging and Aged Blacks to the U.S.Senate Special Committee on Aging. The SessionCoordinator was Dr. Jacquelyne J. Jackson, Asso-ciate Professor of Medical Sociology, Departmentof Psychiatry, Duke University Medical Center,Durham, North Carolina, Secretary of The Na-tional Caucus on the Black Aged, and a memberof the Advisory Council on Aging and AgedBlacks to the U.S. Senate Speci:i Committee onAging and the Gerontological Society. She is alsothe author of the only three published reviews as-sessing the current status of gerontological litera-ture on black aged, which were partially sup-ported by the Nacional Institute of Child Healthand Human Development (Grant #HD 668)and the U.S. Public Health Service (Grant#MH16554).

Those persons specifically responsible for chair-ing selected task forces to aid in developing ourrecommendations and whose tremendous effortsin this direction, as well as their commitment toblack aged, cannot be overlooked include, in addi-tion to those mentioned above, Ms. Peggy Best(Director, State Nutrition Program for OlderPersons, Los Angeles, California); Dr. WilliamT. Carter (U.S. Office of Education and thenGrand Polemarch, Kappa Alpha Psi); FatherDenzil A. Carty (Episcopal Rector, St. Paul,Minnesota); Dr. Aaron Henry (Pharmacist andState President of the National Association forthe Advancement of Colored People, Clarksdale,Mississippi); Ira Hutchison, Jr. (Assistant to thePresident of the National Parks and Recreation

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Association, Washington, D.C.); Maurice Jackson(then Associate Professor of Sociology, Universityof California at Riverside, California, and nowExecutive Associate, American Sociological Asso-ciation, Washington, D.C.); James A. Johnson(Pr-sident, Tuskegee Institute Federal Credit Un-ion and President, Local Chapter, National Asso-ciation of Retired Federal Civil Service Employees,Tuskegee Institute, Alabama); Alan Pinado (As-sistant Vice-President, New York Life InsuranceCompany, New York, New York); and WilliamT. Rogers, Jr. (Field Representative, NationalCommittee Against Discrimination in Housing,New York, New York).

In addition, The National Caucus on the BlackAged and each participant in the Session wereaided immeasurably by background data on blackaged provided by Dr. Robert L. Hill, AssociateResearch Director, National Urban League(Washington, D.C.). Dr. Hill is also a member ofThe National Caucus on the Black Aged and theAdvisory Council on Aging and Aged Blacks tothe U.S. Senate Special Committee on Aging.

We welcome the opportunity to present in Sec-tions One and Two below our recommendationsand selected background data, with the hope thatthey can be implemented to improve dramaticallythe lives of aging and aged blacks and that thespirit in which they were given will become thespirit of the Federal Government which can mo-bilize their enactment.

SECTION ONERecommendations Approved in Session

General1. All policy recommendations emanating from

the Special Concerns Session on Aging and AgedBlacks should receive appropriate follow-up asquickly as possible. At least one black representa-tive should participate in the preparation of thefinal report from each Section (i.e., Education;Employment and Retirement; Physical and Men-tal Health; Housing; Income; Nutrition; Retire-ment Roles and Activities; Spiritual Well-Being;Transportation; Facilities, Programs and Services;Government and Non-Government Organiza-

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tion; Planning; Research and Demonstratic-,and Training). Preferably at least one such blackrepresentative should be from The National Cau-cus on the Black Aged.

2. Above all, first priority should be given toestablishing a system providing at least a guaran-teed, mode'ate income for all black aged. Incomeneeds excee.! all other priorities.

3. When the President's Domestic Council (orwhatever agency makes final recommendations onaging to the President) considers the various pol-icy recommendations, that body should have atleast proportionate black representation on itsstaff and as consultants. if Hobart C. Jackson isnot properly included as a consultant, a copy ofall action taken on all of our recommenaationsshould be forwarded to him for his considerationwithin a reasonable time following the actiontaken, and prior to its presentation to the Presi-dent, so that appropriate modifications can bemade. Those recommendations requiring Federallegislation should be forwarded to appropriatebodies for such consideration and every effortshould be made to involve the CongressionalBlack Caucus.

4. Inasmuch as insufficient data are availableon aging and aged blacks from all Federal agen-cies collecting and interpreting such data, itshould be mandatory that all such agencies becompelled to collect data from a sufficient samplesize to ensure that multivariate analyses providinggreater information on patterns and processes ofaging among blacks can be undertaken. The Fed-eral Government is urged to present a report onaging and aged blacks at regular intervals duringthe years ahead, such as every 5 years, so we canmeasure the changes, if any, occurring in theirconditions. The Census should shift from a de-cennial to a quinquennial format and should re-port data fully for blacks without including us inany category of "nonwhites."

5. The White House Conference on Agingshould provide us with periodic reports for itsfol!ow-up of our recommendations, with the firstreport to be presented in not less than 9 monthsfollowing the close of this Session and with re-maining reports to be presented by the Federalagency or agencies having any responsibility for

the aged yearly following the initial report. Thisreport and all subsequent ones should include allrelevant data, including that on food from theU.S. Department of Agriculture, participation inthe labor force from the U.S. Department ofLabor, housing patterns from the U.S. Depart-ment of Housing and Urban Development, andresearch, demonstration, and training as well ashealth care and Social Security data from the U.S.Department of Health, Education, and Welfare.Copies of such reports should be forwarded to allmembers of The National Caucus on the BlackAged, all State agencies of aging, and all otherrelevant organizations or agencies, as well asbeing made available at cost at the U.S. Govern-ment Printing Office. From time to time, blacksthemselves should be consulted for an evaluationof those reports and for policy formation and im-plementation.

Education

6. The Federal Government should provide,through appropriate training programs, realisticand effective opportunities for elderly blacks tofurther, without cost to them, their educationalgoals.

7. The administration of the proposed pro-gram for effective education for elderly blacksshould provide for funding support to institutionsfor such training projects, or stipend and tuitioncosts to be paid directly to the elderly to enroll incourses or curricula of their choice wherever avail-able.

Employment and Retirement

8. Since income is the most serious problemconfronting many aging and aged blacks, signifi-cant attention should be given to improving sub-stantially the income levels of all blacks.

9. Inasmuch as a significant proportion of con-temporary black aged have been a part of thelabor forceworking fulltime for poverty wagesand in menial jobs generally lacking adequatefringe benefits related to retirementit is recom-mended strongly that employment opportunitiesfor aged blacks should not be regarded as a sub-

stitute for provisions of adequate income withoutany additional work in their old age. In otherwords, while we strongly support efforts made toprovide meaningful employment for those whoare old and black who desire labor force partici-pation for reasons "other than needed income sup-plementation to ensure survival, we feel that oldblacks who do not-desire to work should not hareto engage in employment only to supplement in-adequate incomes, but, as already recommended,should have a guaranteed, moderate annual in-come.

10. The proposed National Senior CitizensCommunity Service Program should be enactedand implemented, with sufficient considerationgiven to black participation and representation atall levels, provided that no aged black is forcedto participate in such a program.

11. The Federal Government should initiateguidelines and policies to govern and enforce ade-quate standards of private pension systems andestablish a mandatory pension portability systemfor all workers.

12. The Federal Government should requirethat all employers pay employees at least mini-mum wages and minimum wage coverage shouldbe extended to all workers, including domesticsand farm laborers. Fringe benefits should includeadequate provisions for sick pay, annual leave,and life insurance which, in cases of employerswith very few employees, could be accomplishedthrough Federally sponsored programs requiringregular financial contribution.; by employers toemployee coverage.

13. The Federal Government should take stepsto reduce significantly high unemployment ratestypically found among blacks so that no signifi-cant differences will characterize black and whiteunemployment rates. It should also remain cogni-zant of those significant links between employ-ment in the earlier years and retirement in thelater years so as to reduce current gaps adverselyaffecting aging and aged blacks.

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Physical and Mental Health14. Medicare coverage should be expanded

and improved to provide coverage for home care,

long-term care and extended care without prioradmission to an acute-care hospital, and ex-panded coverage for home care, -coverage forout-of-hospital drugs, and removal of the 100-daylimit on skilled nursing home care for those pa-tients who continue to need such care should be-come a reality.

15. Parts A and B of Medicare should bemerged and all deductibles and co-paymentsshould be eliminated. Services previously ex-cluded, such as foot care, eyeglasses, eye refrac-tions and examinations for eyeglasses, hearingaids, false teeth and dental care, other prostheses,and out-patient psychiatric care should be in-cluded.

16. Medicare coverage should expand to in-clude disabled Social Security beneficiaries.

17. Front-end financing from the MedicaidTrust Fund should be utilized to develop seniorcitizen day-care centers and a full range of geriat-ric health service centers, including communityhealth outreach workers, transportation, informa-tion referral and advocacy services and such cen-ters should be owned and operated by nonprofitindigenous community corporations.

18. The Administration on Aging, or whateveragency supercedes that'agency in assuming overallresponsibility for all Federal programs related tothe aged, should identify and design and supportopportunities for older persons to render servicesto their communities.

19. The Administration on Aging (with theabove qualification), and any or all public and pri-vate agencies concerning themselves with theaging and the aged, should join together in a co-operate effort to develop programs of technicaland financial assistance for local communitygroups to provide daily meals to ambulatory olderpersons in group settings and to shut-ins at home.

20. The $2 billion spent yearly by the FederalGovernment for private nursing home servicesshould be diverted to nonprofit social utilities andhomes for the aged sponsored by religious or be-nevolent organizations or community corporationswith joint consumer control and equity by a rep-resentative number of the elderly receiving serv-ices. Such homes should receive sufficient financialsupport to ensure their maintenance.

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21. Existing nursing homes and long-term carefacilities . owned by black nonprofit sponsorsshould be given grants and low-interest bearingloans for renovation and construction to meetminimum state and Federal standards.

22. The archaic practice of static custodial carein institutions where the elderly go "to lie anddie" is self-defeating, inhuman, and economicallyunsound. We recommend its abolishment and, inits place, the development of a "Socio-MedicalApproach" utilizing progressive patient care tech-niques (phased intensive, intermediate, minimumcare, rehabilitation, resettlementall representingjoint health team efforts) integrated with com-munity support to maintain the elderly in theirchosen environments, with those services includ-ing, but not being limited to, home healthservices, occupational and physical therapy, recu-perative holidays, meals-on-wheels, day- centers,recreation clubs, and ambulances and other trans-portation services.

23. The following new 'trends in long-termcare should be researched and implemented wher-ever feasible: holiday admissions (the voluntaryadmission to nursing homes/extended care orappropriate facilities during planned family vaca-tions); short-term admissions (providing for in-termitt'nt 2-week admissions of aged patientsevery 4 months) and day hospital (utilizing aunit combining medical and nursing care, physicaland occupational therapy, and a noon meal forthe aged).

24. The implementation of health care legisla-tion should be uniform and mandatory and inde-pendent of matching State funds or voluntaryparticipation of individual States.

25. Wherever feasible within :black communi-ties, comprehensive health services should be de-livered through a community health corporationcomposed of indigenous consumers and provid-ers rather than the traditional approach (medicalschools, public-health departments, and medicalassociations, et cetera). This health corporationshould secure significant input from informed andrelevant consultants within or without its com-munity. Satisfactory implementation of this pro-posal would net needed equity, cultural relevance,self-sufficiency, and self-respect in health-care forblacks.

26. Research in experimental health deliverysystems should be conducted todetermine thebest method of financing comprehensive geriatricservices. Arrangements might include front-endfinancing from Medicare Trust Fund, Medicaidappropriation for neighborhood health centers, ora combination of social insurance and general taxrevenues for Health Maintenance Organizations.

27. Restrictive provisions of H.R.1 (the "Fam-ily Assistance Plan") pertaining to Medicare andMedicaid cutbacks should be opposed. Those sec-tions pertaining to the aged should be separatedfrom those pe1,4ining to non-aged and incorpo-rated into a separate bill. H.R.1 in its presentform should be actively opposed by all- genuinelyconcerned about aging and aged blacks.

28. The scarcity of black health professionalsnecessitates sufficient Federal allocations for train-ing black females and males as physicians, nurses,pharmacists, dentists, technicians, social workers,dieticians, and other relevant health professionalsto increase dramatically available black healthprofessionals in the next decade. Their trainingcurricula should include mandatory geriatric andgerontological exposure.

29. The Federal Government should continueto enforce racial desegregation in all medical fac-ilitiesincluding nursing homescoming underits jurisdiction or using any Federal funds. Suchpolicies should apply to all administrators, staff,and patients.

30. The Federal Government should requireadequate hospital and other health insurance cov-erage for all labor force employeesincludingdomestics and farm laborersor it should moveimmediately towards other coverage methods suchas, in the opinion of some Session participants,nationalized health systems. Irrespective of socio-economic status and geographical location (whichmay necessitate greater medical services deliveredvia aeroplanes), all black aged should have accessto good health care.

Nursing Homes31. Sufficient attention should be given to es-

tablishing nursing homes for black elderly need-ing such facilities, with staff comprised of compe-

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tent personnel with adequate knowledge andunderstanding of and respect for their-subculturalbackgrounds.

32. Governmental reimbursement to nursinghomes for the care of residents whose care isfinanced with public funds should be at a levelconsistent with the actual cost of this care.

33. Private and public nursing homes yet prac-ticing racial discrimination should be made toconform to standards of compliance with nondis-criminatory policies pertaining to race. Enforcedcompliance wherever necessary is essential.

34. The greater problem for black aged is notone-of remaining without but of getting into nurs-ing hows. Thus, sufficient attention to reducingbarriers preventing needed black admissions tonursing homes is urgently needed.

Housing35. The Federal Government should increase

the supply of housing available to low and mod-erate income minority elderly through such meas-ures as providing seed monies and loans for creat-ing and supporting nonprofit minority housingdevelopment organizations. Provisions should bemade for technical assistance and 100 percentfinancing to develop housing available for theelderly of all races.

36. Federal policy should require the provisionfor low and moderate income elderly housing inall new cities or communities, planned unit devel-opments, urban renewal and model-cities areasand other similar developments receiving Federalassistance.

37. The Federal Government should fund asystem of fellowships and scholarships to low-in-ane students to provide education and inservicetraining in -the development and management ofnursing homes and other residentially-oriented fa-cilities. Programs should include a representativenumber of trainees from all racial and ethnicgroups.

Income38, A minimum. guaranteed annual income of

$6,000 for a single aged person and $9,000 for

an aged couple should-be established, with appro-priate cost-of-living indices attached to thesebases. This recommendationparticularly desira-ble for black aged who have experienced lifelongpovertycould be modified to restrict its benefici-aries to those whose average earnings (singularlyin cases of individuals bereft of spouses for atleast W preceding years, and collectively forMarried individuals) never exceeded $9,000 an-nually during their working years.

39. The minimum ageeligibility requirementfor primary beneficiaries of- Old Age, Survivors,Disability, and Health Insurance_ (OASDHIunder Social Security) should be reduced by 8years for black males so as to erase existing racialinequities.

40. Aged workers supplementing -their retire-ment funds through work should not be penal-ized for monies earned unless those earningsplace their total income above the national me-dian income during any taxable year, and, in ad-dition, the category of Old-Age Assistance(OAA) should be deleted from Social Security,since a -majority of blacks receiving that aid- arethose who were denied sufficient participation inOASDHI and in the labor market in their work-ing years. They should merely be eligible forOASDHI at a monthly minimum placing themabove the poverty level. All workers and their de-pendent family members can and should be ade-quately covered by -OASDHI, and- the aged donot need to be stigmatized by coverage arisingfrom OAA. Coverage under OASDHI shouldcontinue until such time as that system is replacedby a more effective system.

Nutrition

41. The Federal Government must allocatesubstantial funds for comprehensive nutrition ac-tion programs to rehabilitate malnourished agedand prevent malnourishment in those approachingretirement. These nutrition action programs mustprovide health-related components in addition toresearch components. Additionally, all nutritionhealth-related research must have a service actioncomponent.

42. Government resources allocated to nutri-

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tion should concentrate on providing food assist-ance to those in need. This food assistance pro-gram must be improved whether by commoditydistribution or food stamps to make more com-modities available to senior adults in more acces-sible distribution centers with transportation forseniors to and from the centers. Commodity foodsmust be packaged in smaller units for one andtwo person families to reduce spoiling and foodpoisoning dangers. An adequate guaranteed in-come, however, should eliminate any need for theabove for older persons would not be in povertyand would be able to purchase "heir foods in themodal American ma»ner.

Retirement Roles and Activities43. Inasmuch as retiroment roles and activities

are influenced heavily by such variables as in-come, health, housing, and education, we recom-mend strongly, sighificant improvements in theseareas for aging and aged blacks, so that we willbe better able to engage in preretirement andretirement roles and activities, including leisureusage of time.

44. Better planning for recreation outlets forblack aged, based upon their needs and desires,should be encouraged, with aged blacks playingdecisive roles in developing and implementingthose plans..

45. Consideration should be given to the needfor improved transportation services at reasonablecosts, better street lighting and police protection inpredominantly black neighborhoods, and otherfactors enhancing aged participation in desiredroles and activities.

46. Public housing designed for the elderlyand especially for elderly blacksshould containtemporary lodging provisions for their out-of-townvisiting relatives since the high costs of commer-cial lodging available often prohibits or adverselyaffects these visiting patterns.

47. All governmental and nongovernmentalagencies concerned with the aged should givegreater consideration to utilizing professional tal-ents and skills of aged blacks, who have a wealthof information and experience to share and whocan enrich the lives of all Americans.

48. All levels of public and private educationshould include training for leisure activities andcontinued adult education outlets should be madeavailable for all older persons.

49. Formal retirement activities for agedblacks should include both age-integrated andage-segregated activities since some aged blacksprefer the former, some the latter, and some,both.

50. While greater emphasis upon developingvoluntary roles and activities for aged blacks withadequate income is needed, greater emphasis mustbe placed upon developing more salaried rolesand activities (which are meaningful and satisfac-tory to them) for those aged blacks without suffi-cient income until such time as they also receiveadequate income.

5L Existing recreational outlets, such as movietheaters and restaurants, should be encouraged toprovide reasonable fares for the aged and to pro-vide servicesincluding entertainmentfavorableto the aged.

Spiritual Well-Being52. The Federal Government should make it

possible for black churches to sponsor housing forblack aged and should give them all the help anddirection possible, including the use of black in-stitutions for financing purposes.

53. All national church denominations shouldbroaden their interpretation of the Fatherhood ofGod and the Brotherhood of Man, which is im-plied in spiritual well-being, by making certainthat all nursing and rest homes and other livingfacilities for the aged under religious aegis reachout to include minorities irrespective of race,color, or creed. This is particularly importantwhen such institutions use government funding.

54. Since spiritual well-being and economicwell-being are significantly correlated in a varietyof ways, the former may be improved by improv-ing the latter. Anything less than a moderateguaranteed alinual income would be meaninglessand simply prolong the suffering of those aged inunnecessary poverty.

55. The Federal Government should sponsor aconsortium of black and white clergymen to seek,

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under the the banner of spiritual well-being, con-certed action within all churches and the commu-nity-at-large, working toward the understandingof the monster of racism so as to eradicate it, inthe' name of God, Father of all mankind, fromour society.

Transportation56. The Federal Government should establish

or stbsidize transportation systems providing serv-ices at lower rates and operating on convenienttime schedules for aged blacks in all areas withblack aged residents. In addition to better busservice, subsidized taxi-cab service, et cetera, physi-cal arrangements should be improved so as to re-duce difficulties black aged may experience inmounting unusually high steps, standing in un-safe places, and waiting services in bad or coldweather.

57. Needed transportation to medical facilities,grocery and other shopping outlets, and businessplaces (such as food stamp'distribution centers atthe present time) should be provided at tr,!;nimalcosts to the participants.

58. Especial attention is needed in reducingtransportation problems of rural black aged.

Facilities, Programs, and Services59. In general, facilities, programs, and serv-

ices for black aged are woefully inadequate dueto a variety of reasons. An assessment of the cur-rent status of black aged in existing programs(including such Federally funded ones as FosterGrandparents, and the training and effective useof subprofessionals and volunteers in Titles I, IV,X, XIV, and XIX under the Social Security Act,food stamp and food distribution programs underthe U.S. Department of Agriculture, and Medi-care under Social Security) should be made avail-able to The National Caucus on the Black Agedfor consideration and policy recommendations toappropriate agencies as quickly as possible.

60. All Federally funded demonstration pro-grams should be required to evaluate themselvesand adequate funds must be built-in to providefor independent evaluation by outsiders to deter-

mine progiam effectiveness and the need. if any.for program continuation.

61. Greater diversity in substantive contentand in geographical location is needed for mostfacilities. programs. and services for black agedand every (Mort should he made to extend suchdiversity so that all black aged will have reasona-ble access to these programs.

62. Manv existing programs and services areunduly hampered by insensitive and incompetentpersonnel insofar as they relate to black aged.One solution is greater employment of Mack:--and especially of older blacksin such programs.

63. Often information about existing facilities.programs. and services is withheld from blacks invarious ways. necessitating thereb a need to in-crease information flow to blacks through primetelevision-viewing hours for older blacks. churches.and other existing and new black communicativenetworks.

64. Considerable outreach to make olderblacks feel comfortable in using facilities, pro-grams. and services from which they were. orwould have been, excluded during most of theirlives because of racial segregation is needed. Si-multaneous efforts should he made to estabhsh fa-cilities. programs. and services amidst the commu-nities where black aged reside.

65. The Federal Government, on continuingbasis, should require all new and existing facili-ties for the aged. includ'ng housing. to report- theextent to which they will and actually are servingminorities. Facilities with poor records should berequired to implement meaningful affirmative ac-tion programs or lose their Federal funding.

66. A majority of the r ticipants were cogni-zant bodi of the need for facilities. programs. andservices for aged blacks and the need to refrainfrom unduly emphasizing those areas at the ex-pense of providing sufficient incomes to blackaged who, in turn, could he effective consumersof available programs. services, and facilities. Thetendency was that of emphasizing greater selectiv-ity or choice by aged blacks. as opposed to morecurrent practices where many aged blacks havealmost no option other than that of being at themercy of those providing services.

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Got.etwmeritNon-Got'ernmthilOranizalion

67. The Federal. State, and local governmentsshould become strong auvocates for aged blacks.serving to identify their nerds. to promote programs of public education and interpretation ofneeds and how those needs may be met. et cetera.

68. Government employees functioning as advocal es for the aged must include individuals re-flecting the race and sex composition of their re-spective cachement areas. When black aged arewithin the cachement areas. every considerationshould be given to weighting that employee com-position to reflect the "multiple jeopardy- affect-ing inany aged blacks.

69. All levels of government should providefinancial resources to black organizations capableof pros Wing more efficient services to black agedthan thOSe they now receive.

70. Greater emphasis should he placed uponthe responsibilities of the private sectors for meet-ing the needs of aged blacks.

71. The Federal Government should act imme-diately to bring about significant changes in unde-sirable housing conditions of aged-1)13(:s: and allFederally-approved homing in which aged blacksreside should he equipped with necessary mecha-nisms to ease their lives, including telephone serve

ice where their own incomes prevent the purchas-ing of that service.

77, More seed monies should be given tonational and regional black organizations inter-ested in the aged so that they can develop viableprogram networks. such organizations should in-clude. but not necessarily he limited to, The Na-tional Caucm on the Black Aged. The NationalUrban League (as is presently the case with cer-tain fundings this organization has already re-ceived), black fraternities and societies (such as

Kappa /1/pha Paz and Delta Sigma Theta). Na-t/0a llo,mal and Nursing Ilinnt limployeel.Union and The Nationa1 Committee ofBlack Churchmen.

73, Information about existing granting pro -

grains and all new granting piograms should bemailed periodically to major black organizationsby the appropriate Federal agencies.

Thc. Federal Go% eminent should ensurethat blacks arc adcquatclt icprcsentcd at all polic-lecei And in Ali stall positions in al; of its agenciesand in its counterpart State agencies (such as aState agent% on aging). Black represent.nion intorle%el administration. on review committees.and as principal investigatOrs of research projectsor directors Of demonstration pat grams involvingany significant number of aging and aged blacksis imperative.

Planning.75. Since planning is so critical. comprehensive

and wel.-integrated planning for aging and agedblacks at all levels is urgent. Aging and agedblacks must lw effectively involved as plannersand as those who 'plan the planners." Such plan-ning should be designed to reduce drastically rac-ism. pmer'v. and ignorance and ant planning for

as opposed to u h --blacks. Blacks must alsobe effectivel imol-zd in planning. planning implementation, and planning evaluation of a "Na-tional Policy on the Aged."

