One hot meal a day in a site for 5 days or more a week in a social setting involving social services is ideal. Let us keep it and try to insist on this arrangement as much as possible but let us also try to provide for the people who meet for a lesser time per week. At least one hot meal a day in the same environment as the 5-day-week program under the same circumstances is better than no meal at all.

Further, gentlemen, it has been proven that these programs are not a waste of money, energy, or time but instead are a means of reaching more elderly, especially the isolated, to motivate them as well as to educate them and to provide social services.

So I beg of you to include this group of programs in the plans for the nutrition program for the elderly.

The goals established in the nutrition program are worthy ones, but let us not overreach, for goals set too high may fail to be as far-reaching as they could be or as realistic.

The conscience of the Nation has been aroused and concern for the elderly has reached new heights. Let us not be hasty to cut off those programs already meeting the needs of the elderly but instead help to reinforce these efforts as new goals are established. At least, let us try. Thank you for inviting me to be with you this afternoon.

I close with the hope that this committee will continued to see fit to work in the interest of enhancing the lives of the senior citizens of this country. In their behalf, again, I thank you.

Senator PERCY. Mr. Kramer?

STATEMENT OF EDWARD J. KRAMER, DIRECTOR, SERVICES TO THE AGED, HENRY STREET SETTLEMENT, NEW YORK CITY

Mr. KRAMER. Thank you, Senator Percy.

I am Edward Kramer, director of the services to the aged at the Henry Street Settlement in New York City.

I will submit my written testimony* for the record and review the major points which I believe are important.

In speaking to many older people, we in New York City, would like to redefine, as was suggested by Mr. O'Malley of our State office, the definition of minority groups to read: "The definition of minority groups should not be limited to specific ethnic or racial groups but should be broadened to include all limited English speaking aged poor."

We also believe in-kind resources should be expanded to include credit for property, rent, facilities, and equipment and that the 10-percent non-Federal matching requirements by the State, the State should be able to consider this as a contribution of a local sponsor.

Senator PERCY. Could I ask a question there that puzzles me on limited English-speaking aged poor. What if you have very large Jewish communities, low income Jewish communities, but there is no problem about English speaking at all. They might speak perfectly fluent English. There is a particular dietary problem, particularly for a lot of orthodox. Wouldn't that be looked upon as a minority group then?

*See p. 288.

Mr. KRAMER. I would hope so. Then again, in many orthodox Jewish communities, you find people speak only Yiddish or Hebrew or mixed German or both.

Senator PERCY. We should not establish a criteria whether they can speak fluent English or not.

For nutrition purposes, we have to take into account that special dietary needs and requirements exist in certain groups in America that must be and should be respected.

Mr. KRAMER. I think one of the problems we found with some of the OEO programs and some of the Model Cities programs is that you get in New York and Chicago, the blacks wanting one program, the whites wanting another program, the Polish people wanting this, the Jews feeling they are left out of that.

As a person working with people for many years, I want to say let's avoid that now and let's not divide groups. There are enough divisions in this country. If we don't specify but limit it to the aged poor, and the other guidelines that are in the regulations, we would be better off.

DEVELOP ETHNIC MENUS AT LOCAL LEVEL

To continue, you had mentioned the regulations provide for meals which would meet ethnic and religious obligations, and I would like to recommend that the ethnic menus be developed at a local level with the cooperation of members of the program, of the site, and that the funds somehow be available for the supervision of the religious requirements.

For example, if we were to have a kosher program, you would need religious supervision, and it raises a question of who would pay for that. In New York City, the cost for that, to have a supervising rabbi, is $1,200 a year, and I would recommend that some decisions need to be made of where these funds would come from. Will they be the Federal funds, the State funds that come from the site, or should that be a contribution of the religious community?

I personally feel it should be a contribution of each religious community, and I am afraid we would get into where we have different leaders who see this as a way of getting Federal funds. I would hope that religious communities will see the benefit of this to contribute their services.

I would like to recommend that we try very hard to get food stamps, to again be able to be accepted for food, meals eaten at the center. It is not allowed at the present time and many people are using the food stamps, the people who are for home-bound meals. But many, many people have food stamps, and want to use them in the center. I hope through your cooperation and the cooperation of the Department of Agriculture this could be worked out.

