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forth, so they can maintain their home and still be productive members of our society and our community. In 1970, we had 105 homemaker cases and half of them-I believe 55-were older people. Now, of this 55 only half had their homemaker services paid by public assistance or Old Age Assistance. The other half had to pull on their own savings, with their own inadequate Social Security check, to pay for the cost. Now, none of these could pay the full fee. But even at 50 cents or a $1 an hour, for the homemaker service, this was a burden on them and the person who needed the service. Therefore, we would like to recommend along the whole line of extending the services on the Medicare bill-that the homemaker services be included. The Division of Aging has made this recommendation, and the older people, the delegates to the pre-White House Conference have made that recommendation. I hope, Senator, that you will be successful in getting that bill passed that you are cosponsoring. Thank you.


Older people in Woonsocket and the entire nation have always been, and still are, hard working people. They have, through their work and labor, contributed to the development of America; struggled with her problems and contradictions, raised her children into manhood, fought her wars; and produced the goods and services that are crucial to a society's survival. They have been the engineers; the doors, the people of action who have made America run. Older people today have the wisdom of hard experience and we should learn from their sweat and work, without which nothing we have today would have been possible. No one can question that their contribution has been indeed great. Because of this, older Americans should not be forgotten, should not be separated from the mainstream of society, should not be isolated, ignored or pushed around. A society or government that does not recognize the contribution of its older, hard working people can only be considered primitive; can only be termed backwards. Such a government that does not provide adequate and effective medical care, income, and social services for the very people who have made so many contributions and sacrifices could only be said to be barbaric-could only be seen as not truly working in the interest of the people.

Therefore, there should really be no question as to the merits of eliminating cost to the individual of Medicare, Part B, or of eliminating such things as fifty dollar deductables or 20% coinsurance provisions. There need be no real debate on extension of Medicare coverage to include a wider range of services. There should be no question that older people are entitled to the finest in dental care, podiatry, optometry, custodial health care, drugs, homemaker services, and diagnostic services. There should also be no real debate or opposition to extending the 100 day limit on skilled nursing care or the 190 day limit on mental health care. There should be no mention of making the older American pay a premium for such coverage he has paid time and time over through his work and his taxes. We, and older Americans should not really have to be lobbying for these things; nor should older Americans have to be asserting various forms of political pressure and maneuver to get Medicare and Medicaid, and the health delivery system to meet their needs. Certainly the provision of health care when needed is the absolute bare minimum that the United States and its Congress can insure for those people responsible for its growth and development.

But we are here today to give our own opinions and share our experiences. Our agency, Woonsocket Family and Child Service, a United Fund agency, delivers homemaker services to families in need. This type of service usually is given in a medical situation-a mother might be in the hospital or recuperating from an operation for a period of weeks, or simply be too ill to carry on her duties as mother or wife; or an elderly couple or individual might be becoming infirm and in need of help to keep their home functioning. In situations like this, one of our trained homemakers, most of whom are experienced, aged people themselves, can enter a home on a regular basis and work with the residents to help with the housework, shopping, and cooking, and generally be a supportive friend and companion, and concretely work to keep the home together. In this

way the household is not broken up, the children are not separated or placed in a foster home, nor is the aged person forced to enter a nursing home or other type of institution. In 1970, we handled 105 homemaker cases. Of these, 55 were with aged families. Usually, these families consisted of a single elderly person who usually had few relatives and friends, and who probably faced placement in an institution unless we were able to get a homemaker to visit them regularly. Many of these aged clients had their homemaker service paid for through Old Age Assistance direct vendor payments. Approximately half, however, either did not qualify for public assistance or did not wish to receive public assistance, and were forced to rely on their own resources for homemaker services. Full fee for such service is $1.85 per hour plus homemaker transportation costs. Very, very few of our elderly clients, struggling on inadequate and unrealistic social security payments, can afford to pay such a fee. Even with a sliding fee scale which lowers individual costs to perhaps fifty cents and a dollar per hour works an unnecessary economic burden on the aged person as well as the homemaker program itself. Such a situation, if allowed to continue threatens the existence of such preventive medical programs in the community, and without such programs, more and more aged people will be forced to continue living isolated, marginal lives, and be forced into nursing homes before it is really necessary.

