current building costs and interest rates prohibit private enterprise from devising an economically sound program for supplying the aging with housing; and Whereas the State of New York has undertaken a program of financing limited profit housing by providing capital at 3 percent interest for 50-year terms; and Whereas the State of California, after World War II, assumed the responsibility for providing self-liquidating financing at very low interest rates to provide housing for its returning veterans: Be it

Resolved, That the 67th convention of the diocese of Los AngelesSupport in principle the use of the State's credit to create a revolving fund out of which loans may be made for housing programs for the elderly ;

Invite parishes to study means of providing low rental housing projects near the church so that elderly persons may maintain close ties and active participation in the life of their parishes.

RESOLUTION ON THE CHURCH AND MEDICAL CARE FOR THE AGING

Whereas the 20th century has witnessed a population explosion at both ends of the age scale-in birth and in numbers of older persons with 171⁄2 million persons over 65 in 1962 and the number increasing at the rate of 1 million every 2 years; and

Whereas census studies show 55 percent of the people over 65 years do not have more than $1,000 per year income; and

Whereas the National Health Survey shows the relationship between family income and chronic disease by age, with the lowest income age experiencing the greatest proportion of chronic illness, and

Whereas according to the National Health Survey the rate of chronic illness (heart disease, diabetes, arthritis) among the aging is more than double that for younger groups, those under 45 years of age, 77 percent versus 34 percent, and

Whereas adequate medical care for the aging has too often been overlooked and neglected by the church and the general public: be it

Resolved, That the 67th annual convention of the Diocese of Los AngelesCall upon individuals to bear a personal responsibility, especially children for their parents who cannot care for themselves;

Direct attention to the necessity for considering multiple approaches to the health problems of retired older persons, including extended prepayment insurance benefits under private auspices;

Urge members of the medical profession and other health workers to cooperate in developing the means by which these approaches can be used to improve the health of America's older citizens and to enhance standards of care and doctorpatient relationships which are fundamental to the healing art;

Call upon the boards and administrators of Episcopal homes, hospitals, and other services to the aging to expand and improve those services and to provide for the chronically ill and infirm.

STATEMENT OF WAYNE R. WILLIAMS, OF SMITH & WILLIAMS, ARCHITECTSENGINEERS, SOUTH PASADENA, CALIF.

I endorse H.R. 10014 United States Commission on Aging because its objectives and provisions hit the mark in diverse and vital areas relating to the aging.

In recent years, the pendulum of both public and professional opinion has swung from indifference to varying and fitful degrees of concern in regard to our older age groups and their needs.

With a few single exceptions, even the best of well-intended efforts to help our senior citizens have been characterized by myopic and unrelated approaches which succeeded in parts and failed in the whole. As a result, what were conceived as well-spent hours and dollars in reality did not satisfy the needs at all. Our agencies, research projects, developers and planners were "spinning their wheels."

This unilateral thinking, this specialization has come to a roaring halt. It is long overdue that we pool resources between adequate State and private agencies, and community programs and research projects.

1 Coeditor, "The Architect Looks at Housing the Aged," published by the Housing Research Council of California.

Only the Federal Government can coordinate the activities of these diverse groups working in the field. Such a U.S. Commission on Aging as proposed in H.R. 10014, provided with sufficient funds as therein stipulated, can promote the cooperation necessary. The Government must provide guidance and assume the role of liaison between the working groups.

The U.S. Commission on Aging is a good peg upon which to hang the fabric of the future of our senior citizens, and about which to orient professional and community concentrations.

As to the objectives of the bill, I firmly believe the author has stated in clear language, in sensible and sensitive phrases, the most significant areas demanding our attention. Unless we pursue all of the 10 objectives described in the bill, ranging from the concern for adequate income through those of opportunity for gainful employment; care for physical and mental health; suitable housing; provision for independence in living arrangements; meaningful participation in civic and community life; the benefit of adequate research; consideration for individual initiative; and the full-time services of an agency of the Federal Government and of each State bent upon the needs of our senior citizens-unless this wholeistic rationale permeates the efforts we make today, there will be left for tomorrow the grim necessity of doing the job all over again.

