Ahrens, Robert J., director, division for senior citizens, city of Chicago___ 1201 Oliver, Mrs. Frank, assistant director, division for senior citizens, city of Weinberg, Dr. Jack, clinical director, Illinois State Psychiatric Institute-- Slader, Daniel A., administrator, Melbourne Nursing Home; represented by Thomas Sullivan and Allen Metz, attorneys; sworn statement of...- Halamandaris, Val, professional staff, Senate Special Committee on Aging; Slader, Daniel A., statement of, continued.. Glass, Dr. Albert, director, Illinois Department of Mental Health.. Snoke, Dr. Albert, coordinator of health services and director of compre- hensive State health planning program, State of Illinois-- Hammerman, Dr. Jerome, assistant professor, School of Social Service Appendix 1.—Additional material from witnesses: Item 1. Impact on the community of the accelerated discharge program of elderly patients from Illinois State mental hospitals; report- division for senior citizens, Robert J. Ahrens, director, Department Item 3. Letter from Alan L. Metz, attorney, Jenner & Block, Chicago, Ill.; exhibits for Mr. Daniel Slader, administrator, Melbourne Exhibit B. Statement of Mr. Marvin Fox, accountant, Melbourne Nursing Home, food cost figures, latest fiscal year.. Exhibit C. Copy of page 2, 1970 partnership tax return, indicat- Appendix 1.-Continued Page Exhibit I. Statement by Daniel A. Slader, ownership of the land and building occupied by Melbourne Nursing Home... Item 4. Dr. Albert J. Glass, acting director, State of Illinois Department of Mental Health....... 1351 1351 Appendix 2.-Statements submitted for the record: Item 1. Prepared statement of David L. Daniel, director, Cook County 1355 Attachment 1. Memorandum-Report on nursing home investigation___ 1357 Attachment 2. Description of field caseworker's job at nursing 1360 Attachment 3. Interoffice, memorandum, reference information 1363 Item 2. Prepared statement of Jerome M. Comar, president, Jewish 1364 Item 3. Prepared statement of Jane Garrettson, director, Service for 1366 1367 Appendix 3.-Statements submitted by the hearing audience: Chiswick, Nancy.. 1371 Fabry, John R.. Kamlager, Carolee.. Leary, Arthur J. McNeilly, Laurina......... 1371 1371 1372 1372 TRENDS IN LONG-TERM CARE SATURDAY, APRIL 3, 1971 U.S. SENATE, SUBCOMMITTEE ON LONG-TERM CARE, Chicago, Ill. The subcommittee met at 9 a.m., pursuant to call, in room 250, Behavioral Sciences Building, University of Illinois, Senator Charles H. Percy, presiding. Present: Senators Percy and Stevenson. Staff members present: William E. Oriol, staff director; Val Halamandaris, professional staff member; John Guy Miller, minority staff director: Gerald D. Strickler, printing assistant; and Patricia G. Slinkard, chief clerk. OPENING STATEMENT OF SENATOR PERCY, PRESIDING Senator PERCY. The second day of hearings on long-term care before the Subcommittee on Long-Term Care of the U.S. Senate Special Committee on Aging will come to order. I will open the proceedings, in the absence of Senator Frank Moss, but again wish to extend the appreciation of both Senator Stevenson and myself for Senator Moss being with us in Chicago yesterday and personally visiting one of our homes. At this time the committee will ask Mr. Robert J. Ahrens, director, city of Chicago Division of Aging to join us here at the witness table. We are happy to have you with us, Mr. Ahrens, and if you would identify yourself officially and your colleague and associate, we will proceed just as you see fit. Mr. AHRENS. All right. My name is Robert J. Ahrens and I should say that I am director of the Division for Senior Citizens of the City of Chicago, Department of Human Resources. This is Andreé Oliver, actually Mrs. Frank Oliver, who is assistant director of the division for senior citizens. STATEMENT OF ROBERT J. AHRENS, DIRECTOR, DIVISION FOR SENIOR CITIZENS, CITY OF CHICAGO Mr. AHRENS. The particular problem that this hearing addresses is seen best as an aspect of an even larger problem, and one that is essentially new. The number of people age 65 and over, only 3.9 per cent of our State's population in 1900, is 10.1 percent today, and the numbers are growing. As the story goes, in 1900 people worked 70 hours a week and died at age 40. Today they work 40 hours a week and are going strong at age 70. Perhaps we need to point out that, of our people age 65 and over, only 4 percent are institutionalized in hospitals, nursing homes for the aged, and similar facilities. Fully 96 percent of our elderly are in the community. Of these, 8 percent are homebound and bedfast and another 6 percent are limited in mobility. CHANGES IN OUR NATION'S POPULATION You know these facts intimately, but our Nation needs to know them better, to understand the changes that have taken place in our population, to have a true picture rather than a false image of aging and our elderly, and to understand and support the programs that must be gotten underway. The problem of numbers of older people in America is relatively new. The medical field of geriatrics and the field