S. 2271 proposes three studies. The first of these is an analysis of various approaches to automatically adjusting benefits, including a cost-of-living adjustment. The bill Congressman Gilbert has introduced provides that benefit amounts would be automatically adjusted annually for each 1 per cent or more of increase in the cost-of-living. There is still need for the broad study proposed by S. 2271 which would encompass methods of adjusting benefits to productivity and rising standards of living and would also assess the appropriateness of the use of a cost-of-living index based on the needs and spending habits of the total population.

The second study proposed by S. 2271 related to general revenue financing. The fact that the Gilbert bill provides for general revenue financing gives assurance that careful attention will be given to this subject.

The third study proposed by S. 2271 concerns the trend toward retirement before age 65 and the effects of that trend upon individual social security beneficiaries. The Gilbert bill would lessen the actuarial reduction imposed on persons claiming benefits before age 65 but it does not eliminate the need for a broad study of the trend toward early retirement.

S. 2272 A bill to amend title II of the Social Security Act to increase the amount of the insurance benefits payable to widows and widowers.

S. 2272 would no longer be needed because the bill introduced by Congressman Gilbert raises the proportion from 822 per cent to 100 per cent of the worker's benefit where the survivor's benefit begins at age 65.

S. 2273 A bill to amend Title II of the Social Security Act to increase the amount of earnings permitted each year without deductions from benefits thereunder.

S. 2273 would no longer be needed. The Gilbert bill proposes the same liberalization of the "retirement test" and in addition provides for automatic adjustment of the annual exempt amount of earnings under the retirement test.

Since introduction of S. 2273 I have become even more aware of the impact of the present retirement test on the participation of older workers in gainful employment. I hope the House Ways and Means Committee will address itself to two questions:

(1) If benefits are raised as contemplated by the Gilbert bill, would pressures for the elimination of the retirement test be reduced? and (2) What additional costs would be involved in eliminating the retirement tests proposed by the Gilbert bill and proposed by President Nixon?

S. 2274 A bill to amend title II of the Social Security Act so as to provide that remarriage shall not disqualify an individual from receiving widow's or widower's benefits thereunder.

S. 2274 would still be needed to deal fully with the problems of reduction or elimination of social security benefits on remarriage.

The CHAIRMAN. Are there any questions? If not, thank you so much for giving of your time to come here today.

Senator WILLIAMS. Thank you, sir, and the other members of the committee.

(The following excerpt was received by the committee:)

EXCERPT FROM DEVELOPMENTS IN AGING, 1968, ANNUAL REPORT OF THE SENATE SPECIAL COMMITTEE ON AGING

CHAPTER XII-THE GROWING NEED FOR TRAINED PERSONNEL IN AGING AND RELATED FIELDS

As the number of older Americans increases, so does the demand for specialized services and trained administrators for many kinds of facilities, including housing, intended to serve the elderly. Aging has thus produced many growth industries, but government and private resources have not yet been

successful in providing the specialists needed now and even more so in the future.

Fortunately, the most comprehensive evaluations made yet about the size and nature of the problem were produced in 1968. In addition, significant steps have been taken to provide innovative training, and educators and others have participated in courses meant to help them develop training programs in aging at universities and other educational institutions.

I. The 1968 surveys of the problem

1

Congressional concern about training needs resulted in a request that the Administration on Aging undertake a study and evaluation of the immediate and foreseeable need for trained personnel to carry out programs related to the objectives of the Older Americans Act. In 1968, the following major findings were reported:

OVERALL NEEDS: Under an AoA contract, the Surveys and Research Corporation issued a report 2 which made the following major points:

Most if not all service programs are faced with critical shortages of trained personnel. The outlook is for little improvement in this regard unless drastic changes are made in the scope and character of the training effort.

At least a third of a million professional and technical workers are employed in programs serving older people exclusively or primarily. In all likelihood, fewer than 10 to 20 percent of these have had formal preparation for work with older people. A projection of future demand, if necessarily a gross one, would place requirements for trained workers in 1980 at a level 2 and 3 times above that of 1968.

Home medical care programs and the provision of social services to older people through social agencies appear destined for major expansion. As these programs grow in number and size, they will make demands for personnel. The need for social workers, social work aides, and community aides trained to serve older people in public-welfare agencies, long-term care facilities, information-referral services. retirement-housing projects, and in other facilities, largely unfulfilled, runs into many thousands.

One of the most serious deficiencies turned up by the present study is the paucity of basic information on the demand for and supply of personnel in the field. The first recommendation in the report is addressed to this subject, in recognition of the fact that such information is fundamental to efforts to recruit personnel and to provide training opportunities. PROBLEMS IN HOUSING: Another AoA contract went to the National Association of Housing and Redevelopment Officials. As a result of NAHRO's survey, the following statements were provided in the final report:

Management personnel in governmentally assisted housing projects designed for occupancy by the elderly currently number about 4,900. Few have had specialized preparation for working with older people. Estimated requirements for such personnel in 1970 range from 8,000 to 13,000. Corresponding figures for 1980 are from 32,000 to 43,000.