I would therefore like to forcefully recommend that pending Medicare legislation be structured so as to include coverage of homemaker service, as well as home health aide care, as part of a comprehensive extension of medical services to aged Americans. I would simply like to reiterate and reinforce the recommendations of the Rhode Island Div. on Aging study, entitled, Aging in the Rhode Island Community, 1970, which pointed out the needs for such an extension of coverage in Medicare for homemaker services, foot and eye care, drugs, and custodial health care. I would also like to reiterate the recommendations of the delegates of the Rhode Island Pre White House Conference on Aging held in October, 1970 at Rhode Island College. As a panel discussion speaker, I was privileged to work closely with the aged delegates who hammered out a series of recommendations relating to health care and Medicare. Among those recommendations which I hope the Congress will give the fullest consideration were:

"Resolved that the Conference go on record as recommending increased benefits under the Medicare program, in particular that the Federal Medicare program be extended to include the cost of prescription medicine, glasses, dental care, dentures, podiatry, optometry, and hearing aids"

"Resolved that the guidelines of the Federal Medicare program be liberalized to include homemaking services."

Finally, I would like to reiterate the often desperate plight under which Older Americans are often forced to struggle, particularly in the areas of effective and adequate health care. I hope that you, Senator Pell, will take back our experiences in dealing with these very difficult problems, and that you will be successful in insuring the health needs of our older citizens, a cause which I know you sincerely champion.

Senator PELL. That is very good and it is a very specific situation that I would like to see included, only don't forget that it always takes a majority in both the House and the Senate to make something come into being. We sometimes try and pass the buck to the administration but, very basically, we in the Congress, when we want to do something in a major way, whether it be health for the aged or health care in general, or the war in Vietnam or wages and price controls, we have the power to do it but we sometimes lose some of our courage and don't do it and pass the buck to the President, and I hope that public opinion around the country will restore us the courage to take the steps in the Congress that should be taken if the administration itself will not do it.

Now, I want to open the meeting to any of you who had a particular idea or thought. Would you identify yourself for the court reporter, please?


Mrs. TELLIER. Senator Pell and my dear friend, John Skiffington, and all my friends from Kennedy Manor; I am here today, Senator, to tell you about what we call "Gay 90's." I was hospitalized for 412 weeks and when I came back I didn't know anything about this, but they sent my lunch every Wednesday. If you think that wasn't a thrill-because I couldn't do it. I would like to take the opportunity to thank every one of the nice workers there; and, at the same time I thought of you, Senator, and I met you before and I am always with you, you know that. You are always welcome in Woonsocket. Senator PELL. Thank you very much indeed.

Mrs. TELLIER. It is a good program and I hope it stays.

Senator PELL. We will do our best. Would you identify yourself?


Mr. KIRK. My name is John Kirk. I am a member of the senior citizens group. One thing that I hope the Senator will include in his report today is that we are the victims of insurance companies in this country. Insurance companies dominate our Social Security benefits. We used to have $50 deductible and it has now been increased to $60. The cost of your Medicare has been increased. If you buy a home you have to deduct it; if you buy an automobile you have to deduct it. Senator Kennedy has said that the insurance companies throughout this country are putting up magnificent buildings, and they are wealthy people. What are they doing for us-only abusing us!

What I maintain, and think should be done, is that the Administration on Aging in the Federal Government should be run as the Veterans' Administration is run. The Veterans' Administration has been a credit to this country and has always helped in need. I would like to see this program follow the same procedure as the Veterans' Administration has done and eliminate these insurance companies. It would be far better for each and every one of us in this country who are served under the aid of Social Security or Medicare. Thank you.


Mr. CORNETT. Senator, ladies and gentlemen; I think most of you out there have met me. As chairman of the steering committee of the State for the pre-White House Conference I met you up there with Senator Pastore; Mr. Hunt, from Boston; Mr. Williamson, from the Division of Aging-and so on down the line. I would like to put across to you something, if I may. It isn't what we say here-it is what you do after you get through talking about it.

Senator PELL. Amen.

Mr. CORNETT. I have been working on this now for 2 years. I hope that I am not stepping out of line but I want to get this across, if I can, for the simple reason that the White House conference will be in November and I hope to be there. I must say that I am quite thrilled about what is going on here in this building. The only thing I can say about this whole thing that is going on here-and what we are talking about here—is money. Every time I go into the Division of Aging

and ask questions-whether it is Mrs. Slater or Mr. Williamson or whoever they say "we haven't got any money. They are cutting back." The Senator just told you that they are making these cutbacks. Then they say, "Why don't you write to your Senators, write to your Congressmen?" Don't forget there are a lot of Senators and a lot of Congressmen in this country. How many of you do that? I would like to read something. Incidentally, I have been sitting here and listening to all these speakers. I am sure there is a lot of truth, but get this. I happen to be on the Governor's advisory board; I am not a politician-I represent the old folks, that is, all you people. I want to read this because this was something that we talked about-and may I do so? Senator PELL. Certainly.

