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is the possibility of establishing a continuing training institute designed to bring together from local areas physicans representatives of all agencies concerned with health, paramedical services, hospitals and the public for special instruction and training. The methodology and text content of such an institute would undergo continual evaluation in order that changing conditions might be met. Such an institute would be expected to coordinate all health endeavors with the center of aging at Duke University thereby merging their energies to focus on the problem of total patient care.

Conclusion. From this report of programs and activities now being conducted in the State of North Carolina, I feel that you will agree with me, representing the Medical Society of the State of North Carolina, that: (1) We are aware of the increasing numbers of older people and their needs; (2) we know our own resources and are combining our efforts to meet present needs and we are increasingly meeting the needs, as well as anticipated needs of the next few years; and (3) through basic research we expect to learn shortly some of the causes and effects of aging so that we may develop services, facilities, and trained personnel to meet these newly defined needs as they are discovered and identified.

Financial assistance in the areas under consideration is but a single part of the total problem of the aging, and trying to solve one portion, in largess while neglecting the minute factors involved in the practical and adequate care of the aged, is not the answer to the total need. I would like to close with the results of a sample survey of the adult population conducted by the Opinion Research Corp., Princeton, N.J., for the American Medical Association. "More than threefourths of the population of the United States want to choose their own physician. In addition, they want to assume all or part of the responsibility for paying their doctor bills." I make this point to emphasize that the attainment of health and human happiness involves a great many choices which the individual must make for himself and that these choices involve the interplay of personal relationships out of which the whole may develop. Therefore, goals of the Forand-type legislation may well miss these important factors, even for the aging population, by removing factors of choice and self-participation which are so essential in a life such as we have so notably founded by experience here in America.

At this time, I would like to recognize other representatives of the Medical Society of the State of North Carolina, President John C. Reece of Morgantown, N.C.; J. P. Rousseau, M.D., Winston-Salem, N.C.; and Mr. James T. Barnes, executive director, headquarters office, Raleigh, N.C. Thank you for your kind attention.

STATEMENT OF OMAR B. KETCHUM, DIRECTOR, VETERANS OF FOREIGN WARS OF THE UNITED STATES

JULY 31, 1959.

Senator PAT MCNAMARA,
Chairman, Subcommittee on Problems of the Aged and Aging, Committee on
Labor and Public Welfare, U.S. Senate, Washington, D.C.

DEAR SENATOR MCNAMARA: Thank you for the invitation to present the views of the Veterans of Foreign Wars concerning the problems of the aged and aging. The legislative efforts of the Veterans of Foreign Wars are controlled in the main by the resolutions adopted at our annual national conventions. Over the past several years the delegates to our conventions have expressed their concern with the problems of the aging in several fields, such as pensions, medical care, employment, and housing. Generally speaking, the members of our organization who participated in World War I have reached or are approaching the retirement age. These veterans are faced with the problems common to all citizens who must adjust to a life of retirement. One of the most vexing problems reaching the national level of our organization is the problem of inadequate pension payments.

The second most pressing problem is the lack of adequate medical care with its high cost, particularly on an outpatient basis. On the inpatient basis more VA hospitals are reporting longer and longer waiting lists for qualified veterans desperately in need of treatment but must wait because of a lack of beds available. For these veterans without funds for medical care, it is a case of desperation and despair.

In the employment field there seems to be a general consensus of opinion that after age 45 it is increasingly more difficult to obtain employment. By the

time a veteran reaches his sixties it is reported that it is practically impossible to obtain any employment. There seems to be a widespread and deep prejudice on the part of employers against hiring so-called older employees, even when the applicant is eminently qualified by training and experience to do the job. From time to time our members have indicated numerous problems relating to sufficient housing for the aging veterans. Most urge we should have more domiciliary-type institutions, both for married veterans and veterans without dependents. Last year, for example, our 59th annual convention recommended inquiring into the possibility of establishing a home for our elderly members, with the possibility of establishing a home in one of our Southern States. It seems certain that adequate housing for the older veterans will become more acute with each passing year.

