IV. ADEQUACY OF OAA CASH GRANTS TO SUPPORT SUCCESSFUL SERVICE EFFORTS Finding No. 3: The inadequacy of old-age assistance cash grants is a source of continued concern and is a basic drawback to better service programs. At the subcommittee's hearings, Dr. Winston testified to the inadequacy of old-age assistance cash grants in many States: " I think the major problem which overshadows all others is adequate payments for public assistance to the elderly and others. As I travel this broad land of ours, I continually hear the concern of thoughtful and responsible Americans. The Welfare Administration's Advisory Council on Public Welfare, which was appointed under section 1114 of the 1962 amendments, has been having hearings around the country. In New York City, Chicago, Atlanta, Washington, D.C., Oklahoma City, and San Francisco-again and again-they have heard rumblings from people in all walks of life: clergymen, businessmen, public welfare administrators, community leaders, labor leaders. The majority stress the importance of a floor under the income maintenance payments of older people, so that the aged have enough for food and rent, and the electric bill and the gas bill, and decent clothes, and a few bus tokens. I may add that the temper of the testimony our Advisory Council has been hearing is strong. Such graphic expressions as "shockingly inadequate," "utterly indecent," "inhuman," are not unusual. And, after all, it is not surprising that any compassionate person would react this way. For the most important service of all, in my opinion, is providing aged people with cash when their own income and resources are insufficient. This is the primary function of the old-age assistance program. As President Roosevelt said in his first fireside chat, it was intended "to provide sound and adequate protection against the vicissitudes of modern life." There is serious question as to whether the objective is being met. I am afraid it is not being met in many parts of the country. We would like to call the committee's attention to the inadequate assistance provided in many States and to the wide variation between sections of the country. For example, as I mentioned earlier, the national average money payment in old-age assistance for May 1965 was $62.30. But that figure includes a range of payments from a high of $96.60 in California to a low of $30.75 in Wisconsin. The Commonwealth of Massachusetts provided an average payment of $70.02 a month. No matter what level of living is used, these payments are too low to be consistent with our traditional concept of what life should be like in this affluent land. Even recognizing that some of these old people have help from relatives or receive some income from OASDI and other sources, so that "average" payments are not synonymous with the actual sums they live on, it is still true that the payments are so low as to make it impossible for many of them to maintain a decent level of living. Indeed, some of these older people are sentenced to an existence halfway between the "poverty line" and absolute destitution. As one woman from Georgia puts it: "When I get through with the immediate bills, I have about $6 or $7 for food for a month, and I have a problem trying to make ends meet *** my biggest problem is money, period; just money. just don't have enough to live on." I Mr. Lourie, again expressing the views of the American Public Welfare Association, testified: 7 *** of highest priority, is the problem of trying to mount a service program in the face of a significantly inadequate approach to income maintenance in old age. We think until a major attack is mounted on the problem of an adequate income in old age, it will be extremely difficult and in some ways futile to launch a well coordinated attack on meeting the service needs of the elderly. Indeed, we need not only a war on poverty, but a war on the poverty of welfare. Father Joseph T. Alves, chairman of the Massachusetts Commission on Aging, expressed a similar conclusion in these words: 8 Whether one's planning is directed toward leisure time, medical care, development of homemaker services, decent public housing, or any of a myriad of important goals for the elderly, in the last analysis these programs will be successful only if the elderly person is in a position to make use of the services-in other words, to pay his way, or to be secure and worry free enough to take advantage of extra services provided. To the same effect, Dr. Charles Schottland, dean of the Florence Heller Graduate School of Social Work, Brandeis University, testified: 9 We are simply not going to be able to help people out of their poverty and make them self-sufficient or self-respecting if their stomachs are empty. Finding No. 4: There is a substantial body of informed opinion in favor of contributions from Federal general revenues to make possible more adequate OASDI cash benefit levels. Several witnesses at our hearing supported this proposal. Those who so testified were Leon Keyserling, president of the Conference on Economic Progress; Charles E. Odell, chairman of the task force. on the aged poor for the Office of Economic Opportunity, and director of the Older and Retired Workers Department of the United Automobile, Aerospace & Agricultural Implement Workers of America, AFL-CIO; Rev. Joseph T. Alves, chairman of the Massachusetts Commission on Aging; and Dr. Charles Schottland, dean of the Florence Heller Graduate School of Social Work, Brandeis University, and former Commissioner of Social Security. My Among those receiving OASDI payments among married couples *** about 58 percent live in poverty by the definition that we have come to accept * * *. If the national conscience were awakened to the point where *** we simply built on the OASDI system and the welfare systems, and brought them up to levels*** where they ought to be, we would be making a full-scale attack on about 27 percent of the whole poverty problem in the United States * * *. own view, increasingly shared by others, is that if the old-age insurance benefits were brought up to the levels they should be, we should no longer continue to rely entirely on payroll taxes***. But as the benefits are increased, a larger portion of the costs in my view should be by general Federal contribution * * Mr. Odell gave additional testimony along this line, as follows:"1 I was staff consultant to the resolutions committee of the 1965 Convention of the National Council of Senior Citizens which proposed that minimum benefit levels under social security and old-age assistance be established at at least $100 a month *** this will cost a sizable amount of additional money. While ? Hearings, p. 46. Hearings, p. 77. 10 Hearings, pp. 14, 16, 20. 11 Hearings, p. 63. some of it will come from broadening the wage base on which social security payroll taxes are collected, I believe that the major portion of it should come from general revenues so that the Federal Government, in effect, becomes an equal copartner with employers and workers in the financing of adequate social security benefit structure which provides older people with a minimum basic standard of living. Father Alves stated: 12 I don't see anything antithetical to our democratic system to put general revenues into a system which is basically an insurance system ***. This is what is done in other countries. It has not made those countries default in any of the other obligations. Dean Schottland's contribution to this line of testimony was as follows: 13 This fetish of not using general funds in the program has already been breached. We are using general funds now when we give credit for military service. We are going to use general funds in medicare for those who are blanketed in during this interim period ***. After all, if we are going to use general funds in one way to support them, there is no reason why we should not use it for another. Many of the foreign countries have found it very feasible to have government contribution along with employer and employee contribution. Another witness, George F. Rohrlich, professor of social policy, University of Chicago School of Social Service Administration, discussed some of the difficulties of accomplishing the purposes of a system of social insurance without use of general revenues, follows: 14 as Probably well known, too, are certain shortcomings which, though not all of them are inescapable, attach to many social insurance programs, including some of our own. One is the difficulty of achieving truly universal coverage of all persons exposed to the risk, while making substantial and extended participation in the labor market a condition of the insured person's eligibility for benefits * Yet another difficulty is involved in keeping up, within the framework of purely contributory social insurance operating under conditions of rising earnings and prices, the real value of benefits, and beyond that, the relative economic position of those retired and others depending entirely on social insurance benefits vis-a-vis the bulk of the economically active population. A resolution, Resolution 176, was adopted on December 14, 1965 at the convention of the AFL-CIO in which it was recommended That the Congress of the United States provide for the payment of contributions to the social security trust funds from general revenues. 12 Hearings, p. 71. 13 Hearings, p. 89. 14 Hearings, p. 91. V. TRAINED SOCIAL WORKER SHORTAGE AS IT AFFECTS SERVICE PROGRAMS Finding No. 5: There is an acute shortage of trained social workers in the United States today; this shortage seriously impedes the development of service programs for the elderly on public assistance. Dean Schottland testified at the subcommittee's hearings 15 that The importance of the 1962 amendments lies not so much in the immediate improvement of services to the 8 million persons receiving public assistance, because these are developing slowly, but in the direction, aim, and philosophy of public assistance which have been significantly affected by the 1962 amendments. The 1962 amendments made it abundantly clear that it was the intent and purpose of the Federal Government to assist the 8 million persons on public relief not only in their distress, but out of their distress; not only to see that they have a minimum of food, clothing, and shelter, but that society was interested in providing the kinds of services that would assist individuals and families to leave their dependency status and become as independent as their circumstances made it possible for them to be To the extent that the philosophy underlying welfare programs goes beyond the mere dispensing of cash benefits and encompasses the objectives described by Dean Schottland, the need is increased for trained social workers. As he expressed it at another point in the hearings: 16 "The objectives of the 1962 amendments are not going to be realized through the efforts of amateurs." Testimony to this effect was given at the hearings by Mrs. Inabel B. Lindsay, dean of the School of Social Wefare, Howard University, who said: 17 Meeting these and many other needs with skill, sensitivity, knowledge, and trained understanding requires special preparation. The