The guidelines I feel are somewhat vague on project staff, and I feel very strongly the selection and competency of project staff be very specifically spelled out.

Let's develop job descriptions for the project director, for the nutritionist, and other people working on the staff.

Let's not get into the situation where we have people who have been in civil service a long time come down and get these jobs. I think the

experience we found in working in the nutrition programs throughout the country, that this is not a 9-to-5 job. People do show up for a meal at all hours, and they cannot be refused because it is my lunch hour or because during the summer I get off at 4 o'clock.

If we do this we will destroy this program for all older Americans. Let's look very carefully at who we hire, how we hire, and the qualifications.

I would also like to comment on the outreach programs.

The regulations specify, somewhat, what outreach is.

I believe, however, that outreach. Leaflets are not enough, radio announcements are not enough, even community meetings are not enough, but it must be mandated that staff spend a certain amount of time doing outreach, knocking on doors, sitting on park benches. You just don't open a program and expect old people to come down.

I also fear that some programs may be established in communities where there is a lot of crime and older people are just not going to come into a specific neighborhood. We must give some thought to the neighborhood, how people are going to get there, will there be adequate police protection at the site and I would suggest to you that it would not be wasting money to hire a guard or security guard at a particular nutrition site if that was a high-crime neighborhood.

I don't think by the time this program gets implemented we will solve the crime problem in our country, and you know this is one of the fears that many older people have.

I would like to end by reading a note, a letter* I received from an older woman the other day. She had seen something we did on the TV, and she writes-she is from Birmingham, Mich. She writes: "We live in a small house. We just about pay our rent and property taxes. The neighborhood is full of young folks. They don't care about us. I think they would like to shoot us. Maybe some day, God willing, they will get old also. We hear they will be feeding us, but when? They move so fast for the younger folks but they don't do it so fast for us older people. We don't have that time to wait.'

And you know, Senator Percy, I was thinking of something Robert Frost, the late poet, said in one of his poems, he said about "the long, long time to go before I sleep."

I hope this program will get off the ground much sooner because older Americans are going to be sleeping much too soon and let's avoid that. Thank you.

PREPARED STATEMENT OF EDWARD J. KRAMER

Distinguished members of the Senate Select Committee on Nutrition and Human Needs. I am Edward J. Kramer, Director of Services to the Aged at the Henry Street Settlement in New York City. I wish to thank you for the opportunity to testify on the proposed regulations and implementation of the Title 7 of the Older American's Act, the Nutrition Program for the Elderly, I believe that sensible regulations must be implemented.

These are some of my suggestions:

1. Definition of Minority Groups.-The definition of minority groups should not be limited to specific ethnic or racial groups but should be broadened to include all limited English Speaking aged poor.

*See Appendix 1, p. 332.

2. In-Kind Resources.-In-Kind resources should be expanded to include credit for property, rent, facilities, and equipment utilized by a local agency receiving a grant. Any labor or staff supervision provided by the sponsoring agency should be considered as applicable toward 10% non-federal matching requirements.

3. Fees for Meals.-The present regulations for fees for meals are vague and contradictory. Four years of experience from the twenty one existing nutrition projects prove that the aged participants want to pay a small fee for their meals. The present regulations perpetuate the narrow "social work and bread line" philosophy of years ago and remove any and all dignity from the program. Instead of the present regulations, it is recommended that the older people at each site be allowed to determine for themselves what they should pay for the meal, and this fee be clearly posted for all to see. Of course, there will be a few who cannot afford to pay. These people can be given meal tickets just as the paying members are, or other sensitive means can be arranged so that non-paying members are not ostricized from the majority.

4. Low Income Areas.-Present regulations make provision for preference in awarding grants to low income neighborhoods. It is recommended that low-income not be defined by the total neighborhood, but by the incomes of elderly people living within. For example, many upper income neighborhoods have within these neighborhoods large concentrations of low income aged people.

5. Menus.-The regulations provide for meals which meet ethnic and religious obligations. It is recommended that ethnic menus be developed at the local level with the cooperation of the members of the program and funds be available for the supervision of the religious requirements. For example, a kosher program would need on-going rabbinical supervision at an approximate $1200 per year. Decisions need to be made where these funds should come from or if it should be a contribution of community service of the local religious community. 6. Food Stamps.-The regulations permit elderly people to use Food Stamps for homebound meals. It is recommended that, with the cooperation of the U.S. Department of Agriculture, elderly people be permitted to use Food Stamps for the meals eaten in the Center.