76. Older blacks should be significantly in-oled inFederal- planningof the delivery and

utilization of sort ices. including integrated ap.roaches to community services and IISCA Of publicfacilities. Federal -regulations pioviding gukidincsfor implementing Federal le,!islation should in-chide rcquired guidelines for establishing and lo-cating programs, sei vices, and facilities in areasof ready access to black aged.

77. Since housing is a critical problem formany blacks. the Federal Government should en-force more fully its anti.discrimination laws inhousing. increase its efforts to provide standardhousing in all geographical areas. eliminate subtlediscriminatory realestate and other practices ad-versely affecting blacks as far as possible, and.above all. upgrade immediately the housing occu-pied by it )st aged blacks.

78. Planning and panning implementationbask e upon this Session's rewminendations and

emanating from the \X'hite House Confer-ence on Aging and pertinent to aged blackslhould be followed up with swift action in termsof short-range and long-range goals. Blacks

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should he meaningfulh imoled in planning andplanning implcmcntation. but they should nut bebrought in merely to rubbcrstamp the plans ofothers. The% should not he brought in after planning has been completed. They should nut bebrought in without an authorit) to participate inplanning and its implementation. Th( rtdo.dGird awnew rind( rrtrit, linam :tot c ugh II

h ipat I( b thi,4t dr( L'tli-t unduh handl, apped when /num.)" (Pa-k, ipatIN! is requin if Mon in tit, b ;tail-r' es :Is

those leading to and including the \N'llite HouseConference on Aging. Most black national orga-nizations lack the necessary financial base to per-1111: such participation.

Research. Downistration._and Training79. At least 12 percent of .111 Federal funds al-

located fur research. demonstratio_ and trainingin aging and in related fields (e.g.. medicine, den-istr. sociology, psychology. social work. ph%siol

ctonomits. and religion) in .any and all fiscalyears during the next decade, and beginning withFiscal Year 1972. should be specifically ear -

marked for blacks.

80. Given the great difficulty often experiencedin obtaining adequate data on aging and agedblacks. and especially those S5 years of age.from Federal statistical sources such as the l'.S.Bureau of the Census of the National Center forHealth Statistics, those agencies should increasesubstantially their sampling sizes in all futuredata collections from okler blacks. Such an in-,:rease--at the very leastwould permit variousmultivariate analyses of data furthering ourknowledge and wide, standing of aging complexi-ties (such as the social, psychological. and biolog-ical processes) among blacks. Data about blacksshould he reported in categories specifically con-fined to blacks as opposed to a customary practiceof collapsing blacks and other nonwhites. Manysimilarities may characterize blacks and other non-whites, but their differemr:s also deserve greaterrecognition, such as the implications of recentcensus data indicating it higher median educa-tional level among blacks than among Mexican-Americans, but a higher median income levelamong the latter than the former (w hich may be

partially explained by the greater concentration ofMexican-Americans in the West and the generallyhigher income level of that region as comparedwith remaining U.S. regions, and particularly theSouth).

81. The paucity of adequate data on blackaged should be rectified by the development of ad-equate gerontological research on -black aged inbasic and applied areas, including longitudinal re-search. Hence, we support proposals to establish aNational Institute of Gerontology (two of whosemajor functions would be basic research andgraduate training support) provided that it con-tain a Division of Black Gerontology controllingapproximately 30 percent of the total Institutefunds. Failing that -we urge the establishment of aFederally fulitled National Institute of BlackGerontology. Until such time as either of thesetwo Institutes becomes a reality, we urge all exist-ing Federal and private agencies to provide basicand applied research funds for black aged research.

82. Basic research is urgently needed to iden-tify more satisfactorily variables inducing prema-ture aging and death among black males, as seenin their significantly shorter life expectancies.This concern can be extended-to other vulnerableminority groups, so we urge the initiation of stud-ies designed to identify factors contributing tosuch vulnerability and practical action upon theemergent findings.

83. We recommend strongly a significant in-crease in trained professionals and paraprofes-sionals in gerontology and geriatrics as related toblack aged, which could be readily facilitated byallocating training funds at least proportionate toour representation in the population to blacks forthese purposes, as suggested in #79 above, withthe understanding that at least does not imply aquota system suggesting no less than, nor anymore than that entitled to by proportionate repre-sentation. In other words, much more than 12percent of allocated funds for training could beused to develop black professionals and parapro-fessionals.

84. Students entering professional programsshould be disciplinary based, and they should beencouraged to train in the best programs in the

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United States, such as at Duke University, Uni-versity of Southern California, University ofMichigan-Wayne State University, and Washing-ton University (St. Louis).

85, 'While we do not support the developmentof separated, isolated programs from the geronto-logical and geriatric mainstream, and while we dosupport pluralistic incorporation of blacks at alllevels in existing gerontological and geriatric pro-grams of high calibre (where curriculum revisionsare needed to ensure training pertinent to variousaged subcultures), we also believe that certainblack colleges should be funded 'sufficiently totrain students and, where needed, faculty inaging. Especially useful would be the integrationof aged curricula into existing curricula. Foursuch institutions which we feel should be fundedshould they so desireare Florida A. and M.University, Tuskegee Institute, Texas SouthernUniversity, and St. Augustine's College, sincethose institutions are strategically located with re-spect to the aged and have, or can readily de-velop, adequate resources -for such programs. Wedo not believe that undergraduate majors shouldspecialize in gerontology, but that feasible Asso-ciate of Arts degree programs could be developedat the aforenamed institutions.

86. M this time, we strongly recommend thatthree black institutions should offer a master's de-gree program in gerontology or a disciplinary orinterdisciplinary-based program with a concentra-tion in gerontology. These three institutions areAtlanta University, Fisk University (where thereis now an existing program funded by the Ad-ministration on Aging as of 1971), and HowardUniversity, since all three are strategically located,with respect to facilities, personnel, resources, andsince a considerable portion of black aged fallwithin their immediate or long-range geographi-cal arm.

87. We recommend that the Adult Aging andDevelopment Branch under the National Instituteof Child Health and Human Development not re-strict its training funds to doctoral programs, butunder special circumstances, release training fundson the master's degree level to Atlanta, Fisk, andHoward Universities should they so desire.

88, We urge the Administration on Aging andits parent body, the Social and RehabilitationService under the Department of Health, Educa-tion, and Welfare, to reconsider the feasibility ofproviding inadequate funds,.as was done in 1971,to -six black institutions for gerontological or ag-ing-oriented programs, since our careful analysisof that situation strongly suggests Federal partici-pation in "programming for failure." Ii thelong-run, programming for quality instead of pro-gramming for quantity will be of greater value.Thus, we recommend careful consideration by theAdministration on Aging in its funding patternsin aging to black colleges and universities in suc-ceeding years of its operation.

89. Since we have not been able to obtain dataon the precise nature and extent of black partici-pation in demonstration programs Federallyfunded, we urge that all Federal agencies so in-volved, such as the Office of Economic Opportu-nity and the Administration on Aging, provide uswith information about those programs within aperiod of 3 months following the publication ofthis final report. Desired data include the num-ber, nature, and locality of programs and the pro-portion and roles of black administrators, staffpersonnel, volunteers, clients, and other partici-pants. We are especially concerned about thelack of evaluation of these programs and recom-mend strongly, outside independent evaluation.The specific area of evaluation with which we areconcerned is the effectiveness of the programs foraged blacks.

90. We strongly recommend the establishmentof a single Federal agency as an umbrella for allFederal programs concerned with the aged, andunder which a National Institute of Gerontologymight be housed. Representative black participa-tion at all levels is a sine qua non.

91. Certain current practices of various educa-tional institutions of higher learning, wherein con-sideration is given to lower-income black studentsor potential students at the expense of middle-income students or potential students, should noloperate in selecting students for gerontological orgeriatric training. That is, the best qualified blackstudents should be selected, irrespective of theirsocioeconomic backgrounds.

SECTION TWOAdditional Recommendationsand Background Information

Additional Recommendations

The following "additional recommendations"constitute those which were developed subsequentto the Special Concerns Session on Aging andAged Blacks, but which have received sufficientsupport to warrant their inclusion in this report.

92. A black Technical Advisory and AssistanceTeam should be established to function as "link"agents in aiding blacks interested in developingprograms, facilities, and services for blacks and inaiding nonblacks concerned about developingsuch programs, facilities, and services. The Na-tional Caucus on the Black Aged has no staff andhas insufficient monies to handle effectively theinnumerable requests it has received for assist-ance. The Federal Government, with the adviceof or through The National Caucus on the BlackAged, could set up that team by underwriting itsfinancial support for an initial period of at least5 years. If this proposal is feasible to the FederalGovernment, Federal assistance in developing andfunding proposals would be greatly appreciated.

93. We strongly recommend that all such Con-ferences include a specific and separate Session onAging and Aged Minorities within such Confer-ences and pay especially close attention toproblems confronting persons over and abovethose merely associated with aging. The initialoversight in omitting a specific focus upon minor-ity group aged should not be an oversightor de-liberate omissionin follow-up conferences andaction. At the very least, most State follow-upconferences should include a Section on Agingand Aged Minorities and a Section on SpecialConcerns from the remaining Special ConcernsSessions.

94. The National Caucus on the Black Agedwishes to express its appreciation to Dr. ArthurFlemming for his capable handling of many as-pects of the White House Conference on Agingand for the cooperation he extended to us in avariety of ways. His leadership and his sensitivitytowards all aged were and are remarkable.

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cs

Background InformationConsiderable background information was in-

fused into deliberations leading up to and includ-ing the Special Concerns Session on Aging andAged Blacks so as to facilitate policy develop-ment already limited by insufficient available dataon black aged. Since various responses may bemade to our recommended policies by persons nothaving the opportunity to deliberate with us, se-lected background information is presented belowso as to provide greater insights about some ofour critical concerns.

Education: Some elderly blacks denied sufficientaccess to formalized education intheir formativeyears who now wish to further their educationcan benefit from additional education by continu-ing to improve their coping skills and techniquesfor functioning in today's technologically chang-ing world. Any number of older blacks couldwell welcome meaningful courses centeredaround hobbies, death and dying, and wills andestate management. The educational needs ofaging blacks (i.e., those not yet old) should beemphasized by placing stress upon substantialqualitative and quantitative education availablefor younger blacks. Further, significant upgradingin educational "pay-offs" for younger blacksshould occur -in occupation, employment, and in-come, and especially so for many blad: females_soas to reduce the significant amount of economicdependence now characteristic of old black fe-males without spouses.

Employment and Retirement: Most aged blackshave been active within the labor force, mostoften in the lowest occupational levels at poverty-level wages. Thus, many black aged have beenin poverty throughout their lives. Some remain inthe labor force after age 65 years (in 1970, about24 percent of the males and 13 percent of the fe-males were still in the labor force) primarily tosupplement meager incomes or, less often, be-cause they hold professional employment wheremandatory retirement occurs beyond 65 years. Anumber experience involuntary retirement at age65 years or even earlier. Labor force participationby aged black females has increased slightly andthat of aged black males has decreased slightly

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over the past decade. In general, increasing diffi-culties older blacks are experiencing in obtainingand maintaining employment at even youngeryears points towards at least the need to redefineold age for retirement benefits for blacks. Provi-sions are needed both for adequate retirement in-comes for retired blacks and for employment op-portunities for those now forced to retire whilethey are still employable. Black heterogeneityshould be considered in developing employmentand retirement policies. Blacks need more prere-tirement programs and, of course, more adequateretirement provisions.

Physical and Mental Health: Widespreadawareness of racial discrimination in the area _ofhealth precludes any need to document it anew inthis report. Often, black medical and dental careis negatively affected by such factors as race,socioeconomic status, scarce health personnel inblack communities, and disrespect to blacks byhealth-care personnel. Many blacksshunted offto the least prestigious health facilities (e.g., pub-lic clinics or public health departments largely de-pendent upon public health nurses) or to sub-standard State mental institutionsreceiveinferior health care. Black morbidity and mortal-ity rates readily attest 1,, racial discrimination.Diseases dispror ,,onately typical of blacks re-ceive considerably less research, curriculum, diag-nostic, and treatment focuses than those typical ofwhites. Reduction of racial discrimination inhealth care should result in improved health carefor aging blacks, including greater availability ofhealth professionals and greater access to medicalconsultations via telephone, as well as a decreasein black mental illness primarily induced by rac-ism. In the years ahead, much greater attentionmust be given to the health care needs of agedblacks since it is quite likely that aged blacks inthe future may not be as healthy as aged blacksin the past. In addition, blacks are increasingly re-garding health care 73 a right and such an atti-tude is likely to he accompanied by a greater de-mand for service.

Nursing Homes: Research is needed on theavailability and use of nursing homes amongblacks. More physically attractive, weli staffed,

and efficient nursing homes are needed for blacks.The likelihood of greater prevalence of infirmitiesamong black aged in the future suggests rising in-stitutionalized rates or at least the need for insti-tutionalization among them. Present planning isneeded for those currently requiring but unable toreceive institutionalization and for those needinginstitutionalization in the years ahead. Among themanifest problems preventing adequate institu-tional facilities for black aged is the Federal Gov-ernment's failure to provide sufficient seed andmaintenance monies to black, nonprofit nursinghomes, so that they can develop and maintain sat-isfactory physical, medical, and social services.Governmental funding should make availableplanning grants, 100 percent capital financing,and operating costs on the basis of the full costsof care and services provided.

Housing: As already noted, substandard housingaffects three out Of every four black aged. Theymay not have hot water or bathrooms with stand-ard safety provisions for the aged. They mayhave drafty houses and broken steps, and so on.Incomplete 1970 Census housing profiles wereavailable at the time of this Conference, and ef-forts by The National Caucus on the Black Agedto obtain all relevant housing data from the 1970Census-were largely unsuccessful.

In general, the monograph on Population,Housing, and Income, and Federal HousingPrograms (U.S. Department of Housing andUrban Development) distributed to Conferenceparticipants, was of scant help in providing uswith a relevant profile of housing patterns and,conditions among aged blacks and of changesover the past decade. Without quibbling aboutthe failure to capitalize the proper noun Negro inthat report, we can point out several gaps. Racialpresentations of data should consider differentialgroup aging. Based upon that assumption, andsince blacks become old at an earlier chronologi-cal timepoint than whites, data on blacks 55 ormore years of age would have been more usefulthan that merely on those 65-or more years ofage, as presented, e.g., in Table 1-S of the HUDreport. Since there are sex differences amongblacks (such as lower median incomes among fe-males than among males), presentation of databy race and -sex would have been useful in the

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majority of the HUD tables, such as in the datapresented on institutionalization. Omitted fromTable 4 was information about blacks occupyingowner and renter units, and subsequent tablesconcerned with that variable were restricted pri-marily to husband-wife families, although a largeproportion of black aged no longer reside in hus-band-wife families, due principally to the deathof their spouses.

Racial information on husband-wife occupiedhousing units by plumbing facilities and personsper room was useful, but the omission of suchdata on spouseless household heads among blackswas significant since substandard housing is prob-ably more severe among the latter than the for-mer. That omission tended to mask the criticalhousing conditions of many black aged.

The failure to report income data by race inTables 9-11 was highly significant since, as afore-mentioned, racial gaps in aged income widenedbetween 1959 and 1969. In all probability, manyConference Delegatesand especially those inthe Income and the Housing Sectionsmay nothave been aware of those racial differences inincome. If they had had available data, some oftheir policy recommendations might have beenmodified or structured differently.

Data were not provided about Department ofHousing and Urban Development housing loansto black nonprofit groups or about the extent towhich such groups had sought loans. Norwere wegiven data about the total proportion of blacks ineach State'S aged population, so, as in Table 19,we could not determine if aged blacks were un-derrepresented, equitably represented, or over-represented in low-rent public housing.

No racial breakdown was presented in Table43 on monthly charges per beds for patients inFHA Nursing Homes by Type of Accommoda-tion. We could infer that very few blacks wereaccommodated since only about seven percent hadmonthly costs under $300, but we were not ableto assess the validity of that assertion. Also, ra-cial distributions by type of room (i.e., private,semi-private, or ward) and locations in each Statewere omitted. Such data could aid in assessing useof nursing homes by blacks.

Data omissions indicated above and similarones could be made available to us by the U.S.Bureau of the Census and by Department ofHousing and Urban Development. A more sys-tematic review of that monograph may also resultin more suggestions for future data collection,analysis, and interpretation from us. The makingavailable of all pertinent housing data collectedby Federal agencies on blacks as well as informa-tion on Federal housing programs for the aged tonational black organizations, including churches,may be useful in stimulating greater black partici-pation in aged housing developments.

Income: In listing their most critical needs, mostblack aged cite income first, a priority validatedby income data on aged blacks, and particularlyso in the case of aged black females whose in-comes are generally even lower than that of agedblack males. While many poor black aged displayextraordinary functional skills in budget manage-ment, every effort should be made to improvetheir low incomes.

The proposal to reduce minimum age-eligibilityrequirements for black male primary beneficiariesof OASDHI received overwhelming support inthe Special Concerns Session on Aging and AgedBlacks, but the Income Section of the Conferencefailed to provide majority approval. Given thecontroversy this proposal may have aroused, somebackground information on it may be helpful inmobilizing additional support.

The background information presented belowwas extracted from Jacquelyne J. Jackson's "Agedblacks: a potpourri in the direction of the reduc-tion of inequities" (Ph/on, 32:260-280, 1971).

In 1967, Herman Brotman noted anew that, onthe average, nonwhites lived fewer years thanwhites. For example, lifetable values at birth in1900-1902 showed that nonwhite males could ex-pect to live 15.7 years less than white males, andnonwhite females 16.0 years less than white fe-males. Corresponding data for 1959-1961 were6.1 years fewer for nonwhite than for whitemales and 7.7 years less for nonwhite than forwhite females.

In 1968, based upon observations that averagelife expectancy was shorter for blacks than for

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whites and that blacks tended to define them-selves as being old at an earlier chronologicalpoint than did whites, Jackson proposed that"The minimum ageeligibility for retirement ben-efits should be racially' differentiated to reflectpresent racial differences in life expectancies."The acquisition of additional supporting data,such as Robert Morgan's 1968 hypothesis thatbody age proceeds at a faster rate among blackthan among white adult males, led her to refinethat proposal, and a petition signed by a numberof North Carolinians was forwarded to PresidentRichard M. Nixon in December, 1970, requestingthat consideration be given to modifying the min-imum age-eligibility requirements for OASDHIretirement benefits through racial differentiationreflecting present racial differences in life expect-ancies, so as to reduce the discriminatory gaps inearned benefits which now occur.

Greater awareness of this proposal has gener-ated issues pertaining to the historical coverage ofblack workers under social insurance and demo-graphic factors related to black aged, the ethicityand/or feasibility of excluding other significantminority groups from the initial proposal, thespecific fact that black beneficiaries may tend toreceive proportionately more benefits as comparedwith payments than do white beneficiaries, andrefinement of the specific proposal by including amore precise specification of the methodology tobe employed in determining racially differen-tiated, minimum age-eligibility requirements.

This proposal focuses upon social insurance towhich workers contribute payments through pay-roll deductions. Most blacks with inadequate orwith no coverage under OASDHI are those effec-tively excluded by the Social Security Act of 1935,which exempted especially agricultural and casuallaborers and private household domestics (occu-pations held by most employed blacks). In 1940,domestics employed in club, fraternity, and soror-ity houses on college campuses were also specifi-cally exempted from coverage. The Acts of 1950and 1954 finally extended coverage to most agri-cultural laborers and domestic workers, with vary-ing degrees of effective enforcement. Currentlymost employed blacks are covered by OASDHI,but a disproportionate number of old blacks mustyet rely upon Old Age Assistance, although had

coverage been extended to them earlier, therewe been less reliance upon OAA.

Relevant data reveal that significantly fewerblack than white males live to reach the presentminimum age required for primary beneficiarystatus for OASDHI. In addition, the trend of de-clining labor force participation among olderblack males especially points toward the need forestablishing other income sources at earlier ages.Clearly no significant decline in poverty amongblack aged occurred over the past decade. Thus,_demographic data support the feasibility of theproposal.

The overriding emphasis upon black males canbe justified on any number of grounds. Whilemany gains sought by blacks accrue to other mi-nority groups as well, black demands for blackaged should be regarded as legitimate demands intheir own rights. But this proposal could be read-ily expanded to include other minority maleswhose racial statuses adversely affect their longev-ity.

It is often assumed that black OASDHI pri-mary beneficiaries tend to receive proportionatelymore benefits (as compared with actual contribu-tions-to OASDHI) than do whites. The facts areotherwise. A significantly larger proportion ofblack male contributors to OASDHI die beforereaching the minimum age for receiving primarybenefits than do their white counterparts. Thus,they are denied an equal probability of receivingbenefits over time. More important is the factthat, on the average, blacks pay proportionatelymore of their earnings -into OASDHI than dowhites. Thus, this proposal can be supported onthe basis of greater proportionate contributionsamong blacks and greater disproportionate receiptof primary benefits by blacks than whites. Racialdisparities can be reduced by utilizing racially ap-propriate life expectancy data for blacks and forwhites.

While further methodological refinement ofthis proposal may be needed, the Federal Govern-ment employs technicians capable of making suchrefinements. The base for determining racial dif-ferences should be established at birth. Then1910 racial life expectancy data at birth could beemployed as the baseline standard for determin-

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L

ing minimum age-eligibility requirements forOASDHI recipients from 1972 through 1981;1920 data for 1982-1991; and so on. 'What ismost critical is that differential age requirementsby race shouldbe effected until such time as nosignificant life expectancy differences distinguishblacks and whites. .

A memorandum from Lawrence Alpern, Dep-uty Chief Actuary, Social Security Administration,dated 23 November 1971, to the Advisory Coun-cil on Aging and Aged Blacks to the U.S. SenateSpecial Committee on Aging, provided cost esti-mates for full-rate benefits for OASDHI forblack males, beginning at age 58 years. Assumingthat the proposed change would apply to all-black males qualified as retired workers, hus-bands, widowers, or parents, and to all dependentsof insured black males 58-F years of age, that thebenefits of dependents and survivors eligible forsame would increase since average monthly earn-ings would be based on the terminal age of 58years, and that the proposed change would applyto beneficiaries cn the rolls as well as to futurebeneficiaries, "additional benefit payments in thefirst full year are estimated- to total $400 million,over and above benefit payments under presentlaw. Of this amount, an estimated $,I80 millionwould be paid to persons receiving benefits forthe first time, and $220 million would be-paid topersons receiving benefits under present law."Even though this estimate-may be higher than ac-tual costs required to implement the proposal, ascompared with the income needs and unemploy-ment rates of many older black males, the imple-mentation coseis.relatively low.

Nutrition: Many Session participants, enraged byhunger among black aged and by degradationthey suffer in seeking food stamps and commodi-ties when exposed to insensitive and inefficientpersonnel in those programs, urged immediateimprovements in ending hunger or meager foodsupplies for those so affected. Preferably blackaged should have incomes permitting them topurchase their own food, but until that goal is re-alized, the U.S. Department of Agricultureshould improve its distribution of food stampsand commodities and should provide The Na-tional Caucus on the Black Aged with a detailedreport on- food distribution patterns to black aged

"Ow

no later than 3 -months following the publicationof the final report, with periodic reports thereaf-ter on at least an annual -basis. Also needed areresearch studies on dietary patterns of blacks andtheir relationships to such factors as longevity.

Retirement Roles and Activities: Scant data areavailable, but, given widespread poverty amongblack aged, most of their retirement roles and ac-tivities are probably centered around income sup-plementation, informal activities with relativesand neighborhood friends, and sedentary activi-ties requiring relatively little monetary expendi-tures (e.g., television-viewing or "just sitting andthinking"). Church activities, typically attendanceat Sunday morning services, characterize somebut not all. Those without well-established pat-terns of church participation and those experienc-ing difficulty in attending church (due to suchfactors as poor health or inadequate transporta-tion) could be excluded. While many grandmoth-ers. especially may enjoy babysitting with grand-children, most feel that child care should be aparental responsibility. Thus, greater support forhigher income levels and other factors permittingless reliance upon older blacks for grandparentalcare is needed. Opportunities for increased socialinteraction with others of varying ages wouldprobably be welcomed.

One factor contributing to extremely low blackutilization of existing senior citizens centers is thefailure of those programs to meet their needs.Many reject such centers. Critical program evalua-tion of such centers may provide more importantrationalizations than those commonly proffered,such as black ignorance, in explaining these lowutilization rates. In other words, many centersneed to reexamine carefully their programs so asto isolate program factors rejected by many blackaged.

Spiritual Well-Being: Major concern focusedupon racial discrimination in religious facilitiesfor the aged and in local religious programs forthe aged. Emphasized was the need for increasedFederal support to aid black churches in develop-ing programs and facilities for the aged. A num-ber of instances of racial discrimination in reli-gious facilities and programs for the aged werecited.