An even more compelling need for trained personnel exists in the field of nursing and personal care homes if these facilities are to provide adequate medical care, restorative services, and stimulating activity programs. Some 24,000 persons are employed in administrative capacities in such homes at the present time, most of whom will require special training if they are to meet licensing requirements now being developed in response to the Social Security Act Amendments of 1967. A special analysis made for the present report points to the strong likelihood of a doubling and a tripling in the number of beds in use by 1980, with a need for corresponding increases in the number of trained personnel.3

RECREATION PERSONNEL: A third contract-granted to the National Recreation and Park Association-was used for a study of personnel needs in the field of recreation. The report declared:

1 See pp. 142-143, "Developments in Aging. 1967". for discussion.

2 The Demand for Personnel and Training in the Field of Aging, Oct. 1, 1968. (Later submitted to the Congress by HEW Secretary Cohen.)

3 For additional discussion of the NAHRO study findings, see "Study of Housing Management for Elderly Points up need for More. Better Trained Management Personnel for All Low-Income Housing," an article in the Journal of Housing, No. 10, 1968.

at present there is a full-time equivalent of approximately 15,000 recre ation personnel working with older adults. Projected needs are for 23,000— 31,000 such workers in 1970 and 26,000—76,000 in 1980.

The C & S report, seeing a clear need for widespread training efforts at universities and elsewhere, made 23 recommendations.*

Survey data clearly indicates a widespread need for more trained personnel in many fields related to aging. Unless great efforts are made to provide such personnel, Federal funds will not be put to best possible use in programs and for purposes of direct importance to elderly Americans. Early congressional consideration should be given to recommendations made in 1968 and to other proposals that may arise.

II. Training programs now at work

A large number of training programs are described in appendix 15 reports from the Administration on Aging, the Social and Rehabilitation Service, the Public Health Service, the Office of Economic Opportunity, the National Institute of Mental Health, and the U.S. Office of Education. The purpose in most cases is to provide support, as far as is possible at present levels of funding, for training of specialists.

Other possibilities for more widespread dissemination of information about aging are suggested by the use to which Administration on Aging funds have been employed in programs that bring representatives of many disciplines of higher education together for intensive lecture and discussion programs.

In New Jersey, the State division on aging conducted two seminars on gerontology and higher education during 1968. Universities, schools of nursing, and community colleges were represented on each occasion. Conferees met from February 1-4 and February 23-25 for the first seminar and for a similar number of days for the second."

Another AoA grant was used in 1968 to fund seminars in social gerontology for faculty of Michigan educational institutions. The University of Michigan— Wayne State University invited faculty of universities and colleges (including junior and community colleges) to conferences intended to help them develop their own training programs in aging at their educational institutions. The seminar consists of eight weekend sessions (Friday evening, Saturday, and Sunday morning) a month apart.

The CHAIRMAN. Our next witness is the Honorable Carl D. Perkins from the State of Kentucky. Mr. Perkins, please come forward to the witness table, if you will and you may proceed as you wish.

Mr. PERKINS. Thank you, Mr. Chairman.

STATEMENT OF HON. CARL D. PERKINS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF KENTUCKY

Mr. PERKINS. Early in the present Congress I introduced two social security bills-one increasing benefits by 20 percent across the board and making both men and women eligible at age 60; another extending medicare to people eligible for disability benefits. In view of the fact that the administration has just now proposed an increase of only 10 percent, along with other changes in the system, and the Committee on Ways and Means is now conducting hearings on that bill, I want to make it plain that I consider such a small increase as 10 percent quite inadequate in times such as these and in view of the present level of benefit payments.

I remind the Congress that the average benefit for a retired worker lacks a few cents of being just $100 a month, while the average benefit for an aged couple is only $168 a month, I maintain that the proper increase for social security benefits, in time such as these, should be

See app. 9. n. 271 for summary.

5 Pp. 128-129. 144. 153, 160, 203.

For additional details, see app. 9. Item 2. p. 271,

36-662-70-pt. 5-14

at least twice the amount the administration has recommended. Such a change would also increase the minimum benefit from $55 to $66 and raise the maximum benefit from an eventual $218 to $261.60. The 20percent increase contained in my bill, H.R. 3287, introduced on January 14 of this year would bring the retired workers' average benefit up to $120 and the aged couple's benefit up to around $202 a month or around $2,400 a year.

