THE NATION'S RURAL ELDERLY

TUESDAY, AUGUST 17, 1976

U.S. SENATE,

SPECIAL COMMITTEE ON AGING,

Gretna, Nebr.

The committee met at 10 a.m., pursuant to notice, in the Municipal Building, 202 North McKenna, Gretna, Nebr., Hon. Dick Clark presiding.

Present: Senator Clark and Representative John McCollister. Also present: William E. Oriol, staff director; Kathleen M. Deignan, professional staff member; David Harf, legislative assistant to Senator Clark; John Guy Miller, minority staff director; and Alison Case, assistant clerk.

OPENING STATEMENT BY SENATOR DICK CLARK, PRESIDING

Senator CLARK. Good morning. It is good to be with you in Gretna for this official hearing of the U.S. Senate Special Committee on Aging. We have several scheduled witnesses and then we will try to hear from people in the audience. A stenographer will record all that is said, and we will issue a printed transcript of the proceedings. Our subject at this and five other hearings this week is "The Nation's Rural Elderly." In other words, we are emphasizing in these hearings the specific problems that people have in rural areas. We know that many of the programs are designed, in fact, for metropolitan areas. The metropolitan areas certainly need programs for the elderly as well; but the particular emphasis of these hearings will be on the problems faced by people who live in small towns, by people who live in the countryside, and what we can do to help them.

I first suggested these hearings a little more than a year ago to Senator Frank Church, who is the chairman of the Senate Special Committee on Aging, and he agreed. We held some meetings, in fact, last April in Washington, and now we are holding them here in the Midwest so we could come out to talk to people who are affected by the Federal programs that have been instituted. I want to make my statement very brief, and call on Congressman McCollister for a statement as well, and then we will have the witnesses. I want to make three or four major points before we start with these hearings.

First of all, the prime objective of these hearings is to determine the responsiveness and the practical help provided to the rural elderly by such programs as the Older Americans Act, medicare, public housing, transportation assistance-how and in what way people in small towns can ride minibuses and other kinds of buses.

Second, there is a real need for this evaluation because, in our view, we failed to do what we said we were going to do in the 1971 White House Conference on Aging. We have not yet arrived at a national policy on aging, particularly on rural areas and/or rural issues. A part of the lag has been caused, I think, by the lack of leadership that we have had in Government in these programs. Another part has been caused by economic uncertainties related to inflation and unemployment. Nationally about 8 million people, or about 28 percent of all the people over 60 years old, live in rural areas— communities like this one and smaller communities-but in some States the percentage of older people who live in rural areas rises to 50 percent or more.

For example, here in the State of Nebraska about 45 percent of all people over 60 years old live in small towns or live in rural areas. In Iowa, we have almost exactly the same percentage-almost half the people over 60 years old live in rural areas. and yet much more than half the total population lives in metropolitan areas. There are major differences among the States and even though each of our hearings has a rural theme, we find that there are special circumstances in each locale that call for close inspection.

Here in Nebraska we will be especially concerned about the delivery of services to the widely scattered rural elderly and the effects of the increasing isolation of the elderly in small towns and communities as they leave the farms and as many younger workers leave to take jobs in other areas. We will be hearing from a number of individuals from all across the State of Nebraska who have confronted some of these problems firsthand.

Another issue on which I hope we can have some discussion today is the financial ability of rural county governments to help pay for services funded by the Older Americans Act, as well as other programs of the Federal Government meant to serve the elderly. I think we often find that in many rural areas local governments are very much in support of services, but find the financial burden imposed on them in meeting the matching requirements for participation in Federal programs particularly difficult.

Finally, I would like to say that in the Older Americans Act program and in all the others, the rural elderly must feel that no one is dictating to them. The progress that we are making in aging is due in no small part to the initiatives and determination of older persons who are making things happen. The Federal share of their effort, if one is needed, ought to be part of the solution, and not part of the problem.

Now I would like to ask Congressman McCollister if he has a statement.

STATEMENT OF HON. JOHN Y. MCCOLLISTER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEBRASKA

Representative MCCOLLISTER. Senator Clark, thank you. Thank you for two reasons: Thank you for coming to Nebraska where large proportion of our population is in the senior citizen category and thus have a very special meaning to us, and because so many of our senior citizens do live in rural communities; and to thank you for in

viting me, a member of the other body, to participate in these deliberatoday. I am grateful, too, for your generous invitation.

i think the policy of the Federal Government toward the rural elderly can only be characterized as one of benign neglect. The Federal Government has a great number of programs for elderly people in our metropolitan centers, but as I go around this State I discover that there are very few programs that are able to be delivered to the people in our smaller rural communities. Thus, these Senate hearings today can serve as a real basis for beginning to formulate policy that will change that neglect of so many of our rural senior citizens.

I think we need many programs designed to address those in rural communities-stronger nutrition programs and transportation programs. I understand in Council Bluffs this afternoon you have some hearings addressed to that subject, as well as other places around Iowa. There are a great many problems that are affecting rural senior citizens.

I say, again, I am grateful to you for your being here and for your invitation to allow me to participate. I am going to be very brief because I think the real meat of what happens here today comes from our panels and from those who will be participating.

Thank you.

Senator CLARK. Thank you very much, Congressman.

Now we are going to hear from a group of persons who are very well qualified to speak on this subject. I think we are going to go in the order in which they are printed here. First, Norman Magnusson, who is chairman of the board of governors, eastern Nebraska Human Services Agency; then we are going to hear from Evelyn Runyon, ombudsman, eastern Nebraska Office on Aging in Omaha; then Pete Lakers of Columbus, Nebr.: Glen Soukup, executive director, Nebraska Commission on Aging in Lincoln; and Marge Stine, director of Senior Citizens Industries, Inc., in Grand Island, Nebr.

