Senator DOMENICI. But to this point, they do not have one?
Mrs. SANCHEZ. No; we are not fully organized.

Senator DOMENICI. And you are just sort of self-appointed spokesman for them today?

Mrs. SANCHEZ. Well, let me tell you this. We got together, and we decided we needed an organization, and I was elected their spokesman. Senator DOMENICI. We will get back to you in just a minute.

Let us finish the testimony, and we will talk a little more.

Mrs. Hill?

STATEMENT OF ADELINA ORTIZ DE HILL, LAS VEGAS, N. MEX.

Mrs. HILL. My name is Mrs. Adelina Ortiz de Hill, and I am a specialist in aging. I am a coordinator for Pro Personas Mayores, an advocacy group for Spanish-speaking aging.

Their problems are the concern of this association. There are three coordinators. One in California, myself, and one in Massachusetts, to advocate on behalf of the Spanish-speaking aging.

I know the intent of Congress in allocating money on nutrition and for aging are those of the high-risk population of aging, and I do not think you can find a higher risk group than you find in boardinghomes. Some of these people have possessions that you can put in a shoebox. This is it.

The conditions of the boardinghomes have been a concern of mine for some time. I was employed by HSSD, and as an adult specialist did some work in this particular area.

I have taken all of the traditional steps of meeting in the community, and at the community level, and have made efforts at implementing programs at the State level. I have also assisted the AARP membership legislative group in their testimony before the State legislative committee on health and aging.

Their primary concern, and their priority, had been concern for the boardinghome recipients or residents.

Senator DOMENICI. When was this testimony?

Mrs. HILL. This testimony was about last August. I gave Mr. Oriol a copy of that testimony that was submitted.1

I am sorry Mr. Carmichael is not here, but we had also attended the hearings in Albuquerque, and had input from community people in Albuquerque about this. Perhaps many of the same people you heard this morning were very concerned about the conditions.

I believe I visited about 50 boardinghomes, not only in the State of New Mexico, but Kansas and California.

I realize that the role of the Federal Government is probably required, because apparently, from my experience in this State, there is a bureaucratic snarl of monumental proportions.

There are many agencies involved in this. and some of the things I can say about boardinghomes. While I realize Mrs. Sanchez has one of the better ones, that for the most part, from my experience, there is isolation, and isolation for the elderly. It is a deprived environment. There is overcrowding. All available space is used for beds. You have a

1 See appendix 1, item 1, p. 1220.

41-757-75-4

vision of a boardinghome being a room where a person has his personal possessions.

You can convert a dining room, living room, and a three-bedroom house into an institution, and in many institutions there are 18 people. There is very little living space. There is very little activity areas in many of these boardinghomes. The diets are inadequate, drugs are administered, and I have mixed feelings about who administers these drugs, and what right boardinghome operators have to give them.

MANY RESIDENTS EXPLOITED

I think the residents are exploited. I have met many people who have had their total check ripped off. There are many mentally incompetent, not competent to manage their own money. Therefore, there is a dubious practice of whether they get any of it at all, and this may even happen in nursing homes where I believe that the person is too ill to spend his own money. I believe the practice is for the nursing home operator to keep it in a savings program, and collect the interest on it, and then who knows what happens to the money. I would like to know myself. I am very curious. Then there has been cases of physical and mental intimidation.

I discussed some cases with the sheriff in San Miguel County, of residents having been beaten. I believe that this has happened in Albuquerque.

Social contacts are not encouraged. There are actually boardinghome operators who will tell people to stay away-social service workers, or just visiting persons-that they are not permitted to visit these people.

There are residents who probably need another level of care, higher or more independent, because many boardinghome operators are very controlling.

If you do not have any money, you cannot step out the door to be independent, and a great dependency level is maintained. I think it works to the advantages of boardinghome operators.

Often problems evolve around licensing standards for enforcement. I have met with representatives from the health department many times, and I have been told that there are not alternatives for these people.