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Transportation, Programs, Facilities, andServices: Major factors hampering recommenda-tions revolved around insufficient data about thecurrent statuses of aged blacks as personnel andusers in these areas. While geographical variationsabound, transportation problems most often men-tioned included no public, or inadequate publictransportation. in a number of areas; inconvenientpublic transportation during the day, on holidays,arid on week-ends; high fares and, in some cities,exact fares for public transits; and great distancesprohibiting walking between homes and site loca-tions of needed services, such as grocery and drugstores. Other problems involved inordinate timelapses between calling for and the arrival of taxi-cabs in major cities, and particularly those wheresome cabdrivers may be reluctant to work in cer-tain neighborhoods, which unfortunately may alsobe those neighborhoods in central cities with afairly high concentration of black aged. Use ofprograms by many black aged is adversely af-fected by their inaccessibility, long waiting pe,riods ("and come back tomorrow" philosophies),et cetera. The National Caucus on the BlackAged urgently needs good data on these areas.Federal agencies and State agencies could aid bymaking those needed data available. -

GovernmentNon-Government Organization:The greatest concern of many Session participantswas the failure of the White House Conferenceon Aging to test the validity of what was, in fact,an invalid assumption: namely, that financial andstaffing resources of national black organizationsequaled those of white organizations. Thus, mostnational black organizations had insufficient re-sources for participating in- the White HouseConference on Aging. Additionally, concern wasexpressed by the significant omission of suchblack national organizations as the National Med-ical Association, the National Dental Associa-tion, the National Pharmaceutical Association,Kappa Alpha Psi Fraternity, Inc., Omega Psi PhiFraternity, Inc., Phi Beta Sigma Fraternity, Inc.,the National Hospital and Nursing Home Em-ployees Union #1199, and the National Associa-tion of Black Social Workers as invited partici-pants until The National Caucus on the BlackAged specifically pointed out these omissions and

7

urged the extending of invitations to them andother national black organizations.

Great concern focused on inadequate blackstaff and board representation on State agencieson aging. This undesirable situation, not readily

explainable by the usual myth of the dearth ofqualified blacks for such positions, can be im-proved immediately by adding more blacks tosuch agencies, with representative distributionacross the board.

Roster of the Planning Committee

Chairman: Hobart C. Jackson, Chairman, The Na-tional Caucus on the Black Aged, Philadelphia,Pennsylvania

GovernmentShirley Bagley, Health Scientists Administrator, Adult

Development and Aging Branch, National Institutefor Child Health and Human Development, NationalInstitutes of Health, Department of Health, Educa-tion, and Welfare; Bethesda, Maryland

Alfreda Hoeber, Office of Contract Compliance andEqual Employment Opportunity, Office of the Assist-ant Secretary for Equal Opportunity, Department ofHousing and Urban Development, Washington, D. C.

Calvin Nophlin, Project Coordinator, Project Evalua-tion by Summer Interns, Office of Special Concerns,Office of the Secretary, Department of Health, Educa-tion, and Welfare, Washington, D. C.

Frank M. Stewart, Technical Staff Assistant, WhiteHouse Conference on Aging, Washington, D. C.

Fredricka Williams, Director, Office of Service Deliv-ery, Community Services Administration, Social andRehabilitation Service, Department of Health, Educa-tion, and Welfare, Washington, D. C.

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Nongovernment

Jay Chunn, Member, National Association of BlackSocial Workers, New York, New York

Dr. Jacquelyn J. Jackson, Secretary, The NationalCaucus on the Black Aged, Philadelphia, Pennsylvania

Jeweldine Jones Londa, Associate Director for SocialWelfare, National Urban League, New York, NewYork

Dr. James Ralph, Member, Black Psychiatrists ofAmerica, Los Angeles, California

M. Wilhelmina Rolark, Assistant Secretary, NationalBar Association, Washington, D. C.

Rev. J. Metz Rollins, Executive Director, NationalCommittee of Black Churchmen, New York, NewYork

Melvin Turner, Deputy Director for Operations,National Welfare Rights Organization, Washington,D. C.

Dr. Robert D. Watkins, Executive Vice President forAdministrative Affairs, National Medical Association,Washington, D. C.

f

THE ELDERLY INDIANr°'° 12 he Special Concerns Session on The

Elderly Indian was requested by theNational Congress of American In-dians. The Navajo Tribal Council, the

National Council on Indian Opportunity, theAmerican Indian Movement, and the NationalTribal Chairmen's Association accepted invita-tions to participate in planning this Session. Fed-eral agencies that named representatives to thePlanning Committee were: the Departments ofHealth, Education, and Welfare, Housing andUrban Development, and Interior; the Office ofEconomic Opportunity, and the Senate SpecialCommittee on Aging.

Because of the desperate economic plight of theAmerican Indian and because there exists a-uniquerelationship between the Indians and the FederalGovernment, it was felt that this Special ConcernsSession would be important if the Conferencewere to address itself to the needs of all segmentsof the older population. The recommendationspresented can be- an important component in ournational policy on aging.

The-Participants

Eighty-two Delegates preregistered for the Ses-sion on The Elderly Indian but they were joinedby other Delegates, observers, and invited guests,so that the estimations of space had to be consid-erably altered and additional facilities made avail-able. Only official Delegates were permitted tovote on recommendations although the discussionof the recommendations was open to all who werepresent.

The majority of those Delegates who chose toattend this Session were themselves American In-dians. Thcy were from several different IndianNations including Apache, Blackfoot, Cherokee,Choctaw, Comanche, Iroquois, Makah, Mohave,Navajo, Pueblo, Seminole, Sioux, Ute, and others.The Alaskan Federation of Natives, the Iroquois

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Confederation, the Inter-Tribal Council of Cali-fornia, the Association on American Indian Af-fairs, the National American Indian Women'sAssociation, the National Indian Physicians' Asso-ciation, the Dallas American Indian Center, andthe National Indian Law Students' Associationwere some of the organizations that sent repre-sentatives to the Session;

Many of the Delegates who attended this Ses-sion had participated in one or more of the re-gional conferences on The Elderly Indian (confer-ences were held for the Northwest, the Southwest,and the Southeast), and many of these Delegateswere acquainted with the comprehensive report ofthe Indian Advisory Council to the Senate SpecialCommittee on Aging. In short, many of theseDelegates came to this Session with a wellgrounded understanding of the scope of theproblems to be discussed and specific suggestionsabout needed changes in national policy on agingand The Elderly Indian.

The Program

In order to provide for maximum in-depth at-tention to several important areas of concern forelderly Indians, the small work group format wasemployed as an important part of the program.The Session was, essentially, divided into threeparts. The opening part was organizational andwas to serve as a very brief orientation to theDelegates' role for the Session. During the secondpart of the meeting, the Delegates were dividedinto five work groups which were asked to discussand develop recommendations within the topicalarea assigned to their group. The five groups dealtwith (1) Housing and Related Facilities, (2)Legal Problems of the Elderly Indian, (3) Spe-cial Health Problems of the Elderly Indian, (4)Spiritual Well-Being and Recreation, and (5)Income (including Employment, Retirement, Education, and Training).

The third part of the program called for the to the entire Session for further discu4sion andwork groups to present the results of their work adoption.


PROGRAMTHE ELDERLY INDIAN

Presiding: FRELL OWL, Former Chairman ofPlanning Board for the Eastern Band of Chero-kee Indians; Member, National Planning Commit-tee of the White House Conference on Aging

8:00 OpeningEARL OLD PERSON, President, Na-tional Congress of American Indians

8:30Working Groups Begin

A. Housing and Related FacilitiesChairman: ROBERT McLAUGHLIN, De-velopmental Planner and Architect, StandingRock Sioux Tribe

Recorder: IRENE CUCH, Member, StandingRock Tribal Council

B. Legal Problems of Elderly IndiansChairman: VIRGIL KIRK, Chief Justice,Navajo Nation Judiciary

Recorder: ELWOOD SAGANEY, Chairman,Alcoholism Subcommittee, Navajo TribalCouncil

C. Special Health Problems of ElderlyIndiansChairman: JOE EXENDINE, Acting Direc-tor, Office of Program Planning, IndianHealth Service

Recorder: DAVID VALLO, Community Or-ganization Specialist, Inter Tribal Council ofCalifornia

D. Spiritual Well-Being and RecreationChairman: REVEREND SCOTT RED-HOUSE, Aging Committee, Navajo TribalCouncil

Recorder: JAMES PETER OLSEN, Guber-natorial Delegate, State of Alaska

E. IncomeChairman: CLAY GIBSON, Director, Choc-taw Community Action AgencyRecorder: RONALD MOORE, Assistant Di-rector, Arizona Affiliated Tribes, Inc.

10:30-7Break

11:00---Presentation of Work GroupReports for Discussion and Voting


THE SESSION REPORT

Introduction

The American Indian and Alaskan Native Dele-gates (hereafter referred to as American Indian)to this White House Conference on Aging, No-vember 28December 2, 1971, appreciate the op-portunity we have been given to participate indeveloping a national strategy in coping withproblems of the .aging. Our elderly citizens facesimilar problems to those of other Americans.However, due to the unique relationships betweenour people and the-Federal Government, we alsohave unique problems. The Indian Delegates tothis Conference support those issues and recom-mendations which will ultimately benefit all olderAmericans.

The Indian Delegates have outlined five gen-eral areas where immediate action must be taken:

1. The United States must reassure our elderlycitizens that the policy concerning terminationis no longer a national policy.

2. That an adequately staffed and funded In-dian desk similar to Indian desks in other Fed-eral agencies be established in the Administra-tion on Aging or its successor. This office wouldact as a central point for information and anadvocate for the needs of the Indian elderly.

3. That sections 303 Part (a) and section 612of the Older Americans Act of 1965, as amendedNovember 1970, be revised so that Indian tribesno longer have to go through State agencies forfunding. This is necessary because of the lackof sympathy by most States for their Indianpopulation. All funds for older Indian pro-.grams should be funded directly to Indiantribes.

4. That agencies serving elderly Indians in-crease funding levels to Indian tribes so as toadequately serve their needs.

5. That a thorough and complete research pro-gram be developed to search, evaluate, andcause to be amended, existing laws and policiesgoverning programs serving the elderly Indian.

Recommendations

The Indian Delegates also identified the fol-lowing issues and have made the following rec-ommendations.

IncomeIssue: The elderly Indian citizen should have anincome which would permit him to live the restof his life in health, decency, and dignity.

Recommendations

1. Because of the past relationships between theFederal Government, through the Bureau of In-dian Affairs, and the Indians, most of our peopledid' not participate in retirement programs suchas: company retirement plans, insurance plans,investing inincome propCrty and, in many cases,Social Security. Therefore, the sole source of in-come for many of the elderly is welfare and forthose fortunate enough to reach 72, Social Secur-ity at the very minimum level. The elderly Indiansmust be permitted to work and earn income for aslong as they want or are able. They should not berequired to forfeit parts of other benefits whencontinuing to earn.

2. That the elderly and middle-aged Indian shouldbe assisted in obtaining job information, training,counseling, placement, and other assistance whichwould permit him to continue employment. Thesesteps would enable him to qualify for an increasedbenefit when he becomes eligible to receive SocialSecurity.

3. That there be an equitable form of tax relieffor the elderly Indian.

4. That retirement plans be worked out in such away that there is a guaranteed pension, that it bevested and with portability.

5. That there be a Social Security "ALERT" toassure that all eligibles receive their entitlements.6. That a Federal policy be established whichwould state that judgment funds are not to be

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considered as assets or windfall, but rather thedue allotment and recompense for misappropri-ated lands and rights. That this policy he bindingto all-State and local welfare agencies.

7. That State public assistance departments ceaseto press the elderly Indian to sell individual al-lotted lands on reservations to meet their ownsubsistence needs, in view of the Indians' desireto retain the tribal homeland intact for furtheruse in accord with President Nixon's rejection oftermination as a Federal policy.

8. That Social Security benefits be extended to allmale and female elderly upon reaching the ageof eligibility regardless of their participation dur-ing previous periods of employment.

9. That separate funds be made available for theestablishment of special manpower programs de-signed by and for elderly Indians.

10. That manpower programs be designed to re-tain the people on or near the homelands of theelderly Indian.

11. That these manpower programs be adequatelyfunded to meet the employment needs of theIndian aged.

Housing

Issue-1: A large percentage of elderly Indianpeople do not have sufficient income to coverhousing and utility costs of existing programsalong with the other necessities of life.

RecommendationThat program policies governing housing not berestrictive but adaptable to the elderly housingneeds and the financial condition of individualIndian people, and wherever necessary, no costhousing should be provided.

Issue-2: Some elderly Indian people live aloneand are too incapacitated to live in existing pri-vate dwellings regardless of whether the home isadequate and modernized. Existing nursing homesand related facilities have not taken into consid-eration the social and emotional needs of theIndian people.

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Recommendations1. That on-site paraprofessional service staff bemade available to assist the elderly Indian.2. That sufficient funds he provided for adequatecare for Indian individuals in custodial or nursinghomes.

3. A system of advocacy be established andmaintained for elderly care.

Issue-3: Indian Senior Citizens have too little tosay about the design, location, and constructionof their homes and other types of living facilities.RecommendationThat full local participation of elderly individualsand organizations be assured in the designing.location, and construction of elderly Indian Hous-ing projects.

Issue-4: The allocation and actual application offunds for homes and other living facilities peryear is not sufficient to meet the needs of thepeople. Lines of communication, coordination,and flow of existing funds are poor. There is needfor direct funding to Indian groups.Recommendations1. Funds should be clearly identified for the el-derly and should be made available in sufficientamounts to meet the-housing needs of the elderly.2. That all organizations dealing with elderly In-dian projects have adequate representation ofelderly Indians on their decision-making boards.3. Changes in Indian housing policy should not beaccomplished without consultation with the Indianpeople.

LegalIssue: The elderly Indian people are not normallyprovided with legal services, therefore. many olderIndians are taken advaMage of because they arenot familiar with legal matters.

RecommendationThat legal services be made available to the el-derly for the purposes of obtaining rights to OldAge Assistance, writing of wills, etc. These serv-ices should be made available in the local arearather than some far removed large metropolitanarea.

Nutrition

Issue: Most older Indians arc malnourished. Thisis the result of both an inadequate nutritionaleducation program and lack of familiar and nutri-tional foods. Present Federal food programs arenot designed to meet the nutritional needs of theelderly Indians.

Recommendations

1, The U.S. Department of Agriculture and Officeof Economic Opportunity must assist Indian tribesin developing a food program utilizing existingprograms it as: commodity foods. food stamps.supplemental food, emergency food, and medicalservices to fit the particular nutritional needs ofthe elderly Indian people.

2. All Federal funds presently being allocated toexisting nutritional education 'programs must befunded directly to Tribal groups or organizationsto carry out the function of nutritional educationto elderly Indians.

3. That all nutritional programs be adequatelyfunded to satisfy the nutritional needs of theelderly Indian,

Nursing Homes

Issue 1. Nursing homes or sheltered care facilitiesare urgently needed by Indian people. However.due to present funding systems for such facilities.Indian people have very little chance to obtainthese facilities. The following examples pinpointsome specific problem areas.

(a) Some States refuse to license nursinghomes on reservations due to a question ofjurisdiction and at the same time Federalfunds will not be authorized unless the facil-ity is licensed by the State.

(b) Hill-Burton Funds are only made avail-able to States for these projects. The Statesin turn establish advisory groups which dic-tate the use of such funds. Most advisorygroups arc composed of urban non-Indianswith little or no sympathy for Indian projects,thereby making nursing homes or shelteredcare facilities almost impossible to obtain byIndian people.

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Issue 2. Indian Health Services are not governedby State regulatims, and nursing homes or shel-tered care facilities arc similar in nature to IndianHealth Service hospitals.

Recommendations

1. Federal funds should be made available diiectlyto Indian tribes or organizations for the design.construction. and operation of these facilities onthe local level.

Indian nursing homes or sheltered care facil-ities on _reservations should not have any Statecontrols imposed on them, but Federal regulationsshould govern these facilities similar to the IndianHealth Service Hospitals.

TransportationIssue 1: Because of the lack of transportation.the elderly American Indian cannot acquire thosenecessities which would assure him a normaland healthy life. This denies him the opportunityio obtain medical services. food, and clothingwhich are available to other citizens in the UnitedStates. In addition. poor road conditions. lack ofcommunication systems. absence of public con-veyances. and isolation compound the problem.

RecommendationFunds should be allocated to assure elderly Ameri-can Indians of their transportation needs. One ofthe ways the problem could be alleviated is byproviding the vehicles deemed necessary to over-come the existing conditions cited above. How-ever. each Indian tribe or organization shoulddefine its own transportation requirements to fitits respective needs.

Education, Physical and SpiritualWell-Being

Issue I. The social, physical. and spiritual well:being is a very important aspect of the AmericanIndian. There are no funds available to financewell-rounded social or culturally-oriented activitiesfor elderly American Indians.

RecommendationThat sufficient funds be allocated for the elderlyAmerican Indian to develop and assure the con-

tinuance of activities which he deems important tohis physical, spiritual and cultural well-being.Such activities might include, but not be limitedto:

(a) Clubs. such as social, sewing, cooking,arts and crafts, recreation, and gardening.These promote good health and keep theelderly from becoming lonely and depressed.(b) In some cases. educational type sessions

might be desirable to fulfill those activitiesselected by the elderly American Indian.

HealthIssue 1. Indian people generally suffer deplorablehealth conditions when compared with other racesin this country. This situation is compounded forthe elderly Indian people. These conditions arefurther aggravated by the lack of funds for dentalprosthetics. hearing aids. eyeglasses, psychologicalservices, etc.

Issue 2. Medical services for elderly Indians areat best inadequate to meet their needs.Several rea-sons for the above arc: insufficient staffing, inade-quate health facilities, and seeming lack of con-cern by the Administration, which is in a positionto determine funding levels. for Indian HealthServices.

Issue 3. Thbre is a lack of Indian professionalmedical staff to assist in upgrading medical serv-ices to elderly Indian people.

RecommendationsI. That all health facilities be immediately up-graded to meet the specific standards of the JointCommission of Accreditation of Hospitals.

2. That sufficient funds be allocated to finance allaspects of health services so as to provide com-plete-health coverage.

3. That educational grants be provided to-encour-age individual Indians who wish to pursue andcomplete professional health careers.


Nongovernmcnt

Fre II Owl (Chairman). Former Chairman of thePlanning Board for She Eastern Band of CherokeeIndians; Member. National Planning Committee ofthe White !louse Conference on Aging, Cherokee,North Carolina

Henry Garnenez, Department Head, Department ofAnimal Husbandry, Navajo community College,Window Rock, Arizona

Richard La Course, Reporter, National Congress ofAmerican Indians, Washington. D.C.

Ronald Moore, Assistant Director, Arizona AffiliatedTribes, Inc., Phoenix, Arizona

Rodger Sandoval, Member, Indian Advisory Councilto the Senate Special Committee on Aging, Wash.ington, D.C.

Government

Clare Jerdonc, Principal Child Welfare Specialist.Division of Social Services, Bureau of Indian Af-fairs, Department of the Interior, Washington,D.C.

Reeves Nahwooksy, Special Assistant, Office of theAssistant Secretary for Equal Opportunity, Depart.ment of Housing and Urban Development, Wash-ington, D. C.

Mary Steers, Chief of Categories Payment and Eligi-bilty Branch, Assistance Payments Administration,Sojal and Rehabilitation Service, Department ofHealth, Education, and Welfare, Washington, D.C.

Frank M. Stewart, Technical Staff Assistant, WhiteHouse Conference on Aging, Washington, D.C.

Benjamin Yamagata, Staff Member, &mate SpecialCommittee on Aging, Washington, D.C.

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Reports of the


PROTECTIVE ANDSOCIAL SUPPORT

witep,,

THE OLDER FAMILYver a year before conferees met in the1971 White House Conference onAging, an intensive campaign wasmounted to insure that, in their delib-

erations, Delegates would give explicit atten-tion to the familial and marital problems of theelderly. To assuage fears that such a topic wouldnot receive proper stress, Conference plannersacknowledged that the family unit was an es-sential ingredient to the understanding and reso-lution of many of the elderly's needs and a factorwhich could not be overlooked in the developmentof a national plan to meet the needs of olderpeople. To insure that adequate attention waspaid their concern, those who had waged thecampaign were urged to involve themselves inthe many different levels of Conference activities.

This challenge to participate was heeded. Sev-eral family life educators, for example, preparedposition papers for the Conference on aspects ofaging and the family. Organizations active in var-ious aspects of family life, counseling, and serv-ices, named representatives to participate in thedeliberations of the National Organization TaskForces. These same organizations urged theirmemberships to become active in other Confer-ence preparatory activities within their communi-ties and States.

A concrete result of such participation can beseen, for example, in the recommendations ema-nating from the Minnesota State White HouseConference on Aging. Delegates to that Confer-ence adopted the following resolution:

In view of our increasing awareness of thedeep, yet often poorly met, familial, marital,and sexual needs of the aging, it is urgentlynecessary for society to provide for olderpeople more adequate social services of aneducational and counseling nature, and toundertake the study and research needed tomake these services effective.

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In meeting the familial, marital, and sexualneeds of the aging, the psychological, emo-tional, social, physiological, and environ-mental aspects must be considered.

Illustrative concerns of this nature might in-clude the following:

1. Relationships with grown children, grand-children, aging parents, intergenerationalneeds

2. Marital health and happiness

3, Intimate interpersonal relationship includ-ing sexual fulfillment

4. Bereavement, grief, and social adjustmentto loss

5. Remarriage

When the Program and Procedures Committeeof the Conference Planning Board voted to in-clude in the program of the National Conference aseries of Sessions devoted to in-depth discussionsof some specific aspects of aging, it was inevitablethat a Special Session on the Older Familyshould be among the first to'be considered.

The National Council of Family Relations, theFamily Service Association of America, the Amer-ican Association of Marriage and Family Counse-lors, and the American Home Economics Associa-tion joined together to sponsor the Session.Meeting with their representatives to plan theSession were Federal personnel from the Admin-istration on Aging, the National Institute ofMental Health, and the 1970 White House Con-ference on Children. Also invited to assist thePlanning Committee were two special consultantswith known interest in the problems of the elderlyfamily.'

1 Sec Roster of Planning Committee, page 208.

The ProgramA small group of some 40 Delegates listened

and joined in discussion with Dr. Evelyn MillisDuvall, a recognized authority on all facets offamily living. The full text of her provocativeaddress Aging Family Members' Roles and Rela-tionships and its extensive bibliography appearson pages 209-218.

The sociodrama which opened the Sessionserved as an unique way in which to stimulateprogram participants. By evoking participant re-sponse to a realistic portrayal of the problemsfaced by aging family members, "A Choice toMake" added to the liveliness of the Session. Theplay was drawn from the Plays for Living Divi-sion of the Family Service Association of Amer-ica, and was performed by volunteers living inthe Washington, D.C., area.

1971 WHITE HOUSE CONFERENCE ON ACING

PROGRAMTHE OLDER FAMILY

Presiding=RUTH H. JEWSON, Executive Offi-cer, National CounciLon Family Relations

8:00 A.M.Opening Remarks and Focus ofthe SessionMRS. RUTH H. JEWSON

8:10 A.M.--A Choice to Make," a play por-traying family problems through the techniquesof professional theatreWashington Area Playsfor Living. Inc.MRS. BARBARA MAT-THEWS, Executive Secretary

8:40 A.M:Discussion of "A Choice to Make"Led by MRS. DORIS RIiIBER, WashingtonArea Plays for Living, Inc.

9:15 A.M.Keynote Address and DiscussionDR. EVELYN MILLIS DUVALL, FamilyLife Consultant, Sarasota, Florida

11:15 AM.Consideration and Adoption ofRecommendations


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THE SESSION REPORT

Introduction

American families bear the brunt of all thecare, economic, and emotional nurturance, andsense of belonging that aging families need. Re-search finds that it is, primarily, to their familiesthat older people turn for help.

Recommendations

We therefore recommend that:

1. A Department of Family Life be establishedwith Cabinet status for its Secretary, so that theAmerican family may be represented in all poli-cies affecting the many millions of families whonow carry the chief responsibilities for their mem-bers of all ages.

2. A National Institute on the Family be de-veloped in which concerns of central importanceto families, and to the society of which familiesare the core, be studied to serve as a basis forconsidered action.

