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The original documents are located in Box 136, folder "Aging" of the Gerald R. Ford Vice
Presidential Papers at the Gerald R. Ford Presidential Library.
Copyright Notice
The copyright law of the United States (Title 17, United States Code) governs the making of
photocopies or other reproductions of copyrighted material. Gerald R. Ford donated to the
United States of America her copyrights in all of her husband's unpublished writings in National
Archives collections. Works prepared by U.S. Government employees as part of their official
duties are in the public domain. The copyrights to materials written by other individuals or
organizations are presumed to remain with them. If you think any of the information displayed
in the PDF is subject to a valid copyright claim, please contact the Gerald R. Ford Presidential
Library.
Some items in this folder were not digitized because it contains copyrighted
materials. Please contact the Gerald R. Ford Presidential Library for access to
these materials.
93D CONGRESS
1st Session
}
SENATE
{
REPORT
No. 93-94
THE RISE AND THREATENED FALL OF
SERVICE PROGRAMS FOR THE ELDERLY
A REPORT
OF THE
SUBCOMMITTEE ON FEDERAL, STATE, AND
COMMUNITY SERVICES
OF THE
SPECIAL COMMITTEE ON AGING
UNITED STATES SENATE
TOGETHER WITH
MINORITY AND SUPPLEMENTAL VIEWS
FORD i LIBRARY GERALD
MARCH 28, 1973.-Ordered to be printed
U.S. GOVERNMENT PRINTING OFFICE
83-010 0
WASHINGTON : 1973
For sale by the Superintendent of Documents
U.S. Government Printing Office, Washington, D.C. 20402
Price 60 cents domestic postpaid or 35 cents GPO Bookstore
Stock Number 5271-00337
FORD
GERALD R.
LIBRARY
PREFACE
How shall older Americans receive social services:
As welfare clients, entitled to help only because their incomes fall
below a certain level?
As a special group, served solely through the Older Americans Act?
SPECIAL COMMITTEE ON AGING
As private purchasers (limited, of course, to those who can afford
FRANK CHURCH, Idaho, Chairman
services, when those services can be found) ?
HARRISON A. WILLIAMS, JR., New Jersey HIRAM L. FONG, Hawaii
One of the most commonly heard complaints in the field of geron-
ALAN BIBLE, Nevada
CLIFFORD P. HANSEN, Wyoming
tology is that not one community in the United States has a genuinely
JENNINGS RANDOLPH, West Virginia
EDWARD J. GURNEY, Florida
effective coordinated service network for its elderly residents.¹
EDMUND S. MUSKIE, Maine
WILLIAM B. SAXBE, Ohio
FRANK E. MOSS, Utah
EDWARD W. BROOKE, Massachusetts
An old person who simply wants information may find that he has
EDWARD M. KENNEDY, Massachusetts
CHARLES H. PERCY, Illinois
to go to several public or private agencies, and even then he may be
WALTER F. MONDALE, Minnesota
ROBERT T. STAFFORD, Vermont
unable to piece together the information into a cohesive package for
VANCE HARTKE, Indiana
J. GLENN BEALL, JR., Maryland
CLAIBORNE PELL, Rhode Island
PETE V. DOMENICI, New Mexico
practical use.
THOMAS F. EAGLETON, Missouri
Medical services are often segregated from social services; senior
JOHN V. TUNNEY, California
centers are often used only by a small but informed minority; a num-
LAWTON CHILES, Florida
ber of small information and referral services, may operate in the
WILLIAM E. ORIOL, Staff Director
same community unknown to each other, or ignoring each other.
DAVID A. AFFELDT, Chief Counsel
VAL J. HALAMANDARIS, Associate Counsel
Quite often, those most in need of services do not receive them be-
JOHN Guy MILLER, Minority Staff Director
cause they (1) don't know about them (2) may not fall neatly into
the category which will "qualify" them for one service or another or
SUBCOMMITTEE ON FEDERAL, STATE AND COMMUNITY SERVICES
(3) cannot reach the services because they have no transportation.
EDWARD M. KENNEDY, Chairman
Such problems have arisen partially because social services in this
ALAN BIBLE, Nevada
J. GLENN BEALL, JR., Maryland
Nation usually develop on a one-at-a-time, meet-a-new-crisis basis.
VANCE HARTKE, Indiana
CHARLES H. PERCY, Illinois
CLAIBORNE PELL, Rhode Island
CLIFFORD P. HANSEN, Wyoming
Some have traditionally been provided by voluntary agencies, such as
THOMAS F. EAGLETON, Missouri
EDWARD W. BROOKE, Massachusetts
visiting nurse services. Others have been largely provided by govern-
JOHN V. TUNNEY, California
HIRAM L. FONG, Hawaii, ex officio
ment, such as social service "Case" work. The task of "putting it all
FRANK CHURCH, Idaho, ex officio
together" has largely been unmet for all age groups.
(II)
SOCIAL SECURITY SERVICES
For these reasons, the decision in 1962 to authorize services² for
those not actually receiving welfare assistance-for those who could
be regarded as potential or past recipients-was of considerable inter-
est to those concerned about developing a service network for the
ФЕНУГО
elderly.
1 At the White House Conference on Aging in December 1971, the Section on Facilities,
Programs and Services declared "In addition to adequate income, an effective network of
facilities, programs and services must be readily available and accessible to permit them
to exercise a wide range of options, regardless of their individual circumstances or where
they happen to live." In 1969, the Gerontological Society issued a report which said that
to date no community in the United States had developed a comprehensive network of
services for the aging and the aged, nor had a full range of service alternatives been
developed to meet the varied and changing needs of the population. See pp. 69-73, A Pre-
White House Conference on Aging Summary of Developments and Data, issued by the
Senate Special Committee on Aging, November 1971, for additional discussion.
2 Through Titles I, IV, X, XIV, & XVI of the Social Security Act. See Part Two of this
report for information on utilization & other details of the Social Services program.
(III)
V
IV
0907
Here was an opportunity to use significant amounts of Federal
REVENUE SHARING
FORD LIBRARY
118898
funding-75 cents out of every dollar committed-for sustained, or-
Still another possible source of support for service programs
derly development of systems, not just programs or projects. Slowly,
emerged in 1972: revenue-sharing. With high-level encouragement,⁶
between 1962 and 1972, States began to make increasing use of the
the elderly were urged to seek a fair share from this new experiment.
Social Security service provisions.
As for revenue-sharing, there is little reason to believe-at this
early date in the history of that program-that it will be widely used
OLDER AMERICANS ACT
to serve the elderly.⁷ Misgivings about future use are common. For
In 1972, also, the Congress and the Administration-prompted by
example, former Administration on Aging Commissioner William
D. Bechill has said:
the forthcoming expiration of the Older Americans Act ³ on June 30
of that year and responding to emphatic recommendations of the
Unlike some others, I do not have much faith in social serv-
White House Conference on Aging-advanced legislative proposals
ices for the elderly being funded under revenue-sharing ap-
calling for a new strategy and increased resources to help meet service
proaches. There may be some communities who will do so, but
needs of the elderly.⁴
the pattern across the country will be uneven.8
Key to the Administration strategy-adopted later by the Congress
And what is patently clear from our past experience, unless we
in a bill finally passed in both Houses by October 1972-was the idea
earmark program funds specifically for the elderly, they are effectively
of establishing a partnership approach in the delivery of services.
excluded from the benefits of those programs.
Under the Older Americans Act, State and local units on aging-as
While the question on revenue-sharing remains unsettled in the
well as new sub-State regional level units called "planning and services
current Congress, a more immediate threat to the orderly evolution of
areas"-were to act as brokers, bringing together available services
a social service delivery system for the elderly has arisen.
with those who need the services.
It was voted into being by the Congress, at administration urging
One major source of services, of course, would be those available
in a hurried attempt to put a ceiling on the spiralling costs incurred
under the Social Security amendments.
through the "open-ended" Social Security services.
The idea was-and is-to make full use of all sources of services
But even during the early months of implementation, the new
in order to develop comprehensive service networks intended to help,
restrictions are threatening widespread disruption of existing or
first, those older Americans most in need, and then others.
planned programs for the elderly. The sudden impact of the new ceil-
Where services did not exist, they could be developed as demonstra-
ing has thrown programs into disarray and produced unfortunate dis-
tion projects or under other authority, either in the Social Security
ruptions in needed services.
titles or under the Older Americans Act.
But a more direct and far-reaching threat developed on February 16
Where public programs failed to offer a service, they could be pur-
when the Department of Health, Education, and Welfare proposed
chased from private providers.
regulations which would further restrict the usefulness of the Social
In addition to providing needed nutrition, transportation, and legal
Security service programs.
services, the Older Americans Act could provide a useful function by
That announcement was accompanied by the official recounting of
providing expertise and some assistance in establishing offices on aging.
"horror stories" intended to prove that the Social Security service
Such agencies, by providing day-to-day advocacy and research func-
funds had been misused or wasted.
tions, could help develop informational services and activities that
It is unfortunate indeed that an administration chooses to ignore
are needed even in the most affluent of communities.
However, the Administration opposed the broad range of services
the many successful programs which have served the elderly and other
Americans with the help of the 75-25 matching Federal funds.
contained in the Older Americans Act.
Overwhelmingly supported in Congress, the proposed Older Ameri-
6 See Appendix 3 for joint letter by national organizations on aging and statement by
cans Comprehensive Services Amendments were nevertheless pocket
Arthur Flemming. Special Consultant to the President on Aging, urging such action.
At a hearing by the Senate Subcommittee on Intergovernmental Relations on Febru-
vetoed by the President on October 28. There was, however, a strong
ary 22, mayors of eleven cities made it clear that they had reservations about revenue-
Congressional rush for reenactment of the legislation early in 1973.5
sharing. Typical of the criticism was this comment from Seattle Mayor Wesley C. Uhlman:
"Most of us have applauded the President's idea of the New Federalism and revenue-
sharing, but it has not turned out to be the saviour of the cities we thought it would be.
Instead. it's a Trojan Horse. full of impoundments and cutbacks and broken promises."
Act and its working relationship, present and potential, with Titles I, IV, X, XIV, and
3 See Appendix 1 of this report for additional information on the Older Americans
8 See Appendix 3, item 2, for summary of findings from questionnaires sent by the
Senate Committee on Aging to members of the Urban Elderly Coalition. This limited survey
XVI Social Security Act.
vielded very little evidence of early use of general revenues for services to the elderly.
Organization The recommended (Dec. 1, 1971) that a much stronger Federal agency on aging be
4 of the White House Conference on Aging Section on Government and Non-Government
A more general survey made by the Senate Subcommittee on Intergovernmental Relation-
ships yielded returns from 750 municipalities by February 15, 1973. Although some encour-
established. Its recommendation was similar to that of an Advisory Council to the Senate
aging examples of the use of general revenues for services to all age groups were cited (in
Committee on Aging in November 1971, an Advisory Group to the Secretary of Health
Education, and Welfare in early 1972, and a Presidential Task Force on Aging in April
Dearborn, for example, the entire revenue-sharing allotment will be used to build two high-
rises for low-income elderly after the Department of Housing and Urban Development
1970. The Senate, on February 20, 1973, passed a revised version of the 1972 Older Americans
turned down a grant application), there was little evidence to suggest that revenue-sharing
will be used to provide social service to the elderly and other age groups.
Act amendments.
9 See Part Two for details of the $2.5 billion ceiling and new eligibility requirements.
FORD
VI
CONTENTS
In Massachusetts, for example, funds from Social Security titles
Page
have a major part in current plans to establish "home care corpora-
Preface
III
tions" which would prevent needless institutionalization by offering
Part 1: Introduction
1
such services as home making, "chores," and transportation. Just this
Part 2: Social Services for the Elderly-Evolution Utilization, and
Complications
5
month, the Commonwealth Executive Office of Elder Affairs signed
I. Origins
5
contracts to establish four such home care units. Others are to follow.
II. Social Services Provisions for the Elderly
6
Of course cost controls must be imposed, and they must be effective.
III. New Restrictions for Social Services
7
Any "open-ended" grant program is certain to cause problems of one
IV. Effect of Changes
9
V. HEW's proposed Social Services Regulations and Other Compli-
kind or another.
cating Factors
11
But there is a difference between killing off programs indiscrimi-
VI. More HEW Rulings
14
Part 3: What Is Happening to People
15
nately and taking constructive action to reduce costs.
I. Minnesota: Impact of Senior Citizens Centers of Minneapolis,
We all know, or should know, that so-called "economy cutbacks" can
and Other Programs
15
cost far more than they save when they are based upon inadequate
Two other Programs in Jeopardy
17
Elsewhere in Minnesota
18
information, poor judgment, and lack of concern about people who
II. Illinois: Statewide Impact and Specific Effects in Chicago
18
need help.
How the Mayor's Office Views the Situation
19
To return to the Massachusetts situation, State officials are now con-
Services for the Impaired Elderly: A Program in Jeopardy?
19
cerned about the future of home care corporations. If, for example,
How Senior Centers View the Situation
20
III. Washington, D.C.: The Threat to Columbia Senior Center
21
homemaker services became optional instead of mandated-as the new
What Does the Center Mean to the People?
22
regulations specify-a major component of the program could be seri-
What does the Center Mean to the Community?
23
ously weakened. A significant, innovative program which has been
The Reprieve: How It Happened-What It Means
23
IV. Georgia: Across-The-Board Cutbacks
23
planned by the Executive Office of Elderly Affairs could be crippled.
Impact on Athens (Ga.) Community Council on Aging Programs_
24
This report provides information that should receive serious con-
What Loss of Services Will Cost the Individual and the Com-
sideration at this time, when proposed regulations are under considera-
munity
25
tion and when time yet remains to correct unfortunate consequences of
What Key Officials Say About Cutbacks
26
V. New York State and Examples in New York City
26
actions already taken.
The Situation in New York City
27
Furthermore, this report serves as only an introductory statement.
Impact of Programs on Henry Street Settlement
28
Of necessity, it must focus upon Social Security services. But many
Impact of Programs at Hudson Guild
29
other issues related to social services for older Americans also deserve
Impact on JASA Community Service Program
31
Part 4: Recommendations
33
consideration and should receive careful inspection at this critical
Recommendations-Immediate.
33
time in the development of social services for all older Americans
Recommendations-Long-Range
34
who need them.
Minority Views of Messers. Beall, Hansen, and Percy
37
Finally, a word of thanks should be given to the National Council
Individual Views of Mr. Fong
43
on the Aging, which provided useful information about the pervasive-
APPENDIXES
ness of the immediate problem described on the pages that follow. In
Appendix 1:
addition, the NCOA authorized its Public Policy Specialist, Mrs. Jane
Relationship Between Older Americans Act and Social Security
Bloom, to write the excellent paper which serves as Part 2 of this
Services
45
Older Americans Comprehensive Services Amendments of 1972
45
report. Another essential task was performed by Mr. Peter Dickinson,
Appendix 2:
former editor of Harvest Years and now consultant on aging. On
Report by the Georgia Department of Human Resources
49
short notice, Mr. Dickinson agreed to make field visits and take other
Attachment A-Actual Title XVI losses (for elderly)
52
actions which enabled him to make the report which appears as Part 3.
Attachment B-Potential Title XVI losses (for elderly)
53
Appendix 3:
Thanks to them and Committee staff, the report will be published
Material Related to Revenue-Sharing.
54
early enough for its recommendations to receive attention while there
Item one: Letter by Dr. Arthur Flemming to National Organi-
is still time to act on them.
zations and Resultant Joint Letter
54
Senator EDWARD M. Kennedy,
Item Two: Summary of Replies to Committee on Aging Question-
naire
58
Chairman, Subcommittee on Federal, State, and Community
A. Cities in which no specific allocations have yet been made
58
Services; Special Committee on Aging.
B. Cities in which some allocation has been made
58
C. Cities with large-scale proposals for future use
59
Item Three: Article by Walter Heller, from Wall Street Journal,
February 22, 1973
59
Appendix 4:
Service programs for families and children and for aged, blind, or
disabled individuals: Titles I, IV (Parts A and B), X, XIV, and
XVI of the Social Security Act (From the Federal Register, Vol. 38,
No. 32, February 16, 1973)
62
(VII)
93D CONGRESS
SENATE
REPORT
1st Session
No. 93-94
THE RISE AND THREATENED FALL OF SERVICE
PROGRAMS FOR THE ELDERLY
MARCH 28, 1973.-Ordered to be printed
GERALD FORD LIBRARY
Mr. Kennedy, from the Special Committee on Aging, submitted the
following
REPORT
together with
MINORITY AND INDIVIDUAL VIEWS
PART 1
INTRODUCTION
A major new threat to the orderly development of social sevices
for older Americans was announced on February 16, 1973, by Health,
Education, and Welfare Secretary Caspar Weinberger.
He proposed new regulations which would drastically curtail the
practical usefulness of the social services provisions in Titles I, IV,
X, XIV and XVI of the Social Security Act. These federally-sup-
ported programs have not only helped to meet present needs, but have
served as an essential component of truly comprehensive service net-
works of the future.
HEW's proposed action-when added to a $2.5 billion ceiling and
narrowed eligibility requirements voted by the Congress last year
with enthusiastic administration encouragement-threatens to undo
progress made slowly since 1962.
It was in that year that the Social Security Act 1 was amended in
order to authorize Federal support for services not only to present
welfare recipients, but to potential and past clients.²
1 Changes in welfare-or old age assistance-laws are usually made through amend-
ments to the Social Security Act. Hence, the service programs authorized for old age
assistance recipients are usually referred to as Social Security Service Programs and
will so be designated in this report.
2 The significance of this provision to the elderly was described by Ellen Winston,
former Commissioner, Welfare Administration, Department, HEW at a speech before
the Gerontological Society in 1968. She said:
"Actually, there are very few former recipients of old age assistance, since one
of the characteristics of the program is that once on the program, the older person is
unlikely to have a change in circumstances which would make him ineligible *
On the other hand, for persons with low incomes between 65 and 70 years of age not on
assistance, the chances of requiring old age assistance and/or social services with
advancing age are substantial. The trend in the public social services today is toward
services that will be not only located close to where large concentrations of individ-
uals needing such services live but also that they will be available to persons at all
social and economic levels. The importance of the definition of potential becomes impor-
tant because if a State should expand its service program to include potential need
for old age assistance, well over half of all elderly people might be assumed to fall
within present and potential groups of beneficiaries of over 10 million older persons."
83-010 o 73 2
(1)
FORD
2
3
GERALD
LIBRARY
The driving concept for such broadened eligibility-as far as the
programs that were being planned to provide much-needed
elderly were concerned-was to provide practical help that would en-
services to Georgia's residents may never be implemented-
able old persons to take care of themselves right in their own homes,
particularly at levels required to make significant impact
unless they were absolutely in need of institutional care.
on the needs of Georgia's some 368,000 elderly residents over
Another major purpose was to break patterns of withdrawal that
age 65.3
lead to isolation and chronic emotional or physical ailments. It was
-In Pennsylvania, State officials report these facts: 1.2 million
felt that services could thus help prevent many of the problems that
elderly (aged 65 and over) reside in Pennsylvania; 24 percent are
take a heavy toll both in human misery and in the use of public funds.
below the poverty level, but only 5 percent receive old age assist-
States put the Social Security funds to widely varying uses, but
ance. Approximately 70 percent of the elderly currently receiving
by 1972 there was strong sentiment for cost controls because of
social services are non-welfare recipients; with the new eligibility
the "open-ended" nature of the Federal share.
restrictions approximately 20,000 older persons, who are poor but
Nevertheless, actions taken in 1972 and now in 1973 have gone
not on welfare, will be excluded from receiving social services.
Pennsylvania now provides services under contracts which are
too far in the opposite direction.
out of compliance with the new HEW regulations. Members of
Even before the proposed regulations were announced, wholesale
its Congressional delegation have introduced legislation-in-
cutbacks were causing major problems.
tended to relieve Pennsylvania and other States from making a
-One of the early effects was denial of services to many elderly
harsh decision suspending services which officials know are vitally-
who otherwise would have been able to avoid dependency status.
needed, or asking an already strained State budget to find fund-
-Incongruous interpretations of the stricter eligibility require-
ing. At the moment, there is no assured source of State funds in
ments have resulted in confusion and dwindling utilization of
sight.
services.
-In some States, programs which had been ready to take the next
All of the examples given thus far in this report (and those de-
steps in extending services are already endangered or curtailed.
scribed in more detail in Part 2) occurred before Secretary Weinber-
Washington State, for example, had hoped to put a project called
ger announced the proposed regulations on February 16.
DARE (Diversified Activities and Recreation Enterprises) on
Those regulations, however, are certain to accelerate the disin-
a statewide basis. Since November 1971, DARE had served an
tegration process, because they would
average of about 2,000 aged, ill, and handicapped residents of
some 20 skilled nursing homes and intermediate care facilities.
-More closely define a "potential" welfare recipient in terms of
Monitoring teams have reported that the program helps the
income and assets. Income could not exceed an amount one third
nursing staff by enabling them to concentrate more on medical
above a State's level of eligibility for receipt of financial assistance.
care; that it has given patients incentive to become interested in
Resources must not be greater than that amount allowed for fi-
the world around them; that it has actually lessened distribution
nancial assistance.
of tranquilizing drugs because of natural release of tension during
-Reduce the time of "past" welfare recipient to three months, and
activities; and that it "has publicized a new image of care facili-
"potential" welfare recipient to six months. Thus, for the elderly,
ties and increased recreational services in those facilities."
a potential recipient of welfare assistance would have to be a
Now, instead of going statewide, DARE is limited to two counties
person of at least age 641/2, whereas, under current law, persons
and is without an assured source of funding.
aged 60 can be considered as "potential."
-In Georgia, State officials had moved systematically since the 1967
-Eliminate sources of matching for the State and local share which
amendments to plan and administer a comprehensive program of
have been crucial in many areas. Donated private funds or in-kind
social services. The $2.5 billion ceiling came when Georgia was
contributions could not be considered as the State's share in claim-
providing over $79 million of social services to eligible Georgia
ing Federal reimbursement.
families and individuals of all categories; the ceiling reduced
-Create an entangling system of redtape which would obscure
that amount to $56.6 million and the new eligibility requirements
the purpose of social service delivery. Redeterminations of eligi-
reduced the number further. Many social service programs-such
3 Full text of a report from the Georgia Department of Human Resources appears
as the home health project described in Part 2 of this report-were
as Appendix 2.
threatened with discontinuation.
The Washington Post, in an editorial called "The Social Services Fund," on February
18, gave this estimate of the situation These regulations are a reversion, almost to the
A survey conducted late in December by the Georgia Depart-
point of parody, to the worst traditions of an ingrown and paternalistic bureaucracy.
A state can extend services to an individual person, under this program, only after a
ment of Human Resources noted:
social worker has drawn up a "service plan" for that person, proving his eligibility,
While the actual cutbacks in Title XVI aging programs
listing what services he is to receive, showing how they will lead to "goals" and setting
"target dates for goal achievement." Boom days are ahead for the paper industry and
have been acute, the potential impact of the revisions appear
for the legion of minor clerks who will crank the wheels inside this large new welfare
machine. But for that part of the population which is poor, and may actually need help,
to be of even greater magnitude. First of all, the advocates
the outlook is not SO jolly.
for elderly services under Title XVI were just initiating
As a budget device, the new regulations amount to impoundment by redtape. Although
the authorization is $2.5 billion, Mr. Nixon's budget provides only $1.9 billion for it
major programs at the time that the Revenue Sharing Act
next year. The administration is clearly counting on the weight of the regulations to
prevent the states from obtaining their full allotments.
restrictions were enacted. This, in effect, has meant that many
4
GERALD FORD LIBRARY
bility would now be made quarterly for the current welfare recip-
ient, within three months for the "past" recipient, and within SIX
PART 2
months for the "potential" recipient.
The Subcommittee on Federal, State, and Community Services
SOCIAL SERVICES FOR THE ELDERLY-EVOLU-
of the Senate Special Committee on Aging believes that the pro-
TION, UTILIZATION, AND COMPLICATIONS
posed regulations are unwarranted and dangerous.
As explained in Part 1, the immediate issue on social services for the
Social Security services were meant to mesh with those pro-
elderly is the promulgation of regulations which would seriously cur-
vided by the Older Americans Act (see Appendix 1 of this
tail the usefulness of Social Security services for the elderly.
report). At a time when the Older Americans Act is about
The full significance of these regulations-and the $2.5 billion ceil-
to be extended and probably broadened considerably, whole-
ing and new eligibility requirements voted as part of the Revenue-
sale cutbacks elsewhere are unfortunate and will, in the
Sharing Act last October-cannot readily be understood without fur-
long run, prove costly.
ther discussion of the origins of the Social Security services funding
In addition, services now provided to older Americans from
authorization, the utilization patterns that were developing at the time
other sources-such as the Office of Economic Opportunity
the Revenue-Sharing Act was passed, and current complications.
and the model cities program are now endangered. To cut
The following account* gives details on these matters.
Social Security services at this time is to invite rapid disin-
I. Origins
tegration of community resources that have been many years
The original Social Security Act of 1935 did not specifically recog-
in developing.
nize "social services" as a program for which Federal funding would
Furthermore, there is great danger that anticipated support
be available. Its objective was to assure security against the risks of
from revenue-sharing may not materialize, or arrive SO late
income loss caused by retirement; later, coverage was extended to in-
in the day that it will be necessary to start once more from
clude income protection against disability and death of the bread-
scratch.
winner. The absence of social services in the public assistance titles
What is vitally needed is a full-scale review of all sources of
reflected the thinking of the time that the limit of legitimate Federal
services for older Americans beginning with (1) interim ac-
concern rested with providing minimum income levels for persons not
tion to prevent abandonment of worthwhile projects that
able to earn a living.1
have been funded largely through the Social Security serv-
It soon became apparent, however, that the needs of many poor and
ice amendments and (2) detailed analysis of linkages be-
disabled recipients of financial assistance extended far beyond mone-
tween the Older Americans Act-when it is extended-and
tary payments. The aged faced such problems as living arrangements,
other endangered sources of services.
loneliness, the need for help with personal care, and a multiplicity of
other needs which money alone could not remedy; disabled and blind
persons faced comparable situations, complicated by their need for
specialized services not readily available for purchase. The State wel-
fare departments thus began to respond to these other needs in an in-
formal way, and gradually "social services" were incorporated as an
accepted part of State welfare programs.
In 1956, the Act was amended to make clear that the concept of ad-
ministrative costs included "services" provided by the State agencies.
The amendment was viewed by Congress not SO much as a change in
the law but as an endorsement of the existing practice of claiming Fed-
eral matching funds for social services to welfare recipients.²
A significant stride forward for these human services was made in
the 1962 amendments to the Social Security Act, when Federal match-
ing monies were made available for social services designed to prevent
or reduce dependency, help strengthen family life, or attain capability
for self-care and self-support. It had become clear that the availability
of various helping services to those who needed them-regardless of
*Prepared for this report by Mrs. Jane Bloom, Public Policy Specialist, the National
Council on the Aging.
1 National Assembly for Social Policy and Development, Redesign of the National Social
Services System, draft pamphlet, October 4, 1972, p. 4.
2 "Proposals for Limiting Federal Expenditures for Social Services", Congressional
Research Service, Library of Congress, August 23, 1972, p. 5.
(5)
7
6
persons who are at or near the dependency level. In effect, a city
their economic status-was a necessary ingredient of community life.
agency could run a homemaker program for the elderly serving
Moreover, it was found that such a social service network could pre-
only 50 percent actual Old Age Assistance recipients and 50 percent
vent poverty and help persons to live independently, rather than to be
marginal income "target area" residents deemed to be "near the
institutionalized at a much higher public cost. It was the growing rec-
dependent level."
ognition of this fact which led to the 1962 amendments.
Under the 1962 amendments, matching was available for this
"Social Services" as now developed are authorized under the public
myriad of services on a ratio of 75 percent Federal funds to 25 percent
assistance titles of the Social Security Act: Title I-Old Age Assist-
State funds. Further, there had been no ceiling placed on the expendi-
ance; Title IV-Aid to Families of Dependent Children; Title X-
tures; funding was therefore referred to as "open-ended," whereby
Aid to the Blind; and Title XIV-Aid to the Permanently and Totally
Congress was authorized to appropriate as much money as needed to
Disabled. At one time, each State was required to administer a separate
match State expenses on a 75-25 basis. Although the law authorized
State plan for the aged under Title I, another for the blind under Title
the HEW Secretary to prescribe limitations with respect to certain
X, and still a third plan to serve the disabled under Title XIV. Con-
services, the amount of Federal funding for which a State could qualify
gress recognized the inefficiency, the duplication of efforts, and the
had been essentially a function of its willingness to raise the 25 percent
added administrative costs of maintaining three distinct programs for
non-Federal share and its ingenuity in designing or redesigning pro-
adult recipients. Accordingly in 1962, Congress enacted Title XVI
grams that could qualify as "social services."
("Grants to States for Aid to the Aged, Blind or Disabled, or for such
Aid and Medical Assistance to the Aged") which enables States to
The Department of Health, Education and Welfare's Social and
operate a "combined adult program" with attendant savings in admin-
Rehabilitation Service, the agency with responsibility for these
istrative costs. Although about 40 percent of the States have adopted
social services, estimated that 1.9 million adults received one or
Title XVI, the remainder continue to provide services to the aged
more social services during 1972 under Titles I, X, XIV, and XVI.⁴
through the other adult titles.⁸
Because some States have been more aggressive and imaginative
in obtaining these funds than others, there have been large dif-
II. Social Services Provisions for the Elderly
ferences among States in the amounts spent per recipient. Alaska,
The primary purpose of the Act's social services program for adults
for example, spent about $1,397 annually per welfare client for
is to reduce dependency and promote the opportunity for independent
social services, while New York spent $242 and Mississippi spent
living and self-support to the fullest possible extent. In the case of
$7.5
the elderly, such services are also intended to support a variety of liv-
ing arrangements as alternatives to institutional care. Certain kinds
Without a ceiling, Federal expenditures for social services have in-
creased at a dramatic rate. In fiscal year 1969, HEW distributed $354
of services must be provided by every State to meet these requirements
million for the program; in 1970, the cost rose to $522 million, and in
while other kinds are optional. Overall, there had been a large area
of discretion at the State level with regard to the extent and kinds of
1971 to $746 million.⁶ The Federal spending in fiscal 1972 more than
doubled that of 1971, for a total of $1,546,756,000; of this total, ap-
services which might be offered.
Mandatory services for the aged, blind, and disabled, include: in-
proximately $439,200,000 were spent under the aged, blind, and dis-
abled categories.⁸ Further, if the fourth quarter rate of social services
formation and referral without regard to eligibility for assistance;
spending for fiscal 1972 were annualized, the total Federal amount
protective services; services to enable persons to remain in or to return
to their homes or communities; supportive services that will contrib-
would approach the $2.5 billion mark.
ute to a "satisfactory and adequate social adjustment of the individ-
III. New Restrictions for Social Services
ual"; and services to meet health needs.
The main focus of debate surrounding the social services pro-
Optional services which States may elect to include in their State
gram has been on the funding mechanism discussed above, not on
plan for the aged, blind and disabled encompass three broad cate-
the validity of the services themselves. The funding is constructed
gories: services to individuals to improve their living arrangements
in such a way as to eliminate executive and congressional control
and enhance activities of daily living; services to individuals and
over either the allocation or the dollar amounts involved, result-
groups to improve opportunities for social and community participa-
ing in this rambling, unplanned, and unevaluated growth.
tion; and services to individuals to meet special needs.
Former Secretary Richardson testified in this regard
Until recently, States have also been allowed great leeway in
determining categories of eligibility to receive these mandatory and
we have no good way to this point of ascertaining the
optional services. In addition to all aged, blind or disabled persons
effectiveness of the expenditures
We are convinced in
who presently receive welfare payments, the State could elect to
a vague sort of way it is a good thing but we have no clear-
provide services to former recipients of financial assistance or to
cut way of determining whether or not and to what extent
potential welfare recipients; this latter category included persons
we are getting our money's worth.9
who are not money payment recipients but are eligible for Medicaid,
4 John Twiname, Social and Rehabilitation Service Administrator, in letter to Senator
persons who are likely to become welfare clients within 5 years, and
Frank Church, January 11, 1973.
John Iglehart, "HEW Program Doubles in Size as Officials Scramble to Check its
Growth," National Journal, Vol. 4, No. 25, June 17, 1972, p. 1007.
3 Jane Bloom and Robert Cohen, Social Services for the Elderly: Funding Projects in
Senate Committee on Finance, Hearings on Revenue Sharing, July 20, 1972.
Model Cities Through Titles I and XVI of the Social Security Act, National League of
7 Ibid.
Cities and National Council on the Aging, July 1972, p. 10.
Twiname, January 11th letter to Senator Church.
Senate Appropriations Committee, Hearings on 1971 HEW Budget, p. 1942.
8
9
The Senate Appropriations Committee took action on the measure,
child in foster care could be provided to persons formerly on
adopting a $2.5 billion ceiling for social services within the 1973 HEW
welfare or likely to become dependent on welfare as well as
appropriations bill (H.R. 15417). Although the ceiling was not ap-
present recipients of welfare. At least 90 percent of expendi-
proved by the House-Senate Conference Committee, the Committee's
tures for all other social services, however, would have to be
report stated that "the conferees agreed with the basic premises of the
provided to individuals receiving aid to the aged, blind, and
Senate amendment: (1) to insure fiscal control over a program which
disabled or aid to families with dependent children. Until a
is presently increasing at an alarming rate and (2) to insure that
State reaches the limitation on Federal matching, 75 percent
funds are disbursed prudently and effectively." The report further
Federal matching would continue to be applicable for social
instructed HEW to submit a comprehensive plan for controlling
services as under present law.
these costs.
IV. Effect of Changes
President Nixon vetoed the bill in August, 1972, stating:
The new law means that Federal funding of social services under
Elementary fiscal responsibility demands that this loophole
Titles I, IV, X, XIV, and XVI of the Social Security Act is now
for unlimited Federal funds for undefined (social) services
limited to no more than $2.5 billion per year-fully eliminating the
must be closed now. The Congress must harness this multi-bil-
open-ended basis for the program. The amount allotted to each State
lion-dollar runaway program by enacting a social services
is based on population; thus a State which has 10 percent of the na-
spending ceiling." 10
tional population would have a limit on social services funding equal
The social services controversy continued to rage during congres-
to $250 million (10 percent of the total ceiling). It should be noted,
sional consideration of the Social Security Amendments (H.R. 1)
however, that no dollar amount by category is mandated within
and the Revenue Sharing Act (H.R. 14370) in the fall. Several news-
the ceiling, e.g., a State which receives $250 million in Federal fund-
papers termed the open-ended program "back door revenue sharing"
ing may spend what it wishes for services to the elderly under its
and the "$5 billion error." It was unfortunate indeed that the total
Title I or XVI program. The elderly could receive all or none of the
facts about the program-its merits as well as its drawbacks-could
$250 million, based on State discretion.
not be provided in the midst of such one-sided publicity. Senator Roth
The Federal allotments by State for fiscal years 1973 and 1974 are
well summarized the situation:
as follows: 13
At this time, there is no single person or agency who knows
Federal allotment for fiscal years 1973 and 1974
how many State programs are being financed under social
Total
$2,500,000,000
Missouri
$57,063,250
services; similarly, nobody knows exactly what the State
Montana
8,632,000
programs are.
