just this for you and for me and our industry. Certainly, our State has a long way to go yet. We need money to do that. One of the things that is taking up most of mine and your time is filling out forms, and answering all of these things that come about as a result of the Federal regulations.

There are a great many things that are required today, and it seems that it is getting worse, Senator, instead of better. It does take money to provide those services to the people who are in need. It takes money, Senator. So money is the barrier:

(1) Federal regulations requires more professional people-nurses, dietitians, therapists, and so forth.

(2) Also expensive fire safety devices are required by regulations where safety had already been applied.

(3) More recordkeeping-forms, and so forth-is more time consuming and therefore more costly.

(4) The cost of living is constantly on the incline in the nursing home as well as other industries.

(5) Our main goal is to meet the needs of the older American as economically as possible and yet render good quality care.

Sir, with these and many other Federal regulations, patient care continues to be high quality care. However, the Federal and State governments are unwilling to pay costs that are required to buy these additional services.

Senator DOMENICI. Thank you very much, Mr. Smith.

We will now hear from Dr. Robert Miller of Truth or Consequences, N. Mex. Doctor, would you want to comment?

STATEMENT OF DR. ROBERT MILLER, TRUTH OR CONSEQUENCES, N. MEX.

Dr. MILLER. Yes, I am Dr. Robert Miller, and I practice in Truth or Consequences. I would consider my practice strictly geriatric, and so I have problems which are very different from other doctors.

At the present time, according to a public health survey, approximately 95 percent of all people over the age of 65 need visual help. This usually means corrective lenses.

However, according to an American Optometric Association study, only about 19.8 percent of these people are receiving any type of visual care. So it looks as if this is an area where we do need to do something to take care of these people.

Earlier in this hearing, the Senator asked if a doctor with a geriatric practice had problems receiving payment from the various government agencies. I would say he definitely does. At least this is true in my practice. In dealing with governmental agencies, I never know how much or when I will be paid.

At the present time, the Medicaid payment agency is in the process of changing its computer system. This has caused payment to be delayed an additional 3 weeks. When something like this occurs, and 80 percent of one's income depends on it, he certainly feels it. Problems like this happen at least twice a year with the Medicaid program.

Senator DOMENICI. I assume that you agree with the testimony stated in the record about the need to include glasses, hearing aids, and

other typical senior citizen medical needs within the scope of coverage, rather than as presently existing, being excluded.

Dr. MILLER. That is correct. Unless a senior citizen has an above average income, or exists at the poverty level, he is left out in the cold as far as visual care is concerned.

Senator DOMENICI. Thank you very much.

Dr. MILLER. Thank you.

Senator DOMENICI. We had one other person that perhaps wanted to comment.

Mrs. Sharon Wussow, Albuquerque, N. Mex.

STATEMENT OF SHARON WUSSOW, ALBUQUERQUE, N. MEX.

Mrs. Wussow. Thank you. In the earlier part of February, I con tacted Laurie McCord, and asked her if she would be interested in looking at the conditions of the boarding homes.

After a few meetings, we did go together 1 day and visit a number of boarding homes.

A "DEPLORABLE SITUATION"

The main thing that I found was the deplorable situation that these people are living under. There are no immediate needs being met for these elderly citizens. There were no railings in the bathrooms. There were no siderails to help these people in their beds so they could move around. There were no clean towels. There was no water in the shower, there was a bathroom that was not usable. There was no washer to wash clothes. The people were not being changed.

We watched a man bring in a meal for an older woman who was very crippled from arthritis, who had no teeth and no dentures. She was brought in her piece of meat that looked like round steak, and was not cut up. She had a cup of coffee, and she asked if she could have milk. He said, we do not have any. The plate was removed from her while we were there visiting, and she had not eaten anything that was on that plate. There were many more things that we had seen, but I do not want to go into them here today.

I think many of the things have been discussed openly in the press, that Laurie covered very well. I just sit and pray that many people will become interested in the forgotten people that are pushed away, pushed under the rug, so that everybody does not have to look at it. They have to be brought out and taken care of.

Senator DOMENICI. Thank you very much. I understand that you are the one that called this to the attention of the "Tribune" reporter. A great deal of light on the situation, and I understand from talking with you and others that your motive was purely personal concern for people. As a result of your concern a special report on boarding homes was printed in the Albuquerque Tribune.1 I am sure it has not ended, but perhaps as a result of your effort, we have focused on the problem, that we can better solve it now than we could have before. We thank you very much.

1 See appendix 1, p. 1113.

We have two guests with us. They have a very important role. We have the chairman of the Commission on Aging, Mr. Whiting. We appreciate your presence. And we have Joe Sanchez, a member of that commission. He was here most of the morning.

We thank both of you for your interest. We hope, Mr. Whiting, that you understand that the Committee on Aging has a sincere commitment to try to get the facts and come up with solutions. People like you are now charged with the ever-expanding role on delivering the services.

We hope you feel free to communicate with the committee and with me as a member.

We will now hear from Mrs. Lola Jaramillo, Albuquerque.