3. The President of the United States call andconvene a White House Conference on the Fam-ily in the near future.

4. Tax reductions be given for qualified familygifts and assistance, as they are now given forcharitable contributions.

Comment: Family support and care of theiraging members, without recognition or relieffrom tax burdens, save the government aswell as private agencies many millions ofdollars, staff years, and expensive programs.

5. Death education be widely encouraged andimplemented.

6. Medical and legal priorities be established

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to assure quality of life, rather than senseless pro-longation of the process of dying.

7: Public and private agencies working on be-half of America's aging recognize the familyroles, relationships, and responsibilities implicit inthe stage of family development represented byeach older person served.

8. All possible steps be taken to make it possi-ble for aging persons to live as long as possiblein their own homes and that kin families be ableto carry out their responsibilities to older families.

9. Housing and homes for aging personsshould be so designed as to allow for privatequarters for couples wishing to share them. At-tractive social centers should be provided whereolder men and women could enjoy the formationof new friendships and relationships to take theplace of those they have lost, and all personnelshould be taught to accord full respect and dig-nity to these.

Continent: We recommend this becauseamong the primary characteristics of agingpersons today are loneliness and emotionaldeprivation, and institutions and personnelinvolved in caring for the aging should beoriented as realistically and humanely aspossible to meet their deep-seated needs forcompanionship and human warmth.

10. The Social Security laws be revised tomake it possible for older families, or for olderpersons wishing to take up family life through re-marriage, to combine their incomes. The presentlaw provides that persons on Social Security whomarry find that their income decreases. The lawshould be changed to allow continued receipt ofSocial Security without decrease in the amount.

11. A national program of family guaranteedincome be established which would include theaged family. This is necessary in order to make itpossible for the older family to have the financial

wherewithal to continue to exist at a time in itsfamily life cycle when income is sharply reduced.In addition, such a guaranteed income will makeit possible for families to continue- to carry outtheir responsibilities and roles in relation to olderfamilies.

12. The Congress and the President of theUnited States be requested to .enact appropriatelegislation to proclaim that the week in whichThanksgiving is celebrated each year under Actof Congress be officially designated as NationalHome and Family Week, that the Sunday of suchweek be designated as Family Sunday-U.S.A. Allcitizens be urged to observe these dates with seri-ous reflection and realization that the principlesof family responsibility to spouse, children andparents, as well as the importance of the stabilityof marriage and the home for our future well-being, require renewed allegiance and everydayimplementation.

13. The paper presented by Dr. Evelyn Duvallat the White House Conference on Aging, in the

Special Session on The Older Family be referredto the President of the United States, to the Ad-ministration on Aging, and to the Secretary of theDepartment of Health, Education, and Welfarewith the strongest possible recommendation thatthe information be studied and implicationsdrawn as a basis for planning, setting agencypriorities, etc.toward support through educationand community resources.

14. Courses on marriage and family living in-clude material on the older family.

15. A Task Force be formed, representing thisConference and major national organizations andagencies concerned, to: (1) explore the presentstatus of family life education in the publicschools of the United States, (.2) develop plansfor strengthening such programs as now exist,and (3) encourage the development of new com-prehensive programs of education for home andfamily living as rapidly as possible, as an integralpart of our American system of public education.


GovernmentEileen Bradley, Specialist on Aging, Administrationon Aging, Social and Rehabilitation Service, Depart-ment of Health, Education, and Welfare, Washing-ton, D. C.Barbara Chandler, Coordinator, Follow-up Unit,1970 White House Conference on Children, Wash-ington, D. C.

Nathan Sloate, Special Assistant to the Director, Na-tional Institute of Mental Health, Health Services andMental Health Administration, Department of Health,Education, and Welfare, Rockville, Maryland

Consultants

Mrs.-Charles McCullough, Springfield, VirginiaBeryl Carter Rice, Washington, D. C.

Nongovernment

Ruth H. Jewson (Chairman), Executive Director,National Council on Family Relations, Minneapolis,Minnesota

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Clark Blackburn, General Director, Family ServiceAssociation of America, New York, New York

Leonore Rivesman, Social Worker, Family ServiceAssociation of America, New York, New York

Edward Rydman, Executive Director, American As-sociation of Marriage and Family Counselors, Dallas,Texas

Irene H. Wolgamot, Retired, Representative of theAmerican Home Economics Association, Alexandria,Virginia

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 specificinterests of special groups of older persons, it isappropriate that this one Session take a wide-angleview of aging members of typical older familiesin the United States today. This is possible througha review of current data from the U.S. Bureau ofCensus, and numerous research studies appearingin the professional literature in recent years. Thesesources are alphabetically listed and numbered atthe end of this booklet, and cited by number wherethey are referred to in the body of the text.

Persons of all complexions and colorsblack,white, brown, red, and yelloware born intofamilies where they establish the foundations oftheir individual personalities within the homestheir parents built. Rich and poor, rural and urban,strong or weak, in the midstream or marginal incommunity life, older persons find their identityas members of the families to which they belong,as they have throughout their lifetimes. To seeclearly the family roots, roles, and relationships ofthe aging in America is of central importance forany who would become effective in meeting theirneeds and tapping their resources.

Most Are Family Members

Most of America's aging are family memberswith the full complement of roles, relationships,needs and challenges that belonging in familiesinvolves. According to recent nationwide studies,four our of five older Americans are members offamilies. Only 20 percent of men and women over65 are virtually kinless in America today.(37)1

I See References starting on page 217.

The lonely old lady in an institutional rockingchair is not to be forgotten, at the same time thatwe remember that she is not typical of her agegroup, or generation. According to November1971 data froth the U.S. Bureau of the Census,only 2.1 percent of the women 65-74 years old,and 2.3 percent of the men between 65 and 74years of age were institutionalized in 1971. Evenamong the very old, above 75 years of age, 8.1percent of the women and 6.0 percent of the menwere in institutions of any kind in 1971. (46)

The great majority of persons over 65 yearsof age-live in families. Four out of five men (79.7percent), and 57.6 percent of all women over 65in the United States are classified as family mem-bers, according to a private communication, No-vember 1, 1971, from Paul C. Glick, AssistantChief, Population Division, Bureau of the Census.Most of these older men and women are marriedand living with their spouses; some are makinghomes for their adult children; others are singlewomen providing for their relatives, in many casestheir elderly parents. In 1971, 4,500,000 men(83.3 percent) and 4,274,000 women (62.3 per-

cent) between 65 and 74 years of age were headsof families. (46, p.13)

Many older persons of both sexes prefer tomaintain their own homes as long as they can.When they are physically and financially able todo so, older men and women enjoy the privacy,freedom and independence that living in their ownhomes provides them. In 1971, some 15 percentof the men and 36 percent of the women over 65in the United States were maintaining their ownhomes. Two out of every three older families own

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their own homes, the great bulk of them free fromindebtedness, with their mortgages paid up. It isnot unusual for spiralling property taxes, andhigher costs of living on fixed incomes to neces-sitate giving up the homes older persons havespent lifetimes paying for, in order to cut expenses.Unfortunately, this robs the elderly of their hardearned independence, and in some instances makesthem a burden upon family members, or the com-munity at large.

Most Are in Touch with Families

The stereotype of older persons being aban-doned by their families is not borne out by thefacts. Research finds a great deal of face-to-facevisiting, telephoning, letter writing and closeassociation between middle-aged and aging parentsand their grown children. (2, 16, 19, 30, 41, 42)A nationwide study finds 84 percent of Americansover 65 live less than one hour away from at leastone of their grown children; nine out of terr haveseen one of their children within the past month,84 percent the past week. (37) Both horizontaland longitudinal studies of families find the agingand middle-aged visiting and being visited byfamily members at frequent intervals. (19, 30, 41,42)

A two-directional, three-generation flow of emo-tional and financial support between older parentsand grandparents and their grown children is foundin many recent studies. (1, 2, 16, 19, 40, 42)Parents generally help their grown children, andthe adult sons and daughters reciprocate in a widevariety of ways. Family help takes many forms:nursing in illness and accidents, shopping, childcare, repairs, personal care, and financial assistancein direct gifts, loans, and help in emergencies.The poor look to their relatives for help and themore affluent get and give it in gifts and legaciesa major theme in recent research reports. (2,19,37,42)

It is to their families that most persons ofevery age and generation turn for help, first of all,when problems arise or trouble strikes. A three-generation study in Minneapolis found that 70percent of the 3,781 instances of help in a one-year period of time were kinship exchanges. Lessthan one-fifth of the three- generation families

studied had used help from outside their familiesduring the year of the study. (19)

There is evidence, too, that the principle of "toeach according to his need, and from each accord-ing to his ability" is applicable to the mutual helpgiven and received by family members. Parentsof married children disproportionally give moreboth to the younger and the older generations;while the grandparents, on retirement budgetsand with diminishing strength, give less than theyreceive from -their grown children. Thus it is thatAmerican families bear the major burden of thecare, emotional and economic support, and thesense of belonging to families that older personsneed, and find primarily within their own kinnetwork.

When asked to respond, to the proposition,"Children who move up in the world tend toneglect their parents," two-thirds of the membersof the older generations, and three-fourths of theyounger do NOT accept this generalization. Thegreat majority of the members of all three genera-tions (65 percent of both older generations, and74 percent of the married child generation) agreethat "A young man has a real responsibility forkeeping in touch with his parents-in-law." Thesedata suggest strongly that it is the youngest genera-tion that is most opposed to each generation's goingits own way. (19, chap. 3)

Adams reports, "The relations between youngadults and -their aging parents are ordinarily theclosest kin tie attitudinally and residentially."(1, p. 589) While Hill sees the "kinkeepingmiddle generation .. . as the lineage bridge acrossthe generations, being most involved with itsadjacent generations both in intergenerationalcontacts in help exchanges." (19, p. 330)

Family Roles Continue

Parent-child relationships and grandparent-grandchild roles continue as long as family mem-bers live. An ever increasing number of Americanslive out their full life span within the web offamily living. The author's original studies findyoung people confiding more in their grand-mothers than in any other persons, according totheir parents. Youth have much in common with

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their grandparents, feel closer to them than toother relatives, except their parents and siblings,and contrary to commonly held stereotypes enjoytheir associations with older family members. (12,32)

Disengagement tends to be into rather than outof the family. As the older person selectively re-tires from many active and time-consuming rolesin the community, he or she tends characteristicallyto enjoy more family contacts and activities. Fami-lies remain the focus of the aging individual'ssocial interaction and emotional satisfaction oninto the latter years of life. (11, 18, 25)

Conceptual Frameworkof Family Development

It is by stage of the family life cycle rather thanchronological age that individuals are most clearlyseen. As the aging are recognized as having rolesand responsibilities at the particular stage of familydevelopment that they occupy, their needs andchallenges are more sharply focused than whenthey are lumped together in age groupings.

Actually, 65-year-olds differ widely from oneanother. A personality tends to become more andmore unique over the years as differential experi-ences, attitudes, values, and commitments makethe individual increasingly himself. We havelearned to recognize individual differences amongchildren; even more is it essential to respect eacholder person for himself, as the unique individualhe is.

Family relationships and roles are a bettergauge of an older person's concerns, preoccupa-tions, and interests than is his or her age alone.Consider, for instance, the differences to be ex-pected between newly-wed 70-year-olds happilyestablishing their new home for the years ahead to-gether; the old grandmother raising young chil-dren while their mother works; and the agingparents launching their "fall crop" of late-bornchildren now emancipating, themselves, long aftertheir older siblings have left home. In many waysthese older persons are more like their counter-parts of younger ages at similar family life cyclestages than they are like others of their age withroles and responsibilities more typical of the post-retirement stage of life.

A person is more clearly understood by stageof his or her family life cycle than by chronologicalage alone, at any period in life. The story is toldof an attractive young woman standing beside

oldtimer at the Fountain of Youth. Her spon-taneous comment was,. "Oh, to be 18 again." Thesenior citizen asked, "How old are you?" Her replycame back quickly, "21." The puzzled response ofthe older tourist was, "But, what's the differencebetween 18 and 21?" To which the young womananswered, "Difference? I'll tell you what the dif-ference is between being 18 and 21it's one hus-band and two children."

Family member roles and relationships changethroughout the entire family life cycle. From thetime the young married couple settle down intheir first home, have their first baby, and learnwhat it means to be parents, as they become re-sponsible for guiding their children through- in-fancy, preschool and school-age periods, and oninto adolescence and young adulthood, they gothrough a series of fast-moving phases. Each stageof the family life cycle has its own problems andprom;ses, its challenges and rewards. Each well-lived prepares for the next, as family members andthe family as a whole satisfies the demands of theperiod. This is quite as true for the later decadesof life as for the earlier years. Family roles and re-lationships shift markedly throughout the yearsthat follow the bearing, rearing, and releasing ofchildren.

Aging, therefore, is seen most clearly as a processof development and decline through the later yearsthat stretch over several decades. The typicalAmerican couple go through a number of distinctlydifferent stages in their life together during thehalf of their lives. Each of these stages has its owndemands and responsibilities, its own roles andrelationships, and its own peculiar problems andpossibilities.

Through the use of current census data, and thefindings of recent studies of the aging process, weare able to trace the process of development thataging families experience. There are typically fourwell differentiated periods that can be distin-guished one from another in the last four decadesof the life of a family: the launching young adultchildren stage, the empty-nest preretirementperiod, the early retirement years, and the final

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phase of the aged terminated by the death of oneafter another of the original husband-wife pair.Characteristics of each of these stages are outlinedfor typical American census families in the follow-ing manner.

Launching Young Adult Children

As children grow up and start to leave home,a family begins to contract in size and in nature.This stage of the family life cycle starts as the firstson or daughter leaves home for marriage, work,military service, or college and other post-high-school educat'on and training. It ends with thedeparture of the last child into a life of his own.Husband and wife typically now are between 45and 54 years of age. More than nine out of tenmen and women of this age group share theirhomes with their marriage partner and/or theirgrown children or other relatives in primaryfamilies. (46)

Mothers of grown children being launched arein menopause, typically. Nearly half of the wivesare working outside their homes, but their hus-bands remain the chief support of the family. Thisis an expensive stage of the family -life cycle asmaturing young adult children cost more thanthey did ^.t younger ages for education, clothing,transportation, recreation, and marriage plans.

The married couple tends to be "quite satisfiedwith their marriage" at this stage. (15) Husband-wife relationships are calm and focused on mutualconcerns for their children, whose choices andchallenges in deciding on appropriate educationalexperiences, work possibilities, marriage prospectsand opportunities, personality development, socialexposures, problems and promises are of deep con-cern to their parents at the time in life when youngadults typically must make their own decisionsand learn to stand on their own feet, without toogreat dependence on parental supervision andcontrol. (12)

Grandparenthood typically begins during thisstage of the family life cycle as one of the sonsor daughters bears the first grandchild. This addsa whole new dimension to life for many a womanwho now finds herself not just a mother and amother-in-law, but a grandmother as well. The

typical American woman in her forties and fiftiesat this stage in her family history finds herself con-currently functioning as wife, mother, mother-in-law, grandmother, sister, sister-in-law, daughter ofaging parents, aunt, cousin, and bridge to othermembers of the extended family through her rolesas kin keeper, letter writer, gift giver, visitor,hostess, homemaker, shopper, chauffeur, etc.At the same Cme, the man of the family is in-volved in parallel relationships as husband, father,father-in-law, grandfather, brother, brother -in -law,son of aging parents, uncle, cousin, and head ofthe family as provider, partner in family activities,father of the bride, companion, counselor, decisionmaker, investment counselor, buyer, property man-ager, etc. In a three-child family at this stage ofthe famly life cycle there are some 66 possibleinterpersonal relationships, each with a multitudeof roles and responsibilities. (12, Chart 5-7; 47)

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Empty Nest

When the last child grows up and leaves homethe typical American parents still have half of theirmarriage still ahead of them. As they enter theempty nest stage of their family they are in theirfifties, on the average. They have ten or more yearsbefore the husband's retirement to build a new lifefor themselves now that their preoccupation withrearing and releasing the:r children is over. Thegreat majofty of men (84 percent) and women(65 percent) in this age group (55-64) live withtheir spouses in their own homes. (46)

Most husbands in these preretirement years arestill working, as are one-third of their wives. Thisis the time of life when they are financially betteroff than they were in earlier years when providinga home base for their growing children drainedthem financially. Now that the children arelaunched and on their own, the middle-agedcouple now has a decade or so in which to estab-lish some security for their own aging years thatlie ahead when the pinch of old age comes. (12)

Middle-aged couples in the empty-nest stage ofthe family life cycle are generous in helping theirgrown children get established. They are found tohelp their young marred sons and daughters withgifts and loans to float a down-payment on a car,a house, a baby, or a program of home and self-

improvement. Their help extends to many othergoods and services for both their young adultchildren and their aging parents: gifts, repairing,shopping, personal care, nursing through illnessand accidents, child care and baby sitting, etc.(19, 41, 42) Hill's three-generation study offamily development finds this middle generationserving in a patron-like status in that they givemore than they receive to both the younger andthe older generations in the family. (19, Chap. 3)

The middle-aged wife may go through anidentity crisis as she finds herself without theactive roles she played when there were childrenin the home and young adults to be released. Ina sense her job of twenty or more years has packedits suitcase and left home, leaving her without afocus for her energies and interests. Many a womanat this stage of life holds a job, finds constructivecommunity work to do, or goes back to collegeto finish a degree and retool for the years that lieahead. If such rechannelling of her energies is notdone, today's middle-aged woman, more vigorousand younger for her age than was her mother orgrandmother before her, may become a meddle;some mother and mother-in-law, a too-dotinggrandmother, or a nuisance to her husband nowat the peak of his career, and community roles.

Husband and wife as a pair may find thesemiddle years a chance to develop their resources.Financially they are better off than they have beenbefore, or will be later on when they live on a re-tirement income. So, they may travel, rebuild theirhome for their own interests now that childrenhave gone, and begin to devote themselves to thethings and interests that mean most to them in-dividually and as a pair. (12)

One used to hear of a man's "dangerous years"when younger women were a temptation, and"being young, virile and active" were male pre-occupations. This period is dangerous not only forthe marriage, but basically for the man himself.As his strength and vitality begin to observablydecline, as the hair line recedes, and the abdominalmuscles fail tc' restrain the swelling paunch, aman must find new meanings in his life beyondhis sheer masculinity and sex attractiveness. Thedisillusionment of the middle years of marriage

has powerful personal and marital componentsthat lie inherently in this stage of family life.

Studies find disenchantment in the middle yearsof marriage among many of the couples studied.(5, 10, 15, 29) One research of married couplesat various stages in the family life cycle finds thatthe middle-aged couple value conjugal factors intheir lives highest now that companionship andcalmness tend to be characteristic of their marriage.(15)

Disenchantment is often a problem for middle-aged men and women, as well as for preretirementcouples. (29) In a sense, they feel they have doneeverything once, and that everything else is arepeat of the same old thing. By now they haverecognized one another's weaknesses, annoyinghabits and tendencies. They each have had to facetheir own problems in themselvesso often harderto take than the other's faults. In the rough andtumble of their years of marriage they havewounded one another, said things that are difficultto forget, and developed scar tissue over areas thatare painful to think about and almost impossibleto discuss with objectivity. Now they face the taskof rebuilding their 'relationship on a wholesomebasis for the years that still lie ahead.

The number of family relationships increasesgreatly at this stage of the family cycle. In a three-child family there are 153 probable interpersonalrelationships between a total of 18 different per-sons now. (12, p. 128) The woman relates toothers in her family as wife, mother, mother-in-law, grandmother, sister, sister-in-law, daughterof aging parents, aunt, cousin, etc. The man of thefamily has interpersonal relationships as husband,father, father-in-law, grandfather, brother-in-law,son of aging parents, uncle, cousin, etc. Some ofthese relationships are with more than one person;as is the case when more than one of their chil-dren marries and brings additional in-laws into thefamily, or as the number of grandchildren increaseover time. While the number of persons in thefamily increases arithmetically, the number of pos-sible interpersonal relationships increases geomet-rically. So, the more the family proliferates, themore complex and complicated the intra-familyrelationships become. Peek in on any family re-union or holiday celebration for an illustration ofwhat this means in family terms.

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Early Retirement YearsComes the time when a man retires from his

work, and a whole new ballgame begins for bothmembers of the pair. He may feel like a fifthwheel around the house where his wife has beenin charge so long. Unless he has prepared well forhis retirement, he may find that the leisure so)ong anticipated when he would be free to gofi3hing and spend more time at home fails tosatisfy as fully as he had dreamed it might.

The family income declines rapidly after thehusband's retirement, since Social Security andprivate pension plans rarely satisfy even the basicneeds of the couple. Less than 10 percent of thewives are still working after their husband's re-tirement, which gives the, pair more time for oneanother, but less money to work with than theyhave had before in their marriage, since theirearliest days together.

The early retirement years, when husband andwife are between 65 and 74 typically, begin whenthe man no longer has his days filled with hiswork. Three out of four (75.3 percent) of the menare still living with their wives at this stage. Butwomen are widowed in large numbers now,especially after the age of seventy. The differentialmortality rates for men and women combine withthe tendency for men to marry women youngerthan themselves to make the chances of beingwidowed much greater for the woman than theman of the family.

The death of a life partner is a crisis for thesurviving member of the pair. (24) Studies showthat reactions vary with the individual, and thatthere is a somewhat predictable process of bereave-ment that starts with disbelief, proceeds to grief,self-blame, depression, and finally into a successfulweathering of one's loss in a constructive channel-ling of the loss through memorials, and/or carry-ing out the mate's wishes and interests as well asone can. (12, pages 468ff)

Older widows are found to fare better thanwomen who lost their husbands at earlier ages.One reason for this appears to be that when anolder woman is widowed there are more friendsher own age in the same predicament, so that shehas new companions and relationships to tie to.(23)

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Men who have lost their wives tend to remarryin about three years; widows remarry in sevenyears, if at all. The discrepancy is accounted for ina number of ways. Men marry younger mates, andso have a wider field of choice than do widows ofthe same age group. Scholars point out that thebenefits of remarriage are greater for the' manthan a woman. A man is better fed and cared forwith a wife to look after him, and when he re-marries he has a housekeeper, hostess and com-panion for his remaining years. (27)

Although marital interaction is low at this stage,there is a general feeling of peacefulness, and thesatisfaction with the marriage approaches that ofnewlyweds. In fact, Feldman finds this a "verysatisfying" period for most of the older coupleshe studied. (15) Older couples after the man'sretirement talk a great deal about religion, health,home repairs. They rarely report "a gay time awayfrom home," but appear to get their satisfactionfrom the peace and quiet, and the lack of stressin their lives. (15, 22, 27, 39)

Years ago a thick book was circulated with thetitle, Sex After Sixty. Its cover was attractive, theformat thick and imposing. But when one openedthe book there were only blank pages. This stereo-type of the cessation of all ,sexual activity in thelater years is still prevalent in spite of evidenceto the contrary. While it is true that sexual inter-course declines in frequency over the years, manycouples continue to enjoy it well into old age.(26, 35 and the Kinsey studies) As passion de-clines, expressive roles dominate the husband-wiferelationship. Throughout the later years affection,interest, kindness, tenderness, intimacy and com-panionship are of great importance to the olderpair. (3, 20, and the work of Dentler, Epstein, andothers)

Great- grandparenthocd is not unusual now, asgrandchildren marry and have children of theirown. The recent retiree and his wife may alreadybegin to feel at the apex of a pyramid with multi-tudes of descendants arriving to carry on the familyname and tradition. There are some older men andwomen who relish their roles as grandparents, whoenjoy their children and grandchildren, and take anactive interest in them 'And their development.Other grandparents are much more remote and

formal as older family members. (7, 28) It isgenerally agreed that young children are too noisyand tiring for the aging to enjoy as a steady diet.It is not unusual for grandparents to be glad whentheir grandchildren and great-grandchildren cometo visit and to be quite as happy when they leave.

Few aging men and women live in three-generation homes, as the popular myth has it.There is but a small minority of grandparents wholife with their married children in homes wherethere are young grandchildren. Much more com-mon is the widowed father or mother, or an oldermarried pair, living with a middle-aged marriedchild whose own children have already left home.Such middle-aged sons and daughters have an on-going interest in their aging parents, as alreadyreviewed in research evidence above. Their homeis established, and large enough to accommodatean aging replacement of the recently launchedyoung adult sons and daughters. (36, 46)

The family relationships of aging members con-tinue to be numerous and complex. A possible 153interpersonal relationships in a three-childrenfamily have been charted, each with a plethora ofroles and responsibilities. (12, Chart 5-7) Thewoman of the family possibly is now a wife orwidow, a mother, mother-in-law, grandmother,great-grandmother, daughter of aging parents, sis-ter, sister-in-law, aunt, great-aunt, cousin, and elderwoman of the family clan. The husband has aparallel number of interpersonal relationships, buttends to be less actively involved in them thanare the woman of the family.

