will insure this other than enactment and speedy carrying out of this bill.

As medical director of continuing patient care, division of Jackson Memorial Hospital, it has been amazing to our department to see the small number of members of the senior centers that have had to be hospitalized or institutionalized in extended care facilities or nursing homes. The members of senior centers who have had to be institutionalized is far below the national average of 5 percent. Only one member has had to be institutionalized in a State mental hospitaland she has been returned to the community, in first a foster home, and now a nursing home setting. In over 9 years, and a membership of several thousand, this is indeed a record.

The Florida Council on Aging has a deep and abiding interest in the health care available to the older citizen of the State of Florida and would certainly strongly encourage the passage of H.R. 17763. Thank you for this opportunity of appearing before your committee, and making this statement.

Mr. BRADEMAS. Thank you very much, Dr. Perdue.
We'll begin with Congressman Pepper.

Mr. PEPPER. Dr. Perdue, I want to thank you very much, along with the distinguished chairman and a member of the committee for coming here today.

I think your testimony is very, very dramatic. You are telling us, as a doctor of long standing, and of outstanding distinction, that the mental attitude, as well as the balanced nourishment of these senior citizens keep them from getting in the hospital, when otherwise they might have to go there. So that a program like this not only saves them as a healthy normal being enjoying life, but also saves the Federal, State, and local governments money. If they're indigent the State government, as well as our Federal programs, must provide support for them, as in the case of a program which would provide for their care in the hospital, which is a great expense.

So do you think then, that this program is a sound financial venture in that it would be of a preventative nature and lessen the need for expenditures in other areas?

Dr. PERDUE. I certainly think so. Up until medicaid came into being our department here in Dade County was spending over $2,000,000 providing care in nursing homes for the older indigent person. This, of course, has dropped some with medicaid, but we have had a department that has furnished medical care to these people in nursing homes, and it has been most distressing that a third of our people have no families to return to and we've tried to get them back in foster homes to take care of some of them, but its been difficult-we've always had a staff here at senior centers to help us plan, along with our department, to get these people back living in the community in order that they could have meals and health maintenance programs providing care for them.

Mr. PEPPER. And this has contributed to keeping them out of the hospital?

Dr. PERDUE. Very definitely.

Mr. PEPPER. Thank you very much, Dr. Perdue.

Mr. BRADEMAS. Dr. Perdue, I'll ask you two quick questions. One, I note in your testimony your observation that adequate funds from

county, as well as from State, were not available to support the kind of program that Mr. Pepper's bill would support.

Why do you feel that no more support has been generated from county funds and from State funds for such programs in a State like Florida?

Dr. PERDUE. It was quite a shock to us because the county had supported the program here, at senior centers, and when the millage was cut to where the county could not go above 10 mills, and there had to be things cut, senior centers and programs for children, and some programs in the hospital were all cut. This was very distressing to everyone, and it was hard to explain.

Mr. BRADEMAS. So there really isn't any satisfactory answer other than an unwillingness on the part of your local and State leaders to come out in support of such programs?

Dr. PERDUE. That's right.

Now, actually, they-we-I think the county kept thinking that at the State level this millage would be allowed to be raised, but after some time, and after tax bills should have gone out, they kept waiting for a decision. When the decision came that they were not allowed to up the 10 mills, I think they were just forced into taking action and this was the manner in which they acted.

Mr. BRADEMAS. And I was also struck, as Congressman Pepper was, by your observation that a much smaller number of senior citizens have had to be hospitalized or institutionalized in extended care facilities and nursing homes than, I take it, you as a physician might normally assume, is that correct?

Dr. PERDUE. Well, the reason that I happen to know this is because in our department those people who are medically indigent are placed through the division, and I am medical director of that, and it's been a very striking thing to us that this has been the truth.

Mr. BRADEMAS. Well, I am very grateful to you for your statement. Coming from you as a physician with particular experience in this field, I think your testimony is all the more persuasive.

Mr. Hansen.

Mr. HANSEN. Thank you, Mr. Chairman.

