lance services. An important aspect of this program will be the development of a rural center through which it may become possible to rotate medical students for some portion of their training. This would have the dual advantages of exposure to a rural setting and the opportunity for medical students to work with physician extenders, thus facilitating their understanding of and confidence in this new type of health manpower.

Senator CLARK. I have some questions, but I will now call on Eunice Anderson.

STATEMENT OF EUNICE ANDERSON, MOUNTAIN PLAINS CONGRESS OF SENIOR ORGANIZATIONS, INC., SIOUX FALLS, S. DAK.

Mrs. ANDERSON. Thank you, Senator.

Senator CLARK. Eunice is vice president of the Mountain Plains Congress of Senior Organizations here in Sioux Falls, I think.

Mrs. ANDERSON. No, that is not right. The Mountain Plains Congress of Senior Organizations have two representatives from each of the 6 States in region 8: South Dakota, North Dakota, Wyoming, Colorado, Utah, and Montana.

Senator CLARK. Where are you from?

Mrs. ANDERSON. I am from Sioux Falls. I am one of the two representatives. We are an advocacy group, the Mountain Plains. This is a very new concept. I don't think there is anything like it in the United States. We all have common problems. We are mostly rural. I am very happy to have been at this hearing and I am going to make good use of this because the material that we have gathered here we will use and bring forth in all of our States. We have found that it is useful to find out what they do in other States. I am going to skip some of my remarks because it has been covered.

We had discussions at our annual conference in South Dakota of the White House Conference on Aging. By the way, we had the largest number of people at our White House conference forums by population of the whole United States. So our people are very interested in each other, thank goodness, and also meetings of the South Dakota Association of Senior Citizens. We all agreed that social, recreational, and educational opportunities are absolutely necessary for the wellbeing of the aged.

So I am coming to the conclusion that everybody else does, the fact that we need transportation; the lack of mobility is so tremendously important. Actually the infirmities of age, if there were a certain amount of mobility, would not be so important whether they live in nursing homes, foster homes, or with relatives. So transportation is related to everything-nutrition, health care, religious and social

activities.

Senator McGovern recently has proposed a national Meals-onWheels Act-and I am not sure whether this has been changed since I read it-which includes information referral services and a demonstration project which would mail a week's supply of food to the homebound elderly. The proposal also contains a training cost for those who would implement the problem.

I have been considering the problems of the rural aged, especially their lack of transportation and resulting difficulties in obtaining the bare essentials for existence. Jack, over here, and I have often talked

about this on the Indian reservations. I would like to propose an alternate to Senator McGovern's Meals-on-Wheels Act which, I would think, would serve far better for the needy elderly and could be administered under the existing title III program.

MOBILE GROCERY SERVICE

I have spent some time in rural Sweden, and I have observed how they have solved some problems relating to the lack of mobility. I propose using mobile vans or units which carry groceries, staples like bread, milk, eggs, frozen meals on wheels, aspirin, mineral oil, stamps, thread, a rotating library of books, magazines, and in addition to the driver, an outreach worker.

Senator CLARK. Rather than hot meals?

Mrs. ANDERSON. Well, if you realize as I do I have been on the Governor's Council on Aging for 12 years. The difficulties in small towns right now is with the cost of gasoline. Several of the little towns have had to give up meals-on-wheels because of the cost of gas. We have trouble with the insurance with the drivers; we have not been able to clarify that.

Senator CLARK. In other words, you think the availability of groceries is a greater problem than the hot meals?

Mrs. ANDERSON. Yes. You can have both. I could see the possibility in some concentrated little town-I am thinking about Crooks, S. Dak.—a little town out here.

Senator CLARK. How big is Crooks?

Mr. ANDERSON. Oh, 100 or 150.

Senator CLARK. I see.

Mrs. ANDERSON. They are getting bigger when they get close to Sioux Falls because they have built more houses. There is no place too big. Those people no longer can drive; they cannot get driver's licenses. The cost, even of a short distance-we have many of these little towns in this area, and when I speak of rural, I am talking about this mobile unit. I can see them going from that which they did in Sweden, although they did serve others besides. In Sweden, it is still more difficult with cars, automobiles, and transportation, although they have mass tranportation buses, but then they go into outreach.