Alabama
42,140,000
Nebraska
18,308,750
I consider this program too important for a decision
Alaska
3,901,750
Nevada
6,327,000
as to its future to be based solely on personal conjecture or
Arizona
23,351,250
New Hampshire
9,256,500
Arkansas
23,747,250
New Jersey
88,446,250
speculation.11
California
245,733,250
New Mexico
12,786,000
The final decisions made about the social services program did,
Colorado
28,297,500
New York
220,497,250
Connecticut
37,001,750
North Carolina
62,597,750
however, in the end rest largely on speculation. With regard to
Delaware
6,783,250
North Dakota
7,587,500
the elderly, HEW remains unable to provide a categorical break-
District of Columbia
8,980,250
Ohio
129,457,750
down by State for expenditures to date, annualized fourth quar-
Florida
87,149,500
Oklahoma
31,623,000
ter rates by categories, and amounts received by recipients. This
Georgia
56,667,000
Oregon
26,196,500
Hawaii
9,712,500
Pennsylvania
143,180,250
information, as SRS Administrator Twiname recently wrote, is
Idaho
9,076,250
Rhode Island
11,621,500
"not available under (HEW's) present reporting system." 12
Illinois
135,076,500
South Carolina
31,995,250
Indiana
63,522,250
South Dakota
8,152,000
A number of new restrictions, including a $2.5 billion ceiling, were
Iowa
34,612,500
Tennessee
48,395,000
thus enacted on October 20, 1972 as part of the Revenue Sharing Act
Kansas
27,109,000
Texas
139,854,750
(P.L. 92-512). The language in the conference report read:
Kentucky
39,607,000
Utah
13,518,500
Louisiana
44,661,250
Vermont
5,546,750
Under the substitute, Federal matching for social services
Maine
12,354,000
Virginia
57,195,250
under programs of aid to the aged, blind, and disabled and
Maryland
48,695,250
Washington
41,335,750
aid to families with dependent children would be subject to a
Massachusetts
69,477,000
West Virginia
21,382,250
Michigan
109,036,000
Wisconsin
54,265,750
State-by-State dollar limitation, effective beginning with
Minnesota
46,774,250
Wyoming
4,142,000
fiscal year 1973. Each State would be limited to its share of
Mississippi
27,169,000
$2,500,000,000 based on its proportion of population in the
NOTE: With respect to fiscal year 1973 only, each allotment set forth above will be
United States. Child care, family planning, services provided
adjusted as provided in section 403 of Public Law 92-603, 86 Stat. 1487, SO that the State,
for the first quarter of Fiscal Year 1973, will receive Federal grants in amounts deter-
to a mentally retarded individual, services related to the treat-
mined under applicable provisions of the Social Security Act (without regard to section
1130 thereof), but not to exceed $50,000,000. In no case will a State receive less than
ment of drug addicts and alcoholics, and services provided a
the allotment set forth above.
House Document 92-343.
11 Senator Roth, "Social Services Program," Congressional Record, Sept. 7, 1972,
13 Federal Register, Vol. 37, No. 252, Dec. 30, 1972.
p. S14259.
12 Twiname letter to Senator Church, January 11, 1973.
83-010 73 3
10
11
Although many believe that an overall $2.5 billion ceiling is a sound
Age Assistance recipients) and only up to 10 percent on past or po-
concept, these same supporters have raised four major questions with
tential recipients. There are six categories which are exempt from
regard to the limit:
this 90-10 welfare/non-welfare eligibility ratio, but services to the
-First, criticism has centered on the allotment formula itself; in-
elderly are not among the exempted categories.
stead of distributing the monies on the basis of straight popula-
Thus, services to the aged are subject to the stipulation that at
tion, it is strongly felt that the formula should reflect the more
least 90 percent of the funds be expended on behalf of elderly
concentrated needs of urban areas and those with larger propor-
welfare recipients.¹⁶
tions of low-income residents.
As a result of the new 90/10 eligibility restrictions, many senior
-A second criticism lies with the reallocation procedures. During
centers and other providers of service have been cut off from funding
Senate consideration of the ceiling, Senators from urban States
by their State welfare departments. One recent letter stated
were successful in gaining approval of an amendment which pro-
vided that any portion of a State's allocation which was not used
Your contract is hereby terminated.
It is our under-
would be distributed among the other States. This provision was,
standing that approximately 50 percent of the clients served
however, eliminated by the House-Senate conferees; as a result,
in your program are recipients of public welfare. We will be
any portion of the allocation which a State does not seek will
glad for you to
determine if a new program proposal
revert to the Treasury. For example, if a State uses only $100 mil-
can be developed SO that we can limit our purchase of service
lion in Federal funding of its allotted $150 million, the $50 million
to the (welfare) recipient.
"surplus" cannot be carried forward into a future fiscal year nor
Several such agencies are protesting the new eligibility requirements
can it be redistributed to other States which exceed their limits.¹
and refusing to submit adjusted program proposals for continued
-The third criticism concerns the retroactive imposition of the ceil-
funding. In New York City, for example, the program's administra-
ing, which further worsens the impact of the new restriction. Be-
tor has recommended that the $6.7 million of Title XVI monies for
cause there is no "hold harmless" provision, States which have
senior centers be forfeited if HEW persists in this "new means test. 17
incurred service expenditure obligations in the time frame July-
Because only 20 percent of the city's 70,000 senior center members have
October, 1972, are solely responsible for these obligations to the
been welfare recipients, State and local financing is being urged to take
extent that they exceed the new ex post facto formula allocation.
the place of Federal Title XVI money in an effort to prevent the "tear-
It is felt that allowances should be built in SO that the limits,
ing apart" of the centers.
retroactive to July 1, 1972, do not require agencies now spending
The full impact of the new restrictions is yet to be realized.
at higher levels to decimate their programs later in the fiscal year.
Some agencies providing these social services have been given
-Lastly, the provision does not contain a State-to-local allocation
short-term "reprieves" while new funding sources are sought or
formula and actually has no language mandating State pass-over
new proposals written. And, because of the poor accounting pro-
to localities. In effect, cities with enormous social service outlays
cedures, it has proved impossible to obtain a listing of all Titles I
have no guarantee that their States will pass any of the State
allotment on to them; the States will receive their share based on
and XVI projects now in operation throughout the country; thus
any thorough analysis of these projects' fate cannot be accom-
population, but the cities will not receive funding on the same
plished. Whether elderly programs are being hurt more by the
basis. It is thus feared that the cities' allotment will be highly
new 90-10 eligibility criteria than the ceiling is still a matter of
arbitrary, giving excessive consideration to political elements in
conjecture.
the State.
While only five States 15 will receive fewer Federal dollars un-
Several social services projects which have recently been curtailed
der the new ceiling than they received in fiscal 1972, it is important
are summarized in Part 3 of this report to better acquaint the reader
to point out that many more States will receive less than their
with the effects that the new law has had upon both the agencies in-
fourth quarter annualized rate of spending. And almost all
volved and their elderly users of service.
States which had just begun to realize the potential of the Titles I
V. HEW's Proposed Social Services Regulations and Other Com-
and XVI program for the aged will find their expansion plans
plicating Factors
thwarted.
On February 16, 1973, HEW's Social and Rehabilitation Service
Another newly enacted provision limits the eligibility for these serv-
issued proposed regulations which explain how the new law will be in-
ices. As reported earlier, any program which had provided services
terpreted and implemented by the State welfare agencies.¹⁸
to past, present, or potential welfare recipients were eligible to re-
16 The 90/10 Rule need not apply to each individual services program, like Senior Center
ceive funding; now 90 percent of the allocated Federal matching
Services, but rather applies to a State-wide average for all services and client groups
(except the 6 groups exempted from the 90/10 rule). Thus, some projects could have 100%
dollars must be spent on current welfare recipients (in this case, Old
welfare recipients and other projects only 50%, providing that the State-wide average
is 90/10. In light of the paper work involved, however, it seems likely that States will
opt for an across-the-board 100% participation for welfare clients and none for others.
14 The state will continue to be eligible, however, for its full $150 million in future years
If it increased its expenditures.
17 Jule Sugarman, "New U.S. Senior Center Rule Decried," New York Times, January 18,
1973.
15 Alaska, Delaware, Washington, New York, and the District of Columbia.
18 See Appendix 4, for full reprint of February 16 Proposed Regulations.
12
13
By curtailing the program's scope, restricting the use of private
A general tightening of reporting requirements has also been pro-
monies, and further limiting the number of persons eligible, the
posed. Quarterly recertification of applicants, instead of the previous
HEW proposal-if finalized-will most certainly keep Federal
yearly recertification, to establish eligibility for services is one such
outlays for social services well below the $2.5 billion ceiling estab-
requirement. Another is found in § 221.8 of the proposed regulations
lished by Congress; it seems likely, in fact, that only $1.7 billion
entitled "Individual Service Plan". Basically the section will mean
will be allowed to be spent through the administration's
that no elderly person can receive any services until a social worker
regulations.
has drawn up a "service plan" for him. The plan lists services that will
The most controversial stipulation in the proposal is the denial of
be received, proves eligibility for the services, explains how the serv-
the use of donated private funds or in-kind contributions as the State's
ices will lead to "goals"," sets "target dates for goal achievement, and
share in claiming Federal reimbursement. Private funds, such as those
presents the extent and duration of the provisions of each service. To
gathered from community drives, have been widely utilized in several
make matters worse, the person's plan must be reviewed at least every
States for matching purposes on a 75-25 ratio. A local United Way, for
6 months, more often if necessary.
example, was able to donate $100,000 for expansion of senior center
A recent newspaper editorial called these reporting restrictions "a
services; the city or State could then apply to the Federal government
reversion, almost to the point of parody, to the worst traditions of an
for $300,000 in matching funds for the center expansion, receiving back
ingrown and materialistic bureaucracy," adding:
a total of $400,000. It has been estimated that private donations of this
Boom days are ahead for the paper industry and for the
sort totaled roughly $150 million a year. 19
legion of minor clerks who will crank the wheels inside this
Federal officials have argued, however, that the money is not really
large new welfare matching. But for that part of the popu-
"donated" to the State, but rather it has become a bookkeeping trans-
lation which is poor, and may actually need help, the outlook
action to get more Federal aid.2 In response to this proposal, forty-six
is not so jolly.²
Senators wrote HEW Secretary Weinberger:
Two other elements in the proposal deserve mention. First, social
This proposed change would seriously undermine the excel-
service programs cannot pay for the subsistence needs of the poor in
lent private-public partnership approach to human problems
institutions nor can they finance medical care. Second, if the regula-
that now exists.
These kinds of cooperative efforts
tions are finalized, States will have to expand existing activities to
should be encouraged rather than discouraged.21
claim Federal funds and cannot reorganize activities under the welfare
Although Federal matching for private funds is disallowed, it should
department for the same purpose. Presumably, this regulation would
be noted that State and local government money can still be used as the
eliminate abuses in which States had received social service grants and
25 percent non-Federal share.
then applied the funds to other uses or paid for existing State pro-
Another proposed alteration affects mandated and optional services.
grams by shifting them to the State welfare agency.
The number of required services has been reduced and the number
In a news briefing on the proposal, HEW Secretary Weinberger
of optional services increased. Each elderly recipient must be provided
said that the intent of the regulations is to give the States greater free-
with at least one of the following defined services "which the State
dom to focus the pared Federal funds on welfare recipients.
elects to include in the State plan": chore services, day care for adults,
"We are saying," added Philip Rutledge, acting administrator of
education services, employment services, foster care for adults, health-
the Social and Rehabilitation Service, "that since there is a ceiling
related services, home delivered or congregate meals, homemaker serv-
and States have to be more careful, we are trying to give them more of
ices, home management and other functional educational services,
an option." 25
housing improvement services, protective services for adults, special
Whether the aged get any of the funds allotted is one such option
services for the blind (of whom approximately 50 percent are over the
left to the States; another, previously discussed, is which services the
age of 65) and transportation services.²²
elderly will get if the State does elect to include them.
The definitions of "former" and "potential" recipients also have
Elizabeth Wickenden, professor of urban affairs at the City Uni-
been substantially changed in the draft regulations. The definition of
versity of New York, termed this aspect of the proposal as consistent
"potential" welfare recipients has been altered to "persons who are
with the current philosophy of the Administration: "They have on
likely to become welfare recipients within six months," instead of the
one hand loosened up insofar as the State decision-making is con-
previous definition of five years. This regulation-if finalized-would
cerned.
And on the other hand they've tightened eligibility on
disentitle persons under the age of 641/2 from receiving social services
who can get the service." 26 The proposal is also in line with the ad-
under Titles I and XVI. "Former" welfare clients will qualify for
ministration's philosophy on Federal spending; it is virtually certain
only three months instead of two years.
that the redtape imposed on the States through the regulations will
prevent them from obtaining their full allotments.
19 "HEW Is Planning Changes in Matching Grants for Social Services," New York Times,
February 13, 1973.
20 'Welfare Spending Would Be Curbed Under HEW Plan," Wall Street Journal, Feb. 16,
23 In the case of adults, the specific goals to be achieved are limited to the following:
1973.
to achieve and maintain personal independence, self-determination and security, including
21 Austin Scott, "HEW Defends New Cutback Rules," Washington Post, February 16,
the achievement of potential for eventual independent living.
1973, p. 1.
24 "The Social Services Fund," The Washington Post, February 18, 1973.
22 221.5. Statutory requirements for services, "Services Programs for Families and
25 Austin Scott, "HEW Defends New Cut-Back Rules," The Washington Post, Febru-
Children and for Aged. Blind, or Disabled," Proposed Rule Making, Federal Register,
ary 16, 1973.
Vol. 38, No. 32, Feb. 16, 1973, p. 4609.
26 Austin Scott, "Cutbacks Planned in Social Services," The Washington Post, Febru-
ary 12, 1973.
14
The public will have until March 19th to make comments, sug-
gestions, and objections to the draft proposal 27 before it is issued
in final form. HEW is aiming for an effective date of April for
most provisions although some would take effect earlier.
PART 3
VI. More HEW Rulings
WHAT IS HAPPENING TO PEOPLE
Another HEW restriction is likely to further limit Federal funding
in an effort to tighten the policing of eligibility requirements. The
New restrictions on social services under the Social Security Act
December 5, 1972, Federal Register published HEW draft regulations
have been in effect for only a few months. (See Parts 1 and 2 for
which, if finalized, will withhold $223 million in matching funds for
details.)
the last half of fiscal year 1973 and $456 million for fiscal year 1974
And yet, the Senate Special Committee on Aging has already
as penalties for ineligible or overpaid welfare recipients. The amount
learned of situations under which the cutbacks are causing hardships
withheld will be in proportion to the percentage of ineligible or over-
and difficulties which may well prove to be costly exercises in false
paid recipients found on each State's rolls as determined by a scien-
economy.
tific sample.
On the following pages, a sampling of such situations is provided.
If totally successful, the program would eliminate about 700,000
It is based upon field visits, interviews, and telephone conversations.
persons now receiving Aid to Families with Dependent Children
(Title IV) and another 147,000 aged, blind and disabled persons on
It should be remembered that the problems described in this
welfare rolls in twenty-one States.28 This regulation will also mean
part of the report were caused solely by the provisions of the law
that at least 90 percent of these 147,000 adults will become ineligible for
enacted in October. The new regulations announced in February
social services-since only 10 percent of social services funding can
by the Department of Health, Education, and Welfare would
be spent on "former" recipients.
certainly intensify such problems, should they become official
policy after March 19 unless successfully challenged.
ST Comments must be submitted in writing to the Administrator, Social and Rehabilita-
tion Service, HEW. 330 Independence Avenue, S.W., Washington, D.C.
I. MINNESOTA: IMPACT ON SENIOR CITIZENS CENTERS
28 Austin Scott, "31 States Hire Law Firm To Fight Welfare Cut", The Washington
Post, December 21, 1972.
OF MINNEAPOLIS, AND OTHER PROGRAMS
The program of Senior Citizens Centers, headquartered at 1505
Park Ave., Minneapolis, demonstrates the need and effectiveness of
social services for the elderly. Karl Dansky is Executive Director and
Robert Light is Director of Social Services.
The basic purpose of the agency is "to provide social, recreational,
and informal education opportunities to all members of the United
Fund Area sixty years and older, through nonsectarian day centers."
The headquarters is located in a public housing project for the
elderly and thus is accessible to a large number of clients. Its funding
is a good example of private donations at work; the project receives
its 75 percent Federal funding by utilizing the county's United Fund
monies as the 25 percent match.
In 1971 the United Fund and Hennepin County Welfare depart-
ment negotiated a Purchase of Service contract. This contract made
it possible for Senior Citizens Centers ("SCC") to provide a pro-
fessional worker for every 500 apartment units. The SCC has put
most of the purchase of service budget into line staff where it would
directly benefit the elderly. Last year it cost SCC about $55 per apart-
ment unit to provide a social worker, a para-professional group
work assistant, and supportive office and administrative staff. This
year it would cost closer to $60 per unit.
During the past years the SCC staff has worked to develop significant
services to enable the elderly to remain independent. Some services are
provided at no cost to seniors. For example:
1 Prepared by Mr. Peter Dickinson, former editor of Harvest Years and now a writer
and consultant on aging.
(15)
16
17
Sears and National Stores provide free portal-to-portal bus shop-
Two OTHER PROGRAMS IN JEOPARDY
ping service each month for nearly 1,500 elderly.
Bob Light of SCC worked out a proposal with the City Relief
Two programs of the Ebenezer Society, a Minneapolis based non-
Department to sell food stamps in all elderly hi-rise housing.
profit society owned by 46 member congregations of the American
Lutheran Church, are in jeopardy because of the funding ceiling and
Through close cooperation between the SCC and the Public
eligibility restrictions. They are:
Health Nurses, over 2,000 persons are receiving preventive health
1. The odel City Protective Service Project is a three-year research
care. The nursing service alone makes significant dollar savings
and demonstration project funded by HEW, administered by the
for the Federal and local governments.
Minnesota Governor's Council on Aging, and operating partially on
For instance, Bob Light tells of the diabetic lady who needed insulin
private funds.
injections. At most this would require about 5 minutes of professional
The purpose of the project is to act as surrogate or guardian for
attention. If the lady had to go to a nursing home or to hire a nurse
those elderly who might be physically or mentally unable to manage
for the injections, the cost would be prohibitive. However, a social
their own affairs. Often, this involves some substantial sums of money
coordinator at the SCC found a retired nurse who gave the necessary
that might be in danger. In one case, the project was able to provide
injections free of charge.
guardianship for a lady whose attorney was milking her of some
In another case, a lady who needed an enema called up the Public
$22,000.
Health Service and was told that it would cost $16 to receive one. But
In another case, a lady had all the assets in her name, but seemed
an SCC social coordinator was able to find a nurse who showed the lady
likely to be survived by an invalid husband. A probate judge sug-
how to administer the enema herself, thus saving the county consider-
gested joint tenancy with survivorship rights so the estate would not
able expense.
shrink before it reached the bereaved husband (who would have to
If these and other elderly had to go to a nursing home (cost $14 to
rely on welfare during the probate period). Joint tenancy was
$22 a day) to receive five minutes of treatment, it would cost the county
achieved; the lady did die; and the transaction of the estate to the
far more than the $50 per apartment unit per year which the SCC
husband was automatic and immediate, without probate or welfare.
charges.
At one time Edward L. MacGaffey, Director of Protective Services,
However, Karl Dansky, Director, recently wrote in a letter to the
had two full-time social workers and one lawyer and consulting psy-
National Council on the Aging: " the language in the Revenue
chiatrist, plus a secretary. The program was running about $60,000
Sharing Bill, by not exempting services to the elderly, completely
a year.
nullifies our project.
The services provided kept many people from losing all their money
"Our project, we believe, successfully demonstrates
or going on welfare. But without funding and with the eligibility
that a nonprofit agency could successfully utilize United
restrictions, many elderly who need this service would have to go on
Fund matching funds to provide social group work and
welfare.
information and referral services to 7,000 elderly resi-
2. Maintaining the Growing Edge is a creative mental health and
dents of public housing and their neighbors
rehabilitation program aimed at enabling older people to regain their
mental and emotional awareness and allowing them to function as re-
"While this service was becoming more restrictive due to the
eligibility standards being imposed, at least. we were able to
sponsible, rational members in their own family or peer group. Fund-
attract the residents. Of these, 50 to 90 percent are potential
ing until now has been through a local fraternal organization. A grant
application for approximately $400,000 has been submitted to NIMH.
OAA or medical assistance clients. Now, by applying the new
restrictions we would be limited to serving only about 45
Thanks to a sensitive staff and creative therapy, the program has
percent of the residents, and that only by applying a means
brought many persons back to reality. For instance:
test.
Ninety-seven-year old Ole (not his real name) lived in a fantasy
"We are currently trying to impress the County Welfare
of memories and wandered frequently prior to the program. After
Department to accept a blanket coverage or else we will be
several months of treatment, he is able to accept and cope with
placed in a position of urging clients to go on the Welfare rolls
reality and accept the present.
against their wishes and at the taxpayer's expense. Also, many
--Eighty-six-year-old Stella was strong-willed, loud and tempera-
marginal residents may have to face institutionalization at
mental, and extremely self-centered. Now she has a much brighter,
taxpayers' expense, too."
more controlled relationship with other individuals, and the
group, and has become a helpful, positive person.
On Thursday, Jan. 4, Mr. Dansky received word that the county will
-Tom and Kara (not real names) are in their seventies. They both
fund the program at the same level as last year, but that he won't be
able to add or increase services. In addition, he won't be able to fill staff
had become confused, disoriented, and out of touch with reality.
vacancies.
Because of the program, they have been able to return to their
He adds: "We'll also be spending a lot of money filling out papers to
home environment.
establish eligibility, rather than providing services."
18
19
While these programs have proven themselves, prospects for
34,327 persons were receiving OAA and medical payment, and some
continuing them are dim. Dr. MacGaffey said that the main hope
41,664 were receiving medical assistance alone. However, Mrs. Betty
for the Protective Service project was tendering it to the public
Breckinridge, Assistant Chief for Programs, Offices for Services for
welfare agency, but "at this point it looks hopeless because of
Aging of the Illinois Department of Public Aid, estimates that there
eligibility restrictions." The best hope for the mental health
are some 250,000 elderly in the State who live below the poverty line.
program is a grant from the NIMH, but this, too, looks bleak.
A recent study released by the Chicago Mayor's Office for Senior
The only other resource might be private money (foundations),
Citizens, shows that 26 percent of the people aged sixty to ninety-nine
but this may not be too feasible at this time.
in Chicago feel they do not have enough money to meet basic needs and
28 percent sometimes have to skip meals.
ELSEWHERE IN MINNESOTA
Other figures were equally depressing, yet 93 percent of the elderly
were qualified voters, and 95 percent voted in the 1968 Presidential
Programs that seem especially threatened on a State level are in-
election and 75.6 percent said they voted in the last primary. In Illi-
formation and referral services and health and welfare services.
nois, 25.3 percent of the voters are over age 60.
Especially affected would be Homemakers and Meals on Wheels pro-
grams as well as bus service to shopping centers.
How THE MAYOR'S OFFICE VIEWS THE SITUATION
Gerald A. Bloedow, Executive Secretary of the Governor's Citizens
Council on Aging, said that the State welfare department had pro-
About one-third of the elderly live in Chicago and about one-half
jected some $96 million for programs but will actually get only about
of Illinois' elderly live in the county area. Andree Oliver, Assistant
$46 million for adult services.
Director of the Mayor's Office for Senior Citizens, and Lillian Mavrin,
Eligibility restrictions are as important as the ceiling limit, says
Specialist in Aging with the Mayor's Office, expressed concern about
Rich Nelson, Assistant Director of the Social Service Division of the
threatened protective services for the elderly.
Department of Public Welfare. He points out that in one month
Although the Mayor's Office for Senior Citizens is primarily a
(May 1972) of 2,883 elderly receiving services, only about 1,322 were
planning and coordinating agency, it is also engaged in research and
receiving some sort of grant money. Health needs topped the list of
demonstration projects. One project-the Senior Central-has as its
services, followed by Homemaker-Housekeeping. protection, education
objective the development at the State level of adult social services
and training, family counseling. If there is no lifting of restrictions
under Title XVI.
or replacing of Federal funds. Mr. Nelson estimates that about 1,200
Mrs. Oliver and Mrs. Mavrin are concerned about the whole
of the elderly served during that month would be ineligible.
range of services to keep the elderly out of institutions-par-
On the State level, Mr. Bloedow reported that most revenue
ticularly Health and Homemakers programs. Said Mrs. Oliver:
sharing money would go to reduce taxes and to buy capital equip-
"Any cutback is a cutback from zero. Most victimized will not
ment for fire departments, etc. He said: "Any local community
be those persons on OAA but those who fall between. The biggest
must bring pressure and establish need to get money for social
need is for money to deliver services to the elderly. Also needed
services."
is transportation to take older people to services or services to
the elderly."
II. ILLINOIS: STATEWIDE IMPACT AND SPECIFIC
Mrs. Oliver and Mrs. Mavrin don't feel that revenue sharing will
EFFECTS IN CHICAGO
help much-that it might be an excuse not to fund programs.
The ceiling limit and qualifications restrictions under Title XVI
SERVICES FOR THE IMPAIRED ELDERLY: A PROGRAM IN JEOPARDY?
would seem to have tremendous impact on programs in the State of
Illinois.
"Services for the Impaired Elderly" is a joint venture of the Illinois
Robert Benson, Chief of the State Office of Social Services,
Department of Public Aid and the Council for Community Services
points out that in 1972 the State spent some $181 million on so-
in Metropolitan Chicago. It is designed to provide quality service
cial services, and the State estimated it would need some $211.6
(Homemaker-Home Delivered Meals, etc.) who without this service
million in 1973. But under the ceiling it expects to get only $115
might have little choice as to whether or not to enter institutional
million-requiring a cut of almost 50 percent.
care. To assure quality service, six voluntary and one public agency
have been directly involved in service delivery and research.
Mr. Benson says that persons most affected will be those under public
A three-year demonstration program, funded by the National In-
aid and mental health-and especially the impaired aged program.
stitute of Mental Health and the National Center for Health Services
Such programs have been providing services to many former and
Research and Development, terminated on August 31, 1972. The new
potential recipients, and the 90/10 eligibility requirements may cut out
program, funded under Title XVI of the Social Security Act began
many people from needed programs. According to recent figures, some
20
21
on September 1, 1972. The planning and research aspects of the dem-
especially the 90 percent quota of public aid clients. Right now only
onstration project will continue until March 1, 1973.
about 30 percent of the clients are on OAA."
This program offers the following services:
Both Miss Connolly and Miss Armbrust don't feel that revenue
sharing will help much. Like others, they feel that the money in the
Information, Referral and Brief Service
City of Chicago will go for police and fire equipment and salaries and
Casework Assessment
not for social services for the aged. However, she feels that revenue
Casework Counseling
sharing money might help some programs outside the City of Chicago.
Service Coordination
Also, Miss Connolly says that because of restrictions, programs
Medical and Psycho-Social Diagnosis
operating with Federal funding must lower their standards. She adds:
Home Health Care
"We don't want to get involved with government funds-that would
Financial Management
mean we'd have to curtail some programs."
Legal Guardianship
Other Legal Services
III. WASHINGTON, D.C.: THE THREAT TO COLUMBIA
Transportation
Cash for Emergencies
SENIOR CENTER
Volunteers' Services
Columbia Center is new: it opened on September 20, 1972 in order
Approximately 1,500 clients would be served, for whom approx-
"to enhance the mental and physical well-being of the elderly in Serv-
imately 8,000 units of service would be provided at a cost per unit of
ice Area #7 by providing them Social Services, Educational, and
$88.
Recreational opportunities."
Robert Adams, Assistant Executive Director of the Council for
These services include:
Community Services, says that he is most concerned about having to
Social Services: Crises intervention and advocacy; Homemaker serv-
renegotiate new funds in March, and the possibility of having to
ices; Housekeeping service; Private residential placement; Friendly
restrict client eligibility. He says that only 27 percent of active cases
visits; Food stamp and Social Security counseling.
are OAA recipients and 73 percent are borderline under the eligibility
Education: Handicrafts; Sewing; Reading; Drama; Spanish; Cre-
requirements, and this would require redrawing the whole program.
ative writing; First Aid; Library; Afro-American history; Dance;
"If we have to limit services to OAA recipients then persons would
Cooking; Group services for the blind; Physical fitness; Consumer
have to get on OAA to get services."
education; Talks; Painting.
He also said that it would be questionable if revenue sharing funds
Recreation: Trips; Parties; Bingo; Programs; Movies; TV; Pool;
would filter down to programs such as his. "If we must find fresh
Musicals; Singing; Games; Ivakota Farm Retreat (year-round trips)
money, there's no way for volunteer agencies. We should be able to take
Special monthly programs with local artists.
present money and be able to get matching funds on that and be held
Special Services: Legal service; Beauty service; Employment;
accountable for better services."
Group shopping trips; Group check cashing.
The Services for the Impaired Elderly Project strives to ac-
The Columbia Center is located in the basement and ground floor of
complish three objectives: (1) extension of service to an especially
a renovated church, office, and apartment building. The quarters have
vulnerable group of people; (2) maximum leverage for the vol-
been completely renovated, with light, bright colors in the offices and
untary dollar; (3) the launching of a sophisticated service de-
activity rooms. It is clean, inviting, and certainly a haven for the pre-
livery system which maximizes public-voluntary agency coopera-
dominantly Black residents of the area. Some Spanish-speaking people
tion and integrates a variety of specialized services. Used as a
are in the area, and the Center has made some effort to include them
model project, it could set the stage for a statewide system of
in activities. A Spanish-speaking secretary at the Center (Mrs. Bertha
services to the aged.
Ramirez) has written letters and has translated for clients.
Columbia is administered by the Family and Child Services of
How SENIOR CENTERS VIEW THE SITUATION
Washington, D.C. Local Model Cities (HUD) monies were used as
the 25 percent match for the 75 percent Federal Title XVI funds. The
The Senior Centers of Metropolitan Chicago's programs-including
annual budget of $300,000 included start-up costs of some $18,000, and
an Outreach program of bringing services to the elderly-are financed
the Program Director, Mrs. Amy O. Green, feels that they could oper-
by corporate and community funds. However, Jane Connolly, Director,
ate on about $250,000 a year (which would just cover rent and
and Madeline Armbrust, Program Director, expressed concern for
expenses).
those protective services projects that are funded under Titles I and
Because of the Federal funding ceiling, the Center was notified that
XVI.
it would be closed down after March 1973. However, the Center has
In a letter to Mrs. Jane Bloom of the National Council on the
been granted a "reprieve" for the time being (details of the reprieve are
Aging, Miss Armbrust said: "The limitations of Title XVI could
discussed later in this report).
play some havoc with the Protective Services Project in Chicago-
At first reports of the threatened shut-down of the Center, Mrs.
Green organized a political-action group that circulated petitions in
83-010 4
FORD
23
22
RALD
English and Spanish in the neighborhood and enlisted the support of
Mrs. Clay participated in an African culture program, making banana
other centers. Petitions, letters, and other messages were sent to the
nut bread with the help of her granddaughter.
Mayor, Congressmen, and civil leaders. A protest demonstration was
All other persons using the Center that day, including those who
were White and not blind expressed similar gratitude for the Center.
planned but was called off.
While Mrs. Green feels that the petitions, letters, and threatened
One Spanish-speaking lady also offered praise (through the interpreta-
demonstrations were largely responsible for getting the new funding,
tion of the Spanish-speaking secretary).
William Whitehurst, Assistant Director for Planning of the Depart-
WHAT DOES THE CENTER MEAN TO THE COMMUNITY?
ment of Human Resources feels that his agency was on top of the
situation and its close contact with the Model Cities agency has been
As to the value of the Center to the community, Program Director
instrumental in getting the new funding.
Mrs. Green says: "If the Center would close many people would have
to go to nursing homes or to mental hospitals (some of the elderly
WHAT DOES THE CENTER MEAN TO THE PEOPLE?
using the Center are former mental patients; the Center helps these
Wednesday of each week is set aside for blind elderly. On one recent
people back into community life). Cutting the program builds wel-
Wednesday, about forty persons were using the center. With perhaps
fare. It's better to have healthy individuals than more welfare."
five exceptions, all were blind and Black; two were men, the rest
THE REPRIEVE: How IT HAPPENED-WHAT IT MEANS
women. There were three white women (not blind) in the group. Many
were making dust mops and other craft items.
As reported earlier, the Center was threatened with closing because
Statements of some of the elderly using the Center indicate what it
of lack of funds, and the Center formed a political-action group to
means to them:
write letters, sign petitions, and plan demonstrations to keep the
Grant Taylor (Black, about age seventy, a stroke victim) "It would
Center open.
be a disaster to close the Center. The staff helps me get to the clinic and
Curtiss Knighton, Chief of Services for the Aging, Department of
helps me with my health problems. I also eat my lunch here."
Human Resources, Washington, D.C. feels that this pressure-plus
(The Center serves about 40 lunches a day which they get from
the interest and involvement of community and civic leaders at all
CHANGE. If a client can afford to pay, he pays 25 cents per meal which
levels of government (including the U.S. Administration on Aging)-
usually consists of meat or fish; two vegetables; bread, butter; soup or
were responsible for granting a "reprieve" for the Center.
juice; dessert).
William Whitehurst, Assistant Director for Planning for the De-
Kitty Butts (Black, age sixty-seven) : "When my husband died, I
partment of Human Resources, says that the Center will be funded on
just sat home doing nothing. I didn't have any place to go or any money
an annual fiscal base of $200,000 a year, and that commitments have
to go anywhere. But when the Center opened, I was born again." Mrs.
been made to keep the Center operating for the next 18 months
Butts says she also gets shoes and clothes at the Center (these are
(through June, 1974). About $47,000 will come from Mr. Knighton's
donated).
Department and the rest from general funds of the Department of
Ila Harn (White, not blind, about age sixty-five) "I'm living with
Human Resources.
a lady who is senile, who I've known for twenty years. If I couldn't
While Mrs. Amy O. Green, Program Director, feels that she needs
get out of the house I'd climb the walls. The Center offers me an
$250,000 annually to keep the Center operating satisfactorily, she
'escape'
it also helps me with legal problems to help my friend."
thinks she'll be able to "get by" on $200,000 by not hiring any more
Ely Waddy (Black, about age seventy) "The Center has helped
staff, adding any new services, and by foregoing the purchase of a bus
me straighten out my age for Social Security benefits. And when the
for transportation.