If a boardinghome is closed, that is it. I think we need to develop alternatives. I developed a package of adult services which has not been implemented. I think that payment, the excuse of payment being insufficient, is not really always the case.

As an example, I used my own home and got a friend of mine who is an engineer to figure out how much I would make, with overhead, and this includes utilities and everything else, and my house happens. to be a little better than average. I pay $175 a month, including the utilities, for my home, which is 1,600 square feet. I could have 18 people in there, and I figured in my overhead, with feeding expenses of $600, which is quite a generous estimate, my income would be $2.160 a month, and I subtract $600 from that, and I am making $1,100 a month.

Senator DOMENICI. Could you do that without any help?

Mrs. HILL. Without any help. They use the residents to do the work.

In fact, the sheriff told me that a woman had reported to him that she had been beaten. The reason given was that she was not carrying her own weight. They do some of the cooking, cleaning, and ironing. I do not object to their having any activity, but I know I would not be doing it alone, and even then, $1,500; I work pretty hard now.

Senator DOMENICI. What is the range of occupancy based upon the information you have?

Mrs. HILL. On my information, that would be a bed with at least 3 feet on either side, which is fairly typical of many boarding homes, with little personal space for storing.

You have a carton box under your bed, where some other patient might steal some of your things.

Senator DOMENICI. What do State regulations require in terms of space?

Mrs. HILL. I am not sure of the licensing regulations, but I know it is far more generous than that. The point is that it is not practiced. I don't know if they moved the bed in after the inspection or not, but in some that are quite crowded, the only place that the resident has to sit is on his own bed.

Senator DOMENICI. In terms of number of occupants; can you give us some idea of the range?

Mrs. HILL. I think that Mrs. Duran reported the average range was eight. There are homes that are as large as 23. I imagine eight would be more the case, because you have to figure that many of these are very small homes.

If you put them on the open market for rent, you could not get more than $80 a month, including utilities. They are not very big, fancy homes that they are using as boardinghomes.

I think this is the common picture the people have of a boardinghome. Would you like to ask some questions?

FEDERAL INTERVENTION: WHAT ROLE?

Senator DOMENICI. I have some questions that I would like to ask now. You have quite forcefully said that you see the problem as being one requiring the Federal Government intervention. Can you tell us how you perceive the Federal Government doing anything about it? Mrs. HILL. I do know that moneys have been allocated to upgrade housing for elderly people. I would give this particular group of people a very high priority. I think there would be some subsidy for decent housing, and I think that this might be an area, I know that in the different communities I visited, like Tucson, and areas like that, many neighborhoods have been wiped out.

Ölder people wanted to live independently. For instance, one section in Tucson which became a model cities reclamation area, and people were moved.

Senator DOMENICI. I think that suggestion in the chain of thought you are talking about is more preventive in terms of how we cut down on the population available for this kind of need. I am asking more specifically. We know we have a problem, we know it exists in many cities in New Mexico. We know it is severe, and we know this cannot continue for very long. If I understand you, you are suggesting that the Federal Government has a role in curing it.

Mrs. HILL. Yes.

Senator DOMENICI. Now, I am not speaking of curing the movement toward them. I am speaking of curing the problems of the hundreds that are in this condition. Do you have any suggestion with reference to what we can do?

Mrs. HILL. I believe there were low-interest loans available to seniors for housing. Many of them did not take them, did not apply for them, because they do not want mortgages beyond the time they expect to be able to pay them back. But perhaps to someone, or some church groups, or some nonprofit organizations, individuals that would want to go into this area, and develop decent housing for isolated individuals. În Las Vegas, we have the alcoholic council, a home for alcoholics, and it is a model home, and I might even use that as an example, because we have a boardinghome for alcoholics.

Senator DOMENICI. Whether I agree with the premise or not, let me tell you what information we are being given.

