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And further, he wished me to express his deep concern about the subject of your inquiry, the costs and delivery of health services to older Americans.

Los Angeles historically has been a mecca for the elderly and retired, who seek sunshine, comfort, and ease of living in their later years. Approximately 10 percent of our city's population is aged 65 and over—that is, some 300,000 senior citizens.

Senator WILLIAMS. Would you just repeat that!

Miss CARROW. Yes. Approximately 10 percent of our city's population is aged 65 or over-that is, some 300,000 citizens.

Senator WILLIAMS. That is just the city of Los Angeles? Miss Carrow. That's right. This important segment of our population comprises a community with few geographical limits but with special needs that must be met by special services from both government and private enterprise.

From the earliest days of his administration Mayor Yorty has taken active interest in the challenges and conditions encountered by our senior citizens. One of his first official acts was to form the Mayor's Committee on Senior Citizens Affairs.

Composed of outstanding persons in fields of endeavor identified with senior citizens, the committee explores and recommends improvements in such areas as recreation, transportation, housing, employment, and health. Not all of these areas are within the province of the city

health services for one is the concern of county, State, and Federal Government.

Even though health care is outside his jurisdiction, Mayor Yorty believes adequate medical care is a primary concern and a right to be enjoyed by all senior citizens. For that reason he has sponsored medicare and its California State counterpart, Medi-Cal.

He has urged a full measure of attention to the health needs of our senior citizens.

The path of medical assistance for the elderly has not been smooth, as you will hear from other speakers today. That is one reason why we welcome your hearing here in Los Angeles.

We believe, as Shakespeare wrote, “To lose thy youth in peace, and to achieve the silver livery of advised age," is one of the rights of all.

We hope and trust that the outcome of your hearings here and across the Nation will make that right a reality for all Americans.

Thank you.

Senator WILLIAMS. I would like to have you repeat that Shakespearean quote again.

Miss Carrow. Thank you.

“To lose thy youth in peace, and to achieve the silver livery of advised age,” is one of the rights of man.

Senator WILLIAMS. Bill Oriol said, “I wish I had said that." Thank you, Miss Carrow.

Miss CARROW. Thank you.

Senator RANDOLPH. Longfellow said it another way. He said “For age is opportunity no less than youth itself, though in another dress," since we are talking about poetry.

Senator WILLIAMS. Thank you very much.
Mrs. Russell, from the California Commission on Aging.
You are chairman, as I understand it?

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Mrs. RUSSELL. Senator Williams and Senator Randolph, and gentlemen, I am Mrs. A. M. G. Russell, chairman of the California Commission on Aging, and on behalf of myself, of Mr. Charles W. Skoien, Jr., executive director of the California Commission on Aging, and of Mr. Carel Mulder, director of health care services of the State of California, and as representative of Governor Reagan today, we welcome you to the State, a State with a senior population of nearly 2 million, approximately 10 percent of our national senior population.

Senator WILLIAMS. "I will say we are going to be a little less than formal here. I don't know what your full name is. I have it A. M. G.

Mrs. RUSSELL. I'm Bonny Russell.
Senator WILLIAMS. They call you Bonny?
Mrs. RUSSELL. That's right.

Because of the importance of this hearing today, and those you have had in the past in Washington and in New York, I would like to provide you with a little bit of background regarding activities that relate to the delivery of health care services in California.

It is the role of the California Commission on Aging to advise and counsel, and cooperate with all governmental and private agencies that are serving the senior Californians.

It is the job and responsibility of the commission to work as enablers in the provision of health services.

It is our sincere belief that in order to render quality health services it is vital that the responsibility not be vested in any one agency or organization—but, must be shared by all. This means that our national society must work together to create an adequate health pro

gram for all.

It has been our privilege in California to see our senior Californians give of their time, their talent, and energy—and most of all, their experience to the local community not only for their own personal benefit, but for the benefit of the health and welfare of each of their communities.

Also, through many innovative and creative ideas, California is developing many new ways to serve the elderly through preventive means.

For example, there are two senior Californian regional education centers, one in San Jose and one in Los Angeles; centers funded through the Older Americans Act with programs which bring the local community and the local college or university together to provide a comprehensive senior program.

Through this effort, in the field of health we will be providing daily meals, nutrition program health lectures, training of health leaders, and most of all-a public education program showing the community the need for adequate health planning.

Other aspects of this program will be a 7-day-a-week multipurpose program, a training center for college and university students, a community outreach program utilizing the senior Californians in the community on a paid basis, and an extensive training program for administrators of nursing homes, board and care homes, homes for aged; administrators in the fields of housing, employment, religion, education; for civic leaders, for those in charge of service clubs or women's organizations; and, of greatest importance, a training program for the seniors themselves.


This example is one of the 44 Older Americans Act programs administered and funded by the California Commission on Aging.

The Older Americans Act programs in California are providing protective services, information and referral services; there are multipurpose centers, Foster Grandparents type programs, reachout programs, shutin programs, counseling services, visitation programs, education classes, casework and group work programs, volunteer services, parttime employment services, training of professional and volunteers and the Older Americans Act in California helps provide complete coordination of services.

With these programs and through the efforts of the 58 counties and the 401 cities in our State, we believe that we can successfully meet the needs for delivery of health services to the people of our State through good sound planning and the development of new and creative ideas.

Full cooperation must be given by the family, community, and society in helping the senior Californian realize an adequate health program. It is our desire and the Governor's desire-in California–to provide every senior Californian a retirement that is productive, creative, and meaningful.

Some of the health service needs are being met through the funding of the Older Americans Act, and as additional funds from this act and others are provided, more services can be made available. We are aware of many of the needs and will continue to work, as a powerful force composed of government, business, industry, and concerned individual Californians, toward meeting the health needs of all our citizens.