STATEMENT OF PACIFIC HEALTH PLAN ON MEDICAL CARE FOR THE AGED

The board of directors of Pacific Health Plan, a nonprofit direct service health plan, has authorized the following statement:

Pacific Health Plan supports the program of medical care for the aged under social security, as the best means of providing critically needed services to persons 65 years and over, who are no longer productively employed and engaged. We are certain that it is not necessary to recite the well-known facts and statistics. It is necessary however, to push aside the curtain which has been created by the American Medical Association and others, which denies not only the existence of any need, but also attempts to becloud the issue by raising a hue and cry of socialism and other political issues.

Medical care for the aged is not a political problem. It is a socioeconomic problem. It consists essentially of three socioeconomic factors:

(1) The retired person has an increase in medical needs.

(2) The decrease in his ability to finance his medical needs, either through personal resources or through insurance.

(3) Continually increasing costs of medical care outdistances his static income and resources.

The aged require more medical services because they are susceptible to chronic illnesses, because medical science has found ways to prolong their life span and to prolong their usefullness.

Again, it goes without saying, that living costs have materially increased and yet the income-producing abilities of the vast majority of our aged cannot cope with these increases in living costs.

Society has an obligation to find ways and means to provide those services for its citizens which the citizen is unable to provide for himself. These services include the national defense, compulsory education, the policeman on the beat, the fireman at the fire station and many other social services too numerous to mention.

To libel these essential government services with the label of socialism, is not only dishonest, but a disservice to the fundamental principles of our democracy.

These libelous labels (of socialized medicine) have nothing to do with medical care for the aged. The program which we support, "specific hospital benefits for recipients of social security," will provide, on a social insurance principle, paid up hospital insurance for employed persons who pay in the social security fund. This method does away with the demeaning "hat in hand," beggar principle of the Kerr-Mills bill.

(It must not be overlooked that under the present Kerr-Mills bill, the proof of establishing medical need is in effect, a pauper's oath and the cost of such proof to the welfare agency, has been estimated at over $200 per applicant. It will cost less than $200 however, to provide the benefits and services of the King-Anderson bill, under social security.)

Our country is faced with a tremendous impact of new scientific endeavors, atomic energy, exploration of space, conquest of cancer, conquest of polio and

other diseases. Simultaneously with these tremendous advances, we must indeed create the sociological as well as economic advances, to enable all the people to reap these benefits.

It is inconceivable that the American Medical Association is correct in its present attitude that these advances in medicine must be reserved for those able to pay. It is inconceivable that we withhold the benefits of scientific and medical progress to a multitude of our citizens because they did not foresee during their productive years, the necessity to save their pennies for the yet unimagined drugs which can prolong their lives.

The issue has nothing to do with socialized medicine. It has nothing to do with the private practice of medicine. It has nothing to do with whether or not, as the American Medical Association says, this is the first step to the total socialization of our Government. It has indeed, nothing to do with freedom or regimentation. If, indeed, we have the courage to look at this issue fearlessly, then it becomes clear and concise, that it is an issue of responsibility. The responsibility of each and every individual citizen in the United States, and this responsibility consists of providing the means and furnishing hospital care to our retired aged, regardless of ability to pay, by means of prepayment through the mechanism of social security by a tax upon the earnings of every productive American.

That is the issue. Not any of the slogans, right or wrong, not any of the issues which have been put forth by the proponents as well as the opponents of this program.

A mature people must face its obligation, it must provide for the welfare of all. To do less, would be immoral and would certainly not be in the spirit of the American people.

We strongly urge this committee to support the King-Anderson bill.

STATEMENT OF CECILIA O'NEIL, VICE PRESIDENT, NATIONAL RETIRED TEACHERS ASSOCIATION

It is my privilege and honor to represent the National Retired Teachers Association and its affiliate, the American Association of Retired Persons. The combined membership is approximately 500,000 under the leadership of their founder-president, Dr. Ethel Percy Andrus.