Old Age Over 75

Even beyond the age of 75 nearly three-fourthsof the men (73.2 percent) and more than half ofthe women are head of the family, often with rela-tives living with them in their own homes. Bythis age, 58 percent of the aged husbands and19.3 percent of the wives are living with theirspouses. Twice as many women (40 percent) asmen (19 percent) over 75 live alone for at leasttwo reasons: old women are more able to take careof themselves, and are less likely to remarry afterthey are widowed than are aging and aged men.Even at advanced ages over 75, a small minorityof men (6 percent) and women (8 percent) are

institutionalized for any reason or type of care.Again this fact blasts the all too common stereo-type that the aged are senile, helpless, and mustbe "put away." (46)

Warm human interaction is still a compellingneed not easily met by those who have lost theirlife companion. The need to be needed remainsas long as life and ability last for most persons.Many aging men and women maintain a fullrepertoire of meaningful relationships with othersin family, friendshlp, church and communitycircles as well as in creative expression of all kinds.Grandma Moses modelled for millions the joyof painting in her later years. Pablo Casals andLeopold Stokowski became ever more giftedmusicians with the passing of time. Jack Bennywas still 39 on his 75th birthday, when on anationwide television celebration of it, he askeda young girl in the audience, "How old do youthink I am?" She looked at him thoughtfully,smiled and said, "Thirth-nine." He beamed, lookeda bit embarrassed and confessed to her that heactually was a little older than that. Gaining con-fidence he came back, "So, how old would you sayI really am?" She looked him straight in the eyeand promptly replied, "75!" At this his face fell,and he stared, and stared, and staredin but a fewseconds emerging in the public eye not as an old39, but a young 75.

The Kansas City Study of Adult Life finds one-third of the old persons in their population mature,integrated, and functioning well with strong egos,a sense of mastery and control, with a feeling ofself-worth and a willingness to take on new rolesand responsibilities to replace those lost as theirfamilies have grown and gone, and their employ-ment no longer is so time-consuming. (18, 28)These are no doubt the older men and womenactive in AARP, NRTA, SCORE, Green-Thumbers, Foster Grandparents, and other nation-wide as well as local programs. Such elderly per-sons have become relaxed and mellow with thepassing of the years. They are relaxed rather thancombative in their relationships with others. Theyuse the wisdom they have accumulated in crea-tively consti:Ictive ways, and remain articulatedinto society as long as life lasts. (28, 31, 33, 34)

In time even the healthiest individual comes to

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the point where the possibility of his or her deathmust be faced. In recent years studies have beenmade of the reactions of persons faced with thelikelihood of dying. Contrary to the common ex-pectation that men and women facing death do notwant to talk about it, the researchers found themwilling and able to talk freely about how they feltabout their own approaching death. A series ofsequential reactions were found in many casesthat began at the first recognition of the possibilityof dying with its denial, and rejection as a possibil-ity. Next came anger, with a possible overlay of"Why me?" as a second phase in personal responseto one's own demise. Bargaining followed withattempts psychologically to trade good behavioror good works for an extension of time. With therecognition that the process of dying would notbe stayed came depression; and lastly, for somecame the peace of acceptance of one's own ap-proaching death. (21)

Quite recent published works have explored thepositive ways of accepting life's final actthat ofdying. One particularly articulate review of whatit means to prepare for one's own death includesthis statement:

"Death is inextricably woven into all that makeslife rich, noble and triumphant. To conceal itis to cheat one's self of what might give mean-ing to life. Indeed, one cannot accept life with-out knowing that it must end. Death is notthe scissors that cuts the thread of our lives. Itis rather one of the threads that is woven intothe design of existence." (13, p. 15)

Family members recently have been urging thattheir loved ones be allowed to die naturally whentheir time comes, rather than be subjected to thesenseless prolongation of vegetative states, or un-necessarily painful, agonizing final days, weeks,months, even years through medical attempts tosustain life as long as possible. One physician ad-vocating medical and legal policies that wouldallow a person to execute a document directingthat he be allowed to die in peace when his timecomes, points out that each end of life is a miracle,"Death like birth is glorious, let it come easy."

Donation of one's own body for surgical replace-

ment of tissue, for medical education and researchis now legally possible in all 50 states under theUniform Anatomical Gift Act. A donor card iscarried in one's wallet specifying the permissionfor posthumous transplants of body tissue uponone's death. Morticians have legal forms for theliving to file specifying that upon one's death thehuman material will be taken directly to a nearbymedical teaching and research center. In place ofthe traditional funeral with the remains present,families and friends come together for a memorialservice in which the departed loved one's life isremembered, celebrated, and openly memorialized.Th:s provides the rite of passage helpful in accept-ing the death of a person whose life has beenmeaningful, with the positive overtones for boththe one who has died, leaving his body to benefitthe living, and to his dear ones who assemble todo him honor confident that he has died as Lclived, with grace and selflessness.

Death education is being advocated widely nowto remove the stigma and taboo from the final actof life. Public education, college and universitycourses, as well as adult education programs nowincreasingly include the latter decades of life, andits termination as a part of their work in humandevelopment, family life education, and philoso-phy. Since every human being, like all other formsof life, is mortal, and inevitably will die, the end oflife is a part of the whole, and in a real sense,death education is seen as preparation for living.(17, 38)

Family membership is a central factor in thelife and death of every citizen of these UnitedStates. Therefore, it is fitting that considerationbe given to the social and personal policies that re-flect family roles and relationships in the economic,educational, emotional, health, housing, personaland public care of and concern for the aging. Atthis point in history then, let pis turn ourselves tothe recommendations that derive from this reviewof research, clinical and census evidence. Only asthe later years of life can be made meaningful andrewarding will life make sense for old and youngalike. For it is inexorably true that all age in time,and if being old is respected, appreciated, andadmired, as a fitting climax of the good life, thenlife itself is to be valued- -at every age.

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r)

References and Bibliography(1) Adams, Bert N., "Isolation, Func Nn, and Beyond:

American Kinship in the 1960's," 'journal of Marriageand the Family 32: 575-597, 1970.

(2) Aldous, Joan, "Intergenerational Visiting Patterns: Vari-ation in Boundary Maintenance as an Explanation," Fam-ily Process 6(2): 235-251, 1967.

(3) Ballweg, John A., "Resolution of Conjugal Role Ad-justment after Retirement," Journal of Marriage andthe Family 29:(2); 277-281, 1967.

(4) Bekker, L deMoyne and Charles Taylor, "AttitudesToward the Aged in a MultiGenerational Sample,"Journal of Gerontology 21(1): 115-118, 1966.

(5) Blood, Robert 0. and Donald M. Wolfe, Husbandsand Wives. New York: The Free Press, 1960.

(6) Borke, Helen, "A Family Over Three Generations: TheTransmission of Interacting and Relating Patterns,"Journal of Marriage and the Family 29(4): 639-655,1967:

Boyd, Rosamonde R., "The Valued Grandparent: AChanging Social Role," in Wilma Donahue et al. (eds.)Living in a Multigenerational Family. Ann Arbor: Insti-tute of Gerontology, 1969.Burgess, Ernest W., "Family Structure and Relation-ships," in Ernest W. Burgess (ed:) Aging in WesternSocieties. Chicago: University of Chicago- Press, 1960.

(9) Clark, Margaret and Barbara G. Anderson, Cultureand Aging. Springfield: Charles Thomas, 1967.

(10) Cuber, John F. and Peggy Harroff, The SignificantAmericans, New York: AppletonCentury-Crofts, 1965.

(11) Cumming, Elaine and William Henry, Growing Old.New York: Basic Books, 1961.

(12) Duvall, Evelyn Millis, Family Development, FourthEdition, Philadelphia: J. B. Lippincott, 1971.

(13) Elliot, Grace Loucks, To Come Full Circle: Toward anUnderstanding of Death, New York, 1971.

(14) Farber, Bernard,- Kinship and Family Organization. NewYork: Wiley and Sons, 1966.

(15) Feldman, Harold, Development of the Husband-WifeRelationship, Research Report. Ithaca: Cornell University,1965.

(16) Gibson, Geoffrey, "Kin Family Network: OverheraldedStructure of Past Conceptualizations of Family Func-tipning." Paper presented at American Sociological As-sociation, San Francisco, 1969.

(17) Green, Betty R. and Donald P. Irish, Death Educa-tion: Preparation foe Living. Cambridge, Mass.: Schenk-man Publishing Company, 1971.

(18) Havighurst, Robert M., M. A. Munnicks, ThomasJoep, and Bernice Neugarten. Adjustment to Retire-ment: A Cross-National Study, Assen, Netherlands: VanGoscum, 1969.

(19) Hill, Reuben et al., Family Development in Three Gen-erations. Cambridge, Mass.: Schenkman Publishing Com-pany, 1970.

(20) Kerckhoff, Alan C., "Family and Retirement," in AdaH. Simpson and John C. McKinney (eds.) Social As-pects of Aging, Durham, N.C.: Duke University Press,1966.

(21) Kublcr.Ross, Elisabeth, On Death and Dying. NewYork: Macmillan, 1969.

(22) Lipman, Aaron, "Role Conceptions and Morale ofCouples in Retirement," Journal of Gerontology 16(3) :267-271.

(i)

(8)

(23) Lopata, Helena Z., Role Changes in Widowhood. Mime-ographed, 1969.

(24) Maddison, David and Agnes Viola, "The Health ofWidows in the Year Following Bereavement," Journalof Psychosomatic Research 12(4): 297-306.

(25) Maddox, George L., "Persistence of Life Style among theElderly: A Longitudinal Study of Patterns of SocialActivity in Relation to Life Satisfaction," in BerniceNeugarten (ed.) Middle Age and Aging. Chicago: Uni-versity of Chicago Press, 1968.

(26) Masters, W. H. and Virginia E. Johnson, "HumanSexual Response: the Aging Female and the AgingMale," in Bernice Neugarten (ed.) Mad': Age andAging. Chicago: University of Chicago Press, 1%8.

(27) McKain, W. C., Retirement Marriages. Storrs, CT:Agricultural Experiment Station Monograph *3, 1969.

(28) Neugarten, Bernice (ed.), Middle Age and Aging. Chi-cago: Univ. of Chicago Press, 1968.

(29) Pineo, Peter, "Disenchantment in the Later Years ofMarriage," in Bernice Neugarten (ed.) Middle Age andAging. Chicago: Univ. of Chimp Press, 1968.

(30) Reiss, Paul J., "Extended Kinship System: Correlates ofand Attitudes on Frequent, of Interaction," Marriageand Family Living 24: 333 ,39.

(31.) Riley, Matilda, et al., Aging and Society, Vol. I, AnInventory of Research Findings. New York: Russell SageFoundation, 1968.

(32) Robins, N. and Mirada Tomanec, "Closeness toBlood Relatives tt!ds the Immediate Family," Mar-riage and Family Living 24: 330-346.

(33) Rose, Arnold M. and Warren A. Peterson, Older Peo-ple and Their Social World. Philadelphia: F. A. DavisCo., 1965.

(34) Rosow, Irving, "Relationship of Older Persons to Fam-ily and Friends," Welfare in Review 3(7): 15, 1965.

(35) Rubin, Isadore, "The 'Sexless Older Years'-A SociallyHarmful Stereotype," Annals of the American Academyof Social Sciences 376: 86-95, 1968.

(36) Schorr, Alvin, Filial Responsibility in the ModernAmerican Family, Washington: Department of Health,Education, and Welfare, 1960.

(37) Shanas, Ethel, "Family Help Patterns and Social Classin Three Countries," Journal of Marriage and the Fam-ily 29(2): 257-266; see also, Shanas, Ethel and GordonF. Streib (eds.) Social Structure and the Family: Genera-tional Relations. Englewood Cliffs, N.J.: PrenticeHall,1965.

(38) Somerville, Rose M., "Death Education as Part of Fam:ily Life Education: Using Imaginative Literature for In-sights into Family Crises," The Family Coordinator20(3): 209-224, 1971.

(39) Stinnett, Nick, Janet Collins and James E. Montgom-ery, "Maritial Need Satisfaction of Older Husbands andWives," Journal of Marriage and the Family 32(3):428-434, 1970.

(40) Streib, Gordon F., "Intergenerational Relations: Per-sNctives of the Two Generations on the Older Parent,"Journal of Marriage and the Family 27(4): 469-476,1965.

(41) Sussman, Marvin B., "Intergenerational Family Rela-tionships and Social Role Changes in Middle Age,"Journal of Gerontology 15(1): 71-75, 1960.

(42) Sussman, Marvin and Lee Burchinal, "Kin Family Net-work: Unheralded Structure in Current Conceptualiza-tions of Family Functioning," Marriage and Family Liv-ing 24:231-240, 1962; see also, "Parental Aid to MarriedChildren: Implications for Family Functioning," Mar-riage and Family Living 24: 320-332, 1962.

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(43) Tibbitts, Clark, Handbook of Soda! Gerontology. Chi-cago: University of Chicago Press, 1960.

(44) Tibbitts, Clark, and Wilma Donahue (eds.), Social andPsychological Aspects of Aging. Aging Around theWorld. New York: Columbia University Press, 1962.

(45) Troll, Lillian E., The Family of Later Life: A DecadeReview," Journal of Marriage and the Family 33(2):263-290, 1971.

(46) U.S. Bureau of the Census. Current Population Reports,Series P.20, No. 225, "Marital Status and Living Ar-rangements: March 1971,- U.S. Government PrintingOffice, Washington, D.C., November 1971.

(47) Vickery, Florence E.. Creatite Programming for OlderAdults. New York: Association Press, In-Press.

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THE RELIGIOUS COMMUNITY

AND THE AGING"nli he Special Concerns Session on The

Religious Community and theAging was requested by the NationalCoUncil on the Aging, Inc. It was felt

that this Session was needed, in addition to theConference Section on Spiritual Well-Being, todevelop recommendations directed specifically tothe religious needs of older people. Other groupsparticipating in the Planning Committee wereThe National Conference of Catholic Charities,The National Presbyterian Center and The ReliefSociety of the Church of Jesus Christ of Latter-Day Saints!

The Participants

During Conference preregistration, approxi-mately 138 Delegates signed up for the Session.Upon opening the Session, however, a number ofother Delegates, observers, and guests attendedthe 4-hour meeting. Only official Conference Del-egates were qualified to vote on the recommenda-tions.

Prior to the Session meeting, the InterreligiousCommittee of General Secretaries prepared astatement relative to the role of the religiouscommunity in providing opportunities for olderpersons to enjoy the basic rights and freedomswithin their communities and to become fully in-volved in programs and services affecting theirwell-being. This statement is reproduced in theAppendix to provide information from whichDelegates were able to draw upon in formulatingrecommendations.

See Roster of Planning Committee. page 224.

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The ProgramIn order to prepare the Delegates for formulat-

ing sound recommendations, the major part ofthe program was devoted to presentations by key-note speakers who discussed some of the mostfrequently voiced criticisms of the religious com-munity. The Planning Committee also invited anumber of representatives from the religious com-munity to respond and comment on the presenta-tions.


PROGRAMTHE RELIGIOUS COMMUNITY

AND THE AGINGPresidingWILLIAM C. FITCH, Executive Di-rector, National Council on the Aging, Inc., Wash-ington, D. C.

8:00 A.M.Opening Remarks

8:15 A.M."The Church and the Commu-nity"DR. REX A. SKIDMORE, Dean,Graduate School of Sociology, University ofUtah, Salt Lake City, Utah

9:00 A.M."Practical Ecumenism"DR.ROBERT N. BUTLER, Chairman, District ofColumbia Advisory` Committee on Aging,Washington, D. C.

9:45 A.M."Church Facilities for MinorityGroupsPolicy versus Practice"HOBARTC. JACKSON, Chairman, National Caucus onthe Black Aged, Philadelphia, Pennsylvania

10:30 .A.M."Ministering for and to theElderly"REVEREND HERBERT C.LAZENBY, Executive Director, Senior Citizens,Inc., Seattle, Washington

(Program continued on iext page)

(Program Continued)

11:15 A.M.POLICY RECOMMENDATIONS AND ACTION -PLANS

1. Formal presentations will discuss someof the most frequently Voiced criti-cisms of the religious community andthe aging.

2. Representatives of the religious com-munity will react or respond to thepresentations.

3. Policy recommendations will be pro-posed and acted on by the group.

4. Suggestions for statement of commit-ment for closing session.

THE SESSION REPORT

Recommendations

1. That a National Conference on SpiritualWell-Being be held within the next two years, andnot later than five years, to review and evaluatethe recommendations in terms of achievements asa result of the 1971 White House Conference onAging.

2. That it should be the national policy thatreligious bodies and other private agencies makeit their concern to bring together the services ofthe entire ,community to provide opportunity forinterfaith broad-based community programs forthe aged through multipurpose community cen-ters.

3. That private institutions of religious andcharitable organizations which discriminate in theadmission of black persons and those of otherminority groups, and deny and abrogate the civilrights of such persons, have their tax exemptionstatus lifted. We urge that the U.S. Congressenact appropriate legislation to bring this about.

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4. That church-related retirement facilities addto their staff (on a salaried and/or volunteerbasis) a retiree in the role of community ombuds-man-advocate, working with older adults withinthe institution and the larger community, servingas a representative with and for older adults.

5, That religiously related educational institu-tions and religious laymen in any teaching situa-tion, be urged to provide a knowledge base foran understanding of the processes of aging, thecharacteristics and needs of older persons, and theimplications of such knowledge for fields of com-munity practice.

6. Subscribing to the principle that responsibil-ity for the care and affectional support of personsof all ages rests with one's immediate family andkinsmen, we, therefore, recommend that (a) taxdeductions, be given for qualified gifts and assist-ance to aged persons, as are now authorized forcharitable contributions, and (b) education be in-augurated for couples in their middle years fortheir tasks in bridging the snerations, includingaccepting death and preparation for the life of asurvivor.

A Message to the Religious Community '

A consideration of policies affecting the agingat the White House Conference should start withrecognition of the dignity of all persons, specifi-cally the elderly. "You shall honor your fatherand your mother," the scripture says, and fromthis commandment flows the necessity for policyand program decisions.

As representatives of our respective religiousorganizations we address this open letter to thereligious community of America on the occasionof the 1971 White House Conference on Aging.

We remind you of the statement on the role ofreligion in the life of the older person in the Re-port of the 1961. White House Conference onAging.

"Religion's concern with human dignity atevery stage in the span of life derives from thefact that each individual is created in the imageof God. As a consequence, religion seeks tobuild a living fellowship of believers in whichthe aging find and share the true benefits ofbeing part of the household of God. It is thisconviction which likewise demands a concernfor such matters as the maintenance of socialwelfare institutions by religious bodies and theproper conduct of those sponsored by Govern-ment or voluntary agencies in a manner conso-nant with the nature of man and the sanctity ofexistence. Similarly, it is the basis of a concernfor the right of every individual to a burialbenefiting human dignity.

"It has been suggested that 'man's potential forchange and growth is much greater than we arewilling to admit and that'old age be regardednot as the age of stagnation but as the-age ofopportunities for inner growth.' In light ofthis, congregations should recognize that theirelder members are often specially endowedwith gifts of wisdom, serenity, and understand-ing. To the aging person, religion extends aninvitation to see the -later years of his life as'rich in possibilities to unlearn the _follies of alifetime, to see through inbred self-deceptions,to deepen understanding and compassion, towiden the horizon of honesty, to refine the

sense of fairness.' The religious community as-sists the older person to deepen his relationshipto God and to accept the assurance of eternallife."

The Facts of LifeWe start from the premise that life for older

people, like that for all others, will be a mixtureof pain and problems, of pleasures and richness.The broad policy issue is whether the difficultiescan be lessened and the strengths enhanced.

There are a number of specific necessitieswhich we call to the attention of members of reli-gious organizations and of Delegates to theWhite House Conference on Aging. Adequatemedical care, an adequate standard of living, anopportunity for cultural enrichment are necessaryfor a full life. Particularly important is the op-portunity to communicate and cooperate with oth-ers, to live with others if this is the mutual de-sire. Similarly, the right to live alone and in one'sown home should be respected. Loneliness shouldbe replaced by companionship, idleness by theopportunity to participate, isolation by involve-ment.

In earlier times when the extended family liv-ing together was the life style, both physical careand social involvement of the aged person was anatural component of family life. The life styleof today's nuclear family, not to mention newerlife styles appearing in the youth culture, do notprovide for the aged person's protection againstsocial isolation and a sense of abandonment. In-stitutions other than the family are looked to forphysical care of the aged to a degree not true ofa half-century ago.

Early retirement at the age of 65, or even ear-lier, has to be faced by many people, and not al-ways on the basis of their own choice. In a society

I Prepared by Bishop Joseph I.. Bernardm. General Secretary,U.S. Catholic Conference; Dr. R. H. Espy, General Secretary,National Council of Churches; and Rabbi Henry Scigman. Ex.ecuticc Vice President, Synagogue Council of America.

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which places high value on those who can pro-duce goods or services which can be marketed inthe ordinary workings of the economic system.compulsory retirement for those who cannot soproduce tends to be inevitable for too many peo-ple. This can destroy a _person's sense of worthand value.

The knowledge, experience, wisdom and goodjudgment that so often accompany the older yearsmay still be of yak(' to society though not neces-sarily to be contributed through the economicchannels of the earlier career. Employers andolder employees may mutually benefit from theexploration of second careers with productionpressures and time schedules adapted to the ca-pacities of older people.

Apart from the economic employment, the vol-untary assistance that can be provided to charita-ble, educational, and public functions by olderpeople drawing on their wide_experience with is-sues and people could be invaluable. Many ofthose who retire today have much to contributeand there are many needs they could meet, buttoo often the person and the need are notbrought together.

Ability to contribute wisdom and experience tocommunity life is not the possession of well-to-door educated people only. People rich in experi-ence though limited in formal education, peoplefrom minority racial and ethnic groups, as well asfrom the majority are entitled to the satisfactionof having their talents valued and utilized by-the-larger community.

The Fact of DeathOne of the most important concerns of the

aging person is the relative proximity of death.

Death is an inexorable event that must befaced. It cannot be denied as a fact; it cannot beavoided as an issue. However, it cannot be has-tened by any positive act of any person. The factof death must be faced, but it should not be con-sidered as something within the determination ofany human being. Extraordinary means need notbe taken to unduly postpone death, but no posi-tive means can be used to bring it about.

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The Role of CommunityAs religious representatives we are, of course,

primarily concerned with the spiritual well-beingof the community. But we also strongly affirmthat spiritual well-being cannot exist in a vacuum.As the prophet Micah wrote, "What does theLord require of you. but to do justice. and to lovekindness, and to walk humbly with your God?"(Micah 6:8)

The human spirit cannot flourish in a societywhich neglects. demeans, or tries men's souls be-yond endurance through the denial of basic rightsand freedoms, such as the right to worship Godaccording to one's own conscience, to freely as-semble with others, and to petition one's govern-ment for redress of grievances.

The religious community by itself cannot pro-vide the social milieu needed to sustain thespiritual well-being of older people.

Government on all levels, organizations in thevoluntary sector, the business community and thefamily, among others, must all play an appropri-ate role in creating a society in which older per-sons can participate in full measure according totheir abilities.

We are mindful of the enormity and complex-ity of the task confronting the community, andthat men of good will are faced by many impor-tant issues.

Do our community_attitudes_reflecta_genu,ine concern for the aging and their familiesand our philosophical affirmation of the dig-nity of man and the richness of the goldenyearsor -do the needs of the aging needmore attention in our national and localpriorities?

Is our vision of the aging clouded by ster-eotypes, and do we thus fail to see the tre-mendous variations in their aspirations, drivefor independence, abilities, interests, handi-caps, limitations, and dependency? Do wethus fail to consider whether we are provid-ing the full range of facilities and serviceswhich they might utilize in maintaining opti-mum independence during declining years?For example, are services such as home

health aides, visiting homemakers, hot meals,and the like available when needed?How much of a gap is there between ourjudgment of what constitutes social justiceand what we actually do; between our stand-ards and our practice; between social policiesand their implementation? For example, arenursing homes really required to operate atan acceptable standard of health and com-fort? Are Social Security payments adequatewhen measured against current costs of liv-ing? Do escalating real estate taxes forcepeople out of the home of their choice?

Do we have adequate mechanisms for get-ting the facts about our aging population,their problems and our progress? Have wedeveloped adequate mechanisms for plan-ning together, locally and nationally, and forsustaining comprehensive, well-coordinatedprograms that are adequate for the fullrange of need ?

The Role of Religious CongregationsWe propose that congregations and those whoserve as 'their spiritual leaders give thoughtfulconsideration to the following responsibilities.1. Include older people fully in the religiousfellowship.

