last only months and they do not want to undertake programs that are ongoing—at least many have told me that. As we consider revenue sharing this year, we should authorize it for a longer period of time to have a better chance that the money will be used for social programs for the elderly.

ARKANSAS' MERCI PROGRAM

Now, in Arkansas, you have a free mobile medical screen which travels to rural areas to provide services to 250 towns' residents. Could you tell us a little about that? How is that funded? How did you happen to start that program?

Mr. SCOTT. I would probably have to characterize that as a success story in the sharing of responsibility between the State and the Federal Government, because it was a project funded several years ago under the old title III strategy. More recently, we refunded it under the Older Americans Act Amendments of 1973. This year the State legislature appropriated funds to the State health department to, in effect, take the program over and make it an integral part of the health program.

So it is being operated now with State funds through the State health department. I think the thing that is most successful about that program is that, even though in the counties we do have what we call public health units, as the case history here pointed out, in most counties that amounts to one public health nurse. The problem with this is that the public health nurse is located in the county seat and is basically a staff of one. It still requires initiative on the part of the elderly to, in effect, get themselves to the service. And the thing about the MERCI program was that it took the service to the people. I don't think that program visited any community in the State of Arkansas with a population over 2,500. They restricted themselves to the very, very rural areas.

Senator CLARK. Another area that has been very largely neglected is the question of unemployment or underemployment. Very little of the money that has been appropriated for employment programs has been spent in rural areas. Could you describe to the committee how Arkansas has supported any manpower efforts in the rural areas? Mr. SCOTT. I guess the most successful effort has been the "green thumb" efforts around the State. It has been a very successful program for us. Of course, at this time when we are faced with unemployment rates like all of the other States, it is hard to talk in terms of employment for older workers when there are so many nonolder workers out of work, too.

We have been able to make use of CETA funds-the Comprehensive Employment Training Act funds-not necessarily for the employment of older people, but for the employment of people to work in some of the Older Americans Act programs. We have been successful in securing bus drivers and personnel such as that to assist us in implementing programs for the elderly.

Governor PRYOR. Mr. Chairman, may I add something?

Senator CLARK. Yes.

Governor PRYOR. You have raised a point that I would like to look into, myself, back on the State level. If we may have the permis sion of the chairman, I would like to supply that for the record if I

could within a few days, because I would like to go back home and look into this particular point.

Senator CLARK. It is a good idea. It is a very difficult problem and one that I think not only the States, but also the Federal Government has not been able to do much about.

It is my feeling that the Older Americans Act has been more beneficial to the urban elderly than the rural elderly. Do you share that view? Do you have any particular evidence one way or the other? Mr. Scott?

RURAL PROBLEMS NOT CONSIDERED

Mr. SCOTT. When I read the legislation and the regulations that come out, and the type of program directions that they are setting, I can't help but get the impression that they certainly did not have Arkansas on their minds when they wrote them. Particularly the examples we used about information referral and coordination of services. This is not to say there are no services to coordinate or that there are no services about which we need to inform people and refer them to. Again, our funds need to be put into more direct types of services as described earlier.

I think that the problems in rural areas have really not been addressed, particularly when you consider the cost factors that we presented here.

Senator CLARK. Governor, I know the interest that you have in nursing homes. This committee recently issued a comprehensive report entitled Nursing Home Care in the United States: Failure in Public Policy. Again, if you have the time, I would appreciate your taking a copy back with you and submitting any comments that you might have on it. Any applicability that report has to Arkansas would be very helpful for us to know about.

Governor PRYOR. Thank you, Mr. Chairman.

Senator CLARK. We appreciate your testimony very much. You have presented a lot of interesting and valuable information that we will carefully review. The Older Americans Act will come before the Senate, I think, in about 2 weeks, and hopefully some of the information that you have provided us with will serve as a basis for some amendments and changes in the Older Americans Act to make it inore effective in rural areas. Certainly the number of statistics that you offer here should be helpful in that regard as well as the number of recommendations you have mentioned. We thank you very much. Governor PRYOR. Thank you.

