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I'm sure everybody wants these things, but you have got to-your premises no matter how beautiful it is, if you are scared, if you are scared, if you have got to live in a neighborhood where you are afraid when you walk out and when you go to sleep, you can not have everything. It is like a rich man with a cancer, he has got all kinds of money but he is dying of cancer. Money is no good to him. So New Orleans has been plagued-this is nothing new, old homes and old areas. New Orleans is an old city. They talk wonderfully about the French Quarter and they keep it old. So old neighborhoods are not a bad thing as long as they have got modern conveniences, heat and electricity, and something to keep them comfortable, but they have got to be not afraid. You have got to have peace with yourself. You have got to live in peace with yourself. When you have that, you are all right.

Senator EAGLETON. Yes, sir.

STATEMENT OF MR. GEORGE, A RESIDENT OF NEW ORLEANS

Mr. GEORGE. I would like to ask this: Why are so many surveys on mass transit made in this area and then put on the shelf? It seems like somebody is making a profit off this thing. If I am an architect, I draw up plans, I get my group. Next year, the next group gets their group and these plans are put on the shelf. That is wasting money.

There have been numerous surveys of mass transit for New Or leans, Jefferson, St. Bernard, St. Tammany areas, mass transit, and still nothing has come up. Everything is inadequate. Somebody is making money.

Then another thing, when you are funding a lot of these things, these programs, by the time the money trickles down to the people that it is supposed to benefit, those at the top with the large salaries have eaten up a vast majority of it and when it trickles down to the little people to support a benefit, they say, "We just run out of funds." [Applause.]

Now, right downtown there in our area there are people who are working without salaries at this very moment. They are working for funding of their programs. I don't know exactly what program they are in, but something has happened that the money has been withheld while the CPA goes over the books.

Now, the little people who are supposed to benefit from these things, they are suffering and they ask, "Where did the money go!" It's just like in the crash of 1929. I was in school, I asked, "Where did the money go?" The professors couldn't answer that. When you are running these programs and the little folks ask you, "Where did the money go?" you have no answer; then they begin to think other things. [Applause.]

Senator JOHNSTON. I just wanted to ask Mr. McKenzie and Ms. Slaybaugh, what percentage of people aged 65 and above in this State does your program reach directly; how many are involved.

more or less?

Ms. SLAYBAUGH. I would estimate less than 3 percent. Senator JOHNSTON. Less than 3 percent? Why is that? Is that funding, is that lack of interest on their part? How many is the optimum number that you could reach?

Ms. SLAYBAUGH. The optimum number would be the total number of elderly which is in excess of 500,000 at the present time. But there simply are not enough resources under the Older Americans Act to provide services to all of these people.

Senator JOHNSTON. Tell me how that 3 percent gets served.

MS. SLAYBAUGH. When I am talking about the 3 percent, I am talking more in terms of actual service. In terms of advocating on behalf of older people, this is something that we are doing, we are speaking on behalf, we hope, of all elderly people within the State. For example, when we had the Governor's Conference on Aging, a very big push in Louisiana to promote what we do feel are the needs of elderly people in terms of getting the response of the public officials and everyone, the State legislature in terms of providing services. This is where I think everyone can benefit from this type of thing and this is one of the primary purposes of the Bureau of Aging.

I think when we get down to talking about actual things, say, nutrition services or actual homemaker services, the direct services themselves are limited from the standpoint of our program from the limited resources.

Senator JOHNSTON. Now, those who do participate, the 3 percentwould you say that these are, by and large, the 3 percent who need it the most or just the 3 percent that happened to be located near the center, or those who get information by whatever chance that process works

MS. SLAYBAUGH. I think you have got to look at a combination of factors. When we are establishing the priorities and setting them up under the Older Americans Act, we are supposed to be establishing the programs to serve the low-income and minority individuals, so it does depend upon where the sites are located, which people are going to be involved.

