have the responsibility of coordinating government efforts with regard to the aging and the aged. Would an addition be involved in making the grants to various local, public, and nonprofit groups for research and training of personnel in the problem areas with regard to aging and aged? I wonder if you would give us the benefit of your observations on this question, whether or not you feel there is a lack of coordination in Federal programs for the aged, and whether you feel the creation of some sort of coordinating group or agency that would have the functions I have described would be of benefit to the aged and to the local, public, and nonpublic agencies that are dealing with the problems. Dr. KIRKPATRICK. I think a commission that would coordinate the research and the implementation of programs for the aged would be good. I think you ought to have an office of education that would support the commission that understands this problem. You have a Department of Labor that I related this to, and Department of Commerce. They should be working at this the same as we would work about the problems relating to the 16-year-old or the 40- or 60-year-old. I don't think a commission that would say, "We are going to take over the implementation of everybody who gets past 60," would help any. This is a problem that cannot be solved by setting a chronological age limit. Some people are old at 30. They fossilize at 30. Some people are active at 70 and 80. I think you have to face the problem of what is psychological and sociological adjustment. Those are the problems that need sociological and psychological help. Mr. O'HARA. I think those comments are very perceptive. Dr. KIRKPATRICK. I would hate to say that at some age we would become wards of the commission on aging. Mr. O'HARA. I think you are absolutely right. I think we need cooperation, but we do not need an operating commission in the sense you spoke of. Dr. KIRKPATRICK. That is right. Chairman BAILEY. Doctor, on behalf of the committee, I want to thank you for your appearance here. I failed in announcing you as our first witness to say that you are president of the governors of West Virginia University, as well as a member of the State Commission on aged and aging. Thank you very much. Dr. KIRKPATRICK. I would like to say we appreciate this committee coming to Wheeling. Chairman BAILEY. Thank you. I am sure we will get some valuable facts. Our second witness will be Miss Dorothy Gingras, American Association of Retired Persons and National Association of Retired Teachers. You may further identify yourself to the reporter and proceed with your testimony. STATEMENT OF MISS DOROTHY GINGRAS, NATIONAL RETIRED TEACHERS ASSOCIATION AND AMERICAN ASSOCIATION OF RETIRED PERSONS Miss GINGRAS. Mr. Chairman and members of the committee, my name is Dorothy Gingras, of Washington, D.C. I represent the National Retired Teachers Association and the American Association of Retired Persons. These two associations are the cooperative enterprise of nearly a half-million mature persons gaining for themselves and their fellow retirees dignity, security, and prestige. Membership benefits of these two associations are: (1) The NRTAAARP Drug Service, which pledges to make every reasonable effort to insure members at least 25 percent off retail prices on both prescription and nonprescription drugs. (2) Subscription to NRTA and AARP publications. (3) Eligibility for the Group Hospital-Surgical-Medical Insurance Plan and Out-of-Hospital and In-Hospital Major Medical Plan for people 65 years of age and over, or for people receiving social security of 62 and over. (4) The NRTA-AARP Travel Services, which arranges low-cost European tours within the budget of hundreds of members. (5) The purchase of hearing aids from a highly respected company at a savings of 333 percent from the regular price. (6) A modern nursing home in Ojai, Calif. (7) Attractive housing projects in Ojai, Calif. The associations have a referral service for members whose inquiries are concerned with health, housing, social security, employment, pension programs, retirement income, education, and volunteer service programs. The National Retired Teachers Association and the American Association of Retired Persons are in favor of a program on the State and Federal level to coordinate and encourage programs for the aging. May I express my appreciation of the privilege of being invited here today. Chairman BAILEY. Does that conclude your formal statement? Mrs. HANSEN. I would like to ask, if I may, about your housing plan. I am interested in this. Is it a rental program or is it a purchase program? Miss GINGRAS. It is a purchase program. Mrs. HANSEN. Do they purchase prior to retirement? Miss GINGRAS. It is after retirement. One that is in operation now is for the National Retired Teachers Association at Ojai, Calif. They have a very lovely project out there. It consists of bungalows and apartments. You pay a certain amount for your apartment or bungalow. That includes life care. In connection with that, there is a nursing home known as the Occasious. There is a monthly fee on top of that for bills. I do not know the fee. Mrs. HANSEN. This is all within the abilities of the retired teachers? Miss GINGRAS. That is for the retired teachers. Now they are opening a hotel known as the Oakes, also in Ojai, for the American Association of Retired Persons. But that is just getting underway. Mr. ELLSWORTH. There is also a housing project in St. Petersburg. Miss GINGRAS. That is the hospitality center. They have a walk-in drug service there. They have a recreation center. They have bought this building. I believe there are a few rooms where they can accommodate people. They do have a referral service for people who might come in and ask for low-income housing. They refer people to these various homes. Mr. O'HARA. Do these housing programs, or your existing program, and the planned additions to it involve use of the provisions of the Housing Act for direct loans in special assistance to nonprofit programs of housing for the aged? Miss GINGRAS. That I could not say. I really would not know. Mr. O'HARA. When we were taking testimony in California, we discovered that some use had been made of these new provisions of the Housing Act by various groups in California and that they had found them quite helpful in establishing housing that met the needs of the elderly at a price the elderly could come closer to affording, with their usually restricted incomes. One of the things we are looking into is just how these programs are being implemented and what could be done to help them appear more effective. I thank you for your testimony. Miss GINGRAS. Thank you. Mrs. HANSEN. How informal are the retirement laws for teachers throughout the United States? Miss GINGRAS. Do you mean the various States? Mrs. HANSEN. Yes. Miss GINGRAS. I think they differ considerably. Mrs. HANSEN. Particularly in the area of emolument, isn't it? Chairman BAILEY. Thank you very much for your testimony. Chairman BAILEY. At this time I would like to request that the