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CHAPTER VI

FEDERAL ORGANIZATION: A U.S. OFFICE OF AGING

If there is any one conclusion reached by this subcommittee, it is that the problems of senior citizens in America have emerged as a major national problem both in terms of intensity and numbers of people involved. Despite this fact, there is presently no special agency in the Federal Government authorized by the Congress to be concerned full time with the total range of problems in this national area of public policy. The Nation's approach to its senior citizens and to planning concerning the problems of the aged and aging is fragmented, piecemeal, haphazard, and without focus. The voices of the elderly are muted in the many agencies of government. The position of the programs concerning the elderly is relegated to a secondary role and low status.

The subcommittee is convinced that the problems of aging are great enough in scope, urgent enough in priority, and complex enough in their interrelationships to require representation as an identifiable agency or office at the Federal level. This is equally true at the State and local levels.

The White House Conference on Aging was a major step in showing the need for a central focus on aging at the Federal, State, and local levels. The recommendations from this Conference indicate a need for a separate agency on aging at each of these levels. The creation of an office, such as a U.S. Office of Aging, and of similar agencies at the State level, will not automatically meet all the needs of senior citizens. But, given sufficient authority and support, it can produce a more systematic, more effective, more efficient approach to aging as a positive goal and social achievement rather than only as a problem.

THE NEED FOR FEDERAL ORGANIZATION

The natural process of governmental organization in the United States provides for resiliency and adaptability to change. As new problems emerge or old problems change in quality or scope, they are incorporated either through enlarging existing agencies or by creating new entities. This process of adaptation, sometimes called "interest group representation," is more properly categorized as a necessary embodiment in structure of major social concerns.

Examples of this natural process are clearly revealed in the creation of such agencies as the Department of Agriculture, the Labor Department, the Commerce Department, the Veterans' Administration, and other units. In addition to the formation of specific policies and the administration of specific programs, these Departments or agencies have a generalized function to give focus and special attention to major social problems in their areas of interest.

There are 16 million senior citizens today with an ever-increasing number in the future. These citizens have problems and concerns

comparable in scope and intensity on a nationwide scale with those which are represented by the agencies mentioned above.

Our older citizens constitute a major natural resource, now sadly neglected, but potentially invaluable to the welfare of the Nation. In this respect they are comparable to other natural resources represented by identifiable agencies in the Federal Government. For example, within the Department of the Interior there is an Assistant Secretary for Fish and Wildlife and another Assistant Secretary for Mineral Resources. Under the latter, there is an Office of Saline Water and an Office for Oil. We realize these are important resources constituting special problems, and requiring representation. The Women's Bureau, the Bureau of Indian Affairs, the Children's Bureau, and others also recognize the need to conserve and promote basic human resources. They provide instruments for information, representation, and help. The senior citizen today, however, still has no legislatively backed agency to turn to in the Federal Govern

ment.

There are currently many piecemeal programs for older persons in the Federal Government. More than two dozen agencies each try to deal with some isolated aspect of aging. Communication, coordination-prevention of waste and duplication-become increasingly difficult as the various agencies attempt to meet complex, interrelated problems from a necessarily singular interest.

The difficulties of preventing unduplicated effort are compounded by the additional job of effective communication and cooperation with State governments and their many similar programs. The added bits and pieces become a confusing web too often marked by obstacles, rather than roadways, to a well-conceived set of programs which might make life for older citizens meaningful and satisfying.

The stimuli of Federal grants and technical assistance, in connection with the White House Conference on Aging, helped many States to establish agencies to give special attention to problems of aging. These agencies were effective in facilitating Federal-State relationships. Most States hope to continue these units in accordance with the recommendations of the White House Conference but financial limitations hamper the prospect. With the termination of the Conference and its stimulative grants, the momentum made may be lost unless a new and better means is created to improve cooperation and coordination between the States and the Federal Government.