May I join my colleagues in expressing appreciation to you, and to your contribution to these hearings, which, I think, is really very important. I think it's fair to say that one of the major obstacles that any new legislation, such as this, is going to cost money during a period when there is a very keen competition for available revenue. It's the cost. For that reason I think your observation is important and relevant. There must be an offset which represents the savings that will accrue, in medical costs and other costs by reason of the more adequate diet provided for older people.

To what extent will the cost of providing better nutrition be offset by the savings, medical costs, and other actual expenses that would otherwise result?

Dr. PERDUE. Well, with rising costs as it is, even in your nursing homes today, and particularly, you know, in the hospitals' cost, the way they're spiralling, the cost of food is so very great to these people that I feel that I couldn't say in what amount, but-and, of course, I know it's not only the food, it's the total program that's been helpful. These people gather together and this is where we have brought all

of our health agencies, teach them. We have had physicians to come and give of their time. We've used all of our volunteer agencies as well as the public health agencies in trying to keep them well. We brought the chest units, we brought immunization from influenza and the results have been almost fantastic. Even just this program.

And they come for lunch and we'd be able to tell them about it, you know. Then all that, and education, and all those activities depend on the total part of your program, and I think this, you're going to have to add, as well finding a place to serve their food. It would be hard for me, right at this time, to tell you how many, a percentage, you will serve. But I would like to get out some of our figures and put it against a national average of people of this age being in hospitals and nursing homes and try to send it to you later because I am intensely interested in it myself.

Mr. HANSEN. Well, I'm sure that we would welcome anything that you could furnish in that area because it seems to me that this is one aspect we should explore in some detail. I suspect that when a pretty careful analysis is made a very substantial part of the cost of the food may be offset in other savings.

Dr. PERDUE. It seems so to me.

Mr. HANSEN. Thank you very much. You've been very helpful.

Mr. BRADEMAS. Thank you very much, Dr. Perdue. We appreciate your very splendid testimony.

Our next witness, who has requested to be heard this morning, is R. O. Beckman.

Mr. Beckman, would you like to come forward, sir.

Mr. Beckman, I understand that you are presently a member, or have been since 1967, of the Florida Commission on Aging?

STATEMENT OF R. O. BECKMAN, MEMBER OF THE FLORIDA COMMISSION ON AGING

Mr. BECKMAN. I was on the Florida Commission on Aging of which Mr. McLoud was our director, and have been associated rather actively, intensively in that sense, with older folks for the past 16 years. I did not prepare a formal statement and hesitated to throw in a brief observation or two which may or may not be interpreted as criticism.

First of all, I'm in thorough accord with the overall objective of the Federal Government and the need to step in and support a nutrition and food program. There's no question about the need here in Miami where local centers have been handicapped by being cut out of funds. That's largely attributable to our apathy toward older people. Frankly speaking, of all the countries I know in the United States, Dade County is one of the most apathetic and indifferent. I regret to say that, but it's true, and I've lived here for a good many years. But as to the overall objective, I certainly agree that not only Miami but other localities need financial support for sound, feasible operating programs.

With great respect to the members of your committee, and particularly Congressmen Pepper whom we have long admired as an outstanding champion in behalf of the elderly, I don't want it thought I'm getting a bit critical, but I do see a few points in the law (as far as I've been able to check it) that are not clear. There is mention of "eligibility" in the law but no further reference to that term. It seems to me that

in this kind of program, because of possible tremendous costs if we undertook to give all people over 65 a free meal, we should have some kind of definition of those in the lower income brackets who are eligible. Free meals for them, with some arrangement by which others in a position to pay what they are able to, will promote social contact, recreational opportunity when brought together at mealtime—an important aspect of the entire food program.

The problem then arises, if we're not going precipitately into legislation of this kind at this time, of getting more factual information instead of the-if I may use the word-emotional approach of citing outstanding and tragic examples of oldsters who are not getting proper food, who are hungry, and there are many of them around the country.

The 30 to 50 food programs now being undertaken in the Nation should be assessed, appraised, and evaluated from the point of view of the benefits, personal, economic, and social derived. Some are in day centers, some are carry-out meals that are important but costly. The housebound are often those that need meal service most.