We do operate statewide, but here again, we have the local people deciding where the services are going to be provided. We mentioned the problem of transportation-if transportation is not available, even though the services may be available, you will have people who will not be able to utilize the services simply because they do not have the means of getting there.

So you have any number of factors which will determine whether or not an individual person will receive the service that may be available or may not be available.

Mr. MCKENZIE. And another factor, too, as some of the individuals here today in the meeting hall have said, in New Orleans, for example, where you do have this center and it is available, but they are really afraid to get out and go to these centers to make use of the benefits that are available.

Senator EAGLETON. One final question, if I may, before we break for lunch. How many nutrition sites are functioning in Louisiana? MS. SLAYBAUGH. 190. I just use that as an estimated figure. Senator EAGLETON. Roughly 190.

Mr. MCKENZIE. With a meal count of approximately 7,000 meals. Senator EAGLETON. A day?

Mr. MCKENZIE. A day.

Senator EAGLETON. Here at Sacred Heart, is this one of the biggest in terms of numbers of meals? Just give me a few statistics. Mr. Gates, we will get to you this afternoon. How many participants on an average basis?

Mr. GATES. There are about 75 participants here.

Senator EAGLETON. What is your biggest one in the New Orleans area?

Mr. GATES. We have one at a high-rise that serves about 180. Senator EAGLETON. 180. Again, a rough percentage, of that 180, how many are rather constant repeaters, that is, if not every day, but frequently participate?

Mr. GATES. They are in a high-rise building that is for elderly people, so their level of participation is pretty high.

Senator EAGLETON. Now, are there others beyond the 180 who would like to participate in that program, but you just don't have the money or equipment or whatever to serve them?

Mr. GATES. Senator, why don't you let me give my testimony? I think we can delay lunch

Senator EAGLETON. No, no, I don't want to delay lunch. Why don't we have it after lunch.

Mr. GATES. I think it is in context with what has been said and we could clear up quite a bit. It is not that long.

Senator EAGLETON. I just didn't want to delay the lunch or have it get cold. No; I am going to be here in any event.

Ms. PILLAULT. It is just whatever you decide.

Senator EAGLETON. I vote in favor of lunch and we will recess

now.

Mrs. BOGGS. I was just going to say that as a part of Mayor-elect Morial's written testimony there is a very good breakdown of the nutrition program and how many people are served.

Senator EAGLETON. Thank you. I will read through that.

We will recess for lunch and we will reconvene at 1 when we will hear Mr. Gates and we have a panel from the Sacred Heart Nutrition Center.

[Whereupon, at 11:55 a.m., a luncheon recess was taken to reconvene at 1 p.m., the same day.]

AFTERNOON SESSION

Senator EAGLETON. Good afternoon, ladies and gentlemen. I think we will proceed with our hearing now. We are glad to have as our next witness Mr. George Gates, director of the New Orleans Council on Aging.

STATEMENT OF GEORGE GATES, DIRECTOR, NEW ORLEANS
COUNCIL ON AGING

Mr. GATES. Thank you, Senator Eagleton.

Some of the people in the back have said that they have problems hearing. If you can hear, raise your hand.

Senator Eagleton, I would like to thank you as the director of the New Orleans Council on Aging for coming down to New Orleans to get firsthand knowledge of the problems of the elderly. Prior to my

testimony, you have been hearing testimony that deals more with planning and coordination from the State office on aging and the area agencies on aging. It is my intent to give you sort of a grassroots idea of what we see as the problems of the elderly in this community.

For the record, I am George M. Gates, executive director of the New Orleans Council on Aging. The New Orleans Council on Aging is an advocacy and service-oriented agency providing a multitude of services to the elderly in Orleans Parish. The Council on Aging was chartered by the Governor of the State in 1966 to be the parish agency to provide these services. There are presently councils on aging operating in every parish of the State.

