Danstedt, Rudolph T., assistant to the president, National Council Dobrof, Rose, associate professor, School of Social Work, Hunter Dubrow, Evelyn, legislative director, International Ladies' Garment HEW Panel: Dr. Arthur S. Flemming, U.S. Commissioner on Aging; Pierce, Keith, and Morgan Vail, American Personnel and Guidance Trautman, Donald D., chairman, legislative committee, National Prepared statement submitted by Judy Lombana and Morgan Vail on Page 1 2 57 71 34 11 63 75 63 Council of Home Health Agencies and Community Health Services, 80 Housing and Urban Development, Department of: Letter of Novem- 90 Sweeney, David A., director of Department of Legislation and Political 96 COMPREHENSIVE HOME HEALTH CARE: WEDNESDAY, NOVEMBER 19, 1975 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON HEALTH AND LONG-TERM CARE, Washington, D.C. The subcommittee met, pursuant to notice, at 12:00 noon, in room 1310, Longworth House Office Building, Hon. Claude Pepper (chairman of the subcommittee) presiding. Subcommittee members present: Representatives Pepper of Florida, Edward P. Beard of Rhode Island, Marilyn Lloyd of Tennessee, William S. Cohen of Maine, and Wm. J. Randall of Missouri, chairman of the full committee and ex officio member of the subcommittee. Mr. PEPPER. We will call the subcommittee meeting to order. Ladies and gentleman, the Subcommittee on Health and LongTerm Care is investigating today three alternatives to the institutionalization of elderly patients in hospitals and nursing homes. The subcommittee will attempt to determine whether certain programs, when integrated together, might provide such alternatives. The title of today's hearing is "Comprehensive Home Health Care: Recommendations for Action." In addition to health services delivered in the home, the subcommittee will also consider the feasibility of multiple purpose senior centers to provide social, recreational, nutritional, and health facilities for older Americans; and the need for outpatient clinics designed specifically to meet the medical needs of the elderly. In other words, our main objectives fall into three categories, with the idea being primarily that the cost of the outpatient service should be borne by the Federal Government, under medicare or some other program where there would be very little, if any, burden upon the individual. The witnesses testifying today are among the most distinguished experts in the country on the health of the elderly. Prior hearings of our subcommittee in Providence, Miami, and here in Washington have established the need for alternatives to institutionalization. Those hearings have also demonstrated the possibility of significant cost savings for the government and the patients themselves in the many cases where expensive nursing home care can be avoided by appropriate home care. Studies by experts indicate that anywhere from 15 percent to 40 percent of the Nation's current over 1 million nursing home patients remain institutionalized because of the lack of alternatives. Just yesterday my attention was drawn to a letter from Mr. W. E. Stroup. This man heard about the efforts of our committee to provide (1) comprehensive home care and was writing to commend our committee for doing this. He said he is 88 years old and he has been trying to stay out of a nursing home. The only thing that will keep him out of a nursing home and enable him to remain at his own home is to get comprehensive care in his home, which is what we are trying to make available to him. I believe that the Federal Government has an obligation to provide for the health needs of its elderly. Our society is being sorely tested today, both at home and abroad, and one measure of whether we succeed or fail will be the way we treat our elderly citizens. Today's hearings are the culmination of our subcommittee's initial investigation of home health care and related alternatives to institutionalization. The subcommittee is asking today's witnesses whether they favor the three suggested alternatives of home health services, outpatient clinics, and senior centers. Most importantly, we are asking our witnesses to recommend legislative changes or administrative action to implement these programs, and to provide any other concrete suggestions they would consider appropriate. In guaranteeing our elderly the right to remain in their own homes whenever possible, we will assure that our senior citizens will retain the dignity and grace which should be the reward of their later years. I hope the witnesses will bear in mind that we are working against obstacles and handicaps today. The Rules Committee of which I am a member is having hearings today on the tax bill. I may have to run over there for a vote. The floor is in session and we had a caucus this morning. We hoped to get started the first thing this morning, but because of the caucus we were not permitted to do so. We would appreciate it if our witnesses would address themselves to the three areas I stated, state whether they think they are wise or unwise, and then suggest what we should do to make it possible for the elderly to enjoy those benefits. Our first witness is Mr. Rudolph Danstedt, assistant to the president, National Council of Senior Citizens. Mr. Danstedt, we are glad to have you. STATEMENT OF RUDOLPH T. DANSTEDT, ASSISTANT TO THE PRESIDENT, NATIONAL COUNCIL OF SENIOR CITIZENS Mr. DANSTEDT. Mr. Chairman, members of the Subcommittee on Health and Long-Term Care of the House of Representatives Select Committee on Aging, I am Rudolph T. Danstedt of the National Council of Senior Citizens. Our national headquarters office is at 1511 K Street NW., Washington, D.C. Mr. Cruikshank, our president, regrets very much that he cannot be here because he has a lot of respect for you, Mr. Chairman, but he has gotten himself busier than he wants to be in his retirement year, so he could not make it today. The National Council is a nonprofit, nonpartisan organization of 3,500 older people's clubs in all States. We are the country's largest organization of senior citizen clubs. We welcome this opportunity to present to this subcommittee our observations and suggestions with respect to the development of |