given sufficient time, given no action, the situation of the people already old will deteriorate still further. Today's young people will face exactly the same problems now facing us when they reach old age. And last, but not least, always remember that we will be heard if we stand together and speak with one voice. The time is now in letting our Nation know that. Thank you for allowing me to present this testimony. [Applause.] Senator PELL. Thank you, Mrs. Curley. And now—— Mrs. DEAN. I would like to say on nursing homes that I have had reports that the patients are charged for therapy where they think they just have a little visit and a little thing with the legs in the nursing home; and when the month was up their husband got a bill for over $100 for therapy which they did not feel they had received. Also, other nursing homes do not provide adequate food; rather patients have to go out, if they are able to walk at all, they go out and ask neighbors for a cup of coffee or something for lunch time. Thank you very much, Senator Pell. [Applause.] Senator PELL. Thank you, Mrs. Dean, for those poignant comments. Now, Mrs. Person, the lady with the arm in the sling, will testify. And maybe she will also mention if she knows what happened to the people who abused her last Friday and where they are at this point. STATEMENT OF RUTH M. PERSON, FIELD AIDE FOR PROJECT SECAP Mrs. PERSON. Thank you. I am Mrs. Ruth Person. I am a field aide for Project SECAP of the model cities area. Time won't permit me to tell of the inadequate coverage of medical needs for glasses, hearing aids, and the rest by Medicare, which is another real problem area for our citizens. We have many situations where a person who cannot meet poverty qualifications must go without glasses or a hearing aid because Medicare does not meet payments for such items. One of our recent cases on September 16, we had a situation which we are still working on where a woman needs two pairs of glasses which will cost approximately $50. She is on Social Security and receives a small veteran's pension and, therefore, does not qualify for welfare and thus has no other help to pay for her glasses, which are sorely needed as she is only able to see shadows. This lady is despondent to the point of vocally suggesting that she will be better off to end it all by taking an overdose of her available medications. One man was unable to get a necessary hearing aid due to his financial situation. A blind man was referred to us by a district nurse. He was living in a deplorable situation at the Continental Hotel. As of this morning our worker was having trouble trying to secure a cane for this blind person. We are in the process of finding a place for this man to live in view of the conditions in which he is living now. We are following up an application for housing in a housing project for the elderly, knowing full well that his name will only end up on a list of 100 or more. Another pressing item is medications that have to have prior authorizations. I can pinpoint many, many cases that have to wait as long as 2 to 3 weeks for a prior authorization from the Providence Public Assistance Department. Too MUCH REDTAPE Once the patient has visited the doctor and receives a prescription, it is necessary for this patient to present the prescription to a pharmacy who has to have a prior authorization. When the authorization comes through, it comes to the druggist, who in turn notifies the client, who in turn notifies our office to pick it up. Some doctors have refused to contact pharmacies by phone to give prescriptions, necessitating a trip by one of our workers to the doctor's office to pick up the prescription and on to the pharmacy to pick up the prescription there. They will not send the prescription through the mail, either. Prior authorization medications are something that go on special slips, and some doctors do not place these prescriptions on the slips, the proper slips, which then necessitates a return trip by one of our workers to the doctor's office to receive the correct form. The redtape involved in securing ordinary medical services and in maintaining medicines for senior citizens leaves much to be desired. In case of pharmacists, they are not only refusing to transport the necessary medicine, but Medicare and Medicaid paying customers will be treated differently and definitely not as well as cash paying customers. It is necessary for the Medicare and Medicaid patient to show identification cards or their last check stubs before receiving medications. While searching for her identification card, one lady on public assistance did not receive her card on time and the doctor would not fill the prescription until she had her card. An identification card was stolen. from one lady and a request was made for a new one to be issued. It was very difficult to obtain a new card and the lady