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Mr. DUARTE. I would just like to interject one point, Senator, which concurs with what you are saying. We have discovered, for example, that some of the senior citizens have passed away and go undetected for 3, 4, or 5 days. Getting back to that point, I should also say, many of them fall and injure themselves, and are unable to communicate with anyone. As a result of that they may lay on the floor for hours. Now, we have established what is called the "phone buddy system." We ask senior citizens to call each other daily to check on their well being and to find out that no one is hurt or dead or injured. Just a generalized feeling of saying "hello" and "is everything all right” and continue on with the day's business.

Senator PELL. Thank you very much. This is particularly interesting to me because it ties directly into the hearing a special hearing I once conducted on nutrition for the hunger committee under the nutrition for the elderly. So I think these hearing records dovetail very well together. I want to congratulate you on the job that you have done and are doing. From the good news that we heard this morning you will be at least able to continue with one portion—the Meals on Wheels, which is an excellent one. Thank you very much.

We now have our fourth panel, Mrs. Ida Wheeler and Mr. Robert Jalette, and I would ask them to come forward.

Prior to asking them to make their statements I would like to acknowledge the presence in this room of several people who are here; and I have failed to acknowledge them before-particularly a very old friend, Doctor Mary Mulvey, the vice president of the National Council of Senior Citizens.

Also I, perhaps, should have mentioned earlier the staff director of the Special Committee on Aging, Mr. William Oriol, is here and has done a lot of work for this hearing. Also, I would like to acknowledge, present in the room, Mr. Arthur Richards who is the president of the Senior Citizens here, and Mr. Reno who is the president of the Warren Heights Senior Citizens Association, and Father Tereau who is here representing the local clergy.

Our next two witnesses are Mrs. Ida Wheeler, who is the director of the Food Lift Information program; and Mr. Robert Jalette, project manager of Woonsocket Housing Authority. They are going to discuss with us the problems of the elderly, particularly from the viewpoint of the Medicaid beneficiary. The first leadoff witness will be Mr. Jalette, who will make a statement; and then Mrs. Wheeler. Then we will come back to the questioning.


Mr. JALETTE. Thank you, Senator. My name is Robert Jalette and my duties are to work closely as possible with our senior citizens in relation to their social problems whichever they may be, and try to solve their problems.

Now, on occasion, we can't seem to solve the problems in regard to Medicaid for this simple reason. Once they go down to the local agencies for help or advice, they are told, "Well, you come under Medicare and this does not cover you in Medicare," and are told they can't help them. Now, on many occasions, I have a few cases where the man was all alone--or the lady—and we worked on two or three or four different cases with the local agency for help. Now, some of the major problems which they are faced with in regard to eye glasses or shoes, ambulances, as well as accident room services is once these services are performed they are given a bill-which they don't have the money to pay. My point to you, Senator, is where do we go from here to help our young seniors when they are in need of help, and welfare, and are refused, and told that they can go to Medicaid, and-in turn— Medicaid tells them they can no longer pay for it?

Senator PELL. Thank you.

Mrs. Wheeler.



Mrs. WHEELER. I have a lot to say. Just to go back and say about the hunger program in Providence; I heard you mention that a while ago-you were interested in it. I am the director of the Food Lift Information Program in Woonsocket, and it is about food stamps. I am the lady that you know if anybody has a problem with the food stamps, and they always come to see me. My problem is to reach people young and elderly. We go door to door, myself and two other aides, in the city of Woonsocket to find people who are eligible for the food stamp program. We also go to SOS-Senior Opportunity Servicewhich Mrs. Doss was talking about. Every Wednesday that is where we find most of our elderly people and this is very important to all concerned.

We have talked to 5,000 families-and this includes elderly people in Woonsocket--and we found two-thirds of the people are elderly, and don't know about the Food Stamp program. We have 700 in our program and the elderly are included in this program. We have found out that the elderly thought the food stamps were only for people who receive welfare. That is why so many of them never got them, because of this. We have explained the Food Stamp program and now they have no question about it. Out of the 700 elderly and families, there are two-thirds on the program that are eating better and are much healthier. The starving has stopped for these people. This is not all the elderly but just the ones that we have on the program. Now, they are getting what they are entitled to. I will see to that, and I will find many more and do the same for them. We know they are out there. My job and my staff's is to find out and give them the information that is needed. We can see that the need for the elderly is very, very great for greater nutrition to get them on the Food Stamp program. Senator PELL. Thank you very much.

* See appendix 1, item 4, p. 200.

Now, Mr. Jalette, give us your recommendation as to what additional benefits you think are most important to try to get included in Medicaid. I gather we don't want to cut it back. So where do you see the needs the greatest, from your experience?

Mr. JALETTE. The need which is greatest in my experience is the rates on the medical part of it-as far as services are concerned. I have one man right here now in the audience, and I will ask him to stand up afterward to give you his viewpoint as well. I was approached weeks ago in regards to a hearing aid that he could no longer pay for, and can't even have it repaired. The price given to him was $180 to have it repaired. Now, his wife just got out of the hospital about a month ago, and is very sickly. He, in turn, has an artificial limb and partly blind. My question to you, Senator, should this man* have to go through all this redtape to get some help?


Senator PELL. The answer is he shouldn't; but that is part of government, and the problem is working together in partnership. Then maybe we can cut through this redtape; and, as you know, lots of time the redtape is used as a means of discouraging applications but again, you have a question of philosophy and approach. We have this problem with OEO itself with many of our programs which, it seems increasingly, are put on the back burner instead of the front burner. They should be burning bright, hard, and shining. Now, the present administration has proposed replacing Medicaid with a proposal, for the poor, by private health insurance premium. Depending on income level of the individual, the Government would pay part of the cost of those insurance premiums. What do you think of this proposal?