Retired persons and other people over 65 yearsare members of religious congregations. As suchthey expect opportunities to participate in pro-grams of worship, education, and service alongwith other members of the congregation. Wherethey have interests or needs peculiar to older peo-ple, they expect to be able to form groups oftheir own and to organize activities of theirchoice. Some older members of the congregationmay need services that can be provided on a vol-unteer basis, such as daily telephone calls of as-surance, transportation to the h-Juse of worship,visiting-shopper service, and the like. Theseshould be provided wherever possible through ar-rangements and plans made by a responsiblegroup in the congregation, making fullest possi-ble use of other elderly members as organizersand volunteer aides.

468-713 Q - 73 - 16

The concept of the congregation as a "fellow-ship of the faithful" or "a beloved community"can be applied in practical ways to alleviate theloneliness and sense of isolation many older peo-ple feel.

2. Be an advocate of older people.Not all the needs of older people can be metthrough volunteer services. Some require changesin law, such as provision for tax exemptions or ofnew public facilities and programs. Some requirechanges in practices and procedures of agencies inthe governmental, voluntary, or commercial sec-tor, such as reduced bus fares, or provision on aneighborhood basis. Senior citizens should be ableto count on the support of social action groupswithin religious congregations in their efforts tosecure needed changes in community services andpractices. One of such advocacy is to provideto older peopl e right to free choice and self-determination whi seek for all groups in thecommunity.

The religious community should do all it canto sensitize the conscience of communities to spir-itual and moral values implicit in policy issueswhich must be faced with respect to the needsand rights of older people.

3. Provide spiritual services to older peoplMeeting the spiritual needs of older peopleposes some practical problems which are not socharacteristic of other age groups. More are home-bound because of illness or infirmity, and wor-ship as well as counseling services must be offeredin the home. Some are in homes for the aged,nursing homes, or other extended care facilities.More than ever they want the spiritual ministrywhich they have come to expect. from the pastor,be he priest, rabbi, or minister, and from con-cerned members of the congregation. Pressure ofother duties must not cause them to be deprivedof comfort and support.

Changes in physical condition, life style, andrelationships to other members of the family con-front the older person with moral and spiritualquestions that are not identical with those facingother members of the congregations. In the totalconduct of parish life and in all programs, olderpersons should be fully involved and their specialneeds considered.

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Finally, churches and synagogues have an obli-gation to help the aged face the necessity ofdeath, with all of its pain and grief. Throughgroup programs when appropriate and especiallythrough pastoral counseling, the elderly should behelped to cope with the many problems surround-ing death. More needs to be done through theo-logical education to equip ministers, priests, andrabbis of all ages to provide the spiritual ministryespecially needed by older people.

Conclusion

The religious community has older as well asyounger members. Its concern must be genuinefor all its members, providing to all spiritual andsocial ministry attuned to their needs. As part of

the total community, the religious communityshares in a responsibility to provide for agingpeople the full opportunity for lives of dignity,usefulness, and satisfaction which social justicedemands.

Roster of the Planning Committee

Lawrence J. Corcoran, Secretary, National Conferenceof Catholic Charities, Washington, D. C.Lowell R. Ditzen, National Presbyterian Center, Wash-ington, D. C.William C. Fitch, Executive Director, National Councilon the Aging, Inc., Washington, D. C.Belle S. Spafford, General President, The Relief Societyof the Church of Jesus Christ of Latter-Day Saints, SaltLake City, Utah.

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THE ELDERLY CONSUMERecognizing their long-standing interestin assuring that the elderly's consumerproblems be designated an area forspecial consideration in the 1971 White

House Conference on Aging, the ConsumerFederation of America, the Consumers Union ofthe United States, and the President's ConsumerAdvisory Council were invited to initiate planningof the Special Concerns Session on The ElderlyConsumer. The National Association of Attor-neys General named a representative to thisgroup, as did the National Council of SeniorCitizens, which had also earlier tried to assurethat consumer issues be treated among the Con-ference subject areas. Joining the planning groupwere representatives of the American Associationof Retired Persons and the National RetiredTeachers Association, the. National Associationfor the Advancement of Colored People, and theRetired Professionals' Action Group.'

Serving as consultants to this group were gov-ernment representatives from Federal depart-ments and agencies actively involved in efforts toassist the elderly consumer. These included theOffice of Consumer Affairs within the ExecutiveOffice of the President; the Departments ofTransportation, and Health, Education, and Wel-fare; and the Federal Trade Commission. TheUnited States Senate Special Committee on Agingalso participated in the planning activities.

Since the 1961 White House Conference onAging, a Consumer Bill of Rights has been pro-nounced and endorsed by three Presidents. Fre-que,,tly, however, the elderlyperhaps the mostdisadvantaged in the modern marketplacehavebeen identified as lacking opportunity- to securethese rights. Beset by low income, increasingphysical infirmity, and a life style frequently unre-


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sponsive to the rapidity of change characterizingcontemporary life, as a population group, the el-derly easily fall prey to marketplace ills. Numer;ous studies, surveys, research and demonstrationprojc:ts, other conferences, and Congressionalhearings have documented the need and offeredrecommendations for the development of publicpolicies directed at assuring the older citizen hisrights. Within such an atmosphere, the groupconvened to plan the Special Concerns Sessionrecognized the opportunity they were presented.

They began their work with the tacit acknowl-edgment that in both implicit and explicit inter-ests, the 1971 White House Conference on Agingwas a consumers' conference -for the elderly. In-come, health, housing, transportation, and theother needs areas around which the Conferencewas structured, were regarded as topics whichwould be addressed in any comprehensive reviewof the older person as a consumer. In addition,through a Conference plan calling for the activeparticipation. of older people themselves in OlderAmericans Forums, community and State confer-ences, and within the National Conference, a firmtenet of consumerismthe involvement of theconsumer in pursuits in his interestwas upheld.

The stage for recognition of the elderly con-sumer's interest was further set for the PlanningCommittee in the recognition which had beengiven consumer issues in the Conference subjectarea of Facilities, Programs, and Services. Work-ing with the Technical Committee in that areawas a Special Consultant Committee on ConsumerServices, which identified specific consumer con-cerns for the consideration of participants inWhite House Conferences on Aging at all levels.

These concerns centered around two questions:(1) What organizational setup at the Federallevel would best serve the interests of the elderly

consumers, and, (2) In assuring consumer protec-tion, what balance should be sought among theconsumer himself, business, and governmentalcontrols?

Other Conference activities contributed to thispropitious climate of concern. Several States hadchosen to extend their considerations beyond thespecific 14 Conference subject areas to the elder-ly's considerable array of marketplace problems.The Kansas State Conference, for example,sparked by a special edition of Probe, the news-letter of the Kansas Citizens Council on Aging,Inc., adopted an older citizens' consumer pro-gram. Savings, investments, and credit, marketsales, consumer representation, protection fromdeceptive home sales, legal rights, and insurancereform Were components of the Kansas consumerprogram which the Planning Committee consid-ered as it sought to hone the focus of the Session.In this regard, the Committee also utilized the re-port of the Michigan State White House Confer-ence Task Force on Consumer Protection. Acomprehensive document, the Task Force Reportheightened the Planning Committee's awarenessof the elderly's concern with the organization ofgovernment to meet their consumer needs, protec-tive services, insurance practices, consumer educa-tion, marketing, and legal rights.

From this wealth of material charting themovement of consumerism among the elderly, thecommittee members developed a platform state-ment to be used as a basis for discussion at theSpecial Concerns Session. They were adamant,however, in their belief that the Session should beso structured as to allow the older consumer him-self an opportunity to raise his voice and seek thechanges necessary to the improvement of the mar-ketplace on his behalf.

The ProgramAs buyers, recipients of services, and victims of

frauds and marketplace abuses, over 225 Dele-gates, most of whom were older people, broughttheir experiences to bear upon the proposals con-tained within the suggested platform statement.The Delegates actively involved themselves inmodifying, deleting, and proposing additionalrecommendations.

Listening as they addresssed themselves toadopting policies and programs which would as-sure all elderly persons of their consumer rights,were decision makers from business and govern-ment. These official listeners, invited by the Ses-sion Planning Committee, attended, not only tohear firsthand of the elderly's particulai consumerproblems, but to learn where it is that the Dele-gates believed responsibility lies for implementingsolutions.

Three teams of nongovernment members serv-ing on the Planning Committee recorded the ac-tion of the Session. Each team held responsibilityfor the discussion in one of the three broad sub-ject areas, drafting the specific recommendationswhich had been made, a process completed dur-ing the ensuing discussion on another of the top-ics, and then presenting the formal recommenda-tions to the Session foradoption.

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1971 WHITE HOUSE CONFERENCE ON ACING

PROGRAMTHE ELDERLY CONSUMER

Chairman.1.1COB CLAYMAN, Administrative Director, In-dustrial Union Department, AFL-CIO, and VicePresident, Consumer Federation of America.

PurposeTo explore solutions for problems of olderconsumers and to develop an action programto solve as many of the problems as possibleand alleviate those that cannot be solved.AgendaChairman opens Session, introduces official lis-teners and explains their role, invites all dele-gates to participate and vote their convictionsas they develop this action program for theolder consumer.

Delegates discuss Consumer Platform, dividedinto three major areas of concern:

Consumer Education and ResearchConsumer Protection and LegislationConsumer Advocacy and Representation

Delegates vote the action program they desire,(Planning Committee members will shape thesedecisions into resolution form during the discus-sion).

(Program continued on next page)

Official ListenersSUE BOE, Consumer Services Director, Pharma-ceutical Manufacturers Association

BARBARA BURNS, Deputy Assistant Secretaryfor Consumer Services, Office of the AssistantSecretary for Community and Field Services, De-partment of Health, Education, and Welfare.

NANCY CHASEN, Legislative Assistant, Officeof Senator Thomas Eagleton of Missouri

BETTE CLEMENS, Director of Consumer Af-fairs, Council of Better Business Bureaus

PHYLLIS CORBITI., Deputy Executive Assistant,Environmental Protection Agency

SAUL HOCH, Deputy Assistant Secretary, De-partment of Labor

GREGG HOVENDEN, Chief of Consumer Af-fairs, Department of Justice

JOHN JENNINGS, Assistant Commissioner,Medical Affairs, Food and Drug Administration,

Public Health Service, Department of Health,Education, and Welfare

MILES W. KIRKPATRICK, Chairman, FederalTrade Commission

VIRGINIA KNAUER, Special Assistant to thePresident, and Director, Office of Consumer Af-fairs, Executive Office of the President

W. C. LAUDERDALE, Fraud Branch Manager,U. S. Postal Service

PHILIP OLSSON, Deputy Assistant Secretary,Department of Agriculture

THOMAS C. PERROT, Assistant Commissioner,Social Security Administration, Department ofHealth, Education, and Welfare

CAROL SMITH, Deputy Assistant Director, Of-fice of Special Concerns, Office of Education, De-partment of Health, Education, and Welfare

ANN UCCELLO, Director of Consumer Affairs,Department of Transportation.

THE SESSION REPORTIntroduction

The Delegates of the Special Concerns Sessionon The Elderly Consumer reaffirm the fourbasic consumer rights of all citizens:

The Right to SafetyThe Right to Be InformedThe Right to Be HeardThe Right to Choose

In order to achieve and maintain these rights,the government and the private sector must effec-tively combine and direct their energies and re-sources toward that goal. Although the majorityof the recommendations from this Conference aredirected to government and voluntary agenciesfor their implementation, the consumer delegatesare particularly concerned that business and in-dustry cooperate with voluntary and governmentagencies to create an equitable, economical, acces-sible, and attractive marketplace for the olderconsumer.

The Special Concerns Session on the ElderlyConsumer stressed specific issues that wouldstrengthen the older consumer's position in themarketplace and which had not been addresseddirectly in other major Conference Sections.

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These issues are:

I. Consumer Education and ResearchII. Consumer Advocacy and RepresentationIII. Consumer Protection and Legislation

Consumer Education and ResearchThe older consumer has the right to be in-

formed. In a country such as ours, where literacyis high and mechanisms for communication areavailable and reasonably inexpensive, the mostimportant approach to consumer education andresearch must be to impart to the older consumerinformation and methods which will alert him tothe problems of the marketplace and enable himto make realistic and prudent decisionsnot onlylearning what to buy, but how to buy.

The following recommendations could help as-sure that the older consumer's rights are pro-tected.

1. Agencies of the Federal, State, and localgovernments, in cooperation with each other,should develop and administer curriculum guide-lines for the education of older consumers. Thefollowing areas, among others, should be cov-ered: banking and lending institutions; budget-

ing; consumer fraud; door-to-door selling and tel-ephone soliciting; false advertising; funerals;health frauds and quackery; insurance (auto,health, home, and life); medical care and services;.nutrition; pricing practices _(particularly in lowin-come areas); public assistance and services avail-able at little or no cost, including legal services;purchasing of all consumer products; real estate;retirement planning; and safety.

2. Consumer education efforts at the local levelshould include the establishment of consumer in-formation and referral centers with appropriateemphasis on and provision for the older con-sumer.

3. Any independent consumer agency established within the Federal government structureshould provide for consumer information servicesfor the elderly. The agency should gather infor-mation from other Federal agencies and non-Fed-eral sources to disseminate to the public throughgovernment-sponsored extension service pro-grams, consumer-oriented seminars, institutes, andother leadership and group participation pro-grams.

4. :n communicating with the elderly con-sumer, there should be a maximum use of such ofthe following methods as have been deemed to beeffective: educational television, commercialtelevision, extension courses, other adult educa-tion courses, radio, newspaper articles, brochures,local club and group activities, storefront offices,and paraprofessionals. Special emphasis should beplaced on person-to-person contacts.

5. The broadcasting industryincluding net-works, local stations and educational televisionand radiois called upon to use its resources toprepare and/or accept and to air informationaland educational programs on the consumer needsof the aging. Special emphasis would be placedon the problems of the' 5,000,000 elderly whoseincome is below the poverty level and, where ap-propriate, the format of such programs should in-volve the elderly themselves.

6. Research should be done by government atall levels in cooperation with the private sector,universities, and nonprofit groups on the prob-lems of the older consumer, the behavior of theolder person in the marketplace, -and on his par-

titular needs for education and protection, soeffective education programs can be developedand remedial action suggested.

7. The results of product research and testingby government and the private sector should betranslated into layman's language and made ac-cessible to th older consumer.

8. Any consumer education and research pro-grams developed at the Federal, State, territorialand local levels can be most effectively adminis-tered at the local level.

Consumer Advocacy and RepresentationThe older consumer must be assured that his

voice will be heard and his wishes consideredwhen decisions are made which affect the qualityof his life. He must also be assured that hisconcerns will be given necessary emphasis andpriority.

The Consumer Concerns Session voted to rec-ommend that:

1. A consumer agency should be establishedwhich would be a separate entity within the pres-ent Federal Government structure and whichwould have the authority to serve as an advocateof the consumer, both as an individual and as aclass, in proceedings before Federal agencies, Fed-eral officials, and Federal courts. Other functionsof this agency would include the authority to con-duct research and education, including the provi-sion of systematic and comparative informationabout consumer products. In addition, the agencymust be adequately financed to fulfil! its responsi-bilities and to have sufficient monies for enforce-ment. Money must be made available for grant-in-aid programs to develop consumer protectionprograms in individual States, jurisdictions, terri-tories and possessions.

2. Consumers should have the right to sue as aclass (class action suits) in proceedings beforeState and Federal courts and agencies.

3. Social seivice agencies and volunteer actionagencies at the Federal, State and local levelsmust be vested with proper advocacy powers torepresent their clients when consumer -issues areinvolved.

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4. Each State should retain its Delegates to thisConference as advisory boards to represent olderconsumers at the State governmental level.

5. A consumer representative should be addedto the newly-established Cabinet-level committeewhich now coordinates Federal policies for improving the quality of life, dignity and productiv-ity of the Nation's older people.

6. The President's Office of Consumer Affairsshould make a specific staff assignment to dealwith the consumer problems of older people.

7. The administrator of every State and localgovernmental agency or office dealing with con-sumer affairs should designate a specific staffmember to deal with consumer problems of olderpeople.

8. Every State investigative team which is cre-ated to inspect health facilities which will provideMedicare and Medicaid services should include aconsumer who is eligible for these services andwho lives in the community of the facility beingsurveyed.

Comment: The Delegates also expressed partic-ular concern regarding fee schedules set byphysicians, attorneys, dentists, morticians, andother feefor-service professionals.

Consumer Protection and Legislation

Today's changing marketplace has become in-creasingly complex and impersonal. Because ofthese characteristics and other factors which relateparticularly to older people, such as fixed and lowincomes, limited mobility, and poor health, a sig-nificant number of older people have difficultiesas consumers. Action must be taken at the State,local, territorial, possession and protectorate, aswell as-Federal levels, to see that the rights of allconsumers are protected- and that particular prob-lems that relate to the older consumer receivenecessary and appropriate attention.

Delegates recognize the need to form consumerorganizations and to know their State and Federallegislators for the purpose of promoting the im--

1 Included in this section are recommendations adopted at theSession, but not included in the initial Report To The Deli,.gates From the Conference Sections and Special Concerns Sesslow issued on December 2, 1971.

plementation of the legislative suggestions madeby the White House Conferences on Aging.

CONSUM ER PRODUCT SAFETY LEGISLATION

We recommend the passage of a consumerproduct safety law which has undiluted responsi-bility for preventing consumers from being ex-posed to unsafe goods, drugs, cosmetics and otherconsumer products, including:

Establishment of a National Injury InformationClearing House to monitor and report accidentsresulting in injury, illness, or death, and iden-tify the agents producing such injury.

Establishment of a Consumer Safety Informa-tion Center to respond to written inquiries fromconsumers concerning consumer safety and toconduct consumer education programs to in-form the public of safety hazards.

Development of proposed product safety stand-ards based on continuous evaluations of inju-ries.

Establishment of a mechanism for withdrawalof banned hazardous- consumer products fromthe market.

Development of generic standards of safety ap-plicable to new and innovative consumer prod-ucts.

Prevention of stockpiling of products prior tothe establishment of a final standard of safetyfor a consumer product.

Petitioning of consumers to commence a pro-ceeding for the issuance of a consumer productsafety standard.

Refund of the purchase price by the manufac-turer of a banned hazardous consumer product.

Recovery of the damages and cost of a suit forsustaining an injury if the Act is violated.

INSURANCE LEGISLATION

Health Insurance: We recommend passage of leg-islation requiring more stringent regulations re-garding private health insurance (with particularemphasis on health insurance which supplementsMedicare) including:

Increased disclosure of financial operations,

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particularly operating expenses and profit re-tention.

Assurance that these firms have sufficient cashresources to avoid problems of insolvency andto prevent fly-by-night operations from cashingin on business generated by the gaps in theMedicare program.

Development of basic coverage requirementsbased on the most pressing areas of coverageneeded to supplement Medicare.

Clear disclosure by the companies of this typeof coverage, and any super-supplemental cover-age, in clear, easily-understandable terms.

Oversight of rates for the required health-in-surance package.

Assurance that duplicate coverage by one insur-ance company should not he used to denyclaims pressed by a consumer against anothercompany with which he holds a policy.

No-Fault /Minn/obi le Insurance: Despite the factthat statistics prove that older people are involvedin fewer accidents per capita, and, therefore, aresafer drivers as a class, they are generally as-sumed to be more at fault and less desirable risks.The older person has a right to purchase insur-ance at a reasonable fee which will safeguard andindemnify him against losses.

We strongly urge that the Delegates return totheir States and work for the passage of lawsat the Federal and/or State level providing forno -fault automobile insurance to replace thepresent inadequate auto reparations system.

HEARING AIDS, PHYSICAL THERAPEUTIC DEVICESAND APPLIANCES LEGISLATION

When an older person needs a hearing aid,physical therapeutic devices and appliances, he isfaced with high prices, confusion, and lack ofsafeguards. We, therefore, urge the Council ofState Governments, the State Attorneys General,and the American Law Institute to draft and pro-mulgate uniform model laws regarding the dis-pensing of hearing aids, physical therapeutic de-vices and appliances, including the followingprovisions:

Licensing of dealers and salesmen by the Statehealth department. The licensing board to be

composed in the majority of odiologists and au-diologists for hearing aids, similar trained per-sons for other devices, and public members.

Requiring a proper audiometric testing and fit-ting before a hearing aid may be fitted by asalesman or dealer.

Assuring recovery of loss when an aid or de-vice is sold improperly.

Prohibiting false and misleading advertising.

Requiring short-term training courses for com-mercial dispensers of hearing aids and them-pettic devices and appliances to be certified bythe State health department.

Establishing a program for testing of hearingaids, audiometers, physical therapeutic devicesand appliances and the publication of the re-sults of such tests by the National Bureau ofStandards. Such testing should include thequality of construction and component partsand performance as compared to the specifica-tions published for the manufacturer by theNational Bureau of Standards. Audiometersshould be tested in accordance with the stand-ards of the International Standards Organiza-tion and the International Electrical Engineer-ing Organizations.

MISCELLANEOUS ADMINISTRATIVE ANDLEGISLATIVE PROPOSALS

Require packaged consumer commoditiesunder the Fair Packaging and Labeling Act to bepriced on a per unit basis, displayed on the pack-age or shelf in print that is easily read and under-stood so prices can be compared.

Reform regulation of land sales to providefor elimination through legislation- of current ex-emptions from the Interstate Land Sales Full Dis-closure Act; better property report disclosure; anda 72-business hour cooling-off period in !awl salescon tracts.

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Provision should be made to allow consum-ers increased opportunities. for settle lent of smallclaims to eliminate lengthy court procedures.

Standards of flammability should be up-datedand effective Federal regulations applied under theFlammable Fabrics Act Amendments of 1968.

Legislation should require the name and allactive ingredients in prescribed, and over-the-counter drugs to be disclosed in standardized'readable terminology on the label of the drug aspackaged for sale or delivery.

No laws or trade practices should prohibitthe advertising of prescription drug prices. Fur-thermore, as a matter of public policy, completeinformation about the availability of pharmaceuti-cal services should be provided to allow informedjudgments as to the value of the products andservices received by consumers.

Legislation should require a 72-business hour(3-day) cooling-off period which would give thebuyer or borrowers, from a seller or lender who isoperating away from his established place of busi-ness (includes door-to-door selling) 72 businesshours to cancel a contract.

Provision for a simple, open-dating systemfor all packaged foods should be required to indi-cate when each item should be removed from thestore shelf.

T- he Food and Drug Administration shall re-quire all manufacturers to print information re-garding ingredient content by percentage, vitamincontent, and caloric count on all packaged foodsto be sold in this country.

Legislation should be passed to abolish hold-er-in-due-course laws.

Legislation should be passed to prevent thedenial of credit to older persons solely on thebasis of age.

Federal safeguards against unrealistic raisesin rent should be continued for the protection ofconsumers of shelter as long as we are in a periodof inflation.

The Federal Government should establish aSenior Savings Bond program to enable the el-

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derly to invest in savings free from the uncertain-ties of inflation.

Truth-in-Savings should be required, tellingconsumers in standard terms the annual percent-age rate, the conditions under which interest willbe and is paid, and any limitations on interest orliquidity of funds.

Gasoline should be required to be labeled atthe pump, giving the amount per gallon of thosestandardized ingredients important to the func-tioning of a car and 4-s, the control of pollution.

Home appliances should be labeled with a-tel-tag" such as has been proven to be used suc-cessfully in Europe, giving as standardized termi-nology such base information as wattage, capac-ity, size, and performance characteristics.

Homestead tax exemption should beprovided the elderly to relieve them from beingtaxed out of their homes.

Housing for the elderly shouldbe designedfor the needs of the elderly, included in commu-nity planning so the elderly can participate incommunity activities, integrated with home healthcare facilities to facilitate the transition of beingcared for by others. It should be economical, at-tractive, and should encourage the elderly to livein a life style that allows for greater socializationand participation with others.

Cash customers should get the same discountthe banks get when they ,give cash to the mer-chant.

Comment: The intent of The Older Citizens'Consumer Program," published by- the- Kan-sas Citizens Council of Aging in Probe, Feb-ruary 1971, was accepted as expressing thegeneral opinion of the Delegates participatingin the Special Concerns Session on TheElderly Consumer.

Roster of Planning Committeestinting the National Association for the Advancementof Colored People)

David Swankin, Director, Washington Office, Con-sumers Union of the United States, Inc., Washington,D. C.

Nongovernment '

Erma Angevine, (Chairman), Executive Director,Consumer Federation of America, Washington, D. C.

Elma Griesel, Staff Coordinator, Retired Profession-als* Action Group, Washington, D. C.