was, therefore, without a card necessary to obtain her medicine. The recognition of the need for more adequate food as a basic element of good health where senior citizens are concerned is long overdue. It would seem to me that a correlation of the Medicare, Medicaid, and Food Stamp program to a better advantage of senior citizens is indicated. We have any number of situations where the need for a housekeeper or someone visiting on a daily basis exists to assure that the elderly are making proper and adequate use of medication provided them. SUPERVISION OF MEDICINES NEEDED In one situation we found a senior citizen who was receiving and taking the same medication which was prescribed by three different physicians. The insight of the field aide to recognize the similarity of the prescriptions made it possible to prevent this woman from taking a real overdose of medication. In another instance, the district nurse asked us to go in daily and supervise the case of one person. In one case, a diabetic lady was almost ready to go into a coma. She received a prescription, but because she could not read and write, it was necessary for her to have a box of crayons and color the chart with the color that described her urine so the doctor could prescribe the necessary medication. The above are only a few of a large number of documented situations in our office regarding the need for some health care and some more active provisions in the immediate areas of senior citizens. Thank you. Senator PELL. Thank you, Mrs. Person. I would add that when we asked you to speak on this panel on Medicare and Medicaid, we would have also asked you to speak on the panel on crime if we had known the sad event that was going to befall you after we asked you to come. Would you describe the incident to us and what happened to the hoodlums who are responsible? Mrs. PERSON. Well, as you know, twice a month we do pick up food stamps and cash checks and do shopping trips for the elderly citizens of the Model Cities area. Of course, this Friday happened to be the day for food stamps. Fortunately, I had delivered all of my food stamps except one. I happened to have a client that lives next door to me. I was delivering her food stamps and I ran into my house next door to make a phone call to the office. At that time, although I didn't make the phone call, I came right out, I had left a young lady, Miss Conway, in the car, who is a volunteer worker, with both of the bags, and I told her that I would be right back. By the time I got back down the stairs, I saw these three gentlemen Senator PELL. Hoodlums. DRAGGED FROM CAR Mrs. PERSON. Hoodlums, tussling with Miss Conway. They had dragged her out of the car. They had walked up, she said, to the passenger side and dragged her out of the car and, naturally, she held onto the two bags. When I ran and saw what was going on, I rushed to try to help also, and at that time I was pushed to the ground. Fortunately, Miss Conway is a very strong lady. She held onto the man until she actually ripped his shirt off. She also, while we were tussling with him, saw the fellow pitch the bags into the air to the other two guys, and they took off. I would like to insert here when I saw what was going on, I started to holler. I said, "We are being robbed, help, help, please help us." And no one came to our rescue. One gentleman that was standing across the street on the steps, he said that he thought we were fighting. but we were actually being robbed. As I said, Miss Conway, in her bag she had personal checks in the amount of $400-some-odd, I'd say I had one lady's food stamps and all my other personal papers and what have you. Senator PELL. What happened to the three hoodlums? Mrs. PERSON. The three hoodlums ran across the field and one of the fellows was picked up by the police, and I must say that the policemen, well, they really were on the ball in this incident. And they cooperated and we tried to cooperate with them. At present they are holding the fellow downtown, the one of them that robbed us. Senator PELL. He is being held for trial? Mrs. PERSON. Yes. Senator PELL. Presumption is that he will go to jail? How old is he? Mrs. PERSON. He can't get bail. Senator PELL. How old is he? Mrs. PERSON. The paper said 32. DARED TO PRESS CHARGES Mrs. NEWSOME. Senator Pell, as a supervisor, the problem now is whether or not I will subject my staff to go into court and identify these folks and then having their homes burglarized. We have already received threats in our office this morning, "if you go to court and press charges against that fellow, we will take care of your first." I am a supervisor at Project SECAP. That is the status of affairs, whether or not we will have the courage to go through and dare them to burn down our houses and come and rob us some more. Senator PELL. Thank you. For the record would you identify yourself? STATEMENT