the First National Conference on Aging in 1950. This committee performed a useful educative role as a pioneer agency in the field. It was reorganized as a Special Staff on Aging in 1956, but given little new responsibility or authority. The Special Staff on Aging does not play any role in the formation of national policy dealing with older persons. Useful and necessary functions include compiling data from published material, publishing a national newsletter on aging, providing some technical services to States and localities and maintaining relationships with voluntary organizations. Its role in coordination is not extensive, but it does provide some opportunity for intradepartmental communication at staff levels. The Special Staff on Aging is not an identifiable item in the budget but is included in the general budget of the Office of the Secretary. Its staff has been very small, increasing only slightly despite the rapid increase in Federal responsibility for the problems of older persons. Slightly more than 5 years ago, Oveta Culp Hobby, then Secretary of Health, Education, and Welfare, said the Department was 10 years behind in its work in behalf of the aged. At that time there was a total of nine employees on the special staff. By the end of 1959, there were just 12, including 6 secretaries. During the recent White House Conference on Aging the Special Staff was merged with the White House Conference temporary staff and devoted its time and energy to arrangements for the Conference. It was not involved, however, in advising or studying the interrelationships of major substantive issues in this field that were before the Nation. 1 As Senator McNamara concluded in an address on this subject: THE NEED FOR COORDINATION AND STIMULATION The single most obvious fact about the problems of aging is that they concern in one way or another practically every department and agency of government. Corollary to this fact is the equally obvious, yet equally important, generalization that every particular problem of older persons affects every other problem and accordingly, the only efficient approach is an organic, overall view. Examples of these interrelationships and the way so many of the problems created by neglecting these interrelationships can be cited at length. The maintenance of good health is related to income, adequate housing, proper recreation and nutrition. Both the Public Health Service and the Department of Agriculture can provide older persons with data on nutritional requirement for health. But neither agency can transform data and statistics into adequate, nutritional meals if the older person's income is too low. Data and advice thus turn to inedible mush. In this connection an Office of Aging-concerned with the total aspects should be aware of the possible use of surplus 1 Address on the floor of the Senate, July 1, 1960, Congressional Record, vol. 106, No. 123. foods and school lunch programs and how they might be available to older persons. Another example involves the productive use of years in retirement. Today approximately 12 million Americans over 65 have retired completely and are spending, on the average, 15 years in retirement. In just 40 years we may have as many as 25-30 million retired persons over 65 living an additional 20 years beyond the period of gainful employment. The prospect of 25 million people spending 20 years with no role or important contribution to the economy and society should raise questions of the basic values of our times. Can our economy support so large a population of "nonproductive" citizens? Even if it can, should it do so? What must be planned and undertaken now and tomorrow to insure that 500 million man-years will not be wasted, but will be devoted to important service to the community and to self-enrichment? Who will be able to concentrate fulltime on these economic implications of aging and provide data and recommendations to reckon with them? This type of reflection, planning and recommendation for action is assigned to no agency at the present time. The problems here involve considerations of employment, health, income, housing, senior centers which are all enterrelated. It is this type of forward thinking and relational analysis which the Office of Aging can and should assume both in behalf of the Nation's senior citizens and the Nation as a whole. Without such a responsible agency there is no end of ad hoc, and generally feeble, efforts at "coordination" of the various activities of governmental agencies dealing with special aspects of aging. An advisory committee of public citizens provides some coordinative thought in housing; a small group of people work in social security to coordinate programs in public assistance with other social security programs; the Public Health Service has a coordinating committee; and there is an additional such committee on research in the National Institutes of Health. These committees perform useful functions in their areas, but are not substitutes for the overall, meaningful thought and direction which are required. SIMILAR DEVELOPMENTS The proposal to create a U.S. Office of Aging parallels in many ways the establishment of the Children's Bureau in 1912. The Bureau is charged with investigating and reporting "upon all matters pertaining to the welfare of children and child life among all classes of our people." Its creation was a legislative accomplishment of the first magnitude, recognizing that the welfare of children is an appropriate, important concern of the Federal Government. Within a period of 50 years it has made incalculable contributions to the health, welfare, and long life expectancy of America's children. The purpose of the Children's Bureau "is to serve all children" everywhere. It is concerned with their health problems, employment, housing, adoption, social services-all interrelated and requiring a view of the child not as fragmented pieces, but as a whole person. Its great contributions have been based on the concept of preventing problems rather than having to deal with them in their acute stages. It is specifically in these areas that the U.S. Office of Aging will fulfill its essential role. It will provide a focal point for considera tion of the needs of older persons as whole people. The problems of the Nation's senior citizens are emerging problems now reaching the scope where national attention and therefore a national agency is required. SOME PROS AND CONS The proposal to establish a U.S. Office of Aging has raised a number of questions with respect to its immediate and longrun value. The questions may be listed as follows: 1. If an Office of Aging is established, will it not tend to take over the functions in the area of aging now being carried out by other departments and agencies? 2. Won't an Office of Aging, located in the Department of Health, Education, and Welfare, be limited in its outlook to the interests of the department? 3. If there is to be an agency dealing with problems of aging on an overall basis, should it not be outside of any operating agency? Don't we need an independent commission instead? 4. Isn't it possible that a Federal agency active in this field will reduce the effectiveness and support of voluntary agencies with interests in this area? These are the major questions which have been raised at various conferences and discussions of the proper Federal organization to meet the problems of an aging population. These questions raise proper concerns, but do not constitute serious objections to the creation of the proposed Office of Aging. The reasons include the following: 1. The Office of Aging will not have service functions of its own, but will be consultative, reflective, stimulative, and financially supportive for programs for senior citizens. It thus will not in any way assume the responsibilities filled by other departments and agencies, but rather will be helpful in strengthening them in the execution of their present responsibilities and the assumption by them of necessary new duties. 