I think we have asked the panelists, if they have an opening statement, to limit their remarks to about 5 minutes, and then we are just going to have discussion back and forth for a while. This panel then will probably end about 5 minutes till 11.

So you proceed in any way you think appropriate, Mr. Magnusson.

STATEMENT OF NORMAN A. MAGNUSSON, BELLEVUE, NEBR., CHAIRMAN, BOARD OF GOVERNORS, EASTERN NEBRASKA HUMAN SERVICES AGENCY

Mr. MAGNUSSON. Senator, first I want to sincerely thank you and your staff. It is very heartening to us in the Midwest to know that we have people in Congress and the Senate who are interested enough in our local problems to come and meet with us on our own grounds. So welcome to Sarpy County, and this is from all the citizens of Sarpy County. We are very happy to have you here.

I think I am known to most of you. In case somebody doesn't know who I am, I am Norman Magnusson. I am on the Sarpy Board of County Commissioners and I serve on several other boards throughout the community. I am also chairman of the Eastern Nebraska Human Services Agency Governing Board.

I am testifying today in regard to the needs and wants, or at least as I regard them, of our senior citizens in the rural area. I will start by saying that some people in the East cannot understand we people in the Midwest. We are a different type of people. We are proud of our heritage, we are proud of what we have accomplished, and we like our home-this is where we like to be.

In Sarpy County I think the board is doing a pretty good job, as far as funds go, of what we are doing for senior citizens. At the present time we have homemaker services, specialized transportation services that is the one that, as far as I am concerned, has been a dismal failure. It is one of the higher cost ones, but it is one of the most needed. There will be some people speaking a little bit more on that. I just wanted to get in what my concerns are.

ADMINISTRATIVE COSTS ERODE FUNDS

I am chairman of the MAPA. In case you don't know what MAPA is, it stands for Metropolitan Area Planning Agency, of the Urban Affairs Committee. Lately we have been getting all kinds of requests for grants in transportation for the elderly from various organizations. At our last meeting I requested that we hold a meeting so we can try to coordinate these services under one head. I don't like to see money going for administration when it should be going for services.

The way the transportation system is fragmented at the present time, this is what we are doing. We are spending money for administration that should be going for furnishing buses or transportation for you people to get to your doctors, to get to your church, to get to any place you want to go in the community. If it is necessary. I will try to get legislation introduced at the next session of the unicameral to take care of that, at least in the State of Nebraska, and hopefully we can get some legislation passed in Congress that will make it national instead of just one State.

We have the ombudsman service where, if you feel you have a complaint, you can go to one of the youngest ladies that I know of in spirit, not in years. She is one of my favorite people. We will hear from her later.

Information and referral services, recreation services, foster grandparents and, beginning in September, the senior companion program, retired senior volunteer program, family services, counseling services, health maintenance clinics: These are other areas that, due to the cooperation of our visiting nursing association, I cannot speak highly enough of. They have done wonders in Sarpy County since we have had them.

All of our nutrition sites-we do have a health maintenance clinic at the present time and this is not just for senior citizens. We, at one time, thought just of senior citizens but, realizing the need for this service for everybody, opened it to everybody. I hope you use it, because the service is there.

Then there are some special needs such as medical services. The older residents have difficulty in maintaining their health due to the difficulty to get periodic medical services. We hope that these health maintenance clinics that are on nutrition sites can overcome part of

that problem. If we can't, write me or call me up. We will see what we can do about it.

Transportation-I spoke about that. This is the most serious thing that we have. A lot of you have your own cars, I know, but there are also many that do not. I think you are entitled to some of the things in life that you can't get unless you can get there. I am very prone to go to church myself. The fact is, when my minister is gone, there are several other churches around and I fill them up. So church is important to me, and I hope it is to you. I hope that we can one day give you transportation so that you can go to the church of your choice on Sunday.

Legal services is another program that we so far have not been able to get off the ground.

We talk about isolation and people in rural areas, or about our children moving away. Mine have been gone for a good many years. Friends are dying off. I am afraid to look at the obituary column any more, I might find my own name there some morning. I don't have the philosophy that some people do. I don't believe in a rural area with high-rise apartments or housing for senior citizens. I still have the old kind of philosophy, "Be it ever so humble, there's no place like home." As far as I am concerned, I think that the broad effort should be made to keep you people in your own homes as much as possible and also to see that the home is taken care of, that it is kept up so it is a decent place to live, and that you have transportation to go from that home to the various activities that are already outlined.

VISITING NURSE PROGRAM ECONOMICAL

Now I know this is a departure from what some people believe in. One reason we got visiting nurses is so that we could keep people out of rest homes, nursing homes, and hospitals. Last year alone the home nursing program saved Sarpy County taxpayers about $170,000-at a total cost to the county of a little over $60,000-by having the nurses go to your home, visit with you, take care of you there, and keeping you out of these costly hospital rooms and nursing homes. The most important part of all this program is that it keeps you home with your loved ones where you belong.

You are an independent people, and you should be. You should be proud of your heritage and proud of what you have accomplished in this great country of ours. It is people like you who have made this country what it is today, and the younger generation growing up can learn a great deal from you-if they just will. I think it is wrong to put your talents on the shelf and say there is no place in society for

yon.

Limited county revenues—yes, our revenues are limited by statute. We have a statutory limit of 14.28 mills. This is as high as the county board can go. Fortunately, we have a board in Sarpy County that feels human services are important, and I will tell you how important they think they are. The total request we had this year would have called for a budget of a little over 17 mills. We have whittled it down to 14.28. Did we whittle down human services? No, we did not, We added $5,000 to the visiting nurses budget. Senior citizens was a little over $7.000 last year; this year it is a little over $36,000.

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