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Publicity Chairman

SPOKANE GERONTOLOGY VOLUNTEERS

"Every man should be encouraged to live his whole life"

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Service Chairman Report Each Month.

Operation Polity

1. Service to Receptive Homes Only

2. Volunteers must maintain service Record.

3. Volunteer Worker must have ID Card

L. Workers must be screened by Organization Representative.
5. Each Organization must serve under its own identity.

6. Service awards presented appropriately

Mrs. MURPHY. The $2 million appropriation for survey is unnecessary as most facts and figures are on hand in the offices of the various States and Federal agencies.

Upon completion of this enterprising venture, these volunteers will begin to share the problems of their fellow men.

These volunteers are not earning dollars, but certificates of which they are most proud, showing man-hours given.

This is an example of what communities of enterprising people will and can do without the spending of our tax dollar.

It is also with some interest that we in the State of Washington note the estimate of $8,000 made by the Department of Health, Education, and Welfare as the per bed cost of construction for what must be presumedly the first-class nursing homes. However, in Spokane the latest places for a 150-patient home will be built for $2,500, a 2-bedroom, or $4,500 complete with furniture and 2-piece plumbing. Senator HILL. Two piece what?

Mrs. MURPHY. Two-piece plumbing in each one.
Senator HILL. Plumbing.

Mrs. MURPHY. Socially, the whole concept of making generous Federal grants to so-called nonprofit groups is neither desirable nor within the scope of good sociological planning.

The idea of a nursing home is everything that those words imply, and specifically, they imply professional nursing care in a home atmosphere.

It is easy to become too altruistic about the problems of our aged groups, and I do not mean to do this. What I mean to tell this committee is that in the State of Washington we have approached and, I believe, solved our problems realistically.

In our homes in Washington we have created an atmosphere for our aging population that we hope, and in most cases know, is a substantial substitute for the home life which our patients, either because of neglect or misfortune, have been deprived.

Our nursing homes are, with the approval of local zoning authorities and town and city officials, located very humanly within the heart of our cities and townships. Here they are within easy communication of their families, local town and city officials, and in most cases close to medical and hospital facilities in the event these facilities are needed.

Mr. Chairman and gentlemen, the Hill-Burton Act, we in Washington feel, has served its most worthwhile purpose in rural areas. An extension of this act, we feel, into the field of nursing home care will be the first step toward integrating nursing homes with hospital facilities and thereby destroying the very concept of the nursing homes.

Such integration is bound to bring the nursing homes into the heart of the metropolitan area wherein are usually situated the hospital facility, and this very great and humane measure, the Hill-Burton Act, will have deviated from its original purpose, from service to the people to the paradoxical purpose of causing the aged and chronically ill to go where the facilities are in order to make them economically

sound.

Thank you.

Senator HILL. How many homes do you have in the State of Washington, Mrs. Murphy?

Mrs. MURPHY. We have 262 licensed nursing homes, I think. Senator HILL. Two hundred and sixty-two?

Mrs. MURPHY. Two hundred and sixty-two. We have 51 in Spokane.

Senator HILL. Fifty-one homes in Spokane.

How many beds do you have altogether; do you know?

Mrs. MURPHY. Eight thousand; a little more than eight thousand.
Senator HILL. Eight thousand.

Mrs. MURPHY. There are 500 vacant today.
Senator HILL. Five hundred vacant beds today?

Mrs. MURPHY. Five hundred.

Senator HILL. Five hundred vacant beds today.
What do you attribute those vacancies to?

Mrs. MURPHY. A great many of the aged people have been put in what they call senile institutions, which are State regulated. Senator HILL. Do you have any questions, Mr. Sneed?

I want to thank you very, very much.

Mrs. MURPHY. Thank you very much.

Senator HILL. That concludes the presentation for the American Association of Nursing Homes, does it?

Mr. MUSE. Yes, sir.

Senator HILL. Now, I noticed on the list here was a Mr. Latham. Is he with your group?

Mr. MUSE He is here, Mr. Chairman.

Senator HILL. Mr. Latham, I don't want to have to rush you, but I am going to have to leave here very shortly. I suppose you are here all the way from Indiana and you want to be heard.

Mr. LATHAM. Yes; we in Indiana usually like to be heard, and we are kind of loud sometimes.

Senator HILL. You may proceed, Mr. Latham.

STATEMENT OF HARRY T. LATHAM, JR., LEGAL ADVISER TO EXECUTIVE DIRECTOR OF THE INDIANA ASSOCIATION OF LICENSED NURSING HOMES

Mr. LATHAM. Thank you, sir. I will make every effort to be brief. I might say, supplemental to the American Association's statement, we have specific statistics that insofar as Indiana is concerned refute certain claims in Mrs. Hobby's report before the House of Representatives.

The administration's decision to inject Federal aid into the nursinghome field, as announced in President Eisenhower's state of the Union message on January 18, 1954, was received by those of us in and connected with the nursing-home profession with disbelief, consternation, and shock.