These programs briefly describe some of the problems that have been brought to the attention of the Veterans of Foreign Wars and reflect our official position with respect to this broad field. We appreciate this opportunity to express our views and will deeply appreciate this letter being made a part of the record of these hearings.

Respectfully yours,

Hon. PAT MCNAMARA,
Member of U.S. Senate,
Senate Office Building,
Washington, D.C.

OMAR B. KETCHUM, Director.

CALIFORNIA INSTITUTE OF SOCIAL WELFARE,
Los Angeles, Calif., August 12, 1959.

DEAR SENATOR MCNAMARA: Thank you for your invitation to testify before your Subcommittee on Problems of the Aged and Aging. As you know, I have devoted more than 20 years to this subject and am most eager to do what I can to assist your subcommittee in its study. Unfortunatley, however, it was necessary for me to remain in Sacramento for the full term of the California State Legislature, representing the elderly people of our State. As a result, it was impossible for me to make the trip to Washington to offer my testimony personally.

Enclosed is a statement I hope the subcommittee will include in its record of hearings. Also enclosed is a brief summary of the California Institute of Social Welfare's activities.

I hope that this material proves of value to your subcommittee. I also hope that you will again invite me to appear before your panel if and when further hearings are scheduled on this subject. Sincerely,

GEORGE MCLAIN, Chairman.

STATEMENT BY GEORGE MCLAIN, CHAIRMAN, NATIONAL INSTITUTE OF SOCIAL WELFARE, LOS ANGELES, CALIF.

Chairman McNamara and gentlemen of the committee, my name is George McLain. I am president of the National Institute of Social Welfare. For more than 20 years I have been working with and representing the elderly people of this country. My experience has shown me that our aging men and women face problems that are insurmountable for most under present conditions. For this reason I am delighted that this committee has undertaken a study of the Nation's aged, to lay the groundwork for legislation that will save older Americans from want and hardship in their declining years.

Reduced to simple terms, the elderly need help most in these fields: (1) Economic.

(2) Medical and health.

(3) Low-rent housing.

For

At the root of most of the difficulties encountered by a large segment of America's elderly population are our present public assistance programs. this reason I believe it is time to take a long, slow look at these programs. When were they born and how well have they grown?

Public assistance came into being with social security, in 1935. The Nation was caught up in a rebirth of the American principles of fair play and brotherhood, dramatically dedicated to the defeat of the depression and the return of prosperity. There were breadlines in the cities. But in the hearts of the people, hope burned fiercely.

Out of this came social security. Under this system, working men and women could pay a small tax, along with their employers, and accumulate a modest retirement fund for the future.

But America was concerned with the present, too. How about the elderly who had already retired, or who would retire soon without the benefits of social security? How about the blind, the needy children?

So public assistance, requiring no contribution from the recipient, was written into the Social Security Act to provide Federal funds to stimulate the States to care for the needy. Wise planners in Washington, D.C., knew the States would never act without Federal prompting. But with the offer of Federal funds, to be matched to some extent by State money, it was hoped that the States would free their elderly, blind, and handicapped from the poorhouses and almshouses, the soup lines, and the social trash heaps.

The Federal funds were held out to the States. Fortunately for the needy, a few strings were attached. Washington told the States, in effect:

No age limit beyond 65 years shall be imposed.
No residence beyond 5 years shall be required.

No other citizenship requirement may be imposed.

A single State agency shall administer.

There shall be uniform administration.

The recipient or applicant shall be granted right of appeal to State agency.

Broad rules. But the humanitarians in Washington who shaped the original program hoped they would suffice. They hoped the fine and noble example set by the Federal Government would inspire the States. How wrong they were. The ink was hardly dry on the public assistance section before the States began erecting their own hedgerows to limit the program. Some insisted that a needy person be a "destitute" person, completely without worldly goods. Others imposed cruel "lien laws." The infamous "responsible relatives law' was revived from pre-Revolutionary decay and put to work once again against the needy and their close kin.