Camille M. Haney, Consumer Affairs Coordinator,Wisconsin State Department of Justice, Madisor, Wis.consin (representing the National Association of At.torneys General)

Eunice -1):- Howe, Chairman, President's ConsumerAdvisory Council, Belmont, Massachusetts

William Hutton, Executive Director. National Coun-cil of Senior Citizens, Inc., Washington, D. C.

George A. Johnson, Member, President's Consume'.Advisory Council, and Assistant Head Master, BostonEnglish High School, Boston, Massachusetts

Ralph Leach, Consumer Information Program Co-ordinator, American Association of Retired PersonsNational Retired Teachers Association, Washington,D. C.

Yvonne Price, Executive Assistant, Leadership Con-ferenth on Civil Rights, Washington, D. C. (repre-

1 Although not actively participating in the work of the Plan-ning Committee, the American Council on Consumer Intere5tsand the Consumer Advisory Task Force of the American Asso-ciation of Emeriti accepted invitations to serve with the otherorganizations as co-sponsors of the Session.

GovernmentDorothy Burkhardt, Assistant for Community In-volvement, Office of Consumer Affairs, Executive Of-fice of the President, Washington, D. C.

Barbara M. Burns, Deputy Assistant Secretary forConsumer Services, Office of the Assistant Secretaryfor Community and Field Services, Department ofHealth, Education, and Welfare, Washington, D. C.Marilee Cavender, Consumer Affairs Specialist, Of-fice of Consumer Affairs, Department of Transporta-tion, Washington, D.C.Patricia Carter, Professional Staff Member, SpecialCommittee on Aging, United States Senate, Washing-ton, D. C.

Ezra Kohn, Director of Research, Office of ConsumerAffairs, Executive-Office of the President, Washing.ton, D. C.

W. Byron Rumford, Assistant Director, Division ofConsumer Education, Federal Trade Commission,Washington, D. C.Ann Uccello, Director, Office of Consumer Affairs,_Department of Transportation, Washington, D. C.

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):7

LEGAL AID AND

THE URBAN AGED

t the request of the American BarAisociation Family Law Section Com-mittee on Legal Problems of the Aging,and the Legal Research and Services

to the Elderly Project of the National Councilof Senior Citizens, this Special Concerns Sessionwas provided. The Institute of Criminal Law andProcedure of the Georgetown University LawCenter also accepted an invitation to membershipon the Planning Committee. These three co-sponsoring organizations were assisted by repre-sentatives from the Office of Services to the Aged,the Public Defender Service of - the District ofColumbia, and Federal 'representatives from -theDepartments of Justice, and Health, Education,and Welfare, and the White House Conferenceon Aging.

ParticipantsNearly 100 Delegates to the 1971 White

House Conference on Aging participated- in thisSession. Many of them were lawyers and knewfirst hand the problems to which this meeting wasaddressed. Other Delegates had themselves expe-rienced problems in getting legal service, and stillothers were concerned about the high incidenceof crime against the older citizens. A workingpaper entitled "Legal Problems Affecting OlderAmericans, "' prepared for the Special Committee

I Available from the Superintendent of Documents, UnitedStates Government Printing Office, Washington, D. C. 20102.Price S.30.

on Aging of the United States Senate, was madeavailable to the Delegates who attenued this Ses-sion. Some of the Delegates were well acquaintedwith the document and were thus able

Itocontrib-

ute to the discussions from more than their ownexperience.

The Program

The program of the Special Concerns Sessionon Legal Aid and the Urban Aged was presentedin two parts reflecting the two major areas ofconcern.

. .

The first part dealt with "The Elderly as Vic-tims of Crime." This part of the program con-cerned itself with the need for protective facilities-to deter "whitecollar crime," such as unfair busi-ness practices and fraud, as well as "crimes ofviolence" such as assaults and robberies. Attentionwas also given to ways to facilitate the participa-tion of the elderly in the criminal justice system.

The second part of the Session was concernedwith providing legal service to the aged; servicessuch as: representation in appeals to governmen-tal agencies, conservatorships and guardianships,administration of estates, and facilitation ofmodel legislation. The suggestions presented inthis report speak to the protection of self, prop-erty, and civil rights for older people. This area ofconcern and these suggestions must be given care-ful attention if the dignity of the later years is tobecome a reality.

233

(See Program on next page)

IT


PROGRAMLEGAL AID AND

THE URBAN AGED

Presiding: Bruce Terris

8:00 A.M.Part ITHE ELDERLY AS VICTIMS OF CRIME

Speaker

SEYMOUR GLANZER, Fraud Division, Officeof the District of Columbia

Resource

JEFFERY HALPRIN, General Counsel to Met-ropolitan Washington Police Department, Dis-trict of Columbia

PRESENTATION OF RESOLUTIONSFOR DISCUSSION AND VOTING

9:45 A.M.Part IILEGAL SERVICES FOR THE AGED

Speakers

DAVID H. MARLIN, Director of Legal Re-search and Services for the Elderly, NationalCouncil of Senior Citizens

DR. CLINTON BAMBURGER, President, Na-tional Legal Aid and Defender Association

Resource Panel

LEON JAWORSKI, President, American BarAssociation

JOHN DOUGLAS, Former President, NationalLegal Aid and Defender Association

ALFRED CONARD, President, Association ofAmerican Law School

JAMES W. COBB, President, National Bar As-sociation

MARVIN LEWIS, President, American TrialLawyers Association

C. NORMAND POIRIER, President, FederalBar Association

NORMAND J. KALCHEIM, Chairman, Corn-mittee on Legal Problems of the Aging, Atheri-can Bar Association

EDWIN VILLMOARE, Program Developmentand Training Division, Office of Legal Services,0E0

PRESENTATION OF RESOLUTIONSFOR DISCUSSION AND ADOPTION


234

,C

THE SESSION REPORTRecommendations

1. The Law Enforcement Assistance Adminis-tration, the Department of Housing & UrbanDevelopment, and other Federal agencies shouldprovide funds for new methods to protect the el-derly against crime. For example, special securitymeasures should be included in 'all housing occu-pied exclusively or largely by the elderly, such asways to call the police from each residence, highquality door and window locks, and extra guards.Social Security and other government checks canbe sent on varied dates instead of all at once, andcan be sent, with the consent of the elderly, di-rectly to banks.

2. Social services should be designated to workclosely with-police departments so that all elderlypersons who are victims of crime, or who reportnon-criminal problems to the police, can obtainall necessary assistance. Such agencies might bewithin or outside the police department itself.Emergency assistance should be immediatelyavailable for persons who have suffered loss ofchecks or money, personal injury or other dam-age. A single telephone number should be publi-cized so that the elderly can readily obtain theseservices. The Law Enforcement Assistance Ad-ministration and other Federal agencies shouldprovide grants to agencies to provide these serv-ices. And the local Bar Association should de-velop programs to ensure that victims of fraudcan obtain attorneys to represent them in suitsseeking compensation for their losses.

3. The criminal justice system should give spe-cial assistance to elderly persons who are victimsof crime or are witnesses in criminal cases. Forexample, police officers, prosecutors, and defenseattorneys should be especially trained to commu-nicate with the elderly. Elderly witnesses mayneed to be provided with transportation for courtappearances. Trials may have to be conductedmore promptly to relieve the burden on the el-derly from repeated and protracted court appear-ances. The Federal Government should provideassistance to these efforts such as by includingthese ideas in training provided by funds- of the

Law Enforcement Assistance Administration forpersonnel.of the criminal justice system.

4. The Federal Government should providefunds to allow consumer protection agencies, withstaff, to be established or expanded by State,county or city government in every locality to pro-tect the elderly from fraud. They should developeducational techniques to alert the elderly to thekinds of frauds frequently practiced and the needto consult a legal service or other attorney whenlarge purchases are being made. They should alsodraft statutes needed to protect the elderly, suchas allowing several days for recession from con-tracts made with door-to-door salesmen of homeimprovements or various 'consumer goods.

5. Fraud units should be established in Fed-eral, State, and local police and prosecutingoffices. The personnel of these offices should re-ceive thorough training in methods to detect andcombat schemes used to deceive the elderly. TheFederal Government, either directly or throughthe Law Enforcement Assistance Administration,should provide training and funds to enable suchprograms to be established.

6. The Federal Government (through theOffice of Economic Opportunity, any successorlegal service agency providing funds for legalservices -to the poor, or other agency) should setaside funds to be used -for special legal services toserve the elderly which are at least proportionateto the elderly's share of the total poor. Theseservices could be provided by existing legal serv-ice programs or new -programs. A minimum of$10,000,000 a year should therefore be set asidefor this purpose immediately. Some of thesefunds should be available to allow organizationsof the elderly to retain partial fees or prepaidlegal insurance for the elderly whose incomes areinadequate to pay full legal fees or the cost ofsuch insurance.

7. The Federal Government (through theOffice of Economic Opportunity, any successorlegal service gency, or other agency) should es-tablish a special center concerning legal rights of

235

the elderly comparable to its centers relating tohealth, housing, consumer, migrant problems.The center should do research, bring test cases,draft and work for model legislation, train legalservice attorneys and legal aides, and have addi-tional funds to support demonstration and re-search concerning the regal problems of -the el-derly.

8. The Federal Government (through theOffice of Economic Opportunity, any successorlegal service agency, or other agency)- should pro-vide funds to train elderly laymen as paid legalaides and to operate programs in which theseaides can act as advocates forthe.elderly beforeadministrative agencieg.

9. Legislation to establish a legal servicesagency to assume the responsibilities of the Officeof Economic Opportunity relating to legal serv-ices should assure that the elderly are representedon the agency's board of directors in approximateproportion to their share of the poor.

10. Legal service programs should themselvesdevelop or work closely with existing outreachprograms to the elderly poor so that the elderlyare fully aware of and have full accessibility tolegal services.

11. All Federal and State benefit programssuch as Medicare, Medicaid, and Old Age Assist-anceshould provide for the payment of attor-neys' fees, which are not taken from the benefitsto which the elderly are entitled, for all elderlypersons who challenge decisions to deny, reduce,

or limit benefits. These fees should be adequateto attract attorneys to provide service to elderlyclients regardless of income.

12. All Federal and State benefit 'programsshould explicitly notify in writing all elderly per-sons whose benefits are denied, reduced or lim-ited, that they have the right to representation byan attorney or trained lay advocate, the desirabil-irrof this representation through legal serviceprograms, Bar Association referral committees,and other means. The Federal or State govern-ment should provide for free counsel chosen bythe elderly if the elderly cannot otherwise obtaincounsel.

13. The elderly should be provided free, com-petent attorneys in all proceedings relating tocivil commitment, conservatorships, and otherproceedings brought to restrict their freedom orother legal rights. Such legislation should allowthe elderly to pay for persons of their.own choos-ing.

14. The States should adopt legislation provid-ing public guardians, conservators, and adminis-trators without cost to the elderly who cannotafford from modest assets to pay for these serv-ices. Such legislation should allow the elderly topay for persons of their own choosing.

15. A subcommittee of this Session should -con-tinue to operate after the Session is concluded towork with the leadership, staff, and Delegates tothe Conference and with other governmentofficials to carry out the above recommendations.

Roster Of Planning Committee

Nongovernment

Bruce Terris, Chairman, Attorney, Washington,D. C.

GovernmentCarlile Bolton-Smith, Assistant to the- Director,Bureau of Hearings and Appeals, Social Security Ad-ministration, Department of Health, Education, andWelfare, Washington, D: C.

Roberta Brown, Director, Office of Services to theAged, Washington, D. C.Jane Comerford, Social Case Worker, Mental HealthDivision, Public Defender Service, Washington, D. C.Axel Kleiboener, Attorney Advisor, Office of Crimi-nal Justice, Office of the Deputy Attorney General,Department of Justice, Washington, D. C.

Frank M. Stewart, Technical Assistant, White HouseConference on Aging, Washington, D. C.

236

Robert Brown, Associate Director, Legal Researchand Services for the Elderly, National Council ofSenior Citizens, Washington, D. C.

Alan Hurst, Research Assistant, Institute of CriminalLaw and Procedure, Georgetown University 1.4wCenter, Washington, D. C.

David H. Marlin, Director, Legal Research and Serv-ices to the Elderly, National Council of Senior Citi-zens, Washington, D. C.

Reports of the


YOUTH AND AGE

VOLUNTEER ROLESFOR OLDER PEOPLE

he American National Red Cross, theB'nal I3'rith Women, the CommunityService Society of New York, theJewish Social Service Agency, and the

National Center for Voluntary Action made upthe membership of the Planning Committee forthe Special Concerns Session on Volunteer Rolesfor Older People. The Foster Grandparent Pro-gram and Retired Senior Volunteer Program ofACTION also sent representatives to the Com-mittee.

The Participants

That older and retired persons want to put theirexperience, skills, and time to the service of othersas volunteers in their communities was clearlydemonstrated by the participants in -this SpecialConcerns Session. Approximately 400 delegatespre-registered for this Session; they were joinedby many other Delegates, observers, and invitedguests. Of the 17 Special Concerns Sessions,the Session on Volunteer Roles for Older Peoplehad the second largest attendance. Official Dele-gates were the only persons at the Session whowere permitted to vote on the recommendations.The participants came to the Session withoutprior knowledge of the format or content of theprogram, but each brought his conviction anddedication to the idea that older people couldfulfill themselves by giving.

The Program

The Session focused on the development ofpolicy and action recommendations that facilitatevolunteering by older persons. As background forthe formulation of recommendations, some consid-erations significant to volunteering by older per-sons were brought into focus in four brief presen-tations.

In her opening remarks, Mrs. Ripley notedthree major current trends in volunteering contri-

239


PROGRAMVOLUNTEER ROLESFOR OLDER PEOPLE

2.

PresidingMRS. ALEXANDER RIPLEY, Presi-dent-Elect, National Conference on Social Welfare

8:00 A.M.-8:15 A.M.Welcome and OpeningRemarks

8:15 A.M.-9:15 A.M.Background for the For-mulation of Recommendations

Volunteering TodayMrs. ALEX-ANDER RIPLEY

Volunteer RolesCHARLES ARCHI-BALD, New Jersey Department of Insti-tutions

--Factors Influencing Volunteering byOlder Persons GWEN O'NEAL,American Association of Retired Persons

Value of Volunteering by Older Per-sonsHARRIET NAYLOR, NationalCenter for Voluntary Action

9:15A.M.- 9:30A.M. Assignment to Sub-groups

9:30 A.M.-10:45 A.M.Preparation of Recom-mendations

Discussion Leaders

Subgroup No. 1CHARLES FREEMAN,The New York Room

Subgroup No. 2THOMAS TEWEY,The Massachusetts Room

Subgroup No. 3ROBERT CURREY,The California Room

Subgroup No. 4DENISE CAVENAUGHand RICHARD- SHAPIRO, The Con-gressional Room

11:00 A.M.-12:00 A.M. Concurrence -on FinalRecommendations


busing to the growing significance of the-volun-tary roles in our society: the great-expansion, bothin quantity and in variety, of opportunities forvolunteer involvement; the expanding resourcesfor volunteer recruitment (the older person andretiree being one of-the most significant of these);and the emergence of special professional leader-ship for voluntary effort at both local and nationallevels, under private as well as governmental aus-pices.

In volunteering, individuals have opportunityto fill many roles Mr. Archibald noted. "Volun-teers" are frequently seen as those who give directservice to others in regularly scheduled programs.Attention was called to the importance of the ser-vice of volunteers in policy and planning rolesand in leadership of the activities of others as wellas in roles of stimulating participation in groupsthat organized 'around special interests, includinggroups that direct their volunteer efforts to mat-ters of concern to the well-being-of senior citizensthemselves.

Chief among the significant factors influencingvolunteering by older persons are the attitudes andmisconceptions of others regarding the capabilitiesof older persons. Miss O'Neal pointed out thatgreat variations in physical, emotional and mentalcapacities exist at every age, and that the inclu-sion of older persons in setting goals and in for-mulating plans and policy may well be the missingingredient in achieving effective, fresh approaches.The fact that some older persons cannot affordfinancially to volunteer is a factor to which at-tention should be given, not in terms of moneyalone, but of fundamental convictions regardingthe values of volunteer services. Job design atevery level is the key to sound planningbuildingthe worth of the volunteer participation into theorganization's total plans.

Volunteering by older persons has special valuesto them as well as to the persons served. As someof these, Mrs. Naylor pointed out: opportunitiesfor the use of knowledge, skills, and judgementacquired through life experience; time for thought-ful listening to persons and problems; the olderperson's need to fill roles- useful to others; andhis greater freedom, to do and be things not pos-

sible in his years of employment. The potentialmanpower in the pool of retired, older per-sons presents both a resource and a challenge tovolunteering.

Following the presentations, four subgroupswere organized to allow as generous an opportun-ity as possible for conferees to express their think-ing. As a means of arriving at substantive recom-mendations in this broad subject area, each sub-group was asked to consider the need, and developrecommendations to meet the need in one offour areas. The Delegates were told that recom-mendations could be developed regarding anyother aspect of volunteering by older persons asthey saw the need, but that all recommendationswere required to receive the approval of the en-tire Session. The four areas were:

1. Recommendations to agencies and organiza-tions with respect to strengthening theircommitment to the involvement of olderpersons as volunteers.

2. Recommendations With respect to how olderpersons can be encouraged to give volunteerservice, including recommendations to or-ganizations whose membership includeolder persons.

3. Recommendations with respect to meetingthe individual's cost in volunteering (reim-bursement and stipends).

4. Recommendations regarding special consid-erations in the development of volunteerparticipation that would encourage orstrengthen the involvement of older persons.

Both the subject matter of this Special ConcernsSession and the small group discussion methodwhich was used contributed to the participantsexchanging a great deal of information and ex-perience regarding the stimulation and develop-ment of volunteer participation by older persons,particularly in the areas of recruitment, guidance,and recognition of volunteers. Much 'of this wasnot essentially in the nature of recommendationsfor action; Recommendations accepted -by theparticipants reassembled in a general session, asreported below, reflect the substance of the muchmore detailed and cowprehensive reports of thediscussion sub-groups.

240

Recommendations1. A national policy should be established to

create awareness in the Nation at large about theworth and talents of older -adults as a nationalresource and to encourage older adults to volun-teer. In this connection, widest possible use shouldbe made of pre-retirement counseling as a- pointof interpreting volunteer opportunities.

2. Existing national older adult volunteer pro-grams should be expanded and funded at ade-quate levels in order to serve extensive numbersof older persons.

3. There should be support for and strengthen-ing of national leadership (governmental andvoluntary) through which local organizations, de-partments, and agencies- can be encouraged andassisted in developing volunteer participation byolder persons.

CominentIn discussion-of this recommendation, as il-lustrative of national leadership, referencewas made to the National Center for Volun-tary Action, the Center for a VoluntarySociety, Retired Senior Volunteer Program,and others.

4. Agencies and organizations (governmentaland. voluntary -at any level) should adapt theirprograms to the use of older volunteers and pro-vide adequately for their training, their -growth,and recognition of their accomplishments; should

provide for adequate staff leadership and prepara-tion of staff to support volunteer involvement.

5. Jobs developed for older volunteers should-meet the needs of older persons, provide for pro-gressive levels of responsibility, and recognize theneed for special job design for adults.

6. Budget planning in both government andivoluntary agencies should provide for makingavailable to older volunteers assistance, whenneeded, with transportation, incidental expenses,and insuran. protection.'

7. Appropriate interested organizations, agen-cies, and departments (governmental and volun-tary) should endeavor to develop a workable def-inition of a Volunteer.

CommentDiscussion-of This recommendation indicatedthe diversity of views with respect to what isa volunteer. But there was concensus on theneed to provide the widest possible rangeof opportunities for older persons to be in-volved in the life of their communities, fromfull-tiMe paid employment to part-time unremunerated service.

Concern was 'expressed regarding the needto clarify, at local levels, the character ofvolunteer service in order to insure that_giv-ing such service should not infringe- therights Of older persons to receive public as-sistance or other public support. .


Nongovernment

Ruth Breslow, Coordinator of Volunteers Services tothe Aging, Jewish Social Service Agency, Rockville,Maryland

Mrs. John Byrnes, Volunteer; American NationalRed Cross, Washitigton, D.C.

Helen Diamond, Director of Training & Develop-ment, B'nai B'rith Women, Washington, D.C.

David Jeffries, Vice President for Administration,National Center for Voluntary Action, Washington,D.C.

Janet Sainer, Director, SERVE Projects, CommunityService Society of New York, New York

241

Phoebe Steffey; Assistant Directoi, Office of Pro-gram Development, American National Red Cross,Washington, D.C.

Isolde Weinberg, Information Researcher, NationalCenter for Voluntary Action, Washington,_ D.C.

GovernmentAnne C. Johnson, Chief, Foster Grandparent Pro-gram, ACTION, Washington, D.C.Alfred N. Larsen, Chief, Retired Senior Volunteer-Program, ACTION, Washington, D.C.Frank Stewart, Technical Staff 'Assistant, WhiteHouse Conference on Aging, Washington, D.C.

'I

YOUTH AND AGE

hen the Planning Board of the 1971White House Conference on Agingwas initially constituted, no youngpeople were named as members. Be-

lieving that the social problems of aging are aconcern of youth as well as adults, Elliot Rich-ardson, Secretary of Health, Education, and Wel-fare, directed Conference planners to involvemembers of the younger segment of the popula-tion.

At its first meeting in the Fall of 1970, the Con-ference Planning Board included youth represen-tatives from eight national youth organizations.These youthful members of the Conference plan-ning body sought to inswe the meaningful partic-ipation of young people in all Conference activitiesand arranged to meet again with the ConferenceDirector to discuss additional routes which thisinvolvement might follow.

Stemming from these two meetings, two youthdelegate positions were allocated to each Stateand territory which was to name Delegates to theConference. In addition, the initial eight youthrepresentatives*had their_number expanded td in-clude-representatives from various minority groupsand_ from among youth not involved in organizednational activities. And, as the Youth Participa-tion Committee of the Planning Board, the groupwas charged with the responsibility for devel-oping plans for- youth participation in the Con-ference.'

Although desirous of having young ConferenceDelegates participate with the same rights andprivileges as other -Conference participants, theYouth Participation Committee sought to makeit possible for Youth Delegates to meet as a groupduring the Conference to develop proposals re-flecting their distinctive attitudes and particularinterests. Through the Special Concerns Session onYouth and Age, Youth Delegates to the Confer-ence, joined by other interested Conference Dele-


gates, observers, and guests, were provided the op-portunity to express themselves and to presenttheir recommendations.

Development of the Session

Central to the planning of the Special ConcernsSession was the notion that it should build uponthe unique opportunity presented by having youngpersons from across the country named to partic-ipate in a conference on the problems of theelderly. To this end, at the initiative of the YouthParticipation Committee, the White House Con-ference on Aging sponsored a series of 4 onedayregional youth meetings. During- October 1971,Boston, Atlanta, Chicago, and-San Francisco eachhosted meetings Df Conference Youth Delegatesfrom geographically proximal States and terri-tories.

The regional "youth think" sessions served as animportant preparatory activity for the Session it-self. Lacking the specificity of concern and focuswhich might be thought to characterize other spe-cial Conference Sessions, it became possible,through the mechanism of the regional discus-sions for Youth Delegates to identify commonareas of concern to serve as the themes aroundwhich substantive discussion and refined recom-mendations- could be forthcoming in the lengthof the morning Session Ln Special Concerns.

The Youth Delegateslargely students fromhigh schools and colleges, but including graduatestudents and young professionals -working withthe agedthrough their discussions with othersfrom their region, with members of the YouthParticipation Committee, and with Conference'Chairman, Arthur S. Flemming, shaped theirthoughts into a working document for use at theSession: -Each regional grouping, drawing uponthe discussions Of those meeting before it and uponthe work of the Youth Participation Committee,worked to formulate the document attached as an-Appendix to this report.

243

__!

Reflecting the concerns of over 100 young peo-ple between the ages of 17 and 25, this documentserved to focus the program and recommendationsof the Special Concerns Session on Youth and Agearound:

1. Youths' overriding concern with severalmajor societal issues.

2. A specific concern with young peoples'awareness, attitudes, and education directedat understanding aging and the problems ofthe aged.

3. An interest in community service and vol-untary action directed at ameliorating theseproblems.

The ProgramAs suggested in the following agenda, most of

the morning Session was spent in small group discussions. Delegates chose to participate within oneof three work groups, each group considering oneof the three core-areas of concern identified byyouth in their preparatory meetings.