Center opened up a beauty salon I didn't have to travel to get my hair
While Mr. Whitehurst and Mr. Knighton feel that this sort of fund-
done (Mrs. Waddy is blind and travel is difficult). Mrs. Waddy hopes
ing will enable the Center to keep operating indefinitely, they add that
to get her husband, who has had a heart attack, involved in Center
they will need more matching funds or revenue sharing funds to ex-
activities, but SO far he has declined to join her.
pand the program to offer more services to more people. Eligibility
Blanche Worrell (Black, about age seventy) "The Center is build-
restrictions don't seem to be a problem in this Center.
ing a bridge for other people to cross over."
Mrs. Green hopes that some sort of permanent funding might be
Calab Drowe (Black, about age seventy-five) "In coming here you
found SO that the Center won't have to face future crises.
forget you're blind. I used to be a recording artist (played clarinet
and drums) and I get encouragement from the Center to continue
IV. GEORGIA: ACROSS-THE-BOARD CUTBACKS
making records."
Catherine Clay (Black, about age sixty-five) "I was a caterer who
The State of Georgia is particularly affected by the ceiling and
lost vision in one eye about three years ago and just lost vision in the
eligibility restrictions of Title XVI:
other eye. I used to cook a lot and still do, using my grandchildren
1. Georgia was providing over $79 million of social services to
as my 'eyes.' If it wasn't for the Center I'd be sitting home doing
eligible families and individuals. With a ceiling of $56.6 million under
nothing. But here I enjoy the singing, recreation, and handicrafts."
the Revenue Sharing Act (a loss of $23 million), many programs will
24
25
be discontinued and cutback. Especially hard-hit will be programs
Some 900 persons received services ranging from Information and
serving the elderly (See Appendix 2 for details).
Referral phone calls to in-home care up to 40 hours per week. (Note:
2. With the ceiling and eligibility restrictions, Jim Parham, Deputy
40-hour clients are accepted who have possibility of rehabilitation or
Commissioner of the State Department of Human Resources, estimates
on an emergency basis.) Approximately 52 percent of these were active
no way of continuing to serve potential candidates. Especially hit will
welfare cases. Another 10 percent to 20 percent had incomes at the
be the statewide nutrition program.
border of public assistance levels.
Affected will be programs of the Department of Human Resources,
It was hoped that this program would serve as a model to be ex-
six priority aging planning areas, local housing authorities, model
panded throughout the State. However, with the new ceiling, the pro-
cities agencies, and other local public and private agencies which plan
gram budget is being cut some $104,000 and staff has been cut by 24
and/or administer programs for Georgia's elderly.
persons. Also, under new guidelines and State mandates, the program
Following is a sample of potential cut-backs in Title XVI funds.
is being re-designed to serve only public assistance clients with re-
The services proposed were:
contracted funds. In the State of Georgia, due to cutbacks in Title
1. Community Services: Many services that had been proposed to
XVI funds, the allowance of the 10 percent margin is not included in
the Department of Human Resources will have to be curtailed or
the new Revenue Sharing Act revisions. Ultimately, many borderline
abandoned.
cases will now have to seek welfare certification in order to receive
2. Areawide Aging Agencies/Select Area Planning and Develop-
needed services. The proposed new budget would serve approximately
ment Commissions: Many of these multi-county planning agencies
52 percent of current caseload who use collectively about 62 percent of
may have their programs curtailed for lack of funds. These agencies
current resources under the previous budget. (The new contract, Jan-
were in the final stages of planning and needed funds to implement
uary 1-June 30, 1973, calls for a budget of $126,000 Title XVI funds.)2
social services. Attachments A and B, appendix 1, show the potential
WHAT Loss OF SERVICES WILL COST THE INDIVIDUAL AND THE
Title XVI losses.
COMMUNITY
Also, Georgia had planned to use Title XVI funds to provide sup-
portive services (transportation, information and referral, counseling,
The following examples show what the loss of services to specific
etc.) for its statewide nutrition program. But with the cutbacks and
cases will cost the individual and the community:
eligibility restrictions, this program will have to be curtailed or cut
1. Client, age 83, receives a small Social Security income. Lives with
back on a statewide basis.
son, age 66, who is also not well and is unreliable. With Homemaker-
In a report on the impact of Title XVI revisions on his State's pro-
Home Health Aide Service 3 hours daily, 5 days a week, ACCA is able
grams, Frank Newton, consultant to the State Department of Human
to maintain the mother in her home at a cost of $219.60. If the son
Resources, said:
did not live with his mother, he too would have to be institutionalized
"If provisions are not made and means of funding these most
because of his health and the inability to support or care for himself
vital programs are not made available, all of the months and
alone.
years of committed planning, coordination, and dedication of
If they cannot be served by ACCA they both would have to be in-
local and State, private and public agencies will be of little value.
stitutionalized at a cost to the taxpayer of $330 per month per person
And, the elderly residents of Georgia will once again hear that
plus an additional $100-$130 per month per individual to meet local
they are being excluded from much needed services-words they
costs of nursing home care.
have heard too often in the past when other age groups have
2. Client, age 48, lives alone with a small income from Aid to Dis-
received top priority in funding for human services."
abled. She was crippled following a very bad automobile accident and
is also nearly completely blind because of cataracts. With Homemaker-
IMPACT ON ATHENS (GA.) COMMUNITY COUNCIL ON AGING PROGRAMS
Home Health Aide Service 2 hours a day, 5 days a week, she is able to
maintain herself in her own home at a cost of $146.40 a month.
The Athens Community Council on Aging, a private non-profit
If she cannot be served by ACCA she would have to convalesce in a
agency representing service agencies, civic.groups and churches, had
nursing home at a cost of approximately $450 per month plus certifica-
developed a comprehensive Home Care and Community Services pro-
tion by a physician, prescriptions, etc.
gram for older adults.¹
3. Client, age 69, has had 3 strokes, is completely paralyzed and
These services were to help older people remain in their homes. Pri-
partially senile. She lives with her husband who is retired. They have
mary beneficiaries were those who needed Homemaker-Home Health
a small Railroad Retirement income. With the help of Homemaker-
Aide and/or related services (Information and Referral, Home De-
Home Health Aide Services 4 hours a day, 5 days a week, both are able
livered Meals, Day Care, Auxiliary Home Services). Secondary bene-
to remain in their own home at a cost of $292.80.
ficiaries were able-bodied mature adults who received specialized train-
If she cannot be served by ACCA she would have to go into a nurs-
ing and full or part time employment.
ing home at a cost of approximately $450 per month plus certification
by a physician, prescriptions, etc.
1 For a description of ACCA's model program see Appendix V in Home Health Services in
the United States: A Report to the Senate Special Committee on Aging, United States
2 Requests for revenue sharing funds have been submitted to both the city of Athens and
Senate, April, 1972, pp. 134-146.
Clarke County. To date no disposition has been made on the requests.
21
26
especially the 90 percent quota of public aid clients. Right now only
There are also many persons who live alone or live with a disabled
about 30 percent of the clients are on OAA."
spouse who need assistance in preparing meals, transportation to
Both Miss Connolly and Miss Armbrust don't feel that revenue
shopping, paying monthly bills, transportation to the doctors and the
sharing will help much. Like others, they feel that the money in the
clinics, and need some personal care. If ACCA is not able to provide
City of Chicago will go for police and fire equipment and salaries and
these and other supportive services to meet the many and varied needs
not for social services for the aged. However, she feels that revenue
of older persons in the Athens-Clarke County area, many would have
sharing money might help some programs outside the City of Chicago.
to be institutionalized at a minimum cost of approximately $430-$460
Also, Miss Connolly says that because of restrictions, programs
per month. ($330 is the cost to the taxpayer plus Medicaid for physi-
operating with Federal funding must lower their standards. She adds:
cian costs, prescriptions, etc. Those not able to provide the differential
"We don't want to get involved with government funds-that would
for local facilities have to be dismembered from the community to
mean we'd have to curtail some programs."
Dublin, Georgia or other facilities which will receive patients at the
public assistance level, thus, further straining an already traumatic
III. WASHINGTON, D.C.: THE THREAT TO COLUMBIA
situation.) Others' expectations for living at home would be greatly
SENIOR CENTER
enhanced for a long period of time if they could secure services offered
by ACCA such as a hot meal delivered to their homes with its daily
Columbia Center is new: it opened on September 20, 1972 in order
person contact, telephone reassurance, plus the knowledge of being
"to enhance the mental and physical well-being of the elderly in Serv-
able to get emergency help when needed. Unfortunately, strictures
ice Area #7 by providing them Social Services, Educational, and
placed upon the agency by new funding guidelines, both State and
Recreational opportunities."
Federal, inhibit extending these services to many who need small
These services include:
services but who will need much greater services at a much greater
Social Services: Crises intervention and advocacy; Homemaker serv-
cost if they cannot get these services now. ACCA officials stress that
ices; Housekeeping service; Private residential placement; Friendly
in order to achieve a creative joining of local, State and Federal funds
visits; Food stamp and Social Security counseling.
it is important that these funds be used with as much discretion and
Education: Handicrafts; Sewing; Reading; Drama; Spanish; Cre-
flexibility as is necessary SO that the whole of the county's elderly
ative writing; First Aid; Library; Afro-American history; Dance;
population may look to the community for a resource, when their
Cooking; Group services for the blind; Physical fitness; Consumer
needs exceed their own capacity to meet these needs.
education; Talks; Painting.
Recreation: Trips; Parties; Bingo; Programs; Movies; TV; Pool;
WHAT KEY OFFICIALS SAY ABOUT CUTBACKS
Musicals; Singing; Games; Ivakota Farm Retreat (year-round trips)
Robert G. Stephens, Representative, 10th Congressional District:
Special monthly programs with local artists.
"I am very sorry that Georgia will not have the funds this year to
Special Services: Legal service; Beauty service; Employment;
expand and improve its existing program to the extent desired, and I
Group shopping trips; Group check cashing.
can certainly understand the frustration felt by those who will be
The Columbia Center is located in the basement and ground floor of
affected by the imposed ceiling. I did not want this limitation, and I
a renovated church, office, and apartment building. The quarters have
will do everything I can to have it removed at the earliest possible
been completely renovated, with light, bright colors in the offices and
date."
activity rooms. It is clean, inviting, and certainly a haven for the pre-
John Howell, Contract Services Representative: "The situation
dominantly Black residents of the area. Some Spanish-speaking people
are in the area, and the Center has made some effort to include them
looks terrible at the present. The termination of contract and loss of
in activities. A Spanish-speaking secretary at the Center (Mrs. Bertha
funds will place many elderly clients in a new crisis. Trained em-
Ramirez) has written letters and has translated for clients.
ployees, too, will face unemployment with the necessary layoffs."
Columbia is administered by the Family and Child Services of
Ed Benson, Chairman of the Athens-Clarke County United Fund
Washington, D.C. Local Model Cities (HUD) monies were used as
Drive: "The Athens Community Council on Aging has established it-
the 25 percent match for the 75 percent Federal Title XVI funds. The
self as a vital part of our community in providing for the special
needs of our older citizens. The unexpected loss of funds will be a
annual budget of $300,000 included start-up costs of some $18,000, and
blow to the needs of our elderly population, especially to prevent
the Program Director, Mrs. Amy O. Green, feels that they could oper-
institutionalization."
ate on about $250,000 a year (which would just cover rent and
expenses).
V. NEW YORK STATE AND EXAMPLES IN NEW YORK
Because of the Federal funding ceiling, the Center was notified that
it would be closed down after March 1973. However, the Center has
CITY
been granted a "reprieve" for the time being (details of the reprieve are
discussed later in this report).
With the $2.5 billion Federal ceiling on social services, New York
State will receive only $220.5 million compared to its estimated need
At first reports of the threatened shut-down of the Center, Mrs.
of some $875 million of Federal funding.
Green organized a political-action group that circulated petitions in
83-010 73 4
23
22
Mrs. Clay participated in an African culture program, making banana
English and Spanish in the neighborhood and enlisted the support of
nut bread with the help of her granddaughter.
other centers. Petitions, letters, and other messages were sent to the
All other persons using the Center that day, including those who
Mayor, Congressmen, and civil leaders. A protest demonstration was
were White and not blind expressed similar gratitude for the Center.
planned but was called off.
One Spanish-speaking lady also offered praise (through the interpreta-
While Mrs. Green feels that the petitions, letters, and threatened
tion of the Spanish-speaking secretary).
FORD
demonstrations were largely responsible for getting the new funding,
William Whitehurst, Assistant Director for Planning of the Depart-
WHAT DOES THE CENTER MEAN TO THE COMMUNITY
ment of Human Resources feels that his agency was on top of the
situation and its close contact with the Model Cities agency has been
As to the value of the Center to the community, Program Director
LIBRARY
instrumental in getting the new funding.
Mrs. Green says: "If the Center would close many people would have
to go to nursing homes or to mental hospitals (some of the elderly
WHAT DOES THE CENTER MEAN TO THE PEOPLE?
using the Center are former mental patients; the Center helps these
people back into community life). Cutting the program builds wel-
Wednesday of each week is set aside for blind elderly. On one recent
fare. It's better to have healthy individuals than more welfare."
Wednesday, about forty persons were using the center. With perhaps
five exceptions, all were blind and Black; two were men, the rest
THE REPRIEVE: How IT HAPPENED-WHAT IT MEANS
women. There were three white women (not blind) in the group. Many
were making dust mops and other craft items.
As reported earlier, the Center was threatened with closing because
Statements of some of the elderly using the Center indicate what it
of lack of funds, and the Center formed a political-action group to
means to them
write letters, sign petitions, and plan demonstrations to keep the
Grant Taylor (Black, about age seventy, a stroke victim) "It would
Center open.
be a disaster to close the Center. The staff helps me get to the clinic and
Curtiss Knighton, Chief of Services for the Aging, Department of
helps me with my health problems. I also eat my lunch here."
Human Resources, Washington, D.C. feels that this pressure-plus
(The Center serves about 40 lunches a day which they get from
the interest and involvement of community and civic leaders at all
CHANGE. If a client can afford to pay, he pays 25 cents per meal which
levels of government (including the U.S. Administration on Aging)-
usually consists of meat or fish; two vegetables; bread, butter; soup or
were responsible for granting a "reprieve" for the Center.
juice; dessert).
William Whitehurst, Assistant Director for Planning for the De-
Kitty Butts (Black, age sixty-seven) "When my husband died, I
partment of Human Resources, says that the Center will be funded on
just sat home doing nothing. I didn't have any place to go or any money
an annual fiscal base of $200,000 a year, and that commitments have
to go anywhere. But when the Center opened, I was born again." Mrs.
been made to keep the Center operating for the next 18 months
Butts says she also gets shoes and clothes at the Center (these are
(through June, 1974). About $47,000 will come from Mr. Knighton's
Department and the rest from general funds of the Department of
donated). Ila Harn (White, not blind, about age sixty-five) : "I'm living with
Human Resources.
a lady who is senile, who I've known for twenty years. If I couldn't
While Mrs. Amy O. Green, Program Director, feels that she needs
get out of the house I'd climb the walls. The Center offers me an
$250,000 annually to keep the Center operating satisfactorily, she
'escape' Ely Waddy (Black, about age seventy) "The Center has helped
it also helps me with legal problems to help my friend."
thinks she'll be able to "get by" on $200,000 by not hiring any more
staff, adding any new services, and by foregoing the purchase of a bus
me straighten out my age for Social Security benefits. And when the
for transportation.
Center opened up a beauty salon I didn't have to travel to get my hair
While Mr. Whitehurst and Mr. Knighton feel that this sort of fund-
done (Mrs. Waddy is blind and travel is difficult). Mrs. Waddy hopes
ing will enable the Center to keep operating indefinitely, they add that
to get her husband, who has had a heart attack, involved in Center
they will need more matching funds or revenue sharing funds to ex-
activities, but so far he has declined to join her.
pand the program to offer more services to more people. Eligibility
Blanche Worrell (Black, about age seventy) "The Center is build-
restrictions don't seem to be a problem in this Center.
ing a bridge for other people to cross over."
Mrs. Green hopes that some sort of permanent funding might be
Calab Drowe (Black, about age seventy-five) : "In coming here you
found SO that the Center won't have to face future crises.
forget you're blind. I used to be a recording artist (played clarinet
and drums) and I get encouragement from the Center to continue
IV. GEORGIA: ACROSS-THE-BOARD CUTBACKS
making records."
Catherine Clay (Black, about age sixty-five) "I was a caterer who
The State of Georgia is particularly affected by the ceiling and
lost vision in one eye about three years ago and just lost vision in the
eligibility restrictions of Title XVI:
other eye. I used to cook a lot and still do, using my grandchildren
1. Georgia was providing over $79 million of social services to
as my 'eyes.' If it wasn't for the Center I'd be sitting home doing
eligible families and individuals. With a ceiling of $56.6 million under
nothing. But here I enjoy the singing, recreation, and handicrafts."
the Revenue Sharing Act (a loss of $23 million), many programs will
24
25
be discontinued and cutback. Especially hard-hit will be programs
Some 900 persons received services ranging from Information and
serving the elderly (See Appendix 2 for details).
Referral phone calls to in-home care up to 40 hours per week. (Note:
2. With the ceiling and eligibility restrictions, Jim Parham, Deputy
40-hour clients are accepted who have possibility of rehabilitation or
Commissioner of the State Department of Human Resources, estimates
on an emergency basis.) Approximately 52 percent of these were active
no way of continuing to serve potential candidates. Especially hit will
welfare cases. Another 10 percent to 20 percent had incomes at the
be the statewide nutrition program.
border of public assistance levels.
Affected will be programs of the Department of Human Resources,
It was hoped that this program would serve as a model to be ex-
six priority aging planning areas, local housing authorities, model
panded throughout the State. However, with the new ceiling, the pro-
cities agencies, and other local public and private agencies which plan
gram budget is being cut some $104,000 and staff has been cut by 24
and/or administer programs for Georgia's elderly.
persons. Also, under new guidelines and State mandates, the program
Following is a sample of potential cut-backs in Title XVI funds.
is being re-designed to serve only public assistance clients with re-
The services proposed were:
contracted funds. In the State of Georgia, due to cutbacks in Title
1. Community Services: Many services that had been proposed to
XVI funds, the allowance of the 10 percent margin is not included in
the Department of Human Resources will have to be curtailed or
the new Revenue Sharing Act revisions. Ultimately, many borderline
abandoned.
cases will now have to seek welfare certification in order to receive
2. Areawide Aging Agencies/Select Area Planning and Develop-
needed services. The proposed new budget would serve approximately
ment Commissions: Many of these multi-county planning agencies
52 percent of current caseload who use collectively about 62 percent of
may have their programs curtailed for lack of funds. These agencies
current resources under the previous budget. (The new contract, Jan-
were in the final stages of planning and needed funds to implement
uary 1-June 30, 1973, calls for a budget of $126,000 Title XVI funds.)2
social services. Attachments A and B, appendix 1, show the potential
Title XVI losses.
WHAT Loss OF SERVICES WILL COST THE INDIVIDUAL AND THE
COMMUNITY
Also, Georgia had planned to use Title XVI funds to provide sup-
portive services (transportation, information and referral, counseling,
The following examples show what the loss of services to specific
etc.) for its statewide nutrition program. But with the cutbacks and
cases will cost the individual and the community:
eligibility restrictions, this program will have to be curtailed or cut
1. Client, age 83, receives a small Social Security income. Lives with
back on a statewide basis.
son, age 66, who is also not well and is unreliable. With Homemaker-
In a report on the impact of Title XVI revisions on his State's pro-
Home Health Aide Service 3 hours daily, 5 days a week, ACCA is able
grams, Frank Newton, consultant to the State Department of Human
to maintain the mother in her home at a cost of $219.60. If the son
Resources, said:
did not live with his mother, he too would have to be institutionalized
"If provisions are not made and means of funding these most
because of his health and the inability to support or care for himself
vital programs are not made available, all of the months and
alone.
years of committed planning, coordination, and dedication of
If they cannot be served by acca they both would have to be in-
local and State, private and public agencies will be of little value.
stitutionalized at a cost to the taxpayer of $330 per month per person
And, the elderly residents of Georgia will once again hear that
plus an additional $100-$130 per month per individual to meet local
they are being excluded from much needed services-words they
costs of nursing home care.
have heard too often in the past when other age groups have
2. Client, age 48, lives alone with a small income from Aid to Dis-
received top priority in funding for human services."
abled. She was crippled following a very bad automobile accident and
is also nearly completely blind because of cataracts. With Homemaker-
IMPACT ON ATHENS (GA.) COMMUNITY COUNCIL ON AGING PROGRAMS
Home Health Aide Service 2 hours a day, 5 days a week, she is able to
maintain herself in her own home at a cost of $146.40 a month.
The Athens Community Council on Aging, a private non-profit
If she cannot be served by acca she would have to convalesce in a
agency representing service agencies, civic groups and churches, had
nursing home at a cost of approximately $450 per month plus certifica-
developed a comprehensive Home Care and Community Services pro-
tion by a physician, prescriptions, etc.
gram for older adults.¹
3. Client, age 69, has had 3 strokes, is completely paralyzed and
These services were to help older people remain in their homes. Pri-
partially senile. She lives with her husband who is retired. They have
mary beneficiaries were those who needed Homemaker-Home Health
a small Railroad Retirement income. With the help of Homemaker-
Aide and/or related services (Information and Referral, Home De-
Home Health Aide Services 4 hours a day, 5 days a week, both are able
livered Meals, Day Care, Auxiliary Home Services). Secondary bene-
to remain in their own home at a cost of $292.80.
ficiaries were able-bodied mature adults who received specialized train-
If she cannot be served by ACCA she would have to go into a nurs-
ing and full or part time employment.
ing home at a cost of approximately $450 per month plus certification
by a physician, prescriptions, etc.
1 For a description of ACCA's model program see Appendix V in Home Health Services in
the United States: A Report to the Senate Special Committee on Aging, United States
2 Requests for revenue sharing funds have been submitted to both the city of Athens and
Senate, April, 1972, pp. 134-146.
Clarke County. To date no disposition has been made on the requests.
26
There are also many persons who live alone or live with a disabled
spouse who need assistance in preparing meals, transportation to
shopping, paying monthly bills, transportation to the doctors and the
clinics, and need some personal care. If ACCA is not able to provide
these and other supportive services to meet the many and varied needs
of older persons in the Athens-Clarke County area, many would have
to be institutionalized at a minimum cost of approximately $430-$460
per month. ($330 is the cost to the taxpayer plus Medicaid for physi-
cian costs, prescriptions, etc. Those not able to provide the differential
for local facilities have to be dismembered from the community to
Dublin, Georgia or other facilities which will receive patients at the
SUPPLEMENTAL VIEWS OF MR. FONG
public assistance level, thus, further straining an already traumatic
While I am generally familiar with the purpose of new regulations
situation.) Others' expectations for living at home would be greatly
proposed by the Department of Health, Education and Welfare for
enhanced for a long period of time if they could secure services offered
by ACCA such as a hot meal delivered to their homes with its daily
services under Titles I, IV, X, XIV, and XVI of the Social Security
Act, I find it necessary to withhold judgment on the issues and recom-
person contact, telephone reassurance, plus the knowledge of being
mendations discussed in the Subcommittee report.
able to get emergency help when needed. Unfortunately, strictures
Since no hearings were held and the Subcommittee did not meet as
placed upon the agency by new funding guidelines, both State and
a body on these complex and difficult matters so that we could get all
Federal, inhibit extending these services to many who need small
points of view before coming to conclusions, substantive comment now
services but who will need much greater services at a much greater
is inappropriate.
cost if they cannot get these services now. ACCA officials stress that
HIRAM L. FONG.
in order to achieve a creative joining of local, State and Federal funds
it is important that these funds be used with as much discretion and
(43)
flexibility as is necessary SO that the whole of the county's elderly
population may look to the community for a resource, when their
needs exceed their own capacity to meet these needs.
WHAT KEY OFFICIALS SAY ABOUT CUTBACKS
Robert G. Stephens, Representative, 10th Congressional District:
"I am very sorry that Georgia will not have the funds this year to
expand and improve its existing program to the extent desired, and I
can certainly understand the frustration felt by those who will be
affected by the imposed ceiling. I did not want this limitation, and I
will do everything I can to have it removed at the earliest possible
date."
John Howell, Contract Services Representative: "The situation
looks terrible at the present. The termination of contract and loss of
funds will place many elderly clients in a new crisis. Trained em-
ployees, too, will face unemployment with the necessary layoffs."
Ed Benson, Chairman of the Athens-Clarke County United Fund
Drive: "The Athens Community Council on Aging has established it-
self as a vital part of our community in providing for the special
needs of our older citizens. The unexpected loss of funds will be a
blow to the needs of our elderly population, especially to prevent
institutionalization."
V. NEW YORK STATE AND EXAMPLES IN NEW YORK
CITY
With the $2.5 billion Federal ceiling on social services, New York
State will receive only $220.5 million compared to its estimated need
of some $875 million of Federal funding.
APPENDIXES
IGERALO R.FORD
Appendix 1
RELATIONSHIP BETWEEN OLDER AMERICANS ACT
AND SOCIAL SECURITY SERVICES
This report deals primarily with services provided under Social
Security titles.
However, the full significance of those services cannot be understood
without some analysis of a service delivery strategy outlined by the
administration during discussion of the Older Americans Comprehen-
sive Services Amendments of 1972.
Those amendments, enacted by the Congress but then pocket-vetoed
on October 28, would have increased the funding available to the
Administration on Aging for some services. But a primary goal of the
administration was establishment of sub-State service units which
could act as coordinators of services available through the Older Amer-
icans Act and through all other federally-assisted sources.
In the following report,* the interrelationship of the Older Ameri-
cans legislation (which was re-enacted in the Senate on February 20)
to the Social Security services is discussed in detail.
OLDER AMERICANS COMPREHENSIVE SERVICES
AMENDMENTS OF 1972
The Older Americans Comprehensive Services Amendments of 1972
(hereinafter referred to as "1972 Amendments") 1 represents a clearer
defining of the relationship between the Federal Government and the
elderly of this Nation. Since the passage of the original Older Ameri-
cans Act in 1965, it had become increasingly more apparent that the
second most important Federal role (after income) was to increase the
availability of a comprehensive range of services which could assist
older persons to remain independent as long as possible.² The 1972
Amendments recognized as the purpose in providing such services to
"secure and maintain maximum independence and dignity in a home
environment for older persons capable of self-care with appropriate
supportive services; and to remove individual and social barriers to
economic and personal independence for older persons." 3
The challenge of the 1972 Amendments was, therefore, to create
*Prepared by Miss Patricia Callahan, Professional Staff Member, U.S. Senate Special
Committee on Aging.
1 H.R. 15657-despite strong bipartisan support was pocket vetoed by the President on
October 28. 1972.
2 Gold, Byron D., "The Administration Proposals to Strengthen the Older Americans
Act". p. 3. (Remarks at Duke University Conference on Aging, June 2. 1972.)
3 "The Comprehensive Older Americans Services Amendments of 1972," House report
92-1203 (accompanying H.R. 15657), p. 26.
(45)
46
47
a mechanism which would bring into existence the skills of manage-
ment and organization in the delivery of such services.⁴ Referring to
Interlocking the Older Americans Act with other funding resources
the elderly, the Legislative History of the Amendments states that "no
is at the crux of the 1972 Amendments. Speaking on behalf of the
other group is affected by the activities of SO many departments and
National Association of Social Workers, Inc., Mr. Stanley J. Brody
agencies with SO few results.' 5 There are over 150 programs which
testified at hearings on the bill that "we endorse the inclusion of the
benefit the elderly and are administered in almost every department
Nutrition program in the Older Americans Act and added "Con-
of the Federal Government.6
gress may appropriately want to insist on a requirement of inclusion
In pointing up the shortcomings of the seven years of experience
specifically of programs under Titles 1, 16, 18 and 19 of the Social
with the Older Americans Act, the then Secretary of the Department
Security Act within each State plan to guarantee maximum integra-
hearings: of Health, Education, and Welfare, Elliot L. Richardson, stated at
tion of existing major human service programs." 16
As stated, the 1972 Amendments intend to target the delivery of com-
prehensive social services to those whose need is the greatest. The
Too often, objectives have not been clearly specified, Fed-
concept of "need" applies to those elderly who are most vulnerable
eral resources have not been targeted in areas of greatest need,
to the loss of independence, rather than "need" based solely upon fi-
other public and private resources have been underutilized
nancial situation. While programs authorized under the Older Amer-
and (un) coordinated-and the catalytic effect which might
icans Act have never depended upon the income of the receivers of
have been achieved has not been.⁷
services as the sole criteria for eligibility, the Committee on Labor
A major objective of the 1972 Amendments, then, was to make
and Public Welfare in its report accompanying the 1972 Amend-
maximum use of limited Federal resources SO as to initiate, expand
ments stated:
or otherwise improve the supply of services for older people.⁸ The
Until such services are available for all older Americans,
State grant program under Title III was substantially revised in order
the State agencies, in dividing States into planning service
to provide for a better organization scheme at the State and local
areas and developing comprehensive coordinated service pro-
levels thereby encouraging the targeting of Federal resources in areas
grams (should) give special consideration to the needs of the
of greatest need by requiring governors to designate priority sub-
low income elderly.¹⁸
State planning areas.¹⁰ The Title III funds were recognized as not
being sufficient to fund a comprehensive services system completely,
However, even though Congress recognized the generally greater
but were intended to be used as an incentive and catalyst. 11 The 1972
need of services by lower income elderly, the application of any type
Amendments envisioned the development of a type of "partnership of
of means test would never be tolerated as an element in the adminis-
older citizens, parents, community, and community, State and local
trative mechanism.
governments, with appropriate assistance from the Federal Govern-
Congress, in passing the Comprehensive Service Amendments, rec-
ment." 12 This newly developed mechanism would thus act as a type
ognized that "for many older persons, (social) services can mean
of go-between, a broker, in ringing together the suppliers and the
the difference between living independently in their homes or being-
recipients of services. For example:
all too often-unnecessarily and prematurely institutionalized at a
In a community where a homemaker service would be in
much higher public cost." 19 The paradox in public policy is that pro-
critical need, the broker might bring together the Community
grams are designed to pay too little to keep elderly persons at home
ment, and a senior center. 14
College, the State Employment Service, the Welfare Depart-
but will readily pay an average of $400-500 a month to keep the same
persons in an institution.² For many older persons, the difference be-
tween independence and incapacity can be as little as one hot meal
As stated in the Legislative History
a day.
Area agencies are intended, primarily to coordinate and
Provision was made in the 1972 Amendments for the integration of
fund existing service providers rather than to establish them-
Title VII nutrition programs into the comprehensive and coordinated
selves as new providers of services to the aging.¹⁵
social services systems funded under Title III. Thus the role of nu-
trition services would be developed as part of the total spectrum of
Gold, Byron D., op. cit., p. 3.
p. or 8. "Comprehensive Older Americans Services Amendments," Senate report 92-1242,
services.
6 Brody, Subcommittee Stanley J., testimony on the Older Americans Act Amendments of
As Secretary Richardson testified:
Senate, the March 23, 1972, on Aging D. 283. of the Com nittee on Labor and Public Welfare, United 1972, States before
The need for nutritional services is really a part of other
States before Subcommittee on Aging of the Committee on Labor and Public Welfare, of United 1972,
7 Richardson, the Elliot L., testimony on the Older Americans Act Amendments
needs that have to do with bringing elderly people out of
Senate, March 23, 1972, p. 229.
the isolation of their own rooms where they are not in con-
8 Gold, Byron D., op. cit., p. 5.
9 Senate report 92-1242 p. 11.
tact with other people and where they may not be properly
10 Richardson, Elliot L., op. cit., p. 230.
11 Senate Report 92-1242 p. 12.
16 Brody, Stanley J., op. cit., p. 294.
Sec. 101 (4).
12 H.R. 15657, the Older Americans Comprehensive Services Amendments of 1972,
17 Gold, Byron D., op. cit., p. 8.
18 Senate Report 92-1242, p. 14.
13 Gold, Byron D., op. cit., p. 5.
19 Comments by Senator Frank Church on the "Older Americans Comprehensive Services
14 Ibid.
Amendments", Congressional Record, January 4, 1973, p. S134.
15 Senate report 92-1242, p. 2.
20 Donnelly, Terrence M., "California : the Need for Community Based Services for the
Elderly and a Proposed Solution-the Social Maintenance Organization", p. 12. (Sub-
mitted to the Joint Committee on Aging of the California State Senate and Assembly,
December 12, 1972.)
48
fed because they are not able to get out often enough to shop
for themselves and where the cycle of discouragement has a
cumulative effect on their general well-being.21
Although directed toward geographic areas with higher concentra-
tions of lower income elderly, the nutrition programs funded under
Title VII would not apply individual means-tests. An applicant pro-
vider under Title VII would have to establish a social program in
conjunction with a hot meals program. Although there is provision in
Title VII for funding of supportive services, the applicant would more
likely attempt funding under Title 1 or 16 of the Social Security Act.
However, under current legislation, programs funded under the Social
SUPPLEMENTAL VIEWS OF MR. FONG
Security Act must be directed principally toward recipients of Old
Age Assistance. Although up to 10 percent of expenditures on services
While I am generally familiar with the purpose of new regulations
(statewide) funded under the Social Security titles can be directed
proposed by the Department of Health, Education and Welfare for
toward the categories of "former" and "potential" welfare recipients,
services under Titles I, IV, X, XIV, and XVI of the Social Security
too many administrators, for the sake of simplification, are di-
Act, I find it necessary to withhold judgment on the issues and recom-
recting Social Security programs to welfare recipients exclusively.
mendations discussed in the Subcommittee report.
For those which still allow up to 10 percent non-welfare participation
Since no hearings were held and the Subcommittee did not meet as
the application of a means test has occurred. Thus the implementation
a body on these complex and difficult matters so that we could get all
of Title VII nutrition programs could in some instances be totally
points of view before coming to conclusions, substantive comment now
negated, while in others it could become engulfed in the effects of
is inappropriate.
means tests.
HIRAM L. FONG.
(43)
21 Richardson, Elliot L., op. cit., p. 262.
APPENDIXES
Appendix 1
RELATIONSHIP BETWEEN OLDER AMERICANS ACT
AND SOCIAL SECURITY SERVICES
This report deals primarily with services provided under Social
Security titles.
However, the full significance of those services cannot be understood
without some analysis of a service delivery strategy outlined by the
administration during discussion of the Older Americans Comprehen-
sive Services Amendments of 1972.
Those amendments, enacted by the Congress but then pocket-vetoed
on October 28, would have increased the funding available to the
Administration on Aging for some services. But a primary goal of the
administration was establishment of sub-State service units which
could act as coordinators of services available through the Older Amer-
icans Act and through all other federally-assisted sources.
In the following report,* the interrelationship of the Older Ameri-
cans legislation (which was re-enacted in the Senate on February 20)
to the Social Security services is discussed in detail.