Here we saw the selfish special interests at work. Shackled to their ancient philosophy of "dog eat dog" and "devil take the hindmost," the spokesmen for the rich exerted all their powerful influence at the State capitols. Smallminded Statehouse politicians heeded their false cries and did their best to make public assistance in the States a mockery of what Congress intended.

The years passed, while the needy elderly suffered in lonely silence. When youthful, bustling America thought about retirement, it was with an awareness of social security benefits. This was the program that affects today's working men and women, not public assistance. True, Congress occasionally increased Federal grants to the States for public assistance, but only on a temporary basis. The frequent cry was, "Who needs public assistance? Everybody soon will have social security."

But

Certainly, many old folks are now collecting social-security benefits. millions of these are the people who worked only briefly or at extremely low pay-under social security. Their benefits are at the lowest level. They must have Federal-State old-age pensions to supplement their incomes if they are to survive.

Last year, for the first time, Congress recognized a public assistance increase as a permanent feature. This was a major breakthrough. Congress also revived its formula for sharing pension costs with the States. Another victory. In addition, Congress tied the formula to the per capita income of the various States. A third success.

Under the new formula, the Federal Government pays $24 of the first $30 provided for the needy elderly, blind, and disabled. Above $30, the Federal Government pays from 50 to 65 percent up to an average payment of $65 with the lowest per capita income States getting the highest percentage of Federal aid. Any State paying pensions of more than $65 on the average must make up the rest out of its own State treasury.

Only 20 of the 50 States do so.

In fact, 12 States pay an average of less than $50 per month to their needy aged, blind, and totally disabled, despite the soaring cost of living, and the Federal grants available for higher benefits.

Moreover, many States pocket social security increases voted by Congress for the needy aged. By reducing the amount of State grants by the amount of the Federal increases, these States enrich themselves at the expense of their aged who receive small social security benefits, plus meager State pensions.

What the Federal Government giveth, the States taketh away-if possible. The situation has grown more serious in recent years. The high-minded planners who originally devised social security and public assistance are gone from the Washington scene. Their places are taken by "organization men," who lean more toward statehouse welfare thinking than toward sympathy for the needy. It is most gratifying that the Senate Committee on Labor and Public Welfare has established this Subcommittee on the Problems of the Aged and Aging to probe into the inequities of our social security and public assistance programs.

Our organization, the National Institute of Social Welfare, with 20 years' experience in the field of social security and public assistance, feels well qualified to make the following recommendations:

Old-age assistance

A Federal sharing formula of 50 to 75 percent above the present basic $30 payment. A sharing formula based on the per capita income of the States with no Federal ceiling on the average payments in which the Government will participate.

A Federal definition of a "needy person."

Federal regulations again lien laws, responsible relatives' laws, and other punitive State policies.

That the age requirements for old-age assistance recipients shall be the same as that established for old-age beneficiaries under title II of the Social Security Act.

The needy aged be allowed to earn up to $50 per month to supplement their assistance.

That the State-imposed residence requirements now allowed by the Federal Government be reduced from 5 years to 1 year.

That the program be administered by each State so as to insure uniform treatment of the aged in all of its political subdivisions.

Old-age security

The maximum monthly benefits paid to the primary beneficiary should be not less than the current minimum wage standard of $1 per hour, or roughly $173.33 per month on a 40-year-per-week basis. This has been determined by Congress to be the absolute minimum on which an employed person can live. Minimum payment to the aged should be, at the very least, 60 percent of basic minimum wages. This would bring the minimum old age benefit to a little over $100 a month.

Health insurance protection which is so desperately needed.

Lowering of age of recipients and applicants to 60 years for both men and

women.

The addition of governmental financial participation with that of the employer and employee in the old age insurance program.

Housing for the elderly

The housing for the elderly provisions contained in the recent bill vetoed by the President should be reenacted. After 3 years of personal experience in this field we have found these provisions to be not only most worthy, but vitally necessary.