OF ELIZABETH NEWSOME, DIRECTOR, PROJECT SECAP Mrs. NEWSOME. I am Mrs. Elizabeth Newsome, the director of Project SECAP. We have gone as far as to go through the lineup and identify these hoodlums. My girls call him a gentleman. This morning Mrs. Conway did not come in. I couldn't blame her. She is a volunteer worker, free, for nothing, serving senior citizens. I say we will go to court and testify against them. Then I will tell you to read the paper where Mrs. Newsome's home, a senior citizen's life, has been robbed again. I will tell you to read the paper that Mrs. Person got more than just those slings helping senior citizens. We have got the courage. When you back us up and we go down there and testify against the gentle hoodlums-[applause]. Senator PELL. Mrs. Newsome, I admire your courage. I recall the words of Colonel McQueeny when he said he also needed courage and needed the help of people who would have the guts to take the risk and stand up and be counted and to identify the hoodlums. Too RISKY FOR $100 A WEEK Mrs. NEWSOME. I was late coming because the police department is out working with the rest of my girls. We did not get all the food stamps picked up Friday because the minute this happened I called in the other five girls. Colonel McQueeny has given us police protection this morning for the rest of the job. I have said to Dick Torshia, "This is going to be your money to pay to protect us. I am not sending any more girls out there without the police protection because I am not going to have people working for measly salaries of $100 a week to end up with that kind of thing happening." Now, if you want your police money to go that way, that's the only way you are going to get the service. I am not going to have for $100 a week people hurt trying to serve senior citizens. Senator PELL. Thank you, Mrs. Newsome. And I do hope you will go in with Mrs. Conway and identify them, although I realize it takes very real guts and courage on your part to do that. Our final witness on this panel is Dr. Mary Mulvey, who has delved deeply into the problems of our elder citizens and who is an old friend of mine. I can assure you she has a comprehensive statement. It will be put in the record in its entirety, and she will review just the major points for us now. STATEMENT OF DR. MARY MULVEY, VICE PRESIDENT, NATIONAL COUNCIL OF SENIOR CITIZENS Dr. MULVEY. Thank you, Senator Pell. I have prepared a statement which I won't read. There are many more people to be heard from this morning. I would like to speak to you on Medicare and its shortcomings. Senator PELL. Right. And the regular statement will be put in the record as is.* Dr. MULVEY. Thank you, Senator. The cost of medical care is one of the principal problems that our elderly people face today. In Rhode Island, the over-65 group in the 1967-69 period had a median family income of only $4,347, which is lower than the national median. The national median at that time was $4,802. It is less than half of the median of people under 65. The median of individuals aged 65 and over who live alone was $1,855 in 1969, and $1,951 in 1970. Furthermore, our older people are slipping more and more into the poverty level year by year. Coupled with the fact that our median for our families in the over 65 group is lower, the cost of living in Rhode Island and the Northeastern urban areas is much higher than in the rest of the country. Total costs of budget can vary from $269 a month in a small southern town to about $400 a month in our New England cities. I have included in my written testimony a chart of what the cost of living is in many urban areas in our country. Now, medical costs also run way ahead of the national average. The average reimbursement of hospital bills for the aged in Rhode Island under the Federal Medicare program in 1969 was $307, as compared to a national average of $237. The average Medicare reimbursement for medical bills, for out-of-hospital medical bills, was $104 in Rhode Island, as compared with the national average of $87. Now, the Federal Medicare was a great social advance, but it does not cover 45 percent of our senior citizens' health costs. And the financial outlay by senior citizens for the coverage has been increasing year by year. Plan A deductible rose from $40 to $60-50 percent increase in 4 years. Out-of-pocket premium payments, Part B, increased from $3 a month to $5.60 in 4 years-an 87-percent increase. Older people who can afford to buy Blue Cross Plan 65 have had their premiums increased 65 percent. REDTAPE CREATES LACK OF UNDERSTANDING So those enrolled in Part B and Blue Cross pay about $153 a year right now, and this does not give them the coverage of the many kinds of services you have heard here today, prescription drugs, eyeglasses, dentures, and so forth. Now, in addition to the shortcomings of Medi *See appendix 1, p. 311. 64-350-72-pt. 3 |