7. Project Staff.-The regulations spell out some vague guidelines for the selection and competency of project staff. It is recommended that all major staff jobs be filled by those people who have proven successful work experience with older people for at least three years. Jobs should not be given to long-time civil service bureaucrats who wish to move from one department to another and who have no experience or sensitivity toward the aged.

8. Outreach Programs.-The regulations do not specify what outreach should be. They refer vaguely to leaflets and some community meetings. It is recommended, however, that the outreach programs of the nutrition centers be aggressive ones. Staff should be assigned directly to the community and spend considerable time out of the center doing the necessary recruitment work. This means that opening a center will not insure that old people in the neighborhood will come unless door bells are rung and staff spends time sitting on benches encouraging old people to come to the center.

Illness resulting from old age and exacerbated by malnutrition leads to tendency among old people to spend their days in clinics, nursing further real or imagined illnesses. Loneliness also leads to further illness-real or imagined— and the clinics in city and private hospitals become improper and impromptu day centers for the lonely old people to gather and share their loneliness with one another. Most older people exist in a society oriented toward youth and they are isolated and in many cases forgotten by their families and friends. There is a tremendous need for a variety of services for these old people and for those services to be located under one roof. In the Nutrition program persons living near a site area should not need to go from place to place looking for the services he needs. It happens so often that even when services are available they are fragmented, uncoordinated and too difficult to locate for any but most sophisticated and persistent. A multi-services senior center would answer this problem. It would also mean that the elderly people could remain in the neighborhood that they know best and with the multi-services of an all purpose center could live in their home situation in their community and continue to function independently. The multi-services center would provide necessities which the older person can use to keep himself out of nursing homes, homes for the aged or other extended care facilities. One of the main purposes of the Nutrition site

must be to enable older adults to function best when they can remain in contact with the familiar environment and community they have known all their lives. Most professionals as well as older people themselves would agree that living in a home situation where you are responsible for yourself is better than being cared for. The Nutrition site must be able to provide short and long term services that will enable older people to continue living independently.

Senator PERCY. Thank you very much, indeed.

Mr. Simonsen?

STATEMENT OF IVAN SIMONSEN, DIRECTOR, SENIOR SERVICES, WESTERN IDAHO COMMUNITY ACTION PROGRAM

Mr. SIMONSEN. Thank you, Senator Percy and staff.

Scattered across America, living in their own little homes, are the rural elderly. Although they may not be concentrated in one area, since they tend to remain in the homes they have had, their needs do not differ from those of the elderly in the cities and the ghettos of America. They know the loneliness of a meal with no one to talk to and the hunger when that meal is skipped or eaten as a snack from the breadboard just simply because there is no incentive to cook properly for "just me."

Four years of work with the Title IV nutrition program for the rural elderly in six counties of Idaho, has shown that success is possible when several small cities are combined under one project. We witnessed and experienced the end results of the purposes stated in the proposed nutrition program for the elderly.

Around the meal program we have built a program that stimulates the whole person and makes him a brighter, more alert citizen and a real asset to the community.

I was going to do some background of the people in the rural areas, giving the background of how they feel; but I will skip that. It is in the report. I will go directly to some of the proposals in the rule sheet. Section 909.33 talks about project councils. This section implies a large central site with a project council elected from its participants, but in the rural areas where there are several senior meal sites separated by a considerable distance and each of these sites has their own advisory board composed mainly of seniors, to establish the proposed project council, rural areas must have the option to select from these local advisory representatives to a regional project council who could deal with the State agency, the Administration of the Aged. It is most important that the advisory board of each senior site has a chance for imput into the daily operation of the project.

Section 909.34, "Selection of Congregate Meal Sites." In section A, it states that the project area selected to receive awards will be chosen from locations having major concentrations of older persons from the low-income brackets. The term "major concentration" does not apply to a nonurban situation. Although Idaho has a high percentage of elderly citizens, our low-income elderly are scattered throughout our counties. Because of these factors, it is essential that the State agency be allowed much flexibility in choosing project areas. Depending on geographic limitations, one project area may consist of one county or several counties with sites in numerous small towns composing the award area.