EXISTING FEDERAL PROGRAMS

Five departments and five independent agencies currently have programs immediately affecting the senior citizens of the country. The fragmentation and scattering of approaches among them have long been apparent to the individual agencies themselves and to students of the subject. It is particularly apparent to State and local agencies and organizations and especially to senior citizensattempting to obtain information and assistance from the Federal Government. There are large areas which are not the responsibility of any agency.

The "Background Paper on Federal Organization" for the White House Conference on Aging gives an indication of the diversity of these agency programs. Among the Departments and agencies involved are the following:

The Department of Health, Education, and Welfare which includes the Social Security Administration, the Public Health Service, Offices of Education and Vocational Rehabilitation, Food and Drug Administration, and Special Staff on Aging.

The Department of Labor and its Bureau of Employment Security, Bureau of Labor Statistics, and Bureau of Women.

The Departments of Agriculture, Commerce, and Treasury.

The Housing and Home Finance Agency which includes a division of housing for the elderly, a public housing unit on aging, and an FHA office for nursing home mortgage guarantees.

The Small Business Administration, the Veterans' Administration, the Civil Service Commission, and the Railroad Retirement Board. It is this proliferation of departments and agencies which the proposed U.S. Office of Aging would view as a whole, studying the implications of individual activities in relation to the whole. It would not assume, in any way, any of their functions or responsibilities. On the contrary it would more likely assist in strengthening the aging activities of these other departments and agencies. It would stimulate, consult, and provide a means of coordination but it would not function as a direct operating agency.

The Federal Council on Aging.-It has been contended that the Federal Council on Aging already performs the stimulating, coordinating functions of an Office of Aging. The Federal Council was set up in 1956 as a sub-Cabinet committee and then reconstituted in 1959 at the Cabinet level by Presidential letter. At the present time it is composed of the Secretary of Health, Education, and Welfare as Chairman, the Secretaries of Agriculture, Commerce, Labor, and Treasury and the heads of the Housing and Home Finance Agency and the Veterans' Administration. Invitations to participate are issued to other departments and agencies when issues concerning them are brought before the Council.

The Council has a staff of two people, an executive secretary and an office secretary. Its budget is small, financed by contributions from the participating departments and agencies. Its duties call for review and evaluation of Federal programs and for recommendations "from time to time on how needs in this field can be better met."

The Federal Council on Aging has a history of meeting infrequently, and in its 4 years of existence either at the sub-Cabinet or Cabinet level-has never recommended a single piece of legislation. In fact its members have had difficulty at times agreeing to an agenda for its meetings. While each of the departments and agencies contributed facts to the various annual reports to the President, an examination of these reports reveals little or nothing in the way of evaluation or recommendation.

The fault does not lie in the individual department or agency, but rather in the inherent inability of understaffed committees to substitute for a full-time, professional agency. With other matters of national and international concern ever-present and urgent, Cabinet heads could only regard the Council as a peripheral activity, if not something of a nuisance. This reaction was often intensified when the Councilpartially because of its ex officio status--became embroiled in conflicts of jurisdiction and prerogative.

The Special Staff on Aging.-About a decade ago a special Committee on Aging was created in the Federal Security Agency, following

the First National Conference on Aging in 1950. This committee performed a useful educative role as a pioneer agency in the field. It was reorganized as a Special Staff on Aging in 1956, but given little new responsibility or authority.

The Special Staff on Aging does not play any role in the formation of national policy dealing with older persons. Useful and necessary functions include compiling data from published material, publishing a national newsletter on aging, providing some technical services to States and localities and maintaining relationships with voluntary organizations. Its role in coordination is not extensive, but it does provide some opportunity for intradepartmental communication at staff levels.

The Special Staff on Aging is not an identifiable item in the budget but is included in the general budget of the Office of the Secretary. Its staff has been very small, increasing only slightly despite the rapid increase in Federal responsibility for the problems of older

persons.