Surplus food stamps

Issuance by the Federal Government of surplus food stamps to those on social security, public assistance and the unemployed has been tragically neglected and should be made available to them as quickly as possible.

CONCLUSION

In conclusion, I urge this committee to study the foregoing recommendations carefully and impartially. I am sure that before you gentlemen conclude your studies of our Nation's older people you will arrive at the same conclusions, and the findings of this committee will parallel to a great extent the proposals I have outlined. For the sake of the millions of elderly Americans who are suffering daily because of the inadequacies of our public assistance programs, I fervently hope that this is borne out.

Thank you for the opportunity to present my views and the views of my organization to this committee.

ACTIVITIES OF THE CALIFORNIA INSTITUTE OF SOCIAL WELFARE, INC. (A NONPROFIT CALIFORNIA CORPORATION)

Established as an outgrowth of the California Citizens Committee for Old Age Pensions, the California Institute of Social Welfare is a nonprofit corporation devoted to the welfare of the aged, the blind, the physically handicapped, and the needy.

It broadcasts a 15-minute radio program 5 days a week over a network of 24 California radio stations.

Its welfare counseling department, headed by Frank Gardner, former member of the California State Social Welfare Board, helps thousands of clients with welfare problems annually.

Speakers of the California Institute of Social Welfare conduct more than 2,000 meetings annually in cities and towns throughout the State.

A monthly newspaper, the National Welfare Advocate, circulates to all members and thousands of nonmembers.

For the past 3 years, the California institute has been engaged in a long-range program to provide low-rent, modern housing for the elderly. At present, the C.I.S.W. is in the final stages of negotiations with the Federal Housing Administration for a federally insured loan to build a $4,500,000 "Senior Citizens Village." Located at Fresno, Calif., it will be the first of several similar developments envisioned by the California institute. It will also be the first large, low-rent housing development for the aged to be built under terms of section 207 (housing for the elderly) of the Federal Housing Act.

C.I.S.W. offices are located in old folks headquarters, 1031 South Grand Avenue, Los Angeles, Calif. This two-story building also houses a broadcasting studio, a complete printing plant, photographic studios, advertising production department, the C.I.S.W. housing department, and the editorial rooms of the National Welfare Advocate. An upstairs clubroom is open to visiting oldsters from 8:30 a.m. to 5 p.m., Monday through Friday. Coffee and snacks are available.

NATIONAL ASSOCIATION OF HOME BUILDERS,

NATIONAL HOUSING CENTER, Washington, D.C., August 14, 1959.

Hon. PAT MCNAMARA,
Senate Office Building,
Washington, D.C.

DEAR SENATOR MCNAMARA: As president of the National Association of Home Builders, the trade association of the homebuilding industry, representing some 40,000 members in 325 State and local associations, I am pleased to submit this statement for the record to the Senate Committee on Problems of the Aging.

We have long felt that there is a real need in the particular field of housing our senior citizens. Last year our association set up a special committee, Housing Senior Citizens Committee, to explore the needs and the market in this field and what our industry can do to meet them. We found that one of the big demands is in the field of rental housing and, therefore, before the House and Senate Banking Committees this year I testified in favor of an FHA program to increase the supply of rental housing by a Government-guaranteed loan program available to both profit and nonprofit organizations. I am happy to report that such a program has been included in the housing bill S. 2539 which will shortly be considered by the Congress.

I can claim some personal knowledge of home production for elderly families, having built over a thousand homes of that type. I believe that there will be a very substantial production of such homes if the provisions in the new housing bill become law. The history of housing legislation in this country has conclusively demonstrated that a workable program using private financing and the enterprise and resourcefulness of the building industry operating in a profit-andloss economy produces most satisfactory results.

I am happy to enclose for your information and study a copy of a roundtable conference held last year on "Housing Our Senior Citizens" sponsored by the National Association of Home Builders, and well attended by Government and industry leaders.

Sincerely yours,

CARL T. MITNICK, President.

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