If the Federal Government, through the Secretary of HEW, was to issue a national mandate that SSI money would not be used for this kind of facility, and defined the minimum kind of facility, we are being told that there would be no facilities for these people.

Do you know whether or not the amount of money available for this is enough for us to expect better facilities from the private sector? Mrs. HILL. Probably not.

Senator DOMENICI. So is it fair to assume-you are suggesting we must find ways to get more money into the hands of the operator, if we are going to demand more of them?

Mrs. HILL. No; because I envision more exploitation. I think unless you have some standards set for operators; yes, then possibly more

money.

ALTERNATIVES SUGGESTED

I believe through HUD there was some housing money available for church groups, or any group that wanted to develop housing for seniors. I am just suggesting that perhaps this might be a priority area, rather than individual apartments, removed from the community, reclaim some of these neighborhoods, and fix up decent housing.

I do not believe institutions are an answer. I would not like such large ones that we have people stacked up, and we get into this depersonalized mechanical dispensation of assistance.

That concerns me, but I would like to see something done in this particular area.

Senator DOMENICI. The staff did talk to you about your observations and your thoughts?

Mrs. HILL. Yes; and I have submitted my testimony and recommendations.1

Senator DOMENICI. Now, might I ask the other two witnesses if they have any suggestions as to what the Federal Government might do to alleviate the situation?

Mrs. DURAN. Mr. Lovato mentioned that many of the senior citizens that he has to deal with, and I think members of the other panel, they

1 See appendix 1, item 6, p. 1229.

would prefer to remain in their own homes. While we do have many residents in boardinghomes, I think that to try to get these people back into their own homes if possible, if we can work somehow with the relatives of these people, and maybe, it was suggested maybe make more money available to the client, or to the resident of the home, so they could help the relatives to stay in their own home.

Senator DOMENICI. However, your facts would indicate a substantial proportion in Las Vegas did not want to take care of them.

CAPABLE OF LIVING INDEPENDENTLY

Mrs. DURAN. Yes; but I do not know how much work has been done with this relative to really helping them see how important it is for these people to remain in their home, or stay close to their relatives.

This is what we are trying to do also, to work with these people, to see how many we can have live independently. I think a large number of them are functional enough to live independently, if they are given a little more money to pay rent, and so forth, if they do not own their own homes. I think that is one way of doing it.

Again, we do not have the staff to do all of this work, to render all of the services, to contact relatives in communities where they come from, and so forth.

Senator DOMENICI. Would you talk of the amount of money that is available, and tell us your views on the adequacy or inadequacy to give good care.

Mrs. SANCHEZ. If we had more money, would we do better for the client? I am sure they would. Another thing we need is more communication between the social services and all departments. You have to have many agencies, and none of them are communicating. Senator DOMENICI. Communicating?

Mrs. SANCHEZ. With the operators. The departments with the operators for the betterment of the home, of her place. I have spoken to a lot of operators. I said, "How did your home rate?" "Nice." Some to them, it is just that. Maybe if they came out and asked our caseworkers, what do you think of my home, do you recommend a change, I am sure they would agree on doing better.

Senator DOMENICI. Well, there is some evidence there are five agencies authorized to inspect. Are you aware of that?

Mrs. SANCHEZ. To inspect?

Senator DOMENICI. Yes.

Mrs. SANCHEZ. Well, so far, the only inspection we have gotten is from the State.

Senator DOMENICI. Five State agencies have authority to inspect or regulate, or that are doing it?

Mrs. SANCHEZ. I did not know that. All I knew is that we are under the State standards of New Mexico, that is it.

Senator DOMENICI. Well, I want to thank the three of you for appearing. You certainly, Mrs. Sanchez. This is a very volatile and very serious problem for you.

I am not going to agree with you in the statements you made about the other operators, or the conditions, but I do want to tell you that I compliment you for coming down here and testifying.

Mrs. SANCHEZ. Thank you.