Appendix 2 AID CENTER REPORT, SUBMITTED BY JEAN SANDMAN 1 AID CENTER: SURVEY OF NEEDS OF RURAL SENIOR CITIZENS IN RURAL AREAS OF NORTH WEST IOWA The form, "Survey of Needs of Rural Senior Citizens" was given to 119 rural residents, age 60 or older, who were attending congregate meals in the towns of Cherokee, Onawa, and LeMars, and visting the Siouxland Senior Center in Sioux City. Service categories in the survey, as well as individual service items, were adapted from the United Way of America Service Identification System (UWASIS). Participants were requested to check service items they felt important to senior citizens, indicating either "needed," "adequate," "available," or a degree of need. Participants were encouraged to make written comments on felt needs and to note other concerns of rural older citizens. These comments are attached to a summary of survey results. No copies of the survey were signed. From answers recorded on the survey, one can conclude rural seniors feel their greatest needs are in the areas of income maintenance, housing, transportation, and health. Income maintenance. Of those completing the survey, 51 percent indicated they needed increased coverage in medicare and 49 percent expressed a need for larger social security allotments. An additional 20 percent requested more coverage in survivor's insurance as well as 20 percent expressed need for emergency financial assistance service. Housing services.-Low to moderate cost housing was checked as a need by 54 percent of the respondents while 14 percent indicated a need for assistance in housing search. Public housing units were seen as a need by 22 percent and rent supplements by 21 percent. Low-cost transportation for older persons.-Fifty percent of persons completing the survey saw transportation within the home community as a need. Transportation to neighboring communities was indicated "needed" by 32 percent and to special functions and events by 37 percent. Health.-Health care ranks high as a concern of older citizens. Twenty-four percent requested more public health nursing, 18 percent called for community clinics, 28 percent asked for home health care, and 24 percent indicated adequate nursing home facilities are needed. Physicians were checked as needed by 47 percent and 30 percent asked for rehabilitation for persons afflicted by crippling diseases. Other priorities.-Other priorities include 31 percent who stated legal aid is a need, 25 percent who checked opportunities for free or inexpensive clothing as a need, and 27 percent who marked jobs for older persons as a need. Sidelights. One item of interest to the respondents was congregate meals which commanded a 60 percent response. Twenty-eight percent indicated more sites are needed, 4 percent requested cheaper meals, and 34 percent stated congregate meals are adequate. Interest of senior citizens in community problems became evident through the questionnaire with 24 percent expressing need for drug and alcohol prevention and treatment and 25 percent marking a need for pollution and litter control. Conclusions.-The survey was made as a sampling of needs of rural senior citizens in the Siouxland area. Though an unscientific and inconclusive study, the survey indicates that older persons in northwest Iowa are aware of their needs and quite ready to express their opinions. Planning for older citizens re1 See statement, p. 212. quires their involvement and a respect for their expression of needs, solutions, and methods. (119 persons interviewed in Woodbury, Monona, Plymouth, and Cherokee Counties, in the State of Iowa) Question: What do you feel is most needed as a service for persons aged 60 and over in your northwest Iowa community--a need that presently is not met? Question: Check one or more categories which apply. Star those items which you feel are priority needs. 1. Employment services for persons 60 years and older: 2. Income maintenance services: Health insurance (Medicare): 61-51% more coverage; 11-9% adequate. Survivor's insurance: 24-20% more coverage; 6-5% adequate. SSI (Supplementary Income): 15-13% more persons covered; 8-7% adequate. Emergency financial assistance: 24-20% needed; 6-5% adequate. Special benefits for persons aged 72 and older: 48-40% needed; 8-7% adequate. 3. Consumer protection and safety services: Consumer Education, classes or individual: 7-6% needed; 6-5% available. Service to handle consumer complaints: 21-18% needed; 5-4% adequate. 4. Food and nutrition services: Food stamp program: 10-8% more persons eligible; 18-15% adequate. Congregate meals: 33-28% more sites needed; 5-4% cheaper meals; 34-28% adequate. Meals on wheels: 18-15% needed in area; 7-6% cheaper meals; 17-14% adequate. 5. Clothing and apparel services: Opportunities for free or inexpensive clothing 30-25% needed; 16-13% adequate. 6. Housing services: Low to moderate-cost housing: 64-54% needed; 3-2% available. 7. Low-cost transportation for older persons: Within the home community: 60-50% needed; 9-8% adequate. Free or low-cost legal aid: 37-31% needed; 2-1% available. 9. Environmental protection: Pollution-littering control: 30-25% needed; 4-3% adequate. Historical conservation-buildings, etc.: 11-9% needed; 6-5% adequate. Communicable disease control: 17-14% needed; 8-7% adequate. Public health sanitation : 12-10% needed; 9-8% adequate. Health education : 10-8% needed; 8-7% adequate. Community clinics: 21-18% needed; 4-3% adequate. Home health care: 33-28% needed; 4-3% adequate. Adequate nursing home facilities: 29-24% needed; 7—6% adequate. 