In the Sioux Falls area it is almost impossible to rent a one-bedroom apartment for less than $125 on the open market that would meet housing code standards. I have included a list with a sample of various rents. As a matter of fact, I understand that the situation is worse in Rapid City, Pierre, Brookings, Yankton, and Vermillion. [The list follows:] Mrs. THOMAS. South Dakota has 3,952 units available for the elderly and handicapped in subsidized housing. I must correct this a little bit because I have not included the figures from the Farmers Home Administration, so that could change this. Now, 2,109 units are public housing while 1,843 are funded under other subsidy rent programs. Only 387 of these are on the Indian reservations. For the 32 percent of the elderly population having incomes below the poverty level, or more than 23,000 people, more lowincome housing is needed to neutralize the effect of inadequate income. If I could divert from my prepared statement just a moment, I was doing some back reading yesterday and I discovered that there was a bill introduced last year in the House of Representatives which would have provided an automatic grant subsidy for anyone on SSI. That bill I think was by Congressman Brademas-I am not sure. If that bill is still around, I would like to see it rejuvenated; it would solve this particular problem we are talking about. MEDICARE, MEDICAID INADEQUACIES In a recent study on the problems of social adjustments of the lowincome elderly living in subsidized housing, I found that even though this minimized many of the problems of inadequate income, most of the persons interviewed said that they needed more money. One of the greatest needs of the elderly is dental care, including dentures. Neither medicare nor medicaid include dental care for adults. Dental care is important to the elderly-it is necessary for proper nutrition, good health, and personal dignity. I believe that we are really putting down our older citizens when we say to them that dentures or dental care is a luxury that is nice to have if you can afford it yourself. Since July 1, 1976, optical and other medical services to adults have been seriously curtailed under the State medicaid program. Let me just remind you that money and services given to the poor help the economy of everyone as this money is put back into immediate circulation and, with the multiplier effect of four, it increases the economy of the entire community. Thank you again for the opportunity. [A letter from Representative Ottinger was submitted for the record.] CONGRESS OF THE UNITED STATES, DEAR FRIEND: I am writing to enlist your support in the effort which I and other Members of Congress have undertaken to effect badly needed reforms in the supplemental security income program. As you will see from the enclosed reprint from the Congressional Record, I have introduced legislation which would provide a supplemental allowance to SSI recipients such that they would not have to pay more than 25 percent of their income for housing. The allowance is limited to a maximum of $1,200 per year. I firmly believe that such rent supplementation is one way of getting around the basic inflexibility of a program that has failed to take regional cost of living differences into consideration in the awarding of benefits. In the higher cost-ofliving areas of the country, rising rent and utilities, coupled with a lack of adequate alternate housing at reasonable prices, has made it increasingly difficult for those on SSI to survive. Although other housing allowance proposals have been introduced, I believe that my bill-H.R. 7138-more adequately addresses itself to the problem. The 25 percent allowance is in line with the standards set by other Federal housing programs, such as the section 8 housing assistance payments program. We must demonstrate highly visible public support for the bill if it is to have a chance of passing. I urge you to encourage the members of your organization to write to their congressmen and, particularly, to the Members of the House Committee on Ways and Means, who are named on the enclosed list. I would also be grateful if you would disseminate this information as widely as possible to any groups or individuals who might have an interest in supporting this legislation. Thank you for your interest, and I hope that I can count on your support. Senator CLARK. Thank you. RICHARD L. OTTINGER, Just a couple of questions of each of you. First, Mr. Johansen. You are obviously in a position to have thought a good deal about the problems of the elderly in South Dakota. You are Chairman of the Advisory Council on Aging. Obviously the purpose of this hearing is in no small part to try to see what is most important-not what is important, but what is most important-in the rural areas. As you look at the situation in South Dakota, if you could increase the funding-either create one new program or increase the funding significantly—which program would you put at the top: transportation, nutrition, unemployment, or housing? As you look at it, what is the greatest problem in South Dakota? Mr. JOHANSEN. I would say, offhand, that transportation would be the most pressing problem. POVERTY LEVEL MINIMUM Senator CLARK. Now I want to ask Vada Thomas a question. I must say I agreed with a great deal of what you said-in fact, I can't think of anything you said that I didn't agree with-but particularly the point that medicare has a long way to go. As you say, you don't get dentures, eyeglasses, prescription drugs, and one could go on and on. I refer particularly, though, to the statement that