There are many areas of concern for members of these groups. First of course is the part inflation plays. Many are in the low income bracket with fixed pensions, low retirement salaries, or other income which were established 10 to 30 years ago and have not been increased. The high cost of suitable housing, increased cost of medical-hospital care and the prohibitive cost of drugs are high on the list.

Other lacks are availability of adequate and suitable cultural and recreational activities-not just card parties, folk dancing, or bingo.

Lack of adequate transportation to keep within their budgets creates an additional problem.

Within our ranks is a reservoir of aging people with "know how," experience, social awareness, and a willingness to serve.

We are constantly identifying the needs of the aging and suggesting programs of activities and services. We encourage and underwrite specific action programs in many areas. There is a definite need to channel these resources in the right direction and to demonstrate a better understanding of the assistance which is available.

The leaders of both organizations look upon education as a lifelong process, they recognize the need for education not only about, for and by the aging person but most important with them.

One of the most encouraging aspects in the field of education and employment has been the counseling, training, and placing of the older workers by other retired persons.

The increased sensitivity to the needs of all aging people is the source of great satisfaction among our members. Time does not permit a complete list of services and activities but the dedicated efforts of our members have made their mark on our homes, neighborhoods, schools, churches, hospitals, and clubs and have been given the stamp of approval in the communities of all States. To evaluate our programs, the highlight, in my estimation, is the increased awareness of the ever-changing role of the aging themselves.

We want for all aging people the right to enjoy a meaningful retirement and to live in simple dignity.

We have too long been satisfied with words and promises, now we want action. I think we have found it in your proposed bills.

Therefore both organizations heartily endorse H.R. 10014, Congressman John E. Fogarty, and S. 2779, Senator Pat McNamara, establishing a new agency, U.S. Commission on Aging.

We approve the forthright statement of the 10 objectives.

The provision for an advisory council to the Commission on Aging is an outstanding feature.

The interdepartmental council on aging will assure coordination of functions and responsibilities.

Projects are a must.

Research, training and demonstration grants will offer a nationwide challenge.

STATEMENT SUBMITTED BY COUNCIL OF SOCIAL PLANNING, ALAMEDA COUNTY, CALIF. 1. Lack of coordinated approach to the problems of aging

There is no one department of Government charged with responsibility to plan and coordinate Government departments which work in this field.

The special staff on aging in the Department of Health, Education, and Welfare has done an admirable job, but they have been handicapped by lack of sufficient staff and funds.

We recommend that a division on aging be set up within HEW with the same status as other divisions and that sufficient funds be provided to permit regional staff to be employed to work out of regional HEW offices to assist local communities with their work on special problems of older citizens.

2. Income maintenance

Income after retirement is too low for the majority of retired persons to be able to buy goods and services adequate to maintain a reasonable standard of living. The Social Security System has done a magnificent job in removing some of the income maintenance problems for the retired person, but the benefits received from social security need to be raised so that they more nearly approximate the cost of living.

3. Grants-in-aid

Programs which provide funds for special research, "seed money" for demonstration projects and funds to both public and voluntary agencies which extend programs to old people in their own dwellings would help local communities which are eager to do a good job for their older residents. Such funds should be administered through the Department of Health, Education, and Welfare in the same manner as child welfare services funds.

4. Health problems

In a recent survey covering nearly 3,000 retired persons in Alameda County, 1,427 or 55.5 percent reported great difficulty in meeting the costs of medical care. Poor health was reported as the greatest single problem by 1,383 or 62.3 percent and the cost of drugs was a serious problem to 1,096 or 41.8 percent of the group. Since 2,027 or 70.8 percent of the total group had yearly incomes below $2,000, it is not surprising that the cost of medical care and drugs uses up a disporportionate share of their budgets and constitutes a nagging worry to them.

In general, we have found from our studies that low income and poor health are the basic problems with old people in this county. Poor housing is a problem which more available income could solve. Activity programs and community service by seniors are often closed to them because they cannot afford the cost of transportation.