Slightly more than 5 years ago, Oveta Culp Hobby, then Secretary of Health, Education, and Welfare, said the Department was 10 years behind in its work in behalf of the aged. At that time there was a total of nine employees on the special staff. By the end of 1959, there were just 12, including 6 secretaries.

During the recent White House Conference on Aging the Special Staff was merged with the White House Conference temporary staff and devoted its time and energy to arrangements for the Conference. It was not involved, however, in advising or studying the interrelationships of major substantive issues in this field that were before the Nation.

1

As Senator McNamara concluded in an address on this subject:
It is clear that the functions and purposes of the proposed
U.S. Office of Aging are not being filled by any of the agencies.
Quite the reverse is true. The functions which it would
perform are now going begging.

THE NEED FOR COORDINATION AND STIMULATION

The single most obvious fact about the problems of aging is that they concern in one way or another practically every department and agency of government. Corollary to this fact is the equally obvious, yet equally important, generalization that every particular problem of older persons affects every other problem and accordingly, the only efficient approach is an organic, overall view.

Examples of these interrelationships and the way so many of the problems created by neglecting these interrelationships can be cited at length.

The maintenance of good health is related to income, adequate housing, proper recreation and nutrition. Both the Public Health Service and the Department of Agriculture can provide older persons with data on nutritional requirement for health. But neither agency can transform data and statistics into adequate, nutritional meals if the older person's income is too low. Data and advice thus turn to inedible mush. In this connection an Office of Aging-concerned with the total aspects-should be aware of the possible use of surplus

1 Address on the floor of the Senate, July 1, 1960, Congressional Record, vol. 106, No. 123.

foods and school lunch programs and how they might be available to older persons.

Another example involves the productive use of years in retirement. Today approximately 12 million Americans over 65 have retired completely and are spending, on the average, 15 years in retirement. In just 40 years we may have as many as 25-30 million retired persons over 65 living an additional 20 years beyond the period of gainful employment. The prospect of 25 million people spending 20 years with no role or important contribution to the economy and society should raise questions of the basic values of our times. Can our economy support so large a population of "nonproductive" citizens? Even if it can, should it do so? What must be planned and undertaken now and tomorrow to insure that 500 million man-years will not be wasted, but will be devoted to important service to the community and to self-enrichment? Who will be able to concentrate fulltime on these economic implications of aging and provide data and recommendations to reckon with them?

This type of reflection, planning and recommendation for action. is assigned to no agency at the present time. The problems here involve considerations of employment, health, income, housing, senior centers which are all enterrelated. It is this type of forward thinking and relational analysis which the Office of Aging can and should assume both in behalf of the Nation's senior citizens and the Nation as a whole. Without such a responsible agency there is no end of ad hoc, and generally feeble, efforts at "coordination" of the various activities of governmental agencies dealing with special aspects of aging. An advisory committee of public citizens provides some coordinative thought in housing; a small group of people work in social security to coordinate programs in public assistance with other social security programs; the Public Health Service has a coordinating committee; and there is an additional such committee on research in the National Institutes of Health.

These committees perform useful functions in their areas, but are not substitutes for the overall, meaningful thought and direction which are required.

SIMILAR DEVELOPMENTS

The proposal to create a U.S. Office of Aging parallels in many ways the establishment of the Children's Bureau in 1912. The Bureau is charged with investigating and reporting "upon all matters pertaining to the welfare of children and child life among all classes of our people." Its creation was a legislative accomplishment of the first magnitude, recognizing that the welfare of children is an appropriate, important concern of the Federal Government. Within a period of 50 years it has made incalculable contributions to the health, welfare, and long life expectancy of America's children.

The purpose of the Children's Bureau "is to serve all children" everywhere. It is concerned with their health problems, employment, housing, adoption, social services-all interrelated and requiring a view of the child not as fragmented pieces, but as a whole person. Its great contributions have been based on the concept of preventing problems rather than having to deal with them in their acute stages. It is specifically in these areas that the U.S. Office of Aging will fulfill its essential role. It will provide a focal point for considera

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