To insure access to those who could implementtheir recommendations, the Session participantsaddressed their remarks to an invited listemngpanel. Persons working within national organiza-tions, particularly those directly involved in youthand volunteeractivities, and representatives of of-fices within the Federal Government with specialinterest in student and youth affairs, heard thechallenge to action presented by the young Dele-gates. Also there to listen, as well as to presentthe keynote address, was Webster B. Todd,Executive Director of the Conference.

1971 wiirrE nous': coNnmuNci: ON AGING

PROGRAMYOUTH AND AGE

PresidingTHOMAS E. -FIELDER, Chairman,Youth Participation Committee, WhiteHouse Conference on Aging

8:00 A.M.Welcome and Opening of theSession, THOMAS E. FIELDER

Introduction of Listening PanelJOAN CATON, Special Assistant

for Student Affairs, Office of theSecretary, Department of Health,Education, and Welfare

GEORGE FREEMAN, Director,Washington Bureau, Boy Scouts ofAmerica

MABEL HAMMERSMITH, Pro-gram Specialist, Girl Scouts of the

States of America

SCOTT HUNT. Director,-Office ofYouth and Student Affairs, Officeof Education, Department of-Health, Education, and Welfare

ALEX MALESKI, Director, Spe-cial Services, Boys Clubiof America

MARGO MARUSI, Staff Member,Office of Robert H. Finch,, Coun-selor to the President, The WhiteHouse

(Iniro.baion of Listening P.sritl Coned)

THOMAS MOONEY, Vice Presi-dent, National Students Association

JACK TENNANT, Coordinator,Office of Teacher Retirement, Na-tional Education Association

STANLEY B. THOMAS, -DeputyAssistant Secretary for Youth andStudent Affairs, Department ofHealth, Education, and Welfare

BARBARA WILLIAMS, Member,Board of Governors, The AmericanNational Red Cross

:ARTHUR WEINER, Urban/Sub-urban Relationships Executive, BoyScouts of America

8:20 A.M.Address, WEBSTER B. TODD,Jr., Executive Director, WhiteHouse Conference on Aging

8:35 A.M.Group DiscussionsYouth Statement of ConcernsYouth Awareness and AgingYouth and Voluntary Action

10:30 A.M.Presentation of Group Recom-mendations for Discussion and Rat-ification


244

THE SESSION REPORT

I. ConcernWhereas, we recognize young and old are one;

and both deserve dignity and respect; and togetherare concerned with the quality of life in the fu-ture as well as the present; and in recognition ofthe urgency of the situation; we therefore pro-pose the following:

1. A radical and immediate reordering of ournational spending policies- and economicpriorities to place human needs before thematerial needs of the military and the spaceprogram.

2. A wide range of accessible-services must beprovided in the areas of nutrition, health,housing. medical and social care. But themost crucial need is to provide all citizensa guaranteed adequate income enabling themto purchase goods and services of their. ownchoosing.

3. That both young and old be represented inthe decision-making processes of all local,State, and national commissions and boardsaffecting the aging.

4. That all persons, particularly the aging, begiven the legal right to choose to die nat-urally and in dignity, avoiding prolongedillness, pain, confinement, and degradation.

5. That we must bridge the gap of young andold by encouraging alternate forms of socialorganization to supplement family structurefrom which young and old are often with-drawn.

6. That government-immediately provide -ade-quate and sufficient housing -for the agingincluding communal settings where youngfamilies and the old can live together.

7. That society should adopt a policy of educa-tion for life such as preparation for job,family, retirement and use of leisure time.This education should begin with youngchildren developing a philosophy of lifeand should be developed by consultationwith government, business, labor, and edu-cational institutions,

8. We urge that many more employment op,portunities, including part-time jobs, bemade available by government and by theprivate sector for both youth and the aging,particularly those jobs which enable themto -work together _and relate to one anotherfor the betterment of themselves and _theircommunities.

H. Awareness

As citizens we are all entitled to full partici-pation in the democratic process. Therefore, weurge that public and privately-sponsored civic edu-cation programs be implemented for the agingto inform them of their legal rights and politicalprivileges and to encourage them to exercise theserights and privileges collectively.

Wherever appropriate, economic boycott, non-violent protest and demonstration, and otherforms of political activity should be used to pursuethe goal )f a better life for all Americans.

In order to effectively implement the positionsstated above, it is recognized that awareness ofthe continuation of life from conception throughdeath is an essential aspect of education through-out the life cycle. It is further recognized thatthere will be many avenues of activity that mustbe exploited and maximized.

We submit the following resolutions regardingeducation:

1. Federal, State, and community agencies shallearmark funds and appoint committees-within the year following the White HouseConference on Aging for the preparation,and utilization of curricular and educationalmaterials for all school levels that deal withthe biological, medical, psychological, social,and environmental aspectS of the continua-tion of life from conception through death.Further, this shall be implemented with in-service training for teachers at all levels, aswell as continuing education for persons allthrough life.

245

It is particularly suggested that in all appro-priate educational institutions, courses suchas sociology, anthropology, etc., be offeredin which younger and older persons canboth enroll on a credit or non-credit basis.

3. Conference follow-up -shall include:a. Contact with student governments at

every available educational level- toidentify a vehicle for their contributionstowards the realizations of the policiesadopted at this Conference.

b. Contact with existing and projectedFederal agencies with funded programsfor youth opportunities' in communityactivities (e.g. ACTION, DomesticCouncil, etc.) to identify aging as anurgent social issue.

c. Contact with universities, State and com-munity colleges and community organi-zations to establish seminar and fieldexperience courses that will involvestudents in all disciplines.

4. Wherever possible, educational systems atall levels should utilize qualified older per-sons as paraprofessionals._Formal credentialrequirements should be relaxed without therelaxation of remuneration for these serv-ices. Funds should beprovided by an ap-propriate Federal agency for these services.

5. We think that without neglecting the incor-poration of preparation -for living into -theschool system, it is urgent that every avail-able avenue for informal education be po-tentiated. Priority (in the appropriation offunds) shall be given to the promotion ofinteraction between youth and aged outsidethe formal school system, in voluntary- or-ganizations and other common activities asa conscious reflection of the need to changecurrent cultural attitudes and stereotypes ofall stages of life.

6. It is finally urged that the President of theUnited States include, as part of a nationalpolicy on aging, an emphasis on achievinglife cycle education as a mandatory compo-nent of all educational institutions.

HI. Action

One of the major aims of the White HouseConference on Aging should be to harness the ac-tivity and energy of youth and link it to the solu-tion of the problems confronting the aging. Threeareas of youth volunteer activity suggest them-selves for immediate action:

1. Providing information to senior citizens re-garding existing social services and financialresources.

2. Rendering direct service to senior citizens.3. Acting as advocates in behalf of the elderly.

However, it is imperative that such programsinvolving youth and aging recognize a relationshipof reciprocal rewards. Additionally, young- peopleshould be reimbursed for expenses incurred involunteer activities.

246

Suggestions for immediate action include:

1.. Providing information

a. Undertake local projects to identify ex-isting resources for and needs of agingAmericans.

b. Staff telephone information and crisiscenters.

c. Utilize the media to inform the agingabout existing resources.

d. Guarantee that youth and aging be rep-resented in all aging-related agencies.

2. Rendering service

a. Form transportation -teams to assist theelderly.

b. Assist in home upkeep and maintenance.

c. Establish friendly visitor programs.

d. Utilize programs sponsored by ACTIONto provide needed staffing.

e. Assist with programming activities inSenior Centers.

f. Provide -escort services, especially atnight.

Provide activities that will- promote so-cial and sexual interaction for the aging.

g-

3. Acting as advocatesa. Utilize existing advocacy groups on be-

half of the elderly.

b. Form community-wide advocacy groups,which will also serve as grievance-boardsand community coordinating committeesfor volunteer activities related to aging.

In-order to implement a program of young as-sisting the aging, means are needed to -mobilizeand coordinate community activities. This can beaccomplished by- Services to Elderly People-

-_(STEP)*, through the formation of local-steeringcommittees. National youth organizations andState agencies should encourage their local affili-ates to.begin creating these committees and _to pro-vide the funding for training programs in thestudy of the aging.

* The STEP concept is discussed more fully in_ the documentengendered by the Youth Delegates in their regional meetings.

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Platform Statement of Youth Delegates'

1971 White House Conference on Aging

Introduction

In preparation for the Special Concerns Sessionon 'Youth and Age, Regional meetings ofYouth Delegates to the 1971 White House Con-ference on Aging were held to develop a compre-hensive working statement of youth concerns andproposals regarding aging and society.

The structure of this working document, whichlent itself to adoption as the framework for thedevelopment of recommendations within the Ses-sion itself, includes a statement of overriding con-cern- and an elaboration upon the themes of edu-cation and voluntary action among youth.

From this working statement, the thought andstudy which its preparatiol. fostered, and theunique opportunity presented young people tomeet in a Special Session of the White HouseConference on Aging, specific recommendationswere framed and presented,to the Nation.

Youth Statement of Concern

The priorities- of this country are not inthe best interest of the needs of the peopleparticularly the aging. We, as citizens ofthe United States of America, isolated andforgot the elderly after allowing them tosacrifice their lifetimes to make it possiblefor us to enjoy a high standard of living.Therefore, we, as Youth Delegates- to-the1971 White House Conference on Agingstrongly support .

Equality for the aged.A balance of spending hi proportion to

Suhrnitted=for the consideration of Delegates to the SpecialConcemc Session on Youth and A.

the percentage of the population theyrepresent, particularly in terms Of Fed-eral funding and State agency spend-ing.

An investigation of national prioritieshi terms of defense and-space spendingas compared to domestic needs.

Youth Awareness of Aging

Aging is not a sudden occurrence-at 50 or 65,but a developmental process proceeding at a rateunique to each individual. Too often, however,peopleand especially young people -- ignore the-developmental aspects of aging and, as a result.'hold many- misconceptions about the aging proc-ess. A more realistic understanding-of others and-a fuller acceptance of one's own developmentalprocess would be gained if individuals were awareof the -potential -problems and disadvantages ex-citements and rewards -of -each stage of the lifecycle from infancy to old-age. Such preparationfor living should deal with the biological factorsof growth-and physical change, -the ensuing psy-chological- needs and strengths, social environ-mental influences affecting personal-development,and the responsibilities of society in dealing-with-the problems and concerns of individuals of dif-ferent age groups.

Awareness of the devel-opmcntal process can be_gained- through association with others- of differ-ent ages. Youth, for instance, can gain under-standing and insight into the concerns of the -el-derly through involvement in common activities-(the voluntary action -segment of this documentdeals more specifically with how face-to-face in-volvement can be- attained). Rut knowledge of-thedevelopmental process and- the social conditions

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that may affect individuals at different steps of thelife cycle can be better gained through formallearning.

The concept of preparationfor living could beincorporated into the school system at all levelsto alert individuals to the feelings and experiencesof others as well as how one's own feelings andexperiences fit into the Overall pattern of life.Such a program would also utilize the resourcesof various segments of the population in theteaching process and tap the resources of youngpeople in-alleviating some of the social problemsaffecting older individuals while at the same timegaining valuable practical experience.

In this section, the following items will be dis-cussed:-

1. Preparation for life at the elementary and pre-elementary school level.

2. Continuing emphasis including career possibil-ities and social problems.

3. Utilizing college students in alleviating somesocial problems.

IDEAS OR DISCUSSION

DiscussionSjritithe regional meetings revolvingaround the -topic -of youth awareness produced=several ideas and -suggestions for ways youthknowledge and understanding of the agingTtoc=css could be increased through the existing schoolsystem. kle-as which are general -in scope are listed-first, followed by those pertaining to elementaryand= high =schooi-s, and universities -

1. Generala. Update the educational system in -order to

-emphasize the individual-developnient-of a lifestyle and philosophy of life that are dynamici.e. accepting and adjusting to change in the.larger-society and in one's physical and mentalcapabilities.

-b. -Expand the scope ofeducation to includeinformation and possibly training for youth on

-the constructive use of free time.

c. As our society becomes more technologicaland industrialized, schools must hear major re-sponsibility for educating people of variousages for second careers or for leisure-time activ-ities.

d. Develop adult education, community aides, .

field placement, training program' for volun-teers of all-ages and educational levels.

2. Pre-Elementary and Elementary SchoolLevelsa. Utilize elderly persons as nursery school help-ers -and day care-center supervisors.

b." Encourage school administrators to availthemselves of older persons as teacher aides,reading tutors, etc.

c. -Provide situations for face-to-face_ interactionbetween young children and older people.d. Hold a National Poster Contest on the theme-Young and Old Together.-

3. High Schoolsa. Provide options for relaxing school require.ments in order that young people may becomemore involved in the community.

b. Discuss the problems of -the aged and ofaging and implications for society as part -ofcontemporary -American government, currentissues, classes, etc. Also, provide optional-

-field experience in social service agencies, seniorcitizens community centers, nursing homes, witholder- individuals, etc.

c. Encourage instructors in the social sciencefields_ :(psychology, sociology, etc.) and in- bi-ology-and health to incluch information on themental, physical, and social aspects of aging,d. In vocational- education programs, promotecourses which will train yozing-peor h. to -workwith older people in- healtil instit.reS such as-nursing homes and hospi_als. Ltilize tetitedlworkers as resource_people >r part-time teachers-in vocational education courses.

e. In home economics-programs, invite mobileelderly from the community and nursing homes(and provide transportation) to food serviceclasses where _meals -are prepared. --Where pos-sible utilize older women in cooking, sewing, orother craft classes.

f. For school activities such as plays, musicals,and sports, set aside special accessible sections,for older: persons, both from the community andfrom nursing -homes. Arrange special _perfor-mances and provide the transportation.

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4. Colleges and Universitiesa. Emphasize research in gerontology.

b. Offer interdisciplinary courses de*aling withthe aging process.

c. Organize more opportunities for field ex-periences for credit.

d. Emphasize flexibility, both in involving var-ious disciplines and types of placement offered.

PROPOSALS FOR IMPLEMENTATION

In order to implement the ideas listed in theprevious section, several program ideas or mech-anisms have been developed. It should be assumedthat the people who know the most about growingold arc those who have actually gone through theprocess. Additionally, it can be assumed that thosewho teach best are usually those who have done itthroughout their lives. If these two assumptionsare granted, then the following proposal shouldenable us to have a significant impact on increas-ing the awareness of the young about growing old.

1. The National Retired Teachers Association(NRTA) should be contacted by the WhiteHouse Conference on Aging follow-through staff,or a representative from the Domestic Council onAging, or from the Department of Health, Edu-cation, and Welfare's Office of Youth and StudentAffairs, -to develop a program and curricula thatcould be used in elementary schools throughoutthe country to achieve the goal of awareness byyouth of the aging process. While the NRTA isdeveloping this program, the National EducationAssociation (NEA), the National Association ofSchool- Boards, and the National Association ofElementary School Principals could also be con-tacted to encourage -them- to initiate this-programin the elementary schools 'throughout the country.Once this program has been developed and re-ceived acceptance by the major organizationsmentioned above, the NRTA could move to im-plement it, in some cases using retired teachers toteach the program, and, in others, using retiredteachers to tutor the teachers who would teach theprogram. In 'addition to aiding the young, such aprogram would utilize a tremendous amount oftalent by using retired teachers manyof whomwould enjoy becoming partially active.

2. Contact should be made by the White House

Conference on Aging follow-through staff, or bya representative from the Domestic Affairs Coun-cil, or from the Department of Health, Education,and Welfare's Office of Youth and Student Affairswith the National Education Association, NationalAssociation of School Boards, and the NationalAssociations of Elementary and Secondary SchoolPrincipals to:

Encourage the involvement of elderly people asclass resources.

Expand the scope of education to include prep-aration for living emphasis.

Delevop community-oriented field experiencesin the field of aging.

3. A "National Poster Contest" could be or-ganized by the State agencies on aging. Contestswould be arranged on local level' in any way theagencies see fit. Then schools, youth gm-ups, andlocal committees on aging would take part. Hope-fully, these posters would be distributed to localbusinesses, nursing homes, senior citizens' clubs,etc. for their use after the contests.

4. A means of reaching high school students isthrough individual high school newspapers. Newsreleases or a series of them could be sent to theschools.

5. Young people throughout the United Statesshould be alerted to the needs, problems, andcontributions of older people. A vehicle whichreaches many young persons -is the college radiostation. A 15-minute program could be organizedon the theme "Young and Old Together." Such aprogram could serve to inform, inspire, andsensitize young people in the area of aging. Theprogram could include:

a. 1-,minute music (hopefully, specially com-posed song)

b. 1-minute introduction by host (well knownfigure)

c. 30seconds of facts on aging

d. 10-12 minute discussion between some YouthDelegates to the White House Conference onAging and perhaps some elderly persons on thetopic-of youth-age cooperation and involvement.

e. 30-seconds of music and "for further- infor-mation. .

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6. ACTION, a new Federal agency, has -pro-vided_ funds. to colleges and universities for thepurpose of locating and developing opportunitiesfor students to spend a year working -on anidentified social-problem for one year of collegecredit. ACTION, Department of Health, Educa-tion, and Welfare Office of Youth and Student-Affairs,:and the Domestic Council Committee onAging_should encourage utilization of these fundsfor field placement in aging by colleges anduniversities.

7. Conference follow up should include contactwith universities in regard to setting up seminar-field experience courses. These should be fairlylong-in duration to enable students to become pro-ficient in their-particular jobs as well as to provideSometneasurt of continuity to the community. Theaim- of the -project is to involve students -from

,disciplines (medicine, social work, law,health,Ionfe economics, etc.) to develop a-multi-purpose community center in a senior citizensneighborhood. In--addition to Work in the field,students would -be exposed to lecttires or-participatein seminars- dealing -with the problems and con-cerns oEthe elderly,or other related topics.

Voluntary ActionThe=concept of an action White House Con-

ference oil Aging in 1971 can be nowhere betterrealized than in activity and interaction betweenyoung and elderly Aniericans. On the one hand,the elderly have a number of- pressing problemsthat demand immediate action. On the other hand;young people -have unlimited resources of energyand idealism. Accordingly, one of the major aimsof the White House Conference on Aging should:be -to harness=this youthful activity and link, it tothe Solution of the -problems confronting agingcitizens.

Iri developing a _program of volunteer youthactivity throughout-thelcountry to itSsist the elderly,three areas of involvement- provide immediateopportunities for service and thereby suggest them-selvo aaiigh prioritygoals:

1. Provide Information to senior citizens re-garding existing social services and financialresources.

Renderdirect service to senior citizens

3. Act- as advocates in behalf of the elderly

Specific projects designed to meet these goalswill vary to adjust to different areas of the country,but each goal can be fulfilled in any region.

To marshal the efforts of young people in themost effective yet immediate manner, several keyassumptions must be made. First, though nationalin scope, such a program can best serve the needsof the aging if implemented on a local, communitylevel. Second, while initially some youth may beuninvolved, the most effective way to mobilizemany young people immediately is through na-tional youth organizations. Consequently, in de-veloping a volunteer youth program to assist theelderly, both, the assumption that it should beimplemented at the community level, and -thatnational youth organizations can most effectivelymobilize youth should be taken into consideration.

PROJECT IDEAS

A number of projects ideas that could beinitiated at the community level originated out ofthe four regional meetings in October. In mostcases these ideas were not specifically developed,but they were the kinds of programs that oncesuggested could better be formulated in respectivecommunities across -the country to meet eachlocality's special needs.

Following is a compilation of those ideas- or-ganized according to the priority goals they,areattempting to fulfill. Hopefully they will be-dis-cussed, expanded, and either accepted or rejected.1. To- provide information- to senior citizens re-

garding existing social services and financialresources.

a. Undertake a community- centered- projectsimilar to Project FIND I to identify resources,needs, and those who are and who are not re-ceiving available resources.

Project FIND (Friendless. Isolated. Nerdy, Disibled)-7Aprogram of research and service was carried out in communitiesin 12 different partsof the country. The project sought to lb.Cate -the elderly poor, to learn something of the source andamount of their income, their state -of health, housing, needs--for assistance of whatever kind; and to help them secure thebenefits of such services and resources as might be-available inthe-community; and when there-were no such services and resources, to stimulate their development. It-also organized-direct:personal help when necessary. (Supported-by a grant from theeOffice of Economic Opportunity, -Project Find was conducted

-by the National Coo-kit on the Aging,-Inc.).

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b. Provide- community telephone "call-in" cen-ters with vital information to aging, and en-courage elderly to use these centers.

c. Utilize the media, via public service advertis-ing, to inform elderly citizens of existing serv-ices.

d. Insure that older citizens have input, by beingrepresented on advisory and planning commit-tees to social agencies that affect them, so thatbetter delivery and informational systems willbe developed.

2. To render direct service to senior citizens.

a. Form transportation teams to assist theelderly in getting around to shop, for medicalattention, to church, etc.

b. Assist in home upkeep similir to home-maker service.

c. Deliver meals to homes, similar to themeals-on-wheels program.

d. E..tablish friendships with -senior citizensand visit them regularly.e. Utilize the student placement program

sponsored by the new ACTION agency to in-crease the staffs of agencies dealing with theaging.

3. To act as advocates in behalf of the elderly.a. Utiliie existing advocacy groups such as

Urban League, Urban Coalition, public interestgroups, and press them to advocate for seniorcitizens. .

b. Form a community group to act not onlyas advocate, but also as -a grievance body andcoordinator of volunteer activities. Include notjust youth, but also social service agency repre-sentatives (Welfare, Social Security) and peoplefrom organizations such as Jaycees,United Fund,Legal Aid, etc.

PROPOSALS FOR IMPLEMENTATION

In order to implement a volunteer program ofyoung volunteers assisting the aging, means areneeded both to mobilize youth and coordinatecommunity, activities. Accordingly, the followingproposal is presented for consideration in an- at-tempt to facilitate the initiation of an immediatenational action prograth.

STEP (Services to Elderly People)

1. Proceeding from the assumption that a pro-gram will best serve older people if it is com-munity-initiated, the key to STEP will be a localsteering committee.

a. The function of the local steering com-mittee will be to coordinate all volunteer activi-ties, recruit volunteers, and to act as both agrievance board and a clearinghouse for infor-mation.

b.. The committee would be composed ofrepresentatives from youth organizations, social -7service agencies, and other community groups.

2. To initiate the formation of local committees,national youth organizations and State agencieson aging should be directed to encourage .theirlocal affiliates-to begin creating the committees. Inthis manner, young people can be easily contactedand mobilized and two forces would be workingto develop and organize the community steeringcommittees throughout the country.

a. To contact the national youth organiza-tions and the State agencies onaging and thento follow -up and insure that directives are be-ing delivered, one staff member during thefollow-up of the White House Conference onAging will be needed.

b. Each national youth organization shouldassign a staff person to oversee their directives,and to assist local units in initiating-the forma-tion of steering committees.

c. Each State agency on aging should assigna staff person to oversee their directive- and toassist local- units (whether aging boards orwelfare departments) in initiating the forma-tion of steering committees.

3. To facilitate the exchange of ideas betweennational youth organizations, a coordinating bodyshould be formed- composed of the staff personfrom each organization responsible for STEP. Thestaff person from the White House Conference onAging follow-up staff, or from the Domestic Colin=cif Committee on- Aging, or the Department ofHealth, Education, and Welfare's Office of Youthand Student Affairs would also be a member ofthis body.

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4. To facilitate the- exchange of information be-tween community steering committees within, aState, the State agency would act as a clearing-house* for such information. This role would befilled by the STEP coordinator assigned by theState agency.

5. To enable the community steering committeeto function most effectively, a director should be

designated. Such a person would handle the day-to-day' STEP activities in his or her community.The funds, if required, to pay this director couldbe contributed by the participating youth organiza-tions and community groups. Ideally, this indi-vidual would be an elderly person. If funding isdifficult, perhaps a local organization or businesscould release an employee. for several hours aweek to fill this position.

Roster of Youth Participation Committee

Tary Adams, Boys Club of 'America, Anderson, Indiana

David Alvarado, San Antonio, Texas

Decker Anstrom, St. Paul, Minnesota

Margaret Bartosek, 4-H Clubs of America, Rockledge,Florida

Rosemary Baxter, Riverside, California -

Kathleen Broderick, The American National RedCross; Harrisburg, Pennsylvania

Thomas E: Fielder, (Chairman), Boy Scouts of Amer-ica, Paducah, Kentucky

Danny Frank, Garden City, New YorkMelinda Ann Lee, Girl Scouts of the United States ofAmerica, Fresno, California

Patricia Roberts, Lake Village, ArkansasBradley Taylor, National Council of Young Mens'Christian Associations, Dallas, TexasSonya Toledo, Dorchester, Massachusetts

Mary Ellen Tully, Girls Club of America, New York,New York

Steve Zumbach, Future Farmers of America, Manches-ter, Iowa

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