According to the Labor Department's Bureau of Standards the amount required for an aged couple to maintain a "moderate" living standard in urban areas of the United States is $4,112 a year. This budget allowed $1,113 a year for food, $1,377 for housing, $364 for transportation, $379 for clothing and personal care, $314 for other family needs and $246 for gifts and contributions. The budget assumed that "urban areas" included a metropolitan area or smaller city. It also assumed that both the man and his wife were in reasonably good health for their age, able to take care of themselves, and fully covered by medicare. They also had average inventories of clothing, home furnishing and major durable goods, such as a washing machine, a stove, a refrigerator and a vacuum cleaner already on hand. This, as we know, is not always the case.

Perhaps 20 percent is not enough. Perhaps we should think in terms of making is possible, through our social security system, for most people to look forward to solving the poverty problem, as it is related to income, for all of our elderly citizens so that we can all look forward to retiring with the assurance of a "moderate living standard" such as I have just described. A statutory advisory council on social security now meeting is charged with reviewing "the scope of coverage, the "adequacy of benefits" and "all other aspects" of the social security and health insurance programs and is probably considering this matter. It must report its findings and recommendations to the Secretary of Health, Education, and Welfare, for transmittal to the Congress, by January 1, 1971.

Another aspect of the program which I believe should have the particular attention of the Congress is the current and complicated retirement age. My bill, H.R. 3287, would reduce the retirement age to age 60 for both men and women, paying them full benefits if they need them at that age. One of the first bills I introduced into the Congress when I came here some years ago, was a bill to lower the eligibility for retirement age to age 60 for both men and women. At that time it had been obligatory that the age 65 for both men and women was the required age which was then obsolete, in my opinion, because it was adopted in the original Social Security Act back in 1935. Since that time we have developed an extremely complicated mechanism which pays full widow's benefits at age 62 but actuarially reduced benefits for wives and women workers at age 62, to widows at age 60, and even more steeply reduced benefits to men who chose to retire at age 62.

I emphasize the fact that changing the retirement age does not make it mandatory retirement age. If a man or woman wants to continue working after age 60, that is entirely up to him or her. But I also emphasize the other fact that retirement age is not, for the individual, always a voluntary matter In some cases it is the decision of his employer or a supplementary pension plan, that he is no longer employable after age 60. In other cases he is "laid off" because of a

slight disability which makes it difficult to keep up the pace of production at which he formerly performed. Instead of being automatic at age 65, "retirement" is in real life and arbitrary, capricious and unpredictable phenomenon. Lowering the retirement age to age 60, I have always believed, is a means of adjusting to this fact of life. For those people who are fortunate enough to continue on the job to age 65-or beyond-our present system works. For those who have the misfortune to be laid off, or to be unable to find a new job before they reach that age, the age 60 retirement age offers an alleviation of what has been called the "valley of despair" between enforced retirement at an earlier age and the attainment of the statutory retirement age. This is particularly true in an economy requiring changing job skills and which is adjusting to automation.

The second major improvement required in our social security system, in my view, is the extension of the medicare provisions, now available only to people aged 65 and over so that people who are receiving benefits because they are severely disabled can qualify.

I lay claim to having been one of the earlier sponsors of providing cash benefits for people retired from the labor market because they have been so severely disabled-a concept finally approved in the 1956 amendments to the Social Security Act and since expanded. The time has now come to go beyond the mere entitlement to cash benefits and to provide the disabled with the medical and hospital care which they quite obviously need. Here again, I will lay claim to being an early advocate. At the time the 1965 amendments which created the medicare program were being considered, I appeared before the Committee on Finance of the Senate to urge such an extension. The report of the advisory council on social security which appeared in 1965, had also advocated such an extension and viewed the disabled as being as much in need of such care as were the aged. In their view "Older people and disabled people have a special need for protection against the cost of hospitalization and related services-they need more care and they have less money to pay for it."

The Congress recognized the problem 2 years later in 1967, but because of uncertain cost factors, at the time, wrote into section 140 of the Social Security Amendments of that year the provision for a special Advisory Council on Health Insurance for the Disabled. It was directed to study the question of extending medicare to the disabled, to determine whether there was an unmet need for health insurance protection for them, and to examine the costs and financial feasibility of such a program.

Their report, which appeared in January of 1969 found that disabled workers who qualify for social security disability benefits use seven times as much hospital care, and three times as much physicians' services as do the aged. They found, as well, that the median income of disabled worker beneficiaries is less than half that of the rest of the population.

In their view "The predominantly high health costs and relatively low incomes of the severely disabled make it unrealistic to expect private voluntary insurance alone to provide the great majority of them with comprehensive protection over the entire period of their disability." The Council concluded that "It is appropriate, feasible, and desirable to use the social insurance approach" used in medicare, to meet this situation. Noting that the level cost of its recommendations