it would seem that in a country as strong and as wealthy as this one, the first priority ought to be to bring people up to the level of poverty so that no one 79-246-77 -2 lived below this level. I cannot remember the exact dollar figure, but it is amazingly small. We introduced legislation to raise social security and SSI for every American to the level of poverty so that no one would live below the level of poverty. I cannot remember the exact dollar figure-it was much, much smaller than I thought. My recollection is that it is about the cost of three Trident submarines. It would be a remarkable thing to be able to say that we don't have anyone in this country that lives below the level of poverty. So I congratulate you on the statement. The one question I wanted to ask you was which program do you see from your experience that we need most? I know we need a lot of different things, but do we need housing? Do we need transportation? Do we need health care? Which of those would you select as being the greatest need? Mrs. THOMAS. In speaking of South Dakota as a total, I would have to again restate transportation. Looking more specifically to Sioux Falls, I see housing as the greatest need. Senator CLARK. Thank you. Congressman Pressler. Representative PRESSLER. I have just a short question which I might address to both Peter and Vada, and that concerns the points that Vada made concerning optical care and other health care. I find I get a lot of mail from senior citizens who actually can't buy glasses, for example. I am the cosponsor of legislation to expand that coverage and I must say that I agree with the things that you have advocated here this morning, but what can we do in the Congress to jar loose thinking? Certainly I suppose by coming here and taking this testimony, but we get a great deal of mail, some of which I will insert into the record at some point. Do you have any specific figures in your groups as to senior citizens in rural areas who are going without dental care or without optical care? It is very difficult to have specific figures on something like that because a lot of it is hidden poverty. Mrs. THOMAS. I don't have a total figure. I can say in the last month I have had five requests for dental care and three for eyeglasses—calls from people who have called me and asked where they could get these. Representative PRESSLER. I find a lot of senior citizens buy these glasses from a drugstore which may be helpful, in some instances, to save the cost of going to an optometrist. Have you found that to be true? There are very low-cost glasses available. Mrs. THOMAS. I have not checked into that. Representative PRESSLER. We don't have any figures available on that? Mrs. THOMAS. No: I don't think there are any available at this time, Dental care-we are trying to document those in a more complex way for the people needing dentures. POVERTY OFTEN HIDDEN Representative PRESSLER. I think in our small town. Senator-and I hope the committee takes this thought back with them-there is a lot of hidden poverty that is very quiet. People in South Dakota and in your State are very proud-they have been very proud-and they are ashamed to admit this need, but it becomes evident through routine things like eyeglasses and care of the teeth. The people just try to get along. We have a great deal of hidden poverty among the aged. Senator CLARK. Thank you very much. The next panel is on older service users and providers. Phil Burke is going to be accompanied by Shirley Overland; Irene Eilts is accompanied by Larry Oppold; and Lillian Nace and Ray Bagley are accompanied by Gerry Eisenbraun. We are going to hear from this panel about older service users and providers, those people who provide the services and those people who use the services that are available to older people. Now, again, because we do have so many witnesses today, let me remind those of you who are going to speak that we would like to have you try to limit your comments to about 4 or 5 minutes so that we might be able to ask some questions afterward; otherwise, we will just have to dispose of the questions. Phil Burke, you are president of the Huron Area Senior Center, Inc., South Dakota. You may proceed at this time. Mrs. OVERLAND. I am going to introduce Mr. Burke. STATEMENT OF SHIRLEY M. OVERLAND, DIRECTOR, HURON AREA SENIOR CENTER, INC., HURON, S. DAK. Mrs. OVERLAND. Senator Clark and Representative Pressler, I am Shirley Overland, director of the Huron Area Senior Center, Inc., here in South Dakota. I am submitting a written statement on the development of our rural multipurpose center, along with comments on title V, our DARE program-developing adult resources in education-and our plans to remodel the Huron College dormitory for low-income elderly housing and a senior citizen center. At this time I will present my testimony to you in written form, but I am very proud to introduce to you Phil Burke, president of the Huron Area Senior Center, Inc. [The prepared statement follows:] PREPARED STATEMENT OF SHIRLEY M. OVERLAND The Huron Area Senior Center, Inc., developed from its meager beginnings because of the interest and perseverance of several retired Federal employees. Some said it could not be done but they continued on in spite of numerous obstacles. The group met in various community buildings and churches before moving into an old rented hatchery about 4 years ago. Much of the remodeling was done by the seniors. Those attending numbered from 35 to 50. The present director was hired with the assurance that this was a part-time job and she could come and go pretty much as she