Mr. JALETTE. Îf it was to go through it would help some; but, if they have a low pension it still wouldn't help them for needs that they have in the present.

Senator PELL. You need direct aid and less redtape?

Mr. JALETTE. Absolutely, right.

Senator PELL. Now, in connection with Mrs. Wheeler, on the food stamps, I have a question. Because having served on the hunger committee for quite a while, I am bugged on these food stamps-that they could be used, and should be used, and are a great thing. A great improvement from the food surplus distribution program. Did you work in the food surplus program?

Mrs. WHEELER. No; Mrs. Doss would know about that.

Senator PELL. Some years ago I was interested in this subject. I think Woonsocket was one of the very few cities in Rhode Island—if my recollection is correct, and somebody correct me on this—but I think Woonsocket was one of the very few cities to use the Food Surplus program. Then you moved to the food stamps which are much better.

*Later information relayed from Mr. Jalette that the problem of the hearing aid was taken care of by a private organization.

64-350 0-71-pt. 2- ——5

Mrs. WHEELER. Oh, yes.

Senator PELL. I understand that they don't like using the food stamps, why is that?

Mrs. WHEELER. Well, I mean we find people that use them-but they think it is charity. So what I do is to try to convince the seniors that it isn't charity to get their Social Security check-and the food stamps are just like that. The Government wants you to have them-so take them.

Senator PELL. How much reluctance do you find on the part of the older citizens to using food stamps?

Mrs. WHEELER. Well, like I say, it was hard to convince them. We talked to them and we keep talking to them. They might say no today but next week-if we keep talking to them-they will say yes.

Senator PELL. I would like, again, to have the audience participate here. I am not going to ask about your own case at all, so you can be perfectly objective in the matter. Those of you who think the Food Stamps program is a good program—and can see the advantage-hold up your hands; those of you who think it is a poor program, and wouldn't take advantage of it. Those who approve it, hold up your hands. All right. Those that don't think it is good, and don't approve, hold up your hands. It seems pretty general.

Mrs. WHEELER. The food stamps, we have to go by guidelines; and that is, if one person makes $180 and they have $2,000 in the bank— the guidelines only allow them to have $1,000. I know what they spend the other $1,000 on. A lot of these seniors save their money for a burial-or, something like Mr. Jalette was talking about-a hearing aid-and they are trying to save the money. They know they can't be helped from the welfare or Medicare, so they save this money for this. When I find them, they get on.


Senator PELL. This is my question-what percentage of these people are holding on to some money for burial, when it should be spent on present needs?

Mrs. WHEELER. A lot of the seniors-like I just said-some of them have $8,000 in the bank and are living on $100 a month. Some have $4,000 in the bank and are living on $60 a month, and they are starving; but they won't take their money out of the bank because they are saving it for their burial. I know this doesn't sound right, but I tell them instead of saving money for burial go see the undertaker man and make a contract with him, and use up that money-let's get on the food stamps.

Senator PELL. What is the average cost of the minimum contract? I agree with that advice of Mrs. Wheeler's, too. What would be the cost of the average contract for burial?

Mr. JALETTE. I recently took a survey on this, Senator, and the figure is around $850 for a decent burial.

Senator PELL. Does the audience think it is more or less? More.
Mrs. WHEELER. About $1,500, I think.

I don't try to get involved with the burial. I just tell them to call, you know, the undertaker. Some of them look at you cold; but, then they get the food stamps and they love me.

Senator PELL. You have a lot of good advice. I thank you both for coming.

Now, we have a final witness, Mr. John Symznkywicz, who was at one time in my office and now is the executive director of Woonsocket Family and Child Services and who has become a very responsible citizen and I believe he has a statement to make.


Mr. SYMZNKYWICZ. I am the director of the Woonsocket Family and Child Services, which is a United Fund agency, and I have a statement to read; but, because of the lateness of the hour, I will just submit it and hope that it will be entered into the record.

Senator PELL. Without objection it will be included in the full record.*

Mr. SYMZNKYWICZ. I did write down a few things here; and I hope, afterwards, that some of our older friends will come up and share their experience with the Senator. I must say that people in Woonsocket-particularly older people are hard working people; very hard working people, who have made very great contributions to the growth and development of our country. They have fought in wars, they have raised children, they have produced goods and services that are necessary for our country's growth. The absolute minimum that our society can give these people, in return for this, is good and adequate health care. I don't really think there should be much question about the individual premium problem that older people have to pay-that should be eliminated. I think by their taxes over the years and their great contributions they have paid time and time again for that.

The Division of Aging, Mrs. Slater's organization, has done a study and they have made this recommendation. I was also a delegate and a speaker at the pre-White House Conference that was held in October; and that was the recommendation that I made there, too—to eliminate extra cost which you have to pay as a premium. I also think there is no question that the limit for nursing home care and for home health care should be extended. I think there are controls on the local level. Miss Huggins and her nurses, for instance, are very competent professionals who aren't going to abuse that service-they can make objective decisions as to the need. I think the limit should definitely be increased in those areas. I also think that older people are entitled to an extension of the coverage to cover eye glasses, hearing aids, homemaker services, and auxiliary food care services. That is the minimum that we can deliver as a society to those people who have made this contribution over a number of years.

Our agency has a homemaker service program. This is a program used when an older person needs some help in the home. One of our homemakers-usually an older lady herself—will go into the home and help keep the home together; so that the person can avoid having to be placed in a nursing home. We have many more people who help on a weekly basis, with shopping or just friendly visiting back and

* See p. 184.

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