clerk read a two-page statement by Dr. Fulton of the staff of West Virginia University. Dr. Fulton is the chairman of the Governor's Commission on Aged and Aging. Would you mind reading it? He requested it be read into the record. (The statement of Dr. Fulton, as read, follows:) STATEMENT OF THOMPSON R. FULTON, PROFESSOR OF SOCIAL WORK, WEST VIRGINIA UNIVERSITY, AND CHAIRMAN, WEST VIRGINIA COMMISSION ON AGING Dr. FULTON. Mr. Chairman, I regret that it is not possible for me to be present in person at the hearing. I appreciate the opportunity to make a statement in writing. The West Virginia Commission on Aging has taken no formal action with respect to proposals for Federal legislation dealing with an agency for the aged and aging. Therefore, except to state to you that the substance of H.R. 10014 was discussed at a recent commission meeting and that there was apparently general approval and no objection, the content of this testimony is my own, and does not necessarily represent the thinking of the commission. It is my considered judgment that, without underrating some excellent provisions in the other House bills dealing with a proposed Federal agency for aged and aging, H.R. 10014 more nearly includes all of the needed provisions which require Federal action : (1) Grants-in-aid to assist States in coordination of State activities: In planning and policymaking, in gathering and disseminating the information are essential to local and statewide planning, and to the development of a social "climate" in which aged and aging citizens can live in comfort and dignity. (2) The H.R. 10014 provision for a U.S. Commission on Aging is, to my mind, both necessary and to be preferred over a bureau or office of aging within HEW. I have high respect for the integrity and competence of HEW; however, the concerns of the aging extend beyond the boundaries of health, welfare, and education and deserve, at least during an initial period of 10 to 25 years, to be represented on the Federal level by an independent commission, which can encompass all of the needs of the aged and can attempt to coordinate and stimulate all of the relevant agencies of Government in the interest of the special needs and potentialities of the aged and aging sector of our population. We in West Virginia have determined that the independent commission-which in our case includes both citizen members and official representatives of relevant State departments is far preferable to an office or agency located in a single department. I think the same pattern is preferable in the Federal establishment, and to so establish it would help to set a pattern for the States. Coordination is, to many, a nasty word; and no agency likes to be coordinated by someone else. However, the commission structure, including an advisory if needed, provides for a democratic sort of coordination, in which the partners are equal and the group decides what should be done and who should do it. (3) The proposal in H.R. 10014 to establish both an advisory council and an interdepartmental committee is in my opinion a sound one, and it appears to provide adequately for coordination of activities both within the Government and between governmental and citizen groups. I would earnestly recommend that the initial grants-in-aid to States for community planning and coordination of activities of all agencies handling programs for those over 65 be outright grants, that is 100percent Federal funds without a requirement for matching. In at least some of the States, there must be a demonstration of the value of such planning and coordination of services for the aged, before matching funds can be obtained. Federal "seed corn" grants, without matching, for a period of 3 years, should meet this urgent need. The West Virginia Commission on Aging is dedicated to mobilization of the resources at hand, in local communities and in the State government, in the interest of the needs of the aging which are beyond the resources of individual persons and their families. In my opinion this goal, however worthy, is not enough; and there is urgent need for Federal supplementation such as envisioned in H.R. 10014. Chairman BAILEY. If there are no objections, I direct the clerk to include Dr. Fulton's formal statement in the testimony before the committee. Now we have Dr. Matt Zubak, Jr., American Optometric Association. Doctor, will you come forward? You may further identify yourself to the reporter and proceed with your testimony. STATEMENT OF DR. MATT F. ZUBAK, JR. Dr. ZUBAK. I am a vice president of the West Virginia Optometric Association. I practice optometry here in Wheeling, W. Va. Optometry is very much interested in the aged for many reasons. We are interested in the visual requirements of individuals as they age and we are particularly interested in the complications that come about with later age. To clarify this statement I would like to identify what an optometrist does and is trained to do. He is trained to recognize eye pathology and diseases. He does not treat diseases. He refers all patients needing medical treatment or surgery to a physician. The optometrist corrects all optical defects with lenses, prisms, contact lenses, et cetera. He is trained to correct misalinement of the two eyes with lenses, prisms, and/or visual training. Concerning problems of the aged, presbyopia, which is the age where the lens begins to show changes, where the muscles are not as elastic as they used to be, where the process of accommodation or adjusting one's focus is not possible any longer, because of presbyopia. This comes on generally in the middle forties and extends from there on. Generally speaking this is the bifocal age. The patient's accommodative processes slow down and the ciliary muscles become less elastic. What his muscles can't do we replace with various power of bifocal aids. As a patient's eyes age the lens in each eye may become a bit cloudy—a beginning cataract due to various disturbances in his metabolism-or to an injury-or various diseases or focal infectionsor radiant energy. The inside of the eye, the vitreous may change its viscosity or develop vitreous floaters. The back of the eye—the retina may show age changes, or changes due to circulatory disturbances, diseases, etc. Lenses may be needed, along with medical treatment, which the physician is taking care of, which will adapt this patient visually so he may enjoy his elderly days. Quite often we use trifocals after a patient gets past his late sixties, which helps extend the patient's range of vision out to the arm's length, the bifocal taking care of the close distance; the trifocal, the arm's length; and the distant portion for the faraway seeing. Sometimes a patient, due to diseases and conditions of the retina, has only islands of vision left. This takes a special type of lenses, which are generally classed as subnormal vision lenses. In West Virginia we have a committee in Charleston. This is furnished through the aid to the blind. West Virginia is participating in this program. There is an optometrist and an ophthalmologist |