STATEMENT OF LOLA JARAMILLO, ALBUQUERQUE, N. MEX.

Mrs. JARAMILLO. I agree with this lady here. I know what is going on, and it is not only in one place, but it is in a lot of places that they are doing the same thing.

I don't know, they go and collect a check for these people from Social Security. These people do not know how to write. They put their cross on it, and turn over the check. They go out and change it and they give them $5. They go out and buy a glass of wine and give it to them, and take the other $5.

We saw some people where the only food they were getting was rice. We are not Chinese. We like to have something to eat once in a while. We take and do a lot of things for the senior citizen, but everytime we try to do something, we have a hard time. Sometimes we see the senior citizens attacked by some young people, and we want that to stop.

We want to work with the senior citizens. We want to help the senior citizens, and we want to do everything we can for the senior citizens, because they do need help. Not only from the hospital, not only from Medicare, but they need a lot of help, and I hope that you, Senator, can do something about this health center that we have got now, the Medicare center, so that you try to help them. They are running out of money, and they need the money, and we need those centers. Thank

you.

Senator DOMENICI. Thank you. One last announcement. If you want a record of this hearing, please turn your name in at the door. I do earnestly believe that the leadership of this country has the same motives that you have.

I think Congress has the same motives, the same desires. I believe the American people would be willing to see Congress appropriate the kind of money, establish the kind of programs to give the senior citizens of this country what we all agree they are entitled to.

I do not think there is any disagreement in the desire, in the attitude, and I think even those who want to cut Federal expenditures, would put highest on the priority list, the very serious moral responsibility of this country to take care of those who preceded us, those who have lived and worked to make this a good country for us.

The problem is not the motive, the problem is the way-how do we do it. It is meetings like these that will help people like myself find a better way.

If there are any other comments you want to make or direct to the committee for purposes of this hearing we would appreciate hearing from you. You can send your comments to the committee, as the instructions say, on your way out.

To you who sat here and listened, to learn and to help, we thank you, and for those who worked hard to testify, we thank you very

much.

I must be in Santa Fe by 2 p.m., that means I have got to get there by car, and to some of the press, I have promised 10 minutes for an interview, so I am going to be late in Santa Fe, but it was a pleasure being here with you all this morning.

Thank you very much. [Applause.]

The hearing stands in recess.

[Whereupon, the committee was recessed at 1 p.m.]

APPENDIXES

Appendix 1

REPRINT FROM THE ALBUQUERQUE TRIBUNE OF A SPECIAL REPORT ON BOARDING HOMES IN ALBUQUERQUE, N. MEX.; BY LAURIE MCCORD, TRIBUNE STAFF WRITER

[Albuquerque Tribune, May 13, 1974]

ABUSE, NEGLECT TOO OFTEN MARK GOLDEN YEARS

(First in Series)

"I walked in and found a woman tied to the toilet with a sheet.

"I asked the aide what on earth was going on. She said they were trying to 'regulate' the woman, that the woman was always messing up her bed.

"I asked if they had taken her to a doctor, and the aide said they had not. "I untied the woman. She was black and blue. She was paying the full $175.” The story is told by Anne Beckman, director of the Albuquerque chapter of the American Association of Retired Persons.

It is the account of a visit she paid to an Albuquerque boarding home for the elderly.

Another story about a boarding home for the elderly in Bernalillo County appeared in the newspapers here recently. It told of the alleged beating of an 82year-old woman by the proprietor of Mi Casa Su Casa boarding home at 2332 Margo SW.

In that incident, the Bernalillo County Sheriff's Department took action, arresting the proprietor, Mrs. Laura Andrade.

There is chilling evidence, however, that other incidents just as grisly-incidents such as the one witnessed by Anne Beckman-may not be at all uncommon. And even when such incidents are reported to authorities, the evidence further suggests, they often go unchecked.

A month-long investigation, including visits to more than 15 boarding homes in Bernalillo County and conversations with some 40 persons connected in one way or another with boarding homes, has produced the following reports:

-In some boarding homes, "incontinent" old people are left to lie for days on wet sheets or in their own excrement.

-In some facilities, people have been found shut up in basements or locked in their rooms.

-Workers in one boarding home recently found an old woman with a halfinch crust on her head from lack of bathing, another with her nylons rotting onto her legs, and another with toenails like claws, so long she could not put on shoes.

-In one South Valley boarding home, residents must go outside, even in midwinter, to get to a central bathroom. In that home, and in others, the stench of urine in the sleeping quarters is almost overpowering.

-Social workers around the state report that many welfare recipients living in boarding homes are lucky if they keep any of their welfare payments for personal expenses, that some operators have the checks signed directly over to them.

-Lunch in many boarding homes has been found to be no more substantial than dry toast or a chunk of carrot boiled in water; in some, only two meals a day are served.

Situations such as these do not occur in all boarding homes.

Everyone interviewed mention examples of fine, caring homes such as Padilla's, at 2111 Raven Lane SW. And some insisted that the gruesome situations occur in only a small minority of homes.

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