OLDER AMERICANS COMPREHENSIVE SERVICES
AMENDMENTS OF 1972
The Older Americans Comprehensive Services Amendments of 1972
(hereinafter referred to as "1972 Amendments") 1 represents a clearer
defining of the relationship between the Federal Government and the
elderly of this Nation. Since the passage of the original Older Ameri-
cans Act in 1965, it had become increasingly more apparent that the
second most important Federal role (after income) was to increase the
availability of a comprehensive range of services which could assist
older persons to remain independent as long as possible.² The 1972
Amendments recognized as the purpose in providing such services to
"secure and maintain maximum independence and dignity in a home
environment for older persons capable of self-care with appropriate
supportive services; and to remove individual and social barriers to
economic and personal independence for older persons." 3
The challenge of the 1972 Amendments was, therefore, to create
*Prepared by Miss Patricia Callahan, Professional Staff Member, U.S. Senate Special
Committee on Aging.
1 H.R. 15657-despite strong bipartisan support was pocket vetoed by the President on
October 28. 1972.
2 Gold, Byron D., "The Administration Proposals to Strengthen the Older Americans
Act". p. 3. (Remarks at Duke University Conference on Aging, June 2. 1972.)
3 "The Comprehensive Older Americans Services Amendments of 1972," House report
92-1203 (accompanying H.R. 15657), p. 26.
(45)
46
47
a mechanism which would bring into existence the skills of manage-
Interlocking the Older Americans Act with other funding resources
ment and organization in the delivery of such services.⁴ Referring to
is at the crux of the 1972 Amendments. Speaking on behalf of the
the elderly, the Legislative History of the Amendments states that "no
National Association of Social Workers, Inc., Mr. Stanley J. Brody
other group is affected by the activities of SO many departments and
testified at hearings on the bill that "we endorse the inclusion of the
agencies with SO few results." 5 There are over 150 programs which
Nutrition program in the Older Americans Act
" and added "Con-
benefit the elderly and are administered in almost every department
gress may appropriately want to insist on a requirement of inclusion
of the Federal Government.⁶
specifically of programs under Titles 1, 16, 18 and 19 of the Social
In pointing up the shortcomings of the seven years of experience
Security Act within each State plan to guarantee maximum integra-
with the Older Americans Act, the then Secretary of the Department
tion of existing major human service programs." 16
of Health, Education, and Welfare, Elliot L. Richardson, stated at
As stated, the 1972 Amendments intend to target the delivery of com-
hearings:
prehensive social services to those whose need is the greatest. The
Too often, objectives have not been clearly specified, Fed-
concept of "need" applies to those elderly who are most vulnerable
eral resources have not been targeted in areas of greatest need,
to the loss of independence, rather than "need" based solely upon fi-
other public and private resources have been underutilized
nancial situation. While programs authorized under the Older Amer-
and (un) coordinated-and the catalytic effect which might
icans Act have never depended upon the income of the receivers of
have been achieved has not been.⁷
services as the sole criteria for eligibility, the Committee on Labor
and Public Welfare in its report accompanying the 1972 Amend-
A major objective of the 1972 Amendments, then, was to make
ments stated:
maximum use of limited Federal resources so as to initiate, expand
or otherwise improve the supply of services for older people.⁸ The
Until such services are available for all older Americans,
State grant program under Title III was substantially revised in order
the State agencies, in dividing States into planning service
to provide for a better organization scheme at the State and local
areas and developing comprehensive coordinated service pro-
levels thereby encouraging the targeting of Federal resources in areas
grams (should) give special consideration to the needs of the
of greatest need by requiring governors to designate priority sub-
low income elderly.¹⁸
State planning areas.¹⁰ The Title III funds were recognized as not
However, even though Congress recognized the generally greater
being sufficient to fund a comprehensive services system completely,
need of services by lower income elderly, the application of any type
but were intended to be used as an incentive and catalyst. 11 The 1972
of means test would never be tolerated as an element in the adminis-
Amendments envisioned the development of a type of "partnership of
trative mechanism.
older citizens, parents, community, and community, State and local
Congress, in passing the Comprehensive Service Amendments, rec-
governments, with appropriate assistance from the Federal Govern-
ognized that "for many older persons, (social) services can mean
ment.' 12 This newly developed mechanism would thus act as a type
the difference between living independently in their homes or being-
of go-between, a broker, in bringing together the suppliers and the
all too often-unnecessarily and prematurely institutionalized at a
recipients of services. 13 For example:
much higher public cost.' 19 The paradox in public policy is that pro-
In a community where a homemaker service would be in
grams are designed to pay too little to keep elderly persons at home
critical need, the broker might bring together the Community
but will readily pay an average of $400-500 a month to keep the same
College, the State Employment Service, the Welfare Depart-
persons in an institution.² For many older persons, the difference be-
ment, and a senior center.¹⁴
tween independence and incapacity can be as little as one hot meal
As stated in the Legislative History
a day.
Provision was made in the 1972 Amendments for the integration of
Area agencies are intended, primarily to coordinate and
Title VII nutrition programs into the comprehensive and coordinated
fund existing service providers rather than to establish them-
social services systems funded under Title III. Thus the role of nu-
selves as new providers of services to the aging.¹
trition services would be developed as part of the total spectrum of
4 Gold, Byron D., op. cit., p. 3.
services.
5 8. "Comprehensive Older Americans Services Amendments," Senate report 92-1242,
As Secretary Richardson testified:
p.
6 Brody, Stanley J., testimony on the Older Americans Act Amendments of 1972, before
the Subcommittee on Aging of the mittee on Labor and Public Welfare, United States
The need for nutritional services is really a part of other
Senate, March 23, 1972, p. 283.
needs that have to do with bringing elderly people out of
7 Richardson, Elliot L., testimony on the Older Americans Act Amendments of 1972,
before the Subcommittee on Aging of the Committee on Labor and Public Welfare, United
the isolation of their own rooms where they are not in con-
States Senate, March 23, 1972, p. 229.
8 Gold, Byron D., op. cit., p. 5.
tact with other people and where they may not be properly
9 Senate report 92-1242 p. 11.
10 Richardson, Elliot L., op. cit., p. 230.
16 Brody, Stanley J., op. cit., p. 294.
11 Senate Report 92-1242 p. 12.
17 Gold, Byron D., op. cit., p. 8.
12 H.R. 15657, the Older Americans Comprehensive Services Amendments of 1972,
18 Senate Report 92-1242, p. 14.
Sec. 101(4).
19 Comments by Senator Frank Church on the "Older Americans Comprehensive Services
13 Gold, Byron D., op. cit., p. 5.
Amendments", Congressional Record, January 4, 1973, p. S134.
16
Ibid.
20 Donnelly, Terrence M., "California : the Need for Community Based Services for the
15 Senate report 92-1242, p. 2.
Elderly and a Proposed Solution-the Social Maintenance Organization", p. 12. (Sub-
mitted to the Joint Committee on Aging of the California State Senate and Assembly,
December 12, 1972.)
48
fed because they are not able to get out often enough to shop
for themselves and where the cycle of discouragement has a
cumulative effect on their general well-being.21
Although directed toward geographic areas with higher concentra-
tions of lower income elderly, the nutrition programs funded under
Title VII would not apply individual means tests. An applicant pro-
Appendix 2
vider under Title VII would have to establish a social program in
conjunction with a hot meals program. Although there is provision in
REPORT BY THE GEORGIA DEPARTMENT OF HUMAN
Title VII for funding of supportive services, the applicant would more
RESOURCES
likely attempt funding under Title 1 or 16 of the Social Security Act.
However, under current legislation, programs funded under the Social
Office of Aging
Security Act must be directed principally toward recipients of Old
Age Assistance. Although up to 10 percent of expenditures on services
IMPACT OF TITLE XVI REVISIONS ON GEORGIA'S ELDERLY SOCIAL SERVICES
(statewide) funded under the Social Security titles can be directed
PROGRAMS
toward the categories of "former" and "potential" welfare recipients,
Background and Purpose
too many administrators, for the sake of simplification, are di-
recting Social Security programs to welfare recipients exclusively.
The Georgia Department of Human Resources has State responsi-
For those which still allow up to 10 percent non-welfare participation
bility for the development, administration and coordination of social
the application of a means test has occurred. Thus the implementation
services for eligible families and individuals throughout Georgia.
These services are authorized under the U.S. Social Security Act, as
of Title VII nutrition programs could in some instances be totally
negated, while in others it could become engulfed in the effects of
amended, (Titles I, [Old Age Assistance] IV-A [Aid to Families
with Dependent Children] x [Aid to the Blind] XIV [Aid to the
means tests.
Permanently and Totally Disabled], and XVI [Combination of the
21 Richardson, Elliot L., op. cit., p. 262.
three adult categories, as chosen in Georgia] and are intended to pre-
serve, rehabilitate, reunite and strengthen eligible families or indi-
viduals or assist members of families or individuals or assist members
of families to attain or retain capability for maximum self-support
and personal independence.
The State of Georgia has moved systematically since the 1967
amendments of the Social Security Act were enacted to plan and ad-
minister a comprehensive program of social services to meet the needs
of Georgia's needy families and individuals. However, through Con-
gressional and Presidential action, the Revenue Sharing Act [P.L.
92-512, October 21, 1972] contains a number of restrictive amendments
to all social service programs and more particularly to the elderly
services funded under Title XVI of the Social Security Act, including
a $2.5 billion national ceiling on these formerly "open-ended"
programs.
Equally and possibly more detrimental to Georgia's efforts to de-
velop a comprehensive network of elderly social services have been
limitations set on the provision of services to old age assistance recipi-
ents. Whereas the former Social Security provisions allowed elderly
social service programs to provide services to past, present or future
recipients of financial assistance, the new Social Security Act provides
that no more than 10 percent of the State's Federal allotment of social
service funds can be utilized for services to past or potential recipients
while the other 90 percent shall be expended for services to current
recipients only. The Revenue Sharing Act specified five exceptions to
the 10 percent limitation, but these exceptions [child care, family plan-
ning, mentally retarded, drug addicts and alcoholics, and child foster
care] will have only a negligible impact on the bulk of Georgia's Title
XVI efforts. In addition, recent Department of Health, Education and
Welfare program regulations have brought about even greater cut-
(49)
50
51
backs in the use of Title XVI funds through a shortened time frame-
in the final steps of planning and will be needing the financial
work for past and potential recipients.
resources identified in order to implement the desired social
In an effort to ascertain a quick assessment of how the recent Social
services. Since these priority aging planning areas have signifi-
Security Act revisions are impacting on Georgia's elderly residents,
cant number and percentages of residents which would have
the Department of Human Resources, Office of Aging has contacted
qualified under the older provisions of Title XVI [past, and
several appropriate State and local agencies which plan and/or admin-
potential recipients], most of the planned services were to be
ister social services programs for the State's elderly residents to ascer-
funded with Title XVI financial assistance.
tain their views on the impact of Title XVI revisions and cutbacks.
Also, since Georgia is to receive only limited funding under
Due to time constraints imposed in carrying out this survey, it is neces-
the Title VII [Older Americans Act] Nutrition Program for
sarily only a sample of the anticipated negative impact on senior citi-
the Elderly, the State had anticipated using Title VII funds
zen services. The total impact on the recent revisions of Title XVI are
for raw food costs and Title XVI assistance for all other sup-
very difficult to ascertain without a more detailed, comprehensive sur-
portive services such as transportation, outreach, information
vey. Nonetheless, the results of this rapid survey indicate the tremen-
and referral, health and welfare counseling, recreation, shop-
douse negative impact which the Title XVI revisions are having on
ping assistance, nutrition education and other needed services.
Georgia's elderly social services programs.
This would have allowed Georgia to develop a meaningful
The agencies surveyed included the Georgia Department of Human
nutrition program for the elderly. Now, with the Social Security
Resources [Community Services and Office of Aging], six priority
Act ceiling and eligibility restrictions, it will be impossible to
aging planning areas, local housing authorities, model cities agencies,
develop a comprehensive nutrition program on a Statewide
select Area Planning and Development Commissions and other ap-
basis.
propriate local public and private agencies which plan and/or admin-
In addition to Georgia's priority aging planning areas, the De-
ister programs for Georgia's elderly residents.
partment of Human Resources had established a network of
At the time the Revenue Sharing Act was enacted [October 21,
community human resource planning and coordination through
1972], Georgia was providing over $79 million of social services [either
Georgia's multi-county Area Planning and Development Com-
through direct services or purchase of services] to eligible Georgia
missions. Each multi-county planning program had been estab-
families and individuals of all categories. With the maximum ceiling
lished under Title IV-A and XVI and each contained a viable
placed upon Georgia's programs at some $23 million lower [$56.6 mil-
planning component on the needs, problems and opportuni-
lion], the State had no choice except to discontinue many social services
ties of the elderly. It was anticipated that each APDC would
that had been long in planning and many that had been actually
develop a meaningful areawide program for the aging which
serving thousands of needy Georgians. Hit hardest by the State allot-
would seek Title XVI financial assistance for operational social
ment ceiling was Georgia's elderly residents. Attachment A identifies
services. A select number of these APDC's have been included
the actual terminations of Title XVI programs in Georgia.
even though many of them are still in their early stages of
While the actual cutbacks in Title XVI aging programs have been
planning.
acute, the potential impact of the revisions appear to be of even greater
magnitude. First of all, the advocates for elderly services under Title
XVI were just initiating major programs at the time that the Revenue
Sharing Act restrictions were enacted. This, in effect, has meant that
many programs that were being planned to provide much needed
services to Georgia's residents may never be implemented-particularly
at levels required to make significant impacts on the needs of Georgia's
some 368,000 elderly residents over age sixty-five.
The following represents a sample of potential cutbacks in Title
XVI funds in Georgia due to the recent Social Security Act amend-
ments. The services proposed were as follows:
(1) Community Services These are services that had been proposed
to the Department of Human Resources. The actual finalized
proposals were on hand and awaiting final review and approval
when the recent revisions were enacted.
(2) Areawide Aging Agencies/Select APDC's: The Department
of Human Resources; Office of Aging, has funded [Under Title
III of the Older Americans Act] five (5) priority multi-county
agencies to plan, administer, coordinate and evaluate major
elderly services programs. Each aging planning agency is now
ATTACHMENT A-Actual title XVI losses (for elderly)
Number of
Name of program
Amount of cut Number served
staff cut
Services terminated
Senior personal services project (Atlanta
$87,961
100
12 Day care center, meal delivery to homes, social
Model Cities) 51.3H.¹
services (evaluation and assessment of each cli-
Federal
- 65, 971
ent; information and referral).
Social services for the elderly (Atlanta Hous-
759, 744
4, 650
77 Information and referral, health maintenance,
ing Authority) 84.3.1
counseling and guidance, homemaker service,
Federal
-569,808
activities to alleviate loneliness, employment,
friendly visiting and chore service, transporta-
tion, nutritional component, training, recruit-
ment and training volunteers to work with
elderly.
Athens Community Council on Aging 55.7
160,620
900
14 Information and referral, service interlinkage,
Federal
120, 465
coordination of volunteer program, home-
maker and home/health aide services.
52
National Council of Jewish Women 57.2 1
13,070
2,400
2 Information and referral, maintain resource file
Federal
-9,802
on all services for the elderly, training of volun-
teers, improve community understanding of
services for elderly.
Alma-Bacon community services for senior
178,924
6,000
23 Transportation, education and enrichment, con-
citizens program (Alma-Bacon Model
sumer education, homemaker services.
Cities) 53.0.¹
Federal
-134,193
Alert West End to Available Resources for
13,200
184
1 Outreach; information and referral.
the Elderly 85.7.1
Federal
-9,900
Savannah senior citizens progam (Savannah
268,834
1, 700
38 Homemaker; chore aide; day care; nutrition;
Model Cities) 88.0.1
prescription delivery; medical transportation;
Federal
-201,625
cultural enrichment; issuance of discount
cards, food stamps, and bus tokens.
1 May renegotiate for services to current recipients only.
ATTACHMENT B.-Potential title XVI losses (for elderly)
1. Community Services Division, Department of Human Resources
Estimated
Estimated
number
Agency
Services
expenditures
to be served
Albany-Daugherty County Council on aging
"Meals-on-wheels" to elderly in public housing
41,136
100
Project Focus Salvation Army, Visiting
Senior citizen center, homemaker-home health services and
98,531
1,000
Nurses Association, National Council of
information and referral.
Jewish Women.
53
Church Women United, Atlanta
Advocacy for elderly, home visits, transportation, chore
25,000
services, trips, health services and information and referral.
Clayton County EOA (Senior Citizens Day
Outreach, educational programs, health delivery systems,
43,589
Care Center).
transportation, homemaker services, information and
referral.
Housing Authority of Camilla
Various services to elderly public housing tenants
3,000
DeKalb County Health Department
Prevention of diseases and disability. Develop nursing care
100,000
services in a complex setting.
(1)
1 Elderly of DeKalb County.
55
The State government will be entitled to receive one-third of the amount allo-
cated to that State. The remaining two-thirds of the State allocation will be
divided among the units of local government, namely, counties, cities and towns.
Local government must use the monies they receive for priority areas of pub-
lic safety, environmental protection, public transpotration, health, recreation,
libraries, social services for the poor or aged, and financial administration.
Appendix 3
The enclosed fact sheet provides additional information relative to the new
law.
MATERIAL RELATED TO REVENUE SHARING
It is clear that some of the Revenue Sharing funds that are made available
to State government could be used to strengthen programs in the field of
Enactment of revenue-sharing legislation (The State and Local
aging.
It is likewise clear that some of the new Federal funds made available to
Fiscal Assistance Act of 1972) raised the possibility of a new source
counties, cities and towns could and should be used for social services for
of funding for social services to older Americans.
older persons. In addition, programs that are worked out for the use of these
Early response to the bill included a letter from Dr. Arthur Flem-
funds by local governments in such areas as public safety, environmental pro-
ming, Chairman of the Post Conference Board of the White House
tection, public transportation, recreation and libraries can and should include
special provisions for dealing with the needs of older persons.
Conference on Aging. He urged leaders of national organizations on
It is essential, however, for representatives of organizations of older per-
aging to urge members to do "everything possible to obtain for older
sons to take the initiative in order to make sure:
persons a fair share of these new Federal dollars." The text of Dr.
-that a meeting is called at the local level of interested organizations and
Flemming's appeal and the joint letter appear as Item One of this
agencies in both the non-governmental and the governmental sectors
-that such a meeting include those voluntary organizations that have demon-
Appendix.
strated a genuine concern for the needs of older persons
To make an early appraisal of the actual and potential usefulness of
-that the meeting results in the development of a specific proposal for assist-
Revenue Sharing in terms of services to the elderly, the Senate Com-
ing older persons in the community in question
mittee on Aging on January 4, with the cooperation of the Urban
-that when the proposal is submitted to the appropriate governmental unit
there is a clear indication that the proposal has the support of many citi-
Elderly Coalition, wrote to 38 cities for a preliminary report. A sum-
zens within the community.
mary of those findings appears as Item Two of this Appendix.
I am delighted to note that all of the organizations to which this letter
Finally, Item Three is a reprint of an article written by one of the
is addressed have agreed in a joint statement to take this initiative in alert-
early advocates of revenue sharing, Mr. Walter W. Heller, in the Wall
ing the communities of the nation to the possibilities outlined in this letter.
This is a new and challenging opportunity for action in the field of aging
Street Journal of February 22, 1973. Mr. Heller first recommended rev-
that can be of help to today's older persons.
enue sharing while serving as Chairman of the Council of Economic
Very sincerely and cordially yours,
Advisers under President Johnson. He is now Regents' Professor of
ARTHUR S. FLEMMING,
Economics at the University of Minnesota.
Chairman.
[Enclosures.]
ITEM ONE: LETTER BY DR. ARTHUR FLEMMING TO NATIONAL
Dictated and signed in his absence.
ORGANIZATIONS AND RESULTANT JOINT LETTER
FACT SHEET ON REVENUE SHARING AND PROGRAMS FOR OLDER PERSONS
POST CONFERENCE BOARD OF THE
In October, 1972 Congress passed and the President signed a historic new
WHITE HOUSE CONFERENCE ON AGING,
law whose formal title is the State and Local Fiscal Assistance Act of 1972,
Washington, D.C., October 20, 1972.
more commonly known as Revenue Sharing. Because this resource is poten-
Mr. FOSTER J. PRATT, President, American Association of Retired Persons.
tially a significant source for financing programs to meet the needs of older
Mr. THOMAS G. WALTERS, President, National Association of Retired Federal
persons, those concerned with developing such programs need to understand,
Employees.
at least in basic outline, how the new law will work. (Services to the poor
Mr. HOBART C. JACKSON, Chairman, National Caucus on the Black Aged.
and the aged have been designated a priority area.)
Dr. DAVID G. SALTEN, President, National Council on the Aging.
Revenue Sharing provides for the distribution, with virtually no strings
Mr. NELSON H. CRUIKSHANK, President, National Council of Senior Citizens, Inc.
attached, of large amounts of Federal resources to 38,000 State and local
Mr. JOSEPH A. FITZGERALD, President, National Retired Teachers Association.
governments. Revenue Sharing permits State and local officials to determine
GENTLEMEN: The enactment into law of the Revenue Sharing Act opens up
the purpose for which available Federal funds shall be spent.
some new opportunities for progress in the field of aging.
The new law provides that for the last half of fiscal year 1972, $2.65
Under this Act a total of $5.64 billion dollars will be paid to 38,000 States and
billion will be distributed; for fiscal year 1973, $5.64 billion; for 1974, $6.05
communities throughout the United States during the fiscal year ending June 30,
billion; for 1975, $6.20 billion; for 1976, $6.35 billion; and for the first half
1973.
of fiscal 1977, $3,325 billion. Each State will receive its share of these funds
based on whichever one of the two formulas gives the State the most money.
(54)
These formulas take several factors into account including State-local tax
56
57
efforts, the size of the population, and the amount of poverty present in the
AMERICAN ASSOCIATION OF RETIRED PERSONS
State's population. The amounts each State will receive for Fiscal Year 1973
NATIONAL ASSOCIATION OF RETIRED FEDERAL EMPLOYEES
are shown in the following table:
NATIONAL CAUCUS ON THE BLACK AGED
NATIONAL COUNCIL ON THE AGING
REVENUE SHARING, FISCAL 1973
NATIONAL COUNCIL OF SENIOR CITIZENS, INC.
Amount of rev-
Amount of rev-
NATIONAL RETIRED TEACHERS ASSOCIATION
enue sharing
enue sharing
Alabama
$116,100,000
Montana
$20,600,000
Each of the signators to this statement has received the attached letter fro
Alaska
6,300,000
Nebraska
42,900,000
the Chairman of the Post-Conference Board of the White House Conference
o
Arizona
50,200,000
Nevada
11,100,000
Aging together with the fact sheet referred to in the letter.
Arkansas
55,000,000
New Hampshire
15,200,000
We believe that the new Revenue Sharing Act does provide the members of a
California
556,100,000
New Jersey
163,600,000
of our organizations with an opportunity to obtain for older persons and the
Colorado
54,600,000
New Mexico
33,200,000
communities, the needed Federal dollars for support of special programs in th
Connecticut
66,200,000
New York
591,400,000
field of aging, and to stimulate greater response to the needs of older persons
Delaware
15,800,000
North Carolina
135,500,000
programs designed to serve the needs of the entire community.
District of Columbia
23,600,000
North Dakota
19,700,000
It is clear, however, that if older persons are to share in the benefits from the
Florida
146,000,000
Ohio
207,000,000
dollars we must act and act quickly.
Georgia
109,900,000
Oklahoma
59,400,000
We are especially desirous of our members doing everything possible to obtai
Hawaii
23,800,000
Oregon
56,200,000
for older persons a fair share of these new Federal dollars that are being all
Idaho
19,900,000
Pennsylvania
274,000,000
cated to counties, cities, and towns. We are heartened by the fact that the ne
Illinois
274,700,000
Rhode Island
23,600,000
law establishes as one of its priorities at the level of local government "socia
Indiana
104,300,000
South Carolina
81,500,000
services for aged." Unless we are alert to our opportunities, this could en
Iowa
77,000,000
South Dakota
25,100,000
up as only a paper recognition of our needs.
Kansas
52,800,000
Tennessee
98,400,000
Services for older persons must be included in Revenue Sharing by local gover
Kentucky
87,300,000
Texas
244,500,000
ments at the outset. If they are not, plans for the use of these funds will becom
Louisiana
113,600,000
Utah
31,400,000
frozen and it will be increasingly difficult for older persons to obtain anythir
Maine
31,100,000
Vermont
14,800,000
approaching a fair share.
Maryland
107,000,000
Virginia
105,200,000
This means that our members must quickly work with the appropriate org
Massachusetts
163,000,000
Washington
84,100,000
nizations and agencies, both non-governmental and governmental, in local con
Michigan
221,900,000
West Virginia
52,300,000
munities to develop proposals for the consideration of the governmental bodie
Minnesota
103,900,000
Wisconsin
133,900,000
that will be spending these new Federal dollars, and they must make it clear tha
Mississippi
90,700,000
Wyoming
9,700,000
their proposals are being supported by a large number of citizens in tl
Missouri
98,800,000
community.
We are contacting our members immediately to call their attention to th
Of these amounts, each State Government is entitled to one-third which it
opportunity and to urge them to take the initiative in calling together immed
may use for virtually any purpose it wishes. The remaining two-thirds of the
ately the representatives of private and public agencies, in helping to develo
funds made available to the State must be passed on to counties, cities and
specific proposals, and in rallying support for those proposals. We intend to giv
towns. Local governments may use these funds for the priority areas of public
our local units vigorous support in this endeavor.
safety, environmental protection, public transportation, health, recreation, li-
We hope that many communities will see this as an opportunity to obtain th
braries, financial administration, and social services for the poor or aged.
funds which will enable them to make a start in the direction of developing a pla
In addition to using these funds for current expenditures in the priority areas,
for the coordination of services for older persons in a community. Some comm
local governments may use funds for legally authorized capital expenditures.
nities will feel that other needs are more pressing. We have confidence in th
Neither the State nor the local shares of Revenue Sharing may be used to
decisions that will be made at the local level.
match other Federal grants.
We recognize that older persons can also benefit from revenue sharing fund
Each jurisdiction receiving funds under revenue sharing must publish its
made available to State Governments. We are urging our State offices to mal
plan for the use of the funds prospectively. Likewise, at the conclusion of the
vigorous representations to Governors in the interest of having some of the
period for which funds were made available, the jurisdiction must publish the
funds used to strengthen the State programs on aging.
actual uses to which the funds were put. Both instances of publishing must
Our principal concern is that the needs of older persons be recognized-n
take place in a newspaper (s) whose coverage includes the entire jurisdiction.
passed over-as the nation shares these Federal dollars with States and loca
By the end of October, 1972 the first distribution of $2.65 billion will be made.
governments.
In January, 1973 another distribution of $2.65 billion will be made. Thereafter,
FOSTER J. PRATT,
payments will take place quarterly.
President, American Association of Retired Persons.
It is clear, therefore, that under the new Revenue Sharing Act the case for
THOMAS G. WALTERS,
new, expanded, and/or improved programs for older persons must be made to
President, National Association of Retired Federal Employees,
each and every State and local governmental unit receiving funds under the
HOBART C. JACKSON,
new Act; and approaches must be made immediately before decisions are made
Chairman, National Caucus on the Black Aged.
which do not provide for utilizing a portion of the Revenue Sharing funds in
DAVID G. SALTEN,
the field of Aging.
President, National Council on the Aging.
NELSON H. CRUIKSHANK,
1 Source Joint Committee on Internal Revenue Taxation Census Bureau.
President, National Council of Senior Citizens, Inc.
JOSEPH A. FITZGERALD,
President, National Retired Teachers Association.
58
59
ITEM TWO: SUMMARY OF REPLIES TO COMMITTEE ON AGING
For example, a "Project Outstretch" permits the City to join in partnership
QUESTIONNAIRE
with appropriate neighborhood agencies and Churches for the provision of uni-
form delivery services and special attention will be given to "areas of elderly
Members of the Urban Elderly Coalition-an organization established in 1972
concentration."
to represent municipal, county, and regional agencies on aging-cooperated with
5. St. Louis has allocated $75,000 for a mobile health van, but the respondent
the Senate Committee on Aging to take an early sampling of uses to which the
indicated that future revenue sharing funds will probably be used to cover
revenue-sharing has been put.
salary increases for city employees.
Questionnaires were sent to 38 localities, and 14 replies were received. Several
respondents indicated that the program was still SO new that it would be difficult
C. CITIES WITH LARGE-SCALE PROPOSALS FOR FUTURE USE
to determine long-term trends. The responses, however, provide some useful
information about the present situation and possible later developments.
1. In Pittsburgh, funds have been allocated generally for capital improve-
ments, but it is expected that general revenue-sharing may in the future support
A. CITIES IN WHICH No SPECIFIC ALLOCATIONS HAVE YET BEEN MADE
two ongoing programs for the elderly Mayor's Office for the Aging (established
in 1973) and a senior citizens recreation program sponsored by the Department
Chicago, Cincinnati, Newark (N.J.), Omaha, South Bend (Ind.), Tucson, and
of Parks and Recreation.
Allen County (Pennsylvania) report that no specific allocations have yet been
2. Seattle reports that no specific allocations have yet been made, but "an
made for the elderly. In some, such as Cincinnati, the 1973 budget had not then
unknown amount may go for subsidy of transit under a new 10 cent fare or $2
been proposed, although there was some hope that future allotments would be
per month pass for 65 and older citizens" also change from city to county-wide
made. In Omaha, the emphasis was to be put on capital improvements, such as a
"metro" transit-no means test." The reply also says: "The elderly will be
riverfront development program. The Allen County Council on Aging reported
considered as a priority target group. Mayor and Council are very much con-
that neither Fort Wayne nor the county has decided how to spend revenue-
cerned. Situation is, however, very confused at the monment. Planning just
sharing funds.
getting under way in substance."
Although there was some pressure for tax relief, attention is turning to capital
improvements.
ITEM THREE: ARTICLE BY WALTER HELLER, FROM WALL STREET
The Newark Senior Citizens Commission Director reported his office has
JOURNAL OF FEBRUARY 22, 1973
been informed that elderly citizens there cannot look forward to receiving one
dollar of revenue-sharing. He added: "All of these funds, we are told have
THE SIDE-EFFECTS OF NIXON'S BUDGET
long since been committed in other urgent directions." In South Bend, it
appeared that a "cultural center has the inside track," even though REAL
(By Walter W. Heller)
Services of that city submitted a proposal calling for a comprehensive Service
In critiques of the President's budget, as in other matters, it's not just what
Center. The Chicago Director of the Mayor's Office for Senior Citizens reported
you say but how you say it.
that the initial revenue sharing grant there will be used to reduce the property
On "Meet the Press' last week I called attention to the sharp swing from
tax.
stimulus to restriction in the Nixon budget. I noted that the full-employment
In Tucson, all of the first round of funding has been directed toward street
budget, as measured in the national income accounts (the best shorthand way
improvement, but some thought is being given to city funding of Model Cities
of gauging the budget's impact on the economy), will shift from a deficit rate of
programs that may be discontinued.
about $15 billion in the current quarter to a small surplus at the end of the year.
One director of a municipal office on aging, in a letter to the director of a YMCA
Although I consciously avoided condemning this shift as too restrictive, I did
seeking revenue funds-commented:
characterize it as "slamming on the brakes."
"It is imperative that federal housing programs for the elderly and programs
That did it. The news dispatches (as well as a scientific sample of three
in many other areas be maintained and increased, along with revenue sharing
viewers I questioned) confidently asserted that I had condemned the budget as
(emphasis added.) It is imperative that we focus our main attention and energies,
too restrictive. Well, is it or isn't it? In the best tradition of economics, let me
and those of the elderly also, on the forthcoming budget battle of the administra-
answer: "It depends."
tion and the Congress about these programs, and not on the diversionary revenue
It depends largely on the course of Federal Reserve policy. If tough fiscal
sharing backfires the national administration seems SO anxious to have lit."
restraint enables the Federal Reserve to pursue a more moderate monetary
policy and avoid a credit crunch, the sharp swing in the budget deficit may be
B. CITIES IN WHICH SOME ALLOCATION HAS BEEN MADE
about right. But if the budget cutback is coupled with a ferociously tight mone-
1. Dallas reported that an undetermined minor amount has been reserved to
tary policy that would level the economy off at 41/2% or more unemployment or
cover loss of revenue due to a $3,000 Tax Exemption for the elderly adopted since
cut the growth of real GNP down to a 2% or 3% rate, the budget swing would
November, and that one bookmobile would be provided for the elderly.
be too sharp.
2. Detroit plans to allot $50,000 for Jan. 1-June 30, 1973 and approximately
Given the likely slippage on the spending side, Mr. Nixon's crusade against
$90,000 for the full year following to establish a Mayor's Senior Citizen Com-
tax increases, and the painful costs of a credit crunch, the President may be
mission. It is hoped that multi-service centers be established later on with satel-
right in erring on the side of fiscal tightness in the face of a surging economy.
lite centers for direct local services.
Not that the choice between bearing down on the fiscal brakes and bearing
3. Kansas City, Missouri, has allocated $100,000 to establish a model project
down on the monetary brakes can be made in a vacuum. One has to weigh the
on nutrition to serve 1,200 meals per day over a 6-month period. The project
respective side effects. Much of the objection to tight money is distributional,
will include both group meals and Meals on Wheels and "will tie in with
namely, that it unduly squeezes housing, small business, and state-local govern-
existing Title III projects of the Older Americans Act. Within two years, revenue-
ment. So if Mr. Nixon achieves a tight fiscal policy mainly by squeezing civilian
sharing funds would be committed to funding of the Model Cities Program, and
programs and low-income recipients rather than pruning the Pentagon or taxing
the well-off, the choice between the two policies on social grounds becomes less
the city agency on aging will submit a proposal for the use of revenue-sharing
clear-cut.
funds for a dial-a-ride system between health facilities and congregates of the
MILITARY FAT
elderly.
4. San Antonio has costed priority items of specific benefit to the elderly
Relentless, even ruthless, in its pursuit of evil among social programs, the
at approximately $335,000. The reply adds:
Nixon budget shows no comparable ruthlessness in paring military fat or chal-
"Expected funds are included in the category "Social Services." While no spe-
lenging tax privilege:
cific amount can be identified, the elderly will be co-beneficiaries with other resi-
dents in the other priority areas."
60
61
Item: In spite of saving about $4 billion on Vietnam, the fiscal 1974 defense
WHAT'S NEEDED
budget goes up $4 billion, for a total rise of $8 billion in non-Vietnam spending.
Item: In the name of cutting waste and inefficiency, subsidies for low-income
What would be the course of reason in a joint reconsideration of the 1974
housing are being summarily suspended but the even more inefficient and waste-
budget?
ful tax give-away of about half a billion dollars in tax shelters for real estate
First, all hands need to recognize that the tasks government has to tackle
investments is left untouched.
today-whether to curb pollution from 40,000 different sources, or upgrade the
Item: Mr. Nixon wrings his hands over our unbearable tax burdens ("more
education of the disadvantaged, or assure decent medical care for the aged-
important than more money to solve a problem is to avoid a tax increase," he
are vastly more complex and demanding than such earlier tasks as transferring
said recently), blithely ignoring the fact that federal income tax rates have been
money to the unemployed and building highways and dams. This consideration
cut by over $20 billion since he took office and more than twice that in the past
calls for lesser promises and greater patience.
decade.