pleased. Her salary was $3,000. She was expected to coordinate a few craft and recreational activities. The director, as an enabler type person, had an abundance of volunteer experiences in developing programs and working with people of all ages. Her study of other Older Americans' Act programs and attendance at workshops plus the enthusiasm and dedication of the board of directors led to increased program activities and involvement of other older volunteers. The center membership mushroomed because of superb news coverage and excellent community involvement but mostly because "each one brought one." The senior center was the place where things were happening. Persons who had been living in isolation and loneliness were brought by other caring senior citizens and soon they too were involved. A wide variety of activities (often more than the old hatchery could contain) enticed others to come just to see what was going on and soon they too joined the ever-increasing membership. The incubators were moved out of the back room to make more space. A new floor and ceiling, and a coat of paint made additional activity areas. The Huron center was chosen as a title VII nutrition site largely because of the existing services, outreach, and concern of its members. The philosophy of service to all rural older Americans and community has built a firm foundation. Three new people joined the staff with title VII funds: a site manager, outreach worker, and bus driver. Two minibuses were provided, one with title VII funds and the other with one-third county, one-third city, and one-third center funds. The center had and continues to have special events that generate some income. Examples: "Country Christmas at the senior center," "Around the world with the senior center," bake sales, gift shop open daily that sells articles made by senior Americans, quilt raffles, "Pioneer Cookery for Modern Cooks" (a cookbook), "Gambles Senior sellabration" (senior center takes over Gambles store for 3 days and handles all sales and countless demonstrations), gift shop at the South Dakota State Fair in Senior Citizens Building (manned by senior citizens serving coffee and cookies to thousands of pioneer South Dakotans during 6 days of fair), etc. The center director is aware the senior center is not for everyone and yet there are many proud rural elderly that have tragic unmet needs. They continue to try and work things out alone because they'd made it through the dirty thirties and depression years. How could these folks be helped? A home care program could provide the answers but how with limited funding? At the same time several members of the board were aware that the other small communities (200 to 500 population) in Beadle County (with large percentage of elderly) had no services provided. Each community was contacted and if interest was indicated, the Huron Center director and several board members met with key community leaders (elderly included). A title III grant provided for a home care director, funding for five satellite centers and money to develop a rural transportation program. The buses go weekly to each small town bringing the people into the county seat (Huron) for services, nutrition, recreation, and visitation. The home care program has been most beneficial. Calls and visits come from families in other parts of the United States. They are concerned for an elderly parent. Grandma could come and live with them but she chooses to remain in her home. A home visit is made and the necessary help provided through information and referral with other agencies. Calls come from the elderly themselves asking for chore and homemaker services. If they cannot pay, they are assisted in working out the details with title XX. Doctors refer hospital dismissal patients on special diets to the home care director. She coordinates meals-onwheels for these individuals. She visits daily in homes of elderly. She assists with tax refunds, SSI and other programs. She operates in a loving, caring, nonthreatening way. She accepts each individual as a fellow human being in need of love and a sense of worth. Each staff member at the Huron center functions in this way. This accounts for a membership that has crossed all economic barriers with an age span of over 40 years. Each satellite center has developed its own program. However in this third year of funding (ordinarily the last) the Huron director is spending time monthly with each group. She is "planting seeds" to assist them in developing to their fullest potential. The philosophy that we look selfishly to our own needs so that we can have a good time is rapidly disappearing. Instead we will reach out to those on the fringe today and then leave something behind tomorrow when we are gone. In this way others can continue to build on our programs, thereby serving more people. If through our services throughout the county we can help elderly rural South Dakotans to remain in their own homes or community and stay out of nursing homes, we will know we have served our fellowmen. A superb example of change of attitude is one couple in particular from one of the satellites. When we first visited their community to discuss a senior center, the committee was receptive. However, a great deal of the conversation that first day concerned an elderly man who had recently married a nearly blind, somewhat retarded young woman. They lived in a tarpaper shack with dirt floor and no conveniences. His prime goal was to have enough wood chopped to keep them warm the next winter. The community laughed about the ridiculous marriage. Several units of subsidized |