2. The history of State and Federal organization provides ample evidence that the effectiveness of an agency in the determination of public policy is directly related to its place in the established departmental structure of government. The use of independent commissions-outside of a regular department is helpful for making studies and recommendations on a temporary basis. They are not, however, ordinarily employed for sustained contributions once the period of extensive study and reporting has taken place. The past decade can be characterized largely as one of study, reports, discussion, and preparation, rather than concrete action. For the past 2 years the White House Conference on Aging and the hearings of this subcommittee have sparked local, State, and regional conferences; has produced numerous surveys, studies, reports, and recommendations; and was climaxed with a national conference of almost 3,000 delegates in Washington. It is the belief of the subcommittee that the Nation is now ready for action and that further committees and further study will only induce disillusion, frustration, and cynicism among our aged citizens. Former Secretary of Health, Education, and Welfare, Marion Folsom, in discussing Federal organization at the White House Confer ence on Aging, did not endorse the Office of Aging bill. But with respect to independent agencies, he said: I do not believe that an independent agency would be feasible. We already have too many independent agencies in the Federal Government; recent studies to improve the efficiency of government have pointed out the desirability of moving in the opposite direction-concentrating functions and eliminating duplication and complication with the several departments now functioning in this field. 3. Assuming that an Office of Aging thus should be located in an established agency, the logical assignment is the Department of Health, Education, and Welfare. Its responsibilities in aging include income maintenance, health, financing medical care, rehabilitation, education, research, and social services. Its role far exceeds that of any other governmental agency and lays a natural basis for integrative thinking in this field. 4. In order to relate closely to the formation of policies in behalf of older persons, the Office should be at the level of an Assistant Secretary of HEW, who would be the immediate assistant to the Secretary in his role as chief adviser to the President on problems of aging. Further coordination could be achieved through an interdepartmental committee, chaired permanently by the Secretary of HEW and staffed by the Assistant Secretary for Aging and his Office. In addition, there would be a combined citizens and public advisory committee which could include Members of the Congress-to broaden and freshen the approach to programs and policies for improving the conditions of senior citizens. 5. The field of aging and its problems are so numerous and manysided that no group-voluntary or public-will in any way be diminished by the creation of such an office. Experience in the field of education, mental health, welfare and health generally evidences that a public response to a felt need gives new impetus and support to voluntary organizations. The Office of Aging could in no way supplant voluntary activity but rather would be available for consultation, assistance, and stimulation. 6. The White House Conference on Aging did not approve any specific form of organization but did set forth the following elements: (a) A statutory basis and more independent leadership; (b) Adequate funds for coordination and other assigned functions through a "line item" appropriation; (c) Responsibility for formulation of legislative proposals for submittal to Congress; and (d) Responsibility for periodic reviews of and reports on the various programs, departments, and agencies working in behalf of older people to achieve their effective coordination and oper ation. A DECADE OF CONGRESSIONAL CONSIDERATION Since 1950, there have been at least 53 bills introduced in the Congress either to establish an agency on aging within the Department of Health, Education, and Welfare, or to create a U.S. Commission on Aging. Interest in these proposals has mounted in the last several years and action on the matter may be on the immediate horizon. (A list of such bills prepared by the Legislative Reference Service of the Library of Congress is presented at the end of this chapter.) Hearings were held on a "Bureau of Older Persons" in the spring of 1958 by a subcommittee of the House Education and Labor Committee. A number of House Members have actively promoted such a proposal since that time. In the past 2 years hearings by this subcommittee dealing with problems of the aged and aging resulted in testimony from a number of witnesses recommending an office of aging. The data collected by the subcommittee, its special studies, the testimony of hundreds of older citizens, as well as that of national experts and local administrators, and the personal visits of the members of the subcommittee to the homes of older persons pointed to the need for a systematic national attack on the problems of the elderly. Introducing a bill to provide for an Office of Aging, Congressman Thomas J. Lane, Democrat, of Massachusetts, stated that a "step-bystep improvisation" approach to the problems of the aged and aging— *** has resulted in too much overlapping and duplication that has obscured other problem areas where the aging need our advice and help. A single office to serve as a clearinghouse for information, for research and training programs, and to provide clear leadership and direction, will coordinate Federal, State, and community action in behalf of a comprehensive yet unified approach to the whole problem (Congressional Record, Aug. 24, 1960, p. 16287). In a recent communication with the subcommittee, Dr. Margaret S. Gordon, associate director, Institute of Industrial Relations, of the University of California (Berkeley) wrote: I should like to see a special Office on Aging established within the U.S. Department of Health, Education, and Welfare which would have as one of its functions the stimulation of research on all aspects of aging. Such an office could work with the various Government agencies that have concern with the aging problem to stimulate research in areas that are currently being neglected or that need greater emphasis. The actual research grants might be awarded in some cases through the National Institutes of Health and in other cases through Social Security Administration, the Bureau of Employment Security, or other appropriate agencies (letter, Aug. 12, 1960). The White House Conference on Aging climaxed 2 years of intensive participation at 77 statewide meetings by more than 30,000 people. Recommendations were suggested by hundreds of local conferences, by Governors' Conferences in each State, by State commissions and finally by the delegates to the White House Conference itself. There is a vast legacy of thought and recommendations which need to be systematized, assigned priorities, and selections made for executive and legislative action at the local, State, and Federal levels. The subcommittee feels that this dramatic effort will be wasted if it does not culminate in establishing a U.S. Office of Aging to follow |