Mrs. SWITZER. It can happen though.

Miss STORMS. Yes, it can.

Mrs. SWITZER. In Crete, the rural churches cooperate just as much as the churches in the town.

Miss STORMS. They have some very active church members in Crete who really have pushed it. We have no nutrition program in Western or in the smaller towns. We have one town of 120, one of 160.

Representative MCCOLLISTER. Thank you.
Senator CLARK. Thank you very much. }

We thank you as a panel. It has been very, very helpful to us.
Mrs. SWITZER. We appreciate the opportunity.

Senator CLARK. We have two more witnesses, and they may both come up at this time. Richard D. Heft, chairman of the Harlan County Board in Alma, and Hans Jensen, legislative committee chairman of the Nebraska Senior Citizens Council in Aurora, Nebr.

I might say as the witnesses come up that the flowers on each of the tables come from the Gretna 60-Plus Club whose representative, I think, is here. Would she stand, please.

I understand that one representative may want to make a brief statement. Am I correct about that?

Mrs. DIETZE. Yes.

Senator CLARK. Please come up to the table.

We are going to hear now from Richard Heft, chairman of the Harlan County Board. We have about 20 minutes and we have three witnesses, so we will try to divide the time evenly.

Mr. Heft, please proceed in any way you think appropriate.

STATEMENT OF RICHARD D. HEFT, CHAIRMAN, HARLAN
COUNTY BOARD, ALMA, NEBR.

Mr. HEFT. Senator Clark, Representative McCollister, my name is Richard Heft, and I am from Alma, Nebr.

When Glen Soukup called me up and wanted me to speak, he went out so far that you cannot even find it from here, you have to go out someplace else. You can't get here from there.

Anyway, when he asked me to speak, I really didn't know what he wanted me to speak about, but he said I would have about 5 minutes to talk. I said, "Well, that should not be any problem because my wife says I talk so slow, it will take me 5 minutes to say what I have to say and then by the time I tell a little story my 5 minutes will be up." So I will tell you a short little story.

There was an elderly gentleman that liked his spirits, and he went into this bar and ordered a drink of whiskey. He told the bartender to put in three drops of water. So the next time the same little gentleman came in and ordered his drink, and he said, "Bartender, just put in two drops of water." And the third night he came in again, and by this time the bartender's curiosity was quite aroused, and he said, "The first time you said you wanted three drops of water in your drink, the second night you wanted two, and tonight you want one. Why?"

He said, "Well. us elderly gentlemen can still hold our whiskey, but we can't hold our water." [Laughter.]

TAX LIMITATION EFFECTS

Anyway, being the chairman of the Harlan County Board, our biggest concern with the elderly is taxation. For just a small countywe have less than 5,000 population in all the county, which covers about 25 square miles. When I first went on the board about 4 years ago they appointed me to the service for the aging, and I thought it was a very worthwhile project. We had no service for the aging at that particular time.

When I went on the board, the first thing I did was to get a survey of what the people in Harlan County wanted first, and it was transportation; second was job chore, and third was a civic center. Well, I am glad to say we have all those, plus several more now. We have a nutrition program along with it. We have the medical lady that comes in and takes blood pressure at least once a month, and we hope to expand a lot further on that.

Anyway, back to taxation. Our county tax valuation is only $30 million, so 1 million brings in only $30,000. By the time you get it all divided between the 14.28 which the State requires you to have, and by the time you take care of all your services, you don't have anything left. Last year the person who represents the counties said there were 31 counties that had reached their mill levy and that there will be over 30 more that will reach it this year. So I am telling the counties that don't have the service for the aging if they don't get the tax relief, there is no way that they will be able to handle it.

Revenue sharing, I understand, has been up before and I think that should probably continue. Before, you could not use any Federal moneys, but I think that is going to be changed to where you can use some of that revenue sharing, too, for some Federal programs. Right now we have only about 0.21 of 1 mill toward service of the aging, because it only brings in about $8,000, and Federal aid from it started off as 90-10.