I bring this to your attention because as you travel around the country acquiring information for the renewal of the Older Americans Act, you are going to find many variations in the methods of service delivery. I have found this system of service delivery (the Council on Aging concept) to be one of the better systems of effectively and efficiently carrying out the legislative intent of the Older Americans Act.

You are here today to get grassroots input of the problems of the elderly. As you may already know the problems of the elderly have compounded since the passage of the Older Americans Act of 1965. The amendments to the act have sought to alleviate some of these problems, but nevertheless, they continue to exist.

We have attempted to prioritize the problems by getting direct input from the elderly. We feel that the problem areas that will be outlined here reflect those areas that are of immediate concern to the elderly in this community.

Elderly persons face tremendous obstacles in getting transported from place to place. Whereas New Orleans has one of the better transit systems in the country, it falls short in meeting the needs of our elderly population. Older persons need a transit system that is tailored to meet their needs. It is no easy task to have to walk two or three blocks with an arm full of groceries.

Older persons have more medical appointments than younger persons and it is often very difficult to get to these appointments via public transportation. In many instances food stamps are stolen from senior citizens after they have left the food stamp office and are on their way home. We have found that our 60-plus population would participate much more in civic, cultural, and recreational activities during the day and night if they were assured of adequate transportation to and from the activity. Taxi drivers are reluctant to transport older people especially from grocery stores because they fear the loss of another fare while assisting the person with his or her packages.

The New Orleans Council on Aging does provide transportation to its meal sites through an agency agreement with the Easter Seal Society, also, a limited amount of grocery store shopping and food stamp transportation, however, the demand far exceeds our capability of supplying service. We would recommend that there be more title III funds made available at the local level in order to provide transportation and that other governmental agencies responsible for

transportation be mandated to be more sensitive to the transportation needs of elderly persons.

Another area of major concern is that of health care. We define health in the context of the World Health Organization's definition, that being "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity".

Health problems of the elderly have been a major concern of the health advisory committee of the Council on Aging and on October 16, 1975, the committee went on record to urge our congressional delegation to support a plan that would provide comprehensive health care to all citizens.

Health problems are compounded for the elderly persons living on fixed incomes. We have numerous cases of elderly people who have medical bills of $80 and $90 a month and are attempting to live on an income of $200 a month or less.

There are instances where elderly persons go to physicians, receive medical treatment, and then are unable to continue the treatment because of lack of finances to purchase medication. There are also cases where persons purchase à prescribed maintenance drug every other month, thereby reducing the effectiveness of the medication.

A comprehensive health plan that would provide education and counseling on the proper use of medication is of a great need. Many times, a person changes doctors because of a difference in fee and continues to take old medication and the medication the new doctor prescribed. There have been instances where elderly persons have become dehydrated because they were taking two or more diuretics prescribed by different physicians.

There are many elderly persons who find themselves caught be tween not being eligible for medicaid but without sufficient income to pay for adequate health care. This group is often identified as the "medically needy." There are thousands of persons in the Or leans area who find themselves in this predicament. These kinds of situations place hardships on the relatives of elderly persons.

For example, there is the case of the lady who had her 83-year-old mother living with her, the mother was receiving $170 a month in social-security benefits but her monthly medicine expenditure was $125 a month. The daughter, who was working, was concerned about her mother being alone but did not want her institutionalized, so she hired a person to be with her while she was working.

While this agreement allays the daughter's anxieties, the cost of this kind of care is placing a financial hardship on the daughter. If there were some health plan to provide for drugs, the mother's social-security benefits would help defray the cost of keeping her in a home situation.

Oftentimes, chronic illnesses that older persons suffer from could have been prevented had they had an opportunity or resources to be involved in a health program that placed emphasis on preven tive medicine. The incidence of heart disease and stroke, which plague our elderly, could be reduced, if there was adequate screening and followup of persons with high-blood pressure. There has to be some type of health coverage that insures that hypertensive persons

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