For instance, the outreach worker could contact these people by telephone. I think this is one of the tremendously necessary things. Every old person, of course, should have a phone so that they have a little idea of what they are going to have. The outreach worker and the personal contact is a necessary part except nowadays we have in our neighborhood a lot of others. We have milk-vans going around the country, but these older people need that personal contact-somebody coming in. They don't have to stay 3 minutes, at least, to see that they are all right or bring them what they need. There are problems.

Senator CLARK. That is an interesting idea of what you say they are doing in Sweden. I don't know whether they did this around here, but in Iowa we had grocery routes like for everything. As a matter of fact, I remember that my father, in the thirties, owned a small general grocery store and he would go out in a different direction every day with that panel truck and it would be filled with everything imaginable. He

would go to every farm, come back, and go out in a different direction. the next day. He would cover an area of about 20 miles. Now those were farmers and the elderly.

You are talking about going to small towns. Why is it that nobody does that any more? Isn't it profitable?

OUTREACH WORKERS "ON A CIRCUIT"

Mrs. ANDERSON. Every so often you have to get an idea. In the old days I could see why it would not cost so much. I am a florist; I know what it costs to deliver a bunch of flowers. These are expensive things to deliver. However, we have to look for some funding from the Federal Government. We are using a lot of these outreach workers who are very necessary and I can just see them riding a circuit. I think that there are some problems which I wrote down here, and you would understand, that would have to be discovered-the use of food stamps. You would have to evaluate the rural grocery store-medicaid, volunteers. I think this can be worked out in the community. Possibly we could not do it under title III.

Senator CLARK. So your whole point is really that the problem is mobility-transportation-to get services to people in rural areas. Mrs. ANDERSON. That is right. I can see on the Indian reservationI have never talked to Jack about that but I can see the possibility of Cherry Creek. I don't know how far that is from Eagle Butte, but they have been carrying meals-on-wheels out there-hot. Well, this is really not very practical. Cherry Creek now, I think, has a grocery store. I think it is a tremendous difference, but they didn't have it. With a mobile unit they could suggest what they need. It could be used on the reservations.

Senator CLARK. There are a lot of people. I don't want to keep your testimony going on, but

Mrs. ANDERSON. That is not where I would start it. I would start it in an area like this where you don't have the great distances.

Senator CLARK. I was just thinking, the people who are beneficiaries of meals-on-wheels, they probably can't fix the meal if you provided the groceries.

Mrs. ANDERSON. See, the meals-on-wheels are not in our area. We have, I think, 60, 70-maybe more than that-meals-on-wheels a day. They are from Wyoming and would never have been interfered with. Neither would it be wherever you could make it preferable, but I can see that some of these frozen meals could be adjusted to other people that really are not now. If you look at the cost of them, they are not so particularly expensive. I can see some old person having a bunch of these just like TV dinners coming out on this truck, especially even made for diabetics. The fact of the matter is the diabetic diet or older person's diet is similar.

Senator CLARK. We appreciate your testimony.

Mrs. ANDERSON. I have one more thing to say.

Senator CLARK. I am sorry.

Mrs. ANDERSON. About 7 years ago, the aged of Wyoming-I was, at the time, the administrator, and we started through title III. It lasted until they demolished that part of the building. I think this is

one of the most important things that we could do, the establishment of day-care centers for the elderly. They should be in the health-care facilities like this nursing home or the small hospitals, and these people are not served ordinarily as senior citizens.

They have handicaps, they are in wheelchairs, and so forth. They need their medication supervised. That is one of them. Then there is another thing that I would like to say, and that is that we need a nutritional thrust outside of title VII. The rules are wrong for title VII for a small town that maybe could have two hot meals a day that cannot afford the whole setup of the administration.

Another thing is the law that exists in many States which specifies that not more than two unrelated persons can live together in a home. I know Colorado has tried to change the law. Here is a woman who has a home and she cannot afford to heat it; it is too big. She might have three or four friends that would like to move in with her but it is against the law-they cannot do it. They could team up. They could eat better, they could have one car, have each other's company. If they did a little fighting, what of it? They would at least have some human contact. There are many ways we can help decrease the isolation of the rural elderly and make their lives more meaningful.