Well, the predicament in Harlan County on the service for the aging came to us. Our No. 1 problem was transportation, so they said, "Well, you go on a 90-10 for the first year." When we got down to it, it came down 75-25. So we have been in it for 1 year and 9 months, and the Federal Government has come out now and said, "We are not funding any more money for transportation in Nebraska; we have it cut off."

So the State has come out and said, "Well, we will continue it at a 50-50 grant. If we had known this to start off with, there is no way in the world that our county could have gone into transportation. We have it now and we have it on the tax rolls, so there is no way that they can take it away from us. The people in our county definitely want transportation, but it makes it all for the bad when they cut it off. They guarantee you at least 3 years, and we have 1 year and 9 months.

The panel that was here before me fairly well covered every aspect of all the programs and I don't think that I need to repeat any more on that, so I will turn it over, then, to this gentleman here. Senator CLARK. Thank you very much.

We are going to hear now from Hans Jensen who is legislative committee chairman, Nebraska Senior Citizens Council, in Aurora, Nebr.

STATEMENT OF HANS O. JENSEN, LEGISLATIVE COMMITTEE CHAIRMAN, NEBRASKA SENIOR CITIZENS COUNCIL, AURORA, NEBR.

Mr. JENSEN. Senator Clark, Congressman McCollister, I am the lobbyist for the senior citizens in Nebraska without any pay. I am glad to do that for them and they probably get as much services as they pay for. However, I served 6 years in the legislature and I am glad that I have the time, and I enjoy being involved. This is one way of being involved, it gives me an opportunity to keep abreast of these things and it also gives me an opportunity to be of service to my fellow man. The world has been good to me and I would like to be of help to the people that made it possible.

One of the peculiarities about the elderly is that they have the tendency to make do. They will sit back and suffer injustices and shortages without really saying much about it.

I attended a meeting in Omaha one time and I will tell you of a little incident. We sat there and listened to the elderly testify and discuss their problems with the mayor. Along about 3:30 in the afternoon some old lady got up and led the group in singing "God Bless America." It almost brought tears to my eyes because the elderly are just as grateful, even though they have as much need as any group, or perhaps more so.

Let me just briefly cite some of the things that I put together.

MEDICARE FORMS COMPLICATED

Most elderly are confused and baffled by the forms connected with the medicare program which they are requested to fill out upon receipt of medical services and care. Oftentimes, words used are medical terms not understood by lay people. Medicare usually pays approximately 80 percent of the bill and other insurance companies are called on to pay the balance. This gives the elderly no end of trouble and concern to understand and to use. It is my opinion that oftentimes medicare is not used because of the problems it brings about.

Language used by medicare to describe action taken should be simplified and amounts covered by medicare either should be increased or charges for medical services reduced so it could all be covered by medicare. It is my opinion that the present policy used is so troublesome that it is limiting the use of medical services which the elderly need.

I am also a representative of the Damascus Farmers Union and I am doing all sorts of lobbying work for them in Nebraska for the same reason. I would like to mention something they prepared for me that I think is of interest to you. Just a brief remark about the Green Thumb program. The National Farmers Union sponsors this program in 28 States, Puerto Rico, and the District of Columbia. There are only

120 older people working under the program in Nebraska to date in 14 communities. There are 49,000 elderly eligible for the Green Thumb program in Nebraska, according to the latest census figures. Therefore, special interest should be placed on enhancing a program of this nature, a program that uses the skills of elderly and part-time work for improving the homes in which they live. It is the kind of program that gives older people the opportunity to earn a better living in our affluent State, rather than being destitute or on public assistance. I might add here, too, that as long as these elderly people feel that they have a purpose in life, they can look forward to tomorrow. I tell you, this makes life a lot easier for them to live.

Senator CLARK. Thank you very, very much.

Let me just ask you one question.