Senator CLARK. The next witness will be Woodrow Morris, associate dean, college of medicine, University of Iowa, and chairman of the Iowa State Commission on Aging.

Dr. Morris, we have heard some interesting testimony from Governor Pryor on the problems of older people in rural areas. I know that you have a great deal of experience in this area and a great deal of knowledge. You are the associate dean at the University of Iowa in the college of medicine, and chairman of the Iowa State Commission on Aging. We are particularly happy to have your testimony. You can proceed in any way you think appropriate and then we will have some time for discussion.

STATEMENT OF WOODROW W. MORRIS, PH. D., ASSOCIATE DEAN, COLLEGE OF MEDICINE, UNIVERSITY OF IOWA, AND CHAIRMAN, IOWA STATE COMMISSION ON THE AGING

Dr. MORRIS. Thank you, Senator Clark.

I appreciate the invitation to participate in this hearing, particularly because our own Senator Dick Clark is now a member of this distinguished committee and is conducting the hearing. It is also a personal pleasure for me to renew my long friendship with Pat and Bill Oriol and with John Guy Miller. And it is good to see Herman Brotman here, too.

It is also a pleasure to appear in the same session with Governor Pryor. We are aware of his work in the Congress. I accept his challenge to make Arkansas No. 1 in the Nation in its way of caring for the elderly. We are tied for second place in the percentage of people over 65. it will be a case of No. 2 that will be trying harder. Maybe we will be able to compete on a very high level.

I was struck, too, sir, with the similarities between the figures he reported from Arkansas and those from Iowa. I am not going to present testimony the same way that Governor Pryor did his, because I have prepared that kind of testimony in this advanced statement. I would hope that this statement would be deposited with the secretary and that it be made a part of the record.

Senator CLARK. It will be made part of the record.*

IOWA'S CONFERENCE/WORKSHOPS

Dr. MORRIS. Thank you. I would like to comment that last year, starting in May of 1974, the college of medicine, with the financial assistance of Iowa program IMPACT, sponsored a series of nine widely located conference/workshops about aging.

The theme of the conferences was "Planning for the Delivery of Services to Older People." Two of the important conclusions we drew from this experience traveling about the State of lowa was the tremendous need to foster community awareness and community commitment to action on the development and delivery of services to older people, and the very significant roles the area agencies on aging are playing in bringing about this kind of community organization and commitment. The contrast between regions with area agencies on aging and those which do not yet have the benefit of an AAA was dramatic. I believe this is testimony to the values of the provisions in the Older Americans Act establishing the area agency on aging pro

gram.

I believe, however, that even with area agencies on aging, rural States such as Iowa have special problems related to the many small rural communities which are spread out over fairly wide geographical areas. Perhaps the most pressing problem is how best to organize these disparate communities so that needed services may be provided to all of the people, and especially the elderly.

I believe Iowa has led the way in demonstrating some solutions to this problem. In my prepared testimony I mentioned the college of medicine experimental model health care delivery programs. A signifi

See p. 20.

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cant aspect of one of these, Red Oak, Iowa, I believe, will prove to be the development of satellite clinics in the smaller communities in the service area. And I might mention for the record that Red Oak is in a rural part of Iowa.

A similar approach taken by the community mental health centers has already demonstrated the utility of this method. This has been so successful and so well received that these centers and their satellite offices now receive 85 percent of their support from local county and community sources.

Housing, and the concern that every effort possible should be made to help elderly people remain in their own homes as long as they wish and are secure, are additional problems seeking creative solutions. As was shown in my prepared text, there is a particular need in the area of residential care facilities, especially low-cost housing.

HOUSE OLDER AMERICANS ACT BILL

Now, if I may comment directly with respect to the House version of the 1975 Older Americans Comprehensive Services Amendment, I believe that it is regrettable that in the provisions for housing for the elderly in title VIII, particularly parts D and F, there are almost none pertaining to the construction of new housing for the elderly.

