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Appendix 2-Continued

Item 5. Prepared statement of John P. Murphy, president, Northern Page
Valley Senior Citizens Association, Albuquerque, N. Mex.

1148 Item 6. Additional statement of Selma Clever, Albuquerque, N. Mex. 1150 Appendix 3. Statements from individuals and organizations:

Item 1. Statement of Mrs. Frances Quakenbush, president, Residential
Aid and Services Homes (R.A.S.II.), Albuquerque, N. Mex.

1152 Item 2. Statement of John Hernandez, Sr., Mesilla Park, N. Mex. 1153 Item 3. Letter from A. E. Triviz, president, chapter 182, NARFE,

and legislative chairman, chapter 1230, AARP, Las Cruces, N. Mex.,
to Senator Pete V. Domenici, dated May 27, 1974.-

1155 Appendix 4. Statements submitted by the hearing audience: Bologh, Josephine, Albuquerque, N. Mex.

1158 Chan, Tony Q., O.D., Albuquerque, N. Mex.

1158 Crespin's Boarding Home, Las Vegas, N. Mex.

1158 Crespin, Priscilla, Las Vegas, N. Mex.

1158 Crespin, Rosalita E., Las Vegas, N. Mex.

1159 Gonzales, Priscella, Albuquerque, N. Mex.

1159 Gonzales, Tillie, Las Vegas, N. Mex.

11.59 Lucero, Adeline, Ojo Caliente, N. Mex.

1159 McKinney, Mary, Albuquerque, N. Mex.

1159 Morrow, Owen L., Carlsbad, N. Mex..

1160 Murphy, Luke, Albuquerque, N. Mex..

1160 Palmer, Bertha T., Las Vegas, N. Mex.

1160 Pankratz, Peter A., Albuquerque, N. Mex.

1161 Petty, Grover E., Albuquerque, N. Mex.

1161 Rudolph, Lena M., Albuquerque, N. Mex.

1161 Smith, Leroy, Lovington, N. Mex.

1162 Snow, Edith, Albuquerque, N. Mex.

1162 Teel, Gloria B., Albuquerque, N. Mex.

1162 Wussow, Sharon, Albuquerque, N. Mex

1162 Family Health Center, Albuquerque, N. Mex.

1162 Taylor, W. E., Clovis, N. Mex.

1163

BARRIERS TO HEALTH CARE FOR OLDER AMERICANS

SATURDAY, MAY 25, 1974

U.S. SENATE,
SUBCOMMITTEE ON HEALTII OF THE ELDERLY OF THE

SPECIAL COMMITTEE OX AGING,

Albuquerque, N. Mex. The committee met, pursuant to notice, at 9 a.m., in the Civic Auditorium, Hon. Pete V. Domenici presiding.

Present: Senator Domenici.

Also present: William E. Oriol, staff director; Patricia G. Oriol, chief clerk; John Guy Miller, minority staff director; and Caroleen Silver, legislative assistant to Senator Domenici.

OPENING STATMENT BY SENATOR PETE V. DOMENICI, PRESIDING

Senator DOMENICI. The committee hearing will come to order. . First, let me thank you all for coming. We will try to stay on schedule. There are many people that want to be heard, that might not get an opportunity to be heard, so let me say right at the outset that if you do not get to express your views on specific problems, if you will take one of these forms, you can identify yourself, and write what your impressions are of various needs in the area of barriers to health care, or any problem of senior citizens. We will take these with us, and make them part of the record of this hearing and the ongoing hearings. The record will remain open for 30 days and we would very much appreciate your views.

Let me start with an opening statement so as we progress through the morning, you will better understand why we are here.

First, I would like to give you a historical note.

I've checked and found that today's hearing is the first one ever conducted by the Senate Special Committee on Aging in New Mexico. So we are here for a precedent-making occasion, and I'm proud to be the one that started this.

Second, I would like to thank everyone here for coming early on this Saturday morning for a proceeding which will necessarily deal with very serious problems and very earnest attempts to do something about those problems.

Our subject is "Barriers to health care for older Americans." We will keep a written record of all that takes place here in Albuquerque this morning and at an afternoon session in Santa Fe. The facts we obtain here will thus become part of the published proceedings of previous hearings conducted in Washington and in four other States, Maine, Illinois, Idaho, and Utah.

As the title of the hearing suggests, we on the Committee on Aging are concerned about problems which elderly persons encounter when they stand in need of medical or health maintenance attention.

The Subcommittee on Health of the Elderly, which is conducting these hearings and on which I serve as ranking Republican member, has already dealt with many such problems.

MEDICARE COVERAGE INADEQUATE

We know, for example, that Medicare—valuable and essential as it is covers only a little over 40 percent of all health care costs of the elderly. Averages can be misleading, of course. Medicare serves many older Americans very well, and it prevents financial disaster when illness strikes. But it has many holes in its protection, and we are exploring these holes very closely. This kind of inspection is very much needed, particularly when there is so much talk about establishing a national health insurance program for all age groups.

One of the biggest gaps in Medicare today-as our earlier hearings have shown-is its failure to encourage greater use of home health care to help those who don't really need to be in institutions. I have sponsored legislation which would help to correct this situation, and I am looking forward to the testimony which I know will be given on this subject later today.

I am also concerned by reports—in the press 1 and elsewhere-about problems arising from the transfer of patients from State hospitals to boarding homes. Later today, I will be hearing about the situation in Las Vegas and Santa Fe where, as in many other cities, boarding homes have been established to meet this new demand.

But we're interested not only in problems but in solutions and in proposed solutions to the problems.

We're interested in getting the facts and then using those facts to insure that Congress does its part in building a better health care system for older Americans.

