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There is one new important item, though, that we should keep under advisement as we consider this issue. That is that there are 412 area agencies on aging throughout the Nation as a result of what could be called the Herculean efforts of the Administration on Aging to put these in place. Every State has an administration on aging. At the local level there is greater opportunity for older persons
and groups concerned with older persons to impact on the decisions made by that community with respect to how those resources will be utilized.
Again, at the Federal level we have the constant and continuing involvement that we had with the Department of Transportation to which Dr. Flemming referred previously which is demonstrated by the fact there have been $20 million which has been allocated by the Department of Transportation specifically for transportation programs for the elderly.
I hope that no member of the committee will by any means think that our interest in allowing this to expire is in any way indicative of our concern with respect to the problems of the transportation of the elderly. It is merely that we do believe that with the growth and the establishment of those area agencies, with the working agreement we have already been able to develop with the Department of Transportation and with new legislation in addition, we can do a far more effective job in providing transportation resources and services to older persons.
Mr. FLEMMING. With respect to rural areas particularly could I identify a couple of significant developments ?
As I indicated earlier, under an amendment to the Federal Highway Act of 1973 about $10 million was appropriated for demonstration projects in rural areas. The Department of Transportation as a result of conversations that we had with them has instructed its regional representatives to contact the Administration on Aging's regional program directors on aging with regard to recommendations for the funding of specific projects in their area.
Then, of course, we have notified the State and area agencies to how they can get into the picture.
But, even more significant, under the National Mass Transportation Act of 1974, for the first time Congress has authorized $500 million for capital assistance in rural areas. We are working with the Department of Transportation to make sure that older people get their fair share of that resource.
Now I understand the skepticism that has been expressed by the Chairman and Mrs. Chisholm. We think the working agreements can add will produce results.
I will be glad, Mr. Chairman, a few months from now, to come before the committee again and report on the transportation situation. I think that we have an opportunity of really helping older persons in this area. It may not work out that way.
Mr. CORNELL. One other question which may be repetitious.
I noted Dr. Flemming mentioned 18 to 20 percent of the elderly living below the poverty level.
Last week in my State I saw it was 25 percent.
The President of the United States has suggested limiting increases in social security benefits to 5 percent.
We have been having double-digit inflation. Since last July, the cost of living has gone up 6 percent. In view of that, and because of the particular economic situation of our elderly, why should not the budget request be substantially more for funds for the next 2 fiscal years?
Mr. THOMAS. As you know, the President has been very clear in his desire to maintain Federal spending the same rate in 1976 as in 1975.
Dr. Flemming mentioned that the whole issue of the economy and available resources will be something that the Congress and the administration will be discussing over the next few months.
All we can say is that within the context of the resources that are made available, we will do all we can to maximize those resources.
In reference to the 5-percent increase, and obviously this is an issue that the Social Security Administration is most involved in, I think it is fair to mention that it is a 5-percent increase and that it is not in any way a decrease.
We are all very well aware of the special problems that face many elements of our society as a consequence of inflation and recession. Within the resources we have available and within the policies established by the administration, we will strive to do a maximum amount in providing resources and services to older persons.
Mr. CORNELL. Thank you.
Mr. BRADEMAS. Another new member of the subcommittee we are pleased to welcome is the gentleman from Rhode Island, Mr. Beard.
Mr. BEARD. Thank you, Mr. Chairman.
Dr. Flemming, there has been a lot of conversation today on the agencies and regulations and supporting agencies in various States.
I have two questions right from the field, from an old lady that lives in a slum in a third-floor apartment.
We have 6,000 people in Rhode Island in nursing homes. She wants to know what is the agency doing to correct some of these swill buckets that we put our elderly people in, not only nursing homes but some of the institutions.
Also, the second question.
There has been a big emphasis in this country on conserving energy. In Rhode Island, we have our public transit system. During the offpeak hours from 9 to 3 in Rhode Island and probably elsewhere there are very few people riding buses.
Is the agency doing anything to get the elderly people to ride free where we won't be wasting gasoline and we will be giving these people a break?
Mr. FLEMMING. As far as your first question is concerned, you have identified, of course, one of the most serious problems confronting our country at the present time. There are about 5 percent of the persons 65 and over, namely, a million people, who are in the kind of institutions that you have identified. There is no doubt at all but that although some render good services, a good many render service that is below any kind of an acceptable standard.
The Department of Health, Education and Welfare over the last few years has been very much involved in this area through the development of new regulations, the implementation of new regulations, and the training of people at the State level and other levels that are involved in making inspections and rendering services.
The present Secretary, and the man who served as Under Secretary up to a few weeks ago, have devoted a great deal of time and effort and energy designed
to bring about some change in these standards. Neither they nor anyone else will allege that adequate progress has been made.
All we have to do is read the New York City newspapers in terms of what is going on in New York State at the present time to realize the kind of problem that we have on our hands.
We, as an Administration on Aging, work directly with the Office of Nursing Home Affairs in the Department of Health, Education and Welfare. As I indicated earlier, we have a chance to review and make recommendations on all of the regulations. We have an opportunity to make suggestions as to a better implementation of the regulations.
We have been assigned responsibility to take a look at the possibility of the ombudsman function, making a contribution to this particular area. I look forward to the possibility of there being a nursing home ombudsman in every State agency on aging.
We need a vigorous implementation of the existing regulations. The department is deeply involved in a program designed to achieve this objective. We are far from satisfied.
As far as your question on transportation is concerned, there are a good many places in the country that do provide some subsidized transportation for older persons in a great variety of ways. Some of those programs are supported through title III funds where an area agency on aging may decide that that is an important priority.