Even today, the motivation, therefore, is somewhat obscure, although, from recent events, exemplified by certain press publications, we feel we may conjecture, almost to the point of certainty, as to the moving force behind this unwarranted invasion of the field of private enterprise.

That the administration itself is somewhat uncertain as to the efficacy of this move may be inferred from the first section of the bill, section 641, S. 2758, which provides in part as follows:

Section 641. There is hereby authorized to be appropriated the sum of $2,000,000 * * for the purpose of surveying the need for nursing homes.

Then after setting up certain procedural steps for spending the money for the survey, the framers of this economic monstrosity, seemingly gaining courage from contemplating the sheer audacity of their mental aberrations, throw reason to the winds and proceed with the following: Section 651. There is hereby authorized to be appropriated for the fiscal year ending June 30, 1955, and for each of the two succeeding fiscal years

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(4) $10 million for grants for the construction of nonprofit nursing homes. What kind of logic this this?

On one page is provided means for a survey to determine whether or not there is a need for a given facility and on the next page is provided an appropriation to build the facility.

Why make the survey in the first place?

My point is simply this: If it were the honest intent of the survey to determine whether or not a need existed, there certainly could be no objection.

I feel confident that, while such a survey might reveal certain regional or local shortages, it would also reveal that the problem is being reaonably well met by private initiative and enterprise which, if bolstered and assisted in a manner hereinafter set out, could in a very short time more than adequately meet the need.

It is our contention, however, that there is a definite move afoot to discredit proprietary nursing homes in general. To substantiate this, I would like to refer you to the Sunday supplement magazine known as "Parade," a syndicated publication that has widespread circulation in Sunday papers throughout the country. It is carried by the Indianapolis Times, the Chicago Sun-Times, the Boston Sunday Post, just to mention a very few.

On Sunday, February 14, appeared one of the most scurrilous attacks on private nursing homes ever conceived, and in one of the most flagrant displays of yellow journalism it has been my misfortune to see it took several situations from the State of Florida, which, incidentally, has just passed its first nursing home licensing and inspection law-August 1953-and then made the very broad, general statement that comparable conditions existed the width and breadth of the United States.

On Sunday, February 21, appeared a second article which again used examples from Florida and a rather vague reference to California, and again said similar conditions existed throughout the country.

The article then referred to the fact that the Federal Government was passing laws to provide for nonprofit homes, inferring that with this action "God's in His Heaven and all is right with the world." Throughout both articles appeared snide comments and inferences about profit.

The source of information for these articles is an organization known as the National Committee on the Aged of the National Social Welfare Assembly. This is one of those professional bleeding-heart groups to whom the word "profit" has a somewhat opprobrious connotation. Further, it feels that the answer to all of the Nation's ills, including health, education, welfare, and what have you, lies in the Federal Government taking over lock, stock and barrel-on a nonprofit basis, of course.

We are morally certain that this organization and others of its like are behind this legislation. It is a well-known fact that they exercised great influence in previous administrations, and, from the looks of things, are still in there pitching even more effectively than before. The situation in Florida was, and perhaps still is, bad. However, the first and most important step has been taken, the passage of a licensing and inspection law. The rate of improvement will be directly proportionate to the vigor with which the law is enforced.

We speak with the authority of knowledge and experience on this, for, you see, the situation was bad in Indiana until our first law was passed in 1943-nor do I wish to infer that all is sweetness and light here even at this time. There is room for improvement still, but the great change effected since the passage of the first law is nothing short of sensational and it is reasonable to asume that the Florida situation will follow the same line.

The same general observation may be made about other States who have passed such laws heretofore.

The point should be made at this time that the moving force back of all these licensing and inspection laws has been the legitimate, conscientious nursing home operators, working in collaboration with State authorities and acting through their respective State organizations.

The further point shall be made that a number of these State organizations banded themselves together to form the American Association of Nursing Homes which said organization proceeded to assist other States in getting passed licensing and inspection laws so that the general nursing home standards would be raised throughout the country.

The American association worked with a group of operators in Florida assisting them in getting the present law passed.

The foregoing comments and observations have been made for the purpose of giving a little background on the private nursing home movement and shall serve as a preface for the following statistical and factual information concerning the nursing home situation in Indiana. We must of necessity confine our remarks to Indiana because of the fact that we have not had time to obtain the information on a national basis since our first knowledge of this contemplated legisla tion was on January 18, 1954. However, we will say, with a degree of confidence, that in many other States comparable information and statistics would apply.

Secretary Hobby in her prepared statement before the Committee on Interstate and Foreign Commerce of the United States House of Representatives in support of H. R. 7341, the identical counterpart of S. 2758, which said statement was delivered February 4, 1954, commented in substance that in the area of chronic-disease hospitals the facilities are 88 percent inadequate. This, of course, includes nursing homes. There were certain charts presented in connection with said statement reflecting this situation. It was also stated that the requirements for civilian noninstitutional facilities are approximately 2 beds per 1,000 of population per year.

From the Indiana Department of Public Welfare, the licensing agency for nursing homes in Indiana, I have obtained the following information as of December 31, 1953:

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