We shall be here throughout the day, gentlemen. We shall be very glad—the three of us—to answer any questions that you might have concerning our program here in California.

Thank you.

Senator WILLIAMS. Very good. Your statement indicates a most enlightened program here in California, which is what I would also describe as a retirement State.

So your percentage of people who are in retirement here probably equals Florida, Arizona, and places where

Mrs. RUSSELL. Our percentage is a rather normal percentage, because California attracts the young as well as the old. It is under the national average_percentagewise.

Mr. WILLIAMS. You are moving across the board to meet the needs of the older people.

You are moving across the board to meet the needs of the older people.

Mrs. RUSSELL. We are certainly trying to.

Senator WILLIAMS. How do you—I hate to talk money—but as a budgetary matter, how do you budget the programs, and how much do you put into the programs you discuss ?

Mrs. RUSSELL. Of course the amount varies as to the kind of program and the size of the community. The regional educational programs

that we are establishing—the center programs—have been funded by the commission at around between $32,000 and $35,000.

Of course the community adds a great deal to this, too, in matching funds. They are required in the first year to only match up to 25 percent. But I think in the two places that we have programs established at the moment, they are matching to a much greater extent than that.

Senator WILLIAMS. The two places are San Jose and-
Mrs. RUSSELL. San Jose and right here in Los Angeles.

Senator WILLIAMS. Yes. And you have many more communities to reach.

Mrs. RUSSELL. Yes. These are regional programs, and we intend to reach into five areas of California, and hope that these centers, on an educational basis, will serve the entire region.

Senator WILLIAMS. Is there any great resistance from the taxpayers?

Mrs. RUSSELL. There seems to be a readiness, certainly, to provide programs in California for older persons. We do have 44 programs funded under the Older Americans Act. And a good many of these are entering their third year of funding and hopefully, some of them, will receive funding by the local community or by private agencies, in the fourth year.

We had perhaps hoped that some of them would have a fourth year of funding allowed.

Senator WILLIAMS. I presume, to make the conclusion, that you unequivocally approve of continuing the Older Americans Act, and you speak for the Governor of the State of California ? Mrs. RUSSELL. Yes. Thank

you. Senator WILLIAMS. Yes. Very good. Senator RANDOLPH. Mrs. RussellMrs. RUSSELL. Oh, I am sorry. Senator RANDOLPH. That's all right. I shall not keep you very long.

I wanted you to tell us what percentage, if you have it as a fact, of the persons over 65 in California who reside with a son or daughter, rather than live in a house or in an apartment which is maintained by that older person.

Mrs. RUSSELL. I don't have that figure, Senator, I think probably along the lines of the national figures—which are rather high in this category.

A good many of our older people continue to live with their children, particularly the very elderly-the people in the over-85 group.

A great number of them live with a son or a daughter. Senator RANDOLPH. Now the areas in California, as in other parts of the country, where the older people have been grouped together: How are they working out in California ?

Just to use Leisure World as an example


Mrs. RUSSELL. Well, it is very interesting to discuss that, and I think that perhaps for the most part they haven't been established long enough to really know their impact on the community.

Reports from individuals living in the communities are very favorable. They like it. And very few of them have, really, moved away from them. On the whole, they are a rather young group at the ma

ment, speaking about the older people in the community. They move there in their younger years of their retirement—so that, in years to come, it will be an older group and perhaps will change in complexion to some extent.

Senator RANDOLPH. Thank you, Mrs. Russell.

Senator WILLIAMS. We are grateful to you ladies for your very helpful testimony on questions of vital interest to the whole Nation, and of legislative concern to ourselves.

We will pause for a moment. I understand the speaker of the Assembly of the State of California, Jesse Unruh, is beleaguered by television interviewers with political questions outside the door.

Senator RANDOLPH. Mrs. Russell, how long have you been in the work in which you are engaged?

Mrs. RUSSELL. Thirty-seven years.

Senator RANDOLPH. You know, I sensed this as you spoke. You were very well grounded in the subject matter. I didn't want to pursue it with further questions-I can tell.

Senator WILLIAMS. I did overlook introducing John Guy Miller, who is one of the members on our staff for this discussion--for the Committee on Aging, and I forgot to ask you if you wanted to ask any questions, John, but we will catch up with that later.

We are honored, indeed, to have a television personality--all those cameras were out there for you, weren't they, Mr. Speaker?

Mr. UNRUH. Well, they are really out there for the Governor—what I had to say about him.

Senator WILLIAMS. The Honorable Jesse M. Unruh, speaker of the Assembly of the State of California.

We want to express our gratitude to you. You came here today to help our discussions on an important matter dealing with older people.



Mr. UNRUH. Mr. Chairman, members of the committee, let me introduce Mike Manley, who is my legislative assistant in Sacramento and is here with me today in case you have any detailed questions beyond what I might, with my somewhat cursory knowledge of the detail in this field, be able to answer.

Let me apologize, first of all, for my having absorbed what I am afraid is far too

much attention that should be directed on the activities of this committee. Unfortunately, I had little control over what the Governor said yesterday about the legislature, and that is what attracted the television attention.

The attention should be focused on this hearing, because what you are doing here today is far more important than anything the Governor and I might have to say about each other.

I do express my thanks to you and your staff for asking me here to testify before you on something which I think is of central, present public concern, which is provision of health care to our senior citizens.

As I said, I am not an expert in depth in this field, but I am very concerned over it. It seems to me there are two fairly obvious comments about the problems of costs and delivery of health care services to older Americans. The first is that using health care in its strictest interpre

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