You may have also noticed, and I think this is a real breakthrough, that the new National Mass Transportation Act mandates that any recipient of capital assistance from UMTA must provide half fares on public transit for older persons and the handicapped. That is now a nationwide policy. The receipt of assistance will be conditioned upon local bodies making provision for that. I think that constitutes a real breakthrough on that particular point.
Mr. BEARD. Thank you.
Mr. BRADEMAS. Another new member of the subcommittee is the gentleman from New York, Mr. Zeferetti.
Mr. ZEFERETTI. I find myself a little bit going back to what my colleagues referred to before as to the expiration of two programs that we feel are essential on the part of the administration.
I find myself asking: Why not keep it within and form some sort of task force to coordinate with the other agencies a viable force to make sure that these programs are extended and that the people can get that type of service that is so much desired at a time when we are trying to help?
It is beneficial and we have such a short period of time between now and the expiration date, that to make an evaluation and say you are going to come back in March or April to give us an understanding of what the other agencies are going to do we might be too shortsighted.
I am wondering whether or not from within there can be some sort of task force or some sort of coordinated effort to keep it in the Administration on Aging and go forth in that direction.
Mr. Thomas. Congressman, I can appreciate very much your concern over meeting the problems of the elderly in housing and multipurpose senior centers and in transportation,
We deliberated on this subject for some time in the Department. In the final analysis, the important thing is that each of the elements of our Department and other Departments have a responsibility in the provision of services to older persons. There are those occasions when, as a consequence of the existence of authorities in other agencies, an agency with the principal responsibility for a particular activity does not meet its responsibisities because it can look to another place.
There is no question that the problems of transportation, and the problems of multi-purpose senior centers are ones that have to be addressed. When it comes to activities in these areas, we in the Department of Health, Education, and Welfare have not built and do not have expertise. Nor do I think we should. I think the Department of Transportation has its responsibilities in transportation; Housing and Urban Development has its responsibilities in housing and urban development; just as in our own Department there are areas concerned with nursing homes, areas concerned with soical security, areas concerned with medicare and medicaid.
Sometimes the attempts to place organizationally in an agency responsibilties for which it has neither the resources or the expertise, I think, misses the point. I do, however, agree wholeheartedly with your comment that it is imperative that we work with the Department of Housing and Urban Development and the Department of Transportation.
As Dr. Flemming has noted, we have initiated that program and we have some positive results. We continue to feel that is the most effective way, from an organizational point of view, from a management point of view, and in terms of the way the Federal Government is organized.
Mr. ZEFERETTI. Thank you, sir.
I am really concerned about the time factor. We don't have that much time.
Until we get some real solid information coming back, we may find ourselves cutting a program that we don't want to cut, to begin with, and that won't have the kind of help necessary for the people we are concerned about.
Thank you, Mr. Chairman.
Mr. BRADEMAS. Another new member of the subcommittee is the gentleman from California, Mr. Miller.
Mr. Miller. I would like to go back to Mr. Cornell's question regarding the 5 percent social security increase.
Mr. Thomas, you stated we have to remember that it is, an increase and not a decrease. I would say that it is less than charitable. In these times, I wouldn't expect a decrease.
Also, it reminds me a bit of a former Governor of the State where I come from who used to tell us he was giving more money to higher education, more money to the poor senior citizens than ever before, but when you looked at it in absolute terms, those institutions and those people were worse off than before.
I would really like to ask you how the administration arrived at the conclusion that a 5-percent increase-in view of the increased cost of food, fuel, shelter, transportation and clothing—is adequate.
Mr. Thomas. Your question obviously would be more appropriately posed to those areas of the Department specifically concerned with social security, the Social Security Administration.
However, as you well know, the budget of the Department of Health, Education, and Welfore, has been increased between 15 and 17 percent a year over the past 3 or 4 years, which means that within a given year our budget goes up in the neighborhood of $17 to $20 billion.
What the President has said is that the Federal Government budget is escalating to a fairly substantial degree because in some areas where we have indexed increments we must increase outlays based on the consumer price index or other indices. I know that he and we in our Department are particularly concerned about the implications of inflation on the more vulnerable elements of our society.
I suggest that for the record I would be delighted to have my colleague, the Commissioner of Social Security, provide you with some background information on how and why that 5-percent figure was arrived at.
Mr. BRADEMAS. Does the gentleman from California yield?
First of all, I am sure you are not, Mr. Secretary, suggesting that social security is funded out of general revenues ?
Mr. THOMAS. No; I am not, Mr. Chairman. I did not mean to.
I always found it quite offensive when the former President of the United States would make an observation about how much more money his administration was spending for human services and then would include into his calculations the huge expenditures through the social security trust fund as if somehow they were the product of his own leadership and largesse which was, of course, terribly misleading.
The other point I would simply make, if my friend from California will yield further, is that yesterday I introduced on behalf of myself and the majority leader, Mr. O'Neill, and Mr. Burke, the chairman of the Subcommittee on Social Security of the Committee on Ways and Means, a resolution expressing the sense of Congress in opposition to President Ford's called-for 5-percent ceiling on social security increases this year which, as I understand, would increase in the summer about 8.7 percent.
I feel very confident that we will not agree to what the President wants.
I thank the gentleman.
I certainly will join in that sense of Congress resolution. I really think that to sit here and go into the records and talk about increments and the way budgets mount up really is just so many words to the people who have to live with those checks on a monthly basis.
I am a strong believer that somehow this country is going to be judged by how we treat these people. I think there are other alternatives that have to be made available. I hope that you would express to the Secretary my interest in how the 5-percent limitation was arrived to, and my biases in that regard. I would appreciate that.
Mr. BRADEMAS. The gentleman from Washington, Mr. Meeds.
Please execuse me for having had to depart a couple of times during your testimony.