Second, we need to define much more sharply the optimum role of the federal
Item: The White House takes pride in noting that "human resource" expendi-
government in its various fields of responsibility. As Charles Schultze has pointed
tures will rise faster than the military budget, but fails to mention that the
out, this requires a careful sorting out of functions according to the type of
great bulk of that rise is in Social Security benefits, self-financed by a giant
federal support that will be most efficient and effective, for example:
increase of $10 billion in harshly regressive payroll taxes.
Often, direct income support is best, as in the case of the aged, the blind, and
Item: Mr. Nixon is proud of redeeming his promises to hold spending and
the working poor.
deficits in check, but what of his pledges (1) to provide possibly $71/2 billion in
To reduce sharp disparities in the ability of local units to supply government
rehabilitation aid to the two Vietnams? (2) to make property tax relief for the
services, the revenue sharing instrument is appropriate.
elderly "a first order of business in our next budget"? (3) to press ahead on
In services like education and health with large geographical "spill-over effects,"
welfare reform, any delay in which, he told us a year ago, would be "unwise"
the national purpose can be served best by categorical aids (specifying not SO
and "cruel"? Not a word and not a dime in the budget to redeem these pledges.
much how the money should be spent, but where and on whom).
So much for priorities. What about economy and efficiency? Most economists
Certain critical services like medical care for the poor may have to be pro-
will applaud White House moves to trim pork barrel projects, stop the flow of
vided directly.
aid to wealthy school districts that are "federally impacted," end 2% REA loans,
In others, as in preserving the environment, enacting taxes and effluent charges
drop subsidies for farm exports, drag the limestone lobby away from the public
to make pollution costly and pollution abatement profitable may be even more
trough, and SO on. In other words, many of Mr. Nixon's "one hundred budget
urgent than a step-up in budget spending.
blows" do hit the right targets.
Third, once the priorities of Mr. Nixon's budget are recognized as other than
But, in killing or gutting programs for urban renewal, model cities, community
God-given money will have to be pried loose for such thrusts as a better welfare
action, public service employment, college student loans, and the like, Mr. Nixon
system, decent health insurance, and major efforts to equalize education and
is on highly debatable ground.
restore hope and opportunity to the inner cities and ghettos. This may require
The projected liquidation of the Community Action Program is a puzzling and
invading the sanctity of the military budget and the tax sanctuaries that are left
poignant case in point. Here is a program that-after many trials and much
untouched in Mr. Nixon's program.
error-was making steady progress in the complex and difficult task of helping
Fourth, Congress should speedily equip itself with budget procedures and
the poor help themselves. And an administration "utilization survey" of 591
staff that will enable it not only to work within viable budget ceilings, but also
Community Action agencies had just concluded that the program offers "genu-
to make informed cost-benefit judgments on such pigs-in-the-poke as the $1.3
ine help in making the decentralization of government succeed during the next
billion-apiece Trident submarine.
few years" and that "the picture clearly shows that the administration's re-
Had Mr. Nixon approached Congress with a "let's reason together" attitude
direction of Community Action was on target."
rather than trying to shove his budget intact down its throat (there is, he said
Ironically, a President professing a deep commitment to decentralization and
in italics, "no room for the postponement of the reductions and terminations
citizen participation is about to kill one of the few programs that was making
proposed in this budget."), one might be more sauguine about a rational process
documented progress on both fronts. Even more revealing of the administration's
of budgeted reformation. Instead, he has thrown down the gauntlet, and Con-
mentality are:
gress has picked it up.
Its sly directive to scuttle OEO by June 30 before its supporters "could
A PROBLEM OF RHETORIC
muster enough strength or will to put Humpty-Dumpty together again."
The statement by the executor of the program, Howard Phillips, that
Finally, while Mr. Nixon's budget actions are a mixture of good and bad, I
he will liquidate the program with relish.
find little of redeeming social value in his budget rhetoric. When a President
Apart from such inconsistencies, Mr. Nixon's budget fails to recognize that a
urges citizens "to get big government off your back and out of your pocket,"
program that's worse than it might be is not necessarily worse than none. Mr.
treats Congress with disdain, and conducts a national crusade against taxes,
Nixon needs to be reminded that getting rid of the program doesn't get rid of
he can only defeat his own broader purposes.
the problem.
Instead of restoring self-reliance, he is putting self-interest on a pedestal.
Congress, in turn, needs to be reminded that saving the program doesn't neces-
Instead of restoring confidence in government, he is inviting contempt for gov-
sarily solve the problem. Goaded by the President's arrogation of power, by his
ernment in general and Congress in particular. Instead of focusing efforts on a
disdainful view of Congressmen as irresponsible instruments of special interests,
higher quality of life, he is appealing to instincts of crass materialism. Instead
and by his effort to give the 1974 budget the status of revealed truth, the Con-
of "if at first you don't succeed, try, try again," his implicit motto on social pro-
gress is venting its anger by trying to push questionable programs back on the
grams seems to be, "if at first you don't succeed, give up."
budget. Instead, it should be hammering out alternatives that will strike the
The battle of the budget may yet result in progress toward more rational and
country as more reasonable and humane.
efficient budget-making. But somehow, a crusade to think small, think simple,
Both arrogance and anger are expensive luxuries, mortal enemies of rationality
and think selfish does not strike me as the best path to either personal salvation
in the budget process. Far better that the White House should treat the Con-
or national greatness.
gress as a coordinate branch of government and seek a detente which recognizes
(1) that the Democratic Congress also enjoyed a big victory at the polls in
November and has every right to participate in the setting of budget priorities:
and (2) that a cooperative advance toward a more rational budget, with some
give on both sides, could pay rich dividends.
63
PARTS 222, 226 [REVOKED]
(2) Parts 222 and 226 are revoked, and their content is revised and transferred
to the new Part 221.
Appendix 4
PART 221-SERVICE PROGRAMS FOR FAMILIES AND CHILDREN AND
[From the Federal Register, Vol. 38, No. 32-Feb. 16, 1973]
FOR AGED, BLIND, OR DISABLED INDIVIDUALS: TITLES I, IV (PARTS
A AND B), X, XIV, AND XVI OF THE SOCIAL SECURITY ACT
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
(3) Part 221 is added to Chapter II to read as set forth below.
Social and Rehabilitation Service
Subpart A-Requirements for Service Programs
[45 CFR Parts 220, 221, 222, and 226]
Sec.
SERVICE PROGRAMS FOR FAMILIES AND CHILDREN AND FOR AGED,
221.0
Scope of programs.
221.1
General.
BLIND, OR DISABLED INDIVIDUALS: TITLES I, IV (PARTS A AND B),
221.2
Organization and administration.
X, XIV, AND XVI OF THE SOCIAL SECURITY ACT
221.3
Relationship to and use of other agencies.
221.4
Freedom to accept services.
Notice of Proposed Rule Making
221.5
Statutory requirements for services.
221.6
Services to additional families and individuals.
Notice is hereby given that the regulations set forth in tentative form below
221.7
Determination and redetermination of eligibility for services.
are proposed by the Administrator, Social and Rehabilitation Service, with the
221.8
Individual service plan.
approval of the Secretary of Health, Education, and Welfare. The amendments
221.9
Definitions of services.
in general revise, combine and transfer to a new Part 221 the regulations for
221.30
Purchase of services.
the Family Services and Adult Services programs (in Parts 220 and 222), and
purchase of service (in Part 226). The revisions eliminate several administra-
Subpart B-Federal Financial Participation
tive requirements; reduce the number of required services-in recognition of
the limitation on Federal funds available for service expenditures-and increase
TITLES I, IV-A, X, XIV AND XVI
the number of optional services; specify the goals to which services must be
221.51
General.
directed clarify the State agency's responsibility for determination and rede-
221.52
Expenditures for which Federal financial participation is available.
termination of eligibility for services shorten the period of eligibility for former
221.53
Expenditures for which Federal financial participation is not available.
and potential recipients; amend the provisions on Federal financial participa-
221.54
Rates and amounts of Federal financial participation.
tion to add the limitations imposed by recent legislation and to clarify the
221.55
Limitations on total amount of Federal funds payable to States for
proper scope of Federal funding; and require written agreements for purchases
Services.
of services.
221.56 Rates and amounts of Federal financial participation for Puerto Rico,
The proposed regulations do not affect current provisions in Part 220 appli-
the Virgin Islands, and Guam.
cable to the work incentive program (WIN) and to child welfare services
(CWS). Amendments to those portions of Part 220 will be published separately.
TITLES I, IV-A, IV-B, X, XIV AND XVI
It is the intent of the Depatment to maintain in the final regulations the effec-
tive dates that are specified throughout the proposed amendments.
221.61 Public sources of State's share.
Prior to the adoption of the proposed regulations, considerations will be given
221.62 Private sources of State's share.
to any comments, suggestions, or objections thereto which are submitted in
AUTHORITY Section 1102. 49 Stat. 647 (42 U.S.C. 1302).
writing to the Administrator, Social and Rehabilitation Service, Department of
Health, Education, and Welfare, 330 Independence Avenue SW., Washington,
§ 221.0 Scope of programs.
DC, on or before March 19, 1973. Comments received will be available for public
(a) Federal financial participation is available for expenditures under the
inspection in Room 5121 of the Department's offices at 301 C Street SW., Wash-
State plan approved under title I, IV-A, IV-B, X, XIV, or XVI of the Act with
ington, DC on Monday through Friday of each week from 8:30 a.m. to 5 p.m.
respect to the administration of service programs under the State plan. The
(area code 202-963-7361).
service programs under these titles are hereinafter referred to as: Family
Dated February 12, 1973.
Services (title IV-A), WIN Support Services (title IV-A, Child Welfare Serv-
PHILIP J. RUTLEDGE,
ices (title IV-B), and Adult Services (titles I,X, XIV, and XVI)). Expenditures
Acting Administrator, Social and Rehabilitation Service.
subject to Federal financial participation are those made for services provided
Approved February 13, 1973.
to families, children, and individuals who have been determined to be eligible,
CASPAR W. WEINBERGER,
and for related expenditures, which are found by the Secretary to be necessary
Secretary.
for the proper and efficient administration of the State plan.
Chapter II, Title 45 of the Code of Federal Regulations is amended as fol-
(b) The basic rate of Federal financial participation for Family Services and
lows:
Adult Services under this part is 75 percent provided that the State plan meets
PART 220 [AMENDED]
all the applicable requirements of this part and is approved by the Social and
Rehabilitation Service. Under title IV-A, effective July 1, 1972, the rates are
(1) Part 220 is revoked, except for §§ 220.35, 220.36, and 220.61 (g) (relating
50 percent for emergency assistance in the form of services, and 90 percent for
to the WIN program under title IV-A of the Social Security Act), and §§ 220.40,
WIN Support Services, and effective January 1, 1973, the rate is 90 percent for
220.49, 220.55, 220.56, 220.62, and 220.65(b), and Subpart D (relating to the
the offering, arranging, and furnishing, directly or on a contract basis, of family
CWS program under title IV-B of the Act). The content of the revoked provi-
planning services and supplies.
sions is revised and transferred to a new Part 221, which, to the extent indicated
(c) Total Federal financial participation for Family Services and Adult Serv-
therein, shall be applicable to the WIN and CWS programs under such Part 220.
ices provided by the 50 States and the District of Columbia may not exceed
(62)
$2,500 million for any fiscal year, allotted to the States on the basis of their
64
65
population. No more than 10 percent of the Federal funds payable to a State
under its allotment may be paid with respect to its service expenditures for
to include in the State plan, and must, under the Adult Services program, provide
individuals who are not current applicants for or recipients of financial assistance
to each appropriate applicant for or recipient of financial assistance under the
classifications. under the State's approved plans, except for services in certain exempt
State plan at least one of the defined services which the State elects to include
in the State plan.
(d) Rates and amounts of Federal financial participation for Puerto Rico,
(b) (1) For the Family Services program, the mandatory services are family
Guam, and the Virgin Islands are subject to different rules.
planning services, foster-care services for children, and protective services for
children. The optional services are daycare services for children, educational serv-
Subpart A-Requirements for Service Programs
ices, employment services (non-WIN), health-related services, homemaker serv-
§ 221.1 General.
ices, home management and other functional educational services, housing im-
provement services, and transportation services.
The State plan with respect to programs of Family Services, WIN Support
(2) For the Adult Services program, the defined services are chore services,
Services, Child Welfare Services, and Adult Services must contain provisions
day-care services for adults, educational services, employment services, family
committing the State to meet the requirements of this subpart.
planning services, foster-care services for adults, health-related services, home
§ 221.2 Organization and administration.
delivered or congregate meals, home-maker services, home management and
(a) Single organizational unit.
other functional educational services, housing improvement services, protective
(1) There must be a single organizational unit, within the single State agency,
services for adults, special services for the blind, and transportation services.
at the State level and also at the local level, which is responsible for the furnish-
§ 221.6 Services to additional families and individuals.
ing of services by agency staff under title IV, parts A and B. Responsibility for
(a) If a State elects to provide services for additional groups of families or
furnishing specific services also furnished to clients under other public assistance
individuals, the State plan must identify such groups and specify the services to
plans (e.g., homemaker service) may be located elsewhere within the agency,
be made available to each group.
provided that this does not tend to create differences in the quality of services
(b) If a service or an element of service is not included for recipients of finan-
for AFDC and CWS cases. (This requirement does not apply to States where
cial assistance under the State plan, it may not be included for any other group.
the title IV-A and title IV-B programs were administered by separate agencies
(c) The State may elect to provide services to all or to reasonably classified sub-
on January 2, 1968).
groups of the following:
(2) Such unit must be under the direction of its chief officer who, at the State
(1) Families and children who are current applicants for financial assistance
level, is not the head of the State agency.
under title IB-A.
(b) Advisory committee on day-care services. An advisory committee on day-
(2) Families and individuals who have been applicants for or recipients of fi-
care services for children must be established at the State level to advise the
nancial assistance under the State plan within the previous 3 months, but only
State agency on the general policy involved in the provision of day-care services
to the extent necessary to complete provision of services initiated before with-
under the title IV-A and title IV-B programs. The committee shall include among
drawal or denial of the application or termination of financial assistance.
its members representatives of other State agencies concerned with day care
(3) Families and individuals who are likely to become applicants for or re-
or services related thereto and persons representative of professional or civic
cipients of financial assistance under the State plan within 6 months, i.e., those
or other public or nonprofit private agencies, organizations or groups concerned
who:
with the provision of day care.
(i) Do not have income exceeding 1331/3 percent of the State's financial as-
(c) Grievance system. There must be a system through which recipients may
sistance payment level under the State's approved plan; and
present grievances about the operation of the service program.
(ii) Do not have resources that exceed permissible levels for such financial
(d) Program implementation. The State plan must provide for State level serv-
assistance; and
ice staff to carry responsibility for:
(iii) In the case of eligibility under ttile IV-A, have a specific problem or
(1) Planning the content of the service programs, and establishing and inter-
problems which are susceptible to correction or amelioration through provision
preting service policies;
of services and which will lead to dependence on financial assistance under title
(2) Program supervision of local agencies to assure that they are meeting plan
IV-A within 6 months if not corrected or ameliorated; and
requirements and State policies, and that funds are being appropriately and effec-
(iv) In the case of eligibility under title I, X, XIV, or XVI, have a specific
tively used and
problem or problems which are susceptible to correction or amelioration through
(3) Monitoring and evaluation of the services programs.
provision of services and which will lead to dependence on financial assistance
(e) Provision of services. The State plan must specify how the services will
under such title, or medical assistance, within 6 months if not corrected or
be provided and, in the case of provision by other public agencies, identify the
ameliorated; and who are
agency and the service to be provided.
(a) At least 641/2 years of age for linkage to title I, or title XVI with respect
§ 221.3 Relationship to and use of other agencies.
to the aged;
There must be maximum utilization of and coordination with other public and
(b) Experiencing serious, progressive deterioration of sight that, as substan-
voluntary agencies providing similar or related services which are available with-
tiated by medical opinion, is likely to reach the level of the State agency's
out additional cost.
definition of blindness within 6 months, for linkage to title X, or title XVI with
respect to the blind; or
§ 221.4 Freedom to accept services.
(c) At least 171/2 years of age and, according to professional opinion, are ex-
Families and individuals must be free to accept or reject services. Acceptance
periencing a physical or mental condition which is likely to result within 6
of a service shall not be a prerequisite for the receipt of any other services or aid
months in permanent and total disability, for linkage to the XIV, or title XVI
under the plan, except for the conditions related to the Work Incentive Program
with respect to the disabled.
or other work program under a State plan approved by the service.
(4) Aged, blind, or disabled persons who are likely to become applicants for
or recipients of financial assistance under the State plan within 6 months as
§ 221.5 Statutory requirements for services.
evidenced by the fact that they are currently eligible for medical assistance
(a) In order to carry out the statutory requirements under the Act with respect
as medically needy individuals under the State's title XIX plan.
to Family Services and Adult Services programs, and in order to be eligible for
75 percent Federal financial participation in the costs of providing services,
§ 221.7 Determination and redetermination of eligibility for services.
including the determination of eligibility for services, the State must, under the
(a) The State agency must make a determination that each family and in-
Family Services program, provide to each appropriate member of the AFDC
dividual is eligible for Family Services or Adult Services prior to the provision
assistance unit the mandatory servic and those optional services the State elects
of services under the State plan.
(1) In the case of current applicants for or recipients of financial assistance
under the State plan, this determination must take the form of verification by
66
67
the organizational unit responsible for development of individual service plans
authorizations for additional periods may be made subject to review requirements
with the organzational unit responsible for determination of eligibility for fi-
in paragraph (b) of this section. No provision of service may be authorized at
nancial assistance that the family or individual has submitted an application
cost to the State agency if it is available without cost to the State agency.
for assistance which has not been withdrawn or denied or that the family or
(e) Efforts to enable individuals and families to clarify their need for serv-
individual is currently receiving financial assistance. This verification must iden-
ices, to identify and make choices of appropriate services, and to use services
tify each individual whose needs are taken into account in the application or the
effectively (i.e., supportive counseling) are assumed as an integral part of de-
determination of the amount of financial assistance.
velopment and maintenance of the individual service plan.
(2) In the case of families or individuals who are found eligible for service
on the basis that they are likely to become applicants for or recipients of fi-
§ 221.9 Definitions of services.
nancial assistance under the State plan, this determination must be based on evi-
(a) This section contains definitions of all mandatory and optional services
dence that the conditions of eligibility have been met, and must identify the
under the Family Services program and the defined services under the Adult
specific problems which, if not corrected or ameliorated, will lead to dependence
Services program (see §§ 221.5 and 221.6).
(b) (1) Chore services. This means the performance of household tasks, essen-
on such financial assistance or, in the case of the aged, blind or disabled, on
tial shopping, simple household repairs, and other light work necessary to enable
medical assistance.
an individual to remain in his own home when, because of frailty or other con-
(b) The State agency must make a redetermination of eligibility of each
ditions, he is unable to perform such tasks himself and they do not require the
family and individual receiving service at the following intervals:
services of a trained homemaker or other specialist.
(1) Quarterly for families and individuals whose eligibility is based on their
(2) Day care services for adults. This means personal care during the day in
status as current applicants for or receipients of financial assistance. (This re-
a protective setting approved by the State or local agency.
determination may be accomplished by comparison of financial assistance pay-
(3) Day care services for children. This means care of a child for a portion of
roll or eligibility listings with service eligibility listings.)
the day, but less than 24 hours, in his own home by a responsible person, or out-
(2) Within 30 days of the date that the status of the family or individual as
side his home in a family day care home, group day care home, or day care center.
a current applicant for or recipient of financial assistance is terminated.
Such care must be for the purposes of enabling the caretaker relatives to par-
(3) Within 6 months of the date of the original determination of eligibility
ticipate in employment, training, or receipt of needed services, where no other
and of any subsequent redetermination of eligibility for families and individuals
member of the child's family is able to provide adequate care and supervision.
whose eligibility is based on the determination that they are likely to become
In-home care must meet State agency standards that, as a minimum, include
applicants for or recipients of financial assistance.
requirements with respect to: The responsible person's age, physical and emo-
(4) Within 3 months of the effective date of this regulation for families and
tional health, and capacity and available time to care properly for children;
individuals receiving service on the basis that they are former applicants for or
minimum and maximum hours to be allowed per 24-hour day for such care;
maximum number of children that may be cared for in the home at any one time
recipients of financial assistance.
and proper feeding and health care of the children. Day care facilities used for
§ 221.8 Individual service plan.
the care of children must be licensed by the State or approved as meeting the
(a) An individual service plan must be developed and maintained on a cur-
standards for such licensing.
rent basis by agency staff for each family and individual receiving service under
(4) Educational services. This means helping individuals to secure educational
the State's title I, IV-A, X, XIV or XVI plan. No service, other than emergency
training most appropriate to their capacities, from available community resources
assistance in the form of services under the title IV-A plan, may be provided
at no cost to the agency.
(5) Employment services (non-WIN under title IV-A and for the blind or
under the State plan until it has been incorporated in the individual service
disabled). This means enabling appropriate individuals to secure paid employ-
plan and a service may be provided only to the extent and for the duration speci-
ment or training leading to such employment, through vocational, educational,
fied in the service plan. The service plan must relate all services provided to the
social, and psychological diagnostic assessments to determine potential for job
specific goals to be achieved by the service program. It must also indicate the tar-
training or employment; and through helping them to obtain vocational educa-
get dates for goal achievement and the extent and duration of the provision of
tion or training at no cost to the agency.
each service. For the purposes of this part, the specific goals to be achieved are
(6) Family planning services. (i) For Family Services this means social edu-
limited to:
cational, and medical services to enable appropriate individuals (including
(1) Self-support goal. To achieve and maintain the feasible level of employ-
minors who can be considered to be sexually active) to limit voluntarily the
ment and economic self-sufficiency. (Not applicable to the aged under the Adult
family size or space the children, and to prevent or reduce the incidence of
services program.)
births out of wedlock. Such services include printed materials, group discussions
(2) Self-sufficiency goal. To achieve and maintain personal independence,
and individual interviews which provide information about and discussion of
self-determination and security, including, for chlidren, the achievement of po-
family planning; medical contraceptive services and supplies; and help in
tential for eventual independent living.
utilizing medical and educational resources available in the community. Such
(b) The service plan must be reviewed as often as necessary to insure that only
services must be offered and be provided promptly (directly or under arrange-
appropriate services are provided to recipients but in any event once every 6
ments with others) to all individuals voluntarily requesting them.
months. At the time of each review the need for and effectiveness of all services
(ii) For Adult Services this means social and educational services, and help
must be reassessed and progress toward achievement of goals must be evaluated
in securing medical services, to enable individuals to limit voluntarily the family
and recorded.
size or space the children, and to prevent or reduce the incidence of births out
(c) Service plans for families and individuals who are determined to be eli-
of wedlock. Such services include printed materials, group discussions, and
gible for service on the basis that they are likely to become applicants for or
individual interviews which provide information about and discussion of family
recipients of financial assistance under the title I, IV-A, X, XIV or VXVI plan
planning; and help in utilizing medical and educational resources available in
may include only services which are necessary to correct or ameliorate the spe-
the community.
cific problems which will lead to dependence on such financial assistance or med-
(7) Foster care services for adults. This means placement of an individual in
ical assistance to aged, blind, or disabled persons under the title XIX plan, as
a substitute home which is suitable to his needs, supervision of such home. and
identified at the time of eligibility determination or redetermination.
periodic review of the placement, at least annually, to determine its continued
(d) Whenever the provider of services specified in the service plan is not lo-
appropriateness. Foster care services do not include activities of the home in
cated within the organizational unit responsible for the maintenance of the
providing care or supervision of the individual during the period of his place-
service plan, there must be a written authorization for the provision of the serv-
ment in the home.
ice to be provided and the individuals to whom it will be provided. No authoriza-
(8) Foster care services for children. This means placement of a child in a
tion for the provision of service may cover a period longer than 6 months but
foster family home, or appropriate group care facility, as a result of a judicial
68
69
determination to the effect that continuation of care in the child's own home
accordance with requirements prescribed by SRS. Effective April 1, 1973, all
would be contrary to the welfare of such child; services needed by such child
purchased services must be provided under agreements which meet the re-
while awaiting placement; supervision of the care of such child in foster care
quirements of this paragraph. A written agreement or written instructions which
and of the foster care home or facility, to assure appropriate care; counseling
meet the requirements of this paragraph must also be executed or issued by
with the parent or other responsible relative to improve home conditions and
the single State or local agency where services are provided under the plan
enable such child to return to his own home or the home of another relative, as
directly by the State or local agency in respect to activities added by reorgani-
zation of administrative structure, redesignation of the State or local agency, or
soon as feasible; and periodic review of the placement to determine its continu-
ing appropriateness. Foster care services do not include activities of the foster
otherwise, occurring after February 15, 1973, or are provided by any public
care home or facility in providing care or supervision of the child during the
agency as to which a waiver of the single State agency requirement pursuant to
section 204 of the Intergovernmental Cooperation Act is granted after February
period of placement of the child in the home or facility. A foster care home or
facility used for care of children must be licensed by the State in which it is
15, 1973. These written purchase of service agreements and other written agree-
ments or instructions are subject to prior review and approval by the SRS
situated or have been approved, by the agency of such State responsible for
Regional Office to the extent prescribed in, and in accordance with, instructions
licensing homes or facilities of this type, as meeting the standards established for
such licensing.
issued by SRS;
(3) Provide that services will be purchased only if such services are not
(9) Health-related services. This means helping individuals and families to
available without cost;
identify health needs and to secure diagnostic, preventive, remedial, ameliorative,
(4) Provide that purchase of services from individuals will be documented as
child health screening, and other needed health services available under Medicaid,
to type, cost, and quantity. If an individual acts as an agent for other providers,
Medicare, maternal and child health programs, handicapped children's programs
he must enter into a formal purchase of services agreement with the State
or other agency health services programs and from other public or private agen-
or local agency in accordance with paragraph (a) (2) of this section;
cies or providers of health services; planning, as appropriate, with the individual,
(5) Provide that overall planning for purchase of services, and monitoring
his relatives or others, and health providers to help assure continuity of treatment
and evaluation of purchased services, must be done directly by staff of the State
and carrying out of health recommendations; and helping such individual to
or local agency;
secure admission to medical institutions and other health-related facilities.
(6) Provide that the State or local agency will determine the eligibility of
(10) Home delivered or congregate meals. This means the preparation and de-
individuals for services and will authorize the types of services to be provided
livery of hot meals to an individual in his home or in a central dining facility as
to each individual and specify the duration of the provision of such services to
necessary to prevent institutionalization or malnutrition.
each individual;
(11) Homemaker services. (i) For Family Services this means care of indi-
(7) Assure that the sources from which services are purchased are licensed
viduals in their own homes, and helping individual caretaker relatives to achieve
or otherwise meet State and Federal standards;
adequate household and family management, through the services of a trained
(8) (i) Provide for the establishment of rates of payment for such services
and supervised homemaker.
which do not exceed the amounts reasonable and necessary to assure quality
(ii) For Adult Services this means care of individuals in their own homes, and
of service, and in the case of services purchased from other public agencies, are
helping individuals in maintaining, strengthening, and safeguarding their func-
in accordance with the cost reasonably assignable to such services;
tioning in the home through the services of a trained and supervised homemaker.
(ii) Describe the methods used in establishing and maintaining such rates;
(12) Home management and other functional educational services. This means
and
formal or informal instruction and training in management of household budgets,
(iii) Indicate that information to support such rates of payment will be
maintenance and care of the home, preparation of food, nutrition, consumer edu-
maintained in accessible form; and
cation, child rearing, and health maintenance.
(9) Provide that, where payment for services is made to the recipient for pay-
(13) Housing improvement services. This means helping families and indi-
ment to the vendor, the State or local agency will specify to the recipient the
viduals to obtain or retain adequate housing. Housing and relocation costs, in-
type, cost, quantity, and the vendor of the service, and the agency will establish
cluding construction, renovation or repair, moving of families or individuals, rent,
procedures to insure proper delivery of the service to, and payment by, the
deposits, and home purchase, may not be claimed as service costs.
recipient.
(14) Protective services for adults. This means identifying and helping to cor-
(b) In the case of services provided, by purchase, as emergency assistance to
rect hazardous living conditions or situations of an individual who is unable to
needy families with children under title IV-A, the State plan may provide for an
protect or care for himself.
exception from the requirements in paragraphs (a) (2), (4), (7), and (8) of this
(15) Protective services for children. This means responding to instances, and
section, but only to the extent and for the period necessary to deal with the
substantiating the evidence, of neglect, abuse, or exploitation of a child; helping
emergency situation.
parents recognize the causes thereof and strengthening (through arrangement of
(c) All other requirements governing the State plan are applicable to the
one or more of the services included in the State plan) parental ability to provide
purchase of services, including:
acceptable care; or, if that is not possible, bringing the situation to the attention
(1) General provisions such as those relating to single State agency, grievances,
of appropriate courts of law enforcement agencies, and furnishing relevant data.
safeguarding of information, civil rights, and financial control and reporting
(16) Special services for the blind. This means helping to alleviate the handi-
requirements; and
capping effects of blindness through: training in mobility, personal care, home
(2) Specific provisions as to the programs of services such as those on re-
management, and communication skills; special aids and appliances; special coun-
quired services, statewideness, maximum utilization of other agencies providing
seling for caretakers of blind children and adults; and help in securing talking
services, and relating services to defined goals.
book machines.
(17) Transportation services. This means making it possible for an individual to
Subpart B-Federal Financial Participation
travel to and from community facilities and resources, as part of a service plan.
TITLES I, IV-A, X, XIV, AND XVI
§ 221.30 Purchase of services.
§ 221.51 General.
(a) A State plan under title I, IV-A, X, XIV, or XVI of the Act, which author-
Federal financial participation is available for expenditures under the State
izes the provision of services by purchase from other State or local public agen-
cies, from nonprofit or proprietary private agencies or organizations, or from
plan which are:
individuals, must with respect to services which are purchased :
(a) Found by the Secretary to be necessary for the proper and efficient admin-
(1) Include a description of the scope and types of services which may be
istration of the State plan;
purchased under the State plan;
(b) (1) For services under the State plan provided in accordance with the
(2) Provide that the State or local agency will negotiate a written purchase
individual service plan to families and individuals included under the State
of services agreement with each public or private agency or organization in
70
71
plan who have been determined (and redetermined) to be eligible pursuant to
(2) Medical examinations for persons caring for children under agency
the provisions of this part
auspices, and are not otherwise available; or
(2) For other activities which are essential to the management and support
(3) For medical (including psychiatric) diagnostic assessments necessary
of such services;
to the development of a service plan for an individual;
(3) For emergency assistance in the form of services to needy families with
(j) Subsistence and other maintenance assistance items even when such items
children (see § 233.120 of this chapter) ; and
are components of a comprehensive program of a service facility;
(c) Identified and allocated in accordance with SRS instructions and OMB
(k) Transportation which is provided under the State's title XIX plan;
Circular A-87.
(1) Effective January 1, 1974, costs of employment services (non-WIN) under
§ 221.52 Expenditures for which Federal financial participation is available.
title IV-A provided to persons who are eligible to participate in WIN under
title IV-C of the Act, unless the WIN program has not been initiated in the local
Federal financial participation is available in expenditures for:
jurisdiction; and
(a) Salary, fringe benefits, and travel costs of staff engaged in carrying out
(m) Other costs not approved by SRS.
service work or service-related work;
(b) Costs of related expenses, such as equipment, furniture, supplies, com-
§ 221.54 Rates and amounts of Federal financial participation.
munications, and office space;
(a) Federal financial participation at the 75 percent rate. (1) For States with
(c) Costs of services purchased in accordance with this part;
a State plan approved as meeting the requirements of Subpart A of this part,
(d) Costs of State advisory committees on day care services for children, in-
and that have in operation an approved separated service system in accordance
cluding expenses of members in attending meetings, supportive staff, and other
with § 205.102 of this chapter, Federal financial participation at the rate of 75
technical assistance;
percent is available for all matchable direct costs of the separated service system,
(e) Costs of agency staff attendance at meetings pertinent to the development
plus all indirect costs which have been allocated in accordance with an approved
or implementation of Federal and State service policies and programs;
cost allocation plan and with the requirements of OMB Circular A-87.
(f) Cost to the agency for the use of volunteers;
(2) For States with a State plan approved as meeting the requirements of
(g) Costs of operation of agency facilities used solely for the provision of
Subpart A of this part, but that do not have in operation an approved separated
services, except that appropriate distribution of costs is necessary when other
service system in accordance with § 205.102 of this chapter, the rate of Federal
agencies also use such facilities in carrying out their functions, as might be
financial participation is governed by the regulations in Parts 220 and 222 of
the case in comprehensive neighborhood service centers;
this chapter as in effect on January 1, 1972, for all matchable direct costs of the
(h) Costs of administrative support activities furnished by other public
services program, plus all indirect costs which have been allocated in accordance
agencies or other units within the single State agency which are allocated to
with an approved cost allocation plan and with the requirements of OMB
the service programs in accordance with an approved cost allocation plan or
Circular A-87.
an approved indirect cost rate as provided in OMB Circular A-87;
(b) Federal financial participation for purchased services. (1) Federal finan-
(i) With prior approval by SRS, costs of technical assistance, surveys, and
cial participation is available in expenditures for purchase of service under the
studies, performed by other public agencies, private organizations, or individuals
State plan to the extent that payment for purchased services is in accordance
to assist the agency in developing, planning, monitoring, and evaluating the
with rates of payment established by the State which do not exceed the amounts
services program when such assistance is not available without cost;
reasonable and necessary to assure quality of service and, in the case of services
(j) Costs of advice and consultation furnished by experts for the purpose
purchased from other public agencies, the cost reasonably assignable to such
of assisting staff in diagnosis and in developing individual service plans;
services, provided the services are purchased in accordance with the require-
(k) Costs of emergency assistance in the form of services under title IV-A;
ments of this part.
(1) Costs incurred on behalf of an individual under title I, X, XIV or XVI
(2) Services which may be purchased with Federal financial participation are
for securing guardianship or commitment (e.g., court costs, attorney's fees and
those for which Federal financial participation is otherwise available under title
guardianship or other costs attendant on securing professional services)
I, IV-A, X, XIV, or XVI of the Act and which are included under the approved
(m) Costs of public liability and other insurance protection and
State plan, except as limited by the provisions of paragraph (6) (3) of this
(n) Other costs, upon approval by SRS.
section.
§ 221.53 Expenditures for which Federal financial participation is not available.