Mr. CORNETT. It says here:

The elderly are urged to protest the cut in funds. Rhode Island senior citizens are urged to write to the State Advisory Committee on Aging and to write their congressional delegation in protesting the administration's cut in Federal funds for programs for the elderly under the Older Americans Act.

In the letter that was sent to senior citizen organizations throughout the State:

Robert S. Berg-the chairman of the United States Bureau of the Budgetstates there is an allocation of $29.5 million for all programs under the Older American Act for the coming fiscal year; despite the fact that the Congress authorized $105 million for these programs.

I have those here, too.

Mr. Berg noted that the allocation for the community grant in Rhode Island as being reduced by $44,000 for the fiscal year-beginning July 1 of this year. Such programs as senior centers, Meals on Wheels and the transportation project, and there would be severe financial problems if this cut were allowed to stand, it was noted. The reduction would also preclude the funding of any new programs in Rhode Island under the Community Grant provisions of the Older American Act. We feel you should be made aware that the Bureau of the Budget has appropriated lesser amounts than Congress wants made available to older people, the letter stated. We would suggest-it continues-that each of you write individual letters to your congressional delegates and to Mr. William E. Oriol, Staff Director of the Senate Committee on Aging.

Senator PELL. Yes, Mr. Oriol is right here, and I would like to have him stand up and take a bow.


Mr. CORNETT. I am telling them what Congress has authorized for programs for the elderly and what should be appropriated by the Bureau of the Budget. Now, I have a list here am I boring you people? Well, listen, this is why you haven't got any money. Just as the Senator said about the cutbacks, and the people that sat at the table there said they haven't got the money to do what they want to do-this is the reason, I don't make these figures. We feel where this letter was sent out to the different units-that you should know this. We feel that you should be made aware of the financial programs affecting the older people. These are in progress in Congress right now. Here are the amounts authorized by Congress; and, note that the Bureau of the Budget appropriated lesser amounts than Congress wants made for all our people. So don't blame the Congressmen, and don't blame the Senators, because this is the meat right here. The congressional authorization-and these are the ones that we are talking

about here the community grants and State agencies; the Congress authorized $30 million, and the Bureau of Budget's allocation brought it down to $5.45 million. I can go on, but I don't want to bore you too much. In closing, here, the final analysis of the whole thing-in the figures compiled-is that the Congress authorization for the elderly was $105 million; and the Bureau of the Budget, the total allocation was cut down to $29.5 million. That is why the State of Rhode Island is working on a budget that is now $44,000 less than in the past. I thank you very much.

Senator PELL. This testimony was particularly helpful because it shows the difference between what is authorized and what is appropriated or spent. We in the Congress authorize, or develop ceilings on the amounts of money that we think should be spent; but, then less money is spent or released in the end. What is needed is a new approach in Government where more money will be spent on what we call the human environment program-the health, the elderly, education-and less money to be spent on defense and space. Will our next witness identify himself?


Mr. RICHARDS. My name is Arthur Richards and I am the general president of 10 different clubs in Woonsocket with a membership, a total membership, of about 3,000 people.

Now, I was happy to hear about the Gay 90's club because I had a dinner, one time, there as a guest. They are doing wonderfully well, but I understand the Gay 90's-if you are making too much money you cannot go ahead and have a meal there. Now, I wonder if it could be arranged that people like myself who live alone, and that cannot prepare meals the way you should, and don't get too much of a pension either-if we could go ahead and pay part of the dinner. Say, for instance, that we pay two-thirds of the dinner; pay that out of our pockets, and we would get one good meal a week. This way the Government could finance the rest. I think that would help those that cannot belong to the Gay 90's club. They could go ahead and have one good meal a week, and it couldn't cost us as much as going to a restaurant which costs around $2 to $3 for a meal. Thank you.

Senator PELL. Thank you very much for the suggestion. It may involve a change in legislation but we will examine it and see what can be done. I would add that I made an error earlier when I said the Meals on Wheels was definitely approved. I have been informed by a subsequent phone conversation that the program is still being considered. We are pushing on one side and the course of the economy is on the other. We were a bit premature. The next witness?


Mr. DURAND. I am Mrs. Alexina Durand, of the Senior Citizens. I want to speak about the cabs which have meters. When I have to shop at a store, or something, just the one way costs me $1.25 and when I return it is the same thing and that comes to almost $3, and nothing to show for it. Then another thing, we have given a bill to Repre

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