We in Congress, of course, can do only part of the job. What is really needed to solve the problems are imaginative, hard-working people working in their own communities to make things better.

We're about to hear from some of those people today, and as one who knows from firsthand experience just how much they and others contribute to this particular community, I am proud to be here, and I am anxious, too, for their testimony.

Now, let me, in my own way if I can, explain some of the problems that have arisen. There are more people in the region that we are covering involved in the problems of our senior citizens than we could invite here as witnesses, many more than we can hear today as witnesses.

There are many more involved in my own community, in their own community, in their own way, in trying to solve the problems of our elderly.

I hope you understand that we could not, in about 3 hours in Albuquerque and 2 hours in Santa Fe, invite everyone that is actively involved in this problem to come, to attend, and be a witness.

1 See appendix 1, p. 1113.

If I did not hold these hearings today-on this very difficult weekend, when many people would prefer to have the extended vacation, I do not think we could have held them for 3 or 4 months. This factfinding in Congress itself is a continuing process, and for those who wonder when will we do this in another community, when will we hear the problems that we did not arrange to hear today, I can only assure you that either formally or informally, throughout my stay, and so long as I am on the Special Committee on Aging, we will try to go to different parts of the State and formally or informally hear the other problems that you want to discuss.

Now, I also know that many of you would like, when the questions come up, to speak in Spanish. You may do that. We welcome it. You know I understand it, but we also have David Vargas from Congressman Manuel Lujan's office, who will be the official interpreter for the record, so that your questions, your comments, if they happen to be in Spanish, will be properly stated for the record, exactly as you have stated them to us.

It is not possible to go through 3 hours in both Spanish and English. We could not get it done. We asked around and most people agreed that we should proceed in English, but those who want to speak in Spanish, we welcome it, and we will have it interpreted; and if the audience needs to understand it, we will state it for them.

For the witnesses, I think you already know we are behind schedule some 20 minutes. You have been asked to keep your remarks within a given time frame. Please try to do that, and try to understand it is not that we are trying to limit you, but rather we are trying to be fair to all of the witnesses we want to hear today.

I think some of you who are witnesses know that a lot of hard work goes into preparing for a hearing. We are very, very fortunate. First, I am fortunate to be on the Special Committee on Aging. We have some of the staff people here helping us. I want to introduce them to you. They work for the U.S. Senate and not for me, but they are here to serve me in my capacity of trying to help the committee understand what the problems are.

On my right is Bill Oriol, who is the staff director of the Senate Special Committee on Aging. On my left is John Guy Miller, the minority staff director of the committee. And then next to Bíll is Caroleen Silver from my office; many of you who are corresponding, writing, or calling have previously gotten to know her over the longdistance telephone and through the mails. I thought you ought to meet her in person. I might say to all of you that she is indeed pleased with what she found in terms of your responsiveness. I hope you who are working for New Mexico find her to be equally responsive, as she has told me you have been.

Then we have Patricia Oriol, chief clerk, from the Senate committee.

This proceeding is being reported in its entirety. It will be made a part of the special committee's record; and eventually, as we proceed with legislation, portions of it will be used to justify either changes in legislation or suggested administrative changes.

I will violate my own rules and tell you two other things, because I do not want to forget them later.

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BOARDING IIOME PROBLEMS First of all, there has been a great deal said in the papers about the boarding home problem. I am aware of them, and I hope nobody thinks that Senator Domenici came to town to be some kind of a critic, that he has some kind of magic wand.

Quite to the contrary, we all know there is a problem.

The State of New Mexico has a role, and we are not here to criticize; we are here to help. The State of New Mexico recognizes the problem. They may without help be able to solve it; they may not.

The purpose of this hearing is to see that board-and-room facilities for our elderly are as good as we can possibly afford; and where legislation is needed, we hope these hearings will help.

We are prodding, pushing, shoving, coercing, even rethinking ways to help solve the problems. We hope our hearings will contribute somewhat to that.

We are going to proceed now with the witnesses.
Mr. ORIOL. Yes.

Senator DOMENICI. We do have two guests that certainly play a vital role in giving us the facts. We have Leroy Smith, president of the New Mexico Health Care Facilities Association; where is Mr. Smith?

We thank you for coming. Mr. Smith will make his statement later on. The Health Care Facilities Association has worked with nursing home care.

And then we have Dr. Robert J. Miller—will you stand up, Dr. Miller-we may have time to hear from Dr. Miller. He is from Truth or Consequences. He is with the American Optometric Association. He is the head of that group. They are interested in the Committee on Aging

Doctor, we thank you for coming from Truth or Consequences. We hope to hear from you if time permits.

First, we are going to hear from a panel. On this panel are John Segura, Albuquerque; Mrs. Selma Ciever, community relations aide, Albuquerque; Mrs. Cora Cooper, Albuquerque; and Mrs. Reyes Abeita, outreach worker, Isleta Community Action program.

John, I think we have agreed you are going to go first, is that correct?

This is Mr. John Segura. John, if you would start, then we will go right to Mrs. Clever.

Mr. SEGURA. All right. I think, as most of you know, we are here on transportation needs for the elderly people.

Senator DOMENICI. John, maybe I could ask one question, and if it is going to be answered in your general statement, wait until then.

I am wondering if you have any special problem in persuading elderly persons to participate in the nutrition programs. If you do, do you have any ideas of how we can overcome these problems? It is kind of difficult to get them to participate, is it not?

Mr. SEGURA. No; the greatest problem I have encountered in contacting the people is that they have no means or way of commuting to places where the sites are.

1 See appendix 1. p. 1113. 2 See statement. p. 1109.

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