(3) Effective March 1, 1973, Federal financial participation is available for a
new purchase of services from another public agency only for services beyond
Federal financial participation is not available under this part in expenditures
those represented by fiscal year 1972 expenditures of the provider agency (or its
for:
predecessors) for the type of service and the type of persons covered by the
(a) Carrying out any assistance payments functions, including the assistance
agreement. A new purchase of service from another public agency is any pur-
payments share of costs of planning and implementing the separation of services
chase of services other than a purchase for the type of service and the type of
from assistance payments;
persons covered by an agreement that was validly subject to Federal financial
(b) Activities which are not related to services provided by agency staff or
participation under title I, IV-A, X, XIV, or XVI prior to February 16, 1973.
volunteers, by arrangements with other agencies, organizations, or individuals,
at no cost to the service program, or by purchase;
EXAMPLE: The welfare agency makes an agreement for purchase of
(c) Purchased services which are not secured in accordance with this part;
services from another public agency. In the year ended June 30, 1972,
(d) Construction and major renovations;
there was no purchase arrangement, and such other agency expended
(e) Vendor payments for foster care (they are assistance payments) ;
$100,000 in non-Federal funds in furnishing the type of services to the
(f) Issuance of licenses or the enforcement of licensing standards;
type of persons covered by the agreement. In the year ending June 30,
(g) Education programs and services that are normally provided by the
1974. Federal financial participation will be available only to the
regular school system;
extent that the expenditures of such other agency for these purposes
(h) Housing and relocation costs, including construction, renovation or repair,
from non-Federal sources are expanded. If the total expenditures are
moving of families or individuals, rent, deposits, and home purchase;
$100,000 or less, there will be no Federal payments. If the total expendi-
(i) Medical, mental health, or remedial care or services, except when they
tures are over $100,000, Federal financial participation will be avail-
are:
able only in the excess over $100,000. Thus, if total expenditures are
(1) Part of the family planning services under title IV-A, including medical
$200,000, the Federal share at 75 percent of expansion would be $75,000.
services or supplies for family planning purposes;
For a new purchase in the period February 16 through June 30, 1973,
for the purpose of computing the Federal financial participation for
72
73
the remainder of the fiscal year ending June 30, 1973, the total fiscal
all of the States as determined from the most recent satisfactory data available
year 1972 expenditures of $100,000 are prorated. Thus, if the new
from the Department of Commerce at such time.
purchase went into effect on April 1, 1973, Federal financial participation
(d) Not more than 10 percent of the Federal funds shall be paid with respect
for the April-June 1973 quarter would be available only in the excess
to expenditures in providing services to individuals (eligible for services) who
over $25,000 for that quarter.
are not recipients of aid or assistance under State plans approved under such
(4) The provisions of paragraph (b) (3) of this section also apply to services
titles, or applicants for such aid or assistance, except that this limitation does
provided, directly or through purchase, by:
not apply to the following services:
(i) Any public agency as to which a waiver of the single State agency
(1) Services provided to meet the needs of a child for personal care, protection,
requirement pursuant to section 204 of the Intergovernmental Cooperation Act
and supervision (as defined under day care services for children) but only in
is granted after February 15, 1973, or
the case of a child where the provision of such services is needed in order to
(ii) The State or local agency, as to activities added by reorganization of
enable a member of such child's family to accept or continue in employment or
administrative structure, redesignation of the State or local agency, or other-
to participate in training to prepare such member for employment, or because of
wise, occurring after February 15, 1973.
the death, continued absence from the home, or incapacity of the child's mother
and the inability of any member of such child's family to provide adequate care
221.55 Limitations on total amount of Federal funds payable to States for
and supervision for such child;
services.
(2) Family planning services;
(a) The amount of Federal funds payable to the 50 States and the District
(3) Any services included in the approved State plan that are provided to an
of Columbia under titles I, IV-A, X, XIV, and XVI for any fiscal year (com-
individual diagnosed as mentally retarded by a State mental retardation clinic
mencing with the fiscal year beginning July 1, 1972) with respect to expendi-
or other agency or organization recognized by the State agency as competent
tures made after June 30, 1972 (see paragraph (b) of this section), for services
to make such diagnoses, or by a licensed physician, but only if such services are
(other than WIN Support Services, and emergency assistance in the form of
needed as part of an individual service plan for such individual by reason of his
services, under title IV-A) is subject to the following limitations:
condition of being mentally retarded;
(1) The total amount of Federal funds paid to the State under all of the
(4) Any services included in the approved State plan provided to an indi-
titles for any fiscal year with respect to expenditures made for such services
vidual who has been diagnosed by a licensed physician as a drug addict or al-
shall not exceed the State's allotment, as determined under paragraph (c) of
coholic, but only if such services are needed by such individual under an individual
this section; and
service plan as part of a program of active treatment of his condition as a drug
(2) The amounts of Federal funds paid to the State under all of the titles
addict or an alcoholic; and
for any fiscal year with respect to expenditures made for such services shall
(5) Foster care services for children when needed by a child under an individ-
not exceed the limits pertaining to the types of individuals served, as specified
ual service plan because he is under foster care.
under paragraph (d) of this section.
§ 221.56 Rates and amounts of Federal financial participation for Puerto Rico,
Notwithstanding the provisions of paragraphs (c) (1) and (d) of this section,
the Virgin Islands, and Guam.
a State's allotment for the fiscal year commencing July 1, 1972, shall consist
of the sum of
(a) For Puerto Rico, the Virgin Islands, and Guam, the basic rate for Federal
(i) An amount not to exceed $50 million payable to the State with respect
financial participation for Family Services and WIN Support Services under title
to the total expenditures incurred, for the calendar quarter beginning July 1,
IV-A is 60 percent. However, effective July 1, 1972, the rate is 50 percent for
1972, for matchable costs of services of the type to which the allotment provi-
emergency assistance in the form of services.
sions apply, and
(b) For family planning services and for WIN Support Services, the total
(ii) An amount equal to three-fourths of the State's allotment as determined
amount of Federal funds that may be paid for any fiscal year shall not exceed
in accordance with paragraphs (c) (1) and (d) of this section.
$2 million for Puerto Rico, $65,000 for the Virgin Islands, and $90,000 for Guam.
Other services are subject to the overall payment limitations for financial assist-
However, no State's allotment for such fiscal year shall be less than it would
ance and services under titles I, IV-A, X, XIV, XVI, as specified in section 1108
otherwise be under the provisions of paragraphs (c) (1) and (d) of this section.
(b) For purposes of this section, expenditures for services are ordinarily
(a) of the Social Security Act.
considered to be incurred on the date on which the cash transactions occur or
(c) The rates and amounts of Federal financial participation set forth in
the date to which allocated in accordance with OMB Circular A-87 and cost
§ 221.54 (a) and (b) of this chapter apply to Puerto Rico, the Virgin Islands and
Guam, except that the 60-percent rate of Federal financial participation is sub-
allocation procedures prescribed by SRS. In the case of local administration,
stituted as may be appropriate. The limitation in Federal payments in § 221.55
the date of expenditure by the local agency governs. In the case of purchase of
services from another public agency, the date of expenditure by such other
of this chapter does not apply.
public agency governs. Different rules may be applied with respect to a State,
TITLES I, IV-A, IV-B, X, XIV, AND XVI
either generally or for particular classes of expenditures, only upon justification
by the State to the Administrator and approval by him. In reviewing State
§ 221.61 Public sources of State's share
requests for approval, the Administrator will consider generally applicable State
(a) Public funds, other than those derived from private resources, used by the
law, consistency of State practice, particularly in relation to periods prior to
State or local agency for its services programs may be considered as the State's
July 1, 1972, and other factors relevant to the purposes of this section.
share in claiming Federal reimbursement where such funds are:
(c) (1) For each fiscal year (commencing with the fiscal year beginning
(1) Appropriated directly to the State or local agency or
July 1, 1972) each State shall be allotted an amount which bears the same ratio
(2) Funds of another public agency which are:
to $2,500 million as the population of such State bears to the population of all
(i) Transferred to the State or local agency and are under its administrative
the States.
control; or
(2) The allotment for each State will be promulgated for each fiscal year by
(ii) Certified by the contributing public agency are representing current ex-
the Secretary between July 1 and August 31 of the calendar year immediately
penditures for services to persons eligible under the State agency's services pro-
preceding such fiscal year on the basis of the population of each State and of
grams, subject to all other limitations of this part.
74
Funds from another public agency may be used to purchase services from the
contributing public agency, in accordance with the regulations in this part on
purchase of services.
(b) Public funds used by the State or local agency for its services programs
may not be considered as the State's share in claiming Federal reimbursement
where such funds are
(1) Federal funds, unless authorized by Federal law to be used to match other
Federal funds ;
(2) Used to match other Federal funds ; or
(3) Used to purchase services which are available without cost.
In respect to purchase of services from another public agency, see also § 221.54
(b) of this chapter with respect to rates and amounts of Federal financial
participation.
§ 221.62 Private sources of State's share.
Donated private funds or in-kind contributions may not be considered as the
State's share in claiming Federal reimbursement.
[FR Doc. 73-3140 Filed 2-15-73 ; 8 :45 am]
Aging
WILLIAM S. COHEN
COMMITTEES:
2D DISTRICT, MAINE
JUDICIARY
MERCHANT MARINE AND
1223 LONGWORTH BUILDING
FISHERIES
(202) 225-6306
Congress of the United States
house of Representatives
Washington, D.C. 20515
November 26, 1973
Dear Colleague:
Millions of elderly Americans now live - often for extended periods of time --
in nursing homes. Last year, the Federal government provided over a billion
dollars to such institutions as part of the Medicare and Medicaid programs.
Despite the worthy purposes of these nursing facilities and the extensive
Federal involvement in them, the sad reality is that in a significant percentage
of these homes the quality of treatment and care falls tragically short of
expected standards and the patients become victims of the institutions
intended to serve them.
People knowledgeable of nursing home conditions can cite endless examples of
the abuse and neglect that can and do occur in such facilities: bed-ridden
incontinent patients left unattended for the entire day; staff stealing food
and money from the residents; an elderly lady classified as senile because
the doctor did not determine that she was stone deaf and could not hear his
questions; a woman whose leg had to be amputated because a blood clot was not
noticed by the staff until the leg had turned gangrenous. It is small wonder
that the elderly dread the day when they may no longer be able to care for
themselves and must enter nursing homes.
I believe strongly that conditions in nursing homes, particularly those
receiving Federal monies, can and must be improved. On Tuesday, December 4,
I will be introducing legislation providing for a Nursing Home Patients'
Bill of Rights. The measure requires that long-term care facilities certified
for Medicare and Medicaid patients adopt, give to their patients, and implement
through appropriate staff training a statement of the rights reserved to the
patients.
The guarantees would include the patients' right to exercise civil and religious
liberties, the right to receive adequate and appropriate medical care, the
right to have full knowledge of their medical condition and to participate in
the planning of their medical treatment, and the right to have private and
unrestricted communications with any person and to present grievances to the
facility or to government officials without fear of reprisal. Should the
patient be adjudicated incompetent, these rights would devolve upon a trusted
sponsor who would act in the patient's behalf.
Instituting a bill of rights would help correct a number of problems inherent
with many nursing homes. For one, it would make it clear to both the patient
and the staff that residents of the facility are individuals and retain the
rights and privileges of other citizens in this country. It would also give
the patient badly needed reassurances about the care he can expect and a measure
of control over the conditions surrounding and affecting him.
FORD & LIBRARY GERALD
November 26, 1973
Page Two
I think it important to point out that the approaches and attitude engendered
by such guarantees would benefit not only the patient but also the nursing home.
A patient who is confident in the care he is receiving and is informed of his
condition will generally be far more cooperative and will respond better to
treatment. A bill of rights can also do much to correct the sometimes over-
whelming atmosphere of apathy and despair which occurs when patients believe
they have been consigned to nursing homes only to await death. In the cold,
authoritarian environment of a medical institution patients come to feel themselv
objects rather than people. Such an atmosphere can inure the most understanding
staff and defeat the entire purpose of the nursing home.
In developing this legislation, I have spoken at length with HEW officials
involved in nursing home standards, with representatives of groups concerned
about elderly problems, and with those involved in nursing home administration.
One nursing home administrator told me that operating under these guarantees
is "just good business sense. Among those I consulted there was strong
agreement that requiring the adoption by nursing homes of a bill of rights
would not be a problem in good nursing homes but could prove a vital mechanism
for improving conditions in substandard facilities. They also felt that placing
such a requirement in Federal law would assure more effective enforcement of
these rights in Medicare and Medicaid facilities and would encourage and assist
the states, who have the responsibility for inspecting and licensing the bulk
of the nursing homes, in adopting similar legislation.
I hope you will agree with me on the importance of legislation and will give it
your support. If you would like to join me in sponsoring the bill or would
like further information on it, please contact Bobbi McCarthy (5-1963) of my
staff by the close of business on Monday, December 3.
Sincerely,
Bill Cohen,
WSCra
ROBERT H. STEELE, CONN., CHAIRMAN
CHARLES A. MOSHER, OHIO
L.A. (SKIP) BAFALIS, FLA.
PETER A. PEYSER, N.Y.
HAROLD R. COLLIER, ILL.
JOEL PRITCHARD, WASH.
JAMES HARVEY, MICH.
RONALD A. SARASIN, CONN.
MARGARET M. HECKLER, MASS.
VICTOR V. VEYSEY, CALIF.
H. JOHN HEINZ III, PA.
WILLIAM B. WIDNALL, N.J.
WILLIAM J. KEATING, OHIO
TASK FORCE ON AGING
C. W. BILL YOUNG, FLA.
JOHN Y. MC COLLISTER, NEBR.
SAMUEL H. YOUNG, ILL.
REPUBLICAN RESEARCH COMMITTEE
JAMES N. BRODER, DIRECTOR
U.S. HOUSE OF REPRESENTATIVES
1620 LONGWORTH HOUSE OFFICE BLDG.
202-225-5107
WASHINGTON, D.C. 20515
October 31, 1973
TO: Republican Members of Congress
GERALD FORD NIBRARK
FROM: Task Force on Aging
RE: Legislation passed and pending in the 93rd Congress which pertains
to the elderly.
The Task Force has compiled this summary of legislation in order to
give you an overview of the current situation so that you may better
answer the questions and meet the needs of your constituents. The
summary is broken down by subject matter, with a brief description
of each problem. This compilation includes summaries of pertinent
legislation passed or pending action through the middle of October.
The Task Force will provide you with addenda to this summary from
time to time.
CONTENTS
PAGE NUMBER
PROBLEM
1
Income
4
Housing
6
Health
8
Nutrition
9
Transportation
10
Education
12
Taxes
13
Elderly as Consumers
14
Age Discrimination in Employment
15
Senior Centers
15
Volunteer Opportunities
I. PROBLEM: INCOME
Economic security is probably the number one problem confronting older citizens.
The elderly have saved for years for their retirement only to find that it is not
nearly enough in the face of inflation. The median income of older persons today
is less than half that of their younger counterparts. In 1970, it was estimated
that almost 5 million elderly persons, or one-fourth of those over 65, live with
an incomebelow the poverty level. While people over 65 make up over 10% of the
population, they make up 20% of the country's poor. The most disadvantaged member
in our society would appear to be the elderly widow. It is estimated that almost
50% of all elderly widows live in poverty.
Older consumers spend a greater proportion of their money on food, housing, house-
hold operations and medical care than do younger consumers. Parenthetically,
those under 6.5 spend more of their income on clothing, recreation, transportation
and household furnishings. However, if given the same amount of money with which
to work, purchasing patterns are the same for older and younger people.
The needs of the elderly person are not less, but he simply cannot afford the
same standard of living as the younger person. And without an adequate income,
there can be little self-reliance for the older person. Moreover, an elderly
person is often discouraged from working because of the loss of social security
benefits. Worse, there exists discrimination against older people who want
to work.
II. WHAT CONGRESS IS DOING
A. NEW LAW
DERALD R. FOR,
1. P.L. 93-66: Social Security Amendments
These amendments provide for a special 5.9% cost-of-living increase in the
Social Security benefits paid between June 1974 and December 1974. Benefits for
months after 1974 will be increased under the provisions of present law which call for
annual cost-of-living increases whenever the Consumer Price Index has risen by 3%.
The 5.9% increase should raise the average monthly benefit paid to a retired person
from $167 to $177 and the average monthly benefit for aged couples from $278 to $295.
The amendments also increase, effective for Jan. 1974, the amount an individual can earn
in any year and still be paid all of his Social Security benefits from $2,100 per
year to $2,400.
In addition, these amendments increase, effective July 1974, SSI payments from $130
to $140 for an individual and from $195 to $210 for a couple.
2. P.L. 93-69: Amendments to the Railroad Retirement Act
Effective July 1, 1974, this legislation permits men with 30 years of railroad
employment to retire on full annuities at age 60. Also, it extends to Dec. 31,
1974 the 15% increase in annuities which became effective in 1970, the 10% increase
in annuities which became effective in 1971, and the 20% increase in annuities
which became effective in 1972. In addition, this legislation provides an
automatic increase in railroad annuities if Social Security benefits are increased
after June 1973 and before January 1975. Increases are also tied dollar for dollar
to increases in Social Security benefits.
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3. Supplemental Security Income (SSI) Program of Income Maintenance for
the Aged, Blind, and Disabled (enacted as part of the Social Security Amendments of
1972: P.L. 92-603)
The new SSI program will begin in January of 1974. To be eligible for SSI benefits,
aged, blind, and disabled persons must have resources of less than $1500 or less
than $2250 in the case of a couple. Resources include such items as cash, stocks,
and bonds. A home, household furnishings, personal effects, and a car will usually
not be counted. Eligibility for SSI payments will be based on several criteria,
including age, blindness, disability, and financial situation. For purposes of
SSI eligibility, an individual must be at least 65 years of age to be considered
"aged".
Under the new SSI program, an aged, blind, or disabled person with no other income
will receive a federal benefit payment of $130 per month. An eligible couple
with no other income will receive $195 per month. Effective July, 1974, these
amounts will be increased to $140 for an individual and $210 for a couple.
Moreover, a recipient's benefits will not be reduced because of the first
$20 of unearned income per month.
The new SSI program includes -many advantages not found in previous pro-
grams of assistance to the aged, blind, and disabled:
a. The law eliminates many of the current complex enrollment procedures.
The applicant needs to go to only the Social Security office, instead of possibly
to the state, local, and/or county offices which is often necessary now. Presently,
in many jurisdictions, an individual's grant is based on a detailed probing into
his or her personal life. The new SSI's flat cash payment eliminates the need for
such inquiry.
b. The new SSI is administered nationally, meaning that valuable
dollars are saved on administration and can be sent directly to recipients.
C. One of the most important aspects of SSI is its expanded coverage.
Under the present programs, about 3.3 million aged, blind, and disabled persons
are receiving payments. Under the new law, the number will increase to 6.3 million,
nearly double the present number of persons. There are a number of reasons for
this large increase in the number of recipients: the federal monthly standards of
$130 and $195 are higher than present standards in about half of the states, thereby
making some persons not presently eligible for assistance eligible under the SSI
program; the federal program ignores certain kinds and amounts of income and resources
that are counted under many state programs; many persons who are eligible under the
state laws have not applied for assistance because of lien laws or relative res-
ponsibility laws, but will apply for SSI benefits. It is critical to note that
Congress has assumed that every eligible individual will receive as much, and in
many cases more, than the amount he or she presently receives.
B. PENDING
1. H.R. 1493 (Fraser) and H.R. 100 (Fraser)
These two identical bills would make certain that recipients of veterans' pension
and compensation will not have the amount of their pension or compensation reduced
because of increases in monthly Social Security benefits.
2. H.R. 4200 (Broyhill)
Pertinent major provisions of H.R. 4200 as passed by the Senate:
a. All private pension plans are required to let a worker join no
later than age 30, provided he has worked for the firm for at least one year.
This provision is effective on enactment for new plans and in 1976 for existing
plans.
-3-
b. The worker is granted 25% vesting after five years in the plan.
This rises by 5% a year for the next five years and by 10% annually for the next
five years, so that after 15 years in the plan, the worker is 100% vested. Workers
already in a firm with a plan can receive five or more years of retroactive credits.
Effective on enactment for new plans, in 1976 for existing plans.
c. Rules are established to make sure employers put enough money into
plans to keep them properly funded.
d. A federal insurance fund is established, to be financed with
premiums from firms having private plans, to insure workers against loss of pension
benefits due to plan bankruptcy or underfunding. A worker would be guaranteed up
to $750 a month or half his monthly average wage for the five highest years of
pay, whichever is less.
d. Fiduciary standards are set and self-dealing is prohibited in
the administration of pension plans.
e. Federal tax deductions are barred for money set aside to pay for
corporate pensions in excess of $75,000 a year or three-quarters of higheset three-
year earning average, whichever is less. This applies to large corporations as
well as to small "closely held" business and professional corporations.
f. A worker changing jobs is allowed to switch credits to his new
employer or to a special new federal pension fund, provided that the old and new
employers agree.
g. A self-employed person is permitted to deduct up to $7,500 a year
(instead of the present $2,500) on his tax return for amounts set aside in a "Keogh
law" self-employed pension plan.
h. A person who works in a job where there isn't any private pension
plan is permitted to deduct up to $1,500 for money set aside for a private pension
plan of his own.
3. H.R. 4763 (Dorn)
Would prohibit the Veterans' Administration from readjusting the schedule of ratings
for disabilities of veterans without first submitting the proposed readjustment
to the Congress.
4. H.R. 10776 (Steele)
Would amend title 10 of the United States Code to restore the system of recompu-
tation of retired pay for certain members and former members of the armed forces.
Provides that the retired pay of any member or former member who was on active duty
or in an active status on or before May 31, 1958, and who became or will become
entitled to receive retired pay, shall be computed at current active duty rates and
increased to reflect later changes in applicable pay rates.
5. Five Bills in the House to Grant Immediate Cost-of-Living Social
Security Increase
Provide that the special cost-of-living increase in Social Security benefits
enacted by P.L. 93-66 shall become effective immediately.
FORD i LIBRARY GERALD
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I. PROBLEM: HOUSING
Elderly persons pay a disproportionately high percentage (35%) of their incomes
for rent or home ownership costs. This is in contrast to 23% for younger persons.
Since retirement income is often very low, very little money is left for other
basic needs, such as food, transportation, medical care, and clothing. Govern-
ment programs should be made available to provide elderly homeowners with grants
or below-market interest loans for home maintenance and repair, property tax
relief, and a comprehensive system of community support services directed toward
prolonging and facilitating the maintenace of older homeowners in their homes.
In addition, the federal government should continue to encourage specifically
designed housing for the elderly since this type of housing arrangement has
been a successful option for many older persons.
II. WHAT CONGRESS IS DOING
A. PRESENT SITUATION
1. Housing Moratorium
Since January 8, 1973, HUD has been making no new commitments under any housing
programs for the elderly, pending review of the current situation of elderly
housing. The Administration has proposed a direct cash assistance program
which would replace the subsidized housing program. The projected annual cost
for reaching all eligible elderly persons is $1 1/2 to $2 1/2 billion. The
current experimental programs are reaching approximately 18,000 families at a
cost of $160 million. The Administration's proposal also allows for the limited
construction of housing for the elderly under Section 23. In addition, funds
under the Better Communities Act would be available at local option for the
construction of further housing units specifically designed for the elderly.
B. PENDING
1. Loan Programs
a. S. 513 (Moss)
Amends Section 232 of the National Housing Act to authorize insured loans to
provide fire safety equipment for nursing homes.
b. S. 2179 (Williams)
Establishes a demonstration direct loan program for elderly housing based on a
revolving trust fund, originally financed by not more than $50 million in
Treasury Notes.
C. H.R. 8382 (Stephens)
Authorizes the use of direct loans under Section 202 of the Housing Act of 1959
to finance the construction of housing projects for the elderly, with refinancing
under Section 236 of the National Housing Act; to increase the amount authorized
for such loans; and to provide for the appointment of an Assistant to the Secretary
of Housing and Urban Development with responsibility for housing and related
programs for the elderly.
2. Grant Programs
a. S. 633 (Church)
Authorizes the Secretary of Labor to make grants for the conduct of older
Americans home repair projects.
b. S. 2180 (Williams): "Housing Security Act of 1973"
Establishes an Office of Security in HUD to make grants for crime prevention
programs for federal housing projects.
C. S. 2181 (Williams): Intermediate Housing for the Elderly and
-5-
Handicapped Amendment to the National Housing Act
Provides funding for the conversion of existing single or double family housing
units into multi-family efficiency units, with supportive services.
d. S. 2185 (Williams): Extension of Section 202, Direct Loan
Elderly Housing
Provides $100 million increase in authorized funding for the purpose of countermanding
HUD phase-out during last 6 years of Section 202 program, which is being replaced
by Section 36 interest subsidies.
e. H.R. 1553 (Helstoski)
Amends the Social Security Act to provide for the payment (from the old-age and
survivors insurance trust fund) of special allowances to help elderly low-income
persons and families to meet their housing costs.
3. Fire Safety
a. H.R. 8569 (Keating)
GERALD FORD ABRARY
Provides for compliance with improved fire safety conditions in multi-family
housing facilities designed for occupancy in whole or substantial part by
the elderly, and authorizes federal assistance in financing the provision of
more adequate fire safety equipment for such facilities.
b. H.R. 2697 (Keating)
Amends Section 232 of the National Housing Act to include fire safety equip-
ment among the items which may be covered by an insured mortgage thereunder,
requires as a condition of eligibility for mortgage insurance that a nursing
home or intermediate care facility complies with the Life Safety Code, and
authorizes insured loans to provide fire safety equipment for such a home or
facility.
C. H.R. 10293 (Steele) "Elderly Life Safety Act of 1973.
Amends the National Housing Act and related laws to provide for compliance with
improved fire safety conditions in multi-family housing facilities designed for
occupancy in whole or substantial part by the elderly and to authorize federal
assistance in financing the provision of more adequate fire safety equipment
for those facilities; to impose additional fire safety requirements upon
nursing homes and similar facilities and assist them in meeting such require-
ments.
d. S. 513 (Moss)
Amends Section 232 of the National Housing Act to authorize insured loans to
provide fire safety equipment for nursing homes.
4. Liberalizing Eligibility Requirements for Subsidized Housing
a. H.R. 229 (Abzug)
Amends Section 236 of the National Housing Act and Section 101 of the Housing
and Urban Development Act of 1965 to reduce from 25 to 20 per centum of the
tenant's income the maximum rent which may be charged for a dwelling unit in a
Section 236 project or a dwelling unit qualifying for assistance under the
rent supplement program.
b. S. 1322 (Williams)
Requires the Secretary of Housing and Urban Development to disregard the increase
in the benefits under Title II of the Social Security Act pursuant to Public
Law 92-336 in determining eligibility or the amount of assistance under certain
laws relating to low-income housing.
-6-
C. S. 835 (Humphrey): "Full Social Security Benefit Act of 1973"
d. H.R. 2495 (Yates)
Requires States to pass along to individuals who are recipients of aid or
assistance under the Federal-State public assistance programs or under certain
other Federal programs, and who are entitled to social security benefits, the
full amount of the 1972 increase in such benefits, either by disregarding it in
determining their need for assistance or otherwise.
5. Other Bills
a. H.R. 226 (Abzug)
To make needed housing available for the elderly.
b. H.R. 3818 (Hechler)
Requires the Secretary of Housing and Urban Development, in the administration of
the housing programs under his jurisdiction, to take more fully into account the
special needs of the elderly.
I. PROBLEM: HEALTH
The medical care costs for older Americans are 3 1/2 times as high as
those for persons under 65. Specifically, older people pay on the average
of $861 per person each year for medical expenses and prescription
drugs, while the individual under 65 pays only $250. Although Medicare
and Medicaid provide some relief, the elderly person is expected to pay
twice the amount of a younger person but with only half the income.
II. WHAT CONGRESS IS DOING
A. PENDING
1. National Health Care
a. H.R. 7974 (Roy) and S. 14 (Kennedy) : Health Maintenance
Organization Act
Would establish a pilot program through which federal financial assistance
is made available to public and nonprofit private organizations for the
planning, construction and initial operation of health maintenance
organizations. Essentially, a health maintenance organization is an organi-
zation which provides a wide range of health care services to an identi-
fiable, enrolled population in return for a predetermined, prepaid premium.
Basic health services would include physician services, inpatient and
outpatient hospital services, diagnostic laboratory services, certain
preventive services and other services defined in the law. Supplemental
health services such as services in long-term care facilities, eye and
dental services, rehabilitative services and prescription drugs would be
provided in return for a supplemental health service payment.
b. H.R. 1 (Ullman): National Health Care Services Reorgani-
zations/Financing Act
Would establish a new program of health care delivery and comprehensive
health care benefits (including catastrophic coverage) to be available
to aged persons, and to unemployed and low-income individuals at a cost
related to their income.
-7-
C. S. 3 (Kennedy): Health Security Act
Would repeal the Medicare program and provide for a program of "Health
Security Benefits" SC that health care coverage would be available to
virtually all U.S. residents. This program would be financed through
payroll taxes and general revenues.
d. S. 915 (Javits): The National Health Insurance and
Health Services Act of 1973
Would provide for the establishment of a national health insurance program
through a gradual expansion of the Medicare program to the general popu-
lation. Benefits would be broadened to include certain services not
presently covered under Medicare.
2. Special Health Programs for the Elderly
FORD & LIBRARY GERALD
a. S. 393 (Humphrey): National Chronicare Demonstration
Act of 1973
Would make grants available to programs which provide aged, blind, and
disabled individuals a wide range of long-term care services in skilled
nursing homes, intermediate care facilities, or in a home health care program.
b. S. 1826 (Moss)
Would authorize an experimental program to help subsidize families who agree
to care for family members age 65 and over in need of home health services.
C. S. 1997 (Moss)
Would authorize the Dept. of Housing and Urban Development to help finance
projects that meet the special health care, housing, and related needs of
elderly persons. Each project would comprise a campus-type setting and
would include a skilled nursing home, a congregate living facility, community
center, and other related facilities.
3. Research in Health as it Relates to the Elderly
a. H.R. 775 (Matsunaga) : Research on Aging Act
Would amend the Public Health Servcie Act to provide for the establishment
of a National Institute on Aging. The Institute would be responsible for con-
ducting and supporting biomedical, social, and behavioral research and training`
relating to the aging process, and special health problems of the elderly.
(This bill is similar to H.R. 14424, which was passed by the 92nd Congress, but
pocket vetoed by the President.]
b. H.R. 6175 (Rogers) : Research on Aging Act
Similar to S. 775 described above.
-8-
I. PROBLEM: NUTRITION
The problem of under nutrition among our elderly citizens is a severe one. One
Federal government study has estimated that the numbers of older persons with
deficient diets might be as high as 6 to 8 million nationally. Another Federal
study found that persons over 60 years of age showed evidence of general under-
nutrition which was not restricted to the very poor or to any single ethnic
group. The problem is compounded for older persons because although they often-
times have greater nutritional needs than younger persons, their income level is
usually considerably lower, and they are often not able to afford many of the
nutritious foods that they need. As it is, older consumers spend a greater
proportion of their income on food than do younger consumers.
Food is more than a source of essential nutrition for older persons, for it can
also be an enjoyable interlude in an otherwise uneventful existence. Community
meals for the elderly, then, at a local school, church, or senior center, for
example, are very important. Such community meals can improve the quality of
the older person's life both socially and psychologically, as well as nutritionally.
The greater use of food stamps for those elderly persons with minimal incomes
is advocated for the payment of community meal and "meals-on-wheels" programs, in
addition to the purchase of food at the grocery store.
II. WHAT CONGRESS IS DOING
A. NEW LAW
1. P.L. 93-50: Appropriation for Nutrition Program for the Elderly
In addition to other appropriations, this law appropriates $100,000,000 to
carry out the Nutrition Program for the Elderly which was added to the Older
Americans Act of 1965 as Title VII by P.L. 92-258. The law provides that these
funds will remain available through Dec. 31, 1973. The amount for Nutrition
Program for the Elderly will provide low-cost, nutritious meals to the elderly
at least once a day, five days a week. These meals must supply at least one-
third of the daily nutritional requirements for adults. Through grants to
states, this program will pay up to 90% of the cost of meals.
2. P.L. 93-86: Agricultural and Consumer Protection Act
A provision of this bill enables certain beneficiaries of the SSI program to
purchase food stamps. The 1972 Social Security Amendments provided that indi-
viduals eligible for benefits under the new SSI program will not be eligible
for food stamps. Also provides that persons age 60 and older and their spouses
may use food stamps to purchase meals prepared by public or private eating
establishments which regularly serve the elderly at designated times.
B. CURRENT LEGISLATION
1. Older Americans Act (Title IV)
This act provides for a nutritional program for older people, popularly known
as Meals-on-Wheels. Prepared hot meals are delivered to the home every day for
a minimal fee. [For information on participating in or starting a Meals-on-Wheels
program in your community, contact your Regional Administration on Aging office.]
-9-
I. PROBLEM: TRANSPORTATION
Transportation is a critical problem for the many elderly who want to remain
involved in community life. The senior centers and services in your community
are useless to older citizens if they do not have ready access to trans-
portation so that they can get to these centers and services. Many projects
have shown that the elderly will get out into the community if appropriate
transportation is available to them. A good number of our nation's elderly
are not able to drive a car for various reasons. Even if an older person
is able to drive, the chances are great that he cannot afford to buy and
maintain an automobile. The need, then, for mass transportation is
particularly great among the elderly. In order to approach the degree of
mobility that they had when they were younger, the elderly must rely on
mass transit. Those older persons living in communities without mass
transportation face isolation and loneliness. Even for those elderly
persons living in places with mass transit, the problem of transportation
may be severe for many. Mass transportation is frequently inaccessible to
persons with infirmities such as the elderly may have, can be costly in
terms of the fixed income within which they must live, and often does not
serve on a regular basis the areas where the elderly live or want to go.
II. WHAT CONGRESS IS DOING
FORD & LIBRARY GERALD
A. NEW LAW
1. P.L. 93-87: Emergency Commuter Relief (Amendment to Federal
Highway Aid Bill of 1973)
This amendment raises from 1 1/2% to 2% of the total funding of the Urban
Mass Transportation Act the amount of money which may be spent on state and
local programs designed to provide transportation facilities and services
for elderly and handicapped persons, with special emphasis on the less
urbanized areas. Of the $1 billion authorized under Title III of UMTA for
each fiscal year, up to $2 million is available for the above purpose. From
this appropriation, UMTA can and has provided funds for such things as:
1) specially designed buses, 2) bus shelters, 3) rapid transit improvements,
4) research, and 5) various demonstration projects. A new feature of this
amendment is that private organizations are now able to apply to the
Department of Transportation directly for funds.
B. PENDING
1. H.R. 9096 (Rosenthal): The "Elderly and Handicapped Americans
Transportation Services" Bill
The strongest and most comprehensive bill under consideration is this bill.
Major provisions include:
a. Requires that all transportation facilities funded by UMTA
accommodate the physically handicapped. Also allows the Secretary of Trans-
portation to prescribe standards to insure that elderly and handicapped
persons have access to buildings and facilities funded by UMTA.
b. Requires the Secretary of Transportation to give preference
to applications for UMTA funding from state and local agencies who agree to
maintain reduced rates for the elderly. These rates must be 50% or less of
the regular fare for all those 65 and over and must be maintained on all
days of operation.