shortages of trained personnel for all the social welfare services-particularly the public services-are a matter of major concern and constitute a bottleneck in efforts to advance the extent and quality of services. Demographic projections of population increase indicate that the total population of the United States is expected to exceed 200 million by 1970 and to include more than 225 million by 1975. This fact alone justifies the expectation that increased numbers of social workers will be needed to man the existing services at even the present inadequate level. In 1960, family services in public welfare, which include services to the aged, had only slightly more than 1 percent professionally trained workers. With new programs emerging and existing programs expanding, the need for an increased supply of qualified social workers becomes even more apparent. Social work, more so than other helping professions such as health and education-suffers from a short supply of qualified personnel. This necessitates extensive use of workers with only partial professional education for the field, or with only baccalaureate degrees; I might insert that in some States without even a baccalaureate degree. Hopefully, that is being corrected. 15 Hearings, p. 81. 16 Hearings, p. 82. 17 Hearings, p. 101. Dean Schottland testified further to this effect: 18 We have practically no trained personnel. A trained person who goes into public welfare does not last long in the frontline trenches. We have many experienced people coming out of social work schools and in 6 months they are supervisors because of the great shortage of trained people. The result is we have a combination of completely untrained people with a tremendous turnover because they have no dedication or interest in the work. Most of our large cities have a personnel turnover of your first-line troops of from 30 to 45 percent per year, which means that in 2 or 3 years you have 100percent turnover. Considering that the most inefficient stay on foreover, once they get civil service status, it means every year and a half, every 2 years certainly, we have 100-percent turnover. This is a very wasteful and inefficient operation. When you consider what the worker has to do on the frontline, even forgetting the type of work I have been talking about, just straight eligibility investigation, this little public assistance worker authorizes the expenditure of between $100,000 and $200,000 of public funds a year, if you take the average caseloads throughout the United States. In order to do that, they have to know something about Federal laws and regulations, and State laws and regulations. They have to be able to work with the person on how to utilize his real property, because that is part of the Social Security Act. He must utilize his property not used as a home. It is really a complicated job, calling for the highest skills, and yet we don't provide any training or background for these things. The result is we have in many States just a sloppy, inefficient administration. Father Alves was another witness who stressed the shortage of trained social workers an as impediment to services: 19 The act provides for increased services by a reduction of the caseload to 60 cases when services are being given. This plan has run into serious difficulties: 1. Staffing: There is a serious shortage of caseworkers, all over the Nation, of course, which was intended to be solved by stepped-up recruitment, but recruitment has barely replaced retiring personnel. The act will pay for educational leave, but because of the staff shortage and because of the requirements of the act itself, it is very difficult to spare workers for further education. Because of the staff shortages, cases must be weighted, and an individual worker can have a caseload of 180 if she does not handle any service cases. Because of the weighting system, the cases with the most serious or most numerous problems get highest priority, and these cases are usually the family receiving aid-to-families-with-dependent-children. The older person, living alone and quietly on a tiny allowance, may suffer just as much and represent just as much wasted potential for dignity and constructive living as the aidto-families-with-dependent-children, but he is only one person. The overworked caseworker cannot, or will not, take the time and effort to locate community resources or provide extra services. 2. Even when the caseworker does devote special attention to the elderly client, much depends on the worker's skill and knowledge of resources available. In many cases, the client could avoid institutionalization if provided with services which do not exist or are unknown to the caseworker. Such services might be a homemaker service, contact with a recreational or service group, or low-cost housing, but the paperwork and time required may be too much for the worker to handle. As things stand, Massachusetts directs its workers to concentrate on other health services for the elderly, a service which will become less necessary when medicare goes into effect. 3. Other provisions of the act were for establishment of new services or demonstration projects, to be financed wholly or in part by the Federal Government. Throughout the country, by the end of 1964, only 17 States had set up demonstration projects, and of these, only 3 were for the elderly. Why? The reason is partly understaffing again, partly the duplication of this provision under the Economic Opportunity Act, and partly lack of concern for the elderly. 18 Hearings, pp. 82 and 83. 19 Hearings, p. 75. |