That is the end of my testimony.

Senator CLARK. Thank you very much.

Now we are going to hear from Don Daughetee.

STATEMENT OF DON DAUGHETEE, STATE COORDINATOR, SOUTH DAKOTA CONGRESS OF SENIOR ORGANIZATIONS, PIERRE, S. DAK.

Mr. DAUGHETEE. Thank you, Senator.

Senator CLARK. I notice that you have a rather long statement. The whole statement will be put in the record as if read, but we would like to have you summarize your views from it.

Mr. DAUGHETEE. Senator Clark, I will make my remarks brief.

I direct your attention to the program operating in the State of Washington which is called the Senior Citizens Services Act which provides a very innovative approach to the delivery of services. I think this is an area that deserves our attention in rural areas.

Housing is a very, very important problem which needs more attention from the Department of Housing and Urban Development, as is the problem of an alternative to nursing home care in our State. The availability of units is of prime importance to people who would like to stay in the rural areas but cannot find housing.

Similarly, I think one of the summary issues of this whole hearing is the fact that one of the greatest problems that the rural elderly face is from their designation of "rural." Many Federal programs define "urban" as a central city population of 50,000, the standard metropolitan area. There is only one town in South Dakota that big and we are here in Sioux Falls today. Everything else is either suburban or rural.

URBAN REGULATIONS INAPPLICABLE

At least population figures define categories into rural/farm and rural/nonfarm. It is rather difficult to implement a Federal program

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in a town of 500 in South Dakota using the same regulations and guidelines required of a city in California of 35,000. One example of this is the Administration on Aging rules which requires multipurpose senior centers to have a paid director and operate 30 hours a week to qualify, yet the majority of the 230 centers within South Dakota cannot afford to have a full-time director, or even a part-time director-let alone operate those 30 hours a week.

Another example would be with the Housing and Community Development Act of 1974, essentially an urban program which allocates 80 percent of the available funding to metropolitan areas. The remaining 20 percent of the funding is available to units of local government for community development to improve housing, environment, and essential services. Of the acceptable eligibility criteria for projects under the law, a fortunate elderly applicant group might be able to secure some funding for acquisition of a facility or to remove restrictive architectural barriers for elderly and handicapped individuals.

In actuality, the decay and deterioration affecting urban centers which this law attempts to remedy are exactly the same problems that rural small towns and communities suffer. Yet, the latter are to attempt solutions with less funding. Somehow, in trying to achieve economies of scale in our Federal programs, we have cut out a substantial portion of the population-and if economies of scale are valid, then no one has told our small family farmers who represent some of the most productive farming units in the world.

Examples of Federal regulations and rules that discriminate against rural areas exist in many Federal agencies and bodies. Recently a local rural project was turned down because it "lacked sufficient visibility" for the Department of Housing and Urban Development.

Senator CLARK. You mean turned that down simply because it did not have enough visibility?

Mr. DAUGHETEE. Yes; that was the case with one local project. I think Shirley Overland can elaborate on that more fully.

Senator CLARK. We would be happy to have her elaborate on it in writing for the record.1 That seems sort of ridiculous.

Mr. DAUGHETEE. Finally, energy policy has been getting increased attention with continued inflation, rising costs of labor, and construction of generating plants. Electric utility rates have increased like everything else; in some areas of South Dakota they have gone up by from 60 to 80 percent. This would not be so bad if individuals were consuming the same amount of electricity, but in many instances consumption is below preoil-embargo days, yet the costs have more than doubled. There is an upper limit as to what older persons on fixed incomes, pensions, or retirement benefits can continue to pay.

The phrase "The more you use, the cheaper rate you pay" is no longer a wise policy, rational practice, or justifiable means to deal with our dwindling resources. Persons who use more should pay more. Electricity is no longer a luxury but, rather, a necessity and all consumers should be provided with a basic amount of electric energy for a minimum rate and service charge. This is called a "lifeline" rate.

I think, in terms of lifeline, that no longer can residential consumers afford to subsidize commercial and industrial users by paying a higher rate for less consumption.

1 See appendix 1, item 1, p. 311.