C. Authorizes to the Administration on Aging $15 million for
FY 73 and $25 million for FY 74 to carry on research and demonstration projects
to improve transportation for the elderly.
2. Other Bills which are Variations on H.R. 9096 (Rosenthal)
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a. Three bills require UMTA funded projects to accommodate the
elderly and handicapped.
b. Two bills contain the same provision as H.R. 9096 for preference
to agencies who agree to have reduced fares for the elderly.
C. Nine bills propose reduced rates on interstate carriers.
d. Twenty proposed bills amend only the Federal Aviation Act
and would authorize reduced rates for the elderly on a space available basis
or during nonpeak hours.
3. S. 1105 (Percy)
"Provides income tax incentives for modification of certain buildings so as to
remove architectural and transportational barriers to the handicapped and
elderly.' It allows tax deductions for the cost of changes in facilities to
make them more accessible to the elderly and handicapped.
I. PROBLEM: EDUCATION
For most persons who have worked all their lives, age 65 and retirement have
a tremendous psychological, social and economic impact on their lives. Few
have had any counseling or education about the changes they will undergo
in their life style. Preretirement education offers one very effective
alternative for easing the older person's abrupt transition from working
to retirement years. Such programs have proven extremely successful in
the past when offered in community college and industry settings. The
pre-retirement curriculum should cover the subjects of health, money
management, financial planning, legal affairs, living arrangements, family
and friends, rewarding use of leisure time, nutrition, available services
and programs for retirees, and consumer information. Moreover, they should
offer counseling and group discussion of retirees' possible problems, as well
as opportunities in the future. Because these programs provide guidance
before the problems arise, they are extremely valuable in preventing many
problems. By minimizing other problems, both the economic and emotional
toll retirement often takes on an older individual is lowered.
II. WHAT CONGRESS IS DOING
A. NEW LAW
1. P.L. 93-29: The Older American Amendments of 1973, Title III
Authorizes grants for model projects for 1973-1974 for public or non-
profit agencies or organizations for the development and administration of state
or community model programs. Under Title IV training and research grants and
model kits are available from the Administration on Aging.
2. Higher Education Act of 1965 Amendment
Title I of the Higher Education Act is amended to authorize the Commissioner
of Education to make grants to institutions of higher education to assist such
institutions in planning, developing, and carrying out programs specifically
designed to apply the resources of higher education to the problems of the
elderly, particularly with regard to transportation and housing problems of
elderly persons living in rural and isolated areas.
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3. National Commission on Libraries and Information Science Act
This act provides that the Commission shall conduct studies, surveys, and analyses
of the library and informational needs of elderly persons. At least one member of
the Commission should be knowledgeable with respect to the library and information
service needs of the elderly.
4. Adult Education Act
This act authorizes the Commissioner of Education to make grants to state and
local educational agencies or other public or private nonprofit agencies for edu-
cational programs for elderly persons whose ability to speak and read the English
lanquage is limited and who live in an area with a culture different than their
own. Programs will be designed to equip these elderly persons to deal success-
fully with the practical problems encountered in their everyday life, including
the making of consumer purchases, meeting their transportation and housing needs,
and complying with governmental requirements such as those for obtaining citizen-
ship, public assistance and social security benefits.
5. Library Services and Construction Act
This act authorizes the Commissioner of Education to carry out a program of grants
to states for older reader services. Grants can be used for: training librarians
to work with the elderly, the conduct of special library programs for the elderly,
the purchase of special library materials for use by the elderly, payment of
salaries for elderly persons who wish to work in libraries as assistants on
programs for the elderly, provision of in-home visits by librarians and other library
personnel to the elderly, establishment of outreach programs to notify the elderly
of library services available to them, furnishing of transportation to enable the
elderly to have access to library services.
B. PENDING
1. H.R. 324: Department of Elderly Affairs
Would establish a Department of Elderly Affairs primarily to serve as a clearing-
house for information related to the problems of the elderly, administer grants
authorized under the Older Americans Act of 1965, as amended, gather statistics
in the field of aging, and publish and disseminate educational materials dealing
with the welfare programs of the elderly.
2. H.R. 3664 (McDade)
Would amend the Vocational Education Act of 1963 to utilize a portion of the
funds for special consumer and homemaking programs for the elderly.
FORD is LIBRARI GERALD
-12-
I. PROBLEM: TAXES
Over 70% of people 65 and older own their own homes and are severely burdened by
rapidly rising property taxes. Millions of our older citizens are expected to
assume these expenses on an income that barely qualifies for the subsistence
level and does not increase adequately with the cost of living. Moreover,
losing one's home is especially difficult for the aged because of the special
importance of a familiar and supportive environment and the lack of supply
of suitable low-income elderly housing.
II. WHAT CONGRESS IS DOING
A. PENDING
1. Currently there are 19 bills pending in the House dealing with
property tax relief for the elderly. Seven different plans are proposed. All
allow a credit on the Federal income tax for all or a part of state and local
real property taxes paid or, in lieu of property taxes, for 25% of yearly rent.
2. Administration's Proposal Regarding Property Tax Relief
Under this proposal, low and middle income homeowners age 65 or older would
receive a Federal tax credit for property tax payments in excess of 5% of their
income, up to a maximum amount of $500. Elderly renters would receive a credit,
subject to the same 5% floor and $500 maximum. The credit given to renters would
be computed on the assumption that 15% of the rent they pay is for property
tazes. Both homeowners and renters with incomes up to $15,000 a year would
receive a full credit. The maximum credit of $500 would be reduced by 5% of
household income in excess of $15,000, so that a taxpayer with household income
of $25,000 or more would get no credit. A taxpayer with no taxable income
would receive a payment in the full amount of the credit.
3. H.R. 3431 (Gubser)
Would amend the Internal Revenue Code of 1954 so that taxpayers age 65 and older
could deduct certain expenses incurred for home repair and home maintenance costs.
-13-
I. PROBLEM: ELDERLY AS CONSUMERS
The elderly, perhaps the most disadvantaged group in the modern marketplace,
are oftentimes denied the consumer rights that they deserve. Because of low
income, increasing physical infirmity, and a life style often unresponsive to
rapid societal change, the elderly easily fall prey to deceptive consumer
practices. Measures must be taken to protect the elderly consumer and assure
him that he will have somewhere to go if he has any consumer complaints, prob-
lems, or suggestions. In addition, the older consumer should be educated as
to his consumer rights.
A. AGENCIES OFFERING CONSUMER EDUCATION AND COMPLAINT HANDLING
1. The Food and Drug Administration is the primary federal consumer
protection agency, enforcing federal product safety laws. At FDA district
offices consumer specialists can provide individuals with information about
FDA programs and policies. If a person knows about a defective product, he or
she should tell the FDA. [Contact the nearest field office or resident
inspection station. Or write directly to FDA, U.S. Department of Health,
Education, and Welfare, 5600 Fishers Lane, Rockville, Md., 20852.]
2. The Federal Trade Commission acts in liaison with state consumer
protection officials to protect the individual from deceptive and unfair trade
practices. [Contact the national or regional FTC office for its consumer
education materials.]
3. The President's Office of Consumer Affairs encourages and assists
in the development and implementation of federal consumer programs; assures
that consumer interests are presented and considered at appropriate levels of
federal government in the formulation of policies and the operation of programs
affecting consumers; conducts investigations, conferences, and surveys con-
cerning consumers; submits recommendations to the President on improvement
of existing federal programs and activities concerning consumers; and takes
action on individual consumer complaints. [Contact the Office of the Director,
Office of Consumer Affairs, New Executive Office Building, 17th and H Streets,
N.W., Washington, D.C. 20506.]
B. PENDING
1. H.R. 3664 (McDade): Amendment to the Vocational Act of 1963
Would utilize a portion of the funds for special consumer and homemaking
programs for the elderly.
FORO :- LIBRARD GERALD
-14-
I. PROBLEM: AGE DISCRIMINATION IN EMPLOYMENT
Employment opportunities for older citizens are not as plentiful as they should
be. Although the Age Discrimination in Employment Act of 1968 makes it a national
policy to eliminate arbitrary age discrimination in employment, many barriers
still face our older Americans on the job market. Some of these obstacles
include:
1. compulsory retirement on reaching a particular birthday, regardless
of ability to work
2. lack of information and couseling on retirement problems and job
opportunities
3. lack of placement and counseling personnel equipped to deal with their
special problems
4. underrepresentation in education, training, rehabilitation, and
other manpower programs
5. enforced retirement resulting from long unemployment as an increasing
number of workers lose their jobs in their fifties when plant shut-
downs or technological changes make their skills obsolete
II. WHAT CONGRESS IS DOING
A. NEW LAW
1. P.L. 93-29: Older American Community Service Employment Amend-
ment (Title IX of Older Americans Comprehensive Services Amendments)
Creates new jobs in community services for low-income people age 55 or older.
A program is established in the Department of Labor to foster and promote
useful part-time work opportunities in community service activities for
unemployed low-incomepersons who are 55 years of age or older and who have
poor employment prospects. Community service activities which are designated
as eligible for participation include: social, health, welfare, educational,
library, recreational, and other similar services; conservation, maintenance,
or restoration of natural resources; community betterment or beautification;
antipollution and environmental quality efforts; economic development; and
other servcies which are essential and necessary to the community as the
Secretary may prescribe. Employment is limited to activities in publicly
owned and operated facilities and projects, or projects sponsored by charitable
organizations exempt from federal taxes. Employment may not be performed
in facilities used as a place of sectarian religious instruction or worship.
2. Senior Opportunities and Services (Amendment to the Economic
Opportunity Act)
Provides that in addition to the amounts authorized to be appropriated and
allocated by the Economic Opportunity Amendments of 1972, there is further
authorized necessary funds for FY 1973 and FY 1974 for the Senior Opportunities
and Services programs.
B. PENDING
1. H.R. 2576 (Dellums): Age Discrimination in Employment Act of
1967 Amendments
Would amend this act to extend the protection of the Act to employees of states
and their political subdivisions.
-15-
I. PROBLEM: SENIOR CENTERS
Every community should have at least one multi-purpose senior center to provide
basic social services, as well as link all older persons to appropriate sources
of help, including home-delivered services. Basic social services that enhance
the ability of the elderly to retain independence should be made available.
II. WHAT CONGRESS IS DOING
A. NEW LAW
1. P.L. 93-29: Older American Act Amendments of 1973
In order to provide a focal point in communities for the development and delivery
of social services and nutritional services designed primarily for older persons,
the amendments authorize the Commissioner to make grants to units of general
purpose local government or other public or nonprofit agencies or organizations.
The amendments also authorize contracts to be made with any agency or organization
to pay not more than 75% of the cost of acquiring, altering, or renovating
existing facilities to serve as multi-purpose senior centers.
I. PROBLEM: VOLUNTEER OPPORTUNITIES
II. WHAT CONGRESS IS DOING
A. CURRENT LEGISLATION
1. National Older Americans Volunteer Program
The Foster Grandparent Program and the Retired Senior Volunteer Program (RSVP)
were authorized by the 1969 Amendments to the Older Americans Act. The
Foster Grandparent Program provides part-time volunteer opportunities for low-
income persons age 60 and older to serve needy children on a person-to-person
basis. The RSVP Program provides volunteer opportunities in community services
for older adults. These two programs are administered by the ACTION agency.
[Write: ACTION, 806 Connecticut Ave., N.W., Washington, D.C. 20525]
GERALD R. LIBRARY FORD
ROBERT H. STEELE, CONN., CHAIRMAN
CHARLES A. MOSHER, OHIO
L. A. (SKIP) BAFALIS, FLA.
ADDRA of
HAROLD R. COLLIER, ILL.
JOBL PRITCHARD. WASH.
JAMES HARVEY, MICH.
RONALD A. SARASIN, CONN.
MARGARET M. HECKLER, MASS.
VICTOR V. VEYSEY, CALIF.
H. JOHN HEINZ III, PA.
WILLIAM B. WIDNALL, N.J.
WILLIAM J. KEATING, OHIO
TASK FORCE ON AGING
c. W. BILL YOUNG, FLA.
JOHN Y. ACCOLLISTER, NEBR,
SAMUEL H. YOUNG, ILL
REPUBLICAN RESEARCH COMMITTEE
JAMES N. BRODER, DIRECTOR
U.S. HOUSE OF REPRESENTATIVES
202-225-5107
WASHINGTON, D.C. 20515
August 13, 1973
TO: REPUBLICAN MEMBERS
Paul 620 LONGWORTH HOUSE OFFICE BLDG.
FROM: TASK FORCE ON AGING
BERALD FORD
SUBJECT: SENATE SPECIAL COMMITTEE ON AGING HEARINGS ON FUTURE DIRECTIONS
IN SOCIAL SECURITY
The following summary of hearings on the Future Directions in Social Security
was provided by the Minority Staff of the Senate Special Committee on Aging.
Principal witnesses at the July 25-26 hearings by the Committee on "Future
Directions in Social Security" were
WILBUR COHEN, former Secretary of
H.E.W.
and CYRIL F. BRICKFIELD, Legislative Counsel for the National
Retired Teachers Association and the American Association of Retired Persons.
...
Assisting Mr. Brickfield in the presentation on behalf of NRTA-AARP
were JOHN B. MARTIN, former U.S. Commissioner on Aging,
...
WILLIAM MITCHELL,
farmer Social Security Commissioner
...
and JAMES HACKING.
MR. COHEN called for creation of a National Health Insurance program for all
citizens through a 5-year "incremental" development based on changes in
Medicare
....
and expanded use of Federal Mechanisms -- including Social
Security -- to further redistribute incomes for the purpose of totally
eliminating poverty in this country
again through a phased approach
attaining this goal between 1980 and 1985.
NRTA-AARP's 154 page prepared statement included a comprehensive assessment
of
...
(1) present and future retirement income needs,
...
(2) adequacy
of OASDI income standards as replacement of income loss due to retirement,
its financing, modifications in the retirement test,
...
(3) updating of
the retirement income tax credit,
(4) need for increased participation
of older persons in the labor market,
and (5) need to coordinate the
nation's basic public pension systems
Implicit in the numerous
recommendations and alternatives presented by NRTA-AARP is the 2-fold goal
of: (1) An adequate minimum income floor for all the aged, and
(2) Provision of retirement benefits which will permit living standards
comparable to those enjoyed in pre-retirement years.
Other hearing witnesses were:
MAX MANES, New York, N.Y., Chairman of Seniors for Adequate Social Security
(SASS), who expressed serious dissatisfaction with the amount and effective
date of the recently enacted Social Security increase (5.9%, effective June 1974)
and criticised Congress and the Administration for failing to implement the
recommendations of the White House Conference on Aging, and
BARBARA F. MARKS, Acting Directing Attorney, Washington Office, National
Senior Citizens Law Center, who reported on services of the Center and dis-
cussed briefly some of the problems faced in adequate implementation of the
new Supplementary Security Income program scheduled to begin in January, 1974.
Page No. 2
HIGHLIGHTS OF MR. COHEN'S TESTIMONY:
Under questioning, Mr. Cohen endorsed the Independent Bi-Partisan Social
Security Commission proposal along the lines recommended in Minority Reports
and embodied in S.J. Res. 48 introduced by Senators Fong, Fannin and others.
Mr. Cohen dismissed "a number of criticisms of financing" of Social Security
by some economists as "not so widely shared by beneficiaries or taxpayers."
He opposed liberalization of the Social Security earnings test beyond $2400,
suggesting that if anything is done, there should be an increase in benefit
increment from 1% to 2% a year for those who defer retirement beyond 65.
Social Security (OASDI) Recommendations:
FORD is LIBRARY 07V838
1. Increase taxable wage base to $20,000 in 1975.
2. Modification of basic financing (retaining the payroll tax) should include:
a. Reduction of burden on low-income earners - - Senator Long's
proposal "to refund to low-income individuals 10% of their
earnings -- roughly the combined social security contribution".
b. General revenues contribution to meet cost of benefits (not
covered by S.S. tax) paid to individuals with less than 40
years coverage.
3. Increase number of "drop-out" years of low or no earnings (Now 5 years.)
4. Payment of disability benefits with 5th month of disability and based
on inability to perform CUSTOMARY occupation.
5. Allow contributions and benefit participation by women performing
household and family duties (wives?) as if self-employed.
6. In addition to cost-of-living increases, adjustments should be made in
benefits as earnings and productivity increases. (Suggests study of
such programs in other countries.)
Supplementary Income Recommendation:
Lower eligibility age now from 65 to 62
...
to 60 in another 2 years
...
and to 55 in 2 more years.
Medical Care and National Health Insurance Recommendations:
1. Cover continuing high cost prescription drugs under Medicare and
hearing aids and glasses with appropriate co-sharing of costs.
2. Combine Parts A & B of Medicare, relieving individual of payments
for the latter after retirement.
Page No. 3
3. Authorize Secretary of H.E.W. to establish local, regional or State
fee schedules for procedures under Medicare. (Says: "No evidence
that physicians have reaped rewards out of line")
4. National Health insurance for all persons should be adopted on an
INCREMENTAL basis
over a period of about 5 years.
...
Specific steps should include:
a. Provide basic Medicaid benefits, with total Federal financing,
to low-income persons through the Medicare program.
b. Add a major medical benefit -- hospital coverage after 30 days
and physician services after $1,000 -- to Medicare, now --
TORD
reducing it as total National Health Insurance takes over.
c. Add maternity benefits, including first year of child's life,
to Medicare.
Other Recommendations in Mr. Cohen's statement include:
1. Re-Examine $2.5 billion limit on social services (under Social Security
Act) set by Congress in 1972.
Considering expansion of services
to aged, young children, retarded and for family planning.
2. Require every major business to provide a minimum private pension
plan
with some vesting
reinsurance of program
full reserves after period of years
...
and complete public disclosure.
3. "Consideration should be given to termination of the General Revenue
Sharing Law when its 5-year duration terminates."
...
If continued
there should be a requirement on States for rebate of taxes to low
income older persons.
4. "The retirement deduction in the Federal income tax should be changed
to a retirement tax credit".
5. Congress should establish a non-partisan Commission to review welfare
reform proposals
...
which Commission should present proposals in
1977 to abolish poverty in the United States by 1982.
HIGHLIGHTS OF ORAL TESTIMONY BY WITNESSES FOR NRTA-AARP:
1. Medicare and Medicaid developments and levels of care they provide were
objects of concern, the opinion being expressed
...
"Instead of progressing
with respect to health care for the elderly, we seem to be regressing."
Opposition to proposals for increased personal cost-sharing under medicare
was voiced.
Page No. 4
2. With the new Supplementary Security Income program to be the means for
providing an adequate income floor for the elderly,
...
"OASDI can
now function primarily as a mechanism to replace an adequate degree of
earnings lost as a result of retirement, disability or death."
3. The aged population will continue to increase in numbers,
will be
living longer and spending more years in retirement,
...
will be better
educated, more skilled and more sophisticated
"and far less likely
to accept the lower standard of living which presently attends retirement."
4. The living standard of future aged should relate directly to pre-retire-
ment experience and should not result in a post-retirement standard
appreciably lower than that immediately prior to retirement.
5. While a standard based on average earnings ADJUSTED for cost of living
and real wage increases has merit
administrative problems may make
it unfeasible
so "our organizations tend to agree with the suggestion
that the standard should be based on 10 of the 15 years immediately prior
to retirement.
6. Because social security will probably continue as the primary earnings
replacement mechanism
...
despite increasing role by private pensions
a 55% replacement of income through OASDI appears reasonable as an
optimum replacement earnings rate. (Not a commitment by NRTA-AARP).
7. "We urge enactment of legislation to lessen the existing regressivity of
the taxes imposed by the Self-Employment Contributions Act and the
Federal Insurance Contributions Act."
Initially limited reform
provided "that the contributory principle is not broken.'
Use of general revenues appears necessary
Complete OASDI financing through general revenues is not now feasible
and inequities in distribution of tax burdens under the income tax
make it an unsuitable vehicle for the full burden of social security.
8. NRTA-AARP could support
a system of exemptions or allowances (in the
payroll tax)
...
to reduce the payroll tax burden on lower-income
groups
subject to some minimum percentage contribution to preserve
the contributory system.
9. NRTA-AARP favors liberalization of the OASDI earnings test to $3600.
10. NRTA-AARP believes that to assure continuity in supervision, direction
and development in Social Security enjoyed in the past
a 3-member
bi-partisan administrative board would best assure integrity, competence
and impartiality and provide protection against purely partisan political
intervention.
FORD & LIBRARY GERALD
Page No. 5
11. "In order to restore tax equity in the treatment of retirees, the amount
of retirement income eligible for credit computation ($1,524) should be
increased to the present maximum primary benefit under social security
($2,500). We further believe that the credit's limitation on earned
income should be liberalized to correspond with the social security
retirement test. In this respect, we would support S.1811. Moreover,
computation of the credit should be simplified."
NRTA-AARP opposes the AGE CREDIT proposal of the administration
which would replace the retirement income tax
because it would
not be available to retirees under age 65 who are presently eligible
for the retirement income credit.
12. NRTA-AARP believes the elderly should have the option to continue work
if they are able and willing.
JOHN MARTIN discussed at length the NRTA-AARP support of new legislation
to provide for actuarily determined increments in OASDI benefits for
years that eligible beneficiaries defer retirement and participation in
benefits.
13. Social Security and other public pension systems, such as Railroad
Retirement should be coordinated to reduce inequity and injustice
resulting from multiple eligibility.
FORD i LIBRARY GERALD
ROBERT H. STEELE
Chairman
Elderly
TASK FORCE ON aging
PROPERTY TAX RELIEF FOR THE ELDERLY:
PROPOSALS BEFORE THE 93rd CONGRESS
FORD & LIBRARY GERALD
By Georgia Springer
REPUBLICAN RESEARCH COMMITTEE 1620 LONGWORTH HOUSE OFFICE BUILDING
WASHINGTON, D.C. 20515 (202) 225-5107/5089
James N. Broder, Director
I. The Property Tax Dilemma of the Elderly.
Recent tremendous property tax rises 1 have hit the aged es-
pecially hard because a high percentage of this group age 65 and
2
older: (1) live on a fixed income, (2) live on lower incomes,
(3) pay a disproportionately large percentage of their income for
housing, 3 (4) own their own homes, 4 and (5) pay a disproportionately
5
large part of their income for property taxes.
Property taxation, rooted in the older, land-based system of
wealth, assumes a direct relationship between either (1) homeowner's
income and his property's value or (2) his ability to pay and
property value. Neither is a correct assumption for the aged.
DERALD FORD
1 'Over the past four years (December 1969 to 1972), the Consumer
Price Index has increased by almost 20 percent Property
taxes have jumped by 39 percent, nearly twice the overall
increase in the Consumer Price Index. U.S. Senate Special
Committee on Aging, "Developments in Aging: 1972 and
2
January-March 1973," P. 15. In 1972, the rise was 9%, p. 20.
In 1971, the median household income for those 65 and over was
$3449 for men and $1706 for women. (From "Money Income in
1971 of Families and Persons in the U.S.,' Table 45, Series
P60, #85 (published December 1972 by the U.S. Census Bureau).)
3 Thirty-four percent of their budget. U.S. Senate Special Com-
mittee on Aging, "Developments in Aging: 1972 and January-
March 1973, p. 15.
4 Seventy percent of the aged are homeowners. Ibid., P. 15.
5"A typical urban family of four turns over about 3.4 percent
of its family income to the property tax assessor. But,
aged homeowners pay, on the average, about 8.1 percent of
their incomes for real estate taxes.
"A recent study by the Advisory Commission on Inter-
governmental Relations (based on 1970 Census data) reveals
that aged homeowners living on less than $2000 a year pay
almost 16 percent of their meager incomes for this regressive
tax. Moreover, an estimated 1.5 million elderly households
with incomes below $7000 a year are saddled with property
taxes amounting to more than 10 percent of their household
income." Ibid., p. 20
Based on state studies of low income elderly done before
state property tax relief programs went into effect, the
average tax-income ratio for those over 55 with incomes under
$1000 was very high: 32.4% (California, 1968); 49% (Minnesota,
1967); 33.2% (Oregon, 1966); 58% (Wisconsin, 1966). U.S.
Senate Special Committee on Aging, "Economics of Aging:
Toward a Full Share in Abundance: Part 4, Homeownership
Aspects,' p. 852.
John Shannon, Assistant Director of the Advisory Council on
Intergovernmental Relations, stated before the Senate Special
Committee on Aging "there is absolutely no question that there
are hundreds of thousands of elderly householders who are being
forced to liquidate their assets in order to pay the local tax on
shelter. 6 Home repair and maintenance costs place additional burdens
on the elderly homeowner's income.
Being forced out of their homes due to high property taxes is
particularly inequitable to elderly who have paid taxes all their
lives and who no longer use the school system financed by their
tax money. Moreover, losing one's home or house is especially
difficult for the aged because of the special importance of a
familiar and supportive environment and the lack of supply of
suitable low income elderly housing.
QERALD FORD LIBRARY
II. Alternative Types of Property Tax Relief.
Possible property tax relief programs vary greatly in amounts
of relief, eligiblity of recipients, and administration. The
three general types now in use at the state level are (a) tax
exemption, (b) tax deferral, and (c) tax credit. All three usually
involve conditions of some sort on: age (usually 60, 62, or 65);
property (i.e., value and amount); income (i.e., no tax relief
over a certain ceiling); occupancy of taxed property for a spe-
cified period. The tax exemption involves a part or all of the
property being totally free of taxes. The deferral means taxes
are deferred until the owner dies or sells the house, at which
time the estate or sale proceeds must furnish the back taxes. The
tax credit, the form used in all the bills pending in the House,
offers a specific credit against federal income tax.
6 U.S. Special Committee on Aging: Subcommittee on Housing for the
Elderly, "Economics of Aging: Toward a Full Share in Abun-
dance: Part 4, Homeownership Aspects, p. 818. Mr. Shannon
has been a noted expert on property tax relief for the elderly
for a number of years.
-2-
The credit, as well as the exemption, can be (1) conditional,
i.e., property valued below "x" amount is exempt from taxation;
if the value exceeds "x" the entirety is taxes (Indiana, Michigan,
Massachusetts), (2) uniform, i.e., a uniform amount of the asessed
value is exempt, regardless of the total value of the asset or
taxpayer's income (Oregon, Georgia), (3) vanishing, i.e., the
amount of property exemptable declines as the valuation increases
until the exemption disappears; the vanishing exemption can also
be tied to increases in the taxpayer's income (Minnesota, Wiscon-
sin, Oregon, California).
GERALD FORD LIBRARY
The ideal plan, according to Shannon, insures (1) broad
beneficiary coverage, i.e., to those older people, both under
and over 65, to renters and homeowners, whose incomes are over-
burdened by property tax payments, (2) safeguards against abuse,
i.e., dollar limit on relief to any taxpayer; inclusion in any
measurement of income all types and sources of income, (3) effi-
cient tax relief formula balancing the burden on the needy tax-
payer with the scarcity of funds (i.e., limitation of relief to
low and moderate income elderly). 7 The Senate Special Committee
on Aging noted the following additional criteria: a graduated
system with the greatest relief to those with the lowest income;
relief as direct as possible without difficult eligibility pro-
cedures; tax refund or rebate for those with incomes too small
to file income tax returns; the linking of tax relief to tax
8
reform; federal assistance to states utilizing these concepts.
III. Pending House Bills
The 19 bills pending in the House offer seven different
plans for property tax relief for the elderly. All allow a credit
on the federal income tax for all or a part of state and local real
property taxes paid or, in lieu of property taxes, for 25% of
7 Ibid., p. 822.
8U.S. Senate Special Committee on Aging; "Developments in Aging:
1971," P. 21.
-3-
yearly rent. All but one give to the individual, to the extent
that the income tax is less than property taxes, a payment from
the U.S. Treasury equal to the difference between the credit and
the property tax or rent paid. The maximum amount of relief a-
vailable varies from $225 to $800. The upper income limit for
the elderly individual varies from $3,750 to $14,999. Age eli-
gibility ranges from 60 or 62 to 65 for either spouse. Certain
bills also extend credit to owners of mobile homes and/or tenant
owners of cooperative housing. One bill also includes provisions for
low interest loans to elderly homeowners for maintenance costs.
H.R. 6027 (Findley and identical bills) have 29 co-sponsors.
They allow a tax credit or refund of up to $300 for the amount
of property taxes or rent paid to any individual 65 or over with
an income under $6500.
All other House bills, with the exception of H.R. 1862, have
single sponsers and vary as shown in the attatched chart. Most
give a credit for a percentage of the tax, with the credit phasing
out gradually as income rises to a level at which no relief at
all is given.
FORD i LIBRARY GERALD
IV. Administration Tax Relief Proposal
The Administration proposed in its April 30, 1973 tax message
a tax credit or refund of up to $500 to the elderly individual
for the amount by which his property tax exceeds 5% of his income.
9
The relief is available to individuals with low and moderate incomes
up to $15,000 after which the credit is phased out by 5% for each
$1000 jump in income, with no relief at $25,000. Unlike the 25%
figure of the other proposals, the Administration proposes that
15% of the yearly rent apply as the property tax burden. The
greatest numbers of elderly covered will be low income since a
lower property tax will constitute 5% of their income. However,
9
Proposals for Tax Change, Department of the Treasury, April 30,
1973, U.S. Government Printing Office.
-4-
by providing relief only on that portion of property taxes or
rent exceeding 5% of a individual's income, some low income in-
dividuals still may get no relief because their taxes, though
a substantial burden to a subsistence income, do not exceed 5%
of their income.
Mr. Dale Collinson, Acting Associate Tax Legislative Counsel,
Department of Treasury, who is drafting the Administration pro-
posal, says that while the framework of the proposal as mentioned
will be introduced by the Administration to the Ways and Means
Committee after Labor Day, it will not necessarily offer statu-
tory language. Thus, passage of any proposal may well not come
until the second session of the 93rd Congress.
V. Critique
GERALD FORD LIBRARY
There are several considerations in evaluating these various
10
tax relief proposals.
Relief should be given to those most in need first, and in
no case does it make sense to deny relief to poverty level elderly
while granting it to middle income aged. A $150 property tax bill
to an individual with a $3500 income is a much greater burden than
a $1000 tax for someone with a $15,000 income. The Administration
proposal gives relief in some cases to individuals with $20,000
incomes while giving none to those with poverty level incomes.
Second, many older persons will have difficulty understanding
any tax relief plan which is at all complicated. 40% of elderly
eligible for the presently complicated retirement income credit
file either no claim or an incorrect claim. 11 A simplified table
10
Support for any tax relief plan for the elderly presupposes en-
dorsement of special treatment for the aged. While the ques-
tion of general tax reform is a vital one, its exploration is
beyond the scope of this analysis. It can be noted, however,
that a consideration in any federal tax relief program is the
disincentive for states and localities to reform their own
systems when they know excessive property taxes are relieved
by the federal government.
11 Proposals for Tax Change," Op. Cit., n. 9, p. 113.
-5-
included in the tax form may be of help. For example, the table
embodied in H.R. 1862 has worked very successfully in Wisconsin
for many years. However, the relief formulas contained in H.R.
1862, H.R. 1573, H.R. 1587, and H.R. 240, as well as the Admini-
stratio proposal are highly complicated.
Also, many low-income persons file no tax return and thus
will get no relief unless a concerted effort is made to inform
low-income elderly and encourage them to file for their refund.
The percentage of rent equalling the normal property tax
burden has been widely accepted at 25%, the figure used by all
the bills. The Administration figure of 15% therefore penalizes
renters.
GERALD FORD LIBRARY
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LIBRARY
BILL
SPONSOR
AGE
MAXIMUM CREDIT
INCOME TEST
CASH PAYMENT
FORD
(either
(for property
(maximum income
spouse)
taxes paid or for
eligibility)
GERALD
25% yearly rent)
H.R. 240
Abzug
62
$375 (relief is
$4166
Refund--to the extent that income
given according to
tax is less than real property
a table by which a
taxes, the individual will re-
lesser percentage
ceive payment from the U.S.
of relief is given
Treasury equal to the difference
as income rises
between the credit and the amount
with a gradual
of real property taxes paid.
phase-out at an
income of
$4166)
H.R. 1556 Helstoski
62
$450, $225 for
$7500 ($3725
Refund
married persons
for married in-
filing joint
dividual filing
return (for prop-
separate return)
erty tax paid)
H.R. 1587
Howard
65
$225 (same table
$3500
Refund
as H.R. 240)
H.R. 1826
Reuss (with Fraser,
62
$375 (relief is
$5025
Refund
Brademas, Gonzalez)
given according to
(printed erroniously;
a table, and is
will be reintroduced)
roughly 75% of the
H.R. 3275
Hansen
property tax with
the percentage de-
clining as income
increases)
H.R. 2175
Roybal (printed er-
60
$800 (relief is
$14,999
Refund
roniously; will be
given according to
reintroduced)
a table, varying
from 100% of the
property tax for
those with incomes
under $5000, 90% of
the tax for incomes
$5000 to $6000, 80%
of the tax for in-
comes $6000 to $7000
etc. with relief
(continued next page)
BILL
SPONSOR
AGE
MAXIMUM CREDIT
INCOME TEST
CASH PAYMENT
H.R. 2175
Roybal (continued)
phasing out at
$15,000 income
level)
H.R 5246
Pritchard
62
$450 (for property
$3,750 ($7,500 for
No refund
tax paid)
married couple)
H.R. 6027
Findley and 19 co-
65
$300 (relief is
$6,500 ($3250 for
Refund
sponsers
given for the
married individual
H.R. 327
Boland
amount of prop-
filing separate
H.R. 2891
Roy
erty tax paid)
return)
H.R. 4163
Yatron
H.R. 4777
Forsythe
LIBRARY
H.R. 6240
Horton
H.R. 6245
Lehman
FORD
H.R. 6797
Murphy (printed
erroniously; will
GERALD'h
be reintroduced)
H.R. 7052
Dellums
H.R. 7350 Rinaldo
H.R. 7845 Rangel
H.R.
Steele
65
$800 (relief is
$11,000
Refund
This bill includes
given for 100%
provisions grant-
of the property
ing low interest
tax burden for those
loans to the eld-
with incomes $6,000
erly homeowner
or less, with credit
for home mainten-
declining by roughly
ance and repair
10-12% with each $500
costs.
jump in income,
phasing out complete-
1y at $11,000 income)
BILL
SPONSOR
AGE
MAXIMUM CREDIT
INCOME TEST
CASH PAYMENT
Administration Proposal (to
65
$500 (relief is
$24,999 (relief
Refund
be introduced into Ways and
given for that
is given for the
Means Committee Fall 1973)
amount of property
totality of the
tax which exceeds
tax exceeding 5%
5% of the indivi-
of the income of
dual's income)
an individual with
income up to
$15,000, after
which point the
credit is phased
LIBRARY
out by 5% for
each $1,000 jump
FORD
in income with no
SERALD
relief being
given at $25,000)
ROBERT H. STEELE, CONN., CHAIRMAN
(Elderly
CHARLES A. MOSHER, OHIO
L.A. (SKIP) BAFALIS, FLA.
