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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.

41-055-75

But incidents of abuse and neglect, of ignorance and exploitation, do go on. And there is a complex network of unfortunate circumstance, indifference and bureaucratic bungling that seems almost to foster such incidents in boarding homes.

In Bernalillo County, there are roughly 35 boarding homes licensed by the state Health and Social Services Department for a total capacity of about 350 residents, Robert Frankalucci, head of the HSSD institutional licensing section reports.

Not temporary abodes for transient workmen passing through town, nor the old-fashioned boarding houses where townsfolk gather for dinner on Sundays, these boarding homes serve a different function.

They are homes for the dispossessed, people who cannot survive alone, but whose families-where there are families cannot or will not keep them at home. Some of the boarders are mentally handicapped adults. But by far the largest number in Bernalillo County homes are merely aged.

Some are senile, some just physically wearing down.

They are not sick; they do not need hospitals, or even nursing homes.

But they do need care. Someone to cook their meals, or to help them remember when it is time to eat.

Someone to help them comb their hair or take a bath, or to make sure they get to a doctor should they become ill.

There is a name for this kind of care. Custodial care, it is called.

And New Mexico, theoretically, has taken into account the need for custodial care with a special state license for "sheltered-care homes."

A sheltered-care home, the licensing regulations state, is a "place which provides, on a continuing 24-hour basis, facilities and resources to give personal services (but no skilled nursing care) to two or more persons not related to the operator."

Those persons, the regulations continue, are ones who "because of age, infirmity, physical or mental limitations and dependence, need help and assistance in daily living activities."

The "personal services" to be rendered, the regulations suggest, might include such things as help in walking, getting in and out of bed, bathing, dressing. Neatly, on paper, the need has been met.

But in reality, there are only about seven licensed sheltered-care facilities in the entire county, and all are full, Joan Tefft, county supervisor of adult services with the HSSD Social Services Agency, said.

And so hundreds of needy, but technically not ill old people must look elsewhere. If they happen to be wealthy, or if their families have enough money, they probably can be placed in a nursing home, even though they do not need medical

care.

If they must rely on Medicaid, however, they will not be admitted to a nursing home, for in a nursing home situation, Medicaid covers only actual illness, and not the ordinary pains and needs of growing old.

The only alternative for a large number of the elderly poor is a boarding home. And under state licensing requirements, a boarding home is required to provide little more than a bed to sleep in and food to eat.

Many of Bernalillo County's boarding homes-the large majority, probablydo provide a somewhat higher level of service than the minimum required by law.

But often, the quality of that service is directly proportionate to the cost. Sandia Ranch at 603 Edith NE, a sprawling, homey structure that once served as a mental hospital, is often praised for the quality of its care.

The home has an extensive staff of aides and orderlies to tend to the residents' needs, and there is even a full-time nurse on duty.

"We cater to their every wish" said proprietor John Chanman.

But rates at Sandia Ranch, start upward at around $350 per month. And for large segments of the elderly population, $350 a month is a sum quite impossible to obtain.

There are an estimated 248 aged and mentally handicapped persons in Bernalillo County boarding homes who live on public assistance, welfare.

The federal government, which as of Jan. 1, took over formerly state-administered financial assistance programs for the elderly, blind and disabled, pays a maximum of $140 per month.

Countless other persons in boarding homes subsist on Social Security payments, which now average $174 a month. Others survive on small pensions providing roughly the same income.

For all those people, there is not much choice as to where they end up.

They land in boarding homes willing to take low-income residents. If they're lucky, they get good food and good care. If they're not....

Anne Beckman, whose organization helps find employment for retired persons, tells of one boarding-home owner who called her a year ago at Easter time.

"She wanted a cook-housekeeper. I sent a woman to the home at 3 p.m. on Friday. She found nothing at all to eat for dinner, and she had to call her husband to go out and buy groceries.

"The next day, the owner arrived with food for dinner that night: one slice of ham and one potato. She told the woman to slice up the potato and give everyone a couple of slices."

Visiting nurses who go into boarding homes to tend patients after their release from hospitals have many stories to tell of their encounters in boarding homes. Jan Thornberg and Judy Mitchell of the cocperative St. Joseph and Presbyterian Hospitals Home Health Care program tell of nurses being turned away at the door by boarding home proprietors.

Ms. Mitchell, director of the program, said she has seen only one decent boarding home in eight years of nursing.

Muriel James, director of the Visiting Nurses Service, Inc., described a visit by one of her nurses to a home where the water and toilets had been turned off, apparently to reduce the water bill; where the food consisted of watery soup; and where residents bore definite signs of mistreatment-explained by the owner as the result of falling out of beds.

Mrs. James said she reports all such situations to various state and local authorities, but said in frustration that she has been reporting them for years. Most of those authorities indicate that they are aware of conditions in boarding homes.

"Some of them admittedly aren't so good," said Bill Allen, Chief Sanitarian with the General Sanitation Division of the city-county Environmental Health Department.

Other people-a former adult specialist with HSSD program development now a social work professor at Highlands University, for one-put it a little more strongly.

"The situation is deplorable, and that's an understatement," said Highlands' Adelina Hill.

"The definition of a boarding home in New Mexico is a flop house.

"Many of the homes are overcrowded. Some are licensed for eight people and have 12.

"I've seen the operators give them half a Vienna sausage out of a can for lunch. I've seen filthy, filthy dishes stacked up. One place doesn't let residents burn lights after 5:30.

"There's no one to monitor the monthly fee," Ms. Hill continued. “Some operators rip off the whole check.

"It's incredible that the situation has been kept under wraps for so long." Albert Sanchez, staff social worker at Bernalillo County Medical Center, in charge of finding suitable situations for persons who might need supervision after their release from the hospital, said he tries to avoid "resorting to" boarding homes.

And one reason, he said, is the condition in which some patients come to the hospital from boarding homes.

Once or twice a month, Mr. Sanchez said, people who have fallen in a boarding home and dislocated a hip, or broken a bone, are brought to BCMC-one or two days after the accident has occurred.

The list of boarding home critics is long.

Barbara Menzie, director of the Metro Areawide Aging Agency also uses the term "flophouse" to describe most boarding homes today.

"In one home, they found three old ladies in a basement, one in a wheelchair. There were no windows, and they hadn't seen the light of day in two years. One of the ladies' son was a banker. He couldn't have cared less."

Lt. Paul Adent of the Albuquerque Fire Prevention Bureau, which does at least yearly inspections of Albuquerque's boarding homes, voiced perhaps the most resounding condemnation of the homes.

"Even the penitentiary," he said, "would be better than some of these places."

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