of social gerontology are both also relatively new. This newness has, of course, important implications for community education in the problems of aging and for recruitment of professionals and other workers to these fields. Most importantly, the institutions of our society, private as well as public, have not yet adjusted their priorities to the realities of this new problem. The elderly are, as a consequence, too often left out of planning considerations, too frequently overlooked and underserved. To the extent that this hearing can constructively affect this larger problem, it will be dealing not just with symptoms but rather with their fundamental causes, and this we need to do. I offer for the record of these hearings two reports prepared by the Division for Senior Citizens. One, issued on January 26, 1971, proposes "Standards for Serving Older People in a Neighborhood Health Center."* Directed to the maintenance in independent living of the 96 percent of the elderly who are in the community, it has been accepted in principle by the Chicago Board of Health. The second report by our staff, called "Impact on the Community of the Accelerated Discharge Program of Elderly Patients from IIlinois State Mental Hospitals: A Statement of the Problem," was published in January 1970.** It was occasioned by the signing into State law in September 1969 of several bills which amended the Illinois Mental Health Code in relation to the elderly. BILLS REVISIONS IN HEALTH CODE In brief, this report points out that these bills revise the definition of a person in need of mental health hospital care in order to exclude senility; provide for the review of aged mental patients to consider the possibility of care outside the hospital; require an ex *Retained in committee files. **See appendix 1, p. 1323. amination of persons age 60 and over prior to hospital admission; and require followup care for patients placed outside the hospital by the Illinois Department of Mental Health. It reports estimates by the Department of Mental Health that 7,000 to 10,000 elderly patients would be returned to the community by mid-1971 under the new legislation. It notes that very few elderly are released to independent living under this program and that most require some type of protective setting such as nursing homes or sheltered care homes, and that these are already operating at near capacity. Further: In Chicago, 32 percent of the nursing home beds were rated noncoforming and noncorrectible by Hill-Burton standards. The supply of sheltered care beds is inadequate. Enforcement of 1970 licensing standards will further deplete the inadequate supply of nursing and sheltered care beds. Supportive followup by the Department of Mental Health is very limited. Although private agencies do offer casework, counseling and other services to the elderly, limited funding and shortages of qualified personnel restrict any significant increases in their caseloads. Most of the elderly to be discharged will be recipients of public assistance. With limited income, these elderly will be least likely to secure long-term care beds which meet acceptable standards. Administrators of many facilities complain that payments from public aid are inadequate to meet their costs for service. Therefore, low priority is given to placement of public aid recipients. Neither Chicago's communities nor its service systems are prepared to absorb immediate implementation of the accelerated release program. The impact of the program will be most severe on those communities whose resources are already severely depleted. These are the salient points of this report, which was given wide circulation in the mental health field and in the field of aging. Seven months earlier, on July 7, 1969, when the legislation involved had been passed, we enclosed materials on this problem in letters directed to the chief editorial writers of four Chicago daily papers, in our continuing efforts to educate leadership to the complexities of the problem. These letters said, in part: The question of placement and removal of elderly patients in state mental hospitals is of concern to many, particularly now the 7,000 are scheduled to be removed from Illinois hospitals and returned to the community. The chief reason for placement of elderly in state mental hospitals has been that adequate alternative community facilities were not available. They are still not available. The problem will not be resolved, nor is it fair to the elderly simply to move them around and have "many small warehouses take the place of the large one." We do not believe the problem has yet been understood in its full complexity. The handling of the accelerated discharge program clearly indicates the need for improvements in statewide planning for our elderly. We believe this might largely be remedied by passage of Illinois Senate bill 147, now before the 77th Illinois General Assembly, which would establish a new and more effective State unit on aging. Passage of this legislation is one positive forward step we can take. |