We need factual information and an analysis of demonstration programs underway to see why they succeed, the extent and nature of service rendered, how they are enjoyed, and particularly their cost. Mr. McKibben, when he headed the senior centers here, told me the overall cost was $1.42 per meal, yet the charge was but $0.50. That differential is such that serving even 5,000 persons though the centers, as Mr. Simson mentioned here, would run to more than a million dollars in Dade County alone. It's difficult to put older folks on the spot with a third-degree social worker quiz but some indication of inability to meet meal costs is needed.

Commissioner on Aging Martin, with that kind of study, could prepare for your committee the hard-boiled facts and expense involved in existing food programs. The Dade program has been fine and, together with public housing, comprises the two outstanding efforts here. But regrettably, the cost of the Dade Centers has been excessive, largely because of overhead expenses. The employment of more senior aides to take over as substitutes and serve with the professional staff would greatly lower operating costs. I'm hopeful some solution will be found.

Without being critical, it seems to me as Senator Cain pointed out earlier we need to find the best way of administering a food program. There appears to be nothing in the bill which indicates how control could be effected from the administrative point of view. I may be talking out of order but I do appreciate the courtesy extended me. Incidentally, Mr. Nicholson, regional administrator for the Administration on Aging, is in the audience. He's well informed in this entire field and you might wish to talk with him.

Mr. BRADEMAS. Thank you very much, Mr. Beckman.

I think your points are very well taken and we welcome the kind of criticism and constructive suggestions that you afforded us, and I think your point on the importance of our undertaking regarding careful cost analysis of the programs of this kind is exceedingly well taken. Now, we do have one other scheduled witness. Unless either of my colleagues cares to put a question to Mr. Beckman, the Chair would like to suggest that we bring our final witness on because we are now running rather short of time, and would like to invite Mr. Bill Wynn,

the executive director of the United Fund to appear and make his statement.

Mr. Wynn, we're glad to see you. Go right ahead, sir.

STATEMENT OF BILL WYNN, EXECUTIVE DIRECTOR, UNITED

FUND

Mr. WYNN. I wish to thank you for giving me the time to express my views on the desirability of continuing the low cost hot meal program in the senior citizens centers of Dade County and wherever else these noble services are presently available. In my humble opinion, it should be a nationwide effort.

Let me, if you please, divide my arguments for low cost meals into two parts. One, the nutritional values of the hot meals for the senior citizens, and two, the socialization of the elderly as they involve themselves into this program. Let us not, however, forget that we must also concern ourselves with the limited mobility of the aged and its housing. The nutritional value for the senior citizen should be self-evident. The fact that many of them because of limited financial resources cannot buy the proper food is a determining factor in the status of their health. Many, and I will say most, live alone and do not take the time to prepare a well balanced meal at least once a day. Some lack the effort to do so or do not possess the physical strength to help themselves. It is quite obvious that a plan must be devised to assist these elderly to receive a well balanced meal at least once per day.

We, at the United Fund, joined with some demonstrating mothers from the Federal Government to aid the senior citizens over a period of time in providing some low cost meals in Dade County. It is our fervent desire to continue this much needed service. We provide this acute need in an environment in a social setting. Thus we meet the needs with a low cost-$.50-for a nutritionally sound hot noonday meal in strategically located centers. We help to ease and sometimes end the isolation of old age through our well rounded social, educational, and cultural programs while at the same time provide casework assistance and health programs on a professional level. We increase the participant's knowledge of nutrition and health in general and promote the positive mental health and independence through the encouragement of greater physical and mental activities. The serving of the tasty, wholesome and satisfying hot meals is the major attraction at our senior centers.

Hence we must acknowledge that the mere serving of good food alone is not sufficient for the well being of the elderly. A well planned social program is good food too. That this is offered without cost to those who attend our centers is a credit to those who made and still make this facility available to all who apply. It assures better health among the elderly and thus eases the financial strain on public welfare agencies. The days of the alms or poor housing, has thru good public housing and the senior center, been relegated to the past. Now, the senior citizen can live out his most rewarding years in quiet dignity which he is entitled to.

Let me also congratulate those who are endeavoring to form a partnership with the Federal Government, the State, county, and local governments to cooperate in meeting the needs of the senior citizens. Perhaps, they too, realize that one day (and in some cases soon) they will be senior citizens.