We hope that the Congress will take action to set up a division of aging within HEW and will give serious attention to the income maintenance and health problems of retired persons.

PREPARED STATEMENT OF JAMES H. CAMPBELL, EXECUTIVE DIRECTOR, HOMEMAKER SERVICE OF LOS ANGELES REGION

At the outset, let me express my appreciation to the General Subcommittee on Education and Labor for this opportunity to present material concerning the

unmet needs of senior citizens (65 years and older), for home-care services, with particular emphasis upon providing Homemaker Service to this group.

To begin our discussion let us define Homemaker Service and the part that it plans in a home-care program. Homemaker Services is best described as an organized, communitywide, nonprofit social service, sponsored by a private or public health and welfare agency who employ qualified personnel to provide supplementary housekeeping, personal care and counseling services on a temporary basis to individuals and families during a period of personal crisis. Its primary objective is the maintenance of the household routine and the preservation or creation of wholesome family living during a time of stress. Homemaker Service is furnished to families with children, to convalescents, aged, acutely or chronically ill, disabled, and mentally ill persons, to maintain and preserve family life that is threatened with disruption by illness, death, ignorance, social maladjustment, and other problems. The services provided are those required to help maintain normal bodily and emotional comforts and to assist the client toward independent living in a safe environment. Because Homemaker Service is offered on the basis of a social diagnosis and often a medical diagnosis as well, experienced and professional persons evaluate the type of service needed and the length of time it should be provided.

A homemaker is an emotionally mature, warm-hearted woman, trained with skills in homemaking who is employed by a responsible community social service agency to help maintain and preserve family life that is threatened by illness, accident, or other causes. A pleasant personality, physical and mental well-being, flexibility, understanding of illness, experience, and training, enable her to assume full or partial responsibility for adult and/or child care, household management and for the maintenance of a wholesome atmosphere in the home. She carries out these responsibilities under the direct supervision of a professional social worker employed by the supervising agency. She exercises initiative and judgment in the performance of her duties, recognizes her limitations and shares her observations and problems with her supervising social worker. For senior citizens a homemaker acts as an attending housekeeper. She is recruited from among socioeconomic levels and must possess that indispensable capacity to provide for older people an inexhaustable measure of tender loving care. She functions as a member of the health service team composed of the physician, nurse, social worker, and therapist.

Homemaker Service is one of the fastest growing, most practical, recently developed social services. It was born out of necessity, because it seeks to meet the needs of a highly mobile population. This is evidenced by the fact that over 80 percent of the families in the Los Angeles metropolitan trade area had their origin elsewhere. Today, when many individuals and families have left their place of origin to seek their fortunes elsewhere, and therefore do not have the normal family support available to earlier generations, Homemaker Service acts as a substitute "old friend" by providing practical help and moral support during a period of temporary crisis.

In many families of severe family or personal difficulty there is a dramatic need for services which are not necessarily dramatic in themselves. Children, shocked by an adversity they cannot comprehend have a first need for the assurance and secureness of familiar routine and warm human care. For adults trapped by circumstances, time itself is a previous commodity. Times to unravel the difficulties of the moment, to regather thoughts and to chart new directionsHomemaker Service seeks to meet these human needs in a practical, tangible way through the skilled helping hands of Homemakers. Specially trained in caring for illness and herself a successful homemaker, she is the heart of this family service. Operating under direct professional supervision and in accordance with a careful social or medical diagnosis, she may assist or lead the family in maintaining household routine, meeting problems which arise and working out satisfactory solutions. She is at once counselor, friend, teacher; a source of immediate strength and support. For each assignment a homemaker is chosen whose experience and disposition promise a friendly rewarding relationship.

Based on our experience with over 1,200 cases in the last 22 years, we believe that Homemaker Service as a part of a coordinated home-care program, has clearly demonstrated that:

(1) Institutional care, either in a hospital or a home (convalescent, nursing, or rest) can be either postponed or eliminated for an adult or couple living alone because of illness or infirmity. Often they cannot manage all of the necessary household duties incident to their physical safety and emotional well