PETER A. PEYSER, N.Y.
HAROLD R. COLLIER, ILL.
JOEL PRITCHARD, WASH.
JAMES HARVEY, MICH.
RONALD A. SARASIN, CONN.
MARGARET M. HECKLER, MASS.
VICTOR V. VEYSEY, CALIF.
H. JOHN HEINZ III, PA.
WILLIAM B. WIDNALL, N.J.
WILLIAM J. KEATING, OHIO
c. W. BILL YOUNG, FLA.
JOHN Y. MC COLLISTER, NEBR.
SAMUEL H. YOUNG, ILL.
REPUBLICAN RESEARCH COMMITTEE
JAMES N. BRODER, DIRECTOR
U.S. HOUSE OF REPRESENTATIVES
1620 LONGWORTH HOUSE OFFICE BLDG.
202-225-5107
WASHINGTON, D.C. 20515
May 31, 1973
FORD & GERALD LIBRARY
Dear Colleague:
Under provisions of the Revenue Sharing Act which imposed a $2.5 billion ceiling
on social services spending, 90% of all welfare funds must be expended on current
welfare recipients. This provision severely limits programs designed to prevent
dependency and Institutionalization of the elderly. It is at best a misguided attempt
at economy, and at worst a cruel hoax whereby the federal government provides a 20%
increase in social security benefits and at the same time effectively terminates the
many social service programs which help to prevent an older American from becoming a
ward of the state. On February 6, 1973 Representative H. John Heinz, III introduced
H.R. 3819 to restore vitally needed social service financing to the elderly.
H.R. 3819 is a fiscally responsible measure. It would leave intact the much
needed $2.5 billion celling on social service funds and would require no additional
expenditure of taxpayer's funds.
Representative Heinz has noted that the social security law, as written, is not
an answer to people who are struggling to get by on modest pensions. Many of them
are able to survive only because the "meals-on-wheets" serves them one hot,
nutritious meal a day, or because the homemaker service provides them with a
sympathetic human contact for four or five hours a week.
There are many greater obstacles to the maintenance of home ownership among
the elderly that will require the attention of Congress and the commitment of
significant resources. Rising property taxes and home repair costs are only two
of these. To force people out of their homes, however, by a denial of social
services is unconscionable.
Over 140 Members of the House have joined in sponsoring the Heinz legislation.
The Republican Task Force on Aging joins the strong bi-partisan support for it.
As chairman of the task force I urge your support.
Sincerely,
Bob Steele
ROBERT H. STEELE
Member of Congress
RHS:jb
P.S. Please contact James Broder, Task Force staff x50589 or x55107; or Warren
Elsenberg in Rep. Heinz' office, x52135.
Republican
National
Elserby
Committee.
May 10, 1973
George Bush, Chairman
The Honorable Gerald R. Ford
U. S. Representative
info
U. S. Capitol H-230
Washington, D. C.
Dear Mr. Ford:
Within the past weeks, I have received a large number of letters
requesting information on the achievements of the Administration in
implementing the recommendations of the White House Conference on
Aging. It well may be that you, too, have had inquiries along this
line.
Very recently, the Department of Health, Education and Welfare
published a 200 page report outlining the responses of the Administration
to the White House Conference and, in that report, is an introduction
which summarizes extremely well a long list of achievements.
I have had copies of this introduction reproduced and I am en-
closing one herewith which I hope may not only prove informative to
you but helpful in replying to any questions that may be addressed
to you by your constituents.
I would be glad to receive your comments.
With all good wishes,
Sincerely,
FORD is LIBRARY GERALD
Bernard S.
Pensider
Bernard S. Van Rensselaer
Director Senior Citizens Division
Dwight D. Eisenhower Republican Center: 310 First Street Southeast, Washington, D.C. 20003. (202) 484-6500.
GEBALD FORD LIBRARY
INTRODUCTION
When President Nixon addressed the delegates to the White House
Conference he noted the characteristic remnants of prior conferences --
stacks of volumes gathering dust. The President said, "I do not want the
volumes--and there will be volumes on this Conference--simply to gather dust
in the Library of Congress or in the Office of the President. =
Responding to the findings and recommendations of the delegates
to the White House Conference is a continuous process. The process was
started by the President when he addressed the delegates at the concluding
session of the Conference. It was continued when the President sent a
Message on Aging to the Congress on March 23, 1972 in which he articulated
a comprehensive strategy to meet the needs of older Americans and trans-
mitted recommendations for action.
This report, "Towards a New Attitude on Aging," is the third
step in this continuous process. In addition to identifying new actions
and commitments that will lead to actions, the report incorporates some
of the responses incorporated in the earlier documents. The report also
identifies areas where conclusions have not been reached but where ex-
plorations are underway designed to facilitate the decision making process.
The report should be read in the light of the following two
paragraphs, which appear in the President's 1974 Budget Message under the
heading of "Meeting Human Needs":
"The 1974 budget for human resources programs, like the three
that have preceded it under this Administration, reflects my conviction
that social compassion is demonstrated not just by the commitment of public
funds in hope of meeting a need, but by the tangible betterments those
funds produce in the lives of our people. My drive for basic reforms that
will improve the Federal Government's performance will continue in the
coming fiscal year.
Between 1969 and 1974, outlays for Federal human resources
programs have increased 97%, while total budget outlays have grown by only
46%. As a result, human resources spending now accounts for close to half
the total budget dollar, compared with just over one-third of the total
at the time I took office."
The report is built around the four major goals of the President's
strategy:
-- assuring an adequate income;
-2-
-- assuring appropriate living arrangements;
-- assuring independence and dignity, and
-- assuring institutional responsiveness and a new
attitude toward aging.
In each instance a summary is provided of the Conference recom-
mendations (which are provided in detail in another volume), and the Admin-
istration's responses to the recommendations.
The report makes clear that the cumulative impact of a series of
actions by both the legislative and executive branches of the Federal govern-
ment has established a momentum which is moving the Nation toward the four
major goals. Differences between positions taken by the delegates to the
White House Conference and the Administration are differences, in most in-
stances, relative to the acceleration of the momentum rather than over the
desirability of achieving the goals toward which the momentum is directed.
Assuring an Adequate Income
The report, which reflects the President's conviction that the
best way to help older persons is by "providing them money so that they can
secure needed services themselves," identifies the following actions which
have contributed to significant momentum in the income area:
-- The passage of the Social Security benefits increases
of January, 1970, January, 1971, and September, 1972,
plus the changes incorporated in H.R. 1 (P.L. 92-603)
mean that the annual income of older persons from
these sources will be $14,5 billion more in the calendar
year 1973 than it would have been if the increases had
not been voted.
-- Social Security benefits have been made inflation-proof.
-- Widows and widowers are now entitled to 100% of the
benefits that were paid to their deceased spouse.
-- A Federal-financed floor has been placed under the in-
come of the elderly. This is the first time in the
Nation's history that provision has been made for a
national income floor for any segment of the population.
This provision alone makes H.R. 1 (P.L. 92-603) the most
significant piece of Federal legislation in the income
area since the Social Security Act of 1935.
-3-
FORD & LIBRARY GERALD
-- A major liberalization in the retirement test assures
a social security beneficiary that the more he earns the
more spendable income he will have.
-- Medicare protection has been extended to the disabled
under age 65 who have been receiving Social Security
disability benefits for twenty-four months or longer.
-- Medicare beneficiaries will be able to choose to have
their covered health care provided through a Health
Maintenance Organization (a prepaid group health or other
capitation plan that meets prescribed standards).
-- Controls on the health service industry which were
established under Phase II of the Economic Stabilization
program will be retained and strengthened under Phase III.
In the area of assuring an adequate income the report also in-
cludes the following commitments on the part of the Administration--com-
mitments which have or will lead to significant action:
-- An interagency task force of the Human Resources Committee
of the Domestic Council will be established to come to
grips with the issue of developing a definition of "ade-
quate" income for older persons.
-- Older Americans should receive a fair share of the
benefits which will accrue to our society as a result of
increased productivity.
-- The President will submit to the Congress a program for
strengthening and encouraging the growth of the private
retirement system and protecting the pension rights of
workers from loss caused by changing jobs or mismanage-
ment of pension funds.
-- The President has stated that he "will submit to the
Congress recommendations for alleviating the often.
crushing burdens which property taxes place upon many
older Americans."
-- The President will submit to the Congress a fiscally
responsible and administratively workable national
health insurance plan. In the development of the plan,
consideration will be given to coverage issues which
are directly applicable to the concerns expressed by
the delegates to the White House Conference relative
to areas not now covered by Medicare.
-4-
-- Specific recommendations by minority groups relative to the
income area are under study by the Social Security Admini-
stration and, when completed, the results of the study will
be discussed with the representatives of these groups.
Assuring Appropriate Living Arrangements
The report identifies the following actions which have contributed
to the development of significant momentum in improving living arrangements:
-- Since 1969, the Federal government has approved approxi-
mately 250,000 units specifically designed for the elderly,
more such units than in the entire 34-year history of the
national housing program preceding 1969.
-- In Fiscal Year 1972, nearly 68,000 units of subsidized
housing specifically designed for the elderly were funded.
-- During the Fiscal Year 1973, while a review of housing policy
is underway and the level of subsidized housing starts during
calendar year 1973 is expected to exceed the previous year's
levels, the Federal government will continue to honor com-
mitments already made.
-- The Department of Housing and Urban Development has initiated
organizational changes, including the establishment of the
position of Assistant to the Secretary for Programs for the
Elderly and the Handicapped, designed to insure that its
programs are responsive to the needs of older persons.
-- Vigorous implementation of the President's eight-point
program for upgrading nursing homes will continue--an
activity which has been strengthened significantly as a
result of the Congressional acceptance of the President's
proposal that the Federal government assume full responsi-
bility for the costs of inspection of Medicaid nursing homes.
-- The President's program will be strengthened further by
the issuance of regulations governing Intermediate Care
facilities under Medicaid.
-5-
GERALD FORD (IBRAR)
-- The Department of Housing and Urban Development and the
Law Enforcement Assistance Administration have set up a
multi-agency task force to seek ways of improving security
in public housing projects.
-- The Department of Housing and Urban Development is under-
taking a series of experiments to evaluate a program of
"housing allowances" for low and moderate income families.
These experiments are testing the effect on the housing
market of recipients' freedom to use their allotments
for renting a house or apartment anywhere they choose.
In the area of assuring appropriate living arrangements the
report also includes the following commitments on the part of the Admini-
stration--commitments which have or will lead to significant actions:
-- The special problems and needs of elderly persons will
be given thorough consideration in connection with the
major housing study now underway under the direction of the
President's Counsellor for Community Development. In-
cluded, among others, in the study will be the follow-
ing agenda items on which delegates expressed concern:
-- policies that will help assure that the elderly have
greater access to adequate housing within their means;
-- the problem faced by older persons with low incomes,
including members of minority groups;
the concept that older persons should have the oppor-
tunity of choosing the type of housing that is best
suited to their needs.
The special problems and needs of older persons will be
given thorough consideration in the development of the
proposed Better Communities Act which the President
will submit to the Congress and in its implementation
upon enactment.
-- Affirmative action has been and will continue to be taken
to insure that when Federally assisted projects force
persons to relocate that adequate replacement units will
be available before persons are displaced.
The Administration will support the use of model project
funds by the Administration on Aging, in conjunction with
the Department of Housing and Urban Development, for
demonstration home maintenance programs.
-6-
-- The development of policies in the area of long-term
care based on in depth studies by the Office of Nursing
Home Affairs of the quality of institutional care, the
alternatives to instutional care, and on ongoing data
collection and analysis.
Assuring Independence and Dignity
and
Institutional Responsiveness
The discussion of the above two goals is being combined in this
Introduction in order to point up an Administration strategy which will
be of major significance to both today's and tomorrow's older persons.
This strategy calls for the coordination of programs involving the ex-
penditures of hundreds of millions of Federal dollars in the field of
aging.
The President in his special message on Aging stated that he was
directing those agencies whose programs have a major impact on the lives
of older persons to provide the Cabinet-level Committee on Aging with an
identification of the amounts they plan to spend during the current fiscal
year to meet the needs of the elderly. This has been done. The results
are set forth in Table I on page 103 of this report. Here are the high-
lights:
-- $55.846 billions of the Federal Government's total
expenditures will be in the field of aging (older
persons 65 and over)
-- $45.604 billions of the expenditures in aging will take
place as a result of trust fund financing
-- $10.242 billions of the expenditures in aging will take
place as a result of general revenue financing
-- $1.832 billions of expenditures in aging from general
revenues will be made in order to support housing and
service programs for older persons.
These figures do not take into consideration the extent to which
38,000 State and local governmental units may use some of the new Federal
dollars made available to them under General Revenue Sharing to initiate
or strengthen programs in the field of aging. Under the law one of the
eight priority areas for which local governments can use these funds, if
they take affirmative action to do so, is "social services for the poor or
aged."
In the light of the magnitude and wide range of the Federal
resources for the services for older persons, and in accordance with his
-7-
FORD is LIBRARY GERALD
basic strategy, the President has directed that "an intense new effort
to develop coordinated services be undertaken." He wants to make sure
that those large sums are spent in such a manner as to be of maximum
benefit to older persons.
The report identifies and discusses the following actions which
have been taken in order to move toward the goal of assuring older persons
independence and dignity:
-- In conformity with its decision to work with States,
local communities and the private sector in a new
effort to bring into existence comprehensive service
programs for older persons at the community level, the
Administration has taken, among others, the following
actions:
The President has submitted to the Congress
proposals for strengthening and expanding service
delivery programs under the Older Americans Act.
Under the Adult Services provisions of the Social
Security Act the Federal Government, within a
ceiling for each State related to an overall national
ceiling of $2.5 billion, will provide funds to pay
75 per cent of the cost of services that enable older
individuals receiving public assistance to remain in
their homes or return to their residences after
hospitalization.
Under General Revenue Sharing, Federal dollars
may be used by both State and local governments,
if they choose to do so, to support coordinated and
comprehensive service programs for older persons.
The Administration will encourage local communities
to utilize Federal dollars that are now or will be
available in such a manner as to include in compre-
hensive and coordinated programs at the local level
services such as the following: health services
through health maintenance organizations, homemaker-
home health aide services, mental health services,
health and medical planning, personal care following
hospitalization, services for the physically and
mentally handicapped, services in the field of edu-
cation, transportation services, housing services,
nutrition services, operation of senior centers,
home repairs, home visitation, telephone reassurance
services, counseling, training and placement programs
for those interested in employment or in participating
as volunteers in community service activities, legal
services, and information and referral services.
-8-
-- A National Health Service Corps has been established
which, in addition to other responsibilities, can
demonstrate the feasibility of providing health services
to the elderly in many inner city and remote rural areas
lacking professional medical assistance.
-- The Administration has spearheaded a national voluntary
effort to implement programs designed to help older men
and women in 300 communities live dignified lives in the
familiar settings of their own homes.
-- The Department of Housing and Urban Development is funding
demonstration programs to improve tenant services provided
by local communities to residents in public housing in-
cluding the elderly.
-- In light of its conviction that opportunities for employment
and voluntary service in all sectors of society must be made
available to older Americans, the Administration has taken,
among others, the following actions:
-- The President has sent a directive to the heads of all
Federal departments and agencies stating that age shall be
no bar to a Federal job which an individual is otherwise
qualified to perform.
-- In Fiscal Year 1973, money for manpower programs for
older workers was doubled.
-- The President has directed the Department of Labor to
work with public employment service to open job oppor-
tunities, including part-time job opportunities for those
65 and over, both in the public and private sectors.
-- The Administration supports the use of model project funds
by the Administration on Aging, in conjunction with the
Department of Labor, for the development of employment
services for older persons.
-- Volunteer programs for older persons have been markedly
expanded, including a doubling of funds for the Foster
Grandparents program, and a tripling of funds for the
Retired Seniors Volunteer Program. The elderly are also
a central part of the large volunteer group participating
in the Veterans Administration medical programs.
-- In the light of its belief that educational opportunities for
older persons should be included in community level compre-
hensive and coordinated service programs for older persons, the
Administration has taken the following actions:
-9-
-- Guidelines furnished the States under the Older Americans
Act will provide that due consideration be given to
educational services in the planning of service programs.
-- The Administration will support the use of Administration
on Aging model project funds to inaugurate, in conjunction
with the Office of Education, demonstration projects
designed to establish education services for older persons.
-- The Administration will pursue a policy of encouraging States,
local school districts and institutions of higher learning,
where appropriate, to use a larger proportion of Federal
funds allocated to them, including vocational and adult
education funds, to provide older persons with educational
opportunities.
-- The Veterans Administration is actively engaged in
educational programs benefiting elderly veterans.
Consistent with its belief that a high priority should be given
to developing access to transportation for older persons, the
Administration has taken, among others, the following actions:
-- The President has directed that all Federal grants which
provide services for older persons also insure that the
transportation needed to take advantage of these services
is available.
-- The Secretary of Health, Education, and Welfare has directed
that guidelines be developed to assure that transportation
is included in the State plans that will be developed under
the amendments to the Older Americans Act.
-- The Department of Transportation has issued guidelines for
applicants for grants under the Urban Mass Transportation
program which require that the transit plan submitted with
applicants include consideration of the service needs of
older persons.
-- The Administration is ready to give priority consideration
to community requests for helping, to deal with the Trans-
portation problems of older persons through capital grants
from the Urban Mass Transportation Fund.
The Administration supports the use of Administration on
Aging model project funds for the development of methods
and programs, in conjunction with the Department of Trans-
portation, to increase the mobility of older persons.
FORDA is LIBRANT 9FRALD
-10-
-- The President has recommended that funds now in the
Highway Trust Fund be used by States and localities
to expand resources in the mass transportation area--
a step that could result in the provision of greater
mobility for older persons.
-- The Office of Consumer Affairs has taken significant actions
designed to deal with the unique problems of older persons
in the area of consumer protection and education.
-- Consideration will be given to the unique needs of older
persons in formulating a legislative proposal to establish
a legal services corporation.
-- The President has directed the Social Security Adminis-
tration field offices to expand their information and re-
ferral services for older persons.
-- The President has included in his 1974 budget $100 million
to implement the Nutritional Program for the Elderly which
is authorized under the Older Americans Act.
The report identifies and discusses the President's commitment to an
"intense new effort to develop coordinated services" directed toward the goal
of assuring older persons independence and dignity. This commitment will
result, among others, in the following moves:
-- An interagency task force will develop, in response to
the President's directive, plans for coordinating the use
of Federal resources in the field of aging (see Table I on
page 104 of the report).
-- The heads of departments and agencies that have programs in
the field of aging will designate persons to coordinate
their programs for older persons with the understanding
that the persons so designated will report to the Secretary
or agency head on such matters.
Each Federal Regional Council has or will establish a
committee on aging in order to accelerate the development
of comprehensive and coordinated programs for the delivery
of services to older persons at the community level.
-- The Administration on Aging will provide information con-
cerning proposed Federal expenditures in aging to the
States so that it can be utilized in State and local
planning; and States will be provided with the opportunity
of transmitting their views on proposed Federal programs.
-11
-- The Administration is committed to a sharpening up of the
Federal Government's objectives in the area of research in
aging and then, in response to a Presidential directive,
coordinating and focusing Federal resources on the achieve-
ment of these objectives.
-- The Administration will provide a focal point within the
Federal governmental structure to assist those colleges
and universities that have made or will make a commitment
to the field of aging to relate to Federal policies (1)
for providing financial assistance for students in higher
education, (2) for providing central coordination for
programs of research in aging, and (3) for using Federal
dollars to encourage the development of comprehensive and
coordinated service programs for older persons at the
community level.
-- The views of voluntary agencies will be solicited in the
establishment of comprehensive and coordinated systems for
the delivery of social and nutritional services.
-- The Administration on Aging will require state planning
groups on aging to include representatives of minority
groups on their advisory bodies.
The coordination of existing Federal resources in the field of aging
will be pursued with vigor and determination. In view of the large sums of
money that are involved, the impact of such an effort will constitute a truly
significant response to many of the recommendations of the delegates to the
White House Conference on Aging. The President is determined to use the
powers of the Presidency in such a manner as to bring about such a result.
***
It is clear that this report cannot properly be viewed as the end of
the process. The work must--and will go on. It must go on in order, as
the President has urged, "to make ours a time of which can be said, 'the
glory of the present age is that in it men and women can grow old' -- and can
do so with grace and pride and dignity, honored and useful citizens of the
land they did so much to build.
BERALD FORD LIBRARY
UPI031
(AGED)
WASHINGTON (UPI) -- CONGRESS HAS OVERWHELMINGLY APPROVED A
LIBRARY
COMPROMISE BILL TO AID THE ELDERLY AFTER DEMOCRATS WORKED OUT AN
INFORMAL AGREEMENT WITH THE WHITE HOUSE TO REDUCE ITS PRICE TAG.
FORD
THE INFORMAL COMPROMISE WITH THE WHITE HOUSE CALLS FOR A $543.6
MILLION EXPENDITURE OVER THREE YEARS FOR CERTAIN PROGRAMS IN THE
076835
BILL, WHILE MAJOR AID TO THE ELDERLY PROJECTS WOULD ALLOW SO-CALLED
"OPEN END AUTHORIZATIONS, # MEANING NO AUTHORIZATION CEILING WAS SET
AND CONGRESSIONAL APPROPRIATIONS COMMITTEES WOULD DETERMINE THE
ACTUAL MONEY.
THE SENATE APPROVED THE NEW LEGISLUTION ON A VOICE VOTE AND THE
HOUSE PASSED BY A 348 TO 0 COUNT.
THE MEASURE WOULD PROVIDE NUTRITIONAL AID TO THE ELDERLY, SUCH AS
A FREE HOT MEAL EACH DAY, PLUS CONSTRUCTION OF SENIOR CITIZENS'
CENTERS AND TRAINING PROJECTS FOR THE ACTIVE ELDERLY TO WORK WITH
AGED SHUT-INS.
UPI 04-19 09:40 AES
UPI173
(AGED
WASHINGTON (UPI) -- DEMOCRATS SAID WEDNESDAY THEY HAD REACHED AN
INFORMAL AGREEMENT WITH THE WHITE HOUSE ON A PROGRAM OF AID TO THE
ELDERLY WHICH PRESIDENT NIXON VETOED LAST YEAR AND SAID HE WOULD
REJECT AGAIN IF THE PROPOSED SPENDING WAS NOT CUT BACK.
THE SENATE AGREED BY VOICE VOTE TO THE COMPROMISE MEASURE AND ITS
SPONSORS HOPED FOR FINAL HOUSE ACTION BEFORE THAT BODY STARTS ITS
EASTER RECESS FRIDAY.
CONGRESS SENT NIXON A $1.9 BILLION, THREE-YEAR OLDER AMERICANS ACT
FORD
LAST YEAR, WHICH COMPARED WITH HIS BUDGET PROPOSALS TOTALLING $500
MILLIONOVER TWO YEARS. HE VETOED THE MEASURE ON GROUNDS IT WAS
EXCESSIVE AUTHORIZATION.
GERALD
LIBRARY
THE HOUSE REWROTE THE MEASURE THIS YEAR CUTTING IT BACK TO $1.3
BILLION, AND THE SENATE APPROVED ITS OWN BILL OF $1.5 BILLION. THE
INFORMAL COMPROMISE WORKED OUT BY SEN. THOMAS F. EAGLETON, D-MO., AND
REP. JOHN BRADEMAS, D-IND., WITH THE WHITE HOUSE WOULD AUTHORIZE
$543.6 MILLION OVER THREE YEARS FOR CERTAIN PROGRAMS IN THE BILL,
WHILE MAJOR AID TO THE ELDERLY PROJECTS WOULD ALLOW SO-CALLED "OPEN
END AUTHORIZATIONS," MEANING NO AUTHORIZATION CEILING WAS SET AND THE
RESPECTIVE APPROPRIATIONS COMMITTEES WOULD DETERMINE THE ACTUAL
MONEY.
THE ORIGINAL BILL WAS ONE OF THE 14 MEASURES NIXON VETOED LAST
YEAR AND WHICH DEMOCRATS PLEDGED TO REPASS, DARING ANOTHER VETO WHICH
THEY HOPED COULD BE OVERRIDDEN. DEMOCRATS HAVE FAILED TO OVERRIDE TWO
SUCH NEW VETOES OF OTHER BILLS so FAR THIS YEAR BUT THEY HAD SAID ALL
ALONG THE OLDER AMERICANS ACT OFFERED THE BEST CHANCE OF OVERRIDE.
PROGRAMS IN THE MEASURE PROVIDE NUTRITIONAL AID TO THE ELEDERLY,
SUCH AS A FREE HOT MEAL A DAY, PLUS CONSTRUCTION OF SENIOR CITIZENS
CENTERS AND TRAINING PROJECTS FOR THE ACTIVE ELDERLY TO WORK WITH
AGED SHUTINS.
UPI 04-18 07807 PES
any of those colleagues.
There was no official an-
nouncement from the Justice
By R. W. APPLE Jr.
Department about Mr. Klein-
sources - Reforms
Special to The New York Times
dienst's decision nor about
Structure Urged
WASHINGTON, April 18 - President Nixon's striking
further indictments. But there
statement about the Watergate case yesterday was in keep-
was wide-ranging speculation
ing with his reliance on bold action in the face of crisis.
in the Capitol about who and
URRAY SCHUMACH
By taking the counteroffensive,
how many persons would be
ork City must be re-
his associates in the White
1 structurally and
House believe, he hopes to
COMPROMISE BILL
accused. Among those figuring
prominently in the speculation
lly, must cut costs
show that he sinned not but
were thhe following:
nd must withdraw en-
was sinned against, to portray
John N. Mitchell, the for-
n some programs be-
himself as the prosecutor and
WILL AID ELDERLY
mer Attorney General who was
10 longer has the re-
not the protector of those to be
Mr. Kleindienst's superior in
meet its demands,
prosecuted. It is,
the Justice Department for
Commission recom-
in effect, a pre-
three years
News
sterday in its report.
emptive strategy.
Congress Passes Measure
JJohn W. Dean 3d, the White
isay administration
Analysis
Get the possible
culprits before the
After Accord With White
House counsel who served
strong attack in the
under Mr. Mitchell and Mr.
grand jury and let
House Ends Veto Threat
Kleindienst in the Justice De-
Scott Commission
the courts work their will; set-
partment in 1969 and 1970.
ns is on Page 62.
tle the civil suits out of court;
qMaurice H. Stans, the for-
above all, demolish the subsidi-
By MARJORIE HUNTER
mer Commerce Department
L, accompanied by
ary issue that had become
Special to New York Times
Secretary who served as a chief
study, for pro-
paramount in recent days: "The
WASHINGTON April 18
fund raiser for Mr. Nixon in
pread disenchant-
White House cover-up." Having
After months of being at log-
the 1972 campaign.
inrealistic "politi-
done all that, SO the thinking
gerheads over spending issues,
CJeb Stuart Magruder, for-
and budgetary
goes, there is little to worry
Congress and the White House
mer deputy director of the
The state-author-
about from the Senate's investi-
reached agreement today on
Committee for the Re-election
issued its re-
gation, which certainly threat-
major legislation that President
FORD
of the President and now a
than a year of
ened to do more damage politi-
Nixon had earlier threatened
Commerce Department official.
terim studies.
cally than any other conceivable
to veto.
Gordon C. Strachan, a for-
terms," the re-
proceeding.
As approved by both houses
mer White House staff aide
city can no
But why did Mr. Nixon sud-
of Congress and sent to the
who is now general counsel of
GERALD
1 the resources
denly decide that the moment
White House, the compromise
the United States Information
form the stag-
of crisis, the moment for ri-
would extend for three years
Agency.
income redis-
poste, had finally arrived?
a series of programs to aid the
vice provision
One thing is clear. He would
nation's elderly, but at sharply
Mitchell Lauds Decision
committed it-
never have arrived at the point
reduced levels.
Mr. Mitchell said in a tele-
lers have not
represented by his two an-
President Nixon had vetoed
phone interview tonight that
er their atti-
nouncements yesterday without
similar legislation last fall and
he did not believe "any inter-
bending deci-
the relentless pursuit of the
had said that he would veto
ences should be drawn one way
bugging episode by the press,
a revised version passed over-
or the other" from Mr. Klein-
62, Column 3
by Senator Sam J. Ervin Jr. of
whelmingly this spring by both
dienst's decision.
North Carolina, chairman of the
the Senate and the House.
He called that decision an
investigating committee, and by
Stalemate Delayed Law-Making
"entirely appropriate and cor-
Bank
Federal Judge John J. Sirica,
The compromise marked the
rect decision for Dick to have
who presided over the trial of
first break in a pattern that
taken" because of the Attorney
the Watergate conspirators.
had Congress passing bills, the
General's "past associations"
The President and most of
President vetoing them and
with a number of the people
his advisers, as well as large
Congress subsequently agree-
who have figured prominently
numbers of people outside the
ing to sustain the President's
in the Watergate speculation.
White House, thought the issue
vetos.
Mr. Mitchell said that what
had been buried in Mr. Nixon's
Because of this stalemate be-
Mr. Kleindienst had done was
landslide victory of last No-
tween the White House and the
"common practice" in private
vember. The issue had not taken
Congress, virtually no new leg-
law as well as in the Justice De-
hold during the electoral cam-
islation has become law SO far
partment. He said that if Mr.
paign, most political analysts
this year.
Kleindienst stayed with the
now agree, because the elec-
The compromise on the bill
investigation, "no matter what
Continued on Page 34, Column 2
he did he would be accused
Continued on Page 30, Column 3
of playing politics because he
knew so many of the people
Levy, Antiwar Army Physician,
who have been mentioned in
this thing."
Wins a Reversal of Conviction
However, Mr. Mitchell in-
sisted, it would be a "serious
mistake" to read into Mr.
By WAYNE KING
Kleindienst's decision the "im-
Special to The New York Times
plication" that those who have
PHILADELPHIA, April 18- year sentence imposed by the
appeared before the Watergate
The United States Court of Ap-
court-martial at Fort Jackson,
grand jury - including Mr.
peals for the Third Circuit de-
S.C.
Mitchell himself - would be
clared today that two key pro-
In its rulings, a three-judge
prosecuted.
visions of the Uniform Code of
panel here declared Mr. Levy's
Mr. Mitchell, who was re-
Military Justice that led to the
conviction on five counts of vio-
ported to have conferred with
court-martial conviction of an
lation of the military code in-
President Nixon sometime last
anti-war Army doctor, Capt.
valid because of unconstitution-
weekend, sounded confident
Howard B. Levy, six years ago
ality.
and relaxed during the conver-
were so vague as to be uncon-
Four of the counts were
sation. He refused to discuss
stitutional.
brought under two articles of
any of the other former or
The court also ruled that the
the Uniform Code of Military
present Administration offi-
conviction of Captain Levy on
Justice dealing with conduct un-
cials who have been con-
a charge of disobeying an order
becoming an officer. The fifth
violated Constitutional guaran-
charge was based on an article
Continued on Page 34, Column 3
tees of due process, and it ord-
on willfully disobeying an order.
ored a new trial within 90 days
In reversing the
on that charge.
Dr. Levy has
MEMO TO MR. FORD FROM MR. MILTICH
Elderly aging
FORD
GERALD
You may recall that Mr. Van Renssalaer of the National Committee sent us a
questionaire re: senior citizens and election campaigns and that we scored
zero on senior citizen political activity in the Fifth District. On Friday
I talked at length with Mr. Van Renssalaer. He suggested that we should do
the following: (and I would assume that Gordie Vender Till would be the one
to
do this):
1. Get up a list of senior citizens centers in the District. These are funded
in part by the Federal Government and are becoming centers for political discussion.
Each center is administered by two or three professionals, usually Democrats.
But each center has an organization made up of the senior citizens themselves.
2. Find out who the organization leaders are in each center.
3. Make contact with the American Association of Retired Persons, the National
Retired Teachers Association, and the National Association of Retired Federal
Employes. Find out where they are located and whether they have chapters in the
District. Van Renssaleer claims these groups are "predominantly conservative
and Republican. " Find out who the state president is. "You went him on your
side. " Also the officers of each chapter in the district.
4. Make friends with these individuals (those mentioned above).
5. Find out what the problems of the senior citizens are.
6. The COP has to identify and seek to solve older Americans' problems and to
involve older citizens in the life of the community.
7. Write aletter to all of the senior citizen leaders. Tell them you went to
got to know them, get to
know heir problems.
8. Set up a meeting with the senior citizen leaders. Talk with them. Van
Renssalaer says, "You'll get an education. They 'll say the President is
against them. You'll have to tell them, "You're wrong. I've talked this over
with the President. We can't handle these problems on a patchwork basis. We've
got to have a program form the aging, and we're working on it."
9. When you have the meeting, inviter in the TV
stations and try to get the
paper to send out a photographer. Get yourself identified as a friend of the
old folks.
10. After making friends with senior citizen leaders, ask one of them to act as
the Senior Citizens Chairman in the District--as a Ford-for-Congress Volunteer.
But pay his carfare and incidental expenses, says Van Renssalaer.
11. Take the Van Renssalaer Questionnaire and follow through
on
all steps
you feel will be useful for the 1972 campaign. The base has to be your contacts
with the semior citizens. It might be good to get the names of senior citizens
groups at churches as well as the others.
18. Have your Senior Citizens District Chairman form a Senior Citizens For
Ford Committee. Build up a mailing list of Senior Citizen Volunteers and involve
them in your campaign. Get them interested in Ford. -hey'll be interested in
you if you are interested in them.
(MORE)
-2-
ADDEN.COM:
FORD is LIBRARY GERALD
Van Renssalaer says that Nixon's ima with older Americans is "bad." He says
everybody knows Congre: SS is going to pass a 10 per cent Social Security benefits
increase and yet Nixon has recommended a 6 per cent increase. This, Van
Renssalaer says, makes senior citizens think the President will veto a 10 per cent
increase. The President, he says (and I certainly agree), should come out for a
10 per cent SS. increase since that's what it's going to be anyway. Van R. also
says that the Budget Bureau has emasculated the Administration on Aging. He says
the Democ rats will restore the cuts and then make political hay out of the situation.
Van R. says the President should also remedy this. He continuens:
"We're
working against a deadline. The Senate Special Committee on Aging is going to hold
hearings starting March 25 under Frank Church and they are going to spotlight the
downgrading of the Admini stration on Aging and the President's 6 per cent Social
Security recommendation. The President should say and do somethi between now
and then and give his Administration S entire approach to the problems of the aging
a new direction."
Van R. claims that 70 per cent of the senior citizens actually get to the polis
and vote. "e says there are 20 million people over 65 in this country and another
9 million between 60 and 65 getting ready toretire. If the President doe sn t get
a majority of this vote, says Van R., he can't win in 1972 in a close election.
######