SERVICE REQUESTS TO INFORMATION CENTER FOR THE
AGING BY COMMUNITY AREA OF RESIDENCE IN CHICAGO

*Based on requests for service for 2, 352 clients whose address was known for the periods January June, 1968; October, 1968

COTTAGE GROVE

ASHLAND 1600

In June of 1968, the Code Sheet Closed Case (Exhibit 4) was introduced to facilitate the tabulation of data collected on the control card, largely the result of a precoding of items as they might appear on the control card. In addition, the codification of these items on the Code Sheet much as they are listed in Figure 1 was instituted to allow the immediate adaptation of the unit record (control card) to electronic data processing.

During the last half of 1968, the service statistics were processed by a computer. In addition to the information yielded by the Monthly Report of Service Statistics through hand tabulation, percents by totals, etc., were included as par of the computer program.

The professional expertise available through the data-processing service engaged was less than sufficient to achieve maximally effective computerization of the service statistics. This limitation in addition to customary adjustments which are to be expected with the introduction of the computer system created excessive delays in reporting of Monthly Service Statistics. The senior and junior statistical elerks and a Center volunteer spent days correcting the statistics and bringing them up-to-date. Despite these problems, had the Center purchased computer service from a more satisfactory source, it is the consensus of staff that the service statistics could be successfully computerized and thereby reproduced. On the one hand, the introduction of the Code Sheet seems to have sharpened the workers' awareness of the items to be recorded for tabulation. This is illustrated by the fact that in March of 1968, prior to the introduction of the Code Sheet, the percent of cases in which more than one need was mentioned, or recorded, according to the Monthly Report of Service Statistics, was 11.7 percent. With the introduction of the Code Sheet in June 1968, the proportion of cases with multiple needs rose to 27.2 percent. Project experience indicates that, initially at least, this increase is more likely to be the result of reinforcing the necessity to record secondary needs via the Code Sheet than it is of any immediate increase in the actual number of cases presenting multiple needs. The introduction of the Code Sheet transferred the duty of coding service statistics from the statistical clerk (heavily burdened by the research demands) to the workers. Workers' errors, mainly those of transcription and omission, did occur. However, with time the workers achieved greater accuracy and error has been reduced.

CHAPTER IV.-UNMET NEEDS: A NON-QUANTITATIVE APPROACH

It has now been more than three years since ICA was set up to work exclusively with aging clients. The staff have examined the individual needs of the persons served, and have attempted a kind of qualitative appraisal of these needs, and the services available to meet them. These perceptions are essentially subjective and do not necessarily have statistical validity.

The staff has been constantly aware of the lack of comprehensive services for the aging in the metropolitan area. Parochialism prevails-the aged client goes to one agency for financial assistance, another for medical services, another for casework counseling, etc. Although the worker in ICA may be assessing the client's needs in toto, when referring him into the service network, she may have to partialize and refer or direct to several agencies and even then may have questions as to how well the total needs may be met. This experience in ICA has convinced staff that the traditional patterns for delivering service are not sufficiently comprehensive to cope with the muli-problem situations so often presented by the aged clients and their families.

ICA staff is aware of the heavy demands upon the agencies and they are indeed cause for concern; however, the staff believes that an information and referral system emphasis must be placed on how well the existing agencies are meeting a community's human needs rather than totally responding to the needs of agencies and institutions. It is in that spirit that this chapter is presented; not to heap further invective on a system that is already laden with criticism.

Financial Assistance.-The December 1969 statistics revealed that a cumulative count from July 1967 through June 1969 showed that 2,458 cases coming into the center were already active with an agency, and that about 88 percent of these cases were active with a public assistance agency. For the most part, these initia

It has been mentioned earlier in this report that the staff believes that the lack of adequate income for the aged seems to be the cause of many other problems. The income deprivation of the aged clients, while statistically significant, appears even more appalling in reality. The following are case examples of the delays in delivery of services:

ICA-ID 11767.-An aged couple called ICA because they had been cut off public assistance and could not understand why. Exploration revealed that this 74 year old man and 68 year old woman were receiving Social Security totaling $105.00 monthly. They had no other income or equity. The ICA worker requested the agency review the budget and after eight weeks and many contacts with the agency, the couple again began receiving OAA supplementations.

ICA-ID-114158.-An 84 year old man was referred to ICA by a Society Security office. He had been placed in a nursing home through the public assistance agency after hospitalization for broken ribs. He refused to remain in the nursing home or to be transferred to another. He did apply for supplementary Old Age Assistance to his Social Security of $79.00. He had found himself adequate housing but needed supplementation badly. ICA exploration revealed that he had been refused supplementation because the agency instead he had received a lump sum from Social Security. After ICA got written evidence that no lump sum had even been granted by Social Security and after the ICA worker had contacted the agency five times and six weeks had passed, supplementation was finally granted.

ICA-ID 212608.—Miss K. first called ICA in April, 1968. Her 81 year old mother was confused, unable to stay at home alone without danger to self or others. She would turn on the gas, and the neighbors were becoming alarmed: constant worry about, concern for and care of the mother were jeopardizing Miss K's job. Miss K., an epileptic, had always supported herself and her mother. At the time of her first contact with ICA she was fearful that her own job was in jeopardy. Miss K. had made application for nursing home placement for her mother at a district public aid office in September 1967. At that time, all necessary medical forms were completed by the attending physician, but the agency advised that the forms were lost. The forms were again completed by the physician, and at the time of ICA contact, placement had still not been made. A total of 16 telephone conversations with Miss K., one with her employer, eight with an agency supervisor, and a letter to that agency culminated in placement of Mrs. K. in a nursing home on July 25, 1968.

ICA-ID 115650.-Mrs. G., seventy-two year old widow of a surgeon, requested ICA's assistance. She had made application to a district office of public assistance on September 2, 1969 for Medical Aid No Grant. The ICA worker called the agency and was told that a caseworker from that agency would call on Mrs. G. at her home in the immediate future. On November 10, 1969, Mrs. G. again called ICA to report that no one from the agency had visited her. She had called the district office on November 3rd and had talked with a caseworker who assured her that someone would be out to visit her. The ICA worker called the agency and was advised by a supervisor that the worker was ill but that someone from the agency would be in touch with Mrs. G. on November 12, 1969. On November 13, 1969, Mrs. G. again called ICA to tell the worker that she had not heard from the agency worker.

At this time ICA contacted the Special Referral Services of the public agency and requested that office assist ICA in getting the district office to establish or deny Mrs. G.'s eligibility for MANG. ICA later received a call back from the Special Referral Services worker informing there was no record at the district office of Mrs. G.'s application. ICA insisted an application had been made and supplied the name of the agency worker who took the application. Later another call came informing ICA that the record had been found and that "service was denied" because Mrs. G. received free medical care from colleagues of her deceased husband. No home visit had ever been scheduled. The agency was vague as to why the client had not been so informed.

ICA's information revealed that Mrs. G. had had some free medical care from Dr. G.'s friends. However, her drug costs averaged $10.00 weekly and she had to borrow money to purchase these prescriptions. Her Social Security was $129 00 monthly and her rent $75.00. All savings were diminished. She did own a 1959 automobile that she drove for grocery shopping. She had a chronic heart problem and had recently undergone a mastectomy. On the basis of this information, ICA insisted Mrs. G.'s application be reactivated on the basis of her drug costs.

Mrs. G. again went to the district office and reapplied. In late November, Mrs.