You identified yourself, Hans, at the beginning by saying that you were a lobbyist for the elderly and that you tried to speak for their interests. One of the impressions that I have in watching elderly clubs, associations, groups, and councils form is that much of the reason that the Congress, the administration, the State legislatures, the county boards of supervisors, and so forth, have responded, to some degree at any rate, to the problems of the elderly is that the elderly have themselves become organized. They have become a strong force and have, in fact, called these people in and talked with them. They have been effectively organized and are an effective voice for their own use and their own needs. Do you tend to share that view?

Mr. JENSEN. Indeed I do, and I am going to quote you on it, too. Senator CLARK. Good. There are a lot of people who think that lobbyists are bad people or that they are bad names-and certainly they can be but in a democracy I don't see how you can work effectively otherwise. I don't see how you can really have your own point of view represented, whether you are elderly or young, farmers or businessmen, or anybody else, without being effectively organized. I think until the last 10 years, the fact is that elderly people had not been well organized for that kind of effort. I think in the last 10 years they have, and I think it is reflected in the kind of legislation and the kinds of administrative actions that have occurred as a result of that. Mr. JENSEN. They have the political moxie, if they just use it. Senator CLARK. That is right.

Mr. McCollister.

Representative MCCOLLISTER. We are short on time. I yield.
Senator CLARK. Please identify yourself.

STATEMENT OF EVA DIETZE, SENIOR NUTRITION PROGRAM, 60-
CLUB, GRETNA, NEBR.

Mrs. DIETZE. I am Eva Dietze.

Senator CLARK. You are here as a representative of the 60-plus club here in town.

Mrs. DIETZE. Yes.

Senator Clark and Congressman McCollister, my name is Eva Dietze and I am speaking for the senior nutrition program in Gretna, known as the Gretna 60-Plus Club, who have signed this statement. We feel that the special problem the senior citizen faces living in a rural

area is transportation. A person living in a rural or farm area who cannot continue to drive because of poor eyesight or other health problems is forced to move into town. The rural town also being without transportation forces the senior to be dependent on others to drive him to the eye doctor or to have glasses fitted to the dentist, podiatrist, et cetera, all of which are located in the metropolitan area.

Now in the area of health care we feel that the nursing home should be required to have a registered nurse on duty 24 hours a day and a reliable resident doctor, or one that would be on call at least 24 hours a day. The nursing home should be required to have large outside areas, fenced in, where the patients can be wheeled outside for fresh air. The area should be large enough for the ambulant patients to walk around. Windbreaks of trees and shrubbery should surround this outside area. We recommend a State inspection, under Federal regulations, of nursing homes, including an inspection of the rooms, perhaps four times a year. We recommend higher and stricter standards to run a nursing home.

We feel there should be more information and education in the area of preventive health care, not only for seniors, but for every American citizen. That is, enlightening people on how to prevent illnesses and take care of their bodies before they are sick. We feel there should be more exposure and tighter controls on the chemicals and additives and the colorings and dyes that are in the foods we are eating, and steps should be taken to eliminate these additives in our foods.

Thank you.

[The written statement of Mrs. Dietze included 41 signatures. Retained in committee files.]

Senator CLARK. Thank you for a very excellent statement.

I was handed a note that there are two additional statements. Although we don't have time to actually read them, I would like for them to be included. I will distribute forms and you may send them back. They will be made a part of the official record.1 They simply invite you to comment on any phase of discussion that we have had today, and read as follows:

Dear Senator Clark: If there had been time for everyone to speak at the hearing in Gretna, Nebr., on August 17, 1976, concerning "The Nation's Rural Elderly," I would have said:

Please feel free to fill these out and bring them to us.

I would like to call on these two people very briefly, and Congressman McCollister and I will speak about 30 seconds, then we will close the program.

If you will please keep your seats, we can have some order. I would like to call on Margaret McMullen, who is president of the State Association of Community Action Agencies.

STATEMENT OF MARGARET A. MCMULLEN, EXECUTIVE DIRECTOR, MID-NEBRASKA COMMUNITY ACTION PROGRAM, INC., KEARNEY,

NEBR.

Mrs. MCMULLEN. Senator and Congressman. I know you are under a tight time frame here, so I will try to make this very brief.

See appendix 3. p. 196.