11. Medical care services: Hospitals: 16-13% needed; 14-12% adequate. 12. Mental health and mental retardation: Psychiatric clinics: 6-5% needed; 7-6% available. Alcoholism prevention and treatment: 12-10% needed; 10-8% available. Drug abuse prevention and treatment: 17-14% needed; 2-1% available. Services, treatment and care of mentally retarded: 14-12% needed; 6-5% adequate. 13. Rehabilitation: (For stroke patients, crippling diseases): 36-30% needed; 2-1% available. 14. Optimal personal and social adjustment services: Chore service: 10-8% needed; 5-4% adequate. Homemaker service: 15-13% needed; 7-6% adequate. Recreation-social groups/senior centers: 18-15% needed; 9-8% adequate. Equal opportunity, civil rights: 6-5% needed; 10-8% adequate. 1. Right for persons to marry without losing pension. 2. Persons can get married without losing pension. 3. Cheaper rates-hospitals and doctors. 4. Right to give your children property while you're living without gift tax. 5. Trouble getting medicare-takes forever. 6. Pension for war widows should not be cut when social security is increased. These widows sometimes have minimum social security and it is difficult for them to make both ends meet. 7. Stop cutting pensions of widows or veterans of WWI every time social security raises. Instead they need a raise. Food and nutrition: 1. Need better meals (congregate). 2. Need better meals (congregate). 3. Deep investigation of present set-up. Make it a State law that all names of persons on welfare and those getting food stamps and those getting ADC be published monthly. Taxpayers have a right to know where their money is being spent and who is getting it (food stamp program). 4. Inequitable, unfair (food stamp program). 5. Not always fair (food stamp program). Housing: 1. Need low-rent housing by HUD. 2. Public housing units-better built buildings. Transportation: 1. Cab service needed in Cherokee. 2. We have excellent minibus service. Personal and social adjustment: More service is needed to supply entertainment to those in nursing homes. Income maintenance: (Plymouth County-34 respondents) 1. We need a larger estate tax exemption. 2. We need a larger estate tax exemption. 3. Lower rates on dental and eye care. 4. There should be an overhaul of the inheritance tax. It is too severe for the little guy. 5. There should be an overhaul of the inheritance tax. It is too severe for the little guy. 6. Insurance for those who pick up old people in their own cars. Food and nutrition: 1. Too much is spent and too many are not eligible (food stamp program). 2. No more persons eligible (food stamp program). 3. Overdone (food stamp program). Housing: 1. Needed bad (low to moderate cost housing). 2. Bad. We need this (low to moderate cost housing). Transportation: 1. County wide transportation needed. 2. Transfer rate for a minibus. (Monona County-30 respondents) Income maintenance: Raise the $60,000 deductible in inheritance tax. Food and nutrition: 1. A place to meet (congregate meals). 2. Need new meeting place (congregate meals). 3. We need a place to meet of our own where there is no stairs to go up and down. Transportation: Ride to doctors, et cetera. Personal and social adjustment: More good fishing areas for older people. (Woodbury County-7 respondents) Transportation: Low-cost transportation for older persons-badly needed. Appendix 3 STATEMENTS SUBMITTED BY THE HEARING AUDIENCE During the course of the hearing, a form was made available by the chairman to those attending who wished to make suggestions and recommendations but were unable to testify because of time limitations. The form reads as follows: DEAR SENATOR CLARK: If there had been time for everyone to speak at the hearing in Ida Grove, Iowa, on August 17, 1976, on "The Nation's Rural Elderly," I would have said: The following replies were received: MARTHA AMENT, Marcus, Iowa We in Cherokee County need more help in transportation. We have only one 10-passenger bus for the whole county. No other public transportation is available in the county, and that includes the city of Cherokee-plus eight other towns. Why penalize the low-income persons when the social security benefits are raised a small percentage? All other help or supplementary income is cut back until their gain is nil. I certainly enjoyed the meeting at Ida Grove. I have worked with the elderly for many years as volunteer, and 5 years with OEO. I can understand their problems. MAY ANDERSON, SIOUX CITY, IOWA I would have inquired concerning the funding of home-delivered meals under other than title VII as compared to nutrition funding under title VII. GEORGE W. KENNEDY, IDA GROVE, IOWA I would like to know what is being done about national health care for the population as a whole. I speak of population as a whole, although I am a senior citizen. I think some other groups of different ages are as important as mine. BETTY MAGUIRE, IDA GROVE, IOWA I am a public health nurse who has functioned entirely on a county-fund payment for 2 years. Our budget has been protected this past year because it was above the 9-percent level. We really could use some sharing money to support our local health agency. There has been talk in other counties of dropping or cutting the service. I hope you can appreciate this disservice to the elderly. I can function as a nurse and earn a living without the employment. But will the elderly be helped and stay as healthy without the public nurses' services? Please try to get some tax dollar money designated to help support countyfunded nurses. I don't feel the nurses that help should have to be hassled by local politics. |