It seems to me that in a time when we are trying as hard as we can to move nursing homes out of the era when they were regarded as old homes for old people to more modern buildings, we would do well to try to develop some new housing instead of a program of conversion and renovation of old housing for older people.

We in Iowa are blessed with a number of very fine retirement homes, but they tend to be either very expensive or moderately expensive. We have found a way in which some of these can bring a program of services to older people of low income.

A few weeks ago I spent part of an afternoon meeting with the health care committee of the board of directors of Meth-Wick Manor retirement home in Cedar Rapids. One of the ideas we discussed concerned their establishment of a day-care center as a community resource. The Meth-Wick board adopted this idea unanimously and in the short time since then they have been seeking local funds and hope to enroll an initial 15 elderly people whose families will be able to drop them off at the center in the morning and pick them up again in the evening.

The program envisages a whole range of services including physical therapy, occupational therapy, teaching of self-care skills, group therapy sessions, supervision of medication, therapeutic recreation, counseling, congregate meals, social services, and a well-run elderly clinic which will provide a routine checkup per physicians' orders once a month, with a weekly followup by a public health nurse.

If this plan can be implemented, the possibilities for similar centers in other retirement residences throughout Iowa are pleasing prospects to contemplate.

MANDATORY AGE RETIREMENT

Now, I would like to comment briefly on the topic you mentioned a moment ago to Governor Pyror, and that is mandatory retirement on the basis of age and on efforts to employ retired persons.

This has always seemed to me to be a strange dilemma of contradictions. In general, people are forcibly retired on the basis of age, without regard for their ability to continue to do their work, and then we begin to develop programs to employ the elderly. The employment of older workers has repeatedly demonstrated their capability to do a job well. Let me illustrate this with an example of a program now going on in Iowa.

The Iowa Commission on the Aging has embarked on a unique cooperative experiment involving Federal and State governmental units and private groups to provide employment opportunities to low-income elderly persons. In our first such effort we will have 61 retired men and women who are working in a project to identify outdated, banned, or otherwise nonsaleable pesticides in the possession of retailers.

The project uses funds provided through title IX of the Older Americans Act which were awarded to the National Retired Teachers Association and the American Association of Retired Persons. Representatives of these groups approached the commission on the aging to develop an employment program. This was accomplished by a consortium of the Iowa State Department of Agriculture, the Iowa Department of Environmental Quality, the Iowa State University Extension Service, and the community colleges working with the commission. Supplementary funds to assist in transportation and training costs were received from the U.S. Department of Labor.

A previous session of the Iowa General Assembly had passed a bill which focused attention on the pesticide problem. This led the commission to propose that this statewide problem could be solved by employment and training of older persons as surveyors.

It is of some interest that a number of persons raised objections on the grounds that the quality of the work of retired people would not be acceptable, that the training period would have to be inordinately long since these old people would demonstrate a limited capacity to learn, and that physically they would not be able to handle the chore of going from store to store to inventory pesticides. One Federal agency, in fact, sent representatives to sit in on the training sessions and decided that the participants were, indeed, learning well. They then felt that the proof would be out in the field, so they requested that they be permitted to send two men out from Washington to travel with the participants to determine for themselves whether these elderly people could do the job.

These men spent 2 weeks in Iowa and made 15 trips with the pesticide liaison personnel. Their reports were extremely good and indicated that the people had grasped the significant technical details very well and were well-received by the retailers on whom they called. It now appears that by means of this program the work will be completed in 85 of Iowa's 99 counties by the time the funding expires. Due to the success of this model, other States, such as New York New Jersey, Texas, Mississippi, and Alabama, have expressed keen interest in discussing the implementation of similar projects in which retired persons will be employed.

We are certain that there must be additional useful employment possibilities around our State and other States in which these or other retired persons could perform functions which would benefit society