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living alone. Now, just the simple desire to prepare a meal becomes an insurmountable task for them; and they have no desire to really sit down and prepare a proper type of nutritional meal. We also find that their buying habits leave an awful lot to be desired. I think there has to be a tremendous educational process for them in a type of manner, a concrete educational process, which is one of the things that we are attempting to do through our program. We find that by bringing them together with their common problems they are neither bashful, shy, or hesitant to participate-because they are together with their peers. I think through an educational process, and by actual demonstration, where we have actually taken groups of people to supermarkets and shown them how to buy. We have also prepared some courses for the senior citizens, they have seen how to prepare a single meal for themselves. I think this is the type of effort that really needs to come about, in order that our senior citizens will be more aware of the types of situation that they are falling into. A lot of them are simply not aware that they are in a particular situation such as this; and, I think that we have to expand programs like this.

I kind of agree with your earlier statement that our society has a tendency to push older people out from the home. I think, if this is going to be a recurring thing, then we have to take the necessary steps to overcome the types of obstacles that people are going to encounter once they are pushed out of their homes. Quite obviously, if the majority of our senior citizens were living with their families, they would not have the problem of malnutrition.


Senator PELL. Thank you. In this connection I am cosponsoring a bill with Senator Kennedy, S. 1163,* that provides for programs where hot meals would be served in community centers such as nonprofit institutions. It would do a great deal to meet this part of the problem.

Another question I would like to ask you. It is a little removed from the nutritional question, but for many years I have been working on the idea of some centers where older people can meet in the daytime. Daytime centers where in the summer it would be cool, and warm in the winter. Where they would have checkers, and chess, and cards, and books, and magazines, and television and they could meet and exchange ideas. Particularly those living alone.

We had this included in the authorization, because I am on the authorizing committee, but we could never get this put into OEO and have it properly funded. Do you have any centers along this line in Woonsocket?

Mr. DUARTE. Yes; we do.

Senator PELL. Would you describe them to me?

Mr. DUARTE. Certainly. We have four target areas in the city which are separated according to the areas of poverty in the community. In those four target areas we have established four neighborhood centers. We also have a fifth center which is geared specially for the elderly in Kennedy Manor; and, incidentally, I would like to make mention at this point that three of these areas are provided by the Woonsocket

* See appendix 2, p. 203. (S. 1163 was passed in the Senate on Nov. 30 by an 89-0 vote.)

Housing Authority-at no cost to the agency-and we are very grateful. Now, within these centers there is a variety of programs that are geared especially for senior citizens. Some of the things that we have discovered with our senior citizens is they do want to be active. Many of them have a great many sewing skills and they are preparing and sewing clothes for teenagers-whose families are on welfare, and otherwise could not afford to buy this type of clothing.

We recently-in the city of Woonsocket-had a Senior Citizens Day where we had over 500 people participating in the program. In each one of the neighborhood centers we have a variety of programs for senior citizens; such as, sewing, some taking typing, English as a second language, adult basic education. Woonsocket Housing Authority also runs what we term a "Young at Heart Club" where the senior citizens sew or play games, read books, and things of that nature. Out of all of this, Senator, we do have-in Woonsocket-a variety of activities which are geared especially for senior citizens and they participate in these programs.

Senator PELL. Thank you. Returning to the idea of the nutritional program, how many people do your programs here serve, and what is the cost per meal?

Mr. DUARTE. Presently-because of our accommodation and the amount of funding-we are serving between 200 and 250 people per week and the cost of the meal averages around 55 cents a meal.

Senator PELL. You say the cost of the meal-does that mean the funding, including the cost of the program as a whole or does that mean just the food?

Mr. DUARTE. Just the food aspect of it, alone.

Senator PELL. The food alone is 55 cents?

Mr. DUARTE. Yes.

Senator PELL. Do you believe that more attention ought to be paid, on the Federal level, to obtaining data and statistical information on the elderly and the poor? Or do you regard what we are getting for information now is enough?

Mr. DUARTE. Senator, our program has been in operation 5 months, and I have been involved in this Agency for 211⁄2 years now. I don't think that we have even begun to amass the type of data that is really necessary to deal with the many facets of problems of our senior citizens. I think all of the programs of the Federal Government that are in existence, a portion of them very well fall into some of the problems of our senior citizens. But we have a long way to go, and there is much more needed in the way of information to really begin to deal with the problems of our senior citizens.

Senator PELL. We both come, really, to the same thought that I opened with our older citizens are very often poor, and also less active, and less able to move about; and people, in general, are not aware of the problems of the older citizen. They are aware of the problems of youth, because they are very visible and mobile. But the older citizens are none of these; and, therefore, their hardships are hidden. This is why we need statistics to bring out the full extent of the really hard times that our older people are going through.


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.

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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 turnMedicaid 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. If 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

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